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Lo HZ, Choy KT, Kong JCH. FDG-PET/MRI in colorectal cancer care: an updated systematic review. Abdom Radiol (NY) 2024:10.1007/s00261-024-04460-z. [PMID: 39073608 DOI: 10.1007/s00261-024-04460-z] [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: 04/23/2024] [Revised: 06/11/2024] [Accepted: 06/15/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE Since its introduction in 2011, FDG-PET/MRI has been advocated as a useful adjunct in colorectal cancer care. However, gaps and limitations in current research remain. This systematic review aims to review the current literature to quantify the utility of FDG-PET/MRI in colorectal cancer care. METHODS An up-to-date review was performed on the available literature between 2000 and 2023 on PubMed, EMBASE, Medline, databases. All studies reporting on the use of FDG-PET/MRI in colorectal cancer care were analyzed. The main outcome measures were accuracy in initial staging, restaging, and detection of metastatic disease in both rectal as well as colon cancers. The secondary outcome was comparing the performance of FDG-PET/MRI versus Standard of Care Imaging (SCI). Finally, the clinical significance of FDG-PET/MRI was measured in the change in management resulting from imaging findings. RESULTS A total of 22 observational studies were included, accounting for 988 patients. When individually compared to current Standard of Care Imaging (SCI)-MRI pelvis for rectal cancer and thoraco-abdominal contrast CT, PET/MRI proved superior in terms of distant metastatic disease detection. This led to as much as 21.0% change in management. However, the technological limitations of PET/MRI were once again highlighted, suggesting SCI should retain its place as first-line imaging. CONCLUSION FDG-PET/MRI appears to be a promising adjunct in staging and restaging of colorectal cancer in carefully selected patients.
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Affiliation(s)
- Hui Zhen Lo
- School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
| | - Kay Tai Choy
- Department of Surgery, Austin Health, Melbourne, VIC, Australia
| | - Joseph Cherng Huei Kong
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Division of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
- Department of Colorectal Surgery, Alfred Hospital, Melbourne, VIC, Australia
- Central Clinical School, Monash University, Melbourne, VIC, Australia
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Maksim R, Buczyńska A, Sidorkiewicz I, Krętowski AJ, Sierko E. Imaging and Metabolic Diagnostic Methods in the Stage Assessment of Rectal Cancer. Cancers (Basel) 2024; 16:2553. [PMID: 39061192 PMCID: PMC11275086 DOI: 10.3390/cancers16142553] [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: 06/10/2024] [Revised: 07/04/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Rectal cancer (RC) is a prevalent malignancy with significant morbidity and mortality rates. The accurate staging of RC is crucial for optimal treatment planning and patient outcomes. This review aims to summarize the current literature on imaging and metabolic diagnostic methods used in the stage assessment of RC. Various imaging modalities play a pivotal role in the initial evaluation and staging of RC. These include magnetic resonance imaging (MRI), computed tomography (CT), and endorectal ultrasound (ERUS). MRI has emerged as the gold standard for local staging due to its superior soft tissue resolution and ability to assess tumor invasion depth, lymph node involvement, and the presence of extramural vascular invasion. CT imaging provides valuable information about distant metastases and helps determine the feasibility of surgical resection. ERUS aids in assessing tumor depth, perirectal lymph nodes, and sphincter involvement. Understanding the strengths and limitations of each diagnostic modality is essential for accurate staging and treatment decisions in RC. Furthermore, the integration of multiple imaging and metabolic methods, such as PET/CT or PET/MRI, can enhance diagnostic accuracy and provide valuable prognostic information. Thus, a literature review was conducted to investigate and assess the effectiveness and accuracy of diagnostic methods, both imaging and metabolic, in the stage assessment of RC.
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Affiliation(s)
- Rafał Maksim
- Department of Radiotherapy, Maria Skłodowska-Curie Białystok Oncology Center, 15-027 Bialystok, Poland;
| | - Angelika Buczyńska
- Clinical Research Centre, Medical University of Bialystok, 15-276 Bialystok, Poland; (A.B.); (A.J.K.)
| | - Iwona Sidorkiewicz
- Clinical Research Support Centre, Medical University of Bialystok, 15-276 Bialystok, Poland;
| | - Adam Jacek Krętowski
- Clinical Research Centre, Medical University of Bialystok, 15-276 Bialystok, Poland; (A.B.); (A.J.K.)
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Ewa Sierko
- Department of Oncology, Medical University of Bialystok, 15-276 Bialystok, Poland
- Department of Radiotherapy I, Maria Sklodowska-Curie Bialystok Oncology Centre, 15-027 Bialystok, Poland
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Hajjafari A, Sadr S, Rahdar A, Bayat M, Lotfalizadeh N, Dianaty S, Rezaei A, Moghaddam SP, Hajjafari K, Simab PA, Kharaba Z, Borji H, Pandey S. Exploring the integration of nanotechnology in the development and application of biosensors for enhanced detection and monitoring of colorectal cancer. INORG CHEM COMMUN 2024; 164:112409. [DOI: 10.1016/j.inoche.2024.112409] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2024]
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4
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Rohan T, Hložanka P, Dostál M, Macek T, Fojtík Z, Šprláková-Puková A, Keřkovský M. Significance of F-18 FDG PET/MRI in the search for the etiology of inflammation of unclear origin and fever of unknown origin. Eur J Radiol 2024; 171:111281. [PMID: 38219354 DOI: 10.1016/j.ejrad.2023.111281] [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: 03/23/2023] [Revised: 11/07/2023] [Accepted: 12/28/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE To evaluate the contribution of F-18 FDG-PET/MRI in the search for the etiology of the inflammation of unknown origin (IUO) and fever of unknown origin (FUO). MATERIAL AND METHODS The study included 104 patients who underwent F-18 FDG-PET/MRI for IUO or FUO. The sensitivity, specificity, predictive values of the PET/MRI findings in relation to the final diagnosis of IUO/FUO were evaluated. A five-point Likert scale was used to semiquantitatively assess the probability of the cause of IUO/FUO based on PET/MRI finding. Furthermore, clinical (fever, arthralgia, weight loss, night sweats, age) and laboratory (C-reactive protein, leukocytes) parameters were monitored and compared with the true positivity rate of PET/MRI. RESULTS In patients with definitively identified etiology of FUO and IUO, FDG-PET/MRI achieved a sensitivity of 96 %, specificity of 82 %, and positive and negative predictive values of 92 and 90 %. The cause of the IUO was determined in 71 patients (68.3 %). In 33 (31.7 %) patients, the etiology of IUO/FUO remained unknown, while in 25 (75.8 %) of them the symptoms resolved spontaneously and in 8 (24.2 %) patients they persisted without explanation even after 12 months of the follow-up. The most significant parameter in relation to subsequent PET/MRI finding was increased level of CRP, which was present in 96 % of true positive PET/MRI and normal CRP level was present in 56 % of true negative PET/MRI. CONCLUSION Based on this study, FDG-PET/MRI is a suitable alternative for the investigation of IUO/FUO, this imaging technique has a very high sensitivity and negative predictive value.
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Affiliation(s)
- Tomáš Rohan
- Department of Radiology and Nuclear Medicine, University Hospital Brno, Brno 625 00, Czechia; Department of Radiology and Nuclear Medicine, Medical Faculty, Masaryk University, Brno 625 00, Czechia
| | - Petr Hložanka
- Department of Radiology and Nuclear Medicine, University Hospital Brno, Brno 625 00, Czechia
| | - Marek Dostál
- Department of Radiology and Nuclear Medicine, University Hospital Brno, Brno 625 00, Czechia; Department of Biophysics, Medical Faculty, Masaryk University, Brno 625 00, Czechia.
| | - Tomáš Macek
- Department of Radiology and Nuclear Medicine, University Hospital Brno, Brno 625 00, Czechia; Department of Radiology and Nuclear Medicine, Medical Faculty, Masaryk University, Brno 625 00, Czechia
| | - Zdeněk Fojtík
- Internal Hematology and Oncology Clinic, University Hospital Brno, Brno 625 00, Czechia; Department of Internal Medicine, Hematology and Oncology, Medical Faculty, Masaryk University, Brno 625 00, Czechia
| | - Andrea Šprláková-Puková
- Department of Radiology and Nuclear Medicine, University Hospital Brno, Brno 625 00, Czechia; Department of Radiology and Nuclear Medicine, Medical Faculty, Masaryk University, Brno 625 00, Czechia
| | - Miloš Keřkovský
- Department of Radiology and Nuclear Medicine, University Hospital Brno, Brno 625 00, Czechia; Department of Radiology and Nuclear Medicine, Medical Faculty, Masaryk University, Brno 625 00, Czechia
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Jayaprakasam VS, Ince S, Suman G, Nepal P, Hope TA, Paspulati RM, Fraum TJ. PET/MRI in colorectal and anal cancers: an update. Abdom Radiol (NY) 2023; 48:3558-3583. [PMID: 37062021 DOI: 10.1007/s00261-023-03897-y] [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: 02/06/2023] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 04/17/2023]
Abstract
Positron emission tomography (PET) in the era of personalized medicine has a unique role in the management of oncological patients and offers several advantages over standard anatomical imaging. However, the role of molecular imaging in lower GI malignancies has historically been limited due to suboptimal anatomical evaluation on the accompanying CT, as well as significant physiological 18F-flurodeoxyglucose (FDG) uptake in the bowel. In the last decade, technological advancements have made whole-body FDG-PET/MRI a feasible alternative to PET/CT and MRI for lower GI malignancies. PET/MRI combines the advantages of molecular imaging with excellent soft tissue contrast resolution. Hence, it constitutes a unique opportunity to improve the imaging of these cancers. FDG-PET/MRI has a potential role in initial diagnosis, assessment of local treatment response, and evaluation for metastatic disease. In this article, we review the recent literature on FDG-PET/MRI for colorectal and anal cancers; provide an example whole-body FDG-PET/MRI protocol; highlight potential interpretive pitfalls; and provide recommendations on particular clinical scenarios in which FDG-PET/MRI is likely to be most beneficial for these cancer types.
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Affiliation(s)
- Vetri Sudar Jayaprakasam
- Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
| | - Semra Ince
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Garima Suman
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Pankaj Nepal
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Thomas A Hope
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, CA, USA
| | | | - Tyler J Fraum
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
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Sabeghi P, Katal S, Chen M, Taravat F, Werner TJ, Saboury B, Gholamrezanezhad A, Alavi A. Update on Positron Emission Tomography/Magnetic Resonance Imaging: Cancer and Inflammation Imaging in the Clinic. Magn Reson Imaging Clin N Am 2023; 31:517-538. [PMID: 37741639 DOI: 10.1016/j.mric.2023.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
Hybrid PET/MRI is highly valuable, having made significant strides in overcoming technical challenges and offering unique advantages such as reduced radiation, precise data coregistration, and motion correction. Growing evidence highlights the value of PET/MRI in broad clinical aspects, including inflammatory and oncological imaging in adults, pregnant women, and pediatrics, potentially surpassing PET/CT. This newly integrated solution may be preferred over PET/CT in many clinical conditions. However, further technological advancements are required to facilitate its broader adoption as a routine diagnostic modality.
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Affiliation(s)
- Paniz Sabeghi
- Department of Radiology, Keck School of Medicine of University of Southern California, Health Science Campus, 1500 San Pablo Street, Los Angeles, CA 90033, USA
| | - Sanaz Katal
- Medical Imaging Department of St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - Michelle Chen
- Department of Radiology, Keck School of Medicine of University of Southern California, Health Science Campus, 1500 San Pablo Street, Los Angeles, CA 90033, USA
| | - Farzaneh Taravat
- Department of Radiology, Keck School of Medicine of University of Southern California, Health Science Campus, 1500 San Pablo Street, Los Angeles, CA 90033, USA
| | - Thomas J Werner
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Babak Saboury
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine of University of Southern California, Health Science Campus, 1500 San Pablo Street, Los Angeles, CA 90033, USA
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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7
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Chen MZ, Zhang X, Mui M, Kong JCH, Heriot AG, Ellis-Clark J. Retrospective audit: Utility of PET scan in routine preoperative rectal cancer staging. ANZ J Surg 2023; 93:617-621. [PMID: 36117452 DOI: 10.1111/ans.18058] [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: 08/06/2022] [Revised: 08/30/2022] [Accepted: 09/02/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Accurate staging for rectal cancer is pertinent with recent introduction of rectum-sparing approaches for patients showing complete clinical response on restaging. Positron emission tomography(PET) is used in detection of recurrence or metastasis, but its value in routine preoperative rectal cancer staging remains unclear. Studies report that preoperative PET altered the stage in 39% and changed the management in 17-27% of patients. Our study aims to look at the utility of PET in routine preoperative staging of rectal cancer within 2 two colorectal units, and to determine if PET did result in a change in management. METHODS Patients in Nepean Hospital (NSW) and Peter MacCallum Cancer Centre (VIC) who were diagnosed with rectal cancer between 1 January 2017 and 31 December 2021 were included in this retrospective study. All patients who did not have a PET scan were excluded. PET scan results were then compared with MRI and CT results. RESULTS Three hundred and fifty-seven patients were included in the study. 30.3% of the patients had Stage 3 rectal cancer. 71.7% received neoadjuvant therapy. PET scan provided additional information in 55.5% of patients when compared with CT and MRI alone; 18.2% of the PET findings resulted in an altered management for the patient. CONCLUSION PET scan can be a valuable tool in accurate staging, especially for ambiguous or equivocal lesions on CT. Our study demonstrated that additional information from PET scan resulted in an altered management plan in 18.2% of the patients. PET/MRI as a newer modality may be more accurate with reduced radiation exposure.
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Affiliation(s)
- Michelle Zhiyun Chen
- Department of Colorectal Surgery, Nepean Hospital, Kingswood, New South Wales, Australia
| | - Xinyi Zhang
- Department of Colorectal Surgery, Nepean Hospital, Kingswood, New South Wales, Australia
| | - Milton Mui
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Joseph C H Kong
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Division of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
- Department of Surgery, Central Clinical School, Monash University, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Alexander G Heriot
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Division of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Jodie Ellis-Clark
- Department of Colorectal Surgery, Nepean Hospital, Kingswood, New South Wales, Australia
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8
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Rooney S, Meyer J, Afzal Z, Ashcroft J, Cheow H, De Paepe KN, Powar M, Simillis C, Wheeler J, Davies J, Joshi H. The Role of Preoperative Imaging in the Detection of Lateral Lymph Node Metastases in Rectal Cancer: A Systematic Review and Diagnostic Test Meta-analysis. Dis Colon Rectum 2022; 65:1436-1446. [PMID: 36102825 DOI: 10.1097/dcr.0000000000002537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Different techniques exist for the imaging of lateral lymph nodes in rectal cancer. OBJECTIVE This study aimed to compare the diagnostic accuracy of pelvic MRI, 18 F-FDG-PET/CT, and 18 F-FDG-PET/MRI for the identification of lateral lymph node metastases in rectal cancer. DATA SOURCES Data sources include PubMed, Embase, Cochrane Library, and Google Scholar. STUDY SELECTION All studies evaluating the diagnostic accuracy of pelvic MRI, 18 F-FDG-PET/CT, and 18 F-FDG-PET/MRI for the preoperative detection of lateral lymph node metastasis in patients with rectal cancer were selected. INTERVENTIONS The interventions were pelvic MRI, 18 F-FDG-PET/CT, and/or 18 F-FDG-PET/MRI. MAIN OUTCOME MEASURES Definitive histopathology was used as a criterion standard. RESULTS A total of 20 studies (1,827 patients) were included out of an initial search yielding 7,360 studies. The pooled sensitivity of pelvic MRI was 0.88 (95% CI, 0.85-0.91), of 18 F-FDG-PET/CT was 0.83 (95% CI, 0.80-0.86), and of 18 F-FDG-PET/MRI was 0.72 (95% CI, 0.51-0.87) for the detection of lateral lymph node metastasis. The pooled specificity of pelvic MRI was 0.85 (95% CI, 0.78-0.90), of 18 F-FDG-PET/CT was 0.95 (95% CI, 0.86-0.98), and of 18 F-FDG-PET/MRI was 0.90 (95% CI, 0.78-0.96). The area under the curve was 0.88 (95% CI, 0.85-0.91) for pelvic MRI and was 0.83 (95% CI, 0.80-0.86) for 18 F-FDG-PET/CT. LIMITATIONS Heterogeneity in terms of patients' populations, definitions of suspect lateral lymph nodes, and administration of neoadjuvant treatment. CONCLUSIONS For the preoperative identification of lateral lymph node metastasis in rectal cancer, this review found compelling evidence that pelvic MRI should constitute the imaging modality of choice. In contrast, to confirm the presence of lateral lymph node metastasis, 18 F-FDG-PET/MRI modalities allow discarding false positive cases because of increased specificity. PROSPERO REGISTRATION NUMBER CRD42020200319.
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Affiliation(s)
- Siobhan Rooney
- Department of Surgery, Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Jeremy Meyer
- Department of Surgery, Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Division of Digestive Surgery, University Hospitals of Geneva, Geneva, Switzerland
- Medical School, University of Geneva, Geneva, Switzerland
| | - Zeeshan Afzal
- Department of Surgery, Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - James Ashcroft
- Department of Surgery, Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Heok Cheow
- Department of Nuclear Medicine/Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Katja N De Paepe
- Department of Nuclear Medicine/Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Michael Powar
- Department of Surgery, Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Constantinos Simillis
- Department of Surgery, Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - James Wheeler
- Department of Surgery, Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Justin Davies
- Department of Surgery, Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Medical School, University of Cambridge, United Kingdom
| | - Heman Joshi
- Department of Surgery, Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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Xu J, Zhao M, Huang S, Wu Q, Bai M, Zhao X, Wang J, Hu Y, Feng J, Zhang Z. RETRACTED ARTICLE: RINT1 is a new suppression target to reduce colon cancer cell growth, migration and invasion through regulating ZW10/NAG-1 expression. Mol Cell Biochem 2022; 477:2683. [PMID: 32754874 PMCID: PMC9618504 DOI: 10.1007/s11010-020-03858-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/24/2020] [Indexed: 02/04/2023]
Affiliation(s)
- Jinheng Xu
- Department of Pathology, Tangshan Gongren Hospital, Lubei District, No. 27 Wenhua Road, Tangshan, 063000, Hebei, China
| | - Meng Zhao
- Department of Pathology, Tangshan Gongren Hospital, Lubei District, No. 27 Wenhua Road, Tangshan, 063000, Hebei, China
| | - Shunxian Huang
- Department of Biological Science, College of Life and Environmental Sciences, Minzu University of China, Beijing, 100081, China
| | - Qian Wu
- Department of Pathology, Tangshan Gongren Hospital, Lubei District, No. 27 Wenhua Road, Tangshan, 063000, Hebei, China
| | - Minghe Bai
- Department of Pathology, Tangshan Gongren Hospital, Lubei District, No. 27 Wenhua Road, Tangshan, 063000, Hebei, China
| | - Xueli Zhao
- Department of Pathology, Tangshan Gongren Hospital, Lubei District, No. 27 Wenhua Road, Tangshan, 063000, Hebei, China
| | - Jixian Wang
- Department of Pathology, Tangshan Gongren Hospital, Lubei District, No. 27 Wenhua Road, Tangshan, 063000, Hebei, China
| | - Yueming Hu
- Department of Pathology, Tangshan Gongren Hospital, Lubei District, No. 27 Wenhua Road, Tangshan, 063000, Hebei, China
| | - Junwei Feng
- Department of Oncological Surgery, Tangshan Gongren Hospital, Lubei District, No. 27 Wenhua Road, Tangshan, 063000, Hebei, China
| | - Zhiyong Zhang
- Department of Pathology, Tangshan Gongren Hospital, Lubei District, No. 27 Wenhua Road, Tangshan, 063000, Hebei, China.
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SM-SegNet: A Lightweight Squeeze M-SegNet for Tissue Segmentation in Brain MRI Scans. SENSORS 2022; 22:s22145148. [PMID: 35890829 PMCID: PMC9319649 DOI: 10.3390/s22145148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/02/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022]
Abstract
In this paper, we propose a novel squeeze M-SegNet (SM-SegNet) architecture featuring a fire module to perform accurate as well as fast segmentation of the brain on magnetic resonance imaging (MRI) scans. The proposed model utilizes uniform input patches, combined-connections, long skip connections, and squeeze-expand convolutional layers from the fire module to segment brain MRI data. The proposed SM-SegNet architecture involves a multi-scale deep network on the encoder side and deep supervision on the decoder side, which uses combined-connections (skip connections and pooling indices) from the encoder to the decoder layer. The multi-scale side input layers support the deep network layers' extraction of discriminative feature information, and the decoder side provides deep supervision to reduce the gradient problem. By using combined-connections, extracted features can be transferred from the encoder to the decoder resulting in recovering spatial information, which makes the model converge faster. Long skip connections were used to stabilize the gradient updates in the network. Owing to the adoption of the fire module, the proposed model was significantly faster to train and offered a more efficient memory usage with 83% fewer parameters than previously developed methods, owing to the adoption of the fire module. The proposed method was evaluated using the open-access series of imaging studies (OASIS) and the internet brain segmentation registry (IBSR) datasets. The experimental results demonstrate that the proposed SM-SegNet architecture achieves segmentation accuracies of 95% for cerebrospinal fluid, 95% for gray matter, and 96% for white matter, which outperforms the existing methods in both subjective and objective metrics in brain MRI segmentation.
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11
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Future of Alzheimer’s Disease: Nanotechnology-Based Diagnostics and Therapeutic Approach. BIONANOSCIENCE 2022. [DOI: 10.1007/s12668-022-00998-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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12
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Boktor RR, Lee ST, Scott AM. PET/CT imaging in colorectal carcinoma. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00033-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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13
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Malviya G, Siow B. Hybrid PET/MR systems. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00145-9] [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
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14
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Zhang S, Yu M, Chen D, Li P, Tang B, Li J. Role of MRI‑based radiomics in locally advanced rectal cancer (Review). Oncol Rep 2021; 47:34. [PMID: 34935061 PMCID: PMC8717123 DOI: 10.3892/or.2021.8245] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/29/2021] [Indexed: 12/12/2022] Open
Abstract
Colorectal cancer is the third most common type of cancer, with high morbidity and mortality rates. In particular, locally advanced rectal cancer (LARC) is difficult to treat and has a high recurrence rate. Neoadjuvant chemoradiotherapy (NCRT) is one of the standard treatment programs of LARC. If the response to treatment and prognosis in patients with LARC can be predicted, it will guide clinical decision‑making. Radiomics is characterized by the extraction of high‑dimensional quantitative features from medical imaging data, followed by data analysis and model construction, which can be used for tumor diagnosis, staging, prediction of treatment response and prognosis. In recent years, a number of studies have assessed the role of radiomics in NCRT for LARC. MRI‑based radiomics provides valuable data and is expected to become an imaging biomarker for predicting treatment response and prognosis. The potential of radiomics to guide personalized medicine is widely recognized; however, current limitations and challenges prevent its application to clinical decision‑making. The present review summarizes the applications, limitations and prospects of MRI‑based radiomics in LARC.
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Affiliation(s)
- Siyu Zhang
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610041, P.R. China
| | - Mingrong Yu
- College of Physical Education, Sichuan Agricultural University, Ya'an, Sichuan 625000, P.R. China
| | - Dan Chen
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610041, P.R. China
| | - Peidong Li
- Second Department of Gastrointestinal Surgery, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Bin Tang
- Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, Sichuan 610041, P.R. China
| | - Jie Li
- Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, Sichuan 610041, P.R. China
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Drami I, Lord AC, Sarmah P, Baker RP, Daniels IR, Boyle K, Griffiths B, Mohan HM, Jenkins JT. Preoperative assessment and optimisation for pelvic exenteration in locally advanced and recurrent rectal cancer: A review. Eur J Surg Oncol 2021; 48:2250-2257. [PMID: 34922810 DOI: 10.1016/j.ejso.2021.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 01/06/2023] Open
Abstract
The pre-operative phase in planning a pelvic exenteration or extended resections is critical to optimising patient outcomes. This review summarises the key components of preoperative assessment and planning in patients with locally advanced rectal cancer (LARC) and locally recurrent rectal cancer (LLRC) being considered for potential curative resection. The preoperative period can be considered in 5 key phases: 1) Multidisciplinary meeting (MDT) review and recommendation for neoadjuvant therapy and surgery, 2) Anaesthetic preoperative assessment of fitness for surgery and quantification of risk, 3) Shared decision making with the patient and the process of informed consent, 4) Prehabilitation and physiological optimisation 5) Technical aspects of surgical planning. This review will focus on patients who have been recommended for surgery by the MDT and have completed neoadjuvant therapy. Other important considerations beyond the scope of this review are the various neoadjuvant strategies employed which in this patient group include Total Neo-adjuvant Therapy and reirradiation. Critical to improving perioperative outcomes is the dual aim of achieving a negative resection margin in a patient fit enough for extended surgery. Advanced, realistic communication is required pre-operatively and should be maintained throughout recovery. Optimising patient's physiological and psychological reserve with a preoperative prehabilitation programme is important, with physiotherapy, psychological and nutritional input. From a surgical perspective, image based technical preoperative planning is important to identify risk points and ensure correct surgical strategy. Careful attention to the entire patient journey through these 5 preoperative phases can optimise outcomes with the accumulation of marginal gains at multiple timepoints.
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Affiliation(s)
- I Drami
- Dukes' Club, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK.
| | - A C Lord
- Dukes' Club, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
| | - P Sarmah
- Dukes' Club, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
| | - R P Baker
- Advanced Malignancy Subcommittee, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
| | - I R Daniels
- Advanced Malignancy Subcommittee, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
| | - K Boyle
- Advanced Malignancy Subcommittee, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
| | - B Griffiths
- Advanced Malignancy Subcommittee, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
| | - H M Mohan
- Dukes' Club, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
| | - J T Jenkins
- Advanced Malignancy Subcommittee, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
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16
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Queiroz MA, Ortega CD, Ferreira FR, Capareli FC, Nahas SC, Cerri GG, Buchpiguel CA. Value of Primary Rectal Tumor PET/MRI in the Prediction of Synchronic Metastatic Disease. Mol Imaging Biol 2021; 24:453-463. [PMID: 34755248 DOI: 10.1007/s11307-021-01674-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE To analyze the associations between positron emission tomography (PET)/magnetic resonance imaging (MRI) features for primary rectal tumors and metastases. PROCEDURES Between November 2016 and April 2018, 101 patients with rectal adenocarcinoma were included in this prospective study (NCT02537340) for whole-body PET/MRI for baseline staging. Two readers analyzed the PET/MRI; they assessed the semiquantitative PET features of the primary tumor and the N- and M-stages. Another reader analyzed the MRI features for locoregional staging. The reference standard for confirming metastatic disease was biopsy or imaging follow-up. Non-parametric tests were used to compare the PET/MRI features of the participants with or without metastatic disease. Binary logistic regression was used to evaluate the associations between the primary tumor PET/MRI features and metastatic disease. RESULTS A total of 101 consecutive participants (median age 62 years; range: 33-87 years) were included. Metastases were detected in 35.6% (36 of 101) of the participants. Among the PET/MRI features, higher tumor lesion glycolysis (352.95 vs 242.70; P = .46) and metabolic tumor volume (36.15 vs 26.20; P = .03) were more frequent in patients with than in those without metastases. Additionally, patients with metastases had a higher incidence of PET-positive (64% vs 32%; P = .009) and MRI-positive (56% vs 32%; P = .03) mesorectal lymph nodes, extramural vascular invasion (86% vs 49%; P > .001), and involvement of mesorectal fascia (64% vs 42%; P = .04); there were also differences between the mrT stages of these two groups (P = .008). No differences in the maximum standardized uptake values for the primary tumors in patients with and without metastases were observed (18.9 vs 19.1; P = .56). Multivariable logistic regression showed that extramural vascular invasion on MRI was the only significant predictor (adjusted odds ratio, 3.8 [95% CI: 1.1, 13.9]; P = .001). CONCLUSION PET/MRI facilitated the identification of participants with a high risk of metastatic disease, though these findings were based mainly on MRI features.
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Affiliation(s)
- Marcelo A Queiroz
- Nuclear Medicine Division, Department of Radiology and Oncology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Doutor Ovidio Pires de Campos, 872, Sao Paulo, SP, 05403-010, Brazil.
| | - Cinthia D Ortega
- Department of Radiology and Oncology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Felipe R Ferreira
- Department of Radiology and Oncology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Fernanda C Capareli
- Department of Radiology and Oncology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Sergio C Nahas
- Department of Surgery, Division of Colorectal Surgery, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Giovanni G Cerri
- Department of Radiology and Oncology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Carlos A Buchpiguel
- Nuclear Medicine Division, Department of Radiology and Oncology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Doutor Ovidio Pires de Campos, 872, Sao Paulo, SP, 05403-010, Brazil
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17
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Kokaine L, Gardovskis A, Gardovskis J. Evaluation and Predictive Factors of Complete Response in Rectal Cancer after Neoadjuvant Chemoradiation Therapy. ACTA ACUST UNITED AC 2021; 57:medicina57101044. [PMID: 34684080 PMCID: PMC8537499 DOI: 10.3390/medicina57101044] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/16/2021] [Accepted: 09/23/2021] [Indexed: 12/18/2022]
Abstract
The response to neoadjuvant chemoradiation therapy is an important prognostic factor for locally advanced rectal cancer. Although the majority of the patients after neoadjuvant therapy are referred to following surgery, the clinical data show that complete clinical or pathological response is found in a significant proportion of the patients. Diagnostic accuracy of confirming the complete response has a crucial role in further management of a rectal cancer patient. As the rate of clinical complete response, unfortunately, is not always consistent with pathological complete response, accurate diagnostic parameters and predictive markers of tumor response may help to guide more personalized treatment strategies and identify potential candidates for nonoperative management more safely. The management of complete response demands interdisciplinary collaboration including oncologists, radiotherapists, radiologists, pathologists, endoscopists and surgeons, because the absence of a multidisciplinary approach may compromise the oncological outcome. Prediction and improvement of rectal cancer response to neoadjuvant therapy is still an active and challenging field of further research. This literature review is summarizing the main, currently known clinical information about the complete response that could be useful in case if encountering such condition in rectal cancer patients after neoadjuvant chemoradiation therapy, using as a source PubMed publications from 2010–2021 matching the search terms “rectal cancer”, “neoadjuvant therapy” and “response”.
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Affiliation(s)
- Linda Kokaine
- Department of Surgery, Riga Stradins University, Dzirciema Street 16, LV-1007 Riga, Latvia; or
- Pauls Stradins Clinical University Hospital, Pilsoņu Street 13, LV-1002 Riga, Latvia
- Correspondence: (L.K.); (J.G.); Tel.: +371-2635-9472 (L.K.)
| | - Andris Gardovskis
- Department of Surgery, Riga Stradins University, Dzirciema Street 16, LV-1007 Riga, Latvia; or
- Pauls Stradins Clinical University Hospital, Pilsoņu Street 13, LV-1002 Riga, Latvia
| | - Jānis Gardovskis
- Department of Surgery, Riga Stradins University, Dzirciema Street 16, LV-1007 Riga, Latvia; or
- Pauls Stradins Clinical University Hospital, Pilsoņu Street 13, LV-1002 Riga, Latvia
- Correspondence: (L.K.); (J.G.); Tel.: +371-2635-9472 (L.K.)
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18
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Orel VE, Ashykhmin A, Golovko T, Rykhalskyi O, Orel VB. Texture Analysis of Tumor and Peritumoral Tissues Based on 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Hybrid Imaging in Patients With Rectal Cancer. J Comput Assist Tomogr 2021; 45:820-828. [PMID: 34469907 DOI: 10.1097/rct.0000000000001218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study aimed to determine whether texture parameters could be used in differentiation between the tumor and the peritumoral tissues based on hybrid 18F-Fluorodeoxyglucose positron emission tomography/computed tomography imaging for patients with rectal cancer. METHODS Seven parameters, including heterogeneity, entropy, energy, skewness, kurtosis, standard deviation, and average brightness, were extracted from positron emission tomography/computed tomography scans of 22 patients (12 male and 10 female; mean age, 61 ± 2 years). RESULTS The peritumoral tissue had a significantly lower value of the heterogeneity parameter (23%) than the tumor. Tumor size (r = -0.48, P < 0.05) and extramural venous invasion scores (r = 0.64, P < 0.05) correlated with heterogeneity in the peritumoral tissue. There were significant differences (P < 0.05) in the correlation coefficients between men and women. CONCLUSIONS Therefore, we provided additional quantitative information to differentiate the tumor from the peritumoral tissue and indicated possible application for extramural venous invasion evaluation in rectal cancer.
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19
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Yamanakkanavar N, Lee B. A novel M-SegNet with global attention CNN architecture for automatic segmentation of brain MRI. Comput Biol Med 2021; 136:104761. [PMID: 34426168 DOI: 10.1016/j.compbiomed.2021.104761] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 11/25/2022]
Abstract
In this paper, we propose a novel M-SegNet architecture with global attention for the segmentation of brain magnetic resonance imaging (MRI). The proposed architecture consists of a multiscale deep network at the encoder side, deep supervision at the decoder side, a global attention mechanism, different sizes of convolutional kernels, and combined-connections with skip connections and pooling indices. The multiscale side input layers were used to support deep layers for extracting the discriminative information and the upsampling layer at the decoder side provided deep supervision, which reduced the gradient problem. The global attention mechanism is utilized to capture rich contextual information in the decoder stage by integrating local features with their respective global dependencies. In addition, multiscale convolutional kernels of different sizes were used to extract abundant semantic features from brain MRI scans in the encoder and decoder modules. Moreover, combined-connections were used to pass features from the encoder to the decoder path to recover the spatial information lost during downsampling and makes the model converge faster. Furthermore, we adopted uniform non-overlapping input patches to focus on fine details for the segmentation of brain MRI. We verified the proposed architecture on publicly accessible datasets for the task of segmentation of brain MRI. The experimental results show that the proposed model outperforms conventional methods by achieving an average Dice similarity coefficient score of 0.96.
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Affiliation(s)
- Nagaraj Yamanakkanavar
- Department of Information and Communications Engineering, Chosun University, Gwangju 61452, South Korea
| | - Bumshik Lee
- Department of Information and Communications Engineering, Chosun University, Gwangju 61452, South Korea.
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20
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Abstract
PET/MR imaging is in routine clinical use and is at least as effective as PET/CT for oncologic and neurologic studies with advantages with certain PET radiopharmaceuticals and applications. In addition, whole body PET/MR imaging substantially reduces radiation dosages compared with PET/CT which is particularly relevant to pediatric and young adult population. For cancer imaging, assessment of hepatic, pelvic, and soft-tissue malignancies may benefit from PET/MR imaging. For neurologic imaging, volumetric brain MR imaging can detect regional volume loss relevant to cognitive impairment and epilepsy. In addition, the single-bed position acquisition enables dynamic brain PET imaging without extending the total study length which has the potential to enhance the diagnostic information from PET.
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Affiliation(s)
- Farshad Moradi
- Department of Radiology, Stanford University, 300 Pasteur Drive, H2200, Stanford, CA 94305, USA.
| | - Andrei Iagaru
- Department of Radiology, Stanford University, 300 Pasteur Drive, H2200, Stanford, CA 94305, USA
| | - Jonathan McConathy
- Department of Radiology, University of Alabama at Birmingham, 619 19th Street South, JT 773, Birmingham, AL 35249, USA
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21
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Crimì F, Valeggia S, Baffoni L, Stramare R, Lacognata C, Spolverato G, Albertoni L, Spimpolo A, Evangelista L, Zucchetta P, Cecchin D, Pucciarelli S. [18F]FDG PET/MRI in rectal cancer. Ann Nucl Med 2021; 35:281-290. [PMID: 33517562 PMCID: PMC7902586 DOI: 10.1007/s12149-021-01580-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/05/2021] [Indexed: 02/06/2023]
Abstract
We conducted a systematic literature review on the use of [18F]FDG PET/MRI for staging/restaging rectal cancer patients with PubMed, Scopus, and Web of Science, based on the PRISMA criteria. Three authors screened all titles and abstracts and examined the full texts of all the identified relevant articles. Studies containing aggregated or duplicated data, review articles, case reports, editorials, and letters were excluded. Ten reports met the inclusion criteria. Four studies examined T staging and one focused on local recurrences after surgery; the reported sensitivity (94-100%), specificity (73-94%), and accuracy (92-100%) varied only slightly from one study to another. The sensitivity, specificity, and accuracy of [18F]FDG PET/MRI for N staging were 90-93%, 92-94%, and 42-92%. [18F]FDG PET/MRI detected malignant nodes better than MRI, resulting in treatment change. For M staging, [18F]FDG PET/MRI outperformed [18F]FDG PET/CT and CT in detecting liver metastases, whereas it performed worse for lung metastases. The results of this review suggest that [18F]FDG PET/MRI should be used for rectal cancer restaging after chemoradiotherapy and to select patients for rectum-sparing approaches thanks to its accuracy in T and N staging. For M staging, it should be associated at least with a chest CT scan to rule out lung metastases.
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Affiliation(s)
- Filippo Crimì
- Department of Medicine DIMED, Institute of Radiology, Padova University Hospital, Via Nicolò Giustiniani 2, 35128, Padova, Italy
| | - Silvia Valeggia
- Department of Medicine DIMED, Institute of Radiology, Padova University Hospital, Via Nicolò Giustiniani 2, 35128, Padova, Italy
| | - Luca Baffoni
- Department of Medicine DIMED, Institute of Radiology, Padova University Hospital, Via Nicolò Giustiniani 2, 35128, Padova, Italy
| | - Roberto Stramare
- Department of Medicine DIMED, Institute of Radiology, Padova University Hospital, Via Nicolò Giustiniani 2, 35128, Padova, Italy
| | - Carmelo Lacognata
- Radiology Unit, Padova University Hospital, Via Nicolò Giustiniani 2, 35128, Padova, Italy
| | - Gaya Spolverato
- Department of Surgical, Oncological and Gastroenterological Sciences DiSCOG, 1st Surgical Clinic, Padova University Hospital, Via Nicolò Giustiniani 2, 35128, Padova, Italy
| | - Laura Albertoni
- Department of Medicine DIMED, Surgical Pathology and Cytopathology Unit, Padova University Hospital, Via Nicolò Giustiniani 2, 35128, Padova, Italy
| | - Alessandro Spimpolo
- Department of Medicine DIMED, Nuclear Medicine Unit, Padova University Hospital, Via Nicolò Giustiniani 2, 35128, Padova, Italy.
| | - Laura Evangelista
- Department of Medicine DIMED, Nuclear Medicine Unit, Padova University Hospital, Via Nicolò Giustiniani 2, 35128, Padova, Italy
| | - Pietro Zucchetta
- Department of Medicine DIMED, Nuclear Medicine Unit, Padova University Hospital, Via Nicolò Giustiniani 2, 35128, Padova, Italy
| | - Diego Cecchin
- Department of Medicine DIMED, Nuclear Medicine Unit, Padova University Hospital, Via Nicolò Giustiniani 2, 35128, Padova, Italy
| | - Salvatore Pucciarelli
- Department of Surgical, Oncological and Gastroenterological Sciences DiSCOG, 1st Surgical Clinic, Padova University Hospital, Via Nicolò Giustiniani 2, 35128, Padova, Italy
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22
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Rutegård MK, Båtsman M, Blomqvist L, Rutegård M, Axelsson J, Ljuslinder I, Rutegård J, Palmqvist R, Brännström F, Brynolfsson P, Riklund K. Rectal cancer: a methodological approach to matching PET/MRI to histopathology. Cancer Imaging 2020; 20:80. [PMID: 33129352 PMCID: PMC7603757 DOI: 10.1186/s40644-020-00347-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 09/17/2020] [Indexed: 12/18/2022] Open
Abstract
Purpose To enable the evaluation of locoregional disease in the on-going RECTOPET (REctal Cancer Trial on PET/MRI/CT) study; a methodology to match mesorectal imaging findings to histopathology is presented, along with initial observations. Methods FDG-PET/MRI examinations were performed in twenty-four consecutively included patients with rectal adenocarcinoma. In nine patients, of whom five received neoadjuvant treatment, a postoperative MRI of the surgical specimen was performed. The pathological cut-out was performed according to clinical routine with the addition of photo documentation of each slice of the surgical specimen, meticulously marking the location, size, and type of pathology of each mesorectal finding. This allowed matching individual nodal structures from preoperative MRI, via the specimen MRI, to histopathology. Results Preoperative MRI identified 197 mesorectal nodal structures, of which 92 (47%) could be anatomically matched to histopathology. Of the matched nodal structures identified in both MRI and histopathology, 25% were found to be malignant. These malignant structures consisted of lymph nodes (43%), tumour deposits (48%), and extramural venous invasion (9%). One hundred eleven nodal structures (55%) could not be matched anatomically. Of these, 97 (87%) were benign lymph nodes, and 14 (13%) were malignant nodal structures. Five were malignant lymph nodes, and nine were tumour deposits, all of which had a short axis diameter < 5 mm. Conclusions We designed a method able to anatomically match and study the characteristics of individual mesorectal nodal structures, enabling further research on the impact of each imaging modality. Initial observations suggest that small malignant nodal structures assessed as lymph nodes in MRI often comprise other forms of mesorectal tumour spread. Trial registration Clinical Trials Identifier:NCT03846882.
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Affiliation(s)
- Miriam K Rutegård
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden.
| | - Malin Båtsman
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | - Lennart Blomqvist
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Martin Rutegård
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.,Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - Jan Axelsson
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
| | - Ingrid Ljuslinder
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Jörgen Rutegård
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Richard Palmqvist
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | - Fredrik Brännström
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Patrik Brynolfsson
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
| | - Katrine Riklund
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
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23
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Clinical Relevance and Practical Approach for Challenging Rectal Cancer MRI Findings. CURRENT RADIOLOGY REPORTS 2020. [DOI: 10.1007/s40134-020-00359-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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24
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Queiroz MA, Ortega CD, Ferreira FR, Nahas SC, Cerri GG, Buchpiguel CA. Diagnostic accuracy of FDG-PET/MRI versus pelvic MRI and thoracic and abdominal CT for detecting synchronous distant metastases in rectal cancer patients. Eur J Nucl Med Mol Imaging 2020; 48:186-195. [PMID: 32561971 DOI: 10.1007/s00259-020-04911-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 06/07/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE We compared the diagnostic accuracy of detecting distant metastases for baseline rectal cancer staging between PET/MRI and conventional staging (CS). MATERIALS AND METHODS This prospective study from November 2016 to April 2018 included 101 rectal adenocarcinoma patients for primary staging. These patients underwent whole-body PET/MRI in addition to CS (pelvic MRI and thoracic and abdominal contrast-enhanced CT). Different readers analyzed CS and PET/MRI findings for primary tumor, nodal, and metastatic staging. The presence, number, and location of metastases were recorded according to the organ involved (non-regional lymph nodes (LNs), liver, lungs, or others). Lesions were defined as positive, negative, or indeterminate. The number of lesions per organ was limited to 10. The McNemar test was used to compare the accuracies. RESULTS PET/MRI exhibited a higher accuracy in detecting metastatic disease than CS in all patients (88.4% vs. 82.6%, p = 0.003) and in patients with extramural vascular invasion (EMVI) (88.9% vs. 85.5%, p = 0.013). The detection rate of PET/MRI was superior to that of CS for all lesions [84.1% vs. 68.9%, p = 0.001], as well as those in the liver (89.2% vs. 84.2%), non-regional LNs (90.0% vs. 36.7%), and lungs (76.4% vs. 66.9%). PET/MRI correctly classified 19/33 (57.5%) patients with indeterminate lesions on CS. CONCLUSION PET/MRI yields higher accuracy than CS for detecting distant synchronous metastases in the baseline staging of patients with rectal cancer and EMVI. PET/MRI exhibited a higher detection rate than CS for identifying non-regional LNs, hepatic lesions, and pulmonary lesions as well as correctly classifying patients with indeterminate lesions. TRIAL REGISTRATION NCT02537340.
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Affiliation(s)
- Marcelo A Queiroz
- Nuclear Medicine Division, Department of Radiology and Oncology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Doutor Ovidio Pires de Campos, 872, Sao Paulo, SP, 05403-010, Brazil.
| | - Cinthia D Ortega
- Department of Radiology and Oncology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Felipe R Ferreira
- Department of Radiology and Oncology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Sergio C Nahas
- Department of Surgery, Division of Colorectal Surgery, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Giovanni G Cerri
- Department of Radiology and Oncology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Carlos A Buchpiguel
- Nuclear Medicine Division, Department of Radiology and Oncology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Doutor Ovidio Pires de Campos, 872, Sao Paulo, SP, 05403-010, Brazil
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25
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Yamanakkanavar N, Choi JY, Lee B. MRI Segmentation and Classification of Human Brain Using Deep Learning for Diagnosis of Alzheimer's Disease: A Survey. SENSORS (BASEL, SWITZERLAND) 2020; 20:E3243. [PMID: 32517304 PMCID: PMC7313699 DOI: 10.3390/s20113243] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/25/2020] [Accepted: 06/03/2020] [Indexed: 02/07/2023]
Abstract
Many neurological diseases and delineating pathological regions have been analyzed, and the anatomical structure of the brain researched with the aid of magnetic resonance imaging (MRI). It is important to identify patients with Alzheimer's disease (AD) early so that preventative measures can be taken. A detailed analysis of the tissue structures from segmented MRI leads to a more accurate classification of specific brain disorders. Several segmentation methods to diagnose AD have been proposed with varying complexity. Segmentation of the brain structure and classification of AD using deep learning approaches has gained attention as it can provide effective results over a large set of data. Hence, deep learning methods are now preferred over state-of-the-art machine learning methods. We aim to provide an outline of current deep learning-based segmentation approaches for the quantitative analysis of brain MRI for the diagnosis of AD. Here, we report how convolutional neural network architectures are used to analyze the anatomical brain structure and diagnose AD, discuss how brain MRI segmentation improves AD classification, describe the state-of-the-art approaches, and summarize their results using publicly available datasets. Finally, we provide insight into current issues and discuss possible future research directions in building a computer-aided diagnostic system for AD.
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Affiliation(s)
- Nagaraj Yamanakkanavar
- Department of Information and Communications Engineering, Chosun University, Gwangju 61452, Korea;
| | - Jae Young Choi
- Division of Computer & Electronic Systems Engineering, Hankuk University of Foreign Studies, Yongin 17035, Korea;
| | - Bumshik Lee
- Department of Information and Communications Engineering, Chosun University, Gwangju 61452, Korea;
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26
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Peacock O, Chang GJ. "Watch and Wait" for complete clinical response after neoadjuvant chemoradiotherapy for rectal cancer. MINERVA CHIR 2019; 74:481-495. [PMID: 31580047 DOI: 10.23736/s0026-4733.19.08184-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The management of rectal cancer has evolved substantially over recent decades, becoming increasingly complex. This was once a disease associated with high mortality and limited treatment options that typically necessitated a permanent colostomy, has now become a model for multidisciplinary evaluation, treatment and surgical advancement. Despite advances in the rates of total mesorectal excision, decreased local recurrence and increased 5-year survival rates, the multimodal treatment of rectal cancer is associated with a significant impact on long-term functional and quality of life outcomes including risks of bowel, bladder and sexual dysfunction, and potential need for a permanent stoma. There is great interest in strategies to decrease the toxicity of treatment, including selective use of radiation, chemotherapy or even surgery. The modern concept of selective use of surgery for patients with rectal cancer are based on the observed pathological complete response in approximately 10-20% of patients following long-course chemoradiation therapy. While definitive surgical resection remains the standard of care for all patients with non-metastatic rectal cancer, a growing number of studies are providing supportive evidence for a watch-and-wait, organ preserving approach in highly selected patients with rectal cancer. However, questions regarding the heterogeneity of patient selection, optimal method for inducing pathological complete response, methods and intervals for assessing treatment response and adequacy of follow-up remain unanswered. The aim of this review is to provide an up-to-date summary of the current evidence for the watch-and-wait management of rectal cancer following a complete clinical response after neoadjuvant chemoradiation.
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Affiliation(s)
- Oliver Peacock
- Colorectal Surgical Oncology, University of Texas MD Anderson Cancer Centre, Houston, TX, USA
| | - George J Chang
- Colorectal Surgical Oncology, University of Texas MD Anderson Cancer Centre, Houston, TX, USA -
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