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Cancers
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PET/CT and Conventional Imaging in Cancers
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PET/CT and Conventional Imaging in Cancers

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: 1 July 2025 | Viewed by 9282

Special Issue Editors

Dr. Francesco Dondi

E-Mail Website
Guest Editor
Nuclear Medicine Department of Asst Spedali Civili Di Brescia, Università Degli Studi Di Brescia, 25123 Brescia, Italy
Interests: PET/CT; oncology
Special Issues, Collections and Topics in MDPI journals
Dr. Domenico Albano

E-Mail Website1 Website2
Guest Editor
Nuclear Medicine, ASST Spedali Civili di Brescia, Università degli Studi di Brescia, Brescia, Italy
Interests: magnetic resonance; computed tomography; diagnostic radiology; ultrasonography; musculoskeletal sonography; musculoskeletal imaging; imaging; diffusion magnetic resonance imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The role of imaging in the diagnosis, assessment of response to treatment, and follow-up of neoplastic diseases is clear and has been established. Moreover, imaging is also able to give fundamental information about the prognosis of patients and can therefore guide their therapy. In this scenario, conventional imaging (such as CT or MR) has played a central role for many years, given its ability to give precise anatomical information. However, in the last year, the role of PET/CT for the evaluation of a high number of diseases has emerged, in particular for neoplastic conditions. The unique feature of this hybrid imaging modality to combine both anatomical and functional information is fundamental for the assessment of neoplasm. Moreover, the use of different positron emitters tracers can provide knowledge about different metabolic pathways, extending in this setting the field of application of PET/CT. Lastly, the rising use of radiomics in both conventional and hybrid imaging is constantly giving new diagnostic perspectives.

The aim of this Special Issue is therefore to analyze the difference between conventional imaging and PET/CT for the assessment of neoplastic disease, also putting attention on the pros and cons of each technique and making a comparison between them.

Dr. Francesco Dondi
Dr. Domenico Albano
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • PET/CT
  • CT
  • MR
  • conventional imaging
  • positron emission tomography
  • neoplasm
  • cancer

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Published Papers (6 papers)

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Research

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13 pages, 2599 KiB  
Article
Limited Additional Value of a Chest CT in Whole-Body Staging with PET-MRI: A Retrospective Cohort Study
by Tineke van de Weijer, Wilhelmina L. van der Meer, Rik P. M. Moonen, Thiemo J. A. van Nijnatten, Hester A. Gietema, Cristina Mitea, Jochem A. J. van der Pol, Joachim E. Wildberger and Felix M. Mottaghy
Cancers 2024, 16(12), 2265; https://doi.org/10.3390/cancers16122265 - 19 Jun 2024
Viewed by 884
Abstract
Hybrid PET-MRI systems are being used more frequently. One of the drawbacks of PET-MRI imaging is its inferiority in detecting lung nodules, so it is often combined with a computed tomography (CT) of the chest. However, chest CT often detects additional, indeterminate lung [...] Read more.
Hybrid PET-MRI systems are being used more frequently. One of the drawbacks of PET-MRI imaging is its inferiority in detecting lung nodules, so it is often combined with a computed tomography (CT) of the chest. However, chest CT often detects additional, indeterminate lung nodules. The objective of this study was to assess the sensitivity of detecting metastatic versus indeterminate nodules with PET-MRI compared to chest CT. A total of 328 patients were included. All patients had a PET/MRI whole-body scan for (re)staging of cancer combined with an unenhanced chest CT performed at our center between 2014 and 2020. Patients had at least a two-year follow-up. Six percent of the patients had lung metastases at initial staging. The sensitivity and specificity of PET-MRI for detecting lung metastases were 85% and 100%, respectively. The incidence of indeterminate lung nodules on chest CT was 30%. The sensitivity of PET-MRI to detect indeterminate lung nodules was poor (23.0%). The average size of the indeterminate lung nodules detected on PET-MRI was 7 ± 4 mm, and the missed indeterminate nodules on PET-MRI were 4 ± 1 mm (p < 0.001). The detection of metastatic lung nodules is fairly good with PET-MRI, whereas the sensitivity of PET-MRI for detecting indeterminate lung nodules is size-dependent. This may be an advantage, limiting unnecessary follow-up of small, indeterminate lung nodules while adequately detecting metastases. Full article
(This article belongs to the Special Issue PET/CT and Conventional Imaging in Cancers)
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18 pages, 3240 KiB  
Article
Prediction of Patient Outcomes in Locally Advanced Cervical Carcinoma Following Chemoradiotherapy—Comparative Effectiveness of Magnetic Resonance Imaging and 2-Deoxy-2-[18F]fluoro-D-glucose Imaging
by Simran Singh Dhesi, Russell Frood, Sarah Swift, Rachel Cooper, Siddhant Muzumdar, Mehvish Jamal and Andrew Scarsbrook
Cancers 2024, 16(3), 476; https://doi.org/10.3390/cancers16030476 - 23 Jan 2024
Cited by 1 | Viewed by 1475
Abstract
Purpose: To evaluate the utility and comparative effectiveness of three five-point qualitative scoring systems for assessing response on PET-CT and MRI imaging individually and in combination, following curative-intent chemoradiotherapy (CRT) in locally advanced cervical cancer (LACC). Their performance in the prediction of subsequent [...] Read more.
Purpose: To evaluate the utility and comparative effectiveness of three five-point qualitative scoring systems for assessing response on PET-CT and MRI imaging individually and in combination, following curative-intent chemoradiotherapy (CRT) in locally advanced cervical cancer (LACC). Their performance in the prediction of subsequent patient outcomes was also assessed; Methods: Ninety-seven patients with histologically confirmed LACC treated with CRT using standard institutional protocols at a single centre who underwent PET-CT and MRI at staging and post treatment were identified retrospectively from an institutional database. The post-CRT imaging studies were independently reviewed, and response assessed using five-point scoring tools for T2WI, DWI, and FDG PET-CT. Patient characteristics, staging, treatment, and follow-up details including progression-free survival (PFS) and overall survival (OS) outcomes were collected. To compare diagnostic performance metrics, a two-proportion z-test was employed. A Kaplan–Meier analysis (Mantel–Cox log-rank) was performed. Results: The T2WI (p < 0.00001, p < 0.00001) and DWI response scores (p < 0.00001, p = 0.0002) had higher specificity and accuracy than the PET-CT. The T2WI score had the highest positive predictive value (PPV), while the negative predictive value (NPV) was consistent across modalities. The combined MR scores maintained high NPV, PPV, specificity, and sensitivity, and the PET/MR consensus scores showed superior diagnostic accuracy and specificity compared to the PET-CT score alone (p = 0.02926, p = 0.0083). The Kaplan–Meier analysis revealed significant differences in the PFS based on the T2WI (p < 0.001), DWI (p < 0.001), combined MR (p = 0.003), and PET-CT/MR consensus scores (p < 0.001) and in the OS for the T2WI (p < 0.001), DWI (p < 0.001), and combined MR scores (p = 0.031) between responders and non-responders. Conclusion: Post-CRT response assessment using qualitative MR scoring and/or consensus PET-CT and MRI scoring was a better predictor of outcome compared to PET-CT assessment alone. This requires validation in a larger prospective study but offers the potential to help stratify patient follow-up in the future. Full article
(This article belongs to the Special Issue PET/CT and Conventional Imaging in Cancers)
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10 pages, 1244 KiB  
Article
Metabolic Tumor Volume from 18F-FDG PET/CT in Combination with Radiologic Measurements to Predict Long-Term Survival Following Transplantation for Colorectal Liver Metastases
by Harald Grut, Pål-Dag Line, Trygve Syversveen and Svein Dueland
Cancers 2024, 16(1), 19; https://doi.org/10.3390/cancers16010019 - 19 Dec 2023
Cited by 1 | Viewed by 1164
Abstract
The aim of the present study is to report on the ability of metabolic tumor volume (MTV) of liver metastases from pre-transplant 18F-FDG PET/CT in combination with conventional radiological measurements from CT scans to predict long-term disease-free survival (DFS), overall survival (OS), [...] Read more.
The aim of the present study is to report on the ability of metabolic tumor volume (MTV) of liver metastases from pre-transplant 18F-FDG PET/CT in combination with conventional radiological measurements from CT scans to predict long-term disease-free survival (DFS), overall survival (OS), and survival after relapse (SAR) after liver transplantation for colorectal liver metastases. The total liver MTV was obtained from the 18F-FDG PET/CT, and the size of the largest metastasis and the total number of metastases were obtained from the CT. DFS, OS, and SAR for patients with a low and high MTV, in combination with a low and high size, number, and tumor burden score, were compared using the Kaplan–Meier method and log–rank test. Patients with a low number of metastases and low MTV had a significantly longer OS than those with a high MTV, with a median survival of 151 vs. 26 months (p = 0.010). Patients with a high number of metastases and low MTV had significantly longer DFS, OS, and SAR than patients with a high MTV (p = 0.034, 0.006, and 0.026). The tumor burden score of group/zone 3, in combination with a low MTV, had a significantly improved DFS, OS, and SAR compared to those with a high MTV (p = 0.034, <0.001, and 0.006). Patients with a low MTV of liver metastases had a long DFS, OS, and SAR despite a high number of liver metastases and a high tumor burden score. Full article
(This article belongs to the Special Issue PET/CT and Conventional Imaging in Cancers)
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9 pages, 2602 KiB  
Article
Radioisotope-Guided Excision of Mediastinal Lymph Nodes in Patients with Non-Small Cell Lung Carcinoma: Feasibility and Clinical Impact
by Cristiano Pini, Edoardo Bottoni, Francesco Fiz, Veronica Maria Giudici, Marco Alloisio, Alberto Testori, Marcello Rodari, Martina Sollini, Arturo Chiti, Umberto Cariboni and Lidija Antunovic
Cancers 2023, 15(13), 3320; https://doi.org/10.3390/cancers15133320 - 24 Jun 2023
Viewed by 1183
Abstract
Background: Intraoperative localisation of nodal disease in non-small cell lung cancer (NSCLC) can be challenging. Lymph node localisation via radiopharmaceuticals is used in many conditions; we tested the feasibility of this approach in NSCLC. Methods: NSCLC patients were prospectively recruited. Intraoperative peri-tumoral injections [...] Read more.
Background: Intraoperative localisation of nodal disease in non-small cell lung cancer (NSCLC) can be challenging. Lymph node localisation via radiopharmaceuticals is used in many conditions; we tested the feasibility of this approach in NSCLC. Methods: NSCLC patients were prospectively recruited. Intraoperative peri-tumoral injections of [99mTc]Tc-albumin nanocolloids were performed, followed by removing the tumour and locoregional lymph nodes. These were examined ex vivo with a gamma probe and labelled sentinel lymph nodes (SLNs) if they showed any activity or non-sentinel lymph nodes (nSLNs) if they did not. Thereafter, the surgical field was scanned with the probe; any further radioactive lymph node was removed and labelled as “extra” SLNs (eSLNs). All specimens were sent to histology, and metastatic status was recorded. Results: 48 patients were enrolled, and 290 nodal stations were identified: 179 SLNs, 87 nSLNs, and 24 eSLNs. A total of 44 nodal metastases were identified in 22 patients, with 36 of them (82%) located within SLNs. Patients with nSLNs metastases had at least a co-existing positive SLN. No metastases were found in eSLNs. Conclusions: The technique shows high sensitivity for intraoperative nodal metastases identification. This information could allow selective lymphadenectomies in low-risk patients or more aggressive approaches in high-risk patients. Full article
(This article belongs to the Special Issue PET/CT and Conventional Imaging in Cancers)
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Review

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15 pages, 869 KiB  
Review
PET/CT and Conventional Imaging for the Assessment of Neuroendocrine Prostate Cancer: A Systematic Review
by Francesco Dondi, Alessandro Antonelli, Nazareno Suardi, Andrea Emanuele Guerini, Domenico Albano, Silvia Lucchini, Luca Camoni, Giorgio Treglia and Francesco Bertagna
Cancers 2023, 15(17), 4404; https://doi.org/10.3390/cancers15174404 - 3 Sep 2023
Cited by 1 | Viewed by 1967
Abstract
Background: Neuroendocrine prostate cancer (NEPC) is a rare neoplasm, and the role of both conventional imaging (CI) and positron emission tomography/computed tomography (PET/CT) for its assessment has not been clearly evaluated and demonstrated. The aim of this systematic review was to analyze the [...] Read more.
Background: Neuroendocrine prostate cancer (NEPC) is a rare neoplasm, and the role of both conventional imaging (CI) and positron emission tomography/computed tomography (PET/CT) for its assessment has not been clearly evaluated and demonstrated. The aim of this systematic review was to analyze the diagnostic performances of these imaging modalities in this setting. Methods: A wide literature search of the PubMed/MEDLINE, Scopus, and Web of Science databases was made to find relevant published articles about the role of CI and PET/CT for the evaluation of NEPC. Results: 13 studies were included in the systematic review. PET/CT imaging with different radiopharmaceuticals has been evaluated in many studies (10) compared to CI (3 studies), which has only a limited role in NEPC. Focusing on PET/CT, a study used [18F]FDG, labeled somatostatin analogs were used in 5 cases, a study used [68Ga]Ga-FAPI-04, [68Ga]Ga-PSMA-11 was evaluated in a single case, and two works used different tracers. Conclusion: Published data on the role of PET/CT for the assessment of NEPC are limited. At present, it is still uncertain which tracer performs best, and although [18F]FDG has been evaluated and seems to offer some advantages in availability and clinical staging, other tracers may be more useful to understand tumor biology or identify targets for subsequent radioligand therapy. Further research is therefore desirable. In contrast, data are still limited to draw a final conclusion on the role and the specific characteristics of CI in this rare form of neoplasm, and therefore, more studies are needed in this setting. Full article
(This article belongs to the Special Issue PET/CT and Conventional Imaging in Cancers)
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Other

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12 pages, 990 KiB  
Systematic Review
The Role of PSMA PET Imaging in the Classification of the Risk of Prostate Cancer Patients: A Systematic Review on the Insights to Guide an Active Surveillance Approach
by Francesco Dondi, Alessandro Antonelli, Nazareno Suardi, Giorgio Treglia and Francesco Bertagna
Cancers 2024, 16(6), 1122; https://doi.org/10.3390/cancers16061122 - 11 Mar 2024
Viewed by 1879
Abstract
Background: active surveillance (AS) is a suitable strategy for patients with prostate cancer (PCa). Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) imaging is an established tool used to assess PCa. The aim of this review was to evaluate the role of PSMA [...] Read more.
Background: active surveillance (AS) is a suitable strategy for patients with prostate cancer (PCa). Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) imaging is an established tool used to assess PCa. The aim of this review was to evaluate the role of PSMA imaging to guide correct risk-based classification and the AS approach in PCa patients. Methods: The Scopus, Embase, Web of Science, Cochrane Library, and PubMed/MEDLINE databases were screened to find relevant published articles. Results: 1774 articles were revealed with the literature search. A total of 1764 articles were excluded after applying exclusion criteria (data not within the field of interest, preclinical papers, conference proceedings, reviews, or editorials). Ten studies were finally included in the review, revealing that PSMA PET could have the ability to guide risk-based classification of PCa and the choice of AS, and to guide the execution of biopsies for the research of high-grade PCa, therefore precluding AS. Conclusion: this systematic review underlined a possible role of PSMA PET imaging in patients with PCa by correctly re-classifying them on the basis of their risk and guiding AS. Full article
(This article belongs to the Special Issue PET/CT and Conventional Imaging in Cancers)
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