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Melosky B, Vincent MD, McGuire AL, Brade AM, Chu Q, Cheema P, Martins I, Spicer JD, Snow S, Juergens RA. Modern era systemic therapies: Expanding concepts of cure in early and locally advanced non-small cell lung cancer. Int J Cancer 2024; 155:963-978. [PMID: 38900018 DOI: 10.1002/ijc.35031] [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: 12/04/2023] [Revised: 03/19/2024] [Accepted: 04/17/2024] [Indexed: 06/21/2024]
Abstract
Cure of cancer is a sensitive and multidimensional concept that is challenging to define, difficult to assert at the individual patient level, and often surrounded by controversy. The notion of cure in non-small cell lung cancer (NSCLC) has changed and continues to evolve with improvements in diagnosis and treatment. Targeted and immune therapies have recently entered the treatment landscape of stage I-III NSCLC. While some initial pivotal trials of such agents failed to improve survival, recently approved epidermal growth factor receptor (EGFR) inhibitors (in EGFR-mutated NSCLC) and immune checkpoint inhibitors have shown delays in disease recurrence or progression and unprecedented survival gains compared to previous standards of care. Additional data is now emerging supporting the benefit of treatment strategies based on alternation-matched targeting (anaplastic lymphoma kinase [ALK] inhibition in ALK-altered disease) and immune checkpoint inhibition in stage I-III NSCLC. Similar to previous developments in the treatment of early and locally advanced NSCLC, it is expected that statistically significant and clinically meaningful trial-level benefits will translate into real-world benefits, including improvements in cure measures. Parallel advances in molecular testing (e.g., circulating tumor DNA analyses) are also allowing for a deeper and more comprehensive characterization of disease status and treatment response. Given the impact that curative-intent treatments have on survival, it is critical that various stakeholders, including clinicians and patients, are aware of new opportunities to pursue cure in stage I-III NSCLC.
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Affiliation(s)
- Barbara Melosky
- BCCA Vancouver Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mark D Vincent
- London Regional Cancer Centre, University of Western Ontario, London, Ontario, Canada
| | - Anna L McGuire
- Vancouver Coastal Health Research Institute, University of British Colombia, Vancouver, British Columbia, Canada
| | - Anthony M Brade
- Trillium Health Partners, University of Toronto, Mississauga, Ontario, Canada
| | - Quincy Chu
- Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Parneet Cheema
- William Osler Health System, University of Toronto, Brampton, Ontario, Canada
| | | | - Jonathan D Spicer
- McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Stephanie Snow
- QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rosalyn A Juergens
- Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada
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2
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Krakorova G, Domecky P, Blazek J, Pesek M, Venclicek O, Havel L, Hrnciarik M, Krejci J, Mullerova A, Marel M, Duba J, Svaton M. Omission of staging PET/CT linked to reduced survival in stage III non-small cell lung cancer: insights from the LUCAS project real-world data. Transl Lung Cancer Res 2024; 13:1495-1504. [PMID: 39118875 PMCID: PMC11304148 DOI: 10.21037/tlcr-24-108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/27/2024] [Indexed: 08/10/2024]
Abstract
Background Stage III non-small cell lung cancer (NSCLC) is a highly heterogeneous stage due to its subgroups (IIIA-IIIC) comprising both resectable and unresectable tumors. Accurate determination of the extent of the disease is essential for excluding stage IV and choosing the optimal treatment regimen. Whole body positron emission tomography and computed tomography scan (PET/CT) is recommended as an initial staging imaging in locally advanced NSCLC. Despite international guidelines for NSCLC diagnosis and treatment, they are not always adhered to due to various reasons. Even in such a groundbreaking study, the phase 3 trial PACIFIC investigating the efficacy of durvalumab as consolidation therapy in patients with stage III NSCLC PET/CT was not mandatory. With the premise that whole body PET/CT of the trunk is essential for diagnosing stage III NSCLC, we performed a retrospective study evaluating the relationship of the use of PET/CT versus conventional staging with CT of the chest and abdomen, in terms of survival. Methods This retrospective study of stage III NSCLC patients used the Czech lung cancer registry LUCAS, which was established in June 2018. As of the data export (up to February 9, 2022), a total of 703 patients were eligible for the analysis. Overall survival (OS) was compared using Kaplan-Meier analysis and a Cox regression model. Continuous variables were tested using the Mann-Whitney test, and categorical variables using the Pearson's Chi-square or Fisher's exact test. Results A total of 703 patients were included in the cohort with an average age of 69 years. PET/CT was performed on 354 patients, and conventional staging using chest and abdominal CT on 349 patients. The median OS among patients with PET/CT was 20.9 months [95% confidence interval (CI): 18.1-23.7], and it was statistically significantly higher (P<0.001) than among patients without PET/CT, where the median OS was 9.0 months (95% CI: 7.3-10.6). The observed effect of PET/CT was also statistically significant when comparing individual stages (IIIA, IIIB, IIIC). The multivariate Cox model confirmed the use of PET/CT as an independent prognostic factor. The most common reason for omission of PET/CT was the local or time unavailability of the examination. Conclusions Omission of PET/CT can mean a significant decrement in survival for the patients in stage III NSCLC, likely due to poor staging and suboptimal treatment. Routine use of PET/CT is strictly recommended for the optimal management of stage III NSCLC patients even outside the high-income countries.
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Affiliation(s)
- Gabriela Krakorova
- Department of Pneumology and Phthisiology, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic
| | - Petr Domecky
- OAKS Consulting s.r.o., Prague, Czech Republic
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Jiri Blazek
- Department of Pneumology and Phthisiology, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic
| | - Milos Pesek
- Department of Pneumology and Phthisiology, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic
| | - Ondrej Venclicek
- Department of Respiratory Diseases, Faculty of Medicine and University Hospital Brno, Masaryk University, Brno, Czech Republic
| | - Libor Havel
- Department of Respiratory Medicine, Thomayer Hospital, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michal Hrnciarik
- Pulmonary Department, University Hospital Hradec Kralove, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Jana Krejci
- Department of Pneumology, Bulovka Hospital, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Andrea Mullerova
- Department of Respiratory Medicine, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Miloslav Marel
- Department of Pulmonology, University Hospital Motol, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Martin Svaton
- Department of Pneumology and Phthisiology, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic
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Zhou Q, Niu X, Zhang Z, O'Byrne K, Kulasinghe A, Fielding D, Möller A, Wuethrich A, Lobb RJ, Trau M. Glycan Profiling in Small Extracellular Vesicles with a SERS Microfluidic Biosensor Identifies Early Malignant Development in Lung Cancer. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024:e2401818. [PMID: 38885350 DOI: 10.1002/advs.202401818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/23/2024] [Indexed: 06/20/2024]
Abstract
Glycosylation is the most common post-translational modification of proteins and regulates a myriad of fundamental biological processes under normal, and pathological conditions. Altered protein glycosylation is linked to malignant transformation, showing distinct glycopatterns that are associated with cancer initiation and progression by regulating tumor proliferation, invasion, metastasis, and therapeutic resistance. The glycopatterns of small extracellular vesicles (sEVs) released by cancer cells are promising candidates for cancer monitoring since they exhibit glycopatterns similar to their cell-of-origin. However, the clinical application of sEV glycans is challenging due to the limitations of current analytical technologies in tracking the trace amounts of sEVs specifically derived from tumors in circulation. Herein, a sEV GLYcan PHenotype (EV-GLYPH) assay that utilizes a microfluidic platform integrated with surface-enhanced Raman scattering for multiplex profiling of sEV glycans in non-small cell lung cancer is clinically validated. For the first time, the EV-GLYPH assay effectively identifies distinct sEV glycan signatures between non-transformed and malignantly transformed lung cells. In a clinical study evaluated on 40 patients, the EV-GLYPH assay successfully differentiates patients with early-stage malignant lung nodules from benign lung nodules. These results reveal the potential to profile sEV glycans for noninvasive diagnostics and prognostics, opening up promising avenues for clinical applications and understanding the role of sEV glycosylation in lung cancer.
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Affiliation(s)
- Quan Zhou
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Xueming Niu
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Zhen Zhang
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Kenneth O'Byrne
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, 4102, Australia
| | - Arutha Kulasinghe
- Frazer Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, 4102, Australia
| | - David Fielding
- Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, 4029, Australia
| | - Andreas Möller
- JC STEM Lab, Li Ka Shing Institute of Health Sciences, Department of Otorhinolaryngology, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong SAR, 999077, China
- Tumour Microenvironment Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4029, Australia
| | - Alain Wuethrich
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Richard J Lobb
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Matt Trau
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD, 4072, Australia
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, 4072, Australia
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Lokre O, Perk TG, Weisman AJ, Govindan RM, Chen S, Chen M, Eickhoff J, Liu G, Jeraj R. Quantitative evaluation of lesion response heterogeneity for superior prognostication of clinical outcome. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06764-0. [PMID: 38819668 DOI: 10.1007/s00259-024-06764-0] [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: 02/22/2024] [Accepted: 05/12/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE Standardized reporting of treatment response in oncology patients has traditionally relied on methods like RECIST, PERCIST and Deauville score. These endpoints assess only a few lesions, potentially overlooking the response heterogeneity of all disease. This study hypothesizes that comprehensive spatial-temporal evaluation of all individual lesions is necessary for superior prognostication of clinical outcome. METHODS [18F]FDG PET/CT scans from 241 patients (127 diffuse large B-cell lymphoma (DLBCL) and 114 non-small cell lung cancer (NSCLC)) were retrospectively obtained at baseline and either during chemotherapy or post-chemoradiotherapy. An automated TRAQinform IQ software (AIQ Solutions) analyzed the images, performing quantification of change in regions of interest suspicious of cancer (lesion-ROI). Multivariable Cox proportional hazards (CoxPH) models were trained to predict overall survival (OS) with varied sets of quantitative features and lesion-ROI, compared by bootstrapping with C-index and t-tests. The best-fit model was compared to automated versions of previously established methods like RECIST, PERCIST and Deauville score. RESULTS Multivariable CoxPH models demonstrated superior prognostic power when trained with features quantifying response heterogeneity in all individual lesion-ROI in DLBCL (C-index = 0.84, p < 0.001) and NSCLC (C-index = 0.71, p < 0.001). Prognostic power significantly deteriorated (p < 0.001) when using subsets of lesion-ROI (C-index = 0.78 and 0.67 for DLBCL and NSCLC, respectively) or excluding response heterogeneity (C-index = 0.67 and 0.70). RECIST, PERCIST, and Deauville score could not significantly associate with OS (C-index < 0.65 and p > 0.1), performing significantly worse than the multivariable models (p < 0.001). CONCLUSIONS Quantitative evaluation of response heterogeneity of all individual lesions is necessary for the superior prognostication of clinical outcome.
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Affiliation(s)
- Ojaswita Lokre
- AIQ Solutions, 8000 Excelsior Dr Suite 400, Madison, WI, 53717, United States of America.
| | - Timothy G Perk
- AIQ Solutions, 8000 Excelsior Dr Suite 400, Madison, WI, 53717, United States of America
| | - Amy J Weisman
- AIQ Solutions, 8000 Excelsior Dr Suite 400, Madison, WI, 53717, United States of America
| | | | - Song Chen
- Department of Nuclear Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Meijie Chen
- Department of Nuclear Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jens Eickhoff
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Glenn Liu
- AIQ Solutions, 8000 Excelsior Dr Suite 400, Madison, WI, 53717, United States of America
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Robert Jeraj
- AIQ Solutions, 8000 Excelsior Dr Suite 400, Madison, WI, 53717, United States of America
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States of America
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Wang Y, Lyu D, Cheng C, Zhou T, Tu W, Xiao Y, Zuo C, Fan L, Liu S. Preoperative nomogram for predicting spread through air spaces in clinical-stage IA non-small cell lung cancer using 18F-fluorodeoxyglucose positron emission tomography/computed tomography. J Cancer Res Clin Oncol 2024; 150:185. [PMID: 38598007 PMCID: PMC11006761 DOI: 10.1007/s00432-024-05674-w] [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: 01/07/2024] [Accepted: 02/29/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE This study aims to assess the predictive value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) radiological features and the maximum standardized uptake value (SUVmax) in determining the presence of spread through air spaces (STAS) in clinical-stage IA non-small cell lung cancer (NSCLC). METHODS A retrospective analysis was conducted on 180 cases of NSCLC with postoperative pathological assessment of STAS status, spanning from September 2019 to September 2023. Of these, 116 cases from hospital one comprised the training set, while 64 cases from hospital two formed the testing set. The clinical information, tumor SUVmax, and 13 related CT features were analyzed. Subgroup analysis was carried out based on tumor density type. In the training set, univariable and multivariable logistic regression analyses were employed to identify the most significant variables. A multivariable logistic regression model was constructed and the corresponding nomogram was developed to predict STAS in NSCLC, and its diagnostic efficacy was evaluated in the testing set. RESULTS SUVmax, consolidation-to-tumor ratio (CTR), and lobulation sign emerged as the best combination of variables for predicting STAS in NSCLC. Among these, SUVmax and CTR were identified as independent predictors for STAS prediction. The constructed prediction model demonstrated area under the curve (AUC) values of 0.796 and 0.821 in the training and testing sets, respectively. Subgroup analysis revealed a 2.69 times higher STAS-positive rate in solid nodules compared to part-solid nodules. SUVmax was an independent predictor for predicting STAS in solid nodular NSCLC, while CTR and an emphysema background were independent predictors for STAS in part-solid nodular NSCLC. CONCLUSION Our nomogram based on preoperative 18F-FDG PET/CT radiological features and SUVmax effectively predicts STAS status in clinical-stage IA NSCLC. Furthermore, our study highlights that metabolic parameters and CT variables associated with STAS differ between solid and part-solid nodular NSCLC.
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Affiliation(s)
- Yun Wang
- Department of Radiology, Second Affiliated Hospital of Navy Medical University, 415 Fengyang Road, Huangpu District, Shanghai, 200003, China
| | - Deng Lyu
- Department of Radiology, Second Affiliated Hospital of Navy Medical University, 415 Fengyang Road, Huangpu District, Shanghai, 200003, China
| | - Chao Cheng
- Department of Nuclear Medicine, Changhai Hospital, Navy Medical University, Shanghai, 200433, China
| | - Taohu Zhou
- Department of Radiology, Second Affiliated Hospital of Navy Medical University, 415 Fengyang Road, Huangpu District, Shanghai, 200003, China
| | - Wenting Tu
- Department of Radiology, Second Affiliated Hospital of Navy Medical University, 415 Fengyang Road, Huangpu District, Shanghai, 200003, China
| | - Yi Xiao
- Department of Radiology, Second Affiliated Hospital of Navy Medical University, 415 Fengyang Road, Huangpu District, Shanghai, 200003, China
| | - Changjing Zuo
- Department of Nuclear Medicine, Changhai Hospital, Navy Medical University, Shanghai, 200433, China.
| | - Li Fan
- Department of Radiology, Second Affiliated Hospital of Navy Medical University, 415 Fengyang Road, Huangpu District, Shanghai, 200003, China.
| | - Shiyuan Liu
- Department of Radiology, Second Affiliated Hospital of Navy Medical University, 415 Fengyang Road, Huangpu District, Shanghai, 200003, China.
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Luo NY, Minne RL, Gallant JP, Gunaratne GS, West JL, Javeri S, Robertson AJ, Lake EW, Engle JW, Mixdorf JC, Aluicio-Sarduy E, Nickel KP, Hernandez R, Kimple RJ, Baschnagel AM, LeBeau AM. Development of an Engineered Single-Domain Antibody for Targeting MET in Non-Small Cell Lung Cancer. Bioconjug Chem 2024; 35:389-399. [PMID: 38470611 DOI: 10.1021/acs.bioconjchem.4c00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
The Mesenchymal Epithelial Transition (MET) receptor tyrosine kinase is upregulated or mutated in 5% of non-small-cell lung cancer (NSCLC) patients and overexpressed in multiple other cancers. We sought to develop a novel single-domain camelid antibody with high affinity for MET that could be used to deliver conjugated payloads to MET expressing cancers. From a naïve camelid variable-heavy-heavy (VHH) domain phage display library, we identified a VHH clone termed 1E7 that displayed high affinity for human MET and was cross-reactive with MET across multiple species. When expressed as a bivalent human Fc fusion protein, 1E7-Fc was found to selectively bind to EBC-1 (MET amplified) and UW-Lung 21 (MET exon 14 mutated) cell lines by flow cytometry and immunofluorescence imaging. Next, we investigated the ability of [89Zr]Zr-1E7-Fc to detect MET expression in vivo by PET/CT imaging. [89Zr]Zr-1E7-Fc demonstrated rapid localization and high tumor uptake in both xenografts with a %ID/g of 6.4 and 5.8 for EBC-1 and UW-Lung 21 at 24 h, respectively. At the 24 h time point, clearance from secondary and nontarget tissues was also observed. Altogether, our data suggest that 1E7-Fc represents a platform technology that can be employed to potentially both image and treat MET-altered NSCLC.
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Affiliation(s)
- Natalie Y Luo
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Rachel L Minne
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Joseph P Gallant
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- Molecular and Cellular Pharmacology Program, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Gihan S Gunaratne
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Jayden L West
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- Molecular and Cellular Pharmacology Program, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Saahil Javeri
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Austin J Robertson
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- Molecular and Cellular Pharmacology Program, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Eric W Lake
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Jonathan W Engle
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Jason C Mixdorf
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Eduardo Aluicio-Sarduy
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Kwang P Nickel
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Reinier Hernandez
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Randall J Kimple
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Andrew M Baschnagel
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Aaron M LeBeau
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
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7
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Lin JT, Li XM, Zhong WZ, Hou QY, Liu CL, Yu XY, Ye KY, Cheng YL, Du JY, Sun YQ, Zhang FG, Yan HH, Liao RQ, Dong S, Jiang BY, Liu SY, Wu YL, Yang XN. Impact of preoperative [ 18F]FDG PET/CT vs. contrast-enhanced CT in the staging and survival of patients with clinical stage I and II non-small cell lung cancer: a 10-year follow-up study. Ann Nucl Med 2024; 38:188-198. [PMID: 38145431 DOI: 10.1007/s12149-023-01888-z] [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: 10/14/2023] [Accepted: 11/21/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVES To elucidate the impact of [18F]FDG positron emission tomography/computed tomography (PET/CT) vs. CT workup on staging and prognostic evaluation of clinical stage (c) I-II NSCLC. METHODS We retrospectively identified 659 cI-II NSCLC who underwent CT (267 patients) or preoperative CT followed by PET/CT (392 patients), followed by curative-intended complete resection in our hospital from January 2008 to December 2013. Differences were assessed between preoperative and postoperative stage. Five-year disease-free survival (DFS) and overall survival (OS) rates were calculated using the Kaplan-Meier approach and compared with log-rank test. Impact of preoperative PET/CT on survival was assessed by Cox regression analysis. RESULTS The study included 659 patients [mean age, 59.5 years ± 10.8 (standard deviation); 379 men]. The PET/CT group was superior over CT group in DFS [12.6 vs. 6.9 years, HR 0.67 (95% CI 0.53-0.84), p < 0.001] and OS [13.9 vs. 10.5 years, HR 0.64 (95% CI 0.50-0.81), p < 0.001]. In CT group, more patients thought to have cN0 migrated to pN1/2 disease as compared with PET/CT group [26.4% (66/250) vs. 19.2% (67/349), p < 0.001], resulting in more stage cI cases being upstaged to pII-IV [24.7% (49/198) vs. 16.1% (47/292), p = 0.02], yet this was not found in cII NSCLC [27.5% (19/69) vs. 27.0% (27/100), p = 0.94]. Cox regression analysis identified preoperative PET/CT as an independent prognostic factor of OS and DFS (p = 0.002, HR = 0.69, 95% CI 0.54-0.88; p = 0.004, HR = 0.72, 95% CI 0.58-0.90). CONCLUSION Addition of preoperative [18F]FDG PET/CT was associated with superior DFS and OS in resectable cI-II NSCLC, which may result from accurate staging and stage-appropriate therapy.
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Affiliation(s)
- Jun-Tao Lin
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Xiang-Meng Li
- Cancer Institute, Southern Medical University, Guangzhou, China
| | - Wen-Zhao Zhong
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Qing-Yi Hou
- Department of PET Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Chun-Ling Liu
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Xin-Yue Yu
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Kai-Yan Ye
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Yi-Lu Cheng
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Jia-Yu Du
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Yun-Qing Sun
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Fu-Gui Zhang
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Hong-Hong Yan
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Ri-Qiang Liao
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Song Dong
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Ben-Yuan Jiang
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Si-Yang Liu
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.
| | - Xue-Ning Yang
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.
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8
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Nguyen HS, Ho DKN, Nguyen NN, Tran HM, Tam KW, Le NQK. Predicting EGFR Mutation Status in Non-Small Cell Lung Cancer Using Artificial Intelligence: A Systematic Review and Meta-Analysis. Acad Radiol 2024; 31:660-683. [PMID: 37120403 DOI: 10.1016/j.acra.2023.03.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/25/2023] [Accepted: 03/28/2023] [Indexed: 05/01/2023]
Abstract
RATIONALE AND OBJECTIVES Recent advancements in artificial intelligence (AI) render a substantial promise for epidermal growth factor receptor (EGFR) mutation status prediction in non-small cell lung cancer (NSCLC). We aimed to evaluate the performance and quality of AI algorithms that use radiomics features in predicting EGFR mutation status in patient with NSCLC. MATERIALS AND METHODS We searched PubMed (Medline), EMBASE, Web of Science, and IEEExplore for studies published up to February 28, 2022. Studies utilizing an AI algorithm (either conventional machine learning [cML] and deep learning [DL]) for predicting EGFR mutations in patients with NSLCL were included. We extracted binary diagnostic accuracy data and constructed a bivariate random-effects model to obtain pooled sensitivity, specificity, and 95% confidence interval. This study is registered with PROSPERO, CRD42021278738. RESULTS Our search identified 460 studies, of which 42 were included. Thirty-five studies were included in the meta-analysis. The AI algorithms exhibited an overall area under the curve (AUC) value of 0.789 and pooled sensitivity and specificity levels of 72.2% and 73.3%, respectively. The DL algorithms outperformed cML in terms of AUC (0.822 vs. 0.775) and sensitivity (80.1% vs. 71.1%), but had lower specificity (70.0% vs. 73.8%, p-value < 0.001) compared to cML. Subgroup analysis revealed that the use of positron-emission tomography/computed tomography, additional clinical information, deep feature extraction, and manual segmentation can improve diagnostic performance. CONCLUSION DL algorithms can serve as a novel method for increasing predictive accuracy and thus have considerable potential for use in predicting EGFR mutation status in patient with NSCLC. We also suggest that guidelines on using AI algorithms in medical image analysis should be developed with a focus on oncologic radiomics.
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Affiliation(s)
- Hung Song Nguyen
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan (H.S.N., N.N.N.); Department of Pediatrics, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam (H.S.N.); Intensive Care Unit Department, Children's Hospital 1, Ho Chi Minh City, Viet Nam (H.S.N.)
| | - Dang Khanh Ngan Ho
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan (D.K.N.H.)
| | - Nam Nhat Nguyen
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan (H.S.N., N.N.N.)
| | - Huy Minh Tran
- Department of Neurosurgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam (H.M.T.)
| | - Ka-Wai Tam
- Center for Evidence-based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (K.-W.T.); Cochrane Taiwan, Taipei Medical University, Taipei City, Taiwan (K.-W.T.); Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (K.-W.T.); Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan (K.-W.T.)
| | - Nguyen Quoc Khanh Le
- Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan (N.Q.K.L.); Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei 110, Taiwan (N.Q.K.L.); AIBioMed Research Group, Taipei Medical University, Taipei 110, Taiwan (N.Q.K.L.); Translational Imaging Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan (N.Q.K.L.).
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9
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Park B, Lim JK, Shin KM, Hong J, Cha JG, Cho SH, Park SY, Ryeom HK, Kim SH, Seo AN, Cha SI, Lee J, Lee H, Park J. Clinical Role of Upfront F-18 FDG PET/CT in Determining Biopsy Sites for Lung Cancer Diagnosis. Diagnostics (Basel) 2024; 14:153. [PMID: 38248030 PMCID: PMC10813933 DOI: 10.3390/diagnostics14020153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/23/2024] Open
Abstract
PURPOSE This study aimed to investigate the impact of FDG PET/CT timing for biopsy site selection in patients with stage IV lung cancer regarding complications and diagnostic yield. METHODS This retrospective analysis was performed on 1297 patients (924 men and 373 women with a mean age of 71.4 ± 10.2 years) who underwent percutaneous needle biopsy (PNB) for stage IV lung cancer diagnosis in two hospitals. Data collected included the patient's characteristics, order date of the biopsy and PET/CT exams, biopsy target site (lung or non-lung), guidance modality, complications, sample adequacy, and diagnostic success. Based on the order date of the PNB and PET/CT exams, patients were categorized into upfront and delayed PET/CT groups. RESULTS PNB for non-lung targets resulted in significantly lower rates of minor (8.1% vs. 16.2%), major (0.2% vs. 3.4%), and overall complications (8.3% vs. 19.6%) compared to PNB for lung targets (p < 0.001 for all types of complications). Compared to the delayed PET/CT group, the upfront PET/CT group exhibited a lower probability of lung target selection of PNB (53.9% vs. 67.1%, p < 0.001), including a reduced incidence of major complications (1.0% vs. 2.9%, p = 0.031). Moreover, there was no significant difference in the occurrence of minor and total complications between the two groups. Upfront PET/CT and delayed PET/CT groups showed no significant difference regarding sample adequacy and diagnostic success. CONCLUSIONS Upfront PET/CT may have an impact on the selection of the biopsy site for patients with advanced lung cancer, which could result in a lower rate of major complications with no change in the diagnostic yield. Upfront PET/CT demonstrates potential clinical implications for enhancing the safety of lung cancer diagnosis in clinical practice.
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Affiliation(s)
- Byunggeon Park
- Department of Radiology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Jae-Kwang Lim
- Department of Radiology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Kyung Min Shin
- Department of Radiology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Jihoon Hong
- Department of Radiology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Jung Guen Cha
- Department of Radiology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Seung Hyun Cho
- Department of Radiology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Seo Young Park
- Department of Radiology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Hun Kyu Ryeom
- Department of Radiology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - See Hyung Kim
- Department of Radiology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - An Na Seo
- Department of Pathology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Seung-Ick Cha
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Jaehee Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Hoseok Lee
- Department of Radiology, Semyung Radiology Clinic, Gumi 39254, Gyeongsangbuk-do, Republic of Korea
| | - Jongmin Park
- Department of Radiology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
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10
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Chen X, Hu P, Yu H, Tan H, He Y, Cao S, Zhou Y, Shi H. Head-to-head intra-individual comparison of total-body 2-[ 18F]FDG PET/CT and digital PET/CT in patients with malignant tumor: how sensitive could it be? Eur Radiol 2023; 33:7890-7898. [PMID: 37338551 DOI: 10.1007/s00330-023-09825-4] [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: 07/29/2022] [Revised: 03/14/2023] [Accepted: 03/26/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES To comparatively evaluate the lesion-detecting ability of 2-[18F]FDG total-body PET/CT (TB PET/CT) and conventional digital PET/CT. METHODS This study enrolled 67 patients (median age, 65 years; 24 female and 43 male patients) who underwent a TB PET/CT scan and a conventional digital PET/CT scan after a single 2-[18F]FDG injection (3.7 MBq/kg). Raw PET data for TB PET/CT were acquired over the course of 5 min, and images were reconstructed using data from the first 1, 2, 3, and 4 min and the entire 5 min (G1, G2, G3, G4, and G5, respectively). The conventional digital PET/CT scan acquired in 2-3 min per bed (G0). Two nuclear medicine physicians independently assessed subjective image quality using a 5-point Likert scale and recorded the number of 2-[18F]FDG-avid lesions. RESULTS A total of 241 lesions (69 primary lesions; 32 liver, lung, and peritoneum metastases; and 140 regional lymph nodes) among 67 patients with various types of cancer were analyzed. The subjective image quality score and SNR (signal-to-noise ratio) increased gradually from G1 to G5, and these values were significantly higher than the values at G0 (all p < 0.05). Compared to conventional PET/CT, G4 and G5 of TB PET/CT detected an additional 15 lesions (2 primary lesions; 5 liver, lung, and peritoneum lesions; and 8 lymph node metastases). CONCLUSION TB PET/CT was more sensitive than conventional whole-body PET/CT in detecting small (4.3 mm, maximum standardized uptake value (SUVmax) of 1.0) or low-uptake (tumor-to-liver ratio of 1.6, SUVmax of 4.1) lesions. CLINICAL RELEVANCE STATEMENT This study explored the gain of the image quality and lesion detectability of TB PET/CT, compared to conventional PET/CT, and recommended the appropriate acquisition time for TB PET/CT in clinical practice with an ordinary 2-[18F] FDG dose. KEY POINTS • TB PET/CT increases the effective sensitivity to approximately 40 times that of conventional PET scanners. • The subjective image quality score and signal-to-noise ratio of TB PET/CT from G1 to G5 were better than those of conventional PET/CT. • 2-[18F]FDG TB PET/CT with a 4-min acquisition time at a regular tracer dose detected an additional 15 lesions compared to conventional PET/CT.
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Affiliation(s)
- Xueqi Chen
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Pengcheng Hu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Haojun Yu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Hui Tan
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Yibo He
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Shuangliang Cao
- Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, 201807, China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, 201807, China
- School of Biomedical Engineering, Shanghai Tech University, Shanghai, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.
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11
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Huang Y, Fu Y, Sun J, Xu B, Wu L, Tang LF. Pulmonary mucoepidermoid carcinoma in children: two case reports and a review of the literature. Front Pediatr 2023; 11:1232185. [PMID: 37772041 PMCID: PMC10522853 DOI: 10.3389/fped.2023.1232185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/29/2023] [Indexed: 09/30/2023] Open
Abstract
Pulmonary mucoepidermoid carcinoma (PMEC) is a rare tumor, particularly in children, and its clinical manifestations vary. When the tumor is small, it may be asymptomatic; however, with larger tumors, patients may present with symptoms such as recurring pneumonia, atelectasis, persistent cough, chest pain, and even hemoptysis. PMEC appears as an exophytic intrabronchial mass. This study aims to report on the clinical manifestations, imaging findings, treatment approaches, and prognosis of two children diagnosed with PMEC at our hospital between January 2018 and December 2022. The age of onset for both children was 9 years, and the masses were located in the right upper lobe bronchi. Following surgical treatment, both patients showed a good prognosis. In addition, we conducted a comprehensive review of the relevant literature to enhance the overall understanding of PMEC.
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Affiliation(s)
- Yuan Huang
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Endoscopy Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yong Fu
- Department of Otorhinolaryngology-Head and Neck Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jing Sun
- Department of Otorhinolaryngology-Head and Neck Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Bin Xu
- Department of Otorhinolaryngology-Head and Neck Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Lei Wu
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Endoscopy Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Lan-fang Tang
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Endoscopy Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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12
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Beers CA, Pond GR, Wright JR, Tsakiridis T, Okawara GS, Swaminath A. The impact of staging FDG-PET/CT on treatment for stage III NSCLC - an analysis of population-based data from Ontario, Canada. Front Oncol 2023; 13:1210945. [PMID: 37681028 PMCID: PMC10482027 DOI: 10.3389/fonc.2023.1210945] [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: 04/23/2023] [Accepted: 07/24/2023] [Indexed: 09/09/2023] Open
Abstract
Purpose Fluoro-2-deoxyglucose positron-emission tomography (FDG-PET/CT) is now considered a standard investigation for the staging of new cases of stage III NSCLC. However, there is not published level 3 evidence demonstrating the impact of FDG-PET/CT on appropriate therapy in this setting. Using retrospective population-based data, we sought to examine the role and timing that FDG-PET/CT scans play in influencing treatment choice, as well as survival in patients diagnosed with stage III NSCLC. Materials and methods A retrospective cohort of patients diagnosed with stage III NSCLC from 2009-2017 in Ontario were identified from the IC/ES (formerly Institute of Clinical Evaluative Sciences) database. FDG-PET/CT utilization over time, trends in mediastinal biopsy technique and usage, the impact of FDG-PET/CT on overall survival (OS), and its influence on use of concurrent chemoradiotherapy (CRT) were explored. The impact of timing of pre-treatment FDG-PET/CT on OS was also analyzed (≤28 days prior to treatment, 29-56 days prior, and >56 days prior). Results Between 2007 and 2017, a total of 13 796 people were diagnosed with stage III NSCLC in Ontario. FDG-PET/CT utilization increased over time with 0% of cases in 2007 and 74% in 2017 with pre-treatment FDG-PET/CT scans. The number of patients who received a mediastinal biopsy similarly increased in this timeframe increasing from 41% to 53%. More patients with pre-treatment FDG-PET/CT scans received curative-intent therapy than those who did not: 23% vs 13% for CRT (p<0.001), and 23% vs 10% for surgery (p<0.001). Median OS was longer in those with FDG-PET/CT scans prior to treatment (17 vs 11 months), as was 5-year survival (22% vs 14%, p<0.001), and this held true on both univariate and multivariate analyses. Timing of FDG-PET/CT scan relative to treatment was not associated with differences in OS. Conclusion Improvements in OS were seen in this cohort of stage III NSCLC patients who underwent a pre-treatment FDG-PET/CT scan. This can likely be attributed to stage-appropriate therapy due to more complete staging using FDG-PET/CT. This study stresses the importance of complete staging for suspected stage III NSCLC using FDG-PET/CT, and a need for continued advocacy for increased access to FDG-PET/CT scans.
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Affiliation(s)
- Craig A. Beers
- Division of Radiation Oncology, Juravinski Cancer Centre, Hamilton, ON, Canada
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Gregory R. Pond
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - James R. Wright
- Division of Radiation Oncology, Juravinski Cancer Centre, Hamilton, ON, Canada
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Theodoros Tsakiridis
- Division of Radiation Oncology, Juravinski Cancer Centre, Hamilton, ON, Canada
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Gordon S. Okawara
- Division of Radiation Oncology, Juravinski Cancer Centre, Hamilton, ON, Canada
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Anand Swaminath
- Division of Radiation Oncology, Juravinski Cancer Centre, Hamilton, ON, Canada
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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13
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Madani MH, Riess JW, Brown LM, Cooke DT, Guo HH. Imaging of lung cancer. Curr Probl Cancer 2023:100966. [PMID: 37316337 DOI: 10.1016/j.currproblcancer.2023.100966] [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: 02/21/2023] [Revised: 04/29/2023] [Accepted: 05/23/2023] [Indexed: 06/16/2023]
Abstract
Lung cancer is the leading cause of cancer-related mortality globally. Imaging is essential in the screening, diagnosis, staging, response assessment, and surveillance of patients with lung cancer. Subtypes of lung cancer can have distinguishing imaging appearances. The most frequently used imaging modalities include chest radiography, computed tomography, magnetic resonance imaging, and positron emission tomography. Artificial intelligence algorithms and radiomics are emerging technologies with potential applications in lung cancer imaging.
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Affiliation(s)
- Mohammad H Madani
- Department of Radiology, University of California, Davis, Sacramento, CA.
| | - Jonathan W Riess
- Division of Hematology/Oncology, Department of Internal Medicine, UC Davis Medical Center, UC Davis Comprehensive Cancer Center, Sacramento, CA
| | - Lisa M Brown
- Division of General Thoracic Surgery, Department of Surgery, UC Davis Health, Sacramento, CA
| | - David T Cooke
- Division of General Thoracic Surgery, Department of Surgery, UC Davis Health, Sacramento, CA
| | - H Henry Guo
- Department of Radiology, Stanford University School of Medicine, Stanford, CA
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14
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Barbur I, Anderson N, Bhagat R, Aranda-Michel E, Bianco V, Giuliano K, Louis C, Blitzer D. A Primer for Students Regarding Cardiothoracic Imaging: Primer 4 of 7. JTCVS OPEN 2023; 14:331-338. [PMID: 37425448 PMCID: PMC10329036 DOI: 10.1016/j.xjon.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/07/2023] [Accepted: 04/03/2023] [Indexed: 07/11/2023]
Affiliation(s)
- Iulia Barbur
- Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, Md
| | - Nicholas Anderson
- College of Osteopathic Medicine, Midwestern University Chicago, Chicago, Ill
| | - Rohun Bhagat
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Edgar Aranda-Michel
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa
| | - Valentino Bianco
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa
| | | | - Clauden Louis
- Division of Cardiothoracic Surgery, Brigham and Women's Hospital, Boston, Mass
| | - David Blitzer
- Division of Cardiothoracic Surgery, Columbia University Irving Medical Center, New York City, NY
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15
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Damirov F, Stoleriu MG, Manapov F, Büsing K, Michels JD, Preissler G, Hatz RA, Hohenberger P, Roessner ED. Histology of the Primary Tumor Correlates with False Positivity of Integrated 18F-FDG-PET/CT Lymph Node Staging in Resectable Lung Cancer Patients. Diagnostics (Basel) 2023; 13:diagnostics13111893. [PMID: 37296745 DOI: 10.3390/diagnostics13111893] [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: 04/17/2023] [Revised: 05/15/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
This study aimed to evaluate the diagnostic accuracy and false positivity rate of lymph node (LN) staging assessed by integrated 18F-fluorodeoxyglucose positron emission computed tomography (18F-FDG-PET/CT) in patients with operable lung cancer to the tumor histology. In total, 129 consecutive patients with non-small-cell lung cancer (NSCLC) undergoing anatomical lung resections were included. Preoperative LN staging was evaluated in the relationship to the histology of the resected specimens (group 1: lung adenocarcinoma/LUAD; group 2: squamous cell carcinoma/SQCA). Statistical analysis was performed by the Mann-Whitney U-test, the chi2 test, and binary logistic regression analysis. To establish an easy-to-use algorithm for the identification of LN false positivity, a decision tree including clinically meaningful parameters was generated. In total, 77 (59.7%) and 52 (40.3%) patients were included in the LUAD and SQCA groups, respectively. SQCA histology, non-G1 tumors, and tumor SUVmax > 12.65 were identified as independent predictors of LN false positivity in the preoperative staging. The corresponding ORs and their 95% CIs were 3.35 [1.10-10.22], p = 0.0339; 4.60 [1.06-19.94], p = 0.0412; and 2.76 [1.01-7.55], and p = 0.0483. The preoperative identification of false-positive LNs is an important aspect of the treatment regimen for patients with operable lung cancer; thus, these preliminary findings should be further evaluated in larger patient cohorts.
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Affiliation(s)
- Fuad Damirov
- Department of Thoracic Surgery, Ludwig Maximilian University of Munich, 81377 Munich, Germany
- Department of Surgery, Division of Surgical Oncology and Thoracic Surgery, University Hospital Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - Mircea Gabriel Stoleriu
- Department of Thoracic Surgery, Ludwig Maximilian University of Munich, 81377 Munich, Germany
- Institute for Lung Biology and Disease, Comprehensive Pneumology Center (CPC), Member of the German Lung Research Center (DZL), Helmholtz Zentrum München, 81377 Munich, Germany
| | - Farkhad Manapov
- Institute for Lung Biology and Disease, Comprehensive Pneumology Center (CPC), Member of the German Lung Research Center (DZL), Helmholtz Zentrum München, 81377 Munich, Germany
- Department of Radiation Oncology, Ludwig Maximilian University of Munich, 81377 Munich, Germany
| | - Karen Büsing
- Clinic for Radiology and Nuclear Medicine, University Hospital Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - Julia Dorothea Michels
- Department of Pulmonology and Critical Care, Thoraxklinik Heidelberg gGmbH, University of Heidelberg, 69126 Heidelberg, Germany
- Translational Lung Research Center (TLRC), Member of the German Lung Research Center (DZL), University of Heidelberg, 69126 Heidelberg, Germany
| | - Gerhard Preissler
- Institute for Lung Biology and Disease, Comprehensive Pneumology Center (CPC), Member of the German Lung Research Center (DZL), Helmholtz Zentrum München, 81377 Munich, Germany
- Department of Thoracic Surgery, Robert Bosch Hospital, Teaching Hospital of University Tübingen, 70376 Stuttgart, Germany
| | - Rudolf A Hatz
- Department of Thoracic Surgery, Ludwig Maximilian University of Munich, 81377 Munich, Germany
- Institute for Lung Biology and Disease, Comprehensive Pneumology Center (CPC), Member of the German Lung Research Center (DZL), Helmholtz Zentrum München, 81377 Munich, Germany
| | - Peter Hohenberger
- Department of Surgery, Division of Surgical Oncology and Thoracic Surgery, University Hospital Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - Eric D Roessner
- Department of Surgery, Division of Surgical Oncology and Thoracic Surgery, University Hospital Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Department of Thoracic Surgery, Center for Thoracic Diseases, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
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Yin H, Hong H, Yin P, Lu W, Niu S, Chen X, Xia Y, Jiang P, Huang Z. Increased levels of N6-methyladenosine in peripheral blood RNA: a perspective diagnostic biomarker and therapeutic target for non-small cell lung cancer. Clin Chem Lab Med 2023; 61:473-484. [PMID: 36542027 DOI: 10.1515/cclm-2022-1033] [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: 07/04/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Due to lack of effective biomarkers for non-small cell lung cancer (NSCLC), many patients are diagnosed at an advanced stage, which leads to poor prognosis. Dysregulation of N6-methyladenosine (m6A) RNA contributes significantly to tumorigenesis and tumor progression. However, the diagnostic value of m6A RNA status in peripheral blood to screen NSCLC remains unclear. METHODS Peripheral blood samples from 152 NSCLC patients and 64 normal controls (NCs) were applied to assess the m6A RNA levels. Bioinformatics and qRT-PCR analysis were performed to identify the specific immune cells in peripheral blood cells and investigate the mechanism of the alteration of m6A RNA levels. RESULTS Robust elevation of m6A RNA levels of peripheral blood cells was exhibited in the NSCLC group. Moreover, the m6A levels increased as NSCLC progressed, and reduced after treatment. The m6A levels contained area under the curve (AUC) was 0.912, which was remarkably greater than the AUCs for CEA (0.740), CA125 (0.743), SCC (0.654), and Cyfra21-1 (0.730). Furthermore, the combination of these traditional biomarkers with m6A levels elevated the AUC to 0.970. Further analysis established that the expression of m6A erasers FTO and ALKBH5 were both markedly reduced and negatively correlated with m6A levels in peripheral blood of NSCLC. Additionally, GEO database and flow cytometry analysis implied that FTO and ALKBH5 attributes to peripheral CD4+ T cells proportion and activated the immune functions of T cells. CONCLUSIONS These findings unraveled that m6A RNA of peripheral blood immune cells was a prospective biomarker for the diagnosis of NSCLC.
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Affiliation(s)
- Haofan Yin
- Department of Clinical Laboratory, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China.,Digestive Diseases Center, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, P.R. China.,Department of Clinical Laboratory, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, P.R. China
| | - Honghai Hong
- Department of Clinical Laboratory, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
| | - Ping Yin
- Department of Clinical Laboratory, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
| | - Wenhua Lu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China
| | - Shiqiong Niu
- Department of Clinical Laboratory, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, P.R. China
| | - Xinchun Chen
- Blood Transfusion Department, University of Chineses Academy of Sciences-Shenzhen Hospital, Shenzhen, Guangdong, P.R. China
| | - Yong Xia
- Department of Clinical Laboratory, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
| | - Ping Jiang
- Department of Clinical Medical Laboratory, Guangzhou First' People Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, P.R. China
| | - Zhijian Huang
- Digestive Diseases Center, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, P.R. China
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17
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Munir M, Setiawan H, Awaludin R, Kett VL. Aerosolised micro and nanoparticle: formulation and delivery method for lung imaging. Clin Transl Imaging 2023; 11:33-50. [PMID: 36196096 PMCID: PMC9521863 DOI: 10.1007/s40336-022-00527-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/26/2022] [Indexed: 02/07/2023]
Abstract
Purpose The application of contrast and tracing agents is essential for lung imaging, as indicated by the wide use in recent decades and the discovery of various new contrast and tracing agents. Different aerosol production and pulmonary administration methods have been developed to improve lung imaging quality. This review details and discusses the ideal characteristics of aerosol administered via pulmonary delivery for lung imaging and the methods for the production and pulmonary administration of dry or liquid aerosol. Methods We explored several databases, including PubMed, Scopus, and Google Scholar, while preparing this review to discover and obtain the abstracts, reports, review articles, and research papers related to aerosol delivery for lung imaging and the formulation and pulmonary delivery method of dry and liquid aerosol. The search terms used were "dry aerosol delivery", "liquid aerosol delivery", "MRI for lung imaging", "CT scan for lung imaging", "SPECT for lung imaging", "PET for lung imaging", "magnetic particle imaging", "dry powder inhalation", "nebuliser", and "pressurised metered-dose inhaler". Results Through the literature review, we found that the critical considerations in aerosol delivery for lung imaging are appropriate lung deposition of inhaled aerosol and avoiding toxicity. The important tracing agent was also found to be Technetium-99m (99mTc), Gallium-68 (68Ga) and superparamagnetic iron oxide nanoparticle (SPION), while the essential contrast agents are gold, iodine, silver gadolinium, iron and manganese-based particles. The pulmonary delivery of such tracing and contrast agents can be performed using dry formulation (graphite ablation, spark ignition and spray dried powder) and liquid aerosol (nebulisation, pressurised metered-dose inhalation and air spray). Conclusion A dual-imaging modality with the combination of different tracing or contrast agents is a future development of aerosolised micro and nanoparticles for lung imaging to improve diagnosis success. Graphical abstract
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Affiliation(s)
- Miftakul Munir
- Research Center for Radioisotope Radiopharmaceutical and Biodosimetry Technology, National Research and Innovation Agency, South Tangerang, 15345 Indonesia
| | - Herlan Setiawan
- Research Center for Radioisotope Radiopharmaceutical and Biodosimetry Technology, National Research and Innovation Agency, South Tangerang, 15345 Indonesia
| | - Rohadi Awaludin
- Research Center for Radioisotope Radiopharmaceutical and Biodosimetry Technology, National Research and Innovation Agency, South Tangerang, 15345 Indonesia
| | - Vicky L. Kett
- School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast, BT9 7BL UK
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18
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FDG-PET/CT tumor to liver SUV ratio (TLR), tumor SUVmax, and tumor size: can this help in differentiating squamous cell carcinoma from adenocarcinoma of the lung? THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00782-4] [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
PET/CT plays an essential role in the diagnosis, staging, and follow-up of lung cancer. We aimed to assess the ability of PET/CT to differentiate between adenocarcinomas (AC) and squamous cell carcinomas (SCC) of the lung using tumor size, tumor maximum standardized uptake value (SUVmax), lymph nodes SUVmax, and tumor to liver SUV ratio (TLR).
Results
A total of 60 patients pathologically proved to have non-small cell lung cancer either AC or SCC were retrospectively evaluated. The mean tumor size, SUVmax of the tumor, and TLR were significantly higher in SCC lesions compared to AC lesions. The mean SCC tumoral size was 7.96 ± 2.18 cm compared to 5.66 ± 2.57 cm in AC lesions (P = 0.008). The mean tumor SUVmax in SCC lesions was 18.95 ± 8.3 compared to 12.4 ± 7.55 in AC lesions (P = 0.04). While the mean TLR of SCC lesions was 10.32 ± 4.03 compared to 7.36 ± 4.61 in AC lesions (P = 0.028). All three parameters showed the same sensitivity (75%), while TLR showed the highest specificity (77.78%) followed by tumor size (76.47%) and then SUVmax of the tumor (72.22%).
Conclusions
SCC of the lung has a higher mean tumor size, SUVmax of the tumor, and TLR as compared to AC which can be helpful tools in differentiation between them using PET/CT.
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19
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Broens B, Duitman JW, Zwezerijnen GJC, Nossent EJ, van der Laken CJ, Voskuyl AE. Novel tracers for molecular imaging of interstitial lung disease: A state of the art review. Autoimmun Rev 2022; 21:103202. [PMID: 36150433 DOI: 10.1016/j.autrev.2022.103202] [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: 08/31/2022] [Accepted: 09/16/2022] [Indexed: 12/14/2022]
Abstract
Interstitial lung disease is an overarching term for a wide range of disorders characterized by inflammation and/or fibrosis in the lungs. Most prevalent forms, among others, include idiopathic pulmonary fibrosis (IPF) and connective tissue disease associated interstitial lung disease (CTD-ILD). Currently, only disease modifying treatment options are available for IPF and progressive fibrotic CTD-ILD, leading to reduction or stabilization in the rate of lung function decline at best. Management of these patients would greatly advance if we identify new strategies to improve (1) early detection of ILD, (2) predicting ILD progression, (3) predicting response to therapy and (4) understanding pathophysiology. Over the last years, positron emission tomography (PET) and single photon emission computed tomography (SPECT) have emerged as promising molecular imaging techniques to improve ILD management. Both are non-invasive diagnostic tools to assess molecular characteristics of an individual patient with the potential to apply personalized treatment. In this review, we encompass the currently available pre-clinical and clinical studies on molecular imaging with PET and SPECT in IPF and CTD-ILD. We provide recommendations for potential future clinical applications of these tracers and directions for future research.
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Affiliation(s)
- Bo Broens
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Rheumatology and Clinical Immunology, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Infection & Immunity, Inflammatory diseases, Amsterdam, the Netherlands.
| | - Jan-Willem Duitman
- Amsterdam Infection & Immunity, Inflammatory diseases, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Department of Pulmonary Medicine, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Experimental Immunology (EXIM), Meibergdreef 9, Amsterdam, the Netherlands.
| | - Gerben J C Zwezerijnen
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Radiology and Nuclear Medicine, De Boelelaan 1117, Amsterdam, the Netherlands.
| | - Esther J Nossent
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Pulmonary Medicine, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences Research Institute, Amsterdam, the Netherlands..
| | - Conny J van der Laken
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Rheumatology and Clinical Immunology, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Infection & Immunity, Inflammatory diseases, Amsterdam, the Netherlands.
| | - Alexandre E Voskuyl
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Rheumatology and Clinical Immunology, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Infection & Immunity, Inflammatory diseases, Amsterdam, the Netherlands.
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20
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Guo Q, Liu L, Chen Z, Fan Y, Zhou Y, Yuan Z, Zhang W. Current treatments for non-small cell lung cancer. Front Oncol 2022; 12:945102. [PMID: 36033435 PMCID: PMC9403713 DOI: 10.3389/fonc.2022.945102] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/06/2022] [Indexed: 12/12/2022] Open
Abstract
Despite improved methods of diagnosis and the development of different treatments, mortality from lung cancer remains surprisingly high. Non-small cell lung cancer (NSCLC) accounts for the large majority of lung cancer cases. Therefore, it is important to review current methods of diagnosis and treatments of NSCLC in the clinic and preclinic. In this review, we describe, as a guide for clinicians, current diagnostic methods and therapies (such as chemotherapy, chemoradiotherapy, targeted therapy, antiangiogenic therapy, immunotherapy, and combination therapy) for NSCLC.
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Affiliation(s)
- Qianqian Guo
- Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou University, Zhengzhou, China
| | - Liwei Liu
- Department of Pharmacy, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zelong Chen
- Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Artificial Intelligence and IoT Smart Medical Engineering Research Center of Henan Province, Zhengzhou, China
| | - Yannan Fan
- Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou University, Zhengzhou, China
| | - Yang Zhou
- Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, China
| | - Ziqiao Yuan
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education, School of Pharmaceutical Sciences, Zhengzhou University, State Key Laboratory of Esophageal Cancer Prevention and Treatment, Zhengzhou University, Zhengzhou, China
- *Correspondence: Wenzhou Zhang, ; Ziqiao Yuan,
| | - Wenzhou Zhang
- Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou University, Zhengzhou, China
- *Correspondence: Wenzhou Zhang, ; Ziqiao Yuan,
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21
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Frisone D, Sandoval J, Friedlaender A, Olivier T, Addeo A. Trends in incidence and mortality of lung cancer in Switzerland: Possible explanations and open questions. Cancer Epidemiol 2022; 80:102232. [PMID: 35905519 DOI: 10.1016/j.canep.2022.102232] [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: 03/23/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Using US population-level data, it has been suggested that novel treatment advances, particularly targeted therapies, have contributed to a sharp fall in NSCLC mortality. Switzerland is a high-income country, with a universal, highly performant health care system, easy access to novel drugs but with different dynamics concerning the smoking epidemic than the US. METHODS We use population-based data from Swiss cancer registries to analyze the trends in incidence, mortality and survival and relate them to recent drug approvals. RESULTS The incidence of NSCLC and SCLC was stable from 1980 to 2018. We noted an important difference between sexes, with an important decrease in men and increase in women, especially for NSCLC. 1-y and 5-y survival have improved for NSCLC between 2004 and 2008 and 2014-2018. CONCLUSION These findings should be regarded as the results of a multifactorial improvement in care and it is difficult for us to pinpoint a unique cause explaining the reduction in mortality.
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Affiliation(s)
- Daniele Frisone
- Department of Oncology, Geneva University Hospital, SCCL, Switzerland
| | - Jose Sandoval
- Department of Oncology, Geneva University Hospital, SCCL, Switzerland
| | - Alex Friedlaender
- Department of Oncology, Geneva University Hospital, SCCL, Switzerland; Clinique Générale Beaulieu, Geneva, Switzerland
| | - Timothée Olivier
- Department of Oncology, Geneva University Hospital, SCCL, Switzerland; Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th St, 2nd Fl, San Francisco, CA 94158, USA
| | - Alfredo Addeo
- Department of Oncology, Geneva University Hospital, SCCL, Switzerland; Geneva University, Faculty of Medicine, Switzerland.
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22
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AĞABABAOĞLU İ, YİLDİZ OO, YAPAR D, ERSÖZ H, HAZER S, HELVACI Ö, GÜLHAN SŞE, KARAOGLANOGLU N. Mediastinal lymphnode positivity clinical scoring system for lung adenocarsinoma-mediastinal lymph node evaluation and staging. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1061755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: The study-cohort aims to assess PET-CT's correlation with adenocarcinomas' subtypes and propose a scoring system for mediastinal lymph nodes staging.
Material and Method: The patient cohort is a multicenter, retrospective analysis of 268 patient that underwent surgery for NSCLC adenocarcinoma. Preoperative PET-CT results for mediastinal lymph node staging was pathologically confirmed on tissue specimens obtained at anatomical resection. Statistical evaluation of PET CT, radiological and pathological outcomes were performed on all subgroups.
Results: The low FDG affinity in the lepidic pattern was statistically significant in the study (p
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Affiliation(s)
| | | | | | | | - Seray HAZER
- UNIVERSITY OF HEALTH SCIENCES, ANKARA ATATÜRK HEALTH RESEARCH CENTER FOR PULMONOLOGY AND THORACIC SURGERY
| | - Özant HELVACI
- Yıldırım Beyazıt Üniversitesi Yenimahalle Eğitim ve Araştırma Hastanesi
| | - Selim Şakir Erkmen GÜLHAN
- UNIVERSITY OF HEALTH SCIENCES, ANKARA ATATÜRK HEALTH RESEARCH CENTER FOR PULMONOLOGY AND THORACIC SURGERY
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23
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Porphyrins as Chelating Agents for Molecular Imaging in Nuclear Medicine. Molecules 2022; 27:molecules27103311. [PMID: 35630788 PMCID: PMC9148099 DOI: 10.3390/molecules27103311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 12/04/2022] Open
Abstract
Porphyrin ligands, showing a significant affinity for cancer cells, also have the ability to chelate metallic radioisotopes to form potential diagnostic radiopharmaceuticals. They can be applied in single-photon emission computed tomography (SPECT) and positron emission tomography (PET) to evaluate metabolic changes in the human body for tumor diagnostics. The aim of this paper is to present a short overview of the main metallic radionuclides complexed by porphyrin ligands and used in these techniques. These chelation reactions are discussed in terms of the complexation conditions and kinetics and the complex stability.
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24
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Ali Z, Vildevall M, Rodriguez GV, Tandiono D, Vamvakaris I, Evangelou G, Lolas G, Syrigos KN, Villanueva A, Wick M, Omar S, Erkstam A, Schueler J, Fahlgren A, Jensen LD. Zebrafish patient-derived xenograft models predict lymph node involvement and treatment outcome in non-small cell lung cancer. J Exp Clin Cancer Res 2022; 41:58. [PMID: 35139880 PMCID: PMC8827197 DOI: 10.1186/s13046-022-02280-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 01/31/2022] [Indexed: 11/25/2022] Open
Abstract
Background Accurate predictions of tumor dissemination risks and medical treatment outcomes are critical to personalize therapy. Patient-derived xenograft (PDX) models in mice have demonstrated high accuracy in predicting therapeutic outcomes, but methods for predicting tumor invasiveness and early stages of vascular/lymphatic dissemination are still lacking. Here we show that a zebrafish tumor xenograft (ZTX) platform based on implantation of PDX tissue fragments recapitulate both treatment outcome and tumor invasiveness/dissemination in patients, within an assay time of only 3 days. Methods Using a panel of 39 non-small cell lung cancer PDX models, we developed a combined mouse-zebrafish PDX platform based on direct implantation of cryopreserved PDX tissue fragments into zebrafish embryos, without the need for pre-culturing or expansion. Clinical proof-of-principle was established by direct implantation of tumor samples from four patients. Results The resulting ZTX models responded to Erlotinib and Paclitaxel, with similar potency as in mouse-PDX models and the patients themselves, and resistant tumors similarly failed to respond to these drugs in the ZTX system. Drug response was coupled to elevated expression of EGFR, Mdm2, Ptch1 and Tsc1 (Erlotinib), or Nras and Ptch1 (Paclitaxel) and reduced expression of Egfr, Erbb2 and Foxa (Paclitaxel). Importantly, ZTX models retained the invasive phenotypes of the tumors and predicted lymph node involvement of the patients with 91% sensitivity and 62% specificity, which was superior to clinically used tests. The biopsies from all four patient tested implanted successfully, and treatment outcome and dissemination were quantified for all patients in only 3 days. Conclusions We conclude that the ZTX platform provide a fast, accurate, and clinically relevant system for evaluation of treatment outcome and invasion/dissemination of PDX models, providing an attractive platform for combined mouse-zebrafish PDX trials and personalized medicine. Supplementary Information The online version contains supplementary material available at 10.1186/s13046-022-02280-x.
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Affiliation(s)
| | | | | | | | | | - Georgios Evangelou
- 3rd Department of Internal Medicine and Laboratory, National & Kapodistrian University of Athens, Athens, Greece
| | - Georgios Lolas
- 3rd Department of Internal Medicine and Laboratory, National & Kapodistrian University of Athens, Athens, Greece.,InCELLiA P.C, Athens, Greece
| | - Konstantinos N Syrigos
- 3rd Department of Internal Medicine and Laboratory, National & Kapodistrian University of Athens, Athens, Greece
| | - Alberto Villanueva
- Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), Oncobell Program, L'Hospitalet del Llobregat, Barcelona, Catalonia, Spain.,Xenopat S.L., Parc Cientific de Barcelona (PCB), Barcelona, Spain
| | | | - Shenga Omar
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Campus US, Entrance 68, Pl. 08, SE-58185, Linköping, Sweden
| | | | | | - Anna Fahlgren
- BioReperia AB, Linköping, Sweden.,Division of Cell Biology, Department of Biomedical and Clinical Sciences, Linköping University, Linöping, Sweden
| | - Lasse D Jensen
- BioReperia AB, Linköping, Sweden. .,Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Campus US, Entrance 68, Pl. 08, SE-58185, Linköping, Sweden.
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25
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Freely available convolutional neural network-based quantification of PET/CT lesions is associated with survival in patients with lung cancer. EJNMMI Phys 2022; 9:6. [PMID: 35113252 PMCID: PMC8814082 DOI: 10.1186/s40658-022-00437-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 01/24/2022] [Indexed: 12/11/2022] Open
Abstract
Background Metabolic positron emission tomography/computed tomography (PET/CT) parameters describing tumour activity contain valuable prognostic information, but to perform the measurements manually leads to both intra- and inter-reader variability and is too time-consuming in clinical practice. The use of modern artificial intelligence-based methods offers new possibilities for automated and objective image analysis of PET/CT data.
Purpose We aimed to train a convolutional neural network (CNN) to segment and quantify tumour burden in [18F]-fluorodeoxyglucose (FDG) PET/CT images and to evaluate the association between CNN-based measurements and overall survival (OS) in patients with lung cancer. A secondary aim was to make the method available to other researchers. Methods A total of 320 consecutive patients referred for FDG PET/CT due to suspected lung cancer were retrospectively selected for this study. Two nuclear medicine specialists manually segmented abnormal FDG uptake in all of the PET/CT studies. One-third of the patients were assigned to a test group. Survival data were collected for this group. The CNN was trained to segment lung tumours and thoracic lymph nodes. Total lesion glycolysis (TLG) was calculated from the CNN-based and manual segmentations. Associations between TLG and OS were investigated using a univariate Cox proportional hazards regression model. Results The test group comprised 106 patients (median age, 76 years (IQR 61–79); n = 59 female). Both CNN-based TLG (hazard ratio 1.64, 95% confidence interval 1.21–2.21; p = 0.001) and manual TLG (hazard ratio 1.54, 95% confidence interval 1.14–2.07; p = 0.004) estimations were significantly associated with OS. Conclusion Fully automated CNN-based TLG measurements of PET/CT data showed were significantly associated with OS in patients with lung cancer. This type of measurement may be of value for the management of future patients with lung cancer. The CNN is publicly available for research purposes.
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26
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Wang T, Liu J, Lv N, Xuan S, Bai L, Ji B, Gao S. Performance of Ultrasound-Guided Core Biopsy Driven by FDG-avid Supraclavicular Lymph Nodes in Patients With Suspected Lung Cancer. Front Med (Lausanne) 2022; 8:803500. [PMID: 35127759 PMCID: PMC8811154 DOI: 10.3389/fmed.2021.803500] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/24/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives Ultrasound-guided core biopsy (UGCB) for supraclavicular lymph nodes (SLNs) represents an attractive procedure to obtain tissues for lung cancer confirmation. The aim of the present study is to evaluate the performance of UGCB driven by FDG-avid SLNs, as performed by nuclear medicine physicians, in patients with suspected lung cancer. Methods Institutional database in our hospital was searched for eligible patients between September 2019 and March 2021. A 3-12 MHz linear probe was used to guide the biopsy process and to ensure that the needle tip was being directed at the metabolically active area that had been indicated by side-by-side PET/CT images. Diagnostic yield, malignancy rate, molecular testing results, and complications were reviewed. Results Among the 54 patients included in this study, definite pathological diagnosis from UGCB specimens was achieved in 53 patients, reaching a diagnostic yield of 98.1% (53/54) and a malignancy rate of 96.2% (51/53). Among the 50 patients confirmed as lung cancer, thirty-eight were spared from further invasive procedures which had been planned. Molecular analyses were adequately performed on all the 38 specimens obtained from non-small cell lung cancer (NSCLS). The positive rate was 36.8% (14/38) for epidermal growth receptor (EGFR) mutation and 31.6% (12/38) for anaplastic lymphoma kinase (ALK) translocation. 28.9% (11/38) of the patients had a tumor proportion score (TPS) ≥ 50% for PD-L1 expression. No complication was observed and the average biopsy time was 15 min. Conclusions Nuclear medicine physicians-performed UGCB driven by FDG-avid SLNs in suspected lung cancer patients could produce a high performance in terms of diagnostic yield, malignancy rate, and molecular analysis, which may obliviate more invasive interventional procedures and lead to fast decisions on subsequent management.
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Affiliation(s)
- Tongtong Wang
- Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Junbao Liu
- Department of Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Ningning Lv
- Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Shi Xuan
- Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Lin Bai
- Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Bin Ji
- Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, China
- Bin Ji
| | - Shi Gao
- Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, China
- *Correspondence: Shi Gao
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27
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Agrawal A, Bhattacharya S. Cutting-edge Nanotechnological Approaches for Lung Cancer Therapy. Curr Drug Res Rev 2022; 14:171-187. [PMID: 35440332 DOI: 10.2174/2589977514666220418085658] [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: 08/26/2021] [Revised: 01/17/2022] [Accepted: 02/22/2022] [Indexed: 06/14/2023]
Abstract
Lung cancer is the second leading cancer with a high rate of mortality. It can be treated using different intervention techniques such as chemotherapy, radiation therapy, surgical removal, and photodynamic therapy. All of these interventions lack specificity, implying that it harms the normal cells adjacent to the infected ones. Nanotechnology provides a promising solution that increases the bioavailability of anticancer drugs at the tumor site with reduced toxicity and improved therapeutic efficacy. Nanotechnology also improves the way lung cancer is diagnosed and treated. Various nanocarriers like liposomes, polymeric nanoparticles, magnetic nanoparticles, and different theranostic approaches are already approved for medical use, while various are under clinical and preclinical stages. This review article covers the details about lung cancer, types of overexpressed receptors, and cutting-edge nanocarriers used for treating lung cancer at its specific target.
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Affiliation(s)
- Amaiyya Agrawal
- Department of Pharmaceutics, School of Pharmacy & Technology Management, SVKM\'S NMIMS Deemed-to-be University, Shirpur 425405, Maharashtra, India
| | - Sankha Bhattacharya
- Department of Pharmaceutics, School of Pharmacy & Technology Management, SVKM\'S NMIMS Deemed-to-be University, Shirpur 425405, Maharashtra, India
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Damuka N, Dodda M, Bansode AH, Sai KKS. PET Use in Cancer Diagnosis, Treatment, and Prognosis. Methods Mol Biol 2022; 2413:23-35. [PMID: 35044651 PMCID: PMC9136679 DOI: 10.1007/978-1-0716-1896-7_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Tumorigenesis is a multistep process marked by variations in numerous metabolic pathways that affect cellular architectures and functions. Cancer cells reprogram their energy metabolism to enable several basic molecular functions, including membrane biosynthesis, receptor regulations, bioenergetics, and redox stress. In recent years, cancer diagnosis and treatment strategies have targeted these specific metabolic changes and the tumor's interactions with its microenvironment. Positron emission tomography (PET) captures all molecular alterations leading to abnormal function and cancer progression. As a result, the development of PET radiotracers increasingly focuses on irregular biological pathways or cells that overexpress receptors that have the potential to function as biomarkers for early diagnosis and treatment measurements as well as research. This chapter reviews both established and evolving PET radiotracers used to image tumor biology. We have also included a few advantages and disadvantages of the routinely used PET radiotracers in cancer imaging.
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Affiliation(s)
- Naresh Damuka
- Department of Radiology, Wake Forest School of Medicine, Winston Salem, NC 27157
| | - Meghana Dodda
- Department of Radiology, Wake Forest School of Medicine, Winston Salem, NC 27157
| | - Avinash H Bansode
- Department of Radiology, Wake Forest School of Medicine, Winston Salem, NC 27157
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Lynch C, Reguilon I, Langer DL, Lane D, De P, Wong WL, Mckiddie F, Ross A, Shack L, Win T, Marshall C, Revheim ME, Danckert B, Butler J, Dizdarevic S, Louzado C, Mcgivern C, Hazlett A, Chew C, O'connell M, Harrison S. A comparative analysis: international variation in PET-CT service provision in oncology-an International Cancer Benchmarking Partnership study. Int J Qual Health Care 2021; 33:6030987. [PMID: 33306102 PMCID: PMC7896108 DOI: 10.1093/intqhc/mzaa166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/10/2020] [Accepted: 12/11/2020] [Indexed: 12/17/2022] Open
Abstract
Objective To explore differences in position emission tomography-computed tomography (PET-CT) service provision internationally to further understand the impact variation may have upon cancer services. To identify areas of further exploration for researchers and policymakers to optimize PET-CT services and improve the quality of cancer services. Design Comparative analysis using data based on pre-defined PET-CT service metrics from PET-CT stakeholders across seven countries. This was further informed via document analysis of clinical indication guidance and expert consensus through round-table discussions of relevant PET-CT stakeholders. Descriptive comparative analyses were produced on use, capacity and indication guidance for PET-CT services between jurisdictions. Setting PET-CT services across 21 jurisdictions in seven countries (Australia, Denmark, Canada, Ireland, New Zealand, Norway and the UK). Participants None. Intervention(s) None. Main Outcome Measure(s) None. Results PET-CT service provision has grown over the period 2006–2017, but scale of increase in capacity and demand is variable. Clinical indication guidance varied across countries, particularly for small-cell lung cancer staging and the specific acknowledgement of gastric cancer within oesophagogastric cancers. There is limited and inconsistent data capture, coding, accessibility and availability of PET-CT activity across countries studied. Conclusions Variation in PET-CT scanner quantity, acquisition over time and guidance upon use exists internationally. There is a lack of routinely captured and accessible PET-CT data across the International Cancer Benchmarking Partnership countries due to inconsistent data definitions, data linkage issues, uncertain coverage of data and lack of specific coding. This is a barrier in improving the quality of PET-CT services globally. There needs to be greater, richer data capture of diagnostic and staging tools to facilitate learning of best practice and optimize cancer services.
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Affiliation(s)
- Charlotte Lynch
- International Cancer Benchmarking Partnership (ICBP), Policy & Information, Cancer Research UK, 2 2 Redman Place, London, E20 1JQ, UK
| | - Irene Reguilon
- International Cancer Benchmarking Partnership (ICBP), Policy & Information, Cancer Research UK, 2 2 Redman Place, London, E20 1JQ, UK.,Brand & Strategy, eConsult Health Ltd, 46-48 East Street, Surrey, KT17 1HQ, UK
| | - Deanna L Langer
- Cancer Imaging, Ontario Health (Cancer Care Ontario), 620 University Avenue, Toronto, ON M5G 2L7, Canada
| | - Damon Lane
- Radiology, Pacific Radiology, 123 Victoria Street, Christchurch Central, Christchurch 8013, New Zealand
| | - Prithwish De
- Surveillance and Cancer Registry, Ontario Health (Cancer Care Ontario), 620 University Avenue, Toronto, ON M5G 2L7, Canada
| | - Wai-Lup Wong
- Nuclear Medicine, Mount Vernon Hospital, East and North Hertfordshire NHS Trust, Rickmansworth Road, Northwood, HA6 2RN, UK
| | - Fergus Mckiddie
- Nuclear Medicine and PET Department, NHS Grampian, 2 Eday Road, Aberdeen AB15 6RE, UK
| | - Andrew Ross
- Dalhousie Medical School, Dalhousie University, 6299 South Street, Halifax, Nova Scotia, NS B3H 4R2, Canada
| | - Lorraine Shack
- Surveillance and Reporting, Alberta Health Services (Cancer Control Alberta), 10030-107 Street NW, Edmonton, Alberta, T5J 3E4, Canada
| | - Thida Win
- General and Respiratory Medicine, Lister Hospital, East and North Hertfordshire NHS Trust, Coreys Mill Lane, Stevenage, SG1 4AB, UK
| | - Christopher Marshall
- Wales Research and Diagnostic PET Imaging Centre, Cardiff University, Cardiff University School of Medicine Health Park, Cardiff, CF14, 4XN, UK
| | - Mona-Eliszabeth Revheim
- Division of Radiology and Nuclear Medicine, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Pb 4950 Nydalen, Oslo, 0424, Norway
| | - Bolette Danckert
- Research Centre, Danish Cancer Society, Strandboulevarden 49, 2100 Kobenhavn, Denmark
| | - John Butler
- International Cancer Benchmarking Partnership (ICBP), Policy & Information, Cancer Research UK, 2 2 Redman Place, London, E20 1JQ, UK.,Gynaecology Department, Royal Marsden NHS Foundation Trust, 203 Fulham Road, London, SW3 6JJ, UK
| | - Sabina Dizdarevic
- Imaging and Nuclear Medicine, Brighton and Sussex University Hospital Trust, Kemptown, Brighton, BN2 1ES, United Kingdom and Brighton and Sussex Medical School, University of Sussex and Brighton, London Road, Brighton, BN1 4GE, UK
| | - Cheryl Louzado
- Strategy Implementation Planning & Partner Relations, Canadian Partnership Against Cancer, 145 King St, Toronto, ON M5H 1J8, Canada
| | - Canice Mcgivern
- Department of Regional Medical Physics, Belfast Health and Social Care Trust, 83 Shankill Road, Belfast, BT13 1FD, UK
| | - Anne Hazlett
- Department of Regional Medical Physics, Belfast Health and Social Care Trust, 83 Shankill Road, Belfast, BT13 1FD, UK
| | - Cindy Chew
- School of Medicine, Dentistry and Nursing, University of Glasgow, University Avenue, Glasgow, G12 8QQ, UK
| | - Martin O'connell
- Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin, DO7 R2WY, Ireland
| | - Samantha Harrison
- International Cancer Benchmarking Partnership (ICBP), Policy & Information, Cancer Research UK, 2 2 Redman Place, London, E20 1JQ, UK
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Berzenji L, Debaenst S, Hendriks JMH, Yogeswaran SK, Lauwers P, Van Schil PE. The role of the surgeon in the management of oligometastatic non-small cell lung cancer: a literature review. Transl Lung Cancer Res 2021; 10:3409-3419. [PMID: 34430376 PMCID: PMC8350094 DOI: 10.21037/tlcr-21-58] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 07/23/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVE In this review, we aim to summarize the most recent data on the surgical management of oligometastatic non-small cell lung cancer (NSCLC). BACKGROUND Approximately 60-70% of all patients with NSCLC initially present with advanced stages of cancer at time of diagnosis. These patients are generally treated with chemotherapy, radiation therapy, or a combination of these modalities. Patients with late-stage disease are usually not considered to be amenable for curative-intent treatments due to poor prognoses. Despite advances in systemic therapies, 5-year overall survival rates in these patients remain poor. However, technological advances in imaging modalities and new imaging strategies have substantially increased tumor detection rates and have resulted in a shift towards earlier diagnosis of NSCLC, possibly in stages in which metastatic disease is limited and still treatable. Studies in recent years have shown that there is a distinct group of patients with metastatic lesions at one or a few sites, often referred to as oligometastatic disease, that may have better survival outcomes compared to patients with more disseminated diseases. Furthermore, it is suggested that these patients may benefit from a combination of systemic treatment and local treatment aimed at the metastatic site(s). However, the role of surgery in this setting remains a controversial subject, with many unanswered questions. METHODS The PubMed/MEDLINE database and the Cochrane database were searched to find relevant articles regarding oligometastatic NSCLC. Specifically, articles regarding definitions of oligometastatic disease, oligometastatic tumor biology, diagnosis, and the treatment of oligometastatic disease were identified. CONCLUSIONS Oligometastatic NSCLC represents a wide spectrum of diseases and encompasses a heterogeneous patient population. Current data suggests that local ablative treatment of oligometastatic lesions with surgery or stereotactic body radiation therapy may result in improved overall survival and progression-free survival rates. However, more data from multi-center prospective trials are necessary to shed light on which therapeutic modalities are most suitable for the treatment of oligometastatic NSCLC. Integration of clinical and molecular staging data is necessary to allow for more personalized treatment approaches.
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Affiliation(s)
- Lawek Berzenji
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Sophie Debaenst
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Jeroen M H Hendriks
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem, Belgium
| | | | - Patrick Lauwers
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Paul E Van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem, Belgium
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Brandão M, Durieux V, Berghmans T. Current and future research efforts in oligometastatic non-small cell lung cancer-a systematic review. Transl Lung Cancer Res 2021; 10:3473-3485. [PMID: 34430381 PMCID: PMC8350078 DOI: 10.21037/tlcr-20-964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 05/17/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Major progresses in the systemic treatment of non-small cell lung cancer (NSCLC) were obtained during the last decade, including the use of immunotherapy and tyrosine kinase inhibitors (TKIs), with impressive results in terms of response and survival rates. Moreover, novel imaging and radiotherapy techniques have allowed the development of stereotactic body radiotherapy (SBRT), with high rates of local disease control and minimal toxicity. These factors propelled the use of combined systemic and local treatment strategies in patients with a low burden of metastases-the oligometastatic disease (OMD). METHODS We systematically review the evidence from prospective randomized and non-randomized trials on local ablative therapy for OMD NSCLC published until June 2020. In addition, we present a review of the ongoing and/or recruiting trials in the field. RESULTS We included 16 articles, reporting on 14 prospective clinical trials, starting from the pilot trial conducted in the early 2000's to the recent randomized trials that have showed benefits in survival. We found 24 ongoing trials, which combine multiple local ablative regimens with new systemic therapies, such as new generation TKIs and immunotherapy. DISCUSSION Despite these vast current and ongoing prospective research efforts, there are several issues that impair the generalizability of their findings. These include the heterogeneous definition of OMD, trial design, staging, patient selection, tumor mutational status and treatments used, which may limit their applicability in the clinical practice.
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Affiliation(s)
- Mariana Brandão
- Clinic of Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Valérie Durieux
- Bibliothèque des Sciences de la Santé, Université Libre de Bruxelles, Brussels, Belgium
| | - Thierry Berghmans
- Clinic of Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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Johnson A, Norman R, Piccolo F, Manners D. The optimal timing of FDG-PET/CT in non-small cell lung cancer diagnosis and staging in an Australian centre. BMC Pulm Med 2021; 21:209. [PMID: 34210303 PMCID: PMC8252249 DOI: 10.1186/s12890-021-01564-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/31/2021] [Indexed: 12/24/2022] Open
Abstract
Background Clinical practice guidelines and re-imbursement schedules vary in the recommended timing of FDG-PET/CT in the diagnostic evaluation of suspected or confirmed lung cancer. The aim was to estimate the probability of requiring more than one invasive test to complete diagnosis and staging in non-small cell lung cancer if FDG-PET/CT was used prior to initial biopsy (FDG-PET/CT First) compared to current Australian funding criteria (CT First). Methods Single-centre retrospective study of individuals with pathologically confirmed NSCLC without evidence of metastatic disease on baseline computed tomography (CT) of the chest. Decision tree analysis based on diagnosis and staging approaches estimated the probability of requiring more than one invasive biopsy. A Monte Carlo analysis with 1000 simulations was used to estimate decision tree precision. Results After exclusions, 115 patients were included with median (IQR) age of 71 (63–79) and 55.6% were male. The majority of cases were early stage (Stage I 43.5%, Stage II 19.1%) and adenocarcinoma (65.2%) histological subtype. The estimated probability of requiring more than one invasive biopsy with FDG-PET/CT prior was 0.12 compared to 0.19 when using the base case CT First scenario. Using the Monte Carlo analysis, the mean (95% CI) probability using the FDG-PET First approach was 0.15 (95%CI 0.12–0.20) versus 0.20 (95% CI 0.15–0.27) for the CT First approach. Only 7.8% had CT Chest-occult metastatic disease on FDG-PET that was accessible by percutaneous biopsy. Conclusion FDG-PET/CT performed prior to initial biopsy may reduce the proportion of people with NSCLC who require more than one biopsy attempt, but the clinical significance and overall cost-utility requires evaluation. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01564-w.
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Affiliation(s)
- Anne Johnson
- St John of God Midland Public and Private Hospitals, Midland, WA, Australia
| | - Richard Norman
- School of Population Health, Curtin University, Bentley, WA, Australia
| | - Francesco Piccolo
- St John of God Midland Public and Private Hospitals, Midland, WA, Australia
| | - David Manners
- St John of God Midland Public and Private Hospitals, Midland, WA, Australia.
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Kim JS, Park CR, Yoon SH, Lee JA, Kim TY, Yang HJ. Improvement of image quality using amplitude-based respiratory gating in PET-computed tomography scanning. Nucl Med Commun 2021; 42:553-565. [PMID: 33625179 DOI: 10.1097/mnm.0000000000001368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study sought to provide data supporting the expanded clinical use of respiratory gating by assessing the diagnostic accuracy of breathing motion correction using amplitude-based respiratory gating. METHODS A respiratory movement tracking device was attached to a PET-computed tomography scanner, and images were obtained in respiratory gating mode using a motion phantom that was capable of sensing vertical motion. Specifically, after setting amplitude changes and intervals according to the movement cycle using a total of nine combinations of three waveforms and three amplitude ranges, respiratory motion-corrected images were reconstructed using the filtered back projection method. After defining areas of interest in the acquired images in the same image planes, statistical analyses were performed to compare differences in standardized uptake value (SUV), lesion volume, full width at half maximum (FWHM), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). RESULTS SUVmax increased by 89.9%, and lesion volume decreased by 27.9%. Full width at half maximum decreased by 53.9%, signal-to-noise ratio increased by 11% and contrast-to-noise ratio increased by 16.3%. Optimal results were obtained when using a rest waveform and 35% duty cycle, in which the change in amplitude in the respiratory phase signal was low, and a constant level of long breaths was maintained. CONCLUSIONS These results demonstrate that respiratory-gated PET-CT imaging can be used to accurately correct for SUV changes and image distortion caused by respiratory motion, thereby providing excellent imaging information and quality.
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Affiliation(s)
- Jung-Soo Kim
- Department of Radiological Technology, Dongnam Health University, Suwon
- Department of Biomedical Science, The Korea University, Sejong
| | - Chan-Rok Park
- Department of Biomedical Science, The Korea University, Sejong
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul
| | - Seok-Hwan Yoon
- Department of Biomedical Science, The Korea University, Sejong
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul
| | - Joo-Ah Lee
- Department of Biomedical Science, The Korea University, Sejong
- Department of Radiation Oncology, Catholic University Incheon St. Mary's Hospital, Incheon
| | - Tae-Yoon Kim
- Department of Radiation Oncology, Catholic University Incheon St. Mary's Hospital, Incheon
- Department of Radiation Oncology, National Cancer Center, Goyang
| | - Hyung-Jin Yang
- Department of Radiation Oncology, Catholic University Incheon St. Mary's Hospital, Incheon
- Department of Physics, The Korea University, Sejong, Korea
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Hu P, Zhang Y, Yu H, Chen S, Tan H, Qi C, Dong Y, Wang Y, Deng Z, Shi H. Total-body 18F-FDG PET/CT scan in oncology patients: how fast could it be? Eur J Nucl Med Mol Imaging 2021; 48:2384-2394. [PMID: 33866409 DOI: 10.1007/s00259-021-05357-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/04/2021] [Indexed: 02/01/2023]
Abstract
PURPOSE The aim of the study was to determine a faster PET acquisition protocol for a total-body PET/CT scanner by assessing the image quality that is equivalent to a conventional digital PET/CT scanner from both a phantom and a clinical perspective. METHODS A phantom study using a NEMA/IEC NU-2 body phantom was first performed in both a total-body PET/CT (uEXPLORER) and a routine digital PET/CT (uMI 780), with a hot sphere to background activity concentration ratio of 4:1. The contrast recovery coefficient (CRC), background variability (BV), and recovery coefficient (RC: RCmax and RCmean) were assessed in the uEXPLORER with different scanning durations and reconstruction protocols, which were compared to those acquired from the uMI 780 with clinical acquisition settings. The coefficient of variation (COV) of the uMI 780 with clinical settings was calculated and used as a threshold reference to determine the optimized scanning duration and reconstruction protocol for the uEXPLORER. The obtained protocol from the phantom study was subsequently tested and validated in 30 oncology patients. Images acquired from the uMI 780 with 2-3 min per bed position were referred as G780 and served as the reference for comparison. All PET raw data from the uEXPLORER were reconstructed using the data-cutting technique to simulate a 30-s, 45-s, or 60-s acquisition duration, respectively. The iterations were 2 and 3 for the uEXPLORER, referred as G30s_3i, G45s_2i, G45s_3i, G60s_2i, and G60s_3i, respectively. A 5-point Likert scale was used in the qualitative analysis to assess the image quality. The image quality was also evaluated by the liver COV, the lesion target-to-background ratio (TBR), and the lesion signal-to-noise ratio (SNR). RESULTS In the phantom study, CRC, BV, RCmax, and RCmean in the uEXPLORER with different scanning durations and reconstruction iterations were compared with those in the uMI 780 with clinical settings. A minor fluctuation was found among different scanning durations. COV of the uMI 780 with clinical settings was 11.6%, and a protocol with a 30-45-s scanning duration and 2 or 3 iterations for the uEXPLORER was found to provide an equivalent image quality as the uMI 780. An almost perfect agreement was shown with a kappa value of 0.875. The qualitative score of the G30s_3i in the uEXPLORER was inferior to the G780 reference (p = 0.001); however, the scores of other groups in the uEXPLORER with a 45-s and above acquisition time were higher than the G780 in the uMI 780. In quantitative analysis, the delay time between the two scans in the two orders was not significantly different. There was no significant difference of the liver COV between the G780 and G30s_3i (p = 0.162). A total of 33 lesions were analyzed in the clinical patient study. There was no significant difference in lesion TBR between the reference G780 and the G45s_2i obtained from the uEXPLORER (p = 0.072), while the latter showed a higher lesion SNR value compared to that in uMI 780 with clinical settings (p < 0.001). CONCLUSIONS This study showed that a fast PET protocol with a 30-45-s acquisition time in the total-body uEXPLORER PET/CT can provide an equivalent image quality as the conventional digital uMI 780 PET/CT with longer clinical acquisition settings.
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Affiliation(s)
- Pengcheng Hu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Yiqiu Zhang
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Haojun Yu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Shuguang Chen
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Hui Tan
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Chi Qi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Yun Dong
- United Imaging Healthcare Co., Ltd., Shanghai, China
| | - Ying Wang
- United Imaging Healthcare Co., Ltd., Shanghai, China
| | - Zilin Deng
- United Imaging Healthcare Co., Ltd., Shanghai, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.
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Zhong S, Golpon H, Zardo P, Borlak J. miRNAs in lung cancer. A systematic review identifies predictive and prognostic miRNA candidates for precision medicine in lung cancer. Transl Res 2021; 230:164-196. [PMID: 33253979 DOI: 10.1016/j.trsl.2020.11.012] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 11/05/2020] [Accepted: 11/24/2020] [Indexed: 02/08/2023]
Abstract
Lung cancer (LC) is the leading cause of cancer-related death worldwide and miRNAs play a key role in LC development. To better diagnose LC and to predict drug treatment responses we evaluated 228 articles encompassing 16,697 patients and 12,582 healthy controls. Based on the criteria of ≥3 independent studies and a sensitivity and specificity of >0.8 we found blood-borne miR-20a, miR-10b, miR-150, and miR-223 to be excellent diagnostic biomarkers for non-small cell LC whereas miR-205 is specific for squamous cell carcinoma. The systematic review also revealed 38 commonly regulated miRNAs in tumor tissue and the circulation, thus enabling the prediction of histological subtypes of LC. Moreover, theranostic biomarker candidates with proven responsiveness to checkpoint inhibitor treatments were identified, notably miR-34a, miR-93, miR-106b, miR-181a, miR-193a-3p, and miR-375. Conversely, miR-103a-3p, miR-152, miR-152-3p, miR-15b, miR-16, miR-194, miR-34b, and miR-506 influence programmed cell death-ligand 1 and programmed cell death-1 receptor expression, therefore providing a rationale for the development of molecularly targeted therapies. Furthermore, miR-21, miR-25, miR-27b, miR-19b, miR-125b, miR-146a, and miR-210 predicted response to platinum-based treatments. We also highlight controversial reports on specific miRNAs. In conclusion, we report diagnostic miRNA biomarkers for in-depth clinical evaluation. Furthermore, in an effort to avoid unnecessary toxicity we propose predictive biomarkers. The biomarker candidates support personalized treatment decisions of LC patients and await their confirmation in randomized clinical trials.
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Affiliation(s)
- Shen Zhong
- Centre for Pharmacology and Toxicology, Hannover Medical School, Hannover, Germany
| | - Heiko Golpon
- Department of Pneumology, Hannover Medical School, Hannover, Germany
| | - Patrick Zardo
- Clinic for Cardiothoracic and Transplantation Surgery, Hannover Medical School, Hannover, Germany
| | - Jürgen Borlak
- Centre for Pharmacology and Toxicology, Hannover Medical School, Hannover, Germany.
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Vekens K, Everaert H, Neyns B, Ilsen B, Decoster L. The Value of 18F-FDG PET/CT in Predicting the Response to PD-1 Blocking Immunotherapy in Advanced NSCLC Patients with High-Level PD-L1 Expression. Clin Lung Cancer 2021; 22:432-440. [PMID: 33879398 DOI: 10.1016/j.cllc.2021.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/26/2021] [Accepted: 03/05/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The objective of this study was to evaluate if 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)-derived parameters are useful in predicting response and survival after programmed cell death protein 1 (PD-1) blocking immunotherapy in patients with advanced NSCLC characterized by a high programmed death-ligand 1 (PD-L1) expression (≥50%) on immunohistochemistry. PATIENTS AND METHODS In 30 patients with advanced stage IV non-small-cell lung cancer (NSCLC) and high PD-L1 expression, 18F-FDG PET/CT parameters before start of treatment with PD-1 blocking immunotherapy were evaluated retrospectively. In 24 out of the 30 patients, 18F-FDG PET/CT was available 8 to 9 weeks after start of the treatment. Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and metabolic responses assessed on 18F-FDG PET/CT were compared. RESULTS Median follow-up was 20 months (range, 4.2-37.6). Median PD-L1 expression was 80%. The objective response rate with RECIST 1.1 was 53.3%. Median progression-free survival (PFS) was 12.4 months (95% confidence interval [CI], 1.0-37.8), and median overall survival (OS) was 14.9 months (95% CI, 2.4-38.2). Baseline 18F-FDG PET/CT parameters did not differ between responders and non-responders (all P > .05). The maximum standardized uptake value (SUVmax) was the only 18F-FDG PET/CT parameter associated with PFS (P = .04), with a trend for OS (P = .06). At first evaluation, response according to total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) were associated with PFS and OS (both P < .0001). This was not the case for RECIST 1.1 (P = .29 for PFS and P = .38 for OS). CONCLUSION Clinical response and survival were independent from metabolic tumor volume at baseline. Reduction of metabolic tumor volume after 8 to 9 weeks of treatment was a better predictor for prolonged survival than RECIST 1.1.
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Affiliation(s)
- Karolien Vekens
- Respiratory Division, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Hendrik Everaert
- Department of Nuclear Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bart Neyns
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bart Ilsen
- Radiology Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lore Decoster
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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Oksuzoglu K, Ones T, Bozkurtlar E, Bostanci K, Tureli D. FDG-Avid Lung Nodule Formation by the Use of Hemostatic Powder: A Potential Cause of False-Positive FDG PET/CT. Clin Nucl Med 2021; 46:e94-e96. [PMID: 33181739 DOI: 10.1097/rlu.0000000000003370] [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: 12/11/2022]
Abstract
ABSTRACT FDG PET/CT is used in the diagnosis and follow-up of various malignant tumors and changes patient management in routine clinical practice. However, inflammatory, infectious, physiological, and technical causes and benign pathological conditions may lead to false-positive FDG uptake. We report a case of a 59-year-old man who was considered having a false-positive FDG-PET pulmonary nodular lesion in favor of metastasis, which was formed by the use of hemostatic powder.
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Affiliation(s)
| | - Tunc Ones
- From the Department of Nuclear Medicine
| | | | | | - Derya Tureli
- Radiology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
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Pfaehler E, Mesotten L, Kramer G, Thomeer M, Vanhove K, de Jong J, Adriaensens P, Hoekstra OS, Boellaard R. Repeatability of two semi-automatic artificial intelligence approaches for tumor segmentation in PET. EJNMMI Res 2021; 11:4. [PMID: 33409747 PMCID: PMC7788118 DOI: 10.1186/s13550-020-00744-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/10/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Positron emission tomography (PET) is routinely used for cancer staging and treatment follow-up. Metabolic active tumor volume (MATV) as well as total MATV (TMATV-including primary tumor, lymph nodes and metastasis) and/or total lesion glycolysis derived from PET images have been identified as prognostic factor or for the evaluation of treatment efficacy in cancer patients. To this end, a segmentation approach with high precision and repeatability is important. However, the implementation of a repeatable and accurate segmentation algorithm remains an ongoing challenge. METHODS In this study, we compare two semi-automatic artificial intelligence (AI)-based segmentation methods with conventional semi-automatic segmentation approaches in terms of repeatability. One segmentation approach is based on a textural feature (TF) segmentation approach designed for accurate and repeatable segmentation of primary tumors and metastasis. Moreover, a convolutional neural network (CNN) is trained. The algorithms are trained, validated and tested using a lung cancer PET dataset. The segmentation accuracy of both segmentation approaches is compared using the Jaccard coefficient (JC). Additionally, the approaches are externally tested on a fully independent test-retest dataset. The repeatability of the methods is compared with those of two majority vote (MV2, MV3) approaches, 41%SUVMAX, and a SUV > 4 segmentation (SUV4). Repeatability is assessed with test-retest coefficients (TRT%) and intraclass correlation coefficient (ICC). An ICC > 0.9 was regarded as representing excellent repeatability. RESULTS The accuracy of the segmentations with the reference segmentation was good (JC median TF: 0.7, CNN: 0.73). Both segmentation approaches outperformed most other conventional segmentation methods in terms of test-retest coefficient (TRT% mean: TF: 13.0%, CNN: 13.9%, MV2: 14.1%, MV3: 28.1%, 41%SUVMAX: 28.1%, SUV4: 18.1%) and ICC (TF: 0.98, MV2: 0.97, CNN: 0.99, MV3: 0.73, SUV4: 0.81, and 41%SUVMAX: 0.68). CONCLUSION The semi-automatic AI-based segmentation approaches used in this study provided better repeatability than conventional segmentation approaches. Moreover, both algorithms lead to accurate segmentations for both primary tumors as well as metastasis and are therefore good candidates for PET tumor segmentation.
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Affiliation(s)
- Elisabeth Pfaehler
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Liesbet Mesotten
- Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium
- Department of Nuclear Medicine, Ziekenhuis Oost Limburg, Schiepse Bos 6, 3600, Genk, Belgium
| | - Gem Kramer
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Michiel Thomeer
- Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium
- Department of Respiratory Medicine, Ziekenhuis Oost Limburg, Schiepse Bos 6, 3600, Genk, Belgium
| | - Karolien Vanhove
- Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium
- Department of Respiratory Medicine, AZ Vesalius Hospital, Hazelereik 51, 3700, Tongeren, Belgium
| | - Johan de Jong
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter Adriaensens
- Institute for Materials Research (IMO) - Division Chemistry, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium
| | - Otto S Hoekstra
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Ronald Boellaard
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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39
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Hendriks AM, Brouwers AH, Giannopoulos P, Lefrandt JD, Timens W, Groen HJM, de Bock GH, Jalving M. 18F-FDG PET/CT Scans Can Identify Sub-Groups of NSCLC Patients with High Glucose Uptake in the Majority of Their Tumor Lesions. J Cancer 2021; 12:562-570. [PMID: 33391452 PMCID: PMC7738988 DOI: 10.7150/jca.45899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 08/09/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Reprogrammed glucose metabolism is a hallmark of cancer making it an attractive therapeutic target, especially in cancers with high glucose uptake such as non-small cell lung cancer (NSCLC). Tools to select patients with high glucose uptake in the majority of tumor lesions are essential in the development of anti-cancer drugs targeting glucose metabolism. Type 2 diabetes mellitus (T2DM) patients may have tumors highly dependent on glucose uptake. Surprisingly, this has not been systematically studied. Therefore, we aimed to determine which patient and tumor characteristics, including concurrent T2DM, are related to high glucose uptake in the majority of tumor lesions in NSCLC patients as measured by 2-deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) scans. Methods: Routine primary diagnostic 18F-FDG PET/CT scans of consecutive NSCLC patients were included. Mean standardized uptake value (SUVmean) of 18F-FDG was determined for all evaluable tumor lesions and corrected for serum glucose levels according to the European Association of Nuclear Medicine Research Ltd guidelines. Patient characteristics potentially determining degree of tumor lesion glucose uptake in the majority of tumor lesions per patient were investigated. Results: The cohort consisted of 102 patients, 28 with T2DM and 74 without T2DM. The median SUVmean per patient ranged from 0.8 to 35.2 (median 4.2). T2DM patients had higher median glucose uptake in individual tumor lesions and per patient compared to non-diabetic NSCLC patients (SUVmean 4.3 vs 2.8, P < 0.001 and SUVmean 5.4 vs 3.7, P = 0.009, respectively). However, in multivariable analysis, high tumor lesion glucose uptake was only independently determined by number of tumor lesions ≥1 mL per patient (odds ratio 0.8, 95% confidence interval 0.7-0.9). Conclusions:18F-FDG PET/CT scans can identify sub-groups of NSCLC patients with high glucose uptake in the majority of their tumor lesions. T2DM patients had higher tumor lesion glucose uptake than non-diabetic patients. However, this was not independent of other factors such as the histological subtype and number of tumor lesions per patient.
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Affiliation(s)
- Anne M Hendriks
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Medical Oncology
| | - Adrienne H Brouwers
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Nuclear Medicine and Molecular Imaging
| | - Panagiotis Giannopoulos
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Medical Oncology
| | - Joop D Lefrandt
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Internal Medicine
| | - Wim Timens
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Pathology
| | - Harry J M Groen
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Pulmonary Diseases
| | - Geertruida H de Bock
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Epidemiology
| | - Mathilde Jalving
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Medical Oncology
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Not All That Shines on a PET Scan Is Cancer: A Silicone-Induced Granuloma Masquerading as Malignancy. Clin Pract 2020; 11:8-12. [PMID: 33599216 PMCID: PMC7774518 DOI: 10.3390/clinpract11010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 10/12/2020] [Indexed: 11/17/2022] Open
Abstract
PET/CT scans are frequently used in the initial workup of suspicious lesions but not all that lights up on a PET is cancerous. We wish to discuss a case of silicone-induced granuloma mimicking malignancy and the role of other imaging modalities for further workup.
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41
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Validation of low-dose lung cancer PET-CT protocol and PET image improvement using machine learning. Phys Med 2020; 81:285-294. [PMID: 33341375 DOI: 10.1016/j.ejmp.2020.11.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To conduct a simplified lesion-detection task of a low-dose (LD) PET-CT protocol for frequent lung screening using 30% of the effective PETCT dose and to investigate the feasibility of increasing clinical value of low-statistics scans using machine learning. METHODS We acquired 33 SD PET images, of which 13 had actual LD (ALD) PET, and simulated LD (SLD) PET images at seven different count levels from the SD PET scans. We employed image quality transfer (IQT), a machine learning algorithm that performs patch-regression to map parameters from low-quality to high-quality images. At each count level, patches extracted from 23 pairs of SD/SLD PET images were used to train three IQT models - global linear, single tree, and random forest regressions with cubic patch sizes of 3 and 5 voxels. The models were then used to estimate SD images from LD images at each count level for 10 unseen subjects. Lesion-detection task was carried out on matched lesion-present and lesion-absent images. RESULTS LD PET-CT protocol yielded lesion detectability with sensitivity of 0.98 and specificity of 1. Random forest algorithm with cubic patch size of 5 allowed further 11.7% reduction in the effective PETCT dose without compromising lesion detectability, but underestimated SUV by 30%. CONCLUSION LD PET-CT protocol was validated for lesion detection using ALD PET scans. Substantial image quality improvement or additional dose reduction while preserving clinical values can be achieved using machine learning methods though SUV quantification may be biased and adjustment of our research protocol is required for clinical use.
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Osman AM, Korashi HI. PET/CT implication on bronchogenic carcinoma TNM staging and follow-up using RECIST/PERCIST criteria: a comparative study with CT. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-020-0133-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To evaluate the role of PET/CT on bronchogenic carcinoma staging as well as treatment response evaluation on follow-up compared to CT study alone.
Methods
A prospective study of 60 patients confirmed histopathologically to have non-small cell bronchogenic carcinoma, 30 of them came for staging (group T) while the rest 30 came for follow-up (group F) to assess therapy response. All patients underwent PET/CT with data analysis done using the eighth edition tumor, nodal, metastatic staging (TNM) staging for group T and RECIST/PERCIST criteria for group F. The CT data alone transferred to a blind radiologist for analysis using the same parameters. The results were collected and compared.
Results
Regarding group T, 12 patients showed different TNM staging between PET/CT and CT alone, 5 cases with different T stagings, 4 cases with different N stagings, and 5 cases with different M stagings. Also, 8 cases showed different surgical stagings. Regarding group F, 9 cases showed a difference between RECIST obtained by CT and PERCIST obtained by PET/CT with most of the cases (6 cases) showed change from partial or stable response to progressive response.
Conclusion
PET/CT has a significant role in TNM staging of bronchogenic carcinoma more at T2 staging due to its ability to differentiate the tumoral mass from the nearby pulmonary reaction. Also, PET/CT makes a difference in tumoral follow-up by its ability to detect the functional changes even before structural changes. Finally, PET/CT is a very important tool in management strategy.
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Tan H, Sui X, Yin H, Yu H, Gu Y, Chen S, Hu P, Mao W, Shi H. Total-body PET/CT using half-dose FDG and compared with conventional PET/CT using full-dose FDG in lung cancer. Eur J Nucl Med Mol Imaging 2020; 48:1966-1975. [PMID: 33244618 DOI: 10.1007/s00259-020-05091-4] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 10/26/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE The purpose was to explore the effects of total-body PET/CT with half-dose 18F-FDG activity on image quality, compared with those of conventional PET/CT with clinical routine full-dose 18F-FDG in lung cancer. METHODS Fifty-six primary lung cancer patients who underwent total-body PET/CT on a uEXPLORER scanner with half-dose (1.85 MBq/kg) 18F-FDG activity before treatment were retrospectively studied; among them, 28 patients were confirmed by postoperative pathologic examination and 28 patients by biopsy. After matching with the pathological study results, the other 28 patients with lung cancer who underwent surgery were selected for the full-dose (3.70 MBq/kg) group. Patients in the full-dose group were studied with a conventional uM780 PET/CT scanner. The acquisition time of the half-dose group was 15 min, split into 4-min and 2-min duration groups, which were all referred to as G15, G4 and G2, respectively. The PET/CT scanning speed in the full-dose group was 2 min/bed. Image quality was evaluated by subjective and objective analyses. The subjective analysis method was carried out with a 5-point scale (5-excellent, 1-poor). Objective analysis indicators of PET image quality included the SUVmax, SUVmean and signal-to-noise ratio (SNR) of the liver; the SUVmax and SUVmean of the blood pool; and the SUVmax and tumour-to-background ratio (TBR) of the lesions. G15 served as the reference for G2 and G4 to test lesion detectability. RESULTS Image quality scores in G2 (4.3 ± 0.7) were significantly higher than those in the full-dose group (3.7 ± 0.6) (p = 0.004). The mean and SD of the image quality scores in G4 and G15 were 4.9 ± 0.2 and 5.0 ± 0.0, respectively. The liver SNR in G2 was significantly higher than that in the full-dose group; the corresponding SNR were 11.7 ± 1.5 and 8.3 ± 1.2 (p < 0.001), respectively. The liver SNR significantly increased with the time of acquisition among G2, G4 and G15 (11.1 ± 1.7, 15.2 ± 3.4 and 30.5 ± 6.0, all p < 0.05). G15 served as the reference, and all these lesions (100%) could be identified by G2 and G4. CONCLUSION Total-body PET/CT with half-dose 18F-FDG activity in G2 and G4 achieved comparable image quality to conventional PET/CT, and its image quality was better than that of conventional PET/CT with clinical routine full-dose 18F-FDG in lung cancer.
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Affiliation(s)
- Hui Tan
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Xiuli Sui
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Hongyan Yin
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Haojun Yu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Yusen Gu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Shuguang Chen
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Pengcheng Hu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Wujian Mao
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. .,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China. .,Shanghai Institute of Medical Imaging, Shanghai, 200032, China.
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Liu WR, Zhang B, Chen C, Li Y, Ye X, Tang DJ, Zhang JC, Ma J, Zhou YL, Fan XJ, Yue DS, Li CG, Zhang H, Ma YC, Huo YS, Zhang ZF, He SY, Wang CL. Detection of circulating genetically abnormal cells in peripheral blood for early diagnosis of non-small cell lung cancer. Thorac Cancer 2020; 11:3234-3242. [PMID: 32989915 PMCID: PMC7606026 DOI: 10.1111/1759-7714.13654] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/21/2020] [Accepted: 08/23/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Circulating genetically abnormal cells (CACs) with specific chromosome variations have been confirmed to be present in non-small cell lung cancer (NSCLC). However, the diagnostic performance of CAC detection remains unclear. This study aimed to evaluate the potential clinical application of the CAC test for the early diagnosis of NSCLC. METHODS In this prospective study, a total of 339 participants (261 lung cancer patients and 78 healthy volunteers) were enrolled. An antigen-independent fluorescence in situ hybridization was used to enumerate the number of CACs in peripheral blood. RESULTS Patients with early-stage NSCLC were found to have a significantly higher number of CACs than those of healthy participants (1.34 vs. 0.19; P < 0.001). The CAC test displayed an area under the receiver operating characteristic (ROC) curve of 0.76139 for discriminating stage I NSCLC from healthy participants with 67.2% sensitivity and 80.8% specificity, respectively. Compared with serum tumor markers, the sensitivity of CAC assays for distinguishing early-stage NSCLC was higher (67.2% vs. 48.7%, P < 0.001), especially in NSCLC patients with small nodules (65.4% vs. 36.5%, P = 0.003) and ground-glass nodules (pure GGNs: 66.7% vs. 40.9%, P = 0.003; mixed GGNs: 73.0% vs. 43.2%, P < 0.001). CONCLUSIONS CAC detection in early stage NSCLC was feasible. Our study showed that CACs could be used as a promising noninvasive biomarker for the early diagnosis of NSCLC. KEY POINTS What this study adds: This study aimed to evaluate the potential clinical application of the CAC test for the early diagnosis of NSCLC. Significant findings of the study: CAC detection in early stage NSCLC was feasible. Our study showed that CACs could be used as a promising noninvasive biomarker for the early diagnosis of NSCLC.
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Affiliation(s)
- Wei-Ran Liu
- Department of Anesthesiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Bin Zhang
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Chen Chen
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yue Li
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Xin Ye
- Joint Research Center of Liquid Biopsy in Guangdong, Hong kong, and Macao, Zhuhai, China.,Zhuhai Sanmed Biotech Ltd., Zhuhai, China.,Guangdong Postdoctoral Innovation Practice Bases, School of Biology and Biological Engineering, South China University of Technology, China
| | - Dong-Jiang Tang
- Joint Research Center of Liquid Biopsy in Guangdong, Hong kong, and Macao, Zhuhai, China.,Zhuhai Sanmed Biotech Ltd., Zhuhai, China
| | - Jun-Cheng Zhang
- Joint Research Center of Liquid Biopsy in Guangdong, Hong kong, and Macao, Zhuhai, China.,Zhuhai Sanmed Biotech Ltd., Zhuhai, China
| | - Jing Ma
- Department of Respiratory and Critical Care, Henan University Huaihe Hospital, Kaifeng, China
| | - Yan-Ling Zhou
- Joint Research Center of Liquid Biopsy in Guangdong, Hong kong, and Macao, Zhuhai, China.,Zhuhai Sanmed Biotech Ltd., Zhuhai, China
| | - Xian-Jun Fan
- Joint Research Center of Liquid Biopsy in Guangdong, Hong kong, and Macao, Zhuhai, China.,Zhuhai Sanmed Biotech Ltd., Zhuhai, China
| | - Dong-Sheng Yue
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Chen-Guang Li
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Hua Zhang
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yu-Chen Ma
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yan-Song Huo
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Zhen-Fa Zhang
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Shu-Yu He
- Joint Research Center of Liquid Biopsy in Guangdong, Hong kong, and Macao, Zhuhai, China.,Zhuhai Sanmed Biotech Ltd., Zhuhai, China
| | - Chang-Li Wang
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
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Freudenstein D, Litchfield C, Caramia F, Wright G, Solomon BJ, Ball D, Keam SP, Neeson P, Haupt Y, Haupt S. TP53 Status, Patient Sex, and the Immune Response as Determinants of Lung Cancer Patient Survival. Cancers (Basel) 2020; 12:cancers12061535. [PMID: 32545367 PMCID: PMC7352604 DOI: 10.3390/cancers12061535] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 12/19/2022] Open
Abstract
Lung cancer poses the greatest cancer-related death risk and males have poorer outcomes than females, for unknown reasons. Patient sex is not a biological variable considered in lung cancer standard of care. Correlating patient genetics with outcomes is predicted to open avenues for improved management. Using a bioinformatics approach across non-small cell lung cancer (NSCLC) subtypes, we identified where patient sex, mutation of the major tumor suppressor gene, Tumour protein P53 (TP53), and immune signatures stratified outcomes in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC), among datasets of The Cancer Genome Atlas (TCGA). We exposed sex and TP53 gene mutations as prognostic for LUAD survival. Longest survival in LUAD occurred among females with wild-type (wt) TP53 genes, high levels of immune infiltration and enrichment for pathway signatures of Interferon Gamma (INF-γ), Tumour Necrosis Factor (TNF) and macrophages-monocytes. In contrast, poor survival in men with LUAD and wt TP53 genes corresponded with enrichment of Transforming Growth Factor Beta 1 (TGFB1, hereafter TGF-β) and wound healing signatures. In LUAD with wt TP53 genes, elevated gene expression of immune checkpoint CD274 (hereafter: PD-L1) and also protein 53 (p53) negative-regulators of the Mouse Double Minute (MDM)-family predict novel avenues for combined immunotherapies. LUSC is dominated by male smokers with TP53 gene mutations, while a minor population of TCGA LC patients with wt TP53 genes unexpectedly had the poorest survival, suggestive of a separate etiology. We conclude that advanced approaches to LUAD and LUSC therapy lie in the consideration of patient sex, TP53 gene mutation status and immune signatures.
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Affiliation(s)
- Donald Freudenstein
- Tumor Suppression Laboratory, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, 3000, Australia; (D.F.); (C.L.); (F.C.); (S.P.K.); (Y.H.)
| | - Cassandra Litchfield
- Tumor Suppression Laboratory, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, 3000, Australia; (D.F.); (C.L.); (F.C.); (S.P.K.); (Y.H.)
| | - Franco Caramia
- Tumor Suppression Laboratory, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, 3000, Australia; (D.F.); (C.L.); (F.C.); (S.P.K.); (Y.H.)
| | - Gavin Wright
- Department of Surgery, St Vincent’s Hospital, The University of Melbourne, Fitzroy, VIC 3065, Australia;
| | - Benjamin J. Solomon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia;
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC 3010, Australia; (D.B.); (P.N.)
| | - David Ball
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC 3010, Australia; (D.B.); (P.N.)
- Department of Radiation Oncology Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, VIC 3000, Australia
| | - Simon P. Keam
- Tumor Suppression Laboratory, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, 3000, Australia; (D.F.); (C.L.); (F.C.); (S.P.K.); (Y.H.)
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC 3010, Australia; (D.B.); (P.N.)
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, VIC 3000, Australia
| | - Paul Neeson
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC 3010, Australia; (D.B.); (P.N.)
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, VIC 3000, Australia
| | - Ygal Haupt
- Tumor Suppression Laboratory, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, 3000, Australia; (D.F.); (C.L.); (F.C.); (S.P.K.); (Y.H.)
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC 3010, Australia; (D.B.); (P.N.)
- Department of Clinical Pathology, University of Melbourne, Parkville, VIC 3010, Australia
- Department of Biochemistry and Molecular Biology, Monash University, Melbourne, VIC 3004, Australia
| | - Sue Haupt
- Tumor Suppression Laboratory, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, 3000, Australia; (D.F.); (C.L.); (F.C.); (S.P.K.); (Y.H.)
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC 3010, Australia; (D.B.); (P.N.)
- Department of Clinical Pathology, University of Melbourne, Parkville, VIC 3010, Australia
- Correspondence:
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Abrantes AM, Pires AS, Monteiro L, Teixo R, Neves AR, Tavares NT, Marques IA, Botelho MF. Tumour functional imaging by PET. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165717. [PMID: 32035103 DOI: 10.1016/j.bbadis.2020.165717] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/15/2020] [Accepted: 01/30/2020] [Indexed: 12/18/2022]
Abstract
Carcinogenesis is a complex multistep process, characterized by changes at different levels, both genetic and epigenetic, which alter cell metabolism. Positron emission tomography (PET) is a very sensitive image modality that allows to evaluate oncometabolism. PET functionalities are immense, since by labelling a molecule that specifically intervenes in a biochemical regulatory pathway of interest with a positron-emitting radionuclide, we can easily image that pathway. Thus, PET makes possible imaging several metabolic processes and assessing risk prediction, screening, diagnosis, response to therapy, metastization and recurrence. In this paper, we provide an overview of different radiopharmaceuticals developed for PET use in oncology, with a focus on brain tumours, breast cancer, hepatocellular carcinoma, neuroendocrine tumours, bladder cancer and prostate cancer because for these cancer types PET has been shown to be valuable. Most of the described tracers are just used in the research environment, with the aim to assess if these tracers could be able to offer an improvement concerning staging/restaging, characterization and stratification of different types of cancer, as well as therapeutic response assessment. In pursuit of personalized therapy, we briefly discuss the more established metabolic tracers and describe recent work on the development of new radiopharmaceuticals, aware that there will continue to exist diagnostic challenges to face modern cancer medicine.
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Affiliation(s)
- Ana Margarida Abrantes
- Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; Clinical Academic Center of Coimbra, 3004-561 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; CNC.IBILI Consortium/Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal.
| | - Ana Salomé Pires
- Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; Clinical Academic Center of Coimbra, 3004-561 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; CNC.IBILI Consortium/Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal.
| | - Lúcia Monteiro
- Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; Clinical Academic Center of Coimbra, 3004-561 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Ricardo Teixo
- Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; Clinical Academic Center of Coimbra, 3004-561 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; CNC.IBILI Consortium/Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Ana Rita Neves
- Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; Clinical Academic Center of Coimbra, 3004-561 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; Project Development Office, Department of Mathematics and Computer Science, Eindhoven University of Technology (TU/e), NL-5612 AE Eindhoven, the Netherlands
| | - Nuno Tiago Tavares
- Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; Clinical Academic Center of Coimbra, 3004-561 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Inês Alexandra Marques
- Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; Clinical Academic Center of Coimbra, 3004-561 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; CNC.IBILI Consortium/Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal; Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Maria Filomena Botelho
- Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; Clinical Academic Center of Coimbra, 3004-561 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; CNC.IBILI Consortium/Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal.
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Measurement Variability in Treatment Response Determination for Non-Small Cell Lung Cancer: Improvements Using Radiomics. J Thorac Imaging 2019; 34:103-115. [PMID: 30664063 DOI: 10.1097/rti.0000000000000390] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Multimodality imaging measurements of treatment response are critical for clinical practice, oncology trials, and the evaluation of new treatment modalities. The current standard for determining treatment response in non-small cell lung cancer (NSCLC) is based on tumor size using the RECIST criteria. Molecular targeted agents and immunotherapies often cause morphological change without reduction of tumor size. Therefore, it is difficult to evaluate therapeutic response by conventional methods. Radiomics is the study of cancer imaging features that are extracted using machine learning and other semantic features. This method can provide comprehensive information on tumor phenotypes and can be used to assess therapeutic response in this new age of immunotherapy. Delta radiomics, which evaluates the longitudinal changes in radiomics features, shows potential in gauging treatment response in NSCLC. It is well known that quantitative measurement methods may be subject to substantial variability due to differences in technical factors and require standardization. In this review, we describe measurement variability in the evaluation of NSCLC and the emerging role of radiomics.
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PET and MRI based RT treatment planning: Handling uncertainties. Cancer Radiother 2019; 23:753-760. [PMID: 31427076 DOI: 10.1016/j.canrad.2019.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/03/2019] [Indexed: 12/11/2022]
Abstract
Imaging provides the basis for radiotherapy. Multi-modality images are used for target delineation (primary tumor and nodes, boost volume) and organs at risk, treatment guidance, outcome prediction, and treatment assessment. Next to anatomical information, more and more functional imaging is being used. The current paper provides a brief overview of the different applications of imaging techniques used in the radiotherapy process, focusing on uncertainties and QA. The paper mainly focuses on PET and MRI, but also provides a short discussion on DCE-CT. A close collaboration between radiology, nuclear medicine and radiotherapy departments provides the key to improve the quality of radiotherapy. Jointly developed imaging protocols (RT position setup, immobilization tools, lasers, flat table…), and QA programs are mandatory. For PET, suitable windowing in consultation with a Nuclear Medicine Physician is crucial (differentiation benign/malignant lesions, artifacts…). A basic knowledge of MRI sequences is required, in such a way that geometrical distortions are easily recognized by all members the RT and RT physics team. If this is not the case, then the radiologist should be introduced systematically in the delineation process and multidisciplinary meetings need to be organized regularly. For each image modality and each image registration process, the associated uncertainties need to be determined and integrated in the PTV margin. When using functional information for dose painting, response assessment or outcome prediction, collaboration between the different departments is even more important. Limitations of imaging based biomarkers (specificity, sensitivity) should be known.
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Quartuccio N, Evangelista L, Alongi P, Caobelli F, Altini C, Cistaro A, Lambertini A, Schiorlin I, Popescu CE, Linguanti F, Laudicella R, Scalorbi F, Di Pierro G, Asabella AN, Cuppari L, Margotti S, Lima GM, Scalisi S, Pacella S, Kokomani A, Ciaccio A, Sturiale L, Vento A, Cardile D, Baldari S, Panareo S, Fanti S, Rubini G, Schillaci O, Chiaravalloti A. Prognostic and diagnostic value of [18F]FDG-PET/CT in restaging patients with small cell lung carcinoma: an Italian multicenter study. Nucl Med Commun 2019; 40:808-814. [PMID: 31136534 DOI: 10.1097/mnm.0000000000001038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The presence of residual disease after initial treatment in small cell lung cancer (SCLC) influences prognosis and impacts patient management. To date, few data exist on the value of fluorine-18-fluorodeoxyglucose ([F]FDG)-PET/computed tomography (CT) in SCLC at restaging. Therefore, in restaging patients with SCLC, we aimed to (a) evaluate the prognostic value yielded by [F]FDG-PET/CT and (b) assess the diagnostic agreement between [F]FDG-PET/CT and contrast-enhanced computed tomography (ceCT). PATIENTS AND METHODS From a multicenter database, we evaluated 164 patients with SCLC who underwent [F]FDG-PET/CT for restaging purposes. PET scans were evaluated visually to identify the presence of recurrence. For each patient, the maximum and the mean standardized uptake value (SUVmax and SUVmean, respectively), metabolic tumor volume, and total lesion glycolysis were calculated, taking into account the lesion with the highest [F]FDG uptake (namely, the index lesion) in the local recurrences, lymph node involvement, and distant metastasis categories. Kaplan-Meier curves were computed to assess the effects of [F]FDG-PET/CT findings on overall survival (OS) and progression-free survival. Furthermore, the agreement between PET/CT and ceCT in detecting metastases was evaluated in 119 patients on a patient-based analysis (Cohen's κ; P < 0.05). RESULTS The presence of metastatic lesions at [F]FDG-PET/CT was associated with a significantly shorter OS (P = 0.039) and progression-free survival (P < 0.001). Higher SUVmax showed a trend toward a shorter OS (P = 0.065). The K-agreement between ceCT and PET/CT in recurrent SCLC was 0.37 (P < 0.001). PET/CT and ceCT showed the same number of lesions in 52 (43.7%) patients, whereas PET/CT detected additional lesions in 35 (29.4%) patients. CONCLUSION Detection of metastatic lesions at restaging by [F]FDG-PET/CT can predict a higher rate of progression and negatively influence OS in patients with SCLC. [F]FDG-PET/CT and ceCT seem to be complementary imaging modalities in patients with metastatic SCLC.
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Affiliation(s)
- Natale Quartuccio
- Nuclear Medicine Unit, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, Palermo
| | - Laura Evangelista
- Nuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Padua
| | - Pierpaolo Alongi
- Department of Radiological Sciences, Nuclear Medicine Unit, Fondazione Istituto G. Giglio, Cefalù
| | - Federico Caobelli
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Angelina Cistaro
- Positron Emission Tomography Centre, IRMET S.p.A., Affidea, Turin
| | - Alessandro Lambertini
- Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna
| | | | | | - Flavia Linguanti
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences 'Mario Serio'
| | - Riccardo Laudicella
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina
| | - Federica Scalorbi
- Nuclear Medicine Department, IRCCS Istituto Nazionale dei Tumori, Milano
| | | | | | - Lea Cuppari
- Nuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Padua
| | - Simone Margotti
- Positron Emission Tomography Centre, IRMET S.p.A., Affidea, Turin
| | - Giacomo M Lima
- Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna
| | - Salvatore Scalisi
- Department of Radiological Sciences, Nuclear Medicine Unit, Fondazione Istituto G. Giglio, Cefalù
| | - Sara Pacella
- Nuclear Medicine Department, Niguarda Ca' Granda Hospital
| | - Aurora Kokomani
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences 'Mario Serio'
| | - Alfonso Ciaccio
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences 'Mario Serio'
| | - Letterio Sturiale
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina
| | - Antonio Vento
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina
| | - Davide Cardile
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina
| | - Sergio Baldari
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina
| | - Stefano Panareo
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, S. Anna University Hospital, Ferrara
| | - Stefano Fanti
- Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna
| | | | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Rome
- IRCCS Neuromed, Pozzilli (IS), Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Rome
- IRCCS Neuromed, Pozzilli (IS), Italy
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Hanania AN, Mainwaring W, Ghebre YT, Hanania NA, Ludwig M. Radiation-Induced Lung Injury: Assessment and Management. Chest 2019; 156:150-162. [PMID: 30998908 PMCID: PMC8097634 DOI: 10.1016/j.chest.2019.03.033] [Citation(s) in RCA: 291] [Impact Index Per Article: 58.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/18/2019] [Accepted: 03/22/2019] [Indexed: 12/22/2022] Open
Abstract
Radiation-induced lung injury (RILI) encompasses any lung toxicity induced by radiation therapy (RT) and manifests acutely as radiation pneumonitis and chronically as radiation pulmonary fibrosis. Because most patients with thoracic and breast malignancies are expected to undergo RT in their lifetime, many with curative intent, the population at risk is significant. Furthermore, indications for thoracic RT are expanding given the advent of stereotactic body radiation therapy (SBRT) or stereotactic ablative radiotherapy (SABR) for early-stage lung cancer in nonsurgical candidates as well as oligometastatic pulmonary disease from any solid tumor. Fortunately, the incidence of serious pulmonary complications from RT has decreased secondary to advances in radiation delivery techniques. Understanding the temporal relationship between RT and injury as well as the patient, disease, and radiation factors that help distinguish RILI from other etiologies is necessary to prevent misdiagnosis. Although treatment of acute pneumonitis is dependent on clinical severity and typically responds completely to corticosteroids, accurately diagnosing and identifying patients who may progress to fibrosis is challenging. Current research advances include high-precision radiation techniques, an improved understanding of the molecular basis of RILI, the development of small and large animal models, and the identification of candidate drugs for prevention and treatment.
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Affiliation(s)
- Alexander N Hanania
- Department of Radiation Oncology, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX
| | - Walker Mainwaring
- Department of Radiation Oncology, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX
| | - Yohannes T Ghebre
- Department of Radiation Oncology, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX
| | - Nicola A Hanania
- Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX.
| | - Michelle Ludwig
- Department of Radiation Oncology, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX
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