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1.
A. A. Kohan J. A. Kolthammer J. L. Vercher-Conejero C. Rubbert S. Partovi R. Jones K. A. Herrmann P. Faulhaber 《European radiology》2013,23(11):3161-3169
Objectives
Evaluate the performance of PET/MRI at tissue interfaces with different attenuation values for detecting lymph node (LN) metastases and for accurately measuring maximum standardised uptake values (SUVmax) in lung cancer patients.Materials and Method
Eleven patients underwent PET/CT and PET/MRI for staging, restaging or follow-up of suspected or known lung cancer. Four experienced readers determined the N stage of the patients for each imaging method in a randomised blinded way. Concerning metastases, SUVmax of FDG-avid LNs were measured in PET/CT and PET/MRI in all patients. A standard of reference was created with a fifth experienced independent reader in combination with a chart review. Results were analysed to determine interobserver agreement, SUVmax correlation between CT and MRI (three-segment model) attenuation correction and diagnostic performance of the two techniques.Results
Overall interobserver agreement was high (κ?=?0.86) for PET/CT and substantial (κ?=?0.70) for PET/MRI. SUVmax showed strong positive correlation (Spearman’s correlation coefficient = 0.93, P?<?0.001) between the two techniques. Diagnostic performance of PET/MRI was slightly inferior to that of PET/CT, without statistical significance (P?>?0.05).Conclusions
PET/MRI using three-segment model attenuation correction for LN staging in lung cancer shows a strong parallel to PET/CT in terms of SUVmax, interobserver agreement and diagnostic performance.Key Points
?F18-FDG PET/MRI shows similar performance to F18-FDG PET/CT in lung cancer N staging. ?PET/MRI has substantial interobserver agreement in N staging. ?A three-segment model attenuation correction is reliable for assessing the mediastinum. 相似文献2.
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3.
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4.
Serkan Kuyumcu Isik Adalet Yasemin Sanli Cuneyt Turkmen Zeynep Gozde Ozkan Dilek Yilmazbayhan 《Annals of nuclear medicine》2012,26(9):689-697
Purpose
Pulmonary carcinoid (PC) tumors are rare neoplasms of the lung with good prognosis but diagnosis may be demanding since there is no exclusive modality alone to clearly differentiate a PC tumor. The purpose of this study is to establish the diagnostic features of somatostatin receptor scintigraphy (SRS), comparatively (where available) with 18FDG PET/CT (PET/CT) correlated with histopathologic findings.Methods
Twenty-one patients who underwent SRS with 111In-octreotide and were diagnosed as having PC tumors were retrospectively studied. Thirteen patients were performed PET/CT. Primary tumour size, Ki-67 indexes, image analysis data of SRS and PET/CT including maximum standardized uptake values (SUVmax) together with false negative, false positive, true positive and true negative lesions were documented and discussed.Results
Eleven (52.4?%) patients were typical (TC) and 10 (47.6?%) were atypical carcinoids (AC) with mean Ki-67 indexes of 2.1 and 24?%, respectively. Patients underwent SRS for solitary pulmonary nodule (SPN) characterization (n?=?12) and determination of disease extension (n?=?9). Overall sensitivity and specificity of SRS in the detection of primary tumour, lymph nodes (LN) and distant metastasis (DM) were 76 and 97?%, respectively, whereas, positive and negative predictive values were 95 and 86?%. PET/CT was performed for determining disease spread (n?=?3) and metabolic characterization (n?=?10) of SPNs. Mean SUVmax in the primary pulmonary lesion in TCs and ACs were 2.9?±?0.8 and 7.9?±?5.4, respectively. Nodal involvement (n?=?5) and DM (n?=?3) were also detected. Sensitivity and specificity of PET/CT in the detection of primary tumour, LNs and DM were 85 and 89.4?%, respectively.Conclusion
SRS is useful in the diagnosis and monitoring of PC tumors when incorporated with 18FDG PET/CT as a primary staging tool particularly in the determination of disease spread. 相似文献5.
Jongtae Cha Soyoung Kim Jiyoung Wang Mijin Yun Arthur Cho 《Nuclear Medicine and Molecular Imaging》2018,52(1):39-45
Purpose
The purpose of this study was to investigate the value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) parameters in the detection of regional lymph node (LN) metastasis in patients with cutaneous melanoma.Methods
We evaluated patients with cutaneous melanoma who underwent FDG PET/CT for initial staging or recurrence evaluation. A total of 103 patients were enrolled, and 165 LNs were evaluated. LNs that were confirmed pathologically or by follow-up imaging were included in this study. PET parameters, including maximum standardized uptake value (SUVmax), total lesion glycolysis and tumour-to-liver ratio, were used to determine the presence of metastases, and the results were compared with CT-determined LN metastasis. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off values of the FDG PET parameters.Results
A total of 93 LNs were malignant, and 84 LNs were smaller than 10 mm. In all 165 LNs, an SUVmax of >2.51 showed a sensitivity of 73.1%, a specificity of 88.9%, and an accuracy of 80.0% in detecting metastatic LNs. CT showed a higher specificity (87.3%) and lower accuracy (65.5%). For non-enlarged regional LNs (<10 mm), an SUVmax cut-off value of 1.4 showed the highest negative predictive value (81.3%). For enlarged LNs (≥10 mm), an SUVmax cut-off value of 2.4 showed the highest sensitivity (90.7%) and accuracy (88.9%) in detecting metastatic LNs.Conclusions
In patients with cutaneous melanoma, an SUVmax of >2.4 showed a high sensitivity (91%) and accuracy (89%) in detecting metastasis in LNs ≥1 cm, and LNs <1 cm with an SUVmax <1.4 were likely to be benign.6.
Lee SM Park CM Paeng JC Im HJ Goo JM Lee HJ Kang CH Kim YW Kim JI 《European radiology》2012,22(7):1556-1563
Objectives
To retrospectively evaluate the diagnostic accuracy and predictive features of F-18 fluorodeoxyglucose positron emission tomography/ computed tomography (FDG-PET/CT) and CT in lymph node (LN) staging of T1 non-small-cell lung cancers (NSCLCs) manifesting as subsolid nodules.Methods
From January 2005 to May 2011, 160 patients with pathologically proven T1 subsolid NSCLCs with LN staging were included in this study. Diagnostic accuracies of FDG-PET/CT and CT for LN staging were evaluated. Maximum standardised uptake value (SUVmax) and CT features of primary tumours were evaluated to investigate predictive factors for LN metastasis.Results
LN metastases were found in nine of the 160 patients (5.6%). No LN metastasis was present in patients with a solid proportion ≤50%. Sensitivity, specificity and accuracy of FDG-PET/CT for LN staging on a per-patient basis were 11.1%, 86.1% and 81.9%; those of CT were 11.1%, 96.7% and 91.9%. Among patients with a solid proportion >50%, there were significant differences in SUVmax, solid portion size, solid proportion and lesion location between patients with and without LN metastasis. Multivariate analysis revealed that higher SUVmax, a larger solid proportion and central location were independent predictors of LN metastasis.Conclusions
FDG-PET/CT adds little value to CT in the lymph node staging of T1 subsolid NSCLCs.Key Points
? Lymph node (LN) metastases are important in non-small-cell lung cancer (NSCLC). ? Positron emission tomography (PET) helps to stage solid NSCLCs. ? FDG-PET/CT adds little to the LN staging of T1 subsolid NSCLCs. ? No LN metastasis in patients with a solid proportion ≤50%. ? LN metastasis is more common in solid and/or centrally sited tumours. 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.
Cristina Nanni Luca Boriani Caterina Salvadori Eleonora Zamparini Giada Rorato Valentina Ambrosini Alessandro Gasbarrini Fabio Tumietto Francesco Cristini Luigia Scudeller Stefano Boriani Pierluigi Viale Stefano Fanti 《European journal of nuclear medicine and molecular imaging》2012,39(10):1538-1544
Purpose
Antibiotic therapy in patients affected by discitis is often empirical. Therefore, early evaluation of response to therapy is important. In many patients inflammatory indexes are low during all the phases of the diseases or are altered by concomitant diseases. The aim of the study was to assess the possible role of FDG PET/CT for the early evaluation of response to therapy in patients affected by infective discitis, in comparison to C-reactive protein (CRP) serum levels.Methods
Enrolled in the study were 38 patients diagnosed with haematogenous infective discitis. Of the 38 patients, 7 had tubercular infection, 1 fungal infection and 30 pyogenic discitis. Four patients were excluded because the second PET/CT scan was not performed. Thus 34 patients (18 women, mean age 64?years) were analysed. All the patients included underwent a FDG PET/CT scan and determination of CRP level at baseline and again 2 to 4?weeks after the start of therapy. The PET results in terms of SUV of the first and second scans (SUV1 and SUV2) and delta-SUVmax were compared to the inflammatory indexes and clinical status during therapy.Results
The mean SUVmax at diagnosis was 8.6?±?3.7. The mean CRP level at diagnosis was 3.8?±?3.8?mg/dl. A progressive clinical response was seen in 26 patients and 8 patients showed no response. SUV1 was not correlated with the baseline CRP level (CRP1, p?=?0.7) and SUV2 was not correlated with the CRP level at the time of the second scan (CRP2, p?=?0.4). In responders, SUV2 and CRP2 were significantly lower than SUV1 and CRP1 (p?<?0.0001 and p?=?0.001, respectively). ROC curves for delta-SUVmax showed a sensitivity of 82?% and a specificity of 82?% with a cut-off of 34?%. ROC curves for SUV2 showed a sensitivity of 83?% and a specificity of 46?% with a cut-off of 6.4. ROC curves for delta-CRP showed a sensitivity of 67?% and a specificity of 89?% with a cut-off of 74?%. ROC curves for CRP2 showed a sensitivity of 65?% and a specificity of 70?% with a cut-off of 0.7?mg/dl. No statistically significant difference was found between delta-SUVmax AUC and delta-CRP AUC (p?=?0.5).Conclusion
Delta-SUVmax provided a higher sensitivity and specificity for identifying responders. SUV2 provided comparable sensitivity, but significantly lower specificity. CRP level performed less well for identifying responders. There was no significant difference in the global performance of the two tests (delta-SUVmax AUC and delta-CRP AUC). However, the higher sensitivity of delta-SUVmax for the early identification of responders may have an important clinical impact in guiding antibiotic therapy especially in patients with a noninformative CRP test at diagnosis. 相似文献9.
Jolanta Kunikowska Renata Matyskiel Sadegh Toutounchi Laretta Grabowska-Derlatka Łukasz Koperski Leszek Królicki 《European journal of nuclear medicine and molecular imaging》2014,41(12):2273-2280
Purpose
Prior studies have suggested that 18F-FDG PET/CT can help characterize adrenal lesions and differentiate adrenal metastases from benign lesions. The aim of this study was to assess the value of 18F-FDG PET/CT for the differentiation of malignant from benign adrenal lesions.Methods
This retrospective study included 85 patients (47 men and 38 women, age 63.8?±?10.8 years) who had undergone 18F-FDG PET/CT (60 min after injection 300 – 370 MBq 18F-FDG; Biograph 64 scanner) for evaluation of 102 nonsecreting adrenal masses. For semiquantitative analysis, the maximum standardized uptake value (SUVmax), adrenal to liver (T/L) SUVmax ratio, mean CT attenuation value and tumour diameter were measured in all lesions and compared with the pathological findings.Results
Malignant adrenal tumours (68 % of evaluated tumours) had a significantly higher mean SUVmax (13.0?±?7.1 vs. 3.7?±?3.0), a higher T/L SUVmax ratio (4.2?±?2.6 vs. 1.0?±?0.9), a higher CT attenuation value (31.9?±?16. 7 HU vs. 0.2?±?25.8 HU) and a greater diameter (43.6?±?23.7 mm vs. 25.6?±?13.3 mm) than benign lesions. The false-positive findings were tuberculosis and benign phaeochromocytoma. Based on ROC analysis, a T/L SUVmax ratio >1.53, an adrenal SUVmax >5.2, an attenuation value >24 HU and a tumour diameter >30 mm were chosen as the optimal cut-off values for differentiating malignant from benign tumours. The areas under the ROC curves for the selected cut-off values were 0.96, 0.96, 0.88 and 0.77, respectively. A multivariate logistic regression model revealed that the T/L SUVmax ratio was an independent prognostic factor for malignancy (p?0.001); a CT attenuation value of >25 HU and a tumour diameter >30 mm had no additional individual importance in the diagnosis of malignancy.Conclusion
Using a T/L SUVmax ratio >1.53 and an adrenal SUVmax >5.2 in 18F-FDG PET/CT led to high diagnostic sensitivity, specificity and negative predictive value for characterizing adrenal tumours. The diagnostic accuracies of the two parameters were comparable, but T/L SUVmax ratio was an independent predictor of malignancy. 相似文献10.
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11.
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12.
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13.
Chang-Bae Kong Byung Hyun Byun Ilhan Lim Chang Woon Choi Sang Moo Lim Won Seok Song Wan Hyeong Cho Dae-Geun Jeon Jae-Soo Koh Ji Young Yoo Soo-Yong Lee 《European journal of nuclear medicine and molecular imaging》2013,40(5):728-736
Purpose
This study evaluated the usefulness of the maximum standardized uptake value (SUVmax) as a measure of histologic response to neoadjuvant chemotherapy in patients with extremity osteosarcoma. The correlation between [18?F]FDG PET SUVmax values and histologic response to preoperative chemotherapy was also assessed prospectively using PET/MRI.Methods
A total of 26 consecutive patients with high-grade osteosarcoma were prospectively enrolled. All patients underwent parallel PET and MRI scans before and after neoadjuvant chemotherapy. Using the PET and MRI images and pathologic mapping, we assessed the percentage necrosis by histology at the highest metabolic activity point in the tumors. This was defined as the minimum histologic response. The predictive values of SUVmax before (SUV1) and after (SUV2) chemotherapy and the SUV change ratio were determined. Correlations were also investigated among SUV2, minimum histologic response and histologic response.Results
Histologically, 13 patients were classified as good responders and 13 as poor responders. Patients with an SUV2 of >5 showed a poor histologic response. A significant correlation was found between SUV2 and histologic response (Spearman’s rho ?0.642; P?<?0.001), and SUV2 and histologic response were both found to be significantly correlated with minimum histologic response (Spearman’s rho ?0.515 and 0.911; P?=?0.007 and P?<?0.001, respectively).Conclusion
A SUVmax of more than 5 after neoadjuvant chemotherapy identified the majority of histologic nonresponders (sensitivity 61.3 %, PPV 88.9 %). Tumor necrosis at the point of maximum metabolic activity was found to be significantly correlated with the histologic response of entire resected specimen. 相似文献14.
Ryo Nakazato MD PhD Damini Dey PhD Erick Alexánderson MD Aloha Meave MD Moisés Jiménez MD Edgar Romero MD Rodrigo Jácome MD Marco Pe?a MD Daniel S. Berman MD Piotr J. Slomka PhD 《Journal of nuclear cardiology》2012,19(3):482-491
Background
Hybrid PET/CT allows for acquisition of cardiac PET and coronary CT angiography (CCTA) in one session. However, PET and CCTA are acquired with differing breathing protocols and require software registration. We aimed to validate automatic correction for breathing misalignment between PET and CCTA acquired on hybrid scanner.Methods
Single-session hybrid PET/CT studies of rest/stress 13N-ammonia PET and CCTA in 32 consecutive patients were considered. Automated registration of PET left ventricular (LV) surfaces with CCTA volumes was evaluated by comparing with expert manual alignment by two observers.Results
The average initial misalignments between the position of LV on PET and CCTA were 27.2?±?11.8, 13.3?±?11.5, and 14.3?±?9.1?mm in x, y, and z axes on rest, and 26.3?±?10.2, 11.1?±?9.5, and 11.7?±?7.1?mm in x, y, and z axes on stress, respectively. The automated PET-CCTA co-registration had 95% agreement as judged visually. Compared with expert manual alignment, the translation errors of the algorithm were 5.3?±?2.8?mm (rest) and 6.0?±?3.5?mm (stress). 3D visualization of combined coronary vessel anatomy and hypoperfusion from PET could be made without further manual adjustments.Conclusion
Software co-registration of CCTA and PET myocardial perfusion imaging on hybrid PET/CT scanners is necessary, but can be performed automatically, facilitating integrated 3D display on PET/CT. 相似文献15.
Purpose
Since the introduction of 68Ga-PSMA-11 PET/CT for imaging prostate cancer (PC) we have frequently observed mediastinal lymph nodes (LN) showing tracer uptake despite being classified as benign. The aim of this evaluation was to further analyze such LN.Methods
Two patient groups with biphasic 68Ga-PSMA-11 PET/CT at 1 h and 3 h p.i. were included in this retrospective evaluation. Group A (n?=?38) included patients without LN metastases, and group B (n?=?43) patients with LN metastases of PC. SUV of mediastinal/paraaortal LN of group A (n?=?100) were compared to SUV of LN metastases of group B (n?=?91). Additionally, 22 randomly selected mediastinal and paraaortal LN of patients without PC were immunohistochemically (IHC) analyzed for PSMA expression.Results
In group A, 7/38 patients (18.4%) presented with at least one PSMA-positive mediastinal LN at 1 h p.i. and 3/38 (7.9%) positive LN at 3 h p.i. with a SUVmax of 2.3?±?0.7 at 1 h p.i. (2.0?±?0.7 at 3 h p.i.). A total of 11 PSMA-positive mediastinal/paraaortal LN were detected in nine patients considering both imaging timing points. SUVmax of LN-metastases was 12.5?±?13.2 at 1 h p.i. (15.8?±?17.0 at 3 h p.i.). SUVmax increased clearly (> 10%) between 1 h and 3 h p.i. in 76.9% of the LN metastases, and decreased significantly in 72.7% of the mediastinal/paraaortal LN. By IHC, PSMA-expression was observed in intranodal vascular endothelia of all investigated LN groups and to differing degrees within germinal centers of 15/22 of them (68.1%). Expression was stronger in mediastinal nodes (p?=?0.038) and when follicular hyperplasia was present (p?=?0.050).Conclusion
PSMA-positive mediastinal/paraaortal benign LN were visible in a notable proportion of patients. PSMA-positivity on the histopathological level was associated with the activation state of the LN. However, in contrast to LN metastases of PC, they presented with significantly lower uptake, which, in addition, usually decreased over time.16.
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17.
Tibor Vag Matthias M. Heck Ambros J. Beer Michael Souvatzoglou Gregor Weirich Konstantin Holzapfel Bernd Joachim Krause Markus Schwaiger Matthias Eiber Ernst J. Rummeny 《European radiology》2014,24(8):1821-1826
Purpose
To compare the diagnostic performance of DWI and 11C-choline PET/CT in the assessment of preoperative lymph node status in patients with primary prostate cancer.Material and methods
Thirty-three patients underwent DWI and 11C-choline PET/CT prior to prostatectomy and extended pelvic lymph node dissection. Mean standardised uptake value (SUVmean) and mean apparent diffusion coefficient (ADC) of 76 identified lymph nodes (LN) were measured and correlated with histopathology. ADC values and SUVs were compared using linear regression analysis.Results
A significant difference between benign and malignant LN was observed for ADC values (1.17 vs. 0.96?×?10-3 mm2/s; P?<?0.001) and SUVmean (1.61 vs. 3.20; P?<?0.001). ROC analysis revealed an optimal ADC threshold of 1.01?×?10-3 mm2/s for differentiating benign from malignant LN with corresponding sensitivity/specificity of 69.70 %/78.57 % and an area under the curve (AUC) of 0.785. The optimal threshold for SUVmean was 2.5 with corresponding sensitivity/specificity of 69.72 %/90.48 % and with an AUC of 0.832. ADC values and SUVmean showed a moderate significant inverse correlation (r?=?-0.63).Conclusion
Both modalities reveal similar moderate diagnostic performance for preoperative lymph node staging of prostate cancer, not justifying their application in routine clinical practice at this time. The only moderate inverse correlation between ADC values and SUVmean suggests that both imaging parameters might provide complementary information on tumour biology.Key Points
? Conventional imaging shows low performance for lymph node staging in prostate cancer. ? DWI and 11C-choline PET/CT both provide additional functional information ? Both functional modalities reveal only moderate diagnostic performance. 相似文献18.
Oliver Seitz Nicole Chambron-Pinho Markus Middendorp Rober Sader Martin Mack Thomas J. Vogl Sotirios Bisdas 《Neuroradiology》2009,51(10):677-686
Introduction
The purpose of this paper is to evaluate the impact of adding combined 18F-PET/CT to MRI for T and N staging of the oral and oropharyngeal cancer and calculation of the gross tumor volume (GTV) having histopathology as reference standard.Methods
PET/CT and MRI were performed in 66 patients with suspected oral and oropharyngeal cancer (41 primary tumors/25 recurrent tumors) and nodal disease (114 nodes). Statistical analysis included the McNemar test, sensitivity, specificity for the diagnostic modalities as well as regression analysis, and Bland–Altman graphs for calculated tumor volumes.Results
There was no statistically significant difference between the two modalities compared to pathological findings regarding detection of disease (P?≥?0.72). The sensitivity/specificity for tumor detection were 100/80% and 96.72/60% for MRI and PET/CT, respectively. The sensitivity/specificity for nodal metastases were 88.46/75% and 83.81/73.91% for MRI and PET/CT, respectively. In 18% of cases, the MRI-based T staging resulted in an overestimation of the pathologic tumor stage. The corresponding rate for PET/CT was 22%. Regarding the treated necks, both modalities showed 100% sensitivity for detection of the recurrent lesions. In necks with histologically N0 staging, MRI and PET/CT gave 22% and 26% false positive findings, respectively. The mean tumor volume in the pathologic specimen was 16.6?±?18.6 ml, the mean volume derived by the MR imaging was 17.6?±?19.1 ml while the estimated by PET/CT volume was 18.8?±?18.1 ml (P?≤?0.007 between the three methods). The Bland–Altman analysis showed a better agreement between PET/CT and MRI.Conclusion
The diagnostic performance of FDG-PET/CT in the local staging of oral cancer is not superior to MRI. 相似文献19.
Matthias Schmidt Elfriede Bollschweiler Markus Dietlein Stefan P. Mönig Carsten Kobe Daniel Vallboehmer Wolfgang Eschner Arnulf Hölscher Harald Schicha 《European journal of nuclear medicine and molecular imaging》2009,36(5):735-744
Purpose
To evaluate the potential of [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) for the assessment of histopathological response and survival after neoadjuvant radiochemotherapy in patients with oesophageal cancer.Patients and methods
In 2005 and 2006, 55 patients (43 men, 12 women; median age 60 years) with locally advanced oesophageal cancer (cT3-4 Nx M0; 24 with squamous cell carcinoma, 31 with adenocarcinoma) underwent transthoracic en bloc oesophagectomy after completion of treatment with cisplatin, 5-fluorouracil, and radiotherapy ad 36 Gy in a prospective clinical trial. Of the 55 patients, 21 (38%) were classified as histopathological responders (<10% vital residual tumour cells) and 34 (62%) as nonresponders. FDG-PET was performed before (PET 1) and 3–4 weeks after the end (PET 2) of radiochemotherapy with assessment of maximum and average standardized uptake values (SUV) for correlation with histopathological response and survival.Results
Histopathological responders had a slightly higher baseline SUV than nonresponders (p<0.0001 between PET 1 and PET 2 for responders and nonresponders) and the decrease was more prominent in responders. Except for SUVmax in patients with squamous cell carcinoma neither baseline nor preoperative SUV nor percent SUV reduction correlated significantly with histopathological response. Histopathological responders had a 2-year overall survival of 91?±?9% and nonresponders a survival of 53?±?10% (p?=?0.007).Conclusion
Our study does not support recent reports that FDG-PET predicts histopathological response and survival in patients with locally advanced oesophageal cancer treated by neoadjuvant radiochemotherapy.20.
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