Prognostic Significance of Volume-based Metabolic Parameters by 18F-FDG PET/CT in Gallbladder Carcinoma

Yoo, Jang; Choi, Joon Young; Lee, Kyu Taek; Heo, Jin Seok; Park, Soo Bin; Moon, Seung Hwan; Choe, Yearn Seong; Lee, Kyung-Han; Kim, Byung‐Tae

doi:10.1007/s13139-012-0147-7

Cited by 31 publications

(17 citation statements)

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“…Analysis of 1673 lesions demonstrated consistently high pooled Sen, Spe, PLR and DOR, but it also showed a lower NLR. According to the previous research, the overall sensitivity and accuracy of CEUS was found to be slightly higher than those of CT, PET/CT and MRI [30][31][32]. According to these results, CEUS can be used in clinical practice as an excellent diagnostic tool for evaluation and diagnosis of gallbladder carcinoma.…”

Section: Discussionmentioning

confidence: 82%

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Meta-analysis of contrast-enhanced ultrasonography for the detection of gallbladder carcinoma

2016

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Aim: To systematically evaluate the accuracy of contrast-enhanced ultrasonography (CEUS) for the detection of gallbladder carcinoma. Material and method: Relevant studies were identified searching PubMed, Embase, Elsevier, the CNKI (China National Knowledge Infrastructure) database and the Cochrane Trial Register searches until August 2015. Patient clinical characteristics, sensitivity and specificity were extracted. The summary receiver operating characteristic (ROC) curve was used to examine the accuracy of CEUS. A meta-analysis was performed to evaluate the clinical utility in the diagnosis of gallbladder carcinoma. Sensitivity analysis was performed after omitting outliers identified in a bivariate boxplot and publication bias was assessed with Egger testing. Results: From 89 citations, 16 were included in the meta-analysis with a total of 1673 lesions. We detected heterogeneity between studies and evidence of publication bias. The methodological quality was moderate. The pooled weighted sensitivity with a corresponding 95% confidence interval (CI) was 0.92 (95%CI: 0.90, 0.94), the specificity was 0.91 (95%CI: 0.89, 0.93), the positive likelihood ratio was 10.01 (95%CI: 7.02, 14.29), the negative likelihood ratio was 0.10 (95%CI: 0.07, 0.14), and the diagnostic odds ratio was 123.02 (95%CI: 78.40, 193.03). The area under the ROC curve was 0.9689 (95%CI: 0.9376, 0.9879). Conclusions: CEUS is a reliable, non-invasive, and no-radiation-exposure imaging modality with a high sensitivity and specificity for detection of gallbladder carcinoma. Nonetheless, it should be applied cautiously, and large scale, well-designed trials are necessary to assess its clinical value.

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Section: Discussionmentioning

confidence: 82%

“…Conversely, previous research has suggested that many of these hindrances can be minimized by the use of ultrasonic contrast. Indeed, the high false-positive rate of contrast-enhanced ultrasound compared to CT may in fact represent its higher sensitivity in the detection of lesions [30][31][32].…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of contrast-enhanced ultrasonography for the detection of gallbladder carcinoma

2016

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“…However, SUV max reflects the value of a single voxel and thus does not account for the metabolism of the entire tumor. Recently, volumetric parameters measured by 18 F-FDG PET such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) have emerged as new prognostic factors in several types of cancer [8][9][10][11][12][13][14]. However, the prognostic value of volumetic metabolic parameters for PNETs has not yet been evaluated.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Volume-Based Metabolic Parameters Measured by 18F-FDG PET/CT of Pancreatic Neuroendocrine Tumors

Kim

Choi

et al. 2014

Nucl Med Mol Imaging

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Purpose To date, the prognostic value of 18 F-FDG PET/CT for patients with pancreatic neuroendocrine tumors (PNETs) has not been well characterized. We investigated the prognostic value of volumetric parameters using 18 F-FDG PET/CT in this patient population. Methods We retrospectively reviewed 20 cases of pathologically proven PNET in patients who had undergone pretherapeutic 18 F-FDG PET/CT. PET parameters including maximum and average standardized uptake values (SUV max , SUV ave ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumor were measured using a threshold SUV to determine the boundaries of the tumors. Univariate and multivariate survival analyses were performed with adjustments for PET parameters and other clinical values.Results The median clinical follow-up was 22.3 (range, 1.2-95.4) months. Cancer-related death occurred in 5 of 20 patients (25 %). Patients had clinical or pathological stages of I in seven patients, II in six patients, III in three patient, and IV in four patients. According to the WHO histological classification of subtypes, 3 patients exhibited well-differentiated PNETs, 13 patients had well-differentiated endocrine carcinomas, and 4 had poorly differentiatedendocrine carcinomas. Univariate analysis showed that tumor size (p=0.028), AJCC stage (p=0.009), T stage (p=0.028), M stage (p=0.029), treatment modality (p=0.045), MTV (p=0.003) and TLG (p=0.027) were significant predictors of overall survival. On multivariate analysis, MTV (HR=10.859, p=0.031) was a significant independent predictor of overall survival along with the AJCC stage (HR=11.556, p=0.027).

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“…Theoretically, volume-based parameters are more suitable indicators of tumor burden than SUV max or SUV mean , because volumebased PET parameters have shown a better predictive performance for prognosis than SUV max in previous studies (21)(22)(23). In addition, MTV demonstrated a significant correlation with occult lymph node metastasis in patients with clinically N0 tongue cancer (8).…”

Section: Discussionmentioning

confidence: 98%

Prediction of Occult Lymph Node Metastasis by Metabolic Parameters in Patients with Clinically N0 Esophageal Squamous Cell Carcinoma

et al. 2014

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The aim of this study was to investigate the value of 18 F-FDG parameters of the primary tumor in predicting occult lymph node metastasis in patients with clinically N0 esophageal squamous cell carcinoma. Methods: The study comprised 143 consecutive patients (mean age ± SD, 63.9 ± 8.6 y; range, 31.8-81.2 y) from May 2003 to January 2010 who had clinically N0 esophageal squamous cell carcinoma based on preoperative imaging studies including chest CT, 18 F-FDG PET/CT, and endoscopic ultrasound. We measured maximum standardized uptake value (SUV max ), mean SUV (SUV mean ), total lesion glycolysis (TLG), and metabolic tumor volume (MTV) of the primary tumor and analyzed the relationship between clinicopathologic variables including PET parameters and occult lymph node metastasis using a logistic regression model. Results: Univariate analysis indicated that clinical T classification, SUV max , SUV mean , MTV, TLG, and longitudinal diameter of tumor were significant risk factors associated with occult lymph node metastasis. Optimal thresholds were cT2-4, SUV max ≥ 4.8, SUV mean ≥ 3.2, MTV ≥ 5.5 cm 3 , TLG ≥ 220, and diameter ≥ 3.8 cm. After multivariate analysis, the logistic regression model revealed that clinical T classification (hazard ratio [HR], 4.6; 95% confidence interval [CI], 1.7-12.4; P 5 0.003) and SUV max (HR, 3.5; 95% CI, 1.3-9.2; P 5 0.012) were independent risk factors. The combination of SUV max and clinical T classification (HR, 13.2; 95% CI, 5.4-31.9; P , 0.001) was a significantly better powerful risk factor for occult lymph node metastasis than SUV max or clinical T classification alone. Sensitivity, specificity, positive predictive value, and negative predictive value of the combination of clinical T classification and SUV max were 73.0%, 81.5%, 60.0%, and 89.7%, respectively. Conclusion: SUV max , combined with clinical T classification, may be useful for predicting occult lymph node metastasis in patients with clinically N0 squamous cell carcinoma of the esophagus. The accurate detection of regional lymph node metastasis in esophageal cancer is important for the selection of the proper treatment strategy. The presence of regional lymph node metastasis is particularly critical when making decisions about treatment, especially when tumor invasion is limited to submucosa of the esophagus. Current evaluation methods for preoperative tumor classification include multiimaging modalities such as CT, endoscopic ultrasonography (EUS), and 18 F-FDG PET/CT (1). However, current imaging modalities have limited capabilities, and diagnostic performance for the detection of regional lymph node metastases is incomplete (2). Despite comprehensive assessment using multiimaging modalities, a considerable percentage of patients with clinically N0 esophageal cancer are found to have regional lymph node metastasis after esophagectomy. The prevalence rate of occult lymph node metastasis ranges from 11% to 56% (3).18 F-FDG PET/CT has an advantage over conventional imaging modalities in that it provides quantitative i...

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Prognostic Significance of Volume-based Metabolic Parameters by 18F-FDG PET/CT in Gallbladder Carcinoma

Cited by 31 publications

References 31 publications

Meta-analysis of contrast-enhanced ultrasonography for the detection of gallbladder carcinoma

Meta-analysis of contrast-enhanced ultrasonography for the detection of gallbladder carcinoma

Prognostic Value of Volume-Based Metabolic Parameters Measured by 18F-FDG PET/CT of Pancreatic Neuroendocrine Tumors

Prediction of Occult Lymph Node Metastasis by Metabolic Parameters in Patients with Clinically N0 Esophageal Squamous Cell Carcinoma

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