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Jason Pantarotto - One of the best experts on this subject based on the ideXlab platform.
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pretreatment 18f fluoro 2 deoxy glucose positron emission tomography maximum Standardized Uptake Value as predictor of distant metastasis in early stage non small cell lung cancer treated with definitive radiation therapy rethinking the role of positron emission tomography in personalizing treatment based on risk status
International Journal of Radiation Oncology Biology Physics, 2014Co-Authors: Vimoj Nair, Robert Macrae, Abby Sirisegaram, Jason PantarottoAbstract:Purpose The aim of this study was to determine whether the preradiation maximum Standardized Uptake Value (SUV max ) of the primary tumor for [ 18 F]-fluoro-2-deoxy-glucose positron emission tomography (FDG-PET) has a prognostic significance in patients with Stage T1 or T2N0 non-small cell lung cancer (NSCLC) treated with curative radiation therapy, whether conventional or stereotactic body radiation therapy (SBRT). Methods and Materials Between January 2007 and December 2011, a total of 163 patients (180 tumors) with medically inoperable histologically proven Stage T1 or T2N0 NSCLC and treated with radiation therapy (both conventional and SBRT) were entered in a research ethics board approved database. All patients received pretreatment FDG-PET / computed tomography (CT) at 1 institution with consistent acquisition technique. The medical records and radiologic images of these patients were analyzed. Results The overall survival at 2 years and 3 years for the whole group was 76% and 67%, respectively. The mean and median SUV max were 8.1 and 7, respectively. Progression-free survival at 2 years with SUV max max ≥7 (67% vs 51%; P =.0096). Tumors with SUV max ≥7 were associated with a worse regional recurrence-free survival and distant metastasis-free survival. In the multivariate analysis, SUV max ≥7 was an independent prognostic factor for distant metastasis-free survival. Conclusion In early-stage NSCLC managed with radiation alone, patients with SUV max ≥7 on FDG-PET / CT scan have poorer outcomes and high risk of progression, possibly because of aggressive biology. There is a potential role for adjuvant therapies for these high-risk patients with intent to improve outcomes.
Won Woo Lee - One of the best experts on this subject based on the ideXlab platform.
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the usefulness of maximum Standardized Uptake Value at the delayed phase of tc 99m sestamibi single photon emission computed tomography computed tomography for identification of parathyroid adenoma and hyperplasia
Medicine, 2020Co-Authors: Won Woo Lee, Hoon Young Suh, So Yeon Park, June Young ChoiAbstract:Tc-99m sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) has been used to help surgeons explore the location of parathyroid diseases, but quantitative parameters have not been systemically investigated for this purpose. We aimed to establish objective criteria for adenoma and hyperplasia using the Standardized Uptake Value (SUV) in patients with hyperparathyroidism.Thirty-nine hyperparathyroid patients (male/female: 17/22, age: 58.33 ± 11.69 years) with at least 1 Uptake-positive lesion of any degree by visual assessment in preoperative Tc-99m sestamibi quantitative SPECT/CT were included from Oct 2015 to Oct 2017. Pathologically, 44 lesions (32 adenomas and 12 hyperplasia) were identified. All patients experienced normalized levels of intact parathyroid hormone immediately after surgery. Quantitative SPECT/CT was performed at 10 minute and 2 hour post injection of Tc-99m sestabmibi (dose = 740 MBq), and maximum SUV (SUVmax) was measured for the parathyroid lesions. Experienced pathologists evaluated the percentage cellular proportions of chief cells, oxyphil cells, and clear cells.SUVmax (g/mL) of adenomas, hyperplasia, and reference thyroid tissue were 12.92 ± 6.68, 7.90 ± 5.49, and 7.01 ± 2.62 at 10min (early phase), decreasing to 7.46 ± 5.66, 4.65 ± 3.14, and 2.21 ± 1.07 at 2 hour (delayed phase), respectively. The adenomas showed significantly higher SUVmax than both the hyperplasia (P = .0131) and reference thyroid tissue (P < .0001) along the early and delayed phases, but the SUVmax of the hyperplasia did not differ from that of the reference thyroid tissue (P = .4196). The adenomas and hyperplasia were discriminated from the reference thyroid tissue using a cutoff SUVmax of 3.26 at the delayed phase. The adenomas had lower %proportions of oxyphil cells than the hyperplasia (P = .0054), but its SUVmax at the delayed phase was positively correlated with the %proportions of mitochondria-abundant oxyphil cells (rho = 0.418, P = .0173). The hyperplasia showed no correlation between SUVmax and cellular proportions.SUVmax at the delayed phase in the Tc-99m sestamibi quantitative SPECT/CT was useful for the identification and differentiation of parathyroid lesions causing hyperparathyroidism.
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minimum Standardized Uptake Value from quantitative bone single photon emission computed tomography computed tomography for evaluation of femoral head viability in patients with femoral neck fracture
Nuclear Medicine and Molecular Imaging, 2019Co-Authors: Hyun Gee Ryoo, Won Woo Lee, Ji Young Kim, Eunjung Kong, Woo Hee Choi, Joonkee YoonAbstract:Bone single-photon emission computed tomography/computed tomography (SPECT/CT) has been widely used for evaluation of femoral head viability in patients with femoral neck fracture. The current study aimed to investigate utility of Standardized Uptake Value (SUV) from quantitative bone SPECT/CT for assessment of femoral head viability. From March 2015 to November 2018, quantitative bone SPECT/CT was performed in 9 patients with non-viable femoral head post femoral neck fracture and in 31 controls. Maximum (SUVmax), mean (SUVmean), and minimum Standardized Uptake Values (SUVmin) were measured over femoral head and neck. Mann-Whitney U test with Bonferroni correction was used to compare SUVs of ipsilateral and contralateral femurs from femoral neck fracture patients with those of control femurs. As for femoral head viability, SUVmax and SUVmean were not significantly decreased in non-viable femoral heads compared to those in controls. Only the SUVmin was significantly reduced in non-viable femoral heads (mean ± standard deviation, 0.57 ± 0.38) than in controls (0.95 ± 0.26, p = 0.006) and contralateral femoral heads (1.36 ± 0.59, p = 0.008). The cutoff SUVmin of 0.61 (g/mL) yielded a sensitivity of 77.8% and specificity of 87.1% for detection of non-viable femoral heads (p = 0.006). Contralateral femoral necks of the femoral neck fracture patients showed significantly higher SUVmean and SUVmin (3.17 ± 1.20 and 1.64 ± 0.63) than those of controls (2.32 ± 0.53 and 1.04 ± 0.27; p = 0.021 and p = 0.002, respectively), which seemed to reflect weight bearing effect or metabolic derangement. The non-viable femoral heads from the femoral neck fracture showed significantly reduced SUVmin. Quantitative bone SPECT/CT holds promise for objective evaluation of femoral head viability.
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maximum Standardized Uptake Value of 99mtc hydroxymethylene diphosphonate spect ct for the evaluation of temporomandibular joint disorder
Radiology, 2016Co-Authors: Min Seok Suh, Pilyoung Yun, Won Woo Lee, Youngkyun Kim, Sang Eun KimAbstract:Purpose To evaluate the diagnostic accuracy of the quantitative parameter Standardized Uptake Value (SUV) at single photon emission computed tomography (SPECT)/computed tomography (CT) for the evaluation of temporomandibular joint (TMJ) disorder (TMD). Materials and Methods This study was approved by the institutional review board, and the need for informed consent was waived. Forty-four TMJs in 22 patients with TMD (five men and 17 women; mean age ± standard deviation, 30.0 years ± 12.1) were evaluated. The patients underwent planar bone scintigraphy and SPECT/CT 3-4 hours after injection of technetium 99m hydroxymethylene diphosphonate. The planar scintigraphy parameter of relative ratio (RR) and SPECT/CT parameters mean SUV (SUVmean) and maximum SUV (SUVmax) were compared for the visual assessment of TMD on planar scintigraphy images and for the presence of TMJ arthralgia. Group comparisons, receiver operating characteristic analysis, and Pearson correlation analysis were conducted. Results SUVmax gradually increased from normal (2.82 ± 0.73) to mild or moderately abnormal (3.56 ± 0.76, P .05). On the other hand, SUVmax was significantly greater in arthralgic TMJs (4.15 ± 1.11) than in nonarthralgic TMJs (2.97 ± 0.75, P < .001), as was SUVmean (1.63 ± 0.42 vs 1.30 ± 0.31, respectively; P = .005). However, there was no significant difference in RR (3.61 ± 0.57 vs 3.76 ± 0.68, P = .45). In receiver operating characteristic curve analyses for arthralgic TMJ, SUVmax had the greatest area under the curve (area of 0.815). Conclusion SUVmax derived from bone SPECT/CT may be useful for the evaluation of TMD. (©) RSNA, 2016 Online supplemental material is available for this article.
Annjoy Cheng - One of the best experts on this subject based on the ideXlab platform.
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influence of pathological nodal status and maximal Standardized Uptake Value of the primary tumor and regional lymph nodes on treatment plans in patients with advanced oral cavity squamous cell carcinoma
International Journal of Radiation Oncology Biology Physics, 2010Co-Authors: Chunta Liao, Hungming Wang, Shiangfu Huang, Chienyu Lin, Joseph Tungchieh Chang, How I Chen, Chuen Hsueh, Liyu Lee, Chihhung Lin, Annjoy ChengAbstract:Purpose A better understanding of the prognostic factors in oral cavity squamous cell carcinoma (OSCC) may optimize the therapeutic approach. In this study, we sought to investigate whether the combination of clinical information, pathologic results, and preoperative maximal Standardized Uptake Value (SUVmax) at the primary tumor and regional lymph nodes might improve the prognostic stratification in this patient group. Methods and Materials A total of 347 consecutive OSCC patients were investigated. All participants underwent fluorodeoxyglucose–positron emission tomography within 2 weeks before surgery and neck dissection. The duration of follow-up was at least 24 months in all surviving patients. The optimal cutoff Values for SUVmax at the primary tumor (SUVtumor-max) and regional lymph nodes (SUVnodal-max) were selected according to the 5-year disease-free survival (DFS) rate. Independent prognosticators were identified by Cox regression analysis. Results In multivariate analysis, a cutoff SUVtumor-max of 8.6, a cutoff SUVnodal-max of 5.7, and the presence of pathologic lymph node metastases were found to be significant prognosticators for the 5-year DFS. A scoring system using these three prognostic factors was formulated to define distinct prognostic groups. The 5-year rates for patients with a score between 0 and 3 were as follows: neck control, 94%, 86%, 77%, 59% ( p p p Conclusion Based on the study findings, the combined evaluation of pathologic node status and SUVmax at the primary tumor and regional lymph nodes may improve prognostic stratification in OSCC patients.
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preoperative 18f fluorodeoxyglucose positron emission tomography Standardized Uptake Value of neck lymph nodes predicts neck cancer control and survival rates in patients with oral cavity squamous cell carcinoma and pathologically positive lymph nodes
International Journal of Radiation Oncology Biology Physics, 2009Co-Authors: Chunta Liao, Hungming Wang, Shiangfu Huang, Ihow Chen, Joseph Tungchieh Chang, Chuen Hsueh, Shuhang Ng, Annjoy ChengAbstract:Purpose Survival in oral cavity squamous cell carcinoma (OSCC) depends heavily on locoregional control. In this prospective study, we sought to investigate whether preoperative maximum Standardized Uptake Value of the neck lymph nodes (SUVnodal-max) may predict prognosis in OSCC patients. Methods and Materials A total of 120 OSCC patients with pathologically positive lymph nodes were investigated. All subjects underwent a [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) scan within 2 weeks before radical surgery and neck dissection. All patients were followed up for at least 24 months after surgery or until death. Postoperative adjuvant therapy was performed in the presence of pathologic risk factors. Optimal cutoff Values of SUVnodal-max were chosen based on 5-year disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS). Independent prognosticators were identified by Cox regression analysis. Results The median follow-up for surviving patients was 41 months. The optimal cutoff Value for SUVnodal-max was 5.7. Multivariate analyses identified the following independent predictors of poor outcome: SUVnodal-max ≥5.7 for the 5-year neck cancer control rate, distant metastatic rate, DFS, DSS, and extracapsular spread (ECS) for the 5-year DSS and OS. Among ECS patients, the presence of a SUVnodal-max ≥5.7 identified patients with the worst prognosis. Conclusion A SUVnodal-max of 5.7, either alone or in combination with ECS, is an independent prognosticator for 5-year neck cancer control and survival rates in OSCC patients with pathologically positive lymph nodes.
Arnaud Scherpereel - One of the best experts on this subject based on the ideXlab platform.
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primary tumor Standardized Uptake Value measured on fluorodeoxyglucose positron emission tomography is of prognostic Value for survival in non small cell lung cancer update of a systematic review and meta analysis by the european lung cancer working party for the international association for the study of lung cancer staging project
Journal of Thoracic Oncology, 2010Co-Authors: Marianne Paesmans, Thierry Berghmans, Michele Dusart, Claude Hosseinfoucher, Celine Mascaux, Martine Roelandts, Camillo Garcia, Jeanjacques Lafitte, Annepascale Meert, Arnaud ScherpereelAbstract:Introduction Few validated prognostic factors are available for survival in patients with lung cancer. [18F]-fluoro-2-deoxy-d-glucose positron emission tomography has been shown to be of additional Value to conventional imaging for staging lung cancer. The prognostic Value of this lung tumor metabolic activity was studied in a first systematic review of studies published until 2006. Methods As further studies have appeared since 2006, this report has as objective to confirm and to estimate with less variability the prognostic Value of primary tumor Standardized Uptake Value (SUV) measured with [18F]-fluoro-2-deoxy-d-glucose positron emission tomography on the basis of an updated search of eligible studies. Results Ten additional studies were eligible for the updated review and eight of them provided, in the publication, data allowing survival results aggregation. All together, 21 studies were analyzed. Comparing patients with low and high SUV, using preferentially the median SUV Value of each study as threshold, we obtained a poor prognostic Value for high SUV compared with low SUV with an overall combined hazard ratio of 2.08, significantly different from one with a 95% confidence interval ranging from 1.69 to 2.56. No interaction between older and newer studies was detectable (P = 0.60) as well as between studies having selected non metastatic patients or studies without selection criterion related to stage (P = 0.46). Conclusions We confirmed the results of our previous review showing that SUV is potentially a very interesting factor for predicting patient outcome. We believe that a meta-analysis based on individual patient data would be of great Value as allowing to assess the independent prognostic Value, to take into account some factors responsible for heterogeneity between studies (SUV assessment method, disease stage, and histology), and to update survival data. We are planning to conduct such a meta-analysis on behalf of the International Association for the Study of Lung Cancer Staging Project.
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primary tumor Standardized Uptake Value suvmax measured on fluorodeoxyglucose positron emission tomography fdg pet is of prognostic Value for survival in non small cell lung cancer nsclc a systematic review and meta analysis ma by the european lung cancer working party for the iaslc lung cancer staging project
Journal of Thoracic Oncology, 2008Co-Authors: Thierry Berghmans, Irène Buvat, Michele Dusart, Marianne Paesmans, Claude Hosseinfoucher, Catherine Castaigne, Arnaud Scherpereel, Celine Mascaux, Michel Moreau, Martine RoelandtsAbstract:Hypothesis The 2-[ 18 F]-fluoro-2-deoxy-d-glucose positron emission tomography is an imaging tool for assessing clinical tumor, node, metastasis in non-small cell lung cancer (NSCLC). Primary tumor Standardized Uptake Value (SUV) has been studied as a potential prognostic factor for survival. However, the sample sizes are limited leading to conduct a meta-analysis to improve the precision in estimating its effect. Methods We performed a systematic literature search. For each publication, we extracted an estimate of the hazard ratio (HR) for comparing patients with a low and a high SUV and we aggregated the individual HRs into a combined HR, using a random-effects model. Results We found 13 eligible studies dedicated to NSCLC. Most of them included patients with stages I to III/IV and used a SUV assessment corrected for body weight. Number of patients ranged from 38 to 315 (total: 1474); 11 studies identified a high SUV as a poor prognostic factor for survival although two studies found no significant correlation between SUV and survival. SUV measurement and SUV threshold for defining high SUV were study dependent, eight studies looked for a so-called best cutoff (maximizing the logrank test statistic) without adjusting the p Value for multiplicity. Overall, the combined HR for the 13 reports was 2.27 (95% confidence interval [CI]: 1.70–3.02); excluding the studies proposing a "best" cutoff, it was 2.08 (95% CI: 1.431–3.04). Conclusion Our meta-analysis suggests that the primary tumor SUV measurement has a prognostic Value in NSCLC; these results should be confirmed in a meta-analysis on individual patients' data.
John M H De Klerk - One of the best experts on this subject based on the ideXlab platform.
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direct comparison of visual and quantitative bone marrow fdg pet ct findings with bone marrow biopsy results in diffuse large b cell lymphoma does bone marrow fdg pet ct live up to its promise
Acta Radiologica, 2015Co-Authors: Hugo J A Adams, Thomas C Kwee, Rob Fijnheer, Stefan V Dubois, Rutger A J Nievelstein, John M H De KlerkAbstract:BackgroundDetection of bone marrow involvement using 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) has been proposed as a non-invasive alternative to standard blind bone marrow biopsy (BMB) of the posterior iliac crest in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL). However, studies that directly compare FDG-PET/CT results with histopathology are currently lacking.PurposeTo directly compare both visual and quantitative bone marrow FDG-PET/CT to BMB at the right posterior iliac crest in patients with newly diagnosed DLBCL.Material and MethodsA total of 40 patients with newly diagnosed DLBCL, who had undergone FDG-PET/CT before BMB of the right posterior iliac crest, were retrospectively included. FDG-PET/CT images were visually assessed for bone marrow involvement in the right posterior iliac crest. 3D partial volume corrected mean Standardized Uptake Value (cSUVmean), maximum Standardized Uptake Value (SUVmax), and peak Standardized upta...
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bone marrow 18f fluoro 2 deoxy d glucose positron emission tomography computed tomography cannot replace bone marrow biopsy in diffuse large b cell lymphoma
American Journal of Hematology, 2014Co-Authors: Hugo J A Adams, Thomas C Kwee, Rob Fijnheer, Stefan V Dubois, Rutger A J Nievelstein, John M H De KlerkAbstract:This study aimed to investigate whether visual and quantitative 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT)-based bone marrow assessment can replace blind bone marrow biopsy (BMB) in newly diagnosed diffuse large B-cell lymphoma (DLBCL). This retrospective study included 78 patients with newly diagnosed DLBCL who had undergone both FDG-PET/CT and BMB. FDG-PET/CT images were visually evaluated for bone marrow involvement. Patient-based sensitivity of visual FDG-PET/CT assessment was calculated using BMB as the reference standard. Metabolically active volume, maximum Standardized Uptake Value, 3D partial volume corrected mean Standardized Uptake Value, and 3D partial volume corrected mean metabolic volume product (cMVPmean) of FDG-avid bone marrow lesions were measured. Cox regression analysis was used to determine the influence of (potential) prognostic factors (BMB status, visual [dichotomous] FDG-PET/CT bone marrow status, metabolically active volume, maximum Standardized Uptake Value, 3D partial volume corrected mean Standardized Uptake Value, 3D partial volume corrected mean metabolic volume product, and International Prognostic Index score) on progression-free survival and overall survival. FDG-PET/CT detected bone marrow involvement in 34 (43.6%) cases and BMB in 16 (20.5%) of 78 cases, of whom 11 were also detected by FDG-PET/CT, resulting in a patient-based sensitivity of 68.8% (95% confidence interval = 44.2%–86.1%) for FDG-PET/CT. In the multivariate Cox proportional hazards model, only BMB status was an independent predictive factor of progression-free survival (P = 0.016) and overall survival (P = 0.004). In conclusion, FDG-PET/CT misses bone marrow involvement that has been detected by BMB in a non-negligible proportion of patients. Furthermore, both visual and quantitative FDG-PET/CT-based bone marrow assessments are prognostically inferior to BMB. Therefore, FDG-PET/CT cannot replace BMB in newly diagnosed DLBCL. Am. J. Hematol. 89:726–731, 2014. © 2014 Wiley Periodicals, Inc.
