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Ethirajan M, Chen Y, Joshi P, Pandey RK. The role of porphyrin chemistry in tumor imaging and photodynamic therapy. Chem Soc Rev 2010; 40:340-62. [PMID: 20694259 DOI: 10.1039/b915149b] [Citation(s) in RCA: 1492] [Impact Index Per Article: 99.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In recent years several review articles and books have been published on the use of porphyrin-based compounds in photodynamic therapy (PDT). This critical review is focused on (i) the basic concept of PDT, (ii) advantages of long-wavelength absorbing photosensitizers (PS), (iii) a brief discussion on recent advances in developing PDT agents, and (iv) the various synthetic strategies designed at the Roswell Park Cancer Institute, Buffalo, for developing highly effective long-wavelength PDT agents and their utility in constructing the conjugates with tumor-imaging and therapeutic potential (Theranostics). The clinical status of certain selected PDT agents is also summarized (205 references).
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Affiliation(s)
- Manivannan Ethirajan
- PDT Center, Cell Stress Biology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
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52
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Peng H, Levin CS. Design study of a high-resolution breast-dedicated PET system built from cadmium zinc telluride detectors. Phys Med Biol 2010; 55:2761-88. [PMID: 20400807 DOI: 10.1088/0031-9155/55/9/022] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We studied the performance of a dual-panel positron emission tomography (PET) camera dedicated to breast cancer imaging using Monte Carlo simulation. The proposed system consists of two 4 cm thick 12 x 15 cm(2) area cadmium zinc telluride (CZT) panels with adjustable separation, which can be put in close proximity to the breast and/or axillary nodes. Unique characteristics distinguishing the proposed system from previous efforts in breast-dedicated PET instrumentation are the deployment of CZT detectors with superior spatial and energy resolution, using a cross-strip electrode readout scheme to enable 3D positioning of individual photon interaction coordinates in the CZT, which includes directly measured photon depth-of-interaction (DOI), and arranging the detector slabs edge-on with respect to incoming 511 keV photons for high photon sensitivity. The simulation results show that the proposed CZT dual-panel PET system is able to achieve superior performance in terms of photon sensitivity, noise equivalent count rate, spatial resolution and lesion visualization. The proposed system is expected to achieve approximately 32% photon sensitivity for a point source at the center and a 4 cm panel separation. For a simplified breast phantom adjacent to heart and torso compartments, the peak noise equivalent count (NEC) rate is predicted to be approximately 94.2 kcts s(-1) (breast volume: 720 cm(3) and activity concentration: 3.7 kBq cm(-3)) for a approximately 10% energy window around 511 keV and approximately 8 ns coincidence time window. The system achieves 1 mm intrinsic spatial resolution anywhere between the two panels with a 4 cm panel separation if the detectors have DOI resolution less than 2 mm. For a 3 mm DOI resolution, the system exhibits excellent sphere resolution uniformity (sigma(rms)/mean) < or = 10%) across a 4 cm width FOV. Simulation results indicate that the system exhibits superior hot sphere visualization and is expected to visualize 2 mm diameter spheres with a 5:1 activity concentration ratio within roughly 7 min imaging time. Furthermore, we observe that the degree of spatial resolution degradation along the direction orthogonal to the two panels that is typical of a limited angle tomography configuration is mitigated by having high-resolution DOI capabilities that enable more accurate positioning of oblique response lines.
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Affiliation(s)
- Hao Peng
- Department of Radiology, Molecular Imaging Program, Stanford University School of Medicine, Stanford, CA 94305, USA.
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de Barros ALB, Cardoso VN, Mota LDG, Leite EA, de Oliveira MC, Alves RJ. A novel d-glucose derivative radiolabeled with technetium-99m: Synthesis, biodistribution studies and scintigraphic images in an experimental model of Ehrlich tumor. Bioorg Med Chem Lett 2010; 20:2478-80. [DOI: 10.1016/j.bmcl.2010.03.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Revised: 02/26/2010] [Accepted: 03/01/2010] [Indexed: 11/27/2022]
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54
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Yu W, McConathy J, Williams L, Camp VM, Malveaux EJ, Zhang Z, Olson JJ, Goodman MM. Synthesis, radiolabeling, and biological evaluation of (R)- and (S)-2-amino-3-[(18)F]fluoro-2-methylpropanoic acid (FAMP) and (R)- and (S)-3-[(18)F]fluoro-2-methyl-2-N-(methylamino)propanoic acid (NMeFAMP) as potential PET radioligands for imaging brain tumors. J Med Chem 2010; 53:876-86. [PMID: 20028004 DOI: 10.1021/jm900556s] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The non-natural amino acids (R)- and (S)-2-amino-3-fluoro-2-methylpropanoic acid 5 and (R)- and (S)-3-fluoro-2-methyl-2-N-(methylamino)propanoic acid 8 were synthesized in shorter reaction sequences than in the original report starting from enantiomerically pure (S)- and (R)-alpha-methyl-serine, respectively. The reaction sequence provided the cyclic sulfamidate precursors for radiosynthesis of (R)- and (S)-[(18)F]5 and (R)- and (S)-[(18)F]8 in fewer steps than in the original report. (R)- and (S)-[(18)F]5 and(R)- and (S)-[(18)F]8 were synthesized by no-carrier-added nucleophilic [(18)F]fluorination in 52-66% decay-corrected yields with radiochemical purity over 99%. The cell assays showed that all four compounds were substrates for amino acid transport and enter 9L rat gliosarcoma cells in vitro at least in part by system A amino acid transport. The biodistribution studies demonstrated that in vivo tumor to normal brain ratios for all compounds were high with ratios of 20:1 to115:1 in rats with intracranial 9L tumors. The (R)-enantiomers of [(18)F]5 and [(18)F]8 demonstrated higher tumor uptake in vivo compared to the (S)-enantiomers.
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Affiliation(s)
- Weiping Yu
- Department of Radiology, School of Medicine, Emory University, 1364 Clifton Road NE, Atlanta, Georgia 30322, USA
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Tian YS, Lee HY, Lim CS, Park J, Kim HM, Shin YN, Kim ES, Jeon HJ, Park SB, Cho BR. A two-photon tracer for glucose uptake. Angew Chem Int Ed Engl 2010; 48:8027-31. [PMID: 19768816 DOI: 10.1002/anie.200901175] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Yu Shun Tian
- Department of Chemistry, Korea University, 1-Anamdong, Seoul 136-701, Korea
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Tian Y, Lee H, Lim C, Park J, Kim H, Shin Y, Kim E, Jeon H, Park S, Cho B. A Two-Photon Tracer for Glucose Uptake. Angew Chem Int Ed Engl 2009. [DOI: 10.1002/ange.200901175] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Qiao Y, He Y, Zhang S, Li G, Liu H, Xu J, Wang X, Qi C, Peng C. Synthesis and evaluation of novel F-18 labeled fluoroarylvaline derivatives: Potential PET imaging agents for tumor detection. Bioorg Med Chem Lett 2009; 19:4873-7. [DOI: 10.1016/j.bmcl.2009.03.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Revised: 02/15/2009] [Accepted: 03/06/2009] [Indexed: 11/25/2022]
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58
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A statistical clustering approach to visualizing the relationship between early and delayed images in whole-body FDG-PET. Radiol Phys Technol 2009; 2:145-50. [DOI: 10.1007/s12194-009-0058-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Revised: 03/26/2009] [Accepted: 03/29/2009] [Indexed: 10/20/2022]
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Uto T, Takehara Y, Nakamura Y, Naito T, Hashimoto D, Inui N, Suda T, Nakamura H, Chida K. Higher Sensitivity and Specificity for Diffusion-weighted Imaging of Malignant Lung Lesions without Apparent Diffusion Coefficient Quantification. Radiology 2009; 252:247-54. [DOI: 10.1148/radiol.2521081195] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Lemonnier I, Baumann C, Jay N, Alzahouri K, Arveux P, Jolly D, Lejeune C, Velten M, Vitry F, Woronoff-Lemsi MC, Guillemin F. Does the availability of positron emission tomography modify diagnostic strategies for solitary pulmonary nodules? An observational study in France. BMC Cancer 2009; 9:139. [PMID: 19426566 PMCID: PMC2687457 DOI: 10.1186/1471-2407-9-139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2008] [Accepted: 05/11/2009] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies showed that at the individual level, positron emission tomography (PET) has some benefits for patients and physicians in terms of cancer management and staging. We aimed to describe the benefits of (PET) in the management of solitary pulmonary nodules (SPNs) in a population level, in terms of the number of diagnostic and invasive tests performed, time to diagnosis and factors determining PET utilization. Methods In an observational study, we examined reports of computed tomography (CT) performed and mentioning "spherical lesion", "nodule" or synonymous terms. We found 11,515 reports in a before-PET period, 2002–2003, and 20,075 in an after-PET period, 2004–2005. Patients were followed through their physician, who was responsible for diagnostic management. Results We had complete data for 112 patients (73.7%) with new cases of SPN in the before-PET period and 250 (81.4%) in the after-PET period. Patients did not differ in mean age (64.9 vs. 64.8 years). The before-PET patients underwent a mean of 4 tests as compared with 3 tests for the after-PET patients (p = 0.08). Patients in the before-PET period had to wait 41.4 days, on average, before receiving a diagnosis as compared with 24.0 days, on average, for patients in the after-PET period who did not undergo PET (p < 0.001). In the after-PET period, 11% of patients underwent PET during the diagnostic process. A spiculated nodule was more likely to determine prescription for PET (p < 0.001). Multivariate analysis revealed that patients in both periods underwent fewer tests when PET was prescribed by general practitioners (p < 0.001) and if the nodule was not spiculated (p < 0.001). The proportion of unnecessary invasive approaches prescribed (47% vs. 49%) did not differ between the groups. Conclusion In our study, 1 year after the availability of PET, the technology was not the first choice for diagnostic management of SPN. Even though we observed a tendency for reduced number of tests and mean time to diagnosis with PET, these phenomena did not fully relate to PET availability in health communities. In addition, the availability of PET in the management of SPN diagnosis did not reduce the overall rate of unnecessary invasive approaches.
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Synthesis and biological evaluation of a novel 99mTc nitrido radiopharmaceutical with deoxyglucose dithiocarbamate, showing tumor uptake. Bioorg Med Chem Lett 2009; 19:2752-4. [DOI: 10.1016/j.bmcl.2009.03.131] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2009] [Revised: 03/20/2009] [Accepted: 03/25/2009] [Indexed: 11/19/2022]
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de Barros ALB, Cardoso VN, Mota LDG, Leite EA, Oliveira MCD, Alves RJ. Synthesis and biological evaluation of technetium-labeled d-glucose-MAG3 derivative as agent for tumor diagnosis. Bioorg Med Chem Lett 2009; 19:2497-9. [DOI: 10.1016/j.bmcl.2009.03.059] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 03/11/2009] [Accepted: 03/12/2009] [Indexed: 11/26/2022]
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McCarthy M, Yuan JB, Campbell A, Lenzo NP, Butler-Henderson K. 18F-fluorodeoxyglucose positron emission tomography imaging in brain tumours: the Western Australia positron emission tomography/cyclotron service experience. J Med Imaging Radiat Oncol 2009; 52:564-9. [PMID: 19178630 DOI: 10.1111/j.1440-1673.2008.02019.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
(18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) scans in the first 49 patients referred with either possible brain tumour or brain tumour recurrence were reviewed. FDG-PET imaging was reported with reference to anatomical imaging. Based on the report the FDG study was classified as either positive or negative for the presence of tumour. Thirty-eight cases were included in the analysis, 21 having pathological data and 17 with diagnostic clinical follow up. Eleven were excluded, as they had inadequate follow-up data. Of the 21 cases with pathology, 18 were shown to have tumour. In this group there were five false-negative scans and two false-positive PET scans. Seventeen cases were assessed by clinical follow up, nine were considered to have been tumour. There were two false negatives with one false positive. The overall sensitivity, specificity and positive and negative predictive values were 74, 73, 87 and 53% respectively. This is similar to figures previously quoted in published work. Despite relatively limited numbers, the utility of FDG PET imaging in our hands is similar to published reports. With a positive predictive value of 87%, a positive FDG study indicates a high likelihood that there is brain tumour present. A negative study does not exclude the presence of tumour.
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Affiliation(s)
- M McCarthy
- Department of Nuclear Medicine, Division of Medical Imaging, Royal Perth Hospital, Perth, Australia.
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Chua MLK, Ong SC, Wee JTS, Ng DCE, Gao F, Tan TWK, Fong KW, Chua ET, Khoo JBK, Low JSH. Comparison of 4 modalities for distant metastasis staging in endemic nasopharyngeal carcinoma. Head Neck 2009; 31:346-54. [DOI: 10.1002/hed.20974] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Li Z, Li Q, Yu X, Conti PS, Leahy RM. Lesion detection in dynamic FDG-PET using matched subspace detection. IEEE TRANSACTIONS ON MEDICAL IMAGING 2009; 28:230-240. [PMID: 19188110 DOI: 10.1109/tmi.2008.929105] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We describe a matched subspace detection algorithm to assist in the detection of small tumors in dynamic positron emission tomography (PET) images. The algorithm is designed to differentiate tumors from background using the time activity curves (TACs) that characterize the uptake of PET tracers. TACs are modeled using linear subspaces with additive Gaussian noise. Using TACs from a primary tumor region of interest (ROI) and one or more background ROIs, each identified by a human observer, two linear subspaces are identified. Applying a matched subspace detector to these identified subspaces on a voxel-by-voxel basis throughout the dynamic image produces a test statistic at each voxel which on thresholding indicates potential locations of secondary or metastatic tumors. The detector is derived for three cases: using a single TAC with white noise of unknown variance, using a single TAC with known noise covariance, and detection using multiple TACs within a small ROI with known noise covariance. The noise covariance is estimated for the reconstructed image from the observed sinogram data. To evaluate the proposed method, a simulation-based receiver operating characteristic (ROC) study for dynamic PET tumor detection is designed. The detector uses a dynamic sequence of frame-by-frame 2-D reconstructions as input. We compare the performance of the subspace detectors with that of a Hotelling observer applied to a single frame image and of the Patlak method applied to the dynamic data. We also show examples of the application of each detection approach to clinical PET data from a breast cancer patient with metastatic disease.
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Affiliation(s)
- Zheng Li
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA 90089, USA
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Ataergin S, Arslan N, Ozet A, Ozguven MA. Abnormal FDG uptake on 18F-fluorodeoxyglucose positron emission tomography in patients with cancer diagnosis: case reports of tuberculous lymphadenitis. Intern Med 2009; 48:115-9. [PMID: 19145057 DOI: 10.2169/internalmedicine.48.1536] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Although 18F-FDG-PET is very sensitive for a variety of malignancies, it can lack specificity. In addition to malignant tissue, any active infectious or inflammatory process can demonstrate FDG avidity. We report 3 patients with different types of cancer who had abnormal 18F-FDG uptake on PET scan caused by tuberculous lymphadenitis. All were found to have incidental multiple lymph adenopathies with increased FDG uptake on PET scan. All three patients were proved to have tuberculosis lymphadenitis by pathologic examination and were successfully treated with anti-tuberculous therapy.
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Affiliation(s)
- Selmin Ataergin
- Department of Medical Oncology, GATA (Gulhane) Faculty of Medicine, Ankara, Turkey.
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Jadvar H, Ye W, Groshen S, Conti PS. [F-18]-fluorodeoxyglucose PET-CT of the normal prostate gland. Ann Nucl Med 2008; 22:787-93. [PMID: 19039557 PMCID: PMC2636719 DOI: 10.1007/s12149-008-0177-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Accepted: 06/11/2008] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We determined the glucose metabolism and computed tomographic (CT) density of the normal prostate gland in relation to age and prostate size on [F-18] fluorodeoxyglucose positron emission tomography (PET)-CT. METHODS We determined the CT density (Hounsfield Units, HU) and glucose metabolism (standardized uptake value, SUV) of the normal prostate in 145 men (age range 22-97 years) on PET-CT scans which were performed for indications unrelated to prostate pathology. Correlations among SUV, HU, prostate size, and age were calculated using Pearson's correlation coefficients, scatter plots, and linear regression trend lines. The SUV and HU values were also compared among different primary cancer types using the Kruskal-Wallis test. RESULTS The population average and range of the normal prostate size were 4.3 +/- 0.5 cm (mean +/- SD) and 2.9-5.5 cm, respectively. The population average of mean and maximum CT densities was 36.0 +/- 5.1 HU (range 23-57) and 91.7 +/- 20.1 HU (range 62-211), respectively. The population average of mean and maximum SUV was 1.3 +/- 0.4 (range 0.1-2.7) and 1.6 +/- 0.4 (range 1.1-3.7), respectively. Mean SUV tended to decrease as the prostate size increased (r = -0.16, P = 0.058). Higher mean HU was correlated with higher mean SUV (r = 0.18, P = 0.033). The strongest association was observed between age and prostate size. The prostate gets larger as age increases (r = 0.32, P < 0.001). Prostate mean SUV, max SUV, mean HU, and max HU were not significantly different among different types of primary cancers. CONCLUSIONS Although the normal prostate size increases with age, it does not significantly affect the gland's metabolism and CT density, and therefore age-correction of these parameters may be unnecessary.
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Affiliation(s)
- Hossein Jadvar
- Department of Radiology and Biomedical Engineering, PET Imaging Science Center, University of Southern California, 2250 Alcazar Street, CSC 102, Los Angeles, CA 90033, USA.
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Abstract
Squamous cell carcinoma is the most frequent malignancy of the head and neck region, accounting for 5% of all malignant tumors worldwide. Accurate staging at diagnosis is critical for selection of appropriate treatment strategy. A variety of therapeutic options are used for treatment, including surgery with or without radical dissection, lymph node dissections of various severities, radiotherapy, chemotherapy, and combinations of these. Precise prediction of the extent of primary tumors, detection of unknown primary tumor, cervical lymph node status, and distant metastatic spread is important for treatment planning and prognosis. Accurate evaluation of these factors prior to treatment helps guide surgical extent or radiation porta, minimizing locoregional treatment failure.
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Wang AZ, Bagalkot V, Vasilliou CC, Gu F, Alexis F, Zhang L, Shaikh M, Yuet K, Cima MJ, Langer R, Kantoff PW, Bander NH, Jon S, Farokhzad OC. Superparamagnetic iron oxide nanoparticle-aptamer bioconjugates for combined prostate cancer imaging and therapy. ChemMedChem 2008; 3:1311-5. [PMID: 18613203 PMCID: PMC3131111 DOI: 10.1002/cmdc.200800091] [Citation(s) in RCA: 210] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2008] [Indexed: 11/08/2022]
Affiliation(s)
- Andrew Z. Wang
- Laboratory of Nanomedicine and Biomaterials, Department of Anesthesia Brighamand Women’s Hospital and Harvard Medical School 75 FrancisStreet, Boston, MA 02115 (USA) Fax: (+ 1) 617-730-2801
- Department of Chemical Engineering Division of Health Science and Technology Massachusetts Institute of Technology 77 Massachusetts Ave., Cambridge, MA 02139 (USA)
| | - Vaishali Bagalkot
- Research Center for Biomolecular Nanotechnology Department of Life Science Gwangju Institute of Science and Technology 1 Oryong-dong, Buk-gu, Gwangju 500712 (South Korea) Fax: (+ 82) 62-970-2504
| | - Christophoros C. Vasilliou
- Department of Electrical Engineering and Computer Science Massachusetts Institute of Technology 77 Massachusetts Ave., Cambridge, MA 02139 (USA)
| | - Frank Gu
- Department of Chemical Engineering Division of Health Science and Technology Massachusetts Institute of Technology 77 Massachusetts Ave., Cambridge, MA 02139 (USA)
| | - Frank Alexis
- Laboratory of Nanomedicine and Biomaterials, Department of Anesthesia Brighamand Women’s Hospital and Harvard Medical School 75 FrancisStreet, Boston, MA 02115 (USA) Fax: (+ 1) 617-730-2801
- Department of Chemical Engineering Division of Health Science and Technology Massachusetts Institute of Technology 77 Massachusetts Ave., Cambridge, MA 02139 (USA)
| | - Liangfang Zhang
- Department of Chemical Engineering Division of Health Science and Technology Massachusetts Institute of Technology 77 Massachusetts Ave., Cambridge, MA 02139 (USA)
| | - Mariam Shaikh
- Department of Chemical Engineering Division of Health Science and Technology Massachusetts Institute of Technology 77 Massachusetts Ave., Cambridge, MA 02139 (USA)
| | - Kai Yuet
- Department of Chemical Engineering Division of Health Science and Technology Massachusetts Institute of Technology 77 Massachusetts Ave., Cambridge, MA 02139 (USA)
| | - Michael J. Cima
- Department of Material Science and Engineering, David H. Koch Institute for Integrative Cancer Research Massachusetts Institute of Technology 77 Massachusetts Ave., Cambridge, MA 02139 (USA)
| | - Robert Langer
- Department of Chemical Engineering Division of Health Science and Technology Massachusetts Institute of Technology 77 Massachusetts Ave., Cambridge, MA 02139 (USA)
| | - Philip W. Kantoff
- Lank Center for Genitourinary Oncology Dana Farber Cancer Institute and Harvard Medical School 44 Binney Street, Boston, MA 02115 (USA)
| | - Neil H. Bander
- Department of Urology, Weill Medical College of Cornell University New York, NY 10021 (USA)
| | - Sangyong Jon
- Research Center for Biomolecular Nanotechnology Department of Life Science Gwangju Institute of Science and Technology 1 Oryong-dong, Buk-gu, Gwangju 500712 (South Korea) Fax: (+ 82) 62-970-2504
| | - Omid C. Farokhzad
- Laboratory of Nanomedicine and Biomaterials, Department of Anesthesia Brighamand Women’s Hospital and Harvard Medical School 75 FrancisStreet, Boston, MA 02115 (USA) Fax: (+ 1) 617-730-2801
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Management of clinically negative neck for the patients with head and neck squamous cell carcinomas in the modern era. Oral Oncol 2008; 44:817-22. [DOI: 10.1016/j.oraloncology.2007.12.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2007] [Revised: 08/03/2007] [Accepted: 12/04/2007] [Indexed: 02/08/2023]
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Caridad V, Arsenak M, Abad MJ, Martín R, Guillén N, Colmenter LF, Taylor P. Effective Radiotherapy of Primary Tumors and Metastasis with 18F-2-Deoxy-2-Fluoro-D-Glucose in C57BL/6 Mice. Cancer Biother Radiopharm 2008; 23:371-5. [DOI: 10.1089/cbr.2007.0451] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Victoria Caridad
- Laboratorio de Patología Celular y Molecular, Centro de Medicina Experimental, Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela
| | - Miriam Arsenak
- Laboratorio de Patología Celular y Molecular, Centro de Medicina Experimental, Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela
| | - María Jesús Abad
- Laboratorio de Patología Celular y Molecular, Centro de Medicina Experimental, Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela
| | - Rafael Martín
- Escuela de Física, Facultad de Ciencias, Universidad Central de Venezuela, Caracas, Venezuela
| | - Nilo Guillén
- Escuela de Física, Facultad de Ciencias, Universidad Central de Venezuela, Caracas, Venezuela
| | | | - Peter Taylor
- Laboratorio de Patología Celular y Molecular, Centro de Medicina Experimental, Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela
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Ahn PH, Garg MK. Positron emission tomography/computed tomography for target delineation in head and neck cancers. Semin Nucl Med 2008; 38:141-8. [PMID: 18243850 DOI: 10.1053/j.semnuclmed.2007.11.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Radiation and concurrent chemoradiation are essential in the treatment of head and neck cancers because they allow a potentially curative organ preservation approach in a manner that greatly affects quality of life. Greater doses of radiation to areas of gross disease have invariably led to greater loco-regional control. Radiation delivery has undergone great strides, especially in the era of intensity-modulated radiotherapy and related technologies. With the ability to sculpt out areas of higher and lower doses of radiation to millimeter accuracy, the role of imaging to better direct the radiation beam to its target via improved localization has become an issue of great promise. The use of (18)F-fluorodeoxyglucose-positron emission tomography (PET) with computed tomography (CT) as a means of noninvasively staging many head and neck cancers has become increasingly popular. With its role as a functional assay of tumor metabolic activity, it is often used in conjunction with physical examination and other imaging modalities to determine levels of nodal metastases as well as the site of head and neck involvement. Several groups have used images derived from PET/CT to outline areas of gross disease to receive definitive doses of radiotherapy. Generally, no statistically significant difference exists in the volumes delineated on CT alone versus PET/CT. However, in the studied populations there is often important and significant wide individual variability. The tumors on PET/CT are either larger or smaller than tumors outlined on CT scan only, in the majority of patients. Although areas of controversy include threshold definition and image resolution, the utility of a functional assay in defining target volume helps determine areas to receive higher doses of radiation in cancers of the head and neck. Exciting new functional modalities are emerging to image other parameters including tumor hypoxia, which presents a new target with the same challenges in target delineation as PET/CT.
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Affiliation(s)
- Peter H Ahn
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
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Heigener DF, Diemel KD, Reck M, Gatzemeier U. Diagnostics and staging procedures in non-small cell lung cancer - is less more? CLINICAL RESPIRATORY JOURNAL 2008; 2:67-73. [PMID: 20298309 DOI: 10.1111/j.1752-699x.2008.00049.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Non-small cell lung cancer (NSCLC) is a common cancer with approximately 85% of patients dying of the disease. The only chance for cure is in the early stages, when surgery or definite chemoradiotherapy can be performed. Diagnosis and staging of lung cancer can sometimes be difficult, particularly because the intrathoracic structures are not easy to reach. OBJECTIVE This review discusses the diagnosis and staging of lung cancer. RESULTS When performing lung cancer diagnostics, both invasive and noninvasive procedures, such as computed tomogram of the chest, bronchoscopy and abdominal ultrasound, are mandatory. Suspected mediastinal involvement should be differentiated: bulky disease, contralateral or high mediastinal nodes need further clarification by endoscopic ultrasound, endobronchial ultrasound or mediastinoscopy. In opposition to current guidelines, in all other cases, surgery should be performed. Positron emission tomography will gain even more importance when becoming widely accessible and might replace other imaging techniques in the future. In case of advanced disease, staging should be limited to those examinations with impact on symptom control. CONCLUSION The diagnosis and staging of lung cancer should involve both invasive and noninvasive diagnostic procedures. In the case of advanced disease, staging should be limited to those examinations with impact on symptom control, whereas early stages call for rapid and thorough diagnosis.
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Affiliation(s)
- David Felix Heigener
- Krankenhaus Grosshansdorf, Onkologischer Schwerpunkt, Woehrendamm, Grosshansdorf Schleswig-Holstein, Germany.
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74
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Ulaner GA, Colletti PM, Conti PS. B-Cell Non-Hodgkin Lymphoma: PET/CT Evaluation after90Y–Ibritumomab Tiuxetan Radioimmunotherapy—Initial Experience1. Radiology 2008; 246:895-902. [DOI: 10.1148/radiol.2463060588] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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75
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In vitro and in vivo studies with [18F]fluorocholine on digestive tumoral cell lines and in an animal model of metastasized endocrine tumor. Nucl Med Biol 2008; 35:123-30. [DOI: 10.1016/j.nucmedbio.2007.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2007] [Revised: 09/16/2007] [Accepted: 09/28/2007] [Indexed: 11/23/2022]
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The Evolving Role of Positron Emission Tomography in Patients with Medullary Thyroid Carcinoma. PET Clin 2007; 2:305-11. [DOI: 10.1016/j.cpet.2008.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Iagaru A, Masamed R, Singer PA, Conti PS. Detection of occult medullary thyroid cancer recurrence with 2-deoxy-2-[F-18]fluoro-D-glucose-PET and PET/CT. Mol Imaging Biol 2007; 9:72-7. [PMID: 17186139 DOI: 10.1007/s11307-006-0072-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE 2-deoxy-2-[F-18]fluoro-D-glucose (FDG)-positron emission tomography (PET) has an established role in restaging of various cancers, including papillary and undifferentiated thyroid carcinoma. However, controversies exist regarding its ability to reliably assess recurrent medullary thyroid cancer (MTC). We were therefore prompted to review our experience with FDG-PET for detection of occult MTC. METHODS This is a retrospective study (Apr 1, 1997-Mar 31, 2004) of 13 patients with histologic diagnosis of MTC, who had PET examinations. The group included six men and seven women, 15-62 years old (average: 48+/-13). The PET scan request was triggered by rising levels of calcitonin and negative anatomical imaging studies. RESULTS Recurrent/metastatic disease was identified by PET in seven (54%) of the 13 patients. The lesions were located in superior mediastinum (4), cervical lymph nodes (3), thyroid bed (2), lung (1) and liver (1). The calcitonin levels ranged from 52 to 5,090 pg/ml (average: 1,996 pg/ml) in patients with negative PET scans and from 132 to 9,500 pg/ml (average: 3,757 pg/ml) in patients with positive studies. The sensitivity and specificity of FDG-PET for disease detection in this cohort were 85.7% (95% CI: 48.7-97.4) and 83.3% (95% CI: 43.6-96.9), respectively. CONCLUSION Our findings suggest a significant role for FDG-PET in patients with suspected MTC recurrence, with sensitivity of 85.7% and specificity of 83.3% for disease detection. FDG-PET provides additional information in a significant fraction of cases (54%) and could be used for restaging of patients with MTC and elevated levels of biomarkers (calcitonin). Additional studies are necessary to further evaluate the role of FDG-PET in MTC.
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Affiliation(s)
- Andrei Iagaru
- PET Imaging Science Center, Department of Radiology, University of Southern California, Keck School of Medicine of USC, 1510 San Pablo St, Suite 350, Los Angeles, CA 90033, USA
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Park J, Lee HY, Cho MH, Park SB. Development of a cy3-labeled glucose bioprobe and its application in bioimaging and screening for anticancer agents. Angew Chem Int Ed Engl 2007; 46:2018-22. [PMID: 17285672 DOI: 10.1002/anie.200604364] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jongmin Park
- Department of Chemistry, College of Natural Science, Seoul National University, Seoul 151-747, Korea
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79
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Zhang J, Olcott PD, Chinn G, Foudray AMK, Levine CS. Study of the performance of a novel 1 mm resolution dual-panel PET camera design dedicated to breast cancer imaging using Monte Carlo simulation. Med Phys 2007; 34:689-702. [PMID: 17388187 PMCID: PMC3696388 DOI: 10.1118/1.2409480] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We studied the performance of a dual-panel positron emission tomography (PET) camera dedicated to breast cancer imaging using Monte Carlo simulation. The PET camera under development has two 10x 15 cm(2) plates that are constructed from arrays of I X 1 X 3 mm(3) LSO crystals coupled to novel ultra-thin (<200 Am) silicon position-sensitive avalanche photodiodes (PSAPD). In this design the photodetectors are configured "edge-on" with respect to incoming photons which encounter a minimum of 2 cm thick of LSO with directly measured photon interaction depth. Simulations predict that this camera will have 10-15% photon sensitivity, for an 8-4 cm panel separation. Detector measurements show approximately 1 mm(3) intrinsic spatial resolution, <12% energy resolution, and approximately 2 ns coincidence time resolution. By performing simulated dual-panel PET studies using a phantom comprising active breast, heart, and torso tissue, count performance was studied as a function of coincident time and energy windows. We also studied visualization of hot spheres of 2.5-4.0 mm diameter and various locations within the simulated breast tissue for 1 X 1 X 3 mm(3), 2 x 2 x 10 mm(3), 3 x 3 x 30 mm(3), and 4 X 4 X 20 mm(3) LSO crystal resolutions and different panel separations. Images were reconstructed by focal plane tomography with attenuation and normalization corrections applied. Simulation results indicate that with an activity concentration ratio of tumor:breast:heart:torso of 10:1:10:1 and 30 s of acquisition time, only the dual-plate PET camera comprising 1 X 1 X 3 mm(3) crystals could resolve 2.5 mm diameter spheres with an average peak-to-valley ratio of 1.3.
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Affiliation(s)
- Jin Zhang
- Department of Radiology and Molecular Imaging Program, Stanford University, Stanford, California 94305, USA.
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80
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Ono K, Ochiai R, Yoshida T, Kitagawa M, Omagari J, Kobayashi H, Yamashita Y. The detection rates and tumor clinical/pathological stages of whole-body FDG-PET cancer screening. Ann Nucl Med 2007; 21:65-72. [PMID: 17373338 DOI: 10.1007/bf03034001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE FDG-PET has been used for cancer screening, mainly in East-Asia, and cancers are found not infrequently. However, their stages have not been clarified. We examined the detection rates of various cancers using whole-body PET for the screening of cancers in asymptomatic individuals, focusing on their clinical and pathological stages. METHODS Whole-body PET was obtained as a part of our cancer screening program among 3,426 healthy subjects. All subjects participated in a course of PET examination in conjunction with conventional examinations including a medical questionnaire, tumor markers, immunological fecal occult blood test, neck and abdominal ultrasonography and whole body computed tomography. A diagnosis and staging was obtained by an analysis of the pathological findings or by an analysis of the clinical follow-up data. RESULTS Malignant tumors were discovered in 65 lesions found in 3,426 participants (1.90%). The PET findings were true-positive in 46 of the 65 cancer cases. The cancers were found in the following organs: the colon 14; thyroid gland 10; stomach 7; lung 5; liver 3; breast 2; and one each in the kidney, gallbladder, esophagus, pancreas and retroperitoneum. The stages were as follows: stage 0 5, stage I 17, stage II 10, stage III 7, and stage IV 6. One was an unknown primary. There were 19 false-negative findings (0.6%) on PET. Six cancers (0.18%) were missed in our screening program. CONCLUSIONS PET imaging has the potential to detect a wide variety of cancers at potentially curative stages. Most PET-negative cancers are early stage cancers, and thus can be detected using other conventional examinations such as endoscopy.
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Affiliation(s)
- Ken Ono
- Department of Radiology, Tenjin-Kai Shin-Koga Hospital, 120 Tenjin-cho, Kurume 830-8577, Japan.
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81
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Kim MR, Roh JL, Kim JS, Lee JH, Cho KJ, Choi SH, Nam SY, Kim SY. Utility of 18F-fluorodeoxyglucose positron emission tomography in the preoperative staging of squamous cell carcinoma of the oropharynx. Eur J Surg Oncol 2007; 33:633-8. [PMID: 17391904 DOI: 10.1016/j.ejso.2007.02.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2007] [Accepted: 02/09/2007] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been reported to be superior to computed tomography (CT)/magnetic resonance imaging (MRI) in the evaluation of head and neck cancers, but little is known about its usefulness in oropharyngeal squamous cell carcinoma (SCC). We therefore compared FDG PET and CT/MRI in the preoperative staging of previously untreated oropharyngeal SCC. METHODS Thirty-two consecutive patients with oropharyngeal SCC underwent FDG PET and CT/MRI before surgery. Each method was interpreted separately to assess primary tumor and cervical node status. Their sensitivity and specificity were compared relative to histopathologic analysis. RESULTS Histopathology revealed metastases in 29 of 39 dissected neck sides and in 47 of 163 dissected cervical levels. FDG PET had higher sensitivities than CT/MRI for primary tumor detection (25/32 vs. 30/32, P=0.063) and for identification of cervical metastases on neck side (22/29 vs. 28/29, P<0.05) and level-by-level (37/47 vs. 45/47, P<0.05) bases. In contrast, the specificity of the two methods did not differ significantly (P>0.5). FDG PET correctly interpreted the false-negative results of CT/MRI in 6 of 7 primary tumors and 8 of 10 cervical levels. CONCLUSIONS The improved preoperative staging of FDG PET may help in planning treatment, but its accuracy is insufficient to replace pathologic staging based on neck dissection.
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Affiliation(s)
- M R Kim
- Department of Otolaryngology, Bundang Jaesaeng General Hospital, Sungnam, South Korea
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82
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Park J, Lee H, Cho MH, Park S. Development of a Cy3-Labeled Glucose Bioprobe and Its Application in Bioimaging and Screening for Anticancer Agents. Angew Chem Int Ed Engl 2007. [DOI: 10.1002/ange.200604364] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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83
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Roh JL, Yeo NK, Kim JS, Lee JH, Cho KJ, Choi SH, Nam SY, Kim SY. Utility of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography and positron emission tomography/computed tomography imaging in the preoperative staging of head and neck squamous cell carcinoma. Oral Oncol 2007; 43:887-93. [PMID: 17207656 DOI: 10.1016/j.oraloncology.2006.10.011] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Revised: 10/24/2006] [Accepted: 10/25/2006] [Indexed: 11/26/2022]
Abstract
The combination of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and computed tomography (CT) has been reported to be more accurate than CT or PET alone in a preoperative setting. We compared the diagnostic utility of preoperative PET/CT, PET and CT/MRI in 167 patients with newly diagnosed head and neck squamous cell carcinoma (HNSCC), of whom 104 underwent FDG PET and 63 underwent combined PET/CT with all receiving CT/MRI. These preoperative PET, PET/CT, and CT/MRI results were reviewed and their accuracies were compared in patients in whom diagnosis was confirmed histopathologically. Age, sex, primary sites and stage, and nodal involvement were comparable between two groups. The accuracy of PET and PET/CT for detecting primary tumors and cervical metastases was comparable, but significantly higher than that of CT/MRI (98%-97% vs. 86-88% for primary; 92%-93% vs. 85%-86% for neck on a level-by-level basis; P<.05). PET and PET/CT gave false negative results: in 2 (2%) and 2 (3%) patients for primary tumors; in 6 (6%) and 3 (5%) patients for neck metastases, respectively. PET and PET/CT also gave false-positive results for cervical metastases in 5 (5%) and 4 (6%) patients, respectively. Compared with PET alone, preoperative FDG PET/CT may not yield significantly improved diagnostic accuracy in patients with HNSCC. Moreover, despite their high accuracy, PET and PET/CT may not abrogate the need for conventional imaging and pathologic staging based on primary resection and neck dissection.
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Affiliation(s)
- Jong-Lyel Roh
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-dong, Songpa-gu, Seoul 138-736, Republic of Korea
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84
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Tamara L, Velez I, Tamara C. Positron Emission Tomography: A Promising Diagnostic Modality for Head and Neck Pathology. J Oral Maxillofac Surg 2006; 64:1272-7. [PMID: 16860223 DOI: 10.1016/j.joms.2006.04.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2004] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study is to discuss the advantages of positron emission tomography (PET) imaging in the diagnosis of head and neck lesions. METHODS To illustrate this diagnostic method, we describe the nuclear medicine basic technique, present 5 cases for comparison of the results between computed tomography (CT) scan and PET, and review the literature. RESULTS The 5 cases show that PET allows assessment of lesions earlier and more definitively than other diagnostic images. CONCLUSIONS PET, a nuclear medicine modality, is a promising tool for diagnosis and follow-up of head and neck lesions. PET allows assessment of changes in the tissue before they would be shown by other diagnostic images. This modality permits differentiation between malignant and benign tumors. It also has the capability to distinguish between scar tissue, necrosis, tumor recurrence, and metastatic disease. It allows the assessment of the patient's progress during therapy, making possible an early identification of nonresponders to therapy.
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Affiliation(s)
- Luis Tamara
- Department of Nuclear Medicine, University of North Carolina, Chapel Hill, NC, USA
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85
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Demos SG, Vogel AJ, Gandjbakhche AH. Advances in optical spectroscopy and imaging of breast lesions. J Mammary Gland Biol Neoplasia 2006; 11:165-81. [PMID: 17091396 DOI: 10.1007/s10911-006-9022-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A review is presented of recent advances in optical imaging and spectroscopy and the use of light for addressing breast cancer issues. Spectroscopic techniques offer the means to characterize tissue components and obtain functional information in real time. Three-dimensional optical imaging of the breast using various illumination and signal collection schemes in combination with image reconstruction algorithms may provide a new tool for cancer detection and treatment monitoring.
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Affiliation(s)
- Stavros G Demos
- Lawrence Livermore National Laboratory, 7000 East Ave., Livermore, CA 94551, USA.
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86
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Sloka JS, Hollett PD, Mathews M. Cost-effectiveness of positron emission tomography in breast cancer. Mol Imaging Biol 2006; 7:351-60. [PMID: 16086227 DOI: 10.1007/s11307-005-0012-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE In this study, we used quantitative decision tree modeling to assess the cost-effectiveness of a positron emission tomography (PET)-based management scenario for breast cancer in Canada. PROCEDURES Two patient management scenarios were compared (with and without PET). A metaanalysis of studies for the accuracy of PET in staging breast cancer was conducted. Life expectancies were calculated. Management costs were determined from previous cost-effective analyses, management costs from our institutions, and recently published Canadian cost estimates of various procedures. RESULTS A cost savings of $695 per person is expected for the PET strategy, with an increase in life expectancy (7.4 days), when compared with the non-PET strategy. This cost savings remained in favor of the PET strategy when subjected to a sensitivity analysis. CONCLUSIONS The use of a PET management strategy for the staging of breast cancer is expected to remain economically viable in Canada under various economic conditions.
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Affiliation(s)
- J Scott Sloka
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland A1B 4S1, Canada.
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87
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Dos Santos DT, Pereira Lima EN, Chojniak R, Cavalcanti MGP. Topographic metabolic map of head and neck squamous cell carcinoma using 18F-FDG PET and CT image fusion. ACTA ACUST UNITED AC 2006; 100:619-25. [PMID: 16243250 DOI: 10.1016/j.tripleo.2005.02.076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2004] [Revised: 02/22/2005] [Accepted: 02/25/2005] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To propose a methodologic approach to evaluate head and neck tumors in order to identify and distinguish areas of higher metabolic activity inside the lesion. STUDY DESIGN The sample consisted of 17 patients with squamous cell carcinoma of the head and neck. Images were simultaneously acquired using a nondedicated PET-CT device and an independent workstation with ENTEGRA 2 NT software to generate the image fusion between PET and CT. Sites of higher metabolic activity inside the tumor were classified as centric or eccentric according to their relative location to the lesion center. RESULTS Seventy-seven percent (n=13) of the patients presented the site of higher metabolic activity at the center of lesion, and in 23% (n=4) the uptake of the tracer was increased at the periphery of the lesion. CONCLUSIONS This technique gave a realistic view of the functional metabolism, locating the anatomical tumor area and helping in future treatment planning.
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Affiliation(s)
- Malik E Juweid
- Department of Radiology and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City 52242, USA.
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89
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Jun Oh S, Ryu JS, Yoon EJ, Bae MS, Choi SJ, Park KB, Moon DH. 99mTc-labeled 1-thio-β-d-glucose as a new tumor-seeking agent: Synthesis and tumor cell uptake assay. Appl Radiat Isot 2006; 64:207-15. [PMID: 16168660 DOI: 10.1016/j.apradiso.2005.07.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2005] [Revised: 05/16/2005] [Accepted: 07/15/2005] [Indexed: 10/25/2022]
Abstract
99mTc-labeled 1-thio-beta-D-glucose (99mTc-1-TG) was synthesized under different ligand concentrations. 1-Thio-beta-D-glucose (1-TG) showed different chemical properties and higher stability at acid pH as compared to neutral and basic pH. Under different ligand concentrations, 99mTc-1-TG was obtained with high labeling efficiency of >97%, but the HPLC chromatogram varied with the ligand concentration. The results of a tumor cell uptake assay also depended on the ligand concentration. With the lowest ligand concentration tested (0.5 mg/ml of 1-TG), we obtained the highest uptake. With different glucose and insulin concentrations, 99mTc-1-TG uptake was not significantly different from that of [18F]FDG.
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Affiliation(s)
- Seung Jun Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Republic of Korea.
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90
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Pepe G, Rossetti C, Sironi S, Landoni C, Gianolli L, Pastorino U, Zannini P, Mezzetti M, Grimaldi A, Galli L, Messa C, Fazio F. Patients with known or suspected lung cancer: evaluation of clinical management changes due to 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) study. Nucl Med Commun 2005; 26:831-7. [PMID: 16096588 DOI: 10.1097/01.mnm.0000175787.04553.99] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To determine prospectively from the referring physician's point of view the impact of F-fluorodeoxyglucose positron emission tomography (F-FDG PET) results on the management decisions in patients with known or suspected lung cancer. METHODS Seventy-five consecutive patients (58 men, 17 women; age range, 33-82 years; mean age, 64 years) with a diagnosis of a pulmonary lesion, obtained by means of morphological imaging studies and/or cytological sampling, were included in the study. The patient population consisted of three groups: (A) patients (n=18) with a solitary lung nodule; (B) patients (n=37) with untreated lung cancer; and (C) patients (n=20) with treated lung cancer. All were referred for whole-body F-FDG PET within 15 days (mean, 11 days) of lung lesion detection. To determine whether and how PET findings could modify the treatment strategy, a questionnaire was sent to the referring physician before and after the PET results. With regard to the treatment strategy, four major options were recognized: (1) further diagnostic investigations; (2) medical therapy; (3) surgical treatment; (4) wait-and-see. For data analysis, intermodality changes, defined as changes between treatment strategies related to PET findings, were considered. RESULTS Before the PET study, the planned management for the overall patient population was as follows: further diagnostic investigations in 44 cases (58%), medical therapy in 17 (23%), surgical treatment in nine (12%) and wait-and-see in five (7%). After the PET study, further diagnostic tools were indicated in 27 cases (36%), medical therapy in 17 (23%), surgical treatment in 28 (37%) and wait-and-see in three (4%). Relative to the initially planned strategy, changes in patient management after PET imaging occurred in 34 (45%) cases. Overall, the most relevant variation after PET concerned the surgical treatment strategy. The highest percentage (67%) of changes in management after PET was found in patients with a solitary pulmonary nodule; the percentages of changes of the three patient groups were significantly different (chi-squared test; P=0.021). CONCLUSIONS In patients with known or suspected lung cancer, F-FDG PET results determined significant variations in major clinical management decisions.
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Affiliation(s)
- Gino Pepe
- Division of Nuclear Medicine, Institute H. S. Raffaele, University of Milan, Via Olgettina 60, 20132 Milan, Italy
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91
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Brooksby B, Jiang S, Dehghani H, Pogue BW, Paulsen KD, Weaver J, Kogel C, Poplack SP. Combining near-infrared tomography and magnetic resonance imaging to study in vivo breast tissue: implementation of a Laplacian-type regularization to incorporate magnetic resonance structure. JOURNAL OF BIOMEDICAL OPTICS 2005; 10:051504. [PMID: 16292948 DOI: 10.1117/1.2098627] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
An imaging system that simultaneously performs near infrared (NIR) tomography and magnetic resonance imaging (MRI) is used to study breast tissue phantoms and a healthy woman in vivo. An NIR image reconstruction that exploits the combined data set is presented that implements the MR structure as a soft-constraint in the NIR property estimation. The algorithm incorporates the MR spatially segmented regions into a regularization matrix that links locations with similar MR properties, and applies a Laplacian-type filter to minimize variation within each region. When prior knowledge of the structure of phantoms is used to guide NIR property estimation, root mean square (rms) image error decreases from 26 to 58%. For a representative in vivo case, images of hemoglobin concentration, oxygen saturation, water fraction, scattering power, and scattering amplitude are derived and the properties of adipose and fibroglandular breast tissue types, identified from MRI, are quantified. Fibroglandular tissue is observed to have more than four times as much water content as adipose tissue, almost twice as much blood volume, and slightly reduced oxygen saturation. This approach is expected to improve recovery of abnormalities within the breast, as the inclusion of structural information increases the accuracy of recovery of embedded heterogeneities, at least in phantom studies.
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Affiliation(s)
- Ben Brooksby
- Dartmouth College, Thayer School of Engineering, 8000 Cummings Hall, Hanover, New Hampshire 03755, USA
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92
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Jadvar H, Xiankui L, Shahinian A, Park R, Tohme M, Pinski J, Conti PS. Glucose Metabolism of Human Prostate Cancer Mouse Xenografts. Mol Imaging 2005; 4:91-7. [PMID: 16105512 DOI: 10.1162/15353500200505118] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2005] [Revised: 03/15/2005] [Accepted: 03/22/2005] [Indexed: 11/04/2022] Open
Abstract
We hypothesized that the glucose metabolism of prostate cancer is modulated by androgen. We performed in vivo biodistribution and imaging studies of [F-18] fluorodeoxyglucose (FDG) accumulation in androgen-sensitive (CWR-22) and androgen-independent (PC-3) human prostate cancer xenografts implanted in castrated and noncastrated male athymic mice. The growth pattern of the CWR-22 tumor was best approximated by an exponential function (tumor size in mm3 = 14.913 e0.108 × days, R2 = .96, n = 5). The growth pattern of the PC-3 tumor was best approximated by a quadratic function (tumor size in mm3 = 0.3511 × days2 + 49.418 × day −753.33, R2 = .96, n = 3). The FDG accumulation in the CWR-22 tumor implanted in the castrated mice was significantly lower, by an average of 55%, in comparison to that implanted in the noncastrated host (1.27 vs. 2.83, respectively, p < .05). The 3-week maximal standardized uptake value (SUVmax) was 0.99 ± 0.43 (mean ± SD) for CWR-22 and 1.21 ± 0.32 for PC-3, respectively. The 5-week SUVmax was 1.22 ± 0.08 for CWR-22 and 1.35 ± 0.17 for PC-3, respectively. The background muscle SUVmax was 0.53 ± 0.11. Glucose metabolism was higher in the PC-3 tumor than in the CWR-22 tumor at both the 3-week (by 18%) and the 5-week (by 9.6%) micro-PET imaging sessions. Our results support the notions that FDG PET may be useful in the imaging evaluation of response to androgen ablation therapy and in the early prediction of hormone refractoriness in men with metastatic prostate cancer.
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Affiliation(s)
- Hossein Jadvar
- Keck School of Medicine, University of Southern California, Los Angeles, CA 9003, USA.
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93
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Choi YW, Munden RF, Erasmus JJ, Park KJ, Chung WK, Jeon SC, Park CK. Effects of radiation therapy on the lung: radiologic appearances and differential diagnosis. Radiographics 2005; 24:985-97; discussion 998. [PMID: 15256622 DOI: 10.1148/rg.244035160] [Citation(s) in RCA: 211] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Radiation-induced lung disease (RILD) due to radiation therapy is common. Radiologic manifestations are usually confined to the lung tissue within the radiation port and are dependent on the interval after completion of treatment. In the acute phase, RILD typically manifests as ground-glass opacity or attenuation or as consolidation; in the late phase, it typically manifests as traction bronchiectasis, volume loss, and scarring. However, the use of oblique beam angles and the development of newer irradiation techniques such as three-dimensional conformal radiation therapy can result in an unusual distribution of these findings. Awareness of the atypical manifestations of RILD can be useful in preventing confusion with infection, recurrent malignancy, lymphangitic carcinomatosis, and radiation-induced tumors. In addition, knowledge of radiologic findings that are outside the expected pattern for RILD can be useful in diagnosis of infection or recurrent malignancy. Such findings include the late appearance or enlargement of a pleural effusion; development of consolidation, a mass, or cavitation; and occlusion of bronchi within an area of radiation-induced fibrosis. A comprehensive understanding of the full spectrum of these manifestations is important to facilitate diagnosis and management in cancer patients treated with radiation therapy.
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Affiliation(s)
- Yo Won Choi
- Department of Radiology, College of Medicine, Hanyang University, Seoul, Korea.
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94
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Affiliation(s)
- Daniel Cham
- PET Imaging Science Center, Department of Radiology, University of Southern California, Los Angeles, California 90033-4609, USA
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95
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Abstract
Diagnostic imaging has played a major role in the evaluation of patients with cancers of the bone and soft tissue. The imaging modalities have included radiography, computed tomography, magnetic resonance imaging, and bone scintigraphy. Current experience suggests that functional imaging with positron emission tomography (PET) and [F-18]fluorodeoxyglucose (FDG) may also have an important role in the imaging evaluation of patients with bone and soft tissue sarcoma, including guiding biopsy, detecting local recurrence in amputation stumps, detecting metastatic disease, predicting and monitoring response to therapy, and assessing for prognosis. Prospective studies with large patient groups will be essential to define the exact diagnostic role of FDG PET in this clinical setting, which should also include an evaluation of the cost-effectiveness and the short-term and long-term benefits in clinical decision making and management. In this article, we review the diagnostic utility of dedicated PET and PET combined with computed tomography imaging system in the evaluation of patients with bone and soft tissue malignancies.
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Affiliation(s)
- Hossein Jadvar
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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96
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Bandoh S, Fujita J, Yamamoto Y, Nishiyama Y, Ueda Y, Tojo Y, Ishii T, Kubo A, Ishida T. A case of lung cancer associated with pneumoconiosis diagnosed by fluorine-18 fluorodeoxyglucose positron emission tomography. Ann Nucl Med 2004; 17:597-600. [PMID: 14651360 DOI: 10.1007/bf03006674] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We report a case of lung cancer arising from progressive massive fibrosis (PMF) associated with pneumoconiosis. In this case, fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) was able to clearly distinguish the lung cancer from PMF, suggesting a potential usefulness of FDG-PET in cancer screening in patients with pneumoconiosis. To our knowledge, this is the first description of an FDG-PET image of lung cancer arising from PMF.
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Affiliation(s)
- Shuji Bandoh
- First Department of Internal Medicine, Kagawa Medical University, Kita-gun, Japan.
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97
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Finkelstein SE, Carrasquillo JA, Hoffman JM, Galen B, Choyke P, White DE, Rosenberg SA, Sherry RM. A prospective analysis of positron emission tomography and conventional imaging for detection of stage IV metastatic melanoma in patients undergoing metastasectomy. Ann Surg Oncol 2004; 11:731-8. [PMID: 15249335 PMCID: PMC2227906 DOI: 10.1245/aso.2004.01.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Positron emission tomography with 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG-PET) is available for evaluation of patients with melanoma. This study evaluates the potential of FDG-PET to improve on conventional imaging (CI) in patients with stage IV melanoma undergoing metastasectomy. METHODS This was a prospective study comparing radiological evaluation of patients who underwent metastasectomy for palliation or cure. Patients underwent preoperative evaluation by physical examination, CI by computed tomography and/or magnetic resonance imaging, and FDG-PET. Independent observers performed three separate analyses of CI alone, FDG-PET alone, or FDG-PET read with knowledge of CI (FDG-PET + CI). Abnormalities were reported as benign or malignant and assessed by pathologic analysis or by clinical outcome determined by disease progression detected on serial evaluations. RESULTS Ninety-four lesions were noted in 18 patients who underwent preoperative assessment, metastasectomy, and long-term follow up (median, 24 months). Lesion-by-lesion analysis for CI demonstrated a sensitivity of 76%, a specificity of 87%, a positive predictive value (PPV) of 86%, and a negative predictive value (NPV) of 76%. FDG-PET demonstrated a sensitivity of 79%, a specificity of 87%, a PPV of 86%, and an NPV of 80%. For FDG-PET + CI, the sensitivity was 88%, specificity was 91%, and PPV and NPV were 91% and 88%, respectively. CONCLUSIONS Combined use of FDG-PET and CI may be an accurate strategy to identify sites of disease in patients with stage IV melanoma being considered for metastasectomy. Interpreted independently, FDG-PET and CI seemed to be equivalent modalities. FDG-PET + CI had both the highest sensitivity on lesion-by-lesion analysis and the best accuracy on patient-by-patient analysis.
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Affiliation(s)
- Steven E Finkelstein
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Building 10, Room 2338, 9000 Rockville Pike, Bethesda, MD 20892, USA.
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98
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Zanzonico P. Positron emission tomography: a review of basic principles, scanner design and performance, and current systems. Semin Nucl Med 2004; 34:87-111. [PMID: 15031810 DOI: 10.1053/j.semnuclmed.2003.12.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Pat Zanzonico
- Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA
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99
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Schaffler GJ, Wolf G, Schoellnast H, Groell R, Maier A, Smolle-Jüttner FM, Woltsche M, Fasching G, Nicoletti R, Aigner RM. Non-small cell lung cancer: evaluation of pleural abnormalities on CT scans with 18F FDG PET. Radiology 2004; 231:858-65. [PMID: 15105451 DOI: 10.1148/radiol.2313030785] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE To evaluate the accuracy of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) in differentiation of pleural malignancy and cancer-unrelated pleural disease in patients with non-small cell lung cancer (NSCLC) and pleural abnormalities at computed tomography (CT). MATERIALS AND METHODS In 92 patients, pleural abnormalities were detected at contrast material-enhanced thoracic CT, which was performed for newly diagnosed NSCLC (n = 41) or restaging (n = 51). CT findings were negative for pleural malignancy when pleural effusion with attenuation of 10 HU or less and/or rib fractures with no evidence of pathologic fracture were present; findings were indeterminate when pleural effusion with attenuation greater than 10 HU and/or solid pleural abnormalities without osseous destruction of the chest wall were present; and findings were positive if any osseous destruction of the chest wall adjacent to a pleural mass was present. All patients underwent FDG PET. Findings were negative for pleural malignancy if pleural activity was absent, equal to, or less than mediastinal background activity; findings were positive if pleural activity was higher than mediastinal background activity. Reading of CT and FDG PET scans was first performed separately and then was combined. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPP), and accuracy were calculated for CT and FDG PET separately and for CT and FDG PET combined, with cytologic and/or histologic analysis as standard of reference. RESULTS In detection of pleural malignancies, CT findings were indeterminate in 65 (71%) patients and true-negative in 27 (29%). Respective sensitivity, specificity, PPV, NPV, and accuracy of FDG PET in detection of pleural malignancies were 100%, 71%, 63%, 100%, and 80%; and those of CT and FDG PET combined, 100%, 76%, 67%, 100%, and 84%. CONCLUSION Findings suggest that a negative FDG PET scan for indeterminate pleural abnormalities at CT indicates a benign character, while positive findings on an FDG PET scan are sensitive for malignancy.
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Affiliation(s)
- Gottfried J Schaffler
- Department of Radiology, University Hospital Graz, Auenbruggerplatz 9, A-8036 Graz, Austria.
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100
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Jadvar H, Tatlidil R, Garcia AA, Conti PS. Evaluation of recurrent gastric malignancy with [F-18]-FDG positron emission tomography. Clin Radiol 2003; 58:215-21. [PMID: 12639527 DOI: 10.1016/s0009-9260(02)00477-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIM We retrospectively assessed the use of [(18)F] fluorodeoxyglucose positron emission tomography (FDG PET) in the evaluation of recurrent disease in patients with history of gastric malignancy. MATERIALS AND METHODS Eighteen patients were referred for FDG PET for evaluation of recurrent gastric cancer. Prior treatments included total (n = 4) or partial gastrectomy (n = 14) followed by chemotherapy alone (n = 7) or combined chemoradiation therapy (n = 2). The interval between the most recent treatment and PET ranged from 3 months to 2 years. Correlative diagnostic data were available in 16 patients and were all obtained within 3 months of the PET study. Validation was by clinical or imaging follow-up (2-45 months) in 16 patients and histology in two patients. RESULTS PET was concordant with computed tomography (CT) in 12 patients (5 TP, 6 TN, 1 FN). In one patient with negative imaging studies, an incidental finding of left obstructive uropathy was determined to be due to metastatic ureteral stricture. Discordant imaging findings were present in four patients (22% of total). PET-detected diffuse metastatic lesions in three of these patients with rising serum tumour markers while other imaging studies were negative. Additional chemotherapy was initiated in these three patients (17% of total) based on PET localization of disease. PET and a gastric anastomosis biopsy were negative in another patient with positive CT. The remaining two patients without correlative imaging studies died shortly after positive PET studies with presumed recurrent cancer. CONCLUSION FDG PET may be useful in the evaluation of recurrent gastric cancer, and can localize the disease when CT is non-diagnostic. Imaging evaluation with PET may also impact on the clinical management of patients with recurrent gastric cancer.
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Affiliation(s)
- H Jadvar
- PET Imaging Science Center, Division of Nuclear Medicine, Department of Radiology, Keck School of Medicine, University of Southern California, California, Los Angeles 90033, USA.
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