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Hu Y, Guo D, Zhu Z, Lu L, Jia Z, Li W, Zhou X, Shen R, Ren L. The value of dual time-point fluorine-18 fluorodeoxyglucose PET/computed tomography imaging in predicting lymph node metastasis in non-small cell lung cancer patients. Nucl Med Commun 2024:00006231-990000000-00304. [PMID: 38803240 DOI: 10.1097/mnm.0000000000001866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
OBJECTIVE The purpose of this study was to analyze the correlation between specified dual time-point fluorine-18 fluorodeoxyglucose (18F-FDG) PET/computed tomography (CT) imaging parameters and pathological characteristics in non-small cell lung cancer (NSCLC) patients. METHODS This study retrospectively analyzed 47 patients with NSCLC. All patients underwent dual time-point 18F-FDG PET/CT imaging. We obtained the metabolic parameters, standardized uptake value (SUV) maximum, SUVmean, delayed standardized uptake value (DSUV) maximum, DSUVmean, delay index standardized uptake value (DISUV) maximum, and DISUVmean, of the primary tumor. The tumor size was measured by CT. All lymph nodes had a definite pathological diagnosis. We next evaluated the status of the lymph node metastases (LNM) and the correlations between metabolic parameters and clinical characteristics. Receiver operating characteristic curves were drawn for the prediction of LNM. RESULTS We found that the DSUVmax, DISUVmax, DSUVmean, and tumor size were significantly related to LNM (P = 0.036, 0.009, and 0.049, respectively). Multivariate analysis revealed that tumor size and DISUVmax were independent risk factors for LNM in lung cancer patients. According to the receiver operating characteristic curve analysis, the optimal cutoff values for DISUVmax and tumor size were 0.33 and 2.8 cm, respectively. When these two parameters were combined, the area under the curve for predicting LNM in NSCLC was 0.768, and the sensitivity was 95.7% for predicting LNM in lung cancer patients. We further allocated the patients to three groups: the high-risk group (tumor size ≥ 2.8 cm, DISUVmax ≥ 0.33), the moderate-risk group (tumor size ≥ 2.8 cm, DISUVmax < 0.33, or tumor size < 2.8 cm, DISUVmax ≥ 0.33), and the low-risk group (tumor size < 2.8 cm, DISUVmax < 0.33). The rates of LNM were 70, 50, and 0%, respectively. CONCLUSION Tumor size and DISUVmax are risk factors for predicting LNM, and they are more useful in combination. Compared with standard PET/CT imaging, dual time-point PET/CT imaging has added value in predicting LNM in NSCLC patients.
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Affiliation(s)
| | - Daohua Guo
- Pharmacy, The First Affiliated Hospital of Bengbu Medical University
| | - Zhigao Zhu
- School of Clinical Medicine, Bengbu Medical University
| | | | | | | | | | | | - Li Ren
- Department of Nuclear Medicine, School of Laboratory Medicine, Bengbu Medical University, Bengbu, China
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Cegla P, Filipczuk A, Cholewinski W. Potential use of [ 18F]FDG heterogeneity in discrimination of two different synchronous primary tumors. Rep Pract Oncol Radiother 2023; 28:433-434. [PMID: 37795392 PMCID: PMC10547406 DOI: 10.5603/rpor.a2023.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/05/2023] [Indexed: 10/06/2023] Open
Affiliation(s)
- Paulina Cegla
- Department of Nuclear Medicine, Greater Poland Cancer Centre, Poznan, Poland
| | - Anna Filipczuk
- Department of Nuclear Medicine, Greater Poland Cancer Centre, Poznan, Poland
| | - Witold Cholewinski
- Department of Nuclear Medicine, Greater Poland Cancer Centre, Poznan, Poland
- Department of Electroradiology, Poznan University of Medical Science, Poznan, Poland
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3
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Naghavi-Behzad M, Vogsen M, Gerke O, Dahlsgaard-Wallenius SE, Nissen HJ, Jakobsen NM, Braad PE, Vilstrup MH, Deak P, Hildebrandt MG, Andersen TL. Comparison of Image Quality and Quantification Parameters between Q.Clear and OSEM Reconstruction Methods on FDG-PET/CT Images in Patients with Metastatic Breast Cancer. J Imaging 2023; 9:jimaging9030065. [PMID: 36976116 PMCID: PMC10058454 DOI: 10.3390/jimaging9030065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
We compared the image quality and quantification parameters through bayesian penalized likelihood reconstruction algorithm (Q.Clear) and ordered subset expectation maximization (OSEM) algorithm for 2-[18F]FDG-PET/CT scans performed for response monitoring in patients with metastatic breast cancer in prospective setting. We included 37 metastatic breast cancer patients diagnosed and monitored with 2-[18F]FDG-PET/CT at Odense University Hospital (Denmark). A total of 100 scans were analyzed blinded toward Q.Clear and OSEM reconstruction algorithms regarding image quality parameters (noise, sharpness, contrast, diagnostic confidence, artefacts, and blotchy appearance) using a five-point scale. The hottest lesion was selected in scans with measurable disease, considering the same volume of interest in both reconstruction methods. SULpeak (g/mL) and SUVmax (g/mL) were compared for the same hottest lesion. There was no significant difference regarding noise, diagnostic confidence, and artefacts within reconstruction methods; Q.Clear had significantly better sharpness (p < 0.001) and contrast (p = 0.001) than the OSEM reconstruction, while the OSEM reconstruction had significantly less blotchy appearance compared with Q.Clear reconstruction (p < 0.001). Quantitative analysis on 75/100 scans indicated that Q.Clear reconstruction had significantly higher SULpeak (5.33 ± 2.8 vs. 4.85 ± 2.5, p < 0.001) and SUVmax (8.27 ± 4.8 vs. 6.90 ± 3.8, p < 0.001) compared with OSEM reconstruction. In conclusion, Q.Clear reconstruction revealed better sharpness, better contrast, higher SUVmax, and higher SULpeak, while OSEM reconstruction had less blotchy appearance.
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Affiliation(s)
- Mohammad Naghavi-Behzad
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark (T.L.A.)
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark
- Centre for Personalized Response Monitoring in Oncology, Odense University Hospital, 5000 Odense, Denmark
- Correspondence: ; Tel.: +45-9160-9622
| | - Marianne Vogsen
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark (T.L.A.)
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark
- Centre for Personalized Response Monitoring in Oncology, Odense University Hospital, 5000 Odense, Denmark
- Department of Oncology, Odense University Hospital, 5000 Odense, Denmark
| | - Oke Gerke
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark (T.L.A.)
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark
| | - Sara Elisabeth Dahlsgaard-Wallenius
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark (T.L.A.)
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark
| | - Henriette Juel Nissen
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark (T.L.A.)
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark
| | - Nick Møldrup Jakobsen
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark (T.L.A.)
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark
| | - Poul-Erik Braad
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark (T.L.A.)
- Department at Clinical Engineering, Region of Southern Denmark, 6200 Aabenraa, Denmark
| | - Mie Holm Vilstrup
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark (T.L.A.)
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark
| | - Paul Deak
- Healthcare Science Technology, GE Healthcare, Chicago, IL 06828, USA
| | - Malene Grubbe Hildebrandt
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark (T.L.A.)
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark
- Centre for Personalized Response Monitoring in Oncology, Odense University Hospital, 5000 Odense, Denmark
- Centre for Innovative Medical Technology, Odense University Hospital, 5000 Odense, Denmark
| | - Thomas Lund Andersen
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark (T.L.A.)
- Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, 2100 Copenhagen, Denmark
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Zirakchian Zadeh M, Asadollahi S, Kaghazchi F, Raynor WY, Mehdizadeh Seraj S, Werner TJ, Seierstad T, Korostoff J, Swisher-McClure S, Alavi A, Revheim ME. Prognostic significance of conventional and volumetric PET parameters with and without partial volume correction in the assessment of head and neck squamous cell carcinoma. Nucl Med Commun 2022; 43:800-806. [PMID: 35552334 DOI: 10.1097/mnm.0000000000001573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND The optimal quantification of PET in assessment of head and neck squamous cell carcinoma (HNSCC) is still under development. The effect of partial volume correction (PVC) on the evaluation of survival in the HNSCC patients has not been investigated yet. METHODOLOGY Pretreatment 18F-FDG-PET/CT scans of a selected group of 57 patients with advanced stage HNSCC were collected. Conventional (SUVmean and SUVmax) and volumetric [total lesion glycolysis (TLG) and metabolic tumor volume (MTV)] PET metrics were calculated. The ROVER software (ABX GmbH, Radeberg, Germany) automatically applied PVC to the PET metrics. Cox proportional hazards regression model calculated hazard ratio (HR) for assessment of predictive parameters of progression-free survival (PFS). RESULTS In multivariate Cox regression analysis, including age, gender, race, human papillomavirus status, and stage, the only significant predictors of PFS were the volumetric PET parameters (TLG: HR, 1.003; 95% CI, 1.001-1.005; P = 0.02), pvcTLG (HR, 1.002; 95% CI, 1.001-1.004; P = 0.01) and MTV (HR, 1.050; 95% CI, 1.024-1.077; P < 0.01). The partial volume-corrected values were significantly higher than the noncorrected values (Wilcoxon sign test; P < 0.05). However, there was not a statistically significant difference between the nonpartial volume corrected and partial volume-corrected PET metrics for assessment of PFS. CONCLUSION Volumetric PET metrics were predictors of PFS in Cox regression analysis. Applying PVC could not significantly improve the accuracy of PET metrics for assessment of PFS.
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Affiliation(s)
| | - Shadi Asadollahi
- Johns Hopkins Medicine and The Russell H. Morgan Department of Radiology and Radiological Sciences at Johns Hopkins Medicine, Baltimore, Maryland
| | | | - William Y Raynor
- Department of Radiology, Hospital of the University of Pennsylvania
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Siavash Mehdizadeh Seraj
- Department of Radiology & Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Thomas J Werner
- Department of Radiology, Hospital of the University of Pennsylvania
| | | | - Jonathan Korostoff
- Division for Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania
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Hansen JA, Naghavi-Behzad M, Gerke O, Baun C, Falch K, Duvnjak S, Alavi A, Høilund-Carlsen PF, Hildebrandt MG. Diagnosis of bone metastases in breast cancer: Lesion-based sensitivity of dual-time-point FDG-PET/CT compared to low-dose CT and bone scintigraphy. PLoS One 2021; 16:e0260066. [PMID: 34793550 PMCID: PMC8601566 DOI: 10.1371/journal.pone.0260066] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 11/02/2021] [Indexed: 11/18/2022] Open
Abstract
We compared lesion-based sensitivity of dual-time-point FDG-PET/CT, bone scintigraphy (BS), and low-dose CT (LDCT) for detection of various types of bone metastases in patients with metastatic breast cancer. Prospectively, we included 18 patients with recurrent breast cancer who underwent dual-time-point FDG-PET/CT with LDCT and BS within a median time interval of three days. A total of 488 bone lesions were detected on any of the modalities and were categorized by the LDCT into osteolytic, osteosclerotic, mixed morphologic, and CT-negative lesions. Lesion-based sensitivity was 98.2% (95.4-99.3) and 98.8% (96.8-99.5) for early and delayed FDG-PET/CT, respectively, compared with 79.9% (51.1-93.8) for LDCT, 76.0% (36.3-94.6) for BS, and 98.6% (95.4-99.6) for the combined BS+LDCT. BS detected only 51.2% of osteolytic lesions which was significantly lower than other metastatic types. SUVs were significantly higher for all lesion types on delayed scans than on early scans (P<0.0001). Osteolytic and mixed-type lesions had higher SUVs than osteosclerotic and CT-negative metastases at both time-points. FDG-PET/CT had significantly higher lesion-based sensitivity than LDCT and BS, while a combination of the two yielded sensitivity comparable to that of FDG-PET/CT. Therefore, FDG-PET/CT could be considered as a sensitive one-stop-shop in case of clinical suspicion of bone metastases in breast cancer patients.
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Affiliation(s)
- Jeanette Ansholm Hansen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Mohammad Naghavi-Behzad
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
- * E-mail:
| | - Oke Gerke
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Christina Baun
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Kirsten Falch
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Sandra Duvnjak
- Radiology Department–Breast Imaging, Herlev Gentofte Hospital, Copenhagen, Denmark
- Mammography Screening Center in the Capital Region, Herlev Gentofte Hospital, Copenhagen, Denmark
| | - Abass Alavi
- Division of Nuclear Medicine, Department of Radiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, United States of America
| | - Poul Flemming Høilund-Carlsen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Malene Grubbe Hildebrandt
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
- Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark
- Centre for Personalized Response Monitoring in Oncology, Odense University Hospital, Odense, Denmark
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6
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Zadeh MZ, Seraj SM, Østergaard B, Mimms S, Raynor WY, Aly M, Borja AJ, Arani LS, Gerke O, Werner TJ, Zhuang H, Revheim ME, Abildgaard N, Høilund-Carlsen PF, Alavi A. Prognostic significance of 18F-sodium fluoride in newly diagnosed multiple myeloma patients. AMERICAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 2020; 10:151-160. [PMID: 32929393 PMCID: PMC7486550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/22/2020] [Indexed: 06/11/2023]
Abstract
Focal bone lesions and fractures due to weakened bone are associated with higher morbidity and mortality of multiple myeloma (MM) patients. 18F-sodium fluoride (18F-NaF) is a sensitive PET radiotracer for detection of abnormal bone metabolism and, therefore, is particularly suited to assess the degree of bone involvement in MM patients. We aimed to investigate the prognostic significance of metabolic active volume (MAV) of 18F-NaF-avid lesions in MM patients. In addition to MAV, conventional methods of PET quantification, namely SUVmean and SUVmax, were measured in each patient for the purpose of comparison. Thirty-seven newly diagnosed MM patients were included. PET imaging was performed after intravenous administration of 200 MBq NaF. Active bone lesions and fractures on whole-body 18F-NaF-PET/CT scans were identified. An adaptive thresholding algorithm automatically calculated the total MAV, SUVmean and SUVmax for each patient (ROVER, ABX, Radeberg, Germany). The patients were followed for a median of 39.8 months after treatment (range: 17.8-55.4). The overall survival (OS) of patients with 18F-NaF-MAV value > 38.65 (36.36% [N of Events/Total N: 4/11]) was significantly shorter than that of patients with 18F-NaF-MAV value < 38.65 (3.85% [1/26]; P = 0.002). In multivariate forward stepwise (conditional LR) Cox regression analysis of prognostic factors of OS (including 18F-NaF-MAV (> 38.65 or < 38.65), age, gender, beta-2 microglobulin, and revised international staging system), 18F-NaF-MAV remained the only significant factor (HR: 14.39, P = 0.02). The results for PFS were not significant. Moreover, Kaplan-Meier analyses of conventional methods of PET quantification did not reveal any statistically significant log-rank p-values. MM patients with high 18F-NaF-MAV had shorter overall survival, compared to those with low 18F-NaF-MAV levels (NCT02187731).
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Affiliation(s)
- Mahdi Zirakchian Zadeh
- Department of Radiology, Hospital of The University of PennsylvaniaPA, USA
- Penn Dental School of Medicine, University of PennsylvaniaPA, USA
| | | | - Brian Østergaard
- Department of Hematology, Odense University HospitalOdense, Denmark
| | | | - William Y Raynor
- Department of Radiology, Hospital of The University of PennsylvaniaPA, USA
- Drexel University College of MedicinePhiladelphia, PA, USA
| | - Mahmoud Aly
- Department of Radiology, Hospital of The University of PennsylvaniaPA, USA
| | - Austin J Borja
- Department of Radiology, Hospital of The University of PennsylvaniaPA, USA
| | - Leila S Arani
- Department of Radiology, Hospital of The University of PennsylvaniaPA, USA
| | - Oke Gerke
- Department of Nuclear Medicine, Odense University HospitalOdense, Denmark
| | - Thomas J Werner
- Department of Radiology, Hospital of The University of PennsylvaniaPA, USA
| | - Hongming Zhuang
- Children’s Hospital of Philadelphia, Division of Nuclear Medicine, Department of RadiologyPA, USA
| | - Mona-Elisabeth Revheim
- Division of Radiology and Nuclear Medicine, Oslo University HospitalOslo, Norway
- Faculty of Medicine, University of OsloNorway
| | - Niels Abildgaard
- Department of Hematology, Odense University HospitalOdense, Denmark
- Hematology Research Unit, Department of Clinical Research, University of SouthernDenmark
| | | | - Abass Alavi
- Department of Radiology, Hospital of The University of PennsylvaniaPA, USA
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Naghavi-Behzad M, Bjerg Petersen C, Vogsen M, Braad PE, Grubbe Hildebrandt M, Gerke O. Prognostic Value of Dual-Time-Point 18F-Fluorodeoxyglucose PET/CT in Metastatic Breast Cancer: An Exploratory Study of Quantitative Measures. Diagnostics (Basel) 2020; 10:diagnostics10060398. [PMID: 32545312 PMCID: PMC7344801 DOI: 10.3390/diagnostics10060398] [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: 05/26/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 11/28/2022] Open
Abstract
This study aimed to compare the prognostic value of quantitative measures of [18F]-fluorodeoxyglucose positron emission tomography with integrated computed tomography (FDG-PET/CT) for the response monitoring of patients with metastatic breast cancer (MBC). In this prospective study, 22 patients with biopsy-verified MBC diagnosed between 2011 and 2014 at Odense University Hospital (Denmark) were followed up until 2019. A dual-time-point FDG-PET/CT scan protocol (1 and 3 h) was applied at baseline, when MBC was diagnosed. Baseline characteristics and quantitative measures of maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), corrected SUVmean (cSUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and corrected TLG (cTLG) were collected. Survival time was analyzed using the Kaplan–Meier method and was regressed on MTV, TLG, and cTLG while adjusting for clinicopathological characteristics. Among the 22 patients included (median age: 59.5 years), 21 patients (95%) died within the follow-up period. Median survival time was 29.13 months (95% Confidence interval: 20.4–40 months). Multivariable Cox proportional hazards regression analyses of survival time showed no influence from the SUVmean, cSUVmean, or SUVmax, while increased values of MTV, TLG, and cTLG were significantly associated with slightly higher risk, with hazard ratios ranging between 1.0003 and 1.004 (p = 0.007 to p = 0.026). Changes from 1 to 3 h were insignificant for all PET measures in the regression model. In conclusion, MTV and TLG are potential prognostic markers for overall survival in MBC patients.
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Affiliation(s)
- Mohammad Naghavi-Behzad
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark; (C.B.P.); (M.V.); (M.G.H.); (O.G.)
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark;
- Open Patient data Explorative Network (OPEN), Odense University Hospital, 5000 Odense, Denmark
- Correspondence: or ; Tel.: +45-91609622
| | - Charlotte Bjerg Petersen
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark; (C.B.P.); (M.V.); (M.G.H.); (O.G.)
| | - Marianne Vogsen
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark; (C.B.P.); (M.V.); (M.G.H.); (O.G.)
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark;
- Open Patient data Explorative Network (OPEN), Odense University Hospital, 5000 Odense, Denmark
- Department of Oncology, Odense University Hospital, 5000 Odense, Denmark
| | - Poul-Erik Braad
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark;
| | - Malene Grubbe Hildebrandt
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark; (C.B.P.); (M.V.); (M.G.H.); (O.G.)
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark;
- Open Patient data Explorative Network (OPEN), Odense University Hospital, 5000 Odense, Denmark
- Centre for Innovative Medical Technology, Odense University Hospital, 5000 Odense, Denmark
- Centre for Personalized Response Monitoring in Oncology, Odense University Hospital, 5000 Odense, Denmark
| | - Oke Gerke
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark; (C.B.P.); (M.V.); (M.G.H.); (O.G.)
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark;
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FDG-PET/CT for Response Monitoring in Metastatic Breast Cancer: Today, Tomorrow, and Beyond. Cancers (Basel) 2019; 11:cancers11081190. [PMID: 31443324 PMCID: PMC6721531 DOI: 10.3390/cancers11081190] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 08/14/2019] [Accepted: 08/14/2019] [Indexed: 12/25/2022] Open
Abstract
While current international guidelines include imaging of the target lesion for response monitoring in metastatic breast cancer, they do not provide specific recommendations for choice of imaging modality or response criteria. This is important as clinical decisions may vary depending on which imaging modality is used for monitoring metastatic breast cancer. FDG-PET/CT has shown high accuracy in diagnosing metastatic breast cancer, and the Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) have shown higher predictive values than the CT-based Response Evaluation Criteria in Solid Tumors (RECIST) for prediction of progression-free survival. No studies have yet addressed the clinical impact of using different imaging modalities or response evaluation criteria for longitudinal response monitoring in metastatic breast cancer. We present a case study of a patient with metastatic breast cancer who was monitored first with conventional CT and then with FDG-PET/CT. We retrospectively applied PERCIST to evaluate the longitudinal response to treatment. We used the one-lesion PERCIST model measuring SULpeak in the hottest metastatic lesion on consecutive scans. This model provides a continuous variable that allows graphical illustration of disease fluctuation along with response categories. The one-lesion PERCIST approach seems able to reflect molecular changes and has the potential to support clinical decision-making. Prospective clinical studies addressing the clinical impact of PERCIST in metastatic breast cancer are needed to establish evidence-based recommendations for response monitoring in this disease.
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Sinigaglia M, Mahida B, Piekarski E, Chequer R, Mikail N, Benali K, Hyafil F, Le Guludec D, Rouzet F. FDG atrial uptake is associated with an increased prevalence of stroke in patients with atrial fibrillation. Eur J Nucl Med Mol Imaging 2019; 46:1268-1275. [DOI: 10.1007/s00259-019-4274-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 01/15/2019] [Indexed: 01/28/2023]
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