scholarly journals Diagnostic Value of Nineteen Different Imaging Methods for Patients with Breast Cancer: a Network Meta-Analysis

2018 ◽  
Vol 46 (5) ◽  
pp. 2041-2055 ◽  
Author(s):  
Xiao-Hong Zhang ◽  
Can Xiao

Background/Aims: We performed a network meta-analysis (NMA) to investigate and compare the diagnostic value of 19 different imaging methods used for breast cancer (BC). Methods: Cochrane Library, PubMed and EMBASE were searched to collect the relevant literature from the inception of the study until November 2016. A combination of direct and indirect comparisons was performed using an NMA to evaluate the combined odd ratios (OR) and draw the surface under the cumulative ranking curves (SUCRA) of the diagnostic value of different imaging methods for BC. Results: A total of 39 eligible diagnostic tests regarding 19 imaging methods (mammography [MG], breast-specific gamma imaging [BSGI], color Doppler sonography [CD], contrast-enhanced magnetic resonance imaging [CE-MRI], digital breast tomosynthesis [DBT], fluorodeoxyglucose positron-emission tomography/computed tomography [FDG PET/CT], fluorodeoxyglucose positron-emission tomography [FDG-PET], full field digital mammography [FFDM], handheld breast ultrasound [HHUS], magnetic resonance imaging [MRI], automated breast volume scanner [ABUS], magnetic resonance mammography [MRM], scintimammography [SMM], single photon emission computed tomography scintimammography [SPECT SMM], ultrasound elastography [UE], ultrasonography [US], mammography + ultrasonography [MG + US], mammography + scintimammography [MG + SMM], and ultrasound elastography + ultrasonography [UE + US]) were included in the study. According to this network meta-analysis, in comparison to the MG method, the CE-MRI, MRI, MRM, MG + SMM and UE + US methods exhibited relatively higher sensitivity, and the specificity of the FDG PET/CT method was higher, while the BSGI and MRI methods exhibited higher accuracy. Conclusion: The results from this NMA indicate that the diagnostic value of the BSGI, MG + SMM, MRI and CE-MRI methods for BC were relatively higher in terms of sensitivity, specificity and accuracy.

Author(s):  
Boby Varkey Maramattom ◽  
Shagos Gopalan Nair Santhamma

Neurotuberculosis (NT) continues to be a global health problem with severe morbidity and mortality. The manifestations of NT are well-known and encompass forms such as meningitis, tuberculomas, military tuberculosis, ventriculitis, and brain abscess. Data of all patients with central nervous system tuberculosis who underwent magnetic resonance imaging (MRI) and/or 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography–computed tomography (PET-CT) were analyzed. Over a 7-year period (2014–2021), we encountered three patients who had dense neurological deficits and 18F-FDG PET-CT results suggesting focal cortical encephalitis. 18F-FDG PET-CT demonstrated focal hypermetabolism involving focal–regional areas of the left hemisphere that corresponded to clinical deficits in two of the three patients. Follow-up 18F-FDG PET-CT showed improvement in cortical hypermetabolism in all three patients that corresponded with clinical improvement. MRI of the brain with contrast showed subtle leptomeningeal enhancement in these areas, along with other features of NT, but it could not detect cortical involvement. A literature review also revealed some previous descriptions that seemed to be consistent with tuberculous encephalitis (TbE). TbE seems to be a distinct subset of NT and may coexist with other features of NT or disseminated tuberculosis. It may be detected by 18F-FDG PET-CT even when brain MRI does not show any evident abnormality to explain a focal neurological deficit. 18F-FDG PET-CT can be considered during the evaluation and monitoring of NT to detect TbE. The presence of TbE may affect the prognosis and treatment duration of NT.


Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1258
Author(s):  
Lu Han ◽  
Qi Wang ◽  
Lanbo Zhao ◽  
Xue Feng ◽  
Yiran Wang ◽  
...  

Backgrounds: The purpose of this paper is to investigate the prognostic value of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) parameters in patients treated with concurrent chemoradiotherapy (CCRT) for locally advanced cervical cancer (LACC). Methods: Studies that met the following criteria were retrieved from PubMed and Embase: patients treated with CCRT for LACC; FDG PET/CT scans performed before CCRT treatment; and a detected relationship between the parameters of FDG PET/CT and the prognosis of patients. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to estimate the overall survival (OS) or event-free survival (EFS). Results: In total, 14 eligible studies with 1313 patients were included in this meta-analysis. Patients with a high maximum standardized uptake value (SUVmax) have a shorter OS than those with a low SUVmax (HR = 2.582, 95% = CI 1.936–3.443, p < 0.001). Primary tumor SUVmax values (HR = 1.938, 95% CI = 1.203–3.054, p = 0.004) were significantly correlated with EFS, with a relatively high heterogeneity (I2 = 84% and I2 = 69.4%, respectively). Based on the limited data, the combined HR for EFS with the highest primary tumor total lesion glycolysis (TLG) and metabolic tumor volume (MTV) was 1.843 (95% CI = 1.100–3.086, p = 0.02) and 2.06 (95% CI = 1.21–3.51, p = 0.007), respectively. Besides, the combined HR for OS with the highest nodal SUVmax was 2.095 (95% CI = 2.027–2.166, p < 0.001). Conclusion: A high primary SUVmax has a significant correlation with the OS and EFS of patients treated with CCRT for LACC and may therefore serve as a prognostic predictor. Due to the limited data, to explore the correlation between survival and TLG, MTV, and nodal SUVmax, further large-scale prospective studies are needed.


2018 ◽  
Vol 18 (12) ◽  
pp. 2323-2332 ◽  
Author(s):  
Yanlin Yin ◽  
Xinwei Liu ◽  
Xinming Yang ◽  
Jie Guo ◽  
Qiang Wang ◽  
...  

2020 ◽  
Vol 9 (5) ◽  
pp. 1581
Author(s):  
Corinna Altini ◽  
Valentina Lavelli ◽  
Artor Niccoli-Asabella ◽  
Angela Sardaro ◽  
Alessia Branca ◽  
...  

Spondylodiscitis is a spine infection for which a diagnosis by a magnetic resonance imaging (MRI) is considered the most appropriate imaging technique. The aim of this study was to compare the role of an 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and an MRI in this field. For 56 patients with suspected spondylodiscitis for whom MRI and 18F-FDG PET/CT were performed, we retrospectively analyzed the results. Cohen’s κ was applied to evaluate the agreement between the two techniques in all patients and in subgroups with a different number of spinal districts analyzed by the MRI. Sensitivity, specificity, and accuracy were also evaluated. The agreements of the 18F-FDG PET/CT and MRI in the evaluation of the entire population, whole-spine MRI, and two-districts MRI were moderate (κ = 0.456, κ = 0.432, and κ = 0.429, respectively). In patients for whom one-district MRI was performed, 18F-FDG PET/CT and MRI were both positive and completely concordant (κ = 1). We also separately evaluated patients with suspected spondylodiscitis caused by Mycobacterium tuberculosis for whom the MRI and 18F-FDG PET/CT were always concordant excepting in 2 of the 18 (11%) patients. Sensitivity, specificity, and accuracy of the MRI and 18F-FDG PET/CT were 100%, 60%, 97%, and 92%, 100%, and 94%, respectively. Our results confirmed the 18F-FDG PET/CT diagnostic value in the diagnosis of spondylodiscitis is comparable to that of MRI for the entire spine evaluation. This could be considered a complementary technique or a valid alternative to MRI.


2018 ◽  
Vol 59 (12) ◽  
pp. 1466-1474 ◽  
Author(s):  
Ying Kan ◽  
Shuxin Zhang ◽  
Wei Wang ◽  
Jie Liu ◽  
Jigang Yang ◽  
...  

Background Metastatic pheochromocytoma and paraganglioma (PCs/PGLs) show high germline mutation, and 18F-FDG and 68Ga-DOTA peptide positron emission tomography/computed tomography (PET/CT) imaging are recommended for the diagnosis of metastatic of PCs. However, there has been lack of direct comparison of the two modalities in the diagnosis of metastatic of PCs up to now. Purpose To evaluate and compare the value of localization of 68Ga-somatostatin receptor analogs and 18F-FDG in the diagnosis of metastatic PCs/PGLs. Material and Methods A comprehensive literature search of PubMed/MEDLINE, ScienceDirect, and Web of Science was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines published in August 2016. We critically reviewed all studies based on the PICOS criteria. QUADAS-2 was used to evaluate the quality of the methodology of the included studies. Results This meta-analysis included 17 studies (629 patients, average age [mean ± SD] = 42.7 ± 6.3 years). The pooled sensitivity and specificity of 18F-FDG and 68Ga peptides were 0.85 (95% confidence interval [CI] = 0.78–0.91) and 0.55 (95% CI = 0.37–0.73), and 0.95 (95% CI = 0.92–0.97) and 0.87 (95% CI = 0.63–0.96), respectively. The area under the sROC curves of the 18F-FDG and 68Ga peptides were 0.88 (95% CI = 0.85–0.91) and 0.78 (95% CI = 0.74–0.81), respectively. A subgroup analysis demonstrated that the difference at the per-lesion level and gene mutation level was significant. Conclusion Compared to 18F-FDG PET/CT, the 68Ga-somatostatin receptor demonstrated good performance in the localization of metastatic PCs/PGLs, especially those with germline mutations. The use of the 68Ga-somatostatin receptor can be a new tool in the diagnosis of metastatic PCs/PGLs.


2015 ◽  
Vol 133 (2) ◽  
pp. 141-150 ◽  
Author(s):  
Rodrigo Regacini ◽  
Andrea Puchnick ◽  
David Carlos Shigueoka ◽  
Wagner Iared ◽  
Henrique Manoel Lederman

CONTEXT AND OBJECTIVE: Positron emission tomography with [18]F-fluoro-2-deoxyglucose (FDG-PET/CT) has been advocated as the method of choice for lymphoma staging, since it enables whole-body analysis with high sensitivity for detection of affected areas and because it combines capacities for anatomical and functional assessment. With technological advances, magnetic resonance imaging (MRI) has emerged as an alternative to FDG-PET/CT. This systematic review with meta-analysis aimed to compare whole-body diffusion-weighted MRI (WB-MRI) with FDG-PET/CT for lymphoma staging. DESIGN AND SETTING: Systematic review on diagnostic test accuracy studies conducted at a public university. METHODS: The Medline, Scopus, Embase and Lilacs databases were searched for studies published up to September 2013 that compared WB-MRI and FDG-PET/CT for lymphoma staging. The reference lists of included studies were checked for any relevant additional citations. RESULTS: Six studies that evaluated the initial lymphoma staging in 116 patients were included. WB-MRI and FDG-PET/CT agreed in 90.5% of the cases (κ = 0.871; P < 0.0001). In most of the studies, when there was disagreement between the methods, WB-MRI overstaged in relation to FDG-PET/CT. The sensitivity of WB-MRI and FDG-PET/CT, in comparison with the clinical-radiological standard, ranged from 59 to 100% and from 63 to 100% respectively. CONCLUSION: WB-MRI is a highly sensitive method for initial lymphoma staging. It has excellent agreement with FDG-PET/CT and is a great alternative for managing lymphoma patients, without using ionizing radiation or an intravenous contrast agent.


2012 ◽  
Vol 22 (6) ◽  
pp. 1031-1036 ◽  
Author(s):  
Maheshkumar N. Upasani ◽  
Umesh M. Mahantshetty ◽  
Venkatesh Rangarajan ◽  
Nilendu Purandare ◽  
Nikhil Merchant ◽  
...  

PurposeAnatomy and morphology–based imaging is routinely used for radiotherapy purpose to deliver precision treatment. There is an interest in using information from functional imaging for conformal radiation therapy planning. These functional imaging techniques need to be validated rigorously before their routine use. We attempted to evaluate and validate the use of 18-fluoro-deoxy-glucose positron emission tomography with computed tomography (18FDG PET-CT) on primary tumor of the cervical carcinoma, with an aim of arriving at a cutoff maximum standardized uptake value (SUVmax) at which the tumor volume correlates best with magnetic resonance imaging (MRI). This observational study was a part of an ethics committee–approved study evaluating pretreatment MRI and FDG PET-CT.Materials and MethodsPatients’ biopsy-proven cervical carcinomas (stages IIB and IIIB) were included in this study and underwent pretreatment MRI and FDG PET-CT as per institutional protocol. Volumes of the disease at the cervix on the MR image were calculated. Volumes at the FDG PET-CT scan at different percentages of SUVmax were auto contoured. Volume at MRI was correlated with each different percentage cutoff of the SUVmax.ResultsData of 74 patients were available for the study. The mean (SD) SUVmax of the primary tumor was 15.7 (7.0). The mean MRI volume correlates significantly (P < 0.001) with 30% and 35% of SUVmax values with good correlation according to the Pearson bivariate correlation (r = 0.79 each). The mean difference between MRI and PET volumes was least with 30% SUVmax.Conclusions18FDG PET-CT SUV-based primary tumor volume estimation at 30% to 35% of SUVmax values correlates significantly with the criterion standard MR volumes for primary cervical tumor with squamous histology in our population.


Author(s):  
K. S. M. van der Geest ◽  
G. Treglia ◽  
A. W. J. M. Glaudemans ◽  
E. Brouwer ◽  
F. Jamar ◽  
...  

Abstract Purpose Polymyalgia rheumatica (PMR) can be difficult to diagnose. Whole-body [18F]FDG-PET/CT allows for a comprehensive evaluation of all relevant articular and extra-articular structures affected by PMR. We aimed to summarize current evidence on the diagnostic value of [18F]FDG-PET/CT for a diagnosis of PMR. Methods PubMed/MEDLINE and the Cochrane Library database were searched from inception through May 31, 2020. Studies containing patients with PMR who underwent [18F]FDG-PET/CT were included. Screening and full-text review were performed by 3 investigators and data extraction by 2 investigators. Risk of bias was examined with the QUADAS-2 tool. Diagnostic test meta-analysis was performed with a bivariate model. Results Twenty studies were included in the systematic review, of which 9 studies (n = 636 patients) were eligible for meta-analysis. [18F]FDG positivity at the following sites was associated with a diagnosis of PMR: interspinous bursae (positive likelihood ratio (LR+) 4.00; 95% CI 1.84–8.71), hips (LR+ 2.91; 95% CI 2.09–4.05), ischial tuberosities (LR+ 2.86; 95% CI 1.91–4.28), shoulders (LR+ 2.57; 95% CI 1.24–5.32) and sternoclavicular joints (LR+ 2.31; 95% CI 1.33–4.02). Negative likelihood ratios (LR−) for these sites, as well as the greater trochanters, were all less than 0.50. Composite [18F]FDG-PET/CT scores, as reported in 3 studies, provided a pooled LR+ of 3.91 (95% CI 2.42–6.32) and LR− of 0.19 (95% CI 0.10–0.36). Moderate to high heterogeneity was observed across the studies, mainly due to differences in patient selection, scanning procedures and/or interpretation criteria. Conclusion Significant [18F]FDG uptake at a combination of anatomic sites is informative for a diagnosis of PMR. [18F]FDG-PET/CT might be an important diagnostic tool in patients with suspected PMR. This study also highlights the need for adherence to published procedural recommendations and standardized interpretation criteria for the use of [18F]FDG-PET/CT in PMR.


2021 ◽  
Vol 20 (5) ◽  
pp. 100-107
Author(s):  
A. V. Laryukov ◽  
R. Sh. Hasanov ◽  
Z. A. Afanasyeva ◽  
E. K. Laryukova

Background. The treatment outcomes for non-small cell lung cancer (NSCLC) depend on the tumor stage and treatment strategy. The imaging techniques play a significant role in the diagnosis, staging and choice of appropriate treatment for NSCLC.Purpose of the study: сomparison of the diagnostic capabilities of magnetic resonance imaging (MR) and positron emission computed tomography to select the optimal approaches to early detection of spinal and pelvic bone metastases.Material and Methods. The treatment outcomes were analyzed in 71 patients with NSCLC. Spinal and pelvic bone metastases were detected in 24 patients using magnetic resonance imaging (MRI) and positron emission computed tomography (PET/CT). Multiple bone lesions were the most common. A total of 69 metastatic lesions were identified. To compare the capabilities of diagnostic techniques, all patients underwent PET/CT with 18F-FDG, and MRI of the spine and pelvic bones using diffused-weighted images (DWI). Statistical data processing included the calculation of the sensitivity, specificity and diagnostic accuracy of the above techniques.Conclusion. The comparative analysis of the capabilities of modern high-tech diagnostic techniques (PET/CT with 18F-FDG and MRI of the spine and pelvic bones with DWI) in early detection of bone metastases in patients with NSCLC, PET/CT with 18F-FDG showed the greatest diagnostic value. However, taking into account the high sensitivity and specificity of MRI with DVI in detection of bone metastases and limited availability of PET/CT for patients, MRI with DVI is recommended to exclude bone metastases. 


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