1909 Objectives The present standard protocols for performing hybrid positron emission tomography (PET) and computed tomography (CT) with 18F-fluoro-2-deoxyglucose (18F-FDG) call for data acquisition to start 50-60 min. post-injection (PI) of the radiopharmaceutical. However, this prolonged period of tracer incubation allows its accumulation in the urinary bladder making it difficult, if not impossible, to identify abnormal growths on the surface of this organ. Our objective was to identify bladder wall lesions using a novel PET/CT and 18F-FDG imaging protocol. This novel approach was inspired by the angiogenesis property observed in cancer cells and the delayed excretion of high activity concentration 18F-FDG in urinary bladder by the kidneys. Methods Early (starting at injection time) dynamic PET/CT and 18F-FDG scans were performed on 7 consecutive male patients with pathology confirmed bladder cancer. A series of 5 dynamic scans of 2 min. each, starting at injection time, were obtained on each patient’s bladder using a single bed-position. Areas of increased 18F-FDG blood flow, observed on bladder wall scans, were considered suspicious for cancer and compared to the final pathologic report. Results Five out of 7 patients’ scans displayed increased blood flow activity to bladder wall areas that were pathologically proven to be malignancies. The other 2 patients’ scans that failed to show increased blood flow activity to the bladder walls were classified, based on pathology reports, as true negative and false negative. The average maximum standard uptake values (SUVmax ± SD) observed in bladder wall areas with increased and normal blood flow were 2.7 ± 0.7 and 1.1 ± 1.3 g/mL, respectively. Conclusions Although the sample size of this study was relatively small and a larger population group is needed to confirm these findings, its results strongly suggest that this novel PET/CT and 18F-FDG bladder imaging approach could be the protocol of the future in bladder cancer evaluation

Early dynamic PET/CT and 18F-FDG blood flow imaging in bladder cancer detection: A novel approach

OBJECTIVE. This review article explores recent advancements in PET/MRI for clinical oncologic imaging. CONCLUSION. Radiologists should understand the technical considerations that have made PET/MRI feasible within clinical workflows, the role of PET tracers for imaging various molecular targets in oncology, and advantages of hybrid PET/MRI compared with PET/CT. To facilitate this understanding, we discuss clinical examples (including gliomas, breast cancer, bone metastases, prostate cancer, bladder cancer, gynecologic malignancy, and lymphoma) as well as future directions, challenges, and areas for continued technical optimization for PET/MRI.

/pdf/current-status-of-hybrid-pet-mri-in-oncologic-imaging-56b8e33qiv.pdf

Current Status of Hybrid PET/MRI in Oncologic Imaging

PurposeThe aim of this study was to conduct a prospective pilot study comparing the diagnostic performance of MRI alone and 18F-FDG simultaneous PET/MRI using a diuresis protocol in bladder cancer patients.MethodsTwenty-two bladder cancer patients underwent 18F-FDG PET/MRI, using intravenous furosem

/pdf/prospective-pilot-study-to-evaluate-the-incremental-value-of-8afccx78ui.pdf

Prospective Pilot Study to Evaluate the Incremental Value of PET Information in Patients With Bladder Cancer Undergoing 18F-FDG Simultaneous PET/MRI.

Purpose of review In this narrative review, we assessed the role of F-fluoro-2-deoxy-D-glucose-positron emission tomography/CT (FDG-PET/CT) in preoperative staging and response evaluation of neoadjuvant chemotherapy in muscle-invasive bladder carcinoma (MIBC), and to assess its incremental value to contrast-enhanced (CE)CT and MRI in terms of patient management at initial diagnosis and detection of recurrence. Recent findings A literature search in PubMed yielded 46 original reports, of which 15 compared FDG-PET/CT with CECT and one with MRI. For primary tumor assessment, FDG-PET/CT proved not accurate enough (13 reports; n = 7-70). For lymph node assessment, sensitivity of FDG-PET/CT is superior to CT with comparable specificity in 19 studies (n = 15-233). For detection of distant metastases, data from eight studies (n = 43-79) suggests that FDG-PET/CT is accurate, although comparative studies are lacking. Limited evidence (four studies, n = 19-50) suggests that FDG-PET/CT is not accurate for response evaluation of neoadjuvant chemotherapy. FDG-PET/CT incited change(s) in patient management in 18-68% of patients (five reports; n = 57-103). For detection of recurrence, seven studies (n = 29-287) indicated that FDG-PET/CT is accurate. Summary Most studies evaluated FDG-PET/CT for lymph node assessment and reported higher sensitivity than CT, with comparable specificity. FDG-PET/CT showed incremental value to CECT for recurrence and often incited change(s) in patient management.

18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in muscle-invasive bladder cancer

Elastofibroma dorsi: Clinical evaluation of 61 cases and review of the literature.

Characteristics of elastofibroma dorsi on PET/CT imaging with 18F-FDG

Due to the development of Artificial Intelligence (AI), Machine Learning (ML), and the improvement of medical imaging equipment, radiomics has become a popular research in recent years. Radiomics can obtain various quantitative features from medical images, highlighting the invisible image traits and significantly enhancing the ability of medical imaging identification and prediction. The literature indicates that radiomics has a high potential in identifying and predicting thyroid nodules. So in this article, we explain the development, definition, and workflow of radiomics. And then, we summarize the applications of various imaging techniques in identifying benign and malignant thyroid nodules, predicting invasiveness and metastasis of thyroid lymph nodes, forecasting the prognosis of thyroid malignancies, and some new advances in molecular level and deep learning. The shortcomings of this technique are also summarized, and future development prospects are provided.

/pdf/the-progress-of-radiomics-in-thyroid-nodules-re8lw4pp.pdf

The progress of radiomics in thyroid nodules

Feasible Method to enable clear visualization of suspected bladder cancer with 18F-FDG PET/CT

Objective To investigative the diagnostic performance of the morphological model, radiomics model, and combined model in differentiating invasive adenocarcinomas (IACs) from minimally invasive adenocarcinomas (MIAs). Methods This study retrospectively involved 307 patients who underwent chest computed tomography (CT) examination and presented as subsolid pulmonary nodules whose pathological findings were MIAs or IACs from January 2010 to May 2018. These patients were randomly assigned to training and validation groups in a ratio of 4:1 for 10 times. Eighteen categories of morphological features of pulmonary nodules including internal and surrounding structure were labeled. The following radiomics features are extracted: first-order features, shape-based features, gray-level co-occurrence matrix (GLCM) features, gray-level size zone matrix (GLSZM) features, gray-level run length matrix (GLRLM) features, and gray-level dependence matrix (GLDM) features. The chi-square test and F1 test selected morphology features, and LASSO selected radiomics features. Logistic regression was used to establish models. Receiver operating characteristic (ROC) curves evaluated the effectiveness, and Delong analysis compared ROC statistic difference among three models. Results In validation cohorts, areas under the curve (AUC) of the morphological model, radiomics model, and combined model of distinguishing MIAs from IACs were 0.88, 0.87, and 0.89; the sensitivity (SE) was 0.68, 0.81, and 0.83; and the specificity (SP) was 0.93, 0.79, and 0.87. There was no statistically significant difference in AUC between three models (p > 0.05). Conclusion The morphological model, radiomics model, and combined model all have a high efficiency in the differentiation between MIAs and IACs and have potential to provide non-invasive assistant information for clinical decision-making.

/pdf/comparison-of-comprehensive-morphological-and-radiomics-tlbawb6z.pdf

Comparison of Comprehensive Morphological and Radiomics Features of Subsolid Pulmonary Nodules to Distinguish Minimally Invasive Adenocarcinomas and Invasive Adenocarcinomas in CT Scan

Purpose To construct a superior single-sequence radiomics signature to assess lymphatic metastasis in patients with cervical cancer after neoadjuvant chemotherapy (NACT). Methods The first half of the study was retrospectively conducted in our hospital between October 2012 and December 2021. Based on the history of NACT before surgery, all pathologies were divided into the NACT and surgery groups. The incidence rate of lymphatic metastasis in the two groups was determined based on the results of pathological examination following lymphadenectomy. Patients from the primary and secondary centers who received NACT were enrolled for radiomics analysis in the second half of the study. The patient cohorts from the primary center were randomly divided into training and test cohorts at a ratio of 7:3. All patients underwent magnetic resonance imaging after NACT. Segmentation was performed on T1-weighted imaging (T1WI), T2-weighted imaging, contrast-enhanced T1WI (CET1WI), and diffusion-weighted imaging. Results The rate of lymphatic metastasis in the NACT group (33.2%) was significantly lower than that in the surgery group (58.7%, P=0.007). The area under the receiver operating characteristic curve values of Radscore_CET1WI for predicting lymph node metastasis and non-lymphatic metastasis were 0.800 and 0.797 in the training and test cohorts, respectively, exhibiting superior diagnostic performance. After combining the clinical variables, the tumor diameter on magnetic resonance imaging was incorporated into the Rad_clin model constructed using Radscore_CET1WI. The Hosmer–Lemeshow test of the Rad_clin model revealed no significant differences in the goodness of fit in the training (P=0.594) or test cohort (P=0.748). Conclusions The Radscore provided by CET1WI may achieve a higher diagnostic performance in predicting lymph node metastasis. Superior performance was observed with the Rad_clin model.

A nomogram-based optimized Radscore for preoperative prediction of lymph node metastasis in patients with cervical cancer after neoadjuvant chemotherapy

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