Relationship of FDG PET/CT imaging features with tumor immune microenvironment and prognosis in colorectal cancer: a retrospective study.

BACKGROUND: Imaging features of colorectal cancers on 2-deoxy-2-[18F]fluoro-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT) have been considered to be affected by tumor characteristics and tumor immune microenvironment. However, the relationship between PET/CT imaging features and immune reactions in tumor tissue has not yet been fully evaluated. This study investigated the association of FDG PET/CT imaging features in the tumor, bone marrow, and spleen with immunohistochemical results of cancer tissue and recurrence-free survival (RFS) in patients with colorectal cancer. METHODS: A total of 119 patients with colorectal cancer who underwent FDG PET/CT for staging work-up and received curative surgical resection were retrospectively enrolled. From PET/CT images, 10 first-order imaging features of primary tumors, including intensity of FDG uptake, volumetric metabolic parameters, and metabolic heterogeneity parameters, as well as FDG uptake in the bone marrow and spleen were measured. The degrees of CD4+, CD8+, and CD163 + cell infiltration and interleukin-6 (IL-6) and matrix metalloproteinase-11 (MMP-11) expression were graded through immunohistochemical analysis of surgical specimens. The relationship between FDG PET/CT imaging features and immunohistochemical results was assessed, and prognostic significance of PET/CT imaging features in predicting RFS was evaluated. RESULTS: Correlation analysis with immunohistochemistry findings showed that the degrees of CD4 + and CD163 + cell infiltration and IL-6 and MMP-11 expression were correlated with cancer imaging features on PET/CT. Patients with enhanced inflammatory response in cancer tissue demonstrated increased FDG uptake, volumetric metabolic parameters, and metabolic heterogeneity. FDG uptake in the bone marrow and spleen was positively correlated with the degree of CD163 + cell infiltration and IL-6 expression, respectively. In multivariate survival analysis, the coefficient of variation of FDG uptake in the tumor (p = 0.019; hazard ratio, 0.484 for 0.10 increase) and spleen-to-liver uptake ratio (p = 0.020; hazard ratio, 24.901 for 1.0 increase) were significant independent predictors of RFS. CONCLUSIONS: The metabolic heterogeneity of tumors and FDG uptake in the spleen were correlated with tumor immune microenvironment and showed prognostic significance in predicting RFS in patients with colorectal cancer.

Prognostic Impact of Visceral Adipose Tissue Imaging Parameters in Patients with Cholangiocarcinoma after Surgical Resection.

Visceral adiposity is known to be related to poor prognosis in patients with cholangiocarcinoma; however, the prognostic significance of the qualitative features of adipose tissue in cholangiocarcinoma has yet to be well defined. This study investigated the prognostic impact of adipose tissue imaging parameters reflecting the quantity and qualitative characteristics of subcutaneous (SAT) and visceral (VAT) adipose tissue on recurrence-free survival (RFS) and overall survival (OS) in 94 patients undergoing resection of cholangiocarcinoma. The area, mean computed tomography (CT) attenuation, and mean 2-deoxy-2-[18F]fluoro-D-glucose (FDG) uptake of SAT and VAT on positron emission tomography (PET)/CT for staging work-up were measured, and the relationship of these adipose tissue imaging parameters with clinicopathological factors and survival was assessed. TNM stage, histologic grade, lymphovascular invasion, and the size of cholangiocarcinoma showed positive correlations with adipose tissue imaging parameters. Multivariate survival analysis demonstrated that the visceral-to-subcutaneous adipose tissue area ratio (VSR) (p = 0.024; hazard ratio, 1.718) and mean FDG uptake of VAT (p = 0.033; hazard ratio, 9.781) were significant predictors for RFS, but all of the adipose tissue imaging parameters failed to show statistical significance for predicting OS. In addition to visceral adiposity, FDG uptake of VAT might be a promising prognostic parameter for predicting RFS in patients with cholangiocarcinoma.

Prediction of metabolites associated with somatic mutations in cancers by using genome-scale metabolic models and mutation data.

BACKGROUND: Oncometabolites, often generated as a result of a gene mutation, show pro-oncogenic function when abnormally accumulated in cancer cells. Identification of such mutation-associated metabolites will facilitate developing treatment strategies for cancers, but is challenging due to the large number of metabolites in a cell and the presence of multiple genes associated with cancer development. RESULTS: Here we report the development of a computational workflow that predicts metabolite-gene-pathway sets. Metabolite-gene-pathway sets present metabolites and metabolic pathways significantly associated with specific somatic mutations in cancers. The computational workflow uses both cancer patient-specific genome-scale metabolic models (GEMs) and mutation data to generate metabolite-gene-pathway sets. A GEM is a computational model that predicts reaction fluxes at a genome scale and can be constructed in a cell-specific manner by using omics data. The computational workflow is first validated by comparing the resulting metabolite-gene pairs with multi-omics data (i.e., mutation data, RNA-seq data, and metabolome data) from acute myeloid leukemia and renal cell carcinoma samples collected in this study. The computational workflow is further validated by evaluating the metabolite-gene-pathway sets predicted for 18 cancer types, by using RNA-seq data publicly available, in comparison with the reported studies. Therapeutic potential of the resulting metabolite-gene-pathway sets is also discussed. CONCLUSIONS: Validation of the metabolite-gene-pathway set-predicting computational workflow indicates that a decent number of metabolites and metabolic pathways appear to be significantly associated with specific somatic mutations. The computational workflow and the resulting metabolite-gene-pathway sets will help identify novel oncometabolites and also suggest cancer treatment strategies.

Adipose Tissue Quantification Improves the Prognostic Value of GLIM Criteria in Advanced Gastric Cancer Patients.

The present study investigated whether the risk of recurrence after curative surgery could be further stratified by combining the Global Leadership Initiative on Malnutrition (GLIM) criteria and changes in subcutaneous (SAT) and visceral (VAT) adipose tissue mass after surgery in patients with advanced gastric cancer (AGC). This study retrospectively analyzed 302 patients with AGC who underwent curative surgery. Based on the GLIM criteria, patients were classified into malnourished and non-malnourished groups. The cross-sectional areas of SAT and VAT were measured from preoperative and 6-month post-operative computed tomography (CT) images. Multivariate survival analyses demonstrated that GLIM-defined malnutrition (p = 0.008) and loss of VAT after surgery (p = 0.008) were independent risk factors for recurrence-free survival (RFS). Evaluation of the prognostic value of combining the two independent predictors showed that malnourished patients with a marked loss of VAT had the worst 5-year RFS rate of 35.2% (p < 0.001). Preoperative GLIM-defined malnutrition and a loss of VAT during the first 6 months after surgery were independent predictors for RFS in patients with AGC. Changes in the VAT area after surgery could further enhance the prognostic value of the GLIM criteria for predicting the risk of gastric cancer recurrence.

Metastatic Infection Following Ear Piercing Detected by FDG PET/CT.

ABSTRACT: Ear piercing is currently a common practice. Although rare, ear piercing can cause systemic infections. We present a case of an 18-year-old woman who underwent FDG PET/CT for prolonged fever and bacteremia. FDG PET/CT showed multifocal FDG uptake at the site of piercing in the left ear, and in the spleen and left atrium and deep thigh vessel. The patient was diagnosed with an ear piercing infection with multiple metastatic infections.

Orthodontic treatment of an open bite after splint therapy for a patient with idiopathic condylar resorption.

In the treatment of orthodontic patients with idiopathic condylar resorption, symptoms of temporomandibular joint disorders and constantly changing occlusions caused by an instability of mandibular position make it difficult for orthodontists to confirm definitive orthodontic diagnosis and treatment plans. Therefore, these patients' temporomandibular joint (TMJ) structures need to be stabilized with splint therapy before active tooth movement to identify and maintain the true mandibular position. For some idiopathic condylar resorption patients, orthognathic surgery can cause further resorption on the vulnerable condyles of the mandible; thus, effective orthodontic camouflage treatment after joint stabilization should be considered. During the orthodontic camouflage treatment, adverse loads on the TMJ structures, which could change the position of condyles, should be avoided, and TMJ-friendly mechanics must be applied.

Systematic analysis of Mendelian disease-associated gene variants reveals new classes of cancer-predisposing genes.

BACKGROUND: Despite the acceleration of somatic driver gene discovery facilitated by recent large-scale tumor sequencing data, the contribution of inherited variants remains largely unexplored, primarily focusing on previously known cancer predisposition genes (CPGs) due to the low statistical power associated with detecting rare pathogenic variant-phenotype associations. METHODS: Here, we introduce a generalized log-regression model to measure the excess of pathogenic variants within genes in cancer patients compared to control samples. It aims to measure gene-level cancer risk enrichment by collapsing rare pathogenic variants after controlling the population differences across samples. RESULTS: In this study, we investigate whether pathogenic variants in Mendelian disease-associated genes (OMIM genes) are enriched in cancer patients compared to controls. Utilizing data from PCAWG and the 1,000 Genomes Project, we identify 103 OMIM genes demonstrating significant enrichment of pathogenic variants in cancer samples (FDR 20%). Through an integrative approach considering three distinct properties, we classify these CPG-like OMIM genes into four clusters, indicating potential diverse mechanisms underlying tumor progression. Further, we explore the function of PAH (a key metabolic enzyme associated with Phenylketonuria), the gene exhibiting the highest prevalence of pathogenic variants in a pan-cancer (1.8%) compared to controls (0.6%). CONCLUSIONS: Our findings suggest a possible cancer progression mechanism through metabolic profile alterations. Overall, our data indicates that pathogenic OMIM gene variants contribute to cancer progression and introduces new CPG classifications potentially underpinning diverse tumorigenesis mechanisms.

Simultaneous determination of the free and total forms of nonylphenol, nonylphenol monoethoxylate, and nonylphenol diethoxylate in human urine by gas chromatography-mass spectrometry.

Nonylphenol (NP), nonylphenol monoethoxylate (NP1EO), and nonylphenol diethoxylate (NP2EO) are widely used in various daily products and have been cataloged as endocrine-disrupting chemicals. Due to their high lipophilicity and low biodegradability, these compounds remain in the environment and enter the human body through the food chain. Growing concerns regarding the potential negative effects of NP, NP1EO, and NP2EO on human health have raised the need for biomonitoring to investigate human exposure to these compounds. In this study, a simultaneous analysis method using solid-phase extraction (SPE) combined with gas chromatography-mass spectrometry (GC-MS) was established by controlling the background contamination of NP, NP1EO, and NP2EO, which are ubiquitous in laboratory environments. The proposed method showed proper linearity of over 0.999 and a recovery greater than 85.8% for all analytes. Accuracy and precision were verified in ranges of 92.97-116.30% and 0.65-9.29%, respectively. The detection limits for NP, NP1EO, and NP2EO were 0.0363 µg L-1, 0.0401 µg L-1, and 0.0364 µg L-1, respectively, which were suitable for determining the trace analytes in human urine. Therefore, this simple and integrated analytical method was applied to measure the free and total forms of the target analytes in 25 human urine samples collected in Korea. Overall, free NP, NP1EO, and NP2EO were detected with average contents of 3.94 ± 4.14 µg L-1, 4.63 ± 2.62 µg L-1, and 0.293 ± 0.638 µg L-1, respectively, and with total NP, NP1EO, and NP2EO contents of 6.14 ± 8.24 µg L-1, 5.99 ± 2.91 µg L-1, and 0.806 ± 1.10 µg L-1, respectively. These data showed that these compounds are prevalent in human urine, and indicate the need for further studies.

Evaluating the Necessity of Adaptive RT and the Role of Deformable Image Registration in Lung Cancer with Different Pathologic Classifications.

BACKGROUND: This study aimed to analyze differential radiotherapy (RT) responses according to the pathological type of lung cancer to see the possibility of applying adaptive radiotherapy (ART). METHODS: ART planning with resampled-computed tomography was conducted for a total of 30 patients (20 non-small-cell lung cancer patients and 10 small-cell lung cancer patients) using a deformable image registration technique to reveal gross tumor volume (GTV) changes according to the duration of RT. RESULTS: The small-cell lung cancer group demonstrated an average GTV reduction of 20.95% after the first week of initial treatment (p = 0.001), whereas the adenocarcinoma and squamous cell carcinoma groups showed an average volume reduction of 20.47% (p = 0.015) and 12.68% in the second week. The application of ART according to the timing of GTV reduction has been shown to affect changes in radiation dose irradiated to normal tissues. This suggests that ART applications may have to be different depending on pathological differences in lung cancer. CONCLUSION: Through these results, the present study proposes the possibility of personalized treatment options for individual patients by individualizing ART based on specific radiation responses by pathologic types of lung cancer.

Emissions and meteorological impacts on PM2.5 species concentrations in Southern California using generalized additive modeling.

The chemical composition of PM2.5 has a significant impact on human health and air quality, and its accurate knowledge can be used to identify contributing emission sources. Assessing and quantifying the impacts of various factors (e.g., emissions, meteorology, and large-scale climate patterns) on the main PM2.5 chemical components can give guidance for implementing effective regulations to improve air quality in the future. In this study, we developed generalized additive models (GAMs) to assess how emissions, meteorological factors, and large-scale climate indices affected ammonium, sulfate, nitrate, elemental carbon, and organic carbon from 2002 to 2019 in the South Coast Air Basin (SoCAB). Concentration trends from three sites in the SoCAB are studied. The statistical results showed that GAMs can capture the variability of these species' daily concentrations (R2 = 0.6 to 0.7) and annual concentrations (R2 = 0.93 to 0.99). Precursor emissions most significantly affect PM2.5 species production, though meteorological factors like maximum temperature, relative humidity, wind speed, and boundary layer height, also influence PM2.5 composition. In the future, these meteorological factors will become more significant in affecting PM2.5 speciation, although emissions will continue to strongly affect formation. Results show that the composition of most PM2.5 species will decrease in the future except for OC, which will become the largest contributor to PM2.5.

Peritoneal and Nodal Gliomatosis Mimicking Metastasis on FDG PET/CT in a Patient With Ovarian Immature Teratoma.

ABSTRACT: Peritoneal and nodal gliomatosis is a rare disease condition characterized by implants of mature glial tissue on the peritoneum and lymph nodes. It is typically associated with teratoma and has no adverse effect on prognosis. We present a case of 22-year-old woman who underwent FDG PET/CT for the staging of ovarian immature teratoma. PET/CT revealed mildly increased FDG uptake in the peritoneal cavity and increased FDG uptake in the internal mammary and cardiophrenic angle lymph nodes, which were histopathologically diagnosed as peritoneal and nodal gliomatosis. This case suggests that PET/CT findings of peritoneal and nodal gliomatosis could mimic metastasis.

A contribution of metabolic engineering to addressing medical problems: Metabolic flux analysis.

Metabolic engineering has served as a systematic discipline for industrial biotechnology as it has offered systematic tools and methods for strain development and bioprocess optimization. Because these metabolic engineering tools and methods are concerned with the biological network of a cell with emphasis on metabolic network, they have also been applied to a range of medical problems where better understanding of metabolism has also been perceived to be important. Metabolic flux analysis (MFA) is a unique systematic approach initially developed in the metabolic engineering community, and has proved its usefulness and potential when addressing a range of medical problems. In this regard, this review discusses the contribution of MFA to addressing medical problems. For this, we i) provide overview of the milestones of MFA, ii) define two main branches of MFA, namely constraint-based reconstruction and analysis (COBRA) and isotope-based MFA (iMFA), and iii) present successful examples of their medical applications, including characterizing the metabolism of diseased cells and pathogens, and identifying effective drug targets. Finally, synergistic interactions between metabolic engineering and biomedical sciences are discussed with respect to MFA.

Relationship of FDG Uptake of the Reticuloendothelial System with Tumor Immune Microenvironment and Prognosis in Patients with Gastric Cancer.

2-deoxy-2-[18F]fluoro-D-glucose (FDG) uptake of the reticuloendothelial system, including the bone marrow (BM) and spleen, on positron emission tomography/computed tomography (PET/CT) has been shown to be a significant prognostic factor in diverse malignancies. However, the relationship between FDG uptake of the BM and spleen and histopathological findings, including the tumor immune microenvironment, has not been fully evaluated. This study aimed to investigate the relationship of FDG uptake in the BM and spleen with histopathological findings and recurrence-free survival (RFS) in patients with gastric cancer. Seventy patients with gastric cancer who underwent pre-operative FDG PET/CT and subsequent curative surgery were retrospectively enrolled. On image analysis, the BM-to-liver uptake ratio (BLR) and spleen-to-liver uptake ratio (SLR) were measured from PET/CT images, and on immunohistochemical analysis, the densities of immune cell infiltration in the tumor tissue were graded. The BLR and SLR showed significant positive correlations with the grades of CD163 cell and CD8 cell infiltration in the tumor tissue, respectively (p < 0.05). In multivariate survival analysis, both BLR and SLR were significant predictors of RFS (p < 0.05). FDG uptake in the BM and spleen might be potential imaging biomarkers for evaluating tumor immune microenvironment conditions and predicting RFS in patients with gastric cancer.

Emissions, meteorological and climate impacts on PM2.5 levels in Southern California using a generalized additive model: Historic trends and future estimates.

Annual fine particulate matter (PM2.5) mass concentrations in the South Coast Air Basin (SoCAB) of California decreased from around 30 µg/m3 to 11 µg/m3 between 2000 and 2013 but rose from 11 µg/m3 to 13 µg/m3 between 2014 and 2018, raising important questions about the effectiveness of ongoing emission control policies. A two-step generalized additive model (GAM)-least squares approach was developed to explore the effects of emissions, large-scale climate events and meteorological factors on daily PM2.5 mass concentrations from 2000 to 2019 to quantitatively link impacts of emissions and meteorological on PM2.5 and to assess factors leading to the increase. The GAM had an R2 = 0.99 and root mean square error (RMSE) = 0.7 µg/m3 for the annual average PM2.5 concentrations. The two-step method had an R2 = 0.93 and RMSE = 4.07 µg/m3 for the 98th percentile 24-hr average PM2.5 concentrations. Variations in both emissions and relative humidity were of high importance compared with other included factors. Interactions of NH3 emissions with NOx and SO2 emissions, which lead to ammonium nitrate and sulfate aerosol formation, were the most important factors. Meteorological effects on PM2.5 explained the majority of the daily PM2.5 fluctuations. Emission changes (increases in SO2 and PM2.5) led to increases in predicted PM2.5 between 2014 and 2018. Predicted future PM2.5, using projected emissions and meteorological data from model simulations of representative concentration pathway (RCP) scenarios, are around 12 µg/m3 (annual) and 30 µg/m3 (98th percentile daily), which are both close to the current National Ambient Air Quality Standards (NAAQS) for PM2.5. Meteorological impacts on the predicted PM2.5 in future years lead to variations of ±2 µg/m3 for the annual average and ±5 µg/m3 for the 98th percentile daily level. Future climate changes lead to a probable year-to-year variation that will let PM2.5 levels in some years exceed the standard.

Analysis of Endocrine Disrupting Nonylphenols in Foods by Gas Chromatography-Mass Spectrometry.

Nonylphenols (NPs) are classified as endocrine-disrupting chemicals (EDCs), which are known to cause disorders in the endocrine systems of organisms. Due to their high lipophilicity and low degradability, these harmful substances are known to accumulate and persist in the environment, and even enter into the food chain. Analytical methods of liquid-liquid extraction using solid-phase extraction for sample clean-up combined with gas chromatography/mass spectrometry were established to determine the presence of NPs in foods. This study aimed to develop and validate these methods using four food matrices representing high-fat and low-fat solid food, as well as high-fat and low-fat liquid food, groups. The single linear isomer 4-n-NP was used to validate the quantification of NPs, which exist in complex isomer mixtures. Our results showed good linearity, with correlation coefficients exceeding 0.998 for all four matrices. The limits of detection and quantification were 0.37-1.79 and 1.11-5.41 µg/kg, respectively. Recovery rates were 86.8-108.6% and 92.6-101.9% for intraday and interday assays, respectively, and the relative standard deviations (RSDs) were below 12% for both assays. The method was applied to analyze 1185 domestic food samples consumed by Koreans, with NPs detected at concentration ranges of 2.57-269.07 µg/kg. Results for each food type over wide concentration ranges indicated that these compounds are highly dependent on the area of cultivation, and are affected by the levels of those contaminants in different environments. The contents of NPs in foods from animal sources were generally higher than those from plant sources, in particular being higher in the intestines than in lean tissue. The present findings could form the basis for determining the level of dietary exposure to NPs and how each food source contributes to it in South Korea.

Predicting the Recurrence of Gastric Cancer Using the Textural Features of Perigastric Adipose Tissue on [18F]FDG PET/CT.

This study aimed to assess the relationship between the histopathological and textural features of perigastric adipose tissue (AT) on 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) and to evaluate the prognostic significance of perigastric AT textural features in predicting recurrence-free survival (RFS) in patients with gastric cancer. Sixty-nine patients with gastric cancer who underwent staging [18F]FDG PET/CT and subsequent curative surgery were retrospectively reviewed. Textural features of perigastric AT were extracted from PET images. On histopathological analysis, CD4, CD8, and CD163 cell infiltration and matrix metalloproteinase-11 and interleukin-6 (IL-6) expression in perigastric AT were graded. The degree of CD163 cell infiltration in perigastric AT was significantly correlated with the mean standardized uptake value (SUV), SUV histogram entropy, grey-level co-occurrence matrix (GLCM) energy, and GLCM entropy of perigastric AT. The degree of IL-6 expression in the perigastric AT was significantly correlated with the mean and median SUVs of perigastric AT. In multivariate survival analysis, GLCM entropy, GLCM dissimilarity, and GLCM homogeneity of perigastric AT were significant predictors of RFS. The textural features of perigastric AT on [18F]FDG PET/CT significantly correlated with inflammatory response in perigastric AT and were significant prognostic factors for predicting RFS in patients with gastric cancer.

Clinical Utility of Quantitative Parameters of Salivary Gland Scintigraphy for Diagnosing Burning Mouth Syndrome.

Burning mouth syndrome (BMS) is a chronic disorder characterized by a burning sensation in the oral cavity, often accompanied by xerostomia, with no relevant clinical or laboratory findings. This study aimed to investigate diagnostic values of quantitative parameters of salivary gland scintigraphy for BMS in patients with xerostomia. A total of 164 patients who underwent salivary gland scintigraphy for the workup of xerostomia were retrospectively reviewed. All patients were classified into patient groups with primary BMS, secondary BMS, and non-specific xerostomia. From salivary gland scintigraphy, 22 quantitative parameters were calculated and their diagnostic values were assessed based on the area under the receiver operating characteristic curve (AUC) values. Among salivary gland scintigraphy parameters, uptake speed in the left submandibular gland showed the highest AUC value (0.647) for detecting BMS and pre-stimulatory oral activity showed the highest AUC value (0.710) for detecting primary BMS. A salivary gland scintigraphy scoring system based on these two parameters further enhanced the diagnostic ability, demonstrating AUC values of 0.731 for BMS and 0.782 for primary BMS. These results suggest a potential diagnostic value of the quantitative parameters of salivary gland scintigraphy for detecting BMS in patients with xerostomia.

Prognostic significance of liver CT-attenuation and 18F-FDG uptake for predicting hepatic recurrence following curative resection of colorectal cancer.

OBJECTIVE: This study investigated the predictive values of computed tomography (CT)-attenuation and fluorine-18-fluorodeoxyglucose (18F-FDG) uptake in the liver for the hepatic recurrence of colorectal cancer. SUBJECT AND METHODS: This study retrospectively included 257 colorectal cancer patients who underwent staging 18F-FDG positron emission tomography (PET)/CT and were subsequently treated with curative surgical resection. Using non contrast-enhanced CT images in PET/CT, the liver-spleen ratio and liver-spleen difference of CT-attenuation and CT-attenuation of the liver were calculated. The maximum and mean 18F-FDG uptake in the liver was measured using the PET images. The relationship of these five liver parameters to recurrence-free survival (RFS), hepatic RFS, and extrahepatic RFS was assessed. RESULTS: In univariate survival analysis, the liver-spleen ratio, liver-spleen difference, and maximum 18F-FDG uptake of the liver were significant predictors of both RFS and hepatic RFS (P<0.05), whereas none of the five liver parameters were significantly associated with extrahepatic RFS (P>0.05). Patients with a low liver-spleen ratio and liver-spleen difference and a high maximum 18F-FDG uptake showed better hepatic RFS than those with a high liver-spleen ratio and liver-spleen difference and a low maximum 18F-FDG uptake. In multivariate analysis, the liver-spleen ratio, liver-spleen difference, and maximum 18F-FDG uptake of liver remained significant predictors for hepatic RFS after adjusting for age, sex, obesity, andstage (P<0.05). CONCLUSION: Computed tomography-attenuation and maximum 18F-FDG uptake in the liver on 18F-FDG PET/CT were significant predictive factors for hepatic RFS in patients with colorectal cancer after curative resection.

Quantitative Scintigraphy Imaging of Lingual Raynaud's Phenomenon Using 3-Dimensional-Ring Cadmium-Zinc-Telluride Single-Photon Emission Computed Tomography/Computed Tomography.

Perfusion scintigraphy with the acquisition of planar blood flow and pool images of bilateral hands has been used to aid diagnosis and to evaluate treatment response to Raynaud's phenomenon (decreased blood flow to hand or foot). However, because of the difficulty in imaging the tongue area with a conventional gamma camera, perfusion scintigraphy imaging of patients with lingual Raynaud's phenomenon has yet to be reported. Here, we report the case of a 59-year-old man with lingual Raynaud's phenomenon in which blood pool imaging of the tongue was performed using three-dimensional (3D)-ring cadmium-zinc-telluride (CZT) single-photon emission computed tomography/computed tomography (SPECT/CT). During follow-up, the patient's lingual symptoms had worsened, and follow-up blood pool SPECT/CT images also revealed decreased blood pool uptake of the tongue, showing a decreased blood pool of more than 25% on quantitative analysis. This case suggests that blood pool imaging of the tongue using 3D-ring CZT SPECT/CT has clinical significance in evaluating patients with lingual Raynaud's phenomenon.