Pub Date : 2024-09-02DOI: 10.1186/s40644-024-00764-x
Min Zhou, Zhuang Nie, Jie Zhao, Yao Xiao, Xiaohua Hong, Yuhui Wang, Chengjun Dong, Alexander P Lin, Ziqiao Lei
Background: Cystathionine accumulates selectively in 1p/19q-codeleted gliomas, and can serve as a possible noninvasive biomarker. This study aims to optimize the echo time (TE) of point-resolved spectroscopy (PRESS) for cystathionine detection in gliomas, and evaluate the diagnostic accuracy of PRESS for 1p/19q-codeletion identification.
Methods: The TE of PRESS was optimized with numerical and phantom analysis to better resolve cystathionine from the overlapping aspartate multiplets. The optimized and 97 ms TE PRESS were then applied to 84 prospectively enrolled patients suspected of glioma or glioma recurrence to examine the influence of aspartate on cystathionine quantification by fitting the spectra with and without aspartate. The diagnostic performance of PRESS for 1p/19q-codeleted gliomas were assessed.
Results: The TE of PRESS was optimized as (TE1, TE2) = (17 ms, 28 ms). The spectral pattern of cystathionine and aspartate were consistent between calculation and phantom. The mean concentrations of cystathionine in vivo fitting without aspartate were significantly higher than those fitting with full basis-set for 97 ms TE PRESS (1.97 ± 2.01 mM vs. 1.55 ± 1.95 mM, p < 0.01), but not significantly different for 45 ms method (0.801 ± 1.217 mM and 0.796 ± 1.217 mM, p = 0.494). The cystathionine concentrations of 45 ms approach was better correlated with those of edited MRS than 97 ms counterparts (r = 0.68 vs. 0.49, both p < 0.01). The sensitivity and specificity for discriminating 1p/19q-codeleted gliomas were 66.7% and 73.7% for 45 ms method, and 44.4% and 52.5% for 97 ms method, respectively.
Conclusion: The 45 ms TE PRESS yields more precise cystathionine estimates than the 97 ms method, and is anticipated to facilitate noninvasive diagnosis of 1p/19q-codeleted gliomas, and treatment response monitoring in those patients. Medium diagnostic performance of PRESS for 1p/19q-codeleted gliomas were observed, and warrants further investigations.
背景:胱硫醚会在1p/19q编码缺失的胶质瘤中选择性蓄积,可作为一种可能的无创生物标记物。本研究旨在优化点分辨光谱法(PRESS)检测胶质瘤中胱硫醚的回波时间(TE),并评估PRESS对1p/19q编码缺失识别的诊断准确性:通过数值分析和模型分析对 PRESS 的 TE 进行了优化,以更好地从重叠的天冬氨酸多信号中分辨出胱硫醚。然后将优化后的和 97 ms TE 的 PRESS 应用于 84 例前瞻性入组的疑似胶质瘤或胶质瘤复发患者,通过拟合含天冬氨酸和不含天冬氨酸的光谱,研究天冬氨酸对胱硫醚定量的影响。评估了 PRESS 对 1p/19q 缺失编码胶质瘤的诊断性能:结果:PRESS 的 TE 优化为 (TE1, TE2) = (17 ms, 28 ms)。胱硫醚和天门冬氨酸的光谱模式在计算和模型中保持一致。在 97 ms TE PRESS 条件下,不含天冬氨酸的体内拟合胱硫醚平均浓度明显高于全基集拟合(1.97 ± 2.01 mM vs. 1.55 ± 1.95 mM,p 结论):45 毫秒 TE PRESS 比 97 毫秒方法能得出更精确的胱硫醚估计值,预计将有助于对 1p/19q 缺失编码胶质瘤进行无创诊断,并监测这些患者的治疗反应。据观察,PRESS 对 1p/19q 缺失编码胶质瘤的诊断效果中等,值得进一步研究。
{"title":"Optimization and validation of echo times of point-resolved spectroscopy for cystathionine detection in gliomas.","authors":"Min Zhou, Zhuang Nie, Jie Zhao, Yao Xiao, Xiaohua Hong, Yuhui Wang, Chengjun Dong, Alexander P Lin, Ziqiao Lei","doi":"10.1186/s40644-024-00764-x","DOIUrl":"10.1186/s40644-024-00764-x","url":null,"abstract":"<p><strong>Background: </strong>Cystathionine accumulates selectively in 1p/19q-codeleted gliomas, and can serve as a possible noninvasive biomarker. This study aims to optimize the echo time (TE) of point-resolved spectroscopy (PRESS) for cystathionine detection in gliomas, and evaluate the diagnostic accuracy of PRESS for 1p/19q-codeletion identification.</p><p><strong>Methods: </strong>The TE of PRESS was optimized with numerical and phantom analysis to better resolve cystathionine from the overlapping aspartate multiplets. The optimized and 97 ms TE PRESS were then applied to 84 prospectively enrolled patients suspected of glioma or glioma recurrence to examine the influence of aspartate on cystathionine quantification by fitting the spectra with and without aspartate. The diagnostic performance of PRESS for 1p/19q-codeleted gliomas were assessed.</p><p><strong>Results: </strong>The TE of PRESS was optimized as (TE1, TE2) = (17 ms, 28 ms). The spectral pattern of cystathionine and aspartate were consistent between calculation and phantom. The mean concentrations of cystathionine in vivo fitting without aspartate were significantly higher than those fitting with full basis-set for 97 ms TE PRESS (1.97 ± 2.01 mM vs. 1.55 ± 1.95 mM, p < 0.01), but not significantly different for 45 ms method (0.801 ± 1.217 mM and 0.796 ± 1.217 mM, p = 0.494). The cystathionine concentrations of 45 ms approach was better correlated with those of edited MRS than 97 ms counterparts (r = 0.68 vs. 0.49, both p < 0.01). The sensitivity and specificity for discriminating 1p/19q-codeleted gliomas were 66.7% and 73.7% for 45 ms method, and 44.4% and 52.5% for 97 ms method, respectively.</p><p><strong>Conclusion: </strong>The 45 ms TE PRESS yields more precise cystathionine estimates than the 97 ms method, and is anticipated to facilitate noninvasive diagnosis of 1p/19q-codeleted gliomas, and treatment response monitoring in those patients. Medium diagnostic performance of PRESS for 1p/19q-codeleted gliomas were observed, and warrants further investigations.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"24 1","pages":"118"},"PeriodicalIF":3.5,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-30DOI: 10.1186/s40644-024-00752-1
Sara Harsini, Patrick Martineau, Sonia Plaha, Heather Saprunoff, Catherine Chen, Julia Bishop, Scott Tyldesley, Don Wilson, François Bénard
<p><strong>Background: </strong>Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is becoming standard of care for men with biochemical recurrence (BCR) of prostate cancer. The implications of a negative PSMA PET/CT scan in this population remain unclear. This study aims to assess the outcome of patients with BCR post radical prostatectomy (RP) who have negative [<sup>18</sup>F]DCFPyL PET/CT scan at relapse.</p><p><strong>Methods: </strong>This is a post-hoc subgroup analysis of a prospective non randomized clinical trial. One hundred and one patients (median age, 75 years) with BCR after RP, who tested negative on [<sup>18</sup>F]DCFPyL PET/CT and subsequently either underwent salvage radiotherapy (sRT) with or without androgen deprivation therapy (ADT) or were followed without active treatment, were included. Freedom from progression (FFP) after negative PSMA PET/CT was determined based on follow-up imaging selected as per clinical practice. Uni- and multivariate Cox regression analyses were performed to examine the association of patients' characteristics, tumor-specific variables, and treatment with clinical progression at the last follow-up. FFP at 1-, 2-, and 3-year were reported using Kaplan Meier analysis.</p><p><strong>Results: </strong>The median PSA level at PET/CT was 0.56 ng/mL (range, 0.4-11.3). Sixty five (64%) patients were followed without receiving further treatment, and 36 (36%) received sRT (18% to the prostate bed only and 18% to the prostate bed and pelvic lymph nodes) within 3 months of the PSMA PET. Seventeen of the sRT patients (17 of 36, 47%) received concomitant androgen deprivation therapy (ADT). Median follow-up was 39 months. Subsequent clinical progression was detected in 21 patients (21%), with 52% in pelvic lymph nodes, 52% in the prostatic fossa, 19% in distant lymph nodes, 14% in lungs, and 10% in bones. The FFP was 95% (95% CI: 91%-99%) at 12 months, 87% (95% CI: 81%-94%) at 24 months, and 79% (95% CI: 71%-88%) at 36 months. Multivariate Cox regression analysis revealed that an initial International Society of Urological Pathology (ISUP) grade 5 was significantly associated with clinical progression at the last follow-up (hazard ratio, 5.1, P value, 0.04). Furthermore, the receipt of sRT correlated significantly with lower clinical progression at the last follow-up (hazard ratio, 0.2, P value, 0.03), whereas other clinical and tumor-specific parameters did not. Following surveillance-only and sRT, 29% (19 of 65) and 6% (2 of 36) of patients, respectively, showed clinical progression. In the sRT group, no significant difference was observed in FFP between patients who underwent sRT to the prostatic fossa versus those who received sRT to the prostatic fossa and pelvic lymph nodes, although the numbers in these groups were small.</p><p><strong>Conclusions: </strong>This study suggests that salvage radiotherapy is associated with a decreased or delayed clinical prog
{"title":"Prognostic significance of a negative PSMA PET/CT in biochemical recurrence of prostate cancer.","authors":"Sara Harsini, Patrick Martineau, Sonia Plaha, Heather Saprunoff, Catherine Chen, Julia Bishop, Scott Tyldesley, Don Wilson, François Bénard","doi":"10.1186/s40644-024-00752-1","DOIUrl":"10.1186/s40644-024-00752-1","url":null,"abstract":"<p><strong>Background: </strong>Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is becoming standard of care for men with biochemical recurrence (BCR) of prostate cancer. The implications of a negative PSMA PET/CT scan in this population remain unclear. This study aims to assess the outcome of patients with BCR post radical prostatectomy (RP) who have negative [<sup>18</sup>F]DCFPyL PET/CT scan at relapse.</p><p><strong>Methods: </strong>This is a post-hoc subgroup analysis of a prospective non randomized clinical trial. One hundred and one patients (median age, 75 years) with BCR after RP, who tested negative on [<sup>18</sup>F]DCFPyL PET/CT and subsequently either underwent salvage radiotherapy (sRT) with or without androgen deprivation therapy (ADT) or were followed without active treatment, were included. Freedom from progression (FFP) after negative PSMA PET/CT was determined based on follow-up imaging selected as per clinical practice. Uni- and multivariate Cox regression analyses were performed to examine the association of patients' characteristics, tumor-specific variables, and treatment with clinical progression at the last follow-up. FFP at 1-, 2-, and 3-year were reported using Kaplan Meier analysis.</p><p><strong>Results: </strong>The median PSA level at PET/CT was 0.56 ng/mL (range, 0.4-11.3). Sixty five (64%) patients were followed without receiving further treatment, and 36 (36%) received sRT (18% to the prostate bed only and 18% to the prostate bed and pelvic lymph nodes) within 3 months of the PSMA PET. Seventeen of the sRT patients (17 of 36, 47%) received concomitant androgen deprivation therapy (ADT). Median follow-up was 39 months. Subsequent clinical progression was detected in 21 patients (21%), with 52% in pelvic lymph nodes, 52% in the prostatic fossa, 19% in distant lymph nodes, 14% in lungs, and 10% in bones. The FFP was 95% (95% CI: 91%-99%) at 12 months, 87% (95% CI: 81%-94%) at 24 months, and 79% (95% CI: 71%-88%) at 36 months. Multivariate Cox regression analysis revealed that an initial International Society of Urological Pathology (ISUP) grade 5 was significantly associated with clinical progression at the last follow-up (hazard ratio, 5.1, P value, 0.04). Furthermore, the receipt of sRT correlated significantly with lower clinical progression at the last follow-up (hazard ratio, 0.2, P value, 0.03), whereas other clinical and tumor-specific parameters did not. Following surveillance-only and sRT, 29% (19 of 65) and 6% (2 of 36) of patients, respectively, showed clinical progression. In the sRT group, no significant difference was observed in FFP between patients who underwent sRT to the prostatic fossa versus those who received sRT to the prostatic fossa and pelvic lymph nodes, although the numbers in these groups were small.</p><p><strong>Conclusions: </strong>This study suggests that salvage radiotherapy is associated with a decreased or delayed clinical prog","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"24 1","pages":"117"},"PeriodicalIF":3.5,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-29DOI: 10.1186/s40644-024-00765-w
Tao Song, Shuang Lu, Jinrong Qu, Hongkai Zhang, Zhaoqi Wang, Zhengyan Jia, Hailiang Li, Yan Zhao, Jianjun Qin, Wen Feng, Shaoyu Wang, Xu Yan
Background: The aim of this research is to prospectively investigate the diagnostic performance of intravoxel incoherent motion (IVIM) using the integrated slice-specific dynamic shimming (iShim) technique in staging primary esophageal squamous cell carcinoma (ESCC) and predicting presence of lymph node metastases from ESCC.
Methods: Sixty-three patients with ESCC were prospectively enrolled from April 2016 to April 2019. MR and IVIM using iShim technique (b = 0, 25, 50, 75, 100, 200, 400, 600, 800 s/mm2) were performed on 3.0T MRI system before operation. Primary tumour apparent diffusion coefficient (ADC) and IVIM parameters, including true diffusion coefficient (D), pseudodiffusion coefficient (D*), pseudodiffusion fraction (f) were measured by two independent radiologists. The differences in D, D*, f and ADC values of different T and N stages were assessed. Intraclass correlation coefficients (ICCs) were calculated to evaluate the interobserver agreement between two readers. The diagnostic performances of D, D*, f and ADC values in primary tumour staging and prediction of lymph node metastasis of ESCC were determined using receiver operating characteristic (ROC) curve analysis.
Results: The inter-observer consensus was excellent for IVIM parameters and ADC (D: ICC = 0.922; D*: ICC = 0.892; f: ICC = 0.948; ADC: ICC = 0.958). The ADC, D, D* and f values of group T1 + T2 were significantly higher than those of group T3 + T4a [ADC: (2.55 ± 0.43) ×10- 3 mm2/s vs. (2.27 ± 0.40) ×10- 3 mm2/s, t = 2.670, P = 0.010; D: (1.82 ± 0.39) ×10- 3 mm2/s vs. (1.53 ± 0.33) ×10- 3 mm2/s, t = 3.189, P = 0.002; D*: 46.45 (30.30,55.53) ×10- 3 mm2/s vs. 32.30 (18.60,40.95) ×10- 3 mm2/s, z=-2.408, P = 0.016; f: 0.45 ± 0.12 vs. 0.37 ± 0.12, t = 2.538, P = 0.014]. The ADC, D and f values of the lymph nodes-positive (N+) group were significantly lower than those of lymph nodes-negative (N0) group [ADC: (2.10 ± 0.33) ×10- 3 mm2/s vs. (2.55 ± 0.40) ×10- 3 mm2/s, t=-4.564, P < 0.001; D: (1.44 ± 0.30) ×10- 3 mm2/s vs. (1.78 ± 0.37) ×10- 3 mm2/s, t=-3.726, P < 0.001; f: 0.32 ± 0.10 vs. 0.45 ± 0.11, t=-4.524, P < 0.001]. The combination of D, D* and f yielded the highest area under the curve (AUC) (0.814) in distinguishing group T1 + T2 from group T3 + T4a. D combined with f provided the highest diagnostic performance (AUC = 0.849) in identifying group N + and group N0 of ESCC.
Conclusions: IVIM may be used as an effective functional imaging technique to evaluate preoperative stage of primary tumour and predict presence of lymph node metastases from ESCC.
研究背景本研究的目的是前瞻性地调查体外非相干运动(IVIM)在对原发性食管鳞状细胞癌(ESCC)分期和预测ESCC淋巴结转移方面的诊断性能:从2016年4月至2019年4月,63名ESCC患者被纳入前瞻性研究。手术前在 3.0T MRI 系统上使用 iShim 技术(b = 0、25、50、75、100、200、400、600、800 s/mm2)进行 MR 和 IVIM 检查。原发肿瘤表观弥散系数(ADC)和IVIM参数,包括真弥散系数(D)、假弥散系数(D*)和假弥散分数(f)由两名独立的放射科医生测量。评估了不同 T 期和 N 期 D、D*、f 和 ADC 值的差异。通过计算类内相关系数(ICC)来评估两位读者之间的观察者间一致性。使用接收器操作特征曲线(ROC)分析确定了D、D*、f和ADC值在ESCC原发肿瘤分期和淋巴结转移预测中的诊断性能:IVIM参数和ADC的观察者间共识非常好(D:ICC = 0.922;D*:ICC = 0.892;f:ICC = 0.948;ADC:ICC = 0.958)。T1 + T2 组的 ADC、D、D* 和 f 值明显高于 T3 + T4a 组[ADC:(2.55 ± 0.43)×10- 3 mm2/s vs. (2.27 ± 0.40) ×10- 3 mm2/s, t = 2.670, P = 0.010; D: (1.82 ± 0.39) ×10- 3 mm2/s vs. (1.53 ± 0.33) ×10- 3 mm2/s, t = 3.189, P = 0.002; D*:46.45 (30.30,55.53) ×10- 3 mm2/s vs. 32.30 (18.60,40.95) ×10- 3 mm2/s, z=-2.408, P = 0.016; f: 0.45 ± 0.12 vs. 0.37 ± 0.12, t = 2.538, P = 0.014]。淋巴结阳性(N+)组的ADC、D和f值明显低于淋巴结阴性(N0)组[ADC:(2.10±0.33)×10- 3 mm2/s vs. (2.55±0.40)×10- 3 mm2/s,t=-4.3 mm2/s vs. (1.78 ± 0.37) ×10- 3 mm2/s, t=-3.726, P * 和 f 在区分 T1 + T2 组和 T3 + T4a 组时产生的曲线下面积(AUC)(0.814)最高。D 联合 f 在鉴别 ESCC 的 N + 组和 N0 组方面具有最高的诊断性能(AUC = 0.849):IVIM可作为一种有效的功能成像技术,用于评估原发肿瘤的术前分期和预测ESCC是否存在淋巴结转移。
{"title":"Intravoxel incoherent motion diffusion-weighted imaging in evaluating preoperative staging of esophageal squamous cell carcinoma : Evaluation of preoperative stage of primary tumour and prediction of lymph node metastases from esophageal cancer using IVIM: a prospective study.","authors":"Tao Song, Shuang Lu, Jinrong Qu, Hongkai Zhang, Zhaoqi Wang, Zhengyan Jia, Hailiang Li, Yan Zhao, Jianjun Qin, Wen Feng, Shaoyu Wang, Xu Yan","doi":"10.1186/s40644-024-00765-w","DOIUrl":"https://doi.org/10.1186/s40644-024-00765-w","url":null,"abstract":"<p><strong>Background: </strong>The aim of this research is to prospectively investigate the diagnostic performance of intravoxel incoherent motion (IVIM) using the integrated slice-specific dynamic shimming (iShim) technique in staging primary esophageal squamous cell carcinoma (ESCC) and predicting presence of lymph node metastases from ESCC.</p><p><strong>Methods: </strong>Sixty-three patients with ESCC were prospectively enrolled from April 2016 to April 2019. MR and IVIM using iShim technique (b = 0, 25, 50, 75, 100, 200, 400, 600, 800 s/mm<sup>2</sup>) were performed on 3.0T MRI system before operation. Primary tumour apparent diffusion coefficient (ADC) and IVIM parameters, including true diffusion coefficient (D), pseudodiffusion coefficient (D<sup>*</sup>), pseudodiffusion fraction (f) were measured by two independent radiologists. The differences in D, D<sup>*</sup>, f and ADC values of different T and N stages were assessed. Intraclass correlation coefficients (ICCs) were calculated to evaluate the interobserver agreement between two readers. The diagnostic performances of D, D<sup>*</sup>, f and ADC values in primary tumour staging and prediction of lymph node metastasis of ESCC were determined using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>The inter-observer consensus was excellent for IVIM parameters and ADC (D: ICC = 0.922; D<sup>*</sup>: ICC = 0.892; f: ICC = 0.948; ADC: ICC = 0.958). The ADC, D, D<sup>*</sup> and f values of group T1 + T2 were significantly higher than those of group T3 + T4a [ADC: (2.55 ± 0.43) ×10<sup>- 3</sup> mm<sup>2</sup>/s vs. (2.27 ± 0.40) ×10<sup>- 3</sup> mm<sup>2</sup>/s, t = 2.670, P = 0.010; D: (1.82 ± 0.39) ×10<sup>- 3</sup> mm<sup>2</sup>/s vs. (1.53 ± 0.33) ×10<sup>- 3</sup> mm<sup>2</sup>/s, t = 3.189, P = 0.002; D<sup>*</sup>: 46.45 (30.30,55.53) ×10<sup>- 3</sup> mm<sup>2</sup>/s vs. 32.30 (18.60,40.95) ×10<sup>- 3</sup> mm<sup>2</sup>/s, z=-2.408, P = 0.016; f: 0.45 ± 0.12 vs. 0.37 ± 0.12, t = 2.538, P = 0.014]. The ADC, D and f values of the lymph nodes-positive (N+) group were significantly lower than those of lymph nodes-negative (N0) group [ADC: (2.10 ± 0.33) ×10<sup>- 3</sup> mm<sup>2</sup>/s vs. (2.55 ± 0.40) ×10<sup>- 3</sup> mm<sup>2</sup>/s, t=-4.564, P < 0.001; D: (1.44 ± 0.30) ×10<sup>- 3</sup> mm<sup>2</sup>/s vs. (1.78 ± 0.37) ×10<sup>- 3</sup> mm<sup>2</sup>/s, t=-3.726, P < 0.001; f: 0.32 ± 0.10 vs. 0.45 ± 0.11, t=-4.524, P < 0.001]. The combination of D, D<sup>*</sup> and f yielded the highest area under the curve (AUC) (0.814) in distinguishing group T1 + T2 from group T3 + T4a. D combined with f provided the highest diagnostic performance (AUC = 0.849) in identifying group N + and group N0 of ESCC.</p><p><strong>Conclusions: </strong>IVIM may be used as an effective functional imaging technique to evaluate preoperative stage of primary tumour and predict presence of lymph node metastases from ESCC.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"24 1","pages":"116"},"PeriodicalIF":3.5,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-29DOI: 10.1186/s40644-024-00750-3
Ayatullah G Mostafa, Zachary Abramson, Mina Ghbrial, Som Biswas, Sherwin Chan, Himani Darji, Jessica Gartrell, Seth E Karol, Yimei Li, Daniel A Mulrooney, Tushar Patni, Tarek M Zaghloul, M Beth McCarville
Background: Patients treated for cancer have a higher incidence of focal liver lesions than the general population and there is often concern for a malignant etiology. This can result in patient, caregiver and physician anxiety and is managed by a "wait and watch" approach, or immediate additional imaging, or biopsy, depending on the degree of clinical concern. Because it is a low-cost, easily accessible, radiation and sedation free modality, we investigated the value of contrast enhanced ultrasound (CEUS) to accurately distinguish benign from malignant liver lesions in patients treated for childhood malignancies.
Methods: We performed an IRB approved retrospective study of 68 subjects who were newly diagnosed, on treatment or off treatment for a pediatric malignancy and had liver lesions discovered on CT, MRI or non-contrast ultrasound and subsequently underwent CEUS between September 2013 and September 2021. Two experienced pediatric radiologists and a radiology trainee, blinded to the etiology of the liver lesions, independently reviewed the CEUS examinations and categorized lesions as benign, indeterminate, or malignant. The reference standard was biopsy for 19 lesions and clinical follow-up for 49. The sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy of CEUS were calculated using only the benign and malignant CEUS classifications. Inter-reviewer agreement was assessed by Cohen's kappa statistic.
Results: There were 26 males and 42 females, mean age, 14.9 years (range, 1-52 years). Fifty subjects were off therapy, twelve receiving treatment, and six with newly diagnosed cancer. By the reference standard, 59 (87%) lesions were benign and 9 (13%) were malignant. Sensitivities of CEUS for the three reviewers ranged from 83 to 100% (95% CI, 35.9-100%), specificities from 93.1 to 96.0% (95% CI, 83.5-99.6%), PPV 60.0-71.4% (95% CI, 29.0-96.3%), NPV 98.0-100% (95% CI, 89.2-100%) and accuracy from 93.8 to 94.6% (95% CI, 85.1-99.7%). The kappa statistic for agreement between the two experienced radiologists was moderate at 0.58.
Conclusions: CEUS is highly accurate in distinguishing benign from malignant etiologies of liver lesions in patients treated for pediatric malignancies.
{"title":"Contrast enhanced ultrasound of liver lesions in patients treated for childhood malignancies.","authors":"Ayatullah G Mostafa, Zachary Abramson, Mina Ghbrial, Som Biswas, Sherwin Chan, Himani Darji, Jessica Gartrell, Seth E Karol, Yimei Li, Daniel A Mulrooney, Tushar Patni, Tarek M Zaghloul, M Beth McCarville","doi":"10.1186/s40644-024-00750-3","DOIUrl":"10.1186/s40644-024-00750-3","url":null,"abstract":"<p><strong>Background: </strong>Patients treated for cancer have a higher incidence of focal liver lesions than the general population and there is often concern for a malignant etiology. This can result in patient, caregiver and physician anxiety and is managed by a \"wait and watch\" approach, or immediate additional imaging, or biopsy, depending on the degree of clinical concern. Because it is a low-cost, easily accessible, radiation and sedation free modality, we investigated the value of contrast enhanced ultrasound (CEUS) to accurately distinguish benign from malignant liver lesions in patients treated for childhood malignancies.</p><p><strong>Methods: </strong>We performed an IRB approved retrospective study of 68 subjects who were newly diagnosed, on treatment or off treatment for a pediatric malignancy and had liver lesions discovered on CT, MRI or non-contrast ultrasound and subsequently underwent CEUS between September 2013 and September 2021. Two experienced pediatric radiologists and a radiology trainee, blinded to the etiology of the liver lesions, independently reviewed the CEUS examinations and categorized lesions as benign, indeterminate, or malignant. The reference standard was biopsy for 19 lesions and clinical follow-up for 49. The sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy of CEUS were calculated using only the benign and malignant CEUS classifications. Inter-reviewer agreement was assessed by Cohen's kappa statistic.</p><p><strong>Results: </strong>There were 26 males and 42 females, mean age, 14.9 years (range, 1-52 years). Fifty subjects were off therapy, twelve receiving treatment, and six with newly diagnosed cancer. By the reference standard, 59 (87%) lesions were benign and 9 (13%) were malignant. Sensitivities of CEUS for the three reviewers ranged from 83 to 100% (95% CI, 35.9-100%), specificities from 93.1 to 96.0% (95% CI, 83.5-99.6%), PPV 60.0-71.4% (95% CI, 29.0-96.3%), NPV 98.0-100% (95% CI, 89.2-100%) and accuracy from 93.8 to 94.6% (95% CI, 85.1-99.7%). The kappa statistic for agreement between the two experienced radiologists was moderate at 0.58.</p><p><strong>Conclusions: </strong>CEUS is highly accurate in distinguishing benign from malignant etiologies of liver lesions in patients treated for pediatric malignancies.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"24 1","pages":"115"},"PeriodicalIF":3.5,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11360734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-27DOI: 10.1186/s40644-024-00760-1
Jacques Dzuko Kamga, Romain Floch, Kevin Kerleguer, David Bourhis, Romain Le Pennec, Simon Hennebicq, Pierre-Yves Salaün, Ronan Abgral
Introduction: The pulmonary Hot Clot artifact (HCa) on 18F-FDG PET/CT is a poorly understood phenomenon, corresponding to the presence of a focal tracer uptake without anatomical lesion on combined CTscan. The hypothesis proposed in the literature is of microembolic origin. Our objectives were to determine the incidence of HCa, to analyze its characteristics and to identify associated factors.
Methods: All 18F-FDG PET/CT retrieved reports containing the keywords (artifact/vascular adhesion/no morphological abnormality) during the period June 2021-2023 at Brest University Hospital were reviewed for HCa. Each case was associated with 2 control patients (same daily work-list). The anatomical and metabolic characteristics of HCa were analyzed. Factors related to FDG preparation/administration, patient and vascular history were investigated. Case-control differences between variables were tested using Chi-2 test and OR (qualitative) or Student's t-test (quantitative).
Results: Of the 22,671 18F-FDG PET/CT performed over 2 years, 211 patients (0.94%) showed HCa. The focus was single in 97.6%, peripheral in 75.3%, and located independently in the right or left lung (51.1% vs. 48.9%). Mean ± SD values for SUVmax, SUVmean, MTV and TLG were 11.3 ± 16.5, 5.1 ± 5.0, 0.3 ± 0.3 ml and 1.5 ± 2.1 g respectively. The presence of vascular adhesion (p < 0.001), patient age (p = 0.002) and proximal venous access (p = 0.001) were statistically associated with the presence of HCa.
Conclusion: HCa is a real but rare phenomenon (incidence around 1%), mostly unique, intense, small in volume (< 1 ml), and associated with the presence of vascular FDG uptake, confirming the hypothesis of a microembolic origin due to probable vein wall trauma at the injection site.
{"title":"Case-control study of the characteristics and risk factors of hot clot artefacts on 18F-FDG PET/CT.","authors":"Jacques Dzuko Kamga, Romain Floch, Kevin Kerleguer, David Bourhis, Romain Le Pennec, Simon Hennebicq, Pierre-Yves Salaün, Ronan Abgral","doi":"10.1186/s40644-024-00760-1","DOIUrl":"10.1186/s40644-024-00760-1","url":null,"abstract":"<p><strong>Introduction: </strong>The pulmonary Hot Clot artifact (HCa) on 18F-FDG PET/CT is a poorly understood phenomenon, corresponding to the presence of a focal tracer uptake without anatomical lesion on combined CTscan. The hypothesis proposed in the literature is of microembolic origin. Our objectives were to determine the incidence of HCa, to analyze its characteristics and to identify associated factors.</p><p><strong>Methods: </strong>All 18F-FDG PET/CT retrieved reports containing the keywords (artifact/vascular adhesion/no morphological abnormality) during the period June 2021-2023 at Brest University Hospital were reviewed for HCa. Each case was associated with 2 control patients (same daily work-list). The anatomical and metabolic characteristics of HCa were analyzed. Factors related to FDG preparation/administration, patient and vascular history were investigated. Case-control differences between variables were tested using Chi-2 test and OR (qualitative) or Student's t-test (quantitative).</p><p><strong>Results: </strong>Of the 22,671 18F-FDG PET/CT performed over 2 years, 211 patients (0.94%) showed HCa. The focus was single in 97.6%, peripheral in 75.3%, and located independently in the right or left lung (51.1% vs. 48.9%). Mean ± SD values for SUVmax, SUVmean, MTV and TLG were 11.3 ± 16.5, 5.1 ± 5.0, 0.3 ± 0.3 ml and 1.5 ± 2.1 g respectively. The presence of vascular adhesion (p < 0.001), patient age (p = 0.002) and proximal venous access (p = 0.001) were statistically associated with the presence of HCa.</p><p><strong>Conclusion: </strong>HCa is a real but rare phenomenon (incidence around 1%), mostly unique, intense, small in volume (< 1 ml), and associated with the presence of vascular FDG uptake, confirming the hypothesis of a microembolic origin due to probable vein wall trauma at the injection site.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"24 1","pages":"114"},"PeriodicalIF":3.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-26DOI: 10.1186/s40644-024-00755-y
Beatriz Ocaña-Tienda, Alba Eroles-Simó, Julián Pérez-Beteta, Estanislao Arana, Víctor M Pérez-García
Background: Lung nodules observed in cancer screening are believed to grow exponentially, and their associated volume doubling time (VDT) has been proposed for nodule classification. This retrospective study aimed to elucidate the growth dynamics of lung nodules and determine the best classification as either benign or malignant.
Methods: Data were analyzed from 180 participants (73.7% male) enrolled in the I-ELCAP screening program (140 primary lung cancer and 40 benign) with three or more annual CT examinations before resection. Attenuation, volume, mass and growth patterns (decelerated, linear, subexponential, exponential and accelerated) were assessed and compared as classification methods.
Results: Most lung cancers (83/140) and few benign nodules (11/40) exhibited an accelerated, faster than exponential, growth pattern. Half (50%) of the benign nodules versus 26.4% of the malignant ones displayed decelerated growth. Differences in growth patterns allowed nodule malignancy to be classified, the most effective individual variable being the increase in volume between two-year-interval scans (ROC-AUC = 0.871). The same metric on the first two follow-ups yielded an AUC value of 0.769. Further classification into solid, part-solid or non-solid, improved results (ROC-AUC of 0.813 in the first year and 0.897 in the second year).
Conclusions: In our dataset, most lung cancers exhibited accelerated growth in contrast to their benign counterparts. A measure of volumetric growth allowed discrimination between benign and malignant nodules. Its classification power increased when adding information on nodule compactness. The combination of these two meaningful and easily obtained variables could be used to assess malignancy of lung cancer nodules.
{"title":"Growth dynamics of lung nodules: implications for classification in lung cancer screening.","authors":"Beatriz Ocaña-Tienda, Alba Eroles-Simó, Julián Pérez-Beteta, Estanislao Arana, Víctor M Pérez-García","doi":"10.1186/s40644-024-00755-y","DOIUrl":"10.1186/s40644-024-00755-y","url":null,"abstract":"<p><strong>Background: </strong>Lung nodules observed in cancer screening are believed to grow exponentially, and their associated volume doubling time (VDT) has been proposed for nodule classification. This retrospective study aimed to elucidate the growth dynamics of lung nodules and determine the best classification as either benign or malignant.</p><p><strong>Methods: </strong>Data were analyzed from 180 participants (73.7% male) enrolled in the I-ELCAP screening program (140 primary lung cancer and 40 benign) with three or more annual CT examinations before resection. Attenuation, volume, mass and growth patterns (decelerated, linear, subexponential, exponential and accelerated) were assessed and compared as classification methods.</p><p><strong>Results: </strong>Most lung cancers (83/140) and few benign nodules (11/40) exhibited an accelerated, faster than exponential, growth pattern. Half (50%) of the benign nodules versus 26.4% of the malignant ones displayed decelerated growth. Differences in growth patterns allowed nodule malignancy to be classified, the most effective individual variable being the increase in volume between two-year-interval scans (ROC-AUC = 0.871). The same metric on the first two follow-ups yielded an AUC value of 0.769. Further classification into solid, part-solid or non-solid, improved results (ROC-AUC of 0.813 in the first year and 0.897 in the second year).</p><p><strong>Conclusions: </strong>In our dataset, most lung cancers exhibited accelerated growth in contrast to their benign counterparts. A measure of volumetric growth allowed discrimination between benign and malignant nodules. Its classification power increased when adding information on nodule compactness. The combination of these two meaningful and easily obtained variables could be used to assess malignancy of lung cancer nodules.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"24 1","pages":"113"},"PeriodicalIF":3.5,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and purpose: Radiomics offers little explainability. This study aims to develop a radiomics model (Rad-Score) using diffusion-weighted imaging (DWI) to predict high-risk patients for nodal metastasis or recurrence in endometrial cancer (EC) and corroborate with choline metabolism.
Materials and methods: From August 2015 to July 2018, 356 EC patients were enrolled. Rad-Score was developed using LASSO regression in a training cohort (n = 287) and validated in an independent test cohort (n = 69). MR spectroscopy (MRS) was also used in 230 patients. Nuclear MRS measured choline metabolites in 70 tissue samples. The performance was compared against European Society for Medical Oncology (ESMO) risk groups. A P < .05 denoted statistical significance.
Results: Rad-Score achieved 71.1% accuracy in the training and 71.0% in the testing cohorts. Incorporating clinical parameters of age, tumor type, size, and grade, Rad-Signature reached accuracies of 73.2% in training and 75.4% in testing cohorts, closely matching the performance to the post-operatively based ESMO's 70.7% and 78.3%. Rad-Score was significantly associated with increased total choline levels on MRS (P = .034) and tissue levels (P = .019).
Conclusions: Development of a preoperative radiomics risk score, comparable to ESMO clinical standard and associated with altered choline metabolism, shows translational relevance for radiomics in high-risk EC patients.
Trial registration: This study was registered in ClinicalTrials.gov on 2015-08-01 with Identifier NCT02528864.
{"title":"Endometrial cancer risk stratification using MRI radiomics: corroborating with choline metabolism.","authors":"Yenpo Lin, Ren-Chin Wu, Yu-Chun Lin, Yen-Ling Huang, Chiao-Yun Lin, Chi-Jen Lo, Hsin-Ying Lu, Kuan-Ying Lu, Shang-Yueh Tsai, Ching-Yi Hsieh, Lan-Yan Yang, Mei-Ling Cheng, Angel Chao, Chyong-Huey Lai, Gigin Lin","doi":"10.1186/s40644-024-00756-x","DOIUrl":"10.1186/s40644-024-00756-x","url":null,"abstract":"<p><strong>Background and purpose: </strong>Radiomics offers little explainability. This study aims to develop a radiomics model (Rad-Score) using diffusion-weighted imaging (DWI) to predict high-risk patients for nodal metastasis or recurrence in endometrial cancer (EC) and corroborate with choline metabolism.</p><p><strong>Materials and methods: </strong>From August 2015 to July 2018, 356 EC patients were enrolled. Rad-Score was developed using LASSO regression in a training cohort (n = 287) and validated in an independent test cohort (n = 69). MR spectroscopy (MRS) was also used in 230 patients. Nuclear MRS measured choline metabolites in 70 tissue samples. The performance was compared against European Society for Medical Oncology (ESMO) risk groups. A P < .05 denoted statistical significance.</p><p><strong>Results: </strong>Rad-Score achieved 71.1% accuracy in the training and 71.0% in the testing cohorts. Incorporating clinical parameters of age, tumor type, size, and grade, Rad-Signature reached accuracies of 73.2% in training and 75.4% in testing cohorts, closely matching the performance to the post-operatively based ESMO's 70.7% and 78.3%. Rad-Score was significantly associated with increased total choline levels on MRS (P = .034) and tissue levels (P = .019).</p><p><strong>Conclusions: </strong>Development of a preoperative radiomics risk score, comparable to ESMO clinical standard and associated with altered choline metabolism, shows translational relevance for radiomics in high-risk EC patients.</p><p><strong>Trial registration: </strong>This study was registered in ClinicalTrials.gov on 2015-08-01 with Identifier NCT02528864.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"24 1","pages":"112"},"PeriodicalIF":3.5,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-20DOI: 10.1186/s40644-024-00753-0
Beatriz Ocaña-Tienda, Julián Pérez-Beteta, Ana Ortiz de Mendivil, Beatriz Asenjo, David Albillo, Luís A Pérez-Romasanta, Manuel LLorente, Natalia Carballo, Estanislao Arana, Víctor M Pérez-García
Background: Stereotactic radiotherapy is the preferred treatment for managing patients with fewer than five brain metastases (BMs). However, some lesions recur after irradiation. The purpose of this study was to identify patients who are at a higher risk of failure, which can help in adjusting treatments and preventing recurrence.
Methods: In this retrospective multicenter study, we analyzed the predictive significance of a set of interpretable morphological features derived from contrast-enhanced (CE) T1-weighted MR images as imaging biomarkers using Kaplan-Meier analysis. The feature sets studied included the total and necrotic volumes, the surface regularity and the CE rim width. Additionally, we evaluated other nonmorphological variables and performed multivariate Cox analysis.
Results: A total of 183 lesions in 128 patients were included (median age 61 [31-95], 64 men and 64 women) treated with stereotactic radiotherapy (57% single fraction, 43% fractionated radiotherapy). None of the studied variables measured at diagnosis were found to have prognostic value. However, the total and necrotic volumes and the CE rim width measured at the first follow-up after treatment and the change in volume due to irradiation can be used as imaging biomarkers for recurrence. The optimal classification was achieved by combining the changes in tumor volume before and after treatment with the presence or absence of necrosis (p < < 0.001).
Conclusion: This study demonstrated the prognostic significance of interpretable morphological features extracted from routine clinical MR images following irradiation in brain metastases, offering valuable insights for personalized treatment strategies.
{"title":"Morphological MRI features as prognostic indicators in brain metastases.","authors":"Beatriz Ocaña-Tienda, Julián Pérez-Beteta, Ana Ortiz de Mendivil, Beatriz Asenjo, David Albillo, Luís A Pérez-Romasanta, Manuel LLorente, Natalia Carballo, Estanislao Arana, Víctor M Pérez-García","doi":"10.1186/s40644-024-00753-0","DOIUrl":"10.1186/s40644-024-00753-0","url":null,"abstract":"<p><strong>Background: </strong>Stereotactic radiotherapy is the preferred treatment for managing patients with fewer than five brain metastases (BMs). However, some lesions recur after irradiation. The purpose of this study was to identify patients who are at a higher risk of failure, which can help in adjusting treatments and preventing recurrence.</p><p><strong>Methods: </strong>In this retrospective multicenter study, we analyzed the predictive significance of a set of interpretable morphological features derived from contrast-enhanced (CE) T1-weighted MR images as imaging biomarkers using Kaplan-Meier analysis. The feature sets studied included the total and necrotic volumes, the surface regularity and the CE rim width. Additionally, we evaluated other nonmorphological variables and performed multivariate Cox analysis.</p><p><strong>Results: </strong>A total of 183 lesions in 128 patients were included (median age 61 [31-95], 64 men and 64 women) treated with stereotactic radiotherapy (57% single fraction, 43% fractionated radiotherapy). None of the studied variables measured at diagnosis were found to have prognostic value. However, the total and necrotic volumes and the CE rim width measured at the first follow-up after treatment and the change in volume due to irradiation can be used as imaging biomarkers for recurrence. The optimal classification was achieved by combining the changes in tumor volume before and after treatment with the presence or absence of necrosis (p < < 0.001).</p><p><strong>Conclusion: </strong>This study demonstrated the prognostic significance of interpretable morphological features extracted from routine clinical MR images following irradiation in brain metastases, offering valuable insights for personalized treatment strategies.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"24 1","pages":"111"},"PeriodicalIF":3.5,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11334491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-19DOI: 10.1186/s40644-024-00761-0
Tomáš Rohan, Petr Hložanka, Marek Dostál, Tereza Kopřivová, Tomáš Macek, Václav Vybíhal, Hiroko Jeannette Martin, Andrea Šprláková-Puková, Miloš Keřkovský
Background: To evaluate and compare the diagnostic power of [18F]FLT-PET with ceMRI in patients with brain tumours or other focal lesions.
Methods: 121 patients with suspected brain tumour or those after brain tumour surgery were enroled in this retrospective study (61 females, 60 males, mean age 37.3 years, range 1-80 years). All patients underwent [18F]FLT-PET/MRI with gadolinium contrast agent application. In 118 of these patients, a final diagnosis was made, verified by histopathology or by follow-up. Agreement between ceMRI and [18F]FLT-PET of the whole study group was established. Further, sensitivity and specificity of ceMRI and [18F]FLT-PET were calculated for differentiation of high-grade vs. low-grade tumours, high-grade vs. low-grade tumours together with non-tumour lesions and for differentiation of high-grade tumours from all other verified lesions.
Results: [18F]FLT-PET and ceMRI findings were concordant in 119 cases (98%). On closer analysis of a subset of 64 patients with verified gliomas, the sensitivity and specificity of both PET and ceMRI were identical (90% and 84%, respectively) for differentiating low-grade from high-grade tumours, if the contrast enhancement and [18F]FLT uptake were considered as hallmarks of high-grade tumour. For differentiation of high-grade tumours from low-grade tumours and lesions of nontumorous aetiology (e.g., inflammatory lesions or post-therapeutic changes) in a subgroup of 93 patients by visual evaluation, the sensitivity of both PET and ceMRI was 90%, whereas the specificity of PET was slightly higher (61%) compared to ceMRI (57%). By receiver operating characteristic analysis, the sensitivity and specificity were 82% and 74%, respectively, when the threshold of SUVmax in the tumour was set to 0.9 g/ml.
Conclusion: We demonstrated a generally very high correlation of [18F]FLT accumulation with contrast enhancement visible on ceMRI and a comparable diagnostic yield in both modalities for differentiating high-grade tumours from low-grade tumours and lesions of other aetiology.
{"title":"The relationship between gadolinium enhancement and [18 F]fluorothymidine uptake in brain lesions with the use of hybrid PET/MRI.","authors":"Tomáš Rohan, Petr Hložanka, Marek Dostál, Tereza Kopřivová, Tomáš Macek, Václav Vybíhal, Hiroko Jeannette Martin, Andrea Šprláková-Puková, Miloš Keřkovský","doi":"10.1186/s40644-024-00761-0","DOIUrl":"10.1186/s40644-024-00761-0","url":null,"abstract":"<p><strong>Background: </strong>To evaluate and compare the diagnostic power of [<sup>18</sup>F]FLT-PET with ceMRI in patients with brain tumours or other focal lesions.</p><p><strong>Methods: </strong>121 patients with suspected brain tumour or those after brain tumour surgery were enroled in this retrospective study (61 females, 60 males, mean age 37.3 years, range 1-80 years). All patients underwent [<sup>18</sup>F]FLT-PET/MRI with gadolinium contrast agent application. In 118 of these patients, a final diagnosis was made, verified by histopathology or by follow-up. Agreement between ceMRI and [<sup>18</sup>F]FLT-PET of the whole study group was established. Further, sensitivity and specificity of ceMRI and [<sup>18</sup>F]FLT-PET were calculated for differentiation of high-grade vs. low-grade tumours, high-grade vs. low-grade tumours together with non-tumour lesions and for differentiation of high-grade tumours from all other verified lesions.</p><p><strong>Results: </strong>[<sup>18</sup>F]FLT-PET and ceMRI findings were concordant in 119 cases (98%). On closer analysis of a subset of 64 patients with verified gliomas, the sensitivity and specificity of both PET and ceMRI were identical (90% and 84%, respectively) for differentiating low-grade from high-grade tumours, if the contrast enhancement and [<sup>18</sup>F]FLT uptake were considered as hallmarks of high-grade tumour. For differentiation of high-grade tumours from low-grade tumours and lesions of nontumorous aetiology (e.g., inflammatory lesions or post-therapeutic changes) in a subgroup of 93 patients by visual evaluation, the sensitivity of both PET and ceMRI was 90%, whereas the specificity of PET was slightly higher (61%) compared to ceMRI (57%). By receiver operating characteristic analysis, the sensitivity and specificity were 82% and 74%, respectively, when the threshold of SUVmax in the tumour was set to 0.9 g/ml.</p><p><strong>Conclusion: </strong>We demonstrated a generally very high correlation of [<sup>18</sup>F]FLT accumulation with contrast enhancement visible on ceMRI and a comparable diagnostic yield in both modalities for differentiating high-grade tumours from low-grade tumours and lesions of other aetiology.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"24 1","pages":"110"},"PeriodicalIF":3.5,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-18DOI: 10.1186/s40644-024-00754-z
Yu Han, Yu-Yao Wang, Yang Yang, Shu-Qi Qiao, Zhi-Cheng Liu, Guang-Bin Cui, Lin-Feng Yan
Objectives: This study aimed to investigate the intra- and inter-observer consistency of the Visually Accessible Rembrandt Images (VASARI) feature set before and after dichotomization, and the association between dichotomous VASARI features and the overall survival (OS) in glioblastoma (GBM) patients.
Methods: This retrospective study included 351 patients with pathologically confirmed IDH1 wild-type GBM between January 2016 and June 2022. Firstly, VASARI features were assessed by four radiologists with varying levels of experience before and after dichotomization. Cohen's kappa coefficient (κ) was calculated to measure the intra- and inter-observer consistency. Then, after adjustment for confounders using propensity score matching, Kaplan-Meier curves were used to compare OS differences for each dichotomous VASARI feature. Next, patients were randomly stratified into a training set (n = 211) and a test set (n = 140) in a 3:2 ratio. Based on the training set, Cox proportional hazards regression analysis was adopted to develop combined and clinical models to predict OS, and the performance of the models was evaluated with the test set.
Results: Eleven VASARI features with κ value of 0.61-0.8 demonstrated almost perfect agreement after dichotomization, with the range of κ values across all readers being 0.874-1.000. Seven VASARI features were correlated with GBM patient OS. For OS prediction, the combined model outperformed the clinical model in both training set (C-index, 0.762 vs. 0.723) and test set (C-index, 0.812 vs. 0.702).
Conclusion: The dichotomous VASARI features exhibited excellent inter- and intra-observer consistency. The combined model outperformed the clinical model for OS prediction.
研究目的本研究旨在调查视觉可及伦勃朗图像(VASARI)特征集在二分法化前后观察者内部和观察者之间的一致性,以及二分法VASARI特征与胶质母细胞瘤(GBM)患者总生存期(OS)之间的关联:这项回顾性研究纳入了2016年1月至2022年6月间351例经病理证实的IDH1野生型GBM患者。首先,由四位经验不同的放射科医生在二分法前后对 VASARI 特征进行评估。计算科恩卡帕系数(κ)来衡量观察者内部和观察者之间的一致性。然后,在使用倾向评分匹配法调整混杂因素后,使用 Kaplan-Meier 曲线比较每个二分法 VASARI 特征的 OS 差异。接下来,按 3:2 的比例将患者随机分层为训练集(n = 211)和测试集(n = 140)。在训练集的基础上,采用Cox比例危险回归分析建立预测OS的综合临床模型,并通过测试集评估模型的性能:结果:κ值为0.61-0.8的11个VASARI特征在二分法后显示出几乎完美的一致性,所有读者的κ值范围为0.874-1.000。七个 VASARI 特征与 GBM 患者的 OS 相关。就OS预测而言,在训练集(C-index, 0.762 vs. 0.723)和测试集(C-index, 0.812 vs. 0.702)中,组合模型的表现均优于临床模型:结论:二分法 VASARI 特征在观察者之间和观察者内部具有极好的一致性。结论:VASARI的二分法特征在观察者之间和观察者内部具有极好的一致性,在预测OS方面,组合模型优于临床模型。
{"title":"Association between dichotomized VASARI feature and overall survival in glioblastoma patients: a single-institution propensity score matching analysis.","authors":"Yu Han, Yu-Yao Wang, Yang Yang, Shu-Qi Qiao, Zhi-Cheng Liu, Guang-Bin Cui, Lin-Feng Yan","doi":"10.1186/s40644-024-00754-z","DOIUrl":"10.1186/s40644-024-00754-z","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the intra- and inter-observer consistency of the Visually Accessible Rembrandt Images (VASARI) feature set before and after dichotomization, and the association between dichotomous VASARI features and the overall survival (OS) in glioblastoma (GBM) patients.</p><p><strong>Methods: </strong>This retrospective study included 351 patients with pathologically confirmed IDH1 wild-type GBM between January 2016 and June 2022. Firstly, VASARI features were assessed by four radiologists with varying levels of experience before and after dichotomization. Cohen's kappa coefficient (κ) was calculated to measure the intra- and inter-observer consistency. Then, after adjustment for confounders using propensity score matching, Kaplan-Meier curves were used to compare OS differences for each dichotomous VASARI feature. Next, patients were randomly stratified into a training set (n = 211) and a test set (n = 140) in a 3:2 ratio. Based on the training set, Cox proportional hazards regression analysis was adopted to develop combined and clinical models to predict OS, and the performance of the models was evaluated with the test set.</p><p><strong>Results: </strong>Eleven VASARI features with κ value of 0.61-0.8 demonstrated almost perfect agreement after dichotomization, with the range of κ values across all readers being 0.874-1.000. Seven VASARI features were correlated with GBM patient OS. For OS prediction, the combined model outperformed the clinical model in both training set (C-index, 0.762 vs. 0.723) and test set (C-index, 0.812 vs. 0.702).</p><p><strong>Conclusion: </strong>The dichotomous VASARI features exhibited excellent inter- and intra-observer consistency. The combined model outperformed the clinical model for OS prediction.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"24 1","pages":"109"},"PeriodicalIF":3.5,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}