You are here

Patz Jr., Edward F.

Overview:

There are numerous ongoing clinical studies primarily focused on the early detection of lung cancer.


The basic science investigations in our laboratory concentration on three fundamental translational areas,

1) Development of molecular imaging probes - We use several different approaches, including phage display, and in collaboration with our colleagues in the Chemistry Department, a mass spectrometry based method. These efforts are to develop novel imaging probes that characterize and phenotype tumors.

2) Discovery of novel lung cancer biomarkers - We explored the use of proteomics, autoantibodies, and genomics to discover blood and tissue biomarkers for early cancer detection and phenotyping of lung cancer.

3) Host response to cancer - We study the native immune response to tumors as this may provide cues to relevant diagnostic and therapeutic targets. Most recently we have focused on intratumoral lymphocytes and their specific tumor antigens.


 

Positions:

James and Alice Chen Professor of Radiology

Radiology, Cardiothoracic Imaging
School of Medicine

Professor of Radiology

Radiology, Cardiothoracic Imaging
School of Medicine

Professor in Pathology

Pathology
School of Medicine

Professor in Pharmacology & Cancer Biology

Pharmacology & Cancer Biology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.S. 1980

B.S. — Duke University

M.D. 1985

M.D. — University of Maryland School of Medicine

Intern In Medicine, Brigham And Women's Hospital

Brockton West Roxbury Va Medical Center

Resident, Radiology, Brigham And Women's Hospital

Harvard University

Chief Resident In Radiology, Brigham And Women's Hospital

Harvard University

Thoracic Imaging Fellow, Brigham And Women's Hospital

Harvard University

News:

Grants:

Integration of CT imaging features with cell-free plasma DNA as biomarkers for early lung cancer detection in patients with indeterminate pulmonary nodules

Administered By
Radiology, Cardiothoracic Imaging
AwardedBy
Society of Thoracic Radiology
Role
Principal Investigator
Start Date
January 01, 2016
End Date
January 15, 2018

Epigenomics Study

Administered By
Radiology, Cardiothoracic Imaging
AwardedBy
Epigenomics AG
Role
Principal Investigator
Start Date
December 28, 2016
End Date
November 30, 2017

Development of a Prognostic Marker for Lung Cancer Using Analysis of Tumor Evolution

Administered By
Radiology, Cardiothoracic Imaging
AwardedBy
Department of Defense
Role
Principal Investigator
Start Date
August 01, 2015
End Date
July 31, 2017

LabCorp-NovellusDX

Administered By
Radiology, Cardiothoracic Imaging
AwardedBy
Laboratory Corporation of America Holdings
Role
Principal Investigator
Start Date
September 28, 2016
End Date
June 30, 2017

Small Animal PET / CT Molecular Imaging

Administered By
Radiology, Nuclear Medicine
AwardedBy
National Institutes of Health
Role
Major User
Start Date
April 01, 2011
End Date
March 31, 2012

Discovery of Biomarkers for Lung Cancer Metastasis

Administered By
Radiology, Cardiothoracic Imaging
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
April 01, 2005
End Date
March 30, 2010

Discovery of Cancer Imaging Probes using SUPREX

Administered By
Chemistry
AwardedBy
National Institutes of Health
Role
Senior Investigator
Start Date
March 01, 2008
End Date
February 28, 2010

Serum Biomarkers for Early Diagnosis of NSCLC

Administered By
Radiology, Cardiothoracic Imaging
AwardedBy
Johns Hopkins University
Role
Principal Investigator
Start Date
July 01, 2007
End Date
February 28, 2009

Phase I/II Trial of ZD1839 and Celecoxib in Ex-Smokers

Administered By
Medicine, Medical Oncology
AwardedBy
National Institutes of Health
Role
Consultant
Start Date
September 26, 2002
End Date
August 31, 2007

Molecular Imaging Center Planning Grant

Administered By
Radiology
AwardedBy
National Institutes of Health
Role
Investigator
Start Date
August 01, 2000
End Date
July 31, 2004

Development of Novel Tumor Imaging Agents

Administered By
Radiology
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
March 07, 2000
End Date
February 28, 2003

Autologous Bone Marrow Transplantation In Breast And Ovari

Administered By
Medicine, Medical Oncology
AwardedBy
National Institutes of Health
Role
Co-Principal Investigator
Start Date
June 01, 1990
End Date
March 31, 1997
Show More

Publications:

Rethinking Autoantibody Signature Panels for Cancer Diagnosis: A Brief Report.

Most pulmonary nodules found on imaging studies are indeterminate, but because of the concern for lung cancer, all patients require further evaluation with resultant radiation risk, significant cost and delays in diagnosis. We hypothesized that a diagnostic blood test based on detection of autoantibodies against cancer antigens would be able to distinguish a benign nodule from lung cancer.We identified a panel of 25 serum autoantibodies associated with NSCLC and constructed a protein microarray containing the autoantigens. We tested the microarray with human sera (125 patients with NSCLC and 125 matched controls with a benign nodule) and attempted to develop a classification algorithm that would separate the two groups.In the training dataset the logistic regression c-index statistic was 0.691; in the validation dataset, the model predicting the score generated from the training set model has a c-index of 0.490. The relationship between the score and outcome (final diagnosis) is not statistically significant (p=0.460).Using the current panel of antigens and assay format, classification algorithms based on levels of autoantibodies to cancer antigens did not prove to have statistically significant value for predicting the presence of cancer. We suggest that there are inherent biological limitations to this approach.

Authors
Campa, MJ; Gottlin, EB; Herndon, JE; Patz, EF
MLA Citation
Campa, MJ, Gottlin, EB, Herndon, JE, and Patz, EF. "Rethinking Autoantibody Signature Panels for Cancer Diagnosis: A Brief Report." Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer (January 23, 2017).
PMID
28126538
Source
epmc
Published In
Journal of Thoracic Oncology
Publish Date
2017
DOI
10.1016/j.jtho.2017.01.017

Autocrine Complement Inhibits IL10-Dependent T-cell-Mediated Antitumor Immunity to Promote Tumor Progression.

In contrast to its inhibitory effects on many cells, IL10 activates CD8(+) tumor-infiltrating lymphocytes (TIL) and enhances their antitumor activity. However, CD8(+) TILs do not routinely express IL10, as autocrine complement C3 inhibits IL10 production through complement receptors C3aR and C5aR. CD8(+) TILs from C3-deficient mice, however, express IL10 and exhibit enhanced effector function. C3-deficient mice are resistant to tumor development in a T-cell- and IL10-dependent manner; human TILs expanded with IL2 plus IL10 increase the killing of primary tumors in vitro compared with IL2-treated TILs. Complement-mediated inhibition of antitumor immunity is independent of the programmed death 1/programmed death ligand 1 (PD-1/PD-L1) immune checkpoint pathway. Our findings suggest that complement receptors C3aR and C5aR expressed on CD8(+) TILs represent a novel class of immune checkpoints that could be targeted for tumor immunotherapy. Moreover, incorporation of IL10 in the expansion of TILs and in gene-engineered T cells for adoptive cell therapy enhances their antitumor efficacy.Our data suggest novel strategies to enhance immunotherapies: a combined blockade of complement signaling by antagonists to C3aR, C5aR, and anti-PD-1 to enhance anti-PD-1 efficacy; a targeted IL10 delivery to CD8(+) TILs using anti-PD-1-IL10 or anti-CTLA4-IL10 fusion proteins; and the addition of IL10 in TIL expansion for adoptive cellular therapy. Cancer Discov; 6(9); 1022-35. ©2016 AACR.See related commentary by Peng et al., p. 953This article is highlighted in the In This Issue feature, p. 932.

Authors
Wang, Y; Sun, S-N; Liu, Q; Yu, Y-Y; Guo, J; Wang, K; Xing, B-C; Zheng, Q-F; Campa, MJ; Patz, EF; Li, S-Y; He, Y-W
MLA Citation
Wang, Y, Sun, S-N, Liu, Q, Yu, Y-Y, Guo, J, Wang, K, Xing, B-C, Zheng, Q-F, Campa, MJ, Patz, EF, Li, S-Y, and He, Y-W. "Autocrine Complement Inhibits IL10-Dependent T-cell-Mediated Antitumor Immunity to Promote Tumor Progression." Cancer discovery 6.9 (September 2016): 1022-1035.
PMID
27297552
Source
epmc
Published In
Cancer Discovery
Volume
6
Issue
9
Publish Date
2016
Start Page
1022
End Page
1035
DOI
10.1158/2159-8290.cd-15-1412

A Therapeutic Antibody for Cancer, Derived from Single Human B Cells.

Some patients with cancer never develop metastasis, and their host response might provide cues for innovative treatment strategies. We previously reported an association between autoantibodies against complement factor H (CFH) and early-stage lung cancer. CFH prevents complement-mediated cytotoxicity (CDC) by inhibiting formation of cell-lytic membrane attack complexes on self-surfaces. In an effort to translate these findings into a biologic therapy for cancer, we isolated and expressed DNA sequences encoding high-affinity human CFH antibodies directly from single, sorted B cells obtained from patients with the antibody. The co-crystal structure of a CFH antibody-target complex shows a conformational change in the target relative to the native structure. This recombinant CFH antibody causes complement activation and release of anaphylatoxins, promotes CDC of tumor cell lines, and inhibits tumor growth in vivo. The isolation of anti-tumor antibodies derived from single human B cells represents an alternative paradigm in antibody drug discovery.

Authors
Bushey, RT; Moody, MA; Nicely, NL; Haynes, BF; Alam, SM; Keir, ST; Bentley, RC; Roy Choudhury, K; Gottlin, EB; Campa, MJ; Liao, H-X; Patz, EF
MLA Citation
Bushey, RT, Moody, MA, Nicely, NL, Haynes, BF, Alam, SM, Keir, ST, Bentley, RC, Roy Choudhury, K, Gottlin, EB, Campa, MJ, Liao, H-X, and Patz, EF. "A Therapeutic Antibody for Cancer, Derived from Single Human B Cells." Cell reports 15.7 (May 4, 2016): 1505-1513.
Website
http://hdl.handle.net/10161/12221
PMID
27160908
Source
epmc
Published In
Cell Reports
Volume
15
Issue
7
Publish Date
2016
Start Page
1505
End Page
1513
DOI
10.1016/j.celrep.2016.04.038

Lung cancer incidence and mortality in National Lung Screening Trial participants who underwent low-dose CT prevalence screening: a retrospective cohort analysis of a randomised, multicentre, diagnostic screening trial.

Annual low-dose CT screening for lung cancer has been recommended for high-risk individuals, but the necessity of yearly low-dose CT in all eligible individuals is uncertain. This study examined rates of lung cancer in National Lung Screening Trial (NLST) participants who had a negative prevalence (initial) low-dose CT screen to explore whether less frequent screening could be justified in some lower-risk subpopulations.We did a retrospective cohort analysis of data from the NLST, a randomised, multicentre screening trial comparing three annual low-dose CT assessments with three annual chest radiographs for the early detection of lung cancer in high-risk, eligible individuals (aged 55-74 years with at least a 30 pack-year history of cigarette smoking, and, if a former smoker, had quit within the past 15 years), recruited from US medical centres between Aug 5, 2002, and April 26, 2004. Participants were followed up for up to 5 years after their last annual screen. For the purposes of this analysis, our cohort consisted of all NLST participants who had received a low-dose CT prevalence (T0) screen. We determined the frequency, stage, histology, study year of diagnosis, and incidence of lung cancer, as well as overall and lung cancer-specific mortality, and whether lung cancers were detected as a result of screening or within 1 year of a negative screen. We also estimated the effect on mortality if the first annual (T1) screen in participants with a negative T0 screen had not been done. The NLST is registered with ClinicalTrials.gov, number NCT00047385.Our cohort consisted of 26 231 participants assigned to the low-dose CT screening group who had undergone their T0 screen. The 19 066 participants with a negative T0 screen had a lower incidence of lung cancer than did all 26 231 T0-screened participants (371·88 [95% CI 337·97-408·26] per 100 000 person-years vs 661·23 [622·07-702·21]) and had lower lung cancer-related mortality (185·82 [95% CI 162·17-211·93] per 100 000 person-years vs 277·20 [252·28-303·90]). The yield of lung cancer at the T1 screen among participants with a negative T0 screen was 0·34% (62 screen-detected cancers out of 18 121 screened participants), compared with a yield at the T0 screen among all T0-screened participants of 1·0% (267 of 26 231). We estimated that if the T1 screen had not been done in the T0 negative group, at most, an additional 28 participants in the T0 negative group would have died from lung cancer (a rise in mortality from 185·82 [95% CI 162·17-211·93] per 100 000 person-years to 212·14 [186·80-239·96]) over the course of the trial.Participants with a negative low-dose CT prevalence screen had a lower incidence of lung cancer and lung cancer-specific mortality than did all participants who underwent a prevalence screen. Because overly frequent screening has associated harms, increasing the interval between screens in participants with a negative low-dose CT prevalence screen might be warranted.None.

Authors
Patz, EF; Greco, E; Gatsonis, C; Pinsky, P; Kramer, BS; Aberle, DR
MLA Citation
Patz, EF, Greco, E, Gatsonis, C, Pinsky, P, Kramer, BS, and Aberle, DR. "Lung cancer incidence and mortality in National Lung Screening Trial participants who underwent low-dose CT prevalence screening: a retrospective cohort analysis of a randomised, multicentre, diagnostic screening trial." The Lancet. Oncology 17.5 (May 2016): 590-599.
PMID
27009070
Source
epmc
Published In
The Lancet Oncology
Volume
17
Issue
5
Publish Date
2016
Start Page
590
End Page
599
DOI
10.1016/s1470-2045(15)00621-x

Interrogation of individual intratumoral B lymphocytes from lung cancer patients for molecular target discovery.

Intratumoral B lymphocytes are an integral part of the lung tumor microenvironment. Interrogation of the antibodies they express may improve our understanding of the host response to cancer and could be useful in elucidating novel molecular targets. We used two strategies to explore the repertoire of intratumoral B cell antibodies. First, we cloned VH and VL genes from single intratumoral B lymphocytes isolated from one lung tumor, expressed the genes as recombinant mAbs, and used the mAbs to identify the cognate tumor antigens. The Igs derived from intratumoral B cells demonstrated class switching, with a mean VH mutation frequency of 4%. Although there was no evidence for clonal expansion, these data are consistent with antigen-driven somatic hypermutation. Individual recombinant antibodies were polyreactive, although one clone demonstrated preferential immunoreactivity with tropomyosin 4 (TPM4). We found that higher levels of TPM4 antibodies were more common in cancer patients, but measurement of TPM4 antibody levels was not a sensitive test for detecting cancer. Second, in an effort to focus our recombinant antibody expression efforts on those B cells that displayed evidence of clonal expansion driven by antigen stimulation, we performed deep sequencing of the Ig genes of B cells collected from seven different tumors. Deep sequencing demonstrated somatic hypermutation but no dominant clones. These strategies may be useful for the study of B cell antibody expression, although identification of a dominant clone and unique therapeutic targets may require extensive investigation.

Authors
Campa, MJ; Moody, MA; Zhang, R; Liao, H-X; Gottlin, EB; Patz, EF
MLA Citation
Campa, MJ, Moody, MA, Zhang, R, Liao, H-X, Gottlin, EB, and Patz, EF. "Interrogation of individual intratumoral B lymphocytes from lung cancer patients for molecular target discovery." Cancer immunology, immunotherapy : CII 65.2 (February 2016): 171-180.
Website
http://hdl.handle.net/10161/11569
PMID
26739486
Source
epmc
Published In
Cancer Immunology, Immunotherapy
Volume
65
Issue
2
Publish Date
2016
Start Page
171
End Page
180
DOI
10.1007/s00262-015-1787-0

Complement Factor H Antibodies from Lung Cancer Patients Induce Complement-Dependent Lysis of Tumor Cells, Suggesting a Novel Immunotherapeutic Strategy.

Characterization of the humoral immune response in selected patients with cancer who uniformly do well may lead to the development of novel therapeutic strategies. We have previously shown an association between patients with early-stage nonmetastatic lung cancer and autoantibodies to complement factor H (CFH). CFH protects normal and tumor cells from destruction by the alternative complement pathway by inactivating C3b, a protein that is essential for formation of a lytic complex on the cell surface. Here, we show that CFH autoantibodies in lung cancer patients recognize a conformationally distinct form of CFH in vitro, are IgG3 subclass, and epitope map to a crucial functional domain of CFH known to interact with C3b. Purified CFH autoantibodies inhibited binding of CFH to A549 lung tumor cells, increased C3b deposition, and caused complement-dependent tumor cell lysis. This work demonstrates that CFH autoantibodies isolated from patients with lung cancer can kill tumor cells in vitro, suggesting that they may perform this function in vivo as well. Development of specific antibodies to the conformationally distinct epitope of CFH may lead to a useful biologic therapy for lung cancer.

Authors
Campa, MJ; Gottlin, EB; Bushey, RT; Patz, EF
MLA Citation
Campa, MJ, Gottlin, EB, Bushey, RT, and Patz, EF. "Complement Factor H Antibodies from Lung Cancer Patients Induce Complement-Dependent Lysis of Tumor Cells, Suggesting a Novel Immunotherapeutic Strategy." Cancer immunology research 3.12 (December 2015): 1325-1332.
PMID
26216416
Source
epmc
Published In
Cancer Immunology Research
Volume
3
Issue
12
Publish Date
2015
Start Page
1325
End Page
1332
DOI
10.1158/2326-6066.cir-15-0122

Primary tumour standardised uptake value is prognostic in nonsmall cell lung cancer: a multivariate pooled analysis of individual data.

(18)F-fluoro-2-deoxy-d-glucose positron emission tomography (PET) complements conventional imaging for diagnosing and staging lung cancer. Two literature-based meta-analyses suggest that maximum standardised uptake value (SUVmax) on PET has univariate prognostic value in nonsmall cell lung cancer (NSCLC). We analysed individual data pooled from 12 studies to assess the independent prognostic value of binary SUVmax for overall survival.After searching the published literature and identifying unpublished data, study coordinators were contacted and requested to provide data on individual patients. Cox regression models stratified for study were used.Data were collected for 1526 patients (median age 64 years, 60% male, 34% squamous cell carcinoma, 47% adenocarcinoma, 58% stage I-II). The combined univariate hazard ratio for SUVmax was 1.43 (95% CI 1.22-1.66) and nearly identical if the SUV threshold was calculated stratifying for histology. Multivariate analysis of patients with stage I-III disease identified age, stage, tumour size and receipt of surgery as independent prognostic factors; adding SUV (HR 1.58, 95% CI 1.27-1.96) improved the model significantly. The only detected interaction was between SUV and stage IV disease.SUV seems to have independent prognostic value in stage I-III NSCLC, for squamous cell carcinoma and for adenocarcinoma.

Authors
Paesmans, M; Garcia, C; Wong, C-YO; Patz, EF; Komaki, R; Eschmann, S; Govindan, R; Vansteenkiste, J; Meert, A-P; de Jong, WK; Altorki, NK; Higashi, K; Van Baardwijk, A; Borst, GR; Ameye, L; Lafitte, J-J; Berghmans, T; Flamen, P; Rami-Porta, R; Sculier, J-P
MLA Citation
Paesmans, M, Garcia, C, Wong, C-YO, Patz, EF, Komaki, R, Eschmann, S, Govindan, R, Vansteenkiste, J, Meert, A-P, de Jong, WK, Altorki, NK, Higashi, K, Van Baardwijk, A, Borst, GR, Ameye, L, Lafitte, J-J, Berghmans, T, Flamen, P, Rami-Porta, R, and Sculier, J-P. "Primary tumour standardised uptake value is prognostic in nonsmall cell lung cancer: a multivariate pooled analysis of individual data." The European respiratory journal 46.6 (December 2015): 1751-1761.
PMID
26405289
Source
epmc
Published In
The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology
Volume
46
Issue
6
Publish Date
2015
Start Page
1751
End Page
1761
DOI
10.1183/13993003.00099-2015

Reply to "Prognostic Value of Fluorodeoxyglucose-Positron Emission Tomography".

Authors
Kwon, W; Howard, BA; Herndon, JE; Patz, EF
MLA Citation
Kwon, W, Howard, BA, Herndon, JE, and Patz, EF. "Reply to "Prognostic Value of Fluorodeoxyglucose-Positron Emission Tomography"." Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer 10.10 (October 2015): e102-. (Letter)
Website
http://hdl.handle.net/10161/11156
PMID
26398827
Source
epmc
Published In
Journal of Thoracic Oncology
Volume
10
Issue
10
Publish Date
2015
Start Page
e102
DOI
10.1097/jto.0000000000000637

FDG Uptake on Positron Emission Tomography Correlates with Survival and Time to Recurrence in Patients with Stage I Non-Small-Cell Lung Cancer.

Patients with stage I non-small-cell lung cancer (NSCLC) have a wide variation in outcomes, most likely because there are undetected metastases at presentation. We retrospectively reviewed patients with early stage lung cancer to determine if FDG uptake of the primary tumor as measured on positron emission tomography (PET) at the time of diagnosis was associated with overall survival (OS) or time to recurrence (TTR).We reviewed the Tumor Registry at our institution and identified 336 consecutive patients diagnosed with stage I NSCLC over a 5-year period who underwent an FDG-PET/computed tomography within 90 days before surgery. Kaplan-Meier curves were used to describe the survival and TTR experience within subgroups defined by PET maximum standardized uptake value (SUVmax). Cox proportional hazards model was used to assess the impact of PET SUVmax as a continuous variable on OS and TTR. Logistic regression was used to analyze the effect of SUVmax on dichotomized outcomes.Three hundred thirty-six consecutive patients (176 women and 160 men) with stage I NSCLC were retrospectively reviewed. Mean SUVmax was 9.2 ± 6.9 (range 0.6-30.3). The hazard or risk of dying and recurrence increased significantly as SUVmax increased (p = 0.0008 and 0.024, respectively).Preoperative FDG uptake in the primary tumor in patients with stage I disease is associated with OS and TTR. This may be useful in identifying early stage patients who may benefit from more aggressive therapy after surgical resection.

Authors
Kwon, W; Howard, BA; Herndon, JE; Patz, EF
MLA Citation
Kwon, W, Howard, BA, Herndon, JE, and Patz, EF. "FDG Uptake on Positron Emission Tomography Correlates with Survival and Time to Recurrence in Patients with Stage I Non-Small-Cell Lung Cancer." Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer 10.6 (June 2015): 897-902.
PMID
25811445
Source
epmc
Published In
Journal of Thoracic Oncology
Volume
10
Issue
6
Publish Date
2015
Start Page
897
End Page
902
DOI
10.1097/jto.0000000000000534

National Lung Screening Trial findings by age: Medicare-eligible versus under-65 population.

The NLST (National Lung Screening Trial) showed reduced lung cancer mortality in high-risk participants (smoking history of ≥30 pack-years) aged 55 to 74 years who were randomly assigned to screening with low-dose computed tomography (LDCT) versus those assigned to chest radiography. An advisory panel recently expressed reservations about Medicare coverage of LDCT screening because of concerns about performance in the Medicare-aged population, which accounted for only 25% of the NLST participants.To examine the results of the NLST LDCT group by age (Medicare-eligible vs. <65 years).Secondary analysis of a group from a randomized trial (NCT00047385).33 U.S. screening centers.19 612 participants aged 55 to 64 years (under-65 cohort) and 7110 participants aged 65 to 74 years (65+ cohort) at randomization.3 annual rounds of LDCT screening.Demographics, smoking and medical history, screening examination adherence and results, diagnostic follow-up procedures and complications, lung cancer diagnoses, treatment, survival, and mortality.The aggregate false-positive rate was higher in the 65+ cohort than in the under-65 cohort (27.7% vs. 22.0%; P < 0.001). Invasive diagnostic procedures after false-positive screening results were modestly more frequent in the older cohort (3.3% vs. 2.7%; P = 0.039). Complications from invasive procedures were low in both groups (9.8% in the under-65 cohort vs. 8.5% in the 65+ cohort). Prevalence and positive predictive value (PPV) were higher in the 65+ cohort (PPV, 4.9% vs. 3.0%). Resection rates for screen-detected cancer were similar (75.6% in the under-65 cohort vs. 73.2% in the 65+ cohort). Five-year all-cause survival was lower in the 65+ cohort (55.1% vs. 64.1%; P = 0.018).The oldest screened patient was aged 76 years.NLST participants aged 65 years or older had a higher rate of false-positive screening results than those younger than 65 years but a higher cancer prevalence and PPV. Screen-detected cancer was treated similarly in the groups.National Institutes of Health.

Authors
Pinsky, PF; Gierada, DS; Hocking, W; Patz, EF; Kramer, BS
MLA Citation
Pinsky, PF, Gierada, DS, Hocking, W, Patz, EF, and Kramer, BS. "National Lung Screening Trial findings by age: Medicare-eligible versus under-65 population." Annals of internal medicine 161.9 (November 2014): 627-633.
PMID
25199624
Source
epmc
Published In
Annals of internal medicine
Volume
161
Issue
9
Publish Date
2014
Start Page
627
End Page
633
DOI
10.7326/m14-1484

Expert opinion: United States Preventive Services Task Force recommendation on screening for lung cancer.

Authors
Boiselle, PM; Chiles, C; Patz, E; Tammemägi, M; Wood, DE
MLA Citation
Boiselle, PM, Chiles, C, Patz, E, Tammemägi, M, and Wood, DE. "Expert opinion: United States Preventive Services Task Force recommendation on screening for lung cancer." Journal of thoracic imaging 29.4 (July 2014): 197-.
PMID
24905632
Source
epmc
Published In
Journal of Thoracic Imaging
Volume
29
Issue
4
Publish Date
2014
Start Page
197
DOI
10.1097/rti.0000000000000094

Estimating overdiagnosis in lung cancer screening--reply.

Authors
Patz, EF; Pinsky, P; Kramer, BS
MLA Citation
Patz, EF, Pinsky, P, and Kramer, BS. "Estimating overdiagnosis in lung cancer screening--reply." JAMA internal medicine 174.7 (July 2014): 1198-1199.
PMID
25003885
Source
epmc
Published In
JAMA Internal Medicine
Volume
174
Issue
7
Publish Date
2014
Start Page
1198
End Page
1199
DOI
10.1001/jamainternmed.2014.1525

Conflict of interest disclosures.

Authors
Patz, EF
MLA Citation
Patz, EF. "Conflict of interest disclosures." JAMA internal medicine 174.5 (May 2014): 823-.
PMID
24799010
Source
epmc
Published In
JAMA Internal Medicine
Volume
174
Issue
5
Publish Date
2014
Start Page
823
DOI
10.1001/jamainternmed.2014.758

Over-diagnosis in Low-Dose Computed Tomography Screening for Lung Cancer (vol 174, pg 269, 2014)

Authors
Jr, PEF
MLA Citation
Jr, PEF. "Over-diagnosis in Low-Dose Computed Tomography Screening for Lung Cancer (vol 174, pg 269, 2014)." JAMA INTERNAL MEDICINE 174.5 (May 2014): 828-828.
Source
wos-lite
Published In
JAMA Internal Medicine
Volume
174
Issue
5
Publish Date
2014
Start Page
828
End Page
828

Redistribution of health care costs after the adoption of positron emission tomography among medicare beneficiaries with non-small-cell lung cancer, 1998-2005.

INTRODUCTION: Treatment patterns and cost implications of increased positron emission tomography imaging use since Medicare approval in 1998 are not well understood. We examined rates of surgery, radiotherapy, and chemotherapy and inpatient and total health care costs between 1998 and 2005 among Medicare beneficiaries with non-small-cell lung cancer. METHODS: Patients in this retrospective cohort study were 51,374 Medicare beneficiaries diagnosed with non-small-cell lung cancer between 1996 and 2005. The main outcome measures were receipt of surgical resection, radiotherapy, and chemotherapy and inpatient and total health care costs within 1 year of diagnosis. RESULTS: Between 1996-1997 and 2004-2005, the proportion of patients undergoing surgical resection decreased from 29% to 25%, the proportion receiving radiation therapy decreased from 49% to 43%, and inpatient costs decreased from $28,900 to $26,900. The proportion of patients receiving chemotherapy increased from 25% to 40% and total costs increased from $47,300 to $52,200 (p < 0.001 for all comparisons). Changes in use and costs remained after adjustment for shifting demographic characteristics during the study period. CONCLUSIONS: Adoption of positron emission tomography between 1998 and 2005 was accompanied by decreases in rates of surgery and radiotherapy and in short-term inpatient costs among Medicare beneficiaries with non-small-cell lung cancer, although there was an increase in chemotherapy and overall costs.

Authors
Dinan, MA; Curtis, LH; Carpenter, WR; Biddle, AK; Abernethy, AP; Patz, EF; Schulman, KA; Weinberger, M
MLA Citation
Dinan, MA, Curtis, LH, Carpenter, WR, Biddle, AK, Abernethy, AP, Patz, EF, Schulman, KA, and Weinberger, M. "Redistribution of health care costs after the adoption of positron emission tomography among medicare beneficiaries with non-small-cell lung cancer, 1998-2005." Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer 9.4 (April 2014): 512-518.
PMID
24736074
Source
epmc
Published In
Journal of Thoracic Oncology
Volume
9
Issue
4
Publish Date
2014
Start Page
512
End Page
518
DOI
10.1097/jto.0000000000000102

Overdiagnosis in low-dose computed tomography screening for lung cancer.

IMPORTANCE: Screening for lung cancer has the potential to reduce mortality, but in addition to detecting aggressive tumors, screening will also detect indolent tumors that otherwise may not cause clinical symptoms. These overdiagnosis cases represent an important potential harm of screening because they incur additional cost, anxiety, and morbidity associated with cancer treatment. OBJECTIVE: To estimate overdiagnosis in the National Lung Screening Trial (NLST). DESIGN, SETTING, AND PARTICIPANTS: We used data from the NLST, a randomized trial comparing screening using low-dose computed tomography (LDCT) vs chest radiography (CXR) among 53 452 persons at high risk for lung cancer observed for 6.4 years, to estimate the excess number of lung cancers in the LDCT arm of the NLST compared with the CXR arm. MAIN OUTCOMES AND MEASURES: We calculated 2 measures of overdiagnosis: the probability that a lung cancer detected by screening with LDCT is an overdiagnosis (PS), defined as the excess lung cancers detected by LDCT divided by all lung cancers detected by screening in the LDCT arm; and the number of cases that were considered overdiagnosis relative to the number of persons needed to screen to prevent 1 death from lung cancer. RESULTS: During follow-up, 1089 lung cancers were reported in the LDCT arm and 969 in the CXR arm of the NLST. The probability is 18.5% (95% CI, 5.4%-30.6%) that any lung cancer detected by screening with LDCT was an overdiagnosis, 22.5% (95% CI, 9.7%-34.3%) that a non-small cell lung cancer detected by LDCT was an overdiagnosis, and 78.9% (95% CI, 62.2%-93.5%) that a bronchioalveolar lung cancer detected by LDCT was an overdiagnosis. The number of cases of overdiagnosis found among the 320 participants who would need to be screened in the NLST to prevent 1 death from lung cancer was 1.38. CONCLUSIONS AND RELEVANCE: More than 18% of all lung cancers detected by LDCT in the NLST seem to be indolent, and overdiagnosis should be considered when describing the risks of LDCT screening for lung cancer.

Authors
Patz, EF; Pinsky, P; Gatsonis, C; Sicks, JD; Kramer, BS; Tammemägi, MC; Chiles, C; Black, WC; Aberle, DR; NLST Overdiagnosis Manuscript Writing Team,
MLA Citation
Patz, EF, Pinsky, P, Gatsonis, C, Sicks, JD, Kramer, BS, Tammemägi, MC, Chiles, C, Black, WC, Aberle, DR, and NLST Overdiagnosis Manuscript Writing Team, . "Overdiagnosis in low-dose computed tomography screening for lung cancer." JAMA Intern Med 174.2 (February 1, 2014): 269-274.
PMID
24322569
Source
pubmed
Published In
JAMA Internal Medicine
Volume
174
Issue
2
Publish Date
2014
Start Page
269
End Page
274
DOI
10.1001/jamainternmed.2013.12738

PET-CT: current applications and new developments in the thorax.

Positron emission tomography computed tomography(PET-CT) imaging has emerged as an essential clinical diagnostic tool in the evaluation of thoracic abnormalities. Currently, its primary role is for tumor imaging; it helps to differentiate benign from malignant nodules, stage tumors, determine response, and follow patients after therapy is complete. It has also been used for nononcologic diseases, but the indications are less well defined. PET is a fundamental component of the molecular imaging initiative, and as new more specific imaging probes and better instrumentation are developed, PET-CT is certain to improve diagnostic accuracy and become even more integrated into the imaging armamentarium.

Authors
Erasmus, JJ; Mawlawi, O; Howard, B; Patz, EF
MLA Citation
Erasmus, JJ, Mawlawi, O, Howard, B, and Patz, EF. "PET-CT: current applications and new developments in the thorax." Seminars in respiratory and critical care medicine 35.1 (February 2014): 145-156.
PMID
24481767
Source
epmc
Published In
Seminars in Respiratory and Critical Care Medicine
Volume
35
Issue
1
Publish Date
2014
Start Page
145
End Page
156
DOI
10.1055/s-0033-1363459

Expert opinion: United States preventive services task force recommendation on screening for lung cancer

Authors
Boiselle, PM; Chiles, C; Patz, E; Tammemägi, M; Wood, DE
MLA Citation
Boiselle, PM, Chiles, C, Patz, E, Tammemägi, M, and Wood, DE. "Expert opinion: United States preventive services task force recommendation on screening for lung cancer." Journal of Thoracic Imaging 29.4 (2014): 197--.
Source
scival
Published In
Journal of Thoracic Imaging
Volume
29
Issue
4
Publish Date
2014
Start Page
197-
DOI
10.1097/RTI.0000000000000094

Changes in Radiation Therapy, Surgery, and Costs for Treatment of Non-Small Cell Lung Cancer After the Adoption of Positron Emission Tomography: 1998-2005

Authors
Dinan, MA; Curtis, LH; Carpenter, WR; Biddle, AK; Abernethy, AP; Patz, EF; Schulman, KA; Weinberger, M
MLA Citation
Dinan, MA, Curtis, LH, Carpenter, WR, Biddle, AK, Abernethy, AP, Patz, EF, Schulman, KA, and Weinberger, M. "Changes in Radiation Therapy, Surgery, and Costs for Treatment of Non-Small Cell Lung Cancer After the Adoption of Positron Emission Tomography: 1998-2005." October 1, 2013.
Source
wos-lite
Published In
International Journal of Radiation Oncology, Biology, Physics
Volume
87
Issue
2
Publish Date
2013
Start Page
S41
End Page
S42

Biomarkers to help guide management of patients with pulmonary nodules.

RATIONALE: Indeterminate pulmonary nodules are a common radiographic finding and require further evaluation because of the concern for lung cancer. OBJECTIVES: We developed an algorithm to assign patients to a low- or high-risk category for lung cancer, based on a combination of serum biomarker levels and nodule size. METHODS: For the serum biomarker assay, we determined levels of carcinoembryonic antigen, α1-antitrypsin, and squamous cell carcinoma antigen. Serum data and nodule size from a training set of 509 patients with (n = 298) and without (n = 211) lung cancer were subjected to classification and regression tree and logistic regression analyses. Multiple models were developed and tested in an independent, masked validation set for their ability to categorize patients with (n = 203) or without (n = 196) lung cancer as being low- or high-risk for lung cancer. MEASUREMENTS AND MAIN RESULTS: In all models, a large percentage of individuals in the validation study with small nodules (<1 cm) were assigned to the low-risk group, and a large percentage of individuals with large nodules (≥3 cm) were assigned to the high-risk group. In the validation study, the classification and regression tree algorithm had overall sensitivity, specificity, and positive and negative predictive values for determining lung cancer of 88%, 82%, 84%, and 87%, respectively. The logistic regression model had overall sensitivity, specificity, and positive and negative predictive values of 80%, 89%, 89%, and 81%, respectively. CONCLUSION: Integration of biomarkers with lung nodule size has the potential to help guide the management of patients with indeterminate pulmonary nodules.

Authors
Patz, EF; Campa, MJ; Gottlin, EB; Trotter, PR; Herndon, JE; Kafader, D; Grant, RP; Eisenberg, M
MLA Citation
Patz, EF, Campa, MJ, Gottlin, EB, Trotter, PR, Herndon, JE, Kafader, D, Grant, RP, and Eisenberg, M. "Biomarkers to help guide management of patients with pulmonary nodules." Am J Respir Crit Care Med 188.4 (August 15, 2013): 461-465.
Website
http://hdl.handle.net/10161/11579
PMID
23306547
Source
pubmed
Published In
American journal of respiratory and critical care medicine
Volume
188
Issue
4
Publish Date
2013
Start Page
461
End Page
465
DOI
10.1164/rccm.201210-1760OC

Variations in use of PET among Medicare beneficiaries with non-small cell lung cancer, 1998-2007.

PURPOSE: To explore demographic and regional factors associated with the use of positron emission tomography (PET) in patients with non-small cell lung cancer (NSCLC) and to determine whether their associations with PET use has changed over time. MATERIALS AND METHODS: The Office of Human Research Ethics at the University of North Carolina and the institutional review board of the Duke University Health System approved (with waiver of informed consent) this retrospective analysis of Surveillance Epidemiology and End Results Medicare data for Medicare beneficiaries given a diagnosis of NSCLC between 1998 and 2007. The primary outcome was change in the number of PET examinations 2 months before to 4 months after diagnosis, examined according to year and sociodemographic subgroup. PET use was compared between demographic and geographic subgroups and between early (1998-2000) and late (2005-2007) cohorts by using χ(2) tests. Factors associated with use of PET during the study period were further examined by using logit and linear probability multivariable regression analyses. RESULTS: The final cohort included 46 544 patients with 46 935 cases of NSCLC. By 2005, more than half of patients underwent one or more PET examinations, regardless of demographic subgroup. In multivariable logistic regression analysis, patients who underwent PET were more likely to be married, nonblack, and younger than 80 years and to live in census tracts with higher education levels or in the Northeast (P < .001 for all). Living within 40 miles of a PET facility was initially associated with undergoing PET (P < .001), but this association disappeared by 2007. Imaging rates increased more rapidly in patients who were nonblack (P ≤ .01), patients who were younger than 81 years (P < .001), and patients who lived in the Northeast and South (P < .001). CONCLUSION: PET imaging among Medicare beneficiaries with NSCLC was initially concentrated among nonblack patients younger than 81 years. Despite widespread adoption among all subgroups, differences within demographic subgroups remained.

Authors
Dinan, MA; Curtis, LH; Carpenter, WR; Biddle, AK; Abernethy, AP; Patz, EF; Schulman, KA; Weinberger, M
MLA Citation
Dinan, MA, Curtis, LH, Carpenter, WR, Biddle, AK, Abernethy, AP, Patz, EF, Schulman, KA, and Weinberger, M. "Variations in use of PET among Medicare beneficiaries with non-small cell lung cancer, 1998-2007." Radiology 267.3 (June 2013): 807-817.
PMID
23418003
Source
pubmed
Published In
Radiology
Volume
267
Issue
3
Publish Date
2013
Start Page
807
End Page
817
DOI
10.1148/radiol.12120174

Reply to M.S. Hofman et al.

Authors
Dinan, MA; Carpenter, WR; Patz, EF; Abernethy, AP; Biddle, AK; Schulman, KA; Curtis, LH
MLA Citation
Dinan, MA, Carpenter, WR, Patz, EF, Abernethy, AP, Biddle, AK, Schulman, KA, and Curtis, LH. "Reply to M.S. Hofman et al." J Clin Oncol 31.6 (February 20, 2013): 820-. (Letter)
PMID
23544205
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
31
Issue
6
Publish Date
2013
Start Page
820
DOI
10.1200/JCO.2012.46.7373

Let's Get SEERious: More Accurate Staging With Consequent High Management Impact Is Not Just Stage Migration Reply

Authors
Dinan, MA; Carpenter, WR; Jr, PEF; Abernethy, AP; Biddle, AK; Schulman, KA; Curtis, LH
MLA Citation
Dinan, MA, Carpenter, WR, Jr, PEF, Abernethy, AP, Biddle, AK, Schulman, KA, and Curtis, LH. "Let's Get SEERious: More Accurate Staging With Consequent High Management Impact Is Not Just Stage Migration Reply." JOURNAL OF CLINICAL ONCOLOGY 31.6 (February 20, 2013): 820-820.
Source
wos-lite
Published In
Journal of Clinical Oncology
Volume
31
Issue
6
Publish Date
2013
Start Page
820
End Page
820
DOI
10.1200/JCO.2012.46.7373

Preliminary evaluation of biplane correlation (BCI) stereographic imaging for lung nodule detection.

A biplane correlation (BCI) imaging system obtains images that can be viewed in stereo, thereby minimizing overlapping structures. This study investigated whether using stereoscopic visualization provides superior lung nodule detection compared to standard postero-anterior (PA) image display. Images were acquired at two oblique views of ±3° as well as at a standard PA position from 60 patients. Images were processed using optimal parameters and displayed on a stereoscopic display. The PA image was viewed in the standard format, while the oblique views were paired to provide a stereoscopic view of the subject. A preliminary observer study was performed with four radiologists who viewed and scored the PA image then viewed and scored the BCI stereoscopic image. The BCI stereoscopic viewing of lung nodules resulted in 71 % sensitivity and 0.31 positive predictive value (PPV) index compared to PA results of 86 % sensitivity and 0.26 PPV index. The sensitivity for lung nodule detection with the BCI stereoscopic system was reduced by 15 %; however, the total number of false positives reported was reduced by 35 % resulting in an improved PPV index of 20 %. The preliminary results indicate observer dependency in terms of relative advantage of either system in the detection of lung nodules, but overall equivalency of the two methods with promising potential for BCI as an adjunct diagnostic technique.

Authors
Boyce, SJ; McAdams, HP; Ravin, CE; Patz, EF; Washington, L; Martinez, S; Koweek, L; Samei, E
MLA Citation
Boyce, SJ, McAdams, HP, Ravin, CE, Patz, EF, Washington, L, Martinez, S, Koweek, L, and Samei, E. "Preliminary evaluation of biplane correlation (BCI) stereographic imaging for lung nodule detection." J Digit Imaging 26.1 (February 2013): 109-114.
PMID
22422436
Source
pubmed
Published In
Journal of Digital Imaging
Volume
26
Issue
1
Publish Date
2013
Start Page
109
End Page
114
DOI
10.1007/s10278-012-9466-6

Preliminary evaluation of biplane correlation (BCI) stereographic imaging for lung nodule detection

A biplane correlation (BCI) imaging system obtains images that can be viewed in stereo, thereby minimizing overlapping structures. This study investigated whether using stereoscopic visualization provides superior lung nodule detection compared to standard postero-anterior (PA) image display. Images were acquired at two oblique views of ±3 as well as at a standard PA position from 60 patients. Images were processed using optimal parameters and displayed on a stereoscopic display. The PA image was viewed in the standard format, while the oblique views were paired to provide a stereoscopic view of the subject. A preliminary observer study was performed with four radiologists who viewed and scored the PA image then viewed and scored the BCI stereoscopic image. The BCI stereoscopic viewing of lung nodules resulted in 71 % sensitivity and 0.31 positive predictive value (PPV) index compared to PA results of 86 % sensitivity and 0.26 PPV index. The sensitivity for lung nodule detection with the BCI stereoscopic system was reduced by 15 %; however, the total number of false positives reported was reduced by 35 % resulting in an improved PPV index of 20 %. The preliminary results indicate observer dependency in terms of relative advantage of either system in the detection of lung nodules, but overall equivalency of the two methods with promising potential for BCI as an adjunct diagnostic technique. © 2012 Society for Imaging Informatics in Medicine.

Authors
Boyce, SJ; McAdams, HP; Ravin, CE; Jr, EFP; Washington, L; Martinez, S; Koweek, L; Samei, E
MLA Citation
Boyce, SJ, McAdams, HP, Ravin, CE, Jr, EFP, Washington, L, Martinez, S, Koweek, L, and Samei, E. "Preliminary evaluation of biplane correlation (BCI) stereographic imaging for lung nodule detection." Journal of Digital Imaging 26.1 (2013): 109-114.
Source
scival
Published In
Journal of Digital Imaging
Volume
26
Issue
1
Publish Date
2013
Start Page
109
End Page
114
DOI
10.1007/s10278-012-9466-6

Expert opinion: The future role of cardiothoracic radiologists in molecular imaging

Authors
Boiselle, PM; Erasmus, JJ; Kauczor, H-U; Li, K; Patz, E
MLA Citation
Boiselle, PM, Erasmus, JJ, Kauczor, H-U, Li, K, and Patz, E. "Expert opinion: The future role of cardiothoracic radiologists in molecular imaging." Journal of Thoracic Imaging 28.1 (2013): 2--.
PMID
23249965
Source
scival
Published In
Journal of Thoracic Imaging
Volume
28
Issue
1
Publish Date
2013
Start Page
2-
DOI
10.1097/RTI.0b013e31827b0fa7

Future trends in lung cancer diagnosis.

Imaging continues to play an essential role in evaluating patients with lung cancer. Improvement in radiologic techniques will produce more accurate diagnostic information, but complementing conventional studies with molecular diagnostics will likely have an even greater impact on patient management. Integration of imaging studies and biomarkers into the diagnostic evaluation of patients with lung cancer provides an opportunity to more efficiently guide diagnosis, staging, treatment, and follow-up.

Authors
Christensen, JD; Patz, EF
MLA Citation
Christensen, JD, and Patz, EF. "Future trends in lung cancer diagnosis." Radiol Clin North Am 50.5 (September 2012): 1001-1008. (Review)
PMID
22974783
Source
pubmed
Published In
Radiologic Clinics of North America
Volume
50
Issue
5
Publish Date
2012
Start Page
1001
End Page
1008
DOI
10.1016/j.rcl.2012.06.002

Stage migration, selection bias, and survival associated with the adoption of positron emission tomography among medicare beneficiaries with non-small-cell lung cancer, 1998-2003.

PURPOSE: Previous studies have linked the use of positron emission tomography (PET) with improved outcomes among patients with non-small-cell lung cancer (NSCLC). However, this association may be confounded by PET-induced stage migration and selection bias. We examined the association between PET use and overall survival among Medicare beneficiaries with NSCLC. PATIENTS AND METHODS: Retrospective analysis of Surveillance, Epidemiology, and End Results (SEER) -Medicare data was used to characterize changes in overall survival, stage-specific survival, and stage distribution among Medicare beneficiaries with NSCLC between 1998 and 2003. RESULTS: A total of 97,007 patients with NSCLC diagnosed between 1998 and 2003 met the study criteria. Two-year and 4-year survival remained unchanged, despite widespread adoption of PET. The proportion of patients staged with advanced disease increased from 44% to 50%. Upstaging of disease was accompanied by stage-specific improved survival, with 2-year survival of stage IV disease increasing from 8% to 11% between 1998 and 2003. PET was more likely to be administered to patients with less advanced disease (stages I through IIIA) and greater overall survival. CONCLUSION: Overall survival among Medicare beneficiaries with NSCLC was unchanged between 1998 and 2003, despite widespread adoption of PET. The association between PET use and increased survival likely reflects an artifact of selection bias and consequent stage migration.

Authors
Dinan, MA; Curtis, LH; Carpenter, WR; Biddle, AK; Abernethy, AP; Patz, EF; Schulman, KA; Weinberger, M
MLA Citation
Dinan, MA, Curtis, LH, Carpenter, WR, Biddle, AK, Abernethy, AP, Patz, EF, Schulman, KA, and Weinberger, M. "Stage migration, selection bias, and survival associated with the adoption of positron emission tomography among medicare beneficiaries with non-small-cell lung cancer, 1998-2003." J Clin Oncol 30.22 (August 1, 2012): 2725-2730.
PMID
22753917
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
30
Issue
22
Publish Date
2012
Start Page
2725
End Page
2730
DOI
10.1200/JCO.2011.40.4392

Identification of potential prognostic biomarkers in patients with untreated, advanced pancreatic cancer from a phase 3 trial (Cancer and Leukemia Group B 80303).

BACKGROUND: Patients with advanced stage adenocarcinoma of the pancreas have a poor prognosis. The identification of prognostic and/or predictive biomarkers may help stratify patients so that therapy can be individualized. METHODS: Serum samples from patients enrolled in the Cancer and Leukemia Group B 80303 phase 3 trial, "Randomized Study of Gemcitabine With Versus Without Bevacizumab in Patients With Locally Advanced or Metastatic Adenocarcinoma of the Pancreas" were used to discover novel biomarkers. For the discovery phase, 40 sera were selected based on length of survival and type of therapy, and subjected to liquid chromatography coupled to tandem mass spectrometry analysis (LC-MS-MS). The top features (proteins) were then further selected for validation by enzyme-linked immunosorbent assay (ELISA). RESULTS: Quantification by nano-LC-MS-MS resulted in 1452 peptides mapping to 156 proteins across all 40 samples, 92 of which had 2 or more peptides. After curation of the data, the authors selected 1 putative prognostic protein, alpha 1-antichymotrypsin (AACT), and 2 putative predictive proteins, histidine-rich glycoprotein (HRG) and complement factor H (CFH), for validation by ELISA. AACT was found to be negatively correlated with overall survival (τ = -0.30 [-0.38, -0.22]; P < .00001). There was no evidence for interaction with bevacizumab and HRG, but there was some evidence for a weak positive correlation of HRG with overall survival (τ = 0.11 [0.03, 0.19]; P < .01). CFH was found to be neither a predictive nor a prognostic factor for overall survival. CONCLUSIONS: AACT may be a useful prognostic marker in patients with advanced stage pancreatic carcinoma, although additional validation studies are needed.

Authors
Roberts, AS; Campa, MJ; Gottlin, EB; Jiang, C; Owzar, K; Kindler, HL; Venook, AP; Goldberg, RM; O'Reilly, EM; Patz, EF
MLA Citation
Roberts, AS, Campa, MJ, Gottlin, EB, Jiang, C, Owzar, K, Kindler, HL, Venook, AP, Goldberg, RM, O'Reilly, EM, and Patz, EF. "Identification of potential prognostic biomarkers in patients with untreated, advanced pancreatic cancer from a phase 3 trial (Cancer and Leukemia Group B 80303)." Cancer 118.2 (January 15, 2012): 571-578.
PMID
21713765
Source
pubmed
Published In
Cancer
Volume
118
Issue
2
Publish Date
2012
Start Page
571
End Page
578
DOI
10.1002/cncr.26270

The Association of Intratumoral Germinal Centers with early-stage non-small cell lung cancer.

INTRODUCTION: Lung cancers can display immune cell infiltration although the role of an adaptive immune response in disease pathogenesis is unknown. To investigate the possibility of a functional humoral response to the tumor, we surveyed histologic sections from non-small cell lung cancer (NSCLC) tumors for germinal centers (GCs) and assessed whether there was an association between the presence of GCs and tumor stage. METHODS: Tumor sections from 91 patients with all stages of NSCLC were examined by a pathologist blinded to clinical data. GCs were identified by hematoxylin and eosin staining patterns and confirmed by immunohistochemical staining for B-cell markers, BCL-6 and CD21. The distribution of GCs within the tumor or the tumor margin was recorded. Statistical analysis was performed to evaluate the association between stage and presence of GCs. RESULTS: Thirty-five percent of all tumors evaluated contained GCs, and sections evaluated by immunohistochemistry showed positive staining for both B-cell markers. GCs were seen both within the tumor and the tumor margin, consistent with an immune response to antigen stimulation. Patients with stage I NSCLC had a higher prevalence of intratumoral GCs than patients with stages II to IV (Cochran-Armitage Trend Test p = 0.02011). There was no association of stage with GCs in the tumor margin. CONCLUSIONS: Intratumoral GCs are associated with early-stage NSCLC. Further characterization of intratumoral GCs may lead to new diagnostic and therapeutic strategies based on manipulation of the adaptive immune response.

Authors
Gottlin, EB; Bentley, RC; Campa, MJ; Pisetsky, DS; Herndon, JE; Patz, EF
MLA Citation
Gottlin, EB, Bentley, RC, Campa, MJ, Pisetsky, DS, Herndon, JE, and Patz, EF. "The Association of Intratumoral Germinal Centers with early-stage non-small cell lung cancer." J Thorac Oncol 6.10 (October 2011): 1687-1690.
PMID
21642860
Source
pubmed
Published In
Journal of Thoracic Oncology
Volume
6
Issue
10
Publish Date
2011
Start Page
1687
End Page
1690
DOI
10.1097/JTO.0b013e3182217bec

The National Lung Screening Trial: overview and study design.

The National Lung Screening Trial (NLST) is a randomized multicenter study comparing low-dose helical computed tomography (CT) with chest radiography in the screening of older current and former heavy smokers for early detection of lung cancer, which is the leading cause of cancer-related death in the United States. Five-year survival rates approach 70% with surgical resection of stage IA disease; however, more than 75% of individuals have incurable locally advanced or metastatic disease, the latter having a 5-year survival of less than 5%. It is plausible that treatment should be more effective and the likelihood of death decreased if asymptomatic lung cancer is detected through screening early enough in its preclinical phase. For these reasons, there is intense interest and intuitive appeal in lung cancer screening with low-dose CT. The use of survival as the determinant of screening effectiveness is, however, confounded by the well-described biases of lead time, length, and overdiagnosis. Despite previous attempts, no test has been shown to reduce lung cancer mortality, an endpoint that circumvents screening biases and provides a definitive measure of benefit when assessed in a randomized controlled trial that enables comparison of mortality rates between screened individuals and a control group that does not undergo the screening intervention of interest. The NLST is such a trial. The rationale for and design of the NLST are presented.

Authors
National Lung Screening Trial Research Team, ; Aberle, DR; Berg, CD; Black, WC; Church, TR; Fagerstrom, RM; Galen, B; Gareen, IF; Gatsonis, C; Goldin, J; Gohagan, JK; Hillman, B; Jaffe, C; Kramer, BS; Lynch, D; Marcus, PM; Schnall, M; Sullivan, DC; Sullivan, D; Zylak, CJ
MLA Citation
National Lung Screening Trial Research Team, , Aberle, DR, Berg, CD, Black, WC, Church, TR, Fagerstrom, RM, Galen, B, Gareen, IF, Gatsonis, C, Goldin, J, Gohagan, JK, Hillman, B, Jaffe, C, Kramer, BS, Lynch, D, Marcus, PM, Schnall, M, Sullivan, DC, Sullivan, D, and Zylak, CJ. "The National Lung Screening Trial: overview and study design." Radiology 258.1 (January 2011): 243-253.
PMID
21045183
Source
pubmed
Published In
Radiology
Volume
258
Issue
1
Publish Date
2011
Start Page
243
End Page
253
DOI
10.1148/radiol.10091808

Discovery of novel cyclophilin A ligands using an H/D exchange- and mass spectrometry-based strategy.

Cyclophilin A (CypA) is an overexpressed protein in lung cancer tumors and as a result is a potential therapeutic and diagnostic target. Described here is use of an H/D exchange- and a matrix assisted laser desorption/ionization (MALDI) mass spectrometry-based assay, termed single-point SUPREX (Stability of Unpurified Proteins from Rates of H/D Exchange), to screen 2 chemical libraries, including the 1280-compound LOPAC library and the 9600-compound DIVERSet library, for binding to CypA. This work represents the first application of single-point SUPREX using a pooled ligand approach, which is demonstrated here to yield screening rates as fast as 6 s/ligand. The false-positive and false-negative rates determined in the current work using a set of control samples were 0% and 9%, respectively. A false-positive rate of 20% was found in screening the actual libraries. Eight novel ligands to CypA were discovered, including 2-(α-naphthoyl)ethyltrimethyl-ammonium iodide, (E)-3-(4-t-Butylphenylsulfonyl)-2-propenenitrile, 3-(N-benzyl-N-isopropyl)amino-1-(naphthalen-2-yl)propan-1-one, cis-diammineplatinum (II) chloride, 1-(3,5-dichlorophenyl)-1H-pyrrole-2,5-dione, N-(3-chloro-1, 4-dioxo-1,4-dihydro-2-naphthalenyl)-N-cyclohexylacetamide, 1-[2-(3,4-dimethoxyphenyl)ethyl]-1H-pyrrole-2,5-dione, and 4-(2-methoxy-4-nitrophenyl)-1-methyl-10-oxa-4-azatricyclo[5.2.1.0~2,6~]dec-8-ene-3,5-dione. These compounds, which had moderate binding affinities to CypA (i.e., K(d) values in the low micromolar range), provide new molecular scaffolds that might be useful in the development of CypA-targeted diagnostic imaging or therapeutic agents for lung cancer.

Authors
Dearmond, PD; West, GM; Anbalagan, V; Campa, MJ; Patz, EF; Fitzgerald, MC
MLA Citation
Dearmond, PD, West, GM, Anbalagan, V, Campa, MJ, Patz, EF, and Fitzgerald, MC. "Discovery of novel cyclophilin A ligands using an H/D exchange- and mass spectrometry-based strategy." J Biomol Screen 15.9 (October 2010): 1051-1062.
PMID
20855564
Source
pubmed
Published In
Journal of Biomolecular Screening
Volume
15
Issue
9
Publish Date
2010
Start Page
1051
End Page
1062
DOI
10.1177/1087057110382775

National Lung Cancer Screening Trial American College of Radiology Imaging Network Specimen Biorepository originating from the Contemporary Screening for the Detection of Lung Cancer Trial (NLST, ACRIN 6654): design, intent, and availability of specimens for validation of lung cancer biomarkers.

Authors
Patz, EF; Caporaso, NE; Dubinett, SM; Massion, PP; Hirsch, FR; Minna, JD; Gatsonis, C; Duan, F; Adams, A; Apgar, C; Medina, RM; Aberle, DR
MLA Citation
Patz, EF, Caporaso, NE, Dubinett, SM, Massion, PP, Hirsch, FR, Minna, JD, Gatsonis, C, Duan, F, Adams, A, Apgar, C, Medina, RM, and Aberle, DR. "National Lung Cancer Screening Trial American College of Radiology Imaging Network Specimen Biorepository originating from the Contemporary Screening for the Detection of Lung Cancer Trial (NLST, ACRIN 6654): design, intent, and availability of specimens for validation of lung cancer biomarkers." J Thorac Oncol 5.10 (October 2010): 1502-1506.
PMID
20871260
Source
pubmed
Published In
Journal of Thoracic Oncology
Volume
5
Issue
10
Publish Date
2010
Start Page
1502
End Page
1506
DOI
10.1097/JTO.0b013e3181f1c634

Correlation of [18F]-2-fluoro-deoxy-D-glucose positron emission tomography standard uptake values with the cellular composition of stage I nonsmall cell lung cancer.

BACKGROUND: The aim of the current study was to determine whether the [18F]-2-fluoro-deoxy-D-glucose (FDG) positron emission tomography (PET) standardized uptake value (SUV) in patients with a new diagnosis of stage I lung cancer correlates with a specific cellular component in the primary tumor. METHODS: This study was Health Insurance Portability and Accountability Act compliant and approved by our Institutional Review Board with a waiver of informed consent. Forty patients with stage I nonsmall cell lung cancer (NSCLC) who underwent FDG-PET imaging at the time of diagnosis followed by surgical resection were retrospectively identified. Histologic sections of the primary tumor were reviewed by a pathologist without any clinical data and scored according to the percentage of each cellular component (tumor cells, normal stroma, inflammatory cells, necrosis, fibrosis, and other). Each component was compared with maximal (SUV(max)) and mean (SUV(mean)) SUVs using Pearson correlation coefficient analysis. RESULTS: The mean SUV(max) and SUV(mean) values for 40 stage I NSCLC tumors were 8.8 and 5.4, respectively. The mean histologic composition of tumor specimens in order of frequency was as follows: tumor cells (38.9%), fibrosis (30.8%), inflammatory cells (14.8%), normal stroma (5.2%), necrosis (5.8%), and other components (4.5%); however, there was considerable variation noted among individual tumors. There was no statistically significant correlation between SUV(max) (r = .19; P = .24) or SUV(mean) (r = .017; P = .29) and the proportion of tumor cells in the tumor mass or any other cellular components. CONCLUSIONS: The cellular composition of stage I NSCLC appears to be highly variable, with no correlation noted between a specific tumor cellular component and FDG activity.

Authors
Christensen, JD; Colby, TV; Patz, EF
MLA Citation
Christensen, JD, Colby, TV, and Patz, EF. "Correlation of [18F]-2-fluoro-deoxy-D-glucose positron emission tomography standard uptake values with the cellular composition of stage I nonsmall cell lung cancer." Cancer 116.17 (September 1, 2010): 4095-4102.
PMID
20533438
Source
pubmed
Published In
Cancer
Volume
116
Issue
17
Publish Date
2010
Start Page
4095
End Page
4102
DOI
10.1002/cncr.25302

Complement factor H autoantibodies are associated with early stage NSCLC.

PURPOSE: To discover diagnostic biomarkers associated with early-stage non-small cell lung cancer (NSCLC), we searched for autoantibodies preferentially present in stage I patients compared with patients with advanced-stage disease. Here we describe an autoantibody against complement factor H (CFH) and this autoantibody's association with early-stage NSCLC. EXPERIMENTAL DESIGN: Immunoblots were used to detect autoantibodies in the sera of stage I NSCLC patients. An autoantibody recognizing a 150 kDa protein was discovered, and the protein was identified by mass spectrometry. The association of the autoantibody with early-stage disease was suggested by the results of immunoblot analysis with sera from 28 stage I patients and 28 stage III/IV patients. This association was confirmed by protein microarray of sera from 125 NSCLC patients of all stages as well as 125 controls matched by age, gender, and smoking history. RESULTS: The immunoreactive protein was identified as CFH. By immunoblot analysis, anti-CFH autoantibody was found in 50% of stage I NSCLC patients and 11% of late-stage NSCLC patients (P = 0.003). By protein microarray analysis, patients with stage I NSCLC had a significantly higher incidence of anti-CFH antibody than those with late-stage NSCLC (P = 0.0051). The percentage of sera with a positive level of CFH autoantibody was 30.4% in stage I, 21.1% in stage II, 12.5% in stage III, 7.4% in stage IV, and 8.0% in the control group. CONCLUSIONS: These findings suggest that in patients with NSCLC, CFH autoantibody is a molecular marker associated with early-stage disease.

Authors
Amornsiripanitch, N; Hong, S; Campa, MJ; Frank, MM; Gottlin, EB; Patz, EF
MLA Citation
Amornsiripanitch, N, Hong, S, Campa, MJ, Frank, MM, Gottlin, EB, and Patz, EF. "Complement factor H autoantibodies are associated with early stage NSCLC." Clin Cancer Res 16.12 (June 15, 2010): 3226-3231.
PMID
20515868
Source
pubmed
Published In
Clinical cancer research : an official journal of the American Association for Cancer Research
Volume
16
Issue
12
Publish Date
2010
Start Page
3226
End Page
3231
DOI
10.1158/1078-0432.CCR-10-0321

Changes in the use and costs of diagnostic imaging among Medicare beneficiaries with cancer, 1999-2006.

CONTEXT: Emerging technologies, changing diagnostic and treatment patterns, and changes in Medicare reimbursement are contributing to increasing use of imaging in cancer. Imaging is the fastest growing expense for Medicare but has not been examined among beneficiaries with cancer. OBJECTIVE: To examine changes in the use of imaging and how those changes contribute to the overall cost of cancer care. DESIGN, SETTING, AND PATIENTS: Analysis of a nationally representative 5% sample of claims from the US Centers for Medicare & Medicaid Services from 1999 through 2008. Patients were Medicare beneficiaries with incident breast cancer, colorectal cancer, leukemia, lung cancer, non-Hodgkin lymphoma, or prostate cancer. MAIN OUTCOME MEASURES: Use and cost of imaging by modality, year, and cancer type. RESULTS: There were 100,954 incident cases of breast cancer, colorectal cancer, leukemia, lung cancer, non-Hodgkin lymphoma, and prostate cancer from 1999 through 2006. Significant mean annual increases in imaging use occurred among all cancer types for positron emission tomography (35.9%-53.6%), bone density studies (6.3%-20.0%), echocardiograms (5.0%-7.8%), magnetic resonance imaging (4.4%-11.5%), and ultrasound (0.7%-7.4%). Conventional radiograph rates decreased or stayed the same. As of 2006, beneficiaries with lung cancer and beneficiaries with lymphoma incurred the largest overall imaging costs, exceeding a mean of $3000 per beneficiary within 2 years of diagnosis. By 2005, one-third of beneficiaries with breast cancer underwent bone scans and half of beneficiaries with lung cancer or lymphoma underwent positron emission tomography scans. Mean 2-year imaging costs per beneficiary increased at a rate greater than the increase in mean total costs per beneficiary for all cancer types. CONCLUSION: Imaging costs among Medicare beneficiaries with cancer increased from 1999 through 2006, outpacing the rate of increase in total costs among Medicare beneficiaries with cancer.

Authors
Dinan, MA; Curtis, LH; Hammill, BG; Patz, EF; Abernethy, AP; Shea, AM; Schulman, KA
MLA Citation
Dinan, MA, Curtis, LH, Hammill, BG, Patz, EF, Abernethy, AP, Shea, AM, and Schulman, KA. "Changes in the use and costs of diagnostic imaging among Medicare beneficiaries with cancer, 1999-2006." JAMA 303.16 (April 28, 2010): 1625-1631.
PMID
20424253
Source
pubmed
Published In
JAMA : the journal of the American Medical Association
Volume
303
Issue
16
Publish Date
2010
Start Page
1625
End Page
1631
DOI
10.1001/jama.2010.460

Thoracic imaging.

The various techniques encompassed in the term 'Thoracic Imaging' have had a dramatic effect on the practice of respiratory medicine over the last 25 years. One of many examples is the increased precision with which lung cancer can be preoperatively staged using CT and PET imaging. The increasing sophistication of thoracic imaging tests brings many benefits, but there are caveats. This review considers a selection of techniques and contains state-of-the-art commentaries by distinguished experts on current challenges and likely future developments.

Authors
Hansell, DM; Boiselle, PM; Goldin, J; Kauczor, H-U; Lynch, DA; Mayo, JR; Patz, EF
MLA Citation
Hansell, DM, Boiselle, PM, Goldin, J, Kauczor, H-U, Lynch, DA, Mayo, JR, and Patz, EF. "Thoracic imaging." Respirology 15.3 (April 2010): 393-400. (Review)
PMID
20136737
Source
pubmed
Published In
Respirology
Volume
15
Issue
3
Publish Date
2010
Start Page
393
End Page
400
DOI
10.1111/j.1440-1843.2009.01698.x

Commentary on "Positron Emission Tomography in the Lung" 25 years after publication in the inaugural issue of the Journal of Thoracic Imaging.

Authors
Patz, EF; Erasmus, JJ
MLA Citation
Patz, EF, and Erasmus, JJ. "Commentary on "Positron Emission Tomography in the Lung" 25 years after publication in the inaugural issue of the Journal of Thoracic Imaging." J Thorac Imaging 25.1 (February 2010): 39-40.
PMID
20160601
Source
pubmed
Published In
Journal of Thoracic Imaging
Volume
25
Issue
1
Publish Date
2010
Start Page
39
End Page
40
DOI
10.1097/RTI.0b013e3181caa973

The role of biomarkers in thoracic imaging

Thoracic imaging plays an essential role in understanding and diagnosing chest disease. It has traditionally relied on conventional anatomic and morphologic imaging, but as technology evolves, novel diagnostic strategies have the potential to improve accuracy. This includes incorporation of biomarkers, which are an objective measure of a biological or pathological process. Biomarkers can be used in multiple different scenarios, and may complement current imaging studies, particularly in establishing a diagnosis, determining prognosis or predicting response to therapy. However, it is important to develop and validate clinically relevant biomarkers. This is a complex, multidisciplinary subject that requires knowledge of the clinical problem, an understanding of the technology and pathology, and significant resources. Ultimately, integration of biomarkers into patient evaluation must be cost effective and improve outcomes. This article will describe the potential roles and limitations of biomarkers in thoracic diseases. © 2010 Future Medicine Ltd.

Authors
Auffermann, WF; Washington, L; Gottlin, EB; Jr, EFP
MLA Citation
Auffermann, WF, Washington, L, Gottlin, EB, and Jr, EFP. "The role of biomarkers in thoracic imaging." Imaging in Medicine 2.5 (2010): 575-581.
Source
scival
Published In
Imaging in Medicine
Volume
2
Issue
5
Publish Date
2010
Start Page
575
End Page
581
DOI
10.2217/iim.10.47

Reply to early changes in tumor size in patients treated for advanced stage nonsmall cell lung cancer do not correlate with survival

Authors
Birchard, KR; Jr, EEP
MLA Citation
Birchard, KR, and Jr, EEP. "Reply to early changes in tumor size in patients treated for advanced stage nonsmall cell lung cancer do not correlate with survival." Cancer 116.6 (2010): 1616--.
Source
scival
Published In
Cancer
Volume
116
Issue
6
Publish Date
2010
Start Page
1616-
DOI
10.1002/cncr.24806

Implementation of IASLC revised staging system: imaging implications

Authors
Patz, JEF
MLA Citation
Patz, JEF. "Implementation of IASLC revised staging system: imaging implications." JOURNAL OF THORACIC ONCOLOGY 4.9 (September 2009): S16-S17.
Source
wos-lite
Published In
Journal of Thoracic Oncology
Volume
4
Issue
9
Publish Date
2009
Start Page
S16
End Page
S17

Hydrogen/deuterium exchange- and protease digestion-based screening assay for protein-ligand binding detection.

A protease digestion strategy was incorporated into single-point stability of unpurified proteins from rates of H/D exchange (SUPREX), which is a hydrogen/deuterium (H/D) exchange- and mass spectrometry-based assay for the detection of protein-ligand binding. Single-point SUPREX is an abbreviated form of SUPREX in which protein-ligand binding interactions are detected by measuring the increase in a protein's thermodynamic stability upon ligand binding. The new protease digestion protocol provides a noteworthy increase in the efficiency of single-point SUPREX because peptide masses can be determined with greater precision than intact protein masses in the matrix-assisted laser desorption ionization (MALDI) readout of single-point SUPREX. The protocol was evaluated in test screens on two model protein systems, including cyclophilin A (CypA) and the minor allele variant of human alanine:glyoxylate aminotransferase (AGTmi). The test screening results obtained on both proteins revealed that the peptide readout of the single-point SUPREX-protease digestion protocol was more efficient than the intact protein readout of the original single-point SUPREX protocol at discriminating hits and nonhits. In addition to this improvement in screening efficiency, the protease digestion strategy described here is expected to significantly increase the generality of the single-point SUPREX assay.

Authors
Hopper, ED; Pittman, AMC; Tucker, CL; Campa, MJ; Patz, EF; Fitzgerald, MC
MLA Citation
Hopper, ED, Pittman, AMC, Tucker, CL, Campa, MJ, Patz, EF, and Fitzgerald, MC. "Hydrogen/deuterium exchange- and protease digestion-based screening assay for protein-ligand binding detection." Anal Chem 81.16 (August 15, 2009): 6860-6867.
PMID
20337380
Source
pubmed
Published In
Analytical Chemistry
Volume
81
Issue
16
Publish Date
2009
Start Page
6860
End Page
6867
DOI
10.1021/ac900854t

Early changes in tumor size in patients treated for advanced stage nonsmall cell lung cancer do not correlate with survival.

BACKGROUND: In clinical trials, change in tumor size is used to stratify patients into response categories. The objective of the current study was to: 1) determine whether early change in the tumor size were correlated with survival in patients with advanced nonsmall cell lung cancer (NSCLC) using modified response categories from the Response Evaluation Criteria in Solid Tumors (RECIST), and 2) to determine whether there was an optimal percentage change in tumor size that could be used to define a partial response that also correlated with survival. METHODS: A total of 99 consecutive patients presenting for the treatment of advanced NSCLC during the year 2003 who had computed tomography (CT) scans before and after treatment available for review were included in the study. The largest target thoracic lesion was measured on CT before treatment, and again 2 months to 3 months after the initiation of treatment. Percent change in tumor size was calculated. The relation between tumor response and patient survival was investigated. RESULTS: There was no definite relation noted between early tumor response and patient survival (P = .754). Patients who had any initial reduction in tumor size were not found to have a significantly different survival compared with patients with initial disease progression (P = .580). In addition, there was no particular percent reduction in tumor size that was found to optimally correlate with survival. CONCLUSIONS: There is no evidence of a relation between early changes in tumor size and survival among patients with advanced stage NSCLC. To predict survival in patients with advanced NSCLC, response criteria other than change in lesion size are needed.

Authors
Birchard, KR; Hoang, JK; Herndon, JE; Patz, EF
MLA Citation
Birchard, KR, Hoang, JK, Herndon, JE, and Patz, EF. "Early changes in tumor size in patients treated for advanced stage nonsmall cell lung cancer do not correlate with survival." Cancer 115.3 (February 1, 2009): 581-586.
PMID
19117348
Source
pubmed
Published In
Cancer
Volume
115
Issue
3
Publish Date
2009
Start Page
581
End Page
586
DOI
10.1002/cncr.24060

Isolation of novel EGFR-specific VHH domains.

Epidermal growth factor receptor (EGFR) is overexpressed or mutated in a high percentage of tumors. EGFR has long been considered a promising target for cancer diagnostic and therapeutic applications. However, monoclonal antibodies and other large antibody constructs diffuse into tumors slowly, limiting their efficacy. To develop lower molecular weight probes for EGFR and other tumor cell receptors, the authors immunized a llama with the extracellular domains (ECDs) of EGFR and an oncogenic mutant receptor, EGFRvIII, and with extracts of tumor cell lines. From the immune repertoire of the llama, the authors constructed a heavy chain variable domain (VHH domain)-phage library. At approximately 16 kDa, the VHH domain is a tenth of the size of a monoclonal antibody and is the smallest antibody fragment that retains specificity. By affinity selection from this library, the authors isolated many VHH domains with specificity for EGFR. The VHH domains bind to whole cells expressing the receptor but not to control cells lacking the receptor and can immunoprecipitate EGFR from cell lysates. Some VHH domains have cross-specificity with existing anti-EGFR monoclonal antibodies and have reasonably high (nM) affinities. The llama-VHH domain library is also potentially a rich source of targeting agents directed toward other tumor cell receptors.

Authors
Gottlin, EB; Xiangrong Guan, ; Pegram, C; Cannedy, A; Campa, MJ; Patz, EF
MLA Citation
Gottlin, EB, Xiangrong Guan, , Pegram, C, Cannedy, A, Campa, MJ, and Patz, EF. "Isolation of novel EGFR-specific VHH domains." J Biomol Screen 14.1 (January 2009): 77-85.
PMID
19171923
Source
pubmed
Published In
Journal of Biomolecular Screening
Volume
14
Issue
1
Publish Date
2009
Start Page
77
End Page
85
DOI
10.1177/1087057108327064

Does computed tomography or positron emission tomography response after neoadjuvant chemotherapy for resectable non-small-cell lung cancer predict survival?

Authors
Patz, EF
MLA Citation
Patz, EF. "Does computed tomography or positron emission tomography response after neoadjuvant chemotherapy for resectable non-small-cell lung cancer predict survival?." J Clin Oncol 26.28 (October 1, 2008): 4542-4543.
PMID
18824705
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
26
Issue
28
Publish Date
2008
Start Page
4542
End Page
4543
DOI
10.1200/JCO.2008.18.2147

Throughput and efficiency of a mass spectrometry-based screening assay for protein-ligand binding detection.

An H/D exchange- and MALDI mass spectrometry-based screening assay was applied to search for novel ligands that bind to cyclophilin A, a potential therapeutic and diagnostic target in lung cancer. The assay is based on stability of unpurified proteins from rates of H/D exchange (SUPREX), which exploits the H/D exchange properties of amide protons to measure the increase in a protein's thermodynamic stability upon ligand binding in solution. The current study evaluates the throughput and efficiency with which 880 potential ligands from the Prestwick Chemical Library (Illkirch, France) could be screened for binding to cyclophilin A. Screening was performed at a rate of 3 min/ligand using a conventional MALDI mass spectrometer. False positive and false negative rates, based on a set of control data, were as low as 0% and 9%, respectively. Based on the 880-member library screening, a false positive rate of 0% was observed when a two-tier selection strategy was implemented. Although novel ligands for cyclophilin A were not discovered, cyclosporin A, a known ligand to CypA and a blind control in the library, was identified as a hit. We also describe a new strategy to eliminate some of the complications related to back exchange that can arise in screening applications of SUPREX.

Authors
Hopper, ED; Roulhac, PL; Campa, MJ; Patz, EF; Fitzgerald, MC
MLA Citation
Hopper, ED, Roulhac, PL, Campa, MJ, Patz, EF, and Fitzgerald, MC. "Throughput and efficiency of a mass spectrometry-based screening assay for protein-ligand binding detection." J Am Soc Mass Spectrom 19.9 (September 2008): 1303-1311.
PMID
18653356
Source
pubmed
Published In
Journal of The American Society for Mass Spectrometry
Volume
19
Issue
9
Publish Date
2008
Start Page
1303
End Page
1311
DOI
10.1016/j.jasms.2008.06.007

Validation of two models to estimate the probability of malignancy in patients with solitary pulmonary nodules.

BACKGROUND: Effective strategies for managing patients with solitary pulmonary nodules (SPN) depend critically on the pre-test probability of malignancy. OBJECTIVE: To validate two previously developed models that estimate the probability that an indeterminate SPN is malignant, based on clinical characteristics and radiographic findings. METHODS: Data on age, smoking and cancer history, nodule size, location and spiculation were collected retrospectively from the medical records of 151 veterans (145 men, 6 women; age range 39-87 years) with an SPN measuring 7-30 mm (inclusive) and a final diagnosis established by histopathology or 2-year follow-up. Each patient's final diagnosis was compared with the probability of malignancy predicted by two models: one developed by investigators at the Mayo Clinic and the other developed from patients enrolled in a VA Cooperative Study. The accuracy of each model was assessed by calculating areas under the receiver operating characteristic (ROC) curve and the models were calibrated by comparing predicted and observed rates of malignancy. RESULTS: The area under the ROC curve for the Mayo Clinic model (0.80; 95% CI 0.72 to 0.88) was higher than that of the VA model (0.73; 95% CI 0.64 to 0.82), but this difference was not statistically significant (Delta = 0.07; 95% CI -0.03 to 0.16). Calibration curves showed that the probability of malignancy was underestimated by the Mayo Clinic model and overestimated by the VA model. CONCLUSIONS: Two existing prediction models are sufficiently accurate to guide decisions about the selection and interpretation of subsequent diagnostic tests in patients with SPNs, although clinicians should also consider the prevalence of malignancy in their practice setting when choosing a model.

Authors
Schultz, EM; Sanders, GD; Trotter, PR; Patz, EF; Silvestri, GA; Owens, DK; Gould, MK
MLA Citation
Schultz, EM, Sanders, GD, Trotter, PR, Patz, EF, Silvestri, GA, Owens, DK, and Gould, MK. "Validation of two models to estimate the probability of malignancy in patients with solitary pulmonary nodules." Thorax 63.4 (April 2008): 335-341.
PMID
17965070
Source
pubmed
Published In
Thorax
Volume
63
Issue
4
Publish Date
2008
Start Page
335
End Page
341
DOI
10.1136/thx.2007.084731

Prognostic value of fluorine-18 fluorodeoxyglucose positron emission tomography imaging in patients with advanced-stage non-small-cell lung carcinoma.

PURPOSE: To determine whether the amount of fluorine-18 fluorodeoxyglucose (FDG) uptake in the primary lung cancer on positron emission tomography (PET) imaging at the time of presentation has prognostic significance in patients with advanced-stage non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: A retrospective review identified 214 patients with advanced-stage NSCLC (stage IIIA, IIIB, and IV) who underwent FDG PET study at the time of diagnosis. Extensive clinical data, including tumor histologic cell type, pathologic stage at presentation, and treatment, were recorded. The maximum standardized uptake value (SUV(max)) in the primary tumor on FDG PET on survival was examined using Cox proportional hazards regression. RESULTS: One hundred fifty-eight (74%) of the 214 patients died and 56 patients were reported alive at 27 months (range, 3 to 140 months) after the diagnosis of NSCLC. Using the median SUV(max) of 11.1, the patient population was subdivided. The median survival of the 106 patients with the primary tumor having an SUV(max) less than 11.1 was 16 months (95% CI, 12 to 21 months), whereas the median survival of the 108 patients with the primary tumor having an SUV(max) > or = 11.1 was 12 months (95% CI, 10 to 15 months). Univariate and multivariate analysis did not provide evidence that survival for patient subgroups defined by the median SUV(max) were significantly different (univariate P = .11; multivariate P = .45). CONCLUSION: FDG uptake of the primary lesions in patients with a new diagnosis of advanced-stage NSCLC does not have a significant relationship with survival.

Authors
Hoang, JK; Hoagland, LF; Coleman, RE; Coan, AD; Herndon, JE; Patz, EF
MLA Citation
Hoang, JK, Hoagland, LF, Coleman, RE, Coan, AD, Herndon, JE, and Patz, EF. "Prognostic value of fluorine-18 fluorodeoxyglucose positron emission tomography imaging in patients with advanced-stage non-small-cell lung carcinoma." J Clin Oncol 26.9 (March 20, 2008): 1459-1464.
PMID
18349396
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
26
Issue
9
Publish Date
2008
Start Page
1459
End Page
1464
DOI
10.1200/JCO.2007.14.3628

Primary tumor standardized uptake value (SUVmax) measured on fluorodeoxyglucose positron emission tomography (FDG-PET) is of prognostic value for survival in non-small cell lung cancer (NSCLC): a systematic review and meta-analysis (MA) by the European Lung Cancer Working Party for the IASLC Lung Cancer Staging Project.

HYPOTHESIS: The 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography is an imaging tool for assessing clinical tumor, node, metastasis in non-small cell lung cancer (NSCLC). Primary tumor standardized uptake value (SUV) has been studied as a potential prognostic factor for survival. However, the sample sizes are limited leading to conduct a meta-analysis to improve the precision in estimating its effect. METHODS: We performed a systematic literature search. For each publication, we extracted an estimate of the hazard ratio (HR) for comparing patients with a low and a high SUV and we aggregated the individual HRs into a combined HR, using a random-effects model. RESULTS: We found 13 eligible studies dedicated to NSCLC. Most of them included patients with stages I to III/IV and used a SUV assessment corrected for body weight. Number of patients ranged from 38 to 315 (total: 1474); 11 studies identified a high SUV as a poor prognostic factor for survival although two studies found no significant correlation between SUV and survival. SUV measurement and SUV threshold for defining high SUV were study dependent, eight studies looked for a so-called best cutoff (maximizing the logrank test statistic) without adjusting the p value for multiplicity. Overall, the combined HR for the 13 reports was 2.27 (95% confidence interval [CI]: 1.70-3.02); excluding the studies proposing a "best" cutoff, it was 2.08 (95% CI: 1.431-3.04). CONCLUSION: Our meta-analysis suggests that the primary tumor SUV measurement has a prognostic value in NSCLC; these results should be confirmed in a meta-analysis on individual patients' data.

Authors
Berghmans, T; Dusart, M; Paesmans, M; Hossein-Foucher, C; Buvat, I; Castaigne, C; Scherpereel, A; Mascaux, C; Moreau, M; Roelandts, M; Alard, S; Meert, A-P; Patz, EF; Lafitte, J-J; Sculier, J-P; European Lung Cancer Working Party for the IASLC Lung Cancer Staging Project,
MLA Citation
Berghmans, T, Dusart, M, Paesmans, M, Hossein-Foucher, C, Buvat, I, Castaigne, C, Scherpereel, A, Mascaux, C, Moreau, M, Roelandts, M, Alard, S, Meert, A-P, Patz, EF, Lafitte, J-J, Sculier, J-P, and European Lung Cancer Working Party for the IASLC Lung Cancer Staging Project, . "Primary tumor standardized uptake value (SUVmax) measured on fluorodeoxyglucose positron emission tomography (FDG-PET) is of prognostic value for survival in non-small cell lung cancer (NSCLC): a systematic review and meta-analysis (MA) by the European Lung Cancer Working Party for the IASLC Lung Cancer Staging Project." J Thorac Oncol 3.1 (January 2008): 6-12. (Review)
PMID
18166834
Source
pubmed
Published In
Journal of Thoracic Oncology
Volume
3
Issue
1
Publish Date
2008
Start Page
6
End Page
12
DOI
10.1097/JTO.0b013e31815e6d6b

Panel of serum biomarkers for the diagnosis of lung cancer.

PURPOSE: Currently, a blood test for lung cancer does not exist. Serum biomarkers that could aid clinicians in making case management decisions would be enormously valuable. We used two proteomic platforms and a literature search to select candidate serum markers for the diagnosis of lung cancer. METHODS: We initially assayed six serum proteins, four discovered by proteomics and two previously known to be cancer associated, on a training set of sera from 100 patients (50 with a new diagnosis of lung cancer and 50 age- and sex-matched controls). Classification and Regression Tree (CART) analysis selected a panel of four markers that most efficiently predicted which patients had lung cancer. An independent, blinded validation set of sera from 97 patients (49 lung cancer patients and 48 matched controls) determined the accuracy of the four markers to predict which patients had lung cancer. RESULTS: Four serum proteins-carcinoembryonic antigen, retinol binding protein, alpha1-antitrypsin, and squamous cell carcinoma antigen-were collectively found to correctly classify the majority of lung cancer and control patients in the training set (sensitivity, 89.3%; specificity, 84.7%). These markers also accurately classified patients in the independent validation set (sensitivity, 77.8%; specificity, 75.4%). Remarkably, 90% of patients who fell into any one of three groupings in the CART analysis had lung cancer. CONCLUSION: This panel of four serum proteins is valuable in suggesting the diagnosis of lung cancer. These data may be useful for treating patients with an indeterminate pulmonary lesion, and potentially in predicting individuals at high risk for lung cancer.

Authors
Patz, EF; Campa, MJ; Gottlin, EB; Kusmartseva, I; Guan, XR; Herndon, JE
MLA Citation
Patz, EF, Campa, MJ, Gottlin, EB, Kusmartseva, I, Guan, XR, and Herndon, JE. "Panel of serum biomarkers for the diagnosis of lung cancer." J Clin Oncol 25.35 (December 10, 2007): 5578-5583.
PMID
18065730
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
25
Issue
35
Publish Date
2007
Start Page
5578
End Page
5583
DOI
10.1200/JCO.2007.13.5392

Frequency and prognostic significance of preoperatively detected enlarged regional lymph nodes in patients with pathological stage I non-small cell lung cancer following resection.

PURPOSE: To explore the clinical significance of enlarged regional lymph nodes in patients with pathological stage I non-small cell lung cancer (NSCLC). MATERIAL AND METHODS: We retrospectively reviewed the tumor registry of the International Association for the Study of Lung Cancer (IASLC) Staging Database to identify 6995 patients between January 1, 1990 and December 31, 2000 with clinical stage I, II, and IIIA tumors (cT1-2N0-2M0, excluding T3N0-2M0 cases) who proved to have pathological stage I NSCLC (T1-2N0M0, pStage I). The frequency of enlarged nodes in patients with pStage I disease is reported, and the overall survival of these patients who had enlarged regional lymph nodes was compared with that of patients with pStage I disease with normal size regional lymph nodes. RESULTS: Enlarged regional lymph nodes (cN1-2) were seen in approximately 12% of patients with pStage I disease. Median survival for patients with enlarged versus normal nodes was 102 versus 107 months (hazard ratio 1.16, p = 0. 01). Survival curves converged at 8 years postsurgery. CONCLUSIONS: Enlarged regional lymph nodes are uncommon in patients with pStage I NSCLC, and the size of regional lymph nodes in these early stage patients does not seem to provide clinically useful prognostic information.

Authors
Hoang, JK; Patz, E; Giroux, D; Goldstraw, P
MLA Citation
Hoang, JK, Patz, E, Giroux, D, and Goldstraw, P. "Frequency and prognostic significance of preoperatively detected enlarged regional lymph nodes in patients with pathological stage I non-small cell lung cancer following resection." J Thorac Oncol 2.12 (December 2007): 1103-1106.
PMID
18090582
Source
pubmed
Published In
Journal of Thoracic Oncology
Volume
2
Issue
12
Publish Date
2007
Start Page
1103
End Page
1106
DOI
10.1097/JTO.0b013e31815c04b4

Haptoglobin and posttranslational glycan-modified derivatives as serum biomarkers for the diagnosis of nonsmall cell lung cancer.

BACKGROUND: The purpose was to evaluate the clinical utility of serum haptoglobin (Hp) and posttranslational glycan modifications of Hp for the diagnosis of nonsmall cell lung cancer (NSCLC). METHODS: Serum proteins from patients with a new diagnosis of NSCLC and age- and sex-matched controls without cancer were compared using 2-dimensional difference gel electrophoresis (2D-DIGE). Four of the differentially expressed gel spots were identified as the beta chain of Hp. Immunoblots confirmed sialyl and fucosyl group posttranslational modifications (PTMs) of Hp. Serum enzyme-linked immunosorbent assays (ELISAs) for total Hp, sialylated Hp (SAHp), and fucosylated Hp (FHp) were designed, and levels of each were measured in an independent sample set of 74 patients. Receiver operating characteristic (ROC) analysis assessed the clinical diagnostic utility of each marker. RESULTS: Statistically significant differences between lung cancer patients and matched controls were found by ELISA for Hp (P < .002), SAHp (P < .001), and FHp (P < .04). ROC analysis determined an area under the curve (AUC) of 0.754 for Hp, 0.740 for SAHp, and 0.794 for FHp. In addition, serum concentrations correlated with stage; Hp (r = 0.388; P = .018), SAHp (r = 0.300; P = .072), and FHp (r = 0.363; P = .027). CONCLUSIONS: Hp and 2 of its glycoforms, SAHp and FHp, are potentially useful in the clinical diagnosis of NSCLC. The markers increase with stage, suggesting they may also be useful in stratifying patients at presentation and in following patients after treatment.

Authors
Hoagland, LFM; Campa, MJ; Gottlin, EB; Herndon, JE; Patz, EF
MLA Citation
Hoagland, LFM, Campa, MJ, Gottlin, EB, Herndon, JE, and Patz, EF. "Haptoglobin and posttranslational glycan-modified derivatives as serum biomarkers for the diagnosis of nonsmall cell lung cancer." Cancer 110.10 (November 15, 2007): 2260-2268.
PMID
17918261
Source
pubmed
Published In
Cancer
Volume
110
Issue
10
Publish Date
2007
Start Page
2260
End Page
2268
DOI
10.1002/cncr.23049

Primary tumour standardized uptake value (SUV max) measured on fluorodeoxyglucose positron emission tomography (FDG-PET) is of prognostic value for survival in non-small cell lung cancer (NSCLC): a systematic review and meta-analysis (MA) by the European Lung Cancer Working Party for the IASLC Staging Project

Authors
Berghmans, T; Paesmans, M; Dusart, M; Hossein-Foucher, C; Castaigne, C; Mascaux, C; Roelandts, M; Lafitte, JJ; Patz, EF; Sculier, JP
MLA Citation
Berghmans, T, Paesmans, M, Dusart, M, Hossein-Foucher, C, Castaigne, C, Mascaux, C, Roelandts, M, Lafitte, JJ, Patz, EF, and Sculier, JP. "Primary tumour standardized uptake value (SUV max) measured on fluorodeoxyglucose positron emission tomography (FDG-PET) is of prognostic value for survival in non-small cell lung cancer (NSCLC): a systematic review and meta-analysis (MA) by the European Lung Cancer Working Party for the IASLC Staging Project." September 2007.
Source
wos-lite
Published In
European Journal of Cancer Supplements
Volume
5
Issue
4
Publish Date
2007
Start Page
364
End Page
365
DOI
10.1016/S1359-6349(07)71352-6

The IASLC Lung Cancer Staging Project: proposals for revision of the M descriptors in the forthcoming (seventh) edition of the TNM classification of lung cancer.

PURPOSE: To analyze all nonlymphatic metastatic components (T4 and M1) of the current TNM system of lung cancer, with the objective of providing suggestions for the next edition of the TNM classification for lung cancer. MATERIAL AND METHODS: Data on 100,809 patients were submitted to the International Association for the Study of Lung Cancer International Database. Of these, 5592 selected T4M0 and M1 patients fulfilled the inclusion criteria for the analysis. Specific categories of clinically staged T4 (lesions not continuous with the primary tumor) and M1 cases were compared with respect to overall survival using Kaplan-Meier survival estimates and comparisons via Cox regression analysis. Relevant findings were validated internally by geographic area and type of database and were validated externally by the North American Surveillance, Epidemiology and End Results Registries. RESULTS: Median survival for cT4M0 with malignant pleural effusion was significantly worse than that of other cT4M0 patients (8 months versus 13 months) and was more comparable with M1 cases with metastases to the contralateral lung only (10 months). M1 cases with metastases outside the lung/pleura had a significantly poorer prognosis than those with metastases confined to the lung, with a median survival of 6 months. CONCLUSIONS: Revisions to the TNM classification system for lung cancer should include grouping cases with malignant pleural effusions and cases with nodules in the contralateral lung in the M1a category, and cases with distant metastases should be designated M1b. In addition, cases with nodule(s) in the ipsilateral lung (nonprimary lobe), currently staged M1, should be reclassified as T4M0, in accordance with the recommendations of the T descriptor subcommittee of the IASLC international staging committee.

Authors
Postmus, PE; Brambilla, E; Chansky, K; Crowley, J; Goldstraw, P; Patz, EF; Yokomise, H; International Association for the Study of Lung Cancer International Staging Committee, ; Cancer Research and Biostatistics, ; Observers to the Committee, ; Participating Institutions,
MLA Citation
Postmus, PE, Brambilla, E, Chansky, K, Crowley, J, Goldstraw, P, Patz, EF, Yokomise, H, International Association for the Study of Lung Cancer International Staging Committee, , Cancer Research and Biostatistics, , Observers to the Committee, , and Participating Institutions, . "The IASLC Lung Cancer Staging Project: proposals for revision of the M descriptors in the forthcoming (seventh) edition of the TNM classification of lung cancer." J Thorac Oncol 2.8 (August 2007): 686-693.
PMID
17762334
Source
pubmed
Published In
Journal of Thoracic Oncology
Volume
2
Issue
8
Publish Date
2007
Start Page
686
End Page
693
DOI
10.1097/JTO.0b013e31811f4703

Clinical stage I non-small cell lung cancer including FDG-PET Imaging: sites and time to recurrence.

INTRODUCTION: Positron emission tomography (PET) has improved the accuracy of staging non-small cell lung cancer (NSCLC), although some early-stage patients will still relapse. The purpose of this study was to determine the sites and time to recurrence in patients with clinical stage I NSCLC whose initial staging evaluation included conventional imaging and fluorodeoxyglucose-PET. METHODS: This study was approved by our institutional review board and complies with the Health Insurance Portability and Accountability Act. We retrospectively searched our PET database and identified 231 patients (125 women, 106 men; ages 36-93 years) with primary NSCLC and clinical stage I disease. The sites and time to recurrence were recorded. The average follow-up time was 33 months. RESULTS: Of the 231 patients with clinical stage I tumors, 196 patients (85%) had pathological stage I disease. Two patients developed a second primary lung cancer, and 40 patients (20%) developed local or distant recurrence. Ninety-three percent of all patients remained disease free at 1 year, and 27% (11/40) of those who recur do so in the first year. The most common site of first recurrence was the thorax, followed by the brain, bone, and adrenal glands. CONCLUSIONS: Twenty percent of stage I NSCLC patients staged with conventional imaging and PET will develop recurrent NSCLC. The sites of recurrence with the addition of PET are similar to those reported with staging by conventional imaging alone. Additional studies are needed to determine the optimal time for follow-up imaging if intervention for recurrent disease is shown to improve survival.

Authors
Gauger, J; Patz, EF; Coleman, RE; Herndon, JE
MLA Citation
Gauger, J, Patz, EF, Coleman, RE, and Herndon, JE. "Clinical stage I non-small cell lung cancer including FDG-PET Imaging: sites and time to recurrence." J Thorac Oncol 2.6 (June 2007): 499-505.
PMID
17545844
Source
pubmed
Published In
Journal of Thoracic Oncology
Volume
2
Issue
6
Publish Date
2007
Start Page
499
End Page
505
DOI
10.1097/JTO.0b013e3180600990

Practical approach to diagnostic CT combined with PET.

OBJECTIVE: Protocols for PET/CT are not yet standardized. In particular, image quality, utilization, and reporting of the findings of the CT component of PET/CT can vary widely, making it complicated for physicians to request the appropriate information. In an effort to address this problem, we describe a set of four PET/CT protocols that satisfy a broad range of clinical needs among oncology patients. Current technology allows acquisition of diagnostic-quality CT scans as part of PET/CT examinations, and referring physicians are given the option of requesting formal interpretation of the CT findings. In this case, the PET and CT images are interpreted by the corresponding specialists, and equivocal or discordant findings are adjudicated through joint review of the PET/CT images. CONCLUSIONS: The menu of PET/CT imaging protocols has gained wide acceptance by our referring physicians and have been used successfully in more than 6,000 PET/CT studies. Newer PET/CT protocols will be developed as technology advances. Continued collaboration among oncologists, CT specialists, and nuclear medicine specialists is essential for deriving the maximum clinical benefit from combined PET/CT. Standardization of imaging protocols will become increasingly important as multiple-institution trials are developed for evaluation of present and future applications of PET/CT.

Authors
Wong, TZ; Paulson, EK; Nelson, RC; Patz, EF; Coleman, RE
MLA Citation
Wong, TZ, Paulson, EK, Nelson, RC, Patz, EF, and Coleman, RE. "Practical approach to diagnostic CT combined with PET." AJR Am J Roentgenol 188.3 (March 2007): 622-629. (Review)
PMID
17312045
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
188
Issue
3
Publish Date
2007
Start Page
622
End Page
629
DOI
10.2214/AJR.06.0813

Radiographic imaging of bronchioloalveolar carcinoma: Screening, patterns of presentation and response assessment (vol 1, pg S 20, 2006)

Authors
Gandara, DR; Aberle, D; Lau, D; Jett, J; Akhurst, T; Heelan, R; Mulshine, J; Berg, C; Jr, PEF
MLA Citation
Gandara, DR, Aberle, D, Lau, D, Jett, J, Akhurst, T, Heelan, R, Mulshine, J, Berg, C, and Jr, PEF. "Radiographic imaging of bronchioloalveolar carcinoma: Screening, patterns of presentation and response assessment (vol 1, pg S 20, 2006)." JOURNAL OF THORACIC ONCOLOGY 2.1 (January 2007): 11-11.
Source
wos-lite
Published In
Journal of Thoracic Oncology
Volume
2
Issue
1
Publish Date
2007
Start Page
11
End Page
11

Erratum: Radiographic imaging of bronchioloalveolar carcinoma: Screening, patterns of presentation and response assessment (Journal of Thoracic Oncology (2006) 1, (S20-S26))

Authors
Gandara, DR; Aberle, D; Lau, D; Jett, J; Akhurst, T; Heelan, R; Mulshine, J; Berg, C; Jr, EFP
MLA Citation
Gandara, DR, Aberle, D, Lau, D, Jett, J, Akhurst, T, Heelan, R, Mulshine, J, Berg, C, and Jr, EFP. "Erratum: Radiographic imaging of bronchioloalveolar carcinoma: Screening, patterns of presentation and response assessment (Journal of Thoracic Oncology (2006) 1, (S20-S26))." Journal of Thoracic Oncology 2.1 (2007): 11--.
Source
scival
Published In
Journal of Thoracic Oncology
Volume
2
Issue
1
Publish Date
2007
Start Page
11-

Tumor infiltrating Foxp3+ regulatory T-cells are associated with recurrence in pathologic stage I NSCLC patients.

BACKGROUND: Early stage lung cancer has a variable prognosis, and there are currently no markers that predict which patients will recur. This study examined the relation between tumor-regulatory T (Treg) cells and total tumor-infiltrating T-cell lymphocytes (TIL) to determine whether they correlated with recurrence. METHODS: The authors reviewed all patients in our tissue databank from 1996 to 2001 and identified 64 consecutive pathologic stage I non-small cell lung cancer (NSCLC) patients who had surgical resection and at least a 2.5 years disease-free follow-up or documented recurrence within 2 years. Immunohistochemical analyses were performed on paraffin-embedded lung cancer tissue and the relation between Treg cells, TIL, and disease-specific survival was determined. A risk index was devised deductively for various possible combinations of Treg cells and TIL. RESULTS: Treg cells and TIL were detected in 33 of 64 (51%) and 53 of 64 (83%) patients, respectively. When data were analyzed by using a Treg/TIL Combination Risk Index, patients with high-risk and intermediate-risk indices had hazard ratios of 8.2 (P = .007) and 3.3 (P = .109), respectively. CONCLUSIONS: Patients with stage I NSCLC who have a higher proportion of tumor Treg cells relative to TIL had a significantly higher risk of recurrence. These data may be useful, particularly if combined with a panel of tumor markers, to suggest at the time of diagnosis which patients with seemingly early-stage NSCLC will relapse.

Authors
Petersen, RP; Campa, MJ; Sperlazza, J; Conlon, D; Joshi, M-B; Harpole, DH; Patz, EF
MLA Citation
Petersen, RP, Campa, MJ, Sperlazza, J, Conlon, D, Joshi, M-B, Harpole, DH, and Patz, EF. "Tumor infiltrating Foxp3+ regulatory T-cells are associated with recurrence in pathologic stage I NSCLC patients." Cancer 107.12 (December 15, 2006): 2866-2872.
PMID
17099880
Source
pubmed
Published In
Cancer
Volume
107
Issue
12
Publish Date
2006
Start Page
2866
End Page
2872
DOI
10.1002/cncr.22282

Proteomics with mass spectrometry

This chapter provides a rudimentary review of the field of proteomics as it applies to mass spectrometry, data handling, and analysis. It points out the potential significance of the field suggesting that the study of nuclei acids has its limitations and that the progressive field of proteomics with spectrometry in tandem with transcription studies could potentially elucidate the link between RNA transcription and concomitant protein expression. Furthermore, we describe the fundamentals of proteomics with mass spectrometry and expound the methodology necessary to manage the vast amounts of data generated in order to facilitate statistical analysis. We explore the underlying technologies with the intention to demystify the complexities of the nascent field and to fuel interest by readers in the near future. © 2006, Idea Group Inc.

Authors
Lin, S; Mungal, S; Haney, R; Patz, EF; Mcconnell, P
MLA Citation
Lin, S, Mungal, S, Haney, R, Patz, EF, and Mcconnell, P. "Proteomics with mass spectrometry." (December 1, 2006): 85-103. (Chapter)
Source
scopus
Publish Date
2006
Start Page
85
End Page
103
DOI
10.4018/978-1-59140-863-5.ch005

Radiographic imaging of bronchioloalveolar carcinoma: screening, patterns of presentation and response assessment.

Bronchioloalveolar carcinoma (BAC) is a previously uncommon subset of adenocarcinoma with unique epidemiology, pathology, radiographic presentation, clinical features, and natural history compared with other non-small cell lung cancer (NSCLC) subtypes. Classically, BAC demonstrates a relatively slow growth pattern and indolent clinical course. However, in a subset of patients, rapid growth and death from bilateral diffuse consolidative disease occurs within months of diagnosis or recurrence. Recent data suggest that the incidence of BAC is increasing, notably in younger nonsmoking women. The initial radiographic presentation of BAC varies considerably, from single ground glass opacities (GGOs) or nodules of mixed ground glass and solid attenuation to diffuse consolidative or bilateral multinodular disease. The rising incidence of BAC is also reflected in recent lung cancer screening studies employing helical computed tomography (CT), where the differential diagnosis of GGOs includes not only BAC and overt adenocarcinoma, but inflammatory disease, focal fibrosis, and atypical adenomatous hyperplasia. Because advanced-stage BAC presents as measurable mass lesions in fewer than 50% of cases, determination of radiographic response to therapy by standard criteria is often difficult. Here, we review current data regarding the radiographic imaging of BAC: its radiographic presentations in asymptomatic early-stage and in advanced-stage disease, the functional imaging characteristics of BAC, and challenges of response assessment, including evolving opportunities for computer-assisted image analysis.

Authors
Gandara, DR; Aberle, D; Lau, D; Jett, J; Akhurst, T; Heelan, R; Mulshine, J; Berg, C; Patz, EF
MLA Citation
Gandara, DR, Aberle, D, Lau, D, Jett, J, Akhurst, T, Heelan, R, Mulshine, J, Berg, C, and Patz, EF. "Radiographic imaging of bronchioloalveolar carcinoma: screening, patterns of presentation and response assessment." J Thorac Oncol 1.9 Suppl (November 2006): S20-S26. (Review)
PMID
17409997
Source
pubmed
Published In
Journal of Thoracic Oncology
Volume
1
Issue
9 Suppl
Publish Date
2006
Start Page
S20
End Page
S26

Radiographic imaging of bronchioloalveolar carcinoma: Screening, patterns of presentation and response assessment

Authors
Gandara, DR; Aberle, D; Lau, D; Jett, J; Akhurst, T; Mulshine, J; Berg, C; Jr, PEF
MLA Citation
Gandara, DR, Aberle, D, Lau, D, Jett, J, Akhurst, T, Mulshine, J, Berg, C, and Jr, PEF. "Radiographic imaging of bronchioloalveolar carcinoma: Screening, patterns of presentation and response assessment." November 2006.
Source
wos-lite
Published In
Journal of Thoracic Oncology
Volume
1
Issue
9
Publish Date
2006
Start Page
S20
End Page
S26
DOI
10.1097/01243894-200611001-00005

Lung cancer screening, overdiagnosis bias, and reevaluation of the Mayo Lung Project.

Authors
Patz, EF
MLA Citation
Patz, EF. "Lung cancer screening, overdiagnosis bias, and reevaluation of the Mayo Lung Project." J Natl Cancer Inst 98.11 (June 7, 2006): 724-725.
PMID
16757691
Source
pubmed
Published In
Journal of the National Cancer Institute
Volume
98
Issue
11
Publish Date
2006
Start Page
724
End Page
725
DOI
10.1093/jnci/djj226

Integration of biomarkers and imaging.

Imaging studies provide essential diagnostic information in the care of cancer patients. Unfortunately, radiographic findings are not always diagnostic and thus an alternative approach with biomarkers has been suggested as part of the diagnostic evaluation. This discussion focuses on integration of biomarkers with imaging in the effort to guide patient management.

Authors
Patz, EF
MLA Citation
Patz, EF. "Integration of biomarkers and imaging." J Thorac Oncol 1.1 (January 2006): 78-80. (Review)
PMID
17409832
Source
pubmed
Published In
Journal of Thoracic Oncology
Volume
1
Issue
1
Publish Date
2006
Start Page
78
End Page
80

Finding diagnostic biomarkers in proteomic spectra.

In seeking to find diagnostic biomarkers in proteomic spectra, two significant problems arise. First, not only is there noise in the measured intensity at each m/z value, but there is also noise in the measured m/z value itself. Second, the potential for overfitting is severe: it is easy to find features in the spectra that accurately discriminate disease states but have no biological meaning. We address these problems by developing and testing a series of steps for pre-processing proteomic spectra and extracting putatively meaningful features before presentation to feature selection and classification algorithms. These steps include an HMM-based latent spectrum extraction algorithm for fusing the information from multiple replicate spectra obtained from a single tissue sample, a simple algorithm for baseline correction based on a segmented convex hull, a peak identification and quantification algorithm, and a peak registration algorithm to align peaks from multiple tissue samples into common peak registers. We apply these steps to MALDI spectral data collected from normal and tumor lung tissue samples, and then compare the performance of feature selection with FDR followed by classification with an SVM, versus joint feature selection and classification with Bayesian sparse multinomial logistic regression (SMLR). The SMLR approach outperformed FDR+SVM, but both were effective in achieving good diagnostic accuracy with a small number of features. Some of the selected features have previously been investigated as clinical markers for lung cancer diagnosis; some of the remaining features are excellent candidates for further research.

Authors
Pratapa, PN; Patz, EF; Hartemink, AJ
MLA Citation
Pratapa, PN, Patz, EF, and Hartemink, AJ. "Finding diagnostic biomarkers in proteomic spectra." Pac Symp Biocomput (2006): 279-290.
PMID
17094246
Source
pubmed
Published In
Pacific Symposium on Biocomputing. Pacific Symposium on Biocomputing
Publish Date
2006
Start Page
279
End Page
290

Radiographic imaging of bronchioloalveolar carcinoma: Screening, patterns of presentation and response assessment

Bronchioloalveolar carcinoma (BAC) is a previously uncommon subset of adenocarcinoma with unique epidemiology, pathology, radiographic presentation, clinical features, and natural history compared with other non-small cell lung cancer (NSCLC) subtypes. Classically, BAC demonstrates a relatively slow growth pattern and indolent clinical course. However, in a subset of patients, rapid growth and death from bilateral diffuse consolidative disease occurs within months of diagnosis or recurrence. Recent data suggest that the incidence of BAC is increasing, notably in younger nonsmoking women. The initial radiographic presentation of BAC varies considerably, from single ground glass opacities (GGOs) or nodules of mixed ground glass and solid attenuation to diffuse consolidative or bilateral multinodular disease. The rising incidence of BAC is also reflected in recent lung cancer screening studies employing helical computed tomography (CT), where the differential diagnosis of GGOs includes not only BAC and overt adenocarcinoma, but inflammatory disease, focal fibrosis, and atypical adenomatous hyperplasia. Because advanced-stage BAC presents as measurable mass lesions in fewer than 50% of cases, determination of radiographic response to therapy by standard criteria is often difficult. Here, we review current data regarding the radiographic imaging of BAC: its radiographic presentations in asymptomatic early-stage and in advanced-stage disease, the functional imaging characteristics of BAC, and challenges of response assessment, including evolving opportunities for computer-assisted image analysis. © 2006International Association for the Study of Lung Cancer.

Authors
Gandara, DR; Aberle, D; Lau, D; Jett, J; Akhurst, T; Mulshine, J; Berg, C; Jr, EFP
MLA Citation
Gandara, DR, Aberle, D, Lau, D, Jett, J, Akhurst, T, Mulshine, J, Berg, C, and Jr, EFP. "Radiographic imaging of bronchioloalveolar carcinoma: Screening, patterns of presentation and response assessment." Journal of Thoracic Oncology 1.9 SUPPL. (2006): S20-S26.
Source
scival
Published In
Journal of Thoracic Oncology
Volume
1
Issue
9 SUPPL.
Publish Date
2006
Start Page
S20
End Page
S26

Consensus Statement: CT Screening for Lung Cancer

Authors
Swensen, S; Aberle, CD; Kazerooni, EA; Naidich, D; Patz, N; Galvin, JR; Henschke, CI
MLA Citation
Swensen, S, Aberle, CD, Kazerooni, EA, Naidich, D, Patz, N, Galvin, JR, and Henschke, CI. "Consensus Statement: CT Screening for Lung Cancer." Journal of Thoracic Imaging 20.4 (November 2005): 321-321.
Source
crossref
Published In
Journal of Thoracic Imaging
Volume
20
Issue
4
Publish Date
2005
Start Page
321
End Page
321
DOI
10.1097/01.rti.0000187437.37256.18

Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society.

Lung nodules are detected very commonly on computed tomographic (CT) scans of the chest, and the ability to detect very small nodules improves with each new generation of CT scanner. In reported studies, up to 51% of smokers aged 50 years or older have pulmonary nodules on CT scans. However, the existing guidelines for follow-up and management of noncalcified nodules detected on nonscreening CT scans were developed before widespread use of multi-detector row CT and still indicate that every indeterminate nodule should be followed with serial CT for a minimum of 2 years. This policy, which requires large numbers of studies to be performed at considerable expense and with substantial radiation exposure for the affected population, has not proved to be beneficial or cost-effective. During the past 5 years, new information regarding prevalence, biologic characteristics, and growth rates of small lung cancers has become available; thus, the authors believe that the time-honored requirement to follow every small indeterminate nodule with serial CT should be revised. In this statement, which has been approved by the Fleischner Society, the pertinent data are reviewed, the authors' conclusions are summarized, and new guidelines are proposed for follow-up and management of small pulmonary nodules detected on CT scans.

Authors
MacMahon, H; Austin, JHM; Gamsu, G; Herold, CJ; Jett, JR; Naidich, DP; Patz, EF; Swensen, SJ; Fleischner Society,
MLA Citation
MacMahon, H, Austin, JHM, Gamsu, G, Herold, CJ, Jett, JR, Naidich, DP, Patz, EF, Swensen, SJ, and Fleischner Society, . "Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society." Radiology 237.2 (November 2005): 395-400.
PMID
16244247
Source
pubmed
Published In
Radiology
Volume
237
Issue
2
Publish Date
2005
Start Page
395
End Page
400
DOI
10.1148/radiol.2372041887

Stable RNA interference-mediated suppression of cyclophilin A diminishes non-small-cell lung tumor growth in vivo.

Cyclophilin A (CypA) was recently reported to be overexpressed in non-small-cell lung cancer, and represents a potentially novel therapeutic target. To determine the role of CypA in oncogenesis, stable RNA interference (RNAi)-mediated knockdown of CypA was established in two non-small-cell lung cancer cell lines (ADLC-5M2 and LC-103H), and these cells were grown as xenografts in severe combined immunodeficient mice. Tumor cell proliferation, apoptosis, and angiogenesis were measured by Ki67, terminal deoxyribonucleotidyl transferase-mediated dUTP nick-end labeling, and CD31 immunohistochemistry, respectively. Tumor glucose metabolism was assessed by fluorodeoxyglucose positron emission tomography imaging. Knockdown of CypA correlated in vivo with slower growth, less fluorodeoxyglucose uptake, decreased proliferation, and a greater degree of apoptosis in the tumors. These results establish the relevance of CypA to tumor growth in vivo, specifically to proliferation and apoptosis. Elucidation of the precise role of CypA in these pathways may lead to new targeted therapies for lung cancer.

Authors
Howard, BA; Furumai, R; Campa, MJ; Rabbani, ZN; Vujaskovic, Z; Wang, X-F; Patz, EF
MLA Citation
Howard, BA, Furumai, R, Campa, MJ, Rabbani, ZN, Vujaskovic, Z, Wang, X-F, and Patz, EF. "Stable RNA interference-mediated suppression of cyclophilin A diminishes non-small-cell lung tumor growth in vivo." Cancer Res 65.19 (October 1, 2005): 8853-8860.
PMID
16204056
Source
pubmed
Published In
Cancer Research
Volume
65
Issue
19
Publish Date
2005
Start Page
8853
End Page
8860
DOI
10.1158/0008-5472.CAN-05-1219

Characterising phase variations in MALDI-TOF data and correcting them by peak alignment.

The use of MALDI-TOF mass spectrometry as a means of analyzing the proteome has been evaluated extensively in recent years. One of the limitations of this technique that has impeded the development of robust data analysis algorithms is the variability in the location of protein ion signals along the x-axis. We studied technical variations of MALDI-TOF measurements in the context of proteomics profiling. By acquiring a benchmark data set with five replicates, we estimated 76% to 85% of the total variance is due to phase variation. We devised a lobster plot, so named because of the resemblance to a lobster claw, to help detect the phase variation in replicates. We also investigated a peak alignment algorithm to remove the phase variation. This operation is analogous to the normalization step in microarray data analysis. Only after this critical step can features of biological interest be clearly revealed. With the help of principal component analysis, we demonstrated that after peak alignment, the differences among replicates are reduced. We compared this approach to peak alignment with a model-based calibration approach in which there was known information about peaks in common among all spectra. Finally, we examined the potential value at each point in an analysis pipeline of having a set of methods available that includes parametric, semiparametric and nonparametric methods; among such methods are those that benefit from the use of prior information.

Authors
Lin, SM; Haney, RP; Campa, MJ; Fitzgerald, MC; Patz, EF
MLA Citation
Lin, SM, Haney, RP, Campa, MJ, Fitzgerald, MC, and Patz, EF. "Characterising phase variations in MALDI-TOF data and correcting them by peak alignment." Cancer Inform 1 (2005): 32-40.
Website
http://hdl.handle.net/10161/11570
PMID
19305630
Source
pubmed
Published In
Cancer Informatics
Volume
1
Publish Date
2005
Start Page
32
End Page
40

In reply [4]

Authors
Jr, EFP; Swensen, SJ; Herndon, JE
MLA Citation
Jr, EFP, Swensen, SJ, and Herndon, JE. "In reply [4]." Journal of Clinical Oncology 23.9 (2005): 2107-2108.
Source
scival
Published In
Journal of Clinical Oncology
Volume
23
Issue
9
Publish Date
2005
Start Page
2107
End Page
2108
DOI
10.1200/JCO.2005.05.267

In reply [12]

Authors
Jr, EFP; Swensen, SJ; II, JEH
MLA Citation
Jr, EFP, Swensen, SJ, and II, JEH. "In reply [12]." Journal of Clinical Oncology 23.10 (2005): 2440-2441.
Source
scival
Published In
Journal of Clinical Oncology
Volume
23
Issue
10
Publish Date
2005
Start Page
2440
End Page
2441
DOI
10.1200/JCO.2005.05.230

Translating biomarkers into clinical practice: prognostic implications of cyclophilin A and macrophage migratory inhibitory factor identified from protein expression profiles in non-small cell lung cancer.

Biomarkers have the potential to significantly change diagnostic strategies and influence therapeutic management. We developed a MALDI-TOF protein expression profiling platform for biomarker discovery and a proof-of-principle study identified two proteins, cyclophilin A (CyPA) and macrophage migration inhibitory factor (MIF), that were overexpressed in non-small cell lung cancer (NSCLC). The current study focused on evaluating the potential of CyPA and MIF as prognostic markers in patients with a new diagnosis of lung cancer for rapid translation into clinical practice. Two hundred and thirty-four primary NSCLC specimens reflecting a broad range of histologies and stages were examined for CyPA and MIF reactivity by tissue microarray immunohistochemistry (TMA-IHC). The percent tumor cell reactivity, staining intensity and a composite staining score were compared with overall patient survival by Kaplan-Meier curves, log rank test and Cox model statistics. Although both proteins were overexpressed in most NSCLC tumors, neither CypA nor MIF showed a correlation with outcome. This pilot project approach can expedite integration of newly discovered biomarkers into clinical practice, with the goal of improving stratification of patients into appropriate treatment regimens. While both proteins considered in this study were overexpressed in the vast majority of NSCLCs, they were not found to be of prognostic significance.

Authors
Howard, BA; Zheng, Z; Campa, MJ; Wang, MZ; Sharma, A; Haura, E; Herndon, JE; Fitzgerald, MC; Bepler, G; Patz, EF
MLA Citation
Howard, BA, Zheng, Z, Campa, MJ, Wang, MZ, Sharma, A, Haura, E, Herndon, JE, Fitzgerald, MC, Bepler, G, and Patz, EF. "Translating biomarkers into clinical practice: prognostic implications of cyclophilin A and macrophage migratory inhibitory factor identified from protein expression profiles in non-small cell lung cancer." Lung Cancer 46.3 (December 2004): 313-323.
PMID
15541816
Source
pubmed
Published In
Lung Cancer
Volume
46
Issue
3
Publish Date
2004
Start Page
313
End Page
323
DOI
10.1016/j.lungcan.2004.05.013

Accentuation of differentially expressed proteins using phage technology.

Protein profiling is frequently used to elucidate disease-specific or differentially expressed proteins. While recent developments have resulted in improved differential profiling, alternative expression platforms that complement existing techniques are continually being explored. We developed a novel method utilizing the amplification and selection capabilities of random peptide-expressing M13 bacteriophage to accentuate differentially expressed proteins in biologic specimens. While the current study used this method to demonstrate differentially expressed proteins in lung cancer tissue in comparison to normal lung tissue, this approach is applicable to a wide range of sample types.

Authors
Suber, RL; Flanders, VL; Campa, MJ; Patz, EF
MLA Citation
Suber, RL, Flanders, VL, Campa, MJ, and Patz, EF. "Accentuation of differentially expressed proteins using phage technology." Anal Biochem 333.2 (October 15, 2004): 351-357.
PMID
15450812
Source
pubmed
Published In
Analytical Biochemistry
Volume
333
Issue
2
Publish Date
2004
Start Page
351
End Page
357
DOI
10.1016/j.ab.2004.06.029

Thermodynamic analysis of cyclosporin a binding to cyclophilin a in a lung tumor tissue lysate.

We report on the application of SUPREX (stability of unpurified proteins from rates of H/D exchange) to the analysis of a protein-ligand binding interaction under the ex vivo solution conditions of a human lung tumor tissue lysate. A SUPREX-derived binding free energy (i.e. DeltaDeltaG(f) value) and dissociation constant (i.e., K(d) value) were determined for the binding of cyclosporin A (CsA) to a cyclophilin A (CypA) sample in which the protein was a component of a tissue lysate derived from fresh frozen lung tumor. The DeltaDeltaG(f) and K(d) values determined by SUPREX for CsA binding to CypA in this unpurified protein sample, 4.7 +/- 0.8 kcal/mol and 77 +/- 17 nM, respectively, were comparable to the those obtained when SUPREX was used to analyze the binding of CsA to a highly purified CypA sample, 4.2 +/- 1.0 kcal/mol and 32 +/- 20 nM, respectively. Moreover, the SUPREX-derived K(d) values determined in this work were both in the range of those previously reported for the CypA-CsA complex. The results of this proof-of-principle work validate the extension of SUPREX to the thermodynamic analysis of proteins and protein-ligand binding interactions in the unpurified, ex vivo conditions of human tissue lysates,and they represent the first K(d) measurement on a protein-ligand complex under such conditions

Authors
Wang, MZ; Shetty, JT; Howard, BA; Campa, MJ; Patz, EF; Fitzgerald, MC
MLA Citation
Wang, MZ, Shetty, JT, Howard, BA, Campa, MJ, Patz, EF, and Fitzgerald, MC. "Thermodynamic analysis of cyclosporin a binding to cyclophilin a in a lung tumor tissue lysate." Anal Chem 76.15 (August 1, 2004): 4343-4348.
PMID
15283571
Source
pubmed
Published In
Analytical Chemistry
Volume
76
Issue
15
Publish Date
2004
Start Page
4343
End Page
4348
DOI
10.1021/ac049536j

Clinical utility of serum amyloid A and macrophage migration inhibitory factor as serum biomarkers for the detection of nonsmall cell lung carcinoma.

BACKGROUND: Early lung carcinoma detection strategies involving imaging studies have yet to demonstrate a reduction in mortality. Identification of serum biomarkers that could complement radiologic studies and facilitate earlier diagnosis of lung carcinoma would be of significant benefit to patients. In the current pilot study, the authors evaluated two overexpressed proteins in lung carcinoma, serum amyloid A (SAA) and macrophage migration inhibitory factor (MIF), as potential diagnostic serum biomarkers for this malignancy. METHODS: Serum levels of SAA and MIF were measured in 50 patients using enzyme-linked immunosorbent assays. The sensitivity, specificity, and accuracy of the markers in detecting lung carcinoma were determined. RESULTS: SAA levels in patients with lung carcinoma were greater than in the control patients (P = 0.07). Serum SAA levels did not exhibit a correlation with tumor size or clinical stage and were higher in patients with squamous cell carcinoma than in patients with other histologic disease types. MIF was unable to differentiate patients with lung carcinoma from patients with other diseases. CONCLUSIONS: SAA possesses potential utility as a serum biomarker for lung carcinoma, probably in conjunction with other serum markers that improve its diagnostic accuracy. Before a larger study is performed, the discovery of additional biomarkers to enhance the specificity of SAA in the diagnosis of lung carcinoma is recommended.

Authors
Khan, N; Cromer, CJ; Campa, M; Patz, EF
MLA Citation
Khan, N, Cromer, CJ, Campa, M, and Patz, EF. "Clinical utility of serum amyloid A and macrophage migration inhibitory factor as serum biomarkers for the detection of nonsmall cell lung carcinoma." Cancer 101.2 (July 15, 2004): 379-384.
PMID
15241837
Source
pubmed
Published In
Cancer
Volume
101
Issue
2
Publish Date
2004
Start Page
379
End Page
384
DOI
10.1002/cncr.20377

Estimate of lung cancer mortality from low-dose spiral computed tomography screening trials: implications for current mass screening recommendations.

PURPOSE: Low-dose computed tomography (CT) has been suggested for lung cancer screening. Several observational trials have published their preliminary results, and some investigators suggest that this technique will save lives. There are no mortality statistics, however, and the current study used published data from these trials to estimate the disease-specific mortality in this high-risk population. PATIENTS AND METHODS: Two nonrandomized CT screening trials were selected from the literature for analysis. The number of trial participants, the number of lung cancers diagnosed per year, and stage distribution of the cancers was recorded. Previously published 5-year survival data were used to calculate the number of predicted lung cancer deaths and estimate the overall lung cancer mortality per 1,000 person-years among participants screened. These statistics were then compared to the previous Mayo Lung Project, which used chest radiographs and sputum cytology for screening high-risk individuals. RESULTS: This study estimates the lung cancer mortality is 4.1 deaths per 1,000 person-years in the Mayo Clinic CT screening trial, and is 5.5 deaths per 1,000 person-years in the Early Lung Cancer Action Program trial. These data are similar to the lung cancer mortality of 4.4 deaths per 1,000 person-years in the interventional arm, and 3.9 deaths per 1,000 person-years in the usual-care arm of the previous Mayo Lung Project. CONCLUSION: These data suggest that CT screening could produce similar outcomes to prior chest radiographic trials in this high-risk group. Results from randomized trials are required, however, before the true utility of mass screening with CT for lung cancer can be determined.

Authors
Patz, EF; Swensen, SJ; Herndon, JE
MLA Citation
Patz, EF, Swensen, SJ, and Herndon, JE. "Estimate of lung cancer mortality from low-dose spiral computed tomography screening trials: implications for current mass screening recommendations." J Clin Oncol 22.11 (June 1, 2004): 2202-2206. (Review)
PMID
15169809
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
22
Issue
11
Publish Date
2004
Start Page
2202
End Page
2206
DOI
10.1200/JCO.2004.12.046

Comparison of whole-body FDG-PET to bone scan for detection of bone metastases in patients with a new diagnosis of lung cancer.

The purpose of this study was to compare the accuracy and agreement of whole-body positron-emission tomography (PET) scan to bone scintigraphy for the detection of bony metastases in staging patients with newly diagnosed lung cancer. The tumor registry and nuclear medicine database at our institution were queried and identified all patients between July 1998 and August 2002 with a new diagnosis of lung cancer, a whole-body 2-deoxy-2-[18F]fluoro-D-glucose (FDG)-PET scan, and a bone scan prior to therapy. All of these patients' radiologic reports were then retrospectively reviewed, and confirmation of bone metastases was determined by consideration of all available clinical information. The sensitivity, specificity, and accuracy for each study were then calculated. Two hundred and fifty-seven patients fulfilled the entrance criteria. One hundred and four patients (40%) presented with stage IV disease, and bone metastases were confirmed in 57 (22%) patients. The accuracies of PET and bone scan were 94 and 85% (P < 0.05), sensitivity values were 91 and 75%, and specificity values were 96 and 95%, respectively. The weighted-kappa statistic suggested moderate agreement between the two modalities KW = 0.510, 95% CI, 0.402-0.618). The use of both whole-body PET and bone scintigraphy as initial staging studies in lung cancer patients provides redundant information about the presence of bony metastases. The improvement in accuracy and sensitivity with PET suggests bone scan can be eliminated from the staging evaluation at presentation. Due to its retrospective nature, the results of this study are subject to several forms of bias including selection bias, verification bias, test review bias, and incorporation bias. A prospective trial with appropriate verification of bony metastases is suggested to confirm the results.

Authors
Cheran, SK; Herndon, JE; Patz, EF
MLA Citation
Cheran, SK, Herndon, JE, and Patz, EF. "Comparison of whole-body FDG-PET to bone scan for detection of bone metastases in patients with a new diagnosis of lung cancer." Lung Cancer 44.3 (June 2004): 317-325.
PMID
15140545
Source
pubmed
Published In
Lung Cancer
Volume
44
Issue
3
Publish Date
2004
Start Page
317
End Page
325
DOI
10.1016/j.lungcan.2003.11.008

False-negative findings for primary lung tumors on FDG positron emission tomography: staging and prognostic implications.

OBJECTIVE: The aim of this study was to determine the stage and outcome of patients with primary lung tumors who had a negative finding on a FDG positron emission tomography (PET) study at the time of diagnosis. MATERIALS AND METHODS: A total of 3912 patients between November 1994 and August 2002 underwent thoracic or whole-body PET performed at our institution for evaluation of a pulmonary abnormality suspicious for lung cancer. We identified 20 patients with a biopsy-proven primary lung tumor and a negative PET study at the time of presentation. Surgical, pathologic, radiographic imaging, and clinical follow-up information were reviewed to confirm the histology, stage, and outcome. RESULTS: Tumor histology included adenocarcinoma (n = 7, 35%), bronchioalveolar cell carcinoma (n = 6, 30%), carcinoid (n = 3, 15%), squamous cell carcinoma (n = 2, 10%), otherwise unspecified non-small cell lung cancer (n = 1, 5%), and sarcomatoid neoplasm (n = 1, 5%). One patient with bronchioalveolar cell carcinoma had multifocal stage IV disease, and all other patients were stage IA (n = 14, 70%) or stage IB (n = 5, 25%). Eighteen (90%) of the 20 patients underwent curative surgical resection. No patient is known to have tumor recurrence after resection, and three (17%) of the 18 patients are known to be living and free of disease 5 years after surgery. CONCLUSION: With the exception of bronchioalveolar cell carcinoma and carcinoid, newly diagnosed lung cancers with negative PET findings are usually early-stage diseases and are associated with a favorable prognosis, suggesting that indeterminate pulmonary nodules, which are PET-negative, can be managed conservatively with serial radiographic studies to monitor for signs of growth. These findings warrant further study and should be confirmed with sufficient follow-up in a large cohort of patients with PET-negative lung lesions.

Authors
Cheran, SK; Nielsen, ND; Patz, EF
MLA Citation
Cheran, SK, Nielsen, ND, and Patz, EF. "False-negative findings for primary lung tumors on FDG positron emission tomography: staging and prognostic implications." AJR Am J Roentgenol 182.5 (May 2004): 1129-1132.
PMID
15100107
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
182
Issue
5
Publish Date
2004
Start Page
1129
End Page
1132
DOI
10.2214/ajr.182.5.1821129

Using phage peptides to detect protein differences between cancer and normal tissues

Authors
Patz, E
MLA Citation
Patz, E. "Using phage peptides to detect protein differences between cancer and normal tissues." Cancer Biology and Therapy 3.12 (2004): 1194-1195.
Source
scival
Published In
Cancer Biology and Therapy
Volume
3
Issue
12
Publish Date
2004
Start Page
1194
End Page
1195

Exploring the proteome with MALDI-TOF (editorial) (vol 3, pg 1659, 2003)

Authors
Campa, MJ; Fitzgerald, MC; Patz, EF
MLA Citation
Campa, MJ, Fitzgerald, MC, and Patz, EF. "Exploring the proteome with MALDI-TOF (editorial) (vol 3, pg 1659, 2003)." PROTEOMICS 3.10 (October 2003): 2067-2067.
Source
wos-lite
Published In
Proteomics
Volume
3
Issue
10
Publish Date
2003
Start Page
2067
End Page
2067

Conflict of interest

Authors
Patz, EF; Goodman, PC
MLA Citation
Patz, EF, and Goodman, PC. "Conflict of interest." AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE 168.5 (September 1, 2003): 613-613.
Source
wos-lite
Published In
American journal of respiratory and critical care medicine
Volume
168
Issue
5
Publish Date
2003
Start Page
613
End Page
613

Identification and validation of a potential lung cancer serum biomarker detected by matrix-assisted laser desorption/ionization-time of flight spectra analysis.

Many abnormalities detected in the thorax by routine conventional imaging studies are benign, yet all require further evaluation because of the concern for cancer. To address this deficiency and develop a serum biomarker for lung cancer, we designed a matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) based platform to display the proteins present in the serum of patients with or without lung cancer, and then challenged the scientific community to analyze these data with the aim of determining specific ion signal differences among the resulting spectra. The most statistically significant ion peak identified by the various analysis algorithms that differentiated the serum of patients with lung cancer from the serum of individuals without lung cancer was found at m/z 11,702. We identified the protein responsible for this ion peak as serum amyloid A (SAA; M(r) = 11,682.7) by partial purification followed by in-gel digestion and peptide mapping. By enzyme-linked immunosorbent assay, we showed SAA to be present at 286 ng/mL in the serum of cancer patients vs. 34.1 ng/mL in the serum of individuals without cancer. These data suggest that the combination of MALDI-TOF MS and computer analysis can be a powerful tool in the search for serum biomarkers of lung cancer and other diseases.

Authors
Howard, BA; Wang, MZ; Campa, MJ; Corro, C; Fitzgerald, MC; Patz, EF
MLA Citation
Howard, BA, Wang, MZ, Campa, MJ, Corro, C, Fitzgerald, MC, and Patz, EF. "Identification and validation of a potential lung cancer serum biomarker detected by matrix-assisted laser desorption/ionization-time of flight spectra analysis." Proteomics 3.9 (September 2003): 1720-1724.
PMID
12973732
Source
pubmed
Published In
Proteomics
Volume
3
Issue
9
Publish Date
2003
Start Page
1720
End Page
1724
DOI
10.1002/pmic.200300514

Analysis of human serum proteins by liquid phase isoelectric focusing and matrix-assisted laser desorption/ionization-mass spectrometry.

Direct matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) analysis of human serum yielded ion signals from only a fraction of the total number of peptides and proteins expected to be in the sample. We increased the number of peptide and protein ion signals observed in the MALDI-TOF mass spectra analysis of human serum by using a prefractionation protocol based on liquid phase isoelectric focusing electrophoresis. This pre-fractionation technique facilitated the MALDI-TOF MS detection of as many as 262 different peptide and protein ion signals from human serum. The results obtained from three replicate fractionation experiments on the same serum sample indicated that 148 different peptide and protein ion signals were reproducibly detected using our isoelectric focusing and MALDI-TOF MS protocol.

Authors
Wang, MZ; Howard, B; Campa, MJ; Patz, EF; Fitzgerald, MC
MLA Citation
Wang, MZ, Howard, B, Campa, MJ, Patz, EF, and Fitzgerald, MC. "Analysis of human serum proteins by liquid phase isoelectric focusing and matrix-assisted laser desorption/ionization-mass spectrometry." Proteomics 3.9 (September 2003): 1661-1666.
PMID
12973721
Source
pubmed
Published In
Proteomics
Volume
3
Issue
9
Publish Date
2003
Start Page
1661
End Page
1666
DOI
10.1002/pmic.200300513

Protein expression profiling identifies macrophage migration inhibitory factor and cyclophilin a as potential molecular targets in non-small cell lung cancer.

Current diagnostic and therapeutic strategies for lung cancer have had no significant impact on lung cancer mortality over the last several decades. This study used a matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) discovery platform to generate protein expression profiles in search of overexpressed proteins in lung tumors as potentially novel molecular targets. Two differentially expressed protein peaks at m/z 12338 and 17882 in the MALDI-TOF spectra were identified in lung tumor specimens as macrophage migration inhibitory factor and cyclophilin A, respectively. Overexpression of both proteins was confirmed by Western blotting, and cyclophilin A was localized to the tumor cells by immunohistochemistry. These data demonstrate the feasibility of using a MALDI-TOF platform to generate protein expression profiles and identify potential molecular targets for cancer diagnostics and therapeutics.

Authors
Campa, MJ; Wang, MZ; Howard, B; Fitzgerald, MC; Patz, EF
MLA Citation
Campa, MJ, Wang, MZ, Howard, B, Fitzgerald, MC, and Patz, EF. "Protein expression profiling identifies macrophage migration inhibitory factor and cyclophilin a as potential molecular targets in non-small cell lung cancer." Cancer Res 63.7 (April 1, 2003): 1652-1656.
PMID
12670919
Source
pubmed
Published In
Cancer Research
Volume
63
Issue
7
Publish Date
2003
Start Page
1652
End Page
1656

Exploring the proteome with MALDI-TOF

Authors
Campa, MJ; Fitzgerald, MC; Jr, EFP
MLA Citation
Campa, MJ, Fitzgerald, MC, and Jr, EFP. "Exploring the proteome with MALDI-TOF." Proteomics 3.9 (2003): 1659-1660.
Source
scival
Published In
Proteomics
Volume
3
Issue
9
Publish Date
2003
Start Page
1659
End Page
1660

Erratum: Exploring the proteome with MALDI-TOF (Editorial) (Proteomics 3: 9 (1659-1660))

Authors
Campa, MJ; Fitzgerald, MC; Jr, EFP
MLA Citation
Campa, MJ, Fitzgerald, MC, and Jr, EFP. "Erratum: Exploring the proteome with MALDI-TOF (Editorial) (Proteomics 3: 9 (1659-1660))." Proteomics 3.10 (2003): 2067--.
Source
scival
Published In
Proteomics
Volume
3
Issue
10
Publish Date
2003
Start Page
2067-
DOI
10.1002/pmic.200390099

Conflict of interest [2] (multiple letters)

Authors
Jr, FWG; Jr, EFP; Goodman, PC
MLA Citation
Jr, FWG, Jr, EFP, and Goodman, PC. "Conflict of interest [2] (multiple letters)." American Journal of Respiratory and Critical Care Medicine 168.5 (2003): 613--.
Source
scival
Published In
American Journal of Respiratory and Critical Care Medicine
Volume
168
Issue
5
Publish Date
2003
Start Page
613-

Use of mixture models in MALDI-TOF proteomic data for peak registration

Authors
Lin, SM; Campa, MJ; Wang, MZ; Howard, B; Fitzgerald, MC; Patz, EF
MLA Citation
Lin, SM, Campa, MJ, Wang, MZ, Howard, B, Fitzgerald, MC, and Patz, EF. "Use of mixture models in MALDI-TOF proteomic data for peak registration." 2003.
Source
wos-lite
Published In
PROCEEDINGS OF THE 7TH JOINT CONFERENCE ON INFORMATION SCIENCES
Publish Date
2003
Start Page
873
End Page
878

Potential conflict of interest in AJRCCM.

Authors
Grannis, FW
MLA Citation
Grannis, FW. "Potential conflict of interest in AJRCCM." Am J Respir Crit Care Med 166.12 Pt 1 (December 15, 2002): 1608-. (Letter)
PMID
12471079
Source
pubmed
Published In
American journal of respiratory and critical care medicine
Volume
166
Issue
12 Pt 1
Publish Date
2002
Start Page
1608
DOI
10.1164/ajrccm.166.12.251c

Potential conflict of interest in AJRCCM

Authors
Patz, EF; Goodman, PC
MLA Citation
Patz, EF, and Goodman, PC. "Potential conflict of interest in AJRCCM." AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE 166.12 (December 15, 2002): 1608-1608.
Source
wos-lite
Published In
American journal of respiratory and critical care medicine
Volume
166
Issue
12
Publish Date
2002
Start Page
1608
End Page
1608

PET imaging in patients with bronchioloalveolar cell carcinoma.

OBJECTIVE: Focal bronchioloalveolar cell carcinoma (BAC) has been reported as often being negative on 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG-PET) scans, but no studies have examined the FDG-PET findings of both the focal and multifocal forms of the disease. The purpose of this study was to examine the sensitivity of PET in detecting both forms of BAC. MATERIALS AND METHODS: A retrospective review of our tumor registry revealed 15 patients who had pathologically proved BAC and who had undergone FDG-PET imaging. FDG-PET scans were interpreted as positive if the tumor demonstrated activity that was greater than the mediastinal blood pool. RESULTS: Eight patients had focal BAC, and seven patients had multifocal disease. Nine of the 15 patients (60%) had a positive PET scan, and of these, six (67%) had multifocal disease. Six of the 15 patients (40%) had negative PET scans, and of these, five patients (83%) had the solitary form of disease. The sensitivity for focal tumors was 38%, and the sensitivity for the multifocal form was 86%. CONCLUSIONS: Our data confirm previous reports describing a high percentage of false negative PET scans in the setting of focal BAC. However, in the presence of multifocal disease, FDG-PET seems to be highly sensitive.

Authors
Heyneman, LE; Patz, EF
MLA Citation
Heyneman, LE, and Patz, EF. "PET imaging in patients with bronchioloalveolar cell carcinoma." Lung Cancer 38.3 (December 2002): 261-266.
PMID
12445747
Source
pubmed
Published In
Lung Cancer
Volume
38
Issue
3
Publish Date
2002
Start Page
261
End Page
266

Screening for lung cancer: Been there and done that - Response

Authors
Patz, EF; Black, WC; Goodman, PC
MLA Citation
Patz, EF, Black, WC, and Goodman, PC. "Screening for lung cancer: Been there and done that - Response." RADIOLOGY 224.3 (September 2002): 928-929.
Source
wos-lite
Published In
Radiology
Volume
224
Issue
3
Publish Date
2002
Start Page
928
End Page
929

Mortality rate and screening - Response

Authors
Patz, EF; Black, WC; Goodman, PC
MLA Citation
Patz, EF, Black, WC, and Goodman, PC. "Mortality rate and screening - Response." RADIOLOGY 224.3 (September 2002): 929-930.
Source
wos-lite
Published In
Radiology
Volume
224
Issue
3
Publish Date
2002
Start Page
929
End Page
930

Development of novel tumor imaging agents with phage-display combinatorial peptide libraries.

RATIONALE AND OBJECTIVES: Current radiologic methods do not provide sufficient information for unambiguous diagnosis and prognosis of cancer. The present investigation sought to address this deficiency by developing a system for designing novel small molecules targeted against tumor-specific molecules for use as radionuclide imaging agents. MATERIALS AND METHODS: Part of a tumor-specific receptor, purified recombinant epidermal growth factor receptor (EGFR), variant III, extracellular domain (rEGFRvIII-ecd), was used as the target in the selection of EGFRvIII-specific peptide ligands from random peptide bacteriophage (phage) display libraries. After three rounds of screening, phage isolates were tested for binding affinity with an enzyme-linked immunosorbent assay. Positive phage were sequenced, and the peptides were synthesized and tested for binding affinity with a surface plasmon resonance assay. RESULTS: Affinity screening identified 49 peptide-expressing phage that showed enhanced binding to the variant receptor compared with wild-type EGFR. Free peptides from the two phage isolates exhibiting the most favorable binding were tested for target binding. One of these demonstrated a binding affinity for rEGFRvIII-ecd in the 30-nmol/L range. CONCLUSION: These data suggest that phage display libraries may be very useful in the design of novel, high-affinity tumor imaging agents.

Authors
Campa, MJ; Serlin, SB; Patz, EF
MLA Citation
Campa, MJ, Serlin, SB, and Patz, EF. "Development of novel tumor imaging agents with phage-display combinatorial peptide libraries." Acad Radiol 9.8 (August 2002): 927-932.
PMID
12186442
Source
pubmed
Published In
Academic Radiology
Volume
9
Issue
8
Publish Date
2002
Start Page
927
End Page
932

T1 lung cancers: sensitivity of diagnosis with fluorodeoxyglucose PET.

PURPOSE: To determine the sensitivity of fluorodeoxyglucose (FDG) positron emission tomography (PET) in patients with T1 (< or =3 cm) lung cancers. MATERIALS AND METHODS: One hundred eighty-five patients with 192 histopathologically proved T1 lung cancers underwent FDG PET imaging at the time of diagnosis. PET results were correlated with tumor size, histopathologic findings, and patient outcome by using the two-sample t test, exact chi(2) test, and log rank test, respectively. RESULTS: Of the 192 lesions, 183 (95%) that ranged in size from 0.5 to 3.0 cm in diameter (mean, 2.0 cm) were positive at PET (ie, demonstrated increased FDG uptake). Of the 192 lesions, nine (5%) that ranged in size from 0.3 to 2.5 cm in diameter (mean, 1.3 cm) were negative at PET (ie, demonstrated low FDG uptake). Patients with small tumors, as well as those with carcinoid tumors and bronchioloalveolar cell carcinoma, were more likely to have a negative PET scan (P =.004, P =.003, respectively). In addition, patients with a negative PET scan who subsequently proved to have cancer had significantly longer survival than did patients with a positive scan and cancer (P =.043). CONCLUSION: Most T1 lung cancers show increased FDG uptake on PET scans.

Authors
Marom, EM; Sarvis, S; Herndon, JE; Patz, EF
MLA Citation
Marom, EM, Sarvis, S, Herndon, JE, and Patz, EF. "T1 lung cancers: sensitivity of diagnosis with fluorodeoxyglucose PET." Radiology 223.2 (May 2002): 453-459.
PMID
11997552
Source
pubmed
Published In
Radiology
Volume
223
Issue
2
Publish Date
2002
Start Page
453
End Page
459
DOI
10.1148/radiol.2232011131

The role of imaging in malignant pleural mesothelioma.

Imaging plays an essential role in the diagnosis, staging, and follow-up of patients with malignant pleural mesothelioma (MPM). The diagnosis is often suggested by a unilateral pleural mass with a moderate to large pleural effusion seen on chest radiographs, but computerized tomography (CT) is the most frequently used technique for evaluation of the lungs in patients with MPM. CT not only suggests pulmonary metastases typically manifested as nodules or masses, but also can demonstrate underlying lung disease often caused by prior asbestos exposure. Magnetic resonance (MR) imaging may be helpful in selected patients with potentially resectable disease to further examine the local extent of tumor. Imaging with positron emission tomography (PET) using the radionuclide imaging agent (18)F fluoro-deoxyglucose (FDG) takes advantage of a basic property of tumor cells, increased glucose metabolism to identify malignant lesions. PET provides not only anatomic information, especially regarding mediastinal node metastasis, but also biochemical information about the lesion. These imaging modalities help triage patients to the most appropriate diagnostic and treatment options. Following patients after therapy usually relies on chest radiographs, although CT can more accurately describe response to therapy. This review will focus on radiologic evaluation in diagnosing, staging, and follow-up patients with MPM.

Authors
Marom, EM; Erasmus, JJ; Pass, HI; Patz, EF
MLA Citation
Marom, EM, Erasmus, JJ, Pass, HI, and Patz, EF. "The role of imaging in malignant pleural mesothelioma." Semin Oncol 29.1 (February 2002): 26-35. (Review)
PMID
11836666
Source
pubmed
Published In
Seminars in Oncology
Volume
29
Issue
1
Publish Date
2002
Start Page
26
End Page
35

A fractionation protocol to reduce signal suppression effects in the MALDI analysis of blood proteins

A protocol involving the combination of liquid-phase isoelectric focusing and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) was developed. Liquid-phase isoelectric focusing was used to separate serum peptides and proteins into 20 different fractions based on their pl values using a Rotofor apparatus. A total of 2 ml of blood was subjected to fractionation. The results from replicate Rotofor runs indicate that the Rotofor fraction a protein appeared in varied from run to run.

Authors
Wang, MZ; Campa, M; Howard, BA; Patz, EF; Fitzgerald, MC
MLA Citation
Wang, MZ, Campa, M, Howard, BA, Patz, EF, and Fitzgerald, MC. "A fractionation protocol to reduce signal suppression effects in the MALDI analysis of blood proteins." Proceedings 50th ASMS Conference on Mass Spectrometry and Allied Topics (2002): 587-588.
Source
scival
Published In
Proceedings 50th ASMS Conference on Mass Spectrometry and Allied Topics
Publish Date
2002
Start Page
587
End Page
588

Potential conflict of interest in AJRCCM [3]

Authors
Jr, FWG; Jr, EFP; Goodman, PC
MLA Citation
Jr, FWG, Jr, EFP, and Goodman, PC. "Potential conflict of interest in AJRCCM [3]." American Journal of Respiratory and Critical Care Medicine 166.12 I (2002): 1608--.
Source
scival
Published In
American Journal of Respiratory and Critical Care Medicine
Volume
166
Issue
12 I
Publish Date
2002
Start Page
1608-

Screening for lung cancer: Been there and done that [2] (multiple letters)

Authors
Hall, FM; Jr, EFP; Black, WC; Goodman, PC
MLA Citation
Hall, FM, Jr, EFP, Black, WC, and Goodman, PC. "Screening for lung cancer: Been there and done that [2] (multiple letters)." Radiology 224.3 (2002): 928-929.
PMID
12202735
Source
scival
Published In
Radiology
Volume
224
Issue
3
Publish Date
2002
Start Page
928
End Page
929

Mortality rate and screening [3] (multiple letters)

Authors
Añorbe, E; Aisa, P; Patz, EF; Black, WC; Goodman, PC
MLA Citation
Añorbe, E, Aisa, P, Patz, EF, Black, WC, and Goodman, PC. "Mortality rate and screening [3] (multiple letters)." Radiology 224.3 (2002): 929-930.
PMID
12202736
Source
scival
Published In
Radiology
Volume
224
Issue
3
Publish Date
2002
Start Page
929
End Page
930

Stage distribution in patients with a small (< or = 3 cm) primary nonsmall cell lung carcinoma. Implication for lung carcinoma screening.

BACKGROUND: Recently, there has been increased interest in the use of computed tomography (CT) for lung carcinoma screening. For this technique to be effective, small tumors must be detected at an earlier stage than large lesions. However, to the authors's knowledge, the relationship between the size of small primary (< or = 3 cm) neoplasms and disease stage at presentation has never been established clearly. The current study was performed to determine whether smaller lesions indeed have an earlier stage distribution compared with larger tumors. METHODS: The Duke University Medical Center Tumor Registry identified 620 patients (261 women and 359 men, with a mean age of 67 years) who presented with pathologically proven primary nonsmall cell lung carcinomas measuring < or = 3 cm between 1980-1999. Surgical, pathologic, and imaging information was reviewed retrospectively to confirm the size of the lesion and the disease stage at the time of presentation. The distribution of tumor size within each stage and the distribution of disease stage according to tumor size were determined. RESULTS: Tumors occurring in patients with TNM Stage IIIB disease were slightly larger than those found in patients with either more advanced or less advanced disease. However, there was no apparent statistically significant relation between the stage distribution and the size of the primary lesion. CONCLUSIONS: The current study data did not find a statistically significant relation between the size of small primary lung tumors and the distribution of disease stage at the time of presentation. This finding suggests that the detection of small tumors using screening CT may not result in a shift to an earlier disease stage distribution. A reduction in mortality needs to be demonstrated by appropriate clinical trials prior to the initiation of mass CT screening programs.

Authors
Heyneman, LE; Herndon, JE; Goodman, PC; Patz, EF
MLA Citation
Heyneman, LE, Herndon, JE, Goodman, PC, and Patz, EF. "Stage distribution in patients with a small (< or = 3 cm) primary nonsmall cell lung carcinoma. Implication for lung carcinoma screening." Cancer 92.12 (December 15, 2001): 3051-3055.
PMID
11753983
Source
pubmed
Published In
Cancer
Volume
92
Issue
12
Publish Date
2001
Start Page
3051
End Page
3055

CT screening for lung cancer: not ready for routine practice.

Lung cancer continues to be a major worldwide health problem. Multiple strategies are being explored in an attempt to reduce lung cancer mortality, including a renewed interest in screening. Multiple low-dose spiral computed tomography (CT) trials have been proposed, as proponents predict that small nodules will represent early-stage disease and detecting them will ultimately translate into improvements in outcomes. At this time, however, only prevalence-screening data are available, and it remains to be seen if CT will truly reduce mortality. The appropriate hypothesis-driven studies still must be performed and the results carefully analyzed before CT screening for lung cancer can be accepted as the standard of care.

Authors
Patz, EF; Black, WC; Goodman, PC
MLA Citation
Patz, EF, Black, WC, and Goodman, PC. "CT screening for lung cancer: not ready for routine practice." Radiology 221.3 (December 2001): 587-591.
PMID
11719648
Source
pubmed
Published In
Radiology
Volume
221
Issue
3
Publish Date
2001
Start Page
587
End Page
591
DOI
10.1148/radiol.2213001643

Stage distribution in patients with a small (

BACKGROUND: Recently, there has been increased interest in the use of computed tomography (CT) for lung carcinoma screening. For this technique to be effective, small tumors must be detected at an earlier stage than large lesions. However, to the authors's knowledge, the relationship between the size of small primary (

Authors
Heyneman, LE; Herndon, JE; Goodman, PC; Patz, EF
MLA Citation
Heyneman, LE, Herndon, JE, Goodman, PC, and Patz, EF. "Stage distribution in patients with a small (." Cancer 92.12 (December 2001): 3051-3055. (Academic Article)
Source
manual
Published In
Cancer
Volume
92
Issue
12
Publish Date
2001
Start Page
3051
End Page
3055

Accuracy of positron emission tomography with fluorodeoxyglucose in T1 lung cancer

Authors
Marom, EM; Sarvis, S; Herndon, JE; Patz, EF
MLA Citation
Marom, EM, Sarvis, S, Herndon, JE, and Patz, EF. "Accuracy of positron emission tomography with fluorodeoxyglucose in T1 lung cancer." RADIOLOGY 221 (November 2001): 408-408.
Source
wos-lite
Published In
Radiology
Volume
221
Publish Date
2001
Start Page
408
End Page
408

Correlation of FDG-PET imaging with Glut-1 and Glut-3 expression in early-stage non-small cell lung cancer.

PURPOSE: To correlate FDG activity on PET with the expression of glucose transporter proteins Glut-1 and Glut-3 in patients with early stage non-small cell lung cancer (NSCLC). METHODS: Over a 5 year period, all patients with a PET scan and clinical stage I NSCLC underwent an immunohistochemical analysis of their tumor for Glut-1 and Glut-3 expression. The amount of FDG uptake in the primary lesion was measured by a standardized uptake ratio (SUR) and correlated with immunohistochemical results. RESULTS: Seventy-three patients with a mean age of 66 years had clinical stage I disease. The final pathologic stage showed 64 patients with stage IA/B disease, eight with stage IIA disease, and one patient with pathologic stage IIIA (T1N2) disease. Glut-1 transporter expression was significantly higher than Glut-3 (P<0.0001), and although there was some association between the SUR and Glut-1 (P=0.085) and SUR and Glut-3 (P=0.074) expression, this did not reach statistical significance. CONCLUSIONS: Glut-1 and Glut-3 transporter expression did not demonstrate a statistically significant correlation with FDG uptake in potentially resectable lung cancer. It appears that these transporters alone do not affect the variation in FDG activity in early stage NSCLC.

Authors
Marom, EM; Aloia, TA; Moore, MB; Hara, M; Herndon, JE; Harpole, DH; Goodman, PC; Patz, EF
MLA Citation
Marom, EM, Aloia, TA, Moore, MB, Hara, M, Herndon, JE, Harpole, DH, Goodman, PC, and Patz, EF. "Correlation of FDG-PET imaging with Glut-1 and Glut-3 expression in early-stage non-small cell lung cancer." Lung Cancer 33.2-3 (August 2001): 99-107.
PMID
11551404
Source
pubmed
Published In
Lung Cancer
Volume
33
Issue
2-3
Publish Date
2001
Start Page
99
End Page
107

Identification of small lung nodules at autopsy: implications for lung cancer screening and overdiagnosis bias.

PURPOSE: Unsuspected cases of lung cancer are reported to be uncommon in autopsy series, and these data have been used to suggest that indolent tumors are rare and that overdiagnosis bias is not an important factor in lung cancer screening. The purpose of this study was to determine if a retrospective autopsy review is indeed accurate in identifying all small lung nodules on CT, and thus provide a true estimate of unsuspected lung tumors. MATERIALS AND METHODS: We identified all 1047 patients who had an autopsy at our institution from 1994 to 1998. We then reviewed the patients radiology records and found 187 patients with a thoracic CT within 2 months of the postmortem examination. All 187 CT reports were reviewed in order to identify patients with at least one pulmonary nodule. CT studies with reports that described a nodule(s) were then re-reviewed to confirm presence and location of the nodule(s). The CT findings were than compared to the autopsy report to determine if the postmortem examination indeed found the nodule(s). RESULTS: 28 autopsy patients had at least one pulmonary nodule identified on their thoracic CT no more than 2 months before death. Nineteen patients (68%) had nodule(s) recorded on the autopsy report, two ( approximately 10%) of which proved to have undiagnosed squamous cell carcinoma. Nine patients (22%) had no mention of pulmonary nodules seen on the CT recorded on their autopsy report. CONCLUSIONS: This study suggests autopsies do not identify all small pulmonary nodules found at CT. The true incidence of clinically insignificant lung cancer is thus uncertain, and overdiagnosis bias in lung cancer screening may be more important than previously recognized.

Authors
Dammas, S; Patz, EF; Goodman, PC
MLA Citation
Dammas, S, Patz, EF, and Goodman, PC. "Identification of small lung nodules at autopsy: implications for lung cancer screening and overdiagnosis bias." Lung Cancer 33.1 (July 2001): 11-16.
PMID
11429191
Source
pubmed
Published In
Lung Cancer
Volume
33
Issue
1
Publish Date
2001
Start Page
11
End Page
16

FDG-PET imaging in patients with paraneoplastic syndromes and suspected small cell lung cancer.

Paraneoplastic syndromes may be the presenting clinical manifestation of small cell lung cancer. In some cases, however, confirming the diagnosis can be difficult because findings on conventional imaging studies can be subtle or nonspecific. This study examined the utility of fluoro-2-deoxy-glucose positron emission tomography (FDG-PET) in identifying clinically suspected small cell lung cancer in patients with paraneoplastic syndromes. FDG-PET appears to be very useful in localizing suspected small cell lung cancer in patients presenting with paraneoplastic syndromes.

Authors
Crotty, E; Patz, EF
MLA Citation
Crotty, E, and Patz, EF. "FDG-PET imaging in patients with paraneoplastic syndromes and suspected small cell lung cancer." J Thorac Imaging 16.2 (April 2001): 89-93.
PMID
11292210
Source
pubmed
Published In
Journal of Thoracic Imaging
Volume
16
Issue
2
Publish Date
2001
Start Page
89
End Page
93

Screening for lung cancer. Reply

Authors
Patz, EF; Goodman, PC; Bepler, G
MLA Citation
Patz, EF, Goodman, PC, and Bepler, G. "Screening for lung cancer. Reply." NEW ENGLAND JOURNAL OF MEDICINE 344.12 (March 22, 2001): 936-936.
Source
wos-lite
Published In
The New England journal of medicine
Volume
344
Issue
12
Publish Date
2001
Start Page
936
End Page
936

Low-dose spiral computed tomography screening for lung cancer: not ready for prime time.

Authors
Patz, EF; Goodman, PC
MLA Citation
Patz, EF, and Goodman, PC. "Low-dose spiral computed tomography screening for lung cancer: not ready for prime time." Am J Respir Crit Care Med 163.4 (March 2001): 813-814.
PMID
11282746
Source
pubmed
Published In
American journal of respiratory and critical care medicine
Volume
163
Issue
4
Publish Date
2001
Start Page
813
End Page
814
DOI
10.1164/ajrccm.163.4.16342b

Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement.

OBJECTIVE: Provide explicit expert-based consensus recommendations for the management of adults with primary and secondary spontaneous pneumothoraces in an emergency department and inpatient hospital setting. The use of opinion was made explicit by employing a structured questionnaire, appropriateness scores, and consensus scores with a Delphi technique. The guideline was designed to be relevant to physicians who make management decisions for the care of patients with pneumothorax. OPTIONS: Decisions for observation, chest tube placement, surgical interventions, and radiographic imaging. OUTCOMES: Effectiveness of pneumothorax resolution, duration of and patient tolerance of care, and pneumothorax recurrence. EVIDENCE: Literature review from 1967 to January 1999 and Delphi questionnaire submitted in three iterations to a multidisciplinary physician panel. VALUES: The guideline development group determined by consensus the relevant outcomes to be considered in developing the Delphi questionnaire. BENEFITS, HARMS, AND COSTS: The type and magnitude of benefits, harms, and costs expected for patients from guideline implementation. RECOMMENDATIONS: Management decisions vary between patients with primary or secondary pneumothoraces, with observation of small pneumothoraces being appropriate only for primary pneumothoraces. The level of consensus varies regarding the specific interventions indicated, but agreement exists for the general principles of care. VALIDATION: Recommendations were peer reviewed by physician experts and were reviewed by the American College of Chest Physicians (ACCP) Health and Science Policy Committee. IMPLEMENTATION: The guideline recommendations will be published in printed and electronic form with distribution of synopses for patients and health care providers. Contents of the guideline will be incorporated into continuing medical education programs. SPONSORS: The ACCP.

Authors
Baumann, MH; Strange, C; Heffner, JE; Light, R; Kirby, TJ; Klein, J; Luketich, JD; Panacek, EA; Sahn, SA
MLA Citation
Baumann, MH, Strange, C, Heffner, JE, Light, R, Kirby, TJ, Klein, J, Luketich, JD, Panacek, EA, and Sahn, SA. "Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement." Chest 119.2 (February 2001): 590-602. (Review)
PMID
11171742
Source
epmc
Published In
Chest
Volume
119
Issue
2
Publish Date
2001
Start Page
590
End Page
602
DOI
10.1378/chest.119.2.590

Stage IA non-small cell lung cancer - A small proportion of cases in the general population

Authors
Patz, EF; Goodman, PC
MLA Citation
Patz, EF, and Goodman, PC. "Stage IA non-small cell lung cancer - A small proportion of cases in the general population." CHEST 119.1 (January 2001): 314-315.
Source
wos-lite
Published In
Chest
Volume
119
Issue
1
Publish Date
2001
Start Page
314
End Page
315

Integration of peripheral blood biomarkers with computed tomography to differentiate benign from malignant pulmonary opacities.

Our purpose was to determine whether peripheral blood biomarkers MUC1 and CK19 could be used to complement imaging studies in differentiating benign from malignant indeterminate pulmonary nodules or masses detected on computed tomography CT. One hundred and eighteen patients had a thoracic CT and blood drawn for tumor marker reverse transcriptase-polymerase chain reaction analysis. Thirty-five of the 118 patients had an indeterminate pulmonary nodular opacity on CT, and the findings then were correlated with the reverse transcriptase-polymerase chain reaction results. The sensitivity and specificity for the markers in determining malignancy was calculated. Thirteen of the 35 opacities on CT proved to be benign, and 22 proved to be lung cancer. Among the patients with indeterminate pulmonary abnormalities, polymorphic epithelial mucin protein 1 had a sensitivity and specificity for lung cancer of 100% and 46%, respectively. Cytokeratin 19 had a sensitivity and specificity for lung cancer of 95% and 8%, respectively. These preliminary data showed that serum biomarkers polymorphic epithelial mucin protein 1 and cytokeratin 19 were not specific for lung cancer, although patients with an indeterminate pulmonary abnormality and negative markers were unlikely to have lung cancer. Integration of imaging studies with the appropriate biomarkers may prove useful in evaluating indeterminate pulmonary nodules or masses.

Authors
Aloia, T; Bepler, G; Harpole, D; Goodman, PC; McAdams, HP; Erasmus, JJ; Herndon, JE; Patz, EF
MLA Citation
Aloia, T, Bepler, G, Harpole, D, Goodman, PC, McAdams, HP, Erasmus, JJ, Herndon, JE, and Patz, EF. "Integration of peripheral blood biomarkers with computed tomography to differentiate benign from malignant pulmonary opacities." Cancer Detect Prev 25.4 (2001): 336-343.
PMID
11531010
Source
pubmed
Published In
Cancer Detection and Prevention
Volume
25
Issue
4
Publish Date
2001
Start Page
336
End Page
343

Screening for lung cancer [2] (multiple letters)

Authors
Austin, JHM; Stellman, SD; Pearson, GDN; Miettinen, OS; Yankelevitz, DF; Henschke, CI; Mulshine, JL; Day, RW; Jr, EFP; Goodman, PC; Bepler, G
MLA Citation
Austin, JHM, Stellman, SD, Pearson, GDN, Miettinen, OS, Yankelevitz, DF, Henschke, CI, Mulshine, JL, Day, RW, Jr, EFP, Goodman, PC, and Bepler, G. "Screening for lung cancer [2] (multiple letters)." New England Journal of Medicine 344.12 (2001): 935-936.
PMID
11263428
Source
scival
Published In
The New England journal of medicine
Volume
344
Issue
12
Publish Date
2001
Start Page
935
End Page
936
DOI
10.1056/NEJM200103223441213

Commentary on Drs Miettinen and Henschke's viewpoint

We should first verify that this form of screening is indeed effective and that its benefits outweigh its harms.

Authors
Jr, PEF; Black, WC; Goodman, PC
MLA Citation
Jr, PEF, Black, WC, and Goodman, PC. "Commentary on Drs Miettinen and Henschke's viewpoint." Radiology 221.3 (2001): 597--.
Source
scival
Published In
Radiology
Volume
221
Issue
3
Publish Date
2001
Start Page
597-

Stage IA non-small cell lung cancer: A small proportion of cases in the general population [4] (multiple letters)

Authors
Crocetti, E; Paci, E; Jr, PEF; Goodman, PC
MLA Citation
Crocetti, E, Paci, E, Jr, PEF, and Goodman, PC. "Stage IA non-small cell lung cancer: A small proportion of cases in the general population [4] (multiple letters)." Chest 119.1 (2001): 313-314.
PMID
11157630
Source
scival
Published In
Chest
Volume
119
Issue
1
Publish Date
2001
Start Page
313
End Page
314
DOI
10.1378/chest.119.1.313

Screening for lung cancer.

Authors
Patz, EF; Goodman, PC; Bepler, G
MLA Citation
Patz, EF, Goodman, PC, and Bepler, G. "Screening for lung cancer." N Engl J Med 343.22 (November 30, 2000): 1627-1633. (Review)
PMID
11096172
Source
pubmed
Published In
The New England journal of medicine
Volume
343
Issue
22
Publish Date
2000
Start Page
1627
End Page
1633
DOI
10.1056/NEJM200011303432208

Staging techniques for lung cancer.

In summary, noninvasive clinical staging techniques aid in stratifying patients into similar prognostic and therapeutic categories. Every patient with presumed non-small cell lung cancer should undergo a thorough history and physical examination, basic routine laboratory testing, PA and lateral chest radiographs, and chest CT scan with upper abdominal cuts to allow evaluation of the liver and adrenals. Recently, FDG-PET scanning has shown tremendous promise in the noninvasive evaluation of the primary tumor, nodal involvement, and metastatic [table: see text] disease. Although valuable, clinical staging has limitations, and when pathologic confirmation of lung cancer is required, minimally invasive techniques, such as bronchoscopy, TTNA, thoracoscopy, anterior mediastinotomy, and cervical and extended mediastinoscopy, may be valuable and simple ways of obtaining tissue.

Authors
Lau, CL; Harpole, DH; Patz, E
MLA Citation
Lau, CL, Harpole, DH, and Patz, E. "Staging techniques for lung cancer." Chest Surg Clin N Am 10.4 (November 2000): 781-801. (Review)
PMID
11091926
Source
pubmed
Published In
Chest surgery clinics of North America
Volume
10
Issue
4
Publish Date
2000
Start Page
781
End Page
801

Integration of peripheral blood biomarkers with CT to differentiate benign from malignant pulmonary opacities

Authors
Aloia, T; McAdams, HP; Bepler, G; Harpole, DH; Goodman, PC; Patz, EF
MLA Citation
Aloia, T, McAdams, HP, Bepler, G, Harpole, DH, Goodman, PC, and Patz, EF. "Integration of peripheral blood biomarkers with CT to differentiate benign from malignant pulmonary opacities." November 2000.
Source
wos-lite
Published In
Radiology
Volume
217
Publish Date
2000
Start Page
469
End Page
469

Design of a novel small peptide targeted against a tumor-specific receptor.

EGFRvIII is the most common deletion variant of the epidermal growth factor receptor and is found in cancers of the brain, breast, ovary, and lung. The complete absence of the receptor in healthy tissues makes it an ideal tumor marker. We sought to design a peptide ligand against EGFRvIII for development as a diagnostic imaging agent. We used the concept of hydropathic complementarity to search for sequences whose amino acid sidechains display a reciprocal pattern of hydropathicity to those of the deletion junction of EGFRvIII. The resulting peptide (PEPHC1) was synthesized and tested for binding to EGFRvIII and EGFR. In in vitro assays, PEPHC1 bound the recombinant EGFRvIII extracellular domain or full-length EGFRvIII solubilized from cell membranes in preference to native EGFR. These results demonstrate the utility of hydropathic complementarity as a basis for the design of highly specific ligands that may prove useful as tumor-targeting agents.

Authors
Campa, MJ; Kuan, CT; O'Connor-McCourt, MD; Bigner, DD; Patz, EF
MLA Citation
Campa, MJ, Kuan, CT, O'Connor-McCourt, MD, Bigner, DD, and Patz, EF. "Design of a novel small peptide targeted against a tumor-specific receptor." Biochem Biophys Res Commun 275.2 (August 28, 2000): 631-636.
PMID
10964715
Source
pubmed
Published In
Biochemical and Biophysical Research Communications
Volume
275
Issue
2
Publish Date
2000
Start Page
631
End Page
636
DOI
10.1006/bbrc.2000.3347

1999 plenary session: Friday imaging symposium : evaluation of focal pulmonary abnormalities with FDG PET.

Authors
Patz, EF
MLA Citation
Patz, EF. "1999 plenary session: Friday imaging symposium : evaluation of focal pulmonary abnormalities with FDG PET." Radiographics 20.4 (July 2000): 1182-1185.
PMID
10903708
Source
pubmed
Published In
Radiographics : a review publication of the Radiological Society of North America, Inc
Volume
20
Issue
4
Publish Date
2000
Start Page
1182
End Page
1185
DOI
10.1148/radiographics.20.4.g00jl171182

FDG PET of pleural effusions in patients with non-small cell lung cancer.

OBJECTIVE: We determined the ability of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) to differentiate benign and malignant pleural effusions in patients with non-small cell lung cancer. MATERIALS AND METHODS: Over a 6-year period, we reviewed all patients with primary non-small cell lung cancer and a pleural effusion on staging CT who underwent FDG PET. We examined 25 patients (18 men and seven women; age range, 37-86 years; mean age, 65 years). FDG PET revealed positive findings if pleural activity was greater than background mediastinal activity; FDG PET revealed negative findings if pleural activity was the same as or less than background mediastinal activity. Results of FDG PET were correlated with pathologic diagnosis determined with thoracentesis or pleural biopsy. RESULTS: All patients had effusions on the same side as the primary tumor. Twenty-two patients had a malignant pleural effusion confirmed with thoracentesis (n = 19) or biopsy (n = 3). FDG PET revealed positive findings in 21 patients and negative findings in one. Three patients had no evidence of malignancy in the pleural space determined with cytologic findings (n = 2) or biopsy results (n = 1). FDG PET uptake revealed positive findings in one of these patients and negative findings in two. Therefore, of 22 patients with positive findings on FDG PET, 21 had pleural metastases, and of three patients with negative findings on FDG PET, one had metastases. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FDG PET for detecting pleural metastases were 95%, 67%, 95%, 67%, and 92%, respectively. CONCLUSION: This study suggests that FDG PET may be useful in improving staging evaluation in patients with non-small cell lung cancer and a pleural effusion. Increased pleural FDG uptake usually indicates pleural metastases; however, because the number of benign effusions studied was small, the relevance of negative findings on FDG PET in this setting is uncertain.

Authors
Erasmus, JJ; McAdams, HP; Rossi, SE; Goodman, PC; Coleman, RE; Patz, EF
MLA Citation
Erasmus, JJ, McAdams, HP, Rossi, SE, Goodman, PC, Coleman, RE, and Patz, EF. "FDG PET of pleural effusions in patients with non-small cell lung cancer." AJR Am J Roentgenol 175.1 (July 2000): 245-249.
PMID
10882281
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
175
Issue
1
Publish Date
2000
Start Page
245
End Page
249

Lung cancer and positron emission tomography with fluorodeoxyglucose.

Over the past years, positron emission tomography (PET) with fluoro-2-deoxy-D-glucose (FDG) has emerged as an important imaging modality. In the thorax, FDG-PET has been shown to differentiate benign from malignant pulmonary lesions and stage lung cancer. Preliminary studies have shown its usefulness in assessing tumor recurrence, and assisting in radiotherapy planning. FDG-PET is often more accurate than conventional imaging studies, and has been proven to be cost-effective in evaluating lung cancer patients. This review will discuss the current applications of FDG-PET as compared with conventional imaging in diagnosing, staging, and following patients with lung cancer.

Authors
Marom, EM; Erasmus, JJ; Patz, EF
MLA Citation
Marom, EM, Erasmus, JJ, and Patz, EF. "Lung cancer and positron emission tomography with fluorodeoxyglucose." Lung Cancer 28.3 (June 2000): 187-202. (Review)
PMID
10812188
Source
pubmed
Published In
Lung Cancer
Volume
28
Issue
3
Publish Date
2000
Start Page
187
End Page
202

Correlation of tumor size and survival in patients with stage IA non-small cell lung cancer.

OBJECTIVE: The purpose of this study was to determine the relationship between tumor size and survival in patients with stage IA non-small cell lung cancer (non-small cell lung cancer; ie, lesions < 3 cm). METHOD: Five hundred ten patients with pathologic stage IA (T1N0M0) non-small cell lung cancer were identified from our tumor registry over an 18-year period (from 1981 to 1999). There were 285 men and 225 women, with a mean age of 63 years (range, 31 to 90 years). The Cox proportional model was used to examine the effect on survival. Tumor size was incorporated into the model as a linear effect and as categorical variables. The Kaplan-Meier product limit estimator was used to graphically display the relationship between the tumor size and survival. RESULTS: The Cox proportional hazards model did not show a statistically significant relationship between tumor size and survival (p = 0.701) as a linear effect. Tumor size was then categorized into quartiles, and again there was no statistically significant difference in survival between groups (p = 0.597). Tumor size was also categorized into deciles, and there was no statistical relationship between tumor size and survival (p = 0.674). CONCLUSIONS: This study confirms stratifying patients with stage IA non-small cell lung cancer in the same TNM classification, given no apparent difference in survival. Unfortunately, these data caution that improved small nodule detection with screening CT may not significantly improve lung cancer mortality. The appropriate prospective randomized trial appears warranted.

Authors
Patz, EF; Rossi, S; Harpole, DH; Herndon, JE; Goodman, PC
MLA Citation
Patz, EF, Rossi, S, Harpole, DH, Herndon, JE, and Goodman, PC. "Correlation of tumor size and survival in patients with stage IA non-small cell lung cancer." Chest 117.6 (June 2000): 1568-1571.
PMID
10858384
Source
pubmed
Published In
Chest
Volume
117
Issue
6
Publish Date
2000
Start Page
1568
End Page
1571

Non-small cell lung cancer: FDG PET for nodal staging in patients with stage I disease.

PURPOSE: To determine the accuracy of 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in the evaluation of regional lymph nodes in patients with stage I non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Imaging and clinical findings obtained during 5 years in 84 patients (mean age, 66 years) were reviewed. Patients had thoracic computed tomographic findings of stage I NSCLC, an FDG PET study, and histopathologic proof of lung cancer. At the time of diagnosis, disease stage was assigned on the basis of FDG PET results and was compared with the histopathologic stage to determine the accuracy of PET. RESULTS: When PET stage was compared with histopathologic stage, the disease in 72 (86%) patients was accurately staged with PET, understaged in two (2%), and overstaged in 10 (12%). The overall sensitivity, specificity, and positive and negative predictive values for PET of regional lymph nodal metastases were 82%, 86%, 47%, and 97%, respectively. CONCLUSION: FDG PET enables accurate staging of regional lymph node disease in patients with stage I NSCLC. A negative PET scan in these patients suggests that mediastinoscopy is unnecessary and that these patients can proceed directly to thoracotomy.

Authors
Farrell, MA; McAdams, HP; Herndon, JE; Patz, EF
MLA Citation
Farrell, MA, McAdams, HP, Herndon, JE, and Patz, EF. "Non-small cell lung cancer: FDG PET for nodal staging in patients with stage I disease." Radiology 215.3 (June 2000): 886-890.
PMID
10831716
Source
pubmed
Published In
Radiology
Volume
215
Issue
3
Publish Date
2000
Start Page
886
End Page
890
DOI
10.1148/radiology.215.3.r00jn29886

Imaging bronchogenic carcinoma.

Imaging plays an integral role in diagnosing, staging, and following patients with lung cancer. Most lung tumors are detected on chest radiographs, but unfortunately, the majority of patients have advanced stage disease at presentation. There is a wide spectrum of radiologic manifestations of lung cancer, and recognition of these findings is essential for patient management. As we continue to understand more about tumor biology, new imaging techniques should emerge and have the potential to significantly improve our diagnostic capabilities.

Authors
Patz, EF
MLA Citation
Patz, EF. "Imaging bronchogenic carcinoma." Chest 117.4 Suppl 1 (April 2000): 90S-95S. (Review)
PMID
10777461
Source
pubmed
Published In
Chest
Volume
117
Issue
4 Suppl 1
Publish Date
2000
Start Page
90S
End Page
95S

Imaging bronchogenic carcinoma

Authors
Patz, EF
MLA Citation
Patz, EF. "Imaging bronchogenic carcinoma." April 2000.
Source
wos-lite
Published In
Chest
Volume
117
Issue
4
Publish Date
2000
Start Page
90S
End Page
95S
DOI
10.1378/chest.117.4_suppl_1.90S

Management of malignant pleural effusions and pneumothorax.

Pneumothorax may occur spontaneously or result from underlying lung disease or as a complication of interventional thoracic procedures. Percutaneous catheter placement enables safe and effective drainage of pneumothoraces with rapid relief of symptoms and restoration of vital capacity and oxygenation.

Authors
Erasmus, JJ; Goodman, PC; Patz, EF
MLA Citation
Erasmus, JJ, Goodman, PC, and Patz, EF. "Management of malignant pleural effusions and pneumothorax." Radiol Clin North Am 38.2 (March 2000): 375-383. (Review)
PMID
10765395
Source
pubmed
Published In
Radiologic Clinics of North America
Volume
38
Issue
2
Publish Date
2000
Start Page
375
End Page
383

Prognostic value of thoracic FDG PET imaging after treatment for non-small cell lung cancer.

OBJECTIVE: We determined the prognostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) for patients with treated lung cancer. MATERIALS AND METHODS: We examined patients who underwent FDG PET after first-line treatment for non-small cell lung cancer. FDG PET results were correlated with survival rates to determine whether FDG PET findings were predictive of outcomes. RESULTS: After initial therapy, 113 patients with non-small cell lung cancer underwent FDG PET. One hundred patients had positive FDG PET results and a median survival of 12 months (95% confidence interval, 9.2-15.4). Thirteen patients had negative FDG PET results, and 11 (85%) of these patients are still living at a median follow-up of 34 months. The difference in survival for patients with positive and negative FDG PET results was statistically significant (p = 0.002). CONCLUSION: FDG PET has prognostic value and strongly correlates with survival rates of patients with treated lung cancer. Patients with positive FDG PET results have a significantly worse prognosis than patients with negative results. Additionally, FDG PET may be helpful in guiding therapeutic treatments.

Authors
Patz, EF; Connolly, J; Herndon, J
MLA Citation
Patz, EF, Connolly, J, and Herndon, J. "Prognostic value of thoracic FDG PET imaging after treatment for non-small cell lung cancer." AJR Am J Roentgenol 174.3 (March 2000): 769-774.
PMID
10701623
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
174
Issue
3
Publish Date
2000
Start Page
769
End Page
774
DOI
10.2214/ajr.174.3.1740769

Lung nodule enhancement at CT: multicenter study.

PURPOSE: To test the hypothesis that absence of statistically significant lung nodule enhancement (< or =15 HU) at computed tomography (CT) is strongly predictive of benignity. MATERIALS AND METHODS: Five hundred fifty lung nodules were studied. Of these, 356 met all entrance criteria and had a diagnosis. On nonenhanced, thin-section CT scans, the nodules were solid, 5-40 mm in diameter, relatively spherical, homogeneous, and without calcification or fat. All patients were examined with 3-mm-collimation CT before and after intravenous injection of contrast material. CT scans through the nodule were obtained at 1, 2, 3, and 4 minutes after the onset of injection. Peak net nodule enhancement and time-attenuation curves were analyzed. Seven centers participated. RESULTS: The prevalence of malignancy was 48% (171 of 356 nodules). Malignant neoplasms enhanced (median, 38.1 HU; range, 14.0-165.3 HU) significantly more than granulomas and benign neoplasms (median, 10.0 HU; range, -20.0 to 96.0 HU; P < .001). With 15 HU as the threshold, the sensitivity was 98% (167 of 171 malignant nodules), the specificity was 58% (107 of 185 benign nodules), and the accuracy was 77% (274 of 356 nodules). CONCLUSION: Absence of significant lung nodule enhancement (< or = 15 HU) at CT is strongly predictive of benignity.

Authors
Swensen, SJ; Viggiano, RW; Midthun, DE; Müller, NL; Sherrick, A; Yamashita, K; Naidich, DP; Patz, EF; Hartman, TE; Muhm, JR; Weaver, AL
MLA Citation
Swensen, SJ, Viggiano, RW, Midthun, DE, Müller, NL, Sherrick, A, Yamashita, K, Naidich, DP, Patz, EF, Hartman, TE, Muhm, JR, and Weaver, AL. "Lung nodule enhancement at CT: multicenter study." Radiology 214.1 (January 2000): 73-80.
PMID
10644104
Source
pubmed
Published In
Radiology
Volume
214
Issue
1
Publish Date
2000
Start Page
73
End Page
80
DOI
10.1148/radiology.214.1.r00ja1473

Lung nodules: dual-kilovolt peak analysis with CT--multicenter study.

PURPOSE: To test the following hypothesis: The greater the increase in the mean computed tomographic (CT) number of a radiologically indeterminate lung nodule from the CT number on a 140-kVp CT image to that on an 80-kVp CT image, the more likely the nodule is benign (ie, contains calcium). MATERIALS AND METHODS: Two hundred forty indeterminate lung nodules were prospectively studied at four institutions: Mayo Clinic Scottsdale, Ariz (n = 160); Mayo Clinic Rochester, Minn (n = 50); Shiga Health Insurance Hospital, Otsu, Japan (n = 25); and Duke University Medical Center, Durham, NC (n = 5). Of the 240 nodules, 157 met the entrance criteria for this study and had a diagnosis. All nodules included were solid, 5-40-mm diameter, relatively spherical, homogeneous, and without visible evidence of calcification or fat. Each nodule was evaluated by using 3-mm-collimation, nonenhanced CT scans with both 140- and 80-kVp x-ray beams. RESULTS: There were 86 (55%) benign and 71 (45%) malignant nodules. The median increase in the nodule mean CT number from the CT number on 140-kVp images to that on 80-kVp images was 2 HU for benign nodules and 3 HU for malignant nodules. This difference was not statistically significant. The area under the receiver operating characteristic curve was 0.505. CONCLUSION: Dual-kilovolt peak analysis with current CT technology does not appear to be helpful in the identification of benign lung nodules.

Authors
Swensen, SJ; Yamashita, K; McCollough, CH; Viggiano, RW; Midthun, DE; Patz, EF; Muhm, JR; Weaver, AL
MLA Citation
Swensen, SJ, Yamashita, K, McCollough, CH, Viggiano, RW, Midthun, DE, Patz, EF, Muhm, JR, and Weaver, AL. "Lung nodules: dual-kilovolt peak analysis with CT--multicenter study." Radiology 214.1 (January 2000): 81-85.
PMID
10644105
Source
pubmed
Published In
Radiology
Volume
214
Issue
1
Publish Date
2000
Start Page
81
End Page
85
DOI
10.1148/radiology.214.1.r00ja2681

Imaging bronchogenic carcinoma

Imaging plays an integral role in diagnosing, staging, and following patients with lung cancer. Most lung tumors are detected on chest radiographs, but unfortunately, the majority of patients have advanced stage disease at presentation. There is a wide spectrum of radiologic manifestations of lung cancer, and recognition of these findings is essential for patient management. As we continue to understand more about tumor biology, new imaging techniques should emerge and have the potential to significantly improve our diagnostic capabilities.

Authors
Jr, EFP
MLA Citation
Jr, EFP. "Imaging bronchogenic carcinoma." Chest 117.4 SUPPL. 1 (2000): 90S-95S.
Source
scival
Published In
Chest
Volume
117
Issue
4 SUPPL. 1
Publish Date
2000
Start Page
90S
End Page
95S

Evaluation of focal pulmonary abnormalities with FDG PET

Authors
Jr, EFP
MLA Citation
Jr, EFP. "Evaluation of focal pulmonary abnormalities with FDG PET." Radiographics 20.4 (2000): 1182-1185.
Source
scival
Published In
Radiographics
Volume
20
Issue
4
Publish Date
2000
Start Page
1182
End Page
1185

From the guest editor

Authors
Patz, EF
MLA Citation
Patz, EF. "From the guest editor." Journal of Thoracic Imaging 15.1 (2000): 2--.
Source
scival
Published In
Journal of Thoracic Imaging
Volume
15
Issue
1
Publish Date
2000
Start Page
2-
DOI
10.1097/00005382-200001000-00002

FDG-PET in patient with clinical T1N0 lung cancer; Determination of nodal status

To assess the usefulness of FDG-PET for evaluating N-factor in small lung cancer, we focused the object to clinical T1N0 cases. Twenty-two patients were eligible for this study. Six of 22 patients were positive for nodal metastasis pathologically. FDG-PET could demonstrate 4 metastases among them. Although the limitation of FDG-PET was 5 false positive results in 16 pathologically NO patients, FDG-PET had excellent negative predictive value (85%) for evaluation of nodal status in small lung cancer.

Authors
Kitase, M; Hara, M; Katoh, K; Satoh, Y; Satake, M; Miyagawa, H; Ogino, H; Itoh, M; Ohba, S; Jr, PEF
MLA Citation
Kitase, M, Hara, M, Katoh, K, Satoh, Y, Satake, M, Miyagawa, H, Ogino, H, Itoh, M, Ohba, S, and Jr, PEF. "FDG-PET in patient with clinical T1N0 lung cancer; Determination of nodal status." Japanese Journal of Clinical Radiology 45.1 (2000): 209-214.
Source
scival
Published In
Japanese Journal of Clinical Radiology
Volume
45
Issue
1
Publish Date
2000
Start Page
209
End Page
214

Clinical T1 lung cancer; evaluation with FDG-PET

To determine the usefulness of F-18 FDG-PET for small size lesions of lung cancer, 38 clinical T1 patients were semiquantitatively analyzed by standardized uptake ratios (SUR). Using an SUR greater than 2.5 as criteria for malignancy, positive ratios were 87% (33/38) in patients with 3cm or less nodule, 78% (14/18) with 2cm or less, and 75% (3/4) with 1.5cm or less, respectively. Five nodules (13%) showed false negative. FDG-PET seems to be valuable even for evaluation of clinical T1 lung cancer.

Authors
Nakayama, J; Hara, M; Miura, N; Sugie, T; Satake, M; Tomita, H; Kitase, M; Ogino, H; Ohba, S; Jr, PEF
MLA Citation
Nakayama, J, Hara, M, Miura, N, Sugie, T, Satake, M, Tomita, H, Kitase, M, Ogino, H, Ohba, S, and Jr, PEF. "Clinical T1 lung cancer; evaluation with FDG-PET." Japanese Journal of Clinical Radiology 45.1 (2000): 215-219.
Source
scival
Published In
Japanese Journal of Clinical Radiology
Volume
45
Issue
1
Publish Date
2000
Start Page
215
End Page
219

Screening for lung cancer

Authors
PATZ, EJ
MLA Citation
PATZ, EJ. "Screening for lung cancer." N Engl J Med. 343 (2000): 1627-1633.
Source
cinii-english
Published In
N Engl J Med.
Volume
343
Publish Date
2000
Start Page
1627
End Page
1633
DOI
10.1056/NEJM200011303432208

Correlation of tumor size and survival in patients stage 1A non-small cell lung cancer

Authors
PATZ, E
MLA Citation
PATZ, E. "Correlation of tumor size and survival in patients stage 1A non-small cell lung cancer." Chest 117 (2000): 1532-1534.
Source
cinii-english
Published In
Chest
Volume
117
Publish Date
2000
Start Page
1532
End Page
1534
DOI
10.1378/chest.117.6.1532

Correlation of tumor size and survival in patients with stage IA non-small cell lung cancer

Authors
EDWARD, F
MLA Citation
EDWARD, F. "Correlation of tumor size and survival in patients with stage IA non-small cell lung cancer." Chest 117 (2000): 1568-1571.
Source
cinii-english
Published In
Chest
Volume
117
Publish Date
2000
Start Page
1568
End Page
1571
DOI
10.1378/chest.117.6.1568

Positron emission tomography imaging in the thorax.

Positron emission tomography imaging has proven valuable in the evaluation and management of thoracic abnormalities. It is more accurate than CT or MR imaging in characterizing indeterminate focal abnormal pulmonary opacities, staging lung cancer, and assessing the therapeutic response. PET imaging in lung cancer also appears to be cost-effective, particularly with whole-body studies. The metabolic and physiologic abnormalities used in FDG-PET imaging, rather than conventional anatomic or morphologic characteristics, provide an invaluable model for the future of tumor imaging.

Authors
Erasmus, JJ; Patz, EF
MLA Citation
Erasmus, JJ, and Patz, EF. "Positron emission tomography imaging in the thorax." Clin Chest Med 20.4 (December 1999): 715-724. (Review)
PMID
10587793
Source
pubmed
Published In
Clinics in Chest Medicine
Volume
20
Issue
4
Publish Date
1999
Start Page
715
End Page
724

Pulmonary nontuberculous mycobacterial infection: radiologic manifestations.

The nontuberculous mycobacteria (NTMB) are a group of bacteria that can infect the cervical lymph nodes, skin, soft tissues, and lung. Pulmonary NTMB disease is increasing in prevalence and is most commonly caused by Mycobacterium avium-intracellulare or M kansasii. Occasionally, M xenopi, M fortuitum, or M chelonae also causes pulmonary disease. Diagnosis of pulmonary NTMB infection is often difficult because isolation of the organism from sputum or bronchoalveolar lavage fluid can represent airway colonization. The radiologic manifestations of pulmonary NTMB infection are protean and include consolidation, cavitation, fibrosis, nodules, bronchiectasis, and adenopathy. Pulmonary NTMB infection has five distinct clinicoradiologic manifestations: (a) classic infection, (b) nonclassic infection, (c) nodules in asymptomatic patients, (d) infection in patients with achalasia, and (e) infection in immunocompromised patients. Although classic NTMB infection may be indistinguishable from active tuberculosis, it is usually more indolent. The radiologic features of nonclassic NTMB infection are characteristic: bronchiectasis and centrilobular nodules isolated to or most severe in the lingula and middle lobe. In patients with acquired immunodeficiency syndrome, mediastinal or hilar adenopathy is the most common radiographic finding. Knowledge of the full spectrum of clinical and radiologic features of pulmonary NTMB infection is important to facilitate diagnosis and treatment.

Authors
Erasmus, JJ; McAdams, HP; Farrell, MA; Patz, EF
MLA Citation
Erasmus, JJ, McAdams, HP, Farrell, MA, and Patz, EF. "Pulmonary nontuberculous mycobacterial infection: radiologic manifestations." Radiographics 19.6 (November 1999): 1487-1505. (Review)
PMID
10555671
Source
pubmed
Published In
Radiographics : a review publication of the Radiological Society of North America, Inc
Volume
19
Issue
6
Publish Date
1999
Start Page
1487
End Page
1505
DOI
10.1148/radiographics.19.6.g99no101487

Thymic hyperplasia after high-dose chemotherapy and autologous stem cell transplantation: incidence and significance in patients with breast cancer.

OBJECTIVE: The purpose of this study was to determine the incidence and clinical significance of thymic hyperplasia after high-dose chemotherapy and autologous stem cell transplantation for treatment of metastatic or high-risk primary (with at least four positive lymph nodes) breast cancer. MATERIALS AND METHODS: We retrospectively reviewed clinical records and CT scans of 102 breast cancer patients treated with high-dose chemotherapy and autologous stem cell transplantation. Patients were 26-63 years old (mean, 46 years). The length and width of the thymus gland were measured on serial CT scans obtained before and after treatment. Moderate thymic hyperplasia was recorded if a focal or diffuse increase was seen in the oblong, triangular soft-tissue opacity conforming to the configuration of the normal gland within the anterior mediastinum after therapy. Minimal hyperplasia was recorded when a minimal increase was seen in soft-tissue attenuation conforming to the configuration of the normal bilobed thymus gland within the anterior mediastinum, but no discrete mass was visible. RESULTS: CT showed no thymic hyperplasia in 91 (89%) of the 102 patients. CT showed thymic hyperplasia in the other 11 patients (11%). Three patients (3%) had moderate hyperplasia, and eight patients (8%) had minimal hyperplasia. When comparing patients with and without hyperplasia, we found no difference in mean age or survival. CONCLUSION: Thymic hyperplasia is rare after high-dose chemotherapy and autologous stem cell transplantation in adult patients with metastatic or high-risk primary breast cancer. In this population, thymic hyperplasia does not appear to correlate with survival.

Authors
Hara, M; McAdams, HP; Vredenburgh, JJ; Herndon, JE; Patz, EF
MLA Citation
Hara, M, McAdams, HP, Vredenburgh, JJ, Herndon, JE, and Patz, EF. "Thymic hyperplasia after high-dose chemotherapy and autologous stem cell transplantation: incidence and significance in patients with breast cancer." AJR Am J Roentgenol 173.5 (November 1999): 1341-1344.
PMID
10541115
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
173
Issue
5
Publish Date
1999
Start Page
1341
End Page
1344
DOI
10.2214/ajr.173.5.10541115

Imaging lung cancer.

Imaging plays an essential role in diagnosing, staging, and following patients with lung cancer. Most tumors are found on chest radiographs, although further evaluation with thoracic computed tomography is performed to stage local disease. Additional radiologic studies, including radionuclide bone scan, brain computed tomography, or magnetic resonance imaging are typically used in select patients in the search for extrathoracic metastases. More recently, whole body positron emission tomography imaging has become an extremely useful tool in evaluating the primary tumor, regional lymph nodes, and distant sites of disease in lung cancer patients. With continued improvements in diagnostic imaging modalities, definition of risk groups, discovery of molecular markers, and development of new therapeutic strategies, improved survival rates should result in the future. This review focuses on the current imaging techniques used to evaluate patients with lung cancer.

Authors
Patz, EF
MLA Citation
Patz, EF. "Imaging lung cancer." Semin Oncol 26.5 Suppl 15 (October 1999): 21-26. (Review)
PMID
10566607
Source
pubmed
Published In
Seminars in Oncology
Volume
26
Issue
5 Suppl 15
Publish Date
1999
Start Page
21
End Page
26

Radiologic findings of bronchogenic carcinoma with pulmonary metastases at presentation.

PURPOSE: To describe the radiologic findings in patients with primary bronchogenic carcinoma and pulmonary metastases at presentation. MATERIALS AND METHODS: A retrospective review of patients with bronchogenic carcinoma who at presentation had pulmonary metastases. RESULTS: Fourteen (52%) men and 13 (48%) women with a mean age of 60 years were identified. Adenocarcinoma was the most common histology (70%). The number of nodules varied, although 78% of patients had greater than 50 nodules. Nodules size ranged from 2 to 30 mm, but 82% of patients had nodules less than 10 mm in diameter. Mediastinal lymphadenopathy was seen in 41% of patients, and pleural disease in 44% of patients. Only 37% had radiologic evidence of extrathoracic disease, with bone metastases (30%) being the most common. CONCLUSION: Multiple pulmonary nodules may be the presenting thoracic manifestation of primary bronchogenic carcinoma, with patterns of metastases and survival rates similar to other stage IV patients.

Authors
Marom, EM; Patz, EF; Swensen, SJ
MLA Citation
Marom, EM, Patz, EF, and Swensen, SJ. "Radiologic findings of bronchogenic carcinoma with pulmonary metastases at presentation." Clin Radiol 54.10 (October 1999): 665-668.
PMID
10541392
Source
pubmed
Published In
Clinical Radiology
Volume
54
Issue
10
Publish Date
1999
Start Page
665
End Page
668

Non-small cell lung cancer: FDG-PET imaging.

Positron emission tomography is a clinically useful imaging modality that complements conventional radiologic studies in the evaluation of focal pulmonary opacities, lung cancer staging, tumor recurrence, treatment response, and prognosis.

Authors
Erasmus, JJ; McAdams, HP; Patz, EF
MLA Citation
Erasmus, JJ, McAdams, HP, and Patz, EF. "Non-small cell lung cancer: FDG-PET imaging." J Thorac Imaging 14.4 (October 1999): 247-256. (Review)
PMID
10524805
Source
pubmed
Published In
Journal of Thoracic Imaging
Volume
14
Issue
4
Publish Date
1999
Start Page
247
End Page
256

Imaging lung cancer

Authors
Patz, EF
MLA Citation
Patz, EF. "Imaging lung cancer." SEMINARS IN ONCOLOGY 26.5 (October 1999): 21-26.
Source
wos-lite
Published In
Seminars in Oncology
Volume
26
Issue
5
Publish Date
1999
Start Page
21
End Page
26

Lung cancer, Part 1

Authors
Patz, EF
MLA Citation
Patz, EF. "Lung cancer, Part 1." JOURNAL OF THORACIC IMAGING 14.4 (October 1999): 227-227.
Source
wos-lite
Published In
Journal of Thoracic Imaging
Volume
14
Issue
4
Publish Date
1999
Start Page
227
End Page
227
DOI
10.1097/00005382-199910000-00001

Staging non-small cell lung cancer with whole-body PET.

PURPOSE: To compare the accuracies of whole-body 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) and conventional imaging (thoracic computed tomography [CT], bone scintigraphy, and brain CT or magnetic resonance [MR] imaging) in staging bronchogenic carcinoma. MATERIALS AND METHODS: Within 20 months, 100 patients with newly diagnosed bronchogenic carcinoma underwent whole-body FDG PET and chest CT. Ninety of these patients underwent radionuclide bone scintigraphy, and 70 patients underwent brain CT or MR imaging. For each patient, all examinations were completed within 1 month. A radiologic stage was assigned by using PET and conventional imaging independently and was compared with the pathologic stage. The accuracy, sensitivity, specificity, and negative and positive predictive values were calculated. RESULTS: PET staging was accurate in 83 (83%) patients; conventional imaging staging was accurate in 65 (65%) patients (P < .005). Staging with mediastinal lymph nodes was correct by using PET in 67 (85%) patients and by using CT in 46 (58%) patients (P < .001). Nine (9%) patients had metastases demonstrated by using PET that were not found with conventional imaging, whereas 10 (10%) patients suspected of having metastases because of conventional imaging findings were correctly shown with PET to not have metastases. CONCLUSION: Whole-body PET was more accurate than thoracic CT, bone scintigraphy, and brain CT or MR imaging in staging bronchogenic carcinoma.

Authors
Marom, EM; McAdams, HP; Erasmus, JJ; Goodman, PC; Culhane, DK; Coleman, RE; Herndon, JE; Patz, EF
MLA Citation
Marom, EM, McAdams, HP, Erasmus, JJ, Goodman, PC, Culhane, DK, Coleman, RE, Herndon, JE, and Patz, EF. "Staging non-small cell lung cancer with whole-body PET." Radiology 212.3 (September 1999): 803-809.
PMID
10478250
Source
pubmed
Published In
Radiology
Volume
212
Issue
3
Publish Date
1999
Start Page
803
End Page
809
DOI
10.1148/radiology.212.3.r99se21803

Thoracic manifestations of breast carcinoma: metastatic disease and complications of treatment.

Breast cancer, a common malignancy in women, is a major cause of cancer-related deaths. Metastases to the thorax are common in patients with breast cancer. Metastases can manifest radiographically as pulmonary nodules, lymphangitis carcinomatosa, endobronchial masses, intrathoracic adenopathy, pericardial or myocardial masses and pleural effusions. Additionally, pulmonary abnormalities occur after radiotherapy, chemotherapy and autologous bone marrow transplantation. Knowledge of the various intrathoracic manifestations of metastases and complications of therapy is important in staging and evaluating patients with breast cancer and deciding on the most appropriate treatment.

Authors
Connolly, JE; Erasmus, JJ; Patz, EF
MLA Citation
Connolly, JE, Erasmus, JJ, and Patz, EF. "Thoracic manifestations of breast carcinoma: metastatic disease and complications of treatment." Clin Radiol 54.8 (August 1999): 487-494. (Review)
PMID
10484214
Source
pubmed
Published In
Clinical Radiology
Volume
54
Issue
8
Publish Date
1999
Start Page
487
End Page
494

Positron emission tomography imaging in lung cancer.

Over the past several years, positron emission tomography (PET) has become a clinically useful, noninvasive study which complements conventional imaging (chest radiographs, computed tomography [CT], and magnetic resonance imaging [MRI]) in the evaluation of patients with lung cancer. PET imaging of lung cancer is typically performed with the radiopharmaceutical 18F-2-deoxy-D-glucose (FDG), a d-glucose analog. Increased glucose metabolism by malignant cells results in increased uptake and accumulation of FDG, which serves as the basis for tumor detection. This review will focus on the current applications of FDG-PET in lung cancer patients including evaluation of focal pulmonary abnormalities, staging lung cancer, determining tumor recurrence, and in assessing prognosis.

Authors
Patz, EF; Erasmus, JJ
MLA Citation
Patz, EF, and Erasmus, JJ. "Positron emission tomography imaging in lung cancer." Clin Lung Cancer 1.1 (August 1999): 42-48.
PMID
14725748
Source
pubmed
Published In
Clinical lung cancer
Volume
1
Issue
1
Publish Date
1999
Start Page
42
End Page
48

Treatment of malignant pleural effusions.

Malignant pleural effusions are common in cancer patients with advanced disease. These patients usually present with chest pain, cough, and progressive shortness of breath, all of which may cause significant impairment in quality of life. Therapeutic options include systemic treatment; thoracentesis; or, most commonly, tube drainage and sclerotherapy. These procedures are usually palliative and are performed depending on patients' symptoms, underlying medical conditions, extent of disease, performance status, and prognosis. This review focuses on the diagnosis and treatment of patients with malignant pleural effusions.

Authors
Erasmus, JJ; Patz, EF
MLA Citation
Erasmus, JJ, and Patz, EF. "Treatment of malignant pleural effusions." Curr Opin Pulm Med 5.4 (July 1999): 250-255. (Review)
PMID
10407696
Source
pubmed
Published In
Current Opinion in Pulmonary Medicine
Volume
5
Issue
4
Publish Date
1999
Start Page
250
End Page
255

Lung cancer staging and management: comparison of contrast-enhanced and nonenhanced helical CT of the thorax.

PURPOSE: To determine whether contrast material-enhanced helical computed tomography (CT) of the thorax and upper abdomen changes the tumor stage and management compared with nonenhanced helical CT in patients with newly diagnosed lung cancer. MATERIALS AND METHODS: During 15 months, any patient in whom lung cancer was strongly suspected or newly diagnosed and who was scheduled for thoracic CT was considered eligible for the study. All patients underwent nonenhanced thoracic helical CT from the lung apices through the adrenal glands and then contrast-enhanced thoracic helical CT from the lung apices through the entire liver. Each study was read independently, and the thoracic radiologic stage was determined. Tissue sampling was performed and the final pathologic stage assigned. RESULTS: Ninety-six patients had a final pathologic diagnosis of lung cancer. There was agreement in stage between the nonenhanced and contrast-enhanced examinations in 92 of the 96 patients. In three patients, the tumor stage at nonehanced CT increased at contrast-enhanced CT, from IA to IIA (n = 1), IIB to IV (n = 1), and IIIB to IV (n = 1). In one patient, the tumor stage decreased from IIIB to IIB. There was no substantial change in management of any patient. CONCLUSION: The results suggest that contrast-enhanced thoracic CT through the liver for staging lung cancer rarely changes the tumor stage determined with nonenhanced CT through the adrenal glands and does not substantially influence management decisions.

Authors
Patz, EF; Erasmus, JJ; McAdams, HP; Connolly, JE; Marom, EM; Goodman, PC; Leder, RA; Keogan, MT; Herndon, JE
MLA Citation
Patz, EF, Erasmus, JJ, McAdams, HP, Connolly, JE, Marom, EM, Goodman, PC, Leder, RA, Keogan, MT, and Herndon, JE. "Lung cancer staging and management: comparison of contrast-enhanced and nonenhanced helical CT of the thorax." Radiology 212.1 (July 1999): 56-60.
PMID
10405720
Source
pubmed
Published In
Radiology
Volume
212
Issue
1
Publish Date
1999
Start Page
56
End Page
60
DOI
10.1148/radiology.212.1.r99jl1956

Positron emission tomographic imaging with fluorodeoxyglucose is efficacious in evaluating malignant pulmonary disease - Commentary

Authors
Patz, EF
MLA Citation
Patz, EF. "Positron emission tomographic imaging with fluorodeoxyglucose is efficacious in evaluating malignant pulmonary disease - Commentary." JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 117.4 (April 1999): 726-727.
Source
wos-lite
Published In
Journal of Thoracic and Cardiovascular Surgery
Volume
117
Issue
4
Publish Date
1999
Start Page
726
End Page
727

Multimodality nuclear medicine imaging in three-dimensional radiation treatment planning for lung cancer: challenges and prospects.

The purpose of this study was to determine the utility of quantitative single photon emission computed tomography (SPECT) lung perfusion scans and F-18 fluorodeoxyglucose positron emission computed tomography (PET) during X-ray computed tomography (CT)-based treatment planning for patients with lung cancer. Pre-radiotherapy SPECT (n = 104) and PET (n = 35) images were available to the clinician to assist in radiation field design for patients with bronchogenic cancer. The SPECT and PET scans were registered with anatomic information derived from CT. The information from SPECT and PET provides the treatment planner with functional data not seen with CT. SPECT yields three-dimensional (3D) lung perfusion maps. PET provides 3D metabolic images that assist in tumor localization. The impact of the nuclear medicine images on the treatment planning process was assessed by determining the frequency, type, and extent of changes to plans. Pre-radiotherapy SPECT scans were used to modify 11 (11%) treatment plans; primarily altering beam angles to avoid highly functioning tissue. Fifty (48%) SPECT datasets were judged to be 'potentially useful' due to the detection of hypoperfused regions of the lungs, but were not used during treatment planning. PET data influenced 34% (12 of 35) of the treatment plans examined, and resulted in enlarging portions of the beam aperture (margins) up to 15 mm. Challenges associated with image quality and registration arise when utilizing nuclear medicine data in the treatment planning process. Initial implementation of advanced SPECT image reconstruction techniques that are not typically used in the clinic suggests that the reconstruction method may influence dose response data derived from the SPECT images and improve image registration with CT. The use of nuclear medicine transmission computed tomography (TCT) for both SPECT and PET is presented as a possible tool to reconstruct more accurate emission images and to aid in the registration of emission data with the planning CT. Nuclear medicine imaging techniques appear to be a potentially valuable tool during radiotherapy treatment planning for patients with lung cancer. The utilization of accurate nuclear medicine image reconstruction techniques and TCT may improve the treatment planning process.

Authors
Munley, MT; Marks, LB; Scarfone, C; Sibley, GS; Patz, EF; Turkington, TG; Jaszczak, RJ; Gilland, DR; Anscher, MS; Coleman, RE
MLA Citation
Munley, MT, Marks, LB, Scarfone, C, Sibley, GS, Patz, EF, Turkington, TG, Jaszczak, RJ, Gilland, DR, Anscher, MS, and Coleman, RE. "Multimodality nuclear medicine imaging in three-dimensional radiation treatment planning for lung cancer: challenges and prospects." Lung Cancer 23.2 (February 1999): 105-114.
PMID
10217614
Source
pubmed
Published In
Lung Cancer
Volume
23
Issue
2
Publish Date
1999
Start Page
105
End Page
114

Malignant pleural effusions: treatment with small-bore-catheter thoracostomy and talc pleurodesis.

Thirty-two patients with a known primary malignancy and a symptomatic malignant pleural effusion underwent small-bore-catheter thoracostomy and talc pleurodesis. Twenty-three patients (72%) had a complete response; four (12%), a partial response; and five (16%), no response. Symptoms in all those who responded were clinically improved. Complications included fever in 13 patients (41%) and moderate shortness of breath, chest pain, or both in six (19%). Small-bore-catheter thoracostomy and talc pleurodesis was successful in treating malignant pleural effusions.

Authors
Marom, EM; Patz, EF; Erasmus, JJ; McAdams, HP; Goodman, PC; Herndon, JE
MLA Citation
Marom, EM, Patz, EF, Erasmus, JJ, McAdams, HP, Goodman, PC, and Herndon, JE. "Malignant pleural effusions: treatment with small-bore-catheter thoracostomy and talc pleurodesis." Radiology 210.1 (January 1999): 277-281.
PMID
9885620
Source
pubmed
Published In
Radiology
Volume
210
Issue
1
Publish Date
1999
Start Page
277
End Page
281
DOI
10.1148/radiology.210.1.r99dc04277

Imaging lung cancer

Imaging plays an essential role in diagnosing, staging, and following patients with lung cancer. Most tumors are found on chest radiographs, although further evaluation with thoracic computed tomography is performed to stage local disease. Additional radiologic studies, including radionuclide bone scan, brain computed tomography, or magnetic resonance imaging are typically used in select patients in the search for extrathoracic metastases. More recently, whole body positron emission tomography imaging has become an extremely useful tool in evaluating the primary tumor, regional lymph nodes, and distant sites of disease in lung cancer patients. With continued improvements in diagnostic imaging modalities, definition of risk groups, discovery of molecular markers, and development of new therapeutic strategies, improved survival rates should result in the future. This review focuses on the current imaging techniques used to evaluate patients with lung cancer.

Authors
Jr, PEF
MLA Citation
Jr, PEF. "Imaging lung cancer." Seminars in Oncology 26.5 SUPPL. 15 (1999): 21-26.
Source
scival
Published In
Seminars in Oncology
Volume
26
Issue
5 SUPPL. 15
Publish Date
1999
Start Page
21
End Page
26

Sclerotherapy for malignant pleural effusions

Authors
Patz, E; Adams, HM; Erasmus, J; Goodman, P; Culhane, D; Gilkeson, R; Herndon, J
MLA Citation
Patz, E, Adams, HM, Erasmus, J, Goodman, P, Culhane, D, Gilkeson, R, and Herndon, J. "Sclerotherapy for malignant pleural effusions." Pneumologie 53.1 (1999): 44--.
Source
scival
Published In
Pneumologie
Volume
53
Issue
1
Publish Date
1999
Start Page
44-

Sclerotherapy for malignant pleural effusions

Authors
Patz, E; McAdams, H; Erasmus, J; Goodman, P; Culhane, D; Gilkeson, R; Herndon, J
MLA Citation
Patz, E, McAdams, H, Erasmus, J, Goodman, P, Culhane, D, Gilkeson, R, and Herndon, J. "Sclerotherapy for malignant pleural effusions." Pneumologie 53.2 (1999): 112--.
Source
scival
Published In
Pneumologie
Volume
53
Issue
2
Publish Date
1999
Start Page
112-

Non-small cell lung cancer: FDG-PET imaging

Positron emission tomography is a clinically useful imaging modality that complements conventional radiologic studies in the evaluation of focal pulmonary opacities, lung cancer staging, tumor recurrence, treatment response, and prognosis.

Authors
Erasmus, JJ; McAdams, HP; Jr, EFP
MLA Citation
Erasmus, JJ, McAdams, HP, and Jr, EFP. "Non-small cell lung cancer: FDG-PET imaging." Journal of Thoracic Imaging 14.4 I (1999): 247-256.
Source
scival
Published In
Journal of Thoracic Imaging
Volume
14
Issue
4 I
Publish Date
1999
Start Page
247
End Page
256

PET imaging in the thorax

Positron emission tomography (PET) is an important imaging modality for the evaluation and management of thoracic abnormalities. It provides not only anatomic but physiologic information that supplements conventional radiologic imaging. While PET with 18F-2-deoxy-D-glucose cannot uniformly provide all the requisite information for patient evaluation, it provides a new model and direction for functional imaging.

Authors
Jr, EFP
MLA Citation
Jr, EFP. "PET imaging in the thorax." Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings 2 (1999): 1329--.
Source
scival
Published In
Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings
Volume
2
Publish Date
1999
Start Page
1329-

Lung cancer, Part I: From the guest editor

Authors
Patz, EF
MLA Citation
Patz, EF. "Lung cancer, Part I: From the guest editor." Journal of Thoracic Imaging 14.4 I (1999): 227--.
Source
scival
Published In
Journal of Thoracic Imaging
Volume
14
Issue
4 I
Publish Date
1999
Start Page
227-

Positron emission tomographic imaging with fluorodeoxyglucose is efficacious in evaluating malignant pulmonary disease

Objective: Positron emission tomography (PET), when used with the intravenously administered radiopharmaceutical F-18 fluorodeoxyglucose (FDG), has the potential to help in the evaluation of patients with lung cancer because the radiopharmaceutical is concentrated by metabolically active cells. We conducted a retrospective study of PET-FDG in 96 patients evaluated at our institution over the past 2 years for suspected primary pulmonary neoplasms. PET-FDG results were compared with the findings of computed tomographic scans on the same patients. All patients underwent surgical exploration with or without resection of the malignant tumors. Sites of potential malignancy were subjected to biopsy and/or excision, with subsequent pathologic evaluation. Results: A total of 96 patients with suspected or proven primary pulmonary malignant disease were evaluated. Sixty-six patients had histologically confirmed malignant tumors, and 30 had benign masses histologically. PET-FDG had an accuracy of detecting malignancy in pulmonary lesions of 92% (sensitivity 97%; specificity 89%). A total of 111 surgically sampled sites were from lymph nodes. PET-FDG was accurate in predicting the malignancy of nodes in 91% of instances, whereas computed tomography was correct in 64%. The sensitivity, specificity, and predictive accuracy of PET in detecting metastatic lymphadenopathy in mediastinal lymph nodes were 98%, 94%, and 95%, respectively. PET-FDG also changed the M stage in 8 (12%) patients (6 with and 2 without metastases). The 6 malignant (positive) lesions were correctly identified by PET-FDG, and the 2 without tumor were accurately predicted as benign (negative). Conclusion: These initial results suggest that PET-FDG is highly accurate in identifying and staging lung cancer. PET-FDG also appears to be more-accurate in detecting metastatic mediastinal lymphadenopathy than computed tomographic scan.

Authors
Graeber, GM; Gupta, NC; Murray, GF; Cooper, JD; Grosso, MA; Jr, PEF
MLA Citation
Graeber, GM, Gupta, NC, Murray, GF, Cooper, JD, Grosso, MA, and Jr, PEF. "Positron emission tomographic imaging with fluorodeoxyglucose is efficacious in evaluating malignant pulmonary disease." Journal of Thoracic and Cardiovascular Surgery 117.4 (1999): 719-727.
PMID
10096967
Source
scival
Published In
Journal of Thoracic and Cardiovascular Surgery
Volume
117
Issue
4
Publish Date
1999
Start Page
719
End Page
727

Radiosynthesis and in-vivo evaluation of the pseudopeptide δ-opioid antagonist [125I]-ITIPP(Ψ)

Authors
Collier, TL; Waterhouse, RN; Schiller, PW; Jr, PEF
MLA Citation
Collier, TL, Waterhouse, RN, Schiller, PW, and Jr, PEF. "Radiosynthesis and in-vivo evaluation of the pseudopeptide δ-opioid antagonist [125I]-ITIPP(Ψ)." Journal of Labelled Compounds and Radiopharmaceuticals 42.SUPPL. 1 (1999): S264-S266.
Source
scival
Published In
Journal of Labelled Compounds and Radiopharmaceuticals
Volume
42
Issue
SUPPL. 1
Publish Date
1999
Start Page
S264
End Page
S266

Bronchial anastomotic complications in lung transplant recipients: virtual bronchoscopy for noninvasive assessment.

PURPOSE: To compare the accuracy of virtual bronchoscopy (VB) with that of axial computed tomography (CT) in the assessment of bronchial anastomotic complications in lung transplant recipients. MATERIALS AND METHODS: Twenty-seven bronchial anastomoses in 17 patients were evaluated with helical CT. Axial CT and VB images were evaluated for surface irregularity and the presence, length, and severity of stenosis. Findings were correlated with the results of fiberoptic bronchoscopy (FOB). RESULTS: There were 12 anastomotic stenoses at FOB. Pooled accuracy (among all four readers) of VB and axial CT for diagnosis of clinically relevant stenosis was 97% and 80%, respectively, at the right bronchial anastomoses and 92% and 75%, respectively, at the left bronchial anastomoses. Pooled accuracy of VB and Axial CT for stenosis length was 72% and 62%, respectively, at the right anastomoses and 81% and 69%, respectively, at the left anastomoses. These differences were not statistically significant. Both the VB and axial CT images showed surface irregularities when anastomotic infection (n = 2) or dehiscence (n = 1) was present but resulted in an overdiagnosis of mucosal abnormalities when anastomoses were normal. CONCLUSION: VB was slightly more accurate than axial CT for diagnosis of clinically relevant stenoses at bronchial anastomoses in lung transplant recipients. However, because VB is not 100% accurate and has no role in the diagnosis of infection or dehiscence, it probably will not replace FOB for assessment of bronchial anastomotic complications in this population.

Authors
McAdams, HP; Palmer, SM; Erasmus, JJ; Patz, EF; Connolly, JE; Goodman, PC; Delong, DM; Tapson, VF
MLA Citation
McAdams, HP, Palmer, SM, Erasmus, JJ, Patz, EF, Connolly, JE, Goodman, PC, Delong, DM, and Tapson, VF. "Bronchial anastomotic complications in lung transplant recipients: virtual bronchoscopy for noninvasive assessment." Radiology 209.3 (December 1998): 689-695.
PMID
9844660
Source
pubmed
Published In
Radiology
Volume
209
Issue
3
Publish Date
1998
Start Page
689
End Page
695
DOI
10.1148/radiology.209.3.9844660

Thoracic CT for staging bronchogenic carcinoma: Does IV contrast enhancement change stage and management?

Authors
Patz, EF; Erasmus, JJ; McAdams, HP; Marom, EM; Connolly, JC; Goodman, PC
MLA Citation
Patz, EF, Erasmus, JJ, McAdams, HP, Marom, EM, Connolly, JC, and Goodman, PC. "Thoracic CT for staging bronchogenic carcinoma: Does IV contrast enhancement change stage and management?." RADIOLOGY 209P (November 1998): 376-376.
Source
wos-lite
Published In
Radiology
Volume
209P
Publish Date
1998
Start Page
376
End Page
376

Whole body positron emission tomography for staging bronchogenic carcinoma

Authors
Marom, EM; Patz, EF; Erasmus, JJ; McAdams, HP; Coleman, E; Goodman, PC
MLA Citation
Marom, EM, Patz, EF, Erasmus, JJ, McAdams, HP, Coleman, E, and Goodman, PC. "Whole body positron emission tomography for staging bronchogenic carcinoma." RADIOLOGY 209P (November 1998): 376-376.
Source
wos-lite
Published In
Radiology
Volume
209P
Publish Date
1998
Start Page
376
End Page
376

The prognostic significance of fluorodeoxyglucose positron emission tomography imaging for patients with nonsmall cell lung carcinoma

BACKGROUND. A fundamental property of malignant tumors is increased glucose metabolism, which can be estimated by imaging the glucose analog fluorodeoxyglucose (FDG). The aim of this study was to determine whether FDG uptake in lung carcinoma, as measured on positron emission tomography (PET) imaging in patients with newly diagnosed bronchogenic carcinoma, has prognostic significance. METHODS. A retrospective review of all patients with a new diagnosis of nonsmall cell lung carcinoma and FDG-PET imaging was performed. Stage at presentation, cell type, tumor size, and survival data were recorded. For each patient, a standardized uptake ratio (SUR) was calculated for the primary lesion on PET and was correlated with clinical information to determine prognostic significance. RESULTS. One hundred fifty- five patients, with a mean age of 56 years, were enrolled. One hundred eighteen patients (76%) had lesions with SUR values <10 and had a median survival of 24.6 months (95% confidence interval [CI]: 20.941.1). Thirty- seven patients (24%) had tumor lesions with SUR values > 10 and had a median survival of 11.4 months (95% CI: 9.3-19.4). An SUR >10 correlated with poorer survival (P = 0.0049). Patients with primary lesions >3 cm and an SUR >10 had the worst prognosis, with a median survival of 5.7 months (95% CI: 4.0- 13.1). Multivariate analysis demonstrated than an SUR >10 provided prognostic information independent of the clinical stage and lesion size. CONCLUSIONS. On PET studies of patients with lung carcinoma, FDG uptake within the primary lesion correlates with survival.

Authors
Ahuja, V; Edward Coleman, R; Herndon, J; Patz, EF
MLA Citation
Ahuja, V, Edward Coleman, R, Herndon, J, and Patz, EF. "The prognostic significance of fluorodeoxyglucose positron emission tomography imaging for patients with nonsmall cell lung carcinoma." Cancer 83.5 (September 1, 1998): 918-924.
Source
scopus
Published In
Cancer
Volume
83
Issue
5
Publish Date
1998
Start Page
918
End Page
924
DOI
10.1002/(SICI)1097-0142(19980901)83:5<918::AID-CNCR17>3.0.CO;2-Y

The prognostic significance of fluorodeoxyglucose positron emission tomography imaging for patients with nonsmall cell lung carcinoma.

BACKGROUND: A fundamental property of malignant tumors is increased glucose metabolism, which can be estimated by imaging the glucose analog fluorodeoxyglucose (FDG). The aim of this study was to determine whether FDG uptake in lung carcinoma, as measured on positron emission tomography (PET) imaging in patients with newly diagnosed bronchogenic carcinoma, has prognostic significance. METHODS: A retrospective review of all patients with a new diagnosis of nonsmall cell lung carcinoma and FDG-PET imaging was performed. Stage at presentation, cell type, tumor size, and survival data were recorded. For each patient, a standardized uptake ratio (SUR) was calculated for the primary lesion on PET and was correlated with clinical information to determine prognostic significance. RESULTS: One hundred fifty-five patients, with a mean age of 56 years, were enrolled. One hundred eighteen patients (76%) had lesions with SUR values <10 and had a median survival of 24.6 months (95% confidence interval [CI]: 20.9-41.1). Thirty-seven patients (24%) had tumor lesions with SUR values >10 and had a median survival of 11.4 months (95% CI: 9.3-19.4). An SUR >10 correlated with poorer survival (P = 0.0049). Patients with primary lesions >3 cm and an SUR > 10 had the worst prognosis, with a median survival of 5.7 months (95% CI: 4.0-13.1). Multivariate analysis demonstrated than an SUR > 10 provided prognostic information independent of the clinical stage and lesion size. CONCLUSIONS: On PET studies of patients with lung carcinoma, FDG uptake within the primary lesion correlates with survival.

Authors
Ahuja, V; Coleman, RE; Herndon, J; Patz, EF
MLA Citation
Ahuja, V, Coleman, RE, Herndon, J, and Patz, EF. "The prognostic significance of fluorodeoxyglucose positron emission tomography imaging for patients with nonsmall cell lung carcinoma." Cancer 83.5 (September 1, 1998): 918-924.
PMID
9731895
Source
pubmed
Published In
Cancer
Volume
83
Issue
5
Publish Date
1998
Start Page
918
End Page
924

Imaging of mediastinal lymph nodes: CT, MR, and FDG PET.

The evaluation of mediastinal lymph nodes is an important aspect of staging in patients with non-small cell lung cancer. Anatomic imaging of lymph nodes with computed tomography (CT) and magnetic resonance (MR) imaging has been limited by the relatively low sensitivity and specificity of these techniques. Advances in physiologic imaging of mediastinal lymph nodes with 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) have resulted in improved diagnostic accuracy in the determination of nodal status. Despite the limitations of CT, this technique still plays an important role by aiding in the selection of the most appropriate procedure for staging, by guiding biopsy, and by providing anatomic information for visual correlation with FDG PET images. At present, anatomic MR imaging of lymph nodes is primarily a problem-solving tool for cases with inconclusive CT results. Physiologic MR imaging with iron oxide is an exciting area of investigation, and the accuracy of this technique is being assessed in clinical trials. Anatomic and physiologic imaging techniques should be considered complementary rather than competitive imaging strategies.

Authors
Boiselle, PM; Patz, EF; Vining, DJ; Weissleder, R; Shepard, JA; McLoud, TC
MLA Citation
Boiselle, PM, Patz, EF, Vining, DJ, Weissleder, R, Shepard, JA, and McLoud, TC. "Imaging of mediastinal lymph nodes: CT, MR, and FDG PET." Radiographics 18.5 (September 1998): 1061-1069. (Review)
PMID
9747607
Source
pubmed
Published In
Radiographics : a review publication of the Radiological Society of North America, Inc
Volume
18
Issue
5
Publish Date
1998
Start Page
1061
End Page
1069
DOI
10.1148/radiographics.18.5.9747607

Evaluation of patients with round atelectasis using 2-[18F]-fluoro-2-deoxy-D-glucose PET.

PURPOSE: Our goal was to determine the spectrum of 2-[18F]fluoro-2-deoxy-D-glucose (FDG) PET findings in patients with round atelectasis (RA). METHOD: All patients from 1992 to 1997 with radiologic features of RA and FDG-PET scans were evaluated. There were nine men ranging in age from 52 to 75 years (mean 65 years). All had chest radiographs and CT scans that were correlated with FDG-PET. FDG-PET was considered positive if lesion activity was greater than mediastinal activity and negative if lesion activity was the same as or less than mediastinal activity. RESULTS: Nine patients had 10 lesions, ranging in size from 1.2 to 5.0 cm (mean 3.1 cm). Lesion locations were right lower lobe (n = 5), left lower lobe (n = 4), and lingula (n = 1). All lesions were homogeneous and of soft tissue attenuation on CT. None contained air bronchograms or calcification. All had in-curving vessels and bronchi (comet tail sign), adjacent pleural thickening, and volume loss on CT. All lesions were negative on FDG-PET. Four lesions were percutaneously biopsied and showed chronic inflammation consistent with RA. Two lesions were unchanged on 2 and 3 year follow-up CT and were presumed to be RA as were four other lesions with characteristic CT features and negative FDG-PET. CONCLUSION: Our experience suggest that RA in not metabolically active on FDG-PET imaging. Thus, FDG-PET scans can play a role in differentiating RA from malignancy when there are few or atypical features of RA on chest radiographs and CT.

Authors
McAdams, HP; Erasums, JJ; Patz, EF; Goodman, PC; Coleman, RE
MLA Citation
McAdams, HP, Erasums, JJ, Patz, EF, Goodman, PC, and Coleman, RE. "Evaluation of patients with round atelectasis using 2-[18F]-fluoro-2-deoxy-D-glucose PET." J Comput Assist Tomogr 22.4 (July 1998): 601-604.
PMID
9676452
Source
pubmed
Published In
Journal of Computer Assisted Tomography
Volume
22
Issue
4
Publish Date
1998
Start Page
601
End Page
604

Molecular characterization of the human delta opioid receptor in lung cancer.

A variety of neuropeptide receptors have been detected in human lung cancer. They are thought to play a role in autocrine/paracrine regulation of cell growth, and may be clinically useful as diagnostic, prognostic or therapeutic targets. The current study characterizes the molecular structure of the delta opioid receptor and its gene expression level in lung cancer cell lines relative to normal human lung using a sensitive RT-PCR approach. The goals of this investigation were a) to define the correlation between receptor binding and gene expression in lung cancer cell lines, and b) to determine the cDNA sequence integrity of this receptor in comparison to the receptor recently found in human brain. Five small cell lung cancer (SCLC) cell lines revealed size-matched RT-PCR products which strongly hybridized to the human brain delta opioid receptor probe. One of three non-small cell lung cancer (NSCLC) cell lines (NCI-H23), known to be negative by binding analysis, demonstrated low level expression. No gene expression was found in normal human lung. RT-PCR products from two SCLC cell lines (SCLC-22H and 16HC) as well as the low level expressing NSCLC cell line (NCI-23) were subjected to bidirectional DNA sequence analysis and the receptor ends were resolved using a 3'-end RACE and 5'-end gene-specific approach. The isolated cDNA sequences proved to be identical to the published human brain delta opioid receptor sequence. These data show that lung cancers with neuroendocrine features express human brain delta opioid receptors in contrast to normal lung, and that the delta opioid receptor mRNA in lung cancer is not mutated. This unique feature of lung cancer may be exploitable for diagnostic, prognostic, and therapeutic strategies.

Authors
Schreiber, G; Campa, MJ; Prabhakar, S; O'Briant, K; Bepler, G; Patz, EF
MLA Citation
Schreiber, G, Campa, MJ, Prabhakar, S, O'Briant, K, Bepler, G, and Patz, EF. "Molecular characterization of the human delta opioid receptor in lung cancer." Anticancer Res 18.3A (May 1998): 1787-1792.
PMID
9673405
Source
pubmed
Published In
Anticancer research
Volume
18
Issue
3A
Publish Date
1998
Start Page
1787
End Page
1792

Cytologically proved malignant pleural effusions: distribution of transudates and exudates.

PURPOSE: This study attempts to determine the distribution of transudates vs exudates in pathologically proved malignant pleural effusions and the necessity for cytologic studies in patients with a transudative effusion. MATERIALS AND METHODS: A retrospective review of all cytologically positive malignant pleural effusions was performed at Duke University Medical Center over an 18-month period. All effusions were characterized as a transudate or an exudate based on standard criteria, including lactate dehydrogenase and protein values. RESULTS: Ninety-eight patients with a mean age of 62 years were identified as having a cytologically positive malignant pleural effusion and blood chemistry values available to distinguish an exudate from transudate. Ninety-seven patients (99%, 95% confidence interval; 0.94 to 0.99) had criteria for an exudative effusion. One patient (1%) with diffuse metastatic lung cancer had a borderline transudate and was in congestive heart failure at the time of thoracentesis. CONCLUSIONS: Cytologically positive pleural effusions for malignancy are almost always exudates. Cytologic evaluation for malignant cells of a transudative pleural effusion is not recommended.

Authors
Assi, Z; Caruso, JL; Herndon, J; Patz, EF
MLA Citation
Assi, Z, Caruso, JL, Herndon, J, and Patz, EF. "Cytologically proved malignant pleural effusions: distribution of transudates and exudates." Chest 113.5 (May 1998): 1302-1304.
PMID
9596310
Source
pubmed
Published In
Chest
Volume
113
Issue
5
Publish Date
1998
Start Page
1302
End Page
1304

Evaluation of primary pulmonary carcinoid tumors using FDG PET.

OBJECTIVE: The purpose of this study was to determine the spectrum of positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) findings in patients who have primary pulmonary carcinoid tumors. CONCLUSION: On FDG PET imaging, pulmonary carcinoid tumors usually have lower FDG uptake than expected for malignant tumors. Biopsy or close radiologic follow-up is therefore recommended for solitary pulmonary nodules that are clinically suspected of being carcinoid tumors and that do not show increased metabolic activity on FDG PET images.

Authors
Erasmus, JJ; McAdams, HP; Patz, EF; Coleman, RE; Ahuja, V; Goodman, PC
MLA Citation
Erasmus, JJ, McAdams, HP, Patz, EF, Coleman, RE, Ahuja, V, and Goodman, PC. "Evaluation of primary pulmonary carcinoid tumors using FDG PET." AJR Am J Roentgenol 170.5 (May 1998): 1369-1373.
PMID
9574618
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
170
Issue
5
Publish Date
1998
Start Page
1369
End Page
1373
DOI
10.2214/ajr.170.5.9574618

Sclerotherapy for malignant pleural effusions: a prospective randomized trial of bleomycin vs doxycycline with small-bore catheter drainage.

BACKGROUND: Malignant pleural effusions are a common problem for patients with metastatic disease. Most patients are treated with tube thoracostomy and sclerotherapy, although there remains no standard approach. The purpose of this study was to compare the efficacy of bleomycin with doxycycline sclerotherapy for the treatment of malignant pleural effusions using small-bore catheters. METHODS: All patients with a symptomatic malignant pleural effusion referred for chest tube drainage and sclerotherapy over a 2-year period were considered eligible. Using image guidance, a 14F self-retaining catheter was inserted into the pleural space and connected to continuous wall suction. When drainage fell below 200 mL/d, patients were randomized to 60 U of bleomycin or 500 mg of doxycycline sclerotherapy. Response at 30 days was determined. RESULTS: One hundred six patients were enrolled in the study. Fifteen men (29%) and 37 women (71%) with a mean age of 57 years received bleomycin sclerotherapy. Twenty-one of the 29 patients (72%) alive and evaluable at 30 days had successful sclerotherapy. Twenty-three men (43%) and 31 women (57%) with a mean age of 61 years received doxycycline sclerotherapy. Twenty-three of the 29 patients (79%) alive and evaluable at 30 days had successful sclerotherapy. There was no significant difference in response rates between doxycycline and bleomycin (p=0.760). CONCLUSIONS: These data continue to support a role for small-bore chest drainage and sclerotherapy, although there was no significant difference in 30-day response rates between doxycycline and bleomycin.

Authors
Patz, EF; McAdams, HP; Erasmus, JJ; Goodman, PC; Culhane, DK; Gilkeson, RC; Herndon, J
MLA Citation
Patz, EF, McAdams, HP, Erasmus, JJ, Goodman, PC, Culhane, DK, Gilkeson, RC, and Herndon, J. "Sclerotherapy for malignant pleural effusions: a prospective randomized trial of bleomycin vs doxycycline with small-bore catheter drainage." Chest 113.5 (May 1998): 1305-1311.
PMID
9596311
Source
pubmed
Published In
Chest
Volume
113
Issue
5
Publish Date
1998
Start Page
1305
End Page
1311

Pre-clinical SPECT studies to evaluate [I-123]HEPIE as a lung cancer imaging agent.

Authors
Waterhouse, RN; Smith, MF; Greer, KL; Collier, TL; Eberl, S; Towson, J; Birrell, A; Gillin, AG; Bautovich, G; Jaszczak, RJ; Patz, EF
MLA Citation
Waterhouse, RN, Smith, MF, Greer, KL, Collier, TL, Eberl, S, Towson, J, Birrell, A, Gillin, AG, Bautovich, G, Jaszczak, RJ, and Patz, EF. "Pre-clinical SPECT studies to evaluate [I-123]HEPIE as a lung cancer imaging agent." JOURNAL OF NUCLEAR MEDICINE 39.5 (May 1998): 227P-227P.
Source
wos-lite
Published In
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
Volume
39
Issue
5
Publish Date
1998
Start Page
227P
End Page
227P

Percutaneous drainage of pleural collections.

Pneumothorax is a frequent complication of interventional pulmonary procedures. Percutaneous catheter placement enables safe and effective drainage of pneumothoraces with rapid restoration of vital capacity, oxygenation, and lung reexpansion.

Authors
Patz, EF; Goodman, PC; Erasmus, JJ
MLA Citation
Patz, EF, Goodman, PC, and Erasmus, JJ. "Percutaneous drainage of pleural collections." J Thorac Imaging 13.2 (April 1998): 83-92. (Review)
PMID
9556285
Source
pubmed
Published In
Journal of Thoracic Imaging
Volume
13
Issue
2
Publish Date
1998
Start Page
83
End Page
92

Prospective investigation of positron emission tomography in lung nodules.

PURPOSE: Solitary pulmonary nodules (SPNs) are commonly identified by chest radiographs and computed tomography (CT). Biopsies are often performed to evaluate the nodules further. An accurate, noninvasive diagnostic test could avoid the morbidity and costs of invasive tissue sampling. We evaluated the ability of fluorine-18 deoxyglucose positron emission tomography (FDG-PET) to discriminate between benign and malignant pulmonary nodules in a prospective, multicenter trial. METHODS: Eighty-nine patients who had newly identified indeterminate SPNs on chest radiographs and CT were evaluated with FDG-PET. PET data were analyzed semiquantitatively by calculating standardized uptake values (SUVs) as an index of FDG accumulation and also by a visual scoring method. PET results were compared with pathology results. RESULTS: Sixty SPNs were malignant and 29 were benign. Using SUV data, PET had an overall sensitivity and specificity for detection of malignant nodules of 92% and 90%. Visual analysis provided a slightly higher, but not statistically significant, sensitivity of 98% and lower specificity of 69%. For SPNs < or = 1.5 cm (34 of 89), the sensitivity and specificity of SUV and visual analysis were 80% and 95% and 100% and 74%, respectively. CONCLUSION: FDG-PET can accurately characterize indeterminate SPNs. PET imaging provides a noninvasive method to evaluate indeterminate SPNs, which can reduce the need for invasive tissue biopsy.

Authors
Lowe, VJ; Fletcher, JW; Gobar, L; Lawson, M; Kirchner, P; Valk, P; Karis, J; Hubner, K; Delbeke, D; Heiberg, EV; Patz, EF; Coleman, RE
MLA Citation
Lowe, VJ, Fletcher, JW, Gobar, L, Lawson, M, Kirchner, P, Valk, P, Karis, J, Hubner, K, Delbeke, D, Heiberg, EV, Patz, EF, and Coleman, RE. "Prospective investigation of positron emission tomography in lung nodules." J Clin Oncol 16.3 (March 1998): 1075-1084.
PMID
9508193
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
16
Issue
3
Publish Date
1998
Start Page
1075
End Page
1084
DOI
10.1200/JCO.1998.16.3.1075

Thoracic imaging features of patients with antiphospholipid antibodies.

PURPOSE: Our aim was to determine the thoracic manifestations of patients with antiphospholipid antibodies (APAs). METHOD: We performed a retrospective review of the clinical records and thoracic imaging studies of 88 patients (63 women, 25 men; mean age 47 years) with APAs to determine the spectrum of thoracic disease. RESULTS: Nine patients (10%) had thoracic abnormalities, including eight with pulmonary embolism (PE) and one with aortic thrombus. One patient with PE had subclavian vein thrombosis. Coexistent thromboses included deep venous thrombosis of the leg in six patients. CONCLUSION: PE was the most common thoracic abnormality in our patients. The presence of these antibodies should be suspected in patients with PE of otherwise unexplained etiology.

Authors
Gilkeson, RC; Patz, EF; Culhane, D; McAdams, HP; Provenzale, JM
MLA Citation
Gilkeson, RC, Patz, EF, Culhane, D, McAdams, HP, and Provenzale, JM. "Thoracic imaging features of patients with antiphospholipid antibodies." J Comput Assist Tomogr 22.2 (March 1998): 241-244.
PMID
9530387
Source
pubmed
Published In
Journal of Computer Assisted Tomography
Volume
22
Issue
2
Publish Date
1998
Start Page
241
End Page
244

Imaging of the solitary pulmonary nodule

The solitary pulmonary nodule continues to be a common finding on radiographic studies. In order to determine etiology, diagnostic evaluation begins with comparison with old films in an attempt to demonstrate at least 2-year stability. If this cannot be established, then additional studies including computed tomography or positron emission tomography imaging are often performed to distinguish a benign lesion from a malignant one. If a specific benign diagnosis cannot made, management options for radiographically indeterminate nodules include percutaneous biopsy, surgical resection, or observation. Treatment decisions are often complex and depend on a number of factors, including radiographic appearance, presenting symptoms, clinical status, and past medical history.

Authors
Erasmus, JJ; Patz, EF
MLA Citation
Erasmus, JJ, and Patz, EF. "Imaging of the solitary pulmonary nodule." Seminars in Respiratory and Critical Care Medicine 19.5 (January 1, 1998): 483-491. (Review)
Source
scopus
Published In
Seminars in Respiratory and Critical Care Medicine
Volume
19
Issue
5
Publish Date
1998
Start Page
483
End Page
491

Malignant pleural effusions: recent advances and ambulatory sclerotherapy.

Malignant pleural effusions are a common problem in cancer patients with advanced disease. Patients typically present with progressive dyspnea, cough, and/or chest pain that significantly compromises their quality of life. Treatment is often palliative, usually consisting of sequential thoracenteses or tube thoracostomy with or without sclerotherapy. The traditional method of treatment--tube thoracostomy with large-bore chest tubes connected to continuous wall suction--requires hospitalization, is expensive, limits patient mobility, and can cause significant patient discomfort. More recent trials have explored new techniques, including thoracoscopic insufflation of talc and small-bore catheters. Most of these studies have been performed on inpatients, although a recent multi-institutional trial was initiated to evaluate the feasibility and efficacy of ambulatory (outpatient) pleural drainage and sclerotherapy using small-bore catheters. All patients fulfilling eligibility criteria had a small-bore catheter placed in the pleural space that was then connected to a closed gravity drainage bag system. When daily tube drainage was <100 mL, sclerotherapy was performed. Response rates at our institution demonstrated 10 patients (53%) had a complete response, 5 (26%) had a partial response, and 4 (21%) had progressive disease at 30-day follow-up. These preliminary results suggest ambulatory sclerotherapy is a safe, viable alternative to conventional inpatient treatment of malignant pleural effusions in a select group of patients.

Authors
Patz, EF
MLA Citation
Patz, EF. "Malignant pleural effusions: recent advances and ambulatory sclerotherapy." Chest 113.1 Suppl (January 1998): 74S-77S. (Review)
PMID
9438694
Source
pubmed
Published In
Chest
Volume
113
Issue
1 Suppl
Publish Date
1998
Start Page
74S
End Page
77S

Imaging features of nonmyxomatous primary neoplasms of the heart and pericardium.

We present the imaging findings in 13 patients with nonmyxomatous primary neoplasms of the heart and pericardium. Ten patients had abnormal chest films. While echocardiography was useful for determining origin of the tumor, CT (computed tomography) and MRI (magnetic resonance imaging) were better at delineating extent of disease. The radiographic appearance of these rare neoplasms of the heart and pericardium is varied. Cross-sectional imaging plays a crucial role in the surgical planning and management of these patients.

Authors
Smith, DN; Shaffer, K; Patz, EF
MLA Citation
Smith, DN, Shaffer, K, and Patz, EF. "Imaging features of nonmyxomatous primary neoplasms of the heart and pericardium." Clin Imaging 22.1 (January 1998): 15-22.
PMID
9421650
Source
pubmed
Published In
Clinical Imaging
Volume
22
Issue
1
Publish Date
1998
Start Page
15
End Page
22

Thoracic FDG PET: state of the art.

The D-glucose analogue 2-(fluorine-18) fluoro-2-deoxy-D-glucose (FDG) is the most commonly used radionuclide in positron emission tomography (PET) of the thorax. Increased glucose metabolism by malignant cells allows physiologic differentiation between benign and malignant abnormalities. FDG PET is consequently useful in characterizing indeterminate pulmonary nodules and in staging and assessing the response to treatment of lung cancer. FDG PET is accurate in classification of indeterminate pulmonary nodules as benign. Nodules with low FDG uptake are followed up radiographically; nodules with increased FDG uptake should be evaluated with biopsy or resected. In the staging of lung cancer, FDG PET is useful in evaluating local disease and pleural and chest wall involvement. The accuracy of FDG PET in demonstrating intrathoracic metastatic nodal disease is greater than that of computed tomography or magnetic resonance imaging. Whole-body PET is useful in detection of extrathoracic metastases. Conventional imaging often does not allow differentiation of tumor from posttreatment scarring. Increased FDG uptake at the sites of residual radiographic abnormalities is indicative of persistent or recurrent tumor.

Authors
Erasmus, JJ; McAdams, HP; Patz, EF; Goodman, PC; Coleman, RE
MLA Citation
Erasmus, JJ, McAdams, HP, Patz, EF, Goodman, PC, and Coleman, RE. "Thoracic FDG PET: state of the art." Radiographics 18.1 (January 1998): 5-20. (Review)
PMID
9460106
Source
pubmed
Published In
Radiographics : a review publication of the Radiological Society of North America, Inc
Volume
18
Issue
1
Publish Date
1998
Start Page
5
End Page
20
DOI
10.1148/radiographics.18.1.9460106

Malignant pleural effusions - Recent advances and ambulatory sclerotherapy

Authors
Patz, EF
MLA Citation
Patz, EF. "Malignant pleural effusions - Recent advances and ambulatory sclerotherapy." January 1998.
Source
wos-lite
Published In
Chest
Volume
113
Issue
1
Publish Date
1998
Start Page
74S
End Page
77S
DOI
10.1378/chest.113.1_Supplement.74S

Prospective investigation of positron emission tomography in lung nodules

Authors
Lowe, VJ; Fletcher, JW; Gobar, L; Lawson, M; Kirchner, P; Valk, P; Karis, J; Hubner, K; Delbeke, D; Heiberg, EV; al, E
MLA Citation
Lowe, VJ, Fletcher, JW, Gobar, L, Lawson, M, Kirchner, P, Valk, P, Karis, J, Hubner, K, Delbeke, D, Heiberg, EV, and al, E. "Prospective investigation of positron emission tomography in lung nodules." Pneumologie 52.7 (1998): 432--.
Source
scival
Published In
Pneumologie
Volume
52
Issue
7
Publish Date
1998
Start Page
432-

Malignant pleural effusions: Recent advances and ambulatory sclerotherapy

Malignant pleural effusions are a common problem in cancer patients with advanced disease. Patients typically present with progressive dyspnea, cough, and/or chest pain that significantly compromises their quality of life. Treatment is often palliative, usually consisting of sequential thoracenteses or tube thoracostomy with or without sclerotherapy. The traditional method of treatment-tube thoracostomy with large-bore chest tubes connected to continuous wall suction-requires hospitalization, is expensive, limits patient mobility, and can cause significant patient discomfort. More recent trials have explored new techniques, including thoracoscopic insufflation of talc and small-bore catheters. Most of these studies have been performed on inpatients, although a recent multi-institutional trial was initiated to evaluate the feasibility and efficacy of ambulatory (outpatient) pleural drainage and sclerotherapy using small-bore catheters. All patients fulfilling eligibility criteria had a small-bore catheter placed in the pleural space that was then connected to a closed gravity drainage bag system. When daily tube drainage was <100 mL, sclerotherapy was performed. Response rates at our institution demonstrated 10 patients (53%) had a complete response, 5 (26%) had a partial response, and 4 (21%) had progressive disease at 30-day follow-up. These preliminary results suggest ambulatory sclerotherapy is a safe, viable alternative to conventional inpatient treatment of malignant pleural effusions in a select group of patients.

Authors
Jr, EFP
MLA Citation
Jr, EFP. "Malignant pleural effusions: Recent advances and ambulatory sclerotherapy." Chest 113.1 SUPPL. (1998): 74S-77S.
Source
scival
Published In
Chest
Volume
113
Issue
1 SUPPL.
Publish Date
1998
Start Page
74S
End Page
77S

Imaging of the solitary pulmonary nodule

The solitary pulmonary nodule continues to be a common finding on radiographic studies. In order to determine etiology, diagnostic evaluation begins with comparison with old films in an attempt to demonstrate at least 2-year stability. If this cannot be established, then additional studies including computed tomography or positron emission tomography imaging are often performed to distinguish a benign lesion from a malignant one. If a specific benign diagnosis cannot made, management options for radiographically indeterminate nodules include percutaneous biopsy, surgical resection, or observation. Treatment decisions are often complex and depend on a number of factors, including radiographic appearance, presenting symptoms, clinical status, and past medical history.

Authors
Erasmus, JJ; Jr, EFP
MLA Citation
Erasmus, JJ, and Jr, EFP. "Imaging of the solitary pulmonary nodule." Seminars in Respiratory and Critical Care Medicine 19.5 (1998): 483-491.
Source
scival
Published In
Seminars in Respiratory and Critical Care Medicine
Volume
19
Issue
5
Publish Date
1998
Start Page
483
End Page
491

Radioiodinated (+)-4-[(αR)-α-[(2S, 5R)-4-(iodopropen-2-yl)-2,5- dimethyl-1-piperazinyl]-3-hydroxybenzyl]-N, N-diethylbenzamide: A potential ligand for in vitro and in vivo investigations of δ-opioid receptors

(+)-4-[(αR)-α-[(2S, 5R)-4-(Iodopropen-2-yl)-2,5-dimethyl-1- piperazinyl]-3-hydroxybenzyl]-N, N-diethylbenzamide (1), a novel radioiodinated derivative of the selective δ-opioid antagonist (+)-BW373U86, was synthesized and evaluated in vitro for binding to opioid receptor subtypes. This new compound was found to have high affinity (Ki = 0.57 ± 0.10 nM) and good selectivity for delta (δ) opioid receptors over mu (μ) (Ki μ/δ = 13.6) and kappa (κ) (Ki κ/δ = 175) receptors. The corresponding 123I and 125I derivatives were prepared by oxidative radioiododestannylation from a trans-vinyltributyltin precursor. The radiochemical yield was 72-78% EOS (74.3 ± 2.6%, n = 3) for 125I-1 and 40-62% EOS (53.9 ± 9.8%, n = 3) for 123I-1. The specific activities were 200-300 mCi/μmol and >5,000 mCi/μmol for the 125I and 123I-labeled tracers, respectively.

Authors
Waterhouse, RN; Campa, MJ; Park, J; Jr, EFP
MLA Citation
Waterhouse, RN, Campa, MJ, Park, J, and Jr, EFP. "Radioiodinated (+)-4-[(αR)-α-[(2S, 5R)-4-(iodopropen-2-yl)-2,5- dimethyl-1-piperazinyl]-3-hydroxybenzyl]-N, N-diethylbenzamide: A potential ligand for in vitro and in vivo investigations of δ-opioid receptors." Journal of Labelled Compounds and Radiopharmaceuticals 41.9 (1998): 801-810.
Source
scival
Published In
Journal of Labelled Compounds and Radiopharmaceuticals
Volume
41
Issue
9
Publish Date
1998
Start Page
801
End Page
810
DOI
10.1002/(SICI)1099-1344(1998090)41:9<801::AID-JLCR130>3.0.CO;2-C

Molecular characterization of the human δ opioid receptor in lung cancer

A variety of neuropeptide receptors have been detected in human lung cancer. They are thought to play a role in autocrin/paracrine regulation of cell growth, and may be clinically useful a diagnostic, prognostic or therapeutic targets. The current study characterizes the molecular structure of the δ opioid receptor and its gene expression level in lung cancer cell lines relative to normal human lung using a sensitive RT-PCR approach. The goals of this investigation were a) to define the correlation between receptor binding and gene expression in lung cancer cell lines, and b) to determine the cDNA sequence integrity of this receptor in comparison the the receptor recently found in human brain. Five small cell lung cancer (SCLC) cell lines revealed size-matched RT-PCR products which strongly hybridized to the human brain δ opioid receptor probe. One of three non-small cell lung cancer (NSCLC) cell lines (NCI-H23), known to be negative by binding analysis, demonstrated low level expression. No gene expression was found in normal human lung. RT-PCR products from two level expressing NSCLC cell line (NCI-23) were subjected to bidirectional DNA sequence analysis and the receptor ends were resolved using a 3'-end RACE and 5'-end gene-specific approach. The isolated cDNA sequences proved to be identical to the published human brain δ opioid receptor sequence. These data show that lung cancers with neuroendocrine features express human brain δ opioid receptors in contrast to normal lung, and that the δ opioid receptor mRNA in lung cancer is not mutated. This unique feature of lung cancer may be exploitable for diagnostic, prognostic, and therapeutic strategies.

Authors
Schreiber, G; Campa, MJ; Prabhakar, S; O'Briant, K; Bepler, G; Jr, EFP
MLA Citation
Schreiber, G, Campa, MJ, Prabhakar, S, O'Briant, K, Bepler, G, and Jr, EFP. "Molecular characterization of the human δ opioid receptor in lung cancer." Anticancer Research 18.3 A (1998): 1787-1792.
Source
scival
Published In
Anticancer research
Volume
18
Issue
3 A
Publish Date
1998
Start Page
1787
End Page
1792

CT appearance of the pleural space after talc pleurodesis.

OBJECTIVE: This study describes the CT appearance of the pleural space after talc pleurodesis. CONCLUSION: After talc pleurodesis, the pleural space reveals variable degrees of pleural thickening and nodularity, often with a residual loculated effusion. High-attenuation areas representing talc deposits are expected and should not be confused with other pleural abnormalities.

Authors
Murray, JG; Patz, EF; Erasmus, JJ; Gilkeson, RC
MLA Citation
Murray, JG, Patz, EF, Erasmus, JJ, and Gilkeson, RC. "CT appearance of the pleural space after talc pleurodesis." AJR Am J Roentgenol 169.1 (July 1997): 89-91.
PMID
9207506
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
169
Issue
1
Publish Date
1997
Start Page
89
End Page
91
DOI
10.2214/ajr.169.1.9207506

Pulmonary mucormycosis: radiologic findings in 32 cases.

OBJECTIVE: The purpose of this study was to characterize the radiologic manifestations of pulmonary mucormycosis with clinical and pathologic correlation. MATERIALS AND METHODS: Clinical records, pathology reports, chest radiographs, and CT scans of 32 cases of pathologically proven pulmonary mucormycosis were retrospectively reviewed. RESULTS: The study group included 20 males and 12 females with a mean age of 47 years old. Clinical data were available for 29 patients. Signs and symptoms included fever (n = 23), cough (n = 21), bloody sputum (n = 9), dyspnea (n = 7), and chest pain (n = 6). Four patients were asymptomatic. Most patients were either immunocompromised (n = 20) or had diabetes mellitus (n = 9). Sputum or bronchoalveolar lavage cultures showed no growth in 17 of 18 cases. Diagnoses were confirmed at surgery or autopsy in all cases. Abnormalities seen on chest radiographs included lobar (n = 15) or multilobar (n = 6) consolidation, solitary (n = 7) or multiple (n = 1) masses, and solitary (n = 3) or multiple (n = 2) nodules. Cavitation was seen on chest radiographs in 13 patients, and intracavitary masses were seen in four. Associated radiographic findings included hilar (n = 3) or mediastinal (n = 3) adenopathy and unilateral (n = 6) or bilateral (n = 3) pleural effusion. CT in 19 patients revealed these significant additional findings: splenic (n = 1) or renal (n = 1) involvement, bronchial occlusion (n = 1), extrapulmonary invasion (n = 1), and pulmonary artery pseudoaneurysm (n = 1). CONCLUSION: In our study, pulmonary mucormycosis typically was manifested in immunocompromised or diabetic patients by consolidation on chest radiographs; cavitation was seen in 40% of patients. CT revealed significant unsuspected abnormalities in 26% of patients. Definitive diagnosis required pathologic demonstration of the organism in affected tissue because cultures from our patients rarely showed growth.

Authors
McAdams, HP; Rosado de Christenson, M; Strollo, DC; Patz, EF
MLA Citation
McAdams, HP, Rosado de Christenson, M, Strollo, DC, and Patz, EF. "Pulmonary mucormycosis: radiologic findings in 32 cases." AJR Am J Roentgenol 168.6 (June 1997): 1541-1548.
PMID
9168721
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
168
Issue
6
Publish Date
1997
Start Page
1541
End Page
1548
DOI
10.2214/ajr.168.6.9168721

Evaluation of adrenal masses in patients with bronchogenic carcinoma using 18F-fluorodeoxyglucose positron emission tomography.

OBJECTIVE: The purpose of this study was to assess the usefulness of positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) when differentiating benign from metastatic adrenal masses in patients with bronchogenic carcinoma. SUBJECTS AND METHODS: For our prospective study, any patient presenting to our institution with pathologically proven bronchogenic carcinoma and an adrenal mass was eligible. Thirty-three adrenal masses (mean size, 3 cm; range, 1-9 cm) in 27 patients were revealed by CT. PET was performed in all 27 patients and interpreted as positive when FDG uptake in the adrenal mass was greater than background activity or negative when FDG uptake in the adrenal mass was equal to or less than background activity. In addition, semiquantitative analysis was performed by computing a standardized uptake ratio. All studies were reviewed independently by three radiologists and then correlated with biopsy and CT findings. Specificity and sensitivity for determining metastatic disease to the adrenal gland were calculated. RESULTS: FDG uptake was positive (abnormally increased) in 25 adrenal masses. Twenty-three (92%) of the 25 masses were metastatic disease. The mean standardized uptake ratio of these was 6.28 (range, 3.22-14.41). The remaining two masses (8%) that had positive FDG uptake showed no tumor at percutaneous biopsy. The standardized uptake ratio values for these two masses were 3.0 and 3.7. FDG uptake was negative (normal) in eight adrenal masses. All these lesions were benign as proven by biopsy (n = 2) and CT attenuation values of less than 10 H (n = 6). The mean standardized uptake ratio value for these eight lesions classified as benign was 1.77 (range, 0.93-3.70). The sensitivity for detecting metastatic disease was 100%, and the specificity was 80%. CONCLUSION: PET with FDG is an accurate, noninvasive way to differentiate benign from metastatic adrenal masses in patients with bronchogenic carcinoma.

Authors
Erasmus, JJ; Patz, EF; McAdams, HP; Murray, JG; Herndon, J; Coleman, RE; Goodman, PC
MLA Citation
Erasmus, JJ, Patz, EF, McAdams, HP, Murray, JG, Herndon, J, Coleman, RE, and Goodman, PC. "Evaluation of adrenal masses in patients with bronchogenic carcinoma using 18F-fluorodeoxyglucose positron emission tomography." AJR Am J Roentgenol 168.5 (May 1997): 1357-1360.
PMID
9129444
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
168
Issue
5
Publish Date
1997
Start Page
1357
End Page
1360
DOI
10.2214/ajr.168.5.9129444

Pulmonary abnormalities and PET data analysis: a retrospective study.

PURPOSE: To assess methods of standard uptake ratio (SUR) calculation with 2-deoxy-2-[fluorine-18]fluoro-D-glucose (FDG) positron emission tomography (PET) in indeterminate focal pulmonary abnormalities. MATERIALS AND METHODS: One hundred ninety-seven adult patients with indeterminate pulmonary abnormalities had complete FDG PET data, consistent methods of data acquisition, and definitive diagnosis with tissue biopsy or negative 2-year follow-up findings. PET studies were evaluated by using SURs calculated with the average or maximum region-of-interest pixel value in the numerator and with weight, lean body mass, or body surface area in the denominator. RESULTS: One hundred twenty malignant lesions and 77 benign processes were identified. Receiver operating characteristic (ROC) curve areas were statistically significantly larger with the average rather than the maximum pixel value in the calculation of the SUR for any of the three denominators (P < or = .05). SURs calculated with weight versus lean body mass versus body surface area in the denominator showed no statistically significant difference in ROC curve areas. CONCLUSION: SURs determined by using average pixel values provide statistically significant improvement in ROC curve areas over those determined by using maximum pixel values. Weight, lean body mass, and body surface area in the denominator of the SUR calculation provide equivalent ROC curve areas and are therefore equivalent in accuracy in this population.

Authors
Lowe, VJ; Duhaylongsod, FG; Patz, EF; Delong, DM; Hoffman, JM; Wolfe, WG; Coleman, RE
MLA Citation
Lowe, VJ, Duhaylongsod, FG, Patz, EF, Delong, DM, Hoffman, JM, Wolfe, WG, and Coleman, RE. "Pulmonary abnormalities and PET data analysis: a retrospective study." Radiology 202.2 (February 1997): 435-439.
PMID
9015070
Source
pubmed
Published In
Radiology
Volume
202
Issue
2
Publish Date
1997
Start Page
435
End Page
439
DOI
10.1148/radiology.202.2.9015070

Diffuse nodular lung disease on chest radiographs: a pilot study of characterization by fractal dimension.

OBJECTIVE: We present a computer-aided diagnostic technique for identifying nodular interstitial lung disease on chest radiographs. The fractal dimension was used as a numerical measure of image texture on digital chest radiographs to distinguish patients with normal lung from those with a diffuse nodular interstitial abnormality. MATERIALS AND METHODS: Twenty digitized chest radiographs were classified as normal (n = 10) or as containing diffuse nodular abnormality (n = 10) on the basis of readings assigned according to the classification of the International Labour Organization. Regions of interest (ROIs) measuring 1.28 cm2 were selected from the intercostal spaces of these radiographs. The fractal dimension of these ROIs was estimated by power spectrum analysis. The cases were not subtle. RESULTS: The fractal dimension provided statistically significant discrimination between normal parenchyma and nodular interstitial lung disease. The area under the receiver operating characteristic curve was 0.90 (+/- 0.02). One operating point provides sensitivity of 88% with a specificity of 80%. CONCLUSION: The fractal dimension can provide a measure of lung parenchymal texture and shows promise as an element of computer-aided diagnosis, characterization, and follow-up of interstitial lung disease.

Authors
Floyd, CE; Patz, EF; Lo, JY; Vittitoe, NF; Stambaugh, LE
MLA Citation
Floyd, CE, Patz, EF, Lo, JY, Vittitoe, NF, and Stambaugh, LE. "Diffuse nodular lung disease on chest radiographs: a pilot study of characterization by fractal dimension." AJR Am J Roentgenol 167.5 (November 1996): 1185-1187.
PMID
8911177
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
167
Issue
5
Publish Date
1996
Start Page
1185
End Page
1187
DOI
10.2214/ajr.167.5.8911177

State-of-the-art imaging of pulmonary embolic disease

Authors
Davey, NC; Davey, IC; McDermott, VG; Smith, TP; Patz, EF; Erasmus, JJ
MLA Citation
Davey, NC, Davey, IC, McDermott, VG, Smith, TP, Patz, EF, and Erasmus, JJ. "State-of-the-art imaging of pulmonary embolic disease." RADIOLOGY 201 (November 1996): 373-373.
Source
wos-lite
Published In
Radiology
Volume
201
Publish Date
1996
Start Page
373
End Page
373

Thoracic FDG PET: State of the art

Authors
Erasmus, JJ; McAdams, HP; Patz, EF; Goodman, PC; Coleman, RE
MLA Citation
Erasmus, JJ, McAdams, HP, Patz, EF, Goodman, PC, and Coleman, RE. "Thoracic FDG PET: State of the art." RADIOLOGY 201 (November 1996): 332-332.
Source
wos-lite
Published In
Radiology
Volume
201
Publish Date
1996
Start Page
332
End Page
332

Pulmonary venoocclusive disease: CT findings in eight patients.

OBJECTIVE: The objective of the study was to describe the CT findings of pulmonary venoocclusive disease. MATERIALS AND METHODS: Eight patients with CT scans of the thorax and a diagnosis of pulmonary venoocclusive disease were identified from three institutions. The six males and two females had a mean age of 32 years old (range, 5-58 years old). All scans were evaluated with consensus reading by two chest radiologists. Lung parenchyma were assessed for the type and distribution of disease. Bronchi, pleura, hila, mediastina, and chest walls were evaluated for abnormalities. Pathologic specimens from five patients were reviewed and specifically correlated with the radiologic findings. RESULTS: Seven of the eight patients had interlobular septal thickening. All eight patients had regions of ground-glass opacity. Four of the eight patients had a mosaic pattern of lung attenuation. No enlarged hilar or mediastinal nodes were revealed. Five patients had bilateral pleural effusions. CONCLUSION: The most common CT findings in these eight patients with pulmonary venoocclusive disease were smooth interlobular septal thickening, diffuse multifocal regions of ground-glass opacity, pleural effusions, enlarged central pulmonary arteries, and pulmonary veins of normal caliber. Four patients had a mosaic pattern of lung attenuation on the CT scans. These findings are highly suggestive of pulmonary venoocclusive disease and may be helpful in difficult cases. Definitive diagnosis requires lung biopsy.

Authors
Swensen, SJ; Tashjian, JH; Myers, JL; Engeler, CE; Patz, EF; Edwards, WD; Douglas, WW
MLA Citation
Swensen, SJ, Tashjian, JH, Myers, JL, Engeler, CE, Patz, EF, Edwards, WD, and Douglas, WW. "Pulmonary venoocclusive disease: CT findings in eight patients." AJR Am J Roentgenol 167.4 (October 1996): 937-940.
PMID
8819387
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
167
Issue
4
Publish Date
1996
Start Page
937
End Page
940
DOI
10.2214/ajr.167.4.8819387

Calcifying fibrous pseudotumor of pleura: radiologic features in three cases.

PURPOSE: Our goal was to describe the radiologic features of calcifying fibrous pseudotumor (CEPT) of pleura. METHOD: Chest radiographs and CT images of three patients, aged 23-34 years, with pathologically proven CFPT of pleura were reviewed with regard to lesion size, location, and appearance. RESULTS: Chest radiographs showed well marginated, noncalcified pleural masses in all cases. Two patients had solitary masses and one had multifocal ipsilateral masses. All masses were located in the inferior aspect of the chest and measured 3-12 cm. All masses were calcified on CT. The calcifications were thick and band-like in two cases and punctate in one. There was no chest wall invasion, pleural effusion, or parenchymal disease. CONCLUSION: CFPTs of pleura are rare lesions that manifest as calcified pleural masses in young adults.

Authors
Erasmus, JJ; McAdams, HP; Patz, EF; Murray, JG; Pinkard, NB
MLA Citation
Erasmus, JJ, McAdams, HP, Patz, EF, Murray, JG, and Pinkard, NB. "Calcifying fibrous pseudotumor of pleura: radiologic features in three cases." J Comput Assist Tomogr 20.5 (September 1996): 763-765.
PMID
8797908
Source
pubmed
Published In
Journal of Computer Assisted Tomography
Volume
20
Issue
5
Publish Date
1996
Start Page
763
End Page
765

Binding of [3H](+)-BW373U86 to delta-opioid receptors in rat brain membranes.

A tritiated form of the non-peptide delta-opioid receptor agonist (+)-BW373U86 ((+)-4-((alpha-R)-alpha-((2S,5R)-4-allyl-2, 5-dimethyl-l-piperazinyl)-3-hydroxybenzyl)-N,N-diethylbenzamide) was synthesized and its binding characteristics studied. [3H](+)-BW373U86 bound with subnanomolar affinity to rat brain membranes and was displaced most effectively by ligands selective for delta-opioid receptors. Naltrindole, naltriben, and 7-benzylidenenaltrexone exhibited apparent inhibition constants of 0.06, 1.54, and 4.49 nM, respectively, while mu- or kappa-selective ligands showed little affinity for this site. [3H](+)-BW373U86 binding was sensitive to the presence of guanine nucleotides; GDP caused a 3-fold decrease and 5'-guanylyl-imidodiphosphate (Gpp[NH]p) caused a 25% increase in binding affinity.

Authors
Campa, MJ; McNutt, RW; Hill, JA; Patz, EF; Chang, KJ
MLA Citation
Campa, MJ, McNutt, RW, Hill, JA, Patz, EF, and Chang, KJ. "Binding of [3H](+)-BW373U86 to delta-opioid receptors in rat brain membranes." Eur J Pharmacol 310.2-3 (August 29, 1996): 263-267.
PMID
8884225
Source
pubmed
Published In
European Journal of Pharmacology
Volume
310
Issue
2-3
Publish Date
1996
Start Page
263
End Page
267

Positron emission tomography in the pretreatment evaluation and follow-up of non-small cell lung cancer patients treated with radiotherapy: preliminary findings.

The purpose of this study was to prospectively evaluate positron emission tomography (PET) for delineating lung cancers preradiotherapy and to assess PET's ability to distinguish residual tumor from scarring following radiotherapy. Between April 1991 and October 1992, 20 patients underwent 18fluoro-2-deoxyglucose (18FDG) PET scanning of the chest prior to radiotherapy for lung cancer. Tumor volumes on chest x-ray (CXR) and computerized tomography (CT) scan were correlated with abnormalities on PET scans. Follow-up PET studies were compared to postradiotherapy chest x-ray and/or CT scans, and correlated with clinical outcome. Six of seven well-demarcated tumors showed increased uptake of 18FDG correlating with the CT/CXR tumor volume. Twelve poorly demarcated tumors demonstrated increased 18FDG uptake. In seven of 12, the CT/CXR abnormality correlated with changes on PET scan. In three of 12, CT/CXR abnormalities were larger than on PET, whereas in two of 12, abnormalities on PET extended outside the region of CT/CXR changes. The 13th patient in the poorly demarcated category had diffuse carcinoma in situ at the surgical margin that demonstrates increased 18FDG uptake, but was not visible by CT/CXR. Of 12 patients with follow-up studies, all had changes on CXR and/or CT that made it difficult to assess response. Four of 12 had a complete response by PET; all remain locally controlled. The remaining eight patients had either a partial response (n = 6) or no response (n = 2) by PET. Four of these eight patients remain alive and well 11-24 months after therapy. 18FDG PET may be useful for delineation of lung cancer volumes that are poorly defined by CXR and/or CT scan. The value of PET in differentiating tumor from fibrosis after radiotherapy for lung cancer remains to be established.

Authors
Hebert, ME; Lowe, VJ; Hoffman, JM; Patz, EF; Anscher, MS
MLA Citation
Hebert, ME, Lowe, VJ, Hoffman, JM, Patz, EF, and Anscher, MS. "Positron emission tomography in the pretreatment evaluation and follow-up of non-small cell lung cancer patients treated with radiotherapy: preliminary findings." Am J Clin Oncol 19.4 (August 1996): 416-421.
PMID
8677917
Source
pubmed
Published In
American Journal of Clinical Oncology: Cancer Clinical Trials
Volume
19
Issue
4
Publish Date
1996
Start Page
416
End Page
421

Transthoracic fine needle aspiration biopsy. Sensitivity in relation to guidance technique and lesion size and location.

OBJECTIVE: To obtain site- and size-specific data on transthoracic fine needle aspiration (TFNA) and determine the sensitivity in relation to guidance technique and lesion size and location. STUDY DESIGN: Data on 112 patients undergoing TFNA between 1992 and 1993 were analyzed for accuracy rates, stratified according to lesion size and location within the lung. The series included 13 benign lesions, 53 metastatic neoplasms and 46 primary carcinomas. RESULTS: Overall sensitivity was 90%, with 92% specificity. There was a clear relationship between nodule size and sensitivity of TFNA, with a sensitivity of 60% for lesions < 1 cm but 93% sensitivity for nodules > or = 2 cm in diameter. Similarly, lesion location affected sensitivity. Sensitivity was 100% for peripherally located nodules but was as low as 82% for nodules in the centrobasal portion of the lung. Sensitivity was higher for fluoroscopy (97%) than computed tomography (80%). CONCLUSION: The guidance technique as well as lesion location and size affect diagnostic accuracy.

Authors
Layfield, LJ; Coogan, A; Johnston, WW; Patz, EF
MLA Citation
Layfield, LJ, Coogan, A, Johnston, WW, and Patz, EF. "Transthoracic fine needle aspiration biopsy. Sensitivity in relation to guidance technique and lesion size and location." Acta Cytol 40.4 (July 1996): 687-690.
PMID
8693887
Source
pubmed
Published In
Acta cytologica
Volume
40
Issue
4
Publish Date
1996
Start Page
687
End Page
690

Complications of lung transplantation: radiologic findings.

The first clinically successful lung transplantation was performed in 1983. Since that time, more than 2700 transplants have been recorded by the International Lung Transplant Registry [1]. Lung transplantation is currently limited to patients with endstage lung disease and a life expectancy of less than 18 months [1]. Unilateral lung transplantation is the most commonly performed procedure. Bilateral transplantation generally is reserved for patients with pulmonary sepsis. One-year survival after transplantation is currently 80-90%, and 5-year survival is estimated at 50% [1]. Early detection and treatment of the complications of lung transplantation are critical to decrease patient morbidity and mortality [2-4]. This article reviews the radiologic findings of the most common complications of lung transplantation, using our experience with 85 patients.

Authors
Murray, JG; McAdams, HP; Erasmus, JJ; Patz, EF; Tapson, V
MLA Citation
Murray, JG, McAdams, HP, Erasmus, JJ, Patz, EF, and Tapson, V. "Complications of lung transplantation: radiologic findings." AJR Am J Roentgenol 166.6 (June 1996): 1405-1411.
PMID
8633454
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
166
Issue
6
Publish Date
1996
Start Page
1405
End Page
1411
DOI
10.2214/ajr.166.6.8633454

Pneumothorax after small-bore catheter placement for malignant pleural effusions.

OBJECTIVE: The objective of this study was to evaluate the incidence and significance of pneumothorax after small-bore chest tube placement for symptomatic malignant pleural effusions. SUBJECTS AND METHODS: Over a 2-year period, 90 patients with a known primary malignant tumor and symptomatic pleural effusion were referred to the radiology service at Duke University Medical Center. All patients underwent placement of a small-bore chest tube with fluid drainage in preparation for intrapleural sclerotherapy. Two of these patients were excluded because of coexisting empyema (n=1) and thoracentesis (n=1). The remaining 88 patients (30 men and 58 women; 26-86 years old [mean, 60 years old], who had 90 chest tubes placed, formed our study group. The incidence, duration, and clinical significance of their pneumothoraces and the amount of pleural effusion drained were recorded. RESULTS: Among the 88 patients with 90 chest tubes, 27 patients with 28 chest tubes (31%) were found to have pneumothorax after the procedure. For 23 patients with 24 chest tubes, pneumothorax was evident on chest radiographs taken immediately after tube insertion and fluid drainage. Four patients with four chest tubes were found to have pneumothorax on chest radiographs taken the next day. No significant difference in the amount of fluid drained during the procedure was noted for patients with or without pneumothorax (831 ml versus 853 ml). No relationship between the size of each pneumothorax and the size of each drainage catheter was seen. The duration of pneumothorax ranged from 2 hr to 18 days (average, 3.5 days). Resolution of pneumothorax was seen in 22 (79%) of 28 cases; the remaining six cases of pneumothorax (21%) were stable, and the patients showed eventual fluid reaccumulation after chest tube removal and no sclerotherapy. No patient developed tension pneumothorax, respiratory distress, or other complications. CONCLUSION: Pneumothorax should be recognized as a common finding after chest tube placement and immediate fluid drainage for malignant pleural effusions. We suggest that this finding is related to rapid removal of fluid from a relatively stiff, noncompliant lung. Patients whose lungs do not fully re-expand in several days will probably not benefit from sclerotherapy. Their tubes may be removed without risk of an enlarging tension pneumothorax.

Authors
Chang, YC; Patz, EF; Goodman, PC
MLA Citation
Chang, YC, Patz, EF, and Goodman, PC. "Pneumothorax after small-bore catheter placement for malignant pleural effusions." AJR Am J Roentgenol 166.5 (May 1996): 1049-1051.
PMID
8615239
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
166
Issue
5
Publish Date
1996
Start Page
1049
End Page
1051
DOI
10.2214/ajr.166.5.8615239

Characterization of delta opioid receptors in lung cancer using a novel nonpeptidic ligand.

Cancer cells are often characterized by the presence of membrane receptors not normally associated with nontransformed cells from the same tissue type. Recent studies have demonstrated increased expression of high-affinity binding sites for opioid receptor-selective ligands in lung cancer cell lines relative to normal lung tissue. We investigated the binding of a nonpeptidic delta opioid receptor ligand in small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) cells with the aim of developing the ligand as a novel lung cancer imaging agent. The ligand, [3H] (+)-4-[alpha-R)-alpha-((2S,5R)-4-allyl-2,5-dimethyl-1-piperazinyl)-3- hydroxybenzyl)-N,N-diethylbenzamide ([3H](+)BW373U86), bound with high-affinity [Kd (dissociation constant) = 0.066 +/- 0.012 nM] to membranes prepared from six different SCLC cell lines but not to those from seven NSCLC cell lines, including one mesothelioma. The number of biding sites varied from 10 to 300 fmol/mg membrane protein. Competition binding studies demonstrated displacement of [3H](+)BW373U86 binding by the delta-selective antagonists naltriben and 7-benzylidenenaltrexone but not with the mu- and kappa- selective antagonists D-Phe-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr-NH2 and trans-(+/-)-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl)cyclohexyl]ben zeneacetamide methanesulfonate. Mean apparent Kis for naltriben and 7-benzylidenenaltrexone in membranes from two SCLC cell lines were 0.17 and 3.9 nM, respectively, but were >10 microM for the mu and kappa ligands. The nonselective antagonist naloxone displaced [3H](+)BW373U86 binding with an apparent Ki of approximately 29 nM. On the basis of these data, we believe the lung cancer receptor to be similar, if not identical, to the human brain delta opioid receptor. The lack of high-affinity [3H](+)BW373U86 binding in normal mouse lung membranes suggests a potential role for this ligand as a novel therapeutic or imaging agent.

Authors
Campa, MJ; Schreiber, G; Bepler, G; Bishop, MJ; McNutt, RW; Chang, KJ; Patz, EF
MLA Citation
Campa, MJ, Schreiber, G, Bepler, G, Bishop, MJ, McNutt, RW, Chang, KJ, and Patz, EF. "Characterization of delta opioid receptors in lung cancer using a novel nonpeptidic ligand." Cancer Res 56.7 (April 1, 1996): 1695-1701.
PMID
8603422
Source
pubmed
Published In
Cancer Research
Volume
56
Issue
7
Publish Date
1996
Start Page
1695
End Page
1701

Ambulatory sclerotherapy for malignant pleural effusions.

PURPOSE: To determine the feasibility of ambulatory drainage and sclerotherapy in malignant pleural effusions. MATERIALS AND METHODS: Nineteen consecutive patients with symptomatic malignant pleural effusions were enrolled. None of the patients previously underwent sclerotherapy. A fluoroscopically placed 10.3-F catheter was connected to a closed gravity drainage bag system. Sclerotherapy was performed with bleomycin when daily drainage was less than 100 mL. Radiographic response was graded at 30 days. All patients were examined for symptomatic response and for complications. RESULTS: The tubes remained in place 2-11 days (mean, 5.1 days). Total pleural drainage ranged from 950 to 3,925 mL (mean, 1,647 mL); all 19 patients had improvement of symptoms. At 30 days, 10 (53%) patients had a complete response, five (26%) had a partial response, and four (21%) had progressive disease. CONCLUSION: Ambulatory sclerotherapy is a safe, viable alternative to conventional inpatient treatment of malignant pleural effusions.

Authors
Patz, EF; McAdams, HP; Goodman, PC; Blackwell, S; Crawford, J
MLA Citation
Patz, EF, McAdams, HP, Goodman, PC, Blackwell, S, and Crawford, J. "Ambulatory sclerotherapy for malignant pleural effusions." Radiology 199.1 (April 1996): 133-135.
PMID
8633136
Source
pubmed
Published In
Radiology
Volume
199
Issue
1
Publish Date
1996
Start Page
133
End Page
135
DOI
10.1148/radiology.199.1.8633136

Cytomegalovirus pneumonia in transplant patients: CT findings.

OBJECTIVE: Our goal was to assess the CT findings of cytomegalovirus (CMV) pneumonia in transplant patients. MATERIALS AND METHODS: The study included 10 transplant patients who had chest CT scan and pathologically proven isolated pulmonary CMV infection. Five patients had bone marrow transplant and five had solid organ transplant. The CT scans were retrospectively reviewed for pattern and distribution of disease and the CT findings compared with the findings on open lung biopsy (n = 9) and autopsy (n = 1). RESULTS: Nine of 10 patients had parenchymal abnormalities apparent at CT and 1 had normal CT scans. The findings in the nine patients included small nodules (n = 6), consolidation (n = 4), ground-glass attenuation (n = 4), and irregular lines (n = 1). The nodules had a bilateral and symmetric distribution and involved all lung zones. The consolidation was most marked in the lower lung zones. CONCLUSION: The CT findings of CMV pneumonia in transplant patients are heterogeneous. The most common patterns include small nodules and areas of consolidation.

Authors
Kang, EY; Patz, EF; Müller, NL
MLA Citation
Kang, EY, Patz, EF, and Müller, NL. "Cytomegalovirus pneumonia in transplant patients: CT findings." J Comput Assist Tomogr 20.2 (March 1996): 295-299.
PMID
8606241
Source
pubmed
Published In
Journal of Computer Assisted Tomography
Volume
20
Issue
2
Publish Date
1996
Start Page
295
End Page
299

Significance of hemoptysis following thrombolytic therapy for acute myocardial infarction.

PURPOSE: To describe the occurrence, cause, and significance of hemoptysis following thrombolytic therapy for acute myocardial infarction. PATIENTS AND METHODS: We retrospectively reviewed 2,634 patients presenting with acute myocardial infarction who received thrombolytic therapy to determine the incidence of hemoptysis. Chart and radiographic review included the type, dose, and route of thrombolytic therapy. In addition, the onset, duration, and severity of hemoptysis were recorded and correlated with radiographic and bronchoscopic findings. RESULTS: Eleven patients (0.4%) developed hemoptysis following administration of thrombolytic therapy for an acute myocardial infarction. The duration and severity had a wide range, although no patient had significant hemodynamic compromise. The source of hemoptysis was identified in only one patient who had a tongue laceration following cardiopulmonary resuscitation, and blood was seen within the oropharynx and trachea. No definitive cause was identified in all other patients. There was no correlation between the different types or doses of thrombolytic therapy and the duration or severity of hemoptysis. Chest radiographs were nonspecific and demonstrated resolution within 11 days following hemoptysis. CT of the thorax in one patient and bronchoscopy in two patients confirmed chest radiographic findings and in no patient was an underlying pulmonary abnormality identified. CONCLUSIONS: Pulmonary hemorrhage and hemoptysis are unusual complications of thrombolytic therapy in patients with acute myocardial infarction. Although hemoptysis may be the first indicator of an underlying pulmonary abnormality, we found no case in which a significant abnormality was unmasked. This study suggests that follow-up chest radiographs are recommended and further evaluation may be unnecessary if complete resolution is demonstrated.

Authors
Chang, YC; Patz, EF; Goodman, PC; Granger, CB
MLA Citation
Chang, YC, Patz, EF, Goodman, PC, and Granger, CB. "Significance of hemoptysis following thrombolytic therapy for acute myocardial infarction." Chest 109.3 (March 1996): 727-729.
PMID
8617083
Source
pubmed
Published In
Chest
Volume
109
Issue
3
Publish Date
1996
Start Page
727
End Page
729

Prospective comparison of helical CT and MR imaging in clinically suspected acute pulmonary embolism.

The purpose of this study is to compare sensitivity and specificity of helical CT and MR imaging for detecting acute pulmonary embolism(PE). Patients who were suspected clinically of having PE were randomly assigned to undergo either helical contrast-enhanced CT or gradient-echo MR (if one modality was contraindicated, the patient was assigned to the other.) Patients were considered to have PE if they had: 1) high-probability V-Q scan and low clinical probability of PE; 2) pulmonary angiogram positive for PE. Patients were considered not to have PE if they had either:1)normal V-Q scan; 2) low probability V-Q scan and low clinical probability of PE; or 3) pulmonary angiogram negative for PE. The CT and MR images were read randomly and independently by five radiologists with varying levels of CT and MR experience. Twenty eight patients underwent CT and 25 MR. A total of 21 patients underwent pulmonary angiography (6 had PE, 15 did not have PE). Of the other 32 patients, 15 had high probability scan/high clinical probability and 17 had low probability scan/low clinical probability. For the five observers, the average sensitivity of CT was 75% and of MR 46%; the average specificity of CT was 89% and of MR 90%. Experience with vascular MR and enhanced CT influenced diagnostic accuracy. For the two vascular MR experts, average sensitivity and specificity of MR were 71% and 97%, and of CT 73% and 97%. In this pilot study, when CT and MR were interpreted with comparable expertise, they had similar accuracy for detecting pulmonary embolism.

Authors
Sostman, HD; Layish, DT; Tapson, VF; Spritzer, CE; DeLong, DM; Trotter, P; MacFall, JR; Patz, EF; Goodman, PC; Woodard, PK; Foo, TK; Farber, JL
MLA Citation
Sostman, HD, Layish, DT, Tapson, VF, Spritzer, CE, DeLong, DM, Trotter, P, MacFall, JR, Patz, EF, Goodman, PC, Woodard, PK, Foo, TK, and Farber, JL. "Prospective comparison of helical CT and MR imaging in clinically suspected acute pulmonary embolism." J Magn Reson Imaging 6.2 (March 1996): 275-281.
PMID
9132089
Source
pubmed
Published In
Journal of Magnetic Resonance Imaging
Volume
6
Issue
2
Publish Date
1996
Start Page
275
End Page
281

The proposed new international TNM staging system for malignant pleural mesothelioma: application to imaging.

Malignant pleural mesothelioma (MPM) is an uncommon and usually fatal primary neoplasm of the pleura. In the past, response to standard therapy has been poor [1-3], but recent studies suggest that some patients may benefit from various therapeutic options, including surgical resection, combined technique treatment, and immunotherapy [4-7]. With improvements in therapy, an accurate, widely accepted staging system will be important in selecting homogeneous groups of patients for entry into clinical trials. Multiple staging systems have previously been proposed for MPM, but none are universally used [8].

Authors
Patz, EF; Rusch, VW; Heelan, R
MLA Citation
Patz, EF, Rusch, VW, and Heelan, R. "The proposed new international TNM staging system for malignant pleural mesothelioma: application to imaging." AJR Am J Roentgenol 166.2 (February 1996): 323-327.
PMID
8553940
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
166
Issue
2
Publish Date
1996
Start Page
323
End Page
327
DOI
10.2214/ajr.166.2.8553940

A rational approach to the solitary pulmonary nodule

Follow a path of diminishing uncertainty when a patient has a solitary pulmonary nodule. Ideally, malignant nodules will be resected promptly and benign ones identified with minimal intervention.

Authors
Kaiser, LR; Jr, EFP; Tuteur, PG
MLA Citation
Kaiser, LR, Jr, EFP, and Tuteur, PG. "A rational approach to the solitary pulmonary nodule." Patient Care 30.12 (1996): 183-198.
Source
scival
Published In
Patient Care
Volume
30
Issue
12
Publish Date
1996
Start Page
183
End Page
198

Thoracic nodal staging with PET imaging with 18FDG in patients with bronchogenic carcinoma.

PURPOSE: To assess the role of positron emission tomographic (PET) imaging with 18-fluoro-2-deoxyglucose (18FDG) in detecting thoracic lymph node metastases in patients with bronchogenic carcinoma. MATERIALS AND METHODS: Over a 2-year period, any patient presenting to our institution with newly diagnosed bronchogenic carcinoma who was to have thoracic nodes sampled was considered eligible. All PET studies were performed prior to nodal sampling and areas of increased uptake were mapped according to the American Thoracic Society classification. Studies were correlated with CT and pathology. Sensitivity and specificity for predicting nodal metastases was calculated. RESULTS: Forty-two patients had 62 nodal stations (40 hilar/lobar, 22 mediastinal) sampled. The sensitivity and specificity for hilar/lobar lymph node station metastases using PET imaging was 73% and 76%, respectively. With CT, the sensitivity and specificity were 27% and 86%. The sensitivity and specificity using PET imaging for mediastinal node station metastases was 92% and 100%, respectively, while with CT the figures were 58% and 80%. The sensitivity and specificity for combined thoracic nodal station metastases using PET imaging was 83% and 82%, respectively, while with CT it was 43% and 85%. There was a strong statistical relationship between positive PET imaging and lymph node abnormalities. CONCLUSIONS: 18FDG-PET imaging is accurate in detecting thoracic lymph node metastases in patients with bronchogenic carcinoma. Normal results of PET studies virtually preclude the need for mediastinal nodal sampling prior to surgery, whereas abnormal results of studies most likely represent mediastinal metastases. Treatment can be based on the extent of disease suggested by PET imaging.

Authors
Patz, EF; Lowe, VJ; Goodman, PC; Herndon, J
MLA Citation
Patz, EF, Lowe, VJ, Goodman, PC, and Herndon, J. "Thoracic nodal staging with PET imaging with 18FDG in patients with bronchogenic carcinoma." Chest 108.6 (December 1995): 1617-1621.
PMID
7497771
Source
pubmed
Published In
Chest
Volume
108
Issue
6
Publish Date
1995
Start Page
1617
End Page
1621

Lung tumor growth correlates with glucose metabolism measured by fluoride-18 fluorodeoxyglucose positron emission tomography.

BACKGROUND: The growth rate, or doubling time, of radiographically indeterminate pulmonary abnormalities is an important determinant of malignancy. Prospective calculation of doubling time, however, delays diagnosis and treatment. Positron emission tomography (PET) using the glucose analogue fluoride-18 fluorodeoxyglucose (FDG) measures the enhanced glucose uptake characteristic of neoplastic cells. We postulated that if FDG activity correlates with doubling time, then PET may allow prompt diagnosis of lung cancer. METHODS: From March 1992 to July 1993, all patients with indeterminate focal pulmonary abnormalities were eligible for FDG PET imaging. In 53 patients, serial chest radiographs or computed tomograms were available and doubling time was computed. The FDG activity within the lesion was expressed as a standardized uptake ratio. RESULTS: The mean standardized uptake ratio (+/- SD) was 5.9 +/- 2.7 in 34 patients with cancer, versus 2.0 +/- 1.7 in 19 with benign disease (p < 0.001). Using a criterion of standardized uptake ratio 2.5 or greater for malignancy, the accuracy of PET was 92% (49 of 53). The standardized uptake ratio was significantly correlated with doubling time (r = -0.89; p = 0.002). CONCLUSION: These data suggest a direct relation between tumor growth and FDG uptake in lung cancer. The technique of FDG PET demonstrates exceptional accuracy and may permit prompt diagnosis of lung cancer.

Authors
Duhaylongsod, FG; Lowe, VJ; Patz, EF; Vaughn, AL; Coleman, RE; Wolfe, WG
MLA Citation
Duhaylongsod, FG, Lowe, VJ, Patz, EF, Vaughn, AL, Coleman, RE, and Wolfe, WG. "Lung tumor growth correlates with glucose metabolism measured by fluoride-18 fluorodeoxyglucose positron emission tomography." Ann Thorac Surg 60.5 (November 1995): 1348-1352.
PMID
8526625
Source
pubmed
Published In
The Annals of Thoracic Surgery
Volume
60
Issue
5
Publish Date
1995
Start Page
1348
End Page
1352
DOI
10.1016/0003-4975(95)00754-9

MR-IMAGING AND CT FOR DETECTING PULMONARY-EMBOLISM AND VENOUS THROMBOEMBOLISM

Authors
SOSTMAN, HD; LAYISH, DT; SPRITZER, CE; GOODMAN, PC; PATZ, EF; MACFALL, JR
MLA Citation
SOSTMAN, HD, LAYISH, DT, SPRITZER, CE, GOODMAN, PC, PATZ, EF, and MACFALL, JR. "MR-IMAGING AND CT FOR DETECTING PULMONARY-EMBOLISM AND VENOUS THROMBOEMBOLISM." RADIOLOGY 197 (November 1995): 303-303.
Source
wos-lite
Published In
Radiology
Volume
197
Publish Date
1995
Start Page
303
End Page
303

NEW INTERNATIONAL TNM STAGING SYSTEM FOR MALIGNANT PLEURAL MESOTHELIOMA

Authors
HEELAN, RT; PATZ, EF; RUSCH, VW
MLA Citation
HEELAN, RT, PATZ, EF, and RUSCH, VW. "NEW INTERNATIONAL TNM STAGING SYSTEM FOR MALIGNANT PLEURAL MESOTHELIOMA." RADIOLOGY 197 (November 1995): 302-302.
Source
wos-lite
Published In
Radiology
Volume
197
Publish Date
1995
Start Page
302
End Page
302

AMBULATORY SCLEROTHERAPY FOR TREATMENT OF MALIGNANT PLEURAL EFFUSION

Authors
MCADAMS, HP; PATZ, EF; GOODMAN, PC; CRAWFORD, J
MLA Citation
MCADAMS, HP, PATZ, EF, GOODMAN, PC, and CRAWFORD, J. "AMBULATORY SCLEROTHERAPY FOR TREATMENT OF MALIGNANT PLEURAL EFFUSION." RADIOLOGY 197 (November 1995): 163-163.
Source
wos-lite
Published In
Radiology
Volume
197
Publish Date
1995
Start Page
163
End Page
163

Pulmonary manifestations of nontuberculous Mycobacterium.

Thoracic nontuberculous or atypical mycobacterial infections typically occur in patients who have underlying lung disease or an immunologic abnormality. These infections are usually indolent and the diagnosis is often difficult to establish and, even if confirmed, is of questionable clinical significance. The most common radiologic pattern is fibronodular opacities in the upper lobes similar to those seen with tuberculosis. Less commonly, patients may have scattered nodularity associated with bronchiectasis. If suspected by radiologic and clinical findings, culture should be obtained for diagnosis. This review focuses on nontuberculous mycobacterial disease in the thorax of the immunocompetent host.

Authors
Patz, EF; Swensen, SJ; Erasmus, J
MLA Citation
Patz, EF, Swensen, SJ, and Erasmus, J. "Pulmonary manifestations of nontuberculous Mycobacterium." Radiol Clin North Am 33.4 (July 1995): 719-729. (Review)
PMID
7610241
Source
pubmed
Published In
Radiologic Clinics of North America
Volume
33
Issue
4
Publish Date
1995
Start Page
719
End Page
729

Detection of primary and recurrent lung cancer by means of F-18 fluorodeoxyglucose positron emission tomography (FDG PET).

Positron emission tomography (PET), with the glucose analog F-18 fluoro-deoxyglucose (FDG), takes advantage of the enhanced glucose uptake observed in neoplastic cells. We examined whether the detection of preferential FDG uptake with PET permits differentiation between benign and malignant focal pulmonary lesions in patients with suspected primary or recurrent lung cancer. Between November 1991 and September 1993, 100 patients with indeterminate focal pulmonary abnormalities including 16 patients who had previous lung resections for cancer were prospectively studied. Tissue diagnosis was obtained by transbronchial or percutaneous biopsy (n = 49) and open biopsy or resection (n = 35). Three patients underwent extended observation (> 2 years) alone. Excluded were 13 patients lacking firm pathologic diagnoses and less than 2-year follow-up. FDG activity in the lesion was expressed as a calculated standardized uptake ratio. Mean standardized uptake ratio (+/- standard deviation) was 6.6 (+/- 3.1) in 59 patients with cancer versus 2.0 (+/- 1.6) in 28 with benign disease (p = 0.0001; unpaired t test, two-sided). With a standardized uptake ratio > or = 2.5 used for detecting malignancy, sensitivity, specificity, and accuracy were 97% (57/59), 82% (23/28), and 92% (80/87), respectively. Notably, in patients evaluated for pulmonary abnormalities after lung resection for cancer, all chest recurrences were correctly identified. The exceptional sensitivity of FDG PET demonstrates that malignant pulmonary lesions preferentially accumulate FDG, which results in a standardized uptake ratio > or = 2.5. PET may be useful for distinguishing recurrent tumor from postoperative, or postradiation, changes. If performed in all patients before open biopsy, PET increases the diagnostic yield by reducing the number of patients who have benign lesions at operation. Moreover, by lowering expenditures for hospitalization and other diagnostic procedures, FDG PET may significantly reduce health care costs.

Authors
Duhaylongsod, FG; Lowe, VJ; Patz, EF; Vaughn, AL; Coleman, RE; Wolfe, WG
MLA Citation
Duhaylongsod, FG, Lowe, VJ, Patz, EF, Vaughn, AL, Coleman, RE, and Wolfe, WG. "Detection of primary and recurrent lung cancer by means of F-18 fluorodeoxyglucose positron emission tomography (FDG PET)." J Thorac Cardiovasc Surg 110.1 (July 1995): 130-139.
PMID
7609536
Source
pubmed
Published In
Journal of Thoracic and Cardiovascular Surgery
Volume
110
Issue
1
Publish Date
1995
Start Page
130
End Page
139
DOI
10.1016/S0022-5223(05)80018-2

Congenital cystic adenomatoid malformation in adults: CT findings.

OBJECTIVE: Congenital cystic adenomatoid malformation (CAM) of the lung usually presents in children, although it has rarely been described in adults. The aim of this study was to review the clinical history and the CT findings in adults with pathologically proven CAM. MATERIALS AND METHODS: Seven patients between 21 and 61 years of age with pathologically proved CAM were retrospectively identified at three institutions. Thoracic CT was reviewed in all cases. RESULTS: Six patients presented with recurrent pneumonia and one patient had recurrent pneumothoraces. Five cases were classified as a Type I CAM, and two were classified as Type II CAM. The CAMs were located exclusively in the lower lobes and exerted a mass effect on adjacent lung. They appeared as multiple thin-walled complex cystic masses ranging from 4 to 12 cm in diameter. No other congenital abnormality was identified in any patient. CONCLUSION: Cystic adenomatoid malformation in adults is rare. Patients usually present with recurrent pneumonia and a thin-walled lower lobe complex cystic mass. The diagnosis should be suggested on the basis of the clinical and CT findings.

Authors
Patz, EF; Müller, NL; Swensen, SJ; Dodd, LG
MLA Citation
Patz, EF, Müller, NL, Swensen, SJ, and Dodd, LG. "Congenital cystic adenomatoid malformation in adults: CT findings." J Comput Assist Tomogr 19.3 (May 1995): 361-364.
PMID
7790542
Source
pubmed
Published In
Journal of Computer Assisted Tomography
Volume
19
Issue
3
Publish Date
1995
Start Page
361
End Page
364

ATYPICAL AND UNUSUAL CALCIFICATIONS OF THE HEART AND GREAT-VESSELS - IMAGING FINDINGS (VOL 163, PG 1349, 1994)

Authors
LEE, VS; PATZ, EF; CHEN, JTT
MLA Citation
LEE, VS, PATZ, EF, and CHEN, JTT. "ATYPICAL AND UNUSUAL CALCIFICATIONS OF THE HEART AND GREAT-VESSELS - IMAGING FINDINGS (VOL 163, PG 1349, 1994)." AMERICAN JOURNAL OF ROENTGENOLOGY 164.4 (April 1995): 1002-1002.
Source
wos-lite
Published In
AJR. American journal of roentgenology
Volume
164
Issue
4
Publish Date
1995
Start Page
1002
End Page
1002

Palliative treatment of malignant pleural effusions: value of small-bore catheter thoracostomy and doxycycline sclerotherapy.

OBJECTIVE: This study evaluates small-bore catheter thoracostomy combined with doxycycline sclerotherapy for palliative treatment of presumed malignant pleural effusions. SUBJECTS AND METHODS: Forty-seven consecutive patients referred from the medical oncology department to the thoracic radiology section with known primary malignant tumors and symptomatic pleural effusions over a 2-year period were treated with small-bore pleural catheter drainage followed by doxycycline sclerotherapy. Of the 47 patients, 20 (43%) died less than 30 days after sclerotherapy, one (2%) died without radiographic follow-up, and five (11%) were lost to follow-up. Twenty-one patients formed the study group. Response to treatment was defined based on findings on follow-up chest radiographs obtained 30 days after sclerotherapy as complete (no reaccumulation of pleural effusion), partial (accumulation above postpleurodesis level but below that at presentation), or as a failure (reaccumulation to the amount seen at presentation). RESULTS: Seventeen (81%) evaluable patients showed complete response to sclerotherapy, three (14%) showed a partial response, and one (5%) showed no response. All complete and partial responders were clinically improved with resolution of their shortness of breath. Therefore, 95% of evaluable patients had clinically and radiographically successful treatment. Six patients underwent sclerotherapy when their tube output was greater than 100 ml/24 hr. Five of the six had completely successful pleurodesis, and one failed to respond. Two (10%) of the 21 patients had greater than 150 ml drainage in the 24 hr after initial doxycycline administration and were therefore given a second dose of intrapleural doxycycline. Both of these patients subsequently had less than 150 ml drainage in an additional 24-hr observation period and went on to complete response. Complications included three patients (14%) with mild discomfort at the chest tube site during drainage, one patient (5%) with pain during instillation of doxycycline, and one patient (5%) with transient fever (38.3 degrees C body temperature) one day after sclerotherapy. CONCLUSION: Small-bore catheter thoracostomy followed by doxycycline sclerotherapy successfully resolves symptomatic pleural effusion in patients with known primary malignant tumors.

Authors
Seaton, KG; Patz, EF; Goodman, PC
MLA Citation
Seaton, KG, Patz, EF, and Goodman, PC. "Palliative treatment of malignant pleural effusions: value of small-bore catheter thoracostomy and doxycycline sclerotherapy." AJR Am J Roentgenol 164.3 (March 1995): 589-591.
PMID
7532350
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
164
Issue
3
Publish Date
1995
Start Page
589
End Page
591
DOI
10.2214/ajr.164.3.7532350

Significance of percutaneous needle biopsy in patients with multiple pulmonary nodules and a single known primary malignancy.

OBJECTIVE: To determine the necessity of percutaneous lung biopsy in patients with a single known primary malignancy and multiple pulmonary nodules. DESIGN: Retrospective study. SETTING: Tertiary care university hospital. RESULTS: We reviewed all percutaneous lung biopsy specimens over a 6-year period. One hundred forty-six patients with a single known primary malignancy and multiple pulmonary nodules had biopsies performed up to 19 years following diagnosis of the primary neoplasm. One hundred thirty-seven biopsy specimens (93.8%) were positive for metastases. Eight patients (5.5%) had a nondiagnostic biopsy specimen; however, subsequent imaging studies and the clinical course strongly suggested diffuse metastatic disease. One patient (< 1%) with breast carcinoma developed nodules 3 years after initial diagnosis and had resolution without a definitive diagnosis or therapy. CONCLUSION: Patients with a single known primary malignancy and multiple pulmonary nodules who present for percutaneous needle biopsy will have pulmonary metastases in the vast majority of cases. Biopsy in these patients rarely changes the clinical course as other diagnoses are rarely established.

Authors
Patz, EF; Fidler, J; Knelson, M; Paine, S; Goodman, P
MLA Citation
Patz, EF, Fidler, J, Knelson, M, Paine, S, and Goodman, P. "Significance of percutaneous needle biopsy in patients with multiple pulmonary nodules and a single known primary malignancy." Chest 107.3 (March 1995): 601-604.
PMID
7874924
Source
pubmed
Published In
Chest
Volume
107
Issue
3
Publish Date
1995
Start Page
601
End Page
604

Detection of pulmonary embolism: comparison of contrast-enhanced spiral CT and time-of-flight MR techniques.

We compared the conspicuity of acute pulmonary emboli with contrast-enhanced spiral computed tomography (CT) and two- and three-dimensional time-of-flight magnetic resonance (MR) techniques. Seven dogs who received experimental pulmonary emboli and one control were imaged with spiral CT and with 2-D (FMPVAS and FASTCARD) and 3-D time-of-flight MR. Blinded, independent, prospective evaluations of the CT and MR images by two MR radiologists and two chest radiologists were then compared to the location of the emboli as determined by subsequent pathologic evaluation of the excised lungs. Embolus/blood contrast-to-noise ratios (CNRs) were calculated on both MR and CT images for pulmonary emboli that could be identified. Fifty emboli ranging from 1.0 to 5.5 mm (mean, 2.7, +/- 0.14 SEM) in diameter and from 3.0 to 60 mm (mean, 28.1 +/- 1.9 SEM) in length were found in the seven embolized dogs on pathologic examination. Three of the four radiologists identified more thrombi on CT images than they did on their best MR pulse sequence (FASTCARD) and with greater confidence. The fourth radiologist identified an equal percentage of clot on CT and FASTCARD images with confidence slightly greater on FASTCARD MR than on spiral CT. Mean CNR for the best MR technique was 43.4 (+/- 3.9 SEM) and for CT was 20.7 (+/- 1.3 SEM). In general, pulmonary emboli were detected more accurately on contrast-enhanced spiral CT than on MR. This occurred although the embolus/blood CNR was higher on MR than on CT. Better pulmonary embolus conspicuity on CT images was attributed to better spatial resolution and fewer artifacts on CT than on MR. One MR radiologist performed equally well with both spiral CT and FASTCARD techniques, suggesting that experience may be a factor in performance.

Authors
Woodard, PK; Sostman, HD; MacFall, JR; DeLong, DM; McDonald, JW; Foo, TK; Patz, EF; Goodman, PC; Spritzer, CE
MLA Citation
Woodard, PK, Sostman, HD, MacFall, JR, DeLong, DM, McDonald, JW, Foo, TK, Patz, EF, Goodman, PC, and Spritzer, CE. "Detection of pulmonary embolism: comparison of contrast-enhanced spiral CT and time-of-flight MR techniques." J Thorac Imaging 10.1 (1995): 59-72.
PMID
7891398
Source
pubmed
Published In
Journal of Thoracic Imaging
Volume
10
Issue
1
Publish Date
1995
Start Page
59
End Page
72

A proposed new international TNM staging system for malignant pleural mesothelioma

Study objective: Investigation of the behavior and treatment of diffuse malignant pleural mesothelioma (MPM) is hindered by the lack of an accurate universally accepted staging system. To address this problem, the International Mesothelioma Interest Group (IMIG) has developed a new TNM- based staging system. Methods: The staging system was developed at a consensus meeting of IMIG members involved in clinical research in MPM, including the originators of previously proposed staging systems. The new staging system is based on the analysis of emerging information about the impact of T and N status on survival. Results: In contrast to five previous staging systems, the T descriptors designated as T1, T2, T3, and T4, provide precise anatomic definitions of the local extent of the primary tumor. The N descriptors, designated as N0, N1, N2, and N3, are virtually identical to those used in the International Lung Cancer Staging System. The stage groupings recognize new data about the better prognosis of T1 and N0 tumors and classify those tumors into stages I and II. The adverse impact of nodal metastases on survival noted in some recent surgical series warrants placing node-positive tumors in stage III. Locally advanced unresectable (T4) tumors and extrathoracic disease (N3 or M1) are classified as stage IV. Conclusion: This proposed staging system reconciles and updates several earlier systems, and can provide the framework for analyzing the results of prospective clinical trials aimed at improving the currently dismal prognosis of MPM.

Authors
Rusch, VW; Aisner, J; Boutin, C; Butchart, EG; Chahinian, P; Faber, LP; Heelan, R; Mattson, K; Pass, HI; Jr, EFP; Robinson, B; Rusch, VW; Tammilehto, L; Vogelzang, NJ; Antman, KH; Belani, CP; Bignon, J; Brodin, O; Feins, R
MLA Citation
Rusch, VW, Aisner, J, Boutin, C, Butchart, EG, Chahinian, P, Faber, LP, Heelan, R, Mattson, K, Pass, HI, Jr, EFP, Robinson, B, Rusch, VW, Tammilehto, L, Vogelzang, NJ, Antman, KH, Belani, CP, Bignon, J, Brodin, O, and Feins, R. "A proposed new international TNM staging system for malignant pleural mesothelioma." Chest 108.4 (1995): 1122-1128.
PMID
7555126
Source
scival
Published In
Chest
Volume
108
Issue
4
Publish Date
1995
Start Page
1122
End Page
1128

Congenital cystic adenomatoid malformation in adults : CT findings

Authors
PATZ, EJ
MLA Citation
PATZ, EJ. "Congenital cystic adenomatoid malformation in adults : CT findings." J Comput Assist Tomogr 19 (1995): 361-364.
Source
cinii-english
Published In
J Comput Assist Tomogr
Volume
19
Publish Date
1995
Start Page
361
End Page
364
DOI
10.1097/00004728-199505000-00004

Atypical and unusual calcifications of the heart and great vessels: imaging findings.

Cardiovascular calcifications in the thorax may be clinically significant and may prove extremely valuable diagnostically. The typical appearance and location of common cardiovascular calcifications have been well described [1, 2]. We present a series of radiologic findings in patients with atypical and unusual cardiovascular calcifications in the thorax.

Authors
Lee, VS; Patz, EF; Chen, JT
MLA Citation
Lee, VS, Patz, EF, and Chen, JT. "Atypical and unusual calcifications of the heart and great vessels: imaging findings." AJR Am J Roentgenol 163.6 (December 1994): 1349-1355.
PMID
7992726
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
163
Issue
6
Publish Date
1994
Start Page
1349
End Page
1355
DOI
10.2214/ajr.163.6.7992726

Semiquantitative and visual analysis of FDG-PET images in pulmonary abnormalities.

UNLABELLED: FDG PET images of the thorax can be analyzed semiquantitatively using standardized uptake ratios (SUR) or activity ratios between abnormal and normal tissue, or qualitatively by visual comparison of the abnormality to normal structures. Standardized uptake ratio evaluation of FDG PET images has been shown to accurately differentiate benign from malignant focal pulmonary abnormalities. The accuracy of activity ratios and visual analysis have not been evaluated. We therefore prospectively analyzed FDG PET images in patients with pulmonary abnormalities to evaluate differences in analytic schemes. METHODS: We evaluated 107 patients with an indeterminate focal abnormality on chest radiograph or CT with FDG PET between November 1991 and March 1993. The PET studies were evaluated using SUR, activity ratios and visual analysis. Activity ratios of maximum activity/cc and average activity/cc between regions of interest (ROIs) in abnormalities and normal lung on the contralateral side were calculated. Visual interpretations were graded on a five-point scale of two observers' confidence of malignancy. FDG uptake in the abnormality was also visually graded in comparison to mediastinal activity. Receiver-operating characteristic (ROC) curve areas were generated for the SUR data, activity ratios and visual analysis. RESULTS: Of 88 patients in which a conclusive diagnosis was made, 61 (69%) patients had malignancy and 27 (31%) patients had a benign process. SUR, maximum activity ratio, average activity ratio and visual interpretation ROC curve areas were 0.96, 0.95, 0.92 and 0.96, respectively. CONCLUSIONS: SUR, activity ratios and visual evaluation are each equally accurate methods of FDG PET data analysis in differentiating malignant from benign focal pulmonary abnormalities.

Authors
Lowe, VJ; Hoffman, JM; DeLong, DM; Patz, EF; Coleman, RE
MLA Citation
Lowe, VJ, Hoffman, JM, DeLong, DM, Patz, EF, and Coleman, RE. "Semiquantitative and visual analysis of FDG-PET images in pulmonary abnormalities." J Nucl Med 35.11 (November 1994): 1771-1776.
PMID
7965154
Source
pubmed
Published In
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
Volume
35
Issue
11
Publish Date
1994
Start Page
1771
End Page
1776

Positron emission tomography imaging of the thorax.

Positron emission tomography (PET) is just beginning to emerge as a clinically useful tool in the thorax. Imaging with FDG is used primarily to differentiate benign from malignant abnormalities, including solitary pulmonary nodules, staging bronchogenic carcinoma, and differentiating recurrent tumor from fibrosis following treatment. This article discusses the fundamental properties of PET images, techniques, and current clinical indications in the thorax.

Authors
Patz, EF; Goodman, PC
MLA Citation
Patz, EF, and Goodman, PC. "Positron emission tomography imaging of the thorax." Radiol Clin North Am 32.4 (July 1994): 811-823.
PMID
7980769
Source
pubmed
Published In
Radiologic Clinics of North America
Volume
32
Issue
4
Publish Date
1994
Start Page
811
End Page
823

CT of the lung: patterns of calcification and other high-attenuation abnormalities.

CT is the most sensitive radiologic method for the detection of differences in radiographic density in chest lesions. Areas of high attenuation (visually as opaque as bony structures) in an abnormality on CT scans can be an important clue to the correct diagnosis. The high attenuation is most often caused by calcification, but may also be due to iodine, barium, or radiopaque foreign bodies. This essay illustrates the patterns of high attenuation associated with chest diseases on unenhanced CT scans.

Authors
Chai, JL; Patz, EF
MLA Citation
Chai, JL, and Patz, EF. "CT of the lung: patterns of calcification and other high-attenuation abnormalities." AJR Am J Roentgenol 162.5 (May 1994): 1063-1066.
PMID
8165982
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
162
Issue
5
Publish Date
1994
Start Page
1063
End Page
1066
DOI
10.2214/ajr.162.5.8165982

Persistent or recurrent bronchogenic carcinoma: detection with PET and 2-[F-18]-2-deoxy-D-glucose.

PURPOSE: To assess positron emission tomography (PET) with 2-[fluorine-18]-2-deoxy-D-glucose (FDG) in the differentiation of recurrent bronchogenic carcinoma from fibrosis after therapy. MATERIALS AND METHODS: Any patient treated for bronchogenic carcinoma who had a residual chest radiographic abnormality was eligible. Forty-three patients (mean age, 63.5 years) participated. Chest radiographs and thoracic computed tomographic scans helped localize the abnormality prior to PET. Semiquantitative analysis was performed on FDG PET images with calculated standardized uptake ratios (SURs). Sensitivity, specificity, and confidence intervals for recurrent disease were determined. RESULTS: Thirty-five patients had recurrent or persistent tumor (median SUR, 7.6; range, 1.9-18.7). Eight patients had fibrosis but no evidence of disease (SUR, 1.6; range, 0.6-2.4). The sensitivity for detecting recurrent tumor (SUR > 2.5) was 97.1%, and specificity was 100%. The SUR for recurrent tumor was statistically significantly higher than for fibrosis (P = .0001). CONCLUSION: FDG PET accurately helps differentiate recurrent bronchogenic carcinoma from fibrosis.

Authors
Patz, EF; Lowe, VJ; Hoffman, JM; Paine, SS; Harris, LK; Goodman, PC
MLA Citation
Patz, EF, Lowe, VJ, Hoffman, JM, Paine, SS, Harris, LK, and Goodman, PC. "Persistent or recurrent bronchogenic carcinoma: detection with PET and 2-[F-18]-2-deoxy-D-glucose." Radiology 191.2 (May 1994): 379-382.
PMID
8153309
Source
pubmed
Published In
Radiology
Volume
191
Issue
2
Publish Date
1994
Start Page
379
End Page
382
DOI
10.1148/radiology.191.2.8153309

DYNAMIC FDG-PET IMAGING OF FOCAL PULMONARY ABNORMALITIES TO IDENTIFY OPTIMUM TIME FOR IMAGING

Authors
LOWE, VJ; DELONG, DM; HOFFMAN, JM; PATZ, EF; COLEMAN, RE
MLA Citation
LOWE, VJ, DELONG, DM, HOFFMAN, JM, PATZ, EF, and COLEMAN, RE. "DYNAMIC FDG-PET IMAGING OF FOCAL PULMONARY ABNORMALITIES TO IDENTIFY OPTIMUM TIME FOR IMAGING." JOURNAL OF NUCLEAR MEDICINE 35.5 (May 1994): P225-P225.
Source
wos-lite
Published In
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
Volume
35
Issue
5
Publish Date
1994
Start Page
P225
End Page
P225

ROC CURVE AND LOGISTIC-REGRESSION ANALYSIS OF VISUAL AND SEMIQUANTITATIVE FDG PET DATA IN THE EVALUATION OF FOCAL PULMONARY ABNORMALITIES

Authors
LOWE, VJ; HOFFMAN, JM; DELONG, DM; PATZ, EF; COLEMAN, RE
MLA Citation
LOWE, VJ, HOFFMAN, JM, DELONG, DM, PATZ, EF, and COLEMAN, RE. "ROC CURVE AND LOGISTIC-REGRESSION ANALYSIS OF VISUAL AND SEMIQUANTITATIVE FDG PET DATA IN THE EVALUATION OF FOCAL PULMONARY ABNORMALITIES." JOURNAL OF NUCLEAR MEDICINE 35.5 (May 1994): P227-P227.
Source
wos-lite
Published In
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
Volume
35
Issue
5
Publish Date
1994
Start Page
P227
End Page
P227

Thoracic lymphangioma in adults: CT and MR imaging features.

OBJECTIVE: Lymphangiomas are rare benign tumors most often seen in childhood. When they occur in adults, radiologic diagnosis can be difficult. A retrospective study of the CT and MR appearances of thoracic lymphangiomas in adult patients was performed in order to describe the range of radiologic features of these tumors. MATERIALS AND METHODS: Cases of adult lymphangioma at three institutions were identified in the records of 19 patients, predominantly female, 18-67 years old. RESULTS: The most common CT appearance was a smoothly marginated cystic mass. Unusual features included calcification, spiculated margins, and homogeneous soft-tissue attenuation. The majority of cases were located in the anterior or superior mediastinum. Unusual locations included the pericardium, pulmonary hilum, and pulmonary parenchyma. Signal characteristics on MR images varied. CONCLUSION: The radiographic appearance of lymphangiomas in the chest in adult patients is varied. The diagnosis cannot be suggested on the basis of radiologic studies alone.

Authors
Shaffer, K; Rosado-de-Christenson, ML; Patz, EF; Young, S; Farver, CF
MLA Citation
Shaffer, K, Rosado-de-Christenson, ML, Patz, EF, Young, S, and Farver, CF. "Thoracic lymphangioma in adults: CT and MR imaging features." AJR Am J Roentgenol 162.2 (February 1994): 283-289.
PMID
8310910
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
162
Issue
2
Publish Date
1994
Start Page
283
End Page
289
DOI
10.2214/ajr.162.2.8310910

Pulmonary drug toxicity following high-dose chemotherapy with autologous bone marrow transplantation: CT findings in 20 cases.

We retrospectively evaluated the computed tomography (CT) findings in 20 patients with pulmonary drug toxicity that followed high-dose chemotherapy and autologous bone marrow transplantation (ABMT). Eighty-five patients with Stage II or III breast cancer that involved > or = 10 axillary lymph nodes were enrolled in a treatment protocol that included four cycles of standard-dose therapy (CAF) followed by one cycle of high-dose treatment (CPA/cDDP/BCNU). After chemotherapy, ABMT was performed. Twenty-six patients (31%) developed pulmonary drug toxicity. Serial thoracic CT studies were available in 20 of these 26 patients. All 20 patients exhibited clinical symptoms (i.e., dyspnea, nonproductive cough, and fever) and abnormal pulmonary function following transplantation. Thirteen patients had pathologically proven drug toxicity, and seven patients had clinical features and treatment responses highly suggestive of this diagnosis. Multiple sputum and blood cultures were negative in all patients. CT scans of 13 patients (65%) demonstrated scattered, predominantly peripheral ground-glass or consolidated opacities that occasionally looked nodular or masslike. Two patients (10%) had CT scans suggestive of pulmonary edema and in five patients (25%), the CT examinations revealed no significant abnormalities. Pleural effusions and adenopathy were uncommon. Pulmonary drug toxicity after high-dose chemotherapy and ABMT should be suspected in the appropriate clinical and radiographic setting, and therapy may be initiated on the basis of these observations.

Authors
Patz, EF; Peters, WP; Goodman, PC
MLA Citation
Patz, EF, Peters, WP, and Goodman, PC. "Pulmonary drug toxicity following high-dose chemotherapy with autologous bone marrow transplantation: CT findings in 20 cases." J Thorac Imaging 9.2 (1994): 129-134.
PMID
8207780
Source
pubmed
Published In
Journal of Thoracic Imaging
Volume
9
Issue
2
Publish Date
1994
Start Page
129
End Page
134

Persistent or recurrent bronchogenic carcinoma : detection with PET and 2-[F-18]-2-deoxy-D-glucose

Authors
PATZ, EJ
MLA Citation
PATZ, EJ. "Persistent or recurrent bronchogenic carcinoma : detection with PET and 2-[F-18]-2-deoxy-D-glucose." Radiology 191 (1994): 379-382.
Source
cinii-english
Published In
Radiology
Volume
191
Publish Date
1994
Start Page
379
End Page
382

Cardiopulmonary complications of pregnancy: radiographic findings.

Physiologic changes during pregnancy affect nearly every organ system. In the thorax, the diaphragm elevates as much as 4 cm because of displacement of the abdominal organs by the gravid uterus, resulting in lower lung volumes. Maternal blood volume and cardiac output increase approximately 45% by mid-pregnancy. Cardiac output can increase as much as 80% during vaginal delivery and up to 50% with cesarean section. These changes result in pulmonary vascular engorgement, progressive left ventricular dilatation, and mild hypertrophy (Fig. 1). Pregnant patients are also prone to a number of pulmonary insults, including infection, aspiration, and neoplastic disease. These abnormalities have several radiographic patterns: cardiogenic and noncardiogenic pulmonary edema, focal pulmonary abnormalities, and extraalveolar air. Radiologists must recognize not only the normal chest radiographic appearance in these patients but also the thoracic complications associated with pregnancy.

Authors
Fidler, JL; Patz, EF; Ravin, CE
MLA Citation
Fidler, JL, Patz, EF, and Ravin, CE. "Cardiopulmonary complications of pregnancy: radiographic findings." AJR Am J Roentgenol 161.5 (November 1993): 937-942.
PMID
8273629
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
161
Issue
5
Publish Date
1993
Start Page
937
End Page
942
DOI
10.2214/ajr.161.5.8273629

Focal pulmonary abnormalities: evaluation with F-18 fluorodeoxyglucose PET scanning.

The authors assessed the role of positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose (FDG) in differentiation of benign from malignant focal pulmonary abnormalities seen on chest radiographs. Fifty-one patients underwent FDG PET scanning. Focal abnormalities at radiography included solitary pulmonary nodules (n = 38), pulmonary masses (n = 5), and poorly marginated infiltrates or opacities (n = 8). Proof of diagnosis was obtained by means of transbronchial biopsy (n = 21), open lung biopsy (n = 14), percutaneous needle biopsy (n = 14), or cytologic evaluation of sputum (n = 1). A nodule in one patient had been radiographically stable for at least 8 years. Quantitative analysis was performed by calculation of a standardized uptake ratio (SUR). Thirty-three malignant lesions had a mean SUR (+/- 1 standard deviation) of 6.5 +/- 2.9. Eighteen benign lesions had a mean SUR of 1.7 +/- 1.2. For a benign lesion with SUR of 2.5 or less, specificity of FDG PET was 100%, while sensitivity was 89%. These results suggest that FDG PET is accurate in differentiation of benign from malignant focal pulmonary abnormalities.

Authors
Patz, EF; Lowe, VJ; Hoffman, JM; Paine, SS; Burrowes, P; Coleman, RE; Goodman, PC
MLA Citation
Patz, EF, Lowe, VJ, Hoffman, JM, Paine, SS, Burrowes, P, Coleman, RE, and Goodman, PC. "Focal pulmonary abnormalities: evaluation with F-18 fluorodeoxyglucose PET scanning." Radiology 188.2 (August 1993): 487-490.
PMID
8327702
Source
pubmed
Published In
Radiology
Volume
188
Issue
2
Publish Date
1993
Start Page
487
End Page
490
DOI
10.1148/radiology.188.2.8327702

DIFFERENTIATION OF BENIGN AND MALIGNANT PULMONARY OPACITIES WITH FDG-PET

Authors
LOWE, VJ; HOFFMAN, JM; PATZ, EF; PAINE, S; BURROWS, P; COLEMAN, RE
MLA Citation
LOWE, VJ, HOFFMAN, JM, PATZ, EF, PAINE, S, BURROWS, P, and COLEMAN, RE. "DIFFERENTIATION OF BENIGN AND MALIGNANT PULMONARY OPACITIES WITH FDG-PET." JOURNAL OF NUCLEAR MEDICINE 34.5 (May 1993): P21-P21.
Source
wos-lite
Published In
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
Volume
34
Issue
5
Publish Date
1993
Start Page
P21
End Page
P21

Variable compensation chest radiography performed with a computed radiography system: design considerations and initial clinical experience.

The authors describe a variable compensation (VC) technique in which an x-ray equalizer and a computed radiography system are used. The VC technique allows retrospective alteration of equalized chest appearance with maintenance of improved signal-to-noise ratio in dense regions. Two imaging plates are used: one upstream of the patient to record the incident beam profile and one down-stream to record the equalized image. Subtraction of a weighted version of the upstream image from the down-stream image permits alteration of the appearance of the VC image, from the extremes of stimulated-unequalized to highly equalized. VC image appearance was optimized with a real-time workstation. The quality of VC images obtained in 33 patients was evaluated by three chest radiologists. Mediastinal appearance was better on VC equalized images than on conventional screen-film images. The stimulation of the appearance of a conventional radiograph with VC proved useful in interpretation of lung appearances on equalized radiographs.

Authors
Dobbins, JT; Rice, JJ; Goodman, PC; Patz, EF; Ravin, CE
MLA Citation
Dobbins, JT, Rice, JJ, Goodman, PC, Patz, EF, and Ravin, CE. "Variable compensation chest radiography performed with a computed radiography system: design considerations and initial clinical experience." Radiology 187.1 (April 1993): 55-63.
PMID
8451437
Source
pubmed
Published In
Radiology
Volume
187
Issue
1
Publish Date
1993
Start Page
55
End Page
63
DOI
10.1148/radiology.187.1.8451437

Identification of internal mammary lymph nodes: value of the frontal chest radiograph.

The article describes eight patients with enlarged internal mammary lymph nodes visualized on the frontal plain chest radiograph. Enlarged internal mammary lymph nodes cast shadows that initially may be mistaken for a mediastinal or pleural abnormality. Although the lateral film alone may suggest these nodes, the findings on the frontal film help lateralize the abnormality.

Authors
Patz, EF; Stark, P; Shaffer, K; Pugatch, RD
MLA Citation
Patz, EF, Stark, P, Shaffer, K, and Pugatch, RD. "Identification of internal mammary lymph nodes: value of the frontal chest radiograph." J Thorac Imaging 8.1 (1993): 81-84.
PMID
8418322
Source
pubmed
Published In
Journal of Thoracic Imaging
Volume
8
Issue
1
Publish Date
1993
Start Page
81
End Page
84

Focal pulmonary abnormalities : evaluation with F-18 fluorodeoxyglucose PET scanning

Authors
PATZ, EJ
MLA Citation
PATZ, EJ. "Focal pulmonary abnormalities : evaluation with F-18 fluorodeoxyglucose PET scanning." Radiology 188 (1993): 487-490.
Source
cinii-english
Published In
Radiology
Volume
188
Publish Date
1993
Start Page
487
End Page
490

Pseudoaneurysms at aortic cannulation site after coronary artery bypass graft: MR findings.

Pseudoaneurysm at the aortic cannulation site is a rare but potentially fatal complication of coronary artery bypass surgery. We present two cases in which MRI provided significant information regarding the anatomy and extent of a pseudoaneurysm. In one case both spin-echo imaging and cine MRI with and without gradient moment nulling (flow compensation) were used. The absence of gradient moment nulling in cine MRI provides additional contrast between flowing and static blood. This contrast may complement conventional cine images with gradient moment nulling, providing further information.

Authors
Woodard, PK; Patz, EF; Sostman, HD
MLA Citation
Woodard, PK, Patz, EF, and Sostman, HD. "Pseudoaneurysms at aortic cannulation site after coronary artery bypass graft: MR findings." J Comput Assist Tomogr 16.6 (November 1992): 883-887.
PMID
1430435
Source
pubmed
Published In
Journal of Computer Assisted Tomography
Volume
16
Issue
6
Publish Date
1992
Start Page
883
End Page
887

Malignant pleural mesothelioma: value of CT and MR imaging in predicting resectability.

OBJECTIVE: Our objective was to determine if CT or MR imaging findings could be used to accurately predict resectability in patients with biopsy-proved malignant pleural mesotheliomas. SUBJECTS AND METHODS: CT and MR findings in 41 consecutive patients with malignant mesotheliomas who were referred to the thoracic surgery clinic for extrapleural pneumonectomy were studied by thoracic radiologists before surgery. Review of radiologic studies focused on local invasion of three separate regions: the diaphragm, chest wall, and mediastinum. Results of all imaging examinations were carefully correlated with intraoperative, gross, and microscopic pathologic findings. RESULTS: After radiologic and clinical evaluation, 34 patients (83%) had thoracotomy; 24 of these had tumors that were resectable. The sensitivity was high (> 90%) for both CT and MR in each region. Specificity, however, was low, probably because of the small number of patients with unresectable tumors. CONCLUSION: CT and MR provided similar information on resectability in most cases. Sensitivity was high for both procedures. Because CT is more widely available and used, we suggest it as the initial study when determining resectability. In difficult cases, important complementary anatomic information can be derived from MR images obtained before surgical intervention.

Authors
Patz, EF; Shaffer, K; Piwnica-Worms, DR; Jochelson, M; Sarin, M; Sugarbaker, DJ; Pugatch, RD
MLA Citation
Patz, EF, Shaffer, K, Piwnica-Worms, DR, Jochelson, M, Sarin, M, Sugarbaker, DJ, and Pugatch, RD. "Malignant pleural mesothelioma: value of CT and MR imaging in predicting resectability." AJR Am J Roentgenol 159.5 (November 1992): 961-966.
PMID
1414807
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
159
Issue
5
Publish Date
1992
Start Page
961
End Page
966
DOI
10.2214/ajr.159.5.1414807

Pulmonary cryptococcosis.

Cryptococcus neoformans is a ubiquitous soil fungus that rarely causes pneumonia in normal hosts but is a common cause of opportunistic infection. Pulmonary disease is initiated by inhalation of the organism, and a spectrum of radiographic manifestations can be seen. The most common finding is a poorly marginated nodule or mass. Lobar or segmental parenchymal opacities and, less commonly, a diffuse scattered nodular or reticulonodular pattern have also been observed. Associated adenopathy, pleural effusions, and cavitation are uncommon; when present, these are more common in immunocompromised patients. Establishing the diagnosis can be difficult, but pulmonary cryptococcosis should be considered in the differential diagnosis of patients in the proper clinical setting and with compatible radiographic findings.

Authors
Patz, EF; Goodman, PC
MLA Citation
Patz, EF, and Goodman, PC. "Pulmonary cryptococcosis." J Thorac Imaging 7.4 (September 1992): 51-55. (Review)
PMID
1404545
Source
pubmed
Published In
Journal of Thoracic Imaging
Volume
7
Issue
4
Publish Date
1992
Start Page
51
End Page
55

Malignant pleural mesothelioma: value of CT and MR imaging in predicting resectability.

Authors
PATZ, EF
MLA Citation
PATZ, EF. "Malignant pleural mesothelioma: value of CT and MR imaging in predicting resectability." AJR 159 (1992): 961-966.
Source
cinii-english
Published In
AJR
Volume
159
Publish Date
1992
Start Page
961
End Page
966

Radiopacity of glass.

Authors
Patz, EF
MLA Citation
Patz, EF. "Radiopacity of glass." AJR Am J Roentgenol 150.2 (February 1988): 472-. (Letter)
PMID
3257345
Source
pubmed
Published In
AJR. American journal of roentgenology
Volume
150
Issue
2
Publish Date
1988
Start Page
472
DOI
10.2214/ajr.150.2.472-a
Show More

Research Areas:

  • Adenocarcinoma
  • Adenocarcinoma, Bronchiolo-Alveolar
  • Affinity Labels
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Amino Acid Sequence
  • Analysis of Variance
  • Antibodies, Monoclonal
  • Antibody Specificity
  • Antigens, CD3
  • Antigens, Neoplasm
  • Antineoplastic Combined Chemotherapy Protocols
  • B-Lymphocytes
  • Bias (Epidemiology)
  • Binding Sites
  • Binding, Competitive
  • Biological Markers
  • Biological Specimen Banks
  • Biopsy
  • Biopsy, Needle
  • Bleomycin
  • Blood Proteins
  • Boston
  • Brain Neoplasms
  • Bronchi
  • Bronchiectasis
  • Bronchoalveolar Lavage Fluid
  • Bronchoscopy
  • Calcinosis
  • Carcinoid Tumor
  • Carcinoma
  • Carcinoma, Bronchogenic
  • Carcinoma, Non-Small-Cell Lung
  • Carcinoma, Small Cell
  • Case-Control Studies
  • Cell Growth Processes
  • Cell Line
  • Chest Tubes
  • Chi-Square Distribution
  • Child, Preschool
  • Clinical Trials as Topic
  • Combinatorial Chemistry Techniques
  • Combined Modality Therapy
  • Conflict of Interest
  • Constriction, Pathologic
  • Contrast Media
  • Costs and Cost Analysis
  • Cross Reactions
  • Cyclophilin A
  • Cyclosporine
  • Cystic Adenomatoid Malformation of Lung, Congenital
  • Data Interpretation, Statistical
  • Deoxyglucose
  • Deuterium
  • Deuterium Exchange Measurement
  • Diabetes Mellitus
  • Diagnosis, Computer-Assisted
  • Diagnosis, Differential
  • Diagnostic Errors
  • Diagnostic Imaging
  • Disease-Free Survival
  • Dose-Response Relationship, Drug
  • Dose-Response Relationship, Radiation
  • Doxycycline
  • Drainage
  • Drug Discovery
  • Drug Therapy, Combination
  • Early Detection of Cancer
  • Early Diagnosis
  • Endpoint Determination
  • Enzyme-Linked Immunosorbent Assay
  • Escherichia coli Proteins
  • Ethnic Groups
  • Exudates and Transudates
  • Feasibility Studies
  • Female
  • Fibrosis
  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Follow-Up Studies
  • Forkhead Transcription Factors
  • Fractals
  • Gene Expression Profiling
  • Germinal Center
  • Glucose
  • Glucose Transporter Type 1
  • Glucose Transporter Type 3
  • Health Care Costs
  • Heart Neoplasms
  • Heart Transplantation
  • Hematologic Diseases
  • Hemoptysis
  • Humans
  • Hydrogen
  • Image Enhancement
  • Image Processing, Computer-Assisted
  • Immunocompromised Host
  • Immunoenzyme Techniques
  • Immunohistochemistry
  • Immunoprecipitation
  • Immunosuppressive Agents
  • Incidence
  • Infant
  • Inflammation
  • Insurance, Health, Reimbursement
  • International Cooperation
  • Iopamidol
  • Kidney Transplantation
  • Kinetics
  • Ligands
  • Likelihood Functions
  • Lung
  • Lung Diseases
  • Lung Diseases, Fungal
  • Lung Diseases, Interstitial
  • Lung Neoplasms
  • Lung Transplantation
  • Lymph Node Excision
  • Lymph Nodes
  • Lymphatic Metastasis
  • Lymphocytes, Tumor-Infiltrating
  • Magnetic Resonance Imaging
  • Male
  • Mass Screening
  • Mass Spectrometry
  • Mediastinoscopy
  • Mediastinum
  • Medicare
  • Mesothelioma
  • Mice
  • Middle Aged
  • Models, Biological
  • Models, Molecular
  • Molecular Imaging
  • Molecular Sequence Data
  • Monosaccharide Transport Proteins
  • Mucormycosis
  • Multivariate Analysis
  • Mycobacterium Infections, Nontuberculous
  • Mycobacterium avium-intracellulare Infection
  • Necrosis
  • Neoadjuvant Therapy
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Neoplasm, Residual
  • Neoplasms
  • Nerve Tissue Proteins
  • Nontuberculous Mycobacteria
  • North Carolina
  • Observer Variation
  • Organ Transplantation
  • Outcome Assessment (Health Care)
  • Palliative Care
  • Pancreatic Neoplasms
  • Paraneoplastic Syndromes
  • Patient Selection
  • Peptide Fragments
  • Peptide Library
  • Peptide Mapping
  • Peptides
  • Pericardium
  • Philadelphia
  • Phylogeny
  • Physician's Practice Patterns
  • Pilot Projects
  • Piperazines
  • Pleura
  • Pleural Diseases
  • Pleural Effusion
  • Pleural Effusion, Malignant
  • Pleural Neoplasms
  • Pleurodesis
  • Pneumonectomy
  • Pneumonia, Bacterial
  • Pneumonia, Viral
  • Pneumothorax
  • Polysaccharides
  • Positron-Emission Tomography
  • Postoperative Complications
  • Practice Guidelines as Topic
  • Predictive Value of Tests
  • Pregnancy Complications
  • Pregnancy Complications, Cardiovascular
  • Preoperative Care
  • Prevalence
  • Probability
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Protein Array Analysis
  • Protein Binding
  • Proteins
  • Pulmonary Atelectasis
  • Pulmonary Embolism
  • Pulmonary Fibrosis
  • Pulmonary Veno-Occlusive Disease
  • Quality-Adjusted Life Years
  • Questionnaires
  • ROC Curve
  • Radiation Dosage
  • Radiation Injuries
  • Radiographic Image Enhancement
  • Radiography, Interventional
  • Radiography, Thoracic
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Radiotherapy
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy, Computer-Assisted
  • Receptor, Epidermal Growth Factor
  • Recombinant Proteins
  • Registries
  • Remission Induction
  • Reproducibility of Results
  • Research Design
  • Retrospective Studies
  • Sclerosing Solutions
  • Sclerotherapy
  • Sensitivity and Specificity
  • Sequence Alignment
  • Serpins
  • Severity of Illness Index
  • Smoking
  • Societies, Medical
  • Solitary Pulmonary Nodule
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
  • Sputum
  • Subtraction Technique
  • Surface Plasmon Resonance
  • Survival Analysis
  • Survival Rate
  • T-Lymphocytes, Regulatory
  • Talc
  • Technology, Radiologic
  • Thermodynamics
  • Thoracic Diseases
  • Thoracic Neoplasms
  • Thoracoscopy
  • Thoracostomy
  • Thorax
  • Thrombolytic Therapy
  • Thymus Gland
  • Thymus Hyperplasia
  • Time Factors
  • Tobacco Industry
  • Tomography, Emission-Computed
  • Tomography, Spiral Computed
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Tritium
  • Tuberculosis, Pulmonary
  • Tumor Cells, Cultured
  • Tumor Markers, Biological
  • United States
  • Validation Studies as Topic
  • Variation
  • Vascular Diseases
  • Video Recording
  • Whole-Body Counting