-
Journal of Medical Virology May 2022Coronavirus disease 2019 (COVID-19) has caused a global pandemic that continues to cause numerous deaths to date. Four vaccines have been approved by the Food and Drug... (Review)
Review
Coronavirus disease 2019 (COVID-19) has caused a global pandemic that continues to cause numerous deaths to date. Four vaccines have been approved by the Food and Drug Administration as of July 2021 to prevent the transmission of COVID-19: Pfizer, Moderna, AstraZeneca, and Janssen. These vaccines have shown great efficacy and safety profile. One side effect that has been widely reported is post-COVID-19 vaccination lymphadenopathy. Due to the mimicry of the lymphadenopathy for metastases in some oncologic patients, there have been reports of patients who underwent biopsies that showed pathologic confirmation of benign reactive lymphadenopathy secondary to the COVID-19 vaccine. Therefore, understanding the incidence of lymphadenopathy post-COVID-19 vaccinations will help guide radiologists and oncologists in their management of patients, both present oncologic patients, and patients with concerns over their newly presenting lymphadenopathy. A systematic literature search was performed using several databases to identify relevant studies that reported lymphadenopathy post-COVID-19 vaccination. Our results revealed that several cases have been detected in patients undergoing follow-up fluorodeoxyglucose (FDG)-positron emission tomography-computerized tomography scans where lymph nodes ipsilateral to the vaccine injection site show increased uptake of FDG. Thus, knowledge of the incidence of lymphadenopathy may help avoid unnecessary biopsies, interventions, and changes in management for patients, especially oncologic patients who are at risk for malignancies.
Topics: COVID-19; COVID-19 Vaccines; Fluorodeoxyglucose F18; Humans; Lymphadenopathy; Positron Emission Tomography Computed Tomography; SARS-CoV-2; United States; Vaccination
PubMed: 35060149
DOI: 10.1002/jmv.27599 -
Hellenic Journal of Nuclear Medicine 2023To conduct a meta-analysis of the diagnostic efficacy of fluorine-18-fluorodeoxyglucose (F-FDG) and gallium-68-labeled fibroblast-activation protein inhibitor (Ga-FAPI)... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To conduct a meta-analysis of the diagnostic efficacy of fluorine-18-fluorodeoxyglucose (F-FDG) and gallium-68-labeled fibroblast-activation protein inhibitor (Ga-FAPI) positron emission tomography/computed tomography (PET/CT) for primary liver cancer based on existing clinical evidence.
MATERIALS AND METHODS
Meta-analysis was carried out according to PRISMA reporting specification. The clinical studies in PubMed/Medline, Embase and the Cochrane Library database were retrieved from the establishment to September 2022. Two researchers independently conducted literature screening and data extraction, evaluated the risk of bias according to QUADAS-2, conducted meta-analysis using Meta Disc 1.4 and Stata15.1 software, and calculated the summarized sensitivity (SEN), specificity (SPE), positive likelihood ratio (+LR), negative likelihood ratio (-LR), and diagnostic odds ratio (DOR). The diagnostic performance of F-FDG PET/CT and Ga-FAPI PET/CT for primary liver cancer was compared using summarized receiver operating characteristic (SROC) curve and area under curve (AUC).
RESULTS
Four original studies on F-FDG PET/CT and Ga-FAPI PET/CT in the diagnosis of primary liver cancer were included, including 159 intrahepatic lesions in 106 patients. Taking lesions as a unit, in four original studies, the pooled results of F-FDG PET/CT diagnosis of primary liver cancer were Sen=0.5 (95% CI:95% CI: 0.41-0.59), Spe=0.87 (95% CI: 0.52-0.98), AUC=0.58 (95% CI:0.53-0.62); The pooled results of Ga-FAPI PET/CT in the diagnosis of primary liver cancer, Sen=0.5 (95% CI: 0.41-0.59), Spe=0.87 (95%CI:0.52-0.98), AUC=0.58 (95% CI:0.53-0.62). Besides, the Sen of Ga-FAPI PET/CT in the diagnosis of primary liver cancer was higher than that of F-FDG PET/CT (Z=2.323, P=0.02), the difference was statistically significant.
CONCLUSION
Gallium-68-FAPI PET/CT is a promising tool. Compared with F-FDG, Ga-FAPI has higher sensitivity to detect more lesions in primary liver cancer and metastatic lesions, and has high performance in the diagnosis of primary liver cancer.
Topics: Humans; Fluorodeoxyglucose F18; Gallium Radioisotopes; Positron Emission Tomography Computed Tomography; Liver Neoplasms; Quinolines
PubMed: 37527048
DOI: 10.1967/s002449912575 -
Contrast Media & Molecular Imaging 2021The present systematic literature review and meta-analysis focused on examining the significance of total lesion glycolysis (TLG) and metabolic tumor volume (MTV) in... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The present systematic literature review and meta-analysis focused on examining the significance of total lesion glycolysis (TLG) and metabolic tumor volume (MTV) in predicting the prognosis of stages I/II non-small-cell lung cancer (NSCLC) based on F-FDG PET parameters.
METHODS
Electronic databases, including Cochrane Library, PubMed, and EMBASE, were comprehensively searched for retrieving relevant articles published in the English language. Furthermore, the significance of TLG and MTV in prognosis prediction was analyzed by pooled hazard ratios (HRs).
RESULTS
This work enrolled eight primary studies with 1292 I/II-stage NSCLC cases. The pooled HR (95% confidence interval [CI]) for the ability of increased TLG to predict progression-free survival (PFS) was 2.02 (1.30-2.13) (=0.350), while for increased MTV it was 3.04 (1.92-4.81) (=0.793). In addition, the pooled HR (95% CI) for the ability of increased TLG to predict overall survival (OS) was 2.16 (1.49-3.14) (=0.624). However, higher MTV correlated with OS, and sensitivity analysis showed that the results were not stable. Multivariate and univariate analyses by subgroup analyses stratified by PFS of MTV and OS of TLG exhibited statistically significant differences, without any statistical heterogeneity across various articles.
CONCLUSION
The present work suggests the predictive value of PET/CT among stage I and II NSCLC patients. Our results verified that stage I/II NSCLC cases with increased TLG and MTV had a higher risk of side reactions, and TLG is related to increased mortality risk.
Topics: Carcinoma, Non-Small-Cell Lung; Fluorodeoxyglucose F18; Glycolysis; Humans; Lung Neoplasms; Positron Emission Tomography Computed Tomography; Prognosis; Radiopharmaceuticals; Tumor Burden
PubMed: 34887713
DOI: 10.1155/2021/7528971 -
PloS One 2019A comprehensive systematic review of the literature was conducted on parameters from 18 F-FDG PET and a meta-analysis of the prognostic value of the maximal standard... (Meta-Analysis)
Meta-Analysis
Prognostic value of maximum standard uptake value, metabolic tumor volume, and total lesion glycolysis of positron emission tomography/computed tomography in patients with breast cancer: A systematic review and meta-analysis.
PURPOSE
A comprehensive systematic review of the literature was conducted on parameters from 18 F-FDG PET and a meta-analysis of the prognostic value of the maximal standard uptake value (SUVmax), metabolic tumor volume (MTV) and total lesional glycolysis (TLG) in patients with breast cancer (BC).
PATIENTS AND METHODS
Relevant English articles from PubMed, EMBASE, and the Cochrane Library were retrieved. Pooled hazard ratios (HRs) were used to assess the prognostic value of SUVmax, MTV, and TLG.
RESULTS
A total of 20 primary studies with 3115 patients with BC were included. The combined HRs (95% confidence interval [CI] of higher SUVmax and higher TLG for event-free survival (EFS) were 1.53 (95% CI, 1.25-1.89, P = 0.0006) and 5.94 (95% CI, 2.57-13.71, P = 0.97), respectively. Regarding the overall survival (OS), the combined HRs were 1.22 (95%CI, 1.02-1.45, P = 0.0006) with higher SUVmax, and 2.91(95% CI, 1.75-4.85, P = 0.44) with higher MTV. Higher MTV showed no correlation with EFS [1.31(95% CI, 0.65-2.65, P = 0.18)] and similarly higher TLG showed no correlation with OS [1.20(95% CI, 0.65-2.23, P = 0.45)]. Subgroup analysis showed that SUVmax, with a median value of 5.55 was considered as a significant risk factor for both EFS and OS in BC patients.
CONCLUSION
Despite clinically heterogeneous BC patients and adoption of various methods between studies, the present meta-analysis results confirmed that patients with high SUVmax are at high risk of adverse events or death in BC patients, high MTV predicted a high risk of death and high TLG predicted a high risk of adverse events.
Topics: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Energy Metabolism; Female; Fluorodeoxyglucose F18; Glycolysis; Humans; Middle Aged; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Prognosis; Tumor Burden
PubMed: 31826010
DOI: 10.1371/journal.pone.0225959 -
Frontiers in Endocrinology 2021The rising demand for F-fluorodeoxyglucose positron emission tomography with computed tomography (F-FDG PET/CT) has led to an increase of thyroid incidentalomas. Current... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The rising demand for F-fluorodeoxyglucose positron emission tomography with computed tomography (F-FDG PET/CT) has led to an increase of thyroid incidentalomas. Current guidelines are restricted in giving options to tailor diagnostics and to suit the individual patient.
OBJECTIVES
We aimed at exploring the extent of potential overdiagnostics by performing a systematic review and meta-analysis of the literature on the prevalence, the risk of malignancy (ROM) and the risk of inconclusive FNAC (ROIF) of focal thyroid incidentalomas (FTI) on F-FDG PET/CT.
DATA SOURCES
A literature search in MEDLINE, Embase and Web of Science was performed to identify relevant studies.
STUDY SELECTION
Studies providing information on the prevalence and/or ROM of FTI on F-FDG PET/CT in patients with no prior history of thyroid disease were selected by two authors independently. Sixty-one studies met the inclusion criteria.
DATA ANALYSIS
A random effects meta-analysis on prevalence, ROM and ROIF with 95% confidence intervals (CIs) was performed. Heterogeneity and publication bias were tested. Risk of bias was assessed using the quality assessment of diagnostic accuracy studies (QUADAS-2) tool.
DATA SYNTHESIS
Fifty studies were suitable for prevalence analysis. In total, 12,943 FTI were identified in 640,616 patients. The pooled prevalence was 2.22% (95% CI = 1.90% - 2.54%, I = 99%). 5151 FTI had cyto- or histopathology results available. The pooled ROM was 30.8% (95% CI = 28.1% - 33.4%, I = 57%). 1308 (83%) of malignant nodules were papillary thyroid carcinoma (PTC). The pooled ROIF was 20.8% (95% CI = 13.7% - 27.9%, I = 92%).
LIMITATIONS
The main limitations were the low to moderate methodological quality of the studies and the moderate to high heterogeneity of the results.
CONCLUSION
FTI are a common finding on F-FDG PET/CTs. Nodules are malignant in approximately one third of the cases, with the majority being PTC. Cytology results are non-diagnostic or indeterminate in one fifth of FNACs. These findings reveal the potential risk of overdiagnostics of FTI and emphasize that the workup of FTI should be performed within the context of the patient's disease and that guidelines should adopt this patient tailored approach.
Topics: Adenocarcinoma; Biopsy, Fine-Needle; Diagnosis, Differential; Fluorodeoxyglucose F18; Humans; Incidental Findings; Positron Emission Tomography Computed Tomography; Predictive Value of Tests; Prevalence; Risk Factors; Thyroid Gland; Thyroid Neoplasms; Thyroid Nodule
PubMed: 34744999
DOI: 10.3389/fendo.2021.723394 -
Hellenic Journal of Nuclear Medicine 2024Our study aims to head to head compare the application of gallium-68-fibroblast activation protein inhibitor (Ga-FAPI) positron emission tomography/computed tomography... (Meta-Analysis)
Meta-Analysis Comparative Study
OBJECTIVE
Our study aims to head to head compare the application of gallium-68-fibroblast activation protein inhibitor (Ga-FAPI) positron emission tomography/computed tomography (PET/CT) and fluorine-18-fluorodeoxyglucose (F-FDG) PET/CT in primary and metastatic lesions of gastric tumor to determine the superior diagnostic tool.
MATERIALS AND METHODS
A systematic search, up to March 31, 2023, across PubMed, Embase, and Cochrane Library databases utilized a data-specific Boolean logic strategy. Sensitivity (SEN) and specificity (SPE) evaluations of Ga-FAPI and F-FDG PET/CT in gastric cancer lesions were conducted. The quality of the studies was assessed using QUADAS-2, and publication bias was examined through Begg and Egger tests.
RESULTS
Analysis involved 141 gastric tumor patients and 2753 metastatic lesions in five studies, with overall satisfactory study quality and no apparent publication bias. Patient-level data showed a combined SEN of 0.95 (95% CI: 0.90-0.98) for Ga-FAPI and 0.84 (95% CI: 0.77-0.89) for F-FDG. At the lesion level, combined SEN were 0.91 (95% CI: 0.84-0.96) for Ga-FAPI and 0.72 (95% CI: 0.63-0.80) for F-FDG. The pooled SEN for detecting lymph node metastases was 0.78 (95% CI: 0.74-0.82) for Ga-FAPI and 0.35 (95% CI: 0.30-0.39) for F-FDG, with pooled SPE values of 0.99 (95% CI: 0.98-0.99) and 0.97 (95% CI: 0.96-0.98), respectively. For detecting distant metastases, pooled SEN values were 0.97 (95% CI: 0.96-0.98) and 0.69 (95% CI: 0.66-0.72) for Ga-FAPI and F-FDG, with pooled SPE values of 0.86 (95% CI: 0.82-0.89) and 0.64 (95% CI: 0.59-0.68), respectively.
CONCLUSION
This meta-analysis concluded that Ga-FAPI PET/CT was significantly more sensitive than F-FDG PET/CT in assessing primary gastric tumors, lymph nodes, and distant metastases, but the difference in the specificity of lymph node metastasis was not significant.
Topics: Stomach Neoplasms; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Humans; Neoplasm Metastasis; Sensitivity and Specificity; Quinolines
PubMed: 38629816
DOI: 10.1967/s002449912703 -
World Neurosurgery May 2023When magnetic resonance imaging (MRI) fails to detect an underlying epileptogenic lesion, the odds of a good outcome after epilepsy surgery are significantly lower... (Meta-Analysis)
Meta-Analysis Review
Seizure Outcome After Surgery for Refractory Epilepsy Diagnosed by F-fluorodeoxyglucose positron emission tomography (F-FDG PET/MRI): A Systematic Review and Meta-Analysis.
OBJECTIVE
When magnetic resonance imaging (MRI) fails to detect an underlying epileptogenic lesion, the odds of a good outcome after epilepsy surgery are significantly lower (20%-65% compared with 60%-90% if a lesion is detected). We investigated the possible effects of introducing hybrid F-fluorodeoxyglucose positron emission tomography (F-FDG PET)/MRI into the decision algorithm for patients with lesioned and nonlesioned drug-resistant epilepsy.
METHODS
Three databases were searched from January 1990 to October 2022. We registered the protocol with International Platform of Registered Systematic Review and Meta-analysis Protocols. Studies in which F-FDG PET/MRI was conducted with ≥12 months of postsurgical follow-up in patients with refractory epilepsy. Random-effects meta-analysis was used to calculate the proportion of patients with good outcomes. Metaregression was used to investigate sources of heterogeneity.
RESULTS
We identified 8105 studies, of which 23 (1292 patients in total) were included. The overall good postoperative outcome rate was 71% (95% confidence interval 63.6-74.9). Good outcome was associated with the location of the refractory epileptic lesion (temporal lobe or extratemporal; risk ratio 1.27 [95% confidence interval 1.01-1.52], P = 0.009); Length of postoperative follow-up ≥40 months included in the same study accounted for 0.6% of the observed heterogeneity.
CONCLUSIONS
Seventy-one percent of patients with refractory epilepsy and F-FDG PET/MRI epileptogenic lesion features had a good outcome of epilepsy after surgery. Our findings can be incorporated into routine preoperative consultations and emphasize the importance of the complete resection of the temporal lobe epileptogenic zone for F-FDG PET/MRI detection when safe and feasible.
Topics: Humans; Fluorodeoxyglucose F18; Drug Resistant Epilepsy; Electroencephalography; Seizures; Positron-Emission Tomography; Epilepsy; Magnetic Resonance Imaging; Epilepsy, Temporal Lobe
PubMed: 36746239
DOI: 10.1016/j.wneu.2023.01.114 -
European Journal of Radiology Sep 2020Respiratory diseases are one of the leading causes of death worldwide, yet effective treatment options remain limited. Although inflammation is thought to be a key...
BACKGROUND
Respiratory diseases are one of the leading causes of death worldwide, yet effective treatment options remain limited. Although inflammation is thought to be a key driver in the pathogenesis and progression of several lung diseases, the underlying molecular mechanisms of lung dysfunction remain poorly understood. Imaging techniques may help to further our understanding of the pathophysiology and facilitate the translation of novel therapies. Positron Emission Tomography (PET) is a functional imaging technique which has the potential to interrogate the underlying inflammatory response. We present a systematic review of the literature summarising the emerging PET radiotracers developed to quantify pulmonary inflammation.
METHOD
We performed a systematic review using the following databases: Medline, Embase, Scopus, PubMed, Web of Science and Cochrane. We included articles between 1995 and 2019 for all studies using PET radiotracers to evaluate inflammatory response in the lung. From a total of 911 articles covering both animal and human studies, two reviewers selected papers based on the inclusion/exclusion criteria and extracted data from 68 articles selected.
RESULTS
53 out of 68 papers, including both human and animal studies, were eligible for synthesis. Heterogenous study populations and differences in study design, image acquisition and analysis made data pooling unfeasible; instead, we provide a narrative synthesis.
CONCLUSIONS
Currently, very few novel radiotracers targeting lung inflammation have crossed the translational gap from animal models to human studies. Nevertheless, our results highlight a handful of promising tracers which warrant further evaluation in humans. F-FDG has been investigated most extensively; although F-FDG is not a specific inflammatory tracer, human studies of several pulmonary diseases support its use as a biomarker for inflammation. Despite ongoing debate about the optimal analysis methodology for F-FDG lung images, standardisation of image acquisition and analysis should help to improve confidence in research outcomes. PET radiotracers can provide quantitative, targeted biomarkers which relate to the activity of molecular pathways and may expedite development of specific anti-inflammatory drugs.
Topics: Animals; Disease Progression; Fluorodeoxyglucose F18; Forecasting; Humans; Pneumonia; Positron-Emission Tomography; Radiopharmaceuticals; Treatment Outcome
PubMed: 32702614
DOI: 10.1016/j.ejrad.2020.109182 -
International Journal of Molecular... Oct 2019Despite its name, prostate-specific membrane antigen (PSMA) has been shown using immunohistochemistry (IHC) to also be over-expressed in the tumor neovasculature of a... (Review)
Review
Despite its name, prostate-specific membrane antigen (PSMA) has been shown using immunohistochemistry (IHC) to also be over-expressed in the tumor neovasculature of a wide variety of solid tumors other than prostate carcinoma. Accordingly, positron-emitting radiolabeled small molecules targeting PSMA, initially developed for positron emission tomography in prostate carcinomas, are currently being explored for their staging and restaging potential as an alternative imaging modality in other solid tumor types where 18-F-fluorodeoxyglucose (FDG)-PET imaging has low diagnostic accuracy. In this paper, the currently available literature in this field is reviewed. Preliminary, mainly retrospective studies are encouraging, with evidence of improved diagnostic sensitivity and specificity in clear cell renal carcinoma, glioma, and hepatocellular carcinoma, leading to a change in patient management in several patients. However, the results published thus far warrant confirmation by larger prospective studies additionally assessing the longitudinal impact on patient outcomes.
Topics: Animals; Antigens, Surface; Diagnosis, Differential; Fluorodeoxyglucose F18; Glutamate Carboxypeptidase II; Humans; Neoplasms; Positron-Emission Tomography; Radiopharmaceuticals
PubMed: 31581638
DOI: 10.3390/ijms20194886 -
BMJ Open Jun 2021This study aimed to explore the diagnostic significance of F-fluorodeoxyglucose (F-FDG) positron emission tomography (PET)/CT for predicting the presence of epidermal... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This study aimed to explore the diagnostic significance of F-fluorodeoxyglucose (F-FDG) positron emission tomography (PET)/CT for predicting the presence of epidermal growth factor receptor () mutations in patients with non-small cell lung cancer (NSCLC).
DESIGN
A systematic review and meta-analysis.
DATA SOURCES
The PubMed, EMBASE and Cochrane library databases were searched from the earliest available date to December 2020.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
The review included primary studies that compared the mean maximum of standard uptake value (SUV) between wild-type and mutant , and evaluated the diagnostic value of F-FDG PET/CT using SUV for prediction of status in patients with NSCLC.
DATA EXTRACTION AND SYNTHESIS
The main analysis was to assess the sensitivity and specificity, the positive diagnostic likelihood ratio (DLR+) and DLR-, as well as the diagnostic OR (DOR) of SUV in prediction of mutations. Each data point of the summary receiver operator characteristic (SROC) graph was derived from a separate study. A random effects model was used for statistical analysis of the data, and then diagnostic performance for prediction was further assessed.
RESULTS
Across 15 studies (3574 patients), the pooled sensitivity for F-FDG PET/CT was 0.70 (95% CI 0.60 to 0.79) with a pooled specificity of 0.59 (95% CI 0.52 to 0.66). The overall DLR+ was 1.74 (95% CI 1.49 to 2.03) and DLR- was 0.50 (95% CI 0.38 to 0.65). The pooled DOR was 3.50 (95% CI 2.37 to 5.17). The area under the SROC curve was 0.68 (95% CI 0.64 to 0.72). The likelihood ratio scatter plot based on average sensitivity and specificity was in the lower right quadrant.
CONCLUSION
Meta-analysis results showed F-FDG PET/CT had low pooled sensitivity and specificity. The low DOR and the likelihood ratio scatter plot indicated that F-FDG PET/CT should be used with caution when predicting mutations in patients with NSCLC.
Topics: Carcinoma, Non-Small-Cell Lung; ErbB Receptors; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radiopharmaceuticals; Sensitivity and Specificity
PubMed: 34103313
DOI: 10.1136/bmjopen-2020-044313