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Lee SW, Kim SJ. Is Delayed Image of 18F-FDG PET/CT Necessary for Mediastinal Lymph Node Staging in Non-Small Cell Lung Cancer Patients? Clin Nucl Med 2022; 47:414-421. [PMID: 35234195 DOI: 10.1097/rlu.0000000000004110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the diagnostic accuracies of dual-time-point (DTP) 18F-FDG PET/CT for detection of mediastinal lymph node (LN) metastasis in non-small cell lung cancer (NSCLC) patients through a systematic review and meta-analysis. PATIENTS AND METHODS The PubMed, Cochrane database, and EMBASE database, from the earliest available date of indexing through October 31, 2021, were searched for studies evaluating diagnostic performance of DTP 18F-FDG PET/CT for detection of metastatic mediastinal LN in NSCLC patients. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic curves. RESULTS Ten studies (758 patients) were included in the current study. In patient-based analysis, early image showed a sensitivity of 0.76 and a specificity of 0.75. Delayed image revealed a sensitivity of 0.84 and a specificity of 0.71. In LN-based analysis, early image showed a sensitivity of 0.80 and a specificity of 0.83. Delayed image revealed a sensitivity of 0.84 and a specificity of 0.87. Retention index or %ΔSUVmax is superior to early or delayed images of DTP 18F-FDG PET/CT for detection of mediastinal LN metastasis. CONCLUSIONS Dual-time-point 18F-FDG PET/CT showed a good diagnostic performances for detection of metastatic mediastinal LNs in NSCLC patients. Early and delayed images of DTP 18F-FDG PET/CT revealed similar diagnostic accuracies for LN metastasis. However, retention index or %ΔSUVmax is superior to early or delayed images of DTP 18F-FDG PET/CT for detection of mediastinal LN metastasis in NSCLC patients. Further large multicenter studies would be necessary to substantiate the diagnostic accuracy of DTP 18F-FDG PET/CT for mediastinal LN staging in NSCLC patients.
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Affiliation(s)
- Sang Woo Lee
- From the Department of Nuclear Medicine, Kyungpook National University, Chilgok Hospital and School of Medicine, Daegu
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Paterson C, Hargreaves S, Rumley CN. Functional Imaging to Predict Treatment Response in Head and Neck Cancer: How Close are We to Biologically Adaptive Radiotherapy? Clin Oncol (R Coll Radiol) 2020; 32:861-873. [PMID: 33127234 DOI: 10.1016/j.clon.2020.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/28/2020] [Accepted: 10/05/2020] [Indexed: 02/07/2023]
Abstract
It is increasingly recognised that head and neck cancer represents a spectrum of disease with a differential response to standard treatments. Although prognostic factors are well established, they do not reliably predict response. The ability to predict response early during radiotherapy would allow adaptation of treatment: intensifying treatment for those not responding adequately or de-intensifying remaining therapy for those likely to achieve a complete response. Functional imaging offers such an opportunity. Changes in parameters obtained with functional magnetic resonance imaging or positron emission tomography-computed tomography during treatment have been found to be predictive of disease control in head and neck cancer. Although many questions remain unanswered regarding the optimal implementation of these techniques, current, maturing and future studies may provide the much-needed homogeneous cohorts with larger sample sizes and external validation of parameters. With a stepwise and collaborative approach, we may be able to develop imaging biomarkers that allow us to deliver personalised, biologically adaptive radiotherapy for head and neck cancer.
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Affiliation(s)
- C Paterson
- Beatson West of Scotland Cancer Centre, Glasgow, UK.
| | | | - C N Rumley
- Department of Radiation Oncology, Townsville University Hospital, Douglas, Australia; South Western Clinical School, University of New South Wales, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia
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Dual-time 18F-FDG PET/CT for the detection of liver metastases in breast cancer. Nucl Med Commun 2018; 39:1183-1189. [DOI: 10.1097/mnm.0000000000000918] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Chang CC, Cho SF, Chuang YW, Lin CY, Huang YF, Tyan YC. Prognostic significance of retention index of bone marrow on dual-phase 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with diffuse large B-cell lymphoma. Medicine (Baltimore) 2018; 97:e9513. [PMID: 29480842 PMCID: PMC5943886 DOI: 10.1097/md.0000000000009513] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The purpose of this study was to determine the prognostic significance of F-18 fluorodeoxyglucose (FDG) uptake on a dual-phase positron emission tomography/computed tomography (PET/CT), focusing on the increment in maximal standardized uptake value (SUVinc) of tumor and bone marrow (BM) between initial and delayed phase images and retention index (RI) of tumor and BM, in patients with diffuse large B-cell lymphoma (DLBCL).From September 2009 to January 2013, 70 patients (37 males and 33 females, aged 60.6 ± 17.5 years) with DLBCL who had undergone dual-phase FDG PET/CT scans for pretreatment staging were enrolled. The patients subsequently received combination chemotherapy with rituximab. The dual-phase SUV, including SUVinc of tumor (SUVinc-t), RI of tumor (RI-t), SUVinc of BM, and RI of BM were measured. The clinical observation period was from September 2009 to December 2014. Both univariate and multivariate analyses were then used to assess the prognostic significance of SUVinc, RI, international prognostic index (IPI), gender, age, clinical stage, and laboratory tests.The median follow-up time was 35.5 months. The 3-year overall survival (OS) for patients with low/high SUVinc-t (cut-off 2.0) and for patients with low/high RI-t (cut-off 20) were 87.5%/ 62.1% (P = .08) and 83.3%/ 62.7% (P = .14), respectively. The 3-year OS for patients with SUVinc-i < 0.35 and for those with SUVinc-i ≥ 0.35 were 73.2% and 53.3%, respectively (P = .10). The 3-year OS for patients with RI-i < 45 and for those with RI-i ≥ 45 were 72.7% and 37.5%, respectively (P = .02). Subsequently, the Cox multivariate forward proportional hazards model revealed that a higher RI-i (hazard ratio: 4.49; 95% confidence interval: 1.64-12.32; P = .0035) and IPI were independent prognostic factors affecting OS.For patients with DLBCL, an elevated RI-i (≥45) was a predictor for shorter OS, independent of IPI score. It added to the value of pretreatment dual-phase FDG PET/CT scans.
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Affiliation(s)
- Chin-Chuan Chang
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital
- Institute of Clinical Medicine, Kaohsiung Medical University
| | - Shih-Feng Cho
- Division of Hematology & Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital
| | - Ya-Wen Chuang
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital
| | - Chia-Yang Lin
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital
| | - Ying-Fong Huang
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital
- Department of Medical Imaging and Radiological Sciences
| | - Yu-Chang Tyan
- Department of Medical Imaging and Radiological Sciences
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University
- Institute of Medical Science and Technology, National Sun Yat-sen University
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Yonezawa N, Minamikawa T, Kitajima K, Takahashi Y, Sasaki R, Nibu KI, Komori T. The maximum standardized uptake value increment calculated by dual-time-point 18F-fluorodeoxyglucose positron emission tomography predicts survival in patients with oral tongue squamous cell carcinoma. NAGOYA JOURNAL OF MEDICAL SCIENCE 2017. [PMID: 28626254 PMCID: PMC5472544 DOI: 10.18999/nagjms.79.2.189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to investigate the prognostic value of dual-time-point (DTP) 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) imaging in primary oral tongue squamous cell carcinoma (OTSCC). The study included 52 patients who underwent preoperative 18F-FDG PET scans at two time points, namely 1 h and 2 h after injection. The following PET parameters were calculated: maximum standardized uptake value (SUVmax) for both time points (SUV early, SUV delayed); retention index (RI); and SUVmax increment (ΔSUVmax). Receiver operating characteristic (ROC) curve analysis was performed to define the optimal cutoff point for these parameters. Overall survival was calculated using the Kaplan–Meier method. Prognostic factors for patients with OTSCC were evaluated using the univariate log-rank test and a multivariate Cox proportional hazards model. ROC analysis revealed that the area under the curve was higher and more accurate for ΔSUVmax than for the other parameters. Additionally, patients with a ΔSUVmax ≥0.9 had significantly worse survival outcomes (28.9% vs 92.6%; p < 0.01). Univariate analysis showed that prognosis was significantly correlated with clinical T stage, local recurrence, perineural invasion, vascular invasion, and PET parameters (p < 0.05 for all). Multivariate analysis showed that local recurrence (hazard ratio = 3.60; p = 0.02) and ΔSUVmax (hazard ratio = 8.43; p < 0.01) were independent prognostic factors. ΔSUVmax determined using DTP 18F-FDG PET may be an additional prognostic factor in OTSCC patients.
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Affiliation(s)
- Natsuki Yonezawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tsutomu Minamikawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazuhiro Kitajima
- Department of Radiology, Division of Nuclear Medicine and PET Center, Hyogo College of Medicine, Japan
| | - Yusuke Takahashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryohei Sasaki
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takahide Komori
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Lim DH, Lee JH. Relationship Between Dual Time Point FDG PET/CT and Clinical Prognostic Indexes in Patients with High Grade Lymphoma: a Pilot Study. Nucl Med Mol Imaging 2017; 51:323-330. [PMID: 29242726 DOI: 10.1007/s13139-017-0480-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/20/2017] [Accepted: 03/21/2017] [Indexed: 11/25/2022] Open
Abstract
Purpose This study investigated the correlative relationship between metabolic parameters estimated from dual time point 2-deoxy-2-[18F] fluoro-D-glucose (18F-FDG) positron emission tomography/computerized tomography (PET/CT) and the clinical tools predicting the outcome of a lymphoma. We also measured metabolic and volumetric alterations between early and delayed 18F-FDG PET/CT in patients with high grade lymphoma (HGL). Methods The samples were 122 lymph nodes and extralymphatic lesions from 26 patients diagnosed with HGL. All patients were applied to the International Prognostic Index (IPI), Ann Arbor stage, and revised IPI as clinical prognostic parameters. 18F-FDG dual time point PET/CT (DTPFP) consisted of an early scan 1 h after 18F-FDG injection and a delayed scan 2 h after the early scan. Based on an analysis of DTPFP, we estimated the standardized uptake value (SUV) of tumors from the early and delayed scans, retention index (RI) representing the percentage change between early and delayed SUV, and metabolic volume different index (MVDI) calculated using metabolic tumor volumes (MTV). Results RImax showed a multiple positive correlative relationship with stage and IPI in lesion-by-lesion analysis (p < 0.01). In the case of IPI, the high risk group exhibited higher RImax than the low risk group (p = 0.004). In the case of revised IPI, the RImax of the low risk group were significantly lower than the intermediate and high risk groups, respectively (p < 0.01). The MVDIs of the best outcome group were decreased in comparison to the moderate outcome group (p = 0.029). There was a significant negative correlative relationship between RImax and MVDI, and the inclinations for decreased MVDIs were slightly associated with increased RIs. Conclusions RImax extracted from DTPFP had a significant relationship to extranodal involvement, staging, IPI, and revised IPI. MVDI showed significant negative correlation with RImax. Further large scale studies are warranted to support and extend these preliminary results.
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Affiliation(s)
- Do Hyoung Lim
- Division of Hematology-Oncology, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, South Korea
| | - Jai Hyuen Lee
- Department of Nuclear Medicine, Dankook University College of Medicine, Dongnam-ku, Anseo-dong Cheonan, 330-715 South Korea
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Castelli J, De Bari B, Depeursinge A, Simon A, Devillers A, Roman Jimenez G, Prior J, Ozsahin M, de Crevoisier R, Bourhis J. Overview of the predictive value of quantitative 18 FDG PET in head and neck cancer treated with chemoradiotherapy. Crit Rev Oncol Hematol 2016; 108:40-51. [PMID: 27931839 DOI: 10.1016/j.critrevonc.2016.10.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 10/08/2016] [Accepted: 10/26/2016] [Indexed: 02/03/2023] Open
Abstract
18 F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) allows to quantify the metabolic activity of a tumor (glycolysis) and has become a reference tool in oncology for the staging, restaging, radiotherapy planning and monitoring response in many cancers. Quantitative analyses have been introduced in order to overcome some of the limits of the visual methods, allowing an easier and more objective comparison of the inter- and intra-patients variations. The aims of this review were to report available evidences on the clinical value of quantitative PET/CT parameters in HNC. Forty-five studies, for a total of 2928 patients, were analyzed. Most of the data available dealt with the intensity of the metabolism, calculated from the Standard Uptake Value (SUV). Metabolic Tumor Volume (MTV) was well correlated with overall survival and disease free survival, with a higher predictive value than the maximum SUV. Spatial distribution of metabolism and textural analyses seems promising.
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Affiliation(s)
- J Castelli
- Radiotherapy Department, CHUV, Lausanne, Switzerland; INSERM, U1099, Rennes, F-35000, France; Université de Rennes 1, LTSI, Rennes, F-35000, France.
| | - B De Bari
- Radiotherapy Department, CHUV, Lausanne, Switzerland
| | - A Depeursinge
- University of Applied Sciences Western Switzerland, 3960 Sierre, Switzerland; Ecole Polytechnique Fédérale de Lausanne, CH-1015 Lausanne VD, Switzerland
| | - A Simon
- INSERM, U1099, Rennes, F-35000, France; Université de Rennes 1, LTSI, Rennes, F-35000, France
| | - A Devillers
- Nuclear Medecine Department, Centre Eugene Marquis, Rennes, F-35000, France
| | - G Roman Jimenez
- INSERM, U1099, Rennes, F-35000, France; Université de Rennes 1, LTSI, Rennes, F-35000, France; Keosys Medical imaging, 1 Impasse Augustin Fresnel, Saint-Herblain, F-44815, France
| | - J Prior
- Nuclear Medecine Department, CHUV, Switzerland
| | - M Ozsahin
- Radiotherapy Department, CHUV, Lausanne, Switzerland
| | - R de Crevoisier
- INSERM, U1099, Rennes, F-35000, France; Université de Rennes 1, LTSI, Rennes, F-35000, France; Radiotherapy Department, Centre Eugene Marquis, Rennes, F-35000, France
| | - J Bourhis
- Radiotherapy Department, CHUV, Lausanne, Switzerland
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Moon H, Noh WC, Kim HA, Kim EK, Park KW, Lee SS, Choi JH, Han KW, Byun BH, Lim I, Kim BI, Choi CW, Lim SM. The Relationship Between Estrogen Receptor, Progesterone Receptor and Human Epidermal Growth Factor Receptor 2 Expression of Breast Cancer and the Retention Index in Dual Phase (18)F-FDG PET/CT. Nucl Med Mol Imaging 2016; 50:246-54. [PMID: 27540429 DOI: 10.1007/s13139-016-0412-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 03/11/2016] [Accepted: 03/16/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study investigates the correlation of retention index (RI) using the dual phase FDG PET/CT scan with the breast cancer biomarkers. METHODS A total of 55 patients with breast cancer underwent dual phase FDG PET/CT scans (60 and 120 min after FDG injection) before treatment. SUVmax and SUVmean of the primary breast tumors were measured, then the percent change of SUVmax and SUVmean between the two scans were calculated, and denoted as RImax and RImean, respectively. After the surgical resection of the breast tumor, the status of biomarkers (ER, PR, and HER-2) was evaluated in the postsurgical specimen. RESULTS RImean was significantly higher in ER (-) (median, 16.2; IQR, 10.8-21.0) or HER-2 (+) (median, 16.1; IQR, 10.7-21.6) tumors than in ER (+) tumors (median, 9.9; IQR, 5.5-15.3) or HER-2 (-) tumors (median, 10.5; IQR, 5.5-16.1). However, there were no significant differences of SUVmax or RImax according to the ER or HER-2 status. There were no significant differences of any PET parameters between PR (+) and PR (-) tumors. Based off ROC curve analyses, RImean predicted the ER (+) tumors (AUC, 0.699; p = 0.006), and HER-2 (+) tumors (AUC, 0.674; p = 0.022), but not the PR (+) tumors. However, neither SUVmax nor RImax predicted ER (+), PR (+), or HER-2 (+) tumors. CONCLUSIONS Retention index of SUVmean can reflect the ER and HER-2 status of breast cancers. Higher retention index of SUVmean might associate with lower ER expression and higher HER-2 expression.
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Affiliation(s)
- Hansol Moon
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75, Nowon-ro, Nowon-gu, Seoul, 139-706 Republic of Korea
| | - Woo Chul Noh
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
| | - Hyun-Ah Kim
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
| | - Eun-Kyu Kim
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
| | - Ko Woon Park
- Department of Radiology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
| | - Seung Sook Lee
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea ; Department of Pathology, Korea Cancer Center Hospital, Seoul, Republic of Korea
| | - Joon Ho Choi
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75, Nowon-ro, Nowon-gu, Seoul, 139-706 Republic of Korea
| | - Kyung Woo Han
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75, Nowon-ro, Nowon-gu, Seoul, 139-706 Republic of Korea
| | - Byung Hyun Byun
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75, Nowon-ro, Nowon-gu, Seoul, 139-706 Republic of Korea
| | - Ilhan Lim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75, Nowon-ro, Nowon-gu, Seoul, 139-706 Republic of Korea
| | - Byung Il Kim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75, Nowon-ro, Nowon-gu, Seoul, 139-706 Republic of Korea
| | - Chang Woon Choi
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75, Nowon-ro, Nowon-gu, Seoul, 139-706 Republic of Korea
| | - Sang Moo Lim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75, Nowon-ro, Nowon-gu, Seoul, 139-706 Republic of Korea
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Shimizu M, Mitsudo K, Koike I, Taguri M, Iwai T, Koizumi T, Oguri S, Kioi M, Hirota M, Inoue T, Tohnai I. Prognostic value of 2-[18 F]fluoro-2-deoxy-D-glucose positron emission tomography for patients with oral squamous cell carcinoma treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:239-47. [DOI: 10.1016/j.oooo.2015.10.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 08/01/2015] [Accepted: 10/19/2015] [Indexed: 11/28/2022]
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Abgral R, Valette G, Robin P, Rousset J, Keromnes N, Le Roux PY, Marianowski R, Salaün PY. Prognostic evaluation of percentage variation of metabolic tumor burden calculated by dual-phase 18
FDG PET-CT imaging in patients with head and neck cancer. Head Neck 2015; 38 Suppl 1:E600-6. [DOI: 10.1002/hed.24048] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 12/30/2014] [Accepted: 03/06/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Ronan Abgral
- Department of Nuclear Medicine; University Hospital of Brest; Brest France
- European University of Brittany; EA3878 GETBO, IFR 148 Brest France
| | - Gérald Valette
- Department of Head and Neck Surgery; University Hospital of Brest; Brest France
| | - Philippe Robin
- Department of Nuclear Medicine; University Hospital of Brest; Brest France
| | - Jean Rousset
- Department of Radiology; Military Hospital of Brest; Brest France
| | - Nathalie Keromnes
- Department of Nuclear Medicine; University Hospital of Brest; Brest France
| | - Pierre-Yves Le Roux
- Department of Nuclear Medicine; University Hospital of Brest; Brest France
- European University of Brittany; EA3878 GETBO, IFR 148 Brest France
| | - Rémi Marianowski
- Department of Head and Neck Surgery; University Hospital of Brest; Brest France
| | - Pierre-Yves Salaün
- Department of Nuclear Medicine; University Hospital of Brest; Brest France
- European University of Brittany; EA3878 GETBO, IFR 148 Brest France
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Povoski SP, Murrey DA, Smith SM, Martin EW, Hall NC. 18F-FDG PET/CT oncologic imaging at extended injection-to-scan acquisition time intervals derived from a single-institution 18F-FDG-directed surgery experience: feasibility and quantification of 18F-FDG accumulation within 18F-FDG-avid lesions and background tissues. BMC Cancer 2014; 14:453. [PMID: 24942656 PMCID: PMC4075626 DOI: 10.1186/1471-2407-14-453] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 06/13/2014] [Indexed: 12/31/2022] Open
Abstract
Background 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is a well-established imaging modality for a wide variety of solid malignancies. Currently, only limited data exists regarding the utility of PET/CT imaging at very extended injection-to-scan acquisition times. The current retrospective data analysis assessed the feasibility and quantification of diagnostic 18F-FDG PET/CT oncologic imaging at extended injection-to-scan acquisition time intervals. Methods 18F-FDG-avid lesions (not surgically manipulated or altered during 18F-FDG-directed surgery, and visualized both on preoperative and postoperative 18F-FDG PET/CT imaging) and corresponding background tissues were assessed for 18F-FDG accumulation on same-day preoperative and postoperative 18F-FDG PET/CT imaging. Multiple patient variables and 18F-FDG-avid lesion variables were examined. Results For the 32 18F-FDG-avid lesions making up the final 18F-FDG-avid lesion data set (from among 7 patients), the mean injection-to-scan times of the preoperative and postoperative 18F-FDG PET/CT scans were 73 (±3, 70-78) and 530 (±79, 413-739) minutes, respectively (P < 0.001). The preoperative and postoperative mean 18F-FDG-avid lesion SUVmax values were 7.7 (±4.0, 3.6-19.5) and 11.3 (±6.0, 4.1-29.2), respectively (P < 0.001). The preoperative and postoperative mean background SUVmax values were 2.3 (±0.6, 1.0-3.2) and 2.1 (±0.6, 1.0-3.3), respectively (P = 0.017). The preoperative and postoperative mean lesion-to-background SUVmax ratios were 3.7 (±2.3, 1.5-9.8) and 5.8 (±3.6, 1.6-16.2), respectively, (P < 0.001). Conclusions 18F-FDG PET/CT oncologic imaging can be successfully performed at extended injection-to-scan acquisition time intervals of up to approximately 5 half-lives for 18F-FDG while maintaining good/adequate diagnostic image quality. The resultant increase in the 18F-FDG-avid lesion SUVmax values, decreased background SUVmax values, and increased lesion-to-background SUVmax ratios seen from preoperative to postoperative 18F-FDG PET/CT imaging have great potential for allowing for the integrated, real-time use of 18F-FDG PET/CT imaging in conjunction with 18F-FDG-directed interventional radiology biopsy and ablation procedures and 18F-FDG-directed surgical procedures, as well as have far-reaching impact on potentially re-shaping future thinking regarding the “most optimal” injection-to-scan acquisition time interval for all routine diagnostic 18F-FDG PET/CT oncologic imaging.
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Affiliation(s)
- Stephen P Povoski
- Division of Surgical Oncology, Department of Surgery, Arthur G, James Cancer Hospital and Richard J, Solove Research Institute and Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
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Chen HHW, Lee BF, Su WC, Lai YH, Chen HY, Guo HR, Yao WJ, Chiu NT. The increment in standardized uptake value determined using dual-phase 18F-FDG PET is a promising prognostic factor in non-small-cell lung cancer. Eur J Nucl Med Mol Imaging 2013; 40:1478-85. [DOI: 10.1007/s00259-013-2452-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 04/30/2013] [Indexed: 11/30/2022]
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When should we recommend use of dual time-point and delayed time-point imaging techniques in FDG PET? Eur J Nucl Med Mol Imaging 2013; 40:779-87. [PMID: 23361859 DOI: 10.1007/s00259-013-2343-9] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 01/04/2013] [Indexed: 10/27/2022]
Abstract
FDG PET and PET/CT are now widely used in oncological imaging for tumor characterization, staging, restaging, and response evaluation. However, numerous benign etiologies may cause increased FDG uptake indistinguishable from that of malignancy. Multiple studies have shown that dual time-point imaging (DTPI) of FDG PET may be helpful in differentiating malignancy from benign processes. However, exceptions exist, and some studies have demonstrated significant overlap of FDG uptake patterns between benign and malignant lesions on delayed time-point images. In this review, we summarize our experience and opinions on the value of DTPI and delayed time-point imaging in oncology, with a review of the relevant literature. We believe that the major value of DTPI and delayed time-point imaging is the increased sensitivity due to continued clearance of background activity and continued FDG accumulation in malignant lesions, if the same diagnostic criteria (as in the initial standard single time-point imaging) are used. The specificity of DTPI and delayed time-point imaging depends on multiple factors, including the prevalence of malignancies, the patient population, and the cut-off values (either SUV or retention index) used to define a malignancy. Thus, DTPI and delayed time-point imaging would be more useful if performed for evaluation of lesions in regions with significant background activity clearance over time (such as the liver, the spleen, the mediastinum), and if used in the evaluation of the extent of tumor involvement rather than in the characterization of the nature of any specific lesion. Acute infectious and non-infectious inflammatory lesions remain as the major culprit for diminished diagnostic performance of these approaches (especially in tuberculosis-endemic regions). Tumor heterogeneity may also contribute to inconsistent performance of DTPI. The authors believe that selective use of DTPI and delayed time-point imaging will improve diagnostic accuracy and interpretation confidence in FDG PET imaging.
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Hustinx R. Newer Methods for Improving Yield from FDG-PET Imaging for Accurate Staging, Determining Tumor Biology, and Assessing Prognosis. PET Clin 2012; 7:425-30. [PMID: 27157648 DOI: 10.1016/j.cpet.2012.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Fluorodeoxyglucose PET/CT is a powerful tool for staging head and neck squamous cell carcinomas and nasopharyngeal carcinomas. These tumors consistently display high fluorodeoxyglucose uptake, and the PET results are also valuable in terms of prognosis, whether they are obtained before treatment or after its completion. Tumors of the head and neck present distinct clinical features. Evaluating differences in biology among tumor, inflammation, and normal tissue with high physiologic uptake by performing dual time point imaging or post hoc analysis of tissue heterogeneity may also prove highly valuable, although clear clinical data are lacking at this stage.
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Affiliation(s)
- Roland Hustinx
- Division of Nuclear Medicine, University Hospital of Liège, University of Liège, Sart Tilman, B35, Liège B-4000, Belgium.
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Lee JE, Kim SW, Kim JS, Choi KY, Kang WK, Oh ST, Yoo IR, Kim SH. Prognostic value of 18-fluorodeoxyglucose positron emission tomography-computed tomography in resectable colorectal cancer. World J Gastroenterol 2012; 18:5072-7. [PMID: 23049216 PMCID: PMC3460334 DOI: 10.3748/wjg.v18.i36.5072] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Revised: 03/09/2012] [Accepted: 03/20/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the prognostic value of preoperative 18 fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) in patients with resectable colorectal cancer.
METHODS: One hundred sixty-three patients with resectable colorectal cancer who underwent FDG-PET/CT before surgery were included. Patient data including pathologic stage at presentation, histology, treatment, disease-free survival and the maximum standardized uptake value (SUVmax) of the primary tumor on FDG-PET/CT were retrospectively analyzed. Median follow up duration was 756 (range, 419-1355). The primary end point was disease-free survival.
RESULTS: Twenty-five of 163 patients (15.3%) had recurrences. The median SUVmax values of the recurrence and no-recurrence groups were 8.9 (range, 5-24) and 8.2 (range, 0-23, P = 0.998). Receiver operating characteristic (ROC) curve analysis showed no significant association between SUVmax and recurrence (area under the curve = 0.5, P = 0.998, 95% CI: 0.389-0.611). Because a statistically significant value was not found, SUVmax was dichotomized at its median of 8.6. The disease-free survival curve was analyzed using the median SUVmax (8.6) as the cut off. Univariate and multivariate analysis did not provide evidence that disease-free survival rates for the subgroups defined by the median SUVmax were significantly different (P = 0.52, P = 0.25).
CONCLUSION: Our study suggests that the high FDG uptake of primary mass in resectable colorectal cancer doesn’t have a significant relationship with tumor recurrence and disease-free survival.
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The use of multiple time point dynamic positron emission tomography/computed tomography in patients with oral/head and neck cancer does not predictably identify metastatic cervical lymph nodes. J Oral Maxillofac Surg 2012; 71:162-77. [PMID: 22742956 DOI: 10.1016/j.joms.2012.03.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Revised: 03/20/2012] [Accepted: 03/21/2012] [Indexed: 11/24/2022]
Abstract
PURPOSE To determine whether the time course of 18-fluorine fluorodeoxyglucose (18F-FDG) activity in multiple consecutively obtained 18F-FDG positron emission tomography (PET)/computed tomography (CT) scans predictably identifies metastatic cervical adenopathy in patients with oral/head and neck cancer. It is hypothesized that the activity will increase significantly over time only in those lymph nodes harboring metastatic cancer. PATIENTS AND METHODS A prospective cohort study was performed whereby patients with oral/head and neck cancer underwent consecutive imaging at 9 time points with PET/CT from 60 to 115 minutes after injection with (18)F-FDG. The primary predictor variable was the status of the lymph nodes based on dynamic PET/CT imaging. Metastatic lymph nodes were defined as those that showed an increase greater than or equal to 10% over the baseline standard uptake values. The primary outcome variable was the pathologic status of the lymph node. RESULTS A total of 2,237 lymph nodes were evaluated histopathologically in the 83 neck dissections that were performed in 74 patients. A total of 119 lymph nodes were noted to have hypermetabolic activity on the 90-minute (static) portion of the study and were able to be assessed by time points. When we compared the PET/CT time point (dynamic) data with the histopathologic analysis of the lymph nodes, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 60.3%, 70.5%, 66.0%, 65.2%, and 65.5%, respectively. CONCLUSIONS The use of dynamic PET/CT imaging does not permit the ablative surgeon to depend only on the results of the PET/CT study to determine which patients will benefit from neck dissection. As such, we maintain that surgeons should continue to rely on clinical judgment and maintain a low threshold for executing neck dissection in patients with oral/head and neck cancer, including those patients with N0 neck designations.
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Relationship Between Dual-Time Point FDG PET and Immunohistochemical Parameters in Preoperative Colorectal Cancer: Preliminary Study. Nucl Med Mol Imaging 2012; 46:48-56. [PMID: 24900032 DOI: 10.1007/s13139-011-0120-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 10/11/2011] [Accepted: 11/18/2011] [Indexed: 12/25/2022] Open
Abstract
PURPOSE The clinical availability of 2-deoxy-2-[18F] fluoro-D-glucose (FDG) dual-time point positron emission tomography/computerized tomography (DTPP) has been investigated in diverse oncologic fields. The aim of this preliminary study was to evaluate the relationship between various immunohistopathologic markers reflecting disease progression of colorectal cancer and parameters extracted from FDG DTPP in colorectal cancer patients. MATERIALS AND METHODS Forty-seven patients with histologically confirmed colorectal cancer were analyzed in this preliminary study. FDG DTPP consisted of an early scan 1 h after FDG injection and a delayed scan 1.5 h after the early scan. Based on an analysis of FDG DTPP, we estimated the maximum standardized uptake value (SUV) of tumors on the early and delayed scans (SUVearly and SUVdelayed, respectively). The retention index (RI) was calculated as follows: (SUVdelayed - SUVearly) × 100/ SUVearly. The clinicopathological findings (size and T and N stages) and immunohistochemical factors [glucose transporter 1 (GLUT-1), hexokinase 2 (HK-2), p53, P504S, and β-catenin] were analyzed by visual analysis. RESULTS The RIs calculated from the SUVs ranged from -1.8 to 73.4 (31.8 ± 15.5). The RIs were significantly higher in patients with high T stages (T3 and T4) than with low T stages (T1 and T2; p < 0.05). Among the immunohistochemical analytic markers, GLUT-1 had the highest positive staining rate (93.6%) compared to other markers. Based on univariable analysis, it was shown that the RI of high-level GLUT-1 expression was significantly higher than low-level GLUT-1 expression (p = 0.01), and the RI of high-level p53 expression was slightly higher than low-level p53 expression (p = 0.08). Multivariate analysis to investigate a link between RI and clinicopathologic parameters of colorectal carcinoma showed that GLUT-1, p53, and T staging were independently connected with increased RIs (p < 0.05, total) using backward selection methods. There was no significant statistical relationship between SUVearly and SUVdelayed and clinicopathologic parameters in this study. CONCLUSION The RIs obtained from preoperative colorectal cancers had a significant relationship to tumor size, T staging, GLUT-1, and p53, in contrast to SUVearly or SUVdelayed. Compared with previous reports, our results showed that RI can better predict GLUT-1 expression than HK-2 and other immunohistochemical markers. This study demonstrated that the RI might have the potential to be applied as a prognostic marker in preoperative colorectal cancer.
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Satoh Y, Nambu A, Onishi H, Sawada E, Tominaga L, Kuriyama K, Komiyama T, Marino K, Aoki S, Araya M, Saito R, Maehata Y, Oguri M, Araki T. Value of dual time point F-18 FDG-PET/CT imaging for the evaluation of prognosis and risk factors for recurrence in patients with stage I non-small cell lung cancer treated with stereotactic body radiation therapy. Eur J Radiol 2011; 81:3530-4. [PMID: 22178287 DOI: 10.1016/j.ejrad.2011.11.047] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 11/22/2011] [Accepted: 11/24/2011] [Indexed: 12/25/2022]
Abstract
PURPOSE To investigate prognostic and risk factors for recurrence after stereotactic body radiation therapy (SBRT) in patients with stage I non-small cell lung carcinoma (NSCLC), focusing on dual time point [18]F-fluorodeoxyglucose positron emission tomography (FDG PET). MATERIALS AND METHODS We prospectively evaluated 57 patients with stage I NSCLC (45 T1N0M0 and 12 T2N0M0) who had undergone pretreatment FDG-PET/CT and were subsequently treated with SBRT. All patients received a whole-body PET/CT scan at 60 min and a whole-lung at 120 min after the injection. The maximum standardized uptake value (SUV) and retention index (RI) of the lesions were calculated. Local recurrence, regional lymph node metastasis, distant metastasis, and the recurrence pattern were evaluated. Cox proportional hazard regression analyses were performed to evaluate prognostic factors or risk factors of recurrence. RESULTS During the median follow-up period of 27 months, local recurrence, regional lymph node metastasis, and distant metastasis were seen in 17 (30%), 12 (21%), and 17 (30%) of the 57 patients, respectively. The 3-year overall survival rate was 63.4%. SUVmax did not affect any recurrence, DFS, OS, or CSS. RI significantly predicted higher distant metastasis (HR 47.546, p=0.026). In contrast, RI tended to predict lower local recurrence (HR 0.175, p=0.246) and regional lymph node metastasis (HR 0.109, p=0.115). CONCLUSIONS SUVmax at staging FDG-PET does not predict any recurrence, DFS, OS or CSS. In contrast, higher RI predicts higher distant metastasis and tended to predict lower local or regional lymph node metastasis.
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Affiliation(s)
- Yoko Satoh
- PET Center, Kofu Neurosurgical Hospital, ZIP Code 400-0805, Sakaori 1-16-18, Kofu city, Yamanashi Prefecture, Japan.
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Limited Predictive Value of Dual-Time-Point F-18 FDG PET/CT for Evaluation of Pathologic N1 Status in NSCLC Patients. Clin Nucl Med 2011; 36:434-9. [DOI: 10.1097/rlu.0b013e31820adef8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kim SJ, Kim BH, Jeon YK, Kim SS, Kim IJ. Limited diagnostic and predictive values of dual-time-point 18F FDG PET/CT for differentiation of incidentally detected thyroid nodules. Ann Nucl Med 2011; 25:347-53. [DOI: 10.1007/s12149-011-0468-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Accepted: 01/07/2011] [Indexed: 10/18/2022]
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Xie P, Li M, Zhao H, Sun X, Fu Z, Yu J. 18F-FDG PET or PET-CT to evaluate prognosis for head and neck cancer: a meta-analysis. J Cancer Res Clin Oncol 2011; 137:1085-93. [PMID: 21229262 DOI: 10.1007/s00432-010-0972-y] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 12/22/2010] [Indexed: 12/22/2022]
Abstract
PURPOSE The purpose of this meta-analysis was to evaluate the prognostic value of standard uptake value (SUV) from serial Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in patients with head and neck cancer. METHODS We searched for articles limited to head and neck cancer, dealt with the impact of SUV on survival and published in English. The endpoints were disease-free survival (DFS), overall survival (OS), and local control (LC). Two reviewers extracted data independently. RESULTS Thirty-five studies were identified; of which, 26 studies involving 1,415 patients met the inclusion criteria. Pooled survival data suggested better DFS, OS, and LC in patients with low SUV of pre-treatment, and the odds ratio (OR) was 0.23, 0.24, and 0.27, respectively. Patients having tumors with low SUV of post-treatment also had significantly better DFS (OR = 0.17) and OS (OR = 0.28) than those with high SUV. CONCLUSIONS The present meta-analysis showed that (18)F-FDG uptake, as measured by the SUV before treatment and metabolic response after treatment, are valuable for predicting long-term survival in head and neck cancer. High (18)F-FDG uptake may be useful for identifying patients requiring more aggressive treatment.
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Affiliation(s)
- Peng Xie
- Department of Radiation Oncology, Shandong Tumor Hospital and Institute, Key Laboratory of Radiation Oncology of Shandong Province, Jiyan Road 440, 250117, Jinan, Shandong Province, China
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Limited prognostic value of dual time point F-18 FDG PET/CT in patients with early stage (stage I & II) non-small cell lung cancer (NSCLC). Radiother Oncol 2011; 98:105-8. [DOI: 10.1016/j.radonc.2010.11.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 10/25/2010] [Accepted: 11/07/2010] [Indexed: 11/23/2022]
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Houseni M, Chamroonrat W, Zhuang J, Gopal R, Alavi A, Zhuang H. Prognostic Implication of Dual-Phase PET in Adenocarcinoma of the Lung. J Nucl Med 2010; 51:535-42. [DOI: 10.2967/jnumed.109.068643] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Kato H, Nakajima M, Sohda M, Tanaka N, Inose T, Miyazaki T, Fukuchi M, Oriuchi N, Endo K, Kuwano H. The clinical application of (18)F-fluorodeoxyglucose positron emission tomography to predict survival in patients with operable esophageal cancer. Cancer 2009; 115:3196-203. [PMID: 19472406 DOI: 10.1002/cncr.24399] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Metabolic tumor activity using (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) was believed to have a predictive value for patient outcome in malignancies. The objective of the current study was to assess the prognostic effectiveness of the highest standardized uptake value (SUV) in the primary or regional area (peak SUV) and the number of PET-positive lymph nodes in esophageal cancer. METHODS The authors retrospectively reviewed their experience with 184 consecutive esophageal cancer patients imaged preoperatively using FDG-PET scanning. RESULTS The median peak SUV was 4.5 (range, 1.4-21.9). The survival curve was analyzed using the median peak SUV as the cutoff value. Comparison of each group and clinicopathologic characteristics revealed significant associations between peak SUV and each of the following factors: tumor status (P < .001), lymph node status (P < .001), metastatic status (P < .05), stage of disease (P < .001), number of PET-positive lymph nodes (P < .001), and the number of histologically positive lymph nodes (P < .001). The 5-year overall survival (OS) rate for patients having FDG uptake with a peak SUV > or =4.5 was 47% and that for patients with a peak SUV <4.5 was 76% (P < .0001). On multivariate survival analysis using the Cox proportional hazards model, peak SUV and the number of PET-positive lymph nodes were found to be independent predictive factors for OS. The number of PET-positive lymph nodes was a single prognostic factor predicting both disease-free survival and OS. CONCLUSIONS Pretreatment PET cannot only potentially diagnose the extent of disease, but also may be predictive of patient survival after esophageal cancer resection.
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Affiliation(s)
- Hiroyuki Kato
- Department of General Surgical Science (Surgery I), Gunma University, Graduate School of Medicine, Maebashi, Japan.
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Suzuki K, Nishioka T, Homma A, Tsuchiya K, Yasuda M, Aoyama H, Onimaru R, Tamaki N, Shirato H. Value of fluorodeoxyglucose positron emission tomography before radiotherapy for head and neck cancer: does the standardized uptake value predict treatment outcome? Jpn J Radiol 2009; 27:237-42. [PMID: 19626409 DOI: 10.1007/s11604-009-0330-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Accepted: 04/20/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim of this study was to determine if the standardized uptake value (SUV) of fluorodeoxyglucose positron emission tomography (FDG-PET) for head and neck cancer can predict the outcome of radiotherapy and if the SUV is correlated with histological grade, mitosis, and apoptosis. MATERIALS AND METHODS The study included 45 head and neck cancer patients who underwent FDG-PET scanning before radiotherapy. The maximum SUV (SUVmax) of their primary lesions were measured. Biopsy was performed in all patients to determine the histological diagnosis. Altogether, 14 biopsy specimens were available for mitotic and apoptotic cell counts. RESULTS The mean SUVmax of T3 tumors was significantly higher than that of T1 (P = 0.01) and T2 (P = 0.011) tumors. The mean SUVmax of stage II disease was significantly lower than that of stage III (P = 0.028) and stage IV (P = 0.007) disease. There was a tendency toward a better locoregional control rate and disease-free survival for the lower SUV group using a cutoff value of 5.5. For 41 patients with squamous cell carcinoma or undifferentiated carcinoma, SUVmax did not reflect the histological grade. There was no correlation between the SUVmax and the mitotic/apoptotic status. CONCLUSION SUVmax may correlate with the T classification and stage, but there was no predictive value for outcome of radiation therapy. Neither histological grading nor mitotic/apoptotic status is correlated with SUVmax.
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Affiliation(s)
- Keishiro Suzuki
- Department of Radiology, Hokkaido University Graduate School of Medicine, Nishi 7-chome Kita 15-Jo, Kita-ku, Sapporo 060-8638, Japan.
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Dual-Time-Point FDG-PET/CT for the Detection of Hepatic Metastases. Mol Imaging Biol 2008; 10:335-40. [DOI: 10.1007/s11307-008-0159-y] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Revised: 04/19/2008] [Accepted: 05/06/2008] [Indexed: 12/23/2022]
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Enomoto K, Inohara H, Higuchi I, Hamada K, Tomiyama Y, Kubo T, Hatazawa J. Prognostic Value of FDG-PET in patients with oropharyngeal carcinoma treated with concurrent chemoradiotherapy. Mol Imaging Biol 2008; 10:224-9. [PMID: 18528731 PMCID: PMC2480511 DOI: 10.1007/s11307-008-0145-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2007] [Revised: 03/03/2008] [Accepted: 04/08/2008] [Indexed: 11/30/2022]
Abstract
Purpose The purpose of this study was to evaluate the predictive value of 2-deoxy-2-[F-18]fluoro-d-glucose-positron emission tomography (FDG-PET) following concurrent chemoradiotherapy (CRT) on survival in patients with carcinoma of the oropharynx (OPC). Methods Eighteen patients with primary OPC who underwent PET pre- and post-CRT were evaluated prospectively for survival. The prognostic performance of post-CRT PET and CT for recurrence was compared. Results Patients with positive post-CRT PET exhibited significantly lower 2-year cause-specific survival and disease-free survival (50% vs. 91%, P < 0.05 and 0% vs. 83%, P < 0.0001); however, patients with positive post-CRT CT did not exhibit any significant difference (67% vs. 83%, P = 0.416 and 50% vs. 75%, P = 0.070). Other factors, such as clinical and pre-CRT PET variables, also did not indicate any significant difference. The accuracy of prediction of residual and local recurrence for post-CRT PET and CT (local%/regional%) was 83%/94% and 83%/78%, respectively. Conclusion OPC patients with positive post-CRT PET exhibit poor survival. The prognostic accuracy of post-CRT PET is superior to that of CT. The results of post-CRT FDG-PET should be included in the management of the OPC patients.
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Affiliation(s)
- Keisuke Enomoto
- Department of Otolaryngology, Osaka University School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
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Veit-Haibach P, Luczak C, Wanke I, Fischer M, Egelhof T, Beyer T, Dahmen G, Bockisch A, Rosenbaum S, Antoch G. TNM staging with FDG-PET/CT in patients with primary head and neck cancer. Eur J Nucl Med Mol Imaging 2007; 34:1953-62. [PMID: 17717661 DOI: 10.1007/s00259-007-0564-5] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2007] [Accepted: 07/25/2007] [Indexed: 11/24/2022]
Abstract
PURPOSE PET/CT, PET+CT, and CT were compared concerning accuracies in TNM staging and malignancy detection in head and neck cancer. The impact of PET/CT compared to the other imaging modalities on therapy management was assessed. MATERIALS AND METHODS Fifty-five patients with suspected head and neck primary cancer underwent whole-body FDG-PET/CT. PET/CT and PET+CT were evaluated by a nuclear medicine physician and a radiologist; CT was evaluated by two radiologists, PET by two nuclear physicians. Histopathology served as the standard of reference. Differences between the staging modalities were tested for statistical significance by McNemar's test. RESULTS Overall TNM-staging and T-staging with PET/CT were more accurate than PET+CT and CT alone (p < 0.05). PET/CT was marginally more accurate than CT alone in N-staging (p = 0.04); no statistically significant difference was found when compared to PET+CT for N-staging. PET/CT altered further treatment in 13 patients compared to CT only and in 7 patients compared to PET+CT. CONCLUSION Combined PET/CT proved to be partly more accurate in assessing the overall TNM-stage than CT and PET+CT. These results were based on a higher accuracy concerning the T-stage, mainly in patients with metallic implants and marginally the N-stage. Therapy decisions have been influenced in a substantial number of patients. PET/CT might be considered as a first line diagnostic tool in patients with suspected primary head and neck cancer.
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Affiliation(s)
- Patrick Veit-Haibach
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, Essen, Germany.
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