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Nomogram using F-18 fluorodeoxyglucose positron emission tomography/computed tomography for preoperative prediction of lymph node metastasis in gastric cancer

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World Journal of Gastrointestinal Oncology 2020年第4期12卷 447-456页

作者： Bong-Il Song Department of Nuclear Medicine Keimyung University Dongsan HospitalKeimyung University School of MedicineDaegu 42601South Korea

BACKGROUND Lymph node(LN)metastasis is an important prognostic factor in patients with gastric cancer(GC).However,the evaluation of LN metastasis status in the preoperative setting is not ***,precise preoperative prediction of LN metastasis status is crucial for optimal treatment in patients with *** To develop a preoperative nomogram for LN metastasis using F-18 fluorodeoxyglucose(F-18 FDG)positron emission tomography/computed tomography(PET/CT)and preoperative laboratory test findings in *** In this study,the data of 566 GC patients who underwent preoperative F-18 FDG PET/CT and subsequent surgical resection were *** LN metastasis prediction model was developed in the training cohort and validated in the internal validation *** preoperative laboratory tests,including albumin and carbohydrate antigen(CA)19-9 were performed in all *** and multivariable logistic regression was performed to validate the preoperative predictive indicators for LN *** Of the 566 patients,232(41%)had confirmed histopathologic LN *** logistic regression revealed that the tumor location,blood hemoglobin,serum albumin levels,neutrophil to lymphocyte ratio,platelet to lymphocyte ratio,CA 19-9,maximum standardized uptake value(SUVmax)of the primary tumor(T_SUVmax),and SUVmax of LN(N_SUVmax)were significantly associated with LN *** multivariate analysis,T_SUVmax(OR=1.08;95%CI:1.02–1.15;P=0.011)and N_SUVmax(OR=1.49;95%CI:1.19–1.97;P=0.002)were found to be significant predictive factors for *** LN metastasis prediction model using T_SUVmax,N_SUVmax,serum albumin,and CA 19-9 yielded an area under the curve(AUC)of 0.733(95%CI:0.683–0.784,P=0.025)in the training cohort and AUC of 0.756(95%CI:0.678–0.833,P<0.001)in the test *** T_SUVmax and N_SUVmax measured by preoperative F-18 FDG PET/CT are independent predictive factors for LN metastasis in GC.

关键词： Gastric cancer Lymph node metastasis Positron emission tomography/computed tomography Fluorodeoxyglucose Prognostication Standardized uptake value

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Positron emission tomography/computed tomography imaging appearance of benign and classic “do not touch” osseous lesions

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World Journal of Radiology 2019年第6期11卷 81-93页

作者： Stacey M Elangovan Ronnie Sebro Department of Radiology University of Pennsylvania Philadelphia PA 19104 United States Department of Orthopedic Surgery University of Pennsylvania Philadelphia PA 19104 United States Department of Genetics University of Pennsylvania Philadelphia PA 19104 United States Department of Biostatistics Epidemiology and Informatics University of Pennsylvania Philadelphia PA 19104 United States

BACKGROUND Classic “do not touch” and benign osseous lesions are sometimes detected on 18-Ffluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) studies. These lesions are often referred for biopsy because the physician interpreting the PET/CT may not be familiar with the spectrum of 18F-FDG uptake patterns that these lesions display. AIM To show that “do not touch” and benign osseous lesions can have increased 18FFDG uptake above blood-pool on PET/CT;therefore, the CT appearance of these lesions should dictate management rather than the standardized uptake values (SUV). METHODS This retrospective study evaluated 287 independent patients with 287 classic “do not touch”(benign cystic lesions, insufficiency fractures, bone islands, bone infarcts) or benign osseous lesions (hemangiomas, enchondromas, osteochondromas, fibrous dysplasia, Paget’s disease, osteomyelitis) who underwent 18F-FDG positron emission tomography/computed tomography (PET/CT) at a tertiary academic healthcare institution between 01/01/2006 and 12/1/2018. The maximum and mean SUV, and the ratio of the maximum SUV to mean blood pool were calculated. Pearson’s correlations between lesion size and maximum SUV were calculated. RESULTS The ranges of the maximum SUV were as follows: For hemangiomas (0.95-2.99), bone infarcts (0.37-3.44), bone islands (0.26-3.29), enchondromas (0.46-2.69), fibrous dysplasia (0.78-18.63), osteochondromas (1.11-2.56), Paget’s disease of bone (0.93-5.65), insufficiency fractures (1.06-12.97) and for osteomyelitis (2.57- 12.64). The range of the maximum SUV was lowest for osteochondromas (maximum SUV 2.56) and was highest for fibrous dysplasia (maximum SUV of 18.63). There was at least one lesion that demonstrated greater 18F-FDG avidity than the blood pool amongst each lesion type, with the highest maximum SUV ranging from 9.34 times blood pool mean (osteomyelitis) to 1.42 times blood pool mean (hemangiomas). There was no correlation between th

关键词： Positron emission tomography/computed tomography Skeletal-axial Skeletal-appendicular “Do not touch” lesions

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Tumor characteristics of ductal carcinoma in situ of breast visualized on [F-18] fluorodeoxyglucose-positron emission tomography/computed tomography: Results from a retrospective study

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World Journal of Radiology 2016年第8期8卷 743-749页

作者： Tomoyuki Fujioka Kazunori Kubota Akira Toriihara Youichi Machida Kaori Okazawa Tsuyoshi Nakagawa Yukihisa Saida Ukihide Tateishi Department of Diagnostic Radiology Tokyo Medical and Dental University Department of Radiology Kameda Kyobashi Clinic Department of Breast Surgery Tokyo Medical and Dental University

AIM To clarify clinicopathological features of ductal carcinoma in situ(DCIS) visualized on [F-18] fluorodeoxyglucosepositron emission tomography/computed tomography(FDG-PET/CT).METHODS This study retrospectively reviewed 52 consecutive tumors in 50 patients with pathologically proven pure DCIS who underwent [F-18] FDG-PET/CT before surgery. [F-18] FDG-PET/CT was performed after biopsy in all patients. The mean interval from biopsy to [F-18] FDGPET/CT was 29.2 d. [F-18] FDG uptake by visual analysis and maximum standardized uptake value(SUVmax) was compared with clinicopathological ***[F-18] FDG uptake was visualized in 28 lesions(53.8%) and the mean and standard deviation of SUVmax was 1.63 and 0.90. On univariate analysis, visual analysis and the SUVmax were associated with symptomatic presentation(P = 0.012 and 0.002, respectively), palpability(P = 0.030 and 0.024, respectively), use of core-needle biopsy(CNB)(P = 0.023 and 0.012, respectively), ultrasound-guided biopsy(P = 0.040 and 0.006, respectively), enhancing lesion ≥ 20 mm on magnetic resonance imaging(MRI)(P = 0.001 and 0.010, respectively), tumor size ≥ 20 mm on histopathology(P = 0.002 and 0.008, respectively). However, [F-18] FDG uptake parameters were not significantly associated with age, presence of calcification on mammography, mass formation on MRI, presence of comedo necrosis, hormone status(estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2), and nuclear grade. The factors significantly associated with visual analysis and SUVmax were symptomatic presentation(P = 0.019 and 0.001, respectively), use of CNB(P = 0.001 and 0.031, respectively), and enhancing lesion ≥ 20 mm on MRI(P = 0.001 and 0.049, respectively) on multivariate *** Although DCIS of breast is generally non-avid tumor, symptomatic and large tumors(≥ 20 mm) tend to be visualized on [F-18] FDG-PET/CT.

关键词： Ductal carcinoma in situ Positron emission tomography Breast cancer [F-18] fluorodeoxyglucosepositron emission tomography/computed tomography

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Feasibility of prostatectomy without prostate biopsy in the era of new imaging technology and minimally invasive techniques

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World Journal of Clinical Cases 2019年第12期7卷 1403-1409页

作者： Nian-Zeng Xing Ming-Shuai Wang Qiang Fu Fei-Ya Yang Chang-Ling Li Ya-Jian Li Su-Jun Han Ze-Jun Xiao Hao Ping Department of Urology National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100021 China Institute of Urology Capital Medical University Department of Urology Beijing Chaoyang Hospital Capital Medical University Beijing 100020 China Department of Urology Shandong Provincial Hospital Jinan 250021 Shandong Province China Department of Urology Beijing Tongren Hospital Capital Medical University Beijing 100005 China

BACKGROUND Routinely, after receiving prostate specific antigen (PSA) testing and digital rectum examination, patients with suspected prostate cancer are required to undergo prostate biopsy. However, the ability of ultrasound-guided prostate biopsy to detect prostate cancer is limited. Nowadays, a variety of diagnostic methods and more sensitive diagnostic methods, such as multi-parameter prostate magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) can be applied clinically. Furthermore, laparoscopic/robot-assisted prostatectomy is also a safe and effective procedure for the treatment of benign prostatic hyperplasia. So maybe it is time to reconsider the necessary to perform prostate biopsy before radical prostatectomy. AIM To explore the feasibility of radical prostatectomy without prostate biopsy in the era of new imaging technology and minimally invasive techniques. METHODS From June 2014 to November 2018, 11 cases of laparoscopic radical prostatectomy without prostate biopsy were performed at the three tertiary medical centers involved in this study. All patients received prostate magnetic resonance imaging and prostate cancer was suspected, including six patients with positive 68Ga- PSMA PET/CT results. Laparoscopic radical prostatectomy and pelvic lymph node dissection were performed for all patients. RESULTS All surgeries were accomplished successfully. The mean age was 69 ± 7.7 year, the mean body mass index was 24.7 ± 1.6 kg/m2, the range of serum PSA was 4.3 to >1000 ng/mL, and the mean prostate volume was 40.9 ± 18.3 mL. The mean operative time was 96 ± 23.3 min, the mean estimated blood loss was 90 ± 90.9 mL, and the median duration of catheter placement was 14 d. The final pathology confirmed that all specimens were prostate cancer except one case of benign prostatic hyperplasia. No major complications occurred in 90 d postoperatively. CONCLUSION The current practice of

关键词： Prostate cancer Biopsy Prostatectomy Magnetic resonance imaging Prostate-specific membrane antigen positron emission tomography/computed tomography

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Surgical management of patients with bowel obstructions secondary to gastric cancer

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World Journal of Gastroenterology 2013年第28期19卷 4559-4567页

作者： Wen-Guang Wu Ping Dong Xiang-Song Wu Mao-Lan Li Qi-Chen Ding Lin Zhang Jia-Hua Yang Hao Weng Qian Ding Zhu-Jun Tan Jian-Hua Lu Jun Gu Ying-Bin Liu Laboratory of General Surgery Department of General Surgery Xinhua Hospital Affiliated to School of Medicine Shanghai Jiaotong University

AIM: To assess whole-body fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the management of small bowel obstructions (SBOs) secondary to gastric cancer and its role in treatment strategies. METHODS: The medical records of all of the patients who were admitted for an intestinal obstruction after curative resection for gastric cancer were retrospectively reviewed. PET/CT was performed before a clinical treatment strategy was established for each patient. The patients were divided into 2 groups: patients with no evidence of a tumor recurrence and patients with evidence of a tumor recurrence. Tumor recurrences included a local recurrence, peritoneal carcinomatosis or distant metastases. The primary endpoint was the 1-year survival rate, and other variables included patient demographics, the length of hospital stay, complications, and mortality. RESULTS: The median time between a diagnosis of gastric cancer and the detection of a SBO was 1.4 years. Overall, 31 of 65 patients (47.7%) had evidence of a tumor recurrence on the PET/CT scan, which was the only factor that was associated with poor survival. Open and close surgery was the main type of surgical procedure reported for the patients with tumor recurrences. R0 resections were performed in 2 patients, including 1 who underwent combined adjacent organ resection. In the group with no evidence of a tumor recurrence on PET/CT, bowel resections were performed in 7 patients, adhesiolysis was performed in 7 patients, and a bypass was performed in 1 patient. The 1-year survival curves according to PET/CT evidence of a tumor recurrence vs no PET/CT evidence of a tumor recurrence were significantly different, and the 1-year survival rates were 8.8% vs 93.5%, respectively. There were no significant differences (P = 0.71) in the 1-year survival rates based on surgical vs nonsurgical management (0% with nonoperative treatment vs 20% after exploratory laparotomy). CONCLUSION: 18 F-FDG PET/CT c

关键词： Positron emission tomography/computed tomography Small bowel obstructions Gastric cancer Clinical treatment strategy

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Clinical value of ^(18)F-FDG PET/CT in assessing suspicious relapse after rectal cancer resection

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World Journal of Gastrointestinal Oncology 2009年第1期1卷 55-61页

作者： Long Sun,Wei-Min Pan,Zuo-Ming Luo,Ji-Hong Wei,Long Zhao,Hua Wu,Minnan PET Center and Department of Nuclear Medicine,the First Hospital of Xiamen University,Xiamen 316003,Fujian Province,China Yong-Song Guan,State Key Laboratory of Biotherapy,West China Medical School,Sichuan University,Gaopeng Street,Keyuan Road 4,Chengdu 610041,Sichuan Province,China Long Sun Wei-Min Pan Zuo-Ming Luo Ji-Hong Wei Long Zhao Hua Wu Minnan PET Center and Department of Nuclear Medicine the First Hospital of Xiamen University Xiamen 316003 Fujian Province China.

AIM:To evaluate the value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT) in the restaging of resected rectal ***:From January 2007 to Sep 2008,21 patients who had undergone curative surgery resection for rectal carcinoma with suspicious relapse in conventional imaging or clinical findings were retrospectively enrolled in our *** patients underwent 28 PET/CT scans(two patients had two scans,one patient had three and one had four scans).Locoregional recurrences and/or distant metastases were confirmed by histological analysis or clinical and imaging ***:Final diagnosis was confirmed by histopathological diagnosis in 12 patients(57.1) and by clinical and imaging follow-up in nine patients(42.9).Eight patients had extrapelvic metastases with no evidence of pelvic *** patients had both pelvic recurrence and extrapelvic metastases,and two patients had pelvic recurrence only.18F-FDG PET/CT was negative in two patients and positive in 19 patients.18F-FDG PET/CT was true positive in 17 patients and false positive in *** accuracy of 18F-FDG PET/CT was 90.5,negative predictive value was 100,and positive predictive value was *** patients with perirectal recurrence underwent 18F-FDG PET/CT image guided tissue core biopsy.18F-FDG PET/CT also guided surgical resection of pulmonary metastases in three patients and monitored the response to salvage chemotherapy and/or radiotherapy in four ***:18F-FDG PET/CT is useful for evaluating suspicious locoregional recurrence and distant metastases in the restaging of rectal cancer after curative resection.

关键词： 18F-fluorodeoxyglucose Positron emission tomography/computed tomography Rectal cancer Follow-up Restaging Locoregional recurrence Distant metastases

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Role of FDG PET-CT in evaluation of locoregional nodal disease for initial staging of breast cancer

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World Journal of Clinical Oncology 2014年第5期5卷 982-989页

作者： Yiyan Liu Nuclear Medicine Service Department of RadiologyNew Jersey Medical School Newark NJ 07103 United States

Fluorodeoxyglucose positron emission tomography/computed tomography(FDG PET/CT) is not indicated or recommended in the initial staging of early breast cancer. Although it is valuable for detecting distant metastasis, providing prognostic information, identifying recurrence and evaluating response to chemotherapy, the role of FDG PET/CT in evaluating locoregional nodal status for initial staging of breast cancer has not yet been well-defined in clinical practice. FDG PET/CT has high specificity but compromised sensitivity for identifying axillary nodal disease in breast cancer. Positive axillary FDG PET/CT is a good predictor of axillary disease and correlates well with sentinel lymph node biopsy(SLNB). FDG PET/CT may help to identify patients with high axillary lymph node burden who could then move directly to axillary lymph node dissection(ALND) and would not require the additional step of SLNB. However, FDG PET/CT cannot replace SLNB or ALND due to unsatisfactory sensitivity. The spatial resolution of PET instruments precludes the detection of small nodal metastases. Although there is still disagreement regarding the management of internal mammary node(IMN) disease in breast cancer, it is known that IMN involvement is of prognostic significance, and IMN metastasis has been associated with higher rates of distant metastasis and lower overall survival rates. Limited clinical observationssuggested that FDG PET/CT has advantages over conventional modalities in detecting and uncovering occult extra-axillary especially IMN lesions with upstaging the disease and an impact on the adjuvant management.

关键词： Breast cancer Fluorodeoxyglucose positron emission tomography/computed tomography Locoregional nodal disease Axillary lymph node Internal mammary lymph node Axillary lymph node dissection Sentinel lymph node biopsy

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Nuclear medicine imaging in osteonecrosis of hip:Old and current concepts

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World Journal of Orthopedics 2017年第10期8卷 747-753页

作者： Kanhaiyalal Agrawal Sujit Kumar Tripathy Ramesh Kumar Sen S Santhosh Anish Bhattacharya Department of Nuclear Medicine All India Institute of Medical Sciences Department of Orthopedics All India Institute of Medical Sciences Department of Orthopedics Fortis Hospital Institute of Nuclear Imaging and Molecular Medicine Tamilnadu Government Multi Super Specialty Hospital Department of Nuclear Medicine PGI-MER

Osteonecrosis(ON) is caused by inadequate blood supply leading to bone death, which results in the collapse of the architectural bony structure. Femoral head is the most common site involved in ON. Magnetic resonance imaging(MRI) is a commonly used imaging modality to detect early ON. When MRI is inconclusive, bone scan is helpful in detecting ON during early phase of the disease. As newer nuclear medicine equipment, like single photon emission computed tomography/computed tomography(CT) and positron emission tomography/CT, are emerging in medical science, we review the role of these imaging modalities in ON of femoral head.

关键词： Osteonecrosis Avascular necrosis Bone scan Magnetic resonance imaging Photon emission computed tomography scan Single photon emission computed tomography/computed tomography

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Gastro-entero-pancreatic neuroendocrine tumors:Is now time for a new approach?

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World Journal of Clinical Oncology 2016年第2期7卷 131-134页

作者： Rossana Berardi Mariangela Torniai Agnese Savini Silvia Rinaldi Stefano Cascinu Department of Medical Oncology Università Politecnica delle Marche

Gastro-entero-pancreatic tumors(GEP-NETs) are rare neoplasms often characterized by an overexpression of somatostatin ***,radiolabeled somatostatin analogues have showed an increasing relevance both in diagnosis and treatment,especially in low-and intermediate-differentiated *** evidences have led to a growing development of new functional imaging techniques as 68 Ga-DOTATATE positron emission tomography/computed tomography(PET/CT) proved useful in the management of these *** these tumors have a heterogeneous behavior also modifying their aggressiveness through *** sometimes 18 F-fluorodeoxyglucose PET/CT appears to be more appropriate to obtain a better assessment of the *** to these considerations,the combination of different functional imaging techniques should be considered in the management of GEP-NETs patients allowing clinicians to choose the tailored therapeutic approach among available options.

关键词： 18F-fluorodeoxyglucose positron emission tomography/computed tomography Gastro-enteropancreatic neuroendocrine tumor 68Ga-DOTATATE positron emission tomography/computed tomography Diagnosis Imaging

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Role of advanced magnetic resonance imaging in the assessment of malignancies of the mediastinum

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World Journal of Radiology 2019年第3期11卷 27-45页

作者： Jordi Broncano Ana María Alvarado-Benavides Sanjeev Bhalla Antonio álvarez-Kindelan Constantine A Raptis Antonio Luna Cardiothoracic Imaging Unit Hospital San Juan de Dios Cardiothoracic Department Mallinckrodt Institute of Radiology Washington University in Saint Louis Thoracic Surgery Department Hospital Reina Sofía MR imaging Unit Clínica Las Nieves

In the new era of functional magnetic resonance imaging(MRI), the utility of chest MRI is increasing exponentially due to several advances, including absence of ionizing radiation, excellent tissue contrast and high capability for lesion characterization and treatment monitoring. The application of several of these diagnostic weapons in a multiparametric fashion enables to better characterize thymic epithelial tumors and other mediastinal tumoral lesions, accurate assessment of the invasion of adjacent structures and detection of pathologic lymph nodes and metastasis. Also, "do not touch lesions" could be identified with the associated impact in the management of those patients. One of the hotspots of the multiparametric chest MR is its ability to detect with acuity early response to treatment in patients with mediastinal malignant neoplasms. This has been related with higher rates of overall survival and progression free ***, in this review we will analyze the current functional imaging techniques available(18 F-Fluorodeoxiglucose positron emission tomography/computed tomography, diffusion-weighted imaging, dynamic contrast-enhanced MRI, diffusion tensor imaging and MR spectroscopy) for the evaluation of mediastinal lesions, with a focus in their correct acquisition and post-processing. Also, to review the clinical applications of these techniques in the diagnostic approach of benign and malignant conditions of the mediastinum.

关键词： Mediastinum Magnetic resonance Diffusion Perfusion ^18FFluorodeoxiglucose positron emission tomography/computed tomography Advanced imaging

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