Search

Purpose The aim of the current meta-analysis was to evaluate diagnostic accuracies of preoperative F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) for prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients. Methods The scientific database such as PubMed, Cochrane, and Embase database were searched for studies evaluating diagnostic accuracies of preoperative F-18 FDG PET or PET/CT for prediction of MVI in HCC patients up to November 30, 2020. Results Fourteen eligible studies (1276 patients) were enrolled. The pooled sensitivity for F-18 FDG PET or PET/CT was 0.67 (95% CI; 0.57–0.76) with heterogeneity and a pooled specificity of 0.80 (95% CI; 0.74–0.85) with heterogeneity. Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 3.3 (95% CI; 2.5–4.5) and negative likelihood ratio (LR−) of 0.41 (95% CI; 0.31–0.55). The pooled diagnostic odds ratio (DOR) was 8 (95% CI; 5–14). Summary receiver operating characteristic (ROC) curve indicates that the area under the curve was 0.81 (95% CI; 0.78–0.84). Conclusion The current meta-analysis showed a low sensitivity and moderate specificity of F-18 FDG PET or PET/CT for the prediction of MVI in HCC patients. F-18 FDG PET or PET/CT might not be useful for the preoperative prediction of MVI in HCC patients and should not be used to exclude MVI. Therefore, cautious application and interpretation should be paid to the F-18 FDG PET or PET/CT for the prediction of MVI in HCC patients preoperatively.

The diagnostic criteria proposed by the World Health Organization did not consider the discrepancy in diagnosis between lumbar spine (LS) and femoral neck (FN) and the clinical implications is unclear. Therefore, this retrospective study evaluated the probability of fracture risk in postmenopausal women with lumbar spine (LS)–femoral neck (FN) bone mineral density (BMD) discordance or not Patients included 1066 healthy postmenopausal women (median age 55.5 years) who visited our hospital for a health check-up between May 2013 and April 2017. Discordance was defined as a difference of one or two degrees between LS BMD and FN BMD. TBS was calculated from dual energy absorptiometry (DXA) images. Fracture risk was assessed using the Fracture Risk Assessment Tool (FRAX), including TBS-adjusted FRAX Seven hundred and two patients (65.9%) showed concordant LS and FN results, whereas 364 patients (34.1%) exhibited discordance. Normal BMD was found in 519 concordant patients (73.9%). Concordant patients showed significantly higher FRAX scores, including TBS-adjusted FRAX results, than discordant patients with low LS or FN. Furthermore, FRAX results in concordant osteopenia patients were similar to that of osteoporosis patients with osteopenia or a normal result at one site. FRAX and TBS-adjusted FRAX results in concordant osteopenia patients were comparable to that of discordant osteoporosis patients We concluded that patients with colncordant osteopenia in both the FN and LS should be managed in a similar way to patients with discordant osteoporosis.

The purpose of the current study was to compare the diagnostic accuracies of F-18 FDG PET/CT and MRI for prediction of pathologic responses to neoadjuvant treatment (NAT) in locally advanced rectal cancer (LARC) patients based on a systematic review and meta-analyses. The PubMed, Cochrane, and Embase databases were searched to identify studies that conducted direct comparisons of the diagnostic performance of F-18 FDG PET/CT and MRI for the prediction of pathologic response to NAT in patients with LARC from the earliest available date of indexing up to July 31, 2020. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR + and LR −), and we constructed summary receiver operating characteristic curves. In nine studies (427 patients), the pooled sensitivity of F-18 FDG PET/CT was 0.79 (95% CI 0.71–0.86) and the pooled specificity was 0.74 (95% CI 0.60–0.84). LR syntheses yielded an overall LR + of 3.1 (95% CI 1.9–5.0) and an LR − of 0.28 (95% CI 0.18–0.43). The pooled diagnostic odds ratio (DOR) was 11 (95% CI 5–26). The pooled sensitivity of MRI was 0.89 (95% CI 0.77–0.95) and the pooled specificity was 0.66 (95% CI 0.55–0.76). LR syntheses yielded an overall LR + of 2.6 (95% CI 1.9–3.6) and an LR − of 0.17 (95% CI 0.08–0.37). The pooled DOR was 15 (95% CI 6–42). In meta-regression analysis, no variable was identified as the source of the study heterogeneity. F-18 FDG PET/CT and MRI showed similar diagnostic performances for the prediction of pathologic responses to NAT in patients with LARC. However, each modality can be a complement to other rather than being used singly.

Objective This study aimed to compare diagnostic performances of 8 different imaging modalities for preoperative detection of axillary lymph node (LN) metastasis in patients with breast cancer by performing a network meta-analysis (NMA) using direct comparison studies with 2 or more imaging techniques. Materials and methods PubMed, Cochrane, and Embase were searched for the studies evaluating the performances of 8 different imaging modalities for preoperative axillary LN staging in patients with breast cancer. The NMA was performed in patient-based analyses. The consistency was evaluated by examining the agreement between direct and indirect treatment effects, and publication bias was assessed by funnel plot asymmetry tests. The surface under the cumulative ranking curve (SUCRA) values were obtained to calculate the probability of each imaging modality being the most effective diagnostic method. Results A total of 2197 patients from 22 direct comparison studies using 8 different imaging modalities for preoperative detection of axillary LN metastasis in patients with breast cancer were included. For preoperative detection of axillary LN metastasis of breast cancer, elastography showed the highest SUCRA values of sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and diagnostic odds ratio. In addition, fluorine-18 fluorodeoxyglucose positron emission tomography (PET) or PET/computed tomography, fluorine-18 fluorodeoxyglucose PET/magnetic resonance, and contrast-enhanced computed tomography showed high SUCRA values. Conclusion Elastography showed the highest SUCRA values. Seven imaging modalities showed the complementary diagnostic roles for preoperative detection of axillary LN metastasis in patients with breast cancer, except mammography.

The present study is to investigate whether extranodal (EN) metabolic tumor volume (MTV) would have a specific clinical meaning for survival in EN diffuse large B cell lymphoma (DLBCL) patients. Two hundred forty DLBCL patients with EN involvement received 18F-fluorodeoxygenase (FDG) positron emission tomography/computed tomography (PET/CT) were enrolled. Survival analysis revealed that low EN MTV (PFS [progression-free survival], HR = 0.278, 95% CI = 0.127-0.807, p = 0.001; OS [overall survival], HR = 0.320, 95% CI = 0.145-0.703, p = 0.003), low total MTV (PFS, HR = 0.194, 95% CI = 0.085-0.445, p < 0.001; OS, HR = 0.213, 95% CI = 0.092-0.491, p < 0.007), and high National Cancer Center Network-International Prognostic Index score (PFS, HR = 3.152, 95% CI = 1.732-5.734, p < 0.001; OS, HR = 2.457, 95% CI = 1.363-4.430, p = 0.003) were independently associated with survivals in the patients. Our data showed that EN MTV is a useful and novel prognostic parameter for predicting survival in DLBCL patients with EN involvement.

The purpose of this study was to compare the changes in DXA values including trabecular bone score (TBS) and bone mineral density (BMD) of lumbar spine (LS) and femur according to the hormone therapies including tamoxifen (TMXF) treatment with or without gonadotropin releasing hormone analog (GnRH analog) in women with breast cancer. We enrolled 119 women with breast cancer who had undergone breast-conserving surgery or mastectomy followed by TMXF treatment for postmenopausal women (TMXF group, n = 63, 52.9%) or by combination therapy of TMXF combined with GnRH analog for premenopausal women (TMXF + GnRH group, n = 56, 47.1%) from December 2013 to December 2017. The median follow-up period was 13 months (interquartile range [IQR], 12.0–14.75) for TMXF group and 13.5 months (IQR, 12.00–16.00) for TMXF + GnRH group, respectively. Patients did not receive bone-modifying therapy. The baseline dual-energy X-ray absorptiometry (DXA) scan before breast cancer surgery and follow-up DXA during hormone therapy. Comparing the first and follow-up DXA results, BMD in LS were significantly decreased in both TMXF (P P P = 0.0011, mean difference: − 0.01) and total femur (P P P = 0.095, mean difference: − 0.007). Regarding TBS, no significant change was found in the TMXF (P = 0.574, mean difference: − 0.004) group, whereas there was a significant decrease in TBS in the TMXF + GnRH (P

Objectives The purpose of the current investigation was to evaluate the diagnostic accuracy of amyloid and F-18 sodium fluoride (NaF) positron emission tomography/computed tomography (PET/CT) for the detection of cardiac amyloidosis (CA) using diagnostic accuracy test. Materials and methods The PubMed, Cochrane, and EMBASE database, from the earliest available date of indexing through February 29, 2020, were searched for results investigating the diagnostic accuracy of amyloid and F-18 NaF PET for the diagnosis of CA. We calculated the pooled sensitivities and specificities of included studies, calculated positive and negative likelihood ratios (LR+ and LR−), and obtained summary receiver operating characteristic (SROC) curves. Results Across 13 studies with 14 results (90 patients), the pooled sensitivity of amyloid PET was 0.97 and a pooled specificity was 0.98. The pooled sensitivity of F-18 NaF PET was 0.63 and a pooled specificity was 1.00. The pooled sensitivity of combined amyloid and F-18 NaF PET was 0.88 and a pooled specificity was 0.98. Conclusion Amyloid PET has a high sensitivity and specificity for the detection of CA. However, F-18 NaF PET showed relatively low sensitivity with high specificity. At present, the literature regarding the use of amyloid and F-18 NaF PET for diagnosis of CA is still limited; thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of amyloid and F-18 NaF PET for detection of CA.

Objective: The purpose of the current study was to investigate the diagnostic performance of 18F fluorodeoxyglucose (FDG) positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) for the prediction of occult lymph node metastasis (OLNM) in non-small cell lung cancer (NSCLC) patients through a systematic review and meta-analysis. Methods: The PubMed, Cochrane, and EMBASE database, from the earliest available date of indexing through March 31, 2020, were searched for studies evaluating the diagnostic performance of preoperative 18F FDG PET or PET/CT for the prediction of OLNM in NSCLC patients. Results: Across 14 studies (3,535 patients), the pooled sensitivity for 18F FDG PET or PET/CT was 0.79 (95% CI; 0.70–0.86) with heterogeneity (I2 = 81.5, p < 0.001) and a pooled specificity of 0.65 (95% CI; 0.57–0.72) with heterogeneity (I2 = 93.7, p < 0.001). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 2.3 (95% CI; 1.9–2.6) and a negative likelihood ratio (LR-) of 0.32 (95% CI; 0.23–0.44). The pooled diagnostic odds ratio (DOR) was 7 (95% CI; 5–10). The hierarchical summary receiver operating characteristic curve indicates that the area under the curve was 0.77 (95% CI; 0.74–0.81). Conclusion: The current meta-analysis showed a moderate sensitivity and specificity of 18F FDG PET or PET/CT for the prediction of OLNM in NSCLC patients. The DOR was low and the likelihood ratio scatter-gram indicated that 18F FDG PET or PET/CT might not be useful for the prediction of OLNM in NSCLC patients and not for its exclusion.

Background The purpose of the current study was to investigate the predictive value of 18F‐fluorodeoxyglucose positron emission tomography/computed tomography (18F‐FDG PET/CT) for programmed death ligand 1 (PD‐L1) in non‐small cell lung cancer (NSCLC) patients through a systematic review and meta‐analysis. Methods The PubMed, Cochrane, and EMBASE database, from the earliest available date of indexing through 30 April 2020, were searched for studies evaluating the diagnostic performance of 18F‐FDG PET/CT for prediction of PD‐L1 expression in NSCLC patients. Results Across six studies (1739 patients), the pooled sensitivity for 18F‐FDG PET/CT was 0.72 (95% CI: 0.58–0.82) with heterogeneity (I2 = 90.9, P, The current meta‐analysis showed a moderate sensitivity and specificity of 18F‐fluorodeoxyglucose positron emission tomography/computed tomography (18F‐FDG PET/CT) for the prediction of PD‐L1 expression in NSCLC patients. The DOR was low and the likelihood ratio scattergram indicated that 18F‐FDG PET/CT might not be useful for the prediction of PD‐L1 expression in NSCLC patients or its exclusion. This study supports that the role of 18F‐FDG PET/CT for predicting tumor expression of PD‐L1 should be further elucidated.

OBJECTIVE The purpose of the current study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) PET/computed tomography (CT) for diagnosis of polymyalgia rheumatic (PMR) through a meta-analysis. METHODS The PubMed, Cochrane and EMBASE database, from the earliest available date of indexing up to 29 February 2020, were searched for studies evaluating the diagnostic performance of F-18 FDG PET/CT for diagnosis of PMR. RESULTS Across the 11 results of seven studies selected for analysis (684 patients), the pooled sensitivity for F-18 FDG PET/CT was 0.76 [95% confidence interval (CI), 0.67-0.83] with heterogeneity (I = 74.9, P

BACKGROUND CONTEXT Positron emission tomography (PET) is a potential imaging technique for the diagnosis of AS. The visualization of physiological change makes PET potentially suitable for early detection of inflammatory processes, even before anatomical changes occur. Thus, PET might provide specificity via the use of receptor targeting tracers and allows quantification of disease activity in order to accurately monitor therapeutic effects. PURPOSE To examine fluorine-18 sodium fluoride (18F-NaF) PET/computed tomography (PET/CT) findings in patients with inflammatory low back pain and evaluate the utility of this modality in the diagnosis of ankylosing spondylitis (AS) according to the Assessment of SpondyloArthritis International Society (ASAS) criteria. STUDY DESIGN Retrospective cohort study. PATIENTS SAMPLE Sixty-eight patients who underwent 18F-NaF PET/CT imaging between April 2015 and April 2017 for evaluation of inflammatory low back pain. OUTCOME MEASURES We defined AS-positive lesions on PET/CT as symmetric sacroiliac joint uptake that suggests sacroiliitis, syndesmophytes on the spine, and enthesopathy at any site. METHODS All patients were evaluated using the ASAS criteria and assigned to either the AS or the control group. The diagnostic criteria of AS on PET/CT images were defined as 18F-NaF PET/CT images with at least one of AS-positive findings. RESULTS The diagnostic rate of AS was 72.1% among the 68 patients according to the ASAS criteria. The baseline characteristics between the two groups differed significantly in terms of serum C-reactive protein levels and the presence of human leucocyte antigen-B27. Compared to the control group, in the AS group, 39 patients (79.5%) exhibited typical 18F-NaF PET/CT-positive findings, such as enthesopathy (65.3%, p=.003), syndesmophytes (61.2%, p=.006) and symmetric sacroiliitis (67.3%, p=.001). PET-positive findings had significantly higher area under the curve values than did single 18F-NaF PET/CT- positive findings, and they had the best performance for concordant diagnosis according to the ASAS criteria. CONCLUSIONS 18F-NaF PET/CT yielded significantly different findings between the two groups according to the ASAS criteria and is useful for diagnosing AS.

OBJECTIVE. We aimed to evaluate the pharmacokinetics and maximum standardized uptake value (SUVmax) of 18F-NaF PET/CT for assessment of disease activity and prediction of response in patients with ankylosing spondylitis (AS). MATERIALS AND METHODS. Twenty-seven patients (age, interquartile range, 30.25-49.75 years) with AS who were receiving a tumor necrosis factor-α (TNF-α) blocker were included. All patients underwent dynamic PET of the pelvis followed by whole-body PET/CT. Quantitative analysis of kinetic data of the sacroiliac joints (SIJs) was performed, and the SUVmax of the SIJs and SUVmax of the spine were calculated. Clinical indexes related to AS disease activity (serum C-reactive protein level, Bath ankylosing spondylitis disease activity index [ BASDAI], and Bath ankylosing spondylitis functional index) were evaluated. Clinical response was defined as an improvement from the initial BASDAI score of 50% or more (BASDAI 50) within 2 years after baseline 18F-NaF PET/CT. RESULTS. The BASDAI score at 18F-NaF PET/CT was significantly different between the responders and nonresponders: 18F-NaF uptake at the spine was significantly higher in the responders than in the nonresponders. Only SUVmax of the spine had a significant positive correlation with BASDAI score at PET/CT (r = 0.38, p = 0.048). The BASDAI score at PET/CT (odds ratio [OR], 35.32; 95% CI, 2.09-57.84; p = 0.014) and SUVmax of the spine (OR, 14.69; 95% CI, 0.79-27.27; p = 0.027) were significantly associated with BASDAI 50 response prediction. CONCLUSION. The results of our study suggest that the SUVmax of the spine on whole-body 18F-NaF PET/CT is a reliable and noninvasive biomarker for predicting therapeutic response to TNF-α blocker and shows better performance for predicting response than quantitative pharmacokinetic parameters. Fluorine-18-labeled NaF PET/CT showed axial bone lesions with bone formation and can be used as a monitoring tool in patients with AS receiving anti-TNF-α drugs. However, these results need to be validated in a larger cohort.

We aimed to investigate inflammation indices based on preablation hematological parameter of the lymphocyte-to-monocyte ratio (LMR) to predict the clinical outcome in papillary thyroid cancer (PTC) patients with low- and intermediate-risk stratification. This retrospective study analyzed 772 patients with low- and intermediate-risk PTC who underwent total thyroidectomy followed by radioiodine therapy between July 2005 and July 2009 with a median of 10 years. Kaplan–Meier statistics were used to test differences in recurrence-free survival (RFS) between groups based on the optimal cutoff point of biomarkers identified using receiver operating characteristic curves. With an optimal cutoff point of 7.05, 215 patients (29.8%) were classified as having low LMR and 557 patients (71.2%) were classified as having high LMR. High LMR was significantly associated with a prolonged RFS (hazard ratio [HR]: 2.048, 95% confidence interval [CI]: 1.062–4.359, p = 0.001). Multivariate analysis showed that low LMR (HR = 2.035, 95% CI: 1.011–4.095, p = 0.012), tumor size over 2 cm (HR = 2.762, 95% CI: 1.303–5.852, p = 0.008), and high preablative simulated thyroglobulin level over 10 ng/ml (HR = 7.826, 95% CI: 2.353–26.033, p

Objective The purpose of the present study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the differentiation of benign and malignant vertebral compression fractures (VCFxs) through a systematic review and meta-analysis. Methods MEDLINE via PubMed, Cochrane, Scopus, and Embase database, from the earliest available date of indexing through September 30, 2019, were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT for the differentiation of malignant VCFxs. We determined the sensitivities and specificities across the studies, calculated the positive and negative likelihood ratios (LR+ and LR−, respectively), and constructed summary receiver operating characteristic curves. Results For the 5 studies (274 patients), the pooled sensitivity was 0.96 (95% confidence interval [CI], 0.82–0.99) without heterogeneity (I2, 50.6) and 0.77 (95% CI, 0.56–0.89) with heterogeneity (I2, 76.1). LR syntheses gave an overall LR+ of 4.1 (95% CI, 2.1–8.0) and LR− of 0.05 (95% CI, 0.01–0.23). The pooled diagnostic odds ratio (DOR) was 78 (95% CI, 19–316). The hierarchical summary receiver operating characteristic curve indicates that the areas under the curve was 0.94 (95% CI, 0.92–0.96). Conclusions The results of the present meta-analysis have shown high sensitivity and moderate specificity for F-18 FDG PET and PET/CT for differentiation of malignant VCFxs. At present, the reported data regarding the use of F-18 FDG PET for differentiation of malignant VCFxs remain limited; thus, further large multicenter studies are necessary to substantiate the diagnostic accuracy of F-18 FDG PET for the differentiation of malignant VCFxs.

We spend about one-third of our lives either sleeping or attempting to sleep. Therefore, the socioeconomic implications of sleep disorders may be higher than expected. However, the fundamental mechanisms and functions of sleep are not yet fully understood. Neuroimaging has been utilized to reveal the connectivity between sleep and the brain, which is associated with the physiology of sleep. Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging studies have become increasingly common in sleep research. Recently, significant progress has been made in understanding the physiology of sleep through neuroimaging and the use of various radiopharmaceuticals, as the sleep–wake cycle is regulated by multiple neurotransmitters, including dopamine, adenosine, glutamate, and others. In addition, the characteristics of rapid eye and non-rapid eye movement sleep have been investigated by measuring cerebral glucose metabolism. The physiology of sleep has been investigated using PET to study glymphatic function as a means to clear the amyloid burden. However, the basic mechanisms and functions of sleep are not yet fully understood. Further studies are needed to investigate the effects and consequences of chronic sleep deprivation, and the relevance of sleep to other diseases.

Objective The objective of this study was to perform a meta-analysis of the diagnostic test accuracy of Glasgow Prognostic Score (GPS) as a prognostic factor for renal cell carcinoma (RCC). Materials and methods Studies were retrieved from PubMed, Cochrane, and Embase databases, and we performed comprehensive searches to identify studies that evaluated the prognostic impact of pretreatment GPS in RCC patients. We assessed sensitivity, specificity, summary receiver operating characteristic curve, and area under the curve (AUC). Results Totally, studies were searched under the prespecified criteria, and 8 studies with a total of 1191 patients were included to evaluate the prognostic impact of GPS in RCC finally. They indicated a pooled sensitivity of 0.785 (95% confidence interval [CI]: 0.705-0.848), specificity of 0.782 (95% CI: 0.656-0.871), diagnostic odds ratio of 13.089 (95% CI: 7.168-23.899), and AUC of 0.83 (95% CI: 0.79-0.86). Heterogeneity was significant, and meta-regression revealed that the presence of metastasis might be the potential source of heterogeneity. Subgroup analysis also demonstrated that the presence of metastasis might be the source of heterogeneity. Conclusion GPS demonstrated a good diagnostic accuracy as a prognostic factor for RCC and especially in the case of nonmetastatic RCC.

We examined the effect of TSH-suppressive dose of LT4 on changes in body composition and proinflammatory markers in ovariectomized rats. Bilateral ovariectomy (OVX) and sham operations (Sham) were ...

Importance Whether radioactive iodine (RAI) therapy for hyperthyroidism can increase cancer risk remains a controversial issue in medicine and public health. Objectives To examine site-specific cancer incidence and mortality and to evaluate the radiation dose-response association after RAI treatment for hyperthyroidism. Data sources The Medline and Cochrane Library electronic databases, using the Medical Subject Headings terms and text keywords, and Embase, using Emtree, were screened up to October 2020. Study selection Study inclusion criteria were as follows: (1) inclusion of patients treated for hyperthyroidism with RAI and followed up until cancer diagnosis or death, (2) inclusion of at least 1 comparison group composed of individuals unexposed to RAI treatment (eg, the general population or patients treated for hyperthyroidism with thyroidectomy or antithyroid drugs) or those exposed to different administered doses of RAI, and (3) inclusion of effect size measures (ie, standardized incidence ratio [SIR], standardized mortality ratio [SMR], hazard ratio [HR], or risk ratio [RR]). Data extraction and synthesis Two independent investigators extracted data according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Overall quality assessment followed the recommendations of United Nations Scientific Committee on the Effects of Atomic Radiation. The SIR and SMRs and the RRs and HRs were pooled using random-effects meta-analysis. Main outcomes and measures Cancer incidence and mortality for exposure vs nonexposure to RAI therapy and by level of RAI administered activity. Results Based on data from 12 studies including 479 452 participants, the overall pooled cancer incidence ratio was 1.02 (95% CI, 0.95-1.09) and the pooled cancer mortality ratio was 0.98 (95% CI, 0.92-1.04) for exposure vs nonexposure to RAI therapy. No statistically significant elevations in risk were observed for specific cancers except thyroid cancer incidence (SIR, 1.86; 95% CI, 1.19-2.92) and mortality (SMR, 2.22; 95% CI, 1.37-3.59). However, inability to control for confounding by indication and other sources of bias were important limitations of studies comparing RAI exposure with nonexposure. In dose-response analysis, RAI was significantly associated with breast and solid cancer mortality (breast cancer mortality, per 370 MBq: 1.35; P = .03; solid cancer mortality, per 370 MBq: 1.14; P = .01), based on 2 studies. Conclusions and relevance In this meta-analysis, the overall pooled cancer risk after exposure to RAI therapy vs nonexposure was not significant, whereas a linear dose-response association between RAI therapy and solid cancer mortality was observed. These findings suggest that radiation-induced cancer risks following RAI therapy for hyperthyroidism are small and, in observational studies, may only be detectable at higher levels of administered dose.

Background: To assess the prognostic capability of the maximum standardized uptake values (SUVmax) measured in the primary tumor and axillary lymph nodes (ALNs) by pretreatment fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography and analyze outcomes according to the molecular breast cancer subtypes. Methods: The databases were systematically searched using keywords for breast cancer, positron emission tomography/computed tomography, and SUVmax; the extracted studies reported at least 1 form of survival data, event-free survival (EFS) and overall survival. Comparative analyses of the pooled hazard ratios (HRs) for EFS and overall survival were performed to assess their correlations with SUVmax. The pooled HR was estimated using random-effects model according to the results of heterogeneity. Results: Thirteen eligible studies comprising 3040 patients with breast cancer were included. The pooled HRs of high SUVmax in the primary tumor and ALN were 3.01 (95% CI 1.83–4.97, P

Importance Accurate preoperative localization of primary hyperparathyroidism (pHPT) is an important and challenging issue for a successful parathyroidectomy. Although new imaging modalities have been introduced during the past decade, direct comparative studies on advanced imaging techniques are limited. Objective To compare the performance of different preoperative imaging modalities for the localization of pHPT by performing a network meta-analysis (NMA). Data Sources PubMed, Embase, and the Cochrane Library were searched from the earliest available indexing date through September 28, 2020. Study Selection The inclusion criteria were diagnostic tests with sensitivities of 2 or more different preoperative imaging modalities for the same indivduals. Data Extraction and Synthesis Two researchers independently reviewed the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension statement of health care intervention guidelines for network meta-analyses. Main Outcomes and Measures After classifying various imaging modalities into 8 representative imaging categories, the pooled estimation between the odds ratio and 95% credible intervals (CrIs) was calculated in the sensitivity for localization of pHPT. The surface under the cumulative ranking curve (SUCRA) values were obtained to calculate the probability of each imaging modality being the most effective diagnostic method. Results A total of 8495 patients from 119 direct comparative studies using 2 or more imaging modalities for localization of pHPT were included. The sensitivity of choline positron emission tomography and computed tomography (PET-CT) was significantly higher than that of technetium 99m sestamibi single-photon emission computed tomography (MIBI SPECT) in both patient-based and lesion-based analyses (patient-based analysis: odds ratio, 5.22; 95% CrI, 2.36-11.80; lesion-based analysis: odds ratio, 17.70; 95% CrI, 5.79-60.10). Among 8 representative imaging modality categories, choline PET-CT showed the highest SUCRA value in both patient-based and lesion-based analyses. In patient-based analysis after 2010, choline PET-CT showed the highest SUCRA value, followed by the CT category, although MIBI SPECT had the highest SUCRA value in analysis before 2009. Conclusions and Relevance The results from this network meta-analysis suggest that choline PET-CT showed the best performance in both patient-based and lesion-based analyses and that choline PET-CT would be the best preoperative imaging modality for localization of pHPT.

We aimed to evaluate the potential role of quantitative methods associated with lymphoscintigraphy for the assessment of severity of lymphedema post-operatively in patients with breast cancer who did not show definite dermal backflow activity on the lymphoscintigraphy. We evaluated 47 lymphoscintigraphies without dermal backflow in patients with lymphedema who received a mastectomy and axillary dissection or sentinel lymph node dissection for invasive ductal carcinoma of the breast. The quantitative asymmetry indices (QAIs) of both arms were calculated for each axilla, upper arm, forearm, and the whole arm. The QAI was defined as the radiopharmaceutical uptake ratio of the affected side to the unaffected side. Arm circumference was measured at four locations per arm to identify the maximal circumference difference (MCD) between affected and unaffected sides. The total and forearm QAIs of each side arm were significantly higher in the group with above moderate stage lymphedema compared with the mild stage group. Previous radiotherapy also had a significant effect on radiotracer retention expressed as QAI. The MCD was significantly correlated with QAI values of the forearm and the whole arm. The QAI of axillary areas was not significantly correlated with circumferential measurements of the arm. The QAIs have significant value for the diagnosis and severity of lymphedema and may therefore potentially be used as an objective tool for the assessment of lymphedema.

Aims The dopamine transporter (DAT) actively translocates dopamine that is released from the presynaptic neurons across the membranes of nerve terminals into the extracellular space. We hypothesized that glucose loading-induced changes in striatal DAT levels could be associated with food intake in humans. Materials and methods An intravenous bolus injection of 18 F-FP-CIT was administered after infusion of glucose or placebo (normal saline), and emission data were acquired over 90 minutes in 33 healthy males. For a volume-of-interest-based analysis, an atlas involving sub-striatal regions of ventral striatum (VST), caudate nucleus and putamen was applied. DAT availability and binding potential (BPND ) were measured using a simplified reference tissue method with cerebellum as the reference. Results The glucose-loaded BPND from the VST negatively correlated with body mass index (BMI), whereas the placebo-loaded BPND from the VST did not. After loading with glucose, there were substantial increases in BPND s: 18.3%, 71.7% and 34.0% on average in the VST, caudate nucleus and putamen, respectively. Conclusion Striatal DAT changes after glucose loading, and BMI is associated with glucose-loaded DAT availability, not with placebo-loaded DAT availability. DAT might have a role in the reward system of eating behavior.

We investigated the effects of maturation on dopamine transporter (DAT) availability in the rat via longitudinal monitoring with positron emission tomography (PET). Eight 5-week-old male Sprague-Dawley rats (113-186 g) were used. Four In CPu, SBRs at 5 weeks (3.25 ± 0.66) were lower than those at 10 weeks (4.59 ± 0.78, p = 0.1151) and at 15 weeks (5.56 ± 0.92, p = 0.0182). In NAc, SBRs at 5 weeks (1.41 ± 0.47) were lower than those at 10 weeks (2.03 ± 0.36, p = 0.1960) and at 15 weeks (2.43 ± 0.50, p = 0.0427). SBRs in CPu and NAc significantly increased with maturation until 15 weeks. However, differences in SBR between 15 and 20 weeks were not significant. Striatal DAT availability increases until 15 weeks postnatally, then remains stable, reflecting maturation of the dopaminergic system in rats. Wir untersuchten die Auswirkungen der Reifung auf die Verfügbarkeit von Dopamintransportern (DAT) in der Ratte durch longitudinale Beobachtung mit Positronen-Emissions-Tomografie (PET). Es wurden acht 5 Wochen alte männliche Sprague-Dawley-Ratten (113–186 g) verwendet. Vier 18F-FP-CIT PET-Aufnahmen wurden nach 5, 10, 15 und 20 Wochen durchgeführt. Die PET-Bilder zu Studienbeginn wurden manuell mit dem eingebauten Magnetresonanztomografie-Template fusioniert. Volumes of Interest (VOIs) wurden manuell definiert, indem ein sphärischer Bereich mit der maximalen Zählrate um den Hotspot gelegt wurde. VOIs wurden auf den bilateralen Caudatus und Putamen (CPu), Nucleus accumbens (NAc) und das Kleinhirn gelegt. Die spezifischen Bindungsratios (SBRs) wurden wie folgt berechnet: (mittlere Aufnahme der bilateralen Ziele – mittlere Aufnahme des bilateralen Kleinhirns)/(mittlere Aufnahme des bilateralem Kleinhirn). Im CPu waren die SBRs nach 5 Wochen (3,25 ± 0,66) niedriger als nach 10 Wochen (4,59 ± 0,78, p = 0,1151) und nach 15 Wochen (5,56 ± 0,92, p = 0,0182). Im NAc waren die SBRs nach 5 Wochen (1,41 ± 0,47) niedriger als nach 10 Wochen (2,03 ± 0,36, p = 0,1960) und nach 15 Wochen (2,43 ± 0,50, p = 0,0427). Die SBRs in CPu und NAc nahmen mit der Reifung bis 15 Wochen signifikant zu. Allerdings waren die Unterschiede in der SBR zwischen 15 und 20 Wochen nicht signifikant. Die Verfügbarkeit von striatalen DAT steigt bis 15 Wochen nach der Geburt an und bleibt dann stabil, was die Reifung des dopaminergen Systems bei Ratten widerspiegelt.

The brain is known to play a central role in controlling the desire to eat. We aimed to evaluate the brain regions that might have a long-term effect on eating behavior and weight changes. We utilized the data of cognitively normal subjects who are examined by several neurologic tests, and followed-up for 36 months from Alzheimer’s Disease Neuroimaging Initiative (ADNI) database, and investigated to search the brain regions that are associated with future weight change. The weight of each subject was measured on each visit at baseline (W0), 36 (W36) months after brain 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET). Percentage (%) change of weight was calculated as follows: [(W36–W0)/W0]*100. We classified each subject’s change into one of three categories: weight loss, stable, and weight gain. Dynamic 3-dimensional scans of six 5-min frames were acquired 30 mins after injection of 185 MBq of FDG. Image analysis was done using Statistical Parametric Mapping 12. Ninety-six subjects were included in this study (male 54, female 42). Subjects with future weight gain showed hypometabolism in left cerebellum compared with those with future weight loss & stable. Percentage change of weight was positively associated with brain metabolism in right insula, and right caudate nucleus. In conclusion, subjects with future weight gain showed hypometabolism in left cerebellum, and percentage change of weight was positively associated with brain metabolism in right insula, and right caudate nucleus. This study raises the possibility that the brain glucose metabolism precedes the future weight change.

Objective The purpose of this investigation was to evaluate the diagnostic accuracy of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) or PET/computed tomography (PET/CT) for the detection of vascular prosthetic graft infection (VPGI) using a diagnostic accuracy test. Methods The MEDLINE/PubMed and Embase databases, from the earliest available date of indexing through March 31, 2018, were searched for results investigating the diagnostic accuracy of 18F-FDG PET or PET/CT for the detection of VPGI. We calculated the pooled sensitivities and specificities of included studies, calculated positive and negative likelihood ratios, and obtained summary receiver operating characteristic curves. Results Across 10 studies (286 patients), the pooled sensitivity was 0.96 (95% confidence interval [CI], 0.89-0.98) without heterogeneity (I2 = 40.2; 95% CI, 0.0-84.4; P = .09), and pooled specificity was 0.74 (95% CI, 0.67-0.81) without heterogeneity (I2 = 39.9; 95% CI, 0.0-84.3; P = .09). Likelihood ratio syntheses showed an overall positive likelihood ratio of 3.7 (95% CI, 2.9-4.9) and negative likelihood ratio of 0.06 (95% CI, 0.02-0.15). The pooled diagnostic odds ratio was 63 (95% CI, 23-173). The hierarchical summary receiver operating characteristic curve showed the area under the curve to be 0.87 (95% CI, 0.83-0.89). Conclusions This study showed the high sensitivity and moderate specificity of 18F-FDG PET or PET/CT for the detection of VPGI. The clinical usefulness of 18F-FDG PET or PET/CT for detection of VPGI should be validated through further large multicenter studies.

Background Evidence suggests that psoriasis may be associated with metabolic syndrome and an increased risk of cardiovascular disease. Objective To determine whether ustekinumab reduces systemic and vascular inflammation associated with metabolic syndrome and cardiovascular disease, measured using 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT). Methods Patients with psoriasis and healthy controls underwent baseline 18 F-FDG PET/CT imaging. Among the patients with psoriasis, moderate to severe psoriasis was treated with ustekinumab, and the patients underwent 18 F-FDG PET/CT again after a Psoriasis Area and Severity Index of 75 was achieved. Results After a Psoriasis Area and Severity Index of 75 was achieved with ustekinumab treatment, standardized uptake values were reduced in the liver, spleen, and five parts of the aorta ( P Limitations Our study does not provide outcome data concerning cardiovascular events or metabolic syndrome; it only shows surrogate markers in a limited (Korean) population. Conclusion Ustekinumab treatment was significantly associated with decreased systemic and vascular inflammation related to metabolic syndrome and cardiovascular disease among patients with psoriasis.

Study design A meta-analysis. Objective The aim of this study was to compare the diagnostic accuracies of F-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) and magnetic resonance imaging (MRI) for the detection of spondylodiscitis through a meta-analysis. Summary of background data There is no meta-analysis study that compares the diagnostic accuracies of F-18 FDG PET and MRI for the detection of spondylodiscitis. Methods The MEDLINE and EMBASE databases were searched from the earliest available date of indexing to January 10, 2018 for studies comparing the diagnostic performance F-18 FDG PET with that of MRI for the detection of spondylodiscitis. We determined the sensitivities and specificities across studies, calculated the positive and negative likelihood ratios (LR+ and LR-), and constructed the summary receiver operating characteristic curves. Results In the seven studies (212 patients) selected, the pooled sensitivity and specificity of F-18 FDG PET were 0.95 (95% confidence interval [CI]: 0.87-0.98) and 0.88 (95% CI: 0.73-0.95), respectively. The LR syntheses showed an overall LR+ of 7.6 (95% CI: 3.4-17.2) and LR- of 0.05 (95% CI: 0.02-0.14). The pooled diagnostic odds ratio was 141 (95% CI: 44-444). The pooled sensitivity and specificity of MRI were 0.85 (95% CI: 0.65-0.95) and 0.66 (95% CI: 0.48-0.80), respectively. The LR syntheses showed an overall LR+ of 2.5 (95% CI: 1.5-4.2) and LR- of 0.22 (95% CI: 0.08-0.60). The pooled diagnostic odds ratio was 11 (95% CI: 3-42). In the meta-regression analysis, no variable was identified as the source of the study heterogeneity. Conclusion The current meta-analysis shows that F-18 FDG PET has better diagnostic accuracy than MRI for the detection of spondylodiscitis. Further large multicenter studies would be necessary to substantiate the diagnostic accuracies of F-18 FDG PET and MRI for spondylodiscitis. Level of evidence 2.

As the importance of personalized therapeutics in aggressive papillary thyroid cancer (PTC) increases, accurate risk stratification is required. To develop a novel prognostic scoring system for patients with PTC (n = 455), we used mRNA expression and clinical data from The Cancer Genome Atlas. We performed variable selection using Network‐Regularized high‐dimensional Cox‐regression with gene network from pathway databases. The risk score was calculated using a linear combination of regression coefficients and mRNA expressions. The risk score and clinical variables were assessed by several survival analyses. The risk score showed high discriminatory power for the prediction of event‐free survival as well as the presence of metastasis. In multivariate analysis, the risk score and presence of metastasis were significant risk factors among the clinical variables that were examined together. In the current study, we developed a risk scoring system that will help to identify suitable therapeutic options for PTC.

Objective Thyroid cancer is the most common malignant endocrine tumour, and its incidence has continuously increased worldwide over the past three decades. We focused on the association of multifocal papillary thyroid carcinoma (PTC) with messenger RNA (mRNA) expression to characterize how molecular and histopathologic features relate to multifocality. Design A retrospective cohort study. Patients The primary and processed data were downloaded from The Cancer Genome Atlas. A total of 490 patients were included in this study. Methods The statistical significance of differences in sex, age, histology, LN metastasis and recurrence were analysed using chi-squared test. To identify differentially expressed genes between BRAF (+) multifocal and unifocal PTCs and between BRAF (-) multifocal and unifocal PTCs, we used the Significance Analysis of Microarray. Over-representation analysis is conducted using CPDB. Results A total of 237 patients had BRAF (+) PTCs, whereas 253 had BRAF (-) PTCs. There were 110 patients with multifocal PTCs and 127 with unifocal PTCs in the BRAF (+) group and 116 patients with multifocal PTCs and 137 with unifocal PTCs in the BRAF (-) group. In BRAF (+) group, multifocal PTCs had increased expression of 158 mRNAs as compared to that in unifocal PTCs. Ten mRNAs were involved in Wnt-related pathways, and seven mRNAs were included in pluripotency-related pathways. Conclusion Multifocal PTCs have higher expression of mRNAs in Wnt- and pluripotency-related pathways when BRAF mutation is present. This might be the mechanism that accounts for the difference between multifocal and unifocal PTCs.

The purpose of the current study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the prediction of v-Ki-ras-2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation in colorectal cancer (CRC) patients through a systematic review and meta-analysis. The PubMed and EMBASE database, from the earliest available date of indexing through April 30, 2018, were searched for studies evaluating the diagnostic performance of F-18 FDG PET/CT for prediction of KRAS mutation in CRC patients. Across 9 studies (804 patients), the pooled sensitivity for F-18 FDG PET/CT was 0.66 (95% CI 0.60–0.73) without heterogeneity (I2 = 34.1, p = 0.14) and a pooled specificity of 0.67 (95% CI 0.62–0.72) without heterogeneity (I2 = 1.63, p = 0.42). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 2.0 (95% CI 1.7–2.4) and negative likelihood ratio (LR−) of 0.5 (95% CI 0.41–0.61). The pooled diagnostic odds ratio (DOR) was 4 (95% CI 3–6). Hierarchical summary receiver operating characteristic (ROC) curve indicates that the areas under the curve were 0.69 (95% CI 0.65–0.73). The current meta-analysis showed the low sensitivity and specificity of F-18 FDG PET/CT for prediction of KRAS mutation in CRC patients. The DOR was very low and the likelihood ratio scatter-gram indicated that F-18 FDG PET/CT might not be useful for prediction of KRAS mutation and not for its exclusion. Therefore, cautious application and interpretation should be paid to the F-18 FDG PET/CT for prediction of KRAS mutation in CRC patients.

Objectives As PET has become a standard of treatment in patients with cancer, publications of oncologic PET have grown sharply. We aimed to organize the data of meta-analyses of oncologic PET and assess the quality of studies. Materials and methods The inclusion criteria were studies that meta-analyzed to combine the data from multiple studies of oncologic PET. We used the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) to assess the reporting quality of the included studies. Results A total of 254 meta-analyses were eligible for inclusion in the study. The peak number of publications increased up to 42 in 2014. Lung (n=39, 15.4%) is the most common site of tumor included in meta-analysis with oncologic PET. Overall, 84% of studies were categorized into diagnostic test accuracy reviews (n=214). Studies published in 2010 or later (n=213) showed higher PRISMA scores than those published in 2009 or before. Conclusion A large number of meta-analyses are published in the field of oncologic PET. Meta-analyses in oncologic PET seem to be cited more often than regular research papers. The overall quality of studies is low; however, they showed improvement after PRISMA statement.

BACKGROUND AND PURPOSE We aimed to determine the association between the annual changes in dopamine transporter (DAT) availability as measured by ¹²³I-ioflupane (¹²³I-FP-CIT) single-photon-emission computed tomography and single-nucleotide polymorphisms (SNPs) known to be risk factors in Parkinson's disease (PD). METHODS In total, 150 PD patients were included from the Parkinson's Progression Markers Initiative database. Specific SNPs that are associated with PD were selected for genotyping. SNPs that were not in Hardy-Weinberg equilibrium or whose minor allele frequency was less than 0.05 were excluded. Twenty-three SNPs met the inclusion criteria for this study. The Kruskal-Wallis test was used to compare annual percentage changes in DAT availability for three subgroups of SNP. RESULTS None of the 23 SNPs exerted a statistically significant effect (p

Background: Eating behavior is determined by both homeostatic and hedonic values. Objective: We investigated the association of hedonic value with striatal dopamine transporter (DAT) availability sub-regionally. Method: An intravenous bolus injection of 18F-FP-CIT was administered after the infusion of glucose or placebo, and the emission data were acquired over 90 min. DAT availability and binding potential (BPND) were measured via the simplified reference tissue method. Subjects were assessed with sensory taste test of sucrose solutions. The “most liked” sucrose concentration (%) was determined as the hedonic rating for sucrose. Results: Twenty healthy males participated in this study. After glucose loading, BPNDs of putamen significantly increased, and those of caudate nucleus showed the increasing trend, while those of ventral striatum were not significantly different. After glucose loading, the “most liked” sucrose concentration (%) was negatively associated with BPNDs of caudate nucleus and showed the trend of positive association with those from ventral striatum. Slopes of regression lines were significantly different according to the sub-regions of striatum. Conclusion: We have highlighted that striatal DAT increased after glucose loading in dorsal striatum, not in ventral striatum. These changes of striatal DAT were sub-regionally associated with the hedonic rating of sucrose from each subject.

OBJECTIVES The purpose of the current study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) or PET/computed tomography (CT) for characterization of intraductal papillary mucinous neoplasms (IPMN) through a systematic review and meta-analysis. METHODS The PubMed and Embase database were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT for characterization of IPMN. RESULTS Across 14 studies (752 patients), the pooled sensitivity for F-18 FDG PET or PET/CT was 0.84 (95% confidence interval [CI], 0.77-0.89) with heterogeneity (I2 = 55.5, P = 0.01) and a pooled specificity of 0.95 (95% CI, 0.88-0.98) with heterogeneity (I2 = 83.9, P < 0.001). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 17.4 (95% CI, 6.5-46.8) and negative likelihood ratio (LR-) of 0.17 (95% CI, 0.12-0.25). The pooled diagnostic odds ratio was 101 (95% CI, 31-327). Hierarchical summary receiver operating characteristic curve and indicates that the areas under the curve were 0.93 (95% CI, 0.90-0.95). CONCLUSIONS The current meta-analysis showed a high sensitivity, specificity, diagnostic odds ratio, and the LR scatter gram of F-18 FDG PET or PET/CT for determination of characteristics of IPMN.

Purpose To perform a systematic review and meta-analysis of the Prognostic Nutritional Index (PNI) as a prognostic factor for renal cell carcinoma (RCC). Materials and methods Eligible studies that evaluated the prognostic impact of pretreatment PNI in RCC patients were identified by comprehensive searching the electronic databases PubMed, Cochrane Central Search library, and EMBASE. The end points were overall/cancer-specific survival (OS/CSS) and recurrence-free/disease-free survival (RFS/DFS). Meta-analysis using random-effects models was performed to calculate hazard ratios (HRs) with 95 % confidence intervals (CIs). Results In total, 9 retrospective, observational, case-control studies involving 5,976 patients were included for final analysis. Eight studies evaluated OS/CSS, and 5 evaluated RFS/DFS. Our results showed that lower PNI was significantly associated with unfavorable OS/CSS (HR = 1.68, 95% CI 1.44-1.96, P Conclusion This meta-analysis indicated that lower PNI was a negative prognostic factor and associated with tumor progression and poorer survival of patients with RCC. Therefore, PNI could be a potential prognostic predictor of treatment outcomes for patients with RCC.

Objectives The present study aimed to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the detection of bone marrow involvement (BMI) in paediatric Hodgkin lymphoma (HL) through a systematic review and meta-analysis. Methods PubMed, Cochrane, and EMBASE databases were searched from the earliest available date of indexing till March 31, 2020 for studies evaluating the diagnostic performance of F-18 FDG PET/CT in the detection of BMI in paediatric HL. Results Across seven studies (1265 patients), the pooled sensitivity of F-18 FDG PET or PET/CT was 0.95 (95% confidence interval [CI]: 0.87–0.98) with heterogeneity (I2 = 86.2, p Conclusions The present meta-analysis revealed high sensitivity and specificity of F-18 FDG PET/CT for the detection of BMI in paediatric HL. Currently, the literature regarding the use of F-18 FDG PET/CT for the detection of BMI in paediatric HL is limited. Large multicentre studies are necessary to substantiate the diagnostic accuracy of F-18 FDG PET/CT in the detection of BMI in paediatric HL. Advances in knowledge Through a meta-analysis, this study provided a more reliable assessment of the diagnostic utility of F-18 FDG PET/CT, which exhibited good diagnostic accuracy in the detection of BMI in paediatric HL.

Background The purpose of the current study was to compare the diagnostic accuracies of F-18 FDG PET or PET/CT and MRI for detection of bone marrow involvement (BMI) in lymphoma patients through a systematic review and meta-analysis. Methods and Materials The PubMed, Cochrane database, and EMBASE database, from the earliest available date of indexing through July 31, 2020, were searched for studies evaluating direct comparison of diagnostic performance of F-18 FDG PET or PET/CT and MRI for BMI in lymphoma patients. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR + and LR-), and constructed summary receiver operating characteristic curves. Results Across 5 studies (212 patients), the pooled sensitivity of F-18 FDG PET or PET/CT was 0.65 (95 % CI; 0.42−0.82) a pooled specificity of 0.90 (95 % CI; 0.85−0.94). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 6.4 (95 % CI; 3.3–12.4) and negative likelihood ratio (LR-) of 0.39 (95 % CI; 0.21−0.73). The pooled DOR was 16 (95 % CI; 5–56). The pooled sensitivity of MRI was 0.78 (95 % CI; 0.55−0.91) and a pooled specificity of 0.86 (95 % CI; 0.67−0.95). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 5.6 (95 % CI; 1.8–17.0) and negative likelihood ratio (LR-) of 0.26 (95 % CI; 0.1−0.65). The pooled DOR was 22 (95 % CI; 3–149). In meta-regression analysis, no variable was the source of the study heterogeneity. Conclusion F-18 FDG PET or PET/CT and MRI showed similar diagnostic performances for the detection of BMI in lymphoma patients. Further large multicenter studies would be necessary to substantiate the diagnostic accuracy of F-18 FDG PET or PET/CT and MRI for the diagnosis of BMI in lymphoma patients.

OBJECTIVES: PET using F-fluorodeoxyglucose (FDG) has proven to be valuable in staging and monitoring of treatment response in breast cancer. We aimed to assess the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with breast cancer. METHODS: A systematic search of MEDLINE and EMBASE was performed using the keywords of breast cancer, PET, and volume. Inclusion criteria were F-FDG PET used as an initial imaging tool; studies limited to patients with breast cancer who had not undergone any treatment before PET scans; and studies reporting survival data. Event-free survival (EFS) and overall survival (OS) were considered markers of outcome. RESULTS: Nine studies comprising 975 patients were included in this study. The pooled hazard ratio (HR) for adverse events was 33.73 (P < 0.00001; I = 0%) with MTV from primary tumor and 2.89 (P < 0.00001; I = 45%) with TLG from primary tumor, meaning that primary tumors with high volumetric parameters were associated with progression or recurrence. However, the combined HRs for EFS of MTV, and TLG, and those for OS of MTV from whole-body tumor were NS. The pooled HR for OS of TLG from whole-body tumor was 2.95 (P = 0.18; I = 71%). CONCLUSION: Volumetric parameters from F-FDG PET are significant prognostic factors for outcome in patients with breast cancer. Patients with a high MTV or TLG from primary tumor have a higher risk of adverse events. Patients with a high TLG from whole-body tumor have a higher risk of deaths.

Positron emission tomography (PET) is a non-invasive technique measuring quantification of physiological and biochemical processes in the living organism. However, there are many considerations including anesthesia and fasting to acquire small animal imaging. We aimed to evaluate the effects of anesthesia and fasting of rats in dopamine transporter (DAT) imaging acquisition. Male Sprague Dawley (SD) rats aged 7 weeks and weighing 180–260 g were used in this study. Rats were randomly divided by 4 groups. Group A was kept under anesthesia for 40 min and fasted over 12 h. Group B was only fasted over 12 h. Group C was only kept under anesthesia for 40 min. Group D was neither kept under anesthesia nor fasted over 12 h. PET scans were started at 40 min after 18F-FP-CIT injection and obtained for 20 min. Volumes-of-interest for striatum and extrastriatal area were used for 18F-FP-CIT PET analysis. Cerebellum was considered as a reference region. Specific binding ratio (SBR) was calculated as follows: [(uptake of target-uptake of cerebellum)]/(uptake of cerebellum). SBR without fasting and anesthesia (group D) was significantly lower than those of other groups (vs group A, p = 0.0004; vs group B, p = 0.0377; vs group C, p = 0.0134). However, SBRs of extrastriatal area (p = 0.5120) were not affected by fasting and anesthesia. In conclusion, the SBR of striatum was increased after anesthesia by isoflurane and fasting. When designing an experiment using DAT imaging, the effects of isoflurane and fasting should be considered.

Thyroid dysfunction is frequently associated with functional disturbances of the brain. We performed a meta-analysis of previous positron emission tomography and single-photon emission computed tomography studies using a coordinate-based technique of activation-likelihood estimation (ALE) to investigate the potential background of neuropsychiatric complications in patients with hypo- and hyperthyroidism. We performed a systematic search of MEDLINE and EMBASE for English-language publications using the keywords of "positron emission tomography", "single-photon emission computed tomography", and "thyroid". The software GingerALE ver 2.3.6 was used to transform all reported coordinates into stereotactic Montreal Neurological Institute space. A threshold of uncorrected p 0.001 (minimum volume of 200 mm

Thyroid dysfunction is frequently associated with functional disturbances of the brain. We performed a meta-analysis of previous positron emission tomography and single-photon emission computed tomography studies using a coordinate-based technique of activation-likelihood estimation (ALE) to investigate the potential background of neuropsychiatric complications in patients with hypo- and hyperthyroidism. We performed a systematic search of MEDLINE and EMBASE for English-language publications using the keywords of “positron emission tomography”, “single-photon emission computed tomography”, and “thyroid”. The software GingerALE ver 2.3.6 was used to transform all reported coordinates into stereotactic Montreal Neurological Institute space. A threshold of uncorrected p 3) was applied to the resulting ALE map using cerebral metabolic rate of glucose (CMRglu), and cerebral blood flow (CBF). Six studies were eligible for inclusion in the study; 4 studies of cerebral metabolic rate of CMRglu, and 2 studies of CBF. In hypothyroidism, significant decreases in CMRglu were identified in 3 clusters including left anterior cingulate, right inferior occipital gyrus, and right cuneus. In hyperthyroidism, a significant decrease in CMRglu was identified in right superior frontal gyrus. In hypothyroidism, a significant decrease in CBF was observed in left postcentral gyrus. In conclusion, several brain regions showed altered CMRglu and CBF in patients with thyroid dysfunction compared with euthyroid controls. These findings might account for underlying mechanisms of thyroid hormones on psychological and physiological effects on brain.

Objective The purpose of the current study was to investigate the diagnostic performance of high mobility group A2 (HMGA2) gene expression for differentiation of malignant thyroid nodules through a systematic review and meta-analysis. Design The MEDLINE/PubMed and EMBASE database, from the earliest available date of indexing through 10 April 2018, were searched for studies evaluating the diagnostic performance of HMGA2 expression for differentiation of thyroid nodules. Methods We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic (ROC) curves. Results Across 7 studies, the pooled sensitivity for HMGA2 expression was 0.78 (95% CI; 0.67-0.86) with heterogeneity (I2 = 86.6) and a pooled specificity of 0.94 (95% CI: 0.85-0.98) with heterogeneity (I2 = 94.7). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 12.6 (95% CI: 5.1-31.3) and negative likelihood ratio (LR-) of 0.24 (95% CI: 0.15-0.36). The pooled diagnostic odds ratio (DOR) was 53 (95% CI: 18-159). Hierarchical summary ROC curve indicates that the areas under the curve were 0.92 (95% CI: 0.89-0.94). In meta-regression analysis, no definite variable was the source of the study heterogeneity. Conclusion The current meta-analysis showed the moderate sensitivity and high specificity of HMGA2 expression for differentiation of malignant thyroid nodules. The likelihood ratio scatter-gram suggested that HMGA2 expression analysis could be useful for confirmation of the presence of malignant thyroid nodules. Considering the heterogeneity of included studies, further large prospective studies are necessary to confirm these results.

The purpose of the current study was to investigate the diagnostic performance of technetium-99m (Tc-99m) methoxy-isobutyl-isonitrile (MIBI) for differentiation of malignant thyroid nodules (TN) through a systematic review and meta-analysis.The MEDLINE/PubMed and EMBASE database, from the earliest available date of indexing through January 31, 2018, were searched for studies evaluating the diagnostic performance of Tc-99m MIBI for TN. The sensitivities and specificities were determined across studies, positive and negative likelihood ratios (LR+ and LR-) were calculated, and summary receiver operating characteristic curves were constructed.Across 22 studies (2421 patients), the pooled sensitivity for Tc-99m MIBI thyroid scan was 0.87 [confidence interval (CI) 0.76-0.93] with heterogeneity (IThe current meta-analysis shows a moderate sensitivity and specificity of Tc-99m MIBI thyroid scan for differentiation of malignant TN. However, the diagnostic odds ratio was relatively low and the LR scattergram indicated that Tc-99m MIBI thyroid scan is not useful for confirming the presence of malignant TN or for its exclusion. Therefore, Tc-99m MIBI thyroid scans should be used restrictively and interpreted cautiously when assessing TN for malignancy.

Purpose This study aimed to examine the discrepancy in osteoporosis diagnoses between central quantitative computed tomography (cQCT) and dual-energy X-ray absorptiometry (DXA) and evaluated correlations among volumetric bone mineral density (vBMD), areal bone mineral density (aBMD), and trabecular bone score(TBS) in postmenopausal women who were undergoing TSH suppressive therapy. Methods We enrolled a total of 81 postmenopausal patients [median age: 58 years; interquartile range (IQR): 57 to 60 years] receiving TSH suppressive therapy with levothyroxine after undergoing total thyroidectomy for papillary thyroid cancer. Patients were diagnosed by their bone mineral density (BMD) T-score and categorized according to a vBMD threshold of 120 mg/cm3 for osteopenia and a threshold of 80 mg/cm3 for osteoporosis. Results When DXA and cQCT were compared, the BMD evaluation results differed in 76% of patients (n = 62; P < 0.001), and the detection rate of osteoporosis was 30.9% for cQCT and 21.0% for DXA. Sixty-two patients had discordant results; in 46 of these patients (74%) whose DXA T-scores were normal, the diagnosis shifted to osteopenia (n = 35) and osteoporosis (n = 11) according to the vBMD on cQCT (P < 0.001), and their vBMD values were significantly correlated with TBS (r = 0.293; P = 0.008). However, aBMD was not significantly correlated with TBS (r = 0.080; P = 0.480). TBS was significantly lower in patients with osteopenia (median: 1.35; IQR: 1.18 to 1.47) and osteoporosis (median: 1.28; IQR: 1.07 to 1.47) than in those with a normal BMD value (median: 1.37; IQR: 1.25 to 1.49; P = 0.041) on cQCT. There was no significant difference in TBS according to DXA BMD status (P = 0.200). Conclusions DXA and cQCT yielded inconsistent results, and detection of osteopenia and osteoporosis was higher using cQCT. TBS showed a more significant correlation with vBMD than with aBMD.

We aimed to investigate the association between genetic factors of SNPs dopamine transporter (DAT) and serotonin transporter (SERT) availabilities in healthy controls. The study population consisted of healthy controls with screening 123I-FP-CIT single-photon emission computed tomography. Specific binding of 123I-FP-CIT regarding DAT and SERT was calculated using a region of interest analysis. VOI template was applied to measure specific binding ratios (SBRs) of caudate nucleus, putamen, striatum, midbrain, and pons. One hundred sixty healthy controls (male 106, female 54, 61.0 ± 11.5 years) were included in this study. Sex difference did not exist in DAT availabilities of caudate nucleus (p = 0.5344), putamen (p = 0.5006), and striatum (p = 0.5056). However, male subjects had higher SERT availabilities of both midbrain (p = 0.0436), and pons (p = 0.0061). Therefore, we analyzed the effect of SNP on DAT availabilities of subjects in all, and that on SERT availabilities of males and females separately. None of 19 SNPs included in this study showed the effect on DAT availabilities. However, rs591323 in Fibroblast Growth Factor 20 on chromosome 8 had a significant impact on SERT availability of both midbrain (p = 0.0056) and pons (p = 0.0007). SNP rs591323 of risk loci for Parkinson’s disease is associated with SERT availability of healthy male subjects.

Background: Psoriasis is a chronic skin disease associated with psychiatric co-morbidities, especially depression. Early detection of psychological vulnerability in patients with psoriasis seems to...

Aim We aimed to explore the role of the diagnostic accuracy of F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) or positron emission tomography/computed tomography (PET/CT) for prediction of malignant potential of gastrointestinal stromal tumor (GIST) through a systematic review and meta-analysis. Methods The MEDLINE, EMBASE, and Cochrane Library database, from the earliest available date of indexing through May 31, 2017, were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT for prediction of malignant potential of GIST. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic curves. Results Across 7 studies (188 patients), the pooled sensitivity for F-18 FDG PET or PET/CT was 0.88 (95% CI; 0.80-0.94) without heterogeneity (χ2=6.15, p=0.72) and a pooled specificity of 0.88 (95% CI; 0.75-0.94) with heterogeneity (χ2=23.2, p= 0.01). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 7.2 (95% CI; 3.3-15.3) and negative likelihood ratio (LR-) of 0.13 (95% CI; 0.07-0.24). The pooled DOR was 54 (95% CI; 16-181). Conclusion F-18 FDG PET or PET/CT demonstrated good sensitivity and specificity for the prediction of malignant potential of GIST. At present, the literature regarding the use of F-18 FDG PET or PET/CT for the prediction of malignant potential of GIST remains still limited; thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of F-18 FDG PET or PET/CT prediction of malignant potential of GIST.

Aims: We aimed to assess the diagnostic accuracy of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for preoperative lymph node (LN) staging in newly diagnosed bladder cancer (BC) patients through a systematic review and meta-analysis. Patients and Methods: MEDLINE, Embase, and the Cochrane Library database, from the earliest available date of indexing through June 30, 2017, were searched for studies evaluating the diagnostic performance of F-18 FDG PET/CT for preoperative LN staging in newly diagnosed BC. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR–), and constructed summary receiver operating characteristic curves. Results: Across 14 studies (785 patients), the pooled sensitivity was 0.57 (95% CI: 0.49–0.64) and the pooled specificity was 0.92 (95% CI: 0.87–0.95). The LR syntheses gave an overall LR+ of 7.4 (95% CI: 4.4–12.3) and an LR– of 0.47 (95% CI: 0.39–0.56). The pooled diagnostic odds ratio was 16 (95% CI: 9–28). Conclusions: F-18 FDG PET/CT shows a low sensitivity and high specificity for the detection of metastatic LNs in patients with newly diagnosed BC.

OBJECTIVE We aimed to determine the factors contributing toward diffusely increased renal uptake on bone scintigraphy using technetium-99m (Tc-99m) diphosphono-propanedicarboxylic acid (DPD) in patients with end-stage renal disease. PATIENTS AND METHODS One-hundred and forty-three bone scintigraphies, performed between June 2007 and July 2013, in 135 patients with chronic kidney disease were analyzed retrospectively, including 22 bone scintigraphies (15 patients; eight women; seven men) with glomerular filtration rates less than 15 ml/min/1.73 m. Patients with nephrocalcinosis were excluded. The clinical records of medication and underlying disease were reviewed retrospectively. The presence of renal artery calcification was visually estimated and the Hounsfield unit (HU) of renal parenchyma was measured by abdominal and pelvic nonenhanced computed tomography. RESULTS Two patients underwent peritoneal dialysis and 13 underwent hemodynamic dialysis. Diffusely increased renal Tc-99m DPD uptake was observed on 15 of 22 (68%) bone scintigraphy images. Laboratory test results were not significantly different between the patients with or without increased renal uptake. A history of inflammatory conditions or antibiotic administration did not correlate with kidney visualization. The significant factor for diffuse renal tracer uptake on multivariate analysis was renal artery calcification (odds ratio: 18.42; 95% confidence interval: 2.01-79.43; P

Peptide receptor radionuclide therapy (PRRT) is a systemic cytotoxic radiation therapy using a compound of β-emitting radionuclide chelated to a peptide for the treatment of tumor with overexpressed specific cell receptor such as somatostatin receptor subtype 2 (SSTR2) of neuroendocrine tumor (NET). Surgical resection should be performed for the curative treatment for NETs when it is feasible; however, a multi-disciplinary approach is needed when locally advanced or metastasized disease. PRRT with lutetium-177 (Lu-177)-labeled somatostatin analogues, as a new treatment modality targeting metastatic or inoperable NETs expressing the SSTR2, have been developed and successfully used for the past two decades. As Lu-177 emits both β- and γ-radiation, it has the ability as a theragnostic agent for NETs compared with only β-emitting yttrium-90 labeled PRRT. Several recent studies reported that Lu-177 gave an overall positive response and improved the patients’ quality of life. To fully exploit its potential, large comparative studies are needed for the assessment of distinct efficacies of Lu-177 labeled PRRT. Additionally, for extending the indications and developing new regimens of Lu-177-based PRRT, more dedicated clinical research is required.