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1.
Timm Denecke Patrick Hundsdörfer Daniel Misch Ingo G. Steffen Stefan Schönberger Christian Furth Michail Plotkin Juri Ruf Hubertus Hautzel Brigitte Stöver Regine Kluge Uta Bierbach Sylke Otto James F. Beck Christiane Franzius Günter Henze Holger Amthauer 《European journal of nuclear medicine and molecular imaging》2010,37(10):1842-1853
Purpose
The objective of this study was to evaluate positron emission tomography (PET) using 18F-fluoro-2-deoxy-D-glucose (FDG) in comparison to volumetry and standardized magnetic resonance imaging (MRI) parameters for the assessment of histological response in paediatric bone sarcoma patients.Methods
FDG PET and local MRI were performed in 27 paediatric sarcoma patients [Ewing sarcoma family of tumours (EWS), n?=?16; osteosarcoma (OS), n?=?11] prior to and after neoadjuvant chemotherapy before local tumour resection. Several parameters for assessment of response of the primary tumour to therapy by FDG PET and MRI were evaluated and compared with histopathological regression of the resected tumour as defined by Salzer-Kuntschik.Results
FDG PET significantly discriminated responders from non-responders using the standardized uptake value (SUV) reduction and the absolute post-therapeutic SUV (SUV2) in the entire patient population (?SUV, p?=?0.005; SUV2, p?=?0.011) as well as in the subgroup of OS patients (?SUV, p?=?0.009; SUV2, p?=?0.028), but not in the EWS subgroup. The volume reduction measured by MRI/CT did not significantly discriminate responders from non-responders either in the entire population (p?=?0.170) or in both subgroups (EWS, p?=?0.950; OS, p?=?1.000). The other MRI parameters alone or in combination were unreliable and did not improve the results. Comparing diagnostic parameters of FDG PET and local MRI, metabolic imaging showed high superiority in the subgroup of OS patients, while similar results were observed in the population of EWS.Conclusion
FDG PET appears to be a useful tool for non-invasive response assessment in the group of OS patients and is superior to MRI. In EWS patients, however, neither FDG PET nor volumetry or standardized MRI criteria enabled a reliable response assessment to be made after neoadjuvant treatment. 相似文献2.
Amandine Pallardy Caroline Bodet-Milin Aurore Oudoux Loïc Campion Emmanuelle Bourbouloux Christine Sagan Catherine Ansquer Aude Testard Isabelle Resche Boumédiène Bridji Françoise Kraeber-Bodéré Caroline Rousseau 《European journal of nuclear medicine and molecular imaging》2010,37(7):1270-1278
Purpose
The aim of this retrospective study was to evaluate the contribution of 18F-FDG PET to the clinical management and survival outcome of patients suspected of recurrent cervical carcinoma and in line with the hypothesis that early diagnosis of recurrent cervical cancer may improve overall survival.Methods
A total of 40 patients underwent conventional imaging (CI) and FDG PET/CT for suspected cervical cancer. Clinical management decisions were recorded with CI and additional PET/CT. Discordances and concordances between CI and PET/CT results were compared to the final diagnosis as based on histopathology analysis or follow-up considered as the gold standard.Results
The final diagnosis was established pathologically (n?=?25) or by median clinical follow-up for 48 months after the PET (n?=?15). The PET/CT was positive in 76% (20/26) of patients compared to 19% (6/26) with CI. Globally PET/CT modified the treatment plan in 55% (22/40) of patients and in 75% (18/24) when the CI was negative prior to PET/CT. These changes led to the use of previously unplanned therapeutic procedures in 37.5% (15/40). When FDG PET was positive for recurrence (>?3 foci), the median overall survival was 12 months (2–70) compared to patients with PET findings with ≤?1 focus for which the median survival was not attained (p?=?0.007). A multivariate analysis of prognostic factors demonstrated that abnormal FDG uptake (>?3 foci) was the most significant factor (p?<?0.03) for death from cervical cancer.Conclusion
FDG PET is a valuable tool in the case of suspected recurrence of cervical cancer on account of its impact on treatment planning and especially in predicting patient outcome. 相似文献3.
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4.
Xavier Cuenca Christophe Hennequin Elif Hindié Sofia Rivera Laetitia Vercellino Valérie Baruch-Hennequin Jean-Marc Gornet Pierre Cattan Mircea Chirica Laurent Quéro 《European journal of nuclear medicine and molecular imaging》2013,40(4):477-485
Purpose
The best way to assess the response to chemoradiotherapy of locally advanced oesophageal carcinomas is not known. We used 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT to evaluate the metabolic response during chemoradiotherapy and tried to correlate this response to survival.Methods
Patients with biopsy-proven oesophageal carcinoma underwent FDG PET/CT with evaluation of the standardized uptake value (SUV) before any treatment (SUV1) and during chemoradiotherapy after two cycles of 5-fluorouracil (FU)/cisplatin and 20 Gy (SUV2). Metabolic response was defined as 1?(SUV2/SUV1). Surgery was discussed after 40 Gy and three cycles of chemotherapy. Results of interim PET were not considered for the therapeutic decision.Results
Among 72 patients who underwent a first FDG PET/CT before any treatment, 59 (82 %) could receive the second FDG PET/CT examination. Median survival was 22.2 months with 1-year and 2-year survivals of 70 and 46 %, respectively. Nineteen patients (32 %) underwent surgery. Mean SUV1 and SUV2 were 12.3?±?6.2 and 6?±?4.1, respectively (p?<?0.001). Using a cut-off for metabolic response of 50 %, sensitivity and specificity for survival were 0.7 and 0.58. The 2-year overall survival of good responders was 62 % as compared to 27 % for poor metabolic responders. A multivariate analysis was performed, including T and N stages, surgery, histology and metabolic response: only metabolic response was significantly (p?=?0.009) associated with 2-year survival.Conclusion
Early evaluation of metabolic response had a great prognostic value and could help identify good responders to chemoradiotherapy. 相似文献5.
Felipe A. Calvo Claudio V. Sole Dolores de la Mata Luis Cabezón Marina Gómez-Espí Emilio Alvarez Paz Madariaga José L. Carreras 《European journal of nuclear medicine and molecular imaging》2013,40(5):657-667
Purpose
To prospectively evaluate the usefulness of 18F-FDG PET/CT) imaging for predicting histopathological response and long-term clinical outcomes in locally advanced rectal cancer (LARC).Methods
This prospective study included 38 patients with a confirmed diagnosis of LARC (cT3-4 or cN+) who underwent 18F-FDG PET/CT before and after neoadjuvant therapy (NAT). Total mesorectal excision was scheduled 6 weeks after NAT and was followed by an expert histopathological analysis of the surgical specimen. Baseline variables and previously identified maximum FDG standardized uptake value (SUVmax) cut-off values before NAT (SUVmaxPRE ≥6) and after NAT (SUVmaxPOST ≥2), and the absolute and percentage reductions from baseline SUVmax (?SUVmax <4 and ?SUVmax% <65 %, respectively) were applied to differentiate patients showing a metabolic tumour response from nonresponders. These features were correlated with tumour regression grade (TRG), disease-free survival (DFS) and overall survival (OS).Results
Significantly higher 5-year DFS and OS were seen in 19 responders (TRG 3 or 4) than in 19 nonresponders (TRG 0–2; 94.4 vs. 48.8 %, p?=?0.001; 94.7 vs. 63.2 %, p?=?0.02, respectively). In multivariate analysis the only PET/CT SUVmax-based parameter significantly correlated with the likelihood of recurrence and survival was ?SUV% <65 % (HR?=?5.95, p?=?0.02, for DFS; HR?=?5.26, p?=?0.04, for OS)Conclusion
This prospective study proved that 18F-FDG PET/CT is a valuable imaging tool for assessing rectal cancer TRG and long-term prognosis, and could potentially serve as an intermediate endpoint in treatment optimization research and rectal cancer patient care. 相似文献6.
Judith E. Kalinyak Wendie A. Berg Kathy Schilling Kathleen S. Madsen Deepa Narayanan Marie Tartar 《European journal of nuclear medicine and molecular imaging》2014,41(2):260-275
Purpose
To compare the performance characteristics of positron emission mammography (PEM) with those of whole-body PET (WBPET) and PET/CT in women with newly diagnosed breast cancer.Methods
A total of 178 women consented to PEM for presurgical planning in an IRB-approved protocol and also underwent either WBPET (n?=?69) or PET/CT (n?=?109) imaging, as per usual care at three centers. Tumor detection sensitivity, positive predictive values, and 18F-fluorodeoxyglucose (FDG) uptake were compared between the modalities. The effects of tumor size, type, and grade on detection were examined. The chi-squared or Fisher’s exact tests were used to compare distributions between groups, and McNemar’s test was used to compare distributions for paired data within subject groups, i.e. PEM versus WBPET or PEM versus PET/CT.Results
The mean age of the women was 59?±?12 years (median 60 years, range 26–89 years), with a mean invasive index tumor size of 1.6?±?0.8 cm (median 1.5 cm, range 0.5–4.0 cm). PEM detected more index tumors (61/66, 92 %) than WBPET (37/66, 56 %; p?<?0.001) or PET/CT (95/109, 87 % vs. 104/109, 95 % for PEM; p?<?0.029). Sensitivity for the detection of additional ipsilateral malignancies was also greater with PEM (7/15, 47 %) than with WBPET (1/15, 6.7 %; p?=?0.014) or PET/CT (3/23, 13 % vs. 13/23, 57 % for PEM; p?=?0.003). Index tumor detection decreased with decreasing invasive tumor size for both WBPET (p?=?0.002) and PET/CT (p?<?0.001); PEM was not significantly affected (p?=?0.20). FDG uptake, quantified in terms of maximum PEM uptake value, was lowest in ductal carcinoma in situ (median 1.5, range 0.7–3.0) and invasive lobular carcinoma (median 1.5, range 0.7–3.4), and highest in grade III invasive ductal carcinoma (median 3.1, range 1.4–12.9).Conclusion
PEM was more sensitive than either WBPET or PET/CT in showing index and additional ipsilateral breast tumors and remained highly sensitive for tumors smaller than 1 cm. 相似文献7.
Laurence Champion Florence Lerebours Pascal Cherel Veronique Edeline Anne-Laure Giraudet Myriam Wartski Dominique Bellet Jean-Louis Alberini 《European journal of nuclear medicine and molecular imaging》2013,40(8):1206-1213
Purpose
Inflammatory breast cancer (IBC) is the most aggressive type of breast cancer with a poor prognosis. Locoregional staging is based on dynamic contrast-enhanced (DCE) CT or MRI. The aim of this study was to compare the performances of FDG PET/CT and DCE CT in locoregional staging of IBC and to assess their respective prognostic values.Methods
The study group comprised 50 women (median age: 51?±?11 years) followed in our institution for IBC who underwent FDG PET/CT and DCE CT scans (median interval 5?±?9 days). CT enhancement parameters were net maximal enhancement, net early enhancement and perfusion.Results
The PET/CT scans showed intense FDG uptake in all primary tumours. Concordance rate between PET/CT and DCE CT for breast tumour localization was 92 %. No significant correlation was found between SUVmax and CT enhancement parameters in primary tumours (p?>?0.6). PET/CT and DCE CT results were poorly correlated for skin infiltration (kappa?=?0.19). Ipsilateral foci of increased axillary FDG uptake were found in 47 patients (median SUV: 7.9?±?5.4), whereas enlarged axillary lymph nodes were observed on DCE CT in 43 patients. Results for axillary node involvement were fairly well correlated (kappa?=?0.55). Nineteen patients (38 %) were found to be metastatic on PET/CT scan with a significant shorter progression-free survival than patients without distant lesions (p?=?0.01). In the primary tumour, no statistically significant difference was observed between high and moderate tumour FDG uptake on survival, using an SUVmax cut-off of 5 (p?=?0.7 and 0.9), or between high and low tumour enhancement on DCE CT (p?>?0.8).Conclusion
FDG PET/CT imaging provided additional information concerning locoregional involvement to that provided by DCE CT on and allowed detection of distant metastases in the same whole-body procedure. Tumour FDG uptake or CT enhancement parameters were not correlated and were not found to have any prognostic value. 相似文献8.
Yuji Nakamoto Kensuke Kurihara Masatoshi Nishizawa Kouhei Yamashita Koya Nakatani Tadakazu Kondo Akifumi Takaori-Kondo Kaori Togashi 《European journal of nuclear medicine and molecular imaging》2013,40(5):708-715
Purpose
PET/CT using FDG has been widely used for the imaging of various malignant tumours, including plasma cell malignancy (PCM), but 11C-methionine (MET), as a radiolabelled amino acid tracer, may also be useful because PCM is able to activate protein synthesis. The purpose of this study was to evaluate the clinical value of PET/CT imaging using MET in PCM, including multiple myeloma, compared with that of FDG PET/CT.Methods
The study group comprised 20 patients with histologically proven PCM who underwent FDG PET/CT and MET PET/CT scans before (n?=?6) or after (n?=?14) treatment. Semiquantitative analysis was performed on a lesion basis. We also visually evaluated the scans qualitatively using a five-point scale (0, negative; 1, probably negative; 2, equivocal; 3, probably positive; 4, positive) on a lesion and a patient basis. The results were compared between the two scans.Results
Active PCM was confirmed in 15 patients, including two patients with extramedullary lesions. Uptake of MET tended to be higher (maximum standardized uptake value 10.3 ± 5.6, mean ± SD) than that of FDG (3.4 ± 2.7, p?<?0.001), and more lesions of grade 3 or 4 were depicted by MET (MET 156 lesions vs. FDG 58 lesions). On a patient basis, two patients were accurately diagnosed only by MET. In the remaining 18 patients, consistent results were obtained, but potential upgrade of staging or restaging was necessary in 6 of 11 positive patients because more abnormal lesions were demonstrated by MET. The patient-based sensitivity, specificity and accuracy of MET for restaging were 89 %, 100 % and 93 %, respectively, while those of FDG were 78 %, 100 % and 86 %, respectively.Conclusion
MET revealed an equal or greater number of lesions in PCM than FDG. MET may be especially useful when negative or inconclusive findings are obtained by FDG despite highly suspicious indications of recurrence. 相似文献9.
Stefano Severi Oriana Nanni Lisa Bodei Maddalena Sansovini Annarita Ianniello Stefania Nicoletti Emanuela Scarpi Federica Matteucci Laura Gilardi Giovanni Paganelli 《European journal of nuclear medicine and molecular imaging》2013,40(6):881-888
Purpose
The prognostic value of FDG PET for neuroendocrine tumours (NETs) has been reported. In this study we evaluated the role of FDG PET in predicting response and progression-free survival (PFS) after 177Lu-DOTATATE peptide receptor radionuclide therapy (Lu-PRRT) in patients with advanced well-differentiated grade 1/2 NETs.Methods
We retrospectively evaluated 52 patients with progressive advanced NETs overexpressing somatostatin receptors and treated with Lu-PRRT with a cumulative activity up to 27.7 GBq divided into five courses. According to WHO 2010/ENETS classification, patients were stratified into two groups: those with grade 1 tumour (Ki-67 index ≤2 %, 19 patients), and those with grade 2 tumour (Ki-67 index >3 % to <20 %, 33 patients). On the basis of the FDG PET scan, 33 patients were classified as PET-positive (PET+) and 19 as PET-negative (PET?).Results
FDG PET was positive in 57 % of patients with grade 1 NET and in 66 % of patients with grade 2 NET, and the rates of disease control (DC, i.e. complete response + partial response + stable disease) in grade 1 and grade 2 patients were 95 % and 79 %, respectively (P?=?0.232). In PET? and PET+ patients, the DC rates were 100 % and 76 % (P?=?0.020) with a PFS of 32 and 20 months, respectively (P?=?0.033). Of the PET+ patients with grade 1 NET, 91 % showed disease control, whereas about one in three PET+ patients with grade 2 NET (32 %) progressed after Lu-PRRT (DC rate 68 %).Conclusion
These results suggest that FDG PET evaluation is useful for predicting response to Lu-PRRT in patients with grade 1/2 advanced NETs. Notably, none of PET? patients had progressed at the first follow-up examination after Lu-PRRT. Grade 2 NET and PET+ (arbitrary SUV cutoff >2.5) were frequently associated with more aggressive disease. PET+ patients with grade 2 NET, 32 % of whom did not respond to Lu-PRRT monotherapy, might benefit from more intensive therapy protocols, such as the combination of chemotherapy and PRRT. 相似文献10.
Ozlem Ozmen Ebru Tatci Atila Gokcek Deniz Koksal Yeliz Dadali Esra Ozaydin Nuri Arslan 《Annals of nuclear medicine》2013,27(10):907-915
Objective
Wegener’s granulomatosis (WG) is a rare disorder characterized by granulomatous necrotizing vasculitis which mainly affects small- and medium-sized vessels. While the classical triad of involvement is upper and lower respiratory system and glomerulonephritis, WG may involve any organ or system in the body. The aim of our study was to investigate the role of positron emission tomography/computerized tomography (PET/CT) both in the initial evaluation and follow-up of patients with WG.Methods
We retrospectively evaluated PET/CT data from 13 patients (6 males; 7 females) with a mean age of 45 ± 12.4 years (range 28–63) who underwent either initial evaluation (n = 12) or response evaluation (n = 2) by conventional imaging methods and FDG with PET/CT. PET/CT images were both visually and quantitatively evaluated. The demographic data, clinical and laboratory findings of each patient were also recorded from the hospital files.Results
Lung (n = 13), parapharyngeal space (n = 8), nose (n = 8), and ear (n = 3) were the most common disease sites detected on PET/CT. The entire initial evaluation patients had either solitary or multiple pulmonary nodular/mass lesions with marked increased FDG uptake (mean SUVmax 12 ± 4, range 3.53–19.51) on PET/CT. There was no significant pathological FDG uptake in patients consistent with complete treatment response after appropriate immunosuppressive therapy. PET/CT clearly demonstrated unexpected disease sites besides the respiratory system, with WG involvement except kidneys. Possibly due to physiological urinary excretion of FDG, urine analysis, BUN and creatinine levels were accepted still the best way for diagnosis of renal involvement.Conclusion
FDG with PET/CT is a valuable tool in the management of patients with WG for a more accurate clinical evaluation regarding disease extension and treatment response. 相似文献11.
Laura E. Moreno-Luna Ju Dong Yang William Sanchez Ricardo Paz-Fumagalli Denise M. Harnois Teresa A. Mettler Denise N. Gansen Piet C. de Groen Konstantinos N. Lazaridis K. V. Narayanan Menon Nicholas F. LaRusso Steven R. Alberts Gregory J. Gores Chad J. Fleming Seth W. Slettedahl William S. Harmsen Terry M. Therneau Gregory A. Wiseman James C. Andrews Lewis R. Roberts 《Cardiovascular and interventional radiology》2013,36(3):714-723
Purpose
Intermediate-stage hepatocellular carcinoma (HCC) is usually treated with locoregional therapy using transarterial chemoembolization (TACE). Transarterial radioembolization (TARE) using β-emitting yttrium-90 integral to the glass matrix of the microspheres is an alternative to TACE. This retrospective case-control study compared the outcomes and safety of TARE versus TACE in patients with unresectable HCC.Materials and Methods
Patients with unresectable HCC without portal vein thrombosis treated with TARE between 2005 and 2008 (n = 61) were retrospectively frequency-matched by age, sex, and liver dysfunction with TACE-treated patients (n = 55) in the Mayo Clinic Hepatobiliary Neoplasia Registry. Imaging studies were reviewed, and clinical and safety outcomes were abstracted from the medical records.Results
Complete tumor response was more common after TARE (12 %) than after TACE (4 %) (p = 0.17). When complete response was combined with partial response and stable disease, there was no difference between TARE and TACE. Median survival did not differ between the two groups (15.0 months for TARE and 14.4 months for TACE; p = 0.47). Two-year survival rates were 30 % for TARE and 24 % for TACE. TARE patients received fewer treatments (p < 0.001). Fifty-nine (97 %) TARE patients received outpatient treatment. In contrast, 53 (98 %) TACE patients were hospitalized for ≥1 day (p < 0.001). Compared with TACE, TARE was more likely to induce fatigue (p = 0.003) but less likely to cause fever (p = 0.02).Conclusion
There was no significant difference in efficacy between TARE and TACE. TARE patients reported more fatigue but had less fever than TACE patients. Treatment with TARE required less hospitalization than treatment with TACE. These findings require confirmation in randomized trials. 相似文献12.
Christelle Tychyj-Pinel Fabien Ricard Michael Fulham Marion Fournier Michel Meignan Thierry Lamy Pierre Vera Gilles Salles Judith Trotman 《European journal of nuclear medicine and molecular imaging》2014,41(3):408-415
Purpose
We aimed to compare the standardized central review of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT scans performed after induction therapy for follicular lymphoma (FL) in the PRIMA study (Salles et al., Lancet 377:42–51, 2011; Trotman et al., J Clin Oncol 29:3194–3200, 2011) to scan review at local centres.Methods
PET/CT scans were independently evaluated by two nuclear medicine physicians using the 2007 International Harmonization Project (IHP) criteria (Cheson et al., J Clin Oncol 25:579–586, 2007; Juweid et al., J Clin Oncol 25:571–578, 2007; Shankar et al., J Nucl Med 47:1059–1066, 2006) and Deauville 5-point scale (5PS) criteria (Meignan et al., Leuk Lymphoma 50:1257–1260, 2009; Meignan et al., Leuk Lymphoma 51:2171–2180, 2010; Barrington et al., Eur J Nucl Med Mol Imaging 37:1824–1833, 2010). PET/CT status was compared with prospectively recorded patient outcomes.Results
Central evaluation was performed on 119 scans. At diagnosis, 58 of 59 were recorded as positive, with a mean maximum standardized uptake value (SUVmax) of 11.7 (range 4.6–35.6). There was no significant association between baseline SUVmax and progression-free survival (PFS). Sixty post-induction scans were interpreted using both the IHP criteria and 5PS. Post-induction PET-positive status failed to predict progression when applying the IHP criteria [p?=?0.14; hazard ratio (HR) 1.9; 95 % confidence interval (CI) 0.8–4.6] or 5PS with a cut-off ≥3 (p?=?0.12; HR 2.0; 95 % CI 0.8–4.7). However, when applying the 5PS with a cut-off ≥4, there was a significantly inferior 42-month PFS in PET-positive patients of 25.0 % (95 % CI 3.7–55.8 %) versus 61.4 % (95 % CI 45.4–74.1 %) in PET-negative patients (p?=?0.01; HR 3.1; 95 % CI 1.2–7.8). The positive predictive value (PPV) of post-induction PET with this liver cut-off was 75 %. The 42-month PFS for patients remaining PET-positive by local assessment was 31.1 % (95 % CI 10.2–55.0 %) vs 64.6 % (95 % CI 47.0–77.6 %) for PET-negative patients (p?=?0.002; HR 3.3; 95 % CI 1.5–7.4), with a PPV of 66.7 %.Conclusion
We confirm that FDG PET/CT status when applying the 5PS with a cut-off ≥4 is strongly predictive of outcome after first-line immunochemotherapy for FL. Further efforts to refine the criteria for assessing minimal residual FDG uptake in FL should provide a reproducible platform for response assessment in future prospective studies of a PET-adapted approach. 相似文献13.
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14.
Yeongjoo Lee Ie Ryung Yoo Sun Ha Boo Hyoungwoo Kim Hye Lim Park Joo Hyun O 《Nuclear Medicine and Molecular Imaging》2017,51(1):69-78
Purpose
The aim of this study was to evaluate the diagnostic and prognostic role of metabolic parameters of FDG PET/CT in patients with intrahepatic cholangiocarcinoma (ICC).Methods
From December 2008 to December 2013, 76 FDG PET/CT scans performed for initial staging of ICC in a single institution (57 male and 19 female; mean age 68?±?9 years) were retrospectively reviewed. Patients with history of other known malignancy were excluded. Detection rates of regional lymph node and distant metastasis by FDG PET/CT were analyzed in comparison with conventional imaging modalities such as CT or MRI. Metabolic parameters including maximum, peak and mean standardized uptake values (SUVmax, SUVpeak, SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), glucose corrected SUV (SUVgluc), and glucose corrected TLG (TLGgluc) were measured for the primary tumor. Cut-off values for the metabolic parameters were calculated by ROC curve analysis, and used to dichotomize the patient groups. The overall survival time (OS) was calculated and compared using the Cox proportional hazard regression analysis.Results
The median duration of follow-up period was 5.4 months (interquartile range: 1.45~15.45). FDG PET/CT showed higher sensitivity than conventional imaging modalities in detection of regional node involvement (74.5 % vs. 61.8 %, p?=?0.013). In six patients, distant metastasis was identified only by FDG PET/CT. The mean SUVmax, SUVpeak, SUVmean, MTV, and TLG for the primary tumor were 8.2?±?3.1, 6.8?±?2.5, 4.0?±?0.8, 192.7?±?360.5 cm3, and 823.7?±?1615.4, respectively. Patients with higher (≥7.3, HR: 4.280, p?=?0.001), higher SUVpeak (≥6.5, HR: 2.333, p?=?0.020), higher SUVmean (≥3.9, HR: 2.799, p?=?0.004), higher SUVgluc (≥8.1, HR: 2.648, p?=?0.012), and higher TLGgluc (≥431.6, HR: 2.186, p?=?0.030) showed significantly shorter survival time. By multivariate study, operability was an independent prognostic factor for longer survival (HR: 4.113, p?=?0.005).Conclusion
FDG PET/CT is an important diagnostic imaging tool in the nodal staging and detection of distant metastasis in ICC patients. Metabolic parameters may have a significant role as prognostic factors in patients with ICC.15.
Yasuhiro Maruoka Koichiro Abe Shingo Baba Takuro Isoda Yoshiyuki Kitamura Noriko Mizoguchi Go Akamatsu Masayuki Sasaki Hiroshi Honda 《Annals of nuclear medicine》2013,27(10):873-879
Purpose
The purpose of this study was to evaluate the clinical usefulness of partial volume effect (PVE)-corrected F-18 FDG PET/CT for predicting I-131 accumulation in metastatic lymph nodes (mLNs) during I-131 therapy for papillary thyroid carcinoma (PTC).Methods
Sixty-five mLNs in 31 PTC patients who underwent F-18 FDG PET/CT in an initial radioiodine therapy (RIT) were retrospectively evaluated. Of these, 25 mLNs were I-131-positive and 40 were I-131-negative. SUVmax and SUVmax with PVE correction (cSUVmax) were measured for each mLN, where PVE correction was performed utilizing a simple table lookup correction method. Then, SUVmax/cSUVmax was compared between I-131-positive and I-131-negative mLNs, including the analyses for the mLNs with small-sized (<1 cm) and weak FDG accumulation (SUVmax <3.5). The predictability for I-131 accumulation with SUVmax/cSUVmax was also compared.Results
For all 65 mLNs, SUVmax/cSUVmax was significantly higher in I-131-negative than I-131-positive mLNs (p < 0.0001). Only in cSUVmax, I-131-negative mLNs were significantly higher than I-131-positive, in terms of the 30 small-sized mLNs (p = 0.0001) and 14 mLNs with weak FDG uptake (p = 0.007). The highest accuracy in predictability for I-131 accumulation was significantly better with cSUVmax (92 %) than SUVmax (62 %) (p < 0.0001).Conclusion
PVE-corrected F-18 FDG PET/CT is a valuable predictor of I-131 accumulation in mLNs during RIT. 相似文献16.
F. Cornelis M. Silk H. Schoder H. Takaki J. C. Durack J. P. Erinjeri C. T. Sofocleous R. H. Siegelbaum M. Maybody S. B. Solomon 《European journal of nuclear medicine and molecular imaging》2014,41(12):2265-2272
Purpose
We sought to evaluate the safety and the diagnostic success rate of percutaneous biopsies performed under intra-procedural 18?F-deoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT) guidance for lesions difficult to see with conventional cross-sectional imaging.Methods
From 2011 to 2013, consecutive clinically indicated percutaneous PET/CT-guided biopsies of 106 masses (mean size, 3.3 cm; range, 0.7–15.9 cm; SD, 2.9 cm) in bones (n?=?33), liver (n?=?26), soft tissues (n?=?18), lung (n?=?15) and abdomen (n?=?14) were reviewed. The biopsy procedures were performed following injection of a mean of 255 MBq (SD, 74) FDG. Mean maximal standardized uptake value (SUV) of lesions was 8.8 (SD, 6.3). A systematic review of the histopathological results and outcomes was performed.Results
Biopsies were positive for malignancy in 76 cases (71.7 %, 76/106) and for benign tissue in 30 cases (28.3 %, 30/106). Immediate results were considered adequate for 100 PET/CT biopsies (94.3 %, 100/106) requiring no further exploration, and for the six others (5.7 %, 6/106) benign diagnoses were confirmed after surgery (n?=?4) or follow-up (n?=?2). The consequent overall sensitivity and the diagnostic success of biopsy were therefore 100 %. No significant differences in terms of detection of malignancy were observed between the different locations. Lesions > 2 cm or with SUV?>?4 were not significantly more likely to be malignant. Complications occurred after four biopsies (3.7 %, 4/106).Conclusion
Intra-procedural PET/CT guidance appears as a safe and effective method and allows high diagnostic success of percutaneous biopsies for metabolically active lesions. 相似文献17.
Aim
A small number of studies evaluated the detection rate of lesions from bladder carcinoma (BC) of 18 F-FDG PET/CT in the restaging process. However, the prognostic role of FDG PET/CT still remains unclear. The aim of the present study was to evaluate the accuracy, the effect upon treatment decision, and the prognostic value of FDG PET/CT in patients with suspected recurrent BC.Materials and Methods
Forty-one patients affected by BC underwent FDG PET/CT for restaging purpose. The diagnostic accuracy of visually interpreted FDG PET/CT was assessed compared to histology (n?=?8), other diagnostic imaging modalities (contrast-enhanced CT in 38/41 patients and MRI in 15/41) and clinical follow-up (n?=?41). Semiquantitative PET values (SUVmax, SUVmean, SUL, MTV, TLG) were calculated using a graph-based method. Progression-free survival (PFS) and overall survival (OS) were assessed by using Kaplan-Meier curves. The risk of progression (hazard ratio, HR) was computed by Cox regression analysis by considering all the available variables.Results
PET was considered positive in 21 of 41 patients. Of these, recurrent BC was confirmed in 20 (95 %). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FDG PET/CT were 87 %, 94 %, 95 %, 85 %, 90 %. AUC was 0.9 (95 %IC 0.8-1). Bayesian positive and negative likelihood ratios were 14.5 and 0.13, respectively. FDG PET/CT findings modified the therapeutic approach in 16 patients (modified therapy in 10 PET-positive patients, watch-and-wait in six PET-negative patients). PFS was significantly longer in patients with negative scan vs. those with pathological findings (85 % vs. 24 %, p?<?0.05; HR?=?12.4; p?=?0.001). Moreover, an unremarkable study was associated with a longer OS (88 % vs. 47 % after 2 years and 87 % vs. 25 % after 3 years, respectively, p?<?0.05). Standardized uptake value (SUV)max?>?6 and total lesion glycolysis (TLG)?>?8.5 were recognized as the most accurate thresholds to predict PFS (2-year PFS 62 % for SUVmax?<?6 vs. 15 % for SUVmax?>?6, p?=?0.018; 2-year PFS 66 % for TLG?<?8.5 vs. 18 % for TLG?>?8.5, p?=?0.09).Conclusion
A very good diagnostic performance for FDG PET/CT was confirmed in patients with suspected recurrent BC. FDG PET/CT allowed for a change in treatment decision in about 40 % of cases and showed an important prognostic value in assessing PFS and OS.18.
Byung Hyun Byun Sun Mi Moon Ui Sup Shin Ilhan Lim Byung Il Kim Chang Woon Choi Sang Moo Lim 《European journal of nuclear medicine and molecular imaging》2014,41(12):2203-2211
Purpose
We evaluated the ability of pretreatment 18?F-FDG uptake by regional lymph nodes to predict the survival of patients with resectable colorectal cancer.Methods
The records of 78 patients with AJCC stage III colorectal cancer (pathologically confirmed node-positive disease without evidence of distant metastasis) treated with surgery and adjuvant chemotherapy were retrospectively reviewed. The maximum standardized uptake values of the primary tumor (SUVp) and regional lymph nodes (SUVn) were measured by pretreatment 18?F-FDG PET/CT. The ROC curve analyses and the Cox proportional hazard model were used to analyze whether SUVp, SUVn, and clinicopathologic parameters could predict disease-free survival.Results
Although there were no significant differences between the median SUVp in the event group and that in the non-event group, the median SUVn was significantly higher in the event group (1.7) than in the non-event group (0.8, p?=?0.023). Based on the ROC curve analysis, SUVn predicted the event for disease-free survival (AUC?=?0.668, p?=?0.02) with the optimal criterion, sensitivity, specificity, and accuracy of?>?1.2, 71 %, 63 %, and 65 %, respectively. However, SUVp did not predict disease-free survival (AUC?=?0.570, p?=?0.349). Univariate analysis revealed that SUVn (p?=?0.011) and venous invasion (p?=?0.016) were associated with disease-free survival, but pathologic N stage was not (p?=?0.09). By multivariate analysis, only SUVn?>?1.2 independently shortened the disease-free survival (relative risk, 2.97; 95 % CI, 1.14–7.74, p?=?0.026).Conclusion
SUVn before surgery may be a useful prognostic marker in patients with AJCC stage III colorectal cancer. 相似文献19.
N. Schramm A. Rominger C. Schmidt J. N. Morelli C. Schmid-Tannwald F. G. Meinel M. F. Reiser C. Rist 《European journal of nuclear medicine and molecular imaging》2013,40(7):1014-1024
Purpose
To determine the value of combined 18F-FDG PET/CT with diagnostic contrast-enhanced CT (CECT) in detecting primary malignancies and metastases in patients with paraneoplastic neurological syndromes (PNS) and to compare this with CECT alone.Methods
PET/CT scans from 66 patients with PNS were retrospectively evaluated. Two blinded readers initially reviewed the CECT portion of each PET/CT scan. In a second session 3 months later, the readers analysed the combined PET/CT scans. Findings on each study were assessed using a four-point-scale (1 normal/benign; 2 inconclusive, further diagnostic work-up may be necessary; 3 malignant; 4 inflammatory). Sensitivity and specificity for malignant findings were calculated for PET/CT and CECT. Interreader agreement was determined by calculating Cohen’s kappa. Pooled data from clinical follow-up (including histopathology and follow-up imaging, median follow-up 20.0 months) served as the reference gold standard.Results
Both readers classified 12 findings in ten patients (15 %) as malignant on the PET/CT scans (two patients had two primary tumours). One such imaging finding (suspected thymic cancer) was false-positive (i.e. benign histology). The most common tumours were bronchial carcinoma (n?=?3), lymph node metastases of gynaecological tumours (n?=?3) and tonsillar carcinoma (n?=?2). Three of 12 findings (25 %) were not detected by CECT alone (cervical carcinoma, lymph node metastasis and tonsillar carcinoma). In a per-patient analysis, sensitivity and specificity for malignant findings were 100 % and 90 % for PET/CT and 78 % and 88 % for CECT. In 24 % (reader 1) and 21 % (reader 2) of the patients, the PET/CT findings were inconclusive. Of these findings, 57 % (reader 1) and 56 % (reader 2) were only diagnosed with PET (e.g. focal FDG uptake of the thyroid, gastrointestinal tract and ovaries). On follow-up, none of these findings corresponded to malignancy. Overall agreement between the two readers was excellent with a Cohen’s kappa of 0.95?±?0.04 (p?<?0.001) for PET/CT and 0.97?±?0.03 (p?<?0.001) for CECT alone.Conclusion
In this cohort of patients with PNS, PET/CT exhibited improved detection of underlying malignancy versus CECT alone. While hybrid imaging produces a greater number of inconclusive findings, sensitivity is increased for the detection of head and neck and gynaecological malignancies as well as metastatic lymph node involvement. 相似文献20.
Sun-pyo Hong Seung Eun Lee Yoon-La Choi Sung Wook Seo Ki-Sun Sung Hong Hoe Koo Joon Young Choi 《Skeletal radiology》2014,43(5):641-648