Analysis of the use of [68Ga]Ga-FAPI and [18F]FDG PET/CT for diagnosing and staging non-small cell lung cancer
Junhao WuHao DengHaoshu ZhongTao WangKai ZhengZijuan RaoWeidong GongYingwei WangYue ChenChunyin Zhang
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Abstract Purpose The current research was developed for comparing the relative diagnostic utility of [ 68 Ga]Ga-FAPI PET/CT and [ 18 F]FDG PET/CT when evaluating initial tumors and metastases in non-small cell lung cancer (NSCLC) patients. Methods A prospective analysis of 28 individuals with histopathologically confirmed NSCLC that underwent [ 68 Ga]Ga-FAPI and [ 18 F]FDG PET/CT imaging was conducted. The relative performance of these different imaging modalities was compared based upon visual assessment, rates of cancer detection, and metabolic parameters (target-to-background ratio [TBR], maximum standard uptake value [SUVmax]) for both primary tumors and metastases. Results In total, this study enrolled 28 cases (13 male, 15 female; median age: 60.5 years, range: 34–78 years. [ 68 Ga]Ga-FAPI PET/CT imaging was found to more effectively discern both metastases and primary tumors as compared to [ 18 F]FDG PET/CT imaging, detecting more primary tumors (28 vs. 27), as well as metastases present within the lymph nodes (53 vs. 49), pleura (8 vs. 7), liver (4 vs. 1), and bone (41 vs. 35). In contrast, [ 68 Ga]Ga-FAPI PET/CT was not capable of detecting as many adrenal metastases as was [ 18 F]FDG PET/CT imaging (0 vs. 2). The SUVmax and TBR values for [ 68 Ga]Ga-FAPI were substantially superior to those for [ 18 F]FDG in lymph node, pleural, and bone metastases. While the SUVmax for these two imaging approaches was comparable for hepatic metastases, [ 68 Ga]Ga-FAPI exhibited a significantly higher TBR in relation to that of [ 18 F]FDG. [ 68 Ga]Ga-FAPI additionally exhibited greater accuracy than that achieved for [ 18 F]FDG PET/CT when used to conduct NSCLC patient N-staging (80% [8/10] vs. 50% [5/10]) and M-staging (92.9% [26/28] vs. 89.3% [25/28]). Conclusions These data highlight the value of [ 68 Ga]Ga-FAPI PET/CT imaging as an approach of diagnosing and staging NSCLC, improving the diagnosis of most metastases and facilitating the superior staging of NSCLC patients relative to that achieved by [ 18 F]FDG PET/CT.Keywords:
PET-CT
Standardized uptake value
Lung cancer is still a leading cause of cancer mortality in the world. The incidence of lung cancer in developed countries started to decrease mainly due to global anti-smoking campaigns. However, the incidence of lung cancer in women has been increasing in recent decades for various reasons. Furthermore, since the screening of lung cancer is not as yet very effective, clinically applicable molecular markers for early diagnosis are much required. Lung cancer in women appears to have differences compared with that in men, in terms of histologic types and susceptibility to environmental risk factors. This suggests that female lung cancer can be derived by carcinogenic mechanisms different from those involved in male lung cancer. Among female lung cancer patients, many are non-smokers, which could be studied to identify alternative carcinogenic mechanisms independent from smoking-related ones. In this paper, we reviewed molecular susceptibility markers and genetic changes in lung cancer tissues observed in female lung cancer patients, which have been validated by various studies and will be helpful to understand the tumorigenesis of lung cancer.
Genetic predisposition
Epidemiology of cancer
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PET-CT
Histopathology
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Standardized uptake value
PET-CT
Table (database)
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The role of Positron Emission Tomography/Computed Tomography (PET/CT)
modalities is becoming more important concomitantly with the increase of
oncology cases in Malaysia. Thus, it is the perfect time to perform a study to
standardise the PET/CT image quality in Malaysia. This study aimed to compare
the quantification of image quality of PET/CT with a standardised uptake value
(SUV) parameter. In general, this study was carried out with the purpose of
identifying the standardisation of quantification of standardised uptake value,
SUVcontrolled for 18F-FDG PET between two independent PET modalities at two
different institutions.
The analysis was done on the SUVcontrolled of technical techniques (PET phantom)
as a control standard for the validation of the PET-CT images of selected subjects
with Fasting Blood Glucose index as the adjusted index to synchronise the two
independent data sets. It was found that the SUVcontrolled was a potential
conversion marker to validate the in vivo standardisation techniques for the two
independent PET/CT modality systems based on the reference standard of the
matched FBS and the in vitro 18F-FDG phantom. This study confirmed that the
two independent PET modalities at paired-centre could potentially be
standardised on the independent image quality based on the SUVmax
quantification as the two independent measured were insignificantly different.
Standardized uptake value
PET-CT
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Abstract Background The risk of cardiovascular disease (CVD) is elevated in metabolic syndrome (MS) and is related to the inflammatory activity of visceral adipose tissue (VAT). We investigated whether the metabolic activity in VAT, assessed by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), is associated with systemic inflammatory status, and related to the number of MS components. Methods 18F-FDG PET/CT was performed in a total of 203 subjects: 59 without an MS component; M(0), 92 with one or two MS components; M(1–2), and 52 with MS. Metabolic activity of VAT was evaluated using the mean standardized uptake value (SUVmean) and the maximum SUV (SUVmax). Metabolic activities of immune-related organs such as spleen and bone marrow (BM) were evaluated using the SUVmax. Results VAT SUVmax correlated with high-sensitivity C-reactive protein (hsCRP) and the SUVmax of spleen and BM, which reflect the status of systemic inflammation. Both hsCRP and the SUVmax of the spleen and BM were higher in the MS group than in the M(1–2) or M(0) groups. In VAT, SUVmax increased with increasing number of MS components, while SUVmean decreased. Conclusions The SUVmax of VAT assessed by 18F-FDG PET/CT could reflect the inflammatory activity of VAT which is increased in the MS patients with systemic inflammation. Funding Acknowledgement Type of funding source: None
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Fluorodeoxyglucose
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Cancer Biomarkers
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The aim of this study was to evaluate the ability of pretreatment 90-min 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to predict the extranodular spread of lymph node metastases in oral squamous cell carcinoma. We retrospectively reviewed the cases of 56 patients who underwent pretreatment 18F-FDG PET/CT and surgery with neck dissection. Maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis were measured for the 56 primary sites and maximum standardized uptake value was measured for 115 lymph node levels. Extranodular spread was present at 9 lymph node levels in 7 patients. Significant differences were found in metabolic tumor volume and total lesion glycolysis of the primary site, and in lymph node maximum standardized uptake value, between patients with and without extranodular spread (p<0.05). Combining primary site total lesion glycolysis and lymph node maximum standardized uptake volume at their respective optimal cutoffs, the sensitivity, specificity, and accuracy for predicting extranodular spread were 89%, 92%, and 92%, respectively. Pretreatment 18F-FDG PET/CT is useful for predicting extranodular spread in patients with oral squamous cell carcinoma. The combined use of primary site total lesion glycolysis and lymph node maximum standardized uptake value showed greater predictive value than either predictor singly.
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Fluorodeoxyglucose
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Limited studies have examined the association between lung cancer and bronchiectasis (BE). This study evaluated the regional association between BE and lung cancer by analyzing the lobar location of lung cancer in patients with underlying BE. This clustered multi-level study enrolled patients who had underlying BE and were newly diagnosed with lung cancer between January 1, 2010 and May 30, 2013 in two referral hospitals in South Korea. By analyzing the presence of lung cancer and underlying BE as event variables at the level of lung lobes on chest computed tomography (CT), we evaluated the association of BE and lung cancer by the locations of the diseases. Eighty-one patients with BE and combined lung cancer were enrolled. Within 486 lung lobes of the patients, combined BE and lung cancer in the same lobe was found in 11 lobes (2.3 %). Using the general estimating equation assuming BE as a risk factor of lung cancer, the results indicated that the prevalence of lung cancer was significantly lower in the lobes with pre-existing BE (β = −1.09, p-value = 0.001). Regionally, pre-existing BE was associated with a lower risk of the occurrence of lung cancer in the same lobe.
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