記述言語：英語   出版者・発行元：British Journal of Radiology  

Objective: To examine whether the machine-learning approach using 18-fludeoxyglucose positron emission tomography (18F-FDG-PET)-based radiomic and deep-learning features is useful for predicting the pathological risk subtypes of thymic epithelial tumors (TETs). Methods: This retrospective study included 79 TET [27 low-risk thymomas (types A, AB and B1), 31 high-risk thymomas (types B2 and B3) and 21 thymic carcinomas] patients who underwent pre-therapeutic18F-FDG-PET/ CT. High-risk TETs (high-risk thymomas and thymic carcinomas) were 52 patients. The 107 PET-based radiomic features, including SUV-related parameters [maximum SUV (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] and 1024 deep-learning features extracted from the convolutional neural network were used to predict the pathological risk subtypes of TETs using six different machine-learning algorithms. The area under the curves (AUCs) were calculated to compare the predictive performances. Results: SUV-related parameters yielded the following AUCs for predicting thymic carcinomas: SUVmax 0.713, MTV 0.442, and TLG 0.479 or high-risk TETs: SUVmax 0.673, MTV 0.533, and TLG 0.539. The bestperforming algorithm was the logistic regression model for predicting thymic carcinomas (AUC 0.900, accuracy 81.0%), and the random forest (RF) model for high-risk TETs (AUC 0.744, accuracy 72.2%). The AUC was significantly higher in the logistic regression model than three SUV-related parameters for predicting thymic carcinomas, and in the RF model than MTV and TLG for predicting high-risk TETs (each; p < 0.05). Conclusion:18F-FDG-PET-based radiomic analysis using a machine-learning approach may be useful for predicting the pathological risk subtypes of TETs. Advances in knowledge: Machine-learning approach using18F-FDG-PET-based radiomic features has the potential to predict the pathological risk subtypes of TETs.

DOI： 10.1259/bjr.20211050

Scopus

PubMed

記述言語：英語   出版者・発行元：(公社)日本医学放射線学会  

免疫チェックポイント阻害剤(ICI)療法が施行された悪性黒色腫患者に対し、3種類の18F-FDG PET/CTによる治療効果判定法(EORTC法、PERCIST法、imPERCIST法)を用いて、腫瘍縮小効果判定能と予後予測能を比較した。調査対象者は2014年8月～2019年10月までの期間内に、後向き多施設共同研究に参加した国内医療施設5施設で、PD-1阻害剤もしくはPD-L1阻害剤療法が施行された悪性黒色腫患者27例(男性18例、女性9例、年齢39～86歳)とした。FDG PET/CT検査は治療前、治療(ニボルマブ投与は21例、ペムブロリズマブ投与は6例)開始後3～9ヵ月行い、治療効果判定はEORTC法、PERCIST法、imPERCIST法で評価した。その結果、harmonized EORTC、PERCIST、imPERCISTによる完全代謝奏効(CMR)/部分代謝奏効(PMR)/安定代謝(SMD)/進行代謝(PMD)は、それぞれ3例/5例/4例/15例、4例/5例/3例/15例、4例/5例/5例/13例で、各治療効果判定法で概ね完全な一致が得られた。しかし、うち20例では悪性黒色腫が進行し、14例は中央値19.2ヵ月後に死亡が確認され、治療奏効患者(CMR/PMR)では非治療奏効患者(SMD/PMD)に比べ、有意にPFSとOSが長かった。以上より、今回評価した3種のharmonized FDG-PET治療効果判定法(EORTC法、PERCIST法、imPERCIST法)により、CMR/PMR/SMD/PMDで高い一致度が得られ、ICI療法の治療効果(腫瘍縮小効果)判定、悪性黒色腫患者の予後予測能が高精度であることが確認された。

記述言語：英語   出版者・発行元：Japanese Journal of Radiology  

Purpose: This study examined the usefulness of the maximum standardized uptake value (SUVmax) of myocardial [123I]-metaiodobenzylguanidine ([123I]-MIBG) to characterize myocardial function by comparing it with echocardiographic parameters in patients with pheochromocytoma. Materials and methods: This study included 18 patients with pheochromocytoma who underwent both planar and [123I]-MIBG single-photon emission computed tomography/computed tomography scans and echocardiography before surgery. Myocardial [123I]-MIBG visibility and SUVmax were compared with echocardiographic parameters related to systolic and diastolic functions. The Mann–Whitney U test, Fisher exact test, or Spearman rank correlation assessed differences or relationships between two quantitative variables. Results: On visual analysis, 6 patients showed normal myocardial [123I]-MIBG uptake, whereas 12 patients showed decreased myocardial [123I]-MIBG uptake. No patients showed systolic dysfunction. A significant difference was observed in the incidence of diastolic dysfunction between the groups with normal and decreased uptake (p = 0.009), and left ventricular (LV) diastolic dysfunction was observed in 9 (75%) of 12 patients with decreased myocardial uptake. The myocardial SUVmax was significantly lower in 9 patients with LV diastolic dysfunction than in 9 patients with normal cardiac function (1.67 ± 0.37 vs. 3.03 ± 1.38, p = 0.047). Myocardial SUVmax was positively correlated with septal e′ (early diastolic velocity of septal mitral annulus) (ρ = 0.51, p = 0.031) and negatively correlated with the septal E/e′ ratio (early mitral E-velocity to early diastolic velocity of septal mitral annulus; ρ = − 0.64, p = 0.004), respectively. Conclusions: LV diastolic dysfunction was inversely related to myocardial [123I]-MIBG uptake. Myocardial [123I]-MIBG SUVmax may be useful for characterizing cardiac function in patients with pheochromocytoma. Second abstract. The semiquantitative analysis using the myocardial SUVmax in 123I-MIBG SPECT/CT was found to be potentially useful for characterizing cardiac function in patients with pheochromocytoma.

DOI： 10.1007/s11604-022-01365-z

Scopus

PubMed

記述言語：日本語   出版者・発行元：一般社団法人 日本核医学会  

DOI： 10.18893/kakuigaku.wgr.2234

記述言語：英語   出版者・発行元：Molecular Imaging and Biology  

Purpose: To examine whether the machine learning (ML) analyses using clinical and pretreatment 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography ([18F]-FDG-PET)–based radiomic features were useful for predicting prognosis in patients with hypopharyngeal cancer. Procedures: This retrospective study included 100 patients with hypopharyngeal cancer who underwent [18F]-FDG-PET/X-ray computed tomography (CT) before treatment, and these patients were allocated to the training (n=80) and validation (n=20) cohorts. Eight clinical (age, sex, histology, T stage, N stage, M stage, UICC stage, and treatment) and 40 [18F]-FDG-PET–based radiomic features were used to predict disease progression. A feature reduction procedure based on the decrease of the Gini impurity was applied. Six ML algorithms (random forest, neural network, k-nearest neighbors, naïve Bayes, logistic regression, and support vector machine) were compared using the area under the receiver operating characteristic curve (AUC). Progression-free survival (PFS) was assessed using Cox regression analysis. Results: The five most important features for predicting disease progression were UICC stage, N stage, gray level co-occurrence matrix entropy (GLCM_Entropy), gray level run length matrix run length non-uniformity (GLRLM_RLNU), and T stage. Patients who experienced disease progression displayed significantly higher UICC stage, N stage, GLCM_Entropy, GLRLM_RLNU, and T stage than those without progression (each, p<0.001). In both cohorts, the logistic regression model constructed by these 5 features was the best performing classifier (training: AUC=0.860, accuracy=0.800; validation: AUC=0.803, accuracy=0.700). In the logistic regression model, 5-year PFS was significantly higher in patients with predicted non-progression than those with predicted progression (75.8% vs. 8.3%, p<0.001), and this model was only the independent factor for PFS in multivariate analysis (hazard ratio = 3.22; 95% confidence interval = 1.03–10.11; p=0.045). Conclusions: The logistic regression model constructed by UICC, T and N stages and pretreatment [18F]-FDG-PET–based radiomic features, GLCM_Entropy, and GLRLM_RLNU may be the most important predictor of prognosis in patients with hypopharyngeal cancer.

DOI： 10.1007/s11307-022-01757-7

Scopus

PubMed

記述言語：英語   出版者・発行元：EJNMMI Research  

Background: To explore the feasibility of short-time-window Ki imaging using a population-based arterial input function (IF) and optimized Bayesian penalized likelihood (BPL) reconstruction as a practical alternative to long-time-window Ki imaging with an individual patient-based IF. Myocardial Ki images were generated from 73 dynamic 18F-FDG-PET/CT scans of 30 patients with cardiac sarcoidosis. For each dynamic scan, the Ki images were obtained using the IF from each individual patient and a long time window (10–60 min). In addition, Ki images were obtained using the normalized averaged population-based IF and BPL algorithms with different beta values (350, 700, and 1000) with a short time window (40–60 min). The visual quality of each image was visually rated using a 4-point scale (0, not visible; 1, poor; 2, moderate; and 3, good), and the Ki parameters (Ki-max, Ki-mean, Ki-volume) of positive myocardial lesions were measured independently by two readers. Wilcoxon’s rank sum test, McNemar’s test, or linear regression analysis were performed to assess the differences or relationships between two quantitative variables. Results: Both readers similarly rated 51 scans as positive (scores = 1–3) and 22 scans as negative (score = 0) for all four Ki images. Among the three types of population-based IF Ki images, the proportion of images with scores of 3 was highest with a beta of 1000 (78.4 and 72.5%, respectively) and lowest with a beta of 350 (33.3 and 23.5%) for both readers (all p < 0.001). The coefficients of determination between the Ki parameters obtained with the individual patient-based IF and those obtained with the population-based IF were highest with a beta of 1000 for both readers (Ki-max, 0.91 and 0.92, respectively; Ki-mean, 0.91 and 0.92, respectively; Ki-volume, 0.75 and 0.60, respectively; and all p < 0.001). Conclusions: Short-time-window Ki images with a population-based IF reconstructed using the BPL algorithm and a high beta value were closely correlated with long-time-window Ki images generated with an individual patient-based IF. Short-time-window Ki images using a population-based IF and BPL reconstruction might represent practical alternatives to long-time-window Ki images generated using an individual patient-based IF.

DOI： 10.1186/s13550-022-00933-8

Scopus

PubMed

記述言語：英語   出版者・発行元：Scientific Reports  

This study assessed the possibility of semi-automatic harmonization of standardized uptake values (SUVs) in multicenter studies. Phantom data were acquired using 16 PET/CT scanners (including 3 PET/CT scanners with a silicon photomultiplier detector). PET images obtained using 30-min/bed scans for optimum harmonization filter calculations and using 90–180-s/bed scans for SUV validation under clinical conditions were obtained. Time of flight and a reconstruction method with point-spread function correction were allowed. The optimal full width at half maximum of the 3D-Gaussian filter that minimizes the root mean square error with the median value of the JSNM harmonization range was calculated semi-automatically. The SUVmax and the SUVpeak of the hot spheres were measured, and the inter-scanner coefficient of variation (COV) was calculated before and after harmonization. The harmonization filter was applied to 11 of the 15 PET/CT scanners in which the SUV calibration accuracy had been verified, but not in the remaining 4 scanners. Under noiseless conditions before harmonization, the inter-scanner COVs of the SUVmax and the SUVpeak were as high as 21.57% and 12.20%, respectively, decreasing to 8.79% and 5.73% after harmonization, respectively. Harmonization brought the SUVmax of all the hot spheres to within the harmonization range. Even under clinical conditions affected by image noise, the inter-scanner COVs for the SUVmax and SUVpeak were as high as 8.83% and 5.18% after harmonization, respectively. By applying an optimal harmonization filter that is calculated semi-automatically, the harmonization of SUVs according to the JSNM strategy is possible in multicenter studies, thereby reducing inter-scanner COVs.

DOI： 10.1038/s41598-021-87942-0

Scopus

PubMed

記述言語：英語   出版者・発行元：Scientific Reports  

The association between 18F-fluorodeoxyglucose (18F-FDG) myocardial uptake and clinical presentations in cardiac sarcoidosis (CS) has not yet been clarified. The Patlak slope, Ki, which represents the rate of 18F-FDG uptake is a quantitative index of 18F-FDG metabolism. This study aims to investigate the usefulness of standardized uptake value (SUV) and Patlak Ki images (Ki images) extracted from dynamic 18F-FDG-PET/CT for evaluating the risk of clinical events (CEs) in CS. The SUV and Ki myocardial images were generated from 30 dynamic 18F-FDG-PET/CT scans of 21 CS patients. The SUV and Ki images both were rated as positive in 19 scans and negative in 11 scans with the same incidence of CEs which were significantly higher in positive than negative scans [cardiac dysfunction: 78.9% (15/19) vs. 27.2% (3/11); arrhythmic events: 65.5% (10/19) vs. 0% (0/11)]. In 19 positive scans, the three Ki parameters (Ki max, Ki mean and Ki volume) were significantly higher in scans for patients with arrhythmic events than in those without. Logistic regression analysis showed that the Ki volume alone was significantly associated with the risk of arrhythmic events. Our study suggests that Ki images may add value to SUV images for evaluating the risk of CEs in CS patients.

DOI： 10.1038/s41598-021-82217-0

Scopus

PubMed

記述言語：英語   出版者・発行元：Abdominal Radiology  

Purpose: To examine the usefulness of machine learning to predict prognosis in cervical cancer using clinical and radiomic features of 2-deoxy-2-[18F]fluoro-D-glucose (18F-FDG) positron emission tomography/computed tomography (CT) (18F-FDG-PET/CT). Methods: This retrospective study included 50 cervical cancer patients who underwent 18F-FDG-PET/CT before treatment. Four clinical (age, histology, stage, and treatment) and 41 18F-FDG-PET-based radiomic features were ranked and a subset of useful features for association with disease progression was selected based on decrease of the Gini impurity. Six machine learning algorithms (random forest, neural network, k-nearest neighbors, naive Bayes, logistic regression, and support vector machine) were compared using the areas under the receiver operating characteristic curve (AUC). Progression-free survival (PFS) was assessed using Cox regression analysis. Results: The five top predictors of disease progression were: stage, surface area, metabolic tumor volume, gray-level run length non-uniformity (GLRLM_RLNU), and gray-level non-uniformity for run (GLRLM_GLNU). The naive Bayes model was the best-performing classifier for predicting disease progression (AUC = 0.872, accuracy = 0.780, F1 score = 0.781, precision = 0.788, and recall = 0.780). In the naive Bayes model, 5-year PFS was significantly higher in predicted non-progression than predicted progression (80.1% vs. 9.1%, p < 0.001) and was only the independent factor for PFS in multivariate analysis (HR, 6.89; 95% CI, 1.92–24.69; p = 0.003). Conclusion: A machine learning approach based on clinical and pretreatment 18F-FDG PET-based radiomic features may be useful for predicting tumor progression in cervical cancer patients.

DOI： 10.1007/s00261-021-03350-y

Scopus

PubMed

記述言語：英語   出版者・発行元：American Journal of Roentgenology  

BACKGROUND. Accurate nodal staging is essential to guide treatment selection in patients with non-small cell lung cancer (NSCLC). To our knowledge, measurement of electron density (ED) using dual-energy CT (DECT) is unexplored for this purpose. OBJECTIVE. The purpose of our study was to assess the utility of ED from DECT in diagnosing metastatic mediastinal lymph nodes in patients with NSCLC in comparison with conventional CT and FDG PET/CT. METHODS. This retrospective study included 57 patients (36 men, 21 women; mean age, 68.4 } 8.9 [SD] years) with NSCLC and surgically resected mediastinal lymph nodes who underwent preoperative DECT and FDG PET/CT. The patients had a total of 117 resected mediastinal lymph nodes (33 metastatic, 84 nonmetastatic). Two radiologists independently reviewed the morphologic features of nodes on the 120-kVp images and also measured the iodine concentration (IC) and ED of nodes using maps generated from DECT data; consensus was reached for discrepancies. Two different radiologists assessed FDG PET/CT examinations in consensus for positive node uptake. Diagnostic performance was evaluated for individual and pairwise combinations of features. RESULTS. The sensitivity, specificity, and accuracy for nodal metastasis were 15.2%, 98.8%, and 75.2% for the presence of necrosis, respectively; 54.5%, 85.7%, and 76.9% for short-axis diameter greater than 8.5 mm; 63.6%, 73.8%, and 70.9% for long-axis diameter greater than 13.0 mm; 51.5%, 79.8%, and 71.8% for attenuation on 120-kVp images of 95.8 HU or less; 87.9%, 58.3%, and 66.7% for ED of 3.48 × 1023/cm3 or less; and 66.7%, 75.0%, and 72.6% for positive FDG uptake. Among pairwise combinations of features, accuracy was highest for the combination of ED and short-axis diameter (accuracy, 82.9%; sensitivity, 54.5%; specificity, 94.0%) and the combination of ED and positive FDG uptake (accuracy, 82.1%; sensitivity, 60.6%; specificity, 90.5%); these accuracies were greater than those for the individual features (p < .05). The remaining combinations exhibited accuracies ranging from 74.4% to 77.8%. Interobserver agreement analysis showed an intraclass correlation coefficient of 0.90 for ED. IC was not significantly different between metastatic and nonmetastatic nodes (p = .18) and was excluded from the diagnostic performance analysis. CONCLUSION. ED derived from DECT may help diagnose metastatic lymph nodes in NSCLC given decreased ED in metastatic nodes.

DOI： 10.2214/AJR.21.26208

Scopus

PubMed

記述言語：英語   出版者・発行元：Annals of Nuclear Medicine  

Objective: The prognostic value of treatment response in patients with non-small cell lung cancer (NSCLC) treated with immune-checkpoint inhibitors (ICIs) shown by 18F-fludeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) results obtained with multiple types of PET scanners using standardized uptake value (SUV) harmonization was evaluated. Methods: Fifty-eight patients treated with ICIs who underwent 18F-FDG PET/CT examinations with nine types of PET scanners at six hospitals were enrolled. SUV harmonization of multiple PET scanner results was performed using the dedicated software packages “RAVAT” and “RC Tool for Harmonization”. Tumor response was assessed by change in sum of harmonized SUVmax, according to the European Organization for Research and Treatment of Cancer (EORTC5) or the SUV of up to five lesions normalized to lean body mass, according to the PET Response Criteria in Solid Tumors (PERCIST5) and immunotherapy-modified PERCIST (imPERCIST5) criteria. The correlation between tumor response according to those three definitions and overall survival (OS) was evaluated and compared to known prognostic factors. Results: One-year OS in responders and non-responders for harmonized EROTC5 was 86 and 32%, for harmonized PERCIST5 was 86 and 32%, and for harmonized imPERCIST5 was 80 and 30%, respectively (each p = 0.001). Univariate analysis showed that all response criteria remained as prognostic factors. However, there was an overlap for the categories stable metabolic disease (SMD) and progression metabolic disease (PMD) in survival curves using the PET treatment response criteria. Conclusion: In patients with NSCLC treated with ICIs, tumor response based on the harmonized response criteria was associated with OS. PET response criteria using harmonized metabolic parameters may be difficult to routinely employ in daily practice due to overlapping SMD and PMD, although may have a supporting role for determining prognosis.

DOI： 10.1007/s12149-021-01667-8

Scopus

PubMed

記述言語：英語   出版者・発行元：(一社)日本核医学会  

免疫チェックポイント阻害薬(ICI)が投与された非小細胞肺癌(NSCLC)患者において、18F-FDG PET/CT検査よる治療効果判定で、PET装置の違いによるSUV値の変動を低減させるためSUV値を調和させることで、18F-FDG PET/CT検査で治療応答性予測が可能か検討した。2014年8月～2019年10月までの期間内に、国内医療施設6施設で免疫チェックポイント阻害薬(ICI)による治療前後に、9種類のPET装置で18F-FDG PET/CT検査が施行されたNSCLC患者のうち、選定基準を満たした患者58例(男性48例、女性10例、年齢54～88歳)を調査対象とした。SUVの調和には専用のソフトウェアを用いて行い、腫瘍応答性はSUV値を調和させたEuropean Organization for Research and Treatment of Cancer(EORTC5)、PET Response Criteria in Solid Tumors(PERCIST5)およびimmunotherapy-modified PERCIST(imPERCIST5)で評価した。その結果、SUV値を調和させたEROTC5、PERCIST5およびimPERCIST5によるレスポンダーおよびノンレスポンダーの1年全生存率(OS)は、それぞれ86%および32%、86%および32%、80%および30%であった。また、単変量解析により、これら全ての治療効果判定基準において予後予測能が認められたが、PET装置による治療効果判定基準を用いた生存曲線で、安定代謝(stable metabolic disease:SMD)と進行代謝(progression metabolic disease:PMD)のカテゴリーで重複が生じた。今回の後向き多施設共同研究により、SMDとPMDで重複が生じたため、本法を日常診療に導入することは難解と考えられたが、PET装置間のSUVを調和させることで施設間差が低減され、ICI治療を受けたNSCLC患者の治療応答性が予測され、OSと有意に関連することが明らかにされた。

記述言語：英語   出版者・発行元：Cancers  

The diagnostic value of18F-fluorodeoxyglucose (FDG) uptake in the management of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas remains unclear. This study aimed to assess the role of FDG uptake in the diagnosis of different degrees of dysplasia of IPMNs. We retrospectively analyzed the following three points in 84 patients with IPMNs: (1) risk factors to predict high-grade dysplasia (HGD) and invasive carcinoma (INV); (2) the relationship between FDG uptake and glucose transporter 1 (GLUT-1) expression; and (3) the relationship between FDG uptake and the presence of mural nodules. The histopathological diagnosis was low-grade dysplasia (LGD) in 43 patients, HGD in 16, and INV in 25. The maximum standardized uptake value (SUV-max) was significantly higher in INV than in LGD/HGD (p < 0.0001, p = 0.0136). The sensitivity and specificity to discriminate INV from LGD/HGD were 80.0% and 86.2%, respectively, using the receiver operator characteristic curve, when the optimal cutoff score of SUV-max was set at 4.03. Those values were not different between HGD and LGD. More than half of HGD patients had low GLUT-1 expression. Taken together, FDG-PET/CT is useful in distinguishing between non-invasive and invasive IPMN. Our results offer critical information that may determine surgical treatment strategies.

DOI： 10.3390/cancers13184633

Scopus

PubMed

記述言語：英語   出版者・発行元：Clinical nuclear medicine  

ABSTRACT: Granulocyte colony-stimulating factor (G-CSF)-producing tumors are malignant tumors associated with a poor prognosis, and G-CSF-producing liposarcoma is particularly rare. We report a case of G-CSF-producing dedifferentiated liposarcoma. 18F-FDG PET/CT showed abnormal 18F-FDG uptake throughout the bone marrow and in the primary site. When a diffuse bone marrow 18F-FDG uptake was observed on 18F-FDG PET/CT, G-CSF-producing dedifferentiated liposarcoma should be included in the differential diagnosis.

DOI： 10.1097/RLU.0000000000003783

Scopus

PubMed

記述言語：英語   出版者・発行元：European Journal of Nuclear Medicine and Molecular Imaging  

Purpose: To investigate the usefulness of the positron emission tomography response criteria in solid tumors 1.0 (PERCIST1.0) for predicting tumor response to neoadjuvant chemotherapy and prognosis and determine whether PERCIST improvements are necessary for esophageal squamous cell carcinoma (ESCC) patients. Patients and methods: We analyzed the cases of 177 ESCC patients and examined the association between PERCIST and their pathological responses. Associations of whole-PERCIST with progression-free survival (PFS) and overall survival (OS) were evaluated by a Kaplan-Meier analysis and Cox proportional hazards model. To investigate potential PERCIST improvements, we used the survival tree technique to understand patients’ prognoses. Results: There were significant correlations between the pathologic response and PERCIST of primary tumor (p < 0.001). The optimal cutoff value of the primary tumors’ SULpeak response to classify pathologic responses was −50.0%. The diagnostic accuracy of SULpeak response was 87.3% sensitivity, 54.1% specificity, 68.9% accuracy, positive predictive value 60.5%, and negative predictive value 84.1%. Whole-PERCIST was significantly associated with PFS and OS. The survival tree results indicated that a high reduction of the whole SULpeak response was significantly correlated with the patients’ prognoses. The cutoff values for the separation of prognoses were − 52.5 for PFS and − 47.1% for OS. Conclusion: PERCIST1.0 can help predict tumor responses and prognoses. However, 18F-FDG-PET/CT tends to underestimate residual tumors in histopathological response evaluations. Modified PERCIST, in which the partial metabolic response is further classified by the SULpeak response (−50%), might be more appropriate than PERCIST1.0 for evaluating tumor responses and stratifying high-risk patients for recurrence and poor prognosis.

DOI： 10.1007/s00259-021-05365-5

Scopus

PubMed

記述言語：英語   出版者・発行元：Medicine  

ABSTRACT: Recent breakthrough results from immune checkpoint inhibitors (ICIs) have paved the way to a new era of cancer immunotherapy, and have thus led to a paradigm shift of cancer treatment. In particular, inhibition of the antiprogrammed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) axis with ICI, including nivolumab and pembrolizumab, has been emerging as a novel treatment strategy for advanced gastric cancers. An accurate noninvasive assessment of the response to ICI is important for the management of patients with advanced or metastatic gastric cancer.To examine whether the European Organization for Research and Treatment of Cancer (EORTC) and PET Response Criteria in Solid Tumors (PERCIST) are valuable for predicting progression-free survival (PFS) in patients with advanced or metastatic gastric cancers treated with nivolumab.Six patients with advanced or metastatic gastric cancers who underwent 18F-FDG-PET/computed tomography (CT) scans before, and from 2 to 6 months after initiation of nivolumab therapy between September 2017 and August 2019, were evaluated retrospectively. The correlation between tumor progression and EORTC or PERCIST was assessed with the Fisher's exact test. The PFS was assessed with the Kaplan-Meier method.Two patients were alive without progression, and the remaining 4 patients exhibited tumor progression. Two patients without progression were classified as partial metabolic response (PMR) patients based on EORTC or PERCIST, while the other 4 patients with progression were classified as progressive metabolic disease (PMD) patients based on EORTC (P = .067), or stable metabolic disease (SMD) patients, or PMD patients based on PERCIST (P = .067).The mean and median PFS of all patients was 12.7 months (95% confidence interval [CI], 4.9-20.4 months) and 5 months (95%CI, 4.0-11.0 months). Two EORTC or PERCIST PMR patients showed significantly longer median PFS compared with 4 non-PMR patients (not reached vs 4.0 months, P = .044). Three PERCIST PMR or SMD patients also showed significantly longer median PFS compared with 3 PMD patients (not reached vs 4.0 months, P = .022). These results suggest that EORTC or PERCIST has the potential to predict PFS of patients with advanced or metastatic gastric cancers treated by nivolumab and further studies are needed to determine its value in larger study populations.

DOI： 10.1097/MD.0000000000025494

Scopus

PubMed

出版者・発行元：メジカルビュー社  

DOI： 10.18885/ci.0000000553

記述言語：英語   出版者・発行元：Abdominal Radiology  

Purpose: To assess the utility of a machine-learning approach for predicting liver function based on technetium-99 m-galactosyl serum albumin (99mTc-GSA) single photon emission computed tomography (SPECT)/CT. Methods: One hundred twenty-eight patients underwent a 99mTc-GSA SPECT/CT-based liver function evaluation. All were classified into the low liver-damage or high liver-damage group. Four clinical (age, sex, background liver disease and histological type) and 8 quantitative 99mTc-GSA SPECT/CT features (receptor index [LHL15], clearance index [HH15], liver-SUVmax, liver-SUVmean, heart-SUVmax, metabolic volume of liver [MVL], total lesion GSA [TL-GSA, liver-SUVmean × MVL] and SUVmax ratio [liver-SUVmax/heart-SUVmax]) were obtained. To predict high liver damage, a machine learning classification with features selection based on Gini impurity and principal component analysis (PCA) were performed using a support vector machine and a random forest (RF) with a five-fold cross-validation scheme. To overcome imbalanced data, stratified sampling was used. The ability to predict high liver damage was evaluated using a receiver operating characteristic (ROC) curve analysis. Results: Four indices (LHL15, HH15, heart SUVmax and SUVmax ratio) yielded high areas under the ROC curves (AUCs) for predicting high liver damage (range: 0.89–0.93). In a machine learning classification, the RF with selected features (heart SUVmax, SUVmax ratio, LHL15, HH15, and background liver disease) and PCA model yielded the best performance for predicting high liver damage (AUC = 0.956, sensitivity = 96.3%, specificity = 90.0%, accuracy = 91.4%). Conclusion: A machine-learning approach based on clinical and quantitative 99mTc-GSA SPECT/CT parameters might be useful for predicting liver function.

DOI： 10.1007/s00261-021-02985-1

Scopus

PubMed

記述言語：英語   出版者・発行元：Molecular Imaging and Biology  

Purpose: To examine the prognostic significance of pretreatment 2-deoxy-2-[18F]fluoro-d-glucose ([18F]-FDG) positron emission tomography (PET)-based radiomic features using a machine learning approach in patients with endometrial cancers. Procedures: Included in this retrospective study were 53 patients with endometrial cancers who underwent [18F]-FDG PET/X-ray computed tomography (CT) before treatment. Since two different PET scanners were used, post-reconstruction harmonization was performed for all PET parameters using the ComBat harmonization method. Four clinical (age, histological type, stage, and treatment method) and 40 [18F]-FDG PET-based radiomic features were ranked, and a subset of useful features was selected based on the decrease in the Gini impurity in terms of associations with disease progression. The machine learning algorithms (random forest, neural network, k-nearest neighbors (kNN), naive Bayes, logistic regression, and support vector machine) were compared using the areas under the receiver operating characteristic curve (AUC) and validated by the random sampling method. Progression-free survival (PFS) and overall survival (OS) were assessed by the Cox regression analysis. Results: The five best predictors of disease progression were coarseness, gray-level run length nonuniformity, stage, treatment method, and gray-level zone length nonuniformity. The kNN model obtained the best performance classifier for predicting the disease progression (AUC =0.890, accuracy =0.849, F1 score =0.848, precision =0.857, and recall =0.849). Coarseness which was the first ranked radiomic feature was selected for survival analyses, and only coarseness remained as a significant and independent factor for both PFS (hazard ratios (HR), 0.65; 95 % confidence interval [CI], 0.49–0.86; p=0.003) and OS (HR, 0.52; 95 % CI, 0.36–0.76; p<0.001) at multivariate Cox regression analysis. Conclusions: [18F]-FDG PET-based radiomic analysis using a machine learning approach may be useful for predicting tumor progression and prognosis in patients with endometrial cancers.

DOI： 10.1007/s11307-021-01599-9

Scopus

PubMed

記述言語：英語   出版者・発行元：Japanese Journal of Radiology  

Objective: In malignant melanoma patients treated with immune checkpoint inhibitor (ICI) therapy, three different FDG-PET criteria, European Organization for Research and Treatment of Cancer (EORTC), PET Response Criteria in Solid Tumors (PERCIST), immunotherapy-modified PERCIST (imPERCIST), were compared regarding response evaluation and prognosis prediction using standardized uptake value (SUV) harmonization of results obtained with various PET/CT scanners installed at different centers. Materials and methods: Malignant melanoma patients (n = 27) underwent FDG-PET/CT examinations before and again 3 to 9 months after therapy initiation (nivolumab, n = 21; pembrolizumab, n = 6) with different PET scanners at five hospitals. EORTC, PERCIST, and imPERCIST criteria were used to evaluate therapeutic response, then concordance of the results was assessed using Cohen’s κ coefficient. Log-rank and Cox methods were employed to determine progression-free (PFS) and overall (OS) survival. Results: Complete metabolic response (CMR)/partial metabolic response (PMR)/stable metabolic disease (SMD)/progressive metabolic disease (PMD) with harmonized EORTC, PERCIST, and imPERCIST was seen in 3/5/4/15, 4/5/3/15, and 4/5/5/13 patients, respectively. Nearly perfect concordance between each pair of criteria was noted (κ = 0.939–0.972). Twenty patients showed progression and 14 died from malignant melanoma after a median 19.2 months. Responders (CMR/PMR) showed significantly longer PFS and OS than non-responders (SMD/PMD) (harmonized EORTC: p < 0.0001 and p = 0.011; harmonized PERCIST: p < 0.0001 and p = 0.0012; harmonized imPERCIST: p < 0.0001 and p = 0.0012, respectively). Conclusions: All harmonized FDG-PET criteria (EORTC, PERCIST, imPERCIST) showed accuracy for response evaluation of ICI therapy and prediction of malignant melanoma patient prognosis. Additional studies to determine their value in larger study populations will be necessary.

DOI： 10.1007/s11604-021-01174-w

Scopus

PubMed

記述言語：英語   出版者・発行元：EJNMMI Research  

Background: The aim of this study was to assess the reader variability in quantitatively assessing pre- and post-treatment 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography ([18F]FDG PET/CT) scans in a defined set of images of cancer patients using the same semi-automated analytical software (Auto-PERCIST™), which identifies tumor peak standard uptake value corrected for lean body mass (SULpeak) to determine [18F]FDG PET quantitative parameters. Methods: Paired pre- and post-treatment [18F]FDG PET/CT images from 30 oncologic patients and Auto-PERCIST™ semi-automated software were distributed to 13 readers across US and international sites. One reader was aware of the relevant medical history of the patients (readreference), whereas the 12 other readers were blinded to history but had access to the correlative images. Auto-PERCIST™ was set up to first automatically identify the liver and compute the threshold for tumor measurability (1.5 × liver mean) + (2 × liver standard deviation [SD]) and then detect all sites with SULpeak greater than the threshold. Next, the readers selected sites they believed to represent tumor lesions. The main performance metric assessed was the percent change in the SULpeak (%ΔSULpeak) of the hottest tumor identified on the baseline and follow-up images. Results: The intra-class correlation coefficient (ICC) for the %ΔSULpeak of the hottest tumor was 0.87 (95%CI: [0.78, 0.92]) when all reads were included (n = 297). Including only the measurements that selected the same target tumor as the readreference (n = 224), the ICC for %ΔSULpeak was 1.00 (95%CI: [1.00, 1.00]). The Krippendorff alpha coefficient for response (complete or partial metabolic response, versus stable or progressive metabolic disease on PET Response Criteria in Solid Tumors 1.0) was 0.91 for all reads (n = 380) and 1.00 including for reads with the same target tumor selection (n = 270). Conclusion: Quantitative tumor [18F]FDG SULpeak changes measured across multiple global sites and readers utilizing Auto-PERCIST™ show very high correlation. Harmonization of methods to single software, Auto-PERCIST™, resulted in virtually identical extraction of quantitative tumor response data from [18F]FDG PET images when the readers select the same target tumor.

DOI： 10.1186/s13550-021-00754-1

Scopus

記述言語：英語   出版者・発行元：Molecular Imaging and Biology  

DOI： 10.1007/s11307-020-01516-6

Scopus

PubMed

記述言語：英語   出版者・発行元：European Journal of Radiology  

DOI： 10.1016/j.ejrad.2020.109397

Scopus

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

出版者・発行元：European Radiology  

DOI： 10.1007/s00330-019-06463-7

Scopus

PubMed

出版者・発行元：European Radiology  

DOI： 10.1007/s00330-019-06517-w

Scopus

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

出版者・発行元：Clinical Radiology  

DOI： 10.1016/j.crad.2019.09.132

Scopus

出版者・発行元：Nuclear Medicine Communications  

DOI： 10.1097/MNM.0000000000001168

Scopus

PubMed

出版者・発行元：Pancreas  

DOI： 10.1097/MPA.0000000000001427

Scopus

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

出版者・発行元：Molecular Imaging and Biology  

DOI： 10.1007/s11307-018-1290-z

Scopus

PubMed

出版者・発行元：Abdominal Radiology  

DOI： 10.1007/s00261-019-01958-9

Scopus

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

出版者・発行元：一般社団法人 日本核医学会  

DOI： 10.18893/kakuigaku.rp.1971

出版者・発行元：一般社団法人 日本核医学会  

DOI： 10.18893/kakuigaku.wgr.1977

出版者・発行元：British Journal of Radiology  

DOI： 10.1259/bjr.20180620

Scopus

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

出版者・発行元：European Journal of Nuclear Medicine and Molecular Imaging  

DOI： 10.1007/s00259-018-4008-1

Scopus

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

出版者・発行元：(一社)インターナショナルハートジャーナル刊行会  

肺高血圧症(PH)患者では肺の123-メタヨードベンジルグアニジン(123I-MIBG)取り込みが低下しているとの仮説を立て、PH患者の肺123I-MIBG取り込みを評価し、心エコー検査や右心カテーテル法で得られた各指標と比較検討した。2003年12月〜2014年12月に123I-MIBGシンチを施行されたPH患者21例と、性別・年齢を一致させた対照8例を対象とした。心エコー、6分間歩行試験、B型ナトリウム利尿ペプチド測定、肺機能検査、右心カテーテル法を施行した。PH患者を慢性血栓塞栓性肺高血圧症(CTEPH)9例(男性2例、女性7例、平均69.1±7.5歳)と肺動脈高血圧症(PAH)12例(男性3例、女性9例、平均54.1±13.4歳)に分けた。平均肺動脈圧はCTEPH群が37.7±6.8mmHg、PAH群が32.3±5.3mmHgで有意差はなかった。両群間でその他の血行動態パラメーターに有意差はなかった。123I-MIBGの肺取り込みはPAH群ではearly image(EI)1.54±0.18、delayed image(DI) 1.41±0.16で、CTEPH群のEI 2.17±0.25、DI 1.99±0.20、対照群のEI2.32±0.27、DI 1.92±0.19よりも有意に低かった。PAH患者では肺血管内皮機能が低下している可能性が示唆された。

出版者・発行元：一般社団法人 インターナショナル・ハート・ジャーナル刊行会  

<p>According to recent studies, lung uptake of iodine-123-metaiodobenzylguanidine (¹²³I-MIBG) is impaired in many lung diseases and low lung uptake of ¹²³I-MIBG suggests endothelial dysfunction of the pulmonary artery. ¹²³I-MIBG scintigraphy in patients with pulmonary hypertension (PH) has not yet been clinically evaluated. We hypothesized that the lung uptake of ¹²³I-MIBG is reduced in patients with PH and differs among PH subtypes. The purpose of the present study was to analyze the lung uptake of ¹²³I-MIBG in patients with PH and compare it with the data obtained by echocardiography or right heart catheterization. ¹²³I-MIBG scintigraphy was performed in 286 consecutive patients from 2003 to 2014. We enrolled 21 patients with PH and 8 control patients. The 21 patients with PH were categorized into those with pulmonary artery hypertension (PAH, <i>n</i> = 12) and those with chronic thromboembolic pulmonary hypertension (CTEPH, <i>n</i> = 9). The mean pulmonary artery pressure was not significantly different between patients with CTEPH and PAH (37.7 ± 6.8 versus 32.3 ± 5.3 mmHg respectively; <i>P</i> = 0.054). There were no significant differences in any other hemodynamic parameters between the two groups. The lung uptake of ¹²³I-MIBG in PAH patients (early image: 1.54 ± 0.18, delayed image: 1.41 ± 0.16) was significantly lower than that of CTEPH patients (early image: 2.17 ± 0.25, <i>P</i> < 0.0001; delayed image: 1.99 ± 0.20, <i>P</i> = 0.0001, adjusted for age and World Health Organization classification) and controls (early image: 2.32 ± 0.27, <i>P</i> = 0.0007; delayed image: 1.92 ± 0.19, <i>P</i> = 0.0007). In conclusion, we found for the first time that the lung uptake of ¹²³I-MIBG in patients with PAH is lower than that in patients with CTEPH and controls.</p>

DOI： 10.1536/ihj.16-629

Scopus

PubMed

出版者・発行元：British Journal of Radiology  

DOI： 10.1259/bjr.20170546

Scopus

PubMed

出版者・発行元：Abdominal Radiology  

DOI： 10.1007/s00261-017-1207-3

Scopus

PubMed

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

出版者・発行元：European Journal of Nuclear Medicine and Molecular Imaging  

DOI： 10.1007/s00259-017-3787-0

Scopus

PubMed

出版者・発行元：Nagoya Journal of Medical Science  

DOI： 10.18999/nagjms.79.4.527

Scopus

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

出版者・発行元：金原出版(株)  

PET検診6256件を対象に、癌発見率と年代や性別、受診回数との関連を検討した。実受診者数は4898人で、うち複数回受検者が710人、内訳は男3562人・女2694人・平均年齢58.0歳であった。162件(167の癌病変、重複癌3人、3重複癌1人を含む)の癌が発見され、癌発見率は延べで3.3%、初回で3.0%、癌病変発見率は延べで2.7%、初回で3.1%、2回目で1.4%であった。男女あわせた年代別発見率の推移では、加齢により有意に癌の発見率が上昇していた。男女別で50歳を境とした2群で年齢と発見率を比較したところ、男性では50歳以上で50歳未満に比べて発見率が高く、女性では有意差はなかった。初回受診者のみの病変発見率をみると、全体と同様に男性で発見率が高く、加齢によりその傾向が顕著であったが、各年代での発見率がより高かった。以上、PET癌検診発見率は受検者の年齢や性別、特に年齢に大きく影響されると考えられた。

出版者・発行元：Journal of the Endocrine Society  

DOI： 10.1210/js.2017-00182

Scopus

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

出版者・発行元：Abdominal Radiology  

DOI： 10.1007/s00261-016-0987-1

Scopus

PubMed

出版者・発行元：Journal of Magnetic Resonance Imaging  

DOI： 10.1002/jmri.25452

Scopus

PubMed

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

出版者・発行元：Abdominal Radiology  

DOI： 10.1007/s00261-016-0947-9

Scopus

PubMed

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

出版者・発行元：European Journal of Nuclear Medicine and Molecular Imaging  

DOI： 10.1007/s00259-016-3506-2

Scopus

PubMed

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

出版者・発行元：(株)メディカルアイ  

18F-FDG-PET/CTにおけるtexture解析は、腫瘍内の不均一性を評価する方法であり、腫瘍の悪性度評価や治療効果判定などに有用と考えられる。Texture解析方法の標準化などを含めて、日常臨床においてtexture解析を活用するには、様々な課題があるが、今後、人工知能(AI)を用いた研究の発展に期待される。(著者抄録)

出版者・発行元：(一社)日本核医学会  

出版者・発行元：(株)メジカルビュー社  

副腎の画像診断においては、代謝機能を反映する核医学画像は古くから非常に重要な役割を果たしてきた。最近ではSPECTやPETの核医学画像と形態画像のCTやMRIとの融合も容易となり、よりわかりやすい画像が得られるようになってきた。(著者抄録)

出版者・発行元：名古屋大学医学部  

開催年月日： 2015年10月

記述言語：英語   会議種別：口頭発表（一般）  

開催地：Hamburg, Germany  

開催年月日： 2015年6月

記述言語：英語   会議種別：口頭発表（一般）  

開催地：Baltimore, USA.  

開催年月日： 2014年11月

記述言語：日本語  

開催地：大阪  

国内学会

開催年月日： 2014年6月

記述言語：英語  

開催地：セントルイス  

国際学会

開催年月日： 2014年4月

記述言語：日本語  

開催地：神奈川  

国内学会

開催年月日： 2013年12月

記述言語：英語  

開催地：シカゴ  

国際学会

開催年月日： 2013年11月

記述言語：英語  

開催地：韓国  

国際学会

開催年月日： 2013年11月

記述言語：日本語  

開催地：福岡  

国内学会

開催年月日： 2013年6月

記述言語：英語  

開催地：カナダ  

国際学会

開催年月日： 2013年4月

記述言語：日本語  

開催地：神奈川  

国内学会

開催年月日： 2012年11月

記述言語：英語  

開催地：シカゴ  

国際学会

開催年月日： 2012年10月

記述言語：日本語  

開催地：札幌  

国内学会

開催年月日： 2012年6月

記述言語：英語  

開催地：マイアミ  

国際学会

開催年月日： 2012年4月

記述言語：日本語  

開催地：神奈川  

国内学会

開催年月日： 2011年11月

記述言語：日本語  

開催地：茨城  

国内学会

開催年月日： 2011年10月

記述言語：英語  

開催地：イギリス  

国際学会

開催年月日： 2011年4月

記述言語：日本語  

開催地：神奈川  

国内学会

記述言語：英語  

記述言語：英語  

記述言語：日本語  

記述言語：英語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：英語  

記述言語：日本語  

記述言語：英語  

記述言語：英語