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Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 2/2012

01.02.2012 | Original Article

Measurement of SUVmax plus ADCmin of the primary tumour is a predictor of prognosis in patients with cervical cancer

verfasst von: Keiichiro Nakamura, Ikuo Joja, Junichi Kodama, Atsushi Hongo, Yuji Hiramatsu

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 2/2012

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Abstract

Purpose

The objectives of this study were to determine if measurements of the maximum standardized uptake value (SUVmax) by positron emission tomography/computed tomography and minimum apparent diffusion coefficient (ADCmin) by magnetic resonance imaging are correlated with the clinical characteristics and prognosis of primary cervical cancer.

Methods

The correlations between biological parameters and prognosis and SUVmax and ADCmin of the primary tumour were determined in 66 patients with cervical cancer before radiotherapy or concurrent chemoradiotherapy.

Results

There were significant correlations between SUVmax of the primary tumour and FIGO stage (p = 0.036), tumour maximum size (p = 0.018) and pelvic lymph node metastasis (p = 0.044). The median durations of disease-free survival (DFS) and overall survival (OS) were 16.1 and 19.2 months, respectively. The DFS and OS of patients exhibiting high SUVmax of the primary tumour were significantly lower than those of patients exhibiting low SUVmax of the primary tumour (p = 0.0171 and p = 0.0367). The OS of patients exhibiting low ADCmin of the primary tumour was significantly lower than that of patients exhibiting high ADCmin of the primary tumour (p = 0.0376). The DFS and OS of patients exhibiting high SUVmax together with low ADCmin of the primary tumour were significantly lower (p = 0.003 and p = 0.001). Multivariate analyses showed that high SUVmax together with low ADCmin of the primary tumour was an independent prognostic factor for both DFS (p = 0.0030) and OS (p = 0.0036).

Conclusion

High SUVmax together with low ADCmin of the primary tumour is an important predictive factor for identifying patients with cervical cancer who have a poor prognosis.
Literatur
1.
Zurück zum Zitat Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108.PubMedCrossRef Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108.PubMedCrossRef
2.
Zurück zum Zitat Benedet JL, Odicino F, Maisonneuve P, Beller U, Creasman WT, Heintz AP, et al. Carcinoma of the cervix uteri. J Epidemiol Biostat. 2001;6(1):7–43.PubMed Benedet JL, Odicino F, Maisonneuve P, Beller U, Creasman WT, Heintz AP, et al. Carcinoma of the cervix uteri. J Epidemiol Biostat. 2001;6(1):7–43.PubMed
3.
Zurück zum Zitat Delgado G, Bundy BN, Fowler Jr WC, Stehman FB, Sevin B, Creasman WT, et al. A prospective surgical pathological study of stage I squamous carcinoma of the cervix: a Gynecologic Oncology Group Study. Gynecol Oncol. 1989;35(3):314–20.PubMedCrossRef Delgado G, Bundy BN, Fowler Jr WC, Stehman FB, Sevin B, Creasman WT, et al. A prospective surgical pathological study of stage I squamous carcinoma of the cervix: a Gynecologic Oncology Group Study. Gynecol Oncol. 1989;35(3):314–20.PubMedCrossRef
4.
Zurück zum Zitat Dudeck O, Zeile M, Pink D, Pech M, Tunn PU, Reichardt P, et al. Diffusion-weighted magnetic resonance imaging allows monitoring of anticancer treatment effects in patients with soft-tissue sarcomas. J Magn Reson Imaging. 2008;27(5):1109–13.PubMedCrossRef Dudeck O, Zeile M, Pink D, Pech M, Tunn PU, Reichardt P, et al. Diffusion-weighted magnetic resonance imaging allows monitoring of anticancer treatment effects in patients with soft-tissue sarcomas. J Magn Reson Imaging. 2008;27(5):1109–13.PubMedCrossRef
5.
Zurück zum Zitat Guo AC, Cummings TJ, Dash RC, Provenzale JM. Lymphomas and high-grade astrocytomas: comparison of water diffusibility and histologic characteristics. Radiology. 2002;224(1):177–83.PubMedCrossRef Guo AC, Cummings TJ, Dash RC, Provenzale JM. Lymphomas and high-grade astrocytomas: comparison of water diffusibility and histologic characteristics. Radiology. 2002;224(1):177–83.PubMedCrossRef
6.
Zurück zum Zitat Taouli B, Vilgrain V, Dumont E, Daire JL, Fan B, Menu Y. Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients. Radiology. 2003;226(1):71–8.PubMedCrossRef Taouli B, Vilgrain V, Dumont E, Daire JL, Fan B, Menu Y. Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients. Radiology. 2003;226(1):71–8.PubMedCrossRef
7.
Zurück zum Zitat Zhang J, Tehrani YM, Wang L, Ishill NM, Schwartz LH, Hricak H. Renal masses: characterization with diffusion-weighted MR imaging – a preliminary experience. Radiology. 2008;247(2):458–64.PubMedCrossRef Zhang J, Tehrani YM, Wang L, Ishill NM, Schwartz LH, Hricak H. Renal masses: characterization with diffusion-weighted MR imaging – a preliminary experience. Radiology. 2008;247(2):458–64.PubMedCrossRef
8.
Zurück zum Zitat Hayashida Y, Hirai T, Morishita S, Kitajima M, Murakami R, Korogi Y, et al. Diffusion-weighted imaging of metastatic brain tumors: comparison with histologic type and tumor cellularity. AJNR Am J Neuroradiol. 2006;27(7):1419–25.PubMed Hayashida Y, Hirai T, Morishita S, Kitajima M, Murakami R, Korogi Y, et al. Diffusion-weighted imaging of metastatic brain tumors: comparison with histologic type and tumor cellularity. AJNR Am J Neuroradiol. 2006;27(7):1419–25.PubMed
9.
Zurück zum Zitat Kanauchi N, Oizumi H, Honma T, Kato H, Endo M, Suzuki J, et al. Role of diffusion-weighted magnetic resonance imaging for predicting of tumor invasiveness for clinical stage IA non-small cell lung cancer. Eur J Cardiothorac Surg. 2009;35(4):706–10.PubMedCrossRef Kanauchi N, Oizumi H, Honma T, Kato H, Endo M, Suzuki J, et al. Role of diffusion-weighted magnetic resonance imaging for predicting of tumor invasiveness for clinical stage IA non-small cell lung cancer. Eur J Cardiothorac Surg. 2009;35(4):706–10.PubMedCrossRef
10.
Zurück zum Zitat Taouli B, Thakur RK, Mannelli L, Babb JS, Kim S, Hecht EM, et al. Renal lesions: characterization with diffusion-weighted imaging versus contrast-enhanced MR imaging. Radiology. 2009;251(2):398–407.PubMedCrossRef Taouli B, Thakur RK, Mannelli L, Babb JS, Kim S, Hecht EM, et al. Renal lesions: characterization with diffusion-weighted imaging versus contrast-enhanced MR imaging. Radiology. 2009;251(2):398–407.PubMedCrossRef
11.
Zurück zum Zitat Koh DM, Collins DJ. Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol. 2007;188(6):1622–35.PubMedCrossRef Koh DM, Collins DJ. Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol. 2007;188(6):1622–35.PubMedCrossRef
12.
Zurück zum Zitat Sharma U, Danishad KK, Seenu V, Jagannathan NR. Longitudinal study of the assessment by MRI and diffusion-weighted imaging of tumor response in patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy. NMR Biomed. 2009;22(1):104–13.PubMedCrossRef Sharma U, Danishad KK, Seenu V, Jagannathan NR. Longitudinal study of the assessment by MRI and diffusion-weighted imaging of tumor response in patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy. NMR Biomed. 2009;22(1):104–13.PubMedCrossRef
13.
Zurück zum Zitat Gambhir SS. Molecular imaging of cancer with positron emission tomography. Nat Rev Cancer. 2002;2(9):683–93.PubMedCrossRef Gambhir SS. Molecular imaging of cancer with positron emission tomography. Nat Rev Cancer. 2002;2(9):683–93.PubMedCrossRef
14.
Zurück zum Zitat Vesselle H, Schmidt RA, Pugsley JM, Li M, Kohlmyer SG, Vallires E, et al. Lung cancer proliferation correlates with [F-18]fluorodeoxyglucose uptake by positron emission tomography. Clin Cancer Res. 2000;6(10):3837–44.PubMed Vesselle H, Schmidt RA, Pugsley JM, Li M, Kohlmyer SG, Vallires E, et al. Lung cancer proliferation correlates with [F-18]fluorodeoxyglucose uptake by positron emission tomography. Clin Cancer Res. 2000;6(10):3837–44.PubMed
15.
Zurück zum Zitat Buck A, Schirrmeister H, Kühn T, Shen C, Kalker T, Kotzerke J, et al. FDG uptake in breast cancer: correlation with biological and clinical prognostic parameters. Eur J Nucl Med Mol Imaging. 2002;29(10):1317–23.PubMedCrossRef Buck A, Schirrmeister H, Kühn T, Shen C, Kalker T, Kotzerke J, et al. FDG uptake in breast cancer: correlation with biological and clinical prognostic parameters. Eur J Nucl Med Mol Imaging. 2002;29(10):1317–23.PubMedCrossRef
16.
Zurück zum Zitat Kurokawa T, Yoshida Y, Kawahara K, Tsuchida T, Okazawa H, Fujibayashi Y, et al. Expression of GLUT-1 glucose transfer, cellular proliferation activity and grade of tumor correlate with [F-18]-fluorodeoxyglucose uptake by positron emission tomography in epithelial tumors of the ovary. Int J Cancer. 2004;109(6):926–32.PubMedCrossRef Kurokawa T, Yoshida Y, Kawahara K, Tsuchida T, Okazawa H, Fujibayashi Y, et al. Expression of GLUT-1 glucose transfer, cellular proliferation activity and grade of tumor correlate with [F-18]-fluorodeoxyglucose uptake by positron emission tomography in epithelial tumors of the ovary. Int J Cancer. 2004;109(6):926–32.PubMedCrossRef
17.
Zurück zum Zitat Nakamoto Y, Saga T, Ishimori T, Mamede M, Togashi K, Higuchi T, et al. Clinical value of positron emission tomography with FDG for recurrent ovarian cancer. AJR Am J Roentgenol. 2001;176(6):1449–54.PubMed Nakamoto Y, Saga T, Ishimori T, Mamede M, Togashi K, Higuchi T, et al. Clinical value of positron emission tomography with FDG for recurrent ovarian cancer. AJR Am J Roentgenol. 2001;176(6):1449–54.PubMed
18.
Zurück zum Zitat Rose PG, Faulhaber P, Miraldi F, Abdul-Karim FW. Positive emission tomography for evaluating a complete clinical response in patients with ovarian or peritoneal carcinoma: correlation with second-look laparotomy. Gynecol Oncol. 2001;82(1):17–21.PubMedCrossRef Rose PG, Faulhaber P, Miraldi F, Abdul-Karim FW. Positive emission tomography for evaluating a complete clinical response in patients with ovarian or peritoneal carcinoma: correlation with second-look laparotomy. Gynecol Oncol. 2001;82(1):17–21.PubMedCrossRef
19.
Zurück zum Zitat Mack MG, Rieger J, Baghi M, Bisdas S, Vogl TJ. Cervical lymph nodes. Eur J Radiol. 2008;66(3):493–500.PubMedCrossRef Mack MG, Rieger J, Baghi M, Bisdas S, Vogl TJ. Cervical lymph nodes. Eur J Radiol. 2008;66(3):493–500.PubMedCrossRef
20.
Zurück zum Zitat Nakamura K, Okumura Y, Kodama J, Hongo A, Kanazawa S, Hiramatsu Y. The predictive value of measurement of SUVmax and SCC-antigen in patients with pretreatment of primary squamous cell carcinoma of cervix. Gynecol Oncol. 2010;119(1):81–6.PubMedCrossRef Nakamura K, Okumura Y, Kodama J, Hongo A, Kanazawa S, Hiramatsu Y. The predictive value of measurement of SUVmax and SCC-antigen in patients with pretreatment of primary squamous cell carcinoma of cervix. Gynecol Oncol. 2010;119(1):81–6.PubMedCrossRef
21.
Zurück zum Zitat Boyce J, Fruchter RG, Nicastri AD, Ambiavagar PC, Reinis MS, Nelson Jr JH. Prognostic factors in stage I carcinoma of the cervix. Gynecol Oncol. 1981;12(2 Pt 1):154–65.PubMedCrossRef Boyce J, Fruchter RG, Nicastri AD, Ambiavagar PC, Reinis MS, Nelson Jr JH. Prognostic factors in stage I carcinoma of the cervix. Gynecol Oncol. 1981;12(2 Pt 1):154–65.PubMedCrossRef
22.
Zurück zum Zitat Burghardt E, Pickel H, Haas J, Lahousen M. Prognostic factors and operative treatment of stages IB to IIB cervical cancer. Am J Obstet Gynecol. 1987;156(4):988–96.PubMed Burghardt E, Pickel H, Haas J, Lahousen M. Prognostic factors and operative treatment of stages IB to IIB cervical cancer. Am J Obstet Gynecol. 1987;156(4):988–96.PubMed
23.
Zurück zum Zitat Van Bommel PF, Van Lindert AC, Kock HC, Leers WH, Neijt JP. A review of prognostic factors in early-stage carcinoma of the cervix (FIGO I B and II A) and implications for treatment strategy. Eur J Obstet Gynecol Reprod Biol. 1987;26(1):69–84.PubMedCrossRef Van Bommel PF, Van Lindert AC, Kock HC, Leers WH, Neijt JP. A review of prognostic factors in early-stage carcinoma of the cervix (FIGO I B and II A) and implications for treatment strategy. Eur J Obstet Gynecol Reprod Biol. 1987;26(1):69–84.PubMedCrossRef
24.
Zurück zum Zitat Provenzale JM, Mukundan S, Barboriak DP. Diffusion-weighted and perfusion MR imaging for brain tumor characterization and assessment of treatment response. Radiology. 2006;239(3):632–49.PubMedCrossRef Provenzale JM, Mukundan S, Barboriak DP. Diffusion-weighted and perfusion MR imaging for brain tumor characterization and assessment of treatment response. Radiology. 2006;239(3):632–49.PubMedCrossRef
25.
Zurück zum Zitat Matsushima N, Maeda M, Takamura M, Takeda K. Apparent diffusion coefficients of benign and malignant salivary gland tumors. Comparison to histopathological findings. J Neuroradiol. 2007;34(3):183–9.PubMed Matsushima N, Maeda M, Takamura M, Takeda K. Apparent diffusion coefficients of benign and malignant salivary gland tumors. Comparison to histopathological findings. J Neuroradiol. 2007;34(3):183–9.PubMed
26.
Zurück zum Zitat Abdel Razek AA, Soliman NY, Elkhamary S, Alsharaway MK, Tawfik A. Role of diffusion-weighted MR imaging in cervical lymphadenopathy. Eur Radiol. 2006;16(7):1468–77.PubMedCrossRef Abdel Razek AA, Soliman NY, Elkhamary S, Alsharaway MK, Tawfik A. Role of diffusion-weighted MR imaging in cervical lymphadenopathy. Eur Radiol. 2006;16(7):1468–77.PubMedCrossRef
27.
Zurück zum Zitat Humphries PD, Sebire NJ, Siegel MJ, Olsen ØE. Tumors in pediatric patients at diffusion-weighted MR imaging: apparent diffusion coefficient and tumor cellularity. Radiology. 2007;245(3):848–54.PubMedCrossRef Humphries PD, Sebire NJ, Siegel MJ, Olsen ØE. Tumors in pediatric patients at diffusion-weighted MR imaging: apparent diffusion coefficient and tumor cellularity. Radiology. 2007;245(3):848–54.PubMedCrossRef
28.
Zurück zum Zitat Naganawa S, Sato C, Kumada H, Ishigaki T, Miura S, Takizawa O. Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix. Eur Radiol. 2005;15(1):71–8.PubMedCrossRef Naganawa S, Sato C, Kumada H, Ishigaki T, Miura S, Takizawa O. Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix. Eur Radiol. 2005;15(1):71–8.PubMedCrossRef
29.
Zurück zum Zitat McVeigh PZ, Syed AM, Milosevic M, Fyles A, Haider MA. Diffusion-weighted MRI in cervical cancer. Eur Radiol. 2008;18(5):1058–64.PubMedCrossRef McVeigh PZ, Syed AM, Milosevic M, Fyles A, Haider MA. Diffusion-weighted MRI in cervical cancer. Eur Radiol. 2008;18(5):1058–64.PubMedCrossRef
30.
Zurück zum Zitat Paulino AC, Johnstone PA. FDG-PET in radiotherapy treatment planning: pandora’s box? Int J Radiat Oncol Biol Phys. 2004;59(1):4–5.PubMedCrossRef Paulino AC, Johnstone PA. FDG-PET in radiotherapy treatment planning: pandora’s box? Int J Radiat Oncol Biol Phys. 2004;59(1):4–5.PubMedCrossRef
31.
Zurück zum Zitat Fukui MB, Blodgett TM, Snyderman CH, Johnson JJ, Myers EN, Townsend DW, et al. Combined PET-CT in the head and neck: part 2. Diagnostic uses and pitfalls of oncologic imaging. Radiographics. 2005;25(4):913–30.PubMedCrossRef Fukui MB, Blodgett TM, Snyderman CH, Johnson JJ, Myers EN, Townsend DW, et al. Combined PET-CT in the head and neck: part 2. Diagnostic uses and pitfalls of oncologic imaging. Radiographics. 2005;25(4):913–30.PubMedCrossRef
32.
Zurück zum Zitat Hickeson M, Yun M, Matthies A, Zhuang H, Adam LE, Lacorte L, et al. Use of a corrected standardized uptake value based on the lesion size on CT permits accurate characterization of lung nodules on FDG-PET. Eur J Nucl Med Mol Imaging. 2002;29(12):1639–47.PubMedCrossRef Hickeson M, Yun M, Matthies A, Zhuang H, Adam LE, Lacorte L, et al. Use of a corrected standardized uptake value based on the lesion size on CT permits accurate characterization of lung nodules on FDG-PET. Eur J Nucl Med Mol Imaging. 2002;29(12):1639–47.PubMedCrossRef
33.
Zurück zum Zitat Kidd EA, Siegel BA, Dehdashti F, Grigsby PW. The standardized uptake value for F-18 fluorodeoxyglucose is a sensitive predictive biomarker for cervical cancer treatment response and survival. Cancer. 2007;110(8):1738–44.PubMedCrossRef Kidd EA, Siegel BA, Dehdashti F, Grigsby PW. The standardized uptake value for F-18 fluorodeoxyglucose is a sensitive predictive biomarker for cervical cancer treatment response and survival. Cancer. 2007;110(8):1738–44.PubMedCrossRef
34.
Zurück zum Zitat Bos R, van Der Hoeven JJ, van Der Wall E, van Der Groep P, van Diest PJ, Comans EF, et al. Biologic correlates of (18)fluorodeoxyglucose uptake in human breast cancer measured by positron emission tomography. J Clin Oncol. 2002;20(2):379–87.PubMedCrossRef Bos R, van Der Hoeven JJ, van Der Wall E, van Der Groep P, van Diest PJ, Comans EF, et al. Biologic correlates of (18)fluorodeoxyglucose uptake in human breast cancer measured by positron emission tomography. J Clin Oncol. 2002;20(2):379–87.PubMedCrossRef
35.
Zurück zum Zitat Higashi T, Tamaki N, Torizuka T, Nakamoto Y, Sakahara H, Kimura T, et al. FDG uptake, GLUT-1 glucose transporter and cellularity in human pancreatic tumors. J Nucl Med. 1998;39(10):1727–35.PubMed Higashi T, Tamaki N, Torizuka T, Nakamoto Y, Sakahara H, Kimura T, et al. FDG uptake, GLUT-1 glucose transporter and cellularity in human pancreatic tumors. J Nucl Med. 1998;39(10):1727–35.PubMed
36.
Zurück zum Zitat Ito K, Kato T, Ohta T, Tadokoro M, Yamada T, Ikeda M, et al. Fluorine-18 fluoro-2-deoxyglucose positron emission tomography in recurrent rectal cancer: relation to tumour size and cellularity. Eur J Nucl Med. 1996;23(10):1372–7.PubMedCrossRef Ito K, Kato T, Ohta T, Tadokoro M, Yamada T, Ikeda M, et al. Fluorine-18 fluoro-2-deoxyglucose positron emission tomography in recurrent rectal cancer: relation to tumour size and cellularity. Eur J Nucl Med. 1996;23(10):1372–7.PubMedCrossRef
37.
Zurück zum Zitat Kim HS, Kim SY. A prospective study on the added value of pulsed arterial spin-labeling and apparent diffusion coefficients in the grading of gliomas. AJNR Am J Neuroradiol. 2007;28(9):1693–9.PubMedCrossRef Kim HS, Kim SY. A prospective study on the added value of pulsed arterial spin-labeling and apparent diffusion coefficients in the grading of gliomas. AJNR Am J Neuroradiol. 2007;28(9):1693–9.PubMedCrossRef
38.
Zurück zum Zitat Higano S, Yun X, Kumabe T, Watanabe M, Mugikura S, Umetsu A, et al. Malignant astrocytic tumors: clinical importance of apparent diffusion coefficient in prediction of grade and prognosis. Radiology. 2006;241(3):839–46.PubMedCrossRef Higano S, Yun X, Kumabe T, Watanabe M, Mugikura S, Umetsu A, et al. Malignant astrocytic tumors: clinical importance of apparent diffusion coefficient in prediction of grade and prognosis. Radiology. 2006;241(3):839–46.PubMedCrossRef
39.
Zurück zum Zitat Murakami R, Sugahara T, Nakamura H, Hirai T, Kitajima M, Hayashida Y, et al. Malignant supratentorial astrocytoma treated with postoperative radiation therapy: prognostic value of pretreatment quantitative diffusion-weighted MR imaging. Radiology. 2007;243(2):493–9.PubMedCrossRef Murakami R, Sugahara T, Nakamura H, Hirai T, Kitajima M, Hayashida Y, et al. Malignant supratentorial astrocytoma treated with postoperative radiation therapy: prognostic value of pretreatment quantitative diffusion-weighted MR imaging. Radiology. 2007;243(2):493–9.PubMedCrossRef
40.
Zurück zum Zitat Ho KC, Lin G, Wang JJ, Lai CH, Chang CJ, Yen TC. Correlation of apparent diffusion coefficients measured by 3 T diffusion-weighted MRI and SUV from FDG PET/CT in primary cervical cancer. Eur J Nucl Med Mol Imaging. 2009;36(2):200–8.PubMedCrossRef Ho KC, Lin G, Wang JJ, Lai CH, Chang CJ, Yen TC. Correlation of apparent diffusion coefficients measured by 3 T diffusion-weighted MRI and SUV from FDG PET/CT in primary cervical cancer. Eur J Nucl Med Mol Imaging. 2009;36(2):200–8.PubMedCrossRef
Metadaten
Titel
Measurement of SUVmax plus ADCmin of the primary tumour is a predictor of prognosis in patients with cervical cancer
verfasst von
Keiichiro Nakamura
Ikuo Joja
Junichi Kodama
Atsushi Hongo
Yuji Hiramatsu
Publikationsdatum
01.02.2012
Verlag
Springer-Verlag
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 2/2012
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-011-1978-7

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