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Luo Y, Jiang H, Meng N, Huang Z, Li Z, Feng P, Fang T, Fu F, Yuan J, Wang Z, Yang Y, Wang M. A comparison study of monoexponential and fractional order calculus diffusion models and 18F-FDG PET in differentiating benign and malignant solitary pulmonary lesions and their pathological types. Front Oncol 2022; 12:907860. [PMID: 35936757 PMCID: PMC9351313 DOI: 10.3389/fonc.2022.907860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/28/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To evaluate the application value of monoexponential, fractional order calculus (FROC) diffusion models and PET imaging to distinguish between benign and malignant solitary pulmonary lesions (SPLs) and malignant SPLs with different pathological types and explore the correlation between each parameter and Ki67 expression. Methods A total of 112 patients were enrolled in this study. Prior to treatment, all patients underwent a dedicated thoracic 18F-FDG PET/MR examination. Five parameters [including apparent diffusion coefficient (ADC) derived from the monoexponential model; diffusion coefficient (D), a microstructural quantity (μ), and fractional order parameter (β) derived from the FROC model and maximum standardized uptake value (SUVmax) derived from PET] were compared between benign and malignant SPLs and different pathological types of malignant SPLs. Independent sample t test, Mann-Whitney U test, DeLong test and receiver operating characteristic (ROC) curve analysis were used for statistical evaluation. Pearson correlation analysis was used to calculate the correlations between Ki-67 and ADC, D, μ, β, and SUVmax. Results The ADC and D values were significantly higher and the μ and SUVmax values were significantly lower in the benign group [1.57 (1.37, 2.05) μm2/ms, 1.59 (1.52, 1.72) μm2/ms, 5.06 (3.76, 5.66) μm, 5.15 ± 2.60] than in the malignant group [1.32 (1.03, 1.51) μm2/ms, 1.43 (1.29, 1.52) μm2/ms, 7.06 (5.87, 9.45) μm, 9.85 ± 4.95]. The ADC, D and β values were significantly lower and the μ and SUVmax values were significantly higher in the squamous cell carcinoma (SCC) group [1.29 (0.66, 1.42) μm2/ms, 1.32 (1.02, 1.42) μm2/ms, 0.63 ± 0.10, 9.40 (7.76, 15.38) μm, 11.70 ± 5.98] than in the adenocarcinoma (AC) group [1.40 (1.28, 1.67) μm2/ms, 1.52 (1.44, 1.64) μm2/ms, 0.70 ± 0.10, 5.99 (4.54, 6.87) μm, 8.76 ± 4.18]. ROC curve analysis showed that for a single parameter, μ exhibited the best AUC value in discriminating between benign and malignant SPLs groups and AC and SCC groups (AUC = 0.824 and 0.911, respectively). Importantly, the combination of monoexponential, FROC models and PET imaging can further improve diagnostic performance (AUC = 0.872 and 0.922, respectively). The Pearson correlation analysis showed that Ki67 was positively correlated with μ value and negatively correlated with ADC and D values (r = 0.402, -0.346, -0.450, respectively). Conclusion The parameters D and μ derived from the FROC model were superior to ADC and SUVmax in distinguishing benign from malignant SPLs and adenocarcinoma from squamous cell carcinoma, in addition, the combination of multiple parameters can further improve diagnostic performance. The non-Gaussian FROC diffusion model is expected to become a noninvasive quantitative imaging technique for identifying SPLs.
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Affiliation(s)
- Yu Luo
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Han Jiang
- Department of Medical Imaging, Xinxiang Medical University & Henan Provincial People’s Hospital, Xinxiang, Henan, China
| | - Nan Meng
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Zhun Huang
- Department of Medical Imaging, Henan University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
| | - Ziqiang Li
- Department of Medical Imaging, Xinxiang Medical University & Henan Provincial People’s Hospital, Xinxiang, Henan, China
| | - Pengyang Feng
- Department of Medical Imaging, Henan University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
| | - Ting Fang
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Fangfang Fu
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
| | - Jianmin Yuan
- Central Research Institute, United Imaging Healthcare Group, Shanghai, China
| | - Zhe Wang
- Central Research Institute, United Imaging Healthcare Group, Shanghai, China
| | - Yang Yang
- Beijing United Imaging Research Institute of Intelligent Imaging, Beijing, China
| | - Meiyun Wang
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
- *Correspondence: Meiyun Wang,
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Zhang L, Ren Z, Xu C, Li Q, Chen J. Influencing Factors and Prognostic Value of 18F-FDG PET/CT Metabolic and Volumetric Parameters in Non-Small Cell Lung Cancer. Int J Gen Med 2021; 14:3699-3706. [PMID: 34321915 PMCID: PMC8312333 DOI: 10.2147/ijgm.s320744] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 06/28/2021] [Indexed: 12/13/2022] Open
Abstract
Objective This study aims to explore factors influencing metabolic and volumetric parameters of [18F]fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) imaging in non-small cell lung cancer (NSCLC) and the predictive value for prognosis of NSCLC. Methods Retrospective analysis was performed on 133 NSCLC patients who received 18F-FDG PET/CT imaging. After 18F-FDG injection at 3.7 MBq/kg, 1 h early imaging and 2 h delayed imaging were performed. The metabolic and volumetric parameters such as SUVmax, SUVpeak, SULmax, SULpeak, MTV and TLG were measured. The tumor markers including CFYRA21-1, NSE, SCC-ag and the immunohistochemical biomarkers including Ki-67, P53 and CK-7 were examined. All patients were followed up for 24 months, and the 1-year and 2-year overall survival rate (OS) were recorded. Results There were significant differences in metabolic and volumetric parameters (SUVmax, SUVpeak, SULmax, SULpeak and TLG) between adenocarcinoma and squamous cell carcinoma of NSCLC. SUVmax, SUVpeak, SULmax, SULpeak, MTV and TLG were correlated with tumor marker NSE and TNM stage. MTV and TLG were related to CYFRA21-1, and only MTV was associated with SCC-ag. SUVpeak and SULmax were related to P53. In addition, early SULpeak and delayed MTV were significant prognostic factors of 1-year OS, while early SUVpeak, delayed TLG and delayed MTV were predictive factors of 2-year OS in NSCLC. Conclusion The metabolic and volumetric parameters of 18F-FDG PET/CT were related to a variety of factors such as NSE, CFYRA21-1, SCC-ag, P53 and TNM stage, and have a predictive value in prognosis of NSCLC.
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Affiliation(s)
- Lixia Zhang
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310006, People's Republic of China
| | - Zhe Ren
- Department of Chest Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310006, People's Republic of China
| | - Caiyun Xu
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310006, People's Republic of China
| | - Qiushuang Li
- Department of Clinical Evaluation Centers, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310006, People's Republic of China
| | - Jinyan Chen
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310006, People's Republic of China
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Kokane AM, Joshi R, Kotnis A, Chatterjee A, Yadav K, Revadi G, Joshi A, Pakhare AP. Descriptive profile of risk factors for cardiovascular diseases using WHO STEP wise approach in Madhya Pradesh. PeerJ 2020; 8:e9568. [PMID: 32844055 PMCID: PMC7415222 DOI: 10.7717/peerj.9568] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/28/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Periodic information on risk factor distribution is critical for public health response for reduction in non-communicable disease (NCDs). For this purpose, the WHO has developed STEPs wise approach. State representative population-based STEPS survey was last conducted in 2007-08 in seven states of In India. Since then no such work has been reported from low ETL states. This survey was carried out to assess the prevalence of risk factors associated with NCDs and the prevalence of NCDs in the low ETL state of Madhya Pradesh using the WHO STEPs approach. METHODS A total of 5680 persons aged 18-69 years were selected from the state of Madhya Pradesh using multi-stage cluster random sampling. Using the WHO STEPs approach, details were collected on demographics, STEP 1 variables (tobacco consumption, alcohol consumption, physical activity, diet), STEP 2 variables (weight, height, waist circumference, blood pressure) and STEP 3 variables (fasting blood glucose, blood cholesterol). RESULTS We found that 9.4% individuals smoked tobacco, 15.3% were overweight/obese, 22.3% had hypertension, and 6.8% have diabetes mellitus. As compared to women, men were less likely to be overweight or obese, but more likely to smoke tobacco, and have diabetes mellitus. Hypertension was also more common in men. Overall, about a fourth of all adults had three or more risk factors for cardiovascular disease. CONCLUSION The survey shows that a large section of the population from Madhya Pradesh is either suffering from NCDs or have risk factors which predispose them to acquire NCDs. This state representative survey provides benchmarking information for behavioural and biological risk factor distribution for recently scaled up National Programme for the Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS).
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Affiliation(s)
- Arun M. Kokane
- Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh, India
| | - Rajnish Joshi
- General Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh, India
| | - Ashwin Kotnis
- Biochemistry, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh, India
| | - Anirban Chatterjee
- Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh, India
| | - Kriti Yadav
- Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh, India
| | - G Revadi
- Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh, India
| | - Ankur Joshi
- Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh, India
| | - Abhijit P. Pakhare
- Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh, India
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Kahn J, Kocher MR, Waltz J, Ravenel JG. Advances in Lung Cancer Imaging. Semin Roentgenol 2020; 55:70-78. [PMID: 31964483 DOI: 10.1053/j.ro.2019.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jacob Kahn
- Department of Radiology and Radiological Sciences, Medical University of South Carolina, Charleston, SC
| | - Madison R Kocher
- Department of Radiology and Radiological Sciences, Medical University of South Carolina, Charleston, SC
| | - Jeffrey Waltz
- Department of Radiology and Radiological Sciences, Medical University of South Carolina, Charleston, SC
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Tang X, Xu X, Han Z, Bai G, Wang H, Liu Y, Du P, Liang Z, Zhang J, Lu H, Yin H. Elaboration of a multimodal MRI-based radiomics signature for the preoperative prediction of the histological subtype in patients with non-small-cell lung cancer. Biomed Eng Online 2020; 19:5. [PMID: 31964407 PMCID: PMC6975040 DOI: 10.1186/s12938-019-0744-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 12/27/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Non-invasive discrimination between lung squamous cell carcinoma (LUSC) and lung adenocarcinoma (LUAD) subtypes of non-small-cell lung cancer (NSCLC) could be very beneficial to the patients unfit for the invasive diagnostic procedures. The aim of this study was to investigate the feasibility of utilizing the multimodal magnetic resonance imaging (MRI) radiomics and clinical features in classifying NSCLC. This retrospective study involved 148 eligible patients with postoperative pathologically confirmed NSCLC. The study was conducted in three steps: (1) feature extraction was performed using the online freely available package with the multimodal MRI data; (2) feature selection was performed using the Student's t test and support vector machine (SVM)-based recursive feature elimination method with the training cohort (n = 100), and the performance of these selected features was evaluated using both the training and the validation cohorts (n = 48) with a non-linear SVM classifier; (3) a Radscore model was then generated using logistic regression algorithm; (4) Integrating the Radscore with the semantic clinical features, a radiomics-clinical nomogram was developed, and its overall performance was evaluated with both cohorts. RESULTS Thirteen optimal features achieved favorable discrimination performance with both cohorts, with area under the curve (AUC) of 0.819 and 0.824, respectively. The radiomics-clinical nomogram integrating the Radscore with the independent clinical predictors exhibited more favorable discriminative power, with AUC improved to 0.901 and 0.872 in both cohorts, respectively. The Hosmer-Lemeshow test and decision curve analysis results furtherly showed good predictive precision and clinical usefulness of the nomogram. CONCLUSION Non-invasive histological subtype stratification of NSCLC can be done favorably using multimodal MRI radiomics features. Integrating the radiomics features with the clinical features could further improve the performance of the histological subtype stratification in patients with NSCLC.
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Affiliation(s)
- Xing Tang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Xiaopan Xu
- School of Biomedical Engineering, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Zhiping Han
- Department of Respiratory Medicine, Xijing Hospital, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Guoyan Bai
- Department of Clinical Laboratory, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, People's Republic of China
| | - Hong Wang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Yang Liu
- School of Biomedical Engineering, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Peng Du
- School of Biomedical Engineering, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Zhengrong Liang
- Departments of Radiology, School of Computer Science and Biomedical Engineering, State University of New York, Stony Brook, NY, USA
| | - Jian Zhang
- Department of Respiratory Medicine, Xijing Hospital, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China.
| | - Hongbing Lu
- School of Biomedical Engineering, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China.
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China.
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Feng ZY, Min XD, Wang L, Li BS, Ke Z, Zhang PP, Kang Z. MRI feature analysis of uncommon prostatic malignant tumors. Asian J Androl 2019; 20:313-315. [PMID: 28566559 PMCID: PMC5952491 DOI: 10.4103/aja.aja_12_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Zhao-Yan Feng
- The Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiang-De Min
- The Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Liang Wang
- The Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ba-Sen Li
- The Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zan Ke
- The Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Pei-Pei Zhang
- The Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhen Kang
- The Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Standardized Uptake Values Derived from 18F-FDG PET May Predict Lung Cancer Microvessel Density and Expression of KI 67, VEGF, and HIF-1 α but Not Expression of Cyclin D1, PCNA, EGFR, PD L1, and p53. CONTRAST MEDIA & MOLECULAR IMAGING 2018; 2018:9257929. [PMID: 29983647 PMCID: PMC6011144 DOI: 10.1155/2018/9257929] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 04/26/2018] [Indexed: 12/19/2022]
Abstract
Background Our purpose was to provide data regarding relationships between 18F-FDG PET and histopathological parameters in lung cancer. Methods MEDLINE library was screened for associations between PET parameters and histopathological features in lung cancer up to December 2017. Only papers containing correlation coefficients between PET parameters and histopathological findings were acquired for the analysis. Overall, 40 publications were identified. Results Associations between SUV and KI 67 were reported in 23 studies (1362 patients). The pooled correlation coefficient was 0.44. In 2 studies (180 patients), relationships between SUV and expression of cyclin D1 were analyzed (pooled correlation coefficient = 0.05). Correlation between SUV and HIF-1α was investigated in 3 studies (288 patients), and the pooled correlation coefficient was 0.42. In 5 studies (310 patients), associations between SUV and MVD were investigated (pooled correlation coefficient = 0.54). In 6 studies (305 patients), relationships between SUV and p53 were analyzed (pooled correlation coefficient = 0.30). In 6 studies (415 patients), associations between SUV and VEGF expression were investigated (pooled correlation coefficient = 0.44). In 5 studies (202 patients), associations between SUV and PCNA were investigated (pooled correlation coefficient = 0.32). In 3 studies (718 patients), associations between SUV and expression of PD L1 were analyzed (pooled correlation coefficient = 0.36). Finally, in 5 studies (409 patients), associations between SUV and EGFR were investigated (pooled correlation coefficient = 0.38). Conclusion SUV may predict microvessel density and expression of VEGF, KI 67, and HIF-1α in lung cancer.
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Surov A, Meyer HJ, Schob S, Höhn AK, Bremicker K, Exner M, Stumpp P, Purz S. Parameters of simultaneous 18F-FDG-PET/MRI predict tumor stage and several histopathological features in uterine cervical cancer. Oncotarget 2018; 8:28285-28296. [PMID: 28423698 PMCID: PMC5438650 DOI: 10.18632/oncotarget.16043] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 02/27/2017] [Indexed: 12/25/2022] Open
Abstract
The purpose of this study was to analyze associations between apparent diffusion coefficient (ADC) and standardized uptake values (SUV) values and different histopathological parameters in uterine cervical cancer. 21 patients with primary uterine cervical cancer were involved into the study. All patients underwent a whole body simultaneous18F-FDG PET/MRI. Mean and maximum SUV were noted (SUVmean and SUVmax). In all tumors minimal, mean, and maximal ADC values (ADCmin, ADCmean, and ADCmax) were estimated. Combined parameters were calculated: SUVmax/SUVmean, ADCmin/ ADCmean, SUVmax/ADCmin and SUVmax/ADCmean. In all cases the diagnosis was confirmed histopathologically by tumor biopsy. Histological slices were stained by hematoxilin and eosin, MIB 1 monoclonal antibody, and p16. All histopathological images were digitalized and analyzed by using a ImageJ software 1.48v. The following parameters were estimated: cell count, proliferation index KI 67, total and average nucleic areas, epithelial and stromal areas. Spearman's correlation coefficient was used to analyze associations between ADC and SUV values and histological parameters. P values ≤ 0.05 were considered as statistically significant. ADCmin and ADCmin/ ADCmean were statistically significant lower in N positive tumors. KI 67 correlated statistically significant with SUVmax (r = 0.59, p = 0.005), SUVmean (0.45, p = 0.04), ADCmin (r = −0.48, p = 0.03), SUVmax/ADCmin (r = 0.71, p = 0.001), SUVmax/ADCmean (0.75, p = 0.001). SUVmax correlated well with epithelial area (r = 0.71, p = 0.001) and stromal areas (r = −0.71, p = 0.001). SUV values, ADCmin, SUVmax/ADCmin and SUVmax/ADCmean correlated statistically significant with KI 67 and can be used to estimate the proliferation potential of tumors. SUV values correlated strong with epithelial area of tumor reflected metabolic active areas.
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Affiliation(s)
- Alexey Surov
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, 04103 Leipzig, Germany
| | - Hans Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, 04103 Leipzig, Germany
| | - Stefan Schob
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, 04103 Leipzig, Germany
| | - Anne-Kathrin Höhn
- Department of Pathology University Hospital of Leipzig, 04103 Leipzig, Germany
| | - Kristina Bremicker
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, 04103 Leipzig, Germany
| | - Marc Exner
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, 04103 Leipzig, Germany
| | - Patrick Stumpp
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, 04103 Leipzig, Germany
| | - Sandra Purz
- Department of Nuclear Medicine, University Hospital of Leipzig, 04103 Leipzig, Germany
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Shen G, Ma H, Pang F, Ren P, Kuang A. Correlations of 18F-FDG and 18F-FLT uptake on PET with Ki-67 expression in patients with lung cancer: a meta-analysis. Acta Radiol 2018; 59:188-195. [PMID: 28475024 DOI: 10.1177/0284185117706609] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Positron emission tomography (PET) imaging using the radiotracers 18F-fluorodeoxyglucose (FDG) or 18F-fluorothymidine (FLT) has been proposed as imaging biomarkers of cell proliferation. Purpose To explore the correlations of FDG and FLT uptake with the Ki-67 labeling index in patients with lung cancer. Material and Methods Major databases were systematically searched for all relevant literature published in English. The correlation coefficient (rho) and its 95% confidence interval (CI) of individual studies were meta-analyzed using a random-effects model. The sources of heterogeneity were explored by subgroup analyses. Results Twenty-seven articles involving 1213 patients were included in this meta-analysis, comprising 22 studies for FDG uptake/Ki-67 expression correlation and eight for FLT uptake/Ki-67 expression correlation. The pooled rho values for 18F-FDG/Ki-67 correlation and 18F-FLT/Ki-67 correlation were 0.45 (95% CI, 0.41-0.50) and 0.65 (95% CI, 0.56-0.73), respectively, which indicated a moderate correlation for the former and a significant one for the latter. Although the subgroup analyses based on study design, scanner, sample method, and Ki-67 labeling method did not significantly explain the heterogeneity, these factors were potential sources of heterogeneity. In lung cancer, the pooled SUVmax of FDG uptake was significantly higher than that of FLT uptake (7.59 versus 3.86, P < 0.05). In addition, compared to FDG, FLT showed higher specificity yet lower sensitivity for the diagnosis of pulmonary lesions. Conclusion Both 18F-FDG and 18F-FLT correlate significantly with the Ki-67 labeling index in pulmonary lesions, and the latter, with a stronger correlation, may be more reliable for assessing tumor cell proliferation in lung cancer.
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Affiliation(s)
- Guohua Shen
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, PR China
| | - Huan Ma
- Key Laboratory of Radiation Physics and Technology, Ministry of Education, Institute of Nuclear Science and Technology, Sichuan University, Chengdu, PR China
| | - Fuwen Pang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, PR China
| | - Pengwei Ren
- Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Anren Kuang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, PR China
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Jiang R, Dong X, Zhu W, Duan Q, Xue Y, Shen Y, Zhang G. Combining PET/CT with serum tumor markers to improve the evaluation of histological type of suspicious lung cancers. PLoS One 2017; 12:e0184338. [PMID: 28877268 PMCID: PMC5587306 DOI: 10.1371/journal.pone.0184338] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 08/22/2017] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Histological type is important for determining the management of patients with suspicious lung cancers. In this study, PET/CT combined with serum tumor markers were used to evaluate the histological type of lung lesions. MATERIALS AND METHODS Patients with suspicious lung cancers underwent 18F-FDG PET/CT and serum tumor markers detection. SUVmax of the tumor and serum levels of tumor markers were acquired. Differences in SUVmax and serum levels of tumor markers among different histological types of lung cancers and between EGFR mutation statues of adenocarcinoma were compared. The diagnostic efficiencies of SUVmax alone, each serum tumor marker alone, combined tumor markers and the combination of both methods were further assessed and compared. RESULTS SCC had the highest level of SUVmax, followed by SCLC and adenocarcinoma, and benign lesions had a lowest level. CYFRA21-1 and SCC-Ag were significantly higher in SCC, NSE was significantly higher in SCLC (P<0.001), and CEA was higher in adenocarcinoma (P = 0.343). The diagnostic efficiencies in evaluating histological types of suspicious lung cancers were insufficient when using each serum tumor marker or SUVmax alone. When combined, the AUC, sensitivity and specificity increased significantly (P<0.05 for all). Additionally, to adenocarcinoma, no significant difference was found between EGFR mutation statuses in SUVmax or serum tumor markers (P>0.05 for all). CONCLUSIONS SUVmax and serum tumor markers show values in evaluating the histological types of suspicious lung cancers. When properly combined, the diagnostic efficiency can increase significantly.
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Affiliation(s)
- Rifeng Jiang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ximin Dong
- Central Sterile Supply Department, Fujian Medical University Union Hospital, Fuzhou, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qing Duan
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yunjing Xue
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yanxia Shen
- Department of Nuclear medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- * E-mail: (GPZ); (YXS)
| | - Guopeng Zhang
- Department of Nuclear medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- * E-mail: (GPZ); (YXS)
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Surov A, Meyer HJ, Wienke A. Associations between apparent diffusion coefficient (ADC) and KI 67 in different tumors: a meta-analysis. Part 1: ADC mean. Oncotarget 2017; 8:75434-75444. [PMID: 29088879 PMCID: PMC5650434 DOI: 10.18632/oncotarget.20406] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 08/15/2017] [Indexed: 02/07/2023] Open
Abstract
Diffusion weighted imaging (DWI) is a magnetic resonance imaging (MRI) technique based on measure of water diffusion in tissues. This diffusion can be quantified by apparent diffusion coefficient (ADC). Some reports indicated that ADC can reflect tumor proliferation potential. The purpose of this meta-analysis was to provide evident data regarding associations between ADC and KI 67 in different tumors. Studies investigating the relationship between ADC and KI 67 in different tumors were identified. MEDLINE library was screened for associations between ADC and KI 67 in different tumors up to April 2017. Overall, 42 studies with 2026 patients were identified. The following data were extracted from the literature: authors, year of publication, number of patients, tumor type, and correlation coefficients. Associations between ADC and KI 67 were analyzed by Spearman's correlation coefficient. The reported Pearson correlation coefficients in some studies were converted into Spearman correlation coefficients. The pooled correlation coefficient between ADCmean and KI 67 for all included tumors was ρ = -0.44. Furthermore, correlation coefficient for every tumor entity was calculated. The calculated correlation coefficients were as follows: ovarian cancer: ρ = -0.62, urothelial carcinomas: ρ = -0.56, cerebral lymphoma: ρ = -0.55, neuroendocrine tumors: ρ = -0.52, glioma: ρ = -0.51, lung cancer: ρ = -0.50, prostatic cancer: ρ = -0.43, rectal cancer: ρ = -0.42, pituitary adenoma:ρ = -0.44, meningioma, ρ = -0.43, hepatocellular carcinoma: ρ = -0.37, breast cancer: ρ = -0.22.
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Affiliation(s)
- Alexey Surov
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Hans Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin Luther University of Halle-Wittenberg, Halle, Germany
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Meta-Analysis of the Correlation between Apparent Diffusion Coefficient and Standardized Uptake Value in Malignant Disease. CONTRAST MEDIA & MOLECULAR IMAGING 2017; 2017:4729547. [PMID: 29097924 PMCID: PMC5612674 DOI: 10.1155/2017/4729547] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 01/15/2017] [Indexed: 12/19/2022]
Abstract
The objective of this meta-analysis is to explore the correlation between the apparent diffusion coefficient (ADC) on diffusion-weighted MR and the standard uptake value (SUV) of 18F-FDG on PET/CT in patients with cancer. Databases such as PubMed (MEDLINE included), EMBASE, and Cochrane Database of Systematic Review were searched for relevant original articles that explored the correlation between SUV and ADC in English. After applying Fisher's r-to-z transformation, correlation coefficient (r) values were extracted from each study and 95% confidence intervals (CIs) were calculated. Sensitivity and subgroup analyses based on tumor type were performed to investigate the potential heterogeneity. Forty-nine studies were eligible for the meta-analysis, comprising 1927 patients. Pooled r for all studies was −0.35 (95% CI: −0.42–0.28) and exhibited a notable heterogeneity (I2 = 78.4%; P < 0.01). In terms of the cancer type subgroup analysis, combined correlation coefficients of ADC/SUV range from −0.12 (lymphoma, n = 5) to −0.59 (pancreatic cancer, n = 2). We concluded that there is an average negative correlation between ADC and SUV in patients with cancer. Higher correlations were found in the brain tumor, cervix carcinoma, and pancreas cancer. However, a larger, prospective study is warranted to validate these findings in different cancer types.
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Tsuchiya N, Doai M, Usuda K, Uramoto H, Tonami H. Non-small cell lung cancer: Whole-lesion histogram analysis of the apparent diffusion coefficient for assessment of tumor grade, lymphovascular invasion and pleural invasion. PLoS One 2017; 12:e0172433. [PMID: 28207858 PMCID: PMC5313135 DOI: 10.1371/journal.pone.0172433] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 02/04/2017] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Investigating the diagnostic accuracy of histogram analyses of apparent diffusion coefficient (ADC) values for determining non-small cell lung cancer (NSCLC) tumor grades, lymphovascular invasion, and pleural invasion. MATERIALS AND METHODS We studied 60 surgically diagnosed NSCLC patients. Diffusion-weighted imaging (DWI) was performed in the axial plane using a navigator-triggered single-shot, echo-planar imaging sequence with prospective acquisition correction. The ADC maps were generated, and we placed a volume-of-interest on the tumor to construct the whole-lesion histogram. Using the histogram, we calculated the mean, 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of ADC, skewness, and kurtosis. Histogram parameters were correlated with tumor grade, lymphovascular invasion, and pleural invasion. We performed a receiver operating characteristics (ROC) analysis to assess the diagnostic performance of histogram parameters for distinguishing different pathologic features. RESULTS The ADC mean, 10th, 25th, 50th, 75th, 90th, and 95th percentiles showed significant differences among the tumor grades. The ADC mean, 25th, 50th, 75th, 90th, and 95th percentiles were significant histogram parameters between high- and low-grade tumors. The ROC analysis between high- and low-grade tumors showed that the 95th percentile ADC achieved the highest area under curve (AUC) at 0.74. Lymphovascular invasion was associated with the ADC mean, 50th, 75th, 90th, and 95th percentiles, skewness, and kurtosis. Kurtosis achieved the highest AUC at 0.809. Pleural invasion was only associated with skewness, with the AUC of 0.648. CONCLUSIONS ADC histogram analyses on the basis of the entire tumor volume are able to stratify NSCLCs' tumor grade, lymphovascular invasion and pleural invasion.
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Affiliation(s)
- Naoko Tsuchiya
- Department of Radiology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Mariko Doai
- Department of Radiology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Katsuo Usuda
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Hidetaka Uramoto
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Hisao Tonami
- Department of Radiology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
- * E-mail:
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Baliyan V, Das CJ, Sharma R, Gupta AK. Diffusion weighted imaging: Technique and applications. World J Radiol 2016; 8:785-798. [PMID: 27721941 PMCID: PMC5039674 DOI: 10.4329/wjr.v8.i9.785] [Citation(s) in RCA: 182] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 06/11/2016] [Accepted: 08/15/2016] [Indexed: 02/06/2023] Open
Abstract
Diffusion weighted imaging (DWI) is a method of signal contrast generation based on the differences in Brownian motion. DWI is a method to evaluate the molecular function and micro-architecture of the human body. DWI signal contrast can be quantified by apparent diffusion coefficient maps and it acts as a tool for treatment response evaluation and assessment of disease progression. Ability to detect and quantify the anisotropy of diffusion leads to a new paradigm called diffusion tensor imaging (DTI). DTI is a tool for assessment of the organs with highly organised fibre structure. DWI forms an integral part of modern state-of-art magnetic resonance imaging and is indispensable in neuroimaging and oncology. DWI is a field that has been undergoing rapid technical evolution and its applications are increasing every day. This review article provides insights in to the evolution of DWI as a new imaging paradigm and provides a summary of current role of DWI in various disease processes.
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