Correlation between tumor glucose metabolism and multiparametric functional MRI (IVIM and R2*) metrics in cervical carcinoma: Evidence from integrated 18 F-FDG PET/MR.

BACKGROUND: Multiparameter, multimodality 18 F-FDG PET/MRI holds great potential for the diagnosis of cervical cancer based on the correlation between tumor glucose metabolism and imaging parameters. PURPOSE: To characterize the heterogeneity of tumor glucose metabolism by evaluating the correlation between 18 F-FDG uptake parameters and multiparametric functional MRI metrics in cervical carcinoma. STUDY TYPE: Retrospective. POPULATION: Fifty-four patients with cervical carcinoma. FIELD STRENGTH/SEQUENCE: Hybrid PET/MR (3T), multi-b DWI, and R2* mapping. ASSESSMENT: The maximum and mean standardized uptake values (SUVmax and SUVmean , respectively) from PET and functional MRI metrics (D, D*, f, and R2*) were obtained. Cervical carcinoma tissues also underwent HIF-1α, VEGF, and GLUT-1 immunohistochemical staining. STATISTICAL TESTS: Single-factor Spearman rank and Pearson correlation analysis and multiple linear regression (MLR) analysis were applied. RESULTS: R2*, D, and f have different degrees of correlation (moderate, weak, moderately strong correlation, respectively) with SUVmax and SUVmean (r = 0.530 and 0.527, and P < 0.001 for R2*; r = -0.292 and -0.291, and P < 0.05 for D; r = 0.539 and 0.520, and P < 0.001 for f, respectively). Immunohistochemical staining showed that HIF-1α expression has a moderate degree of correlation with R2* (r = 0.491; P < 0.001); GLUT-1 expression was significantly correlated with SUVmax and SUVmean (r = 0.633 and 0.622; P < 0.001), and VEGF expression had a moderately strong correlation with f (r = 0.457; P = 0.001). If SUVmax is the dependent variable, MLR yields an R-squared value after adjustment (adjusted R-squared) = 0.358, and F = 10.833 (P < 0.001), and the fitting linear equation is Y (SUVmax ) = 9.184 + 0.161X1 (R2*)+50.343X2 (f)-4.780 (D). Otherwise, MLR yields the adjusted R-squared = 0.342, and F = 10.187 (P < 0.001), and the linear regression equation is Y (SUVmean ) = 5.925 + 0.102X1 (R2*)+28.029X2 (f)-2.907X3 (D). DATA CONCLUSION: The functional MRI sequence parameters R2*, f, and D can provide information on the hypoxic condition, blood perfusion, and molecular diffusion of the tumor. 18 F-FDG PET/MR multi-imaging technique can be adopted to evaluate the heterogeneity of glucose metabolism in cervical carcinoma. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;49:1704-1712.

Early PET/CT after radiofrequency ablation in colorectal cancer liver metastases: is it useful? / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Morphologic imaging after radiofrequency ablation (RFA) of liver metastases is hampered by an inflammatory response in the ablation margin, making the identification of local tumor progression (LTP) difficult. The aim of this study was to evaluate the efficacy of early (18)F-FDG PET/CT scanning to monitor the effectiveness of RFA in colorectal liver metastases.</p><p><b>METHODS</b>Twelve patients with 20 metastases were treated with RFA for colorectal liver metastases. They underwent PET/CT within 2 weeks before RFA and within 24 hours after RFA (so termed "early PET/CT"). PET/CT was repeated at 1, 3, and 6 months, and then every 6 months after ablation. The standard of reference was based on available clinical and radiological follow-up data.</p><p><b>RESULTS</b>Early PET/CT revealed total photopenia in 16 RFA-treated metastases, which were found to be without residual tumor on the final PET/CT scan. Three RFA-treated metastases with focal uptake were identified as local tumor progression, which necessitated further treatment. One RFA-treated metastasis with rim-shaped uptake was regarded as inflammation. The results of the early PET/CT scanning were consistent with the findings of the final follow-up.</p><p><b>CONCLUSIONS</b>PET/CT performed within 24 hours after RFA can effectively detect whether residual tumor exists for colorectal cancer liver metastases. The results can guide further treatment, and may improve the efficacy of RFA.</p>

Analysis of the placement of multiple metallic stents in the treatment of hilar cholangiocarcinoma / 中华放射学杂志

Objective To evaluate the clinical efficacy of multiple stents placement in the management of hilar cholangiocarcinoma,especially in the complex cases of which the hepatic ducts are invaded.Methods Forty-five consecutive patients with hilar cholangiocarcinoma were treated with percutaneous transhepatic placement of two or three self-expandable metallic endoprostheses.The cause of hilar obstructions in these patients were all cholangiocarcinoma,including Bismuth classification type Ⅱ(n 12 ),Ⅲa(n 17),Ⅲb(n 10),and Ⅳ(n 6).Two or 3 stents were placed in the configuration of T,Y or X over the strictures.Results Stent placement with 2 or 3 endoprostheses was successful in all patients.All patients showed significant decrease in serum bilirubin level.The mortality rate within 30 days of stent placement was 2.2%(1/45).The mean survival and stent patency times were 215.3 d(26— 516 d)and 181.5 d(26—473 d),respectively.Conclusion Deploying of multiple metallic stents is an effective method to treat complex hilar cholangiocarcinoma,especially for the cases of which hepatic ducts are invaded:the henatic ducts should be drained as much as nossible.