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OBJECTIVE: This study aimed to determine the prognostic role of baseline maximum standardized uptake value (SUVmax) obtained by pretreatment PET/CT and the change in SUVmax (ΔSUVmax [%]) in patients with axillary lymph node-positive breast cancer receiving neoadjuvant chemotherapy (NAC). METHODS: One hundred and eighty patients with baseline SUVmax and 121 patients with SUVmax measurement after treatment were evaluated in the study. The baseline SUVmax value of the breast (SUVmaxBI) and axilla (SUVmaxAI) and the change in the SUVmax of the breast (ΔSUVmaxB) and axilla (ΔSUVmaxA) were measured. The optimal cut-off value of SUVmax and ΔSUVmax were determined by ROC curve analysis. Disease-free survival (DFS) and overall survival (OS) were calculated using Kaplan-Meier curves. RESULTS: ΔSUVmaxB, pCRB, pCRA, and pCR parameters were found to be associated with relapse (p < 0.001, p = 0.033, p = 0.016, and p = 0.013, respectively). ΔSUVmaxB and SUVmaxAI were associated with mortality (p = 0.001 and p = 0.006, respectively). Multiple Cox regression analyses revealed that ΔSUVmaxB value was an independent prognostic factor for relapse and mortality (p = 0.013 and p = 0.010, respectively). CONCLUSION: The results showed that ΔSUVmaxB was an independent prognostic factor for relapse and mortality in patients with axillary lymph node-positive breast cancer who received NAC.
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OBJECTIVE: One-third of patients newly diagnosed with a kidney tumor have metachoronous disease, 25-50% have synchronous metastasis, and approximately 30-40% of patients have metastasis at the time of diagnosis. Metastasis mostly occurs in the lungs, regional lymph nodes, bones, and liver. The present study was aimed to determine the effect on mortality the values of standard uptake value (SUV)max measured with positron emission tomography (PET) in metastases of kidney tumors. MATERIAL AND METHODS: A retrospective review was conducted of the files of 77 patients newly diagnosed with kidney tumor and disease staging determined with PET in the Nuclear medicine Department of Saglik Bilimleri University Diyarbakir Gazi Yasargil Training and Research Hospital between August 2007 and April 2012. The gender, age, histological types, metastases, SUVmax values, and dates of death of the patients were recorded in the SPSS software. RESULTS: It was observed that higher SUVmax values indicated a shorter survival time (r = .303) (P = 0.022). Patients with metastasis lived for a shorter period (P < 0.001), particularly those with liver metastasis (r = .515) (P = 0.049). Metastases were most frequently seen in lymph nodes (42.1%); the SUVmax values of lung metastases were higher (P = 0.025) and papillary carcinomas showed higher SUVmax uptake (P = 0.015). CONCLUSIONS: In the present study, it was concluded that the higher the SUVmax value the shorter the survival time. The survival time of patients with metastasis was shorter, and this could be estimated through the measured SUVmax values.
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Carcinoma de Células Renais/diagnóstico , Fluordesoxiglucose F18/administração & dosagem , Neoplasias Renais/diagnóstico , Linfonodos/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Carcinoma de Células Renais/mortalidade , Carcinoma de Células Renais/cirurgia , Feminino , Humanos , Estimativa de Kaplan-Meier , Neoplasias Renais/mortalidade , Neoplasias Renais/cirurgia , Neoplasias Pulmonares/diagnóstico , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Período Pós-Operatório , Valor Preditivo dos Testes , Cuidados Pré-Operatórios/métodos , Prognóstico , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Sensibilidade e Especificidade , Carga TumoralRESUMO
PURPOSE: Solitary pulmonary nodules (SPNs) are round or oval lesions with a clear border with the surrounding parenchymal tissue and a radiologic diameter smaller than 3 cm which are not associated with atelectasis, pneumonia, lymphadenopathy, or chest wall pathologies. The purpose of the present study was to evaluate the efficacy of positron emission tomography (PET) / computerized tomography (CT) in differentiating benign from malignant SPNs. METHODS: In this retrospective study, 209 patients, who were diagnosed with SPN by thoracic CT and demonstrated positive or negative results for malignancy in the PET/ CT examination between January 2007 and June 2010, were enrolled. Among the 91 patients who gave consent for interventional procedures, performed were bronchoscopic endobronchial biopsy in 10, transbronchial biopsy in 15, bronchoscopic brushing in 4, transthoracic needle biopsy in 11, video-assisted thoracoscopy (VATS) in 4, lobectomy in 22, pneumonectomy in 2, and wedge resection in 23. The materials were histopathologically examined. RESULTS: 129 (61.72%) of the SPN cases were benign and 80 (38.27%) malignant. The mean SUVmax value for the benign SPNs was 2.06 ± 3.29 and 7.39±5.69 for the malignant SPNs (p=0.000). Positive correlation was found between the nodule diameter and risk for malignancy. A SUVmax value of 4 was found to have the best sensitivity and specificity. CONCLUSION: PET/CT was shown to be an accurate method in the differential diagnosis of benign from malignant solitary pulmonary nodules.
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Neoplasias Pulmonares/diagnóstico , Tomografia por Emissão de Pósitrons , Nódulo Pulmonar Solitário/diagnóstico , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Distribuição de Qui-Quadrado , Diagnóstico Diferencial , Reações Falso-Positivas , Feminino , Fluordesoxiglucose F18 , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Valor Preditivo dos Testes , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/patologia , Nódulo Pulmonar Solitário/cirurgia , Adulto JovemRESUMO
BACKGROUND AND OBJECTIVES: Malignant pleural mesothelioma (MPM) is a fatal malignancy. Radiological imaging is necessary for the diagnosis, staging, and clinical management of patients with MPM. The 18 fluorodeoxyglucose positron emission tomography (18 FDG-PET) scan has proven useful in preoperative staging and as a prognostic tool in MPM. We aimed to investigate the relationship between the pre-treatment 18 FDG PET/CT results, together with other known clinical parameters, and the survival of patients with MPM in our region. PATIENTS AND METHODS: A retrospective analysis was performed on the data of 177 patients with MPM between April 2007 and April 2011. Pre-treatment 18 FDG PET/CT scans were done on all patients. Survival time was calculated by the Kaplan-Meier method. RESULTS: The mean age was 55.40 years. There were 56% male patients and 44% female patients. The mean survival time was 11 months from time of diagnosis. According to multivariate analysis results, being of male gender increased the poor prognosis 5.30 times, a Karnofsky performance score (KPS) < 60 increased a poor prognosis 2.18 times, being on "best supportive care" increased a poor prognosis 25.40 times, the stage III-IV increased a poor prognosis 11.13 times, and a level of maximum standardized uptake value (SUVmax) > 5 increased a poor prognosis 4.34 times. CONCLUSIONS: MPM remains a fatal prognosis. Significant predictors of survival include KPS, stage of disease, gender, treatment regimen and level of SUVmax. An understanding of the importance of these markers for MPM prognosis should allow targeted treatments to be developed.
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Fluordesoxiglucose F18 , Mesotelioma/diagnóstico por imagem , Neoplasias Pleurais/diagnóstico por imagem , Compostos Radiofarmacêuticos , Idoso , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Mesotelioma/mortalidade , Pessoa de Meia-Idade , Análise Multivariada , Neoplasias Pleurais/mortalidade , Tomografia por Emissão de Pósitrons , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores Socioeconômicos , SobrevidaRESUMO
PURPOSE: The purpose of this retrospective single-center study was to evaluate the prognostic implication on overall survival (OS) of the F-18 FDG PET scan in locally advanced or metastatic non small cell lung cancer (NSCLC) patients. METHODS: We retrospectively reviewed 120 locally advanced or metastatic NSCLC patients (December 2004-November 2011) treated/followed at the Dicle University, School of Medicine, Department of Medical Oncology. SUVmax and other potential prognostic variables (n=18) were chosen for analysis. Univariate and multivariate analyses were conducted to identify prognostic factors for OS. RESULTS: Among 18 variables of univariate analysis, 6 were identified to bear prognostic significance: sex (p=0.01), performance status (PS) (p =0.03), stage (p=0.04), bone metastases (p=0.002), serum albumin (p=0.01) and blood glucose level (p=0.03). Multivariate analysis showed that PS, bone metastases and serum albumin level were independent prognostic factors for OS (p=0.01, p=0.004, p=0.003, respectively). CONCLUSION: PS, serum albumin levels and bone metastases were independent prognostic factors, while FDG uptake of the primary lesion was not associated with prognosis of OS in locally advanced or metastatic NSCLC patients.