A Prospective Study Comparing the Role of 18 FDG PET-CT with Contrast-Enhanced Computed Tomography and Tc99m Bone Scan for Staging Locally Advanced Breast Cancer

Author(s):  
Sandeep Bhoriwal ◽  
S. V. S. Deo ◽  
Rakesh Kumar ◽  
Sanjay Thulkar ◽  
Ajay Gogia ◽  
...  



2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Chien-shan Cheng ◽  
Wei Liu ◽  
Liangping Zhou ◽  
Wei Tang ◽  
Ailing Zhong ◽  
...  

Introduction. Contrast-enhanced computed tomography (CECT) imaging is commonly used to assess pancreatic adenocarcinoma (PAC). However, the value of semiquantitative and quantitative assessments of CECT parameters used to predict survival in PAC remains unknown. This study aims to investigate the prognostic role of pretreatment CECT imaging in patients with locally advanced pancreatic adenocarcinoma (LAPAC). Materials and Methods. From June 2013 to May 2017, eighty-six newly diagnosed patients with pathologically and radiologically confirmed LAPAC were retrospectively recruited. All patients were evaluated by CECT and experienced gemcitabine-based chemotherapy. The relationship between overall survival (OS) and clinical factors including age, sex, serum carbohydrate antigen 19-9 value, and CECT findings (including tumour location, tumour volume, peripancreatic involvement, blood vessel involvement, tumour enhanced rate, and distance liver metastasis) was determined using Cox proportional hazard regression models, and a nomogram was constructed for the prediction of 1- and 1.5-year survival rates of patients with LAPAC. Results. On univariate analysis, patients who had a tumour enhanced rate (TER) less than 80.465% and those who had a TER ≥ 80.465% are with a 3.587-fold increase in OS (p<0.001). After multivariate Cox regression, a nomogram was established based on a new model containing the predictive variables of high Ca19-9 level, higher clinical stages, larger tumour volume, the presence of peripancreatic involvement, and liver metastases. The model displayed good accuracy in predicting OS with a C-index of 0.614. The calibration plots also showed a good discrimination and calibration of the nomogram between the predicted and observed survival probabilities. Conclusion. Our results showed that TER can be used to predict survival in LAPAC, and we developed a nomogram for determining the prognosis of patients with LAPAC. However, the purposed nomogram still requires external data verification in future applications.



2013 ◽  
Vol 34 (6) ◽  
pp. 557-561 ◽  
Author(s):  
Kuruva Manohar ◽  
Bhagwant R. Mittal ◽  
Amit Bhoil ◽  
Anish Bhattacharya ◽  
Gurpreet Singh




Author(s):  
Nagarjuna Burela ◽  
Tej Prakash Soni ◽  
Nidhi Patni ◽  
JK Bhagat ◽  
T Senthil Kumar ◽  
...  

<p>Accurate tumor diagnosis is important in highly conformal techniques such as Intensity Modulated Radiotherapy (IMRT), which aims for high therapeutic ratio. We compared Gross Tumor Volume (GTV) (primary and nodal) delineated on <sup>18</sup>F-fluorodeoxyglucose positron emission tomography ([<sup>18</sup>F]-FDG-PET) scan to those delineated on contrast-enhanced computed tomography (CECT) scan and its impact on staging treated by IMRT.<strong> </strong>A total of 30 consecutive patients with locally advanced squamous cell carcinoma of head and neck were included in this study. FDG-PET and CECT scans were performed with dedicated positron emission tomography–computed tomography (PET/CT) scanner in a single session as part of radiotherapy treatment planning for IMRT. After treatment with concurrent chemoradiotherapy, all patients were followed for one year. Three out of 30 patients were excluded from the final analysis, as there was complete remission in PET/CT after neoadjuvant chemotherapy. For remaining 27 cases, the primary sites were 17 oropharynx, 2 hypopharynx, 7 larynx and 1 unknown primary with secondary neck node. PET–CT resulted in changes of CT-based staging in 25% patients (up-staged in 3 and down-staged in 4). GTV delineated on PET vs CT scan was GTV-PET (primary) of 20.15 cm<sup>3</sup> vs GTV-CT (primary) of 18.75 cm<sup>3</sup>, <em>p</em> = 0.803; and GTV-PET (nodes) of 28.45 cm<sup>3</sup> vs GTV-CT (nodes) of 21.56 cm<sup>3</sup>, <em>p</em> = 0.589. The mismatch between two target volumes was statistically insignificant (<em>p</em> = 0.635 for GTV primary, <em>p</em> = 0.187 for nodes). The mean GTV-PET outside CT for primary was 5.83 cm<sup>3</sup>, and for node was 8.47 cm<sup>3</sup>. Median follow-up was 12 months. One-year loco-regional control was 92%. The target delineation of GTV can be improved with functional imaging [<sup>18</sup>F]-FDG-PET/CT.</p>





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