Cancer Imaging最新文献

{"title":"Evaluation of CE-MATRIX-Enhanced FLAIR imaging in the detection of leptomeningeal metastasis.","authors":"Junhui Yuan, Shaobo Fang, Fan Meng, Yue Wu, Dongqiu Shan, Chunmiao Xu, Renzhi Zhang, Xuejun Chen","doi":"10.1186/s40644-025-00867-z","DOIUrl":"10.1186/s40644-025-00867-z","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the diagnostic value of CE-MATRIX-T1FLAIR and 3D CE-T2FLAIR sequences based on Contrast Enhancement Modulated flip Angle Technique in Refocused Imaging with eXtended echo train (CE-MATRIX) technology for detecting Leptomeningeal Metastasis (LM) using Fluid Attenuated Inversion Recovery (FLAIR) imaging.</p><p><strong>Methods: </strong>This prospective study included 563 hospitalized patients with clinically suspected LM, diagnosed with malignant tumors between January 2022 and October 2023 at Henan Cancer Hospital. Both CE-MATRIX-T1FLAIR and 3D CE-T2FLAIR sequences were used for imaging. Two radiologists independently evaluated image quality, diagnostic confidence, and objective measurements, diagnosing LM as positive or negative, with disagreements resolved by consultation. Subjective and objective scores were compared using the Wilcoxon signed-rank test. The diagnostic performance of the sequences was compared using ROC curve analysis, with cerebrospinal fluid (CSF) cytology as the gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and area under the curve (AUC) values were calculated and compared using Z-tests.</p><p><strong>Results: </strong>LM was confirmed in 321 patients. CE-MATRIX-T1FLAIR showed superior subjective scores in image quality and diagnostic confidence (p < 0.001). Though CE-MATRIX-T1FLAIR had a lower SNR (p = 0.013), it demonstrated higher sensitivity, specificity, PPV, NPV, accuracy, and AUC than 3D CE-T2FLAIR (p < 0.001). Both sequences provided effective diagnosis and differentiation of LM.</p><p><strong>Conclusion: </strong>CE-MATRIX-T1FLAIR offers superior diagnostic performance compared to 3D CE-T2FLAIR for LM, with slightly better subjective ratings despite a lower SNR. Both sequences are effective for diagnosing LM.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"53"},"PeriodicalIF":3.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glymphatic system dysfunction and cerebrospinal fluid retention in gliomas: evidence from perivascular space diffusion and volumetric analysis.","authors":"Weiqiang Liang, Wenbo Sun, Chunyan Li, Jie Zhou, Changyou Long, Huan Li, Dan Xu, Haibo Xu","doi":"10.1186/s40644-025-00868-y","DOIUrl":"10.1186/s40644-025-00868-y","url":null,"abstract":"<p><strong>Background: </strong>Gliomas may impair glymphatic function and alter cerebrospinal fluid (CSF) dynamics through structural brain changes, potentially affecting peritumoral brain edema (PTBE) and fluid clearance. This study investigated the impact of gliomas on glymphatic system function and CSF volume via diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) and volumetric magnetic resonance imaging (MRI), which clarified the relationships between tumor characteristics and glymphatic system disruption.</p><p><strong>Methods: </strong>In this prospective study, 112 glioma patients and 56 healthy controls underwent MRI to calculate DTI-ALPS indices and perform volumetric analyses of CSF, tumor, and PTBE. Statistical analyses were used to assess the relationships between the DTI-ALPS index, tumor volume, PTBE volume, and clinical characteristics.</p><p><strong>Results: </strong>Glioma patients had significantly lower DTI-ALPS indices (1.266 ± 0.258 vs. 1.395 ± 0.174, p < 0.001) and greater CSF volumes (174.53 ± 34.89 cm³ vs. 154.25 ± 20.89 cm³, p < 0.001) than controls did. The DTI-ALPS index was inversely correlated with tumor volume (r = -0.353, p < 0.001) and PTBE volume (r = -0.266, p = 0.015). High-grade gliomas were associated with lower DTI-ALPS indices and larger PTBE volumes (all p < 0.001). Tumor grade emerged as an independent predictor of the DTI-ALPS index in multivariate analysis (β = -0.244, p = 0.011).</p><p><strong>Conclusion: </strong>Gliomas are associated with significant glymphatic dysfunction, as evidenced by reduced DTI-ALPS indices and increased CSF and PTBE volumes. The DTI-ALPS index serves as a potential biomarker of glymphatic disruption in glioma patients, offering insights into tumor-related fluid changes and the pathophysiology of brain-tumor interactions.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"51"},"PeriodicalIF":3.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PET/MRI is superior to PET/CT in detecting oesophago and gastric carcinomas: a meta-analysis.","authors":"Bo Peng, Hui Sun, Jian Hou, Jian-Xing Luo","doi":"10.1186/s40644-025-00871-3","DOIUrl":"10.1186/s40644-025-00871-3","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the accuracy rates of the detection and staging of oesophago and gastric carcinomas between PET/MRI and PET/CT.</p><p><strong>Methods: </strong>An extensive librarian-led literature search of PubMed, Embase, Web of Science, the Cochrane Central Library, and CNKI was performed and a meta-analysis was done.</p><p><strong>Results: </strong>Six studies, including 123 participants, were analyzed. PET/MRI had a comparatively high sensitivity in primary lesion detection compared with PET/CT. (RR = 1.14, 95% CI 1.01-1.29, P = 0.036).PET/MRI had no significant statistical differences in all aspects of TNM staging compared with PET/CT.</p><p><strong>Conclusions: </strong>This systematic review confirmed the advantage of PET/MRI in detecting oesophago and gastric carcinomas.Compared with PET/CT, it can reduce unnecessary radiation exposure and can be used in relevant patients without contraindications of MRI.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"50"},"PeriodicalIF":3.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of extracellular volume fraction determined using enhanced computed tomography for pathological grading of clear cell renal cell carcinoma: a preliminary study.","authors":"Jian Liu, Xunlan Zhang, Rui Lv, Xiaoyong Zhang, Rongpin Wang, Xianchun Zeng","doi":"10.1186/s40644-025-00866-0","DOIUrl":"10.1186/s40644-025-00866-0","url":null,"abstract":"<p><strong>Objective: </strong>To explore the potential of using the extracellular volume fraction (ECV), measured through enhanced computed tomography (CT), as a tool for determining the pathological grade of clear cell renal cell carcinoma (ccRCC).</p><p><strong>Methods: </strong>This retrospective study, approved by the institutional review board, included 65 patients (median age: 58.40 ± 10.84 years) who were diagnosed with ccRCC based on the nucleolar grading of the International Society of Urological Pathology (ISUP). All patients underwent preoperative abdominal enhanced CT between January 2022 and August 2024. CT features from the unenhanced, corticomedullary, nephrographic, and delayed phases were analyzed, and the extracellular volume fraction (ECV) of ccRCC was calculated by measuring CT values from regions of interest in both the unenhanced and nephrographic phases. Statistical significance was evaluated for differences in these parameters across the four ISUP grades. Additionally, diagnostic efficiency was assessed using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>The ECV showed significant differences across the four ISUP grades of ccRCC, its potential as an important predictor of high-grade ccRCC (P = 0.035). The ROC curve analysis indicated that ECV exhibited the highest diagnostic efficacy for assessing the lower- and higher- pathological grade of ccRCC, with an area under the ROC curve of 0.976. The optimal diagnostic threshold for ECV was determined to be 41.64%, with a sensitivity of 91.31% and a specificity of 97.62%.</p><p><strong>Conclusions: </strong>ECV derived from enhanced CT has the potential to function as an in vivo biomarker for distinguishing between lower- and higher-grade ccRCC. This quantitative measure provides diagnostic value that extends beyond traditional qualitative CT features, offering a more precise and objective assessment of tumor grade.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"49"},"PeriodicalIF":3.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic model using LI-RADS v2018 for predicting early recurrence of microvascular invasion-negative solitary hepatocellular carcinoma.","authors":"Yingying Liang, Xiaorui Han, Tingwen Zhou, Chuyin Xiao, Changzheng Shi, Xinhua Wei, Hongzhen Wu","doi":"10.1186/s40644-025-00865-1","DOIUrl":"10.1186/s40644-025-00865-1","url":null,"abstract":"<p><strong>Objectives: </strong>To develop a diagnostic model for predicting the early recurrence of microvascular invasion (MVI)-negative hepatocellular carcinoma (HCC) after surgical resection, using the Liver Imaging Reporting and Data System (LI-RADS) version 2018.</p><p><strong>Methods: </strong>This retrospective study included 73 patients with MVI-negative HCC who underwent Gadoxetic acid-enhanced MRI (EOB-MRI) scanning before surgical resection. The clinical factors and LI-RADS v2018 MRI features associated with early recurrence were determined using univariable and multivariable analyses. A diagnostic model predicting early recurrence after surgical resection was developed, and its predictive ability was evaluated via a receiver operating characteristic curve. Then, the recurrence-free survival (RFS) rates were analyzed by Kaplan-Meier method.</p><p><strong>Results: </strong>In total, 26 (35.6%) patients were diagnosed with early recurrence according to the follow-up results. Infiltrative appearance and targetoid hepatobiliary phase (HBP) appearance were independent predictors associated with early recurrence (p < 0.05). For the established diagnostic model that incorporated these two significant predictors, the AUC value was 0.76 (95% CI: 0.64-0.85) for predicting early recurrence after resection, which was higher than the infiltrative appearance (AUC: 0.67, 95% CI: 0.55-0.78, p = 0.019) and targetoid HBP appearance (AUC: 0.68, 95% CI:0.57-0.79, p = 0.028). In the RFS analysis, patients with infiltrative appearance and targetoid HBP appearance showed significantly lower RFS rates than those without infiltrative appearance (2-year RFS rate, 48.0% vs. 72.0%; p = 0.009) and targetoid HBP appearance (2-year RFS rate, 60.0% vs. 35.0%; p = 0.003).</p><p><strong>Conclusion: </strong>An EOB-MRI model based on infiltrative appearance and targetoid HBP appearance showed good performance in predicting early recurrence of HCC after surgery, which may provide personalized guidance for clinical treatment decisions in patients with MVI-negative HCC.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"46"},"PeriodicalIF":3.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-based breast MRI for predicting axillary lymph node metastasis: a systematic review and meta-analysis.","authors":"Chia-Fen Lee, Joseph Lin, Yu-Len Huang, Shou-Tung Chen, Chen-Te Chou, Dar-Ren Chen, Wen-Pei Wu","doi":"10.1186/s40644-025-00863-3","DOIUrl":"10.1186/s40644-025-00863-3","url":null,"abstract":"<p><strong>Background: </strong>To perform a systematic review and meta-analysis that assesses the diagnostic performance of deep learning algorithms applied to breast MRI for predicting axillary lymph nodes metastases in patients of breast cancer.</p><p><strong>Methods: </strong>A systematic literature search in PubMed, MEDLINE, and Embase databases for articles published from January 2004 to February 2025. Inclusion criteria were: patients with breast cancer; deep learning using MRI images was applied to predict axillary lymph nodes metastases; sufficient data were present; original research articles. Quality Assessment of Diagnostic Accuracy Studies-AI and Checklist for Artificial Intelligence in Medical Imaging was used to assess the quality. Statistical analysis included pooling of diagnostic accuracy and investigating between-study heterogeneity. A summary receiver operating characteristic curve (SROC) was performed. R statistical software (version 4.4.0) was used for statistical analyses.</p><p><strong>Results: </strong>A total of 10 studies were included. The pooled sensitivity and specificity were 0.76 (95% CI, 0.67-0.83) and 0.81 (95% CI, 0.74-0.87), respectively, with both measures having moderate between-study heterogeneity (I² = 61% and 60%, respectively; p < 0.01). The SROC analysis yielded a weighted AUC of 0.788.</p><p><strong>Conclusion: </strong>This meta-analysis demonstrates that deep learning algorithms applied to breast MRI offer promising diagnostic performance for predicting axillary lymph node metastases in breast cancer patients. Incorporating deep learning into clinical practice may enhance decision-making by providing a non-invasive method to more accurately predict lymph node involvement, potentially reducing unnecessary surgeries.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"44"},"PeriodicalIF":3.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic significance of semi-quantitative metabolic parameters and tumoral metabolic activity based on ¹²³I-MIBG SPECT/CT in pretreatment neuroblastoma patients.","authors":"Ziang Zhou, Xu Yang, Guanyun Wang, Xiaoya Wang, Jun Liu, Yanfeng Xu, Kan Ying, Wei Wang, Jigang Yang","doi":"10.1186/s40644-025-00858-0","DOIUrl":"10.1186/s40644-025-00858-0","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the prognosis predictive value of semi-quantitative metabolic parameters and tumoral metabolic activity based on ¹²³I-meta-iodobenzylguanidine (MIBG) SPECT/CT in pretreatment neuroblastoma (NB) patients.</p><p><strong>Methods: </strong>A total of 50 children (25 girls, 25 boys, median age 37 months, range 1-102 months) with newly diagnosed NB, consecutively examined with pretherapeutic ¹²³I-MIBG SPECT/CT between 2018 and 2024, were included in this retrospective study. The semi-quantitative metabolic parameters and activity of primary tumor were measured, including Tmax/Lmax, Tmean/Lmean, Tmax/Lmean, Tmax/Mmax, Tmean/Mmean and asphericity (ASP). The ratio was maximum or mean count of primary tumor, liver and muscle. Clinical data and image-related factors was recorded as well. The outcome endpoint was event-free survival (EFS). Independent predictors were identified through univariate and multivariate logistic regression analyses. Receiver operating characteristic (ROC) and Kaplan Meier analysis with log-rank test for EFS were performed.</p><p><strong>Results: </strong>Median follow-up was 42 months (range 2.5-74 months; 4 patients showed disease progression/relapse, 7 patients died). The univariate and multivariate Cox regression analysis demonstrated that bone/bone marrow metastasis [95% confidence interval (CI): 1.051, 18.570, p = 0.043], Tmax/Lmax (95% CI: 1.074, 1.459, p = 0.004) and ASP (95% CI: 2.618, 273.477, p = 0.006) were independent predictors of EFS. The Kaplan Meier survival analyses demonstrated that Tmax/Lmax undefined[Formula: see text]]]>6 and ASP [Formula: see text]undefined]]>34% and with bone/bone marrow metastasis had worse outcomes.</p><p><strong>Conclusion: </strong>In this exploratory study, pretherapeutic ¹²³I-MIBG image-derived semi-quantitative metabolic parameters and tumor asphericity provided prognostic value for EFS in NB patients. Tmax/Lmax [Formula: see text]undefined]]>6 and ASP [Formula: see text]undefined]]>34%, along with the presence of bone/bone marrow metastasis, could be considered as supplementary factors alongside existing ones.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"45"},"PeriodicalIF":3.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiating high-grade patterns and predominant subtypes for IASLC grading in invasive pulmonary adenocarcinoma using radiomics and clinical-semantic features.","authors":"Sunyi Zheng, Jiaxin Liu, Jiping Xie, Wenjia Zhang, Keyi Bian, Jing Liang, Jingxiong Li, Jing Wang, Zhaoxiang Ye, Dongsheng Yue, Xiaonan Cui","doi":"10.1186/s40644-025-00864-2","DOIUrl":"10.1186/s40644-025-00864-2","url":null,"abstract":"<p><strong>Objectives: </strong>The International Association for the Study of Lung Cancer (IASLC) grading system for invasive non-mucinous adenocarcinoma (ADC) incorporates high-grade patterns (HGP) and predominant subtypes (PS). Following the system, this study aimed to explore the feasibility of predicting HGP and PS for IASLC grading.</p><p><strong>Materials and methods: </strong>A total of 529 ADCs from patients who underwent radical surgical resection were randomly divided into training and validation datasets in a 7:3 ratio. A two-step model consisting of two submodels was developed for IASLC grading. One submodel assessed whether the HGP exceeded 20% for ADCs, whereas the other distinguished between lepidic and acinar/papillary PS. The predictions from both submodels determined the final IASLC grades. Two variants of this model using either radiomic or clinical-semantic features were created. Additionally, one-step models that directly assessed IASLC grades using clinical-semantic or radiomic features were developed for comparison. The area under the curve (AUC) was used for model evaluation.</p><p><strong>Results: </strong>The two-step radiomic model achieved the highest AUC values of 0.95, 0.85, 0.96 for grades 1, 2, 3 among models. The two-step models outperformed the one-step models in predicting grades 2 and 3, with AUCs of 0.89 and 0.96 vs. 0.53 and 0.81 for radiomics, and 0.68 and 0.77 vs. 0.44 and 0.63 for clinical-semantics (p < 0.001). Radiomics models showed better AUCs than clinical-semantic models for grade 3 regardless of model steps.</p><p><strong>Conclusions: </strong>Predicting HGP and PS using radiomics can achieve accurate IASLC grading in ADCs. Such a two-step radiomics model may provide precise preoperative diagnosis, thereby supporting treatment planning.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"42"},"PeriodicalIF":3.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of intrahepatic cholangiocarcinoma with LI-RADS in the high-risk population: MRI diagnosis and postoperative survival.","authors":"Ruofan Sheng, Beixuan Zheng, Yunfei Zhang, Chun Yang, Dong Wu, Jianjun Zhou, Mengsu Zeng","doi":"10.1186/s40644-025-00860-6","DOIUrl":"10.1186/s40644-025-00860-6","url":null,"abstract":"<p><strong>Background: </strong>The precise impact of LI-RADS-defined risk factors on the diagnosis and prognosis of intrahepatic cholangiocarcinoma (iCCA) remains unclear.</p><p><strong>Objective: </strong>To assess the value of LI-RADS categories and features for iCCA diagnosis, focusing on the diagnostic and prognostic implications of LI-RADS-defined risk factors.</p><p><strong>Methods: </strong>Totally 214 high risk patients, including 107 surgically-confirmed solitary iCCAs and 107 hepatocellular carcinomas (HCC) from two centers were retrospectively enrolled. Clinical and MRI features based on LI-RADS v2018 were compared, and the performance of targetoid features for discriminating iCCA was evaluated. Recurrence-free survival (RFS) was compared across different pathologic diagnoses and LI-RADS categories. Multivariate Cox analysis was performed to identify the independent risk factors for RFS.</p><p><strong>Results: </strong>In the LI-RADS defined high-risk patients, iCCAs differed from HCCs in MRI manifestation. The LR-M category enabled the accurate classification of most iCCAs (89/107, 83.2%), achieving high sensitivity (83.2%), specificity (85.1%), and accuracy (84.1%). The optimal diagnostic performance for iCCA was achieved when at least one targetoid appearance was required for LR-M categorization (AUC = 0.828). Although 26.2% iCCAs presented at least one major feature and 15.0% iCCAs were miscategorized as probably or definitely HCC, only one iCCA case was categorized as LR-5. RFS varied according to both pathologic diagnosis (P = 0.030) and LI-RADS category (P = 0.028), with LI-RADS category demonstrating an independent association with RFS (HR = 1.736, P = 0.033).</p><p><strong>Conclusions: </strong>In high-risk patients, iCCAs frequently exhibit HCC major features, leading to miscategorization as probable HCC. However, the LR-5 category remains highly specific for ruling out iCCA. Furthermore, in high-risk patients with solitary resected iCCA or HCC, LI-RADS category enables the prediction of postsurgical prognosis independently from pathological diagnosis.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"40"},"PeriodicalIF":3.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of ¹⁸F-FDG PET/CT and ¹⁸F-DOPA PET/CT in determining the initial surgical strategy of patients with medullary thyroid cancer : Preoperative PET/CT imaging for medullary thyroid cancer.","authors":"Eline C Jager, Adrienne H Brouwers, Madelon J H Metman, Dilay Aykan, Lisa H de Vries, Lutske Lodewijk, Menno R Vriens, Schelto Kruijff, Thera P Links","doi":"10.1186/s40644-025-00862-4","DOIUrl":"10.1186/s40644-025-00862-4","url":null,"abstract":"<p><strong>Background: </strong>While total thyroidectomy with central neck dissection (CND) is standard for medullary thyroid cancer (MTC), performing a lateral neck dissection (LND) depends on locoregional metastatic spread and is usually decided per individual. This study evaluated the utility of preoperative PET/CT in staging patients at diagnosis and guiding the initial surgical plan, while also exploring the value of neck ultrasound, MRI, and CT.</p><p><strong>Methods: </strong>All MTC patients from two tertiary hospitals (2000 - 2020) were identified from two retrospective databases. All reports of neck ultrasounds, MRIs, CTs and PET/CTs < 8 months prior to primary surgery or < 4 months after MTC diagnosis were reviewed. The sensitivity and specificity of each imaging modality for locating locoregional lymph node metastases (LNM) was determined.</p><p><strong>Results: </strong>A total of 175 MTC patients were included (91 females and 57 hereditary MTCs). Median age at presentation was 52 years (IQR 38 - 62). Initial treatment included a total thyroidectomy, CND and LND in 155 (89%), 140 (80%) and 59 (33%) patients. Preoperative imaging of the neck included ultrasound (91, 52%), MRI (33, 19%) and CT (31, 18%). PET/CT imaging was performed in 56 (32%) patients (35 ¹⁸F-FDG PET/CTs and 33 ¹⁸F-DOPA PET/CTs). Sensitivity for LNM in the central compartment was 72%, 39%, 6%, 42% and 93% for ¹⁸F-FDG PET/CT, ¹⁸F-DOPA PET/CT, ultrasound, MRI and CT, respectively. Respective specificity rates were 80%, 100%, 100%, 71% and 100%. Sensitivity rates for lateral neck LNM were 89%, 81%, 77%, 76% and 75%, for ¹⁸F-FDG PET/CT, ¹⁸F-DOPA PET/CT, ultrasound, MRI and CT, while specificity rates were 100%, 100%, 75%, 78% and 50%, respectively. Twenty-three patients had distant metastases on imaging. In total, 14 ¹⁸F-FDG PET/CTs and 9 ¹⁸F-DOPA PET/CTs were made in these 23 patients (both in six patients). All but one PET/CT showed distant metastases.</p><p><strong>Conclusions: </strong>PET/CT is a powerful tool to detect locoregional LNM and can particularly help identify cases where LNDs are required, avoiding reoperation later on. For accurate staging of the central neck, PET may be combined with diagnostic CT. Finally, PET/CT's ability to detect distant metastases may support de-escalation of a surgical intervention when cure is unlikely.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"41"},"PeriodicalIF":3.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}