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Malignant Histiocytic Neoplasm of the Mediastinum with Pericardial Involvement in a Child. 一名儿童纵隔恶性组织细胞肿瘤伴心包受累
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-03-01 DOI: 10.1148/rycan.230133
Jessie Huang, Maria Clara Lorca, Irene Y Chen, Apeksha Chaturvedi
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引用次数: 0
Genetic Screening, Cancer Syndromes, and the Radiologist. 基因筛查、癌症综合征和放射科医生。
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-03-01 DOI: 10.1148/rycan.240045
Peter L Choyke
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引用次数: 0
Multimodality Imaging to Direct Management of Primary and Recurrent Rectal Adenocarcinoma Beyond the Total Mesorectal Excision Plane. 多模态成像指导全直肠系膜切除术后的原发性和复发性直肠腺癌治疗
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-03-01 DOI: 10.1148/rycan.230077
Joshua D Shur, Sheng Qiu, Edward Johnston, Diana Tait, Nicos Fotiadis, Christos Kontovounisios, Shahnawaz Rasheed, Paris Tekkis, Angela Riddell, Dow-Mu Koh

Rectal tumors extending beyond the total mesorectal excision (TME) plane (beyond-TME) require particular multidisciplinary expertise and oncologic considerations when planning treatment. Imaging is used at all stages of the pathway, such as local tumor staging/restaging, creating an imaging-based "roadmap" to plan surgery for optimal tumor clearance, identifying treatment-related complications, which may be suitable for radiology-guided intervention, and to detect recurrent or metastatic disease, which may be suitable for radiology-guided ablative therapies. Beyond-TME and exenterative surgery have gained acceptance as potentially curative procedures for advanced tumors. Understanding the role, techniques, and pitfalls of current imaging techniques is important for both radiologists involved in the treatment of these patients and general radiologists who may encounter patients undergoing surveillance or patients presenting with surgical complications or intercurrent abdominal pathology. This review aims to outline the current and emerging roles of imaging in patients with beyond-TME and recurrent rectal malignancy, focusing on practical tips for image interpretation and surgical planning in the beyond-TME setting. Keywords: Abdomen/GI, Rectum, Oncology © RSNA, 2024.

直肠肿瘤延伸到全直肠系膜切除术(TME)平面以外(beyond-TME),在计划治疗时需要特别的多学科专业知识和肿瘤学考虑。影像学应用于治疗路径的各个阶段,如局部肿瘤分期/预后、创建基于影像学的 "路线图 "以规划手术,从而达到最佳的肿瘤清除效果、识别与治疗相关的并发症(可能适合放射学引导的介入治疗)以及检测复发或转移性疾病(可能适合放射学引导的消融治疗)。作为晚期肿瘤的潜在根治性手术,Beyond-TME 和肠外手术已被越来越多的人接受。了解当前成像技术的作用、技术和陷阱对于参与治疗这些患者的放射科医生和可能遇到接受监测的患者或出现手术并发症或腹部并发病变的患者的普通放射科医生都很重要。本综述旨在概述当前和新出现的影像学在TME以外和复发直肠恶性肿瘤患者中的作用,重点是TME以外情况下的影像解读和手术规划实用技巧。关键词腹部/消化道 直肠 肿瘤学 © RSNA, 2024.
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引用次数: 0
Characterizing Metabolic Heterogeneity of Hepatocellular Carcinoma with Hyperpolarized 13C Pyruvate MRI and Mass Spectrometry. 用超极化13C丙酮酸核磁共振成像和质谱法表征肝细胞癌的代谢异质性
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-03-01 DOI: 10.1148/rycan.230056
Qianhui Dou, Aaron K Grant, Patricia Coutinto de Souza, Marwan Moussa, Imad Nasser, Muneeb Ahmed, Leo L Tsai

Purpose To characterize the metabolomic profiles of two hepatocellular carcinoma (HCC) rat models, track evolution of these profiles to a stimulated tumor state, and assess their effect on lactate flux with hyperpolarized (HP) carbon 13 (13C) MRI. Materials and Methods Forty-three female adult Fischer rats were implanted with N1S1 or McA-RH7777 HCC tumors. In vivo lactate-to-pyruvate ratio (LPR) was measured with HP 13C MRI at 9.4 T. Ex vivo mass spectrometry was used to measure intratumoral metabolites, and Ki67 labeling was used to quantify proliferation. Tumors were first compared with three normal liver controls. The tumors were then compared with stimulated variants via off-target hepatic thermal ablation treatment. All comparisons were made using the Mann-Whitney test. Results HP 13C pyruvate MRI showed greater LPR in N1S1 tumors compared with normal liver (mean [SD], 0.564 ± 0.194 vs 0.311 ± 0.057; P < .001 [n = 9]), but not for McA-RH7777 (P = .44 [n = 8]). Mass spectrometry confirmed that the glycolysis pathway was increased in N1S1 tumors and decreased in McA-RH7777 tumors. The pentose phosphate pathway was also decreased only in McA-RH7777 tumors. Increased proliferation in stimulated N1S1 tumors corresponded to a net increase in LPR (six stimulated vs six nonstimulated, 0.269 ± 0.148 vs 0.027 ± 0.08; P = .009), but not in McA-RH7777 (eight stimulated vs six nonstimulated, P = .13), despite increased proliferation and metastases. Mass spectrometry demonstrated relatively increased lactate production with stimulation in N1S1 tumors only. Conclusion Two HCC subtypes showed divergent glycolytic dependency at baseline and during transformation to a high proliferation state. This metabolic heterogeneity in HCC should be considered with use of HP 13C MRI for diagnosis and tracking. Keywords: Molecular Imaging-Probe Development, Liver, Abdomen/GI, Oncology, Hepatocellular Carcinoma © RSNA, 2024 See also commentary by Ohliger in this issue.

目的 描述两种肝细胞癌(HCC)大鼠模型的代谢组学特征,跟踪这些特征在肿瘤刺激状态下的演变,并通过超极化(HP)碳13(13C)磁共振成像评估它们对乳酸通量的影响。材料与方法 将 43 只成年雌性费舍尔大鼠植入 N1S1 或 McA-RH7777 HCC 肿瘤。体内质谱法用于测量瘤内代谢物,Ki67标记用于量化增殖。首先将肿瘤与三个正常肝脏对照组进行比较。然后将肿瘤与通过肝脏脱靶热消融治疗刺激的变异体进行比较。所有比较均采用 Mann-Whitney 检验。结果 HP 13C 丙酮酸核磁共振成像显示,与正常肝脏相比,N1S1 肿瘤中的 LPR 更大(平均值[SD],0.564 ± 0.194 vs 0.311 ± 0.057;P < .001 [n = 9]),但 McA-RH7777 中的 LPR 不大(P = .44 [n = 8])。质谱分析证实,N1S1 肿瘤中糖酵解途径增加,而 McA-RH7777 肿瘤中糖酵解途径减少。磷酸戊糖途径也仅在 McA-RH7777 肿瘤中减少。受刺激的 N1S1 肿瘤的增殖增加与 LPR 的净增加相对应(6 例受刺激 vs 6 例非受刺激,0.269 ± 0.148 vs 0.027 ± 0.08;P = .009),但在 McA-RH7777 肿瘤中则不然(8 例受刺激 vs 6 例非受刺激,P = .13),尽管增殖和转移增加了。质谱分析表明,只有 N1S1 肿瘤在受到刺激后乳酸生成相对增加。结论 两种 HCC 亚型在基线和向高增殖状态转化期间表现出不同的糖酵解依赖性。在使用 HP 13C MRI 进行诊断和追踪时,应考虑到 HCC 的这种代谢异质性。关键词分子成像-探针开发 肝脏 腹部/消化道 肿瘤学 肝细胞癌 © RSNA, 2024 另请参阅本期 Ohliger 的评论。
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引用次数: 0
18F-FDG Dedicated Breast PET Complementary to Breast MRI for Evaluating Early Response to Neoadjuvant Chemotherapy. 18F-FDG 专用乳腺 PET 与乳腺 MRI 相辅相成,用于评估新辅助化疗的早期反应。
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-03-01 DOI: 10.1148/rycan.230082
Devan Diwanji, Natsuko Onishi, Deep K Hathi, Courtney Lawhn-Heath, John Kornak, Wen Li, Ruby Guo, Julissa Molina-Vega, Youngho Seo, Robert R Flavell, Diane Heditsian, Susie Brain, Laura J Esserman, Bonnie N Joe, Nola M Hylton, Ella F Jones, Kimberly M Ray

Purpose To compare quantitative measures of tumor metabolism and perfusion using fluorine 18 (18F) fluorodeoxyglucose (FDG) dedicated breast PET (dbPET) and breast dynamic contrast-enhanced (DCE) MRI during early treatment with neoadjuvant chemotherapy (NAC). Materials and Methods Prospectively collected DCE MRI and 18F-FDG dbPET examinations were analyzed at baseline (T0) and after 3 weeks (T1) of NAC in 20 participants with 22 invasive breast cancers. FDG dbPET-derived standardized uptake value (SUV), metabolic tumor volume, and total lesion glycolysis (TLG) and MRI-derived percent enhancement (PE), signal enhancement ratio (SER), and functional tumor volume (FTV) were calculated at both time points. Differences between FDG dbPET and MRI parameters were evaluated after stratifying by receptor status, Ki-67 index, and residual cancer burden. Parameters were compared using Wilcoxon signed rank and Mann-Whitney U tests. Results High Ki-67 tumors had higher baseline SUVmean (difference, 5.1; P = .01) and SUVpeak (difference, 5.5; P = .04). At T1, decreases were observed in FDG dbPET measures (pseudo-median difference T0 minus T1 value [95% CI]) of SUVmax (-6.2 [-10.2, -2.6]; P < .001), SUVmean (-2.6 [-4.9, -1.3]; P < .001), SUVpeak (-4.2 [-6.9, -2.3]; P < .001), and TLG (-29.1 mL3 [-71.4, -6.8]; P = .005) and MRI measures of SERpeak (-1.0 [-1.3, -0.2]; P = .02) and FTV (-11.6 mL3 [-22.2, -1.7]; P = .009). Relative to nonresponsive tumors, responsive tumors showed a difference (95% CI) in percent change in SUVmax of -34.3% (-55.9%, 1.5%; P = .06) and in PEpeak of -42.4% (95% CI: -110.5%, 8.5%; P = .08). Conclusion 18F-FDG dbPET was sensitive to early changes during NAC and provided complementary information to DCE MRI that may be useful for treatment response evaluation. Keywords: Breast, PET, Dynamic Contrast-enhanced MRI Clinical trial registration no. NCT01042379 Supplemental material is available for this article. © RSNA, 2024.

目的 比较新辅助化疗(NAC)早期治疗期间使用氟18(18F)脱氧葡萄糖(FDG)专用乳腺PET(dbPET)和乳腺动态对比增强(DCE)MRI对肿瘤代谢和灌注进行的定量测量。材料与方法 对 20 名患有 22 例浸润性乳腺癌的患者在基线(T0)和接受新辅助化疗 3 周后(T1)进行的前瞻性 DCE MRI 和 18F-FDG dbPET 检查进行分析。在这两个时间点计算了 FDG dbPET 导出的标准化摄取值 (SUV)、代谢肿瘤体积和总病变糖酵解 (TLG),以及 MRI 导出的增强百分比 (PE)、信号增强比 (SER) 和功能性肿瘤体积 (FTV)。根据受体状态、Ki-67 指数和残留癌负荷进行分层后,评估 FDG dbPET 和 MRI 参数之间的差异。参数比较采用 Wilcoxon 符号秩检验和 Mann-Whitney U 检验。结果 高 Ki-67 肿瘤的基线 SUVmean 值(差异为 5.1;P = .01)和 SUVpeak 值(差异为 5.5;P = .04)较高。在 T1 期,观察到 FDG dbPET 测量值(伪中位数差异 T0 减 T1 值 [95% CI])SUVmax(-6.2 [-10.2, -2.6]; P < .001)、SUVmean(-2.6 [-4.9, -1.3]; P < .001), SUVpeak (-4.2 [-6.9, -2.3]; P < .001), and TLG (-29.1 mL3 [-71.4, -6.8]; P = .005) and MRI measures of SERpeak (-1.0 [-1.3, -0.2]; P = .02) and FTV (-11.6 mL3 [-22.2, -1.7]; P = .009)。与非反应性肿瘤相比,反应性肿瘤的 SUVmax 百分比变化差异(95% CI)为-34.3%(-55.9%,1.5%;P = .06),PEpeak 百分比变化差异为-42.4%(95% CI:-110.5%,8.5%;P = .08)。结论 18F-FDG dbPET 对 NAC 期间的早期变化很敏感,并能提供 DCE MRI 的补充信息,可能对治疗反应评估有用。关键词乳腺 正电子发射 动态对比增强磁共振成像 临床试验注册号本文有补充材料。© RSNA, 2024.
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引用次数: 0
Quantitative US Delta Radiomics to Predict Radiation Response in Individuals with Head and Neck Squamous Cell Carcinoma. 用定量 US Delta 放射线组学预测头颈部鳞状细胞癌患者的放射反应。
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-03-01 DOI: 10.1148/rycan.230029
Laurentius Oscar Osapoetra, Archya Dasgupta, Daniel DiCenzo, Kashuf Fatima, Karina Quiaoit, Murtuza Saifuddin, Irene Karam, Ian Poon, Zain Husain, William T Tran, Lakshmanan Sannachi, Gregory J Czarnota

Purpose To investigate the role of quantitative US (QUS) radiomics data obtained after the 1st week of radiation therapy (RT) in predicting treatment response in individuals with head and neck squamous cell carcinoma (HNSCC). Materials and Methods This prospective study included 55 participants (21 with complete response [median age, 65 years {IQR: 47-80 years}, 20 male, one female; and 34 with incomplete response [median age, 59 years {IQR: 39-79 years}, 33 male, one female) with bulky node-positive HNSCC treated with curative-intent RT from January 2015 to October 2019. All participants received 70 Gy of radiation in 33-35 fractions over 6-7 weeks. US radiofrequency data from metastatic lymph nodes were acquired prior to and after 1 week of RT. QUS analysis resulted in five spectral maps from which mean values were extracted. We applied a gray-level co-occurrence matrix technique for textural analysis, leading to 20 QUS texture and 80 texture-derivative parameters. The response 3 months after RT was used as the end point. Model building and evaluation utilized nested leave-one-out cross-validation. Results Five delta (Δ) parameters had statistically significant differences (P < .05). The support vector machines classifier achieved a sensitivity of 71% (15 of 21), a specificity of 76% (26 of 34), a balanced accuracy of 74%, and an area under the receiver operating characteristic curve of 0.77 on the test set. For all the classifiers, the performance improved after the 1st week of treatment. Conclusion A QUS Δ-radiomics model using data obtained after the 1st week of RT from individuals with HNSCC predicted response 3 months after treatment completion with reasonable accuracy. Keywords: Computer-Aided Diagnosis (CAD), Ultrasound, Radiation Therapy/Oncology, Head/Neck, Radiomics, Quantitative US, Radiotherapy, Head and Neck Squamous Cell Carcinoma, Machine Learning Clinicaltrials.gov registration no. NCT03908684 Supplemental material is available for this article. © RSNA, 2024.

目的 研究放射治疗(RT)第一周后获得的定量 US(QUS)放射组学数据在预测头颈部鳞状细胞癌(HNSCC)患者治疗反应中的作用。材料与方法 这项前瞻性研究纳入了 55 名在 2015 年 1 月至 2019 年 10 月期间接受根治性 RT 治疗的大结节阳性 HNSCC 患者(21 名完全反应患者[中位年龄 65 岁{IQR:47-80 岁},20 名男性,1 名女性;34 名不完全反应患者[中位年龄 59 岁{IQR:39-79 岁},33 名男性,1 名女性])。所有参与者均在 6-7 周内接受了 70 Gy 放射治疗,分 33-35 次进行。在接受 RT 治疗 1 周之前和之后,采集了转移淋巴结的 US 射频数据。QUS 分析产生了五个频谱图,并从中提取了平均值。我们采用灰度共现矩阵技术进行纹理分析,得出了 20 个 QUS 纹理参数和 80 个纹理衍生参数。以 RT 3 个月后的反应作为终点。模型的建立和评估采用了嵌套留一交叉验证。结果 五个 delta (Δ) 参数的差异具有统计学意义(P < .05)。支持向量机分类器在测试集上的灵敏度为 71%(21 个中的 15 个),特异度为 76%(34 个中的 26 个),平衡准确率为 74%,接收器工作特征曲线下面积为 0.77。所有分类器的性能在治疗第一周后都有所提高。结论 利用HNSCC患者RT第一周后获得的数据建立的QUS Δ-放射组学模型可预测治疗结束3个月后的反应,准确性较高。关键词计算机辅助诊断(CAD) 超声波 放射治疗/肿瘤学 头颈部 放射组学 定量 US 放射治疗 头颈部鳞状细胞癌 机器学习 Clinicaltrials.gov registration no.NCT03908684 本文有补充材料。© RSNA, 2024.
{"title":"Quantitative US Delta Radiomics to Predict Radiation Response in Individuals with Head and Neck Squamous Cell Carcinoma.","authors":"Laurentius Oscar Osapoetra, Archya Dasgupta, Daniel DiCenzo, Kashuf Fatima, Karina Quiaoit, Murtuza Saifuddin, Irene Karam, Ian Poon, Zain Husain, William T Tran, Lakshmanan Sannachi, Gregory J Czarnota","doi":"10.1148/rycan.230029","DOIUrl":"10.1148/rycan.230029","url":null,"abstract":"<p><p>Purpose To investigate the role of quantitative US (QUS) radiomics data obtained after the 1st week of radiation therapy (RT) in predicting treatment response in individuals with head and neck squamous cell carcinoma (HNSCC). Materials and Methods This prospective study included 55 participants (21 with complete response [median age, 65 years {IQR: 47-80 years}, 20 male, one female; and 34 with incomplete response [median age, 59 years {IQR: 39-79 years}, 33 male, one female) with bulky node-positive HNSCC treated with curative-intent RT from January 2015 to October 2019. All participants received 70 Gy of radiation in 33-35 fractions over 6-7 weeks. US radiofrequency data from metastatic lymph nodes were acquired prior to and after 1 week of RT. QUS analysis resulted in five spectral maps from which mean values were extracted. We applied a gray-level co-occurrence matrix technique for textural analysis, leading to 20 QUS texture and 80 texture-derivative parameters. The response 3 months after RT was used as the end point. Model building and evaluation utilized nested leave-one-out cross-validation. Results Five delta (Δ) parameters had statistically significant differences (<i>P</i> < .05). The support vector machines classifier achieved a sensitivity of 71% (15 of 21), a specificity of 76% (26 of 34), a balanced accuracy of 74%, and an area under the receiver operating characteristic curve of 0.77 on the test set. For all the classifiers, the performance improved after the 1st week of treatment. Conclusion A QUS Δ-radiomics model using data obtained after the 1st week of RT from individuals with HNSCC predicted response 3 months after treatment completion with reasonable accuracy. <b>Keywords:</b> Computer-Aided Diagnosis (CAD), Ultrasound, Radiation Therapy/Oncology, Head/Neck, Radiomics, Quantitative US, Radiotherapy, Head and Neck Squamous Cell Carcinoma, Machine Learning Clinicaltrials.gov registration no. NCT03908684 <i>Supplemental material is available for this article.</i> © RSNA, 2024.</p>","PeriodicalId":20786,"journal":{"name":"Radiology. Imaging cancer","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10988345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139932640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Radiologic-Pathologic Correlation of Nonmass Enhancement Contiguous with Malignant Index Breast Cancer Masses at Preoperative Breast MRI. 术前乳腺磁共振成像中与恶性指数乳腺癌肿块毗连的非肿块增强的放射学与病理学相关性。
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-03-01 DOI: 10.1148/rycan.230060
Derek L Nguyen, Mira Lotfalla, Ashley Cimino-Mathews, Mehran Habibi, Emily B Ambinder

Purpose To determine the pathologic features of nonmass enhancement (NME) directly adjacent to biopsy-proven malignant masses (index masses) at preoperative MRI and determine imaging characteristics that are associated with a malignant pathologic condition. Materials and Methods This retrospective study involved the review of breast MRI and mammography examinations performed for evaluating disease extent in patients newly diagnosed with breast cancer from July 1, 2016, to September 30, 2019. Inclusion criteria were limited to patients with an index mass and the presence of NME extending directly from the mass margins. Wilcoxon rank sum test, Fisher exact test, and χ2 test were used to analyze cancer, patient, and imaging characteristics associated with the NME diagnosis. Results Fifty-eight patients (mean age, 58 years ± 12 [SD]; all women) were included. Malignant pathologic findings for mass-associated NME occurred in 64% (37 of 58) of patients, 43% (16 of 37) with ductal carcinoma in situ and 57% (21 of 37) with invasive carcinoma. NME was more likely to be malignant when associated with an index cancer that had a low Ki-67 index (<20%) (P = .04). The presence of calcifications at mammography correlating with mass-associated NME was not significantly associated with malignant pathologic conditions (P = .19). The span of suspicious enhancement measured at MRI overestimated the true span of disease at histologic evaluation (P < .001), while there was no evidence of a difference between span of calcifications at mammography and true span of disease at histologic evaluation (P = .27). Conclusion Mass-associated NME at preoperative MRI was malignant in most patients with newly diagnosed breast cancer. The span of suspicious enhancement measured at MRI overestimated the true span of disease found at histologic evaluation. Keywords: Breast, Mammography © RSNA, 2024 See also the commentary by Newell in this issue.

目的 确定术前 MRI 检查中与活检证实的恶性肿块(指标肿块)直接相邻的非肿块增强(NME)的病理特征,并确定与恶性病理状况相关的成像特征。材料与方法 该回顾性研究回顾了 2016 年 7 月 1 日至 2019 年 9 月 30 日期间为评估新诊断为乳腺癌患者的疾病范围而进行的乳腺 MRI 和乳腺 X 光检查。纳入标准仅限于有指数肿块且存在直接从肿块边缘延伸的 NME 的患者。采用Wilcoxon秩和检验、Fisher精确检验和χ2检验分析与NME诊断相关的癌症、患者和影像学特征。结果 共纳入 58 例患者(平均年龄 58 岁 ± 12 [SD];均为女性)。64%的患者(58 例中有 37 例)出现肿块相关 NME 的恶性病理结果,其中 43%(37 例中有 16 例)为导管原位癌,57%(37 例中有 21 例)为浸润癌。当指标癌的Ki-67指数较低时,NME更有可能是恶性的(P = .04)。乳腺放射摄影中出现的钙化与肿块相关的NME与恶性病理情况无明显关联(P = .19)。核磁共振成像测量的可疑强化跨度高估了组织学评估的真实病变跨度(P < .001),而乳腺X光检查的钙化跨度与组织学评估的真实病变跨度之间没有差异(P = .27)。结论 大多数新诊断的乳腺癌患者术前磁共振成像中与肿块相关的 NME 是恶性的。磁共振成像测得的可疑强化跨度高估了组织学评估时发现的真实疾病跨度。关键词乳腺、乳腺放射摄影 © RSNA, 2024 另请参阅本期 Newell 的评论。
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引用次数: 0
Breast Cancer Detection Using a Low-Dose Positron Emission Digital Mammography System. 使用低剂量正电子发射数字乳腺 X 射线摄影系统检测乳腺癌。
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-03-01 DOI: 10.1148/rycan.230020
Vivianne Freitas, Xuan Li, Anabel Scaranelo, Frederick Au, Supriya Kulkarni, Sandeep Ghai, Samira Taeb, Oleksandr Bubon, Brandon Baldassi, Borys Komarov, Shayna Parker, Craig A Macsemchuk, Michael Waterston, Kenneth O Olsen, Alla Reznik

Purpose To investigate the feasibility of low-dose positron emission mammography (PEM) concurrently to MRI to identify breast cancer and determine its local extent. Materials and Methods In this research ethics board-approved prospective study, participants newly diagnosed with breast cancer with concurrent breast MRI acquisitions were assigned independently of breast density, tumor size, and histopathologic cancer subtype to undergo low-dose PEM with up to 185 MBq of fluorine 18-labeled fluorodeoxyglucose (18F-FDG). Two breast radiologists, unaware of the cancer location, reviewed PEM images taken 1 and 4 hours following 18F-FDG injection. Findings were correlated with histopathologic results. Detection accuracy and participant details were examined using logistic regression and summary statistics, and a comparative analysis assessed the efficacy of PEM and MRI additional lesions detection (ClinicalTrials.gov: NCT03520218). Results Twenty-five female participants (median age, 52 years; range, 32-85 years) comprised the cohort. Twenty-four of 25 (96%) cancers (19 invasive cancers and five in situ diseases) were identified with PEM from 100 sets of bilateral images, showcasing comparable performance even after 3 hours of radiotracer uptake. The median invasive cancer size was 31 mm (range, 10-120). Three additional in situ grade 2 lesions were missed at PEM. While not significant, PEM detected fewer false-positive additional lesions compared with MRI (one of six [16%] vs eight of 13 [62%]; P = .14). Conclusion This study suggests the feasibility of a low-dose PEM system in helping to detect invasive breast cancer. Though large-scale clinical trials are essential to confirm these preliminary results, this study underscores the potential of this low-dose PEM system as a promising imaging tool in breast cancer diagnosis. ClinicalTrials.gov registration no. NCT03520218 Keywords: Positron Emission Digital Mammography, Invasive Breast Cancer, Oncology, MRI Supplemental material is available for this article. © RSNA, 2024 See also commentary by Barreto and Rapelyea in this issue.

目的 探讨低剂量正电子发射乳腺放射摄影(PEM)与核磁共振成像(MRI)同时进行以识别乳腺癌并确定其局部范围的可行性。材料和方法 在这项经研究伦理委员会批准的前瞻性研究中,新诊断为乳腺癌并同时进行了乳腺核磁共振成像检查的参试者被独立分配到不同的乳腺密度、肿瘤大小和组织病理学癌症亚型中,接受最多 185 MBq 氟 18 标记的氟脱氧葡萄糖(18F-FDG)的低剂量正电子发射乳腺放射摄影检查。两名乳腺放射科医生在不知道癌症位置的情况下,分别查看了注射 18F-FDG 1 小时和 4 小时后的 PEM 图像。检查结果与组织病理学结果相互关联。使用逻辑回归和汇总统计对检测准确性和参与者的详细信息进行了检查,并通过比较分析评估了 PEM 和 MRI 额外病灶检测的效果(ClinicalTrials.gov:NCT03520218)。结果 组群中有 25 名女性参与者(中位年龄 52 岁;范围 32-85 岁)。PEM从100组双侧图像中识别出了25个癌症中的24个(96%)(19个浸润性癌症和5个原位疾病),即使在放射性示踪剂吸收3小时后仍能显示出相当的性能。浸润性癌症的中位尺寸为 31 毫米(范围为 10-120)。PEM 还漏检了另外三个 2 级原位病变。与磁共振成像相比,PEM 发现的假阳性病变更少(6 例中 1 例 [16%] 对 13 例中 8 例 [62%];P = .14),但意义不大。结论 这项研究表明,低剂量 PEM 系统在帮助检测浸润性乳腺癌方面是可行的。尽管大规模临床试验对于证实这些初步结果至关重要,但本研究强调了低剂量 PEM 系统作为乳腺癌诊断成像工具的潜力。ClinicalTrials.gov 注册号:NCT03520218NCT03520218 关键词正电子发射数字乳腺 X 线照相术 浸润性乳腺癌 肿瘤学 MRI 这篇文章有补充材料。© RSNA, 2024 另请参阅本期 Barreto 和 Rapelyea 的评论。
{"title":"Breast Cancer Detection Using a Low-Dose Positron Emission Digital Mammography System.","authors":"Vivianne Freitas, Xuan Li, Anabel Scaranelo, Frederick Au, Supriya Kulkarni, Sandeep Ghai, Samira Taeb, Oleksandr Bubon, Brandon Baldassi, Borys Komarov, Shayna Parker, Craig A Macsemchuk, Michael Waterston, Kenneth O Olsen, Alla Reznik","doi":"10.1148/rycan.230020","DOIUrl":"10.1148/rycan.230020","url":null,"abstract":"<p><p>Purpose To investigate the feasibility of low-dose positron emission mammography (PEM) concurrently to MRI to identify breast cancer and determine its local extent. Materials and Methods In this research ethics board-approved prospective study, participants newly diagnosed with breast cancer with concurrent breast MRI acquisitions were assigned independently of breast density, tumor size, and histopathologic cancer subtype to undergo low-dose PEM with up to 185 MBq of fluorine 18-labeled fluorodeoxyglucose (<sup>18</sup>F-FDG). Two breast radiologists, unaware of the cancer location, reviewed PEM images taken 1 and 4 hours following <sup>18</sup>F-FDG injection. Findings were correlated with histopathologic results. Detection accuracy and participant details were examined using logistic regression and summary statistics, and a comparative analysis assessed the efficacy of PEM and MRI additional lesions detection (ClinicalTrials.gov: NCT03520218). Results Twenty-five female participants (median age, 52 years; range, 32-85 years) comprised the cohort. Twenty-four of 25 (96%) cancers (19 invasive cancers and five in situ diseases) were identified with PEM from 100 sets of bilateral images, showcasing comparable performance even after 3 hours of radiotracer uptake. The median invasive cancer size was 31 mm (range, 10-120). Three additional in situ grade 2 lesions were missed at PEM. While not significant, PEM detected fewer false-positive additional lesions compared with MRI (one of six [16%] vs eight of 13 [62%]; <i>P</i> = .14). Conclusion This study suggests the feasibility of a low-dose PEM system in helping to detect invasive breast cancer. Though large-scale clinical trials are essential to confirm these preliminary results, this study underscores the potential of this low-dose PEM system as a promising imaging tool in breast cancer diagnosis. ClinicalTrials.gov registration no. NCT03520218 <b>Keywords:</b> Positron Emission Digital Mammography, Invasive Breast Cancer, Oncology, MRI <i>Supplemental material is available for this article.</i> © RSNA, 2024 See also commentary by Barreto and Rapelyea in this issue.</p>","PeriodicalId":20786,"journal":{"name":"Radiology. Imaging cancer","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10988332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139707638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Primary Osteosarcoma of the Sternum with Lung Metastases. 胸骨原发性骨肉瘤伴肺部转移。
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-03-01 DOI: 10.1148/rycan.230199
Anitha Mandava, Sanath Kandem, Rakesh Juluri, Arvind K Reddy, Veeraiah Koppula
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引用次数: 0
Calvarial Epithelioid Hemangioendothelioma Mimicking Osteosarcoma. 模仿骨肉瘤的钙化上皮样血管内皮瘤
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-03-01 DOI: 10.1148/rycan.230198
Yashaswi Singh, Amit Gupta, Asit Ranjan Mridha, Krithika Rangarajan
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引用次数: 0
期刊
Radiology. Imaging cancer
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