Qiufang Liu

The Role of 18F-FDG PET/CT and MRI in Assessing Pathological Complete Response to Neoadjuvant Chemotherapy in Patients with Breast Cancer: A Systematic Review and Meta-Analysis

Purpose. We performed this meta-analysis to determine the utilities of 18F-FDG PET/CT and MRI in assessing the pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in the same cohort of patients with breast cancer. Methods. Two reviewers systematically searched on PubMed, Scopus, and Springer (from the beginning of 1992 to Aug. 1, 2015) for the eligible articles. Heterogeneity, pooled sensitivity and specificity, positive likelihood ratio, negative likelihood ratio, and the summary receiver operating characteristic (SROC) curve were calculated to estimate the diagnostic efficacy of 18F-FDG PET/CT and MRI. Results. A total of 6 studies including 382 pathologically confirmed patients were eligible. The pooled sensitivity and specificity of 18F-FDG PET/CT were 0.86 (95% CI: 0.76–0.93) and 0.72 (95% CI: 0.49–0.87), respectively. Pooled sensitivity and specificity of MRI were 0.65 (95% CI: 0.45–0.80) and 0.88 (95% CI: 0.75–0.95), respectively. The area under the SROC curve of 18F-FDG PET/CT and MRI was 0.88 and 0.84, respectively. Conclusion. Study indicated that 18F-FDG PET/CT had a higher sensitivity and MRI had a higher specificity in assessing pCR in breast cancer patients. Therefore, the combined use of these two imaging modalities may have great potential to improve the diagnostic performance in assessing pCR after NAC.

131I-Labeled Copper Sulfide-Loaded Microspheres to Treat Hepatic Tumors via Hepatic Artery Embolization

Purpose: Transcatheter hepatic artery embolization therapy is a minimally invasive alternative for treating inoperable liver cancer but recurrence is frequent. Multifunctional agents, however, offer an opportunity for tumor eradication. In this study, we were aim to synthesized poly (lactic-co-glycolic acid) (PLGA) microspheres encapsulating hollow CuS nanoparticles (HCuSNPs) and paclitaxel (PTX) that were then labeled with radioiodine-131 (131I) to produce 131I-HCuSNPs-MS-PTX. This compound combines the multi-theranostic properties of chemotherapy, radiotherapy and photothermal therapy. In addition, it can also be imaged with single photon emission computed tomography (SPECT) imaging and photoacoustic imaging. Methods: We investigated the value of therapeutic and imaging of 131I-HCuSNPs-MS-PTX in rats bearing Walker-256 tumor transplanted in the liver. After the intra-arterial (IA) injection of 131I-HCuSNPs-MS-PTX, 18F-Fluorodeoxyglucose (18F-FDG) micro-positron emission tomography/computed tomography (micro-PET/CT) imaging was used to monitor the therapeutic effect. PET/CT findings were verified by immunohistochemical analysis. SPECT/CT and photoacoustic imaging were performed to demonstrate the distribution of 131I-HCuSNPs-MS-PTX in vivo. Results: We found that embolization therapy in combination with chemotherapy, radiotherapy and photothermal therapy offered by 131I-HCuSNPs-MS-PTX completely ablated the transplanted hepatic tumors at a relatively low dose. In comparison, embolization monotherapy or combination with one or two other therapies had less effective anti-tumor efficacy. The combination of SPECT/CT and photoacoustic imaging effectively confirmed microsphere delivery to the targeted tumors in vivo and guided the near-infrared laser irradiation. Conclusion: Our study suggests that there is a clinical theranostic potential for imaging-guided arterial embolization with 131I-HCuSNPs-MS-PTX for the treatment of liver tumors.

The role of fluorine-18 fluorodeoxyglucose PET in prognosis evaluation for stem cell transplantation of lymphoma: a systematic review and meta-analysis.

The role of fluorine-18 fluorodeoxyglucose PET (18F-FDG PET) in prognostic evaluation of pre-stem cell transplantation (SCT) and post-SCT is still uncertain. A systematic review and meta-analysis were carried out to detect the prognostic power of 18F-FDG PET. ‘PubMed’, EMBASE, and Springer were searched for relevant articles. Subgroup analysis was carried out to evaluate the 18F-FDG PET in predicting the prognosis between Hodgkin lymphoma (HL) and non-Hodgkin lymphoma. Finally, 17 studies that included 1192 patients were eligible, 16 studies for progression-free survival (PFS) and 12 studies for overall survival (OS). For the pre-SCT PET or PET/computed tomography scan, the combined hazard ratios (HRs) of PET for PFS and OS were 2.32 and 2.64, respectively. Subgroup analysis showed that the HRs of PFS for HL and non-Hodgkin lymphoma were 3.28 and 2.00, respectively. For the post-SCT PET scan, the combined HR for PFS was 4.61. The sensitivity analysis showed that exlcusion of any single study had no significant effect on HR. We found that 18F-FDG PET was especially effective in predicting pre-STC and post-STC prognosis. The patients with a negative PET scan had a better prognosis compared with those with a positive scan in PFS and OS. In the subgroup analysis, 18F-FDG PET had a higher value in predicting prognosis before SCT for HL patients.

131I Therapy in Patients with Differentiated Thyroid Cancer: Study of External Dose Rate Attenuation Law and Individualized Patient Management

BACKGROUND Therapy with radioactive iodine (131I) is a well established treatment method for postsurgical differentiated thyroid carcinoma (DTC). A fixed discharge time is generally set, regardless of individual differences in residual body radioactivity (RBA). This study aimed to investigate the RBA of each patient to find the attenuation law and to identify underlying factors in order to predict the time point for a safe, scientifically sound discharge plan. METHODS A total of 231 DTC patients undergoing 131I treatment were all treated with 3.7 GBq (100 mCi) of 131I. RBA was estimated by measuring the external body dose rate (EDR) at a distance of 1 m from the body surface between 0 and 72 hours after oral administration of 131I. Data from each patient were used to establish a time-EDR value (h-μSv/h) curve. Software was developed to predict the time when a patients dose equivalent meets the national safety standard by including six time points between 40 and 60 hours. Several factors that might affect that time were analyzed. RESULTS The EDR attenuation law in patients could be described with a double exponential decay model, and the cutoff value was set as 23.3 μSv/h, upon which the predictive software was developed. Students t-test showed there was no statistical difference between predicted values and the actual measured values (p > 0.05). Correlation analysis found that serum thyroglobulin, total triiodothyronine, total thyroxine, free triiodothyronine, free thyroxine, thyrotropin, 2- and 24-hour iodine uptake rate of the thyroid, scores of 99mTc-pertechnetate thyroid scan, scores of 131I whole-body scan, scores of ultrasound scan, and gastrointestinal residues were associated with attenuation speed. A further multiple linear regression analysis found that 24-hour iodine uptake (X1), residual thyroid grading by 131I whole-body scan (X2), blood free triiodothyronine (X3) and free thyroxine (X4) predominantly influenced the decline of the EDR. The regression equation was Ŷ = 2.091X1 + 6.370X2 + 4.529X3 + 2.466X4 - 8.614 (F = 44.03, p < 0.01). CONCLUSIONS An effective and convenient method was created to measure and predict the individual safety time for discharge. This could play a significant role not only for scientific hospital discharge planning, rational use of medical resources, and better individualized management, but also in public radiation protection.

The combined therapeutic effects of 131 iodine-labeled multifunctional copper sulfide-loaded microspheres in treating breast cancer

Compared to conventional cancer treatment, combination therapy based on well-designed nanoscale platforms may offer an opportunity to eliminate tumors and reduce recurrence and metastasis. In this study, we prepared multifunctional microspheres loading 131I-labeled hollow copper sulfide nanoparticles and paclitaxel (131I-HCuSNPs-MS-PTX) for imaging and therapeutics of W256/B breast tumors in rats. 18F-fluordeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging detected that the expansion of the tumor volume was delayed (P<0.05) following intra-tumoral (i.t.) injection with 131I-HCuSNPs-MS-PTX plus near-infrared (NIR) irradiation. The immunohistochemical analysis further confirmed the anti-tumor effect. The single photon emission computed tomography (SPECT)/photoacoustic imaging mediated by 131I-HCuSNPs-MS-PTX demonstrated that microspheres were mainly distributed in the tumors with a relatively low distribution in other organs. Our results revealed that 131I-HCuSNPs-MS-PTX offered combined photothermal, chemo- and radio-therapies, eliminating tumors at a relatively low dose, as well as allowing SPECT/CT and photoacoustic imaging monitoring of distribution of the injected agents non-invasively. The copper sulfide-loaded microspheres, 131I-HCuSNPs-MS-PTX, can serve as a versatile theranostic agent in an orthotopic breast cancer model.

Giant Solitary Fibrous Tumor of Posterior Mediastinum: A Case Report

A 54-year-old male was taken to a hospital after experiencing persistent back pain for a month. A spinal column MRI showed a mass in T5-T8 fanterior edge. After four months follow-up, another MRI revealed the mass had grown up to the site of T3-T9. An 18F-FDG PET/CT imaging was underwent and the imaging showed three tumors mass which all had a high uptake of 18F-FDG locating in thorax, abdomen and pelvis, respectively. The thoracoscopic biopsy histological revealed the mass was mesenchymal tumor and immunohistochemistry showed positive for CD34 and CD39, that all proved the mass is solitary fibrous tumor.