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Ulaner GA, Vaz SC, Groheux D. Quarter-Century Transformation of Oncology: Positron Emission Tomography for Patients with Breast Cancer. PET Clin 2024; 19:147-162. [PMID: 38177052 DOI: 10.1016/j.cpet.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
PET radiotracers have become indispensable in the care of patients with breast cancer. 18F-fluorodeoxyglucose has become the preferred method of many oncologists for systemic staging of breast cancer at initial diagnosis, detecting recurrent disease, and for measuring treatment response after therapy. 18F-Sodium Fluoride is valuable for detection of osseous metastases. 18F-fluoroestradiol is now FDA-approved with multiple appropriate clinical uses. There are multiple PET radiotracers in clinical trials, which may add utility of PET imaging for patients with breast cancer in the future. This article will describe the advances during the last quarter century in PET for patients with breast cancer.
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Affiliation(s)
- Gary A Ulaner
- Molecular Imaging and Therapy, Hoag Family Cancer Institute, Irvine, CA, USA; Departments of Radiology and Translational Genomics, University of Southern California, Los Angeles, CA, USA.
| | - Sofia Carrilho Vaz
- Nuclear Medicine-Radiopharmacology, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - David Groheux
- Nuclear Department of Nuclear Medicine, Saint-Louis Hospital, Paris, France; Centre d'Imagerie Radio-Isotopique (CIRI), La Rochelle, France; University Paris-Diderot, INSERM U976, HIPI, Paris, France
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Ulaner GA, Vaz SC. Women's Health Update: Growing Role of PET for Patients with Breast Cancer. Semin Nucl Med 2024; 54:247-255. [PMID: 38365547 DOI: 10.1053/j.semnuclmed.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 01/28/2024] [Indexed: 02/18/2024]
Abstract
Positron Emission Tomography (PET) has been growing in usage for patients with breast cancer, due to an increased number of FDA-approved PET radiotracers pertinent to patients with breast cancer as well as increased prospective evidence for the value of these agents. The leading PET radiotracer for patients with breast cancer is 18F-fluorodeoxyglucose (18F-FDG), which measures glucose metabolism. There is prospective evidence for the use of 18F-FDG PET in systemic staging of newly diagnosed locally advanced breast cancer (stages IIB-IIIC), monitoring breast cancer treatment response, and detecting breast cancer recurrence, particularly in no special type (NST) breast cancer. 16α-18F-fluoro-17β-Fluoroestradiol (18F-FES) is a radiolabeled estrogen which evaluates estrogen receptor (ER) accessible for estrogen binding. There is prospective evidence supporting 18F-FES PET as a predictive biomarker for selecting patients with metastatic breast cancer for endocrine therapies. 18F-FES PET has also been shown to be valuable in the evaluation of ER status of lesions which are difficult to biopsy, for evaluation of ER status in lesions that are equivocal on other imaging modalities, and for selecting optimal dosage of novel ER-targeted systemic therapies in early clinical trials. Multiple investigators have suggested 18F-FES PET will have an increasing role for patients with invasive lobular breast cancer (ILC), which is less optimally evaluated by 18F-FDG PET. Sodium 18F-Fluoride (18F-NaF) evaluates bone turnover and has been effective in evaluation of malignancies which commonly metastasize to bone. In patients with metastatic breast cancer, 18F-NaF PET/CT has demonstrated superior sensitivity for osseous metastases than 99mTc-MDP or CT. In addition to these three FDA-approved PET radiotracers, there are multiple novel radiotracers currently in clinical trials with potential to further increase PET usage for patients with breast cancer.
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Affiliation(s)
- Gary A Ulaner
- Molecular Imaging and Therapy, Hoag Family Cancer Institute, Newport Beach, CA; Radiology, University of Southern California, Los Angeles, CA.
| | - Sofia Carrilho Vaz
- Nuclear Medicine-Radiopharmacology, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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Chopra S, Mathur Y, Roesch F, Moon ES, Rana N, Irrinki S, Walia R, Duseja A, Singh H, Kumar R, Shukla J, Mittal BR. 68Ga-DOTA.SA.FAPi as a Versatile Diagnostic Probe for Various Epithelial Malignancies: A Head-to-Head Comparison with 18F-FDG. Acad Radiol 2024:S1076-6332(23)00677-3. [PMID: 38233261 DOI: 10.1016/j.acra.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 01/19/2024]
Abstract
RATIONALE AND OBJECTIVES Fibroblast Activation Protein (FAP) expressing cancer-associated fibroblasts has been a major breakthrough causing a paradigm shift in targeted theranostics focusing on the tumor microenvironment. In this study, a squaric acid derivative DOTA.SA.FAPi (SA.FAPi) has been evaluated as a potential diagnostic probe in diverse epithelial cancers and compared to the standard-of-care 18F-FDG. METHODS 25 patients enrolled in this prospective study underwent 18F-FDG and 68Ga-SA.FAPi PET scans on two different days. For biodistribution, standardized uptake values (SUV) were computed by delineating region-of-interest on various body organs. For comparative analysis in disease identification, lesion tracer uptake was quantified using SUVs corrected for lean body mass (SUL), SUVmax, tumor-to-background ratio (TBR) with liver and blood pool as the reference, total lesion glycolysis (TLG for 18F-FDG) and total lesion FAP expression (TLF for 68Ga-SA.FAPi). RESULTS 25 patients (mean age: 58 ± 8 years) with four types of cancers including hepatocellular carcinoma (HCC, 56% of cohort), gall bladder carcinoma (GB Ca, 12%), adrenocortical carcinoma (ACC, 16%), and breast carcinoma (breast Ca, 16%) were prospectively evaluated. Physiological tracer uptake of 68Ga-SA.FAPi was noted in the salivary glands, thyroid, liver, pancreas, muscles and kidneys with variable uptake in the lacrimal glands, extra-ocular muscles, oral mucosa and uterus. Lesion-based comparative analysis between both the radiotracers demonstrated complete concordant findings in detection of all primary lesions and distant metastases in liver, bones, adrenals and peritoneum whereas discordant findings were noted in lung nodules (20%) and lymph nodes (13%). In overall analysis, 68Ga-SA.FAPi exhibited significantly higher SUVmax (10.3 vs 8.8, p-0.019), SULpeak (6.8 vs 4.9, p-0.000) and SULavg (5.4 vs 4.1, p-0.019) in comparison to 18F-FDG whereas TBR was comparable for both the tracers [TBRLiver: median 1.9 (IQR: 2.6-1.4) vs 1.8 (2.6-1.1), p-0.275; TBRBloodpool: 2.1 (3.7-1.4) vs 2.0 (2.7-1.4), p-0.207]. In subcategorical analysis, 68Ga-SA.FAPi demonstrated higher SUVmax, SULpeak and SULavg values for primary disease (SUVmax: 14.8 (18.7-9.7) vs (12.9-6.6), p-0.087; SULpeak: 8.2 (11.2-6.8) vs 6.3 (8.5-4.4), p-0.037; SULavg: 6.9 ± 2.5 vs 5.1 ± 2.2, p-0.023] and distant metastases (8.8 vs 7.2, p-0.038); 6.3 (8.8-4.4) vs 3.6 (4.4-2.0), p-0.000; 5.4 vs 3.5, p-0.000] whereas comparable values were noted for both the tracers in nodal metastases [9 (13.5-4.1) vs 8 (12.7-4.7), p-0.726; 4.5 (6.2-1.8) vs 4.3 (5.7-2.2), p-0.727; 4.1 ± 2.3 vs 3.7 ± 1.8, p-0.129]. In primary disease, highest 68Ga-SA.FAPi avidity was noted in ACC followed by GB Ca and HCC. In distant metastases, gall bladder, lung and skeletal lesions demonstrated higher 68Ga-SA.FAPi avidity. Moreover, 68Ga-SA.FAPi identified five additional lung lesions which were missed by 18F-FDG in one case of ACC. CONCLUSION 68Ga-SA.FAPi emerged as an effective, versatile diagnostic probe for imaging various epithelial malignancies similar to 18F-FDG.
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Affiliation(s)
- Sejal Chopra
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India (S.C., Y.M., N.R., H.S., R.K., J.S., B.R.M.)
| | - Yamini Mathur
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India (S.C., Y.M., N.R., H.S., R.K., J.S., B.R.M.)
| | - Frank Roesch
- Department of Chemistry, Johannes Gutenberg University, Mainz, Germany (F.R., E.S.M.)
| | - Euy Sung Moon
- Department of Chemistry, Johannes Gutenberg University, Mainz, Germany (F.R., E.S.M.)
| | - Nivedita Rana
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India (S.C., Y.M., N.R., H.S., R.K., J.S., B.R.M.)
| | - Santhosh Irrinki
- Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India (S.I.)
| | - Rama Walia
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India (R.W.)
| | - Ajay Duseja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India (A.D.)
| | - Harmandeep Singh
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India (S.C., Y.M., N.R., H.S., R.K., J.S., B.R.M.)
| | - Rajender Kumar
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India (S.C., Y.M., N.R., H.S., R.K., J.S., B.R.M.)
| | - Jaya Shukla
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India (S.C., Y.M., N.R., H.S., R.K., J.S., B.R.M.).
| | - Bhagwant Rai Mittal
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India (S.C., Y.M., N.R., H.S., R.K., J.S., B.R.M.)
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Asahara Y, Kameyama M, Ishii K, Ishibashi K. Diagnostic performance of the cingulate island sign ratio for differentiating dementia with Lewy bodies from Alzheimer's disease changes depending on the mini-mental state examination score. J Neurol Sci 2023; 455:122782. [PMID: 37976791 DOI: 10.1016/j.jns.2023.122782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND The cingulate island sign (CIS) ratio is a diagnostic adjunct for differentiating dementia with Lewy bodies (DLB) from Alzheimer's disease (AD). A recent study showed that the CIS ratio in DLB changed depending on the Mini-Mental State Examination (MMSE) score. We aimed to evaluate whether the diagnostic performance (sensitivity and specificity) of the CIS ratio for differentiating DLB from AD changes depending on the MMSE score. METHODS Twenty-two patients with DLB and 26 amyloid-positive patients with AD, who underwent 18F-FDG PET and completed an MMSE examination, were classified into three groups according to MMSE scores: Group A (MMSE >24), Group B (20 ≤ MMSE ≤24), and Group C (MMSE <20). In each group, we compared the CIS ratio between patients with DLB and AD and conducted receiver operating characteristic (ROC) curve analysis to calculate the sensitivity and specificity. RESULTS Within Group B, the CIS ratio in DLB was significantly higher than that in AD (p = 0.0005), but not within Groups A (p = 0.5117) and C (p = 0.8671). ROC curve analyses showed that the sensitivities and specificities of the CIS ratio for differentiating DLB from AD were 66.7% and 77.8% in Group A, 91.7% and 100.0% in Group B, and 75.0% and 66.7% in Group C, respectively. CONCLUSIONS The present study suggests that the diagnostic performance of the CIS ratio for differentiating DLB from AD changes depending on the MMSE score, with higher sensitivity and specificity at MMSE scores of 20-24.
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Affiliation(s)
- Yuki Asahara
- Research Team for Neuroimaging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan; Department of Neurology, The Jikei University School of Medicine, 3-25-8, Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masashi Kameyama
- Research Team for Neuroimaging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Kenji Ishii
- Research Team for Neuroimaging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Kenji Ishibashi
- Research Team for Neuroimaging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
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Wakfie-Corieh CG, Ferrando-Castagnetto F, García-Esquinas M, Cabrera-Martín MN, Rodríguez Rey C, Ortega Candil A, Couto Caro RM, Carreras Delgado JL. Metabolic characterization of structural lung changes in patients with findings suggestive of incidental COVID-19 pneumonia on 18F-FDG PET/CT. Pathophysiological insights from multimodal images obtained during the pandemic. Rev Esp Med Nucl Imagen Mol 2023; 42:380-387. [PMID: 37454730 DOI: 10.1016/j.remnie.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/03/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE To evaluate the metabolic uptake of different tomographic signs observed in patients with incidental structural findings suggestive of COVID-19 pneumonia through 18F-FDG PET/CT. MATERIALS AND METHODS We retrospectively analyzed 596 PET/CT studies performed from February 21, 2020 to April 17, 2020. After excluding 37 scans (non-18F-FDG PET tracers and brain studies), we analyzed the metabolic activity of several structural changes integrated in the CO-RADS score using the SUVmax of multimodal studies with 18F-FDG. RESULTS Forty-three patients with 18F-FDG PET/CT findings suggestive of COVID-19 pneumonia were included (mean age: 68±12.3 years, 22 male). SUVmax values were higher in patients with CO-RADS categories 5-6 than in those with lower CO-RADS categories (6.1±3.0 vs. 3.6±2.1, p=0.004). In patients with CO-RADS 5-6, ground-glass opacities, bilaterality and consolidations exhibited higher SUVmax values (p-values of 0.01, 0.02 and 0.01, respectively). Patchy distribution and crazy paving pattern were also associated with higher SUVmax (p-values of 0.002 and 0.01). After multivariate analysis, SUVmax was significantly associated with a positive structural diagnosis of COVID-19 pneumonia (odds ratio=0.63, 95% confidence interval=0.41-0.90; p=0.02). The ROC curve of the regression model intended to confirm or rule out the structural diagnosis of COVID-19 pneumonia showed an AUC of 0.77 (standard error=0.072, p=0.003). CONCLUSIONS In those patients referred for standard oncologic and non-oncologic indications (43/559; 7.7%) during pandemic, imaging with 18F-FDG PET/CT is a useful tool during incidental detection of COVID-19 pneumonia. Several CT findings characteristic of COVID-19 pneumonia, specifically those included in diagnostic CO-RADS scores (5-6), were associated with higher SUVmax values.
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Affiliation(s)
- C G Wakfie-Corieh
- Department of Nuclear Medicine, Hospital Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - F Ferrando-Castagnetto
- Department of Cardiology, Cardiovascular University Center, Hospital de Clínicas Dr. Manuel Quintela, Montevideo, Uruguay
| | - M García-Esquinas
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Department of Radiology, Hospital Clínico San Carlos, Madrid, Spain
| | - M N Cabrera-Martín
- Department of Nuclear Medicine, Hospital Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - C Rodríguez Rey
- Department of Nuclear Medicine, Hospital Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - A Ortega Candil
- Department of Nuclear Medicine, Hospital Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - R M Couto Caro
- Department of Nuclear Medicine, Hospital Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - J L Carreras Delgado
- Department of Nuclear Medicine, Hospital Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Yu J, Cao X, Zhou R, Chen Q, Wang Y. Abnormal brain glucose metabolism patterns in patients with advanced non-small-cell lung cancer after chemotherapy:A retrospective PET study. Brain Res Bull 2023; 202:110751. [PMID: 37625525 DOI: 10.1016/j.brainresbull.2023.110751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/24/2023] [Accepted: 08/23/2023] [Indexed: 08/27/2023]
Abstract
PURPOSE This study was designed to investigate the acute or chronic post-chemotherapy effect and different chemotherapy cycles effect on brain glucose metabolism. METHODS A total of seventy-three patients who received chemotherapy after being diagnosed with advanced non-small-cell lung cancer (NSCLC) and underwent 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan at Nuclear Medicine Department of the Fifth Hospital of Sun Yat-sen University between September 2017 and August 2022 were included. Seventy-two healthy control patients who underwent whole-body 18F-FDG PET/CT scans at our department, without any evidence of malignancy and confirmed by follow-up visits, were included. Advanced NSCLC patients were classified into six arms: short-to-long course (chemotherapy cycles under 4, between 5 and 8 and more than 8) in acute chemotherapy effect (AC) group (scanned 18F-FDG PET/CT within 6 months post-chemotherapy) or chronic chemotherapy effect (CC) group (the interval between scanning and the last chemotherapy session more than six months). Statistical Parametric Mapping (SPM) analysis between patients' groups and healthy controls' brain 18F-FDG PET was performed (uncorrected p ˂ 0.001 with cluster size above 20 contiguous voxels). RESULTS There were no significant differences between patients' groups and healthy controls in age, gender and body mass index (BMI). SPM PET analyses revealed anomalous brain metabolic activity in different groups (p ˂ 0.001). Short-course + AC group exhibited hypermetabolism in the cerebellum and widespread hypometabolism in bilateral frontal lobe predominantly. Only hypometabolic brain regions were observed in middle-course + AC patients. Long-course + AC group displayed a greater number of abnormalities. Notably, these metabolic abnormalities tended to decrease in CC groups versus AC groups across all courses. CONCLUSION Our study revealed that patients with advanced NSCLC who underwent chemotherapy exhibited persistent abnormal brain metabolism patterns during continuous chemotherapy and these abnormalities tended to recover after completion of chemotherapy over time, but without correlation to an increasing number of chemotherapy cycles. 18F-FDG PET/CT may serve as a possible modality for evaluating brain function and guiding appropriate treatment timing.
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Affiliation(s)
- Jie Yu
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Xiaoling Cao
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Renwei Zhou
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Qingling Chen
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Ying Wang
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China.
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Jin H, Jin M, Lim CH, Choi JY, Kim SJ, Lee KH. Metabolic bulk volume predicts survival in a homogeneous cohort of stage II/III diffuse large B-cell lymphoma patients undergoing R-CHOP treatment. Front Oncol 2023; 13:1186311. [PMID: 37384292 PMCID: PMC10293666 DOI: 10.3389/fonc.2023.1186311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/24/2023] [Indexed: 06/30/2023] Open
Abstract
Purpose Accurate risk stratification can improve lymphoma management, but current volumetric 18F-fluorodeoxyglucose (FDG) indicators require time-consuming segmentation of all lesions in the body. Herein, we investigated the prognostic values of readily obtainable metabolic bulk volume (MBV) and bulky lesion glycolysis (BLG) that measure the single largest lesion. Methods The study subjects were a homogeneous cohort of 242 newly diagnosed stage II or III diffuse large B-cell lymphoma (DLBCL) patients who underwent first-line R-CHOP treatment. Baseline PET/CT was retrospectively analyzed for maximum transverse diameter (MTD), total metabolic tumor volume (TMTV), total lesion glycolysis (TLG), MBV, and BLG. Volumes were drawn using 30% SUVmax as threshold. Kaplan-Meier survival analysis and the Cox proportional hazards model assessed the ability to predict overall survival (OS) and progression-free survival (PFS). Results During a median follow-up period of 5.4 years (maximum of 12.7 years), events occurred in 85 patients, including progression, relapse, and death (65 deaths occurred at a median of 17.6 months). Receiver operating characteristic (ROC) analysis identified an optimal TMTV of 112 cm3, MBV of 88 cm3, TLG of 950, and BLG of 750 for discerning events. Patients with high MBV were more likely to have stage III disease; worse ECOG performance; higher IPI risk score; increased LDH; and high SUVmax, MTD, TMTV, TLG, and BLG. Kaplan-Meier survival analysis showed that high TMTV (p = 0.005 and < 0.001), MBV (both p < 0.001), TLG (p < 0.001 and 0.008), and BLG (p = 0.018 and 0.049) were associated with significantly worse OS and PFS. On Cox multivariate analysis, older age (> 60 years; HR, 2.74; 95% CI, 1.58-4.75; p < 0.001) and high MBV (HR, 2.74; 95% CI, 1.05-6.54; p = 0.023) were independent predictors of worse OS. Older age (hazard ratio [HR], 2.90; 95% CI, 1.74-4.82; p < 0.001) and high MBV (HR, 2.36; 95% CI, 1.15-6.54; p = 0.032) were also independent predictors of worse PFS. Furthermore, among subjects ≤60 years, high MBV remained the only significant independent predictor of worse OS (HR, 4.269; 95% CI, 1.03-17.76; p = 0.046) and PFS (HR, 6.047; 95% CI, 1.73-21.11; p = 0.005). Among subjects with stage III disease, only greater age (HR, 2.540; 95% CI, 1.22-5.30; p = 0.013) and high MBV (HR, 6.476; 95% CI, 1.20-31.9; p = 0.030) were significantly associated with worse OS, while greater age was the only independent predictor of worse PFS (HR, 6.145; 95% CI, 1.10-4.17; p = 0.024). Conclusions MBV easily obtained from the single largest lesion may provide a clinically useful FDG volumetric prognostic indicator in stage II/III DLBCL patients treated with R-CHOP.
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Affiliation(s)
- Hyun Jin
- Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Myung Jin
- Department of Electrical and Computer Engineering, Seoul, Republic of Korea
| | - Chae Hong Lim
- Department of Nuclear Medicine, Soonchunhyang University School of Medicine, Seoul, Republic of Korea
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seok-Jin Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyung-Han Lee
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Marcus C, Subramaniam RM. Paragangliomas and Pheochromocytomas: Positron Emission Tomography/Computed Tomography Diagnosis and Therapy. PET Clin 2023; 18:233-242. [PMID: 36585340 DOI: 10.1016/j.cpet.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Molecular imaging evaluation of pheochromocytomas and paragangliomas depends on multiple factors, such as localized versus metastatic disease, the genetic, and biochemical profile of tumors. Positron emission tomography/computed tomography (PET/CT) imaging of these tumors outperforms Meta-Iodo-Benzyl-Guanidine (MIBG) scintigraphy in most cases. A few PET radiotracers have been studied in evaluating these patients with somatostatin receptor PET imaging and have shown superior performance compared with other agents in most of these patients. 18F-fluorodeoxyglucose PET/CT imaging is useful in select patients, such as those with succinate dehydrogenase complex subunit B-associated disease. Treatment strategy depends on multiple factors and necessitates a multidisciplinary approach.
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Affiliation(s)
- Charles Marcus
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Radiological Sciences, Emory University School of Medicine, 1364 Clifton Road Northeast, 1st Floor #E163, Atlanta, GA 30322, USA.
| | - Rathan M Subramaniam
- Department of Medicine, Otago Medical School, University of Otago, 1st Floor, Dunedin Hospital, 201 Great King Street, Dunedin 9016, New Zealand; Duke University Medical Center, Department of Radiology, 2301 Erwin Road, Box 3808, Durham, NC 27710, USA
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Dondi F, Albano D, Bellini P, Cerudelli E, Treglia G, Bertagna F. Prognostic role of baseline 18F-FDG pet/CT in stage I and stage ii non-small cell lung cancer. Clin Imaging 2023; 94:71-78. [PMID: 36495848 DOI: 10.1016/j.clinimag.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE investigate the prognostic role of baseline 18F-FDG PET/CT in stage I-II NSCLC. MATERIAL AND METHODS 296 patients were included. Clinicopathological features and PET/CT semiquantitative parameters [standardized uptake value (SUV) body weight max (SUVmax), SUV body weight mean (SUVmean), SUV lean body mass (SUVlbm), SUV body surface area (SUVbsa), metabolic tumor volume (MTV), total lesion glycolysis (TLG), ratio SUVmax/liver (S-L) and ratio SUVmax/blood-pool (S-BP) were extracted]. Anova and Kruskall-Wallis tests were used to assess the relationship between these parameters. Kaplan-Meier, univariate and multivariate analysis were performed to search independent prognostic factors for progression free (PFS), overall survival (OS) and disease specific survival (DSS). RESULTS Correlation between PET/CT semiquantitative parameters and histology, stage, size, grading and presence of nodal metastasis were reported. Mean PFS was 28.1 months, relapse/progression of disease occurred in 85 patients (28.7%). Mean OS was 33.3 months, death occurred in 43 patients (14.5%); specific death by NSCLC occurred in 26 subjects (8.8%). Kaplan-Meier analyses revealed most of semiquantitative parameters as predictive for PFS, OS and DSS. For DSS, this was confirmed when dividing between patients with surgery and surgery with other therapies. SUVmax, SUVmean, SUVlbm, SUVbsa and S-L revealed to be independent prognosticators for OS and DSS. S-BP was an independent prognosticator for DSS. SUVmax, SUVmean, SUVlbm, S-L and S-BP were confirmed as independent prognosticators for DSS in the group of patients treated with surgery and subsequent adjuvant therapy. CONCLUSION Baseline 18F-FDG PET/CT semiquantitative parameters are confirmed as prognostic tools for stage I-II NSCLC, in particular for DSS.
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Affiliation(s)
- Francesco Dondi
- Nuclear Medicine, ASST Spedali Civili di Brescia, Brescia, Italy.
| | - Domenico Albano
- Nuclear Medicine, Università degli Studi di Brescia and ASST Spedali Civili di Brescia, Brescia, Italy
| | - Pietro Bellini
- Nuclear Medicine, Università degli Studi di Brescia and ASST Spedali Civili di Brescia, Brescia, Italy
| | | | - Giorgio Treglia
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Francesco Bertagna
- Nuclear Medicine, Università degli Studi di Brescia and ASST Spedali Civili di Brescia, Brescia, Italy
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10
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Huang D, Yang X, Liu Y, Huang Z. Prostate Cancer presenting as a solitary sacral osteolytic metastasis mimicking chordoma on 18F-FDG PET/CT. Urology 2022; 170:e3-e5. [PMID: 36115425 DOI: 10.1016/j.urology.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/17/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Dong Huang
- Departments of Nuclear Medicine, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, No.82 Qinglong St. Chengdu, Sichuan, China. 610031
| | - Xing Yang
- Departments of Nuclear Medicine, Sichuan Science City Hospital, No. 64, Mianshan Road, Mianyang, Sichuan, PR China. 621000
| | - Ya Liu
- Department of Nuclear Medicine, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, PR China. 646000; Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, PR China. 646000
| | - Zhanwen Huang
- Department of Nuclear Medicine, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, PR China. 646000; Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, PR China. 646000.
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11
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Heidemeier A, Schloetelburg W, Thurner A, Metz C, Heidemeier H, Rasche L, Martin Kortuem K, Boeckle D, Weiland E, Benkert T, Nickel D, Werner R, Buck AK, Bley TA. Multi-parametric whole-body MRI evaluation discerns vital from non-vital multiple myeloma lesions as validated by 18F-FDG and 11C-methionine PET/CT. Eur J Radiol 2022; 155:110493. [PMID: 36027759 DOI: 10.1016/j.ejrad.2022.110493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 08/04/2022] [Accepted: 08/15/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE We tested a novel multi-parametric (mp) whole body (WB)-MRI evaluation algorithm for medullary lesions in comparison to positron emission tomography (PET) radiotracers 18F-fluorodeoxyglucose (18F-FDG) and 11C-methionine (11C-MET). METHODS AND MATERIALS This retrospective single-center study included 44 MM patients, who received both 18F-FDG-PET and WB-MRI within ten days. MRI classified focal lesions as vital when showing 1) significant diffusion-restriction, 2) a fat fraction (FF) less than 20 % and 3) homogenous hypointensity on T2-weighted images. On a lesion-by-lesion level the findings were compared to 18F-FDG PET by using a 5-point scoring system (analogous to the Deauville score [DS]). In 24/44 (55 %) patients additional comparison to 11C-MET PET was available. RESULTS Among two radiologists, an excellent inter-observer reliability for mpWB-MRI in a total of 84 medullary lesions was observed (ICC = 1, k = 1, p <.01). 16/17 (94.1 %) MRI-classified vital lesions had a DS of 4 or 5 on either 18F-FDG-PET or 11C-MET-PET. MRI-rated non-vital lesions correlated with PET-based DS ≤ 3. When results of mpWB-MRI were compared to 18F-FDG, a fair inter-observer agreement was recorded (ICC = 0.52, k = 0.53, p <.01), while for 11C-MET, an excellent concordance rate was achieved (ICC = 0.81, k = 0.79, p <.01). CONCLUSION The proposed mpWB-MRI interpretation algorithm allowed to assess tumor activity of myeloma lesions with high inter-observer reproducibility. We observed a substantial concordance between the mpWB-MRI classification of lesions and PET assessment based on a semi-automatically calculated 5-point scoring system analogous to the Deauville scores.
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Affiliation(s)
- Anke Heidemeier
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacherstr 6, 97080 Würzburg, Germany.
| | - Wiebke Schloetelburg
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacherstr 6, 97080 Würzburg, Germany
| | - Annette Thurner
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacherstr 6, 97080 Würzburg, Germany
| | - Corona Metz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacherstr 6, 97080 Würzburg, Germany
| | - Heike Heidemeier
- Department of Psychology, Private University Göttingen, Weender Landstrasse 3-7, 37073 Göttingen, Germany
| | - Leo Rasche
- Department of Internal Medicine II, University Hospital Würzburg, Oberdürrbacherstr 6, 97080 Würzburg, Germany
| | - K Martin Kortuem
- Department of Internal Medicine II, University Hospital Würzburg, Oberdürrbacherstr 6, 97080 Würzburg, Germany
| | - David Boeckle
- Department of Internal Medicine II, University Hospital Würzburg, Oberdürrbacherstr 6, 97080 Würzburg, Germany
| | - Elisabeth Weiland
- Department of MR Application Predevelopment, Siemens Healthcare, 91301 Erlangen, Germany
| | - Thomas Benkert
- Department of MR Application Predevelopment, Siemens Healthcare, 91301 Erlangen, Germany
| | - Dominik Nickel
- Department of MR Application Predevelopment, Siemens Healthcare, 91301 Erlangen, Germany
| | - Rudolf Werner
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacherstr 6, 97080 Würzburg, Germany
| | - Andreas Konrad Buck
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacherstr 6, 97080 Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacherstr 6, 97080 Würzburg, Germany
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12
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Borja AJ, Saini J, Raynor WY, Ayubcha C, Werner TJ, Alavi A, Revheim ME, Nagaraj C. Role of Molecular Imaging with PET/MR Imaging in the Diagnosis and Management of Brain Tumors. PET Clin 2022; 17:431-451. [PMID: 35662494 DOI: 10.1016/j.cpet.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Gliomas are the most common primary brain tumors. Hybrid PET/MR imaging has revolutionized brain tumor imaging, allowing for noninvasive, simultaneous assessment of morphologic, functional, metabolic, and molecular parameters within the brain. Molecular information obtained from PET imaging may aid in the detection, classification, prognostication, and therapeutic decision making for gliomas. 18F-fluorodeoxyglucose (FDG) has been widely used in the setting of brain tumor imaging, and multiple techniques may be employed to optimize this methodology. More recently, a number of non-18F-FDG-PET radiotracers have been applied toward brain tumor imaging and are used in clinical practice.
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Affiliation(s)
- Austin J Borja
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Jitender Saini
- Department of Neuro Imaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, Karnataka 560-029, India
| | - William Y Raynor
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Cyrus Ayubcha
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Thomas J Werner
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Mona-Elisabeth Revheim
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Sognsvannsveien 20, Oslo 0372, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Problemveien 7, Oslo 0315, Norway
| | - Chandana Nagaraj
- Department of Neuro Imaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, Karnataka 560-029, India.
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13
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Palombit A, Silvestri E, Volpi T, Aiello M, Cecchin D, Bertoldo A, Corbetta M. Variability of regional glucose metabolism and the topology of functional networks in the human brain. Neuroimage 2022; 257:119280. [PMID: 35525522 DOI: 10.1016/j.neuroimage.2022.119280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/04/2022] [Accepted: 05/02/2022] [Indexed: 11/17/2022] Open
Abstract
The brain consumes the most energy per relative mass amongst the organs in the human body. Theoretical and empirical studies have shown that behavioral processes are relatively inexpensive metabolically, and that most energy goes to maintaining the status quo, i.e., the balance of cell membranes' resting potentials and subthreshold spontaneous activity. Spontaneous activity fluctuates across brain regions in a correlated fashion that defines multi-scale hierarchical networks called resting-state networks (RSNs). Different regions of the brain display different metabolic consumption, but the relationship between regional brain metabolism and RSNs is still under investigation. Here, we examine the variability of glucose metabolism across brain regions, measured with the relative standard uptake value (SUVR) using 18F-FDG PET, and the topology of RSNs, measured through graph analysis applied to fMRI resting-state functional connectivity (FC). We found a moderate linear relationship between the strength (STR) of pairwise regional FC and metabolism. Moreover, the linear correlation between SUVR and STR grew stronger as we considered more connected regions (hubs). Regions connecting different RSNs, or connector hubs, showed higher SUVR than regions connecting nodes within the same RSN, or provincial hubs. Our results show that functional connections as probed by fMRI are related to glucose metabolism, especially in a system of provincial and connector hubs.
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Affiliation(s)
- Alessandro Palombit
- Department of Information Engineering, University of Padova, 35131 Padova, Italy; Padova Neuroscience Center (PNC), University of Padova, 35131 Padova, Italy
| | - Erica Silvestri
- Department of Information Engineering, University of Padova, 35131 Padova, Italy; Padova Neuroscience Center (PNC), University of Padova, 35131 Padova, Italy
| | - Tommaso Volpi
- Padova Neuroscience Center (PNC), University of Padova, 35131 Padova, Italy; Department of Neuroscience, University of Padova, 35128 Padova, Italy
| | | | - Diego Cecchin
- Unit of Nuclear Medicine, Department of Medicine, University of Padova, Padova, Italy; Padova Neuroscience Center (PNC), University of Padova, 35131 Padova, Italy
| | - Alessandra Bertoldo
- Department of Information Engineering, University of Padova, 35131 Padova, Italy; Padova Neuroscience Center (PNC), University of Padova, 35131 Padova, Italy
| | - Maurizio Corbetta
- Padova Neuroscience Center (PNC), University of Padova, 35131 Padova, Italy; Department of Neuroscience, University of Padova, 35128 Padova, Italy; Venetian Institute of Molecular Medicine (VIMM) Biomedical Foundation, 35128 Padova, Italy.
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14
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Shidahara M, Funaki Y, Watabe H. Noninvasive estimation of human radiation dosimetry of 18F-FDG by whole-body small animal PET imaging in rats. Appl Radiat Isot 2022; 181:110071. [PMID: 34952332 DOI: 10.1016/j.apradiso.2021.110071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 12/02/2021] [Accepted: 12/15/2021] [Indexed: 11/02/2022]
Abstract
PURPOSE Small animal PET provides the biodistribution of administrated radiotracer in vivo and have a potential to contribute on dosimetry study. The aim of this study is to investigate the effect of region-of-interest (ROI)-delineation in whole-body rat PET image toward non-invasive estimation of human dosimetry of 18F-FDG. METHOD After administration of 18F-FDG (averaged 11.7 MBq), 3.5-h PET and 20-min CT scans were sequentially performed for three rats by Clairvivo PET/CT system. Seven source organs, and the remainder of the body, were studied to extrapolate %ID(t) and estimate time-integrated activity coefficients [kBq-h/MBq] in human. The mean absorbed dose in each target organ and the effective dose were estimated by MIRD method. Effects of ROI-definitions on both extrapolated %ID(t) in human and estimated doses were also investigated by using (i) small ROIs of high uptake region and (ii) whole organ ROIs. RESULTS Averaged effective doses of 18F-FDG in human by using high-uptake and whole-organ ROIs were 27.8 ± 6.54 and 19.3 ± 2.72 μSv/MBq, respectively. CONCLUSION The use of small animal PET scanner, which allows repeatedly PET scans, have a potential to contribute on the reduction of the number of experimental animals. However, the ways of ROI drawing influences on the estimated effective dose and safe-side ROI definition may be preferred.
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Affiliation(s)
- Miho Shidahara
- Division of Applied Quantum Medical Engineering, Department of Quantum Science and Energy Engineering, Graduate School of Engineering, Tohoku University, Japan.
| | - Yoshihito Funaki
- Division of Radiopharmaceutical Chemistry, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - Hiroshi Watabe
- Division of Radiation Protection and Safety Control, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
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15
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Sengoz T, Karakaya YA, Gultekin A, Yaylali O, Senol H, Yuksel D. Relationships of 18F-FDG uptake by primary tumors with prognostic factors and molecular subtype in ductal breast cancer. Rev Esp Med Nucl Imagen Mol 2022; 41:32-38. [PMID: 34991834 DOI: 10.1016/j.remnie.2021.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/18/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES In this study, we aimed to investigate the correlation between SUVmax of primary tumor and prognostic factors/molecular subtype in ductal breast cancer patients. MATERIALS AND METHODS We retrospectively reviewed 150 female patients with pathologically proven invasive ductal breast cancer from January 2015 to October 2019 who underwent 18F-FDG PET/CT for initial staging. Histopathological prognostic features of the primary tumor (histological grade, hormone receptor status, Ki-67 index, vb.) were obtained from the tru-cut biopsy report. In 18F-FDG PET/CT studies, the maximum standardized uptake value (SUVmax) of the primary breast tumor was calculated and compared with the presence of axillary lymphadenopathy and/or distant metastases, histopathological prognostic factors and molecular subtype. RESULTS The high SUVmax of primary breast tumors is significantly correlated with the clinicopathological factors: high tumor size, high histologic grade, high Ki-67 index, axillary lymph node positivity and distant metastasis. SUVmax value was significantly higher in patients with basal subtype than patients with Luminal A subtype (8,14 ± 3,71 and 4,64 ± 2,45, p = 0,002). Correlation analysis revealed a low correlation between Ki-67 index and SUVmax (r = 0,276, p = 0,001) and moderate correlation between tumor size and SUVmax (r = 0,470, p = 0,001). In multivariate linear regression analysis, Ki-67 index and tumor size had a statistically significant effect on SUVmax values. As these parameters increase, it is seen that it increases SUVmax values (p = 0,004, Std Beta: 0,228, 95% CI:0,010-0,055 and p = 0,001, Std Beta:0,374, 95% CI:0,55-0,136, respectively). CONCLUSION High SUVmax value is associated with factors suggesting poor prognosis. Pretreatment 18F-FDG PET/CT can be used as a tool to predict prognosis in breast cancer.
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Affiliation(s)
- Tarik Sengoz
- Pamukkale University, Medical Faculty, Department of Nuclear Medicine, Denizli, Turkey.
| | - Yeliz Arman Karakaya
- Pamukkale University, Medical Faculty, Department of Pathology, Denizli, Turkey.
| | - Aziz Gultekin
- Pamukkale University, Medical Faculty, Department of Nuclear Medicine, Denizli, Turkey.
| | - Olga Yaylali
- Pamukkale University, Medical Faculty, Department of Nuclear Medicine, Denizli, Turkey.
| | - Hande Senol
- Pamukkale University, Medical Faculty, Department of Biostatistics, Denizli, Turkey.
| | - Dogangun Yuksel
- Pamukkale University, Medical Faculty, Department of Nuclear Medicine, Denizli, Turkey.
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Casáns-Tormo I, Alcalá-López JE, Espinet-Coll C, Pubul-Núñez V, Martínez-Rodríguez I. 18F-FDG PET/CT in cardiovascular infection and inflammation. Rev Esp Med Nucl Imagen Mol 2021; 40:397-408. [PMID: 34627726 DOI: 10.1016/j.remnie.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/22/2021] [Indexed: 11/21/2022]
Abstract
The diagnosis of cardiovascular infection and inflammation by [18F]FDG PET/CT in Nuclear Cardiology is of growing interest, because with respect to echocardiography this technique has improved the certainty in the diagnosis of infective endocarditis in patients with prosthetic valves, the increasing number of patients with implantable cardiac devices because of the progressive ageing of the population, as well as in patients with suspected large vessel vasculitis. All are serious clinical situations which require correct diagnosis and appropriate treatment as soon as possible, because they can cause severe complications, high mortality and also increased health care costs. We review the use of [18F]FDG PET/CT in cardiovascular infection and inflammation, including the clinical point of view and the contribution of other image modalities. We focus on the appropriate methodology for this exploration, patient preparation, image acquisition and correct interpretation and the quantification possibilities, defining the specific characteristics of the diagnosis in patients with prosthetic valves, implantable cardiac devices and large vessel vasculitis in the initial diagnosis as well as during follow-up to assess treatment response. We analyze the possible causes of false positive and false negative results and emphasize the special value of a multidisciplinary team for optimal management of these patients.
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Abstract
Imaging plays an integral role in the clinical care of patients with breast cancer. This review article focuses on the use of PET imaging for breast cancer, highlighting the clinical indications and limitations of 2-deoxy-2-[18F]fluoro-d-glucose (FDG) PET/CT, the potential use of PET/MRI, and 16α-[18F]fluoroestradiol (FES), a newly approved radiopharmaceutical for estrogen receptor imaging.
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Affiliation(s)
- Amy M Fowler
- Breast Imaging and Intervention Section, Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252, USA; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Avenue, Madison, WI 53705, USA; University of Wisconsin Carbone Cancer Center, 600 Highland Avenue, Madison, WI 53792, USA.
| | - Steve Y Cho
- University of Wisconsin Carbone Cancer Center, 600 Highland Avenue, Madison, WI 53792, USA; Nuclear Medicine and Molecular Imaging Section, Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252, USA
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18
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Maier A, Liao SL, Lescure T, Robson PM, Hirata N, Sartori S, Narula N, Vergani V, Soultanidis G, Morgenthau A, Kovacic JC, Padilla M, Narula J, Jacobi A, Fayad ZA, Trivieri MG. Pulmonary Artery 18F-Fluorodeoxyglucose Uptake by PET/CMR as a Marker of Pulmonary Hypertension in Sarcoidosis. JACC Cardiovasc Imaging 2021; 15:108-120. [PMID: 34274283 DOI: 10.1016/j.jcmg.2021.05.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES This study investigated whether pulmonary artery (PA) 18F-FDG uptake is associated with hypertension, and if it correlates to elevated pulmonary pressures. BACKGROUND 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) combined with computed tomography or cardiac magnetic resonance (CMR) has been used to assess inflammation mostly in large arteries of the systemic circulation. Much less is known about inflammation of the vasculature of the pulmonary system and its relationship to pulmonary hypertension (PH). METHODS In a single-center cohort of 175 patients with suspected cardiac sarcoidosis, who underwent hybrid thoracic PET/CMR, 18F-FDG uptake in the PA was quantified according to maximum standardized uptake value (SUVmax) and target-to-background ratio (TBR) and compared with available results from right heart catheterization (RHC) or transthoracic echocardiography (TTE). RESULTS Thirty-three subjects demonstrated clear 18F-FDG uptake in the PA wall. In the subgroup of patients who underwent RHC (n = 10), the mean PA pressure was significantly higher in the group with PA 18F-FDG uptake compared with the group without uptake (34.4 ± 7.2 mm Hg vs 25.6 ± 9.3 mm Hg; P = 0.003), and 9 (90%) patients with PA 18F-FDG uptake had PH when a mean PA pressure cutoff of 25 mm Hg was used compared with 18 (45%) in the nonuptake group (P < 0.05). In the subgroup that underwent TTE, signs of PH were present in a significantly higher number of patients with PA 18F-FDG uptake (14 [51.9%] vs 37 [29.8%]; P < 0.05). Qualitative assessment of 18F-FDG uptake in the PA wall showed a sensitivity of 33% and specificity of 96% for separating patients with PH based on RHC-derived PA pressures. SUVmax and TBR in the PA wall correlated with PA pressure derived from RHC and/or TTE. CONCLUSIONS We demonstrate that 18F-FDG uptake by PET/CMR in the PA is associated with PH and that its intensity correlates with PA pressure.
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Affiliation(s)
- Alexander Maier
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Steve Lin Liao
- Division of Noninvasive Cardiovascular Imaging at the Icahn School of Medicine at Mount Sinai, New York, USA
| | - Thomas Lescure
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Philip M Robson
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Naoki Hirata
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Samantha Sartori
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Navneet Narula
- Department of Pathology, New York University Langone Medical Center, New York, New York, USA
| | - Vittoria Vergani
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Georgios Soultanidis
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Adam Morgenthau
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jason C Kovacic
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia; St Vincent's Clinical School, University of New South Wales, Darlinghurst, New South Wales, Australia
| | - Maria Padilla
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jagat Narula
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Adam Jacobi
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Zahi A Fayad
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Maria G Trivieri
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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Bottoni G, Piccardo A, Fiz F, Siri G, Matteucci F, Rocca A, Nanni O, Monti M, Brain E, Alberini JL, Dib B, Sacchetti GM, Saggia C, Rossi V, Harbeck N, Wuerstlein R, Degenhardt T, DeCensi A, Rollandi GA, Gennari A. Heterogeneity of bone metastases as an important prognostic factor in patients affected by oestrogen receptor-positive breast cancer. The role of combined [18F]Fluoroestradiol PET/CT and [18F]Fluorodeoxyglucose PET/CT. Eur J Radiol 2021; 141:109821. [PMID: 34139575 DOI: 10.1016/j.ejrad.2021.109821] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the prognostic role of different inter and intralesional expression (heterogeneity) of oestrogen receptor (ER) in bone metastases, as identified by the combined use of [18F]FES PET/CT and [18F]FDG PET/CT in patients with oestrogen receptor-positive (ER+) metastatic breast cancer (BC). METHODS We analysed patients with a new diagnosis of bone metastases who were candidates for first-line systemic endocrine therapy. Before starting therapy, patients underwent baseline [18F]FES PET/CT and [18]FDG PET/CT. Semi-quantitative evaluation of whole-body bone metabolic burden (WB-B-MB) was performed on [18F]FES and [18F]FDG PET/CT in order to evaluate disease extent, tumour metabolism and ER heterogeneity. We used time-to-event analyses (Kaplan-Meier and Cox proportional-hazards methods) to estimate progression-free (PFS) and overall survival (OS), in order to assess the independent prognostic value of [18F]FES PET/CT and [18F]FDG PET/CT, alone and in combination. RESULTS According to our criteria, we enrolled 49 patients. Over a median follow-up of 44.7 months, 35 patients suffered disease progression (71.4 %) and 15 died of disease (30.6 %). When the risk of disease progression was calculated by means of the Cox model, only [18F]FDG WB-B-MB was independently and directly associated to PFS (p = 0.02). On analysing the association between all prognostic parameters and survival, the Cox model showed that the only parameter associated with OS was the WB-B-MB FES/FDG ratio (p = 0.01). CONCLUSION The combined use of [18F]FES-PET/CT and [18F]FDG-PET/CT can identify ER heterogeneity in BC bone metastases. This heterogeneity is significantly associated with survival. Moreover, the extension of the FDG-avid component correlates with the risk of disease progression.
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Sengoz T, Karakaya YA, Gültekin A, Yaylali O, Senol H, Yuksel D. Relationships of 18F-FDG uptake by primary tumors with prognostic factors and molecular subtype in ductal breast cancer. Rev Esp Med Nucl Imagen Mol 2021; 41:S2253-654X(20)30211-0. [PMID: 34090841 DOI: 10.1016/j.remn.2020.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES In this study, we aimed to investigate the correlation between SUVmax of primary tumor and prognostic factors/molecular subtype in ductal breast cancer patients. MATERIALS AND METHODS We retrospectively reviewed 150 female patients with pathologically proven invasive ductal breast cancer from January 2015 to October 2019 who underwent 18F-FDG PET/CT for initial staging. Histopathological prognostic features of the primary tumor (histological grade, hormone receptor status, Ki-67 index, vb.) were obtained from the tru-cut biopsy report. In 18F-FDG PET/CT studies, the maximum standardized uptake value (SUVmax) of the primary breast tumor was calculated and compared with the presence of axillary lymphadenopathy and/or distant metastases, histopathological prognostic factors and molecular subtype. RESULTS The high SUVmax of primary breast tumors is significantly correlated with the clinicopathological factors: high tumor size, high histologic grade, high Ki-67 index, axillary lymph node positivity and distant metastasis. SUVmax value was significantly higher in patients with basal subtype than patients with Luminal A subtype (8.14±3.71 and 4.64±2.45, p=0.002). Correlation analysis revealed a low correlation between Ki-67 index and SUVmax (r=0.276, p=0.001) and moderate correlation between tumor size and SUVmax (r=0.470, p=0.001). In multivariate linear regression analysis, Ki-67 index and tumor size had a statistically significant effect on SUVmax values. As these parameters increase, it is seen that it increases SUVmax values (p=0.004, Std Beta: 0.228, 95% CI: 0.010-0.055 and p=0.001, Std Beta: 0.374, 95% CI: 0.55-0.136, respectively). CONCLUSION High SUVmax value is associated with prognotic factors suggesting poor prognosis. Pretreatment 18F-FDG PET/CT can be used as a tool to predict prognosis in breast cancer.
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Affiliation(s)
- T Sengoz
- Pamukkale University, Medical Faculty, Department of Nuclear Medicine, Denizli, Turkey.
| | - Y A Karakaya
- Pamukkale University, Medical Faculty, Department of Pathology, Denizli, Turkey
| | - A Gültekin
- Pamukkale University, Medical Faculty, Department of Nuclear Medicine, Denizli, Turkey
| | - O Yaylali
- Pamukkale University, Medical Faculty, Department of Nuclear Medicine, Denizli, Turkey
| | - H Senol
- Pamukkale University, Medical Faculty, Department of Biostatistics, Denizli, Turkey
| | - D Yuksel
- Pamukkale University, Medical Faculty, Department of Nuclear Medicine, Denizli, Turkey
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Abstract
Several studies have demonstrated the effectiveness of somatostatin receptor (SSTR)-targeted imaging for diagnosis, staging, evaluating the possibility of treatment with cold somatostatin analogs, as well peptide receptor radionuclide therapy (PRRT), and evaluation of treatment response. PET with 68Ga-labeled somatostatin analogs provides excellent sensitivity and specificity for diagnosing and staging neuroendocrine tumors (NETs). Metabolic imaging with PET with fludeoxyglucose 18F/computed tomography (CT) complements the molecular imaging with 68Ga-SSTR PET/CT toward a personalized therapy in NET patients. The documented response rate of PRRT in NET summing up complete response, partial response, minor response, and stable disease is 70% to 80%.
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Affiliation(s)
- Margarida Rodrigues
- Department of Nuclear Medicine, Medical University of Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria.
| | - Hanna Svirydenka
- Department of Nuclear Medicine, Medical University of Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria
| | - Irene Virgolini
- Department of Nuclear Medicine, Medical University of Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria
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Roll W, Evers G, Strotmann R, Albring J, Reicherts C, Noto B, Weckesser M, Lenz G, Schäfers M, Stelljes M. Fluorodeoxyglucose F 18 for the Assessment of Acute Intestinal Graft-versus-Host Disease and Prediction of Response to Immunosuppressive Therapy. Transplant Cell Ther 2021; 27:603-10. [PMID: 33910102 DOI: 10.1016/j.jtct.2021.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/28/2021] [Accepted: 04/13/2021] [Indexed: 12/13/2022]
Abstract
Graft-versus-host disease (GVHD) is a common complication that increases morbidity and mortality after allogeneic stem cell transplantation (allo-SCT). Fluorodeoxyglucose F 18 (18F-FDG)-positron emission tomography (PET) imaging has been demonstrated to be highly informative for evaluating and mapping of intestinal GVHD. To corroborate and extend existing findings and to investigate whether glucose metabolism assessed by 18F-FDG-PET might be an effective diagnostic tool to predict corticosteroid-refractory acute GVHD and overall survival. In this retrospective analysis, 101 patients with clinically suspected acute intestinal GVHD underwent 18F-FDG-PET between June 2011 and February 2019. Seventy-four of these patients with clinically and/or histologically proven acute intestinal GVHD as well as positive 18F-FDG-PET findings were analyzed in detail to assess the predictive value of 18F-FDG-PET regarding the response to immunosuppressive therapy and survival. Quantitative PET parameters, particularly the maximum standard uptake value (SUVmax), of patients with a fast response (ie, clinical improvement and decreased GVHD activity by at least 1 stage after 1 week of GVHD treatment) or slow/no response (ie, persistent disease activity for more than 1 week or increasing GVHD activity following first-line immunosuppressive therapy) were evaluated. 18F-FDG-PET detected intestinal GVHD with a sensitivity of 93% (95% confidence interval [CI], 85% to 97%) and specificity of 73% (95% CI, 45% to 91%). Patients with a fast response to immunosuppressive therapy had a mean SUVmax of 13.7 (95% CI, 11.0 to 16.5) compared with 7.6 (95% CI, 7.0 to 8.3; P = .005) observed in patients with prolonged or no response. The median overall survival (OS) was 573.0 days (95% CI, 539.5 to 606.5 days) for patients with fast response versus 255 days (95% CI, 161.0 to 349.0 days; P = .009) for patients with slow or no responses. A SUVmax threshold >8.95 applied to 18F-FDG-PET performed within 100 days after transplantation identified patients with a median OS of 390 versus 117 days for patients with SUVmax ≤8.95 (P = .036). SUVmax threshold and donor type were independent factors for OS. Our results indicate that 18F-FDG-PET is highly accurate in identifying patients with acute intestinal GVHD and may predict responses to immunosuppressive therapy as well as survival, particularly when applied within the first 100 days after transplantation. These results provide a strong rationale to integrate PET imaging in future prospective trials evaluating new therapies for acute GVHD.
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Aydos U, Ünal ER, Özçelik M, Akdemir D, Ekinci Ö, Taştepe AI, Memiş L, Atay LÖ, Akdemir ÜÖ. Texture features of primary tumor on 18F-FDG PET images in non-small cell lung cancer: The relationship between imaging and histopathological parameters. Rev Esp Med Nucl Imagen Mol 2021; 40:S2253-654X(20)30134-7. [PMID: 33785321 DOI: 10.1016/j.remn.2020.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/16/2020] [Accepted: 06/19/2020] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aims of this study were to evaluate the relationships between textural features of the primary tumor on FDG PET images and clinical-histopathological parameters which are useful in predicting prognosis in newly diagnosed non-small cell lung cancer (NSCLC) patients. MATERIAL AND METHODS PET/CT images of ninety (90) patients with NSCLC prior to surgery were analyzed retrospectively. All patients had resectable tumors. From the images we acquired data related to metabolism (SUVmax, metabolic tumor volume [MTV] and total lesion glycolysis [TLG]) and texture features of primary tumors. Histopathological tumor types and subgroups, degree of Ki-67 expression and necrosis rates of the primary tumor, mediastinal lymph node (MLN) status and nodal stages were recorded. RESULTS Among the 2histologic tumor types (adenocarcinoma and squamous cell carcinoma) significant differences were present regarding metabolic parameters, Ki-67 index with higher values and kurtosis with lower values in the latter group. Textural heterogeneity was found to be higher in poorly differentiated tumors compared to moderately differentiated tumors in patients with adenocarcinoma. While Ki-67 index had significant correlations with metabolic parameters and kurtosis, tumor necrosis rate was only significantly correlated with textural features. By univariate and multivariate analyses of the imaging and histopathological factors examined, only gradient variance was significant predictive factor for the presence of MLN metastasis. CONCLUSIONS Textural features had significant associations with histologic tumor types, degree of pathological differentiation, tumor proliferation and necrosis rates. Texture analysis has potential to differentiate tumor types and subtypes and to predict MLN metastasis in patients with NSCLC.
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Affiliation(s)
- U Aydos
- Gazi University, Faculty of Medicine, Department of Nuclear Medicine, Beşevler/Ankara, Turquía.
| | - E R Ünal
- Gazi University, Faculty of Medicine, Department of Pathology, Beşevler/Ankara, Turquía
| | - M Özçelik
- Yüzüncü Yıl University, Faculty of Medicine, Department of Nuclear Medicine, Van, Turquía
| | - D Akdemir
- Michigan State University, Department of Epidemiology and Biostatistics, East Lansing, MI, Estados Unidos
| | - Ö Ekinci
- Gazi University, Faculty of Medicine, Department of Pathology, Beşevler/Ankara, Turquía
| | - A I Taştepe
- Gazi University, Faculty of Medicine, Department of Thoracic Surgery, Beşevler/Ankara, Turquía
| | - L Memiş
- Gazi University, Faculty of Medicine, Department of Pathology, Beşevler/Ankara, Turquía
| | - L Ö Atay
- Gazi University, Faculty of Medicine, Department of Nuclear Medicine, Beşevler/Ankara, Turquía
| | - Ü Ö Akdemir
- Gazi University, Faculty of Medicine, Department of Nuclear Medicine, Beşevler/Ankara, Turquía
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Chammah SE, Allenbach G, Jumeau R, Boughdad S, Prior JO, Nicod Lalonde M, Schaefer N, Meyer M. Impact of prophylactic cranial irradiation and hippocampal sparing on 18F-FDG brain metabolism in small cell lung cancer patients. Radiother Oncol 2021; 158:200-206. [PMID: 33667589 DOI: 10.1016/j.radonc.2021.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/09/2021] [Accepted: 02/13/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Prophylactic cranial irradiation (PCI) in small-cell lung cancer (SCLC) patients improves survival. However, it is also associated with cognitive impairment, although the underlying mechanisms remain poorly understood. Our study aims to evaluate the impact of PCI and potential benefit of hippocampal sparing (HS) on brain metabolism assessed by 18F-Fluoro-Deoxy-Glucose Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT). MATERIALS AND METHODS We retrospectively included 22 SCLC patients. 50% had hippocampal-sparing (HS) PCI. 18F-FDG PET/CT was performed 144.5 ± 73 days before and 383 ± 451 days after PCI. Brain 18F-FDG PET scans were automatically segmented in 12 regions using Combined-AAL Atlas from MI-Neurology Software (Syngo.Via, Siemens Healthineers). For all atlas regions, we computed SUV Ratio using brainstem as a reference region (SUVR = SUVmean/Brainstem SUVmean) and compared SUVR before and after PCI, using a Wilcoxon test, with a level of significance of p < 0.05. RESULTS We found significant decreases in 18F-FDG brain metabolism after PCI in the basal ganglia (p = 0.004), central regions (p = 0.001), cingulate cortex (p < 0.001), corpus striata (p = 0.003), frontal cortex (p < 0.001), parietal cortex (p = 0.001), the occipital cortex (p = 0.002), precuneus (p = 0.001), lateral temporal cortex (p = 0.001) and cerebellum (p < 0.001). Conversely, there were no significant changes in the mesial temporal cortex (MTC) which includes the hippocampi (p = 0.089). The subgroup who received standard PCI showed a significant decrease in metabolism of the hippocampi (p = 0.033). Contrastingly, the subgroup of patients who underwent HS-PCI showed no significant variation in metabolism of the hippocampi (p = 0.783). CONCLUSION PCI induced a diffuse decrease in 18F-FDG brain metabolism. HS-PCI preserves metabolic activity of the hippocampi.
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Affiliation(s)
| | - Gilles Allenbach
- Nuclear Medicine and Molecular Imaging Department, CHUV, Lausanne, Switzerland
| | | | - Sarah Boughdad
- Nuclear Medicine and Molecular Imaging Department, CHUV, Lausanne, Switzerland
| | - John O Prior
- Nuclear Medicine and Molecular Imaging Department, CHUV, Lausanne, Switzerland
| | - Marie Nicod Lalonde
- Nuclear Medicine and Molecular Imaging Department, CHUV, Lausanne, Switzerland
| | - Niklaus Schaefer
- Nuclear Medicine and Molecular Imaging Department, CHUV, Lausanne, Switzerland.
| | - Marie Meyer
- Nuclear Medicine and Molecular Imaging Department, CHUV, Lausanne, Switzerland
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25
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Albano D, Dondi F, Paderno A, Nocivelli G, Maddalo M, Magrini SM, Nicolai P, Maroldi R, Giubbini R, Bertagna F. 18F-FDG-PET/CT in laryngeal cancer: Comparison with conventional imaging and prognostic role. Rev Esp Med Nucl Imagen Mol 2021. [PMID: 33642259 DOI: 10.1016/j.remn.2020.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the diagnostic accuracy of staging 18F-FDG-PET/CT in laryngeal cancer, compare these results with conventional imaging (CI) and assess the value of 18F-FDG-PET/CT features to predict survival. METHODS Fifty-four patients with laryngeal squamous cell cancer and baseline 18F-FDG-PET/CT were retrospectively enrolled. The PET images were analyzed visually and semi-quantitatively by measuring several metabolic parameters. A combination of clinical follow-up/imaging follow-up and/or histopathology was taken as reference standard. Progression free survival (PFS) and disease specific survival (DSS) were computed using Kaplan-Meier curves. RESULTS All primary tumors were clearly identified by CI, and 52/54 by 18F-FDG-PET/CT with a sensitivity of 96.3%. Cervical nodal metastases were detected in 40/54 patients at 18F-FDG-PET/CT and in 34/49 patients at CI. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy on a patient-based analysis for nodal disease were 100%, 85.7%, 94.6%, 100% and 95.9% at 18F-FDG-PET/CT, and 91.4%, 85.7%, 94.1%, 80%, 89.8% at CI. Diagnostic performances of PET/CT and CI were not significantly different on a patient-based, side-by-side and level-by-level analysis. 18F-FDG-PET/CT recognized distant metastases in 7 patients allowing to an upstaging. At a median follow-up of 27 months, relapse/progression of disease occurred in 31 patients and death occurred in 32. Metabolic tumor volume (MTV T), MTV total and total lesion glycolysis (TLG) showed to be independent prognostic factors for PFS. CONCLUSIONS Both CI and PET/CT had good diagnostic performances for the staging of laryngeal cancer; baseline metabolic features (MTV and TLG) showed an important prognostic value in assessing the rate of PFS.
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Affiliation(s)
- D Albano
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italia.
| | - F Dondi
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italia
| | - A Paderno
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia and Spedali Civili Brescia, Brescia, Italia
| | - G Nocivelli
- Department of Radiology, University of Brescia and Spedali Civili Brescia, Brescia, Italia
| | - M Maddalo
- Department of Radiation Oncology, University of Brescia and Spedali Civili, Brescia, Italia
| | - S M Magrini
- Department of Radiation Oncology, University of Brescia and Spedali Civili, Brescia, Italia
| | - P Nicolai
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia and Spedali Civili Brescia, Brescia, Italia
| | - R Maroldi
- Department of Radiology, University of Brescia and Spedali Civili Brescia, Brescia, Italia
| | - R Giubbini
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italia
| | - F Bertagna
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italia
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26
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Zhao L, Chen S, Chen S, Pang Y, Dai Y, Hu S, Lin L, Fu L, Sun L, Wu H, Chen H, Lin Q. 68Ga-fibroblast activation protein inhibitor PET/CT on gross tumour volume delineation for radiotherapy planning of oesophageal cancer. Radiother Oncol 2021; 158:55-61. [PMID: 33621587 DOI: 10.1016/j.radonc.2021.02.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE To compare 68Ga-fibroblast activation protein inhibitor (FAPI) and 18F-FDG PET/CT in imaging locally advanced oesophageal cancer, and evaluate the potential usefulness of 68Ga-FAPI PET/CT on gross target volume (GTV) delineation aimed at radiotherapy planning for oesophageal cancer as compared with contrast-enhanced CT (CE-CT) and 18F-FDG PET/CT. MATERIALS AND METHODS Twenty-one patients with newly diagnosed oesophageal cancer who underwent both 18F-FDG and 68Ga-FAPI PET/CT scans were selected. GTVs of the primary tumours based on CE-CT (GTVCT), PET/CT, and CE-CT plus PET/CT were delineated. Gross tumour lengths were measured by GTVs and endoscopy and recorded. RESULTS The 68Ga-FAPI PET showed significantly higher radiotracer uptake than 18F-FDG PET (median SUVmax 16.71 vs. 11.23; P = 0.002) in the primary tumours. SUV thresholds of FAPI ×20%, 30%, 40%, and FDG ×40% showed similar lesion lengths compared with that in endoscopic examination (P > 0.05). GTVCT demonstrated the largest volume (median: 48.80 mm3, range: 14.83-162.23 mm3) than PET-based GTVs. For PET/CT-guided complementary contouring of GTVCT, four patients (19%) were increased by FAPI ×20% and 30%, two patients (9.5%) were increased by FAPI ×40%, and only one patient was increased by FDG ×40%. Furthermore, the volume of GTV based on CE-CT plus FAPI ×20%, 30%, and 40% showed no significant difference with GTVCT and planning target volume based CE-CT plus FAPI-PET and meets the organ at risk standard. CONCLUSION The 68Ga-FAPI PET/CT methodology showed favourable tumour-to-background contrast in oesophageal cancer and might provide additional information for target volume delineation and help avoid tumour geographic misses.
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Bergesio F, De Maggi A, Coronado M, Pardal E, Plaza R, Hernández AC, Sarandeses MDP, Cortes M, Setoain X, Simó M, Rotger A, Grande C, Caballero MD, Chauvie S. The 18F phantom clinical trials qualification for 18F-FDG-PET scanning adopted by GELTAMO (Grupo Español de Linfomas/Trasplante Autólogo de Médula Ósea). Rev Esp Med Nucl Imagen Mol 2021; 40:149-154. [PMID: 33485832 DOI: 10.1016/j.remn.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/04/2020] [Accepted: 06/10/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND OBJECTIVES Since different PET/CT (Positron Emission Tomography/Computed Tomography) scanners give different qualitative readings, a program for clinical trial qualification (CTQ) is mandatory to guarantee a reliable and reproducible use of PET/CT in prospective multi-centre clinical trials. Within this work we will show the results carried out in performing CTQ in Spain. MATERIALS AND METHODS We set up, under the auspices of Grupo Español de Linfomas/Trasplante Autólogo de Médula Osea (GELTAMO), a CTQ program consisting of the acquisition and analysis of 18F uniformity and image quality phantoms for the reduction of inter-scanner variability (ISV). The ISV was estimated on background activity concentration (BAC) and sphere to background ratio (SBR) and defined as their 95% confidence level. RESULTS Twenty-six out of 27 (96%) scanners fulfilled the CTQ requirements. The CTQ was fulfilled at the first round in 27% of the cases, while in 38%, 15% and 20%, two, three or more than three iterations, were required, respectively. The mean CTQ time was (1.8 ± 1.4) months (range: 0.3-4.6). The ISV in BAC and SBR were 20.3% and 67.7%. CONCLUSIONS The CTQ proven to be a reliable tool to reduce ISV. This enabled to set-up clinical trials in which PET/CT was used to evaluate different clinical endpoints.
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Affiliation(s)
- Fabrizio Bergesio
- Medical Physics Division, Santa Croce e Carle Hospital, Cuneo, Italia
| | - Adriano De Maggi
- Medical Physics Division, Santa Croce e Carle Hospital, Cuneo, Italia
| | - Mónica Coronado
- Nuclear Medicine Department, Hospital Universitario La Paz, Madrid, España
| | | | - Rafael Plaza
- Radiophysics Unit, Hospital Universitario La Paz, Madrid, España
| | | | | | - Montserrat Cortes
- Nuclear Medicine Department-IDI, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, España
| | - Xavier Setoain
- Nuclear Medicine Department, Hospital Clínic, Barcelona, España
| | - Marc Simó
- Nuclear Medicine Department, Hospital Universitario Vall d́Hebron, Barcelona, España
| | - Amanda Rotger
- Nuclear Medicine Department, Hospital Universitario Gregorio Marañón, Madrid, España
| | - Carlos Grande
- Haematology Department, Hospital Universitario Doce de Octubre, Madrid, España
| | | | - Stephane Chauvie
- Medical Physics Division, Santa Croce e Carle Hospital, Cuneo, Italia.
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Wu JY, Wang L, Yang MF. [Incidence and etiological analysis of abnormal cardiac uptake in patients underwent oncologic PET/CT imaging]. Zhonghua Xin Xue Guan Bing Za Zhi 2020; 48:936-941. [PMID: 33210865 DOI: 10.3760/cma.j.cn112148-20191209-00742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the incidence, location and etiology of abnormal cardiac uptake in patients underwent oncologic 18F-fluorodeoxyglucose positron emission tomography/computed tomography(PET/CT) imaging. Methods: The 18F-FDG PET/CT images of 2000 consecutive patients with suspected or diagnosed malignancy in Beijing Chaoyang Hospital from January 2014 to September 2016 were retrospectively analyzed. Fasting time was more than 12 hours before imaging, and fasting blood glucose level before 18F-FDG injection was less than 6.7 mmol/L. Focal uptake in the non-basal and non-papillary regions of the left ventricle, uptake in the right ventricle exceeding uptake in the left ventricle, and uptake in the atrium higher than that of the blood pool (when uptake of left ventricle was zero or low) were defined as abnormal, and all abnormal uptake was visually determined by experienced nuclear medicine physicians. General clinical data and the results of cardiac examination were collected to explore the incidence, location and etiology of cardiac diseases. Results: There were 138 patients with history of diabetes (6.90%), 228 patients with history of cardiovascular disease (11.40%) out of the 2 000 patients ((60.5±13.2) years, 1 117 male (55.85%)). The number and proportion of patients with malignancy, benign lesions, diseases of unknown etiology were 939 (46.95%), 484 (24.20%), 557 (28.85%), respectively. Abnormal cardiac uptake was detected in 145 patients (7.3%). The proportion of abnormal uptake in left ventricle, right ventricle and atrium was 52.4% (76 cases), 12.4% (18 cases), 35.2% (51 cases), respectively. Of the 76 individuals who had abnormal uptake in left ventricle, 25 cases (32.9%) were caused by coronary artery disease, and other causes included hypertrophic cardiomyopathy and myocardial damage caused by chemotherapy drugs, etc. Of the 18 cases who had abnormal uptake in right ventricle, 14 cases (14/18) were caused by pulmonary hypertension. In addition, 20 out of the 51 cases (39.3%) with abnormal uptake in atrium suffered from atrial fibrillation. Seventy-one patients with abnormal cardiac uptake (49.0%) had no clear manifestation and evidence of heart disease before imaging. Conclusions: The abnormal 18F-FDG uptake on oncologic PET/CT is not rare. The most common site of abnormal uptake is left ventricle, coronary artery disease, pulmonary hypertension and atrial fibrillation are common causes of abnormal 18F-FDG uptake.
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Affiliation(s)
- J Y Wu
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - L Wang
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M F Yang
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Quintos-Meneses HA, Aranda-Lara L, Morales-Ávila E, Torres-García E, Camacho-López MÁ, Sánchez-Holguín M, Luna-Gutiérrez MA, Ramírez-Durán N, Isaac-Olivé K. In vitro irradiation of doxorubicin with 18F-FDG Cerenkov radiation and its potential application as a theragnostic system. J Photochem Photobiol B 2020; 210:111961. [PMID: 32736225 DOI: 10.1016/j.jphotobiol.2020.111961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/18/2020] [Accepted: 07/12/2020] [Indexed: 01/10/2023]
Abstract
Doxorubicin (DOX), an effective chemotherapeutic agent, has a wide excitation band centred at 480 nm. Cerenkov radiation (CR) is considered an internal light source in photodynamic therapy (PDT). DOX could be photoactivated by CR and thus, enhancing its cytotoxicity. In this work, 18F-FDG was used to evaluate the effect of Cerenkov radiation on DOX, in comparison to irradiation with a 450-nm laser beam, in terms of ROS production. The production of 1O2 and O2⁎- reactive species during DOX irradiation was detected indirectly by ABMA and DCPIP bleaching, respectively. The cytotoxic effect of the DOX / 18F-FDG CR system was evaluated in the T47D breast cancer cell line. The irradiation of DOX produced 1O2 and O2⁎- species using both 18F-FDG CR and a 450-nm laser beam. The majority reactive species produced in both cases was 1O2; a favourable result, given the greater cytotoxicity of this species. The viability of T47D cells in presence of DOX (5 nM), 18F-FDG (37.5 μCi) and DOX (5 nM)/18F-FDG (37.5 μCi) was (86 ± 9)%, (84 ± 8)% and (64 ± 5)%, respectively; these results suggest a synergistic cytotoxic effect derived from the cytotoxic activity of DOX and its photoactivation by 18F-FDG CR. It is worth noting that the system could be optimized in terms of DOX concentration and 18F-FDG activity for better results. Due to the fact that 18F-FDG is widely used in nuclear imaging, the DOX/18F-FDG system also possesses theragnostic characteristics. Thus, in this work, it is demonstrated that DOX can be used in a dual therapy system based on chemotherapy-PDT when 18F-FDG CR is used as a DOX excitation source.
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Rodríguez-Alfonso B, Simó-Perdigó M, Orcajo Rincón J. Functional image in soft tissue sarcomas: An update of the indications of 18F-FDG-PET/CT. Rev Esp Med Nucl Imagen Mol 2020; 39:233-243. [PMID: 32616457 DOI: 10.1016/j.remn.2020.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 11/29/2022]
Abstract
Soft tissue sarcomas (STS) are a rare and heterogeneous group of tumors. They account for 1% of solid malignant tumors in adults and 7% in children and are responsible for 2% of cancer mortality. They require a multidisciplinary approach in centers with experience. This collaboration aims to update the scientific evidence to strengthen, together with clinical experience, the bases for the use and limitations of 18F-FDG-PET/CT in STSs. The general recommendations for the use of PET/CT in STS at present are summarized as the initial evaluation of soft tissue tumours when conventional image does not establish benignity with certainty and this determines the approach; in biopsy guiding in selected cases; in the initial staging, as additional tool, for rhabdomyosarcoma and STS of extremities or superficial trunk and head and neck tumours; in the suspicion of local recurrence when the CT or MRI are inconclusive and in the presence of osteosynthesis or prosthetic material and in assessment of therapy response to local/systemic therapy in stages ii/iii. In addition, PET/CT has the added value of being a surrogate marker of the histopathological response and it provides prognostic information, both in the baseline study and after treatment.
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Affiliation(s)
- B Rodríguez-Alfonso
- Servicio de Medicina Nuclear, Hospital Universitario Puerta de Hierro de Majadahonda, Majadahonda, Madrid, España.
| | - M Simó-Perdigó
- Servicio de Medicina Nuclear, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - J Orcajo Rincón
- Servicio de Medicina Nuclear, Hospital General Universitario Gregorio Marañón, Madrid, España; Miembro del Grupo Español de Investigación en Sarcomas (GEIS)
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Lasnon C, Coudrais N, Houdu B, Nganoa C, Salomon T, Enilorac B, Aide N. How fast can we scan patients with modern (digital) PET/CT systems? Eur J Radiol 2020; 129:109144. [PMID: 32593080 DOI: 10.1016/j.ejrad.2020.109144] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 05/13/2020] [Accepted: 06/16/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE To seek for the minimal duration per bed position with a digital PET system without compromising image quality and lesion detection in patients requiring fast 18F-FDG PET imaging. MATERIALS AND METHODS 19 cancer patients experiencing pain or dyspnea and 9 pediatric patients were scanned on a Vereos system. List mode data were reconstructed with decreasing time frame down to 10 s per bed position. Noise was evaluated in the liver, blood pool and muscle, and using target-to-background ratios. Five PET readers recorded image quality, number of clinically relevant foci and of involved anatomical sites in reconstructions ranging from 60 to 10 s per bed position, compared to the standard 90 s reconstruction. RESULTS The following reconstructions, which harboured a noise not significantly higher than that of the standard reconstruction, were selected for clinical evaluation: 1iterations/10 subsets/20sec (1i10 s20sec), 1i10 s30sec, and 2i10 sPSF60sec. Only the 60 s per bed acquisition displayed similar target-to-background ratios compared to the standard reconstruction, but mean ratios were still higher than 2.0 for the 30 s reconstruction. Inter-rater agreement for the number of involved anatomical sites and detected lesion was good or almost perfect (Kappa: 0.64-0.91) for all acquisitions. In particular, kappa for the 30 s per bed acquisition was 0.78 and 0.91 for lesion and anatomical sites number, respectively. Intra-rater agreement was also excellent for the 30 s reconstruction (kappa = 0.72). Median estimated total PET acquisition time for the 1i10 s30sec, and the standard reconstruction were 4 and 12 min, respectively. CONCLUSIONS Fast imaging is feasible with state-of-the-art PET systems. Acquisitions of 30 s per bed position are feasible with the Vereos system, requiring optimization of reconstruction parameters.
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Affiliation(s)
- Charline Lasnon
- Centre François Baclesse, Nuclear Medicine Department, Caen, France; INSERM ANTICIPE, Normandie University, Caen, France
| | | | - Benjamin Houdu
- CHU de Caen, Nuclear Medicine Department, Caen, France; Normandie University, France
| | | | | | | | - Nicolas Aide
- CHU de Caen, Nuclear Medicine Department, Caen, France; INSERM ANTICIPE, Normandie University, Caen, France; Normandie University, France.
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Albano D, Tomasini D, Bonù M, Giubbini R, Bertagna F. 18F-FDG PET or PET/CT role in plasmacytoma: A systematic review. Rev Esp Med Nucl Imagen Mol 2020; 39:220-224. [PMID: 32522411 DOI: 10.1016/j.remn.2019.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/04/2019] [Accepted: 12/12/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND The metabolic behavior of plasmacytoma at 18F-FDG PET/CT is not yet clear. OBJECTIVE The aim of this systematic review was to analyze published data about the role of 18F-FDG PET or PET/CT in patients affected by plasmacytoma. METHODS Acomprehensive computer literature search of the Scopus, PubMed/MEDLINE, Embase and Cochrane Library databases was conducted including articles up to July 2019 to find relevant published papers about the performance of 18F-FDG PET and PET/CT in plasmacytoma. RESULTS The comprehensive computer literature search revealed 371 articles. On reviewing the titles and abstracts, 363 articles were excluded because the reported data were not within the field of interest of this review. Eight articles were selected and retrieved in full-text version. From the analyses of the selected studies, the following main findings have been founded: 1) plasmacytoma generally is a 18F-FDG-avid tumor and PET/CT had good diagnostic performance with high sensitivity; 2) 18F-FDG PET/CT influenced patient management in most cases avoiding useless therapies and choosing the best therapeutic approach; 3) prognostic value of PET/CT qualitative and semiquantitative parameters is only suggested with controversial reports. CONCLUSION Despite several limitations affect this analysis, especially related to the low number of articles and patients studied, plasmacytoma looks to be an 18F-FDG-avid tumor in most of the cases; 18F-FDG PET or PET/CT had good diagnostic performance and had a significant clinical impact in change of therapeutic approach. Moreover, a possible prognostic role of PET/CT features is described.
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Affiliation(s)
- D Albano
- Nuclear Medicine, University of Brescia and Spedali Civili, Brescia, Italia.
| | - D Tomasini
- Department of Radiation Oncology, University of Brescia and Spedali Civili, Brescia, Italia
| | - M Bonù
- Department of Radiation Oncology, University of Brescia and Spedali Civili, Brescia, Italia
| | - R Giubbini
- Nuclear Medicine, University of Brescia and Spedali Civili, Brescia, Italia
| | - F Bertagna
- Nuclear Medicine, University of Brescia and Spedali Civili, Brescia, Italia
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Niñerola-Baizán A, Aguiar P, Cabrera-Martín MN, Vigil C, Gómez-Grande A, Lorenzo C, Rubí S, Sopena P, Camacho V. Relevance of quantification in brain PET studies with 18F-FDG. Rev Esp Med Nucl Imagen Mol 2020; 39:184-192. [PMID: 32345572 DOI: 10.1016/j.remn.2020.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 03/01/2020] [Accepted: 03/03/2020] [Indexed: 12/14/2022]
Abstract
The inclusion of 18F-FDG PET as a biomarker in the diagnostic criteria of neurodegenerative diseases and its indication in the presurgical assessment for drug-resistant epilepsies allow to improve specificity of these diagnosis. The traditional interpretation of neurological PET studies has been performed qualitatively, although in the last decade, several quantitative evaluation methods have emerged. This technical development has become relevant in clinical practice, improving specificity, reproducibility and reducing the interrater reliability derived from visual analysis. In this article we update/review the main imaging processing techniques currently used. This may allow the Nuclear Medicine physician to know their advantages and disadvantages when including these procedures in daily clinical practice.
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Affiliation(s)
- A Niñerola-Baizán
- Servicio de Medicina Nuclear, Hospital Clínic, Barcelona, España; Grupo de Imagen Biomédica, Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, España
| | - P Aguiar
- Grupo de Imaxe Molecular e Física Médica, Departamento de Radioloxía, Facultade de Medicina, Universidade de Santiago de Compostela, Santiago de Compostela, España; Servicio de Medicina Nuclear, Hospital Clínico de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, España
| | - M N Cabrera-Martín
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Madrid, España
| | - C Vigil
- Servicio Medicina Nuclear, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, España.
| | - A Gómez-Grande
- Servicio de Medicina Nuclear, Hospital Universitario 12 de Octubre, Madrid, España
| | - C Lorenzo
- Servicio de Medicina Nuclear, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España
| | - S Rubí
- Servicio de Medicina Nuclear, Hospital Universitari Son Espases, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, España
| | - P Sopena
- Servicio de Medicina Nuclear, Hospital Vithas-Nisa 9 de Octubre, Valencia, España; Servicio de Medicina Nuclear, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - V Camacho
- Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
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Chang Y, Donglan Y, Xinchong S, Ganhua L, Bing Z, Yao L, Rutong Z, Qiao H, Xiangsong Z. One-day protocol for 18F-FDG and 13N-ammonia PET/CT with uptake decoupling score in differentiating untreated low-grade glioma from inflammation. Rev Esp Med Nucl Imagen Mol 2020; 39:68-74. [PMID: 32005511 DOI: 10.1016/j.remn.2019.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/27/2019] [Accepted: 08/27/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Accurate identification of low-grade gliomas (LGGs; World Health Organization grades I and II) and their differentiation from brain inflammation lesions (BILs) remains difficult; however, it is essential for treatment. This study assessed whether a one-day protocol for voxel-wise 18F-FDG and 13N-ammonia PET/CT with uptake decoupling analysis could differentiate LGGs from BILs. MATERIALS AND METHODS Twenty-eight patients with LGGs and 16 patients with BILs underwent 18F-FDG and 13N-ammonia PET/CT on the same day before any type of therapy. The decoupling score and tumor-to-normal tissue (T/N) ratio of 18F-FDG and 13N-ammonia were calculated at each location. Student's t-test was used to compare values, and ROC curve analysis was used to establish a cut-off value for the T/N ratio and decoupling score. Area under the curve (AUC) was calculated to evaluate differential efficacy. RESULTS Significant differences were observed in 13N-ammonia T/N ratio (p=0.018) and decoupling score (p=0.003) between LGGs and BILs; however, the 18F-FDG T/N ratio did not show any differences (p=0.413). Optimal cut-off values for 18F-FDG T/N ratio, 13N-ammonia T/N ratio, and decoupling score were 0.73, 0.97, and 2.31, respectively, with corresponding AUCs of 0.48, 0.68, and 0.77. The respective sensitivity, specificity, and accuracy parameters using these cut-off values were 53.6%, 62.5%, and 56.8%, respectively, for 18F-FDG; 50.0%, 75.0%, and 59.1%, respectively, for 13N-ammonia; and 60.7%, 93.8%, and 72.7%, respectively, for decoupling score. CONCLUSIONS 18F-FDG/13N-ammonia uptake decoupling score can be used to discriminate between LGGs and BILs. Use of a decoupling map of these two tracers can improve visual analysis and diagnostic accuracy.
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Affiliation(s)
- Y Chang
- Department of Nuclear Medicine, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Y Donglan
- Department of Medical Engineering, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - S Xinchong
- Department of Nuclear Medicine, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - L Ganhua
- Department of Nuclear Medicine, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Z Bing
- Department of Nuclear Medicine, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - L Yao
- School of Data and Computer Science, Sun Yat-Sen University, Guangzhou, China
| | - Z Rutong
- School of Data and Computer Science, Sun Yat-Sen University, Guangzhou, China
| | - H Qiao
- Department of Nuclear Medicine, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Z Xiangsong
- Department of Nuclear Medicine, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
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Albano D, Durmo R, Treglia G, Giubbini R, Bertagna F. 18F-FDG PET/CT or PET Role in MALT Lymphoma: An Open Issue not Yet Solved-A Critical Review. Clin Lymphoma Myeloma Leuk 2019; 20:137-146. [PMID: 32029397 DOI: 10.1016/j.clml.2019.10.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 10/14/2019] [Accepted: 10/14/2019] [Indexed: 12/12/2022]
Abstract
Mucosa-associated lymphoid tissue (MALT) lymphoma involves the mucosa-associated lymphoid tissue potentially arising from any mucosal site, with the stomach as the most common site of involvement. MALT lymphoma is not usually an aggressive disease with a good prognosis except for selected cases. Fluorine-18 (18F) fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is a noninvasive imaging tool used for staging, restaging, and evaluation of the treatment response in non-Hodgkin and Hodgkin lymphoma. However, its effective role in MALT lymphoma is not yet clear. The open question is whether these lymphomas are 18F-FDG avid or not, with conflicting results reported in the literature. Consequently, the possible clinical role of 18F-FDG PET/CT for staging and restaging purposes is under debate. The aim of the present review was to analyze the reported data about the role of 18F-FDG PET or PET/CT in patients with MALT lymphoma. We performed a comprehensive computer literature search of the Scopus, Cochrane, PubMed/MEDLINE, and Embase databases, including articles reported up to August 2019. We included 32 studies that had analyzed 18F-FDG PET or PET/CT for patients with MALT lymphoma. We analyzed the metabolic behavior of MALT lymphoma using 18F-FDG PET and the effect of the PET findings in the staging, treatment response evaluation, and prognosis.
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Affiliation(s)
- Domenico Albano
- Department of Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy.
| | - Rexhep Durmo
- Department of Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy
| | - Giorgio Treglia
- Clinic of Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland; Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Health Technology Assessment Unit, General Directorate, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Raffaele Giubbini
- Department of Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy
| | - Francesco Bertagna
- Department of Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy
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Wang Z, Mao Z, Zhang X, He D, Wang X, Du Q, Xiao Z, Zhu D, Zhu Y, Wang H. Utility of 13N-Ammonia PET/CT to Detect Pituitary Tissue in Patients with Pituitary Adenomas. Acad Radiol 2019; 26:1222-8. [PMID: 30318288 DOI: 10.1016/j.acra.2018.09.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 11/24/2022]
Abstract
RATIONALE AND OBJECTIVES It is clinically essential, but sometimes challenging, to distinguish pituitary tissue from pituitary adenomas (PAs). It is helpful to avoid damage of pituitary tissue during management. We evaluated the ability of 13N-ammonia positron emission tomography (PET)/computed tomography (CT) to locate and distinguish pituitary tissue from PAs. MATERIALS AND METHODS Forty-eight patients (four with prolactinoma, 10 with Cushing's disease, 12 with acromegaly, and 22 with nonfunctional PAs) prospectively underwent magnetic resonance imaging (MRI), 13N-ammonia PET/CT, 18F-FDG PET/CT, prior to surgery. RESULTS Pituitary position could be determined in 31 (64.5%) patients by 13N-ammonia PET/CT, and by MRI in 26 (54.2%) patients. It was detected by 13N-ammonia PET/CT and MRI in eight of eight patients (100%) with pituitary microadenoma, tumor maximum diameter (TMD) <1 cm, and in nine of 10 patients (90%) with PAs with TMD ≥1 cm, but <2 cm. In 16 patients with PAs with TMD ≥2 cm, but <3 cm, pituitary tissue position was detected by 13N-ammonia PET/CT in nine (56%), and by MRI in 8 (50.0%) patients by MRI. In 14 patients with PAs with TMD ≥3 cm, pituitary tissue position was detected by 13N-ammonia PET/CT in five (35.7%) patient, and by MRI in 1 (7.1%). In seven patients, the pituitary tissue could be detected by 13N-ammonia PET, but not by MRI, and in two patients by MRI, but not by 13N-ammonia PET. CONCLUSION 13N-ammonia PET/CT imaging is a sensitive means for locating and distinguishing pituitary tissue from PAs, particularly those with TMD <2 cm. It is potentially valuable in detection of pituitary tissue in patients with PAs.
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Ottoy J, Verhaeghe J, Niemantsverdriet E, De Roeck E, Wyffels L, Ceyssens S, Van Broeckhoven C, Engelborghs S, Stroobants S, Staelens S. 18F-FDG PET, the early phases and the delivery rate of 18F-AV45 PET as proxies of cerebral blood flow in Alzheimer's disease: Validation against 15O-H 2O PET. Alzheimers Dement 2019; 15:1172-82. [PMID: 31405824 DOI: 10.1016/j.jalz.2019.05.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/27/2019] [Accepted: 05/21/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Dual-biomarker positron emission tomography (PET), providing complementary information on cerebral blood flow and amyloid-β deposition, is of clinical interest for Alzheimer's disease (AD). The purpose of this study was to validate the perfusion components of early-phase 18F-florbetapir (eAV45), the 18F-AV45 delivery rate (R1), and 18F-FDG against 15O-H2O PET and assess how they change with disease severity. METHODS This study included ten controls, 19 amnestic mild cognitive impairment, and 10 AD dementia subjects. Within-subject regional correlations between modalities, between-group regional and voxel-wise analyses of covariance per modality, and receiver operating characteristic analyses for discrimination between groups were performed. RESULTS FDG standardized uptake value ratio, eAV45 (0-2 min) standardized uptake value ratio, and AV45-R1 were significantly associated with H2O PET (regional Pearson r = 0.54-0.82, 0.70-0.94, and 0.65-0.92, respectively; P < .001). All modalities confirmed reduced cerebral blood flow in the posterior cingulate of patients with amnestic mild cognitive impairment and AD dementia, which was associated with lower cognition (r = 0.36-0.65, P < .025) and could discriminate between patient and control groups (area under the curve > 0.80). However, eAV45 was less sensitive to reflect the disease severity than AV45-R1 or FDG. DISCUSSION R1 is preferable over eAV45 for accurate representation of brain perfusion in dual-biomarker PET for AD.
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Luft C, Greggio S, Venturin GT, da Costa MS, da Costa JC, Donadio MVF. Sex differences in the effects of acute stress on cerebral glucose metabolism: A microPET study. Brain Res 2019; 1722:146355. [PMID: 31356782 DOI: 10.1016/j.brainres.2019.146355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/01/2019] [Accepted: 07/25/2019] [Indexed: 12/19/2022]
Abstract
Stress has been considered as a risk factor for the development and aggravation of several diseases. The hypothalamic-pituitary-adrenal axis (HPA) is one of the main actors for the stress response and homeostasis maintenance. Positron emission tomography (PET) has been used to evaluate neuronal activity and to study brain regions that may be related to the HPA axis response. Since neuroimaging is an important tool in detecting neuroendocrine-related changes, we used fluorodeoxyglucose-18 (18F-FDG) and positron emission microtomography (microPET) to evaluate sexual differences in the glucose brain metabolism after 10, 30 and 40 min of acute stress in Balb/c mice. We also investigated the effects of restraint stress in blood, liver and adrenal gland 18F-FDG biodistribution using a gamma counter. A decreased glucose uptake in the whole brain in both females and males was found. Additionally, there were time and sex-dependent alterations in the 18F-FDG uptake after restraint stress in specific brain regions, indicating that males could be more vulnerable to the short-term effects of acute stress. According to the gamma counter biodistribution, only females showed a significant decreased glucose uptake in the blood, liver and right adrenal after restraint stress. In addition, in comparisons between the sexes, males showed a decreased glucose uptake in the whole brain and in several brain regions compared to females. In conclusion, exposure to acute restraint stress resulted in significant decreased glucose metabolism in the brain, with particular effects in different regions and organs in a sex-specific manner.
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Kong Z, Jiang C, Zhu R, Feng S, Wang Y, Li J, Chen W, Liu P, Zhao D, Ma W, Wang Y, Cheng X. 18F-FDG-PET-based radiomics features to distinguish primary central nervous system lymphoma from glioblastoma. Neuroimage Clin 2019; 23:101912. [PMID: 31491820 PMCID: PMC6702330 DOI: 10.1016/j.nicl.2019.101912] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 06/22/2019] [Accepted: 06/25/2019] [Indexed: 12/28/2022]
Abstract
The differential diagnosis of primary central nervous system lymphoma from glioblastoma multiforme (GBM) is essential due to the difference in treatment strategies. This study retrospectively reviewed 77 patients (24 with lymphoma and 53 with GBM) to identify the stable and distinguishable characteristics of lymphoma and GBM in 18F-fluorodeocxyglucose (FDG) positron emission tomography (PET) images using a radiomics approach. Three groups of maps, namely, a standardized uptake value (SUV) map, an SUV map calibrated with the normal contralateral cortex (ncc) activity (SUV/ncc map), and an SUV map calibrated with the normal brain mean (nbm) activity (SUV/nbm map), were generated, and a total of 107 radiomics features were extracted from each SUV map. The margins of the ROI were adjusted to assess the stability of the features, and the area under the curve (AUC) of the receiver operating characteristic curve of each feature was compared with the SUVmax to evaluate the distinguishability of the features. Nighty-five radiomics features from the SUV map were significantly different between lymphoma and GBM, 46 features were numeric stable after marginal adjustment, and 31 features displayed better performance than SUVmax. Features extracted from the SUV map demonstrated higher AUCs than features from the further calibrated maps. Tumors with solid metabolic patterns were also separately evaluated and revealed similar results. Thirteen radiomics features that were stable and distinguishable than SUVmax in every circumstance were selected to distinguish lymphoma from glioblastoma, and they suggested that lymphoma has a higher SUV in most interval segments and is more mathematically heterogeneous than GBM. This study suggested that 18F-FDG-PET-based radiomics is a reliable noninvasive method to distinguish lymphoma and GBM. 18F-FDG-PET is a reliable technique to differentiate primary CNS lymphoma from GBM. Radiomics identify the stable and distinguishable characteristics of lymphoma and GBM. 18F-FDG-PET-based radiomics provide assistance to the preoperative diagnosis.
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Affiliation(s)
- Ziren Kong
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Chendan Jiang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Ruizhe Zhu
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Shi Feng
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Yaning Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Jiatong Li
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China; School of Medicine, Tsinghua University, Haidian District, Beijing, China
| | - Wenlin Chen
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Penghao Liu
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Dachun Zhao
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Wenbin Ma
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Yu Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Xin Cheng
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China.
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Bascuñana P, García-García L, Javela J, Fernández de la Rosa R, Shiha AA, Kelly J, Delgado M, Pozo MÁ. PET Neuroimaging Reveals Serotonergic and Metabolic Dysfunctions in the Hippocampal Electrical Kindling Model of Epileptogenesis. Neuroscience 2019; 409:101-110. [PMID: 31034972 DOI: 10.1016/j.neuroscience.2019.04.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/10/2019] [Accepted: 04/12/2019] [Indexed: 12/29/2022]
Abstract
Glucose metabolism and serotonergic neurotransmission have been reported to play an important role in epileptogenesis. We therefore aimed to use neuroimaging to evaluate potential alterations in serotonin 5-HT1A receptor and glucose metabolism during epileptogenesis in the rat electrical kindling model. To achieve this goal, we performed positron emission tomography (PET) imaging in a rat epileptogenesis model triggered by electrical stimulation of the hippocampus using 2-deoxy-2-[18F]fluoro-D-glucose (18F-FDG), a radiolabeled analog of glucose, and 2'-methoxyphenyl-(N-2'-pyridinyl)-p-18F-fluoro-benzamidoethylpiperazine (18F-MPPF), a radiolabeled 5-HT1A receptor ligand, to evaluate brain metabolism and 5-HT1A receptor functionality. Since the 5-HT1A receptor is also highly expressed in astrocytes, glial fibrillary acidic protein (GFAP) immunofluorescence was performed to detect astrogliosis arising from the kindling procedure once the study was finalized. Lastly, in vitro18F-MPPF autoradiography was performed to evaluate changes in 5HT1A receptor expression. 18F-FDG PET showed reduction of glucose uptake in cortical structures, whereas 18F-MPPF PET revealed an enhancement of tracer binding potential (BPND) in key areas rich in 5-HT1A receptor involved in epilepsy, including septum, hippocampus and entorhinal cortex of kindled animals compared to controls. However, in vitro 5-HT1A receptor autoradiography showed no changes in densitometric signal in any brain region, suggesting that the augmentation in BPND found by PET could be caused by reduction of synaptic serotonin. Importantly, astroglial activation was detected in the hippocampus of kindled rats. Overall, electrical kindling induced hypometabolism, astrogliosis and serotonergic alterations in epilepsy-related regions. Furthermore, the present findings point to 5-HT1A receptor as a valuable epileptogenesis biomarker candidate and a potential therapeutic target.
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Affiliation(s)
- Pablo Bascuñana
- Unidad de Cartografía Cerebral, Instituto Pluridisciplinar, Universidad Complutense de Madrid, Paseo Juan XXIII, 1, 28040, Madrid, Spain.
| | - Luis García-García
- Unidad de Cartografía Cerebral, Instituto Pluridisciplinar, Universidad Complutense de Madrid, Paseo Juan XXIII, 1, 28040, Madrid, Spain; Departamento de Farmacología, Farmacognosia y Botánica, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040, Madrid, Spain
| | - Julián Javela
- Grupo de Clínica y Salud Mental, Programa de Psicología, Universidad Católica de Pereira, Av Sur/Las Américas, Pereira, Colombia
| | - Rubén Fernández de la Rosa
- Unidad de Cartografía Cerebral, Instituto Pluridisciplinar, Universidad Complutense de Madrid, Paseo Juan XXIII, 1, 28040, Madrid, Spain
| | - Ahmed Anis Shiha
- Unidad de Cartografía Cerebral, Instituto Pluridisciplinar, Universidad Complutense de Madrid, Paseo Juan XXIII, 1, 28040, Madrid, Spain
| | - James Kelly
- Department of Radiology, Weill Cornell Medicine, New York, NY 10021, USA; Curium Pharma Spain (formerly Instituto Tecnológico PET), C/ Manuel Bartolomé Cossío, 10, 28040, Madrid, Spain
| | - Mercedes Delgado
- Unidad de Cartografía Cerebral, Instituto Pluridisciplinar, Universidad Complutense de Madrid, Paseo Juan XXIII, 1, 28040, Madrid, Spain; Departamento de Farmacología, Farmacognosia y Botánica, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040, Madrid, Spain
| | - Miguel Ángel Pozo
- Unidad de Cartografía Cerebral, Instituto Pluridisciplinar, Universidad Complutense de Madrid, Paseo Juan XXIII, 1, 28040, Madrid, Spain; Curium Pharma Spain (formerly Instituto Tecnológico PET), C/ Manuel Bartolomé Cossío, 10, 28040, Madrid, Spain; Departamento de Fisiología, Facultad de Medicina, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040, Madrid, Spain
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41
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Bonacina M, Albano D, Gazzilli M, Durmo R, Cerudelli E, Bosio G, Bertagna F, Giubbini R. 18F-FDG PET/CT brown fat detection: Differences between adult and pediatric population in a 12 year experience. Rev Esp Med Nucl Imagen Mol 2019; 38:224-228. [PMID: 30987886 DOI: 10.1016/j.remn.2019.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 12/11/2018] [Accepted: 01/21/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To analyze epidemiological and anthropometric features of patients with brown adipose tissue (BAT) activation detected by fluorine18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). MATERIAL AND METHODS From 2005 to 2017, 818 18F-FDG PET/CT studies positive for BAT detection were retrospectively included, 742 examinations performed on the adult population and 76 PET/CT on the pediatric population. A Chi-squared test was performed to compare features distribution between the adult and pediatric patients. RESULTS Adults showed a higher rate of BAT detection in females (79% vs. 61%, P<0.001) and in hyperglycaemic patients (>100mg/dL) (24% vs. 16%, P=0.02), no significant difference was found with regard to overweight patients (BMI>25kg/m2) (22% vs. 20%, P=.55). Considering females only, the adults showed a higher rate of BAT detection both in hyperglycaemic (83% vs. 42%, P<0.001) and overweight patients (80% vs. 67%, P=0.005). In both populations BAT activation happened more frequently in cold seasons; there was no significant distribution difference with regard to season of birth (P=0.2). CONCLUSIONS Sex, glycemia and BMI play a major role in predicting BAT activation, with significant differences between adults and pediatric patients. Cold exposure is confirmed as an important predicting factor, while season of birth is not significant.
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Affiliation(s)
- M Bonacina
- Nuclear Medicine, Spedali Civili Brescia, Brescia, Italia.
| | - D Albano
- Nuclear Medicine, Spedali Civili Brescia, Brescia, Italia
| | - M Gazzilli
- Nuclear Medicine, Spedali Civili Brescia, Brescia, Italia
| | - R Durmo
- Nuclear Medicine, Spedali Civili Brescia, Brescia, Italia
| | - E Cerudelli
- Nuclear Medicine, Spedali Civili Brescia, Brescia, Italia
| | - G Bosio
- Nuclear Medicine, Spedali Civili Brescia, Brescia, Italia
| | - F Bertagna
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italia
| | - R Giubbini
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italia
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Kim SJ, Lee SW, Jeong SY, Pak K, Kim K. A systematic review and meta-analysis of 18F-fluorodeoxyglucose positron emission tomography or positron emission tomography/computed tomography for detection of infected prosthetic vascular grafts. J Vasc Surg 2019; 70:307-313. [PMID: 30922755 DOI: 10.1016/j.jvs.2019.01.051] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 01/05/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The purpose of this investigation was to evaluate the diagnostic accuracy of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) or PET/computed tomography (PET/CT) for the detection of vascular prosthetic graft infection (VPGI) using a diagnostic accuracy test. METHODS The MEDLINE/PubMed and Embase databases, from the earliest available date of indexing through March 31, 2018, were searched for results investigating the diagnostic accuracy of 18F-FDG PET or PET/CT for the detection of VPGI. We calculated the pooled sensitivities and specificities of included studies, calculated positive and negative likelihood ratios, and obtained summary receiver operating characteristic curves. RESULTS Across 10 studies (286 patients), the pooled sensitivity was 0.96 (95% confidence interval [CI], 0.89-0.98) without heterogeneity (I2 = 40.2; 95% CI, 0.0-84.4; P = .09), and pooled specificity was 0.74 (95% CI, 0.67-0.81) without heterogeneity (I2 = 39.9; 95% CI, 0.0-84.3; P = .09). Likelihood ratio syntheses showed an overall positive likelihood ratio of 3.7 (95% CI, 2.9-4.9) and negative likelihood ratio of 0.06 (95% CI, 0.02-0.15). The pooled diagnostic odds ratio was 63 (95% CI, 23-173). The hierarchical summary receiver operating characteristic curve showed the area under the curve to be 0.87 (95% CI, 0.83-0.89). CONCLUSIONS This study showed the high sensitivity and moderate specificity of 18F-FDG PET or PET/CT for the detection of VPGI. The clinical usefulness of 18F-FDG PET or PET/CT for detection of VPGI should be validated through further large multicenter studies.
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Affiliation(s)
- Seong-Jang Kim
- Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea; BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea; Department of Nuclear Medicine, College of Medicine, Pusan National University, Yangsan, Korea.
| | - Sang-Woo Lee
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Korea; Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Shin Young Jeong
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Korea; Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Kyoungjune Pak
- Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea
| | - Keunyoung Kim
- Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea
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Üstün F, Tokuc B, Tastekin E, Durmuş Altun G. Tumor characteristics of lung cancer in predicting axillary lymph node metastases. Rev Esp Med Nucl Imagen Mol 2019; 38:80-86. [PMID: 30638878 DOI: 10.1016/j.remn.2018.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/29/2018] [Accepted: 09/08/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE In lung cancer, axillary lymph node metastases (ALM) are rare, and according to the 8th grading system, it is classified as M1b disease. The aim of this study is to evaluate1) the presence of ALM and2) the effect of the primary tumors characteristics on the development of ALM. METHODS We performed a descriptive cross-sectional study, with retrospective revision, to identify ALM. RESULTS There were 157 patients included in this analysis: ALM (63 patients) and control group (94 patients). The presence of extrathoracic lymph node, contralateral pulmonary parenchymal and distant metastasis and all SUVmax values were significantly higher in the study group versus the control group (P<0.05). The SUVmax value of the primary tumor was not a predictor of ALM. According to the primary histopathologic diagnosis, small cell lung cancer was found to cause ALM development 3.4 times as much as squamous cancer (SQC) (OR: 3.40 [95% CI 1.3-10.20], P=0.029) and adenocarcinoma group was found to cause ALM development 4 times as much as SQC (OR: 4.02 [95% CI 1.73-9.34], P=0.001). The likelihood of developing ALM was significantly higher in tumors located in the central and upper lobe versus the lower lobe. CONCLUSION The finding of ALM on PET/CT images, the necessity of histopathologic confirmation is determined according to the results of primary tumor localization, primary tumor histopathology, M stage on PET/CT imaging, localization of ALM according to primary tumor, and N stage on PET/CT imaging.
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Affiliation(s)
- F Üstün
- Trakya University, Faculty of Medicine, Department of Nuclear Medicine, Edirne, Turquía.
| | - B Tokuc
- Trakya University, Faculty of Medicine, Department of Public Health, Edirne, Turquía
| | - E Tastekin
- Trakya University, Faculty of Medicine, Department of Pathology, Edirne, Turquía
| | - G Durmuş Altun
- Trakya University, Faculty of Medicine, Department of Nuclear Medicine, Edirne, Turquía
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Abstract
Bone is the most common site of metastases from advanced breast cancer. Whole-body bone scintigraphy has been most frequently used in the process of managing cancer patients; its advantage is that it provides rapid whole-body imaging for screening of osteoblastic or sclerotic/mixed bone metastases at reasonable cost. Recent advanced techniques, such as single-photon emission computed tomography (SPECT)/CT, quantitative analysis, and bone scan index, contribute to better understanding of the disease state. More recent advances in machines and PET drugs improve the staging of the skeleton with higher sensitivity and specificity.
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Abstract
Nuclear medicine studies evaluate physiology on a molecular level providing earlier detection of lesions before morphologic change is evident. 99mTc-MDP and 18F-fluoride bone scans detect osteomyelitis earlier than radiographs and computed tomography (CT); aid in diagnosis of temporomandibular joint disorder; and evaluate activity of condylar hyperplasia, extent of Paget disease, and viability of bone grafts. 18F-FDG PET/CT distinguish between soft tissue and bone infections and diagnose osteomyelitis complicated by fracture or surgery. FDG PET is more accurate than CT alone and has a major role in staging, restaging, and assessing response to therapy for head and neck malignancies and in detecting sequelae of therapy.
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Affiliation(s)
- Heidi R Wassef
- Department of Radiology, Keck School of Medicine of USC, PET Center, 1500 San Pablo Street, Los Angeles, CA 90033, USA.
| | - Patrick M Colletti
- Department of Radiology, Keck School of Medicine of USC, GNH 3549, Off Campus, Los Angeles, CA 90089-9311, USA
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Aguadé Bruix S, Roque Pérez A, Cuéllar Calabria H, Pizzi MN. Cardiac 18F-FDG PET/CT procedure for the diagnosis of prosthetic endocarditis and intracardiac devices. Rev Esp Med Nucl Imagen Mol 2018; 37:163-171. [PMID: 29496402 DOI: 10.1016/j.remn.2018.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 01/17/2018] [Accepted: 01/23/2018] [Indexed: 11/17/2022]
Abstract
Infective endocarditis (IE) is a serious condition with a poor prognosis, its mortality unchanged significantly despite diagnostic and therapeutic advances in the last 30years. The diagnostic ability of the modified Duke criteria in prosthetic endocarditis and/or devices does not exceed 50%, so new tools are necessary for the diagnosis of this entity in this context. The 18F-FDG PET/CTA combines a highly sensitive technique to detect inflammatory-infectious activity with a technique with high anatomical resolution to assess the structural lesions associated with endocarditis. With a diagnostic sensitivity between 91-97%, this hybrid technique has become a useful diagnostic tool for patients with prosthetic valves or devices and suspicion of IE, becoming a major criterion in the diagnostic algorithm of current guidelines. This excellent diagnostic ability depends directly on the quality of the obtained exploration and the knowledge at the time of interpreting the images. The aim of this review is to describe and standardize the methodology of cardiac 18F-FDG PET/CTA in the diagnosis of endocarditis in prosthetic valves and intracardiac devices, with special emphasis on the particularities of the patient's preparation, the PET and CT acquisition procedures, and the subsequent imaging postprocessing and interpretation.
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Affiliation(s)
- S Aguadé Bruix
- Servicio de Medicina Nuclear, Hospital Universitari Vall d'Hebron, Barcelona, España; VHIR: Vall d'Hebron Institut de Recerca, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España.
| | - A Roque Pérez
- Servicio de Radiología, Hospital Universitari Vall d'Hebron, Barcelona, España; IDI: Institut de Diagnòstic per la Imatge, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España
| | - H Cuéllar Calabria
- Servicio de Radiología, Hospital Universitari Vall d'Hebron, Barcelona, España; IDI: Institut de Diagnòstic per la Imatge, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España
| | - M N Pizzi
- Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Barcelona, España; VHIR: Vall d'Hebron Institut de Recerca, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España
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Jiménez-Ballvé A, García García-Esquinas M, Salsidua-Arroyo O, Serrano-Palacio A, García-Sáenz JA, Ortega Candil A, Fuentes Ferrer ME, Rodríguez Rey C, Román-Santamaría JM, Moreno F, Carreras-Delgado JL. Prognostic value of metabolic tumour volume and total lesion glycolysis in 18F-FDG PET/CT scans in locally advanced breast cancer staging. Rev Esp Med Nucl Imagen Mol 2018; 35:365-372. [PMID: 26948652 DOI: 10.1016/j.remn.2016.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 01/19/2016] [Accepted: 01/26/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine whether metabolic tumour volume (MTV) and total lesion glycolysis (TLG) are able to predict recurrence risk in locally advanced breast cancer (LABC) patients. MATERIAL AND METHODS Retrospective study of LABC patients who undertook neoadjuvant, local and adjuvant treatment and follow up. A 18F-FDG PET/CT study for initial staging was performed analysing in this study different metabolic parameters (MTV, TLG, SUVmax and SUVmed) both in the primary tumour (T) as well as in axillary nodes (N) and whole-body (WB). RESULTS Forty females were included between January 2010-2011; follow up until January 2015 was completed. The average follow-up was 46 months. Twenty percent presented recurrence: local disease (n=2) and distant metastasis (n=6); 3 patients died (38% of the patients which recurred and 7.5% from the total). SUVmax, MTV and TLG, in T, N and WB, were higher in those patients with recurrence. The MTV and TLG parameters in the tumour (T) were related to the recurrence rate (P=.020 and P=.028, respectively); whereas SUVmax in the lymph nodes (N) was significantly related (P=.008) to the recurrence rate. The best cut-off points to predict recurrence where: MTV T ≥19.3cm3, TLG T≥74.4g and SUVmax N≥13.8, being 10-12 times more likely to recidivate when these thresholds where exceeded. Tumour grade was the only clinical-pathological variable which was related to recurrence probability (p=.035). CONCLUSIONS In this study of LABC patients the metabolic parameters which have a better relationship with recurrence rate are: MTV and TLG in the primary tumour, SUVmax in the regional lymph node disease and whole-body PET data.
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Affiliation(s)
- A Jiménez-Ballvé
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España.
| | - M García García-Esquinas
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - O Salsidua-Arroyo
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - A Serrano-Palacio
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - J A García-Sáenz
- Servicio de Oncología Médica, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - A Ortega Candil
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - M E Fuentes Ferrer
- Unidad de Gestión Clínica de Medicina Preventiva, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - C Rodríguez Rey
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - J M Román-Santamaría
- Servicio de Ginecología y Obstetricia, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - F Moreno
- Servicio de Oncología Médica, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - J L Carreras-Delgado
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
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Sundermann B, Schröder JB, Warnecke T, Heindel W, Schäfers M, Weckesser M, Buerke B. Imaging Workup of Suspected Classical Paraneoplastic Neurological Syndromes: A Systematic Review and Retrospective Analysis of 18F-FDG-PET-CT. Acad Radiol 2017; 24:1195-1202. [PMID: 28551401 DOI: 10.1016/j.acra.2017.03.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/29/2017] [Accepted: 03/30/2017] [Indexed: 11/17/2022]
Abstract
RATIONALE AND OBJECTIVES This study aimed to assess the clinical efficacy of positron emission tomography (PET) or combined PET-computed tomography (CT) with 18F-fluorodeoxyglucose (FDG) for whole-body cancer screening in patients with suspected paraneoplastic neurological syndromes (PNS). The following main research questions were addressed: What is the percentage of positive findings to be expected in whole-body FDG-PET-CT in adult patients with PNS? How many false positives can be expected as assessed by clinical and histopathological workup? Are there patients who present with a tumor despite initially negative findings? MATERIALS AND METHODS This is a systematic review of the literature and retrospective analysis of FDG-PET-CT and clinical follow-up data from 45 consecutive patients (age: 56.6 ± standard deviation 15.8 years, 14 female, 31 male). Suspicious lesions were identified and correlated with immediate workup and clinical follow-up. RESULTS Fourteen studies were included in the review. Eleven malignancies (24.4% of patients) were identified by FDG-PET-CT in this sample. This is a higher percentage of positive findings compared to most previous reports. There was one initially negative finding. CONCLUSIONS Whole-body FDG-PET-CT is suitable to identify additional malignancies in patients with suspected classical PNS referred to a tertiary medical center. The utility by means of true-positive findings is higher in classical PNS than suggested by studies in less select patient populations.
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Affiliation(s)
- Benedikt Sundermann
- University Hospital Münster, Department of Clinical Radiology, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Münster, Germany.
| | | | - Tobias Warnecke
- University Hospital Münster, Department of Neurology, 48149 Münster, Germany
| | - Walter Heindel
- University Hospital Münster, Department of Clinical Radiology, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Münster, Germany
| | - Michael Schäfers
- University Hospital Münster, Department of Nuclear Medicine, 48149 Münster, Germany; University of Münster, DFG EXC 1003 "Cells in Motion" Cluster of Excellence, 48149 Münster, Germany; University of Münster, European Institute of Molecular Imaging, 48149 Münster, Germany
| | - Matthias Weckesser
- University Hospital Münster, Department of Nuclear Medicine, 48149 Münster, Germany
| | - Boris Buerke
- University Hospital Münster, Department of Clinical Radiology, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Münster, Germany
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Servente L, Gigirey V, García Fontes M, Alonso O. Incidental focal colonic uptake in studies 18F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol 2017; 37:15-19. [PMID: 28750749 DOI: 10.1016/j.remn.2017.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 03/06/2017] [Accepted: 03/09/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To assess the frequency of focal colonic uptake as an incidental observation in 18F-FDG PET/CT studies, and to correlate this finding with histopathological results. MATERIAL AND METHODS Out of a total of 3,176 PET/CT studies with 18F-FDG systematic analysis was carried out on 30 studies in which colonic focal uptake was observed. Patients with known colorectal neoplasia were excluded. The maximum standardised uptake values (SUVm) and the morphological findings provided by the CT were recorded. The studies were reported by a radiologist and a nuclear medicine doctor. The findings were compared with endoscopy and pathology findings. RESULTS Of the 30 patients with focal hypermetabolic lesions of the colon (0.94%), 15 were men and 15 were women with ages between 27 and 73 (mean 55 years). The reasons for PET/CT were bronchopulmonary cancer (4), breast cancer (4), tumour of unknown origin (4), melanoma (3), renal carcinoma (3), cervical neoplasia (2), adenocarcinoma of ovary (2), and others (8). Of the 23 colonoscopies performed, 10 patients (43.4%) had malignant lesions, 6 (26.1%) had pre-malignant lesions, and in 7 patients (30.4%) no lesion was identified or was benign. No endoscopy was performed on 7 patients for various reasons (patient refusal to perform the study, advanced oncological disease). An analysis was performed with the SUVm, with no statistically significant differences being found between malignant-premalignant lesions and benign lesions. CONCLUSIONS Focal uptake in the colon of 18F-FDG has clinical relevance, and is mainly associated with morphological lesions in CT. It should be evaluated, as it may be a second tumour or a pre-malignant lesion. It is recommended that all focal uptakes of the colon be evaluated with endoscopy.
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Affiliation(s)
- L Servente
- Centro Uruguayo de Imagenología Molecular (CUDIM), Montevideo, Uruguay.
| | - V Gigirey
- Centro Uruguayo de Imagenología Molecular (CUDIM), Montevideo, Uruguay
| | - M García Fontes
- Centro Uruguayo de Imagenología Molecular (CUDIM), Montevideo, Uruguay
| | - O Alonso
- Centro Uruguayo de Imagenología Molecular (CUDIM), Montevideo, Uruguay
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Rubí S, Noguera A, Tarongí S, Oporto M, García A, Vico H, Espino A, Picado MJ, Mas A, Peña C, Amer G. Concordance between brain 18F-FDG PET and cerebrospinal fluid biomarkers in diagnosing Alzheimer's disease. Rev Esp Med Nucl Imagen Mol 2018; 37:3-8. [PMID: 28645685 DOI: 10.1016/j.remn.2017.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Cortical posterior hypometabolism on PET imaging with 18F-FDG (FDG-PET), and altered levels of Aß1-42 peptide, total Tau (tTau) and phosphorylated Tau (pTau) proteins in cerebrospinal fluid (CSF) are established diagnostic biomarkers in Alzheimer's disease (AD). An evaluation has been made of the concordance and relationship between the results of FDG-PET and CSF biomarkers in symptomatic patients with suspected AD. MATERIAL AND METHODS A retrospective review was carried out on 120 patients with cognitive impairment referred to our Cognitive Neurology Unit, and who were evaluated by brain FDG-PET and a lumbar puncture for CSF biomarkers. In order to calculate their Kappa coefficient of concordance, the result of the FDG-PET and the set of the three CSF biomarkers in each patient was classified as normal, inconclusive, or AD-compatible. The relationship between the results of both methods was further assessed using logistic regression analysis, including the Aß1-42, tTau and pTau levels as quantitative predictors, and the FDG-PET result as the dependent variable. RESULTS The weighted Kappa coefficient between FDG-PET and CSF biomarkers was 0.46 (95% CI: 0.35-0.57). Logistic regression analysis showed that the Aß1-42 and tTau values together were capable of discriminating an FDG-PET result metabolically suggestive of AD from one non-suggestive of AD, with a 91% sensitivity and 93% specificity at the cut-off line Aß1-42=44+1.3×tTau. CONCLUSIONS The level of concordance between FDG-PET and CSF biomarkers was moderate, indicating their complementary value in diagnosing AD. The Aß1-42 and tTau levels in CSF help to predict the patient FDG-PET cortical metabolic status.
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