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Annals of Nuclear Medicine Aug 2023To provide an overview of the current available data about FAPI PET in breast cancer patients, with a perspective point of view. A literature search for studies about...
To provide an overview of the current available data about FAPI PET in breast cancer patients, with a perspective point of view. A literature search for studies about FAPI PET in the last 5 years (from 2017 to January 2023) was carried out on MEDLINE databases, such as PubMed, EMBASE, Web of Science and Google Scholar using the following keywords: "PET" AND "FAPI" AND "Breast Cancer" AND "Fibroblast imaging". The Critical Appraisal Skills Program (CASP) checklist for diagnostic test studies was used for testing the quality of selected papers. 13 articles were selected, including 172 patients affected by breast cancer who underwent FAPI-based PET images. CASP checklist was used in 5/13 papers, demonstrating a general low quality. Different types of FAPI-based tracers were used. No difference in terms of FAPI uptake was reported based on the histopathological characteristics, such as immunohistochemistry and grading of breast cancer. FAPI demonstrated more lesions and yielded much higher tumor-to-background ratios than 2-[18F]FDG. Preliminary experiences with FAPI PET in breast cancer showed some advantages than the current available 2-[18F]FDG, although prospective trials are needed to further evaluate its diagnostic utility in clinical practice.
Topics: Female; Humans; Breast Neoplasms; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18
PubMed: 37341971
DOI: 10.1007/s12149-023-01852-x -
Annals of Surgical Oncology Jan 2024The tumor microenvironment (TME) plays a crucial role in therapy response and modulation of immunologic surveillance. Adjuvant immunotherapy has recently been introduced... (Review)
Review
Potential Predictive Immune and Metabolic Biomarkers of Tumor Microenvironment Regarding Pathological and Clinical Response in Esophageal Cancer After Neoadjuvant Chemoradiotherapy: A Systematic Review.
INTRODUCTION
The tumor microenvironment (TME) plays a crucial role in therapy response and modulation of immunologic surveillance. Adjuvant immunotherapy has recently been introduced in post-surgery treatment of locally advanced esophageal cancer (EC) with residual pathological disease after neoadjuvant chemoradiotherapy (nCRT). F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG-PET/CT) remains a valuable imaging tool to assess therapy response and to visualize metabolic TME; however, there is still a paucity in understanding the interaction between the TME and nCRT response. This systematic review investigated the potential of TME biomarkers and F-FDG-PET/CT features to predict pathological and clinical response (CR) after nCRT in EC.
METHODS
A literature search of the Medline and Embase electronic databases identified 4190 studies. Studies regarding immune and metabolic TME biomarkers and F-FDG-PET/CT features were included for predicting pathological response (PR) and/or CR after nCRT. Separate analyses were performed for F-FDG-PET/CT markers and these TME biomarkers.
RESULTS
The final analysis included 21 studies-10 about immune and metabolic markers alone and 11 with additional F-FDG-PET/CT features. High CD8 infiltration before and after nCRT, and CD3 and CD4 infiltration after nCRT, generally correlated with better PR. A high expression of tumoral or stromal programmed death-ligand 1 (PD-L1) after nCRT was generally associated with poor PR. Moreover, total lesion glycolysis (TLG) and metabolic tumor volume (MTV) of the primary tumor were potentially predictive for clinical and PR.
CONCLUSION
CD8, CD4, CD3, and PD-L1 are promising immune markers in predicting PR, whereas TLG and MTV are potential F-FDG-PET/CT features to predict clinical and PR after nCRT in EC.
Topics: Humans; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Neoadjuvant Therapy; B7-H1 Antigen; Tumor Microenvironment; Chemoradiotherapy; Esophageal Neoplasms; Biomarkers, Tumor; Radiopharmaceuticals; Tumor Burden; Retrospective Studies
PubMed: 37777688
DOI: 10.1245/s10434-023-14352-z -
Journal of Nuclear Cardiology :... Dec 2023Contrast-enhanced cardiac magnetic resonance (Ce-CMR) and Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) are frequently utilized in clinical... (Meta-Analysis)
Meta-Analysis Review
Comparison of cardiac magnetic resonance imaging and fluorodeoxyglucose positron emission tomography in the assessment of myocardial viability: meta-analysis and systematic review.
AIM
Contrast-enhanced cardiac magnetic resonance (Ce-CMR) and Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) are frequently utilized in clinical practice to assess myocardial viability. However, studies evaluating direct comparison between Ce-CMR and FDG-PET have a smaller sample size, and no clear distinction between the two imaging modalities has been defined. To address this gap, we conducted a meta-analysis of studies comparing Ce-CMR and FDG-PET for the assessment of myocardial viability.
METHODS
We searched PubMed, EMBASE, Scopus, and Web of Science databases from their inception to 4/20/2022 with search terms "viability" AND "heart diseases" AND "cardiac magnetic resonance imaging" AND "positron-emission tomography." We extracted patient characteristics, segment level viability assessment according to Ce-CMR and FDG-PET, and change in regional wall motion abnormalities (RWMA) at follow-up.
RESULTS
We included four studies in the meta-analysis which provided viability assessment with Ce-CMR and FDG-PET in all patients and change in RWMA at follow-up. There were 82 patients among the four included studies, and 585 segments were compared for viability assessment. There were 59 (72%) males, and mean age was 65 years. The sensitivity (95% confidence interval-CI) and specificity (CI) of Ce-CMR for predicting myocardial recovery were 0.88 (0.66-0.96) and 0.64 (0.49-0.77), respectively. The sensitivity (CI) and specificity (CI) of FDG-PET for predicting myocardial recovery were 0.91 (0.63-0.99) and 0.67 (0.49-0.81), respectively.
CONCLUSION
FDG-PET and Ce-CMR have comparable diagnostic parameters in myocardial viability assessment and are consistent with prior research.
Topics: Male; Humans; Aged; Female; Fluorodeoxyglucose F18; Tomography, X-Ray Computed; Positron-Emission Tomography; Magnetic Resonance Imaging; Heart; Radiopharmaceuticals; Sensitivity and Specificity
PubMed: 37758962
DOI: 10.1007/s12350-023-03377-2 -
Reviews in Endocrine & Metabolic... Feb 2024In the last years growing evidences on the role of radiomics and machine learning (ML) applied to different nuclear medicine imaging modalities for the assessment of... (Review)
Review
BACKGROUND
In the last years growing evidences on the role of radiomics and machine learning (ML) applied to different nuclear medicine imaging modalities for the assessment of thyroid diseases are starting to emerge. The aim of this systematic review was therefore to analyze the diagnostic performances of these technologies in this setting.
METHODS
A wide literature search of the PubMed/MEDLINE, Scopus and Web of Science databases was made in order to find relevant published articles about the role of radiomics or ML on nuclear medicine imaging for the evaluation of different thyroid diseases.
RESULTS
Seventeen studies were included in the systematic review. Radiomics and ML were applied for assessment of thyroid incidentalomas at F-FDG PET, evaluation of cytologically indeterminate thyroid nodules, assessment of thyroid cancer and classification of thyroid diseases using nuclear medicine techniques.
CONCLUSION
Despite some intrinsic limitations of radiomics and ML may have affect the results of this review, these technologies seem to have a promising role in the assessment of thyroid diseases. Validation of preliminary findings in multicentric studies is needed to translate radiomics and ML approaches in the clinical setting.
Topics: Humans; Fluorodeoxyglucose F18; Machine Learning; Nuclear Medicine; Radiomics; Thyroid Neoplasms; Thyroid Nodule; Thyroid Diseases
PubMed: 37434097
DOI: 10.1007/s11154-023-09822-4 -
European Journal of Nuclear Medicine... Dec 2023To provide comprehensive data on the diagnostic and prognostic value of [F]-FDG PET (PET) in anal canal cancer patients. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To provide comprehensive data on the diagnostic and prognostic value of [F]-FDG PET (PET) in anal canal cancer patients.
METHODS
This study was designed following the PRISMA-DTA guidelines. For the meta-analysis, published original articles (until December 2022) that met the following criteria were included: Evaluated PET for locoregional and/or distant disease detection in patients with histopathology-proven anal canal cancer; Compared PET with a valid reference standard; Provided crude data to calculate meta-analytic estimates. Diagnostic measurements from subgroups were calculated in evaluating primary tumour detection, T stage, lymph node and distant metastases. Articles providing prognostic information on PET were also reported as a systematic review. For pooled meta-analytic calculations, the hierarchical method was used. The bivariate model was conducted to find the summary estimates. Analyses were performed using STATA 16.
RESULTS
After the screening, 28 studies were eligible to enter the meta-analytic calculations, and data from 15 were reported descriptively. For distinguishing T3/T4 from other T-stages, PET had pooled sensitivity and specificity of 91%(95%CI:72%-97%) and 96%(95%CI:88%-98%), respectively. The sensitivity and specificity for detecting metastatic (regional and/or distant) disease were 100% (95%CI:82%-100%) and 95% (95%CI:90%-98%), respectively. For therapy response assessment, the sensitivity and specificity of PET were 96%(95%CI:78%-99%) and 86%(95%CI:75%-93%), respectively. Higher pre-treatment total metabolic tumour volume was predictive of poorer survival. Conversely, for those achieving complete metabolic response, the 2-year PFS was 94%(95%CI:91%-97%) versus 51%(95%CI:42%-59%) for others (p-value < 0.001).
CONCLUSION
PET may be a useful tool for anal canal cancer therapy planning and provides valuable prognostic information.
Topics: Humans; Fluorodeoxyglucose F18; Positron-Emission Tomography; Anal Canal; Radiopharmaceuticals; Sensitivity and Specificity; Positron Emission Tomography Computed Tomography; Neoplasms
PubMed: 37592085
DOI: 10.1007/s00259-023-06393-z -
Aging Clinical and Experimental Research Mar 2024Mild cognitive impairment (MCI) may evolve into dementia. Early recognition of possible evolution to Alzheimer's disease (AD) and dementia with Lewy Bodies (DLB) is of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Mild cognitive impairment (MCI) may evolve into dementia. Early recognition of possible evolution to Alzheimer's disease (AD) and dementia with Lewy Bodies (DLB) is of importance, but actual diagnostic criteria have some limitations. In this systematic review and meta-analysis, we aimed to find the most accurate markers that can discriminate patients with DLB versus AD, in MCI stage.
METHODS
We searched several databases up to 17 August 2023 including studies comparing markers that may distinguish DLB-MCI from AD-MCI. We reported data regarding sensitivity, specificity, and the area under the curves (AUCs) with their 95% confidence intervals (CIs).
RESULTS
Among 2219 articles initially screened, eight case-control studies and one cohort study were included for a total of 832 outpatients with MCI. The accuracy of cerebrospinal fluid (CSF) markers was the highest among the markers considered (AUC > 0.90 for the CSF markers), with the AUC of CSF Aβ42/Aβ40 of 0.94. The accuracy for clinical symptom scales was very good (AUC = 0.93), as evaluated in three studies. Although limited to one study, the accuracy of FDG-PET (cingulate island sign ratio) was very good (AUC = 0.95) in discriminating DLB from AD in MCI, while the accuracy of SPECT markers and EEG frequencies was variable.
CONCLUSIONS
Few studies have assessed the accuracy of biomarkers and clinical tools to distinguish DLB from AD at the MCI stage. While results are promising for CSF markers, FDG-PET and clinical symptoms scales, more studies, particularly with a prospective design, are needed to evaluate their accuracy and clinical usefulness.
CLINICAL TRIAL REGISTRATION
Prospero (CRD42023422600).
Topics: Humans; Alzheimer Disease; Cohort Studies; Fluorodeoxyglucose F18; Lewy Body Disease; Cognitive Dysfunction
PubMed: 38451331
DOI: 10.1007/s40520-024-02704-y -
European Radiology Jan 2024To calculate the pooled diagnostic performances of whole-body [F]FDG PET/MR in M staging of [F]FDG-avid cancer entities. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To calculate the pooled diagnostic performances of whole-body [F]FDG PET/MR in M staging of [F]FDG-avid cancer entities.
METHODS
A diagnostic meta-analysis was conducted on the [F]FDG PET/MR in M staging, including studies: (1) evaluated [F]FDG PET/MR in detecting distant metastasis; (2) compared[ F]FDG PET/MR with histopathology, follow-up, or asynchronous multimodality imaging as the reference standard; (3) provided data for the whole-body evaluation; (4) provided adequate data to calculate the meta-analytic performances. Pooled performances were calculated with their confidence interval. In addition, forest plots, SROC curves, and likelihood ratio scatterplots were drawn. All analyses were performed using STATA 16.
RESULTS
From 52 eligible studies, 2289 patients and 2072 metastases were entered in the meta-analysis. The whole-body pooled sensitivities were 0.95 (95%CI: 0.91-0.97) and 0.97 (95%CI: 0.91-0.99) at the patient and lesion levels, respectively. The pooled specificities were 0.99 (95%CI: 0.97-1.00) and 0.97 (95%CI: 0.90-0.99), respectively. Additionally, subgroup analyses were performed. The calculated pooled sensitivities for lung, gastrointestinal, breast, and gynecological cancers were 0.90, 0.93, 1.00, and 0.97, respectively. The pooled specificities were 1.00, 0.98, 0.97, and 1.00, respectively. Furthermore, the pooled sensitivities for non-small cell lung, colorectal, and cervical cancers were 0.92, 0.96, and 0.86, respectively. The pooled specificities were 1.00, 0.95, and 1.00, respectively.
CONCLUSION
[F]FDG PET/MR was a highly accurate modality in M staging in the reported [F]FDG-avid malignancies. The results showed high sensitivity and specificity in each reviewed malignancy type. Thus, our findings may help clinicians and patients to be confident about the performance of [F]FDG PET/MR in the clinic.
CLINICAL RELEVANCE STATEMENT
Although [F]FDG PET/MR is not a routine imaging technique in current guidelines, mostly due to its availability and logistic issues, our findings might add to the limited evidence regarding its performance, showing a sensitivity of 0.95 and specificity of 0.97.
KEY POINTS
• The whole-body [F]FDG PET/MR showed high accuracy in detecting distant metastases at both patient and lesion levels. • The pooled sensitivities were 95% and 97% and pooled specificities were 99% and 97% at patient and lesion levels, respectively. • The results suggested that F-FDG PET/MR was a strong modality in the exclusion and confirmation of distant metastases.
Topics: Humans; Fluorodeoxyglucose F18; Radiopharmaceuticals; Sensitivity and Specificity; Multimodal Imaging; Neoplasm Staging; Neoplasms; Positron-Emission Tomography; Positron Emission Tomography Computed Tomography
PubMed: 37535156
DOI: 10.1007/s00330-023-10009-3 -
Clinical Otolaryngology : Official... Jan 2024To develop recommendations for the radiological investigation of clinically occult primary cancer in the head and neck. (Review)
Review
OBJECTIVES
To develop recommendations for the radiological investigation of clinically occult primary cancer in the head and neck.
DESIGN AND SETTING
In accordance with PRISMA guidelines, a search was performed on Medline, Embase and Cochrane library databases to investigate the efficacy of ultrasound guided Fine Needle Aspiration (US FNAC), contrast enhanced CT (CECT), magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose PET-CT (18F-FDG PET-CT) in the investigation of head and neck squamous cell carcinoma from an unknown primary (HNSCCUP) presenting with a metastatic cervical lymph node (s). The Quality Assessment of Diagnostic Accuracy Studies Version 2 tool and SIGN 50 guidelines were used to assess the risk of bias and quality of the included studies.
PARTICIPANTS
Adult patients presenting with metastatic cervical lymph nodes from a HNSCCUP.
MAIN OUTCOME MEASURES
Utility of different imaging modalities (PET-CT, MRI, CE CT and US FNAC in the management of HNSCCUP).
RESULTS
Twenty-eight studies met inclusion criteria; these were meta-analyses, systematic reviews, prospective and retrospective studies.
CONCLUSIONS
The optimal imaging strategy involves utilisation of various imaging modalities. US FNAC can provide the initial diagnosis and HPV status of the occult primary tumour. CECT and MRI detect up to 44% of occult tumours and guide management. FDG PET-CT is the most sensitive imaging modality for the detection of CUP and should be performed prior to panendoscopy.
Topics: Adult; Humans; Positron Emission Tomography Computed Tomography; Neoplasms, Unknown Primary; Head and Neck Neoplasms; Retrospective Studies; Prospective Studies; Squamous Cell Carcinoma of Head and Neck; Fluorodeoxyglucose F18; Lymph Nodes; Radiopharmaceuticals
PubMed: 37846889
DOI: 10.1111/coa.14111 -
Nuclear Medicine Communications Aug 2023Brain metastases may manifest as hypermetabolism or hypometabolism compared with normal brain activity on 18 fluorine-fluorodeoxyglucose PET ( 18 F-FDG PET). We aim to... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Brain metastases may manifest as hypermetabolism or hypometabolism compared with normal brain activity on 18 fluorine-fluorodeoxyglucose PET ( 18 F-FDG PET). We aim to undertake a systematic review and meta-analysis to determine the diagnostic accuracy of FDG PET for detecting brain metastases from different extracranial primary cancers.
METHODS
PubMed and EMBASE were searched systematically. Study selection and quality assessment were performed independently by two authors. Meta-analysis was performed using a bivariate random-effects model. Subgroup analysis and meta-regression would be performed if heterogeneity was found.
RESULTS
A total of 2227 patients from 11 studies were included in the review and analysis. Using the bivariate random-effects model, summary patient-based sensitivity and specificity for all 11 studies were estimated to be 0.440 [95% confidence interval (CI)] 0.295-0.597) and 0.997 (95% CI, 0.977-1.000). In view of significant between-study heterogeneity ( I2 = 74.0% for sensitivity and I2 = 67.3% for specificity), subgroup analyses were performed. Meta-regression showed significantly higher patient-based summary sensitivity for the three better-quality studies (a total of 1037 patients) with satisfactory index test (counting both hypermetabolism and hypometabolism as positive index test) and satisfactory reference standards (other imaging and clinical follow-up) compared with other included studies [0.735 (95% CI, 0.601-0.836) vs 0.304 (95% CI, 0.223-0.400), P value = 0.000].
CONCLUSION
Our systematic review and meta-analysis showed that FDG PET has overall limited sensitivity and excellent specificity in the detection of brain metastases from extracranial primary cancers. Importantly, subgroup analyses showed that the sensitivity can be significantly improved by raising awareness of asymmetrical hypometabolism. Further studies are warranted to assess the benefits of including the brain in FDG PET studies for all or certain groups of oncological patients.
Topics: Humans; Fluorodeoxyglucose F18; Fluorine; Positron-Emission Tomography; Brain Neoplasms; Brain; Sensitivity and Specificity; Radiopharmaceuticals; Positron Emission Tomography Computed Tomography
PubMed: 37272294
DOI: 10.1097/MNM.0000000000001715 -
BMC Neurology Oct 2023Dementia is generally caused by neurodegenerative diseases affecting the brain, which leads to a progressive neurocognitive decline characterized by inability to perform... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dementia is generally caused by neurodegenerative diseases affecting the brain, which leads to a progressive neurocognitive decline characterized by inability to perform major higher functioning tasks. Fluorodeoxyglucose-positron emission tomography (FDG-PET) scan is one of the main imaging tests performed for diagnostic purposes. However, with FDG-PET being quite expensive and not widely available, an attempt to find an alternative is set. Arterial-spin-labelling magnetic resonance imaging (ASL-MRI) is an increasingly investigated substitute to FDG-PET for the diagnosis of dementia. Thereby, the main purpose of this systematic review and meta-analysis is to compare the diagnostic ability of FDG-PET and ASL-MRI in detecting dementia.
METHODS
PRISMA checklist for diagnostic test accuracy was employed in outlining this paper. A literature search was done using several search engines including PubMed, Core, and Cochrane. Two researchers (HH and SH) extracted the essential information from all included articles. Risk of bias was evaluated by the Quality Assessment of Diagnostic Accuracy Studies tool, version 2 (QUADAS-2). A qualitative analysis and summary of studies' results were provided. In addition, a meta-analysis was executed based on the studies which involved sensitivity and specificity measures of diagnostic accuracy.
RESULTS
Fourteen total studies were included in the given review. Qualitative analysis of the articles showed that nine studies demonstrated an overlap between metabolic and perfused brain maps as derived by FDG-PET and ASL-MRI respectively, while the remaining five studies registered significant differences across both modalities, with superiority to FDG-PET. As for the meta-analysis implemented, summary ROC-curve analysis revealed that FDG-PET performed better than ASL-MRI, with pooled sensitivity being significantly higher for FDG-PET.
CONCLUSIONS
Comparing the diagnostic value of FDG-PET and ASL-MRI, the results of this systematic review and meta-analysis indicate that FDG-PET still has an advantage over ASL-MRI. Such implication could be related to the technical differences relating to both modalities, with ASL-MRI having lower temporal resolution. It's worth mentioning that specificity was rather quite similar among both modalities and some studies found an overridden metabolic and perfused images. These findings call for future research to focus their scope of investigation while exploring the diagnostic value of ASL-MRI.
Topics: Humans; Fluorodeoxyglucose F18; Spin Labels; Positron-Emission Tomography; Sensitivity and Specificity; Magnetic Resonance Imaging; Dementia; Radiopharmaceuticals
PubMed: 37875879
DOI: 10.1186/s12883-023-03432-y