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International Journal of Medical... 2024To create a nomogram using single photon emission computed tomography (SPECT) myocardial perfusion imaging and F-FDG positron emissions tomography (PET) gated...
To create a nomogram using single photon emission computed tomography (SPECT) myocardial perfusion imaging and F-FDG positron emissions tomography (PET) gated myocardial metabolism imaging to forecast major adverse cardiovascular events (MACE) in chronic total occlusion (CTO) patients treated with optimal medical therapy (OMT). A total of 257 patients who received OMT between January 2016 and December 2021 were included in this retrospective study. Patients were randomly divided into development (n=179) and validation (n=78) cohorts. A thorough evaluation was conducted, encompassing clinical features and imaging analysis, which involved assessing myocardial perfusion and metabolism. Independent risk factors were identified using least absolute shrinkage and selection operator (LASSO) and multivariate Cox regression analyses. Calibration curves and decision curve analysis (DCA) were used to evaluate the clinical usefulness. In the development cohort, 53 patients (29.6%) experienced MACE out of 179 patients, while in the validation cohort, MACE occurred in 23 (29.5%) patients out of 78. The PET-left ventricular end-systolic volume (P-ESV) (HR 1.01; 95% CI 1.003-1.017; p=0.003), hibernating myocardium / total perfusion defect (HM/TPD) (HR 1.053; 95% CI 1.038-1.069; p<0.001), PET-left ventricular ejection fraction (P-LVEF) (HR 0.862; 95% CI 0.788-0.943; p=0.001), and left anterior descending branch (LAD) (HR 2.303; 95% CI 1.086-4.884; p=0.03) were significantly associated with MACE and were used to develop the nomogram. The nomogram demonstrated excellent discrimination with C-indexes of 0.931 and 0.911 in the development and validation cohorts. DCA determined that the model exhibited a considerably superior net advantage in predicting MACE. A new nomogram integrating clinical factors and imaging features was created to predict the risk of MACE in patients with CTO.
Topics: Humans; Nomograms; Male; Female; Middle Aged; Aged; Coronary Occlusion; Retrospective Studies; Myocardial Perfusion Imaging; Chronic Disease; Positron-Emission Tomography; Tomography, Emission-Computed, Single-Photon; Risk Factors; Fluorodeoxyglucose F18; Risk Assessment
PubMed: 38774760
DOI: 10.7150/ijms.94644 -
Journal of Cancer Research and Clinical... May 2024Incidental colorectal fluorodeoxyglucose (FDG) uptake, observed during positron emission tomography/computed tomography (PET/CT) scans, attracts particular attention due...
Clinical significance of F-FDG-PET/CT for detection of incidental pre-malignant and malignant colonic lesions: correlation with colonoscopic and histopathological results.
BACKGROUND
Incidental colorectal fluorodeoxyglucose (FDG) uptake, observed during positron emission tomography/computed tomography (PET/CT) scans, attracts particular attention due to its potential to represent both benign and pre-malignant/malignant lesions. Early detection and excision of these lesions are crucial for preventing cancer development and reducing mortality. This research aims to evaluate the correlation between incidental colorectal FDG uptake on PET/CT with colonoscopic and histopathological results.
METHODS
Retrospective analysis was performed on data from all patients who underwent PET/CT between December 2019 and December 2023 in our hospital. The study included 79 patients with incidental colonic FDG uptake who underwent endoscopy. Patient characteristics, imaging parameters, and the corresponding colonoscopy and histopathological results were studied. A comparative analysis was performed among the findings from each of these modalities. The optimal cut-off value of SUVmax for F-FDG PET/CT diagnosis of premalignant and malignant lesions was determined by receiver operating characteristic (ROC) curves. The area under the curve (AUC) of SUVmax and the combined parameters of SUVmax and colonic wall thickening (CWT) were analyzed.
RESULTS
Among the 79 patients with incidental colorectal FDG uptake, histopathology revealed malignancy in 22 (27.9%) patients and premalignant polyps in 22 (27.9%) patients. Compared to patients with benign lesions, patients with premalignant and malignant lesions were more likely to undergo a PET/CT scan for primary evaluation (p = 0.013), and more likely to have focal GIT uptake (p = 0.001) and CWT (p = 0.001). A ROC curve analysis was made and assesed a cut-off value of 7.66 SUVmax (sensitivity: 64.9% and specificity: 82.4%) to distinguish premalignant and malignant lesions from benign lesions. The AUCs of the SUVmax and the combined parameters of SUVmax and CWT were 0.758 and 0.832 respectively.
CONCLUSION
For patients undergo PET/CT for primary evaluation, imaging features of colorectal focal FDG uptake and CWT were more closely associated with premalignant and malignant lesions. The SUVmax helps determine benign and premalignant/malignant lesions of the colorectum. Moreover, the combination of SUVmax and CWT parameters have higher accuracy in estimating premalignant and malignant lesions than SUVmax.
Topics: Humans; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Male; Female; Middle Aged; Colonoscopy; Retrospective Studies; Aged; Radiopharmaceuticals; Incidental Findings; Colonic Neoplasms; Adult; Precancerous Conditions; Colorectal Neoplasms; Aged, 80 and over; Clinical Relevance
PubMed: 38769201
DOI: 10.1007/s00432-024-05806-2 -
Scientific Reports May 2024Candidates for prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) of metastatic castration-resistant prostate cancer (mCRPC) frequently have...
Candidates for prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) of metastatic castration-resistant prostate cancer (mCRPC) frequently have "mismatch" lesions with pronounced 18-fluorodeoxyglucose ([F]FDG) but attenuated PSMA ligand uptake on positron emission tomography (PET). However, no quantitative criteria yet exist to identify mismatch lesions and predict their response to RLT. To define such criteria, we retrospectively analyzed 267 randomly-selected glucometabolic mCRPC metastases from 22 patients. On baseline PET, we determined [F]FDG and [Ga]Ga-PSMA-11 maximum standardized uptake value (SUV), and calculated the [F]FDG SUV/[Ga]Ga-PSMA-11 SUV quotient (FPQ). From follow-up [F]FDG PET after two lutetium-177-PSMA-617 RLT cycles, we evaluated the treatment response and categorized the lesions into three subgroups (partial remission, stable disease, progression) based on change in [F]FDG SUV. Lastly, we compared the baseline PET variables in progressing versus non-progressing lesions. Variables differing significantly, and a score incorporating them, were assessed via receiver operator characteristic (ROC) curve analysis, regarding ability to predict lesional progression, with area under the curve (AUC) as metric. Cut-offs with optimal sensitivity and specificity were determined using the maximum value of Youden's index. Fifty-one of 267 lesions (19.1%) progressed, 102/267 (38.2%) manifested stable disease, and 114/267 (42.7%) partially responded after two RLT cycles. At baseline, median [Ga]Ga-PSMA-11 SUV was significantly lower (p < 0.001), median FPQ significantly higher (p < 0.001), and median [F]FDG SUV similar in progressing versus non-progressing lesions. [Ga]Ga-PSMA-11 SUV and FPQ showed predictive power regarding progression (AUCs: 0.89, 0.90). An introduced clinical score combining both further improved predictive performance (AUC: 0.94). Optimal cut-offs to foretell progression were: [Ga]Ga-PSMA-11 SUV < 11.09 (88.2% sensitivity, 81.9% specificity), FPQ ≥ 0.92 (90.2% sensitivity, 78.7% specificity), clinical score ≥ 6/9 points (88.2% sensitivity, 87.5% specificity). At baseline, a low [ Ga]Ga-PSMA-11 SUV and a high FPQ predict early lesional progression under RLT; [F]FDG SUV does not. A score combining [ Ga]Ga-PSMA-11 SUV and FPQ predicts early lesional progression even more effectively and might therefore be useful to quantitatively identify mismatch lesions.
Topics: Humans; Male; Prostatic Neoplasms, Castration-Resistant; Aged; Fluorodeoxyglucose F18; Positron-Emission Tomography; Middle Aged; Retrospective Studies; Disease Progression; Gallium Radioisotopes; Radiopharmaceuticals; Antigens, Surface; Glutamate Carboxypeptidase II; Aged, 80 and over; Lutetium
PubMed: 38760451
DOI: 10.1038/s41598-024-61961-z -
Thoracic Cancer Jun 2024The aim of the present study was to evaluate the impact of intratumoral metabolic heterogeneity and quantitative F-FDG PET/CT imaging parameters in predicting patient...
BACKGROUND
The aim of the present study was to evaluate the impact of intratumoral metabolic heterogeneity and quantitative F-FDG PET/CT imaging parameters in predicting patient outcomes in thymic epithelial tumors (TETs).
METHODS
This retrospective study included 100 patients diagnosed with TETs who underwent pretreatment F-FDG PET/CT. The maximum and mean standardized uptake values (SUVmax and SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on PET/CT were measured. Heterogeneity index-1 (HI-1; standard deviation [SD] divided by SUVmean) and heterogeneity index-2 (HI-2; linear regression slopes of the MTV according with different SUV thresholds), were evaluated as heterogeneity indices. Associations between these parameters and patient survival outcomes were analyzed.
RESULTS
The univariate analysis showed that Masaoka stage, TNM stage, WHO classification, SUVmax, SUVmean, TLG, and HI-1 were significant prognostic factors for progression-free survival (PFS), while MTV, HI-2, age, gender, presence of myasthenia gravis, and maximum tumor diameter were not. Subsequently, multivariate analyses showed that HI-1 (p < 0.001) and TNM stage (p = 0.002) were independent prognostic factors for PFS. For the overall survival analysis, TNM stage, WHO classification, SUVmax, and HI-1 were significant prognostic factors in the univariate analysis, while TNM stage remained an independent prognostic factor in multivariate analyses (p = 0.024). The Kaplan Meier survival analyses showed worse prognoses for patients with TNM stages III and IV and HI-1 ≥ 0.16 compared to those with stages I and II and HI-1 < 0.16 (log-rank p < 0.001).
CONCLUSION
HI-1 and TNM stage were independent prognostic factors for progression-free survival in TETs. HI-1 generated from baseline F-FDG PET/CT might be promising to identify patients with poor prognosis.
Topics: Humans; Positron Emission Tomography Computed Tomography; Male; Female; Fluorodeoxyglucose F18; Thymus Neoplasms; Middle Aged; Prognosis; Retrospective Studies; Aged; Adult; Neoplasms, Glandular and Epithelial; Young Adult; Aged, 80 and over
PubMed: 38757212
DOI: 10.1111/1759-7714.15331 -
JPMA. the Journal of the Pakistan... Apr 2024Immunotherapy related adverse events are commonly seen with immune check point inhibitors therapy. We report the case of a 40-year-old female diagnosed with stage IVB...
Immunotherapy related adverse events are commonly seen with immune check point inhibitors therapy. We report the case of a 40-year-old female diagnosed with stage IVB endometroid grade III endometrial cancer, on pembrolizumab immunotherapy, an anti-programmed-death-receptor-1 (PD-1) antibody. Patient was referred for 18F-FDG PET/CT for restaging. 18F-FDG PET/CT demonstrated diffuse increased FDG uptake throughout the body of the pancreas associated with fat stranding in the peripancreatic region, suggestive of pembrolizumab-induced pancreatitis. The diagnosis was confirmed by elevated amylase and lipase levels. immune-related adverse events (irAE) are frequently identified on 18F-FDG PET-CT, which may lead to early diagnosis, close clinical follow-up, and appropriate clinical management of immune-related adverse events.
Topics: Humans; Female; Pancreatitis; Positron Emission Tomography Computed Tomography; Adult; Antibodies, Monoclonal, Humanized; Fluorodeoxyglucose F18; Antineoplastic Agents, Immunological; Radiopharmaceuticals
PubMed: 38751292
DOI: 10.47391/JPMA.24-31 -
JPMA. the Journal of the Pakistan... Apr 2024Neurolymphomatosis (NL) is an uncommon and rare neurologic disorder characterised by extranodal lymphoma, where the tumour cells invade the cranial nerves, nerve plexus,... (Review)
Review
Neurolymphomatosis (NL) is an uncommon and rare neurologic disorder characterised by extranodal lymphoma, where the tumour cells invade the cranial nerves, nerve plexus, nerve root, spinal nerve roots, trunk nerves or peripheral nerves. MRI is the modality of choice, but is often challenging in detection of early recurrence, assessing residual disease and response evaluation. 18FFDG PET/CT has superior diagnostic performance compared with body CT in the evaluation of NL. 18F-FDG PET-CT is helpful in evaluation of disease extent and potential to guide biopsy. 18F-FDG PETCT is a highly sensitive technique for early localisation of NL than MRI or CT alone. Besides diagnostic and prognostic value in NL, it might be very helpful in response assessment.
Topics: Humans; Fluorodeoxyglucose F18; Magnetic Resonance Imaging; Neurolymphomatosis; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals
PubMed: 38751291
DOI: 10.47391/JPMA.24-30 -
Scientific Reports May 2024This study aimed to analyze the characteristics of the non-specific uptake (NSU) of F-labeled fibroblast activation protein inhibitor (F-FAPI) of the pancreas and... (Clinical Trial)
Clinical Trial
This study aimed to analyze the characteristics of the non-specific uptake (NSU) of F-labeled fibroblast activation protein inhibitor (F-FAPI) of the pancreas and investigate the related factors. Totally, 78 patients who underwent both F-fluorodeoxyglucose (FDG) and F-FAPI PET/CT examinations were divided into normal (n = 53) and NSU (n = 25) groups. The differences in general information, medical history, laboratory indexes and uptake were compared. Receiver operating characteristic (ROC) curves were used to analyze the optimal cut-off values. The correlations between F-FAPI-SUVmax and blood cell analysis, liver function indexes, tumor markers, and inflammatory indices were analyzed. The logistic regression model was used to estimate the independent factors. Both F-FAPI (4.48 ± 0.98 vs. 2.01 ± 0.53, t = 11.718, P < 0.05) and F-FDG (2.23 ± 0.42 vs. 2.02 ± 0.44, t = 2.036, P = 0.045) showed significantly higher in NSU group. Patients in the NSU group tended to be complicated with a history of drinking (P = 0.034), chronic liver diseases (P = 0.006), and surgery of gastrectomy (P = 0.004). ROC analysis showed cutoff values of 3.25 and 2.05 for F-FAPI and F-FDG in identifying the NSU. Patients in the NSU group showed less platelet count, higher platelet volume, higher total bilirubin, direct or indirect bilirubin (P < 0.05). Platelet count, platelet crit, large platelet ratio, aspartate aminotransferase (AST), α-L-fucosidase, and total, direct or indirect bilirubin were correlated with F-FAPI-SUVmax (P < 0.05). AST [1.099 (1.014, 1.192), P = 0.021] and total bilirubin [1.137 (1.035, 1.249), P = 0.007] were two independent factors in the step forward logistic regression, and platelet/% [1.079 (1.004, 1.160), P = 0.039] and total bilirubin [1.459 (1.016, 2.095), P = 0.041] were two independent factors in the step backward logistic regression for the prediction of pancreatic uptake of F-FAPI. F-FAPI-PET/CT was better than F-FDG in predicting the pancreatic NSU, and NSU is related to a history of drinking, chronic liver diseases, gastrectomy, heteromorphic platelet, and impaired liver function.
Topics: Humans; Male; Female; Middle Aged; Pancreas; Positron Emission Tomography Computed Tomography; Aged; Prospective Studies; Fluorodeoxyglucose F18; ROC Curve; Adult; Radiopharmaceuticals; Pancreatic Neoplasms
PubMed: 38750103
DOI: 10.1038/s41598-024-62005-2 -
Respiratory Medicine Case Reports 2024Pulmonary amyloidosis is characterized by extracellular deposition of fibrous protein called amyloid in the lungs and has three subtypes: nodular, diffuse, and...
Pulmonary amyloidosis is characterized by extracellular deposition of fibrous protein called amyloid in the lungs and has three subtypes: nodular, diffuse, and tracheobronchial amyloidosis. Pulmonary nodular amyloidosis can mimic other lung diseases including infectious diseases, metastatic lung tumors, sarcoidosis, and pulmonary hyalinizing granuloma. A biopsy of the lesion is essential for a definitive diagnosis. Herein, we report the case of a 66-year-old man who presented for shortness of breath on exertion and was diagnosed with nodular pulmonary amyloidosis on ultrasound-guided percutaneous needle biopsy. A chest X-ray and computed tomography (CT) revealed bilateral slowly growing multiple calcified pulmonary nodules and cavities. Malignancy was suspected based on 18F-fluoro-deoxyglucose (18F-FDG) positron emission tomography/CT (PET/CT) images. An ultrasound-guided percutaneous needle biopsy was performed, and histopathologic examination of the lesion confirmed nodular pulmonary amyloidosis. This case highlights the importance of considering nodular pulmonary amyloidosis in the differential diagnosis of pulmonary nodules with increased uptake of 18F-FDG on PET/CT and the utility of ultrasound-guided needle biopsy in the definitive diagnosis.
PubMed: 38745726
DOI: 10.1016/j.rmcr.2024.102025 -
Transcriptomic characteristics according to tumor size and SUV in papillary thyroid cancer patients.Scientific Reports May 2024The SUV is a measure of FDG uptake and is related with tumor aggressiveness in thyroid cancer, however, its association with molecular pathways is unclear. Here, we...
The SUV is a measure of FDG uptake and is related with tumor aggressiveness in thyroid cancer, however, its association with molecular pathways is unclear. Here, we investigated the relationship between SUV and gene expression profiles in 80 papillary thyroid cancer (PTC) patients. We conducted an analysis of DEGs and enriched pathways in relation to SUV and tumor size. SUV showed a positive correlation with tumor size and correlated with glucose metabolic process. The genes that indicate thyroid differentiation, such as SLC5A5 and TPO, were negatively correlated with SUV. Unsupervised analysis revealed that SUV positively correlated with DNA replication(r = 0.29, p = 0.009), pyrimidine metabolism(r = 0.50, p < 0.0001) and purine metabolism (r = 0.42, p = 0.0001). Based on subgroups analysis, we identified that PSG5, TFF3, SOX2, SL5A5, SLC5A7, HOXD10, FER1L6, and IFNA1 genes were found to be significantly associated with tumor aggressiveness. Both high SUV PTMC and macro-PTC are enriched in pathways of DNA replication and cell cycle, however, gene sets for purine metabolic pathways are enriched only in high SUV macro-PTC but not in high SUV PTMC. Our findings demonstrate the molecular characteristics of high SUV tumor and metabolism involved in tumor growth in differentiated thyroid cancer.
Topics: Humans; Thyroid Cancer, Papillary; Female; Male; Thyroid Neoplasms; Middle Aged; Transcriptome; Adult; Fluorodeoxyglucose F18; Gene Expression Regulation, Neoplastic; Aged; Gene Expression Profiling; Tumor Burden
PubMed: 38745021
DOI: 10.1038/s41598-024-61839-0 -
PloS One 2024Correct identification of estrogen receptor (ER) status in breast cancer (BC) is crucial to optimize treatment; however, standard of care, involving biopsy and...
BACKGROUND AND OBJECTIVES
Correct identification of estrogen receptor (ER) status in breast cancer (BC) is crucial to optimize treatment; however, standard of care, involving biopsy and immunohistochemistry (IHC), and other diagnostic tools such as 2-deoxy-2-[18F]fluoro-D-glucose or 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG), can yield inconclusive results. 16α-[18F]fluoro-17β-fluoroestradiol ([18F]FES) can be a powerful tool, providing high diagnostic accuracy of ER-positive disease. The aim of this study was to estimate the budget impact and cost-effectiveness of adding [18F]FES PET/CT to biopsy/IHC in the determination of ER-positive status in metastatic (mBC) and recurrent breast cancer (rBC) in the United States (US).
METHODS
An Excel-based decision tree, combined with a Markov model, was developed to estimate the economic consequences of adding [18F]FES PET/CT to biopsy/IHC for determining ER-positive status in mBC and rBC over 5 years. Scenario A, where the determination of ER-positive status is carried out solely through biopsy/IHC, was compared to scenario B, where [18F]FES PET/CT is used in addition to biopsy/IHC.
RESULTS
The proportion of true positive and true negative test results increased by 0.2 to 8.0 percent points in scenario B compared to scenario A, while re-biopsies were reduced by 94% to 100%. Scenario B resulted in cost savings up to 142 million dollars.
CONCLUSIONS
Adding [18F]FES PET/CT to biopsy/IHC may increase the diagnostic accuracy of the ER status, especially when a tumor sample cannot be obtained, or the risk of a biopsy-related complication is high. Therefore, adding [18F]FES PET/CT to biopsy/IHC would have a positive impact on US clinical and economic outcomes.
Topics: Humans; Breast Neoplasms; Positron Emission Tomography Computed Tomography; Female; Receptors, Estrogen; Cost-Benefit Analysis; United States; Neoplasm Recurrence, Local; Estradiol; Neoplasm Metastasis; Middle Aged; Fluorodeoxyglucose F18; Radiopharmaceuticals
PubMed: 38743917
DOI: 10.1371/journal.pone.0302486