1
|
Kumar R, Manchanda S, Hota A, Devaraja K, Thakur R, Sherif PM, Sagar P, Khan MA, Bhalla AS, Kumar R. Ultrasound Characteristics of Metastatic Occult Cervical Lymph Nodes in Early Tongue Cancer. Indian J Otolaryngol Head Neck Surg 2023; 75:2786-2791. [PMID: 37974888 PMCID: PMC10645852 DOI: 10.1007/s12070-023-03881-4] [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: 12/27/2022] [Accepted: 05/08/2023] [Indexed: 11/19/2023] Open
Abstract
Introduction: Identification of occult lymph node metastasis is challenging in early tongue cancers. We conducted a prospective study to determine the most characteristics ultrasonic feature suggestive of metastatic node. Material and Methods: A preliminary study based on feasibility was planned on twenty five patients with squamous cell carcinoma of tongue (T1,T2) and N0 neck underwent ultrasonography of neck. The results of each ultrasonic parameters (size, shape, echogenicity, margin and hilum) for suspicion were analysed. Pathologic evaluation of surgical resected neck specimen served as the reference standard. Results: USG yielded sensitivity and specificity by size, by morphology, either size or morphology are 50.0% and 87.5%, 75.0% and 87.5, 75.0 and 83.3% respectively. Morphology alone has highest negative predictive value (NPV:91.3%) with accuracy of 84.3%. Conclusion: Morphology of the lymph node had highest sensitivity and specificity with highest negative predictive value correlating with its metastatic nature.
Collapse
Affiliation(s)
- Rajeev Kumar
- Department of Otolaryngology-Head Neck Surgery, AIIMS, New Delhi, 110029 India
| | | | - Ashutosh Hota
- Department of Head & Neck Oncology, AHPGIC, Cuttack, India
| | - K. Devaraja
- Department of Otolaryngology-Head Neck Surgery, KMC, Manipal, India
| | - Rishikesh Thakur
- Department of Otolaryngology-Head Neck Surgery, AIIMS, New Delhi, 110029 India
| | | | - Prem Sagar
- Department of Otolaryngology-Head Neck Surgery, AIIMS, New Delhi, 110029 India
| | | | | | - Rakesh Kumar
- Department of Otolaryngology-Head Neck Surgery, AIIMS, New Delhi, 110029 India
| |
Collapse
|
2
|
Wang J, Kang B, Sun C, Du F, Lin J, Ding F, Dai Z, Zhang Y, Yang C, Shang L, Li L, Hong Q, Huang C, Wang G. CT-based radiomics nomogram for differentiating gastric hepatoid adenocarcinoma from gastric adenocarcinoma: a multicentre study. Expert Rev Gastroenterol Hepatol 2023; 17:205-214. [PMID: 36625225 DOI: 10.1080/17474124.2023.2166490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND To develop a CT-based radiomics nomogram for the high-precision preoperative differentiation of gastric hepatoid adenocarcinoma (GHAC) patients from gastric adenocarcinoma (GAC) patients. RESEARCH DESIGN AND METHODS 108 patients with GHAC from 6 centers and 108 GAC patients matched by age, sex and T stage undergoing pathological examination were retrospectively reviewed. Patients from 5 centers were divided into two cohorts (training and internal validation) at a 7:3 ratio, the remaining patients were external test cohort. Venous-phase CT images were retrieved for tumor segmentation and feature extraction. A radiomics model was developed by the least absolute shrinkage and selection operator method. The nomogram was developed by clinical factors and the radiomics score. RESULTS 1409 features were extracted and a radiomics model consisting of 19 features was developed, which showed a favorable performance in discriminating GHAC from GAC (AUCtraining cohort = 0.998, AUCinternal validation set = 0.942, AUCexternal test cohort = 0.731). The radiomics nomogram, including the radiomics score, AFP, and CA72_4, achieved good calibration and discrimination (AUCtraining cohort = 0.998, AUCinternal validation set = 0.954, AUCexternal test cohort = 0.909). CONCLUSIONS The noninvasive CT-based nomogram, including radiomics score, AFP, and CA72_4, showed favorable predictive efficacy for differentiating GHAC from GAC and might be useful for clinical decision-making.
Collapse
Affiliation(s)
- Jing Wang
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Bing Kang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Cong Sun
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Fengying Du
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Jianxian Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Fanghui Ding
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Zhengjun Dai
- Scientific Research Department, Huiying Medical Technology Co., Ltd,Beijing, China
| | - Yifei Zhang
- Department of Gastrointestinal Surgery, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, Shandong, China
| | - Chenggang Yang
- Department of Gastrointestinal Surgery, Liaocheng people's hospital, Liaocheng, Shandong, China
| | - Liang Shang
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Leping Li
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Qingqi Hong
- Department of Gastrointestinal Oncology Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.,The School of Clinical Medicine, Fujian Medical University, The Graduate School of Fujian Medical University, Xiamen, Fujian, China
| | - Changming Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Guangbin Wang
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.,Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| |
Collapse
|
3
|
Ma D, Zhang Y, Shao X, Wu C, Wu J. PET/CT for Predicting Occult Lymph Node Metastasis in Gastric Cancer. Curr Oncol 2022; 29:6523-6539. [PMID: 36135082 PMCID: PMC9497704 DOI: 10.3390/curroncol29090513] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/11/2022] [Accepted: 09/06/2022] [Indexed: 11/28/2022] Open
Abstract
A portion of gastric cancer patients with negative lymph node metastasis at an early stage eventually die from tumor recurrence or advanced metastasis. Occult lymph node metastasis (OLNM] is a potential risk factor for the recurrence and metastasis in these patients, and it is highly important for clinical prognosis. Positron emission tomography (PET)/computed tomography (CT) is used to assess lymph node metastasis in gastric cancer due to its advantages in anatomical and functional imaging and non-invasive nature. Among the major metabolic parameters of PET, the maximum standardized uptake value (SUVmax) is commonly used for examining lymph node status. However, SUVmax is susceptible to interference by a variety of factors. In recent years, the exploration of new PET metabolic parameters, new PET imaging agents and radiomics, has become an active research topic. This paper aims to explore the feasibility and predict the effectiveness of using PET/CT to detect OLNM. The current landscape and future trends of primary metabolic parameters and new imaging agents of PET are reviewed. For gastric cancer patients, the possibility to detect OLNM non-invasively will help guide surgeons to choose the appropriate lymph node dissection area, thereby reducing unnecessary dissections and providing more reasonable, personalized and comprehensive treatments.
Collapse
Affiliation(s)
- Danyu Ma
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Ying Zhang
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
- Institute of Cell Therapy, Soochow University, Changzhou 213003, China
| | - Xiaoliang Shao
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Chen Wu
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
- Institute of Cell Therapy, Soochow University, Changzhou 213003, China
- Correspondence: (C.W.); (J.W.)
| | - Jun Wu
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
- Correspondence: (C.W.); (J.W.)
| |
Collapse
|
4
|
Freihat O, Zoltán T, Pinter T, Kedves A, Sipos D, Repa I, Kovács Á, Zsolt C. Correlation between Tissue Cellularity and Metabolism Represented by Diffusion-Weighted Imaging (DWI) and 18F-FDG PET/MRI in Head and Neck Cancer (HNC). Cancers (Basel) 2022; 14:cancers14030847. [PMID: 35159115 PMCID: PMC8833888 DOI: 10.3390/cancers14030847] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 01/02/2023] Open
Abstract
Simple Summary We report on the correlation between the diffusion-weighted imaging (DWI) and the metabolic volume parameters derived from a PET scan, to determine the correlation between these parameters and the tumor cellularity in head and neck primary tumors. Our findings implied that there was no correlation between the information derived from the DWI and the information derived from the FDG metabolic parameters. Thus, both imaging techniques might play a complementary role in HNC diagnosis and assessment. This is significant because the treatment plan of patients with HNC should be well evaluated by using all the available diagnosis techniques, for a better understanding of how the tumor will react. Abstract Background: This study aimed to assess the association of 18F-Fluorodeoxyglucose positron-emission-tomography (18F-FDG/PET) and DWI imaging parameters from a primary tumor and their correlations with clinicopathological factors. Methods: We retrospectively analyzed primary tumors in 71 patients with proven HNC. Primary tumor radiological parameters: DWI and FDG, as well as pathological characteristics were analyzed. Spearman correlation coefficient was used to assess the correlation between DWI and FDG parameters, ANOVA or Kruskal–Wallis, independent sample t-test, Mann–Whitney test, and multiple regression were performed on the clinicopathological features that may affect the 18F- FDG and apparent-diffusion coefficient (ADC) of the tumor. Results: No significant correlations were observed between DWI and any of the 18F-FDG parameters (p > 0.05). SUVmax correlated with N-stages (p = 0.023), TLG and MTV correlated with T-stages (p = 0.006 and p = 0.001), and ADC correlated with tumor grades (p = 0.05). SUVmax was able to differentiate between N+ and N− groups (p = 0.004). Conclusions: Our results revealed a non-significant correlation between the FDG-PET and ADC-MR parameters. FDG-PET-based glucose metabolic and DWI-MR-derived cellularity data may represent different biological aspects of HNC.
Collapse
Affiliation(s)
- Omar Freihat
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
- Correspondence: (O.F.); (Á.K.); Tel.: +36-52-411-600 (Á.K.)
| | - Tóth Zoltán
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- MEDICOPUS Healthcare Provider and Public Nonprofit Ltd., Somogy County Moritz Kaposi Teaching Hospital, 7400 Kaposvár, Hungary
| | - Tamas Pinter
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, “Moritz Kaposi” Teaching Hospital, 7400 Kaposvár, Hungary;
| | - András Kedves
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, “Moritz Kaposi” Teaching Hospital, 7400 Kaposvár, Hungary;
- Institute of Information Technology and Electrical Technology, Faculty of Engineering and Information Technology, University of Pécs, 7621 Pécs, Hungary
| | - Dávid Sipos
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, “Moritz Kaposi” Teaching Hospital, 7400 Kaposvár, Hungary;
| | - Imre Repa
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, “Moritz Kaposi” Teaching Hospital, 7400 Kaposvár, Hungary;
| | - Árpád Kovács
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Department of Oncoradiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- Correspondence: (O.F.); (Á.K.); Tel.: +36-52-411-600 (Á.K.)
| | - Cselik Zsolt
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Csolnoky Ferenc County Hospital, 8200 Veszprém, Hungary
| |
Collapse
|
5
|
Zhang S, Zhang R, Gong W, Wang C, Zeng C, Zhai Y, Fang Q, Dai L. Positron Emission Tomography-Computed Tomography Parameters Predict Efficacy of Immunotherapy in Head and Neck Squamous Cell Carcinomas. Front Oncol 2021; 11:728040. [PMID: 34650916 PMCID: PMC8506113 DOI: 10.3389/fonc.2021.728040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/31/2021] [Indexed: 12/18/2022] Open
Abstract
Background This study aims to assess the association between positron emission tomography-computed tomography (PET-CT) parameters and the response to immune checkpoint inhibitors in unresectable head and neck squamous cell carcinoma (HNSCC). Methods A total of 105 patients receiving immunotherapy (pembrolizumab or sintilimab with/without cisplatin) were retrospectively enrolled in this study; pretreatment data regarding metabolic tumor volume (MTV) and maximum standardized uptake value (SUVmax) were collected. The primary interest of the study was objective response rate (ORR), and the secondary was progression-free survival (PFS). Results The mean total MTV was 40.6 cm3 (range: 8.5-100.3), ORRs in tumors with total MTV of ≥40.6 and <40.6 cm3 were 43.1% and 23.1%, respectively; the difference was statistically significant (p = 0.018). Survival analysis indicated similar PFS rates in the two groups (p = 0.057). The mean total SUVmax was 12.5, ORRs in tumors with total SUVmax ≥12.5 and <12.5 were 40.0% and 26.0%, respectively; the difference was not significant (p = 0.092). Survival analysis reported patients with total SUVmax of ≥12.5 had significantly worse PFS (p = 0.001) than patients with total SUVmax of <12.5. Conclusions In HNSCC, total MTV ≥40.6 cm3 translated into improved clinical response but not into better PFS; total SUVmax had no effect on clinical response, but total SUVmax ≥12.5 was associated with worse PFS.
Collapse
Affiliation(s)
- Songtao Zhang
- Department of Thyroid and Head Neck, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Runfang Zhang
- Department of Thyroid and Head Neck, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Wenbo Gong
- Department of Thyroid and Head Neck, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Chao Wang
- Department of Thyroid and Head Neck, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Chen Zeng
- Department of Thyroid and Head Neck, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Yifei Zhai
- Department of Thyroid and Head Neck, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Qigen Fang
- Department of Thyroid and Head Neck, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Liyuan Dai
- Department of Thyroid and Head Neck, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| |
Collapse
|
6
|
Li J, Liu S, Li Z, Han X, Que L. Prognostic Value of Perineural Invasion in Oral Tongue Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. Front Oncol 2021; 11:683825. [PMID: 34322385 PMCID: PMC8311439 DOI: 10.3389/fonc.2021.683825] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/24/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES A significant number of recently published research has outlined the contribution of perineural invasion (PNI) to clinical outcomes in oral tongue squamous cell carcinoma (OTSCC), but some results remain conflicting. This study aimed to determine whether patients with OTSCC with PNI have a worse prognosis than those without PNI. MATERIALS AND METHODS PubMed, Embase, and the Cochrane Library were queried for potentially eligible articles published up to December 2020. The primary outcomes were the hazard ratio (HR) for locoregional recurrence, overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS). The random-effect model was used in all analyses. RESULTS Seventeen studies (4445 patients) were included. Using adjusted HRs, the presence of PNI was associated with a higher risk of locoregional recurrence (HR=1.73, 95%CI: 1.07-2.79, P=0.025, I2 = 33.1%, Pheterogeneity=0.224), worse OS (HR=1.94, 95%CI: 1.39-2.72, P<0.001, I2 = 0.0%, Pheterogeneity=0.838), worse DFS (HR=2.13, 95%CI: 1.53-2.96, P<0.001, I2 = 48.4%, Pheterogeneity=0.071), and worse CSS (HR=1.93, 95%CI: 1.40-2.65, P<0.001, I2 = 25.5%, Pheterogeneity=0.251). PNI had an impact on locoregional recurrence in early-stage OTSCC but not in all stages, and on OS, DFS, and CSS in all-stage and early-stage OTSCC. The sensitivity analyses showed that the results were robust. CONCLUSION The presence of PNI significantly affects the locoregional recurrence and survival outcomes among patients with OTSCC.
Collapse
Affiliation(s)
- Jiajia Li
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shan Liu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhangao Li
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xinxin Han
- Department of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Lin Que
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| |
Collapse
|