共查询到20条相似文献,搜索用时 15 毫秒
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Tomonori Kanda Kazuhiro Kitajima Yuko Suenaga Jyunya Konishi Ryohei Sasaki Koichi Morimoto Miki Saito Naoki Otsuki Ken-ichi Nibu Kazuro Sugimura 《European journal of radiology》2013
Purpose
To assess the clinical value of retrospective image fusion of neck MRI and 18F-fluorodeoxyglucose (18F-FDG) PET for locoregional extension and nodal staging of neck cancer.Materials and methods
Thirty patients with carcinoma of the oral cavity or hypopharynx underwent PET/CT and contrast-enhanced neck MRI for initial staging before surgery including primary tumor resection and neck dissection. Diagnostic performance of PET/CT, MRI, and retrospective image fusion of PET and MRI (fused PET/MRI) for assessment of the extent of the primary tumor (T stage) and metastasis to regional lymph nodes (N stage) was evaluated.Results
Accuracy for T status was 87% for fused PET/MRI and 90% for MRI, thus proving significantly superior to PET/CT, which had an accuracy of 67% (p = 0.041 and p = 0.023, respectively). Accuracy for N status was 77% for both fused PET/MRI and PET/CT, being superior to MRI, which had an accuracy of 63%, although the difference was not significant (p = 0.13). On a per-level basis, the sensitivity, specificity and accuracy for detection of nodal metastasis were 77%, 96% and 93% for both fused PET/MRI and PET/CT, compared with 49%, 99% and 91% for MRI, respectively. The differences for sensitivity (p = 0.0026) and accuracy (p = 0.041) were significant.Conclusion
Fused PET/MRI combining the individual advantages of MRI and PET is a valuable technique for assessment of staging neck cancer. 相似文献4.
The future clinical use of the combination of positron emission tomography (PET) with 2-Fluoro[F-18]-2-Deoxy-d-Glucose (FDG)and MRI is still unclear. If a patient requires a PET and breast DCE-MRI for staging purposes, both scans can be done in the same visit. In the breast, DCE-MRI is better at lesion detection (sensitivity), margin evaluation, and has a higher specificity than CT. The potential for multiparametric qualitative and quantitative imaging is also an advantage of PET/MRI which provides opportunity to improve tumor characterization and may ultimately lead to outcome prediction. This review discusses technical and clinical aspects of this emerging technology in breast cancer patients. 相似文献
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Halpern BS Yeom K Fueger BJ Lufkin RB Czernin J Allen-Auerbach M 《European journal of radiology》2007,62(2):199-204
Background
18F-FDG PET has a high accuracy for re-staging of head and neck cancer. The purpose of this study was to determine whether the diagnostic accuracy can be further improved with integrated PET/CT.Materials and methods
Forty-nine patients with a mean age of 59 ± 18 years were studied retrospectively. Histo-pathological verification was available either from complete tumor resection with or without lymph node dissection (n = 27) or direct endoscopic biopsy (n = 16) or ultrasound guided biopsy (n = 6). Two reviewers blinded to the pathological findings read all PET images in consensus. An experienced radiologist was added for the interpretation of the PET/CT images.Results
Tissue verification was available for 110 lesions in 49 patients. Sixty-seven lesions (61%) were biopsy positive and 43 (39%) were negative for malignant disease. PET and PET/CT showed an overall accuracy for cancer detection of 84 and 88% (p = 0.06), respectively. Sensitivity and specificity for PET were 78 and 93% versus 84 (p = NS) and 95% (p = NS) with PET/CT. A patient-by-patient analysis yielded a sensitivity, specificity and accuracy for PET of 80, 56 and 76%, compared to 88% (p = NS), 78% (p = NS) and 86% (p = 0.06) for PET/CT.Conclusion
The results of this study indicate that PET/CT does not significantly improve the detection of recurrence of head and neck cancer. However, a trend towards improved accuracy was observed (p = 0.06). 相似文献6.
Mona A. El-Hariri Ghada K. Gouhar Ali M. Refat 《The Egyptian Journal of Radiology and Nuclear Medicine》2012
Purpose
The purpose of this study was to evaluate the role of integrated PET/CT in the staging of lung cancer compared with CT alone or PET alone.Materials and methods
Thirty-three patients underwent integrated PET/CT for the staging of lung cancer. The tumor, node and metastasis (TNM) stages were assessed with CT, PET and integrated PET–CT and compared with the surgical and pathological staging.Results
CT correctly evaluated the (T) status in (64%) of the patients, PET in (59%) and PET/CT in (86%). CT correctly evaluated the (N) status in (73%) of the patients, PET in (76%), and PET/CT (88%) with accuracy, sensitivity, specificity, PPV and NPV were 73%, 78%, 71%, 50% and 94% for CT, 76%, 67%, 79%, 55% and 95% for PET and 88%, 89%, 88%, 73% and 100% for PET/CT respectively, and for (M) status were 91%, 86%, 92%, 75% and 96% for CT, 88%, 71%, 92%, 71% and 92% for PET and 97%, 100%, 96%, 88% and 100% for PET/CT respectively. Regarding the overall TNM staging CT correctly staged 24 patients. PET correctly staged 23 cases while PET/CT correctly staged 30 cases. A significant difference in the accuracy of overall tumor staging between PET/CT and CT (P = 0.0412) or PET (P = 0.0233).Conclusion
The integrated PET/CT is superior to either CT or PET in the staging of lung cancer which has an important impact on selection of the appropriate treatment regimen. 相似文献7.
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Leonardo Pace Emanuele Nicolai Angelo Luongo Marco Aiello Onofrio A. Catalano Andrea Soricelli Marco Salvatore 《European journal of radiology》2014
Purpose
To compare the performance of PET/MRI imaging using MR attenuation correction (MRAC) (DIXON-based 4-segment -map) in breast cancer patients with that of PET/CT using CT-based attenuation correction and to compare the quantification accuracy in lesions and in normal organ tissues.Methods
A total of 36 patients underwent a whole-body PET/CT scan 1 h after injection and an average of 62 min later a second scan using a hybrid PET/MRI system. PET/MRI and PET/CT were compared visually by rating anatomic allocation and image contrast. Regional tracer uptake in lesions was quantified using volumes of interest, and maximal and mean standardized uptake values (SUVmax and SUVmean, respectively) were calculated. Metabolic tumor volume (MTV) of each lesion was computed on PET/MRI and PET/CT. Tracer uptake in normal organ tissue was assessed as SUVmax and SUVmean in liver, spleen, left ventricular myocardium, lung, and muscle.Results
Overall 74 FDG positive lesions were visualized by both PET/CT and PET/MRI. No significant differences in anatomic allocation scores were found between PET/CT and PERT/MRI, while contrast score of lesions on PET/MRI was significantly higher. Both SUVmax and SUVmean of lesions were significantly higher on PET/MRI than on PET/CT, with strong correlations between PET/MRI and PET/CT data (ρ = 0.71–0.88). MTVs of all lesions were 4% lower on PET/MRI than on PET/CT, but no statistically significant difference was observed, and an excellent correlation between measurements of MTV with PET/MRI and PET/CT was found (ρ = 0.95–0.97; p < 0.0001). Both SUVmax and SUVmean were significantly lower by PET/MRI than by PET/CT for lung, liver and muscle, no significant difference was observed for spleen, while either SUVmax and SUVmean of myocardium were significantly higher by PET/MRI. High correlations were found between PET/MRI and PET/CT for both SUVmax and SUVmean of the left ventricular myocardium (ρ = 0.91; p < 0.0001), while moderate correlations were found for the other normal organ tissues (ρ = 0.36–0.61; p < 0.05).Conclusions
PET/MRI showed equivalent performance in terms of qualitative lesion detection to PET/CT. Despite significant differences in tracer uptake quantification, due to either methodological and biological factors, PET/MRI and PET/CT measurements in lesions and normal organ tissues correlated well. This study demonstrates that integrated whole-body PET/MRI is feasible in a clinical setting with high quality and in a short examination time. 相似文献9.
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Kazuhiro Kitajima Yuko Suenaga Yoshiko Ueno Tomonori Kanda Tetsuo Maeda Satoru Takahashi Yasuhiko Ebina Yoshiya Miyahara Hideto Yamada Kazuro Sugimura 《European journal of radiology》2013
Purpose
To investigate the diagnostic value of retrospective fusion of pelvic MRI and 18F-fluorodeoxyglucose (18F-FDG) PET images for assessment of locoregional extension and nodal staging of endometrial cancer.Materials and methods
Thirty patients with biopsy-proven endometrial cancer underwent preoperative contrast-enhanced PET/CT (PET/ceCT) and pelvic dynamic contrast-enhanced MRI for initial staging. Diagnostic performance of PET/ceCT, contrast-enhanced MRI, and retrospective image fusion from PET and MRI (fused PET/MRI) for assessing the extent of the primary tumor (T stage) and metastasis to regional LNs (N stage) was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis.Results
Fused PET/MRI and MRI detected 96.7% of the primary tumors, whereas PET/ceCT detected 93.3%. Accuracy for T status was 80.0% for fused PET/MRI, and MRI proved significantly more accurate than PET/ceCT, which had an accuracy of 60.0% (p = 0.041). Patient-based sensitivity, specificity and accuracy for detecting pelvic nodal metastasis were 100%, 96.3% and 96.7% for both fused PET/MRI and PET/ceCT, and 66.7%, 100% and 96.7% for MRI, respectively. These three parameters were not statistically significant (p = 1).Conclusion
Fused PET/MRI, which complements the individual advantages of MRI and PET, is a valuable technique for assessment of the primary tumor and nodal staging in patients with endometrial cancer. 相似文献11.
Integrated positron emission tomography (PET)/magnetic resonance imaging (MRI), which can provide complementary functional and anatomical information about a specific organ or body system at the molecular level, has become a powerful imaging modality to understand the molecular biology details, disease mechanisms, and pharmacokinetics in animals and humans. Although the first experiment on the PET/MRI was performed in the early 1990s, its clinical application was accomplished in recent years because there were various technical challenges in integrating PET and MRI in a single system with minimum mutual interference between PET and MRI. This paper presents the technical challenges and recent advances in combining PET and MRI along with several approaches for improving PET image quality of the PET/MRI hybrid imaging system. 相似文献
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During the past decade, combined PET/MRI has been translated from a basic technical concept to a clinical research tool and a clinically applied hybrid imaging modality. Numerous clinical and scientific applications have been proposed for this novel hybrid modality including oncologic, neurologic and cardiovascular imaging. Among these, PET/MRI in children has emerged as a key application, not only due to possible diagnostic advantages but also because of reduced radiation exposure compared to alternative techniques. A variety of clinical indications exists for the use of PET/MR imaging in children mainly in but not limited to the field of paediatric oncology. The purpose of this review article is to discuss possible applications of combined PET/MR in paediatric imaging and to illustrate these by presenting cases from clinical practice. 相似文献
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Jacene HA Goudarzi B Wahl RL 《European journal of nuclear medicine and molecular imaging》2008,35(1):89-94
Purpose To describe increased 2-deoxy-2-[18F] fluoro-D-glucose (FDG) uptake in the scalene muscles in a large population of patients referred for evaluation with FDG
positron emission tomography/computed tomography (PET/CT) imaging.
Methods The study met criteria for institutional review board exemption. FDG PET/CT images from 410 patients (179 males; mean age
56.8 years, range 6-88) were retrospectively reviewed for the presence or absence of FDG uptake in the neck that corresponded
to the scalene muscles on the concurrent CT scan. Medical records were reviewed and data including age, sex, smoking history,
reason for referral, and history of obstructive airways disease, thoracotomy, and thoracic radiation were recorded and evaluated.
Results One hundred and forty-seven of the 410 scans (36%) demonstrated increased FDG uptake on PET that corresponded to the scalene
muscles on the CT scan. The uptake was most often bilateral, symmetrical, and linear (n = 117). Other patterns of scalene
muscle uptake included unilateral and linear uptake (n = 27) and unilateral and focal uptake (n = 3). Scalene muscle uptake
was more common in patients referred for evaluation of lung carcinomas compared to other types of tumors (52% vs. 32%, p = 0.05).
Conclusion Linear FDG uptake in scalene muscles is a commonly seen pattern on PET/CT. This finding should be recognized as a distinct
entity and not misinterpreted on transverse images as metastatic disease. 相似文献
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Hyun Su Kim MD Kyung Soo Lee MD Yoshiharu Ohno MD PhD Edwin J.R. van Beek MD PhD 《Journal of magnetic resonance imaging : JMRI》2015,42(2):247-260
Positron emission tomography / computed tomography (PET/CT), with its metabolic data of 18F‐fluorodeoxyglucose (FDG) cellular uptake in addition to morphologic CT data, is an established technique for staging of lung cancer and has higher sensitivity and accuracy for lung nodule characterization than conventional approaches. Its strength extends outside the chest, with unknown metastases detected or suspected metastases excluded in a significant number of patients. Lastly, PET/CT is used in the assessment of therapy response. Magnetic resonance imaging (MRI) in the chest has been difficult to establish, but with the advent of new sequences is starting to become an increasingly useful alternative to conventional approaches. Diffusion‐weighted MRI (DWI) is useful for distinguishing benign and malignant pulmonary nodules, has high sensitivity and specificity for nodal staging, and is helpful for evaluating an early response to systemic chemotherapy. Whole‐body MRI/PET promises to contribute additional information with its higher soft‐tissue contrast and much less radiation exposure than PET/CT and has become feasible for fast imaging and can be used for cancer staging in patients with a malignant condition. J. Magn. Reson. Imaging 2015;42:247–260. 相似文献
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Ivan Platzek Bettina Beuthien-Baumann Matthias Schneider Volker Gudziol Hagen H. Kitzler Jens Maus Georg Schramm Manuel Popp Michael Laniado Jörg Kotzerke Jörg van den Hoff 《European journal of radiology》2014
Objective
To assess the diagnostic value of PET/MR (positron emission tomography/magnetic resonance imaging) with FDG (18F-fluorodeoxyglucose) for lymph node staging in head and neck cancer.Materials and methods
This prospective study was approved by the local ethics committee; all patients signed informed consent. Thirty-eight patients with squamous cell carcinoma of the head and neck region underwent a PET scan on a conventional scanner and a subsequent PET/MR on a whole-body hybrid system after a single intravenous injection of FDG. The accuracy of PET, MR and PET/MR for lymph node metastases were compared using receiver operating characteristic (ROC) analysis. Histology served as the reference standard.Results
Metastatic disease was confirmed in 16 (42.1%) of 38 patients and 38 (9.7%) of 391 dissected lymph node levels. There were no significant differences between PET/MR, MR and PET and MR (p > 0.05) regarding accuracy for cervical metastatic disease. Based on lymph node levels, sensitivity and specificity for metastatic involvement were 65.8% and 97.2% for MR, 86.8% and 97.0% for PET and 89.5% and 95.2% for PET/MR.Conclusions
In head and neck cancer, FDG PET/MR does not significantly improve accuracy for cervical lymph node metastases in comparison to MR or PET. 相似文献18.
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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20.
《Journal of the American College of Radiology》2019,16(12):1695-1701
ObjectiveHead and neck carcinomas are clinically challenging malignancies because of tumor heterogeneities and resilient tumor subvolumes that require individualized treatment planning and delivery for an improved outcome. Although current approaches to diagnosis and therapy have boosted locoregional control, the long-term survival in this patient group remains unchanged over the last decades. A new approach to head and neck cancer management is therefore needed to better identify patient subgroups that are responsive to specific therapies. The aim of this article is to review the current status of knowledge and practice utilizing big data toward personalized therapy in head and neck cancers based on CT and PET imaging modalities.MethodsLiterature published in English since 2000 was searched using Medline. Additional articles were retrieved via pearling of identified literature. Publications were reviewed and summarized in tabulated format.ResultsStudies based on big data in head and neck cancer are limited; however, the field of radiomics is under continuous development and provides valuable input for personalized treatment. Using PET/PET CT biomarkers for patient treatment individualization and response prediction seems promising, especially in regard to detection of hypoxia and clonogenic cancer stem cells. Literature shows that macroscopic changes in medical images (whether structural or functional) are correlated with biologic and biochemical changes within a tumor.ConclusionCurrent trends in data science suggest that the ideal model for decision support in head and neck cancers should be based on human-machine collaboration, namely, on (1) software-based algorithms, (2) physician innovation collaboratives, and (3) clinician mix optimization. 相似文献