Introduction. This study compared the diagnostic test accuracy of magnetic resonance imaging (MRI) with that of 18 F-fluoro-2-glucose-positron emission tomography/ computed tomography (FDG-PET/CT) imaging in assessment of response to neoadjuvant chemotherapy (NAC) in breast cancer. Methods. A systematic search was performed in PubMed and EMBASE (last updated in June 2015). Studies investigating the performance of MRI and FDG-PET or FDG-PET/CT imaging during or after completion of NAC in patients with histologically proven breast cancer were eligible for inclusion. We considered only studies reporting a direct comparison between these imaging modalities to establish precise summary estimates in the same setting of patients. Pathologic response was considered as the reference standard. Two authors independently screened and selected studies that met the inclusion criteria and extracted the data.

Prostate cancer (PCa) remains a leading cause of cancer mortality among American men. Multi-parametric magnetic resonance imaging (mpMRI) is widely used to assist with detection of PCa and characterization of its aggressiveness. Computer-aided diagnosis (CADx) of PCa in MRI can be used as clinical decision support system to aid radiologists in interpretation and reporting of mpMRI. We report on the development of a convolution neural network (CNN) model to support CADx in PCa based on the appearance of prostate tissue in mpMRI, conducted as part of the SPIE-AAPM-NCI PROSTATEx challenge. The performance of different combinations of mpMRI inputs to CNN was assessed and the best result was achieved using DWI and DCE-MRI modalities together with the zonal information of the finding. On the test set, the model achieved an area under the receiver operating characteristic curve of 0.80.

The high diagnostic performance of FDG PET/CT in detecting recurrence in curatively treated patients with head and neck cancer supports its use in clinical practice for patient follow-up. Further studies are needed to evaluate the prognostic utility of PET/CT in the follow-up of head and neck cancer.

Objective To evaluate the impact of intra-tumoral metabolic heterogeneity and quantitative FDG-PET/CT imaging parameters for predicting patient outcomes in primary oropharyngeal squamous cell cancer (OPSCC). METHOD AND MATERIALS We retrospective investigated 105 patients with HPV-positive OPSCC. Maximum standardized uptake value (SUVmax,), and metabolic tumor volume (MTV)were measured for the primary tumors and when available for the metastatic sites. Primary tumor intra-tumoral metabolic heterogeneity was calculated as the area under a cumulative SUV-volume Histograms curve (AUC-CSH). The median follow-up time was 35.4 months (range 3-92 months). Outcome endpoint was event free survival (EFS). Kaplan–Meier survival plots and Cox regression analyses were performed. RESULTS Of the 105 patients included, 19 patients relapsed and 11 deceased during the study period. AUC-CSH indexes were associated with EFS using PET gradient-based (p=0.034) and 50%-Threshold (p=0.02) segmentation methods, on multivariate analysis. Kaplan–Meier survival analysis using optimum cutoff of 16.7 SUVmax and 12.7 ml total MTV were significant predictors of EFS. Combining SUVmax and AUC-CSH index in three subgroups, patients with higher intra-tumoral heterogeneity and higher SUVmax were associated with worse outcome (log-rank p=0.026). Similarly, patients with higher intra-tumoral heterogeneity tumors and higher MTV had worse prognosis (log-rank, p= 0.022). CONCLUSION Intra-tumoral metabolic heterogeneity using FDG-PET was a prognostic factor for EFS in patients with primary HPV (+) OPSCC. The combined predictive effect of FDG avidity, metabolic tumor burden and intra-tumoral heterogeneity provided prognostic survival information in these patients.

ObjectiveDifferent indices and formulas of CBC parameters have been suggested as indicators of early stage screenings to detect couples with β-thalassemia minor (BTMi). In this study, we evaluated the accuracy of five previous published formulas and compared them to our new formula (│80-MCV│×│27-MCH│) in screening of β-thalassemia.MethodsAll couples in the premarital β-thalassemia screening program of Roodbar, Iran, for whom molecular analysis had been done, were selected during two years. The red blood cell parameters were applied to each formula, and a ROC curve was plotted for each one to check its discriminative effectiveness in β-thalassemia detection.ResultNone of the studied indices and formulas demonstrated 100% precision. However, we found that the Shine–Lal formula and our formula had the highest sensitivity in identifying BTMi individuals. The highest specificity belonged to our formula and Sirdah formula.ConclusionPrevious studies reported different sensitivities and specificities for the formulas. This can be attributed to different kinds of HBB gene mutations in various populations. Undoubtedly, physicians in different areas should evaluate the accuracy of published formulas for their own populations in the discrimination of BTMi from other causes of microcytic hypochromic anemia.

The purpose of this study was to evaluate the value of an 18 F-FDG PET/CT-based interpretation system (Hopkins criteria) to assess the therapy response and survival in lung cancer. Methods: This is an Institutional Review Board-approved, retrospective study. A total of 201 patients with biopsy-proven lung cancer, who underwent therapy assessment 18 F-FDG PET/CT within 6 mo (mean, 7.5 wk) of completion of treatment, were included. Patients were primarily treated with surgical resection, chemotherapy, radiation therapy, or a combination of these treatments. PET/CT studies were interpreted by 2 nuclear medicine physicians, and discrepancies were resolved by a third interpreter. The studies were scored using a qualitative 5-point scale for the primary tumor, mediastinum, distant metastatic site, if present, and overall assessment. Scores 1, 2, and 3 were considered negative and scores 4 and 5 were considered positive for residual disease. Patients were followed for a median of 12 mo (up to 128 mo). Kaplan-Meier plots with a Mantel-Cox log-rank test were performed considering death as the endpoint. Results: Overall, the PET/CT studies were positive in 144 (71.6%) and negative in 57 (28.4%) patients. There was substantial agreement between 2 interpreters (R1, R2), with a k of 0.78 (P , 0.001). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the Hopkins scoring system were 89%, 80%, 92.8%, 71.4%, and 86.7%, respectively. Overall, PET/CT resulted in starting a new treatment plan in 70.8% of patients with positive residual disease on therapy assessment PET/CT. There was a significant difference in overall survival (OS) between patients who were categorized as positive in comparison to those who were categorized as negative (hazard ratio [HR] 5 2.12; 95% confidence interval 5 1.44-3.12), which remained significant after adjustment for disease stage, prior clinical suspicion, and primary treatment. Subgroup analysis according to the tumor histology showed that positive Hopkins scoring could significantly predict the OS in both small cell lung cancer (HR 5 2.88; log-rank, P 5 0.02) and non-small cell lung cancer (HR 5 2.01; log-rank, P 5 0.001). Similarly, there was a significant difference in OS between patients with positive and negative Hopkins score both in those who had surgical resection as part of the primary treatment (HR 5 6.09; log-rank, P , 0.001) and in those who were treated with chemotherapy with or without radiation (HR 5 1.60; log-rank, P 5 0.02). Conclusion: The 5-point qualitative therapy response interpretation for lung cancer has substantial interinterpreter agreement and high accuracy and could significantly predict survival in lung cancer, irrespective of tumor histology and treatment modality.

ADC metrics could differentiate GP 3 + 4 from 4 + 3 PCa with high specificity and moderate accuracy while PI-RADSv2, did not differentiate between these patterns.

18F-fludeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) has been performed widely in diagnosis and management of patients with oropharyngeal squamous cell carcinoma (OPSCC). This review summarizes the literature on this tool in the management of these patients. The use of FDG-PET/CT helps in accurate staging of primary tumor, nodal involvement, and distant metastasis of patients with OPSCC. Contrast-enhanced FDG-PET/CT combines high-resolution CT and functional FDG-PET, providing the optimum imaging information for patient management. Using contrast-enhanced PET/CT leads to a combined anatomic and metabolic approach to radiation therapy planning in OPSCC. Moreover, PET/CT not only is a good modality for therapy assessment but also is a powerful tool in early recurrence detection of OPSCC. Finally, the PET/CT parameters provide survival information in patients with OPSCC; however, further studies are needed to introduce a scoring system to use clinically for prognosis prediction.