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European Journal of Radiology Feb 2024The aim of our meta-analysis and systematic review was to contrast the positivity rates of [68Ga]Ga-FAPI PET and [18F]FDG PET in detecting bone and lymph node metastases... (Meta-Analysis)
Meta-Analysis
Head-to-head comparison of [68Ga]Ga-FAPI PET and [18F]FDG PET in the detection of bone and lymph node metastasis in various cancers: A systematic review and meta-analysis.
PURPOSE
The aim of our meta-analysis and systematic review was to contrast the positivity rates of [68Ga]Ga-FAPI PET and [18F]FDG PET in detecting bone and lymph node metastases across diverse cancer types.
METHODS
We conducted a comprehensive search for eligible articles up until August 2023, utilizing databases including PubMed, Embase, and Web of Science. Studies focusing on the positivity rate of [68Ga]Ga-FAPI PET vs. [18F]FDG PET for bone and lymph metastasis were included. Using random-effect model, the positivity rate for [68Ga]Ga-FAPI PET and [18F]FDG PET were generated. In order to gauge the heterogeneity among aggregated studies, we utilized the I statistic. Additionally, we applied the Quality Assessment of Diagnostic Performance Studies (QUADAS-2) methodology to evaluate the caliber of the studies encompassed in our analysis.
RESULTS
A total of 430 publications were initially identified in the search. Eventually, 25 studies, involving 779 patients, met the inclusion criteria. In terms of bone metastasis, the findings indicate no statistically significant difference between the use of [68Ga]Ga-FAPI PET and [18F]FDG PET (P = 0.34). However, concerning lymph node metastasis, the results demonstrate significant difference between the two imaging agents (P = 0.04).
CONCLUSIONS
This systematic review suggests that [68Ga]Ga-FAPI PET appears to outperform [18F]FDG PET in detecting lymph node metastases. However, when it comes to bone metastasis, no statistically significant difference was observed. It is crucial to acknowledge that the insights concerning bone metastasis stem from studies with comparatively modest sample sizes. Consequently, there is a pressing demand for further, expansive prospective studies in this field.
Topics: Humans; Fluorodeoxyglucose F18; Lymphatic Metastasis; Prospective Studies; Databases, Factual; Positron-Emission Tomography; Positron Emission Tomography Computed Tomography; Gallium Radioisotopes
PubMed: 38219352
DOI: 10.1016/j.ejrad.2024.111302 -
Current Medical Imaging 2023F-FDG PET/CT imaging represents the most important functional imaging method in oncology. European Society of Medical Oncology and the National Comprehensive Cancer...
BACKGROUND
F-FDG PET/CT imaging represents the most important functional imaging method in oncology. European Society of Medical Oncology and the National Comprehensive Cancer Network guidelines defined a crucial role of F-FDG PET/CT imaging for local/locally advanced breast cancer. The application of artificial intelligence on PET images might potentially contributes in the field of precision medicine.
OBJECTIVE
This review aims to summarize the clinical indications and limitations of PET imaging for comprehensive artificial intelligence in relation to breast cancer subtype, hormone receptor status, proliferation rate, and lymphonodal (LN)/distant metastatic spread, based on recent literature.
METHODS
A literature search of the Pubmed/Scopus/Google Scholar/Cochrane/EMBASE databases was carried out, searching for articles on the use of artificial intelligence and PET in breast tumors. The search was updated from January 2010 to October 2021 and was limited to original articles published in English and about humans. A combination of the search terms "artificial intelligence", "breast cancer", "breast tumor", "PET", "Positron emission tomography", "PET/CT", "PET/MRI", "radiomic"," texture analysis", "machine learning", "deep learning" was used.
RESULTS
Twenty-three articles were selected following the PRISMA criteria from 139 records obtained from the Pubmed/Scopus/Google Scholar/Cochrane/EMBASE databases according to our research strategy. The QUADAS of 30 full-text articles assessed reported seven articles that were excluded for not being relevant to population and outcomes and/or for lower level of evidence. The majority of papers were at low risk of bias and applicability. The articles were divided per topic, such as the value of PET in the staging and re-staging of breast cancer patients, including new radiopharmaceuticals and simultaneous PET/MRI.
CONCLUSION
Despite the current role of AI in this field remains still undefined, several applications for PET/CT imaging are under development, with some preliminary interesting results particularly focused on the staging phase that might be clinically translated after further validation studies.
Topics: Humans; Fluorodeoxyglucose F18; Positron-Emission Tomography; Positron Emission Tomography Computed Tomography; Artificial Intelligence; Intelligence; Neoplasms
PubMed: 36703586
DOI: 10.2174/1573405619666230126093806 -
Radiography (London, England : 1995) Nov 2021Anxiety is an emotional reaction often experienced by patients who undergo Positron Emission Tomography/Computed Tomography (PET/CT) with 18F-2-fluoro-2-deoxy-d-glucose... (Review)
Review
INTRODUCTION
Anxiety is an emotional reaction often experienced by patients who undergo Positron Emission Tomography/Computed Tomography (PET/CT) with 18F-2-fluoro-2-deoxy-d-glucose (F-FDG). This systematic review aimed to summarise the evidence currently available considering the anxiety experienced by adult oncological patients concerning pre and post F-FDG PET/CT examination and the factors contributing to anxiety.
METHODS
A systematic review search of CINAHL, PsycINFO, PubMed, Scopus and Web Science databases and other manual search sources, was conducted from November to February 2021. The research included articles published from January 2000 to December 2020. It included quantitative studies, which analysed the anxiety experienced by oncological patients who had undergone F-FDG PET/CT.
RESULTS
Ten articles met the inclusion criteria for this systematic review. The studies selected were published between 2011 and 2020 and carried out in five countries. Anxiety experienced by patients was evaluated at the various stages of the F-FDG PET/CT, eight studies assessed it in the pre-examination, seven studies in the post-examination and five studies at both times. Four main anxiety factors were found: patients' clinical situation, first-time patients' examination, scan procedure, and patients concern with the examination result.
CONCLUSION
Moderate to high levels of anxiety are present in most of the patients who undergo the examination. This review also highlights several factors related to the anxiety levels through different procedure moments.
IMPLICATIONS FOR PRACTICE
The results of this research will allow health professionals to adjust non-pharmacological strategies to decrease anxiety levels in oncological patients undergoing F-FDG PET/CT.
Topics: Anxiety; Fluorodeoxyglucose F18; Humans; Medical Oncology; Positron Emission Tomography Computed Tomography
PubMed: 34175212
DOI: 10.1016/j.radi.2021.06.001 -
The Journal of Laryngology and Otology Jan 2023There is currently no consensus on the ideal protocol of imaging for post-treatment surveillance of head and neck squamous cell carcinoma. This study aimed to... (Meta-Analysis)
Meta-Analysis Review
Systematic review and meta-analysis of the diagnostic effectiveness of positron emission tomography-computed tomography versus magnetic resonance imaging in the post-treatment surveillance of head and neck squamous cell carcinoma.
OBJECTIVE
There is currently no consensus on the ideal protocol of imaging for post-treatment surveillance of head and neck squamous cell carcinoma. This study aimed to consolidate existing evidence on the diagnostic effectiveness of positron emission tomography-computed tomography versus magnetic resonance imaging.
METHOD
Systematic electronic searches were conducted using Medline, Embase and Cochrane Library (updated February 2021) to identify studies directly comparing positron emission tomography-computed tomography and magnetic resonance imaging scans for detecting locoregional recurrence or residual disease for post-treatment surveillance.
RESULTS
Searches identified 3164 unique records, with three studies included for meta-analysis, comprising 176 patients. The weighted pooled estimates of sensitivity and specificity for scans performed three to six months post-curative treatment were: positron emission tomography-computed tomography, 0.68 (95 per cent confidence interval, 0.49-0.84) and 0.89 (95 per cent confidence interval, 0.84-0.93); magnetic resonance imaging, 0.72 (95 per cent confidence interval, 0.54-0.88) and 0.85 (95 per cent confidence interval, 0.79-0.89), respectively.
CONCLUSION
Existing studies do not provide evidence for superiority of either positron emission tomography-computed tomography or magnetic resonance imaging in detecting locoregional recurrence or residual disease following curative treatment of head and neck squamous cell carcinoma.
Topics: Humans; Positron Emission Tomography Computed Tomography; Squamous Cell Carcinoma of Head and Neck; Positron-Emission Tomography; Neoplasm Recurrence, Local; Magnetic Resonance Imaging; Sensitivity and Specificity; Head and Neck Neoplasms; Fluorodeoxyglucose F18
PubMed: 35086577
DOI: 10.1017/S0022215122000317 -
International Journal of Radiation... May 2022Posttreatment surveillance for local recurrence (LR) after stereotactic ablative body radiotherapy (SABR) can include both fluorodeoxyglucose-positron emission... (Review)
Review
A Systematic Review Into the Radiologic Features Predicting Local Recurrence After Stereotactic Ablative Body Radiotherapy (SABR) in Patients With Non-Small Cell Lung Cancer (NSCLC).
PURPOSE
Posttreatment surveillance for local recurrence (LR) after stereotactic ablative body radiotherapy (SABR) can include both fluorodeoxyglucose-positron emission tomography (FDG-PET) and computed tomography (CT). Radiation-induced lung injury shares a similar appearance to LR after treatment, making the detection of LR on imaging difficult for clinicians. We aimed to summarize radiologic features of CT and FDG-PET predicting LR and to evaluate radiomics as another tool for detecting LR.
METHODS AND MATERIALS
We searched MEDLINE, EMBASE, and PubMed databases for published studies and Web of Science, Wiley Online, and Science Direct databases for conference abstracts that had patient populations with non-small cell lung cancer and reported post-SABR radiologic features of FDG-PET or CT and radiomics from either FDG-PET or CT. Studies for inclusion were independently reviewed by 2 authors.
RESULTS
Across 32 relevant studies, the incidence of LR was 13% (222/1726). On CT, certain gross radiologic appearances and kinetic features of changes in size, diameter, volume, or 3 consecutive rises in volume of masslike consolidation are suggestive of LR. **Particular regard should be made for the presence of any ≥3 high-risk features on CT or the individual high-risk features of enlarging opacity at ≥12 month's post-SABR as being highly suspicious of LR. On FDG-PET a relative reduction of <5% of maximum standardised uptake value (SUV) from baseline in the first 12 months or cut-offs of SUV >5 and SUV >3.44 after 12 months can indicate LR. There is limited evidence available to corroborate radiomic features suggestive of LR.
CONCLUSIONS
This research has identified common features of LR compared with radiation-induced lung injury, which may aid in early and accurate detection of LR post-SABR; further research is required to validate these findings.
Topics: Carcinoma, Non-Small-Cell Lung; Fluorodeoxyglucose F18; Humans; Lung Injury; Lung Neoplasms; Positron-Emission Tomography; Radiation Injuries; Radiosurgery
PubMed: 34879247
DOI: 10.1016/j.ijrobp.2021.11.027 -
Journal of Vascular Surgery Dec 2020Vascular graft and endograft infection (VGEI) has high morbidity and mortality rates. Diagnosis is complicated because symptoms vary and can be nonspecific. A... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Vascular graft and endograft infection (VGEI) has high morbidity and mortality rates. Diagnosis is complicated because symptoms vary and can be nonspecific. A meta-analysis identified F-fluoro-d-deoxyglucose positron emission tomography-computed tomography (F-FDG PET/CT) as the most valuable tool for diagnosis of VGEI and favorable to computed tomography as the current standard. However, the availability and varied use of several interpretation methods, without consensus on which interpretation method is best, complicate clinical use. The aim of this study was to evaluate the diagnostic performance of different interpretation methods of F-FDG PET/CT in diagnosis of VGEI.
METHODS
A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data sources included PubMed/MEDLINE, Embase, and Cochrane Library. A meta-analysis was conducted on the different interpretation methods for F-FDG PET/CT in diagnosis of VGEI, including visual FDG uptake intensity, visual FDG uptake pattern, and quantitative maximum standardized uptake (SUVmax).
RESULTS
Of 613 articles, 13 were included (10 prospective and 3 retrospective articles). The FDG uptake pattern method (I = 26.2%) showed negligible heterogeneity, whereas the FDG uptake intensity (I = 42.2%) and SUVmax (I = 42.1%) methods showed moderate heterogeneity. The pooled sensitivity for FDG uptake intensity was 0.90 (95% confidence interval [CI], 0.79-0.96); for uptake pattern, 0.94 (95% CI, 0.89-0.97); and for SUVmax, 0.95 (95% CI, 0.76-0.99). The pooled specificity for FDG uptake intensity was 0.59 (95% CI, 0.38-0.78); for FDG uptake pattern, 0.81 (95% CI, 0.71-0.88); and for SUVmax, 0.77 (95% CI, 0.63-0.87). The uptake pattern interpretation method demonstrated the best positive and negative post-test probability, 82% and 10%, respectively.
CONCLUSIONS
This meta-analysis identified the FDG uptake pattern as the most accurate assessment method of F-FDG PET/CT for diagnosis of VGEI. The optimal SUVmax cutoff, depending on the vendor, demonstrated strong sensitivity and moderate specificity.
Topics: Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Endovascular Procedures; Fluorodeoxyglucose F18; Humans; Positron Emission Tomography Computed Tomography; Predictive Value of Tests; Prosthesis-Related Infections; Radiopharmaceuticals; Reproducibility of Results; Treatment Outcome
PubMed: 32645420
DOI: 10.1016/j.jvs.2020.05.065 -
European Journal of Nuclear Medicine... Jun 2021Polymyalgia rheumatica (PMR) can be difficult to diagnose. Whole-body [18F]FDG-PET/CT allows for a comprehensive evaluation of all relevant articular and extra-articular... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Polymyalgia rheumatica (PMR) can be difficult to diagnose. Whole-body [18F]FDG-PET/CT allows for a comprehensive evaluation of all relevant articular and extra-articular structures affected by PMR. We aimed to summarize current evidence on the diagnostic value of [18F]FDG-PET/CT for a diagnosis of PMR.
METHODS
PubMed/MEDLINE and the Cochrane Library database were searched from inception through May 31, 2020. Studies containing patients with PMR who underwent [18F]FDG-PET/CT were included. Screening and full-text review were performed by 3 investigators and data extraction by 2 investigators. Risk of bias was examined with the QUADAS-2 tool. Diagnostic test meta-analysis was performed with a bivariate model.
RESULTS
Twenty studies were included in the systematic review, of which 9 studies (n = 636 patients) were eligible for meta-analysis. [18F]FDG positivity at the following sites was associated with a diagnosis of PMR: interspinous bursae (positive likelihood ratio (LR+) 4.00; 95% CI 1.84-8.71), hips (LR+ 2.91; 95% CI 2.09-4.05), ischial tuberosities (LR+ 2.86; 95% CI 1.91-4.28), shoulders (LR+ 2.57; 95% CI 1.24-5.32) and sternoclavicular joints (LR+ 2.31; 95% CI 1.33-4.02). Negative likelihood ratios (LR-) for these sites, as well as the greater trochanters, were all less than 0.50. Composite [18F]FDG-PET/CT scores, as reported in 3 studies, provided a pooled LR+ of 3.91 (95% CI 2.42-6.32) and LR- of 0.19 (95% CI 0.10-0.36). Moderate to high heterogeneity was observed across the studies, mainly due to differences in patient selection, scanning procedures and/or interpretation criteria.
CONCLUSION
Significant [18F]FDG uptake at a combination of anatomic sites is informative for a diagnosis of PMR. [18F]FDG-PET/CT might be an important diagnostic tool in patients with suspected PMR. This study also highlights the need for adherence to published procedural recommendations and standardized interpretation criteria for the use of [18F]FDG-PET/CT in PMR.
Topics: Fluorodeoxyglucose F18; Giant Cell Arteritis; Humans; Polymyalgia Rheumatica; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radiopharmaceuticals
PubMed: 33372248
DOI: 10.1007/s00259-020-05162-6 -
BMC Cancer Feb 2022Renal cell carcinoma (RCC) is one of the most common malignancies worldwide. Noninvasive imaging techniques, such as magnetic resonance imaging (MRI), single photon... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Renal cell carcinoma (RCC) is one of the most common malignancies worldwide. Noninvasive imaging techniques, such as magnetic resonance imaging (MRI), single photon emission computed tomography (SPECT), and positron emission tomography (PET), have been involved in increasing evolution to detect RCC. This meta-analysis aims to compare to compare the performance of MRI, SPECT, and PET in the detection of RCC in humans, and to provide evidence for decision-making in terms of further research and clinical settings.
METHODS
Electronic databases including PubMed, Web of Science, Embase, and Cochrane Library were systemically searched. The keywords such as "magnetic resonance imaging", "MRI", "single-photon emission computed tomography", "SPECT", "positron emission tomography", "PET", "renal cell carcinoma" were used for the search. Studies concerning MRI, SPECT, and PET for the detection of RCC were included. Pooled sensitivity, specificity, and the area under the summary receiver operating characteristic (SROC) curve (AUC), etc. were calculated.
RESULTS
A total of 44 articles were finally detected for inclusion in this study. The pooled sensitivities of MRI, F-FDG PET and F-FDG PET/CT were 0.80, 0.83, and 0.89, respectively. Their respective overall specificities were 0.90, 0.86, and 0.88. The pooled sensitivity and specificity of MRI studies at 1.5 T were 0.86 and 0.94, respectively. With respect to prospective PET studies, the pooled sensitivity, specificity and AUC were 0.90, 0.93 and 0.97, respectively. In the detection of primary RCC, PET studies manifested a pooled sensitivity, specificity, and AUC of 0.77, 0.80, and 0.84, respectively. The pooled sensitivity, specificity, and AUC of PET/CT studies in detecting primary RCC were 0.80, 0.85, and 0.89.
CONCLUSION
Our study manifests that MRI and PET/CT present better diagnostic value for the detection of RCC in comparison with PET. MRI is superior in the diagnosis of primary RCC.
Topics: Adult; Aged; Carcinoma, Renal Cell; Early Detection of Cancer; Female; Fluorodeoxyglucose F18; Humans; Kidney Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Prospective Studies; Radiopharmaceuticals; Sensitivity and Specificity; Tomography, Emission-Computed, Single-Photon; Young Adult
PubMed: 35148700
DOI: 10.1186/s12885-022-09239-3 -
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