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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. 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)

  9. [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...

  10. 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...

  11. 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

  12. 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)

  13. 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)

  14. 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.

  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. 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.)

  3. 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....

  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. 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)

  6. 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

  7. 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.

  8. 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

  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. 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)

  14. 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

  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. 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

  19. 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)

  20. 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.)

  1. {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.)

  2. 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 ...

  3. 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)

  4. 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)

  5. 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)

  6. 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...

  7. 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

  8. 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

  9. 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)

  10. 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

  11. 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...

  12. 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

  13. 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

  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/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

  16. 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.)

  17. 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

  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. 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.)

  5. 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)

  6. 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

  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. 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

  11. 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

  12. 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.

  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. 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.)

  18. 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)

  19. (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...

  20. 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)

  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. 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

  4. 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

  5. 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...

  6. 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.

  7. 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)

  8. 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'.

  9. 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.

  10. 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.)

  11. 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.

  12. 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

  13. 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

  14. 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

  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. 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)

  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. {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)

  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. {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.

  5. 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

  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. {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.)

  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. 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...

  15. 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 ...

  16. 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.

  17. 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

  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. 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

  14. 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)

  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. 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

  17. 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.)

  18. 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.)

  19. 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

  20. 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

  1. 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

  2. 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)

  3. 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

  4. 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)

  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. 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.)

  12. 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.)

  13. {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.

  14. 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.)

  15. 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.)

  16. {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.

  17. 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)

  18. 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.)

  19. 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

  20. 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

  1. 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

  2. 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.)

  3. 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

  4. {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

  5. 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.)

  6. 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

  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. 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.)

  9. 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.

  10. 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.

  11. {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)

  12. 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...

  13. 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...

  14. 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...

  15. 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

  16. 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 ...

  17. 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.

  18. 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

  19. 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)

  20. 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

  1. 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

  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. 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

  5. {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.)

  6. 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

  7. 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.)

  8. 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

  9. 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

  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. 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.

  12. 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.)

  13. 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.

  14. 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

  15. 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.

  16. 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)

  17. 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)

  18. 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

  19. 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)

  20. 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.)

  1. 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.

  2. 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)

  3. 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.

  4. 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)

  5. 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...

  6. 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.)

  7. 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)

  8. 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).

  9. 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.

  10. 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.

  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. 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.)

  13. 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.)

  14. 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.)

  15. 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.

  16. 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

  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. 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

  2. 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.)

  3. {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

  4. 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

  5. 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.)

  6. 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

  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. 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

  9. 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

  10. 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)

  11. Multiple 18F-FDG, PET-CT for Postoperative Monitoring of Breast Cancer Patients

    Background: Positron emission tomography (PET)-computed tomography (CT) may be useful in the post-treatment follow-up of breast cancer patients. Purpose: To assess the usefulness of 18F-fluorodeoxyglucose (FDG) PET-CT (PET-CT) for postoperative monitoring of breast cancer patients. Material and Methods: One hundred twenty-nine PET-CT studies performed on 55 female postoperative breast cancer patients (median age 56 years, range 36-86 years) were analyzed. The median interval between the PET-CT studies was 6 months (range 1-15 months). In order to determine the usefulness of serial PET-CT examinations in the postoperative follow-up of breast cancer patients, the PET-CT findings were compared with the physical findings, findings obtained by other imaging modalities, and the 18F-FDG-PET (PET) findings. Results: The PET findings were negative in 4 metastatic bone lesions with a positive bone scan. The PET findings were also negative in 6 of 9 osteogenic bone metastases and one of 64 osteolytic bone lesions. There were 5 cases with false-positive of PET, which were determined to be areas of soft-tissue hyperactivity. All false-positive/-negative findings were corrected by the addition of CT. Conclusion: The results of this study lend support to the clinical role of PET-CT in the postoperative follow-up/monitoring of breast cancer patients

  12. Detection of primary tumor by 18F-FDG-TEP in patients with cup syndrome

    To study the performance of whole body 18F-FDG-PET in the detection of the primary tumor in patients with unknown primary carcinoma in comparison with conventional imaging. Patients and methods: Forty-one patients, without previous history of known cancer, (18 women and 23 men; average age 64,1 years) with bone, brain, lymph node, liver, cutaneous, pleural and epidural metastases were included in a retrospective study. Results of PET (UGM Penn PET 240 H) were compared with those of techniques used in the current conventional procedure. There were 26 true positives, 2 false negatives (1 renal carcinoma and 1 myeloma) and one false positive results. Origins were lung [16], gut [6], breast [3] and head and neck [1] but stayed undetermined in 8 patients. Results of PET were superior to conventional diagnostic procedure in 12 patients and led to modify the therapy management in 11 patients. All known metastatic lesions were detected by PET. FDG-PET can be useful to determine the origin of metastasis. It allows detection of the primary tumor (26/33 patients) and allows evaluation of the spread of the disease. These results have to be confirmed and particularly in patients with highly treatable unknown primary carcinoma. (author)

  13. Role of 18F-FDG PET/CT in diagnostic evaluation of secondary bone dissemination

    The tendency of modern diagnostic imaging of oncological diseases is aimed at reducing the number of different diagnostic procedures and single-step obtaining a large amount of information from one modality. This requirement is met by the hybrid imaging modalities and the benefit from their implementation in daily oncological practice is corroborated by the increasing number of this type of diagnostic centers. Cancer diseases are among the first with social significance of mortality and one of the ways to reduce this statistic, after prevention, is early diagnosis, accurate staging, reliable monitoring of the chosen therapy and follow-up. 18F-FDG PET/CT is a hybrid system that covers many of the shortcomings of each of its constituent parts and by monitoring the metabolism and accumulation of the glucose isotopic analogue it gives sufficiently precise information about the morphology and metabolism of the primary malignancy, loco-regional distribution and secondary deposits. The ability of hybrid technology to characterize bone metastases regardless of their morphological characteristics gives it a priority over the choice of several other complementary methods for obtaining comprehensive diagnostic information. Application of the method has already yielded results by the choice of the best treatment according to the oncological stage and the change, if necessary, of the unsuitable therapeutic scheme. (authors)

  14. Multiple 18F-FDG, PET-CT for Postoperative Monitoring of Breast Cancer Patients

    Kurata, A.; Murata, Y.; Kubota, K.; Shibuya, H. (Dept. of Radioloy, Tokyo Medical and Dental Univ. Hospital, Tokyo (Japan)); Osanai, T. (Dept. of Breast Surgery, Tokyo Medical and Dental Univ. Hospital, Tokyo (Japan))

    2009-11-15

    Background: Positron emission tomography (PET)-computed tomography (CT) may be useful in the post-treatment follow-up of breast cancer patients. Purpose: To assess the usefulness of 18F-fluorodeoxyglucose (FDG) PET-CT (PET-CT) for postoperative monitoring of breast cancer patients. Material and Methods: One hundred twenty-nine PET-CT studies performed on 55 female postoperative breast cancer patients (median age 56 years, range 36-86 years) were analyzed. The median interval between the PET-CT studies was 6 months (range 1-15 months). In order to determine the usefulness of serial PET-CT examinations in the postoperative follow-up of breast cancer patients, the PET-CT findings were compared with the physical findings, findings obtained by other imaging modalities, and the 18F-FDG-PET (PET) findings. Results: The PET findings were negative in 4 metastatic bone lesions with a positive bone scan. The PET findings were also negative in 6 of 9 osteogenic bone metastases and one of 64 osteolytic bone lesions. There were 5 cases with false-positive of PET, which were determined to be areas of soft-tissue hyperactivity. All false-positive/-negative findings were corrected by the addition of CT. Conclusion: The results of this study lend support to the clinical role of PET-CT in the postoperative follow-up/monitoring of breast cancer patients

  15. Clinical Application of {sup 18}F-FDG PET in Malignant Mesothelioma

    Lee, Eun Jeong [Kangbuk Samsung Hospital, Seoul (Korea, Republic of)

    2008-12-15

    Malignant pleural mesothelioma (MPM) has a poor prognosis and a strong association with exposure to asbestos. Although there are not generally accepted guidelines for treatment of MPM, recent reports suggest that multimodality therapy combining chemotherapy, radiotherapy, and surgery can improve the survival of patients with MPM. Therefore exact staging is required to decide the best treatment option. However, it is well known that there are many difficulties in determining precise preoperative stage, predicting prognosis, and monitoring response to therapy with conventional imaging modalities such as CT and MRI in MPM. Recently PET with {sup 18}F-FDG comes into the spotlight as an important staging method. There is increasing evidence that PET is superior to other conventional imaging modalities in diagnosis and staging of MPM. Particularly PET/CT improves the diagnostic and staging accuracy over PET or CT alone in MPM because it provides anatomic imaging data as well as functional information. PET and PET/CT are also useful for monitoring response to therapy and SUV is reported as a prognostic factor in MPM.

  16. A Study on the Quality Control of 18F-FDG Radiopharmaceutical

    The types of test items which were recorded in this test report of quality control domestic 18F-FDG radiopharmaceutical which consisted of 13 different types: appearance, half-life, radioactive heterokaryosis, radiochemical Confirmation (measure of Rf value), radiochemical Purity, Ethanol, Acetonitrile, Kryptofix, Aluminium, pH, Endotoxin, aseptic test, and radioactivity·ml-1. The record was fully recorded in 'appearance', 'radioactive heterokaryosis', 'pH', 'Endotoxin', and 'aseptic test'. In 'half-life', 'radiochemical Confirmation (measure of Rf value), 'radiochemical Purity', 'Ethanol', 'Acetonitrile', 'Kryptofix', 'Aluminium', 'radioactivity·ml-1', there were differences in records of each manufacturing business on radioactive medicine and medical supplies. The result of the test showed all 13 items of quality control test were 100% suitable on the basis of recorded data. There were more radiopharmaceutical made in the laboratory than in hospitals and businesses and in for result of suitability test, the laboratory showed higher suitability than did the hospitals or businesses. Domestically, there are differences of the test report items in the safety of radiopharmaceutical of each facility, and since it is not standardized, supplements are needed. To submit standardized test reports of quality guarantee in radiopharmaceutical, GMP of U.S. and CE Mark of Europe should be referred as well as receiving advice from professionals to standardize as suitable domestic standard

  17. IgG4-associated multifocal systemic fibrosis detected by cancer screening with 18F-FDG positron emission tomography/computed tomography

    Serial fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) studies were performed with an interval of one year in a 62-year-old man with IgG4-associated multifocal systemic fibrosis (IMSF). He first underwent 18F-FDG PET/CT cancer screening, which revealed multiple 18F-FDG-avid uptakes in the pancreas, prostate, and lymph nodes in the upper mediastinum, pulmonary hila, porta hepatis, and the left iliac and inguinal regions. He was not symptomatic at this initial examination. The follow-up 18F-FDG PET/CT study showed disappearance of 18F-FDG-avid uptake foci in the pancreas despite no treatment having been administered, but demonstrated new lesions in the abdominal para-aortic region and more intense FDG uptake in the porta hepatis lesion. Serial 18F-FDG PET/CT studies might be useful in monitoring patients with IMSF, as well as evaluating the state of systemic involvement. Findings of 18F-FDG PET/CT may provide information useful for determining the optimal initiation of IMSF treatment. (author)

  18. Study of clinical application of 18F-FDG spect with coincidence in the recurrent or metastatic tumor of digestive system

    Purpose: To investigate the clinical value of 18F-FDG SPECT with coincidence in the diagnosis of recurrent or metastatic tumor of digestive system. Methods: 35 cases of postoperative patients with tumor of digestive system were enrolled in this study with 18F-FDG SPECT with coincidence. The results were analyzed by calculating its accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and 95% confidence interval and compared with UB, CT and MRI. Results: In 35 cases of postoperative patients with tumor of digestive system, the accuracy, sensitivity, specificity, PPV and NPV were 91.4%, 88.9%, 100%, 100%, 72.7%, respectively, and their 95% confidence interval were 77% - 98%, 71% - 98%, 63% - 100%, 86% - 100%, 39% - 94%, respectively. The diagnostic accuracy and sensitivity of 18F-FDG SPECT with coincidence were significantly higher than that of UB, while there were no significant difference between the result of other 18F-FDG SPECT with coincidence and CT and MRI. The analysis of 95% confidence interval showed a higher tendency in 18F-FDG SPECT with coincidence than in UB, CT and MRI. There is complementation among 18F-FDG SPECT with coincidence combined with UB, CT and MRI in some cases. Conclusions: 18F-FDG SPECT/PET has high clinical value in the diagnosis of recurrent or metastatic tumor of digestive system. (authors)

  19. Background 18F-FDG uptake in positron emission mammography (PEM): Correlation with mammographic density and background parenchymal enhancement in breast MRI

    We aimed to determine whether background 18F-FDG uptake in positron emission mammography (PEM) was related to mammographic density or background parenchymal enhancement in breast MRI. Methods: We studied a total of 52 patients (mean age, 50.9 years, 26 premenopausal, 26 postmenopausal) with newly diagnosed breast cancer who underwent 18F-FDG PEM (positron emission mammography), conventional mammography and breast MRI. The background mean 18F-FDG uptake value on PEM was obtained by drawing a user-defined region of interest (ROI) in a normal area of the contralateral breast. We reviewed the mammography retrospectively for overall breast density of contralateral breast according to the four-point scale (grade 1–4) of the Breast Imaging Reporting and Data System (BI-RADS) classification. The background parenchymal enhancement of breast MRI was classified as minimal, mild, moderate, or marked. All imaging findings were interpreted by two readers in consensus without knowledge of image findings of other modalities. Results: Multiple linear regression analysis revealed a significant correlation between background 18F-FDG uptake on PEM and mammographic density after adjustment for age and menopausal status (P 18F-FDG uptake on PEM and background parenchymal enhancement on MRI. Conclusion: Background 18F-FDG uptake on PEM significantly increases as mammographic density increases. Background parenchymal enhancement in breast MRI was not an independent predictor of the background 18F-FDG uptake on PEM unlike mammographic density

  20. Combined 18F-Fluoride and 18F-FDG PET/CT Scanning for Evaluation of Malignancy: Results of an International Multicenter Trial

    Iagaru, Andrei; Mittra, Erik; Mosci, Camila; Dick, David W.; Sathekge, Mike; Prakash, Vineet; Iyer, Victor Vishwanath; Lapa, Paula; Isidoro, Jorge; de Lima, Joao M.; Gambhir, Sanjiv Sam

    2012-01-01

    PET/CT examination for evaluation of cancer patients and compared it with separate 18F2 PET/CT and 18F-FDG PET/CT scans. Methods: One hundred fifteen participants with cancer were prospectively enrolled in an international multicenter trial evaluating 18F2 PET/CT, 18F-FDG PET/CT, and combined 18F2/18F......-FDG PET/CT. The 3 PET/CT scans were performed sequentially within 4 wk of one another for each patient. Results: 18F2/18FFDG PET/CT allowed for accurate interpretation of radiotracer uptake outside the skeleton, with findings similar to those of 18F-FDG PET/CT. In 19 participants, skeletal disease was...... more extensive on 18F2 PET/CT and 18F2/18F-FDG PET/CT than on 18F-FDG PET/CT. In another 29 participants, 18F2 PET/CT and 18F2/18F-FDG PET/CT showed osseous metastases where 18FFDG PET/CT was negative. The extent of skeletal lesions was similar in 18 participants on all 3 scans. Conclusion: This trial...

  1. Comparison between 18F-FDG PET/CT and EMG Mapping for Identifying Dystonic Superficial Muscles in Primary Cervical Dystonia: Preliminary Results

    This study was conducted to compare 18F-FDG PET/CT and electromyography (EMG) mapping in patients with primary cervical dystonia (PCD) to find dystonic superficial cervical muscles. Ten consecutive patients with PCD (M:F=5:5, age 44±13 years) whose dystonic posture was not relieved with conventional muscle relaxant therapy were included. Target cervical muscles for the comparison between 18F-FDG PET/CT and EMG mapping were four representative superficial bilateral cervical muscles: splenius capitis muscle, sternocleidomstoid muscle, upper trapeziums muscle, and levitator scapulae muscle. The diagnostic efficacy was compared between 18F-FDG PET/CT and EMG mapping using physical exam and measurement of rotation angle as the gold standard. Among 80 muscles evaluated, there were 21 (26%) dystonic superficial cervical muscles assessed with physical exam and motion analysis. The sensitivity, specificity, and accuracy for localizing dystonic muscles were 76, 92, and 88% for 18F-FDG PET/CT, and 95, 66, and 74% for EMG mapping, respectively. The sensitivity of EMG mapping was significantly higher than that of 18F-FDG PET/CT. In contrast, 18F-FDG PET/CT is more specific and accurate than EMG mapping for finding superficial dystonic cervical muscles. The high sensitivity of EMG mapping suggests that 18F-FDG PET/CT and EMG mapping are complementary for finding dystonic superficial cervical muscles.

  2. 放射性核素标记胆碱与18F-FDG PET肿瘤显像的对比研究%Comparison choline with 18F-FDG PET in various tumors imaging

    李亚军; 张慧娟

    2010-01-01

    18F-FDG PET has become the preferred method of staging and restaging of many malignant neoplasms. Its application has increased diagnostic accuracy and exerted a considerable impact on the treatment of patients. 18F-FDG PET has also become extremely valuable in therapy efficacy monitoring of many malignant neoplasms. Choline is critical for cellular membrane structures and function. Choline metabolism increases in malignant neoplasms. 11C-/18F-choline PET has been used in diagnosis and detection of many malignant neoplasms and metastases. This paper reviews the value of 18F-FDG and 11C-/18F-choline PET in tumors imaging and compares their advantages and limitations.%18F-FDG PET是目前临床上许多恶性肿瘤分期和再分期的首选检查方法,可明显提高恶性肿瘤的诊断准确性,对患者的治疗方案的选择产生了很大影响,而且在恶性肿瘤的疗效监测中也有很大价值.胆碱是保持细胞膜结构和功能完整性的重要成分,恶性肿瘤的胆碱代谢增高.11C-/18F-胴碱PET在临床上已用于许多恶性肿瘤的诊断及转移瘤的检出.该文回顾了18F-FDG和11C-/18F-胆碱PET在肿瘤显像中的应用价值,并比较了其优势和限度.

  3. Routine use of dual time 18F-FDG PET for staging of preoperative lung cancer. Does it affect clinical management?

    The objective of this study was to compare the diagnostic accuracy of dual-time-point 18F-fluorodeoxy-glucose (18F-FDG) positron emission tomography (PET) to single-time-point 18F-FDG PET for staging of preoperative lung cancer. Between November 2008 and December 2009, 107 patients who were diagnosed as having lung cancer or strongly suspected of having lung cancer were enrolled. They underwent dual-time-point 18F-FDG PET following conventional imaging. Dual-time-point 18F-FDG PET imaging (whole body) was performed at 1-h (early) post-FDG injection and repeated (2 h delayed) after injection. The diagnostic accuracy of pre-PET staging and post-PET staging was retrospectively evaluated, and the diagnostic accuracy of dual-time-point 18F-FDG PET was compared to that of single-time-point 18F-FDG PET. In 100 patients, the early 18F-FDG PET scan resulted in upstaging of the tumor in ten (10%) and down-staging of the tumor in five (5%) compared to the conventional scan. The delayed phase of 18F-FDG PET provided no additional information on staging for lung cancer patients. The remaining seven patients were diagnosed as not having lung cancer. This study confirmed that dual-time-point 18F-FDG PET is useful for differential diagnosis between benign and malignant lesions, but has no major impact on staging and therapeutic management of patients with pathologically proven lung cancer. (author)

  4. 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; JOSÉ SOARES JÚNIOR; MÁRIO TERRA FILHO

    2002-01-01

    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...

  5. Using {sup 18F} FDG PET/CT to Detect an occult Mesenchymal Tumor Causing Oncogenic Osteomalacia

    Seo, Hyo Jung; Choi, Yun Jung; Kim, Hyun Jeong; Jeong, Yong Hyu; Cho, Arthur; Lee, Jae Hoon; Yun, Mijin; Lee, Jong Doo; Kang, Won Jun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2011-09-15

    Oncogenic osteomalacia is a rare paraneoplastic syndrome characterized by renal phosphate excretion, hypophosphatemia, and osteomalacia. This syndrome is often caused by tumors of mesenchymal origin. Patients with oncogenic osteomalacia have abnormal bone mineralization, resulting in a high frequency of fractures. Tumor resection is the treatment of choice, as it will often correct the metabolic imbalance. Although oncogenic osteomalacia is a potentially curable disease, diagnosis is difficult and often delayed because of the small size and sporadic location of the tumor. Bone scintigraphy and radiography best characterize osteoma lacia; magnetic resonance imaging findings are nonspecific. Here, we report a case of oncogenic osteomalacia secondary to a phosphaturic mesenchymal tumor that was successfully detected by {sup 18F} fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18F} FDG PET/CT). This case illustrates the advantages of {sup 18F} FDG PET/CT in detecting the occult mesenchymal tumor that causes oncogenic osteomalacia.

  6. Lung Adenocarcinoma Staged as an Unknown Primary Presenting with Symptomatic Colon Metastases: Staging by 18F FDG PET/CT

    Makis, William [Brandon Regional Health Centre, Brandon (Canada); Ciarallo, Anthony [Royal Victoria Hospital, Montreal (Canada)

    2011-12-15

    A 66 year old man, who presented with bright red blood per rectum, was referred for an {sup 18F} FDG PET/CT after colonoscopy showed two suspicious colon masses, which were biopsied to reveal an adenocarcinoma of unknown origin. PET/CT showed two intensely FDG avid colon massed as well as an unsuspected FDG avid lung mass, which was biopsied to reveal a primary lung adenocarcinoma. Immunohistochemistry confirmed the two colon metastases were of pulmonary origin. It is extremely rare for lung carcinoma to present with symptomatic colon metastases, with only 11 cases described in the literature. We report the first case of the utility of {sup 18F} FDG PET/CT in staging a patient who presented with symptomatic colon metastases of an unknown primary lung malignancy.

  7. Giant Cell Tumor Pulmonary Metastases Mimic Primary malignant Pulmonary Nodules on 18F FDG PET/CT

    A 59-year-old man with a 30-year history of multiple recurrences of a giant cell tumor (GCT) of the left knee was referred for an 18F-FDG PET/CT to evaluate a solitary pulmonary nodule. The nodule was mildly FDG-avid, raising suspicion of malignancy. It was excised and histologically proven to be a GCT pulmonary metastasis. A follow-up PET/CT done 2 years later revealed a new, larger lung mass that was more intensely FDG-avid, but of the same histology. This rare report highlights a pitfall in the evaluation of solitary pulmonary lesions by 18F-FDG PCT/CT in patients with GCT of the bone

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

    Omami, Galal [Dept. of Oral Diagnosis and Polyclinics, Faculty of Dentistry, The Hong Kong University, Hong Kong (Hong Kong); Tamimi, Dania [BeamReaders Inc., Orlando (United States); Branstette, Barton F. [Dept. of Otolaryngology and Radiology, University of Pittsburgh School of Medicine, Pittsburgh (United States)

    2014-12-15

    A combination of positron emission tomography (PET) with 18F-labeled fluoro-2-deoxyglucose ({sup 18}F-FDG) and computed tomography ({sup 18}F-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.

  9. Desmoplastic small round cell tumor: impact of 18F-FDG PET induced treatment strategy in a patient with long-term outcome

    Alessio Imperiale

    2009-07-01

    Full Text Available The desmoplastic small round cell tumor (DSRCT is an uncommon and highly aggressive cancer. The role of 18F-FDG PET in management of DSRCT is little reported. We report a case of metastasized abdominal DSRCT detected in a 43-year old patient whose diagnostic and therapeutic approaches were influenced by 18F-FDG PET-CT. The patient is still alive ten years after diagnosis. 18F-FDG PET-CT seems to be a useful method for assessing therapeutic efficiency and detecting early recurrences even in rare malignancies such as DSRCT.

  10. [18F]FDG is not transported by P-glycoprotein and breast cancer resistance protein at the rodent blood–brain barrier

    Introduction: Transport of 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) by the multidrug efflux transporters P-glycoprotein (ABCB1) and breast cancer resistance protein (ABCG2) at the blood–brain barrier (BBB) may confound the interpretation of [18F]FDG brain PET data. Aim of this study was to assess the influence of ABCB1 and ABCG2 at the BBB on brain distribution of [18F]FDG in vivo by performing [18F]FDG PET scans in wild-type and transporter knockout mice and by evaluating changes in [18F]FDG brain distribution after transporter inhibition. Methods: Dynamic small-animal PET experiments (60 min) were performed with [18F]FDG in groups of wild-type and transporter knockout mice (Abcb1a/b(−/−), Abcg2(−/−) and Abcb1a/b(−/−)Abcg2(−/−)) and in wild-type rats without and with i.v. pretreatment with the known ABCB1 inhibitor tariquidar (15 mg/kg, given at 2 h before PET). Blood was sampled from animals from the orbital sinus vein at the end of the PET scans and measured in a gamma counter. Brain uptake of [18F]FDG was expressed as the brain-to-blood radioactivity concentration ratio in the last PET time frame (Kb,brain). Results: Kb,brain values of [18F]FDG were not significantly different between different mouse types both without and with tariquidar pretreatment. The blood-to-brain transfer rate constant of [18F]FDG was significantly lower in tariquidar-treated as compared with vehicle-treated rats (0.350 ± 0.025 mL/min/g versus 0.416 ± 0.024 mL/min/g, p = 0.026, paired t-test) but Kb,brain values were not significantly different between both rat groups. Conclusion: Our results show that [18F]FDG is not transported by Abcb1 at the mouse and rat BBB in vivo. In addition we found no evidence for Abcg2 transport of [18F]FDG at the mouse BBB. Advances in knowledge and implications for patient care: Our findings imply that functional activity of ABCB1 and ABCG2 at the BBB does not need to be taken into account when interpreting brain [18F]FDG PET data

  11. Radiation exposure to nuclear medicine staffs during 18F-FDG PET/CT procedures at Ramathibodi Hospital

    Donmoon, T.; Chamroonrat, W.; Tuntawiroon, M.

    2016-03-01

    The aim of this study is to estimate the whole body and finger radiation doses per study received by nuclear medicine staff involved in dispensing, administration of 18F-FDG and interacting with radioactive patients during PET/CT imaging procedures in a PET/CT facility. The whole-body doses received by radiopharmacists, technologists and nurses were measured by electronic dosimeter and the finger doses by ring dosimeter during a period of 4 months. In 70 PET/CT studies, the mean whole-body dose per study to radiopharmacist, technologist, and nurse were 1.07±0.09, 1.77±0.46, μSv, and not detectable respectively. The mean finger doses per study received by radiopharmacist, technologist, and nurse were 265.65±107.55, 4.84±1.08 and 19.22±2.59 μSv, respectively. The average time in contact with 18F-FDG was 5.88±0.03, 39.06±1.89 and 1.21±0.02 minutes per study for radiopharmacist, technologist and nurse respectively. Technologists received highest mean effective whole- body dose per study and radiopharmacist received the highest finger dose per study. When compared with the ICRP dose limit, each individual worker can work with many more 18F- FDG PET/CT studies for a whole year without exceeding the occupational dose limits. This study confirmed that low levels of radiation does are received by our medical personnel involved in 18F-FDG PET/CT procedures.

  12. Prediction of Pathologic Grade and Prognosis in Mucoepidermoid Carcinoma of the Lung Using 18F-FDG PET/CT

    Park, Byungjoon; Kim, Hong Kwan; Choi, Yong Soo; Kim, Jhingook; Zo, Jae Il; Choi, Joon Young; Shim, Young Mog

    2015-01-01

    Objective The maximum standardized uptake value (SUVmax) of pulmonary mucoepidermoid carcinoma (PMEC) in fluorine-18fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) was evaluated as a preoperative predictor of pathologic grade and survival rate. Materials and Methods Twenty-three patients who underwent preoperative PET/CT and complete resection for PMEC were enrolled. The optimal cut-off SUVmax for tumor grade was calculated as 6.5 by receiver operating cha...

  13. Optimization of Quantitative Processing Data of Positron Emission Tomography with 18F-FDG in Patients with Lung Cancer

    Granov A.M.; Tyutin L.А.; Tlostanova М.S.; Avetisyan А.О.; Ryzhkova D.V.

    2012-01-01

    The aim of the investigation is to increase efficiency of positron emission tomography (PET) with 18F-FDG in differential diagnostics of ung cancer and non-neoplastic diseases by means of quantitative processing data optimization. Materials and Methods. PET findings of 347 patients with focal or infiltrative changes in the lungs were studied. Quantitative processing of the findings included the measurement of scintigraphic size of the focus, SUV index calculations and SUV/size. Diagnostic...

  14. Role of 18F-FDG PET Scan in Rheumatoid Lung Nodule: Case Report and Review of the Literature

    Lohr, Kristine M.; Chhakchhuak, Christine L.; Mehdi Khosravi

    2013-01-01

    Flourine-18 fluoro-2-deoxy-glucose (18F-FDG) positron emission tomography combined with computed tomography (PET/CT) is a useful test for the management of malignant conditions. Inflammatory and infectious processes, however, can cause increased uptake on PET scanning, often causing diagnostic dilemmas. This knowledge is important to the rheumatologist not only because of the inflammatory conditions we treat but also because certain rheumatic diseases impose an increased risk of malignancy ei...

  15. The evolving role of 18F-FDG PET scans in patients with aggressive non-Hodgkin’s lymphoma

    Hosein, Peter J.; Lossos, Izidore S.

    2010-01-01

    Functional imaging by 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) is being increasingly incorporated into the evaluation of patients with aggressive non-Hodgkin lymphoma (NHL). Its use for the initial staging in combination with computed tomography has now become standard. PET has recently been included in consensus criteria for response after therapy for Hodgkin lymphoma and aggressive NHL. At the end of therapy, PET has a high positive and negative predictive value (PP...

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

    To evaluate the impact of 18F-FDG PET/CT on target volume delineation in gynaecological cancer. 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 using the signal-to-background (SBR) ratio-based adaptive thresholding technique (GTVSBR). Overlap analysis were conducted to assess geographic mismatches between the GTVs delineated using the different techniques. Inter- and intra-observer variability were also assessed. The mean GTVCT (43.65 cm3) was larger than the mean GTVPET/CT (33.06 cm3), p = 0.02. In 6 patients, GTVPET/CT added substantial tumor extension outside the GTVCT even though 90.4% of the GTVPET/CT was included in the GTVCT and 30.2% of the GTVCT was found outside the GTVPET/CT. The inter- and intra-observer variability was not significantly reduced with the inclusion of 18F-FDG PET imaging (p = 0.23 and p = 0.18, respectively). The GTVSBR was smaller than GTVCT p ≤ 0.005 and GTVPET/CT p ≤ 0.005. The use of 18F-FDG PET/CT images for target volume delineation of recurrent or post-surgical residual gynaecological cancer alters the GTV in the majority of patients compared to standard CT-definition. The use of SBR-based auto-delineation showed significantly smaller GTVs. The use of PET/CT based target volume delineation may improve the accuracy of RT treatment planning in gynaecologic cancer

  17. Response evaluation of gastrointestinal stromal tumors treated with imatinib using 18F-FDG PET/CT

    Full text: Several studies have demonstrated the effective use of adjuvant treatment with Imatinib mesylate for unresectable, metastatic or recurrent Gastrointestinal Stromal Tumors (GIST). We retrospectively evaluated the role of 18F-FDG PET/CT scanning in assessing the response of GIST patients to imatinib mesylate therapy. Materials and Methods: Thirteen consecutive patients with GIST confirmed by surgery (5 stomach, 6 small bowel, 1 small bowel and peritoneum, and 1 rectum) underwent 60 18F-FDG PET/CT imaging before and after beginning imatinib mesylate therapy (400 mg/day or greater if disease progression). PET/CT scan was acquired 60 minutes after the intravenous injection of 333-707 MBq of 18F-FDG. Visual and semiquantitative (standardized uptake value (SUV)) analysis of images was performed. A decrease in SUV of more than 50% was considered as significant response, decrease in SUV of more than 25% was considered as partial response. Increase in SUV of more than 25% or appearance of new lesion (s) was considered as progression of disease. Response to therapy was assessed according to EORTC recommendations for PET. Results were confirmed by clinical follow-up, CECT findings or histological analysis (when available). Results: Complete response to imatinib mesylate was observed in 5 patients. Partial response and stable disease was noted in two each. Four patient demonstrated progression of disease, two developed liver metastasis, one developed abdominal lymphnode pathology and one had increase in size and uptake of tumor. Conclusion: 18F-FDG PET/CT scan identified the degree of GIST response to imatinib therapy. Patients who responded to therapy showed normalisation of FDG uptake or a decrease in the SUV of lesions. Patients with progression of disease demonstrated increase in uptake value or development of new lesion

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

    Rui-xue CUI

    2014-04-01

    Full Text Available 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 (FTD, 10 dementia with Lewy body (DLB, 7 progressive supranuclear palsy (PSP, 3 primary progressive aphasia (PPA, 1 corticobasal ganglionic degeneration (CBD, 1 multiple system atrophy (MSA. 18F-FDG PET images of each group were analyzed and compared to 20 healthy controls using SPM5. Results Disease-specific patterns of relatively decreased metabolic activity were found in AD (bilateral parietotemporal regions and frontal regions sparing sensorimotor cortex, FTD (asymmetric frontotemporal regions, DLB (occipital lobe, visual cortex and bilateral superior temporal gyrus, PSP (bilateral dorsolateral prefrontal cortex, anterolateral temporal regions, caudate nucleus and mesencephalon, PPA (Broca's area in left frontal lobe, left temporal cortex excepting posterior superior temporal gyrus, CBD (asymmetricly involved cortical regions, prodominately on right side, around bilateral central sulcus and right basal ganglia, MSA (bilateral cerebellum dorsolateral cortex and left putamen, and right medial temporal cortex.  Conclusions Specific dementia related cerebral metabolic patterns in 18F-FDG PET might assist in early differential diagnosis of neurodegenerative diseases. doi: 10.3969/j.issn.1672-6731.2014.04.008

  19. Correlation between EGFR gene mutation, cytologic tumor markers, 18F-FDG uptake in non-small cell lung cancer

    Cho, Arthur; Hur, Jin; Moon, Yong Wha; Hong, Sae Rom; Suh, Young Joo; Kim, Yun Jung; Im, Dong Jin; Hong, Yoo Jin; Lee, Hye-Jeong; Kim, Young Jin; Shim, Hyo Sup; Lee, Jae Seok; Kim, Joo-Hang; Choi, Byoung Wook

    2016-01-01

    Background EGFR mutation-induced cell proliferation causes changes in tumor biology and tumor metabolism, which may reflect tumor marker concentration and 18F-FDG uptake on PET/CT. Direct aspirates of primary lung tumors contain different concentrations of tumor markers than serum tumor markers, and may correlate better with EGFR mutation than serum tumor markers. The purpose of this study is to investigate an association between cytologic tumor markers and FDG uptake with EGFR mutation statu...

  20. Differentiation of cardiac thrombus from cardiac tumor combining cardiac MRI and 18F-FDG-PET/CT Imaging.

    Rinuncini, Massimo; Zuin, Marco; Scaranello, Fiorenzo; Fejzo, Majlinda; Rampin, Lucia; Rubello, Domenico; Faggian, Giuseppe; Roncon, Loris

    2016-06-01

    Radiological differentiation of an unknown cardiac masse is often a challenging issue. 18F-FDG-PET/CT imaging was performed to evaluate a left ventricle mass visualized on transthoracic echocardiogram (TTE) and cardiac magnetic resonance (CMR) in a patient with an history of ischemic heart disease. The metabolically inert area on the PET/CT, corresponding to the relatively homogenous hypodensity in the LV, was thought to represent an old organized LV thrombus. Histopathological examination confirmed the imaging diagnosis. PMID:27038712

  1. 18F-FDG metabolism in a rat model of chronic infarction. A 17-sector semiquantitative analysis

    Strategies to establish the functional benefit of cell therapy in cardiac regeneration and the potential mechanism are needed. Aims: Development of a semi-quantitative method for non invasive assessment of cardiac viability and function in a rat model of myocardial infarction (MI) based on the use of microPET. Animals, methods: Ten rats were subjected to myocardial imaging 2, 7, 14, 30, 60 and 90 days after left coronary artery ligation. Intravenous 18F-fluoro-2-deoxy-2-D-glucose (18F-FDG) was administered and regional 18F activity concentrations per unit area were measured in 17 regions of interest (ROIs) drawn on cardiac polar maps. By comparing the differences in 18F uptake between baseline and each of the follow up time points, parametric polar maps of statistical significance (PPMSS) were calculated. Left ventricular ejection fraction (LVEF) was blindly assessed echocardiographically. All animals were sacrificed for histopathological analysis after 90 days. Results: The diagnostic quality of 18F-FDG microPET images was excellent. PPMSS demonstrated a statistically significant decrease in 18F concentrations as early as 48 hours after MI in 4 of the 17 ROIs (segments 7, 13, 16 and 17; p 18F-FDG uptake correlated with echocardiographic decrease in LVEF (p <0.001). Conclusion: The use of PPMSS based on 18F-FDG-microPET provides valuable semi-quantitative information of heart glucose metabolism allowing for non-invasive follow up thus representing a useful strategy for assessment of novel therapies in cardiac regeneration. (orig.)

  2. 18F-FDG PET/CT for Diagnosis of Osteosclerotic and Osteolytic Vertebral Metastatic Lesions: Comparison with Bone Scintigraphy

    Uchida, Kenzo; Nakajima, Hideaki; Miyazaki, Tsuyoshi; Tsuchida, Tatsuro; Hirai, Takayuki; Sugita, Daisuke; Watanabe, Shuji; Takeura, Naoto; Yoshida, Ai; Okazawa, Hidehiko; Baba, Hisatoshi

    2013-01-01

    Study Design A retrospective study. Purpose The aims of this study were to investigate the diagnostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in PET/computed tomography (CT) in the evaluation of spinal metastatic lesions. Overview of Literature Recent studies described limitations regarding how many lesions with abnormal 18F-FDG PET findings in the bone show corresponding morphologic abnormalities. Methods The subjects for this retrospective study were 227 pat...

  3. Functional imaging of infection: conventional nuclear medicine agents and the expanding role of {sup 18-}F-FDG PET

    Parisi, Marguerite T. [Seattle Children' s Hospital, Department of Radiology R-5417, Seattle, WA (United States)

    2011-07-15

    A growing body of literature suggests that 18-fluorine fluorodeoxyglucose positron emission tomography ({sup 18}F-FDG PET), particularly when combined with CT, is a useful tool for the detection of infectious and inflammatory disease processes. This article will briefly review the data to date on the use of FDG PET in diagnosing musculoskeletal infections and fever of unknown origin, comparing it to conventional scintigraphic techniques in both adults and, when available, in children. (orig.)

  4. Functional imaging of infection: conventional nuclear medicine agents and the expanding role of 18-F-FDG PET

    A growing body of literature suggests that 18-fluorine fluorodeoxyglucose positron emission tomography (18F-FDG PET), particularly when combined with CT, is a useful tool for the detection of infectious and inflammatory disease processes. This article will briefly review the data to date on the use of FDG PET in diagnosing musculoskeletal infections and fever of unknown origin, comparing it to conventional scintigraphic techniques in both adults and, when available, in children. (orig.)

  5. Accuracy of 18F-FDG PET/CT for lymph node staging in non-small-cell lung cancers

    LIU Bao-jun; DONG Jing-cheng; XU Chang-qing; ZUO Chuan-tao; LE Jing-jing; GUAN Yi-hui; ZHAO Jun; WU Jin-feng; DUAN Xiao-hong; CAO Yu-xue

    2009-01-01

    Background This retrospective study evaluated the diagnostic accuracy of 2-(F18)-fluoro-2-deoxy-D-glucose-positron emission tomography(18F-FDG-PET)/COmputed tomography(PET/CT)in the preoperative diagnosis of metastatic mediastinal and hilar lymph node in patients with non-small-cell lung cancer(NSCLC).Methods A total of 39 patients received preoperative 18F-FDG PET/CT and the postoperative biopsy.We compared preoperative PET/CT scan results with corresponding intraoperative histopathalogic findings in 39 NSCLC patients.The sensitivity,specificity,accuracy,positive and negative predictive value of 18F-FDG PET/CT were assessed.Results Histopathologic examination confirmed metastasis in 57 out of the 208 excised lymph nodes;23 of the 57 nodes were mediastinal and hilar lymph nodes.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of PET/CT in the preoperative diagnosis of mediastinal lymph node metastasis in NSCLC patients were 65%,96.8%,92%,78.5%and 90%,respectively.Conclusions PET/CT scan showed good accuracy in the preoperative diagnosis of mediastinal and hilar lymph node metastasis in the patients with NSCLC.We recommend that PET/CT scanning be used as a first-line evaluation tool for tumor diagnosis,therapy evaluation and follow-up.

  6. Comparison of diagnostic value between 18F-FDG PET/CT and MRI in nasopharyngeal carcinoma

    Objective: To determine whether the use of 18F-FDG PET/CT alters staging and management of nasopharyngeal carcinoma (NPC) when compared with MRI staging practice; and to explore the relation of standard uptake value (SUV) of 18F-FDG PET/CT and the pathological classification and T staging of NPC. Methods: The study was performed retrospectively on a group of 41 patients with a new diagnosis of NPC. All the patients underwent whole body PET/CT scanning and head and neck MRI scanning within 3 weeks of each other. The AJCC protocol was introduced to stage NPC and the results of the PET/CT were compared with MRI based on pathologic diagnosis. Results: (1)Primary tumor: the accuracy of T staging of PET/CT was significantly higher than MRI (85.37% υs 60.98%, U=2.49, Ps=0.706, P18F-FDG PET/CT stages NPC more accurately and sensitively than does MRI. (authors)

  7. Different 18F-FDG Uptake According to Tumor Location and Morphology of Cholangiocarcinoma and Its Clinical Implication

    18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) scan has been found to reflect tumor aggressiveness and prognosis in various types of cancer. However, pattern of FDG uptake in biliary malignancies and its clinical significance have not been studied well. The purpose of this study was to assess the additional value of 18F-FDG PET in differential diagnosis and prognosis of cholangiocarcinoma (CC) according to the tumor location and tumor morphology. From April 2005 to May 2008, eighty two patients (M:F=55:27, age 66.2±9.6 yrs) with CC underwent 18F-FDG PET. For semiquantitative analysis, the maximum standardized uptake value (SUVmax) was obtained from the primary tumor. The difference of SUVmax according to the tumor location and tumor growth pattern, such as scirrhous type, nodular type, polypoid type were compared. Overall sensitivity of PET scan was 81.7% in CC. SUVmax on PET scan in intrahepatic CC was significantly higher compared to extrahepatic CC. In extrahepatic CC, polypoid type showed significantly higher SUVmax compared to scirrhous type. 18F-FDG PET may have a significant impact on clinical decision-making and on the management of Intrahepatic cholangiocarcinoma. And it is related to the shape of the tumor and the sensitivity of detection is higher in the mass-forming type than in the scirrhous type

  8. The Prevalence and Characteristics of Brown Adipose Tissue in an 18F-FDG PET Study of Koreans

    The object of this study was to evaluate the prevalence and characteristics of brown adipose tissue (BAT) in Korean subjects using 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET). Six thousand and five consecutive 18F-FDG PET/CT scans of 5,115 patients (3,007 females and 2,108 males, mean age 53.5 years) were retrospectively reviewed. We characterized the nature of BAT, such as tis location, and we assessed the influence of sex, age, body mass index (BMI), and temperature on BAT. The prevalence of BAT in Koreans in a single 18F-FDG PET/CT scan in average conditions was 1.07%. The BAT detection rate was higher in females than males (1.32% vs 0.73%), and also with younger age (7.94% vs 0.73%), and lower BMI (BMI with BAT, 21.1 vs BMI without BAT, 23.15) and cold outdoor temperature (1.65% vs 0.49%). The most frequent location of BAT was the supraclavicular area (left, 0.91%; right, 0.88%) and ventral neck area (left, 0.62%; right, 0.63%). Conclusions The characteristics of BAT in Koreans are not different from those described for Caucasians. However, the low prevalence of BAT in our study might be related to some scan condition like ambient temperature, but further study is needed.

  9. The role of 18F-FDG PET in the differentiation between lung metastases and synchronous second primary lung tumours

    In lung cancer patients with multiple lesions, the differentiation between metastases and second primary tumours has significant therapeutic and prognostic implications. The aim of this retrospective study was to investigate the potential of 18F-FDG PET to discriminate metastatic disease from second primary lung tumours. Of 1,396 patients evaluated by the thoracic oncology group between January 2004 and April 2009 at the Radboud University Nijmegen Medical Centre, patients with a synchronous second primary lung cancer were selected. Patients with metastatic disease involving the lungs served as the control group. Maximum standardized uptake values (SUVs) measured with 18F-FDG PET were determined for two tumours in each patient. The relative difference between the SUVs of these tumours (∇SUV) was determined and compared between the second primary group and metastatic disease group. Receiver-operating characteristic (ROC) curve analysis was performed to determine the sensitivity and specificity of the ∇SUV for an optimal cut-off value. A total of 37 patients (21 metastatic disease, 16 second primary cancer) were included for analysis. The ∇SUV was significantly higher in patients with second primary cancer than in those with metastatic disease (58 vs 28%, respectively, p 18F-FDG PET images can be helpful in differentiating metastatic disease from second primary tumours in patients with synchronous pulmonary lesions. Further studies are warranted to confirm the consistency of these results. (orig.)

  10. Monitoring of anti-cancer treatment with (18)F-FDG and (18)F-FLT PET

    Jensen, Mette Munk; Kjaer, Andreas

    2015-01-01

    treatment effect early in a treatment course and by that to stratify patients into responders and non-responders. With 2-deoxy-2-[(18)F]fluoro-D-glucose ((18)F-FDG) and 3'-deoxy-3'-[(18)F]fluorothymidine((18)F-FLT) two of the cancer hallmarks, altered energy metabolism and increased cell proliferation, can...... be visualized and quantified non-invasively by PET. With (18)F-FDG and (18)F-FLT PET changes in energy metabolism and cell proliferation can thereby be determined after initiation of cancer treatment in both clinical and pre-clinical studies in order to predict, at an early time-point, treatment...... response. It is hypothesized that decreases in glycolysis and cell proliferation may occur in tumors that are sensitive to theapplied cancer therapeutics and that tumors that are resistant to treatment will show unchanged glucose metabolism and cell proliferation. Whether (18)F-FDG and/or (18)F-FLT PET can...

  11. Metabolic brain networks in patients with Parkinson's disease based on 18F-FDG PET imaging

    Objective: To validate PD-related pattern (PDRP) network as a measure of PD by 18F-FDG PET imaging. Methods: Thirty-two PD patients with different severities and 32 healthy controls matched by age and gender were recruited in studies of resting-state brain 18F-FDG PET imaging. To obtain the PDRP, principal component analysis (PCA) was used. The correlations between PDRP expression and the severities of PD (classified by unified PD rating scale (UPDRS) motor scores and Hoehn and Yahr stages) were investigated. The two-sample t test and Pearson correlation analysis were used for statistical analysis. Results: PDRP was characterized by relative metabolic increases in the putamen, globus pallidus (GP), thalamus, pons, cerebellum and primary motor cortex, and was associated with decreases in the premotor and posterior parietal areas. The value of PDRP expression in PD group (1.605±0.655) was significantly higher than that of healthy controls (0.000±0.523; t=10.829, P<0.001). The value of PDRP expression also correlated significantly with UPDRS motor scores (r=0.760, P<0.001) and Hoehn and Yahr stages in PD group (r=0.736, P<0.001). Conclusion: The PDRP based on 18F-FDG PET imaging can be useful for identification of PD patients from healthy controls and correlates well with the severity of the disease. (authors)

  12. 18F-FDG PET/CT is a valuable tool for relapsing polychondritis diagnose and therapeutic response monitoring

    To retrospectively investigate the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for the diagnosis and therapeutic response in relapsing polychondritis (RP) patients. 18F-FDG PET/CT findings were reviewed in six RP patients. The initial scans were performed for all patients, follow-up scans were performed during steroid therapy for five patients. Changes in the abnormal lesions and the maximal standard uptake value (SUVmax) were analyzed. The initial PET/CT scans revealed intense FDG uptake in the cartilages for all six patients. The lesions of abnormal FDG uptake were tracheal/bronchial cartilage (n=4), costicartilage (n=4), nasal cartilage (n=3), cricoid cartilage (n=3), auricular cartilage (n=3), arytenoid cartilage (n=3), thyroid cartilage (n=2), hyoid cartilage (n=1) and mediastinum lymph node (n=1). The mean visual score and the mean SUVmax were 2.96 ± 0.20 and 4.10 ± 0.6. The intense uptake reduced or disappeared during steroid therapy for five patients, the mean visual score and the mean SUVmax were 1.58 ± 1.4 and 1.51 ± 1.4. 18F-FDG PET/CT enables the acquisition of both morphologic and glucose metabolic of the related cartilage structures. It plays a valuable role in assessing almost all cartilage and detecting RP, which is a better selection of a biopsy site as well as therapeutic response monitoring. (author)

  13. Measurement of glucose metabolism in patients with dilated cardiomyopathy using positron emission tomography with 18F-FDG: Initial Experience

    Introduction: Fluorine18 deoxyglucose (18F-FDG) has been used in numerous studies to determine the cardiac rate of glucose metabolism in normal and pathological conditions. It is known that during heart failure the metabolic pattern is altered. Patlack's graphical analysis allows the assessment of heart muscle glucose consumption in patients with non-ischaemic heart failure and normal subjects. Methods: Standardized measurement of glucose metabolism was performed in four patients with dilated cardiomyopathy and three healthy subjects. All subjects received an oral load of carbohydrates (75gr) previous to scanning. Dynamic images of the thorax were acquired. Myocardial uptake was estimated from time-activity curves in the atrium and left ventricle using Patlack's graphical analysis. Results: All subjects studied were male. 18F-FDG uptake rate for the group with dilated cardiomyopathy was 1.31±0.2, versus 1.26±0.37 ml/100gr/min in the control group. Conclusion: Measurement of cardiac glucose metabolism by 18F-FDG PET is feasible in a clinical service, allowing impact evaluation of physiologic and metabolic changes in the myocardium in different pathologic scenarios in addition to therapy assessment

  14. Assessment of aortitis by semiquantitative analysis of 180-min 18F-FDG PET/CT acquisition images

    The aim of this study was to evaluate the contribution of semiquantitative analysis of 180-min 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT images for the assessment of aortitis in cases of suspected large vessel vasculitis (LVV) and to establish a threshold index for application in the clinical setting. This prospective study included 43 patients (mean age 67.5 ± 12.9 years) with suspicion of LVV (25 with a final diagnosis of aortitis). 18F-FDG PET/CT scan was acquired 180 min after injection of 7 MBq/kg of 18F-FDG. A semiquantitative analysis was performed calculating the aortic wall maximum standardized uptake value (SUVmax) (T), the lumen SUVmax (B) and the target to background ratio (TBR). These results were also compared with those obtained in a control population. The mean aortic wall SUVmax was 2.00 ± 0.62 for patients with aortitis and 1.45 ± 0.31 for patients without aortitis (p max (0.997 vs 0.871). The highest sensitivity and specificity was obtained for a TBR of 1.34 (sensitivity 100 %, specificity 94.4 %). Semiquantitative analysis of PET/CT images acquired 180 min after 18F-FDG injection and the TBR index of 1.34 show very high accuracy and, therefore, are strongly recommended for the diagnosis of aortitis in the clinical setting. (orig.)

  15. Potential role of 1'8F-FDG PET in pre-op assessment and prognostication of pseudomyxoma peritonei

    The peritoneum is a serous lining of mesothelial cells with rich vascular and lymphatic capillary network that covers the abdominal and pelvic walls and organs. Peritoneal neoplasia can originate de novo from the peritoneal tissues (primary) or can spread into the peritoneum from adjacent or remote organs (secondary). Pseudomyxoma peritonei (PMP) is a rare condition characterized by large amounts of mucinous gelatinous deposition in the peritoneal cavity with or without demonstratable cancerous cells in the histopathological examination. It was first described by Rokitansky in 1842. It is a slow progressive process seen as extensive mucinous deposition within the abdominal and pelvic peritoneal cavity. PMP is a relatively rare pathology affecting 1 per million population, with an estimated incidence of 2 cases per 10,000 laparotomies. Pseudomyxoma peritonei: Role of 18F-FDG PET in preoperative evaluation of pathological grade and potential for complete cytoreduction. This included 34 patients of PMP, who underwent pre-operative 18F-FDG PET scanning. They underwent a preoperative 18F-FDG PET with a double radiological evaluation and an explorative laparotomy with the objective of optimal cytoreduction followed by a hyperthermic intra-operative intraperitoneal chemotherapy (HIPEC). Patients with non resectable disease underwent debulking surgery without HIPEC. The Completeness of Cytoreduction was assessed by CC score. This study involved specialized teams for pathological grading of PMP

  16. Respiratory-gated 18F-FDG PET/CT for the diagnosis of liver metastasis

    Purpose: To ascertain the role of respiratory-gated PET/CT with 18F-fluorodeoxyglucose (18F-FDG) for accurate diagnosis of liver metastasis. Materials and methods: Forty patients with suspected liver metastasis underwent conventional whole-body PET/CT scan initially, followed by respiratory-gated PET/CT scan covering the liver. Visual detectability (using a 5-point confidence scale), maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV) of hepatic metastatic lesions were assessed for three data sets including ordinary whole-body (WB) scan, and non-respiratory-gated (nRG) and respiratory-gated (RG) scans. Results of enhanced CT and/or MRI, or clinical and radiological follow-up were used for reference. Results: Sixteen of the patients were found to have 53 metastatic lesions in the liver. Patient-based accuracy of WB, nRG, and RG was 92.5%, 95.0%, and 97.5%, respectively, with a lesion-based detection rate of 67.9%, 73.6%, and 73.6%, respectively. The average SUVmax of 34 liver metastatic lesions for WB, nRG, and RG was 6.60 ± 2.34, 7.19 ± 2.66, and 8.08 ± 3.24, respectively. SUVmax for RG was significantly higher than that for WB (p = 0.0069). The average MTV of these 40 lesions for the three protocols was 5.32 ± 4.78 cm3, 5.07 ± 4.73 cm3, and 4.73 ± 4.67 cm3, respectively. Among the three protocols, RG showed the best visual and quantitative evaluation for diagnosis of liver metastasis. Conclusion: Respiratory-gated PET/CT allows more accurate identification of liver metastases than non-respiratory-gated PET/CT

  17. Improved characterization of molecular phenotypes in breast lesions using 18F-FDG PET image homogeneity

    Cao, Kunlin; Bhagalia, Roshni; Sood, Anup; Brogi, Edi; Mellinghoff, Ingo K.; Larson, Steven M.

    2015-03-01

    Positron emission tomography (PET) using uorodeoxyglucose (18F-FDG) is commonly used in the assessment of breast lesions by computing voxel-wise standardized uptake value (SUV) maps. Simple metrics derived from ensemble properties of SUVs within each identified breast lesion are routinely used for disease diagnosis. The maximum SUV within the lesion (SUVmax) is the most popular of these metrics. However these simple metrics are known to be error-prone and are susceptible to image noise. Finding reliable SUV map-based features that correlate to established molecular phenotypes of breast cancer (viz. estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) expression) will enable non-invasive disease management. This study investigated 36 SUV features based on first and second order statistics, local histograms and texture of segmented lesions to predict ER and PR expression in 51 breast cancer patients. True ER and PR expression was obtained via immunohistochemistry (IHC) of tissue samples from each lesion. A supervised learning, adaptive boosting-support vector machine (AdaBoost-SVM), framework was used to select a subset of features to classify breast lesions into distinct phenotypes. Performance of the trained multi-feature classifier was compared against the baseline single-feature SUVmax classifier using receiver operating characteristic (ROC) curves. Results show that texture features encoding local lesion homogeneity extracted from gray-level co-occurrence matrices are the strongest discriminator of lesion ER expression. In particular, classifiers including these features increased prediction accuracy from 0.75 (baseline) to 0.82 and the area under the ROC curve from 0.64 (baseline) to 0.75.

  18. Response assessment of colorectal liver metastases with contrast enhanced CT/18F-FDG PET

    Purpose: Evaluate the diagnostic performance of contrast enhanced CT/PET (ceCT/PET) in the response assessment of patients with colorectal cancer liver metastases. Methods: 33 ce CT/PET studies of 19 patients with colorectal liver metastases were prospectively evaluated. All of them, 13 (68.4%) were males and 6 (31.6%) females. Mean age and range were 63 [42–78]. All patients were treated with neoadjuvant chemotherapy. In all cases post-therapy diagnostic confirmation of liver lesions was obtained. A ce CT PET/was obtained 1 h after the injection of 370 MBq of 18F-FDG. Metabolic and morphologic studies were evaluated by two blinded nuclear physicians and radiologists respectively to assess the location, size and suspected diagnosis of lesions (benign or malignant). A combined assessment of both techniques was performed. The final diagnosis was established by histopathology or clinical/radiological follow-up greater than 6 months. Results: A total of 120 liver lesions were identified, 115 were malignant and 5 benign. From the malignant lesions, 105 were identified with the ceCT, 44 with the PET and 109 with ceCT/PET. All of the benign lesions were correctly classified with any of the three imaging techniques. The sensitivity of PET, ceCT and ceCT/PET were of 38%, 91% and 95% respectively and the specificity was 100% in all three of the diagnostic studies. Conclusion: Administration of intravenous contrast in the PET/CT is mandatory to evaluate treatment response rate of liver metastases due to the limitations of isolated metabolic images in these cases

  19. {sup 18}F-FDG PET in stage IB/IIB cervical adenocarcinoma/adenosquamous carcinoma

    Chou, Hung-Hsueh; Lai, Chyong-Huey; Wu, Tzu-I; Chen, Ming-Yu.; Chang, Ting-Chang [Chang Gung Memorial Hospital and Chang Gung University, Department of Obstetrics and Gynaecology, Taoyuan (China); Chang, Hsiu-Ping; Yen, Tzu-Chen [Chang Gung Memorial Hospital and Chang Gung University, Department of Nuclear Medicine, Taoyuan (China); Ng, Koon-Kwan [Chang Gung Memorial Hospital and Chang Gung University, Department of Diagnostic Radiology, Taoyuan (China); Hsueh, Swei [Chang Gung Memorial Hospital and Chang Gung University, Department of Pathology, Taoyuan (China); Hong, Ji-Hong [Chang Gung Memorial Hospital and Chang Gung University, Department of Radiation Oncology, Taoyuan (China)

    2010-04-15

    The diagnostic and prognostic value of {sup 18}F-FDG PET in cervical adenocarcinoma/adenosquamous carcinoma (AC/ASC) is unclear. The aim of this study was to assess the value of PET in the management of cervical AC/ASC. Patients with resectable FIGO stage IB/IIB cervical AC/ASC receiving a preoperative MRI scan and a PET or PET/CT scan before radical surgery were eligible. Diagnostic efficacy was compared by receiver operating characteristic (ROC) analysis. Correlations between clinicopathological parameters and outcome and maximum standardized uptake values (SUVmax) of FDG uptake were evaluated. The study group comprised 83 patients (mean age 48.3{+-}9.7 years) Five-year overall survival was 85.5%, with a median follow-up time of 38.6 months (range 2.8-87.2 months). Pelvic lymph node (PLN) and paraaortic lymph node (PALN) metastases were seen in 32.5% and 8.4% of patients, respectively. The difference in diagnostic efficacy in identifying metastatic PALN between PET and MRI was significant (PET versus MRI, area under the curve 0.832 versus 0.607, p=0.039). SUVmax in primary tumour was correlated with LN metastasis and deep stromal invasion. Overall survival was significantly related to FIGO stage, PLN metastasis, deep cervical stromal invasion, tumour size measured by MRI, and SUVmax of the primary cervical tumour. PET provided significantly better diagnostic efficacy than MRI in detecting PALN metastasis. Poor prognostic factors in cervical AC/ASC were SUVmax of the primary cervical tumour >5.3, stage IIB, deep cervical stromal invasion, tumour size measured by MRI {>=}40 mm, and PLN metastasis. (orig.)

  20. 18F-FDG PET in stage IB/IIB cervical adenocarcinoma/adenosquamous carcinoma

    The diagnostic and prognostic value of 18F-FDG PET in cervical adenocarcinoma/adenosquamous carcinoma (AC/ASC) is unclear. The aim of this study was to assess the value of PET in the management of cervical AC/ASC. Patients with resectable FIGO stage IB/IIB cervical AC/ASC receiving a preoperative MRI scan and a PET or PET/CT scan before radical surgery were eligible. Diagnostic efficacy was compared by receiver operating characteristic (ROC) analysis. Correlations between clinicopathological parameters and outcome and maximum standardized uptake values (SUVmax) of FDG uptake were evaluated. The study group comprised 83 patients (mean age 48.3±9.7 years) Five-year overall survival was 85.5%, with a median follow-up time of 38.6 months (range 2.8-87.2 months). Pelvic lymph node (PLN) and paraaortic lymph node (PALN) metastases were seen in 32.5% and 8.4% of patients, respectively. The difference in diagnostic efficacy in identifying metastatic PALN between PET and MRI was significant (PET versus MRI, area under the curve 0.832 versus 0.607, p=0.039). SUVmax in primary tumour was correlated with LN metastasis and deep stromal invasion. Overall survival was significantly related to FIGO stage, PLN metastasis, deep cervical stromal invasion, tumour size measured by MRI, and SUVmax of the primary cervical tumour. PET provided significantly better diagnostic efficacy than MRI in detecting PALN metastasis. Poor prognostic factors in cervical AC/ASC were SUVmax of the primary cervical tumour >5.3, stage IIB, deep cervical stromal invasion, tumour size measured by MRI ≥40 mm, and PLN metastasis. (orig.)

  1. The Clinical Usefulness of 18F FDG PET/CT in Patients with Systemic Autoimmune Disease

    Individuals with systemic autoimmune disease have an increased susceptibility to both inflammation and malignancy. The aim of this study was to evaluate the clinical usefulness of 18F FDG PET/CT in patients with systemic autoimmune disease. Forty patients diagnosed with systemic autoimmune disease were enrolled. Diagnostic accuracy of FDG PET/CT for detecting malignancy was assessed. FDG PET/CT findings, including maximum standardized uptake (SUVmax) of lymphadenopathy (LAP), liver, bone marrow, spleen, joint and muscles, were considered for the characterization of LAPs. FDG PET/CT could detect metabolically activated lesions in 36 out of 40 patients (90%) including inflammatory lesions in 28 out of 32 patients (88%). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG PET/CT for the detection of malignancy were 100, 67, 70, 25, and 100%, respectively. Multiple LAPs were found in 25 of 40 patients (63%), and comprised three malignancies, four cases of tuberculosis, and 18 reactive changes. A SUVmax ratio of bone marrow to liver below 0.78 could distinguish malignancy from tuberculosis + reactive change (AUC=1.000, sensitivity: 100%, specificity: 100%). The SUVmax ratio of spleen to liver in the reactive group was also significantly higher than that in the malignancy group (P=0.014). SUVmax of LAP in the TB group was significantly higher than that in the reactive group (P=0.040). PET/CT is useful in detecting and differentiating inflammation and malignancy in patients with systemic autoimmune disease. Frequent false positive interpretations can be minimized by consideration of FDG uptake in bone marrow and spleen.

  2. Fluorine-18 radiopharmaceuticals beyond [{sup 18}F]FDG for use in oncology and neurosciences

    Coenen, H.H. [Institut fuer Neurowissenschaften und Medizin, INM-5: Institut fuer Nuklearchemie, Forschungszentrum Juelich GmbH, D-52425 Juelich (Germany); Elsinga, P.H. [Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Hanzeplein 1, Groningen (Netherlands); Iwata, R. [Cyclotron and Radioisotope Center, Tohoku University, Aramaki, Aoba-ku, Sendai 980-8578 (Japan); Kilbourn, M.R. [Division of Nuclear Medicine, Department of Radiology, University of Michigan Medical School, 2276 Medical Science I Building, Ann Arbor, MI 48109 (United States); Pillai, M.R.A., E-mail: m.r.a.pillai@iaea.or [Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Wagramer Strasse 5, A-1400 Vienna (Austria); Rajan, M.G.R. [Radiation Medicine Centre, Bhabha Atomic Research Centre, TMH Annexe, Parel, Mumbai 400012 (India); Wagner, H.N. [School of Hygiene and Public Health, The Johns Hopkins University, Baltimore, Maryland 21205-2179 (United States); Zaknun, J.J. [Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Wagramer Strasse 5, A-1400 Vienna (Austria)

    2010-10-15

    Positron emission tomography (PET) is a rapidly expanding clinical modality worldwide thanks to the availability of compact medical cyclotrons and automated chemistry for the production of radiopharmaceuticals. There is an armamentarium of fluorine-18 ({sup 18}F) tracers that can be used for PET studies in the fields of oncology and neurosciences. However, most of the {sup 18}F-tracers other than 2-deoxy-2-[18F]fluoro-D-glucose (FDG) are in less than optimum human use and there is considerable scope to bring potentially useful {sup 18}F-tracers to clinical investigation stage. The International Atomic Energy Agency (IAEA) convened a consultants' group meeting to review the current status of {sup 18}F-based radiotracers and to suggest means for accelerating their use for diagnostic applications. The consultants reviewed the developments including the synthetic approaches for the preparation of {sup 18}F-tracers for oncology and neurosciences. A selection of three groups of {sup 18}F-tracers that are useful either in oncology or in neurosciences was done based on well-defined criteria such as application, lack of toxicity, availability of precursors and ease of synthesis. Based on the recommendations of the consultants' group meeting, IAEA started a coordinated research project on 'Development of {sup 18}F radiopharmaceuticals (beyond [{sup 18}F]FDG) for use in oncology and neurosciences' in which 14 countries are participating in a 3-year collaborative program. The outcomes of the coordinated research project are expected to catalyze the wider application of several more {sup 18}F-radiopharmaceuticals beyond FDG for diagnostic applications in oncology and neurosciences.

  3. 18F-FDG PET/CT surgically proved finding in patient with NSCLC

    Full text: Introduction: The 18F-FDG PET / CT has an important role in the staging and evaluation of the treatment response of non-small cell lung cancer. Despite the high sensitivity and specificity of the method cases are known of increased metabolic activity in benign lesions from fungal and bacterial infections, sarcoidosis, radiation pneumonitis, and the like. Materials and Methods: We present a case of a woman 55, diagnosed with peripheral squamous moderately differentiated carcinoma of the right lung. The surgery was done 18 months ago - upper right lobectomy. Nine months before the PET / CT she underwent two craniotomies and metastasectomies regarding brain metastases left occipital and right frontal, diagnosed during previous PET / CT and MRI. Results: On the re-staging PET / CT metabolically active areas are visualized in the middle and lower right lung lobe, with sizes up to 16/11 mm and metabolic activity SUV max 5.7. On the native computerized tomography these findings are presented as an irregular shape and not very high density, except those in the lower part, which have larger density and sharper edges. Dissemination in the lower portion of the right lung was observed, while other findings are inconclusive. Atypical resections were conducted of two of the three lesions. The histological verification proves focal fibrosis and anthracosis. The tracking PET / CT did not identify metabolically active lung lesions. Conclusion: The increased metabolic activity is not always of malignant origin. Despite the high sensitivity PET / CT does not have enough specificity. This requires that, even in cases where there is histologically proven secondary changes, the newly observed lesions are traced dynamically before surgery, in order to avoid the potential operational trauma

  4. Study of the demand for radiopharmaceutical 18F-FDG in the metropolitan regions of Sao Paulo and adjacent areas

    Nuclear Medicine in Brazil and worldwide has developed distinction with diagnosis techniques that allow metabolic research of the disease, changing in a significant fashion the patient's outcome. This innovative technology leads expectations from specific fields up to society itself. This research studied the use of 18F-FDG radiopharmaceutical in the metropolitan region of Sao Paulo and adjacent areas, as well as the recent trade structure and the difficulties that should be overcome with the increase of the 18F-FDG demand. This research counted on the analysis of the international radiopharmaceutical trade and the main changes that have been happening in this area in Brazil during the past few years. Interviews were performed with professionals within the area of nuclear medicine and data has been collected through questionnaire sent to the consuming centers of the radiopharmaceutical in the region covered in this research. The interviews expressed the opinions of the interviewees concerning transformations in this field and future tendencies and the information obtained from the survey was the basis of complementation of the use of radiopharmaceutical on equipment such as Single Photon Emission Computed Tomography (SPECT), Positron Emission Tomography (PET) and Positron Emission Tomography I Computer Tomography (PET/CT). The major use of 18F-FDG has been used for oncology diagnosis with equipment such as PET and PEC/CT. This use shall grow in the next years, maybe expanding to other specialties such as neurology and cardiology. Although nowadays restricted to the cities of Sao Paulo and Rio de Janeiro, there is a possibility of expansion to other diagnosis modalities in other states of the country that are starting to structure the production of the radioisotope. The recent change in the constitution permitting the production and commerce of short half-life radioisotopes also contributes to the increase the interest of private funding of this sector in which

  5. Comparative study of 18F-FLT PET and 18F-FDG PET of lung cancer

    Xi LIU

    2011-12-01

    Full Text Available Objective The current paper aims to investigate the value of 18F-FLT PET in the diagnosis of lung cancer and the monitoring of tumor proliferation.Methods A total of 36 patients received and cured by the General Hospital of Chinese PLA from September 2005 to October 2008(27 males and 9 females,aged 38 years to 74 years with chest CT suspected lung cancer were examined with 18F-FLT PET.Up to 42 patients(29 males and 13 females,aged 37 years to 75 years received and cured at the same time also underwent 18F-FDG PET.The current experimental results were compared with that of the tumor pathology.Immunohistochemistry was used to measure the expression of cell nuclear antigen of excisional disease tissues Ki-67.Results The 18F-FDG PET standardize uptake value(SUV of lung cancer(SUV,5.2±2.9 was higher than that of the 18F-FLT PET SUV(3.2±1.3(P < 0.05.The sensitivity of 18F-FLT PET for the detection of primary lung cancer was 77%,the specificity was 86%,and the accuracy was 78%.The sensitivity,specificity,and accuracy of 18F-FDG PET were 88%,50%,and 79%,respectively.The sensitivity,specificity,and accuracy for the lymph node staging with 18F-FLT PET were 47%,88% and 75%,respectively,compared with the 68%,84%,and 79% for 18F-FDG PET,respectively.18F-FLT SUV of lung cancer was positively correlated with the Ki-67 index(r=0.8278,P < 0.001 than that of 18F-FDG SUV(r=0.0079,P=0.968.Conclusions 18F-FLT can be made to uptake by specificity of lung cancer tissue,and its uptake value is correlated significantly with the proliferation of lung cancer.Therefore,18F-FLT PET can be applied to assist the diagnosis of lung tumor,and is expected to be a tool to determine the proliferation activity of tumor cells.

  6. What parameters from {sup 18}F-FDG PET/CT are useful in evaluation of adrenal lesions?

    Kunikowska, Jolanta; Matyskiel, Renata; Krolicki, Leszek [Medical University of Warsaw, Nuclear Medicine Department, Warsaw (Poland); Toutounchi, Sadegh [Medical University of Warsaw, Department of Radiology, Warsaw (Poland); Grabowska-Derlatka, Laretta [Medical University of Warsaw, Department of General Surgery and Chest Diseases, Warsaw (Poland); Koperski, Lukasz [Medical University of Warsaw, Department of Pathology, Warsaw (Poland)

    2014-12-15

    Prior studies have suggested that {sup 18}F-FDG PET/CT can help characterize adrenal lesions and differentiate adrenal metastases from benign lesions. The aim of this study was to assess the value of {sup 18}F-FDG PET/CT for the differentiation of malignant from benign adrenal lesions. This retrospective study included 85 patients (47 men and 38 women, age 63.8 ± 10.8 years) who had undergone {sup 18}F-FDG PET/CT (60 min after injection 300 - 370 MBq {sup 18}F-FDG; Biograph 64 scanner) for evaluation of 102 nonsecreting adrenal masses. For semiquantitative analysis, the maximum standardized uptake value (SUVmax), adrenal to liver (T/L) SUVmax ratio, mean CT attenuation value and tumour diameter were measured in all lesions and compared with the pathological findings. Malignant adrenal tumours (68 % of evaluated tumours) had a significantly higher mean SUVmax (13.0 ± 7.1 vs. 3.7 ± 3.0), a higher T/L SUVmax ratio (4.2 ± 2.6 vs. 1.0 ± 0.9), a higher CT attenuation value (31.9 ± 16. 7 HU vs. 0.2 ± 25.8 HU) and a greater diameter (43.6 ± 23.7 mm vs. 25.6 ± 13.3 mm) than benign lesions. The false-positive findings were tuberculosis and benign phaeochromocytoma. Based on ROC analysis, a T/L SUVmax ratio >1.53, an adrenal SUVmax >5.2, an attenuation value >24 HU and a tumour diameter >30 mm were chosen as the optimal cut-off values for differentiating malignant from benign tumours. The areas under the ROC curves for the selected cut-off values were 0.96, 0.96, 0.88 and 0.77, respectively. A multivariate logistic regression model revealed that the T/L SUVmax ratio was an independent prognostic factor for malignancy (p < 0.001); a CT attenuation value of >25 HU and a tumour diameter >30 mm had no additional individual importance in the diagnosis of malignancy. Using a T/L SUVmax ratio >1.53 and an adrenal SUVmax >5.2 in {sup 18}F-FDG PET/CT led to high diagnostic sensitivity, specificity and negative predictive value for characterizing adrenal tumours. The

  7. Tracking of [18F]FDG-labeled natural killer cells to HER2/neu-positive tumors

    Introduction: The objective of this study was to label the human natural killer (NK) cell line NK-92 with [18F]fluoro-deoxy-glucose (FDG) for subsequent in vivo tracking to HER2/neu-positive tumors. Methods: NK-92 cells were genetically modified to NK-92-scFv(FRP5)-zeta cells, which express a chimeric antigen receptor that is specific to the tumor-associated ErbB2 (HER2/neu) antigen. NK-92 and NK-92-scFv(FRP5)-zeta cells were labeled with [18F]FDG by simple incubation at different settings. Labeling efficiency was evaluated by a gamma counter. Subsequently, [18F]FDG-labeled parental NK-92 or NK-92-scFv(FRP5)-zeta cells were intravenously injected into mice with implanted HER2/neu-positive NIH/3T3 tumors. Radioactivity in tumors was quantified by digital autoradiography and correlated with histopathology. Results: The NK-92 and NK-92-scFv(FRP5)-zeta cells could be efficiently labeled with [18F]FDG by simple incubation. Optimal labeling efficiencies (80%) were achieved using an incubation period of 60 min and additional insulin (10 IU/ml). After injection of 5x106 [18F]FDG-labeled NK-92-scFv(FRP5)-zeta cells into tumor-bearing mice, digital autoradiography showed an increased uptake of radioactivity in HER2/neu-positive tumors at 60 min postinjection. Conversely, injection of 5x106 NK-92 cells not directed against HER2/neu receptors did not result in increased uptake of radioactivity in the tumors. Histopathology confirmed an accumulation of the NK-92-scFv(FRP5)-zeta cells, but not the parental NK cells, in tumor tissues. Conclusion: The human NK cell line NK-92 can be directed against HER2/neu antigens by genetic modification. The genetically modified NK cells can be efficiently labeled with [18F]FDG, and the accumulation of these labeled NK cells in HER2/neu-positive tumors can be monitored with autoradiography

  8. Predictive value of 18F-FDG PET/CT in restaging patients affected by ovarian carcinoma: a multicentre study

    Ovarian cancer is the eighth most common malignancy among women and has a high mortality rate. Prognostic factors able to drive an effective therapy are essential. 18F-Fluoro-2-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) has been investigated in patients with epithelial ovarian cancer and showed promise in diagnosing, staging, detecting recurrent lesions and monitoring treatment response. Conversely, its prognostic role remains unclear. We aimed at assessing the prognostic value of 18F-FDG PET/CT performed in the restaging process in a multicentre study. We evaluated 168 patients affected by ovarian carcinoma, who underwent a restaging 18F-FDG PET/CT. The presence of local recurrences, lymph node involvement and distant metastasis was recorded as well as lesion dimensions, maximum and mean standardized uptake values (SUVmax and SUVmean, respectively). Progression-free survival (PFS) and overall survival (OS) at 3 and 4 years were computed by using Kaplan-Meier curves. Increased odds ratio was assessed using Cox regression analysis testing all lesion parameters measured by PET/CT. PFS was significantly longer in patients with a negative than a positive restaging PET/CT study (3- and 4-year PFS 64 and 53 % vs 23 and 12 %, respectively; p < 0.001). Similarly, a negative study was associated with a significantly higher OS rate after 4 years of follow-up (67 vs 25 % in negative and positive groups, respectively; p < 0.001). Lymph node or distant involvement were also independently associated with an increased risk of disease progression [hazard ratio (HR) 1.6 and 2.2, respectively; p = 0.003]. Moreover, PET/CT showed an incremental prognostic value compared to the International Federation of Gynecology and Obstetrics (FIGO) staging system. In the analysis of patient subsets, individuals with the same FIGO stage I-II but with negative PET had a significantly better 4-year OS than patients with low FIGO stage but positive PET. This

  9. Preliminary PET/CT Study of 18F-FDG Uptake in Cervical and Supraclavicular Brown Adipose Tissue

    Na Fang; Wei Ding; Yanli Wang; Xinjian Cui; Lei Zeng; Lili Ma; Xiumei Zhao; Wei Zhao; Qing Wang; Shan Gao

    2008-01-01

    OBJECTIVE The clinical use of PET/CT in oncology has led to the realization that 18F-FDG uptake in brown adipose tissue (BAT)can be a common cause of potentially misleading false-positive PET scans.The goal of this study was to study 18F-FDG uptake in cervical and supraclavicular regions and its characteristics with PET/CT.METHODS All the PET/CT scans obtained at our institution from July 2007 to January 2008 were retrospectively reviewed for increased 18F-FDG uptake in BAT.The cases in which increased 18F-FDG in cervical and supraclavicular regions was not localized to a soft-tissue mass or lymph node or muscle on the CT images,were included in this study.The following features were recorded:body weight,body mass index (BMI) and maximal standardized uptake value (SUVmax).In these selected patients,the BAT uptake in other area of the body was also recorded.RESULTS PET/CT scans were obtained in 457 patients (259 males and 198 females).In all of the scans,cervical and supraclavicular BAT uptake was observed in 12 patients (2 males and 10 females) and was typically bilateral,symmetric and intense.The range of the SUVmax was 3.6~12.82 (mean 6.9 ± 2.6).BAT uptake was more common in females than in males,showing a significant difference (P = 0.004).Although 18F-FDG uptake in BAT occurred more often in underweight patients with low BMI,there was no difference in the body weight (P = 0.607) or BMI (P =0.491) of these patients with hypermetabolic BAT compared with controls.CONCLUSION Hypermetabolic BAT uptake can be localized in cervical and supraclavicular regions with it occurring more commonly in females compared to males.Knowledge of this potential pitfall with PET/CT is important in improving diagnostic interpretation and accurate staging.

  10. Role of 18F-FDG PET/CT in the evaluation of primary tumours of unknown origin; experience of the Hospital Angeles del Pedregal

    It was in 1994 when published studies appear that evaluate the utility of the 18F-FDG PET in the patients with primary tumors of unknown origin (TOD); starting from then diverse studies that support the clinical utility of the study arise with 18F-FDG PET in the detection of the primary tumor. It is as well as it has been calculated that the study with 18F-FDG PET is able to detect the primary tumor in around 40% of the patients with negative results in the conventional diagnostic procedures. Until the moment, most of the studies published in relation to the primary tumors of unknown origin only evaluate the paper of the study with 18F-FDG PET, without including the image fusion technique PET/CT, which has demonstrated in diverse studies; in oncological scenarios different from the TOD, a superior diagnosis certainty. (Author)

  11. Usefulness of {sup 18}F FDG PET/CT for the evaluation of bone marrow involvement in patients with high grade non Hodgkin's lymphoma

    Lee, Yukyung; Hwang, Kyung Hoon; Hong, Jun Shik; Park, Jinny; Lee, Jae Hoon; Ahn, Jeong Yeal; Kim, Ji Hyun; Lee, Hae Jun; Kim, Seog Gyun; Shin, Ji Young [Gachon Univ. Gil Hospital, Incheon (Korea, Republic of)

    2012-12-15

    To assess the usefulness of {sup 18}F fluorodeoxyglucose PET/CT in the detection of bone marrow (BM) involvement of high grade non Hodgkin's lymphoma (NHL). One hundred twenty patients with newly diagnosed nosed diffuse large b cell lymphoma or peripheral t cell lymphoma between January 2007 and dune 2011, who re received bw trephine biopsy and {sup 18}F FDG PET/CT images and bone marrow biopsy (BMB) results. After reviewing the images, we reviewed the medical records and radiological findings of interesting patients. There were 23 {sup 18}F FDG PET/CT scans in which the marrow was considered to be abnormal (either positive or equivocal), and 97 {sup 18}F FDG PET/CT scans were regarded as having negative FDG uptake. Of 120 patients, 100 (83.3%) had a concordant result of BM interpretation between {sup 18}F FDG PET/CT and BMB, and the remaining 20 patients had discordant results. Among 23 patients with either positive or equivocal {sup 18}F FDG PET/CT scans, 1 of 12 patients with 'positive' {sup 18}F FDG PET/CT had a lymphomatous involvement on BMB. In contrast, 10 of 11 patients with 'equivocal' BM hypermetabolism were reported as having positive involvement on BMB. Patients with abnormal {sup 18}F FDG PET/CT had significantly higher mSUV{sup highestt}han those with normal FDG PET/CT. {sup 18}F FDG PET/CT and BMB are complementary techniques in assessing the presence of BM involvement in patients with high grade NHL. the increasing availability of {sup 18}F FDG PET/CT will raise the need for additional biopsy for FDG avid lesions, especially in patients with negative standard BMBs {sup 18}F FDG PET/CT can be useful as a decision as an initial staging procedure. a direct bone biopsy for FDG avid lesion as an initial staging procedure. a direct bone biopsy for FDG positive bone lesions should be included in staging guidelines in future. In {sup 18}F FDG PET/CT negative cases, BMB is still a powerful procedure, but BMB alone is insufficient

  12. Usefulness of 18F FDG PET/CT for the evaluation of bone marrow involvement in patients with high grade non Hodgkin's lymphoma

    To assess the usefulness of 18F fluorodeoxyglucose PET/CT in the detection of bone marrow (BM) involvement of high grade non Hodgkin's lymphoma (NHL). One hundred twenty patients with newly diagnosed nosed diffuse large b cell lymphoma or peripheral t cell lymphoma between January 2007 and dune 2011, who re received bw trephine biopsy and 18F FDG PET/CT images and bone marrow biopsy (BMB) results. After reviewing the images, we reviewed the medical records and radiological findings of interesting patients. There were 23 18F FDG PET/CT scans in which the marrow was considered to be abnormal (either positive or equivocal), and 97 18F FDG PET/CT scans were regarded as having negative FDG uptake. Of 120 patients, 100 (83.3%) had a concordant result of BM interpretation between 18F FDG PET/CT and BMB, and the remaining 20 patients had discordant results. Among 23 patients with either positive or equivocal 18F FDG PET/CT scans, 1 of 12 patients with 'positive' 18F FDG PET/CT had a lymphomatous involvement on BMB. In contrast, 10 of 11 patients with 'equivocal' BM hypermetabolism were reported as having positive involvement on BMB. Patients with abnormal 18F FDG PET/CT had significantly higher mSUVhighestthan those with normal FDG PET/CT. 18F FDG PET/CT and BMB are complementary techniques in assessing the presence of BM involvement in patients with high grade NHL. the increasing availability of 18F FDG PET/CT will raise the need for additional biopsy for FDG avid lesions, especially in patients with negative standard BMBs 18F FDG PET/CT can be useful as a decision as an initial staging procedure. a direct bone biopsy for FDG avid lesion as an initial staging procedure. a direct bone biopsy for FDG positive bone lesions should be included in staging guidelines in future. In 18F FDG PET/CT negative cases, BMB is still a powerful procedure, but BMB alone is insufficient for full evaluation of BM

  13. The Clinical Role of Dual-Time-Point 18F-FDG PET/CT in Differential Diagnosis of the Thyroid Incidentaloma

    Lee, Sinae; Park, Taegyu; Park, Soyeon; Pahk, Kisoo; Rhee, Seunghong; Cho, Jaehyuk; Jeong, Eugene; Kim, Sungeun; CHOE, JAE GOL

    2013-01-01

    Thyroid incidentalomas are common findings during imaging studies including 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for cancer evaluation. Although the overall incidence of incidental thyroid uptake detected on PET imaging is low, clinical attention should be warranted owing to the high incidence of harboring primary thyroid malignancy. We retrospectively reviewed 2,368 dual-time-point 18F-FDG PET/CT cases that were undertaken for cancer eval...

  14. The Impact of Energy Substrates, Hormone Level and Subject-Related Factors on Physiologic Myocardial 18F-FDG Uptake in Normal Humans

    In a whole-body 18F-FDG PET/CT, non-specific 18F-FDG uptake of the myocardium is a common finding and can be very variable, ranging from background activity to intense accumulation and inhomogeneity. We investigated the effect of energy substrates and plasma/serum hormones that may have an influence on myocardial 18F-FDG uptake. F-FDG PET/CT was performed on 100 normal volunteers from November 2007 to August 2008. Blood samples were taken just before 18F-FDG injection from all subjects. Myocardial 18F-FDG uptake was measured as the mean (SUVmean) and maximal (SUVmax) standardized uptake value. The myocardium was delineated on the PET/CT image by a manual volume of interest (VOI).We analyzed the influence of age, sex, presence of diabetes, fasting duration, insulin, glucagon, fasting glucose, lactate, free fatty acid (FFA), epinephrine (EPi), norepinephrine (NEp), free triiodothyronine (T3), free thyroxine (T4), thyroid-stimulating hormone (TSH) and body mass index (BMI). Overall, 92 subjects (mean age 50.28±8.30, male 57) were enrolled. The average of myocardial SUVmean was 2.08 and of myocardial SUVmax was 4.57, respectively and there was a strong linear correlation between SUVmean and SUVmax (r =0.98). FFA and fasting duration showed significant negative correlation with myocardial 18F-FDG uptake, respectively (r =-0.40 in FFA; r =-0.41 in fasting duration). No significant relationships were observed between myocardial uptake and age, sex, presence of diabetics, insulin, glucagon, fasting glucose, lactate, EPi, NEp, free T3, free T4, TSH and BMI. Myocardial 18F-FDG uptake decreases with longer fasting duration and higher FFA level in normal humans. Modulating myocardial uptake could improve 18F-FDG PET/CT imaging for specific oncologic and cardiovascular indications

  15. Positron emission tomography with [18F]FDOPA and [18F]FDG in the imaging of small cell lung carcinoma: preliminary results

    Small cell lung carcinomas (SCLC) express neuroendocrine markers, and dihydroxyphenylalanine (DOPA) is known to accumulate in neuroendocrine tumours. This study was performed with the aim of evaluating the uptake of 3,4-dihydroxy-6-18F-fluoro-phenylalanine ([18F]FDOPA) by SCLC, based on comparison with the results of fluorine-18 fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) and standard imaging procedures. [18F]FDG PET and [18F]FDOPA PET were performed on four patients with newly diagnosed SCLC. There was agreement between the results of [18F]FDOPA PET and [18F]FDG PET in four tumoural sites out of 11, whereas [18F]FDG PET and standard imaging procedures were in full agreement. A semi-quantitative analysis based on standardised uptake values (SUVs) was performed in order to compare [18F]FDG and [18F]FDOPA tumour uptake. The median [18F]FDG SUVmax was 5.9 (with a 95% confidence interval from 4.4 to 9.2), while the median [18F]FDOPA SUVmax was 1.9 (with a 95% confidence interval from 1.6 to 3.8). The difference between [18F]FDG SUVmax and [18F]FDOPA SUVmax was significant (P18F]FDOPA PET appeared less sensitive than [18F]FDG PET and standard imaging procedures in the staging of SCLC. No clear relation between [18F]FDOPA uptake and positivity of neuroendocrine markers on immunohistochemistry emerged from these preliminary results; however, since [18F]FDOPA uptake may reflect better differentiation of the tumour, and possibly a better prognosis, this point warrants clarification in a larger study. (orig.)

  16. [Comparison Study of Left Ventricular Function Assessment by 18F-FDG PET, Gated SPECT and 2D-Echocardiography in Patients with Myocardial Infarction].

    Li, Fanglan; Huang, Rui; Ou, Xiaohong; Li, Lin

    2015-10-01

    The aim of this study is to analyze the concordance between EDV, ESV and LVEF values derived from 18F-FDG PET, GSPECT and ECHO in patients with myocardial infarction. Sixty-four patients with coronary artery disease (CAD) and myocardial infarction were enrolled in the study. Each patient underwent at least two of the above mentioned studies within 2 weeks. LVEF, EDV and ESV values were analyzed with dedicated software. Statistical evaluation of correlation and agreement was carried out EDV was overestimated by 18F-FDG PET compared with GSPECT [(137.98 ± 61.71) mL and (125.35 ± 59.34) mL]; ESV was overestimated by 18F-FDG PET (85.89 ± 55.21) mL and GSPECT (82.39 ± 55.56) mL compared with ECHO (68.22 ± 41.37) mL; EF was overestimated by 18F-FDG PET (41.96% ± 15.08%) and ECHO (52.18% ± 13.87%) compared with GSPECT (39.75% ± 15.64%), and EF was also overestimated by 18F-FDG PET compared with GSPECT. The results of linear regression analysis showed good correlation between EDV, ESV and LVEF values derived from 18F-FDG PET, GSPECT and ECHO (r = 0.643-0.873, P = 0.000). Bland-Altman analysis indicated that 18F-FDG PET correlated well with ECHO in the Left ventricular function parameters. While GSPECT correlated well with 18F-FDG PET in ESV, GSPECT had good correlation with Echo in respect of EDV and EF; whereas GSPECT had poor correlation with PET/ECHO in the remaining left ventricular function parameters. Therefore, the clinical physicians should decide whether they would use the method according to the patients' situation and diagnostic requirements. PMID:26964317

  17. 18F-FDG PET/CT bone/bone marrow findings in Hodgkin's lymphoma may circumvent the use of bone marrow trephine biopsy at diagnosis staging

    Accurate staging of Hodgkin's lymphoma (HL) is necessary in selecting appropriate treatment. Bone marrow trephine biopsy (BMB) is the standard procedure for depicting bone marrow involvement. BMB is invasive and explores a limited part of the bone marrow. 18F-FDG PET/CT is now widely used for assessing response to therapy in HL and a baseline study is obtained to improve accuracy. The aim of this retrospective analysis was to assess whether routine BMB remains necessary with concomitant 18F-FDG PET/CT. Data from 83 patients (newly diagnosed HL) were reviewed. All patients had received contrast-enhanced CT, BMB and 18F-FDG PET/CT. Results of BMB were not available at the time of 18F-FDG PET/CT imaging. Seven patients had lymphomatous involvement on BMB. Four patients had bone involvement on conventional CT (two with negative BMB). All patients with bone marrow and/or bone lesions at conventional staging were also diagnosed on 18F-FDG PET/CT scan. PET/CT depicted FDG-avid bone/bone marrow foci in nine additional patients. Four of them had only one or two foci, while the other had multiple foci. However, the iliac crest, site of the BMB, was not involved on 18F-FDG PET/CT. Osteolytic/sclerotic lesions matching FDG-avid foci were visible on the CT part of PET/CT in three patients. MRI ordered in three other patients suggested bone marrow involvement. Interim and/or end-therapy 18F-FDG PET/CT documented response of FDG-avid bone/bone marrow foci to chemotherapy in every patient. 18F-FDG PET/CT highly improves sensitivity for diagnosis of bone/bone marrow lesions in HL compared to conventional staging. (orig.)

  18. Relations between pathological markers and radioiodine can and 18F-FDG PET/CT findings in papillary thyroid cancer patients with recurrent cervical nodal metastases

    The aim of this study was to investigate relationships between the immunohistochemical results and radioiodine scan and 18F-FDG PET findings in papillary thyroid cancer (PTC) patients with recurrent cervical nodal metastases. A total of 46 PTC patients who had undergone a radioiodine scan and/or 18F-FDG PET/CT and a subsequent operation on recurrent cervical lymph nodes were enrolled. Twenty-seven patients underwent 18F-FDG PET/CT, 8 underwent radioiodine scans, and 11 underwent both scans. In all surgical specimens, the immunoexpressions of thyroglobulin (Tg), sodium-iodide symporter (NIS), glucose transporter 1 (Glut-1), and somatostatin receptor 1 and 2A (SSTR1 and SSTR2A) were assessed, and associations between these expressions and radioiodine scan and 18F-FDG PET findings were evaluated. Of the 38 patients who underwent 18F-FDG PET/CT, all patients with weak Tg expression had positive 18F-FDG uptake, while only 45 % of the patients with moderate or strong Tg expression showed positive uptake (p = 0.01). The proportion of patients with positive 18F-FDG uptake increased as the degree of Glut-1 expression with luminal accentuation increased. Of the 19 patients who underwent a radioiodine scan, the proportion with positive radioiodine uptake was greater among patients with strong NIS and SSTR2A expression than among patients expressing these markers at weak levels (p = 0.04 for all). All three patients with weak Tg expression were negative for radioiodine uptake. The 18F-FDG uptakes of recurrent cervical nodes are related to strong Glut-1 expression with luminal accentuation and weak Tg expression, whereas radioiodine uptake is related to the strong expressions of NIS and SSTR2A

  19. Relations between pathological markers and radioiodine can and {sup 18}F-FDG PET/CT findings in papillary thyroid cancer patients with recurrent cervical nodal metastases

    Lee, Jeong Won [Dept. of Nuclear Medicine, Catholic Kwandong University International St. Mary' s Hospital, Seoul (Korea, Republic of); Min, Hye Sook [Dept. of athology, Seoul National University Hospital, Seoul (Korea, Republic of); Lee, Sang Mi [Dept. of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Kwon, Hyun Woo; Chung, June Key [Dept. of Nuclear Medicine,Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    The aim of this study was to investigate relationships between the immunohistochemical results and radioiodine scan and {sup 18}F-FDG PET findings in papillary thyroid cancer (PTC) patients with recurrent cervical nodal metastases. A total of 46 PTC patients who had undergone a radioiodine scan and/or {sup 18}F-FDG PET/CT and a subsequent operation on recurrent cervical lymph nodes were enrolled. Twenty-seven patients underwent {sup 18}F-FDG PET/CT, 8 underwent radioiodine scans, and 11 underwent both scans. In all surgical specimens, the immunoexpressions of thyroglobulin (Tg), sodium-iodide symporter (NIS), glucose transporter 1 (Glut-1), and somatostatin receptor 1 and 2A (SSTR1 and SSTR2A) were assessed, and associations between these expressions and radioiodine scan and {sup 18}F-FDG PET findings were evaluated. Of the 38 patients who underwent {sup 18}F-FDG PET/CT, all patients with weak Tg expression had positive {sup 18}F-FDG uptake, while only 45 % of the patients with moderate or strong Tg expression showed positive uptake (p = 0.01). The proportion of patients with positive {sup 18}F-FDG uptake increased as the degree of Glut-1 expression with luminal accentuation increased. Of the 19 patients who underwent a radioiodine scan, the proportion with positive radioiodine uptake was greater among patients with strong NIS and SSTR2A expression than among patients expressing these markers at weak levels (p = 0.04 for all). All three patients with weak Tg expression were negative for radioiodine uptake. The {sup 18}F-FDG uptakes of recurrent cervical nodes are related to strong Glut-1 expression with luminal accentuation and weak Tg expression, whereas radioiodine uptake is related to the strong expressions of NIS and SSTR2A.

  20. Clinically unrecognized pulmonary aspiration during gastrointestinal endoscopy with sedation: A potential pitfall interfering the performance of 18F-FDG PET for cancer screening

    Purpose: We found several cases with unexpected pulmonary abnormalities on the 18F-FDG PET scan after the gastrointestinal endoscopy with sedation during a compact health check-up course, interfering the interpretations of 18F-FDG PET scan for cancer screening. The current studies aimed to analyze the incidence and the clinical relevance of this pulmonary finding. Materials and methods: From June to December 2009, 127 subjects undergoing the sequential gastrointestinal endoscopy with sedation and 18F-FDG PET scan within 48 h as part of routine health check-up were retrospectively enrolled in this study. The incidence of abnormal pulmonary findings and their SUVmax of FDG were calculated and correlated with the clinical manifestations. Results: Five subjects had abnormal 18F-FDG PET findings but pulmonary symptoms were only found in 2. The SUVmax did not seem to reflect the severity of pulmonary symptoms or the need of intervention. Although the incidence of unrecognized pulmonary aspiration featuring inflammation detected by the 18F-FDG PET scan was high (3.94%, 5/127), the incidence of events needed intervention remained low (0.79%, 1/127), similar to those previously reported literatures. Conclusions: Although higher incidence of pulmonary aspiration in this study, it probably reflects the better sensitivity of 18F-FDG PET for inflammation. The low incidence of clinical events needed intervention may still reflect the safety of sedation used for gastrointestinal endoscopy. Proper arrangement of the sequential examinations if subjects need both gastrointestinal endoscopy with sedation and 18F-FDG PET is important to reduce the interference degrading the performance of 18F-FDG PET in cancer screening, diagnosis or staging.

  1. Diagnostic value of combining {sup 11}C-choline and {sup 18}F-FDG PET/CT in hepatocellular carcinoma

    Castilla-Lievre, Maria-Angela [University Department Hepatinov, Assistance-Publique Hopitaux de Paris, Department of Nuclear Medicine, Hopital Antoine Beclere, Clamart (France); IMIV - UMR 1023 Inserm/CEA/Universite Paris Sud - ERL 9218 CNRS, Orsay (France); Franco, Dominique [Universite Paris-Sud, Department of Surgery, Hopital Antoine Beclere, University Department Hepatinov, Assistance-Publique Hopitaux de Paris, Clamart (France); Gervais, Philippe; Kuhnast, Bertrand; Desarnaud, Serge; Helal, Badia-Ourkia [IMIV - UMR 1023 Inserm/CEA/Universite Paris Sud - ERL 9218 CNRS, Orsay (France); CEA, DSV, I2BM, Service Hospitalier Frederic Joliot, Orsay (France); Agostini, Helene [University Department Hepatinov, Assistance-Publique Hopitaux de Paris, Clinical Research Unit of Hopitaux universitaires Paris-Sud, Hopital Kremlin Bicetre (France); Marthey, Lysiane [Universite Paris-Sud, Department of Gastroenterology, Hopital Antoine Beclere, University Department Hepatinov, Assistance-Publique Hopitaux de Paris, Clamart (France)

    2016-05-15

    In this prospective study, our goal was to emphasize the diagnostic value of combining {sup 11}C-choline and {sup 18}F-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 {sup 11}C-choline, {sup 18}F-FDG and combined {sup 11}C-choline and {sup 18}F-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 {sup 18}F-FDG-positive lesions than those with {sup 18}F-FDG-negative lesions (p < 0.05). Early recurrence (n=2) or early death (n=5) occurred more frequently in patients with {sup 18}F-FDG-positive lesions than in those with {sup 18}F-FDG-negative lesions (p < 0.05). The combined use of {sup 11}C-choline and {sup 18}F-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.)

  2. [18F]-FDG coincidence imaging in patients with increased CA 15-3 levels during follow-up for breast cancer

    This study evaluated the usefulness of 18-Fluoro-Deoxy-Glucose imaging performed with a Coincidence Detection Emission Tomography camera ([18F]-FDG-CDET) in the detection of breast cancer recurrence. 27 patients with increasing CA 15-3 levels during follow-up were included in this study. 18FDG imaging was performed with a CDET camera in all patients. [18F]-FDG-CDET findings were compared with other imaging modalities results. Recurrence was confirmed in 25/27 patients and included 5 patients with local-regional recurrences and one with local-regional and liver metastasis, 10 with visceral metastases and 9 patients with bone metastases. No recurrence was confirmed in the remaining 2 patients during a 2 years follow-up. The overall sensitivity of [18F]-FDG-CDET and other imaging modalities was similar (88% and 80% respectively). [18]-FDG-CDET and abdominal CT had similar sensitivity (66% and 63% respectively) in the diagnosis of liver metastases. In detection of bone metastases, the sensitivity of [18F]-FDG-CDET and bone scintigraphy was similar. In patients with local-regional recurrences, [18F]-FDG-CDET detected 6/6 recurrences and other imaging modalities 4/6. In this study, [18F]-FDG-TEDC had similar performance than a strategy combining several imaging modalities for metastases and a better performance for local-regional recurrence detection. (author)

  3. Critical considerations on the combined use of {sup 18}F-FDG and {sup 18}F-fluoride for PET assessment of metastatic bone disease

    Cheng, Gang [Philadelphia VA Medical Center, Department of Radiology, Philadelphia, PA (United States); Hospital of the University of Pennsylvania, Division of Nuclear Medicine, Department of Radiology, Philadelphia, PA (United States); Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Basu, Sandip [Tata Memorial Hospital Annexe, Radiation Medicine Centre (Bhabha Atomic Research Centre), Parel, Bombay (India); Alavi, Abass [Hospital of the University of Pennsylvania, Division of Nuclear Medicine, Department of Radiology, Philadelphia, PA (United States)

    2013-08-15

    {sup 18}F-FDG PET/CT is a reliable imaging tool in the detection of osseous metastasis in most cases. Adedicated bone scan (including {sup 18}F-fluoride PET/CT) may not be indicated in many cancers for the evaluation of osseous metastasis, especially at early stages. Combined use of dual tracers may compromise the imaging quality of both studies, especially for 1sF-FDG PET with respect to its ability to detect lesions in the bone marrow. The authors have no doubt that {sup 18}F-fluoride PET may be valuable and provide some additional value in some selected cases and selected cancers, where {sup 18}F-FDG is of limited value. However, the value of using the combined approach is limited in most situations. The logical notion, is that for {sup 18}F-FDG-avid tumors, there is no evidence in the literature that {sup 18}F-fluoride PET/CT detects more osseous lesions than {sup 18}F-FDG PET/CT, while for non-t8F-FDc-avid tumors, {sup 18}F-FDG PET/CT is not indicated. Both the rare occasions (when both {sup 18}F-FDG PET and {sup 18}F-fluoride PET are indicated) and the advantages of performing a dual tracer PET remain to be defined.

  4. Role of 18F- FDG PET-CT in detection of primary tumors in carcinoma of unknown primary site: an Indian experience

    Full text: The management of the patients with carcinoma of an unknown primary represents a difficult challenge in oncology. Metastatic cancers of unknown primary origin are characterised by a poor prognosis. Conventional radiological imaging allows only detection of 20%-27% of primary cancers. To evaluate the role of 18F-FDG PET/CT in detection of primary tumors in carcinoma of unknown primary site. Methods: In the present study, a total of 31 patients (22 males, 9 females; mean age 53.1 years) with biopsy or cytopathology proven metastatic carcinoma and negative conventional diagnostic procedures (CT, MRI or Panendoscopy) were included. All patients underwent whole body 18F-FDG PET/CT study. Patient data was retrospectively analysed. Histopathological diagnosis is kept as the gold standard. Hypermetabolic areas at the site of CT changes were considered as positive and rate of detection of primary site is evaluated. Among 31 patients, 18F-FDG PET/CT detected primary site in 14 patients. 18F-FDG PET/CT was negative in remaining 17 patients and could not localise primary. Among the 14 positive PET-CT patients, the results of 2 patients became false positive. The detection rate of 18F-FDG PET/CT in localising primary site was 38%. It is concluded that 18F-FDG PET/CT was found to be useful diagnostic procedure for the evaluation of patients with metastatic carcinoma and primary of unknown origin

  5. PET/CT studies of multiple myeloma using 18F-FDG and 18F-NaF: comparison of distribution patterns and tracers' pharmacokinetics

    The aim of this prospective study is to evaluate the combined use of fluorine-18 fluorodeoxyglucose (18F-FDG) and fluorine-18 sodium fluoride (18F-NaF) PET/CT in the skeletal assessment of patients with multiple myeloma (MM) and to compare the efficacy of these two PET tracers regarding detection of myeloma-indicative osseous lesions. The study includes 60 patients with multiple myeloma (MM) diagnosed according to standard criteria. All patients underwent dynamic (dPET/CT) scanning of the pelvis as well as whole body PET/CT studies with both tracers. The interval between the two exams was one day. Sites of focal increased 18F-FDG uptake were considered as highly suspicious of myelomatous involvement. The lesions detected on the 18F-NaF PET/CT scans were then correlated with those detected on 18F-FDG PET/CT, which served as a reference. Moreover, the 18F-FDG PET/CT results were also correlated with the low-dose CT findings. The evaluation of dPET/CT studies was based on qualitative evaluation, SUV calculation, and quantitative analysis based on a 2-tissue compartment model and a non-compartmental approach. Whole body 18F-FDG PET/CT revealed approximately 343 focal lesions while 18F-NaF PET/CT revealed 135 MM-indicative lesions (39 % correlation). CT demonstrated 150 lesions that correlated with those in 18F-FDG PET/CT (44 % correlation). Six patients demonstrated a diffuse pattern of disease with 18F-FDG, while 15 of them had a mixed (diffuse and focal) pattern of skeletal 18F-FDG uptake. A high number of degenerative, traumatic and arthritic disease lesions were detected with 18F-NaF PET/CT. In three patients with multiple focal 18F-FDG-uptake, 18F-NaF PET/CT failed to demonstrate any bone lesion. The dPET/CT scanning of the pelvic area with 18F-FDG and 18F-NaF revealed 77 and 24 MM-indicative lesions, respectively. Kinetic analysis of 18F-FDG revealed the following mean values: SUVaver = 5.1, k1 = 0.37 (1/min), k3 = 0.10 (1/min), VB = 0.06, influx = 0.04 (1/min

  6. Aortic {sup 18}F-FDG uptake in patients suffering from granulomatosis with polyangiitis

    Kemna, Michael J. [Maastricht University Medical Center, Department of Nephrology and Clinical Immunology, Maastricht (Netherlands); Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Bucerius, Jan [Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); University Hospital RWTH Aachen, Department of Nuclear Medicine, Aachen (Germany); Drent, Marjolein [Maastricht University, Department of Pharmacology and Toxicology, Maastricht (Netherlands); Voeoe, Stefan [Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); Veenman, Martine [Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Paassen, Pieter van [Maastricht University Medical Center, Department of Nephrology and Clinical Immunology, Maastricht (Netherlands); Tervaert, Jan Willem Cohen [Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Sint Franciscus Gasthuis, Noordoever Academy, Rotterdam (Netherlands); Kroonenburgh, Marinus J.P.G. van [Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands)

    2015-08-15

    The objective of the study was to systematically assess aortic inflammation in patients with granulomatosis with polyangiitis (GPA) using {sup 18}F-2-deoxy-2-[{sup 18}F]fluoro-D-glucose (FDG) positron emission tomography (PET)/CT. Aortic inflammation was studied in PET/CT scans obtained from 21 patients with GPA; 14 patients with sarcoidosis were included as disease controls, 7 patients with stage I or II head and neck carcinoma ascertained during routine clinical practice were used as healthy controls (HC) and 5 patients with large vessel vasculitis (LVV) were used as positive controls. Aortic {sup 18}F-FDG uptake was expressed as the blood-normalized maximum standardized uptake value (SUV{sub max}), known as the target to background ratio (mean TBR{sub max}). The mean TBR{sub max} (interquartile range) of the aorta in patients with GPA, sarcoidosis, HC and LVV were 1.75 (1.32-2.05), 1.62 (1.54-1.74), 1.29 (1.22-1.52) and 2.03 (1.67-2.45), respectively. The mean TBR{sub max} was significantly higher in patients suffering from GPA or LVV compared to HC (p < 0.05 and p < 0.005, respectively) and tended to be higher in patients suffering from sarcoidosis, but this did not reach statistical significance (p = 0.098). The mean TBR{sub max} of the most diseased segment was significantly higher compared to HC [1.57 (1.39-1.81)] in LVV patients [2.55 (2.22-2.82), p < 0.005], GPA patients [2.17 (1.89-2.83), p < 0.005] and patients suffering from sarcoidosis [2.04 (1.88-2.20), p < 0.05]. In GPA patients, the mean TBR{sub max} of the aorta was significantly higher in patients with previous renal involvement [2.01 (1.69-2.53)] compared to patients without renal involvement in the past [1.60 (1.51-1.80), p < 0.05]. Interrater reproducibility with a second reader was high (all intraclass correlation coefficients >0.9). Patients suffering from GPA show marked aortic FDG uptake. (orig.)

  7. Initial clinical results of simultaneous {sup 18}F-FDG PET/MRI in comparison to {sup 18}F-FDG PET/CT in patients with head and neck cancer

    Kubiessa, K.; Gawlitza, M.; Kuehn, A.; Fuchs, J.; Kahn, T.; Stumpp, P. [University Hospital of Leipzig, Department of Diagnostic and Interventional Radiology, Leipzig (Germany); Purz, S.; Steinhoff, K.G.; Sabri, O.; Kluge, R. [University Hospital of Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Boehm, A. [University Hospital of Leipzig, ENT Department, Leipzig (Germany)

    2014-04-15

    The aim of this study was to evaluate the diagnostic capability of simultaneous {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/MRI compared to {sup 18}F-FDG PET/CT as well as their single components in head and neck cancer patients. In a prospective study 17 patients underwent {sup 18}F-FDG PET/CT for staging or follow-up and an additional {sup 18}F-FDG PET/MRI scan with whole-body imaging and dedicated examination of the neck. MRI, CT and PET images as well as PET/MRI and PET/CT examinations were evaluated independently and in a blinded fashion by two reader groups. Results were compared with the reference standard (final diagnosis determined in consensus using all available data including histology and follow-up). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. A total of 23 malignant tumours were found with the reference standard. PET/CT showed a sensitivity of 82.7 %, a specificity of 87.3 %, a PPV of 73.2 % and a NPV of 92.4 %. Corresponding values for PET/MRI were 80.5, 88.2, 75.6 and 92.5 %. No statistically significant difference in diagnostic capability could be found between PET/CT and PET/MRI. Evaluation of the PET part from PET/CT revealed highest sensitivity of 95.7 %, and MRI showed best specificity of 96.4 %. There was a high inter-rater agreement in all modalities (Cohen's kappa 0.61-0.82). PET/MRI of patients with head and neck cancer yielded good diagnostic capability, similar to PET/CT. Further studies on larger cohorts to prove these first results seem justified. (orig.)

  8. Assessing the role of {sup 18}F-FDG PET and {sup 18}F-FDG PET/CT in the diagnosis of soft tissue musculoskeletal malignancies: a systematic review and meta-analysis

    Etchebehere, Elba C. [The University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Sirio Libanes Hospital, Department of Nuclear Medicine, Sao Paulo (Brazil); Hobbs, Brian P.; Milton, Denai R. [The University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States); Malawi, Osama [The University of Texas MD Anderson Cancer Center, Department of Imaging Physics, Houston, TX (United States); Patel, Shreyaskumar; Benjamin, Robert S. [The University of Texas MD Anderson Cancer Center, Department of Sarcoma Medical Oncology, Houston, TX (United States); Macapinlac, Homer A. [The University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States)

    2016-05-15

    Twelve years ago a meta-analysis evaluated the diagnostic performance of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in assessing musculoskeletal soft tissue lesions (MsSTL). Currently, PET/CT has substituted PET imaging; however, there has not been any published meta-analysis on the use of PET/CT or a comparison of PET/CT with PET in the diagnosis of MsSTL. Therefore, we conducted a meta-analysis to identify the current diagnostic performance of {sup 18}F-FDG PET/CT and determine if there is added value when compared to PET. A systematic review of English articles was conducted, and MEDLINE PubMed, the Cochrane Library, and Embase were searched from 1996 to March 2015. Studies exploring the diagnostic accuracy of {sup 18}F-FDG PET/CT (or dedicated PET) compared to histopathology in patients with MsSTL undergoing investigation for malignancy were included. Our meta-analysis included 14 articles composed of 755 patients with 757 soft tissue lesions. There were 451 (60 %) malignant tumors and 306 benign lesions. The {sup 18}F-FDG PET/CT (and dedicated PET) mean sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for diagnosing MsSTL were 0.96 (0.90, 1.00), 0.77 (0.67, 0.86), 0.88 (0.85, 0.91), 0.86 (0.78, 0.94), and 0.91 (0.83, 0.99), respectively. The posterior mean (95 % highest posterior density interval) for the AUC was 0.92 (0.88, 0.96). PET/CT had higher specificity, accuracy, and positive predictive value when compared to a dedicated PET (0.85, 0.89, and 0.91 vs 0.71, 0.85, and 0.82, respectively). {sup 18}F-FDG PET/CT and dedicated PET are both highly accurate in the diagnosis of MsSTL. PET/CT is more accurate and specific and has a higher positive predictive value than PET. (orig.)

  9. Assessing the role of 18F-FDG PET and 18F-FDG PET/CT in the diagnosis of soft tissue musculoskeletal malignancies: a systematic review and meta-analysis

    Twelve years ago a meta-analysis evaluated the diagnostic performance of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in assessing musculoskeletal soft tissue lesions (MsSTL). Currently, PET/CT has substituted PET imaging; however, there has not been any published meta-analysis on the use of PET/CT or a comparison of PET/CT with PET in the diagnosis of MsSTL. Therefore, we conducted a meta-analysis to identify the current diagnostic performance of 18F-FDG PET/CT and determine if there is added value when compared to PET. A systematic review of English articles was conducted, and MEDLINE PubMed, the Cochrane Library, and Embase were searched from 1996 to March 2015. Studies exploring the diagnostic accuracy of 18F-FDG PET/CT (or dedicated PET) compared to histopathology in patients with MsSTL undergoing investigation for malignancy were included. Our meta-analysis included 14 articles composed of 755 patients with 757 soft tissue lesions. There were 451 (60 %) malignant tumors and 306 benign lesions. The 18F-FDG PET/CT (and dedicated PET) mean sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for diagnosing MsSTL were 0.96 (0.90, 1.00), 0.77 (0.67, 0.86), 0.88 (0.85, 0.91), 0.86 (0.78, 0.94), and 0.91 (0.83, 0.99), respectively. The posterior mean (95 % highest posterior density interval) for the AUC was 0.92 (0.88, 0.96). PET/CT had higher specificity, accuracy, and positive predictive value when compared to a dedicated PET (0.85, 0.89, and 0.91 vs 0.71, 0.85, and 0.82, respectively). 18F-FDG PET/CT and dedicated PET are both highly accurate in the diagnosis of MsSTL. PET/CT is more accurate and specific and has a higher positive predictive value than PET. (orig.)

  10. Evaluation of organ-specific glucose metabolism by 18F-FDG in insulin receptor substrate-1 (IRS-1) knockout mice as a model of insulin resistance

    Insulin resistance (IR) is a physiological condition in which the body produces insulin but does not result in a sufficient biological effect. Insulin resistance is usually asymptomatic but is associated with health problems and is a factor in the metabolic syndrome. The aim of the present study is to clarify organ-specific insulin resistance in normal daily conditions using [18F]-2-fluoro-2-deoxy-D-glucose ([18F]-FDG). The biodistribution of [18F]-FDG was examined in insulin receptor substrate-1 (IRS-1) knockout mice, an animal model of skeletal muscle insulin resistance, and C57BL/6J (wild-type) mice with and without insulin loading. Mice received 0.5 MBq of [18F]-FDG injected into the tail vein, immediately followed by nothing (control cohorts) or an intraperitoneal injection of 1.5 mU/g body weight of human insulin as an insulin loading test. Blood glucose concentrations for all of the experimental animals were assessed at 0, 20, 40, and 60 min post-injection. The mice were subsequently killed, and tissue was collected for evaluation of [18F]-FDG biodistribution. The radioactivity of each organ was measured using a gamma counter. In the absence of insulin, the blood glucose concentrations of wild-type mice (132±26 mg/dl) and IRS-1 knockout mice (134±18 mg/dl) were not significantly different. Blood glucose concentrations decreased following insulin administration, with lower concentrations in wild-type mice than in knockout mice at 20, 40, and 60 min. A statistically significant difference in [18F]-FDG uptake between wild-type mice and IRS-1 knockout mice was confirmed in the heart, abdominal muscle, and femoral muscle. With insulin loading, [18F]-FDG uptake in the heart, back muscle, and abdominal muscle was significantly increased compared to without insulin loading in both wild-type mice and knockout mice. Our results showed that IR significantly affected [18F]-FDG uptake in the heart in normal daily conditions. IR was associated with decreased [18F]-FDG

  11. The prognostic value of 18F-FDG PET-CT in the management of Hodgkin's lymphoma: preliminary results of a prospective study

    To date, Hodgkin's lymphoma (HL) patients have achieved long-term survival of more than 80%. Unfortunately, longer follow-up has shown serious adverse effects of the treatments used. For this reason, therapeutic strategies are becoming more tailored to the individual patient's prognosis. Pre-treatment risk factors for early-stage and advanced-stage HL are well known indicators of prognosis. Recently, early interim 18F-FDG PET has been shown as a strong and independent predictor of progression-free survival in HL. Our aim was to assess response to therapy by repeating 18F-FDG-PET/CT after four and six chemotherapy cycles. We evaluated 21 consecutive patients affected by (HL) and presenting for assessment over a period of three years. All patients underwent initial staging with 18F-FDG-PET/CT along with standard staging procedures. The prognostic value of 18F-FDG PET-CT in the management of Hodgkin's lymphoma: preliminary results of a prospective study. We tailored an individual treatment plan dependent on pre-treatment risk factors and initial 18F-FDG-PET/CT. With the aim of the best definition of response to treatment, we repeated 18F-FDG-PET/CT after two (FDG-PET 2), four (FDG-PET 4) and six (FDG-PET 6) chemotherapy cycles. Chemotherapy was typically given for four cycles in early disease stages and was prolonged to six to eight cycles in advanced disease stages, depending on PET findings. Our results showed a strong negative predictive value in detecting responders in early stage HL and a positive predictive value in advanced-stage patients. Clinical stage, extra-nodal sites and the positivity of the 18F-FDG-PET/CT performed during chemotherapy were also noted as strong determinants of response to treatment. Moreover, in our series the 18F-FDG-PET/CT data obtained after only two chemotherapy cycles (FDG-PET 2) were the same of those obtained after FDGPET 4 and FDG-PET 6 controls. The preliminary data of the present study confirm those of previous published

  12. Diagnostic accuracy of 18F-FDG PET/CT compared with that of contrast-enhanced MRI of the breast at 3 T

    To compare the diagnostic accuracy of prone 18F-FDG PET/CT with that of contrast-enhanced MRI (CE-MRI) at 3 T in suspicious breast lesions. To evaluate the influence of tumour size on diagnostic accuracy and the use of maximum standardized uptake value (SUVMAX) thresholds to differentiate malignant from benign breast lesions. A total of 172 consecutive patients with an imaging abnormality were included in this IRB-approved prospective study. All patients underwent 18F-FDG PET/CT and CE-MRI of the breast at 3 T in the prone position. Two reader teams independently evaluated the likelihood of malignancy as determined by 18F-FDG PET/CT and CE-MRI independently. 18F-FDG PET/CT data were qualitatively evaluated by visual interpretation. Quantitative assessment was performed by calculation of SUVMAX. Sensitivity, specificity, diagnostic accuracy, area under the curve and interreader agreement were calculated for all lesions and for lesions <10 mm. Histopathology was used as the standard of reference. There were 132 malignant and 40 benign lesions; 23 lesions (13.4 %) were <10 mm. Both 18F-FDG PET/CT and CE-MRI achieved an overall diagnostic accuracy of 93 %. There were no significant differences in sensitivity (p = 0.125), specificity (p = 0.344) or diagnostic accuracy (p = 1). For lesions <10 mm, diagnostic accuracy deteriorated to 91 % with both 18F-FDG PET/CT and CE-MRI. Although no significant difference was found for lesions <10 mm, CE-MRI at 3 T seemed to be more sensitive but less specific than 18F-FDG PET/CT. Interreader agreement was excellent (κ = 0.85 and κ = 0.92). SUVMAX threshold was not helpful in differentiating benign from malignant lesions. 18F-FDG PET/CT and CE-MRI at 3 T showed equal diagnostic accuracies in breast cancer diagnosis. For lesions <10 mm, diagnostic accuracy deteriorated, but was equal for 18F-FDG PET/CT and CE-MRI at 3 T. For lesions <10 mm, CE-MRI at 3 T seemed to be more sensitive but less specific than 18F-FDG PET/CT. Quantitative

  13. Diagnostic accuracy of {sup 18}F-FDG PET/CT compared with that of contrast-enhanced MRI of the breast at 3 T

    Magometschnigg, Heinrich F.; Baltzer, Pascal A.; Fueger, Barbara; Helbich, Thomas H.; Weber, Michael [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Vienna (Austria); Karanikas, Georgios [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Vienna (Austria); Dubsky, Peter [Medical University of Vienna, Department of Surgery, Vienna (Austria); Rudas, Margaretha [Medical University of Vienna, Department of Pathology, Vienna (Austria); Pinker, Katja [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Vienna (Austria); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York (United States)

    2015-10-15

    To compare the diagnostic accuracy of prone {sup 18}F-FDG PET/CT with that of contrast-enhanced MRI (CE-MRI) at 3 T in suspicious breast lesions. To evaluate the influence of tumour size on diagnostic accuracy and the use of maximum standardized uptake value (SUV{sub MAX}) thresholds to differentiate malignant from benign breast lesions. A total of 172 consecutive patients with an imaging abnormality were included in this IRB-approved prospective study. All patients underwent {sup 18}F-FDG PET/CT and CE-MRI of the breast at 3 T in the prone position. Two reader teams independently evaluated the likelihood of malignancy as determined by {sup 18}F-FDG PET/CT and CE-MRI independently. {sup 18}F-FDG PET/CT data were qualitatively evaluated by visual interpretation. Quantitative assessment was performed by calculation of SUV{sub MAX}. Sensitivity, specificity, diagnostic accuracy, area under the curve and interreader agreement were calculated for all lesions and for lesions <10 mm. Histopathology was used as the standard of reference. There were 132 malignant and 40 benign lesions; 23 lesions (13.4 %) were <10 mm. Both {sup 18}F-FDG PET/CT and CE-MRI achieved an overall diagnostic accuracy of 93 %. There were no significant differences in sensitivity (p = 0.125), specificity (p = 0.344) or diagnostic accuracy (p = 1). For lesions <10 mm, diagnostic accuracy deteriorated to 91 % with both {sup 18}F-FDG PET/CT and CE-MRI. Although no significant difference was found for lesions <10 mm, CE-MRI at 3 T seemed to be more sensitive but less specific than {sup 18}F-FDG PET/CT. Interreader agreement was excellent (κ = 0.85 and κ = 0.92). SUV{sub MAX} threshold was not helpful in differentiating benign from malignant lesions. {sup 18}F-FDG PET/CT and CE-MRI at 3 T showed equal diagnostic accuracies in breast cancer diagnosis. For lesions <10 mm, diagnostic accuracy deteriorated, but was equal for {sup 18}F-FDG PET/CT and CE-MRI at 3 T. For lesions <10 mm, CE-MRI at 3 T seemed

  14. The association of 18F-FDG PET/CT parameters with survival in malignant pleural mesothelioma

    Malignant pleural mesothelioma (MPM) is a disease with poor prognosis despite multimodal therapy but there is variation in survival between patients. Prognostic information is therefore potentially valuable in managing patients, particularly in the context of clinical trials where patients could be stratified according to risk. Therefore we have evaluated the prognostic ability of parameters derived from baseline 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT). In order to determine the relationships between metabolic activity and prognosis we reviewed all 18F-FDG PET/CT scans used for pretreatment staging of MPM patients in our institution between January 2005 and December 2011 (n = 60) and measured standardised uptake values (SUV) including mean, maximum and peak values, metabolic tumour volume (MTV) and total lesion glycolysis (TLG). Overall survival (OS) or time to last censor was recorded, as well as histological subtypes. Median follow-up was 12.7 months (1.9-60.9) and median OS was 14.1 months (1.9-54.9). By univariable analysis histological subtype (p = 0.013), TLG (p = 0.024) and MTV (p = 0.038) were significantly associated with OS and SUVmax was borderline (p = 0.051). On multivariable analysis histological subtype and TLG were associated with OS but at borderline statistical significance (p = 0.060 and 0.058, respectively). No statistically significant differences in any PET parameters were found between the epithelioid and non-epithelioid histological subtypes. 18F-FDG PET/CT parameters that take into account functional volume (MTV, TLG) show significant associations with survival in patients with MPM before adjusting for histological subtype and are worthy of further evaluation to determine their ability to stratify patients in clinical trials. (orig.)

  15. The diagnostic value of [18F]-FDG-PET/CT in hematopoietic radiation toxicity. A Tibet minipig model

    This study was undertaken to assess the diagnostic value of 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography with computed tomography ([18F]-FDG-PET/CT) in the detection of radiation toxicity in normal bone marrow using Tibet minipigs as a model. Eighteen Tibet minipigs were caged in aseptic rooms and randomly divided into six groups. Five groups (n=3/group) were irradiated with single doses of 2, 5, 8, 11 and 14 Gy of total body irradiation (TBI) using an 8-MV X-ray linear accelerator. These pigs were evaluated with [18F]-FDG-PET/CT, and their marrow nucleated cells were counted. The data were initially collected at 6, 24 and 72 h after treatment and were then collected on Days 5-60 post-TBI at 5-day intervals. At 24 and 72 h post-TBI, marrow standardized uptake value (SUV) data showed a dose-dependent decrease in the radiation dose range from 2-8 Gy. Upon long-term observation, SUV and marrow nucleated cell number in the 11-Gy and 14-Gy groups showed a continuous and marked reduction throughout the entire time course, while Kaplan-Meier curves of survival showed low survival. In contrast, the SUVs in the 2-, 5- and 8-Gy groups showed early transient increases followed by a decline from approximately 72 h through Days 5-15 and then normalized or maintained low levels through the endpoint; marrow nucleated cell number and survival curves showed approximately the same trend and higher survival, respectively. Our findings suggest that [18F]-FDG-PET/CT may be helpful in quickly assessing the absorbed doses and predicting the prognosis in patients. (author)

  16. Fever of unknown origin: A value of 18F-FDG-PET/CT with integrated full diagnostic isotropic CT imaging

    Aim: The aim of presented work is to evaluate the clinical value of 18F-FDG-PET/CT in patients with fever of unknown origin (FUO) and to compare PET/CT finding with the results of the following investigation. Material and method: 48 patients (24 men, 24 women, mean age 57.6 years with range 15-89 years) underwent 18F-FDG-PET/CT due to the fever of unknown origin. All examinations were performed using complex PET/CT protocol combined PET and whole diagnostic contrast enhanced CT with sub-millimeter spatial resolution (except patient with history of iodine hypersensitivity or sever renal impairment). CT data contained diagnostic images reconstructed with soft tissue and high-resolution algorithm. PET/CT finding were compared with results of biopsies, immunology, microbiology or autopsy. Results: The cause of FUO was explained according to the PET/CT findings and followed investigations in 44 of 48 cases-18 cases of microbial infections, nine cases of autoimmune inflammations, four cases of non-infectious granulomatous diseases, eight cases of malignancies and five cases of proved immunity disorders were found. In 46 cases, the PET/CT interpretation was correct. Only in one case, the cause was overlooked and the uptake in atherosclerotic changes of arteries was misinterpreted as vasculitis in the other. The reached sensitivity was 97% (43/44), and specificity 75% (3/4) respectively. Conclusion: In patients with fever of unknown origin, 18F-FDG-PET/CT might enable the detection of its cause.

  17. Correlation between 18F-FDG uptake on PET/CT and prognostic factors in triple-negative breast cancer

    The purpose of this study was to investigate whether a correlation exists between 18F-fluorodeoxyglucose (FDG) uptake and prognostic factors in triple-negative breast cancer (TNBC). Between January 2009 and December 2013, 103 patients (mean age, 50.6 years) with primary TNBC (mean, 2.6 cm; range, 1.0-6.5 cm) underwent 18F-FDG PET/CT for initial staging. Correlations between maximum standardized uptake value (SUVmax) on PET/CT and prognostic factors including tumour size, nodal status, histological grade, Ki-67 proliferation index, tumour suppressor p53, and 'basal-like' markers (epidermal growth factor receptor and CK 5/6) were assessed. The mean SUVmax of the 103 tumours was 10.94 ± 5.25 (range: 2-32.8). There was a positive correlation between SUVmax and Ki-67 (Spearman's rho = 0.29, P = 0.003) and tumour size (Spearman's rho = 0.27, P = 0.006), whereas this relationship was not observed in the nodal status, histological grade, p53 status and 'basal-like' phenotypes. In a multivariate regression analysis, Ki-67 (P < 0.001) and tumour size (P = 0.009) were significantly associated with SUVmax in TNBCs. Increased 18F-FDG uptake on PET/CT was correlated with a high Ki-67 proliferation index and larger tumour size in TNBC. These results suggest a potential role of 18F-FDG PET/CT in identifying TNBC with more aggressive behaviour. (orig.)

  18. Prognostic value of interim 18F-FDG PET/CT in diffuse large B-cell lymphoma

    Zhitao Ying; Xuejuan Wang; Yuqin Song; Wen Zheng; Xiaopei Wang; Yan Xie; Ningjing Lin

    2013-01-01

    Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease.The prognostic factor currently used is not accurate enough to predict the outcomes of patients with DLBCL.The prognostic significance of interim PET/CT in DLBCL remains controversial.The aim of this study is to determine the predictive value of interim 18F-FDG PET/CT after first-line treatment in patients with DLBCL.Methods:Thirty-two patients with DLBCL underwent baseline,interim and post-treatment 18F-FDG PET/CT scans.Imaging results were analyzed for the survival of patients via software SPSS 13.0,retrospectively.Results:Thirty-one of the 32 patients were treated with R-CHOP regimen,and interim 18F-FDG PET/CT of 24 patients was performed after 2 cycles of treatment.After a median follow-up period of 16.7 months,the 2-year progression-free survival (PFS) rates were significandy different between the groups above and below SUVmax cut-off value of 2.5 (P=0.039).No significant differences were found in the 2-year PFS rates if SUVmax cut-offvalues were set as 2.0 and 3.0,respectively (P=0.360; P=0.113).Conclusions:Interim PET/CT could predict the prognosis of DLBCL patients with the SUVmax cut-off value of 2.5,but more clinical data should be concluded to confirm this conclusion.

  19. Assessment of aortitis by semiquantitative analysis of 180-min {sup 18}F-FDG PET/CT acquisition images

    Martinez-Rodriguez, Isabel [University of Cantabria, Department of Nuclear Medicine, Marques de Valdecilla University Hospital, Santander (Spain); Hospital Universitario Marques de Valdecilla, S. Medicina Nuclear, Santander (Spain); Martinez-Amador, N.; Banzo, I.; Quirce, R.; Jimenez-Bonilla, J.; Arcocha-Torres, M. de; Ibanez-Bravo, S.; Lavado-Perez, C.; Bravo-Ferrer, Z.; Carril, J.M. [University of Cantabria, Department of Nuclear Medicine, Marques de Valdecilla University Hospital, Santander (Spain); Blanco, R.; Gonzalez-Gay, M.A. [University of Cantabria, Department of Rheumatology, Marques de Valdecilla University Hospital, Santander (Spain)

    2014-12-15

    The aim of this study was to evaluate the contribution of semiquantitative analysis of 180-min {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT images for the assessment of aortitis in cases of suspected large vessel vasculitis (LVV) and to establish a threshold index for application in the clinical setting. This prospective study included 43 patients (mean age 67.5 ± 12.9 years) with suspicion of LVV (25 with a final diagnosis of aortitis). {sup 18}F-FDG PET/CT scan was acquired 180 min after injection of 7 MBq/kg of {sup 18}F-FDG. A semiquantitative analysis was performed calculating the aortic wall maximum standardized uptake value (SUV{sub max}) (T), the lumen SUV{sub max} (B) and the target to background ratio (TBR). These results were also compared with those obtained in a control population. The mean aortic wall SUV{sub max} was 2.00 ± 0.62 for patients with aortitis and 1.45 ± 0.31 for patients without aortitis (p < 0.0001). The TBR was 1.66 ± 0.26 for patients with aortitis and 1.24 ± 0.08 for patients without aortitis (p < 0.0001). The differences were also statistically significant when the patients with aortitis and controls were compared. Receiver-operating characteristic (ROC) analysis revealed that the area under the curve was greater for the TBR than for the aortic wall SUV{sub max} (0.997 vs 0.871). The highest sensitivity and specificity was obtained for a TBR of 1.34 (sensitivity 100 %, specificity 94.4 %). Semiquantitative analysis of PET/CT images acquired 180 min after {sup 18}F-FDG injection and the TBR index of 1.34 show very high accuracy and, therefore, are strongly recommended for the diagnosis of aortitis in the clinical setting. (orig.)

  20. A standardized [18F]-FDG-PET template for spatial normalization in statistical parametric mapping of dementia.

    Della Rosa, Pasquale Anthony; Cerami, Chiara; Gallivanone, Francesca; Prestia, Annapaola; Caroli, Anna; Castiglioni, Isabella; Gilardi, Maria Carla; Frisoni, Giovanni; Friston, Karl; Ashburner, John; Perani, Daniela

    2014-10-01

    [18F]-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) is a widely used diagnostic tool that can detect and quantify pathophysiology, as assessed through changes in cerebral glucose metabolism. [18F]-FDG PET scans can be analyzed using voxel-based statistical methods such as Statistical Parametric Mapping (SPM) that provide statistical maps of brain abnormalities in single patients. In order to perform SPM, a "spatial normalization" of an individual's PET scan is required to match a reference PET template. The PET template currently used for SPM normalization is based on [15O]-H2O images and does not resemble either the specific metabolic features of [18F]-FDG brain scans or the specific morphological characteristics of individual brains affected by neurodegeneration. Thus, our aim was to create a new [18F]-FDG PET aging and dementia-specific template for spatial normalization, based on images derived from both age-matched controls and patients. We hypothesized that this template would increase spatial normalization accuracy and thereby preserve crucial information for research and diagnostic purposes. We investigated the statistical sensitivity and registration accuracy of normalization procedures based on the standard and new template-at the single-subject and group level-independently for subjects with Mild Cognitive Impairment (MCI), probable Alzheimer's Disease (AD), Frontotemporal lobar degeneration (FTLD) and dementia with Lewy bodies (DLB). We found a significant statistical effect of the population-specific FDG template-based normalisation in key anatomical regions for each dementia subtype, suggesting that spatial normalization with the new template provides more accurate estimates of metabolic abnormalities for single-subject and group analysis, and therefore, a more effective diagnostic measure. PMID:24952892

  1. The association of {sup 18}F-FDG PET/CT parameters with survival in malignant pleural mesothelioma

    Klabatsa, Astero; Lang-Lazdunski, Loic [Guys and St Thomas' NHS Foundation Trust, Department of Thoracic Oncology, London (United Kingdom); Chicklore, Sugama; Barrington, Sally F.; Goh, Vicky [Kings College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Cook, Gary J.R. [Kings College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Kings College London, Clinical PET Centre, Division of Imaging Sciences and Biomedical Engineering, St Thomas' Hospital, London (United Kingdom)

    2014-02-15

    Malignant pleural mesothelioma (MPM) is a disease with poor prognosis despite multimodal therapy but there is variation in survival between patients. Prognostic information is therefore potentially valuable in managing patients, particularly in the context of clinical trials where patients could be stratified according to risk. Therefore we have evaluated the prognostic ability of parameters derived from baseline 2-[{sup 18}F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT). In order to determine the relationships between metabolic activity and prognosis we reviewed all {sup 18}F-FDG PET/CT scans used for pretreatment staging of MPM patients in our institution between January 2005 and December 2011 (n = 60) and measured standardised uptake values (SUV) including mean, maximum and peak values, metabolic tumour volume (MTV) and total lesion glycolysis (TLG). Overall survival (OS) or time to last censor was recorded, as well as histological subtypes. Median follow-up was 12.7 months (1.9-60.9) and median OS was 14.1 months (1.9-54.9). By univariable analysis histological subtype (p = 0.013), TLG (p = 0.024) and MTV (p = 0.038) were significantly associated with OS and SUV{sub max} was borderline (p = 0.051). On multivariable analysis histological subtype and TLG were associated with OS but at borderline statistical significance (p = 0.060 and 0.058, respectively). No statistically significant differences in any PET parameters were found between the epithelioid and non-epithelioid histological subtypes. {sup 18}F-FDG PET/CT parameters that take into account functional volume (MTV, TLG) show significant associations with survival in patients with MPM before adjusting for histological subtype and are worthy of further evaluation to determine their ability to stratify patients in clinical trials. (orig.)

  2. Determination of the chemical and radiochemical purity and specific radioactivity of [18F]FDG by HPLC

    High performance liquid chromatography (HPLC) in combination with the radioactivity detection is the best control method for the radiochemical purity of [18F]FDG. An anion exchange separation mechanism allows isocratic separation of carbohydrates. Using a strong basic eluent, the weakly acid carbohydrates form anions and are therefore retained on the anion exchange resin. The chemical and radiochemical purity and specific radioactivity can be determined simultaneously by including in the chromatographic system a mass detector sensitive, enough for quantitative determination of the product species. (orig.)

  3. Clinically relevant strategies for lowering cardiomyocyte glucose uptake for {sup 18}F-FDG imaging of myocardial inflammation in mice

    Thackeray, James T.; Bankstahl, Jens P.; Bengel, Frank M. [Hanover Medical School, Department of Nuclear Medicine, Hanover (Germany); Wang, Yong; Wollert, Kai C. [Hanover Medical School, Department of Cardiology and Angiology, Hanover (Germany)

    2015-04-01

    Myocardial inflammation is an emerging target for novel therapies and thus for molecular imaging. Positron emission tomography (PET) with {sup 18}F-fluorodeoxyglucose (FDG) has been employed, but requires an approach for suppression of cardiomyocyte uptake. We tested clinically viable strategies for their suitability in mouse models in order to optimize preclinical imaging protocols. C57BL/6 mice (n = 56) underwent FDG PET under various conditions. In healthy animals, the effect of low-dose (5 units/kg) or high-dose (500 units/kg, 15 min prior) intravenous heparin, extended fasting (18 h) and the impact of conscious injection with limited, late application of isoflurane anaesthesia after 40 min of conscious uptake were examined in comparison to ketamine/xylazine anaesthesia. Conscious injection/uptake strategies were further evaluated at 3 days after permanent coronary artery occlusion. Under continuous isoflurane anaesthesia, neither heparin administration nor extended fasting significantly impacted myocardial {sup 18}F-FDG accumulation. Injection with 40 min uptake in awake mice resulted in a marked reduction of global myocardial {sup 18}F-FDG uptake compared to standard isoflurane anaesthesia (5.7 ± 1.1 %ID/g vs 30.2 ± 7.9 %ID/g, p < 0.01). Addition of heparin and fasting further reduced uptake compared to conscious injection alone (3.8 ± 1.5 %ID/g, p < 0.01) similar to ketamine/xylazine (2.4 ± 2.2 %ID/g, p < 0.001). In the inflammatory phase, 3 days after myocardial infarction, conscious injection/uptake with and without heparin/fasting identified a marked increase in myocardial {sup 18}F-FDG accumulation that was similar to that observed under ketamine/xylazine. Continuous isoflurane anaesthesia obscures any suppressive effect of heparin or fasting on cardiomyocyte glucose utilization. Conscious injection of FDG in rodents significantly reduces cardiomyocyte uptake and enables further suppression by heparin and fasting, similar to clinical observations. In

  4. Role of 18F-FDG PET/CT in restaging of patients with recurrent malignant melanoma

    The incidence of malignant melanoma has increased in recent years. Patients with familial melanoma and a personal history of melanoma have a very high risk for the development of recurrence at other sites even after adequate treatment which demands a non invasive imaging modality for the early and accurate restaging of the recurrence of melanoma. We evaluated the role of 18F-FDG PET/CT in restaging of patients with recurrent malignant melanoma. It is found to be an sensitive tool for restaging recurrent malignant melanoma

  5. The utility of 18 F-FDG PET/CT for suspected recurrent breast cancer: impact and prognostic stratification

    Cochet, Alexandre; David, Steven; Moodie, Kate; Drummond, Elizabeth; Dutu, Gaelle; MacManus, Michael; Chua, Boon; Hicks, Rodney J.

    2014-01-01

    Background The incremental value of 18FDG PET/CT in patients with breast cancer (BC) compared to conventional imaging (CI) in clinical practice is unclear. The aim of this study was to evaluate the management impact and prognostic value of 18 F-FDG PET/CT in this setting. Methods Sixty-three patients who were referred to our institution for suspicion of BC relapse were retrospectively enrolled. All patients had been evaluated with CI and underwent PET/CT. At a median follow-up of 61 months, s...

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

    Vees Hansjörg

    2012-10-01

    Full Text Available Abstract 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 using the signal-to-background (SBR ratio-based adaptive thresholding technique (GTVSBR. Overlap analysis were conducted to assess geographic mismatches between the GTVs delineated using the different techniques. Inter- and intra-observer variability were also assessed. Results The mean GTVCT (43.65 cm3 was larger than the mean GTVPET/CT (33.06 cm3, p = 0.02. In 6 patients, GTVPET/CT added substantial tumor extension outside the GTVCT even though 90.4% of the GTVPET/CT was included in the GTVCT and 30.2% of the GTVCT was found outside the GTVPET/CT. The inter- and intra-observer variability was not significantly reduced with the inclusion of 18F-FDG PET imaging (p = 0.23 and p = 0.18, respectively. The GTVSBR was smaller than GTVCT p ≤ 0.005 and GTVPET/CT p ≤ 0.005. Conclusions The use of 18F-FDG PET/CT images for target volume delineation of recurrent or post-surgical residual gynaecological cancer alters the GTV in the majority of patients compared to standard CT-definition. The use of SBR-based auto-delineation showed significantly smaller GTVs. The use of PET/CT based target volume delineation may improve the accuracy of RT treatment planning in gynaecologic cancer.

  7. Non-malignant 18F-FDG uptake in the thorax by positron emission tomography computed tomography fusion imaging

    Fluorine-18 2-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography (PET) has been used exclusively to diagnose malignancies. However, increased FDG uptake is not always limited to malignant tissue. Many false positive findings for PET have been reported. Moreover, the use of PET/CT may allow the reassessment of previously recognized patterns of physiological bio-distribution of a tracer. In this report we demonstrate the physiological FDG uptake of normal structures in the thorax using PET/CT imaging and illustrate many benign pathological conditions with standardized uptake values greater than 2.5

  8. {sup 18}F-FDG PET/CT in inflammation of unknown origin: a cost-effectiveness pilot-study

    Balink, H. [Medical Center Leeuwarden, Department of Nuclear Medicine, Leeuwarden (Netherlands); Tan, S.S. [Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam (Netherlands); Veeger, N.J.G.M. [University Medical Center Groningen, Department of Epidemiology, Groningen (Netherlands); Holleman, F. [Academic Medical Center Amsterdam, Department of Internal Medicine, Amsterdam (Netherlands); Eck-Smit, B.L.F. van; Bennink, R.J.; Verberne, H.J. [Academic Medical Center, Department of Nuclear Medicine, Amsterdam (Netherlands)

    2015-08-15

    Patients with increased inflammatory parameters, nonspecific signs and symptoms without fever and without a diagnosis after a variety of diagnostic procedures are a diagnostic dilemma and are referred to as having inflammation of unknown origin (IUO). The objective of this pilot study was to compare the cost-effectiveness of a diagnostic work-up/strategy with and without {sup 18}F-FDG PET/CT in patients with IUO using a published dataset as a reference. IUO patients without {sup 18}F-FDG PET/CT (group A, 46 patients) and IUO patients referred for {sup 18}F-FDG PET/CT (group B, 46 patients) were selected. IUO was defined as the combination of nonspecific signs and symptoms and a prolonged erythrocyte sedimentation rate (ESR), defined as ≥age/2 in men and ≥(age + 10)/2 in women (ESR in millimetres per hour and age in years), and/or C-reactive protein (CRP) ≥15 mg/l. The costs of all tests and procedures and the number of hospitalization days in each patient to reach a diagnosis were calculated using current Dutch tariffs. In group A a diagnosis was reached in 14 of the 46 patients. The mean cost per patient of all the diagnostic procedures was EUR2,051, and including the cost of hospitalization was EUR12,614. In group B a diagnosis was reached in 32 of the 46 patients. The mean cost per patient of all the diagnostic procedures was EUR1,821, significantly lower than in group A (p < 0.0002), and including the cost of hospitalization was EUR5,298. In IUO {sup 18}F-FDG PET/CT has the potential to become a cost-effective routine imaging technique indicating the direction for further diagnostic decisions thereby allowing unnecessary, invasive and expensive diagnostic investigations to be avoided and possibly the duration of hospitalization to be reduced. However, a prospective multicentre ''bottom-up microcosting'' cost-effectiveness study is warranted before these preliminary data can be extrapolated to clinical practice. (orig.)

  9. The value of {sup 18}F-FDG PET/CT in the assessment of active idiopathic retroperitoneal fibrosis

    Moroni, Gabriella; Longhi, Selena; Messa, Piergiorgio [Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Division of Nephrology, Milan (Italy); Castellani, Massimo; Martinelli, Isabella; Gerundini, Paolo [Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Department of Nuclear Medicine, Milan (Italy); Balzani, Aurora; Bonelli, Nicola [Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Department of Radiology, Milan (Italy); Dore, Roberto [University of Pavia, Institute of Radiology, IRCCS Foundation, San Matteo Medical Center, Pavia (Italy)

    2012-10-15

    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 {sup 18}F-FDG PET/CT in this clinical setting. {sup 18}F-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 <20 HU, 1 20-30 HU, 2 {>=}30 HU). SUVmax and CE scores were correlated with the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels. The value of PET/CT in assessing the variation of disease activity over time was also investigated by analysing the changes in metabolic volume (MV) of the retroperitoneal lesion between repeat patient studies. PET/CT accurately discriminated (93.9 %) active from inactive disease. Significant agreement (p < 0.01) was observed between visual and semiquantitative analysis of {sup 18}F-FDG uptake, and CE score. A significant correlation (p < 0.01) was found among SUVmax, CRP levels (rho = 0.54) and ESR (rho = 0.55). Corresponding variations in MV and CE score were observed in patients with multiple studies (p < 0.01; rho = 0.68). {sup 18}F-FDG PET/CT may be considered an alternative imaging method for the assessment of different stages of IRF. (orig.)

  10. Effect of ethanol in BET assay performed by kinetic chromogenic method for (18F) radiopharmaceuticals other than (18F) FDG

    Full text: In recent years, several (18F) labeled radiopharmaceuticals other than 2-(18F)fluoro-2-deoxy-D-glucose have become increasingly important for molecular imaging studies in oncology, and a rapid BET assay is essential to quantify the bacterial endotoxin that may be present in such radiopharmaceutical preparations, prior to use in patients. The radiochemical synthesis of (18F) labelled radiopharmaceuticals like 3'-Deoxy-3'-(18F)fluorothymidine ((18F)FLT), (18F) fluoroazomycinarabinoside ((18F)FAZA) etc is based on use of SEP-PAK cartridge for isolation and purification instead of HPLC purification and requires 15% ethanolic water as elution solvent. BET assay for these radiopharmaceuticals can be routinely performed by Portable Test System (PTS)kinetic reader obtained from Endosafe Inc. The assay is based on kinetic chromogenic method and is known to be inhibited by presence of ethanol. Since all the above mentioned radiopharmaceuticals preparations contains ethanol, the aim of our study was to detect at what ppm/percentage level of ethanol, in final formulation, inhibition in BET assay is observed. The ppm/percentage levels of ethanol in final radiopharmaceutical formulations were detected by gas chromatography. In the present study, the BET Assay for (18F)FDG and (18F)FDG and (18F)FLT was performed at six different dilutions i.e 1:500, 1:200, 1:100, 1:50, 1:20 and 1:10 and all these dilutions were less than the Maximum Valid dilution (MVD). (18F) FDG was chosen as control since the elution solvent for it is 100% water and for all the dilutions mentioned above, the spike recovery was between 50-200%. The CV of negative and positive control samples were found to be 0.0% and less than 10% respectively. However, in case of (18F)FLT, for 1:20 and 1:10 dilutions, the spike recovery was below 50% but coefficient variance of negative and positive control sample were same as (18F)FDG. These results indicate inhibition at 1:20 and 1:10 dilution due to presence of

  11. Asymptomatic cauda equina metastasis in a patient with nasopharyngeal carcinoma: Detection by 18F-FDG PET/CT

    The central nervous system metastasis from nasopharyngeal carcinoma (NPC) is an extremely rare occurrence, although direct intracranial invasion is not infrequent in patients with NPC. Herein we report a case of a 62-year-old male with NPC, in whom the asymptomatic cauda equina metastasis was detected on staging 18F-Fluordeoxyglucose positron emission tomography-computed tomography (F-FDG PET/CT). By demonstrating distant metastasis to cauda equina, 18F-FDG PET/CT detection helped in change of management in this patient

  12. {sup 18F}-FDG PET imaging with dual head gamma camera and co-incidence detection

    Quach, T.; Camden, B.M.; Chu, J.M.G. [Liverpool Health Services, Liverpool, NSW (Australia). Department of Nuclear Medicine and Clinical Ultrasound

    1998-06-01

    Full text: {sup 18F}-Fluorodeoxyglucose (FDG) positron tomography is based on the detection of two 511 keV photons which are produced 180 deg apart as a result of an annihilation of a positron and an electron. Apart from the dedicated PET scanner, dual head gamma camera designed for Co-incidence Detection (CD) can now perform `{sup 18}F-FDG PET studies. CD imaging involves using a dual head gamma camera to detect those photons which are 180 deg apart and fall within a timing window of 15 nsec. No collimators are required as a timing gate of 15 nsec is used. {sup 18}F-FDG studies are performed using an ADAC Solus Molecular Co-incidence Detection (MCD) dual head gamma camera. The patients are fasted from midnight but well hydrated before the scan. Prior to injection, the blood sugar levels (BSL) are measured. For optimal {sup 18}F-FDG uptake, the BSL should be less than 8.9 mmol/L. A dose of 200MBq of {sup 18}F-FDG is intravenously injected via a cannula. Scanning commences at 1 hour post injection. To perform a wholebody tomography of the torso, the patient must void before scanning to reduce bladder activity. Excessive bladder activity leads to significant image degradation, therefore the wholebody tomography is started from the pelvis. Depending on the patient torso length, either 2 or 3 tomographies are collected with a 50% overlap. Each tomography is collected for 40 seconds per step for 32 steps. To avoid attenuation from the upper limbs, the patient is positioned supine with the arms above the head. If a patient cannot tolerate this position, scanning with the arms by the side may be necessary since the scanning time may take up to 50 minutes. If the area of interest is the neck, scanning with the patient`s arms down by their sides is preferred, although attenuation will occur. To scan the brain, a circular tomography is performed using 32 steps at 80 seconds per step. For processing purposes, the Singles count rate for each detector must be between 800K and

  13. Diagnostic value of 18F-FDG PET and 11C-PIB PET on early stage posterior cortical atrophy

    Shuai LIU

    2015-08-01

    Full Text Available Background  Posterior cortical atrophy (PCA is a kind of progressive neurodegenerative disease with cortical visual impairment as the first symptom. Because of rare clinical incidence, early onset age, special clinical symptoms and unobvious MRI abnormality, the definitive diagnosis of PCA is difficult. This study used 18F-fluoro-2-deoxy-D-glucose (18F-FDG PET and 11C-Pittsburgh compound B (11C-PIB PET for PCA patients with unobvious MRI abnormality, so as to discuss the value of PET in the early diagnosis of PCA.  Methods  Five patients diagnosed as PCA in our hospital between April 2012 and March 2015 were enrolled in this study. Cognitive function was measured by Mini-Mental State Examination (MMSE, Montreal Cognitive Assessment (MoCA, Activities of Daily Living (ADL and Clock Drawing Test (CDT. Brain MRI, 18F-FDG PET and 11C-PIB PET were performed to analyze glucose metabolism and perfusion of posterior cortex.  Results Neuropsychological tests revealed that the ability of writing, calculating, visuospatial and executive function of all these patients were impaired. Color vision tests showed abnormal results. MRI showed that the posterior atrophy (PA scores were 0-2 (average 1 on the left side and 0-1 (average 0.80 on the right side. The medial temporal atrophy (MTA scores were 1-3 (average 1.80 on the left side and 1-4 (average 2 on the right side. The ventricular enlargement (VE scores were 1-2 (average 1.80 on the left side and 1-2 (average 1.60 on the right side. 18F-FDG PET showed glucose metabolism decreased obviously on bilateral temporo-parieto-occipital cortex, precuneus and cingulate gyrus, and slightly on frontal lobes and subcortical structure. 11C-PIB PET showed radioactive 11C-PIB deposition on bilateral frontal, temporal, parietal and occipital cortex, and the outline of cerebellar cortex was clear.  Conclusions  For PCA patients whose parietal and occipital cortical atrophy is not obvious on MRI, 18F-FDG PET

  14. Background {sup 18}F-FDG uptake in positron emission mammography (PEM): Correlation with mammographic density and background parenchymal enhancement in breast MRI

    Koo, Hye Ryoung, E-mail: huilings@hanmail.net [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Moon, Woo Kyung, E-mail: moonwk@snu.ac.kr [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Chun, In Kook, E-mail: inkook.chun@gmail.com [Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Eo, Jae Seon, E-mail: jaeseon76@gmail.com [Department of Nuclear Medicine, Korea University Guro Hospital, 148 Gurodongro, Guro-gu, Seoul 152-703 (Korea, Republic of); Jeyanth, Joseph Xavier, E-mail: jeyanth7@snu.ac.kr [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Chang, Jung Min, E-mail: imchangjm@gmail.com [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Cho, Nariya, E-mail: river7774@gmail.com [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Kang, Keon Wook, E-mail: kangkw@snu.ac.kr [Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of)

    2013-10-01

    We aimed to determine whether background {sup 18}F-FDG uptake in positron emission mammography (PEM) was related to mammographic density or background parenchymal enhancement in breast MRI. Methods: We studied a total of 52 patients (mean age, 50.9 years, 26 premenopausal, 26 postmenopausal) with newly diagnosed breast cancer who underwent {sup 18}F-FDG PEM (positron emission mammography), conventional mammography and breast MRI. The background mean {sup 18}F-FDG uptake value on PEM was obtained by drawing a user-defined region of interest (ROI) in a normal area of the contralateral breast. We reviewed the mammography retrospectively for overall breast density of contralateral breast according to the four-point scale (grade 1–4) of the Breast Imaging Reporting and Data System (BI-RADS) classification. The background parenchymal enhancement of breast MRI was classified as minimal, mild, moderate, or marked. All imaging findings were interpreted by two readers in consensus without knowledge of image findings of other modalities. Results: Multiple linear regression analysis revealed a significant correlation between background {sup 18}F-FDG uptake on PEM and mammographic density after adjustment for age and menopausal status (P < 0.01), but not between background {sup 18}F-FDG uptake on PEM and background parenchymal enhancement on MRI. Conclusion: Background {sup 18}F-FDG uptake on PEM significantly increases as mammographic density increases. Background parenchymal enhancement in breast MRI was not an independent predictor of the background {sup 18}F-FDG uptake on PEM unlike mammographic density.

  15. The influence of tumor oxygenation on 18F-FDG (Fluorine-18 Deoxyglucose) uptake: A mouse study using positron emission tomography (PET)

    This study investigated whether changing a tumor's oxygenation would alter tumor metabolism, and thus uptake of 18F-FDG (fluorine-18 deoxyglucose), a marker for glucose metabolism using positron emission tomography (PET). Tumor-bearing mice (squamous cell carcinoma) maintained at 37°C were studied while breathing either normal air or carbogen (95% O2, 5% CO2), known to significantly oxygenate tumors. Tumor activity was measured within an automatically determined volume of interest (VOI). Activity was corrected for the arterial input function as estimated from image and blood-derived data. Tumor FDG uptake was initially evaluated for tumor-bearing animals breathing only air (2 animals) or only carbogen (2 animals). Subsequently, 5 animals were studied using two sequential 18F-FDG injections administered to the same tumor-bearing mouse, 60 min apart; the first injection on one gas (air or carbogen) and the second on the other gas. When examining the entire tumor VOI, there was no significant difference of 18F-FDG uptake between mice breathing either air or carbogen (i.e. air/carbogen ratio near unity). However, when only the highest 18F-FDG uptake regions of the tumor were considered (small VOIs), there was a modest (21%), but significant increase in the air/carbogen ratio suggesting that in these potentially most hypoxic regions of the tumor, 18F-FDG uptake and hence glucose metabolism, may be reduced by increasing tumor oxygenation. Tumor 18F-FDG uptake may be reduced by increases in tumor oxygenation and thus may provide a means to further enhance 18F-FDG functional imaging

  16. Complementary roles of tumour specific PET tracer 18F-FAMT to 18F-FDG PET/CT for the assessment of bone metastasis

    The usefulness of 18F-FDG PET/CT for bone metastasis evaluation has already been established. The amino acid PET tracer [18F]-3-fluoro-alpha-methyl tyrosine (18F-FAMT) has been reported to be highly specific for malignancy. We evaluated the additional value of 18F-FAMT PET/CT to complement 18F-FDG PET/CT in the evaluation of bone metastasis. This retrospective study included 21 patients with bone metastases of various cancers who had undergone both 18F-FDG and 18F-FAMT PET/CT within 1 month of each other. 18F-FDG-avid bone lesions suspicious for malignancy were carefully selected based on the cut-off value for malignancy, and the SUVmax of the 18F-FAMT in the corresponding lesions were evaluated. A total of 72 18F-FDG-positive bone lesions suspected to be metastases in the 21 patients were used as the reference standard. 18F-FAMT uptake was found in 87.5 % of the lesions. In the lesions of lung cancer origin, the uptake of the two tracers showed a good correlation (40 lesions, r = 0.68, P 18F-FAMT uptake. Bone metastatic lesions of squamous cell carcinoma showed higher 18F-FAMT uptake than those of adenocarcinoma. No significant difference in 18F-FAMT uptake was seen between osteoblastic and osteolytic bone metastatic lesions. The usefulness of 18F-FAMT PET/CT for bone metastasis detection regardless of the lesion phenotype was demonstrated. The fact that 18F-FAMT uptake was confirmed by 18F-FDG uptake suggests that 18F-FAMT PET/CT has the potential to complement 18F-FDG PET/CT for the detection of bone metastases. (orig.)

  17. Comparison of 18F-DOPA, 18F-FDG and 68Ga-somatostatin analogue PET/CT in patients with recurrent medullary thyroid carcinoma

    To retrospectively evaluate and compare 18F-FDG, 18F-DOPA and 68Ga-somatostatin analogues for PET/CT in patients with residual/recurrent medullary thyroid carcinoma (MTC) suspected on the basis of elevated serum calcitonin levels. Included in the study were 18 patients with recurrent MTC in whom functional imaging with the three tracers was performed. The PET/CT results were compared on a per-patient basis and on a per-lesion-basis. At least one focus of abnormal uptake was observed on PET/CT in 13 patients with 18F-DOPA (72.2% sensitivity), in 6 patients with 68Ga-somatostatin analogues (33.3%) and in 3 patients with 18F-FDG (16.7%) (p 18F-DOPA and 18F-FDG PET/CT (p 18F-DOPA and 68Ga-somatostatin analogue PET/CT (p = 0.04). Overall, 72 lesions were identified on PET/CT with the three tracers. 18F-DOPA PET/CT detected 85% of lesions (61 of 72), 68Ga-somatostatin analogue PET/CT 20% (14 of 72) and 18F-FDG PET/CT 28% (20 of 72). There was a statistically significant difference in the number of lymph node, liver and bone lesions detected with the three tracers (p 18F-DOPA PET/CT and 18F-FDG PET/CT (p 18F-DOPA PET/CT and 68Ga-somatostatin analogue PET/CT (p 18F-DOPA PET/CT seems to be the most useful imaging method for detecting recurrent MTC lesions in patients with elevated serum calcitonin levels, performing better than 18F-FDG and 68Ga-somatostatin analogue PET/CT. 18F-FDG may complement 18F-DOPA in patients with an aggressive tumour. (orig.)

  18. [18F]FDG and [18F]FLT positron emission tomography imaging following treatment with belinostat in human ovary cancer xenografts in mice

    Belinostat is a histone deacetylase inhibitor with anti-tumor effect in several pre-clinical tumor models and clinical trials. The aim of the study was to evaluate changes in cell proliferation and glucose uptake by use of 3’-deoxy-3’-[18F]fluorothymidine ([18F]FLT) and 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) positron emission tomography (PET) following treatment with belinostat in ovarian cancer in vivo models. In vivo uptake of [18F]FLT and [18F]FDG in human ovary cancer xenografts in mice (A2780) were studied after treatment with belinostat. Mice were divided in 2 groups receiving either belinostat (40 mg/kg ip twice daily Day 0–4 and 6–10) or vehicle. Baseline [18F]FLT or [18F]FDG scans were made before treatment (Day 0) and repeated at Day 3, 6 and 10. Tracer uptake was quantified using small animal PET/CT. Tumors in the belinostat group had volumes that were 462 ± 62% (640 mm3) at Day 10 relative to baseline which was significantly different (P = 0.011) from the control group 769 ± 74% (926 mm3). [18F]FLT SUVmax increased from baseline to Day 10 (+30 ± 9%; P = 0.048) in the control group. No increase was observed in the treatment group. [18F]FDG SUVmean was significantly different in the treatment group compared to the control group (P = 0.0023) at Day 10. Within treatment groups [18F]FDG uptake and to a lesser extent [18F]FLT uptake at Day 3 were significantly correlated with tumor growth at Day 10. [18F]FDG uptake early following treatment initiation predicted tumor sizes at Day 10, suggesting that [18F]FDG may be a valuable biomarker for non-invasive assessment of anti-tumor activity of belinostat

  19. Role of [18F]FDG PET in prediction of KRAS and EGFR mutation status in patients with advanced non-small-cell lung cancer

    The tumour molecular profile predicts the activity of epidermal growth factor receptor (EGFR) inhibitors in non-small-cell lung cancer (NSCLC). However, tissue availability and tumour heterogeneity limit its assessment. We evaluated whether [18F]FDG PET might help predict KRAS and EFGR mutation status in NSCLC. Between January 2005 and October 2011, 340 NSCLC patients were tested for KRAS and EGFR mutation status. We identified patients with stage III and IV disease who had undergone [18F]FDG PET/CT scanning for initial staging. SUVpeak, SUVmax and SUVmean of the single hottest tumour lesions were calculated, and their association with KRAS and EGFR mutation status was assessed. A receiver operator characteristic (ROC) curve analysis and a multivariate analysis (including SUVmean, gender, age and AJCC stage) were performed to identify the potential value of [18F]FDG PET/CT for predicting KRAS mutation. From 102 patients staged using [18F]FDG PET/CT, 28 (27 %) had KRAS mutation (KRAS+), 22 (22 %) had EGFR mutation (EGFR+) and 52 (51 %) had wild-type KRAS and EGFR profiles (WT). KRAS+ patients showed significantly higher [18F]FDG uptake than EGFR+ and WT patients (SUVmean 9.5, 5.7 and 6.6, respectively; p 18F]FDG uptake between EGFR+ patients and WT patients. ROC curve analysis for KRAS mutation status discrimination yielded an area under the curve of 0.740 for SUVmean (p 18F]FDG uptake than WT patients, as assessed in terms of SUVpeak, SUVmax and SUVmean. A multivariate model based on age, gender, AJCC stage and SUVmean might be used as a predictive marker of KRAS mutation status in patients with stage III or IV NSCLC. (orig.)

  20. Retrocrural Lymph Node Metastasis Disclosed by 18F-FDG PET/CT: A Predictor of Supra-diaphragmatic Spread in Ovarian Cancer

    Retrocrual lymph nodes (RCLNs) communicate with retroperitoneal and posterior mediastinal LNs. It is possible that, when RCLNs are involved, supra diaphragmatic extension will occur in abdomino pelvic cancers. The authors investigated performance of 18F FDG PET/CT to diagnose RCLN metastasis and whether RCLN metastases were associated with supra diaphragmatic lymphatic metastases of ovarian cancer. Sixty seven patients with stage IV ovarian cancer who had undergone 18F FDG PET/CT were included in this retrospective study. Diagnostic performance of 18F FDG PET/CT for RCLN metastasis was evaluated. Patients were divided into two groups by presence or absence of supra diaphragmatic LN metastasis. The prevalences of RCLN metastasis between the two groups were compared and the odds ratio was calculated. Sensitivity and specificity of 18F FDG PET/CT for RCLN metastasis were 96.3 and 100%, respectively. Of the 67 study subjects, 27 patients had RCLN metastases (40.3%). Fifty patients had supra diaphragmatic LN metastases. 18F FDG PET/CT showed 26 RCLN metastases in patients with supra diaphragmatic LN metastases (54.5%), and only 1 in patients without supra diaphragmatic LN metastasis (5.9%), and the difference between two groups was statistically significant (P18F FDG PET/CT to diagnose RCLN metastasis was excellent. RCLN metastasis revealed by 18F FDG PET/CT was strongly associated with supra diaphragmatic LN spread of ovarian cancer. Thus, RCLN metastasis could be used as a predictor of supra diaphragmatic lymphatic metastasis of ovarian cancer

  1. Performance of 18F-FDG PET/CT as a postoperative surveillance imaging modality for asymptomatic advanced gastric cancer patients

    The purpose of this study was to investigate the diagnostic performance of postoperative fluorine-18 fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) as a surveillance modality for advanced gastric cancer patients who were asymptomatic and negative by conventional follow-up. We retrospectively collected 46 advanced gastric cancer patients who received approximately 1-year-postoperative 18F-FDG PET/CT surveillance following curative resection (mean age 60.6 ± 11.5 years). 18F-FDG PET/CT was interpreted by nuclear medicine physicians who were blind to the clinical information. Final confirmation was determined by clinical follow-up using tumor markers, conventional CT scan, upper gastrointestinal endoscopy and with/without subsequent histopathologic diagnosis. Four patients developed recurrence (8.7%; 1 local and 3 distant recurrences). For local recurrence, 18F-FDG PET/CT found four hypermetabolic lesions and one was local recurrence. For distant recurrence, seven hypermetabolic lesions were found in six patients and true-positive was three lesions. False-positive cases were mainly turned out to be physiologic small bowel uptake. Regardless of the recurrence site, the sensitivity, specificity, positive predictive value and negative predictive value of 18F-FDG PET/CT were 100% (4/4, 95% confidence interval (CI) 39.6-100%), 88.1% (37/42, 95% CI 73.6-95.5%), 44.4% (4/9, 95% CI 15.3-77.3%) and 100% (37/37, 95% CI 88.3-100%), respectively in the patient-based analysis. Our study showed good specificity of postoperative surveillance 18F-FDG PET/CT for detecting recurrence. Careful caution should be made for interpreting some false-positive hypermetabolic lesions in postoperative 18F-FDG PET/CT, especially at the local anastomosis site. (author)

  2. Comparison of 18F-FDG PET and 201 thallium chloride SPECT in the evaluation of cerebral glioma prior to surgery

    Full text: The purpose of the study was to compare the accuracy of 18F-FDG PET and 201Tl SPECT in detecting and grading primary cerebral glioma through comparison to surgical pathology. A total of 33 patients with primary cerebral glioma had 35 18F-FDG PET/201Tl SPECT scans prior to surgery. Pre-operative 18F -FDG PET and 201Tl SPECT studies were reviewed and compared with histologic tumour grade. Radiological comparisons were also performed when pre-operative studies were available. 17/18 patients with glioblastoma multiforme demonstrated hypermetabolic lesions on 18F-FDG PET scan and increased thallium uptake on SPECT scan. Increased 18F -FDG and thallium uptake were also demonstrated in patients with anaplastic astrocytoma, gemistocytic astrocytoma, and one biopsy which was difficult to grade because of small biopsy sample and co-existing radiation necrosis. In general, low grade gliomas had reduced 18F -FDG uptake and normal thallium uptake (6/7, where two patients had tumour with hypermetabolic and hypometabolic regions). MRI correctly identified 4/7 patients with low to intermediate grade glioma. Pilocytic astrocytoma, protoplastic astrocytoma and oligoastrocytoma all demonstrated hypometabolic PET activity and normal thallium uptake. In conclusion, 18F-FDG PET and 201Tl SPECT are very sensitive in pre-operative prediction of high grade glioma. In low grade tumour, 201Tl SPECT appeared to be less useful in the absence of breakdown of the blood brain barrier. MR imaging accurately identified the presence of tumour but was less accurate in determining the grade of tumour. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  3. Patterns of extension of gastrointestinal stromal tumors (GIST) treated with imatinib (Gleevec®) by 18F-FDG PET/CT Patrones de extensión de los tumores del estroma gastrointestinal (GIST) tratados con imatinib (Gleevec®) mediante PET/TC con 18F-FDG

    Eulalia Valls-Ferrusola; Juan Ramón García-Garzón; Ana Ponce-López; Marina Soler-Peter; Silvia Fuertes-Cabero; Merce Moragas-Solanes; Eduard Riera-Gil; Ignasi Carrió-Gasset; Francisco Lomeña-Caballero

    2012-01-01

    Background and aim: currently it is recognized the usefulness of 18F-FDG PET in assessing response to therapy with imatinib (Gleevec®) in the gastrointestinal tract sarcomas (GIST). To facilitate the follow-up of these studies is important to know the patterns of metastatic spread. The aim of this paper is to describe patterns observed in the 18F-FDG PET/CT. Method: retrospective study included 29 patients who underwent 18F-FDG PET/CT after being diagnosed with unresectable or metastatic GIST...

  4. PET/CT imaging analysis of 18 F-FDG uptake in brown adipose tissue%18F-FDG PET/CT棕色脂肪摄取的影像学分析

    张建; 程超; 左长京; 王少雁; 刘庆华; 孔令山

    2012-01-01

    目的:分析18F-FDG PET/CT检查中棕色脂肪组织(BAT)摄取的规律和特点,以避免不必要的误诊.方法:回顾性分析行PET/CT全身检查的2350例受检者的图像.结果:34例(1.44%)有不同程度BAT摄取,其中恶性肿瘤患者9例(甲状腺癌术后4例).BAT显影主要在寒冷季节出现,女性比例(2.57%)高于男性(0.76%);特征性表现为对称性分布于肩颈部、锁骨上区、脊柱两旁、纵隔、肾上腺及肾周区的高摄取灶,SUVmax为7.18±4.27.BAT显影部位的数目与摄取的SUVmax呈正相关(r=0.78,P<o.05);5例检查者进行了延迟扫描,延迟后BAT分布、形态无明显变化,SUVmax显著升高(P<0.05).4例甲状腺癌术后复查病例的BAT摄取不同程度影响了对区域淋巴结的观察.结论:BAT摄取的分布及影像表现具有一定的特征性,显影部位越多,SUVmax越大,延迟扫描后SUVmax显著升高,容易干扰对显影区域病灶的观察.%Objective:To analysis the characteristics and the pattern of 18F-FDG uptake in brown adipose tissue (BAT) on PET/CT imaging,in order to prevent unnecessary misdiagnosis. Methods:The clinical data of 2350 patients who received whole-body PET/CT were retrospectively analyzed. Results:Of the 2350 patients,there were 34 patients (1. 44%) had various degrees of 18F-FDG uptake in BAT including 11 patients with malignant tumor (4 patients had previous thyroid carcinoma operation). 18F-FDG uptake in BAT was mainly seen in cold season,the proportion of female (2. 57%) was far more than that of male (0. 76%). The PET/CT characteristic appearances were symmetrically distributed high uptake in shoulder,neck,supraclavicular area,both sides of spinal columne, mediastinum, adrenal and peri-renal areas, with SUVmax as 7. 18±4. 27. The number of 18-FDG uptake areas were positively correlated with SUVmax value CR = 0. 78,P<0. 05). 5 cases had delay scan,the distribution sites and pattern of uptake showed no apparent change,but the SUVmax

  5. 11C-choline vs. 18F-FDG PET/CT in assessing bone involvement in patients with multiple myeloma

    Ambrosini Valentina

    2007-06-01

    Full Text Available Abstract Background Multiple Myeloma (MM is a B cell neoplasm causing lytic or osteopenic bone abnormalities. Whole body skeletal survey (WBSS, Magnetic resonance (MR and 18F-FDG PET/CT are imaging techniques routinely used for the evaluation of bone involvement in MM patients. Aim As MM bone lesions may present low 18F-FDG uptake; the aim of this study was to assess the possible added value and limitations of 11C-Choline to that of 18F-FDG PET/CT in patients affected with MM. Methods Ten patients affected with MM underwent a standard 11C-Choline PET/CT and an 18F-FDG PET/CT within one week. The results of the two scans were compared in terms of number, sites and SUVmax of lesions. Results Four patients (40% had a negative concordant 11C-Choline and 18F-FDG PET/CT scans. Two patients (20% had a positive 11C-Choline and 18F-FDG PET/CT scans that identified the same number and sites of bone lesions. The remaining four patients (40% had a positive 11C-Choline and 18F-FDG PET/CT scan, but the two exams identified different number of lesions. Choline showed a mean SUVmax of 5 while FDG showed a mean SUVmax of 3.8 (P = 0.042. Overall, 11C-Choline PET/CT scans detected 37 bone lesions and 18F-FDG PET/CT scans detected 22 bone lesions but the difference was not significant (P = 0.8. Conclusion According to these preliminary data, 11C-Choline PET/CT appears to be more sensitive than 18F-FDG PET/CT for the detection of bony myelomatous lesions. If these data are confirmed in larger series of patients, 11C-Choline may be considered a more appropriate functional imaging in association with MRI for MM bone staging.

  6. Comparison of 18F-AIF-NOTA-PRGD2 and 18F-FDG uptake in lymph node metastasis of differentiated thyroid cancer.

    Weiwei Cheng

    Full Text Available A widespread application of integrin αvβ3 imaging has been emerging in both pre-clinical and clinical studies. But few studies reported its value as compared with 18F-FDG PET, especially for differentiated thyroid cancer (DTC. In this study, we compared the tracer uptake of 18F-AIF-NOTA-PRGD2 and 18F-FDG in lymph node metastasis of DTC to evaluate 18F-AIF-NOTA-PRGD2 as compared with 18F-FDG.20 DTC patients with presumptive lymph node metastasis were examined with 18F-AIF-NOTA-PRGD2 and 18F-FDG PET/CT. 16 patients undergoing fine needle aspiration biopsy (FNAB were evaluated by cytology results. For lesions without FNAB, the findings of clinical staging procedures served as the standard of reference (including neck ultrasound and serum thyroglobulin.A total of 39 presumptive lymph node metastases were visualized on PET/CT images. 35 lesions were confirmed as malignant by FNAB and other clinical findings. The mean 18F-AIF-NOTA-PRGD2 in radioactive iodine-refractory (RAIR lesions and benign lesions were 2.5±0.9 and 2.8±0.9 respectively. The mean SUV for 18F-FDG in all malignant lesions was 4.5±1.6 while in benign lesions it was 3.3±1.2. For all malignant lesions, the mean SUV for 18F-FDG was significantly higher than that for 18F-AIF-NOTA-PRGD2 (P<0.05. No significant correlation was found between the SUVs of 18F-AIF-NOTA-PRGD2 and 18F-FDG for 35 lesions (r = 0.114, P = 0.515. Moreover, 15 lesions of which the diameter larger than 1.5 cm had higher 18F-AIF-NOTA-PRGD2 uptake as compared with the lesions smaller than 1.5 cm.Although most lymph node metastases of DTC showed abnormal uptake of 18F-AIF-NOTA-PRGD2, its diagnostic value was inferior to 18F-FDG. No correlation was found between the uptake of 18F-AIF-NOTA-PRGD2 and 18F-FDG, which may suggest the two tracers provide complementary information in DTC lesions.

  7. Reduced myocardial 18F-FDG uptake after calcium channel blocker administration. Initial observation for a potential new method to improve plaque detection

    Physiological glucose uptake by the myocardium may hamper visualization of coronary atherosclerotic plaques in 18F-FDG PET studies. Intracellular myocardial calcium relates to glucose influx. We assessed whether administration of a calcium channel blocker such as verapamil could decrease myocardial 18F-FDG uptake in mice. Experiments were conducted on ten male C57BL/6JOlaHsd mice. The mice were studied by 18F-FDG PET/CT under basal conditions and after a single administration of verapamil injected 1 h prior to 18F-FDG administration at doses of 1 mg/kg (group A, n = 5) and 20 mg/kg (group B, n = 5). PET scanning was started 60 min after injection of 18F-FDG employing a dedicated small-animal PET/CT system (ARGUS-CT). In each mouse, post-verapamil PET images were coregistered with the basal PET images. Volumetric regions of interest (VOI) were drawn on the basal study containing the myocardium of the whole left ventricle and quantitatively compared with the same VOI applied to the post-verapamil scan. The SUVmean was used to express the mean myocardial 18F-FDG uptake. The relative coefficient of variation (RV) between the basal and post-verapamil conditions was calculated. Verapamil administration decreased myocardial 18F-FDG uptake in all animals. The median (range) SUVmean values in group A were 2.6 (1.6-4.1) under basal conditions and 1.7 (1.1-2.9) after verapamil administration (p = 0.043), and in group B were 1.6 (1.3-2.0) under basal conditions and 1.0 (0.9-1.4) after verapamil administration (p = 0.043). The median (range) RV values were -31% (-5%, -50%) in group A, and -37% (-10%, -51%) in group B (p = 0.6). In this animal model there was a significant reduction in 18F-FDG uptake in the myocardium following verapamil administration. This type of intervention could facilitate the definition of coronary atherosclerotic plaque inflammation on 18F-FDG PET scans. (orig.)

  8. Combination of nitric oxide stimulation with high-dose 18F-FDG promotes apoptosis and enhances radiation therapy of endothelial cells

    Introduction: High-dose 18F-FDG can provide targeted nuclear therapy of cancer. Endothelial cell injury is a key determinant of tumor response to radiotherapy. Here, we tested the hypothesis that activation of endothelial cell glycolytic metabolism with nitric oxide can enhance the therapeutic effect of high-dose 18F-FDG. Methods: Calf pulmonary artery endothelial (CPAE) cells were treated with graded doses of 18F-FDG. Glycolysis was stimulated by 24 h of exposure to the nitric oxide donor, sodium nitroprusside (SNP). Cell viability was assessed by MTT and clonogenic assays. Apoptosis was evaluated by ELISA of cytosolic DNA fragments and Western blots of cleaved caspase-3. Results: SNP stimulation (0.1 and 1 mM) augmented CPAE cell 18F-FDG uptake to 2.6- and 4.6-fold of controls without adverse effects. Treatment with 333 μCi/ml 18F-FDG alone reduced viable cell number to 35.4% of controls by Day 3. Combining 0.1 mM SNP stimulation significantly enhanced the killing effect, reducing cell numbers to 19.2% and 39.2% of controls by 333 and 167 μCi/ml of 18F-FDG, respectively. 18F-FDG also suppressed clonogenic survival to 80.8% and 43.2% of controls by 83 and 167 μCi/ml, which was again intensified by SNP to 59.7% and 21.1% of controls. The cytotoxic effect of 18F-FDG was attributed to induction of apoptosis as shown by increased cytosolic fragmented DNA and cleaved caspase-3 levels (26.4% and 30.7% increases by 167 μCi/ml). Combining SNP stimulation significantly increased both of these levels to 1.8-fold of control cells. Conclusion: High-dose 18F-FDG combined with nitric oxide-stimulated glycolysis is an effective method to inhibit endothelial cell survival and promote apoptosis. These results suggest a potential role of this strategy for targeted radiotherapy of angiogenic vasculature.

  9. 18F-FDG uptake at the surgical margin after hepatic resection: Patterns of uptake and differential diagnosis

    To evaluate the patterns of 18F-FDG uptake at the surgical margin after hepatectomy to identify features that may differentiate benign and malignant uptake. Patients who had undergone a PET/CT after hepatectomy were identified. Delay between resection and PET/CT, presence of uptake at the surgical margin, pattern of uptake, and maximal standardized value were recorded. The PET/CT findings were correlated with contrast-enhanced CT or MRI. There were 26 patients with increased 18F-FDG uptake; uptake was diffuse in seven and focal in 19. Diffuse uptake was due to inflammation in all cases. Focal uptake was due to recurrence in 12 and inflammation in seven cases. Defining a focal pattern only as a positive for malignancy yielded 100 % sensitivity, 87 % specificity, 37 % false positive rate. As expected, SUVmax was significantly higher for recurrence than inflammation, but did overlap. Contrast-enhanced CT allowed differentiation between malignant and benign uptake in all cases. F-FDG uptake after hepatectomy does not equate to recurrence and yields a high false positive rate. Diffuse uptake did not require additional evaluation in our sample. Focal uptake, however, may be due to recurrence; differentiating benign and malignant nodular uptake relies on optimal contrast-enhanced CT or MRI. (orig.)

  10. Diagnostic value of 18F-FDG PET/CT for the patients with cancer of unknown primary

    Objective :The prognosis of the patients with cancer of unknown primary (CUP) is poor. Detection of the primary tumor could determine the treatment strategy, improve the prognosis and the survival rate. The study was to assess the diagnostic value of 18F-FDG PET/CT in the patients with CUP. Methods:Seventy patients with CUP underwent a whole-body PET/CT imaging study. All the images were blindly interpreted by two experienced nuclear medicine physicians. The final diagnosis was based on pathology and follow-up for more than 3 months. Results :The primary tumor site was correctly identified by PET/CT in 35 patients (35/70, 50%), 1 false negative and 1 false positive cases were encountered. In 33 patients (33/70, 47.1%), the primary tumor site was not localized. In addition, PET/CT scan identified further unexpected metastases in 36 patients, patient management was changed in 39 patients (39/70, 55.7%). Conclusion: 18F-FDG PET/CT is a useful tool in the assessment and initial stages of the management process. (authors)

  11. Prediction of response to neoadjuvant chemotherapy in osteosarcoma using dual-phase {sup 18}F-FDG PET/CT

    Byun, Byung Hyun [The Catholic University of Korea, Division of Nuclear Medicine, Department of Radiology, College of Medicine, Seoul (Korea, Republic of); Korea Institute of Radiological and Medical Sciences (KIRAMS), Departments of Nuclear Medicine, Seoul (Korea, Republic of); Kim, Sung Hoon; Chung, Soo Kyo [The Catholic University of Korea, Division of Nuclear Medicine, Department of Radiology, College of Medicine, Seoul (Korea, Republic of); Lim, Sang Moo; Lim, Ilhan [Korea Institute of Radiological and Medical Sciences (KIRAMS), Departments of Nuclear Medicine, Seoul (Korea, Republic of); Kong, Chang-Bae; Song, Won Seok; Cho, Wan Hyeong; Jeon, Dae-Geun; Lee, Soo-Yong [Korea Institute of Radiological and Medical Sciences (KIRAMS), Orthopedic Surgery, Seoul (Korea, Republic of); Koh, Jae-Soo [Korea Institute of Radiological and Medical Sciences (KIRAMS), Pathology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2015-07-15

    We evaluated the ability of dual-phase {sup 18}F-FDG PET/CT to predict the histological response after neoadjuvant chemotherapy (NAC) in osteosarcoma. Thirty-one patients with osteosarcoma treated with NAC and surgery were prospectively enrolled. After injection of {sup 18}F-FDG, both early (∝60 min) and delayed (∝150 min) PET were acquired before and after the completion of NAC. SUVmax, early/delayed SUVmax change (RImax), and early/delayed SUVmean change (RImean) of tumour were measured before (SUV1, RImax1, and RImean1) and after NAC (SUV2, RImax2, and RImean2). Then, we calculated the percentage changes between SUV1 and SUV2 (%SUV). Twelve patients (39 %) exhibited good histological response after NAC. SUVmax, RImax, and RImean significantly decreased after NAC. Before NAC, only RImean1 predicted good histological response with the optimal criterion of < 10 %, sensitivity of 92 %, specificity of 57 %, and accuracy of 71 %. After NAC, %SUV, SUV2, and RImax2 predicted histological response. By using combined criterion of %SUV and RImax2 or SUV2 and RImean1 or SUV2 and RImax2, accuracies were 81 %, 77 %, and 77 %, respectively. The histological response after NAC could be predicted by using RImean1 before the initiation of NAC in osteosarcoma. The combined use of SUV and RI values may provide a better prediction. (orig.)

  12. Characterization of solitary pulmonary nodules with 18F-FDG PET/CT relative activity distribution analysis

    Zhao, Liang; Lin, Jie; Tang, Kun; Zheng, SiSi; Yin, WeiWei; Zheng, XiangWu [The First Affiliated Hospital of Wenzhou Medical University, Division of PET/CT, Department of Radiology, Wenzhou (China); Tong, Li [The First People' s Hospital of Hefei, CT Department, Hefei (China); Li, WenFeng [The First Affiliated Hospital of Wenzhou Medical University, Department of Radiotherapy and Chemotherapy, Wenzhou (China); Cheng, DeZhi [The First Affiliated Hospital of Wenzhou Medical University, Department of Cardiothoracic Surgery, Wenzhou (China)

    2015-07-15

    To compare the capability of relative activity distribution (RAD), a new index of fluorodeoxyglucose F18 ({sup 18}F-FDG) uptake, with those of the typical markers for differentiating benign and malignant solitary pulmonary nodules (SPNs) by integrated positron emission tomography (PET)/computed tomography (CT). RAD, maximal standardised uptake value (SUV{sub max}), partial volume corrected SUV{sub max} (corrSUV{sub max}), and retention index (RI) were calculated prospectively for 115 malignant and 60 benign SPNs. Area under receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy were compared (P < 0.05). Malignant lesions (0.98 ± 0.03) had significantly lower RAD than benign lesions (1.01 ± 0.02). AUC (0.935) was significantly larger and specificity (96.67 %) was significantly higher for RAD than for SUV{sub max} (P ≤ 0.0001), corrSUV{sub max} (P < 0.0001), RI (P < 0.0001), and visual assessment (P = 0.01 and 0.002, respectively). Further, RAD had significantly higher sensitivity (92.17 %) than SUV{sub max} (P = 0.0007) and higher accuracy (93.71 %) than SUV{sub max} (P < 0.0001), corrSUV{sub max} (P < 0.0001), and RI (P = 0.002). RAD seems to be more specific and accurate than the typical markers for differentiating malignant and benign SPNs by {sup 18}F-FDG PET/CT. (orig.)

  13. On the interest of PET with 18F-FDG in the management of cancer of unknown primary (CUP)

    Aim and method: This retrospective study, performed on 37 patients. gave us the opportunity to evaluate the impact of 18F-FDG PET/CT for cancer of unknown primary (CUP). We first wanted to study the precision of the exam to detect the primary, after a negative check-up, for the extension of the disease, and to judge the impact of the results on management and survival of those patients. Result: The PET/CT led to the detection of the primary for 14 patients out of 37, after a negative check-up composed of five exams on average. For 10 patients, the exam allows the detection of supplementary metastases. The management was changed after the exam in more than one third of the patients, but without any significant impact on the time of survival of these patients, for whom the prognostic is usually dismal. Conclusion: The 18F-FDG PET/CT appears a valuable tool for detection of primary. changing the management of many of the patients. These results must he completed by a prospective study, in particular to judge the impact of exam's results on the survival. (authors)

  14. Using Positron Emission Tomography with [18F]FDG to Predict Tumor Behavior in Experimental Colorectal Cancer

    Bryan M. Burt

    2001-01-01

    Full Text Available This study investigates the relationship between FDG uptake as determined by positron emission tomography (PET imaging and rates of tumor growth, cellular GLUT1 transporter density, and the activities of hexokinase and glucose-6-phosphatase in a solid tumor implant model. Five different human colorectal xenografts of different growth properties were implanted in athymic rats and evaluated by dynamic 18F-FDG-PET. The phosphorylating and dephosphorylating activities of the key glycolytic enzymes, hexokinase and glucose-6-phosphatase, were measured in these tumor types by spectrophotometric assays and the expression of GLUT1 glucose transporter protein was determined by immunohistochemistry. Correlations among FDG accumulation, hexokinase activity, and tumor doubling time are reported in these colon xenografts. The results indicate that the activity of tumor hexokinase may be a marker of tumor growth rate that can be determined by 18F-FDG-PET imaging. PET scanning may not only be a useful tool for staging patients for extent of disease, but may provide important prognostic information concerning the proliferative rates of malignancies.

  15. {sup 18}F-FDG PET/CT diagnosis of unexpected extracardiac septic embolisms in patients with suspected cardiac endocarditis

    Bonfiglioli, Rachele; Nanni, Cristina; Morigi, Joshua James; Ambrosini, Valentina; Fanti, Stefano [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Nuclear Medicine, Bologna (Italy); Graziosi, Maddalena; Rapezzi, Claudio [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Cardiology, Bologna (Italy); Trapani, Filippo; Bartoletti, Michele; Tumietto, Fabio; Viale, Pier Luigi [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Infective Diseases, Bologna (Italy); Ferretti, Alice; Rubello, Domenico [Azienda Ospedaliera S. Maria della Misericordia, Nuclear Medicine, Radiology, Neuroradiology, Medical Physics, Rovigo (Italy)

    2013-08-15

    Acute infective endocarditis is a potentially life-threatening disease. Its outcome strongly depends on systemic embolization and extracardiac infections. When present, these conditions usually lead to a more aggressive therapeutic approach. However, the diagnosis of peripheral septic embolism is very challenging. {sup 18}F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has proven to be accurate for the detection of inflammatory diseases and occult infections. The aim of this study was to assess the added value of {sup 18}F-FDG PET/CT in the detection of extracardiac embolisms in the evaluation of patients with suspected valvular endocarditis (VE). Seventy-one patients with suspected infective endocarditis, enrolled between June 2010 and December 2012, underwent {sup 18}F-FDG PET/CT with the standard procedure on a dedicated PET/CT scanner. Extracardiac findings were subsequently evaluated with other imaging procedures. Of the 71 patients with suspicion of infective endocarditis, we found unexpected extracardiac findings in 17 patients (24 %) without any clinical suspicion. Extracardiac findings were subsequently evaluated with other imaging procedures. PET/CT detected unexpected extra sites of infection in 24 % of cases, leading to changes in therapeutic management in a very relevant percentage of patients. These findings may have important therapeutic implications. (orig.)

  16. Quantification of tumour {sup 18}F-FDG uptake: Normalise to blood glucose or scale to liver uptake?

    Keramida, Georgia [Brighton and Sussex Medical School, Clinical Imaging Sciences Centre, Brighton (United Kingdom); Brighton and Sussex University Hospitals NHS Trust, Department of Nuclear Medicine, Brighton (United Kingdom); University of Sussex, Clinical Imaging Sciences Centre, Brighton (United Kingdom); Dizdarevic, Sabina; Peters, A.M. [Brighton and Sussex Medical School, Clinical Imaging Sciences Centre, Brighton (United Kingdom); Brighton and Sussex University Hospitals NHS Trust, Department of Nuclear Medicine, Brighton (United Kingdom); Bush, Janice [Brighton and Sussex Medical School, Clinical Imaging Sciences Centre, Brighton (United Kingdom)

    2015-09-15

    To compare normalisation to blood glucose (BG) with scaling to hepatic uptake for quantification of tumour {sup 18}F-FDG uptake using the brain as a surrogate for tumours. Standardised uptake value (SUV) was measured over the liver, cerebellum, basal ganglia, and frontal cortex in 304 patients undergoing {sup 18}F-FDG PET/CT. The relationship between brain FDG clearance and SUV was theoretically defined. Brain SUV decreased exponentially with BG, with similar constants between cerebellum, basal ganglia, and frontal cortex (0.099-0.119 mmol/l{sup -1}) and similar to values for tumours estimated from the literature. Liver SUV, however, correlated positively with BG. Brain-to-liver SUV ratio therefore showed an inverse correlation with BG, well-fitted with a hyperbolic function (R = 0.83), as theoretically predicted. Brain SUV normalised to BG (nSUV) displayed a nonlinear correlation with BG (R = 0.55); however, as theoretically predicted, brain nSUV/liver SUV showed almost no correlation with BG. Correction of brain SUV using BG raised to an exponential power of 0.099 mmol/l{sup -1} also eliminated the correlation between brain SUV and BG. Brain SUV continues to correlate with BG after normalisation to BG. Likewise, liver SUV is unsuitable as a reference for tumour FDG uptake. Brain SUV divided by liver SUV, however, shows minimal dependence on BG. (orig.)

  17. Isolated skeletal muscle metastatic deposit in a patient with micropapillary carcinoma thyroid identified by 18F FDG PET CT

    Micropapillary carcinoma of thyroid is said to be low risk differentiated thyroid malignancy with excellent prognosis. We report the identification of an isolated FDG avid muscle deposit in a treated case of micropapillary carcinoma of the right lobe and widely invasive follicular carcinoma of the left lobe thyroid gland. Patient was found to have an elevated thyroglobulin level with negative iodine scan (TENIS syndrome) on follow up at 6 months. An 18F FDG PET CT (18 fluorine- fluorodeoxyglucose positron emission computed tomography) whole body study revealed a solitary FDG avid deltoid muscle deposit which was histopathologically confirmed to be metastatic papillary carcinoma. While follicular carcinoma is known to have distant metastases, this may be the first reported case of solitary skeletal metastases from micropapillary carcinoma of thyroid and probably the second reported skeletal muscle deposit from DTC detected on 18F FDG PET CT done following elevated thyroglobulin level and negative 131 iodine WB scan (TENIS). This case also assumes importance because it demonstrates possibility of metastases even from a micropapillary carcinoma in contrast to American Thyroid Association guidelines (2009) which suggests that micropapillary carcinoma of thyroid does not merit further treatment after a Total Thyroidectomy.

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

    Yoon, Ye Ri; Choi, Ji Youn; Lee, Sang Mi; Kim, Yeo Joo; Cho, Hyun Deuk; Lee, Jeong Won; Jeon, Youn Soo [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2015-03-15

    A follow-up 18F-fluorodeoxyglucose ({sup 18}F-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 {sup 18}F-FDG PET/CT scan may be useful for differentiating hyperattenuated cysts from other soft tissue masses.

  19. 18F-FDG PET Reveals Fronto-temporal Dysfunction in Children with Fever-Induced Refractory Epileptic Encephalopathy

    Fever-induced refractory epileptic encephalopathy in school-age children (FIRES) is a recently described epileptic entity whose etiology remains unknown. Brain abnormalities shown by MRI are usually limited to mesial-temporal structures and do not account for the catastrophic neuro-psychologic findings. Methods: We conducted FIRES studies in 8 patients, aged 6-13 y, using 18F-FDG PET to disclose eventual neo-cortical dysfunction. Voxel-based analyses of cerebral glucose metabolism were performed using statistical parametric mapping and an age-matched control group. Results: Group analysis revealed a widespread inter-ictal hypo-metabolic network including the temporo-parietal and orbito-frontal cortices bilaterally. The individual analyses in patients identified hypo-metabolic areas corresponding to the predominant electroencephalograph foci and neuro-psychologic deficits involving language, behavior, and memory. Conclusion: Despite clinical heterogeneity, 18F-FDG PET reveals a common network dysfunction in patients with sequelae due to fever-induced refractory epileptic encephalopathy. (authors)

  20. {sup 18}F-FDG PET/CT for early prediction of response to neoadjuvant chemotherapy in breast cancer

    Duch, Joan; Fuster, David; Munoz, Montserrat; Fernandez, Pedro Luis; Paredes, Pilar; Fontanillas, Montserrat; Guzman, Flavia; Rubi, Sebastia; Lomena, Francisco Juan; Pons, Francesca [Hospital Clinic de Barcelona, Nuclear Medicine Department, Barcelona (Spain)

    2009-10-15

    The aim of this study was to prospectively evaluate {sup 18}F-FDG PET/CT in predicting response to neoadjuvant chemotherapy in large primary breast cancer. Fifty consecutive patients underwent PET/CT at baseline and after the second cycle. Baseline MRI was performed to establish tumour size. All findings were confirmed by histopathological analysis. Changes in maximum standardized uptake value (SUV{sub max}) between baseline study and after two cycles of neoadjuvant chemotherapy (epirubicin + cyclophosphamide + taxanes) were compared using response evaluation criteria in solid tumours (RECIST) criteria and the Miller and Payne (M and P) scale. The mean tumour size was 4.3 {+-} 1.4 cm. Forty patients were considered responders and ten as non-responders. SUV{sub max} changes in patients with good prognosis (M and P grades 4-5) were higher than in patients with bad prognosis (M and P grades 1-3) (p = 0.025). SUV{sub max} changes between responders and non-responders following RECIST criteria were also statistically significant (p = 0.0028). A cut-off {delta}SUV value of 40% differentiates both groups, with a sensitivity of 77% and a specificity of 80%. {sup 18}F-FDG PET/CT can predict response to neoadjuvant chemotherapy at an early stage. (orig.)

  1. {sup 18}F-FDG uptake at the surgical margin after hepatic resection: Patterns of uptake and differential diagnosis

    Peungjesada, Silanath [University New Mexico, Department of Radiology, Albuquerque, NM (United States); Aloia, Thomas A. [University of Texas MD Anderson Cancer Center, Department of Surgical Oncology, Unit 444, Houston, TX (United States); Fox, Patricia [University of Texas MD Anderson Cancer Center, Department of Biostatistics, Unit 1411, Houston, TX (United States); Chasen, Beth [University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Unit 1483, Houston, TX (United States); Shin, Sooyoung; Loyer, Evelyne M. [University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Unit 1473, Houston, TX (United States); Baiomy, Ali [Cairo University, National Cancer Center, Cairo (Egypt)

    2015-08-15

    To evaluate the patterns of {sup 18}F-FDG uptake at the surgical margin after hepatectomy to identify features that may differentiate benign and malignant uptake. Patients who had undergone a PET/CT after hepatectomy were identified. Delay between resection and PET/CT, presence of uptake at the surgical margin, pattern of uptake, and maximal standardized value were recorded. The PET/CT findings were correlated with contrast-enhanced CT or MRI. There were 26 patients with increased 18F-FDG uptake; uptake was diffuse in seven and focal in 19. Diffuse uptake was due to inflammation in all cases. Focal uptake was due to recurrence in 12 and inflammation in seven cases. Defining a focal pattern only as a positive for malignancy yielded 100 % sensitivity, 87 % specificity, 37 % false positive rate. As expected, SUV{sub max} was significantly higher for recurrence than inflammation, but did overlap. Contrast-enhanced CT allowed differentiation between malignant and benign uptake in all cases. F-FDG uptake after hepatectomy does not equate to recurrence and yields a high false positive rate. Diffuse uptake did not require additional evaluation in our sample. Focal uptake, however, may be due to recurrence; differentiating benign and malignant nodular uptake relies on optimal contrast-enhanced CT or MRI. (orig.)

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

    Gutte Borgwardt, 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 (13)C-pyruvate magnetic resonance spectroscopic imaging (MRSI) and (18)F-FDG-PET imaging. This procedure was performed in a clinical PET/MRI scanner with a canine cancer patient. We...... have named this concept hyper PET. Intravenous injection of the hyperpolarized (13)C-pyruvate results in an increase of (13)C-lactate, (13)C-alanine and (13)C-CO2 ((13)C-HCO3) resonance peaks relative to the tissue, disease and the metabolic state probed. Accordingly, with dynamic nuclear polarization...... local recurrence of a liposarcoma on the right forepaw was imaged using a combined PET/MR clinical scanner. PET was performed as a single-bed, 10 min acquisition, 107 min post injection of 310 MBq (18)F-FDG. (13)C-chemical shift imaging (CSI) was performed just after FDG-PET and 30 s post injection of...

  3. Cortical activity during olfactory stimulation in multiple chemical sensitivity: a {sup 18}F-FDG PET/CT study

    Chiaravalloti, Agostino; Di Pietro, Barbara [University Tor Vergata, Department of Biomedicine and Prevention, Rome (Italy); Pagani, Marco [Institute of Cognitive Sciences and Technologies, CNR, Rome (Italy); Department of Nuclear Medicine Karolinska Hospital Stockholm, Stockholm (Sweden); Micarelli, Alessandro; Alessandrini, Marco [University Tor Vergata, Department of Medical Science and Translational Medicine, Rome (Italy); Genovesi, Giuseppe [University La Sapienza, Department of Experimental Medicine, Rome (Italy); University La Sapienza, Regional Center for Diagnosis, Treatment and Prevention of MCS, Rome (Italy); Schillaci, Orazio [University Tor Vergata, Department of Biomedicine and Prevention, Rome (Italy); IRCCS Neuromed, Pozzilli (Italy)

    2015-04-01

    To investigate the differences in brain glucose consumption during olfactory stimulation between subjects affected by multiple chemical sensitivity (MCS) and a group of healthy individuals. Two {sup 18}F-FDG PET/CT scans were performed in 26 subjects (6 men and 20 women; mean age 46.7 ± 11 years) with a clinical diagnosis of MCS and in 11 healthy controls (6 women and 5 men; mean age 45.7 ± 11 years), the first scan after a neutral olfactory stimulation (NS) and the second after a pure olfactory stimulation (OS). Differences in {sup 18}F-FDG uptake were analysed by statistical parametric mapping (SPM2). In controls OS led to an increase in glucose consumption in BA 18 and 19 and a reduction in glucose metabolism in BA 10, 11, 32 and 47. In MCS subjects, OS led to an increase in glucose consumption in BA 20, 23, 18 and 37 and a reduction in glucose metabolism in BA 8, 9 and 10. The results of our study suggest that cortical activity in subjects with MCS differs from that in healthy individuals during olfactory stimulation. (orig.)

  4. {sup 18}F-FDG PET response to neoadjuvant chemotherapy for Ewing sarcoma and osteosarcoma are different

    Gaston, Louie L. [Philippine General Hospital, Department of Orthopedics, Manila (Philippines); Di Bella, Claudia [Saint Vincent' s Hospital, Department of Orthopedics, East Melbourne, VIC (Australia); Peter MacCallum Cancer Centre, Bone and Soft Tissue Sarcoma Service, East Melbourne, VIC (Australia); Slavin, John [Saint Vincent' s Hospital, Department of Pathology, Melbourne (Australia); Hicks, Rodney J. [The Peter MacCallum Cancer Centre, Centre for Cancer Imaging, Translational Research Group, Molecular Imaging and Targeted Therapeutics Laboratory, East Melbourne, VIC (Australia); Choong, Peter F.M. [Saint Vincent' s Hospital, Department of Orthopedics, East Melbourne, VIC (Australia); Peter MacCallum Cancer Centre, Bone and Soft Tissue Sarcoma Service, East Melbourne, VIC (Australia); University of Melbourne, Department of Surgery, Melbourne (Australia)

    2011-08-15

    Ewing sarcoma (ES) and osteosarcoma (OS) have different biological characteristics and respond differently to chemotherapy. We reviewed {sup 18}F-FDG PET imaging characteristics of ES and OS patients at baseline and following treatment to determine whether this biological variation is reflected in their imaging phenotype. A retrospective review of ES and OS patients treated with neoadjuvant chemotherapy and surgery was done, correlating PET results with histologic response to chemotherapy. Change in the maximum standardized uptake value (SUVmax) between baseline and post-treatment scanning was not significantly associated with histologic response for either ES or OS. Metabolic tumor volume (MTV) and the percentage of injected {sup 18}F-FDG dose (%ID) in the primary tumor were found to be different for ES and OS response subgroups. A 50% reduction in MTV (MTV2:1 < 0.5) was found to be significantly associated with favorable histologic response in OS. Using the same criteria for ES incorrectly predicted good responders. Increasing the cut-off values for ES to a 90% reduction in MTV (MTV2:1 < 0.1) resulted in association with favorable histologic response. Response to neoadjuvant chemotherapy as reflected by changes in PET characteristics should be interpreted differently for ES and OS. (orig.)

  5. Prediction of response to neoadjuvant chemotherapy in osteosarcoma using dual-phase 18F-FDG PET/CT

    We evaluated the ability of dual-phase 18F-FDG PET/CT to predict the histological response after neoadjuvant chemotherapy (NAC) in osteosarcoma. Thirty-one patients with osteosarcoma treated with NAC and surgery were prospectively enrolled. After injection of 18F-FDG, both early (∝60 min) and delayed (∝150 min) PET were acquired before and after the completion of NAC. SUVmax, early/delayed SUVmax change (RImax), and early/delayed SUVmean change (RImean) of tumour were measured before (SUV1, RImax1, and RImean1) and after NAC (SUV2, RImax2, and RImean2). Then, we calculated the percentage changes between SUV1 and SUV2 (%SUV). Twelve patients (39 %) exhibited good histological response after NAC. SUVmax, RImax, and RImean significantly decreased after NAC. Before NAC, only RImean1 predicted good histological response with the optimal criterion of < 10 %, sensitivity of 92 %, specificity of 57 %, and accuracy of 71 %. After NAC, %SUV, SUV2, and RImax2 predicted histological response. By using combined criterion of %SUV and RImax2 or SUV2 and RImean1 or SUV2 and RImax2, accuracies were 81 %, 77 %, and 77 %, respectively. The histological response after NAC could be predicted by using RImean1 before the initiation of NAC in osteosarcoma. The combined use of SUV and RI values may provide a better prediction. (orig.)

  6. Depiction and characterization of liver lesions in whole body [{sup 18}F]-FDG PET/MRI

    Beiderwellen, Karsten, E-mail: karsten.beiderwellen@uk-essen.de [Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen (Germany); Gomez, Benedikt, E-mail: Benedikt.gomez@uk-essen.de [Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen (Germany); Buchbender, Christian, E-mail: Christian.buchbender@med.uni-duesseldorf.de [Department of Diagnostic and Interventional Radiology, University of Dusseldorf, 40225 Dusseldorf (Germany); Hartung, Verena, E-mail: Verena.hartung@uk-essen.de [Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen (Germany); Poeppel, Thorsten D., E-mail: Thorsten.Poeppel@uk-essen.de [Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen (Germany); Nensa, Felix, E-mail: felix.nensa@gmail.com [Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen (Germany); Kuehl, Hilmar, E-mail: Hilmar.Kuehl@uk-essen.de [Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen (Germany); Bockisch, Andreas, E-mail: Andreas.bockisch@uk-essen.de [Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen (Germany); Lauenstein, Thomas C., E-mail: Thomas.Lauenstein@uk-essen.de [Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen (Germany)

    2013-11-01

    Objectives: To assess the value of PET/MRI with [{sup 18}F]-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 [{sup 18}F]-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.

  7. Comparative study of 18F-DOPA, 13 N-ammonia and 18F-FDG PET/CT in primary brain tumors

    To determine the diagnostic reliability of 18F-FDOPA, 13N-ammonia and 18F-FDG PET/CT in primary brain tumors. We evaluated the amino acid and glucose metabolism of brain tumors by using PET with 18F-FDOPA, 13N-ammonia and 18F-FDG PET/CT. Nine patients undergoing evaluation for brain tumors were studied. Tracer uptake was quantified by the use of standardized uptake values and the ratio of tumor uptake to normal identical area of contra lateral hemisphere (T/N). In addition, PET uptake with 18F-FDOPA was quantified by use of ratio of tumor uptake to striatum uptake (T/S). The results were correlated with the patient's clinical profile. Both high-grade and low-grade tumors were well visualized with 18F-FDOPA. The sensitivity for identifying tumors was substantially higher with 18F-FDOPA PET than with 18F-FDG and 13N-Ammonia PET as determined by simple visual inspection. The sensitivity for identifying recurrence in low grade gliomas is higher with 13N-Ammonia than with 18F-FDG. 18F-FDOPA PET is more reliable than 18F-FDG and 13N-Ammonia PET for evaluating brain tumors. (author)

  8. Role of 18F-FDG PET-CT imaging for the detection of an unknown primary tumour: preliminary results in 21 patients

    Metastatic cancer of unknown primary origin is a syndrome characterised by a poor prognosis, with a typical survival rate from diagnosis of no longer than 1 year. Only 20-27% of primary tumours are identified by conventional radiological imaging. By contrast, it has been reported that 18F-fluorodeoxyglucose positron emission tomography (FDG PET) allows the identification of 24-40% of otherwise unrecognised primary tumours. To our knowledge, the studies on this topic have been conducted using 18F-FDG PET imaging alone. The aim of this study was to evaluate the potential additional diagnostic role of fused 18F-FDG PET-CT imaging for the detection of metastatic occult primary tumours. The study population consisted of 21 consecutive patients with biopsy-proven metastatic disease and negative conventional diagnostic procedures. Each patient underwent a PET scan, carried out according to a standard procedure (6 h of fasting, i.v. injection of 370 MBq of 18F-FDG and image acquisition with a dedicated PET-CT scanner for 4 min per bed position). 18F-FDG PET-CT detected the occult primary tumour in 12 patients (57% of cases), providing a detection rate higher than that reported with any other imaging modality, including conventional 18F-FDG PET. The favourable results of this study need to be confirmed in larger patient populations with long-term follow-up. (orig.)

  9. 68Ga-AMBA and 18 F-FDG for preclinical PET imaging of breast cancer: effect of tamoxifen treatment on tracer uptake by tumor

    Introduction: AMBA is a bombesin analogue that binds to GRPr. In a mouse model of estrogen-dependent human breast cancer, we tested whether 68Ga-AMBA can be used for PET detection of GRPr-expressing tumors and could be more accurate than 18F-FDG to monitor tumor response to hormone therapy. Methods: The radiolabeling of 68Ga-AMBA was automated using a R and D Synchrom module. ZR75-1, a breast cancer cell line, was xenografted in nude mice. 68Ga-AMBA tumor uptake was compared with that of 18F-FDG before and after treatment with tamoxifen. Results: AMBA was 68Ga-radiolabelled in 30 min with 95.3% yield and purity ≥ 98%. Prior to treatment, 68Ga-AMBA was highly concentrated into tumors (tumor to non-tumor ratio = 2.4 vs. 1.3 with 18F-FDG). With tamoxifen treatment (n = 6) 68Ga-AMBA uptake plateaued after 1 week and decreased after 2 weeks, with a significant reduction compared to controls (n = 4). In contrast the effect of tamoxifen treatment could not be appreciated using 18F-FDG. Conclusions: 68Ga-AMBA appeared better than 18F-FDG to visualize and monitor the response to hormone treatment in this breast cancer model

  10. Pre-medication to block [18F]FDG uptake in the brown adipose tissue of pediatric and adolescent patients

    Radiopharmaceutical uptake of [18F]2-deoxy-2-glucose (FDG) in brown adipose tissue is noted on 15-20% of positron emission tomography (PET) scans in children and adolescents. To determine whether [18F]FDG uptake in brown adipose tissue can be adequately blocked by pre-medication other than moderate-dose oral diazepam. One hundred and eighteen [18F]FDG PET body imaging studies were performed in 69 pediatric patients with a variety of solid tumors. The mean age at the time of imaging was 12.9 years (range 1.2-22.6 years), and 33 studies were performed in patients younger than 10 years old. Seventy-six were performed in boys and 42 in girls. Patients were imaged using a dedicated PET camera. Pre-medication was given in 88 studies: 45 received intravenous fentanyl (0.75-1.0 μg/kg), 34 received low-dose oral diazepam (0.06 mg/kg) and 9 received moderate-dose oral diazepam (0.10 mg/kg). Thirty patients received no pre-medication, 7 of whom were known to have received opiates for pain during the 12 h before the study. Six body regions in the neck and chest were reviewed for [18F]FDG uptake in brown adipose tissue. Uptake of FDG in brown fat was visually graded: 0 for no FDG uptake, 1 for low-grade uptake, 2 for moderate uptake, and 3 for intense uptake. Visual grades 2 and 3 were considered to interfere potentially with image interpretation in the neck and chest. Data were analyzed by multivariate regression using a Poisson distribution. [18F]FDG uptake in brown adipose tissue was most often seen in the lateral neck region and superior and lateral to the lungs (in 36 and 39 studies, respectively). Uptake was also seen near the costovertebral junctions (15 studies), in the superior and central neck in 7 studies and in the anterior mediastinum in 2. Brown adipose tissue uptake was thought to interfere potentially with image interpretation (visual grades 2 and 3) in 19 studies - in 6 of 23 (26.1%) studies after no pre-medication and no opiates for pain, in 10 of 34 (29

  11. Role of {sup 18}F-FDG PET/CT in the evaluation of primary tumours of unknown origin; experience of the Hospital Angeles del Pedregal; Papel del 18F-FDG PET/CT en la evaluacion de tumores primarios de origen desconocido; experiencia del Hospital Angeles del Pedregal

    Sanchez, N.; Serna, J.A.; Quiroz, O.; Valenzuela, J.; Romo, C.; Ramirez, J.L. [Hospital Angeles del Pedregal, Mexico D.F. (Mexico)

    2007-07-01

    It was in 1994 when published studies appear that evaluate the utility of the {sup 18}F-FDG PET in the patients with primary tumors of unknown origin (TOD); starting from then diverse studies that support the clinical utility of the study arise with {sup 18}F-FDG PET in the detection of the primary tumor. It is as well as it has been calculated that the study with {sup 18}F-FDG PET is able to detect the primary tumor in around 40% of the patients with negative results in the conventional diagnostic procedures. Until the moment, most of the studies published in relation to the primary tumors of unknown origin only evaluate the paper of the study with {sup 18}F-FDG PET, without including the image fusion technique PET/CT, which has demonstrated in diverse studies; in oncological scenarios different from the TOD, a superior diagnosis certainty. (Author)

  12. One-pot production of 18F-biotin by conjugation with 18F-FDG for pre-targeted imaging: Synthesis and radio-labelling of a PEGylated precursor

    The biotin-avidin affinity system is exploited in pre-targeted imaging using avidin-conjugated antibodies. 18F-FDG is available at all PET centres. 18F-FDG forms oximes by reaction with oxyamine. Herein we describe the synthesis of oxyamine-funtionalised biotin, its 18F-labelling by conjugation with 18F-FDG and confirm its ability to interact with avidin.

  13. Multimodality approach of perioperative 18F-FDG PET/CT imaging, intraoperative 18F-FDG handheld gamma probe detection, and intraoperative ultrasound for tumor localization and verification of resection of all sites of hypermetabolic activity in a case of occult recurrent metastatic melanoma

    Walker Michael J

    2008-01-01

    Full Text Available Abstract Background The use of diagnostic 18F-fluorodeoxyglucose (18F-FDG positron emission tomography/computed tomography (PET/CT imaging for the staging, restaging, and treatment monitoring of melanoma patients has become a well-recognized standard of care. It plays a key role in detecting sites of occult disease and is widely utilized in the medical and surgical planning of such patients. In the current report, we describe an innovative multimodality approach of perioperative 18F-FDG PET/CT imaging, intraoperative 18F-FDG handheld gamma probe detection, and intraoperative ultrasound for tumor localization and verification of resection of all sites of hypermetabolic tumor foci in a case of occult recurrent metastatic melanoma. Case presentation This report discusses a case of occult recurrent metastatic melanoma, isolated to three separate sites within the subcutaneous tissues of the left thigh region, which was not clinically apparent but was found on diagnostic restaging whole body 18F-FDG PET/CT scan utilizing an intravenous injection of 14.8 mCi 18F-FDG. Then, on the day of surgery, the patient received an intravenous injection of 12.8 mCi 18F-FDG. A multimodality approach of intraoperative handheld gamma probe detection, intraoperative ultrasound tumor localization, specimen PET/CT imaging, and postoperative PET/CT imaging was utilized for accomplishing and verifying the excision of all three sites of occult recurrent metastatic melanoma within the left thigh region. Conclusion This innovative multimodality approach of perioperative 18F-FDG PET/CT imaging, intraoperative 18F-FDG handheld gamma probe detection, and intraoperative ultrasound is promising combined technology for aiding in tumor localization and verification of excision and may ultimately impact positively upon long-term outcome of selected patients.

  14. 3D tumour spheroids as a model to assess the suitability of [18F]FDG-PET as an early indicator of response to PI3K inhibition

    Background: [18F] Fluorodeoxyglucose Positron Emission Tomography ([18F]FDG-PET) is widely used to monitor response to therapy in the clinic and has, more recently, been proposed as an early marker of long term response. This relies on the assumption that a change in glucose consumption parallels a reduction in viability and long term growth potential. However, cells may utilise substrates other than glucose and as many therapeutics interfere with glucose metabolism directly, it is entirely plausible that a positive [18F]FDG-PET response may be unrelated to long term growth. Furthermore, changes in metabolism and proliferation may take place on different temporal scales, thus restricting the time window in which [18F]FDG-PET is predictive. The PI3K oncogenic signalling pathway is a master regulator of multiple cellular processes including glucose metabolism, proliferation and cell survival. Inhibition of PI3K has been shown to reduce [18F]FDG uptake in several tumour types but the relative influence of this pathway on glucose metabolism and proliferation is not fully established. Aim: We proposed to (i) assess the suitability of [18F]FDG as a tracer for measuring response to PI3K inhibition and (ii) determine the optimum imaging schedule, in vitro. We used multicellular tumour spheroids, an excellent 3D in vitro model of avascular tumours, to investigate the effects of the PI3K inhibitors, NVP-BKM120 and NVP-BEZ235, on [18F]FDG uptake and its relation to 3D growth. Methods: Spheroids were prepared from two cell lines with a constitutively active PI3K/Akt pathway, EMT6 (highly proliferative mouse mammary) and FaDu (moderately proliferate human nasopharyngeal). Treatment consisted of a 24 h exposure to either inhibitor, and growth was monitored over the following 7 days. To mimic potential imaging regimens with [18F]FDG-PET, average [18F]FDG uptake per viable cell was measured (a) directly following the 24 h exposure, (b) following an additional 24 h recovery period

  15. Preliminary evaluation of β3-adrenoceptor agonist-induced 18F-FDG metabolic activity of brown adipose tissue in obese Zucker rat

    Background: We have investigated β3-adrenoceptor agonist mediated brown adipose tissue (BAT) activation using 18F-FDG PET/CT in Zucker lean (ZL) and obese (ZF) rats. Methods: 18F-FDG was injected into ZL and ZF rats pretreated with saline or agonist CL316,243 for scans. 18F-FDG metabolic activity was computed as standard uptake values. Results: CL316,243 in ZL activated BAT up to 4-fold compared to saline, while ZF BAT was only up by 2 fold. The decreased activation was consistent with lower β3-adrenoceptor levels in ZF rats. Conclusions: The genetically modified ZL and ZF rats may provide a useful rat model to evaluate the significance of β3-adrenoceptor agonist-induced BAT activation in obesity

  16. [18F-FDG PET/CT diagnosis of liver cyst infection in a patient with autosomal dominant polycystic kidney disease and fever of unknown origin].

    Banzo, J; Ubieto, M A; Gil, D; Prats, E; Razola, P; Tardín, L; Andrés, A; Rambalde, E F; Ayala, S M; Cáncer, L; Velilla, J

    2013-01-01

    The diagnosis, localization and treatment of infected cysts in the kidney or liver of patients with autosomal dominant polycystic kidney disease (ADPKD) remain a clinical challenge. We report the findings of (18)F-FDG PET-CT in an ADPKD diagnosed patient who required renal transplantation five years before and in his follow up presented repeated episodes of bacteriemia without known focus on radiological tests performed. The (18)F-FDG PET-CT scan showed numerous hypermetabolic images with focal or ring-shaped morphology related to the content and the wall of some hepatic cysts. The increased metabolic activity was localized on segments VI and VII. We proceeded to drainage of one cyst in segment VI, removing 110 cc of purulent fluid which grew E. Coli BLEE. The (18)F-FDG PET/CT scan should be included in the diagnostic algorithm for detecting infected liver cysts in patients with ADPKD and fever of unknown origin. PMID:23153986

  17. Dose-response relationship in cyclophosphamide-treated B-cell lymphoma xenografts monitored with [{sup 18}F]FDG PET

    Brepoels, Lieselot; Saint-Hubert, Marijke de; Mortelmans, Luc [University Hospital Gasthuisberg Leuven, Department of Nuclear Medicine, Leuven (Belgium); Stroobants, Sigrid [University Hospital Antwerpen, Department of Nuclear Medicine, Edegem (Belgium); Verhoef, Gregor [University Hospital Gasthuisberg Leuven, Department of Hematology, Leuven (Belgium); Balzarini, Jan [KU Leuven, Department of Microbiology and Immunology, Leuven (Belgium); Mottaghy, Felix M. [University Hospital Gasthuisberg Leuven, Department of Nuclear Medicine, Leuven (Belgium); Universitaetsklinikum der RWTH Aachen, Klinik fuer Nuklearmedizin, Aachen (Germany)

    2010-09-15

    Although [{sup 18}F]FDG PET can measure therapy response sooner and more accurately than morphological imaging techniques, there is still some debate as to whether [{sup 18}F]FDG uptake really reflects changes in the viable cell fraction. In this study changes in [{sup 18}F]FDG uptake were investigated in a lymphoma model at several time-points after treatment and with different doses of chemotherapy. Data were analysed in terms of several parameters. SCID mice were subcutaneously inoculated with 5 x 10{sup 6} Daudi cells in the right thigh. One group was not treated (control group). The other groups received cyclophosphamide 75 mg/kg (low-dose group), 125 mg/kg (medium-dose group) and 175 mg/kg (high-dose group) on day 0. Sequential [{sup 18}F]FDG small-animal PET ({mu}PET) scans were performed on days 0, 2, 6, 9, 13 and 16 after treatment. The mean and maximum standardized uptake value (SUV{sub mean} and SUV{sub max}), metabolic tumour volume (Vol{sub metab}) and total lesion glycolysis (TLG) were calculated. A significant decrease in [{sup 18}F]FDG uptake was observed on day 2 in the medium-dose and high-dose groups and on day 6 in the low-dose group, all preceding morphological changes. SUV{sub mean} and SUV{sub max} formed a plateau from day 6 to day 9, corresponding to the known influx of inflammatory cells. No obvious plateau was observed with TLG which was found to be the most sensitive parameter clearly differentiating the low-dose group from the medium- and high-dose groups early after therapy. [{sup 18}F]FDG uptake was able to reflect the dose-response relationship for cyclophosphamide. TLG was the best parameter for dose-related response assessment in this tumour model. (orig.)

  18. Comparative studies of '18F-FDG PET/CT brain imaging and EEG in preoperative localization of temporal lobe epileptic focus

    Objective: To compare the value of 18F-FDG PET/CT brain imaging and EEG in preoperative localization of the epileptic focus at the temporal lobe. Methods: A total of 152 patients (108 males, 44 females, age ranged from 3 to 59 years old) with past history of temporal lobe epilepsy were included.All patients underwent 18F-FDG PET/CT brain imaging and long-range or video EEG, and 29 patients underwent intracranial electrode EEG due to the failure to localize the disease focus by non-invasive methods.Histopathologic findings after operative treatment were considered the gold standard for disease localization. All patients were followed up for at least six months after the operation. The accuracy of the 18F-FDG PET/CT brain imaging and long-range or video EEG examination were compared using χ2 test. Results: The accuracy of locating the epileptic focus was 80.92% (123/152) for 18F-FDG PET/CT brain imaging and 43.42% (66/152) for long-range or video EEG (χ2=22.72, P<0.01). The accuracy of locating the epileptic focus for the 29 cases with intracranial electrode EEG was 100%. Conclusions: Interictal 18F-FDG PET/CT brain imaging is a sensitive and effective method to locate the temporal lobe epileptic focus and is better than long-range or video EEG. The combination of 18F-FDG PET/CT brain imaging and intracranial electrode EEG examination can further improve the accuracy of locating the epileptic focus. (authors)

  19. Cerebral metabolism and perfusion in MR-negative individuals with refractory focal epilepsy assessed by simultaneous acquisition of (18)F-FDG PET and arterial spin labeling.

    Boscolo Galazzo, Ilaria; Mattoli, Maria Vittoria; Pizzini, Francesca Benedetta; De Vita, Enrico; Barnes, Anna; Duncan, John S; Jäger, Hans Rolf; Golay, Xavier; Bomanji, Jamshed B; Koepp, Matthias; Groves, Ashley M; Fraioli, Francesco

    2016-01-01

    The major challenge in pre-surgical epileptic patient evaluation is the correct identification of the seizure onset area, especially in MR-negative patients. In this study, we aimed to: (1) assess the concordance between perfusion, from ASL, and metabolism, from (18)F-FDG, acquired simultaneously on PET/MR; (2) verify the utility of a statistical approach as supportive diagnostic tool for clinical readers. Secondarily, we compared (18)F-FDG PET data from the hybrid PET/MR system with those acquired with PET/CT, with the purpose of validate the reliability of (18)F-FDG PET/MR data. Twenty patients with refractory focal epilepsy, negative MR and a defined electro-clinical diagnosis underwent PET/MR, immediately followed by PET/CT. Standardized uptake value ratio (SUVr) and cerebral blood flow (CBF) maps were calculated for PET/CT-PET/MR and ASL, respectively. For all techniques, z-score of the asymmetry index (zAI) was applied for depicting significant Right/Left differences. SUVr and CBF images were firstly visually assessed by two neuroimaging readers, who then re-assessed them considering zAI for reaching a final diagnosis. High agreement between (18)F-FDG PET/MR and ASL was found, showing hypometabolism and hypoperfusion in the same hemisphere in 18/20 patients, while the remaining were normal. They were completely concordant in 14/18, concordant in at least one lobe in the remaining. zAI maps improved readers' confidence in 12/20 and 15/20 patients for (18)F-FDG PET/MR and ASL, respectively. (18)F-FDG PET/CT-PET/MR showed high agreement, especially when zAI was considered. The simultaneous metabolism-perfusion acquisition provides excellent concordance on focus lateralisation and good concordance on localisation, determining useful complementary information. PMID:27222796

  20. Computer-aided diagnosis of interictal 18F-FDG PET images for presurgical evaluation of epileptic foci in extratemporal lobe epilepsy

    Interictal 18F-FDG PET is beneficial to patients with epilepsy to define the epileptic foci before operation, especially to decide the laterality of temporal lobe epilepsy (TLE). However usefulness has not been clearly established in extra TLE. We retrospectively applied Z-score analysis to interictal preoperative 18F-FDG PET images for detection of the epileptic foci in order to achieve better performance. Seventeen epileptic patients (women/men; 8/9, age; 11-55 yrs) underwent resection of epileptic foci with good outcome (Engel's stage of I or II) even after more than a year from operation. Presurgical 18F-FDG PET images were spatially normalized using statistical parametric mapping 99 (SPM99) with an original Japanese template for 18F-FDG and compared with normal database constructed from 31 healthy volunteers (women/men; 14/17, age; 19-59 yrs). A software program, easy Z-score imaging system (eZIS), for analysis of patient data was developed by calculating Z-score in each voxel and visualizing the score in a standardized stereotactic space; Z-score=(normal mean-patient's value)/a standard deviation of normal data. Detectability of epileptic foci for this computer-aided analysis was compared with visual inspection of original 18F-FDG PET images by five radiologists without any clinical information. In all cases, there was significant reduction of glucose metabolism in the operated area. The sensitivities of the detection of epileptic foci obtained from visual inspection were 47-59%. In contrast to, computer analysis by eZIS showed 71% sensitivity when we defined the highest Z-score in the cerebrum to be the focus diagnosed by eZIS. Computer-aided diagnosis with eZIS for 18F-FDG PET study is useful for detecting epileptic foci in extra TLE. (author)

  1. {sup 18}F-FDG PET predicts survival after pretargeted radioimmunotherapy in patients with progressive metastatic medullary thyroid carcinoma

    Salaun, Pierre-Yves; Robin, Philippe [University Hospital, Nuclear Medicine Department, Brest (France); Campion, Loic [ICO-Gauducheau Cancer Institute, Statistical Department, Nantes (France); Ansquer, Catherine; Mathieu, Cedric [University Hospital, Nuclear Medicine Department, Nantes (France); Frampas, Eric [University Hospital, Radiology Department, Nantes (France); Universite de Nantes, Nantes-Angers Cancer Research Center, Inserm, U 892, CNRS, UMR 6299, Nantes (France); Bournaud, Claire [University Hospital, Nuclear Medicine Department, Lyon (France); Vuillez, Jean-Philippe [University Hospital, Nuclear Medicine Department, Grenoble (France); Taieb, David [University Hospital, Nuclear Medicine Department, Marseille (France); Rousseau, Caroline [Universite de Nantes, Nantes-Angers Cancer Research Center, Inserm, U 892, CNRS, UMR 6299, Nantes (France); ICO-Rene Gauducheau, Nuclear Medicine Department, Nantes (France); Drui, Delphine [University Hospital, Endocrinology Department, Nantes (France); Mirallie, Eric [University Hospital, Surgery Department, Nantes (France); Borson-Chazot, Francoise [University Hospital, Endocrinology Department, Lyon (France); Goldenberg, David M. [IBC Pharmaceuticals, Inc., and Immunomedics, Inc., Morris Plains, NJ (United States); Center for Molecular Medicine and Immunology, Garden State Cancer Center, Morris Plains, NJ (United States); Chatal, Jean-Francois [GIP ARRONAX, Saint-Herblain (France); Barbet, Jacques [Universite de Nantes, Nantes-Angers Cancer Research Center, Inserm, U 892, CNRS, UMR 6299, Nantes (France); GIP ARRONAX, Saint-Herblain (France); Kraeber-Bodere, Francoise [University Hospital, Nuclear Medicine Department, Nantes (France); Universite de Nantes, Nantes-Angers Cancer Research Center, Inserm, U 892, CNRS, UMR 6299, Nantes (France); ICO-Rene Gauducheau, Nuclear Medicine Department, Nantes (France); Hotel Dieu University Hospital, Nuclear Medicine Department, Nantes (France)

    2014-08-15

    PET is a powerful tool for assessing targeted therapy. Since {sup 18}F-FDG shows a potential prognostic value in medullary thyroid carcinoma (MTC), this study evaluated {sup 18}F-FDG PET alone and combined with morphological and biomarker evaluations as a surrogate marker of overall survival (OS) in patients with progressive metastatic MTC treated with pretargeted anti-CEA radioimmunotherapy (pRAIT) in a phase II clinical trial. Patients underwent PET associated with morphological imaging (CT and MRI) and biomarker evaluations, before and 3 and 6 months, and then every 6 months, after pRAIT for 36 months. A combined evaluation was performed using anatomic, metabolic and biomarker methods. The prognostic value of the PET response was compared with demographic parameters at inclusion including age, sex, RET mutation, time from initial diagnosis, calcitonin and CEA concentrations and doubling times (DT), SUV{sub max}, location of disease and bone marrow involvement, and with response using RECIST, biomarker concentration variation, impact on DT, and combined methods. Enrolled in the study were 25 men and 17 women with disease progression. The median OS from pRAIT was 3.7 years (0.2 to 6.5 years) and from MTC diagnosis 10.9 years (1.7 to 31.5 years). After pRAIT, PET/CT showed 1 patient with a complete response, 4 with a partial response and 24 with disease stabilization. The combined evaluation showed 20 responses. For OS from pRAIT, univariate analysis showed the prognostic value of biomarker DT (P = 0.011) and SUV{sub max} (P = 0.038) calculated before pRAIT and impact on DT (P = 0.034), RECIST (P = 0.009), PET (P = 0.009), and combined response (P = 0.004) measured after pRAIT. PET had the highest predictive value with the lowest Akaike information criterion (AIC 74.26) as compared to RECIST (AIC 78.06), biomarker variation (AIC 81.94) and impact on DT (AIC 79.22). No benefit was obtained by combining the methods (AIC 78.75). This result was confirmed by the

  2. SU-D-201-03: Imaging Cellular Pharmacokinetics of 18F-FDG in Inflammatory/Stem Cells

    Purpose: Atherosclerosis is a progressive inflammatory condition that underlies coronary artery disease (CAD)—the leading cause of death in the USA. Thus, understating the metabolism of inflammatory cells can be a valuable tool for investigating CAD. To the best of our knowledge, we are the first to successfully investigate the pharmacokinetics of [18F]fluoro-deoxyglucose (18F-FDG) uptake in a single macrophages and compared with induced pluripotent stem cells (iPSCs) and mesenchymal stem cells (MSCs) with a novel imaging technique, radioluminescence microscopy, initially developed for cancer imaging. Methods: Live cells were cultured sparsely on Matrigel in a glass-bottom dish and starved for 1 hour before incubation with 250 microCi of 18F-FDG for 45 minutes. Excess radiotracer was removed using DMEM medium without glucose. Before imaging, DMEM (1 mL) was added to the cell culture and a 100 microm-thin CdWO4 scintillator plate was placed on top of the cells. Light produced following beta decay was imaged with a highly sensitive inverted microscope (LV200, Olympus) fitted with a 40x/1.3 high-NA oil objective, and an EM-CCD camera. The images were collected over 18,000 frames with 4×4 binning (1200 MHz EM Gain, 300ms exposure). Custom-written software was developed in MATLAB for image processing (Figure 1). For statistical analysis 10 different region-of-interests (ROIs) were selected for each cell type. Results: Figures 2A–2B show bright-field/fusion images for all three different cell types. The relationship between cell-to-cell comparisons was found to be linear for macrophages unlike iPSCs and MSCs, which were best fitted with moving or rolling average (Figure 2C). The average observed decay of 18F-FDG in a single cell of MSCs per second (0.067) was 20% and 36% higher compared to iPSCs (0.054) and macrophages (0.043), respectively (Figure 2D). Conclusion: MSCs was found to be 2–3x more sensitive to glucose molecule despite constant parameters for each

  3. Clinical value of 18F-FDG PET/CT in the diagnosis of primary peritoneal papillary serous carcinoma

    Objective: To explore the diagnostic value of 18F-FDG PET/CT in primary peritoneal papillary serous carcinoma (PPPSC). Methods: Ten postmenopausal female cases of pathologically diagnosed PPPSC from March 2009 to October 2011 were retrospectively reviewed (age range: 61-81 years, mean: (69.4±6.2) years). All cases underwent 18F-FDG PET/CT.The CT characteristics and SUVmax of lesions on PET images were analyzed. Serum CA125 levels were measured before or after PET/CT within one week. The patterns of PPPSC on PET/CT were compared with histopathological results. Linear correlation analysis was used to evaluate the correlation between the CA125 and the maximum SUVmax of lesions presented in parietal peritoneum, greater omentum or mesentery. Results: The PET/CT uptake pattern of the 10 PPPSC cases was described as floccus, multi-nodular or cake-like in greater omentum (SUVmax =6.32±2.87), and as diffuse or localized nodules,or non-uniform strip-like thickening in 9 parietal peritoneum and 8 mesentery cases (SUVmax=5.96±2.14 and 5.70± 1.69, respectively). The most commonly involved sites were pelvic wall of peritoneum and mesentery of small intestine. All 10 cases had different degrees of ascites, mainly intrapelvic and perihepatic. Hypermetabolic ovarian enlargement (all <5 cm) was bilateral in 2 patients and right-sided in 1 patient. Four patients had retroperitoneal lymph node metastasis and others were found with punctate calcifications in metastatic lymph nodes, small pleural effusions, liver metastasis,as well as portal node metastasis. CA125 concentration was elevated in all cases ((51.25±26.40) ×104 U/L), but there was no significant correlation between CA125 and the maximum SUVmax of lesions found in parietal peritoneum, greater omentum or mesentery (r=0.05, P>0.05). Conclusion: 18F-FDG PET/CT could show the positions and metabolic status of PPPSC lesions.It may be an effective imaging modality in the diagnosis and assessment of PPPSC. (authors)

  4. SU-D-201-03: Imaging Cellular Pharmacokinetics of 18F-FDG in Inflammatory/Stem Cells

    Zaman, R; Tuerkcan, S; Mahmoudi, M; Toshinobu, T; Kosuge, H; Yang, P; Chin, F; McConnell, M; Xing, L [Stanford University School of Medicine, Stanford, CA (United States)

    2015-06-15

    Purpose: Atherosclerosis is a progressive inflammatory condition that underlies coronary artery disease (CAD)—the leading cause of death in the USA. Thus, understating the metabolism of inflammatory cells can be a valuable tool for investigating CAD. To the best of our knowledge, we are the first to successfully investigate the pharmacokinetics of [18F]fluoro-deoxyglucose (18F-FDG) uptake in a single macrophages and compared with induced pluripotent stem cells (iPSCs) and mesenchymal stem cells (MSCs) with a novel imaging technique, radioluminescence microscopy, initially developed for cancer imaging. Methods: Live cells were cultured sparsely on Matrigel in a glass-bottom dish and starved for 1 hour before incubation with 250 microCi of 18F-FDG for 45 minutes. Excess radiotracer was removed using DMEM medium without glucose. Before imaging, DMEM (1 mL) was added to the cell culture and a 100 microm-thin CdWO4 scintillator plate was placed on top of the cells. Light produced following beta decay was imaged with a highly sensitive inverted microscope (LV200, Olympus) fitted with a 40x/1.3 high-NA oil objective, and an EM-CCD camera. The images were collected over 18,000 frames with 4×4 binning (1200 MHz EM Gain, 300ms exposure). Custom-written software was developed in MATLAB for image processing (Figure 1). For statistical analysis 10 different region-of-interests (ROIs) were selected for each cell type. Results: Figures 2A–2B show bright-field/fusion images for all three different cell types. The relationship between cell-to-cell comparisons was found to be linear for macrophages unlike iPSCs and MSCs, which were best fitted with moving or rolling average (Figure 2C). The average observed decay of 18F-FDG in a single cell of MSCs per second (0.067) was 20% and 36% higher compared to iPSCs (0.054) and macrophages (0.043), respectively (Figure 2D). Conclusion: MSCs was found to be 2–3x more sensitive to glucose molecule despite constant parameters for each

  5. 18F-FDG PET/CT imaging and diagnosis method of small intestine primary malignant neoplasms

    18F-FDG PET/CT data of 44 patients with small intestine disease (malignant, 25; benign, 19) were analyzed retrospectively. All results were proved by pathological, or diagnostic therapy and/or clinical follow-up. Visual and quantitative [intestinal wall thickness (IWT)] and semiquantitative methods [standardized uptake value (SUV)] were used to analyze the imaging features. The SUVmean and IWT were taken as the diagnostic threshold value for malignant when the Youden's index (YI) was maximum. The diagnostic test evaluation was compared with the final diagnostic results. The following results were obtained. (1) The 18F-FDG PET/CT imaging signs of small intestine carcinoma presented as intestinal local mass formation (84.00%), local wall thickening (76.00%), stenosis (25.00%), obstruction (32.00%) and enlargement of mesenteric lymph nodes (72.00%). But the incidence rates of these signs in the benign lesions were 31.58%, 42.11%, 10.53%, 15.79% and 52.63%, respectively. Only the signs of intestinal local mass formation (χ2=10.40, p2=3.90, pmax =0.589, the diagnostic threshold of IWT was 9.5 mm. The sensitivity, specificity and accuracy were 80.00%, 78.95% and 79.55%, respectively. (3) The SUVmean of intestinal malignant and benign lesions was 3.55±1.84 and 6.98±3.62 (t=3.77, pmax =0.379,the diagnostic threshold of SUVmean was 3.65. The sensitivity, specificity and accuracy were 80.00%, 57.89% and 70.48%, respectively. (4) Taking the intestinal mass formation as the diagnostic standard of malignant lesions, the sensitivity, specificity and accuracy were 84.00%, 78.95% and 81.82%, respectively. The YImax was 0.630. (5) Taking the intestinal mass formation and SUVmean of max was 0.855. It can be used as the main evidence to differentiate the small intestine primary malignant and benign lesion with the 18F-FDG PET/CT imaging qualitative and quantitative signs for the intestinal mass formation, at SUVmean <3.65, and local wall thickening or IWT <9.50 mm. (authors)

  6. The role of 18F-FDG PET for differentiating malignant from benign lesions in the pancreas

    Objective: To investigate the role of PET with 18F-fluorodeoxyglucose (FDG) for differentiating malignant form benign lesions in the pancreas. Methods: 18F-FDG PET imaging was performed on 30 patients including 20 cases with pancreatic malignant tumors (15 adenocarcinoma, 1 low malignant islet cell tumor, 1 carcinosarcoma, and 3 patients with recurrent tumor after resection of primary pancreatic adenocarcinoma), and 10 cases with chronic pancreatitis (pancreatic pseudocysts were found in 3 of them). The final diagnosis was obtained by pathologic (n=22) and clinical or radiologic follow-up lasted 3-12 months (n=8). PET findings were compared with the results of abdominal CT (n=25) and/or MRI(n=8) done within 2 weeks. Fasting blood sugar levels were controlled in 3.9-5.9 mmol/L in all patients at first, then 222-296 MBq of 18F-FDG was intravenously injected, the transmission and emission scan were performed 1 h after injection. The images of FDG PET were analyzed visually and semiquantitatively using standard uptake value (SUV). Results: Nineteen of twenty patients with malignant tumors (95.0%) showed increased FDG uptake with a SUV of 4.91 ± 3.65, and 9 of 10 patients with chronic pancreatitis (90%) showed low FDG uptake with a SUV of 1.70 ± 1.12 (t=2.69, P=0.012 5 cm, of SUV of 5.46 ± 2.29 (n=10, χ2=9.02, P=0.011). Using a cut-off value of > 2.5 for the SUV, the sensitivity, specificity and accuracy for diagnosing pancreatic malignant tumors using FDG PET were higher than that of abdominal CT (95.0%, 90.0% and 93.3% versus 75.0%, 55.6% and 68.0%, respectively, χ2=5.89, P=0.015). Conclusion: 18F-FDG PET is a sensitive and specific noninvasive technique for diagnosing pancreatic disorders

  7. Value of 18F-FDG PET/CT in the diagnosis of primary gastric cancer via stomach distension

    Objective: To clarify the usefulness of 18F-FDG PET/CT for detecting primary gastric cancer via gastric distention using a mixture of milk and Diatrizoate Meglumine. Materials and methods: A total of 68 patients (male: 47, female: 21; age: 41–87 years) suspected of gastric carcinoma underwent 18F-FDG PET/CT imaging. After whole-body PET/CT imaging in a fasting state, the patients drank a measured amount of milk with Diatrizoate Meglumine. Local gastric district PET/CT imaging was performed 30 min later. The imaging was analyzed by semi-quantitative analysis, standardized uptake value (SUV) of the primary tumor was measured in a region of interest. The diagnosis results were confirmed by gastroscopy, pathology, and follow-up results. Results: Of the 68 patients, 56 malignant gastric neoplasm patients (male: 37, female: 19) were conformed. The sensitivity, specificity, positive predictive value and negative predictive value of fasting whole-body PET/CT imaging for a primary malignant tumor were 92.9%, 75.0%, 94.5%, and 69.0%, respectively. The values for distension with a mixture of milk and Diatrizoate Meglumine were 91.1%, 91.7%, 98.1%, and 68.8%, respectively. The area under the curve was 0.919 ± 0.033 and 0.883 ± 0.066 for the diagnosis of gastric cancer with SUVmax in a fasting state and after intake of mixture respectively, the differences were not statistically significant (P = 0.359). Using gastric distension with a mixture of milk and Diatrizoate Meglumine, the mean ratio of the lesion's SUVmax to the adjacent gastric wall SUVmax increased significantly from 3.30 ± 3.05 to 13.50 ± 15.05, which was statistically significant (P < 0.001). Conclusions: 18F-FDG PET/CT imaging is highly accurate for the diagnosis of primary gastric carcinoma. Gastric distention can display the lesions more clearly, however, it cannot significantly improve diagnostic accuracy

  8. Value of {sup 18}F-FDG PET/CT in the diagnosis of primary gastric cancer via stomach distension

    Ma, Quanmei, E-mail: 444656285@qq.com [Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004 (China); Xin, Jun, E-mail: xinj@sj-hospital.org [Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004 (China); Zhao, Zhoushe, E-mail: zhoushe.zhao@ge.com [GE, Shenyang 110004 (China); Guo, Qiyong, E-mail: guoqy@vip.sina.com [Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004 (China); Yu, Shupeng, E-mail: drizzleyu@163.com [Department of Nuclear Medicine, Shengjing Hospital of China Medical University, Shenyang 110004 (China); Xu, Weina, E-mail: xuwn@sj-hospital.org [Department of Nuclear Medicine, Shengjing Hospital of China Medical University, Shenyang 110004 (China); Liu, Changping, E-mail: liucp1698@163.com [Department of Nuclear Medicine, Shengjing Hospital of China Medical University, Shenyang 110004 (China); Zhai, Wei, E-mail: zhw69@163.com [Department of Nuclear Medicine, Shengjing Hospital of China Medical University, Shenyang 110004 (China)

    2013-06-15

    Objective: To clarify the usefulness of {sup 18}F-FDG PET/CT for detecting primary gastric cancer via gastric distention using a mixture of milk and Diatrizoate Meglumine. Materials and methods: A total of 68 patients (male: 47, female: 21; age: 41–87 years) suspected of gastric carcinoma underwent {sup 18}F-FDG PET/CT imaging. After whole-body PET/CT imaging in a fasting state, the patients drank a measured amount of milk with Diatrizoate Meglumine. Local gastric district PET/CT imaging was performed 30 min later. The imaging was analyzed by semi-quantitative analysis, standardized uptake value (SUV) of the primary tumor was measured in a region of interest. The diagnosis results were confirmed by gastroscopy, pathology, and follow-up results. Results: Of the 68 patients, 56 malignant gastric neoplasm patients (male: 37, female: 19) were conformed. The sensitivity, specificity, positive predictive value and negative predictive value of fasting whole-body PET/CT imaging for a primary malignant tumor were 92.9%, 75.0%, 94.5%, and 69.0%, respectively. The values for distension with a mixture of milk and Diatrizoate Meglumine were 91.1%, 91.7%, 98.1%, and 68.8%, respectively. The area under the curve was 0.919 ± 0.033 and 0.883 ± 0.066 for the diagnosis of gastric cancer with SUV{sub max} in a fasting state and after intake of mixture respectively, the differences were not statistically significant (P = 0.359). Using gastric distension with a mixture of milk and Diatrizoate Meglumine, the mean ratio of the lesion's SUV{sub max} to the adjacent gastric wall SUV{sub max} increased significantly from 3.30 ± 3.05 to 13.50 ± 15.05, which was statistically significant (P < 0.001). Conclusions: {sup 18}F-FDG PET/CT imaging is highly accurate for the diagnosis of primary gastric carcinoma. Gastric distention can display the lesions more clearly, however, it cannot significantly improve diagnostic accuracy.

  9. 18F-FDG PET and 67Ga-Citrate imaging in the evaluation of HIV positive patients

    Full text: A 32-year-old HIV positive man presented with a four-day history of fever, sweats and chills, a one-week history of mild cough and shortness of breath, and a one-month history of intermittent epigastric pain. Clinical examination showed fever, mild hepatosplenomegaly and bibasal chest crepitations. A chest X-ray showed bilateral upper lobe non-cavitating lesions, confirmed on a CT scan. Upper gastro-intestinal endoscopy showed multiple nodules on the gastric mucosa. Biopsy of the nodules revealed large cell non-Hodgkin''s Iymphoma. As part of the staging procedure, the patient was referred for a gallium scan. The patient was injected with 67Ga-citrate and imaged on a Trionix BIAD gamma camera. Anterior and posterior whole body studies were performed at 48 hours and static views at 72 hours. Intense uptake of gallium in the left upper quadrant of the abdomen was found to be consistent with gastric Iymphoma. There was also marked pericardial uptake thought to be due to either Iymphomatous involvement or pericarditis. Foci of increased uptake in the apex of each lung were also noted. A fluorine-18-FDG PET scan was then performed to further evaluate the pericardial and lung uptake. The patient was injected with 370 MBq of 18F-FDG and imaged 40 minutes post-injection on the Siemens PET scanner. A whole body study was acquired consisting of eight 10 cm bed positions at eight minutes each. FDG accumulation was noted in the upper abdomen and correlated with the site of gallium uptake by the gastric Iymphoma. Two focal areas of increased glucose uptake was demonstrated at both lung apices due to metabolically active tumour. There was no glucose uptake in the pericardium to suggest tumour infiltration. CT scans and clinical follow up confirmed pericarditis as the cause of 67Ga uptake. Gallium scanning in HIV patients is complicated by increased uptake in both inflammatory and some neoplastic conditions.18F- FDG PET was able to differentiate Iymphoma from

  10. Locally advanced esophageal adenocarcinoma: Response to neoadjuvant chemotherapy and survival predicted by {sup [18F]}FDG-PET/CT

    Kauppi, Juha T.; Salo, Jarmo A.; Sihvo, Eero I.; Raesaenen, Jari V. [Helsinki Univ. Central Hospital, Div. of General Thoracic and Esophageal Surgery, Dept. of Cardiothoracic Surgery, Helsinki Univ. Central Hospital, Helsinki (Finland)], Email: jarmo.salo@hus.fi; Oksala, Niku [Dept. of Vascular Surgery, Tampere Univ. Central Hospital, Tampere (Finland); Helin, Heikki [HUSLAB/Dept. of Pathology, Helsinki Univ. Central Hospital, Helsinki (Finland); Karhumaeki, Lauri [HUSLAB/Dept. of Clinical Physiology and Nuclear Medicine, Helsinki Univ. Central Hospital, Helsinki (Finland); Kemppainen, Jukka [PET-Center, Turku Univ., Turku (Finland)

    2012-05-15

    Background. {sup [18F]}fluorodeoxyglucose-Positron Emission Tomography/Computer Tomography ({sup [18F]}FDG-PET/CT) is commonly used in staging of locally advanced esophageal cancer. Its predictive value for response to neoadjuvant therapy and survival after multimodality therapy is controversial. Methods. Sixty-six consecutive patients with locally advanced adenocarcinoma of the esophagus or esophagogastric junction underwent surgery after neoadjuvant chemotherapy. Staging was done prospectively with {sup [18F]}FDG-PET/CT, before and after completion of neoadjuvant therapy. Pre- and post-therapy maximal standardized uptake values for the primary tumor (SUV1 and SUV2) were determined, and their relative change (SUV{Delta}%) calculated. Percentage change in SUV1 was compared with histopathologic response (HPR, complete or subtotal histologic remission), disease-free- (DFS) and overall survival (OS). Results. Resection with negative margins was achieved in 60 patients. HPR rate was 14 of 66 (21.2%). Median follow-up was 16 months (range 4-72). For all patients, OS probability at three years was 59% and DFS 50%. In receiver operating characteristics (ROC) analysis, HPR was optimally predicted by a > 67% change in baseline maximal SUV (sensitivity 79% and specificity 75%). In univariate survival analysis (Cox regression proportional hazards), HPR associated with improved DFS (HR 0.208, p = 0.033) but not OS (HR 0.030, p = 0.101), SUV % > 67% associated with improved OS (HR 0.249, p = 0.027) and DFS (HR 0.383, p 0.040). In a multivariate model (adjusted by age, sex, and ASA score), neither HPR nor SUV{Delta}% > 67% was predictive of improved OS and DFS. However, SUV{Delta}% as a continuous variable was an independent predictor of OS (HR 0.966, p < 0.0001) or DFS (HR 0.973, p < 0.0001). Conclusion. Our results support previous results showing that {sup [18F]}FDG-PET/CT can distinguish a group of patients with worse prognosis after neoadjuvant chemotherapy in

  11. The study on glucose metabolism of the brain of patients with Parkinson's disease using 18F-FDG PET

    Objective: To study glucose metabolism of the brain of patients with Parkinson's disease (PD) by PET, to investigate the imaging characteristics of 18F-FDG PET in Chinese patients with PD. Methods: 50 min after intravenous administration of 18F-FDG, brain scan was performed on 33 patients with PD and 32 age-matched healthy subjects. Semiquantitative analysis was applied to assess the metabolic function of the brain by the ratio of mean radioactivity of various cerebral lobes (substantia nigra, putamen, caudatum, thalamus, temporal lobe, frontal lobe, parietal lobe, occipital lobe, hippocampus) to cerebellum (Rcl/cb). PET scan was compared with MRI. Results: In healthy subjects PET scan showed clear and symmetrical distribution of radioactivity in the cerebral lobes. 96.97% of PD patients showed abnormal PET images, 30.30% of PD patients' MRI showed abnormal, but only 9.09% of that was special. The radioactivity ratio of cerebral lobes to cerebellum of PD patients in nigra-striatum dopaminergic system and cerebral lobes was significantly decreased than that in healthy subjects. The opposite nigra-striatum system and frontal lobe of the more serious sick limbs were significantly more hypo-metabolic than the same side cerebral lobes. The characteristic PET images of PD patients showed that asymmetrical substantia nigra hypometabolism in 93.94% of the PD cases, striatum, thalamus asymmetrical hypometabolism in 69.70% and 36.36% PD cases; slight asymmetrical increase of radioactivity in striatum and thalamus in 15.15% PD cases; cerebral lobes asymmetrical hypometabolism of temporal lobe in 51.52%, frontal in 39.39%, parietal in 15.15%, occipital in 9.09%, hippocampal in 45.46% PD cases; slight cerebral asymmetrical hypermetabolism in 9.09% PD cases. Conclusions: In addition to cerebral structural lesions in the brain, asymmetrical hypometabolism and slight hypermetabolism can be found in nigra-striatum dopaminergic system accompany with cerebral hypometabolism or slight

  12. The applications of 18F-FDG combined with 11C-acetate PET-CT imaging in the diagnosis of hepatic cancer

    The incidence of hepatocellular carcinoma which threatens our health and life seriously ranks third in all the tumors in developing countries. Though most of the disease can be diagnosed by traditional imaging method such as CT, MRI, ultrasonography, for primary hepatocellular cartinoma that diagnoses hard with traditional method, PET-CT can be used as an effective supplement methods. The positive rate of 18F-FDG PET-CT in diagnosis of primary hepato carcinoma was low. But when combined with 11C-acetate PET-CT, the sensitivity and accuracy of 18F-FDG PET-CT in diagnosis of primary hepato carcinoma could be improved. (authors)

  13. 18F-FDG PET and PET/CT in the Localization and Characterization of Lesions in Patients with Ovarian Cancer

    Caprio, Maria Grazia; Capacchione, Daniela; Mainolfi, Ciro; Spera, Anna Maria; Salvatore, Barbara; Cella, Laura; Salvatore, Marco; Pace, Leonardo

    2012-01-01

    Aim: The aim was to compare the imaging findings of 18F-fluorodeoxyglucose (18F-FDG) PET and integrated PET/CT in patients with primary, recurrent or metastatic ovarian cancer. Materials and methods. 21 women with ovarian cancer were evaluated. All patients had a integrated PET/CT scan. Localization, infiltration and uptake intensity of [18F]FDG were evaluated on PET and PET/CT. The certainty of localisation and characterisation was scored on a 3 point scale (L1 definite localisation; L2 p...

  14. Diuretic {sup 18}F-FDG PET/CT imaging for detection and locoregional staging of urinary bladder cancer: prospective evaluation of a novel technique

    Nayak, Brusabhanu; Dogra, Prem Nath [All India Institute of Medical Sciences, Department of Urology, New Delhi (India); Naswa, Niraj [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Kumar, Rakesh [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); New Delhi (India)

    2013-03-15

    Positron emission tomography/computed tomography (PET/CT) with {sup 18}F-fluorodeoxyglucose (FDG) has been used with limited success in the past in primary diagnosis and locoregional staging of urinary bladder cancer, mainly because of the pharmacokinetics of renal excretion of {sup 18}F-FDG. In the present prospective study, we have evaluated the potential application of diuretic {sup 18}F-FDG PET/CT in improving detection and locoregional staging of urinary bladder tumours. Twenty-five patients suspected of having primary carcinoma of the urinary bladder were evaluated prospectively for diagnosis and staging. All of these 25 patients underwent conventional contrast-enhanced computed tomography (CECT) of the abdomen/pelvis and whole-body diuretic {sup 18}F-FDG PET/CT. In addition, pelvic PET/CT images were obtained using the special technique of forced diuresis using intravenous furosemide (20-40 mg). Of the 25 patients, 10 underwent radical cystectomy and 15 underwent transurethral resection of the bladder tumour (TURBT). Results of CECT and diuretic {sup 18}F-FDG PET/CT were compared considering histopathology as a reference standard. Of the 25 patients, CECT detected a primary tumour in 23 (sensitivity 92 %), while {sup 18}F-FDG PET/CT was positive in 24 patients (sensitivity 96 %). Mean size and maximum standardized uptake value of the bladder tumours were 3.33 cm (range 1.6-6.2) and 5.3 (range 1.3-11.7), respectively. Of the 25 patients, only 10 patients underwent radical cystectomy based on disease status on TURBT. Among those ten patients, nine had locoregional metastases. Among the nine patients who had positive lymph nodes for metastasis on histopathology, CECT and PET/CT scan had a sensitivity of 44 and 78 %, respectively. {sup 18}F-FDG PET/CT was found to be superior to CECT in the detection of the primary tumour and locoregional staging (p < 0.05). Diuretic {sup 18}F-FDG PET/CT is highly sensitive and specific and plays an important role in improving

  15. The Impact of Energy Substrates, Hormone Level and Subject-Related Factors on Physiologic Myocardial {sup 18}F-FDG Uptake in Normal Humans

    Jeong, Juhye; Kong, Eunjung; Chun, Kyungah; Cho, Ihnho [Yeung-Nam Univ. Hoepital, Daegu (Korea, Republic of)

    2013-12-15

    In a whole-body {sup 18}F-FDG PET/CT, non-specific {sup 18}F-FDG uptake of the myocardium is a common finding and can be very variable, ranging from background activity to intense accumulation and inhomogeneity. We investigated the effect of energy substrates and plasma/serum hormones that may have an influence on myocardial {sup 18}F-FDG uptake. F-FDG PET/CT was performed on 100 normal volunteers from November 2007 to August 2008. Blood samples were taken just before {sup 18}F-FDG injection from all subjects. Myocardial {sup 18}F-FDG uptake was measured as the mean (SUVmean) and maximal (SUV{sub max}) standardized uptake value. The myocardium was delineated on the PET/CT image by a manual volume of interest (VOI).We analyzed the influence of age, sex, presence of diabetes, fasting duration, insulin, glucagon, fasting glucose, lactate, free fatty acid (FFA), epinephrine (EPi), norepinephrine (NEp), free triiodothyronine (T3), free thyroxine (T4), thyroid-stimulating hormone (TSH) and body mass index (BMI). Overall, 92 subjects (mean age 50.28±8.30, male 57) were enrolled. The average of myocardial SUVmean was 2.08 and of myocardial SUV{sub max} was 4.57, respectively and there was a strong linear correlation between SUVmean and SUV{sub max} (r =0.98). FFA and fasting duration showed significant negative correlation with myocardial {sup 18}F-FDG uptake, respectively (r =-0.40 in FFA; r =-0.41 in fasting duration). No significant relationships were observed between myocardial uptake and age, sex, presence of diabetics, insulin, glucagon, fasting glucose, lactate, EPi, NEp, free T3, free T4, TSH and BMI. Myocardial {sup 18}F-FDG uptake decreases with longer fasting duration and higher FFA level in normal humans. Modulating myocardial uptake could improve {sup 18}F-FDG PET/CT imaging for specific oncologic and cardiovascular indications.

  16. Comparison of 18F-FDG and 68Ga PET imaging in the assessment of experimental osteomyelitis due to Staphylococcus aureus

    Although positron emission tomography (PET) using 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) is a promising imaging modality for bone infections, the technique may still give false-positive results due to unspecific uptake in healing bone. This experimental study compared 18F-FDG and 68Ga in PET imaging of osteomyelitis and normal bone healing. A diffuse osteomyelitis model of the tibia was applied in the rat (n=50). Two weeks after operation, PET imaging with 18F-FDG and 68Ga was performed, followed by peripheral quantitative computed tomography (pQCT) and radiography. Osteomyelitis was verified by quantitative bacteriology. In addition to in vivo imaging, ex vivo measurements of tissue radioactivity were performed to verify uptake of the tracers. Compared with controls with normal bone healing, the osteomyelitic tibias showed increased SUV ratios (i.e. radioactivity ratios between the operated and non-operated sides) for both 18F-FDG (1.74±0.37) and 68Ga (1.62±0.28) (P18F-FDG and P68Ga). The intensity of 68Ga uptake reflected pathological changes of osteomyelitic bones measured by pQCT. The uptake of 18F-FDG, however, did not show as close a correlation with the anatomical changes. The healing bones without infection exhibited slightly elevated uptake of 18F-FDG (SUV ratio 1.16±0.06), but 68Ga did not accumulate in the healing bone, as judged on the basis of both in vivo imaging (SUV ratio 1.02±0.05) and ex vivo measurements (SUV 0.92±0.21) (P=0.003 and P=0.022 compared with 18F-FDG uptake, respectively). This study suggests the feasibility of 68Ga PET imaging of bone infections. However, further studies are needed to clarify the value of 68Ga PET for clinical purposes. (orig.)

  17. 18F-FDG PET /CT for the detection of primary malignancy in patients with cervical lymph node metastatses from unknown origin

    宋建华

    2014-01-01

    Objective To investigate the value of18F-FDG PET/CT for the detection of primary malignancy in patients with cervical lymph node metastases from unknown origin.Methods Seventy-eight patients(48 males,30 females,average age(56.4±14.7)years)who were diagnosed as cervical lymph node metastases from unknown origin by fine needle aspiration underwent18F-FDG PET/CT from 2007 to 2012.ROI was drawn with SUVmaxcalculated.The distribution of the lymph nodes was classified according

  18. Cerebral metabolism and perfusion in MR-negative individuals with refractory focal epilepsy assessed by simultaneous acquisition of 18F-FDG PET and arterial spin labeling

    Galazzo, I. B.; Mattoli, M. V.; Pizzini, F. B.; Vita, E.; Barnes, A.; Duncan, J.S.; Jager, R.; Golay, X.; Bomanji, J. B.; Koepp, M.; Groves, A M; Fraioli, F.

    2016-01-01

    The major challenge in pre-surgical epileptic patient evaluation is the correct identification of the seizure onset area, especially in MR-negative patients. In this study, we aimed to: (1) assess the concordance between perfusion, from ASL, and metabolism, from 18F-FDG, acquired simultaneously on PET/MR; (2) verify the utility of a statistical approach as supportive diagnostic tool for clinical readers. Secondarily, we compared 18F-FDG PET data from the hybrid PET/MR system with those acquir...

  19. Comparison of 99mTc-annexin A5 with 18F-FDG for the detection of atherosclerosis in ApoE-/- mice

    99mTc-annexin A5, a marker of ongoing apoptosis, and 18F-FDG, a marker of the increased metabolism of inflammatory cells, are supposed to be useful in the detection of metabolically active atheroma. This study reports a comparison of the intralesional distribution of these tracers in relation to lesion development in ApoE-/- mice. Male ApoE-/- mice (n = 12-14/group) were maintained on a Western-type diet after the age of 5 weeks. At 25 weeks, 99mTc-annexin A5 or 18F-FDG was injected and the aortas were harvested for autoradiography (ARG) and Oil Red O staining. Regional radioactivity accumulation was compared in relation to the Oil Red O staining score (ranging from 0 to 3, a semiquantitative parameter for evaluating lesion development). Both 99mTc-annexin A5 and 18F-FDG showed preferential uptake into atherosclerotic lesions, with higher uptake levels for 18F-FDG (mean, 56.07 %ID x kg/m2) than for 99mTc-annexin A5 (mean, 10.38 %ID x kg/m2). The regional uptake levels of each tracer correlated with the Oil Red O staining score (r = 0.65, p 99mTc-annexin A5; r = 0.56, p 18F-FDG). The uptake ratios of advanced lesions (score >0.5) to early lesions (score 99mTc-annexin A5 than for 18F-FDG (f = 4.73, p = 0.03). Both 99mTc-annexin A5 and 18F-FDG accumulate in atherosclerotic lesions and correlate with the severity of each lesion. The higher absolute uptake levels of 18F-FDG may be advantageous for lesion detection, whereas the preferential uptake of 99mTc-annexin A5 in advanced lesions may be a useful indicator of late-stage lesions or vulnerable plaque transformation. (orig.)

  20. 18F-FDG PET/CT in staging patients with locally advanced or inflammatory breast cancer: comparison to conventional staging

    The prognosis of patients with locally advanced breast cancer (LABC) remains poor. We prospectively investigated the impact of 18F-FDG PET/CT at initial staging in this clinical setting and compared PET/CT performance with that of conventional distant work-up. During 60 mo, consecutive patients with LABC (clinical T4 or N2-N3 disease) underwent 18F-FDG PET/ CT. The yield was assessed in the whole group and separately for non-inflammatory and inflammatory cancer. The performance of PET/CT was compared with that of a conventional staging approach including bone scanning, chest radiography, or dedicated CT and abdomino-pelvic sonography or contrast-enhanced CT. 117 patients with inflammatory (n = 35) or non-inflammatory (n = 82) LABC were included. 18F-FDG PET/CT confirmed N3 nodal involvement in stage IIIC patients and revealed unsuspected N3 nodes (infra-clavicular, supraclavicular, or internal mammary) in 32 additional patients. Distant metastases were visualized on PET/CT in 43 patients (46% of patients with inflammatory carcinoma and 33% of those with non-inflammatory LABC). Overall, 18F-FDG PET/CT changed the clinical stage in 61 patients (52%). Unguided conventional imaging detected metastases in only 28 of the 43 patients classified M1 with PET/CT (65%). 18F-FDG PET/CT outperformed conventional imaging for bone metastases, distant lymph nodes, and liver metastases, whereas CT was more sensitive for lung metastases. The accuracy in diagnosing bone lesions was 89.7% for planar bone scanning versus 98.3% for 18F-FDG PET/CT. The accuracy in diagnosing lung metastases was 98.3% for dedicated CT versus 97.4% for 18F-FDG PET/CT. 18F-FDG PET/CT had the advantage of allowing chest, abdomen and bone to be examined in a single session. Almost all distant lesions detected by conventional imaging were depicted with PET/CT, which also showed additional lesions. (authors)

  1. Skin Manifestation of Unsuspecting Prostate Cancer Detected by {sup 18}F-FDG PET/CT Performed To Assess Underlying Multiple Myeloma

    AbAziz, Aini; Mahaletchumy, Thanuja; Chung, Junekey [Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur (Malaysia)

    2013-12-15

    Skin metastases from either prostate adenocarcinoma or multiple myeloma rarely occur. We report the case of a 73-year-old man with multiple myeloma who presented with multiple subcutaneous nodules 3 years after his initial diagnosis. Fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging was suggestive of a concomitant second primary from the prostate. This case highlights not only a rare initial manifestation of prostate cancer, but also the role of 18F-FDG-PET/CT in detecting a clinically unsuspected second malignancy. It potentially corroborates the possible association of both diseases, as has been reported before.

  2. Correlation of Glut-1 glucose transporter expression with [{sup 18}F]FDG uptake in non-small cell lung cancer

    Higashi, Kotaro; Wang, Xiao; Xu, Linfeng; Oguchi, Manabu; Taki, Suzuka; Tonami, Hisao; Yamamoto, Itaru [Department of Radiology, Kanazawa Medical University, Ishikawa (Japan); Ueda, Yoshimichi; Sakurai, Aya; Katsuda, Shogo [Department of Pathology, Kanazawa Medical University, Ishikawa (Japan); Murakami, Manabu [Medical Research Institute, Kanazawa Medical University, Ishikawa (Japan); Seki, Hiroyasu [Department of Radiology, Kanazawa Cardiovascular Hospital, Ishikawa (Japan); Nambu, Yoshihiro [Department of Internal Medicine, Division of Respiratory Disease, Kanazawa Medical University, Ishikawa (Japan)

    2000-12-01

    Positron emission tomography (PET) with [{sup 18}F]2-fluoro-2-deoxy-D-glucose (FDG) may show negative results for bronchioloalveolar lung carcinoma. We investigated the correlation of Glut-1 glucose transporter expression with [{sup 18}F]FDG uptake in non-small cell lung cancer. Thirty-two patients with 34 non-small cell lung cancers (7 bronchioloalveolar carcinomas, 23 non-bronchioloalveolar adenocarcinomas, 3 squamous cell carcinomas, and 1 adenosquamous cell carcinoma) were studied. Final diagnoses were established by histology (via thoracotomy) in all patients. [{sup 18}F]FDG PET was performed 40 min after i.v. injection of 185 MBq [{sup 18}F]FDG. For semi-quantitative analysis of [{sup 18}F]FDG uptake, standardized uptake values (SUVs) were calculated. Glut-1 expression was studied in terms of the immunohistochemistry of paraffin sections using anti-Glut-1 antibody to determine the intensity (0-3) of Glut-1 immunoreactivity and percentage of the Glut-1-positive area. Of seven bronchioloalveolar carcinomas, six (85.7%) were negative for the expression of Glut-1, while only one (4.3%) of 23 non-bronchioloalveolar adenocarcinomas was negative (P<0.0001). The percentages of Glut-1-positive area, as well as the SUVs, were significantly lower in bronchioloalveolar carcinomas (n=7) (2.86%{+-}7.56% and 1.25{+-}0.75, respectively) than in non-bronchioloalveolar adenocarcinomas (n=23) (54.83%{+-}25.64%, P<0.0001, and 3.94{+-}1.93, P=0.001, respectively). The degree of cell differentiation correlated with the percentage of Glut-1-positive area and SUVs in adenocarcinoma of the lung. Correlations between SUVs and the intensity of Glut-1 immunoreactivity were also significant (intensities 0 and 1, n=11, SUV 1.47{+-}0.63; intensities 2 and 3, n=23, SUV 4.78{+-}2.13; P<0.0001). The percentage of Glut-1-positive area correlated significantly with SUVs (n=34, r=0.658, P<0.01). Overexpression of Glut-1 correlated with high [{sup 18}F]FDG uptake. These findings suggest that Glut

  3. Usefulness of 11C-methionine PET in evaluation of brain lesions with hypo- or isometabolism on 18F-FDG PET

    Because some brain tumors show iso-or hypometabolism on 18F-FDG PET, there have been problems in detection of primary or recurrent tumor and in differentiation from benign lesion with 18F-FDG PET. We investigated the usefulness of 11C-methionine PET in characterizing brain lesions in these conditions. In 34 patients with brain lesions (27 for initial diagnosis, 7 for detecting recurrence ) who showed hypo- or isometabolism compared to normal brain tissue on 18F-FDG PET, we performed 11C-methionine PET. Five minutes after injection of 550 MBq 11C-methionine, attenuation corrected brain images were obtained with a dedicated PET scanner. Brain lesions were 18 gliomas, 4 metastatic brain tumors, 2 meningiomas, 1 mixed germ cell tumor and 3 benign tumors and 6 non-tumorous lesions (3 neurocysticercosis, 2 meningiomas, 1 mixed germ cell tumor and 3 benign tumors and 6 non-tumorous lesions (3 neurocysticercosis, 2 tumor necrosis, 1 granuloma). To find the correlation between methione uptake and proliferation activity, Ki 67 proliferation Index in 8 patients or Proliferation index (P1=G2+M+S/total cycle) using DNA flow cytometry in 10 patients were obtained. Of 25 tumorous lesions without definitive hypermetabolism on 18F-FDG PET, all except two glioma (92%) showed moderate to high uptake in entire or thick peripheral tumor uptake in 11C-methionine PET. The uptake ratio of tumor to normal brain in 18F-FDG and 11C-methionine PET were 0.96 ±0.32 and 2.43 ± 1.26, respectively. Nine benign lesions with hypo- or isometabolism on 18F-FDG PET were also no significantly increased 11C-methionine uptake. 11C-methionine uptake and proliferation activity were correlated with Ki 67 index or PI (r=0.6). Two glioma shown no increased 11C-methionine uptake had low proliferative activity (Ki 67 11C-methionin PET could detect brain tumors and differentiate brain lesions with high sensitivity and good contrast, which showed iso- or hypometabolism on 18F-FDG PET. In evaluation of these

  4. Usefulness of {sup 11}C-methionine PET in evaluation of brain lesions with hypo- or isometabolism on {sup 18}F-FDG PET

    Kim, Y. K.; Chung, J. K.; Yeo, J. S.; Lee, D. S.; Jeong, H. W.; Lee, M. C. [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2000-07-01

    Because some brain tumors show iso-or hypometabolism on {sup 18}F-FDG PET, there have been problems in detection of primary or recurrent tumor and in differentiation from benign lesion with {sup 18}F-FDG PET. We investigated the usefulness of {sup 11}C-methionine PET in characterizing brain lesions in these conditions. In 34 patients with brain lesions (27 for initial diagnosis, 7 for detecting recurrence ) who showed hypo- or isometabolism compared to normal brain tissue on {sup 18}F-FDG PET, we performed {sup 11}C-methionine PET. Five minutes after injection of 550 MBq {sup 11}C-methionine, attenuation corrected brain images were obtained with a dedicated PET scanner. Brain lesions were 18 gliomas, 4 metastatic brain tumors, 2 meningiomas, 1 mixed germ cell tumor and 3 benign tumors and 6 non-tumorous lesions (3 neurocysticercosis, 2 meningiomas, 1 mixed germ cell tumor and 3 benign tumors and 6 non-tumorous lesions (3 neurocysticercosis, 2 tumor necrosis, 1 granuloma). To find the correlation between methione uptake and proliferation activity, Ki 67 proliferation Index in 8 patients or Proliferation index (P1=G2+M+S/total cycle) using DNA flow cytometry in 10 patients were obtained. Of 25 tumorous lesions without definitive hypermetabolism on {sup 18}F-FDG PET, all except two glioma (92%) showed moderate to high uptake in entire or thick peripheral tumor uptake in {sup 11}C-methionine PET. The uptake ratio of tumor to normal brain in {sup 18}F-FDG and {sup 11}C-methionine PET were 0.96 {+-}0.32 and 2.43 {+-} 1.26, respectively. Nine benign lesions with hypo- or isometabolism on {sup 18}F-FDG PET were also no significantly increased {sup 11}C-methionine uptake. {sup 11}C-methionine uptake and proliferation activity were correlated with Ki 67 index or PI (r=0.6). Two glioma shown no increased {sup 11}C-methionine uptake had low proliferative activity (Ki 67 < 1%). {sup 11}C-methionin PET could detect brain tumors and differentiate brain lesions with high

  5. Evaluation of anesthesia effects on [{sup 18}F]FDG uptake in mouse brain and heart using small animal PET

    Toyama, Hiroshi E-mail: htoyama@fujita-hu.ac.jp; Ichise, Masanori; Liow, Jeih-San; Vines, Douglass C.; Seneca, Nicholas M.; Modell, Kendra J.; Seidel, Jurgen; Green, Michael V.; Innis, Robert B

    2004-02-01

    This study evaluates effects of anesthesia on {sup 18}F-FDG (FDG) uptake in mouse brain and heart to establish the basic conditions of small animal PET imaging. Prior to FDG injection, 12 mice were anesthetized with isoflurane gas; 11 mice were anesthetized with an intraperitoneal injection of a ketamine/xylazine mixture; and 11 mice were awake. In isoflurane and ketamine/xylazine conditions, FDG brain uptake (%ID/g) was significantly lower than in controls. Conversely, in the isoflurane condition, %ID/g in heart was significantly higher than in controls, whereas heart uptake in ketamine/xylazine mice was significantly lower. Results suggest that anesthesia impedes FDG uptake in mouse brain and affects FDG uptake in heart; however, the effects in the brain and heart differ depending on the type of anesthesia used.

  6. A 18F-FDG uptake study of brain and abnormal brain connection in advanced Parkinson's disease

    Objective: To assess the changes in regional glucose metabolism and abnormal brain connection in advanced Parkinson's disease (PD) with 18F-fluorodeoxyglucose (FDG) PET imaging. Methods: Ten advanced PD patients and 10 age-matched healthy subjects underwent 18F-FDG PET imaging at rest-state. Statistical parametric mapping (SPM) was used to investigate regional cerebral metabolic rate of glucose. Results: Compared to age-matched healthy subjects, the regional glucose metabolism increased in bilateral hippocampus, thalamus, precentral cortex (BA6) and lentiform, whereas decreased in bilateral prefrontal motor area (BA46, BA47), parietal area (BA7, BA39) in advanced PD cases. Conclusions: Hypermetabolism in thalamus and lentiform accompany with hypometabolism in prefrontal motor and parietal cortex area was found in advanced PD patients, thereby the abnormal functional connection showed by FDG PET imaging is helpful to the diagnosis and also for the study of the pathophysiology of PD

  7. Hypermetabolic axillary mass on 18F FDG PET/CT: breast cancer arising from accessory breast tissue

    Differential diagnosis among several causes of axillary malignant mass is important. The most common cause of palpable malignant axillary mass is metastatic lymphadenopathy. Although carcinoma arising from ectopic breast tissue is rare, the diagnosis should be kept in mind when evaluation malignant axillary mass. In this report we present a case with carcinoma arising from ectopic breast tissue. 18F FDG PET/CT was performed for the purpose of localizing primary breast cancer lesion and systemic evaluation. PET/CT showed hypermetabolic lesions only in the right axilla. There is no evidence of malignancy in both breasts. When nuclear physicians encounter a hypermetabolic axillary mass indicating malignant lesion without evidence of primary breast malignant lesion, carcinoma arising from ectopic breast tissue should be included in the differential diagnosis

  8. Hypermetabolic axillary mass on {sup 18}F FDG PET/CT: breast cancer arising from accessory breast tissue

    Park, Ji Sun; Lee, Ah Young; Bae, Sang Gyun; Lee, Seok Mo [Inje University, Pusan Paik Hospital, Busan (Korea, Republic of)

    2010-12-15

    Differential diagnosis among several causes of axillary malignant mass is important. The most common cause of palpable malignant axillary mass is metastatic lymphadenopathy. Although carcinoma arising from ectopic breast tissue is rare, the diagnosis should be kept in mind when evaluation malignant axillary mass. In this report we present a case with carcinoma arising from ectopic breast tissue. {sup 18}F FDG PET/CT was performed for the purpose of localizing primary breast cancer lesion and systemic evaluation. PET/CT showed hypermetabolic lesions only in the right axilla. There is no evidence of malignancy in both breasts. When nuclear physicians encounter a hypermetabolic axillary mass indicating malignant lesion without evidence of primary breast malignant lesion, carcinoma arising from ectopic breast tissue should be included in the differential diagnosis

  9. Comparison of prone versus supine 18F-FDG-PET of locally advanced breast cancer: Phantom and preliminary clinical studies

    Williams, Jason M.; Rani, Sudheer D.; Li, Xia; Whisenant, Jennifer G.; Abramson, Richard G. [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232 and Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee 37232 (United States); Arlinghaus, Lori R. [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232 (United States); Lee, Tzu-Cheng [Department of Bioengineering, University of Washington, Seattle, Washington 98195 (United States); MacDonald, Lawrence R.; Partridge, Savannah C. [Department of Radiology, University of Washington, Seattle, Washington 98195 (United States); Kang, Hakmook [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232 and Department of Biostatistics, Vanderbilt University, Nashville, Tennessee 37232 (United States); Linden, Hannah M. [Department of Medical Oncology, University of Washington, Seattle, Washington 98195 (United States); Kinahan, Paul E. [Department of Radiology, University of Washington, Seattle, Washington 98195 (United States); Department of Bioengineering, University of Washington, Seattle, Washington 98195 (United States); Department of Physics, University of Washington, Seattle, Washington 98195 (United States); Department of Electrical Engineering, University of Washington, Seattle, Washington 98195 (United States); Yankeelov, Thomas E., E-mail: thomas.yankeelov@vanderbilt.edu [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232 (United States); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee 37232 (United States); Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee 37232 (United States); Department of Physics, Vanderbilt University, Nashville, Tennessee 37232 (United States); Department of Cancer Biology, Vanderbilt University, Nashville, Tennessee 37232 (United States)

    2015-07-15

    Purpose: Previous studies have demonstrated how imaging of the breast with patients lying prone using a supportive positioning device markedly facilitates longitudinal and/or multimodal image registration. In this contribution, the authors’ primary objective was to determine if there are differences in the standardized uptake value (SUV) derived from [{sup 18}F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in breast tumors imaged in the standard supine position and in the prone position using a specialized positioning device. Methods: A custom positioning device was constructed to allow for breast scanning in the prone position. Rigid and nonrigid phantom studies evaluated differences in prone and supine PET. Clinical studies comprised 18F-FDG-PET of 34 patients with locally advanced breast cancer imaged in the prone position (with the custom support) followed by imaging in the supine position (without the support). Mean and maximum values (SUV{sub peak} and SUV{sub max}, respectively) were obtained from tumor regions-of-interest for both positions. Prone and supine SUV were linearly corrected to account for the differences in 18F-FDG uptake time. Correlation, Bland–Altman, and nonparametric analyses were performed on uptake time-corrected and uncorrected data. Results: SUV from the rigid PET breast phantom imaged in the prone position with the support device was 1.9% lower than without the support device. In the nonrigid PET breast phantom, prone SUV with the support device was 5.0% lower than supine SUV without the support device. In patients, the median (range) difference in uptake time between prone and supine scans was 16.4 min (13.4–30.9 min), which was significantly—but not completely—reduced by the linear correction method. SUV{sub peak} and SUV{sub max} from prone versus supine scans were highly correlated, with concordance correlation coefficients of 0.91 and 0.90, respectively. Prone SUV{sub peak} and SUV{sub max} were

  10. Grading staging and prognosis of follicular lymphoma: the value of 18F-FDG PET/CT

    Objective: To evaluate the value of 18F-FDG PET/CT in histological grading and staging of follicular lymphoma (FL) and prediction of prognosis after first-line treatment. Methods: From May 2007 to April 2013, 24 patients (11 males, 13 females; median age 55 years) with histopathological proof of FL were retrospectively studied. All patients were evaluated by 18F-FDG PET/CT before the first-line treatment and were divided into indolent FL and aggressive FL according to their histological grades and clinical stages. The sensitivity,specificity and SUVmax were calculated. Analysis of variance of factorial design was used to analyze the data. Within the same study period, 18F-FDG PET/CT was also performed in 16 FL patients (9 males,7 females; median age 50.5 years) after first-line treatment (7/16 patients belonged to the aforementioned group with pretreatment PET/CT performed); and they were then divided into PET/CT-positive and PET/CT-negative groups. All 16 patients were followed for 6-49 months to evaluate the prognosis. The rates of overall survival (OS) and progression-free survival (PFS) were calculated. Results: (1) The sensitivities of PET/CT in indolent and aggressive FL were 92.3% (12/13) and 100% (11/11), respectively. The SUVmax was 5.26± 1.70 vs 9.54±5.09 (F=5.196, P<0.05). (2) According to PET/CT, 3 patients(12.5%,3/24) were upstaged from Ⅰ-Ⅱ to Ⅲ-Ⅳ, and 2 patients(8.3%,2/24) were down-staged from Ⅲ-Ⅳ to Ⅰ-Ⅱ. The SUVmax of stage Ⅰ-Ⅱ and Ⅲ-Ⅳ FL was 5.22±2.92 and 8.04±4.46 (F=2.904, P>0.05). (3)For the 16 FL patients with PET/CT after first-line treatment, the negative and positive groups had different OS and PFS. The 6-month OS, 1-year OS and 3-year OS were 100% (13/13), 9/9, 4/5, respectively for the negative group, and 2/3, 2/3, 1/2, respectively for the positive group; while the corresponding 6-month PFS, 1-year PFS and 3-year PFS were 92.3% (12/13), 8/9, 3/5 and 2/3, 0/3, 0/2, respectively. Conclusions: 18F-FDG PET/CT is

  11. Simultaneous whole-body 18F-FDG PET-MRI in primary staging of breast cancer: A pilot study

    Highlights: • Initial staging of breast cancer important in treatment planning and prognostication. • We assessed role of simultaneous 18F-FDG PET-MRI in initial staging of breast cancer. • Primary, nodes and metastases on PET, MRI and PET-MRI for count and diagnostic confidence. • High diagnostic accuracy and confidence in detecting index and satellite lesions. • Comprehensive nodal and distant metastases staging with altered management (12 cases). - Abstract: Purpose: Accurate initial staging in breast carcinoma is important for treatment planning and for establishing the likely prognosis. The purpose of this study was to assess the utility of whole body simultaneous 18F-FDG PET-MRI in initial staging of breast carcinoma. Methods: 36 patients with histologically confirmed invasive ductal carcinoma underwent simultaneous whole body 18F-FDG PET-MRI on integrated 3 T PET-MR scanner (Siemens Biograph mMR) for primary staging. Primary lesion, nodes and metastases were evaluated on PET, MRI and PET-MRI for lesion count and diagnostic confidence (DC). Kappa co relation analysis was done to assess agreement between the satellite, nodal and metastatic lesions detected by PET and MRI. Histopathology, clinical/imaging follow-up served as the reference standard. Results: 36 patients with 37 histopathologically proven index breast cancer were retrospectively studied. Of 36 patients, 25 patients underwent surgery and 11 patients received systemic therapy. All index cancers were seen on PET and MR. Fused PET-MRI showed highest diagnostic confidence score of 5 as compared to PET (median 4; range 3–5) and MRI (median 4; range 4–5) alone. 2/36 (5.5%) patients were detected to have unsuspected contralateral synchronous cancer. 47 satellite lesions were detected on DCE MRI of which 23 were FDG avid with multifocality and multicentricity in 21 (58%) patients. Kappa co relation analysis revealed fair agreement for satellite lesion detection by the two modalities (κ = 0

  12. Efficacy of {sup 18}F-FDG PET/CT in the evaluation of patients with recurrent cervical carcinoma

    Mittra, Erik; Rodriguez, Cesar A.; Quon, Andrew; Ross McDougall, I.; Iagaru, Andrei [Stanford Hospitals and Clinics, Division of Nuclear Medicine, Stanford, CA (United States); El-Maghraby, Tarek [Cairo University, Nuclear Medicine, Cairo (Egypt); Saad Specialist Hospital, Nuclear Medicine, Al Khobar (Saudi Arabia); Gambhir, Sanjiv S. [Stanford Hospitals and Clinics, Division of Nuclear Medicine, Stanford, CA (United States); Stanford Hospital and Clinics, Division of Nuclear Medicine, Departments of Radiology and Bioengineering, Stanford, CA (United States)

    2009-12-15

    Only a limited number of studies have evaluated the efficacy of {sup 18}F-FDG PET/CT for recurrent cervical carcinoma, which this study seeks to expand upon. This is a retrospective study of 30 women with cervical carcinoma who had a surveillance PET/CT after initial therapy. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated using a 2 x 2 contingency table with pathology results (76%) or clinical follow-up (24%) as the gold standard. The Wilson score method was used to perform 95% confidence interval estimations. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of PET/CT for the detection of local recurrence at the primary site were 93, 93, 93, 86, and 96%, respectively. The same values for the detection of distant metastases were 96, 95, 95, 96, and 95%, respectively. Seventy-one percent of the scans performed in symptomatic patients showed true-positive findings. In comparison, 44% of scans performed in asymptomatic patients showed true-positive findings. But, all patients subsequently had a change in their management based on the PET/CT findings such that the effect was notable. The maximum standardized uptake value ranged from 5 to 28 (average: 13 {+-} 7) in the primary site and 3 to 23 (average: 8 {+-} 4) in metastases which were significantly different (p = 0.04). This study demonstrates favorable efficacy of {sup 18}F-FDG PET/CT for identification of residual/recurrent cervical cancer, as well as for localization of distant metastases. (orig.)

  13. Selective intra-arterial administration of {sup 18}F-FDG to the rat brain - effects on hemispheric uptake

    Arnberg, Fabian; Samen, Erik; Lundberg, Johan; Grafstroem, Jonas; Soederman, Michael; Stone-Elander, Sharon; Holmin, Staffan [Karolinska Institutet, Department of Clinical Neuroscience, Stockholm (Sweden); Karolinska University Hospital-Solna, Department of Neuroradiology, Stockholm (Sweden); Lu, Li [Karolinska University Hospital-Solna, KERIC, Stockholm (Sweden)

    2014-05-15

    The purpose of this study was to investigate the radioligand uptake and iodine contrast distribution in the intra- and extracranial circulation of the rat, after intra-arterial injections to the common carotid artery and different parts of the internal carotid artery. All animal experiments were carried out in accordance with Karolinska Institutet's guidelines and were approved by the local laboratory animal ethics committee. We used clinical neurointerventional systems to place microcatheters in the extra- or intracranial carotid artery of 15 Sprague-Dawley rats. Here, injection dynamics of iodine contrast was assessed using digital subtraction angiography. Maintaining the catheter position, the animals were placed in a micro PET and small-animal positron emission tomography (PET) was used to analyze injections [2-{sup 18}F]-2-fluoro-2-deoxy-d-glucose ({sup 18}F-FDG). Microcatheters had to be placed in the intracranial carotid artery (iICA) for the infusate to distribute to the brain. Selective injection via the iICA resulted in a 9-fold higher uptake of {sup 18}F-FDG in the injected hemisphere (p < 0.005) compared to both intravenous and more proximal carotid artery injections. Furthermore, selective injection gave a dramatically improved contrast between the brain and extracranial tissue. Intra-arterial injection increases the cerebral uptake of a radiotracer dramatically compared to systemic injection. This technique has potential applications for endovascular treatment of malignancies allowing intra-interventional modifications of injection strategy, based on information on tumor perfusion and risk to surrounding normal parenchyma. Furthermore the technique may increase diagnostic sensitivity and avoid problems due to peripheral pharmacological barriers and first passage metabolism of labile tracers. (orig.)

  14. Comparison of [18 F]FDG PET/CT and MRI in the diagnosis of active osteomyelitis

    Demirev, Anastas; Mottaghy, Felix [University Hospital of Maastricht, Department of Nuclear Medicine, Maastricht (Netherlands); Weijers, Rene [University Hospital of Maastricht, Department of Radiology, Maastricht (Netherlands); Geurts, Jan; Walenkamp, Geert [University Hospital of Maastricht, Department of Orthopedic Surgery, Maastricht (Netherlands); Brans, Boudewijn [University Hospital of Maastricht, Department of Nuclear Medicine, Maastricht (Netherlands); Maastricht University Medical Centre, Department of Nuclear Medicine, PO Box 5800, Maastricht (Netherlands)

    2014-05-15

    In diagnosing osteomyelitis (OM) both MRI and [18 F]FDG PET-CT proved to be accurate modalities. In anticipation of the advent of hybrid PET/MRI scanners we analyzed our patient group to give direction to future imaging strategies in patients with suspected OM. In this retrospective study all patients of a tertiary referral center who underwent both an MRI and a PET for the diagnosis of OM were included. The results of those scans were evaluated using patient's histology, microbiological findings, and clinical/radiological follow-up. Additionally, ROC curve analysis of the SUVmax and the SUVmax ratio on the PET scans was performed. Two imaging strategies were simulated: first MRI followed by PET, or vice versa. Twenty-seven localizations in 26 patients were included. Both MRI and PET were shown to be accurate in our patients for the qualitative detection of OM. A cut-off value for the SUVmax of 3 gave optimal results (a specificity of 90 % with a sensitivity of 88 %). The SUVmax ratio gave a worse performance. The two simulated imaging strategies showed no difference in the final diagnosis in 20 out of 27 cases. Remarkably, 6 equivocal cases were all correctly diagnosed by the second modality, i.e., PET or MRI. Both MRI and [18 F]FDG PET were accurate in diagnosing OM in a tertiary referral hospital population. Simulation of imaging strategies showed that a combined sequential strategy was optimal. It seems preferable to use MRI as a primary imaging tool for uncomplicated unifocal cases, whereas in cases with (possible) multifocal disease or a contraindication for MRI, PET is preferred. This combined sequential strategy looks promising, but needs to be confirmed in a larger prospective study. (orig.)

  15. Prognostic value of 18F-FDG positron emission tomography in patients with coronary artery disease and left ventricular dysfunction

    Objective: To evaluate the prognostic value of 18F-FDG positron emission tomography (PET) in patients (pts) with coronary artery disease (CAD)and left ventricular dysfunction and to clarify whether revascularization (RVS) will decrease the cardiac events in pts with myocardial perfusion-metabolism mismatch(MM). Methods: 107 consecutive pts (mean age 57 +- 9 yr.) with CAD and left ventricular dysfunction [left ventricular ejection fraction (LVEF)=(38 +- 9)%] who underwent 18F-FDG PET imaging and 99Tcm-MIBI SPECT imaging were followed up for (24 +- 5) months. Myocardial segments were classified as myocardial perfusion-metabolism mismatch (MM) and match (M). LVEF and left ventricular end diastolic diameter (LVEDD) were measured with echocardiography (Echo). Results: Fifty-nine pts underwent RVS and 48 pts underwent medical therapy. Three months (POS1) and 6 months (POS2) after RVS, Echo was performed on forty-six pts and 23 pts, respectively. Cardiac death, myocardial infarction, unstable angina pectoris and late RVS (>3 mon) were considered as cardiac events. Among 64 patients with 2 or more MM segments, 35 pts received RVS (MM1) and 29 pts received medical therapy (MM2). Among 43 pts with less than 2 MM segments, 24 pts underwent RVS (M1) and 19 pts underwent medical therapy (M2). After RVS, LVEF in MM1 was increased from (38 +- 8)% to (48 +- 10)% (P0.05). The cardiac event rate of 51.7% (15/29) in MM2 was significantly higher than that of 2.9% (1/35) in MM1 (x2 = 20.14, P2 = 7.02, P24.52, P<0.05). Conclusions: The results suggest that the presence of MM in pts with CAD and left ventricular dysfunction is associated with poor prognosis on medical therapy, and these pts may need aggressive RVS to prevent a future cardiac event and to improve left ventricular function

  16. Prognostic significance of volume based metabolic parameters by 18F FDG PET/CT in gallbladder carcinoma

    We investigated the prognostic values of volume based metabolic parameters by 18F fluorodeoxyglucose (18F FDG)positron emission tomography (PET)/computed tomography (CT)in gallbladder carcinoma patients and compared them with other prognostic parameters. We enrolled 44 patients, who were initially diagnosed with gallbladder carcinoma and under going 18F FDG PET/CT. Various metabolic volume based PET parameters of primary tumors, including maximum and average standardized uptake values (SUVmax, SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), were measured in gallbladder carcinoma patients using mediastinal blood pool activity as a threshold SUV for determining the tumor boundaries. Overall survival analysis was performed using the Kaplan Meier method with PET parameters and other clinical variables. For determining independent prognostic factors, Cox proportional hazards regression analysis was performed. Of the 44 enrolled patients, cancer- or treatment related death occurred in 30 (68.2%). The mean clinical follow up period was 22.2±10.4m (range, 0.6-35.9m). Univariate analysis demonstrated that clinical or pathologic TNM stage (P3, P=0.001), and TLG (cutoff=7.090, P<0.05)were significant prognostic factors. In multivariate analysis, both clinical or pathologic TNM stage [hazard ratio (HR)=2.019 (I vs II), 21.287 (I vs III), and 24.354 (I vs IV); P=0.001)and TLG (HR=2.930; P<0.05)were independent prognostic factors for predicting overall survival. In gallbladder cancer, TLG of the primary tumor, a volume based metabolic parameter, is a significant independent prognostic factor for overall survival in conjunction with the clinical or pathological TNM stage

  17. The value of 18F-FDG PET/CT in the diagnosis of incidental pituitary macroadenoma

    Objective: To study the incidence difference between healthy people and patients with malignant tumor, and to discuss the diagnostic value of whole-body 18F-FDG PET/CT examination on incidental pituitary macroadenomas. Methods: A review analysis was made about the image data of 1830 consecutive subjects with no history of pituitary tumor, including 600 healthy subjects and 1230 patients with known or suspected malignancy who underwent 18F-FDG PET/CT examination. The uptake intensity was recorded by maximum standardized uptake value (SUVmax) of those unexpected pituitary tumor (shot diameter greater than 1.0 cm) with high uptake. The final diagnosis was based on pathology and a 3-26 months follow-up. Compared the incidence difference between healthy people and patients with malignant tumor by Fisher exact test (SPSS 16.0). Assessed the diagnostic efficacy of PET/CT examination. Results: Pituitary tumor was accidentally discovered in 15 patients (SUVmax varied between 4.2 and 22.2), including 1 metastases SUVmax 19.5 and 14 (0.77%) pituitary macroadenomas; the incidence rate 0.17% (only 1 case was confirmed of pituitary macroadenomas) among the healthy subjects is higher than that of 1.06% (13 cases) among the malignant tumor patients. The sensitivity and accuracy of PET/CT in detecting large pituitary adenomas were 100% and 93.33% respectively. Conclusions: The incidence of pituitary macroadenoma is higher in patients with malignant tumor than that in the healthy controls. PET/CT is of practical significance in the diagnosis of the pituitary macroadenomas. (authors)

  18. The acetabular fossa hot spot on {sup 18}F-FDG PET/CT: epidemiology, natural history, and proposed etiology

    Kubicki, Shelby L. [Trinity University, San Antonio, TX (United States); Richardson, Michael L. [University of Washington, Department of Radiology, Seattle, WA (United States); Martin, Thomas [X-Ray Associates of New Mexico, Department of Radiology, Albuquerque, NM (United States); Rohren, Eric [The University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, Division of Nuclear Medicine, Houston, TX (United States); Wei, Wei [The University of Texas M.D. Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States); Amini, Behrang [The University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, Division of Musculoskeletal Radiology, Houston, TX (United States)

    2015-01-15

    To describe a benign focus of increased activity in the acetabular fossa (the acetabular fossa hot spot, AFHS) on {sup 18}F-FDG PET/CT that can mimic a neoplasm. {sup 18}F-FDG PET/CT images from four patient populations were examined. Group 1 (n = 13) was collected from a search of radiology reports and used to define the AFHS and for hypothesis generation. Group 2 (n = 1,150) was used for prevalence of AFHS. Group 3 (n = 1,213) had PET/CT and MRI pelvis within a week of each other and was used to correlate metabolic and anatomic findings. Group 4 (n = 100) was used to generate the control group. Data were collected on demographics, common comorbidities, underlying cancer diagnosis and status, and hip symptoms. Prevalence of AFHS was 0.36 % (95 % CI 0.10-0.91 %). None progressed to malignancy or was associated with cancer status. The majority (71 %) were on the left, and 6 % were bilateral. Mean SUV{sub max} of the AFHS was 4.8 (range, 2.7-7.8). Male patients were more likely to have the AFHS (OR = 8.69, 95 % CI 1.88-40.13). There was no difference with respect to other collected data, including hip symptoms. Average minimum duration of AFHS was 346 days (range, 50-1,010 days). Readers did not detect corresponding hip abnormalities on MRIs. AFHS is a benign finding that may be caused by subclinical ligamentum teres injury, focal synovitis, or degeneration of acetabular fossa fat. Despite uncertainty regarding its etiology, recognition of AFHS as a benign finding can prevent morbidity associated with unnecessary biopsy or initiation of therapy. (orig.)

  19. Supraclavicular skin temperature as a measure of 18F-FDG uptake by BAT in human subjects.

    Mariëtte R Boon

    Full Text Available Brown adipose tissue (BAT has emerged as a novel player in energy homeostasis in humans and is considered a potential new target for combating obesity and related diseases. The current 'gold standard' for quantification of BAT volume and activity is cold-induced 18F-FDG uptake in BAT. However, use of this technique is limited by cost and radiation exposure. Given the fact that BAT is a thermogenic tissue, mainly located in the supraclavicular region, the aim of the current study was to investigate whether cold-induced supraclavicular skin temperature and core body temperature may be alternative markers of BAT activation in humans.BAT volume and activity were measured in 24 healthy lean adolescent males (mean age 24.1±0.8 years, using cold-induced 18F-FDG uptake with PET-CT. Core body temperature was measured continuously in the small intestine with use of an ingestible telemetric capsule and skin temperature was measured by eighteen wireless iButtons attached to the skin following ISO-defined locations.Proximal and distal (hand/feet skin temperatures markedly decreased upon cold exposure, while supraclavicular skin temperature significantly increased (35.2±0.1 vs. 35.5±0.1°C, p = 0.001. Furthermore, cold-induced supraclavicular skin temperature positively correlated with both total (R2 = 0.28, P = 0.010 and clavicular BAT volume (R2 = 0.20, P = 0.030 and clavicular SUVmax (R2 = 0.27, P = 0.010, while core body temperature did not.Supraclavicular skin temperature as measured by iButtons may have predictive value for BAT detection in adult humans. This is highly desirable considering the increasing interest in pharmacological interventions to stimulate BAT in human subjects.NTR 2473.

  20. The acetabular fossa hot spot on 18F-FDG PET/CT: epidemiology, natural history, and proposed etiology

    To describe a benign focus of increased activity in the acetabular fossa (the acetabular fossa hot spot, AFHS) on 18F-FDG PET/CT that can mimic a neoplasm. 18F-FDG PET/CT images from four patient populations were examined. Group 1 (n = 13) was collected from a search of radiology reports and used to define the AFHS and for hypothesis generation. Group 2 (n = 1,150) was used for prevalence of AFHS. Group 3 (n = 1,213) had PET/CT and MRI pelvis within a week of each other and was used to correlate metabolic and anatomic findings. Group 4 (n = 100) was used to generate the control group. Data were collected on demographics, common comorbidities, underlying cancer diagnosis and status, and hip symptoms. Prevalence of AFHS was 0.36 % (95 % CI 0.10-0.91 %). None progressed to malignancy or was associated with cancer status. The majority (71 %) were on the left, and 6 % were bilateral. Mean SUVmax