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Jiang J, Miao L, Zhang L, Shi Z, Zhang H, Wen X, Hu S, Xu L, Gong L, Li M. Assessing the Feasibility of Simplifying the Scanning Protocol for Spinal Metastases With Vertebral Compression Fractures Using Only the Dixon T2-Weighted Sequence. J Comput Assist Tomogr 2024:00004728-990000000-00307. [PMID: 38595136 DOI: 10.1097/rct.0000000000001612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Conventional imaging protocols, including sagittal T1-weighted imaging (T1WI) and water-only T2-weighted imaging (T2WI), are time consuming when screening for spinal metastases with vertebral compression fractures (VCFs). In this study, we aimed to assess the accuracy of using only the Dixon T2-weighted sequence in the diagnosis of spinal metastases with VCFs to determine its suitability as a simplified protocol for this task. METHODS This retrospective study included 27 patients diagnosed with spinal metastases and VCFs. Qualitative analysis was performed separately by two musculoskeletal radiologists, who independently performed diagnostic evaluations of each vertebra using both conventional and simplified protocols. McNemar's test was then used to compare the differences in diagnostic results, and Cohen's kappa coefficient was used to assess interobserver and interprotocol agreement. Diagnostic performance values for both protocols, including sensitivity, specificity, and area under the curve, were then determined based on the reference standard. Quantitative image analysis was performed randomly for 30 metastases on T1WI and fat-only T2WI to measure the signal intensity, signal-to-noise ratio, and contrast-to-noise ratio. RESULTS The diagnosis of VCFs by both radiologists was in full agreement with the reference standard. The classification of spinal metastases and diagnostic performance values determined by both radiologists were not significantly different between the two protocols (all P > 0.05), and the consistency between observers and protocols was excellent (κ = 0.973-0.991). The contrast-to-noise ratio of fat-only T2WI was significantly higher than that of T1WI (P < 0.001). CONCLUSIONS The Dixon T2-weighted sequence alone performed well in diagnosing spinal metastases with VCFs, performing no worse than the conventional protocol (T1WI and water-only T2WI). This suggests that the Dixon T2-weighted sequence alone can serve as a simplified protocol for the diagnosis of spinal metastases with VCFs, thereby avoiding the need for more intricate scanning procedures.
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Affiliation(s)
| | - Lei Miao
- From the Departments of Diagnostic Radiology
| | - Li Zhang
- From the Departments of Diagnostic Radiology
| | - Zhuo Shi
- From the Departments of Diagnostic Radiology
| | | | - Xin Wen
- From the Departments of Diagnostic Radiology
| | - Sijie Hu
- From the Departments of Diagnostic Radiology
| | | | - Lihua Gong
- Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meng Li
- From the Departments of Diagnostic Radiology
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Turkbey B, Oto A, Allen BC, Akin O, Alexander LF, Ari M, Froemming AT, Fulgham PF, Gettle LM, Maranchie JK, Rosenthal SA, Schieda N, Schuster DM, Venkatesan AM, Lockhart ME. ACR Appropriateness Criteria® Post-Treatment Follow-up of Prostate Cancer: 2022 Update. J Am Coll Radiol 2023; 20:S164-S186. [PMID: 37236741 DOI: 10.1016/j.jacr.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 05/28/2023]
Abstract
Prostate cancer has a wide spectrum ranging between low-grade localized disease and castrate-resistant metastatic disease. Although whole gland and systematic therapies result in cure in the majority of patients, recurrent and metastatic prostate cancer can still occur. Imaging approaches including anatomic, functional, and molecular modalities are continuously expanding. Currently, recurrent and metastatic prostate cancer is grouped in three major categories: 1) Clinical concern for residual or recurrent disease after radical prostatectomy, 2) Clinical concern for residual or recurrent disease after nonsurgical local and pelvic treatments, and 3) Metastatic prostate cancer treated by systemic therapy (androgen deprivation therapy, chemotherapy, immunotherapy). This document is a review of the current literature regarding imaging in these settings and the resulting recommendations for imaging. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Baris Turkbey
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
| | - Aytekin Oto
- Panel Chair, University of Chicago, Chicago, Illinois
| | - Brian C Allen
- Panel Vice-Chair, Duke University Medical Center, Durham, North Carolina
| | - Oguz Akin
- Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Mim Ari
- The University of Chicago, Chicago, Illinois, Primary care physician
| | | | - Pat F Fulgham
- Urology Clinics of North Texas, Dallas, Texas; American Urological Association
| | | | | | - Seth A Rosenthal
- Sutter Medical Group, Sacramento, California; Commission on Radiation Oncology
| | - Nicola Schieda
- Ottawa Hospital Research Institute and the Department of Radiology, The University of Ottawa, Ottawa, Ontario, Canada
| | - David M Schuster
- Emory University, Atlanta, Georgia; Commission on Nuclear Medicine and Molecular Imaging
| | | | - Mark E Lockhart
- Specialty Chair, University of Alabama at Birmingham, Birmingham, Alabama
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Wei XF, Chen XK, Lu L, Luo P, Xu L, Xie HN, Yang YF, Yu YK, Li HM, Liu Q, Zhang RX, Qin JJ, Li Y. 99m Tc bone scintigraphy does not affect preoperative workup for patients with potentially resectable esophageal squamous cell carcinoma. Thorac Cancer 2022; 13:2371-2376. [PMID: 35811377 PMCID: PMC9376155 DOI: 10.1111/1759-7714.14575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 06/21/2022] [Indexed: 11/28/2022] Open
Abstract
Background 99mTc bone scintigraphy (BS) is the mainstay and most widely used technique in evaluation of bone metastasis (BM) in China. This study aimed to investigate the value of 99mTc BS in preoperative workup for patients with potentially resectable (cT1−4aN0−3) esophageal squamous cell carcinoma (ESCC). Methods This prospective cross‐section clinical trial (ChiCTR1800020304) enrolled a total of 385 patients with ESCC diagnosed at thoracic surgery clinic from October 2018 to September 2020. All patients were diagnosed with stage cT1−4aN0−3 and were potential candidates for surgical resection. BS was performed preoperatively and the treatment strategy was changed after confirmation of BM. The primary endpoint was the rate of change of the treatment regimen because of BM, while the secondary endpoint was the rate of positive BS findings. Results Out of the 385 patients, only two (0.5%) changed their treatment regimen because of BM. The rate of positive BS findings was 1%, while two patients (0.5%) had false‐positive or false‐negative results. The BS diagnostic performance for BM was sensitivity 50%, specificity 99.5%, positive predictive value 50%, negative predictive value 99.5%, and accuracy 99.0%. There was no significant difference in BM in relation to age, sex, tumor location or clinical stage. Conclusion Our data demonstrated that 99mTc bone scintigraphy does not significantly affect the preoperative workup in patients with potentially resectable ESCC, especially in early clinical stage patients.
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Affiliation(s)
- Xiu-Feng Wei
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xian-Kai Chen
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lu Lu
- Department of Thoracic Surgery, Beijing Chui Yang Liu Hospital, Beijing, China
| | - Peng Luo
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Xu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hou-Nai Xie
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ya-Fan Yang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yong-Kui Yu
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Zhengzhou, China
| | - Hao-Miao Li
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Zhengzhou, China
| | - Qi Liu
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Zhengzhou, China
| | - Rui-Xiang Zhang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian-Jun Qin
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yin Li
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Vermersch M, Mulé S, Chalaye J, Galletto Pregliasco A, Emsen B, Amaddeo G, Monnet A, Stemmer A, Baranes L, Laurent A, Leroy V, Itti E, Luciani A. Impact of the 18F-FDG-PET/MRI on Metastatic Staging in Patients with Hepatocellular Carcinoma: Initial Results from 104 Patients. J Clin Med 2021; 10:jcm10174017. [PMID: 34501465 PMCID: PMC8432497 DOI: 10.3390/jcm10174017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/28/2021] [Accepted: 09/01/2021] [Indexed: 02/07/2023] Open
Abstract
Optimal HCC therapeutic management relies on accurate tumor staging. Our aim was to assess the impact of 18F-FDG-WB-PET/MRI on HCC metastatic staging, compared with the standard of care CT-CAP/liver MRI combination, in patients with HCC referred on a curative intent or before transarterial radioembolization. One hundred and four consecutive patients followed for HCC were retrospectively included. The WB-PET/MRI was compared with the standard of care CT-CAP/liver MRI combination for HCC metastatic staging, with pathology, followup, and multidisciplinary board assessment as a reference standard. Thirty metastases were identified within 14 metastatic sites in 11 patients. The sensitivity of WB-PET/MRI for metastatic sites and metastatic patients was significantly higher than that of the CT-CAP/liver MRI combination (respectively 100% vs. 43%, p = 0.002; and 100% vs. 45%, p = 0.01). Metastatic sites missed by CT-CAP were bone (n = 5) and distant lymph node (n = 3) in BCLC C patients. For the remaining 93 nonmetastatic patients, three BCLC A patients identified as potentially metastatic on the CT-CAP/liver MRI combination were correctly ruled out with the WB-PET/MRI without significant increase in specificity (100% vs. 97%; p = 0.25). The WB-PET/MRI may improve HCC metastatic staging and could be performed as a “one-stop-shop” examination for HCC staging with a significant impact on therapeutic management in about 10% of patients especially in locally advanced HCC.
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Affiliation(s)
- Mathilde Vermersch
- Medical Imaging Department, Henri Mondor Hospital, APHP, 94000 Créteil, France; (S.M.); (A.G.P.); (L.B.); (A.L.)
- Institut Mondor de la Recherche Biomédicale (IMRB) Team 18, INSERM Unit 955, Henri Mondor Hospital, 94000 Créteil, France
- Medical Imaging Department, Lille University Hospital, 59000 Lille, France
- Correspondence: ; Tel.: +33-6-3119-1558
| | - Sébastien Mulé
- Medical Imaging Department, Henri Mondor Hospital, APHP, 94000 Créteil, France; (S.M.); (A.G.P.); (L.B.); (A.L.)
- Institut Mondor de la Recherche Biomédicale (IMRB) Team 18, INSERM Unit 955, Henri Mondor Hospital, 94000 Créteil, France
| | - Julia Chalaye
- Nuclear Medicine Department, Henri Mondor Hospital, APHP, 94000 Créteil, France; (J.C.); (B.E.); (E.I.)
| | - Athena Galletto Pregliasco
- Medical Imaging Department, Henri Mondor Hospital, APHP, 94000 Créteil, France; (S.M.); (A.G.P.); (L.B.); (A.L.)
| | - Berivan Emsen
- Nuclear Medicine Department, Henri Mondor Hospital, APHP, 94000 Créteil, France; (J.C.); (B.E.); (E.I.)
| | - Giuliana Amaddeo
- Department of Hepatogastroenterology, Henri Mondor Hospital, APHP, 94000 Créteil, France; (G.A.); (V.L.)
| | - Aurélien Monnet
- Siemens Healthineers, Siemens Healthcare GmbH, 91052 Erlangen, Germany; (A.M.); (A.S.)
| | - Alto Stemmer
- Siemens Healthineers, Siemens Healthcare GmbH, 91052 Erlangen, Germany; (A.M.); (A.S.)
| | - Laurence Baranes
- Medical Imaging Department, Henri Mondor Hospital, APHP, 94000 Créteil, France; (S.M.); (A.G.P.); (L.B.); (A.L.)
| | - Alexis Laurent
- Hepatobiliary Surgery and Liver Transplantation, Henri Mondor Hospital, APHP, 94000 Créteil, France;
| | - Vincent Leroy
- Department of Hepatogastroenterology, Henri Mondor Hospital, APHP, 94000 Créteil, France; (G.A.); (V.L.)
| | - Emmanuel Itti
- Nuclear Medicine Department, Henri Mondor Hospital, APHP, 94000 Créteil, France; (J.C.); (B.E.); (E.I.)
| | - Alain Luciani
- Medical Imaging Department, Henri Mondor Hospital, APHP, 94000 Créteil, France; (S.M.); (A.G.P.); (L.B.); (A.L.)
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T2-weighted Dixon MRI of the spine: A feasibility study of quantitative vertebral bone marrow analysis. Diagn Interv Imaging 2021; 102:431-438. [PMID: 33612414 DOI: 10.1016/j.diii.2021.01.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/17/2021] [Accepted: 01/30/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE To compare the measurements of fat fraction (FF) and in-phase vs. opposed-phase ratio between two-dimensional T2-weighted (T2W) spin-echo (SE) Dixon and three-dimensional (3D) T1-weighted (T1W) volume interpolated breath-hold examination (VIBE) Dixon sequences in malignant vertebral lesions and normal vertebral bone marrow. MATERIALS AND METHODS Thirty patients with focal vertebral malignancies (20 men, mean age, 67.3±9.4 [SD] years; age range: 41-84 years) and 30 patients without malignant spinal disease (11 men, mean age, 70.1±12.9 [SD]; age range: 53-93 years) were retrospectively included. Each patient underwent spine MRI at 1.5 Tesla including T2W SE and T1W VIBE 2-point Dixon sequences. Two readers independently performed 3D-volume of interest (VOI) and region of interest (ROI)-based FF and IO-ratio measurements of malignant lesions and normal vertebrae. Student t-test, Pearson correlation (r) test and two-way mixed model intraclass correlation coefficients (ICC) were used to compare measurements. RESULTS T2W SE and T1W VIBE mean FF and IO-ratio were significantly smaller in malignancy compared to normal marrow, but there were significant differences of paired measurement mean values between T2W SE and T1W VIBE Dixon parameters in malignant lesions T2W SE VOI FF=9%, T2W SE ROI FF=7%, T2W SE IO-ratio=4% vs. T1W VIBE VOI FF=11%, T1W VIBE ROI FF=9%, T1W VIBE IO-ratio=-2%, and in normal vertebrae T2W SE VOI FF=74%, T2W SE ROI FF=77%, T2W SE IO-ratio=51% vs. T1W VIBE VOI FF=67%, T1W VIBE ROI FF=73%, T1W VIBE IO-ratio=58% (each P comparing the paired T2W TSE and T1W VIBE parameter, respectively<0.001). There was excellent positive correlation between T2W SE and T1W VIBE-FF (r≥0.99) and VOI and ROI FF measurements for each sequence (r≥0.99). Inter-reader agreement was excellent for all measurements (ICC≥0.94 for all). CONCLUSION Calculation of T2W SE Dixon derived FF is feasible and gave valid results that help discriminate between malignant vertebral lesions and normal vertebral bone marrow.
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Burden of metastatic bone disease measured on 18F-NaF PET/computed tomography studies as a prognostic indicator in patients with medullary thyroid cancer. Nucl Med Commun 2021; 41:469-476. [PMID: 32187160 DOI: 10.1097/mnm.0000000000001175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of the study was to assess the association between the burden of metastatic bone disease measured on F-NaF PET/computed tomography (CT) studies and the overall survival (OS) of patients with medullary thyroid cancer (MTC). METHODS We retrospectively analyzed 31 patients with MTC who performed 18F-NaF PET/CT studies to assess skeletal metastases. The outcomes of the patients (dead or alive) were established based on the last information available on their files. In the studies considered positives for skeletal metastases, the burden of metastatic bone disease was established calculating the fluoride tumor volume (FTV). The FTV was defined using isocontour thresholds based on percentages of maximal standardized uptake values (SUVmax) in the lesions. These percentages varied from lesion to lesion and were established by visual analysis. The patients were divided into three groups as follows: without skeletal metastases (n = 11), with low FTV (≤50 cm; n = 11) and with high FTV (>50cm; n = 9). The Kaplan-Meier curves were used to analyze the OS in the three groups of patients and the log-rank test was used to determine the statistical significance of the difference between the groups. RESULTS There were statistically significant differences in the OS between the group with high FTV and the groups of patients with low FTV (P = 0.036) and without skeletal metastases (P = 0.001). There was not a statistically significant difference between the groups of patients with low FTV and without skeletal metastases (P = 0.147). CONCLUSION In patients with MTC, the burden of metastatic bone disease is associated with OS.
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Ueda CE, Duarte PS, de Castroneves LA, Coura-Filho GB, Sado HN, Sapienza MT, Hoff AO, Buchpiguel CA. Comparison of 18F-NaF PET/CT with Other Imaging Methods in the Detection of Bone Metastases in Patients with Medullary Thyroid Cancer: a Report of a Series of 31 Cases. Nucl Med Mol Imaging 2020; 54:281-291. [PMID: 33281999 PMCID: PMC7704988 DOI: 10.1007/s13139-020-00666-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/21/2020] [Accepted: 09/18/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To compare the 18F-NaF PET/CT studies (18F-NaF) with other imaging methods in the detection of skeletal metastases (SM) in patients with medullary thyroid cancer (MTC). METHODS We retrospectively analyzed 31 patients with MTC who performed 18F-NaF to assess SM. The results of the 18F-NaF were compared with other imaging methods performed for metastasis detection: 99Tc-MDP bone scan (BS), magnetic resonance imaging (MRI), contrast-enhanced CT (CT), and 68Ga-Dotatate and 18F-FDG PET/CT studies. A qualitative analysis comparing the 18F-NaF findings with the ones of the other methods was performed, and the results were classified as superior (>), equal (=), and inferior (<). RESULTS Eleven patients had no bone metastases detected on any of the imaging methods used. Twenty patients presented SM depicted on 18F-NaF. Of these 20 patients, 12 performed bone scan (in 9 18F-NaF > BS and in 3 18F-NaF = BS), 1 performed 18F-FDG (18F-NaF > 18F-FDG), 4 performed 68Ga-Dotatate (in 2 18F-NaF > 68Ga-Dotatate and in 2 18F-NaF = 68Ga-Dotatate), 20 performed CT of at least one body segment (in 15 18F-NaF = CT and in 5 18F-NaF > CT), and 16 performed MRI of at least one body segment, and in all of them, the 18F-NaF was equal to the MRI. Beside this, the 18F-NaF detected SM in body segments not routinely scanned in MRI and CT. CONCLUSION In patients with MTC, the 18F-NaF seems to be equal or superior to other imaging modalities in the detection of SM and allows the analysis of the whole skeletal in a single study.
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Affiliation(s)
- Cristina Emiko Ueda
- Division of Nuclear Medicine, São Paulo Cancer Institute (ICESP), São Paulo, Brazil
| | | | | | | | - Heitor Naoki Sado
- Division of Nuclear Medicine, São Paulo Cancer Institute (ICESP), São Paulo, Brazil
- Division of Nuclear Medicine, Department of Radiology and Oncology, Medical School of University of São Paulo (FMUSP), São Paulo, Brazil
| | - Marcelo Tatit Sapienza
- Division of Nuclear Medicine, Department of Radiology and Oncology, Medical School of University of São Paulo (FMUSP), São Paulo, Brazil
| | - Ana Oliveira Hoff
- Division of Endocrinology, São Paulo Cancer Institute (ICESP), São Paulo, Brazil
| | - Carlos Alberto Buchpiguel
- Division of Nuclear Medicine, São Paulo Cancer Institute (ICESP), São Paulo, Brazil
- Division of Nuclear Medicine, Department of Radiology and Oncology, Medical School of University of São Paulo (FMUSP), São Paulo, Brazil
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Evaluation of whole-body MRI with diffusion-weighted sequences in the staging of pediatric cancer patients. PLoS One 2020; 15:e0238166. [PMID: 32853252 PMCID: PMC7451574 DOI: 10.1371/journal.pone.0238166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 08/11/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The purpose of this study was to determine whether whole-body MRI (WBMRI) with diffusion-weighted sequences, which is free of ionizing radiation, can perform as well as traditional methods when used alone for staging or follow-up of pediatric cancer patients. METHODS After obtaining approval from our institutional research ethics committee and appropriate informed consent, we performed 34 examinations in 32 pediatric patients. The examinations were anonymized and analyzed by two radiologists with at least 10 years' experience. RESULTS The sensitivity and specificity findings, respectively, were as follows: 100% and 100% for primary tumor; 100% and 86% for bone metastasis; 33% and 100% for lung metastasis; 85% and 100% for lymph node metastasis; and 100% and 62% for global investigation of primary or secondary neoplasias. We observed excellent interobserver agreement for WBMRI and excellent agreement with standard staging examination results. CONCLUSIONS Our results suggest that pediatric patients can be safely imaged with WBMRI, although not as the only tool but in association with low-dose chest CT (for subcentimeter pulmonary nodules). However, additional exams with ionizing radiation may be necessary for patients who tested positive to correctly quantify and locate the lesions.
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Marazzi F, Orlandi A, Manfrida S, Masiello V, Di Leone A, Massaccesi M, Moschella F, Franceschini G, Bria E, Gambacorta MA, Masetti R, Tortora G, Valentini V. Diagnosis and Treatment of Bone Metastases in Breast Cancer: Radiotherapy, Local Approach and Systemic Therapy in a Guide for Clinicians. Cancers (Basel) 2020; 12:cancers12092390. [PMID: 32846945 PMCID: PMC7563945 DOI: 10.3390/cancers12092390] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/13/2020] [Accepted: 08/20/2020] [Indexed: 12/12/2022] Open
Abstract
The standard care for metastatic breast cancer (MBC) is systemic therapies with imbrication of focal treatment for symptoms. Recently, thanks to implementation of radiological and metabolic exams and development of new target therapies, oligometastatic and oligoprogressive settings are even more common-paving the way to a paradigm change of focal treatments role. In fact, according to immunophenotype, radiotherapy can be considered with radical intent in these settings of patients. The aim of this literature review is to analyze available clinical data on prognosis of bone metastases from breast cancer and benefits of available treatments for developing a practical guide for clinicians.
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Affiliation(s)
- Fabio Marazzi
- “A. Gemelli” IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario, 00168 Roma, Italy; (F.M.); (S.M.); (M.M.); (M.A.G.); (V.V.)
| | - Armando Orlandi
- “A. Gemelli” IRCCS, UOC di Oncologia Medica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario, 00168 Roma, Italy; (A.O.); (E.B.); (G.T.)
| | - Stefania Manfrida
- “A. Gemelli” IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario, 00168 Roma, Italy; (F.M.); (S.M.); (M.M.); (M.A.G.); (V.V.)
| | - Valeria Masiello
- “A. Gemelli” IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario, 00168 Roma, Italy; (F.M.); (S.M.); (M.M.); (M.A.G.); (V.V.)
- Correspondence:
| | - Alba Di Leone
- “A. Gemelli” IRCCS, UOC di Chirurgia Senologica, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario, 00168 Roma, Italy; (A.D.L.); (F.M.); (G.F.); (R.M.)
| | - Mariangela Massaccesi
- “A. Gemelli” IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario, 00168 Roma, Italy; (F.M.); (S.M.); (M.M.); (M.A.G.); (V.V.)
| | - Francesca Moschella
- “A. Gemelli” IRCCS, UOC di Chirurgia Senologica, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario, 00168 Roma, Italy; (A.D.L.); (F.M.); (G.F.); (R.M.)
| | - Gianluca Franceschini
- “A. Gemelli” IRCCS, UOC di Chirurgia Senologica, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario, 00168 Roma, Italy; (A.D.L.); (F.M.); (G.F.); (R.M.)
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Emilio Bria
- “A. Gemelli” IRCCS, UOC di Oncologia Medica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario, 00168 Roma, Italy; (A.O.); (E.B.); (G.T.)
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Maria Antonietta Gambacorta
- “A. Gemelli” IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario, 00168 Roma, Italy; (F.M.); (S.M.); (M.M.); (M.A.G.); (V.V.)
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Riccardo Masetti
- “A. Gemelli” IRCCS, UOC di Chirurgia Senologica, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario, 00168 Roma, Italy; (A.D.L.); (F.M.); (G.F.); (R.M.)
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Giampaolo Tortora
- “A. Gemelli” IRCCS, UOC di Oncologia Medica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario, 00168 Roma, Italy; (A.O.); (E.B.); (G.T.)
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Vincenzo Valentini
- “A. Gemelli” IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario, 00168 Roma, Italy; (F.M.); (S.M.); (M.M.); (M.A.G.); (V.V.)
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
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Clinical association between pre-treatment levels of plasma fibrinogen and bone metastatic burden in newly diagnosed prostate cancer patients. Chin Med J (Engl) 2020; 132:2684-2689. [PMID: 31725446 PMCID: PMC6940101 DOI: 10.1097/cm9.0000000000000506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Due to the different treatments for low-volume metastatic prostate cancer (PCa) as well as high-volume ones, evaluation of bone metastatic status is clinically significant. In this study, we evaluated the correlation between pre-treatment plasma fibrinogen and the burden of bone metastasis in newly diagnosed PCa patients. Methods: A single-center retrospective analysis, focusing on prostate biopsies of newly diagnosed PCa patients, was performed. A total of 261 patients were enrolled in this study in a 4-year period. All subjects were submitted to single-photon emission computerized tomography-computed tomography to confirm the status of bone metastasis and, if present, the number of metastatic lesions would then be calculated. Clinical information such as age, prostate-specific antigen (PSA), fibrinogen, clinical T stage, and Gleason score were collected. Patients were divided into three groups: (i) a non-metastatic group, (ii) a high volume disease (HVD) group (>3 metastases with at least one lesion outside the spine), and (iii) a low volume disease (LVD) group (metastatic patients excluding HVD ones). The main statistical methods included non-parametric Mann-Whitney test, Spearman correlation, receiver operating characteristic (ROC) curves, and logistic regression. Results: Fibrinogen positively correlated with Gleason score (r = 0.180, P = 0.003), PSA levels (r = 0.216, P < 0.001), and number of metastatic lesions (r = 0.296, P < 0.001). Compared with the non-metastatic and LVD groups, the HVD group showed the highest PSA (104.98 ng/mL, median) and fibrinogen levels (3.39 g/L, median), as well as the largest proportion of Gleason score >7 (86.8%). Both univariate (odds ratio [OR] = 2.16, 95% confidential interval [CI]: 1.536–3.038, P < 0.001) and multivariate (OR = 1.726, 95% CI: 1.206–2.472, P = 0.003) logistic regressions showed that fibrinogen was independently associated with HVD. The ROC curve suggested that fibrinogen acts as a predictor of HVD patients, yielding a cut-off of 3.08 g/L, with a sensitivity of 0.684 and a specificity of 0.760 (area under the curve = 0.739, 95% CI: 0.644–0.833, P < 0.001). Conclusions: Pre-treatment plasma fibrinogen is positively associated with bone metastatic burden in PCa patients. Our results indicate that fibrinogen might be a potential predictor of HVD.
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Taralli S, Caldarella C, Lorusso M, Scolozzi V, Altini C, Rubini G, Calcagni ML. Comparison between 18F-FDG and 18F-NaF PET imaging for assessing bone metastases in breast cancer patients: a literature review. Clin Transl Imaging 2020. [DOI: 10.1007/s40336-020-00363-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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12
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A two-step risk assessment method for radiofrequency ablations of spine metastases. Comput Biol Med 2019; 108:174-181. [PMID: 31005009 DOI: 10.1016/j.compbiomed.2019.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/08/2019] [Accepted: 03/09/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Spine metastases (MTS) can be treated via Radiofrequency Ablation (RFA) electrodes. To bring these electrodes into vertebral MTS, pathways have to be created. This can be done via transpedicular hammering or drilling. However, this is challenging due to spatial constraints, and because MTS can alter bone density considerably. METHOD In this work a two-step method is presented that intends to offer cognitive and physical assistance. Step 1 comprises two visualization methods that depict safety margins between and in risk structures. For Step 2, the correlation between Hounsfield Units (HUs) and drilling forces was analyzed to support manual and robot-assisted RFAs. RESULTS In-depth descriptions of two clinical cases and detailed feedback from the local clinic of neuroradiology are used to present the capabilities of the proposed method. Furthermore, a stiffness criterion is presented to predict drilling force changes from the local distribution and homogeneity of HUs with an inaccuracy of less than 1 mm. CONCLUSIONS The combination of visualization and drilling force prediction shows potential to support manual and robot-assisted spine RFAs. However, limitations have to be addressed in the future. For example, it has to be carefully evaluated to which extent the proposed method can speed up the planning process and increase intervention safety.
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Smith CP, Laucis A, Harmon S, Mena E, Lindenberg L, Choyke PL, Turkbey B. Novel Imaging in Detection of Metastatic Prostate Cancer. Curr Oncol Rep 2019; 21:31. [DOI: 10.1007/s11912-019-0780-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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14
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Gennaro KH, Porter KK, Gordetsky JB, Galgano SJ, Rais-Bahrami S. Imaging as a Personalized Biomarker for Prostate Cancer Risk Stratification. Diagnostics (Basel) 2018; 8:diagnostics8040080. [PMID: 30513602 PMCID: PMC6316045 DOI: 10.3390/diagnostics8040080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/13/2018] [Accepted: 11/15/2018] [Indexed: 02/07/2023] Open
Abstract
Biomarkers provide objective data to guide clinicians in disease management. Prostate-specific antigen serves as a biomarker for screening of prostate cancer but has come under scrutiny for detection of clinically indolent disease. Multiple imaging techniques demonstrate promising results for diagnosing, staging, and determining definitive management of prostate cancer. One such modality, multiparametric magnetic resonance imaging (mpMRI), detects more clinically significant disease while missing lower volume and clinically insignificant disease. It also provides valuable information regarding tumor characteristics such as location and extraprostatic extension to guide surgical planning. Information from mpMRI may also help patients avoid unnecessary biopsies in the future. It can also be incorporated into targeted biopsies as well as following patients on active surveillance. Other novel techniques have also been developed to detect metastatic disease with advantages over traditional computer tomography and magnetic resonance imaging, which primarily rely on defined size criteria. These new techniques take advantage of underlying biological changes in prostate cancer tissue to identify metastatic disease. The purpose of this review is to present literature on imaging as a personalized biomarker for prostate cancer risk stratification.
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Affiliation(s)
- Kyle H Gennaro
- Department of Urology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Kristin K Porter
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Jennifer B Gordetsky
- Department of Urology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Samuel J Galgano
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Soroush Rais-Bahrami
- Department of Urology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
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Böker SM, Adams LC, Bender YY, Fahlenkamp UL, Wagner M, Hamm B, Makowski MR. Differentiation of Predominantly Osteoblastic and Osteolytic Spine Metastases by Using Susceptibility-weighted MRI. Radiology 2018; 290:146-154. [PMID: 30375926 DOI: 10.1148/radiol.2018172727] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To evaluate the use of susceptibility-weighted MRI for the differentiation of predominantly osteoblastic and osteolytic spine metastases. Materials and Methods For this prospective study, 53 study participants (mean age, 54.5 years ± 14.3 [range, 22-88 years]; 27 men with a mean age of 55.3 years ± 12.7 [range, 22-72 years] and 26 women with a mean age of 53.8 years ± 15.7 [range, 23-88 years]) with clinically suspected spine metastases underwent imaging with standard MRI sequences, susceptibility-weighted MRI, and CT. Sensitivities and specificities of MRI sequences for the detection of predominantly osteoblastic and osteolytic metastases were determined by using CT as the reference standard. The metastases-to-vertebral body signal intensity ratio (MVR) was calculated to compare modalities. Phantom measurements were obtained to correlate bone densities between MRI sequences and CT. Results A total of 64 metastases (38 predominantly osteoblastic, 26 predominantly osteolytic) were detected. Susceptibility-weighted MRI achieved a sensitivity of 100% (38 of 38) and specificity of 96% (25 of 26) for predominantly osteoblastic metastases and a sensitivity of 96% (25 of 26) and specificity of 100% (38 of 38) for predominantly osteolytic metastases. Standard MRI sequences achieved a sensitivity of 89% (34 of 38) and specificity of 73% (19 of 26) for predominantly osteoblastic metastases and a sensitivity of 73% (19 of 26) and specificity of 92% (35 of 38) for predominantly osteolytic metastases. MVR measurements obtained with susceptibility-weighted MRI demonstrated a strong correlation with those obtained with CT (R2 = 0.75), whereas those obtained with T1-weighted MRI, T2-weighted MRI, and turbo inversion-recovery magnitude MRI showed a weak to moderate correlation (R2 = 0.00, R2 = 0.35, and R2 = 0.39, respectively). Susceptibility-weighted MRI showed a strong correlation with CT with regard to metastases size (R2 = 0.91). In phantom measurements, susceptibility-weighted MRI enabled the reliable differentiation of different degrees of mineralization (R2 = 0.92 compared with CT). Conclusion Susceptibility-weighted MRI enables the reliable differentiation between predominantly osteoblastic and osteolytic spine metastases with a higher accuracy than standard MRI sequences. © RSNA, 2018 Online supplemental material is available for this article. See also the editorial by Schweitzer in this issue.
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Affiliation(s)
- Sarah M Böker
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Lisa C Adams
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Yvonne Y Bender
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Ute L Fahlenkamp
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Moritz Wagner
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Bernd Hamm
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Marcus R Makowski
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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Zamboglou C, Eiber M, Fassbender TR, Eder M, Kirste S, Bock M, Schilling O, Reichel K, van der Heide UA, Grosu AL. Multimodal imaging for radiation therapy planning in patients with primary prostate cancer. Phys Imaging Radiat Oncol 2018; 8:8-16. [PMID: 33458410 PMCID: PMC7807571 DOI: 10.1016/j.phro.2018.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/22/2018] [Accepted: 10/23/2018] [Indexed: 12/22/2022] Open
Abstract
Implementation of advanced imaging techniques like multiparametric magnetic resonance imaging (mpMRI) or Positron Emission Tomography (PET) in radiation therapy (RT) planning of patients with primary prostate cancer demands several preconditions: accurate staging of the extraprostatic and intraprostatic tumor mass, robust delineation of the intraprostatic gross tumor volume (GTV) and a reproducible characterization of the prostate cancer's biological properties. In the current review we searched for the currently available imaging techniques and we discussed their ability to fulfill these preconditions. We found that current pretreatment imaging was mainly performed with mpMRI and/or Prostate-specific membrane antigen PET imaging. Both techniques offered an accurate detection of the extraprostatic and intraprostatic tumor burden and had a major impact on RT concepts. However, some studies postulated that mpMRI and PSMA PET had complementary information for intraprostatic GTV detection. Moreover, interobserver differences for intraprostatic tumor delineation based on mpMRI were observed. It is currently unclear whether PET based GTV delineation underlies also interobserver heterogeneity. Further research is warranted to answer whether multimodal imaging is able to visualize biological processes related to prostate cancer pathophysiology and radiation resistance.
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Affiliation(s)
- Constantinos Zamboglou
- Department of Radiation Oncology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg, Germany
- Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Germany
| | - Matthias Eiber
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg, Germany
| | - Thomas R. Fassbender
- Department of Nuclear Medicine, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Matthias Eder
- Department of Nuclear Medicine, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Simon Kirste
- Department of Radiation Oncology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg, Germany
| | - Michael Bock
- Division of Medical Physics, Department of Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg, Germany
| | - Oliver Schilling
- Institute of Surgical Pathology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg, Germany
| | - Kathrin Reichel
- Department of Urology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Uulke A. van der Heide
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Anca L. Grosu
- Department of Radiation Oncology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg, Germany
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Janssen JC, Woythal N, Meißner S, Prasad V, Brenner W, Diederichs G, Hamm B, Makowski MR. [ 68Ga]PSMA-HBED-CC Uptake in Osteolytic, Osteoblastic, and Bone Marrow Metastases of Prostate Cancer Patients. Mol Imaging Biol 2018; 19:933-943. [PMID: 28707038 DOI: 10.1007/s11307-017-1101-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE The aim of this study was to evaluate potential differences in "Glu-NH-CO-NH-Lys" radio-labeled with [68Ga]gallium N,N-bis[2-hydroxy-5-(carboxyethyl)benzyl]ethylenediamine-N,N-diacetic acid ([68Ga]PSMA-HBED-CC) uptake in osteolytic, osteoblastic, mixed, and bone marrow metastases in prostate cancer (PC) patients. PROCEDURES This retrospective study was approved by the local ethics committee. Patients who received [68Ga]PSMA-HBED-CC positron emission tomography/computed tomography ([68Ga]PSMA-PET/CT) with at least one positive bone metastasis were included in this study. Only patients who have not received systemic therapy for their PC were included. Bone metastases had to be confirmed by at least one other imaging modality or follow-up investigation. The maximum standardized uptake value (SUVmax) and mean Hounsfield units (HUmean) of each metastasis were measured. Based on CT, each metastasis was classified as osteolytic (OL), osteoblastic (OB), bone marrow (BM), or mixed (M). RESULTS One hundred fifty-four bone metastases in 30 patients were evaluated. Eighty out of 154 (51.9%) metastases were classified as OB, 21/154 (13.6%) as OL, 23/154 (14.9%) as M, and 30/154 (19.5%) as BM. The SUVmax for the different types of metastases were 10.6 ± 7.07 (OB), 24.0 ± 19.3 (OL), 16.0 ± 21.0 (M), and 14.7 ± 9.9 (BM). The SUVmax of OB vs. OL and OB vs. BM metastases differed significantly (p ≤ 0.025). A significant negative correlation between HUmean and SUVmax (r = -0.23, p < 0.05) was measured. CONCLUSIONS [68Ga]PSMA-HBED-CC uptake is higher in osteolytic and bone marrow metastases compared to osteoblastic metastases. Information derived from [68Ga]PSMA-PET and CT complement each other for the reliable diagnosis of the different types of bone metastases in PC patients.
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Affiliation(s)
- Jan-Carlo Janssen
- Department of Radiology, Charité, Charitéplatz 1, 10117, Berlin, Germany.
| | - Nadine Woythal
- Department of Nuclear Medicine, Charité, Charitéplatz 1, 10117, Berlin, Germany
| | - Sebastian Meißner
- Department of Radiology, Charité, Charitéplatz 1, 10117, Berlin, Germany
| | - Vikas Prasad
- Department of Nuclear Medicine, Charité, Charitéplatz 1, 10117, Berlin, Germany
| | - Winfried Brenner
- Department of Nuclear Medicine, Charité, Charitéplatz 1, 10117, Berlin, Germany
| | - Gerd Diederichs
- Department of Radiology, Charité, Charitéplatz 1, 10117, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité, Charitéplatz 1, 10117, Berlin, Germany
| | - Marcus R Makowski
- Department of Radiology, Charité, Charitéplatz 1, 10117, Berlin, Germany
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Bone and Calcified Soft Tissue Metastases of Medullary Thyroid Carcinoma Better Characterized on 18F-Fluoride PET/CT than on 68Ga-Dotatate PET/CT. Nucl Med Mol Imaging 2018; 52:318-323. [PMID: 30100945 DOI: 10.1007/s13139-018-0527-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/06/2018] [Accepted: 05/09/2018] [Indexed: 10/14/2022] Open
Abstract
Herein, we report a case of a 19-year-old man with multiple endocrine neoplasia type 2B (MEN2B) and medullary thyroid carcinoma (MTC) diagnosed when he was 12 years of age. The patient had previously undergone total thyroidectomy, cervical radiotherapy, and chemotherapy. He progressed with known bone, pulmonary, and lymph node metastases and was scanned with 18F-fluoride (18F-NaF) and 68Ga-dotatate whole-body positron emission tomography/computed tomography (PET/CT) for metastatic disease monitoring. We found that the MTC bone metastases and soft tissue calcified metastases were better characterized on 18F-NaF PET/CT than on 68Ga-dotatate PET/CT. This case illustrates that the 18F-NaF PET/CT could be helpful not only to the detection of bone metastases but also to the detection of calcified soft tissue metastases in patients with MTC.
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ACR Appropriateness Criteria ® Post-treatment Follow-up Prostate Cancer. J Am Coll Radiol 2018; 15:S132-S149. [DOI: 10.1016/j.jacr.2018.03.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 03/04/2018] [Indexed: 11/23/2022]
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20
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Moon SH, Choi WH, Yoo IR, Lee SJ, Paeng JC, Jeong SY, Lee SW, Kim K, Choi JY. Prognostic Value of Baseline 18F-Fluorodeoxyglucose PET/CT in Patients with Multiple Myeloma: A Multicenter Cohort Study. Korean J Radiol 2018; 19:481-488. [PMID: 29713226 PMCID: PMC5904475 DOI: 10.3348/kjr.2018.19.3.481] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 10/18/2017] [Indexed: 01/09/2023] Open
Abstract
Objective We investigated the prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with multiple myeloma (MM). Materials and Methods Subjects were 76 patients with newly diagnosed myeloma and pretreatment with 18F-FDG PET/CT from four hospitals. The PET/CT features were evaluated and the clinical characteristics were reviewed. Prognostic factors related to poor progression-free survival (PFS) and overall survival (OS) were identified using a Cox proportional hazards regression model and a prediction scale was developed based on the identified factors. Results Multivariate analysis showed that the presence of 18F-FDG-avid focal bone lesions (≥ 3) was a significant and independent predictor of PFS (hazard ratio [HR] = 3.28, p = 0.007) and OS (HR = 11.78, p = 0.001). The presence of extramedullary disease on PET/CT scan was also a significant predictor of poor PFS (HR = 2.79, p = 0.006) and OS (HR = 3.89, p = 0.003). A prognostic scale was developed using these two predictors. An increase in score on the scale corresponded to a significantly increased risk of poor OS (p = 0.005). In addition, Kaplan-Meier analysis demonstrated that patient survival varied significantly according to the scale (p < 0.001 for OS and p = 0.001 for PFS). Conclusion 18F-FDG-avid focal lesions and the presence of extramedullary disease on PET/CT scan are significantly associated with poor OS in MM patients. The scale developed according to these predictors represents a potential prognostic tool for evaluation of patients with MM.
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Affiliation(s)
- Seung Hwan Moon
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Woo Hee Choi
- Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, Korea
| | - Ie Ryung Yoo
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Soo Jin Lee
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Jin Chul Paeng
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Shin Young Jeong
- Department of Nuclear Medicine, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu 41566, Korea
| | - Sang-Woo Lee
- Department of Nuclear Medicine, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu 41566, Korea
| | - Kihyun Kim
- Department of Medicine, Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
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Hahn S, Lee YH, Suh JS. Detection of vertebral metastases: a comparison between the modified Dixon turbo spin echo T 2 weighted MRI and conventional T 1 weighted MRI: a preliminary study in a tertiary centre. Br J Radiol 2018; 91:20170782. [PMID: 29393668 DOI: 10.1259/bjr.20170782] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To compare the diagnostic performance of modified Dixon (mDixon) turbo spin echo (TSE) T2 weighted MRI and conventional T1 weighted MRI in vertebral metastasis detection. METHODS Between September 2014 and October 2016, 33 patients with 68 metastases who had undergone whole-spine MRI were enrolled. The following sagittal image sets were evaluated: T1WI, and mDixon TSE T2 weighted water and fat images. Two radiologists independently evaluated each image-set for metastasis. The MR findings were compared with positron emission tomography-CT (PET-CT) scans. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each sequence. The diagnostic performance of each sequence was evaluated using receiver operating characteristic (ROC) curves. RESULTS Sensitivity, specificity, PPV and NPV for reviewer 1 were 83.8, 99.1, 89.1 and 98.6%, respectively, with T1WI; 79.4, 98.8, 85.7 and 98.2%, respectively, with mDixon TSE T2 weighted water imaging; and 86.8, 99.1, 89.4 and 98.8%, respectively, with mDixon TSE T2 weighted fat imaging. For reviewer 2, the respective scores were 91.2, 99.2, 91.2 and 99.2%; 85.3, 99.5, 93.4 and 98.7%; and 89.7, 99.3, 92.4 and 99.1%. With PET-CT as the gold standard, the ROC curves of the three sequences showed no significant difference (all p > 0.05). CONCLUSION The diagnostic performance of mDixon TSE T2 weighted water and fat imaging was comparable to that of conventional T1WI in the detection of vertebral metastases. Advances in knowledge: mDixon TSE T2WI can be a good alternative to conventional T1WI for detecting vertebral metastases.
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Affiliation(s)
- Seok Hahn
- 1 Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine , Seoul , Republic of Korea.,2 Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital , Busan , Republic of Korea
| | - Young Han Lee
- 1 Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine , Seoul , Republic of Korea
| | - Jin-Suck Suh
- 1 Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine , Seoul , Republic of Korea
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Giovanella L, Castellani M, Suriano S, Ruberto T, Ceriani L, Tagliabue L, Lucignani G. Multi-field-of-view SPECT is superior to whole-body scanning for assessing metastatic bone disease in patients with prostate cancer. TUMORI JOURNAL 2018; 97:629-33. [DOI: 10.1177/030089161109700515] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim The aim of this study was to compare the diagnostic performance of whole-body bone scintigraphy (WBS) and multi-field-of-view single photon emission tomography (multi-FOV SPECT) with 99mTc-oxidronate (99mTc-HDP) in patients with prostate cancer (PCa). Methods In a prospective study, WBS and SPECT acquisitions were performed in194 patients with histologically confirmed PCa and serum prostate-specific antigen (PSA) levels above 10 ng/mL. Scans obtained using the two modalities were interpreted separately. Clinical and biochemical follow-up, radiological studies and biopsies served as benchmarks for the assessments. The impact of PSA level on WBS and SPECT results was also evaluated. Results The patient-based sensitivity, specificity, accuracy, PPV and NPV values of SPECT examinations were higher than those of WBS, especially in patients with serum PSA levels ≶40 ng/mL. Conclusion Multi-FOV SPECT proved to be more sensitive and specific than WBS in detecting bone metastases in PCa patients.
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Affiliation(s)
- Luca Giovanella
- Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | | | - Sergio Suriano
- Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Teresa Ruberto
- Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Luca Ceriani
- Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Luca Tagliabue
- Department of Diagnostic Services, Unit of Nuclear Medicine, San Paolo Hospital, Milan
| | - Giovanni Lucignani
- Department of Diagnostic Services, Unit of Nuclear Medicine, San Paolo Hospital, Milan
- Department of Biomedical Sciences and Technologies and Center of Molecular and Cellular Imaging (IMAGO), University of Milan, Milan, Italy
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Whole-body magnetic resonance imaging for detection of skeletal metastases in children and young people with primary solid tumors - systematic review. Pediatr Radiol 2018; 48:241-252. [PMID: 29151119 PMCID: PMC5790860 DOI: 10.1007/s00247-017-4013-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 09/18/2017] [Accepted: 10/11/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Many solid neoplasms have a propensity for osteomedullary metastases of which detection is important for staging and subsequent treatment. Whole-body magnetic resonance imaging (WB-MRI) has been shown to accurately detect osteomedullary metastases in adults, but these findings cannot be unconditionally extrapolated to staging of children with malignant solid tumors. OBJECTIVE To conduct a literature review on the sensitivity of WB-MRI for detecting skeletal metastases in children with solid tumors. MATERIALS AND METHODS Searches in MEDLINE and EMBASE databases up to 15 May 2017 were performed to identify studies on the diagnostic value of WB-MRI. Inclusion criteria were children and adolescents (age <21 years) with a primary solid tumor who were evaluated for skeletal metastases by WB-MRI and compared to any type of reference standard. The number of included patients had to be at least five and data on true positives, true negatives, false-positives and false-negatives had to be extractable. RESULTS Five studies including 132 patients (96 patients with solid tumors) were eligible. Patient groups and used reference tests were heterogeneous, producing unclear or high risk of bias. Sensitivity of WB-MRI ranged between 82% and 100%. The positive predictive value of WB-MRI was variable among the studies and influenced by the used reference standard. CONCLUSION Although WB-MRI may seem a promising radiation-free technique for the detection of skeletal metastases in children with solid tumors, published studies are small and too heterogeneous to provide conclusive evidence that WB-MRI can be an alternative to currently used imaging techniques.
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Ha YS, Kim TH. The Surveillance for Muscle-Invasive Bladder Cancer (MIBC). Bladder Cancer 2018. [DOI: 10.1016/b978-0-12-809939-1.00030-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Maeder Y, Dunet V, Richard R, Becce F, Omoumi P. Bone Marrow Metastases: T2-weighted Dixon Spin-Echo Fat Images Can Replace T1-weighted Spin-Echo Images. Radiology 2017; 286:948-959. [PMID: 29095674 DOI: 10.1148/radiol.2017170325] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To test the potential of Dixon T2-weighted fat-only sequences to replace T1-weighted sequences for the detection of bone metastases, with the hypothesis that diagnostic performance with an alternative magnetic resonance (MR) imaging protocol (sagittal spin-echo Dixon T2-weighted fat-only and water-only imaging) would not be inferior to that with the standard protocol (sagittal spin-echo T1-weighted and spin-echo Dixon T2-weighted water-only imaging). Materials and Methods A total of 121 consecutive whole-spine MR imaging examinations (63 men; mean age ± standard deviation, 61.4 years ± 11.8) performed for suspected vertebral bone metastases were included in this retrospective, institutional review board-approved study. Quantitative image analysis was performed for 30 randomly selected spine levels. Qualitative analysis was performed separately by two musculoskeletal radiologists, who registered the number of metastases for each spine level. Areas under the curve with the protocols were compared on the basis of nonparametric receiver operating characteristic curve estimations by using a noninferiority test on paired data, with a best valuable comparator as a reference. Interobserver and interprotocol agreement was assessed by using κ statistics. Results Contrast-to-noise ratio was significantly higher on the alternative protocol images than on the standard protocol images (181.1 [95% confidence interval: 140.4, 221.7] vs 84.7 [95% confidence interval: 66.3, 103.1] respectively; P < .001). Diagnostic performance was not significantly inferior with the alternative protocol than with the standard protocol for both readers in a per-patient analysis (sensitivity, 97.9%-98.9% vs 93.6%-97.9%; specificity, 85.2%-92.6% vs 92.6%-96.3%; area under the curve, 0.92-0.96 vs 0.95, respectively; all P ≤ .02) and a per-spine level analysis (all P < .01). Interobserver and interprotocol agreement was good to very good (κ = 0.70-0.81). Conclusion Dixon T2-weighted fat-only and water-only imaging provide, in one sequence, diagnostic performance similar to that of the standard combination of morphologic sequences for the detection of probable spinal bone metastases, thereby providing an opportunity to reduce imaging time by eliminating the need to perform T1 sequences. © RSNA, 2017 An earlier incorrect version of this article appeared online. This article was corrected on November 6, 2017.
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Affiliation(s)
- Yaël Maeder
- From the Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Vincent Dunet
- From the Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Raphael Richard
- From the Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Fabio Becce
- From the Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Patrick Omoumi
- From the Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
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Zarzour JG, Galgano S, McConathy J, Thomas JV, Rais-Bahrami S. Lymph node imaging in initial staging of prostate cancer: An overview and update. World J Radiol 2017; 9:389-399. [PMID: 29104741 PMCID: PMC5661167 DOI: 10.4329/wjr.v9.i10.389] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 05/26/2017] [Accepted: 07/17/2017] [Indexed: 02/06/2023] Open
Abstract
Accurate nodal staging at the time of diagnosis of prostate cancer is crucial in determining a treatment plan for the patient. Pelvic lymph node dissection is the most reliable method, but is less than perfect and has increased morbidity. Cross sectional imaging with computed tomography (CT) and magnetic resonance imaging (MRI) are non-invasive tools that rely on morphologic characteristics such as shape and size of the lymph nodes. However, lymph nodes harboring metastatic disease may be normal sized and non-metastatic lymph nodes may be enlarged due to reactive hyperplasia. The optimal strategy for preoperative staging remains a topic of ongoing research. Advanced imaging techniques to assess lymph nodes in the setting of prostate cancer utilizing novel MRI contrast agents as well as positron emission tomography (PET) tracers have been developed and continue to be studied. Magnetic resonance lymphography utilizing ultra-small super paramagnetic iron oxide has shown promising results in detection of metastatic lymph nodes. Combining MRL with diffusion-weighted imaging may also improve accuracy. Considerable efforts are being made to develop effective PET radiotracers that are performed using hybrid-imaging systems that combine PET with CT or MRI. PET tracers that will be reviewed in this article include [18F]fluoro-D-glucose, sodium [18F]fluoride, [18F]choline, [11C]choline, prostate specific membrane antigen binding ligands, [11C]acetate, [18F]fluciclovine, gastrin releasing peptide receptor ligands, and androgen binding receptors. This article will review these advanced imaging modalities and ability to detect prostate cancer metastasis to lymph nodes. While more research is needed, these novel techniques to image lymph nodes in the setting of prostate cancer show a promising future in improving initial lymph node staging.
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Affiliation(s)
- Jessica G Zarzour
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35249, United States
| | - Sam Galgano
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35249, United States
| | - Jonathan McConathy
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35249, United States
| | - John V Thomas
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35249, United States
| | - Soroush Rais-Bahrami
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35249, United States
- Department of Urology, University of Alabama at Birmingham, Birmingham, AL 35249, United States
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Semiquantitative Assessment of 18F-FDG Uptake in the Normal Skeleton: Comparison Between PET/CT and Time-of-Flight Simultaneous PET/MRI. AJR Am J Roentgenol 2017; 209:1136-1142. [PMID: 28777652 DOI: 10.2214/ajr.17.18044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Differences in the attenuation correction methods used in PET/CT scanners versus the newly introduced whole-body simultaneous PET/MRI reportedly result in differences in standardized uptake values (SUVs) in the normal skeleton. The aim of the study was to compare the semiquantitative FDG uptake in the normal skeleton using time-of-flight (TOF) PET/MRI versus PET/CT with and without TOF. SUBJECTS AND METHODS Participants received a single FDG injection and underwent non-TOF and TOF PET/CT (n = 23) or non-TOF PET/CT and TOF PET/MRI (n = 50). Mean SUV (SUVmean) and maximum SUV (SUVmax) were measured from all PET scans for nine normal regions of the skeleton. Pearson correlation coefficients (r) were used to evaluate the SUVmax and SUVmean of normal skeleton between non-TOF and TOF PET/CT, as well as between non-TOF PET/CT and TOF PET/MRI. In addition, percentage differences in SUVmax and SUVmean of the normal skeleton between non-TOF and TOF PET/CT and between non-TOF PET/CT and TOF PET/MRI were evaluated. RESULTS The SUVmax and SUVmean in the normal skeleton significantly increased between non-TOF and TOF PET/CT, but they significantly decreased between non-TOF PET/CT and TOF PET/MRI. The SUVmax and SUVmean in normal skeleton showed good correlation between non-TOF PET/CT and TOF PET/MRI (SUVmax, r = 0.88; SUVmean, r = 0.91) and showed a similar trend between non-TOF and TOF PET/CT (SUVmax, r = 0.88; SUVmean, r = 0.94). CONCLUSION In the normal skeleton, SUVmax and SUVmean showed high correlations between PET/MRI and PET/CT. The MRI attenuation correction used in TOF PET/MRI provides reliable semiquantitative measurements in the normal skeleton.
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Łukaszewski B, Nazar J, Goch M, Łukaszewska M, Stępiński A, Jurczyk MU. Diagnostic methods for detection of bone metastases. Contemp Oncol (Pozn) 2017; 21:98-103. [PMID: 28947878 PMCID: PMC5611498 DOI: 10.5114/wo.2017.68617] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 11/30/2015] [Indexed: 12/27/2022] Open
Abstract
Skeletal metastases are severe complications in the course of cancer, and they indicate a worse prognosis. The use of modern imaging techniques allows rapid diagnosis of bone metastases. Properly selected diagnostic imaging (scintigraphy, positron emission tomography, whole body MRI) allows us to evaluate the number of metastatic foci in the skeletal system. Complementary imaging examinations (X-ray, computed tomography, magnetic resonance imaging) determine the extent of metastasis and its character: osteolytic, osteoblast, mixed). Hypercalcaemia is a symptom of low specificity for metastatic bone disease (a result of osteolysis); nevertheless, it is a significant complication in oncological treatment and worsens the prognosis of the patient. A biopsy is the final stage of the diagnostic process, which allows us to assess cell and tissue changes. Guided biopsies are performed under the control of musculoskeletal imaging methods (CT, MRI) and they are the most promising tools in bone metastases diagnosis. The development of guided biopsy techniques has led to the conclusion that they should be standard in diagnosing bone metastases. Liquid biopsy (LB) seems to be the most promising diagnostic method for detection of bone metastases. LB based on tumour-specific DNA mutation gives an opportunity for early detection and assessment of the molecular heterogeneity of the overall disease.
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Affiliation(s)
- Bartosz Łukaszewski
- Department of Orthopaedics and Traumatology of the Locomotor System, Heliodor Swiecicki Clinical Hospital at the Poznan University of Medical Sciences, Poznan, Poland
| | - Jerzy Nazar
- Department of Orthopaedics and Traumatology of the Locomotor System, Heliodor Swiecicki Clinical Hospital at the Poznan University of Medical Sciences, Poznan, Poland
| | - Maciej Goch
- Department of Orthopaedics and Traumatology of the Locomotor System, Heliodor Swiecicki Clinical Hospital at the Poznan University of Medical Sciences, Poznan, Poland
| | - Marta Łukaszewska
- Chair of Family Medicine, Heliodor Swiecicki Clinical Hospital at the Poznan University of Medical Sciences, Poznan, Poland
| | - Adrian Stępiński
- Department of Orthopaedics and Traumatology of the Locomotor System, Heliodor Swiecicki Clinical Hospital at the Poznan University of Medical Sciences, Poznan, Poland
| | - Mieczysława U. Jurczyk
- Chair of Mother and Child Health, Gynaecologic and Obstetrical University Hospital, Poznan University of Medical Sciences, Poznan, Poland
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Koolstra K, Börnert P, Brink W, Webb A. Improved image quality and reduced power deposition in the spine at 3 T using extremely high permittivity materials. Magn Reson Med 2017; 79:1192-1199. [PMID: 28543615 PMCID: PMC5811912 DOI: 10.1002/mrm.26721] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 03/06/2017] [Accepted: 03/27/2017] [Indexed: 11/22/2022]
Abstract
Purpose To explore the effect of using extremely high permittivity (εr∼1,000) materials on image quality and power requirements of spine imaging at 3 T. Theory and Methods A linear array of high permittivity dielectric blocks made of lead zirconate titanate (PZT) was designed and characterized by electromagnetic simulations and experiments. Their effect on the transmit efficiency, receive sensitivity, power deposition, and diagnostic image quality was analyzed in vivo in 10 healthy volunteers. Results Simulation results showed that for quadrature mode excitation, the PZT blocks improve the transmit efficiency by 75% while reducing the maximum 10g average specific absorption rate (SAR10) by 20%. In vivo experiments in 10 healthy volunteers showed statistically significant improvements for the transmit efficiency, and image quality. Compared to active radiofrequency shimming, image quality was similar, but the required system input power was significantly lower for quadrature excitation using the PZT blocks. Conclusion For single‐channel transmit systems, using high permittivity PZT blocks offer a way to improve transmit efficiency and image quality in the spine. Results show that the effect, and therefore optimal design, is body mass index and sex specific. Magn Reson Med 79:1192–1199, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
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Affiliation(s)
- Kirsten Koolstra
- C. J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter Börnert
- C. J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Wyger Brink
- C. J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Andrew Webb
- C. J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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Baek JH, Park IH, Seo SH. An Experimental Study for Minimum Level of Decalcification to Detect the Osteolytic Bone Metastasis of Long Bone on Plain Radiography. J Bone Metab 2016; 23:135-42. [PMID: 27622177 PMCID: PMC5018606 DOI: 10.11005/jbm.2016.23.3.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 05/17/2016] [Accepted: 05/25/2016] [Indexed: 11/15/2022] Open
Abstract
Background In 1951, Ardran reported that metastatic bone lesions could be detectable on plain radiography with 30% to 50% of decalcification. Authors performed experimental study for minimum level of decalcification to detect the osteolytic bone metastasis of long bone with recent technique of radiographs. Methods One pair of fibula and humerus from two cadavers was cut into specimen 1 inch in length. Distal half of specimen was dipped into hydrochloride (HCl) with 15 min interval. All 16 specimens were checked by film-type radiography (FR), computed radiography (CR), digital radiography (DR). To exclude inter-observer's variance, 3 radiologists evaluated images. Calcium amount before and after decalcification was measured and expressed in percentage of decalcification. Results Osteolytic changes were detectable with 11% to 16% of decalcification for fibula and 3% to 8% for humerus on plain radiography with FR, CR, and DR. Conclusions Our study showed that minimum of 3% and maximum of 16% of decalcification is necessary when osteolytic metastatic bone lesions of long bone could be detected on plain radiography.
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Affiliation(s)
- Jun Ho Baek
- Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Il Hyung Park
- Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Sung Hwa Seo
- Department of Medical and Health Science, Gyeongju University, Gyeongju, Korea
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Azad GK, Cook GJ. Multi-technique imaging of bone metastases: spotlight on PET-CT. Clin Radiol 2016; 71:620-31. [PMID: 26997430 DOI: 10.1016/j.crad.2016.01.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/30/2015] [Accepted: 01/13/2016] [Indexed: 12/12/2022]
Abstract
There is growing evidence that molecular imaging of bone metastases with positron-emission tomography (PET) can improve diagnosis and treatment response assessment over current conventional standard imaging methods, although cost-effectiveness has not been assessed. In most cancer types, 2-[(18)F]-fluoro-2-deoxy-d-glucose ((18)F-FDG)-PET is an accurate method for detecting bone metastases. For example, in breast cancer, combined (18)F-FDG-PET and computed tomography (CT) is more sensitive at detecting bone metastases than (99m)technetium (Tc)-labelled diphosphonate planar bone scintigraphy (BS) and there is increasing evidence to support the use of serial (18)F-FDG-PET for the assessment of osseous response to treatment. Preliminary data suggest improved diagnostic accuracy of (18)F-FDG-PET-CT in a number of other malignancies including lung, thyroid, head and neck, gastro-oesophageal cancers, and osteosarcoma. As a bone-specific tracer, there is accumulating evidence to support the use of sodium (18)F-fluoride ((18)F-NaF) PET-CT in the diagnosis of skeletal metastases in breast and prostate cancer, although relatively little data are available to support its use for assessment of treatment response. In prostate cancer, (11)C-choline and (18)F-choline PET-CT have better specificities than (18)F-NaF-PET-CT, but equivalent sensitivities in the detection of bone metastases. We review the current literature for staging and response assessment of bone metastases in different cancers.
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Affiliation(s)
- Gurdip K Azad
- Cancer Imaging Department, Division of Imaging Sciences and Biomedical Engineering, King's College London, St Thomas' Hospital, London, UK
| | - Gary J Cook
- Cancer Imaging Department, Division of Imaging Sciences and Biomedical Engineering, King's College London, St Thomas' Hospital, London, UK; Clinical PET Centre, St Thomas' Hospital, London, UK.
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Rubini G, Niccoli-Asabella A, Ferrari C, Racanelli V, Maggialetti N, Dammacco F. Myeloma bone and extra-medullary disease: Role of PET/CT and other whole-body imaging techniques. Crit Rev Oncol Hematol 2016; 101:169-83. [DOI: 10.1016/j.critrevonc.2016.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/08/2016] [Accepted: 03/03/2016] [Indexed: 01/08/2023] Open
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Abstract
Prostate cancer is unique in that unlike other solid organ malignancies, only recently has imaging been employed to routinely detect and localize disease. The introduction of transrectal ultrasound was a significant development, transitioning digitally guided prostate biopsies to ultrasound guidance. The arrival of multiparametric MRI has become the next major step, transforming the way Urologist's diagnose, stage, and treat prostate cancer. Recent recommendations against PSA screening have changed the landscape of urologic oncology with the changing needs being reflected in the initiation of additional robust imaging techniques at different time points in prostate cancer care. The current review aims to provide a clinical perspective in the history, current standard of care, and novel imaging modalities in the evaluation of prostate cancer.
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Affiliation(s)
- Celso Darío Ramos
- PhD, Professor at School of Medical Sciences, Director, Service of Nuclear Medicine, Department of Radiology, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil. E-mail:
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Usuda K, Sagawa M, Motomo N, Ueno M, Tanaka M, Machida Y, Maeda S, Matoba M, Tonami H, Ueda Y, Sakuma T. Recurrence and metastasis of lung cancer demonstrate decreased diffusion on diffusion-weighted magnetic resonance imaging. Asian Pac J Cancer Prev 2015; 15:6843-8. [PMID: 25169535 DOI: 10.7314/apjcp.2014.15.16.6843] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diffusion-weighted magnetic resonance imaging (DWI) is reported to be useful for detecting malignant lesions. The purpose of this study is to clarify characteristics of imaging, detection rate and sensitivity of DWI for recurrence or metastasis of lung cancer. METHODS A total of 36 lung cancer patients with recurrence or metastasis were enrolled in this study. While 16 patients underwent magnetic resonance imaging (MRI), computed tomography (CT) and positron emission tomography-computed tomography (PET-CT), 17 underwent MRI and CT, and 3 underwent MRI and PET-CT. RESULTS Each recurrence or metastasis showed decreased diffusion, which was easily recognized in DWI. The detection rate for recurrence or metastasis was 100% (36/36) in DWI, 89% (17/19) in PET-CT and 82% (27/33) in CT. Detection rate of DWI was significantly higher than that of CT (p=0.0244) but not significantly higher than that of PET-CT (p=0.22). When the optimal cutoff value of the apparent diffusion coefficient value was set as 1.70?10-3 mm2/sec, the sensitivity of DWI for diagnosing recurrence or metastasis of lung cancer was 95.6%. CONCLUSIONS DWI is useful for detection of recurrence and metastasis of lung cancer.
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Affiliation(s)
- Katsuo Usuda
- Department of Thoracic Surgery, Kanazawa Medical University,Uchinada, Ishikawa, Japan E-mail :
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Jambor I, Kuisma A, Ramadan S, Huovinen R, Sandell M, Kajander S, Kemppainen J, Kauppila E, Auren J, Merisaari H, Saunavaara J, Noponen T, Minn H, Aronen HJ, Seppänen M. Prospective evaluation of planar bone scintigraphy, SPECT, SPECT/CT, 18F-NaF PET/CT and whole body 1.5T MRI, including DWI, for the detection of bone metastases in high risk breast and prostate cancer patients: SKELETA clinical trial. Acta Oncol 2015; 55:59-67. [PMID: 25833330 DOI: 10.3109/0284186x.2015.1027411] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE Detection of bone metastases in breast and prostate cancer patients remains a major clinical challenge. The aim of the current trial was to compare the diagnostic accuracy of (99m)Tc-hydroxymethane diphosphonate ((99m)Tc-HDP) planar bone scintigraphy (BS), (99m)Tc-HDP SPECT, (99m)Tc-HDP SPECT/CT, (18)F-NaF PET/CT and whole body 1.5 Tesla magnetic resonance imaging (MRI), including diffusion weighted imaging, (wbMRI+DWI) for the detection of bone metastases in high risk breast and prostate cancer patients. MATERIAL AND METHODS Twenty-six breast and 27 prostate cancer patients at high risk of bone metastases underwent (99m)Tc-HDP BS, (99m)Tc-HDP SPECT, (99m)Tc-HDP SPECT/CT, (18)F-NaF PET/CT and wbMRI+DWI. Five independent reviewers interpreted each individual modality without the knowledge of other imaging findings. The final metastatic status was based on the consensus reading, clinical and imaging follow-up (minimal and maximal follow-up time was 6, and 32 months, respectively). The bone findings were compared on patient-, region-, and lesion-level. RESULTS (99m)Tc-HDP BS was false negative in four patients. In the region-based analysis, sensitivity values for (99m)Tc-HDP BS, (99m)Tc-HDP SPECT, (99m)Tc-HDP SPECT/CT, (18)F-NaF PET/CT, and wbMRI+DWI were 62%, 74%, 85%, 93%, and 91%, respectively. The number of equivocal findings for (99m)Tc-HDP BS, (99m)Tc-HDP SPECT, (99m)Tc-HDP SPECT/CT, (18)F-NaF PET/CT and wbMRI+DWI was 50, 44, 5, 6, and 4, respectively. CONCLUSION wbMRI+DWI showed similar diagnostic accuracy to (18)F-NaF PET/CT and outperformed (99m)Tc-HDP SPECT/CT, and (99m)Tc-HDP BS.
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Affiliation(s)
- Ivan Jambor
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
| | - Anna Kuisma
- Department of Oncology and Radiotherapy, University of Turku, Turku, Finland
| | - Susan Ramadan
- Department of Oncology and Radiotherapy, University of Turku, Turku, Finland
| | - Riikka Huovinen
- Department of Oncology and Radiotherapy, University of Turku, Turku, Finland
| | - Minna Sandell
- Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland
| | | | | | - Esa Kauppila
- Department of Clinical Physiology and Nuclear Medicine, North-Karelia Central Hospital, Joensuu, Finland
| | - Joakim Auren
- Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland
| | | | - Jani Saunavaara
- Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland
| | - Tommi Noponen
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Heikki Minn
- Department of Oncology and Radiotherapy, University of Turku, Turku, Finland
- Turku PET Centre, Turku, Finland
| | - Hannu J. Aronen
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
- Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland
| | - Marko Seppänen
- Turku PET Centre, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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Imagerie des métastases osseuses. ONCOLOGIE 2015. [DOI: 10.1007/s10269-015-2500-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Comparison of choline-PET/CT, MRI, SPECT, and bone scintigraphy in the diagnosis of bone metastases in patients with prostate cancer: a meta-analysis. Skeletal Radiol 2014; 43:1503-13. [PMID: 24841276 DOI: 10.1007/s00256-014-1903-9] [Citation(s) in RCA: 243] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 04/22/2014] [Accepted: 04/25/2014] [Indexed: 02/05/2023]
Abstract
Published data on the diagnosis of bone metastases of prostate cancer are conflicting and heterogeneous. We performed a comprehensive meta-analysis to compare the diagnostic performance of choline-PET/CT, MRI, bone SPECT, and bone scintigraphy (BS) in detecting bone metastases in parents with prostate cancer. Pooled sensitivity, specificity, and diagnostic odds ratios (DOR) were calculated both on a per-patient basis and on a per-lesion basis. Summary receiver operating characteristic (SROC) curves were also drawn to obtain the area under curve (AUC) and Q* value. Sixteen articles consisting of 27 studies were included in the analysis. On a per-patient basis, the pooled sensitivities by using choline PET/CT, MRI, and BS were 0.91 [95% confidence interval (CI): 0.83-0.96], 0.97 (95% CI: 0.91-0.99), 0.79 (95% CI: 0.73-0.83), respectively. The pooled specificities for detection of bone metastases using choline PET/CT, MRI, and BS, were 0.99 (95% CI: 0.93-1.00), 0.95 (95% CI: 0.90-0.97), and 0.82 (95% CI: 0.78-0.85), respectively. On a per-lesion basis, the pooled sensitivities of choline PET/CT, bone SPECT, and BS were 0.84 (95% CI: 0.81-0.87), 0.90 (95% CI: 0.86-0.93), 0.59 (95% CI: 0.55-0.63), respectively. The pooled specificities were 0.93 (95% CI: 0.89-0.96) for choline PET/CT, 0.85 (95% CI: 0.80-0.90) for bone SPECT, and 0.75 (95% CI: 0.71-0.79) for BS. This meta-analysis indicated that MRI was better than choline PET/CT and BS on a per-patient basis. On a per-lesion analysis, choline PET/CT with the highest DOR and Q* was better than bone SPECT and BS for detecting bone metastases from prostate cancer.
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Das A, Pandit S, Das SK, Basuthakur S, Das S. An osteolytic metastasis of humerus from an asymptomatic squamous cell carcinoma of lung: a rare clinical entity. Case Rep Pulmonol 2014; 2014:636017. [PMID: 25184068 PMCID: PMC4145377 DOI: 10.1155/2014/636017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 07/08/2014] [Accepted: 07/23/2014] [Indexed: 11/29/2022] Open
Abstract
Advanced lung cancer is complicated by skeletal metastases either due to direct extension from adjacent primaries or, more commonly, due to haematogenous dissemination of neoplastic cells. Lumber spine is the most common site for bony metastases in bronchogenic carcinoma. Proximal lone bones, especially humerus, are unusual sites for metastases from lung primaries. Small cell and large cell varieties of lung cancer are most commonly associated with skeletal dissemination. It is also unusual that an asymptomatic squamous cell carcinoma of lung presents with painful, soft tissue swelling with osteolytic metastasis of humerus which is reported in our case. Systemic cytotoxic chemotherapy, local palliative radiotherapy, adequate analgesia, and internal fixation of the affected long bone are different modalities of treatment in this advanced stage of disease. But the prognosis is definitely poor in this stage IV disease.
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Affiliation(s)
- Anirban Das
- Department of Pulmonary Medicine, Medical College, 88 College Street, Kolkata, West Bengal 700 073, India
| | - Sudipta Pandit
- Department of Pulmonary Medicine, Medical College, 88 College Street, Kolkata, West Bengal 700 073, India
| | - Sibes k. Das
- Department of Pulmonary Medicine, Medical College, 88 College Street, Kolkata, West Bengal 700 073, India
| | - Sumitra Basuthakur
- Department of Pulmonary Medicine, Medical College, 88 College Street, Kolkata, West Bengal 700 073, India
| | - Somnath Das
- Department of Pulmonary Medicine, Medical College, 88 College Street, Kolkata, West Bengal 700 073, India
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Fournier L, Ammari S, Thiam R, Cuénod CA. Imaging criteria for assessing tumour response: RECIST, mRECIST, Cheson. Diagn Interv Imaging 2014; 95:689-703. [PMID: 24951349 DOI: 10.1016/j.diii.2014.05.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Most methods define a limited number of "target" lesions to be measured and other "non-target" lesions to be evaluated qualitatively. RECIST criteria are the most widely used although other criteria have been proposed that are derived from them based on size alone, or size and attenuation. Modified RECIST (mRECIST) criteria only concern hepatocellular carcinoma and only take into account the viable portion (enhanced after injection during the arterial phase). Cheson criteria are more complex as target lesions are defined differently depending on the organ (lymph nodes, liver or spleen, other organs), and involve both CT and PET scans, as well as the clinical examination and bone marrow biopsy.
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Affiliation(s)
- L Fournier
- Paris Descartes Sorbonne Paris Cité University, Radiology, AP-HP Georges Pompidou European Hospital, 20, rue Leblanc, 75015 Paris, France; Paris Descartes Sorbonne Paris Cité University, Inserm UMR-S970, 12, rue de l'École de médecine, 75006 Paris, France.
| | - S Ammari
- Paris Descartes Sorbonne Paris Cité University, Radiology, AP-HP Georges Pompidou European Hospital, 20, rue Leblanc, 75015 Paris, France
| | - R Thiam
- Paris Descartes Sorbonne Paris Cité University, Radiology, AP-HP Georges Pompidou European Hospital, 20, rue Leblanc, 75015 Paris, France; Paris Descartes Sorbonne Paris Cité University, Inserm UMR-S970, 12, rue de l'École de médecine, 75006 Paris, France
| | - C-A Cuénod
- Paris Descartes Sorbonne Paris Cité University, Radiology, AP-HP Georges Pompidou European Hospital, 20, rue Leblanc, 75015 Paris, France; Paris Descartes Sorbonne Paris Cité University, Inserm UMR-S970, 12, rue de l'École de médecine, 75006 Paris, France
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Abtahi SM, Mao Y, Prapruttam D, Elmi A, Hedgire SS. Magnetic resonance imaging of pelvic metastases in male patients. Magn Reson Imaging Clin N Am 2014; 22:201-15, vi. [PMID: 24792678 DOI: 10.1016/j.mric.2014.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Magnetic resonance (MR) imaging offers a noninvasive tool for diagnosis of primary and metastatic pelvic tumors. The diagnosis of a pelvic metastatic lesion implies an adverse prognosis and dictates the management strategies. Knowledge of normal MR imaging anatomy of the pelvis and the signal characteristics of normal and abnormal structures is essential for accurate interpretation of pelvic MR imaging. This article reviews imaging manifestations of nodal, visceral, and musculoskeletal metastatic lesions of the pelvis along with current and evolving MR imaging techniques.
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Affiliation(s)
- Seyed Mahdi Abtahi
- Division of Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA
| | - Yun Mao
- Division of Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA
| | - Duangkamon Prapruttam
- Division of Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA
| | - Azadeh Elmi
- Division of Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA
| | - Sandeep S Hedgire
- Division of Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA.
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Lynch K, O'Brien R. ¹H magnetic resonance spectroscopy: a review of the current literature and its potential utility in veterinary oncology. Vet J 2014; 200:240-7. [PMID: 24662026 DOI: 10.1016/j.tvjl.2014.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 02/04/2014] [Accepted: 02/06/2014] [Indexed: 11/15/2022]
Abstract
Advanced imaging of veterinary cancer patients has evolved in recent years and modalities once limited to human medicine have now been described for diagnostic purposes in veterinary medicine (positron emission tomography/computed tomography, single-photon emission computed tomography, whole body magnetic resonance imaging). Magnetic resonance spectroscopy (MRS) is a non-invasive and non-ionizing technique that is well described in the human medical literature and is most frequently used to evaluate the metabolic activity of tissues with questionable malignant transformation. Differentiation of neoplastic tissue from surrounding normal tissue is dependent on variations in cellular metabolism. Positive identification of malignancy can be made when neoplastic alterations are occurring at the cellular level prior to gross anatomic changes. This improved, early detection of cancer occurrence (or recurrence) can improve patient survival and direct medical therapy. MRS techniques are largely underutilized in veterinary medicine, with current research predominantly limited to the brain (both evaluation of normal and diseased tissue). Given the clinical utility of MRS in humans, the technique may also be useful in the staging of cancer in veterinary medicine.
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Affiliation(s)
- Katherine Lynch
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61801, USA.
| | - Robert O'Brien
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61801, USA
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Tombal B, Lecouvet F. Diagnosis and Management of Metastatic Prostate Cancer. Prostate Cancer 2014. [DOI: 10.1002/9781118347379.ch13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Shukla-Dave A, Hricak H. Role of MRI in prostate cancer detection. NMR IN BIOMEDICINE 2014; 27:16-24. [PMID: 23495081 DOI: 10.1002/nbm.2934] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 01/08/2013] [Accepted: 01/25/2013] [Indexed: 06/01/2023]
Abstract
The standard approach for the detection of prostate cancer--prostate-specific antigen (PSA) screening followed by transrectal ultrasonography (TRUS)-guided biopsy--has low sensitivity and provides limited information about the true extent and aggressiveness of the cancer. Improved methods are needed to assess the extent and aggressiveness of the cancer and to identify patients who will benefit from therapy. In recent years, there has been tremendous development of acquisition and processing tools for physiological and metabolic MRI techniques which play a potential role in the detection, localization and characterization of prostate cancer, such as dynamic contrast-enhanced MRI (DCE-MRI), diffusion-weighted MRI (DW-MRI) and/or proton MR spectroscopic imaging ((1)H MRSI). The standard protocol for prostate MRI without the use of a contrast agent involves multi-planar T1 -weighted MRI, T2 -weighted MRI and DW-MRI. This review discusses the potential role of MRI in the detection of prostate cancer, specifically describing the status of MRI as a tool for guiding targeted prostate biopsies and for detecting cancer in the untreated and treated gland. In addition, future areas of MRI research are briefly discussed. Groups conducting clinical trials should consider the recommendations put forward by the European Consensus Meeting, which state that the minimum requirements for prostate MRI are T1 -weighted MRI, T2 -weighted MRI, DCE-MRI (which involves the use of a contrast agent) and DW-MRI with a pelvic phased-array coil and propose the use of transperineal template mapping biopsies as the optimal reference standard.
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Affiliation(s)
- Amita Shukla-Dave
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Rakheja R, Chandarana H, Ponzo F, Seltzer AL, Beltran LS, Geppert C, Friedman KP. Fluorodeoxyglucose positron emission tomography/magnetic resonance imaging: current status, future aspects. PET Clin 2013; 9:237-52. [PMID: 25030285 DOI: 10.1016/j.cpet.2013.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Simultaneous positron emission tomography (PET)/magnetic resonance (MR) imaging is a promising novel technology for oncology diagnosis and staging and neurologic and cardiac applications. Our institution's current research protocol results in a total imaging time of approximately 45 to 70 minutes with simultaneous PET/MR imaging, making this a feasible total body imaging protocol. Further development of MR-based attenuation correction will improve PET quantification. Quantitatively accurate multiparametric PET/MR data sets will likely improve diagnosis of disease and help guide and monitor the therapies for individualized patient care.
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Affiliation(s)
- Rajan Rakheja
- Department of Nuclear Medicine/Radiology, Royal University Hospital, Saskatoon, Saskatchewan, Canada.
| | - Hersh Chandarana
- Department of Radiology, New York University School of Medicine, 550 First Avenue, New York, NY, USA
| | - Fabio Ponzo
- Department of Radiology, New York University School of Medicine, 550 First Avenue, New York, NY, USA
| | - Alexandra L Seltzer
- Department of Radiology, New York University School of Medicine, 550 First Avenue, New York, NY, USA
| | - Luis S Beltran
- Department of Radiology, New York University School of Medicine, 550 First Avenue, New York, NY, USA
| | | | - Kent P Friedman
- Department of Radiology, New York University School of Medicine, 550 First Avenue, New York, NY, USA
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Park S, Lee SJ, Chang WJ, Maeng CH, Hong JY, Choi MK, Kim YS, Jung CW, Jang JH, Kim SJ, Kim WS, Choi JY, Kim K. Positive correlation between baseline PET or PET/CT findings and clinical parameters in multiple myeloma patients. Acta Haematol 2013; 131:193-9. [PMID: 24296366 DOI: 10.1159/000354839] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 07/07/2013] [Indexed: 11/19/2022]
Abstract
Recently, positron emission tomography (PET) has been incorporated into a series of prospective studies as a predictor of outcomes in multiple myeloma (MM), and the number of (18)F-fluorodeoxuglucose (FDG)-avid focal lesions (FLs) and the intensity of tumor metabolism have been designated as important surrogate markers for predicting prognosis. Here, we compared initial clinical characteristics of MM patients with baseline PET parameters: the number of FLs and the maximum standardized uptake value (SUVmax). A total of 59 patients diagnosed with MM between August 2004 and February 2012 were reviewed. At diagnosis, 23 patients (40.0%) had ≤3 FLs, 11 patients (18.6%) 4-9 FLs, and 25 patients (42.4%) ≥10 FLs. The median SUVmax was 5.3 (range 0-24.3), and 40 patients (67.8%) showed a SUVmax >4. No clinical characteristics were significantly different between groups with a SUVmax ≤4 and a SUVmax >4. However, there were significant differences in several clinical indices between the FLs ≤3 and FLs >3 groups; elevated β2-microglobulin, elevated lactate dehydrogenase, anemia and more advanced disease by the Durie-Salmon stage corresponded to FLs >3 at baseline PET. Adverse baseline PET findings are positively correlated with prognostically relevant clinical parameters. Regarding PET parameters, FLs are more likely to be well correlated with disease aggressiveness and pathophysiology compared to SUVmax.
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Affiliation(s)
- Silvia Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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[Pharmacological therapy of urogenital cancer: rational routine diagnostic imaging]. Urologe A 2013; 52:1564-73. [PMID: 24197084 DOI: 10.1007/s00120-013-3253-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Imaging studies are an integral and important diagnostic modality to stage, monitor, and follow-up patients with metastatic urogenital cancer. The currently available guidelines on diagnosis and treatment of urogenital cancer do not provide the clinician with evidence-based recommendations for daily routine. It is the aim of the current manuscript to develop scientifically valid recommendations with regard to the most appropriate imaging technique and the most useful time interval in metastatic urogenital cancer patients undergoing systemic therapy. RESULTS Therapeutic response of soft tissue metastases is evaluated with the use of the RECIST criteria. In skeletal metastases, bone scans with validated algorithms must be performed to assess response. In patients with testicular germ cell tumors, computed tomography (CT) of the chest, the retroperitoneum, and the abdomen represents the standard imaging technique of choice usually performed prior to and at the end of systemic chemotherapy. Only in seminomas with residual tumors > 3 cm in diameter should FDG-PET/CT be performed about 6 weeks after chemotherapy. Metastatic renal cell carcinomas treated with molecular targeted therapies are routinely evaluated by CT scans at 3 month intervals. In specific cases, FDG-PET/CT is able to predict responses as early as 8 weeks after initiation of treatment. In patients with metastatic urothelial carcinomas, imaging studies should be performed after every second cycle of cytotoxic therapy. In patients with metastatic prostate cancer, the modality and the frequency of imaging studies depends on the type of the treatment. In men undergoing androgen deprivation therapy, no routine imaging studies are recommended except for patients with new onset symptoms or significant PSA progression prior to change of treatment. In men with metastatic castration-resistant PCA who are treated with cytotoxic regimes, routine imaging studies in the presence of decreasing or stable PSA serum concentrations are not indicated. In men treated with lyase inhibitor or inhibitors of the androgen receptor signaling cascade, imaging studies should be performed at 3 month intervals due to the low correlation of PSA serum concentrations with clinical response. CONCLUSIONS Imaging studies to assess therapeutic response to systemic treatment in metastatic cancers of the urogenital tract must be chosen depending on the treatment regime, primary organ, and potential consequences of the findings. Routine imaging studies without specific clinical or therapeutic relevance are not justified.
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Complementary roles of tumour specific PET tracer 18F-FAMT to 18F-FDG PET/CT for the assessment of bone metastasis. Eur J Nucl Med Mol Imaging 2013; 40:1672-81. [DOI: 10.1007/s00259-013-2487-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 06/11/2013] [Indexed: 11/25/2022]
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Sartor O, Eisenberger M, Kattan MW, Tombal B, Lecouvet F. Unmet needs in the prediction and detection of metastases in prostate cancer. Oncologist 2013; 18:549-57. [PMID: 23650019 DOI: 10.1634/theoncologist.2013-0027] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The therapeutic landscape for the treatment of advanced prostate cancer is rapidly evolving, especially for those patients with metastatic castration-resistant prostate cancer (CPRC). Despite advances in therapy options, the diagnostic landscape has remained relatively static, with few guidelines or reviews addressing the optimal timing or methodology for the radiographic detection of metastatic disease. Given recent reports indicating a substantial proportion of patients with CRPC thought to be nonmetastatic (M0) are in fact metastatic (M1), there is now a clear opportunity and need for improvement in detection practices. Herein, we discuss the current status of predicting the presence of metastatic disease, with a particular emphasis on the detection of the M0 to M1 transition. In addition, we review current data on newer imaging technologies that are changing the way metastases are detected. Whether earlier detection of metastatic disease will ultimately improve patient outcomes is unknown, but given that the therapeutic options for those with metastatic and nonmetastatic CPRC vary, there are considerable implications of how and when metastases are detected.
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Affiliation(s)
- Oliver Sartor
- Tulane Cancer Center, New Orleans, Louisiana 70112, USA.
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