A systematic review of PET and PET/CT in oncology: A way to personalize cancer treatment in a cost-effective manner?

Langer, A.

doi:10.1186/1472-6963-10-283

Cited by 82 publications

(47 citation statements)

References 86 publications

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“…CT and MRI have great significance in localization diagnosis and qualitative diagnosis of gliomas (18). CT is extremely accurate and reliable in the localization of diagnosis of gliomas with a certain reference value for qualitative diagnosis.…”

Section: A B a Bmentioning

confidence: 99%

Expression of VEGF and MMP-9 and MRI imaging changes in cerebral glioma

et al. 2011

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Abstract. The purpose of the present study was to investigate the association of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) expression with the histopathological grading of tumors in cerebral glioma. A total of 45 patients with pathologically confirmed cerebral glioma were divided into two groups: a low-grade group (grades I and II, 21 cases) and a high-grade group (grades III and IV, 24 cases). Immunohistochemical staining of tumor samples showed the percentages of tumors expressing VEGF and MMP-9 in the high-grade group to be 95.83 and 75%, respectively, significantly higher than those of the low-grade group (66.67 and 23.81%, P<0.05 and P<0.01, respectively). The magnetic resonance imaging (MRI) results indicated that the peripheral edema index (EI), enhancement percentage (EP), and the maximum diameter of the tumor in the high-grade group were significantly higher than those in the low-grade group (P<0.05, P<0.01, and P<0.05). Moreover, the expression of VEGF and MMP-9 was positively correlated with EI, EP and the maximum diameter of the tumor (P<0.05). Therefore, VEGF and MMP-9 expression were correlated to the invasion of glioma. The association of their expression levels with EI, EP and the maximum tumor diameter indicates that these markers may be used to estimate tumor malignancy for future clinical diagnosis and treatment. IntroductionNeuroglioma, or glioma, is the most common primary tumor of the central nervous system, accounting for approximately 40-50% of all intracranial tumors (1). These tumors are characterized by a high invasive potential and a wide diversity of histological appearance. As with other tumors, one of the crucial steps in invasion is angiogenesis of the peritumoral tissues (2,3). Two primary factors that mediate tumor angiogenesis, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9), have been researched in various tumor types (1-3). These studies show that VEGF and MMP-9 expression varies in the majority of tumor cells and is directly associated with tumor invasion.Recent advances in imaging techniques have increased the use of non-invasive examination in the diagnosis and treatment of glioma. Magnetic resonance imaging (MRI) is one such valuable imaging technique, which has the advantages of non-traumatic, non-ionizing radiation and multiple planar imaging. In combination with other approaches, MRI is capable of visualizing various intracranial lesions (both structural and functional) and detecting the correlation between the major white matter fiber bundle and glioma lesions. Additionally, the complexity of these tumors has generated interest in identifying biomarkers that are capable of aiding in the diagnosis and treatment of gliomas (4). The current study used MRI to determine the correlation of expression of VEGF and MMP-9 with MRI characteristics and clinical pathological grades of cerebral gliomas to aid in clinical treatment and prognosis assessment. Materials and methodsStudy subjects. The study involved...

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Section: A B a Bmentioning

confidence: 99%

Expression of VEGF and MMP-9 and MRI imaging changes in cerebral glioma

et al. 2011

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“…1,2 The usefulness of this kind of images for the differential diagnosis of undefined lesions, initial tumor staging, detection of relapse, and therapeutic response monitoring has been extensively reported. 3 Depending on the clinical needs, several radiopharmaceuticals are currently employed for functional imaging with PET; nevertheless, the most common radiotracer in use today is certainly 18 F-fluorodeoxyglucose (FDG), which is a radiolabeled sugar able to detect sites of abnormal glucose metabolism and can localize many types of tumors.…”

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Use of Dual-Point Fluorodeoxyglucose Imaging to Enhance Sensitivity and Specificity

Schillaci

2012

Seminars in Nuclear Medicine

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Positron emission tomography (PET) and positron emission tomography/computed tomography imaging with fluorodeoxyglucose (FDG) are widely used as a powerful evaluation modality in oncological nuclear medicine not only for detecting tumors but also for staging and for therapy monitoring. Nevertheless, there are numerous causes of FDG uptake in benign processes seen on PET images. In fact, the degree of FDG uptake is related to the cellular metabolic rate and the number of glucose transporters. FDG accumulation in tumors is due, in part, to an increased number of glucose transporters in malignant cells. However, FDG is not specific for neoplasms: a similar situation exists in inflammation; activated inflammatory cells demonstrate increased expression of glucose transporters. Therefore, there is growing interest in improving the specificity of FDG-PET in patients with cancer. Preliminary studies showed that in several neoplasms, the uptake of FDG continues to increase for hours after radiopharmaceutical injection, and this difference in the time course of FDG uptake could be useful to improve the accuracy of PET to distinguish benign lesions from malignant ones. Also in experimental cultures, dual-point acquisition (early at 40-60 minutes postinjection and delayed at 90-270 minutes) demonstrated that it is able to differentiate inflammatory from neoplastic tissue. In general, inflammatory tissue is expected to reduce FDG uptake as the time goes by, whereas the uptake in the neoplastic lesions is supposed to be increasing. There is evidence in the recent literature of the clinical usefulness of dual-time-point FDG-PET imaging in a wide variety of malignancies, including those of head and neck, lung, breast, gallbladder, cervix, liver, and in brain tumors. A lesion is likely to be malignant if the standard uptake value increases over time, whereas it is likely to be benign if the standard uptake value is stable or decreases. It is worth noting that in many of these studies, dual-time-point PET improved not only the specificity but also the sensitivity in assessing breast, pulmonary, liver, and other tumors because of increased lesion-to-background ratio, as a consequence of FDG washout from the surrounding normal tissues and increasing neoplastic uptake. Semin Nucl Med 42:267-280

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“…PET is cost-effective in staging of non-small cell lung carcinoma (NSCLC) and seems to be cost-effective for diagnosing solitary pulmonary nodules (SPN) [4] . Then, PET cost is appropriate in staging of lung cancer and diagnosis of indeterminate SPNs [5] .…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of Fluorine-18-Fluorodeoxyglucose positron emission tomography in tumours other than lung cancer: A systematic review

Annunziata

Caldarella

Treglia

2014

WJR

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AIM:To systematically review published data on the cost-effectiveness of Fluorine-18-Fluorodeoxyglucose positron emission tomography (FDG-PET) or PET/computed tomography (PET/CT) in tumours other than lung cancer. METHODS:A comprehensive literature search of studies published in PubMed/MEDLINE, Scopus and Embase databases through the 10 th of October in 2013 was carried out. A search algorithm based on a combination of the terms: (1) "PET" or " PET/computed tomography (PET/CT)" or "positron emission tomography"; and (2) "cost-effectiveness" or "cost-utility" or "cost-efficacy" or "technology assessment" or "health technology assessment" was used. Only cost-effectiveness or cost-utility analyses in English language were included. Exclusion criteria were: (1) articles not within the field of interest of this review; (2) review articles, editorials or letters, conference proceedings; and (3) outcome evaluation studies, cost studies or health technology assessment reports. For each included study, information was collected concerning basic study, type of tumours evaluated, perspective/type of study, results, unit and comparison alternatives. RESULTS:Sixteen studies were included. Head and neck tumours were evaluated in 4 articles, lymphoma in 4, colon-rectum tumours in 3 and breast tumours in 2. Only one article was retrieved for melanoma, oesophagus and ovary tumours. Cost-effectiveness results of FDG-PET or PET/CT ranged from dominated to dominant. CONCLUSION:Literature evidence about the costeffectiveness of FDG-PET or PET/CT in tumours other than lung cancer is still limited. Nevertheless, FDG-PET or PET/CT seems to be cost-effective in selective indications in oncology (staging and restaging of head and neck tumours, staging and treatment evaluation in lymphoma).

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A systematic review of PET and PET/CT in oncology: A way to personalize cancer treatment in a cost-effective manner?

Cited by 82 publications

References 86 publications

Expression of VEGF and MMP-9 and MRI imaging changes in cerebral glioma

Expression of VEGF and MMP-9 and MRI imaging changes in cerebral glioma

Use of Dual-Point Fluorodeoxyglucose Imaging to Enhance Sensitivity and Specificity

Cost-effectiveness of Fluorine-18-Fluorodeoxyglucose positron emission tomography in tumours other than lung cancer: A systematic review

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