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1.
Nunzia Cinzia Paladino Carole Guérin Aoïfe Lowery Andrea Attard Wassim Essamet Eveline Slotema Isabelle Morange Frédéric Castinetti Thierry Brue Anderson Loundou David Taïeb Frédéric Sebag 《Surgical oncology》2018,27(2):231-235
Background
adrenal tumor-to-liver uptake value (Tmx:Lmx) on 18F-FDG PET/CT is an accurate and reproducible PET parameter in the distinction between benign and malignant adrenal masses. The potential impact of steroid hormone secretion on 18F-FDG uptake is still debatable. The aim of this study was to evaluate this relationship.Methods
2010–2015: 73 patients who underwent adrenalectomy for adrenocortical tumors [49 secreting/(SA) and 24 non-secreting/(NSA)] were retrospectively included in the study. Fourteen were malignant. All patients underwent hormonal evaluation, functional and anatomical imaging, Weiss scoring and Ki 67 evaluation.Results
malignant tumors exhibit higher SUVmax than benign tumors (median 7.75 vs 3.06 respectively, p?<?0.001) and Tmx:Lmx was 2.7 vs 1.17 for benign tumors, p?<?0.001.Tmx:Lmx was positively correlated to Weiss score (p?<?0.001).No significant difference was observed for Tmx:Lmx between SA and NSA overall (p?=?0.851), regardless of the subgroup of tumors analyzed. Tmx:Lmx was not correlated to tumor size (p?<?0.508) or 24?h free urinary cortisol level (p?<?0.522).Conclusions
no correlation was observed between Tmx:Lmx and hormonal status, however the correlation between ratio, malignancy and Weiss score confirm the utility of 18F-FDG PET/CT for the differentiation of benign from malignant adrenal lesions, irrespective of the hormone secretory status of the tumor. 18F-FDG PET/CT is a useful biomarker in the diagnosis of adrenal tumors, regardless of the secretion status. 相似文献2.
M. Samim I.Q. Molenaar M.F.J. Seesing P.S.N. van Rossum M.A.A.J. van den Bosch T.J.M. Ruers I.H.M. Borel Rinkes R. van Hillegersberg M.G.E.H. Lam H.M. Verkooijen 《Surgical oncology》2017,26(1):37-45
Purpose
Uncertainty exists regarding the optimal imaging modality for timely detection of disease progression (DP) after ablation therapy for colorectal liver metastases. We evaluated the diagnostic accuracy of 18F-FDG PET(/CT), CT and MRI for detection of DP following ablation therapy.Methods
A systematic search was performed on May 18, 2016. The analysis included studies that reported on the diagnostic accuracy of 18F-FDG PET(/CT), CT and/or MRI for post-ablative evaluation of patients with liver metastases. Primary outcome was the diagnostic accuracy of the imaging modalities for detection of DP. Methodological quality was assessed using the QUADAS-2 tool. Pooled sensitivities and specificities were estimated using bivariate random-effects models.Results
Ten studies were included in the meta-analysis, including seven comparative studies. Nine reported data on diagnostic accuracy of 18F-FDG PET(/CT), seven on CT imaging. Only two studies reported the diagnostic accuracy of MRI, hence not included in the meta-analysis. Quality assessment raised concerns about the risk of bias regarding the use of the reference standard, blinding of the index tests and the follow-up time. Pooled sensitivity was respectively 84.6% (75.0–90.6) and 53.4% (29.0–76.4) for 18F-FDG PET(/CT) and CT (P = 0.005). Pooled specificity was respectively 92.4% (86.5–95.9) and 95.7% (87.5–98.6) (P = 0.392).Conclusion
18F-FDG PET/(CT) yields a higher sensitivity for detecting DP after ablation therapy compared with CT and has a comparably high specificity. These findings indicate that the use of 18F-FDG PET(/CT) in this setting particularly allows for minimization of the false-negative rate compared with CT without compromising the low false-positive rate. 相似文献3.
Lilan Fu Mohammed Shah Alam Yunyan Ren Wei Guan Hubing Wu Quanshi Wang Yanjiang Han Wenlan Zhou Hongsheng Li Zhen Wang 《Clinical lung cancer》2018,19(3):221-229
Background
The present study was performed to investigate the maximum standardized uptake value (SUVmax) in 2-[fluorine-18]-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) to preoperatively distinguish invasive from less-invasive pulmonary adenocarcinoma.Patients and Methods
A total of 106 patients with resectable pulmonary adenocarcinoma (≤ 3 cm) who had undergone whole-body 18F-FDG PET/CT were enrolled. The SUVmax, diameter, and consolidation/tumor (C/T) ratio of the lung tumors were measured with 18F-FDG PET/CT and regional thin-section CT.Results
Of the 106 patients, 32 had adenocarcinoma in situ (AIS), 13 had minimally invasive adenocarcinoma (MIA), and 61 had invasive adenocarcinoma (IAC). IAC lesions showed greater uptake of 18F-FDG, a larger tumor diameter, and greater C/T ratios than AIS and MIA (P < .001 for all). A multivariate analysis revealed that only the SUVmax, tumor diameter, and C/T ratio were independent risk factors for tumor invasiveness (P < .05 for all). The best cutoff values for the prediction of invasiveness were 2.15 for the SUVmax, 1.36 cm for the tumor diameter, and 0.36 for the C/T ratio. The SUVmax, tumor diameter, and C/T ratio showed similar predictive sensitivity (83.6%, 82.0%, and 88.5%, respectively). However, the SUVmax showed a greater predictive specificity than the C/T ratio (93.3% vs. 73.3%, respectively; P = .011) but similar to that of the tumor diameter. The predictive sensitivity and specificity were not improved using the 3 combined parameters compared with SUVmax alone.Conclusion
The present study has demonstrated that the SUVmax is a good preoperative predictor for the invasiveness of pulmonary adenocarcinoma (≤ 3 cm). It will help surgeons plan low invasive treatment of preinvasive tumors. 相似文献4.
Francesco Cantiello Fabio Crocerossa Giorgio Ivan Russo Vincenzo Gangemi Matteo Ferro Mihai Dorin Vartolomei Giuseppe Lucarelli Maria Mirabelli Chiara Scafuro Giuseppe Ucciero Ottavio De Cobelli Giuseppe Morgia Rocco Damiano Giuseppe Lucio Cascini 《Clinical genitourinary cancer》2018,16(5):385-391
Purpose
To evaluate the diagnostic performance of 64Cu-PSMA-617 positron emission tomography (PET) with computed tomography (CT) for restaging prostate cancer after biochemical recurrence (BCR) and to compare it with 18F-choline PET/CT in a per-patient analysis.Patients and Methods
An observational study was performed of 43 patients with BCR after laparoscopic radical prostatectomy who underwent 64Cu-PSMA-617 PET/CT and subsequently 18F-choline PET/CT for restaging. The detection rates (DR) of 64Cu-PSMA-617 PET/CT and of 18F-choline PET/CT were calculated by standardized maximum uptake value (SUVmax) at 4 hours and SUVmax at 1 hour as reference, respectively. Furthermore, univariate logistic regression analysis was carried out to identify independent predictive factors of positivity with 64Cu-PSMA-617 PET/CT.Results
An overall positivity with 64Cu-PSMA-617 PET/CT was found in 32 patients (74.4%) versus 19 (44.2%) with 18F-choline PET/CT. Specifically, after stratifying for prostate-specific antigen (PSA) values, we found a good performance of 64Cu-PSMA-617 PET/CT at low PSA levels compared to 18F-choline PET/CT, with a DR of 57.1% versus 14.3% for PSA 0.2-0.5 ng/mL (P = .031), and of 60% versus 30% with PSA 0.5-1 ng/mL. At univariate binary logistic regression analysis, PSA level was the only independent predictor of 64Cu-PSMA-617 PET/CT positivity. No significant difference in terms of DR for both 64Cu-PSMA-617 PET/CT and 18F-choline PET/CT was found according to different Gleason score subgroups.Conclusion
In our study cohort, a better performance was observed for 64Cu-PSMA-617 PET/CT compared to 18F-choline PET/CT in restaging after BCR, especially in patients with low PSA values. 相似文献5.
J. Hynninen M. Laasik T. Vallius J. Kemppainen S. Grönroos J. Virtanen J. Casado S. Hautaniemi S. Grenman M. Seppänen A. Auranen 《Clinical oncology (Royal College of Radiologists (Great Britain))》2018,30(8):507-514
Aims
To prospectively evaluate the use of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in the definition of the treatment response after primary treatment of advanced epithelial ovarian cancer (EOC).Materials and methods
Forty-nine patients with advanced EOC had an 18F-FDG PET/CT scan before and after primary treatment. The treatment response was defined with the currently used radiological and serological Response Criteria in Solid Tumors (RECIST1.1/GCIC) criteria and the modified PET Response Criteria in Solid Tumors (PERCIST). The concordance of the two methods was analysed. If the patient had a complete response to primary treatment by conventional criteria, the end of treatment 18F-FDG PET/CT scan (etPET/CT) was not opened until retrospectively at the time of disease progression. The ability of etPET/CT to predict the time to disease recurrence was analysed. The recurrence patterns were observed with an 18F-FDG PET/CT at the first relapse.Results
The agreement of the RECIST1.1/GCIC and modified PERCIST criteria in defining the primary treatment response in the whole patient cohort was good (weighted kappa coefficient = 0.78). Of the complete responders (n = 28), 34% had metabolically active lesions present in the etPET/CT, most typically in the lymph nodes. The same anatomical sites tended to activate at disease relapse, but were seldom the only site of relapse. In patients with widespread intra-abdominal carsinosis at diagnosis, the definition of metabolic response was challenging due to problems in distinguishing the physiological FDG accumulation in the bowel loops from the residual tumour in the same area. The presence of metabolically active lesions in the etPET/CT did not predict earlier disease relapse in the complete responders.Conclusions
In the present study, etPET/CT revealed metabolically active lesions in complete responders after EOC primary therapy, but they were insignificant for the patient's prognosis. The current study does not favour routine use of 18F-FDG PET/CT after EOC primary treatment for complete responders. 相似文献6.
Jae-Ryong Shim Seung Duk Lee Sung-Sik Han Sang Jae Lee Dong Eun Lee Seok-Ki Kim Seong Hoon Kim Sang Jae Park Jae-Hwan Oh 《European journal of surgical oncology》2018,44(5):670-676
Introduction
Colorectal cancer liver metastasis (CRLM) can be cured with surgery. To improve survival, optimal selection of CRLM patients should be done cautiously, which may be facilitated by preoperative [F-18] fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT).Methods
A total of 245 patients with CRLM between February 2007 and January 2015 were retrospectively studied. All clinical variables, pathological data, and various PET/CT parameters were correlated with disease-free survival (DFS) and overall survival (OS). Metastatic tumor maximum standardized uptake value (SUVmax) and normal liver mean SUV (SUVmean) ratio was selected for group classification.Results
The median DFS in months were 24.5 months and median OS were 41.7 months. Multivariate analysis found an increased risk of worse prognosis in DFS for primary colon cancer T3～T4, N2 stage, neoadjuvant chemotherapy, synchronous metastasis, multiple metastatic tumor number and metastatic tumor SUVmax/normal liver SUVmean ratio >4.3. The DFS rate of each group classified by SUV ratio was 58.1%, 39.0%, and 33.6% vs. 39.3%, 20.8%, and 15.8% at 1, 3, and 5 years (p = 0.017). Patients with multiple tumors and SUV ratio of >4.3 showed worst survival (OS rate: 74.2%, 41.5%, and 24.2%, p = 0.001 at 1, 3, and 5 years, respectively).Conclusions
PET/CT variables can be a valuable prognostic factor in patients with CRLM for the prediction of recurrence. Preoperative PET/CT may improve risk stratification and optimize outcomes of patients with CRLM. 相似文献7.
Riccardo Schiavina Lorenzo Bianchi Federico Mineo Bianchi Marco Borghesi Cristian Vincenzo Pultrone Hussam Dababneh Paolo Castellucci Francesco Ceci Cristina Nanni Caterina Gaudiano Michelangelo Fiorentino Angelo Porreca Francesco Chessa Andrea Minervini Stefano Fanti Eugenio Brunocilla 《Clinical genitourinary cancer》2018,16(4):305-312.e1
Purpose
To evaluate the accuracy of 11C-choline positron emission tomography (PET)/computed tomography (CT) for nodal staging of prostate cancer (PCa) in different populations of high-risk patients.Patients and Methods
We evaluated 262 individuals with intermediate- or high-risk PCa submitted to radical prostatectomy and extended pelvic lymph node dissection. Within men with high-risk disease, we identified a subgroup of individuals harboring very high-risk (VHR, n = 28) disease: clinical stage ≥ T2c and more than 5 cores with Gleason score 8-10; primary biopsy Gleason score of 5; 3 high-risk features; or prostate-specific antigen ≥ 30 ng/mL. The diagnostic accuracy of PET/CT and contrast-enhanced CT (CECT) was assessed after stratifying patients according to risk group classification on a patient- and anatomic region–based analysis.Results
On patient-based analysis, considering high-risk patients (n = 155), 11C-choline PET/CT versus CECT had sensitivity and specificity of 50% and 76% versus 21% and 92%, respectively. Considering VHR men as separate subgroups (n = 28), 11C-choline PET/CT versus CECT had sensitivity and specificity of 71% and 93% versus 25% and 79%, respectively. Accordingly, in the VHR category, the area under the curve of 11C-choline PET/CT versus CECT was 0.86 (95% confidence interval, 0.71-1.0) versus 0.69 (95% confidence interval, 0.52-0.86), respectively. On anatomic region–based analysis, considering the VHR group, 11C-choline PET/CT versus CECT had sensitivity and specificity of 70.6% and 95.5% versus 35.3% and 98.5%, respectively.Conclusion
Patients with VHR characteristics could represent the ideal candidate to undergo disease staging with PET/CT before surgery with the highest cost efficacy. 相似文献8.
D.P. Noij R.M. Martens T. Koopman O.S. Hoekstra E.F.I. Comans B. Zwezerijnen R. de Bree P. de Graaf J.A. Castelijns 《Clinical oncology (Royal College of Radiologists (Great Britain))》2018,30(12):780-792
Aims
Our purpose was to assess the diagnostic accuracy and prognostic value of diffusion-weighted imaging (DWI) and 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (18F-FDG-PET/CT) carried out 3–6 months after (chemo)radiotherapy in head and neck squamous cell carcinoma.Materials and methods
For this retrospective cohort study we included 82 patients with advanced-stage head and neck squamous cell carcinoma treated between 2012 and 2015. Primary tumours and lymph nodes were assessed separately. DWI was analysed qualitatively and quantitatively. 18F-FDG-PET/CT was evaluated using the Hopkins criteria. Dichotomous qualitative analysis was carried out for both modalities. Cox regression analysis was used for univariate analysis of recurrence-free survival (RFS). Significant univariate parameters were included in multivariate analysis.Results
In 12 patients, locoregional recurrence occurred. With all imaging strategies, either single-modality or multi-modality, a high negative predictive value (NPV) was achieved (94.3–100%). In response evaluation of the primary site, the preferred strategy is 18F-FDG-PET/CT only, which resulted in a sensitivity of 85.7%, specificity of 86.5%, positive predictive value (PPV) of 37.5% and NPV of 98.5%. For response evaluation of the neck, the best results were obtained with a sequential approach only including the second modality in positive reads of the first modality. It did not matter which modality was assessed first. This strategy for lymph node assessment resulted in a sensitivity, specificity, PPV and NPV of 83.3%, 95.6%, 62.5%, and 98.5%, respectively. After correction for received treatment and human papillomavirus status, primary tumour (P = 0.009) or lymph node (P < 0.001) Hopkins score ≥4 on 18F-FDG-PET/CT remained significant predictors of RFS.Conclusion
For response evaluation of the primary tumour 18F-FDG-PET/CT only is the preferred strategy, whereas for the neck a sequential approach including both DWI and 18F-FDG-PET/CT resulted in the best diagnostic accuracy for follow-up after (chemo)radiotherapy. Qualitative analysis of 18F-FDG-PET/CT is a stronger predictor of RFS than DWI analysis. 相似文献9.
Thabo Lengana Ismaheel O. Lawal Tebatso G. Boshomane Gbenga O. Popoola Kgomotso M.G. Mokoala Evelyn Moshokoa Alex Maes Neo P. Mokgoro Christophe Van de Wiele Mariza Vorster Mike M. Sathekge 《Clinical genitourinary cancer》2018,16(5):392-401
Purpose
68Ga ligands targeting prostate-specific membrane antigen (PSMA) are rapidly emerging as a significant step forward in the management of prostate cancer. PSMA is a type II transmembrane protein with high expression in prostate carcinoma cells. We prospectively evaluated the use of 68Ga-PSMA positron emission tomography/computed tomography (PET/CT) in patients with prostate cancer and compared the results to those for technetium-99m (99mTc)-10-metacyloyloxydecyl dihydrogen phosphate (MDP) bone scintigraphy (BS).Patients and Methods
A total 113 patients with biopsy-proven prostate cancer referred for standard-of-care BS were prospectively enrolled onto this study. 68Ga-PSMA PET/CT was performed after BS. Metastasis diagnosed on each technique was compared against a final diagnosis based on CT, magnetic resonance imaging, skeletal survey, clinical follow-up, and histologic correlation.Results
Ninety-one bone lesions were interpreted as bone metastases in 25 men undergoing 68Ga-PSMA PET/CT compared to only 61 lesions in 19 men undergoing 99mTc-MDP BS. Of the 7 bone scans that missed skeletal metastases, 54% of these missed lesions were due to either marrow or lytic skeletal metastases. The median standardized uptake value in all malignant bone lesions was 13.84. 68Ga-PSMA PET/CT showed significantly higher sensitivity and accuracy than BS (96.2% vs. 73.1%, and 99.1% vs. 84.1%) for the detection of skeletal lesions. For extraskeletal lesions, 68Ga-PSMA PET/CT showed an additional 96 unexpected lesions with a median standardized uptake value of 17.6.Conclusion
68Ga-PSMA PET/CT is superior to and can potentially replace bone scan in the evaluation for skeletal metastases in the clinical and trial setting because of its ability to detect lytic and bone marrow metastases. 相似文献10.
Jinhai Huo Yiyi Chu Karim Chamie Marc C. Smaldone Stephen A. Boorjian Jacques G. Baillargeon Yong-Fang Kuo Preston Kerr Padraic O&#x;Malley Eduardo Orihuela Douglas S. Tyler Stephen J. Freedland Sharon H. Giordano Raghu Vikram Ashish M. Kamat Stephen B. Williams 《Clinical genitourinary cancer》2018,16(1):e99-e111
Background
The purpose of this study was to examine temporal nationwide utilization patterns and predictors for use of positron emission tomography/computed tomography (PET/CT) in comparison with magnetic resonance imaging (MRI) and computed tomography (CT) among patients diagnosed with bladder cancer.Materials and Methods
A total of 36,855 patients aged 66 years or older diagnosed with clinical stage TI-IV, N0M0 bladder cancer from 2004 to 2011 were analyzed. We used multivariable logistic regression analyses to discern factors associated with receipt of imaging within 12 months from diagnosis. The Cochran-Armitage test for trend was used to determine changes in the proportion of patients receiving imaging after cancer diagnosis.Results
Independent of clinical stage, there was marked increase in use of PET/CT throughout the study period (2011 vs. 2004: odds ratio, 17.55; 95% confidence interval, 10.14-30.38; P < .001). Although use of CT imaging remained stable during the study period, there was significantly decreased utilization of MRI (odds ratio, 0.60; 95% confidence interval, 0.49-0.75; P < .001) in 2011 versus 2004. The mean incremental cost of PET/CT versus CT and MRI was $1040 and $612 (in 2016 dollars), respectively. Extrapolating these findings to the patients with bladder cancer in the United States results in excess spending of $11.6 million for PET/CT imaging.Conclusion
We identified rapid adoption of PET/CT imaging independent of clinical stage, resulting in excess national spending of $11.6 million for this imaging modality alone. Further value-based research discerning the clinical versus economic benefits of advanced imaging among patients with bladder cancer are needed. 相似文献11.
Aparna H. Kesarwala Diana J. Lu Eric Xanthopoulos Smith Apisarnthanarax Keith A. Cengel Tracey L. Evans Charu Aggarwal Roger B. Cohen Corey J. Langer Ramesh Rengan Charles B. Simone 《Clinical lung cancer》2018,19(2):e205-e209
Introduction
Prophylactic cranial irradiation (PCI) improves survival for small-cell lung cancer (SCLC). Evidence for PCI in limited-stage SCLC largely derives from studies requiring only chest x-ray (CXR) to determine remission status. We analyzed thoracic chemoradiation therapy (TCRT) outcomes according to imaging modality to determine which patients benefitted most from PCI.Patients and Methods
All limited-stage SCLC patients who received TCRT as well as PCI at our institution were reviewed. Imaging between TCRT end and PCI start was characterized as complete (CR), partial (PR), or other response.Results
Thirty-eight consecutive patients were assessed for TCRT response before PCI with CXR (n = 21), chest computed tomography (CT; n = 27), and/or positron emission tomography (PET)/CT (n = 11). CR was identified on 71% of CXRs, 41% of CT scans, and 18% of PET/CT scans. Median survival was 28.3 months for the entire cohort and did not differ for patients who had CXR alone versus CT and/or PET/CT for restaging (P = .78) or those with PR using any modality versus CR using all modalities (22.6 months vs. 45.5 months; P = .22). CT CR patients had numerical but not statistically significant improved 2-year (P = .18) and 3-year (P = .13) survival compared with CT PR.Conclusion
CXR remains an appropriate modality to assess TCRT response before PCI in limited-stage SCLC. Advanced imaging did not inform the decision to offer PCI in this study. Because of similar excellent survival profiles independent of imaging modality and TCRT response, this analysis suggests limited-stage SCLC patients with PR using any modality should not be denied PCI, akin to standards for extensive-stage SCLC. 相似文献12.
Na Fang Yanli Wang Xinjian Cui Lei Zeng Lili Ma Xiumei Zhao Wei Zhao Qing Wang Shan Gao Wei Ding 《临床肿瘤与癌症研究(英文版)》2008,5(5):349-353
OBJECTIVE The clinical use of PET/CT in oncology has led to the realization that 18F-FDG uptake in brown adipose tissue（BAT） can be a common cause of potentially misleading false-positive PET scans.The goal of this study was to study ^18F-FDG uptake in cervical and supraclavicular regions and its characteristics with PET/CT.
METHODSAll the PET/CT scans obtained at our institutionfrom July 2007 to January 2008 were retrospectively reviewed forincreased 18F-FDG uptake in BAT.The cases in which increased^18F-FDG in cervical and supraclavicular regions was not localizedto a so -tissue mass or lymph node or muscle on the CT images,were included in this study.The following features were recorded：body weight,body mass index（BMI） and maximal standardizeduptake value（SUVmax）.In these selected patients,the BAT uptake in other area of the body was also recorded.
RESULTS PET/CT scans were obtained in 457 patients（259 males and 198 females）.In all of the scans,cervical and supraclavicular BAT uptake was observed in 12 patients（2 males and 10 females） and was typically bilateral,symmetric and intense.The range of the SUVmax was 3.6～12.82（mean 6.9 ± 2.6）.BAT uptake was more common in females than in males,showing a significant difference（P = 0.004）.Although 18F-FDG uptake in BAT occurred more o en in underweight patients with low BMI,there was no difference in the body weight（P = 0.607） or BMI（P = 0.491） of these patients with hypermetabolic BAT compared with controls.
CONCLUSION Hypermetabolic BAT uptake can be localized in cervical and supraclavicular regions with it occurring more commonly in females compared to males.Knowledge of this potential pitfall with PET/CT is important in improving diagnostic interpretation and accurate staging. 相似文献
METHODSAll the PET/CT scans obtained at our institutionfrom July 2007 to January 2008 were retrospectively reviewed forincreased 18F-FDG uptake in BAT.The cases in which increased^18F-FDG in cervical and supraclavicular regions was not localizedto a so -tissue mass or lymph node or muscle on the CT images,were included in this study.The following features were recorded：body weight,body mass index（BMI） and maximal standardizeduptake value（SUVmax）.In these selected patients,the BAT uptake in other area of the body was also recorded.
RESULTS PET/CT scans were obtained in 457 patients（259 males and 198 females）.In all of the scans,cervical and supraclavicular BAT uptake was observed in 12 patients（2 males and 10 females） and was typically bilateral,symmetric and intense.The range of the SUVmax was 3.6～12.82（mean 6.9 ± 2.6）.BAT uptake was more common in females than in males,showing a significant difference（P = 0.004）.Although 18F-FDG uptake in BAT occurred more o en in underweight patients with low BMI,there was no difference in the body weight（P = 0.607） or BMI（P = 0.491） of these patients with hypermetabolic BAT compared with controls.
CONCLUSION Hypermetabolic BAT uptake can be localized in cervical and supraclavicular regions with it occurring more commonly in females compared to males.Knowledge of this potential pitfall with PET/CT is important in improving diagnostic interpretation and accurate staging. 相似文献
13.
Sylvain Carras Benjamin Dubois Delphine Senecal Jean-Philippe Jais Michel Peoc&#x;h Philippe Quittet Charles Foussard Krimo Bouabdallah Thomas Gastinne Eric Jourdan Laurence Sanhes Marjan Ertault Thierry Lamy Lysiane Molina 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(3):191-198
Background
Patients with advanced stage Hodgkin lymphoma still present unsatisfactory outcomes.Patients and Methods
The Groupe d’étude des Leucémies Aigues et des Maladies du Sang (GOELAMS) group conducted a prospective multicentric trial (NCT00920153) for advanced stage Hodgkin lymphoma to evaluate a positron emission tomography (PET)-adapted strategy. Patients received an intensive regimen (VABEM [vindesine, doxorubicin, carmustine, etoposide, and methylprednisolone]) in front-line and interim 18FFDG-PET evaluation after 2 courses (PET-2). Patients with negative PET-2 findings received 1 additional course. Patients with positive PET-2 findings underwent early salvage therapy followed by high-dose therapy/autologous stem cell transplantation.Results
Fifty-one patients were included. The final complete remission rate was 88%. With a median follow up of 5.3 years, 5-year event-free survival and overall survival rates were 75.3% and 85.3%, respectively, for the whole cohort. Patients who were PET–2-negative had 5-year event-free survival and overall survival rates of, respectively, 77.8% and 88.2% versus 85.1% and 91.7% for patients who were PET–2-positive.Conclusion
A PET-guided strategy with early salvage therapy and high-dose therapy/autologous stem cell transplantation for patients with interim PET–2-positive findings is safe and feasible and provide similar outcome as patients with a negative PET-2. 相似文献14.
Kazushige Kawai Hiroaki Nozawa Keisuke Hata Toshiaki Tanaka Takeshi Nishikawa Koji Oba Toshiaki Watanabe 《Clinical colorectal cancer》2018,17(2):e163-e170
Introduction
Although 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) has been increasingly used to evaluate the response to preoperative chemoradiotherapy (CRT) in patients with rectal cancer, the optimal intervals between completion of CRT, PET, and surgery have not been fully investigated.Patients and Methods
A total of 148 consecutive patients with rectal adenocarcinoma who received CRT followed by FDG-PET and radical surgery were retrospectively analyzed. The association between the FDG-PET maximum standardized uptake value (SUVmax) and pathological response was assessed using a logistic regression model, with a primary focus on the intervals between CRT and PET as well as between PET and surgery.Results
The baseline SUVmax showed no association with pathological response (P = .201; area under the curve [AUC] = 0.528), whereas the SUVmax after CRT completion showed a strong association (P < .001; AUC = 0.707). Logistic regression analysis revealed that the ability of the SUVmax to accurately predict pathological good responders was significantly associated with a long CRT–PET interval (≥ 7 weeks; P = .027), but was not affected by the length of PET–surgery interval. In patients with a short CRT–PET interval (< 7 weeks), the ability of the SUVmax to predict good responders was poor (P = .201; AUC = 0.669); however, in patients with long intervals (≥ 7 weeks), the predictive ability markedly improved (P < .001; AUC = 0.879).Conclusion
A minimum wait time of 7 weeks is recommended before performing FDG-PET after neoadjuvant CRT for rectal cancer to obtain maximal predictive accuracy for pathological response. 相似文献15.
Ronit Gurion Hanna Bernstine Liran Domachevsky Carmela Michelson Pia Raanani Liat Vidal Tzippy Shochat Anat Gafter-Gvili 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(10):687-691
Background
Fluorine-18 fluorodeoxyglucose (FDG) avidity varies in peripheral T-cell lymphoma (PTCL). We evaluated FDG avidity of pretreatment positron emission tomography/computed tomography (P-PET/CT), to appraise the prognostic significance of interim PET/CT (I-PET/CT) and end of treatment PET/CT (E-PET/CT) in PTCL.Patients and Methods
We performed a retrospective cohort study of patients with newly diagnosed or relapsed PTCL who had received any chemotherapy regimen from 2008 to 2015 in a tertiary center. P-PET/CT, I-PET/CT, and E-PET/CT studies were centrally reviewed. The primary outcomes were the prognostic role of I-PET/CT and E-PET/CT on progression-free survival (PFS) and overall survival (OS). The secondary outcomes were P-PET/CT avidity, the prognostic role of other baseline characteristics, and the correlation between the PET/CT and bone marrow biopsy findings.Results
We included 40 patients in the present analysis. The median OS and PFS for the whole cohort was 39 and 16 months, respectively. Of the 40 patients, 36 had positive P-PET/CT findings. A total of 23 patients underwent I-PET/CT, with positive findings for 10. Of the 40 patients, 34 underwent E-PET/CT, 26 of which had positive findings. The sensitivity, specificity, and negative predictive value of P-PET/CT for bone marrow involvement was 40%, 83%, and 89%, respectively. The factors significantly associated with PFS and OS on univariate analysis included elevated lactate dehydrogenase, and low lymphocyte, hemoglobin, and albumin levels. On multivariate analysis, only lymphopenia remained prognostic for PFS and OS. The E-PET/CT and I-PET/CT results were not prognostic for PFS or OS.Conclusion
Our study has shown that 90% of PTCL cases will be FDG avid. However, PET/CT was not predictive for PFS or OS at any point. The only predictive factor was the presence of lymphopenia. 相似文献16.
Yasuharu Nakano Masakuni Noguchi Miki Yokoi-Noguchi Yukako Ohno Emi Morioka Takeo Kosaka Tomoko Takahashi Hiroshi Minato 《Breast cancer (Tokyo, Japan)》2017,24(1):121-127
Background
There is a need for less invasive techniques for preoperative identification of axillary lymph node (ALN) metastases.Method
Patients underwent ultrasonography (US) and 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT), and then US-guided fine needle aspiration cytology (FNAC) and/or sentinel lymph node (SLN) biopsy were performed based on the US findings of the ALNs. Subsequently, patients with positive FNAC as well as those with positive SLN underwent axillary lymph node dissection (ALND). Postoperatively, removed SLNs and ALNs were examined histologically.Results
Fifty (85 %) of 59 patients with positive 18F-FDG uptake in the axilla had axillary metastases, but 18F-FDG uptake results were false-positive in 9 (15 %) cases. On the other hand, 29 patients with positive FNAC underwent ALND without the need for SLN biopsy, while the remaining 20 patients with negative FNAC as well as 249 patients with negative US findings underwent SLN biopsy. Subsequently, 68 patients with positive SLN underwent ALND.Conclusions
Positive FDG uptake in the axilla does not always indicate axillary metastasis. US-guided FNAC is useful to avoid unnecessary ALND in patients with positive 18F-FDG uptake. However, SLN biopsy is needed in patients with negative US findings of the ALNs and those with negative FNAC.17.
D. Rubello L. Rampin C. Nanni E. Banti M. Ferdeghini S. Fanti A. Al-Nahhas M.D. Gross 《European journal of surgical oncology》2008
Aim
To assess the diagnostic role of 18F-FDG PET/CT performed with a hybrid tomograph in the detection of tumoral deposits of recurrent medullary thyroid carcinoma (MTC).Methods
Nineteen MTC patients with elevated serum calcitonin levels (58–1350 pg/ml) after first treatment were enrolled (11 F, 8 M, mean age 53.4 years, 14 sporadic MTC, 5 MEN-related MTC). All patients had previously undergone total thyroidectomy and lymphoadenectomy. When referred to us, they were studied with ultrasound (US), 18F-FDG PET/CT, 111In-pentetreotide scan, and contrast-enhanced whole-body CT (c.e. CT). In 4 patients with equivocal abdominal findings at 18F-FDG PET/CT and/or at c.e. CT, laparoscopy was also performed.Results
18F-FGD PET/CT depicted metastases in 15 patients, 111In-pentetreotide in 8, c.e. CT in 11, US in 6. In 2 patients, liver micrometastases were detected at laparoscopy only. At a lesion-by-lesion analysis, 18F-FDG PET/CT visualized a total of 26 metastatic deposits, c.e. CT 18, 111In-pentetreotide 12, US 8. Final diagnosis was obtained by cytological or surgical findings. Four patients with evidence of limited metastatic spread to neck/upper mediastinum were re-operated, and in 2 of them serum calcitonin levels normalized.Conclusions
In our study, 18F-FDG PET/CT was the most sensitive imaging modality in detecting metastases in recurrent MTC patients with increased serum calcitonin levels. Moreover, 18F-FDG PET/CT was useful in some patients to plan a more accurate re-operation. From a diagnostic point of view, a multimodality imaging approach is recommended in recurrent MTC, especially based on the combination of c.e. CT and 18F-FDG PET/CT. 相似文献18.
Na Young Jung Sung Hoon Kim Sung Hun Kim Ye Young Seo Jin Kyoung Oh Hyun Su Choi Won Jong You 《JOURNAL OF BREAST CANCER》2015,18(1):63-72
Purpose
We evaluated the utility of magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for the preoperative staging of invasive lobular carcinoma (ILC) of the breast and compared the results with those of invasive ductal carcinoma (IDC).Methods
The study included pathologically proven 32 ILCs and 73 IDCs. We compared clinical and histopathological characteristics and the diagnostic performances of MRI and 18F-FDG PET/CT for the primary mass, additional ipsilateral and/or contralateral lesion(s), and axillary lymph node metastasis between the ILC and IDC groups.Results
Primary ILCs were greater in size, but demonstrated lower maximum standardized uptake values than IDCs. All primary masses were detected on MRI. The detection rate for ILCs (75.0%) was lower than that for IDCs (83.6%) on 18F-FDG PET/CT, but the difference was not significant. For additional ipsilateral lesion(s), the sensitivities and specificities of MRI were 87.5% and 58.3% for ILC and 100.0% and 66.7% for IDC, respectively; whereas the sensitivities and specificities of 18F-FDG PET/CT were 0% and 91.7% for ILC and 37.5% and 94.7% for IDC, respectively. The sensitivity of 18F-FDG PET/CT for ipsilateral lesion(s) was significantly lower in the ILC group than the IDC group. The sensitivity for ipsilateral lesion(s) was significantly higher with MRI; however, specificity was higher with 18F-FDG PET/CT in both tumor groups. There was no significant difference in the diagnostic performance for additional contralateral lesion(s) or axillary lymph node metastasis on MRI or 18F-FDG PET/CT for ILC versus IDC.Conclusion
The MRI and 18F-FDG PET/CT detection rates for the primary cancer do not differ between the ILC and IDC groups. Although 18F-FDG PET/CT demonstrates lower sensitivity for primary and additional ipsilateral lesions, it shows higher specificity for additional ipsilateral lesions, and could play a complementary role in the staging of ILC as well as IDC. 相似文献19.
Moller AK Loft A Berthelsen AK Damgaard Pedersen K Graff J Christensen CB Perell K Petersen BL Daugaard G 《The oncologist》2011,16(4):445-451
Background.
Carcinoma of unknown primary (CUP) represents a heterogeneous group of metastatic malignancies for which no primary tumor site can be identified after extensive diagnostic workup. Failure to identify the primary site may negatively influence patient management. The aim of this review was to evaluate 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) as a diagnostic tool in patients with extracervical CUP.Materials and Methods.
A comprehensive literature search was performed and four publications were identified (involving 152 patients) evaluating 18F-FDG PET/CT in CUP patients with extracervical metastases. All studies were retrospective and heterogeneous in inclusion criteria, study design, and diagnostic workup prior to 18F-FDG PET/CT.Results.
18F-FDG PET/CT detected the primary tumor in 39.5% of patients with extracervical CUP. The lung was the most commonly detected primary tumor site (∼50%). The pooled estimates of sensitivity, specificity, and accuracy of 18F-FDG PET/CT in the detection of the primary tumor site were 87%, 88%, and 87.5%, respectively.Conclusions.
The present review of currently available data indicates that 18F-FDG PET/CT might contribute to the identification of the primary tumor site in extracervical CUP. However, prospective studies with more uniform inclusion criteria are required to evaluate the exact value of this diagnostic tool. 相似文献20.
K. Lehmann D. Eshmuminov P. Bauerfeind C. Gubler P. Veit-Haibach A. Weber H. Abdul-Rahman M. Fischer C. Reiner P.M. Schneider 《European journal of surgical oncology》2017,43(1):196-202