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1.
Kobe C Scheffler M Holstein A Zander T Nogova L Lammertsma AA Boellaard R Neumaier B Ullrich RT Dietlein M Wolf J Kahraman D 《European journal of nuclear medicine and molecular imaging》2012,39(7):1117-1127
Purpose
To evaluate the predictive value of early and late residual 18F-fluorodeoxyglucose (FDG) and 18F-fluorothymidine (FLT) uptake using different SUV measurements in PET in patients with advanced non-small-cell lung cancer (NSCLC) treated with erlotinib.Methods
We retrospectively reviewed data from 30 patients with untreated stage IV NSCLC who had undergone a combined FDG PET and FLT PET scan at 1?week (early) and 6?weeks (late) after the start of erlotinib treatment. Early and late residual FDG and FLT uptake were measured in up to five lesions per scan with different quantitative standardized uptake values (SUVmax, SUV2Dpeak, SUV3Dpeak, SUV50, SUVA50, SUVA41) and compared with short-term outcome (progression vs. nonprogression after 6?weeks of erlotinib treatment). Receiver-operating characteristics (ROC) curve analysis was used to determine the optimal cut-off value for detecting nonprogression after 6?weeks. Kaplan-Meier analysis and the log-rank test were used to evaluate the association between residual uptake and progression-free survival (PFS).Results
Nonprogression after 6?weeks was associated with a significantly lower early and late residual FDG uptake, measured with different quantitative parameters. In contrast, nonprogression after 6?weeks was not associated with early and late residual FLT uptake. Furthermore, patients with a lower early residual FDG uptake measured in terms of SUVmax and SUV2Dpeak had a significantly prolonged PFS (282?days vs. 118?days; p?=?0.022) than patients with higher values. Similarly, lower late residual FDG uptake and early residual FLT uptake measured in terms of SUV3Dpeak, SUVA50 and SUVA41, and late FLT uptake measured in terms of SUV3Dpeak and SUVA50 was associated with an improved PFS.Conclusion
Early and late residual FDG uptake, measured using different quantitative SUV parameters, are predictive factors for short-term outcome in patients with advanced NSCLC treated with erlotinib. Additionally, low residual FDG and FLT uptake early and late in the course of erlotinib treatment is associated with improved PFS. 相似文献2.
Groheux D Giacchetti S Moretti JL Porcher R Espié M Lehmann-Che J de Roquancourt A Hamy AS Cuvier C Vercellino L Hindié E 《European journal of nuclear medicine and molecular imaging》2011,38(3):426-435
Purpose
The aim of this study was to determine the impact of the main clinicopathological and biological prognostic factors of breast cancer on 18F-fluorodeoxyglucose (FDG) uptake. Only women with tumours larger than 20?mm (T2?CT4) were included in order to minimize bias of partial volume effect.Methods
In this prospective study, 132 consecutive women received FDG PET/CT imaging before starting neoadjuvant chemotherapy. Maximum standardized uptake values (SUVmax) were compared to tumour characteristics as assessed on core biopsy.Results
There was no influence of T and N stage on SUV. Invasive ductal carcinoma showed higher SUV than lobular carcinoma. However, the highest uptake was found for metaplastic tumours, representing 5% of patients in this series. Several biological features usually considered as bad prognostic factors were associated with an increase in FDG uptake: the median of SUVmax was 9.7 for grade 3 tumours vs 4.8 for the lower grades (p?0.0001); negativity for oestrogen receptors (ER) was associated with higher SUV (ER+?SUV?=?5.5; ER? SUV?=?7.6; p?=?0.003); triple-negative tumours (oestrogen and progesterone receptor negative, no overexpression of c-erbB-2) had an SUV of 9.2 vs 5.8 for all others (p = 0005); p53 mutated tumours also had significantly higher SUV (7.8 vs 5.0; p?0.0001). Overexpression of c-erbB-2 had no effect on the SUV value.Conclusion
Knowledge of the factors influencing uptake is important when interpreting FDG PET/CT scans. Also, findings that FDG uptake is highest in those patients with poor prognostic features (high grade, hormone receptor negativity, triple negativity, metaplastic tumours) is helpful to determine who are the best candidates for baseline staging. 相似文献3.
Byun BH Jeong UG Hong SP Min JJ Chong A Song HC Bom HS 《Annals of nuclear medicine》2012,26(6):471-477
Purpose
The presence of central lymph node (LN) metastasis increases the risk of cervical LN recurrence or distant metastasis in patients with papillary thyroid microcarcinoma (PTMC). We investigated the value of preoperative 18F-fluoro-2-deoxy-d-glucose-positron emission tomography (FDG PET)?Ccomputerized tomography (CT) and ultrasonography (US) to predict central LN metastasis from PTMC.Patients and methods
Two hundred patients with newly diagnosed unifocal PTMC were enrolled. Preoperative FDG PET?CCT was performed, and the highest SUV (SUVmax) of focally increased uptake at thyroid was measured. Tumor size was measured using preoperative US. Uni- and multivariate analyses were performed using the presence of focally increased uptake at thyroid (FDG positivity), SUVmax, tumor size, and clinical risk factor for central LN metastasis. ROC curves for risk factors were then analyzed. These analyses were undertaken in two groups: the all patients group and the FDG-positive group. Finally, we combined risk factors associated with central LN metastasis to improve predictive accuracy.Results
Tumor size >6?mm was associated with central LN metastasis. FDG positivity was identified in 110 patients (55.0?%) and the SUVmax ranged from 1.8 to 12.8 (median 3.0). In FDG-positive group, SUVmax >2.8 was associated with central LN metastasis. Addition of SUVmax >2.8 to size >6?mm of PTMC improved sensitivity of predicting central LN metastasis from 55.0 to 67.5?%, while specificity remained at 70.6?%.Conclusion
Both FDG PET?CCT and US are valuable for preoperative prediction of central LN metastasis from PTMC. Combined use of SUVmax and tumor size improves sensitivity without changing specificity. 相似文献4.
M.G. Caprio A. Cangiano M. Imbriaco F. Soscia G. Di Martino A. Farina G. Avitabile L. Pace P. Forestieri M. Salvatore 《La Radiologia medica》2010,115(2):215-224
Purpose
The authors sought to evaluate whether the reacquisition of images 3 h after administration of radiotracer improves the sensitivity of fluorine-18 fluorodeoxyglucose positron emission tomography computed tomography ([18F]-FDG PET/CT) in patients with suspicious breast lesions.Materials and methods
Forty-eight patients with 59 breast lesions underwent an [18F]-FDG PET/CT study in the prone position with a dual-time-point acquisition performed in the early phase 1 h after FDG administration (PET-1) and in the delayed phase 3 h after FDG administration (PET-2). Both examinations were evaluated qualitatively and semiquantitatively with calculation of the mean percentage variation of the standard uptake values (Δ% SUVmax) between PET-1 and PET-2. All lesions with an SUVmax ≥2.5 at PET-1 or a reduction in SUV between PET-1 and PET-2 were considered benign. The definitive histopathological diagnosis was available for all patients included in the study.Results
The dual-time-point acquisition of [18F]-FDG PET/CT displayed an accuracy of 85% for lesions with an SUVmax ≥2.5 and/or positive Δ% SUVmax, with sensitivity and specificity values of 81% and 100% compared with 69%, 63% (both p<0.001) and 100% (p=n.s.), respectively, for the single-time-point acquisition. Malignant lesions showed an increase in FDG uptake between PET-1 and PET-2, with a Δ% SUVmax of 10±7 (p<0.04). In contrast, benign lesions showed a decrease in SUV between PET-1 and PET-2, with aΔ% SUVmax of ?21±7 (p<0.001).Conclusions
The delayed repeat acquisition of PET images improves the accuracy of [18F]-FDG PET/CT in patients with suspicious breast lesions with respect to the single-time-point acquisition. In addition, malignant breast lesions displayed an increase in FDG uptake over time, whereas benign lesions showed a reduction. These variations in FDG uptake between PET-1 and PET-2 are a reliable parameter that can be used for differentiating between benign and malignant breast lesions. 相似文献5.
B. B. Koolen M. J. T. F. D. Vrancken Peeters J. Wesseling E. H. Lips W. V. Vogel T. S. Aukema E. van Werkhoven K. G. A. Gilhuijs S. Rodenhuis E. J. Th. Rutgers R. A. Valdés Olmos 《European journal of nuclear medicine and molecular imaging》2012,39(12):1830-1838
Purpose
The aim of this study was to evaluate the association of primary tumour 18F-fluorodeoxyglucose (FDG) uptake with clinical, histopathological and molecular characteristics of breast cancer patients scheduled for neoadjuvant chemotherapy. Second, we wished to establish for which patients pretreatment positron emission tomography (PET)/CT could safely be omitted because of low FDG uptake.Methods
PET/CT was performed in 214 primary stage II or III breast cancer patients in the prone position with hanging breasts. Tumour FDG uptake was qualitatively evaluated to determine the possibility of response monitoring with PET/CT and was quantitatively assessed using maximum standardized uptake values (SUVmax). FDG uptake was compared with age, TNM stage, histology, hormone and human epidermal growth factor receptor 2 status, grade, Ki-67 and molecular subtype in univariable and multivariable analyses.Results
In 203 tumours (95?%) FDG uptake was considered sufficient for response monitoring. No subgroup of patients with consistently low tumour FDG uptake could be identified. In a univariable analysis, SUVmax was significantly higher in patients with distant metastases at staging examination, non-lobular carcinomas, tumours with negative hormone receptors, triple negative tumours, grade 3 tumours, and in tumours with a high proliferation index (Ki-67 expression). After multiple linear regression analysis, triple negative and grade 3 tumours were significantly associated with a higher SUVmax.Conclusion
Primary tumour FDG uptake in breast cancer patients scheduled for neoadjuvant chemotherapy is significantly higher in tumours with prognostically unfavourable characteristics. Based on tumour characteristics associated with low tumour FDG uptake, this study was unable to identify a subgroup of patients unlikely to benefit from pretreatment PET/CT. 相似文献6.
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7.
Arthur Varoquaux Olivier Rager Karl-Olof Lovblad Karen Masterson Pavel Dulguerov Osman Ratib Christoph D. Becker Minerva Becker 《European journal of nuclear medicine and molecular imaging》2013,40(6):842-852
Purpose
Head and neck squamous cell carcinoma (HNSCC) may cause a decreased apparent diffusion coefficient (ADC) on diffusion-weighted magnetic resonance imaging (DW MRI) and an increased standardized uptake value (SUV) on fluorodeoxyglucose (FDG) positron emission tomography (PET/CT). We analysed the reproducibility of ADC and SUV measurements in HNSCC and evaluated whether these biomarkers are correlated or independent.Methods
This retrospective analysis of DW MRI and FDG PET/CT data series included 34 HNSCC in 33 consecutive patients. Two experienced readers measured tumour ADC and SUV values independently. Statistical comparison and correlation with histopathology was done. Intra- and inter-observer agreement for ADC and SUV measurements was assessed.Results
Intraclass correlation coefficient (ICC) analysis showed almost perfect reproducibility (>0.90) for ADCmean, ADCmin, SUVmax and SUVmean values for intra-observer and inter-observer agreement. Mean ADCmean and ADCmin in HNSCC were 1.05?±?0.34 × 10?3?mm2/s and 0.65?±?0.29 × 10?3?mm2/s, respectively. Mean SUVmean and mean SUVmax were 7.61?±?3.87 and 12.8?±?5.0, respectively. Although statistically not significant, a trend towards higher SUV and lower ADC was observed with increasing tumour dedifferentiation. Pearson’s correlation analysis showed no significant correlation between ADC and SUV measurements (r ?0.103, ?0.051; p 0.552, 0.777).Conclusion
Our data suggest that ADC and SUV values are reproducible and independent biomarkers in HNSCC. 相似文献8.
Objectives
Physiological myocardial uptake of 18F-FDG during positron emission tomography can mask adjacent abnormal uptake in mediastinal malignancy and inflammatory cardiac diseases. Myocardial uptake is unpredictable and variable. This study evaluates the impact of a low-carbohydrate diet in reducing myocardial FDG uptake.Method
Patients attending for clinically indicated oncological FDG PET were asked to have an “Atkins-style” low-carbohydrate diet (less than 3 g) the day before examination and an overnight fast. A total of 120 patients following low-carbohydrate diet plus overnight fast were compared with 120 patients prepared by overnight fast alone. Patients having an Atkins-style diet also completed a diet compliance questionnaire. SUVmax and SUVmean for myocardium, blood pool and liver were measured in both groups.Results
Myocardial SUVmax fell from 3.53?±?2.91 in controls to 1.77?±?0.91 in the diet-compliant group. 98 % of diet-compliant patients had a myocardial SUVmax less than 3.6 compared with 67 % of controls. Liver and blood pool SUVmax rose from 2.68?±?0.49 and 1.82?±?0.30 in the control group to 3.14?±?0.57 and 2.06?±?0.30.Conclusion
An Atkins-style diet the day before PET, together with an overnight fast, effectively suppresses myocardial FDG uptake.Key Points
? Low-carbohydrate diet (LCD) the day before PET suppresses myocardial FDG uptake. ? LCD before PET increases liver and blood pool SUV max and SUV mean . ? Suppression of myocardial uptake may improve PET imaging of thoracic disease. ? Suppression of myocardial uptake may help imaging cardiac inflammatory disease with PET. 相似文献9.
Henry Lindholm Ove Johansson Cathrine Jonsson Hans Jacobsson 《European journal of nuclear medicine and molecular imaging》2012,39(11):1685-1690
Purpose
At 18F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) examinations a high tracer uptake of the skeletal muscles is sometimes encountered which can lead to reduced uptake in pathological lesions. This was evaluated in retrospect in patients being recalled for a repeat examination after reducing the muscular uptake.Methods
Ten patients with increased muscular tracer uptake were examined with FDG PET/CT on two occasions with a mean of 6?days. All patients showed at least one pathological lesion with increased tracer uptake. The muscular uptake was reduced at the second examination by informing the patient to refrain from physical activity together with pretreatment with diazepam. The maximum standardized uptake value (SUVmax) of the pathological lesion and SUVmean of certain skeletal muscles, liver, spleen, lungs, blood and certain bone marrow portions were calculated.Results
In all patients, the muscular uptake was reduced to a normal level at visual evaluation as well as at comparison of SUVs with 25 consecutive clinical patients exhibiting a normal FDG distribution (p?<?0.001). The mean lesion SUVmax increased from 2.4 to 3.7 (54?%) between the examinations (p?<?0.05). All reference tissues/organs showed a significant increase of SUV at the second examination. Relating lesion SUVmax to the activity of any of the reference tissues/organs there was no significant difference between the studies.Conclusion
The distribution of FDG constitutes a relative mechanism. This must be especially considered at longitudinal examinations in the same patient at therapy evaluations. In examinations with a somehow distorted general distribution of the activity, it may be more relevant to relate the lesion activity to a reference tissue/organ than relying on SUV assessments. 相似文献10.
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11.
Shin Young Jeong Sang-Woo Lee Hui Joong Lee Sungmin Kang Ji-Hyoung Seo Kyung Ah Chun Ihn Ho Cho Kyung Sook Won Seok Kil Zeon Byeong-Cheol Ahn Jaetae Lee 《European journal of nuclear medicine and molecular imaging》2010,37(12):2334-2343
Purpose
The purpose of this study was to determine the incidence of incidental pituitary uptake on whole-body 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and to investigate its clinical significance.Methods
The files of 40,967 patients who underwent whole-body FDG PET/CT were retrospectively reviewed. Quantification of pituitary metabolic activity was obtained by using the maximum standardized uptake value (SUVmax). Hormone assays and pituitary MRIs were performed to assess pituitary lesions.Results
Focally increased pituitary FDG uptake on PET/CT was found in 30 of 40,967 patients, accounting for an incidence of 0.073%. The mean SUVmax of 30 patients was 8.9?±?6.6 (range: 3.2–32.6). Histological diagnosis was obtained in three patients and included two growth hormone-secreting adenomas and one non-functioning adenoma. Hormone assays were performed on serum samples from 11 patients, 2 of whom were shown to have hypersecretion of pituitary hormone. MRI was performed on 19 patients. Abnormal MRI findings suggesting a pituitary mass were found in 18 of 19 cases (94.7%). The mean SUVmax calculated without correction for partial volume effect for macroadenomas was significantly higher than the SUVmax for microadenomas (11.5?±?8.4 vs 4.8?±?1.3; p?<?0.05). There were no cases diagnosed with metastasis to the pituitary gland during clinical follow-up.Conclusion
Incidental pituitary FDG uptake was a very rare finding. Cases with incidental pituitary FDG uptake were diagnosed primarily with clinically non-functioning adenomas, and there were also a few functioning adenomas. Further evaluations, including hormone assays and pituitary MRI, are warranted when pituitary uptake is found on FDG PET/CT. 相似文献12.
Ivan Platzek Bettina Beuthien-Baumann Matthias Schneider Volker Gudziol Jens Langner Georg Schramm Michael Laniado J?rg Kotzerke J?rg van den Hoff 《European journal of nuclear medicine and molecular imaging》2013,40(1):6-11
Purpose
To evaluate the feasibility of PET/MRI (positron emission tomography/magnetic resonance imaging) with FDG (18F-fluorodeoxyglucose) for initial staging of head and neck cancer.Methods
The study group comprised 20 patients (16 men, 4 women) aged between 52 and 81?years (median 64?years) with histologically proven squamous cell carcinoma of the head and neck region. The patients underwent a PET scan on a conventional scanner and a subsequent PET/MRI examination on a whole-body hybrid system. FDG was administered intravenously prior to the conventional PET scan (267?C395?MBq FDG, 348?MBq on average). The maximum standardized uptake values (SUVmax) of the tumour and of both cerebellar hemispheres were determined for both PET datasets. The numbers of lymph nodes with increased FDG uptake were compared between the two PET datasets.Results
No MRI-induced artefacts where observed in the PET images. The tumour was detected by PET/MRI in 17 of the 20 patients, by PET in 16 and by MRI in 14. The PET/MRI examination yielded significantly higher SUVmax than the conventional PET scanner for both the tumour (p?<?0.0001) and the cerebellum (p?=?0.0009). The number of lymph nodes with increased FDG uptake detected using the PET dataset from the PET/MRI system was significantly higher the number detected by the stand-alone PET system (64 vs. 39, p?=?0.001).Conclusion
The current study demonstrated that PET/MRI of the whole head and neck region is feasible with a whole-body PET/MRI system without impairment of PET or MR image quality. 相似文献13.
Dimosthenis Andreou Henrike Boldt Daniel Pink Björn Jobke Mathias Werner Markus Schuler Peter Reichardt Per-Ulf Tunn 《European journal of nuclear medicine and molecular imaging》2014,41(6):1076-1083
Purpose
The objective of this study was to determine whether 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) can adequately assess the risk of systemic disease progression in patients with primary, localized, high-grade soft tissue sarcomas of the extremities undergoing neoadjuvant isolated limb perfusion (ILP) with tumour necrosis factor and melphalan.Methods
This was a retrospective analysis of the files of 35 patients who underwent a PET or PET/CT scan prior to and after ILP followed by surgical resection with curative intent between 2006 and 2012. SUVmax1 was defined as the maximum standardized uptake value (SUV) at diagnosis, SUVmax2 as the maximum SUV after ILP and ΔSUVmax as the percentage difference between SUVmax1 and SUVmax2.Results
The median follow-up was 40 months for all patients. The median SUVmax1 amounted to 7.6, while the median SUVmax2 was 4.7. The median ΔSUVmax was ?44 %. Overall survival (OS) probability at 2 and 5 years amounted to 78 and 70 %, respectively, while metastasis-free survival (MFS) probability at 2 and 5 years was 67 and 64 %, respectively. Receiver-operating characteristic (ROC) curve analysis showed that both SUVmax2 and ΔSUVmax could predict systemic disease progression, while SUVmax1 could not adequately identify patients who went on to develop metastatic disease. The optimal cut-off value was 6.9 for SUVmax2 and ?31 % for ΔSUVmax. Patients with an SUVmax2 <6.9 had a 2-year MFS of 80 %, compared to 31 % for patients with an SUVmax2?≥?6.9 (p?<?0.001). Patients with a ΔSUVmax?<??31 %, i.e. patients with a higher metabolic response, had an MFS of 76 % at 2 years, compared to 42 % for patients with a ΔSUVmax?≥??31 % (p?=?0.050).Conclusion
SUVmax after ILP for primary, locally advanced, non-metastatic high-grade soft tissue sarcomas of the extremities appears to be significantly correlated with prognosis. Whether patients with a high SUVmax after ILP will benefit from standard or experimental adjuvant systemic treatment options should be evaluated in future studies. 相似文献14.
Antonio Avallone Luigi Aloj Corradina Caracò Paolo Delrio Biagio Pecori Fabiana Tatangelo Nigel Scott Rossana Casaretti Francesca Di Gennaro Massimo Montano Lucrezia Silvestro Alfredo Budillon Secondo Lastoria 《European journal of nuclear medicine and molecular imaging》2012,39(12):1848-1857
Purpose
The aim of the present study is to prospectively evaluate the prognostic value of previously defined [18F]2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) criteria of early metabolic response in patients with locally advanced rectal cancer (LARC) after long-term follow-up.Methods
Forty-two patients with poor prognosis LARC underwent three biweekly courses of chemotherapy with oxaliplatin, raltitrexed and 5-fluorouracil modulated by levofolinic acid during pelvic radiotherapy. FDG PET studies were performed before and 12?days after the beginning of the chemoradiotherapy (CRT) treatment. Total mesorectal excision (TME) was carried out 8?weeks after completion of CRT. A previously identified cutoff value of ≥52?% reduction of the baseline mean FDG standardized uptake value (SUVmean) was applied to differentiate metabolic responders from non-responders and correlated to tumour regression grade (TRG) and survival.Results
Twenty-two metabolic responders showed complete (TRG1) or subtotal tumour regression (TRG2) and demonstrated a statistically significantly higher 5-year relapse-free survival (RFS) compared with the 20 non-responders (86 vs 55?%, p?=?.014) who showed TRG3 and TRG4 pathologic responses. A multivariate analysis demonstrated that early ?SUVmean was the only pre-surgical parameter correlated to the likelihood of recurrence (p?=?.05).Conclusion
This study is the first prospective long-term evaluation demonstrating that FDG PET is not only an early predictor of pathologic response but is also a valuable prognostic tool. Our results indicate the potential of FDG PET for optimizing multidisciplinary management of patients with LARC. 相似文献15.
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16.
Myeong Jun Song Si Hyun Bae Sung Won Lee Do Sun Song Hee Yeon Kim Ie Ryung Yoo Joon-IL Choi Young June Lee Ho Jong Chun Hae Giu Lee Jong Young Choi Seung Kew Yoon 《European journal of nuclear medicine and molecular imaging》2013,40(6):865-873
Purpose
18F-FDG PET monitoring of FDG uptake may be a useful tool for assessment of the biological behaviour of hepatocellular carcinoma (HCC). We evaluated the correlation between FDG uptake on 18F-FDG PET and clinical characteristics and prognosis.Methods
In total, 58 HCC patients undergoing 18F-FDG PET before transarterial chemoembolization (TACE) between May 2007 and May 2010 at Seoul St. Mary’s Hospital were evaluated retrospectively. The predictive value of the ratio of maximal tumour standardized uptake value (SUV) to mean liver SUV (Tsuv max/Lsuv mean) was tested. Primary endpoints were the clinical characteristics and treatment response according to Tsuv max/Lsuv mean. The secondary endpoint was time to progression (TTP).Results
A high SUV ratio (cutoff value 1.70) correlated significantly with tumour size (≥5 cm) and serum AFP level (≥400 ng/mL). Objective response rates were significantly different between those with a ratio above (15.7 %) and those with a ratio below (66.6 %) the cutoff value (P?=?0.023). Patients in the low SUV ratio group had a median TTP of 16.8 months compared with 8.1 months in the high SUV ratio group (P?=?0.011). Overall survival in the high SUV ratio group was worse than in the low SUV ratio group (median 56.5 vs. 23.3 months), although the difference was not statistically significant in a multivariate analysis.Conclusion
Tumour metabolic activity (Tsuv max/Lsuv mean), assessed by PET/CT, is an independent predictor of response to TACE in patients with intermediate-stage HCC. Tsuv max/Lsuv mean can be used to predict tumour progression. Thus, 18F-FDG PET can provide valuable information for prediction of prognosis and aid in decisions regarding treatment strategy. 相似文献17.
Herrmann K Erkan M Dobritz M Schuster T Siveke JT Beer AJ Wester HJ Schmid RM Friess H Schwaiger M Kleeff J Buck AK 《European journal of nuclear medicine and molecular imaging》2012,39(5):846-851
Purpose
Despite recent advances in clinical imaging modalities, differentiation of pancreatic masses remains difficult. Here, we tested the diagnostic accuracy of molecular-based imaging including 3′-deoxy-3′-[18F]fluorothymidine (FLT) positron emission tomography (PET) and [18F]fluorodeoxyglucose (FDG) PET/CT in patients with suspected pancreatic masses scheduled to undergo surgery.Methods
A total of 46 patients with pancreatic tumours suspicious for malignancy and scheduled for resective surgery were recruited prospectively. In 41 patients, FLT PET and FDG PET/CT scans were performed. A diagnostic CT performed on a routine basis was available in 31 patients. FLT PET and FDG PET/CT emission images were acquired according to standard protocols. Tracer uptake in the tumour [FDG and FLT standardized uptake value (SUV)] was quantified by the region of interest (ROI) technique. For FDG PET/CT analysis, correct ROI placement was ensured via side-by-side reading of corresponding CT images.Results
Of 41 patients, 33 had malignancy, whereas 8 patients had benign disease. Visual analysis of FDG and FLT PET resulted in sensitivity values of 91% (30/33) and 70% (23/33), respectively. Corresponding specificities were 50% (4/8) for FDG PET and 75% (6/8) for FLT PET. In the subgroup of patients with contrast-enhanced CT (n?=?31), sensitivities were 96% (PET/CT), 88% (CT alone), 92% (FDG PET) and 72% (FLT PET), respectively. Mean FLT uptake in all malignant tumours was 3.0 (range SUVmax 1.1–6.5; mean FDG SUVmax 7.9, range 3.3–17.8; p?0.001).Conclusion
For differentiation of pancreatic tumours, FDG PET and FDG PET/CT showed a higher sensitivity but lower specificity than FLT PET. Interestingly, visual analysis of FLT PET led to two false-positive findings by misinterpreting physiological bowel uptake as pathological FLT uptake in the pancreas. Due to the limited number of patients, the clinical value of adding FLT PET to the diagnostic workup of pancreatic tumours remains to be determined. 相似文献18.
Hye Ryoung Koo Jeong Seon Park Keon Wook Kang Nariya Cho Jung Min Chang Min Sun Bae Won Hwa Kim Su Hyun Lee Mi Young Kim Jin You Kim Mirinae Seo Woo Kyung Moon 《European radiology》2014,24(3):610-618
Objectives
To determine whether a correlation exists between maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and the subtypes of breast cancer.Methods
This retrospective study involved 548 patients (mean age 51.6 years, range 21–81 years) with 552 index breast cancers (mean size 2.57 cm, range 1.0–14.5 cm). The correlation between 18F-FDG uptake in PET/CT, expressed as SUVmax, and immunohistochemically defined subtypes (luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) positive and triple negative) was analyzed.Results
The mean SUVmax value of the 552 tumours was 6.07?±?4.63 (range 0.9–32.8). The subtypes of the 552 tumours were 334 (60 %) luminal A, 66 (12 %) luminal B, 60 (11 %) HER2 positive and 92 (17 %) triple negative, for which the mean SUVmax values were 4.69?±?3.45, 6.51?±?4.18, 7.44?±?4.73 and 9.83?±?6.03, respectively. In a multivariate regression analysis, triple-negative and HER2-positive tumours had 1.67-fold (P?<?0.001) and 1.27-fold (P?=?0.009) higher SUVmax values, respectively, than luminal A tumours after adjustment for invasive tumour size, lymph node involvement status and histologic grade.Conclusion
FDG uptake was independently associated with subtypes of invasive breast cancer. Triple-negative and HER2-positive breast cancers showed higher SUVmax values than luminal A tumours.Key Points
? 18 F-FDG PET demonstrates increased tissue glucose metabolism, a hallmark of cancers. ? Immunohistochemically defined subtypes appear significantly associated with FDG uptake (expressed as SUV max ). ? Triple-negative tumours had 1.67-fold higher SUV max values than luminal A tumours. ? HER2-positive tumours had 1.27-fold higher SUV max values than luminal A tumours. 相似文献19.
Asae Nozawa Ali Hosseini Rivandi Santosh Kesari Carl K. Hoh 《European journal of nuclear medicine and molecular imaging》2013,40(7):997-1004
Purpose
To retrospectively assess the utility of 18F fluorodeoxyglucose (FDG) positron emission tomography (PET) images of standardized uptake values corrected for blood glucose (SUVgluc), and to compare this to various quantitative methods to identify the presence or absence of high grade malignancy.Methods
A retrospective review in 42 patients, found 81 central nervous system (CNS) lesions. Fifty one were malignant and 30 were benign or post treatment changes based on pathology (n?=?32) and on clinical outcome (n?=?49). Dynamic FDG PET scans were processed to generate parametric images of SUVgluc, SUV, glucose metabolic rate (GMR), and lesion to cerebellum ratios (SUVRc), and contralateral white matter ratios (SUVRw). The SUVgluc was calculated from $ {{{\mathrm{SU}{{\mathrm{V}}_{\max }}*\mathrm{BG}}} \left/ {{\left[ {100\,\mathrm{mg}/\mathrm{dl}} \right]}} \right.} $ , where SUVmax is the maximum SUV and BG is the blood glucose level (mg/dL).Results
Using a malignant threshold for SUVgluc of 4.5 and GMR of 13.0 μmole/min/100 g, the accuracies were similar for the SUVgluc (80 %) and GMR (81 %) and were higher than the conventional SUVmax (73 %). The area under the receiver operating characteristic (ROC) curve for the SUVgluc (0.8661) was better than that for the SUVmax (0.7955) (p?<?0.02) and was similar to those of the GMR (0.8694), SUVRc (0.8278), and SUVRw (0.8559).Conclusion
These results suggest that the SUVgluc may assist in the interpretation of FDG PET brain images in patients with CNS lesions. The SUVgluc method avoids the complexity of kinetic modeling and the definition of a reference region. 相似文献20.
Atsushi Isoda Tetsuya Higuchi Sachiko Nakano Yukiko Arisaka Kyoichi Kaira Tadashi Kamio Momoko Mawatari Morio Matsumoto Morio Sawamura Yoshito Tsushima 《Annals of nuclear medicine》2012,26(10):811-816