Role Of Positron Emission Tomography-computed Tomography Research Articles

ПЭТ/КТ В ДЕТСКОЙ ОНКОЛОГИИ

Prescriptions for the positron emission tomography-computed tomography (PET-CT) in adult cancer patients are based on the results of multicenter studies, systematic reviews, and meta-analyses. Thus, published international guidelines help nuclear medicine specialists, oncologists and radiologists in determining the most appropriate diagnostic algorithms for each patient with the purpose of selecting the most appropriate treatment as well as allowing the introduction of the new prognostic factors. Compared with adult patients, the use of PET-CT in pediatric oncology is somewhat limited due to the lack of systematic, large multicenter studies and, therefore, precise and clear guidelines. The reasons for the lack of the large studies may be the relatively low incidence of malignant neoplasms in pediatric practice and the fear for the delayed effects of exposure of ionizing radiation on the growing child's body. The purpose of this bibliographical review was to provide a summary of the use and the role of PET-CT in children with the most frequent malignancies.

Risk Factors of Progression in Low-tumor Burden Follicular Lymphoma Initially Managed by Watch and Wait in the Era of PET and Rituximab

Patients (pts) with asymptomatic low-burden follicular lymphoma (FL) are usually observed at diagnosis. Time to lymphoma treatment (TLT) initiation can however be very heterogeneous and risk factors of progression are poorly studied. Our study evaluated 201 pts with grade 1-3a low-tumor burden FL diagnosed in four French centers between 2010 and 2020 and managed by a watch and wait strategy in real-life settings. After a median follow-up of 4.8 years, the median TLT was 4.2 years (95% confidence interval, 3.1-5.5). On multivariate analysis, elevated lactate dehydrogenase (hazard ratio [HR] = 2.2; P = 0.02), more than 4 nodal areas involved (HR = 1.7; P = 0.02) and more than 1 extranodal involvement (HR = 2.7; P = 0.01) were identified as independent predictors of TLT. The median TLT was 5.8 years for pts with no risk factor, 2.4 years for 1 risk factor, and 1.3 years for >1 risk factors (P < 0.01). In a subanalysis of 75 pts staged with positron emission tomography-computed tomography (PET-CT), total metabolic tumor volume (TMTV) ≥14 cm3 and standardized Dmax (reflecting tumor dissemination) >0.32 m-1 were also associated with shorter TLT (HR = 3.4; P = 0.004 and HR = 2.4; P = 0.007, respectively). In multivariate models combining PET-CT parameters and clinical variables, TMTV remained independent predictor of shorter TLT. These simple parameters could help to identify FL patients initially observed at higher risk of early progression. The role of PET-CT (extranodal sites and PET metrics) in low-burden FL appears promising and warrants further assessment in large cohorts.

Role of PET-CT (Positron Emission Tomography-Computed Tomography) in Cancer Evaluation and Treatment

Context: Positron emission tomography is a nuclear medicine imaging that deals with physiological function using radioisotopes. With the most PET (Positron Emission Tomography) scanners in integration with the CT scanners of late, this technology has registered phenomenal growth. The small amount of radioactive material is called Radiotracers. Objective: Like 18F- Fluro-deoxy-2-glucose has widely used. In this article, the author introduced clinical applications of PET out of 25 patients who studied hypermetabolic lesions in lymph nodes. Methods: PET imaging is coincidence imaging which is different from the other imaging technique PET image formed from multiple rings of detector crystals. Each decay positron travel in tissue annihilation reaction is going on. FDG is the most commonly used radiotracer to detect and stage various types of malignancies. Result: The field of PET/CT imaging cares for many oncology patients. PET improved localization of malignant lesions. It improved staging biopsy and therapy. Conclusion: Finally, studies to data showed 4% to 10% improvement in the overall accuracy of staging/restaging in lesions. If we use Monte Carlo simulation, OLINDA/EXM software may improve further with widely used.

Role of positron emission tomography-computed tomography in non-small cell lung cancer.

Lung cancer is the leading cause of cancer-related mortality worldwide. Non-small cell carcinoma and small cell carcinoma are the main histological subtypes and constitutes around 85% and 15% of all lung cancer respectively. Multimodality treatment plays a key role in the successful management of lung cancer depending upon the histological subtype, stage of disease, and performance status. Imaging modalities play an important role in the diagnosis and accurate staging of the disease, in assessing the response to neoadjuvant therapy, and in the follow-up of the patients. Last decade has witnessed voluminous upsurge in the use of positron emission tomography-computed tomography (PET-CT); role of PET-CT has widened exponentially in the management of lung cancer. The present article reviews the role of 18-fluoro-deoxyglucose PET-CT in the management of non small cell lung cancer with emphasis on staging of the disease and the assessment of response to neoadjuvant therapy based on available literature.

The Role of PET-CT in Evaluation of Cervical Lymph Node Metastases in Oral Cavity Squamous Cell Carcinomas.

The aim of this study is to determine the sensitivity and specificity of positron emission tomography-computed tomography (PET-CT) in the evaluation of cervical lymph node metastasis in oral cavity squamous cell cancers (SCCs) and to determine the SUV-max values in differentiating reactive and metastatic lymph nodes as a supportive parameter. In this study, 23 patients were included who were diagnosed with oral cavity SCC and treated with surgery between 2006 and 2013 in our department. All the patients were scanned with PET-CT during the pretreatment evaluation. Detailed pretreatment PET-CT (retention sites and SUV-max values) and histopathological examination results were obtained. SPSS 17.0 software package was used for statistical analysis of the data. Categorical measurement was summarized as number and percentage and continuous measurements as mean and standard deviation (median and minimum-maximum where necessary). Chi-square test or Fisher's test were used in the comparison of categorical variables. Compliance of methods was assessed by Kappa coefficient analysis. In this study, the advantages of PET-CT were determined by the calculation of sensitivity and specificity values with histopathological examination results considered as the gold standard, and SUV-max value was assessed by examining the area under the ROC curve. In all tests, the level of statistical significance was accepted as 0.05. The threshold value for SUV-max depending on the data of the histopathological examination and results of PET-CT of the 23 patients was 2.50. The reliability of this threshold was determined as AUC=0.819. In demonstrating neck metastasis in patients with cancer of the oral cavity, PET-CT has a sensitivity of 89% and specificity of 98%. Compliance between the histopathological examination and PET-CT for metastatic cervical lymph nodes was determined to be 0.416 by kappa coefficient analysis. There was FDG uptake on PET-CT in the cervical lymph node regions of all patients with metastatic cervical lymph nodes. There were no metastases in any of the patients with no FDG retention. The sensitivity and specificity of PET-CT in determining cervical lymph node metastasis were 89% and 98%, respectively, with a threshold SUV-max value considered as 2.50 in patients with FDG retention.

Good survival in a patient with recurrent transitional cell carcinoma of the ovary: A case report of PET-CT for detection and follow-up.

Transitional cell carcinoma (TCC) of the ovary is a rare subtype of epithelial ovarian cancer. The present study reports the case of a 55-year-old patient from The Affiliated Tumor Hospital of Harbin Medical University (Harbin, Heilongjiang, China) who underwent successful surgery for recurrence of a TCC of the ovary with rectum metastases following the initial surgery and chemotherapy. Positron emission tomography/computed tomography (PET-CT) was used in the pre-operative detection of the tumor and the post-operative follow-up of the patient. To date, the patient has experienced 8 years of disease-free survival. The aim of the present study was to convey the good survival rate of the patient following recurrent TCC of the ovary, and the role of PET-CT in detection and follow-up, in order to aid in the future selection of appropriate diagnostic methods and therapies for this disease.

The role of fluorine-18-fluorodeoxyglucose positron emission tomography in evaluating the response to tyrosine-kinase inhibitors in patients with metastatic primary renal cell carcinoma.

BackgroundPositron emission tomography-computed tomography (PET-CT) using fluorodeoxyglucose (FDG) is increasingly used in the evaluation of patients with advanced renal cell carcinoma (RCC), primarily for staging purposes. The aim of this paper is to perform a systematic review about the usefulness of PET-CT using FDG in response assessment after treatment with tyrosine-kinase inhibitors (TKIs) in patients with advanced RCC.Materials and methods.The scientific literature about the role of PET-CT using FDG in the assessment of response to treatment with TKIs in patients affected by advanced RCC was systematically reviewed.ResultsSeven studies about the role of PET-CT using FDG in the response assessment after treatment with TKIs (essentially sunitinib and sorafenib) in advanced RCC were retrieved in full-text and analysed, to determine the predictive role of this morpho-functional imaging method on patient outcome.ConclusionsTo date, the role of PET-CT using FDG in evaluating the response to TKIs in metastatic RCC patients is still not well defined, partly due to heterogeneity of available studies; however, PET-CT reveals potential role for the selection of patients undergoing therapy with TKIs. The use of contrast-enhanced PET-CT appears to be promising for a “multi-dimensional” evaluation of treatment response in these patients.

Pseudocirrhosis of Breast Cancer Metastases to the Liver Treated by Chemotherapy

Pseudocirrhosis refers to a condition that shows changes in hepatic contour that mimic cirrhosis radiographically in the absence of the typical histopathological findings of cirrhosis. This condition has been observed in patients with cancer metastatic to the liver, both in those who have undergone prior systemic chemotherapy and those who have not. Pseudocirrhosis may cause difficulty in interpretation of the response to chemotherapy and hepatic decompression and complication of portal hypertension have a negative effect on the prognosis. We report on a case of breast cancer with liver metastases that showed cirrhotic changes during disease progression. Progression of liver metastases was confirmed by F18 fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT). We also performed ultrasound-guided liver biopsy and confirmed tumor infiltration with severe desmoplastic fibrosis. This case suggests the pathogenesis of pseudocirrhosis through histopathological findings and the role of PET-CT in evaluation of the response to chemotherapy in patients with pseudocirrhosis.

Best Practices: Consensus on Performing Positron Emission Tomography-Computed Tomography for Radiation Therapy Planning and for Therapy Response Assessment

The incorporation of positron emission tomography-computed tomography (PET-CT) into oncological imaging has expanded rapidly since the hybrid scanners were introduced approximately 10 years ago. PET-CT is becoming the standard of practice for the imaging diagnosis and staging of most cancers. Since its introduction, hardware-registered PET and CT images produced by a PET-CT scan were recognized as valuable not only for detection, staging and restaging applications but also for optimizing radiation treatment planning. Even before the introduction of PET-CT, the value of metabolic imaging with the use of FDG PET was recognized as a potentially powerful means of assessing response to various therapies, particularly chemotherapy regimens. To better understand the optimal use of PET-CT in radiation therapy planning and the role of PET-CT in assessing response to therapy, we invited experts from various disciplines to participate in focus group meetings that took place in 2009 and 2010. The Symposia focused on the use of PET-CT imaging in radiation therapy planning (2009) and the use of PET-CT in therapy response assessment (2010). This article will summarize areas of consensus reached by the group regarding many of the discussion topics. The consensus summaries covered in this article are meant to provide direction for future discussions on how to improve the application of this hybrid modality to optimize patient care.