scholarly journals A Head-to-Head Comparison of 68Ga-DOTA-FAPI-04 and 18F-FDG PET/MR in Patients with Nasopharyngeal Carcinoma: A Prospective Study

2021 ◽  
Author(s):  
Chunxia Qin ◽  
Fang Liu ◽  
Jing Huang ◽  
Weiwei Ruan ◽  
Qingyao Liu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Nasopharyngeal Carcinoma ◽  
Lymph Nodes ◽  
Skull Base ◽  
Primary Tumor ◽  
Fdg Pet ◽  
Distant Metastases ◽  
Tracer Uptake ◽  
Visual Evaluation ◽  
Primary Tumors

Abstract PurposeTo conduct a head-to-head comparison of the diagnostic ability of 68Ga-DOTA-FAPI-04 (68Ga-FAPI) and 18F-FDG PET/MR in nasopharyngeal carcinoma (NPC) patients.MethodsPatients diagnosed with NPC were prospectively enrolled. All patients underwent head-and-neck 68Ga-FAPI PET/MR and 18F-FDG PET/MR within one week. Primary tumor, lymph node numbers, and tracer uptake were compared by SUVmax and visual evaluation. The primary tumor volumes derived from 68Ga-FAPI, 18F-FDG PET, and MRI were also compared.ResultsFifteen patients were enrolled from June to August 2020. Both 68Ga-FAPI and 18F-FDG PET had 100% detection rate of the primary tumor. The 68Ga-FAPI SUVmax of primary tumors (13.87±5.13) was lower than that of 18F-FDG (17.73±6.84), but the difference was not significant (p=0.078). Compared with 18F-FDG, 68Ga-FAPI PET improved the delineation of skull-base invasion in eight out of eight patients and intracranial invasion in four out of four patients. When 25%SUVmax of 68Ga-FAPI or 20%SUVmax of 18F-FDG was utilized as a threshold for determining tumor volume, it was highly consistent with MRI. 18F-FDG PET detected much more positive lymph nodes than 68Ga-FAPI (100 vs 48). The SUVmax of 48 paired lymph nodes was significantly lower on 68Ga-FAPI than 18F-FDG (8.67±3.88 vs 11.79±6.17, p<0.001). Additionally, 68Ga-FAPI further detected four highly suspected small, distant metastases in three patients. Compared with 18F-FDG, 68Ga-FAPI changed overall staging in six of fifteen patients, with three patients being up-staged, and three down-staged.Conclusion68Ga-FAPI outperforms 18F-FDG in delineating the primary tumor and detecting suspected distant metastases, particularly in the evaluation of skull-base and intracranial invasion, suggesting 68Ga-FAPI hybrid PET/MR has the potential to serve as a single-step staging modality for patients with NPC. However, its value regarding lymph node and distant metastases evaluation needs further study.Trial registration: NCT04554719. Registered September 8, 2020 - retrospectively registered, http://clinicaltrails.gov/show/ NCT04554719

scholarly journals Origins of lymphatic and distant metastases in human colorectal cancer

Science ◽  
2017 ◽  
Vol 357 (6346) ◽  
pp. 55-60 ◽  
Author(s):  
Kamila Naxerova ◽  
Johannes G. Reiter ◽  
Elena Brachtel ◽  
Jochen K. Lennerz ◽  
Marc van de Wetering ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Phylogenetic Trees ◽  
Evolutionary Relationship ◽  
Distant Metastases ◽  
Human Colorectal Cancer ◽  
Regional Lymph Nodes ◽  
Primary Tumors

The spread of cancer cells from primary tumors to regional lymph nodes is often associated with reduced survival. One prevailing model to explain this association posits that fatal, distant metastases are seeded by lymph node metastases. This view provides a mechanistic basis for the TNM staging system and is the rationale for surgical resection of tumor-draining lymph nodes. Here we examine the evolutionary relationship between primary tumor, lymph node, and distant metastases in human colorectal cancer. Studying 213 archival biopsy samples from 17 patients, we used somatic variants in hypermutable DNA regions to reconstruct high-confidence phylogenetic trees. We found that in 65% of cases, lymphatic and distant metastases arose from independent subclones in the primary tumor, whereas in 35% of cases they shared common subclonal origin. Therefore, two different lineage relationships between lymphatic and distant metastases exist in colorectal cancer.

Primary Tumor Site, Size, Patients Age and Axillary Lymph Nodes in Breast Cancers

1986 ◽  
Vol 72 (3) ◽  
pp. 259-265 ◽  
Author(s):  
Salvatore Toma ◽  
Stefano Bonassi ◽  
Riccardo Puntoni ◽  
Guido Nicolò
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Lymph Node Involvement ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancers ◽  
Primary Tumor Site ◽  
Primary Tumors ◽  
Node Involvement

This study considers the correlations between some characteristics of the primary tumor and level of lymph node involvement in 185 primary breast cancers. The average number of lymph nodes was higher in N + women than in N— women. Primary tumors with a diameter of more than 4 cm yielded the highest mean number of lymph nodes (17.5). The risk of developing lymph node metastases was fourfold in tumors with a diameter greater than 2 cm when compared to those with a diameter less than or equal to 2 cm. The most commonly metastasized lymph node level, in both large and small tumors, was the first; however, one-fifth of the patients had simultaneous lymph node metastasis in all three axillary levels. Although the left breast was the most affected (58.9 %), there was no evidence of a different risk of metastasis between the two breasts; 34.1 % of the tumors were multifocal. Lymph node involvement was higher in women under 50 years of age with a primary tumor larger than 2 cm.

scholarly journals Mitochondrial DNA alteration in primary and metastatic colorectal cancer: Different frequency and association with selected clinicopathological and molecular markers

Tumor Biology ◽  
2017 ◽  
Vol 39 (3) ◽  
pp. 101042831769224 ◽  
Author(s):  
Britta Kleist ◽  
Thuja Meurer ◽  
Micaela Poetsch
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Microsatellite Instability ◽  
Metastatic Colorectal Cancer ◽  
Lymph Node Metastases ◽  
Primary Tumor ◽  
Distant Metastases ◽  
Primary Tumors ◽  
Node Metastases ◽  
Mitochondrial Microsatellite Instability

This study attempts to determine whether primary tumor tissue could reliably represent metastatic colorectal cancer in therapy-guiding analysis of mitochondrial microsatellite instability. Therefore, we investigated the concordance of microsatellite instability in D310, D514, and D16184 (mitochondrial DNA displacement loop), and its association with selected clinical categories and KRAS/NRAS/BRAF/PIK3CA/TP53 mutation status between primary and metastatic colorectal cancer tissue from 119 patients. Displacement loop microsatellite instability was significantly more frequently seen in lymph node metastases (53.1%) compared to primary tumors (37.5%) and distant metastases (21.4%) ( p = 0.0183 and p = 0.0005). The discordant rate was significantly higher in lymph node metastases/primary tumor pairs (74.6%) than in distant metastases/primary tumor pairs (52.4%) or lymph node metastases/distant metastases pairs (51.6%) ( p = 0.0113 and p = 0.0261) with more gain (86.7%) than loss (61.1%) of microsatellite instability in the discordant lymph node metastases ( p = 0.0024). Displacement loop instability occurred significantly more frequently in lymph node metastases and distant metastases of patients with early colorectal cancer onset age <60 years ( p = 0.0122 and p = 0.0129), was found with a significant high rate in a small cohort of TP53-mutated distant metastases ( p = 0.0418), and was associated with TP53 wild-type status of primary tumors ( p = 0.0009), but did not correlate with KRAS, NRAS, BRAF, or PIK3CA mutations. In conclusion, mitochondrial microsatellite instability and its association with selected clinical and molecular markers are discordant in primary and metastatic colorectal cancer, which could have importance for surveillance and therapeutic strategies.

scholarly journals Prognostic Value of Quantitative 18F-FDG PET/CT Parameters Measured in Primary Tumors and Suspicious Lymph Nodes in Patients With Esophageal Carcinoma

2020 ◽  
Author(s):  
Francisco Tustumi ◽  
Flávio Roberto Takeda ◽  
Paulo Schiavom Duarte ◽  
David Gutiérrez Albenda ◽  
Rubens Antonio Aissar Sallum ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Nodes ◽  
Neoadjuvant Therapy ◽  
Burden Of Disease ◽  
Primary Tumor ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Primary Tumors ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Objective:Quantitative 18F-FDG PET/CT parameters have been described as prognostic indicators in esophageal cancer. The objective of this study isto evaluate the prognostic value of the maximum standardized uptake value (SUVmax), metabolic tumor value (MTV) and total lesion glycolysis (TLG) measured in the primary tumor and suspicious lymph nodes.Methods: A cohort study was performed to assess the association of SUVmax, MTV and TLG measured prior to and post neoadjuvant therapywithoverall survival (OS) of patients with esophageal cancer who received trimodal therapy. The quantitative techniques were applied in the primary tumor and suspicious lymph nodes. The OS rates were analyzed. Results: Before neoadjuvant therapy, 106 patients underwent PET/CT, and 39 patients underwent post-neoadjuvant therapy PET/CT exams. Before neoadjuvanttherapy, PET/CT showed that all the variables of the evaluated lymph nodes were statistically significant in predicting OS. Postneoadjuvanttherapy, none of the PET/CT variables of lymph nodes were related to prognosis. On the other hand, all primary tumor volumetric variables were related to overall survival. The MTV (HR: 4.66; 95% CI: 1.54-14.08) and TLG (HR: 4.86; 95% CI: 1.66-14.26) of the primary tumor post neoadjuvanttherapy and the variations in MTV (HR: 2.95; 95% CI: 1.01-3.52) and TLG (HR: 3.49; 95% CI: 1.01-3.52) of the primary tumor pre-to-post-neoadjuvanttherapy were prognostic variables. Conclusion: In patients with esophageal cancer, the burden of disease in suspicious lymph nodes and the primary tumor prior to therapy and the residual burden of disease in the primary tumor post therapy assessed by PET/CT were associated with prognosis.

Metastatic Spread of Stage I Melanoma of the Skin

1983 ◽  
Vol 69 (5) ◽  
pp. 449-454 ◽  
Author(s):  
◽  
Natale Cascinelli ◽  
Ferdinando Preda ◽  
Maurizio Vaglini ◽  
Sergio Orefice ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Regional Lymph Node ◽  
Distant Metastases ◽  
Stage I ◽  
Regional Lymph Nodes ◽  
Prognostic Criteria ◽  
Regional Node ◽  
Node Metastases

1164 patients with stage I melanoma of the skin who were submitted to wide excision only of the primary tumor were studied to evaluate the rates of regional lymph node and distant metastases. Of these, 516 (44.3%) had a recurrence of the disease which was at regional lymph nodes in 264 (22.7%), at distant sites in 91 (7.8%), and simultaneously at regional lymph nodes and distant sites in 161 (13.8%). Most of the patients had a relapse within 5 years: regional node metastases were most frequently observed during the first 3 years, and distant metastases appeared later. The ratio regional:distant metastases was not different (P > 0.05) when subgroups of patients were considered according to prognostic criteria (sex, site of origin, levels, thickness, ulceration). Sex, levels, thickness and ulceration were found to be significantly related with the frequency of recurrences (regional and distant). It is concluded that the prognostic criteria considered do not predict whether the tumor will metastasize to regional nodes or to distant sites.

scholarly journals Is Unenhanced 18F-FDG–PET/CT Better than Enhanced CT in the Detection of Retropharyngeal Lymph node Metastasis in Nasopharyngeal Carcinoma?

2016 ◽  
Vol 95 (4-5) ◽  
pp. 4-5
Author(s):  
Iuan-Sheng Wu ◽  
Guang-Uei Hung ◽  
Bo-Ling Chang ◽  
Chi-Kuang Liu ◽  
Tung-Hao Chang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Nasopharyngeal Carcinoma ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Detection Rate ◽  
Retropharyngeal Lymph Node ◽  
Axial Diameter ◽  
Pet Ct ◽  
Enhanced Ct ◽  
Fdg Pet Ct

Positron-emission tomography/computed tomography (PET/CT) has been proposed as a means to enhance the pretreatment evaluation of cervical lymph node status in patients with nasopharyngeal carcinoma (NPC). We conducted a prospective study to compare PET/CT and enhanced CT for the detection of retropharyngeal lymph node (RLN) metastasis in NPC, and to ascertain the factors that affect its diagnostic performance. Our study population was made up of 33 patients—24 men and 9 women, aged 30 to 81 years (mean: 52)—with newly diagnosed NPC who had been treated over a 2-year period. All patients underwent enhanced CT first, followed by unenhanced 18F-fluorodeoxyglucose (FDG) PET/CT. The detection rate of RLN metastasis on PET/CT was significantly lower than that on enhanced CT (36.4 vs. 75.8%; p < 0.001). A total of 25 of 26 nodes with a discordant finding were negative on PET/CT; they included 13 metastatic lymph nodes with low FDG uptake, 9 that were located close to the primary tumor, 2 that were confluent RLNs, and 1 that was adjacent to the physiologic FDG-avid prevertebral muscle. The maximum standardized uptake value (SUVmax) of RLNs was positively correlated with the minimum axial diameter (r = 0.803, p < 0.001). The PET/CT detection rate was 0% for lymph nodes smaller than 5 mm, 9% for those 5 to 10 mm, and 73% for those 1 cm or larger. The detection rate of PET/ CT at level C1 was significantly lower than that at C2 (22 vs. 67%; p = 0.035). We conclude that unenhanced PET/CT is markedly inferior to enhanced CT for detecting RLN metastasis in NPC, especially in lymph nodes with a minimum axial diameter of less than 1 cm and those in proximity to the primary tumor. Using enhanced CT in PET/CT is justified to improve the recognition of RLN metastasis in patients with NPC.

Expression of CEACAM1 in pulmonary adenocarcinoma cells and their metastases

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 17071-17071
Author(s):  
E. Laack ◽  
O. Schult-Kronefeld ◽  
I. Burkholder ◽  
M. Görn ◽  
B. Andritzky ◽  
...  
Keyword(s):  
Lymph Node ◽  
Metastatic Disease ◽  
Lung Tissue ◽  
Primary Tumor ◽  
Distant Metastases ◽  
Pulmonary Adenocarcinoma ◽  
Normal Lung Tissue ◽  
Normal Lung ◽  
Primary Tumors ◽  
Adenocarcinoma Cells

17071 Background: The cell adhesion molecule CEACAM1 is involved in intercellular adhesion and is expressed in a variety of normal human tissues such as mammary gland, colonic mucosa and prostate. In cases of malignant transformation of these tissues a down regulation or loss of CEACAM1 has been shown. In contrary, CEACAM1 is not expressed in normal lung tissue or melanocytes and it has been demonstrated that a expression in these tissues is associated with the development of metastatic disease. The aim of the present investigation was to analyze a possible association between the expression of CEACAM1 in pulmonary adenocarcinoma cells and their lymph node and hematogenous metastatic cells. Methods: CEACAM1 expression was immunhistochemically evaluated in primary tumor cells, cells in lymph nodes and in distant metastases of 96 patients with metastatic adenocarcinoma of the lung who had undergone surgery between 1999 and 2002. Results: An expression of CEACAM1 has been shown in 78 of 96 primary tumors. We found a significant positive correlation between the CEACAM1 expression on the cells of the primary tumor and the lymph node metastases (p<0.005) and the hematogenous metastases (p<0.05). Conclusion: As shown before, CEACAM1 is not expressed in normal lung tissue but in most primary adenocarcinomas of the lung. We are the first to demonstrate, that its expression is preserved in the lymph node and hematogenous metastases in metastatic disease implicating that its expression is of functional significance of both metastatic sites. No significant financial relationships to disclose.

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