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Hellenic Journal of Nuclear Medicine 2024Recent studies have utilized fluorine-18-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) specifically to diagnose cases of... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Recent studies have utilized fluorine-18-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) specifically to diagnose cases of idiopathic inflammatory myopathies (IIM), excluding inclusion body myositis (IBM). Conversely, carbon-11 (C) labeled Pittsburgh compound B (PIB)-PET imaging is exclusively used for the detection of IBM. This research is designed to evaluate the diagnostic accuracy of PET/CT in identifying IIM by employing rigorous diagnostic accuracy testing methodologies.
MATERIALS AND METHODS
A systematic review and meta-analysis were conducted across multiple databases including PubMed, and Embase. We focused on the diagnostic utility of PET/CT in IIM, assessing sensitivities, specificities, and deriving likelihood ratios (LR+ and LR-). The study was registered with PROSPERO (CRD42022343222).
RESULTS
This systematic review identified 635 citations, of which 10 eligible trials were included, with a total of 419 participants. The results indicated a sensitivity of 0.86 (0.81-0.90), and a specificity of 0.93 (0.88-0.96). The synthesis of LR revealed the LR+ of 10.35 (6.31-16.98), and LR-of 0.15 (0.07-0.32). The summary receiver operating characteristic curve (SROC) showed an area under the curve (AUC) of 0.9658. Regarding IBM, the sensitivity was 0.84 (0.60-0.97), and the specificity was 1 (0.69-1). The synthesis of LR showed the LR+ of 9.61 (1.46-63.15) and an LR- of 0.21 (0.09-0.51). For disease activity, the sensitivity was 0.96 (0.92-0.99), and the specificity was 0.91 (0.084-0.96). The synthesis of LR showed an LR+ of 9.43 (5.39-16.51) and an LR- of 0.05 (0.02-0.11).
CONCLUSION
Positron emission tomography/CT has great potential for accurately diagnosing and monitoring patients with IIM, and may have implications for their clinical management.
Topics: Humans; Positron Emission Tomography Computed Tomography; Sensitivity and Specificity; Myositis; Reproducibility of Results; Male; Female
PubMed: 38678384
DOI: 10.1967/s002449912711 -
Current Obesity Reports Jun 2023To summarize the results of adult obesity neuroimaging studies (structural, resting-state, task-based, diffusion tensor imaging) published from 2010, with a focus on the... (Review)
Review
PURPOSE OF REVIEW
To summarize the results of adult obesity neuroimaging studies (structural, resting-state, task-based, diffusion tensor imaging) published from 2010, with a focus on the treatment of sex as an important biological variable in the analysis, and identify gaps in sex difference research.
RECENT FINDINGS
Neuroimaging studies have shown obesity-related changes in brain structure, function, and connectivity. However, relevant factors such as sex are often not considered. We conducted a systematic review and keyword co-occurrence analysis. Literature searches identified 6281 articles, of which 199 met inclusion criteria. Among these, only 26 (13%) considered sex as an important variable in the analysis, directly comparing the sexes (n = 10; 5%) or providing single-sex/disaggregated data (n = 16, 8%); the remaining studies controlled for sex (n = 120, 60%) or did not consider sex in the analysis (n = 53, 27%). Synthesizing sex-based results, obesity-related parameters (e.g., body mass index, waist circumference, obese status) may be generally associated with more robust morphological alterations in men and more robust structural connectivity alterations in women. Additionally, women with obesity generally expressed increased reactivity in affect-related regions, while men with obesity generally expressed increased reactivity in motor-related regions; this was especially true under a fed state. The keyword co-occurrence analysis indicated that sex difference research was especially lacking in intervention studies. Thus, although sex differences in the brain associated with obesity are known to exist, a large proportion of the literature informing the research and treatment strategies of today has not specifically examined sex effects, which is needed to optimize treatment.
Topics: Adult; Female; Humans; Male; Diffusion Tensor Imaging; Obesity; Body Mass Index; Brain; Sex Characteristics
PubMed: 36933153
DOI: 10.1007/s13679-023-00498-0 -
Contrast Media & Molecular Imaging 2022Cancer-associated fibroblasts (CAFs) can strongly modulate the response to therapy of malignant tumor cells, facilitating their continuous proliferation and invading... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Cancer-associated fibroblasts (CAFs) can strongly modulate the response to therapy of malignant tumor cells, facilitating their continuous proliferation and invading behaviors. In this context, several efforts were made in identifying the fibroblast activation protein (FAP) as a CAF recognizer and in designing FAP-specific PET radiotracers (as Ga-FAPI) along with FAP-specific therapeutic radioligands. Herein, we review different clinical studies using the various FAP-specific radioligands as novel theranostic agents in a wide range of oncologic and nononcologic indications.
METHODS
A comprehensive systematic search was conducted on the PubMed and Scopus databases to find relevant published articles concerning the FAP-specific PET imaging as well as the FAP-specific radionuclide therapy in patients with oncologic and nononcologic indications. The enrolled studies were dichotomized into oncologic and nononcologic categories, and the required data were extracted by precisely reviewing the whole text of each eligible study. A meta-analysis was also performed comparing the detection rates of Ga-FAPI vs. F-FDG PET/CT using odds ratio (OR) and risk difference as outcome measures.
RESULTS
Of the initial 364 relevant papers, 49 eligible articles (1479 patients) and 55 case reports were enrolled in our systematic review. These studies observed high radiolabeled FAPI avidity as early as 10 minutes after administration in primary sites of various malignant tumors. Based on the meta-analysis which was done on the reported detection rates of the Ga-FAPI and F-FDG PET/CT scans, the highest OR belonged to the primary lesion detection rate of gastrointestinal tumors (OR = 32.079, 95% CI: 4.001-257.212; = 0.001) with low heterogeneity (I = 0%). The corresponding value of the nodal metastases belonged to hepatobiliary tumors (OR = 11.609, 95% CI: 1.888-71.365; = 0.008) with low heterogeneity (I = 0%). For distant metastases, the highest estimated OR belonged to nasopharyngeal carcinomas (OR = 77.451, 95% CI: 7.323-819.201; < 0.001) with low heterogeneity (I = 0%).
CONCLUSIONS
The outperformance of Ga-FAPI PET/CT over F-FDG PET/CT in identifying certain primary tumors as well as in detecting their metastatic lesions may open indications for evaluation of cases with inconclusive F-FDG PET/CT findings. What needs to be emphasized is that the false-positive results might be problematic and must be taken into account in Ga-FAPI PET/CT interpretation. More clarification on the role of FAPI radioligands in oncologic imaging, radionuclide therapy, and radiotherapy treatment planning is therefore required.
Topics: Endopeptidases; Fluorodeoxyglucose F18; Gallium Radioisotopes; Humans; Ligands; Membrane Proteins; Positron Emission Tomography Computed Tomography; Radioligand Assay
PubMed: 35280710
DOI: 10.1155/2022/3948873 -
International Journal of Nanomedicine 2022The recent advancements in hybrid positron emission tomography-magnetic resonance imaging systems (PET/MRI) have brought massive value in the investigation of disease... (Review)
Review
The recent advancements in hybrid positron emission tomography-magnetic resonance imaging systems (PET/MRI) have brought massive value in the investigation of disease processes, in the development of novel treatments, in the monitoring of both therapy response and disease progression, and, not least, in the introduction of new multidisciplinary molecular imaging approaches. While offering potential advantages over PET/CT, the hybrid PET/MRI proved to improve both the image quality and lesion detectability. In particular, it showed to be an effective tool for the study of metabolic information about lesions and pathological conditions affecting the brain, from a better tumor characterization to the analysis of metabolic brain networks. Based on the PRISMA guidelines, this work presents a systematic review on PET/MRI in basic research and clinical differential diagnosis on brain oncology and neurodegenerative disorders. The analysis includes literature works and clinical case studies, with a specific focus on the use of PET tracers and MRI contrast agents, which are usually employed to perform hybrid PET/MRI studies of brain tumors. A systematic literature search for original diagnostic studies is performed using PubMed/MEDLINE, Scopus and Web of Science. Patients, study, and imaging characteristics were extracted from the selected articles. The analysis included acquired data pooling, heterogeneity testing, sensitivity analyses, used tracers, and reported patient outcomes. Our analysis shows that, while PET/MRI for the brain is a promising diagnostic method for early diagnosis, staging and recurrence in patients with brain diseases, a better definition of the role of tracers and imaging agents in both clinical and preclinical hybrid PET/MRI applications is needed and further efforts should be devoted to the standardization of the contrast imaging protocols, also considering the emerging agents and multimodal probes.
Topics: Brain; Contrast Media; Humans; Magnetic Resonance Imaging; Neoplasms; Positron Emission Tomography Computed Tomography
PubMed: 35937076
DOI: 10.2147/IJN.S362192 -
Seminars in Nuclear Medicine Nov 2023F-FDG-PET/CT imaging has become a key tool to evaluate infectious and inflammatory diseases. However, application of F-FDG-PET/CT in patients in the intensive care unit... (Review)
Review
F-FDG-PET/CT imaging has become a key tool to evaluate infectious and inflammatory diseases. However, application of F-FDG-PET/CT in patients in the intensive care unit (ICU) is limited, which is remarkable since the development of critical illness is closely linked to infection and inflammation. This limited use is caused by perceived complexity and risk of planning and executing F-FDG-PET/CT in such patients. The aim of this systematic review was to investigate the feasibility of F-FDG-PET/CT in ICU patients with special emphasis on patient preparation, transport logistics and safety. Therefore, a systematic search was performed in PubMed, Embase, and Web of Science using the search terms: intensive care, critically ill, positron emission tomography and F-FDG or derivates. A total of 1183 articles were found of which 10 were included. Three studies evaluated the pathophysiology of acute respiratory distress syndrome, acute lung injury and acute chest syndrome. Three other studies applied F-FDG-PET/CT to increase understanding of pathophysiology after traumatic brain injury. The remaining four studies evaluated infection of unknown origin. These four studies showed a sensitivity and specificity between 85%-100% and 57%-88%, respectively. A remarkable low adverse event rate of 2% was found during the entire F-FDG-PET/CT procedure, including desaturation and hypotension. In all studies, a team consisting of an intensive care physician and nurse was present during transport to ensure continuation of necessary critical care. Full monitoring during transport was used in patients requiring mechanical ventilation or vasopressor support. None of the studies used specific patient preparation for ICU patients. However, one article described specific recommendations in their discussion. In conclusion, F-FDG-PET/CT has been shown to be feasible and safe in ICU patients, even when ventilated or requiring vasopressors. Specific recommendations regarding patient preparation, logistics and scanning are needed. Including F-FDG-PET/CT in routine workup of infection of unknown origin in ICU patients showed potential to identify source of infection and might improve outcome.
Topics: Humans; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Positron-Emission Tomography; Critical Care; Intensive Care Units; Sensitivity and Specificity
PubMed: 37258380
DOI: 10.1053/j.semnuclmed.2023.05.003 -
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 -
Annals of Surgical Oncology Jan 2024The tumor microenvironment (TME) plays a crucial role in therapy response and modulation of immunologic surveillance. Adjuvant immunotherapy has recently been introduced... (Review)
Review
Potential Predictive Immune and Metabolic Biomarkers of Tumor Microenvironment Regarding Pathological and Clinical Response in Esophageal Cancer After Neoadjuvant Chemoradiotherapy: A Systematic Review.
INTRODUCTION
The tumor microenvironment (TME) plays a crucial role in therapy response and modulation of immunologic surveillance. Adjuvant immunotherapy has recently been introduced in post-surgery treatment of locally advanced esophageal cancer (EC) with residual pathological disease after neoadjuvant chemoradiotherapy (nCRT). F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG-PET/CT) remains a valuable imaging tool to assess therapy response and to visualize metabolic TME; however, there is still a paucity in understanding the interaction between the TME and nCRT response. This systematic review investigated the potential of TME biomarkers and F-FDG-PET/CT features to predict pathological and clinical response (CR) after nCRT in EC.
METHODS
A literature search of the Medline and Embase electronic databases identified 4190 studies. Studies regarding immune and metabolic TME biomarkers and F-FDG-PET/CT features were included for predicting pathological response (PR) and/or CR after nCRT. Separate analyses were performed for F-FDG-PET/CT markers and these TME biomarkers.
RESULTS
The final analysis included 21 studies-10 about immune and metabolic markers alone and 11 with additional F-FDG-PET/CT features. High CD8 infiltration before and after nCRT, and CD3 and CD4 infiltration after nCRT, generally correlated with better PR. A high expression of tumoral or stromal programmed death-ligand 1 (PD-L1) after nCRT was generally associated with poor PR. Moreover, total lesion glycolysis (TLG) and metabolic tumor volume (MTV) of the primary tumor were potentially predictive for clinical and PR.
CONCLUSION
CD8, CD4, CD3, and PD-L1 are promising immune markers in predicting PR, whereas TLG and MTV are potential F-FDG-PET/CT features to predict clinical and PR after nCRT in EC.
Topics: Humans; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Neoadjuvant Therapy; B7-H1 Antigen; Tumor Microenvironment; Chemoradiotherapy; Esophageal Neoplasms; Biomarkers, Tumor; Radiopharmaceuticals; Tumor Burden; Retrospective Studies
PubMed: 37777688
DOI: 10.1245/s10434-023-14352-z -
Research and Reports in Urology 2021Primary urethral cancer (PUC) is a rare but highly aggressive malignancy that causes malignant urethral obstruction. We conducted a literature review using PubMed to... (Review)
Review
Primary urethral cancer (PUC) is a rare but highly aggressive malignancy that causes malignant urethral obstruction. We conducted a literature review using PubMed to identify original research studies that assessed the diagnosis and management of primary urethral cancer. PUC affects men more than women, is more common in African Americans than Caucasians, and is associated with history of chronic inflammation and irritation of the urinary tract. Patients suspected of PUC should undergo a complete work-up including cystoscopy, magnetic resonance imaging, and biopsy. In men and women, surgical monotherapy ranging from organ-sparing to more radical reconstructive procedures has adequate survival rates for early stage PUC and has been shown to be similarly as effective as radiation monotherapy, while multimodal therapy has become the standard of treatment for advanced stage PUC. Salvage surgery or radiation therapy has been linked with increased survival rates. Nodal involvement at the time of diagnosis is a negative prognosticator and should be treated with multimodal therapy. Further prospective studies with greater sample sizes and standardized clinical trials would allow for greater consistency in evaluating the different treatment modalities for PUC.
PubMed: 34104638
DOI: 10.2147/RRU.S264720 -
Frontiers in Pediatrics 2022Percutaneous interventions have completely refashioned the management of children with congenital heart diseases (CHD) and the use of non-invasive imaging has become the...
Percutaneous interventions have completely refashioned the management of children with congenital heart diseases (CHD) and the use of non-invasive imaging has become the gold standard to plan and guide these procedures in the modern era. We are now facing a dual challenge to improve the standard of care in low-risk patients, and to shift our strategies from the classic open chest surgery to imaging-guided percutaneous interventions in high-risk patients. Such rapid evolution of ultrasound technologies over the last 20 years have permitted the integration of transthoracic, transesophageal and intracardiac echocardiography into the interventional workflow to improve image guidance and reduce radiation burden from fluoroscopy and angiography. Specifically, miniaturization of transesophageal probe and advances in three-dimensional (3D) imaging techniques have enabled real-time 3D image guidance during complex interventional procedure, In addition, multimodality and fusion imaging techniques harness the strengths of different modalities to enhance understanding of anatomical and spatial relationship between different structures, improving communication and coordination between interventionalists and imaging specialists. In this review, we aim to provide an overview of 3D imaging modalities and multimodal fusion in procedural planning and live guidance of percutaneous interventions. At the present times, 3D imaging can no longer be considered a luxury but a routine clinical tool to improve procedural success and patient outcomes.
PubMed: 35664875
DOI: 10.3389/fped.2022.894472 -
Brain Imaging and Behavior Dec 2022Computational imaging and quantitative biomarkers offer invaluable insights in the pre-symptomatic phase of neurodegenerative conditions several years before clinical... (Review)
Review
Computational imaging and quantitative biomarkers offer invaluable insights in the pre-symptomatic phase of neurodegenerative conditions several years before clinical manifestation. In recent years, there has been a focused effort to characterize pre-symptomatic cerebral changes in familial frontotemporal dementias using computational imaging. Accordingly, a systematic literature review was conducted of original articles investigating pre-symptomatic imaging changes in frontotemporal dementia focusing on study design, imaging modalities, data interpretation, control cohorts and key findings. The review is limited to the most common genotypes: chromosome 9 open reading frame 72 (C9orf72), progranulin (GRN), or microtubule-associated protein tau (MAPT) genotypes. Sixty-eight studies were identified with a median sample size of 15 (3-141) per genotype. Only a minority of studies were longitudinal (28%; 19/68) with a median follow-up of 2 (1-8) years. MRI (97%; 66/68) was the most common imaging modality, and primarily grey matter analyses were conducted (75%; 19/68). Some studies used multimodal analyses 44% (30/68). Genotype-associated imaging signatures are presented, innovative study designs are highlighted, common methodological shortcomings are discussed and lessons for future studies are outlined. Emerging academic observations have potential clinical implications for expediting the diagnosis, tracking disease progression and optimising the timing of pharmaceutical trials.
Topics: Humans; Frontotemporal Dementia; Magnetic Resonance Imaging; Mutation; tau Proteins; Progranulins; Gray Matter
PubMed: 35920960
DOI: 10.1007/s11682-022-00711-z