Cancer Research and Treatment

Original Articles

Hematologic malignancy

Assessment of Bone Marrow Involvement in Extranodal NK/T-Cell Lymphoma: Positron Emission Tomography versus Bone Marrow Biopsy, and the Significance of Minimal Involvement by EBV+ Cells (KROG 18-09): Tae Hoon Lee, Hyun Ju Kim, Jong Hoon Lee, Jeongshim Lee, Jin Hee Kim, Dongryul Oh, Keun-Yong Eom; Cancer Res Treat. 2024;56(2):688-696. Published online December 11, 2023; DOI: https://doi.org/10.4143/crt.2023.1049

Abstract PDF PubReader ePub: Purpose
This study aims to investigate the diagnostic significance of positron emission tomography/computed tomography (PET/CT) in assessing bone marrow (BM) involvement through a comparison of PET/CT findings with BM biopsy in extranodal natural killer/T-cell lymphoma.
Materials and Methods
The medical records of 193 patients were retrospectively reviewed. Patients were categorized as having early-stage (PET-ES) or advanced-stage (PET-AS) disease based on PET/CT results. The BM involvement was classified into three groups according to BM biopsy: gross BM involvement, minimal BM involvement (defined as the presence of a limited number of Epstein-Barr virus–positive cells in BM), and no involvement. Calculations of the accuracy of PET/CT in detecting BM involvement and analysis of the clinical outcomes (progression-free survival [PFS] and overall survival [OS]) according to the BM biopsy status were performed.
Results
PET/CT exhibited a sensitivity of 64.7% and a specificity of 96.0% in detecting gross BM involvement. For detecting any (both gross and minimal) BM involvement, the sensitivity was 30.4%, while the specificity was 99.0%. Only one patient (0.7%) demonstrated gross BM involvement among the PET-ES group. Survival outcomes of the PET-ES group with minimal BM involvement (3-year PFS, 55.6%; OS, 77.0%) were closer to those of the PET-ES group with no BM involvement (3-year PFS, 62.2%; OS, 80.6%) than to those of the PET-AS group (3-year PFS, 20.1%; OS, 29.9%).
Conclusion
PET/CT exhibits high specificity, but moderate and low sensitivity in detecting gross and minimal BM involvement, respectively. The clinical significance of minimal BM involvement for patients in the PET-ES group may be limited.

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Hematologic Malignancy

Baseline Total Metabolic Tumor Volume and Total Lesion Glycolysis Measured on ¹⁸F-FDG PET-CT Predict Outcomes in T-Cell Lymphoblastic Lymphoma: Xiaoyan Feng, Xin Wen, Ling Li, Zhenchang Sun, Xin Li, Lei Zhang, Jingjing Wu, Xiaorui Fu, Xinhua Wang, Hui Yu, Xinran Ma, Xudong Zhang, Xinli Xie, Xingmin Han, Mingzhi Zhang; Cancer Res Treat. 2021;53(3):837-846. Published online December 2, 2020; DOI: https://doi.org/10.4143/crt.2020.123

Abstract PDF Supplementary Material PubReader ePub

Purpose
There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL.
Materials and Methods
Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test.
Results
The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001).
Conclusion
Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.

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Metabolic parameters predict survival and toxicity in chimeric antigen receptor T‐cell therapy‐treated relapsed/refractory large B‐cell lymphoma
Hazim S. Ababneh, Andrea K. Ng, Jeremy S. Abramson, Jacob D. Soumerai, Ronald W. Takvorian, Matthew J. Frigault, Chirayu G. Patel
Hematological Oncology.2024;[Epub] CrossRef
Diagnosis of bone marrow involvement in angioimmunoblastic T-cell lymphoma should be based on both [ 18 F]FDG-PET/CT and bone marrow biopsy findings
Xinyu Liang, Chunli Yang, Minggang Su, Liqun Zou
Current Medical Research and Opinion.2024; 40(5): 803. CrossRef
The Role of Pre-therapeutic 18F-FDG PET/CT in Pediatric Hemophagocytic Lymphohistiocytosis With Epstein-Barr Virus Infection
Xia Lu, Ang Wei, Xu Yang, Jun Liu, Siqi Li, Ying Kan, Wei Wang, Tianyou Wang, Rui Zhang, Jigang Yang
Frontiers in Medicine.2022;[Epub] CrossRef
Prognostic Value of Heterogeneity Index Derived from Baseline 18F-FDG PET/CT in Mantle Cell Lymphoma
Fei Liu, Bingxin Gu, Nan Li, Herong Pan, Wen Chen, Ying Qiao, Shaoli Song, Xiaosheng Liu
Frontiers in Oncology.2022;[Epub] CrossRef
Staging and response assessment of lymphoma: a brief review of the Lugano classification and the role of FDG-PET/CT
Kwai Han Yoo
Blood Research.2022; 57(S1): S75. CrossRef
Prediction of prognosis and pathologic grade in follicular lymphoma using 18F-FDG PET/CT
Hongyan Li, Min Wang, Yajing Zhang, Fan Hu, Kun Wang, Chenyang Wang, Zairong Gao
Frontiers in Oncology.2022;[Epub] CrossRef
PET/CT Evaluation of the Effect of Allogeneic Hematopoietic Stem Cell Transplantation in the Treatment of T‐Cell Lymphoblastic Lymphoma
Jin Zhao, Xiaojing Guo, Li Ma, Meijing Zheng, Tao Guan, Liping Su, Mohammad Farukh Hashmi
Contrast Media & Molecular Imaging.2022;[Epub] CrossRef
Clinical and prognostic role of 2-[18F]FDG PET/CT and sarcopenia in treatment-naïve patients with T-cell lymphoblastic lymphoma
Xiaoyue Tan, Hui Yuan, Dongjiang Li, Xiaolin Sun, Chongyang Ding, Lei Jiang
Annals of Hematology.2022; 101(12): 2699. CrossRef
Prognostic value of baseline total metabolic tumour volume of 18F-FDG PET/CT imaging in patients with angioimmunoblastic T-cell lymphoma
Huanyu Gong, Tiannv Li, Jianyong Li, Lijun Tang, Chongyang Ding
EJNMMI Research.2021;[Epub] CrossRef

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Gynecologic cancer

Early Assessment of Response to Neoadjuvant Chemotherapy with ¹⁸F-FDG-PET/CT in Patients with Advanced-Stage Ovarian Cancer: Young Shin Chung, Hyun-Soo Kim, Jung-Yun Lee, Won Jun Kang, Eun Ji Nam, Sunghoon Kim, Sang Wun Kim, Young Tae Kim; Cancer Res Treat. 2020;52(4):1211-1218. Published online April 28, 2020; DOI: https://doi.org/10.4143/crt.2019.506

Abstract PDF Supplementary Material PubReader ePub

Purpose
The aim of this study was to evaluate the ability of sequential 18F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG-PET/CT) after one cycle of neoadjuvant chemotherapy (NAC) to predict chemotherapy response before interval debulking surgery (IDS) in advanced-stage ovarian cancer patients.
Materials and Methods
Forty consecutive patients underwent ¹⁸F-FDG-PET/CT at baseline and after one cycle of NAC. Metabolic responses were assessed by quantitative decrease in the maximum standardized uptake value (SUV_max) with PET/CT. Decreases in SUV_max were compared with cancer antigen 125 (CA-125) level before IDS, response rate by Response Evaluation Criteria in Solid Tumors criteria before IDS, residual tumor at IDS, and I chemotherapy response score (CRS) at IDS.
Results
A 40% cut-off for the decrease in SUVmax provided the best performance to predict CRS 3 (compete or near-complete pathologic response), with sensitivity, specificity, and accuracy of 81.8%, 72.4%, and 72.4%, respectively. According to this 40% cut-off, there were 17 (42.5%) metabolic responders (≥ 40%) and 23 (57.5%) metabolic non-responders (< 40%). Metabolic responders had higher rate of CRS 3 (52.9% vs. 8.7%, p=0.003), CA-125 normalization (< 35 U/mL) before IDS (76.5% vs. 39.1%, p=0.019), and no residual tumor at IDS (70.6% vs. 31.8%, p=0.025) compared with metabolic non-responders. There were significant associations with progression-free survival (p=0.021) between metabolic responders and non-responders, but not overall survival (p=0.335).
Conclusion
Early assessment with ¹⁸F-FDG-PET/CT after one cycle of NAC can be useful to predic response to chemotherapy before IDS in patients with advanced-stage ovarian cancer.

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The Evaluation Value of CT in the Efficacy of Neoadjuvant Chemotherapy in Ovarian Cancer Patients
Daying Mou, Shengyan Xie, Pingyuan Li, Mohammad Farukh Hashmi
Contrast Media & Molecular Imaging.2022;[Epub] CrossRef
Radiomics Analysis of PET and CT Components of 18F-FDG PET/CT Imaging for Prediction of Progression-Free Survival in Advanced High-Grade Serous Ovarian Cancer
Xihai Wang, Zaiming Lu
Frontiers in Oncology.2021;[Epub] CrossRef

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SUVmax Predicts Disease Progression after Stereotactic Ablative Radiotherapy in Stage I Non-small Cell Lung Cancer: Yoo-Kang Kwak, Hee Hyun Park, Kyu Hye Choi, Eun Young Park, Soo Yoon Sung, Sea-Won Lee, Ji Hyun Hong, Hyo Chun Lee, Ie Ryung Yoo, Yeon Sil Kim; Cancer Res Treat. 2020;52(1):85-97. Published online May 17, 2019; DOI: https://doi.org/10.4143/crt.2019.007

Abstract PDF PubReader ePub

Purpose
Fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) is gaining evidence as a predictive factor in non-small cell lung cancer (NSCLC). Stereotactic ablative radiotherapy (SABR) is the standard treatment in early-stage NSCLC when a patient is unsuitable for surgery. We performed a study to assess the prognostic clinical significance of PET-CT after SABR in early-stage NSCLC.
Materials and Methods
Seventy-six patients with stage I NSCLC treated with SABR were investigated. Total radiation dose ranged from 36 to 63 Gy in three to eight fractions depending on tumor location and size. Respiratory motion control was implemented at simulation and during treatment. PET-CT prior to SABR was performed in 66 patients (86.8%).
Results
Median follow-up time was 32 months (range, 5 to 142 months). Local control rate at 1, 2, and 5 years were 95.9%, 92.8%, and 86.7%, respectively. Overall survival (OS) at 1, 2, and 5 years were 91.0%, 71.3%, and 52.1% respectively. Cause-specific survival at 1, 2, and 5 years were 98.6%, 93.1%, and 84.3% respectively. Tumor size and pre-SABR maximal standardized uptake value (SUVmax) demonstrated statistical significance in the Kaplan-Meier survival analyses with log-rank test. In multivariate analyses pre-SABR SUVmax remained statistically significant in correlation to OS (p=0.024; hazard ratio [HR], 3.2; 95% confidence interval [CI], 1.2 to 8.8) and with marginal significance in regards to regional progression-free survival (p=0.059; HR, 32.5; 95% CI, 2.6 to 402.5).
Conclusion
Pre-SABR SUVmax demonstrated a predictive power in statistical analyses. Tumors with SUVmax above 6 at diagnosis were associated with inferior outcomes.

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Enhanced NSCLC subtyping and staging through attention-augmented multi-task deep learning: A novel diagnostic tool
Runhuang Yang, Weiming Li, Siqi Yu, Zhiyuan Wu, Haiping Zhang, Xiangtong Liu, Lixin Tao, Xia Li, Jian Huang, Xiuhua Guo
International Journal of Medical Informatics.2025; 193: 105694. CrossRef
Invasive Nodal Staging via Endobronchial Ultrasound and Outcome in Patients Treated with Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer – Results from a Single Institution Study
Benjamin George, Atallah Baydoun, Samar Bhat, Lauryn Bailey, Theodore Arsenault, Yilun Sun, Yuxia Zhang, Yiran Zheng, Prashant Vempati, Tarun Podder, Tithi Biswas
Clinical Lung Cancer.2024; 25(4): e181. CrossRef
Prognostic value of consolidation-to-tumor ratio on computed tomography in NSCLC: a meta-analysis
Yongming Wu, Wenpeng Song, Denian Wang, Junke Chang, Yan Wang, Jie Tian, Sicheng Zhou, Yingxian Dong, Jing Zhou, Jue Li, Ziyi Zhao, Guowei Che
World Journal of Surgical Oncology.2023;[Epub] CrossRef
Tumor to liver maximum standardized uptake value ratio of FDG-PET/CT parameters predicts tumor treatment response and survival of stage III non-small cell lung cancer
Pengfei Zhang, Wei Chen, Kewei Zhao, Xiaowen Qiu, Tao Li, Xingzhuang Zhu, Peng Sun, Chunsheng Wang, Yipeng Song
BMC Medical Imaging.2023;[Epub] CrossRef
Evaluation of response to stereotactic body radiation therapy for nonsmall cell lung cancer: PET response criteria in solid tumors versus response evaluation criteria in solid tumors
Jixia Han, Qi Song, Feng Guo, Rui Du, Henghu Fang, Jingbo Kang, Zejun Lu
Nuclear Medicine Communications.2022;[Epub] CrossRef
Assessing tumor angiogenesis using dynamic contrast-enhanced integrated magnetic resonance-positron emission tomography in patients with non-small-cell lung cancer
Yu-Sen Huang, Jenny Ling-Yu Chen, Hsin-Ming Chen, Li-Hao Yeh, Jin-Yuan Shih, Ruoh-Fang Yen, Yeun-Chung Chang
BMC Cancer.2021;[Epub] CrossRef
Potential role of functional imaging in predicting outcome for patients treated with carbon ion therapy: a review
Giulia Riva, Sara Imparato, Giovanni Savietto, Mattia Pecorilla, Alberto Iannalfi, Amelia Barcellini, Sara Ronchi, Maria Rosaria Fiore, Chiara Paganelli, Giulia Buizza, Mario Ciocca, Guido Baroni, Lorenzo Preda, Ester Orlandi
The British Journal of Radiology.2021;[Epub] CrossRef
Prognostic value of metabolic signature on 18F-FDG uptake in breast cancer patients after radiotherapy
Jin Meng, Emmanuel Deshayes, Li Zhang, Wei Shi, Xiaomeng Zhang, Xingxing Chen, Xin Mei, Jinli Ma, Yizhou Jiang, Jiong Wu, Zhimin Shao, Xiaoli Yu, Zhaozhi Yang, Xiaomao Guo
Molecular Therapy - Oncolytics.2021; 23: 412. CrossRef
Parámetros cuantitativos de la PET/TC con 18F-FDG como factores pronósticos en el cáncer de pulmón localizado e inoperable
J.R. Infante, J. Cabrera, J.I. Rayo, C. Cruz, J. Serrano, M. Moreno, A. Martínez, P. Jiménez, A. Cobo
Revista Española de Medicina Nuclear e Imagen Molecular.2020; 39(6): 353. CrossRef
18F-FDG PET/CT quantitative parameters as prognostic factors in localized and inoperable lung cancer
J.R. Infante, J. Cabrera, J.I. Rayo, C. Cruz, J. Serrano, M Moreno, A. Martínez, P. Jiménez, A. Cobo
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition).2020; 39(6): 353. CrossRef

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Detecting Metastatic Bladder Cancer Using ¹⁸F-Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography: Hakan Öztürk; Cancer Res Treat. 2015;47(4):834-843. Published online February 12, 2015; DOI: https://doi.org/10.4143/crt.2014.157

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to retrospectively investigate the contribution of 18F-fluorodeoxyglucose- positron emission tomography/computed tomography (18F-FDG-PET/CT) to detection of metastatic bladder cancer. Materials and Methods The present study included 79 patients (69 men and 10 women) undergoing 18F-FDGPET/ CT upon suspicion of metastatic bladder cancer between July 2007 and April 2013. The mean age was 66.1 years with a standard deviation of 10.7 years (range, 21 to 85 years). Patients were required to fast for 6 hours prior to scanning, and whole-body PET scanning from the skull base to the upper thighs was performed approximately 1 hour after intravenous injection of 555 MBq of 18F-FDG. Whole body CT scanning was performed in the cranio-caudal direction. FDG-PET images were reconstructed using CT data for attenuation correction. Suspicious recurrent or metastatic lesions were confirmed by histopathology or clinical follow-up. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 18F-FDG-PET/CT were 89%, 78%, 90%, 75%, and 86%, respectively. Conclusion 18F-FDG-PET/CT can detect metastases with high sensitivity and positive predictive values in patients with metastatic bladder carcinoma.

Citations

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Radiotherapy in metastatic bladder cancer
Sophie Ashley, Ananya Choudhury, Peter Hoskin, YeePei Song, Priyamvada Maitre
World Journal of Urology.2024;[Epub] CrossRef
PET Imaging in Bladder Cancer: An Update and Future Direction
Jules Zhang-Yin, Antoine Girard, Etienne Marchal, Thierry Lebret, Marie Homo Seban, Marine Uhl, Marc Bertaux
Pharmaceuticals.2023; 16(4): 606. CrossRef
Accuracy of FDG-PET/CT for Response Evaluation of Muscle-Invasive Bladder Cancer following Neoadjuvant or Induction Chemotherapy
Olivier Fitoussi, Jean Baptiste Roche, Julien Riviere, Hervé Wallerand, Jean Eude Poulain, Pierre Gordien, Sigolène Galland, Bénédicte Henriques, Camille Dupin, Muriel Vincent, Thomas Kuratle, Mo Saffarini, Sonia Ramos-Pascual
Urologia Internationalis.2023; 107(3): 239. CrossRef
PET/CT in Bladder Cancer: An Update
Kirsten Bouchelouche
Seminars in Nuclear Medicine.2022; 52(4): 475. CrossRef
Quantitative positron emission tomography imaging in the presence of iodinated contrast media using electron density quantifications from dual‐energy computed tomography
Nadav Shapira, Joshua Scheuermann, Amy E. Perkins, Johoon Kim, Leening P Liu, Joel S. Karp, Peter B. Noël
Medical Physics.2021; 48(1): 273. CrossRef
18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in muscle-invasive bladder cancer
Sarah M.H. Einerhand, Erik J. van Gennep, Laura S. Mertens, Kees Hendricksen, Maarten L. Donswijk, Henk G. van der Poel, Bas W.G. van Rhijn
Current Opinion in Urology.2020; 30(5): 654. CrossRef
The Role of 18F-FDG PET/CT in Guiding Precision Medicine for Invasive Bladder Carcinoma
Antoine Girard, Helena Vila Reyes, Hiram Shaish, Jean-François Grellier, Laurent Dercle, Pierre-Yves Salaün, Olivier Delcroix, Mathieu Rouanne
Frontiers in Oncology.2020;[Epub] CrossRef
Cancers de la vessie
A. Girard, J.F. Grellier, P.Y. Salaün
Médecine Nucléaire.2019; 43(1): 69. CrossRef
Comment on: Relationship between the expression of PD-1/PD-L1 and 18F-FDG uptake in bladder cancer
Antoine Girard, Mathieu Rouanne
European Journal of Nuclear Medicine and Molecular Imaging.2019; 46(6): 1212. CrossRef
Comparison between the diagnostic accuracies of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and conventional imaging in recurrent urothelial carcinomas: a retrospective, multicenter study
Fabio Zattoni, Elena Incerti, Michele Colicchia, Paolo Castellucci, Stefano Panareo, Maria Picchio, Federico Fallanca, Alberto Briganti, Marco Moschini, Andrea Gallina, Jeffrey R. Karnes, Val Lowe, Stefano Fanti, Riccardo Schiavina, Ilaria Rambaldi, Vince
Abdominal Radiology.2018; 43(9): 2391. CrossRef
The role of PET/CT in the evaluation of patients with urothelial cancer: a systematic review and meta-analysis
Anna Rita Cervino, Lea Cuppari, Pasquale Reccia, Marta Burei, Giorgio Saladini, Laura Evangelista
Clinical and Translational Imaging.2018; 6(2): 77. CrossRef
Pelvic Lymph Node Staging by Combined 18 F-FDG-PET/CT Imaging in Bladder Cancer Prior to Radical Cystectomy
Renate Pichler, Tobias De Zordo, Josef Fritz, Alexander Kroiss, Friedrich Aigner, Isabel Heidegger, Irene Virgolini, Wolfgang Horninger, Christian Uprimny
Clinical Genitourinary Cancer.2017; 15(3): e387. CrossRef
Metabolic coupling in urothelial bladder cancer compartments and its correlation to tumor aggressiveness
Julieta Afonso, Lúcio L. Santos, António Morais, Teresina Amaro, Adhemar Longatto-Filho, Fátima Baltazar
Cell Cycle.2016; 15(3): 368. CrossRef
The importance of clinical stage among patients with a complete pathologic response at radical cystectomy after neoadjuvant chemotherapy
William P. Parker, Philip L. Ho, Stephen A. Boorjian, Jonathan J. Melquist, Prabin Thapa, Jeffrey M. Holzbeierlein, Igor Frank, Ashish M. Kamat, Eugene K. Lee
World Journal of Urology.2016; 34(11): 1561. CrossRef

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Clinical Value of Whole Body F-18 FDG PET in The Management of Recurrent Colorectal Malignancy: Seok Byung Lim, Hyo Seong Choi, Sung Bum Kang, Seung Chul Heo, Young Jin Park, Seung Yong Jeong, Kyu Joo Park, Han Kwang Yang, Kyung Hoon Hwang, Jae Min Jeong, Dong Soo Lee, June Key Chung, Myung Chul Lee, Keon Wook Kang, Jae Gahb Park; Cancer Res Treat. 2003;35(4):349-354. Published online August 31, 2003; DOI: https://doi.org/10.4143/crt.2003.35.4.349

Abstract PDF: PURPOSE
The aim of this study was to evaluate the clinical value of whole body 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in the patient with a recurrence of a previously treated colorectal malignancy.
MATERIALS AND METHODS
Fifty-eight cases were scanned using PET at the PET Center of Seoul National University Hospital between May 1995 and Aug 2002. All the patients had had a previous operation for a colorectal malignancy. The PET scans were performed for the following reasons: - investigation of a recurrence (n=12), investigation of the operability (n=38) and clinical follow up (n=8). In these 58 cases, 47 of the CT scans and 55 of the CEA (Carcinoembryonic antigen) were checked prior to the FDG- PET. The accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the PET scans were calculated, and compared with those of conventional CT scan and CEA, which were also compared with the previous reported data. Eight cases, whose managements were influenced by the PET findings, were analyzed.
RESULTS
Recurrences, or metastases, of colorectal cancer developed in 51 cases, with 49 of these being detected by the PET. The accuracy, sensitivity and specificity of the PET were 96.6 (56/58), 96.1 (49/51) and 100% (7/7), respectively. The PPV and NPV of the PET were 100 (49/49) and 77.8% (7/9), respectively. The accuracy and sensitivity of the PET were higher than those of the CT (85.1 and 88.1%), with the differences being statistically significant (p-value 0.001 and 0.003, respectively).
CONCLUSION
It is concluded that a FDG-PET scan is a more accurate and sensitive diagnostic tool than a CT scan for the detection of a recurrence or metastasis in a colorectal malignancy. In addition, a FDG-PET may alter the management of patients with recurrent colorectal cancer. Therefore, it is recommended that a PET should be considered when a tumor recurrence is suspected during conventional follow up.

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Correlation of GLUT-1 Expression and F-18-FDG Uptake on Positron Emission Tomography in Breast Carcinoma: Gi Jeong Cheon, June Key Chung, Bo Kwang Kim, Yong Jin Lee, Dong Young Noh, Ja June Jang, Jeong Seok Yeo, Jae Min Jeong, Dong Soo Lee, Myung Chul Lee; J Korean Cancer Assoc. 2000;32(6):1067-1074.

Abstract PDF: PURPOSE
Fluorine-18-fluorodeoxyglucose (F-18-FDG) positron emission tomography (PET) has been proven to be useful in the detection of breast cancer. However, the degree of FDG uptake was variable. In this study, we evaluated the relationship between glucose transporter-1 (GLUT-1) expression with the FDG uptake in patients with breast cancer.
MATERIALS AND METHODS
15 patients with proven breast cancer underwent F-18-FDG PET. After surgical resection, anti-GLUT-1 immunohistochemical staining was performed in tumor tissues to measure the GLUT-1 expression. We evaluated the correlation between semi-quantitative FDG uptake by standardized uptake value (SUV) and GLUT-1 expression.
RESULTS
In total 15 patients, there was no significant correlation between SUV and GLUT-1 expression. We separated the patients into two groups according to the tumor size. In the group of large tumor (short diameter > or =2 cm), there was no significant correlation. However, in the group of small tumor (short diameter <2 cm), there was a significant correlation between the FDG uptake and GLUT-1 expression (rho=0.812, p=0.047).
CONCLUSION
GLUT-1 expression can influence the FDG uptake in the small breast cancers. For large breast cancers, other factors as well as GLUT-1 expression may influence the FDG uptake.

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Efficiency of Positron Emission Tomography (PET) in Diagnosis of Breast Cancer: Seok Jin Nam, Jee Hyung Noh, Byung Tae Kim; J Korean Cancer Assoc. 1997;29(2):235-242.

Abstract PDF: PURPOSE
PET developed on the basis of biochemical characteristics of malignant tissues where the increase in glucose metabolism. Therefore, early and accurate detection of primary or metastatic lesion can be expected. This study is to compare PET and other traditional methods in detection of primary breast carcinoma and metastatic lesion, and to find the advantage of PET.
MATERIALS AND METHODS
We compared and analysed the results of PET, US, mammogr aphy, bone scan, CT and biopsy reports of the 46 patients who were examined in our hospital from September 1, 19094 to July 31, 1995. PET Trace 200 cyclotron and PET Advanced Scenner were used for FDG synthesis and imaging respectively.
RESULTS
10 of the 12 cases who had preoperative PET were consistent with the results of mammography and ultrasound and 9 of the 10 cases were consistent with the pathologic results. In one case, which did mammography and PET after excis ional biopsy, PET gaves a false positive result. In the detection of axilliary node metastasis, PeT after excisional biopsy, PET gaves a false positive result. In the detection of axilliary node metastasis, PET shows 100% sensitivity and specificity but bone scan shows 100%, 72.2% respectively.
CONCLUSION
PET is useful for diagnosis of primary breast cancer and is superior to bone scan in specificity for diagnosis of bone metastasis and in early detection of response to treatment. Because PET cannot exclude false (+) in inflamm atory lesion, continuous investigation is needed for establishment of indication and reduction of false (+), false (-).In spite of high cost, PET may become a new and useful diagnostic tool.

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