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Background and Objectives 18F-fluorodeoxyglucose PET/CT scans can be a useful method to detect recurrence. However, its role in locally advanced head and neck squamous cell carcinomas (HNSCCs) patients after definitive chemoradiotherapy (CRT) has not yet been determined. The current study was performed to identify the role of therapeutic response evaluation using PET/CT after definitive CRT.Subjects and Method We conducted a retrospective review of patients with locally advanced HNSCCs, and who have undergone definitive CRT from 2009 to 2017 at a single institution. The patients were divided into two groups according to their responses to the treatment (metabolic complete remission [mCR] group or non-mCR group), assessed by PET/CT scans after definitive CRT.Results Twenty-eight patients were consecutively enrolled. The most common primary site of cancer was the oropharynx, followed by the oral cavity, hypopharynx, and nasal cavity. The therapeutic response assessed by PET/CT scans was mCR in 14 patients. The median progression- free survival (PFS) was not reached in the mCR group but was 13.3 months for the non-mCR group (p=0.001). The median overall survival was significantly longer for the mCR group (52.5 months) than for the non-mCR group (15.2 months, p=0.002). A multivariate analysis showed PET/CT response and high-sensitivity C-reactive protein (hsCRP) as independent prognostic factors for PFS (mCR: p=0.027; hsCRP: p=0.042) and for the overall survival (mCR: p=0.006; hsCRP: p=0.020).Conclusion PET/CT scans after definitive CRT predicted the prognosis in patients with locally advanced HNSCCs. CRP was a prognostic factor affecting the outcomes of treatments.

The purpose of the current study was to evaluate the diagnostic accuracies of 18 F-FDG PET or PET/CT for diagnosis of Merkel cell carcinoma (MCC) through a systematic review and meta-analysis.The PubMed, Cochrane database, and EMBASE database, from January 1990 to January 31, 2022, were searched for studies evaluating diagnostic performance of 18 F-FDG PET or PET/CT for MCC. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic curves.Across 9 studies (259 patients), the pooled sensitivity of 18 F-FDG PET or PET/CT was 0.91 (95% confidence interval [CI], 0.85-0.95) and a pooled specificity of 0.93 (95% CI, 0.86-0.97). Likelihood ratio syntheses gave an overall LR+ of 14.0 (95% CI, 6.6-29.6) and LR- of 0.09 (95% CI, 0.05-0.17). The pooled diagnostic odds ratio was 153 (95% CI, 57-416).18 F-FDG PET/CT showed an excellent performance for diagnosis of MCC. The likelihood ratio scattergram indicated that 18 F-FDG PET or PET/CT is useful for exclusion and confirmation of MCC. Further large multicenter studies would be necessary to substantiate the diagnostic accuracy of 18 F-FDG PET or PET/CT for MCC patients.

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.

The aims of this study are to compare the performance of various preoperative imaging modalities for assessing the malignant potential of pancreatic cystic lesions (PCLs) through a network meta-analysis (NMA) and to clarify the role of 18 F-FDG PET in the management of patients with PCL.PubMed, EMBASE, and Cochrane Library were searched for the studies evaluating the performance of preoperative imaging modalities for identifying malignant PCLs. The NMA was performed for 4 representative categories of various imaging modalities in terms of diagnostic performance for differentiating malignant from benign PCL and intraductal papillary mucinous neoplasms only as a subgroup analysis. To calculate the probability of each imaging modality being the most effective diagnostic method, the surface under the cumulative ranking curve values were obtained.A total of 1018 patients from 17 direct comparison studies using 2 or more preoperative imaging modalities were included for differentiating malignant from benign PCL. The positive predictive value (PPV) and accuracy of 18 F-FDG PET were significantly higher than that of CT (PPV: odds ratio [OR], 2.66; 95% credible interval [CrI], 1.21-6.17; accuracy: OR, 2.63; 95% CrI, 1.41-5.38) or MRI (PPV: OR, 2.50; 95% CrI, 1.09-6.26; accuracy: OR, 2.50; 95% CrI, 1.28-5.47) in all PCLs, as well as in the subgroup analysis for intraductal papillary mucinous neoplasm only. 18 F-FDG PET showed the highest surface under the cumulative ranking curve values in all diagnostic performance areas of sensitivity, specificity, PPV, negative predictive value, and accuracy, followed by MRI or CT.The results from this NMA suggest that 18 F-FDG PET is the best preoperative imaging modality for differentiating malignant from benign PCLs and that it can be used for the preoperative evaluation of PCLs.

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 present systematic review and meta-analysis compared the diagnostic performance of F-18 fludeoxyglucose positron emission tomography (18F-FDG PET) and conventional imaging, including MRI, echocardiography, and CT, in characterising cardiac masses. Methods: A literature search of the PubMed, Cochrane, and EMBASE databases for studies comparing the diagnostic accuracies of 18F-FDG PET and conventional imaging in characterising cardiac masses, from inception of indexing to 31 July 2020, was performed. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess study quality. Sensitivity and specificity across the studies were determined, positive and negative likelihood ratios (LR+ and LR-, respectively) were calculated, and summary receiver operating characteristic curves were constructed. Results: Of six included studies (n = 212 patients), 18F-FDG PET demonstrated a pooled sensitivity of 0.89 (95% confidence interval [CI] 0.81–0.94) and a pooled specificity of 0.89 (95% CI 0.80–0.94). LR syntheses yielded an overall LR+ of 7.9 (95% CI 4.3–14.6) and LR- of 0.12 (95% CI 0.07–0.22). The calculated pooled diagnostic odds ratio (DOR) was 64 (95% CI 23–181). For conventional imaging, the pooled sensitivity was 0.70 (95% CI 0.57–0.81) and the pooled specificity was 0.96 (95% CI 0.88–0.98). LR syntheses yielded an overall LR+ of 16.1 (95% CI 5.8–44.5) and LR- of 0.31 (95% CI 0.21–0.46). The evaluated pooled DOR was 52 (95% CI 17–155). Conclusion: 18F-FDG PET and conventional imaging demonstrated comparable diagnostic accuracies for the characterisation of cardiac masses. Further large multicentre studies are, however, required to corroborate the diagnostic performances of 18F-FDG PET and conventional imaging for the characterisation of cardiac masses. Advances in knowledge: No previous studies have comprehensively analysed the diagnostic performance of 18F-FDG PET/CT compared with conventional imaging techniques including echocardiography, CT, and MRI. According to the current study, 18F-FDG PET/CT yielded a pooled DOR of 64, whereas other conventional imaging techniques demonstrated a DOR of 52. As such, 18F-FDG PET/CT demonstrated sensitivity and specificity, with a high pooled DOR comparable with other conventional imaging modalities.

The purpose of this study was to evaluate the diagnostic accuracies of dual-time-point (DTP) 18F-FDG PET/CT for detection of mediastinal lymph node (LN) metastasis in non-small cell lung cancer (NSCLC) patients through a systematic review and meta-analysis.The PubMed, Cochrane database, and EMBASE database, from the earliest available date of indexing through October 31, 2021, were searched for studies evaluating diagnostic performance of DTP 18F-FDG PET/CT for detection of metastatic mediastinal LN in NSCLC 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.Ten studies (758 patients) were included in the current study. In patient-based analysis, early image showed a sensitivity of 0.76 and a specificity of 0.75. Delayed image revealed a sensitivity of 0.84 and a specificity of 0.71. In LN-based analysis, early image showed a sensitivity of 0.80 and a specificity of 0.83. Delayed image revealed a sensitivity of 0.84 and a specificity of 0.87. Retention index or %ΔSUVmax is superior to early or delayed images of DTP 18F-FDG PET/CT for detection of mediastinal LN metastasis.Dual-time-point 18F-FDG PET/CT showed a good diagnostic performances for detection of metastatic mediastinal LNs in NSCLC patients. Early and delayed images of DTP 18F-FDG PET/CT revealed similar diagnostic accuracies for LN metastasis. However, retention index or %ΔSUVmax is superior to early or delayed images of DTP 18F-FDG PET/CT for detection of mediastinal LN metastasis in NSCLC patients. Further large multicenter studies would be necessary to substantiate the diagnostic accuracy of DTP 18F-FDG PET/CT for mediastinal LN staging in NSCLC patients.

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.

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 ...

The purpose of the current study was to evaluate the diagnostic accuracies of 18F-FDG PET/CT for detection of lymph node (LN) metastasis in penile cancer (PeCA) patients through a systematic review and meta-analysis.The PubMed, Cochrane database, and Embase database, from the earliest available date of indexing through August 31, 2021, were searched for studies evaluating diagnostic performance of 18F-FDG PET/CT for detection of metastatic LN in PeCA patients. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-, respectively), and constructed summary receiver operating characteristic curves.Across 12 studies (479 patients), the pooled sensitivity of 18F-FDG PET/CT was 0.87 (95% confidence interval [CI], 0.79-0.92) and the pooled specificity was 0.88 (95% CI, 0.79-0.93). Likelihood ratio syntheses gave an overall LR+ of 7.2 (95% CI, 3.9-13.1) and LR- of 0.15 (95% CI, 0.1-0.24). The pooled diagnostic odds ratio was 47 (95% CI, 19-116). In meta-regression analysis, no variable was the source of the study heterogeneity.18F-FDG PET/CT showed a good diagnostic performances for detection of metastatic LN in PeCA patients. Also, 18F-FDG PET/CT revealed similar diagnostic accuracy for detection of inguinal and pelvic LN metastasis in PeCA patients.

The purpose of current study was to investigate the value of textural features used fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (Seventy two patients with pancreatic cancer who underwentThe SUVmax did not have prognostic values for RFS and OS. Median values of TLG and intratumoral heterogeneity parameter (kurtosis) were 63.95, and 3.15. High TLG and high kurtosis patients group showed shorter OS. Cox proportional hazards regression analysis revealed differentiation of the tumor, kurtosis and TLG were the significant predictive factors on OS. Besides, kurtosis presented no correlation with the conventional PET parameters, such as SUVmax, MTV and TLG.This study suggests that intratumoral heterogeneity and volumetric parameter induced by

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.