Clinical and Translational Imaging最新文献

Objective

This study explores the diagnostic value of quantitative parameters from ⁶⁸Ga-FAPI-04 PET/CT and ¹⁸F-FDG PET/CT in the detection of mediastinal lymph node metastasis in non-small cell lung cancer (NSCLC) patients.

Methods

Seventeen NSCLC patients patients undergoing imaging with FAPI and FDG were included in the study. Measurements were taken for short diameter, long diameter, density of mediastinal lymph nodes, as well as SUVmax of mediastinal blood pool (MBP- SUVmax), primary tumor (PT-SUVmax), and lymph nodes (LN-SUVmax) in both imaging modalities. LN-SUVmax / MBP- SUVmax, LN-SUVmax / PT-SUVmax, and LN-SUVmax /short diameter ratios were calculated for lymph nodes. Statistical differences between the parameters of imaging modalities in the mediastinal lymph node metastasis group and the non-metastasis group were analyzed. Statistical differences between FAPI and FDG imaging parameters were also compared. Receiver Operating Characteristic (ROC) curves were utilized to determine optimal diagnostic thresholds, along with corresponding sensitivity, specificity, and area under the curve (AUC) for each parameter in the detection of mediastinal lymph node metastasis.

Results

In FAPI imaging, LN-SUVmax, LN-SUVmax / MBP- SUVmax, LN-SUVmax / PT-SUVmax, and LN-SUVmax /short diameter were higher in the mediastinal lymph node metastasis group compared to the non-metastasis group, with statistical significance (p < 0.05). In FDG imaging, only LN-SUVmax / PT-SUVmax was higher in the mediastinal lymph node metastasis group, with statistical significance (p < 0.05). Two parameters (LN-SUVmax/MBP-SUVmax, LN-SUVmax/PT-SUVmax) in the FAPI group and three parameters (LN-SUVmax, LN-SUVmax/MBP-SUVmax, LN-SUVmax/short diameter) in the FDG group showed positive and negative correlations, respectively, in the mediastinal lymph node metastasis and non-metastasis groups, all with statistical significance (p < 0.05). The AUC of FAPI imaging for LN-SUVmax (0.907 vs. 0.667) and LN-SUVmax/PT- SUVmax (0.772 vs. 0.704) were higher compared to FDG imaging, with statistical significance (p < 0.05).

Conclusion

⁶⁸Ga-FAPI-04 PET/CT imaging exhibits a certain advantage over ¹⁸F-FDG PET/CT in the detection of mediastinal lymph node metastasis in NSCLC patients, suggesting potential clinical value in the staging of NSCLC patients.

Introduction

Radioactive iodine (RAI) therapy is part of the treatment option for Graves’ disease, and it is widely accepted to be safe. However, some evidence suggests its association to a small increased risk of thyroid cancer and rarely to an aggressive form of thyroid carcinoma.

Case report

Here, we report a case of anaplastic thyroid carcinoma (ATC) following RAI treatment for Graves’ disease. A 48 year-old woman had been diagnosed with Graves’ disease and thyroid nodules. A single RAI treatment had been performed after an unsuccessful medical therapy approach. More than 10 years later, the patient was admitted to our clinic due to dysphonia, weight loss and a rapidly growing neck mass. Thyroid ultrasound and neck computed tomography suggested a thyroid carcinoma and she was diagnosed with a V600E BRAF-mutated ATC. She was given carboplatin, paclitaxel, and radiotherapy. The patient died a few months after the first symptoms of the disease occurred.

Discussion

It is not clear if the occurrence of ATC could be influenced by the RAI therapy for hyperthyroidism. Therefore, we reviewed the different cases and characteristics of ATC after RAI published so far in the literature. Patients were exclusively females, the median age at diagnosis was 66,5 years old (IQR: 51,5–69, range 29–75) and the median time occurring from RAI treatment and ATC diagnosis was 7 years. To our knowledge, here we report the first patient with V600E BRAF-mutation in ATC after RAI for Graves’ disease.

Background

Osteosarcomas (OSTs) and Ewing’s sarcomas (EWSs) present significant challenges in pediatric and adolescent oncology due to their diverse pathological features and clinical behaviors. The advent of [¹⁸F]fluoro-2-deoxy-2-d-glucose positron emission tomography ([¹⁸F]FDG PET) has introduced new potential prognostic parameters, such as the SUVmax, MTV, and TLG, but their predictive value in patients with OST and EWS remains debatable.

Methods

This systematic review and network meta-analysis were conducted in accordance with PRISMA-NMA guidelines. A comprehensive literature search covered studies from the last 15 years on [¹⁸F]FDG PET metabolic parameters in patients with OST and EWS. The prognostic value of [¹⁸F]FDG PET parameters, including pre- and posttreatment standardized uptake values (SUV1, SUV2 and the SUV2/SUV1 ratio), metabolic tumor volume (MTV1, MTV2) and total lesion glycolysis (TLG1, TLG2), on event-free survival and overall survival in patients with OST and EWS was examined. The data analysis involved traditional and network meta-analyses (NMA), including subgroup analyses and meta-regression.

Results

Our analysis included 20 studies with 858 patients. We found significant associations between higher SUV1, SUV2, MTV1 and TLG1 and survival outcomes. The NMA revealed the superior predictive strength of SUV2, MTV, and TLG over SUV1. Subgroup analysis highlighted the variable prognostic value of these parameters, particularly between pediatric and adult patients.

Conclusion

Our study suggested that [¹⁸F]FDG PET parameters, particularly SUV2, MTV1, and TLG1, have significant prognostic value in patients with OST and EWS. Further research involving larger cohorts and standardized methodologies is essential to confirm and build upon these findings.

Aim

Dopamine is one of the major neurotransmitters of the central nervous system. Dopamine is involved in various cerebral and peripheral physiological functions and pathological conditions. The aim of this mini review is to overview the dopamine, PET radiotracers of dopaminergic system and their clinical applications.

Methods

Dopamine synthesis, dopamine receptors, role of dopamine in physiological functions and diseases, PET radiotracers of dopaminergic system and their clinical applications were reviewed.

Results

There is a large number of PET radiotracers to assess various elements of dopaminergic system such as F-18 fluorodopamine to assess dopamine transfer and storage in peripheral catecholamine-synthesizing cells, F-18 FDOPA to assess L-DOPA transfer via l-amino acid transporters, conversion of L-DOPA to dopamine by aromatic l-amino acid decarboxylase and storage of dopamine at vesicles, C-11 methylphenidat, C-11 dihydrotetrabenazine, and C-11 deprenyl to assess dopamine transport via dopamine transporters, dopamine transport into vesicles by vesicular monoamine transporter-2, and dopamine degredation by monoamine oxidase, respectively, in presynaptic dopaminergic nerve terminals in the brain and in certain peripheral cells and C-11 raclopride and C-11 SCH 23,390 to assess dopamine receptors at postsynaptic nerve terminals. Among these radiotracers, only F-18 FDOPA is widely and commercially available. The other radiotracers are available in limited centers, mainly for research purpose. Dopaminergic PET radiotracers help to detect or diagnose various diseases such as parkinsonian syndromes, huntington’s disease, dementias, schizophrenia, drug addictions, paragangliomas, pheochromocytoma, medullary thyroid carcinoma, gut carcinoids, gliomas and hyperinsulinemic hypoglycemia.

Conclusion

There is a large number of dopaminergic PET radiotracers which help to detect or diagnose diseases of the various systems in which dopaminergic system is involved.

Purpose

This study aims to explore the long-term effects on parathyroid function and risk factors associated with permanent hypoparathyroidism (HPT) in differentiated thyroid cancer (DTC) patients treated with ¹³¹I.

Methods

201 postoperative DTC patients were included. Serum levels of parathyroid hormone (PTH), 25-hydroxyvitamin D (25-OH-VD), calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP) were collected before (baseline) and after ¹³¹I treatment. Patients were divided into permanent HPT group and non-permanent HPT group, and risk factors were analyzed using penalized logistic regression (PLR).

Results

There were no statistically significant differences in serum levels of PTH, 25-OH-VD, Ca, P, and ALP among the five time points (baseline, 6 months, 12 months, 24 months, and 36 months) (P > 0.05). Multivariate PLR analysis revealed that the presence of functional metastases in the first ¹³¹I-SPECT/CT-whole-body scan (¹³¹I-WBS) was a significant risk factor for permanent HPT (OR = 21.392, P < 0.05).

Conclusions

Postoperative ¹³¹I therapy for DTC has no significant adverse effects on the parathyroid function within three years, but extremely few patients still develop permanent HPT, with an increased risk in those with functional metastases in the first ¹³¹I-WBS.

Purpose

Psoriasis is a chronic autoimmune inflammatory disease that affects skin and nails but may also involve further sites of clinical or subclinical inflammation, including the joints. The aim of this review is to explore the role of PET imaging in psoriasis and psoriatic arthritis, especially in the assessment of joint and systemic inflammation and vascular inflammation, such as aortitis.

Methods

We conducted an unstructured search of the literature for any studies employing the f [¹⁸F]-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) in the assessment of inflammation in patients with psoriasis or psoriatic arthritis.

Results

The role of [¹⁸F]-FDG PET/CT has been explored, with special focus on potential novel biomarkers, assessment of disease severity, and the imaging monitoring and validation of novel therapeutic strategies, including also future perspectives concerning further PET tracers, such as [¹⁸F]fluoride PET imaging.

Conclusions

The possibility of the evaluation of inflammation in different sites can be used to evaluate both systemic, articular and periarticular inflammation, giving the possibility of a comprehensive assessment of the patients. The emerging clinical needs for novel biomarkers in the psoriasis field can be potentially supported by novel biomarkers on FDG PET imaging in several research settings but further multicentric trials are needed for the implementation in the clinical practice.

Purpose

Our meta-analysis aimed to compare the positivity rates of [⁶⁸Ga]Ga-FAPI-04 PET and [¹⁸F]FDG PET in gastric and pancreatic cancer.

Methods

We conducted a comprehensive search of PubMed, Embase, and Web of Science databases up to May 2023. The selected studies focused on evaluating the positivity rates of [¹⁸F]FDG PET and [⁶⁸Ga]Ga-FAPI-04 PET in detecting gastric and pancreatic cancer.

Results

A total of 2,401 studies were screened and 13 articles were finally included. The positivity rates of [¹⁸F]FDG PET for primary gastric cancer, lymph node and peritoneal metastases were 0.74 [95% confidence interval (CI): 0.55–0.89], 0.49 (95% CI: 0.33–0.65) and 0.52 (95% CI: 0.37–0.67), respectively. On the other hand, [⁶⁸Ga]Ga-FAPI-04 PET demonstrated significantly higher positivity rates at 0.98 (95% CI: 0.92-1.00), 0.76 (95% CI: 0.60–0.89) and 0.99 (95% CI: 0.93-1.00) (P < 0.01,P = 0.02, P < 0.01), respectively. For pancreatic cancer, [¹⁸F]FDG PET showed positivity rates of 0.93 (95% CI: 0.76-1.00) and 0.46 (95% CI: 0.23–0.69) for primary cancer and lymph node metastases, respectively. In comparison, [⁶⁸Ga]Ga-FAPI-04 PET showed similar positivity rates of 1.00 (95% CI: 0.94-1.00) and 0.68 (95% CI: 0.40–0.90), (P = 0.27, 0.23). There was no significant difference in histopathological positivity rates for signet ring cell carcinoma and TNM stages I and II-IV (P = 0.96, 0.85,0.56).

Conclusion

[⁶⁸Ga]Ga-FAPI-04 PET exhibited a higher positivity rate compared to [¹⁸F]FDG PET in the detection of primary gastric cancer, lymph node and peritoneal metastases. For pancreatic cancer, both [¹⁸F]FDG PET and [⁶⁸Ga]Ga-FAPI-04 PET demonstrated comparable, high positivity rates for primary cancer diagnosis and lymph node metastasis detection. There is still a requirement for more extensive and forward-looking research in this field.