WorldWideScience

Sample records for 18f-fdg nas regioes

  1. Administered activities of {sup 18}F-FDG PET clinics in pediatrics patients in Brazil- preliminary study; Atividades administradas de {sup 18}F-FDG aos pacientes pediatricos nas clinicas PET no Brasil - estudo preliminar

    Oliveira, Cassio Miri, E-mail: cmo@cdtn.br [Universidade Federal de Minas Gerais (PCTN/UFMG), Belo Horizonte, MG (Brazil). Pos-Graduacao em Ciencias e Tecnicas Nucleares; Silva, Teogenes A. da, E-mail: silvata@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Sa, Lidia V. de, E-mail: lidia@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2013-07-01

    A survey was conducted among the Brazilian clinical PET, with the purpose of investigating the activities administered to pediatric oncology patients and assess whether significant differences between the protocols adopted. In addition, this survey can cooperate to the suggestion diagnostic reference levels (DRLs) in nuclear medicine. Although the methodology for delivering doses by most clinics be based on patient's weight, the results showed variations of up to 191, 6% between the activities administered in clinics, even for similar devices. The average value of the distribution of activities reported was 4.46 {+-} 1,6 MBq /kg. These data demonstrate the need for harmonization and optimization of {sup 18}F-FDG/PET procedures, as well as training for professionals involved in the clinical routine.

  2. (18)F-FDG PET imaging of murine atherosclerosis

    Hag, Anne Mette Fisker; Pedersen, Sune Folke; Christoffersen, Christina;

    2012-01-01

    To study whether (18)F-FDG can be used for in vivo imaging of atherogenesis by examining the correlation between (18)F-FDG uptake and gene expression of key molecular markers of atherosclerosis in apoE(-/-) mice.......To study whether (18)F-FDG can be used for in vivo imaging of atherogenesis by examining the correlation between (18)F-FDG uptake and gene expression of key molecular markers of atherosclerosis in apoE(-/-) mice....

  3. Production And Quality Control Of Radiopharmaceutical 18F-FDG

    18F-FDG is a radiopharmaceutical for imaging diagnosis with PET/CT in Nuclear Medicine. Criteria of injection pharmaceuticals are the highest standards. So, quality assurance and quality control must be followed very strictly. The selection of the procedure for 18F-FDG has based on several criteria: high chemical efficiency, short synthesis time, toxic component free and etc. The quality control of 18F-FDG consist many fields such as: nuclear physic (nuclear purity), radiochemistry (radionuclear purity, radiochemical purity), chemistry (chemical purity), radiation measurement (half life), microbiology (pyrogen, endotoxin), etc. which is following USP, BP or EP. (author)

  4. [18F]FDG PET/CT outperforms [18F]FDG PET/MRI in differentiated thyroid cancer

    To evaluate the diagnostic potential of PET/MRI with [18F]FDG in comparison to PET/CT in patients with differentiated thyroid cancer suspected or known to have dedifferentiated. The study included 31 thyroidectomized and remnant-ablated patients who underwent a scheduled [18F]FDG PET/CT scan and were then enrolled for a PET/MRI scan of the neck and thorax. The datasets (PET/CT, PET/MRI) were rated regarding lesion count, conspicuity, diameter and characterization. Standardized uptake values were determined for all [18F]FDG-positive lesions. Histology, cytology, and examinations before and after treatment served as the standards of reference. Of 26 patients with a dedifferentiated tumour burden, 25 were correctly identified by both [18F]FDG PET/CT and PET/MRI. Detection rates by PET/CT and PET/MRI were 97 % (113 of 116 lesions) and 85 % (99 of 113 lesions) for malignant lesions, and 100 % (48 of 48 lesions) and 77 % (37 of 48 lesions) for benign lesions, respectively. Lesion conspicuity was higher on PET/CT for both malignant and benign pulmonary lesions and in the overall rating for malignant lesions (p < 0.001). There was a difference between PET/CT and PET/MRI in overall evaluation of malignant lesions (p < 0.01) and detection of pulmonary metastases (p < 0.001). Surgical evaluation revealed three malignant lesions missed by both modalities. PET/MRI additionally failed to detect 14 pulmonary metastases and 11 benign lesions. In patients with thyroid cancer and suspected or known dedifferentiation, [18F]FDG PET/MRI was inferior to low-dose [18F]FDG PET/CT for the assessment of pulmonary status. However, for the assessment of cervical status, [18F]FDG PET/MRI was equal to contrast-enhanced neck [18F]FDG PET/CT. Therefore, [18F]FDG PET/MRI combined with a low-dose CT scan of the thorax may provide an imaging solution when high-quality imaging is needed and high-energy CT is undesirable or the use of a contrast agent is contraindicated. (orig.)

  5. [18F] FDG PET in gastric non-Hodgkin's lymphoma

    The possibility of using [18F] FDG PET for assessment of tumor extension in primary gastric non-Hodgkin's lymphoma (NHL) was studied in 8 patients (6 high-grade and 2 low-grade, one of the MALT type) and in a control group of 7 patients (5 patients with NHL without clinical signs of gastric involvement, 1 patient with NHL and benign gastric ulcer and 1 patient with adenocarcinoma of the stomach). All patients with gastric NHL and the two with benign gastric ulcer and adenocarcinoma, respectively, underwent endoscopy including multiple biopsies for histopathological diagnosis. All patients with high-grade and one of the two with low-grade NHL and the patient with adenocarcinoma displayed high gastric uptake of [18F] FDG corresponding to the pathological findings at endoscopy and/or CT. No pathological tracer uptake was seen in the patient with low-grade gastric NHL of the MALT type. In 6/8 patients with gastric NHL, [18F] FDG PET demonstrated larger tumor extension in the stomach than was found at endoscopy, and there was high tracer uptake in the stomach in two patients who were evaluated as normal on CT. [18F] FDG PET correctly excluded gastric NHL in the patient with a benign gastric ulcer and in the patients with NHL without clinical signs of gastric involvement. Although the experience is as yet limited, [18F] FDG PET affords a novel possibility for evaluation of gastric NHL and would seem valuable as a complement to endoscopy and CT in selected patients, where the technique can yield additional information decisive for the choice of therapy. (orig.)

  6. (18)F-FDG PET patterns and BAL cell profiles in pulmonary sarcoidosis.

    Keijsers, R.G.; Grutters, J.C.; Velzen-Blad, H. van; Bosch, J.M. van den; Oyen, W.J.G.; Verzijlbergen, F.J.

    2010-01-01

    PURPOSE: Bronchoalveolar lavage (BAL) and (18)F-fluorodeoxyglucose ((18)F-FDG) PET can both demonstrate sarcoid activity. To assess whether metabolic activity imaged by (18)F-FDG PET represents signs of disease activity as reflected by BAL, (18)F-FDG PET patterns were compared with BAL cell profiles

  7. [18F]FDG-PET in lung cancer: current status

    Jane Dobbs, H; Quint, Leslie Eisenbud; Miles, K A

    2005-01-01

    Increasingly, evidence of safety, effectiveness and cost-effectiveness is required to support funding of new diagnostic technologies. However, diagnostic imaging is a rapidly changing speciality with new data constantly being added to the evidence base. This article aims to review the evidence base for the application of fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) in lung cancer and to identify areas in which the evidence base is evolving. Currently, there is strong evidenc...

  8. Large-Vessel Vasculitis: Interobserver Agreement and Diagnostic Accuracy of 18F-FDG-PET/CT

    K. D. F. Lensen

    2015-01-01

    Full Text Available Introduction. 18F-FDG-PET visualises inflammation. Both atherosclerosis and giant cell arteritis cause vascular inflammation, but distinguishing the two may be difficult. The goal of this study was to assess interobserver agreement and diagnostic accuracy of 18F-FDG-PET for the detection of large artery involvement in giant cell arteritis (GCA. Methods. 31 18F-FDG-PET/CT scans were selected from 2 databases. Four observers assessed vascular wall 18F-FDG uptake, initially without and subsequently with predefined observer criteria (i.e., vascular wall 18F-FDG uptake compared to liver or femoral artery 18F-FDG uptake. External validation was performed by two additional observers. Sensitivity and specificity of 18F-FDG-PET were determined by comparing scan results to a consensus diagnosis. Results. The highest interobserver agreement (kappa: 0.96 in initial study and 0.79 in external validation was observed when vascular wall 18F-FDG uptake higher than liver uptake was used as a diagnostic criterion, although agreement was also good without predefined criteria (kappa: 0.68 and 0.85. Sensitivity and specificity were comparable for these methods. The criterion of vascular wall 18F-FDG uptake equal to liver 18F-FDG uptake had low specificity. Conclusion. Standardization of image assessment for vascular wall 18F-FDG uptake promotes observer agreement, enables comparative studies, and does not appear to result in loss of diagnostic accuracy compared to nonstandardized assessment.

  9. Low carbohydrate diet before 18F-FDG tumor imaging contributes to reduce myocardial 18F-FDG uptake

    Objective: To evaluate whether low carbohydrate diet before 18F-FDG tumor imaging could reduce myocardial 18F-FDG uptake. Methods: From April 2011 to January 2012, 70 patients were enrolled in this study.They were randomly divided into control group (34 cases) and test group (36 cases). Patients in control group were on regular diet, while those in test group had low carbohydrate diet in the evening before imaging. Blood samples were taken before injection of 18F-FDG for the measurement of serum glucose, free fatty acid,insulin and ketone body. Whole body 18F-FDG tomography was performed with dual-head coincidence SPECT. The myocardial uptake of FDG was assessed visually and scored as 0 for no uptake, 1 for uptake lower than liver, 2 for uptake similar to liver, 3 for uptake higher than liver, and 4 for remarkable uptake.The ratio of myocardium to liver (H/L) was calculated. Two-sample t test, Wilcoxon rank sum test and linear correlation analysis were performed. Results: The myocardial uptake in test group was significantly lower than that in control group with H/L ratios of 0.94±0.57 and 1.50±1.04, respectively (t=-2.75, P<0.05). The concentrations of serum free fatty acid and ketone body in test group were significantly higher than those in control group: (0.671±0.229) mmol/L vs (0.547±0.207) mmol/L and (0.88±0.60) mmol/L vs (0.57±0.32) mmol/L, t=2.38 and 2.67, both P<0.05. The concentrations of glucose and insulin were (5.28±1.06) mmol/L and (35.16±33.70) pmol/L in test group, which showed no significant difference with those in control group ((5.19±0.78) mmol/L and (41.64±35.13) pmol/L, t=0.39 and-0.79, both P>0.05). A negative correlation was found between the myocardial uptake of 18F-FDG and serum free fatty acid/ketone body concentration (r=-0.40, -0.33, both P<0.01), respectively. There was no correlation between the myocardial uptake of 18F-FDG and glucose/insulin (r=-0.02, 0.13, both P>0.05), respectively. Conclusion: Low carbohydrate diet

  10. Assessment of Tumor Response to Therapy in Lymphoma Using 18F-FDG PET: Diagnostic Performance of 18F-FDG PET and Interval Likelihood Ratio

    In this paper, the authors intended to summarize briefly the features of lymphoma with regard to 18F-FDG PET for assessment of tumor response to therapy, to describe why assessment of treatment response should be performed, to review what method so far has been used in monitoring treatment response, to discuss what limitations of morphologic imaging criteria for assessing tumor response are, in compared with 18F-FDG PET, and to introduce recently proposed criteria for assessing tumor response in malignant lymphoma. And also the authors emphasize the need to understand the characteristics of diagnostic performance of 18F-FDG PET in several clinical settings in order to interpret 18F-FDG PET results appropriately, and to encourage the use of interval likelihood ratio to enhance clinical implications of test results which, in turns, allows referring physicians to understand the meaning of interpretation with easy. Until recently, treatment response has been assessed according to the morphologic criteria. Metabolic imaging with 18F-FDG PET was adopted to have important role for treatment assessment in IWC+PET criteria proposed recently by IHP. To accomplish this role, we should perform and interpret 18F-FDG PET according to IWC+PET criteria. It is important for referring physicians to understand the various limitations of 18F-FDG PET and pitfalls in PET interpretation, and to understand that clinical information are needed by nuclear medicine physicians to optimize the interpretation of 18F-FDG PET

  11. Acute and subacute toxicity of 18F-FDG

    Before starting clinical trials of a new drug, it is necessary to perform a battery of safety tests for assessing human risk. Radiopharmaceuticals like any new drug must be tested taking into account its specificity, duration of treatment and especially the toxicity of both parties, the unlabeled molecule and its radionuclide, apart from impurities emanating from radiolysis. Regulatory agencies like the Food and Drug Administration - USA (FDA) and the European Medicine Agency (EMEA), establish guidelines for the regulation of production and research of radiopharmaceuticals. In Brazil the production of radiopharmaceuticals was not regulated until the end of 2009, when were established by the National Agency for Sanitary Surveillance (ANVISA) resolutions No. 63, which refers to the Good Manufacturing Practices of Radiopharmaceuticals and No. 64 which seeks the registration of record radiopharmaceuticals. To obtain registration of radiopharmaceuticals are necessary to prove the quality, safety, efficacy and specificity of the drug . For the safety of radiopharmaceuticals must be presented studies of acute toxicity, subacute and chronic toxicity as well as reproductive, mutagenic and carcinogenic. Nowadays IPEN-CNEN/SP produces one of the most important radiopharmaceutical of nuclear medicine, the 18F-FDG, which is used in many clinical applications, particularly in the diagnosis and staging of tumors. The objective of this study was to evaluate the systemic toxicity (acute/ subacute) radiopharmaceutical 18F-FDG in an in vivo test system, as recommended by the RDC No. 64, which will serve as a model for protocols toxicity of radiopharmaceuticals produced at IPEN. The following tests were performed: tests of acute and subacute toxicity, biodistribution studies of 18F-FDG, comet assay and reproductive toxicity. In acute toxicity, healthy rats were injected . (author)

  12. Acute and subacute toxicity of 18F-FDG

    Before initiating clinical trials of a new drug, it is necessary to perform a battery of safety tests, for evaluating the risk in humans. Radiopharmaceuticals must be tested taking into account its specificity, duration of treatment and especially the toxicity of both, the unlabelled molecule and its radionuclide, apart from impurities emanating from radiolysis. In Brazil the production of radiopharmaceuticals was not regulated until the end of 2009, when ANVISA established the Resolutions No. 63, which refers to the Good Manufacturing Practices of radiopharmaceuticals and No. 64 which seeks the registration of radiopharmaceuticals. Nowadays IPEN produces one of the most important radiopharmaceutical for nuclear medicine, the 18F-FDG, which is used in the diagnosis. The objective of this study is to assess systemic toxicity (acute / subacute) of 18F-FDG in an in vivo test system, as recommended by the RDC No. 64. In acute tests the administration occurred on the first day, healthy rats were observed for 14 days reporting their clinical signs and water consumption, and on the 15th day they were euthanized and necropsied. The assay of subacute toxicity observations were made over a period of 28 days and the first dose was administered at the beginning of the test and after a fortnight a second dose was administered. The parameters evaluated were the necropsy, histopathology of target organs, hematology studies and liver and kidney function. The results are being processed and evaluated. Initial observations did not show any acute toxicity in animals when compared to control animals. (author)

  13. Clinical Application of 18F-FDG PET in Multiple Myeloma

    This review focuses on the clinical use of 18F-FDG PET to evaluate multiple myeloma. 18F-FDG PET is useful for diagnosis, staging of multiple myeloma and differential diagnosis of myeloma related disease such as monoclonal gammopathy of undetermined significance or plasmacytoma. For therapy response, 18F-FDG PET may be effective after chemotherapy for multiple myeloma and radiotherapy for plasmacytoma

  14. Clinical Application of {sup 18}F-FDG PET in Testicular Cancer

    Yoon, Joon Kee [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2008-12-15

    {sup 18}F-FDG PET has a higher diagnostic accuracy than CT in initial staging of testicular cancer. In seminoma, it can discriminate residual tumor from necrosis/fibrosis or mature teratoma. {sup 18}F-FDG PET is also useful for the response evaluation of chemotherapy. However, there's no clinical evidence for the use of {sup 18}F-FDG PET in the diagnosis and differential diagnosis of testicular cancer.

  15. Clinical impact of 18F-FDG PET/CT on suspected cervical cancer recurrence

    Objective: To evaluate the clinical impact of 18F-FDG PET/CT on patients with suspected cervical cancer recurrence. Methods: Fifty-one cervical cancer patients, clinically suspected to have tumor recurrence during follow-up, underwent 18F-FDG PET/CT examination. 18F-FDG PET/CT results were compared with those of conventional images, as referred to histopathology or clinical follow-up. Impacts of 18F-FDG PET/CT were evaluated based on documented changes of clinical management. Results: In total, 43 patients were found to have positive lesions by 18F-FDG PET/CT, in which 40 were true recurrence,but 2 were pelvic abscess and 1 was radiation enterocolitis. Other 8 patients were found negative by 18F-FDG PET/CT and confirmed by pathology or follow-up. In patient-based analyses, the sensitivity, specificity, and accuracy of 18F-FDG PET/CT for the detection of tumor recurrence were 100% (40/40), 72.73% (8/11), and 94.12% (48/51) respectively. In 7 patients, the clinical management was changed due to 18F-FDG PET/CT findings. Conclusion: 18F-FDG PET/CT is an efficient tool for determining the recurrence of cervical cancer and instructing the clinical management. (authors)

  16. 18F-FDG PET in children with lymphomas

    The aim of this study was to retrospectively evaluate the performance of positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) in children with lymphomas, at various stages of their disease. Twenty-eight children (mean age 12.5 years, 14 girls, 14 boys) with Hodgkin's disease (HD, n=17) or non-Hodgkin's lymphoma (NHL, n=11) were evaluated. Patients were investigated at initial staging (n=19), early in the course of treatment (n=19), at the end of treatment (n=16) and during long-term follow-up (n=19). A total of 113 whole-body PET studies were performed on dedicated scanners. PET results were compared with the results of conventional methods (CMs) such as physical examination, laboratory studies, chest X-rays, computed tomography, magnetic resonance imaging, ultrasonography and bone scan when available. At initial evaluation (group 1), PET changed the disease stage and treatment in 10.5% of the cases. In early evaluation of the response to treatment (group 2), PET failed to predict two relapses and one incomplete response to treatment. In this group, however, PET did not show any false positive results. There were only 4/75 false positive results for PET among patients studied at the end of treatment (group 3, specificity 94%) or during the systematic follow-up (group 4, specificity 95%), as compared with 27/75 for CMs (specificity 54% and 66%, respectively). 18F-FDG-PET is a useful tool for evaluating children with lymphomas. Large prospective studies are needed to appreciate its real impact on patient management. (orig.)

  17. Acute and subacute toxicity of {sup 18F}-FDG

    Dantas, Danielle M.; Silva, Natanael G. da; Manetta, Ana Paula; Osso Junior, Joao A., E-mail: danielle_2705@hotmail.com, E-mail: jaossoj@yahoo.com.br, E-mail: ngsilva@ipen.br, E-mail: apaulasp2008@hotmail.co [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2013-07-01

    Before initiating clinical trials of a new drug, it is necessary to perform a battery of safety tests, for evaluating the risk in humans. Radiopharmaceuticals must be tested taking into account its specificity, duration of treatment and especially the toxicity of both, the unlabelled molecule and its radionuclide, apart from impurities emanating from radiolysis. In Brazil the production of radiopharmaceuticals was not regulated until the end of 2009, when ANVISA established the Resolutions No. 63, which refers to the Good Manufacturing Practices of radiopharmaceuticals and No. 64 which seeks the registration of radiopharmaceuticals. Nowadays IPEN produces one of the most important radiopharmaceutical for nuclear medicine, the {sup 18}F-FDG, which is used in the diagnosis. The objective of this study is to assess systemic toxicity (acute / subacute) of {sup 18}F-FDG in an in vivo test system, as recommended by the RDC No. 64. In acute tests the administration occurred on the first day, healthy rats were observed for 14 days reporting their clinical signs and water consumption, and on the 15th day they were euthanized and necropsied. The assay of subacute toxicity observations were made over a period of 28 days and the first dose was administered at the beginning of the test and after a fortnight a second dose was administered. The parameters evaluated were the necropsy, histopathology of target organs, hematology studies and liver and kidney function. The results are being processed and evaluated. Initial observations did not show any acute toxicity in animals when compared to control animals. (author)

  18. {sup 18}F-FDG PET in children with lymphomas

    Depas, Gisele; Barsy, Caroline De; Foidart, Jacqueline; Rigo, Pierre; Hustinx, Roland [University Hospital, Division of Nuclear Medicine, Liege (Belgium); Jerusalem, Guy [University Hospital, Division of Medical Oncology, Liege (Belgium); Hoyoux, Claire; Dresse, Marie-Francoise [CHR Citadelle, Division of Pediatric Hematology and Oncology, Liege (Belgium); Fassotte, Marie-France [University Hospital, Division of Hematology, Liege (Belgium); Paquet, Nancy [Hotel de Dieu, Levis, Division of Nuclear Medicine, Quebec (Canada)

    2005-01-01

    The aim of this study was to retrospectively evaluate the performance of positron emission tomography (PET) with {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) in children with lymphomas, at various stages of their disease. Twenty-eight children (mean age 12.5 years, 14 girls, 14 boys) with Hodgkin's disease (HD, n=17) or non-Hodgkin's lymphoma (NHL, n=11) were evaluated. Patients were investigated at initial staging (n=19), early in the course of treatment (n=19), at the end of treatment (n=16) and during long-term follow-up (n=19). A total of 113 whole-body PET studies were performed on dedicated scanners. PET results were compared with the results of conventional methods (CMs) such as physical examination, laboratory studies, chest X-rays, computed tomography, magnetic resonance imaging, ultrasonography and bone scan when available. At initial evaluation (group 1), PET changed the disease stage and treatment in 10.5% of the cases. In early evaluation of the response to treatment (group 2), PET failed to predict two relapses and one incomplete response to treatment. In this group, however, PET did not show any false positive results. There were only 4/75 false positive results for PET among patients studied at the end of treatment (group 3, specificity 94%) or during the systematic follow-up (group 4, specificity 95%), as compared with 27/75 for CMs (specificity 54% and 66%, respectively). {sup 18}F-FDG-PET is a useful tool for evaluating children with lymphomas. Large prospective studies are needed to appreciate its real impact on patient management. (orig.)

  19. [{sup 18}F]FDG PET monitoring of tumour response to chemotherapy: does [{sup 18}F]FDG uptake correlate with the viable tumour cell fraction?

    Spaepen, Karoline; Stroobants, Sigrid; Dupont, Patrick; Bormans, Guy; Mortelmans, Luc [Department of Nuclear Medicine, UZ Gasthuisberg, Herestraat 49, 3000, Leuven (Belgium); Balzarini, Jan [Rega Institute, Katholieke Universiteit, Leuven (Belgium); Verhoef, Gregor; Vandenberghe, Peter [Department of Hematology, UZ Gasthuisberg, Leuven (Belgium); De Wolf-Peeters, Christine [Department of Pathology, UZ Gasthuisberg, Leuven (Belgium)

    2003-05-01

    Because metabolic changes induced by chemotherapy precede the morphological changes, fluorine-18 fluorodeoxyglucose positron emission tomography ([{sup 18}F]FDG PET) is thought to predict response to therapy earlier and more accurately than other modalities. To be a reliable predictor of response, changes in tumour [{sup 18}F]FDG uptake should reflect changes in viable cell fraction, but little is known about the contribution of apoptotic and necrotic cancer cells and inflammatory tissue to the [{sup 18}F]FDG signal. In a tumour mouse model we investigated the relation between chemotherapy-induced changes in various tumoral components and tumour uptake and size. SCID mice were subcutaneously inoculated in the right thigh with 5 x 10{sup 6} Daudi cells. When the tumour measured 15-20 mm, Endoxan was given intravenously. At different time points [1-15 days (d1-d15) after the injection of Endoxan], ex vivo autoradiography and histopathology were performed in two mice and [{sup 18}F]FDG uptake in the tumour and tumour size were correlated with the different cell fractions measured with flow cytometry in five mice. At d1/d3, similar reductions in [{sup 18}F]FDG uptake and viable tumoral cell fraction were observed and these reductions preceded changes in tumour size. By d8/d10, [{sup 18}F]FDG uptake had stabilised despite a further reduction in viable tumoral cell fraction. At these time points a major inflammatory response was observed. At d15, an increase in viable tumour cells was again observed and this was accurately predicted by an increase in [{sup 18}F]FDG uptake, while the tumour volume remained unchanged. In contrast with variations in tumour volume, [{sup 18}F]FDG is a good marker for chemotherapy response monitoring. However, optimal timing seems crucial since a transient increase in stromal reaction may result in overestimation of the fraction of viable cells. (orig.)

  20. Artifacts and pitfalls in oncologic {sup 18}F-FDG-PET-CT imaging; Artefakte und Fallstricke in der onkologischen {sup 18}F-FDG-PET-CT-Diagnostik

    Falck, Christian von [Medizinische Hochschule Hannover (Germany). Schwerpunkt multimodale Bildgebung; Raatschen, Hans-Juergen [Charite Berlin (Germany). Radiologie; Bengel, Frank M. [Medizinische Hochschule Hannover (Germany)

    2011-12-15

    Hybrid imaging such as {sup 18}F-FDG PET-CT synergistically combines the advantages of metabolic and morphologic imaging. Due to its increasing role in the imaging of oncologic disease there is a growing demand for the general radiologists to have a basic unterstanding of the method and its limitations. Therefore, the objective of this review is to explain und illustrate the typical artifacts and pitfalls of oncologic PET-CT imaging using {sup 18}F-FDG. (orig.)

  1. Reproducibility of 18F-FDG microPET Studies in Mouse Tumor Xenografts

    Dandekar, Mangal; Tseng, Jeffrey R.; Gambhir, Sanjiv S.

    2007-01-01

    18F-FDG has been used to image mouse xenograft models with small-animal PET for therapy response. However, the reproducibility of serial scans has not been determined. The purpose of this study was to determine the reproducibility of 18F-FDG small-animal PET studies.

  2. Local transport of 18F FDG: guidelines and practical aspects

    Full text: Transport of radioactive material in India is governed by Atomic Energy Regulatory Board (AERB) safety code AERB/SC/TR-1 which is based on the International Atomic Energy Agency (IAEA) regulations for the safe transport of radioactive material. The basic requirement for the transport of radioactive material is that the package containing the material shall be designed and prepared in such a way that during the whole process of transport, the radioactive material remains contained to prevent contamination and remains shielded to avoid unacceptable radiation exposure to cargo handlers and public. The types of packages used for the transport of radioactive materials are Excepted, Industrial, Type A, Type B(U) and Type B(M) packages. Type A packages are used for the transport of dispersible radioactive material of moderate activity such as nuclear medicine sources used for diagnostic and therapeutic purposes. Transport of 18F FDG comes under this category. The use of PET-CT in India has grown rapidly over the last few years. Currently, in India, there are around 60 PET-CTs and 15 cyclotrons. Most of these PET-CT facilities are supplied with FDG from off-site cyclotrons. The prime responsibility for ensuring safe transport of 18F FDG lies with the consignor. The consignor needs to ensure that the appropriate packaging is selected for the transport of 18F FDG and the package is prepared, marked and labeled as per the regulations. A material such as Tungsten or lead of appropriate thickness and design is used in packaging. Once the package is prepared as per the prescribed procedures, it can be transported by any mode of transport i.e. by road, rail, sea or air. Transport documents are very important during transport; they include (1) declaration by the consignor, (2) instructions to the carrier, (3) a Transport Emergency Card (TREMCARD) and (4) Instructions in writing to the carrier for emergency measures. In addition to this, one working radiation survey

  3. Human radiation dosimetry of 6-[{sup 18}F]FDG predicted from preclinical studies

    Muzic, Raymond F., E-mail: raymond.muzic@case.edu [Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio 44106 (United States); Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106 (United States); Case Center for Imaging Research, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio 44106 (United States); Chandramouli, Visvanathan; Hatami, Ahmad [Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio 44106 (United States); Huang, Hsuan-Ming; Wu, Chunying [Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106 and Case Center for Imaging Research, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio 44106 (United States); Ismail-Beigi, Faramarz [Department of Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio 44106 (United States)

    2014-03-15

    Purpose: The authors are developing 6-[{sup 18}F]fluoro-6-deoxy-D-glucose (6-[{sup 18}F]FDG) as an in vivo tracer of glucose transport. While 6-[{sup 18}F]FDG has the same radionuclide half-life as 2-[{sup 18}F]fluoro-2-deoxy-D-glucose (2-[{sup 18}F]FDG) which is ubiquitously used for PET imaging, 6-[{sup 18}F]FDG has special biologic properties and different biodistributions that make it preferable to 2-[{sup 18}F]FDG for assessing glucose transport. In preparation for 6-[{sup 18}F]FDG use in human PET scanning, the authors would like to determine the amount of 6-[{sup 18}F]FDG to inject while maintaining radiation doses in a safe range. Methods: Rats were injected with 6-[{sup 18}F]FDG, euthanized at specified times, and tissues were collected and assayed for activity content. For each tissue sample, the percent of injected dose per gram was calculated and extrapolated to that for humans in order to construct predicted time-courses. Residence times were calculated as areas under the curves and were used as inputs to OLINDA/EXM in order to calculate the radiation doses. Results: Unlike with 2-[{sup 18}F]FDG for which the urinary bladder wall receives the highest absorbed dose due to urinary excretion, with 6-[{sup 18}F]FDG there is little urinary excretion and osteogenic cells and the liver are predicted to receive the highest absorbed doses: 0.027 mGy/MBq (0.100 rad/mCi) and 0.018 mGy/MBq (0.066 rad/mCi), respectively. Also, the effective dose from 6-[{sup 18}F]FDG, i.e., 0.013 mSv/MBq (0.046 rem/mCi), is predicted to be approximately 30% lower than that from 2-[{sup 18}F]FDG. Conclusions: 6-[{sup 18}F]FDG will be safe for use in the PET scanning of humans.

  4. [{sup 18}F]FDG PET/CT outperforms [{sup 18}F]FDG PET/MRI in differentiated thyroid cancer

    Vrachimis, Alexis; Wenning, Christian; Weckesser, Matthias; Stegger, Lars [University Hospital Muenster, Department of Nuclear Medicine, Muenster (Germany); Burg, Matthias Christian; Allkemper, Thomas [University Hospital Muenster, Department of Clinical Radiology, Muenster (Germany); Schaefers, Michael [University Hospital Muenster, Department of Nuclear Medicine, Muenster (Germany); Westfaelische Wilhelms University Muenster, European Institute for Molecular Imaging, Muenster (Germany)

    2016-02-15

    To evaluate the diagnostic potential of PET/MRI with [{sup 18}F]FDG in comparison to PET/CT in patients with differentiated thyroid cancer suspected or known to have dedifferentiated. The study included 31 thyroidectomized and remnant-ablated patients who underwent a scheduled [{sup 18}F]FDG PET/CT scan and were then enrolled for a PET/MRI scan of the neck and thorax. The datasets (PET/CT, PET/MRI) were rated regarding lesion count, conspicuity, diameter and characterization. Standardized uptake values were determined for all [{sup 18}F]FDG-positive lesions. Histology, cytology, and examinations before and after treatment served as the standards of reference. Of 26 patients with a dedifferentiated tumour burden, 25 were correctly identified by both [{sup 18}F]FDG PET/CT and PET/MRI. Detection rates by PET/CT and PET/MRI were 97 % (113 of 116 lesions) and 85 % (99 of 113 lesions) for malignant lesions, and 100 % (48 of 48 lesions) and 77 % (37 of 48 lesions) for benign lesions, respectively. Lesion conspicuity was higher on PET/CT for both malignant and benign pulmonary lesions and in the overall rating for malignant lesions (p < 0.001). There was a difference between PET/CT and PET/MRI in overall evaluation of malignant lesions (p < 0.01) and detection of pulmonary metastases (p < 0.001). Surgical evaluation revealed three malignant lesions missed by both modalities. PET/MRI additionally failed to detect 14 pulmonary metastases and 11 benign lesions. In patients with thyroid cancer and suspected or known dedifferentiation, [{sup 18}F]FDG PET/MRI was inferior to low-dose [{sup 18}F]FDG PET/CT for the assessment of pulmonary status. However, for the assessment of cervical status, [{sup 18}F]FDG PET/MRI was equal to contrast-enhanced neck [{sup 18}F]FDG PET/CT. Therefore, [{sup 18}F]FDG PET/MRI combined with a low-dose CT scan of the thorax may provide an imaging solution when high-quality imaging is needed and high-energy CT is undesirable or the use of a contrast

  5. Detection of histologically proven peritoneal carcinomatosis with fused 18F-FDG-PET/MDCT

    Dirisamer, Albert [Department of Nuclear Medicine, St. Vincent' s Hospital, Seilerstaette 4, 4010 Linz (Austria); Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria)], E-mail: albert.dirisamer@meduniwien.ac.at; Schima, Wolfgang [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Heinisch, Martin [Department of Nuclear Medicine, St. Vincent' s Hospital, Seilerstaette 4, 4010 Linz (Austria); Weber, Michael [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Lehner, Hans Peter [Department of Nuclear Medicine, St. Vincent' s Hospital, Seilerstaette 4, 4010 Linz (Austria); Haller, Joerg [Department of Radiology, Hanusch Krankenhaus, Heinrich-Collin-Strasse 30, 1140 Vienna (Austria); Langsteger, Werner [Department of Nuclear Medicine, St. Vincent' s Hospital, Seilerstaette 4, 4010 Linz (Austria)

    2009-03-15

    Objective: To evaluate peritoneal carcinomatosis in patients with gastrointestinal and gynecologic malignancies and to assess the diagnostic role for 18-FDG-PET and MDCT alone in comparison to the diagnostic accuracy of fused 18F-FDG-PET/MDCT by using surgical and histopathological findings as the standard of reference. Methods and subjects: Sixty-two patients (13 males, 49 females; age range 43-81; mean age, 62 years with suspected peritoneal carcinomatosis were reviewed for the presence of peritoneal lesions on 18F-FDG-PET/MDCT scans (Discovery LS, GE Medical Systems). The results were compared with the histological findings at laparatomy. Thirty-one patients had peritoneal metastases, while 31 patients had negative histological findings at laparotomy. Results: CT detected peritoneal seeding in 26/31 patients, 18F-FDG-PET in 25/31 patients, and 18F-FDG-PET/MDCT in 30/31 patients, for a sensitivity of 88%, 88%, and 100%, respectively. False-positive findings were seen in MDCT in one patient, in 18F-FDG-PET in two patients, and in 18F-MDCT-PET/MDCT in one patient, for a specificity of 97%, 94%, and 97%, respectively. Conclusion: Fused 18F-FDG-PET/MDCT is superior to MDCT and 18F-FDG-PET alone for the detection of peritoneal carcinomatosis especially in small lesions and it offers exact anatomic information for surgical treatment.

  6. Detection of histologically proven peritoneal carcinomatosis with fused 18F-FDG-PET/MDCT

    Objective: To evaluate peritoneal carcinomatosis in patients with gastrointestinal and gynecologic malignancies and to assess the diagnostic role for 18-FDG-PET and MDCT alone in comparison to the diagnostic accuracy of fused 18F-FDG-PET/MDCT by using surgical and histopathological findings as the standard of reference. Methods and subjects: Sixty-two patients (13 males, 49 females; age range 43-81; mean age, 62 years with suspected peritoneal carcinomatosis were reviewed for the presence of peritoneal lesions on 18F-FDG-PET/MDCT scans (Discovery LS, GE Medical Systems). The results were compared with the histological findings at laparatomy. Thirty-one patients had peritoneal metastases, while 31 patients had negative histological findings at laparotomy. Results: CT detected peritoneal seeding in 26/31 patients, 18F-FDG-PET in 25/31 patients, and 18F-FDG-PET/MDCT in 30/31 patients, for a sensitivity of 88%, 88%, and 100%, respectively. False-positive findings were seen in MDCT in one patient, in 18F-FDG-PET in two patients, and in 18F-MDCT-PET/MDCT in one patient, for a specificity of 97%, 94%, and 97%, respectively. Conclusion: Fused 18F-FDG-PET/MDCT is superior to MDCT and 18F-FDG-PET alone for the detection of peritoneal carcinomatosis especially in small lesions and it offers exact anatomic information for surgical treatment.

  7. Prognostic Value of Dual-Time-Point 18F-FDG PET for Idiopathic Pulmonary Fibrosis

    Umeda, Yukihiro; DEMURA, Yoshiki; Morikawa, Miwa; Anzai, Masaki; Kadowaki, Maiko; Ameshima, Shingo; TSUCHIDA, Tatsuro; TSUJIKAWA, Tetsuya; Kiyono, Yasushi; OKAZAWA, Hidehiko; Ishizaki, Takeshi; Ishizuka, Tamotsu

    2015-01-01

    The aim of this prospective study was to clarify whether dual-time-point (18)F-FDG PET imaging results are useful to predict long-term survival of idiopathic pulmonary fibrosis (IPF) patients.METHODS:Fifty IPF patients underwent (18)F-FDG PET examinations at 2 time points: 60 min (early imaging) and 180 min (delayed imaging) after (18)F-FDG injection. The standardized uptake value (SUV) at each point and retention index value (RI-SUV) calculated from those were evaluated, and then the results...

  8. Diagnostic value of 18F-FDG PET/CT for cancer pain of peripheral nerves

    Fang, Lei; Jian-ping AN; Hui ZHAO; Xu, Xiao-Hong; Jun-feng MAO; Li, Yun; Dai, Wei

    2013-01-01

    Objective To observe the characteristics of cancer pain of the peripheral nerves on 18F-FDG PET/CT images, and explore the diagnostic value of 18F-FDG PET/CT for cancer pain of the peripheral nerves. Methods Imaging data of 18F-FDG PET/CT of 10 patients with cancer pain of the peripheral nerves confirmed by histopathology or long-term follow-up were analyzed retrospectively. The similarities and differences in PET/CT manifestations between the diseased side peripheral nerves and contralateral...

  9. Usefulness of 18F-FDG PET in the brain mass survey

    The aim of this study is to determine the clinical significance of 18F-FDG PET in the brain mass survey studies. Thirty-two (58%) out of 55 patients examined showed regional decreases in the cerebrum and cerebellum, which were caused by ischemia, macroangiopathy of diabetes mellitus, crossed cerebellar diaschisis and Alzheimer's disease. Two patients with suspicious Alzheimer's disease (early stage) and one with cerebrovascular dementia were observed. One patient showed high uptake of 18F-FDG in the pituitary gland with pituitary adenoma. 18F-FDG PET is very useful not only to pick up early stage of dementia but also to examine several pathological conditions. (author)

  10. [18F]FDG Accumulation in Early Coronary Atherosclerotic Lesions in Pigs

    Tarkia, Miikka; Saraste, Antti; Stark, Christoffer; Vähäsilta, Tommi; Savunen, Timo; Strandberg, Marjatta; Saunavaara, Virva; Tolvanen, Tuula; Teuho, Jarmo; Teräs, Mika; Metsälä, Olli; Rinne, Petteri; Heinonen, Ilkka; Savisto, Nina; Pietilä, Mikko

    2015-01-01

    Objective Inflammation is an important contributor to atherosclerosis progression. A glucose analogue 18F-fluorodeoxyglucose ([18F]FDG) has been used to detect atherosclerotic inflammation. However, it is not known to what extent [18F]FDG is taken up in different stages of atherosclerosis. We aimed to study the uptake of [18F]FDG to various stages of coronary plaques in a pig model. Methods First, diabetes was caused by streptozotocin injections (50 mg/kg for 3 days) in farm pigs (n = 10). Af...

  11. Preliminary investigation of brain 18F-FDG PET imaging in neonate

    Objective: To study brain 18F-fluorodeoxyglucose (FDG) PET imaging and to understand its metabolic function in neonate with pneumonia and premature infants. Methods: Nine neonate with pneumonia and seven premature infants were examined with routine 18F-FDG PET brain scan. Results: The brain 18F-FDG PET image of neonate was significantly different from that of adult and child. The structure of whole brain was not clearly demarcated. The active glucose metabolic areas were in thalamus, cerebellum, sensorimotor cortex and basal ganglia. The 18F-FDG uptake was most in thalamus, while least in cerebral cortex. The image quality showed no significant difference among 1, 2 and 3 min transmission scan for attenuation correction. Conclusions: 18F-FDG PET brain imaging may be one of effective methods to study cerebral function and metabolism in neonate. But the CT transmission time should reduce to be the shortest. (authors)

  12. Metabolism of 18F-FDG (2-fluoro-2-deoxy-D-glucose) in tumor cells

    Tumor cell components obtained at 5 min, 1 hr and 3 hr after 18F-FDG injections were analyzed by radio-thin-layer chromatography (TLC). Major metabolites were 18F-FDG-phosphate and 18F-FDM-phosphate. 18F-FDM and three unidentified compounds were found as minor metabolites. Time course of the composition of metabolites are as follows; 18F-FDG-phosphate was 88% at 5 mm after injection, but decreased to 53% at 3 hr after. 18F-FDM-phosphate was increased to 38% at 3 hr after injection. In conclusion, 18F-FDG is promptly phosphorylated after transportation into cell, and then exists as FDG-phosphate or 18F-FDM-phosphate. These results support known FDG distribution and metabolism, and it is possible that we use the information accumulated until now employing FDG manufactured by commercial supply system. (author)

  13. Evaluation of thymic tumors with 18F-FDG PET-CT - A pictorial review

    Sharma, Punit; Singhal, Abhinav; Bal, Chandrasekhar; Malhotra, Arun; Kumar, Rakesh [Dept. of Nuclear Medicine, All India Inst. of Medical Sciences, New Delhi (India)], e-mail: rkphulia@yahoo.com; Kumar, Arvind [Dept. of Surgical Disciplines, All India Inst. of Medical Sciences, New Delhi (India)

    2013-02-15

    Thymic tumors represent a broad spectrum of neoplastic disorders and pose considerable diagnostic difficulties. A non-invasive imaging study to determine the nature of thymic lesions can have significant impact on management of such tumors. 18F-flurorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) has shown promising results in characterization of thymic tumors. The objective of this article is to provide an illustrative tutorial highlighting the clinical utility of 18F-FDG PET-CT imaging in patients with thymic tumors. We have pictorially depicted the 18F-FDG PET-CT salient imaging characteristics of various thymic tumors, both epithelial and non-epithelial. Also discussed is the dynamic physiology of thymus gland which is to be kept in mind when evaluating thymic pathology on 18F-FDG PET-CT, as it can lead to interpretative pitfalls.

  14. Clinical Application of 18F-FDG PET in Alzheimer's Disease

    PET of the cerebral metabolic rate of glucose is increasingly used to support the clinical diagnosis in the examination of patients with suspected major neurodegenerative disorders, such as Alzheimer's disease. 18F-FDG PET has been reported to have high diagnostic performance, especially, very high sensitivity in the diagnosis and clinical assessment of therapeutic efficacy. According to clinical research data hitherto, 18F-FDG PET is expected to be an effective diagnostic tool in early and differential diagnosis of Alzheimer's disease. Since 2004, Medicare covers 18F-FDG PET scans for the differential diagnosis of fronto-temporal dementia (FTD) and Alzheimer's disease (AD) under specific requirements; or, its use in a CMS approved practical clinical trial focused on the utility of 18F-FDG PET in the diagnosis or treatment of dementing neurodegenerative diseases

  15. Clinical Application of {sup 18}F-FDG PET and PET-CT in Adrenal Tumor

    Hwang, Kyung Hoon; Choi, Duck Joo; Lee, Min Kyung; Choe, Won Sick [Gachon University Gil Hospital, Incheon (Korea, Republic of)

    2008-12-15

    Adrenal tumors are increasingly detected by widespread use of anatomical imaging such as CT, MRI, etc. For these adrenal tumors, differentiation between malignancy and benignancy is very important. In diagnostic assessment of adrenal tumor, {sup 18}F-FDG PET and PET-CT have been reported to have high diagnostic performance, especially, very excellent performance in evaluation of adrenal metastasis in the oncologic patient. In cases of adrenal incidentalomas, {sup 18}F-FDG PET or PET-CT is helpful if CT or chemical-shift MRI is inconclusive. {sup 18}F-FDG PET and PET-CT may be applied to the patients with MIBG-negative pheochromocytomas. In summary, {sup 18}F-FDG PET and PET-CT are expected to be effective diagnostic tools in the management of adrenal tumor.

  16. Evaluation of thymic tumors with 18F-FDG PET-CT - A pictorial review

    Thymic tumors represent a broad spectrum of neoplastic disorders and pose considerable diagnostic difficulties. A non-invasive imaging study to determine the nature of thymic lesions can have significant impact on management of such tumors. 18F-flurorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) has shown promising results in characterization of thymic tumors. The objective of this article is to provide an illustrative tutorial highlighting the clinical utility of 18F-FDG PET-CT imaging in patients with thymic tumors. We have pictorially depicted the 18F-FDG PET-CT salient imaging characteristics of various thymic tumors, both epithelial and non-epithelial. Also discussed is the dynamic physiology of thymus gland which is to be kept in mind when evaluating thymic pathology on 18F-FDG PET-CT, as it can lead to interpretative pitfalls

  17. Brown adipose tissue {sup 18}F-FDG uptake in pediatric PET/CT imaging

    Hong, Terence S. [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Shammas, Amer; Charron, Martin [The Hospital for Sick Children, Department of Diagnostic Imaging, Division of Nuclear Medicine, Toronto (Canada); Zukotynski, Katherine A. [Harvard Medical School, Department of Imaging, Division of Nuclear Medicine, Dana-Farber Cancer Institute, Boston, MA (United States); Drubach, Laura A. [Children' s Hospital Boston, Harvard Medical School, Department of Radiology, Division of Nuclear Medicine/PET, Boston, MA (United States); Lim, Ruth [Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2011-06-15

    Positron emission tomography (PET) using [F-18]2-fluoro-2-deoxyglucose (FDG) fused with CT ({sup 18}F-FDG PET/CT) has been widely adopted in oncological imaging. However, it is known that benign lesions and other metabolically active tissues, such as brown adipose tissue (BAT), can accumulate {sup 18}F-FDG, potentially resulting in false-positive interpretation. Previous studies have reported that {sup 18}F-FDG uptake in BAT is more common in children than in adults. We illustrate BAT FDG uptake in various anatomical locations in children and adolescents. We also review what is known about the effects of patient-related physical attributes and environmental temperatures on BAT FDG uptake, and discuss methods used to reduce BAT FDG uptake on {sup 18}F-FDG PET. (orig.)

  18. Brown adipose tissue 18F-FDG uptake in pediatric PET/CT imaging

    Positron emission tomography (PET) using [F-18]2-fluoro-2-deoxyglucose (FDG) fused with CT (18F-FDG PET/CT) has been widely adopted in oncological imaging. However, it is known that benign lesions and other metabolically active tissues, such as brown adipose tissue (BAT), can accumulate 18F-FDG, potentially resulting in false-positive interpretation. Previous studies have reported that 18F-FDG uptake in BAT is more common in children than in adults. We illustrate BAT FDG uptake in various anatomical locations in children and adolescents. We also review what is known about the effects of patient-related physical attributes and environmental temperatures on BAT FDG uptake, and discuss methods used to reduce BAT FDG uptake on 18F-FDG PET. (orig.)

  19. Clinical Application of {sup 18}F-FDG PET in Alzheimer's Disease

    Ryu, Young Hoon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2008-12-15

    PET of the cerebral metabolic rate of glucose is increasingly used to support the clinical diagnosis in the examination of patients with suspected major neurodegenerative disorders, such as Alzheimer's disease. {sup 18}F-FDG PET has been reported to have high diagnostic performance, especially, very high sensitivity in the diagnosis and clinical assessment of therapeutic efficacy. According to clinical research data hitherto, {sup 18}F-FDG PET is expected to be an effective diagnostic tool in early and differential diagnosis of Alzheimer's disease. Since 2004, Medicare covers {sup 18}F-FDG PET scans for the differential diagnosis of fronto-temporal dementia (FTD) and Alzheimer's disease (AD) under specific requirements; or, its use in a CMS approved practical clinical trial focused on the utility of {sup 18}F-FDG PET in the diagnosis or treatment of dementing neurodegenerative diseases.

  20. Comparison of 18F-FET and 18F-FDG PET in brain tumors

    The purpose of this study was to compare the diagnostic value of positron emission tomography (PET) using [18F]-fluorodeoxyglucose (18F-FDG) and O-(2-[18F]fluoroethyl)-L-tyrosine (18F-FET) in patients with brain lesions suspicious of cerebral gliomas. Methods: Fifty-two patients with suspicion of cerebral glioma were included in this study. From 30 to 50 min after injection of 180 MBq 18F-FET, a first PET scan (18F-FET scan) was performed. Thereafter, 240 MBq 18F-FDG was injected and a second PET scan was acquired from 30 to 60 min after the second injection (18F-FET/18F-FDG scan). The cerebral accumulation of 18F-FDG was calculated by decay corrected subtraction of the 18F-FET scan from the 18F-FET/18F-FDG scan. Tracer uptake was evaluated by visual scoring and by lesion-to-background (L/B) ratios. The imaging results were compared with the histological results and prognosis. Results: Histology revealed 24 low-grade gliomas (LGG) of World Health Organization (WHO) Grade II and 19 high-grade gliomas (HGG) of WHO Grade III or IV, as well as nine others, mainly benign histologies. The gliomas showed increased 18F-FET uptake (>normal brain) in 86% and increased 18F-FDG uptake (>white matter) in 35%. 18F-FET PET provided diagnostically useful delineation of tumor extent while this was impractical with 18F-FDG due to high tracer uptake in the gray matter. A local maximum in the tumor area for biopsy guidance could be identified with 18F-FET in 76% and with 18F-FDG in 28%. The L/B ratios showed significant differences between LGG and HGG for both tracers but considerable overlap so that reliable preoperative grading was not possible. A significant correlation of tracer uptake with overall survival was found with 18F-FDG only. In some benign lesions like abscesses, increased uptake was observed for both tracers indicating a limited specificity of both techniques. Conclusions: 18F-FET PET is superior to 18F-FDG for biopsy guidance and treatment planning of cerebral gliomas

  1. (18)F-FDG PET/CT in a rare case of Stewart-Treves syndrome

    Jensen, Mads Radmer; Friberg, Lars; Karlsmark, Tonny;

    2011-01-01

    The aim of this article is to illustrate the possible applications of (18)F-fluorodeoxyglucose positron emission tomography/computer tomography ((18)F-FDG PET/CT) in chronic extremity lymphedema and its complications.......The aim of this article is to illustrate the possible applications of (18)F-fluorodeoxyglucose positron emission tomography/computer tomography ((18)F-FDG PET/CT) in chronic extremity lymphedema and its complications....

  2. A simple method for the quality control of [(18)F]FDG

    Koziorowski, J

    2010-01-01

    Most automated synthesis modules produce [(18)F]FDG within half an hour, but the quality control involving up to three separate methods and three different analytical systems is time consuming. The use of HPLC, TLC, and GC for the quality control of [(18)F]FDG is both time consuming and expensive...... (high purchase costs). Presented here is a method using a single HPLC system for all three analyses....

  3. In vivo 18F-FDG tumour uptake measurements in small animals using Cerenkov radiation

    2-[18F]Fluoro-2-deoxy-D-glucose (18F-FDG) is a widely used PET radiotracer for the in vivo diagnosis of several diseases such as tumours. The positrons emitted by 18F-FDG, travelling into tissues faster than the speed of light in the same medium, are responsible for Cerenkov radiation (CR) emission which is prevalently in the visible range. The purpose of this study is to show that CR escaping from tumour tissues of small living animals injected with 18F-FDG can be detected with optical imaging (OI) techniques using a commercial optical instrument equipped with charge-coupled detectors (CCD). The theory behind the Cerenkov light emission and the source depth measurements using CR is first presented. Mice injected with 18F-FDG or saline solution underwent dynamic OI acquisition and a comparison between images was performed. Multispectral analysis of the radiation was used to estimate the depth of the source of Cerenkov light. Small animal PET images were also acquired in order to compare the 18F-FDG bio-distribution measured using OI and PET scanner. Cerenkov in vivo whole-body images of tumour-bearing mice and the measurements of the emission spectrum (560-660 nm range) are presented. Brain, kidneys and tumour were identified as a source of visible light in the animal body: the tissue time-activity curves reflected the physiological accumulation of 18F-FDG in these organs. The identification is confirmed by the comparison between CR and 18F-FDG images. These results will allow the use of conventional OI devices for the in vivo study of glucose metabolism in cancer and the assessment, for example, of anti-cancer drugs. Moreover, this demonstrates that 18F-FDG can be employed as it is a bimodal tracer for PET and OI techniques. (orig.)

  4. Clinical Application of {sup 18}F-FDG PET in Nonmelanomatous Skin Cancer

    Yoon, Joon Kee [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2008-12-15

    Nonmelanomatous skin cancer includes basal cell carcinoma, squamous cell carcinoma, merkel cell carcinoma and dermatofibrosarcoma protuberance. So far, there have been a few reports that {sup 18}F-FDG PET was useful in the evaluation of metastasis and therapeutic response in nonmelanomatous skin cancer, however, those are very weak evidences. Therefore, further studies on the usefulness of {sup 18}F-FDG PET in nonmelanomatous skin cancer are required.

  5. Characteristics of Integrated 18F-FDG PET/CT in Pulmonary Cryptococcosis

    Chung-Jen Huang; Li-Han Hsu (Div. of Pulmonary and Intensive Care Medicine, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China)); Dong-Ling You; Pei-Ing Lee (Dept. of Nuclear Medicine, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China)); Chia-Chuan Liu; Chih-Shiun Shih (Div. of Thoracic Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China)); Chiang-Ching Shih; Hsiu-Chin Tseng (Dept. of Internal Medicine, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (China))

    2009-05-15

    Background: Pulmonary cryptococcosis is an uncommon cause of pulmonary nodules found by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scans. It is rarely reported but may mislead interpretation. Purpose: To describe the 18F-FDG PET/CT findings of pulmonary cryptococcosis. Material and Methods: The 18F-FDG PET/CT images of seven patients with pulmonary cryptococcosis were evaluated. Results: The 18F-FDG PET/CT exams showed single or multiple nodular lesions. The standardized uptake values (SUV) in early images varied significantly for the seven patients (ranging from 2.2 to 11.6). Delayed SUVs showed significant increases in four patients. Conclusion: Pulmonary cryptococcosis mimics primary or metastatic lung cancer on 18F-FDG PET/CT scan. Tissue confirmation should be considered for any suspicious pulmonary nodules found on 18F-FDG PET/CT scan with an SUV score higher than 2.5, in order to avoid overdiagnosis or overstaging.

  6. Characteristics of Integrated 18F-FDG PET/CT in Pulmonary Cryptococcosis

    Background: Pulmonary cryptococcosis is an uncommon cause of pulmonary nodules found by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scans. It is rarely reported but may mislead interpretation. Purpose: To describe the 18F-FDG PET/CT findings of pulmonary cryptococcosis. Material and Methods: The 18F-FDG PET/CT images of seven patients with pulmonary cryptococcosis were evaluated. Results: The 18F-FDG PET/CT exams showed single or multiple nodular lesions. The standardized uptake values (SUV) in early images varied significantly for the seven patients (ranging from 2.2 to 11.6). Delayed SUVs showed significant increases in four patients. Conclusion: Pulmonary cryptococcosis mimics primary or metastatic lung cancer on 18F-FDG PET/CT scan. Tissue confirmation should be considered for any suspicious pulmonary nodules found on 18F-FDG PET/CT scan with an SUV score higher than 2.5, in order to avoid overdiagnosis or overstaging

  7. Two years of experience with the [18F]FDG production module

    Chemistry module for a conventional [18F]FDG production by using tetrabutylammonium bicarbonate (TBA) and an acidic hydrolysis has been manufactured and evaluated. In this experiment, 75 mM (pH 7.5-7.8) of TBA solution and a ca. 2-curies order of [18F]-fluoride have been used for the evaluation. The commercial acidic purification cartridge was purchased from GE or UKE. The operation system (OS) was programmed with Lab-View which was selected because of its easy customization of the OS. Small sized solenoid valves (Burkert; type 6124) were selected to reduce the module dimensions (W 350 x D 270 x H 250). The total time for the synthesis of [18F]FDG was 30 ± 3 min. The production yield of [18F]FDG was 60 ± 2% on an average at EOS, with the decay uncorrected. This experimental data show that the traditional chemistry module can provide a good [18F]FDG production yield by optimizing the operational conditions. The radiochemical purity, radionuclidic purity, acidity, residual solvent, osmolality and endotoxin were determined to assess the quality of [18F]FDG. The examined contents for the quality control of [18F]FDG were found to be suitable for a clinical application

  8. Effects of anesthesia upon 18F-FDG uptake in rhesus monkey brains

    The kinetics of 18F-fluorodeoxyglucose (18F-FDG) in the monkey brain were monitored, and comparisons were made between the conscious state and when under ketamine and pentobarbital anesthesia. Rhesus monkeys were intravenously injected with 18F-FDG and followed by 60 min of PET scanning. In the conscious state, the 18F-FDG concentration reached a plateau 5 min after intravenous injection. Under ketamine anesthesia, the 18F-FDG concentration gradually increased with time in all monitored regions. At 60 min after injection, the concentration in the striatum was about 3.2 times greater than that in the conscious state, and about 4.5 times greater in the cerebral cortex. Under pentobarbital anesthesia, the 18F-FDG concentration in the occipital cortex was slightly lower. These findings demonstrate that 18F-FDG concentration in the monkey brain is significantly affected by anesthesia. The results also imply the existence of a short-term regulation mechanism for hexokinase activity in intact monkey brain. (author)

  9. The study of 18F-FDG DHC imaging used for diagnosing breast cancer

    Objective: To explore the diagnostic value of 18F-fluorodeoxyglucose (FDG) dual-head coincidence (DHC) imaging for detecting breast cancer and axillary lymph node metastases. Methods: Thirty-one female patients were studied by 18F-FDG DHC imaging, and 21 of them received fine needle aspiration biopsy after 18F-FDG DHC imaging. The results of 18F-FDG DHC imaging and fine needle aspiration biopsy were compared with those of histopathology. Results: 1) Among the 26 cases of breast carcinoma by 18F-FDG DHC imaging, the FDG uptake of 21 cases showed positive. The lesion diameters ranged from 1.7-8 (mean 3.2 ±1.6) cm, the lesion/background (L/B) ratio range was 1.4-7.3 (mean 2.4 ±1.3). The other 5 malignancies were negative, their diameter range was 0.8-3.3 (mean 1.9) cm. 2) Ten cases of the malignancies were confirmed with axillary lymph node metastases. Three cases by 18F-FDG DHC imaging were positive. Those lymph node diameters were 1.4, 1.8 and 5.2 cm, respectively. The L/B ratios were 1.3, 1.5 and 6.2, respectively. The other 7 cases were negative. The lymph node diameter range was 0.2-1.8 cm. 3) Twenty-one cases received fine needle aspiration biopsy. Tumor cells were found in 13 cases. 4) The sensitivity, specificity and accuracy of 18F-FDG DHC imaging for diagnosing primary breast carcinoma were 80.8%, 5/5 and 83.9%, respectively. The sensitivity, specificity and accuracy of 18F-FDG DHC imaging for diagnosing lymph node metastases were 30.0%, 100% and 77.4%, respectively. The sensitivity, specificity and accuracy of fine needle aspiration biopsy for diagnosing primary breast carcinoma were 72.2%, 3/3 and 76.2%, respectively. 5) There was no significant difference between the sensitivity of 18F-FDG DHC imaging and fine needle aspiration biopsy (P>0.05). Conclusion: 18F-FDG DHC imaging possesses higher sensitivity and specificity in the diagnosis of breast cancer. It can be used as a noninvasive modality for evaluating breast cancer

  10. Clinical significance of patterns of incidental thyroid uptake at 18F-FDG PET/CT

    Incidental uptake of 2-[18F]-fluoro-2-deoxy-D-glucose (18F-FDG) in the thyroid gland is not uncommonly encountered in day-to-day practice of oncological 18F-FDG positron-emission tomography/computed tomography (PET/CT). These are often felt to be “nuisance lesions” by referring clinicians and radiologists alike. However, recognition of the importance of different patterns of FDG uptake in the thyroid gland and knowledge of the possible underlying aetiologies are crucial in ensuring that patients are managed appropriately in the clinical context of their primary diagnosis, as the underlying pathological condition may be clinically important in a significant minority of such cases. This review describes the various patterns of 18F-FDG uptake within the thyroid and discusses the clinical significance and possible impact on patient management. Incidental low-grade homogeneous diffuse increased thyroid 18F-FDG uptake is usually seen in the patients with chronic thyroiditis, Grave's disease, and hypothyroidism. Thyroid function tests and antibody profiling are advised in these patients. Incidental focal 18F-FDG thyroid uptake should raise the possibility of underlying malignancy. Ultrasound with or without fine-needle aspiration cytology is usually recommended for the evaluation of these lesions. Heterogeneous uptake with prominent focal uptake in the thyroid should be further evaluated to exclude malignancy

  11. A Cochrane review on brain [18F]FDG PET in dementia: limitations and future perspectives

    Based on a large body of evidence on its diagnostic sensitivity for the identification of AD, in 2004 [18F]FDG PET imaging was approved by the Centers for Medicare and Medicaid Services (CMS, USA) as a routine examination tool for early and differential diagnosis of AD. Since then, large amounts of additional [18F]FDG PET data have become available showing that the addition of [18F]FDG PET to clinical examinations increases diagnostic accuracy in identifying AD patients even in the predementia stage. Of course, new opportunities and new challenges are coming up, which require the definition of the specific role of [18F]FDG PET in the era of AD biomarkers (i.e. relationship with other biomarkers and role as a marker of progression in AD [46, 48]). Meanwhile, in daily clinical practice, nuclear medicine experts should continue to perform high-quality [18F]FDG PET scans, constantly improving the standard through continuous education and the use of appropriate tools, knowing that it is one of the most informative biomarkers currently available for the prediction of dementia at the MCI stage.

  12. Evaluation of 18F-FDG PET in acute ischemic stroke. Assessment of hyper accumulation around the lesion

    Although pathophysiology of cerebrovascular disease has been reported previously, few clinical studies of glucose metabolism in acute stroke have been published. Purpose of this study is to evaluate glucose metabolism in acute stroke patients by 18F-FDG PET. Twenty-four patients with acute ischemic stroke were involved in this study. All subjects underwent MRI (conventional T1- and T2-weighted images, diffusion-weighted imaging, and MR angiography), CT and 18F-FDG PET. 18F-FDG PET was performed within 1 to 7 days after the first episode. 18F-FDG PET images were visually evaluated as well as MRI and CT images. Four patients out of 24 showed no abnormal 18F-FDG accumulation, while MRI demonstrated abnormal signal area and abnormal vascular findings that suggested acute stroke. Decreased 18F-FDG accumulation corresponding with abnormal signal area on MR images was noted in 20 cases. In 7 cases among these 20 with decreased 18F-FDG, hyper accumulation of 18F-FDG was recognized around the decreased accumulation area. Increased 18F-FDG accumulation (increased glucose metabolization) around the lesion may be due to: acceleration of anaerobic glycolysis, activated repair process of damaged brain tissue, i.e., phagocytosis and gliosis, and neuronal excitation by excito-toxic amino acids which can be released after ischemia. (author)

  13. Diagnostic value of combined {sup 18}F-FDG PET/MRI for staging and restaging in paediatric oncology

    Pfluger, Thomas; Melzer, Henriette I.; Mueller, Wolfgang P.; Bartenstein, Peter [Ludwig Maximilians University of Munich, Department of Nuclear Medicine, Munich (Germany); Coppenrath, Eva [Ludwig Maximilians University of Munich, Department of Radiology, Munich (Germany); Albert, Michael H.; Schmid, Irene [Ludwig Maximilians University of Munich, Department of Paediatric Oncology/Haematology, Munich (Germany)

    2012-11-15

    The present study compares the diagnostic value of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and MRI to combined/registered {sup 18}F-FDG PET/MRI for staging and restaging in paediatric oncology. Over 8 years and 2 months, 270 {sup 18}F-FDG PET and 270 MRI examinations (mean interval 5 days) were performed in 132 patients with proven (n = 117) or suspected (n = 15) malignant disease: solid tumours (n = 64), systemic malignancy (n = 53) and benign disease (n = 15). A total of 259 suspected tumour lesions were analysed retrospectively during primary diagnosis and 554 lesions during follow-up. Image analysis was performed separately on each modality, followed by analysis of combined and registered {sup 18}F-FDG PET/MRI imaging. A total of 813 lesions were evaluated and confirmed by histopathology (n = 158) and/or imaging follow-up (n = 655) after 6 months. In the separate analysis of {sup 18}F-FDG PET and MRI, sensitivity was 86 %/94 % and specificity 85 %/38 %. Combined/registered {sup 18}F-FDG PET/MRI led to a sensitivity of 97 %/97 % and specificity of 81 %/82 %. False-positive results ({sup 18}F-FDG PET n = 69, MRI n = 281, combined {sup 18}F-FDG PET/MRI n = 85, registered {sup 18}F-FDG PET/MRI n = 80) were due to physiological uptake or post-therapeutic changes. False-negative results ({sup 18}F-FDG PET n = 50, MRI n = 20, combined {sup 18}F-FDG PET/MRI n = 11, registered {sup 18}F-FDG PET/MRI n = 11) were based on low uptake or minimal morphological changes. Examination-based evaluation during follow-up showed a sensitivity/specificity of 91 %/81 % for {sup 18}F-FDG PET, 93 %/30 % for MRI and 96 %/72 % for combined {sup 18}F-FDG PET/MRI. For the detection of single tumour lesions, registered {sup 18}F-FDG PET/MRI proved to be the methodology of choice for adequate tumour staging. In the examination-based evaluation, MRI alone performed better than {sup 18}F-FDG PET and combined/registered imaging during primary diagnosis. At follow

  14. Metabolic patterns of 18F FDG uptake in patients of spinal tuberculosis and their comparison with MR findings

    18F FDG PET imaging has been established as a useful modality in Oncologic imaging. However, the metabolic tracer 18F FDG is not specific for the tumors and potential role of PET imaging is being studied in evaluation of infectious and inflammatory disorders. Few studies have shown metabolic pattern of 18F FDG uptake in spinal tuberculosis. The aim of this pilot investigation was to study the patterns of 18F FDG uptake in patients of spinal tuberculosis before and at various time points after initiation of antitubercular treatment (AKT). In addition PET findings were compared to the MR findings in these patients. (author)

  15. Synthesis of 18F-FDG using improved single-pot acid hydrolysis process

    In order to explore an optimum condition to increase the synthesis yield of 2-18F-2-deoxy-β-D-glucose (18F-FDG) by using improved single-pot acid hydrolysis Chemistry Process Control Unit (CPCU), various production conditions such as the reaction temperature, the time of acid hydrolysis and others were tested. The results showed that the determinant factor which affects the synthesis yield was the quantities of water present in reaction media. The total 18F-FDG synthesis time could be minimized by effective dehydration step and regulating the amount of hydrogen chloride. The synthesis yield could be increased by improving the production conditions of 18F-FDG. (authors)

  16. Paediatric dosimetry of 18F-FDG whole body PET/CT scans

    A combined 18F-FDG (18F-2-deoxy-D-glucose) positron emission tomography/computed tomography (PET/CT) scan provides both the metabolic information from FDG-PET and anatomic information from CT in a single examination. The use of PET/CT for management of malignancies in children has increased over the past few years. This raises an important consideration of radiation exposure in children since they are relatively more radiosensitive than adults and also have a potential for a longer life thereby increasing the probability of manifestation of late radiation effects; particularly cancer. Unfortunately, the data regarding the doses received by children from undergoing such examinations is scarce. The present study aims at estimating the effective doses to paediatric patients from whole body 18F-FDG PET/CT studies. The purpose of the study is to estimate the radiation doses to children from undergoing whole body PET/CT scans using 18F-FDG

  17. Usefulness of {sup 18}F-FDG PET in the brain mass survey

    Odano, Ikuo [Niigata Univ. (Japan). Graduate School of Medicine and Dental Sciences; Uno, Kimiichi; Tomemori, Takashi [Nishidai Clinic Diagnostic Imaging Center, Tokyo (Japan)] [and others

    2002-12-01

    The aim of this study is to determine the clinical significance of {sup 18}F-FDG PET in the brain mass survey studies. Thirty-two (58%) out of 55 patients examined showed regional decreases in the cerebrum and cerebellum, which were caused by ischemia, macroangiopathy of diabetes mellitus, crossed cerebellar diaschisis and Alzheimer's disease. Two patients with suspicious Alzheimer's disease (early stage) and one with cerebrovascular dementia were observed. One patient showed high uptake of {sup 18}F-FDG in the pituitary gland with pituitary adenoma. {sup 18}F-FDG PET is very useful not only to pick up early stage of dementia but also to examine several pathological conditions. (author)

  18. The value of {sup 18}F-FDG PET/CT in diagnosing infectious endocarditis

    Kouijzer, Ilse J.E. [Radboud University Nijmegen Medical Centre, Department of Internal Medicine, P.O. Box 9101, Nijmegen (Netherlands); Vos, Fidel J. [Radboud University Nijmegen Medical Centre, Department of Internal Medicine, P.O. Box 9101, Nijmegen (Netherlands); Sint Maartenskliniek, Nijmegen (Netherlands); Janssen, Marcel J.R. [Radboud University Nijmegen Medical Centre, Department of Nuclear Medicine, Nijmegen (Netherlands); Dijk, Arie P.J. van [Radboud University Nijmegen Medical Centre, Department of Cardiology, Nijmegen (Netherlands); Oyen, Wim J.G. [Radboud University Nijmegen Medical Centre, Department of Nuclear Medicine, Nijmegen (Netherlands); Radboud University Nijmegen Medical Centre, Nijmegen Institute for Infection, Inflammation and Immunity (N4i), Nijmegen (Netherlands); Bleeker-Rovers, Chantal P. [Radboud University Nijmegen Medical Centre, Department of Internal Medicine, P.O. Box 9101, Nijmegen (Netherlands); Radboud University Nijmegen Medical Centre, Nijmegen Institute for Infection, Inflammation and Immunity (N4i), Nijmegen (Netherlands)

    2013-07-15

    Early detection of infectious endocarditis is challenging. For diagnosing infectious endocarditis, the revised Duke criteria are the gold standard. Evidence of endocardial involvement on echocardiography is a major criterion, but sensitivity and specificity of echocardiography are not optimal. Here we investigated the utility of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) to diagnose infectious endocarditis in patients with gram-positive bacteraemia. Seventy-two patients with gram-positive bacteraemia were prospectively included. Patients with a positive blood culture growing Staphylococcus aureus, Streptococcus species or Enterococcus species were eligible when a risk factor for developing metastatic infectious foci was present. Infectious endocarditis was defined according to the revised Duke criteria. All patients underwent {sup 18}F-FDG PET/CT and echocardiography. {sup 18}F-FDG uptake in or around the heart valves was evaluated independently by two nuclear medicine physicians. Sensitivity for diagnosing infectious endocarditis with {sup 18}F-FDG PET/CT was 39 % and specificity was 93 %. The positive predictive value was 64 % and negative predictive value was 82 %. The mortality rate in patients without infectious endocarditis and without increased {sup 18}F-FDG uptake in or around the heart valves was 18 %, and in patients without infectious endocarditis but with high {sup 18}F-FDG uptake in or around the heart valves the mortality rate was 50 % (p = 0.181). {sup 18}F-FDG PET/CT is currently not sufficiently adequate for the diagnosis of infectious endocarditis because of its low sensitivity. Improvements such as patient preparation with low carbohydrate-fat allowed diet and technical advances in the newest PET/CT scanners may increase sensitivity in future studies. (orig.)

  19. {sup 18}F-FDG positron emission tomography in the early diagnosis of enterocolitis: preliminary results

    Kresnik, E.; Gallowitsch, H.J.; Igerc, I.; Kumnig, G.; Gomez, I.; Lind, P. [Nuclear Medicine and Special Endocrinology, PET Centre, General Hospital, St. Veiterstrasse 47, 9020 Klagenfurt (Austria); Mikosch, P.; Alberer, D.; Hebenstreit, A. [Department of Internal Medicine and Gastroenterology, General Hospital, Klagenfurt (Austria); Wuertz, F. [Department of Pathology, General Hospital, Klagenfurt (Austria); Kogler, D.; Gasser, J. [Department of Radiology, General Hospital, Klagenfurt (Austria)

    2002-10-01

    Collagenous and eosinophilic colitis are rare diseases characterised by chronic watery diarrhoea. Radiographic evaluation of the gastrointestinal tract and colonoscopy are usually non-diagnostic since as many as one-third of patients will have minor abnormalities. To date a few investigators have reported increased fluorine-18 fluorodeoxyglucose ({sup 18}F-FDG) uptake on positron emission tomography (PET) in patients with acute enterocolitis, but there have been no reports on the use of {sup 18}F-FDG PET for the diagnosis of collagenous or eosinophilic colitis in an early clinical stage. The aim of this preliminary study was to evaluate the usefulness of {sup 18}F-FDG PET in the early diagnosis of patients with colitis. We investigated five women (mean age 61.2{+-}12.1 years) who had been diagnosed as having colitis in an early clinical stage. In all but one of the patients, the diagnosis of colitis was based on biopsy. Magnetic resonance colonography, ultrasonography and colonoscopy were performed in all but one of the patients. Two women were identified as having collagenous colitis in an early clinical stage. Another two patients had eosinophilic colitis. The morphological imaging methods, magnetic resonance colonography and ultrasonography, yielded no suspicious findings, and the results of colonoscopy similarly showed no abnormalities. One patient had colitis due to bacterial infection. In all patients {sup 18}F-FDG PET showed a pathological increase in tracer uptake in the large bowel, suggestive of colitis. In four of the five patients, colitis was confirmed by histology, and in one, by bacterial analysis. {sup 18}F-FDG PET was able to detect colitis in an early clinical stage, when morphological imaging methods and colonoscopy were non-diagnostic. The early performance of {sup 18}F-FDG PET imaging in patients with possible colitis is encouraging. (orig.)

  20. Absorbed 18F-FDG Dose to the Fetus During Early Pregnancy

    We describe a rare case of a woman who underwent 18F-FDG PET/CT during early pregnancy (fetus age, 10 wk). The fetal absorbed dose was calculated by taking into account the 18F-FDG fetal self-dose, photon dose coming from the maternal tissues, and CT dose received by both mother and fetus. Methods: The patient (weight, 71 kg) had received 296 MBq of 18F-FDG. Imaging started at 1 h, with unenhanced CT acquisition, followed by PET acquisition. From the standardized uptake value measured in fetal tissues, we calculated the total number of disintegrations per unit of injected activity. Monte Carlo analysis was then used to derive the fetal 18F-FDG self-dose, including positrons and self-absorbed photons. Photon dose from maternal tissues and CT dose were added to obtain the final dose. Results: The maximum standardized uptake value in fetal tissues was 4.5. Monte Carlo simulation showed that the fetal self-dose was 3.0 * 10-2 mGy/MBq (2.7 * 10-2 mGy/MBq from positrons and 0.3 * 10-2 mGy/MBq from photons). The estimated photon dose to the fetus from maternal tissues was 1.04*10-2 mGy/MBq. Accordingly, the specific 18F-FDG dose to the fetus was about 4.0 *10-2 mGy/MBq (11.8 mGy in this patient). The CT scan added a further 10 mGy. Conclusion: The dose to the fetus during early pregnancy can be as high as 4.0*10-2 mGy/MBq of 18F-FDG. Current dosimetric standards in early pregnancy may need to be revised. (authors)

  1. Clinical Significance of Focal Breast Lesions Incidentally Identified by 18F-FDG PET/CT

    We evaluated the incidence and malignant risk of focal breast lesions incidentally detected by 18F-FDG PET/CT. Various PET/CT findings of the breast lesions were also analyzed to improve the differentiation between benign from malignant focal breast lesions. The subjects were 3,768 consecutive 18F-FDG PET/CT exams performed in adult females without a history of breast cancer. A focal breast lesion was defined as a focal 18F-FDG uptake or a focal nodular lesion on CT image irrespective of 18F-FDG uptake in the breasts. The maximum SUV and CT pattern of focal breast lesions were evaluated, and were compared with final diagnosis. The incidence of focal breast lesions on PET/CT in adult female subjects was 1.4% (58 lesions in 53 subjects). In finally confirmed 53 lesions of 48 subjects, 11 lesions of 8 subjects (20.8%) were proven to be malignant. When the PET/CT patterns suggesting benignancy (maximum attenuation value > 75 HU or 20) were added as diagnostic criteria of PET/CT to differentiate benign from malignant breast lesions along with maximum SUV, the area under ROC curve of PET/CT was significantly increased compared with maximum SUV alone (0.680±0.093 vs. 0.786±0.076, p18F-FDG PET/CT is not low, deserving further diagnostic confirmation. Image interpretation considering both 18F-FDG uptake and PET/CT pattern may be helpful to improve the differentiation from malignant and benign focal breast lesion

  2. Diffuse 18F-FDG Muscle Uptake in Trichinella spiralis Infection.

    Deroose, Christophe M; Van Weehaeghe, Donatienne; Tousseyn, Thomas; Van Rompuy, Anne-Sophie; Vanderschueren, Steven; Blockmans, Daniel; Gheysens, Olivier

    2016-01-01

    Two patients were referred to our emergency department with myalgia, fever, general malaise, eosinophilia, and elevated serum levels of creatine kinase and troponin T. 18F-FDG PET/CT scan was performed showing a diffuse and homogenous moderately elevated glucose uptake in all muscle groups. Trichinella spiralis infection was confirmed by a muscle biopsy and detection of trichinella antibodies. The muscle biopsy was taken in the left quadriceps because of equal involvement of the skeletal muscles. The differential diagnosis of diffuse 18F-FDG muscle uptake should include trichinella infection, in particular, in the presence of infectious symptoms, eosinophilia, and biochemical signs of muscle damage. PMID:26252328

  3. The role of 18F FDG-PET/CT in diagnosis of pulmonary nodules

    We reviewed the role of 18F fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT in differentiation between benign and malignant pulmonary nodules. By evaluating pulmonary nodules using both spiculation in CT and FDG standardized uptake value (SUV) max in 18F FDG-PET/CT, the sensitivity for the diagnosis of pulmonary nodule enhanced compared to diagnosing either the method alone. The combination of 18F FDG-PET/CT with thin slice CT might be useful for the diagnosis of pulmonary nodules. (author)

  4. Chilean experience in production of 18F-FDG from 18F in a reactor

    18F-FDG (fluorine-deoxy-D-glucose) is an important and useful radiopharmaceutical for imaging and study of myocardial viability. Usually cyclotron-produced 18F is used to label 18F-FDG. The availability of a 5 MW Nuclear Reactor in Chile and the absence of a quality cyclotron to produce 18F required that we developed a method in order to obtain suitable 18F to label 18F-FDG using the facilities we have at the Nuclear Center of La Reina, Chilean Nuclear Energy Commission. The nuclear reactions involved are: 6Li(n,aα)3H and 16O(3H,n)18F. Enriched Li2CO3 (6Li = 95 %) was irradiated in a 5 MW swimming pool type nuclear reactor with a neutron flux of 5. 7 x 1013 n cm-2 s-1 for 4 hours. The irradiated Li2CO3 was dissolved in H2SO4 (1:1) and distilled as trimethylsilyl(18F)fluoride (18F-TMS). The labelling of the sugar was carried out using the method described by Hamacker. The 18F-TMS was trapped in a solution of acetonitrile, water, potassium carbonate, and kriptofix and hydrolysed to form 18F fluoride. The nucleophilic complex reacts with 1,3,4,6, tetra-O-acetyl- 2-O-trifluoromethanesulfonyl-bβ-D-mannopyranose. The acetylated carbohydrate by acid hydrolysis produces 18F-FDG. The final product was purified using an ion retarding resin (AG11-A8) and a system two Sep Pak Plus: Alumina and C-18 cartridge and sterilised by Millipore 0.22 μm filter. The 18F-FDG was obtained in an apyrogenic and sterile solution. The 18F radionuclide purity was higher than 99.9% and the radiochemical purity ofthe18F-FDG obtained was over than 99%. Residual 3H content was as low as 20 (Bq 3H/MBq 18F-FDG.). The yield of the process 18F-FDG was 13.2 %. (authors)

  5. A False Positive 18F-FDG PET/CT Scan Caused by Breast Silicone Injection

    Chen, Chao-Jung; Lee, Bi-Fang; Yao, Wei-Jen; Wu, Pei-Shan; Chen, Wen-Chung; Peng, Shu-Lin; Chiu, Nan-Tsing

    2009-01-01

    We present here the case of a 40-year-old woman with a greater than 10 year prior history of bilateral breast silicone injection and saline bag implantation. Bilateral palpable breast nodules were observed, but the ultrasound scan was suboptimal and the magnetic resonance imaging showed no gadolinium-enhanced tumor. The 18F-FDG PET/CT scan showed a hypermetabolic nodule in the left breast with a 30% increase of 18F-FDG uptake on the delayed imaging, and this mimicked breast cancer. She underw...

  6. A False Positive 18F-FDG PET/CT Scan Caused by Breast Silicone Injection

    We present here the case of a 40-year-old woman with a greater than 10 year prior history of bilateral breast silicone injection and saline bag implantation. Bilateral palpable breast nodules were observed, but the ultrasound scan was suboptimal and the magnetic resonance imaging showed no gadolinium enhanced tumor. The 18F-FDG PET/CT scan showed a hypermetabolic nodule in the left breast with a 30% increase of 18F-FDG uptake on the delayed imaging, and this mimicked breast cancer. She underwent a left partial mastectomy and the pathology demonstrated a siliconoma

  7. The Value of 18F-FDG PET in Predicting the Prognosis of NSCLC

    Wang, Yuzhou; Lin ZHAO; Cheng, Xin; Ning, Xiaohong; Yajuan SHAO

    2009-01-01

    Background and objective 18F-FDG PET has been widely applied in the diagnosis, treatment evaluation and following up of NSCLC. But the usefulness of PET in the prognosis predicting of NSCLC is uncertain.The purpose of the study is to investigate the value of 18F-FDG PET in the prognosis of NSCLC. Methods The value of SUV of primary and metastasis lesions to the prognosis of NSCLC were analyzed. Results SUV of primary lesions, all the metastasis lesions and hilar and/or mediastinal metastatic ...

  8. The clinical application of 18F-FDG PET/CT scan in the thyroid carcinoma

    The incidence of thyroid cancer is the top ranking among endocrine carcinoma worldwide. Many imaging modalities have been applied in diagnosing, characterization of the biological behaviors and predicting the outcomes of various thyroid carcinoma. Over the years, 18F-FDG PET/CT has been largely used to identify undifferentiated thyroid carcinoma cells in thyroid carcinoma patients with or without 131I avid lesion. The purpose of this mini-review was to update the clinical role and positive impact of 18F-FDG PET/CT in various thyroid carcinoma patients. (authors)

  9. Guidelines for 18F-FDG PET and PET-CT imaging in paediatric oncology

    Stauss, J.; Franzius, C.; Pfluger, T.;

    2008-01-01

    tomography ((18)F-FDG PET) in paediatric oncology. The Oncology Committee of the European Association of Nuclear Medicine (EANM) has published excellent procedure guidelines on tumour imaging with (18)F-FDG PET (Bombardieri et al., Eur J Nucl Med Mol Imaging 30:BP115-24, 2003). These guidelines, published by...... Association of Nuclear Medicine. They should be taken in the context of "good practice" of nuclear medicine and of any national rules, which may apply to nuclear medicine examinations. The recommendations of these guidelines cannot be applied to all patients in all practice settings. The guidelines should not...

  10. Chilean experience in production of 18F-FDG from 18F of reactor

    18F-FDG (fluorine-deoxy-D-glucose) is an important and useful radiopharmaceutical for imaging and study of miocardial viability. Usually cyclotron produced 18F is used to label 18F-FDG. Due to the availability of a 5MW Nuclear Reactor in Chile and the absence of a qualified Cyclotron to produce 18F we have developed a method in order to obtain suitable 18F to label 18F-FDG using the facilities we have at the Nuclear Center of La Reina, Chilean Nuclear Energy Commission. The nuclear reactions involved are: 6Li(n,alpha) 3H and 16O(3H,n)18F. Li-2CO-3, enrich (6Li =95%) was irradiated in a 5 MW swimming pool type Nuclear Reactor at a Neutron flux of 5.7x 1013 n cm-2sec-1during 4 hours. The irradiated Li-2CO-3 was dissolved in H-2SO-4(1:1) and distilled as trimethylsilyl (18F) fluoride (18F-TMS). The labelling of the sugar was carried out using the method described by Hamacker. The 18F-TMS was trapped in a solution of acetonitrile, water, potassium carbonate and kriptofix and hydrolysed to form 18F fluoride. The nucleofilic complex reacts with 1,3,4,6, tetra-O-acetyl-2-O-trifluormethanesulfonyl-beta-D-mannopyranose. The acetiled carbohydrate by acid hydrolysis produce 18FDG. The final product was purified using a ion retarding resin (AG11-A8) and a system a two Sep Pak Plus: Alumina and C-18 cartridge and sterilised by Millipore 0,22 um filter. The 18F-FDG was obtained in an apyrogenic and sterile solution. The 18F Radionucleidic Purity was higher than 99,9% and the Radiochemical Purity of the 18F-FDG obtained was over than 99%. Residual 3H content was as low as 20 (Bq3 H/MBq 18F-FDG). The yield of the process of 18F-FDG was 37 %. Studies in patient with recently myocardial disease have showed the successful of the 18F-FDG. The C.CH.E.N supports an active diagnostic nuclear cardiology program

  11. Canine study on myocardial ischemic memory with 18F-FDG PET/CT imaging

    Objective: To explore whether the existence and duration of ischemia measured by dynamic 18F-FDG PET/CT imaging correlated with the extent of myocardial ischemia in a canine model of myocardial ischemia-reperfusion. Methods: Canine coronary artery occlusion was carried out for 20 min (n=4) and for 40 min (n=4) followed by 24 h of open-artery reperfusion. All dogs underwent dynamic 18F-FDG PET/CT and 99Tcm-MIBI SPECT imaging at baseline and 1 h and 24 h after reperfusion.Quantitative analysis of myocardial 18F-FDG uptake was performed using Carimas Core software,and the extraction ratio of 18F-FDG (K) was calculated by the ratio of 18F-FDG uptake rate in the ischemic area (kischemia) and normoperfused region (knormoperfused). Echocardiographic data were also acquired between each PET/CT imaging study to detect the wall motion in the ischemic and normoperfused myocardium. Paired t test and non-parametric statistical tests, measured by SPSS 19.0, were used to analyze the data. Results: Coronary occlusion produced sustained, abnormal wall motion in the ischemic region for more than 1 h. Similar K values were demonstrated between the 20 min and 40 min groups at baseline (1.02 ±0.06 and 1.03 ±0.05, Z=-0.29, P>0.05). At 1 h after reperfusion, the reperfusion regions showed normal perfusion but with increased 18F-FDG uptake, which was higher in the 40 min ischemic group than in the 20 min ischemic group (2.31 ±0.13 and 1.87 ±0.09, Z=-2.31, P<0.05). At 24 h after reperfusion, however, only the 40 min ischemic group showed slightly higher 18F-FDG uptake than baseline (1.15 ± 0.02 and 1.03 ±0.05, t=4.32, P<0.05), whereas no significant difference was found in the 20 min ischemic group (1.05 ± 0.04 and 1.02 ± 0.06, t=0.87, P>0.05). Histological examination of the ischemic myocardium from both groups revealed neatly arranged cells without interstitial edema, hemorrhage nor inflammatory response. Conclusions: Myocardial 'ischemic memory' was correlated with the

  12. Analysis of 18F-FDG PET mapping in malignant tumor patients with depression by SPM

    Objective: To investigate brain 18F-fluorodeoxyglucose (FDG) PET mapping in malignant tumor patients with depressive emotion. Methods: 18F-FDG PET imaging was performed in 21 malignant tumor patients (tumor group) and 21 healthy controls (control group). All were evaluated by self-rating depression scale (SDS)and 24 questions Hamilton rating scale for depression (HAMD). Results: (1) The standard total score of SDS and HAMD of the tumor group were higher than those of the control group (P18F-FDG PET imagings. The abnormalities of glucose metabolism might be related to their depressive emotion. (authors)

  13. Clinical Application of 18F-FDG PET in Parkinson's Disease

    Parkinson's disease is the second most common neurodegenerative disorder. It is slowly progressive disease that affects a small area of cells in the mid brain known as the substantia nigra. Gradual degeneration of these cells causes a reduction in a vital chemical known as dopamine. In the diagnosis of Parkinson's disease, it has difficulty in biopsy and limits in radiologic modalities. 18F-FDG PET shows various findings from normal to diffuse decrement of FDG uptake. 18F-FDG PET is expected to be a evaluation tool in the treatment of Parkinson's disease

  14. Anesthesia condition for {sup 18}F-FDG imaging of lung metastasis tumors using small animal PET

    Woo, Sang-Keun; Lee, Tae Sup; Kim, Kyeong Min; Kim, June-Youp; Jung, Jae Ho; Kang, Joo Hyun [Division of Nuclear Medicine and RI Application, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of); Cheon, Gi Jeong [Division of Nuclear Medicine and RI Application, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of); Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of)], E-mail: larry@kcch.re.kr; Choi, Chang Woon; Lim, Sang Moo [Division of Nuclear Medicine and RI Application, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of); Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of)

    2008-01-15

    Small animal positron emission tomography (PET) with {sup 18}F-FDG has been increasingly used for tumor imaging in the murine model. The aim of this study was to establish the anesthesia condition for imaging of lung metastasis tumor using small animal {sup 18}F-FDG PET. Methods: To determine the impact of anesthesia on {sup 18}F-FDG distribution in normal mice, five groups were studied under the following conditions: no anesthesia, ketamine and xylazine (Ke/Xy), 0.5% isoflurane (Iso 0.5), 1% isoflurane (Iso 1) and 2% isoflurane (Iso 2). The ex vivo counting, standard uptake value (SUV) image and glucose SUV of {sup 18}F-FDG in various tissues were evaluated. The {sup 18}F-FDG images in the lung metastasis tumor model were obtained under no anesthesia, Ke/Xy and Iso 0.5, and registered with CT image to clarify the tumor region. Results: Blood glucose concentration and muscle uptake of {sup 18}F-FDG in the Ke/Xy group markedly increased more than in the other groups. The Iso 2 group increased {sup 18}F-FDG uptake in heart compared with the other groups. The Iso 0.5 anesthesized group showed the lowest {sup 18}F-FDG uptake in heart and chest wall. The small size of lung metastasis tumor (2 mm) was clearly visualized by {sup 18}F-FDG image with the Iso 0.5 anesthesia. Conclusion: Small animal {sup 18}F-FDG PET imaging with Iso 0.5 anesthesia was appropriate for the detection of lung metastasis tumor. To acquire {sup 18}F-FDG PET images with small animal PET, the type and level of anesthetic should be carefully considered to be suitable for the visualization of target tissue in the experimental model.

  15. 18F-FDG PET and biomarkers for tumour angiogenesis in early breast cancer

    Tumour angiogenesis is an independent and strong prognostic factor in early breast carcinoma. We performed this study to investigate the ability of 18F-FDG to detect angiogenesis in early breast carcinoma using PET/CT. Twenty consecutive patients with early (T1-T2) breast carcinoma were recruited prospectively for 18F-FDG PET/CT. The PET/CT data were used to calculate whole tumour maximum standardized uptake value (SUVmax) and mean standardized uptake value (SUVmean). All patients underwent subsequent surgery without prior chemotherapy or radiotherapy. The excised tumour underwent immunohistochemistry for vascular endothelial growth factor (VEGF), CD105 and glucose transporter protein 1 (GLUT1). The SUVmax showed the following correlation with tumour histology: CD105: r = 0.60, p = 0.005; GLUT1: r = 0.21, p = 0.373; VEGF: r = -0.16, p = 0.496. The SUVmean showed the following correlation with tumour histology: CD105: r = 0.65, p = 0.002; GLUT1: r = 0.34, p = 0.144; VEGF: r = -0.18, p = 0.443 18F-FDG uptake is highly significantly associated with angiogenesis as measured by the immunohistochemistry with CD105 for new vessel formation. Given that tumour angiogenesis is an important prognostic indicator and a predictor of treatment response, 18F-FDG PET may have a role in the management of primary breast cancer patients even in early-stage disease. (orig.)

  16. 18F-FDG PET/CT in fever and inflammation of unknown origin

    J.J.M. Balink

    2015-01-01

    This thesis describes the role and the interpretation of imaging results with hybrid 18F-FDG PET/CT in patients with non-localizing or non-specific signs and symptoms like fever, weight loss, malaise and prolonged increased inflammatory parameters, without a diagnosis after routine diagnostic evalua

  17. (18F) FDG PET/CT in patients with fever of unknown origin: AIIMS experience

    Full text: The aim of this study was to assess the value of (18F) FDG PET/CT in evaluation of patients with Fever of Unknown Origin (FUO). We retrospectively analysed clinical data and (18F) FDG PET scan of 48 patients over a period of 1 year. These patients met the revised definition criteria of FUO (febrile illness of greater than 3 weeks duration, temperature greater than 38.3 C and no diagnosis after appropriate in-patient or out-patient evaluation). Most of the patients recruited in this study had normal clinical and radiological examination. (18F) FDG PET was helpful in making a diagnosis in 24 patients. An infective/inflammatory cause of FUO was found in thirteen (27%) patients, a neoplasm in six (12.5%) patients, autoimmune cause in five (10.4%) patients. A definitive diagnosis could not be made in twenty four (50%) patients. Out of these 24 patients, 15 had normal PET/CT study, 9 had positive PET/CT findings but they lost in follow up and 2 died within 1 month of PET/CT study without any diagnosis. (18F) FDG PET/CT is a useful tool for evaluation of patients with FUO. It provides important diagnostic clues not suggested by other conventional imaging modalities. Patients with positive PET/CT findings but no definitive diagnosis should be followed up further to improve utility of PET/CT

  18. Clinical value of 18F-FDG coincidence imaging for patients with fever of unknown origin

    Objective: The aim of this study was to assess the clinical value of 18F-fluorodeoxyglucose (FDG) coincidence imaging in the diagnosis of fever of unknown origin (FUO). Methods: Fifty-eight patients with FUO (temperature>38.3 degree C, fever more than 3 weeks) underwent SPECT imaging with 18F-FDG. Region of interest (ROI) was drawn over the lesions (L) and contralateral or adjacent normal tissue (B). The radioactivity ratio L/B was calculated for both benign and malignant pathologies and compared by t test. Results In 48 patients(83%), at least one site of abnormal 18F-FDG accumulation on SPECT was found, which led to the final diagnosis of malignant disease in 20 patients, and infectious or other benign disease in 23 patients. Five patients remained unknown.Four in 10 (17%) cases with negative 18F-FDG SPECT were later proven as infectious disease (2 with urinary tract infection, 2 with lymphadenitis); 3 were found to have connective tissue and collagen disease (1 with rheumatism, 1 with adult onset still's disease. 1 with systemic lupus erythematosus); while the last 3 remained unknown. The L/B ratio of benign foci was 1.93 ± 0.39, and that of malignant foci was 3.58 ± 1.01 (statistically significant difference with t=6.955. P18F-FDG coincidence imaging is valuable in the diagnosis for FUO. (authors)

  19. Evaluating the effect of radiosensitizer early by uptake of 18F-FDG human pancreatic carcinoma cell Patu 8988

    Objective: to evaluate the effect of radiotherapy and joint action with CMNa and 2-DG early by uptake of 18F-FDG in human pancreatic carcinoma cell Patu 8988. Methods: The human pancreatic carcinoma cell Patu 8988 were exposed to a single fraction of X-ray radiation either with glycodidazolum natrium (CMNa) or 2-deoxy-D-glucose (2-DG) or irradiation-only. The uptake of 18F-FDG was calculated 24 and 48 h after irradiation. Results: The differences of 18F-FDG uptake between groups of various dose had no significance 24 h after irradiation (P>0.05). 18F-FDG uptake in the 2-DG groups and CMNa groups were lower than that in the irradiation-only groups (P<0.05 or <0.01). The differences of 18F-FDG uptake in 2-DG groups, CMNa groups and irradiation-only groups had significance 24 and 48 h after irradiation (P<0.05). 18F-FDG uptake decreased with the increasing dose of X-ray. Uptake was positively correlated with the A value 24 and 48 h after irradiation (r=0.759, r=0.814, P<0.01). Conclusion: The uptake of 18F-FDG with human pancreatic carcinoma cell Patu 8988 decreased 24 h after irradiation with 2-DG or CMNa. Response to radiotherapy could be predicted early by 18F-FDG PET scans. (authors)

  20. The usefulness of 18F-FDG PET in patients with head and neck tumors

    Objective: The purpose of this study is to assess the usefulness of 18F-fluorodeoxyglucose (FDG) PET in patients with head and neck tumors. Methods: Thirty-nine patients (56 studies) with pathologically confirmed head and neck tumors underwent whole body 18F-FDG PET imaging for staging (5 cases) or for post-therapeutic monitoring and restaging. The results of whole body 18F-FDG PET imaging were evaluated with both visual and semiquantitative analyses (standardized uptake value, SUV). Results: (1) 18F-FDG PET helped to define the extent of lesions in 3 patients and downstage another patient before treatment, and accurately detected residual or recurrent lesions in 6, local lymph node metastasis in 11, lung and bone metastases in 4 and 3 cases after treatment. (2) Of 22 positive 18F-FDG PET imaging, 20 were true positive confirmed by surgeries or follow-up studies. All of 17 patients with negative 18F-FDG PET findings remained disease-free during follow-up. The sensitivity, specificity and accuracy of 18F-FDG PET imaging in detecting residual, recurrent and metastatic lesions were 100%, 89.5%, and 94.9% respectively. (3) 18F-FDG PET imaging detected more lesions than CT or MRI in 3 of 21 cases, and corrected another 6 CT or MRI false-positive findings. (4) Consecutive PET studies were carried out in 9 patients. Remission was found in 5 patients and progression in 3. In one patient with nasopharyngeal carcinoma, PET imaging showed complete response of primary lesion and metastatic lymph nodes to treatment, but found another high uptake focus in the middle part of descending colon which was confirmed to be an adenoma by colonoscopy. Conclusion: Due to its high sensitivity and accuracy in the detection of residual, recurrent, metastatic lesions and of second primary tumor, FDG PET imaging is a useful modality for staging and post-therapeutic follow-up in patients with head and neck tumors. (authors)

  1. [18F]FDG Accumulation in Early Coronary Atherosclerotic Lesions in Pigs.

    Miikka Tarkia

    Full Text Available Inflammation is an important contributor to atherosclerosis progression. A glucose analogue 18F-fluorodeoxyglucose ([18F]FDG has been used to detect atherosclerotic inflammation. However, it is not known to what extent [18F]FDG is taken up in different stages of atherosclerosis. We aimed to study the uptake of [18F]FDG to various stages of coronary plaques in a pig model.First, diabetes was caused by streptozotocin injections (50 mg/kg for 3 days in farm pigs (n = 10. After 6 months on high-fat diet, pigs underwent dual-gated cardiac PET/CT to measure [18F]FDG uptake in coronary arteries. Coronary segments (n = 33 were harvested for ex vivo measurement of radioactivity and autoradiography (ARG.Intimal thickening was observed in 16 segments and atheroma type plaques in 10 segments. Compared with the normal vessel wall, ARG showed 1.7±0.7 times higher [18F]FDG accumulation in the intimal thickening and 4.1±2.3 times higher in the atheromas (P = 0.004 and P = 0.003, respectively. Ex vivo mean vessel-to-blood ratio was higher in segments with atheroma than those without atherosclerosis (2.6±1.2 vs. 1.3±0.7, P = 0.04. In vivo PET imaging showed the highest target-to-background ratio (TBR of 2.7. However, maximum TBR was not significantly different in segments without atherosclerosis (1.1±0.5 and either intimal thickening (1.2±0.4, P = 1.0 or atheroma (1.6±0.6, P = 0.4.We found increased uptake of [18F]FDG in coronary atherosclerotic lesions in a pig model. However, uptake in these early stage lesions was not detectable with in vivo PET imaging. Further studies are needed to clarify whether visible [18F]FDG uptake in coronary arteries represents more advanced, highly inflamed plaques.

  2. Does Delayed-Time-Point Imaging Improve 18F-FDG-PET in Patients With MALT Lymphoma?

    Mayerhoefer, Marius E.; Giraudo, Chiara; Senn, Daniela; Hartenbach, Markus; Weber, Michael; Rausch, Ivo; Kiesewetter, Barbara; Herold, Christian J.; Hacker, Marcus; Pones, Matthias; Simonitsch-Klupp, Ingrid; Müllauer, Leonhard; Dolak, Werner; Lukas, Julius; Raderer, Markus

    2016-01-01

    Purpose To determine whether in patients with extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue lymphoma (MALT), delayed–time-point 2-18F-fluoro-2-deoxy-d-glucose-positron emission tomography (18F-FDG-PET) performs better than standard–time-point 18F-FDG-PET. Materials and Methods Patients with untreated histologically verified MALT lymphoma, who were undergoing pretherapeutic 18F-FDG-PET/computed tomography (CT) and consecutive 18F-FDG-PET/magnetic resonance imaging (MRI), using a single 18F-FDG injection, in the course of a larger-scale prospective trial, were included. Region-based sensitivity and specificity, and patient-based sensitivity of the respective 18F-FDG-PET scans at time points 1 (45–60 minutes after tracer injection, TP1) and 2 (100–150 minutes after tracer injection, TP2), relative to the reference standard, were calculated. Lesion-to-liver and lesion-to-blood SUVmax (maximum standardized uptake values) ratios were also assessed. Results 18F-FDG-PET at TP1 was true positive in 15 o f 23 involved regions, and 18F-FDG-PET at TP2 was true-positive in 20 of 23 involved regions; no false-positive regions were noted. Accordingly, region-based sensitivities and specificities were 65.2% (confidence interval [CI], 45.73%–84.67%) and 100% (CI, 100%-100%) for 18F-FDG-PET at TP1; and 87.0% (CI, 73.26%–100%) and 100% (CI, 100%-100%) for 18F-FDG-PET at TP2, respectively. FDG-PET at TP1 detected lymphoma in at least one nodal or extranodal region in 7 of 13 patients, and 18F-FDG-PET at TP2 in 10 of 13 patients; accordingly, patient-based sensitivity was 53.8% (CI, 26.7%–80.9%) for 18F-FDG-PET at TP1, and 76.9% (CI, 54.0%–99.8%) for 18F-FDG-PET at TP2. Lesion-to-liver and lesion-to-blood maximum standardized uptake value ratios were significantly lower at TP1 (ratios, 1.05 ± 0.40 and 1.52 ± 0.62) than at TP2 (ratios, 1.67 ± 0.74 and 2.56 ± 1.10; P = 0.003 and P = 0.001). Conclusions Delayed–time-point imaging

  3. Toxoplasmic Lymphadenitis Mimicking a Metastatic Thyroid Carcinoma at 18F-FDG-PET/CT

    A 28-year-old woman underwent total thyroidectomy for a papillary thyroid carcinoma in the right thyroid lobe (pTx, pN1b). Subsequently a 131I-ablation (4.4 GBq) was performed. Four years later the patient presented increased thyroglobulin (Tg) serum levels (8.4 μg/l) during thyroxine treatment. Furthermore, enlarged hypoechoic and round-shaped bilateral cervical lymph nodes were detected at cervical ultrasonography (US). Based on laboratory and US findings suspicious for lymph nodal recurrence of thyroid carcinoma, the patient underwent an 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) to check for distant metastases (Fig. 1). The patient underwent a US-guided fine-needle aspiration cytology on an 18F-FDG-avid cervical lymph-node. The smears were hypercellulated and consisted of numerous small- to medium-sized lymphocytes, macrophages, dendritic cells and tingible body macrophages. The cytological diagnosis was consistent with that of reactive lymphadenitis. Serological test revealed elevated IgM and IgG anti-Toxoplasma antibodies with a very low IgG-avidity, indicating an acute toxoplasmosis. Serum Tg was then measured by using heterophilic antibody blocking tubes, as previously reported, and serum value dropped to 18F-FDG-PET/CT in oncological patients. Few reports have described toxoplasmic infection mimicking malignancy at 18F-FDG-PET/CT; these findings were found mainly in immunodepressive patients or with history of lymphoma. Conversely, we described here a case of toxoplasmosis inducing false-positive Tg measurement, neck US and 18F-FDG-PET/CT findings in a patient with papillary thyroid carcinoma

  4. Can 18F-FDG PET improve the evaluation of suspicious breast lesions on MRI?

    Highlights: • Prone 18F-FDG PET can improve the evaluation of suspicious breast lesions on MRI. • 18F-FDG PET's results were better for mass lesions higher than 10 mm. • 18F-FDG PET has the potential to identify more aggressive breast tumors. - Abstract: Objective: To evaluate the impact of adding 18F-fluorine-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in the evaluation of suspicious breast lesions on magnetic resonance imaging (MRI). Methods: Sixty patients with suspicious breast lesions on MRI were selected to perform a PET–CT in prone position, dedicated to the evaluation of the breasts. The areas with increased 18F-FDG concentration relative to normal parenchyma were considered positive on PET–CT. Fusion of PET and MRI images (PET–MRI) was performed on a dedicated workstation to better locate corresponding lesions, and its findings were compared with histological results. Results: 76 lesions were evaluated, including 64 mass lesions (84.2%) and 12 non-mass lesions (15.8%). Lesions’ mean diameter on MRI was 29.6 ± 19.2 mm (range 6–94 mm). PET–CT showed increased metabolically activity on 57 lesions (75.0%), with mean maximum SUV of 5.7 ± 5.0 (range 0.8–23.1). On histopathology, there were 17 (22.4%) benign and 59 (79.7%) malignant lesions. Considering all lesions, PET–MRI fusion provided 89.8% sensitivity, 76.5% specificity and 86.8% accuracy. Considering only mass lesions higher than 10 mm, PET–MRI fusion provided 95.8% sensitivity, 83.3% specificity and 93.3% accuracy. Conclusion: The inclusion of 18F-FDG PET on the evaluation of suspicious breast lesions on MRI helped to differentiate benign from malignant breast lesions, especially for mass lesions with a diameter higher than 10 mm

  5. High and typical {sup 18}F-FDG bowel uptake in patients treated with metformin

    Gontier, Eric; Bonardel, Gerald; Mantzarides, Marina; Foehrenbach, Herve [Military Hospital Val-de-Grace, Department of Nuclear Medicine, Paris, cedex 05 (France); Fourme, Emmanuelle [Cancer Research Center Rene Huguenin, Department of Medical Statistics, Saint-Cloud (France); Wartski, Myriam; Pecking, Alain-Paul; Alberini, Jean-Louis [Cancer Research Center Rene Huguenin, Department of Nuclear Medicine, Saint-Cloud (France); Blondet, Cyrille [University Hospital of Strasbourg, Department of Nuclear Medicine, Strasbourg (France); Le Stanc, Elise [Foch Hospital, Department of Nuclear Medicine, Suresnes (France)

    2008-01-15

    This prospective and bi-centric study was conducted in order to determine the impact of antidiabetic treatments (AD) on {sup 18}F-FDG bowel uptake in type 2 diabetic patients. Fifty-five patients with previously diagnosed and treated type 2 diabetes mellitus (group 1) were divided in two subgroups: AD treatment including metformin (n=32; group 1a) and AD treatment excluding metformin (n=23; group 1b). The 95 patients without diabetes mellitus made up controls (group 2). {sup 18}F-FDG uptake in small intestine and colon was visually graded and semi-quantitatively measured using the maximum standardized uptake value. {sup 18}F-FDG bowel uptake was significantly increased in AD patients (group 1) as compared to controls (group 2) (p<0.001). Bowel uptake was significantly higher in AD patients including metformin (group 1a) as compared to AD patients excluding metformin (group 1b) (p<0.01), whose bowel uptake was not significantly different from controls (group 2). A metformin treatment was predictive of an increased bowel uptake in the small intestine (odds ratio OR=16.9, p<0.0001) and in the colon (OR=95.3, p<0.0001), independently of the other factors considered in the multivariate analysis. Bowel uptake pattern in the patients treated with metformin was typically intense, diffuse and continuous along the bowel, strongly predominant in the colon, in both the digestive wall and lumen. This study emphasizes that metformin significantly increases {sup 18}F-FDG uptake in colon and, to a lesser extent, in small intestine. It raises the question of stopping metformin treatment before an {sup 18}F-FDG PET/CT scan is performed for intra-abdominal neoplasic lesion assessment. (orig.)

  6. Study on radiation dose caused by 18F-FDG in PET/CT examination

    Objective: The aim of this study was to investigate the radiation dose caused by 18F-flu- orodeoxyglucose (FDG) in PET/CT examination and to optimize the concerned radiation protection. Methods: Thirty patients from our conventional PET/CT examination were simple randomly selected, and they all underwent whole body PET/CT imaging. The radioactive dose of injected 18F-FDG was recorded. The internal radiation dose was calculated and the external radiation dose from patients was measured with the 451P-DE-SI ion chamber survey meter. The staff's dose was recorded with thermoluminescent detector (TLD). All dosimetry data were processed and analyzed statistically with Excel 2003. Results: The injected radioactive dose of 18F-FDG was (432.9 ± 51.8) MBq, and effective dose equivalent received per patient was (8.23 ± 0.99) mSv. The correlation coefficient (r) of the dose equivalent rate and distance was -0.994 by power function curve fitting, and that of dose equivalent rate and time was -0.988 by exponential curve fitting. The staff's dose was lower than the annual dose limit. Conclusions: The patient's internal radiation dose caused by 18F-FDG in PET/CT examination is low, nonetheless, the clinician should always consider optimizing and minimizing the necessary radiation received by the patients. The patients having been injected with 18F-FDG should stay in one place to decrease their radiation to the public. From the medical point of view in optimizing radiation exposure, there may still be a potential to lower the injected 18F-FDG activity. (authors)

  7. Acute and subacute toxicity of {sup 18}F-FDG; Toxicidade aguda e subaguda do radiofarmaco {sup 18}F-FDG

    Dantas, Danielle Maia

    2013-07-01

    Before starting clinical trials of a new drug, it is necessary to perform a battery of safety tests for assessing human risk. Radiopharmaceuticals like any new drug must be tested taking into account its specificity, duration of treatment and especially the toxicity of both parties, the unlabeled molecule and its radionuclide, apart from impurities emanating from radiolysis. Regulatory agencies like the Food and Drug Administration - USA (FDA) and the European Medicine Agency (EMEA), establish guidelines for the regulation of production and research of radiopharmaceuticals. In Brazil the production of radiopharmaceuticals was not regulated until the end of 2009, when were established by the National Agency for Sanitary Surveillance (ANVISA) resolutions No. 63, which refers to the Good Manufacturing Practices of Radiopharmaceuticals and No. 64 which seeks the registration of record radiopharmaceuticals. To obtain registration of radiopharmaceuticals are necessary to prove the quality, safety, efficacy and specificity of the drug . For the safety of radiopharmaceuticals must be presented studies of acute toxicity, subacute and chronic toxicity as well as reproductive, mutagenic and carcinogenic. Nowadays IPEN-CNEN/SP produces one of the most important radiopharmaceutical of nuclear medicine, the {sup 18}F-FDG, which is used in many clinical applications, particularly in the diagnosis and staging of tumors. The objective of this study was to evaluate the systemic toxicity (acute/ subacute) radiopharmaceutical {sup 18}F-FDG in an in vivo test system, as recommended by the RDC No. 64, which will serve as a model for protocols toxicity of radiopharmaceuticals produced at IPEN. The following tests were performed: tests of acute and subacute toxicity, biodistribution studies of {sup 18}F-FDG, comet assay and reproductive toxicity. In acute toxicity, healthy rats were injected . (author)

  8. {sup 123}I-MIBG scintigraphy/SPECT versus {sup 18}F-FDG PET in paediatric neuroblastoma

    Melzer, Henriette Ingrid; Bartenstein, Peter; Pfluger, Thomas [Ludwig Maximilian University of Munich, Department of Nuclear Medicine, Munich (Germany); Coppenrath, Eva [Ludwig Maximilian University of Munich, Department of Radiology, Munich (Germany); Schmid, Irene; Albert, Michael H. [Ludwig Maximilian University of Munich, Department of Paediatric Haematology/Oncology, Munich (Germany); Schweinitz, Dietrich von [Ludwig Maximilian University of Munich, Department of Paediatric Surgery, Munich (Germany); Tudball, Coral [Royal Children' s Hospital, Department of Nuclear Medicine, Melbourne, VIC (Australia)

    2011-09-15

    To analyse different uptake patterns in {sup 123}I-MIBG scintigraphy/SPECT imaging and {sup 18}F-FDG PET in paediatric neuroblastoma patients. We compared 23 {sup 123}I-MIBG scintigraphy scans and 23 {sup 18}F-FDG PET scans (mean interval 10 days) in 19 patients with a suspected neuroblastic tumour (16 neuroblastoma, 1 ganglioneuroblastoma, 1 ganglioneuroma and 1 opsomyoclonus syndrome). SPECT images of the abdomen or other tumour-affected regions were available in all patients. Indications for {sup 18}F-FDG PET were a {sup 123}I-MIBG-negative tumour, a discrepancy in {sup 123}I-MIBG uptake compared to the morphological imaging or imaging results inconsistent with clinical findings. A lesion was found by {sup 123}I-MIBG scintigraphy and/or {sup 18}F-FDG PET and/or morphological imaging. A total of 58 suspicious lesions (mean lesion diameter 3.8 cm) were evaluated and 18 were confirmed by histology and 40 by clinical follow-up. The sensitivities of {sup 123}I-MIBG scintigraphy and {sup 18}F-FDG PET were 50% and 78% and the specificities were 75% and 92%, respectively. False-positive results (three {sup 123}I-MIBG scintigraphy, one {sup 18}F-FDG PET) were due to physiological uptake or posttherapy changes. False-negative results (23 {sup 123}I-MIBG scintigraphy, 10 {sup 18}F-FDG PET) were due to low uptake and small lesion size. Combined {sup 123}I-MIBG scintigraphy/{sup 18}F-FDG PET imaging showed the highest sensitivity of 85%. In 34 lesions the {sup 123}I-MIBG scintigraphy and morphological imaging findings were discrepant. {sup 18}F-FDG PET correctly identified 32 of the discrepant findings. Two bone/bone marrow metastases were missed by {sup 18}F-FDG PET. {sup 123}I-MIBG scintigraphy and {sup 18}F-FDG PET showed noticeable differences in their uptake patterns. {sup 18}F-FDG PET was more sensitive and specific for the detection of neuroblastoma lesions. Our findings suggest that a {sup 18}F-FDG PET scan may be useful in the event of discrepant or inconclusive

  9. 18F-FDG PET/CT features of pulmonary sclerosing hemangioma

    Background: Pulmonary sclerosing hemangioma (PSH) has been reported to show increased FDG uptake and be potential false-positives on 18F-FDG PET/CT examination. However, it is still unclear whether the previously-reported high FDG uptake is a universal characteristic of PSH, and furthermore, there have been no investigations on what kind of radiologic or histologic features may have been related with its FDG uptake values. Purpose: To investigate the 18F-FDG PET/CT features of pulmonary sclerosing hemangiomas (PSHs), and to evaluate the relating factors with their FDG uptake values. Material and Methods: We identified 10 PSHs in eight patients who had a pathologic diagnosis and available antecedent 18F-FDG PET/CT images. 18F-FDG PET/CT images were investigated both qualitatively and quantitatively, along with their histopathologic features. Correlation between 18F-FDG PET features and radiologic as well as histopathologic features were also evaluated. Results: Mean diameter of the 10 PSHs in our study was 16.9 mm ± 6.26 (range 5 - 25 mm). Four tumors showed intense uptake, and four tumors showed moderate uptake on 18F-FDG PET/CT scans. In the remaining two tumors, there were no significant FDG uptakes. The SUVmax of tumors ranged from 0.60 - 4.7 (median 2.30; 2.51 ± 1.42), and was significantly correlated with the tumor size (r = 0.754, P = 0.012) and three out of four tumors ≥2 cm (75%) showed intense FDG uptake and their SUVmax values were greater than 2.5. Immunohistochemical results for GLUT-1, GLUT-4, and Ki-67 and other pathologic features were not correlated with the tumors' FDG uptake. Conclusion: The majority of PSHs show increased FDG uptakes, and their SUVmax values are significantly correlated with their tumor size. PSH ≥2 cm can frequently be falsely interpreted as malignancy in FDG-PET/CT. Further studies with large study population are warranted to confirm our observations

  10. Synthesis of [18F] FDG under ultrasound promoted without phase transfer catalyst

    2-18F-Fluoro-2-deoxyl-D-glucose(18F-FDG) is one of the most important radiopharma- ceuticals used in PET. Since the synthesis of 18F-FDG in 1978, many methods have been developed. The common method is based on the phase-transfer catalyst(PTS) to promote nucleophilic fluorination. We try to use chemical effects of ultrasound enhance reaction rates to take place of phase transfer catalyst to synthesis of 18F-FDG, and accelerate the ester hydrolysis. A ultrasound bath(20 KHz, 50 w) was used in nucleophilic fluorination and hydrolysis in production of 18F-FDG. The reactor was immersed in center position of ultrasonic bath and the solvent level was under the water bath level by 2 cm, and the temperature of nucleophilic fluorination was 82 degree C. The others were same with classical methods. The yield of 18FFDGOAC4 was measured by radio-TLC. The Rf of free F-18 ion was 0, 18F-FDG was 0.45, 18F-FDG-OAc4 was 0.7. The result showed that the 2-nucleophilic substitution of F ion has relationship with PTS and temperature (Table 1). The ultrasound-promoted nucleophilic substitution reaction have completed 98% at 92 degree C without PTS. The normal nucleophilic reaction have reached 92% at 82 degree C with 10 mg K2.2.2 catalyst. Compared with normal nucleophilic reaction, ultrasound promoted method get lower yield at the same temp, but it can get high fluorination yield at high temp without PTS, and the hangover in reactor was lower 4% nearly. We failed in ultrasonic acceleration of 18F-FDGOAC4 ester hydrolyses with 1 N HCl under room temperature or 90 degree C . Sonochemistry had been used in sonocatalysed nucleophilic reaction and acceleration of ester hydrolyses. We succeed in the synthesis of 18FFDG at substitution reaction. Sonochemistry can been used in other radiopharmaceuticals preparation.

  11. Diagnostic value of 18F-FDG PET/CT for cancer pain of peripheral nerves

    Lei FANG

    2013-11-01

    Full Text Available Objective To observe the characteristics of cancer pain of the peripheral nerves on 18F-FDG PET/CT images, and explore the diagnostic value of 18F-FDG PET/CT for cancer pain of the peripheral nerves. Methods Imaging data of 18F-FDG PET/CT of 10 patients with cancer pain of the peripheral nerves confirmed by histopathology or long-term follow-up were analyzed retrospectively. The similarities and differences in PET/CT manifestations between the diseased side peripheral nerves and contralateral normal peripheral nerves were observed, and the maximum standardized uptake values (SUVmax were compared by paired t test with SPSS 17.0 software. Results Seventeen secondary malignant peripheral nerve lesions were found in 10 cases. On PET images, the lesions were found to spread along the plexus, nerve bundle or intervertebral foramen, and manifested as bundle-, root-hair- or nodule-like high 18F-FDG metabolic tissue, with the SUVmax as high as 6.67±3.24. The lesions on CT images manifested as bundle-, root-hair- or nodule-like soft tissue density shadows spreading along the nerve bundle or nerve root canal, and there was no clear border between the lesions and the surrounding soft and fat tissues. The contralateral normal peripheral nerves showed no abnormal images on 18F-FDG PET or CT, and the SUVmax was 1.19±0.48, which was significantly different from that of nerves on disease side (t=9.389, P<0.001. Conclusion 18F-FDG PET/CT can accurately show invasion and metastasis to the peripheral nerve of tumor, and it also can display the size, shape, distribution and tumor activity of the lesions, thus it is valuable for the diagnosis of cancer pain of the peripheral nerves. DOI: 10.11855/j.issn.0577-7402.2013.11.009

  12. Value of 18F-FDG PET/CT in the detection of ovarian malignancy

    Ovarian cancer is a leading cause of gynecologic malignancy. As symptoms of ovarian cancer are nonspecific, only 20 % of ovarian cancers are diagnosed while they are still limited to the ovaries. Thus, early and accurate detection of disease is important for an improved prognosis. For the accurate and effective diagnosis of ovarian malignancy on 18F-fluorodeoxyglucose (18F--FDG) positron emission tomography/computed tomography (PET/CT), we analyzed several parameters, including visual assessment. A total of 51 peritoneal lesions in 19 patients who showed ovarian masses with diffuse peritoneal infiltration were enrolled. Twelve patients were confirmed to have ovarian malignancy and seven patients with benign disease by pathologic examination. All patients were examined by 18F--FDG PET/CT, and an additional 2-h delayed 18F--FDG PET/CT was also performed for 15 patients with 42 peritoneal lesions. We measured semiquantitative parameters including maximum and mean standardized uptake values (SUVmax, SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on a 1-h initial 18F--FDG PET/CT image (Parameter1) and on a 2-h delayed image (Parameter2). Additionally, retention indices of each parameter were calculated, and each parameter among the malignant and benign lesions was compared by Mann-Whitney U test. We also assessed the visual characteristics of each peritoneal lesion, including metabolic extent, intensity, shape, heterogeneity, and total visual score. Associations between visual grades and malignancy were analyzed using linear by linear association methods. Moreover, a receiver operating characteristic (ROC) curve was analyzed to compare the effectiveness of significant parameters. In a comparison between the malignant and benign groups in the analysis of 51 total peritoneal lesions, SUVmax1, SUVmean1, and TLG1 showed significant differences. Also, in the analysis of 42 peritoneal lesions that underwent an additional 2-h 18F--FDG PET

  13. Disseminated osteomyelitis or bone metastases of breast cancer. 18F-FDG-PET/CT helps unravel an unusual presentation

    We present a case wherein striking 18F-FDG-PET/CT findings initially considered consistent with recurrent disseminated skeletal metastases of breast cancer were later identified as an unusual presentation of disseminated chronic pyogenic osteomyelitis with Staphylococcus aureus and warneri identified on microbiological culture. A 76-year-old female with previous history of breast cancer presented with a 6-month history of pyrexia, myalgia and weight loss. Besides neutrophilia and elevated C-reactive protein, other blood indices, cultures and conventional imaging failed to identify the cause of pyrexia of unknown origin (PUO). 18F-FDG-PET/CT demonstrated multiple widespread foci of intense FDG uptake in lytic lesions throughout the skeleton. Coupled with previous history of malignancy, findings were strongly suggestive of disseminated metastases of breast cancer. Through targeting an FDG avid lesion, 18F-FDG-PET/CT aided CT-guided biopsy, which instead identified the lesions as chronic pyogenic osteomyelitis. Following prolonged antibiotic therapy, repeat 18F-FDG-PET/CT demonstrated significant resolution of lesions. This case demonstrated an unusual presentation of disseminated osteomyelitis on 18F-FDG-PET/CT and highlighted the use of 18F-FDG-PET/CT as a trouble shooter in PUO but demonstrated that unusual presentations of benign or malignant pathologies cannot always reliably be differentiated on imaging alone without aid of tissue sampling. Furthermore, this case highlights the potential role 18F-FDG-PET/CT could provide in assessing response to antibiotic therapy. (author)

  14. Synthesis of 18F-FDG with FDG MicroLabTM system. Basic studies for clinical application

    We synthesized 18F-FDG by using an automated synthetic apparatus ''FDG MicroLab'' (GE Medical Systems) which produces 18F-FDG by a solid phase 18F-fluorination. Its quality and reproducibility were evaluated in order to assess feasibility of the apparatus for routine clinical production of 18F-FDG. For 5 consecutive 18F-FDG synthesis, target irradiation was carried out at 15 μA for 60 min. 18F-FDG was obtained in 50 min after EOB with an end-of-synthesis yield of 9.34±1.06 GBq. Radiochemical yield and radiochemical purity were 47±3% (decay corrected) and 98.0±0.5%, respectively. Other several quality control parameters tested conformed with Standards of Compounds Labeled with Positron Nuclides'' (RADIOISOTOPES, 44, 1995). Thus, the automated synthetic apparatus ''FDG MicroLab'' has proven to stably produce 18F-FDG with high yield and high purity. The apparatus is feasible for routine clinical production of 18F-FDG. (author)

  15. Reproducibility of (18)F-FDG PET uptake measurements in head and neck squamous cell carcinoma on both PET/CT and PET/MR

    Rasmussen, J H; Fischer, B M; Aznar, M C;

    2015-01-01

    OBJECTIVE: To investigate reproducibility of fluorine-18 fludeoxyglucose ((18)F-FDG) uptake on (18)F-FDG positron emission tomography (PET)/CT and (18)F-FDG PET/MR scans in patients with head and neck squamous cell carcinoma (HNSCC). METHODS: 30 patients with HNSCC were included in this prospecti...

  16. Imaging findings and literature review of 18F-FDG PET/CT in primary systemic AL amyloidosis

    Although several case reports and case series have described 18F-FDG PET/CT in amyloidosis, the value of 18F-FDG PET/CT for diagnosing amyloidosis has not been clarified. We investigated the imaging findings of 18F-FDG PET/CT in patients with primary systemic AL amyloidosis. Subjects were 15 patients (M:F = 12:3; age, 61.5 ± 7.4 years) with histologically confirmed primary systemic AL amyloidosis who underwent pretreatment 18F-FDG PET/CT to rule out the possibility of malignancy or for initial workup of alleged cancer. For involved organs, visual and semiquantitative analyses were performed on 18F-FDG PET/CT images. In total, 22 organs (10 hearts, 5 kidneys, 2 stomachs, 2 colons, 1 ileum, 1 pancreas, and 1 liver) were histologically confirmed to have primary systemic AL amyloidosis. F-FDG uptake was significantly increased in 15 of the 22 organs (68.2 %; 10 hearts, 2 kidneys, 1 colon, 1 ileum, and 1 liver; SUVmax = 7.0 ± 3.2, range 2.1–14.1). However, in 11 of 15 PET-positive organs (78.6 %; 10 hearts and the ileum), it was difficult to differentiate pathological uptake from physiological uptake. Definitely abnormal 18F-FDG uptake was found in only 4 of the 22 organs (18.2 %; 2 kidneys, 1 colon, and the liver). 18F-FDG uptake was negative for pancreas and gastric lesions. Although 18F-FDG PET/CT showed high uptake in two-thirds of the organs involving primary systemic AL amyloidosis, its sensitivity appeared to be low to make differentiation of pathological uptake from physiological uptake. However, due to the small number of cases, further study for the role of 18F-FDG PET/CT in amyloidosis will be warranted

  17. (18)F-FDG PET/CT in a rare case of Stewart-Treves syndrome

    Jensen, Mads Radmer; Friberg, Lars; Karlsmark, Tonny;

    2011-01-01

    BACKGROUND: The aim of this article is to illustrate the possible applications of (18)F-fluorodeoxyglucose positron emission tomography/computer tomography ((18)F-FDG PET/CT) in chronic extremity lymphedema and its complications. METHODS AND RESULTS: (18)F-FDG PET/CT findings in a rare case of...... Stewart-Treves Syndrome (STS), angiosarcoma secondary to chronic extremity lymphedema, are presented. Lymphedema of the extremities is a debilitating disease characterized by chronic swelling due to interstitial edema caused by insufficient lymphatic drainage capacity. Progression with skin thickening......, subcutaneous fibrosis, and increased adipose tissue volume is common. Chronic inflammation has been suggested as a key pathophysiologic component. STS is a rare complication with a very poor prognosis; however, early diagnosis and radical treatment is associated with increased survival. Thus, accurate...

  18. Soft tissue metastases from differentiated thyroid cancer diagnosed by {sup 18}F FDG PET-CT

    Califano, Ines; Quildrian, Sergio; Otero, Jose; Coduti, Martin; Califano, Leonardo; Rojas Bilbao, Erica, E-mail: ines.m.califano@gmail.com [Instituto de Oncologia Angel H. Roffo, Universidad de Buenos Aires (Argentina)

    2013-06-15

    Distant metastases of differentiated thyroid cancer are unusual; lung and bones are the most frequently affected sites. Soft tissue metastases (STM) are extremely rare. We describe two cases of patients with differentiated thyroid cancer metastasizing to soft tissues. Both patients had widespread metastatic disease; clinically asymptomatic soft tissue metastases were found by 18-Fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F FDG PET-CT), and confirmed by cytological and/or histopathological studies. These findings underscore the ability of {sup 18}F FDG PET-CT in accurately assessing the extent of the disease, as well as the utility of the method to evaluate regions of the body that are not routinely explored. (author)

  19. Positron emission tomography with [{sup 18}F]FDG for therapy response monitoring in lymphoma patients

    Spaepen, Karoline; Stroobants, Sigrid; Mortelmans, Luc [Department of Nuclear Medicine, UZ Gasthuisberg, Herestraat 49, 3000, Leuven (Belgium); Verhoef, Gregor [Department of Hematology, UZ Gasthuisberg, Herestraat 49, 3000, Leuven (Belgium)

    2003-06-01

    Lymphomas are a heterogeneous group of diseases with differing histopathology, clinical behaviour, response to therapy and outcome. Lymphomas are highly sensitive to chemotherapy and radiotherapy, and the recent developments in treatment have considerably improved clinical outcome. However, there is increasing recognition that this has been at the cost of long-term treatment-related effects in a relatively young patient population. Thus, one of the most challenging aspects in the imaging of lymphoma patients is tailoring the intensity of the treatment to the individual patient. This paper reviews recently published data concerning the use of fluorine-18 fluorodeoxyglucose positron emission tomography ([{sup 18}F]FDG-PET) for therapy monitoring in lymphoma patients and highlights the shortcomings and future directions. A temporary strategy for the implementation of [{sup 18}F]FDG-PET in the management of lymphoma patients is proposed. (orig.)

  20. Restaging in patients with preoperative breast cancer using 18F-FDG-PET/CT

    The purpose of this study was to investigate the usefulness of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT) in the assessment of patients with preoperative breast cancer. During April 2006 to February 2008, 294 patients (age 34-73 years) with biopsy proven breast cancer were enrolled in this preoperative staging study. Distant metastases such as bone, extraaxiall lymphnode, lung, liver, were disclosed by 18F-FDG-PET/CT in 4.6% cases of clinical Stage II and in 17% cases of clinical Stage III, and in 7.2% cases of clinical Stage II and III. Otherwise, 80% of them had not been demonstrated. 18F-FDG-PET/CT has the usefulness in restaging the patients with clinical Stage II and III of preoperative breast cancer. (author)

  1. Bilateral Tubo Ovarian Abscess Mimics Ovarian Cancer on MRI and 18F FDG PET/CT

    A 20 year old woman, who presented with a several week history of abdominal pain, was referred for magnetic resonance imaging (MRI) and 18F fluorodeoxy glucose (FDG) positron emission tomography (PET)/computed tomography (CT) after an ultrasound showed complex cystic masses arising from both ovaries. The MRI and 18F FDG PET/CT imaging characteristics of the ovarian masses were strongly suspicious for malignancy, and the masses were surgically removed. Histopathological evaluation revealed a bilateral tuboovarian abscess, with no evidence of malignancy. This case highlights a potentially serious pitfall in the evaluation of suspicious pelvic masses by 18F FDG PET/CT, Whereby a complex bilateral tuboovarian abscess may mimic the PET/CT imaging characteristics of an ovarian or pelvic malignancy.

  2. Epimerization study on [18F]FDG produced by an alkaline hydrolysis on solid support under stringent conditions

    Since 1998, routine [18F]FDG syntheses are being carried out by alkaline hydrolysis on a solid support, i.e. the labeled intermediate is trapped on a tC18 solid phase extraction cartridge, purified and finally hydrolyzed within the cartridge, at room temperature, using sodium hydroxide. The present study demonstrated that no epimerization of [18F]FDG to [18F]FDM occurs even when 12 N NaOH is used and when the hydrolysis time is extended up to 1 h. The alkaline hydrolysis on solid support appears to be a simple method leading to [18F]FDG with high purity

  3. The Usefulness of {sup 18}F-FDG PET as a Cancer Screening Test

    Ko, Doo Heun; Choi, Joon Young; Song, Yun Mi; Lee, Su Jin; Kim, Young Hwan; Lee, Kyung Han; Kim, Byung Tae; Lee, Moon Kyu [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2008-12-15

    The aim of this study was to evaluate the usefulness of whole body positron emission tomography (PET) using {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) for cancer screening in asymptomatic subjects. The subjects were 1,762 men and 259 women who voluntarily underwent {sup 18}F-FDG PET for cancer screening as a part of a routine health examination. Final diagnosis was decided by other diagnostic studies, pathological results or clinical follow-up for 1 year. Of 2,021 subjects, 40 (2.0%) were finally proved to have cancer. Abnormal focal {sup 18}F-FDG uptake suggesting malignancy was found in 102 subjects (5.0%). Among them, 21 subjects (1.0%) were proved to have cancer. Other tests in the routine health examination could not find 9 of 21 cancers (42.9%) detected by PET. The sensitivity, specificity, positive predictive value, and negative predictive value of PET for cancer screening were 52.5%, 95.9%, 20.6%, and 99.0%, respectively. Pathologies of cancers missed on PET were adenocarcinoma (n=9; 3 colon cancers, 3 prostate cancers, 2 stomach cancers, and 1 rectal cancer), differentiated thyroid carcinoma (n=6), bronchioalveolar cell carcinoma (n=2), urinary bladder cancer (n=1), and melanoma (n=1). More than half of cancers which were not detected by PET were smaller than 1 cm in diameter. {sup 18}F-FDG PET might be useful for cancer screening in asymptomatic subjects due to its high specificity and negative predictive value and play a supplementary role to the conventional health check-up, but it could not replace due to limited sensitivity for urological cancers, small-sized tumors and some hypometaboic cancers.

  4. The Usefulness of 18F-FDG PET as a Cancer Screening Test

    The aim of this study was to evaluate the usefulness of whole body positron emission tomography (PET) using 18F-fluorodeoxyglucose (18F-FDG) for cancer screening in asymptomatic subjects. The subjects were 1,762 men and 259 women who voluntarily underwent 18F-FDG PET for cancer screening as a part of a routine health examination. Final diagnosis was decided by other diagnostic studies, pathological results or clinical follow-up for 1 year. Of 2,021 subjects, 40 (2.0%) were finally proved to have cancer. Abnormal focal 18F-FDG uptake suggesting malignancy was found in 102 subjects (5.0%). Among them, 21 subjects (1.0%) were proved to have cancer. Other tests in the routine health examination could not find 9 of 21 cancers (42.9%) detected by PET. The sensitivity, specificity, positive predictive value, and negative predictive value of PET for cancer screening were 52.5%, 95.9%, 20.6%, and 99.0%, respectively. Pathologies of cancers missed on PET were adenocarcinoma (n=9; 3 colon cancers, 3 prostate cancers, 2 stomach cancers, and 1 rectal cancer), differentiated thyroid carcinoma (n=6), bronchioalveolar cell carcinoma (n=2), urinary bladder cancer (n=1), and melanoma (n=1). More than half of cancers which were not detected by PET were smaller than 1 cm in diameter. 18F-FDG PET might be useful for cancer screening in asymptomatic subjects due to its high specificity and negative predictive value and play a supplementary role to the conventional health check-up, but it could not replace due to limited sensitivity for urological cancers, small-sized tumors and some hypometaboic cancers

  5. Role of 18F FDG PET scan to localize tumor in patients of oncogenic osteomalacia

    Full text: Oncogenic osteomalacia is a rare paraneoplastic syndrome of renal phosphate wasting which is usually caused by phosphaturic mesenchymal tumors. Conventional radiologic techniques usually fail to detect these small, slow growing neoplasms located at unusual sites. The objective of this study was to evaluate the role of 18F FDG PET imaging in patients of oncogenic osteomalacia. Materials and Methods: Fifteen patients (8 males and 7 females) (mean age: 38.5 ± 12.2 years) with clinical and biochemical evidence of oncogenic osteomalacia were subjected to 'total' whole body 18F FDG PET scan including both limbs and skull views. The images were reconstructed and the final output was displayed as per the standard institution protocol. Results: 18F FDG PET imaging localized suspicious hypermetabolic foci of SUVmax ranging from 1.4 to 3.8 (Mean ± S.D.: 2.39 ± 0.63) suggesting presence of occult tumor in 11 of 15 patients. The suspected foci were localized in lower limbs in ten patients and in the petrous temporal region of skull in 1 patient. FDG localized tumors were histopathologically correlated in 6 patients who underwent surgical biopsy/excision after correlative radiological investigations. Four of these patients were cured after surgical excision while partial surgical excision/biopsy was performed in two patients. Conclusions: 18F FDG PET imaging is a promising technique for detection of occult tumors in patients of oncogenic osteomalacia. It is mandatory to include limbs in the field as these tumors are common in limbs and may be easily missed. Preoperative localization increases odds for cure after surgical removal of tumor

  6. Langerhans cell histiocytosis in adults: Contribution of PET-CT with 18F-FDG

    Langerhans cell histiocytosis is a rare disease whose clinical presentation is highly variable, and with unpredictable outcome. Once the diagnosis is established, evaluation of the extent of the disease is required for therapeutic purposes and prognosis. PET-CT with 18F-FDG can detect multi systemic involvement, demonstrating metabolically active lesions. We present a case report showing the utility of PET-CT in staging and therapy response evaluation

  7. Diagnostic value of 18F-FDG uptake by spleen in acute radiation disease

    Shao-jie WU

    2015-07-01

    Full Text Available Objective To investigate whether 18F-FDG uptake can be applied in dosimetry to facilitate a rapid and accurate evaluation of individual radiation dosage after a nuclear accident. Methods Forty-eight Tibetan minipigs were randomly assigned into 6 groups, i.e., 0, 1, 2, 5, 8 and 11Gy groups. Animals in all except 0Gy group received total body irradiation (TBI with a 8MV X centrifugal linear accelerator, and 18F-FDG combined positron-emission tomography and computed tomography (PET/CT were carried out before TBI, and also at 6, 24 and 72h after receiving TBI in different doses ranging from 1 to 11Gy. Spleen tissues and blood samples were collected for histological examination, apoptosis, and routine blood analysis. Results Mean standardized uptake values (SUVs of the spleen showed significant differences between experimental groups and control group. The spleen SUVs at 6h post-irradiation showed significant correlation with radiation dose; Spearman's correlation coefficient was 0.95(P<0.01. Histopathological observations showed that the degree of splenic damage was proportional to the radiation dose. Moreover, flow cytometry revealed that apoptosis was one of the major forms of splenic lymphocyte death. Conclusion In the Tibetan minipig model, it was shown that radiation doses bear a close relationship with the 18F-FDG uptake of spleen. This finding suggests that 18F-FDG PET/CT may be useful for the rapid detection of individual radiation dosage after acute radiation disease (ARD. DOI: 10.11855/j.issn.0577-7402.2015.07.08

  8. Different metabolic patterns analysis of Parkinsonism on the 18F-FDG PET

    Idiopathic Parkinson's disease (IPD), progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are the most common movement disorders associated with neurodegenerative disease. A clinical differential diagnosis of IPD and atypical Parkinsonian disorders, such as MSA and PSP, is often complicated by the presence of symptoms common to both groups. Since Parkinsonism has a different pathophysiology in the cortical and subcortical brain structures, assessing the regional cerebral glucose metabolism may assist in making a differential diagnosis of Parkinsonism. The 18F-FDG PET images of IPD, MSA and PSP were assessed using statistical parametric mapping (SPM) in order to determine the useful metabolic patterns. Twenty-four patients with Parkinsonism: eight patients (mean age 67.9±10.7 years; M/F: 3/5) with IPD, nine patients (57.9±9.2 years; M/F: 4/5) with MSA and seven patients (67.6±4.8 years; M/F: 3/4) with PSP were enrolled in this study. All patients with Parkinsonism and 22 age-matched normal controls underwent 18F-FDG PET, (after 370 MBq 18F-FDG). The three groups and the individual IPD, MSA and PSP patients were compared with a normal control group using a two-sided t-test of SPM (uncorrected P100 voxel). The IPD, MSA and PSP groups showed significant hypometabolism in the cerebral neocortex compared to the normal control group. The MSA group showed significant hypometabolism in the putamen, pons and cerebellum compared to the normal controls and IPD groups. In addition, PSP showed significant hypometabolism in the caudate nucleus, the thalamus, midbrain and the cingulate gyrus compared to the normal controls, the IPD and the MSA groups. In conclusion, an assessment of the 18F-FDG PET images using SPM may be a useful adjunct to a clinical examination when making a differential diagnosis of Parkinsonism

  9. 18F-FDG PET/CT in Neurolymphomatosis: Report of 3 Cases

    Nguyen Xuan Canh; Ngo Van Tan; Tran Thanh Tung; Nguyen Truong Son; Simone Maurea

    2014-01-01

    Neurolymphomatosis is a rare manifestation of non-Hodgkin lymphoma characterized by infiltration of peripheral nerves, nerve roots, plexus and cranial nerves by malignant lymphocytes. This report presents positron emission tomography/computed tomography (PET/CT)imaging with 2-deoxy-2-18F-fluoro-D-glucose (18F-FDG) in 3 cases of non-Hodgkin lymphoma with nerve infiltration, including one newly diagnosed lymphoma, one recurrent lymphoma in previous nerve lesions and one newly recurrent lymphoma...

  10. Value of 18F-FDG PET in differentiating Alzheimer's disease with frontotemporal dementia

    Rui-xue CUI

    2014-03-01

    Full Text Available Objective To delineate the pattern of reduction of cerebral glucose metabolism in patients with Alzheimer's disease (AD and frontotemporal dementia (FTD and investigate the value of 18F-FDG PET in the differential diagnosis. Methods Twenty patients with FTD (behavioral variant and 20 AD patients underwent 18F-FDG PET scanning. All the images were compared with that from 20 healthy age-matched control subjects on a voxel-based analysis (VBA using SPM5. Visual analyses of 18F-FDG PET were performed by 2 independent nuclear medicine specialists who were blinded to the clinical background. Results 1 The PET scans of all the patients in 2 groups presented impairment of cortical metabolism. 2 Subjects with AD showed hypometabolism in the bilateral temporoparietal association cortex and posterior cingulate cortex, and hypometabolim in part of bilateral frontal lobes was observed in patients with progression. The metabolic activity was relatively kept in the primary motor-sensor cortex, occipital lobes and subcortical structures (basal ganglia and thalamus. The asymmetric hemispheric hypometabolic involvement was rare and observed in only 2 of 20 cases. 3 Subjects with FTD showed a significant hypometabolism of the frontal lobes and anterior temporal lobes, accompanied by mild to moderate reductions in glucose metabolism in parietal cortices and subcortical structures. The asymmetric hemispheric hypometabolic involvement was commonly observed in 16 of 20 cases with right-dominant type in 4 of 16 cases and left-dominant type in 12 cases. Conclusions 18F-FDG PET is a reliable diagnostic test in distinguishing FTD from AD due to the sharp contrast pattern of cerebral glucose hypometabolism.

  11. Serial 18F-FDG-PET/CT during radiotherapy in nasopharyngeal carcinoma: a prospective clinical study

    Objective: The primary aim of this prospective study was to use serial 18F-FDG PET/CT to evaluate the trend of the tumor's maximum standardized uptake value (SUVmax) during radiotherapy (RT) on patients with nasopharyngeal carcinoma (NPC). Methods: 60 patients with primary biopsy-proven NPC were prospectively enrolled into the study, approved by the institutional review board of our hospital. All patients underwent four /18F-FDG PET/CT scans: one initial scan before RT/ cisplatin based concurrent chemo radiotherapy, at the point of 50 Gy during RT, the end of RT, and one month after RT, respectively. Results: There was a significant difference (Pmax of primary site among pre treatment and post treatment at the dose of 50 Gy, at the end of RT and one month after RT. There was also significant difference (Pmax of neck nodes site. However, there was significant difference of the SUVmax between histological WHO type Ⅱ B and type Ⅱ A in the primary site (P=0.044) (67% reduction at dose 50 Gy for type Ⅱ B vs. 55% for type Ⅱ A) but not in the lymph nodes. Conclusions: Serial 18F-FDG-PET/CT scan demonstrates significant decreasing values of the tumor's SUVmax during and after radiotherapy in NPC. The most significant reduction was at the point 50 Gy and SUV is reduced to basal level (≤2.5) at one month after RT both in primary site and lymph nodes. WHO type Ⅱ B has more dramatic response than type Ⅱ A at the primary site but not in lymph node. The study indicates that inflammation caused by RT do not significantly influence the uptake on 18F-FDG PET in NPC. Therefore, early PET scan during or right after RT instead of conventional 3 months interval after RT is indicated to evaluate tumor response and develop individualized adaptive radiotherapy in NPC. (authors)

  12. Metabolic Super Scan in 18F-FDG PET/CT Imaging

    Kim, Dae-Weung; Kim, Chang Guhn; Park, Soon-Ah; Jung, Sang-Ah; Yang, Sei-Hoon

    2010-01-01

    A 50-yr-old man presented with intermittent hemoptysis and was diagnosed small cell lung cancer. 18F-FDG PET/CT for staging demonstrated extensive hypermetabolic lesions throughout the skeleton and liver. Interestingly, skeletal muscles of limbs, mediastinum, bowel, and especially brain showed very low FDG uptake. Because of some characteristics in common with super scan on skeletal scintigraphy, this case could be considered as 'metabolic super scan'.

  13. Different metabolic patterns analysis of Parkinsonism on the {sup 18}F-FDG PET

    Juh, Rahyeong; Kim, Jaesung; Moon, Daehyuk; Choe, Boyoung; Suh, Tasuk E-mail: suhsanta@catholic.ac.kr

    2004-09-01

    Idiopathic Parkinson's disease (IPD), progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are the most common movement disorders associated with neurodegenerative disease. A clinical differential diagnosis of IPD and atypical Parkinsonian disorders, such as MSA and PSP, is often complicated by the presence of symptoms common to both groups. Since Parkinsonism has a different pathophysiology in the cortical and subcortical brain structures, assessing the regional cerebral glucose metabolism may assist in making a differential diagnosis of Parkinsonism. The {sup 18}F-FDG PET images of IPD, MSA and PSP were assessed using statistical parametric mapping (SPM) in order to determine the useful metabolic patterns. Twenty-four patients with Parkinsonism: eight patients (mean age 67.9{+-}10.7 years; M/F: 3/5) with IPD, nine patients (57.9{+-}9.2 years; M/F: 4/5) with MSA and seven patients (67.6{+-}4.8 years; M/F: 3/4) with PSP were enrolled in this study. All patients with Parkinsonism and 22 age-matched normal controls underwent {sup 18}F-FDG PET, (after 370 MBq {sup 18}F-FDG). The three groups and the individual IPD, MSA and PSP patients were compared with a normal control group using a two-sided t-test of SPM (uncorrected P<0.01, extent threshold >100 voxel). The IPD, MSA and PSP groups showed significant hypometabolism in the cerebral neocortex compared to the normal control group. The MSA group showed significant hypometabolism in the putamen, pons and cerebellum compared to the normal controls and IPD groups. In addition, PSP showed significant hypometabolism in the caudate nucleus, the thalamus, midbrain and the cingulate gyrus compared to the normal controls, the IPD and the MSA groups. In conclusion, an assessment of the {sup 18}F-FDG PET images using SPM may be a useful adjunct to a clinical examination when making a differential diagnosis of Parkinsonism.

  14. 18F-FDG and 18F-FET uptake in experimental soft tissue infection

    The aim of this study was to compare the uptake of 18F-fluoroethyl-L-tyrosine (18F-FET) with that of 18F-fluorodeoxyglucose (18F-FDG) in activated inflammatory white blood cells. Unilateral thigh muscle abscesses were induced in 11 rats by intramuscular inoculation of 0.1 ml of a bacterial suspension (S. aureus, 1.2 x 109 CFU/ml). Four animals were intraperitoneally injected with 130-180 MBq 18F-FDG, four with 140-170 MBq 18F-FET and three with a mixture of 140-170 MBq 18F-FET and 1.8 MBq 14C-deoxyglucose. Autoradiography (10 μm slice thickness) of the abscess and the contralateral muscle was performed and detailed spatial correlation of autoradiography and histopathology (haematoxylin-eosin staining) was obtained. Regions of interest were placed on the abscess wall and the grey values (digitised image intensities) measured were converted to kBq/cc per kBq injected activity per gram (SUV). Areas with increased 18F-FDG uptake corresponded to cellular inflammatory infiltrates mainly consisting of granulocytes. The SUV was calculated to be 4.08±0.65 (mean±SD). The uptake of 18F-FET in activated white blood cells was not increased: the SUV of the abscess wall, at 0.74±0.14, was even below that of contralateral muscle. The low uptake of 18F-FET in non-neoplastic inflammatory cells promises a higher specificity for the detection of tumour cells than is achieved with 18F-FDG, since the immunological host response will not be labelled and inflammation can be excluded. (orig.)

  15. Input functions derived from 18F-FDG PET/CT imaging in canines

    Objective: The input functions are of necessity in quantitative PET imaging. In this study the authors tried to derive non-invasively the input functions from canine 18F-FDG PET/CT scans, as compared with standardized input functions determined invasively from serial arterial plasma sampling. Methods: Five dogs underwent serial PET/CT scans using dynamic scanning protocol after 18F-FDG administration. Meanwhile, continuous arteries blood samples were collected through catheters inserted into femoral arteries of the dogs. Image derived input functions (IDIF) were obtained using ROI defined on dynamic PET/CT images over various cardiovascular structures such as left ventricle (LV), right ventricle (RV), right atria (RA), aortic arch (AC), ascending aorta (AA) and descending aorta (DA). Area under curve (AUC) method was used to calculate each input function from arterial plasma sampling. Canine myocardial inhibition constant (Ki) values were estimated using Patlak graphical analyses. Results: IDIF from 18F-FDG PET/CT scans were significantly correlated with input functions derived from arterial plasma sampling using AUC (r≥0.97). When AC and DA regions were chosen for the calculation, the mean Ki estimated thereby using IDIF were almost identical to those using input functions from artery blood sampling analyses (the ratios between two sets of Ki being 1.0 ± 0.1 and 1.1 ± 0.1 respectively). Conclusion: It might be feasible to use IDIF derived from ROIs over AC and DA on a dynamic 18F-FDG PET/CT scan, as a non-invasive procedure, for quantitative analyses. (authors)

  16. {sup 18}F-FDG PET in neuro-degenerative Langerhans cell histiocytosis

    Ribeiro, M.Jo. [CEA, DSV, DRM, Serv Hosp Frederic Joliot, F-91406 Orsay (France); Idbaih, A.; Hoang-Xuan, K. [UPMC, Grp Hosp Pitie Salpetriere, ServNeurol Mazarin, AP-HP, Paris (France); Thomas, C. [CHU Nantes, Unite Hematol et Oncol Pediat, F-44035 Nantes 01 (France); Remy, P. [CEA, Serv Hosp Frederic Joliot, CNRS, URA 2210, F-91406 Orsay (France); Remy, P. [CHU Henri Mondor, Fac Med Paris 12, Dept Neurosci, AP-HP, F-94010 Creteil (France)

    2008-07-01

    Introduction: The so called 'neuro-degenerative Langerhans cell histiocytosis' (ND-LCH) is a rare and severe complication of LCH presenting as a progressive cerebellar ataxia associated with pyramidal tract signs, and cognitive impairment. MRI is the gold standard to investigate CNS lesions of ND-LCH but little is known about functional changes observed in this disease. Objectives: To search for CNS metabolic changes in NDLCH. Methods: Seven patients suffering from ND-LCH were investigated by {sup 18}F-FDG PET in this prospective study and compared with 21 healthy controls. Results: ND-LCH patients demonstrated recurrent abnormalities including bilateral hypo-metabolism in the cerebellum, the basal ganglia (caudate nuclei), frontal cortex and, bilateral, a relatively increased metabolism in the amygdalae (p {<=} 0.001). Functional changes in these anatomical regions may be detected in the absence of any apparent lesion on MRI. Conclusions: ND-LCH demonstrates a recurrent {sup 18}F-FDG PET metabolic signature. Our results suggest that {sup 18}F-FDG PET might be a useful tool for an early diagnosis of ND-LCH before neuro-radiologic abnormalities appear. (authors)

  17. PET imaging of cerebral metabolic change in tinnitus using 18F-FDG

    Tinnitus is an auditory disorder hardly assessable by clinical technology. PET imaging of the brain in 13 cases with and 10 without tinnitus was undertaken at 40 min after injection of 280-440 MBq 18F-FDG. To ensure the quality of the PET study, all cases followed a normalized procedure with visual and auditory blockage. CT/MRI imaging and routine acoustic tests were carried out in all subjects. PET revealed that an increased uptake of 18F-FDG at left med-temporal lobe (primary auditory center, PAC) present exclusively in tinnitus, regardless the side of hearing hallucination. Significant asymmetry was noted between left and right PAC, but not at other cortex area. While control cases showed no asymmetric uptake between two hemispheres. The abnormal PAC uptake did not respond to external pure sound stimulus, nor did it relate to the severity of hearing loss assessed by acoustic tests. No anatomical or morphological alteration could be proven on CT/MRI. In conclusion, PET/18F-FDG objectively revealed an increased metabolic change at left PAC in tinnitus, which is of diagnostic value; and there is evidence suggesting tinnitus is most likely induced by a functional change in the brain

  18. The precision of textural analysis in 18F-FDG-PET scans of oesophageal cancer

    Measuring tumour heterogeneity by textural analysis in 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) provides predictive and prognostic information but technical aspects of image processing can influence parameter measurements. We therefore tested effects of image smoothing, segmentation and quantisation on the precision of heterogeneity measurements. Sixty-four 18F-FDG PET/CT images of oesophageal cancer were processed using different Gaussian smoothing levels (2.0, 2.5, 3.0, 3.5, 4.0 mm), maximum standardised uptake value (SUVmax) segmentation thresholds (45 %, 50 %, 55 %, 60 %) and quantisation (8, 16, 32, 64, 128 bin widths). Heterogeneity parameters included grey-level co-occurrence matrix (GLCM), grey-level run length matrix (GLRL), neighbourhood grey-tone difference matrix (NGTDM), grey-level size zone matrix (GLSZM) and fractal analysis methods. The concordance correlation coefficient (CCC) for the three processing variables was calculated for each heterogeneity parameter. Most parameters showed poor agreement between different bin widths (CCC median 0.08, range 0.004-0.99). Segmentation and smoothing showed smaller effects on precision (segmentation: CCC median 0.82, range 0.33-0.97; smoothing: CCC median 0.99, range 0.58-0.99). Smoothing and segmentation have only a small effect on the precision of heterogeneity measurements in 18F-FDG PET data. However, quantisation often has larger effects, highlighting a need for further evaluation and standardisation of parameters for multicentre studies. (orig.)

  19. Efficiency calibration of a HPGe detector for [{sup 18}F] FDG activity measurements

    Fragoso, Maria da Conceicao de Farias; Lacerda, Isabelle Viviane Batista de; Albuquerque, Antonio Morais de Sa, E-mail: mariacc05@yahoo.com.br, E-mail: isabelle.lacerda@ufpe.br, E-mail: moraisalbuquerque@hotmaiI.com [Universidade Federal de Pernambuco (DEN/UFPE), Recife, PE (Brazil). Departamento de Energia Nuclear; Oliveira, Mercia Liane de; Hazin, Clovis Abrahao; Lima, Fernando Roberto de Andrade, E-mail: mercial@cnen.gov.br, E-mail: chazin@cnen.gov.br, E-mail: falima@cnen.gov.br [Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE/CNEN-PE), Recife, PE (Brazil)

    2013-11-01

    The radionuclide {sup 18}F, in the form of flurodeoxyglucose (FDG), is the most used radiopharmaceutical for Positron Emission Tomography (PET). Due to [{sup 18}F]FDG increasing demand, it is important to ensure high quality activity measurements in the nuclear medicine practice. Therefore, standardized reference sources are necessary to calibrate of {sup 18}F measuring systems. Usually, the activity measurements are performed in re-entrant ionization chambers, also known as radionuclide calibrators. Among the existing alternatives for the standardization of radioactive sources, the method known as gamma spectrometry is widely used for short-lived radionuclides, since it is essential to minimize source preparation time. The purpose of this work was to perform the standardization of the [{sup 18}F]FDG solution by gamma spectrometry. In addition, the reference sources calibrated by this method can be used to calibrate and test the radionuclide calibrators from the Divisao de Producao de Radiofarmacos (DIPRA) of the Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE). Standard sources of {sup 152}Eu, {sup 137}Cs and {sup 68}Ge were used for the efficiency calibration of the spectrometer system. As a result, the efficiency curve as a function of energy was determined in wide energy range from 122 to 1408 keV. Reference sources obtained by this method can be used in [{sup 18}F]FDG activity measurements comparison programs for PET services localized in the Brazilian Northeast region. (author)

  20. 18F-FDG PET in neuro-degenerative Langerhans cell histiocytosis

    Introduction: The so called 'neuro-degenerative Langerhans cell histiocytosis' (ND-LCH) is a rare and severe complication of LCH presenting as a progressive cerebellar ataxia associated with pyramidal tract signs, and cognitive impairment. MRI is the gold standard to investigate CNS lesions of ND-LCH but little is known about functional changes observed in this disease. Objectives: To search for CNS metabolic changes in NDLCH. Methods: Seven patients suffering from ND-LCH were investigated by 18F-FDG PET in this prospective study and compared with 21 healthy controls. Results: ND-LCH patients demonstrated recurrent abnormalities including bilateral hypo-metabolism in the cerebellum, the basal ganglia (caudate nuclei), frontal cortex and, bilateral, a relatively increased metabolism in the amygdalae (p ≤ 0.001). Functional changes in these anatomical regions may be detected in the absence of any apparent lesion on MRI. Conclusions: ND-LCH demonstrates a recurrent 18F-FDG PET metabolic signature. Our results suggest that 18F-FDG PET might be a useful tool for an early diagnosis of ND-LCH before neuro-radiologic abnormalities appear. (authors)

  1. Quantification of [18F]-FDG uptake in atherosclerotic plaque. Impact of renal function

    Impaired renal function causes both increased and prolonged tracer availability in the blood-pool which might result in increased tracer accumulation in atherosclerotic lesions. Therefore, the aim of this study was to investigate a possible correlation between the intensity of tracer uptake in atherosclerotic lesions and renal function. Data from 50 [18F]-fluoro-2-deoxy-D-glucose (FDG) scans were visually evaluated for tracer uptake in vessel wall alterations. Lesions were analyzed semiquantitatively by determining the blood-pool standardized uptake values (SUVblood-pools), maximum SUVs (SUVmaxs), and the target-to-background ratio (TBR). These parameters were tested for correlation with estimated glomerular filtration rate (eGFR), and cardiovascular risk factors. Both SUVblood-pools (rs=-0.32, p=0.03) and SUVmaxs for [18F]-FDG (rs=-0.50, p18F]-FDG demonstrated a significant positive correlation with eGFRs (rs=0.21, p=0.02). This study found that both intravascular tracer availability (SUVblood-pool) and intralesional tracer uptake (SUVmax) are influenced by renal function. Calculation of TBR to account for that effect may result in overcorrection in case of [18F]-FDG. Renal insufficiency or subclinical changes in renal function have to be considered as a confounding factor in PET of atherosclerotic lesions. (author)

  2. Efficiency calibration of a HPGe detector for [18F] FDG activity measurements

    The radionuclide 18F, in the form of flurodeoxyglucose (FDG), is the most used radiopharmaceutical for Positron Emission Tomography (PET). Due to [18F]FDG increasing demand, it is important to ensure high quality activity measurements in the nuclear medicine practice. Therefore, standardized reference sources are necessary to calibrate of 18F measuring systems. Usually, the activity measurements are performed in re-entrant ionization chambers, also known as radionuclide calibrators. Among the existing alternatives for the standardization of radioactive sources, the method known as gamma spectrometry is widely used for short-lived radionuclides, since it is essential to minimize source preparation time. The purpose of this work was to perform the standardization of the [18F]FDG solution by gamma spectrometry. In addition, the reference sources calibrated by this method can be used to calibrate and test the radionuclide calibrators from the Divisao de Producao de Radiofarmacos (DIPRA) of the Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE). Standard sources of 152Eu, 137Cs and 68Ge were used for the efficiency calibration of the spectrometer system. As a result, the efficiency curve as a function of energy was determined in wide energy range from 122 to 1408 keV. Reference sources obtained by this method can be used in [18F]FDG activity measurements comparison programs for PET services localized in the Brazilian Northeast region. (author)

  3. 123I-Mibg scintigraphy and 18F-Fdg-Pet imaging for diagnosing neuroblastoma

    Bleeker, Gitta; Tytgat, Godelieve Am; Adam, Judit A; Caron, Huib N; Kremer, Leontien Cm; Hooft, Lotty; van Dalen, Elvira C

    2015-01-01

    Background Neuroblastoma is an embryonic tumour of childhood that originates in the neural crest. It is the second most common extracranial malignant solid tumour of childhood. Neuroblastoma cells have the unique capacity to accumulate Iodine-123-metaiodobenzylguanidine (123I-MIBG), which can be used for imaging the tumour. Moreover, 123I-MIBG scintigraphy is not only important for the diagnosis of neuroblastoma, but also for staging and localization of skeletal lesions. If these are present, MIBG follow-up scans are used to assess the patient's response to therapy. However, the sensitivity and specificity of 123I-MIBG scintigraphy to detect neuroblastoma varies according to the literature. Prognosis, treatment and response to therapy of patients with neuroblastoma are currently based on extension scoring of 123I-MIBG scans. Due to its clinical use and importance, it is necessary to determine the exact diagnostic accuracy of 123I-MIBG scintigraphy. In case the tumour is not MIBG avid, fluorine-18-fluorodeoxy-glucose (18F-FDG) positron emission tomography (PET) is often used and the diagnostic accuracy of this test should also be assessed. Objectives Primary objectives: 1.1 To determine the diagnostic accuracy of 123I-MIBG (single photon emission computed tomography (SPECT), with or without computed tomography (CT)) scintigraphy for detecting a neuroblastoma and its metastases at first diagnosis or at recurrence in children from 0 to 18 years old. 1.2 To determine the diagnostic accuracy of negative 123I-MIBG scintigraphy in combination with 18F-FDG-PET(-CT) imaging for detecting a neuroblastoma and its metastases at first diagnosis or at recurrence in children from 0 to 18 years old, i.e. an add-on test. Secondary objectives: 2.1 To determine the diagnostic accuracy of 18F-FDG-PET(-CT) imaging for detecting a neuroblastoma and its metastases at first diagnosis or at recurrence in children from 0 to 18 years old. 2.2 To compare the diagnostic accuracy of 123I

  4. Toxoplasmic Lymphadenitis Mimicking a Metastatic Thyroid Carcinoma at {sup 18}F-FDG-PET/CT

    Treglia, Giorgio; Bongiovanni, Massimo; Ceriani, Luca; Paone, Gaetano; Giovanella, Luca [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland)

    2013-12-15

    A 28-year-old woman underwent total thyroidectomy for a papillary thyroid carcinoma in the right thyroid lobe (pTx, pN1b). Subsequently a {sup 131}I-ablation (4.4 GBq) was performed. Four years later the patient presented increased thyroglobulin (Tg) serum levels (8.4 μg/l) during thyroxine treatment. Furthermore, enlarged hypoechoic and round-shaped bilateral cervical lymph nodes were detected at cervical ultrasonography (US). Based on laboratory and US findings suspicious for lymph nodal recurrence of thyroid carcinoma, the patient underwent an {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG-PET/CT) to check for distant metastases (Fig. 1). The patient underwent a US-guided fine-needle aspiration cytology on an {sup 18}F-FDG-avid cervical lymph-node. The smears were hypercellulated and consisted of numerous small- to medium-sized lymphocytes, macrophages, dendritic cells and tingible body macrophages. The cytological diagnosis was consistent with that of reactive lymphadenitis. Serological test revealed elevated IgM and IgG anti-Toxoplasma antibodies with a very low IgG-avidity, indicating an acute toxoplasmosis. Serum Tg was then measured by using heterophilic antibody blocking tubes, as previously reported, and serum value dropped to <0.2 μg/l. It is well known that antibody interference may falsely increase serum Tg; in particular, increased anti-Toxoplasma antibodies likely interfered to the Tg measurement in our case. Additionally, activated granulocytes and macrophages may display significantly increased glucose consumption, giving false-positive results at {sup 18}F-FDG-PET/CT in oncological patients. Few reports have described toxoplasmic infection mimicking malignancy at {sup 18}F-FDG-PET/CT; these findings were found mainly in immunodepressive patients or with history of lymphoma. Conversely, we described here a case of toxoplasmosis inducing false-positive Tg measurement, neck US and {sup 18}F-FDG

  5. {sup 18}F-FDG positron autoradiography with a particle counting silicon pixel detector

    Russo, P; Lauria, A; Mettivier, G; Montesi, M C [Dipartimento di Scienze Fisiche, Universita di Napoli Federico II, and INFN Sezione di Napoli, I-80126 Napoli (Italy); Marotta, M [Dipartimento di Medicina Sperimentale, Universita di Napoli Federico II, I-80131 Napoli (Italy); Aloj, L; Lastoria, S [Medicina Nucleare, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, I-80131 Napoli (Italy)], E-mail: adele.lauria@na.infn.it

    2008-11-07

    We report on tests of a room-temperature particle counting silicon pixel detector of the Medipix2 series as the detector unit of a positron autoradiography (AR) system, for samples labelled with {sup 18}F-FDG radiopharmaceutical used in PET studies. The silicon detector (1.98 cm{sup 2} sensitive area, 300 {mu}m thick) has high intrinsic resolution (55 {mu}m pitch) and works by counting all hits in a pixel above a certain energy threshold. The present work extends the detector characterization with {sup 18}F-FDG of a previous paper. We analysed the system's linearity, dynamic range, sensitivity, background count rate, noise, and its imaging performance on biological samples. Tests have been performed in the laboratory with {sup 18}F-FDG drops (37-37 000 Bq initial activity) and ex vivo in a rat injected with 88.8 MBq of {sup 18}F-FDG. Particles interacting in the detector volume produced a hit in a cluster of pixels whose mean size was 4.3 pixels/event at 11 keV threshold and 2.2 pixels/event at 37 keV threshold. Results show a sensitivity for {beta}{sup +} of 0.377 cps Bq{sup -1}, a dynamic range of at least five orders of magnitude and a lower detection limit of 0.0015 Bq mm{sup -2}. Real-time {sup 18}F-FDG positron AR images have been obtained in 500-1000 s exposure time of thin (10-20 {mu}m) slices of a rat brain and compared with 20 h film autoradiography of adjacent slices. The analysis of the image contrast and signal-to-noise ratio in a rat brain slice indicated that Poisson noise-limited imaging can be approached in short (e.g. 100 s) exposures, with {approx}100 Bq slice activity, and that the silicon pixel detector produced a higher image quality than film-based AR.

  6. Biological distribution of reactor produced 18F-FDG. Local experience

    Introduction: Quality control through an animal model that relates bio distribution of a substance is fundamental prior to using it in human beings. For the evaluation of myocardial viability after recent myocardial infarction, the use of reactor produced 18F-FDG (a radiotracer usually obtained in cyclotron) is proposed, production of wish had never been attempted in our country. The aim of the study was to compare the specific activities found in the different tissues after the injection of this reactor produced radiopharmaceutical with those obtained by others authors with cyclotron 18F-FDG. Material WISTAR female white mice, men weight 25,28 +/- 1,09 g (23,8-26,9 range) in standard support conditions was used. 1,22 MBq (33 mCi) of 18F-FDG were injected in a lateral tail vein. Previously anaesthetised with Chloroform, the animals were sacrificed by jugular section at 5, 30 and 60 minutes intervals post injection. Blood and organs were removed (liver, lungs, heart, brain, urine plus bladder, kidneys, femur, muscle and quivers), placed in vials, then weighed, and finally taken to a Gamma Packard Minaxi γ Auto-gamma 5000 serie counter to obtain the counts per minute (cpm) (previously the empty vials were weighed too). At same time, STANDARDS (STD) (3 dilutions) cpm and BACKGROUND (BKG) cpm were collected. We calculate 1) mean BKG cpm, 2) mean STD cpm, who then were corrected by decay factor and dilution, and 3) each one of the tissues cpm, that then were corrected by decay factor, divided by the corresponding dilution cpm and multiplied by 100 to obtain the Injected Activity % (IA%). Finally, the IA% was divided by the tissue weight and get the Specific Activity (SA). Mean and standard deviation for each tissue at the 3 intervals were calculated. Results: The uptake distribution at 30 and 60 minutes were similar between reactor and cyclotron produced 18F-FDG, with significant bigger SA in heart and brain respect of the rest organs. There were significant

  7. {sup 18}F-FDG PET/CT in Primary AL Hepatic Amyloidosis Associated with Multiple Myeloma

    Son, Youn Mi; Bak, Cheol Hee [Seoul Medical Center, Seoul (Korea, Republic of); Choi, Joon Young; Cheon, Mi Ju; Kim, Young Eun; Lee, Kyung Han; Kim, Byung Tae [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-10-15

    We report here on a rare case of primary AL hepatic amyloidosis associated with multiple myeloma in a 64-year-old woman. The patient was referred for evaluating her progressive jaundice and right upper quadrant pain. {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET)/computed tomography (CT) showed diffusely and markedly increased {sup 18}F-FDG uptake in the liver. Although there have been several case studies showing positive {sup 18}F-FDG uptake in pulmonary amyloidosis, to the best of our knowledge, the {sup 18}F-FDG PET/CT findings of hepatic amyloidosis or primary hepatic amyloidosis associated with multiple myeloma have not been reported previously.

  8. Relationship between pSUV of 18F-FDG PET/CT and pathological diagnosis in breast cancer

    The purpose of this study was to evaluate the Pathological Diagnosis associated with pSUV uptake of 18F-FDG PET/CT. We had enrolled 39 women that underwent 18F-FDG PET/CT before operative. We evaluated whether there was correlation between the pSUV of 18F-FDG PET/CT and prognostic factors. As a results, pSUV level increase according to tumor size but pSUV had no significant association with tumor size. pSUV of high histologic grade was higher than low histologic grade, and pSUV showed positive correlations with histologic grade. The ER and PR showed significant negative correlations with the pSUV of 18F-FDG PET/CT. Therefore, our results demonstrated that an correlation exists between pSUV and prognostic factors such as histologic grade, ER and PR

  9. The radiochemistry of [{sup 18} F]-FDG: the first experience in Mexico; La radioquimica del [{sup 18} F]-FDG: la primera experiencia en Mexico

    Lopez D, F.A. [Unidad PET-Ciclotron, Facultad de Medicina, UNAM, Av. Universidad 3000, Ciudad Universitaria, Coyoacan, 04500 Mexico, D. F. (Mexico)]. e-mail: fred-alonso@correo.unam.mx

    2004-07-01

    The present work describes the more used method for the synthesis of 2 - [{sup 18} F] - fluorine-2-deoxy-D-glucose that is the more used radiopharmaceutical in the nuclear medicine in the cancer diagnostic. The process consists on two chemical reactions: i) [{sup 18} F{sup -}] - nucleophilic radio fluorination and i i) a hydrolysis catalyzed by acid. The first reaction incorporates to the [{sup 18} F]- fluorine labelled inside the organic precursor 1,3,4,6-tetra- O -acetil-2- O-trifluoromethanesulfonyl- {beta}-D-mannopyranose (triflate of mannose). The mechanism of this reaction is a bimolecular nucleophilic substitution (SN{sub 2}) with the ion [{sup 18} F{sup -}] - fluoride; in the second reaction, the hydrolysis of those protective acetyl groups generate the hydroxyl groups free of the [{sup 18} F]-FDG. The process includes an azeotropic distillation and several purification steps. (Author)

  10. Typical cerebral metabolic patterns in various types of dementia: an SPM analysis of 18F-FDG PET images

    Cui, Rui-Xue; Niu, Na; Zhang, Ying; Yuan, Jing; Li, Fang

    2014-01-01

    Objective To delineate the cerebral metabolic patterns presented in 18F-FDG PET images in various types of dementia with SPM analysis.  Methods Patients who underwent 18F-FDG PET scanning with a retrospectively confirmed diagnosis according to strictly defined clinical research criteria were studied. Clinical follow-up enabled appropriate patient inclusion. A total of 62 patients were included, of which 20 patients were diagnosed as Alzheimer's disease (AD), 20 frontotemporal dementia ...

  11. Adrenal tuberculosis masquerading as disseminated malignancy: A pitfall of (18)F-FDG PET/CT Imaging.

    Gorla, A K R; Gupta, K; Sood, A; Biswal, C K; Bhansali, A; Mittal, B R

    2016-01-01

    Non-invasive characterization of adrenal lesions is a commonly encountered diagnostic challenge. Characteristic clinical and correlative imaging findings may assist in only arriving at a probable diagnosis. Currently, (18)F-FDG PET/CT is considered to provide the most comprehensive imaging information. We here present a case of bilateral adrenal tuberculosis that highlights the need for caution during the interpretation of (18)F-FDG PET/CT and also the need to suggest histopathological correlation. PMID:26853485

  12. Diagnostic value of combining 11C-choline and 18F-FDG PET/CT in hepatocellular carcinoma

    In this prospective study, our goal was to emphasize the diagnostic value of combining 11C-choline and 18F-FDG PET/CT for hepatocellular carcinoma (HCC) in patients with chronic liver disease. Thirty-three consecutive patients were enrolled. All patients were suspected to have HCC based on CT and/or MRI imaging. A final diagnosis was obtained by histopathological examination or by imaging alone according to American Association for the Study of Liver Disease criteria. All patients underwent PET/CT with both tracers within a median of 5 days. All lesions showing higher tracer uptake than normal liver were considered positive for HCC. We examined how tracer uptake was related to biological (serum α-fetoprotein levels) and pathological (differentiation status, peritumoral capsule and vascular invasion) prognostic markers of HCC, as well as clinical observations at 6 months (recurrence and death). Twenty-eight HCC, four cholangiocarcinomas and one adenoma were diagnosed. In the HCC patients, the sensitivity of 11C-choline, 18F-FDG and combined 11C-choline and 18F-FDG PET/CT for the detection of HCC was 75 %, 36 % and 93 %, respectively. Serum α-fetoprotein levels >200 ng/ml were more frequent among patients with 18F-FDG-positive lesions than those with 18F-FDG-negative lesions (p < 0.05). Early recurrence (n=2) or early death (n=5) occurred more frequently in patients with 18F-FDG-positive lesions than in those with 18F-FDG-negative lesions (p < 0.05). The combined use of 11C-choline and 18F-FDG PET/CT detected HCC with high sensitivity. This approach appears to be of potential prognostic value and may facilitate the selection of patients for surgical resection or liver transplantation. (orig.)

  13. Automatic extraction analysis of the anatomical functional area for normal brain 18F-FDG PET imaging

    Using self-designed automatic extraction software of brain functional area, the grey scale distribution of 18F-FDG imaging and the relationship between the 18F-FDG accumulation of brain anatomic function area and the 18F-FDG injected dose, the level of glucose, the age, etc., were studied. According to the Talairach coordinate system, after rotation, drift and plastic deformation, the 18F-FDG PET imaging was registered into the Talairach coordinate atlas, and then the average gray value scale ratios between individual brain anatomic functional area and whole brain area was calculated. Further more the statistics of the relationship between the 18F-FDG accumulation of every brain anatomic function area and the 18F-FDG injected dose, the level of glucose and the age were tested by using multiple stepwise regression model. After images' registration, smoothing and extraction, main cerebral cortex of the 18F-FDG PET brain imaging can be successfully localized and extracted, such as frontal lobe, parietal lobe, occipital lobe, temporal lobe, cerebellum, brain ventricle, thalamus and hippocampus. The average ratios to the inner reference of every brain anatomic functional area were 1.01 ± 0.15. By multiple stepwise regression with the exception of thalamus and hippocampus, the grey scale of all the brain functional area was negatively correlated to the ages, but with no correlation to blood sugar and dose in all areas. To the 18F-FDG PET imaging, the brain functional area extraction program could automatically delineate most of the cerebral cortical area, and also successfully reflect the brain blood and metabolic study, but extraction of the more detailed area needs further investigation

  14. {sup 18}F-FDG PET, genotype-corrected ACE and sIL-2R in newly diagnosed sarcoidosis

    Keijsers, Ruth G.; Verzijlbergen, Fred J. [St. Antonius Hospital Nieuwegein, Department of Nuclear Medicine, P.O. Box 2500, Nieuwegein (Netherlands); Oyen, Wim J. [Radboud University Nijmegen Medical Center, Department of Nuclear Medicine, Nijmegen (Netherlands); Bosch, Jules M. van den; Grutters, Jan C. [St. Antonius Hospital Nieuwegein, Department of Pulmonology, Nieuwegein (Netherlands); Ruven, Henk J. [St. Antonius Hospital Nieuwegein, Department of Clinical Chemistry, Nieuwegein (Netherlands); Velzen-Blad, Heleen van [St. Antonius Hospital Nieuwegein, Department of Medical Microbiology and Immunology, Nieuwegein (Netherlands)

    2009-07-15

    Angiotensin-converting enzyme (ACE) and soluble interleukin-2 receptor (sIL-2R) are serological markers, widely used for determining sarcoidosis activity. {sup 18}F-FDG PET has proven to be a sensitive technique in the imaging of sarcoidosis. The aim of this study was to determine sensitivity of {sup 18}F-FDG PET, genotype-corrected ACE and sIL-2R in active sarcoidosis as well as their correlation. This retrospective study included 36 newly diagnosed, symptomatic sarcoidosis patients. ACE and sIL-2R levels were simultaneously obtained within 4 weeks of {sup 18}F-FDG PET. ACE was corrected for genotype and expressed as Z-score. {sup 18}F-FDG PET was visually evaluated and scored as positive or negative. Maximum and average standardized uptake values (SUV{sub max} and SUV{sub avg}) were compared with ACE and sIL-2R. {sup 18}F-FDG PET was found positive in 34 of 36 patients (94%). Thirteen patients (36%) showed an increased ACE with the highest sensitivity found in patients with the I/I genotype (67%). Seventeen patients (47%) showed an increased sIL-2R. No correlation was found between SUV and ACE or sIL-2R. Increased ACE and sIL-2R correlated with a positive {sup 18}F-FDG PET in 12 patients (92%) and 16 patients (94%), respectively. {sup 18}F-FDG PET is a very sensitive technique to assess active sarcoidosis, in contrast with ACE and sIL-2R, suggesting a pivotal role for {sup 18}F-FDG PET in future sarcoidosis assessment. (orig.)

  15. 18F-FDG Positron Emission Tomography – An Innovative Technique for the Diagnosis of a Canine Lameness

    Mann, Kelly; Hart, Juliette; Duerr, Felix

    2016-01-01

    Introduction Positron emission tomography (PET) imaging with fluorine-18-fluorodeoxyglucose (18F-FDG) is widely known for its use in the diagnosis and tracking of primary and metastatic tumors via uptake and retention of the radiopharmaceutical by hypermetabolic cells. 18F-FDG is also used to study the normal physiology of glucose uptake, metabolism, and muscle activity during and after exercise. Background A pilot study adding PET imaging to the diagnostic evaluation of canine patients under...

  16. The analysis of several factors relevant to brain 18F-FDG metabolism by using the statistical parameter mapping

    Objective: To study the relationship of the regional brain 18F-fluorodeoxyglucose (FDG) metabolism and aging process, the dosage of the imaging agent, the level of blood sugar to cerebral PET (cPET) image data by using statistical parameter mapping (SPM) software. Methods: 18F-FDG cPET imaging data acquired from 30 healthy volunteers were collected and analyzed with SPM by the multiple linear regression model designed with dosage of tracer, and blood sugar level as explaining variables and the 18F-FDG accumulation as responding variables. Results: It's showed that the age, dosage and sugar level were all related with the 18F-FDG accumulation in the brain. The accumulation of the radiotracer in the brain areas like cingulate gyri, inferior temporal gyri of both sides and the cerebellum increased with the tracer dosage, and the blood sugar escalating and the 18F-FDG uptake in the brain areas like frontal lobes, parietal lobes, precentral gyri of both sides and cerebellum decreased at the same time, and the aging process led to a pancephalic 18F-FDG decrease. Conclusions: The injection dosage, sugar level and the age are all related with accumulation of the 18F-FDG, and the SPM software can be used to analyze the multiple factors relevant to cPET imaging data based on voxel level and so can explain the experimental results more correctly

  17. 18F FDG Uptake of Human Testis on PET/CT: Correlation with Age, Sex Hormones, and Vasectomy

    The purpose of this study was to evaluate glucose metabolism of normal human testis on 18F FDG PET/CT and to assess possible correlation among age, the serum levels of sex hormones, and vasectomy. 18F FDG PET/CT was performed in 66 normal healthy men (50.8±13.6 years, range 22-81), and mean standard uptake values (SUV) of 18F FDG in testis and adductor muscle were measured. Testis muscle SUV ratios (T/M ratios) were calculated. Serum levels of total testosterone, free testosterone, estradiol, and of sex hormone binding globulin (SHBG) were measured. We searched for correlations between T/M ratios and age and the serum concentrations of sex hormones. 18F FDG PET/CT was also performed in 32 vasectomized men (55.7±7.8 years, range 38-71) and 52 nonvasectomized men (55.4±11.6 years, range 37-72). Mean SUVs of testis and adductor muscle were measured, and T/M ratios were calculated. A significant age related decline was found in T/M ratio (r=-0.509, p18F FDG uptake may have attributed to testicular function and testicular histology. Our findings may have important implications for the interpretation of testicular 18F FDG uptake in the normal adult population.

  18. Novel synthesis and initial preclinical evaluation of 18F-[FDG] labeled rhodamine: a potential PET myocardial perfusion imaging agent

    Myocardial perfusion imaging is one of the most commonly performed investigations in nuclear medicine studies. Due to the clinical importance of [18F]-fluoro-2-deoxy-D-glucose ([18F]-FDG) and its availability in almost every PET center, a new radiofluorinated [18F]-FDG-rhodamine conjugate was synthesized using [18F]-FDG as a prosthetic group. In a convenient and simple one-step radiosynthesis, [18F]-FDG-rhodamine conjugate was prepared in quantitative radiochemical yields, with total synthesis time of nearly 20 min and radiochemical purity of greater than 98%, without the need for HPLC purification, which make these approaches amenable for automation. Biodistribution studies in normal rats at 60 min post-injection demonstrated a high uptake in the heart (> 11% ID/g) and favorable pharmacokinetics. Additionally, [18F]-FDG-rhodamine showed an extraction value of 27.63% ± 5.12% in rat hearts. These results demonstrate that [18F]-FDG-rhodamine conjugate may be useful as an imaging agent for the positron emission tomography evaluation of myocardial perfusion. - Highlights: • Division of Nuclear Medicine and Molecular Imaging, Boston Children’s Hospital, Boston • Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children’s Hospital, Boston • Harvard Medical School, Boston

  19. Nursing intervention of 18F-FDG SPECT/CT brown adipose tissue distribution%18F-FDG SPECT/CT棕色脂肪分布的护理干预

    吴继珍; 范义相; 黄凯龄; 梁智欣; 李科斌; 江树昌

    2013-01-01

    目的:分析18氟代脱氧葡萄糖(18F-FDG)符合线路正电子成像断层(SPECT/CT)显像在棕色脂肪组织(BAT)分布及护理方法,为合理有效避免BAT摄取18F-FDG提供参考依据.方法:选取2009年8月~2012年2月在我院行18F-FDG SPECT/CT全身检查的受检者共3580例,如患者出现BAT摄取18F-FDG,经提供特定护理后3~7d进行第2次18F-FDG SPECT/CT显像,对其18F-FDG SPECT/CT显像结果进行分析.结果:共发现25例存在BAT摄取,以冬季多见.25例BAT摄取异常增高者在保暖和充分休息后,于检查后的3~7d进行第2次18F-FDG SPECT/CT显像,其中20例BAT摄取基本消失,3例BAT摄取范围明显缩小,摄取18F-FDG程度减低,2例无明显改变.结论:在寒冷冬季,护理人员应针对特定的患者提供特定保暖可降低BAT摄取,减少18F-FDG SPECT/CT影像诊断的假阳性.

  20. Prognostic significance of mediastinal 18F-FDG uptake in PET/CT in advanced ovarian cancer

    To evaluate the prognostic significance of increased mediastinal 18F-FDG uptake in PET/CT for the staging of advanced ovarian cancer. We retrospectively evaluated patients managed for FIGO stage III/IV ovarian cancer between 1 January 2006 and 1 June 2009. Patients were included if they had undergone 18F-FDG PET/CT and surgery for initial staging. Exclusion criteria were age younger than 18 years, inability to undergo general anaesthesia, recurrent ovarian cancer, and borderline or nonepithelial malignancy. Whole-body PET/CT was performed after intravenous 18F-FDG injection. The location of abnormal hot spots and 18F-FDG maximal standard uptake values (SUVmax) were recorded. We compared the complete cytoreduction and survival rates in groups defined based on mediastinal 18F-FDG uptake and SUVmax values. Kaplan-Meier curves of overall survival and disease-free survival were compared using the log-rank test. Hazard ratios with their 95% confidence intervals were computed. Adjusted hazard ratios were obtained using a multivariate Cox model. We included 53 patients, of whom 17 (32%) had increased mediastinal 18F-FDG uptake. Complete cytoreduction was achieved in 14 (87.5%) of the 16 patients managed with primary surgery and in 21 (75%) of the 28 patients managed with interval surgery. Complete cytoreduction was achieved significantly more often among patients without increased mediastinal 18F-FDG uptake (80.6% vs. 35.3%; p = 0.001). Disease-free survival was comparable between the two groups. By univariate analysis, overall mortality was significantly higher among patients with increased mediastinal 18F-FDG uptake (hazard ratio 5.70, 95% confidence interval 1.74-18.6). The only factor significantly associated with overall survival by multivariate analysis was complete cytoreduction (adjusted hazard ratio 0.24, 95% confidence interval 0.07-0.89). Increased mediastinal 18F-FDG uptake was common in patients with advanced ovarian cancer. However, complete cytoreduction

  1. Prognostic significance of mediastinal {sup 18}F-FDG uptake in PET/CT in advanced ovarian cancer

    Bats, Anne-Sophie; Lecuru, Fabrice [Universite Paris Descartes, Sorbonne Paris Cite, Faculte de Medecine, Paris (France); Hopital Europeen Georges-Pompidou, Assistance Publique-Hopitaux de Paris, Service de Chirurgie Gynecologique et Cancerologique, Paris (France); Universite Paris Descartes, Sorbonne Paris Cite, INSERM UMR-S 747, Paris (France); Hugonnet, Florent; Faraggi, Marc [Universite Paris Descartes, Sorbonne Paris Cite, Faculte de Medecine, Paris (France); Hopital Europeen Georges-Pompidou, Assistance Publique-Hopitaux de Paris, Service de Medecine Nucleaire, Paris (France); Huchon, Cyrille [Universite Paris Descartes, Sorbonne Paris Cite, Faculte de Medecine, Paris (France); Hopital Europeen Georges-Pompidou, Assistance Publique-Hopitaux de Paris, Service de Chirurgie Gynecologique et Cancerologique, Paris (France); Bensaid, Cherazade [Hopital Europeen Georges-Pompidou, Assistance Publique-Hopitaux de Paris, Service de Chirurgie Gynecologique et Cancerologique, Paris (France); Pierquet-Ghazzar, Nadia [Hopital Europeen Georges-Pompidou, Assistance Publique-Hopitaux de Paris, Service de Medecine Nucleaire, Paris (France)

    2012-03-15

    To evaluate the prognostic significance of increased mediastinal {sup 18}F-FDG uptake in PET/CT for the staging of advanced ovarian cancer. We retrospectively evaluated patients managed for FIGO stage III/IV ovarian cancer between 1 January 2006 and 1 June 2009. Patients were included if they had undergone {sup 18}F-FDG PET/CT and surgery for initial staging. Exclusion criteria were age younger than 18 years, inability to undergo general anaesthesia, recurrent ovarian cancer, and borderline or nonepithelial malignancy. Whole-body PET/CT was performed after intravenous {sup 18}F-FDG injection. The location of abnormal hot spots and {sup 18}F-FDG maximal standard uptake values (SUV{sub max}) were recorded. We compared the complete cytoreduction and survival rates in groups defined based on mediastinal {sup 18}F-FDG uptake and SUV{sub max} values. Kaplan-Meier curves of overall survival and disease-free survival were compared using the log-rank test. Hazard ratios with their 95% confidence intervals were computed. Adjusted hazard ratios were obtained using a multivariate Cox model. We included 53 patients, of whom 17 (32%) had increased mediastinal {sup 18}F-FDG uptake. Complete cytoreduction was achieved in 14 (87.5%) of the 16 patients managed with primary surgery and in 21 (75%) of the 28 patients managed with interval surgery. Complete cytoreduction was achieved significantly more often among patients without increased mediastinal {sup 18}F-FDG uptake (80.6% vs. 35.3%; p = 0.001). Disease-free survival was comparable between the two groups. By univariate analysis, overall mortality was significantly higher among patients with increased mediastinal {sup 18}F-FDG uptake (hazard ratio 5.70, 95% confidence interval 1.74-18.6). The only factor significantly associated with overall survival by multivariate analysis was complete cytoreduction (adjusted hazard ratio 0.24, 95% confidence interval 0.07-0.89). Increased mediastinal {sup 18}F-FDG uptake was common in patients

  2. Right ventricular 18F-FDG uptake is an important indicator for cardiac involvement in patients with suspected cardiac sarcoidosis

    Cardiac sarcoidosis is most commonly found in the left ventricular (LV) free wall. Presence in the right ventricle (RV) is less common but might be useful for detecting cardiac involvement of sarcoidosis. 18F-fluoro-deoxyglucose (18F-FDG) PET has been used to detect LV regions with cardiac sarcoidosis. However, the same has not been done for RV involvement. The aims of the current study were to evaluate RV 18F-FDG uptake and its relationship to the distribution of LV wall 18F-FDG-positive segments in the LV, and to evaluate whether patients with positive RV 18F-FDG uptake met the 1993 diagnostic criteria of the Japanese Ministry of Health and Welfare (JMHW) guidelines regarding sarcoidosis with suspected cardiac involvement. Fifty-nine biopsy-proven extra-cardiac sarcoidosis patients (age 56.1 ± 14.7 years) with suspected cardiac involvement based on abnormal electrocardiography or echocardiography findings underwent fasting 18F-FDG PET or PET/CT. The LV wall was divided into 17 segments and RV uptake was also evaluated. Among 59 patients, 35 (59.3%) showed some abnormal 18F-FDG uptake in the RV and/or LV wall. With respect to the RV wall, 13 (22.0%) showed abnormal 18F-FDG uptake. The number of LV-involved segments was 4.8 ± 2.4 in the patients with RV 18F-FDG uptake, which was significantly higher than in the patients without RV uptake, 1.8 ± 2.2 (P < 0.0001). Patients with RV uptake more frequently met the diagnostic criteria of the 1993 JMHW guidelines (n=27), than did those without RV uptake (84.6 vs. 34.8%, P=0.0033). 18F-FDG PET identified RV involvement less frequently than LV involvement in this study population. However, patients who had RV uptake showed a greater number of LV-involved segments and met the JMHW diagnostic criteria more frequently. Although RV uptake is less frequent, 18F-FDG RV uptake may be useful in diagnosing cardiac involvement in sarcoidosis. (author)

  3. The role of '18F-FDG PET/CT in detecting small intestine adenocarcinoma

    Objective: To evaluate the value of whole body 18F-FDG PET/CT in detecting small intestine adenocarcinoma (SIA). Methods: A retrospective study of 18F-FDG PET/CT was performed on 29 cases (male 17,female 12) of SIA, 21 cases of small intestine lymphoma (SIL) (male 15, female 6) and 10 cases of small intestine tuberculosis (SIT) (male 4, female 6). Visual and semi-quantitative methods (SUVmax) were used to summarize and analyse the 18F-FDG PET/CT results. One-way analysis of variance and χ2 test were used to analyze the data. Results: (1) 18F-FDG PET/CT for SIA showed a partially conglomerate pattern of hypermetabolic small bowel masses with nodular configurations. A typical SIL showed a partially annular abnormal growth with aggregated foci of radioactivity. SIT lesions were usually in form of stripes and/or nodules with high metabolic foci or lesions with 'skipped' distribution. The SUVmax of SIA (8.44±3.82) was significantly lower than that of SIL (11.54±4.02; F=86.96, t=2.77, both P<0.01), but not significantly different when compared with SIT (8.61±2.99; t=0.11, P>0.05). (2) The incidence rates of peri-lesion lymph node enlargement in SIA, SIL and SIT were 72.41% (21/29), 85.71% (18/21) and 70.00% (7/10), respectively (χ2=1.50, P>0.05). The SUVmax of peri-lesion lymph nodes in SIA (5.59±2.86) was significantly lower than that of SIL (11.10±5.72; F=56.56, t=3.85, both P<0.01), but was not significantly different when compared with SIT (5.63± 3.36; t=0.30, P>0.05). The detection rate of PET/CT on peri-lesion lymph node enlargement of SIA was higher than CT (41.38%, 12/29; χ2=5.69, P<0.05). (3) The incidence rate of extra-intestinal metastases was 55.17% (16/29) in SIA, and the most common metastatic sites were liver,bone and adrenal gland. The incidence rate of extra-intestinal lesions was 66.67% (14/21) in SIL, most commonly presented as widespread multifocal nodal permeation. Extra abdominal tuberculous loci were found in 80.00% (8/10) of SIT

  4. Value of {sup 18}F-FDG PET/CT in the detection of ovarian malignancy

    Park, Tae Gyu; Lee, Si Nae; Park, So Yeon [Dept. of Nuclear Medicine, Korea University Guro Hospital, Seoul (Korea, Republic of); and others

    2015-03-15

    Ovarian cancer is a leading cause of gynecologic malignancy. As symptoms of ovarian cancer are nonspecific, only 20 % of ovarian cancers are diagnosed while they are still limited to the ovaries. Thus, early and accurate detection of disease is important for an improved prognosis. For the accurate and effective diagnosis of ovarian malignancy on {sup 18}F-fluorodeoxyglucose ({sup 18}F--FDG) positron emission tomography/computed tomography (PET/CT), we analyzed several parameters, including visual assessment. A total of 51 peritoneal lesions in 19 patients who showed ovarian masses with diffuse peritoneal infiltration were enrolled. Twelve patients were confirmed to have ovarian malignancy and seven patients with benign disease by pathologic examination. All patients were examined by {sup 18}F--FDG PET/CT, and an additional 2-h delayed {sup 18}F--FDG PET/CT was also performed for 15 patients with 42 peritoneal lesions. We measured semiquantitative parameters including maximum and mean standardized uptake values (SUV{sub max}, SUV{sub mean}), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on a 1-h initial {sup 18}F--FDG PET/CT image (Parameter1) and on a 2-h delayed image (Parameter2). Additionally, retention indices of each parameter were calculated, and each parameter among the malignant and benign lesions was compared by Mann-Whitney U test. We also assessed the visual characteristics of each peritoneal lesion, including metabolic extent, intensity, shape, heterogeneity, and total visual score. Associations between visual grades and malignancy were analyzed using linear by linear association methods. Moreover, a receiver operating characteristic (ROC) curve was analyzed to compare the effectiveness of significant parameters. In a comparison between the malignant and benign groups in the analysis of 51 total peritoneal lesions, SUV{sub max1}, SUV{sub mean1}, and TLG1 showed significant differences. Also, in the analysis of 42 peritoneal lesions

  5. The precision of textural analysis in {sup 18}F-FDG-PET scans of oesophageal cancer

    Doumou, Georgia; Siddique, Musib [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Tsoumpas, Charalampos [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); University of Leeds, The Division of Medical Physics, Leeds (United Kingdom); Goh, Vicky [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Guy' s and St Thomas' Hospitals NHS Foundation Trust, Radiology Department, London (United Kingdom); Cook, Gary J. [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Guy' s and St Thomas' Hospitals NHS Foundation Trust, The PET Centre, London (United Kingdom); University of Leeds, The Division of Medical Physics, Leeds (United Kingdom); St Thomas' Hospital, Clinical PET Centre, Division of Imaging Sciences and Biomedical Engineering, Kings College London, London (United Kingdom)

    2015-09-15

    Measuring tumour heterogeneity by textural analysis in {sup 18}F-fluorodeoxyglucose positron emission tomography ({sup 18}F-FDG PET) provides predictive and prognostic information but technical aspects of image processing can influence parameter measurements. We therefore tested effects of image smoothing, segmentation and quantisation on the precision of heterogeneity measurements. Sixty-four {sup 18}F-FDG PET/CT images of oesophageal cancer were processed using different Gaussian smoothing levels (2.0, 2.5, 3.0, 3.5, 4.0 mm), maximum standardised uptake value (SUV{sub max}) segmentation thresholds (45 %, 50 %, 55 %, 60 %) and quantisation (8, 16, 32, 64, 128 bin widths). Heterogeneity parameters included grey-level co-occurrence matrix (GLCM), grey-level run length matrix (GLRL), neighbourhood grey-tone difference matrix (NGTDM), grey-level size zone matrix (GLSZM) and fractal analysis methods. The concordance correlation coefficient (CCC) for the three processing variables was calculated for each heterogeneity parameter. Most parameters showed poor agreement between different bin widths (CCC median 0.08, range 0.004-0.99). Segmentation and smoothing showed smaller effects on precision (segmentation: CCC median 0.82, range 0.33-0.97; smoothing: CCC median 0.99, range 0.58-0.99). Smoothing and segmentation have only a small effect on the precision of heterogeneity measurements in {sup 18}F-FDG PET data. However, quantisation often has larger effects, highlighting a need for further evaluation and standardisation of parameters for multicentre studies. (orig.)

  6. Analysis of 18F-FDG PET images of patients with sarcoidosis

    Objective: To analyse 18F-fluorodeoxyglucose (FDG) PET images of patients with sarcoidosis, make an abstract of image characteristics. Methods: Twenty-four cases with sarcoidosis underwent both PET and CT. Among them, 5 were with pathologic evidence and had clinical symptoms, 19 were with positive Kveim test but asymptomatic. All 24 cases kept a fast of 6 h and the blood glucose was controlled below 6.7 mmol/L before injection of FDG. 40 min after administration, PET scan was performed with Siemens ECAT 47. After getting images through reconstruction by computer, the location and contour of the lesions were reviewed; the sizes and standardized uptake value (SUV) were measured. Results: For all 24 cases, strings of nodules were observed along the hili of lungs and the mediastinum, one of them had a nodule with high uptake of 18F-FDG in the left axilla in addition to the nodules along the hili of lungs and mediastinum. Sizes of nodules of 5 cases with symptoms and of 19 without symptoms were (2.16±0.67) and (1.55±0.21) cm, respectively; SUV were 2.68 ± 0.58 and 1.46±0.24, respectively. There was significant difference in the sizes and SUV of nodules between 5 with symptoms and 19 without symptoms (P 18F-FDG PET image characteristics of sarcoidosis i. e. strings of nodules distributing along the lung hili and mediastinum. Sizes of nodules were bigger and uptakes of 18F-FDG were higher for cases with symptoms than those for the asymptomatic cases

  7. 18F FDG PET/CT in differential diagnosis of Parkinsonian disorders

    Full text: Differential diagnosis of Parkinsonian disorders can be challenging in the early phase of disease course. Positron Emission Tomography (PET) imaging with 18F Fluorodeoxyglucose (FDG) has been used to identify characteristic patterns of glucose metabolism in patients with idiopathic Parkinson's Disease (PD) as well as variant forms of Parkinsonism such as Multisystem Atrophy (MSA), Progressive Supranuclear Palsy (PSP) and cortico basal ganglionic degeneration (CBGD). In this study we assessed the utility of 18F FDG PET/CT in the differential diagnosis Parkinsonian syndromes. 66 Parkinsonian patients with a mean age of 59.6 ± 11.50 years, male: female ratio of 3.12:1, age range of 35-84 years with a disease duration of 2.6 ± .68 years were referred for FDG PET to determine whether their scan patterns could distinguish idiopathic Parkinsons from the Parkinson plus syndromes. Approximately 60 minutes following intravenous injection of 370 MBq of 18F-FDG, PET/CT scan of the brain was acquired in a whole-body Full Ring PET/CT scanner (Discovery STE16 camera). A low dose CT was obtained on the same area without IV contrast for attenuation correction and coregistration. Images were reconstructed using a 3D VUE algorithm and slices were reformatted into transaxial, coronal and sagittal views. Subsequently the images were processed and visually analyzed on Xeleris workstation. Images were classified by visual analysis into the various subgroups, those with normal to increased basal ganglia uptake were classified into Idiopathic Parkinson's (40/45) and when basal ganglia uptake was decreased they were Parkinsons Plus (19/21). The study demonstrates that 18F FDG PET performed at the time of initial referral for parkinsonism could accurately classify patients into Parkinson's disease and Parkinson plus subtypes

  8. Estimation of radiation dose received by the radiation worker during 18F FDG injection process

    The radiation dosimetric literature concerning the medical and non-medical personnel working in nuclear medicine departments are limited, particularly radiation doses received by radiation worker in nuclear medicine department during positron emission tomography (PET) radiopharmaceutical injection process. This is of interest and concern for the personnel. To measure the radiation dose received by the staff involved in injection process of Fluorine-18 Fluorodeoxyglucose (FDG). The effective whole body doses to the radiation workers involved in injections of 1511 patients over a period of 10 weeks were evaluated using pocket dosimeter. Each patient was injected with 5 MBq/kg of 18F FDG. The 18F-FDG injection protocol followed in our department is as follows. The technologist dispenses the dose to be injected and records the pre-injection activity. The nursing staff members then secure an intravenous catheter. The nuclear medicine physicians/residents inject the dose on a rotation basis in accordance with ALARA principle. After the injection of the tracer, the nursing staff members flush the intravenous catheter. The person who injected the tracer then measures the post-injection residual dose in the syringe. The mean effective whole body doses per injection for the staff were the following: Nurses received 1.44 ± 0.22 μSv/injection (3.71 ± 0.48 nSv/MBq), for doctors the dose values were 2.44 ± 0.25 μSv/injection (6.29 ± 0.49 nSv/MBq) and for technologists the doses were 0.61 ± 0.10 μSv/injection (1.58 ± 0.21 nSv/MBq). It was seen that the mean effective whole body dose per injection of our positron emission tomography/computed tomography (PET/CT) staff who were involved in the 18F-FDG injection process was maximum for doctors (54.34% differential doses), followed by nurses (32.02% differential doses) and technologist (13.64% differential doses). This study confirms that low levels of radiation dose are received by staff during 18F-FDG injection and these

  9. Diagnostic value of 18F-FDG PET/CT in thyroid nodules

    Objective: To investigate the diagnostic value of 18F-FDG PET/CT for thyroid nodules. Methods: From January 2008 to May 2012, 34 patients (13 males, 21 females; age range: 21-73 years, mean (53.00± 12.57) years) with thyroid nodules on 18F-FDG PET/CT and with histopathological results were retrospectively analyzed. From January 2011 to December 2011, 20 cases (9 males, 11 females; age range: 40-55 years, mean (45.00±4.72) years) were selected as control group. Wilcoxon rank sum test and ROC analysis (AUC ≥0.7 was considered the standard of medium-high accuracy) were used. PET/CT features taken to suggest malignant thyroid nodules were: focally high uptake on PET, indistinct boundary or heterogeneous density on CT with punctuate, round or curved calcifications, or with hypermetabolic cervical lymph nodes as ancillary supportive findings of metastasis. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT for diagnosing thyroid nodules were calculated. Results: (1) There were 18 patients with malignant and 16 with benign thyroid nodules. The SUVmax of benign, malignant nodules and normal controls were 7.59±8.69, 5.75±4.48 and 1.38±0.57, respectively. The differences between malignant thyroid nodules and controls, between benign nodules and controls were significant (u=3.553, 3.408, both P<0.01). There was no significant difference between benign and malignant thyroid nodules (u =0.207, P>0.05). (2) The AUC for the differentiation of benign and malignant thyroid nodules by ROC analysis was 0.557 (<0.70). (3) The sensitivity, specificity, positive predictive value,negative predictive value and accuracy of 18F-FDG PET/CT for the differentiation of benign and malignant thyroid nodules were 72.2% (13/18), 75.0% (12/16), 76.5% (13/17), 70.6% (12/17) and 73.5% (25/34), respectively. Conclusions: 18F-FDG PET/CT has limited value for the differentiation between benign and malignant thyroid nodules based alone on the

  10. Retroperitoneal Bronchogenic Cyst Presenting Paraadrenal Tumor Incidentally Detected by 18F-FDG PET/CT

    Yoon, Ye Ri; Choi, Jiyoun; Lee, Sang Mi; Kim, Yeo Joo; Cho, Hyun Deuk; Lee, Jeong Won; Jeon, Youn Soo

    2014-01-01

    A follow-up 18F-fluorodeoxyglucose (18F-FDG) PET/CT scan of a 57-year-old asymptomatic male who had undergone total thyroidectomy for thyroid cancer revealed a 5.0 × 4.0-cm, well-defined, ovoid-shaped mass around the left adrenal gland without definite FDG uptake. On the adrenal CT scan, the left paraadrenal tumor showed high attenuation on the precontrast scan without enhancement. The average Hounsfield unit (HU) was 58.1 on the precontrast scan and 58.4 on the postcontrast scan. The patient...

  11. The clinical value of 18F-FDG PET-CT in diagnosis of the pleural or peritoneal carcinomatosis

    Objective: To evaluate the clinical value of 18F-FDG PET-CT in diagnosis of the pleural or peritoneal carcinomatosis. Methods: A total of 37 patients with pleural effusion or ascites of unknown origin were analyzed retrospectively. All patients underwent whole body 18F-FDG PET-CT. The 18F-FDG distributional pattern and the maximum standardized uptake value (SUVmax) of lesions were analyzed. The final diagnosis of all cases were established based on the results of catamnestic analysis,tumor markers assay, histopathology or clinical follow-up. Results: Of all the 37 cases, 29 had positive findings on 18F-FDG PET-CT,of which 26 were pleural or peritoneal carcinomatosis and 3 were pleural or peritoneal tuberculosis; 8 patients had negative findings on 18F-FDG PET-CT, of which 6 were pleural or peritoneal benign lesions and 2 were peritoneal carcinomatosis. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of 18F-FDG PET-CT in diagnosis of peritoneal carcinomatosis were 92.9%, 66.7%, 86.5%, 89.7% and 75.0% respectively. The SUVmax between the ring-form and strip-type lesions were significantly different (5.97±3.39 vs. 2.89±0.92, t=2.93, P<0.05). Conclusions: 18F-FDG PET-CT is simple,noninvasive and high sensitive in detecting pleural or peritoneal carcinomatosis, and may be an ideal technique of highly clinical usefulness in the diagnosis of the pleural or peritoneal carcinomatosis. (authors)

  12. The impact of 18F-FDG PET on the management of patients with suspected large vessel vasculitis

    We aimed to assess the impact of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the management of patients with suspected large vessel vasculitis. An international expert panel determined diagnoses and clinical management in patients with suspected large vessel vasculitis, with and without the results of 18F-FDG PET, respectively. The accuracy of the clinical diagnosis and the resulting clinical management with and without the 18F-FDG PET results were compared using logistic regression models. The analysis included 30 patients referred to a tertiary care centre with large vessel vasculitis and 31 controls. 18F-FDG PET had an overall sensitivity of 73.3% [95% confidence interval (CI) 54.1-87.7%], a specificity of 83.9% (95% CI 66.3-94.5%), a positive predictive value of 81.5% (95% CI 61.9-93.7%) and a negative predictive value of 76.5% (95% CI 58.8-89.3%). The diagnostic accuracy of 18F-FDG PET was higher in patients not receiving immunosuppressive drugs (93.3 vs 64.5%, p = 0.006). Taken in context with other available diagnostic modalities, the addition of 18F-FDG PET increased the clinical diagnostic accuracy from 54.1 to 70.5% (p = 0.04). The addition of 18F-FDG PET increased the number of indicated biopsies from 22 of 61 patients (36.1%) to 25 of 61 patients (41.0%) and changed the treatment recommendation in 8 of 30 patients (26.7%) not receiving immunosuppressive medication and in 7 of 31 patients (22.6%) receiving immunosuppressive medication. 18F-FDG PET is a sensitive and specific imaging tool for large vessel vasculitis, especially when performed in patients not receiving immunosuppressive drugs. It increases the overall diagnostic accuracy and has an impact on the clinical management in a significant proportion of patients. (orig.)

  13. Comparative PET/CT study with 11C-MET and 18F-FDG for diagnosing Glioma

    In this paper, we investigate the diagnostic value of 11C-methionine (MET) positron emission tomography/computed tomography (PET/CT) for brain gliomas, and compare the results to 18F-fluorodeoxyglucose. Forty-four patients with suspected gliomas were examined with 11C-MET and 18F-FDG PET/CT. 18F-FDG and 11C-MET PET/CT images were compared and evaluated by visual and semiquantitative analysis. The accuracy of 11C-MET and 18F-FDG PET/CT for detecting gliomas were 88.6% and 65.9%, respectively. Semiquantitative analysis showed that the 26 gliomas had higher mean ± SD T/NGmax ratio on 11C-MET PET/CT than on 18F-FDG PET/CT(1.95±0.52 vs. 0.90±0.27, t=9.101, P11C-MET had a higher sensitivity than 18F-FDG (83.3% vs.33.3%, χ2 =4.16, P18F-FDG in the sensitivity for high-grade gliomas(100% vs. 64.3%, χ2=3.20, P>0.05). The difference was no significant, too, between high-and low-grade gliomas, compared by 11C-MET T/NGmax ratio (2.07±0.51 vs. 1.81±0.52, t=1.302, P=0.205). 18F-FDG T/NGmax ratio in high-grade gliomas was significantly higher than that in low-grade gliomas (1.03±0.30 vs. 0.75±0.11, t=3.198, P=0.004). It is concluded that 11C-MET PET/CT is more accurate than 18F-FDG PET/CT for detecting and delineating gliomas, especially for low-grade gliomas, and it can play a complement role to 18F-FDG in tumor grading. (authors)

  14. Adrenergic pathway activation enhances brown adipose tissue metabolism: A [18 F]FDG PET/CT study in mice

    Objective: Pharmacologic approaches to study brown adipocyte activation in vivo with a potential of being translational to humans are desired. The aim of this study was to examine pre- and postsynaptic targeting of adrenergic system for enhancing brown adipose tissue (BAT) metabolism quantifiable by [18 F]fluoro-2-deoxyglucose ([18 F]FDG) positron emission tomography (PET)/computed tomography (CT) in mice. Methods: A β3-adrenoreceptor selective agonist (CL 316243), an adenylyl cyclase enzyme activator (forskolin) and a potent blocker of presynaptic norepinephrine transporter (atomoxetine), were injected through the tail vein of Swiss Webster mice 30 minutes before intravenous (iv) administration of [18 F]FDG. The mice were placed on the PET/CT bed for 30 min PET acquisition followed by 10 min CT acquisition for attenuation correction and anatomical delineation of PET images. Results: Activated interscapular (IBAT), cervical, periaortic and intercostal BAT were observed in 3-dimentional analysis of [18 F]FDG PET images. CL 316243 increased the total [18 F]FDG standard uptake value (SUV) of IBAT 5-fold greater compared to that in placebo-treated mice. It also increased the [18 F]FDG SUV of white adipose tissue (2.4-fold), and muscle (2.7-fold), as compared to the control. There was no significant difference in heart, brain, spleen and liver uptakes between groups. Forskolin increased [18 F]FDG SUV of IBAT 1.9-fold greater than that in placebo-treated mice. It also increased the [18 F]FDG SUV of white adipose tissue (2.2-fold) and heart (5.4-fold) compared to control. There was no significant difference in muscle, brain, spleen, and liver uptakes between groups. Atomoxetine increased [18 F]FDG SUV of IBAT 1.7-fold greater than that in placebo-treated mice. There were no significant differences in all other organs compared to placebo-treated mice except liver (1.6 fold increase). A positive correlation between SUV levels of IBAT and CT Hounsfield unit (HU) (R2 = 0

  15. Imaging findings and literature review of {sup 18}F-FDG PET/CT in primary systemic AL amyloidosis

    Lee, Joo Hee; Lee, Ga Yeon; Kim, Seok Jin; Kim, Ki Hyun; Jeon, Eun Seok; Lee, Kyung Han; Kim, Byung Tae; Choi, Joon Young [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-09-15

    Although several case reports and case series have described {sup 18}F-FDG PET/CT in amyloidosis, the value of {sup 18}F-FDG PET/CT for diagnosing amyloidosis has not been clarified. We investigated the imaging findings of {sup 18}F-FDG PET/CT in patients with primary systemic AL amyloidosis. Subjects were 15 patients (M:F = 12:3; age, 61.5 ± 7.4 years) with histologically confirmed primary systemic AL amyloidosis who underwent pretreatment {sup 18}F-FDG PET/CT to rule out the possibility of malignancy or for initial workup of alleged cancer. For involved organs, visual and semiquantitative analyses were performed on {sup 18}F-FDG PET/CT images. In total, 22 organs (10 hearts, 5 kidneys, 2 stomachs, 2 colons, 1 ileum, 1 pancreas, and 1 liver) were histologically confirmed to have primary systemic AL amyloidosis. F-FDG uptake was significantly increased in 15 of the 22 organs (68.2 %; 10 hearts, 2 kidneys, 1 colon, 1 ileum, and 1 liver; SUV{sub max} = 7.0 ± 3.2, range 2.1–14.1). However, in 11 of 15 PET-positive organs (78.6 %; 10 hearts and the ileum), it was difficult to differentiate pathological uptake from physiological uptake. Definitely abnormal {sup 18}F-FDG uptake was found in only 4 of the 22 organs (18.2 %; 2 kidneys, 1 colon, and the liver). {sup 18}F-FDG uptake was negative for pancreas and gastric lesions. Although {sup 18}F-FDG PET/CT showed high uptake in two-thirds of the organs involving primary systemic AL amyloidosis, its sensitivity appeared to be low to make differentiation of pathological uptake from physiological uptake. However, due to the small number of cases, further study for the role of {sup 18}F-FDG PET/CT in amyloidosis will be warranted.

  16. Retroperitoneal bronchogenic cyst presenting paraadrenal tumor incidentally detected by 18F-FDG PET/CT

    A follow-up 18F-fluorodeoxyglucose (18F-FDG) PET/CT scan of a 57-year-old asymptomatic male who had undergone total thyroidectomy for thyroid cancer revealed a 5.0 x 4.0-cm, well-defined, ovoid-shaped mass around the left adrenal gland without definite FDG uptake. On the adrenal CT scan, the left paraadrenal tumor showed high attenuation on the precontrast scan without enhancement. The average Hounsfield unit (HU) was 58.1 on the precontrast scan and 58.4 on the postcontrast scan. The patient underwent laparoscopic adrenalectomy for resection of the left paraadrenal tumor. The final histopathologic examination revealed a bronchogenic cyst. Although retroperitoneal bronchogenic cysts are rare, they should be considered in the differential diagnosis of retroperitoneal cystic tumors. The preoperative diagnosis is difficult, but a contrast-enhanced CT scan or 18F-FDG PET/CT scan may be useful for differentiating hyperattenuated cysts from other soft tissue masses

  17. Detection of recurrence of head and neck cancer with 18F-FDG PET

    Objective: To evaluate 18F-FDG PET in detection of suspected recurrence of head and neck cancer after treatment, in comparison with CT imaging. Methods: Thirty-eight patients with clinically suspected recurrence of head and neck cancer underwent 18F-FDG PET, twenty-eight of them also underwent CT imaging. The images were interpreted visually and semiquantitatively as tumor-to-normal (T/N). The accumulation of radioactivity in tumor was graded as follows: grade 0 (no FDG uptake), grade I (slight uptake), grade II (moderate uptake), grade III (intensive uptake). The accumulation of grade II or grade III was defined as recurrence, the final diagnoses of recurrence were based on histological examine or clinical follow up. Results: The sensitivity and specificity of visual interpretation of PET for recurrence were 90.6% (29/32), 83.3%(5/6), respectively; and those of CT were 63,6% (14/22), 50% (3/6), respectively. The ratio of T/N of recurrent tumors was much higher than that of benign ones. Conclusions: Compared with CT imaging, PET has a higher accuracy in detection of recurrent head and neck cancer after treatment

  18. Effect of subcutaneous injection of insulin on 18F-FDG myocardial imaging in diabetics

    Objective: To evaluate the effect of subcutaneous injection of insulin on 18F-fluorodeoxyglucose (FDG) myocardial imaging in patients with diabetes mellitus. Methods: Fifty-seven patients with coronary artery disease complicated with diabetes mellitus [mean age (60 +- 8) years] underwent 18F-FDG PET and dual isotope simultaneous acquisition SPECT with 99Tcm-MIBI/18F-FDG. Thirty minutes before FDG injection, blood glucose was measured with an automatic glucose analyzer and insulin was subcutaneously used, the dose was adjusted according to the level of blood glucose. Results: Regression analysis showed that the insulin was positively associated with blood glucose. The linear regression analysis showed that the correlation between dose of insulin (y) and blood glucose (x) was good, r 0.8172; the linear regression equation was y = -5.4 + 1.2x. 52 of 57 images were of good quality with 91% success rate. Conclusion: Subcutaneous injection of insulin is an effective and simple method for obtaining cardiac FDG images of good quality in patients with diabetes mellitus

  19. Mucoepidermoid carcinoma of bronchus in a pediatric patient: {sup 18}F-FDG PET findings

    Lee, Edward Y. [Children' s Hospital Boston and Harvard Medical School, Departments of Radiology and Medicine, Pulmonary Division, Boston, MA (United States); Vargas, Sara O. [Children' s Hospital Boston and Harvard Medical School, Department of Pathology, Boston, MA (United States); Sawicki, Gregory S.; Boyer, Debra [Children' s Hospital Boston and Harvard Medical School, Division of Respiratory Diseases, Boston, MA (United States); Grant, Frederick D.; Voss, Stephan D. [Children' s Hospital Boston and Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2007-12-15

    In children, primary neoplasms of the tracheobronchial tree and lungs are rare; most are malignant. Of the primary malignant pulmonary neoplasms arising in childhood, mucoepidermoid carcinoma accounts for approximately 10%. Due to its well-confined local growth within the airway, mucoepidermoid carcinoma commonly produces respiratory symptoms from progressive tracheal or bronchial obstruction. Mucoepidermoid tumor has minimal metastatic potential in children, and local resection alone is the current treatment of choice. Early detection, diagnosis, and surgical resection of mucoepidermoid tumor are especially important in pediatric patients since the bulk of the remaining pulmonary parenchyma can be preserved, thereby decreasing the thoracic deformity and pulmonary functional morbidity. Radiographic and CT imaging findings of bronchial mucoepidermoid carcinoma in children have been described in several case reports. However, to the best of our knowledge, imaging findings of 2-({sup 18}F)-fluoro-2-deoxy-d-glucose positron emission tomography ({sup 18}F-FDG PET) of mucoepidermoid carcinoma of the bronchus in pediatric patients have not been well established. We report a mucoepidermoid carcinoma arising from the right upper lobe bronchus in a 15-year-old girl with an emphasis on the {sup 18}F-FDG PET findings. (orig.)

  20. Mucoepidermoid carcinoma of bronchus in a pediatric patient: 18F-FDG PET findings

    In children, primary neoplasms of the tracheobronchial tree and lungs are rare; most are malignant. Of the primary malignant pulmonary neoplasms arising in childhood, mucoepidermoid carcinoma accounts for approximately 10%. Due to its well-confined local growth within the airway, mucoepidermoid carcinoma commonly produces respiratory symptoms from progressive tracheal or bronchial obstruction. Mucoepidermoid tumor has minimal metastatic potential in children, and local resection alone is the current treatment of choice. Early detection, diagnosis, and surgical resection of mucoepidermoid tumor are especially important in pediatric patients since the bulk of the remaining pulmonary parenchyma can be preserved, thereby decreasing the thoracic deformity and pulmonary functional morbidity. Radiographic and CT imaging findings of bronchial mucoepidermoid carcinoma in children have been described in several case reports. However, to the best of our knowledge, imaging findings of 2-(18F)-fluoro-2-deoxy-d-glucose positron emission tomography (18F-FDG PET) of mucoepidermoid carcinoma of the bronchus in pediatric patients have not been well established. We report a mucoepidermoid carcinoma arising from the right upper lobe bronchus in a 15-year-old girl with an emphasis on the 18F-FDG PET findings. (orig.)

  1. Pitfalls in [18F]FDG PET imaging in gynecological malignancies.

    Hernandez Pampaloni, Miguel; Facchetti, Luca; Nardo, Lorenzo

    2016-06-01

    Gynecologic malignancies are the leading causes of cancer in women and they represent about 10 to 20% of all solid tumors. During the past few decades, technological advancements in the detection and staging have gained a pivotal role in all oncological processes, including the gynecological ones. Beyond ultrasound, computed tomography (CT) and magnetic resonance (MR) imaging that are conventionally used for anatomical imaging, [18F]FDG imaging and its hybrid further development as PET/CT has become a crucial tool due of its ability to combine functional metabolic and anatomic information, and the ability to image the entire whole body in a single examination. Since the introduction of integrated hybrid PET/CT systems into clinical practice the accurate analysis of the images has detected a number of limitations and pitfalls. The purpose of this review was to describe in detail the different pitfalls related to the use of [18F]FDG PET/CT in the gynecological malignancies, providing imaging examples and discussing possible ways to avoid misinterpretations. PMID:26937887

  2. Comparison between 18F-FDG PET and CT in evaluating the activity of pulmonary tuberculosis

    Objective: To compare the difference between 18F-FDG PET and CT for evaluating the activity of pulmonary tuberculosis. Methods: 18F-FDG PET-CT was performed in 31 pulmonary tuberculosis patients,the activity of the tuberculosis lesions was evaluated by PET and CT images, the results of the two imaging methods were compared separately. Results: The results obtained with the two imaging methods were consistent in 26 cases and inconsistent in 5 cases.6 eases which CT diagnosed as inactive tuberculosis (healed lesions) were also judged as inactive lesions by PET imaging. In 16 cases, CT displayed that most of the lesions were calcified and associated with little streaks and diagnosed as inactive tuberculosis (obsolete lesions), among them PET judged 5 cases as active lesions, of which 3 cases with partly calcified lesion associated with mild radioactive uptake, 2 eases with streaks associated with mild radioactive uptake. 9 cases which CT diagnosed as active pulmonary tuberculosis, PET judged as active lesions too. Conclusions: 18FFDG PET and CT have the same judgment in diagnosing healed and active tuberculosis lesions, while 18FFDG PET is superior to CT in evaluating the active lesions residue in obsolete lesions. (authors)

  3. Metabolic and anatomic characteristics of bronchioloalveolar carcinoma on 18F-FDG PET/CT

    Objective: The aims were to investigate the value of 18F-fluorodeoxyglucose (FDG) PET/CT in the diagnosis of bronchioloalveolar carcinoma (BAC) and its metabolic and anatomic features in differentiating from non-BAC adenocarcinoma (non-BAC AC ). Methods: This was a retrospective 18F-FDG PET/CT study on a consecutive series of 87 patients (32 BAC, 55 non-BAC AC) with 110 pathology-proven lesions. The maximum standardized uptake value ( SUVmax) was calculated for all lesions. Tumor's location, morphology and margins, internal structures were analyzed on CT. Statistical analysis compared the mean SUVmax between the two groups, analysed the relationship between tumor subtype and features on CT and compared the diagnostic accuracies with PET alone, CT alone and PET/CT. The t-test, McNemar test, Fisher exact test were used to analyze the data using SPSS 12.0. Results: Significant differences were found between mean SUVmax in a total of 47 lesions with BAC and 63 lesions with non-BAC AC (1.51 ± 0.17 vs 6.28 ± 3.04, t=-10.374, P 18F-FDG activity. (authors)

  4. Depiction and characterization of liver lesions in whole body [18F]-FDG PET/MRI

    Objectives: To assess the value of PET/MRI with [18F]-FDG using a whole body protocol for the depiction and characterization of liver lesions in comparison to PET/CT. Methods: 70 patients (31 women, 39 men) with solid tumors underwent [18F]-FDG PET/CT and followed by an additional PET/MRI using an integrated scanner. Two readers rated the datasets (PET/CT; PET/MRI) regarding conspicuity of hepatic lesions (4-point ordinal scale) and diagnostic confidence (5-point ordinal scale). Median scores for lesion conspicuity and diagnostic confidence were compared using Wilcoxon's rank sum test. Prior examinations, histopathology and clinical follow-up (116 ± 54 days) served as standard of reference. Results: 36 of 70 (51%) patients showed liver lesions. Using PET/CT and PET/MRI all patients with liver metastases could correctly be identified. A total of 97 lesions were found (malignant n = 26; benign n = 71). For lesion conspicuity significantly higher scores were obtained for PET/MRI in comparison to PET/CT (p < 0.001). Significantly better performance for diagnostic confidence was observed in PET/MRI, both for malignant as for benign lesions (p < 0.001). Conclusions: PET/MRI, even in the setting of a whole body approach, provides higher lesion conspicuity and diagnostic confidence compared to PET/CT and may therefore evolve as an attractive alternative in oncologic imaging

  5. A Cochrane review on brain [{sup 18}F]FDG PET in dementia: limitations and future perspectives

    Morbelli, Silvia [University of Genoa, Nuclear Medicine Unit, IRCCS San Martino - IST, Department of Health Sciences, Genoa (Italy); Garibotto, Valentina [Geneva University and Geneva University Hospitals, Department of Medical Imaging, Geneva (Switzerland); Giessen, Elsmarieke van de [University of Amsterdam, Department of Nuclear Medicine, Academic Medical Center, Amsterdam (Netherlands); Arbizu, Javier [University of Navarra, Nuclear Medicine Department, Clinica Universidad de Navarra, Pamplona (Spain); Chetelat, Gael [Inserm, U1077, Caen (France); Universite de Caen Basse-Normandie, UMR-S1077, Caen (France); Ecole Pratique des Hautes Etudes, UMR-S1077, Caen (France); CHU de Caen, U1077, Caen (France); Drezgza, Alexander [Universitaet zu Koeln, Klinik und Poliklinik fuer Nuklearmedizin, Koeln (Germany); Hesse, Swen [University of Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Lammertsma, Adriaan A. [VU University Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam (Netherlands); Law, Ian [Copenhagen University Hospital, Rigshospitalet, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen (Denmark); Pappata' , Sabina [Institute of Biostructure and Bioimaging, CNR, Naples (Italy); Payoux, Pierre [INSERM UMR 825 Toulouse Univ., Imagerie Cerebrale et Handicaps Neurologiques (France); Pagani, Marco [Institute of Cognitive Sciences and Technologies, CNR, Rome (Italy); Karolinska Hospital, Department of Nuclear Medicine, Stockholm (Sweden); Collaboration: European Association of Nuclear Medicine

    2015-09-15

    Based on a large body of evidence on its diagnostic sensitivity for the identification of AD, in 2004 [18F]FDG PET imaging was approved by the Centers for Medicare and Medicaid Services (CMS, USA) as a routine examination tool for early and differential diagnosis of AD. Since then, large amounts of additional [18F]FDG PET data have become available showing that the addition of [18F]FDG PET to clinical examinations increases diagnostic accuracy in identifying AD patients even in the predementia stage. Of course, new opportunities and new challenges are coming up, which require the definition of the specific role of [18F]FDG PET in the era of AD biomarkers (i.e. relationship with other biomarkers and role as a marker of progression in AD [46, 48]). Meanwhile, in daily clinical practice, nuclear medicine experts should continue to perform high-quality [18F]FDG PET scans, constantly improving the standard through continuous education and the use of appropriate tools, knowing that it is one of the most informative biomarkers currently available for the prediction of dementia at the MCI stage.

  6. 18F-FDG PET/CT is Useful for pretreatment Assessment of the Histopathologic Type of Thymic Epithelial Tumors

    This study was performed to assess the usefulness of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) of PET/computed tomography (CT) for distinguishing thymic epithelial tumors according to World Health Organization (WHO) classifications. We analyzed a total of 45 patients (range, 29-75 years of age; mean, 55 years) with pathologically confirmed thymic epithelial tumors who underwent pretreatment 18F-FDG PET or PET/CT between November 2003 and October 2009. The size, visual grading of uptake value, peak standardized uptake value (SUVpeak), uptake pattern, and contour of each tumor, and associated findings on PET or PET/CT, were analyzed relative to the three simplified WHO subgroups: lee-invasive thymomas (types A and AB), more-invasive thymomas (types B1, B2, and B3) and thymic carcinomas. We statistically assessed the relationship of 18F-FDG PET or PET/CT findings with these simplified subgroups. Of the 45 patients, ten had less-invasive thymomas, 23 had more-invasive thymomas, and 12 had thymic carcinomas. The SUVpeak of the less- and more-invasive thymomas were significantly lower than those of thymic carcinomas (p18F-FDG PET or PET/CT differed significantly by histologic subgroups. Pretreatment evaluation with 18F-FDG PET or PET/CT might be helpful in differentiating subgroups of thymic epithelial tumors.

  7. Can brown fat uptake of 18F-FDG be reduced by beta-blockers?

    With the increasing application of F-18-fluorodeoxyglucose (FDG) positron emission imaging, there has been an evolving appreciation for the range of normal variants and the realization that false- positives can lead to serious consequences. One of the most common causes of a false-positive study is the uptake of FDG in areas of brown adipose tissue. BAT is generally present in deep cervical regions, including the supraclavicular areas, the interscapular and paravertebral regions, and areas near large vessels. Areas of involvement are often spatially closely related to important lymph node groups in the neck, axilla, and upper mediastinum, making critical differentiation difficult. The uptake of 18F FDG in brown adipose tissue (BAT) limits the ability of a PET scan to detect the sites of viable disease. Many studies have been done after premedication with Diazepam (benzodiazepines) to reduce the uptake of FDG by brown fat. But they are of limited value. Thus, it would be ideal if a drug could completely reverse the brown fat uptake and thus aid in proper management of the patient. The aim of this study is to see if by giving a single dose of a beta-blocker such as 'Ciplar' (Propranolol) 40 mg, 30 minutes prior to the FDG injection will help in reduction of brown fat uptake of 18F-FDG or not. Materials and Methods: Patients who were referred for a PET scan, either for a pretreatment or a post treatment evaluation and who showed FDG uptake in brown adipose tissue (BAT) were taken up for this study. The total number of patients was 14. A repeat PET scan was done after a gap of at least 48 hrs after the first study. The patients were advised to keep themselves warm with adequate warm clothing on the day of the second study. 40 mg of 'Ciplar' (propranolol) was given orally 30 minutes prior to the 18F-FDG injection. A whole body PET scan was performed on a dedicated whole body PET scanner (ADVANCE, GE Medical Systems, Milwaukee, WI.), using attenuation correction with 68

  8. Initial evaluation of 18F-NaF, 18F-FDG and cocktail 18F-NaF/18F-FDG PET/CT for evaluation of skeletal metastasis

    Full text: 18F-FDG PET/CT is the commonest radiotracer used for initial staging of malignancy and subsequent treatment strategy evaluation while Sodium 18F PET/CT is a favoured skeletal radiotracer in oncology. The combined administration of 18F and 18F-FDG in a single PET/CT study can be done for cancer detection and initial staging. Materials and Methods: This is a prospective study (July'09-June'10) of 18 patients with histologically proven malignancy, for initial staging (10 carcinoma breast, 2 carcinoma lung, 1 carcinoma prostate, 3 NHL and 2 carcinoma salivary glands) who underwent 18F PET/CT, 18F-FDG PET/CT and combined 18F+18F-FDG PET/CT (cocktail) study on different days for evaluation of malignancy (a total of 3 scans each). There were 7 males and 11 females, age 48 ± 1.4 yrs (range 20-72 yrs). The findings of each study were compared lesion by lesion, with bone marrow aspiration/biopsy/MRI being the reference standard for marrow metastasis and follow up/CT being the reference standard for metastatic lesions. Results: Interpretation of the combined scans (1 lesion missed) compared favourably with that of 18F-FDG PET/CT (2 lesions missed) and 18F PET/CT scan (3 lesions missed). The cocktail and 18F-FDG PET/CT study demonstrated a sensitivity of 93.75% and 87% respectively, but both had equal utility for detection of marrow metastasis. However, the 18F PET/CT study revealed lowest sensitivity 81% but similar specificity i.e. 50% as the cocktail study. 18F-FDG study gave the highest specificity (100%) out of the three. Conclusion: The prospective study demonstrated that a cocktail study using 18F and 18F-FDG is beneficial for cancer detection and initial staging. The combined method opens the feasibility for detection of the visceral, skeletal and marrow metastasis in a single sitting, improving the patient logistic and turnover and with the current CT co-registration, the false positives can be ruled out

  9. 18F-FDG SPECT/CT in the diagnosis of differentiated thyroid carcinoma with elevated thyroglobulin and negative iodine-131 scans

    Aim of the present study was to investigate the usefulness of 18F-FDG SPECT/CT in differentiated thyroid cancer (DTC) with elevated serum thyroglobulin (Tg) but negative iodine-131 scan. This retrospective review of patients with DTC recurrence who had 18F-FDG SPECT/CT and 18F-FDG PET/CT for elevated serum Tg but negative iodine-131 scan (March 2007-October 2012). After total thyroidectomy followed by radioiodine ablation, 86 consecutive patients with elevated Tg levels underwent 18F-FDG SPECT/CT or 18F-FDG PET/CT. Of these, 45 patients had 18F-FDG SPECT/CT, the other 41 patients had 18F-FDG PET/CT 3-4 weeks after thyroid hormone withdrawal. The results of 18F-FDG PET/CT and SPECT/CT were correlated with patient follow-up information, which included the results from subsequent imaging modalities such as neck ultrasound, MRI and CT, Tg levels, and histologic examination of surgical specimens. The diagnostic accuracy of the two imaging modalities was evaluated. In 18F-FDG SPECT/CT scans, 24 (24/45) patients had positive findings, 22 true positive in 24 patients, false positive in 2 patients, true-negative and false-negative in 6, 15 patients, respectively. The overall sensitivity, specificity, and accuracy of 18F-FDG SPECT/CT were 59.5%, 75% and 62.2%, respectively. Twenty six patients had positive findings on 18F-FDG PET/CT scans, 23 true positive in 26 (26/41) patients, false positive in 3 patients, true-negative and false-negative in 9, 6 patients, respectively. The overall sensitivity, specificity, and accuracy of 18F-FDG PET/CT were 79.3%, 81.8% and 78.1%, respectively. Clinical management changed for 13 (29%) of 45 patients by 18F-FDG SPECT/CT, 14 (34%) of 41 patients by 18F-FDG PET/CT including surgery, radiation therapy, or multi kinase inhibitor. Based on the retrospective analysis of 86 patients, 18F-FDG SPECT/CT has lower sensitivity in the diagnosis of DTC recurrence with elevated Tg and negative iodine-131scan to 18F-FDG PET/CT. The clinical application

  10. 18F-FDG PET imaging of postoperative and post radiotherapeutic intracranial glioma compared with CT, MRI in 16 cases

    Objective: To discuss the clinical value of 18F-FDG PET imaging in postoperative and post radiotherapeutic intracranial glioma during follow up study. Methods: 18F-FDG PET imaging in 16 cases of postoperative and post radiotherapeutic intracranial glioma was compared with CT and/or MRI. Results: Contrast CT or MRI showed prominent irregular circular or nodular enhancement in 14 of 16 cases (64%), can not distinguished from postoperative changes, radioactive injury, tumor residue or recurrence. Among them, 9 cases showed tumor residue or recurrence based on significantly increased FDG uptake, 5 were confirmed by pathologic study. The other 5 cases of cerebral necrosis and 2 cases with postoperative cerebral malacia demonstrated FDG uptake defects. Conclusions: 18F-FDG PET imaging has significant dominance in characterizing lesions for differentiating residue or recurrent disease from radioactive injury in intracranial glioma. Combined with CT and MRI can provide both anatomical and functional information

  11. Estudo do metabolismo da glicose na tuberculose pulmonar ativa utilizando a tomografia por emissão de pósitrons (18F-FDG PET Evaluation of glucose metabolism in active lung tuberculosis by positron-emission tomography (18F-FDG PET

    SIDNEY BOMBARDA

    2002-09-01

    Full Text Available Os métodos de imagem utilizados na avaliação da tuberculose pulmonar incluem a radiografia e a tomografia computadorizada do tórax. As imagens obtidas pelos métodos de medicina nuclear permitem estudos funcionais e metabólicos dos órgãos de interesse, através do uso de radiofármacos específicos. Alterações do metabolismo da glicose podem ser detectadas pela tomografia por emissão de pósitrons (PET utilizando-se o 18F-fluorodesoxiglicose (18F-FDG. Essas alterações estão presentes nas doenças neoplásicas, inflamatórias e infecciosas. A tuberculose é uma doença granulomatosa causada pelo Mycobacterium tuberculosis, que se utiliza de glicose como fonte de energia. Objetivo: O estudo do metabolismo da glicose na tuberculose pulmonar através da PET e sua comparação com a tomografia computadorizada de tórax. Material e métodos: Foram avaliados 20 pacientes portadores de tuberculose pulmonar. Todos foram submetidos à PET e à tomografia computadorizada de tórax, em até 30 dias após o início do tratamento. Resultados: Todos os pacientes apresentaram captação positiva do 18F-FDG na PET. Na tomografia computadorizada do tórax, todos os pacientes apresentaram sinais compatíveis com atividade de tuberculose. A sensibilidade dos dois métodos foi de 100%. Houve concordância entre os achados do 18F-FDG PET e da tomografia computadorizada (K = 0,27 e p Current methods to evaluate lung tuberculosis include chest radiography and computed tomography. Nuclear medicine imaging techniques are performed after administration of specific radiopharmaceuticals that accumulate in the organs of interest. Alterations of glucose metabolism can be observed by positron-emission tomography, using 18F-fluorodeoxyglucose (18F-FDG PET. These findings are present in the neoplasms, but also in inflammatory and infectious diseases. Tuberculosis is a granulomatous disease caused by Mycobacterium tuberculosis , that uses glucose as an energy source

  12. {sup 18}F-FDG-PET/CT in staging, restaging, and treatment response assessment of male breast cancer

    Groheux, David, E-mail: dgroheux@yahoo.fr [Department of Nuclear Medicine, Saint-Louis Hospital, Paris (France); Doctoral School of Biology and Biotechnology, University Institute of Hematology, University of Paris VII, Paris (France); Hindié, Elif [Department of Nuclear Medicine, Haut-Lévêque Hospital, CHU Bordeaux, University Bordeaux-Segalen, Bordeaux (France); Marty, Michel [Breast Diseases Unit and Department of Medical Oncology, Saint-Louis Hospital, Paris (France); Centre for Therapeutic Innovation, Saint-Louis Hospital, Paris (France); Espié, Marc [Breast Diseases Unit and Department of Medical Oncology, Saint-Louis Hospital, Paris (France); Rubello, Domenico [Department of Nuclear Medicine, Santa Maria della Misericordia, Rovigo Hospital, Rovigo (Italy); Vercellino, Laetitia [Department of Nuclear Medicine, Saint-Louis Hospital, Paris (France); Doctoral School of Biology and Biotechnology, University Institute of Hematology, University of Paris VII, Paris (France); Bousquet, Guilhem [Breast Diseases Unit and Department of Medical Oncology, Saint-Louis Hospital, Paris (France); INSERM U728, University Institute of Hematology, University of Paris VII, Paris (France); Ohnona, Jessica; Toubert, Marie-Elisabeth [Department of Nuclear Medicine, Saint-Louis Hospital, Paris (France); Merlet, Pascal [Department of Nuclear Medicine, Saint-Louis Hospital, Paris (France); Doctoral School of Biology and Biotechnology, University Institute of Hematology, University of Paris VII, Paris (France); Misset, Jean-Louis [Breast Diseases Unit and Department of Medical Oncology, Saint-Louis Hospital, Paris (France)

    2014-10-15

    Purpose: Male breast cancer (BC) is a rare disease, with patterns different from those found in women. Most tumors are detected at more advanced stages than in women. The aim of this study was to analyze the performance of [18F]fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG-PET/CT) in staging, restaging, and therapy response assessment. Methods: We performed a systematic analysis in the database of Saint-Louis Hospital to identify male patients with BC referred for PET/CT. {sup 18}F-FDG-PET/CT findings considered suspicious for malignancy were compared to biopsy results, further work-up and/or patient follow-up of at least 6 months. Performances of {sup 18}F-FDG-PET/CT were compared to that of conventional imaging (CI) using the McNemar test. The impact of PET/CT on management was evaluated. Results: During 6 consecutive years, among 12,692 {sup 18}F-FDG-PET/CT oncology studies, 30 were performed in 15 men with BC: 7 examinations for initial staging, 11 for restaging, and 12 for response assessment. Tumors profile was ER+ and one had HER2 overexpression. PET/CT sensitivity, specificity, positive predictive value, negative predictive value and accuracy to detect distant metastases were 100%, 67%, 86%, 100% and 89%, respectively. PET/CT was more informative than CI in 40% of studies (p = 0.03; 95% confidence interval: 3.26 – 40%). Findings from {sup 18}F-FDG-PET/CT led to modification in the planned treatment in 13/30 cases (43%). Conclusion: Although all the tumors were ER+, primary lesions and metastases were diagnosed with high sensitivity. {sup 18}F-FDG-PET/CT seems to be a powerful imaging method to perform staging, restaging and treatment response assessment in male patients with BC.

  13. Longitudinal imaging of Alzheimer pathology using [11C]PIB, [18F]FDDNP and [18F]FDG PET

    [11C]PIB and [18F]FDDNP are PET tracers for in vivo detection of the neuropathology underlying Alzheimer's disease (AD). [18F]FDG is a glucose analogue and its uptake reflects metabolic activity. The purpose of this study was to examine longitudinal changes in these tracers in patients with AD or mild cognitive impairment (MCI) and in healthy controls. Longitudinal, paired, dynamic [11C]PIB and [18F]FDDNP (90 min each) and static [18F]FDG (15 min) PET scans were obtained in 11 controls, 12 MCI patients and 8 AD patients. The mean interval between baseline and follow-up was 2.5 years (range 2.0-4.0 years). Parametric [11C]PIB and [18F]FDDNP images of binding potential (BPND) and [18F]FDG standardized uptake value ratio (SUVr) images were generated. A significant increase in global cortical [11C]PIB BPND was found in MCI patients, but no changes were observed in AD patients or controls. Subsequent regional analysis revealed that this increase in [11C]PIB BPND in MCI patients was most prominent in the lateral temporal lobe (p 18F]FDDNP, no changes in global BPND were found. [18F]FDG uptake was reduced at follow-up in the AD group only, especially in frontal, parietal and lateral temporal lobes (all p 11C]PIB binding (ρ = -0.42, p 18F]FDG uptake (ρ = 0.54, p 18F]FDDNP binding (ρ = -0.18, p = 0.35) were not. [11C]PIB and [18F]FDG track molecular changes in different stages of AD. We found increased amyloid load in MCI patients and progressive metabolic impairment in AD patients. [18F]FDDNP seems to be less useful for examining disease progression. (orig.)

  14. Recognition of fibrous dysplasia of bone mimicking skeletal metastasis on 18F-FDG PET/CT imaging

    Fibrous dysplasia of bone (FDB) reveals intense 18F-FDG uptake mimicking metastases on 18F-FDG PET/CT. We reviewed sites of FDB revealed by 18F-FDG PET/CT imaging to allow identification of this abnormality. Eleven patients (7 male, 4 female, aged 16-78 years) were evaluated after 55 MBq (0.15 mCi)/kg 18F-FDG utilizing a 16-slice multiple detector CT (MDCT) whole-body PET scanner, with LOR algorithm 3D reconstruction. One- and 2-h imaging was performed in 9 patients. Standard uptake value (SUV) for each lesion, on early and delayed imaging, was calculated. Lesions were confirmed in 6 patients by biopsy. The PET images correlated with MDCT to establish the imaging characteristics. Solitary lesions were found in 4 patients, two lesions in 1 patient, and in 6 patients there were multiple bone lesions. The SUVearly ranged from 1.23 to 9.64 with an average of 3.76 ± 2.40. The SUVdelayed ranged from 1.76 to 11.42 with an average of 4.51 ± 3.07. The SUVdelayed decreased or increased slightly (-31% to 5%) in 6 of our patients, and increased significantly (11% to 39%) in 3. There was a negative correlation between SUVs and age, as well as the number of affected bones. In our study, FDB had wide skeletal distribution with variability of 18F-FDG uptake and CT appearance. SUV in the delayed stage was seen to either decrease or increase on dual-time 18F-FDG PET scanning. It is very important to recognize the characteristics of this skeletal dysplasia to allow differentiation from skeletal metastasis. (orig.)

  15. Kinetic analysis of experimental rabbit tumour and inflammation model with 18F-FDG PET/CT

    Non-specific accumulation of 18F-FDG by both tumour and inflammatory lesions can make diagnostic analysis difficult. Our aim was to explore the difference in 18F-FDG uptake kinetics between tumour and inflammatory cells. To this end, we investigated VX2 tumour lesions and inflammatory lesions in rabbits. Methods: Six rabbits with VX2 tumour cells transplanted into one forelimb muscle and inflammatory lesions induced by turpentine oil in the contralateral forelimb were scanned for 60 minutes post 18F-FDG injection. Imaging data was analyzed with the standard 2-tissue-compartment model. Parameters, VB, Ki, K1, k2, k3, k4, were compared between tumour and inflammatory lesions. SUV and dual time scan methods were also compared in the experiment. Results: Time activity curves of VX2 tumour lesions showed a characteristic pattern of gradually increasing 18F-FDG uptake up to 60 min, whereas, 18F-FDG uptake in inflammatory lesions increased more slowly than in tumours. Parameters estimated from the uptake process showed that forward transport constant, K1, and influx constant, Ki, values in VX2 tumour lesions (0.186 ± 0.053 and 0.048 ± 0.014, respectively) was significantly higher than that in inflammatory lesions (0.129 ± 0.024 and 0.022 ± 0.007, respectively) (p 18F-FDG injection were also significantly higher in the VX2 tumor lesions than in the inflammatory lesions. Retention index (RI) was not significantly different between VX2 tumours and inflammatory lesions (1.134 ± 0.076 vs. 1.060 ± 0.058, p > 0.05). Conclusion: Different kinetic parameters (Ki, K1, k3) exist between inflammatory and tumour lesions. (orig.)

  16. Comprehensive evaluation of occupational radiation exposure to intraoperative and perioperative personnel from 18F-FDG radioguided surgical procedures

    The purpose of the current study was to comprehensively evaluate occupational radiation exposure to all intraoperative and perioperative personnel involved in radioguided surgical procedures utilizing 18F-fluorodeoxyglucose (18F-FDG). Radiation exposure to surgeon, anesthetist, scrub technologist, circulating nurse, preoperative nurse, and postoperative nurse, using aluminum oxide dosimeters read by optically stimulated luminescence technology, was evaluated during ten actual radioguided surgical procedures involving administration of 18F-FDG. Mean patient dosage of 18F-FDG was 699 ± 181 MBq (range 451-984). Mean time from 18F-FDG injection to initial exposure of personnel to the patient was shortest for the preoperative nurse (75 ± 63 min, range 0-182) followed by the circulating nurse, anesthetist, scrub technologist, surgeon, and postoperative nurse. Mean total time of exposure of the personnel to the patient was longest for the anesthetist (250 ± 128 min, range 69-492) followed by the circulating nurse, scrub technologist, surgeon, postoperative nurse, and preoperative nurse. Largest deep dose equivalent per case was received by the surgeon (164 ± 135 μSv, range 10-580) followed by the anesthetist, scrub technologist, postoperative nurse, circulating nurse, and preoperative nurse. Largest deep dose equivalent per hour of exposure was received by the preoperative nurse (83 ± 134 μSv/h, range 0-400) followed by the surgeon, anesthetist, postoperative nurse, scrub technologist, and circulating nurse. On a per case basis, occupational radiation exposure to intraoperative and perioperative personnel involved in 18F-FDG radioguided surgical procedures is relatively small. Development of guidelines for monitoring occupational radiation exposure in 18F-FDG cases will provide reassurance and afford a safe work environment for such personnel. (orig.)

  17. Recognition of fibrous dysplasia of bone mimicking skeletal metastasis on 18F-FDG PET/CT imaging

    Su, Ming Gang; Tian, Rong; Fan, Qiu Ping; Tian, Ye; Li, Fang Lan; Li, Lin; Kuang, An Ren [Sichuan University School of Medicine, National Key Discipline of Medical Imaging and Nuclear Medicine, Department of Nuclear Medicine, West China Hospital, Chengdu, Sichuan (China); Miller, John Howard [Loma Linda University School of Medicine, Division of Pediatric Radiology, Department of Radiology, Loma Linda, CA (United States)

    2011-03-15

    Fibrous dysplasia of bone (FDB) reveals intense 18F-FDG uptake mimicking metastases on 18F-FDG PET/CT. We reviewed sites of FDB revealed by 18F-FDG PET/CT imaging to allow identification of this abnormality. Eleven patients (7 male, 4 female, aged 16-78 years) were evaluated after 55 MBq (0.15 mCi)/kg 18F-FDG utilizing a 16-slice multiple detector CT (MDCT) whole-body PET scanner, with LOR algorithm 3D reconstruction. One- and 2-h imaging was performed in 9 patients. Standard uptake value (SUV) for each lesion, on early and delayed imaging, was calculated. Lesions were confirmed in 6 patients by biopsy. The PET images correlated with MDCT to establish the imaging characteristics. Solitary lesions were found in 4 patients, two lesions in 1 patient, and in 6 patients there were multiple bone lesions. The SUV{sub early} ranged from 1.23 to 9.64 with an average of 3.76 {+-} 2.40. The SUV{sub delayed} ranged from 1.76 to 11.42 with an average of 4.51 {+-} 3.07. The SUV{sub delayed} decreased or increased slightly (-31% to 5%) in 6 of our patients, and increased significantly (11% to 39%) in 3. There was a negative correlation between SUVs and age, as well as the number of affected bones. In our study, FDB had wide skeletal distribution with variability of 18F-FDG uptake and CT appearance. SUV in the delayed stage was seen to either decrease or increase on dual-time 18F-FDG PET scanning. It is very important to recognize the characteristics of this skeletal dysplasia to allow differentiation from skeletal metastasis. (orig.)

  18. 18F-FDG-PET/CT in staging, restaging, and treatment response assessment of male breast cancer

    Purpose: Male breast cancer (BC) is a rare disease, with patterns different from those found in women. Most tumors are detected at more advanced stages than in women. The aim of this study was to analyze the performance of [18F]fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in staging, restaging, and therapy response assessment. Methods: We performed a systematic analysis in the database of Saint-Louis Hospital to identify male patients with BC referred for PET/CT. 18F-FDG-PET/CT findings considered suspicious for malignancy were compared to biopsy results, further work-up and/or patient follow-up of at least 6 months. Performances of 18F-FDG-PET/CT were compared to that of conventional imaging (CI) using the McNemar test. The impact of PET/CT on management was evaluated. Results: During 6 consecutive years, among 12,692 18F-FDG-PET/CT oncology studies, 30 were performed in 15 men with BC: 7 examinations for initial staging, 11 for restaging, and 12 for response assessment. Tumors profile was ER+ and one had HER2 overexpression. PET/CT sensitivity, specificity, positive predictive value, negative predictive value and accuracy to detect distant metastases were 100%, 67%, 86%, 100% and 89%, respectively. PET/CT was more informative than CI in 40% of studies (p = 0.03; 95% confidence interval: 3.26 – 40%). Findings from 18F-FDG-PET/CT led to modification in the planned treatment in 13/30 cases (43%). Conclusion: Although all the tumors were ER+, primary lesions and metastases were diagnosed with high sensitivity. 18F-FDG-PET/CT seems to be a powerful imaging method to perform staging, restaging and treatment response assessment in male patients with BC

  19. Experimental study of the molecular mechanisms of myocardial ischemic memory with 18F-FDG PET/CT imaging

    This study was aimed to explore whether the changes of mRNA and the existence and duration of ischemic 18F-FDG uptake correlate with the extent of myocardial ischemia in ischemia-reperfusion canine model. The 20-minute (n= 4) and 40-minute (n=4) coronary artery occlusion followed by 24 h of open-artery reperfusion in canine model were per- formed. All dogs underwent fasting (>12 h) dynamic 18F-FDG PET/CT and 99Tcm-MIBI SPECT imaging at baseline, 1 h and 24 h after reperfusion. When all imaging were completed, myocardial samples from the ischemic and nonischemic region were obtained, and the mRNA expression of glucose transporter-l (GLUT-1), glucose transporter-4 (GLUT-4), and heart-fatty acid binding protein (H-FABP) were estimated by Real Time PCR. There was no difference in the ratio of hypoperfused region/nomoperfused region of 18F-FDG up- take between the 20-minute group and 40-minute group at baseline. When examined at 1 h, increased 18F-FDG uptake was observed in the 40-minute group. When estimated at 24 h, only the 40-minute group showed slightly higher 18F-FDG uptake than baseline, whereas no such difference was demonstrated in the 20-minute group. Similar mRNA expression of GLUT-1, GLUT-4 and H-FABP were demonstrated in the nonischemic regions between the 2 groups, whereas increased expressions of GLUT-1 and GLUT-4, and decreased H-FABP mRNA were demonstrated in the ischemic regions. The changes of mRNA expression were more obvious in the 40 minute group than in the 20-minute group. The results showed that the existence and persistent period of ischemic 18F-FDG uptake (ischemic memory) was correlated with the extent of myocardial ischemia. (authors)

  20. {sup 18F} FDG Uptake of Human Testis on PET/CT: Correlation with Age, Sex Hormones, and Vasectomy

    Moon, Seung Hwan; Eo, Jae Sun; Lee, Jong Jin; Chung, June Key; Lee, Dong Soo; Lee, Myung Chul [Seoul National Univ. Hospital, Seoul (Korea, Republic of)

    2011-12-15

    The purpose of this study was to evaluate glucose metabolism of normal human testis on {sup 18F} FDG PET/CT and to assess possible correlation among age, the serum levels of sex hormones, and vasectomy. {sup 18F} FDG PET/CT was performed in 66 normal healthy men (50.8{+-}13.6 years, range 22-81), and mean standard uptake values (SUV) of {sup 18F} FDG in testis and adductor muscle were measured. Testis muscle SUV ratios (T/M ratios) were calculated. Serum levels of total testosterone, free testosterone, estradiol, and of sex hormone binding globulin (SHBG) were measured. We searched for correlations between T/M ratios and age and the serum concentrations of sex hormones. {sup 18F} FDG PET/CT was also performed in 32 vasectomized men (55.7{+-}7.8 years, range 38-71) and 52 nonvasectomized men (55.4{+-}11.6 years, range 37-72). Mean SUVs of testis and adductor muscle were measured, and T/M ratios were calculated. A significant age related decline was found in T/M ratio (r=-0.509, p<0.0001). Serum levels of total testosterone and free testosterone were also found to be positively correlated with T/M ratio (r=-0.427, p=0.0003; r=0.435, p=0.0003, respectively). The mean SUV and T/M ratio of vasectomized men were significantly lower than those of nonvasectomized men (p<0.0378 and p=0.0001, respectively). Glucose metabolism in the testis in an adult population was found to be correlated with age, serum sex hormone level, and vasectomy history. These results indicate that testicular {sup 18F} FDG uptake may have attributed to testicular function and testicular histology. Our findings may have important implications for the interpretation of testicular {sup 18F} FDG uptake in the normal adult population.

  1. Usefulness of dynamic 18F-FDG PET scan in lung cancer and inflammation disease

    The diagnostic utility of fluorine-18 2-deoxy-D-glucose positron emission tomography (18F-FDG PET) for the non-invasive differentiation of focal lung lesions originated from cancer or inflammation disease by combined visual image interpretation and semi-quantitative uptake value analysis has been documented. In general, Standardized Uptake Value (SUV) is used to diagnose lung disease. But SUV dose not contain dynamic information of lung tissue for the glucose. Therefore, this study was undertaken to hypothesis that analysis of dynamic kinetics of focal lung lesions base on 18F-FDG PET may more accurately determine the lung disease. So we compared Time Activity Curve (TAC), Standardized Uptake Value-Dynamic Curve (SUV-DC) graph pattern with Glucose Metabolic Rate (MRGlu) from Patlak analysis. With lung disease, 17 patients were examined. They were injected with 18F-FDG over 30-s into peripheral vein while acquisition of the serial transaxial tomographic images were started. For acquisition protocol, we used twelve 10-s, four 30-s, sixteen 60-s, five 300-s and one 900-s frame for 60 mins. Its images were analyzed by visual interpretation TAC, SUV-DC and a kinetic analysis (Patlak analysis). The latter was based on region of interest (ROIs) which were drawn with the lung disease shape. Each optimized patterns were compared with itself. In TAC patterns, it hard to observe cancer type with inflammation disease in early pool blood area but over the time cancer type slope more remarkably increased than inflammation disease. SUV-DC was similar to TAC pattern. In the result of Patlak analysis, In time activity curve of aorta, even though inflammation disease showed higher blood activity than cancer, at first as time went by, blood activity of inflammation disease became the lowest. However, in time activity curve of tissue, cancer had the highest uptake and inflammation disease was in the middle. Through the examination, TAC and SUV-DC could approached the results that lung

  2. {sup 18}F-FDG PET/CT impact on testicular tumours clinical management

    Ambrosini, Valentina; Nicolini, Silvia; Nanni, Cristina; Allegri, Vincenzo; Fanti, Stefano [S.Orsola-Malpighi University Hospital, Nuclear Medicine, Bologna (Italy); Zucchini, Giorgia; Berselli, Annalisa; Martoni, Andrea; Cricca, Antonia [S.Orsola-Malpighi University Hospital, Oncology, Bologna (Italy); Domenico, Rubello [S.Maria della Misericordia Hospital, Nuclear Medicine, Rovigo (Italy)

    2014-04-15

    Testicular tumour is the most common malignancy in young men. The diagnostic work-up is mainly based on morphological imaging. The aim of our study was to evaluate the clinical impact of {sup 18}F-FDG PET/CT in patients with testicular tumour. We retrospectively evaluated all patients studied by {sup 18}F-FDG PET/CT at our centre. Inclusion criteria were: pathological confirmation of testicular tumour, contrast-enhanced CT scan performed within a month of the PET/CT scan, and clinical/imaging follow-up performed at the Oncology Unit of our hospital. Overall, 56 patients were enrolled and 121 PET/CT scans were evaluated. {sup 18}F-FDG PET/CT was performed following standard procedures and the results were compared with clinical, imaging and follow-up data. Clinicians were contacted to enquire whether the PET/CT scan influenced the patient's management. Answers were scored as follows: start/continue chemotherapy or radiotherapy, indication for surgery of secondary lesions, and clinical surveillance. On a scan basis, 51 seminoma and 70 nonseminoma (NS) cases were reviewed. Of the 121 cases. 32 were found to be true-positive, 74 true-negative, 8 false-positive and 6 false-negative by PET/CT. PET/CT showed good sensitivity and specificity for seminoma lesion detection (92 % and 84 %, respectively), but its sensitivity was lower for NS forms (sensitivity and specificity 77 % and 95 %, respectively). The PET/CT scan influenced the clinical management of 47 of 51 seminomas (in 6 chemotherapy was started/continued, in 3 radiotherapy was started/continued, in 2 surgery of secondary lesions was performed, and in 36 clinical surveillance was considered appropriate), and 59 of 70 NS (in 18 therapy/surgery was started/continued, and in 41 clinical surveillance was considered appropriate). Our preliminary data demonstrate the potential usefulness of PET/CT for the assessment of patients with testicular tumour. It provides valuable information for the clinical management

  3. The diagnostic value of 18F-FDG PET and MRI in paediatric histiocytosis

    To analyse the diagnostic value of 18F-FDG PET and MRI for the evaluation of active lesions in paediatric Langerhans cell histiocytosis. We compared 21 18F-FDG PET scans with 21 MRI scans (mean time interval 17 days) in 15 patients (11 male, 4 female, age range 4 months to 19 years) with biopsy-proven histiocytosis. Primary criteria for the lesion-based analysis were signs of vital histiocyte infiltrates (bone marrow oedema and contrast enhancement for MRI; SUV greater than the mean SUV of the right liver lobe for PET). PET and MR images were analysed separately and side-by-side. The results were validated by biopsy or follow-up scans after more than 6 months. Of 53 lesions evaluated, 13 were confirmed by histology and 40 on follow-up investigations. The sensitivity and specificity of PET were 67 % and 76 % and of MRI were 81 % and 47 %, respectively. MRI showed seven false-positive bone lesions after successful chemotherapy. PET showed five false-negative small bone lesions, one false-negative lesion of the skull and three false-negative findings for intracerebral involvement. PET showed one false-positive lesion in the lymphoid tissue of the head and neck region and two false-positive bone lesions after treatment. Combined PET/MR analysis decreased the number of false-negative findings on primary staging, whereas no advantage over PET alone was seen in terms of false-positive or false-negative results on follow-up. Our retrospective analysis suggests a pivotal role of 18F-FDG PET in lesion follow-up due to a lower number of false-positive findings after chemotherapy. MRI showed a higher sensitivity and is indispensable for primary staging, evaluation of brain involvement and biopsy planning. Combined MRI/PET analysis improved sensitivity by decreasing the false-negative rate during primary staging indicating a future role of simultaneous whole-body PET/MRI for primary investigation of paediatric histiocytosis. (orig.)

  4. 18F-FDG PET/CT impact on testicular tumours clinical management

    Testicular tumour is the most common malignancy in young men. The diagnostic work-up is mainly based on morphological imaging. The aim of our study was to evaluate the clinical impact of 18F-FDG PET/CT in patients with testicular tumour. We retrospectively evaluated all patients studied by 18F-FDG PET/CT at our centre. Inclusion criteria were: pathological confirmation of testicular tumour, contrast-enhanced CT scan performed within a month of the PET/CT scan, and clinical/imaging follow-up performed at the Oncology Unit of our hospital. Overall, 56 patients were enrolled and 121 PET/CT scans were evaluated. 18F-FDG PET/CT was performed following standard procedures and the results were compared with clinical, imaging and follow-up data. Clinicians were contacted to enquire whether the PET/CT scan influenced the patient's management. Answers were scored as follows: start/continue chemotherapy or radiotherapy, indication for surgery of secondary lesions, and clinical surveillance. On a scan basis, 51 seminoma and 70 nonseminoma (NS) cases were reviewed. Of the 121 cases. 32 were found to be true-positive, 74 true-negative, 8 false-positive and 6 false-negative by PET/CT. PET/CT showed good sensitivity and specificity for seminoma lesion detection (92 % and 84 %, respectively), but its sensitivity was lower for NS forms (sensitivity and specificity 77 % and 95 %, respectively). The PET/CT scan influenced the clinical management of 47 of 51 seminomas (in 6 chemotherapy was started/continued, in 3 radiotherapy was started/continued, in 2 surgery of secondary lesions was performed, and in 36 clinical surveillance was considered appropriate), and 59 of 70 NS (in 18 therapy/surgery was started/continued, and in 41 clinical surveillance was considered appropriate). Our preliminary data demonstrate the potential usefulness of PET/CT for the assessment of patients with testicular tumour. It provides valuable information for the clinical management, particularly for clinical

  5. The diagnostic value of {sup 18}F-FDG PET and MRI in paediatric histiocytosis

    Mueller, Wolfgang Peter; Melzer, Henriette Ingrid; Bartenstein, Peter; Pfluger, Thomas [Ludwig-Maximilians-University of Munich, Department of Nuclear Medicine, Munich (Germany); Schmid, Irene [Ludwig-Maximilians-University of Munich, Department of Paediatric Oncology, Munich (Germany); Coppenrath, Eva [Ludwig-Maximilians-University of Munich, Department of Radiology, Munich (Germany)

    2013-03-15

    To analyse the diagnostic value of {sup 18}F-FDG PET and MRI for the evaluation of active lesions in paediatric Langerhans cell histiocytosis. We compared 21 {sup 18}F-FDG PET scans with 21 MRI scans (mean time interval 17 days) in 15 patients (11 male, 4 female, age range 4 months to 19 years) with biopsy-proven histiocytosis. Primary criteria for the lesion-based analysis were signs of vital histiocyte infiltrates (bone marrow oedema and contrast enhancement for MRI; SUV greater than the mean SUV of the right liver lobe for PET). PET and MR images were analysed separately and side-by-side. The results were validated by biopsy or follow-up scans after more than 6 months. Of 53 lesions evaluated, 13 were confirmed by histology and 40 on follow-up investigations. The sensitivity and specificity of PET were 67 % and 76 % and of MRI were 81 % and 47 %, respectively. MRI showed seven false-positive bone lesions after successful chemotherapy. PET showed five false-negative small bone lesions, one false-negative lesion of the skull and three false-negative findings for intracerebral involvement. PET showed one false-positive lesion in the lymphoid tissue of the head and neck region and two false-positive bone lesions after treatment. Combined PET/MR analysis decreased the number of false-negative findings on primary staging, whereas no advantage over PET alone was seen in terms of false-positive or false-negative results on follow-up. Our retrospective analysis suggests a pivotal role of {sup 18}F-FDG PET in lesion follow-up due to a lower number of false-positive findings after chemotherapy. MRI showed a higher sensitivity and is indispensable for primary staging, evaluation of brain involvement and biopsy planning. Combined MRI/PET analysis improved sensitivity by decreasing the false-negative rate during primary staging indicating a future role of simultaneous whole-body PET/MRI for primary investigation of paediatric histiocytosis. (orig.)

  6. Association between {sup 18}F-FDG uptake and molecular subtype of breast cancer

    Kitajima, Kazuhiro; Fukushima, Kazuhito; Igarashi, Yoko; Katsuura, Takayuki; Maruyama, Kaoru [Hyogo College of Medicine, Department of Nuclear Medicine and PET center, Nishinomiya, Hyogo (Japan); Miyoshi, Yasuo; Nishimukai, Arisa [Hyogo College of Medicine, Department of Breast and Endocrine Surgery, Nishinomiya, Hyogo (Japan); Hirota, Seiichi [Hyogo College of Medicine, Department of Surgical Pathology, Nishinomiya, Hyogo (Japan); Hirota, Shozo [Hyogo College of Medicine, Department of Radiology, Nishinomiya, Hyogo (Japan)

    2015-08-15

    To determine whether {sup 18}F-FDG uptake in breast cancer correlates with immunohistochemically defined subtype and is able to predict molecular subtypes. This retrospective study involved 306 patients with 308 mass-type invasive breast cancers (mean size 2.65 cm, range 1.0-15.0 cm) who underwent {sup 18}F-FDG PET/CT before therapy. The correlations between primary tumour {sup 18}F-FDG uptake on PET/CT, expressed as SUVmax, and clinicopathological findings and molecular subtype, i.e. luminal A, luminal B (HER2-negative), luminal B (HER2-positive), HER2-positive and triple-negative, were analysed. The predictors of these subtypes were investigated. The mean SUVmax of the 308 tumours was 5.33 ± 3.63 (range 1.15-19.01). Among the subtypes of the 308 tumours, 87 (28.2 %) were luminal A, 111 (36.0 %) were luminal B (HER2-negative), 31 (10.1 %) were luminal B (HER2-positive), 26 (8.4 %) were HER2-positive and 53 (17.2 %) were triple-negative, and the corresponding mean SUVmax were 3.41 ± 2.07 (range 1.18-14.30), 5.17 ± 3.52 (range 1.35-19.01), 6.57 ± 3.84 (range 1.42-15.58), 7.55 ± 3.63 (range 2.30-13.60) and 6.97 ± 4.17 (range 1.15-16.06), respectively. A cut-off value of 3.60 yielded 70.1 % sensitivity and 66.1 % specificity with an area under the receiver operating characteristics curve (AUC) of 0.734 for predicting that a tumour was of the luminal A subtype. A cut-off value of 6.75 yielded 65.4 % sensitivity and 75.2 % specificity with an AUC of 0.704 for predicting a HER2-positive subtype. SUVmax, a metabolic semiquantitative parameter, shows a significant correlation with the molecular subtype of breast cancer, and is useful for predicting the luminal A or HER2-positive subtype. (orig.)

  7. Diagnostic value of 18F-FDG PET/CT in detection of single spinal metastasis

    Objective: To evaluate the efficacies and advantages of 18F-FDG PET/CT in detection of single spinal metastasis. Methods: A total of 67 patients (41 males, 26 females, with age range of 40-83 years,mean (61.5 ± 10.2) years) with history of primary cancer and suspected single spinal metastasis by CT and/or MRI were enrolled into this retrospective study. All patients underwent 18F-FDG PET/CT. The final diagnosis was confirmed by pathological results or follow-up (≥6 months). The efficacies of PET/CT imaging in detection of single spinal metastasis were compared with PET, CT and MRI. χ2 test was used to analyze data. Results: The sensitivity,specificity,positive predictive value, negative predictive value and accuracy for PET/CT imaging were 96.3% (52/54), 84.6% (11/13), 96.3 % (52/54), 84.6% (11/13) and 94.0% (63/67), respectively. The sensitivity,negative predictive value and accuracy of PET/CT imaging were better than those of PET (81.5 % (44/54), 44.4% (8/18), 77.6% (52/67); χ2=6.000, 5.134, 7.421, all P<0.05) or CT (79.6% (43/54), 38.9% (7/18), 74.6% (50/67) ; χ2=7.083, 6.482, 9.543, all P<0.05), and the specificity of PET/CT was also higher than that of CT(53.8% (7/13); χ2=4.248, P<0.05). The accuracy of PET/CT imaging was higher than that of MRI (80.6% (54/67); χ2=5.457, P<0.05). Conclusion: 18F-FDG PET/CT imaging has high efficacies and advantages in detection of single spinal metastasis, and it could be considered as a useful diagnostic method when MRI imaging findings are equivocal. (authors)

  8. Analysis of 18F-FDG maximum standardized uptake value in gastric cancer with coincidence imaging

    Objective: To investigate the value of 18F-FDG SUVmax in gastric cancer diagnosis with coincidence imaging. Methods: The coincidence imaging was performed in 92 patients with gastric diseases (60 males, 32 females,age 65 (32-85) years; 78 malignant cases, 14 benign cases). The malignant cases included 3 remnant gastric cancers and 75 primary gastric cancers (staging: 4 of Tis, 13 of T1, 9 of T2, 33 of T3, 11 of T4 and 5 without surgery). The well-, moderately-and poorly-differentiated adenocarcinomas were 22, 15 and 28, respectively. Images were analyzed retrospectively with visual method and 18F-FDG SUVmax, and the diagnostic results were compared with the histopathological findings. The ROC curve was used to analyze the SUVmax. The Pearson's correlation analysis was performed to evaluate the relationship between SUVmax and tumor size. The Wilcoxon rank sum test was applied to determine the difference of SUVmax between early and advanced gastric cancers. The Kruskal-Wallis test was used to analyze the difference of SUVmax in various types of differentiated adenocarcinoma. Results: No matter visual method or SUVmax was used, the sensitivity, specificity and accuracy of coincidence imaging in diagnosis of gastric cancer were 64.1% (50/78), 64.3% (9/14) and 64.1% (59/92), respectively. The AUC of SUVmax was 0.695 and the cut-off value was 0.700. SUVmax Was positively correlated with tumor size significantly (r=0.489, P<0.001). There was statistically significant difference between SUVmax of Tis-1 and that of T2-4 (0.676± 1.288 vs 3.851 ±3.764; Z=-3.754, P<0.001). However, there was no statistically significant difference among SUVmax of various grades of differentiated adenocarcinoma(2.805±4.008, 3.447±2.365, 3.413± 3.737; χ2=2.459, P> 0.05). Conclusions: SUVmax provides more information than visual method in assessing gastric cancer with 18F-FDG coincidence imaging. Appropriate cut-off value of SUV is necessary for improvement of the diagnostic efficiency

  9. Epimerization study on [18F]FDG produced by an alkaline hydrolysis on solid support under stringent conditions

    Mosdzianowski, C.; Lemaire, Christian; Simoens, F.; Aerts, Joël; Morelle, J. L.; Luxen, André

    2002-01-01

    Since 1998, routine [18F]FDG syntheses are being carried out by alkaline hydrolysis on a solid support, i.e. the labeled intermediate is trapped on a tC18 solid phase extraction cartridge, purified and finally hydrolyzed within the cartridge, at room temperature, using sodium hydroxide. The present study demonstrated that no epimerization of [18F]FDG to [18F]FDM occurs even when 12 N NaOH is used and when the hydrolysis time is extended up to 1 h. The alkaline hydrolysis on solid support appe...

  10. Multiple primary malignant tumors of upper gastrointestinal tract:A novel role of ~(18)F-FDG PET/CT

    2010-01-01

    AIM: To evaluate the capacity of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for detecting multiple primary cancer of upper gastrointestinal (UGI) tract. METHODS: Fifteen patients (12 without cancer histories and 3 with histories of upper GI tract cancer) were investigated due to the suspicion of primary cancer of UGI tract on X-ray barium meal and CT scan. Subsequent whole body 18F-FDG PET/CT scan was carried out for initial staging or restaging. All the patient...

  11. Quantifying murine bone marrow and blood radiation dose response following {sup 18}F-FDG PET with DNA damage biomarkers

    Manning, Grainne [Biological Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire OX11 ORQ (United Kingdom); Taylor, Kristina [Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, ON (Canada); Finnon, Paul [Biological Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire OX11 ORQ (United Kingdom); Lemon, Jennifer A.; Boreham, Douglas R. [Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, ON (Canada); Badie, Christophe, E-mail: christophe.badie@phe.gov.uk [Biological Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire OX11 ORQ (United Kingdom)

    2014-12-15

    Highlights: • Mice received either a range of {sup 18}F-FDG activities or whole body X-ray doses. • Blood samples were collected at 24 and 43 h for MN-RET and QPCR analysis. • Regression analysis showed that both types of exposure produced a linear response. • BM doses of 33 mGy ({sup 18}F-FDG) and 25 mGy X-rays were significantly higher than controls. • No significant difference between internal ({sup 18}F-FDG) and external (X-ray) was found. - Abstract: The purpose of this study was to quantify the poorly understood radiation doses to murine bone marrow and blood from whole-body fluorine 18 ({sup 18}F)-fluorodeoxyglucose (FDG) positron emission tomography (PET), by using specific biomarkers and comparing with whole body external low dose exposures. Groups of 3–5 mice were randomly assigned to 10 groups, each receiving either a different activity of {sup 18}F-FDG: 0–37 MBq or whole body irradiated with corresponding doses of 0–300 mGy X-rays. Blood samples were collected at 24 h and at 43 h for reticulocyte micronucleus assays and QPCR analysis of gene expression in peripheral blood leukocytes. Blood and bone marrow dose estimates were calculated from injected activities of {sup 18}F-FDG and were based on a recommended ICRP model. Doses to the bone marrow corresponding to 33.43 mGy and above for internal {sup 18}F-FDG exposure and to 25 mGy and above for external X-ray exposure, showed significant increases in radiation-induced MN-RET formation relative to controls (P < 0.05). Regression analysis showed that both types of exposure produced a linear response with linear regression analysis giving R{sup 2} of 0.992 and 0.999 for respectively internal and external exposure. No significant difference between the two data sets was found with a P-value of 0.493. In vivo gene expression dose–responses at 24 h for Bbc3 and Cdkn1 were similar for {sup 18}F-FDG and X-ray exposures, with significant modifications occurring for doses over 300 mGy for Bbc3

  12. Imaging of lung metastasis tumor mouse model using [{sup 18}F]FDG small animal PET and CT

    Kim, June Youp; Woo, Sang Keun; Lee, Tae Sup [Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul (Korea, Republic of)] (and others)

    2007-02-15

    The purpose of this study is to image metastaic lung melanoma model with optimal pre-conditions for animal handling by using [{sup 18}F]FDG small animal PET and clinical CT. The pre-conditions for lung region tumor imaging were 16-22 h fasting and warming temperature at 30 .deg. C. Small animal PET image was obtained at 60 min postinjection of 7.4 MBq [{sup 18}F]FDG and compared pattern of [{sup 18}F]FDG uptake and glucose standard uptake value (SUVG) of lung region between Ketamine/Xylazine (Ke/Xy) and Isoflurane (Iso) anesthetized group in normal mice. Metastasis tumor mouse model to lung was established by intravenous injection of B16-F10 cells in C57BL/6 mice. In lung metastasis tumor model, [{sup 18}F]FDG image was obtained and fused with anatomical clinical CT image. Average blood glucose concentration in normal mice were 128.0 {+-} 22.87 and 86.0 {+-} 21.65 mg/dL in Ke/Xy group and Iso group, respectively. Ke/Xy group showed 1.5 fold higher blood glucose concentration than Iso group. Lung to Background ratio (L/B) in SUVG image was 8.6 {+-} 0.48 and 12.1 {+-}0.63 in Ke/Xy group and Iso group, respectively. In tumor detection in lung region, [{sup 18}F]FDG image of Iso group was better than that of Ke/Xy group, because of high L/B ratio. Metastatic tumor location in [{sup 18}F]FDG small animal PET image was confirmed by fusion image using clinical CT. Tumor imaging in small animal lung region with [{sup 18}F]FDG small animal PET should be considered pre-conditions which fasting, warming and an anesthesia during [{sup 18}F]FDG uptake. Fused imaging with small animal PET and CT image could be useful for the detection of metastatic tumor in lung region.

  13. The Role of 18F-FDG-Positron Emission Tomography/Computed Tomography in Staging Primary Breast Cancer

    Naoki Niikura, Naoto T. Ueno

    2010-01-01

    Full Text Available Despite Medicare approving the use of positron emission tomography/computed tomography (PET/CT in staging primary breast cancer, little evidence is available to support the use of 18F-FDG-PET/CT for the detection of distant metastases in the initial staging of breast cancer. In this review of the literature listed in MEDLINE, we examine whether 18F-FDG-PET/CT may play a role in the initial staging of breast cancer. We discuss studies comparing PET/CT with conventional imaging for diagnosing distant metastases and axillary and extra-axillary lymph node metastases.

  14. {sup 18}F-FDG uptake on PET in primary mediastinal non-thymic neoplasm: A clinicopathological study

    Kaira, Kyoichi, E-mail: kkaira1970@yahoo.co.jp [Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Abe, Masato [Division of Pathology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Nakagawa, Kazuo; Ohde, Yasuhisa; Okumura, Takehiro [Division of Thoracic Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Takahashi, Toshiaki; Murakami, Haruyasu; Shukuya, Takehito; Kenmotsu, Hirotsugu; Naito, Tateaki [Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Hayashi, Isamu [Division of Pathology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Oriuchi, Noboru [Department of Diagnostic Radiology and Nuclear medicine, Gunma University Graduate School of Medicine, Showa-machi, Maebashi 371-8511, Gunma (Japan); Endo, Masahiro [Division of Diagnostic Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Kondo, Haruhiko [Division of Thoracic Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Nakajima, Takashi [Division of Pathology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Yamamoto, Nobuyuki [Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan)

    2012-09-15

    Background: The usefulness of 2-[{sup 18}F]-fluoro-2-deoxy-D-glucose ({sup 18}F-FDG) positron emission tomography (PET) has been investigated in thymic epithelial tumors. However, little is known about PET imaging of {sup 18}F-FDG in primary non-thymic mediastinal neoplasms. The aim of this study is to explore the clinicopathological significance of {sup 18}F-FDG PET in primary mediastinal (non-thymic) neoplasms. Methods: Twenty-one patients with mediastinal neoplasms who underwent {sup 18}F-FDG PET before treatment were included in this study. Tumor sections were stained by immunohistochemistry for glucose transporter 1 (Glut1); glucose transporter 3 (Glut3); hypoxia-inducible factor-1 alpha (HIF-1α); hexokinase I; vascular endothelial growth factor (VEGF); microvessels (CD34); epidermal growth factor receptor (EGFR); Akt/mTOR signaling pathway (p-Akt and p-mTOR); cell cycle control (p53). Results: Seventeen of 21 patients were imaged on PET system using {sup 18}F-FDG, but 4 patients with a histology of cyst showed nothing abnormal in PET scans. The histology of the resected tumors was as follows: 6 schwannoma, 3 teratoma, 4 cyst, 3 sarcoma, 1 undifferentiated carcinoma, 1 seminoma, 1 mediastinal goiter, 1 ganglioneuroma, and 1 Hodgkin lymphoma. {sup 18}F-FDG uptake was significantly correlated with Glut1, HIF-1α, EGFR, p-Akt and p-S6K. These biomarkers were highly expressed in schwannoma, teratoma and high grade malignancies, whereas all patients with cyst and ganglioneuroma had no positive expression of these biomarkers. High uptake of {sup 18}F-FDG was significant associated with Glut1, VEGF, EGFR, p-Akt, p-S6K and tumor maximal size. Conclusion: The amount of {sup 18}F-FDG uptake in primary mediastinal non-thymic neoplasms is determined by the presence of glucose metabolism (Glut1), hypoxia (HIF-1α) and upstream components of HIF-1α (EGFR, p-Akt and p-S6K)

  15. Impact of 18F-FDG PET/CT on target volume delineation in recurrent or residual gynaecologic carcinoma

    Vees, Hansjoerg; Casanova, Nathalie; Zilli, Thomas; Imperiano, Hestia; Ratib, Osman; Popowski, Youri; Wang, Hui; Zaidi, Habib; Miralbell, Raymond

    2012-01-01

    Background To evaluate the impact of 18F-FDG PET/CT on target volume delineation in gynaecological cancer. Methods F-FDG PET/CT based RT treatment planning was performed in 10 patients with locally recurrent (n = 5) or post-surgical residual gynaecological cancer (n = 5). The gross tumor volume (GTV) was defined by 4 experienced radiation oncologists first using contrast enhanced CT (GTVCT) and secondly using the fused 18F-FDG PET/CT datasets (GTVPET/CT). In addition, the GTV was delineated u...

  16. Basic principles and applications of 18F-FDG-PET/CT in oral and maxillofacial imaging: A pictorial essay

    A combination of positron emission tomography (PET) with 18F-labeled fluoro-2-deoxyglucose (18F-FDG) and computed tomography (18F-FDG-PET/CT) has increasingly become a widely used imaging modality for the diagnosis and management of head and neck cancer. On the basis of both recent literature and our professional experience, we present a set of principles with pictorial illustrations and clinical applications of FDG-PET/CT in the evaluation and management planning of squamous cell carcinoma of the oral cavity and oropharynx. We feel that this paper will be of interest and will aid the learning of oral and maxillofacial radiology trainees and practitioners.

  17. Quantifying murine bone marrow and blood radiation dose response following 18F-FDG PET with DNA damage biomarkers

    Highlights: • Mice received either a range of 18F-FDG activities or whole body X-ray doses. • Blood samples were collected at 24 and 43 h for MN-RET and QPCR analysis. • Regression analysis showed that both types of exposure produced a linear response. • BM doses of 33 mGy (18F-FDG) and 25 mGy X-rays were significantly higher than controls. • No significant difference between internal (18F-FDG) and external (X-ray) was found. - Abstract: The purpose of this study was to quantify the poorly understood radiation doses to murine bone marrow and blood from whole-body fluorine 18 (18F)-fluorodeoxyglucose (FDG) positron emission tomography (PET), by using specific biomarkers and comparing with whole body external low dose exposures. Groups of 3–5 mice were randomly assigned to 10 groups, each receiving either a different activity of 18F-FDG: 0–37 MBq or whole body irradiated with corresponding doses of 0–300 mGy X-rays. Blood samples were collected at 24 h and at 43 h for reticulocyte micronucleus assays and QPCR analysis of gene expression in peripheral blood leukocytes. Blood and bone marrow dose estimates were calculated from injected activities of 18F-FDG and were based on a recommended ICRP model. Doses to the bone marrow corresponding to 33.43 mGy and above for internal 18F-FDG exposure and to 25 mGy and above for external X-ray exposure, showed significant increases in radiation-induced MN-RET formation relative to controls (P < 0.05). Regression analysis showed that both types of exposure produced a linear response with linear regression analysis giving R2 of 0.992 and 0.999 for respectively internal and external exposure. No significant difference between the two data sets was found with a P-value of 0.493. In vivo gene expression dose–responses at 24 h for Bbc3 and Cdkn1 were similar for 18F-FDG and X-ray exposures, with significant modifications occurring for doses over 300 mGy for Bbc3 and at the lower dose of 150 mGy for Cdkn1a. Both

  18. Comparison of 18F-FDG PET/CT and PET/MRI in patients with multiple myeloma

    Sachpekidis, Christos; Hillengass, Jens; Goldschmidt, Hartmut; Mosebach, Jennifer; Pan, Leyun; Schlemmer, Heinz-Peter; Haberkorn, Uwe; Dimitrakopoulou-Strauss, Antonia

    2015-01-01

    PET/MRI represents a promising hybrid imaging modality with several potential clinical applications. Although PET/MRI seems highly attractive in the diagnostic approach of multiple myeloma (MM), its role has not yet been evaluated. The aims of this prospective study are to evaluate the feasibility of 18F-FDG PET/MRI in detection of MM lesions, and to investigate the reproducibility of bone marrow lesions detection and quantitative data of 18F-FDG uptake between the functional (PET) component ...

  19. Administered activities of 18F-FDG PET clinics in pediatrics patients in Brazil- preliminary study

    A survey was conducted among the Brazilian clinical PET, with the purpose of investigating the activities administered to pediatric oncology patients and assess whether significant differences between the protocols adopted. In addition, this survey can cooperate to the suggestion diagnostic reference levels (DRLs) in nuclear medicine. Although the methodology for delivering doses by most clinics be based on patient's weight, the results showed variations of up to 191, 6% between the activities administered in clinics, even for similar devices. The average value of the distribution of activities reported was 4.46 ± 1,6 MBq /kg. These data demonstrate the need for harmonization and optimization of 18F-FDG/PET procedures, as well as training for professionals involved in the clinical routine

  20. The radiochemistry of [18 F]-FDG: the first experience in Mexico

    The present work describes the more used method for the synthesis of 2 - [18 F] - fluorine-2-deoxy-D-glucose that is the more used radiopharmaceutical in the nuclear medicine in the cancer diagnostic. The process consists on two chemical reactions: i) [18 F-] - nucleophilic radio fluorination and i i) a hydrolysis catalyzed by acid. The first reaction incorporates to the [18 F]- fluorine labelled inside the organic precursor 1,3,4,6-tetra- O -acetil-2- O-trifluoromethanesulfonyl- β-D-mannopyranose (triflate of mannose). The mechanism of this reaction is a bimolecular nucleophilic substitution (SN2) with the ion [18 F-] - fluoride; in the second reaction, the hydrolysis of those protective acetyl groups generate the hydroxyl groups free of the [18 F]-FDG. The process includes an azeotropic distillation and several purification steps. (Author)

  1. 18F-FDG SPECT myocardial imaging of right ventricle in patients with idiopathic pulmonary hypertension

    Objective: To investigate the value of 18F-FDG SPECT myocardial imaging in evaluating haemodynamic change, treatment outcome and prognosis for idiopathic pulmonary arterial hypertension (IPAH). Methods: All 24 patients with IPAH underwent 18F-FDG SPECT myocardial imaging. Right ventricle/left ventricle (RV/LV)-FDG uptake was calculated by ROI method drawing over the central areas of left and right ventricular free walls. All patients underwent right heart catheterization within 3 days after imaging studies. Mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) were recorded. After six month pharmaceutical treatment, 15 IPAH patients were re-examined with 18F-FDG SPECT myocardial imaging followed by repeated right heart catheterization within 3 days. Plasma N-terminal pro-brain naturetic peptide (NT-proBNP) and endothelin-1 (ET-1) were measured in 17 patients using electrochemiluminescent immunoassay and enzyme immunoassay respectively. All patients were followed up for 12 months at least. Correlations between RV/LV-FDG uptake and mPAP and PVR were determined by simple linear regression analysis. Change of RV/LV-FDG before and after treatment was calculated using Student's t-test. Survival in groups with RV/LV FDG uptake ≥ 1.15 and RV/LV-FDG uptake<1.15 were compared using Log-rank test. Results: Significant correlations were found between RV/LV-FDG uptake and mPAP (r=0.562, P<0.01), and between RV/LV-FDG uptake and PVR (r=0.574, P<0.01). There were no significant correlation between RV/LV-FDG uptake and NT-proBNP (r=0.181, P>0.05), but a significant correlation between RV/LV-FDG and ET-1 was observed (r=0.669, P<0.01). The RV/LV-FDG uptake in patients with positive treatment outcome (n=6) decreased from 1.38 ± 0.52 to 0.92 ±0.26 (t=4.018, P<0.05) after 6 months treatment. In contrast, no significant change of RV/LV-FDG uptake was seen in those patients (n=9) with negative treatment outcome (t=1.861, P>0.05). The mean follow-up time

  2. 18F-FDG-avid sites mimicking active disease in pediatric Hodgkin's

    About 1,700 children in the United States are diagnosed yearly with lymphomas; Hodgkin's disease accounts for approximately half of these cases, or 6% of all childhood cancers. Contemporary therapy allows for the achievement of remission in the majority of cases. The fusion of positron emission tomography (PET) with CT provides the most accurate imaging method for disease characterization and treatment response. However, experience with 18F-FDG PET-CT is limited in pediatric Hodgkin's disease. Numerous non-oncologic processes can mimic recurrent or residual tumor. This pictorial addresses mimickers of disease such as uptake in normal structures, infections, transforming germinal canters and effects of therapy on normal tissues. It is essential for radiologists to be familiar with these findings in order to stage disease activity and therapeutic response accurately. (orig.)

  3. A multi-run chemistry module for the production of [18F]FDG

    We have developed a new chemistry module for the production of up to four batches of [18F]FDG. Prior to starting a batch sequence, the module automatically performs a series of self-diagnostic tests, including a reagent detection sequence. The module then executes a user-defined production sequence followed by an automated process to rinse tubing, valves, and the reaction vessel prior to the next production sequence. Process feedback from the module is provided to a graphical user interface by mass flow controllers, radiation detectors, a pressure switch, a pressure transducer, and an IR temperature sensor. This paper will describe the module, the operating system, and the results of multi-site trials, including production data and quality control results

  4. Double-phase 18F-FDG PET-CT for determination of pulmonary tuberculoma activity

    The aim of this study is to evaluate the potential role of double phase acquisition of 18F fluorodeoxyglucose (FDG) positron emission tomography (PET) for the differentiation of active pulmonary tuberculoma. A total of 25 consecutive patients with pulmonary tuberculoma were enrolled. PET/CT imaging was performed 60 (range 53-71) and 120 min (range 109-131) after injection of 18F-FDG. The intensity of 18F-FDG uptake by pulmonary lesions was assessed visually, and the intensity was scored with a four-point scale (grade 1: absent, grade 2: faint, grade 3: moderate, grade 4: intense). Active tuberculoma shows statistically significant higher values in maximal standardized uptake values SUVmaxE (active = 2.3 ± 0.75, inactive 0.79 ± 0.15), SUVmaxD (active = 2.48 ± 0.79, inactive = 0.75 ± 0.13), and %ΔSUVmax (active = 8.07 ± 7.77%, inactive = -3.83 ± 6.59) than those of inactive tuberculoma. When greater than or equal to visual grade 2 was used as the cutoff value, the sensitivity and specificity were 100 and 81.8%. When SUVmaxE 1.05 was used as the cutoff point, the sensitivity and specificity were 100 and 100%. When SUVmaxD 0.97 was used as the cutoff value, the sensitivity and specificity were 92.8 and 100%. When %ΔSUVmax 6.59 was used as the cutoff value, the sensitivity and specificity were 71.4 and 100%. The %ΔSUVmax was the potent predictor by logistic regression analysis. The ΔSUVmax is a potential predictor for activity of pulmonary tuberculoma. However, the diagnostic performances were similar between visual and quantitative analyses. The visual assessment may be sufficient for determination of pulmonary tuberculoma activity. Further studies are needed to confirm these results and improve statistical accuracy. (orig.)

  5. Metabolic Pattern of Asymptomatic Hip-Prosthesis by 18F-FDG-Positron-Emission-Tomography

    Joint replacement is a procedure with a major impact on the quality of life of patients with joint degenerative disease or traumatic injuries. However, some patients develop symptoms after the intervention caused by mechanical loosening or infection. Metabolic imaging by 18F-FDG-PET investigated in these patients isoften hampered by low specificity for diagnosis of possible septic vs. mechanical loosening. The reason for this shortcoming is to our opinion the unawareness of physiological remodeling processes that could be seen in asymptomatic patients. In order to overcome this drawback, we aimed to find out the physiological metabolic functional pattern in asymptomatic patients with implanted hip prosthesis Twelve patients (6 males, 6 females); mean age 73 ± 7 (range 58 - 91) years were prospectively enrolled in the study. The patients were admitted to our department for oncological referral with implanted hip prostheses. All patients explained no symptoms with regard to their implanted prosthesis. The attenuation corrected images were used for analysis. Fourteen hip prostheses in 12 patients were visually analyzed. Seven out of 14 prostheses among 12 patients showed focal periprosthetic enhanced metabolism, two of which showed two sites of enhanced uptake; whereas, the remaining five prostheses showed singular hypermetabolic areas within the periprosthetic site. The remaining seven prostheses in the other five patients showed no periprosthetic-enhanced uptake. Of the asymptomatic patients investigated, 58% showed focal enhanced periprosthetic glucose metabolism. This finding should be taken into consideration as a more probable unspecific metabolic pattern for correct interpretation of 18F-FDG-PET studies in patients with suspected septic loosening of the hip prosthesis

  6. Improved quality control of [18F]FDG by HPLC with UV detection.

    Nakao, Ryuji; Ito, Takehito; Yamaguchi, Masatoshi; Suzuki, Kazutoshi

    2005-11-01

    A conventional high-performance liquid chromatographic (HPLC) method for the analysis of 2-fluoro-2-deoxy-d-glucose (FDG) and 2-deoxy-2-chloro-d-glucose (ClDG) in [18F]FDG preparations is described. This method was based on a postcolumn derivatization with 2-cyanoacetamide (2-CA) and UV detection. FDG and ClDG were separated on a normal-phase column using acetonitrile/water as the mobile phase. The eluate was mixed with 2-CA in sodium borate buffer solution at the outlet of a PTFE coil (10 m x 0.5 mm id) from the column, and the reaction was carried out at 100 degrees C during the passage through the coil. The UV absorbance of the resultant product was monitored at 276 nm. Under optimum conditions, the detection limits [signal-to-noise (S/N) ratio=3] for FDG and ClDG were 0.31 and 0.17 microg/ml for a 20-microl injection volume, respectively, and the linearity ranges were 0.5-100 microg/ml for both compounds. The intra- and interday reproducibilities were better than 2.2% [relative standard deviation (R.S.D.)]. This HPLC separation procedure is also useful for determining the radiochemical purity of [18F]FDG preparations since it allows the analysis of 2-[18F]fluoro-1,3,4,6-tetra-O-acetyl-d-glucose ([18F]TAG), partially hydrolyzed [18F]TAG and [18F]F-. This method can be used at many positron emission tomography (PET) facilities since it does not require an expensive, sophisticated electrochemical detector. PMID:16253817

  7. Predicting future morphological changes of lesions from radiotracer uptake in 18F-FDG-PET images.

    Bagci, Ulas; Yao, Jianhua; Miller-Jaster, Kirsten; Chen, Xinjian; Mollura, Daniel J

    2013-01-01

    We introduce a novel computational framework to enable automated identification of texture and shape features of lesions on (18)F-FDG-PET images through a graph-based image segmentation method. The proposed framework predicts future morphological changes of lesions with high accuracy. The presented methodology has several benefits over conventional qualitative and semi-quantitative methods, due to its fully quantitative nature and high accuracy in each step of (i) detection, (ii) segmentation, and (iii) feature extraction. To evaluate our proposed computational framework, thirty patients received 2 (18)F-FDG-PET scans (60 scans total), at two different time points. Metastatic papillary renal cell carcinoma, cerebellar hemongioblastoma, non-small cell lung cancer, neurofibroma, lymphomatoid granulomatosis, lung neoplasm, neuroendocrine tumor, soft tissue thoracic mass, nonnecrotizing granulomatous inflammation, renal cell carcinoma with papillary and cystic features, diffuse large B-cell lymphoma, metastatic alveolar soft part sarcoma, and small cell lung cancer were included in this analysis. The radiotracer accumulation in patients' scans was automatically detected and segmented by the proposed segmentation algorithm. Delineated regions were used to extract shape and textural features, with the proposed adaptive feature extraction framework, as well as standardized uptake values (SUV) of uptake regions, to conduct a broad quantitative analysis. Evaluation of segmentation results indicates that our proposed segmentation algorithm has a mean dice similarity coefficient of 85.75 ± 1.75%. We found that 28 of 68 extracted imaging features were correlated well with SUV(max) (p<0.05), and some of the textural features (such as entropy and maximum probability) were superior in predicting morphological changes of radiotracer uptake regions longitudinally, compared to single intensity feature such as SUV(max). We also found that integrating textural features with SUV

  8. {sup 18}F-FDG uptake in breast cancer correlates with immunohistochemically defined subtypes

    Koo, Hye Ryoung [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Hanyang University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Park, Jeong Seon [Hanyang University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Kang, Keon Wook [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Cho, Nariya; Chang, Jung Min; Bae, Min Sun; Kim, Won Hwa; Lee, Su Hyun; Seo, Mirinae; Moon, Woo Kyung [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Kim, Mi Young [Konkuk University Medical Center, Department of Radiology, Seoul (Korea, Republic of); Kim, Jin You [Pusan National University Hospital, Department of Radiology, Pusan (Korea, Republic of)

    2014-03-15

    To determine whether a correlation exists between maximum standardized uptake value (SUV{sub max}) on {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) and the subtypes of breast cancer. This retrospective study involved 548 patients (mean age 51.6 years, range 21-81 years) with 552 index breast cancers (mean size 2.57 cm, range 1.0-14.5 cm). The correlation between {sup 18}F-FDG uptake in PET/CT, expressed as SUV{sub max}, and immunohistochemically defined subtypes (luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) positive and triple negative) was analyzed. The mean SUV{sub max} value of the 552 tumours was 6.07 ± 4.63 (range 0.9-32.8). The subtypes of the 552 tumours were 334 (60 %) luminal A, 66 (12 %) luminal B, 60 (11 %) HER2 positive and 92 (17 %) triple negative, for which the mean SUV{sub max} values were 4.69 ± 3.45, 6.51 ± 4.18, 7.44 ± 4.73 and 9.83 ± 6.03, respectively. In a multivariate regression analysis, triple-negative and HER2-positive tumours had 1.67-fold (P < 0.001) and 1.27-fold (P = 0.009) higher SUV{sub max} values, respectively, than luminal A tumours after adjustment for invasive tumour size, lymph node involvement status and histologic grade. FDG uptake was independently associated with subtypes of invasive breast cancer. Triple-negative and HER2-positive breast cancers showed higher SUV{sub max} values than luminal A tumours. circle {sup 18} F-FDG PET demonstrates increased tissue glucose metabolism, a hallmark of cancers. (orig.)

  9. The preliminary study of 18F-FDG brain PET in diagnosis of alzheimer's disease

    Objective: To investigate the imaging characteristics and diagnostic criteria of 18F-FDG brain PET in diagnosis of Alzheimer's disease (AD). Methods: The sutdy included 12 normal subjects, 12 patients with AD and 11 patients with non-AD dementia. 40 min after intravenous administration of 18F-FDG, brain scan was performed using Siemens ECAT47 scanner. The transaxial, coronal and sagittal images were then reconstructed by computer. At the same time, semiquantitative analysis was also applied to help evaluation using the ratio of mean radioactivity of cerebral lobe to cerebellum (Rcl/cb). Results: In normal subjects PET scan showed clear images of cerebral cortex, basal ganglia, thalamus and cerebellum with symmetrical distribution of radioactivity. PET images from Alzheimer's disease patients were classified into 3 patterns: bilateral parietal hypometabolism in 5 cases, bilateral temporo-parietal hypometabolism in 4 cases and unilateral temporo-parietal hypometabolism in 3 cases. The Rcl/cb of AD patients in parietal and temporal lobe was significantly decreased than normal subjects (Pcl/cb was also reflecting thedementia degree. Compared with MRI imaging , 12 patients with AD had cerebral hypometabolism but only 10 had hippocampus atrophy. 10 patients with non-AD dementia had local structural foci seen in MRI, including old hemorrhage, infarction and encephalomalacia, but these lesions were not found in AD. Conclusions: Based on excluding cerebral structural lesions which are better detected by MRI, bilateral or unilateral parietal or temporo-parietal hypometabolism found in FDG PET can be considered indicative of Alzheimer's disease. Semiquantitative analysis of the images yielded can help to evaluate the dementia degree

  10. Accuracy of [18F]FDG PET/MRI for the Detection of Liver Metastases.

    Karsten Beiderwellen

    Full Text Available The aim of this study was to compare the diagnostic accuracy of [18F]FDG-PET/MRI with PET/CT for the detection of liver metastases.32 patients with solid malignancies underwent [18F]FDG-PET/CT and subsequent PET/MRI of the liver. Two readers assessed both datasets regarding lesion characterization (benign, indeterminate, malignant, conspicuity and diagnostic confidence. An imaging follow-up (mean interval: 185±92 days and/-or histopathological specimen served as standards of reference. Sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV were calculated for both modalities. Accuracy was determined by calculating the area under the receiver operating characteristic (ROC curve. Values of conspicuity and diagnostic confidence were compared using Wilcoxon-signed-rank test.The standard of reference revealed 113 liver lesions in 26 patients (malignant: n = 45; benign: n = 68. For PET/MRI a higher accuracy (PET/CT: 82.4%; PET/MRI: 96.1%; p<0.001 as well as sensitivity (67.8% vs. 92.2%, p<0.01 and NPV (82.0% vs. 95.1%, p<0.05 were observed. PET/MRI offered higher lesion conspicuity (PET/CT: 2.0±1.1 [median: 2; range 0-3]; PET/MRI: 2.8±0.5 [median: 3; range 0-3]; p<0.001 and diagnostic confidence (PET/CT: 2.0±0.8 [median: 2; range: 1-3]; PET/MRI 2.6±0.6 [median: 3; range: 1-3]; p<0.001. Furthermore, PET/MRI enabled the detection of additional PET-negative metastases (reader 1: 10; reader 2: 12.PET/MRI offers higher diagnostic accuracy compared to PET/CT for the detection of liver metastases.

  11. The value of 18F-FDG PET/CT in the assessment of active idiopathic retroperitoneal fibrosis

    The different stages in idiopathic retroperitoneal fibrosis (IRF) are generally assessed by assay of inflammatory markers and analysis of contrast-enhanced CT images of the retroperitoneal mass. We investigated the potential role of 18F-FDG PET/CT in this clinical setting. 18F-FDG uptake was assessed visually and semiquantitatively (using maximum standardized uptake values, SUVmax) in images of the abdominal mass in 22 patients prospectively enrolled from June 2008 to December 2010 who underwent a total of 33 PET/CT studies. The accuracy in discriminating active from inactive disease was calculated assuming as reference a biochemical instrumental evaluation of patients with IRF mostly based on the level of inflammatory indices and contrast enhancement (CE) of the mass at the time of each PET study. In particular, the relationship between SUVmax and CE, the latter calculated from the change in radiodensity (Hounsfield units) between the basal and postcontrast venous portal phases, was evaluated on a three-point scale (0 18F-FDG uptake, and CE score. A significant correlation (p 18F-FDG PET/CT may be considered an alternative imaging method for the assessment of different stages of IRF. (orig.)

  12. The value of 18F-FDG PET/CT in the diagnosis of secondary malignant peripheral nerve lesion

    Objective: To investigate the characteristics and diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT in patients with secondary malignant peripheral nerve lesions. Methods: 18F-FDG PET/CT studies of 8 cases of secondary malignant peripheral nerve lesions confirmed by histopathology or follow-up were analyzed retrospectively. The maximum standardized uptake value (SUVmax) of infiltrating peripheral nerves and contralateral normal peripheral nerves was measured and compared with their morphological appearances on CT. Paired student t-test was performed by SPSS 10.0. Results: Twelve secondary malignant peripheral nerve lesions with high 18F-FDG metabolism were found in 8 cases. On PET imaging, the lesions distributed along the neurovascular tissues or intervertebral foramina with appearances resembling those of fibre bundles, radices or nodes on PET but no density differences with the surrounding soft tissue or fat planes on CT. The SUVmax was 6.86 ± 3.87. The contralateral normal peripheral nerves showed no abnormal 18F-FDG uptake with a SUVmax of 1.10 ±0.46, which was significantly different from that of the secondary malignant peripheral nerve lesions (t = 9.231, P18F-FDG PET/CT may be useful in locating the secondary malignant peripheral nerve lesions and in assessing its regional infiltration. (authors)

  13. Conversion of arterial input functions for dual pharmacokinetic modeling using Gd-DTPA/MRI and 18F-FDG/PET.

    Poulin, Eric; Lebel, Réjean; Croteau, Etienne; Blanchette, Marie; Tremblay, Luc; Lecomte, Roger; Bentourkia, M'hamed; Lepage, Martin

    2013-03-01

    Reaching the full potential of magnetic resonance imaging (MRI)-positron emission tomography (PET) dual modality systems requires new methodologies in quantitative image analyses. In this study, methods are proposed to convert an arterial input function (AIF) derived from gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA) in MRI, into a (18)F-fluorodeoxyglucose ((18)F-FDG) AIF in PET, and vice versa. The AIFs from both modalities were obtained from manual blood sampling in a F98-Fisher glioblastoma rat model. They were well fitted by a convolution of a rectangular function with a biexponential clearance function. The parameters of the biexponential AIF model were found statistically different between MRI and PET. Pharmacokinetic MRI parameters such as the volume transfer constant (K(trans)), the extravascular-extracellular volume fraction (ν(e)), and the blood volume fraction (ν(p)) calculated with the Gd-DTPA AIF and the Gd-DTPA AIF converted from (18)F-FDG AIF normalized with or without blood sample were not statistically different. Similarly, the tumor metabolic rates of glucose (TMRGlc) calculated with (18) F-FDG AIF and with (18) F-FDG AIF obtained from Gd-DTPA AIF were also found not statistically different. In conclusion, only one accurate AIF would be needed for dual MRI-PET pharmacokinetic modeling in small animal models. PMID:22570280

  14. The value of 18F-FDG PET/CT in diagnosing brain metastases from unknown primary tumor

    Objective: To investigate the value of 18F-FDG PET/CT in diagnosis of brain metastases from unknown primary tumor. Method: The 18F-FDG PET/CT findings of 17 patients with brain metastases from unknown primary tumor were retrospectively analyzed. Results: Primary tumors of the seventeen cases were confirmed by biopsy, the accuracy rate was 100%. There were thirteen cases with primary lung cancer, accounted for 76%, including two cases of lung cancer which were found in the second PET/CT examination,two cases with liver cancer, accounted for 12%, one case with cardia cancer, accounted for 6%, one case with the ascending colon cancer,accounted for 6%. On the base of founding the primary tumor, 18F-FDG PET/CT also found 10 cases accompanied by lung metastasis (2 cases), lymph node metastases (3 cases), bone metastases (2 cases)and other sites of metastases (3 cases), a total of 61 lesions were detected. Two cases of liver cancer patients with single brain metastases had cerebral apoplexy. Conclusion: 18F-FDG PET/CT contributes important value in finding brain metastases from unknown primary tumor,and is very helpful for clinical staging and treatment. (authors)

  15. Diagnostic value of 18F-FDG PET/CT in trauma patients with suspected chronic osteomyelitis

    To retrospectively evaluate the diagnostic value of 18F-FDG PET/CT in trauma patients with suspected chronic osteomyelitis. Thirty-three partial body 18F-FDG PET/CT scans were performed in 33 patients with trauma suspected of having chronic osteomyelitis. In 10 and 23 patients, infection was suspected in the axial and appendicular skeleton, respectively. In 18 patients, PET/CT was performed in the presence of metallic implants. Histopathology or bacteriological culture was used as the standard of reference. For statistical analysis, sensitivity, specificity and accuracy were calculated in relation to findings of the reference standard. Of 33 PET/CT scans, 17 were true positive, 13 true negative, two false positive and one false negative. Eighteen patients had chronic osteomyelitis and 15 had no osseous infection according to the reference standard. Sensitivity, specificity and accuracy for 18F-FDG PET/CT was 94%, 87% and 91% for the whole group, 88%, 100% and 90% for the axial skeleton and 100%, 85% and 91% for the appendicular skeleton, respectively. 18F-FDG PET/CT is a highly sensitive and specific method for the evaluation of chronic infection in the axial and appendicular skeleton in patients with trauma. PET/CT allows precise anatomical localisation and characterisation of the infectious focus and demonstrates the extent of chronic osteomyelitis with a high degree of accuracy. (orig.)

  16. Significance of 18F-FDG PET/CT imaging in the evaluation of the efficacy of lymphoma

    CHEN Chengcheng; WANG Zhengguang; CHENG Nan

    2014-01-01

    To evaluate the 18F-labeled deoxyglucose (18F-FDG) PET/CT imaging in the evaluation of the efficacy of ly-mphoma significance.Methods:42 cases of our hospital patients with malignant lymphoma for 2-5 times 18F-FDG PET/CT imaging results in the treatment process, and the treatment process simple CT results were compared and analyzed, the final results were confirmed by pathology and clinical. Results:The lesions were found in153,including 141 malignant, benign 12, sensitivity, specificity, and accuracy evaluating of lymphoma treatment effect of 18F-FDG PET/CT were, 99.30%, 91.67%, 98.70%, were significantly better than CT examination (P18F-FDG PET/CT in the evaluation of ly-mphoma treatment was superior to CT scan purely, it is an effective means of monitoring the efficacy of lymphoma, it can provide the basis for effective treatment programs in clinical work.

  17. The value of 18F-FDG SPECT-CT in detecting recurrence or metastasis of cervical cancer

    Objective: To evaluate the value of 18F-fluorodeoxyglucose (18F-FDG) SPECT-CT in detecting recurrence and (or) metastasis of cervical cancer. Methods: Retrospective analysis of 62 patients who underwent 18F-FDG SPECT-CT to evaluate recurrence and/or metastasis of cervical cancer at Fujian Tumor Hospital. The diagnostic results were confirmed by second surgery, biopsy or clinical follow-up, and also compared with the coincidence images obtained by CT scan and the serum squamous cell carcinoma related antigen (SCCA) levels. Results: It is confirmed that 36 of 62 patients had recurrence and (or) metastasis of cervical cancer by biopsy or clinical follow-up. The sensitivity, specificity, positivity predictive value (PPV), negative predictive value (NPV), and accuracy of 18F-FDG SPECT-CT were 94.4%, 92.3%, 94.4%, 92.3% and 93.5%. Those of CT scan were 69.4%, 80.8%, 83.3%, 65.6% and 74.2%. Those of SCCA measurement were 66.7%, 46.2%, 63.2%, 50.0% and 58.1%. Conclusion: 18F-FDG SPECT-CT has greater clinical value to monitor recurrence and (or) metastasis of cervical cancer. (authors)

  18. 18F-FDG Uptake Rate Is a Biomarker of Eosinophilic Inflammation and Airway Response in Asthma

    Harris, R. Scott; Venegas, José G.; Wongviriyawong, Chanikarn; Winkler, Tilo; Kone, Mamary; Musch, Guido; Vidal Melo, Marcos F.; De Prost, Nicolas; Daniel L Hamilos; Afshar, Roshi; Cho, Josalyn; Luster, Andrew D.; Medoff, Benjamin D.

    2011-01-01

    In asthma, the relationship among airway inflammation, airway hyperresponsiveness, and lung function is poorly understood. Methods to noninvasively assess these relationships in human subjects are needed. We sought to determine whether 18F-FDG uptake rate (Ki, min−1) could serve as a biomarker of eosinophilic inflammation and local lung function.

  19. The diagnostic value of [18F]FDG PET for the detection of chronic osteomyelitis and implant-associated infection

    The diagnosis of osteomyelitis and implant-associated infections in patients with nonspecific laboratory or radiological findings is often unsatisfactory. We retrospectively evaluated the contributions of [18F]FDG PET and [18F]FDG PET/CT to the diagnosis of osteomyelitis and implant-associated infections, enabling timely and appropriate decision-making for further therapy options. [18F]FDG PET or PET/CT was performed in 215 patients with suspected osteomyelitis or implant-associated infections between 2000 and 2013. We assessed the diagnostic accuracy of both modalities together and separately with reference to intraoperative microbial findings, with a mean clinical follow-up of 69 ± 49 months. Infections were diagnosed clinically in 101 of the 215 patients. PET and PET/CT scans revealed 87 true-positive, 76 true-negative, 38 false-positive, and 14 false-negative results, indicating a sensitivity of 86 %, a specificity of 67 %, a positive predictive value (PPV) of 70 %, a negative predictive value (NPV) of 84 % and an accuracy of 76 %. The sensitivity of PET/CT was 88 %, but specificity, PPV, NPV and accuracy (76 %, 76 %, 89 % and 82 %, respectively) were higher than those of stand-alone PET. [18F]FDG PET is able to identify with high sensitivity the presence of osteomyelitis in orthopaedic surgery patients with nonspecific clinical symptoms of infection. (orig.)

  20. Rebound Thymic Hyperplasia Detected by 18F-FDG PET/CT After Radioactive Iodine Ablation Therapy for Thyroid Cancer

    Jeon, Tae Joo; Lee, Yong Sang; Lee, Jae-Hoon; Chang, Hang Seok; Ryu, Young Hoon

    2014-01-01

    Background: Rebound thymic hyperplasia (RTHP) is not an uncommon finding after radiation or chemotherapy in patients with various malignancies. However, there are limited case reports of this phenomenon after radioactive iodine ablation therapy (RIAT) in differentiated thyroid cancer (DTC). The goal of this study was to evaluate the incidence, patterns, and factors affecting RTHP after RIAT using 18F-FDG PET/CT.

  1. Comparison of tumor volumes derived from glucose metabolic rate maps and SUV maps in dynamic 18F-FDG PET.

    Visser, E.P.; Philippens, M.E.P.; Kienhorst, L.; Kaanders, J.H.A.M.; Corstens, F.H.M.; Geus-Oei, L.F. de; Oyen, W.J.G.

    2008-01-01

    Tumor delineation using noninvasive medical imaging modalities is important to determine the target volume in radiation treatment planning and to evaluate treatment response. It is expected that combined use of CT and functional information from 18F-FDG PET will improve tumor delineation. However, u

  2. 18F-NaF Positive Bone Metastases of Non 18F-FDG Avid Mucinous Gastric Cancer

    Çiğdem Soydal; Elgin Özkan; Özlem Nuriye Küçük

    2015-01-01

    Detection of gastric cancer bone metastasis is crucial since its presence is an independent prognostic factor. In this case report, we would like to present 18F-NaF positive bone metastases of non 18F-FDG avid gastric mucinous cancer.

  3. 18F-FDG PET/CT in detection of sarcomatous degeneration of renal angiomyolipoma in setting of tuberous sclerosis

    Angiomyolipomas (AMLs) of kidneys are one of the common extracranial manifestations of tuberous sclerosis (TSC). AMLs when large may cause life-threatening hemorrhage, but seldom undergo malignant degeneration. We describe the appearance of renal AML degenerated to angiosarcoma on 18F-flruorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and contrast-enhanced CT (CECT)

  4. Metastatic melanoma causing small bowel intussusception: diagnosis by {sup 1}8F-FDG PET/CT

    Souza, Frederico Ferreira de; Johnston, Ciaran [Harvard Medical School, Boston, MA (United States). Brigham and Women' s Hospital. Dana Farber Cancer Institute], e-mail: ffsouza@partners.org; Souza, Felipe Ferreira de; Souza, Daniel Andrade Tinoco de [Harvard Medical School, Boston, MA, (United States). Brigham and Women' s Hospital

    2009-09-15

    Malignant melanoma is a common and aggressive disease that frequently causes metastases to the small bowel. This study illustrates a case of small bowel intussusception secondary to metastatic melanoma visualized at {sup 1}8F-FDG PET/CT in a 48-year-old woman who had this examination for restaging purposes. (author)

  5. The value of 18F-FDG PET/CT imaging in diagnosing and prognosticating Malignant Pleural Mesothelioma

    In order to evaluate the importance of 18F-FDG PET/CT imaging in diagnosing and prognosticating Malignant Pleural Mesothelioma (MPM), The clinical 18F-FDG PET/CT images of nineteen patients, treated in this hospital from October, 2006 to March, 2010, were reviewed. The patients' plasma carcinoembryonic antigen (CEA) was measured, and the maximum standardized uptake value (SUVmax) was determined from the most active pleural lesion in each patient, MPM was histologically confirmed in 17 patients while 2 patients were diagnosed to have benign pleural diseases. The coincidence rate of PET/CT was 89%. Significant differences in SUVmax were found between patients with MPM (11.88±5.39) and those with benign pleural lesions (4.1±0.85) (P=0.0058, P 18F-FDG PET/CT is an sensitive technique for diagnosing malignant pleural mesothelioma and the SUVmax is correlated histologically with clinical grades, update types and CEA levels. Poor prognosis was observed for the following cases: non- epithelial sub- type; Grad Ⅳ, encasing updated group, and the group with CEA ≥ 5 μg/L. In summary, 18F-FDG PET/CT should play important roles in diagnosing and prognosticating malignant pleural mesothelioma. (authors)

  6. Simultaneous hyperpolarized 13C-pyruvate MRI and 18F-FDG-PET in cancer (hyperPET)

    Gutte, Henrik; Hansen, Adam E.; Henriksen, Sarah T.;

    2015-01-01

    In this paper we demonstrate, for the first time, the feasibility of a new imaging concept - combined hyperpolarized 13C-pyruvate magnetic resonance spectroscopic imaging (MRSI) and 18F-FDG-PET imaging. This procedure was performed in a clinical PET/MRI scanner with a canine cancer patient. We ha...

  7. Evolving role of 18F-FDG-PET/CT for the body tumor and metastases in pediatrics

    18F-FDG-positron emission tomography-computerized tomography (18F-FDG-PET/CT) scan is an important imaging tool which may provide both functional and anatomical information in a single diagnostic test. It has the potential to be a valuable tool in the noninvasive evaluation and monitoring of pediatric tumors including the metastases because 18fluorodeoxyglucose (18F-FDG) is a glucose analogue that concentrates in areas of active metabolic activity. This review provides an update on functional and metabolic imaging approaches for assessment and management of the body tumor and metastases in pediatrics using a combined whole body 18F-FDG-PET/CT scanners. We discuss the benefits include improved pediatric patients' outcome facilitated by staging and monitoring of disease and better treatment planning. It is worth to concern the preparation of children undergoing PET studies and radiation dosimetry and its implications for family and caregivers. It is important to consider the normal distribution of 18FDG in children, common variations of the normal distribution. We show some of our cases that most tumors in children accumulate and retain FDG, allowing high-quality images of their distribution and pathophysiology either at the primary site as well as in the areas of metastatic disease.

  8. Evolving role of {sup 18}F-FDG-PET/CT for the body tumor and metastases in pediatrics

    Chen Zhengguang, E-mail: guangchen1@gmail.co [Department of Radiology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, No. 5 Hai Yun Cang Beijing 100700 (China); Li Xiaozhen, E-mail: lixiaozhen79@gmail.co [Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shui Fu Yuan, Wang Fu Jing Da Jie, Beijing 100730 (China); Li Fang, E-mail: lifang@gmail.co [Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shui Fu Yuan, Wang Fu Jing Da Jie, Beijing 100730 (China); Ouyang Qiaohong [Department of Nuclear Medicine, First Affiliated Hospital, PLA General Hospital, Beijing 100853 (China); Yu Tong [Imaging Center, Beijing Children' s Hospital Affiliated to Capital Medical University. 56, Nanlishi Road, Xicheng District, Beijing 100045 (China)

    2010-09-15

    {sup 18}F-FDG-positron emission tomography-computerized tomography ({sup 18}F-FDG-PET/CT) scan is an important imaging tool which may provide both functional and anatomical information in a single diagnostic test. It has the potential to be a valuable tool in the noninvasive evaluation and monitoring of pediatric tumors including the metastases because {sup 18}fluorodeoxyglucose ({sup 18}F-FDG) is a glucose analogue that concentrates in areas of active metabolic activity. This review provides an update on functional and metabolic imaging approaches for assessment and management of the body tumor and metastases in pediatrics using a combined whole body {sup 18}F-FDG-PET/CT scanners. We discuss the benefits include improved pediatric patients' outcome facilitated by staging and monitoring of disease and better treatment planning. It is worth to concern the preparation of children undergoing PET studies and radiation dosimetry and its implications for family and caregivers. It is important to consider the normal distribution of {sup 18}FDG in children, common variations of the normal distribution. We show some of our cases that most tumors in children accumulate and retain FDG, allowing high-quality images of their distribution and pathophysiology either at the primary site as well as in the areas of metastatic disease.

  9. Early Tumor Response to Hsp90 Therapy Using HER2 PET: Comparison with 18F-FDG PET

    Smith-Jones, Peter M.; Solit, David; Afroze, Farzana; Rosen, Neal; Larson, Steven M.

    2006-01-01

    We compared 68Ga-DOTA-F(ab′)2-herceptin (DOTA is 1,4,7,10-tetraazacyclododecane-N,N′,N″,N‴-tetraacetic acid [HER2 PET]) and 18F-FDG PET for imaging of tumor response to the heat shock protein 90 (Hsp90) inhibitor 17-allylamino-17-demethoxygeldanamycin (17AAG).

  10. Histopathological Analysis of High {sup 18}F-FDG Uptake in Meniscoid Ulcer of Colon Carcinoma: Report of A Case

    Bahk, Yong Whee [Sung Ae Hospital, Seoul (Korea, Republic of); Jang, Ja June [Seoul National University School of Medicine, Seoul (Korea, Republic of)

    2008-04-15

    Prominent 18F-fluorodeoxyglucose (18F-FDG) accumulation has been reported to occur in meniscoid ulcer of gastric carcinoma. A mouse-model study carried out by Kubota et al. revealed that inflammatory cells, particularly macrophages, in necrotic tumor accumulates 18F-FDG more avidly than viable tumor cells. A search of literature failed to disclose earlier publication reporting histological study on such high 18F-FDG metabolism in patient with ulcerating colon cancer. This communication presents prominent 18FDG uptake observed in relation with chronic inflammation in meniscoid ulcer of sigmoid colon carcinoma. Cross correlation of PET findings with those of CT scan and colonoscopy showed that the high 18F-FDG uptake was localized to ulcerated part of tumor and not in heaved-up border that was not ulcerated. Histopathology of removed tumor revealed that the denuded bottom of ulcer consisted of a thick layer of submucosal tissue diffusely infiltrated with inflammatory cells. The meniscoid malignant ulcer, originally described in 1921 by Carman and re-studied in detail by Kirklin, is created by barium filling of crescent defect of ulcerating gastric carcinoma. Since then the sign has long been appreciated as a clue of ulcerating gastric carcinoma. In the meantime, the sign has also been reported to occur in the carcinomas of the esophagus by Gloyna et al. and the colon by Siskind and Burrell.

  11. Assessment of the metabolic trapping rate of FDG in rat brain using dual tracer autoradiography with 18F-FDG and 14C-FDG

    The dual tracer autoradiography using 18F-FDG and 14C-FDG was applied to the estimation of changes in the metabolic trapping rate in rat brain. Rats were infused with kainic acid (1 μg/μL) into the right striatum 3 hours prior to the tracer experiment. 18F-FDG was intravenously injected into the rats, and 14C-FDG was injected 44 minutes after 18F-FDG injection. The rats were decapitated at 1 minute post-injection of 14C-FDG, and frozen brain sections were prepared. The slices were exposed on imaging plate for 1 hour, and 18F-FDG images (45 minutes) were obtained. After the decay of 18F, the same slices were contacted with imaging plate for 1 week, and 14C-FDG images (1 minute) were obtained. Radioactivity concentrations in cerebral cortex at 1 minute and 45 minutes after 18F-FDG injection were determined by the dissection method, the values were used to normalize 18F-FDG and 14C-FDG image. The subtraction image was made by subtracting the normalized 14C-FDG image from the 18F-FDG image. In the results, intrastriatal infusion of kainic acid significantly enhanced the metabolic trapping process of FDG. The dual tracer autoradiography with 18F-FDG and 14C-FDG seems to be useful to assess the metabolic trapping rate of FDG in brain injury. (author)

  12. The impact of {sup 18}F-FDG PET on the management of patients with suspected large vessel vasculitis

    Fuchs, Martin; Rasch, Helmut; Berg, Scott; Ng, Quinn K.T.; Mueller-Brand, Jan; Walter, Martin A. [University Hospital, Institute of Nuclear Medicine, Basel (Switzerland); Briel, Matthias [University Hospital Basel, Institute for Clinical Epidemiology and Biostatistics, Basel (Switzerland); McMaster University, Department of Clinical Epidemiology and Biostatistics, Hamilton, ON (Canada); Daikeler, Thomas; Tyndall, Alan [University Hospital Basel, Department of Rheumatology, Basel (Switzerland); Walker, Ulrich A. [Felix Platter Spital, Department of Rheumatology of Basle University, Basel (Switzerland); Raatz, Heike [University Hospital Basel, Institute for Clinical Epidemiology and Biostatistics, Basel (Switzerland); Jayne, David [Addenbrooke' s Hospital, Vasculitis and Lupus Unit, Cambridge (United Kingdom); Koetter, Ina [University Hospital Tuebingen, Department of Internal Medicine II, Tuebingen (Germany); Blockmans, Daniel [University Hospital Gasthuisberg, Department of General Internal Medicine, Leuven (Belgium); Cid, Maria C.; Prieto-Gonzalez, Sergio [Hospital Clinic, University of Barcelona, IDIBAPS, Department of Systemic Autoimmune Diseases, 08036-Barcelona (Spain); Lamprecht, Peter [University Hospital of Schleswig-Holstein, Department of Rheumatology, Luebeck (Germany); Salvarani, Carlo [Arcispedale S. Maria Nuova, Department of Rheumatology, Reggio Emilia (Italy); Karageorgaki, Zaharenia [Agios Dimitrios General Hospital, 1st Department of Internal Medicine, Thessaloniki (Greece); Watts, Richard [University of East Anglia, Norwich Medical School, Norwich (United Kingdom); Ipswich Hospital NHS Trust, Ipswich (United Kingdom); Luqmani, Raashid [Nuffield Orthopaedic Centre, Department of Rheumatology, Oxford (United Kingdom)

    2012-02-15

    We aimed to assess the impact of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the management of patients with suspected large vessel vasculitis. An international expert panel determined diagnoses and clinical management in patients with suspected large vessel vasculitis, with and without the results of {sup 18}F-FDG PET, respectively. The accuracy of the clinical diagnosis and the resulting clinical management with and without the {sup 18}F-FDG PET results were compared using logistic regression models. The analysis included 30 patients referred to a tertiary care centre with large vessel vasculitis and 31 controls. {sup 18}F-FDG PET had an overall sensitivity of 73.3% [95% confidence interval (CI) 54.1-87.7%], a specificity of 83.9% (95% CI 66.3-94.5%), a positive predictive value of 81.5% (95% CI 61.9-93.7%) and a negative predictive value of 76.5% (95% CI 58.8-89.3%). The diagnostic accuracy of {sup 18}F-FDG PET was higher in patients not receiving immunosuppressive drugs (93.3 vs 64.5%, p = 0.006). Taken in context with other available diagnostic modalities, the addition of {sup 18}F-FDG PET increased the clinical diagnostic accuracy from 54.1 to 70.5% (p = 0.04). The addition of {sup 18}F-FDG PET increased the number of indicated biopsies from 22 of 61 patients (36.1%) to 25 of 61 patients (41.0%) and changed the treatment recommendation in 8 of 30 patients (26.7%) not receiving immunosuppressive medication and in 7 of 31 patients (22.6%) receiving immunosuppressive medication. {sup 18}F-FDG PET is a sensitive and specific imaging tool for large vessel vasculitis, especially when performed in patients not receiving immunosuppressive drugs. It increases the overall diagnostic accuracy and has an impact on the clinical management in a significant proportion of patients. (orig.)

  13. Background Intestinal 18F-FDG Uptake Is Related to Serum Lipid Profile and Obesity in Breast Cancer Patients.

    Hai-Jeon Yoon

    Full Text Available This study investigated the relationships between background intestinal uptake on 18F-FDG PET and cardio-metabolic risk (CMR factors.A total of 326 female patients that underwent 18F-FDG PET to determine the initial stage of breast cancer were enrolled. None of the patients had history of diabetes or hypertension. The background intestinal uptake on PET was visually graded (low vs. high uptake group and quantitatively measured using the maximal standardized uptake value (SUVmax. SUVmax of 7 bowel segments (duodenum, jejunum, ileum, cecum, hepatic flexure, splenic flexure, and descending colon-sigmoid junction were averaged for the total bowel (TB SUVmax. Age, body mass index (BMI, fasting blood glucose level (BST, triglyceride (TG, cholesterol, high density lipoprotein (HDL, and low density lipoprotein (LDL were the considered CMR factors. The relationships between background intestinal 18F-FDG uptake on PET and diverse CMR factors were analyzed.The visual grades based on background intestinal 18F-FDG uptake classified 100 (30.7% patients into the low uptake group, while 226 (69.3% were classified into the high uptake group. Among CMR factors, age (p = 0.004, BMI (p<0.001, and TG (p<0.001 were significantly different according to visual grade of background intestinal 18F-FDG uptake. Quantitative TB SUVmax showed significant positive correlation with age (r = 0.203, p<0.001, BMI (r = 0.373, p<0.001, TG (r = 0.338, p<0.001, cholesterol (r = 0.148, p = 0.008, and LDL (r = 0.143, p = 0.024 and significant negative correlation with HDL (r = -0.147, p = 0.022. Multivariate analysis indicated that BMI and TG were independent factors in both visually graded background intestinal 18F-FDG uptake (p = 0.027 and p = 0.023, respectively and quantitatively measured TB SUVmax (p = 0.006 and p = 0.004, respectively.Increased background intestinal 18F-FDG uptake on PET may suggest alteration of lipid metabolism and risk of cardio-metabolic disease in non

  14. Characterizing IgG4-related disease with 18F-FDG PET/CT: a prospective cohort study

    IgG4-related disease (IgG4-RD) is an increasingly recognized clinicopathological disorder with immune-mediated inflammatory lesions mimicking malignancies. A cohort study was prospectively designed to investigate the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in characterizing IgG4-RD. Thirty-five patients diagnosed with IgG4-RD according to the consensus criteria were enrolled with informed consent. All patients underwent baseline 18F-FDG PET/CT evaluation. Among them, 29 patients underwent a second 18F-FDG PET/CT scan after 2 to 4 weeks of steroid-based therapy. All 35 patients were found with 18F-FDG-avid hypermetabolic lesion(s); 97.1 % (34/35) of these patients showed multi-organ involvement. Among the 35 patients, 71.4 % (25/35) patients were found with more organ involvement on 18F-FDG PET/CT than conventional evaluations including physical examination, ultrasonography, and computed tomography (CT). 18F-FDG PET/CT demonstrated specific image characteristics and pattern of IgG4-RD, including diffusely elevated 18F-FDG uptake in the pancreas and salivary glands, patchy lesions in the retroperitoneal region and vascular wall, and multi-organ involvement that cannot be interpreted as metastasis. Comprehensive understanding of all involvement aided the biopsy-site selection in seven patients and the recanalization of ureteral obstruction in five patients. After 2 to 4 weeks of steroid-based therapy at 40 mg to 50 mg prednisone per day, 72.4 % (21/29) of the patients showed complete remission, whereas the others exhibited > 81.8 % decrease in 18F-FDG uptake. F-FDG PET/CT is a useful tool for assessing organ involvement, monitoring therapeutic response, and guiding interventional treatment of IgG4-RD. The image pattern is suggested to be updated into the consensus diagnostic criteria for IgG4-RD. (orig.)

  15. Characterizing IgG4-related disease with {sup 18}F-FDG PET/CT: a prospective cohort study

    Zhang, Jingjing; Ma, Yanru; Niu, Na; Wang, Xinwei; Li, Fang; Zhu, Zhaohui [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Nuclear Medicine, Peking Union Medical College Hospital, Beijing (China); Chen, Hua; Lin, Wei; Zhang, Fengchun; Zhang, Wen [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Rheumatology, Peking Union Medical College Hospital, Beijing (China); Xiao, Yu; Liang, Zhiyong [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Pathology, Peking Union Medical College Hospital, Beijing (China)

    2014-08-15

    IgG4-related disease (IgG4-RD) is an increasingly recognized clinicopathological disorder with immune-mediated inflammatory lesions mimicking malignancies. A cohort study was prospectively designed to investigate the value of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in characterizing IgG4-RD. Thirty-five patients diagnosed with IgG4-RD according to the consensus criteria were enrolled with informed consent. All patients underwent baseline {sup 18}F-FDG PET/CT evaluation. Among them, 29 patients underwent a second {sup 18}F-FDG PET/CT scan after 2 to 4 weeks of steroid-based therapy. All 35 patients were found with {sup 18}F-FDG-avid hypermetabolic lesion(s); 97.1 % (34/35) of these patients showed multi-organ involvement. Among the 35 patients, 71.4 % (25/35) patients were found with more organ involvement on {sup 18}F-FDG PET/CT than conventional evaluations including physical examination, ultrasonography, and computed tomography (CT). {sup 18}F-FDG PET/CT demonstrated specific image characteristics and pattern of IgG4-RD, including diffusely elevated {sup 18}F-FDG uptake in the pancreas and salivary glands, patchy lesions in the retroperitoneal region and vascular wall, and multi-organ involvement that cannot be interpreted as metastasis. Comprehensive understanding of all involvement aided the biopsy-site selection in seven patients and the recanalization of ureteral obstruction in five patients. After 2 to 4 weeks of steroid-based therapy at 40 mg to 50 mg prednisone per day, 72.4 % (21/29) of the patients showed complete remission, whereas the others exhibited > 81.8 % decrease in {sup 18}F-FDG uptake. F-FDG PET/CT is a useful tool for assessing organ involvement, monitoring therapeutic response, and guiding interventional treatment of IgG4-RD. The image pattern is suggested to be updated into the consensus diagnostic criteria for IgG4-RD. (orig.)

  16. Localization of dystonic muscles using {sup 18}F-FDG PET/CT in idiopathic cervical dystonia

    Choi, J. Y.; Seung, D. H.; Kim, D. H.; Kim, E. S.; Sohn, Y. I.; Choi, Y.; Choi, E. S.; Lee, K. H.; Kim, B. T. [Samsung Medical Center, Seoul (Korea, Republic of)

    2007-07-01

    Chemodenervation with botulinum toxin (BT) is regarded as a first-line treatment for idiopathic cervical dystonia (ICD), sometimes referred to as spasmodic torticollis. Moreover, because effective treatment involves the injection of BT into most dystonic muscles, the accurate localization of dystonic muscles is clinically important. In this preliminary study, we investigated whether {sup 18}F-FDG PET/CT is useful for localizing dystonic cervical muscles in ICD by comparing disease severity after and before BT injection into muscles determined to be hypermetabolic by PET/CT. Six consecutive patients (all males; age 37 16 y) underwent {sup 18}F-FDG PET/CT once (n = 4) or twice (n = 2) in a supine (n = 5) or sitting position (n = 3) during the {sup 18}F-FDG uptake period. Dystonic muscles suitable for BT injection therapy were defined as those showing diffusely increased {sup 18}F-FDG uptake. To evaluate response to BT injection, the Tsui scale and the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) were applied. On PET/CT, hypermetabolic cervical muscles were identified in all 6 patients (3 in a supine position and 3 in a sitting position during {sup 18}F-FDG uptake periods). In 2 patients who underwent PET/CT in a supine and in a sitting position during 18F-FDG uptake, abnormal hypermetabolic muscles were observed only by PET/CT in a sitting position with patients heads and necks in the assumed abnormal involuntary posture. Symptoms were significantly improved, according to the Tsui (10.0 2.9 to 1.8 1.3, 82% reduction) and TWSTRS scales (severity: 21.3 2.1 to 5.8 5.3, 73% reduction; disability: 19.8 1.9 to 3.8 3.8, 81 % reduction) in all 4 patients who underwent BT injection therapy guided by PET/CT and who were clinically follow-up. {sup 18}F-FDG PET/CT is potentially useful for identifying dystonic cervical muscles in patients with ICD.

  17. Clinical values for abnormal {sup 18}F-FDG uptake in the head and neck region of patients with head and neck squamous cell carcinoma

    Lee, Hwan Seo [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Jae Seung [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Roh, Jong-Lyel, E-mail: rohjl@amc.seoul.kr [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Choi, Seung-Ho; Nam, Soon Yuhl [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Sang Yoon [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Biomedical Research Institute, Korea Institute of Science and Technology, Seoul (Korea, Republic of)

    2014-08-15

    Highlights: • Abnormal {sup 18}F-FDG uptakes in the head and neck (HN) region can be carefully interpreted as being index primary, second primary cancer (SP) or benign. • {sup 18}F-FDG PET/CT identified 91.9% primary HN squamous cell carcinomas (HNSCC). • The specificity and negative predictive value of {sup 18}F-FDG PET/CT for identification of SP were as high as 98.7% and 99.3%, respectively. • Proper detection of primary tumors and SP in the HN region may promote appropriate therapeutic planning of HNSCC patients. - Abstract: Purpose: Fluorine 18-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET)/computed tomography (CT) is used to identify index or second primary cancer (SP) of the head and neck (HN) through changes in {sup 18}F-FDG uptake. However, both physiologic and abnormal lesions increase {sup 18}F-FDG uptake. Therefore, we evaluated {sup 18}F-FDG uptake in the HN region to determine clinical values of abnormal tracer uptake. Methods: A prospective study approved by the institutional review board was conducted in 314 patients with newly diagnosed HN squamous cell carcinoma (HNSCC) and informed consent was obtained from all enrolled patients. The patients received initial staging workups including {sup 18}F-FDG PET/CT and biopsies. All lesions with abnormal HN {sup 18}F-FDG uptake were recorded and most of those were confirmed by biopsies. Diagnostic values for abnormal {sup 18}F-FDG uptake were calculated. Results: Abnormal {sup 18}F-FDG uptake was identified in primary tumors from 285 (91.9%) patients. False-negative results were obtained for 22.3% (23/103) T1 tumors and 2.2% (2/93) T2 tumors (P < 0.001). Thirty-eight regions of abnormal {sup 18}F-FDG uptake were identified in 36 (11.5%) patients: the thyroid (n = 13), maxillary sinus (n = 7), palatine tonsil (n = 6), nasopharynx (n = 5), parotid gland (n = 2) and others (n = 5). Synchronous SP of the HN was identified in eight (2.5%) patients: the thyroid (n = 5), palatine

  18. Dynamic {sup 18}F-FDG PET for Assessment of Tumor Physiology in Two Breast Carcinoma Xenografts

    Kristian, Alexandr; Nilsen, Line B.; Roe, Kathrine; Revheim, Monaelisabeth; Engebraten, Olav; Maelandsmo, Gunhild M.; Holm, Ruth; Malinen Eirik; Seierstad, Therese [Oslo Univ. Hospital, Oslo (Norway)

    2013-09-15

    To compare dynamic 2-deoxy-2-[{sup 18}F]fluoro-D-glucose positron emission tomography ({sup 18}F-FDG PET) parameters in two selected human breast cancer xenografts and to evaluate associations with immunohistochemistry and histology. Dynamic {sup 18}F-FDG PET of luminal-like MAS98.06 and basal-like MAS98.12 xenografts was performed, and the compartmental transfer rates (k{sub 1}, k{sub 2}, k{sub 3}), blood volume fraction (v{sub B}) and metabolic rate of {sup 18}F-FDG(MR{sub FDG}) were estimated from pharmacokinetic model analysis. After sacrifice, analyses of hypoxia (pimonidazole), proliferation (Ki-67), vascularization (CD31), glucose transport receptor (GLUT1) and necrosis (HE) was performed. The level of hexokinase 2 (HK2) was estimated from Western blot analysis. The {sup 18}F-FDG uptake curves for the two xenografts were significantly different (p<0.05). k{sub 1} and v{sub B} were higher for MAS98.12 (p<0.01), while k{sub 3} was higher for MAS98.06 (p<0.01). MAS98.12 had a higher fraction of stromal tissue and higher microvessel density (MVD), and it was less necrotic and hypoxic than MAS98.06 MAS98.12 had stronger positive GLUT1 staining and lower Ki-67 than MAS98.06. In both models significant correlations were found between k{sub 1} and the GLUT1 score, between k{sub 3} and the level of HK2, and between v{sub B} and MVD. Significant differences in dynamic {sup 18}F-FDG parameters between the two human breast cancer xenografts were found. The differences could be explained by underlying histological and physiological characteristics.

  19. Evaluation of Avulsion-Induced Neuropathology in Rat Spinal Cords with 18F-FDG Micro-PET/CT.

    Ze-Min Ling

    Full Text Available Brachial plexus root avulsion (BPRA leads to dramatic motoneuron death and glial reactions in the corresponding spinal segments at the late stage of injury. To protect spinal motoneurons, assessment of the affected spinal segments should be done at an earlier stage of the injury. In this study, we employed 18F-FDG small-animal PET/CT to assess the severity of BPRA-induced cervical spinal cord injuries. Adult Sprague-Dawley rats were randomly treated and divided into three groups: Av+NS (brachial plexus root avulsion (Av treated with normal saline, Av+GM1 (treated with monosialoganglioside, and control. At time points of 3 day (d, 1 week (w, 2 w, 4 w and 8 w post-injury, 18F-FDG micro-PET/CT scans and neuropathology assessments of the injured spinal roots, as well as the spinal cord, were performed. The outcomes of the different treatments were compared. The results showed that BPRA induced local bleeding and typical Wallerian degeneration of the avulsed roots accompanied by 18F-FDG accumulations at the ipsilateral cervical intervertebral foramen. BPRA-induced astrocyte reactions and overexpression of neuronal nitric oxide synthase in the motoneurons correlated with higher 18F-FDG uptake in the ipsilateral cervical spinal cord during the first 2 w post-injury. The GM1 treatment reduced BPRA-induced astrocyte reactions and inhibited the de novo nNOS expressions in spinal motoneurons. The GM1 treatment also protected spinal motoneurons from avulsion within the first 4 w post-injury. The data from this study suggest that 18F-FDG PET/CT could be used to assess the severity of BPRA-induced primary and secondary injuries in the spinal cord. Furthermore, GM1 is an effective drug for reducing primary and secondary spinal cord injuries following BPRA.

  20. Clearance of the high intestinal {sup 18}F-FDG uptake associated with metformin after stopping the drug

    Oezuelker, Tamer [Okmeydani Training and Research Hospital, Department of Nuclear Medicine, istanbul (Turkey); Daruessafaka Mah. Gazeteciler Sitesi, Maslak, Istanbul (Turkey); Oezuelker, Filiz; Oezpacaci, Tevfik [Okmeydani Training and Research Hospital, Department of Nuclear Medicine, istanbul (Turkey); Mert, Meral [Okmeydani Training and Research Hospital, Department of Internal Medicine, istanbul (Turkey)

    2010-05-15

    This study was done to determine whether interruption of metformin before {sup 18}F-FDG PET/CT imaging could prevent the increased {sup 18}F-FDG uptake in the intestine caused by this drug. Included in the study were 41 patients with known type 2 diabetes mellitus who were referred to our department for evaluation of various neoplastic diseases. Patients underwent two {sup 18}F-FDG PET/CT scans, the first while they were on metformin and the second after they had stopped metformin. They stopped metformin and did not take any other oral antidiabetic medication starting 3 days before the second study and their blood glucose level was regulated with insulin when necessary to keep it within the range 5.55-8.33 mmol/l. FDG uptake was graded visually according to a four-point scale and semiquantitatively by recording the maximum standardized uptake value (SUVmax) in different bowel segments. A paired-samples t-test method was used to determine whether there was a significant difference between SUVmax measurements and visual analysis scores of the metabolic activity of the bowel in the PET/CT scans before and after stopping metformin. Diffuse and intense {sup 18}F-FDG uptake was observed in bowel segments of patients, and the activity in the colon was significantly decreased both visually and semiquantitatively in PET/CT scans performed after patients stopped metformin (p<0.05). There was a statistically significant decrease in activity in the small intestine on visual analysis (p<0.05), but semiquantitative measurements did not show a significant decrease in the SUVmax values in the duodenum or jejunum (p>0.05). Metformin causes an increase in {sup 18}F-FDG uptake in the bowel and stopping metformin before PET/CT study significantly decreased this unwanted uptake, especially in the colon, facilitating the interpretation of images obtained from the abdomen and preventing the obliteration of lesions. (orig.)

  1. Potential of {sup 18}F-FDG PET toward personalized radiotherapy or chemoradiotherapy in lung cancer

    Choi, Noah C.; Chun, Tristen T.; Niemierko, Andrzej; Ancukiewicz, Marek [Massachusetts General Hospital, Harvard Medical School, Department of Radiation Oncology, Boston, MA (United States); Fidias, Panos M. [Massachusetts General Hospital, Harvard Medical School, Department of Medicine, Boston, MA (United States); Kradin, Richard L. [Massachusetts General Hospital, Harvard Medical School, Department of Pathology, Boston, MA (United States); Mathisen, Douglas J. [Massachusetts General Hospital, Harvard Medical School, Department of Surgery, Boston, MA (United States); Lynch, Thomas J. [Massachusetts General Hospital, Harvard Medical School, Department of Medicine, Boston, MA (United States); Yale Cancer Center, New Haven, CT (United States); Fischman, Alan J. [Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Boston, MA (United States); Shriner' s Burns Institute, Boston, MA (United States)

    2013-06-15

    We investigated the metabolic response of lung cancer to radiotherapy or chemoradiotherapy by {sup 18}F-FDG PET and its utility in guiding timely supplementary therapy. Glucose metabolic rate (MRglc) was measured in primary lung cancers during the 3 weeks before, and 10-12 days (S2), 3 months (S3), 6 months (S4), and 12 months (S5) after radiotherapy or chemoradiotherapy. The association between the lowest residual MRglc representing the maximum metabolic response (MRglc-MMR) and tumor control probability (TCP) at 12 months was modeled using logistic regression. We accrued 106 patients, of whom 61 completed the serial {sup 18}F-FDG PET scans. The median values of MRglc at S2, S3 and S4 determined using a simplified kinetic method (SKM) were, respectively, 0.05, 0.06 and 0.07 {mu}mol/min/g for tumors with local control and 0.12, 0.16 and 0.19 {mu}mol/min/g for tumors with local failure, and the maximum standard uptake values (SUVmax) were 1.16, 1.33 and 1.45 for tumors with local control and 2.74, 2.74 and 4.07 for tumors with local failure (p < 0.0001). MRglc-MMR was realized at S2 (MRglc-S2) and the values corresponding to TCP 95 %, 90 % and 50 % were 0.036, 0.050 and 0.134 {mu}mol/min/g using the SKM and 0.70, 0.91 and 1.95 using SUVmax, respectively. Probability cut-off values were generated for a given level of MRglc-S2 based on its predicted TCP, sensitivity and specificity, and MRglc {<=}0.071 {mu}mol/min/g and SUVmax {<=}1.45 were determined as the optimum cut-off values for predicted TCP 80 %, sensitivity 100 % and specificity 63 %. The cut-off values (MRglc {<=}0.071 {mu}mol/min/g using the SKM and SUVmax {<=}1.45) need to be tested for their utility in identifying patients with a high risk of residual cancer after standard dose radiotherapy or chemoradiotherapy and in guiding a timely supplementary dose of radiation or other means of salvage therapy. (orig.)

  2. The preliminary study of 18F-FDG PET in diagnosis of Alzheimer's disease

    To investigate the imaging characteristic and diagnostic criteria of 18F-FDG brain PET in detecting Alzheimer's disease (AD). The study included in 12 normal subject, 12 patients with AD, 6 patients with vascular dementia, 3 patients with Lewy body disease (LBD) and 2 patients with mixed dementia. The dementia severity was measured by ESD and MMSE. 12 cases had mild, 7 moderate and 4 severe dementia. 23 patients and 6 normal subjects underwent MR imaging of the brain. All participants fasted for at least 6 hours. 40 minutes after intravenous administration of 185-370 MBq 18F-FDG, 2D brain scan in 25 cases and 3D scan in 10 cases were performed using SIEMENS ECAT 47 scanner. The transaxial, coronal and sagittal images were then reconstructed by computer. At the same time, semiquantitative analysis was also applied to help evaluation using the ratio of mean radioactivity between cerebral lobe to cerebellum (Rcl/cb). In normal subjects PET scan showed clear images of cerebral cortex, basal ganglia, thalamus and cerebellum with symmetrical distribution of radioactivity. 22 of 23 patients were found to have decreased uptake of FDG in the brain. 20 patients had cerebral atrophy and it also appeared in 6 normal elder people. PET images for Alzheimer's disease were classified in 6 normal elder people. PET image for Alzheimer's 3 patterns: bilateral parietal hypo metabolism in 5 cases, bilateral temporo-parietal hypo metabolism in 4 cases and unilateral temporo-parietal hypo metabolism in 3 cases. The Rcl/cb of AD patents in parietal and temporal was significantly decreased than normal subjects (p<0.05). PET images for non-AD dementia were also classified 3 patterns: multiple and asymmetrical patch foci with decreased radioactivity in 8 cases, bilateral temporo-parietal with diffuse cortical hypo metabolism in 2 cases, and normal imaging in 1 case. The hypo metabolic involvement was accorded with severity of dementia. The more dementia had, the bigger hypometabloic region

  3. Correlation of BRAFV600E Mutation and Glucose Metabolism in Thyroid Cancer Patients: An 18F-FDG PET Study

    Nagarajah, James; Ho, Alan L.; Tuttle, R. Michael; Weber, Wolfgang A.; Grewal, Ravinder K.

    2016-01-01

    There is significant interest in a better understanding of the genetic underpinnings of the increased glucose metabolic rates of cancer cells. Thyroid cancer demonstrates a broad variability of 18F-FDG uptake as well as several well-characterized oncogenic mutations. In this study, we evaluated the differences in glucose metabolism of the BRAFV600E mutation versus BRAF wild-type (BRAF-WT) in patients with metastatic differentiated thyroid cancer (DTC) and poorly differentiated thyroid cancer (PDTC). Methods Forty-eight DTC and 34 PDTC patients who underwent 18F-FDG PET/CT for tumor staging were identified from a database search. All patients were tested for the BRAFV600E mutation and assigned to 1 of 2 groups: BRAFV600E mutated and BRAF-WT. 18F-FDG uptake of tumor tissue was quantified by maximum standardized uptake value (SUVmax) of the hottest malignant lesion in 6 prespecified body regions (thyroid bed, lymph nodes, lung, bone, soft tissue, and other). When there were multiple lesions in 1 of the prespecified body regions, only the 1 with the highest 18F-FDG uptake was analyzed. Results In the DTC cohort, 24 tumors harbored a BRAFV600E mutation, whereas 24 tumors were BRAF-WT. 18F-FDG uptake of BRAFV600E-positive lesions (median SUVmax, 6.3; n = 53) was significantly higher than that of BRAF-WT lesions (n = 39; median SUVmax, 4.7; P = 0.019). In the PDTC group, only 5 tumors were BRAFV600E-positive, and their 18F-FDG uptake was not significantly different from the BRAF-WT tumors. There was also no significant difference between the SUVmax of all DTCs and PDTCs, regardless of BRAF mutational status (P = 0.90). Conclusion These data suggest that BRAFV600E-mutated DTCs are significantly more 18F-FDG–avid than BRAF-WT tumors. The effect of BRAFV600E on tumor glucose metabolism in PDTC needs further study in larger groups of patients. PMID:25814520

  4. {sup 18}F-FDG PET/CT changes therapy management in high-risk DTC after first radioiodine therapy

    Rosenbaum-Krumme, Sandra J.; Goerges, Rainer; Bockisch, Andreas; Binse, Ina [University Hospital Essen, Department of Nuclear Medicine, Essen (Germany)

    2012-09-15

    Advanced tumour stage and initial metastases are associated with reduced general and tumour-free survival in patients with differentiated thyroid carcinoma. Optimal initial therapy is mandatory for a positive patient outcome, but can only be performed if all non-iodine-avid tumour lesions are known before planning treatment. We analysed the benefit of {sup 18}F-FDG PET/CT at initial diagnosis in patients with high-risk differentiated thyroid carcinoma and determined whether the {sup 18}F-FDG PET/CT results led to a deviation from the standard procedure, which consists of two consecutive radioiodine treatments with thyroid hormone suppression in between and no additional imaging, with individual patient management. The study group comprised 90 consecutive patients with either extensive or metastasized high-risk differentiated thyroid carcinoma who received {sup 18}F-FDG PET/CT after the first radioiodine treatment approximately 4 weeks after thyroidectomy under endogenous TSH stimulation. We carried out PET/CT imaging with low-dose CT without contrast medium, which we only used for attenuation correction of PET images. {sup 18}F-FDG PET/CT was positive in 26 patients (29%) and negative in 64 patients (71%). Compared to the results of posttherapeutic {sup 131}I whole-body scintigraphy, the same lesions were PET-positive in 7 of the 26 patients, different lesions were PET-positive in 15 patients, and some PET-positive lesions were the same and some were different in 4 patients. TNM staging was changed due to the PET results in 8 patients. Management was changed in 19 of the 90 patients (21%), including all patients with only FDG-positive lesions and all patients with both FDG-positive and iodine-positive lesions. Age was not a predictive factor for the presence of FDG-positive lesions. FDG-positive and iodine-positive lesions were associated with high serum thyroglobulin. However, at low serum thyroglobulin values, tumour lesions (iodine- and/or FDG-avid) were also

  5. The evaluation of breast cancer curative effect and prognosis in 18F-FDG PET/CT

    Objective: To evaluate the value of using 18F-Fluro-deoxy-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in followup studies of breast cancer patients which have been given to comprehensive treatment. Methods: Measuring the standardized uptake value (SUV) of 18F-FDG PET/CT by a retrospective research breast cancer patients in PET Center during November, 2003 to December, 2010 and following up. And analyzing the prognosis of the patients. Results: 114 patients of breast cancer which was confirmed by pathology have been screened out. In which 64 patients showed negative results when having 18F-FDG PET/CT scan, while in other 50 cases of recurrence, residual or metastasis, showed positive results. Average standardized uptake value (SUVave) of the positive results was ranging from 1.0∼11.2 (3.9±1.9), and maximum standardized uptake value (SUVmax) was from 1.1∼ 16.2 (5.0±2.8). The sensitivity, specificity and accuracy of 18F-FDG PET/CT were 96.0%, 100% and 98.5% in diagnosis of breast cancer, while in traditional imaging were 81.8%, 77.6% and 72.9%. By the time of following up, 33 out of 50 positive patients had undergone certain therapies of breast cancer. 17 positive patients were without any therapy. Spearman rank correlation analysis results showed the positive patients in PET/CT scanning with higher maximum standardized uptake value the worse the prognosis. Fisher exact test showed the positive patients with or without treatment prognosis had significant difference. Other 43 patients had no evidence of disease/recurrence or new metastases of breast cancer. 28 of them had undergone certain therapies of breast cancer, while 36 hadn't. Fisher exact test showed the positive patients with or without treatment prognosis hadn't significant difference. Conclusion: 18F-FDG PET/CT scan can find recurrence or metastases of breast cancer at the early stage. It will be a valid way to project prognosis of the patient. And 18F-FDG PET/CT scan can

  6. An Unusual Case of Plasmablastic Lymphoma Presenting as Paravertebral Mass Evaluated by {sup 18}F-FDG PET/CT

    Treglia, Giorgio; Paone, Gaetano; Stathis, Anastasios; Ceriani, Luca; Giovanella, Luca [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland)

    2014-03-15

    A 60-year-old man underwent radiological investigations due to the onset of back pain. Computed tomography (CT) and magnetic resonance imaging (MRI) showed the presence of a paravertebral mass located ahead the body of the third thoracic vertebra. Based on these findings the patient underwent biopsy of the paravertebral mass, which showed the presence of a plasmablastic lymphoma. Therefore, the patient underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) for staging. Before {sup 18}F-FDG injection, the patient had fasted for at least 6 h; at the time of the radiopharmaceutical injection he presented glucose blood levels corresponding to 98 mg/dl. Images were acquired 1 h after intravenous injection of 280 MBq of {sup 18}F-FDG according to the body mass index. PET images were interpreted visually and semiquantitatively by using the maximal standardized uptake value (SUVmax). {sup 18}F-FDG PET/CT showed moderate radiopharmaceutical uptake corresponding to the paravertebral lesion (SUVmax 3.3) and diffuse uptake in the skeleton suspicious for bone marrow neoplastic involvement, with more evident hypermetabolic areas in the left scapula (SUVmax 3.7), right sixth rib (SUVmax 3.5), and left iliac bone (SUVmax 3.4) (Fig. 1). Subsequent bone marrow biopsy confirmed the bone marrow infiltration by plasmablastic cells. Based on these findings, a final diagnosis of plasmablastic lymphoma with bone marrow involvement was performed and the patient was addressed to chemotherapy. Plasmablastic lymphoma is a rare CD20-negative large-cell lymphoma with plasmablastic features occurring primarily in HIV or Epstein-Barr virus positive individuals. Distinguishing this tumor from myeloma could be challenging. The most frequent site of presentation is the oral cavity, whereas extraoral localizations of plasmablastic lymphoma are considered to be very rare and they should be differentiated from extraosseous localization of

  7. 18F-FDG PET/CT changes therapy management in high-risk DTC after first radioiodine therapy

    Advanced tumour stage and initial metastases are associated with reduced general and tumour-free survival in patients with differentiated thyroid carcinoma. Optimal initial therapy is mandatory for a positive patient outcome, but can only be performed if all non-iodine-avid tumour lesions are known before planning treatment. We analysed the benefit of 18F-FDG PET/CT at initial diagnosis in patients with high-risk differentiated thyroid carcinoma and determined whether the 18F-FDG PET/CT results led to a deviation from the standard procedure, which consists of two consecutive radioiodine treatments with thyroid hormone suppression in between and no additional imaging, with individual patient management. The study group comprised 90 consecutive patients with either extensive or metastasized high-risk differentiated thyroid carcinoma who received 18F-FDG PET/CT after the first radioiodine treatment approximately 4 weeks after thyroidectomy under endogenous TSH stimulation. We carried out PET/CT imaging with low-dose CT without contrast medium, which we only used for attenuation correction of PET images. 18F-FDG PET/CT was positive in 26 patients (29%) and negative in 64 patients (71%). Compared to the results of posttherapeutic 131I whole-body scintigraphy, the same lesions were PET-positive in 7 of the 26 patients, different lesions were PET-positive in 15 patients, and some PET-positive lesions were the same and some were different in 4 patients. TNM staging was changed due to the PET results in 8 patients. Management was changed in 19 of the 90 patients (21%), including all patients with only FDG-positive lesions and all patients with both FDG-positive and iodine-positive lesions. Age was not a predictive factor for the presence of FDG-positive lesions. FDG-positive and iodine-positive lesions were associated with high serum thyroglobulin. However, at low serum thyroglobulin values, tumour lesions (iodine- and/or FDG-avid) were also diagnosed. Thus, the serum

  8. The application of 18F-FDG PET and HRCT in the diagnosis of bronchial alveolar carcinoma

    Objective: To investigate the features and diagnostic values of 18F-FDG PET and high resolution CT (HRCT) in patients with bronchial alveolar carcinoma(BAC). Methods: Seventeen cases with pathologically confirmed BAC and 1 case confirmed inflammation were studied retrospectively. The standardized uptake value (SUV) of the lesions were detected and 18F-FDG uptake characteristics were studied. The diagnostic values of 18F-FDG PET, HRCT and 18F-FDG PET combined with HRCT were analyzed. Results: (1) In the group of solitary nodule (n =5), SUV of lesions were 1.5-3.5. HRCT (4/5) demonstrated spiculated(4/4), lobulated (3/4), pleural indentation (3/4), vascular convergence (3/4), vacuole sign (2/4) and ground-glass sign (1/4). (2) In the group of lobar consolidation (n=6), SUV of lesions were 1.6-2.3. HRCT (5/6) demonstrated ground-glass (5/5), pleural indentation (3/5), vacuole sign (2/5), air bronchogram sign (2/5) and blood vessel convergency (1/5). (3) In the group of mixed shadow(n=4), SUV of lesions were 4.5-10.0. Ground-glass sign, vacuole sign, pleural tag and air bronchogram sign were seen in 2, 1, 2 and 3 cases respectively. (4) There was 1 case in the group of mass lesion. The SUV of lesion was 5.6, and HRCT demonstrated lobulated, cavity, pleural indentation and blood vessel convergency. (5) There was 1 case in the multi-nodular group, SUV was 4.6, lobulation and spiculation sign were found. (6) SUV was 1.2 in the false positive case, with the lesion size of 2.1 cm x 2.3 cm. Conclusions: Low uptake of 18F-FDG in solitary nodule and lobar consolidation groups might cause false negative in the diagnosis of BAC. To improve the diagnosis accuracy and to decrease misdiagnosis rate of BAC, combination of HRCT with 18F-FDG PET should be carried out. (authors)

  9. Kinetic analysis of experimental rabbit tumour and inflammation model with {sup 18}F-FDG PET/CT

    Liu, P. [Dept. of Nuclear Medicine, Ninth People' s Hospital, Medical School of Jiaotong Univ., SH (China); Huang, G.; Dong, S.; Wan, L. [Dept. of Nuclear Medicine, Renji Hospital, Medical School of Jiaotong Univ., SH (China)

    2009-07-01

    Non-specific accumulation of {sup 18}F-FDG by both tumour and inflammatory lesions can make diagnostic analysis difficult. Our aim was to explore the difference in {sup 18}F-FDG uptake kinetics between tumour and inflammatory cells. To this end, we investigated VX2 tumour lesions and inflammatory lesions in rabbits. Methods: Six rabbits with VX2 tumour cells transplanted into one forelimb muscle and inflammatory lesions induced by turpentine oil in the contralateral forelimb were scanned for 60 minutes post {sup 18}F-FDG injection. Imaging data was analyzed with the standard 2-tissue-compartment model. Parameters, VB, Ki, K1, k2, k3, k4, were compared between tumour and inflammatory lesions. SUV and dual time scan methods were also compared in the experiment. Results: Time activity curves of VX2 tumour lesions showed a characteristic pattern of gradually increasing {sup 18}F-FDG uptake up to 60 min, whereas, {sup 18}F-FDG uptake in inflammatory lesions increased more slowly than in tumours. Parameters estimated from the uptake process showed that forward transport constant, K1, and influx constant, Ki, values in VX2 tumour lesions (0.186 {+-} 0.053 and 0.048 {+-} 0.014, respectively) was significantly higher than that in inflammatory lesions (0.129 {+-} 0.024 and 0.022 {+-} 0.007, respectively) (p < 0.05). In contrast, mean values of VB, k2, k3 and k4 derived from VX2 tumours were not significantly different from that of inflammatory lesions. SUVs at 60 minutes post {sup 18}F-FDG injection were also significantly higher in the VX2 tumor lesions than in the inflammatory lesions. Retention index (RI) was not significantly different between VX2 tumours and inflammatory lesions (1.134 {+-} 0.076 vs. 1.060 {+-} 0.058, p > 0.05). Conclusion: Different kinetic parameters (Ki, K1, k3) exist between inflammatory and tumour lesions. (orig.)

  10. Validation of a new protocol for 18F-FDG infusion using an automatic combined dispenser and injector system

    In nuclear medicine, radiopharmaceuticals are usually administered in unit doses partitioned from multi-dose vials. The partitioning typically takes place in a radiopharmacy, depending on local practice. Automatic, as opposed to manual, partitioning and administration should reduce radiation exposure of the personnel involved, improve the accuracy of the administration and mitigate contamination. This study set out to verify and validate the 18F-fluorodeoxyglucose (FDG) administration procedure performed using Intego trademark (MEDRAD, Inc., Warrendale, PA, USA), a combined dispenser and injector system. We considered maintenance of sterility and the system's potential to improve, with respect to the manual procedure, the accuracy of net administered 18F-FDG radioactivity in patients and the radiation protection of operators. A media-fill procedure was used to assess whether sterility is maintained during use of the Intego trademark system. Simulating a typical working day's setup and use of the system, we investigated the accuracy of the net administered 18F-FDG activity obtained with Intego trademark versus the manual dose delivery system. We also measured personnel radiation exposure during use of Intego trademark and during manual administration and recorded and compared environmental doses in the two conditions. The radiopharmaceutical remained sterile in all the tests performed. The accuracy of the net 18F-FDG activity delivered to the patients was found to be within 3 % points, as required by European Association of Nuclear Medicine (EANM) guidelines on 18F-FDG imaging procedures. With Intego trademark, the residual radioactivity in the tubing was 0.20 MBq, corresponding to approximately 0.07 % of the mean activity delivered. With manual injection, the residual radioactivity in the syringe averaged 7.37 MBq, corresponding to a mean error of 2.9 % in the delivered dose. During the injection step of the positron emission tomography (PET) procedure, whole