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European Journal of Vascular and... Dec 2021Previous studies on the relationship between positron emission tomography (PET) images and abdominal aortic aneurysm (AAA) progression have shown contradictory results,...
OBJECTIVE
Previous studies on the relationship between positron emission tomography (PET) images and abdominal aortic aneurysm (AAA) progression have shown contradictory results, and the objective of this study was to systematically review the role of PET in predicting AAA prognosis.
DATA SOURCES
PubMed, Embase, and Web of Science were searched for studies evaluating the correlation between PET imaging results and AAA growth, repair, or rupture.
REVIEW METHODS
Two authors independently performed the study search, data extraction, and quality assessment following a standard method.
RESULTS
Of the 11 studies included in this review, nine used F-fluorodeoxyglucose (F-FDG) PET and computed tomography (CT) imaging, whereas the remaining two used F-sodium fluoride (F-NaF) PET/CT and F-FDG PET/magnetic resonance imaging (MRI). Findings from the F-FDG PET/CT studies were contradictory. Six studies found no significant association or correlation, and two studies found a significant negative correlation between F-FDG uptake and AAA expansion. Additionally, one study found that the F-FDG uptake was statistically positively related to the expansion rate in a specific AAA subgroup whose AAAs expanded significantly. Two studies suggested that increased F-FDG uptake was significantly associated with AAA repair, while the other studies either found no association between F-FDG uptake and AAA rupture or repair or failed to report the occurrence of clinical events. One PET/CT study that used F-NaF as a tracer showed that an increased tracer uptake was significantly associated with AAA growth and clinical events. Finally, the F-FDG PET/MRI study indicated that F-FDG uptake was not significantly correlated with AAA expansion.
CONCLUSION
A definitive role for F-FDG PET imaging for AAA prognosis awaits further investigation, and new PET tracers such as F-NaF have the potential to be a promising method for predicting AAA clinical outcomes.
Topics: Aged; Aortic Aneurysm, Abdominal; Female; Fluorodeoxyglucose F18; Humans; Male; Molecular Imaging; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Predictive Value of Tests; Radiopharmaceuticals; Sodium Fluoride
PubMed: 34696984
DOI: 10.1016/j.ejvs.2021.08.010 -
Strahlentherapie Und Onkologie : Organ... Mar 2021Treatment of patients with laryngeal squamous cell carcinoma with radiotherapy or chemoradiation is an established alternative to laryngeal surgery in many cases, but...
PURPOSE
Treatment of patients with laryngeal squamous cell carcinoma with radiotherapy or chemoradiation is an established alternative to laryngeal surgery in many cases, but particularly for advanced tumors without cartilage invasion. Imaging modalities face the challenge of distinguishing between posttherapeutic changes and residual disease in the complex anatomic subsite of the larynx. Guidelines concerning restaging of head and neck squamous cell carcinomas (HNSCC) are presented by the National Comprehensive Cancer Network (NCCN) and other national guidelines, but clearly defined recommendations for routine restaging particularly for laryngeal cancer are lacking.
METHODS
A systematic search was carried out in PubMed to identify studies evaluating routine restaging methods after primary non-surgical treatment of laryngeal squamous cell carcinoma from 2009 to 2020.
RESULTS
Only three studies were deemed eligible, as they included at least ≥50% patients with laryngeal squamous cell carcinoma and evaluated imaging modalities to detect residual cancer. The small number of studies in our review suggest restaging with fluoro-deoxy-glucose positron-emission tomography/computed tomography (FDG PET/CT) 3 months after initial treatment, followed by direct laryngoscopy with biopsy of the lesions identified by FDG PET/CT.
CONCLUSION
Studies evaluating restaging methods after organ-preserving non-surgical treatment of laryngeal carcinoma are limited. As radiotherapy (RT), chemoradiotherapy (CRT), systemic therapy followed by RT and radioimmunotherapy are established alternatives to surgical treatment, particularly in advanced laryngeal cancers, further studies are needed to assess and compare different imaging modalities (e.g. PET/CT, MRI, CT, ultrasound) and clinical diagnostic tools (e.g., video laryngoscopy, direct laryngoscopy) to offer patients safe and efficient restaging strategies. PET or PET/CT 3 months after initial treatment followed by direct laryngoscopy with biopsy of the identified lesions has the potential to reduce the number of unnecessary laryngoscopies.
Topics: Biopsy; Carcinoma, Squamous Cell; Chemoradiotherapy; Fluorodeoxyglucose F18; Humans; Laryngeal Neoplasms; Laryngoscopy; Larynx; Neoplasm Staging; Positron Emission Tomography Computed Tomography
PubMed: 33216194
DOI: 10.1007/s00066-020-01706-9 -
Revista Da Associacao Medica Brasileira... 2023
Meta-Analysis
Topics: Humans; Female; Breast Neoplasms; Tomography, X-Ray Computed; Positron-Emission Tomography; Radiopharmaceuticals; Patients; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography
PubMed: 37556635
DOI: 10.1590/1806-9282.2023S116 -
The Cochrane Database of Systematic... Nov 2021Rhabdomyosarcoma (RMS) is the most common paediatric soft-tissue sarcoma and can emerge throughout the whole body. For patients with newly diagnosed RMS, prognosis for... (Meta-Analysis)
Meta-Analysis Review
Fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) computed tomography (CT) for the detection of bone, lung, and lymph node metastases in rhabdomyosarcoma.
BACKGROUND
Rhabdomyosarcoma (RMS) is the most common paediatric soft-tissue sarcoma and can emerge throughout the whole body. For patients with newly diagnosed RMS, prognosis for survival depends on multiple factors such as histology, tumour site, and extent of the disease. Patients with metastatic disease at diagnosis have impaired prognosis compared to those with localised disease. Appropriate staging at diagnosis therefore plays an important role in choosing the right treatment regimen for an individual patient. Fluorine-18-fluorodeoxyglucose (F-FDG) positron emission tomography (PET) is a functional molecular imaging technique that uses the increased glycolysis of cancer cells to visualise both structural information and metabolic activity. F-FDG-PET combined with computed tomography (CT) could help to accurately stage the extent of disease in patients with newly diagnosed RMS. In this review we aimed to evaluate whether F-FDG-PET could replace other imaging modalities for the staging of distant metastases in RMS.
OBJECTIVES
To determine the diagnostic accuracy of F-FDG-PET/CT imaging for the detection of bone, lung, and lymph node metastases in RMS patients at first diagnosis.
SEARCH METHODS
We searched MEDLINE in PubMed (from 1966 to 23 December 2020) and Embase in Ovid (from 1980 to 23 December 2020) for potentially relevant studies. We also checked the reference lists of relevant studies and review articles; scanned conference proceedings; and contacted the authors of included studies and other experts in the field of RMS for information about any ongoing or unpublished studies. We did not impose any language restrictions.
SELECTION CRITERIA
We included cross-sectional studies involving patients with newly diagnosed proven RMS, either prospective or retrospective, if they reported the diagnostic accuracy of F-FDG-PET/CT in diagnosing lymph node involvement or bone metastases or lung metastases or a combination of these metastases. We included studies that compared the results of the F-FDG-PET/CT imaging with those of histology or with evaluation by a multidisciplinary tumour board as reference standard.
DATA COLLECTION AND ANALYSIS
Two review authors independently performed study selection, data extraction, and methodological quality assessement according to Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). We analysed data for the three outcomes (nodal involvement and lung and bone metastases) separately. We used data from the 2 × 2 tables (consisting of true positives, false positives, true negatives, and false negatives) to calculate sensitivity and specificity in each study and corresponding 95% confidence intervals. We did not consider a formal meta-analysis to be relevant because of the small number of studies and substantial heterogeneity between studies.
MAIN RESULTS
Two studies met our inclusion criteria. The diagnostic accuracy of F-FDG-PET/CT was reported in both studies, which included a total of 36 participants. We considered both studies to be at high risk of bias for the domain reference standard. We considered one study to be at high risk of bias for the domain index test and flow and timing. Sensitivity and specificity of F-FDG-PET/CT for the detection of bone metastases was 100% in both studies (95% confidence interval (CI) for sensitivity was 29% to 100% in study one and 40% to 100% in study two; 95% CI for specificity was 83% to 100% in study one and 66% to 100% in study two). The reported sensitivity of F-FDG-PET/CT for the detection of lung metastases was not calculated since only two participants in study two showed lung metastases, of which one was detected by F-FDG-PET/CT. Reported specificity was 96% in study one (95% CI 78% to 100%) and 100% (95% CI 72% to 100%) in study two. The reported sensitivity for the detection of nodal involvement was 100% (95% CI 63% to 100% in study one and 40% to 100% in study two); the reported specificity was 100% (95% CI 78% to 100%) in study one and 89% (95% CI 52% to 100%) in study two.
AUTHORS' CONCLUSIONS
The diagnostic accuracy of F-FDG-PET/CT for the detection of bone, lung, and lymph node metastases was reported in only two studies including a total of only 36 participants with newly diagnosed RMS. Because of the small number of studies (and participants), there is currently insufficient evidence to reliably determine the diagnostic accuracy of F-FDG-PET/CT in the detection of distant metastases. Larger series evaluating the diagnostic accuracy of F-FDG-PET/CT for the detection of metastases in patients with RMS are necessary.
Topics: Cross-Sectional Studies; Fluorodeoxyglucose F18; Humans; Lung; Lymphatic Metastasis; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Prospective Studies; Radiopharmaceuticals; Retrospective Studies; Rhabdomyosarcoma; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 34753195
DOI: 10.1002/14651858.CD012325.pub2 -
PET Clinics Jan 2020This systematic review summarizes the current applications of F-FDG PET imaging in the diagnosis, staging, radiation treatment response assessment, and outcome...
This systematic review summarizes the current applications of F-FDG PET imaging in the diagnosis, staging, radiation treatment response assessment, and outcome prognostication of head and neck cancers. For head and neck cancers of unknown primary origin, F-FDG PET/CT increases the likelihood of identifying the primary tumor and establishing the diagnosis. F-FDG PET/CT is important in the accurate staging of locoregionally advanced cases of HNSCC, which can greatly affect recommendations for treatment. Following definitive chemoradiation, F-FDG PET/CT is validated as a means of treatment response assessment. Emerging PET tracers of hypoxia and their potential applications are reviewed.
Topics: Fluorodeoxyglucose F18; Head and Neck Neoplasms; Humans; Incidental Findings; Neoplasm Recurrence, Local; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Squamous Cell Carcinoma of Head and Neck; Thoracic Neoplasms; Treatment Outcome
PubMed: 31735303
DOI: 10.1016/j.cpet.2019.08.010 -
Gynecologic Oncology Nov 2020Imaging is essential in detecting lymph node metastases for radiotherapy treatment planning in locally advanced cervical cancer (LACC). There are not many data on the...
PURPOSE
Imaging is essential in detecting lymph node metastases for radiotherapy treatment planning in locally advanced cervical cancer (LACC). There are not many data on the performance of [F]FDG-PET(CT) in showing lymph node metastases in LACC. We pooled sensitivity and specificity of [F]FDG-PET(CT) for detecting pelvic and/or para-aortic lymph node metastases in patients with LACC. Also, the positive and negative posttest probabilities at high and low levels of prevalence were determined.
METHODS
MEDLINE and EMBASE searches were performed and quality characteristics assessed. Logit-sensitivity and logit-specificity estimates with corresponding standard errors were calculated. Summary estimates of sensitivity and specificity with corresponding 95% confidence intervals (CIs) were calculated by anti-logit transformation. Positive and negative likelihood ratios (LRs) were calculated from the mean logit-sensitivity and mean logit-specificity and the corresponding standard errors. The posttest probabilities were determined by Bayesian approach.
RESULTS
Twelve studies were included with a total of 778 patients aged 10-85 years. For pelvic nodes, summary estimates of sensitivity, specificity, LR+ and LR- were: 0.88 (95%CI: 0.40-0.99), 0.93 (95%CI: 0.85-0.97), 11.90 (95%CI: 5.32-26.62) and 0.13 (95%CI: 0.01-1.08). At the lowest prevalence of 0.15 the positive predictive value (PPV) and negative predictive value (NPV) were 0.68 and 0.98, at the highest prevalence of 0.65, 0.96 and 0.81. For the para-aortic nodes, the summary estimates of sensitivity, specificity LR+ and LR- were: 0.40 (95%CI: 0.18-0.66), 0.93 (95%CI: 0.91-0.95), 6.08 (95%CI: 2.90-12.78) and 0.64 (95%CI: 0.42-0.99), respectively. At the lowest prevalence of 0.17 the PPV and NPV were 0.55 and 0.88, at the highest prevalence of 0.50, 0.86 and 0.61.
CONCLUSION
The PPV and NPV of [F]FDG-PET(CT) showing lymph node metastases in patients with LACC improves with higher prevalence. Prevalence and predictive values should be taken into account when determining therapeutic strategies based on [F]FDG-PET(CT).
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Female; Fluorodeoxyglucose F18; Humans; Lymphatic Metastasis; Middle Aged; Positron Emission Tomography Computed Tomography; Predictive Value of Tests; Radiopharmaceuticals; Uterine Cervical Neoplasms; Young Adult
PubMed: 32921477
DOI: 10.1016/j.ygyno.2020.08.021 -
Hellenic Journal of Nuclear Medicine 2021The purpose of current investigation was to evaluate the diagnostic accuracy of fluorine-18-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The purpose of current investigation was to evaluate the diagnostic accuracy of fluorine-18-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) for the determination of disease activity of idiopathic inflammatory myopathies (IM) using diagnostic accuracy test.
SUBJECTS AND METHODS
The PubMed and EMBASE database, from the earliest available date of indexing through August 31, 2020, were searched for results investigating the diagnostic accuracy of F-FDG PET/CT for the determination of disease activity of IM. We calculated the pooled sensitivities and specificities of included studies, calculated positive and negative likelihood ratios (LR+ and LR-), and obtained summary receiver operating characteristic (SROC) curves.
RESULTS
Across 4 studies with 5 results (90 patients), the pooled sensitivity was 0.94 (95% CI; 0.87-0.97) without heterogeneity (I=0.0, P=0.8) and a pooled specificity was 0.90 (95% CI; 0.72-0.97) with heterogeneity (I=65.1, P=0.02). Likelihood ratio (LR) syntheses showed an overall positive likelihood ratio (LR+) of 9.2 (95% CI; 3.1-28.0) and negative likelihood ratio (LR-) of 0.07 (95% CI; 0.03-0.16). The pooled DOR was 131 (95% CI; 26-664). The hierarchical SROC curve shows the areas under the curve of 0.96 (95% CI; 0.94-0.98).
CONCLUSION
Fluorine-18-FDG PET/CT has a good performance for the detection of active disease status in patients with IM. Although there are no guidelines for adopting imaging techniques, more objective and updated criteria for the assessment of disease activity incorporated with F-FDG PET/CT should be introduced and validated. Further studies are necessary to determine if 18F-FDG PET/CT-based treatment of IM can improve outcomes.
Topics: Fluorodeoxyglucose F18; Humans; Myositis; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radiopharmaceuticals; Sensitivity and Specificity
PubMed: 34352048
DOI: 10.1967/s002449912353 -
The Journal of Spinal Cord Medicine Jul 2021: The importance of physiologic distribution of F-FDG in the spinal cord.: The recognition of the physiologic distribution of F-FDG in the spinal cord is pivotal for...
: The importance of physiologic distribution of F-FDG in the spinal cord.: The recognition of the physiologic distribution of F-FDG in the spinal cord is pivotal for accurate PET/CT imaging interpretation, especially in oncologic patients. Therefore, we performed a systematic review to investigate the normal distribution of F-FDG throughout the spinal cord.: Data sources: We carried out a comprehensive search of the literature on the physiologic patterns of F-FDG distribution in the spinal cord. PubMed and Scopus databases were searched using the following keywords: "spinal cord" AND "FDG". Data extraction: Findings of the selected articles were described.: Thirteen studies comprising 24,125 patients entered the systematic review. These investigations showed discrepancies in location, size, number, and intensity of F-FDG uptake throughout the spinal cord. However, cumulative results showed that F-FDG uptake was higher in the lower thoracic portion of spinal cord (T11-T12). Moreover, a decreasing trend in F-FDG uptake was observed from cervical to lumbar levels. Low maximal standardized uptake values, female sex, and higher body weight seem to be related to the physiological spinal cord F-FDG uptake.: On F-FDG PET/CT imaging, focal hypermetabolism of the spinal cord at the level of lower thoracic and lower cervical vertebrae should be considered physiological until proven otherwise.
Topics: Female; Fluorodeoxyglucose F18; Humans; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Spinal Cord; Spinal Cord Injuries
PubMed: 31682787
DOI: 10.1080/10790268.2019.1672954 -
Critical Reviews in Oncology/hematology Nov 2019Sarcomas are a heterogeneous group of malignant tumours with variable clinical outcomes. Their presence in multiple body locations represents significant diagnostic and...
BACKGROUND
Sarcomas are a heterogeneous group of malignant tumours with variable clinical outcomes. Their presence in multiple body locations represents significant diagnostic and therapeutic challenges. Positron emission tomography/computed tomography (PET/CT) is an imaging tool that provides semiquantitative measurements of radiotracer concentration in tissue, such as SUV (standardised uptake value) and is increasingly used in clinical practice. This systematic review aims to evaluate the utility of PET/CT in sarcoma grading and prognostication, evaluation of treatment response, staging and restaging.
METHODS
Relevant studies published from January 2003 to August 2017 evaluating the utility of PET/CT in sarcoma grading and prognostication, staging, evaluation of treatment response and restaging were systematically searched for in scientific databases (e.g. PubMed, Medline and Embase) using key terms, including "soft tissue sarcoma," "osteosarcoma," "utility" and "PET/CT". Additionally, references of identified studies were reviewed. Study quality was assessed by "Quality Assessment of Diagnostic Accuracy Studies".
RESULTS
A total of 12 prospective studies (level II to III evidence) were included in the review for tumour grading and prognostication. There was a strong correlation between SUV and tumour grade where majority of intermediate/ high-grade STS have a significantly higher SUV. PET/CT has also shown potential in prognostication where decrease in SUV correlated with recurrence-free survival in both osteosarcoma and STS. Furthermore, 8 prospective trials of level II to IV evidence according to Oxford Centre of Evidence-based Medicine (CEBM) demonstrated the use of PET/CT in early identification of patients who will respond to treatment where ≥60% decrease in FDG uptake resulted in sensitivity and specificity of 100% and 71% respectively for assessment of histopathologic response. 11 retrospective trials (level III to IV evidence) reported on the use of PET/CT in staging and restaging with heterogeneous results.
CONCLUSION
Overall, higher quality evidence demonstrated PET/CT to be an important contributor towards sarcoma grading, prognostication and evaluation of treatment response. Larger prospective trials will be helpful to further establish the clinical value of PET/CT in sarcoma staging and restaging.
Topics: Bone Neoplasms; Fluorodeoxyglucose F18; Humans; Neoplasm Grading; Neoplasm Staging; Osteosarcoma; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Sarcoma; Soft Tissue Neoplasms
PubMed: 31449981
DOI: 10.1016/j.critrevonc.2019.07.002 -
Medicine Oct 2019FDG-PET might be able to reflect histopathology features of tumors. Ki 67 in head and neck carcinomas (HNSCC). The present study sought to elucidate the association... (Meta-Analysis)
Meta-Analysis
BACKGROUND
FDG-PET might be able to reflect histopathology features of tumors. Ki 67 in head and neck carcinomas (HNSCC). The present study sought to elucidate the association between Ki 67 index and SUVmax based upon a large patient sample.
METHODS
PubMed database was screened for studies analyzed the relationship between Ki 67 and SUV in HNSCC. Nine studies comprising 211 patients were suitable for analysis.
RESULTS
SUVmax increased with tumor grade and was statistically significant different between G1, G2, and G3 tumors. The ROC analysis for discrimination between G1/G2 and G3 tumors revealed an area under curve of 0.71. In the overall patient sample, SUVmax correlated statistically significant with Ki 67 index (r = 0.154, P = .032).
CONCLUSION
The present study identified a weak correlation between SUV values and proliferation index Ki 67 index in HNSCC in a large patient sample. Therefore, SUVmax cannot be used as surrogate parameter for proliferation activity in HNSCC.
Topics: Fluorodeoxyglucose F18; Head and Neck Neoplasms; Humans; Ki-67 Antigen; Positron-Emission Tomography; Squamous Cell Carcinoma of Head and Neck
PubMed: 31577779
DOI: 10.1097/MD.0000000000017472