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Rosu A, Ghaemi B, Bulte JW, Shakeri-Zadeh A. Tumor-tropic Trojan horses: Using mesenchymal stem cells as cellular nanotheranostics. Theranostics 2024; 14:571-591. [PMID: 38169524 PMCID: PMC10758060 DOI: 10.7150/thno.90187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/21/2023] [Indexed: 01/05/2024] Open
Abstract
Various classes of nanotheranostics have been developed for enhanced tumor imaging and therapy. However, key limitations for a successful use of nanotheranostics include their targeting specificity with limited off-site tissue accumulation as well as their distribution and prolonged retention throughout the entire tumor. Due to their inherent tumor-tropic properties, the use of mesenchymal stem cells (MSCs) as a "Trojan horse" has recently been proposed to deliver nanotheranostics more effectively. This review discusses the current status of "cellular nanotheranostics" for combined (multimodal) imaging and therapy in preclinical cancer models. Emphasis is placed on the limited knowledge of the signaling pathways and molecular mechanisms of MSC tumor-tropism, and how such information may be exploited to engineer MSCs in order to further improve tumor homing and nanotheranostic delivery using image-guided procedures.
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Affiliation(s)
| | | | | | - Ali Shakeri-Zadeh
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research and Cellular Imaging Section and Vascular Biology Program, Institute for Cell Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Yu X, He L, Wang Y, Dong Y, Song Y, Yuan Z, Yan Z, Wang W. A deep learning approach for automatic tumor delineation in stereotactic radiotherapy for non-small cell lung cancer using diagnostic PET-CT and planning CT. Front Oncol 2023; 13:1235461. [PMID: 37601687 PMCID: PMC10437048 DOI: 10.3389/fonc.2023.1235461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/10/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Accurate delineation of tumor targets is crucial for stereotactic body radiation therapy (SBRT) for non-small cell lung cancer (NSCLC). This study aims to develop a deep learning-based segmentation approach to accurately and efficiently delineate NSCLC targets using diagnostic PET-CT and SBRT planning CT (pCT). Methods The diagnostic PET was registered to pCT using the transform matrix from registering diagnostic CT to the pCT. We proposed a 3D-UNet-based segmentation method to segment NSCLC tumor targets on dual-modality PET-pCT images. This network contained squeeze-and-excitation and Residual blocks in each convolutional block to perform dynamic channel-wise feature recalibration. Furthermore, up-sampling paths were added to supplement low-resolution features to the model and also to compute the overall loss function. The dice similarity coefficient (DSC), precision, recall, and the average symmetric surface distances were used to assess the performance of the proposed approach on 86 pairs of diagnostic PET and pCT images. The proposed model using dual-modality images was compared with both conventional 3D-UNet architecture and single-modality image input. Results The average DSC of the proposed model with both PET and pCT images was 0.844, compared to 0.795 and 0.827, when using 3D-UNet and nnUnet. It also outperformed using either pCT or PET alone with the same network, which had DSC of 0.823 and 0.732, respectively. Discussion Therefore, our proposed segmentation approach is able to outperform the current 3D-UNet network with diagnostic PET and pCT images. The integration of two image modalities helps improve segmentation accuracy.
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Affiliation(s)
- Xuyao Yu
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Tianjin Medical University, Tianjin, China
| | - Lian He
- Perception Vision Medical Technologies Co Ltd, Guangzhou, China
| | - Yuwen Wang
- Department of Radiotherapy, Tianjin Cancer Hospital Airport Hospital, Tianjin, China
| | - Yang Dong
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Yongchun Song
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Zhiyong Yuan
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Ziye Yan
- Perception Vision Medical Technologies Co Ltd, Guangzhou, China
| | - Wei Wang
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
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Mallum A, Mkhize T, Akudugu JM, Ngwa W, Vorster M. The Role of Positron Emission Tomography and Computed Tomographic (PET/CT) Imaging for Radiation Therapy Planning: A Literature Review. Diagnostics (Basel) 2022; 13:diagnostics13010053. [PMID: 36611345 PMCID: PMC9818506 DOI: 10.3390/diagnostics13010053] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 12/28/2022] Open
Abstract
PET/CT is revolutionising radiotherapy treatment planning in many cancer sites. While its utility has been confirmed in some cancer sites, and is used in routine clinical practice, it is still at an experimental stage in many other cancer sites. This review discusses the utility of PET/CT in cancer sites where the role of PET/CT has been established in cases such as head and neck, cervix, brain, and lung cancers, as well as cancer sites where the role of PET/CT is still under investigation such as uterine, ovarian, and prostate cancers. Finally, the review touches on PET/CT utilisation in Africa.
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Affiliation(s)
- Abba Mallum
- Department of Radiotherapy and Oncology, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
- Department of Radiotherapy and Oncology, Inkosi Albert Luthuli Central Hospital, Durban 4091, South Africa
- University of Maiduguri Teaching Hospital, Maiduguri 600104, Nigeria
- Correspondence: or
| | - Thokozani Mkhize
- Department of Nuclear Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
- Department of Nuclear Medicine, Inkosi Albert Central Hospital, Durban 4091, South Africa
| | - John M. Akudugu
- Division of Radiobiology, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa
| | - Wilfred Ngwa
- School of Medicine, Johns Hopkins University, Baltimore, MD 21218, USA
- Brigham and Women’s Hospital, Dana-Farmer Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Mariza Vorster
- Department of Nuclear Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
- Department of Nuclear Medicine, Inkosi Albert Central Hospital, Durban 4091, South Africa
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Muacevic A, Adler JR, Nittala MR, Velazquez AE, Huddleston BL, Rugnath NA, Adari N, Yajurvedi AK, Komanduri A, Yang CC, Duggar WN, Berlin WP, Duszak R, Vijayakumar V. Changing Role of PET/CT in Cancer Care With a Focus on Radiotherapy. Cureus 2022; 14:e32840. [PMID: 36694538 PMCID: PMC9867792 DOI: 10.7759/cureus.32840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
Positron emission tomography (PET) integrated with computed tomography (CT) has brought revolutionary changes in improving cancer care (CC) for patients. These include improved detection of previously unrecognizable disease, ability to identify oligometastatic status enabling more aggressive treatment strategies when the disease burden is lower, its use in better defining treatment targets in radiotherapy (RT), ability to monitor treatment responses early and thus improve the ability for early interventions of non-responding tumors, and as a prognosticating tool as well as outcome predicting tool. PET/CT has enabled the emergence of new concepts such as radiobiotherapy (RBT), radioimmunotherapy, theranostics, and pharmaco-radiotherapy. This is a rapidly evolving field, and this primer is to help summarize the current status and to give an impetus to developing new ideas, clinical trials, and CC outcome improvements.
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H. Morris R, R. Geraldi N, C. Pike L, Pawelke J, L. Hoffmann A, Doy N, L. Stafford J, Spicer A, I. Newton M. Advanced Sandwich Composite Cores for Patient Support in Advanced Clinical Imaging and Oncology Treatment. MATERIALS 2020; 13:ma13163549. [PMID: 32806610 PMCID: PMC7475909 DOI: 10.3390/ma13163549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/29/2020] [Accepted: 08/04/2020] [Indexed: 01/18/2023]
Abstract
Ongoing advances in both imaging and treatment for oncology purposes have seen a significant rise in the use of not only the individual imaging modalities, but also their combination in single systems such as Positron Emission Tomography combined with Computed Tomography (PET–CT) and PET–MRI (Magnetic Resonance Imaging) when planning for advanced oncology treatment, the most demanding of which is proton therapy. This has identified issues in the availability of suitable materials upon which to support the patient undergoing imaging and treatment owing to the differing requirements for each of the techniques. Sandwich composites are often selected to solve this issue but there is little information regarding optimum materials for their cores. In this paper, we presented a range of materials which are suitable for such purposes and evaluated the performance for use in terms of PET signal attenuation, proton beam stopping, MRI signal shading and X-Ray CT visibility. We found that Extruded Polystyrene offers the best compromise for patient support and positioning structures across all modalities tested, allowing for significant savings in treatment planning time and delivering more efficient treatment with lower margins.
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Affiliation(s)
- Robert H. Morris
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (N.R.G.); (N.D.); (J.L.S.); (A.S.); (M.I.N.)
- Correspondence:
| | - Nicasio R. Geraldi
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (N.R.G.); (N.D.); (J.L.S.); (A.S.); (M.I.N.)
| | - Lucy C. Pike
- King’s College London and Guy’s and St Thomas’ PET Centre, School of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, UK;
| | - Jörg Pawelke
- OncoRay—National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, 01307 Dresden, Germany; (J.P.); (A.L.H.)
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology-OncoRay, 01328 Dresden, Germany
| | - Aswin L. Hoffmann
- OncoRay—National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, 01307 Dresden, Germany; (J.P.); (A.L.H.)
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology-OncoRay, 01328 Dresden, Germany
| | - Nicola Doy
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (N.R.G.); (N.D.); (J.L.S.); (A.S.); (M.I.N.)
| | - Johanna L. Stafford
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (N.R.G.); (N.D.); (J.L.S.); (A.S.); (M.I.N.)
| | - Abi Spicer
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (N.R.G.); (N.D.); (J.L.S.); (A.S.); (M.I.N.)
| | - Michael I. Newton
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (N.R.G.); (N.D.); (J.L.S.); (A.S.); (M.I.N.)
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Alongi P, Laudicella R, Desideri I, Chiaravalloti A, Borghetti P, Quartuccio N, Fiore M, Evangelista L, Marino L, Caobelli F, Tuscano C, Mapelli P, Lancellotta V, Annunziata S, Ricci M, Ciurlia E, Fiorentino A. Positron emission tomography with computed tomography imaging (PET/CT) for the radiotherapy planning definition of the biological target volume: PART 1. Crit Rev Oncol Hematol 2019; 140:74-79. [PMID: 30795884 DOI: 10.1016/j.critrevonc.2019.01.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/11/2019] [Accepted: 01/21/2019] [Indexed: 02/07/2023] Open
Abstract
AIM Functional and molecular imaging, including positron emission tomography with computed tomography imaging (PET/CT) is increasing for radiotherapy (RT) definition of the target volume. This expert review summarizes existing data of functional imaging modalities and RT management, in terms of target volume delineation, for the following anatomical districts: brain (for primary and secondary tumors), head/neck and lung. MATERIALS AND METHODS A collection of available published data was made, by PubMed a search. Only original articles were carefully and critically revised. RESULTS For primary and secondary brain tumors, amino acid PET radiotracers could be useful to identify microscopic residual areas and to differ between recurrence and treatment-related alterations in case of re-irradiation. As for head and neck neoplasms may benefit from precise PET/CT-based target delineation, due to the major capability to identify high-risk RT areas. In primary and secondary lung cancer, PET/CT could be useful both to delimit a tumor and collapsed lungs and as a predictive parameter of treatment response. CONCLUSION Taken together, molecular and functional imaging approaches offer a major step to individualize radiotherapeutic care going forward. Nevertheless, several uncertainties remain on the standard method to properly assess the target volume definition including PET information for primary and secondary brain tumors.
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Affiliation(s)
- Pierpaolo Alongi
- Department of Radiological Sciences, Nuclear Medicine Service, Fondazione Istituto G. Giglio, Cefalu. Italy
| | - Riccardo Laudicella
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina. Italy
| | - Isacco Desideri
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", Section of Radiation Oncology, University of Florence, Italy
| | - Agostino Chiaravalloti
- IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, Pozzilli, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Paolo Borghetti
- Radiation Oncology Department University and Spedali Civili, Brescia, Italy
| | | | - Michele Fiore
- Radiation Oncology, Campus Bio-Medico University, Rome, Italy
| | - Laura Evangelista
- Nuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Lorenza Marino
- Radiotherapy Oncology Department, REM, Viagrande, Catania, Italy
| | - Federico Caobelli
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Carmelo Tuscano
- Radiotherapy Oncology Department, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - Paola Mapelli
- Department of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Salvatore Annunziata
- Fondazione Policlinico A. Gemelli IRCCS-Università Cattolica Sacro Cuore, Roma, Italy
| | - Maria Ricci
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Elisa Ciurlia
- Radiotherapy Oncology Department, Vito Fazzi Hospital, Lecce, Italy
| | - Alba Fiorentino
- Radiotherapy Oncology Department, General Regional Hospital "F. Miulli", Strada Prov. 127 Km 4, 70021, Acquaviva delle Fonti, Bari, Italy.
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Outcome and toxicity of intensity-modulated radiotherapy with simultaneous integrated boost in patients with pharyngo-laryngeal cancer. Clin Transl Oncol 2018; 21:881-890. [PMID: 30506131 DOI: 10.1007/s12094-018-1995-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 11/17/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE The present work aims at evaluating intensity-modulated radiation therapy with simultaneous integrated boost (IMRT-SIB) in squamous cell carcinomas (SCC) of the larynx and hypopharynx. METHODS/PATIENTS We performed a single institutional retrospective analysis on 116 pharyngo (29%)-laryngeal (71%) SCC patients (93% male) treated with IMRT-SIB to 66-69.96 Gy in 33 fractions between 2008 and 2016. Those who underwent surgery (54%) received adjuvant radiation of 66 Gy at 2 Gy/fraction to the surgical bed. 16 patients (14%) were treated for a local recurrence after prior surgery. High-risk lymph node regions received 59.4 Gy at 1.8 Gy/fraction and low risk regions 54.12 Gy at 1.64 Gy/fraction. The median age was 60 years and 95% of patients had an ECOG performance status 0-2. Most had advanced stage disease (III 22%, IV 74%). Chemotherapy was delivered in 74% of cases. RESULTS Median follow-up was 32 months. Two and three-year overall survival for all patients was 87% and 82%, respectively. There were 28 (24%) locoregional recurrences and 19 (16%) distant failures. Grade 3 mucositis, dermatitis, and xerostomy were observed in 12%, 10%, and 3%, respectively. A longer IMRT-SIB overall treatment time was associated with a higher risk of mortality (HR 1.09, CI 1.01-1.17, P = 0.02). Postoperative IMRT-SIB associated with a significantly lower risk of any recurrence (HR 0.34, CI 0.18-0.64, P = 0.001) and higher local control (HR 0.06, CI 0.01-0.24, P < 0.01). Additionally, it associated with a lower risk of mucositis (P = 0.029) compared with definitive radio (chemo) therapy. CONCLUSIONS IMRT-SIB is a safe and feasible radiation treatment technique for pharyngo-laryngeal SCC patients with a tolerable acute toxicity profile.
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A comparative study of quantitative assessment with fluorine-18-fluorodeoxyglucose positron-emission tomography and endoscopic ultrasound in oesophageal cancer. Nucl Med Commun 2018; 39:628-635. [PMID: 29672466 DOI: 10.1097/mnm.0000000000000844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES This study aims to assess the correlation between PET/CT and endoscopic ultrasound (EUS) parameters in patients with oesophageal cancer. PATIENTS AND METHODS All patients who had complete PET/CT and EUS staging performed for oesophageal cancer at our centre between 2010 and 2016 were included. Images were retrieved and analysed for a range of parameters including tumour length, volume and position relative to the aortic arch. RESULTS Seventy patients were included in the main analysis. A strong correlation was found between EUS and PET/CT in the tumour length, the volume and the position of the tumour relative to the aortic arch. Regression modelling showed a reasonable predictive value for PET/CT in calculating EUS parameters, with r higher than 0.585 in some cases. CONCLUSION Given the strong correlation between EUS and PET parameters, fluorine-18 fluorodeoxyglucose (F-FDG) PET can provide accurate information on the length and the volume of tumour in patients who either cannot tolerate EUS or have impassable strictures.
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Kerr A, Reed N, Harrand R, Graham K, Sadozye AH. Evaluating the Use of 18F-FDG PET CT for External Beam Radiotherapy Planning in Gynaecological Malignancies. Curr Oncol Rep 2018; 20:84. [PMID: 30206712 DOI: 10.1007/s11912-018-0735-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE OF REVIEW To evaluate the evidence for the use of fluorine-18-fluorodeoyglucose (18F-FDG) PET CT in external beam radiotherapy planning for treatment of gynaecological malignancies. RECENT FINDINGS Our review confirms that the incorporation of 18F-FDG PET CT during radiotherapy planning may decrease inter-observer variability during target delineation. It can also provide useful functional information regarding the tumour, which may facilitate the development of techniques for dose escalation and 'dose painting' not only for primary disease, especially in cervical cancer, but also nodal metastasis. The utilisation of this functional modality in external beam radiotherapy planning, particularly in locally advanced cervical malignancy, is an exciting topic that warrants further prospective research. Perhaps the most valuable role may be the potential to deliver dose escalation to 18F-FDG PET CT avid targets previously limited by organ at risk constraints, now that we have significantly more advanced radiotherapy planning tools at our disposal.
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Affiliation(s)
- Ashleigh Kerr
- Beatson West of Scotland Cancer Centre, Gartnavel General Hospital, Glasgow, G12 0YN, UK
| | - Nicholas Reed
- Beatson West of Scotland Cancer Centre, Gartnavel General Hospital, Glasgow, G12 0YN, UK
| | - Rosie Harrand
- Beatson West of Scotland Cancer Centre, Gartnavel General Hospital, Glasgow, G12 0YN, UK
| | - Kathryn Graham
- Beatson West of Scotland Cancer Centre, Gartnavel General Hospital, Glasgow, G12 0YN, UK
| | - Azmat H Sadozye
- Beatson West of Scotland Cancer Centre, Gartnavel General Hospital, Glasgow, G12 0YN, UK.
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Tu CY, Hsia TC, Fang HY, Liang JA, Yang ST, Li CC, Chien CR. A Population-based Study of the Effectiveness of Stereotactic Ablative Radiotherapy Versus Conventional Fractionated Radiotherapy for Clinical Stage I Non-small Cell Lung Cancer Patients. Radiol Oncol 2017; 52:181-188. [PMID: 30018522 PMCID: PMC6043889 DOI: 10.1515/raon-2017-0058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/18/2017] [Indexed: 12/11/2022] Open
Abstract
Background Stereotactic ablative radiotherapy (SABR) is a promising option for non-operated early-stage non-small cell lung cancer (NSCLC) compared to conventional fractionated radiotherapy (CFRT). However, results from conclusive randomized controlled trials are not yet available. The aim of our study was to explore the effectiveness of SABR vs. CFRT for non-operated early-stage NSCLC. Patients and methods We used a comprehensive population-based database to identify clinical stage I non-operated NSCLC patients in Taiwan diagnosed from 2007 to 2013 who were treated with either SABR or CFRT. We used inverse probability weighting and the propensity score as the primary form of analysis to address the nonrandomization of treatment. In the supplementary analyses, we constructed subgroups based on propensity score matching to compare survival between patients treated with SABR vs. CFRT. Results We identified 238 patients in our primary analysis. A good balance of covariates was achieved using the propensity score weighting. Overall survival (OS) was not significantly different between those treated with SABR vs. CFRT (SABR vs. CFRT: probability weighting adjusted hazard ratio [HR] 0.586, 95% confidence interval 0.264-1.101, p = 0.102). However, SABR was significantly favored in supplementary analyses. Conclusions In this population-based propensity-score adjusted analysis, we found that OS was not significantly different between those treated with SABR vs. CFRT in the primary analysis, although significance was observed in the supplementary analyses. Our results should be interpreted with caution given the database (i.e., nonrandomized) approach used in our study. Overall, further studies are required to explore these issues.
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Affiliation(s)
- Chih-Yen Tu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Te-Chun Hsia
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.,Department of Respiratory Therapy, College of Health Care, China Medical University, Taichung, Taiwan
| | - Hsin-Yuan Fang
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Ji-An Liang
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Su-Tso Yang
- Department of Radiology, China Medical University Hospital, Taichung, Taiwan.,School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Chin Li
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Ru Chien
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
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Slavine NV, Seiler SJ, McColl RW, Lenkinski RE. Image improvement method for positron emission mammography. Phys Med 2017; 39:164-173. [PMID: 28688583 DOI: 10.1016/j.ejmp.2017.06.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 06/09/2017] [Accepted: 06/29/2017] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To evaluate in clinical use a rapidly converging, efficient iterative deconvolution algorithm (RSEMD) for improving the quantitative accuracy of previously reconstructed breast images by a commercial positron emission mammography (PEM) scanner. MATERIALS AND METHODS The RSEMD method was tested on imaging data from clinical Naviscan Flex Solo II PEM scanner. This method was applied to anthropomorphic like breast phantom data and patient breast images previously reconstructed with Naviscan software to determine improvements in image resolution, signal to noise ratio (SNR) and contrast to noise ratio (CNR). RESULTS In all of the patients' breast studies the improved images proved to have higher resolution, contrast and lower noise as compared with images reconstructed by conventional methods. In general, the values of CNR reached a plateau at an average of 6 iterations with an average improvement factor of about 2 for post-reconstructed Flex Solo II PEM images. Improvements in image resolution after the application of RSEMD have also been demonstrated. CONCLUSIONS A rapidly converging, iterative deconvolution algorithm with a resolution subsets-based approach (RSEMD) that operates on patient DICOM images has been used for quantitative improvement in breast imaging. The RSEMD method can be applied to PEM images to enhance the resolution and contrast in cancer diagnosis to monitor the tumor progression at the earliest stages.
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Affiliation(s)
- Nikolai V Slavine
- Translational Research, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9061, USA.
| | - Stephen J Seiler
- Breast Imaging, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9061, USA
| | - Roderick W McColl
- Clinical Medical Physics, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9061, USA
| | - Robert E Lenkinski
- Translational Research, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9061, USA
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12
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Nuclear medicine for photodynamic therapy in cancer: Planning, monitoring and nuclear PDT. Photodiagnosis Photodyn Ther 2017; 18:236-243. [PMID: 28300723 DOI: 10.1016/j.pdpdt.2017.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 02/27/2017] [Accepted: 03/09/2017] [Indexed: 12/16/2022]
Abstract
Photodynamic therapy (PDT) is a modality with promising results for the treatment of various cancers. PDT is increasingly included in the standard of care for different pathologies. This therapy relies on the effects of light delivered to photosensitized cells. At different stages of delivery, PDT requires imaging to plan, evaluate and monitor treatment. The contribution of molecular imaging in this context is important and continues to increase. In this article, we review the contribution of nuclear medicine imaging in oncology to PDT for planning and therapeutic monitoring purposes. Several solutions have been proposed to plan PDT from nuclear medicine imaging. For instance, photosensitizer biodistribution has been evaluated with a radiolabeled photosensitizer or with conventional radiopharmaceuticals on positron emission tomography. The effects of PDT delivery have also been explored with specific SPECT or PET radiopharmaceuticals to evaluate the effects on cells (apoptosis, necrosis, proliferation, metabolism) or vascular damage. Finally, the synergy between photosensitizers and radiopharmaceuticals has been studied considering the Cerenkov effect to activate photosensitized cells.
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External beam radiotherapy in thyroid carcinoma: clinical review and recommendations of the AIRO "Radioterapia Metabolica" Group. TUMORI JOURNAL 2016; 103:114-123. [PMID: 27647221 DOI: 10.5301/tj.5000532] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2016] [Indexed: 02/07/2023]
Abstract
The therapeutic approach to thyroid carcinoma usually involves surgery as initial treatment. The use of external beam radiotherapy (EBRT) is limited to high-risk patients and depends on clinical stage and histologic type. Different behavior patterns and degrees of aggressiveness of thyroid carcinomas require different management for differentiated, medullary, and anaplastic carcinoma. However, the role of EBRT is an issue of debate. Most clinical studies are retrospective and based on single-institution experiences. In this article, we review the main literature and give recommendations for the use of EBRT in thyroid carcinoma on behalf of the "Radioterapia Metabolica" Group of the Italian Radiation Oncology Association.
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