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Introduction: Locally advanced carcinoma cervix (LACC) is a heterogeneous disease with variable combinations of primary tumour extensions with or without nodal involvement. Metabolic information from 18 fluro‐deoxyglucose positron emission tomography combined with contrast‐enhanced computerized tomography (FDG PET‐CT) may potentially augment treatment decision‐making for LACC. This study ascertained FDG‐PET CT influence on chemoradiation therapy (CTRT) decisions in LACC. We report oncologic and patient‐reported outcome measures (PROMs). Methods: FDG PET‐CT scans were reviewed independently by two nuclear medicine specialists and two radiation oncologists. Pelvic CTRT plan digressions were documented and therapy was adapted accordingly. Pelvis radiation (50 Gy/25#/5 weeks) using tomotherapy with weekly cisplatin was used in node‐negative disease. Dose‐escalated simultaneous integrated boost (SIB) 60 Gy/25#/5 weeks was delivered to involved pelvic nodes. All received brachytherapy. Post‐treatment PET‐CT scans were at 6 months. Functional assessment of cancer therapy scores were calculated at baseline, treatment completion, 3 months, 1 year and 3 years. Results: Between November 2015 and January 2018, 85 patients were screened, and 77 consented. Extrapelvic disease was seen in 12 (16%) patients (9 para‐aortic nodes, 2 distant metastases and 1 synchronous carcinoma breast); 60 patients were included in the final analysis. Decision changes were seen in 10/77 (13%) screened, 8/60 (13%) included and 32 (53.3%) received SIB. Post‐treatment, 27 (45%) had grade 2 GI/GU/GYN toxicity, one (2%) had grade 3 GI and five (8.3%) had grade 3 neutropenia. At median follow‐up of 54.2 months (95% CI 52.8–58.3), 5‐year local failure, pelvic nodal and para‐aortic nodal‐free survival were 86.8% (95% CI 78.0–96.6), 85.2% (95% CI 76.1–95.3) and 85.2% (95% CI 76.2–95.4). Functional assessment of cancer therapy trial outcome index (FACT TOI) improved by 10.43 at 3 months with no further decline. Grade 3 toxicity was noted for abdominal pain in one (1.7%), cystitis in four (6.7%) and lymphoedema in one (1.7%) at 5 years. Conclusion: PET‐CT resulted in major decision changes in 13%. PET‐adapted CTRT was associated with acceptable toxicity, encouraging long‐term survival and improvement in PROMS. [ABSTRACT FROM AUTHOR]

The objective of present study is to assess the role of the [18Fluorine] 2-Fluoro-2-Deoxy-D-Glucose Positron-Emission-Tomography Computed-Tomography (18F-FDG PET/CT) scan to detect the bone marrow involvement, predict disease free interval (DFI) and histopathological Transformation (HT) in Follicular Lymphoma (FL). Sixty patients were evaluated. Staging 18F-FDG PET/CT scan showed poor sensitivity for bone marrow involvement. Thus, staging 18F-FDG PET/CT cannot replace initial bone marrow biopsy in FL. Maximum standardized uptake value (SUVmax) of lymphomatous lesions in staging 18F-FDG PET/CT scan has no correlation with DFI and HT. Treatment response based on 5-point Deauville Score (5PDS) of interim 18F-FDG PET/CT scan is significantly associated with DFI. Interim 18F-FDG PET/CT scan plays an important role in deciding treatment modification in FL to prevent future recurrence. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to evaluate the role of 18F-2-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) scan in the detection of axillary lymph node (ALN) involvement and comparison with sentinel lymph node biopsy (SLNB) in operable early-stage breast cancer (EBC). Settings and Design: It is a retrospective analysis of staging PET-CT scan of EBC. Methods: A total of 128 patients with histopathologically proven breast cancer (BC) were included in the study. Preoperative mammography supplemented with ultrasonography and staging 18F-FDG PET-CT scan was done for all patients. Surgery was done within 30 (mean ± standard deviation = 13.8 ± 10.5) days of staging. SLNB was performed in patients without PET-positive ALNs. All patients with positive sentinel nodes and PET-positive ALNs underwent axillary lymph node dissection (ALND). Statistical Analysis Used: The comparison between categorical variables was made by Chi-square/Fisher's exact test as applicable. For continuous variables comparisons, Student's t-test and one-way analysis of variance tests were used. Results: Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PET-CT scan for detection of ALN involvement were 41.7%, 93.2%, 92.1%, and 45.6%, respectively. Sensitivity, specificity, PPV, and NPV of mammography were 84.5%, 54.5%, 78.0%, and 68.6%, respectively. Sixteen out of 46 (34.7%) patients with negative ALNs in PET-CT scan finally showed involvement in histopathology report after SLNB resulting in upstage of the disease. The size of tumor deposits in sentinel nodes was significantly smaller than PET-positive ALNs (P = 0.01). Our observations correlate with the results of earlier studies published in the literature. Conclusions: 18F-FDG PET-CT scan cannot substitute SLNB for ALN screening in EBC. The limitations are most marked in smaller and micrometastatic tumor deposits in ALNs and may be attributed to limitations of PET resolution. However, PET-positive nodes showed good specificity for disease involvement in our study. Therefore, ALND can safely be performed by omitting SLNB in such cases. [ABSTRACT FROM AUTHOR]

Byline: Prateek. Jain, Rajeev. Sharan, Kapila. Manikantan, Gautam. Biswas, Soumendranath. Ray, Pattatheyil. Arun BACKGROUND: Papillary carcinoma of thyroid (PTC) is usually indolent with good prognosis and excellent long-term survival. However, [...]

Objective: This retrospective study aimed to investigate whether metabolic parameters of primary tumour i.e. maximum standardized uptake value (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) predict overall survival (OS) in patients with advanced stage nonsmall cell lung cancer (NSCLC). Materials and Methods: SUVmax, MTV and TLG of the primary tumors were measured in staging 18F-Fluorodeoxyglucose Positron emission tomography-Computed tomography (18F-FDG PET/CT) scan of 97 NSCLC patients by gradient based tumour segmentation method. Prognostic ability was assessed for overall survival (OS) of the patients. Result: The median follow-up period of the study was 15.84 months (range 1.3 to 47.97 months).The estimated median OS was 11.29 months (range 1.37 to 38.63 months). Total of 40 (41.24%) patients had progressive disease and 21 (21.65%) patients died during the follow up period. Receiver Operating Characteristic (ROC) analysis showed that the area under the curve (AUC) for MTV was significant (area = 0.652 ± 0.065; 95% CI = 0.548 -- 0.746; P = 0.020). Kaplan-Meier survival curves showed that the OS differences between the groups of patients who were dichotomized by the median value of MTV (38.76 ml, P = 0.0150) and TLG (301.69 ml, P = 0.0046) were significant. MTV (hazard ratio = 4.524; 95% CI = 1.244 -- 16.451; P = 0.022) was found to be an independent prognostic factor for OS in multivariate analysis. Conclusion: MTV of the primary tumor is a potential prognostic parameter for OS in our population of advanced NSCLC patients independent of other risk factors. [ABSTRACT FROM AUTHOR]

Intraluminal portal venous tumor thrombus is an infrequent association with primary gastric malignancy. Ultrasonography features such as low pulsatile flow within the thrombus, expansion of vein, and enhancement of thrombus are nonspecific findings for diagnosis. 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan can differentiate between the benign and malignant thrombus as well as it helps proper metastatic work up. We report such a case. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to evaluate the role of 18 F-2-fluoro-2-deoxy-D-glucose ( 18 F-FDG) positron emission tomography-computed tomography (PET-CT) scan in the detection of axillary lymph node (ALN) involvement and comparison with sentinel lymph node biopsy (SLNB) in operable early-stage breast cancer (EBC)., Settings and Design: It is a retrospective analysis of staging PET-CT scan of EBC., Methods: A total of 128 patients with histopathologically proven breast cancer (BC) were included in the study. Preoperative mammography supplemented with ultrasonography and staging 18 F-FDG PET-CT scan was done for all patients. Surgery was done within 30 (mean ± standard deviation = 13.8 ± 10.5) days of staging. SLNB was performed in patients without PET-positive ALNs. All patients with positive sentinel nodes and PET-positive ALNs underwent axillary lymph node dissection (ALND)., Statistical Analysis Used: The comparison between categorical variables was made by Chi-square/Fisher's exact test as applicable. For continuous variables comparisons, Student's t -test and one-way analysis of variance tests were used., Results: Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PET-CT scan for detection of ALN involvement were 41.7%, 93.2%, 92.1%, and 45.6%, respectively. Sensitivity, specificity, PPV, and NPV of mammography were 84.5%, 54.5%, 78.0%, and 68.6%, respectively. Sixteen out of 46 (34.7%) patients with negative ALNs in PET-CT scan finally showed involvement in histopathology report after SLNB resulting in upstage of the disease. The size of tumor deposits in sentinel nodes was significantly smaller than PET-positive ALNs ( P = 0.01). Our observations correlate with the results of earlier studies published in the literature., Conclusions: 18 F-FDG PET-CT scan cannot substitute SLNB for ALN screening in EBC. The limitations are most marked in smaller and micrometastatic tumor deposits in ALNs and may be attributed to limitations of PET resolution. However, PET-positive nodes showed good specificity for disease involvement in our study. Therefore, ALND can safely be performed by omitting SLNB in such cases., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Nuclear Medicine.)

Objective: This retrospective study aimed to investigate whether metabolic parameters of primary tumour i.e. maximum standardized uptake value (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) predict overall survival (OS) in patients with advanced stage non-small cell lung cancer (NSCLC)., Materials and Methods: SUVmax, MTV and TLG of the primary tumors were measured in staging 18 F-Fluorodeoxyglucose Positron emission tomography- Computed tomography ( 18 F-FDG PET/CT) scan of 97 NSCLC patients by gradient based tumour segmentation method. Prognostic ability was assessed for overall survival (OS) of the patients., Result: The median follow-up period of the study was 15.84 months (range 1.3 to 47.97 months).The estimated median OS was 11.29 months (range 1.37 to 38.63 months). Total of 40 (41.24%) patients had progressive disease and 21 (21.65%) patients died during the follow up period. Receiver Operating Characteristic (ROC) analysis showed that the area under the curve (AUC) for MTV was significant (area = 0.652 ± 0.065; 95% CI = 0.548 - 0.746; P = 0.020). Kaplan-Meier survival curves showed that the OS differences between the groups of patients who were dichotomized by the median value of MTV (38.76 ml, P = 0.0150) and TLG (301.69 ml, P = 0.0046) were significant. MTV (hazard ratio = 4.524; 95% CI = 1.244 - 16.451; P = 0.022) was found to be an independent prognostic factor for OS in multivariate analysis., Conclusion: MTV of the primary tumor is a potential prognostic parameter for OS in our population of advanced NSCLC patients independent of other risk factors., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Journal of Nuclear Medicine.)