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1.
M. Picchio M. Kirienko P. Mapelli I. Dell’Oca E. Villa F. Gallivanone L. Gianolli C. Messa I. Castiglioni 《European journal of nuclear medicine and molecular imaging》2014,41(1):21-31
Purpose
The aim of this study was to evaluate the predictive role of pre-therapy fluorodeoxyglucose (FDG) uptake parameters of primary tumour in head and neck cancer (HNC) patients undergoing intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) on FDG-positive volume—positron emission tomography (PET) gross tumour volume (PET-GTV).Methods
This retrospective study included 19 patients (15 men and 4 women, mean age 59.2 years, range 23–81 years) diagnosed with HNC between 2005 and 2011. Of 19 patients, 15 (79 %) had stage III–IV. All patients underwent FDG PET/CT before treatment. Metabolic indexes of primary tumour, including metabolic tumour volume (MTV), maximum and mean standardized uptake value (SUVmax, SUVmean) and total lesion glycolysis (TLG) were considered. Partial volume effect correction (PVC) was performed for SUVmean and TLG estimation. Correlations between PET/CT parameters and 2-year disease-free survival (DFS), local recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) were assessed. Median patient follow-up was 19.2 months (range 4–24 months).Results
MTV, TLG and PVC-TLG predicting patients’ outcome with respect to all the considered local and distant disease control endpoints (LRFS, DMFS and DFS) were 32.4 cc, 469.8 g and 547.3 g, respectively. SUVmean and PVC-SUVmean cut-off values predictive of LRFS and DFS were 10.8 and 13.3, respectively. PVC was able to compensate errors up to 25 % in the primary HNC tumour uptake. Moreover, PVC enhanced the statistical significance of the results.Conclusion
FDG PET/CT uptake parameters are predictors of patients’ outcome and can potentially identify patients with higher risk of treatment failure that could benefit from more aggressive approaches. Application of PVC is recommended for accurate measurement of PET parameters. 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.
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4.
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5.
Irene A. Burger Hebert Alberto Vargas Debra A. Goldman Mithat Gonen Anita Kumar Andrew D. Zelenetz Heiko Schöder Hedvig Hricak 《European journal of nuclear medicine and molecular imaging》2013,40(5):701-707
Purpose
Based on prior reports suggesting a positive correlation between fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/CT and total sperm count and concentration, we sought to identify changes in testicular FDG uptake over the course of chemotherapy in young men with Hodgkin’s lymphoma.Methods
Fifty-two patients with a mean age of 24.2 years (range 15.5–44.4) at diagnosis monitored with FDG PET/CT to assess treatment response for Hodgkin’s lymphoma were selected for this retrospective analysis under an Institutional Review Board waiver. Of the patients, 26 were treated with a chemotherapy regimen known to cause prolonged and sometimes permanent azoospermia (BEACOPP—bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisolone) and 26 with a regimen known to have a much milder effect on gonadal function (ABVD—doxorubicin, bleomycin, vincristine, and dacarbazine). Each patient underwent one FDG PET/CT before treatment and at least one FDG PET/CT after start of chemotherapy. In all examinations, FDG activity was measured in the testes with different quantification metrics: maximum standardized uptake value (SUVmax), SUVmean, functional volume (FV) and total testicular glycolysis (TTG), and blood pool activity determined (SUVmean).Results
Testicular FDG uptake (SUVmax) was significantly associated with blood pool activity (p?<?0.001). Furthermore, testicular FDG uptake metrics incorporating volume (e.g., FV and TTG) were associated with age. There was no significant change in SUVmax, SUVmean, FV, and TTG from the PET/CT at baseline to the PET/CTs over the course of chemotherapy either for patients treated with BEACOPP or for patients treated with ABVD.Conclusion
For patients undergoing chemotherapy for Hodgkin’s lymphoma, there is a significant association between testicular FDG uptake and blood pool activity, but no significant changes in FDG uptake over the course of chemotherapy. Therefore, FDG uptake may not be a feasible surrogate marker for fertility monitoring in patients with Hodgkin’s lymphoma undergoing chemotherapy. 相似文献6.
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7.
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8.
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9.
Xiaorong Sun Fen Zhao Lu Sun Shanshan Li Wenwu Li Xinqin Zhang Ligang Xing 《Annals of nuclear medicine》2014,28(7):610-616
Purpose
To compare glucose metabolism and chemosensitivity between recurrence within the irradiation field and metastases outside the irradiation field in the same patient using 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography images (PET/CT).Methods
The 18F-FDG PET/CT images of 43 cancer patients with both local recurrence (in-field) and distal metastases (out-field) after initial treatments were reviewed. 23 patients after definitive radiotherapy/chemoradiotherapy and 20 patients after radical surgery were assigned to a radiation group and surgery group, respectively. The tumor maximal diameter on CT and PET images (D CT and D PET), maximal SUV (SUVmax), and mean SUV (SUVmean) were measured. All the patients were administered chemotherapy, and 17 patients from the radiation group and 10 patients from the surgery group underwent PET/CT scanning within 1–2 months after the treatment. The changes in D CT, D PET, SUVmax and SUVmean for each lesion were calculated and compared between in-field and out-field tumors for both groups.Results
In the surgery group, no significant difference was found in tumor size or FDG uptake between the local recurrence and metastases. In the radiation group, both SUVmax (7.03 ± 3.48) and SUVmean (4.33 ± 1.67) of the in-field tumors were lower than those (8.45 ± 4.34 and 5.36 ± 2.51, respectively, P < 0.05) of out-field tumors. Moreover, the response extent of in-field tumors was lower than that of out-field tumors in the radiation group (P < 0.05). However, in the surgery group, there was no difference in the response extent (tumor size and SUVs) between the local recurrence and metastases (P > 0.05).Conclusion
The recurrence within the irradiation field and metastases outside the irradiation field in the same patient do not share the same biological characteristics or treatment response, with inferior glucose metabolism and chemosensitivity seen in locally recurrent tumors. 相似文献10.
Jan Bucerius Venkatesh Mani Stephanie Wong Colin Moncrieff David Izquierdo-Garcia Josef Machac Valentin Fuster Michael E. Farkouh James H. F. Rudd Zahi A. Fayad 《European journal of nuclear medicine and molecular imaging》2014,41(5):934-945
Purpose
There is evidence that the link between obesity and cardiovascular disease might relate to inflammation in both fat tissue and the arterial wall. 18F-FDG uptake on PET is a surrogate marker of vessel wall inflammation. The aim of the study was to measure FDG uptake in both regions using PET and identify links between adipose and arterial inflammation.Methods
Included in the study were 173 cardiovascular patients who were prospectively imaged with FDG PET/CT. Arterial FDG uptake was measured in the carotid arteries and ascending aorta. The same was done in fat tissue in the neck, the presternal region (both subcutaneous) and the pericardium. FDG uptake was quantified as average maximal target-to-background ratio (meanTBRmax). Multivariate regression analyses were performed to identify significant associations between arterial and adipose tissue FDG uptake and clinical variables as given by the standardized correlation coefficient (β).Results
FDG uptake values in all fat tissue regions were highly predictive of vascular FDG uptake in both the carotids (β 0.262, p?<?0.0001, in the neck subcutaneous region) and aorta (β 0.22, p?=?0.008, in the chest pericardial region; β 0.193, p?=?0.019, in the chest subcutaneous region). Obesity was significantly associated with elevated FDG uptake in adipose tissue (β 0.470, p?<?0.0001, in the neck subcutaneous region; β 0.619, p?=?0.028, in the chest subcutaneous region; β 0.978, p?=?0.035, in the chest pericardial region).Conclusion
FDG uptake in diverse fat tissue regions was significantly associated with arterial FDG uptake, a reasonable surrogate of inflammation. Increasing body weight significantly predicted the level of fatty inflammation. FDG PET therefore provides imaging evidence of an inflammatory link between fat tissue and the vasculature in patients with cardiovascular disease. 相似文献11.
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12.
Isabel Martínez-Rodríguez N. Martínez-Amador I. Banzo R. Quirce J. Jiménez-Bonilla M. De Arcocha-Torres S. Ibáñez-Bravo C. Lavado-Pérez Z. Bravo-Ferrer R. Blanco M. A. González-Gay J. M. Carril 《European journal of nuclear medicine and molecular imaging》2014,41(12):2319-2324
Purpose
The aim of this study was to evaluate the contribution of semiquantitative analysis of 180-min 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT images for the assessment of aortitis in cases of suspected large vessel vasculitis (LVV) and to establish a threshold index for application in the clinical setting.Methods
This prospective study included 43 patients (mean age 67.5?±?12.9?years) with suspicion of LVV (25 with a final diagnosis of aortitis). 18F-FDG PET/CT scan was acquired 180 min after injection of 7 MBq/kg of 18F-FDG. A semiquantitative analysis was performed calculating the aortic wall maximum standardized uptake value (SUVmax) (T), the lumen SUVmax (B) and the target to background ratio (TBR). These results were also compared with those obtained in a control population.Results
The mean aortic wall SUVmax was 2.00?±?0.62 for patients with aortitis and 1.45?±?0.31 for patients without aortitis (p?0.0001). The TBR was 1.66?±?0.26 for patients with aortitis and 1.24?±?0.08 for patients without aortitis (p?0.0001). The differences were also statistically significant when the patients with aortitis and controls were compared. Receiver-operating characteristic (ROC) analysis revealed that the area under the curve was greater for the TBR than for the aortic wall SUVmax (0.997 vs 0.871). The highest sensitivity and specificity was obtained for a TBR of 1.34 (sensitivity 100 %, specificity 94.4 %).Conclusion
Semiquantitative analysis of PET/CT images acquired 180 min after 18F-FDG injection and the TBR index of 1.34 show very high accuracy and, therefore, are strongly recommended for the diagnosis of aortitis in the clinical setting. 相似文献13.
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14.
Benjapa Khiewvan Homer A. Macapinlac Dina Lev Ian E. McCutcheon John M. Slopis Ghadah Al Sannaa Wei Wei Hubert H. Chuang 《European journal of nuclear medicine and molecular imaging》2014,41(9):1756-1766
Purpose
Our objective was to determine how positron emission tomography (PET)/CT had been used in the clinical treatment of malignant peripheral nerve sheath tumor (MPNST) patients at The University of Texas MD Anderson Cancer Center.Methods
We reviewed a database of MPNST patients referred to MD Anderson Cancer Center during 1995–2011. We enrolled 47 patients who underwent PET/CT imaging. Disease stage was based on conventional imaging and PET/CT findings using National Comprehensive Cancer Network (NCCN) guidelines. Treatment strategies based on PET/CT and conventional imaging were determined by chart review. The maximum and mean standardized uptake values (SUVmax, SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), change in SUVmax, change in MTV, and change in TLG were calculated from the PET/CT studies before and after treatment. Response prediction was based on imaging studies performed before and after therapy and categorized as positive or negative for residual tumor. Clinical outcome was determined from chart review.Results
PET/CT was performed for staging in 16 patients, for restaging in 29 patients, and for surveillance in 2 patients. Of the patients, 88 % were correctly staged with PET/CT, whereas 75 % were correctly staged with conventional imaging. The sensitivity to detect local recurrence and distant metastasis at restaging was 100 and 100 % for PET/CT compared to 86 and 83 % for conventional imaging, respectively. PET/CT findings resulted in treatment changes in 31 % (5/16) and 14 % (4/29) of patients at staging and restaging, respectively. Recurrence, MTV, and TLG were prognostic factors for survival, whereas SUVmax and SUVmean were not predictive. For 21 patients who had imaging studies performed both before and after treatment, PET/CT was better at predicting outcome (overall survival, progression-free survival) than conventional imaging. A decreasing SUVmax ≥ 30 % and decrease in TLG and MTV were significant predictors for overall and progression-free survival.Conclusion
PET/CT is valuable in MPNST management because of its high accuracy in staging and high sensitivity and accuracy in restaging as well as improvements in treatment planning. MTV from baseline staging studies is predictive of survival. Additionally, change in SUVmax, TLG, and MTV accurately predicted outcomes after treatment. 相似文献15.
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16.
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17.
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
Objective
l-[3-18F]-alpha-methyltyrosine (18F-FAMT) is an amino-acid tracer for positron emission tomography (PET), with uptake related to overexpression of L-type amino-acid transporter 1 and proliferative activity in tumour cells. This study evaluated the diagnostic performance of 18F-FAMT PET compared with 2-[18F]-fluoro-2-deoxy-d-glucose (18F-FDG) PET in patients with multiple myeloma (MM).Methods
Eleven patients with MM (newly diagnosed, n?=?3; relapsed after treatment, n?=?8) underwent whole-body 18F-FAMT and 18F-FDG PET within a 2-week interval. Magnetic resonance imaging (MRI) of the spine was also performed to assess patterns of bone marrow infiltration. Tracer uptake was semi-quantitatively evaluated using maximal standardized uptake value (SUVmax). Mean SUV was also determined for normal bone marrow and the aortic arch as mediastinal background SUV to calculate lesion-to-bone marrow (L/B) and lesion-to-mediastinum (L/M) ratios, respectively. Those values were statistically compared using Student??s t test.Results
In 8 patients showing focal infiltration on MRI, 34 FDG-avid bone lesions were identified, with each showing increased FAMT uptake. Mean SUVmax and L/B ratio of FDG (3.1?±?1.2 and 3.3?±?1.9, respectively) were significantly higher than those of FAMT (2.0?±?1.0 and 2.6?±?1.1, respectively; p?<?0.05 each). In contrast, the L/M ratio of FDG showed no significant difference to that of FAMT (2.2?±?1.0 and 2.4?±?1.2, respectively; p?=?0.3).Conclusions
Clear 18F-FAMT PET uptake was seen in most 18F-FDG-avid lesions among patients with MM, and an equivalent semi-quantitative value was obtained using L/M ratio. Our preliminary data suggest that 18F-FAMT PET provides a useful imaging modality for detecting active myelomatous lesions. 相似文献18.
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19.
Alexander W. Sauter Daniel Spira Maximilian Schulze Christina Pfannenberg Jürgen Hetzel Matthias Reimold Ernst Klotz Claus D. Claussen Marius S. Horger 《European journal of nuclear medicine and molecular imaging》2013,40(5):677-684
Purpose
The aim of this study was to investigate correlations between glucose metabolism as determined by [18F]FDG PET/CT and tumour perfusion as quantified by volume perfusion CT in primary tumours and mediastinal lymph nodes (MLN) of patients with non-small-cell lung cancer (NSCLC).Methods
Enrolled in the study were 17 patients with NSCLC. [18F]FDG uptake was quantified in terms of SUVmax and SUVavg. Blood flow (BF), blood volume (BV) and flow extraction product (Ktrans) were determined as perfusion parameters. The correlations between the perfusion parameters and [18F]FDG uptake values were subsequently evaluated.Results
For the primary tumours, no correlations were found between perfusion parameters and [18F]FDG uptake. In MLN, there were negative correlations between BF and SUVavg (r?=??0.383), BV and SUVavg (r?=??0.406), and BV and SUVmax (r?=??0.377), but not between BF and SUVmax, Ktrans and SUVavg, or Ktrans and SUVmax. Additionally, in MLN with SUVmax >2.5 there were negative correlations between BF and SUVavg (r?=??0.510), BV and SUVavg (r?=??0.390), BF and SUVmax (r?=??0.536), as well as BV and SUVmax (r?=??0.346).Conclusion
Perfusion and glucose metabolism seemed to be uncoupled in large primary tumours, but an inverse correlation was observed in MLN. This information may help improve therapy planning and response evaluation. 相似文献20.
Hai-Jeon Yoon Keon Wook Kang In Kook Chun Nariya Cho Seock-Ah Im Sunjoo Jeong Song Lee Kyeong Cheon Jung Yun-Sang Lee Jae Min Jeong Dong Soo Lee June-Key Chung Woo Kyung Moon 《European journal of nuclear medicine and molecular imaging》2014,41(8):1534-1543