AIM: This study aimed to investigate the relationship between PET and CT parameters and sarcopenia, adipose tissue, and tumor metabolism in esophageal carcinoma (EC) and its impact on survival in EC. METHOD: Our study in...AIM: This study aimed to investigate the relationship between PET and CT parameters and sarcopenia, adipose tissue, and tumor metabolism in esophageal carcinoma (EC) and its impact on survival in EC. METHOD: Our study included 122 EC patients who underwent PET/CT for staging. Muscle and adipose tissue characteristics were evaluated, including lumbar (L3) and cervical (C3) muscle areas, psoas major (PM) and sternocleidomastoid muscle (SCM) parameters, and PET parameters for visceral and subcutaneous adipose tissue (SAT). Sarcopenia was determined using CT images, with a threshold for muscle tissue at the L3 vertebral level, and its impact on overall survival (OS) was investigated. RESULTS: Sarcopenia was detected in 48 patients. SULmax in the primary tumor (PT) was significantly higher in sarcopenic patients (SP). The frequency of distant metastasis was higher in SP and OS was significantly lower. In the locally advanced stage, sarcopenia status decreased survival. L3, PM, C3, and SCM muscle areas were highly correlated. Subcutaneous adipose tissue SUVmax was significantly increased in SP and those with distant metastasis. Univariate analysis identified PT SULmax, PT SUVmean, PT TLG, lymph node and distant metastasis, SAT SUVmax, and sarcopenia as poor prognostic factors, while multivariate analysis confirmed BMI, distant metastasis, PT SUVmean, PT TLG as independent predictors of OS. CONCLUSION: This study demonstrated that sarcopenia, linked to reduced survival, correlates with primary tumor SULmax, distant metastasis, and subcutaneous tissue PET parameters, exerting a notable impact on survival, particularly in locally advanced stages. Attenuation-corrected CT can be used instead of diagnostic CT, and sarcopenia can be diagnosed using not only L3 but also C3 slices.
Latin America (LA) is one of the regions in the world with the highest levels of overweight, dyslipidemia, and diabetes mellitus, which, together with smoking and high blood pressure, are common risk factors for cardiova...Latin America (LA) is one of the regions in the world with the highest levels of overweight, dyslipidemia, and diabetes mellitus, which, together with smoking and high blood pressure, are common risk factors for cardiovascular and oncological diseases. Chemotherapy (CT) and Radiotherapy (RT) have become two of the mainstays of treatment for several types of cancer. One of the most worrisome side effects generated by CT and RT is cardiotoxicity. There are several imaging techniques in cardiology that can inform the presence of underlying disease, but they differ in their availability and access to the masses, their accuracy and repeatability, all of which are important determinants of the applicability of these techniques in routine clinical practice. Thus, it is mandatory to promote a clinically effective and a cost-effective multimodality approach for risk stratification, diagnosis and management of cardiovascular diseases in oncologic patients. The purpose of this review is to inform cardiologists, oncologists, cardio-oncologists and imaging cardiologists on the cardiac imaging modalities that can be applied in patients with cancer, the differences among imaging techniques and recommendations on how to apply them in LA.
OBJECTIVE: The aim of this study is to analyze the correlation between [18F]-FDG PET/CT (positron emission tomography/computed tomography) findings and pathological subtypes of lung adenocarcinoma with ground-glass opaci...OBJECTIVE: The aim of this study is to analyze the correlation between [18F]-FDG PET/CT (positron emission tomography/computed tomography) findings and pathological subtypes of lung adenocarcinoma with ground-glass opacity (GGO). MATERIALS AND METHODS: 88 patients were included in this study, which underwent [18F]-FDG PET/CT and were finally diagnosed with lung adenocarcinoma. A total of 90 GGO lesions were analyzed. The size and SUV of all lesions were measured, the proportion of solid components of GGO in lesions was calculated, and quantitative classification was performed. The above GGO lesions were divided into three groups based on the 2011 IASLC/ATS/ERS lung adenocarcinoma pathological classification, namely good prognosis group, relatively good prognosis group and poor prognosis group. Chi-square test, independent sample t test, and analysis of variance were used for statistical analysis. RESULTS: There was a negative correlation between the SUV and quantitative classification value (r = -0.638, P < 0.001). Atypical adenomatous hyperplasia (AAH), acinar predominant adenocarcinoma (APA), lepidic predominant adenocarcinoma (LPA), papillary predominant adenocarcinoma (PPA), and solid predominant adenocarcinoma (SPA) had significant differences in GGO lesion size, SUV, and quantitative classification value (F = 3.849, P = 0.019; F = 27.420, P < 0.001; F = 4.353, P = 0.002). There were significant differences in GGO lesion size, SUV, and quantitative classification value among the good prognosis group, relatively good prognosis group, and poor prognosis group (F = 5.626, P = 0.011; F = 37.587, P < 0.001; F = 5.119, P = 0.008). CONCLUSION: GGO lesion size, SUV, and quantitative classification value are correlated with different pathological subtypes and can be used toevaluate the prognosis of lung adenocarcinoma with GGO.
Mínguez Gabiña P, Monserrat Fuertes T, Santos Zorrozua B
… +6 more, Esteban Figueruelo A, Astudillo Sarmiento MA, Peña Fuentes A, Vinagre Pérez I, Rodeño Ortiz de Zarate E, Fernández Tercero IL
PURPOSE: The main objectives were to study differences between the first and the fourth cycle in dosimetry variables in patients treated for neuroendocrine tumours with four cycles of [Lu]Lu-DOTA-TATE, as well as to look...PURPOSE: The main objectives were to study differences between the first and the fourth cycle in dosimetry variables in patients treated for neuroendocrine tumours with four cycles of [Lu]Lu-DOTA-TATE, as well as to look for absorbed dose-effect correlations aiming to help individualise and optimise this therapy for future patients. MATERIAL AND METHODS: SPECT/CT based dosimetry of tumour lesions and kidneys was performed in the first and the fourth cycles of the [Lu]Lu-DOTA-TATE treatments for 17 patients from 2020 to 2023. Clinical variables of interest were collected in order to look for correlations with some dosimetry variables. Statistical analysis was performed using the R software. RESULTS: Regarding dosimetry variables, for lesions a significant decrease in absorbed dose, mass and initial activity between the first and fourth cycles was observed. For kidneys, a significant increase in absorbed dose was observed. Effective decay constants did not significantly change neither for lesions nor for kidneys. The relative decrease in lesion masses correlated with their total absorbed dose. Total absorbed doses to kidneys were well below the toxicity limits mostly used in this therapy. Relative decrease in lesion absorbed doses was significantly lower for tumour primary sites in ileum and jejunum compared to those in pancreas. Moreover, radiological response correlated with clinical response. CONCLUSIONS: The results seem to indicate that the current treatment scheme could be optimised in order to obtain better treatment outcomes.
INTRODUCTION AND OBJECTIVES: Tissue attenuation reduces the specificity of the myocardial perfusion imaging single photon emission tomography (SPECT), which leads reduced diagnostic accuracy. The aim of this study is to...INTRODUCTION AND OBJECTIVES: Tissue attenuation reduces the specificity of the myocardial perfusion imaging single photon emission tomography (SPECT), which leads reduced diagnostic accuracy. The aim of this study is to compare performances of non-attenuation corrected (NAC), computed tomography based-attenuation corrected (AC) and prone images for qualitative and semi-quantitative analysis of myocardial perfusion SPECT in diagnosis of coronary artery disease (CAD). MATERIALS AND METHODS: Eightysix patients in whom NAC, AC and prone images were obtained with SPECT, and whose coronary angiography/CT coronary angiography was completed within 3 months, were retrospectively studied. Myocardial perfusion scintigraphy was performed using SPECT/CT dual-headed gamma camera. Images were evaluated qualitatively and semi-quantitatively using 20-segment model. Analyzes of global myocardium and LAD, RCA, Cx vascular areas as regional analysis were performed. In qualitative evaluation, if SPECT study was abnormal, relevant coronary artery area was recorded. Quantitative Perfusion SPECT (QPS) program was used in semi-quantitative analysis; SSS (Summed Stress Score) ≥ 4 was accepted for presence of CAD in per-patient analysis. In regional analysis SSS ≥ 2 was taken into account. Coronary angiography/CT coronary angiography was used as gold standard. Threshold value was determined as ≥50% and above luminal diameter narrowing. While AC and NAC methods were compared for per-patient analysis and each vascular area; 3 imaging methods including prone acqusition, were compared for the RCA area. Diagnostic performances of the methods were evaluated by comparing the areas under the curve with ROC analysis. RESULTS: In visual evaluation, sensitivity of AC was significantly lower than NAC in analyzes of per-patient, RCA and Cx areas (global 76.92% vs 86.15%, RCA 60.87% vs 82.61%, Cx 58.97% vs 69.23%, respectively; p < 0.05). Sensitivity of prone imaging was significantly higher than AC in analysis of the RCA area (76.09% vs 60.87%, respectively; p < 0.05) Specificity values were higher in analyzes of global, RCA and Cx areas in AC than in NAC method; this difference was significant in RCA and Cx areas (RCA 70% vs 42.50%, Cx 85.11% vs 70.21%, respectively; p < 0.05). In semi-quantitative evaluation, AC and NAC had similar sensitivity and specificity in global and regional analyzes; in RCA area, no significant difference was detected between the 3 methods. In ROC analysis, no significant difference was detected between methods in per-patient and regional analyzes both in visual and semi-quantitative evaluation. CONCLUSIONS: CT-based attenuation correction increases specificity, but reduces sensitivity in the diagnosis of CAD in regional areas of RCA and Cx. Prone imaging remains important in evaluation of RCA area.
OBJECTIVE: Overexpression of Human Epidermal Growth Factor Receptor 2 (HER2) is thought to be more aggressive in gastric cancer. This study aimed to evaluate the predictability of HER2 status and other prognostic patholo...OBJECTIVE: Overexpression of Human Epidermal Growth Factor Receptor 2 (HER2) is thought to be more aggressive in gastric cancer. This study aimed to evaluate the predictability of HER2 status and other prognostic pathologic parameters using [F]FDG PET/CT and to investigate its impact on survival. METHODS: Pretreatment metabolic parameters measured by [F]FDG PET/CT as a prognostic factor were retrospectively evaluated in 117 HER2-analysed patients. The relationship between pathological data, tumor metabolic characteristics, and distant metastases was examined, and the effect on survival was investigated. RESULTS: Among the 117 patients, 17.1% were HER2-positive (HER2+), and 82.9% were HER2-negative (HER2-). There was no significant association between PET/CT parameters in the HER2+ and HER2- patient groups. HER2+ patients had higher 1- and 3-year survival expectations than HER2- patients (80%-%37.9; %47.5-%20; respectively). There was no statistically significant difference in overall survival. In Cox-regression analysis, while the presence of vascular invasion, local invasion, and distant metastasis were poor prognostic factors, HER2 was not a prognostic factor. Vascular invasion and local invasion (T3/T4) were also associated with higher SUVmax values. Patients with distant metastases had significantly higher SUVmax, SUVmean, and TLG. CONCLUSION: This study showed no association between HER2 expression and [F]FDG PET/CT metabolic parameters. However, regardless of HER2 status, the results indicated distant metastasis, local invasion, and vascular invasion could be associated with primary tumor metabolism. PET/CT parameters predict tumor aggressiveness and disease prognosis better than HER2 status.
F-FDG PET/CT has been positioned over time as a useful tool in the evaluation of osteoarticular infections, overcoming conventional explorations like MRI or bone scintigraphy in some indications. Its ability to provide f...F-FDG PET/CT has been positioned over time as a useful tool in the evaluation of osteoarticular infections, overcoming conventional explorations like MRI or bone scintigraphy in some indications. Its ability to provide functional and anatomical images simultaneously and its excellent resolution contributes to a more precise and personalised approach in the treatment of osteoarticular diseases such as spondylodiscitis. In addition, it has proven valuable in patients with suspected infection that is complex to diagnose or treat, improving detection in subclinical stages. However, some limitations have been identified, such as difficulty in the differential diagnosis of infection vs. inflammation (as in diabetic foot) or in the interpretation of patients with osteosynthesis materials. In this manuscript, we present a brief review providing general and practical information about the role of F-FDG PET/CT in infectious osteoarticular pathology, while part 2 discusses the role of F-FDG PET/CT in osteoarticular inflammation.
PURPOSE: Colorectal adenomas (CRAs) are at a higher risk of progressing to colorectal cancer (CRC) as their histological grade increases. Herein, this study investigated the relationship between the maximum standardized...PURPOSE: Colorectal adenomas (CRAs) are at a higher risk of progressing to colorectal cancer (CRC) as their histological grade increases. Herein, this study investigated the relationship between the maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose positron emission tomography-computed tomography (F-FDG PET/CT) and the histological grades of CRAs and constructed the optimal regression model for distinguishing between different histological grades. METHODS: This study retrospectively analyzed the data of 153 patients with CRAs who had colorectal F-FDG uptake incidentally found on PET/CT. The patients were categorized into low-grade intraepithelial neoplasia (LGIN) and high-grade intraepithelial neoplasia (HGIN) groups based on their histological grade. After the analysis of the relationship between SUVmax measured on preoperative F-FDG PET/CT scans and histological grades, receiver-operating characteristic (ROC) curves were analyzed to determine the optimal cut-off values for distinguishing between the two groups. Common clinical and pathological factors were included and subjected to univariate and multivariate logistic regression analyses to identify independent risk factors. A diagnostic model integrating SUVmax and several risk factors was developed with the multivariate logistic regression analysis. RESULTS: SUVmax was significantly different between the two groups (P < 0.001) and increased with an elevation in the malignancy degree. The area under the ROC curve (AUC) for identifying LGIN and HGIN was 0.796, and the AUC of the combination model was 0.822. Furthermore, SUVmax was an independent risk factor for distinguishing between different histological grades in pairwise comparisons. CONCLUSION: The regression model involving SUVmax on F-FDG PET/CT can distinguish between histological grades of CRAs, which therefore can be used as a noninvasive tool for the accurate diagnosis of CRAs and assist in developing patient-specific treatment strategies before surgery.
UNLABELLED: The characterization of pulmonary nodules (PN) is a primary indication for [F]-FDG PET/CT. However, respiratory movements hinder this characterization, especially for PN located in the lower lobes. Various me...UNLABELLED: The characterization of pulmonary nodules (PN) is a primary indication for [F]-FDG PET/CT. However, respiratory movements hinder this characterization, especially for PN located in the lower lobes. Various methods have been developed to improve image resolution. OBJECTIVE: Our objective was to compare the diagnostic efficacy of [F]-FDG PET/CT in deep inspiration breath-hold (DIBH) versus free-breathing corrected by software, in the evaluation of PN. METHODS: We prospectively analyzed 51 patients to assess PN using [F]-FDG PET/CT in DIBH and free-breathing corrected by software. A total of 84 nodules with an average size of 10 mm were analyzed, with pathological anatomy or medical treatment decide by a multidisciplinary tumor board used as reference. RESULTS: A total of 84 PN were evaluated, comparing those in DIBH versus free-breathing, finding statistically significant differences in SUVmax values P(< 0.05) (mean SUVmax 3.7 in free-breathing vs. 5.33 in DIBH). When analyzed by location in lobes, we did not find statistically significant differences, though there was a trend towards higher SUVmax values in the lower lobes. [F]-FDG PET/CT in DIBH showed high sensitivity (95%) and negative predictive value (NPV) (92%), indicating it may be a promising tool for PN characterization. CONCLUSIONS: The acquisition of [F]-FDG PET/CT in DIBH significantly improves the sensitivity and diagnostic efficacy in the assessment of PN. Although no statistically significant differences were found based on location, there is a potential benefit for the lower lobes. These findings could support its use in clinical practice.
OBJECTIVE: To evaluate the diagnostic accuracy of [Ga]Ga-PSMA-11 PET/CT (PET-PSMA) in local and loco-regional nodal staging compared with histopathological results in intermediate- and high-risk prostate cancer patients...OBJECTIVE: To evaluate the diagnostic accuracy of [Ga]Ga-PSMA-11 PET/CT (PET-PSMA) in local and loco-regional nodal staging compared with histopathological results in intermediate- and high-risk prostate cancer patients treated with radical prostatectomy (RP) and pelvic lymph node dissection (PLND). MATERIALS Y METHODS: A total of 122 intermediate- and high-risk prostate cancer (PCa) patients staged with PET-PSMA and treated with RP (36/122) and RP plus PLND (86/122) from December 2018 to December 2023 were included. Visual and semiquantitative analysis findings using the SUVmax of the molecular imaging were correlated with histopathological results. RESULTS: The primary tumor was visible by PET-PSMA in 96.7% of the patients. A positive correlation was found between PSA levels and SUVmax (Spearman's r: 0.303, p < 0.001). PET-PSMA detected nodal involvement in 25/89 patients (28.08%). The sensitivity, specificity, and diagnostic accuracy of PET-PSMA for detecting nodal involvement were 75%, 82.2%, and 80.9%, respectively. Patients with PSA levels >20 ng/mL, Gleason score ≥7b, ISUP grade >2, and extracapsular extension showed significantly higher SUVmax values. No differences were observed in SUVmax between risk groups or in other histopathological variables. CONCLUSIONS: PET-PSMA is an effective tool for the initial staging of intermediate- and high-risk PCa. SUVmax values were significantly higher in patients with unfavorable clinical features.
BACKGROUND AND OBJECTIVES: To assess the feasibility of performing selective parathyroidectomy without intraoperative parathyroid hormone (PTHio) determination when first-line preoperative localization tests (ultrasonogr...BACKGROUND AND OBJECTIVES: To assess the feasibility of performing selective parathyroidectomy without intraoperative parathyroid hormone (PTHio) determination when first-line preoperative localization tests (ultrasonography and [Tc]Tc-MIBI) are negative and/or discordant, and second-line [F]F-Colina PET-CT, is positive. MATERIALS AND METHODS: Retrospective cohort study, including patients with negative or discordant ultrasound and MIBI scans and positive [F]F-Colina PET-CT, who underwent selective parathyroidectomy between 2019 and 2022. Groups were compared based on PTHio determination. Study variables were: gender, mean age, biochemical cure assessed by PTH value (pg/mL) and corrected calcium by albumin (mg/dL) at 6 months post-surgery follow-up, and histopathological analysis. RESULTS: The final sample included 42 patients. At 6 months post-surgery, in the PTHio group (20 patients), PTH values were 64.50 pg/mL and calcium 9.30 pg/mL, with 19 adenomas and 1 hyperplasia found. In the non-PTHio group (22 patients), PTH values were 61 pg/mL and calcium 9.37 pg/mL, with 22 adenomas found. No statistically significant differences were found between both groups. CONCLUSIONS: Based on the results obtained in our patient cohort, selective parathyroidectomy could be considered with negative or discordant first-line tests and positive [F]F-Colina PET-CT, without intraoperative PTH determination.