A New Publication from the BRIGHT Team
Hello BRIGHT Run Family,
Happy November!
I am excited to share a research update with you. Our research paper “18F-FDG PET/CT Semiquantitative and Radiomic Features for Assessing Pathologic Axillary Lymph Node Status in Clinical Stage I–III Breast Cancer Patients: A Systematic Review” has been published in the journal Current Oncology. (18F-FDG PET/CT Semiquantitative and Radiomic Features for Assessing Pathologic Axillary Lymph Node Status in Clinical Stage I–III Breast Cancer Patients: A Systematic Review)
Medical images, such as PET/CTs and MRIs, captured in patients with cancer show the location and appearance of the abnormality and its surrounding regions, often called regions of interest (ROIs). These ROIs could be visually interpreted.
Recent research shows that computers can also evaluate these ROIs by converting them into a set of numbers. The information presented through these numbers cannot be derived by the naked eye. Often these numbers are associated with a clinical event, such as a response to a treatment, risk of the disease coming back, or survival.
In our study, the clinical event of interest was spread of cancer to axillary lymph nodes of Stage I-III breast cancer patients. Typically, a sentinel lymph node biopsy and/or axillary lymph node dissection is done to confirm the spread.
However, imaging analysis has been reported by many researchers at their institutions to relate with the spread. This is good; if this finding holds everywhere then it would reduce the patient’s discomfort of having a biopsy and/or dissection as non-invasive imaging analysis would suffice.
Our research paper found that most of the studies reviewed for spread to axillary lymph node using PET/CT focused on basic measurements from the PET scans, such as:
- SUVmax: the highest concentration of a radioactive tracer in the tumour.
- MTV (Metabolic Tumor Volume): the size of the active tumor.
- TLG (Total Lesion Glycolysis): a measure combining tumor size and activity.
While some studies showed differences in these measurements between patients with and without lymph node involvement, the results were inconsistent. For example, the average SUVmax values varied widely across studies, making it hard to draw firm conclusions. A few studies used more advanced image analysis (radiomics) to build models that could predict lymph node spread with high accuracy. However, these studies often lacked rigorous quality standards.
Thus, our recommendation from the review is to improve the quality and account for the diversity of future studies so that consistent results could be drawn.
This work was done by my student Dr. Anna Hwang and me, along with collaborators Drs. Shi, Rashid, Levine and Ms. Blew.
This fall, so far, has been an exciting and busy one. My second Master’s student completed all her degree requirements, prepared her research publications, and will be awarded her degree this month. Two new Master’s students joined my team and have started working on their research projects.
As a student supervisor and researcher, I feel happy. And of course, just like research, the colours in fall keep me mesmerized (see photo taken by my husband).
Stay safe and happy,
Best,
Ashirbani
