CT radiomics analysis of primary colon cancer patients with or without liver metastases: a correlative study with [18F]FDG PET uptake values.

PURPOSE: Utilizing [18F]Fluoro-2-deoxy-D-glucose Positron Emission Tomography/Computed Tomography ([18F]FDG PET/CT) scans on primary colon cancer (CC) patients including with liver metastases (LM), we aimed to determine the relationship between structural CT radiomic features and metabolic PET standard uptake value (SUV) in these patients. MATERIAL AND METHOD: A retrospective analysis was performed on 60 patients with primary CC, of which 40 had liver metastases that were more than 2 cm in diameter. [18F]FDG PET/CT was used to calculate SUVmax, and 42 CT radiomic characteristics were extracted from non-enhanced CT images. Tumors were manually segmented on fused PET/CT scans by two experienced nuclear medicine physicians. Sixty primary CC and forty LM lesions were segmented accordingly. In the cases of multiple LM lesions, the lesion with the largest diameter was chosen for segmentation. In a univariate analysis approach, we used Spearman correlation with multiple testing correction (Benjamini-Hutchberg false discovery rate (FDR), α = 0.05) to ascertain the relationship between SUVmax and CT radiomic features. RESULT: Twenty-two (52.3%) and twenty-six (61.9%) CT radiomic features were found to be significantly correlated with SUVmax values of primary CC (n = 60) and LM (n = 40) lesions, respectively (FDR-corrected p value < 0.05 and 0.6 < |ρ| < 1). GLCM_homogeneity (ρ = 0.839), GLCM_dissimilarity (ρ = - 0.832), GLZLM_ZLNU (ρ = 0.827), and GLCM_contrast (ρ = - 0.815) were the 4 features most correlated with SUVmax in CC. On the other hand, in LM, the 4 features most correlated with SUVmax were GLRLM_LRHGE (ρ = 0.859), GLRLM_LRE (ρ = 0.859), GLRLM_LRLGE (ρ = 0.857), and GLRLM_RP (ρ = - 0.820). CONCLUSION: We investigated the relationship between SUVmax of preoperative primary CC lesions and their LM with CT radiomic features. We found some CT radiomic features having relationships with the metabolic characteristics of lesions. This work suggests that non-invasive predictive imaging biomarkers for precision medicine can be derived from CT radiomic.

A rare case of pulmonary benign metastasising leiomyomatosis in a woman with a previous history of hysterectomy for uterine fibroids.

Benign metastasising leiomyomatosis (BML) is a rare disease, predominantly seen in premenopausal women. It poses a diagnostic dilemma and can be misdiagnosed as malignancy. Here we present a case of 41-year-old woman with a previous history of hysterectomy 10 years ago for multiple fibroids. She presented with shortness of breath and chest discomfort. Chest X-ray showed pulmonary infiltrates. She was diagnosed with sarcoidosis and treated with steroids without any improvement. Further investigations including CT scan and bronchoscopy and lavage failed to confirm a diagnosis. Subsequently she underwent video-assisted thoracoscopic surgery and histopathology revealed leiomyomatosis (so-called leiomyomatous hamartomas/benign metastasising leiomyomatosis). Oestrogen and progesterone receptors showed diffuse and strong nuclear staining. The patient was commenced on tamoxifen and a repeat chest X-ray in 8 weeks showed significant improvement. In women of reproductive age with previous hysterectomy and multiple lung nodules on imaging, the diagnosis of BML should be taken into consideration.

Amelioration of Tumor Targeting and In Vivo Biodistribution of 99mTc-Methotrexate-Gold Nanoparticles (99mTc-Mex-AuNPs).

Gold nanoparticles (AuNPs) represent very attractive and promising drug delivery carriers due to their unique dimensions, adjustable surface functions, and controllable drug release. Therefore, AuNPs are used to overcome the limitations of conventional chemotherapy, for example methotrexate (Mex), one of the first-generation chemotherapy drugs for cancer treatment, whose usefulness has been restricted due to drug resistance and dose-dependent side effects. In the present study, the AuNPs drug delivery system was synthesized and loaded with technetium-99 m radiolabeled Methotrexate (99mTc-Mex) to produce new potential nanoradiopharmaceutical for tumor targeting and further imaging. The Methotrexate loaded gold nanoparticles (Mex-AuNPs) successfully prepared in small spherical particle size (20.3 nm), polydispersity index PDI (< 0.5) and a zeta potential (-17.6 mV) with loading efficiency% (93 ± 1.2%) of methotrexate at 30 min as an optimum stirring time and showed strong absorption peak for Mex-AuNPs at λmax, 525 nm. The in vitro release profile of Mex-AuNPs showed high release percent of methotrexate at pH 5; the Q0.5 h and Q8h were 21.2 ± 1.5% and 92.9 ± 3.4%, respectively. The in vitro cytotoxicity was investigated at different concentrations (0.024-50 µl/100 µl) of Mex-AuNPs (1 mg/ml) against MCF-7 (Michigan Cancer Foundation-7) breast cancer cells by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay technique. Mex-AuNPs showed higher anticancer activity with low inhibitory concentration (IC50 = 0.098 µl/100 µl) that was three times lower than the inhibitory concentration (IC50) of methotrexate (IC50 = 0.3 µl/100 µl). 99mTc-Mex complex prepared by direct reduction method at maximum radiochemical yield (RCY)% Ì´ 98.3 ± 1.09 % was loaded in AuNPs to form 99mTc-Mex-AuNPs with loading efficiency% (93 ± 1.2 %) at 30 min of stirring time. 99mTc-Mex-AuNPs showed convenient in vitro stability in mice serum up to 24 h with RCY% > 90 %. The preclinical biodistribution studies of 99mTc-Mex-AuNPs were performed in 3 experimental groups A (intravenous (I.V.) injected normal mice), B and C (I.V. and intratumor (I.T.) injected tumor bearing mice, respectively). The 99mTc-Mex-AuNPs achieved highest tumor uptake (93 ± 0.39 %ID/g) and highest Target/NonTarget (T/NT) ratio (58.1 ± 0.91) with high Tumor/Blood (T/B) ratio (25.8 ± 0.11) at 10 min post I.T. injection and retained high tumor uptake (79 ± 0.65 %ID/g) up to 60 min post I.T. injection before escaping into blood stream. Consequently, 99mTc-Mex-AuNPs can be considered as new potential nanoradiopharmaceutical in tumor diagnosis.