Diagnostic Imaging and Assessment of Therapeutical Response in Lung and Pleural Neoplasms

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 6831

Special Issue Editor


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Guest Editor
Medical Thoracic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
Interests: lung cancer; pleural mesothelioma; tobacco control and prevention; immunotherapy; breath analysis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, the landscape of treatment of lung and pleural neoplasms has been revolutionized by new treatments, mainly represented by target therapies and immunotherapy. PET scan and CT scan are contributing to response assessment during these treatments via a different evaluation with respect to classical dimensional RECIST criteria.

Indeed, the introduction of i-RECIST (immune-RECIST) and revised m-RECIST for Pleural Mesothelioma represent criteria of response assessment tailored to the treatment and type of neoplasms.

In particular, the therapeutic response during targeted therapies and immune-checkpoint inhibitors requires a knowledge of particular aspects of diagnostic imaging; for example, the identification of a pseudoprogression is challenging, and the contribution of multiple techniques, including nuclear medicine imaging, would be beneficial in these cases.

Furthermore, recent reports have described some morphological characteristics as potentially predictive parameters of response to treatments and interesting findings in radiomics research could provide useful insights in the future.

This Special Issue will focus on the role and new aspects of diagnostic management during these treatments, with the awareness that a multidisciplinary contribution could help to achieve a better outcome for patients.

Dr. Annamaria Catino
Guest Editor

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Keywords

  • Lung and pleural neoplasms
  • Diagnostic imaging
  • Immunotherapy
  • Target therapy
  • Radiomics

Published Papers (3 papers)

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Research

11 pages, 917 KiB  
Article
Validation of a Cytological Classification System for the Rapid On-Site Evaluation (Rose) of Pulmonary and Mediastinal Needle Aspirates
by Lina Zuccatosta, Giulio Rossi, Stefano Gasparini, Maurizio Ferretti, Federico Mei, Michele Sediari, Francesca Barbisan, Gaia Goteri, Giuseppe Maria Corbo and Alessandro Di Marco Berardino
Diagnostics 2022, 12(11), 2777; https://doi.org/10.3390/diagnostics12112777 - 14 Nov 2022
Cited by 1 | Viewed by 1999
Abstract
Rapid on-site evaluation (ROSE) is a procedure that allows immediate assessment of adequacy of cytological specimens obtained by fine needle aspiration (FNA). The application of ROSE diagnostic categories has been applied in various organs, but not in thoracic pathology. We aimed to retrospectively [...] Read more.
Rapid on-site evaluation (ROSE) is a procedure that allows immediate assessment of adequacy of cytological specimens obtained by fine needle aspiration (FNA). The application of ROSE diagnostic categories has been applied in various organs, but not in thoracic pathology. We aimed to retrospectively assess the concordance with the final diagnosis of a categorization from C1 (inadequate) to C5 (neoplastic) during ROSE performed with bronchoscopic or percutaneous sampling procedures of thoracic lesions in a large series of consecutive cases. This retrospective single-center study evaluated 2282 consecutive ROSEs performed on 1827 patients from January 2016 to December 2020 in 994 cases of transbronchial needle aspiration (TBNA) in peripheral pulmonary lesions, in 898 transthoracic FNAs, in 318 ultrasound-guided TBNAs, in 50 conventional TBNAs and in 22 endobronchial TBNAs. False positive and false negative cases of ROSE were 43 (1.88%) and 73 (3.2%), respectively, when compared with the definitive diagnosis. The sensitivity, specificity and the positive and negative prognostic values of ROSE were 94.84%, 95.05%, 96.89% and 91.87%, respectively. Overall concordance between ROSE and the final diagnosis was 0.8960 (Cohen’s kappa). No significant differences were observed in terms of sampling procedures and type and location of the lesions. A tiered classification scheme of ROSE from C1 to C5 during bronchoscopic and percutaneous sampling procedures is helpful in effectively guiding clinical management of patients with thoracic lesions. Full article
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13 pages, 1333 KiB  
Article
Is It Possible to Establish a Reliable Correlation between Maximum Standardized Uptake Value of 18-Fluorine Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Histological Types of Non-Small Cell Lung Cancer? Analysis of the Italian VATS Group Database
by Duilio Divisi, Marta Rinaldi, Stefano Necozione, Carlo Curcio, Federico Rea, Francesco Zaraca, Andrea De Vico, Gino Zaccagna, Gabriella Di Leonardo, Roberto Crisci and on behalf of the Italian VATS Group
Diagnostics 2021, 11(10), 1901; https://doi.org/10.3390/diagnostics11101901 - 14 Oct 2021
Cited by 2 | Viewed by 1640
Abstract
Background. Although positron emission tomography/computed tomography, often integrated with 2-deoxy-2-[fluorine-18] fluorine-D-glucose (18F-FDG-PET/CT), is fundamental in the assessment of lung cancer, the relationship between metabolic avidity of different histotypes and maximum standardized uptake value (SUVmax) has not yet been thoroughly investigated. The aim of [...] Read more.
Background. Although positron emission tomography/computed tomography, often integrated with 2-deoxy-2-[fluorine-18] fluorine-D-glucose (18F-FDG-PET/CT), is fundamental in the assessment of lung cancer, the relationship between metabolic avidity of different histotypes and maximum standardized uptake value (SUVmax) has not yet been thoroughly investigated. The aim of the study is to establish a reliable correlation between Suvmax and histology in non-small cell lung cancer (NSCLC), in order to facilitate patient management. Methods. We retrospectively assessed the data about lung cancer patients entered in the Italian Registry of VATS Group from January 2014 to October 2019, after establishing the eligibility criteria of the study. In total, 8139 patients undergoing VATS lobectomy were enrolled: 3260 females and 4879 males. The relationship between SUVmax and tumor size was also analyzed. Results. The mean values of SUVmax in the most frequent types of lung cancer were as follows: (a) 4.88 ± 3.82 for preinvasive adenocarcinoma; (b) 5.49 ± 4.10 for minimally invasive adenocarcinoma; (c) 5.87 ± 4.18 for invasive adenocarcinoma; and (d) 8.85 ± 6.70 for squamous cell carcinoma. Processing these data, we displayed a statistically difference (p < 0.000001) of FDG avidity between adenocarcinoma and squamous cell carcinoma. Moreover, by classifying patients into five groups based on tumor diameter and after evaluating the SUVmax value for each group, we noted a statistical correlation (p < 0.000001) between size and FDG uptake, also confirmed by the post hoc analysis. Conclusions. There is a correlation between SUVmax, histopathology outcomes and tumor size in NSCLC. Further clinical trials should be performed in order to confirm our data. Full article
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11 pages, 1850 KiB  
Article
Immune Checkpoint Inhibitors in Advanced NSCLC: [18F]FDG PET/CT as a Troubleshooter in Treatment Response
by Cristina Ferrari, Giulia Santo, Nunzio Merenda, Alessia Branca, Paolo Mammucci, Pamela Pizzutilo, Cosmo Damiano Gadaleta and Giuseppe Rubini
Diagnostics 2021, 11(9), 1681; https://doi.org/10.3390/diagnostics11091681 - 15 Sep 2021
Cited by 5 | Viewed by 2395
Abstract
Introduction: The aim of this study was to investigate whether [18F]FDG PET/CT-derived semi-quantitative parameters can predict immunotherapy treatment response in non-small cell lung cancer (NSCLC) patients. Secondly, immune-related adverse events (irAEs) and lymphoid cell-rich organs activation were evaluated. Materials and Methods: [...] Read more.
Introduction: The aim of this study was to investigate whether [18F]FDG PET/CT-derived semi-quantitative parameters can predict immunotherapy treatment response in non-small cell lung cancer (NSCLC) patients. Secondly, immune-related adverse events (irAEs) and lymphoid cell-rich organs activation were evaluated. Materials and Methods: Twenty-eight patients who underwent [18F]FDG PET/CT scans before and at first restaging therapy with immuno-checkpoint inhibitors (ICIs) were retrospectively analyzed. PET-based semi-quantitative parameters extracted from both scans were respectively: SUVmax and SUVpeak of the target lesion, whole-body metabolic tumor volume (MTVWB), and whole-body total lesion glycolysis (TLGWB), as well as their interval changes (ΔSUVmaxTL, ΔSUVpeakTL, ΔMTVWB, ΔTLGWB). These PET-derived parameters were correlated to controlled disease (CD) assessed by RECIST 1.1. IrAEs, if present, were also described and correlated with clinical benefit (CB). SUVmax of the spleen and bone marrow at restaging scans were also correlated to CB. Results: The CD was achieved in 54% of patients. Out of 28 eligible patients, 13 (46%) experienced progressive disease (PD), 7 showed SD, 7 had PR, and only in one patient CR was achieved. ΔSUVmaxTL (p = 0.002) and ΔSUVpeakTL (p < 0.001) as well as ΔMTVWB (p < 0.001) and ΔTLGWB (p < 0.005) were significantly associated with PD vs. non-PD. IrAEs and lymphoid cell-rich organs activation did not correlate with CB. Conclusions: [18F]FDG PET/CT by using interval changes of PET-derived semi-quantitative parameters could represent a reliable tool in immunotherapy treatment response evaluation in NSCLC patients. Full article
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