Prognostic Value of Interim / 中国实验血液学杂志

OBJECTIVE@#To explore the value of interim @*METHODS@#Twenty-one patients with ENKTL who were pathologically diagnosed at Shanghai General Hospital of Nanjing Medical University (Shanghai General Hospital) from January 2015 to December 2018 were retrospectively collected, and @*RESULTS@#After treatment, 11 patients had complete remission (CR), 3 had partial remission (PR), 1 had stable disease (SD), and 6 had disease progression (PD). The CR patients' △SUVmax was significantly higher than non-CR patients ［(66.07±22.33)% vs (36.87±23.28)%, t=2.927, P=0.009］. Calculated from the receiver operating curve (ROC), the optimal cut-off point of ΔSUVmax was 51.45%. The median follow-up time was 32 months. Kaplan-Meier survival analysis showed that KPI, DS and ΔSUVmax had significance in predicting PFS and OS (P<0.05). COX regression analysis showed that DS was an independent risk factor affecting PFS (P<0.05), and KPI and ΔSUVmax were independent risk factors affecting OS (P<0.05).@*CONCLUSION@#Interim

(18)F-FDG PET/CT for extranodular natural killer/T-cell lymphoma nasal type: imaging findings and clinical value / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the value of (18)F-FDG PET/CT in the diagnosis and treatment evaluation in patients with pretreatment or recurrent extranodular natural killer/T-cell lymphoma nasal type (ENTCL).</p><p><b>METHODS</b>(18)F-FDG PET/CT images and clinical records of 35 cases (67 scans) of pathologically confirmed ENTCL treated in our hospital within the last 9 years were analyzed. The imaging characteristics of the upper aerodigestive tract (UAT) and the non-aerodigestive tract (NUAT) lesions were analyzed. Lesion distribution, clinical stages, SUVmax and patient survival data were compared between pretreatment and recurrent cases.</p><p><b>RESULTS</b>s All the ENTCL lesions were hypermetabolic. The UAT lesions involved mainly the nasal cavity and pharynx, while the NUAT lesions may involve the lymph nodes and all the organs. UAT lesions were more common in pretreatment cases while NUAT lesions tended to increase in recurrent cases. The SUVmax of pretreatment and recurrent lesions were 10.4∓4.4 and 9.6∓5.2, and showed no significant difference among patients with different lesion distribution patterns, clinical stages, or treatment history. The tumor remission rate evaluated by PET/CT were higher in cases with an initial diagnosis than in those with recurrence [(89.5% (17/19) vs 33.3% (5/15), P<0.005)]. Cox regression analysis revealed no significant differences in the survival rates among patients with different treatment history, clinical stages, lesion distribution patterns, or SUVmax levels (P>0.05).</p><p><b>CONCLUSION</b>(18)F-FDG PET/CT can sensitively detect the pretreatment or recurrent lesions in ENTCL patients and helps in accurate tumor staging and curative effect evaluation.</p>

The role of 18F-FDG SPECT-CT in detecting recurrence and metastases in breast cancer patients with elevated tumor markers / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare retrospectively the role of (18)F-FDG SPECT-CT and conventional imaging in the detection of recurrence and metastases in postoperative breast cancer patients with elevated level of tumor markers, and to evaluate the impact of (18)F-FDG SPECT-CT on the management of breast cancer patients.</p><p><b>METHODS</b>(18)F-FDG SPECT-CT was performed in 35 breast cancer patients with suspected recurrence based on elevated level of serum tumor markers. Chest, abdomen and pelvic CT were performed in all patients and whole-body bone scan was performed in only 21 patients. The final diagnosis of recurrent breast cancer was confirmed by either pathology or observation by imaging during the follow-up for more than 1 year.</p><p><b>RESULTS</b>Among the 35 patients, the final diagnosis of recurrence or metastasis was established in 19 patients. Of the 114 sites of increased FDG uptake, 93 were interpreted as malignant and 21 as benign. On site-based analysis, the sensitivity, specificity, accuracy, positive and negative predictive values were 93.1%, 55.6%, 84.2%, 87.1% and 71.4%, respectively, for (18)F-FDG SPECT-CT, and 80.5%, 60.5%, 75.6%, 80.2% and 65.1%, respectively, for conventional imaging. On the patient-based analysis, the sensitivity, specificity, accuracy, positive and negative predictive values were 84.2%, 62.5%, 74.3%, 72.7% and 76.9%, respectively, for (18)F-FDG SPECT-CT, and 74.1%, 67.6%, 70.6%, 68.3% and 73.9%, respectively, for conventional imaging. The results of (18)F-FDG SPECT-CT led to changes in the subsequent clinical management of 40.0% of these patients.</p><p><b>CONCLUSION</b>In postoperative breast cancer patients with elevated level of tumor markers during the follow-up, (18)F-FDG SPECT-CT is more sensitive for detecting recurrence and metastases than conventional imaging.</p>

Evaluation of the primary lesion detection in colorectal carcinoma with (18)F-FDG PET-CT / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the clinical value of detecting primary lesions of colorectal carcinoma with (18)F-FDG PET-CT.</p><p><b>METHODS</b>Clinical data of 23 cases of colorectal carcinoma collected from April 2007 to June 2008, including PET-CT, endoscopy, operation and pathology, were analyzed retrospectively.</p><p><b>RESULTS</b>Of the 23 colorectal cancer patients, including 15 males and 8 females, 11 received abdominal CT contrast examination, 7 abdominal CT general examination and 5 chest CT examination. The lesions located in caecum in 5 cases, ascending colon 4 cases, transverse colon 2 cases, descending colon 2 cases, sigmoid colon 4 cases, rectum 6 cases. CT images showed local mass, incrassation and nodes in colon. PET images revealed intensely hypermetabolic lesions. The maximum of standard uptake value (SUVmax) was 11.7+/-9.5, and the delay SUVmax was 14.8+/-11.0. The bigger was the mass, the higher was the SUV. The highest SUV was 44.8. Metastatic lesions were found in 15 cases. More cases and more metastatic lesions were found by (18)F-FDG PET-CT.</p><p><b>CONCLUSION</b>The primary and metastatic lesions of colorectal carcinoma can be detected sensitively and exactly by (18)F-FDG PET-CT, which is helpful in tumor staging and making the treatment plan.</p>

Comparison of 18F-FDG coincidence SPECT imaging and computed tomography in the initial staging and therapeutic evaluation of lymphomas / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the clinical value of 18F-fluorodeoxyglucose (18F-FDG) coincidence SPECT imaging versus computed tomography (CT) for malignant lymphoma in the initial staging, early response to therapy, evaluation after completion of therapy and long-term follow-up.</p><p><b>METHODS</b>18F-FDG SPECT scans was performed on 61 patients with pathologically proven malignant lymphoma. The mean age of this series was 55 years ranged from 12 to 85 years. The data of these patients were retrospectively analyzed, and the result of 18F-FDG SPECT scan was compared with the CT imaging result performed within 2 weeks before or after FDG scan. 161 18F-FDG SPECT scans were performed for initial tumor staging (n=61), early response to therapy (n=42), evaluation after completion of therapy (n=26) and long-term follow-up (n=32). Each patient had a follow-up >6 months.</p><p><b>RESULTS</b>(1) Compared with CT scan, 18F-FDG SPECT imaging accurately upstaged the disease for 34.4% (21/61) of these patients at initial staging. It detected the lesions which were undetected by CT including bone marrow infiltration (n=17), foci of lymph node (n=3) and liver involvement (n=1). However, 3 patients were incorrectly staged, either downstaged or upstaged by 18F-FDG SPECT imaging. Of 212 lesions in 61 patients, 18-FDG SPECT imaging detected more lesions than CT (P < 0.01). The correspondence rate of '18-FDG SPECT imaging with marrow histology was 80.3% (49/61). (2) In early evaluation of the response to treatment, the accuracy, positive predictive value and negative predictive value of 18F-FDG SPECT imaging was 85.7%, 92.0% and 76.5% respectively, which is much higher than that of CT (64.3%, 75.0% and 50.0%), therefore, the therapeutic scheme in 21.4% (9/42) of these patients was changed by 18F-FDG SPECT imaging. Of 17 cases with negative 18F-FDG SPECT scan in early evaluation of therapy, clinical remission (13 complete remission and 3 partial remission) were achieved in 16 patients. Of the 25 patients with positive ones, 13 were considered as having progressive disease. (3) In the evaluation at the end of therapy or during follow-up, 58 18F-FDG SPECT imagings were performed in 26 patients. The specificity and positive predictive value were 85.7% and 68.4% versus 59.5% and 43.3%, respectively, by CT scan. Of 14 patients with residual masses detected by CT scan, 8 were diagnosed as complete remission (CR) by 18F-FDG SPECT imaging based on persistently negative FDG scans; The other 6 were interpreted as CR (n=1), partial remission (PR, n=2), non-remission (n=1) and progressive disease (n=2), thus there was only one false-positive FDG scan in these 14 patients.</p><p><b>CONCLUSION</b>18F-FDG imaging is quite effective and superior to CT scan for malignant lymphoma in initial staging, evaluation of early response to therapy and after completion of therapy, and long-term follow-up, especially for evaluating the residual masse.</p>

Therapeutic Evaluation of ~(18)F-FDG Coincidence SPECT Imaging in Malignant Lymphoma / 上海第二医科大学学报

Objective To study the clinical value of ~(18)F-fluorodeoxyglucose(~(18)F-FDG) coincidence SPECT imaging in the therapy of malignant lymphoma. Methods Serial ~(18)F-FDG SPECT imaging were performed on 42 patients with malignant lymphoma before and after treatment.The results were compared with other conventional imaging.Patients were divided into two groups. Twenty-seven new-diagnosed patients(group Ⅰ) and 15 operated patients(group Ⅱ) had ~(18)F-FDG imaging pre-and post-chemotherapy. Results(In group Ⅰ,) 15 cases(achieved) clinical remission,five cases relapsed and one case progressed.In group Ⅱ,tumor residues were detected in four patients,and one patient relapsed. Conclusion Serial ~(18)F-FDG imaging during treatment is very useful for therapeutic evaluation in malignant lymphoma.