Correlation Between 18F-FDG PET/CT Findings and BI-RADS Assessment Using Ultrasound in the Evaluation of Breast Lesions: A Multicenter Study.

RATIONALE AND OBJECTIVES: To analyze the correlation between ultrasound breast imaging reporting and data system (BI-RADS) category and fluorodeoxyglucose [18F] (18F-FDG) positron emission tomography/computed tomography (PET/CT) findings and their value in breast lesion diagnosis. MATERIALS AND METHODS: Cases involving hypermetabolic lesions identified by 18F-FDG PET/CT and ultrasound were retrospectively analyzed. The correlation between the maximum standardized uptake values (SUVmax) of the lesions and the BI-RADS grades was calculated. Histologic diagnosis or evidence at the end of a 2-year follow-up as the standard of truth were analyzed to determine the sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) of the diagnostic methods. Area under the curve (AUC) of BI-RADS, SUVmax, and BI-RADS/SUVmax combined were obtained using receiver-operating characteristic curve (ROC) analysis. RESULTS: Of 206 cases, 92 were benign and 114 were malignant. The difference between the SUVmax and the BI-RADS grades was statistically significant (p < 0.001). The critical value of the optimal SUVmax was 2.325, and the accuracy, sensitivity, specificity, PPV, and NPV were 84.5%, 91.2%, 76.1%, 82.5%, and 87.5%, respectively. For diagnosis using BI-RADS, these values were 85.9%, 98.2%, 70.7%, 80.6%, and 97.0%, respectively. ROC analysis of 206 breast lesions for distinguishing benign from malignant lesions yielded AUCs of 0.948, 0.896, and 0.977 for BI-RADS, SUVmax, and BI-RADS/SUVmax combined, respectively. The critical value of the optimal SUVmax in grade 3 and 4 lesions (as determined using BI-RADS) was 2.705, and the accuracy, sensitivity, specificity, PPV, and NPV were 82.6%, 77.8%, 85.7%, 77.8%, and 85.7%, respectively. For diagnosis using BI-RADS in cases with grade 3 and 4 lesions, these values were 68.5%, 94.4%, 51.8%, 55.7%, and 93.5%, respectively. In ROC analysis for distinguishing benign from malignant for BI-RADS grade 3-4 lesions, the AUC of BI-RADS, SUVmax, and BI-RADS/SUVmax combined were 0.731, 0.859, and 0.882, respectively. CONCLUSION: Both 18F-FDG PET/CT and ultrasound-dependent BI-RADS grading are effective for diagnosing breast lesions. However, in cases of BI-RADS grades 3 and 4, 18F-FDG PET/CT has better specificity and may be useful for further differential diagnosis.

Worldwide research productivity in nuclear medicine literature.

AIM: This study aimed to assess the quantity and quality of papers published in subspecialty nuclear medicine journals and provide an overview of worldwide research activity carried out in the field of nuclear medicine. METHODS: Papers published in subspecialty nuclear medicine journals between 2008 and 2017 were retrieved from the Web of Science. The number of papers and citations were used to evaluate the quantity and quality of the articles. The correlation between the research productivity of different countries and their population size and gross domestic product (GDP) were analyzed. RESULTS: There were 12,861 articles published in these journals between 2008 and 2017. A rapidly increasing trend was observed in the number of articles published per year (p < 0.001). The United States published the largest proportion of papers (23.22 %) followed by Germany (9.94 %), Japan (9.46 %), Italy (6.53 %), and China (6.36 %). The United States had the highest number of total citations. The number of articles from different countries had a significant correlation with their population size and GDP (p < 0.01). Switzerland had the highest mean citations (23.66) followed by the Netherlands (23.54), and Germany (22.77). However, the Netherlands was first (42.43) followed by Denmark (32.89) and Switzerland (31.79) when adjustments for population size were made. When adjustments for GDP were made, the Netherlands was again the leader (82.91) followed by Denmark (69.49) and Greece (61.77). CONCLUSIONS: There has been a significant increase in nuclear medicine research over the last decade. The United States is the leader of worldwide research productivity. However, when population and GDP are taken into consideration, certain smaller countries in Europe exhibit performed better. ZIEL:: Ziel dieser Studie war es, die Quantität und Qualität von Publikationen, die in Fachzeitschriften für Nuklearmedizin veröffentlicht wurden, zu bewerten und einen Überblick über die weltweiten Forschungsaktivitäten auf dem Gebiet der Nuklearmedizin zu geben. METHODEN: In den Fachzeitschriften für Nuklearmedizin zwischen 2008 und 2017 erschienene Artikel wurden aus dem Web of Science abgerufen. Die Anzahl der Artikel und Zitate wurde verwendet, um die Menge und Qualität der Artikel zu bewerten. Die Korrelation zwischen der Forschungsproduktivität verschiedener Länder und ihrer Bevölkerungsgröße sowie dem Bruttoinlandsprodukt (BIP) wurde analysiert. ERGEBNISSE: Zwischen 2008 und 2017 wurden 12861 Artikel in diesen Zeitschriften veröffentlicht. Die Anzahl der jährlich veröffentlichten Artikel zeigte einen rasch ansteigenden Trend (p < 0,001). Die Vereinigten Staaten veröffentlichten den größten Anteil der Veröffentlichungen (23,22 %), gefolgt von Deutschland (9,94 %), Japan (9,46 %), Italien (6,53 %) und China (6,36 %). Die Vereinigten Staaten hatten die höchste Gesamtzahl von Zitaten. Die Anzahl der Artikel aus verschiedenen Ländern korrelierte signifikant mit ihrer Bevölkerungsgröße und dem BIP (p < 0,01). Die Schweiz hatte den höchsten Mittelwert für Zitierungen (23,66), gefolgt von den Niederlanden (23,54) und Deutschland (22,77). Angepasst auf die Bevölkerungszahl aber kamen zuerst die Niederlande (42,43), gefolgt von Dänemark (32,89) und der Schweiz (31,79). Nach Anpassungen für das BIP, waren die Niederlande erneut führend (82,91), gefolgt von Dänemark (69,49) und Griechenland (61,77). SCHLUSSFOLGERUNGEN: Die nuklearmedizinische Forschung hat in den vergangenen zehn Jahren erheblich zugenommen. Die Vereinigten Staaten sind der Führer der weltweiten Forschungsproduktivität. Wenn jedoch Bevölkerung und BIP berücksichtigt werden, schneiden bestimmte kleinere Länder in Europa besser ab.

Global scientific productivity in the field of PET: a 10-year survey of research activities.

OBJECTIVE: The objective of this study was to assess global research output in the field of PET and to provide a general picture of PET research. MATERIALS AND METHODS: Publications on PET from 2007 to 2016 were identified using the Web of Science. The total number of papers, the number of papers adjusted by gross domestic product (GDP)/population size, total citations, and average citations were investigated. RESULTS: A total of 40 670 papers were identified in the field of PET between 2007 and 2016. The number of papers published per year were significantly increased during this period (P=0.000). High-income countries published the maximum papers (89.95%), followed by middle-income countries (10.05%), whereas no papers were published by authors from low-income countries. The USA published the largest number of papers (11 936), followed by Japan (3667), Germany (3424), China (2508), and the UK (2424), and the USA had the highest total number of citations (361 498). The UK had the highest average citations (31.81). Positive correlations were found between the total number of papers and GDP (P=0.000, r=0.909)/population (P=0.000, r=0.772). When normalized by GDP, Denmark ranked the first (23.56), followed by The Netherlands (17.18) and Belgium (15.32). When adjusted for population, Denmark ranked the first (111.55), followed by The Netherlands (87.91) and Switzerland (86.93). CONCLUSION: Global scientific production represents a rapid increase in the PET field in recent years. The majority of PET papers are from high-income countries. The USA is the most prolific country, whereas some smaller European countries may be more prolific relative to their GDP/population.

Comparison of meta-analyses among elastosonography (ES) and positron emission tomography/computed tomography (PET/CT) imaging techniques in the application of prostate cancer diagnosis.

The early diagnosis of prostate cancer (PCa) appears to be of vital significance for the provision of appropriate treatment programs. Even though several sophisticated imaging techniques such as positron emission tomography/computed tomography (PET/CT) and elastosonography (ES) have already been developed for PCa diagnosis, the diagnostic accuracy of these imaging techniques is still controversial to some extent. Therefore, a comprehensive meta-analysis in this study was performed to compare the accuracy of various diagnostic imaging methods for PCa, including 11C-choline PET/CT, 11C-acetate PET/CT, 18F-fluorocholine PET/CT, 18F-fluoroglucose PET/CT, transrectal real-time elastosonography (TRTE), and shear-wave elastosonography (SWE). The eligible studies were identified through systematical searching for the literature in electronic databases including PubMed, Cochrane, and Web of Science. On the basis of the fixed-effects model, the pooled sensitivity (SEN), specificity (SPE), and area under the receiver operating characteristics curve (AUC) were calculated to estimate the diagnostic accuracy of 11C-choline PET/CT, 11C-acetate PET/CT, 18F-fluorocholine (FCH) PET/CT, 18F-fluoroglucose (FDG) PET/CT, TRTE, and SWE. All the statistical analyses were conducted with R language Software. The present meta-analysis incorporating a total of 82 studies demonstrated that the pooled sensitivity of the six imaging techniques were sorted as follows: SWE > 18F-FCH PET/CT > 11C-choline PET/CT > TRTE > 11C-acetate PET/CT > 18F-FDG PET/CT; the pooled specificity were also compared: SWE > 18F-FCH PET/CT > 11C-choline PET/CT > TRTE > 18F-FDG PET/CT > 11C-acetate PET/CT; finally, the pooled diagnostic accuracy of the six imaging techniques based on AUC were ranked as below: SWE > 18F-FCH PET/CT > 11C-choline PET/CT > TRTE > 11C-acetate PET/CT > 18F-FDG PET/CT. SWE and 18F-FCH PET/CT imaging could offer more assistance in the early diagnosis of PCa than any other studied imaging techniques. However, the diagnostic ranking of the six imaging techniques might not be applicable to the clinical phase due to the shortage of stratified analysis.

A Biomimic Reconstituted High-Density-Lipoprotein-Based Drug and p53 Gene Co-delivery System for Effective Antiangiogenesis Therapy of Bladder Cancer.

A biomimic reconstituted high-density-lipoprotein-based drug and p53 gene co-delivery system (rHDL/CD-PEI/p53 complexes) was fabricated as a targeted co-delivery nanovector of drug and gene for potential bladder cancer therapy. Here, CD-PEI was utilized to effectively condense the p53 plasmid, to incorporate the plasmid into rHDL, and to act as an antitumor drug to suppress tumor angiogenesis. The rHDL/CD-PEI/p53 complexes exhibited desirable and homogenous particle size, neutral surface charge, and low cytotoxicity in vitro. The results of confocal laser scanning microscopy and flow cytometry confirmed that SR-BI-targeted function induced specific cytoplasmic delivery and high gene transfection efficiency in MBT-2 murine bladder cells. In addition, rHDL/CD-PEI/p53 complexes co-delivering CD and p53 gene achieved synergistic angiogenesis suppression by more effectively downregulating the expression of vascular endothelial growth factor (VEGF) messenger RNA (mRNA) and protein via different pathways in vitro. In vivo investigation on C3H/He mice bearing MBT-2 tumor xenografts revealed that rHDL/CD-PEI/p53 complexes possessed strong antitumor activity. These findings suggested that rHDL/CD-PEI/p53 complexes could be an ideal tumor-targeting system for simultaneous transfer of drug and gene, which might be a new promising strategy for effective bladder cancer therapy.

OLC1 is overexpressed in breast cancer and its expression correlates with poor patient survival.

The overexpressed in lung cancer 1 (OLC1) has been demonstrated to be associated with numerous biological and pathological processes. However, the role of OLC1 in breast cancer has not been thoroughly elucidated. The purpose of this study was to assess OLC1 expression and to explore its contribution to the breast cancer. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was conducted to detect OLC1 messenger RNA (mRNA) expression in 45 pairs of fresh-frozen breast cancer tissues and corresponding noncancerous tissues. Immunohistochemistry was performed to detect the expression of OLC1 in 145 breast cancer tissues. The relationship between the expression of OLC1 and clinicopathological characteristics and prognosis was statistically analyzed. We found that the expression levels of OLC1 mRNA and protein in breast cancer tissues were significantly higher than those in adjacent noncancerous tissues (P < 0.001). In addition, OLC1 expression was significantly correlated with tumor size (P = 0.034), grade (P = 0.015), stage (P < 0.001), and lymph node metastases (P = 0.028). Kaplan-Meier survival analysis showed that a high expression level of OLC1 resulted in a significantly poor prognosis of breast cancer patients. Further, Cox multivariate analysis indicated that OLC1 expression level was an independent prognostic factor for the overall survival rate of breast cancer patients. These findings provide evidence that a high expression level of OLC1 serves as a biomarker for poor prognosis for breast cancer. Thus, we speculate that OLC1 may be a potential target of antiangiogenic therapy for breast cancer.

miR-200c enhances radiosensitivity of human breast cancer cells.

Due to the intrinsic resistance of many tumors to radiotherapy, current methods to improve the survival of cancer patients largely depend on increasing tumor radiosensitivity. It is well-known that miR-200c inhibits epithelial-mesenchymal transition (EMT), and enhances cancer cell chemosensitivity. We sought to clarify the effects of miR-200c on the radiosensitization of human breast cancer cells. In this study, we found that low levels of miR-200c expression correlated with radiotolerance in breast cancer cells. miR-200c overexpression could increase radiosensitivity in breast cancer cells by inhibiting cell proliferation, and by increasing apoptosis and DNA double-strand breaks. Additionally, we found that miR-200c directly targeted TANK-binding kinase 1 (TBK1). However, overexpression of TBK1 partially rescued miR-200c mediated apoptosis induced by ionizing radiation. In summary, miR-200c can be a potential target for enhancing the effect of radiation treatment on breast cancer cells.

Mangiferin aglycone attenuates radiation-induced damage on human intestinal epithelial cells.

Recent studies suggest that mangiferin aglycone (norathyriol) has great potential as a novel radioprotector without any known toxic side effects. In this study, we assessed the protective effects of mangiferin aglycone against radiation-induced injuries on normal human intestinal epithelial cells (HIECs), while using mangiferin as a reference compound. The in vitro experiments showed that pretreatment of either mangiferin aglycone or mangiferin could inhibit cytotoxic effects of ionizing irradiation (IR) on HIECs. Cellular changes were estimated by measuring cell viability, clonogenic surviving rate, and apoptotic rate. Compared to mangiferin, we found mangiferin aglycone had greater radioprotective effects of mangiferin aglycone on HIECs. It has been demonstrated that the cytotoxicity of ionizing radiation relates to its capacity to induce DNA damage. In view of this, we monitored DNA double-strand breaks (DSBs) using γH2AX foci formation to test whether mangiferin aglycone and mangiferin could modulate genotoxic effects of radiation. It shows that mangiferin aglycone could eliminate 46.8% of the total DSBs of the cells exposed to 2 Gy IR, which is significantly better than mangiferin. Complementing earlier results from our group, it appears possible to conclude that mangiferin aglycone presents potential useful effects on IR-induced damage and may be a better radioprotective agent than mangiferin therapeutically.

Hydrogen-rich saline protects immunocytes from radiation-induced apoptosis.

BACKGROUND: Radiation often causes depletion of immunocytes in tissues and blood, which results in immunosuppression. Molecular hydrogen (H2) has been shown in recent studies to have potential as a safe and effective radioprotective agent through scavenging free radicals. This study was designed to test the hypothesis that H2 could protect immunocytes from ionizing radiation (IR). MATERIAL/METHODS: H2 was dissolved in physiological saline or medium using an apparatus produced by our department. A 2-[6-(4'-hydroxy) phenoxy-3H-xanthen-3-on-9-yl] benzoate (HPF) probe was used to detect intracellular hydroxyl radicals (•OH). Cell apoptosis was evaluated by annexin V-FITC and Propidium iodide (PI) staining as well as the caspase 3 activity. Finally, we examined the hematological changes using an automatic Sysmex XE 2100 hematology analyzer. RESULTS: We demonstrated H2-rich medium pretreatment reduced •OH level in AHH-1 cells. We also showed H2 reduced radiation-induced apoptosis in thymocytes and splenocytes in living mice. Radiation-induced caspase 3 activation was also attenuated by H2 treatment. Finally, we found that H2 rescued the radiation-caused depletion of white blood cells (WBC) and platelets (PLT). CONCLUSIONS: This study suggests that H2 protected the immune system and alleviated the hematological injury induced by IR.