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1.
Hongzan Sun Jun Xin Shaomin Zhang Qiyong Guo Yueyue Lu Wei Zhai Long Zhao Weiai Peng Baijun Wang 《European journal of nuclear medicine and molecular imaging》2014,41(5):898-905
Purpose
To evaluate the concordance among 18F-FDG PET imaging, MR T2-weighted (T2-W) imaging and apparent diffusion coefficient (ADC) maps with diffusion-weighted (DW) imaging in cervical cancer using hybrid whole-body PET/MR.Methods
This study prospectively included 35 patients with cervical cancer who underwent pretreatment 18F-FDG PET/MR imaging. 18F-FDG PET and MR images were fused using standard software. The percent of the maximum standardized uptake values (SUVmax) was used to contour tumours on PET images, and volumes were calculated automatically. Tumour volumes measured on T2-W and DW images were calculated with standard techniques of tumour area multiplied by the slice profile. Parametric statistics were used for data analysis.Results
FDG PET tumour volumes calculated using SUVmax (14.30?±?4.70) and T2-W imaging volume (33.81?±?27.32 cm3) were similar (P?>?0.05) at 35 % and 40 % of SUVmax (32.91?±?18.90 cm3 and 27.56?±?17.19 cm3 respectively) and significantly correlated (P?<?0.001; r?=?0.735 and 0.766). The mean DW volume was 30.48?±?22.41 cm3. DW volumes were not significantly different from FDG PET volumes at either 35 % SUVmax or 40 % SUVmax or from T2-W imaging volumes (P?>?0.05). PET subvolumes with increasing SUVmax cut-off percentage showed an inverse change in mean ADC values on DW imaging (P?<?0.001, ANOVA).Conclusion
Hybrid PET/MR showed strong volume concordance between FDG PET, and T2-W and DW imaging in cervical cancer. Cut-off at 35 % or 40 % of SUVmax is recommended for 18F-FDG PET/MR SUV-based tumour volume estimation. The linear tumour subvolume concordance between FDG PET and DW imaging demonstrates individual regional concordance of metabolic activity and cell density. 相似文献2.
Xiang Li Daniel Heber Ivo Rausch Dietrich Beitzke Marius E. Mayerhoefer Sazan Rasul Michael Kreissl Markus Mitthauser Wolfgang Wadsak Markus Hartenbach Alexander Haug Xiaoli Zhang Christian Loewe Thomas Beyer Marcus Hacker 《European journal of nuclear medicine and molecular imaging》2016,43(8):1503-1512
Purpose
PET with 18F-FDG has the potential to assess vascular macrophage metabolism. 18F-FDG is most often used in combination with contrast-enhanced CT to localize increased metabolism to specific arterial lesions. Novel 18F-FDG PET/MRI hybrid imaging shows high potential for the combined evaluation of atherosclerotic plaques, due to the superior morphological conspicuity of plaque lesions. The purpose of this study was to evaluate the reliability and accuracy of 18F-FDG PET/MRI uptake quantification compared to PET/CT as a reference standard in patients with carotid atherosclerotic plaques.Methods
The study group comprised 34 consecutive oncological patients with carotid plaques who underwent both PET/CT and PET/MRI with 18F-FDG on the same day. The presence of atherosclerotic plaques was confirmed by 3 T MRI scans. Maximum standardized uptake values (SUVmax) for carotid plaque lesions and the average SUV of the blood pool within the adjacent internal jugular vein were determined and target-to-blood ratios (TBRs, plaque to blood pool) were calculated.Results
Atherosclerotic lesions with maximum colocalized focal FDG uptake were assessed in each patient. SUVmax values of carotid plaque lesions were significantly lower on PET/MRI than on PET/CT (2.3?±?0.6 vs. 3.1?±?0.6; P?<?0.01), but were significantly correlated between PET/CT and PET/MRI (Spearman’s r?=?0.67, P?<?0.01). In contrast, TBRmax values of plaque lesions were similar on PET/MRI and on PET/CT (2.2?±?0.3 vs. 2.2?±?0.3; P?=?0.4), and again were significantly correlated between PET/MRI and PET/CT (Spearman’s r?=?0.73, P?<?0.01). Considering the increasing trend in SUVmax and TBRmax values from early to delayed imaging time-points on PET/CT and PET/MRI, respectively, with continuous clearance of radioactivity from the blood, a slight underestimation of TBRmax values may also be expected with PET/MRI compared with PET/CT.Conclusion
SUVmax and TBRmax values are widely accepted reference parameters for estimation of the radioactivity of atherosclerotic plaques on PET/CT. However, due to a systematic underestimation of SUVmax and TBRmax with PET/MRI, the optimal cut-off values indicating the presence of inflamed plaque tissue need to be newly defined for PET/MRI.3.
Axel Wetter Christine Lipponer Felix Nensa Philipp Heusch Herbert Rübben Jens-Christian Altenbernd Thomas Schlosser Andreas Bockisch Thorsten Pöppel Thomas Lauenstein James Nagarajah 《European journal of nuclear medicine and molecular imaging》2014,41(1):79-88
Purpose
The aim of this study was to evaluate the positron emission tomography (PET) component of [18F]choline PET/MRI and compare it with the PET component of [18F]choline PET/CT in patients with histologically proven prostate cancer and suspected recurrent prostate cancer.Methods
Thirty-six patients were examined with simultaneous [18F]choline PET/MRI following combined [18F]choline PET/CT. Fifty-eight PET-positive lesions in PET/CT and PET/MRI were evaluated by measuring the maximum and mean standardized uptake values (SUVmax and SUVmean) using volume of interest (VOI) analysis. A scoring system was applied to determine the quality of the PET images of both PET/CT and PET/MRI. Agreement between PET/CT and PET/MRI regarding SUVmax and SUVmean was tested using Pearson’s product-moment correlation and Bland-Altman analysis.Results
All PET-positive lesions that were visible on PET/CT were also detectable on PET/MRI. The quality of the PET images was comparable in both groups. Median SUVmax and SUVmean of all lesions were significantly lower in PET/MRI than in PET/CT (5.2 vs 6.1, p?<?0.05 and 2.0 vs 2.6, p?<?0.001, respectively). Pearson’s product-moment correlation indicated highly significant correlations between SUVmax of PET/CT and PET/MRI (R?=?0.86, p?<?0.001) as well as between SUVmean of PET/CT and PET/MRI (R?=?0.81, p?<?0.001). Bland-Altman analysis revealed lower and upper limits of agreement of ?2.77 to 3.64 between SUVmax of PET/CT vs PET/MRI and ?1.12 to +2.23 between SUVmean of PET/CT vs PET/MRI.Conclusion
PET image quality of PET/MRI was comparable to that of PET/CT. A highly significant correlation between SUVmax and SUVmean was found. Both SUVmax and SUVmean were significantly lower in [18F]choline PET/MRI than in [18F]choline PET/CT. Differences of SUVmax and SUVmean might be caused by different techniques of attenuation correction. Furthermore, differences in biodistribution and biokinetics of [18F]choline between the subsequent examinations and in the respective organ systems have to be taken into account. 相似文献4.
Linda Heijmen Lioe-Fee de Geus-Oei Johannes H. W. de Wilt Dimitris Visvikis Mathieu Hatt Eric P. Visser Johan Bussink Cornelis J. A. Punt Wim J. G. Oyen Hanneke W. M. van Laarhoven 《European journal of nuclear medicine and molecular imaging》2012,39(12):1858-1867
Purpose
Several studies showed potential for monitoring response to systemic therapy in metastatic colorectal cancer patients with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET). Before 18F-FDG PET can be implemented for response evaluation the repeatability should be known. This study was performed to assess the magnitude of the changes in standardized uptake value (SUV), volume and total lesion glycolysis (TLG) in colorectal liver metastases and validate the biological basis of 18F-FDG PET in colorectal liver metastases.Methods
Twenty patients scheduled for liver metastasectomy underwent two 18F-FDG PET scans within 1?week. Bland-Altman analysis was performed to assess repeatability of SUVmax, SUVmean, volume and TLG. Tumours were delineated using an adaptive threshold method (PETSBR) and a semiautomatic fuzzy locally adaptive Bayesian (FLAB) delineation method.Results
Coefficient of repeatability of SUVmax and SUVmean were ~39 and ~31?%, respectively, independent of the delineation method used and image reconstruction parameters. However, repeatability was worse in recently treated patients. The FLAB delineation method improved the repeatability of the volume and TLG measurements compared to PETSBR, from coefficients of repeatability of over 85?% to 45?% and 57?% for volume and TLG, respectively. Glucose transporter 1 (GLUT1) expression correlated to the SUVmean. Vascularity (CD34 expression) and tumour hypoxia (carbonic anhydrase IX expression) did not correlate with 18F-FDG PET parameters.Conclusion
In conclusion, repeatability of SUVmean and SUVmax was mainly affected by preceding systemic therapy. The repeatability of tumour volume and TLG could be improved using more advanced and robust delineation approaches such as FLAB, which is recommended when 18F-FDG PET is utilized for volume or TLG measurements. Improvement of repeatability of PET measurements, for instance by dynamic PET scanning protocols, is probably necessary to effectively use PET for early response monitoring. 相似文献5.
Purpose
Head and neck soft tissue sarcoma (HNSTS) is a rare type of tumor with various histological presentations and clinical behaviors. 18F-FDG PET/CT is being increasingly used for staging, grading, and predicting treatment outcomes in various types of human cancers, although this modality has been rarely studied in the survival prediction of HNSTS. Here we examined the prognostic value of tumor metabolic parameters measured using 18F-FDG PET/CT in patients with HNSTS.Methods
This study included 36 consecutive patients with HNSTS who underwent 18F-FDG PET/CT scanning prior to treatment at our institution. Tumor gross total volume (GTV) was measured from pretreatment contrast-enhanced CT scans, and maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured using pretreatment 18F-FDG PET/CT scans. Univariate and multivariate Cox proportional hazard regression analyses were used to identify associations between imaging parameters and disease-specific survival (DSS) or overall survival (OS).Results
Univariate analyses showed that SUVmax, MTV, and TLG, but not GTV, were significantly associated with DSS and OS (all P?<?0.05). After controlling for clinicopathological factors, SUVmax, MTV, and TLG were significantly associated with DSS and OS (all P?<?0.05). Patients with a tumor SUVmax value of >7.0 experienced an approximately fivefold increase in mortality in terms of DSS and OS relative to those with a tumor SUVmax <7.0.Conclusion
Quantitative metabolic measurements on pretreatment 18F-FDG PET/CT can yield values that are significantly predictive of survival after treatment for HNSTS.6.
Thomas de Perrot Olivier Rager Max Scheffler Martin Lord Marc Pusztaszeri Christophe Iselin Osman Ratib Jean-Paul Vallee 《European journal of nuclear medicine and molecular imaging》2014,41(9):1744-1755
Purpose
To report the first results of hybrid 18F-fluorocholine PET/MRI imaging for the detection of prostate cancer.Methods
This analysis included 26 consecutive patients scheduled for prostate PET/MRI before radical prostatectomy. The examinations were performed on a hybrid whole-body PET/MRI scanner. The MR acquisitions which included T2-weighted, diffusion-weighted and dynamic contrast-enhanced sequences were followed during the same session by whole-body PET scans. Parametric maps were constructed to measure normalized T2-weighted intensity (nT2), apparent diffusion coefficient (ADC), volume transfer constant (K trans), extravascular extracellular volume fraction (v e) and standardized uptake values (SUV). With pathology as the gold standard, ROC curves were calculated using logistic regression for each parameter and for the best combination with and without PET to obtain a MR model versus a PETMR model.Results
Of the 26 patients initially selected, 3 were excluded due to absence of an endorectal coil (2 patients) or prosthesis artefacts (1 patient). In the whole prostate, the area under the curve (AUC) for SUVmax, ADC, nT2, K trans and v e were 0.762, 0.756, 0.685, 0.611 and 0.529 with a best threshold at 3.044 for SUVmax and 1.075 × 10?3 mm2/s for ADC. The anatomical distinction between the transition zone and the peripheral zone showed the potential of the adjunctive use of PET. In the peripheral zone, the AUC of 0.893 for the PETMR model was significantly greater (p?=?0.0402) than the AUC of 0.84 for the MR model only. In the whole prostate, no relevant correlation was observed between ADC and SUVmax. The SUVmax was not affected by the Gleason score.Conclusion
The performance of a hybrid whole-body 18F-fluorocholine PET/MRI scan in the same session combined with a prostatic MR examination did not interfere with the diagnostic accuracy of the MR sequences. The registration of the PET data and the T2 anatomical MR sequence data allowed precise localization of hypermetabolic foci in the prostate. While in the transition zone the adenomatous hyperplasia interfered with cancer detection by PET, the quantitative analysis tool performed well for cancer detection in the peripheral zone. 相似文献7.
Hyo Sang Lee Jungsu S. Oh Young Soo Park Se Jin Jang Ik Soo Choi Jin-Sook Ryu 《Annals of nuclear medicine》2016,30(4):309-319
Objective
We aimed to explore the ability of textural heterogeneity indices determined by 18F-FDG PET/CT for grading the malignancy of thymic epithelial tumors (TETs).Methods
We retrospectively enrolled 47 patients with pathologically proven TETs who underwent pre-treatment 18F-FDG PET/CT. TETs were classified by pathological results into three subgroups with increasing grades of malignancy: low-risk thymoma (LRT; WHO classification A, AB and B1), high-risk thymoma (B2 and B3), and thymic carcinoma (TC). Using 18F-FDG PET/CT, we obtained conventional imaging indices including SUVmax and 20 intratumoral heterogeneity indices: i.e., four local-scale indices derived from the neighborhood gray-tone difference matrix (NGTDM), eight regional-scale indices from the gray-level run-length matrix (GLRLM), and eight regional-scale indices from the gray-level size zone matrix (GLSZM). Area under the receiver operating characteristic curve (AUC) was used to demonstrate the abilities of the imaging indices for differentiating subgroups. Multivariable logistic regression analysis was performed to show the independent significance of the textural indices. Combined criteria using optimal cutoff values of the SUVmax and a best-performing heterogeneity index were applied to investigate whether they improved differentiation between the subgroups.Results
Most of the GLRLM and GLSZM indices and the SUVmax showed good or fair discrimination (AUC >0.7) with best performance for some of the GLRLM indices and the SUVmax, whereas the NGTDM indices showed relatively inferior performance. The discriminative ability of some of the GLSZM indices was independent from that of SUVmax in multivariate analysis. Combined use of the SUVmax and a GLSZM index improved positive predictive values for LRT and TC.Conclusions
Texture analysis of 18F-FDG PET/CT scans has the potential to differentiate between TET tumor grades; regional-scale indices from GLRLM and GLSZM perform better than local-scale indices from the NGTDM. The SUVmax and heterogeneity indices may have complementary value in differentiating TET subgroups.8.
Sergios Gatidis Holger Schmidt Christian la Fougère Konstantin Nikolaou Nina F. Schwenzer Jürgen F. Schäfer 《European journal of nuclear medicine and molecular imaging》2016,43(13):2283-2289
Purpose
To explore the feasibility of reducing administered tracer activities and to assess optimal activities for combined 18F-FDG-PET/MRI in pediatric oncology.Methods
30 18F-FDG-PET/MRI examinations were performed on 24 patients with known or suspected solid tumors (10 girls, 14 boys, age 12?±?5.6 [1–18] years; PET scan duration: 4 min per bed position). Low-activity PET images were retrospectively simulated from the originally acquired data sets using randomized undersampling of list mode data. PET data of different simulated administered activities (0.25–2.5 MBq/kg body weight) were reconstructed with or without point spread function (PSF) modeling. Mean and maximum standardized uptake values (SUVmean and SUVmax) as well as SUV variation (SUVvar) were measured in physiologic organs and focal FDG-avid lesions. Detectability of organ structures and of focal 18F-FDG-avid lesions as well as the occurrence of false-positive PET lesions were assessed at different simulated tracer activities.Results
Subjective image quality steadily declined with decreasing tracer activities. Compared to the originally acquired data sets, mean relative deviations of SUVmean and SUVmax were below 5 % at 18F-FDG activities of 1.5 MBq/kg or higher. Over 95 % of anatomic structures and all pathologic focal lesions were detectable at 1.5 MBq/kg 18F-FDG. Detectability of anatomic structures and focal lesions was significantly improved using PSF. No false-positive focal lesions were observed at tracer activities of 1 MBq/kg 18F-FDG or higher. Administration of 18F-FDG activities of 1.5 MBq/kg is, thus, feasible without obvious diagnostic shortcomings, which is equivalent to a dose reduction of more than 50 % compared to current recommendations.Conclusion
Significant reduction in administered 18F-FDG tracer activities is feasible in pediatric oncologic PET/MRI. Appropriate activities of 18F-FDG or other tracers for specific clinical questions have to be further established in selected patient populations.9.
Kyoichi Kaira Masahiro Endo Koiku Asakura Asuka Tsuya Yukiko Nakamura Tateaki Naito Haruyasu Murakami Toshiaki Takahashi Nobuyuki Yamamoto 《Annals of nuclear medicine》2010,24(10):697-705
Background
The maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG PET) within the primary tumor may predict outcome in patients with surgically resected non-small cell lung cancer (NSCLC). However, it remains uncertain whether the SUVmax of the primary tumor predicts outcome after chemotherapy in advanced NSCLC. Thus, we evaluated the ratio of SUVmax of the metastatic tumor to the primary tumor (M/P ratio) to determine whether it could be a useful marker in predicting response and outcome after chemotherapy in advanced NSCLC. 相似文献10.
Byung Hyun Byun Woo Chul Noh Ilhan Lim Seung Sook Lee A. Ra Cho Ji Ae Park Kyeong Min Kim Hyun-Ah Kim Eun-Kyu Kim Byung Il Kim Chang Woon Choi Sang Moo Lim 《Annals of nuclear medicine》2013,27(8):720-728
Objective
The aim of this study was to measure the apparent diffusion coefficient (ADC) value at the region with the highest FDG uptake using sequential 18F-FDG PET and MRI, and to correlate it with the histological grade of invasive ductal carcinoma (IDC) of the breast.Methods
A retrospective study was conducted on 75 untreated patients with IDC. First, a PET/CT scan and subsequent breast MRI were done and the SUVmax of the each breast tumor was recorded. Then, a PET image and ADC map were co-registered. On the axial slice containing the pixel with SUVmax, we drew multiple circular ROIs within the tumor and measured the mean ADC value of each ROI. The average (ADC-mean) and minimum (ADC-min) of the mean ADC values for all ROIs within the tumor were calculated, respectively. Then, a circular ROI was placed at the corresponding location to the pixel with the highest SUV and the mean ADC value of the ROI was denoted as ADC-PET. We compared the averages of the ADC parameters and assessed the correlations among SUVmax and ADC parameters. ROC curve and logistic regression analyses were performed to assess the utility of ADC and SUVmax for detecting histological grade 3.Results
ADC-min was significantly lower than the ADC-mean or ADC-PET. All of the ADC parameters showed a negative correlation with SUVmax. The area under the ROC curve for identifying histological grade 3 using ADC-PET, ADC-min, ADC-mean and SUVmax was 0.684, 0.660, 0.633 and 0.639, respectively. By multivariate analysis, ADC-PET was a significant, independent predictor of histological grade 3 (p = 0.004).Conclusions
We estimated the ADC value at the breast tumor region with the highest FDG uptake using sequential 18F-FDG PET and MRI. This new ADC parameter distinguished high-grade IDC, supporting the feasibility of the combined PET-MRI system in patients with breast cancer. 相似文献11.
Domenico Albano Giovanni Bosio Raffaele Giubbini Francesco Bertagna 《Japanese journal of radiology》2017,35(10):574-583
Purpose
Langerhans cell histiocytosis (LCH) is a rare hematological disorder for which the utility of18F-FDG PET/CT is unclear. Our aim was to explore the metabolic features of LCH and the possible role of18F-FDG PET/CT in LCH evaluation.Materials and methods
We found 17 patients with histologically proven LCH who underwent 1718F-FDG PET/CT scans for staging and 42 scans for restaging/follow-up purposes. PET/CT results were compared with those obtained from other conventional imaging modalities (bone scintigraphy, plain radiogram, computed tomography, magnetic resonance).Results
18F-FDG PET/CT was positive in 15/17 patients, and it detected 36/37 lesions; all bone and extraskeletal lesions, except for a cecal lesion, were18F-FDG-avid. Only 1/4 of the patients with lung LCH had hypermetabolic lesions. The average SUVmax of the FDG-avid lesions was 7.3 ± 6.7, the average lesion-to-liver SUVmax ratio was 3.4 ± 2.5, and the average lesion-to-blood pool SUVmax ratio was 4 ± 3.2. In comparison to other imaging methods,18F-FDG PET/CT detected additional lesions or was able to evaluate treatment response earlier in 33/74 cases; it was confirmatory in 38/74 and detected fewer lesions in 3/74 (all three with lung LCH).Conclusions
18F-FDG PET/CT seems to be useful for evaluating LCH when compared to conventional imaging, except in pulmonary cases. It can be used both for staging and restaging purposes.12.
Chieh Lin Chi-Lai Ho Shu-Hang Ng Po-Nan Wang Yenlin Huang Yu-Chun Lin Tzung-Chih Tang Shu-Fan Tsai Alain Rahmouni Tzu-Chen Yen 《European journal of nuclear medicine and molecular imaging》2014,41(1):41-49
Purpose
We investigated the potential value of 11C-acetate (ACT) PET/CT in characterizing multiple myeloma (MM) compared with 18F-FDG PET/CT. Bone marrow histological and whole-body (WB) MRI findings served as the reference standards.Methods
In this prospective study, 15 untreated MM patients (10 men and 5 women, age range 48?69 years) underwent dual-tracer 11C-ACT and 18F-FDG PET/CT and WB MRI for pretreatment staging, and 13 of them had repeated examinations after induction therapy. Diffuse and focal bone marrow uptake was assessed by visual and quantitative analyses, including measurement of the maximum standardized uptake value (SUVmax). Between-group differences and correlations were assessed with the Mann-Whitney U test and the Pearson test.Results
At staging, all 15 patients had diffuse myeloma involvement upon bone marrow examination with 30–90 % of plasma cell infiltrates. Diffuse infiltration was detected in all of them (100 %) using 11C-ACT with a positive correlation between bone marrow uptake values and percentages of plasma cell infiltrates (r = +0.63, p?=?0.01). In contrast, a diagnosis of diffuse infiltration could be established using 18F-FDG in only six patients (40 %). Focal lesions were shown in 13 patients on both 11C-ACT PET/CT and WB MRI, and in 10 patients on 18F-FDG PET/CT. Focal lesions demonstrated 11C-ACT uptake with a mean SUVmax of 11.4 ± 3.3 (range 4.6?19.6, n?=?59), which was significantly higher than the 18F-FDG uptake (mean SUVmax 6.6 ± 3.1, range 2.3?13.7, n?=?29; p?<?0.0001). After treatment, the diffuse bone marrow 11C-ACT uptake showed a mean SUVmax reduction of 66 % in patients with at least a very good partial response versus 34 % in those with at most a partial response only (p?=?0.01).Conclusion
PET/CT using 11C-ACT as a biomarker showed a higher detection rate for both diffuse and focal myeloma lesions at diagnosis than using 18F-FDG, and may be valuable for response assessment. 相似文献13.
Lee JW Lee SM Lee MS Shin HC 《European journal of nuclear medicine and molecular imaging》2012,39(9):1425-1434
Purpose
The study evaluated the role of preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT in the prediction of recurrent gastric cancer after curative surgical resection.Methods
A total of 271 patients with gastric cancer who underwent 18F-FDG PET/CT and subsequent curative surgical resection were enrolled. All patients underwent follow-up for cancer recurrence with a mean duration of 24?±?12?months. 18F-FDG PET/CT images were visually assessed and, in patients with positive 18F-FDG cancer uptake, the maximum standardized uptake value (SUVmax) of cancer lesions was measured. 18F-FDG PET/CT findings were tested as prognostic factors for cancer recurrence and compared with conventional prognostic factors. Furthermore, 18F-FDG PET/CT findings were assessed as prognostic factors according to histopathological subtypes.Results
Of 271 patients, 47 (17?%) had a recurrent event. Positive 18F-FDG cancer uptake was shown in 149 patients (55?%). Tumour size, depth of invasion, presence of lymph node metastasis, positive 18F-FDG uptake and SUVmax were significantly associated with tumour recurrence in univariate analysis, while only depth of invasion, positive 18F-FDG uptake and SUVmax had significance in multivariate analysis. The 24-month recurrence-free survival rate was significantly higher in patients with negative 18F-FDG uptake (95?%) than in those with positive 18F-FDG uptake (74?%; p?0.0001). In subgroup analysis, 18F-FDG uptake was a significant prognostic factor in patients with tubular adenocarcinoma (p?=?0.003) or poorly differentiated adenocarcinoma (p?=?0.0001). However, only marginal significance was shown in patients with signet-ring cell carcinoma and mucinous carcinoma (p?=?0.05).Conclusion
18F-FDG uptake of gastric cancer is an independent and significant prognostic factor for tumour recurrence. 18F-FDG PET/CT could provide effective information on the prognosis after surgical resection of gastric cancer, especially in tubular adenocarcinoma and poorly differentiated adenocarcinoma. 相似文献14.
J H Rasmussen B M Fischer M C Aznar A E Hansen I R Vogelius J L?fgren F L Andersen A Loft A Kjaer L H?jgaard L Specht 《The British journal of radiology》2015,88(1048)
Objective:
To investigate reproducibility of fluorine-18 fludeoxyglucose (18F-FDG) uptake on 18F-FDG positron emission tomography (PET)/CT and 18F-FDG PET/MR scans in patients with head and neck squamous cell carcinoma (HNSCC).Methods:
30 patients with HNSCC were included in this prospective study. The patients were scanned twice before radiotherapy treatment with both PET/CT and PET/MR. Patients were scanned on the same scanners, 3 days apart and according to the same protocol. Metabolic tumour activity was measured by the maximum and peak standardized uptake value (SUVmax and SUVpeak, respectively), and total lesion glycolysis from the metabolic tumour volume defined from ≥50% SUVmax. Bland–Altman analysis with limits of agreement, coefficient of variation (CV) from the two modalities were performed in order to test the reproducibility. Furthermore, CVs from SUVmax and SUVpeak were compared. The area under the curve from cumulative SUV–volume histograms were measured and tested for reproducibility of the distribution of 18F-FDG uptake.Results:
24 patients had two pre-treatment PET/CT scans and 21 patients had two pre-treatment PET/MR scans available for further analyses. Mean difference for SUVmax, peak and mean was approximately 4% for PET/CT and 3% for PET/MR, with 95% limits of agreement less than ±20%. CV was small (5–7%) for both modalities. There was no significant difference in CVs between PET/CT and PET/MR (p = 0.31). SUVmax was not more reproducible than SUVpeak (p = 0.09).Conclusion:
18F-FDG uptake in PET/CT and PET/MR is highly reproducible and we found no difference in reproducibility between PET/CT and PET/MR.Advances in knowledge:
This is the first report to test reproducibility of PET/CT and PET/MR.Functional imaging with fluorine-18 fludeoxyglucose positron emission tomography combined with CT (18F-FDG PET/CT) has been shown to be useful for prognostication of head and neck squamous cell carcinoma (HNSCC),1–3 and the use of 18F-FDG PET/CT has also been shown to reduce interobserver variability in target delineation for radiotherapy.4,5 Furthermore, 18F-FDG PET/CT can identify regions of the tumour with a high risk of relapse, leading to the idea that 18F-FDG uptake might be a target for dose painting.6,7 Finally, 18F-FDG PET/CT may be used in response evaluation.8,9 Maximum standardized uptake value (SUVmax) has for many years been the main uptake measurement in prognostic studies for various malignancies. More recent studies have focused on demonstrating prognostic value of PET/CT-based volumetric parameters such as metabolic tumour volume (MTV) and total lesion glycolysis (TLG). MTV is the sum of the volume of voxels with standard uptake value (SUV) exceeding a certain threshold value in a tumour, and TLG is calculated by multiplying MTV and the mean standardized uptake value (SUVmean) of the MTV. These volume-based PET parameters have increasingly gained interest and have been reported to be significant prognostic factors for various malignancies including HNSCC.10–13 18F-FDG PET/CT is currently not routinely recommended as a diagnostic tool in HNSCC except in very specific situations,14 but reproducibility of the 18F-FDG signal is a prerequisite for a more widespread use of 18F-FDG PET for the above-mentioned indications. Yet, only a few studies of the reproducibility of 18F-FDG PET/CT exist8,15–21 and none of these studies includes patients with HNSCC.MRI is gaining acceptance as an imaging modality for oncology as it offers superior soft-tissue contrast compared with CT alone, and it has been suggested that information from PET/CT and MR is complementary in head and neck cancer.22 The introduction of the integrated PET/MR scanner offers a unique opportunity to combine the high soft-tissue contrast of MR with the functional imaging from PET within a single imaging session. PET/MR is still in its infancy, but the combined modality imaging is potentially useful in the management of patients with HNSCC.22–28 However, the same criteria of reproducibility as with PET/CT should be upheld by this new modality. The purpose of this prospective test–retest study is to assess the reproducibility of both 18F-FDG PET/CT and 18F-FDG PET/MR in a homogenous cohort of patients with HNSCC. 相似文献15.
Rania E. Mohamed Mohamad F. Sherif Mohamed A. Amin 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(3):764-775
Aim of the work
To evaluate the diagnostic reliability of qualitative and quantitative data of 18F-FDG PET/CT scanning in the identification and differentiation of adrenal incidentalomas discovered in cancer patients.Materials and methods
Forty-five consecutive cancer patients (24 males and 21 females), with 54 discovered adrenal incidentalomas, were subjected to whole-body 18F-FDG PET/CT scanning protocol. For each adrenal nodule, the adrenal SUVmax, SUVavg, T/L SUVratio and activity scores were estimated.Results
Most of the detected adrenal incidentalomas were benign (61.82%), and unilateral (77.8%). The mean T/L SUVratio was significantly higher in malignant compared to benign incidentalomas (P?<?0.001). Most of benign incidentalomas had activity score 1 (60%), while, most of malignant incidentalomas had activity score 3 (62.5%). The ROC curves analyses of 18F-FDG PET/CT in the studied adrenal incidentalomas revealed that, for identification of malignant lesions, the T/L SUVratio at cut-off value >1.60 showed the highest accuracy (99.09%) sensitivity (97.1%) and specificity (100%).Conclusion
The quantitative (T/L SUVratio at cut-off value?>?1.60 and SUVmax at cut-off value?>?2.97) and qualitative (activity score of?≥?2) analytic data obtained by 18F-FDG PET/CT can be considered as powerful parameters for identification and differentiation of adrenal incidentalomas in cancer patients. 相似文献16.
Yu-Erh Huang Yu-Jie Huang Mary Ko Chien-Chin Hsu Chih-Feng Chen 《Annals of nuclear medicine》2016,30(9):652-658
Objective
Granulomatous diseases (GDs) can be metabolically active and indistinguishable from lung cancer on 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) imaging. Evaluation of solitary pulmonary lesions remains a diagnostic challenge in regions with endemic GD. This study sought to determine the efficacy of dual-time-point (DTP) 18F-FDG PET/computed tomography (CT) imaging in diagnosing solitary pulmonary lesions from such regions.Methods
A total of 50 patients with solitary pulmonary nodules or masses with confirmed histopathological diagnoses underwent DTP 18F-FDG PET/CT imaging at 1 and 3 h after tracer injection. The maximum standardized uptake value (SUVmax) on early and delayed scans (SUV1h and SUV3h, respectively) and retention index (RI) were calculated for each pulmonary lesion. Receiver operating characteristic analysis was performed to evaluate the discriminating validity of the parameters.Results
There were 37 malignant and 13 benign solitary pulmonary lesions. Eight of the 13 (62 %) benign lesions were GDs. The sensitivity/specificity/accuracy of SUV1h, SUV3h and RI were 84/69/80 %, 84/85/84 %, and 81/54/74 %, respectively. SUV3h had the best diagnostic performance, especially regarding specificity. The values of SUV1h and SUV3h were significantly different between malignant lesions and GD, while the RI values of malignant lesions and GD were both high (18.6 ± 19.5 and 18.7 ± 15.3 %, respectively; P = not significant).Conclusion
SUV3h appeared to improve the diagnostic specificity of 18F-FDG PET/CT in evaluating solitary pulmonary lesions from regions with endemic GD.17.
Johannes Salamon Thorsten Derlin Peter Bannas Jasmin D. Busch Jochen Herrmann Maximilian Bockhorn Christian Hagel Reinhard E. Friedrich Gerhard Adam Victor F. Mautner 《European journal of nuclear medicine and molecular imaging》2013,40(5):685-692
Purpose
The aim of the study was to evaluate the potential usefulness of intratumoural tracer uptake heterogeneity on 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT as compared to a cut-off maximum standardized uptake value (SUVmax) for characterization of peripheral nerve sheath tumours (PNSTs) in neurofibromatosis type 1 (NF1).Methods
Fifty patients suffering from NF1 were examined by 18F-FDG PET/CT. Intralesional tracer uptake was analysed qualitatively and semi-quantitatively by measuring the mean and maximum SUV. Uptake heterogeneity was graded qualitatively using a three-point scale and semi-quantitatively by calculating an SUV-based heterogeneity index (HISUV). Cohen’s κ was used to determine inter- and intra-rater agreement. Histopathological evaluation and clinical as well as radiological follow-up examinations served as the reference standards.Results
A highly significant correlation between the degree of intratumoural uptake heterogeneity on 18F-FDG PET and malignant transformation of PNSTs was observed (p?<?0.0001). Semi-quantitative HISUV was significantly higher in malignant PNSTs (MPNSTs) than in benign tumours (p?=?0.0002). Both intralesional heterogeneity and SUVmax could be used to identify malignant tumours with a sensitivity of 100 %. Cohen’s κ was 0.86 for inter-rater agreement and 0.88 for intra-rater agreement on heterogeneity.Conclusion
MPNSTs in patients with NF1 demonstrate considerable intratumoural uptake heterogeneity on 18F-FDG PET/CT. Assessment of tumour heterogeneity is highly reproducible. Both tumour heterogeneity and a cut-off SUVmax may be used to sensitively identify malignant PNSTs, but the specificity is higher for the latter. A combination of both methods leads to a non-significant improvement in diagnostic performance. 相似文献18.
Chae Hong Lim Seung Hyup Hyun Seung Hwan Moon Young Seok Cho Yearn Seong Choe Kyung-Han Lee Byung-Tae Kim Joon Young Choi 《Nuclear Medicine and Molecular Imaging》2017,51(3):247-251
Purpose
We investigated the incidence, location, and clinical significance of focal 18F-FDG uptake of the spinal cord in patients with cancer.Methods
We reviewed the medical records of 22,937 consecutive adult patients with known or suspicious malignancy who underwent 18F-FDG PET/CT. PET/CT scans with incidental focal spinal cord uptake were selected and retrospectively reviewed to determine the presence, location, number, and maximum standardized uptake value (SUVmax) of any focal hypermetabolic lesions of the spinal cord. In subjects with focal spinal uptake, clinical characteristics and clinical follow-up results, including follow-up PET/CT, were reviewed.Results
Incidental focal spinal cord uptake was observed in 69 of 22,937 adult patients (incidence?=?0.3%; M:F?=?31:38; age, 55.8?±?14.7 years). Seventy-eight focal hypermetabolic lesions on spinal cord in the PET/CT scans of the 69 study subjects were analyzed. The most common sites of focal spinal cord uptake were the T12 vertebra (47/78; 60.3%) and L1 vertebra (20/78; 25.6%). Multifocal cord uptake was found in 8 of 69 patients (11.6%). The average SUVmax for cord uptake was 2.5?±?0.5 (range, 1.4~3.9). There was no clinical or imaging evidence of abnormalities in the spinal cord, both at the time of PET/CT and during clinical follow-up.Conclusions
Although incidental focal 18F-FDG uptake of the spinal cord is rare in patients with cancer, it may be physiological or benign, but it should not be considered as malignant involvement. Common sites for the uptake were in the T12 and L1 spine levels.19.
Xiaohui Luan Yong Huang Song Gao Xiaorong Sun Suzhen Wang Li Ma Xuepeng Teng Hong Lu Jinming Yu Shuanghu Yuan 《European journal of nuclear medicine and molecular imaging》2016,43(13):2336-2342
Purpose
The study aims to investigate the role of 18F-alfatide positron emission tomography/computed tomography (PET/CT) in predicting the short-term outcome of concurrent chemoradiotherapy (CCRT) in patients with advanced non-small cell lung cancer (NSCLC).Methods
Eighteen patients with advanced NSCLC had undergone 18F-alfatide PET/CT scans before CCRT and PET/CT parameters including maximum and mean standard uptake values (SUVmax/SUVmean), peak standard uptake values (SUVpeak) and tumor volume (TVPET and TVCT) were obtained. The SUVmax of tumor and normal tissues (lung, blood pool and muscle) were measured, and their ratios were denoted as T/NT (T/NTlung, T/NTblood and T/NTmuscle). Statistical methods included the Two-example t test, Wilcoxon rank-sum test, Receiver-operating characteristic (ROC) curve analysis and logistic regression analyses.Results
We found that SUVmax, SUVpeak, T/NTlung, T/NTblood and T/NTmuscle were higher in non-responders than in responders (P?=?0.0024, P?=?0.016, P?<?0.001, P?=?0.003, P?=?0.004). According to ROC curve analysis, the thresholds of SUVmax, SUVpeak, T/NTlung, T/NTblood and T/NTmuscle were 5.65, 4.46, 7.11, 5.41, and 11.75, respectively. The five parameters had high sensitivity, specificity and accuracy in distinguishing non-responders and responders. Multivariate logistic regression analyses showed that T/NTlung was an independent predictor of the short-term outcome of CCRT in patients with advanced NSCLC (P?=?0.032).Conclusions
18F-alfatide PET/CT may be useful in predicting the short-term outcome of CCRT in patients with advanced NSCLC.20.
Christos Sachpekidis Hartmut Goldschmidt Dirk Hose Leyun Pan Caixia Cheng Klaus Kopka Uwe Haberkorn Antonia Dimitrakopoulou-Strauss 《European journal of nuclear medicine and molecular imaging》2014,41(7):1343-1353