11 results on '"Czibor S"'
Search Results
2. Optimal timing and criteria of interim PET in DLBCL: a comparative study of 1692 patients
- Author
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Eertink, J.J., Burggraaff, C.N., Heymans, M.W., Dührsen, U., Hüttmann, A., Schmitz, C., Müller, S., Lugtenburg, P.J., Barrington, S.F., Mikhaeel, N.G., Carr, R., Czibor, S., Györke, T., Ceriani, L., Zucca, E., Hutchings, M., Kostakoglu, L., Loft, A., Fanti, S., Wiegers, S.E., Pieplenbosch, S., Boellaard, R., Hoekstra, O.S., Zijlstra, J.M., and de Vet, H.C.W.
- Published
- 2021
- Full Text
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3. Optimal timing and criteria of interim PET in DLBCL:a comparative study of 1692 patients
- Author
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Eertink, Jakoba J., Burggraaff, Coreline N., Heymans, M.W., Duhrsen, U, Huttmann, A, Schmitz, C, Muller, S, Lugtenburg, Elly, Barrington, S. F., Mikhaeel, N. G., Carr, R., Czibor, S., Györke, T., Ceriani, Luca, Zucca, E, Hutchings, M, Kostakoglu, L., Loft, A., Fanti, S., Wiegers, Sanne E., Pieplenbosch, Simone, Boellaard, R, Hoekstra, O.S., Zijlstra, J. M., de Vet, H.C.W., Eertink, Jakoba J., Burggraaff, Coreline N., Heymans, M.W., Duhrsen, U, Huttmann, A, Schmitz, C, Muller, S, Lugtenburg, Elly, Barrington, S. F., Mikhaeel, N. G., Carr, R., Czibor, S., Györke, T., Ceriani, Luca, Zucca, E, Hutchings, M, Kostakoglu, L., Loft, A., Fanti, S., Wiegers, Sanne E., Pieplenbosch, Simone, Boellaard, R, Hoekstra, O.S., Zijlstra, J. M., and de Vet, H.C.W.
- Abstract
Interim 18F-fluorodeoxyglucose positron emission tomography (Interim- 18F-FDG-PET, hereafter I-PET) has the potential to guide treatment of patients with diffuse large B-cell lymphoma (DLBCL) if the prognostic value is known. The aim of this study was to determine the optimal timing and response criteria for evaluating prognosis with I-PET in DLBCL. Individual patient data from 1692 patients with de novo DLBCL were combined and scans were harmonized. I-PET was performed at various time points during treatment with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy. Scans were interpreted using the Deauville score (DS) and change in maximum standardized uptake value (DSUVmax ). Multilevel Cox proportional hazards models corrected for International Prognostic Index (IPI) score were used to study the effects of timing and response criteria on 2-year progression-free survival (PFS). I-PET after 2 cycles (I-PET2) and I-PET4 significantly discriminated good responders from poor responders, with the highest hazard ratios (HRs) for I-PET4. Multivariable HRs for a PET-positive result at I-PET2 and I-PET4 were 1.71 and 2.95 using DS4-5, 4.91 and 6.20 using DS5, and 2.93 and 4.65 using DSUVmax , respectively. DSUVmax identified a larger proportion of poor responders than DS5 did. For all criteria, the negative predictive value was >80%, and positive predictive values ranged from 30% to 70% at I-PET2 and I-PET4. Unlike I-PET1, I-PET3 discriminated good responders from poor responders using DS4-5 and DS5 thresholds (HRs, 2.94 and 4.67, respectively). I-PET2 and I-PET4 predict good response equally during R-CHOP therapy in DLBCL. Optimal timing and response criteria depend on the clinical context. Good response at I-PET2 is suggested for de-escalation trials, and poor response using DSUVmax at I-PET4 is suggested for randomiz
- Published
- 2021
4. Optimal timing and criteria of interim PET in DLBCL: A comparative study of 1692 patients
- Author
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Sanne E Wiegers, Stefan P. Müller, N. G. Mikhaeel, Robert Carr, Luca Ceriani, Annika Loft, Tamás Györke, Martin Hutchings, Jakoba J Eertink, Pieternella J. Lugtenburg, Emanuele Zucca, Ulrich Dührsen, Ronald Boellaard, Christine Schmitz, Simone Pieplenbosch, Andreas Hüttmann, H.C.W. de Vet, Sally F. Barrington, S. Czibor, J. M. Zijlstra, L. Kostakoglu, Coreline N. Burggraaff, Otto S. Hoekstra, Stefano Fanti, Martijn W. Heymans, Eertink JJ, Burggraaff CN, Heymans MW, Dührsen U, Hüttmann A, Schmitz C, Müller S, Lugtenburg PJ, Barrington SF, Mikhaeel NG, Carr R, Czibor S, Györke T, Ceriani L, Zucca E, Hutchings M, Kostakoglu L, Loft A, Fanti S, Wiegers SE, Pieplenbosch S, Boellaard R, Hoekstra OS, Zijlstra JM, de Vet HCW., Hematology, VU University medical center, Internal medicine, Epidemiology and Data Science, APH - Methodology, APH - Personalized Medicine, Radiology and nuclear medicine, Amsterdam Neuroscience - Brain Imaging, CCA - Imaging and biomarkers, and CCA - Cancer Treatment and quality of life
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Oncology ,medicine.medical_specialty ,Medizin ,Context (language use) ,Standardized uptake value ,DLBCL, interim PET ,030218 nuclear medicine & medical imaging ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,International Prognostic Index ,Randomized controlled trial ,Fluorodeoxyglucose F18 ,law ,Prednisone ,Internal medicine ,Humans ,Medicine ,Lymphoid Neoplasia ,business.industry ,Proportional hazards model ,Hazard ratio ,Hematology ,Prognosis ,Vincristine ,Positron-Emission Tomography ,030220 oncology & carcinogenesis ,Rituximab ,Lymphoma, Large B-Cell, Diffuse ,business ,medicine.drug - Abstract
Interim 18F-fluorodeoxyglucose positron emission tomography (Interim- 18F-FDG-PET,hereafter I-PET) has the potential to guide treatment of patients with diffuse large B-celllymphoma (DLBCL) if the prognostic value is known. The aim of this study was to determinethe optimal timing and response criteria for evaluating prognosis with I-PET in DLBCL.Individual patient data from 1692 patients with de novo DLBCL were combined and scans were harmonized. I-PET was performed at various time points during treatment with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy. Scans were interpreted using the Deauville score (DS) and change in maximum standardized uptake value (DSUVmax ). Multilevel Cox proportional hazards models corrected for International Prognostic Index (IPI) score were used to study the effects oftiming and response criteria on 2-year progression-free survival (PFS). I-PET after 2 cycles (I-PET2) and I-PET4 significantly discriminated good responders from poor responders, with the highest hazard ratios (HRs) for I-PET4. Multivariable HRs for a PET-positive result at I-PET2 and I-PET4 were 1.71 and 2.95 using DS4-5, 4.91 and 6.20 using DS5, and 2.93 and 4.65 using DSUVmax , respectively. DSUVmax identified a larger proportion of poor respondersthan DS5 did. For all criteria, the negative predictive value was >80%, and positivepredictive values ranged from 30% to 70% at I-PET2 and I-PET4. Unlike I-PET1, I-PET3discriminated good responders from poor responders using DS4-5 and DS5 thresholds (HRs,2.94 and 4.67, respectively). I-PET2 and I-PET4 predict good response equally during R-CHOPtherapy in DLBCL. Optimal timing and response criteria depend on the clinical context. Goodresponse at I-PET2 is suggested for de-escalation trials, and poor response using DSUVmax atI-PET4 is suggested for randomized trials that are evaluating new therapies
- Published
- 2021
5. Validation of an Artificial Intelligence-Based Prediction Model Using 5 External PET/CT Datasets of Diffuse Large B-Cell Lymphoma.
- Author
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Ferrández MC, Golla SSV, Eertink JJ, Wiegers SE, Zwezerijnen GJC, Heymans MW, Lugtenburg PJ, Kurch L, Hüttmann A, Hanoun C, Dührsen U, Barrington SF, Mikhaeel NG, Ceriani L, Zucca E, Czibor S, Györke T, Chamuleau MED, Zijlstra JM, and Boellaard R
- Abstract
The aim of this study was to validate a previously developed deep learning model in 5 independent clinical trials. The predictive performance of this model was compared with the international prognostic index (IPI) and 2 models incorporating radiomic PET/CT features (clinical PET and PET models). Methods: In total, 1,132 diffuse large B-cell lymphoma patients were included: 296 for training and 836 for external validation. The primary outcome was 2-y time to progression. The deep learning model was trained on maximum-intensity projections from PET/CT scans. The clinical PET model included metabolic tumor volume, maximum distance from the bulkiest lesion to another lesion, SUV
peak , age, and performance status. The PET model included metabolic tumor volume, maximum distance from the bulkiest lesion to another lesion, and SUVpeak Model performance was assessed using the area under the curve (AUC) and Kaplan-Meier curves. Results: The IPI yielded an AUC of 0.60 on all external data. The deep learning model yielded a significantly higher AUC of 0.66 ( P < 0.01). For each individual clinical trial, the model was consistently better than IPI. Radiomic model AUCs remained higher for all clinical trials. The deep learning and clinical PET models showed equivalent performance (AUC, 0.69; P > 0.05). The PET model yielded the highest AUC of all models (AUC, 0.71; P < 0.05). Conclusion: The deep learning model predicted outcome in all trials with a higher performance than IPI and better survival curve separation. This model can predict treatment outcome in diffuse large B-cell lymphoma without tumor delineation but at the cost of a lower prognostic performance than with radiomics., (© 2024 by the Society of Nuclear Medicine and Molecular Imaging.)- Published
- 2024
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6. Volumetric and textural analysis of PET/CT in patients with diffuse large B-cell lymphoma highlights the importance of novel MTVrate feature.
- Author
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Czibor S, Csatlós Z, Fábián K, Piroska M, and Györke T
- Abstract
Objectives: To investigate the prognostic value of clinical, volumetric, and radiomics-based textural parameters in baseline [18F]FDG-PET/CT scans of diffuse large B-cell lymphoma (DLBCL) patients., Methods: We retrospectively investigated baseline PET/CT scans and collected clinical data of fifty DLBCL patients. PET images were segmented semiautomatically to determine metabolic tumor volume (MTV), then the largest segmented lymphoma volume of interest (VOI) was used to extract first-, second-, and high-order textural features. A novel value, MTVrate was introduced as the quotient of the largest lesion's volume and total body MTV. Receiver operating characteristics (ROC) analyses were performed and 24-months progression-free survival (PFS) of low- and high-risk cohorts were compared by log-rank analyses. A machine learning algorithm was used to build a prognostic model from the available clinical, volumetric, and textural data based on logistic regression., Results: The area-under-the-curve (AUC) on ROC analysis was the highest of MTVrate at 0.74, followed by lactate-dehydrogenase, MTV, and skewness, with AUCs of 0.68, 0.63, and 0.55, respectively which parameters were also able to differentiate the PFS. A combined survival analysis including MTV and MTVrate identified a subgroup with particularly low PFS at 38%. In the machine learning-based model had an AUC of 0.83 and the highest relative importance was attributed to three textural features and both MTV and MTVrate as important predictors of PFS., Conclusion: Individual evaluation of different biomarkers yielded only limited prognostic data, whereas a machine learning-based combined analysis had higher effectivity. MTVrate had the highest prognostic ability on individual analysis and, combined with MTV, it identified a patient group with particularly poor prognosis., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2024
- Full Text
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7. Radioembolization Planning With Dual-Isotope Acquisition of 166 Ho-Labeled Microparticles and 99m Tc-Mebrofenin.
- Author
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Czibor S, Bibok A, Horváthy D, Fábián K, and Györke T
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- Male, Humans, Aged, Tomography, Emission-Computed, Single-Photon methods, Yttrium Radioisotopes therapeutic use, Isotopes, Liver Neoplasms diagnostic imaging, Liver Neoplasms radiotherapy, Liver Neoplasms drug therapy, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular radiotherapy, Carcinoma, Hepatocellular drug therapy, Embolization, Therapeutic
- Abstract
Abstract: A 76-year-old man with hepatocellular carcinoma was referred for liver radioembolization. Given a prior left hemihepatectomy, it was clinically important to consider potentially irradiated healthy liver at planning. Thus, at the SPECT/CT imaging of the scout dose 166 Ho-microparticles before injected superselectively in the right hepatic artery, 99m Tc-mebrofenin was injected intravenously, and functional volumetry SPECT was performed simultaneously. Based on the 2 image sets, the nonirradiated healthy liver was calculated as 1589 mL (functional liver reserve of 85.5% on 99m Tc-mebrofenin SPECT). Posttreatment dosimetry calculations showed optimal normal tissue and tumor absorbed doses, and the patient is clinically well after 3 months., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2023
- Full Text
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8. Preliminary study on individual radiation dose received by medical staff for dose constraint determination.
- Author
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Milecz-Mitykó R, Bérczi V, Czibor S, Bánsághi Z, Taba G, Kári B, and Györke T
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- Humans, Extremities, Hospitals, Radiation Dosage, Medical Staff, Lens, Crystalline
- Abstract
The staff of the Radiation Protection Service of a European clinical center measured the radiation dose by type-tested thermoluminescent dosemeter systems to which the medical staff was exposed, to assess the effectiveness of current procedures and equipment for optimalisation prompted by the requirements EU Basic Safety Standard 2013. There were three participating sites, the Site 1 was an external hospital, whereas Sites 2 and 3 are part of the same clinical center, who provided data regarding their personnel, from technologists, nurses and medical doctors. In this preliminary study, only a low number of cases were available and used to establish a new, more realistic yearly dose constraint, namely 6 (from two) mSv for whole-body effective dose, 15 (from two) mSv for eye lens dose and 300 (from 50) mSv for extremity dose. Furthermore, the state of safety culture and protection equipment was assessed. Collection of the sufficient amount of data for statistical evaluation is ongoing., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Published
- 2023
- Full Text
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9. Prognostic parameters on baseline and interim [ 18 F]FDG-PET/computed tomography in diffuse large B-cell lymphoma patients.
- Author
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Czibor S, Carr R, Redondo F, Auewarakul CU, Cerci JJ, Paez D, Fanti S, and Györke T
- Subjects
- Humans, Female, Middle Aged, Prognosis, Positron Emission Tomography Computed Tomography, Tomography, X-Ray Computed, Body Weight, Retrospective Studies, Tumor Burden, Fluorodeoxyglucose F18, Lymphoma, Large B-Cell, Diffuse diagnostic imaging
- Abstract
Objective: 2-[ 18 F]fluoro-2-deoxy- d -glucose PET/computed tomography ([ 18 F]FDG-PET/CT) is a widely used imaging method in the management of diffuse large B-cell lymphomas (DLBCL). Our aim was to investigate the prognostic performance of different PET biomarkers in a multicenter setting., Methods: We investigated baseline volumetric values [metabolic tumor volume (MTV) and total lesion glycolysis (TLG), also normalized for body weight] segmented with three different methods [>SUV4 (glob4); 41% isocontour (41pc), and a gradient-based lesion growing algorithm (grad)] and interim parameters [Deauville score, maximal standardized uptake value (ΔSUVmax), modified qPET, and ratio PET (rPET)] alongside clinical parameters (stage, revised International Prognostic Index), using 24-month progression-free survival as the clinical endpoint. Receiver operating characteristics analyses were performed to define optimal cutoff points for the continuous PET parameters., Results: A total of 107 diffuse large B-cell lymphoma patients were included (54 women; mean age: 53.7 years). MTV and TLG calculations showed good correlation among glob4, 41pc, and grad methods; however, optimal cutoff points were markedly different.Significantly different PFS was observed between low- and high-risk groups according to baseline MTV, body weight-adjusted (bwa) MTV, TLG, bwaTLG, as well as interim parameters Deauville score, ΔSUVmax, mqPET, and rPET. Univariate Cox regression analyses showed hazard ratios (HRs) lowest for bwaMTVglob4 (HR = 2.3) and highest for rPET (HR = 9.09). In a multivariate Cox-regression model, rPET was shown to be an independent predictor of PFS ( P = 0.041; HR = 9.15). Combined analysis showed that ΔSUVmax positive patients with high MTV formed a group with distinctly poor PFS (35.3%)., Conclusion: Baseline MTV and TLG values and optimal cutoff points achieved with different segmentation methods varied markedly and showed a limited prognostic impact. Interim PET/CT parameters provided more accurate prognostic information with semiquantitative 'Deauville-like' parameters performing best in the present study., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2023
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10. Oncologic patient with COVID-19 discovered incidentally by PET/CT examination: (A COVID–19-pandémia orvosszakmai kérdései)
- Author
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Czibor S, Kristóf E, Kecskés K, Barra M, Szántó P, Maurovich-Horvat P, and Györke T
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- Aged, COVID-19, Coronavirus Infections epidemiology, Humans, Pandemics, Pneumonia, Viral epidemiology, Positron Emission Tomography Computed Tomography, Coronavirus Infections diagnostic imaging, Incidental Findings, Neoplasms therapy, Pneumonia, Viral diagnostic imaging
- Abstract
The scientific literature of coronavirus-disease 2019 (COVID-19) is rapidly expanding. There is a growing evidence on the discrepancy between clinical symptoms and radiologic findings in many patients. This case report gives details about a patient with only mild symptoms but relatively severe radiological findings. The 75-year-old patient suffering from oncologic disease had a planned a F18-fluoro-deoxy-glucose positron-emission tomography/computer tomography scan with a routine oncological indication where incidental radiomorphologic findings of pneumonia suspect for COVID-19 were detected. After immediate isolation, the patient was transferred to the corresponding medical department, where further investigations verified the diagnosis of COVID-19. With this case, our aim is to raise the awareness for the importance of the instant evaluation of chest computer tomography series when performing planned imaging examination, especially in frail patients. With this practice, potential radiomorphologic findings of pneumonia suspect for COVID-19 could be identified in time, which fundamentally determines further patient management steps. Orv Hetil. 2020; 161(23): 971-976.
- Published
- 2020
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11. Coexistence of aortic valve stenosis and cardiac amyloidosis: echocardiographic and clinical significance.
- Author
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Peskó G, Jenei Z, Varga G, Apor A, Vágó H, Czibor S, Prohászka Z, Masszi T, and Pozsonyi Z
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- Aged, Echocardiography, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Retrospective Studies, Amyloidosis diagnostic imaging, Aortic Valve Stenosis diagnostic imaging, Cardiomyopathies diagnostic imaging
- Abstract
Background: Left ventricular hypertrophy and diastolic dysfunction are common echocardiographic features of both aortic valve stenosis (AS) and cardiac amyloidosis (CA). These two different entities therefore may mask each other. From recent years, there is a growing body of evidence about the relatively high incidence of wild-type transthyretin (wtTTR) amyloidosis in AS, but there are scarce data on the prevalence of AS in CA, particularly in AL-type amyloidosis. The echocardiographic approach to these patients is not obvious, and not evidence based. We aimed to study the prevalence, severity, and type of AS in patients with CA and also to evaluate the potential of echocardiography in the diagnostic process., Methods: Between January 2009 and January 2019, we retrospectively analyzed the clinical and echocardiographic data, and the echocardiographic work up of 55 consecutive CA patients., Results: 80% of our CA patients had AL amyloidosis. We identified 5 patients (9%) with moderate to severe AS: two with moderate AS and three with low-flow, low-grade AS (LFLG AS). Further analysis of the latter three patients with dobutamine stress echocardiography revealed pseudo-severe LFLG AS in two, and true-severe AS in one patient., Conclusion: The prevalence of moderate to severe AS is 9% in our population of CA patients, the majority of whom have AL amyloidosis. Dobutamine echocardiography seems to be appropriate for the further characterization of patients with LFLG AS, even with normal ejection fraction.
- Published
- 2019
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