Language：English   Publishing type：Research paper (scientific journal)   Publisher：Nagoya Journal of Medical Science  

We retrospectively evaluated the frequency of unexpected accumulation of radioactive iodine on the post-therapy whole-body scan (Rx-WBS) after radioactive iodine (RAI) ablation therapy in patients with differentiated thyroid cancer (DTC). We searched our institutional database for Rx-WBSs of DTC patients who underwent RAI ablation or adjuvant therapy between 2012 and 2019. Patients with distant metastasis diagnosed by CT or PET/CT before therapy, and those had previously received RAI therapy were excluded. In total, 293 patients (201 female and 92 male, median age 54 years) were selected. Two nuclear medicine physicians interpreted the Rx-WBS images by determining the visual intensity of radioiodine uptake by the thyroid bed, cervical and mediastinal lymph nodes, lungs, and bone. Clinical features of the patients with and without the metastatic accumulation were compared by chi-square test and median test. Logistic regression analyses were performed to compare the association between the presence of metastatic accumulation and these clinical factors. Eighty-four of 293 patients (28.7%) showed metastatic accumulation. Patients with metastatic RAI accumulation showed a significantly higher frequency of pathological N1 (pN1) and serum thyroglobulin (Tg) > 1.5 ng/ml under TSH stimulation (p = 0.035 and p = 0.031, respectively). Logistic regression analysis indicated that a serum Tg > 1.5 ng/ml was significantly correlated with the presence of metastatic accumulation (odds ratio = 1.985; p = 0.033). In conclusion, Patients with Tg > 1.5 ng/ml were more likely to show metastatic accumulation. In addition, the presence of lymph node metastasis at the initial thyroid surgery was also associated with this unexpected metastatic accumulation.

DOI： 10.18999/nagjms.82.2.205

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Clinical Nuclear Medicine  

Purpose This paper aims to explore the role of a metabolic parameter on 18F-FDG-PET/CT for clinical T-classification in early-stage adenocarcinoma. Patients and Methods One hundred six surgically resected pathological TNM stage (p-stage) 0/I lung adenocarcinomas were retrospectively reviewed. The solid size (SS) measured on thin-section CT and the pathological invasive size (IS) of tumors were recorded. The SUVmax and metabolic tumor volume with SUV ≥1.0 (MTV1.0) derived from PET/CT data were measured on a workstation, and the metabolic tumor diameter with SUV ≥1.0 (MTD1.0) was calculated automatically from MTV1.0. For the correlations between the IS and the SS, MTD1.0, or SUVmax, Pearson's correlation coefficients were compared using the Meng-Rosenthal-Rubin method. Additionally, the reproducibility between the clinical TNM stage (c-stage), based on the SS or MTD1.0, and the p-stage was analyzed using the kappa coefficient (k). Results For the correlations between the IS and the other parameters, Pearson correlation coefficient was 0.630 for the SS, 0.600 for the SUVmax, and 0.725 for MTD1.0. MTD1.0 correlated significantly and more strongly with the IS than the SS and the SUVmax did (P = 0.040, and P = 0.008, respectively). The reproducibility between p-stage and c-stage based on the SS was moderate (k = 0.529, P < 0.001), whereas that between p-stage and c-stage based on MTD1.0 was substantial (k = 0.676, P < 0.001). Conclusions MTD1.0 on FDG-PET/CT was correlated significantly and more strongly with the pathological IS in lung adenocarcinomas than with the SS on thin-section CT. FDG-PET/CT could classify more precisely early-stage lung adenocarcinoma than the presently used T-classification based on thin-section CT findings.

DOI： 10.1097/RLU.0000000000002591

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Cancer Imaging  

Background: For subsolid non-small cell lung cancers (NSCLCs), solid size (SS), which is the maximal diameter of the solid component, correlates more accurately with tumor prognosis than the total size, which is the maximal diameter of the entire tumor, including ground-glass opacity. We reviewed the propriety of the TNM staging based on the SS for early-stage NSCLCs. Methods: We retrospectively reviewed the preoperative radiological reports, clinical records, and pathological reports of NSCLC cases in our hospital between 2010 and 2013, and clinical stage (c-Stage) 0 and I tumors were selected. Disease-free survival (DFS), based on survival analysis, was used to assess the tumor characteristics that predicted the prognosis. Results: A total of 247 NSCLC diagnoses in 231 patients (88 women and 143 men; age, 67 ± 7 years) were included in our cohort. They were classified into solid (n = 131) and subsolid (n = 116) nodules. The DFS curves indicated that prognosis was significantly worse in the following order: c-Stage 0, c-Stage IA, and c-Stage IB tumors (p = 0.016). Patients with solid nodules showed a significantly worse prognosis than patients with subsolid nodules (p < 0.001). A multivariate Cox proportional hazards model showed that the significant predictive factors for DFS were c-Stage (hazard ratio, 1.600; p = 0.020) and solid nodules (hazard ratio, 3.077; p = 0.031). Conclusions: For early-stage NSCLCs, the c-Stage based on the SS in subsolid nodules was useful for predicting postoperative DFS. In addition, whether nodules were solid or subsolid was another independent prognostic factor.

DOI： 10.1186/s40644-019-0219-3

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Radiology  

Purpose: To investigate the relationship between the postoperative prognosis of patients with part-solid non–small cell lung cancer and the solid component size acquired by using three-dimensional (3D) volumetry software on multidetector computed tomographic (CT) images. Materials and A retrospective study by using preoperative multidetector Methods: CT data with 0.5-mm section thickness, clinical records, and pathologic reports of 96 patients with primary subsolid non–small cell lung cancer (47 men and 49 women; mean age 6 standard deviation, 66 years 6 8) were reviewed. Two radiologists measured the two-dimensional (2D) maximal solid size of each nodule on an axial image (hereafter, 2D MSSA), the 3D maximal solid size on multiplanar reconstructed images (hereafter, 3D MSSMPR), and the 3D solid volume of greater than 0 HU (hereafter, 3D SV0HU) within each nodule. The correlations between the postoperative recurrence and the effects of clinical and pathologic characteristics, 2D MSSA, 3D MSSMPR, and 3D SV0HU as prognostic imaging biomarkers were assessed by using a Cox proportional hazards model. Results: For the prediction of postoperative recurrence, the area under the receiver operating characteristics curve was 0.796 (95% confidence interval: 0.692, 0.900) for 2D MSSA, 0.776 (95% confidence interval: 0.667, 0.886) for 3D MSSMPR, and 0.835 (95% confidence interval: 0.749, 0.922) for 3D SV0HU. The optimal cutoff value for 3D SV0HU for predicting tumor recurrence was 0.54 cm3, with a sensitivity of 0.933 (95% confidence interval: 0.679, 0.998) and a specificity of 0.716 (95% confidence interval: 0.605, 0.811) for the recurrence. Significant predictive factors for disease-free survival were 3D SV0HU greater than or equal to 0.54 cm3 (hazard ratio, 6.61; P = .001) and lymphatic and/or vascular invasion derived from histopathologic analysis (hazard ratio, 2.96; P = .040). Conclusion: The measurement of 3D SV0HU predicted the postoperative prognosis of patients with part-solid lung cancer more accurately than did 2D MSSA and 3D MSSMPR.

DOI： 10.1148/radiol.2018172319

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