Performance Evaluation of a Deep Learning System for Differential Diagnosis of Lung Cancer With Conventional CT and FDG PET/CT Using Transfer Learning and Metadata

In China, lung cancer is one of the leading causes of death among residents. Early diagnosis is of great significance for early interventional treatment and prolonging survival. PET/CT uses positron radiopharmaceuticals to observe the physiological and biochemical changes of the drug and its metabolites in the body and finally diagnoses the disease. 18F-FDG is a commonly used imaging agent, but its short isotopic half-life limits clinical high-throughput testing. This study retrospectively analyzed the imaging material of 100 lung cancer patients pathologically confirmed. Patients with lymph node metastasis were classified into the LM group ( n = 30 cases), and those with no lymph node metastasis were classified into the NLM group ( n = 70 cases). The results showed that MRI of superparamagnetic nanoferric oxide was better than diagnosis of lung cancer by the 18F-FDG PET/CT and had a high predictive power for lymph node metastasis. These turned out to be high-value lung cancer diagnosis of superparamagnetic nanoferric oxide MRI and high-capacity lymph node metastasis prediction of 18F-FDG PET/CT, which were worthy of implementation.

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Differential Diagnosis of Pulmonary Fungal Infection and Lung Cancer via 18F-FDG PET/CT: A Retrospective Study

10.21203/rs.3.rs-191078/v1 ◽

2021 ◽

Author(s):

Xin Feng ◽

Chunmei Deng ◽

Xiaofeng Li ◽

Ye Qiu ◽

Jiehua Deng ◽

...

Keyword(s):

Lung Cancer ◽

Differential Diagnosis ◽

Fungal Infection ◽

Fdg Pet ◽

Pathological Examination ◽

Imaging Features ◽

Antigen Test ◽

Fdg Uptake ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Background: There is limited evidence regarding the 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) characteristics of lung fungal (LF) infections with nodules or masses, which are often misdiagnosed as lung cancer (LC) with indications for surgery. We aimed to investigate the PET/CT findings of LF infections with nodules in comparison to those of LC and clarify the diagnostic value of 18F-FDG PET/CT in the differential diagnosis of LF infections.Methods: We enrolled 21 patients who presented with pulmonary nodules or masses on CT, were diagnosed with LF infections, and underwent PET/CT as the LF group and randomly selected 42 patients with LC diagnosed by pathology as the LC group. Clinical and PET/CT imaging data were statistically analyzed.Results: LC was the most common misdiagnosed disease in the LF group (52.38%). There were no significant differences in lung imaging features between the two groups. The levels of white blood cells, neutrophils, and IgG and the positive rates for fungal antigen test in the LF group were significantly higher than those in the LC group (P<0.05). Lung masses larger than 3 cm were more common in the LC group (P<0.05). Overall, 80.95% (17/21) of patients in the LF group showed increased 18F-FDG uptake. There were no significant between-group differences in the maximal standardized uptake value (SUVmax, 8.20 [2.70, 12.95] vs. 8.80 [7.00, 12.38]). In the LF group, eight, five, and eight patients had cryptococcal, Aspergillus, and Talaromyces marneffei infections, respectively, with no significant difference in SUVmax among them (5.10 [1.70, 14.40] vs. 8.20 [1.50, 8.20] vs. 8.50 [5.10, 11.30]). Conclusions: Both LF infection and LC can present with increased 18F-FDG uptake on PET/CT. Thus, it is difficult to distinguish between them according to lung PET/CT and CT manifestations. Patients presenting with pulmonary masses should also be suspected to have fungal infection, even those with an increased SUVmax and simultaneous lymph node and bone involvement; particular attention is needed for patients with abnormal inflammation indexes and fungal antigen test. We should be emphasized preoperative pathological examination and fungal etiology.

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Relation between [18F]-FDG-PET/CT and volume perfusion-CT in primary tumors and mediastinal lymph nodes of non-small cell lung cancer

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren ◽

10.1055/s-0033-1346385 ◽

2013 ◽

Vol 185 (S 01) ◽

Author(s):

W Sauter ◽

D Spira ◽

M Schulze ◽

C Pfannenberg ◽

J Hetzel ◽

...

Keyword(s):

Lung Cancer ◽

Fdg Pet ◽

Small Cell ◽

Perfusion Ct ◽

Mediastinal Lymph Nodes ◽

Small Cell Lung ◽

Primary Tumors ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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FDG PET/CT Radiomics Analyses of Lung Cancer Patients Treated With Immunotherapy

Case Medical Research ◽

10.31525/ct1-nct04007068 ◽

2019 ◽

Author(s):

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Fdg Pet ◽

Lung Cancer Patients ◽

Pet Ct ◽

Fdg Pet Ct

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Enhancing 18F-FDG-PET/CT analysis in lung cancer patients

Nuklearmedizin ◽

10.3413/nukmed-0763-15-08 ◽

2015 ◽

Vol 54 (06) ◽

pp. 247-254 ◽

Cited By ~ 1

Author(s):

A. Kapfhammer ◽

T. Winkens ◽

T. Lesser ◽

A. Reissig ◽

M. Steinert ◽

...

Keyword(s):

Lung Cancer ◽

Image Fusion ◽

Chest Wall ◽

Fdg Pet ◽

Ct Image ◽

Lung Cancers ◽

Pet Ct ◽

Peripheral Lung ◽

Fdg Pet Ct ◽

Tumour Infiltration

SummaryAim: To retrospectively evaluate the feasibility and value of CT-CT image fusion to assess the shift of peripheral lung cancers with/-out chest wall infiltration, comparing computed tomography acquisitions in shallow-breathing (SB-CT) and deep-inspiration breath-hold (DIBH-CT) in patients undergoing FDG-PET/ CT for lung cancer staging. Methods: Image fusion of SB-CT and DIBH-CT was performed with a multimodal workstation used for nuclear medicine fusion imaging. The distance of intrathoracic landmarks and the positional shift of tumours were measured using semitransparent overlay of both CT series. Statistical analyses were adjusted for confounders of tumour infiltration. Cutoff levels were calculated for prediction of no-/infiltration. Results: Lateral pleural recessus and diaphragm showed the largest respiratory excursions. Infiltrating lung cancers showed more limited respiratory shifts than non-infiltrating tumours. A large respiratory tumour-motility accurately predicted non-infiltration. However, the tumour shifts were limited and variable, limiting the accuracy of prediction. Conclusion: This pilot fusion study proved feasible and allowed a simple analysis of the respiratory shifts of peripheral lung tumours using CT-CT image fusion in a PET/CT setting. The calculated cutoffs were useful in predicting the exclusion of chest wall infiltration but did not accurately predict tumour infiltration. This method can provide additional qualitative information in patients with lung cancers with contact to the chest wall but unclear CT evidence of infiltration undergoing PET/CT without the need of additional investigations. Considering the small sample size investigated, further studies are necessary to verify the obtained results.

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PD-L1 expression correlation with metabolic parameters of FDG PET/CT and clinicopathological characteristics in non-small cell lung cancer

EJNMMI Research ◽

10.1186/s13550-020-00639-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Xiaodong Wu ◽

Yan Huang ◽

Qingping Zhao ◽

Lei Wang ◽

Xiao Song ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Fdg Pet ◽

Clinicopathological Characteristics ◽

Small Cell ◽

Metabolic Parameters ◽

Small Cell Lung ◽

Pet Ct ◽

Fdg Pet Ct

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Impact of [18F]FDG-PET and [18F]FLT-PET-Parameters in Patients with Suspected Relapse of Irradiated Lung Cancer

Diagnostics ◽

10.3390/diagnostics11020279 ◽

2021 ◽

Vol 11 (2) ◽

pp. 279

Author(s):

Tine N. Christensen ◽

Seppo W. Langer ◽

Gitte Persson ◽

Klaus Richter Larsen ◽

Annemarie G. Amtoft ◽

...

Keyword(s):

Lung Cancer ◽

Overall Survival ◽

Fdg Pet ◽

Tumor Volume ◽

High Dose ◽

Flt Pet ◽

Pet Ct ◽

Radiation Induced ◽

Fdg Pet Ct ◽

Induced Changes

Radiation-induced changes may cause a non-malignant high 2-deoxy-2-[18F]fluoro-d-glucose (FDG)-uptake. The 3′-deoxy-3′-[18F]fluorothymidine (FLT)-PET/CT performs better in the differential diagnosis of inflammatory changes and lung lesions with a higher specificity than FDG-PET/CT. We investigated the association between post-radiotherapy FDG-PET-parameters, FLT-PET-parameters, and outcome. Sixty-one patients suspected for having a relapse after definitive radiotherapy for lung cancer were included. All the patients had FDG-PET/CT and FLT-PET/CT. FDG-PET- and FLT-PET-parameters were collected from within the irradiated high-dose volume (HDV) and from recurrent pulmonary lesions. For associations between PET-parameters and relapse status, respectively, the overall survival was analyzed. Thirty patients had a relapse, of these, 16 patients had a relapse within the HDV. FDG-SUVmax and FLT-SUVmax were higher in relapsed HDVs compared with non-relapsed HDVs (median FDG-SUVmax: 12.8 vs. 4.2; p < 0.001; median FLT-SUVmax 3.9 vs. 2.2; p < 0.001). A relapse within HDV had higher FDG-SUVpeak (median FDG-SUVpeak: 7.1 vs. 3.5; p = 0.014) and was larger (median metabolic tumor volume (MTV50%): 2.5 vs. 0.7; 0.014) than the relapsed lesions outside of HDV. The proliferative tumor volume (PTV50%) was prognostic for the overall survival (hazard ratio: 1.07 pr cm3 [1.01–1.13]; p = 0.014) in the univariate analysis, but not in the multivariate analysis. FDG-SUVmax and FLT-SUVmax may be helpful tools for differentiating the relapse from radiation-induced changes, however, they should not be used definitively for relapse detection.

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