scholarly journals CLINICAL IMPACT OF 18F FDG PET-CT ON MANAGEMENT OF GERM CELL TUMORS

2015 ◽  
Vol 1 (2) ◽  
Author(s):  
Saima Riaz ◽  
Humayun Bashir ◽  
Nargis Muzzafar ◽  
Ahmed Murtaza ◽  
Amin Hayee

Purpose: The purpose of this study was to review the impact of 18F- fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET-CT) scans on the management of patients with germ cell tumours (GCT) at our centre. Methods: A descriptive, cross-sectional, retrospective review of a total of 29 FDG PET-CT scans acquired in 20 patients with GCT between December 2009 and May 2013. Results: Sixteen males and four females with the average age of 34.4 years (+18SD) were identi ed who underwent FDG PET-CT scans for treatment response/outcome evaluation on an average period of 3 months after completion of therapy. Hypermetabolic residual disease (PET-CT positive) was identi ed in 8 (40%). 6 (30%) had non-FDG-avid residual morphologic disease (PET negative and CT positive) and 6 (30%) were disease free (PET-CT negative). FDG PET-CT led to change in the management plan of 12 (60%) of cases as compared to the CT alone ndings. Follow-up was available for a median of 2.9 years (±1.5 SD). The overall 5-year disease-free survival was found to be PET-CT positive patients = 62%, PET-negative and CT-positive patients = 80% and PET-CT-negative patients = 100%. Conclusion: FDG PET-CT scanning has a potential role in the evaluation of response to treatment and can predict the survival outcome. Key words: 18F- uorodeoxyglucose positron emission tomography computed tomography, disease-free survival, germ cell tumour, standardised uptake value 

2016 ◽  
Vol 50 (4) ◽  
pp. 360-369 ◽  
Author(s):  
Kursat Okuyucu ◽  
Sukru Ozaydın ◽  
Engin Alagoz ◽  
Gokhan Ozgur ◽  
Semra Ince ◽  
...  

Abstract Background Non-Hodgkin’s lymphomas arising from the tissues other than primary lymphatic organs are named primary extranodal lymphoma. Most of the studies evaluated metabolic tumor parameters in different organs and histopathologic variants of this disease generally for treatment response. We aimed to evaluate the prognostic value of metabolic tumor parameters derived from initial FDG-PET/CT in patients with a medley of primary extranodal lymphoma in this study. Patients and methods There were 67 patients with primary extranodal lymphoma for whom FDG-PET/CT was requested for primary staging. Quantitative PET/CT parameters: maximum standardized uptake value (SUVmax), average standardized uptake value (SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were used to estimate disease-free survival and overall survival. Results SUVmean, MTV and TLG were found statistically significant after multivariate analysis. SUVmean remained significant after ROC curve analysis. Sensitivity and specificity were calculated as 88% and 64%, respectively, when the cut-off value of SUVmean was chosen as 5.15. After the investigation of primary presentation sites and histo-pathological variants according to recurrence, there is no difference amongst the variants. Primary site of extranodal lymphomas however, is statistically important (p = 0.014). Testis and central nervous system lymphomas have higher recurrence rate (62.5%, 73%, respectively). Conclusions High SUVmean, MTV and TLG values obtained from primary staging FDG-PET/CT are potential risk factors for both disease-free survival and overall survival in primary extranodal lymphoma. SUVmean is the most significant one amongst them for estimating recurrence/metastasis.


2021 ◽  
Vol 20 ◽  
pp. 153303382110564
Author(s):  
Na Dai ◽  
Hang Liu ◽  
Shengming Deng ◽  
Shibiao Sang ◽  
Yiwei Wu

Purpose: In the present study, we mainly aimed to evaluate the prognostic value of 2-deoxy-2-[18F]fluoro-D-glucose ([18F]F-FDG) positron emission tomography (PET)/computed tomography (CT) after allogeneic stem cell transplantation (allo-SCT) in lymphoblastic lymphoma (LBL) patients using Deauville Scores (DS). Materials and Methods: A total of 63 LBL patients who benefited from 18F-FDG PET-CT after allo-SCT in our institution between April 2010 and August 2020 were enrolled in this retrospective study. These above-mentioned patients were divided into two groups based on the Deauville criteria. Diagnostic efficiency of 18F-FDG PET/CT and integrated CT in detecting lymphoma were calculated. Consistencies were evaluated by comparing 18F-FDG PET/CT and integrated CT results through kappa coefficient. Kaplan-Meier method was used in survival analysis, and the log-rank method was adopted in comparisons. Prognostic factor analysis was performed by the Cox regression model. Results: The sensitivity, specificity, positive predictive value, negative predictive value, accuracy of post-SCT 18F-FDG PET-CT were 100%(12/12), 92.2%(47/51), 75.0%(12/16), 100%(47/47) and 93.7%(59/63). The consistency of 18F-FDG PET-CT and integrated CT was moderate(Kappa = .702,P < .001). Positive post-SCT 18F-FDG PET-CT was associated with lower progression-free survival (PFS) but not overall survival (OS) (p = .000 and p = .056, respectively). The 3-year PFS of the PET-positive group and PET-negative group was 18.8% and 70.2%, respectively. Multivariate analysis showed that post-SCT PET-CT findings was an independent prognostic factor for PFS (p = .000; HR, 3.957; 95%CI, 1.839-8.514). Other factors independently affecting PFS were sex (p = .018; HR, 2.588; 95% CI, 1.181 − 5.670) and lactate dehydrogenase (LDH) (p = .005; HR, 3.246; 95% CI, 1.419 − 7.426). However, none of the above-mentioned factors were associated with OS. Conclusions: Collectively, we found that 18F-FDG PET-CT after allo-SCT was a strong indicator for PFS, but not OS, which might provide important evidence for the selection of subsequent treatment regimen for LBL patients. Trial registration number: ChiCTR2100046709.


2017 ◽  
Vol 06 (02) ◽  
pp. 081-083
Author(s):  
Saima Riaz ◽  
Humayun Bashir ◽  
Hassan Iqbal ◽  
Arif Jamshed ◽  
Ahmad Murtaza ◽  
...  

Abstract Background: Overview of clinical impact of positron emission tomography-computed tomography (PET-CT) scans in patients with head and neck carcinomas at our center. Methods: Retrospective review of posttreatment 18F-fluorodeoxyglucose (18F-FDG) PET-CT scans in patients with head and neck carcinomas with risk of residual disease. Clinical outcome served as the reference standard. Results: This study included 93 patients (65.6% males, mean age: 48.8 years ± 17.2 standard deviation) with squamous cell carcinoma as most frequent histopathology (91.4%). PET-CT scans were performed on average 6 months posttreatment. Diagnostic accuracy, positive predictive value, and negative predictive value of PET-CT for disease were found to be 88%, 88%, and 92%, respectively. A median follow-up of 24 months was available for 91 patients. Kaplan–Meier curves showed significantly higher disease-free survival with negative PET-CT as compared to positive PET-CT (P = 0.01) and maximum standardized uptake values of <5.0 (P = 0.01). Conclusion: FDG PET-CT has diagnostic and prognostic implications in treated patient of head and neck cancers.


2014 ◽  
Vol 56 (12) ◽  
pp. 1463-1470 ◽  
Author(s):  
Ji Eun Jo ◽  
Jin You Kim ◽  
Suck Hong Lee ◽  
Suk Kim ◽  
Taewoo Kang

2019 ◽  
Author(s):  
Styliani Mantziari ◽  
Anastasia Pomoni ◽  
John O Prior ◽  
Michael Winiker ◽  
Pierre Allemann ◽  
...  

Abstract Background Although 18 F- FDG PET/CT is validated in baseline workup of esophageal cancer to detect distant metastases, it remains underused in assessing local staging and biology of the primary tumor. This study aimed to evaluate the association between 18 F- FDG PET/CT-derived parameters of esophageal cancer, and its clinico-pathological features and prognosis.Methods All patients (n=86) with esophageal adenocarcinoma or squamous cell cancer operated between 2005-2014 were analyzed. Linear regression was used to identify clinico-pathologic features of esophageal cancer associated with the tumor’s maximal Standardized Uptake Value (SUV max ), Total Lesion Glycolysis (TLG) and Metabolic Tumor Volume (MTV). ROC curve analysis was performed to precise the optimal cutoff of each variable associated with a locally advanced (cT3/4) status, long-term survival and recurrence. Kaplan Meier curves and Cox regression were used for survival analyses.Results High baseline SUV max was associated with cT3/4 status and middle-third tumor location, TLG with a cT3/4 and cN+ status, whereas MTV only with active smoking. A cT3/4 status was significantly predicted by a SUV max >8.25g/mL (p<0.001), TLG>41.7 (p<0.001) and MTV>10.70 cm 3 (p<0.01) whereas a SUV max > 12.7 g/mL was associated with an early tumor recurrence and a poor disease-free survival (median 13 versus 56 months, p=0.030), particularly in squamous cell cancer.Conclusions Baseline 18 F- FDG PET/CT has a high predictive value of preoperative cT stage, as its parameters SUV max , TLG and MTV can predict a locally advanced tumor with high accuracy. A SUV max > 12.7 g/mL may herald early tumor recurrence and poor disease-free survival.


2019 ◽  
Author(s):  
Styliani Mantziari ◽  
Anastasia Pomoni ◽  
John O Prior ◽  
Michael Winiker ◽  
Pierre Allemann ◽  
...  

Abstract Background Although 18 F- FDG PET/CT is validated in baseline workup of esophageal cancer to detect distant metastases, it remains underused in assessing local staging and biology of the primary tumor. This study aimed to evaluate the association between 18 F- FDG PET/CT-derived parameters of esophageal cancer, and its clinico-pathological features and prognosis.Methods All patients (n=86) with esophageal adenocarcinoma or squamous cell cancer operated between 2005-2014 were analyzed. Linear regression was used to identify clinico-pathologic features of esophageal cancer associated with the tumor’s maximal Standardized Uptake Value (SUV max ), Total Lesion Glycolysis (TLG) and Metabolic Tumor Volume (MTV). ROC curve analysis was performed to precise the optimal cutoff of each variable associated with a locally advanced (cT3/4) status, long-term survival and recurrence. Kaplan Meier curves and Cox regression were used for survival analyses.Results High baseline SUV max was associated with cT3/4 status and middle-third tumor location, TLG with a cT3/4 and cN+ status, whereas MTV only with active smoking. A cT3/4 status was significantly predicted by a SUV max >8.25g/mL (p<0.001), TLG>41.7 (p<0.001) and MTV>10.70 cm 3 (p<0.01) whereas a SUV max > 12.7 g/mL was associated with an early tumor recurrence and a poor disease-free survival (median 13 versus 56 months, p=0.030), particularly in squamous cell cancer.Conclusions Baseline 18 F- FDG PET/CT has a high predictive value of preoperative cT stage, as its parameters SUV max , TLG and MTV can predict a locally advanced tumor with high accuracy. A SUV max > 12.7 g/mL may herald early tumor recurrence and poor disease-free survival.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Amin Haghighat Jahromi ◽  
Donald A. Barkauskas ◽  
Matthew Zabel ◽  
Aaron M. Goodman ◽  
Garret Frampton ◽  
...  

Abstract Purpose Deriving links between imaging and genomic markers is an evolving field. 2-[18F]FDG PET/CT (18F-fluorodeoxyglucose positron emission tomography–computed tomography) is commonly used for cancer imaging, with maximum standardized uptake value (SUVmax) as the main quantitative parameter. Tumor mutational burden (TMB), the quantitative variable obtained using next-generation sequencing on a tissue biopsy sample, is a putative immunotherapy response predictor. We report the relationship between TMB and SUVmax, linking these two important parameters. Methods In this pilot study, we analyzed 1923 patients with diverse cancers and available TMB values. Overall, 273 patients met our eligibility criteria in that they had no systemic treatment prior to imaging/biopsy, and also had 2-[18F]FDG PET/CT within 6 months prior to the tissue biopsy, to ensure acceptable temporal correlation between imaging and genomic evaluation. Results We found a linear correlation between TMB and SUVmax (p < 0.001). In the multivariate analysis, only TMB independently correlated with SUVmax, whereas age, gender, and tumor organ did not. Conclusion Our observations link SUVmax in readily available, routinely used, and noninvasive 2-[18F]FDG PET/CT imaging to the TMB, which requires a tissue biopsy and time to process. Since higher TMB has been implicated as a prognostic biomarker for better outcomes after immunotherapy, further investigation will be needed to determine if SUVmax can stratify patient response to immunotherapy.


Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1258
Author(s):  
Lu Han ◽  
Qi Wang ◽  
Lanbo Zhao ◽  
Xue Feng ◽  
Yiran Wang ◽  
...  

Backgrounds: The purpose of this paper is to investigate the prognostic value of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) parameters in patients treated with concurrent chemoradiotherapy (CCRT) for locally advanced cervical cancer (LACC). Methods: Studies that met the following criteria were retrieved from PubMed and Embase: patients treated with CCRT for LACC; FDG PET/CT scans performed before CCRT treatment; and a detected relationship between the parameters of FDG PET/CT and the prognosis of patients. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to estimate the overall survival (OS) or event-free survival (EFS). Results: In total, 14 eligible studies with 1313 patients were included in this meta-analysis. Patients with a high maximum standardized uptake value (SUVmax) have a shorter OS than those with a low SUVmax (HR = 2.582, 95% = CI 1.936–3.443, p < 0.001). Primary tumor SUVmax values (HR = 1.938, 95% CI = 1.203–3.054, p = 0.004) were significantly correlated with EFS, with a relatively high heterogeneity (I2 = 84% and I2 = 69.4%, respectively). Based on the limited data, the combined HR for EFS with the highest primary tumor total lesion glycolysis (TLG) and metabolic tumor volume (MTV) was 1.843 (95% CI = 1.100–3.086, p = 0.02) and 2.06 (95% CI = 1.21–3.51, p = 0.007), respectively. Besides, the combined HR for OS with the highest nodal SUVmax was 2.095 (95% CI = 2.027–2.166, p < 0.001). Conclusion: A high primary SUVmax has a significant correlation with the OS and EFS of patients treated with CCRT for LACC and may therefore serve as a prognostic predictor. Due to the limited data, to explore the correlation between survival and TLG, MTV, and nodal SUVmax, further large-scale prospective studies are needed.


2021 ◽  
Vol 5 (1) ◽  
pp. 1151-1160
Author(s):  
A.S. Lukashevich ◽  

Purpose. The purpose of the article is to evaluate the diagnostic significance of positron emission tomography / computed tomography with 18F -fluorodeoxyglucose (18F -FDG PET/CT) for the diagnosis of prosthetic endocarditis. Methods of research. The study included 82 patients with suspected prosthetic endocarditis in accordance with the criteria proposed by Duke University [1-5]. The patients received hospital treatment at the State Institution RSPC "Cardiology" from January 2016 to March 2021. The study was of a prospective, non-randomized, single-center cohort design. The duration of the monitor period was 12 months from the moment of patients’ inclusion in the study. Whole-body positron emission tomography / computed tomography (PET/CT) examinations were performed in 82 patients. 27 patients were selected for surgical treatment. Conservative treatment group included 16 patients. 27 patients were selected into the observation group, they were suspected to have prosthetic heart valve infection in the primary referral and underwent PET/CT scanning, according to which the diagnosis of prosthetic endocarditis was excluded. The event under the study did not develop in this group during the year of observation. Results and conclusion. The history of infective endocarditis was not statistically significant and did not increase the risk of developing prosthetic endocarditis in the sample presented. The Duke criteria are less reliable in establishing the diagnosis of prosthetic endocarditis. The median number of days from the date of the first prosthesis implantation to the onset of prosthetic endocarditis was about 4 years. This study revealed that the development of the infectious process in the area of the prosthesis was noted in a more distant postoperative period compared to literature data. Histological confirmation of infection was noted in 100% (27 patients) of cases in reoperated patients. The presence of a more formidable complication such as valve ring abscess located mainly in the projection of the aortic valve ring was quite common in both groups. Presepsin and Interleukin-6 have a statistically significant (U = 394,50 p = 0,01 and U = 94,50 p = 0.004) value in the prognosis of prosthetic endocarditis. Considering the data obtained from ROC analysis, it can be said that the cut-off point at which it is possible to diagnose prosthetic endocarditis based on PETCT is 2.85. The presented methods for the interpretation of whole-body FDG-PET/CT images of patients with suspected infectious complications after cardiac surgery, as well as with the presence of prosthetic endocarditis, show high sensitivity and specificity.


Sign in / Sign up

Export Citation Format

Share Document