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Li T, Liu Y, Dai M, Zhao X, Han J, Zhang Z, Jing F, Tian W, Zhang J, Zhao X, Wang J, Hao T, Wang T. Value of Semi-Quantitative Parameters of 68Ga-FAPI-04 PET/CT in Primary Malignant and Benign Diseases: A Comparison with 18F-FDG. Cancer Biother Radiopharm 2024. [PMID: 38808470 DOI: 10.1089/cbr.2024.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024] Open
Abstract
Objectives: We aimed to compare the value of the semiquantitative parameters of 68Ga-labeled FAP inhibitor (68Ga-FAPI)-04 positron emission tomography/computed tomography (PET/CT) and 18F-fluorodeoxyglucose (18F-FDG) in diagnosing primary malignant and benign diseases. Materials and Methods: 18F-FDG and 68Ga-FAPI-04 PET/CT images of 80 patients were compared. Semiquantitative parameters, including maximum standardized uptake value (SUVmax), mean SUV (SUVmean), peak SUV (SUVpeak), peak SUV by lean body mass (SULpeak), metabolic tumor volume (or tumor volume of FAPI; FAPI-TV), and TLG (or total lesion activity of FAPI; FAPI-TLA), were automatically obtained using the IntelliSpace Portal image processing workstation with a threshold of 40% SUVmax. The liver blood pool was measured as the background, and the tumor-to-background ratio (TBRliver) was calculated. Results: In all malignant lesions, FAPI-TV and FAPI-TLA were higher in 68Ga-FAPI-04 PET/CT than in 18F-FDG. In the subgroup analysis, 68Ga-FAPI-04 had higher FAPI-TV and FAPI-TLA and lower SUVmax than 18F-FDG had in group A, including gynecological tumor, esophageal, and colorectal cancers. However, six semiquantitative parameters were higher in group B (the other malignant tumors). For the benign diseases, SUVmax, SUVmean, SUVpeak, and SULpeak were lower in 68Ga-FAPI-04 PET/CT than in 18F-FDG. 68Ga-FAPI-04 PET/CT showed a lower liver background and a higher TBRliver than 18F-FDG did. 68Ga-FAPI-04 PET/CT had higher accuracy, sensitivity, and specificity than 18F-FDG had. Conclusion: More accurate semiquantitative parameters and lower abdominal background in 68Ga-FAPI-04 PET/CT make it more competitive in the differential diagnosis of malignant and benign diseases than in 18F-FDG.
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Affiliation(s)
- Tianyue Li
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Shijiazhuang, China
| | - Yunuan Liu
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Meng Dai
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiujuan Zhao
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jingya Han
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhaoqi Zhang
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Fenglian Jing
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Weiwei Tian
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jingmian Zhang
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Shijiazhuang, China
| | - Xinming Zhao
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Shijiazhuang, China
| | - Jianfang Wang
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tiancheng Hao
- Department of Nuclear Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tingting Wang
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Qu H, Li J, Zeng R, Du M. The presence of a cribriform pattern is related to poor prognosis in lung adenocarcinoma after surgical resection: A meta-analysis. Gen Thorac Cardiovasc Surg 2024:10.1007/s11748-024-02044-8. [PMID: 38801566 DOI: 10.1007/s11748-024-02044-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/18/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE Previous studies reported that the cribriform pattern (CP) was associated with poor prognosis in lung adenocarcinoma (ADC) patients; therefore, a meta-analysis was performed to thoroughly evaluate the prognostic impact of cribriform pattern in postoperative ADC patients. METHODS Eligible studies were retrieved from PubMed, Embase databases, and Web of Science until April 2023. Studies evaluating the effect of the cribriform pattern on the prognosis of postoperative ADC patients were included. Subsequently, subgroup analysis was conducted according to the proportion of the cribriform pattern, with disease-free survival (DFS) and/or overall survival (OS) as outcomes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were used as effect estimates in the meta-analyses, which were performed with a random-effects model despite the heterogeneity. RESULTS Nine studies published between 2015 and 2022 were included, with 4,289 ADC patients in total. The pooled results revealed a significantly poorer DFS (HR1.56, 95%CI 1.18-2.06, P = 0.11, I2 = 45%) and OS (HR2.11, 95%CI 1.63-2.72, P = 0.01, I2 = 56%) in patients with the cribriform pattern. Furthermore, the subgroup analysis showed that patients with a cribriform pattern (DFS: HR1.32, 95% CI 1.04-1.68 OS:HR2.30, 95% CI 1.55-3.39) and patients with a predominantly cribriform pattern (DFS:HR2.04, 95% CI 1.32--3.15 OS: HR1.92, 95% CI 1.41-2.61) were associated with poor prognosis. CONCLUSIONS The presence of a cribriform pattern is related to poor prognosis in postoperative ADC patients, despite not being a main tumor component. However, the results should be confirmed by large-scale and prospective studies owing to the small sample and potential heterogeneity.
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Affiliation(s)
- Haoran Qu
- Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Jianfeng Li
- Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Rui Zeng
- Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Ming Du
- Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Dang S, Han D, Duan H, Jiang Y, Aihemaiti A, Yu N, Yu Y, Duan X. The value of T2-weighted MRI contrast ratio combined with DWI in evaluating the pathological grade of solid lung adenocarcinoma. Clin Radiol 2024; 79:279-286. [PMID: 38216369 DOI: 10.1016/j.crad.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/30/2023] [Accepted: 12/09/2023] [Indexed: 01/14/2024]
Abstract
AIM To assess the predictive value of T2-weighted (T2W) magnetic resonance imaging (MRI) in combination with diffusion-weighted imaging (DWI) for determining the pathological grading of solid lung adenocarcinoma. MATERIALS AND METHODS The clinical and imaging data from 153 cases of solid lung adenocarcinoma (82 men, 71 women, mean age 63.2 years) confirmed at histopathology in The First Affiliated Hospital of Xi'an Jiaotong University from January 2017 to May 2022 were analysed retrospectively. Adenocarcinomas were classified into low-grade (G1 and G2) and high-grade (G3) groups following the 2020 pathological grading system proposed by the International Association for the Study of Lung Cancer. The T2-weighted contrast ratio (T2CR), calculated as the T2 signal intensity of the lung mass/nodule divided by the T2 signal intensity of the right rhomboid muscle was utilised. Two experienced radiologists reviewed the MRI images independently, measured the T2CR, and obtained apparent diffusion coefficient (ADC) values. The Mann-Whitney U-test was used to compare general characteristics (sex, age, maximum diameter), T2CR, and ADC values between the low-grade and high-grade groups. The non-parametric Kruskal-Wallis test determined differences in T2CR and ADC values among the five adenocarcinoma subtypes. Receiver characteristic curve (ROC) analysis, along with area under the curve (AUC) calculation, assessed the effectiveness of each parameter in distinguishing the pathological grade of lung adenocarcinoma. A Z-test was used to compare the AUC values. RESULTS Among the 153 patients with adenocarcinoma, 103 had low-grade adenocarcinoma, and 50 had high-grade adenocarcinoma. The agreement between T2CR and ADC observers was good (0.948 and 0.929, respectively). None of the parameters followed a normal distribution (p<0.05). The ADC value was lower in the high-grade adenocarcinoma group compared to the low-grade adenocarcinoma group (p=0.004), while the T2CR value was higher in the high-grade group (p=0.011). Statistically significant differences were observed in maximum diameter and gender between the two groups (p<0.001 and p=0.005, respectively), while no significant differences were noted in age (p=0.980). Among the five adenocarcinoma subtypes, only the lepidic and micropapillary subtypes displayed statistical differences in ADC values (p=0.047), with the remaining subtypes showing no statistical differences (p>0.05). The AUC values for distinguishing high-grade adenocarcinoma from low-grade adenocarcinoma were 0.645 for ADC and 0.627 for T2CR. Combining T2CR, ADC, sex, and maximum diameter resulted in an AUC of 0.778, sensitivity of 70%, and specificity of 75%. This combination significantly improved diagnostic efficiency compared to T2CR and ADC alone (p=0.008, z = 2.624; p=0.007, z = 2.679). CONCLUSION The MRI quantitative parameters are useful for distinguishing the pathological grades of solid lung adenocarcinoma, offering valuable insights for precise lung cancer treatment.
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Affiliation(s)
- S Dang
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi 710061, China; Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - D Han
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi 710061, China; Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - H Duan
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi 710061, China; Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - Y Jiang
- Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - A Aihemaiti
- Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - N Yu
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China; Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - Y Yu
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi 710061, China; Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China; Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - X Duan
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi 710061, China.
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Yang H, Liu X, Wang L, Zhou W, Tian Y, Dong Y, Zhou K, Chen L, Wang M, Wu H. 18 F-FDG PET/CT characteristics of IASLC grade 3 invasive adenocarcinoma and the value of 18 F-FDG PET/CT for preoperative prediction: a new prognostication model. Nucl Med Commun 2024; 45:338-346. [PMID: 38312089 DOI: 10.1097/mnm.0000000000001819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
OBJECTIVE This study is performed to investigate the imaging characteristics of the International Association for the Study of Lung Cancer grade 3 invasive adenocarcinoma (IAC) on PET/CT and the value of PET/CT for preoperative predicting this tumor. MATERIALS AND METHODS We retrospectively enrolled patients with IAC from August 2015 to September 2022. The clinical characteristics, serum tumor markers, and PET/CT features were analyzed. T test, Mann-Whitney U test, χ 2 test, Logistic regression analysis, and receiver operating characteristic analysis were used to predict grade 3 tumor and evaluate the prediction effectiveness. RESULTS Grade 3 tumors had a significantly higher maximum standardized uptake value (SUV max ) and consolidation-tumor-ratio (CTR) ( P < 0.001), while Grade 1 - 2 tumors were prone to present with air bronchogram sign or vacuole sign ( P < 0.001). A stepwise logistic regression analysis revealed that smoking history, CEA, SUV max , air bronchogram sign or vacuole sign and CTR were useful predictors for Grade 3 tumors. The established prediction model based on the above 5 parameters generated a high AUC (0.869) and negative predictive value (0.919), respectively. CONCLUSION Our study demonstrates that grade 3 IAC has a unique PET/CT imaging feature. The prognostication model established with smoking history, CEA, SUV max , air bronchogram sign or vacuole sign and CTR can effectively predict grade 3 tumors before the operation.
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Affiliation(s)
- Hanyun Yang
- GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Hong TH, Hwang S, Cho J, Choi YL, Han J, Lee G, Jeon YJ, Lee J, Park SY, Cho JH, Choi YS, Kim J, Shim YM, Kim HK. Clinical Significance of the Proposed Pathologic Criteria for Invasion by the International Association for the Study of Lung Cancer in Resected Nonmucinous Lung Adenocarcinoma. J Thorac Oncol 2024; 19:425-433. [PMID: 37924973 DOI: 10.1016/j.jtho.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/18/2023] [Accepted: 10/11/2023] [Indexed: 11/06/2023]
Abstract
INTRODUCTION Accurate diagnostic criteria for tumor invasion are essential for precise pathologic tumor (pT) staging. Recently, the International Association for the Study of Lung Cancer (IASLC) Pathology Committee suggested a new set of criteria for assessing tumor invasion, but the clinical usefulness of the proposed criteria has not been evaluated. METHODS The study included 1295 patients with resected part-solid lung adenocarcinoma from January 2017 to December 2019 at the Samsung Medical Center, Seoul, Korea. The revised pT stage was determined by the extent of the newly measured invasive component using the IASLC criteria. The primary outcome was to compare the performance of the revised pT stage with the original pT stage in predicting recurrence-free survival and proof of invasion status (i.e., recurrence or lymph node metastasis). The secondary outcome was the correlation with radiologic surrogates of tumor invasiveness (consolidation-to-tumor ratio and maximum standardized uptake value) and pathologic risk factors. RESULTS The re-evaluation resulted in a 22% downstaging and 2.5% upstaging of pT, which improved the correlation with radiologic (consolidation-to-tumor ratio and maximum standardized uptake value) and pathologic risk factors. The revised pT staging allowed for more accurate discrimination of recurrence-free survival than the original pT staging (c-index = 0.794 versus 0.717). Moreover, the revised pT staging significantly improved the prediction of recurrence or lymph node metastasis (area under the curve = 0.818 versus 0.741, p < 0.001). CONCLUSIONS To our knowledge, this is the first study evaluating the clinical significance of the IASLC-proposed criteria for invasion. The proposed IASLC criteria offered better alignment with clinicopathologic risk factors and improved prognostication. Further studies are warranted to assess the impact of the IASLC criteria on treatment decisions and patient outcomes.
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Affiliation(s)
- Tae Hee Hong
- Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea; Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
| | - Soohyun Hwang
- Department of Pathology and Translational Genomics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Juhee Cho
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Korea; Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea; Center for Clinical Epidemiology, Future Medicine Institute, Samsung Medical Center, Seoul, Korea
| | - Yoon-La Choi
- Department of Pathology and Translational Genomics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Joungho Han
- Department of Pathology and Translational Genomics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Genehee Lee
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Korea; Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Yeong Jeong Jeon
- Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Junghee Lee
- Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Seong Yong Park
- Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Jong Ho Cho
- Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Yong Soo Choi
- Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Jhingook Kim
- Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Young Mog Shim
- Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea; Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Korea
| | - Hong Kwan Kim
- Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea; Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Korea; Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.
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Zhou L, Sun J, Long H, Zhou W, Xia R, Luo Y, Fang J, Wang Y, Chen X. Imaging phenotyping using 18F-FDG PET/CT radiomics to predict micropapillary and solid pattern in lung adenocarcinoma. Insights Imaging 2024; 15:5. [PMID: 38185779 PMCID: PMC10772036 DOI: 10.1186/s13244-023-01573-9] [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: 09/10/2023] [Accepted: 11/22/2023] [Indexed: 01/09/2024] Open
Abstract
OBJECTIVES To develop and validate a machine learning model using 18F-FDG PET/CT radiomics signature and clinical features to predict the presence of micropapillary and solid (MP/S) components in lung adenocarcinoma. METHODS Eight hundred and forty-six patients who underwent preoperative PET/CT with pathologically confirmed adenocarcinoma were enrolled. After segmentation, 1688 radiomics features were extracted from PET/CT and selected to construct predictive models. Then, we developed a nomogram based on PET/CT radiomics integrated with clinical features. Receiver operating curves, calibration curves, and decision curve analysis (DCA) were performed for diagnostics assessment and test of the developed models for distinguishing patients with MP/S components from the patients without. RESULTS PET/CT radiomics-clinical combined model could well distinguish patients with MP/S components from those without MP/S components (AUC = 0.87), which performed better than PET (AUC = 0.829, p < 0.05) or CT (AUC = 0.827, p < 0.05) radiomics models in the training cohort. In test cohorts, radiomics-clinical combined model outperformed the PET radiomics model in test cohort 1 (AUC = 0.859 vs 0.799, p < 0.05) and the CT radiomics model in test cohort 2 (AUC = 0.880 vs 0.829, p < 0.05). Calibration curve indicated good coherence between all model prediction and the actual observation in training and test cohorts. DCA revealed PET/CT radiomics-clinical model exerted the highest clinical benefit. CONCLUSION 18F-FDG PET/CT radiomics signatures could achieve promising prediction efficiency to identify the presence of MP/S components in adenocarcinoma patients to help the clinician decide on personalized treatment and surveillance strategies. The PET/CT radiomics-clinical combined model performed best. CRITICAL RELEVANCE STATEMENT: 18F-FDG PET/CT radiomics signatures could achieve promising prediction efficiency to identify the presence of micropapillary and solid components in adenocarcinoma patients to help the clinician decide on personalized treatment and surveillance strategies.
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Affiliation(s)
- Linyi Zhou
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Jinju Sun
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - He Long
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Weicheng Zhou
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Renxiang Xia
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Yi Luo
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Jingqin Fang
- Department of Ultrasound, Daping Hospital, Army Medical University, Chongqing, China.
| | - Yi Wang
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China.
| | - Xiao Chen
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China.
- Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China.
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Park SH. New Oncologic Imaging Section in the Korean Journal of Radiology. Korean J Radiol 2024; 25:6-7. [PMID: 38184763 PMCID: PMC10788602 DOI: 10.3348/kjr.2023.1165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 11/21/2023] [Indexed: 01/08/2024] Open
Affiliation(s)
- Seong Ho Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Song YH, Moon JW, Kim YN, Woo JY, Son HJ, Lee SH. Prone position PET/CT is useful in reducing gravity-dependent opacity-related [ 18F]fluorodeoxyglucose uptake. Eur Radiol 2023; 33:8270-8278. [PMID: 37322163 DOI: 10.1007/s00330-023-09831-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/26/2023] [Accepted: 03/30/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES This study aimed to investigate whether performing [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) in the prone position could reduce [18F]FDG uptake in dependent lungs. METHODS Patients who underwent [18F]FDG PET/CT in both supine and prone positions from October 2018 to September 2021 were reviewed retrospectively. [18F]FDG uptake of dependent and nondependent lungs was analysed visually and semi-quantitatively. A linear regression analysis was performed to examine the association between the mean standardised uptake value (SUVmean) and the Hounsfield unit (HU). RESULTS A total of 135 patients (median age, 66 years [interquartile range: 58-75 years]; 80 men) were included. Dependent lungs showed significantly higher SUVmean and HU than nondependent lungs on supine position PET/CT (sPET/CT, 0.59 ± 0.14 vs. 0.36 ± 0.09, p < 0.001; - 671 ± 66 vs. - 802 ± 43, p < 0.001, respectively) and prone position PET/CT (pPET/CT, 0.45 ± 0.12 vs. 0.42 ± 0.08, p < 0.001; - 731 ± 67 vs. - 790 ± 40, p < 0.001, respectively). Linear regression analysis revealed a strong association between the SUVmean and HU in sPET/CT (R = 0.86, p < 0.001) and moderate association in pPET/CT (R = 0.65, p < 0.001). One hundred and fifteen patients (85.2%) had visually discernible [18F]FDG uptake in the posterior lung on sPET/CT, which disappeared on pPET/CT in all but one patient (0.7%, p < 0.001). CONCLUSIONS [18F]FDG uptake of the lung had moderate-to-strong associations with HU. Gravity-dependent opacity-related [18F]FDG uptake can be effectively reduced on prone position PET/CT. CLINICAL RELEVANCE STATEMENT Prone position PET/CT effectively reduces gravity-dependent opacity-related [18F]fluorodeoxyglucose uptake in the lung, potentially improving diagnostic accuracy in evaluating nodules in dependent lungs and offering a more accurate assessment of lung inflammation parameters in interstitial lung disease evaluations. KEY POINTS • The study evaluated whether performing [18F]fluorodeoxyglucose ([18F]FDG) PET/CT could reduce [18F]FDG uptake in lungs. • In prone and supine position PET/CT, the [18F]FDG uptake and Hounsfield unit were moderately to strongly associated. • Prone position PET/CT can reduce gravity-dependent opacity-related [18F]FDG uptake by the posterior lung.
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Affiliation(s)
- Yun Hye Song
- Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul, 07441, Republic of Korea
| | - Jung Won Moon
- Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul, 07441, Republic of Korea
| | - Yoo Na Kim
- Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul, 07441, Republic of Korea
| | - Ji Young Woo
- Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul, 07441, Republic of Korea
| | - Hye Joo Son
- Department of Nuclear Medicine, Dankook University Medical Center, Cheonan, Chungnam, Republic of Korea
| | - Suk Hyun Lee
- Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul, 07441, Republic of Korea.
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Dong H, Wang X, Qiu Y, Lou C, Ye Y, Feng H, Ye X, Chen D. Establishment and visualization of a model based on high-resolution CT qualitative and quantitative features for prediction of micropapillary or solid components in invasive lung adenocarcinoma. J Cancer Res Clin Oncol 2023; 149:10519-10530. [PMID: 37289235 DOI: 10.1007/s00432-023-04854-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/13/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To predict the existence of micropapillary or solid components in invasive adenocarcinoma, a model was constructed using qualitative and quantitative features in high-resolution computed tomography (HRCT). METHODS Through pathological examinations, 176 lesions were divided into two groups depending on the presence or absence of micropapillary and/or solid components (MP/S): MP/S- group (n = 128) and MP/S + group (n = 48). Multivariate logistic regression analyses were used to identify independent predictors of the MP/S. Artificial intelligence (AI)-assisted diagnostic software was used to automatically identify the lesions and extract corresponding quantitative parameters on CT images. The qualitative, quantitative, and combined models were constructed according to the results of multivariate logistic regression analysis. The receiver operating characteristic (ROC) analysis was conducted to evaluate the discrimination capacity of the models with the area under the curve (AUC), sensitivity, and specificity calculated. The calibration and clinical utility of the three models were determined using the calibration curve and decision curve analysis (DCA), respectively. The combined model was visualized in a nomogram. RESULTS The multivariate logistic regression analysis using both qualitative and quantitative features indicated that tumor shape (P = 0.029 OR = 4.89; 95% CI 1.175-20.379), pleural indentation (P = 0.039 OR = 1.91; 95% CI 0.791-4.631), and consolidation tumor ratios (CTR) (P < 0.001; OR = 1.05; 95% CI 1.036-1.070) were independent predictors for MP/S + . The areas under the curve (AUC) of the qualitative, quantitative, and combined models in predicting MP/S + were 0.844 (95% CI 0.778-0.909), 0.863 (95% CI 0.803-0.923), and 0.880 (95% CI 0.824-0.937). The combined model of AUC was the most superior and statistically better than qualitative model. CONCLUSION The combined model could assist doctors to evaluate patient's prognoses and devise personalized diagnostic and treatment protocols for patients.
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Affiliation(s)
- Hao Dong
- Department of Radiology, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, No. 199 Xinnan Road, Xiaoshan, Hangzhou, Zhejiang, China
| | - Xinbin Wang
- Department of Radiology, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, No. 199 Xinnan Road, Xiaoshan, Hangzhou, Zhejiang, China
| | - Yonggang Qiu
- Department of Radiology, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, No. 199 Xinnan Road, Xiaoshan, Hangzhou, Zhejiang, China
| | - Cuncheng Lou
- Department of Radiology, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, No. 199 Xinnan Road, Xiaoshan, Hangzhou, Zhejiang, China
| | - Yinfeng Ye
- Department of Radiology, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, No. 199 Xinnan Road, Xiaoshan, Hangzhou, Zhejiang, China
| | - Han Feng
- Department of Radiology, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, No. 199 Xinnan Road, Xiaoshan, Hangzhou, Zhejiang, China
| | - Xiaodan Ye
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
- Shanghai Institute of Medical Imaging, Shanghai, China.
- Department of Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Dihong Chen
- Department of Radiology, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, No. 199 Xinnan Road, Xiaoshan, Hangzhou, Zhejiang, China.
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10
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Damirov F, Stoleriu MG, Manapov F, Büsing K, Michels JD, Preissler G, Hatz RA, Hohenberger P, Roessner ED. Histology of the Primary Tumor Correlates with False Positivity of Integrated 18F-FDG-PET/CT Lymph Node Staging in Resectable Lung Cancer Patients. Diagnostics (Basel) 2023; 13:diagnostics13111893. [PMID: 37296745 DOI: 10.3390/diagnostics13111893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/15/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
This study aimed to evaluate the diagnostic accuracy and false positivity rate of lymph node (LN) staging assessed by integrated 18F-fluorodeoxyglucose positron emission computed tomography (18F-FDG-PET/CT) in patients with operable lung cancer to the tumor histology. In total, 129 consecutive patients with non-small-cell lung cancer (NSCLC) undergoing anatomical lung resections were included. Preoperative LN staging was evaluated in the relationship to the histology of the resected specimens (group 1: lung adenocarcinoma/LUAD; group 2: squamous cell carcinoma/SQCA). Statistical analysis was performed by the Mann-Whitney U-test, the chi2 test, and binary logistic regression analysis. To establish an easy-to-use algorithm for the identification of LN false positivity, a decision tree including clinically meaningful parameters was generated. In total, 77 (59.7%) and 52 (40.3%) patients were included in the LUAD and SQCA groups, respectively. SQCA histology, non-G1 tumors, and tumor SUVmax > 12.65 were identified as independent predictors of LN false positivity in the preoperative staging. The corresponding ORs and their 95% CIs were 3.35 [1.10-10.22], p = 0.0339; 4.60 [1.06-19.94], p = 0.0412; and 2.76 [1.01-7.55], and p = 0.0483. The preoperative identification of false-positive LNs is an important aspect of the treatment regimen for patients with operable lung cancer; thus, these preliminary findings should be further evaluated in larger patient cohorts.
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Affiliation(s)
- Fuad Damirov
- Department of Thoracic Surgery, Ludwig Maximilian University of Munich, 81377 Munich, Germany
- Department of Surgery, Division of Surgical Oncology and Thoracic Surgery, University Hospital Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - Mircea Gabriel Stoleriu
- Department of Thoracic Surgery, Ludwig Maximilian University of Munich, 81377 Munich, Germany
- Institute for Lung Biology and Disease, Comprehensive Pneumology Center (CPC), Member of the German Lung Research Center (DZL), Helmholtz Zentrum München, 81377 Munich, Germany
| | - Farkhad Manapov
- Institute for Lung Biology and Disease, Comprehensive Pneumology Center (CPC), Member of the German Lung Research Center (DZL), Helmholtz Zentrum München, 81377 Munich, Germany
- Department of Radiation Oncology, Ludwig Maximilian University of Munich, 81377 Munich, Germany
| | - Karen Büsing
- Clinic for Radiology and Nuclear Medicine, University Hospital Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - Julia Dorothea Michels
- Department of Pulmonology and Critical Care, Thoraxklinik Heidelberg gGmbH, University of Heidelberg, 69126 Heidelberg, Germany
- Translational Lung Research Center (TLRC), Member of the German Lung Research Center (DZL), University of Heidelberg, 69126 Heidelberg, Germany
| | - Gerhard Preissler
- Institute for Lung Biology and Disease, Comprehensive Pneumology Center (CPC), Member of the German Lung Research Center (DZL), Helmholtz Zentrum München, 81377 Munich, Germany
- Department of Thoracic Surgery, Robert Bosch Hospital, Teaching Hospital of University Tübingen, 70376 Stuttgart, Germany
| | - Rudolf A Hatz
- Department of Thoracic Surgery, Ludwig Maximilian University of Munich, 81377 Munich, Germany
- Institute for Lung Biology and Disease, Comprehensive Pneumology Center (CPC), Member of the German Lung Research Center (DZL), Helmholtz Zentrum München, 81377 Munich, Germany
| | - Peter Hohenberger
- Department of Surgery, Division of Surgical Oncology and Thoracic Surgery, University Hospital Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - Eric D Roessner
- Department of Surgery, Division of Surgical Oncology and Thoracic Surgery, University Hospital Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Department of Thoracic Surgery, Center for Thoracic Diseases, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
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11
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Tang R, Bi L, Xiang B, Ye L, Chen Y, Li G, Zhao G, Huang Y. [Advances in the Study of Invasive Non-mucinous Adenocarcinoma
with Different Pathological Subtypes]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2023; 26:22-30. [PMID: 36792077 PMCID: PMC9987059 DOI: 10.3779/j.issn.1009-3419.2022.102.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Lung cancer is the leading cause of cancer death in the world today, and adenocarcinoma is the most common histopathological type of lung cancer. In May 2021, World Health Organization (WHO) released the 5th edition of the WHO classification of thoracic tumors, which classifies invasive non-mucinous adenocarcinoma (INMA) into lepidic adenocarcinoma, acinar adenocarcinoma, papillary adenocarcinoma, solid adenocarcinoma, and micropapillary adenocarcinoma based on its histological characteristics. These five pathological subtypes differ in clinical features, treatment and prognosis. A complete understanding of the characteristics of these subtypes is essential for the clinical diagnosis, treatment options, and prognosis predictions of patients with lung adenocarcinoma, including recurrence and progression. This article will review the grading system, morphology, imaging prediction, lymph node metastasis, surgery, chemotherapy, targeted therapy and immunotherapy of different pathological subtypes of INMA.
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Affiliation(s)
- Ruke Tang
- Department of Thoracic Surgery I, Third Affiliated Hospital of Kunming Medical University, Kunming 650118, China
| | - Lina Bi
- Department of Nephrology, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Bingquan Xiang
- Department of Intensive Care Unit, Third Affiliated Hospital of Kunming Medical University, Kunming 650118, China
| | - Lianhua Ye
- Department of Thoracic Surgery I, Third Affiliated Hospital of Kunming Medical University, Kunming 650118, China
| | - Ying Chen
- Department of Thoracic Surgery I, Third Affiliated Hospital of Kunming Medical University, Kunming 650118, China
| | - Guangjian Li
- Department of Thoracic Surgery I, Third Affiliated Hospital of Kunming Medical University, Kunming 650118, China
| | - Guangqiang Zhao
- Department of Thoracic Surgery I, Third Affiliated Hospital of Kunming Medical University, Kunming 650118, China
| | - Yunchao Huang
- Department of Thoracic Surgery I, Third Affiliated Hospital of Kunming Medical University, Kunming 650118, China
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12
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Filippi L, Bianconi F, Schillaci O, Spanu A, Palumbo B. The Role and Potential of 18F-FDG PET/CT in Malignant Melanoma: Prognostication, Monitoring Response to Targeted and Immunotherapy, and Radiomics. Diagnostics (Basel) 2022; 12:diagnostics12040929. [PMID: 35453977 PMCID: PMC9028862 DOI: 10.3390/diagnostics12040929] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 12/17/2022] Open
Abstract
Novel therapeutic approaches, consisting of immune check-point inhibitors (ICIs) and molecularly targeted therapy, have thoroughly changed the clinical management of malignant melanoma (MM), the most frequent and deadly skin cancer. Since only 30–40% of MM patients respond to ICIs, imaging biomarkers suitable for the pre-therapeutic stratification and response assessment are warmly welcome. In this scenario, positron emission computed tomography (PET/CT) with 18F-fluorodeoxyglucose (18F-FDG) has been successfully utilized for advanced MM staging and therapy response evaluation. Furthermore, several PET-derived parameters (SUVmax, MTV, TLG) were particularly impactful for the prognostic evaluation of patients submitted to targeted and immunotherapy. In this review, we performed a web-based and desktop research on the clinical applications of 18F-FDG PET/CT in MM, with a particular emphasis on the various metabolic criteria developed for interpreting PET/CT scan in patients undergoing immunotherapy or targeted therapy or a combination of both. Furthermore, the emerging role of radiomics, a quantitative approach to medical imaging applying analysis methodology derived by the field of artificial intelligence, was examined in the peculiar context, putting a particular emphasis on the potential of this discipline to support clinicians in the delicate process of building patient-tailored pathways of care.
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Affiliation(s)
- Luca Filippi
- Nuclear Medicine Unit, “Santa Maria Goretti” Hospital, Via Antonio Canova, 04100 Latina, Italy
- Correspondence: ; Tel.: +39-077-3655-3591
| | - Francesco Bianconi
- Department of Engineering, Università Degli Studi di Perugia, Via Goffredo Duranti 93, 06135 Perugia, Italy;
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133 Rome, Italy;
- IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Angela Spanu
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy;
| | - Barbara Palumbo
- Section of Nuclear Medicine and Health Physics, Department of Medicine and Surgery, Università Degli Studi di Perugia, Piazza Lucio Severi 1, 06132 Perugia, Italy;
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