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Hoffman-La Roche Ltd. supplied the reagent cobas (R) cfDNA Sample Preparation Kit for cfDNA extraction.

Analysis of institutional authors

González De Aledo-Castillo JmAuthorSoler-Perromat AAuthorFuster DAuthorReguart NAuthorViñolas NAuthorVollmer, IAuthorParedes PAuthorPuig-Butille JaCorresponding Author

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Article

Cell-free DNA concentration and fragment size fraction correlate with FDG PET/CT-derived parameters in NSCLC patients

Publicated to:European Journal Of Nuclear Medicine And Molecular Imaging. 48 (11): 3631-3642 - 2021-10-01 48(11), DOI: 10.1007/s00259-021-05306-2

Authors: Gonzalez de Aledo-Castillo, JM; Casanueva-Eliceiry, S; Soler-Perromat, A; Fuster, D; Pastor, V; Reguart, N; Vinolas, N; Reyes, R; Vollmer, I; Paredes, P; Puig-Butille, JA

Affiliations

‎ August Pi i Sunyer Biomed Res Inst IDIBAPS, Barcelona, Spain - Author
‎ Hosp Clin Barcelona, Biochem & Mol Genet Dept, Barcelona, Spain - Author
‎ Hosp Clin Barcelona, Dept Med Oncol, Barcelona, Spain - Author
‎ Hosp Clin Barcelona, Mol Biol CORE, Villarroel 170, Barcelona 08036, Spain - Author
‎ Hosp Clin Barcelona, Nucl Med Dept, Barcelona, Spain - Author
‎ Hosp Clin Barcelona, Radiol Dept, Barcelona, Spain - Author
‎ Hosp Clin Barcelona, Thorac Oncol Unit, Barcelona, Spain - Author
‎ Univ Barcelona, Fac Med, Barcelona, Spain - Author
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Abstract

Purpose The aim of our study was to investigate the correlation between cfDNA concentration and fragment size fraction with FDG PET/CT- and CT-derived parameters in untreated NSCLC patient. Methods Fifty-three patients diagnosed of locally advanced or metastatic NSCLC who had undergone FDG PET/CT, CT and cfDNA analysis prior to any treatment were included in this retrospective study. CfDNA concentration was measured by fluorometry and fragment size fractions were determined by microchip electrophoresis. [F-18]F-FDG PET/CT was performed and standardised uptake values (SUV), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) were calculated for primary, extrapulmonary and total disease. CT scans were evaluated according to RECIST 1.1 criteria. Results CfDNA concentration showed a positive correlation with extrapulmonary MTV (r(2) = 0.36, P = 0.009), and extrapulmonary TLG (r(2) = 0.35, P = 0.009) and their whole-body (wb) ratios. Higher concentrations of total cfDNA were found in patients with liver lesions. Short fragments of cfDNA (100-250 bp) showed a positive correlation with extrapulmonary MTV (r(2) = 0.49, P = 0.0005) and extrapulmonary TLG (r(2) = 0.39, P = 0.006) and their respective wb ratios, and a negative correlation with SUVmean (r(2) = -0.31, P = 0.03) and SUVmean/SUVmax ratio (r(2) = -0.34, P = 0.02). A higher fraction of short cfDNA fragments was found in patients with liver and pleural lesions. Conclusions This study supports the hypothesis that cfDNA concentration and short cfDNA fragment size fraction reflect the tumour burden as well as metabolic activity in advanced NSCLC patients. This suggests their suitability as complementary tests for a more accurate diagnosis of tumour metabolic behaviour and to allow personalised therapies.

Keywords

cfdna concentrationcfdna fragment size fractionsctfdg petCell free nucleic acidCell-free nucleic acidsCfdna concentrationCfdna fragment size fractionsCtDiagnostic imagingFdg petFdg pet/ctFluorodeoxyglucose f 18Fluorodeoxyglucose f18HumanHumansLung neoplasmsLung tumorNsclcPositron emission tomography computed tomographyPositron emission tomography-computed tomographyPrognosisRetrospective studiesRetrospective studyTumor burdenTumor volume

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal European Journal Of Nuclear Medicine And Molecular Imaging due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2021, it was in position 8/136, thus managing to position itself as a Q1 (Primer Cuartil), in the category Radiology, Nuclear Medicine & Medical Imaging. Notably, the journal is positioned above the 90th percentile.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 2.17, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jun 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-06-30, the following number of citations:

  • WoS: 8
  • Scopus: 7
  • Europe PMC: 5

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-06-30:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 30.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 30 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 0.75.
  • The number of mentions on the social network X (formerly Twitter): 1 (Altmetric).

Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (González de Aledo Castillo, José Manuel) and Last Author (Puig Butillé, Joan Anton).

the author responsible for correspondence tasks has been Puig Butillé, Joan Anton.