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Kouzu K, Tsujimoto H, Tamura K, Einama T, Kishi Y, Ishida J, Ueno H. Impact of retention index on the neoadjuvant chemotherapy effect and the prognosis in oesophageal cancer. Jpn J Clin Oncol 2023; 53:1130-1137. [PMID: 37626445 DOI: 10.1093/jjco/hyad115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVE The relationship between retention index calculated from dual-time point 18F-fluorodeoxyglucose positron emission tomography-computed tomography and oesophageal cancer prognosis remains unknown. This study aimed to determine usefulness of retention index as a predictor of long-term prognosis of oesophageal cancer and neoadjuvant chemotherapy efficacy. METHODS A total of 151 patients with oesophageal cancer who underwent esophagectomy were evaluated retrospectively in this study. We acquired positron emission tomography scans 60 and 120 min (SUVmax1 and SUVmax2, respectively) after the intravenous administration of 3.7 Mbq/kg 18F-fluorodeoxyglucose. The patients were divided into two groups: high-retention index (retention index ≥29%, 107 patients) and low-retention index (retention index <29%, 44 patients). Retention index was calculated as follows: retention index (%) = [(SUVmax2 - SUVmax1)/SUVmax1] × 100. RESULTS The overall survival and relapse-free survival rates in the high-retention index group were significantly lower than those in the low-retention index group (P < 0.001). Our multivariate analysis identified that the high-retention index group contained independent risk factors for overall survival (hazard ratio: 2.44, P = 0.009) and relapse-free survival (hazard ratio: 2.61, P = 0.002). The high-retention index group exhibited a lower partial response rate to neoadjuvant chemotherapy evaluated by computed tomography (P < 0.001) and a lower pathological therapeutic effect in the resected specimen (P = 0.019) than the low-retention index group. CONCLUSIONS The retention index was associated with neoadjuvant chemotherapy responses and long-term prognosis for oesophageal cancer.
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Affiliation(s)
- Keita Kouzu
- Department of Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Hironori Tsujimoto
- Department of Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan
| | | | - Takahiro Einama
- Department of Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yoji Kishi
- Department of Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Jiro Ishida
- Eijinkai Seeds Clinic, Tokorozawa, Saitama, Japan
| | - Hideki Ueno
- Department of Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan
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Abraham AG, Riauka T, Hudson M, Ghosh S, Zebak S, Alba V, Vaihenberg E, Warkentin H, Tankel K, Severin D, Bedard E, Spratlin J, Mulder K, Joseph K. 18F-Fluorodeoxyglucose Positron Emission Tomography Parameters can Predict Long-Term Outcome Following Trimodality Treatment for Oesophageal Cancer. Clin Oncol (R Coll Radiol) 2023; 35:177-187. [PMID: 36402622 DOI: 10.1016/j.clon.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/06/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022]
Abstract
AIMS 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18FDG-PET/CT) is routinely used for the pre-treatment staging of oesophageal or gastro-oesophageal junction cancers (EGEJC). The aim of this study was to identify objective 18FDG-PET/CT-derived parameters that can aid in predicting the patterns of recurrence and prognostication in patients with EGEJC. PATIENTS AND METHODS EGEJC patients referred for consideration of preoperative chemoradiation therapy were identified and clinicopathological data were collected. 18FDG-PET/CT imaging data were reviewed and correlated with treatment outcomes. Maximum standardised uptake value (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis were assessed and association with recurrence-free survival (RFS), locoregional recurrence-free survival (LR-RFS), oesophageal cancer-specific survival (ECSS) and overall survival were evaluated using receiver operating characteristic curves, as well as Cox regression and Kaplan-Meier models. RESULTS In total, 191 EGEJC patients completed trimodality treatment and 164 with 18FDG-PET/CT data were included in this analysis. At the time of analysis, 15 (9.1%), 70 (42.7%) and two (1.2%) patients were noted to have locoregional, distant and both locoregional and distant metastases, respectively. The median RFS was 30 months (9.6-50.4) and the 5-year RFS was 31.1%. The 5-year overall survival and ECSS were both noted to be 34.8%. Pre-treatment MTV25 > 28.5 cm3 (P = 0.029), MTV40 > 12.4 cm3 (P = 0.018) and MTV50 > 10.2 cm3 (P = 0.005) predicted for worse LR-RFS, ECSS and overall survival for MTV definition of voxels ≥25%, 40% and 50% of SUVmax. CONCLUSION 18FDG-PET/CT parameters MTV and total lesion glycolysis are useful prognostic tools to predict for LR-RFS, ECSS and overall survival in EGEJC. MTV had the highest accuracy in predicting clinical outcomes. The volume cut-off points we identified for different MTV thresholds predicted outcomes with significant accuracy and may potentially be used for decision making in clinical practice.
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Affiliation(s)
- A G Abraham
- Division of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - T Riauka
- Department of Nuclear Medicine, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada; Division of Medical Physics, Department of Oncology, University of Alberta, Edmonton, Canada
| | - M Hudson
- Department of Nuclear Medicine, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - S Ghosh
- Division of Medical Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - S Zebak
- Division of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - V Alba
- Division of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - E Vaihenberg
- Division of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - H Warkentin
- Division of Medical Physics, Department of Oncology, University of Alberta, Edmonton, Canada
| | - K Tankel
- Division of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - D Severin
- Division of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - E Bedard
- Department of Thoracic Surgery, Royal Alexandra Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - J Spratlin
- Division of Medical Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - K Mulder
- Division of Medical Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - K Joseph
- Division of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada.
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Yamatsuji T, Ishida N, Takaoka M, Hayashi J, Yoshida K, Shigemitsu K, Urakami A, Haisa M, Naomoto Y. False-Positive Cases of Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomographic Scans in Metastasis of Esophageal Cancer. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2017; 10:1179547617703402. [PMID: 28469502 PMCID: PMC5398648 DOI: 10.1177/1179547617703402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 03/09/2017] [Indexed: 11/15/2022]
Abstract
Of 129 esophagectomies at our institute from June 2010 to March 2015, we experienced three preoperative positron emission tomography-computed tomographic (PET/CT) false positives. Bone metastasis was originally suspected in 2 cases, but they were later found to be bone metastasis negative after a preoperative bone biopsy and clinical course observation. The other cases suspected of mediastinal lymph node metastasis were diagnosed as inflammatory lymphadenopathy by a pathological examination of the removed lymph nodes. Conducting a PET/CT is useful when diagnosing esophageal cancer metastasis, but we need to be aware of the possibility of false positives. Therapeutic decisions should be made based on appropriate and accurate diagnoses, with pathological diagnosis actively introduced if necessary.
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Affiliation(s)
- Tomoki Yamatsuji
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Naomasa Ishida
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Munenori Takaoka
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Jiro Hayashi
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Kazuhiro Yoshida
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Kaori Shigemitsu
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Atsushi Urakami
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Minoru Haisa
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Yoshio Naomoto
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
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Chang CC, Tu HP, Chen YW, Lin CY, Hou MF. Tumour and lymph node uptakes on dual-phased 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography correlate with prognostic parameters in breast cancer. J Int Med Res 2014; 42:1209-21. [PMID: 25339454 DOI: 10.1177/0300060514549785] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To examine correlations between the uptake of 2-deoxy-2-[18F]fluoro-D-glucose (FDG) by primary tumours and axillary lymph nodes, and clinical and biological tumour prognostic parameters, in patients with newly diagnosed breast cancer. METHODS Newly diagnosed breast cancer patients who had received a dual-phased FDG positron emission tomography/computed tomography scan for pretreatment staging were enrolled retrospectively. Maximal standardized uptake values at 1 h (SUV1), 2 h (SUV2), and retention indices (RI) of the tumours and ipsilateral axillary lymph nodes were measured. SUV and RI were compared with clinical and biological prognostic parameters. RESULTS A total of 32 patients participated in the study. Tumour FDG uptake correlated with histological grade and tumour size. FDG uptake in axillary lymph nodes correlated positively with lymph node status, metastasis status and clinical stage. RI values for the tumour and lymph nodes were significantly positively correlated with human epidermal growth factor receptor-2 positivity. CONCLUSIONS FDG uptake in tumours and lymph nodes showed correlations with some clinical and biological parameters, and may serve as a predictive marker of tumour biological behaviour in breast cancer.
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Affiliation(s)
- Chin-Chuan Chang
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Wen Chen
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chia-Yang Lin
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ming-Feng Hou
- Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Department of Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
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Potential performance of dual-time-point 18F-FDG PET/CT compared with single-time-point imaging for differential diagnosis of metastatic lymph nodes. Nucl Med Commun 2014; 35:1003-10. [DOI: 10.1097/mnm.0000000000000168] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Xue J, Zheng J, Guo H, Wang X, Han A. Predictive value of 18 F-fluorodeoxyglucose positron emission tomography - computed tomography compared to postoperative pathological findings for patients with non-small-cell lung cancer. Mol Clin Oncol 2014; 3:109-114. [PMID: 25469279 DOI: 10.3892/mco.2014.408] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 08/12/2014] [Indexed: 11/06/2022] Open
Abstract
This study was conducted to investigate the predictive value of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) in patients with non-small-cell lung cancer (NSCLC), compared to that of postoperative pathological findings, for T and N staging and the associations of the metabolic parameters of the primary tumor with histological type and differentiation. The preoperative contrast-enhanced CT and 18F-FDG PET-CT and postoperative pathological findings of 112 NSCLC patients treated with lobectomy or pneumonectomy combined with systematic mediastinal lymphadenectomy were retrospectively reviewed. Compared to the postoperative pathological findings, the effect of contrast-enhanced CT and 18F-FDG PET-CT on T and N staging were evaluated. The metabolic tumor volume (MTV) and maximum standardized uptake value (SUVmax) of the primary tumor were measured. The associations between these metabolic parameters and histological type and differentiation were also evaluated. The differences in the accuracy in overall staging and T staging between PET-CT and contrast-enhanced CT were significant (91.1 vs. 69.6%, P=0.000; and 92.9 vs. 76.8%, P=0.000, respectively). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of regional lymph node metastasis detection were 91.7, 93.0, 86.5, 95.8 and 92.6%, respectively, with PET-CT; and 71.3, 77.2, 60.6, 84.5 and 75.2%, respectively, with contrast-enhanced CT. The SUVmax (7.29±1.83 vs. 5.91±1.65, t=4.15, P=0.000) and MTV (48.20±22.47 vs. 30.21±19.72 cm3, t=4.48, P=0.000) were significantly higher for squamous cell carcinoma (SCC) compared to those for adenocarcinoma (AC). There was a positive correlation between the MTV and SUVmax of the primary tumor (Pearson's r=0.838, P=0.000). Significant differences were observed among differentiation subgroups in the SUVmax and MTV of the primary tumor for both SCC and AC. In conclusion, compared to the postoperative pathological findings, the predictive value of 18F-FDG PET-CT for T and N staging in NSCLC was higher compared to that of contrast-enhanced CT. The FDG uptake of the primary tumor was associated with histological type and differentiation and the difference was statistically significant. Therefore, the SUVmax and MTV of the primary tumor may be valuable indices to partly predict the histological type and grade of differentiation of NSCLC.
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Affiliation(s)
- Jie Xue
- Department of Oncology, The Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, Shandong 250031, P.R. China ; School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong 250022, P.R. China
| | - Jinsong Zheng
- Departments of Nuclear Medicine, Shandong Cancer Hospital, Jinan, Shandong 250117, P.R. China
| | - Hongbo Guo
- Departments of Thoracic Surgery and Shandong Cancer Hospital, Jinan, Shandong 250117, P.R. China
| | - Xiaohui Wang
- Departments of Nuclear Medicine, Shandong Cancer Hospital, Jinan, Shandong 250117, P.R. China
| | - Anqin Han
- Departments of Radiation Oncology and Shandong Cancer Hospital, Jinan, Shandong 250117, P.R. China ; Departments of Key Laboratory of Radiation Oncology of Shandong Province, Shandong Cancer Hospital, Jinan, Shandong 250117, P.R. China
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Povoski SP, Murrey DA, Smith SM, Martin EW, Hall NC. 18F-FDG PET/CT oncologic imaging at extended injection-to-scan acquisition time intervals derived from a single-institution 18F-FDG-directed surgery experience: feasibility and quantification of 18F-FDG accumulation within 18F-FDG-avid lesions and background tissues. BMC Cancer 2014; 14:453. [PMID: 24942656 PMCID: PMC4075626 DOI: 10.1186/1471-2407-14-453] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 06/13/2014] [Indexed: 12/31/2022] Open
Abstract
Background 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is a well-established imaging modality for a wide variety of solid malignancies. Currently, only limited data exists regarding the utility of PET/CT imaging at very extended injection-to-scan acquisition times. The current retrospective data analysis assessed the feasibility and quantification of diagnostic 18F-FDG PET/CT oncologic imaging at extended injection-to-scan acquisition time intervals. Methods 18F-FDG-avid lesions (not surgically manipulated or altered during 18F-FDG-directed surgery, and visualized both on preoperative and postoperative 18F-FDG PET/CT imaging) and corresponding background tissues were assessed for 18F-FDG accumulation on same-day preoperative and postoperative 18F-FDG PET/CT imaging. Multiple patient variables and 18F-FDG-avid lesion variables were examined. Results For the 32 18F-FDG-avid lesions making up the final 18F-FDG-avid lesion data set (from among 7 patients), the mean injection-to-scan times of the preoperative and postoperative 18F-FDG PET/CT scans were 73 (±3, 70-78) and 530 (±79, 413-739) minutes, respectively (P < 0.001). The preoperative and postoperative mean 18F-FDG-avid lesion SUVmax values were 7.7 (±4.0, 3.6-19.5) and 11.3 (±6.0, 4.1-29.2), respectively (P < 0.001). The preoperative and postoperative mean background SUVmax values were 2.3 (±0.6, 1.0-3.2) and 2.1 (±0.6, 1.0-3.3), respectively (P = 0.017). The preoperative and postoperative mean lesion-to-background SUVmax ratios were 3.7 (±2.3, 1.5-9.8) and 5.8 (±3.6, 1.6-16.2), respectively, (P < 0.001). Conclusions 18F-FDG PET/CT oncologic imaging can be successfully performed at extended injection-to-scan acquisition time intervals of up to approximately 5 half-lives for 18F-FDG while maintaining good/adequate diagnostic image quality. The resultant increase in the 18F-FDG-avid lesion SUVmax values, decreased background SUVmax values, and increased lesion-to-background SUVmax ratios seen from preoperative to postoperative 18F-FDG PET/CT imaging have great potential for allowing for the integrated, real-time use of 18F-FDG PET/CT imaging in conjunction with 18F-FDG-directed interventional radiology biopsy and ablation procedures and 18F-FDG-directed surgical procedures, as well as have far-reaching impact on potentially re-shaping future thinking regarding the “most optimal” injection-to-scan acquisition time interval for all routine diagnostic 18F-FDG PET/CT oncologic imaging.
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Affiliation(s)
- Stephen P Povoski
- Division of Surgical Oncology, Department of Surgery, Arthur G, James Cancer Hospital and Richard J, Solove Research Institute and Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
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Cheung GSM. Contribution of PET–CT in radiotherapy planning of oesophageal carcinoma: A review. Radiography (Lond) 2013. [DOI: 10.1016/j.radi.2013.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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When should we recommend use of dual time-point and delayed time-point imaging techniques in FDG PET? Eur J Nucl Med Mol Imaging 2013; 40:779-87. [PMID: 23361859 DOI: 10.1007/s00259-013-2343-9] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 01/04/2013] [Indexed: 10/27/2022]
Abstract
FDG PET and PET/CT are now widely used in oncological imaging for tumor characterization, staging, restaging, and response evaluation. However, numerous benign etiologies may cause increased FDG uptake indistinguishable from that of malignancy. Multiple studies have shown that dual time-point imaging (DTPI) of FDG PET may be helpful in differentiating malignancy from benign processes. However, exceptions exist, and some studies have demonstrated significant overlap of FDG uptake patterns between benign and malignant lesions on delayed time-point images. In this review, we summarize our experience and opinions on the value of DTPI and delayed time-point imaging in oncology, with a review of the relevant literature. We believe that the major value of DTPI and delayed time-point imaging is the increased sensitivity due to continued clearance of background activity and continued FDG accumulation in malignant lesions, if the same diagnostic criteria (as in the initial standard single time-point imaging) are used. The specificity of DTPI and delayed time-point imaging depends on multiple factors, including the prevalence of malignancies, the patient population, and the cut-off values (either SUV or retention index) used to define a malignancy. Thus, DTPI and delayed time-point imaging would be more useful if performed for evaluation of lesions in regions with significant background activity clearance over time (such as the liver, the spleen, the mediastinum), and if used in the evaluation of the extent of tumor involvement rather than in the characterization of the nature of any specific lesion. Acute infectious and non-infectious inflammatory lesions remain as the major culprit for diminished diagnostic performance of these approaches (especially in tuberculosis-endemic regions). Tumor heterogeneity may also contribute to inconsistent performance of DTPI. The authors believe that selective use of DTPI and delayed time-point imaging will improve diagnostic accuracy and interpretation confidence in FDG PET imaging.
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SUV on dual-phase FDG PET/CT correlates with the Ki-67 proliferation index in patients with newly diagnosed non-Hodgkin lymphoma. Clin Nucl Med 2012; 37:e189-95. [PMID: 22785526 DOI: 10.1097/rlu.0b013e318251e16e] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE PET using 18F-FDG integrated with CT is beneficial for staging patients with non-Hodgkin lymphoma (NHL). The Ki-67 index is used to assess the proliferation potential of tumor cells. The aim of this study was to evaluate the correlation of the Ki-67 index in tissue samples with the SUV at different sites on dual-phase FDG PET/CT of patients with newly diagnosed NHL. MATERIALS AND METHODS From September 2009 to March 2011, patients with newly diagnosed NHL who had received dual-phase FDG PET/CT for staging and biopsy samples that were evaluated for the Ki-67 expression were enrolled. The SUVmax of the biopsy site, the tumorous lesion sites, and 3 different bone marrow sites (right iliac crest, sternum, and L1) were measured. The SUVmean of the liver and spleen were also measured. RESULTS There were a total of 27 patients in this study. Significant correlations were observed between the Ki-67 index and the SUVmax of the right iliac crest in patients with early-stage disease (stage I and II) patients, the SUVmax of the biopsy and whole-body lesion sites in patients with late-stage disease (stage III and IV), and the retention index of SUVmax of the right iliac crest in patients whose bone marrow were involved by lymphoma cells. CONCLUSIONS For patients with newly diagnosed NHL, the significant correlation between the Ki-67 index and the SUV in this study suggests that dual-phase FDG PET/CT may be used as a noninvasive measurement of tumor proliferation.
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Clinical value of 18F-FDG PET-CT in detecting primary tumor for patients with carcinoma of unknown primary. Cancer Epidemiol 2012; 36:470-5. [DOI: 10.1016/j.canep.2012.03.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 02/23/2012] [Accepted: 03/10/2012] [Indexed: 12/20/2022]
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Wong R, Walker-Dilks C, Raifu A. Evidence-based guideline recommendations on the use of positron emission tomography imaging in oesophageal cancer. Clin Oncol (R Coll Radiol) 2012; 24:86-104. [PMID: 21962904 DOI: 10.1016/j.clon.2011.09.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 07/11/2011] [Accepted: 08/09/2011] [Indexed: 12/22/2022]
Abstract
AIMS To provide evidence-based practice guideline recommendations on the use of fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) for diagnosis, staging, assessing treatment response, liver metastasis and restaging or recurrence of oesophageal cancer. MATERIALS AND METHODS A systematic review by Facey et al. (Health Technology Assessment 2007;11(44):iii-iv, xi-267) was used as the evidence base for recommendation development. As the review was limited to August 2005, the evidence base was updated to May 2010 using the same search strategies for MEDLINE and EMBASE used in the original review. The authors of the current systematic review drafted recommendations, which were reviewed, adapted and accepted by consensus by the Ontario provincial Gastrointestinal Disease Site Group and a special meeting of clinical experts. RESULTS The results from the Facey et al. review for oesophageal cancer included four other systematic reviews and six primary studies. The 2005 to 2010 updated search included two additional systematic reviews and 29 primary studies. Recommendations were developed based on this evidence and accepted by consensus. CONCLUSIONS PET is recommended to improve the accuracy of M staging for the staging work-up of patients with oesophageal cancer who are potential candidates for curative therapy. Due to insufficient evidence, no recommendation was made for or against the use of PET for the assessment of treatment response and the evaluation of suspected recurrence.
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Affiliation(s)
- R Wong
- Princess Margaret Hospital, Toronto, Ontario, Canada
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Kato H, Nakajima M. The Efficacy of FDG-PET for the Management of Esophageal Cancer: Review Article. Ann Thorac Cardiovasc Surg 2012; 18:412-9. [DOI: 10.5761/atcs.ra.12.01954] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Smyth EC, Shah MA. Role of ( 18F) 2-fluoro-2-deoxyglucose positron emission tomography in upper gastrointestinal malignancies. World J Gastroenterol 2011; 17:5059-74. [PMID: 22171140 PMCID: PMC3235589 DOI: 10.3748/wjg.v17.i46.5059] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2011] [Revised: 06/09/2011] [Accepted: 06/16/2011] [Indexed: 02/06/2023] Open
Abstract
The role of whole-body FDG [(18F) 2-fluoro-2-deoxyglucose] positron emission tomography (PET) scanning as an imaging modality in the management of patients with malignancy has evolved enormously over the past two decades. FDG-PET has demonstrated significant efficacy in the staging, prognostication and detection of occult metastatic disease in malignancies of the gastrointestinal tract, in addition to assessment of the response to cytotoxic chemotherapy in a more timely manner than has traditionally been possible by more conventional imaging tools. The sensitivity and specificity of FDG-PET for the detection and staging of malignancy depend not only on the site and size of the primary tumor and metastases, but also on histological cell type, reflecting underlying disparities in glucose metabolism. The metabolic response to neo-adjuvant chemotherapy or to chemo-radiotherapy in cancers of the gastro-esophageal junction or stomach has been demonstrated in several prospective studies to correlate significantly with both the histological tumor response to treatment and with consequent improvements in overall survival. This may offer a future paradigm of personalized treatment based on the PET response to chemotherapy. FDG-PET has been less successful in efforts to screen for and detect recurrent upper gastrointestinal malignancies, and in the detection of low volume metastatic peritoneal disease. Efforts to improve the accuracy of PET include the use of novel radiotracers such as (18F) FLT (3-deoxy-3-fluorothymidine) or 11C-choline, or fusion PET-CT with concurrent high-resolution computed tomography. This review focuses on the role of FDG-PET scanning in staging and response assessment in malignancies of the upper gastrointestinal tract, specifically gastric, esophageal and pancreas carcinoma.
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Hsiao YC, Wu PS, Chiu NT, Yao WJ, Lee BF, Peng SL. The use of dual-phase 18F-FDG PET in characterizing thyroid incidentalomas. Clin Radiol 2011; 66:1197-202. [DOI: 10.1016/j.crad.2011.08.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 07/04/2011] [Accepted: 08/01/2011] [Indexed: 10/17/2022]
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LEE SZETING, SCOTT ANDREWM. Are we ready for dual-time point FDG PET imaging? J Med Imaging Radiat Oncol 2011; 55:351-2. [DOI: 10.1111/j.1754-9485.2011.02296.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nakajo M, Nakajo M, Tani A, Kajiya Y, Shimaoka S, Matsuda A, Nioh T, Nihara T, Suenaga T, Tanaka S, Shirahama H, Higashi M, Koriyama C. Clinical significance of primary lesion FDG uptake for choice between oesophagectomy and endoscopic submucosal dissection for resectable oesophageal squamous cell carcinomas. Eur Radiol 2011; 21:2396-407. [PMID: 21750887 DOI: 10.1007/s00330-011-2196-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 04/21/2011] [Accepted: 05/13/2011] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To correlate primary oesophageal squamous cell carcinoma (SCC) (18)F-fluoro-deoxyglucose (FDG) uptake with pathological factors and examine its significance regarding choice of therapy. METHODS We retrospectively examined the factors affecting visible and non-visible FDG uptake in 37 primary lesions in 32 oesophageal SCC patients who underwent PET/CT before oesophagectomy or endoscopic submucosal dissection (ESD). We divided the lesions into pathological depth invasion ≥sm2 oesophagectomy (n = 18) and ≤sm1 ESD (n = 19) indicated groups and compared the diagnostic accuracy of FDG-PET with that of endoscopic ultrasound (EUS) performed for 23 superficial lesions to discriminate between these groups. RESULTS There were 17 visible and 20 non-visible lesions. The lesion visibility was significantly higher in the larger (≥40 mm), non-flat type, more deeply invaded, positive vascular invasion (P < 0.001 each), positive nodal metastasis (P = 0.04) and higher Glut-1 score (P = 0.005) tumour groups. When the visible and non-visible lesions indicated a need for oesophagectomy and ESD respectively, the sensitivity, specificity and accuracy of oesophagectomy were 94% (17/18), 100% (19/19) and 97% (36/37) and those of EUS were 75% (3/4), 79% (15/19) and 78% (18/23) respectively. CONCLUSIONS Primary lesion FDG visibility can be one of the indicators for choosing between oesophagectomy and ESD for resectable oesophageal SCCs.
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Affiliation(s)
- Masatoyo Nakajo
- Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan.
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Value of Dual-Time-Point FDG PET/CT for Mediastinal Nodal Staging in Non-Small-Cell Lung Cancer Patients With Lung Comorbidity. Clin Nucl Med 2011; 36:429-33. [DOI: 10.1097/rlu.0b013e3182173810] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shum WY, Hsieh TC, Yeh JJ, Chen JH, Su CC, Liang JA, Kao CH. Clinical usefulness of dual-time FDG PET-CT in assessment of esophageal squamous cell carcinoma. Eur J Radiol 2011; 81:1024-8. [PMID: 21458941 DOI: 10.1016/j.ejrad.2011.03.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 02/28/2011] [Accepted: 03/01/2011] [Indexed: 12/22/2022]
Abstract
PURPOSE We conducted this study to investigate the value of the dual-time 2-[(18)F]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography-computed tomography (PET-CT) in assessment of the primary tumor, loco-regional lymph node and distant metastasis in patients with esophageal squamous cell carcinoma. METHODS Twenty-six patients with histologically proved esophageal squamous cell carcinoma underwent dual-time FDG PET-CT before radical surgery. The standardized uptake values (SUV(max)) were obtained including early SUV(max) and delayed SUV(max), respectively. The retention index (RI) was also calculated. The results were evaluated retrospectively according to the final pathologic findings. Four diagnostic criteria including (1) early SUV(max)≧ 2.5 alone, (2) RI ≧ 10% alone, (3) a combination of early SUV(max)≧ 2.5 and RI ≧ 10%, and (4) a combination of early SUV(max)≧ 2.5 or RI ≧ 10% were used for differentiating malignancy from a benign lesion, respectively. RESULTS The sensitivity of FDG PET-CT in detecting the primary tumor with combination of early SUV(max)≧ 2.5 or RI ≧ 10% was 96.2%. It was statistically significantly higher than the results using the other three criteria (p<0.0001). For loco-regional lymph node detection, there was no significant difference among the 4 criteria. For distal metastases, the significantly higher specificity (100%) was found when using combination of early SUV(max)≧ 2.5 and RI ≧ 10% or using early SUV(max)≧ 2.5 alone than using the other two criteria (p=0.0058). With regard to accuracy, no significant correlations were observed among primary tumor, loco-regional lymph nodes and distant metastasis (p>0.05). CONCLUSION The preliminary result of this study demonstrated that dual-time point FDG PET-CT had limited value in detection of primary tumor and loco-regional lymph nodes metastasis. For the distant metastasis, the sensitivity and specificity would be improved if RI ≧ 10% is used as a supplemental criterion. Efforts should be made to improve the ability of the dual-time FDG PET-CT technique to assess primary tumor and loco-regional lymph nodes metastasis.
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Affiliation(s)
- Weng-Yoon Shum
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
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Dual-Time-Point Fluorodeoxyglucose Positron Emission Tomography for Diagnosis of Cervical Lymph Node Metastases in Patients With Head and Neck Squamous Cell Carcinoma. J Comput Assist Tomogr 2011; 35:303-7. [DOI: 10.1097/rct.0b013e31820a0af2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kim SJ, Kim BH, Jeon YK, Kim SS, Kim IJ. Limited diagnostic and predictive values of dual-time-point 18F FDG PET/CT for differentiation of incidentally detected thyroid nodules. Ann Nucl Med 2011; 25:347-53. [DOI: 10.1007/s12149-011-0468-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Accepted: 01/07/2011] [Indexed: 10/18/2022]
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Defining the role of modern imaging techniques in assessing lymph nodes for metastasis in cancer: evolving contribution of PET in this setting. Eur J Nucl Med Mol Imaging 2011; 38:1353-66. [DOI: 10.1007/s00259-010-1717-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Accepted: 12/16/2010] [Indexed: 11/26/2022]
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Choi WH, Yoo IR, O JH, Kim SH, Chung SK. The value of dual-time-point 18F-FDG PET/CT for identifying axillary lymph node metastasis in breast cancer patients. Br J Radiol 2010; 84:593-9. [PMID: 21081574 DOI: 10.1259/bjr/56324742] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The sensitivity of 18-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) for detecting axillary lymph node (ALN) metastases in breast cancer is reported to be low. Several studies have shown, however, that dual-time-point (18)F-FDG PET imaging provides improved accuracy in the diagnosis of certain primary tumours when compared with single-scan imaging. The purpose of this study was to assess whether the use of dual-time-point (18)F-FDG PET/CT scans could improve the diagnostic accuracy of ALN metastasis in breast cancer. METHOD The study included 171 breast cancer patients who underwent pre-operative (18)F-FDG PET/CT scans at 2 time-points, the first at 1 h after radiotracer injection and the second 3 h after injection. Where (18)F-FDG uptake was in the ALN perceptibly increased, the maximum standardised uptake values for both time-points (SUVmax1 and SUVmax2) and the retention index (RI) were calculated. Correlation between the PET/CT results and post-operative histological results was assessed. RESULTS The performance of 1 h and 3 h PET/CT scans was equal, with sensitivity 60.3% and specificity 84.7%, in detecting ALN metastasis. Out of 171 patients, 60 had ALNs with increased (18)F-FDG uptake on 1 h or 3 h images. There was no significant difference in RI between the metastatic ALN-positive group and the node-negative group. The area under the receiver operating characteristic (ROC) curve for SUVmax1 was 0.90 (p<0.001) and 0.87 for SUVmax2 (p<0.001). CONCLUSION Dual time-point imaging did not improve the overall performance of (18)F-FDG PET/CT in detecting ALN metastasis in breast cancer patients.
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Affiliation(s)
- W H Choi
- Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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