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Frontiers in Medicine 2024Retroperitoneal fibrosis, a condition of uncertain origin, is rarely linked to 8% of malignant cases, including breast, lung, gastrointestinal, genitourinary, thyroid,...
BACKGROUND
Retroperitoneal fibrosis, a condition of uncertain origin, is rarely linked to 8% of malignant cases, including breast, lung, gastrointestinal, genitourinary, thyroid, and carcinoid. The mechanism leading to peritoneal fibrosis induced by tumors is not well understood, possibly encompassing direct infiltration of neoplastic cells or the initiation of inflammatory responses prompted by cytokines released by tumor cells. We report a case of breast cancer with renal metastasis and retroperitoneal fibrosis detected using F-FDG PET/CT, providing help for clinical diagnosis and treatment.
CASE REPORT
A 49-year-old woman was referred to the hospital with elevated creatinine and oliguria for over a month. Abdominal computer tomography (CT) and magnetic resonance imaging (MRI) showed a retroperitoneal fibrosis-induced acute kidney injury (AKI) was suspected. However, a percutaneous biopsy of the kidney lesion confirmed metastasis from breast cancer. The physical examination revealed inverted nipples and an orange peel appearance on the skin of both breasts. Ultrasonography revealed bilateral hyperplasia (BIRADS 4a) of the mammary glands and bilateral neck and axillary lymphadenopathy. Subsequently, F-deoxyglucose positron emission tomography/computer tomography (F-FDG PET/CT) detected abnormally high uptake (SUVmax) in the bilateral mammary glands and axillary lymph nodes, suggesting bilateral breast cancer. Furthermore, abnormal F-FDG uptake was detected in the kidney, suggesting renal metastasis. In addition, abnormal F-FDG uptake was observed in the vertebrae, accompanied by an elevation in inhomogeneous bone mineral density, raising suspicion of bone metastases. However, the possibility of myelodysplasia cannot be dismissed, and further investigations will be conducted during close follow-ups. There was significant F-FDG uptake in the retroperitoneal position indicating a potential association between retroperitoneal fibrosis and breast cancer. The final pathological diagnosis of the breast tissue confirmed bilateral invasive ductal carcinoma. The patient had been treated with 11 cycles of albumin-bound (nab)-paclitaxel (0.3 mg) and had no significant adverse reaction.
CONCLUSION
In this case, neither the bilateral breast cancer nor the kidney metastatic lesion showed typical nodules or masses, so breast ultrasound, abdominal CT, and MRI did not suggest malignant lesions. PET/CT played an important role in detecting occult metastases and primary lesions, thereby contributing to more accurate staging, monitoring treatment responses, and prediction of prognosis in breast cancer.
PubMed: 38741768
DOI: 10.3389/fmed.2024.1353822 -
Journal of Translational Medicine May 2024The lack of distinct biomarkers for pancreatic cancer is a major cause of early-stage detection difficulty. The pancreatic cancer patient group with high metabolic tumor...
BACKGROUND
The lack of distinct biomarkers for pancreatic cancer is a major cause of early-stage detection difficulty. The pancreatic cancer patient group with high metabolic tumor volume (MTV), one of the values measured from positron emission tomography-a confirmatory method and standard care for pancreatic cancer, showed a poorer prognosis than those with low MTV. Therefore, MTV-associated differentially expressed genes (DEGs) may be candidates for distinctive markers for pancreatic cancer. This study aimed to evaluate the possibility of MTV-related DEGs as markers or therapeutic targets for pancreatic cancer.
METHODS
Tumor tissues and their normal counterparts were obtained from patients undergoing preoperative 18F-FDG PET/CT. The tissues were classified into MTV-low and MTV-high groups (7 for each) based on the MTV2.5 value of 4.5 (MTV-low: MTV2.5 < 4.5, MTV-high: MTV2.5 ≥ 4.5). Gene expression fold change was first calculated in cancer tissue compared to its normal counter and then compared between low and high MTV groups to obtain significant DEGs. To assess the suitability of the DEGs for clinical application, the correlation of the DEGs with tumor grades and clinical outcomes was analyzed in TCGA-PAAD, a large dataset without MTV information.
RESULTS
Total RNA-sequencing (MTV RNA-Seq) revealed that 44 genes were upregulated and 56 were downregulated in the high MTV group. We selected the 29 genes matching MTV RNA-seq patterns in the TCGA-PAAD dataset, a large clinical dataset without MTV information, as MTV-associated genes (MAGs). In the analysis with the TCGA dataset, MAGs were significantly associated with patient survival, treatment outcomes, TCGA-PAAD-suggested markers, and CEACAM family proteins. Some MAGs showed an inverse correlation with miRNAs and were confirmed to be differentially expressed between normal and cancerous pancreatic tissues. Overexpression of KIF11 and RCC1 and underexpression of ADCY1 and SDK1 were detected in ~ 60% of grade 2 pancreatic cancer patients and associated with ~ 60% mortality in stages I and II.
CONCLUSIONS
MAGs may serve as diagnostic markers and miRNA therapeutic targets for pancreatic cancer. Among the MAGs, KIF11, RCC1, ADCY, and SDK1 may be early diagnostic markers.
Topics: Humans; Pancreatic Neoplasms; Biomarkers, Tumor; Gene Expression Regulation, Neoplastic; Tumor Burden; Male; Gene Expression Profiling; Female; Molecular Targeted Therapy; Middle Aged; Aged; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18
PubMed: 38741142
DOI: 10.1186/s12967-024-05181-z -
International Journal of Molecular... Apr 2024The skeletal muscles account for approximately 40% of the body weight and are crucial in movement, nutrient absorption, and energy metabolism. Muscle loss and decline in... (Review)
Review
The skeletal muscles account for approximately 40% of the body weight and are crucial in movement, nutrient absorption, and energy metabolism. Muscle loss and decline in function cause a decrease in the quality of life of patients and the elderly, leading to complications that require early diagnosis. Positron emission tomography/computed tomography (PET/CT) offers non-invasive, high-resolution visualization of tissues. It has emerged as a promising alternative to invasive diagnostic methods and is attracting attention as a tool for assessing muscle function and imaging muscle diseases. Effective imaging of muscle function and pathology relies on appropriate radiopharmaceuticals that target key aspects of muscle metabolism, such as glucose uptake, adenosine triphosphate (ATP) production, and the oxidation of fat and carbohydrates. In this review, we describe how [F]fluoro-2-deoxy-D-glucose ([F]FDG), [F]fluorocholine ([F]FCH), [C]acetate, and [O]water ([O]HO) are suitable radiopharmaceuticals for diagnostic imaging of skeletal muscles.
Topics: Humans; Muscle, Skeletal; Radiopharmaceuticals; Positron-Emission Tomography; Fluorodeoxyglucose F18; Animals; Positron Emission Tomography Computed Tomography
PubMed: 38732077
DOI: 10.3390/ijms25094860 -
BMC Pulmonary Medicine May 2024F-fluorodeoxyglucose (FDG) PET/CT has been widely used for the differential diagnosis of cancer. Semi-quantitative standardized uptake value (SUV) is known to be...
OBJECTIVES
F-fluorodeoxyglucose (FDG) PET/CT has been widely used for the differential diagnosis of cancer. Semi-quantitative standardized uptake value (SUV) is known to be affected by multiple factors and may make it difficult to differentiate between benign and malignant lesions. It is crucial to find reliable quantitative metabolic parameters to further support the diagnosis. This study aims to evaluate the value of the quantitative metabolic parameters derived from dynamic FDG PET/CT in the differential diagnosis of lung cancer and predicting epidermal growth factor receptor (EGFR) mutation status.
METHODS
We included 147 patients with lung lesions to perform FDG PET/CT dynamic plus static imaging with informed consent. Based on the results of the postoperative pathology, the patients were divided into benign/malignant groups, adenocarcinoma (AC)/squamous carcinoma (SCC) groups, and EGFR-positive (EGFR+)/EGFR-negative (EGFR-) groups. Quantitative parameters including K, k, k, and K of each lesion were obtained by applying the irreversible two-tissue compartmental modeling using an in-house Matlab software. The SUV analysis was performed based on conventional static scan data. Differences in each metabolic parameter among the group were analyzed. Wilcoxon rank-sum test, independent-samples T-test, and receiver-operating characteristic (ROC) analysis were performed to compare the diagnostic effects among the differentiated groups. P < 0.05 were considered statistically significant for all statistical tests.
RESULTS
In the malignant group (N = 124), the SUV, k, k, and K were higher than the benign group (N = 23), and all had-better performance in the differential diagnosis (P < 0.05, respectively). In the AC group (N = 88), the SUV, k, and K were lower than in the SCC group, and such differences were statistically significant (P < 0.05, respectively). For ROC analysis, K with cut-off value of 0.0250 ml/g/min has better diagnostic specificity than SUV (AUC = 0.999 vs. 0.70). In AC group, 48 patients further underwent EGFR testing. In the EGFR (+) group (N = 31), the average K (0.0279 ± 0.0153 ml/g/min) was lower than EGFR (-) group (N = 17, 0.0405 ± 0.0199 ml/g/min), and the difference was significant (P < 0.05). However, SUV and k did not show such a difference between EGFR (+) and EGFR (-) groups (P>0.05, respectively). For ROC analysis, the K had a cut-off value of 0.0350 ml/g/min when predicting EGFR status, with a sensitivity of 0.710, a specificity of 0.588, and an AUC of 0.674 [0.523-0.802].
CONCLUSION
Although both techniques were specific, Ki had a greater specificity than SUVmax when the cut-off value was set at 0.0250 ml/g/min for the differential diagnosis of lung cancer. At a cut-off value of 0.0350 ml/g/min, there was a 0.710 sensitivity for EGFR status prediction. If EGFR testing is not available for a patient, dynamic imaging could be a valuable non-invasive screening method.
Topics: Humans; Positron Emission Tomography Computed Tomography; Lung Neoplasms; Fluorodeoxyglucose F18; ErbB Receptors; Male; Diagnosis, Differential; Female; Middle Aged; Aged; Mutation; Adult; Radiopharmaceuticals; ROC Curve; Carcinoma, Squamous Cell; Aged, 80 and over; Adenocarcinoma; Retrospective Studies
PubMed: 38730287
DOI: 10.1186/s12890-024-02997-9 -
The Clinical Respiratory Journal May 2024Some solitary pulmonary nodules (SPNs) as early manifestations of lung cancer, it is difficult to determine its nature, which brings great trouble to clinical diagnosis...
BACKGROUND
Some solitary pulmonary nodules (SPNs) as early manifestations of lung cancer, it is difficult to determine its nature, which brings great trouble to clinical diagnosis and treatment. Radiomics can deeply explore the essence of images and provide clinical decision support for clinicians. The purpose of our study was to explore the effect of positron emission tomography (PET) with 2-deoxy-2-[fluorine-18] fluoro-d-glucose integrated with computed tomography (CT; F-FDG-PET/CT) combined with radiomics for predicting probability of malignancy of SPNs.
METHODS
We retrospectively enrolled 190 patients with SPNs confirmed by pathology from January 2013 to December 2019 in our hospital. SPNs were benign in 69 patients and malignant in 121 patients. Patients were randomly divided into a training or testing group at a ratio of 7:3. Three-dimensional regions of interest (ROIs) were manually outlined on PET and CT images, and radiomics features were extracted. Synthetic minority oversampling technique (SMOTE) method was used to balance benign and malignant samples to a ratio of 1:1. In the training group, least absolute shrinkage and selection operator (LASSO) regression analyses and Spearman correlation analyses were used to select the strongest radiomics features. Three models including PET model, CT model, and joint model were constructed using multivariate logistic regression analysis. Receiver operating characteristic (ROC) curves, calibration curves, and decision curves were plotted to evaluate diagnostic efficiency, calibration degree, and clinical usefulness of all models in training and testing groups.
RESULTS
The estimative effectiveness of the joint model was superior to the CT or PET model alone in the training and testing groups. For the joint model, CT model, and PET model, area under the ROC curve was 0.929, 0.819, 0.833 in the training group, and 0.844, 0.759, 0.748 in the testing group, respectively. Calibration and decision curves showed good fit and clinical usefulness for the joint model in both training and testing groups.
CONCLUSION
Radiomics models constructed by combining PET and CT radiomics features are valuable for distinguishing benign and malignant SPNs. The combined effect is superior to qualitative diagnoses with CT or PET radiomics models alone.
Topics: Humans; Solitary Pulmonary Nodule; Fluorodeoxyglucose F18; Male; Female; Positron Emission Tomography Computed Tomography; Retrospective Studies; Lung Neoplasms; Middle Aged; Aged; Radiopharmaceuticals; Adult; Radiomics
PubMed: 38725315
DOI: 10.1111/crj.13751 -
European Thyroid Journal Jun 2024Langerhans cell histiocytosis (LCH) may present as unifocal disease of the suprasellar region, with symptoms and signs of hypopituitarism, arginine vasopressin...
Langerhans cell histiocytosis (LCH) may present as unifocal disease of the suprasellar region, with symptoms and signs of hypopituitarism, arginine vasopressin deficiency (AVP-D), and weight gain. Transcranial biopsy is necessary to define diagnosis and guide treatment decisions, but it is associated with significant morbidity. We describe a patient with Hashimoto thyroiditis and a single hypothalamic mass in whom LCH diagnosis was made by thyroid fine-needle aspiration cytology (FNAC) performed despite nonspecific findings in thyroid imaging, on the basis of a slightly elevated [18F]-fluorodeoxyglucose (FDG) avidity on PET/CT and volume increase during follow-up.
Topics: Humans; Histiocytosis, Langerhans-Cell; Biopsy, Fine-Needle; Thyroid Gland; Female; Positron Emission Tomography Computed Tomography; Hashimoto Disease; Fluorodeoxyglucose F18; Adult; Male; Cytology
PubMed: 38718824
DOI: 10.1530/ETJ-24-0011 -
Cancer Imaging : the Official... May 2024In the present study, we investigated the value of F-fibroblast-activation protein inhibitor (FAPI) positron emission tomography/computed tomography (F-FAPI-42 PET/CT)... (Comparative Study)
Comparative Study
BACKGROUND
In the present study, we investigated the value of F-fibroblast-activation protein inhibitor (FAPI) positron emission tomography/computed tomography (F-FAPI-42 PET/CT) to preoperative evaluations of appendiceal neoplasms and management for patients.
METHODS
This single-center retrospective clinical study, including 16 untreated and 6 treated patients, was performed from January 2022 to May 2023 at Southern Medical University Nanfang Hospital. Histopathologic examination and imaging follow-up served as the reference standard. F-FAPI-42 PET/CT was compared to F-fluorodeoxyglucose (F-FDG) PET/CT and contrast-enhanced CT (CE-CT) in terms of maximal standardized uptake value (SUVmax), diagnostic efficacy and impact on treatment decisions.
RESULTS
The accurate detection of primary tumors and peritoneal metastases were improved from 28.6% (4/14) and 50% (8/16) for CE-CT, and 43.8% (7/16) and 85.0% (17/20) for F-FDG PET/CT, to 87.5% (14/16) and 100% (20/20) for F-FAPI-42 PET/CT. Compared to F-FDG PET/CT, F-FAPI-42 PET/CT detected more regions infiltrated by peritoneal metastases (108 vs. 43), thus produced a higher peritoneal cancer index (PCI) score (median PCI: 12 vs. 5, P < 0.01). F-FAPI-42 PET/CT changed the intended treatment plans in 35.7% (5/14) of patients compared to CE-CT and 25% (4/16) of patients compared to F-FDG PET/CT but did not improve the management of patients with recurrent tumors.
CONCLUSIONS
The present study revealed that F-FAPI-42 PET/CT can supplement CE-CT and F-FDG PET/CT to provide a more accurate detection of appendiceal neoplasms and improved treatment decision making for patients.
Topics: Humans; Positron Emission Tomography Computed Tomography; Female; Male; Fluorodeoxyglucose F18; Retrospective Studies; Middle Aged; Appendiceal Neoplasms; Aged; Radiopharmaceuticals; Adult; Peritoneal Neoplasms; Tomography, X-Ray Computed
PubMed: 38715096
DOI: 10.1186/s40644-024-00706-7 -
Human Brain Mapping May 2024Tau pathology and its spatial propagation in Alzheimer's disease (AD) play crucial roles in the neurodegenerative cascade leading to dementia. However, the underlying...
Tau pathology and its spatial propagation in Alzheimer's disease (AD) play crucial roles in the neurodegenerative cascade leading to dementia. However, the underlying mechanisms linking tau spreading to glucose metabolism remain elusive. To address this, we aimed to examine the association between pathologic tau aggregation, functional connectivity, and cascading glucose metabolism and further explore the underlying interplay mechanisms. In this prospective cohort study, we enrolled 79 participants with F-Florzolotau positron emission tomography (PET), F-fluorodeoxyglucose PET, resting-state functional, and anatomical magnetic resonance imaging (MRI) images in the hospital-based Shanghai Memory Study. We employed generalized linear regression and correlation analyses to assess the associations between Florzolotau accumulation, functional connectivity, and glucose metabolism in whole-brain and network-specific manners. Causal mediation analysis was used to evaluate whether functional connectivity mediates the association between pathologic tau and cascading glucose metabolism. We examined 22 normal controls and 57 patients with AD. In the AD group, functional connectivity was associated with Florzolotau covariance (β = .837, r = 0.472, p < .001) and glucose covariance (β = 1.01, r = 0.499, p < .001). Brain regions with higher tau accumulation tend to be connected to other regions with high tau accumulation through functional connectivity or metabolic connectivity. Mediation analyses further suggest that functional connectivity partially modulates the influence of tau accumulation on downstream glucose metabolism (mediation proportion: 49.9%). Pathologic tau may affect functionally connected neurons directly, triggering downstream glucose metabolism changes. This study sheds light on the intricate relationship between tau pathology, functional connectivity, and downstream glucose metabolism, providing critical insights into AD pathophysiology and potential therapeutic targets.
Topics: Humans; Alzheimer Disease; Male; Female; Aged; Positron-Emission Tomography; tau Proteins; Magnetic Resonance Imaging; Middle Aged; Fluorodeoxyglucose F18; Nerve Net; Glucose; Connectome; Prospective Studies; Brain; Aged, 80 and over
PubMed: 38703095
DOI: 10.1002/hbm.26689 -
Cancer Imaging : the Official... May 2024This study aimed to compare the diagnostic value of [ Ga]Ga-DOTA-FAPI-04 and [F]FDG PET/CT imaging for primary lesions and metastatic lymph nodes in patients with... (Comparative Study)
Comparative Study
BACKGROUND
This study aimed to compare the diagnostic value of [ Ga]Ga-DOTA-FAPI-04 and [F]FDG PET/CT imaging for primary lesions and metastatic lymph nodes in patients with tonsil cancer.
METHOD
Twenty-one tonsil cancer patients who underwent [ Ga]Ga-DOTA-FAPI-04 and [F]FDG PET/CT scans within two weeks in our centre were retrospectively enrolled. The maximum standardized uptake value (SUVmax) and tumor-to-background ratio (TBR) of the two tracers were compared by using the Mann‒Whitney U test. In addition, the sensitivity, specificity, and accuracy of the two methods for diagnosing metastatic lymph nodes were analysed.
RESULTS
In detecting primary lesions, the efficiency was higher for [ Ga]Ga-DOTA-FAPI-04 PET/CT (20/22) than for [F]FDG PET/CT (9/22). Although [ Ga]Ga-DOTA-FAPI-04 uptake (SUVmax, 5.03 ± 4.06) was lower than [F]FDG uptake (SUVmax, 7.90 ± 4.84, P = 0.006), [ Ga]Ga-DOTA-FAPI-04 improved the distinction between the primary tumor and contralateral normal tonsillar tissue. The TBR was significantly higher for [ Ga]Ga-DOTA-FAPI-04 PET/CT (3.19 ± 2.06) than for [F]FDG PET/CT (1.89 ± 1.80) (p < 0.001). In lymph node analysis, SUVmax and TBR were not significantly different between [ Ga]Ga-DOTA-FAPI-04 and [F]FDG PET/CT (7.67 ± 5.88 vs. 8.36 ± 6.15, P = 0.498 and 5.56 ± 4.02 vs. 4.26 ± 3.16, P = 0.123, respectively). The specificity and accuracy of [ Ga]Ga-DOTA-FAPI-04 PET/CT were higher than those of [F]FDG PET/CT in diagnosing metastatic cervical lymph nodes (all P < 0.05).
CONCLUSION
The availability of [ Ga]Ga-DOTA-FAPI-04 complements the diagnostic results of [F]FDG by improving the detection rate of primary lesions and the diagnostic accuracy of cervical metastatic lymph nodes in tonsil cancer compared to [F]FDG.
Topics: Humans; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Male; Female; Retrospective Studies; Lymphatic Metastasis; Middle Aged; Aged; Tonsillar Neoplasms; Radiopharmaceuticals; Adult; Gallium Radioisotopes; Organometallic Compounds; Lymph Nodes
PubMed: 38702821
DOI: 10.1186/s40644-024-00699-3 -
Radiotherapy and Oncology : Journal of... Jul 2024Recently, a comprehensive xerostomia prediction model was published, based on baseline xerostomia, mean dose to parotid glands (PG) and submandibular glands (SMG)....
BACKGROUND AND PURPOSE
Recently, a comprehensive xerostomia prediction model was published, based on baseline xerostomia, mean dose to parotid glands (PG) and submandibular glands (SMG). Previously, PET imaging biomarkers (IBMs) of PG were shown to improve xerostomia prediction. Therefore, this study aimed to explore the potential improvement of the additional PET-IBMs from both PG and SMG to the recent comprehensive xerostomia prediction model (i.e., the reference model).
MATERIALS AND METHODS
Totally, 540 head and neck cancer patients were split into training and validation cohorts. PET-IBMs from the PG and SMG, were selected using bootstrapped forward selection based on the reference model. The IBMs from both the PG and SMG with the highest selection frequency were added to the reference model, resulting in a PG-IBM model and a SMG-IBM model which were combined into a composite model. Model performance was assessed using the area under the curve (AUC). Likelihood ratio test compared the predictive performance between the reference model and models including IBMs.
RESULTS
The final selected PET-IBMs were 90 percentile of the PG SUV and total energy of the SMG SUV. The additional two PET-IBMs in the composite model improved the predictive performance of the reference model significantly. The AUC of the reference model and the composite model were 0.67 and 0.69 in the training cohort, and 0.71 and 0.73 in the validation cohort, respectively.
CONCLUSION
The composite model including two additional PET-IBMs from PG and SMG improved the predictive performance of the reference xerostomia model significantly, facilitating a more personalized prediction approach.
Topics: Humans; Fluorodeoxyglucose F18; Head and Neck Neoplasms; Female; Male; Middle Aged; Xerostomia; Positron-Emission Tomography; Radiopharmaceuticals; Aged; Adult; Submandibular Gland; Parotid Gland; Salivary Glands
PubMed: 38702014
DOI: 10.1016/j.radonc.2024.110319