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Cancer Medicine Aug 2023Positron emission tomography (PET) images of head and neck squamous cell carcinoma (HNSCC) patients can assess the functional and biochemical processes at cellular... (Meta-Analysis)
Meta-Analysis Review
A systematic review and meta-analysis of predictive and prognostic models for outcome prediction using positron emission tomography radiomics in head and neck squamous cell carcinoma patients.
BACKGROUND
Positron emission tomography (PET) images of head and neck squamous cell carcinoma (HNSCC) patients can assess the functional and biochemical processes at cellular levels. Therefore, PET radiomics-based prediction and prognostic models have the potentials to understand tumour heterogeneity and assist clinicians with diagnosis, prognosis and management of the disease. We conducted a systematic review of published modelling information to evaluate the usefulness of PET radiomics in the prediction and prognosis of HNSCC patients.
METHODS
We searched bibliographic databases (MEDLINE, Embase, Web of Science) from 2010 to 2021 and considered 31 studies with pre-defined inclusion criteria. We followed the CHARMS checklist for data extraction and performed quality assessment using the PROBAST tool. We conducted a meta-analysis to estimate the accuracy of the prediction and prognostic models using the diagnostic odds ratio (DOR) and average C-statistic, respectively.
RESULTS
Manual segmentation method followed by 40% of the maximum standardised uptake value (SUV ) thresholding is a commonly used approach. The area under the receiver operating curves of externally validated prediction models ranged between 0.60-0.87, 0.65-0.86 and 0.62-0.75 for overall survival, distant metastasis and recurrence, respectively. Most studies highlighted an overall high risk of bias (outcome definition, statistical methodologies and external validation of models) and high unclear concern in terms of applicability. The meta-analysis showed the estimated pooled DOR of 6.75 (95% CI: 4.45, 10.23) for prediction models and the C-statistic of 0.71 (95% CI: 0.67, 0.74) for prognostic models.
CONCLUSIONS
Both prediction and prognostic models using clinical variables and PET radiomics demonstrated reliable accuracy for detecting adverse outcomes in HNSCC, suggesting the prospect of PET radiomics in clinical settings for diagnosis, prognosis and management of HNSCC patients. Future studies of prediction and prognostic models should emphasise the quality of reporting, external model validation, generalisability to real clinical scenarios and enhanced reproducibility of results.
Topics: Humans; Squamous Cell Carcinoma of Head and Neck; Prognosis; Reproducibility of Results; Positron-Emission Tomography; Head and Neck Neoplasms; Fluorodeoxyglucose F18
PubMed: 37353996
DOI: 10.1002/cam4.6278 -
Anticancer Research Sep 2023F-fluorodeoxyglucose (FDG) is known to accumulate in the liver. We investigated whether accumulation of FDG was correlated with the degree of liver fibrosis and the...
BACKGROUND/AIM
F-fluorodeoxyglucose (FDG) is known to accumulate in the liver. We investigated whether accumulation of FDG was correlated with the degree of liver fibrosis and the grade of necro-inflammatory activity.
PATIENTS AND METHODS
This retrospective study included 35 patients who underwent FDG-positron emission tomography (PET)/computed tomography (CT) before liver surgery. On fusion images of CT and PET, by placing regions of interest on the lateral, anterior and posterior segments of the liver and the aorta, the standardized uptake value (SUV) mean, and SUV normalized by lean body mass (SUL) mean of the liver were measured, and the ratio SUVmean liver/SUVmean aorta was calculated. According to the New Inuyama Classification, subjects were classified into three groups based on the grade of liver-fibrosis degree, i.e., F0, F1+F2 and F3+F4, and into three groups based on the grade of necro-inflammatory activity, i.e., A0, A1 and A2. Each of the above parameters was then compared among the groups using a Tukey test.
RESULTS
Average SULmean liver values of the F0, F1+F2 and F3+F4 groups were 1.573±0.211, 1.845±0.220 and 1.716±0.119, respectively. The SULmean liver of the F1+F2 group was significantly higher than that of the F0 group (p=0.0296). No significant difference was observed for the other two parameters. None of the parameters exhibited significant difference among the A0, A1, and A2 groups.
CONCLUSION
FDG accumulation in the liver may be increased in the early stage of liver fibrosis. SULmean liver could be used to determine the necessity for therapeutic intervention in chronic liver disease.
Topics: Humans; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Retrospective Studies; Liver Cirrhosis
PubMed: 37648319
DOI: 10.21873/anticanres.16614 -
Cardiovascular Research Aug 2023
Topics: Humans; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Diabetes Mellitus, Type 1; Positron-Emission Tomography; Inflammation
PubMed: 37463514
DOI: 10.1093/cvr/cvad109 -
Clinical Nuclear Medicine Dec 2023A 51-year-old woman with a history of IgA nephropathy was found to have a mass in the right lobe of the liver by abdominal ultrasound. The PET/CT scan revealed elevated...
A 51-year-old woman with a history of IgA nephropathy was found to have a mass in the right lobe of the liver by abdominal ultrasound. The PET/CT scan revealed elevated 68 Ga-FAPI-04 uptake in the aforementioned lesion, indicating the potential presence of liver cancer. However, subsequent histopathological analysis confirmed it to be an arteriovenous malformation. This case illustrates that 68 Ga-FAPI-04 uptake can occur in arteriovenous malformation and is a benign cause of 68 Ga-FAPI-04 uptake.
Topics: Female; Humans; Middle Aged; Glomerulonephritis, IGA; Positron Emission Tomography Computed Tomography; Arteriovenous Malformations; Quinolines; Fluorodeoxyglucose F18
PubMed: 37883057
DOI: 10.1097/RLU.0000000000004887 -
Clinical Nuclear Medicine Jan 2024Wandering spleen is a rare condition caused by either lack or the laxity of ligaments, which results malposition in the lower abdomen or pelvis. FDG PET/CT is the...
Wandering spleen is a rare condition caused by either lack or the laxity of ligaments, which results malposition in the lower abdomen or pelvis. FDG PET/CT is the cornerstone of the staging procedures in the management of lymphomas leading to upstaging and picking up occult lesions in the spleen and extranodal sites. Herein, we reported initial staging 18 F-FDG PET/CT findings of a woman with Hodgkin lymphoma whose spleen was absent in normal position and multiple intense heterogenous hypermetabolism in a pelvic mass raised a suspicion of wandering splenic involvement. The confirmation was made with selective spleen SPECT/CT images thereafter.
Topics: Female; Humans; Wandering Spleen; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Lymphoma
PubMed: 37976521
DOI: 10.1097/RLU.0000000000004949 -
Nuclear Medicine Communications Nov 2023In this study, the potential advantage of FAPI over 18 F-labelled deoxyglucose ( 18 F-FDG) in evaluation of the initial staging colorectal cancer (CRC) was investigated.
OBJECTIVE
In this study, the potential advantage of FAPI over 18 F-labelled deoxyglucose ( 18 F-FDG) in evaluation of the initial staging colorectal cancer (CRC) was investigated.
MATERIALS AND METHODS
Thirty-two patients with histopathologically confirmed primary CRC were included in our study. They all underwent both 18 F-FDG and FAPI PET/CT. Lesion detectability and tracer uptakes, mainly quantified by maximum standardized uptake value (SUVmax) and target-to-background ratio (TBR), were compared for paired lesions between both modalities using the Wilcoxon signed-rank test and paired t-test.
RESULTS
Thirty-five CRC lesions in 32 patients were diagnosed. The sensitivity of FAPI PET/CT in diagnosis of the CRC lesions was 100% while 93.8% of 18 F-FDG PET/CT. FAPI and 18 F-FDG had a similar uptake in CRC lesion (mean SUVmax: 14.3 ± 8.6 vs. 15.4 ± 9.8, P = 0.604), but lesions contained mucus and/or signet-ring cell carcinoma seemed to have a trend of higher FAPI uptake although there was no statistical difference (mean SUVmax: 12.7 ± 5.6 vs. 8.5 ± 4.1, P = 0.152) and higher TBR (13.4 ± 6.2 vs. 4.9 ± 2.2, P = 0.004) than those of 18 F-FDG. For regional lymph node metastases, both FAPI and FDG PET/CTs showed high sensitivity (7/8 vs. 7/8), specificity (7/8 vs. 6/8) and accuracy (14/16 vs. 13/16) (all P > 0.05). For distant metastasis, FAPI PET/CT depicted more positive lesions in distant lymph node (46 vs. 26), liver (13 vs. 7) and peritoneum (107 vs. 45) than 18 F-FDG PET/CT. FAPI PET/CT also had a higher peritoneal cancer index score (median 11 vs 4; P < 0.001) than 18 F-FDG PET/CT in evaluation of peritoneal metastases.
CONCLUSION
FAPI PET/CT showed high sensitivity in detection of primary CRC and superiority to 18 F-FDG PET/CT in detection of metastases to distant lymph node, liver and peritoneum.
Topics: Humans; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Positron-Emission Tomography; Colorectal Neoplasms; Fibroblasts; Gallium Radioisotopes; Quinolines
PubMed: 37661771
DOI: 10.1097/MNM.0000000000001751 -
Clinical Nuclear Medicine Sep 2023Benign metastasizing leiomyomas (BMLs) are benign disseminated extrauterine tumors in patients with prior history of uterine leiomyomas and may occur years after...
Benign metastasizing leiomyomas (BMLs) are benign disseminated extrauterine tumors in patients with prior history of uterine leiomyomas and may occur years after hysterectomy. In this case, we presented 18 F-FDG and 68 Ga-FAPI PET/CT findings in a 37-year-old woman with benign leiomyoma metastasizing to lung and pelvis. The metastatic lesions demonstrated faint 18 F-FDG but elevated 68 Ga-FAPI activity, indicating the low level of glucose metabolism but excessive accumulation of activated fibroblasts in the BMLs. This case demonstrated that 68 Ga-FAPI PET/CT may be potentially useful in the evaluation of BMLs.
Topics: Female; Humans; Adult; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Leiomyoma; Biological Transport; Gallium Radioisotopes
PubMed: 37335290
DOI: 10.1097/RLU.0000000000004748 -
Skeletal Radiology Dec 2023This study investigated the distribution and characteristics of various bone and joint lesions on F-FAPI PET/CT in lung cancer patients.
OBJECTIVE
This study investigated the distribution and characteristics of various bone and joint lesions on F-FAPI PET/CT in lung cancer patients.
METHODS
Seventy-four lung cancer patients who underwent F-FAPI PET/CT were reviewed. Bone and joint lesions with elevated F-FAPI uptake were recorded and analyzed. The distribution and maximum uptake value (SUV) of different benign lesions or bone metastases were presented. In addition, the SUV of bone metastases on F-FDG and F-FAPI-04 PET/CT were also compared.
RESULTS
In 53 patients, a total of 262 lesions presented F-FAPI accumulation. Bone metastases were mainly in vertebrae, pelvis, and ribs, while benign lesions were in vertebral margins, alveolar bone, and shoulder joints. The SUV of bone metastases was significantly higher than that of benign lesions ([Formula: see text] vs. [Formula: see text], [Formula: see text]), with NSCLC cases having higher SUV values than SCLC cases ([Formula: see text] vs. [Formula: see text], [Formula: see text]). Among benign lesions, arthritis and periodontitis demonstrated higher SUV than degenerative lesions (arthritis: [Formula: see text]; periodontitis: [Formula: see text]; degenerative diseases: [Formula: see text]; [Formula: see text] and [Formula: see text], respectively). The SUV of bone metastases was comparable between F-FDG and F-FAPI PET/CT. However, F-FAPI PET/CT was found to be superior in identifying cranial metastases compared to F-FDG PET/CT (TBR: [Formula: see text] vs. [Formula: see text], [Formula: see text]).
CONCLUSION
This study demonstrated that F-FAPI PET/CT is a valuable imaging modality for detecting bone and joint lesions in lung cancer patients. The SUV of malignant lesions was higher than that of benign lesions, but cannot accurately distinguish benign and malignant lesions. The uptake of FAPI differs among lesions with different pathological types.
Topics: Humans; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Lung Neoplasms; Arthritis; Periodontitis
PubMed: 37129613
DOI: 10.1007/s00256-023-04335-2 -
Journal of Nuclear Cardiology :... Aug 2023
Topics: Humans; Fluorodeoxyglucose F18; Positron-Emission Tomography; Radiopharmaceuticals; Positron Emission Tomography Computed Tomography
PubMed: 37127724
DOI: 10.1007/s12350-023-03250-2 -
[F]DPA-714 PET Imaging in the Presurgical Evaluation of Patients With Drug-Resistant Focal Epilepsy.Neurology Nov 2023Translocator protein 18 kDa (TSPO) PET imaging is used to monitor glial activation. Recent studies have proposed TSPO PET as a marker of the epileptogenic zone (EZ) in...
BACKGROUND AND OBJECTIVES
Translocator protein 18 kDa (TSPO) PET imaging is used to monitor glial activation. Recent studies have proposed TSPO PET as a marker of the epileptogenic zone (EZ) in drug-resistant focal epilepsy (DRFE). This study aims to assess the contributions of TSPO imaging using [F]DPA-714 PET and [F]FDG PET for localizing the EZ during presurgical assessment of DRFE, when phase 1 presurgical assessment does not provide enough information.
METHODS
We compared [F]FDG and [F]DPA-714 PET images of 23 patients who had undergone a phase 1 presurgical assessment, using qualitative visual analysis and quantitative analysis, at both the voxel and the regional levels. PET abnormalities (increase in binding for [F]DPA-714 vs decrease in binding for [F]FDG) were compared with clinical hypotheses concerning the localization of the EZ based on phase 1 presurgical assessment. The additional value of [F]DPA-714 PET imaging to [F]FDG for refining the localization of the EZ was assessed. To strengthen the visual analysis, [F]DPA-714 PET imaging was also reviewed by 2 experienced clinicians blind to the EZ location.
RESULTS
The study included 23 patients. Visual analysis of [F]DPA-714 PET was significantly more accurate than [F]FDG PET to both, show anomalies (95.7% vs 56.5%, = 0.022), and provide additional information to refine the EZ localization (65.2% vs 17.4%, = 0.019). All 10 patients with normal [F]FDG PET had anomalies when using [F]DPA-714 PET. The additional value of [F]DPA-714 PET seemed to be greater in patients with normal brain MRI or with neocortical EZ (especially if insula is involved). Regional analysis of [F]DPA-714 and [F]FDG PET provided similar results. However, using voxel-wise analysis, [F]DPA-714 was more effective than [F]FDG for unveiling clusters whose localization was more often consistent with the EZ hypothesis (87.0% vs 39.1%, = 0.019). Nonrelevant bindings were seen in 14 of 23 patients in visual analysis and 9 patients of 23 patients in voxel-wise analysis.
DISCUSSION
[F]DPA-714 PET imaging provides valuable information for presurgical assessments of patients with DRFE. TSPO PET could become an additional tool to help to the localization of the EZ, especially in patients with negative [F]FDG PET.
TRIAL REGISTRATION INFORMATION
Eudract 2017-003381-27. Inclusion of the first patient: September 24, 2018.
CLASSIFICATION OF EVIDENCE
This study provides Class IV evidence on the utility of [F]DPA-714 PET compared with [F]FDG PET in identifying the epileptic zone in patients undergoing phase 1 presurgical evaluation for intractable epilepsy.
Topics: Humans; Drug Resistant Epilepsy; Fluorodeoxyglucose F18; Magnetic Resonance Imaging; Positron-Emission Tomography; Epilepsies, Partial; Electroencephalography; Receptors, GABA
PubMed: 37748889
DOI: 10.1212/WNL.0000000000207811