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International Journal of Molecular... Oct 2021Several recent studies comparing radiolabeled fibroblast activation protein inhibitors (FAPI) and fluorine-18 fluorodeoxyglucose ([F]F-FDG) as positron emission... (Comparative Study)
Comparative Study
Several recent studies comparing radiolabeled fibroblast activation protein inhibitors (FAPI) and fluorine-18 fluorodeoxyglucose ([F]F-FDG) as positron emission tomography (PET) radiotracers in oncology have been published. The aim of this systematic review is to perform an updated evidence-based summary about the comparison of these PET radiotracers in oncology to better address further research in this setting. Studies or subsets of studies comparing radiolabeled FAPI and [F]F-FDG as PET radiotracers in oncology were eligible for inclusion in this systematic review. A systematic literature search of PubMed/MEDLINE and Cochrane library databases was performed until August 2021. Literature data about the comparison of [F]F-FDG and radiolabeled FAPI are rapidly increasing. Overall, taking into account radiotracer uptake and tumor-to-background uptake ratio, compared to [F]F-FDG PET, an equal or higher detection of primary tumors and/or metastatic lesions was usually demonstrated by using radiolabeled FAPI PET. In particular, the cancer entities with better detection rate of tumor lesions by using radiolabeled FAPI PET, compared to [F]F-FDG PET, were gastrointestinal tumors, liver tumors, breast cancer and nasopharyngeal carcinoma. Further comparison studies are needed to better evaluate the best field of application of radiolabeled FAPI PET.
Topics: Endopeptidases; Fluorodeoxyglucose F18; Gallium Radioisotopes; Heterocyclic Compounds, 1-Ring; Humans; Medical Oncology; Membrane Proteins; Neoplasms; Positron Emission Tomography Computed Tomography
PubMed: 34681850
DOI: 10.3390/ijms222011192 -
European Journal of Nuclear Medicine... Sep 2021To systematically review the literature evaluating clinical utility of imaging metrics derived from baseline fluorine-18 fluorodeoxyglucose positron emission...
PURPOSE
To systematically review the literature evaluating clinical utility of imaging metrics derived from baseline fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for prediction of progression-free (PFS) and overall survival (OS) in patients with classical Hodgkin lymphoma (HL) and diffuse large B cell lymphoma (DLBCL).
METHODS
A search of MEDLINE/PubMed, Web of Science, Cochrane, Scopus and clinicaltrials.gov databases was undertaken for articles evaluating PET/CT imaging metrics as outcome predictors in HL and DLBCL. PRISMA guidelines were followed. Risk of bias was assessed using the Quality in Prognosis Studies (QUIPS) tool.
RESULTS
Forty-one articles were included (31 DLBCL, 10 HL). Significant predictive ability was reported in 5/20 DLBCL studies assessing SUVmax (PFS: HR 0.13-7.35, OS: HR 0.83-11.23), 17/19 assessing metabolic tumour volume (MTV) (PFS: HR 2.09-11.20, OS: HR 2.40-10.32) and 10/13 assessing total lesion glycolysis (TLG) (PFS: HR 1.078-11.21, OS: HR 2.40-4.82). Significant predictive ability was reported in 1/4 HL studies assessing SUVmax (HR not reported), 6/8 assessing MTV (PFS: HR 1.2-10.71, OS: HR 1.00-13.20) and 2/3 assessing TLG (HR not reported). There are 7/41 studies assessing the use of radiomics (4 DLBCL, 2 HL); 5/41 studies had internal validation and 2/41 included external validation. All studies had overall moderate or high risk of bias.
CONCLUSION
Most studies are retrospective, underpowered, heterogenous in their methodology and lack external validation of described models. Further work in protocol harmonisation, automated segmentation techniques and optimum performance cut-off is required to develop robust methodologies amenable for clinical utility.
Topics: Fluorodeoxyglucose F18; Humans; Lymphoma, Large B-Cell, Diffuse; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Prognosis; Retrospective Studies; Treatment Outcome; Tumor Burden
PubMed: 33604689
DOI: 10.1007/s00259-021-05233-2 -
Contrast Media & Molecular Imaging 2020The purpose of this study was to assess the diagnostic value of F-fluorodeoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) for detection of... (Meta-Analysis)
Meta-Analysis
AIMS
The purpose of this study was to assess the diagnostic value of F-fluorodeoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) for detection of lymph node (LN) metastasis of colorectal cancer. . A computerized search was performed to determine the relevant articles, published before October 2019. Stata Statistical Software, version 15.0, and Meta-Disc (version 1.4) were used for the meta-analysis.
RESULTS
the sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 0.65, 0.75, 4.57, and 0.37 respectively. Studies that used SUV cut-off value (≤2.5) demonstrated the best accuracy.
CONCLUSION
F-FDG PET/CT shows a low sensitivity and high specificity for detecting the metastasis of LNs in patients with newly diagnosed colorectal cancer.
Topics: Adult; Aged; Aged, 80 and over; Colorectal Neoplasms; Female; Fluorodeoxyglucose F18; Humans; Lymphatic Metastasis; Male; Middle Aged; Positron Emission Tomography Computed Tomography; Prevalence; Publication Bias; Publications; Young Adult
PubMed: 32733174
DOI: 10.1155/2020/5439378 -
Epilepsia Open Sep 2022Interictal 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) is used in the workup for epilepsy surgery when MRI and EEG video monitoring are not conclusive....
Interictal 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) is used in the workup for epilepsy surgery when MRI and EEG video monitoring are not conclusive. Timing of FDG-PET is crucial to avoid the metabolically dynamic (post)ictal state that complicates interpretation, but the exact time window is unclear. We performed a systematic review to provide an evidence-based recommendation for the minimal time interval between last seizure and FDG-PET acquisition. We searched PubMed and Embase for articles on the effect of time since last seizure on FDG-PET outcome. Quality assessment was conducted with the Critical Appraisal Skills Programme Cohort Study Checklist. We identified five studies. Three studies were classified as of low to moderate quality, mainly due to undocumented data or insufficient statistical measurements. Two high-quality studies included only adults with Temporal Lobe Epilepsy (TLE). The metabolic interictal phase is 24 or 48 hours after the last seizure, depending on seizure type. The recommendation is based on the best available evidence from two small study populations for TLE. If clinically possible, interictal FDG-PET in adults should be performed at least 24 hours after focal aware seizures and 48 hours after focal impaired awareness and focal to bilateral tonic-clonic seizures.
Topics: Adult; Cohort Studies; Epilepsy; Epilepsy, Temporal Lobe; Fluorodeoxyglucose F18; Humans; Positron-Emission Tomography; Seizures
PubMed: 35666076
DOI: 10.1002/epi4.12617 -
Molecules (Basel, Switzerland) Apr 2021Immunotherapy is an effective therapeutic option for several cancers. In the last years, the introduction of checkpoint inhibitors (ICIs) has shifted the therapeutic...
Immunotherapy is an effective therapeutic option for several cancers. In the last years, the introduction of checkpoint inhibitors (ICIs) has shifted the therapeutic landscape in oncology and improved patient prognosis in a variety of neoplastic diseases. However, to date, the selection of the best patients eligible for these therapies, as well as the response assessment is still challenging. Patients are mainly stratified using an immunohistochemical analysis of the expression of antigens on biopsy specimens, such as PD-L1 and PD-1, on tumor cells, on peritumoral immune cells and/or in the tumor microenvironment (TME). Recently, the use and development of imaging biomarkers able to assess in-vivo cancer-related processes are becoming more important. Today, positron emission tomography (PET) with 2-deoxy-2-[F]fluoro-D-glucose ([F]FDG) is used routinely to evaluate tumor metabolism, and also to predict and monitor response to immunotherapy. Although highly sensitive, FDG-PET in general is rather unspecific. Novel radiopharmaceuticals (immuno-PET radiotracers), able to identify specific immune system targets, are under investigation in pre-clinical and clinical settings to better highlight all the mechanisms involved in immunotherapy. In this review, we will provide an overview of the main new immuno-PET radiotracers in development. We will also review the main players (immune cells, tumor cells and molecular targets) involved in immunotherapy. Furthermore, we report current applications and the evidence of using [F]FDG PET in immunotherapy, including the use of artificial intelligence (AI).
Topics: Antineoplastic Agents, Immunological; Artificial Intelligence; B7-H1 Antigen; Fluorodeoxyglucose F18; Gene Expression Regulation, Neoplastic; Humans; Immune Checkpoint Inhibitors; Immunotherapy, Adoptive; Killer Cells, Natural; Neoplasms; Positron-Emission Tomography; Programmed Cell Death 1 Receptor; Radiopharmaceuticals; Signal Transduction; T-Lymphocytes, Cytotoxic; T-Lymphocytes, Regulatory; Tumor Microenvironment
PubMed: 33920423
DOI: 10.3390/molecules26082201 -
Annals of Palliative Medicine Apr 2021To investigate the value of 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) in diagnosing local tumor invasion (T... (Meta-Analysis)
Meta-Analysis
BACKGROUND
To investigate the value of 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) in diagnosing local tumor invasion (T stage), evaluating regional lymph node involvement (N stage), and detecting distant metastasis (M stage) in breast cancer patients.
METHODS
A comprehensive computer search and manual search were performed to select any potentially eligible studies that evaluated the diagnostic efficacy of 18F-FDG PET/MRI in the tumor-node-metastasis (TNM) staging of breast cancer. Data from the included studies were extracted to calculate the pooled sensitivity, specificity, and area under the curve (AUC) to evaluate the value of 18F-FDG PET/MRI in TNM staging. Quality and publication bias were also assessed in this meta-analysis.
RESULTS
Based on seven studies, the pooled sensitivity, specificity and AUC for the diagnosis of T stage were 91% (95% CI: 84-96%), 91% (95% CI: 81-96%), and 0.96 (95% CI: 0.94-0.98), respectively. For N stage evaluation, four studies were included, with values of 94% (95% CI: 83-98%), 90% (95% CI: 81-95%), and 0.96 (95% CI: 0.94-0.97). For M stage detection, five studies were evaluated, with values of 98% (95% CI: 96-99%), 96% (95% CI: 83-99%), and 0.99 (95% CI: 0.98-1.00).
CONCLUSIONS
18F-FDG PET/MRI demonstrates higher diagnostic value in the TNM staging of breast cancer and can serve as an effective and promising imaging biomarker for future evaluation of TNM stage in breast cancer patients.
Topics: Breast Neoplasms; Fluorodeoxyglucose F18; Humans; Magnetic Resonance Imaging; Neoplasm Staging; Positron-Emission Tomography; Radiopharmaceuticals; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 33894709
DOI: 10.21037/apm-20-2555 -
Advances in Nutrition (Bethesda, Md.) Sep 2020There is considerable interest in dietary and other approaches to maintaining blood glucose concentrations within the normal range and minimizing exposure to...
There is considerable interest in dietary and other approaches to maintaining blood glucose concentrations within the normal range and minimizing exposure to postprandial hyperglycemic excursions. The accepted marker to evaluate the sustained maintenance of normal blood glucose concentrations is glycated hemoglobin A1c (HbA1c). However, although this is used in clinical practice to monitor glycemic control in patients with diabetes, it has a number of drawbacks as a marker of efficacy of dietary interventions that might beneficially affect glycemic control in people without diabetes. Other markers that reflect shorter-term glycemic exposures have been studied and proposed, but consensus on the use and relevance of these markers is lacking. We have carried out a systematic search for studies that have tested the responsiveness of 6 possible alternatives to HbA1c as markers of sustained variation in glycemic exposures and thus their potential applicability for use in dietary intervention trials in subjects without diabetes: 1,5-anhydroglucitol (1,5-AG), dicarbonyl stress, fructosamine, glycated albumin (GA), advanced glycated end products (AGEs), and metabolomic profiles. The results suggest that GA may be the most promising for this purpose, but values may be confounded by effects of fat mass. 1,5-AG and fructosamine are probably not sensitive enough to the range of variation in glycemic exposures observed in healthy individuals. Use of measures based on dicarbonyls, AGEs, or metabolomic profiles would require further research into possible specific molecular species of interest. At present, none of the markers considered here is sufficiently validated and sensitive for routine use in substantiating the effects of sustained variation in dietary glycemic exposures in people without diabetes.
Topics: Biomarkers; Blood Glucose; Deoxyglucose; Diabetes Mellitus; Fructosamine; Glycated Hemoglobin; Humans
PubMed: 32449931
DOI: 10.1093/advances/nmaa058 -
Thoracic Cancer Nov 2020The purpose of the current study was to investigate the predictive value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for... (Meta-Analysis)
Meta-Analysis
Predictive value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography for PD-L1 expression in non-small cell lung cancer: A systematic review and meta-analysis.
BACKGROUND
The purpose of the current study was to investigate the predictive value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for programmed death ligand 1 (PD-L1) in non-small cell lung cancer (NSCLC) patients through a systematic review and meta-analysis.
METHODS
The PubMed, Cochrane, and EMBASE database, from the earliest available date of indexing through 30 April 2020, were searched for studies evaluating the diagnostic performance of 18F-FDG PET/CT for prediction of PD-L1 expression in NSCLC patients.
RESULTS
Across six studies (1739 patients), the pooled sensitivity for 18F-FDG PET/CT was 0.72 (95% CI: 0.58-0.82) with heterogeneity (I = 90.9, P < 0.001) and a pooled specificity of 0.69 (95% CI: 0.64-0.74) with heterogeneity (I = 77.9, P < 0.001). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR +) of 2.3 (95% CI: 1.8-2.9) and negative likelihood ratio (LR-) of 0.41 (95% CI: 0.26-0.63). The pooled diagnostic odds ratio (DOR) was six (95% CI: 3-11). Hierarchical summary receiver operating characteristic (ROC) curve indicated that the area under the curve was 0.74 (95% CI: 0.70-0.78).
CONCLUSIONS
The current meta-analysis showed a moderate sensitivity and specificity of 18F-FDG PET/CT for the prediction of PD-L1 expression in NSCLC patients. The DOR was low and the likelihood ratio scatter-gram indicated that 18F-FDG PET/CT might not be useful for the prediction of PD-L1 expression in NSCLC patients and not for its exclusion.
KEY POINTS
Significant findings of the study The current meta-analysis showed a moderate sensitivity and specificity of 18F-FDG PET/CT for the prediction of PD-L1 expression in NSCLC patients. The DOR was low and the likelihood ratio scattergram indicated that 18F-FDG PET/CT might not be useful for the prediction of PD-L1 expression in NSCLC patients and not for its exclusion. What this study adds This study concluded that the role of 18F-FDG PET/CT in predicting tumor expression of PD-L1 should be further elucidated.
Topics: B7-H1 Antigen; Carcinoma, Non-Small-Cell Lung; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Positron Emission Tomography Computed Tomography
PubMed: 32951338
DOI: 10.1111/1759-7714.13664 -
The American Journal of Tropical... Jan 2021The diagnosis of visceral leishmaniasis (VL) is complicated and often unsuspected. Little is known of the usefulness of nuclear imaging in VL. Our objective was to...
The diagnosis of visceral leishmaniasis (VL) is complicated and often unsuspected. Little is known of the usefulness of nuclear imaging in VL. Our objective was to describe findings seen in fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in cases of VL. We retrospectively reviewed VL cases diagnosed at Vall d'Hebron University Hospital from May 2012 to May 2018 and selected those that had an FDG-PET/CT performed. Information on procedures and details of the FDG-PET/CT features and follow-up were collected. We then systematically reviewed the literature on VL and FDG-PET/CT. Four of 43 patients diagnosed with VL had an FDG-PET/CT performed. All four patients presented diffuse splenic uptake of FDG-PET/CT. Adenopathy was not always present, and bone marrow uptake was found in two patients. A posttreatment FDG-PET/CT in one patient revealed normalization of initial findings. In the literature review, 43 of 50 cases presented similar splenic uptake in the PET/CT, being described as different patterns: "increased metabolism," "homogeneous," "diffuse," "diffuse and multifocal," "nodular," "patchy and granular," "subcortical," and "compatible with lymphoma." Other frequent findings were bone marrow uptake and adenopathies. We, therefore, conclude that FDG-PET/CT could become a useful tool for the diagnosis and follow-up of VL and that VL should be taken into account in patients with fever of unknown origin with enhanced splenic uptake in FDG-PET/CT. Differential diagnosis in these cases should be made with splenic primary lymphoma, virus infections, chemotherapy, and colony-stimulating factor therapy. Further structured studies with more cases are needed to define its diagnostic and prognostic value.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cohort Studies; Female; Fluorodeoxyglucose F18; Humans; Leishmania donovani; Leishmaniasis, Visceral; Male; Middle Aged; Positron Emission Tomography Computed Tomography; Retrospective Studies; Spain; Ultrasonography; Young Adult
PubMed: 33534763
DOI: 10.4269/ajtmh.19-0858 -
The Oncologist Sep 2019In endometrial carcinoma (EC), preoperative classification is based on histopathological criteria, with only moderate diagnostic performance for the risk of lymph node... (Meta-Analysis)
Meta-Analysis
BACKGROUND
In endometrial carcinoma (EC), preoperative classification is based on histopathological criteria, with only moderate diagnostic performance for the risk of lymph node metastasis (LNM). So far, existing molecular classification systems have not been evaluated for prediction of LNM. Optimized use of clinical biomarkers as recommended by international guidelines might be a first step to improve tailored treatment, awaiting future molecular biomarkers.
AIM
To determine the diagnostic accuracy of preoperative clinical biomarkers for the prediction of LNM in endometrial cancer.
METHODS
A systematic review was performed according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Studies identified in MEDLINE and EMBASE were selected by two independent reviewers. Included biomarkers were based on recommended guidelines (cancer antigen 125 [Ca-125], lymphadenopathy on magnetic resonance imaging, computed tomography, and F-fluorodeoxyglucose positron emission tomography/computed tomography [FDG PET-CT]) or obtained by physical examination (body mass index, cervical cytology, blood cell counts). Pooled sensitivity, specificity, area under the curve (AUC), and likelihood ratios were calculated with bivariate random-effects meta-analysis. Likelihood ratios were classified into (0.5-1.0 or 1-2.0), (0.2-0.5 or 2.0-5.0) or (0.1-0.2 or ≥ 5.0) impact.
RESULTS
Eighty-three studies, comprising 18,205 patients, were included. Elevated Ca-125 and thrombocytosis were associated with a increase in risk of LNM; lymphadenopathy on imaging with a increase. Normal Ca-125, cytology, and no lymphadenopathy on FDG PET-CT were associated with a decrease. AUCs were above 0.75 for these biomarkers. Other biomarkers had an AUC <0.75 and incurred only impact.
CONCLUSION
Ca-125, thrombocytosis, and imaging had a and impact on risk of LNM and could improve preoperative risk stratification.
IMPLICATIONS FOR PRACTICE
Routine lymphadenectomy in clinical early-stage endometrial carcinoma does not improve outcome and is associated with 15%-20% surgery-related morbidity, underlining the need for improved preoperative risk stratification. New molecular classification systems are emerging but have not yet been evaluated for the prediction of lymph node metastasis. This article provides a robust overview of diagnostic performance of all clinical biomarkers recommended by international guidelines. Based on these, at least measurement of cancer antigen 125 serum level, assessment of thrombocytosis, and imaging focused on lymphadenopathy should complement current preoperative risk stratification in order to better stratify these patients by risk.
Topics: Biomarkers, Tumor; CA-125 Antigen; Endometrial Neoplasms; Female; Fluorodeoxyglucose F18; Humans; Lymph Nodes; Lymphatic Metastasis; Positron-Emission Tomography; Preoperative Period; Prognosis
PubMed: 31186375
DOI: 10.1634/theoncologist.2019-0117