Whole-body 18 F-FDG PET/CT for M staging in the patient with newly diagnosed nasopharyngeal carcinoma: Who needs?

Ren, Yunyan; Li, You-Cai; Wu, Hubing; Wang, Quanshi; Han, Yanjiang; Zhou, Wenlan; Li, Hongsheng

doi:10.1016/j.ejrad.2017.02.002

Cited by 20 publications

(12 citation statements)

References 22 publications

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“…For example, the clinical course and prognosis of cancer of the salivary glands vary greatly, depending on histopathological subtype. The most important factors predicting survival outcomes are histological grade and clinical stage at presentation (13).…”

Section: Discussionmentioning

confidence: 99%

Distant metastases and synchronous malignancies on FDG-PET/CT in patients with head and neck cancer: a retrospective study

et al. 2020

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Background: Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has been proven to be a good method to detect distant spread of head and neck cancer (HNC). However, most prior studies are based on Asian populations and may not be directly transferable to western populations. Purpose: To investigate the frequency and distribution of distant metastases and synchronous malignancies detected by PET/CT in HNC in a northern Swedish population. Material and Methods: All primary whole-body FDG-PET/CT examinations performed on the suspicion of HNC (n ¼ 524 patients) between 1 January 2013 and 31 December 2016 at Umeå University Hospital in Sweden were retrospectively reviewed . After the exclusion of 189 examinations without evidence of primary HNC, 335 examinations were analyzed. Results: Distant metastases were detected in 10 (3%) patients, all with advanced primary tumors corresponding to TNM stage 3-4, most frequently in salivary gland adenocarcinoma, where 50% of patients had distant spread. Four patients had metastases below the diaphragm, representing 20% of the salivary gland malignancies. In the remaining six patients, metastases were supraphrenic, of which all but one were identified by CT alone. Synchronous malignancies were discovered in 14 (4.2%) patients, of which five were below the diaphragm. Conclusion: The overall frequency of distant spread and synchronous malignancy in primary HNC was generally low. However, the risk for distant metastases below the diaphragm was relatively higher in salivary gland adenocarcinoma, supporting whole-body FDG-PET/CT in the primary diagnostic work-up in these patients.

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Section: Discussionmentioning

confidence: 99%

Distant metastases and synchronous malignancies on FDG-PET/CT in patients with head and neck cancer: a retrospective study

et al. 2020

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“…According to the 8th edition AJCC/UICC staging system [25], stage IVB is classified as M1 with any T and any N. There are approximately 5-8% of NPC patients have distant metastasis at first diagnosis. 18 F-FDG PET/CT is superior to conventional imaging modalities for detecting distant metastasis, and it is recommended for patients of NPC with a high risk of distant metastasis at initial diagnosis [42][43][44].…”

Section: Discussionmentioning

confidence: 99%

Establishment and Validation of a Nomogram with Intratumoral Heterogeneity Derived from 18F-FDG PET/CT for Predicting Individual Conditional Risk of 5-Year Recurrence before Initial Treatment of Nasopharyngeal Carcinoma

Song

et al. 2019

Preprint

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Objectives Intratumoral heterogeneity has an enormous effect on patient treatment and outcome. The purpose of the current study was to establish and validate a nomogram with intratumoral heterogeneity derived from 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for prognosis of 5-Year progression-free survival (PFS) of patients with nasopharyngeal carcinoma (NPC).Methods A total of 171 NPC patients who underwent pretreatment 18F-FDG PET/CT were retrospectively enrolled. Data was randomly divided into training cohort (n=101) and validation cohort (n=70). The clinicopathologic parameters and the following PET parameters were analyzed: maximum and mean standardized uptake value (SUVmax, SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and heterogeneity index (HI, SUVmax/SUVmean) for primary tumor and maximal neck lymph node. Cox analyses were performed on PFS in the training cohort. A prognostic nomogram based on this model was developed and validated.Results For the primary tumor, MTV-2.5, TLG-2.5, MTV-70%, and TLG-70% were significantly correlated with PFS. For the maximal neck lymph node, short diameter and HI were significantly correlated with PFS. Among the clinicopathologic parameters, M stage was a significant prognostic factor for recurrence. In multivariate analysis, M stage (P=0.006), TLG-T-70% (P=0.002), and HI-N (P=0.018) were independent predictors. Based on this prognostic model, a nomogram was generated. The C-index of this model was 0.74 (95% CI: 0.63-0.85). For the cross validation, the C-index for the model was 0.73 (95% CI: 0.62-0.83) with the validation cohort. Patients with a risk score of ≥111 had poorer survival outcomes than those with a risk score of 0-76 and 77-110.Conclusions Intratumoral heterogeneity derived from 18F-FDG PET/CT could predict long-term outcome in patients with primary NPC. A combination of PET parameters and the TNM stage enables better stratification of patients into subgroups with different PFS rates.

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“…18 F-FDG was manufactured using a tracer synthesis system (TRACERlab FX FDG ; GE Healthcare, United States) and had a > 95% radiochemical purity. Approximately 60 min after the intravenous injection of 318-524 MBq (8.6-14.2 mCi, 150 μCi/kg) 18 F-FDG, whole-body PET/CT was performed at our centre according to established protocols[ 24 ].…”

Section: Methodsmentioning

confidence: 99%

Low glucose metabolism in hepatocellular carcinoma with GPC3 expression

Yang

Zhou

et al. 2018

WJG

Self Cite

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AIMTo investigate the relationship between glucose metabolism and glypican-3 (GPC3) expression in hepatocellular carcinoma (HCC).METHODSImmunohistochemical staining of pathological samples for GPC3 and glucose transporter 1 (GLUT1), and whole-body 18F-FDG PET/CT for measuring tumour glucose uptake were performed in 55 newly diagnosed HCC patients. The maximum standard uptake value (SUVmax) and tumour-to-non-tumourous liver uptake (T/NT) ratio were used to quantify 18F-FDG uptake. In vitro 18F-FDG uptake assay of GPC3-expressing HepG2 and non-GPC3-expressing RH7777 cells was used to examine the effect of GPC3 in cellular glucose metabolism. The relationships between GPC3 expression and 18F-FDG uptake, GLUT1 expression, tumour differentiation, and other clinical indicators were analysed using Spearman rank correlation, univariate and multiple logistic regression analyses.RESULTSPositive GPC3 expression was observed in 67.3% of HCC patients, including 75.0% of those with well or moderately differentiated HCC and 36.4% of those with poorly differentiated HCC. There was an inverse relationship between GPC3 expression and SUVmax (Spearman correlation coefficient = -0.281, P = 0.038) and a positive relationship between GLUT1 expression and SUVmax (Spearman correlation coefficient = 0.681, P < 0.001) in patients with HCC. Univariate analysis showed that two glucose metabolic parameters (SUVmax and T/NT ratio), tumour differentiation, lymph node metastasis, and TNM stage were all significantly associated with GPC3 expression (P < 0.05), whereas GLUT1 expression, sex, age, tumour size, intrahepatic lesion number, and distant metastasis showed no statistical association (P > 0.05). Further multivariate analysis revealed that only the T/N ratio was signiﬁcantly correlated with GPC3 expression in patients with HCC (P < 0.05). In vitro assay revealed that the uptake of 18F-FDG in GPC3-expressing HepG2 cells was significantly lower than that of non-GPC3-expressing RH7777 cells (t = -20.352, P < 0.001).CONCLUSIONThe present study demonstrated that GPC3 expression is inversely associated with glucose metabolism, suggesting that GPC3 may play a role in regulating glucose metabolism in HCC.

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Whole-body 18 F-FDG PET/CT for M staging in the patient with newly diagnosed nasopharyngeal carcinoma: Who needs?

Cited by 20 publications

References 22 publications

Distant metastases and synchronous malignancies on FDG-PET/CT in patients with head and neck cancer: a retrospective study

Distant metastases and synchronous malignancies on FDG-PET/CT in patients with head and neck cancer: a retrospective study

Establishment and Validation of a Nomogram with Intratumoral Heterogeneity Derived from 18F-FDG PET/CT for Predicting Individual Conditional Risk of 5-Year Recurrence before Initial Treatment of Nasopharyngeal Carcinoma

Low glucose metabolism in hepatocellular carcinoma with GPC3 expression

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