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Dual time point 18F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in primary breast cancer.

ABSTRACT: BACKGROUND:To evaluate the clinicopathological and prognostic significance of the percentage change between maximum standardized uptake value (SUVmax) at 60?min (SUVmax1) and SUVmax at 120?min (SUVmax2) (?SUVmax%) using dual time point 18F-fluorodeoxyglucose emission tomography/computed tomography (18F-FDG PET/CT) in breast cancer. METHODS:Four hundred and sixty-four patients with primary breast cancer underwent 18F-FDG PET/CT for preoperative staging. ?SUVmax% was defined as (SUVmax2?-?SUVmax1) / SUVmax1?×?100. We explored the optimal cutoff value of SUVmax parameters (SUVmax1 and ?SUVmax%) referring to the event of relapse by using receiver operator characteristic curves. The clinicopathological and prognostic significances of the SUVmax1 and ?SUVmax% were analyzed by Cox's univariate and multivariate analyses. RESULTS:The optimal cutoff values of SUVmax1 and ?SUVmax% were 3.4 and 12.5, respectively. Relapse-free survival (RFS) curves were significantly different between high and low SUVmax1 groups (P?=?0.0003) and also between high and low ?SUVmax% groups (P?=?0.0151). In Cox multivariate analysis for RFS, SUVmax1 was an independent prognostic factor (P?=?0.0267) but ?SUVmax% was not (P?=?0.152). There was a weak correlation between SUVmax1 and ?SUVmax% (P?

SUBMITTER: Yamagishi Y

PROVIDER: S-EPMC6882358 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Dual time point <sup>18</sup>F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (<sup>18</sup>F-FDG PET/CT) in primary breast cancer.

Yamagishi Yoji Y Koiwai Tomomi T Yamasaki Tamio T Einama Takahiro T Fukumura Makiko M Hiratsuka Miyuki M Kono Takako T Hayashi Katsumi K Ishida Jiro J Ueno Hideki H Tsuda Hitoshi H

BMC cancer 20191127 1

<h4>Background</h4>To evaluate the clinicopathological and prognostic significance of the percentage change between maximum standardized uptake value (SUV<sub>max</sub>) at 60 min (SUV<sub>max</sub>1) and SUV<sub>max</sub> at 120 min (SUV<sub>max</sub>2) (ΔSUV<sub>max</sub>%) using dual time point <sup>18</sup>F-fluorodeoxyglucose emission tomography/computed tomography (<sup>18</sup>F-FDG PET/CT) in breast cancer.<h4>Methods</h4>Four hundred and sixty-four patients with primary breast cancer un ...[more]

PMID: 31775675

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Project description:BackgroundThe International Myeloma Working Group recommends the use of 18-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for treatment response evaluation, as it is superior to magnetic resonance imaging (MRI). However, at initial staging, the sensitivity of FDG-PET remains inferior to that of MRI. Therefore, there is a need for an imaging technique that could have a sensitivity equal to that of MRI at diagnosis and could serve to evaluate therapy. 18F-choline has shown increased sensitivity when compared with 18-FDG, with about 75% more lesions detected in patients with relapsed or progressive multiple myeloma (MM).ObjectiveOur primary objective is to prospectively compare the detection rate of bone lesions by 18F-choline PET/CT (FCH-PET) and FDG-PET in newly diagnosed MM. Our secondary objectives are to assess the accuracy of both PET modalities for the detection of bone lesions and the diagnosis of diffuse disease, to assess the detection rate of extramedullary lesions.MethodsWe will prospectively include 30 patients in a paired comparative accuracy study. Patients with de novo MM will undergo FCH-PET, FDG-PET, and whole-body MRI (WB-MRI) within a 3-week period. WB-MRI will be composed of conventional sequences on the spine and pelvis and of whole-body diffusion axial sequences. The following 6 skeletal areas will be defined: skull, sternum/costal grid, spine, pelvis, superior limbs, and inferior limbs. The number of focal lesions, their respective localization, and intensity of uptake will be retrieved for each skeletal area. Readings will be performed blinded from other imaging techniques. The reference standard will be WB-MRI. Focal lesions present on PET/CT but not on WB-MRI will require a decision made with a consensus of experts based on clinical and imaging data. The number of bone lesions and number of extramedullary lesions will be compared using the Wilcoxon test. The accuracy of FCH-PET and FDG-PET will be compared using the McNemar test.ResultsThe study started in September 2019, and enrollment is ongoing. As of June 2020, 8 participants have been included. Data collection is expected to be completed in June 2021, and the results are expected to be available in December 2021.ConclusionsThis study will assess if FCH-PET is superior to FDG-PET for the evaluation of MM tumor burden. This will pave the way for future prospective evaluations of the prognostic value of 18-FCH for treatment response evaluation in MM patients. Additionally, this work may provide new perspectives for better assessment of the risk of smoldering MM progressing to MM.Trial registrationClinicalTrials.gov NCT03891914; https://clinicaltrials.gov/ct2/show/NCT03891914.International registered report identifier (irrid)DERR1-10.2196/17850.

Project description:Background Fluorine 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) has been proven to be valuable in guiding the diagnosis and management of sarcoidosis. However, its differential value for sarcoidosis is unclear. The objective of this study was to explore the value of 18F-FDG PET/CT in differentiation sarcoidosis from lung cancer with lymph node metastasis. Methods A total of 361 consecutively diagnosed sarcoidosis patients and 1,944 consecutively diagnosed lung cancer patients at Shanghai Pulmonary Hospital were retrospectively reviewed. Among them, 85 patients diagnosed with sarcoidosis and 94 lung cancer patients with lymph node metastasis were enrolled. Demographic data and 18F-FDG PET/CT parameters were analyzed by the chi-square test or independent sample Student’s t-test. Receiver operating characteristic (ROC) curves were generated to identify cut-off values. Multivariate logistic regression was performed to identify independent predictors of sarcoidosis on 18F-FDG PET/CT, and those with P<0.1 were included in a regression model using the forward log rank (LR) method to generate a ROC curve. Results The ratio of extrapulmonary lymph node involvement in sarcoidosis patients was significantly higher than that in lung cancer patients (64.7% vs. 29.8%, P<0.001). After adjusting for gender and age, extrapulmonary lymph node involvement [odds ratio (OR): 3.160; 95% confidence interval (CI): 1.105–9.035], maximum standardized uptake value (SUVmax) of mediastinum/hilar lymph nodes >13.86 (OR: 3.245; 95% CI: 1.045–10.083), and short axis of the corresponding lymph node >11.5 mm (OR: 5.470; 95% CI: 1.149–26.037) on 18F-FDG PET/CT were independent predictors of sarcoidosis, with a sensitivity and specificity of 77.5% and 69.3%, respectively. The area under the curve was 0.769. Conclusions 18F-FDG PET/CT could be helpful to distinguish sarcoidosis from lung cancer patients with lymph node metastasis.

Project description:Positron emission tomography (PET) visualizes increased cellular [F]fluorodeoxyglucose ([F]FDG) uptake. Pulmonary hypertension (PH) is conceived of a proliferative disease of the lung vessels. Increased glucose uptake can be quantified as pulmonary [F]FDG uptake via PET imaging. Because the angioproliferative mechanisms in PH are still in need of further description, the aim of the present study was to investigate whether [F]FDG PET/CT imaging can elucidate these pathophysiologic mechanisms in different etiologies of PH.Patients (n?=?109) with end-stage pulmonary disease being evaluated for lung transplant were included in this observational study. Mean standardized uptake value (SUVmean) of predefined regions of interest in lung parenchyma (LP), left (LV), and right ventricle (RV) of the heart, and SUVmax in pulmonary artery (PA) were determined and normalized to liver uptake. These SUV ratios (SUVRs) were compared with results from right heart catheterization (mean pulmonary artery pressure [mPAP], pulmonary vascular resistance [PVR]), and serum N-terminal pro-brain natriuretic peptide. Group comparisons were performed and Pearson correlation coefficients (r) were calculated.The [F]FDG uptake ratios in LP, RV, RV/LV, and PA, but not in LV, were found to be significantly higher in both patients with mPAP ?25?mm Hg (P?=?0.013, P?=?0.006, P?=?0.049, P?=?0.002, P?=?0.68, respectively) and with PVR ?480?dyn·s/cm (P?<?0.001, P?=?0.045, P?<?0.001, P?<?0.001, P?=?0.26, respectively). The [F]FDG uptake in these regions positively correlated also with mPAP, PVR, and N-terminal pro-brain natriuretic peptide. The SUVR of PA positively correlated with the SUVR of LP and RV (r?=?0.55, r?=?0.42, respectively).Pulmonary and cardiac [F]FDG uptake in PET imaging positively correlated with the presence and severity of PH in patients with end-stage pulmonary disease. Increased glucose metabolism in the central PAs seems to play a certain role in terms of severity of PH. These results suggest that [F]FDG-PET imaging can help understand the pathophysiology of PH as a proliferative pulmonary disease.

Project description:COPD and smoking are characterised by pulmonary inflammation. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging may improve knowledge of pulmonary inflammation in COPD patients and aid early development of novel therapies as an imaging biomarker. To evaluate pulmonary inflammation, assessed by FDG uptake, in whole and regional lung in "usual" (smoking-related) COPD patients, alpha-1 antitrypsin deficiency (α1ATD) COPD patients, smokers without COPD and never-smokers using FDG PET/CT. Secondly, to explore cross-sectional associations between FDG PET/CT and systemic inflammatory markers in COPD patients and repeatability of the technique in COPD patients. Data from two imaging studies were evaluated. Pulmonary FDG uptake (normalised Ki; nKi) was measured by Patlak graphical analysis in four subject groups: 84 COPD patients, 11 α1ATD-COPD patients, 12 smokers and 10 never-smokers. Within the COPD group, associations between nKi and systemic markers of inflammation were assessed. Repeatability was evaluated in 32 COPD patients comparing nKi values at baseline and at 4-month follow-up. COPD patients, α1ATD-COPD patients and smokers had increased whole lung FDG uptake (nKi) compared with never-smokers (0.0037±0.001, 0.0040±0.001, 0.0040±0.001 versus 0.0028±0.001 mL·cm-3·min-1, respectively, p<0.05 for all). Similar results were observed in upper and middle lung regions. In COPD participants, plasma fibrinogen was associated with whole lung nKi (β=0.30, p=0.02) in multivariate analysis adjusted for current smoking, forced expiratory volume in 1 s % predicted, systemic neutrophils and C-reactive protein levels. Mean percentage difference in nKi between the baseline and follow-up was 3.2%, and the within subject coefficient of variability was 7.7%. FDG PET/CT has potential as a noninvasive tool to enable whole lung and regional quantification of FDG uptake to assess smoking- and COPD-related pulmonary inflammation.

Project description:BackgroundPheochromocytomas and paragangliomas (PPGLs) are rare tumors of the adrenal medulla and extra-adrenal sympathetic chromaffin tissues; their anatomical and functional imaging are critical to guiding treatment decisions. This study aimed to compare the sensitivity and specificity of (18)F-fluorodeoxyglucose positron emission tomography with computed tomography ((18)F-FDG PET/CT) for tumor localization and staging of PPGLs with that of conventional imaging by [(123)I]-metaiodobenzylguanidine single photon emission CT ((123)I-MIBG SPECT), CT, and magnetic resonance imaging (MRI).MethodsA total of 216 patients (106 men, 110 women, aged 45.2 ± 14.9 years) with suspected PPGL underwent CT or MRI, (18)F-FDG PET/CT, and (123)I-MIBG SPECT/CT. Sensitivity and specificity were measured as endpoints and compared by the McNemar test, using two-sided P values only.ResultsSixty (28%) of patients had nonmetastatic PPGL, 95 (44%) had metastatic PPGL, and 61 (28%) were PPGL negative. For nonmetastatic tumors, the sensitivity of (18)F-FDG was similar to that of (123)I-MIBG but less than that of CT/MRI (sensitivity of (18)F-FDG = 76.8%; of (123)I-MIBG = 75.0%; of CT/MRI = 95.7%; (18)F-FDG vs (123)I-MIBG: difference = 1.8%, 95% confidence interval [CI] = -14.8% to 14.8%, P = .210; (18)F-FDG vs CT/MRI: difference = 18.9%, 95% CI = 9.4% to 28.3%, P < .001). The specificity was 90.2% for (18)F-FDG, 91.8% for (123)I-MIBG, and 90.2% for CT/MRI. (18)F-FDG uptake was higher in succinate dehydrogenase complex- and von Hippel-Lindau syndrome-related tumors than in multiple endocrine neoplasia type 2 (MEN2) related tumors. For metastases, sensitivity was greater for (18)F-FDG and CT/MRI than for (123)I-MIBG (sensitivity of (18)F-FDG = 82.5%; of (123)I-MIBG = 50.0%; of CT/MRI = 74.4%; (18)F-FDG vs (123)I-MIBG: difference = 32.5%, 95% CI = 22.3% to 42.5%, P < .001; CT/MRI vs (123)I-MIBG: difference = 24.4%, 95% CI = 11.3% to 31.6%, P < .001). For bone metastases, (18)F-FDG was more sensitive than CT/MRI (sensitivity of (18)F-FDG = 93.7%; of CT/MRI = 76.7%; difference = 17.0%, 95% CI = 4.9% to 28.5%, P = .013).ConclusionsCompared with (123)I-MIBG SPECT and CT/MRI, both considered gold standards for PPGL imaging, metastases were better detected by (18)F-FDG PET. (18)F-FDG PET provides a high specificity in patients with a biochemically established diagnosis of PPGL.

Dataset Information

Dual time point 18F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in primary breast cancer.

Publications

Dual time point <sup>18</sup>F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (<sup>18</sup>F-FDG PET/CT) in primary breast cancer.

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