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Annals of Nuclear Medicine 32-6
Original Article
1. Intratumoral heterogeneity in 18F-FDG PET/CT by textural analysis in breast cancer as a predictive and prognostic subrogate (pp379–388)
David Molina-García, Ana María García-Vicente, Julián Pérez-Beteta, Mariano Amo-Salas, Alicia Martínez-González, María Jesús Tello-Galán, Ángel Soriano-Castrejón, Víctor M. Pérez-García
Ana María García-Vicente (angarvice@yahoo.es)
Nuclear Medicine Department University General Hospital, Ciudad Real, Spain
2. Prediction of tumor differentiation using sequential PET/CT and MRI in patients with breast cancer (pp389–397)
Joon Ho Choi, Ilhan Lim, Woo Chul Noh, Hyun-Ah Kim, Min-Ki Seong, Seonah Jang, Hyesil Seol, Hansol Moon, Byung Hyun Byun, Byung Il Kim, Chang Woon Choi, Sang Moo Lim
Sang Moo Lim (smlim328@kcch.re.kr)
Department of Nuclear Medicine, Korea Cancer Center Hospital Korea Institute of Radiological and Medical Sciences (KIRAMS)Seoul, Republic of Korea
3. The correlation between striatal and cortical binding ratio of 11C-PiB-PET in amyloid-uptake-positive patients (pp398–403)
Julia Sauerbeck, Kazunari Ishii, Chisa Hosokawa, Hayato Kaida, Franziska T. Scheiwein, Kohei Hanaoka, Axel Rominger, Matthias Brendel, Peter Bartenstein, Takamichi Murakami
Kazunari Ishii (ishii@med.kindai.ac.jp)
Department of Radiology Kindai University Faculty of Medicine Osakasayama, Japan
Neurocognitive Disorders Center Kindai University Hospital Osakasayama, Japan
Division of Positron Emission Tomography, Institute of Advanced Clinical Medicine Kindai University Osakasayama, Japan
4. Implications of electrocardiographic frontal QRS axis on left ventricular diastolic parameters derived from electrocardiogram-gated myocardial perfusion single photon emission computed tomography (pp404–409)
Satoshi Kurisu, Kazuhiro Nitta, Yoji Sumimoto, Hiroki Ikenaga, Ken Ishibashi, Yukihiro Fukuda, Yasuki Kihara
Satoshi Kurisu, (skurisu@nifty.com)
Department of Cardiovascular Medicine Hiroshima University Graduate School of Biomedical and Health Sciences Hiroshima, Japan
5. 18F-FDG PET/CT metabolic tumor parameters and radiomics features in aggressive non-Hodgkin’s lymphoma as predictors of treatment outcome and survival (pp410–416)
Aatif Parvez, Noam Tau, Douglas Hussey, Manjula Maganti, Ur Metser
Ur Metser (Ur.metser@uhn.ca)
Joint Department of Medical Imaging, Princess Margaret Cancer Centre, University Health Network, Mount Sinai Hospital and Women’s College Hospital University of Toronto Toronto, Canada
6. Predictive factors for the outcomes of initial I-131 low-dose ablation therapy to Japanese patients with differentiated thyroid cancer (pp418–424)
Shinji Ito, Shingo Iwano, Katsuhiko Kato, Shinji Naganawa
Shinji Ito (itoshj@med.nagoya-u.ac.jp)
Department of Radiology Nagoya University Graduate School of Medicine Nagoya, Japan
Short Communication
7. Comparison of 125I- and 111In-labeled peptide probes for in vivo detection of oxidized low-density lipoprotein in atherosclerotic plaques (pp 425–429)
Takashi Temma, Naoya Kondo, Keiko Yoda, Kantaro Nishigori, Satoru Onoe, Masashi Shiomi, Masahiro Ono, Hideo Saji
Hideo Saji (hsaji@pharm.kyoto-u.ac.jp)
Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences Kyoto University Kyoto, Japan
Kyoto University Research Administration Office Kyoto, Japan
1. Intratumoral heterogeneity in 18F-FDG PET/CT by textural analysis in breast cancer as a predictive and prognostic subrogate
David Molina-García, Ana María García-Vicente, Julián Pérez-Beteta, Mariano Amo-Salas, Alicia Martínez-González, María Jesús Tello-Galán, Ángel Soriano-Castrejón, Víctor M. Pérez-García
Abstract
Aim
To assess the predictive and prognostic value of textural parameters in locally advanced breast cancer (LABC) obtained by 18F-FDG PET/CT.
Methods
Prospective study including 68 patients with LABC, neoadjuvant chemotherapy (NC) indication and a baseline 18F-FDG PET/CT. Breast specimens were grouped into molecular phenotypes and classified as responders or non-responders after completion of NC. Patients underwent standard follow-up to obtain the disease-free survival (DFS) and overall survival (OS). After breast tumor segmentation, three-dimensional (3D) textural measures were computed based on run-length matrices (RLM) and co-occurrence matrices (CM). Relations between textural features with risk categories attending to molecular phenotypes were explored. Kaplan–Meier analysis and univariate and multivariate Cox proportional hazard analysis were used to study the potential of textural variables, molecular phenotypes and histologic response to predict DFS and OS. Receiver operating characteristic (ROC) analysis was used to obtain the best cut-off value, the area under the curve (AUC) and sensitivity and specificity considering OS and DFS.
Results
Eighteen patients were classified as responders. Mean ± SD of DFS and OS was 70.87 ± 21.85 and 76.77 ± 18.80 months, respectively. Long run emphasis (LRE) and long run high gray-level emphasis (LRHGE) showed a relation with risk categories. Low gray-level run emphasis (LGRE), LRHGE and run-length non-uniformity (RLNU) showed association with the NC response. Textural variables were significantly associated with OS and DFS in univariate analysis. Regarding the multivariate Cox regression analysis, PET stage with short run high gray-level emphasis (SRHGE) was significantly associated with OS, and PET stage and high gray-level run emphasis (HGRE) with DFS.
Conclusion
Textural variables obtained with 18F-FDG PET/CT were predictors of neoadjuvant chemotherapy response and prognosis, being as relevant as PET stage at diagnosis for OS and DFS prediction.
Keywords
Breast cancer, 18F-FDG PET/CT, Textural features, Neoadjuvant chemotherapy response, Overall survival, Disease-free survival
2. Prediction of tumor differentiation using sequential PET/CT and MRI in patients with breast cancer
Joon Ho Choi, Ilhan Lim, Woo Chul Noh, Hyun-Ah Kim, Min-Ki Seong, Seonah Jang, Hyesil Seol, Hansol Moon, Byung Hyun Byun, Byung Il Kim, Chang Woon Choi, Sang Moo Lim
Abstract
The aim of this study is to assess tumor differentiation using parameters from sequential positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) in patients with breast cancer.
This retrospective study included 78 patients with breast cancer. All patients underwent sequential PET/CT and MRI. For fluorodeoxyglucose (FDG)-PET image analysis, the maximum standardized uptake value (SUVmax) of FDG was assessed at both 1 and 2 h and metabolic tumor volume (MTV) and total lesion glycolysis (TLG). The kinetic analysis of dynamic contrast-enhanced MRI parameters was performed using dynamic enhancement curves. We assessed diffusion-weighted imaging (DWI)–MRI parameters regarding apparent diffusion coefficient (ADC) values. Histologic grades 1 and 2 were classified as low-grade, and grade 3 as high-grade tumor.
Forty-five lesions of 78 patients were classified as histologic grade 3, while 26 and 7 lesions were grade 2 and grade 1, respectively. Patients with high-grade tumors showed significantly lower ADC-mean values than patients with low-grade tumors (0.99 ± 0.19 vs.1.12 ± 0.32, p = 0.007). With respect to SUVmax1, MTV2.5, and TLG2.5, patients with high-grade tumors showed higher values than patients with low-grade tumors: SUVmax1 (7.92 ± 4.5 vs.6.19 ± 3.05, p = 0.099), MTV2.5 (7.90 ± 9.32 vs.4.38 ± 5.10, p = 0.095), and TLG2.5 (40.83 ± 59.17 vs.19.66 ± 26.08, p = 0.082). However, other parameters did not reveal significant differences between low-grade and high-grade malignancies. In receiver-operating characteristic (ROC) curve analysis, ADC-mean values showed the highest area under the curve of 0.681 (95%CI 0.566–0.782) for assessing high-grade malignancy.
Lower ADC-mean values may predict the poor differentiation of breast cancer among diverse PET–MRI functional parameters.
Keywords
Breast cancer, Histological grade, FDG-PET, DCE–MRI, DWI–MRI
3. The correlation between striatal and cortical binding ratio of 11C-PiB-PET in amyloid-uptake-positive patients
Julia Sauerbeck, Kazunari Ishii, Chisa Hosokawa, Hayato Kaida, Franziska T. Scheiwein, Kohei Hanaoka, Axel Rominger, Matthias Brendel, Peter Bartenstein, Takamichi Murakami
Abstract
In subjects with amyloid deposition, striatal accumulation of 11C-Pittsburgh compound B (PiB) demonstrated by positron emission tomography (PET) is related to the stage of Alzheimer’s disease (AD). In this study, we investigated the correlation between striatal and cortical non-displaceable binding potential (BPND).
Seventy-three subjects who complained of cognitive disturbance underwent dynamic PiB-PET studies and showed positive PiB accumulation were retrospectively selected. These subjects included 34 AD, 26 mild cognitive impairment, 2 frontotemporal lobar degeneration, 2 Parkinson’s disease, 5 dementia with Lewy bodies, and 4 undefined diagnosis patients. Individual BPND images were produced from the dynamic data of the PiB-PET study, and voxel-based analyses were performed to estimate the correlations between striatal and other regional cortical BPND measures.
There were highly significant correlations between striatal and prefrontal BPND, with the highest correlation being demonstrated in left Brodmann area 11. We found that almost all of the high cortical BPND values correlated with striatal BPND values, with the exception of the occipital cortex with low correlation.
Our study demonstrated positive correlations in amyloid deposits between the striatum and other cortical areas with functional and anatomical links. The amyloid distribution in the brain is not random, but spreads following the functional and anatomical connections.
Keywords
Dementia, Alzheimer’s disease, 11C-PiB-PET, FDG-PET, Amyloid deposit, Striatum
4. Implications of electrocardiographic frontal QRS axis on left ventricular diastolic parameters derived from electrocardiogram-gated myocardial perfusion single photon emission computed tomography
Satoshi Kurisu, Kazuhiro Nitta, Yoji Sumimoto, Hiroki Ikenaga, Ken Ishibashi, Yukihiro Fukuda, Yasuki Kihara
Abstract
Current electrocardiographic (ECG) machines report various variables including frontal QRS axis automatically. We tested the hypothesis that QRS axis is associated with left ventricular (LV) diastolic parameters derived from ECG-gated myocardial perfusion single photon emission computed tomography (SPECT) independent of myocardial ischemia.
Ninety-three patients with preserved LV ejection fraction and no evidence of myocardial ischemia were enrolled based on ECG-gated SPECT. Peak filling rate (PFR), one-third mean filling rate (1/3 MFR) and time to peak filling (TTPF) were obtained as LV diastolic parameters.
There were 82 male and 11 female patients with a mean age of 69 ± 9 years. QRS axis ranged from − 40° to 85° (36° ± 31°). QRS axis was correlated with PFR (r = 0.28, p < 0.01), 1/3 MFR (r = 0.25, p = 0.02) and TTPF (r = − 0.21, p = 0.04). QRS axis was also correlated with age (r = − 0.23, p = 0.03), body mass index (BMI) (r = − 0.36, p < 0.01) and LV mass index (LVMI) (r = − 0.27, p < 0.01). Linear regression analysis showed that QRS axis was associated with PFR, 1/3 MFR and TTPF for LV diastolic function, but was not associated with these LV diastolic parameters after adjustment of various confounders.
Our data suggest that QRS axis depends on age, BMI or LVMI, and serves as a surrogate marker of LV diastolic function.
Keywords
Electrocardiogram, Diastolic function, SPECT
5. 18F-FDG PET/CT metabolic tumor parameters and radiomics features in aggressive non-Hodgkin’s lymphoma as predictors of treatment outcome and survival
Aatif Parvez, Noam Tau, Douglas Hussey, Manjula Maganti, Ur Metser
Abstract
To determine whether metabolic tumor parameters and radiomic features extracted from 18F-FDG PET/CT (PET) can predict response to therapy and outcome in patients with aggressive B-cell lymphoma.
This institutional ethics board-approved retrospective study included 82 patients undergoing PET for aggressive B-cell lymphoma staging. Whole-body metabolic tumor volume (MTV) using various thresholds and tumor radiomic features were assessed on representative tumor sites. The extracted features were correlated with treatment response, disease-free survival (DFS) and overall survival (OS).
At the end of therapy, 66 patients (80.5%) had shown complete response to therapy. The parameters correlating with response to therapy were bulky disease > 6 cm at baseline (p = 0.026), absence of a residual mass > 1.5 cm at the end of therapy CT (p = 0.028) and whole-body MTV with best performance using an SUV threshold of 3 and 6 (p = 0.015 and 0.009, respectively). None of the tumor texture features were predictive of first-line therapy response, while a few of them including GLNU correlated with disease-free survival (p = 0.013) and kurtosis correlated with overall survival (p = 0.035).
Whole-body MTV correlates with response to therapy in patient with aggressive B-cell lymphoma. Tumor texture features could not predict therapy response, although several features correlated with the presence of a residual mass at the end of therapy CT and others correlated with disease-free and overall survival. These parameters should be prospectively validated in a larger cohort to confirm clinical prognostication.
Keywords
PET/CT, Non-Hodgkin’s lymphoma, Texture Radiomics, Metabolic tumor volume
6. Predictive factors for the outcomes of initial I-131 low-dose ablation therapy to Japanese patients with differentiated thyroid cancer
Shinji Ito, Shingo Iwano, Katsuhiko Kato, Shinji Naganawa
Abstract
To identify prognostic factors associated with a low-iodine diet (LID) and the amount of remnant thyroid tissue in Japanese patients with differentiated thyroid cancer (DTC) who received initial I-131 remnant ablation (RAI) using a fixed low dose of I-131 (1110 MBq).
In this prospective study, we enrolled 45 patients. Patients were classified into a self-managed LID group and a strict LID group. We measured the urinary iodine concentration on the day of RAI after patients consumed LID for 2 weeks. Thyroid-stimulating hormone-induced thyroglobulin (Tg) levels and I-131 uptake by the remnant thyroid tissue were also evaluated. A response-evaluation whole-body scan (WBS) was performed 6–8 months after RAI to determine the outcome of the therapy.
Post-LID urinary iodine levels of the strict LID group tended to be lower than those of the self-managed LID group. Twenty-five cases (56%) showed absence of uptake, whereas 20 cases (44%) showed residual uptake on the response-evaluation WBS. There were no significant differences between “absence” and “residual” groups in urinary iodine concentrations and Tg levels (p = 0.253 and p = 0.234, respectively). However, significant differences were observed in I-131 uptake by the thyroid bed (p = 0.035).
For patients following the current Japanese method of a 2-week LID, the urinary iodine concentration was not a predictive factor for the successful outcome of RAI. In contrast, low I-131 uptake by the thyroid bed, revealed by the scintigram after RAI, may serve as a favorable predictive factor.
Keywords
I-131 remmnant ablation, Differentiated thyroid cancer, Low dose of I-131, Low-iodine diet, Urinary iodine
Short Communication
7. Comparison of 125I- and 111In-labeled peptide probes for in vivo detection of oxidized low-density lipoprotein in atherosclerotic plaques
Takashi Temma, Naoya Kondo, Keiko Yoda, Kantaro Nishigori, Satoru Onoe, Masashi Shiomi, Masahiro Ono, Hideo Saji
Abstract
Oxidized low-density lipoprotein (OxLDL) plays a pivotal role in atherosclerotic plaque destabilization, which suggests its potential as a nuclear medical imaging target. We previously developed radioiodinated 125I-AHP7, a peptide probe carrying a 7-residue sequence from the OxLDL-binding protein Asp-hemolysin, for specific OxLDL imaging. Although 125I-AHP7 recognized OxLDL, it had low stability. Thus, to improve stability, we designed radiolabeled 22-residue peptide probes, 125I-AHP22 and 111In-AHP22, which include the entire AHP7 sequence, and evaluated the stability, activity, and applications of these probes in vitro and in vivo.
Probes consisting of a 21-residue peptide derived from the Asp-hemolysin sequence and an N-terminal Cys or aminohexanoic acid for labeling with 125I-N-(3-iodophenyl)maleimide or 111In diethylene triamine pentaacetic acid were termed 125I-AHP22 and 111In-AHP22. An in vitro-binding inhibition assay with OxLDL was performed using 125I-AHP7 as a radiotracer. Radioactivity accumulation in the atherosclerotic aorta and plasma intact fraction was evaluated 30 min after intravenous administration of probes in myocardial infarction-prone Watanabe heritable hyperlipidemic (WHHLMI) rabbits.
125I-AHP22 and 111In-AHP22 were synthesized in ~ 360 and 60 min, respectively, with > 98% radiochemical purities after RP-HPLC purification. An in vitro-binding assay revealed similar or greater inhibition of OxLDL binding by both In-AHP22 and I-AHP22 compared to I-AHP7. The fraction of intact 125I-AHP22 and 111In-AHP22 in plasma was estimated to be approximately tenfold higher than that of 125I-AHP7. Both probes were rapidly cleared from the blood. 111In-AHP22 had a 2.3-fold higher accumulation in WHHLMI rabbit aortas compared to control rabbits, which was similar to 125I-AHP7. However, 125I-AHP22 accumulated to similar levels in aortas of WHHLMI and control rabbits due to high nonspecific accumulation in normal aortas that could be due to high lipophilicity.
111In-AHP22, easily prepared within 1 h, showed moderate affinity for OxLDL, high stability in vivo, and high accumulation in atherosclerotic aortas. 111In-AHP22 could be a potential lead compound to develop future effective OxLDL imaging probes.
Keywords
Atherosclerosis, Oxidized low-density lipoprotein, Peptide, Nuclear medical imaging, WHHLMI rabbit
