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1.
Carlos Caicedo Maria Jose Garcia-Velloso Maria Dolores Lozano Tania Labiano Carmen Vigil Diaz Jose Maria Lopez-Picazo Alfonso Gurpide Javier Zulueta Jose Angel Richter Echevarria Jose Luis Perez Gracia 《European journal of nuclear medicine and molecular imaging》2014,41(11):2058-2065
Purpose
The tumour molecular profile predicts the activity of epidermal growth factor receptor (EGFR) inhibitors in non-small-cell lung cancer (NSCLC). However, tissue availability and tumour heterogeneity limit its assessment. We evaluated whether [18F]FDG PET might help predict KRAS and EFGR mutation status in NSCLC.Methods
Between January 2005 and October 2011, 340 NSCLC patients were tested for KRAS and EGFR mutation status. We identified patients with stage III and IV disease who had undergone [18F]FDG PET/CT scanning for initial staging. SUVpeak, SUVmax and SUVmean of the single hottest tumour lesions were calculated, and their association with KRAS and EGFR mutation status was assessed. A receiver operator characteristic (ROC) curve analysis and a multivariate analysis (including SUVmean, gender, age and AJCC stage) were performed to identify the potential value of [18F]FDG PET/CT for predicting KRAS mutation.Results
From 102 patients staged using [18F]FDG PET/CT, 28 (27 %) had KRAS mutation (KRAS+), 22 (22 %) had EGFR mutation (EGFR+) and 52 (51 %) had wild-type KRAS and EGFR profiles (WT). KRAS+ patients showed significantly higher [18F]FDG uptake than EGFR+ and WT patients (SUVmean 9.5, 5.7 and 6.6, respectively; p?0.001). No significant differences were observed in [18F]FDG uptake between EGFR+ patients and WT patients. ROC curve analysis for KRAS mutation status discrimination yielded an area under the curve of 0.740 for SUVmean (p?0.001). The multivariate analysis showed a sensitivity and specificity of 78.6 % and 62.2 %, respectively, and the AUC was 0.773.Conclusion
NSCLC patients with tumours harbouring KRAS mutations showed significantly higher [18F]FDG uptake than WT patients, as assessed in terms of SUVpeak, SUVmax and SUVmean. A multivariate model based on age, gender, AJCC stage and SUVmean might be used as a predictive marker of KRAS mutation status in patients with stage III or IV NSCLC. 相似文献2.
Julie C. Dutoit Matthias A. Vanderkerken Joris Anthonissen Frederick Dochy Koenraad L. Verstraete 《European radiology》2014,24(11):2754-2765
Objectives
To evaluate DWI of the bone marrow in the differentiation of monoclonal gammopathy of undetermined significance (MGUS), smouldering myeloma (SMM) and multiple myeloma (MM).Methods
The retrospective study includes 64 patients with MGUS, 27 with SMM, 64 with new MM and 12 controls. Signal intensity (SI) of spinal SE-MRI and DWI (b0-1000) as well as apparent diffusion coefficients (ADC) were measured in the T10 and L3. Qualitative assessment of b-images was performed by one experienced radiologist.Results
ADC600 and ADC1000 are the best ADC values in differentiating patient groups (p?0.030). SIT2, SIb1000 and ADC1000 are higher and SIT1 lower in L3 compared to T10 (p?0.050). All quantitative parameters of L3 can differentiate significantly between MGUS and MM (p?0.050) and between patients with percentage plasma cells (PC%) between 0-10 % compared to >50 % (p?=?0.001). Only SIT2 for L3 can differentiate MGUS from SMM (p?=?0.044) and PC%0-10 from PC%10-25 (p?=?0.033). Qualitative interpretation of b1000 images allows differentiating MM patients from those with MGUS or SMM (p?0.001).Conclusions
Spinal SE-MRI can differentiate among MGUS, SMM, MM and control subjects. DWI based on the SI on b1000 images and ADC values is increased in MM compared to MGUS and SMM. Qualitative assessment of b-images can differentiate MM from MGUS or SMM.Key points
? ADC values are higher in patients with MM compared to MGUS ? DWI parameters change late in disease evolution ? DWI is sensitive but not specific in diagnosing patients with MM ? Qualitative DWI assessment is good in detecting myeloma patients 相似文献3.
Objective
Our objective was to evaluate ultrafast cone-beam computed tomography (u-CBCT) image data using cross-sectional images, perfusion blood volume (PBV), and image fusion during tumour detection at the course of transarterial chemoembolization.Methods
One hundred and fifty patients (63?±?20 years; 33–82) were examined from February to October 2013 with u-CBCT. Tumour delineation and conspicuity were determined using u-CBCT cross-sectional PBV and u-CBCT-magnetic resonance imaging (MRI) fused data sets for hyperenhanced (HYET), heterogeneously enhanced (HEET), and unenhanced (UET) tumour categories. Catheter localisation and tumour feeding vessels were assessed using all data sets. Quantitative and qualitative analyses were performed using appropriate statistical tests.Result
Qualitative and quantitative tumour delineation showed significant difference (all P?0.05) among tumour categories. Mean tumour–liver–contrast was higher in HYET than in HEET, and UET; moreover, differences between tumour categories were statistically significant (all P?0.0001). Fused data showed higher value with statistical significance (P?0.05) compared with other data sets during catheter localisation and feeding-vessel identification.Conclusion
Tumour delineation was clearly possible using u-CBCT cross sections with contrast material. PBV uses color-coded images to increase detection and produces good tumour differentiation. Image fusion helps accurately identify tumour and feeding vessels and locate contrast material injection sites and catheter tips without additional data acquisition.Key points
? Ultrafast CBCT cross-sectional data provide good tumour delineation with contrast material ? Postprocessed PBV using u-CBCT increased detectability and tumour differentiation ? u-CBCT cross-sectional PBV and u-CBCT-MRI data helps image guidance during chemoembolization ? u-CBCT-MRI can identify tumours and feeding vessels and locate catheter tip accurately 相似文献4.
Satoshi Takeuchi Aparna Balachandran Mouhammed Amir Habra Alexandria T. Phan Roland L. Bassett Jr. Homer A. Macapinlac Hubert H. Chuang 《European journal of nuclear medicine and molecular imaging》2014,41(11):2066-2073
Purpose
Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy. Limited data are available about on value of 18F-FDG PET/CT in ACC. We evaluated the impact of PET/CT on the management of ACC.Methods
We performed a retrospective review in patients with ACC who had undergone PET/CT. The impact of PET/CT on the management plan was evaluated by comparing the findings on PET/CT to the findings on contrast-enhanced CT. The sensitivity, specificity, and accuracy of each form of imaging were calculated. The correlations between PET/CT parameters, including maximum standardized uptake value (SUVmax), total lesion glycolysis, and decline in SUVmax after chemotherapy, and clinical outcome were evaluated.Results
Included in the analysis were 106 patients with 180 PET/CT scans. Of the 106 patients, 7 underwent PET/CT only for initial staging, 84 underwent PET/CT only for restaging, and 15 underwent PET/CT for both initial staging and restaging. PET/CT changed the management plan in 1 of 22 patients (5 %) at initial staging and 9 of 99 patients (9 %) at restaging. In 5 of the patients in whom PET/CT changed the management plan, PET/CT showed response to chemotherapy but contrast-enhanced CT showed stable disease. Sensitivity, specificity, and accuracy were 100 %, 100 %, and 100 % for PET/CT at initial staging; 92.6 %, 100 %, and 96.4 % for CT at initial staging; 98.4 %, 100 %, and 99.5 % for PET/CT at restaging; and 96.8 %, 98.6 %, and 98.0 % for CT at restaging, respectively. No PET/CT parameters were associated with survival at either initial diagnosis or recurrence.Conclusion
PET/CT findings could substantially change the management plan in a small proportion of patients with ACC. Although lesion detection was similar between PET/CT and CT, PET/CT may be preferred for chemotherapeutic response assessment because it may predict response before anatomic changes are detected on CT. 相似文献5.
Bangkim Chandra Khangembam Sellam Karunanithi Punit Sharma Sudhir Suman Kc Rajeev Kumar Pramod Kumar Julka Rakesh Kumar Chandrasekhar Bal 《Neuroradiology》2014,56(10):893-902
Introduction
We assessed the validity of “perfusion-metabolism coupling” hypothesis in recurrent glioma with 13N-ammonia (13N-NH3) PET/CT and 18F-fluorodeoxyglucose (18F-FDG) PET/CT.Methods
Fifty-six consecutive patients (age, 38.8?±?12.1 years; 62.5 % males) with histologically proven and previously treated glioma presenting with clinical suspicion of recurrence were prospectively enrolled and evaluated with 13N-NH3 PET/CT and 18F-FDG PET/CT. PET/CT images were evaluated both qualitatively and semiquantitatively. Tumor to white matter uptake ratio (T/W) and tumor to gray matter uptake ratio (T/G) were calculated and analyzed for both the modalities. A combination of clinico-radiological follow-up, repeated imaging, and biopsy (when available) were considered as the reference standard.Results
Based on the reference standard, 27/56 patients had recurrence. 13N-NH3 PET/CT and 18F-FDG PET/CT were concordant in 55/56 patients. Overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 13N-NH3PET/CT were 77.8, 86.2, 84.0, 80.7, and 82.1 %, respectively, and for 18F-FDG PET/CT were 77.8, 89.7, 87.5, 81.2, and 83.9 %, respectively. There was excellent agreement between results of 13N-NH3 PET/CT and 18F-FDG PET/CT (??=?0.964; P?0.001). The performances of 13N-NH3 PET/CT and 18F-FDG PET/CT were not significantly different between high-grade and low-grade glioma (P?=?1.000). A strong positive correlation was noted between the uptake ratios derived on the two modalities (ρ?=?0.866, P?0.001 for T/W; ρ?=?0.918, P?0.001 for T/G).Conclusion
A combination of 13N-NH3 PET/CT and 18F-FDG PET/CT demonstrates that perfusion and metabolism are coupled in recurrent gliomas. These tracers target two different but interrelated aspects of the same pathologic process and can be used as surrogates for each other. 相似文献6.
Faqin Lv Yanting Ning Xuan Zhou Yukun Luo Tong Liang Yongkang Nie Tanshi Li Jie Tang 《European radiology》2014,24(10):2640-2648
Objective
To analyse the correlation between contrast-enhanced ultrasound (CEUS)-based classification of the severity of abdominal parenchymal organ trauma and clinical outcomes, and to explore CEUS in classifying patients with such trauma, expecting that the use of CEUS will potentially enhance the quality and speed of the emergency management of abdominal trauma.Methods
Three hundred six consecutive patients with blunt abdominal parenchymal organ trauma who received CEUS examination were retrospectively analysed. Two CEUS radiologists (identified as Reader A and Reader B in this study) who were not involved in the CEUS examinations of the patients were then asked to classify the patients independently according to their CEUS results. The classification results were later compared with patients’ clinical outcomes using Spearman’s rank correlation.Results
The final clinical outcomes showed that 25.5 % (78/306) of patients received conservative treatment, 52.0 % (159/306) received minimally invasive treatment, and 22.5 % (69/306) received surgery. Spearman's rank correlation coefficients between the CEUS-based classification and clinical outcome were 0.952 from Reader A and 0.960 from Reader B.Conclusions
CEUS can play an important role in the emergency management of abdominal trauma through the classification of patients for different treatment methods.Key points
? The severity of abdominal trauma was classified by contrast-enhanced ultrasound (CEUS) ? There was a high correlation between CEUS-based classification and clinical outcomes ? CEUS-based classification is helpful for surgeons in the emergency management of abdominal trauma 相似文献7.
Kai-Hsiung Ko Hsian-He Hsu Tsai-Wang Huang Hong-Wei Gao Daniel H. Y. Shen Wei-Chou Chang Yi-Chih Hsu Tsun-Hou Chang Chi-Ming Chu Ching-Liang Ho Hung Chang 《European journal of nuclear medicine and molecular imaging》2014,41(10):1889-1897
Purpose
The identification of the mutation status of the epidermal growth factor receptor (EGFR) is important for the optimization of treatment in patients with pulmonary adenocarcinoma. The acquisition of adequate tissues for EGFR mutational analysis is sometimes not feasible, especially in advanced-stage patients. The aim of this study was to predict EGFR mutation status in patients with pulmonary adenocarcinoma based on 18F-fluorodeoxyglucose (FDG) uptake and imaging features in positron emission tomography/computed tomography (PET/CT), as well as on the serum carcinoembryonic antigen (CEA) level.Methods
We retrospectively reviewed 132 pulmonary adenocarcinoma patients who underwent EGFR mutation testing, pretreatment FDG PET/CT and serum CEA analysis. The associations between EGFR mutations and patient characteristics, maximal standard uptake value (SUVmax) of primary tumors, serum CEA level and CT imaging features were analyzed. Receiver-operating characteristic (ROC) curve analysis was performed to quantify the predictive value of these factors.Results
EGFR mutations were identified in 69 patients (52.2 %). Patients with SUVmax ≥6 (p?=?0.002) and CEA level ≥5 (p?=?0.013) were more likely to have EGFR mutations. The CT characteristics of larger tumors (≥3 cm) (p?=?0.023) and tumors with a nonspiculated margin (p?=?0.026) were also associated with EGFR mutations. Multivariate analysis showed that higher SUVmax and CEA level, never smoking and a nonspiculated tumor margin were the most significant predictors of EGFR mutation. The combined use of these four criteria yielded a higher area under the ROC curve (0.82), suggesting a good discrimination.Conclusion
The combined evaluation of FDG uptake, CEA level, smoking status and tumor margins may be helpful in predicting EGFR mutation status in patients with pulmonary adenocarcinoma, especially when the tumor sample is inadequate for genetic analysis or genetic testing is not available. Further large-scale prospective studies are needed to validate these results. 相似文献8.
Published data on the diagnosis of bone metastases of prostate cancer are conflicting and heterogeneous. We performed a comprehensive meta-analysis to compare the diagnostic performance of choline-PET/CT, MRI, bone SPECT, and bone scintigraphy (BS) in detecting bone metastases in parents with prostate cancer. Pooled sensitivity, specificity, and diagnostic odds ratios (DOR) were calculated both on a per-patient basis and on a per-lesion basis. Summary receiver operating characteristic (SROC) curves were also drawn to obtain the area under curve (AUC) and Q* value. Sixteen articles consisting of 27 studies were included in the analysis. On a per-patient basis, the pooled sensitivities by using choline PET/CT, MRI, and BS were 0.91 [95 % confidence interval (CI): 0.83–0.96], 0.97 (95 % CI: 0.91–0.99), 0.79 (95 % CI: 0.73–0.83), respectively. The pooled specificities for detection of bone metastases using choline PET/CT, MRI, and BS, were 0.99 (95 % CI: 0.93–1.00), 0.95 (95 % CI: 0.90–0.97), and 0.82 (95 % CI: 0.78–0.85), respectively. On a per-lesion basis, the pooled sensitivities of choline PET/CT, bone SPECT, and BS were 0.84 (95 % CI: 0.81–0.87), 0.90 (95 % CI: 0.86–0.93), 0.59 (95 % CI: 0.55–0.63), respectively. The pooled specificities were 0.93 (95 % CI: 0.89–0.96) for choline PET/CT, 0.85 (95 % CI: 0.80–0.90) for bone SPECT, and 0.75 (95 % CI: 0.71–0.79) for BS. This meta-analysis indicated that MRI was better than choline PET/CT and BS on a per-patient basis. On a per-lesion analysis, choline PET/CT with the highest DOR and Q* was better than bone SPECT and BS for detecting bone metastases from prostate cancer. 相似文献
9.
Yoriko Horiguchi Tomohiro Ueda Tomofumi Shiomori Masahiko Kanna Hirooki Matsushita Tomoko Kawaminami Yuta Sudo Shinnosuke Kikuchi Ryo Sasaki Jun Hoshimiya Yukiko Morita 《Annals of nuclear medicine》2014,28(8):707-715
Objective
IQ-SPECT (Siemens AG, Munich, Germany) is a highly sensitive single-photon-emission computed tomography (SPECT) myocardial perfusion imaging (MPI) system that uses a multifocal collimator. We searched for a suitable protocol for short-time imaging by IQ-SPECT in thallium-201 (Tl-201) MPI by evaluating phantom images and also by comparing human IQ-SPECT images with conventional SPECT images as reference standards.Methods
We assessed the image quality using the normalized mean square error (NMSE) and drew up count profiles in Tl-201 SPECT images acquired with IQ-SPECT in a phantom study. We also performed Tl-201 stress myocardial SPECT/CT in 21 patients and compared delayed images acquired by using IQ-SPECT with 36 or 17 views per head with images obtained by using conventional SPECT.Results
The NMSE of SPECT images from IQ-SPECT with 36 views was approximately one-fifth of that with 17 views. The myocardial count profile of images with 17 views was lower than those of images with 36 or 104 views in some regions. Defect scores were significantly lower, and image quality scores higher, in images from conventional SPECT than in those from IQ-SPECT with 17 views. Defect scores and image quality scores were equivalent in images from conventional SPECT and those from IQ-SPECT with 36 views. Agreement with the results of conventional SPECT in terms of coronary artery territory-based defect judgment was the best in IQ-SPECT with 36 views with computed tomography-derived attenuation correction (CTAC): the kappa values for IQ-SPECT with 36 views were 0.76 (without CTAC) and 0.83 (with CTAC), and those for IQ-SPECT with 17 views were 0.62 (without CTAC) and 0.59 (with CTAC). The difference in quantitative tracer uptake between conventional SPECT images and IQ-SPECT images was significantly greater for IQ-SPECT images with 17 views than for those with 36 views.Conclusions
Scanning with 36 views per head with CTAC may be appropriate for Tl-201 MPI using IQ-SPECT, because it provides images equivalent to those using conventional SPECT. 相似文献10.
Elisa Regini Giovanna Mariscotti Manuela Durando Gianluca Ghione Andrea Luparia Pier Paolo Campanino Caterina Chiara Bianchi Laura Bergamasco Paolo Fonio Giovanni Gandini 《La Radiologia medica》2014,119(10):741-749
Objective
This study was done to assess breast density on digital mammography and digital breast tomosynthesis according to the visual Breast Imaging Reporting and Data System (BI–RADS) classification, to compare visual assessment with Quantra software for automated density measurement, and to establish the role of the software in clinical practice.Materials and methods
We analysed 200 digital mammograms performed in 2D and 3D modality, 100 of which positive for breast cancer and 100 negative. Radiological density was assessed with the BI–RADS classification; a Quantra density cut-off value was sought on the 2D images only to discriminate between BI–RADS categories 1–2 and BI–RADS 3–4. Breast density was correlated with age, use of hormone therapy, and increased risk of disease.Results
The agreement between the 2D and 3D assessments of BI–RADS density was high (K 0.96). A cut-off value of 21 % is that which allows us to best discriminate between BI–RADS categories 1–2 and 3–4. Breast density was negatively correlated to age (r = ?0.44) and positively to use of hormone therapy (p = 0.0004). Quantra density was higher in breasts with cancer than in healthy breasts.Conclusions
There is no clear difference between the visual assessments of density on 2D and 3D images. Use of the automated system requires the adoption of a cut-off value (set at 21 %) to effectively discriminate BI–RADS 1–2 and 3–4, and could be useful in clinical practice. 相似文献11.
Henri Wichmann Antje Güttler Dr. Matthias Bache Prof. Helge Taubert Dr. Martina Vetter Prof. Peter Würl Prof. Hans J. Holzhausen Prof. Alexander W. Eckert Dr. Matthias Kappler Prof. Dirk Vordermark 《Strahlentherapie und Onkologie》2014,190(10):912-918
Background
Human epidermal growth factor receptor 2 (ErbB2) is overexpressed in a variety of human malignancies. Moreover, ErbB2 has been reported to influence cancer patient survival and progression of different tumor entities. However, information regarding the prognostic impact of ErbB2 in soft tissue sarcoma (STS) patients is limited and conflicting.Material and methods
ErbB2 mRNA and protein levels were defined by quantitative real-time PCR and enzyme-linked immunosorbent assay (ELISA), and the prognostic impact of ErbB2 mRNA and protein levels in tumor tissue of 124 soft tissue sarcoma patients were investigated.Results
The median ErbB2 mRNA expression level in tumor tissue was decreased 3.9-fold compared to non-neoplastic surrounding tissue (p?=?0.001). Furthermore, an increased ErbB2 mRNA expression level was associated with an improved tumor-specific survival (p?=?0.01, log rank test). Multivariate Cox’s proportional hazard regression analyses revealed an increased ErbB2 mRNA expression level as an independent favorable prognostic factor for tumor-specific survival of STS patients (n?=?124; RR?=?3.0; 95?% CI?=?1.6–5.7; p?0.001). In addition, multivariate Cox’s proportional hazard regression analyses showed that an increased ErbB2 protein expression level correlated with poorer recurrence-free survival of STS patients (n?=?47; RR?=?9.9; 95?% CI?=?1.7–59.7; p?=?0.012), in particular for STS patients who received postoperative radiotherapy (n?=?27; RR?=?17.9; 95?% CI?=?1.3–247.7; p?=?0.031).Conclusion
This study suggests an inverse prognostic value of ErbB2 mRNA and protein expression level. 相似文献12.
Gijsbert J. Blokhuis Chantal P. Bleeker-Rovers Marije G. Diender Wim J. G. Oyen Jos M. Th. Draaisma Lioe-Fee de Geus-Oei 《European journal of nuclear medicine and molecular imaging》2014,41(10):1916-1923
Purpose
Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression.Methods
All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis.Results
FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively.Conclusions
FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value. 相似文献13.
Lars Schimmöller Michael Quentin Christian Arsov Andreas Hiester Christian Buchbender Robert Rabenalt Peter Albers Gerald Antoch Dirk Blondin 《European radiology》2014,24(10):2582-2589
Purpose
This study evaluated the accuracy of MR sequences [T2-, diffusion-weighted, and dynamic contrast-enhanced (T2WI, DWI, and DCE) imaging] at 3T, based on the European Society of Urogenital Radiology (ESUR) scoring system [Prostate Imaging Reporting and Data System (PI-RADS)] using MR-guided in-bore prostate biopsies as reference standard.Methods
In 235 consecutive patients [aged 65.7?±?7.9 years; median prostate-specific antigen (PSA) 8 ng/ml] with multiparametric prostate MRI (mp-MRI), 566 lesions were scored according to PI-RADS. Histology of all lesions was obtained by targeted MR-guided in-bore biopsy.Results
In 200 lesions, biopsy revealed prostate cancer (PCa). The area under the curve (AUC) for cancer detection was 0.70 (T2WI), 0.80 (DWI), and 0.74 (DCE). A combination of T2WI + DWI, T2WI + DCE, and DWI + DCE achieved an AUC of 0.81, 0.78, and 0.79. A summed PI-RADS score of T2WI + DWI + DCE achieved an AUC of 0.81. For higher grade PCa (primary Gleason pattern?≥?4), the AUC was 0.85 for T2WI + DWI, 0.84 for T2WI + DCE, 0.86 for DWI + DCE, and 0.87 for T2WI + DWI + DCE. The AUC for T2WI + DWI + DCE for transitional-zone PCa was 0.73, and for the peripheral zone 0.88. Regarding higher-grade PCa, AUC for transitional-zone PCa was 0.88, and for peripheral zone 0.96.Conclusion
The combination of T2WI + DWI + DCE achieved the highest test accuracy, especially in patients with higher-grade PCa. The use of ≤2 MR sequences led to lower AUC in higher-grade and peripheral-zone cancers.Key Points
? T2WI + DWI + DCE achieved the highest accuracy in patients with higher grade PCa ? T2WI + DWI + DCE was more accurate for peripheral- than for transitional-zone PCa ? DCE increased PCa detection accuracy in the peripheral zone ? DWI was the leading sequence in the transitional zone 相似文献14.
Jean François Grellier Laetitia Vercellino Thierry Leblanc Pascal Merlet Catherine Thieblemont Pierre Weinmann Marie-Elisabeth Toubert Nathalie Berenger Josette Brière Pauline Brice 《European journal of nuclear medicine and molecular imaging》2014,41(11):2023-2030
Purpose
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare Hodgkin lymphoma distinguished from classical Hodgkin lymphoma (cHL) by the nature of the neoplastic cells which express B-cell markers. We wanted to determine the diagnostic performance of FDG PET/CT in initial assessment and its therapeutic impact on staging.Methods
We retrospectively studied a population of 35 patients with NLPHL (8 previously treated for NLHPL, 27 untreated). All patients underwent an initial staging by pretherapeutic FDG PET/CT. The impact on initial stage or relapse stage was assessed by an independent physician.Results
In a per-patient analysis, the sensitivity of the pretherapeutic FDG PET/CT was 100 %. In a per-site analysis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pretherapeutic FDG PET/CT were 100 %, 99 %, 97 %, 100 % and 99 %, respectively. Pretherapeutic FDG PET/CT led to a change in the initial stage/relapse stage in 12 of the 35 patients (34 %). In contrast to previous results established without FDG PET/CT, 20 % of patient had osteomedullary lesions.Conclusion
Pretherapeutic FDG PET/CT has excellent performance for initial staging or relapse staging of NLPHL. 相似文献15.
PD Dr. Florian Sterzing Thomas B. Brunner Iris Ernst Wolfgang W. Baus Burkhard Greve Klaus Herfarth Matthias Guckenberger 《Strahlentherapie und Onkologie》2014,190(10):872-881
Purpose
This report of the Working Group on Stereotactic Radiotherapy of the German Society of Radiation Oncology (DEGRO) aims to provide a practical guideline for safe and effective stereotactic body radiotherapy (SBRT) of liver tumors.Methods
The literature on the clinical evidence of SBRT for both primary liver tumors and liver metastases was reviewed and analyzed focusing on both physical requirements and special biological characteristics.Results
Recommendations were developed for patient selection, imaging, planning, treatment delivery, motion management, dose reporting, and follow-up. Radiation dose constraints to critical organs at risk are provided.Conclusion
SBRT is a well-established treatment option for primary and secondary liver tumors associated with low morbidity. 相似文献16.
Andrei S. Purysko Namita S. Gandhi R. Mathew Walsh Nancy A. Obuchowski Joseph C. Veniero 《European radiology》2014,24(12):3134-3141
Objectives
To assess the value of secretin during magnetic resonance cholangiopancreatography (MRCP) in demonstrating communication between cystic lesions and the pancreatic duct to help determine the diagnosis of side-branch intraductal papillary mucinous neoplasm (SB-IPMN).Methods
This is an IRB-approved, HIPAA-compliant retrospective study of 29 SB-IPMN patients and 13 non-IPMN subjects (control) who underwent secretin-enhanced MRCP (s-MRCP). Two readers blinded to the final diagnosis reviewed three randomised image sets: (1) pre-secretin HASTE, (2) dynamic s-MRCP and (3) post-secretin HASTE. Logistic regression, generalised linear models and ROC analyses were used to compare pre- and post-secretin results.Results
There was no significant difference in median scores for the pre-secretin [reader 1: 1; reader 2: 2 (range -2 to 2)] and post-secretin HASTE [reader 1: 1; reader 2: 1 (range -2 to 2)] in the SB-IPMN group (P?=?0.14), while the scores were lower for s-MRCP [reader 1: 0.5 (range -2 to 2); reader 2: 0 (range -1 to 2); P?=?0.016]. There was no significant difference in mean maximum diameter of SB-IPMN on pre- and post-secretin HASTE, and s-MRCP (P?>?0.05).Conclusion
Secretin stimulation did not add to MRCP in characterising pancreatic cystic lesions as SB-IPMN.Key Points
? Magnetic resonance cholangiopancreatography (MRCP) is used to evaluate pancreatic cystic lesions. ? Intraductal papillary mucinous neoplasm (IPMN) is a type of pancreatic cystic neoplasm. ? Secretin administration does not facilitate the diagnosis of IPMN on MRCP. 相似文献17.
Nobuyuki Kawai Wei Lin Wei-Dong Cao Daisuke Ogawa Keisuke Miyake Reiji Haba Yukito Maeda Yuka Yamamoto Yoshihiro Nishiyama Takashi Tamiya 《European journal of nuclear medicine and molecular imaging》2014,41(10):1870-1878
Purpose
Hypoxia and its consequences at the molecular level promote tumour progression and affect patient prognosis. One of the main early cellular events evoked by hypoxia is induction of hypoxia-inducible factor 1 (HIF-1) and subsequent upregulation of vascular endothelial growth factor (VEGF). In this study we sought to determine whether hypoxia detected by 18F-fluoromisonidazole (FMISO) PET accurately reflects the expression of HIF-1α and VEGF in the tumour and can be used as a biomarker of antiangiogenic treatment and as a prognostic factor in newly diagnosed and recurrent malignant gliomas.Methods
Enrolled in this study were 32 patients with newly diagnosed glioma and 16 with recurrent glioma of grade III or grade IV. All the patients had undergone FMISO PET preoperatively. The maximum tumour-to-blood FMISO activity ratio (T/Bmax) was used to evaluate the degree of tumour hypoxia and the hypoxic volume (HV) was calculated using a tumour-to-blood FMISO uptake ratio of ≥1.2. Immunohistochemical expressions of HIF-1α and VEGF were evaluated semiquantitatively using the immunoreactivity score (IRS, scores 0 to 12) and the correlation was examined between IRS of HIF-1α or VEGF and FMISO uptake of the tumour (SUVtumour) using navigation-based sampling. Survival was estimated using the Kaplan-Meier method in relation to the T/Bmax and the HV.Results
The T/Bmax and the HV in grade IV gliomas were significantly higher than in grade III gliomas (P?0.01 and P?0.01, respectively). Moderate to strong HIF-1α and VEGF expression was observed in the majority of malignant gliomas. The IRS of HIF-1α and VEGF in the tumour were not significantly different between grade III and grade IV gliomas. The IRS of HIF-1α in the tumour did not correlate with the SUVtumour of FMISO in either newly diagnosed or recurrent glioma. There was a significant but weak correlation between the IRS of VEGF and the SUVtumour of FMISO in newly diagnosed glioma, but not in recurrent glioma. The overall survival time in patients with a small HV and a low FMISO T/Bmax was significantly longer than in those with a large HV and a high FMISO T/Bmax (P?0.01 and P?0.05, respectively).Conclusion
Preoperative FMISO uptake is significantly correlated with the expression of VEGF in the tumour and might be used as a biomarker of antiangiogenic treatment in newly diagnosed malignant gliomas. However, caution is required because the correlation was weak and there was a large overlap of FMISO uptake between glioma with high and low VEGF expression. In addition, hypoxia determined by FMISO PET appears to be a suitable biomarker for predicting a highly malignant tumour and a poor prognosis in patients with malignant glioma. 相似文献18.
Sven-Ola Hietala Herbert Silfvenius Jan Aasly Magnus Olivecrona Lars Jonsson 《European journal of nuclear medicine and molecular imaging》1990,16(8-10):683-687
Technetium (99mTc) hexamethyl propylene amine oxime (HM-PAO) was injected into the internal carotid artery in ten epileptic patients after the end of amobarbital speech-memory tests. The cerebral perfusion as visualized from SPET was compared to cerebral angiographies, which showed unilateral filling of intracranial vessels in seven patients. SPET revealed cross-flow between the hemispheres in four of these seven patients. In three patients in whom the angiograms had shown bilateral contrast filling, SPET showed cross-flow in only two. It is concluded that99mTc-HM-PAO SPET examinations provide valuable information for correct interpretation of amobarbital tests on cognitive hemisphere functions. The SPET technique may help to explain atypical speech and memory responses caused by unusual intracranial vascularization. 相似文献
19.
Luka Lezaic Sebastijan Rep Mojca Jensterle Sever Tomaz Kocjan Marko Hocevar Jure Fettich 《European journal of nuclear medicine and molecular imaging》2014,41(11):2083-2089
Purpose
Primary hyperparathyroidism is a common endocrine disorder which is diagnosed biochemically and for which therapy is surgical. A prerequisite for minimally invasive surgery, which minimizes morbidity and cost, is accurate localization of the involved gland(s). The aim of this study was to evaluate the usefulness of 18F-fluorocholine PET/CT for preoperative localization of hyperfunctioning parathyroid tissue.Methods
18F-Fluorocholine PET/CT and conventional parathyroid scintigraphic imaging consisting of 99mTc-sestaMIBI SPECT/CT, 99mTc-sestaMIBI dual-phase imaging and 99mTc-sestaMIBI/pertechnetate subtraction imaging were performed in 24 patients. The diagnostic performance of the imaging methods was compared against histology as the gold standard and postoperative serum Ca2+ and iPTH values.Results
The sensitivity and specificity of 18F-fluorocholine PET/CT were 92 % and 100 %, respectively, in contrast to 49 % and 100 %, 46 % and 100 %, and 44 % and 100 % for 99mTc-sestaMIBI SPECT/CT, 99mTc-sestaMIBI/pertechnetate subtraction imaging and 99mTc-sestaMIBI dual-phase imaging, respectively. Combined conventional scintigraphic imaging had a sensitivity and specificity of 64 % and 100 %, respectively. The performance of 18F-fluorocholine PET/CT was superior particularly in patients with multiple lesions or hyperplasia.Conclusion
18F-Fluorocholine PET/CT appears to be a promising, effective imaging method for localization of hyperfunctioning parathyroid tissue. 相似文献20.
Jihyun Kim Junshik Hong Seog Gyun Kim Kyung Hoon Hwang Minsu Kim Hee Kyung Ahn Sun Jin Sym Jinny Park Eun Kyung Cho Dong Bok Shin Jae Hoon Lee 《Nuclear Medicine and Molecular Imaging》2014,48(3):187-195