1
|
Meng Y, Liu S, Yu M, Liang H, Tong Y, Song J, Shi J, Cai W, Wu Q, Wen Z, Wang J, Guo F. The Changes of Blood and CSF Ion Levels in Depressed Patients: a Systematic Review and Meta-analysis. Mol Neurobiol 2024; 61:5369-5403. [PMID: 38191692 DOI: 10.1007/s12035-023-03891-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 12/19/2023] [Indexed: 01/10/2024]
Abstract
Micronutrient deficiencies and excesses are closely related to developing and treating depression. Traditional and effective antidepressants include tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and lithium. There is no consensus on the fluctuation of zinc (Zn2+), magnesium (Mg2+), calcium (Ca2+), copper (Cu2+), iron (Fe2+), and manganese (Mn2+) ion levels in depressed individuals before and after therapy. In order to determine whether there were changes in blood and cerebrospinal fluid (CSF) levels of these ions in depressed patients compared with healthy controls and depressed patients treated with TCAs, SSRIs, or lithium, we applied a systematic review and meta-analysis. Using the Stata 17.0 software, we performed a systematic review and meta-analysis of the changes in ion levels in human samples from healthy controls, depressive patients, and patients treated with TCAs, SSRIs, and lithium, respectively. By searching the PubMed, EMBASE, Google Scholar, Web of Science, China National Knowledge Infrastructure (CNKI), and WAN FANG databases, 75 published analyzable papers were chosen. In the blood, the levels of Zn2+ and Mg2+ in depressed patients had decreased while the Ca2+ and Cu2+ levels had increased compared to healthy controls, Fe2+ and Mn2+ levels have not significantly changed. After treatment with SSRIs, the levels of Zn2+ and Ca2+ in depressed patients increased while Cu2+ levels decreased. Mg2+ and Ca2+ levels were increased in depressed patients after Lithium treatment. The findings of the meta-analysis revealed that micronutrient levels were closely associated with the onset of depression and prompted more research into the underlying mechanisms as well as the pathophysiological and therapeutic implications.
Collapse
Affiliation(s)
- Yulu Meng
- Department of Pharmacy, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, China
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang, 110122, China
| | - Shuangshuang Liu
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Miao Yu
- Science Experiment Center, China Medical University, Shenyang, 110122, China
| | - Hongyue Liang
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang, 110122, China
| | - Yu Tong
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang, 110122, China
| | - Ji Song
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang, 110122, China
| | - Jian Shi
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang, 110122, China
| | - Wen Cai
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang, 110122, China
| | - Qiong Wu
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Zhifeng Wen
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, China.
| | - Jialu Wang
- Department of Neurology, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, China.
| | - Feng Guo
- Department of Pharmacy, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, China.
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang, 110122, China.
| |
Collapse
|
2
|
Guja KE, Behr G, Bedmutha A, Kuhn M, Nadel HR, Pandit-Taskar N. Molecular Imaging with PET-CT and PET-MRI in Pediatric Musculoskeletal Diseases. Semin Nucl Med 2024; 54:438-455. [PMID: 38688770 DOI: 10.1053/j.semnuclmed.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 05/02/2024]
Abstract
Molecular imaging has emerged as an integral part of oncologic imaging. Given the physiologic changes that precede anatomic changes, molecular imaging can enable early detection of disease and monitoring of response. [18F] Fluorodeoxyglucose (FDG) Positron emission tomography (PET) is the predominant molecular imaging modality used in oncologic assessment and can be performed using PET/CT or PET/MR. In pediatric patients, PET/MRI imaging is generally preferred due to low radiation exposure and PET/MRI is particularly advantageous for imaging musculoskeletal (MSK) diseases, as MRI provides superior characterization of tissue changes as compared to CT. In this article, we provide an overview of the typical role of PET CT/MRI in assessment of some common pediatric malignancies and benign MSK diseases with case examples. We also discuss the relative advantages of PET/MRI compared to PET/CT, and review published data with a primary focus on the use of PET/MR.
Collapse
Affiliation(s)
- Kip E Guja
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Gerald Behr
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York; Weil Cornell Medical College, New York, New York
| | - Akshay Bedmutha
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marlena Kuhn
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Helen R Nadel
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Neeta Pandit-Taskar
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York; Weil Cornell Medical College, New York, New York.
| |
Collapse
|
3
|
Martin TW, Griffin L. Prospective pilot study utilizing changes in quantitative values obtained on serial fluorine-18 fluorodeoxyglucose ( 18F-FDG) positron emission tomography-computed tomography (PET/CT) in dogs with appendicular osteosarcoma before and after stereotactic body radiation therapy (SBRT) and carboplatin chemotherapy to assess for prediction of survival and therapeutic effectiveness. Vet Radiol Ultrasound 2024. [PMID: 38655687 DOI: 10.1111/vru.13361] [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: 11/30/2023] [Revised: 01/24/2024] [Accepted: 03/10/2024] [Indexed: 04/26/2024] Open
Abstract
Serial fluorine 18 fluorodeoxyglucose (18F-FDG) positron emission tomography-CT (PET/CT) is commonly used in human oncology to prognosticate and evaluate for therapeutic effectiveness. In this pilot study, dogs with naturally occurring appendicular osteosarcoma were evaluated with serial 18F-FDG PET/CT in an attempt to assess for response to therapy, prognostic factors, and appropriateness of imaging intervals. Fourteen dogs were enrolled in the trial. All dogs had the initial 18F-FDG PET/CT (PET1), with nine dogs having their end-of-therapy 18F-FDG PET/CT (EoT PET) 3 months after stereotactic body radiation therapy (SBRT) to the primary tumor. The median percent change from the PET1 to the EoT PET for the standard uptake value maximum (SUVmax%) was -58% (range: -17 to -88%), metabolic tumor volume (MTV%) was -99.8% (range: -65 to -100%), and total lesion glycolysis (TLG%) was -99.8% (range: -75 to -100%), all of which were significant (P < .05, <.05, and <.05, respectively). On evaluation, it was found that volumes of GTV and CTV were significant for survival (P < .05 and <.05), MTV1, TLG1, and SUVmax on the EoT PET (SUVmaxEoT) were predictive of metastasis (P < .05), and the SUVmax% was significantly correlated to the time to first event (P < .05). Based on this data, serial 18F-FDG PET/CT performed 3 months after SBRT can show a significant reduction in avidity, and the quantitative data collected may help predict metastatic disease in canine appendicular osteosarcoma.
Collapse
Affiliation(s)
- Tiffany W Martin
- Department of Clinical Sciences, Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, USA
| | - Lynn Griffin
- VCA Canada Central Victoria Veterinary Hospital, Victoria, British Columbia, Canada
| |
Collapse
|
4
|
Puranik AD, Choudhury S, Ghosh S, Dev ID, Ramchandani V, Uppal A, Bhosale V, Palsapure A, Rungta R, Pandey R, Khatri S, George G, Satamwar Y, Maske R, Agrawal A, Shah S, Purandare NC, Rangarajan V. Tata Memorial Centre Evidence Based Use of Nuclear medicine diagnostic and treatment modalities in cancer. Indian J Cancer 2024; 61:S1-S28. [PMID: 38424680 DOI: 10.4103/ijc.ijc_52_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 01/31/2024] [Indexed: 03/02/2024]
Abstract
ABSTRACT PET/CT and radioisotope therapy are diagnostic and therapeutic arms of Nuclear Medicine, respectively. With the emergence of better technology, PET/CT has become an accessible modality. Diagnostic tracers exploring disease-specific targets has led the clinicians to look beyond FDG PET. Moreover, with the emergence of theranostic pairs of radiopharmaceuticals, radioisotope therapy is gradually making it's way into treatment algorithm of common cancers in India. We therefore would like to discuss in detail the updates in PET/CT imaging and radionuclide therapy and generate a consensus-driven evidence based document which would guide the practitioners of Oncology.
Collapse
Affiliation(s)
- Ameya D Puranik
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital and Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Zhang C, Wu H, Xu G, Xu Y, Ma W, Li Z, Zhang J. Incidence, survival, and associated factors estimation in osteosarcoma patients with lung metastasis: a single-center experience of 11 years in Tianjin, China. BMC Cancer 2023; 23:506. [PMID: 37271825 DOI: 10.1186/s12885-023-11024-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 05/30/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Osteosarcoma is the most common primary malignant bone tumor. The current study was conducted to describe the general condition of patients with primary osteosarcoma in a single cancer center in Tianjin, China and to investigate the associated factors in osteosarcoma patients with lung metastasis. METHODS From February 2009 to October 2020, patients from Tianjin Medical University Cancer Institute and Hospital, China were retrospectively analyzed. The Kaplan-Meier method was used to evaluate the overall survival of osteosarcoma patients. The Cox proportional hazard regression analysis was performed to analyze the prognostic factors of all osteosarcoma patients and those patients with lung metastasis, respectively. Furthermore, risk factors for developing lung metastasis were identified in synchronous lung metastasis (SLM) and metachronous lung metastasis (MLM) patients. RESULTS A total of 203 patients were involved and 150 patients were successfully followed up for survival status. The 5-year survival rate of osteosarcoma was 70.0% and the survival months for patients with SLM and MLM were 33.3 ± 12.6 and 45.8 ± 7.4 months, respectively. The presence of lung metastasis was one of the independent prognostic factors for prognosis of osteosarcoma. In patients with lung metastasis, twenty-one (10.3%) showed lung metastasis at the diagnosis of osteosarcoma and 67 (33%) were diagnosed with lung metastases during the later course. T3 stage (OR = 11.415, 95%CI 1.362-95.677, P = 0.025) and bone metastasis (OR = 6.437, 95%CI 1.69-24.51, P = 0.006) were risk factors of SLM occurrence. Bone metastasis (OR = 1.842, 95%CI 1.053-3.224, P = 0.032), good necrosis (≥ 90%, OR = 0.032, 95%CI 0.050-0.412, P < 0.001), elevated Ki-67 (OR = 2.958, 95%CI 1.098-7.969, P = 0.032) and elevated LDH (OR = 1.791, 95%CI 1.020-3.146, P = 0.043) were proved to be independent risk factors for developing MLM. CONCLUSION The overall survival, prognostic factors and risk factors for lung metastasis in this single center provided insight about osteosarcoma management.
Collapse
Affiliation(s)
- Chao Zhang
- Department of Bone and Soft Tissue Tumors, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, 300000, China.
| | - Haixiao Wu
- Department of Bone and Soft Tissue Tumors, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, 300000, China
| | - Guijun Xu
- Department of Orthopedics, Tianjin Hospital, Tianjin, 300211, China
| | - Yao Xu
- Department of Bone and Soft Tissue Tumors, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, 300000, China
| | - Wenjuan Ma
- Department of Breast Imaging, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for CancerTianjin's Clinical Research Center for Cancer, Tianjin, 300000, China
| | - Zhijun Li
- Department of Radiology, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, 300000, China
| | - Jin Zhang
- Department of Bone and Soft Tissue Tumors, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, 300000, China.
| |
Collapse
|
6
|
Oh C, Bishop MW, Cho SY, Im HJ, Shulkin BL. 18F-FDG PET/CT in the Management of Osteosarcoma. J Nucl Med 2023:jnumed.123.265592. [PMID: 37201958 DOI: 10.2967/jnumed.123.265592] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/26/2023] [Indexed: 05/20/2023] Open
Abstract
Osteosarcoma is the most common type of primary malignant bone tumor. 18F-FDG PET/CT is useful for staging, detecting recurrence, monitoring response to neoadjuvant chemotherapy, and predicting prognosis. Here, we review the clinical aspects of osteosarcoma management and assess the role of 18F-FDG PET/CT, in particular with regard to pediatric and young adult patients.
Collapse
Affiliation(s)
- Chiwoo Oh
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - Michael W Bishop
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Steve Y Cho
- Nuclear Medicine and Molecular Imaging Section, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Hyung-Jun Im
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea;
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea; and
| | - Barry L Shulkin
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee
| |
Collapse
|
7
|
Karaarslan E, Alis D, Basar Y, Kumbasar B, Kalayci CB, Alpan B, Ozger H. The Role of Whole-Body Magnetic Resonance Imaging in Assessing Extrapulmonary Metastases in Osteosarcoma Staging and Restaging: A Pilot Study. J Comput Assist Tomogr 2023:00004728-990000000-00148. [PMID: 36944103 DOI: 10.1097/rct.0000000000001455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE The aim of the study is to investigate the role of whole-body magnetic resonance imaging (MRI) in assessing extrapulmonary metastases in primary osteosarcoma staging. METHODS We retrospectively reviewed medical data to identify primary osteosarcoma patients with available preoperative whole-body MRI obtained in the staging or restaging. Histopathology was the reference test for assessing the diagnostic performance, if available. Otherwise, oncology board decisions were used as the reference. In addition, the benefits of whole-body MRI to F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) and bone scintigraphy were investigated. RESULTS In all, 36 patients with osteosarcoma (24 staging, 12 restaging) with a mean age of 16.36 ± 5.63 years (range, 9-29 years) were included in the study. The median follow-up duration was 26.61 months (interquartile range, 33.3 months). Of 36 patients, 8 had skeletal, 1 had a lymph node, and 1 had a subcutaneous metastasis. Whole-body MRI correctly identified all patients with metastatic disease but incorrectly classified a bone infarct in one patient as a skeletal metastasis, equating a scan-level sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of 100%, 96.3%, 97.3%, 100%, and 90.91%. Whole-body MRI contributed to bone scintigraphy by identifying a skeletal metastasis in one patient and positron emission tomography-computed tomography by ruling out a skeletal metastasis in another. CONCLUSIONS Whole-body MRI could accurately identify extrapulmonary metastases in primary osteosarcoma patients for staging or restaging. In addition, it might contribute to the standard whole-body imaging methods.
Collapse
Affiliation(s)
- Ercan Karaarslan
- From the Department of Radiology, Acibadem Mehmet Ali Aydinlar University, School of Medicine
| | - Deniz Alis
- From the Department of Radiology, Acibadem Mehmet Ali Aydinlar University, School of Medicine
| | - Yeliz Basar
- Department of Radiology, Acibadem Healthcare Group
| | | | | | - Bugra Alpan
- Department of Orthopedics and Traumatology, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey
| | - Harzem Ozger
- Department of Orthopedics and Traumatology, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey
| |
Collapse
|
8
|
Mendoza H, Nosov A, Pandit-Taskar N. Molecular imaging of sarcomas with FDG PET. Skeletal Radiol 2023; 52:461-475. [PMID: 36173459 DOI: 10.1007/s00256-022-04182-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 02/02/2023]
Abstract
Sarcoma comprises a heterogenous entity of musculoskeletal malignancies arising from a mesenchymal origin. The diagnosis and management of pediatric sarcoma requires a multidisciplinary approach and the use of various imaging modalities including CT, MRI and FDG PET scans. FDG PET/CT (FDG PET), as a metabolic imaging, complements and provides superior diagnostic information as against other imaging modalities alone. Advantages of FDG PET in differentiating malignant sarcomatous lesions from benign lesions, and value in staging and restaging have been noted in several studies. The use of FDG PET in clinical management has increased over the years. The data on prognostication of outcomes or predicting responders to therapy with FDG PET in patients with sarcoma is somewhat limited. This review will focus on the pearls and pitfalls of FDG PET and role of FDG PET in initial extent of disease assessment, treatment response, and surveillance imaging pertaining to osteosarcoma, chondrosarcoma, Ewing's sarcoma, and rhabdomyosarcoma. We also discuss the limitations and unmet needs of FDG PET in the management of patients with sarcoma.
Collapse
Affiliation(s)
- Humberto Mendoza
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Anton Nosov
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Neeta Pandit-Taskar
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
- Department of Radiology, Weill Cornell Medical College, New York, NY, USA.
| |
Collapse
|
9
|
Zhang Q, Feng H, Li J, Feng R. Diagnostic accuracy of fluorine-18 fluorodeoxyglucose positron emission tomography for suspected primary and postoperative pyogenic spondylitis. J Orthop Surg Res 2023; 18:23. [PMID: 36627651 PMCID: PMC9830889 DOI: 10.1186/s13018-023-03507-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 01/03/2023] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) and PET/CT have been suggested for confirming or excluding musculoskeletal infection but the diagnostic value of this tool for pyogenic spondylitis remains to be confirmed. This meta-analysis was performed to verify the accuracy of 18F-FDG PET and PET/CT in diagnosing suspected pyogenic spondylitis by performing a systematic review and meta-analysis. METHODS We conducted a comprehensive literature search of PubMed, Embase and Cochrane Library to retrieve diagnostic accuracy studies in which suspected pyogenic spondylitis was assessed with 18F-FDG PET or PET/CT. The pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR), summarized receiver operating characteristic curve (sROC) and the area under the sROC (AUC) were calculated by using Stata software. RESULTS A total of 18 eligible studies (660 patients) with suspected pyogenic spondylitis were included in the quantitative analysis. 18F-FDG PET and PET/CT illustrated relatively high sensitivity (0.91, 95% CI: 0.84-0.95) and specificity (0.90, 95% CI: 0.79-0.95) for the diagnosis of pyogenic spondylitis. The pooled DOR and AUC were 86.00 (95% CI, 31.00-240.00) and 0.96 (95% CI, 0.94-0.97), respectively. For diagnosing pyogenic spondylitis without previous spine surgery, the pooled sensitivity, specificity, DOR and AUC were 0.93 (95% CI, 0.85-0.97), 0.91 (95% CI, 0.77-0.97), 136 (95% CI, 35-530) and 0.97 (95% CI, 0.95-0.98), respectively. For diagnosing postoperative pyogenic spondylitis, the pooled sensitivity, specificity, DOR and AUC were 0.85 (95% CI, 0.71 to 0.93), 0.87 (95% CI, 0.66 to 0.96), 38 (95% CI, 9 to 167) and 0.92 (95% CI, 0.89 to 0.94), respectively. CONCLUSION 18F-FDG PET and PET/CT presented satisfactory accuracy for diagnosing pyogenic spondylitis. The diagnostic effect of this nuclear imaging method for pyogenic spondylitis without previous spine surgery seems to be better than that for the postoperative ones. However, whether 18F-FDG PET and PET/CT could become a routine in patients with suspected pyogenic spondylitis remains to be confirmed. LEVEL OF EVIDENCE Level I evidence, a summary of meta-analysis.
Collapse
Affiliation(s)
- Qingyu Zhang
- grid.460018.b0000 0004 1769 9639Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021 Shandong China
| | - Haotian Feng
- grid.460018.b0000 0004 1769 9639Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021 Shandong China
| | - Jianmin Li
- grid.27255.370000 0004 1761 1174Department of Orthopedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China
| | - Rongjie Feng
- grid.460018.b0000 0004 1769 9639Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021 Shandong China
| |
Collapse
|
10
|
Stanborough R, Demertzis JL, Wessell DE, Lenchik L, Ahlawat S, Baker JC, Banks J, Caracciolo JT, Garner HW, Hentz C, Lewis VO, Lu Y, Maynard JR, Pierce JL, Scott JA, Sharma A, Beaman FD. ACR Appropriateness Criteria® Malignant or Aggressive Primary Musculoskeletal Tumor-Staging and Surveillance: 2022 Update. J Am Coll Radiol 2022; 19:S374-S389. [PMID: 36436964 DOI: 10.1016/j.jacr.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/27/2022]
Abstract
Malignant or aggressive primary musculoskeletal tumors are rare and encompass a wide variety of bone and soft tissue tumors. Given the most common site for metastasis from these primary musculoskeletal tumors is to the lung, chest imaging is integral in both staging and surveillance. Extrapulmonary metastases are rarely encountered with only a few exceptions. Following primary tumor resection, surveillance of the primary tumor site is generally recommended. Local surveillance imaging recommendations differ between primary tumors of bone origin versus soft tissue origin. This document consolidates the current evidence and expert opinion for the imaging staging and surveillance of these tumors into five clinical scenarios. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer-reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which peer-reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
Collapse
Affiliation(s)
| | - Jennifer L Demertzis
- Diagnostic Imaging Associates, Chesterfield, Missouri; Partner, ProSight Radiology.
| | | | - Leon Lenchik
- Panel Vice-Chair, Wake Forest University School of Medicine, Winston Salem, North Carolina
| | - Shivani Ahlawat
- The Johns Hopkins University School of Medicine, Baltimore, Maryland; member
| | - Jonathan C Baker
- MSK Imaging and Interventions Fellowship Director, Mallinckrodt Institute of Radiology Washington University School of Medicine, Saint Louis, Missouri
| | - James Banks
- Nova Southeastern University, Fort Lauderdale, Florida; FRS 2023 Program Chair; ACR alternate counselor from Florida; MSK Section Chair for group; Medical student radiology rotation clerkship director for HCA Florida Aventura and Kendall Hospitals
| | - Jamie T Caracciolo
- Section Head, MSK Imaging, Moffitt Cancer Center and University of South Florida Morsani College of Medicine, Tampa, Florida; MSK-RADS (Bone) Committee; Chairman
| | - Hillary W Garner
- Mayo Clinic Florida, Jacksonville, Florida; Committee Chair, Society of Skeletal Radiology and International Skeletal Society
| | - Courtney Hentz
- Stritch School of Medicine Loyola University Chicago, Maywood, Illinois; Commission on Radiation Oncology
| | - Valerae O Lewis
- University of Texas Health Science Center, Houston, Texas; American Academy of Orthopaedic Surgeons; Chair, Department of Orthopaedic Surgery
| | - Yi Lu
- Brigham & Women's Hospital & Harvard Medical School, Boston, Massachusetts; American Association of Neurological Surgeons/Congress of Neurological Surgeons; Director, Neurosurgical Trauma; Codirector, Spinal Deformity and Scoliosis Surgery Brigham and Women's Hospital; Cochair, Spinal Cord Injury Section, North American Spine Society; Chair, Payor Response
| | - Jennifer R Maynard
- Mayo Clinic Florida, Jacksonville, Florida; Primary care physician; Jacksonville Sports Medicine Program, Chair of the Governing Board; Program Director Sports Medicine Fellowship, Mayo Clinic Florida
| | - Jennifer L Pierce
- University of Virginia, Charlottesville, Virginia; Associate Division Chair, Musculoskeletal Radiology, University of Virginia; Radiology Residency Global Health Leadership Track Program Director, University of Virginia
| | - Jinel A Scott
- Chief Quality Officer, SUNY Downstate Health Sciences University, Brooklyn, New York
| | - Akash Sharma
- Mayo Clinic, Jacksonville, Florida; Commission on Nuclear Medicine and Molecular Imaging; Chair, Research Committee, Radiology, Mayo Clinic Florida; Chair, PET-MRI Workgroup, Mayo Clinic Florida
| | | |
Collapse
|
11
|
Choi S, Kim YI, Lee GD, Choi S, Kim HR, Kim YH, Kim DK, Park SI, Ryu JS. Diagnostic value of 18F-FDG PET/CT in discriminating between benign and malignant lesions of the ribs. Medicine (Baltimore) 2022; 101:e29867. [PMID: 35801734 PMCID: PMC9259158 DOI: 10.1097/md.0000000000029867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Imaging biomarkers for rib mass are needed to optimize treatment plan. We investigated the diagnostic value of metabolic and volumetric parameters from 18F-fluorodeoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT) in discriminating between benign and malignant lesions of the ribs. PATIENTS AND METHODS Fifty-seven patients with pathologically proven diagnosis of rib lesions were retrospectively enrolled. The size of rib lesions, the maximum, mean, and peak standardized uptake value (SUVmax, SUVmean, SUVpeak), tumor-to-background ratio (TBR), metabolic tumor volume (MTV), and total lesions glycolysis (TLG) were measured. The FDG uptake patterns (segmental and discrete) and CT findings (soft tissue involvement and fracture) were also reviewed. RESULTS Among the multiple parameters extracted from PET/CT, the MTV of malignant lesions was significantly higher than that of benign lesions (median; 4.7 vs 0.2, respectively, P = .041). In receiver operating characteristics curve analysis, MTV had the largest area under curve of 0.672 for differentiating malignant from benign lesions. For identifying malignant lesions, an MTV threshold of 0.5 had a sensitivity of 85.0%, specificity of 47.1%, positive predictive value of 79.1%, negative predictive value of 57.1%, and accuracy of 73.7%. The presence of adjacent soft tissue involvement around rib lesions showed a significant association with malignancy (odds ratio = 6.750; 95% CI, 1.837-24.802, P = .003). CONCLUSIONS The MTV is a useful PET/CT parameter for assisting in the differential diagnosis of suspected malignant lesions of the ribs. CT finding of adjacent soft tissue involvement around rib was significantly associated with malignant lesions of the ribs.
Collapse
Affiliation(s)
- Sunju Choi
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan college of Medicine, Seoul, Republic of Korea
- Department of Nuclear Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Yong-il Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan college of Medicine, Seoul, Republic of Korea
- *Correspondence: Yong-il Kim, Department of Nuclear Medicine, Asan Medical Center, University of Ulsan college of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea (e-mail: )
| | - Geun Dong Lee
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sehoon Choi
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyeong Ryul Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yong-Hee Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dong Kwan Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seung-Il Park
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jin-Sook Ryu
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan college of Medicine, Seoul, Republic of Korea
| |
Collapse
|
12
|
Menendez N, Epelman M, Shao L, Douglas D, Meyers AB. Pediatric Osteosarcoma: Pearls and Pitfalls. Semin Ultrasound CT MR 2022; 43:97-114. [PMID: 35164914 DOI: 10.1053/j.sult.2021.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Osteosarcoma is a malignant bone tumor most commonly presenting in children. It has a bimodal distribution with a peak incidence occurring during the ages of 10-14 years old and in adults greater than age 65. The first peak of osteosarcoma correlates with the increased proliferation of bone during the pubertal growth period. Osteosarcoma most frequently presents with localized bone pain, swelling, and an antalgic gait. The patient may attribute symptoms to trauma or strenuous exercise, causing the patient to be managed conservatively. In these cases, the pain persists and eventually leads to further evaluation. The most common type of osteosarcoma is the conventional high-grade osteosarcoma. For conventional osteosarcoma, the diagnosis is typically made or strongly suggested based upon the initial radiographic appearance. Other types of osteosarcomas include low grade central, telangiectatic, small-cell, surface and intracortical. Consequently, it is important for radiologists to be aware of these subtypes and the imaging features that differentiate them from other etiologies to prevent a delay in treatment.
Collapse
Affiliation(s)
- Nelson Menendez
- University of Central Florida College of Medicine, Orlando, FL; Department of Radiology, Nemours Children's Health System/Nemours Children's Hospital, Orlando, FL
| | - Monica Epelman
- University of Central Florida College of Medicine, Orlando, FL; Department of Radiology, Nemours Children's Health System/Nemours Children's Hospital, Orlando, FL
| | - Lei Shao
- University of Central Florida College of Medicine, Orlando, FL; Department of Pathology and Lab Medicine, Nemours Children's Health System/Nemours Children's Hospital, Orlando, FL
| | - Dorothea Douglas
- University of Central Florida College of Medicine, Orlando, FL; Department of Pediatrics, Nemours Children's Health System/Nemours Children's Hospital, Orlando, FL
| | - Arthur B Meyers
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Dept. of Radiology, Cincinnati, OH.
| |
Collapse
|
13
|
Ingley KM, Maleddu A, Grange FL, Gerrand C, Bleyer A, Yasmin E, Whelan J, Strauss SJ. Current approaches to management of bone sarcoma in adolescent and young adult patients. Pediatr Blood Cancer 2022; 69:e29442. [PMID: 34767314 DOI: 10.1002/pbc.29442] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/02/2021] [Accepted: 10/16/2021] [Indexed: 01/05/2023]
Abstract
Bone tumors are a group of histologically diverse diseases that occur across all ages. Two of the commonest, osteosarcoma (OS) and Ewing sarcoma (ES), are regarded as characteristic adolescent and young adult (AYA) cancers with an incidence peak in AYAs. They are curable for some but associated with unacceptably high rates of treatment failure and morbidity. The introduction of effective new therapeutics for bone sarcomas is slow, and to date, complex biology has been insufficiently characterized to allow more rapid therapeutic exploitation. This review focuses on current standards of care, recent advances that have or may soon change that standard of care and challenges to the expert clinical research community that we suggest must be met.
Collapse
Affiliation(s)
- Katrina M Ingley
- London Sarcoma Service, University College London Hospitals NHS Trust, London, UK
| | - Alessandra Maleddu
- London Sarcoma Service, University College London Hospitals NHS Trust, London, UK
| | - Franel Le Grange
- London Sarcoma Service, University College London Hospitals NHS Trust, London, UK
| | - Craig Gerrand
- London Sarcoma Service, Department of Orthopaedic Oncology, Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
| | - Archie Bleyer
- Oregon Health and Science University, Portland, Oregon
| | - Ephia Yasmin
- Reproductive Medicine Unit, University College London Hospitals NHS Trust, London, UK
| | - Jeremy Whelan
- London Sarcoma Service, University College London Hospitals NHS Trust, London, UK
| | - Sandra J Strauss
- London Sarcoma Service, University College London Hospitals NHS Trust, London, UK.,UCL Cancer Institute, London, UK
| |
Collapse
|
14
|
Camacho M, Carvalho M, Munhoz R, Etchebehere M, Etchebehere E. FDG PET/CT in bone sarcomas. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00062-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
15
|
Cheung H, Yechoor A, Behnia F, Abadi AB, Khodarahmi I, Soltanolkotabi M, Shafiei M, Chalian M. Common Skeletal Neoplasms and Nonneoplastic Lesions at 18F-FDG PET/CT. Radiographics 2021; 42:250-267. [PMID: 34919467 DOI: 10.1148/rg.210090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Numerous primary and metastatic osseous lesions and incidental osseous findings are encountered at fluorine 18 (18F) fluorodeoxyglucose (FDG) PET/CT. These lesions show varying degrees of FDG uptake. Malignancies are generally more FDG avid than are benign lesions, but many exceptions exist. Although aggressive lesions tend to be more FDG avid than nonaggressive lesions, this concept holds true particularly for lesions of the same histologic subtype. In addition, some benign osseous processes such as Paget disease have variable degrees of FDG avidity on the basis of disease metabolic activity. This creates a diagnostic dilemma for radiologists and clinicians, especially in patients with known malignancies, and can result in unnecessary diagnostic imaging or interventions for incidental osseous lesions. Evaluation of morphologic CT characteristics of osseous lesions at FDG PET/CT can be a valuable adjunct to metabolic analysis to further characterize lesions, enhance diagnostic and staging accuracy, and avoid unnecessary invasive biopsy procedures. The authors review the common primary and metastatic bone lesions at FDG PET/CT, with an emphasis on morphologic CT assessment of lesions to help narrow the differential diagnosis. Imaging manifestations of common incidental nonneoplastic bone lesions at FDG PET/CT are discussed to provide information on differentiation of these lesions from osseous neoplasms. The guidelines of the National Comprehensive Cancer Network (NCCN) for common primary osseous malignancies are also summarized. Online supplemental material is available for this article. ©RSNA, 2021.
Collapse
Affiliation(s)
- Hoiwan Cheung
- From the Department of Radiology, Divisions of Musculoskeletal Imaging and Intervention (H.C., A.Y., A.B.A., M. Shafiei, M.C.) and Nuclear Medicine (F.B.), University of Washington, UW Radiology-Roosevelt Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105; Department of Radiology, Division of Musculoskeletal Imaging, NYU Langone Health, New York, NY (I.K.); and Department of Radiology, Division of Musculoskeletal Imaging, University of Utah, Salt Lake City, Utah (M. Soltanolkotabi)
| | - Alekhya Yechoor
- From the Department of Radiology, Divisions of Musculoskeletal Imaging and Intervention (H.C., A.Y., A.B.A., M. Shafiei, M.C.) and Nuclear Medicine (F.B.), University of Washington, UW Radiology-Roosevelt Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105; Department of Radiology, Division of Musculoskeletal Imaging, NYU Langone Health, New York, NY (I.K.); and Department of Radiology, Division of Musculoskeletal Imaging, University of Utah, Salt Lake City, Utah (M. Soltanolkotabi)
| | - Fatemeh Behnia
- From the Department of Radiology, Divisions of Musculoskeletal Imaging and Intervention (H.C., A.Y., A.B.A., M. Shafiei, M.C.) and Nuclear Medicine (F.B.), University of Washington, UW Radiology-Roosevelt Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105; Department of Radiology, Division of Musculoskeletal Imaging, NYU Langone Health, New York, NY (I.K.); and Department of Radiology, Division of Musculoskeletal Imaging, University of Utah, Salt Lake City, Utah (M. Soltanolkotabi)
| | - Alireza Behrad Abadi
- From the Department of Radiology, Divisions of Musculoskeletal Imaging and Intervention (H.C., A.Y., A.B.A., M. Shafiei, M.C.) and Nuclear Medicine (F.B.), University of Washington, UW Radiology-Roosevelt Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105; Department of Radiology, Division of Musculoskeletal Imaging, NYU Langone Health, New York, NY (I.K.); and Department of Radiology, Division of Musculoskeletal Imaging, University of Utah, Salt Lake City, Utah (M. Soltanolkotabi)
| | - Iman Khodarahmi
- From the Department of Radiology, Divisions of Musculoskeletal Imaging and Intervention (H.C., A.Y., A.B.A., M. Shafiei, M.C.) and Nuclear Medicine (F.B.), University of Washington, UW Radiology-Roosevelt Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105; Department of Radiology, Division of Musculoskeletal Imaging, NYU Langone Health, New York, NY (I.K.); and Department of Radiology, Division of Musculoskeletal Imaging, University of Utah, Salt Lake City, Utah (M. Soltanolkotabi)
| | - Maryam Soltanolkotabi
- From the Department of Radiology, Divisions of Musculoskeletal Imaging and Intervention (H.C., A.Y., A.B.A., M. Shafiei, M.C.) and Nuclear Medicine (F.B.), University of Washington, UW Radiology-Roosevelt Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105; Department of Radiology, Division of Musculoskeletal Imaging, NYU Langone Health, New York, NY (I.K.); and Department of Radiology, Division of Musculoskeletal Imaging, University of Utah, Salt Lake City, Utah (M. Soltanolkotabi)
| | - Mehrzad Shafiei
- From the Department of Radiology, Divisions of Musculoskeletal Imaging and Intervention (H.C., A.Y., A.B.A., M. Shafiei, M.C.) and Nuclear Medicine (F.B.), University of Washington, UW Radiology-Roosevelt Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105; Department of Radiology, Division of Musculoskeletal Imaging, NYU Langone Health, New York, NY (I.K.); and Department of Radiology, Division of Musculoskeletal Imaging, University of Utah, Salt Lake City, Utah (M. Soltanolkotabi)
| | - Majid Chalian
- From the Department of Radiology, Divisions of Musculoskeletal Imaging and Intervention (H.C., A.Y., A.B.A., M. Shafiei, M.C.) and Nuclear Medicine (F.B.), University of Washington, UW Radiology-Roosevelt Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105; Department of Radiology, Division of Musculoskeletal Imaging, NYU Langone Health, New York, NY (I.K.); and Department of Radiology, Division of Musculoskeletal Imaging, University of Utah, Salt Lake City, Utah (M. Soltanolkotabi)
| |
Collapse
|
16
|
Abdella AEF, Elshafey KI, Sherif MF, Nagy HA. Diagnostic performance of PET/CT in primary malignant bone tumors. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00618-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Nowadays, PET/CT plays a substantial role in the diagnosis of different types of tumor by its ability to provide combined functional and anatomic imaging in the same session. The purpose of this study is to evaluate the added value of PET/CT in staging and re-staging of primary malignant bone tumors.
Results
Out of the studied 40 patients, 7 patients were referred for primary staging of different types of histologically proven primary malignant bone tumors, their FDG-PET/CT studies yielded additional diagnostic information in 28.6% of them. Thirty three patients were referred either for assessment of treatment response or for follow-up to detect any viable lesions; FDG-PET/CT was more sensitive and specific than CT in follow-up and assessment of treatment response with PET/CT sensitivity 94.4%, specificity 86.7%, and total accuracy 90.9% and CT sensitivity 88.2%, specificity 81.2%, and total accuracy 84.8%.
Conclusions
PET/CT was an accurate imaging modality in evaluation of primary malignant bone tumors regarding tumor staging, assessment of therapeutic response and detection of metastatic disease as compared to CT.
Collapse
|
17
|
Tilden W, Saifuddin A. An update on imaging of Paget's sarcoma. Skeletal Radiol 2021; 50:1275-1290. [PMID: 33386903 DOI: 10.1007/s00256-020-03682-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 02/02/2023]
Abstract
Paget's sarcoma is a rare and particularly aggressive tumour arising within pagetic bone, affecting approximately 1% of patients with Paget's disease during the course of their disease. Most of these tumours are osteosarcomas, but the age profile, skeletal distribution and clinical outcomes differ considerably from conventional osteosarcoma. In this review, we outline the clinical, radiographic/CT, scintigraphic and magnetic resonance imaging features of Paget's sarcoma. We also review the neoplastic and non-neoplastic mimics of Paget's sarcoma that should be considered in the differential diagnosis when encountering an aggressive lesion within pagetic bone.
Collapse
Affiliation(s)
- William Tilden
- Department of Radiology, The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK.
| | - Asif Saifuddin
- Department of Radiology, The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
| |
Collapse
|
18
|
Novel FAP ligands enable improved imaging contrast in sarcoma patients due to FAPI-PET/CT. Eur J Nucl Med Mol Imaging 2021; 48:3918-3924. [PMID: 34018010 PMCID: PMC8484190 DOI: 10.1007/s00259-021-05374-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/18/2021] [Indexed: 12/19/2022]
Abstract
Purpose A high expression of fibroblast activation protein (FAP) was observed in multiple sarcomas, indicating an enormous potential for PET/CT using 68Ga-radiolabeled inhibitors of FAP (FAPI). Therefore, this retrospective study aimed to evaluate the role of the novel hybrid imaging probe for sarcomas as a first clinical evaluation. Methods A cohort of 15 patients underwent 68Ga-FAPI-PET/CT for staging or restaging. The acquisition of PET scans was performed 60 min after administration of 127 to 308 MBq of the tracer. The uptake of 68Ga-FAPI in malignant tissue as well as in healthy organs was quantified by standardized uptake values SUVmean and SUVmax. Results Excellent tumor-to-background ratios (> 7) could be achieved due to low background activity and high SUVmax in primary tumors (median 7.16), local relapses (median 11.47), and metastases (median 6.29). The highest uptake was found for liposarcomas and high-grade disease (range 18.86–33.61). A high SUVmax (> 10) was observed for clinically more aggressive disease. Conclusion These preliminary findings suggest a high potential for the clinical use of 68Ga-FAPI-PET/CT for patients diagnosed with sarcoma.
Collapse
|
19
|
Staging and Classification of Primary Musculoskeletal Bone and Soft Tissue Tumors Based on the 2020 WHO Update, From the AJR Special Series on Cancer Staging. AJR Am J Roentgenol 2021; 217:1038-1052. [PMID: 33852362 DOI: 10.2214/ajr.21.25658] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Staging of primary musculoskeletal bone and soft tissue tumors is most commonly performed using the AJCC and the Enneking or Musculoskeletal Tumor Society (MSTS) staging systems. Radiologic imaging is integral in achieving adequate musculoskeletal neoplastic staging by defining lesion extent and identifying regional lymph node involvement and distant metastatic disease. Additional important features in surgical planning, though not distinct components of the staging systems, include cortical involvement, joint invasion, and neurovascular encasement; these features are optimally evaluated by MRI. In 2020, the WHO updated the classification of primary musculoskeletal tumors of soft tissue and bone. The update reflects the continued explosion in identification of novel gene alterations in many bone and soft tissue neoplasms. This has resulted in newly designated lesions, reclassification of lesion categories, and improved specificity of diagnosis. While radiologists do not need to have a comprehensive knowledge of the pathologic details, a broad working understanding of the most recent update is important to aid accurate and timely diagnosis given that histologic grading is a component of all staging systems. By approaching primary musculoskeletal neoplasms through a multidisciplinary approach with colleagues in pathology, orthopedic oncology, radiation oncology, and medical oncology, radiologists may promote improved diagnosis, treatment, and outcomes.
Collapse
|
20
|
Abstract
We present a review of several bone (osteoid)-forming tumors including enostosis, osteoid osteoma, osteoblastoma, and osteosarcoma. These entities were chosen because they are reasonably common-neither seen every day nor rare. When applicable, recent information about the lesions is included.
Collapse
Affiliation(s)
- Behrang Amini
- Department of Musculoskeletal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Raul Fernando Valenzuela
- Department of Musculoskeletal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Justin E Bird
- Department of Orthopaedic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tamara Miner Haygood
- Department of Musculoskeletal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
21
|
Slinkard PT, Randall EK, Griffin LR. Retrospective analysis of use of fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography ( 18F-FDG PET/CT) for detection of metastatic lymph nodes in dogs diagnosed with appendicular osteosarcoma. CANADIAN JOURNAL OF VETERINARY RESEARCH = REVUE CANADIENNE DE RECHERCHE VETERINAIRE 2021; 85:131-136. [PMID: 33883821 PMCID: PMC7995539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/03/2020] [Indexed: 06/12/2023]
Abstract
The purpose of this retrospective analysis was to determine if fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG PET/CT) could potentially be an accurate staging tool for detecting metastatic lymph nodes in dogs with appendicular osteosarcoma based on the quantitative measurement of the maximum standard uptake value (SUVmax) of lymph nodes. A total of 53 dogs were identified that presented for staging via 18F-FDG PET/CT for primary appendicular osteosarcoma. Patients were categorized according to lymph node status of having either metastatic or non-metastatic nodes based on cytological or histological analysis. Maximum standard uptake (SUVmax) values of the sampled lymph node(s) were recorded and 3/77 (3.9%) of sampled lymph nodes were confirmed metastatic. A Mann-Whitney test revealed a statistical difference in the SUVmax of the metastatic versus non-metastatic lymph nodes [median: 6.6 to 95% confidence interval (CI): 2.56 to 14.37 versus 2.18 95% CI: 2.32 to 3.17, respectively, P-value = 0.05]. This retrospective analysis revealed a significant difference in the SUVmax as measured on 18F-FDG PET/CT between metastatic lymph nodes and non-metastatic lymph nodes in canine patients afflicted with appendicular osteosarcoma, in spite of the small numbers analyzed. While these results are promising, they should be interpreted with caution and further studies are justified.
Collapse
Affiliation(s)
- Powell T Slinkard
- College of Veterinary Medicine and Biomedical Sciences (CVMBS) (Slinkard) and Department of Environmental and Radiological Health Sciences (ERHS) (Randall, Griffin), Colorado State University, Fort Collins, Colorado 80523, USA
| | - Elissa K Randall
- College of Veterinary Medicine and Biomedical Sciences (CVMBS) (Slinkard) and Department of Environmental and Radiological Health Sciences (ERHS) (Randall, Griffin), Colorado State University, Fort Collins, Colorado 80523, USA
| | - Lynn R Griffin
- College of Veterinary Medicine and Biomedical Sciences (CVMBS) (Slinkard) and Department of Environmental and Radiological Health Sciences (ERHS) (Randall, Griffin), Colorado State University, Fort Collins, Colorado 80523, USA
| |
Collapse
|
22
|
Filizoglu N, Engur CO, Turkoz HK, Ones T, Erdil TY. Calcified Adrenal Metastasis of High-Grade Osteosarcoma on FDG PET/CT. Clin Nucl Med 2021; 46:e176-e178. [PMID: 33208618 DOI: 10.1097/rlu.0000000000003395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
ABSTRACT Classic type of high-grade osteosarcoma is the most common type of skeletal malignancy in children and adolescents. Metastasis of osteosarcoma frequently occurs in the lung. Adrenal metastasis of osteosarcoma is extremely rare, with only few reported case in the literature. Herein, we present the case of a 13-year-old boy with adrenal metastasis of high-grade osteosarcoma, which was seen as a solitary calcified hypermetabolic adrenal lesion on FDG PET/CT.
Collapse
Affiliation(s)
| | | | - Huseyin Kemal Turkoz
- Pathology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Tunc Ones
- From the Departments of Nuclear Medicine
| | | |
Collapse
|
23
|
Rajakulasingam R, Attard V, Botchu R, James SL, Saifuddin A. The value of chest and skeletal staging in parosteal osteosarcoma: two-centre experience and literature review. Skeletal Radiol 2021; 50:301-309. [PMID: 32705301 DOI: 10.1007/s00256-020-03557-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/14/2020] [Accepted: 07/14/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the value of chest and skeletal staging in patients with parosteal osteosarcoma (POS), and the incidence of late local and chest recurrence. MATERIALS AND METHODS Retrospective review of patients across two institutions with histological confirmation of POS diagnosed between January 2007 and March 2020. Data collected included age, sex, skeletal location, results of chest CT and whole-body bone scintigraphy (WB-BSc) or whole-body MRI (WB-MRI) obtained at initial diagnosis. The histological tumour grade based on surgical resection specimens was classified as low-grade POS (LG-POS) and dedifferentiated POS (DD-POS). Findings of chest CT and skeletal staging were correlated with tumour grade. Follow-up chest CT and MRI studies were reviewed to determine the rate of late lung metastases and local recurrence. RESULTS There were 27 males and 44 females, mean age 33 years (range 12-79 years). The femur (n = 43) and tibia (n = 14) were the most commonly involved bones. From surgical resection histology, 42 (59.2%) were LG-POS and 29 (40.8%) were DD-POS. WB-BSc/WB-MRI showed no skeletal metastases, while 1 case of DD-POS presented with bilateral calcified lung metastases. At follow-up, 7 patients (9.9%) developed lung metastases (mean of 18.9 months, range 10-48 months) from initial presentation, of which all were DD-POS. All but 1 patient who developed subsequent lung metastases had a local recurrence. CONCLUSIONS Skeletal staging is unlikely to be of value in POS. Staging chest CT is very unlikely to demonstrate lung metastases in LG-POS and could be limited to DD-POS, particularly at the time of local recurrence.
Collapse
Affiliation(s)
- R Rajakulasingam
- Department of Medical Imaging, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
| | - V Attard
- Department of Medical Imaging, Mater Dei Hospital, Msida, MSD, 2090, Malta
| | - R Botchu
- Department of Medical Imaging, Royal Orthopaedic Hospital, The Woodlands, Bristol Road South, Birmingham, B31 2AP, UK
| | - S L James
- Department of Medical Imaging, Royal Orthopaedic Hospital, The Woodlands, Bristol Road South, Birmingham, B31 2AP, UK
| | - A Saifuddin
- Department of Medical Imaging, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| |
Collapse
|
24
|
Diffuse Increased 68Ga-DOTATATE But Unimpressive 18F-FDG Osseous Activity in a Patient With Rapid-Progressing Synchronous Multifocal Osteosarcoma. Clin Nucl Med 2020; 45:824-826. [PMID: 32796243 DOI: 10.1097/rlu.0000000000003228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Osteosarcoma is usually F-FDG-avid. Here we report a case of an 18-year-old young man with widespread osteoblastic and slight osteolytic changes, which had diffusely increased Ga-DOTATATE uptake in the osseous lesions, whereas the F-FDG PET/CT was unrevealing. The final diagnosis is synchronous multifocal osteosarcoma based on the pathological, clinical, and imaging features.
Collapse
|
25
|
Jia W, Song Y, Yang L, Kong J, Boczek T, He Z, Wang Y, Zhang X, Hu H, Shao D, Tang H, Xia L, Xu X, Guo F. The changes of serum zinc, copper, and selenium levels in epileptic patients: a systematic review and meta-analysis. Expert Rev Clin Pharmacol 2020; 13:1047-1058. [PMID: 32856976 DOI: 10.1080/17512433.2020.1816821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION It is widely accepted that trace elements have been implicated in various metabolic processes. Valproic acid (VPA) is a remarkably safe and effective antiepileptic drug. There is no consensus option regarding the fluctuations in serum zinc (Zn), copper (Cu), and selenium (Se) in epileptic patients treated with VPA. We applied a meta-analysis to systematically assess the effects of VPA on serum ions in these patients. AREAS COVERED In this study, we performed a meta-analysis of the changes in serum Zn, Cu, and Se levels in human samples of healthy controls, epileptic patients, and patients treated with VPA. Twenty-two published analyzable studies were selected by searching the databases of PubMed, China National Knowledge Infrastructure (CNKI), Google Scholar, Web of Science, EMBASE, WAN FANG and Vip. EXPERT OPINION Serum Se levels in epileptic patients were decreased compared to healthy controls. Serum Zn levels in patients with VPA treatment were significantly lower than those in epileptic patients. The results of this meta-analysis are instructive for the intake of trace elements such as Zn, Cu, and Se in the diet balance of patients with epilepsy treated with VPA. Meanwhile, this study provides a theoretical basis for the combined use of other drugs that affect the intake and absorption of trace elements and VPA.
Collapse
Affiliation(s)
- Wanying Jia
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University , Shenyang, China
| | - Yang Song
- School of Humanities and Social Sciences, China Medical University , Shenyang, China
| | - Lei Yang
- Tianjin Customs, Technical Center for Safety of Industrial Products , Tianjin, China
| | - Jingjing Kong
- Department of Gerontology, The First Affiliated Hospital of Dalian Medical University , Dalian, China
| | - Tomasz Boczek
- Department of Ophthalmology, Stanford University School of Medicine , Palo Alto, CA, USA
| | - Zhenwei He
- Department of Neurology, The Fourth Affiliated Hospital of China Medical University , Shenyang, China
| | - Yuting Wang
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University , Shenyang, China
| | - Xiaohong Zhang
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University , Shenyang, China
| | - Huiyuan Hu
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University , Shenyang, China
| | - Dongxue Shao
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University , Shenyang, China
| | - Hong Tang
- School of Public Health, China Medical University , Shenyang, China
| | - Liguang Xia
- Department of Pediatric Surgery, The Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, China
| | - Xiaoxue Xu
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University , Shenyang, China
| | - Feng Guo
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University , Shenyang, China
| |
Collapse
|
26
|
Chen B, Feng H, Xie J, Li C, Zhang Y, Wang S. Differentiation of soft tissue and bone sarcomas from benign lesions utilizing 18F-FDG PET/CT-derived parameters. BMC Med Imaging 2020; 20:85. [PMID: 32711449 PMCID: PMC7382845 DOI: 10.1186/s12880-020-00486-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/16/2020] [Indexed: 01/07/2023] Open
Abstract
Background Accurate differentiation between malignant and benign changes in soft tissue and bone lesions is essential for the prevention of unnecessary biopsies and surgical resection. Nevertheless, it remains a challenge and a standard diagnosis modality is urgently needed. The objective of this study was to evaluate the usefulness of 18F-fluorodeoxyglucose (18F-FDG) PET/CT-derived parameters to differentiate soft tissue sarcoma (STS) and bone sarcoma (BS) from benign lesions. Methods Patients who had undergone pre-treatment 18F-FDG PET/CT imaging and subsequent pathological diagnoses to confirm malignant (STS and BS, n = 37) and benign (n = 33) soft tissue and bone lesions were retrospectively reviewed. The tumor size, PET and low-dose CT visual characteristics, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and heterogeneous factor (HF) of each lesion were measured. Univariate and multivariate logistic regression analyses were conducted to determine the significant risk factors to distinguish sarcoma from benign lesions. To establish a regression model based on independent risk factors, and the receiver operating characteristic curves (ROCs) of individual parameters and their combination were plotted and compared. Conventional imaging scans were re-analyzed, and the diagnostic performance compared with the regression model. Results Univariate analysis results revealed that tumor size, SUVmax, MTV, TLG, and HF of 18F-FDG PET/CT imaging in the STS and BS group were all higher than in the benign lesions group (all P values were < 0.01). The differences in the visual characteristics between the two groups were also all statistically significant (P < 0.05). However, the multivariate regression model only included SUVmax and HF as independent risk factors, for which the odds ratios were 1.135 (95%CI: 1.026 ~ 1.256, P = 0.014) and 7.869 (95%CI: 2.119 ~ 29.230, P = 0.002), respectively. The regression model was constructed using the following expression: Logit (P) = − 2.461 + 0.127SUVmax + 2.063HF. The area under the ROC was 0.860, which was higher than SUVmax (0.744) and HF (0.790). The diagnostic performance of the regression model was superior to those of individual parameters and conventional imaging. Conclusion The regression model including SUVmax and HF based on 18F-FDG PET/CT imaging may be useful for differentiating STS and BS from benign lesions.
Collapse
Affiliation(s)
- Bo Chen
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Shahekou district, Zhongshan road, NO.467, Dalian, Liaoning Province, People's Republic of China.,Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Xigang district, Zhongshan road, No.222, Dalian, China
| | - Hongbo Feng
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Xigang district, Zhongshan road, No.222, Dalian, China
| | - Jinghui Xie
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Xigang district, Zhongshan road, No.222, Dalian, China
| | - Chun Li
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Xigang district, Zhongshan road, No.222, Dalian, China
| | - Yu Zhang
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Shahekou district, Zhongshan road, NO.467, Dalian, Liaoning Province, People's Republic of China
| | - Shaowu Wang
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Shahekou district, Zhongshan road, NO.467, Dalian, Liaoning Province, People's Republic of China.
| |
Collapse
|
27
|
Italiano A, Mir O, Mathoulin-Pelissier S, Penel N, Piperno-Neumann S, Bompas E, Chevreau C, Duffaud F, Entz-Werlé N, Saada E, Ray-Coquard I, Lervat C, Gaspar N, Marec-Berard P, Pacquement H, Wright J, Toulmonde M, Bessede A, Crombe A, Kind M, Bellera C, Blay JY. Cabozantinib in patients with advanced Ewing sarcoma or osteosarcoma (CABONE): a multicentre, single-arm, phase 2 trial. Lancet Oncol 2020; 21:446-455. [PMID: 32078813 DOI: 10.1016/s1470-2045(19)30825-3] [Citation(s) in RCA: 153] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/23/2019] [Accepted: 12/10/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Patients with Ewing sarcoma or osteosarcoma have a median overall survival of less than 12 months after diagnosis, and a standard treatment strategy has not yet been established. Pharmacological inhibition of MET signalling and aberrant angiogenesis has shown promising results in several preclinical models of Ewing sarcoma and osteosarcoma. We aimed to investigate the activity of cabozantinib, an inhibitor of MET and VEGFR2, in patients with advanced Ewing sarcoma and osteosarcoma. METHODS We did a multicentre, single-arm, two-stage, phase 2 trial in patients with advanced Ewing sarcoma or osteosarcoma recruited from ten centres in the French Sarcoma Group. Key eligibility criteria were aged 12 years or older, Eastern Cooperative Oncology Group performance status of 0-1, and documented disease progression (according to Response Evaluation Criteria in Solid Tumors version 1.1) before study entry. The number of previous lines of treatment was not limited. Patients received cabozantinib (adults 60 mg, children [<16 years] 40 mg/m2) orally once daily in 28-day cycles until disease progression, unacceptable toxicity, the investigator's decision to discontinue, or participant withdrawal. The primary endpoint for Ewing sarcoma was best objective response within 6 months of treatment onset; for osteosarcoma, a dual primary endpoint of 6-month objective response and 6-month non-progression was assessed. All enrolled patients who received at least one dose of cabozantinib were included in the safety analysis, and all participants who received at least one complete or two incomplete treatment cycles were included in the efficacy population. This study was registered with ClinicalTrials.gov, number NCT02243605. FINDINGS Between April 16, 2015, and July 12, 2018, 90 patients (45 with Ewing sarcoma 45 with osteosarcoma) were recruited to the study. Median follow-up was 31·3 months (95% CI 12·4-35·4) for patients with Ewing sarcoma and 31·1 months (24·4-31·7) for patients with osteosarcoma. 39 (87%) patients with Ewing sarcoma and 42 (93%) patients with osteosarcoma were assessable for efficacy after histological and radiological review. In patients with Ewing sarcoma, ten (26%; 95% CI 13-42) of 39 patients had an objective response (all partial responses) by 6 months; in patients with osteosarcoma, five (12%; 4-26) of 42 patients had an objective response (all partial responses) and 14 (33%; 20-50) had 6-month non-progression. The most common grade 3 or 4 adverse events were hypophosphataemia (five [11%] for Ewing sarcoma, three [7%] for osteosarcoma), aspartate aminotransferase increase (two [4%] for Ewing sarcoma, three [7%] for osteosarcoma), palmar-plantar syndrome (three [7%] for Ewing sarcoma, two [4%] for osteosarcoma), pneumothorax (one [2%] for Ewing sarcoma, four [9%] for osteosarcoma), and neutropenia (two [4%] for Ewing sarcoma, four [9%] for osteosarcoma). At least one serious adverse event was reported in 61 (68%) of 90 patients. No patients died from drug-related toxic effects. INTERPRETATION Cabozantinib has antitumor activity in patients with advanced Ewing sarcoma and osteosarcoma and was generally well tolerated. Cabozantinib could represent a new therapeutic option in this setting, and deserves further investigation. FUNDING Institut Bergonié; French National Cancer Institute; Association pour la Recherche contre le Cancer.
Collapse
Affiliation(s)
- Antoine Italiano
- Early Phase Trials and Sarcoma Unit, Institut Bergonié, Bordeaux, France; University of Bordeaux, Bordeaux, France.
| | - Olivier Mir
- Department of Medicine, Institut Gustave Roussy, Villejuif, France
| | - Simone Mathoulin-Pelissier
- Unité d'épidémiologie et de recherche cliniques, Institut Bergonié, Bordeaux, France; Inserm UMR 1219, Équipe Epicene, Bordeaux, France; Inserm CIC-EC 1401, Bordeaux, France
| | - Nicolas Penel
- Department of Medical Oncology, Centre Oscar Lambret, University of Lille, Lille, France
| | | | - Emmanuelle Bompas
- Department of Medicine, Institut Cancerologie de l'Ouest, Nantes, France
| | | | - Florence Duffaud
- Department of Medical Oncology, Assistance Publique des Hôpitaux de Marseille, Hôpital La Timone, Marseille, France
| | - Natacha Entz-Werlé
- Department of Tumor Pediatrics, University Hospital Centre of Strasbourg, Strasbourg, France
| | - Esma Saada
- Department of Medicine, Centre Antoine Lacassagne, Nice, France
| | | | - Cyril Lervat
- Department of Tumor Pediatrics, Centre Oscar Lambret, University of Lille, Lille, France
| | - Nathalie Gaspar
- Department of Tumor Pediatrics, Institut Gustave Roussy, Villejuif, France
| | | | | | - John Wright
- Cancer Therapy Evaluation Program (CTEP), Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD, USA
| | - Maud Toulmonde
- Early Phase Trials and Sarcoma Unit, Institut Bergonié, Bordeaux, France
| | | | | | | | - Carine Bellera
- Unité d'épidémiologie et de recherche cliniques, Institut Bergonié, Bordeaux, France; Inserm CIC-EC 1401, Bordeaux, France
| | - Jean-Yves Blay
- Department of Medicine, Centre Leon Berard, Lyon, France
| |
Collapse
|
28
|
Incidental Detection of a Giant Fecaloma on 18F-FDG PET/CT. Clin Nucl Med 2020; 45:83-84. [DOI: 10.1097/rlu.0000000000002805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|