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1.
Ho Seong Kim Joon Young Choi Dong Wook Choi Ho Yeong Lim Joo Hee Lee Sun Pyo Hong Young Seok Cho Kyung-Han Lee Byung-Tae Kim 《Nuclear Medicine and Molecular Imaging》2014,48(3):180-186
Purpose
To date, the prognostic value of 18F-FDG PET/CT for patients with pancreatic neuroendocrine tumors (PNETs) has not been well characterized. We investigated the prognostic value of volumetric parameters using 18F-FDG PET/CT in this patient population.Methods
We retrospectively reviewed 20 cases of pathologically proven PNET in patients who had undergone pre-therapeutic 18F-FDG PET/CT. PET parameters including maximum and average standardized uptake values (SUVmax, SUVave), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumor were measured using a threshold SUV to determine the boundaries of the tumors. Univariate and multivariate survival analyses were performed with adjustments for PET parameters and other clinical values.Results
The median clinical follow-up was 22.3 (range, 1.2–95.4) months. Cancer-related death occurred in 5 of 20 patients (25 %). Patients had clinical or pathological stages of I in seven patients, II in six patients, III in three patient, and IV in four patients. According to the WHO histological classification of subtypes, 3 patients exhibited well-differentiated PNETs, 13 patients had well-differentiated endocrine carcinomas, and 4 had poorly differentiatedendocrine carcinomas. Univariate analysis showed that tumor size (p = 0.028), AJCC stage (p = 0.009), T stage (p = 0.028), M stage (p = 0.029), treatment modality (p = 0.045), MTV (p = 0.003) and TLG (p = 0.027) were significant predictors of overall survival. On multivariate analysis, MTV (HR = 10.859, p = 0.031) was a significant independent predictor of overall survival along with the AJCC stage (HR = 11.556, p = 0.027).Conclusion
In patients with PNETs, the MTV of the primary tumor as measured by 18F-FDG PET/CT along with the AJCC stage may be a significant independent prognostic factor for overall survival. 相似文献2.
Sae-Ryung Kang Ho-Chun Song Byung Hyun Byun Jong-Ryool Oh Hyeon-Sik Kim Sun-Pyo Hong Seong Young Kwon Ari Chong Jahae Kim Sang-Geon Cho Hee Jeong Park Young-Chul Kim Sung-Ja Ahn Jung-Joon Min Hee-Seung Bom 《Nuclear Medicine and Molecular Imaging》2014,48(1):16-25
Purpose
We evaluated the value of variable 18F-FDG PET/CT parameters for the prediction of disease progression after concurrent chemoradiotherapy (CCRT) in patients with inoperable stage III non-small-cell lung cancer (NSCLC).Methods
One hundred sixteen pretreatment FDG PET/CT scans of inoperable stage III NSCLC were retrospectively reviewed (stage IIIA: 51; stage IIIB: 65). The volume of interest was automatically drawn for each primary lung tumor, and PET parameters were assessed as follows: maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) using the boundaries presenting SUV intensity exceeding 3.0, and the area under the curve of the cumulative SUV-volume histograms (AUC-CSH), which is known to reflect the tumor heterogeneity. Progression-free survival (PFS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were compared with each PET and clinical parameters by univariate and multivariate survival analysis.Results
In the ROC analysis, the optimal cutoff values of SUVmax, MTV (cm3), and AUC-CSH for prediction of PFS were determined as 21.5, 27.7, and 4,800, respectively. In univariate analysis, PFS was statistically significantly reduced in those with AUC-CSH < 4,800 (p = 0.004). In multivariate analysis, AUC-CSH and SUVmax were statistically significant independent prognostic factors (HR 3.35, 95 % CI 1.79–6.28, p < 0.001; HR 0.25, 95 % CI 0.09–0.70, p = 0.008, respectively). Multivariate analysis showed that AUC-CSH was the most significant independent prognostic factor for LRFS and DMFS (HR 3.27, 95 % CI 1.54–6.94, p = 0.002; HR 2.79, 95 % CI 1.42–5.50, p = 0.003).Conclusions
Intratumoral metabolic heterogeneity of primary lung tumor in 18F-FDG PET/CT can predict disease progression after CCRT in inoperable stage III NSCLC. 相似文献3.
Kyu-Ho Choi Ie Ryung Yoo Eun Ji Han Yeon Sil Kim Gi Won Kim Sae Jung Na Dong-Il Sun So Lyung Jung Chan-Kwon Jung Min-Sik Kim So-Yeon Lee Sung Hoon Kim 《Nuclear Medicine and Molecular Imaging》2011,45(1):43-51
Purpose
We assessed the prognostic value of metabolic tumor volume (MTV) measured using18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) inpatients with locally advanced head and neck squamous cell carcinoma (HNSCC).Methods
We retrospectively reviewed 56 patients (51 men, five women; mean age 56.0 ± 8.8years) who had locally advanced HNSCC and underwent FDG PET/CT for initial evaluation. All patients had surgical resection and radiotherapy with or without concurrent chemotherapy. The peak standardized uptake value (SUVpeak) and MTV of the target lesion, including primary HNSCC andmetastatic cervical lymph nodes, were measured from FDG PET/CT images. We compared SUVpeak, MTV, and clinicopathologic variables such as age, Eastern Cooperative Oncology Group (ECOG) performance status, pN stage, pT stage, TNM stage, histologic grade and treatment modality to disease-free survival (DFS) and overall survival (OS).Results
On the initial FDG PET/CT scans, the median SUVpeak was 7.8 (range, 1.8-19.0) and MTV was17.0 cm3 (range, 0.1-131.0 cm3). The estimated 2-year DFS and OS rates were 67.2% and 81.8%. The cutoff points of SUVpeak 6.2 and MTV 20.7 cm3 were the best discriminative values for predicting clinical outcome. MTV and ECOG performance status were significantly related to DFS and OS on univariate and multivariate analyses (p < 0.05).Conclusion
The MTV obtained from initial FDG PET/CT scan is a significant prognostic factor for disease recurrence and mortality in locally advanced HNSCC treated with surgery and radiotherapy with or without chemotherapy. 相似文献4.
Joo Hyun O Woo Hee Choi Eun Ji Han Eun-Kyoung Choi Byung Joo Chae Yong-Gyu Park Sung Hoon Kim 《Nuclear Medicine and Molecular Imaging》2013,47(4):263-267
Purpose
We evaluated whether the maximum standardized uptake values (SUVmax) of primary tumor from the initial staging by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of patients with breast cancer could identify patients at risk for early recurrence within 2 years, particularly in comparison to the American Joint Committee on Cancer (AJCC) stage.Methods
We reviewed the staging 18F-FDG PET/CT images of patients with primary breast cancer and their medical records. The SUVmax of the primary tumor was measured. The presence or absence of FDG uptake in the axillary lymph node (ALN) was also assessed. The patient’s pathologic primary tumor stage (pT), pathologic regional lymph node stage (pN), stage grouping, age, estrogen receptor (ER) and progesterone receptor (PR) status, and neoadjuvant chemotherapy history were evaluated with the FDG uptake parameters for recurrence within 2 years following the end of first-line therapy.Results
Recurrence within 2 years was present in 9.1 % (n = 40) out of the 441 patients assessed. The FDG uptake in ALN, pT, pN, stage grouping and neoadjuvant chemotherapy history were prognostic for early recurrence, while primary tumor SUVmax, age, and ER or PR status were not significant on logistic regression. On multivariate analysis, only the stage grouping (odds ratio 2.79; 95 % CI 1.73, 4.48; p < 0.0001) and neoadjuvant chemotherapy history (odds ratio 2.70; 95 % CI 1.22, 5.98; p = 0.0141) could identify patients at increased risk for recurrence within 2 years.Conclusions
Primary tumor FDG uptake measured by SUVmax, and visual assessment of FDG uptake in the ALN in the initial staging PET/CT of patients with breast cancer may not have additional prognostic value compared with the AJCC stage grouping for early recurrence. 相似文献5.
Hyung-Jun Im Yu Kyeong Kim Yong-il Kim Jong Jin Lee Won Woo Lee Sang Eun Kim 《Nuclear Medicine and Molecular Imaging》2013,47(1):36-43
Purpose
The purpose of this study was to investigate the usefulness of metabolic-volumetric indices of 18F- fluorodeoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for the evaluation of neoadjuvant chemotherapy outcomes in breast cancer.Methods
Twenty-four patients with locally advanced breast cancer were enrolled in the study. They underwent baseline 18F-FDG PET/CT scan and received four or six cycles of neoadjuvant chemotherapy, interim 18F-FDG PET/CT was done after second cycle of chemotherapy. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary lesions were calculated. Reduction rates of these parameters were obtained between baseline and interim 18F-FDG PET/CT. Chemotherapy outcomes were assessed using tumor size reduction rate and histological grading system (Miller and Payne system). Reduction rates of SUVmax, MTV, and TLG correlated with chemotherapy outcomes.Results
MTV and TLG reduction rates showed significant correlation with tumor size reduction rate (R = 0.68, P = 0.0004; R = 0.62, P = 0.002, respectively). However, SUVmax reduction rate showed no significant correlation. MTV and TLG reduction rates were significantly higher in responders than nonresponders, as determined by Miller and Payne system (P < 0.0007, P < 0.002). However, SUVmax reduction rate showed no significant difference. On ROC analysis, the area under the MTV and TLG curves was 0.886, and that of SUVmax was 0.743. Sensitivity, specificity, positive predictive value, and negative predictive value to predict histopathologic response were the same for MTV and TLG, and the values were 100 %, 85.7 %, 83.3 %, and 100 %, respectively (at the reduction rate of 93.2 % for MTV, and 95.8 % for TLG).Conclusion
Changes of metabolic–volumetric indices successfully reflected the neoadjuvant chemotherapy outcomes. MTV and TLG could be robust indices in discriminating pathologic responder as SUVmax, after neoadjuvant chemotherapy. 相似文献6.
Jahae Kim Su Woong Yoo Sae-Ryung Kang Sang-Geon Cho Jong-Ryool Oh Ari Chong Jung-Joon Min Hee-Seung Bom Jung-Han Yoon Ho-Chun Song 《Nuclear Medicine and Molecular Imaging》2012,46(4):278-285
Purpose
We investigated whether PET indices measured by 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) can predict prognosis in patients with operable primary breast cancer.Methods
We reviewed 53 patients with operable primary breast cancer who underwent pretreatment FDG PET/CT. PET indices, maximum standardized uptake value (SUV) and metabolic tumor volume (MTV), were measured in the primary breast tumor (P), metastatic lymph nodes (N) and total tumor (T). The Cox proportional hazards model was used with age, tumor size, clinical lymph node status, method of surgery, presence or absence of neoadjuvant chemotherapy, histological type, histological grade, hormone receptors and HER2 status to predict disease-free survival (DFS) and overall survival (OS).Results
Median follow-up period was 50 months (range, 17–73 months), during which 17 patients had recurrent disease and nine of whom died. The univariate analysis showed that high SUV of N (NSUV, P = 0.011), MTV of N (NMTV, P = 0.011) and MTV of T (TMTV, P = 0.045) as well as high histological grade (P = 0.008), negative estrogen (P = 0.045) and negative progesterone (P = 0.029) receptor status were associated with shorter DFS. High NSUV (P = 0.035), NMTV (P = 0.035) and TMTV (P = 0.035) as well as high histological grade (P = 0.012) and negative estrogen receptor status (P = 0.009) were associated with shorter OS. NSUV, NMTV and TMTV were found to be significantly associated with high histological grade (P = 0.005). However, those failed to be statistically significant prognostic factors on multivariate analysis.Conclusions
PET indices seem to be useful in the preoperative evaluation of prognosis in patients with operable primary breast cancer. NSUV, NMTV and TMTV might be considerable factors associated with patient outcome in operable breast cancer. 相似文献7.
Su Jin Lee Joon Young Choi Hwan Joo Lee Chung-Hwan Baek Young-Ik Son Seung Hyup Hyun Seung Hwan Moon Byung-Tae Kim 《Korean journal of radiology》2012,13(6):752-759
Objective
To evaluate the prognostic value of volume-based metabolic parameters measured with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in patients with clinically node-negative (cN0) oral tongue squamous cell carcinoma (OTSCC) as compared with other prognostic factors.Materials and Methods
In this study, we included a total of 57 patients who had been diagnosed with cN0 tongue cancer by radiologic, 18F-FDG PET/CT, and physical examinations. The maximum standardized uptake value (SUVmax), average SUV (SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for primary tumors were measured with 18F-FDG PET. The prognostic significances of these parameters and other clinical variables were assessed by Cox proportional hazards regression analysis.Results
In the univariate analysis, pathological node (pN) stage, American Joint Committee on Cancer (AJCC) stage, SUVmax, SUVavg, MTV, and TLG were significant predictors for survival. On a multivariate analysis, pN stage (hazard ratio = 10.555, p = 0.049), AJCC stage (hazard ratio = 13.220, p = 0.045), and MTV (hazard ratio = 2.698, p = 0.033) were significant prognostic factors in cN0 OTSCC patients. The patients with MTV ≥ 7.78 cm3 showed a worse prognosis than those with MTV < 7.78 cm3 (p = 0.037).Conclusion
The MTV of primary tumor as a volumetric parameter of 18F-FDG PET, in addition to pN stage and AJCC stage, is an independent prognostic factor for survival in cN0 OTSCC. 相似文献8.
Jeonghun Kim Seok Tae Lim Chang Ju Na Yeon-Hee Han Chan-Young Kim Hwan-Jeong Jeong Myung-Hee Sohn 《Nuclear Medicine and Molecular Imaging》2014,48(1):33-40
Purpose
We performed this study to evaluate the predictive value of pretreatment F-18 FDG PET/CT for progression-free survival (PFS) in patients with gastric cancer.Methods
Of 321 patients with a diagnosis of gastric cancer, we retrospectively enrolled 97 patients (men:women = 61:36, age 59.8 ± 13.2 years), who underwent pretreatment F-18 fluoro-2-deoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) from January 2009 to December 2009. Maximum standardized uptake value (SUVmax) was measured for each case with detectable primary lesions. In the remaining non-detectable cases, SUVmax was measured from the corresponding site seen on gastroduodenoscopy for analysis. In subgroup analysis, metabolic tumor volume (MTV) was measured in 50 patients with clearly distinguishable primary lesions. SUVmax, stage, depth of tumor invasion and presence of lymph node metastasis were analyzed in terms of PFS. Receiver operating characteristic (ROC) curves were used to find optimal cutoff values of SUVmax and MTV for disease progression. The relationship between SUVmax, MTV and PFS was analyzed using the Kaplan-Meier with log-rank test and Cox’s proportional hazard regression methods.Results
Of 97 patients, 15 (15.5 %) had disease progression. The mean follow-up duration was 29.6 ± 10.2 months. The mean PFS of low SUVmax group (≤5.74) was significantly longer than that of the high SUVmax group (>5.74) (30.9 ± 8.0 vs 24.3 ± 13.6 months, p = 0.008). In univariate analysis, stage (I vs II, III, IV), depth of tumor invasion (T1 vs T2, T3, T4), presence of lymph node metastasis and SUVmax (>5.74 vs ≤5.74) were significantly associated with recurrence. In multivariate analysis, high SUVmax (>5.74) was the only poor prognostic factor for PFS (p = 0.002, HR 11.03, 95 % CI 2.48–49.05). Subgroup multivariate analysis revealed that high MTV (>16.42) was the only poor prognostic factor for PFS (p = 0.034, HR 3.59, 95 % CI 1.10–11.71).Conclusion
In gastric cancer, SUVmax measured by pretreatment F-18 FDG PET/CT has a significant predictive value for PFS. In addition, if MTV is measurable, high MTV is an independent factor for disease progression. 相似文献9.
Chun-Yi Lin Hui-Yi Chen Hueisch-Jy Ding Kuo-Yang Yen Chia-Hung Kao 《Korean journal of radiology》2013,14(2):337-342
Objective
Angiomyolipoma is the most common benign kidney tumor. However, literature describing FDG PET findings on renal angiomyolipoma (AML) is limited. This study reports the FDG PET and PET/CT findings of 21 cases of renal AML.Materials and Methods
The study reviews FDG PET and PET/CT images of 21 patients diagnosed with renal AML. The diagnosis is based on the classical appearance of an AML on CT scan with active surveillance for 6 months. The study is focused on the observation of clinical and radiographic features.Results
Six men and 15 women were included in our study. The mean age of the patients was 57.14 ± 9.67 years old. The mean diameter of 21 renal AML on CT scans was 1.76 ± 1.00 cm (Min: 0.6 cm; Max: 4.4 cm). CT scans illustrated renal masses typical of AMLs, and the corresponding FDG PET scans showed minimal FDG activities in the area of the tumors. None of the 21 AMLs showed a maximum standardized uptake value (SUVmax) greater than 1.98. No statistically significant correlation was present between SUVmax and tumor size.Conclusion
Renal AMLs demonstrate very low to low uptake on FDG PET and PET/CT imaging in this study. When a fat-containing tumor in the kidney is found on a CT scan, it is critical to differentiate an AML from a malignant tumor including an RCC, liposarcoma, and Wilms tumor. This study suggests that FDG PET or PET/CT imaging is useful for differentiating a renal AML from a fat-containing malignant tumor. 相似文献10.
Jang Yoo Joon Young Choi Kyu Taek Lee Jin Seok Heo Soo Bin Park Seung Hwan Moon Yearn Seong Choe Kyung-Han Lee Byung-Tae Kim 《Nuclear Medicine and Molecular Imaging》2012,46(3):201-206
Purpose
We investigated the prognostic values of volume-based metabolic parameters by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) in gallbladder carcinoma patients and compared them with other prognostic parameters.Materials and Methods
We enrolled 44 patients, who were initially diagnosed with gallbladder carcinoma and undergoing 18F-FDG PET/CT. Various metabolic volume-based PET parameters of primary tumors, including maximum and average standardized uptake values (SUVmax, SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), were measured in gallbladder carcinoma patients using mediastinal blood pool activity as a threshold SUV for determining the tumor boundaries. Overall survival analysis was performed using the Kaplan-Meier method with PET parameters and other clinical variables. For determining independent prognostic factors, Cox proportional hazards regression analysis was performed.Results
Of the 44 enrolled patients, cancer- or treatment-related death occurred in 30 (68.2 %). The mean clinical follow-up period was 22.2 ± 10.4 m (range, 0.6-35.9 m). Univariate analysis demonstrated that clinical or pathologic TNM stage (P < 0.001), treatment modality (P < 0.001), MTV (cutoff = 135 cm3, P = 0.001), and TLG (cutoff = 7,090, P < 0.05) were significant prognostic factors. In multivariate analysis, both clinical or pathologic TNM stage [hazard ratio (HR) = 2.019 (I vs II), 21.287 (I vs III), and 24.354 (I vs IV); P = 0.001) and TLG (HR = 2.930; P < 0.05) were independent prognostic factors for predicting overall survival.Conclusions
In gallbladder cancer, TLG of the primary tumor, a volume-based metabolic parameter, is a significant independent prognostic factor for overall survival in conjunction with the clinical or pathological TNM stage. 相似文献11.
Suk Hyun Lee Sangwon Han Hyo Sang Lee Sun Young Chae Jong Jin Lee Dong Eun Song Jin-Sook Ryu 《Nuclear Medicine and Molecular Imaging》2016,50(1):38-45
Purpose
The BRAF mutation, a potential prognostic factor in papillary thyroid carcinoma (PTC), is associated with a high expression of the glucose transporter gene. We investigated which clinicopathologic factors, including BRAF mutation status, influence 18F-fluoro-2-deoxyglucose (18F-FDG) avidity.Methods
We retrospectively reviewed 55 patients who underwent BRAF analysis from biopsy-confirmed PTC and 18F-FDG positron emission tomography/computed tomography within 6 months before undergoing thyroid surgery from September 2008 to August 2014. Tumors were considered to be 18F-FDG avid if the uptake was greater than that of the liver. 18F-FDG uptake of PTCs was also analyzed semiquantitatively using SUVmax. The association between 18F-FDG avidity and clinicopathologic variables (age, tumor size, perithyroidal extension, cervical lymph node status, and BRAF mutation status) was investigated.Results
Twenty-nine (52.7 %) of 55 patients had 18F-FDG-avid PTCs. PTCs with the BRAF mutation showed higher 18F-FDG avidity (24/38, 63.2 %) than those without (5/17, 29.4 %). The BRAF mutation (p = 0.025) and tumor size (p = 0.003) were significantly associated with 18F-FDG avidity in univariate analysis, and the BRAF mutation status remained significant after adjusting for tumor size in multivariate analysis (p = 0.015). In the subgroup of tumor size ≥ 1 cm, the BRAF mutation was the only factor significantly associated with 18F-FDG avidity (p = 0.021). The mean SUVmax of PTCs with the BRAF mutation was significantly higher than that of those without (4.89 ± 6.12 vs. 1.96 ± 1.10, p = 0.039).Conclusions
The BRAF mutation must be one of the most important factors influencing 18F-FDG avidity in PTCs, especially in those with a tumor size ≥ 1 cm. 相似文献12.
Hyo Jung Seo Yun Jung Choi Hyun Jeong Kim Yong Hyu Jeong Arthur Cho Jae Hoon Lee Mijin Yun Hye Jin Choi Jong Doo Lee Won Jun Kang 《Nuclear Medicine and Molecular Imaging》2011,45(3):203-211
Purpose
Bone metastasis from hepatocellular carcinoma (HCC) can present with soft tissue formation, resulting in oncologic emergency. Contrast-enhanced FDG PET/CT and bone scintigraphy were compared to evaluate characteristics of bone metastases with or without soft tissue formation from HCC.Methods
Of 4,151 patients with HCC, 263 patients had bone metastases. Eighty-five patients with bone metastasis from HCC underwent contrast-enhanced FDG PET/CT. Fifty-four of the enrolled subjects had recent 99mTc-HDP bone scintigraphy available for comparison. Metastatic bone lesions were identified with visual inspection on FDG PET/CT, and maximum standardized uptake value (SUVmax) was used for the quantitative analysis. Confirmation of bone metastasis was based on histopathology, combined imaging modalities, or serial follow-up studies.Results
Forty-seven patients (55%) presented with soft tissue formation, while the remaining 38 patients presented without soft tissue formation. Frequent sites of bone metastases from HCC were the spine (39%), pelvis (19%), and rib cage (14%). The soft-tissue-formation group had more frequent bone pain (77 vs. 37%, p < 0.0001), higher SUVmax (6.02 vs. 3.52, p < 0.007), and higher incidence of photon defect in bone scintigraphy (75 vs. 0%) compared to the non-soft-tissue-formation group. FDG PET/CT had higher detection rate for bone metastasis than bone scintigraphy both in lesion-based analysis (98 vs. 53%, p = 0.0015) and in patient-based analysis (100 vs. 80%, p < 0 .001).Conclusions
Bone metastasis from HCC showed a high incidence of soft tissue formation requiring emergency treatment. Although the characteristic findings for soft tissue formation such as photon defect in bone scintigraphy are helpful in detection, overall detectability of bone metastasis is higher in FDG PET/CT. Contrast-enhanced PET/CT will be useful in finding and delineating soft-tissue-forming bone metastasis from HCC. 相似文献13.
Min Young Yoo Jin Chul Paeng Gi Jeong Cheon Dong Soo Lee June-Key Chung E. Edmund Kim Keon Wook Kang 《Nuclear Medicine and Molecular Imaging》2015,49(4):291-297
Purpose
C-11 methionine (MET) PET is commonly used for diagnosing high-grade glioma (HGG). Recently, volumetric analysis has been widely applied to oncologic PET imaging. In this study, we investigated the prognostic value of metabolic tumor volume (MTV) on MET PET in HGG.Methods
A total of 30 patients with anaplastic astrocytoma (n = 12) and glioblastoma multiforme (n = 18) who underwent MET PET before treatment (surgery followed by chemo-radiotherapy) were retrospectively enrolled. Maximal tumor-to-normal brain ratio (TNRmax, maximum tumor activity divided by mean of normal tissue) and MTV (volume of tumor tissue that shows uptake >1.3-fold of mean uptake in normal tissue) were measured on MET PET. Adult patients were classified into two subgroups according to Radiation Therapy Oncology Group Recursive Partitioning Analysis (RTOG RPA) classification. Prognostic values of TNRmax, MTV and clinicopathologic factors were evaluated with regard to progression-free survival (PFS).Results
Median PFS of all patients was 7.9 months (range 1.0–53.8 months). In univariate analysis, MTV (cutoff 35 cm3) was a significant prognostic factor for PFS (P = 0.01), whereas TNRmax (cutoff 3.3) and RTOG RPA class were not (P = 0.80 and 0.61, respectively). Treatment of surgical resection exhibited a borderline significance (P = 0.06). In multivariate analysis, MTV was the only independent prognostic factor for PFS (P = 0.03).Conclusion
MTV on MET PET is a significant and independent prognostic factor for PFS in HGG patients, whereas TNRmax is not. Thus, performing volumetric analysis of MET PET is recommended in HGG for better prognostication. 相似文献14.
Ji-Eun Shin Hyuck Jae Choi Mi-hyun Kim Kyoung-Sik Cho 《Korean journal of radiology》2011,12(4):456-462
Objective
We wanted to evaluate the diagnostic value of serum CA-125 concentration, when used in combination with the preoperative contrast-enhanced CT results, to differentiate borderline ovarian tumors (BOTs) from stage I malignant epithelial ovarian tumors (MEOTs).Materials and Methods
Ninety-eight masses (46 BOTs and 52 stage I MEOTs) from 87 consecutive patients (49 with BOTs and 38 with stage I MEOTs) who had undergone preoperative contrast-enhanced computed tomography (CT) and surgical staging were evaluated retrospectively and independently by two radiologists. The preoperative serum CA-125 concentration was measured in all patients. The utility of analyzing serum CA-125 concentration in combination with the CT results was evaluated by receiver operating characteristic (ROC) curve analysis.Results
An irregular tumor surface and lymphadenopathy were predictive of a MEOT. ROC analysis showed that the combination of CT data and the serum CA-125 level resulted in a higher diagnostic performance than did using the CT alone for differentiating BOTs from MEOTs. The areas under the curves (AUCs) without and with the use of the serum CA-125 level data were 0.67 (95% confidence interval [CI]: 0.57-0.77) and 0.78 (95% CI: 0.68-0.85), respectively, for reader 1 (p = 0.029) and 0.71 (95% CI: 0.61-0.80) and 0.81 (95% CI: 0.72-0.89), respectively, for reader 2 (p = 0.009).Conclusion
The serum CA-125 concentration is of additional diagnostic value when used in conjunction with the CT imaging results for differentiating BOTs from MEOTs. 相似文献15.
Hae Won Kim Kyoung Sook Won Bong-Il Song Yu Na Kang 《Nuclear Medicine and Molecular Imaging》2015,49(2):135-142
Purpose
Histopathologic features could affect the FDG uptake of primary gastric cancer and detection rate on FDG PET/CT. The aim of this study was to evaluate the FDG uptake of primary gastric cancer by correlating it with the histopathologic features of the tumors.Methods
Fifty patients with locally advanced gastric adenocarcinoma who were referred for preoperative FDG-PET/CT scans were enrolled in this study. The detection rate of PET/CT and maximum standardized uptake values (SUVmax) of the primary tumor were compared using the WHO, Lauren, Ming and Borrmann classifications and tumor size and location.Results
In 45 of the 50 patients (90 %), the primary gastric tumors were detected by FDG PET/CT. On comparison using the WHO classification, the detection rate and SUVmax of the tubular type were significantly higher than those of the poorly cohesive type. On comparison using the Lauren and Ming classifications, the SUVmaxs of the intestinal type and expanding type were significantly higher than those of the diffuse and infiltrative type, respectively. On comparison using the Borrmann classification and tumor size and location, there was no significant difference in the detection rate and SUVmax of primary gastric tumors.Conclusion
This study demonstrates that the poorly cohesive type according to the WHO classification, diffuse type according to the Lauren classification and infiltrative type according to the Ming classification have low FDG uptake in patients with locally advanced gastric carcinoma. Understanding the relationship between primary tumor FDG uptake and histopathologic features would be helpful in detecting the primary tumor by FDG PET/CT in patients with gastric cancer. 相似文献16.
Kyoungjune Pak Seong-Jang Kim In Joo Kim Keunyoung Kim Heeyoung Kim So Jung Kim 《Nuclear Medicine and Molecular Imaging》2012,46(3):176-181
Purpose
We aimed to evaluate the relation between visceral fat volume and fluorodeoxyglucose (FDG) uptake of the liver measured by maximum or mean standardized uptake value.Methods
We retrospectively analyzed 96 consecutive records of positron emission tomography/computed tomography (PET/CT) performed for cancer screening between May 2011 and December 2011. Subjects were divided into 2 groups according to Hounsfield unit (HU) of the liver comparing with that of the spleen. The control group (20 women, 56 men) demonstrating HU of the liver equal or greater than that of the spleen included 76 patients, while the fatty liver group (2 women, 18 men) showing HU of the liver less than that of the spleen included 20 patients. We compared FDG uptake of the liver and visceral fat volume between two groups. We evaluated correlation of hepatic FDG uptake measured by maximum or mean standardized uptake value (SUV) with visceral fat volume and attenuation.Results
The fatty liver disease group showed higher aspartate aminotransferase (AST)of (24.42 ± 7.22, p = 0.012), alanine aminotransferase (ALT) of (25.16 ± 11.68, p = 0.001), body mass index (BMI) of (24.58 ± 3.29, p = 0.021), and visceral fat volume (3063.53 ± 1561.43, p = 0.011) than the control group. There were no statistically significant differences of mean standardized uptake value of the liver (liver SUVmean) (2.73 ± 0.19, p = 0.723), maximum standardized uptake value of the liver (liver SUVmax) (3.39 ± 0.53, p = 0.8248) and liver SUVmean/spleen SUVmean (1.13 ± 0.10, p = 0.081) between the two groups. Strong correlations were shown between liver SUVmean and BMI (r = 0.609, p < 0.001) and between liver SUVmean and visceral fat volume (r = 0.457, p < 0.001). Liver SUVmax was also strongly correlated with BMI (r = 0.622, p = 0.001) and visceral fat volume (r = 0.547, p < 0.001). There was no significant association of mean attenuation value of the liver (liver HUmean) with liver SUVmean (r = -0.003, p = 0.979) or liver SUVmax (r = -0.120, p = 0.244).Conclusion
Hepatic FDG uptake quantified as SUVmean or SUVmax is not correlated with hepatic steatosis but with visceral fat volume in cancer screening. 相似文献17.
A. Ra Cho Ilhan Lim Im Il Na Du Hwan Choe Joon Yeun Park Byung Il Kim Gi Jeong Cheon Chang Woon Choi Sang Moo Lim 《Nuclear Medicine and Molecular Imaging》2011,45(1):52-58
Purpose
The aim of this study was to assess the diagnostic efficacy of PET/CT using various parameters for the characterization of adrenal nodules in lung cancer patients.Methods
Sixty-one adrenal nodules in 51 lung cancer patients were evaluated. The final diagnosis was based on histology (n = 2) or imaging follow-up (n = 59, range of follow-up: 7–57 months, median 27 months). Each adrenal nodule was analyzed using four parameters of PET/CT: the maximum standardized uptake value (SUVmax), the adrenal nodule/liver ratio of the SUV (SUV ratio), Hounsfield units (HU) and size. The optimal cutoff of each parameter for the identification of metastatic nodule was determined by ROC analysis and then the diagnostic efficacy was compared among the parameters.Results
Of the 61 adrenal nodules, 45 (73%) were considered metastasis. The optimal cutoff values of the parameters were SUVmax >2.7, SUV ratio >1.3, HU >18 and size >20 mm, respectively. The sensitivity, specificity and accuracy by SUVmax >2.7 were 88.9%, 87.5% and 88.5%, and those by SUV ratio >1.3 were 84.4%, 100% and 88.5%, respectively. The combination of SUV ratio >1.3 and HU >18 had sensitivity of 97.7%, specificity of 81.2% and accuracy of 93.4% to predict adrenal metastasis in patients with lung cancer.Conclusion
SUV ratio from F-18 FDG PET/CT could identify the adrenal metastasis in lung cancer patients. The combination of SUV ratio and HU can improve the accuracy of differentiating benign and metastatic adrenal lesions in lung cancer patients. 相似文献18.
Jae Pil Hwang Ilhan Lim Im II Na Eung Ho Cho Byung II Kim Chang Woon Choi Sang Moo Lim 《Nuclear Medicine and Molecular Imaging》2014,48(2):114-120
Objective
The aim of this study is to investigate the prognostic value of F-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET)/computed tomography (CT) in gallbladder cancer patients.Methods
From June 2004 to June 2010, a total of 50 patients with gallbladder cancer who underwent diagnostic staging with F-18 FDG PET/CT following curative or palliative treatments were retrospectively evaluated. For the analysis, all patients were classified by age, sex, maximum standardized uptake value (SUVmax), lymph node (LN) or distant metastasis, serum level of CA19-9 and CEA, type of treatment and American Joint Committee on Cancer (AJCC) stage.Results
The median survival for the 50 patients was 245 days and the median SUVmax in PET/CT was 8.3 (range, 0-19.7). Patients with SUVmax < 6 survived significantly longer than patients with SUVmax ≥ 6 (median 405 days vs 203 days, p = 0.0400). On Kaplan-Meier analysis, SUVmax (p = 0.0400), stage (p = 0.0001), CA19-9 (p = 0.013), CEA (p = 0.006), LN metastasis (p = 0.0001), distant metastasis (p = 0.0020), type of treatment (p = 0.0001) were significantly associated with overall survival. Multivariate analysis study revealed that the patients with lower SUVmax measured from initial staging PET/CT (p = 0.0380), no LN metastasis (p = 0.0260), a lower stage (p = 0.026) and curative treatment (p = 0.0005) had longer survivals.Conclusions
The present study shows that SUVmax on F-18 FDG PET/CT can provide prognostic information in patients with gallbladder cancer. 相似文献19.
Dae-Weung Kim Woo Hyoung Kim Chang Guhn Kim 《Nuclear Medicine and Molecular Imaging》2012,46(3):196-200
Purpose
Dual-time-point (DTP) FDG PET/CT has been shown to be useful for lymph node (LN) staging in patients with non-small-cell lung cancer (NSCLC). The aim of this study was to evaluate the LN staging ability of DTP FDG PET/CT in the predominant area of pulmonary tuberculosis.Methods
Sixty-nine NSCLC patients underwent DTP PET/CT. Regions of interest were placed on each LN of each station, and the maximum SUVs were measured. Three variables were obtained: (1) the SUV on the early scan (SUVearly), (2) the SUV on the delayed scan (SUVdelayed), and (3) the retention index of the SUV (RI). Each patient had one final LN stage and three other LN stages according to the cutoff values of SUVearly, SUVdelayed, and RI.Results
In the LN-based analysis, the area under the ROC curve of SUVdelayed (0.884) was significantly larger (P < 0.01) than those of SUVearly (0.868) and RI (0.717). Among the three variables, SUVdelayed was more accurate (P < 0.01) for detecting the mediastinal LN metastasis than SUVearly and RI. In the patient-based analysis, SUVdelayed had correctly determined LN stages in 55 of 69 patients (sensitivity, specificity, and accuracy = 88.7 %, 50.0 %, and 79.7 %), whereas SUVearly and RI correctly determined LN stages in 53 and 52 patients, respectively.Conclusions
In this study, comparing the diagnostic efficacy of SUVearly, SUVdelayed, and RI for LN staging in patients with NSCLC, SUVdelayed was the most accurate variable for LN staging. DTP PET/CT could provide improved diagnostic accuracy for the LN staging of NSCLC. 相似文献20.
Masatoyo Nakajo Masayuki Nakajo Megumi Jinguji Yoshihiko Fukukura Yoshiaki Nakabeppu Atsushi Tani Takashi Yoshiura 《The British journal of radiology》2015,88(1055)