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1.
M. J. Murcia Dur��ndez L. Frutos Esteban J. Luj��n M. D. Frutos G. Valero J. L. Navarro Fern��ndez L. Mohamed Salem G. Ruiz Merino M. A. Claver Valderas 《European journal of nuclear medicine and molecular imaging》2013,40(1):91-97
Purpose
Neoadjuvant radiochemotherapy (RCT) is an accepted treatment for locally advanced rectal cancer (LARC) that improves surgical outcomes. If a pathological complete response is achieved, conservative surgery can be considered. The objective of our study was to assess the reliability of 18F-FDG PET/CT for evaluating the response to neoadjuvant RCT in LARC.Methods
We prospectively studied 41 patients diagnosed with LARC and candidates for neoadjuvant RCT. PET/CT was performed before RCT and again 7?weeks later. A visual and semiquantitative analysis was carried out. The pathological response was classified according to the Mandard tumour regression grade (TRG). We analysed: (a) the relationship between TRG and the result of the posttreatment PET/CT scan, and (b) the correlation between the percentage of pathological response and the percentage decrease in SUVmax according to the response index (RI).Results
The mean SUVmax of the rectal lesions at diagnosis was 13.6 and after RCT 3.96. The mean RI was 65.32?%. Sensitivity was 88.88?%, specificity 92.86?%, positive predictive value 96?%, negative predictive value 81?%. Of the 41 patients, 8 had TRG I (all negative PET/CT); 6 had TRG II (5 negative, 1 positive PET/CT); 16 had TRG III (13 positive, 3 negative PET/CT); 9 had TRG IV (all positive PET/CT); 2 had TRG V (all positive PET/CT). Of the 14 patients classified as responders (TRG I, II), 13 (92.86?%) had negative PET/CT. Of the 27 patients classified as nonresponders (TRG III?CV), 24 (88.88?%) had positive PET/CT. Differences were statistically significant (p?<?0.0001). The RI in responders was 79.9?% and in nonresponders was 60.3?%. Differences were statistically significant (p?<?0.037).Conclusion
PET/CT is a reliable technique for assessing response to neoadjuvant RCT in LARC, with a view to considering more conservative surgical treatment. The combination of the visual and semiquantitative analysis increases the diagnostic validity of PET/CT. 相似文献2.
Park JC Lee JH Cheoi K Chung H Yun MJ Lee H Shin SK Lee SK Lee YC 《European journal of nuclear medicine and molecular imaging》2012,39(7):1107-1116
Purpose
Few studies have evaluated metabolic activity by 18F-FDG PET as a prognostic factor in advanced gastric cancer (AGC). We investigated its prognostic role in metastatic AGC.Methods
We enrolled 82 patients with metastatic AGC, who were treatment-naive and underwent pretreatment 18F-FDG PET/CT scanning. In each patient, the maximal standardized uptake value (SUVmax) was measured in each target lesion. StomachSUVmax was defined as SUVmax in the stomach, while TotalSUVmax was defined as the highest SUVmax among all the target lesions.Results
The stomach was the organ most frequently displaying the highest SUVmax among all the target lesions (in 67.1?% of patients). A TotalSUVmax value of 11.5 was the value with the maximum sum of sensitivity and specificity from receiver-operating characteristic curves for progression-free survival (PFS). PFS was significantly longer in patients with a TotalSUVmax value <11.5 than in those with a TotalSUVmax value ≥11.5 (P?=?0.023); however, overall survival (OS) was not (P?=?0.055). A StomachSUVmax value of 6.0 was derived by similar methods. PFS and OS were significantly longer in those with a StomachSUVmax value <6.0 than in those with a StomachSUVmax value ≥6.0 (P?=?0.001 and P?=?0.006, respectively). Furthermore, those with a low TotalSUVmax and those with a low StomachSUVmax showed better chemotherapeutic responses (P?=?0.016 and P?=?0.034, respectively). Among patients with histologically undifferentiated carcinomas, those with lower TotalSUVmax and those with lower StomachSUVmax showed longer median PFS (P?=?0.027 and P?=?0.005, respectively) and OS (P?=?0.009 and P <0.001, respectively). Multivariate analysis demonstrated StomachSUVmax as an independent predictor of PFS (P?=?0.002) and OS (P?=?0.038).Conclusion
Pretreatment metabolic activity may be a useful prognostic marker in patients with metastatic AGC undergoing palliative chemotherapy. Notably, StomachSUVmax was the single, most robust factor predicting prognosis. 相似文献3.
Ronan Abgral Nathalie Keromnes Philippe Robin Pierre-Yves Le Roux David Bourhis Xavier Palard Jean Rousset Gérald Valette Rémi Marianowski Pierre-Yves Salaün 《European journal of nuclear medicine and molecular imaging》2014,41(4):659-667
Purpose
The objective of this study was to investigate the value of metabolic tumour volume (MTV) assessed with 18F-FDG PET/CT in predicting event-free survival (EFS) and overall survival (OS) in patients with head and neck squamous cell carcinoma (HNSCC), and particularly to compare it with more conventional parameters such as maximum standardized uptake value (SUVmax).Methods
Patients referred to our department for 18F-FDG PET/CT for staging of HNSCC were prospectively included between February 2009 and March 2011. Each patient was scanned using a Philips Gemini PET/CT system at 1 h after injection. The MTV was calculated semiautomatically for the primary site using methods based on SUV with various thresholds: 3-D contour around voxels equal to or greater than 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, 5.0, 5.5, 6.0, 6.5 and 7.0 times SUV, or more than 30 %, 40 % and 50 % of SUVmax. ROC analysis was used to test the statistical significance of the differences among the calculated MTVs. EFS and OS were determined using the Kaplan-Meier method and compared with MTV in univariate and multivariate analyses, including the usual prognostic factors: age, sex, primary site, treatment, SCC histologic grade, AJCC stage, TNM classification, tumour SUVmax and SUVpeak.Results
The study included 80 consecutive patients (70 men, 10 women; mean age 62.4?±?9.0 years). ROC analysis revealed that pretreatment MTV using a threshold of 5.0 times SUV (MTV5.0) was the best parameter to predict recurrence and death after treatment. In univariate analysis, MTV5.0 >4.9 ml was predictive of poor EFS (p?<?0.0001) and poor OS (p?<?0.0001). In multivariate, MTV5.0 persisted as an independent predictive factor for EFS (p?=?0.011) and OS (p?=?0.010), while SUVmax became nonsignificant (p?=?0.277 for EFS, p?=?0.975 for OS).Conclusion
Our results suggest that MTV measured by 18F-FDG PET/CT has independent prognostic value of in patients with HNSCC, stronger than SUVmax. 相似文献4.
Anna Margherita Maffione Alice Ferretti Gaia Grassetto Elena Bellan Carlo Capirci Sotirios Chondrogiannis Marcello Gava Maria Cristina Marzola Lucia Rampin Claudia Bondesan Patrick M. Colletti Domenico Rubello 《European journal of nuclear medicine and molecular imaging》2013,40(6):853-864
Purpose
The aim of this study was to correlate qualitative visual response and various PET quantification factors with the tumour regression grade (TRG) classification of pathological response to neoadjuvant chemoradiotherapy (CRT) proposed by Mandard.Methods
Included in this retrospective study were 69 consecutive patients with locally advanced rectal cancer (LARC). FDG PET/CT scans were performed at staging and after CRT (mean 6.7 weeks). Tumour SUVmax and its related arithmetic and percentage decrease (response index, RI) were calculated. Qualitative analysis was performed by visual response assessment (VRA), PERCIST 1.0 and response cut-off classification based on a new definition of residual disease. Metabolic tumour volume (MTV) was calculated using a 40 % SUVmax threshold, and the total lesion glycolysis (TLG) both before and after CRT and their arithmetic and percentage change were also calculated. We split the patients into responders (TRG 1 or 2) and nonresponders (TRG 3–5).Results
SUVmax MTV and TLG after CRT, RI, ΔMTV% and ΔTLG% parameters were significantly correlated with pathological treatment response (p?<?0.01) with a ROC curve cut-off values of 5.1, 2.1 cm3, 23.4 cm3, 61.8 %, 81.4 % and 94.2 %, respectively. SUVmax after CRT had the highest ROC AUC (0.846), with a sensitivity of 86 % and a specificity of 80 %. VRA and response cut-off classification were also significantly predictive of TRG response (VRA with the best accuracy: sensitivity 86 % and specificity 55 %). In contrast, assessment using PERCIST was not significantly correlated with TRG.Conclusion
FDG PET/CT can accurately stratify patients with LARC preoperatively, independently of the method chosen to interpret the images. Among many PET parameters, some of which are not immediately obtainable, the most commonly used in clinical practice (SUVmax after CRT and VRA) showed the best accuracy in predicting TRG. 相似文献5.
Claudio V. Sole Felipe A. Calvo Emilio Alvarez Jose L. Carreras 《European journal of nuclear medicine and molecular imaging》2016,43(8):1444-1452
Purpose
Vascular endothelial growth factor receptor-2 (VEGFR-2), epidermal growth factor receptor-1 (EGFR) and cyclooxygenase-2 (COX-2) stimulate key processes involved in tumour progression and are important targets for cancer therapeutics. 18F-FDG maximum standardized uptake value (SUVmax) on PET/CT is a marker of tumour metabolic activity. The purpose of this study was to measure percentage reductions in SUVmax (?SUVmax%), VEGFR-2 (?VEGFR-2%), EGFR (?EGFR%) and COX-2 (?COX-2%) in patients with locally advanced rectal cancer (LARC) after preoperative treatment, and to correlate the changes in these markers of response with pathological response in terms of tumour regression grade (TRG) using Rödel’s scale and long-term clinical outcome.Methods
VEGFR-2, EGFR and COX-2 were measured using a quantitative and qualitative compound immunohistochemistry analysis (immunoreactive score) of the pretreatment endoscopic biopsy and definitive surgical specimens. Composite indexes using ?SUVmax% and the three molecules were developed to differentiate patients with metabolic and molecular responses from nonresponders. Cox proportional hazards model was used to explore associations between the tumour markers, disease-free survival (DFS) and overall survival (OS).Results
The analysis included 38 patients with a median follow-up of 86 months (range 5 – 113 months). The ?VEGFR-2%/?SUVmax% index correctly identified 13 of 19 pathological responders (TRG 3 and 4) and 17 of 19 nonresponders (TRG 0 – 2) (sensitivity 68 %, specificity 89 %, accuracy 79 %, positive predictive value 87 %, negative predictive value 74 %). In multivariate analysis, only the ?VEGFR-2%/?SUVmax% index was associated with DFS (HR 0.11, p?=?0.001) and OS (HR 0.15, p?=?0.02).Conclusion
In patients with LARC the ?VEGFR-2%/?SUVmax% response index is associated with outcome. Determination of the optimal diagnostic cut-off level for this novel biomarker association should be explored. Evaluation in a clinical trial is required to determine whether selected patients could benefit from treatment with a VEGFR-targeted therapeutic agent.6.
Purpose
The aim of this study was to investigate the prognostic value of baseline 18F-FDG PET/CT textural analysis in locally-advanced rectal cancer (LARC).Methods
Eighty-six patients with LARC underwent 18F-FDG PET/CT before treatment. Maximum and mean standard uptake values (SUVmax and SUVmean), metabolic tumoral volume (MTV), total lesion glycolysis (TLG), histogram-intensity features, as well as 11 local and regional textural features, were evaluated. The relationships of clinical, pathological and PET-derived metabolic parameters with disease-specific survival (DSS), disease-free survival (DFS) and overall survival (OS) were assessed by Cox regression analysis. Logistic regression was used to predict the pathological response by the Dworak tumor regression grade (TRG) in the 66 patients treated with neoadjuvant chemoradiotherapy (nCRT).Results
The median follow-up of patients was 41 months. Seventeen patients (19.7%) had recurrent disease and 18 (20.9 %) died, either due to cancer progression (n = 10) or from another cause while in complete remission (n = 8). DSS was 95% at 1 year, 93% at 2 years and 87% at 4 years. Weight loss, surgery and the texture parameter coarseness were significantly associated with DSS in multivariate analyses. DFS was 94 % at 1 year, 86 % at 2 years and 79 % at 4 years. From a multivariate standpoint, tumoral differentiation and the texture parameters homogeneity and coarseness were significantly associated with DFS. OS was 93% at 1 year, 87% at 2 years and 79% after 4 years. cT, surgery, SUVmean, dissimilarity and contrast from the neighborhood intensity-difference matrix (contrastNGTDM) were significantly and independently associated with OS. Finally, RAS-mutational status (KRAS and NRAS mutations) and TLG were significant predictors of pathological response to nCRT (TRG 3-4).Conclusion
Textural analysis of baseline 18F-FDG PET/CT provides strong independent predictors of survival in patients with LARC, with better predictive power than intensity- and volume-based parameters. The utility of such features, especially coarseness, should be confirmed by larger clinical studies before considering their potential integration into decisional algorithms aimed at personalized medicine.7.
Claudio V. Sole Felipe A. Calvo Emilio Alvarez Isabel Peligros Pilar Garcia-Alfonso Carlos Ferrer Enrique Ochoa Rafael Herranz Jose L. Carreras 《European journal of nuclear medicine and molecular imaging》2013,40(11):1635-1644
Purpose
Vascular endothelial growth factor receptor-2 (VEGFR-2), epidermal growth factor receptor-1 (EGFR), and cyclooxygenase-2 (COX-2) stimulate key processes involved in tumor progression and are important targets for cancer drugs. 18F-FDG maximum standardized uptake value (SUVmax) is a marker of tumor metabolic activity. The purpose of this study was to measure SUVmax combined with VEGFR-2, EGFR and COX-2 proteins in pretreatment tumor biopsies from patients with locally advanced rectal cancer receiving intensive neoadjuvant treatment and to correlate the findings with clinical outcome.Methods
VEGFR-2, EGFR and COX-2 were measured using the immunoreactive score (IRS). SUVmax (median 8.4) was quantified in tumors with molecular overexpression (IRS ≥3 + SUVmax ≥ 8.4 indicating active tumors; SUVmax <8.4 indicating inactive tumors). The Cox proportional hazards model was used to explore associations between tumor markers, disease-free survival (DFS) and overall survival (OS).Results
The study group comprised 38 patients with a median follow-up of 69.3 months (range 4.5 – 92 months). Multivariate analysis showed that active tumors (overexpressing VEGFR-2, high SUVmax) were associated with worse DFS (HR 4.73, 95 % CI 1.18 – 22.17; p?=?0.04) and OS (HR 4.28, 95 % CI 1.04 – 20.12; p?=?0.05).Conclusion
Active tumors overexpressing VEGFR-2 are associated with a worse overall outcome in patients with rectal cancer treated with induction chemotherapy followed by pelvic chemoradiation and surgery. The optimal diagnostic cut-off level for this novel biomarker association should be investigated. Evaluation in a clinical trial is required to determine whether selected patients could benefit from a VEGFR-targeting drug. 相似文献8.
Kenneth E. Pengel Bas B. Koolen Claudette E. Loo Wouter V. Vogel Jelle Wesseling Esther H. Lips Emiel J. Th. Rutgers Renato A. Valdés Olmos Marie Jeanne T. F. D. Vrancken Peeters Sjoerd Rodenhuis Kenneth G. A. Gilhuijs 《European journal of nuclear medicine and molecular imaging》2014,41(8):1515-1524
Purpose
To explore the potential complementary value of PET/CT and dynamic contrast-enhanced MRI in predicting pathological response to neoadjuvant chemotherapy (NAC) of breast cancer and the dependency on breast cancer subtype.Methods
We performed 18F-FDG PET/CT and MRI examinations before and during NAC. The imaging features evaluated on both examinations included baseline and changes in 18F-FDG maximum standardized uptake value (SUVmax) on PET/CT, and tumour morphology and contrast uptake kinetics on MRI. The outcome measure was a (near) pathological complete response ((near-)pCR) after surgery. Receiver operating characteristic curves with area under the curve (AUC) were used to evaluate the relationships between patient, tumour and imaging characteristics and tumour responses.Results
Of 93 patients, 43 achieved a (near-)pCR. The responses varied among the different breast cancer subtypes. On univariate analysis the following variables were significantly associated with (near-)pCR: age (p?=?0.033), breast cancer subtype (p?<?0.001), relative change in SUVmax on PET/CT (p?<?0.001) and relative change in largest tumour diameter on MRI (p?<?0.001). The AUC for the relative reduction in SUVmax on PET/CT was 0.78 (95 % CI 0.68–0.88), and for the relative reduction in tumour diameter at late enhancement on MRI was 0.79 (95 % CI 0.70–0.89). The AUC increased to 0.90 (95 % CI 0.83–0.96) in the final multivariate model with PET/CT, MRI and breast cancer subtype combined (p?=?0.012).Conclusion
PET/CT and MRI showed comparable value for monitoring response during NAC. Combined use of PET/CT and MRI had complementary potential. Research with more patients is required to further elucidate the dependency on breast cancer subtype. 相似文献9.
In Sun Ryu Jae Seung Kim Jong-Lyel Roh Kyung-Ja Cho Seung-Ho Choi Soon Yuhl Nam Sang Yoon Kim 《European journal of nuclear medicine and molecular imaging》2014,41(3):452-461
Purpose
Metabolic tumour volume (MTV) and total lesion glycolysis (TLG) from 18F-FDG PET/CT are emerging prognostic biomarkers in human solid cancers; yet few studies have investigated their clinical and prognostic significance in oral cavity squamous cell carcinoma (OSCC). The present retrospective study evaluated the utility of pretreatment MTV and TLG measured by 18F-FDG PET/CT to predict survival and occult metastasis (OM) in OSCC.Methods
Of 162 patients with OSCC evaluated preoperatively by 18F-FDG PET/CT, 105 who underwent definitive surgery with or without adjuvant therapy were eligible. Maximum standardized uptake value (SUVmax), MTV and TLG were measured. For calculation of MTV, 3-D regions of interest were drawn and a SUV threshold of 2.5 was used for defining regions. Univariate and multivariate analyses identified clinicopathological and imaging variables associated with OM, disease-free survival (DFS) and overall survival (OS).Results
The median (range) SUVmax, MTV and TLG were 7.3 (0.7–41.9), 4.5 ml (0.7–115.1 ml) and 18.3 g (2.4–224.1 g), respectively. Of 53 patients with clinically negative lymph nodes, OM was detected in 19 (36 %). By univariate and multivariate analyses, MTV (P?=?0.018) and TLG (P?=?0.011) were both independent predictive factors for OM, although they were not independent of each other. The 4-year DFS and OS rates were 53.0 % and 62.0 %, respectively. Univariate and multivariate analyses revealed that MTV (P?=?0.001) and TLG (P?=?0.006), with different cut-off levels, were both independent predictive factors for DFS, although they were not independent of each other, and MTV (P?=?0.001), TLG (P?=?0.002) and the involved resection margin (P?=?0.007) were independent predictive factors for OS.Conclusion
Pretreatment MTV and TLG may be useful in stratifying the likelihood of survival and predicting OM in OSCC. 相似文献10.
Helen H. W. Chen Bi-Fang Lee Wu-Chou Su Yu-Hsuan Lai Hung-Yu Chen How-Ran Guo Wei-Jen Yao Nan-Tsing Chiu 《European journal of nuclear medicine and molecular imaging》2013,40(10):1478-1485
Purpose
We aimed to determine whether the increment in the maximal standardized uptake value (SUVmax) of the primary lung tumour between the initial and delayed imaging by dual-phase 18F-FDG PET has prognostic value in patients with non-small-cell lung cancer (NSCLC).Methods
We reviewed the records of patients with NSCLC who underwent pretreatment dual-phase 18F-FDG PET/CT scans acquired at 1 h and 2 h after injection. The SUVmax increment (SUVinc) of the primary lung tumour was the 2-h SUVmax minus the 1-h SUVmax. Univariate and multivariate analyses were used to assess the prognostic significance of SUVinc, retention index, whole-body total metabolic tumour volume, whole-body total lesion glycolysis (TLGwb), 1-h SUVmax, 2-h SUVmax, gender, age, performance status, histological subtype, T stage, N stage and clinical stage.Results
The records of 187 consecutive patients were reviewed. The median follow-up time was 3.9 years. The estimated median progression-free survival (PFS) and overall survival (OS) were 1.3 years and 4.4 years, respectively. An SUVinc cut-off value of >1 had the best discriminative yield for PFS. The 3-year PFS and OS were 61.6 % and 87.8 % in patients with SUVinc ≤1 versus 21.1 % and 46.2 % in patients with SUVinc >1 (all P?<?0.01). Using the forward stepwise multivariate Cox proportional hazards model, SUVinc, TLGwb, and clinical stage were significant factors for PFS (all P?<?0.01). A subgroup analysis of 117 patients treated with surgery showed that SUVinc (P?=?0.02) and clinical stage (P?<?0.01) were significant prognostic factors for PFS. Furthermore, in stage I patients treated with surgery alone, SUVinc was the only significant prognostic factor (HR 28.07; 95 % CI 2.42 – 326.41).Conclusion
SUVinc determined from dual-phase 18F-FDG PET is a promising prognostic factor for NSCLC. It adds to the value of dual-phase 18F-FDG PET. 相似文献11.
Astero Klabatsa Sugama Chicklore Sally F. Barrington Vicky Goh Loic Lang-Lazdunski Gary J. R. Cook 《European journal of nuclear medicine and molecular imaging》2014,41(2):276-282
Purpose
Malignant pleural mesothelioma (MPM) is a disease with poor prognosis despite multimodal therapy but there is variation in survival between patients. Prognostic information is therefore potentially valuable in managing patients, particularly in the context of clinical trials where patients could be stratified according to risk. Therefore we have evaluated the prognostic ability of parameters derived from baseline 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT).Methods
In order to determine the relationships between metabolic activity and prognosis we reviewed all 18F-FDG PET/CT scans used for pretreatment staging of MPM patients in our institution between January 2005 and December 2011 (n?=?60) and measured standardised uptake values (SUV) including mean, maximum and peak values, metabolic tumour volume (MTV) and total lesion glycolysis (TLG). Overall survival (OS) or time to last censor was recorded, as well as histological subtypes.Results
Median follow-up was 12.7 months (1.9–60.9) and median OS was 14.1 months (1.9–54.9). By univariable analysis histological subtype (p?=?0.013), TLG (p?=?0.024) and MTV (p?=?0.038) were significantly associated with OS and SUVmax was borderline (p?=?0.051). On multivariable analysis histological subtype and TLG were associated with OS but at borderline statistical significance (p?=?0.060 and 0.058, respectively). No statistically significant differences in any PET parameters were found between the epithelioid and non-epithelioid histological subtypes.Conclusion
18F-FDG PET/CT parameters that take into account functional volume (MTV, TLG) show significant associations with survival in patients with MPM before adjusting for histological subtype and are worthy of further evaluation to determine their ability to stratify patients in clinical trials. 相似文献12.
Hidenori Suzuki Katsuhiko Kato Yasushi Fujimoto Yoshiyuki Itoh Mariko Hiramatsu Takashi Maruo Shinji Naganawa Yasuhisa Hasegawa Tsutomu Nakashima 《Annals of nuclear medicine》2013,27(3):297-302
Objectives
We investigated the relationship between overall survival of patients and pretreatment [18F]-2-fluorodeoxyglucose (18F-FDG) uptake, assessed by positron emission tomography combined with computed tomography (PET/CT) in hypopharyngeal squamous cell carcinoma.Methods
Thirty-one patients who were newly diagnosed as resectable hypopharyngeal squamous cell carcinoma underwent pretreatment 18F-FDG-PET/CT. We used the maximum standardized uptake value (SUVmax) as 18F-FDG uptake. Overall survival rate was calculated by the Kaplan–Meier method.Results
The median SUVmax was 11.53 (range 2.49–22.33). Patients with SUVmax ≥ 13 significantly exhibited shorter overall survival in univariate analysis (p < 0.01). Moreover, by Cox proportional hazards model of multivariate analysis, SUVmax ≥ 13 was a significant prognostic factor independent of clinical T and N classification, and treatment group (p < 0.02).Conclusions
These results suggested that SUVmax obtained by pretreatment 18F-FDG PET/CT assessment is an important prognostic factor in patients with hypopharyngeal squamous cell carcinoma. 相似文献13.
Masatoyo Nakajo Masayuki Nakajo Yoriko Kajiya Megumi Jinguji Nobuaki Nishimata Shunji Shimaoka Tohru Nihara Kuniaki Aridome Sadao Tanaka Yoshihiko Fukukura Atushi Tani Chihaya Koriyama 《European journal of nuclear medicine and molecular imaging》2013,40(8):1223-1232
Purpose
To examine the diagnostic performance of 18F-fluorothymidine (FLT) PET/CT in primary and metastatic lymph node colorectal cancer foci in comparison with 18F-fluorodeoxyglucose (FDG) PET/CT.Methods
The study population comprised 28 patients with 30 newly diagnosed colorectal cancers who underwent surgical resection of the primary lesion and regional lymph nodes after both FLT and FDG PET/CT. The associations between SUVmax levels and pathological factors were evaluated using the Mann-Whitney U or Kruskal-Wallis test. Differences in diagnostic indexes for detecting nodal metastasis between the two tracers were estimated using the McNemar exact or χ 2 test.Results
All 30 primary cancers (43.0?±?20.0 mm, range 14 – 85 mm) were visualized by both tracers, but none of the FLT SUVmax values exceeded the FDG SUVmax values in any of the primary cancers (6.6?±?2.4 vs. 13.6?±?5.8, p?<?0.001). The sensitivity, specificity and accuracy for detecting nodal metastasis were 41 % (15/37), 98.8 % (493/499) and 94.8 % (508/536) for FDG PET/CT, and 32 % (12/37), 98.8 % (493/499) and 94.2 % (505/536) for FLT PET/CT, respectively. The sensitivity (p?=?0.45), specificity (p?=?0.68) and accuracy (p?=?0.58) were not different between the tracers. Nodal uptake of FLT and FDG was discordant in 7 (19 %) of 37 metastatic nodes. There were ten concordant true-positive nodes of which six showed higher FDG SUVmax and four showed higher FLT SUVmax, but the difference between FDG and FLT SUVmax was not significant (5.56?±?3.55 and 3.62?±?1.45, respectively; p?=?0.22).Conclusion
FLT has the same potential as FDG in PET/CT for the diagnosis of primary and nodal foci of colorectal cancer despite significantly lower FLT uptake in primary foci. 相似文献14.
Pierre Lovinfosse Zsolt Levente Janvary Philippe Coucke Sébastien Jodogne Claire Bernard Mathieu Hatt Dimitris Visvikis Nicolas Jansen Bernard Duysinx Roland Hustinx 《European journal of nuclear medicine and molecular imaging》2016,43(8):1453-1460
Introduction
With 18F-FDG PET/CT, tumor uptake intensity and heterogeneity have been associated with outcome in several cancers. This study aimed at investigating whether 18F-FDG uptake intensity, volume or heterogeneity could predict the outcome in patients with non-small cell lung cancers (NSCLC) treated by stereotactic body radiation therapy (SBRT).Methods
Sixty-three patients with NSCLC treated by SBRT underwent a 18F-FDG PET/CT before treatment. Maximum and mean standard uptake value (SUVmax and SUVmean), metabolic tumoral volume (MTV), total lesion glycolysis (TLG), as well as 13 global, local and regional textural features were analysed. The predictive value of these parameters, along with clinical features, was assessed using univariate and multivariate analysis for overall survival (OS), disease-specific survival (DSS) and disease-free survival (DFS). Cutoff values were obtained using logistic regression analysis, and survivals were compared using Kaplan-Meier analysis.Results
The median follow-up period was 27.1 months for the entire cohort and 32.1 months for the surviving patients. At the end of the study, 25 patients had local and/or distant recurrence including 12 who died because of the cancer progression. None of the clinical variables was predictive of the outcome, except age, which was associated with DFS (HR 1.1, P?=?0.002). None of the 18F-FDG PET/CT or clinical parameters, except gender, were associated with OS. The univariate analysis showed that only dissimilarity (D) was associated with DSS (HR?=?0.822, P?=?0.037), and that several metabolic measurements were associated with DFS. In multivariate analysis, only dissimilarity was significantly associated with DSS (HR?=?0.822, P?=?0.037) and with DFS (HR?=?0.834, P?<?0.01).Conclusion
The textural feature dissimilarity measured on the baseline 18F-FDG PET/CT appears to be a strong independent predictor of the outcome in patients with NSCLC treated by SBRT. This may help selecting patients who may benefit from closer monitoring and therapeutic optimization.15.
Punit Sharma Bangkim Chandra Khangembam K. C. Sudhir Suman Harmandeep Singh Sishir Rastogi Shah Alam Khan Sameer Bakhshi Sanjay Thulkar Chandrasekhar Bal Arun Malhotra Rakesh Kumar 《European journal of nuclear medicine and molecular imaging》2013,40(7):1036-1043
Purpose
To evaluate the diagnostic accuracy of 18F-FDG PET/CT for detecting recurrence in patients with primary skeletal Ewing sarcoma.Methods
We retrospectively analysed data from 53 patients (age 20.1?±?10.5 years, 39 male) who had undergone 71 18F-FDG PET/CT studies for suspected recurrence (52 studies) or for routine follow-up (19 studies) after primary therapy of skeletal Ewing sarcoma. 18F-FDG PET/CT studies were evaluated qualitatively and quantitatively (maximum standardized uptake value, SUVmax) by two nuclear medicine physicians in consensus. Sensitivity, specificity, predictive values and accuracy were calculated on per study basis. Clinical/imaging follow-up (minimum 6 months) and/or histopathology (when available) were taken as the reference standard.Results
Of the total of 71 18F-FDG PET/CT studies, 42 (59.1 %) were positive for recurrence and 29 (40.9 %) were negative for recurrence. Local recurrence was most common (38 studies) followed by bone metastasis (9 studies), and node and lung metastasis (2 studies each). Of the 71 studies, 38 were true-positive, 27 were true-negative, 4 were false-positive and 2 were false-negative. Overall per study based sensitivity was 95 %, specificity was 87 %, PPV was 90 %, NPV was 93 % and accuracy was 91.5 %. No significant difference was found in the accuracy of PET/CT between the suspected recurrence group and the routine follow-up group (94 % vs. 84 %; P?=?0.390). Overall mean lesion SUVmax was 7.8?±?4.1 (range 1.9–17.2). No site-based difference was found in SUVmax.Conclusion
18F-FDG PET/CT demonstrates high diagnostic accuracy for detecting recurrence in patients with primary skeletal Ewing sarcoma, when it is suspected (clinically or on imaging) or during routine follow-up. 相似文献16.
Emmanuel Itti Michel Meignan Alina Berriolo-Riedinger Alberto Biggi Amanda F. Cashen Pierre Véra Hervé Tilly Barry A. Siegel Andrea Gallamini René-Olivier Casasnovas Corinne Haioun 《European journal of nuclear medicine and molecular imaging》2013,40(9):1312-1320
Purpose
The role of interim PET/CT in guiding therapeutic strategies in diffuse large B-cell lymphoma (DLBCL) is debated, mainly because interpretation rules vary among centres. This study aimed to explore the reproducibility and confirm the prognostic value of early PET/CT using the Deauville criteria and ΔSUVmax.Methods
This international confirmatory study retrospectively evaluated 114 patients with newly diagnosed DLBCL treated with a rituximab-containing regimen. All patients underwent 18F-FDG PET/CT at baseline (PET0) and after two cycles (PET2), with no therapy change based on the latter. Scans were interpreted by three observers using the Deauville five-point scale and ΔSUVmax between PET0 and PET2 was calculated. Interpretations were evaluated for interobserver agreement and for progression-free survival (PFS) prediction.Results
Median follow-up was 39 months. Early PET/CT was predictive of outcome when interpreted with the Deauville criteria and ΔSUVmax. Using the five-point scale, the overall kappa value was 0.66 with the reference background set in the liver (score ≥4) and interobserver agreement was even better using a 66 % ΔSUVmax cut-off (κ?=?0.83). Moreover, the prognostic value of interim PET was slightly inferior when using a Deauville score ≥4 than when using a 66 % ΔSUVmax cut-off: for the Deauville score the 3-year PFS estimate was 59 % (45–73 %) in PET2-positive patients vs. 81 % (71–91 %) in PET2-negative patients (P?=?0.003); for the 66 % ΔSUVmax cut-off the 3-year PFS estimate was 44 % (23–65 %) in PET2-positive patients vs. 79 % (70–88 %) in PET2-negative patients (P?=?0.0002).Conclusion
Although the Deauville criteria are valid for assessing the prognostic value of early PET/CT in DLBCL, computation of the ΔSUVmax leads to better performance and interobserver reproducibility, and should be preferred when a baseline scan is available. 相似文献17.
Domenico Albano Mattia Bertoli Marco Battistotti Carlo Rodella Massimo Statuto Raffaele Giubbini Francesco Bertagna 《Annals of nuclear medicine》2018,32(8):532-541
Objective
Primary brain lymphoma is an aggressive extranodal non-Hodgkin lymphoma with poor prognosis. Many possible prognostic factors are investigated with controversial results, but possible prognostic role of 18fluorine-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) features remains unclear. Our aim was to study the metabolic behavior of brain lymphoma at 18F-FDG PET/CT and the prognostic impact of qualitative and semiquantitative PET/CT parameters.Methods
Between 2006 and 2018, 52 patients (26 females and 26 males; mean age: 61 years) with histologically confirmed diagnosis of brain lymphoma who underwent 18F-FDG PET/CT for staging before any treatment were included. PET images were qualitatively and semiquantitatively analyzed by measuring the maximum standardized uptake value body weight (SUVbw), lean body mass (SUVlbm), body surface area (SUVbsa), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). The Kaplan–Meier method was used to estimate the progression-free survival (PFS) and overall survival (OS) times. Cox regression models were performed to determinate the relation between qualitative and semiquantitative PET/CT features and OS and PFS.Results
Thirty-nine patients had positive 18F-FDG PET/CT showing 18F-FDG uptake (mean SUVbw of 18.2; SUVlbm of 13.9; SUVbsa of 5; MTV of 14.8; TLG of 153) at the corresponding cerebral lesion; the remaining 13 were not 18F-FDG avid. Relapse or progression of disease occurred in 22 patients with an average time of 9.7 months; death occurred in 18 patients with an average of 7.9 months. There was no difference in PFS and OS between baseline PET/CT positive and negative groups or considering SUVbw, SUVlbm, and SUVbsa. PFS and OS was significantly shorter in patients with MTV ≥?9.8 cm3 (p?=?0.037 and p?=?0.022, respectively) and TLG ≥?94 (p?=?0.045 and p?=?0.0430, respectively).Conclusions
18F-FDG avidity was noted in 75% of cases. Only metabolic tumor parameters (MTV and TLG) were independently correlated with PFS and OS.18.
Antonio Avallone Luigi Aloj Corradina Caracò Paolo Delrio Biagio Pecori Fabiana Tatangelo Nigel Scott Rossana Casaretti Francesca Di Gennaro Massimo Montano Lucrezia Silvestro Alfredo Budillon Secondo Lastoria 《European journal of nuclear medicine and molecular imaging》2012,39(12):1848-1857
Purpose
The aim of the present study is to prospectively evaluate the prognostic value of previously defined [18F]2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) criteria of early metabolic response in patients with locally advanced rectal cancer (LARC) after long-term follow-up.Methods
Forty-two patients with poor prognosis LARC underwent three biweekly courses of chemotherapy with oxaliplatin, raltitrexed and 5-fluorouracil modulated by levofolinic acid during pelvic radiotherapy. FDG PET studies were performed before and 12?days after the beginning of the chemoradiotherapy (CRT) treatment. Total mesorectal excision (TME) was carried out 8?weeks after completion of CRT. A previously identified cutoff value of ≥52?% reduction of the baseline mean FDG standardized uptake value (SUVmean) was applied to differentiate metabolic responders from non-responders and correlated to tumour regression grade (TRG) and survival.Results
Twenty-two metabolic responders showed complete (TRG1) or subtotal tumour regression (TRG2) and demonstrated a statistically significantly higher 5-year relapse-free survival (RFS) compared with the 20 non-responders (86 vs 55?%, p?=?.014) who showed TRG3 and TRG4 pathologic responses. A multivariate analysis demonstrated that early ?SUVmean was the only pre-surgical parameter correlated to the likelihood of recurrence (p?=?.05).Conclusion
This study is the first prospective long-term evaluation demonstrating that FDG PET is not only an early predictor of pathologic response but is also a valuable prognostic tool. Our results indicate the potential of FDG PET for optimizing multidisciplinary management of patients with LARC. 相似文献19.
Satoshi Takeuchi Benjapa Khiewvan Patricia S. Fox Stephen G. Swisher Eric M. Rohren Roland L. Bassett Jr. Homer A. Macapinlac 《European journal of nuclear medicine and molecular imaging》2014,41(5):906-914
Purpose
Our objective was to determine the impact of initial 18F-FDG PET/CT (PET/CT) staging on clinical stage and the management plan and the prognostic value of PET/CT in patients with non-small-cell lung cancer (NSCLC).Methods
We retrospectively reviewed the records of 592 patients with NSCLC who were referred to The University of Texas MD Anderson Cancer Center during 2002/2011 and had both PET/CT and conventional CT for initial staging. Clinical stages and management plans were compared between PET/CT and CT. The impact of PET/CT on management plans was considered medium/high when PET/CT changed the planned treatment modality or treatment intent. PET/CT and CT stages were compared with all-cause mortality and survival rates. We also assessed potential prognostic factors for progression-free survival (PFS) and overall survival (OS).Results
PET/CT changed the stage in 170 patients (28.7 %; 16.4 % upstaged, 12.3 % downstaged). PET/CT had a medium/high impact on the management plan in 220 patients (37.2 %). PFS and OS were significantly worse in patients with upstaged disease than in patients with no change in stage (median PFS 29.0 vs. 53.8 months, P?<?0.001; median OS:64.7 vs. 115.9 months, P?=?0.006). PFS and OS were significantly worse in patients with medium/high impact of PET/CT than in patients with no/low impact of PET/CT (median PFS 24.7 vs. 60.6 months, P?<?0.001; median OS 64.7 vs. 115.9 months, P?<?0.001). In multivariate analysis, a medium/high impact of PET/CT was an independent predictor of worse PFS (hazard ratio, HR, 1.73; 95 % CI 1.30 – 2.29; P?=?0.0002) and OS (HR 1.84; 95 % CI 1.26 – 2.69; P?=?0.002).Conclusion
Initial PET/CT staging not only impacts stage and management plan but also has prognostic value. 相似文献20.
Selin Carkaci Christopher T. Sherman Efe Ozkan Beatriz E. Adrada Wei Wei Eric M. Rohren Osama R. Mawlawi Naoto T. Ueno Thomas A. Buchholz Wei T. Yang 《European journal of nuclear medicine and molecular imaging》2013,40(12):1809-1816