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Sarikaya I. Biology of Cancer and PET Imaging: Pictorial Review. J Nucl Med Technol 2022; 50:jnmt.121.263534. [PMID: 35440477 DOI: 10.2967/jnmt.121.263534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/10/2022] [Indexed: 11/16/2022] Open
Abstract
Development and spread of cancer is a multi-step and complex process which involves number of alterations, interactions and molecular networks. PET imaging is closely related with biology of cancer as it detects the cancer based on biological and pathological changes in tumor cells and tumor microenvironment. In this review article, biology of development and spread of cancer and role of PET imaging in Oncology was summarized and supported with various PET images demonstrating cancer spread patterns.
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Yang C, Dong J, Liu Z, Guo Q, Nie Y, Huang D, Qin N, Shu J. Prediction of Metastasis in the Axillary Lymph Nodes of Patients With Breast Cancer: A Radiomics Method Based on Contrast-Enhanced Computed Tomography. Front Oncol 2021; 11:726240. [PMID: 34616678 PMCID: PMC8488257 DOI: 10.3389/fonc.2021.726240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/27/2021] [Indexed: 12/29/2022] Open
Abstract
Background The use of traditional techniques to evaluate breast cancer is restricted by the subjective nature of assessment, variation across radiologists, and limited data. Radiomics may predict axillary lymph node metastasis (ALNM) of breast cancer more accurately. Purpose The aim was to evaluate the diagnostic performance of a radiomics model based on ALNs themselves that used contrast-enhanced computed tomography (CECT) to detect ALNM of breast cancer. Methods We retrospectively enrolled 402 patients with breast cancer confirmed by pathology from January 2016 to October 2019. Three hundred and ninety-six features were extracted for all patients from axial CECT images of 825 ALNs using Artificial Intelligent Kit software (GE Medical Systems, Version V3.1.0.R). Next, the radiomics model was trained, validated, and tested for predicting ALNM in breast cancer by using a support vector machine algorithm. Finally, the performance of the radiomics model was evaluated in terms of its classification accuracy and the value of the area under the curve (AUC). Results The radiomics model yielded the best classification accuracy of 89.1% and the highest AUC of 0.92 (95% CI: 0.91-0.93, p=0.002) for discriminating ALNM in breast cancer in the validation cohorts. In the testing cohorts, the model also demonstrated better performance, with an accuracy of 88.5% and an AUC of 0.94 (95% CI: 0.93-0.95, p=0.005) for predicting ALNM in breast cancer. Conclusion The radiomics model based on CECT images can be used to predict ALNM in breast cancer and has significant potential in clinical noninvasive diagnosis and in the prediction of breast cancer metastasis.
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Affiliation(s)
- Chunmei Yang
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jing Dong
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Ziyi Liu
- The Institute of Systems Science and Technology, Southwest Jiaotong University, Chengdu, China
| | - Qingxi Guo
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yue Nie
- Department of Radiology, Luzhou People's Hospital, Luzhou, China
| | - Deqing Huang
- The Institute of Systems Science and Technology, Southwest Jiaotong University, Chengdu, China
| | - Na Qin
- The Institute of Systems Science and Technology, Southwest Jiaotong University, Chengdu, China
| | - Jian Shu
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Zang J, Liu Q, Sui H, Guo H, Peng L, Li F, Lang L, Jacobson O, Zhu Z, Mao F, Chen X. Combined 68Ga-NOTA-Evans Blue Lymphoscintigraphy and 68Ga-NOTA-RM26 PET/CT Evaluation of Sentinel Lymph Node Metastasis in Breast Cancer Patients. Bioconjug Chem 2020; 31:396-403. [PMID: 31880916 DOI: 10.1021/acs.bioconjchem.9b00789] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In this study, we applied a new strategy to identify sentinel lymph node (SLN) metastasis by combining 68Ga-NOTA-Evans Blue (68Ga-NEB) for SLN mapping and 68Ga-NOTA-RM26 for LN metastasis detection in breast cancer patients. A total of 24 female patients with breast cancer diagnosed by core biopsy or suspected by mammography or ultrasonography were recruited and provided informed consent. All patients underwent 68Ga-NEB and 68Ga-NOTA-RM26 PET/CT imaging. Visual analysis of 68Ga-NEB PET/CT images was used to determine SLNs, and then compared with the 68Ga-NOTA-RM26 results and histopathological findings. SLNs were visualized in 24 of 24 patients (100.0%) within 4.0-10.0 (5.6 ± 1.4) min. All patients were pathologically diagnosed with breast cancer, and 12 patients had ipsilateral lymph node metastasis. By combining 68Ga-NEB and 68Ga-NOTA-RM26 images, 7/12 (58.3%) patients showed mild to intense uptake of 68Ga-NOTA-RM26 in SLNs, 1/12 patient (8.3%) had moderate uptake of 68Ga-NOTA-RM26 in the non-SLNs rather than SLN, indicating possible bypass lymphatic drainage, partially accounting for the false negatives in SLN biopsy during surgery. No false positives were found. The SUVmax of 68Ga-NOTA-RM26 activity in metastatic SLNs was significantly higher than that in non-metastatic SLNs (2.2 ± 2.3 vs 0.7 ± 0.1, P = 0.047). This study manifests the value of combination of 68Ga-NEB and 68Ga-NOTA-RM26 dual tracer PET/CT in preoperative evaluation of SLN metastasis in breast cancer patients, especially in those patients with lymphatic obstruction and bypass drainage. In general, positive 68Ga-NOTA-RM26 uptake in either SLN or other lymph nodes can apply lymph node dissection rather than intraoperative SLN biopsy.
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Affiliation(s)
- Jie Zang
- Department of Nuclear Medicine, Peking Union Medical College Hospital , Chinese Academy of Medical Science and Peking Union Medical College , Beijing 100730 , China.,Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine , Beijing 100730 , China
| | - Qingxing Liu
- Department of Nuclear Medicine, Peking Union Medical College Hospital , Chinese Academy of Medical Science and Peking Union Medical College , Beijing 100730 , China.,Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine , Beijing 100730 , China
| | - Huimin Sui
- Department of Nuclear Medicine, Peking Union Medical College Hospital , Chinese Academy of Medical Science and Peking Union Medical College , Beijing 100730 , China.,Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine , Beijing 100730 , China
| | - Hua Guo
- Department of Nuclear Medicine, Peking Union Medical College Hospital , Chinese Academy of Medical Science and Peking Union Medical College , Beijing 100730 , China.,Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine , Beijing 100730 , China
| | - Li Peng
- Department of Breast Surgery, Peking Union Medical College Hospital , Chinese Academy of Medical Science and Peking Union Medical College , Beijing 100730 , China
| | - Fang Li
- Department of Nuclear Medicine, Peking Union Medical College Hospital , Chinese Academy of Medical Science and Peking Union Medical College , Beijing 100730 , China.,Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine , Beijing 100730 , China
| | - Lixin Lang
- Laboratory of Molecular Imaging and Nanomedicine (LOMIN), National Institute of Biomedical Imaging and Bioengineering (NIBIB) , National Institutes of Health (NIH) , Bethesda , Maryland 20892 , United States
| | - Orit Jacobson
- Laboratory of Molecular Imaging and Nanomedicine (LOMIN), National Institute of Biomedical Imaging and Bioengineering (NIBIB) , National Institutes of Health (NIH) , Bethesda , Maryland 20892 , United States
| | - Zhaohui Zhu
- Department of Nuclear Medicine, Peking Union Medical College Hospital , Chinese Academy of Medical Science and Peking Union Medical College , Beijing 100730 , China.,Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine , Beijing 100730 , China
| | - Feng Mao
- Department of Breast Surgery, Peking Union Medical College Hospital , Chinese Academy of Medical Science and Peking Union Medical College , Beijing 100730 , China
| | - Xiaoyuan Chen
- Laboratory of Molecular Imaging and Nanomedicine (LOMIN), National Institute of Biomedical Imaging and Bioengineering (NIBIB) , National Institutes of Health (NIH) , Bethesda , Maryland 20892 , United States
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Sarikaya I, Sarikaya A, Albatineh AN, Tastekin E, Sezer YA. Is there a difference in FDG PET findings of invasive ductal carcinoma of the breast with and without coexisting DCIS? ASIA OCEANIA JOURNAL OF NUCLEAR MEDICINE & BIOLOGY 2020; 8:27-35. [PMID: 32064280 PMCID: PMC6994776 DOI: 10.22038/aojnmb.2019.41658.1284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 09/05/2019] [Accepted: 09/14/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Studies have reported that invasive ductal carcinoma (IDC) with coexisting ductal carcinoma in situ (DCIS) show lower metastatic potential and recurrence and better overall survival than pure IDC. In this study, we assessed F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) images of patients with newly diagnosed IDC to determine if there is any difference in PET findings in IDC-DCIS and pure IDC cases. METHODS FDG PET/CT images of patients with newly diagnosed IDC of the breast who subsequently underwent breast surgery and had histopathology result in our records were further evaluated. Tumor grade, pathological staging, and presence of DCIS were noted from the histopathology results. Standardized uptake value (SUV) of the primary tumor (SUVmax and SULmax), other hypermetabolic foci in the breast, and ipsilateral normal breast were measured. Presence of axillary and distant metastases was noted. RESULTS Fifty seven (57) patients with IDC were included. Coexisting DCIS was present in 44 (IDC-DCIS) and not present in 13 (pure IDC) cases. Per histopathology, the primary tumor was unifocal in 33 IDC-DCIS (75%) and 12 pure IDC (92.3%) cases, and multifocal in 11 IDC-DCIS cases (25%), and 1 pure IDC case (7.7%). FDG uptake was multifocal in 20 IDC-DCIS cases (45.5%) and 1 pure IDC case (7.7%), and unifocal in 24 IDC-DCIS (54.5%), and 12 pure IDC (92.3%) cases. There was no significant difference in patient age, size of the primary tumor, SUVmax and SULmax of the primary tumor and SUVmax of the normal breast in IDC-DCIS and pure IDC cases (p>0.05). Pathology showed axillary metastasis in all 13 pure IDC (100%), and 27 IDC-DCIS (61.4%) cases. PET showed axillary uptake in 25 IDC-DCIS (56.8%), and 8 pure IDC (61.5%) cases, and abnormal/questionable distant uptake in 12 IDC-DCIS cases and 1 pure IDC case. CONCLUSION In our preliminary findings, multifocal breast FDG uptake and multifocal tumor appear to be more common in IDC-DCIS than pure IDC. There is no significant difference in SUV and size of the primary tumor in IDC-DCIS and pure IDC cases. Axillary metastases appear to be more common in pure IDC than IDC-DCIS cases.
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Affiliation(s)
- Ismet Sarikaya
- Faculty of Medicine, Department of Nuclear Medicine, Kuwait University and Mubarak Al-Kabeer Hospital, Kuwait
| | - Ali Sarikaya
- Faculty of Medicine, Department of Nuclear Medicine, Trakya University, Edirne, Turkey
| | - Ahmed N. Albatineh
- Faculty of Medicine, Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait
| | - Ebru Tastekin
- Faculty of Medicine, Department of Pathology, Trakya University, Edirne, Turkey
| | - Yavuz Atakan Sezer
- Faculty of Medicine, Department of Surgery, Trakya University, Edirne, Turkey
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