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Ebrahimi S, Lundström E, Batasin SJ, Hedlund E, Stålberg K, Ehman EC, Sheth VR, Iranpour N, Loubrie S, Schlein A, Rakow-Penner R. Application of PET/MRI in Gynecologic Malignancies. Cancers (Basel) 2024; 16:1478. [PMID: 38672560 PMCID: PMC11048306 DOI: 10.3390/cancers16081478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 03/23/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
The diagnosis, treatment, and management of gynecologic malignancies benefit from both positron emission tomography/computed tomography (PET/CT) and MRI. PET/CT provides important information on the local extent of disease as well as diffuse metastatic involvement. MRI offers soft tissue delineation and loco-regional disease involvement. The combination of these two technologies is key in diagnosis, treatment planning, and evaluating treatment response in gynecological malignancies. This review aims to assess the performance of PET/MRI in gynecologic cancer patients and outlines the technical challenges and clinical advantages of PET/MR systems when specifically applied to gynecologic malignancies.
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Affiliation(s)
- Sheida Ebrahimi
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Elin Lundström
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
- Department of Surgical Sciences, Radiology, Uppsala University, 751 85 Uppsala, Sweden
- Center for Medical Imaging, Uppsala University Hospital, 751 85 Uppsala, Sweden
| | - Summer J. Batasin
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Elisabeth Hedlund
- Department of Surgical Sciences, Radiology, Uppsala University, 751 85 Uppsala, Sweden
| | - Karin Stålberg
- Department of Women’s and Children’s Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Eric C. Ehman
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | - Vipul R. Sheth
- Department of Radiology, Stanford University, Palo Alto, CA 94305, USA; (V.R.S.)
| | - Negaur Iranpour
- Department of Radiology, Stanford University, Palo Alto, CA 94305, USA; (V.R.S.)
| | - Stephane Loubrie
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Alexandra Schlein
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Rebecca Rakow-Penner
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
- Department of Bioengineering, University of California San Diego, La Jolla, CA 92093, USA
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2
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Shakur A, Lee JYJ, Freeman S. An Update on the Role of MRI in Treatment Stratification of Patients with Cervical Cancer. Cancers (Basel) 2023; 15:5105. [PMID: 37894476 PMCID: PMC10605640 DOI: 10.3390/cancers15205105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Cervical cancer is the fourth most common cancer in women worldwide and the most common gynaecological malignancy. The FIGO staging system is the most commonly utilised classification system for cervical cancer worldwide. Prior to the most recent update in the FIGO staging in 2018, the staging was dependent upon clinical assessment alone. Concordance between the surgical and clinical FIGO staging decreases rapidly as the tumour becomes more advanced. MRI now plays a central role in patients diagnosed with cervical cancer and enables accurate staging, which is essential to determining the most appropriate treatment. MRI is the best imaging option for the assessment of tumour size, location, and parametrial and sidewall invasion. Notably, the presence of parametrial invasion precludes surgical options, and the patient will be triaged to chemoradiotherapy. As imaging is intrinsic to the new 2018 FIGO staging system, nodal metastases have been included within the classification as stage IIIC disease. The presence of lymph node metastases within the pelvis or abdomen is associated with a poorer prognosis, which previously could not be included in the staging classification as these could not be reliably detected on clinical examination. MRI findings corresponding to the 2018 revised FIGO staging of cervical cancers and their impact on treatment selection will be described.
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Affiliation(s)
| | | | - Sue Freeman
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.S.); (J.Y.J.L.)
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3
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Allahqoli L, Hakimi S, Laganà AS, Momenimovahed Z, Mazidimoradi A, Rahmani A, Fallahi A, Salehiniya H, Ghiasvand MM, Alkatout I. 18F-FDG PET/MRI and 18F-FDG PET/CT for the Management of Gynecological Malignancies: A Comprehensive Review of the Literature. J Imaging 2023; 9:223. [PMID: 37888330 PMCID: PMC10607780 DOI: 10.3390/jimaging9100223] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE Positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro- D-glucose integrated with computed tomography (18F-FDG PET/CT) or magnetic resonance imaging (18F-FDG PET/MRI) has emerged as a promising tool for managing various types of cancer. This review study was conducted to investigate the role of 18F- FDG PET/CT and FDG PET/MRI in the management of gynecological malignancies. SEARCH STRATEGY We searched for relevant articles in the three databases PubMed/MEDLINE, Scopus, and Web of Science. SELECTION CRITERIA All studies reporting data on the FDG PET/CT and FDG PET MRI in the management of gynecological cancer, performed anywhere in the world and published exclusively in the English language, were included in the present study. DATA COLLECTION AND ANALYSIS We used the EndNote software (EndNote X8.1, Thomson Reuters) to list the studies and screen them on the basis of the inclusion criteria. Data, including first author, publication year, sample size, clinical application, imaging type, and main result, were extracted and tabulated in Excel. The sensitivity, specificity, and diagnostic accuracy of the modalities were extracted and summarized. MAIN RESULTS After screening 988 records, 166 studies published between 2004 and 2022 were included, covering various methodologies. Studies were divided into the following five categories: the role of FDG PET/CT and FDG-PET/MRI in the management of: (a) endometrial cancer (n = 30); (b) ovarian cancer (n = 60); (c) cervical cancer (n = 50); (d) vulvar and vagina cancers (n = 12); and (e) gynecological cancers (n = 14). CONCLUSIONS FDG PET/CT and FDG PET/MRI have demonstrated potential as non-invasive imaging tools for enhancing the management of gynecological malignancies. Nevertheless, certain associated challenges warrant attention.
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Affiliation(s)
- Leila Allahqoli
- Ministry of Health and Medical Education, Tehran 1467664961, Iran
| | - Sevil Hakimi
- Faculty of Nursing and Midwifery, Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz 516615731, Iran;
| | - Antonio Simone Laganà
- Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy;
| | - Zohre Momenimovahed
- Department of Midwifery and Reproductive Health, Qom University of Medical Sciences, Qom 3716993456, Iran;
| | - Afrooz Mazidimoradi
- Neyriz Public Health Clinic, Shiraz University of Medical Sciences, Shiraz 7134845794, Iran;
| | - Azam Rahmani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran 141973317, Iran;
| | - Arezoo Fallahi
- Department of Public Health, Faculty of Health, Kurdistan University of Medical Sciences, Sanandaj 6617713446, Iran;
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand 9717853076, Iran;
| | - Mohammad Matin Ghiasvand
- Department of Computer Engineering, Amirkabir University of Technology (AUT), Tehran 1591634311, Iran;
| | - Ibrahim Alkatout
- University Hospitals Schleswig-Holstein, Campus Kiel, Kiel School of Gynaecological Endoscopy, Arnold-Heller-Str. 3, Haus 24, 24105 Kiel, Germany;
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4
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Rao Q, Han X, Wei Y, Zhou H, Gong Y, Guan M, Feng X, Lu H, Chen Q. Novel prognostic nomograms in cervical cancer based on analysis of 1075 patients. Cancer Med 2023; 12:6092-6104. [PMID: 36394197 PMCID: PMC10028162 DOI: 10.1002/cam4.5335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/19/2022] [Accepted: 09/25/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To explore the factors affecting the prognosis of cervical cancer (CC), and to construct and evaluate predictive nomograms to guide individualized clinical treatment. METHODS The clinicopathological and follow-up data of CC patients from June 2013 to December 2019 in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were retrospectively analyzed. Log-rank test was used for univariate survival analysis, and Cox multivariate regression was used to identify independent prognostic factors, based on which nomogram models were established and evaluated in multiple aspects. RESULTS Patients were randomly assigned into the training (n = 746) and validation sets (n = 329). Survival analysis of the training set identified cervical myometrial invasion, parametrial involvement, and malignant tumor history as prognosticators of postoperative DFS and pathological type, cervical myometrial invasion, and history of STD for OS. C-index was 0.799 and 0.839 for the nomograms for DFS and OS, respectively. Calibration curves and Brier scores also indicated high performance. Importantly, decision curve analysis suggested great clinical applicability of these nomograms. CONCLUSIONS In this study, we analyzed a cohort of 1075 CC patients and identified DFS- or OS-associated clinicohistologic characteristics. Two nomograms were subsequently constructed for DFS and OS prognostication, respectively, and showed high performance in terms of discrimination, calibration, and clinical applicability. These models may facilitate individualized treatment and patient selection for clinical trials. Future investigations with larger cohorts and prospective designs are warranted for validating these prognostic models.
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Affiliation(s)
- Qunxian Rao
- Department of Gynaecological Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xue Han
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Guangdong Pharmaceutical University, Guangzhou, China
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yuan Wei
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Guangdong Pharmaceutical University, Guangzhou, China
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Hui Zhou
- Department of Gynaecological Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yajie Gong
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Guangdong Pharmaceutical University, Guangzhou, China
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Meimei Guan
- Department of Gynaecological Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyan Feng
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Guangdong Pharmaceutical University, Guangzhou, China
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Huaiwu Lu
- Department of Gynaecological Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qingsong Chen
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Guangdong Pharmaceutical University, Guangzhou, China
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
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5
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[F18]FDG PET/CT-Derived Metabolic and Volumetric Biomarkers Can Predict Response to Treatment in Locally Advanced Cervical Cancer Patients. Cancers (Basel) 2022; 14:cancers14184382. [PMID: 36139543 PMCID: PMC9496806 DOI: 10.3390/cancers14184382] [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: 08/15/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Carcinoma of the uterine cervix is one of the most common and severe malignancies in women. Up to 40% of locally advanced cervical cancer patients treated with definitive chemoradiation therapy will not respond or will develop disease recurrence. The aim of this retrospective study was to evaluate the relationship between quantitative metabolic and volumetric parameters extracted from FDG PET/CT imaging data and the response rate to definitive chemoradiation therapy in this group of patients. FDG PET/CT studies of 90 cervical cancer patients were analyzed, and it was found that quantitative metabolic and volumetric parameters such as SUVmax, SUVmean, MTV, and TLG are higher in locally advanced cervical cancer patients who will not respond to definitive chemoradiation therapy. Specifically, in patients who are not metastatic at staging, MTV and TLG values can serve as a predictor for treatment response and thus may alter treatment strategy. Abstract (1) Purpose: Current study aimed at evaluating the relationship between quantitative metabolic and volumetric FDG PET/CT parameters and the response to definitive chemoradiation therapy in locally advanced cervical cancer patients; (2) Methods: Ninety newly diagnosed locally advanced cervical cancer patients (FIGO IB2-IVA) were investigated. All patients underwent PET/CT at staging and after treatment. Metabolic and volumetric parameters, including SUVmax, SUVmean, Total Lesion Glycolysis (TLG), and Metabolic Tumor Volume (MTV) of the primary tumor and metastatic lymph nodes were measured and compared between patients with and without complete metabolic response (CMR). A similar analysis was performed in a subgroup of FIGO IB2-IIB patients; (3) Results: SUVmax and SUVmean of the primary tumor as well as those of metastatic lymph nodes, MTV, and TLG were found to be significantly different between CMR and non-CMR patients. In a subgroup of patients with FIGO IB2-IIB disease, MTV and TLG identified women who will achieve CMR with a threshold of 31.1 cm3 for MTV and 217.8 for TLG; (4) Conclusions: PET/CT-derived quantitative metabolic and volumetric parameters are higher in locally advanced cervical cancer patients who will not respond to definitive chemoradiation therapy. Specifically, in patients who are not metastatic at staging, MTV and TLG values can serve as a predictor for treatment response and thus may alter treatment strategy.
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6
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Ming Y, Dong X, Zhao J, Chen Z, Wang H, Wu N. Deep learning-based multimodal image analysis for cervical cancer detection. Methods 2022; 205:46-52. [DOI: 10.1016/j.ymeth.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/25/2022] [Accepted: 05/16/2022] [Indexed: 10/18/2022] Open
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7
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Squamous Cell Carcinoma Antigen: Clinical Application and Research Status. Diagnostics (Basel) 2022; 12:diagnostics12051065. [PMID: 35626221 PMCID: PMC9139199 DOI: 10.3390/diagnostics12051065] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 02/04/2023] Open
Abstract
The squamous cell carcinoma antigen (SCCA) is a tumor marker that has gained increasing attention for its biological functions and significance in normal physiological and pathological processes. Not only SCCA but also circulating immune complexes of SCCA and immunoglobulin M (IgM) are involved in normal physiological and pathological processes, providing a background for numerous clinical studies aimed at assessing the potential role of SCCA, SCCA–IgM, and SCCA isoform complexes in clinical practice. Previous studies support the clinical value of SCCA as a tumor marker for either diagnosing squamous cancers or monitoring the response to radiotherapy or chemotherapy, tumor relapse, and treatment failure. However, these studies show contrasting results, making the diagnostic or prognostic value of SCCA controversial. To reduce clinical heterogeneity across studies and achieve a more accurate and reliable comparison of results, a standardized detection method, scoring system, and cutoff level need to be established. Moreover, despite the fact that performances of different methods are comparable, the dynamic observation of tumor marker kinetics should be conducted under the same method.
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8
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Scharl S, Weidenbaecher CB, Hugo C, Brambs CE, Knorr K, Combs SE, Schüttrumpf L. First experiences with PET-MRI/CT in radiotherapy planning for cervical cancer. Arch Gynecol Obstet 2022; 306:1821-1828. [PMID: 35262779 PMCID: PMC9519516 DOI: 10.1007/s00404-022-06395-6] [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: 03/09/2021] [Accepted: 01/04/2022] [Indexed: 11/29/2022]
Abstract
Purpose PET-CT has recently been included in the NCCN staging recommendations for cervical cancer stages II–IV and is already routinely applied to radiotherapy planning for other malignancies, as it is expected to provide higher accuracy for the detection of areas with tumor cell spread. In this study, we report on our first experiences of PET-based radiotherapy planning for cervical cancer. Methods 19 patients with cervical cancer that underwent pre-therapeutic PET imaging treated at our institution between January 2016 and April 2019 were included in the study. Information on the primary tumor, lymph node involvement, metastatic spread and changes in the radiotherapy procedure based on the PET findings are described. Results A previously unknown primary tumor extension that was detected by PET imaging in one patient. In patients who underwent a PET before the systematic pelvic and paraaortic lymphonodectomy (n = 2), PET was false negative for pelvic lymph node metastases in 50%. In patients who underwent a PET after the systematic LNE (n = 13), additional lymph node metastases were detected in seven patients (53.80%). Distant metastases were suspected in three patients (15.7%) based on PET imaging. The suspicion was confirmed in one patient (peritoneal spread) and excluded in two patients (supra-diaphragmatic lymph nodes). In 13 patients (68.4%), RT procedures were altered due to findings in PET imaging. Conclusion PET-based radiochemotherapy planning may improve control rates by identifying areas of tumor cell spread eligible for dose escalation. False positivity, however, should be excluded in patients with findings that lead to major modifications of the therapeutic strategy.
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Affiliation(s)
- Sophia Scharl
- Department of Radiation Oncology, Technische Universität München (TUM), Ismaninger Straße 22, Munich, Germany.,Department of Radiation Oncology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Clara-Bianca Weidenbaecher
- Department of Radiation Oncology, Technische Universität München (TUM), Ismaninger Straße 22, Munich, Germany
| | - Christine Hugo
- Department of Radiation Oncology, Technische Universität München (TUM), Ismaninger Straße 22, Munich, Germany
| | - Christine E Brambs
- Department of Obstetrics and Gynecology, Technische Universität München (TUM), Ismaninger Straße 22, Munich, Germany
| | - Karina Knorr
- Department of Nuclear Medicine, Technische Universität München (TUM), Ismaninger Straße 22, Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, Technische Universität München (TUM), Ismaninger Straße 22, Munich, Germany.,Deutsches Konsortium Für Translationale Krebsforschung (DKTK), Partner Site Munich, Munich, Germany.,Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Ingolstädter Landstraße 1, Neuherberg, Germany
| | - Lars Schüttrumpf
- Department of Radiation Oncology, Technische Universität München (TUM), Ismaninger Straße 22, Munich, Germany.
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Burchardt E, Warenczak-Florczak Z, Cegła P, Piotrowski A, Cybulski Z, Burchardt W, Roszak A, Cholewiński W. Differences between [18F]FLT and [18F]FDG Uptake in PET/CT Imaging in CC Depend on Vaginal Bacteriology. Diagnostics (Basel) 2021; 12:diagnostics12010070. [PMID: 35054237 PMCID: PMC8774914 DOI: 10.3390/diagnostics12010070] [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: 12/09/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022] Open
Abstract
This study aims to investigate if vaginal bacteriology obtained prior to treatment influences the 3′-deoxy-3 18F-fluorothymidine (FLT) [18F]FLT and 2-deoxy-2-[18F]fluoro-d-glucose (2-[18F]FDG) [18F]FDG parameters in positron emission tomography (PET/CT) in cervical cancer (CC) patients. Methods: Retrospective analysis was performed on 39 women with locally advanced histologically confirmed cervical cancer who underwent dual tracer PET/CT examinations. The [18F]FLT and [18F]FDG PET parameters in the primary tumor, including SUVmax, SUVmean, MTV, heterogeneity, before radiotherapy (RT) were analyzed, depending on the bacteriology. The p-values < 0.05 were considered statistically significant. Results: In the vaginal and/or cervical smears, there were 27 (79.4%) positive results. In seven (20.6%) cases, no opportunistic pathogen growth was observed (No Bacteria Group). In positive bacteriology, eleven (32%) Gram-negative bacilli (Bacteria group 2) and fifteen (44%) Gram-positive bacteria (Bacteria group 1) were detected. Five patients with unknown results were excluded from the analysis. Data analysis shows a statistically significant difference between the SUVmax, and SUVmin values for three independent groups for the [18F]FLT. Conclusions: The lowest values of SUVmax and SUVmin for [18F]FLT are registered in Gram-negative bacteria, higher are in Gram-positive, and the absence of bacteria causes the highest [18F]FLT values.
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Affiliation(s)
- Ewa Burchardt
- Department of Radiotherapy and Oncological Gynecology, Greater Poland Cancer Center, 61-866 Poznan, Poland; (Z.W.-F.); (A.R.)
- Department of Electroradiology, University of Medical Science Poznan, 61-866 Poznan, Poland; (W.B.); (W.C.)
- Correspondence:
| | - Zaneta Warenczak-Florczak
- Department of Radiotherapy and Oncological Gynecology, Greater Poland Cancer Center, 61-866 Poznan, Poland; (Z.W.-F.); (A.R.)
- Department of Electroradiology, University of Medical Science Poznan, 61-866 Poznan, Poland; (W.B.); (W.C.)
| | - Paulina Cegła
- Department of Nuclear Medicine, Greater Poland Cancer Center, 61-866 Poznan, Poland;
| | - Adam Piotrowski
- Faculty of Physics, Adam Mickiewicz University, 61-614 Poznan, Poland;
| | - Zefiryn Cybulski
- Greater Poland Cancer Center, Microbiology Laboratorium, 61-866 Poznan, Poland;
| | - Wojciech Burchardt
- Department of Electroradiology, University of Medical Science Poznan, 61-866 Poznan, Poland; (W.B.); (W.C.)
- Department of Brachytherapy, Greater Poland Cancer Center, 61-866 Poznan, Poland
| | - Andrzej Roszak
- Department of Radiotherapy and Oncological Gynecology, Greater Poland Cancer Center, 61-866 Poznan, Poland; (Z.W.-F.); (A.R.)
- Department of Electroradiology, University of Medical Science Poznan, 61-866 Poznan, Poland; (W.B.); (W.C.)
| | - Witold Cholewiński
- Department of Electroradiology, University of Medical Science Poznan, 61-866 Poznan, Poland; (W.B.); (W.C.)
- Department of Nuclear Medicine, Greater Poland Cancer Center, 61-866 Poznan, Poland;
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10
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Cegla P, Bryl M, Witkowska K, Bos-Liedke A, Pietrasz K, Kycler W, Malicki J, Piotrowski T, Czepczyński R. Differences between TNM classification and 2-[ 18F]FDG PET parameters of primary tumor in NSCLC patients. ACTA ACUST UNITED AC 2021; 26:445-450. [PMID: 34277098 PMCID: PMC8281901 DOI: 10.5603/rpor.a2021.0072] [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: 11/30/2020] [Accepted: 02/11/2021] [Indexed: 12/09/2022]
Abstract
Background The aim of the study was to compare the TNM classification with 2-[18F]FDG PE T biological parameters of primary tumor in patients with NSCLC. Materials and methods Retrospective analysis was performed on a group of 79 newly diagnosed NSCLC patients. PET scans were acquired on Gemini TF PET/CT scanner 60–70 min after injection of 2-[18F]FDG with the mean activity of 364 ± 75 MBq, with the area being examined from the vertex to mid-thigh. The reconstructed PET images were evaluated using MIM 7.0 Software for SUVmax, MTV and TLG values. Results The analysis of the cancer stage according to TNM 8th edition showed stage IA2 in 8 patients, stage IA3 — 6 patients, stage IB — 4 patients, IIA — 3 patients, 15 patients with stage IIB, stage IIIA — 17 patients, IIIB — 5, IIIC — 5, IVA in 7 patients and stage IVB in 9 patients. The lowest TLG values of primary tumor were observed in stage IA2 (11.31 ± 15.27) and the highest in stage IIIC (1003.20 ± 953.59). The lowest value of primary tumor in SUVmax and MTV were found in stage IA2 (6.8 ± 3.8 and 1.37 ± 0.42, respectively), while the highest SUVmax of primary tumor was found in stage IIA (13.4 ± 11.4) and MTV in stage IIIC (108.15 ± 127.24). Conclusion TNM stages are characterized by different primary tumor 2-[18F]FDG PET parameters, which might complement patient outcome.
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Affiliation(s)
- Paulina Cegla
- Department of Nuclear Medicine, Greater Poland Cancer Centre, Poznan, Poland
| | - Maciej Bryl
- Oncology Department at Regional Centre of Lung Diseases in Poznan and Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | | | - Agnieszka Bos-Liedke
- Department of Macromolecular Physics, Adam Mickiewicz University, Poznan, Poland
| | - Katarzyna Pietrasz
- Department of Nuclear Medicine, Greater Poland Cancer Centre, Poznan, Poland
| | - Witold Kycler
- Gastrointestinal Surgical Oncology Department, Greater Poland Cancer Centre, Poznan, Poland.,Department of Head and Neck Surgery, Poznan University of Medical Science, Poznan, Poland
| | - Julian Malicki
- Chair and Department of Electroradiology, Poznan University of Medical Science, Poland.,Medical Physics Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Tomasz Piotrowski
- Chair and Department of Electroradiology, Poznan University of Medical Science, Poland.,Medical Physics Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Rafał Czepczyński
- Department of Nuclear Medicine, Affidea Poznań, Poland.,Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Science, Poland
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11
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Tavakoli F, Khatami SS, Momeni F, Azadbakht J, Ghasemi F. Cervical Cancer Diagnosis: Insights into Biochemical Biomarkers and Imaging Techniques. Comb Chem High Throughput Screen 2021; 24:605-623. [PMID: 32875976 DOI: 10.2174/1386207323666200901101955] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/14/2020] [Accepted: 08/06/2020] [Indexed: 11/22/2022]
Abstract
Cervical malignancy is known as one of the important cancers which is originated from cervix. This malignancy has been observed in women infected with papillomavirus who had regular oral contraceptives, multiple pregnancies, and sexual relations. Early and fast cervical cancer diagnosis is known as two important aspects of cervical cancer therapy. Several investigations indicated that early and fast detection of cervical cancer could be associated with better treatment process and increasing survival rate of patients with this malignancy. Imaging techniques are very important diagnosis tools that could be employed for diagnosis and following responses to therapy in various cervical cancer stages. Multiple lines of evidence indicated that utilization of imaging techniques is related to some limitations (i.e. high cost, and invasive effects). Hence, it seems that along with using imaging techniques, finding and developing new biomarkers could be useful in the diagnosis and treatment of subjects with cervical cancer. Taken together, many studies showed that a variety of biomarkers including, several proteins, mRNAs, microRNAs, exosomes and polymorphisms might be introduced as prognostic, diagnostic and therapeutic biomarkers in cervical cancer therapy. In this review article, we highlighted imaging techniques as well as novel biomarkers for the diagnosis of cervical cancer.
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Affiliation(s)
- Fatemeh Tavakoli
- Department of Biotechnology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sara Sadat Khatami
- Department of Biotechnology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Fatemeh Momeni
- Isfahan Research Committee of Multiple Sclerosis, Alzahra Research Institute, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Javid Azadbakht
- Department of Radiology and Imaging, Kashan University of Medical Science, Kashan, Iran
| | - Faezeh Ghasemi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
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Mu W, Liang Y, Hall LO, Tan Y, Balagurunathan Y, Wenham R, Wu N, Tian J, Gillies RJ. 18F-FDG PET/CT Habitat Radiomics Predicts Outcome of Patients with Cervical Cancer Treated with Chemoradiotherapy. Radiol Artif Intell 2020; 2:e190218. [PMID: 33937845 PMCID: PMC8082355 DOI: 10.1148/ryai.2020190218] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/29/2020] [Accepted: 07/08/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE To determine if quantitative features extracted from pretherapy fluorine 18 fluorodeoxyglucose (18F-FDG) PET/CT estimate prognosis in patients with locally advanced cervical cancer treated with chemoradiotherapy. MATERIALS AND METHODS In this retrospective study, PET/CT images and outcomes were curated from 154 patients with locally advanced cervical cancer, who underwent chemoradiotherapy from two institutions between March 2008 and June 2016, separated into independent training (n = 78; mean age, 51 years ± 13 [standard deviation]) and testing (n = 76; mean age, 50 years ± 10) cohorts. Radiomic features were extracted from PET, CT, and habitat (subregions with different metabolic characteristics) images that were derived by fusing PET and CT images. Parsimonious sets of these features were identified by the least absolute shrinkage and selection operator analysis and used to generate predictive radiomics signatures for progression-free survival (PFS) and overall survival (OS) estimation. Prognostic validation of the radiomic signatures as independent prognostic markers was performed using multivariable Cox regression, which was expressed as nomograms, together with other clinical risk factors. RESULTS The radiomics nomograms constructed with T stage, lymph node status, and radiomics signatures resulted in significantly better performance for the estimation of PFS (Harrell concordance index [C-index], 0.85 for training and 0.82 for test) and OS (C-index, 0.86 for training and 0.82 for test) compared with International Federation of Gynecology and Obstetrics staging system (C-index for PFS, 0.70 for training [P = .001] and 0.70 for test [P = .002]; C-index for OS, 0.73 for training [P < .001] and 0.70 for test [P < .001]), respectively. CONCLUSION Prognostic models were generated and validated from quantitative analysis of 18F-FDG PET/CT habitat images and clinical data, and may have the potential to identify the patients who need more aggressive treatment in clinical practice, pending further validation with larger prospective cohorts.Supplemental material is available for this article.© RSNA, 2020.
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Affiliation(s)
| | | | - Lawrence O. Hall
- From the Department of Cancer Physiology (W.M., Y.T., Y.B., R.J.G.) and Gynecologic Oncology (R.W.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, Tampa, FL 33612; Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.L., N.W.); Department of Computer Science and Engineering, University of South Florida, Tampa, Fla (L.O.H.); Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, Beijing, China (J.T.); and CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China (J.T.)
| | - Yan Tan
- From the Department of Cancer Physiology (W.M., Y.T., Y.B., R.J.G.) and Gynecologic Oncology (R.W.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, Tampa, FL 33612; Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.L., N.W.); Department of Computer Science and Engineering, University of South Florida, Tampa, Fla (L.O.H.); Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, Beijing, China (J.T.); and CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China (J.T.)
| | - Yoganand Balagurunathan
- From the Department of Cancer Physiology (W.M., Y.T., Y.B., R.J.G.) and Gynecologic Oncology (R.W.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, Tampa, FL 33612; Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.L., N.W.); Department of Computer Science and Engineering, University of South Florida, Tampa, Fla (L.O.H.); Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, Beijing, China (J.T.); and CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China (J.T.)
| | - Robert Wenham
- From the Department of Cancer Physiology (W.M., Y.T., Y.B., R.J.G.) and Gynecologic Oncology (R.W.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, Tampa, FL 33612; Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.L., N.W.); Department of Computer Science and Engineering, University of South Florida, Tampa, Fla (L.O.H.); Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, Beijing, China (J.T.); and CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China (J.T.)
| | - Ning Wu
- From the Department of Cancer Physiology (W.M., Y.T., Y.B., R.J.G.) and Gynecologic Oncology (R.W.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, Tampa, FL 33612; Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.L., N.W.); Department of Computer Science and Engineering, University of South Florida, Tampa, Fla (L.O.H.); Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, Beijing, China (J.T.); and CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China (J.T.)
| | - Jie Tian
- From the Department of Cancer Physiology (W.M., Y.T., Y.B., R.J.G.) and Gynecologic Oncology (R.W.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, Tampa, FL 33612; Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.L., N.W.); Department of Computer Science and Engineering, University of South Florida, Tampa, Fla (L.O.H.); Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, Beijing, China (J.T.); and CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China (J.T.)
| | - Robert J. Gillies
- From the Department of Cancer Physiology (W.M., Y.T., Y.B., R.J.G.) and Gynecologic Oncology (R.W.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, Tampa, FL 33612; Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.L., N.W.); Department of Computer Science and Engineering, University of South Florida, Tampa, Fla (L.O.H.); Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, Beijing, China (J.T.); and CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China (J.T.)
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Nazir A, Matthews R, Chimpiri AR, Henretta M, Varughese J, Franceschi D. Fluorodeoxyglucose positron-emission tomography-magnetic resonance hybrid imaging: An emerging tool for staging of cancer of the uterine cervix. World J Nucl Med 2020; 20:150-155. [PMID: 34321967 PMCID: PMC8285997 DOI: 10.4103/wjnm.wjnm_53_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 12/24/2022] Open
Abstract
Positron-emission tomography-magnetic resonance imaging (PET-MRI) is an emerging hybrid imaging modality that utilizes the superior soft tissue resolution of MR with the metabolic data from PET. In this study, we sought to assess the clinical value of fluorodeoxyglucose (FDG) PET-MRI with dedicated pelvic PET-MR in the initial staging of cervical cancer. In this institutional-approved study, we identified 23 adult females who underwent FDG PET-MRI on hybrid camera for staging of primary uterine cervical cancer that included a dedicated PET-MR of the pelvis. A nuclear medicine physician and a radiologist reviewed the PET, MRI, and fusion-body and pelvis images alone and then with consensus read characterizing PET and MR abnormal findings. There were 23 patients who underwent FDG PET-MRI for initial staging of cervical cancer with an average age of 52.2 ± 14.0 years. A total of 23 suspected lymph nodes in eight different patients were detected within the pelvis with increased metabolic activity on PET. Both the dedicated pelvis and whole-body PET imaging detected the same corresponding pelvic lymph nodes, although the pelvic PET imaging had better lymph node uptake delineation due to longer acquisition time. Using a 10-mm short-axis criterion, MRI identified only 43.5% of the FDG avid lymph nodes. The average SUVmax on the pelvis PET sequences was higher with SUV 8.9 ± 5.2 compared to the whole-body PET with SUV 7.8 ± 5.4 but was not statistically significant (P > 0.05). Primary cervical cancer was identified in 18 patients on both PET imaging and MRI with dedicated MR pelvis providing better characterization. Based on our results of the patients with cervical cancer evaluated for initial staging, combining dedicated pelvic PET-MRI with whole-body PET/MR provides the most complete status of malignant disease in reference to delineation of primary tumor, involvement of surrounding tissues, and regional lymph nodes.
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Affiliation(s)
- Alina Nazir
- Department of Radiology, Stony Brook University Hospital in Stony Brook, NY, USA
| | - Robert Matthews
- Department of Radiology, Stony Brook University Hospital in Stony Brook, NY, USA
| | | | - Melissa Henretta
- Division of Gynecologic Oncology, Trinity Health of New England, Hartford, CT, USA
| | - Joyce Varughese
- Gynecologic Oncology, Capital Health Surgical Group, Pennington, NJ, USA
| | - Dinko Franceschi
- Department of Radiology, Stony Brook University Hospital in Stony Brook, NY, USA
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Capaldi DPI, Hristov DH, Kidd EA. Parametric Response Mapping of Coregistered Positron Emission Tomography and Dynamic Contrast Enhanced Computed Tomography to Identify Radioresistant Subvolumes in Locally Advanced Cervical Cancer. Int J Radiat Oncol Biol Phys 2020; 107:756-765. [PMID: 32251757 DOI: 10.1016/j.ijrobp.2020.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/06/2020] [Accepted: 03/19/2020] [Indexed: 01/31/2023]
Abstract
PURPOSE To identify subvolumes that may predict treatment response to definitive concurrent chemoradiation therapy using parametric response mapping (PRM) of coregistered positron emission tomography (PET) and dynamic contrast-enhanced (DCE) computed tomography (CT) in locally advanced cervical carcinoma. METHODS AND MATERIALS Pre- and midtreatment (after 23 ± 4 days of concurrent chemoradiation therapy) DCE CT and PET imaging were performed on 21 patients with cervical cancer who were enrolled in a pilot study to evaluate the prognostic value of CT perfusion for primary cervical cancer (NCT01805141). Three-dimensional coregistered maps of PET/CT standardized uptake value (SUV) and DCE CT blood flow (BF) were generated. PRM was performed using voxel-wise joint histogram analysis to classify voxels within the tumor as highly metabolic and perfused (SUVhiBFhi), highly metabolic and hypoxic (SUVhiBFlo), low metabolic activity and hypoxic (SUVloBFlo), or low metabolic activity and perfused (SUVloBFhi) tissue based on thresholds determined from population means of pretreatment PET SUV and DCE CT BF. Relationships between baseline pretreatment imaging metrics and relative changes in metabolic tumor volume (ΔMTV), calculated from before treatment and during treatment imaging, were determined using univariable and multivariable linear regression models. RESULTS The relative volume of three PRM subvolumes significantly changed during treatment (SUVhiBFhi: P = .04; SUVhiBFlo: P = .0008; SUVloBFhi: P = .02), whereas SUVloBFlo did not (P = .9). Pretreatment PET SUVmax (r = -.58, P = .006), PET SUVmean (ρ = -.59, P = .005), DCE CT BFmean (r = -.50, P = .02), tumor volume (ρ = -.65, P = .001) and PRM SUVhiBFhi (ρ = -.59, P = .004) were negatively correlated with ΔMTV, whereas PRM SUVloBFlo was positively related to ΔMTV (r = .77, P < .0001). In a multivariable model that predicted ΔMTV, PRM SUVloBFlo, which combines both PET/CT and DCE CT, was the only significant variable (β = 1.825, P = .03), dominating both imaging modalities independently. CONCLUSIONS PRM was applied in locally advanced cervical carcinoma treated definitively with chemoradiation, and radioresistant subvolumes were identified that correlated with changes in MTV and predicted treatment response. Identification of these subvolumes may assist in clinical decision making to tailor therapies, such as brachytherapy, in an effort to improve patient outcomes.
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Affiliation(s)
- Dante P I Capaldi
- Department of Radiation Oncology, School of Medicine, Stanford University, Stanford, California
| | - Dimitre H Hristov
- Department of Radiation Oncology, School of Medicine, Stanford University, Stanford, California
| | - Elizabeth A Kidd
- Department of Radiation Oncology, School of Medicine, Stanford University, Stanford, California.
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Influence of Biological Parameters Assessed in [18F]FDG PET/CT on Overall Survival in Cervical Cancer Patients. Clin Nucl Med 2019; 44:860-863. [PMID: 31348081 DOI: 10.1097/rlu.0000000000002733] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIM The aim of this study was to estimate the influence of biological parameters assessed in [F]FDG PET/CT on overall survival (OS) in cervical cancer patients. METHODS Retrospective analysis was performed on a group of 371 patients with newly diagnosed and histologically confirmed cervical cancer. PET biological parameters in primary tumor including SUVmax, SUVmean, total lesion glycolysis (TLG), metabolic tumor volume (MTV), heterogeneity, and parameters referring both to primary tumor and metastatic lesions: SUVtotal, TLGtotal, and MTVtotal, were analyzed. RESULTS Based on PET/CT results, 3 subgroups were identified: cervical only-with disease limited only to the cervix (38%), +regional nodes-where increased glucose accumulation in addition to the cervical area was also observed in regional lymph nodes (36%), and +distal metastases-where PET scan showed a disseminated disease (26%). Depending on the stage of the disease, in the cervical-only group, 5-year survival rate was 86%; in the +regional nodes group, it was 80%; whereas in the +distal metastases group, 5-year survival rate was only 55%. However, based on Cox regression model, significant influence on OS was found only in heterogeneity of primary tumor; more inhomogeneous tumors suggest worse prognosis (0.25 ± 0.04 vs 0.16 ± 0.09, P < 0.001), SUVtotal (76.6 ± 130.1 vs 45.4 ± 73.4, P = 0.002), and MTVtotal (79.03 ± 88.27 vs 63.00 ± 83.80 cm, P = 0.03). For heterogeneity, cutoff point suggesting worse prognosis was 0.18; for SUVtotal, 52.3; and for MTVtotal, 66.55 cm. CONCLUSIONS Stage of disease assessed in [F]FDG PET/CT significantly influences survival rate in patients with cervical cancer. SUVtotal, MTVtotal, and heterogeneity of primary tumor are independent prognostic factors on OS in cervical cancer patients.
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16
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Gafita A, Calais J, Franz C, Rauscher I, Wang H, Roberstson A, Czernin J, Weber WA, Eiber M. Evaluation of SUV normalized by lean body mass (SUL) in 68Ga-PSMA11 PET/CT: a bi-centric analysis. EJNMMI Res 2019; 9:103. [PMID: 31792771 PMCID: PMC6889088 DOI: 10.1186/s13550-019-0572-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/04/2019] [Indexed: 12/17/2022] Open
Abstract
Introduction The aim of this analysis was to investigate whether the standardized uptake value (SUV) normalized by lean body mass (SUL) is a more appropriate quantitative parameter compared to the commonly used SUV normalized by patient’s weight in 68Ga-PSMA11 PET/CT. Material and methods 68Ga-PSMA11 PET/CT scans of 121 patients with prostate cancer from two institutions were evaluated. Liver SUV was measured within a 3-cm volume-of-interest (VOI) in the right hepatic lobe and corrected for lean body mass using the Janmahasatian formula. SUV and SUL repeatability between baseline and follow-up scans of the same patients were assessed. Results SUV was significantly positively correlated with body weight (r = 0.35, p = 0.02). In contrast, SUL was not correlated with body weight (r = 0.23, p = 0.07). No significant differences were found between baseline and follow-up scan (p = 0.52). Conclusion The Janmahasatian formula annuls the positive correlations between SUV and body weight, suggesting that SUL is preferable to SUV for quantitative analyses of 68Ga-PSMA11 PET/CT scans.
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Affiliation(s)
- Andrei Gafita
- Department of Nuclear Medicine, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany.
| | - Jeremie Calais
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, USA
| | - Charlott Franz
- Department of Nuclear Medicine, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
| | - Isabel Rauscher
- Department of Nuclear Medicine, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
| | - Hui Wang
- Department of Nuclear Medicine, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
| | - Andrew Roberstson
- Department of Nuclear Medicine, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
| | - Johannes Czernin
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, USA
| | - Wolfgang A Weber
- Department of Nuclear Medicine, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
| | - Matthias Eiber
- Department of Nuclear Medicine, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
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Abstract
OBJECTIVE. Imaging plays an important role in the diagnosis and staging of malignancies. Many common lymphoproliferative and other solid tumor malignancies can be viral-related. CONCLUSION. This review discusses the imaging findings that can be associated with common viral-induced malignancies. Knowledge of these imaging presentations can help narrow the differential diagnosis to reach a specific diagnosis through a precise workup and proper management.
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Draghini L, Costantini S, Vicenzi L, Italiani M, Loreti F, Trippa F, Arcidiacono F, Casale M, Mantello G, Maranzano E. Positron emission tomography for staging locally advanced cervical cancer and assessing intensity modulated radiotherapy approach. Radiol Med 2019; 124:819-825. [PMID: 30904982 DOI: 10.1007/s11547-019-01023-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 03/11/2019] [Indexed: 12/13/2022]
Abstract
AIMS To evaluate toxicity and outcome of concomitant chemotherapy and intensity modulated radiotherapy (IMRT) with 18-fluorodeoxyglucose positron emission tomography/computed tomography (18FDG-PET/CT) based simultaneous integrated boost (SIB) of locally advanced cervical cancer (LACC). METHODS Patients with LACC underwent chemo-radiation with IMRT and SIB. Staging and follow-up were performed with clinical evaluation and CT, MRI, 18FDG-PET/CT. SIB was done on positive nodes with 18FDG-PET/CT based planning. CT-based planning high-dose-rate brachytherapy (HDR-BT) was delivered as subsequent boost to the primary tumor. Cisplatin concomitant chemotherapy was administered during IMRT. RESULTS Fourteen patients with cervical cancer were prospectively recruited between August 2014 and June 2017, 13 (93%) had a LACC, one (7%) patient was not evaluable because 18FDG-PET/CT evidenced metastases to the liver undetected by previous CT/MRI. Patients had a median age of 59 years, a median Karnofsky performance status of 100%, and a prevalence of squamous cell carcinoma histology (85%). SIB was delivered on 23 positive lymph nodes. IMRT median dose to the pelvis was 48.6 Gy in 27 fractions, SIB median dose 54 Gy in 27 fractions, HDR-BT boost median dose 21 Gy in 3 fractions. After a median follow-up of 30 months, 2-year local control and distant control were 86% and 86%, respectively. There were no grade 4 acute and/or late toxicities. CONCLUSIONS The 18FDG-PET/CT influenced stage assessment and RT treatment planning due to its high specificity in distant metastases and nodal involvement detection. The IMRT with SIB for positive nodes was an effective therapy with acceptable toxicity in LACC.
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Affiliation(s)
- Lorena Draghini
- Radiotherapy Oncology Centre, "S. Maria" Hospital, Terni, Italy
| | - Sara Costantini
- Radiation Oncology Centre, Ospedali Riuniti Umberto I°, Ancona, Italy
| | - Lisa Vicenzi
- Radiation Oncology Centre, Ospedali Riuniti Umberto I°, Ancona, Italy
| | - Marco Italiani
- Radiotherapy Oncology Centre, "S. Maria" Hospital, Terni, Italy
| | - Fabio Loreti
- Nuclear Medicine Service, "S. Maria" Hospital, Terni, Italy
| | - Fabio Trippa
- Radiotherapy Oncology Centre, "S. Maria" Hospital, Terni, Italy
| | | | | | - Giovanna Mantello
- Radiation Oncology Centre, Ospedali Riuniti Umberto I°, Ancona, Italy
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Cordero-Gallardo F, Lee Burnett O, McNamara MM, Weber TM, Zarzour J, Bae S, Jang S, Barrett OC, McDonald A, Kim RY. Incidence of mesorectal node metastasis in locally advanced cervical cancer: its therapeutic implications. Int J Gynecol Cancer 2019; 29:48-52. [PMID: 30640683 DOI: 10.1136/ijgc-2018-000031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/29/2018] [Accepted: 09/06/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To evaluate the incidence and risk factors for mesorectal node metastasis (MRNM) in locally advanced cervical cancer. METHODS/MATERIALS We performed an observational retrospective cohort study of 122 patients with cervical cancer who received definitive chemo-radiation treatment between December 2013 and June 2017 to evaluate the incidence of MRNM. Three diagnostic radiologists assessed all available pre-treatment images. In this study, the pelvic node metastasis was defined as ≥ 1.0 cm and MRNM as ≥ 0.5 cm for CT and MRI scans and as a maximum standardized uptake value of > 2.5 for PET/CT. The relationship of MRNM with FIGO stage, pelvic node metastasis, and mesorectal fascia involvement was evaluated. RESULTS The incidence of MRNM in all 122 patients was 8 (6.6%). However, in advanced stage (III- IV) patients, MRNM occurred in 4 of 39 (10.3%) compared with 4 of 83 (4.8%) in early stage (IB1-IIB) patients (p = 0.27). In patients with a positive pelvic node, MRNM occurred in 7 of 55 (12.7%) and 1 of 67 (1.5%) in those with negative pelvic node (p = 0.02). In addition, the incidence of MRNM was 3 of 9 (33.3%) in the presence of mesorectal fascia involvement and 5 of 113 (4.4%) among those without mesorectal fascia involvement (p = 0.013). CONCLUSION This study indicates that pelvic node metastasis and mesorectal fascia involvement are high-risk factors for MRNM. Therefore, vigilance of reviewing images in the mesorectum for MRNM is necessary for high-risk patients.
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Affiliation(s)
| | - O Lee Burnett
- Department of Radiation Oncology, University of Alabama Medical Center, Birmingham, Alberta, USA
| | - Michelle M McNamara
- Department of Diagnostic Radiology, University of Alabama Medical Center, Birmingham, Alabama, USA
| | - Therese M Weber
- Department of Diagnostic Radiology, University of Alabama Medical Center, Birmingham, Alabama, USA
| | - Jessica Zarzour
- Department of Diagnostic Radiology, University of Alabama Medical Center, Birmingham, Alabama, USA
| | - Sejong Bae
- Preventative Medicine, University of Alabama Medical Center, Birmingham, Alabama, USA
| | - Samuel Jang
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Olivia Claire Barrett
- Department of Radiation Oncology, University of Alabama Medical Center, Birmingham, Alberta, USA
| | - Andrew McDonald
- Department of Radiation Oncology, University of Alabama Medical Center, Birmingham, Alberta, USA
| | - Robert Y Kim
- Department of Radiation Oncology, University of Alabama Medical Center, Birmingham, Alberta, USA
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Jelić I, Isaković V, Jovanović S, Odalović S. The significance of positron emission and computerized tomography with fluorodeoxyglucose in the post-therapeutic evaluation of patients with uterine carcinoma. MEDICINSKI PODMLADAK 2019. [DOI: 10.5937/mp70-17690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Bollineni VR, Ytre-Hauge S, Gulati A, Halle MK, Woie K, Salvesen Ø, Trovik J, Krakstad C, Haldorsen IS. The prognostic value of preoperative FDG-PET/CT metabolic parameters in cervical cancer patients. Eur J Hybrid Imaging 2018. [DOI: 10.1186/s41824-018-0042-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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22
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Li B, Sun H, Zhang S, Wang X, Guo Q. Amide proton transfer imaging to evaluate the grading of squamous cell carcinoma of the cervix: A comparative study using 18 F FDG PET. J Magn Reson Imaging 2018; 50:261-268. [PMID: 30430677 DOI: 10.1002/jmri.26572] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/25/2018] [Accepted: 10/27/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Amide proton transfer (APT) imaging has shown great potential value in the diagnosis of cancer, but has yet not been applied in cervical carcinoma patients. PURPOSE To investigate the utility of APT imaging in estimating histologic grades of squamous cell carcinoma of the cervix (SCCC), compared with the standardized uptake value (SUV). STUDY TYPE Prospective. POPULATION Thirty-one patients with SCCC (median age 51 years) were included. FIELD STRENGTH/SEQUENCE Ingenia 3.0 T CX, Axial T1 -weighted imaging (T1 WI), Axial T2 WI, 3D turbo spin echo sequence for APT imaging. ASSESSMENT Patient pathology was confirmed by surgery and the patients were divided into three groups based on histologic grades: Grade 1 (n = 9), Grade 2 (n = 12), and Grade 3 (n = 10). The APT signal intensity (APT SI), maximum SUV (SUVmax ) and mean SUV (SUVmean ) for each grade were assessed by experienced radiologists in a blinded manner. STATISTICAL TESTS The obtained parameters were compared by one-way analysis of variance with Tukey honest significant difference post-hoc test. The correlations between the parameters and histologic grades were analyzed by Spearman's correlation coefficient. The Pearson correlation coefficients of the APT SI with the SUVmax and SUVmean were also calculated. RESULTS The APT SIs for the three grades were significantly different (P = 0.0002). The APT SIs of Grade 2 and Grade 3 had significant differences (P = 0.009). The Spearman correlation coefficients for the correlations between the parameters and histological grade were as follows: APT SI: 0.684 (P = 0.00002), SUVmax : 0.318 (P = 0.082), and SUVmean : 0.261 (P = 0.157). The Pearson correlation coefficients of the APT SI with the SUVmax and SUVmean were 0.108 (P = 0.564) and 0.178 (P = 0.337), respectively. DATA CONCLUSION The APT SI was positively correlated with the SCCC grades. APT imaging maybe a promising method for predicting SCCC histologic grades. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:261-268.
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Affiliation(s)
- Beibei Li
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, PRC
| | - Hongzan Sun
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, PRC
| | - Siyu Zhang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, PRC
| | - Xiaoqi Wang
- Philips Healthcare, World Profit Centre, Chaoyang District, Beijing, PRC
| | - Qiyong Guo
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, PRC
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Evaluation of 18F-FDG PET/CT parameters for reflection of aggressiveness and prediction of prognosis in early-stage cervical cancer. Nucl Med Commun 2018; 39:1045-1052. [PMID: 30204642 DOI: 10.1097/mnm.0000000000000909] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE The aim of this study was to investigate the value of five typical fluorine-18-fluorodeoxyglucose PET/computed tomography (CT) parameters (including SUVmax, SUVmean, SUVpeak, MTV and TLG) in the reflecting aggressiveness and predicting prognosis in patients with early-stage cervical cancer. PATIENTS AND METHODS Our study enrolled 85 primary cervical cancer patients who underwent preoperative fluorine-18-fluorodeoxyglucose PET/CT scans. We investigated the association of five parameters derived from PET/CT with clinicopathological characteristics. Immunohistochemistry was utilized to evaluate the expression of glucose transporter protein-1 (GLUT-1), TP53-induced glycolysis and apoptosis regulator (TIGAR), and vascular endothelial growth factor (VEGF), and the correlation between PET/CT parameters and the expression of GLUT-1, TIGAR, and VEGF was analyzed. In addition, we also investigated the correlation between disease-free survival of cervical cancer patients and PET/CT parameters. RESULTS The mean peak standardized uptake value (SUV)peak showed significant differences between all three International Federation of Gynecology and Obstetrics stages (P<0.001-0.032). The patients with lymph node metastasis had significantly higher SUVpeak, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) compared with those with the absence of lymph node metastasis (P=0.038, 0.024, and 0.010, respectively). All the five parameters showed an association with tumor size and cervical stromal invasion depth. Immunohistochemistry results indicated that the SUVpeak showed the highest association with the expression of GLUT-1, TIGAR, and VEGF (rs=0.705, P<0.001, rs=-0.466, P<0.001, rs=0.580, P<0.001, respectively) in these five parameters. The survival analysis showed that SUVpeak, MTV, and TLG were correlated with disease-free survival (P=0.042, P<0.001, and P=0.004, respectively). CONCLUSION Early-stage cervical cancer with high SUVpeak may reflect more aggressive behavior, and SUVpeak, MTV, and TLG can be used to predict the prognosis of early-stage cervical cancer patients. It may help with the choice of individualized treatment options.
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Lima GM, Matti A, Vara G, Dondi G, Naselli N, De Crescenzo EM, Morganti AG, Perrone AM, De Iaco P, Nanni C, Fanti S. Prognostic value of posttreatment 18F-FDG PET/CT and predictors of metabolic response to therapy in patients with locally advanced cervical cancer treated with concomitant chemoradiation therapy: an analysis of intensity- and volume-based PET parameters. Eur J Nucl Med Mol Imaging 2018; 45:2139-2146. [PMID: 30069578 PMCID: PMC6182406 DOI: 10.1007/s00259-018-4077-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 06/19/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE To investigate the prognostic value of posttreatment 18F-FDG PET/CT in patients with locally advanced cervical cancer (LACC) treated with concomitant chemoradiation therapy (CCRT). The secondary aim was to assess the possible role of intensity-based and volume-based PET parameters including SUVmax, SUVmean, MTV and TLG, and clinical parameters including age, pathology, FIGO stage and nodal involvement as factors predicting response to treatment. METHODS This retrospective study included 82 patients affected by LACC treated with CCRT. All patients underwent 18F-FDG PET/CT both before and after treatment. The posttreatment PET/CT scans were used to classify patients as complete metabolic responders (CMR) or non-complete metabolic responders (N-CMR) according to the EORTC criteria. Kaplan-Meier analysis was used to evaluate differences in overall survival (OS) between the CMR and N-CMR groups. Student's t test, Pearson's chi-squared test and logistic regression were used to investigate the possible value of PET and clinical parameters as predictors of metabolic response to therapy. RESULTS Kaplan-Meier analysis showed a highly significant difference in OS between the CMR and N-CMR groups (log-rank test p < 0.0001). Significant independent predictors of response to therapy were MTV (p = 0.019, odds ratio = 1.015, 95% CI = 1.002-1.028, Nagelkerke R2 = 0.110), TLG (p = 0.045, odds ratio = 1.001, 95% CI = 1.000-1.002, Nagelkerke R2 = 0.081) and nodal involvement (p = 0.088, odds ratio = 2.361, 95% CI = 0.879-6.343, Nagelkerke R2 = 0.051). CONCLUSION 18F-FDG PET/CT-based response assessment using the EORTC criteria reliably predicts OS in LACC patients treated with CCRT. In our cohort of patients, pretreatment MTV and TLG and nodal involvement were predictors of response to therapy. MTV was the best predictor of response. However, its additional risk value seems to be low (MTV odds ratio = 1.015).
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Affiliation(s)
- Giacomo Maria Lima
- Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
| | - Antonella Matti
- Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Giulio Vara
- Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Giulia Dondi
- Oncologic Gynecology Unit, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Nicoletta Naselli
- Radiology Unit, Department of Diagnostic and Preventive Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | | | - Alessio Giuseppe Morganti
- Radiation Oncology Centre, Department of Experimental, Diagnostic and Specialty Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Anna Myriam Perrone
- Oncologic Gynecology Unit, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Pierandrea De Iaco
- Oncologic Gynecology Unit, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Cristina Nanni
- Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Stefano Fanti
- Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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Abstract
The incidence of gynecological malignancies is on the rise partly because of the availability of screening programmes, awareness, higher technological advancements, and availability of better medical care. Early diagnosis of any malignancy leads to prompt treatment. Use of 18Fluorine-Fluorodeoxyglucose (F-FDG) PET/CT in the treatment and follow-up of patients with Ca cervix considerably improves patient management. The primary diagnosis of Ca cervix is made either by biopsy of a visible tumor on the cervix or by a cone biopsy of a nonvisible malignant cervical focus. The staging procedure is purely clinical (i.e. gynecologic examination under general anesthesia) according to the International Federation of Gynaecology and Obstetrics classification. Earlier, with the nonavailability of sophisticated medical equipment and imaging specialists, oncologists relied heavily on clinical examination. However, anatomical and functional imaging has been proven to be considerably superior in understanding parametrial involvement and nodal/distant metastases in the cancer cervix than clinical examination alone. Data are evolving on the usage of F-FDG PET/CT in initial staging, treatment planning, and monitoring therapy response for gynecological malignancies. Prognostic information derived from the primary lesion such as the maximum standardized uptake value, metabolic tumor volume, and extent of para-aortic nodal metastatic disease plays a critical role in tailoring therapy on the basis of patient tumor-specific factors rather than on International Federation of Gynaecology and Obstetrics stage alone. Thus, F-FDG PET/CT needs to be listed not only under the panel of pretherapy investigations for Ca cervix but also for recurrence and therapy response assessments. It allows a more confident approach to patient management at initial staging, especially in terms of the decision to choose surgical versus palliation measures.
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Adam JA, Arkies H, Hinnen K, Stalpers LJ, van Waesberghe JH, Stoker J, van Os R, Laan JJ, Mom CH, van Eck-Smit BL. 18F-FDG-PET/CT guided external beam radiotherapy volumes in inoperable uterine cervical cancer. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2018; 62:420-428. [PMID: 29869485 DOI: 10.23736/s1824-4785.18.03083-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND In patients with advanced stage cancer of the uterine cervix who undergo irradiation with curative intent, there is the necessity to treat all suspicious nodes on imaging. Our hypothesis was that adding fluorodeoxyglucose positron emission computer tomography/computer tomography (FDG-PET/CT) to the imaging workup would alter the external beam radiotherapy (EBRT) treatment plan, either resulting in an extended external beam radiotherapy (EBRT) field to the para-aortal region or an additional boost to suspicious nodes. Since extended field radiotherapy or additional boost can cause toxicity, our secondary aim was to assess the incidence of severe late bowel toxicity in patients treated with extended para-aortal EBRT-field and boost compared to elective pelvic radiotherapy. METHODS Eighty-eight patients were enrolled. First, the optimal radiation treatment plan (EBRT and boost) was retrospectively determined based on magnetic resonance imaging (MRI) or FDG-PET/CT. Second, the severe bowel toxicity caused by the extended para-aortal field was assessed, based on the executed radiotherapy. RESULTS Based on MRI 8/88 patients would receive EBRT with para-aortic extension, this was 21/88 for FDG-PET/CT. Based on MRI 47/704 lymph node regions would receive additional boost, while based on PET/CT 91/704. Late severe bowel toxicity was seen in 12/84 patients, 6/65 in the group who received elective pelvic irradiation and 6/19 with para-aortal EBRT and boost at common iliac and/or para-aortal lymph nodes. Significant worse overall survival was seen of patients who needed para-aortal irradiation. CONCLUSIONS Addition of FDG-PET/CT leads to an extension of the elective EBRT volume and more suspicious lymph nodes receive a boost. However, when deciding to intensify radiation therapy, late severe bowel toxicity has to be taken into account.
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Affiliation(s)
- Judit A Adam
- Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands -
| | - Hester Arkies
- Department of Nuclear Medicine, Isala Clinics, Zwolle, The Netherlands
| | - Karel Hinnen
- Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands
| | - Lukas J Stalpers
- Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands
| | - Jan H van Waesberghe
- Department of Radiology and Nuclear Medicine, Free University Medical Center, Amsterdam, The Netherlands
| | - Jaap Stoker
- Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Rob van Os
- Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands
| | - Janna J Laan
- Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands
| | - Constantijne H Mom
- Department of Gynecology, Academic Medical Center, Amsterdam, The Netherlands
| | - Berthe L van Eck-Smit
- Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
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Construction and Evaluation of the Tumor-Targeting, Cell-Penetrating Multifunctional Molecular Probe iCREKA. CONTRAST MEDIA & MOLECULAR IMAGING 2018; 2018:7929617. [PMID: 29686590 PMCID: PMC5857341 DOI: 10.1155/2018/7929617] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 12/24/2017] [Accepted: 02/05/2018] [Indexed: 11/27/2022]
Abstract
A novel tumor stroma targeting and membrane-penetrating cyclic peptide, named iCREKA, was designed and labeled by fluorescein isothiocyanate (FITC) and positron emitter 18F to build the tumor-targeting tracers. The FITC-iCREKA was proved to have significantly higher cellular uptake in the glioma U87 cells in the presence of activated MMP-2 than that in absence of activated MMP-2 by cells fluorescence test in vitro. The tumor tissue fluorescence microscope imaging demonstrated that FITC-iCREKA accumulated in the walls of the blood vessels and the surrounding stroma in the glioma tumor at 1 h after intravenous injection. While at 3 h after injection, FITC-iCREKA was found to be uptaken in the tumor cells. However, the control FITC-CREKA can only be found in the tumor stroma, not in the tumor cells, no matter at 1 h or 3 h after injection. The whole-animal fluorescence imaging showed that the glioma tumor could be visualized clearly with high fluorescence signal. The microPET/CT imaging further demonstrated that 18F-iCREKA could target U87MG tumor in vivo from 30 min to 2 h after injection. The present study indicated the iCREKA had the capacity of tumor stroma targeting and the membrane-penetrating. It was potential to be developed as the fluorescent and PET tracers for tumor imaging.
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Shaha K, Agrawal A, Mittal N, Purandare N, Mahantshetty U, Shah S, Puranik A, Rangarajan V. Pigmented Villonodular Synovitis: A Close Mimic of Metastasis on 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography. INDIAN JOURNAL OF NUCLEAR MEDICINE : IJNM : THE OFFICIAL JOURNAL OF THE SOCIETY OF NUCLEAR MEDICINE, INDIA 2018; 33:82-83. [PMID: 29430127 PMCID: PMC5798111 DOI: 10.4103/ijnm.ijnm_117_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Kunal Shaha
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Archi Agrawal
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Neha Mittal
- Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Nilendu Purandare
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Umesh Mahantshetty
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sneha Shah
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Amey Puranik
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Venkatesh Rangarajan
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Viswanathan C, Faria S, Devine C, Patnana M, Sagebiel T, Iyer RB, Bhosale PR. [18F]-2-Fluoro-2-Deoxy-D-glucose-PET Assessment of Cervical Cancer. PET Clin 2018; 13:165-177. [PMID: 29482748 DOI: 10.1016/j.cpet.2017.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This article provides an overview of PET in cervical cancer, primarily with regard to the use of 18F-2-fluoro-2-deoxy-d-glucose-PET/computed tomography. A brief discussion of upcoming technologies, such as PET/MR imaging, is presented.
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Affiliation(s)
- Chitra Viswanathan
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4008, USA.
| | - Silvana Faria
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4008, USA
| | - Catherine Devine
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4008, USA
| | - Madhavi Patnana
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4008, USA
| | - Tara Sagebiel
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4008, USA
| | - Revathy B Iyer
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4008, USA
| | - Priya R Bhosale
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030-4008, USA
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Evaluating the Role of F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Scanning in the Staging of Patients With Stage IIIB Cervical Carcinoma and the Impact on Treatment Decisions. Int J Gynecol Cancer 2018; 28:379-384. [DOI: 10.1097/igc.0000000000001174] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Guler OC, Torun N, Yildirim BA, Onal C. Pretreatment metabolic tumour volume and total lesion glycolysis are not independent prognosticators for locally advanced cervical cancer patients treated with chemoradiotherapy. Br J Radiol 2018; 91:20170552. [PMID: 29293366 DOI: 10.1259/bjr.20170552] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the prognostic significance of metabolic parameters derived from fludeoxyglucose (FDG) positron emission tomography (PET)/CT, in cervical cancer patients treated with concurrent chemoradiotherapy. METHODS We retrospectively reviewed medical records from 129 biopsy-proven non-metastatic cervical cancer patients treated with external radiotherapy and intracavitary brachytherapy at our department. Correlation between metabolic parameters and tumour characteristics was evaluated. Prognostic factors for survival, local control and distant metastasis were analysed. RESULTS The median follow up for all patients and surviving patients was 30.0 months (range, 3.7-94.7 months) and 50.5 months (range, 14.5-94.7 months), respectively. The 2- and 5-year overall survival (OS) and disease-free survival (DFS) rates were 68 42, 54 and 38%, respectively. The maximum standardized uptake value (SUVmax), SUVmean, metabolic tumour volume (MTV) and total lesion glycolysis were significantly higher in patients with larger tumours (>4 cm) and partial regression or progressive disease after definitive treatment compared to patients with smaller tumour (≤4 cm) and post-treatment complete response. On univariate analysis, stage, lymph node metastasis, tumour size >4 cm, SUVmax, MTV, SUVmean and total lesion glycolysis were prognostic factors for OS and DFS. On multivariate analysis, only larger tumour and presence of lymph node metastasis were significant prognostic factors for both OS and DFS. Additionally, extensive stage was a significant prognosticator for DFS. CONCLUSION Although, metabolic parameters derived from FDG-PET/CT had a prognostic significance in univariate analysis, the significance was lost in multivariate analysis where tumour stage, size and lymph node status were the only independent parameters. Advances in knowledge: The clinical benefit of using FDG-PET/CT metabolic parameters to evaluate the high-risk patients among cervical cancer patients and to eventually change patient management still needs further clarification.
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Affiliation(s)
- Ozan Cem Guler
- 1 Department of Radiation Oncology, Karadeniz Technical University Faculty of Medicine , Trabzon , Turkey
| | - Nese Torun
- 2 Department of Nuclear Medicine, Baskent University Faculty of Medicine , Adana , Turkey
| | - Berna Akkus Yildirim
- 3 Department of Radiation Oncology, Baskent University Faculty of Medicine , Adana , Turkey
| | - Cem Onal
- 3 Department of Radiation Oncology, Baskent University Faculty of Medicine , Adana , Turkey
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Dappa E, Elger T, Hasenburg A, Düber C, Battista MJ, Hötker AM. The value of advanced MRI techniques in the assessment of cervical cancer: a review. Insights Imaging 2017; 8:471-481. [PMID: 28828723 PMCID: PMC5621992 DOI: 10.1007/s13244-017-0567-0] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/18/2017] [Accepted: 07/18/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To assess the value of new magnetic resonance imaging (MRI) techniques in cervical cancer. METHODS We searched PubMed and MEDLINE and reviewed articles published from 1990 to 2016 to identify studies that used MRI techniques, such as diffusion weighted imaging (DWI), intravoxel incoherent motion (IVIM) and dynamic contrast enhancement (DCE) MRI, to assess parametric invasion, to detect lymph node metastases, tumour subtype and grading, and to detect and predict tumour recurrence. RESULTS Seventy-nine studies were included. The additional use of DWI improved the accuracy and sensitivity of the evaluation of parametrial extension. Most studies reported improved detection of nodal metastases. Functional MRI techniques have the potential to assess tumour subtypes and tumour grade differentiation, and they showed additional value in detecting and predicting treatment response. Limitations included a lack of technical standardisation, which limits reproducibility. CONCLUSIONS New advanced MRI techniques allow improved analysis of tumour biology and the tumour microenvironment. They can improve TNM staging and show promise for tumour classification and for assessing the risk of tumour recurrence. They may be helpful for developing optimised and personalised therapy for patients with cervical cancer. TEACHING POINTS • Conventional MRI plays a key role in the evaluation of cervical cancer. • DWI improves tumour delineation and detection of nodal metastases in cervical cancer. • Advanced MRI techniques show promise regarding histological grading and subtype differentiation. • Tumour ADC is a potential biomarker for response to treatment.
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Affiliation(s)
- Evelyn Dappa
- Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University Medical Centre, Langenbeckstr. 1, 55131, Mainz, Germany.
| | - Tania Elger
- Department of Gynaecology and Obstetrics, Johannes Gutenberg-University Medical Centre, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Annette Hasenburg
- Department of Gynaecology and Obstetrics, Johannes Gutenberg-University Medical Centre, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Christoph Düber
- Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University Medical Centre, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Marco J Battista
- Department of Gynaecology and Obstetrics, Johannes Gutenberg-University Medical Centre, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Andreas M Hötker
- Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University Medical Centre, Langenbeckstr. 1, 55131, Mainz, Germany
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Xu W, Yu S, Xin J, Guo Q. Relationship of 18F-FDG PET/CT metabolic, clinical and pathological characteristics of primary squamous cell carcinoma of the cervix. J Investig Med 2016; 64:1246-1251. [PMID: 27436350 DOI: 10.1136/jim-2016-000166] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2016] [Indexed: 11/04/2022]
Abstract
The objectives of this retrospective study were to use preoperative 18fluoro-d-glucose (18FDG) PET/CT in patients with primary cervical squamous cell carcinoma to explore the relationship between clinical, pathological and metabolic characteristics. Eighty consecutive patients with squamous cell carcinoma of cervix received 18FDG PET/CT scan before treatment. Metabolic tumor volume (MTV), total lesion glycolysis (TLG) and the peak standardized uptake value (SUVpeak) of the cervical tumors were calculated by an iterative adaptive algorithm. The association of these metabolic markers with serum squamous cell carcinoma antigen (SCC-ag), International Federation of Gynecology and Obstetrics (FIGO) stage, maximum tumor size and depth of cervical stromal invasion of the tumor was determined by the multivariate analysis. MTV and TLG were significantly higher in subjects with serum SCC-ag levels ≥3.95, with FIGO stage 1b2 and with a maximum tumor size of ≥4 cm (p≤0.009). Higher SUVpeak levels were associated with a maximum tumor size of ≥4 cm and with a cervical stromal invasion depth of ≥1/2 (p≤0.003). Multivariate analysis indicated that MTV was independently associated with FIGO stage Ib2 (p=0.041) and depth of cervical stromal invasion (p=0.020). TLG and SUVpeak were independently associated with maximum tumor size (p≤0.004) and depth of cervical stromal invasion (p≤0.013). Significant linear correlation was found between SUVpeak and tumor size; the Pearson correlation coefficient was 0.34 (p=0.002). Metabolic parameters such as MTV, TLG and SUVpeak are able to predict clinical and pathological status in preoperative cervical cancer.
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Affiliation(s)
- Weina Xu
- Department of Nuclear Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shupeng Yu
- Department of Nuclear Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jun Xin
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qiyong Guo
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
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Mocciaro V, Scollo P, Stefano A, Gieri S, Russo G, Scibilia G, Cosentino S, Murè G, Baldari S, Sabini MG, Fraggetta F, Gilardi MC, Ippolito M. Correlation between histological grade and positron emission tomography parameters in cervical carcinoma. Oncol Lett 2016; 12:1408-1414. [PMID: 27446445 PMCID: PMC4950245 DOI: 10.3892/ol.2016.4771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 05/12/2016] [Indexed: 01/23/2023] Open
Abstract
The aim of the present study was to evaluate the changes in cervical cancer glucose metabolism for different levels of cellular differentiation. The metabolic activity was measured by standardized uptake value (SUV), SUV normalized to lean body mass, metabolic tumor volume and total lesion glycolysis using fluorine-18 fluorodeoxyglucose positron emission tomography (PET). A correlation study of these values could be used to facilitate therapeutic choice and to improve clinical practice and outcome. This study considered 32 patients with diagnosed cervical cancers, at different International Federation of Gynecology and Obstetrics stages. Glucose metabolism was assessed by PET examination, and histological specimens were examined to determine their initial grade of differentiation. A correlation study of these values was evaluated. Histological examination showed that all cases were of squamous cell carcinoma. Regarding the differentiation of the tumor, 19 well- to moderately-differentiated tumors and 13 poorly-differentiated tumors were determined. Negative findings for correlations between metabolic parameters and initial grade of histological differentiation were found, and considering that histological grade has been shown to have no consistent prognostic value in cervical cancer treatment, PET imaging could play a significant role in cervical cancer prognosis.
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Affiliation(s)
- Vanessa Mocciaro
- Institute of Molecular Bioimaging and Physiology, National Research Council, Cefalù, I-90015 Palermo, Italy
| | - Paolo Scollo
- Department of Gynecology, Cannizzaro Hospital, I-95126 Catania, Italy
| | - Alessandro Stefano
- Institute of Molecular Bioimaging and Physiology, National Research Council, Cefalù, I-90015 Palermo, Italy
| | - Stefania Gieri
- Institute of Molecular Bioimaging and Physiology, National Research Council, Cefalù, I-90015 Palermo, Italy
| | - Giorgio Russo
- Institute of Molecular Bioimaging and Physiology, National Research Council, Cefalù, I-90015 Palermo, Italy
| | - Giuseppe Scibilia
- Department of Gynecology, Cannizzaro Hospital, I-95126 Catania, Italy
| | | | - Gabriella Murè
- Department of Nuclear Medicine, Cannizzaro Hospital, I-95126 Catania, Italy
| | - Sara Baldari
- Department of Nuclear Medicine, Cannizzaro Hospital, I-95126 Catania, Italy
| | | | | | - Maria Carla Gilardi
- Institute of Molecular Bioimaging and Physiology, National Research Council, Cefalù, I-90015 Palermo, Italy
| | - Massimo Ippolito
- Department of Nuclear Medicine, Cannizzaro Hospital, I-95126 Catania, Italy
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Bourgioti C, Chatoupis K, Moulopoulos LA. Current imaging strategies for the evaluation of uterine cervical cancer. World J Radiol 2016; 8:342-354. [PMID: 27158421 PMCID: PMC4840192 DOI: 10.4329/wjr.v8.i4.342] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 01/15/2016] [Accepted: 01/31/2016] [Indexed: 02/06/2023] Open
Abstract
Uterine cervical cancer still remains an important socioeconomic issue because it largely affects women of reproductive age. Prognosis is highly depended on extent of the disease at diagnosis and, therefore, accurate staging is crucial for optimal management. Cervical cancer is clinically staged, according to International Federation of Gynecology and Obstetrics guidelines, but, currently, there is increased use of cross sectional imaging modalities [computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography-CT (PET-CT)] for the study of important prognostic factors like tumor size, parametrial invasion, endocervical extension, pelvic side wall or adjacent/distal organs involvement and lymph node status. Imaging indications also include cervical cancer follow-up, evaluation of tumor response to treatment and selection of suitable candidates for less radical surgeries like radical trachelectomy for fertility preservation. The preferred imaging method for local cervical cancer evaluation is MRI; CT is equally effective for evaluation of extrauterine spread of the disease. PET-CT shows high diagnostic performance for the detection of tumor relapse and metastatic lymph nodes. The aim of this review is to familiarize radiologists with the MRI appearance of cervical carcinoma and to discuss the indications of cross sectional imaging during the course of the disease in patients with cervical carcinoma.
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Papadopoulou I, Stewart V, Barwick TD, Park WHE, Soneji N, Rockall AG, Bharwani N. Post–Radiation Therapy Imaging Appearances in Cervical Carcinoma. Radiographics 2016; 36:538-53. [DOI: 10.1148/rg.2016150117] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Prognostic Implications of the SUVmax of Primary Tumors and Metastatic Lymph Node Measured by 18F-FDG PET in Patients With Uterine Cervical Cancer. Clin Nucl Med 2016; 41:34-40. [DOI: 10.1097/rlu.0000000000001049] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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FDG PET/CT for Management and Assessing Outcomes of Squamous Cell Cancer of the Oral Cavity. AJR Am J Roentgenol 2015; 205:W150-61. [DOI: 10.2214/ajr.14.13830] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Abstract
OBJECTIVE CT remains the imaging modality of choice in the diagnosis of colorectal cancer (CRC) and anal cancer. However, advances in imaging have expanded the role of MRI and PET/CT. This article focuses on the evolving role of FDG PET/CT in the diagnosis, radiation therapy planning, therapy assessment, and posttherapy monitoring of CRC and anal cancer. CONCLUSION FDG PET/CT is a valuable imaging modality that impacts the clinical management of patients with CRC and those with anal cancer.
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Hildebrandt MG, Kodahl AR, Teilmann-Jørgensen D, Mogensen O, Jensen PT. [18F]Fluorodeoxyglucose PET/Computed Tomography in Breast Cancer and Gynecologic Cancers. PET Clin 2015; 10:89-104. [DOI: 10.1016/j.cpet.2014.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Chakravarty R, Hong H, Cai W. Positron emission tomography image-guided drug delivery: current status and future perspectives. Mol Pharm 2014; 11:3777-97. [PMID: 24865108 PMCID: PMC4218872 DOI: 10.1021/mp500173s] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
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Positron
emission tomography (PET) is an important modality in
the field of molecular imaging, which is gradually impacting patient
care by providing safe, fast, and reliable techniques that help to
alter the course of patient care by revealing invasive, de facto procedures
to be unnecessary or rendering them obsolete. Also, PET provides a
key connection between the molecular mechanisms involved in the pathophysiology
of disease and the according targeted therapies. Recently, PET imaging
is also gaining ground in the field of drug delivery. Current drug
delivery research is focused on developing novel drug delivery systems
with emphasis on precise targeting, accurate dose delivery, and minimal
toxicity in order to achieve maximum therapeutic efficacy. At the
intersection between PET imaging and controlled drug delivery, interest
has grown in combining both these paradigms into clinically effective
formulations. PET image-guided drug delivery has great potential to
revolutionize patient care by in vivo assessment
of drug biodistribution and accumulation at the target site and real-time
monitoring of the therapeutic outcome. The expected end point of this
approach is to provide fundamental support for the optimization of
innovative diagnostic and therapeutic strategies that could contribute
to emerging concepts in the field of “personalized medicine”.
This review focuses on the recent developments in PET image-guided
drug delivery and discusses intriguing opportunities for future development.
The preclinical data reported to date are quite promising, and it
is evident that such strategies in cancer management hold promise
for clinically translatable advances that can positively impact the
overall diagnostic and therapeutic processes and result in enhanced
quality of life for cancer patients.
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Affiliation(s)
- Rubel Chakravarty
- Department of Radiology, University of Wisconsin-Madison , Madison, Wisconsin 53705-2275, United States
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Recent Trends in PET Image Interpretations Using Volumetric and Texture-based Quantification Methods in Nuclear Oncology. Nucl Med Mol Imaging 2014; 48:1-15. [PMID: 24900133 DOI: 10.1007/s13139-013-0260-2] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 12/10/2013] [Accepted: 12/12/2013] [Indexed: 12/22/2022] Open
Abstract
Image quantification studies in positron emission tomography/computed tomography (PET/CT) are of immense importance in the diagnosis and follow-up of variety of cancers. In this review we have described the current image quantification methodologies employed in (18)F-fluorodeoxyglucose ((18)F-FDG) PET in major oncological conditions with particular emphasis on tumor heterogeneity studies. We have described various quantitative parameters being used in PET image analysis. The main contemporary methodology is to measure tumor metabolic activity; however, analysis of other image-related parameters is also increasing. Primarily, we have identified the existing role of tumor heterogeneity studies in major cancers using (18)F-FDG PET. We have also described some newer radiopharmaceuticals other than (18)F-FDG being studied/used in the management of these cancers. Tumor heterogeneity studies are being performed in almost all major oncological conditions using (18)F-FDG PET. The role of these studies is very promising in the management of these conditions.
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