Nuclear Medicine Communications最新文献

Objectives: The aim of this study is to investigate the jaw pathologies of patients with medication-related osteonecrosis of the jaw (MRONJ) using a computer program to assess the bone scan index (BSI), especially comparison of standardized uptake values (SUVs) with bone single-photon emission-computed tomography/computed tomography (SPECT/CT).

Methods: Sixty-three patients with MRONJ underwent bone SPECT/CT in this prospective study. BSI and high-risk hot spot as bone metastases in the patients with MRONJ were evaluated using a computer program for BSI that scanned SPECT/CT and automatically defined the data. The maximum and mean SUVs with SPECT/CT were obtained using commercially available software. Statistical analyses were performed by Pearson chi-square test, Mann-Whitney U -test, or one-way analysis of variance with Tukey's honestly significant difference test. A P value lower than 0.05 was considered statistically significant.

Results: The maximum and mean SUVs for a high-risk hot spot of the jaw with MRONJ [28.2 ± 10.2 and 11.7 ± 3.8; n  = 6 (6/63 : 9.5%)] were significantly higher than those for a low-risk hot spot [18.5 ± 6.4 and 6.2 ± 1.9; n  = 23 (23/63 : 36.5%)] and no-risk hot spot [14.2 ± 9.4 and 5.3 ± 5.1; n  = 34 (34/63 : 54.0%)], respectively.

Conclusion: The computer program for BSI indicated that 9.5% of the jaw with MRONJ were false positive of bone metastases. The study suggests that high-risk hot spots of the jaw with MRONJ depend on the SUVs.

Purpose: To investigate the diagnostic value of 18 F-fluorodeoxyglucose(FDG) PET/computed tomography (CT) for infiltrative subsolid nodules at different stages of lung adenocarcinoma and to explore predictive factors for invasive adenocarcinoma, providing compelling evidence for timely intervention.

Methods: A retrospective analysis was conducted on PET/CT imaging data of 170 subsolid nodules lesions confirmed postoperatively as lung adenocarcinoma or precursor glandular lesions. Lesions were categorized into preinvasive lesions including atypical adenomatous hyperplasia and adenocarcinoma in situ, microinvasive adenocarcinoma, and invasive adenocarcinoma. Compared the differences in imaging features and metabolic parameters among different groups and used a multifactor logistic regression model and receiver operating characteristic curve analysis to identify predictive factors for invasive adenocarcinoma.

Results: From preinvasive lesions through microinvasive adenocarcinoma to invasive adenocarcinoma, there was a gradual increase in nodule diameter, nodule area, and proportion of part-solid nodule. Statistical significance ( P  < 0.05) was observed in the rates of spiculation and pleural indentation between preinvasive lesions versus microinvasive adenocarcinoma and invasive adenocarcinoma groups. The maximum standardized uptake value and maximum standardized uptake ratio show statistically significant differences ( P  < 0.05) between the invasive adenocarcinoma group and the other groups. Logistic regression analysis indicated that nodule composition, nodule diameter, and maximum standardized uptake ratio were predictive factors for invasive adenocarcinoma ( P  < 0.05). For part-solid nodules, the longest diameter of the solid component has a high diagnostic value.

Conclusion: The imaging features of 18 F-FDG PET/CT contribute to the diagnosis of infiltrative subsolid nodules at different stages of lung adenocarcinoma, providing robust evidence for timely intervention.

Background: PET-Magnetic Resonance (PET-MR) imaging is an upcoming investigative modality with a few installations in Asia and only three in India. PET-Computed Tomography (PET-CT) is an established diagnostic cornerstone for oncological indications but with limited resolution for small lesions due to low soft-tissue contrast and additional radiation exposure.

Objective: Our primary objective was to evaluate the diagnostic performance of simultaneous PET-MR and PET-CT in lesion detection in oncological practice. Secondly to assess the referral pattern and study the clinical utility of PET-MR in a university hospital practice.

Materials and methods: A total of 100 consecutive biopsy-proven cancer patients (breast or lung malignancy with suspected metastases) underwent 18 F Fluorodeoxyglucose (FDG) PET-MR and PET-CT for staging as a single injection, double examination protocol. Morphological lesion detection on correlative imaging/histopathology was used as the gold standard. Analysing the referral pattern, a total of 9366 patients underwent simultaneous PET-MR imaging for various indications in the past 5 years since installation.

Results: 18 F FDG PET-MR detected 100% of primary tumours in breast/lung carcinoma patients while PET-CT was positive in 96%. Overall accuracy of nodal metastases detection for PET-MR and PET-CT was 96 and 88%, while for distant metastases the accuracy was 100 and 93%, respectively. FDG PET-MR proved more sensitive and specific than PET-CT for regional nodal ( P  = 0.011 and P  < 0.001) and distant metastases detection ( P  = 0.017 and P < 0.001, respectively). Analysing the general referral pattern for PET-MR, the majority were oncology referrals when compared to nononcological indications (66.5, 33.5%). About 66.24% were FDG based, followed by 68 Ga Prostate-Specific Membrane Antigen (PSMA) and dodecane tetraacetic acid (DOTA). The general utility of PET-MR was found incremental in better delineation of small lesions especially in head, neck, liver, brain and gynaecological malignancies.

Conclusion: In our past 5 years of PET-MR practice, we found that simultaneous PET-MR is a highly recommended ideal imaging technique for oncological and nononcological indications. It has excellent diagnostic performance with high sensitivity, specificity and accuracy when compared to PET-CT in primary tumour, nodal and distant metastases (TNM) staging in specific subgroup of breast and lung malignancy patients.

Objectives: Here, we have compiled all key statements derived from these guidelines and delved into details on which scenarios the diagnostic whole-body iodine scan (DxWBIS) might be useful.

Methods: We identified all relevant guidelines by searching the MEDLINE/PubMed databases, Google Scholar, and Ovid from 2006 onwards using keywords related to DxWBIS, RxWBIS, iodine scintigraphy, and iodine scan. We excluded case reports/series, original articles, and clinical trials while including guidelines or consensus opinions. Additionally, we reviewed existing literature to ensure no guidelines were overlooked.

Results: Overall, 23 relevant guidelines or consensus opinions discussed their views on the role of DxWBIS. Different indications for DxWBIS have been largely discussed in the last few years. However, the role of DxWBIS has been well established after treatment with 131I, with still limited evidence in the other clinical assessments.

Conclusions: Most guidelines find DxWBIS appealing for higher-risk patients, particularly those with a chance of recurrence; additional well-designed studies are required to address further indications.

Objective: To establish nomograms for predicting preoperative lymph-vascular space invasion (LVSI) and survival outcomes of cervical squamous cell carcinoma (CSCC) based on PET/CT radiomics.

Methods: One hundred and twenty-three patients with CSCC and LVSI status were enrolled retrospectively. Independent predictors of LVSI were identified through clinicopathological factors and PET/CT metabolic parameters. We extracted 1316 features from PET and CT volume of interest, respectively. Additionally, four models (PET-RS: radiomic signature of PET only; CT-RS: radiomic signature of CT only; PET/CT-RS + clinical data; PET/CT-RS: radiomic signature of PET and CT) were established to predict LVSI status. Calculation of radiomics scores of PET/CT was executed for assessment of the survival outcomes, followed by development of nomograms with radiomics (NR) or without radiomics (NWR).

Results: One hundred and twenty-three patients with pathologically confirmed CSCC had been categorized into two sets (training and testing sets). It was found that only maximum standardized uptake value (SUV max ) and squamous cell carcinoma antigen were independent predictors of LVSI. Meanwhile, the PET/CT-RS + clinical data outperformed the other three models in the training set [area under the curve (AUC): 0.91 vs. 0.861 vs. 0.81 vs. 0.814] and the testing set (AUC: 0.885 vs. 0.857 vs. 0.783 vs. 0.798). Additionally, SUV max and LVSI had been demonstrated to be independent prognostic indicators for progression-free survival and overall survival. Decision curve analysis and calibration curve indicated that NRs were superior to NWRs. The survival outcomes were assessed.

Conclusion: PET/CT-based radiomic signature nomogram enables a new method for preoperative prediction of LVSI and survival prognosis for patients with CSCC.

Purpose: This study aimed to investigate a deep learning model to classify amyloid plaque deposition in the brain PET images of patients suspected of Alzheimer's disease.

Methods: A retrospective study was conducted on patients who were suspected of having a mild cognitive impairment or dementia, and brain amyloid 18 F florapronol PET/computed tomography images were obtained from 2019 to 2022. Brain PET images were visually assessed by two nuclear medicine specialists, who classified them as either positive or negative. Image rotation was applied for data augmentation. The dataset was split into training and testing sets at a ratio of 8 : 2. For the convolutional neural network (CNN) analysis, stratified k-fold ( k  = 5) cross-validation was applied using training set. Trained model was evaluated using testing set.

Results: A total of 175 patients were included in this study. The average age at the time of PET imaging was 70.4 ± 9.3 years and included 77 men and 98 women (44.0% and 56.0%, respectively). The visual assessment revealed positivity in 62 patients (35.4%) and negativity in 113 patients (64.6%). After stratified k-fold cross-validation, the CNN model showed an average accuracy of 0.917 ± 0.027. The model exhibited an accuracy of 0.914 and an area under the curve of 0.958 in the testing set. These findings affirm the model's high reliability in distinguishing between positive and negative cases.

Conclusion: The study verifies the potential of the CNN model to classify amyloid positive and negative cases using brain PET images. This model may serve as a supplementary tool to enhance the accuracy of clinical diagnoses.

Objective: Pancreatic cancer is an increasing cause of cancer-related mortality, with persistently low survival rates. We investigated the clinical diagnostic value of the combination of preoperative serum carbohydrate antigen 19-9 (CA19-9), albumin-bilirubin (ALBI) score, and 18 F-fluoro-2-deoxy- d -glucose PET integrated with computed tomography ( 18 F-FDG PET/CT) imaging in pancreatic cancer preoperative resectability.

Methods: This study included 143 pancreatic cancer patients, including 68 preoperative resectable and 75 preoperative unresectable pancreatic cancer patients. Meanwhile, 67 patients with non-pancreatic cancer were included as the control group. The clinical data were collected. Serum CA19-9 level was measured by ELISA. The levels of total bilirubin and albumin were determined using a biochemical analyzer, with the ALBI score calculated. All patients underwent 18 F-FDG PET/CT imaging. The consistency of the diagnosis was evaluated by the Kappa test. Logistic univariate and multivariate regression analyses were performed. The diagnostic efficacy of these parameters was evaluated using receiver operating characteristic (ROC) curves, and the optimal ROC curve thresholds were obtained using the Youden index.

Results: The preoperative serum CA19-9 and ALBI score of patients with preoperative resectable pancreatic cancer were increased, which helped diagnose preoperative resectable pancreatic cancer. 18 F-FDG PET/CT imaging had diagnostic value for preoperative resectable pancreatic cancer. Preoperative serum CA19-9, ALBI score, and 18 F-FDG PET/CT imaging were independent influencing factors for pancreatic cancer preoperative resectability, and their combination had higher diagnostic value for preoperative resectable pancreatic cancer than any single of these indexes.

Conclusion: The combination of preoperative serum CA19-9, ALBI score, and 18 F-FDG PET/CT imaging had high diagnostic value for pancreatic cancer preoperative resectability.

Purpose: The purposes was to build model incorporating PET +  computed tomography (CT) radiomics features from baseline PET/CT + clinical parameters to predict outcomes in patients with non-Hodgkin lymphomas.

Methods: Cohort of 138 patients with complete clinical parameters and follow up times of 25.3 months recorded. Textural analysis of PET and manual correlating contouring in CT images analyzed using LIFE X software. Defined outcomes were overall survival (OS), disease free-survival, radiotherapy, and unfavorable response (defined as disease progression) assessed by end of therapy PET/CT or contrast CT. Univariable and multivariable analysis performed to assess association between PET, CT, and clinical.

Results: Male ( P  = 0.030), abnormal lymphocytes ( P  = 0.030), lower value of PET entropy ( P  = 0.030), higher value of SHAPE sphericity ( P  = 0.002) were significantly associated with worse OS. Advanced stage (III or IV, P  = 0.013), abnormal lymphocytes ( P  = 0.032), higher value of CT gray-level run length matrix (GLRLM) LRLGE mean ( P  = 0.010), higher value of PET gray-level co-occurrence matrix energy angular second moment ( P  < 0.001), and neighborhood gray-level different matrix (NGLDM) busyness mean ( P  < 0.001) were significant predictors of shorter DFS. Abnormal lymphocyte ( P  = 0.033), lower value of CT NGLDM coarseness ( P  = 0.082), and higher value of PET GLRLM gray-level nonuniformity zone mean ( P  = 0.040) were significant predictors of unfavorable response to chemotherapy. Area under the curve for the three models (clinical alone, clinical + PET parameters, and clinical + PET + CT parameters) were 0.626, 0.716, and 0.759, respectively.

Objective: Fluorodeoxyglucose PET/computed tomography (FDG PET/CT) is effective in detecting large vessel vasculitis. Digital PET cameras have improved spatial resolution compared with analog PET, resulting in more prominent physiological uptake in arterial walls. This study's goal was to define qualitative normal variants of arterial activity on digital PET/CT.

Methods: We retrospectively reviewed 126 oncological PET/CT studies. Exclusion criteria included history of vasculitis, immunosuppressant therapy, hyperglycemia, or altered FDG biodistribution. Qualitative vessel wall activity (common carotid, brachiocephalic, subclavian, aorta, and femoral) was visually graded by two nuclear physicians with guideline-proposed criteria: 0: ≤mediastinum, 1: liver, where grade 3 is compatible, 2 is possible, and <2 is negative for vasculitis. Cranial artery uptake was visually graded as follows: grade 0: ≤surrounding tissues, grade 1: just above surrounding tissues, and grade 2: significantly above surrounding tissues, with grades 1 and 2 considered positive for cranial artery vasculitis.

Results: Large vessel uptake was grade 3 in 0 subjects, grade 2 in four subjects (3%), grade 1 in 87 subjects (69%), and grade 0 in 35 subjects (28%). In studies acquired ≥75 min post-injection, 1/15 subjects had grade 2 uptake. Four subjects (3%) had grade 1 vertebral artery uptake. No subjects had temporal, maxillary, or occipital artery uptake.

Conclusion: A minority of our subjects presented with grade 2 large vessel uptake, which was associated with longer uptake times, or grade 1 cranial artery uptake, which was associated with higher age and glycemia. These findings should be interpreted with caution in patients referred for suspected vasculitis, as they may represent normal variants on digital PET.

A woman in her 70s presented with features of hyperandrogenism including clitoral enlargement and deepening of her voice. Biochemical investigations revealed raised plasma androgens and urinary androgen metabolites and imaging findings showed a highly F-18 fluorodeoxyglucose (FDG)-PET avid left adrenal tumour initially suspected to be a malignant adrenocortical carcinoma (ACC). She subsequently underwent an uncomplicated laparoscopic adrenalectomy where complete resection of her tumour was achieved. Histopathological analysis demonstrated a benign adrenal oncocytoma with no evidence of malignancy. This case illustrates a rare presentation of a functioning virilising adrenal oncocytoma as a benign mimic of ACC.