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Sample records for 18f-fluorodeoxyglucose positron emission

  1. 18F-fluorodeoxyglucose positron emission tomography in uterine carcinosarcoma

    Uterine carcinosarcomas clinically confined to the uterus usually harbor occult metastases. We conducted a pilot study to evaluate the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in uterine carcinosarcoma. Patients with histologically confirmed uterine carcinosarcoma were enrolled. Abdominal and pelvic magnetic resonance imaging (MRI)/whole-body computed tomography (CT) scan, and whole-body 18F-FDG PET or PET/CT were undertaken for primary staging, evaluating response, and restaging/post-therapy surveillance. The clinical impact of 18F-FDG PET was determined on a scan basis. A total of 19 patients were recruited and 31 18F-FDG PET scans (including 8 scans performed on a PET/CT scanner) were performed. Positive impacts of scans were found in 36.8% (7/19) for primary staging, 66.7% (2/3) for monitoring response, and 11.1% (1/9) for restaging/post-therapy surveillance. PET excluded falsely inoperable disease defined by MRI in two patients. Aggressive treatment applying to three patients with PET-defined resectable stage IVB disease seemed futile. Two patients died of disease shortly after salvage therapy restaged by PET. With PET monitoring, one stage IVB patient treated by targeted therapy only was alive with good performance. Using PET did not lead to improvement of overall survival of this series compared with the historical control (n = 35) (P 0.779). The preliminary results suggest that 18F-FDG PET is beneficial in excluding falsely inoperable disease for curative therapy and in making a decision on palliation for better quality of life instead of aggressive treatment under the guidance of PET. PET seems to have limited value in post-therapy surveillance or restaging after failure. (orig.)

  2. [Basic principles of 18F-fluorodeoxyglucose positron emission tomography].

    Standke, R

    2002-01-01

    Positron emission tomography uses photons to receive regional information about dynamic, physiologic, and biochemical processes in the living body. A positron decay is measured indirectly by the simultaneous registration of both gamma rays created by the annihilation. The event is counted, if two directly opposite located detectors register gamma rays in coincidence. Unfortunately the detectors of a positron emission tomography system do not register only true coincident events. There are also scattered and random coincidences. Different types of positron tomographs are presented and scintillation crystals, which are in use for positron emission tomography are discussed. The 2D- and 3D-acquisition methods are described as well as preprocessing methods, such as correction for attenuation, scatter and dead time. For quantification the relative parameter standard uptake value (SUV) is explained. Finally hybrid systems, such as combined positron emission tomography/computed tomography scanners and the use of computed tomography data for attenuation correction are introduced. PMID:12506765

  3. Risk of malignancy in thyroid incidentalomas detected by (18)f-fluorodeoxyglucose positron emission tomography

    Soelberg, Kerstin; Bonnema, Steen Joop; Brix, Thomas Heiberg;

    2012-01-01

    Background: The expanding use of (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) has led to the identification of increasing numbers of patients with an incidentaloma in the thyroid gland. We aimed to review the proportion of incidental thyroid cancers found by (18)F-FDG PET...... uptake, 7 of whom (4.4%) had thyroid malignancy. In the eight studies reporting individual maximum standardized uptake values (SUV(max)), the mean SUV(max) was 4.8 (standard deviation [SD] 3.1) and 6.9 (SD 4.7) in benign and malignant lesions, respectively (p...

  4. Predicting Outcome in Patients with Rhabdomyosarcoma: Role of [{sup 18}F]Fluorodeoxyglucose Positron Emission Tomography

    Casey, Dana L. [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Wexler, Leonard H. [Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Fox, Josef J. [Department of Nuclear Medicine, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Dharmarajan, Kavita V. [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York (United States); Schoder, Heiko [Department of Nuclear Medicine, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Price, Alison N. [Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Department of Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania (United States); Wolden, Suzanne L., E-mail: woldens@mskcc.org [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States)

    2014-12-01

    Purpose: To evaluate whether [{sup 18}F]fluorodeoxyglucose positron emission tomography (FDG-PET) response of the primary tumor after induction chemotherapy predicts outcomes in rhabdomyosarcoma (RMS). Methods and Materials: After excluding those with initial tumor resection, 107 patients who underwent FDG-PET after induction chemotherapy at Memorial Sloan Kettering Cancer Center from 2002 to 2013 were reviewed. Local control (LC), progression-free survival (PFS), and overall survival (OS) were calculated according to FDG-PET response and maximum standardized uptake value (SUV) at baseline (PET1/SUV1), after induction chemotherapy (PET2/SUV2), and after local therapy (PET3/SUV3). Receiver operator characteristic curves were used to determine the optimal cutoff for dichotomization of SUV1 and SUV2 values. Results: The SUV1 (<9.5 vs ≥9.5) was predictive of PFS (P=.02) and OS (P=.02), but not LC. After 12 weeks (median) of induction chemotherapy, 45 patients had negative PET2 scans and 62 had positive scans: 3-year PFS was 72% versus 44%, respectively (P=.01). The SUV2 (<1.5 vs ≥1.5) was similarly predictive of PFS (P=.005) and was associated with LC (P=.02) and OS (P=.03). A positive PET3 scan was predictive of worse PFS (P=.0009), LC (P=.05), and OS (P=.03). Conclusions: [{sup 18}F]fluorodeoxyglucose positron emission tomography is an early indicator of outcomes in patients with RMS. Future prospective trials may incorporate FDG-PET response data for risk-adapted therapy and early assessment of new treatment regimens.

  5. Muscle activity during a dash shown by 18F-fluorodeoxyglucose positron emission tomography

    18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been used to examine muscle activity during running. The dash is a basic activity in various kinds of sports but differs from running in terms of intensity and severity. The purpose of this study was to evaluate muscle activity during running at full speed using FDG PET. Six healthy men were investigated during a dash for 10 min after intravenous injection of FDG (37 MBq). Another six healthy men were studied as controls. PET images were obtained 45 min after the FDG injection. Regions of interest were drawn on the anterior and posterior thighs and the anterior and posterior legs. The standardized uptake value (SUV) was calculated to examine the FDG uptake of muscle tissue per unit volume according to an equation. In the control group, the mean SUVs of the anterior thigh, posterior thigh, anterior leg, and posterior leg were 0.49±0.04, 0.44±0.02, 0.46±0.05, and 0.44±0.07, respectively. In the dash group, the mean SUVs of the anterior thigh, posterior thigh, anterior leg, and posterior leg were 0.74±0.20, 0.79±0.08, 0.61±0.07, and 0.60±0.08, respectively. FDG accumulation of every one of the four compartments in the dash group was significantly higher than that in the control. FDG accumulation of the posterior thigh was significantly higher than that of the anterior and the posterior leg in the dash group (P<0.02). Based on the results of our investigation, posterior thigh muscles were especially active during a dash. (author)

  6. {sup 18}F-fluorodeoxyglucose uptake on positron emission tomography in mucinous adenocarcinoma

    Murakami, Shuji, E-mail: murakamis@kcch.jp [Department of Thoracic Oncology, Kanagawa Cancer Center Hospital (Japan); Saito, Haruhiro; Karino, Fumi; Kondo, Tetsuro; Oshita, Fumihiro; Ito, Hiroyuki; Nakayama, Haruhiko [Department of Thoracic Oncology, Kanagawa Cancer Center Hospital (Japan); Yokose, Tomoyuki [Department of Pathology, Kanagawa Cancer Center Hospital (Japan); Yamada, Kouzo [Department of Thoracic Oncology, Kanagawa Cancer Center Hospital (Japan)

    2013-11-01

    Background: The prognostic value of maximum standardized uptake value (maxSUV) on {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) is known for localized pulmonary adenocarcinoma, which is most commonly non-mucinous adenocarcinoma. We examined the validity of thin-section computed tomography (TS-CT) and FDG-PET findings in mucinous adenocarcinoma. Materials and Methods: TS-CT and FDG-PET were performed on 25 patients with mucinous lung adenocarcinoma that was subsequently resected between January 2009 and March 2013. Based on the percentage reduction of maximum tumor diameter on the mediastinal window image compared with the diameter on the lung window image on TS-CT, tumors were classified as air-type (≥50%) or solid-type (<50%). All resected specimens were pathologically diagnosed according to the International Association for the Study of Lung Cancer (IASLC) classification, and the diameter of the pathological invasive area was assessed. Results: Most mucinous adenocarcinomas were located in the lower lobe. All except two were classified as solid-type tumor on TS-CT. Multiple regression analysis revealed the correlation of maxSUV with pathological tumor size and diameter of pathological invasive area; these two parameters showed no significant correlation with each other (r = 0.354, p = 0.083). maxSUV was significantly lower for tumors with invasive area ≤5 mm than for tumors with invasive area >5 mm (1.62 vs. 3.77, p = 0.01), but no statistically significant difference was found in terms of other pathological invasive findings such as the presence of lymphatic or vascular invasion, pleural involvement, or predominant histological subtype. Conclusions: Most mucinous adenocarcinomas had appearances of solid-type tumor on TS-CT. maxSUV on FDG-PET indicates the pathological invasive area in mucinous adenocarcinoma as well as non-mucinous adenocarcinoma.

  7. Highly metabolic thrombus of the portal vein: 18F fluorodeoxyglucose positron emission tomography/computer tomography demonstration and clinical significance in hepatocellular carcinoma

    Sun, Long; Guan, Yong-Song; Pan, Wei-Ming; Chen, Gui-Bing; Luo, Zuo-Ming; Wei, Ji-Hong; Wu, Hua

    2008-01-01

    AIM: To assess the ability of 18F-fluorodeoxyglucose positron emission tomography/computer tomography (18F-FDG PET/CT) to differentiate between benign and malignant portal vein thrombosis in hepatocellular carcinoma (HCC) patients.

  8. Arterial Stiffness Is Positively Associated With 18F-fluorodeoxyglucose Positron Emission Tomography-Assessed Subclinical Vascular Inflammation in People With Early Type 2 Diabetes

    de Boer, Stefanie A; Hovinga-de Boer, Marieke C; Heerspink, Hiddo J L; Lefrandt, Joop D; van Roon, Arie M; Lutgers, Helen L; Glaudemans, Andor W J M; Kamphuisen, Pieter W; Slart, Riemer H J A; Mulder, Douwe J

    2016-01-01

    OBJECTIVE: Type 2 diabetes is accompanied by premature atherosclerosis and arterial stiffness. The underlying association remains incompletely understood. The possible relationship between subclinical arterial inflammation assessed by (18)F-fluorodeoxyglucose (FDG) positron emission tomography/compu

  9. Lymphomatous involvement of gastrointestinal tract: Evaluation by positron emission tomography with 18F-fluorodeoxyglucose

    Sith Phongkitkarun; Vithya Varavithya; Toshiki Kazama; Silvana C Faria; Martha V Mar; Donald A Podoloff; Homer A Macapinlac

    2005-01-01

    AIM: To demonstrate the 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) findings in patients with non-Hodgkin's lymphoma (NHL) involving the gastrointestinal (GI) tract and the clinical utility of modality despite of the known normal uptake of FDG in the GI tract.METHODS: Thirty-three patients with biopsy-proven gastrointestinal NHL who had undergone FDG-PET scan were included. All the patients were injected with 10-15 mCi FDG and scanned approximately 60 min later with a CTI/Siemens HR (+) PET scanner. PET scans were reviewed and the maximum standard uptake value (SUVmax) of the lesions was measured before and after the treatment,if data were available and compared with histologic diagnoses.RESULTS: Twenty-five patients had a high-grade lymphoma and eight had a low-grade lymphoma. The stomach was the most common site of the involvement (20 patients). In high-grade lymphoma, PET showed focal nodular or diffuse hypermetabolic activity. The average SUVmax±SD was 11.58±5.83. After the therapy,the patients whose biopsies showed no evidence of lymphoma had a lower uptake without focal lesions.The SUVmax±SD decreased from 11.58±5.83 to 2.21±0.78. In patients whose post-treatment biopsies showed lymphoma, the SUVmax±SD was 9.42±6.27. Low-grade follicular lymphomas of the colon and stomach showed diffuse hypermetabolic activity in the bowel wall (SUVmax 8.2 and 10.3, respectively). The SUVmax was 2.02-3.8 (mean 3.02) in the stomach lesions of patients with MALT lymphoma.CONCLUSION: 18F-FDG PET contributes to the diagnosis of high-grade gastrointestinal non-Hodgkin's lymphoma,even when there is the normal background FDG activity. Furthermore, the SUV plays a role in evaluating treatment response. Low-grade NHL demonstrates FDG uptake but at a lesser intensity than seen in high-grade NHL.

  10. Contrast-enhanced 18F-fluorodeoxyglucose positron emission tomography/computed tomography in immunoglobulin G4-related retroperitoneal fibrosis

    Immunoglobulin G4 (IgG4)-related disease encompasses a wide variety of immune disorders previously thought be distinct. IgG4-related retroperitoneal fibrosis is one such entity. Metabolic imaging with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) can be useful in the management of IgG4-related retroperitoneal fibrosis. We here discuss the case of 63-year-old male with IgG4-related retroperitoneal fibrosis and the role, 18F-FDG PET/CT played in his management

  11. Role of 18F fluorodeoxyglucose positron-emission tomography/computed tomography in the management of Askin's tumor

    A primitive neuroectodermal tumor (PNET) of the thoraco-abdominal region is one of a group of small round cell tumors usually found in children and young adults, originally described by Askin et al. Most cases arise in the soft-tissues of the thorax, but may rarely occur within the lung with the symptoms of chest wall pain, pleural effusion and dyspnea. The authors present two cases demonstrating the utility of 18F fluorodeoxyglucose positron-emission tomography/computed tomography in the staging and prognosis of PNET of the chest wall. (author)

  12. 18F-fluorodeoxyglucose positron emission tomography/computed tomography in a case of non-ketotic hyperglycemia

    Hemichorea and generalized chorea are rare syndromes associated with nonketotic hyperglycemia. This disorder usually afflicts elderly females, and may herald the onset of new onset diabetes, usually type 2. There are conflicting reports of the underlying pathophysiology of this rare entity. Magnetic resonance imaging findings have been described in the past, and are characteristic. There are very few reports of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) findings of this unusual dyskinetic syndrome. This report describes the PET/CT features of this rare disease. Early detection and prompt correction of hyperglycemia may lead to complete or significant amelioration of symptoms

  13. Venous thrombosis of sarcoidosis as an unusual incidental finding on 18F-fluorodeoxyglucose positron emission tomography/computed tomography

    Sarcoidosis is defined as a multisystem granulomatous disorder of unknown cause. Venous thrombosis (VT) in the sarcoidosis is rare. The routine use of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) has resulted in clinicians detecting many incidental findings, which have proven to be clinically significant such as thrombosis. Here, we present a case with VT of sarcoidosis in the inferior vena cava and portal vein as an unusual incidental finding on 18F-FDG PET/CT

  14. Diagnostic role of 18F-fluorodeoxyglucose positron emission tomography for follicular lymphoma with gastrointestinal involvement

    Masaya Iwamuro; Hiroyuki Okada; Katsuyoshi Takata; Katsuji Shinagawa; Shigeatsu Fujiki; Junji Shiode; Atsushi Imagawa

    2012-01-01

    AIM:To investigate the capacity for 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)to evaluate patients with gastrointestinal lesions of follicular lymphoma.@@METHODS:This retrospective case series consisted of 41 patients with follicular lymphoma and gastrointestinal involvement who underwent 18F-FDG-PET and endoscopic evaluations at ten different institutions between November 1996 and October 2011.Data for endoscopic,radiological,and biological examinations performed were retrospectively reviewed from clinical records.A semi-quantitative analysis of 18F-FDG uptake was performed for each involved area by calculating the maximum standardized uptake value (SUVmax).Based on the positivity of 18F-FDG uptake in the gastrointestinal lesions analyzed,patients were subdivided into two groups.To identify potential predictive factors for 18F-FDG positivity,these two groups were compared with respect to gender,age at diagnosis of lymphoma,histopathological grade,pattern of follicular dendritic cells,mitotic rate,clinical stage,soluble interleukin-2 receptor levels detected by 18F-FDG-PET,lactate dehydrogenase (LDH) levels,hemoglobin levelsbone marrow involvement,detectability of gastrointestinal lesions by computed tomography (CT) scanningand follicular lymphoma international prognostic index (FLIPI) risk.@@RESULTS:Involvement of follicular lymphoma in the stomach,duodenum,jejunum,ileum,cecum,colon,and rectum was identified in 1,34,6,3,2,3,and 6patients,respectively.No patient had esophageal involvement.In total,19/41 (46.3%) patients exhibited true-positive 18F-FDG uptake in the lesions present in their gastrointestinal tract.In contrast,false-negative 18F-FDG uptake was detected in 24 patients (58.5%),while false-positive 18F-FDG uptake was detected in 5 patients (12.2%).In the former case,2/19 patients had both 18F-FDG-positive lesions and 18F-FDG-negative lesions in the gastrointestinal tract.In patients with 18F-FDG avidity,the SUVmax value of

  15. 18F-fluorodeoxyglucose positron emission tomography and magnetic resonance imaging findings of primary intracranial histiocytic sarcoma in a dog

    A 10-year-old, neutered male, Maltese dog presented with a three week history of intention tremor, right hind limb rigidity, poor coordination, and occasional circling to the left. On magnetic resonance imaging (MRI) of the brain, a mass was identified in the right occipital lobe and cerebellum. Three weeks after the initial MRI scan, we performed an sup(18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) of the brain. The FDG-PET demonstrated areas of hypermetabolism in the right occipital lobe, cerebellum, pons, and medulla oblongata. When the standardized uptake value was calculated, the hypermetabolic lesion was higher than the gray matter values. The anatomical location of the hypermetabolic lesion was more precisely identified by the PET-MRI fusion images. The dog was definitively diagnosed as a primary histiocytic sarcoma of the brain. This is the first report of PET findings of an intracranial histiocytic sarcoma in a dog

  16. Contribution of 18F-fluorodeoxyglucose positron emission tomography in the detection and evaluation of peritoneal metastasis in colorectal cancer

    Accurate detection of peritoneal metastasis in colorectal cancer remains a diagnostic challenge. The accuracy of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in the diagnosis of peritoneal recurrence was evaluated, FDG-PET was conducted in 18 patients previously treated for colorectal cancer and suspected recurrence with clinical symptoms, computed tomography (CT), and tumor markers. Final Diagnosis was obtained by histological evaluation (n=14) or clinical follow-up (n=4). FDG-PET sensitivity was 88%, and accuracy in detecting peritoneal recurrence was 78%. For CT scans, sensitivity was 38% and accuracy 44% Six patients were suspected to have peritoneal recurrence based on FDG-PET and 5 were identified pathologically with peritoneal metastasis. Lesions smaller than 30 mm were not detected by CT. FDG-PET detected 15 mm lesions. In conclusion, FDG-PET is an accurate, noninvasive way to detect peritoneal recurrence in colorectal cancer and would play an important role in clinical management. (author)

  17. [18F]Fluorodeoxyglucose (FDG)-Positron Emission Tomography (PET)/Computed Tomography (CT) in Suspected Recurrent Breast Cancer

    Hildebrandt, Malene Grubbe; Gerke, Oke; Baun, Christina;

    2016-01-01

    PURPOSE: To prospectively investigate the diagnostic accuracy of [(18)F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) with dual-time-point imaging, contrast-enhanced CT (ceCT), and bone scintigraphy (BS) in patients with suspected breast cancer recurrence....... PATIENTS AND METHODS: One hundred women with suspected recurrence of breast cancer underwent 1-hour and 3-hour FDG-PET/CT, ceCT, and BS within approximately 10 days. The study was powered to estimate the precision of the individual imaging tests. Images were visually interpreted using a four......-point assessment scale, and readers were blinded to other test results. The reference standard was biopsy along with treatment decisions and clinical follow-up (median, 17 months). RESULTS: FDG-PET/CT resulted in no false negatives and fewer false positives than the other imaging techniques. Accuracy of results...

  18. Realizing the potential of positron emission tomography with 18F-fluorodeoxyglucose to improve the treatment of Alzheimer's disease.

    Foster, Norman L; Wang, Angela Y; Tasdizen, Tolga; Fletcher, P Thomas; Hoffman, John M; Koeppe, Robert A

    2008-01-01

    Positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG-PET) thus far rarely has been used to advance the development of new treatments for Alzheimer's disease (AD). Now that FDG-PET with standard acquisition protocols for dementia is widely available, change in cerebral glucose metabolism is a feasible outcome variable for clinical drug trials. Individual analysis of FDG-PET results also might prove valuable. FDG-PET can detect metabolic changes very early in the course of AD and identify subjects for earlier treatment. FDG-PET reliably distinguishes AD from frontotemporal dementia so that only those most likely to benefit are enrolled in trials. Finally, objectively identifying phenotypic variations of AD with FDG-PET might have pathogenic and prognostic implications that can be used for personalized treatment approaches. The judicious use of FDG-PET is needed to accelerate the evaluation of promising new drugs and more rationally target treatments for dementing diseases. PMID:18631997

  19. Clinical impact of 18F-fluorodeoxyglucose positron emission tomography in the diagnosis of neurological diseases

    In this review it will be discussed in which neurological disorders positron emission tomography can yield important diagnostic information. Because positron emission tomography is an expensive method indications have to be cleary defined. One important question concerns the differentiation of tumor recurrence and scar due to radiation therapy or an operation. The grading of brain tumors is another application. In HIV patients fluorodeoxyglucose positron emission tomography can separate lymphoma and toxoplasmosis. In the evaluation of dementia positron emission tomography can help to clarify the differential diagnosis. Another important area is the presurgical evaluation of epilepsy patients and patients with cerebrovascular disease in whom a surgical revascularization procedure is planned. In extrapyramidal disorders, positron emission tomography can often help to establish the final diagnosis. (author)

  20. 18F-fluorodeoxyglucose positron emission tomography optimizes neoadjuvant chemotherapy for primary breast cancer to achieve pathological complete response

    The background of this study was to assess the usefulness of positron emission tomography combined with computed tomography using 18F-fluorodeoxyglucose (FDG positron emission tomography (PET)/CT) for optimizing chemotherapy during neoadjuvant chemotherapy for primary breast cancer. One hundred and eight patients (110 tumors) with breast cancer (≥2 cm, stages II and III) received neoadjuvant chemotherapy consisting of an anthracycline-based regimen and taxane. The maximal value of the baseline standardized uptake value (SUV) and the change in SUV after four cycles of an anthracycline-based regimen relative to baseline SUV were assessed for predicting pathological complete response (pCR) after sequential taxane. Tumors with pCR had significantly higher baseline SUV (9.3±3.7 SD) compared to those with non-pCR (7.2±3.8 SD) (p=0.02), but there was a considerable overlap between two groups. On PET scan after four cycles of chemotherapy, thirty-three patients (33.7%) with a 72.1% or greater reduction in SUV were considered as responders and the performance in predicting pCR had a sensitivity of 88.9% and specificity of 78.7%. The baseline SUV could not be a useful indicator for predicting pCR due to the wide range in sensitivity. On the other hand, a relative change in SUV after completion of an anthracycline-based regimen could be useful for predicting pCR. (author)

  1. Regional cerebral metabolic alterations in dementia of the Alzheimer type: positron emission tomography with [18F]fluorodeoxyglucose

    Alzheimer disease is the most common cause of dementia in adults. Despite recent advances in our understanding of its anatomy and chemistry, we remain largely ignorant of its pathogenesis, physiology, diagnosis, and treatment. Dynamic positron emission tomography using [18F]fluorodeoxyglucose (FDG) was performed on the Donner 280-crystal ring in 10 subjects with dementia of the Alzheimer type and six healthy age-matched controls. Ratios comparing mean counts per resolution element in frontal, temporoparietal, and entire cortex regions in brain sections 10 mm thick obtained 40-70 min following FDG injection showed relatively less FDG uptake in the temporoparietal cortex bilaterally in all the Alzheimer subjects (p less than 0.01). Left-right alterations were less prominent than the anteroposterior changes. This diminished uptake was due to lowered rates of FDG use and suggests that the metabolic effects of Alzheimer disease are most concentrated in the temporoparietal cortex. Positron emission tomography is a most powerful tool for the noninvasive in vivo assessment of cerebral pathophysiology in dementia

  2. 18F-fluorodeoxyglucose positron emission tomography-positive sarcoidosis after chemoradiotherapy for Hodgkin’s disease: a case report

    Pham Alan

    2011-06-01

    Full Text Available Abstract Introduction The occurrence of granulomatous disease in the setting of Hodgkin's disease is rare; however, when it occurs it can pose significant clinical and diagnostic challenges for physicians treating these patients. Case presentation We report the case of a 33-year-old Caucasian woman of Mediterranean descent with newly diagnosed 18F-fluorodeoxyglucose (18F-FDG positron emission tomography (PET/computed tomography (CT scan-positive, early-stage Hodgkin's disease involving the cervical nodes who, despite having an excellent clinical response to chemotherapy, had a persistent 18F-FDG PET scan-positive study, which was suggestive of residual or progressive disease. A subsequent biopsy of her post-chemotherapy PET-positive nodes demonstrated sarcoidosis with no evidence of Hodgkin's disease. Conclusion This case highlights the fact that abnormalities observed on posttherapy PET/CT scans in patients with Hodgkin's disease are not always due to residual or progressive disease. An association between Hodgkin's disease and/or its treatment with an increased incidence of granulomatous disease appears to exist. Certain patterns of 18F-FDG uptake observed on PET/CT scans may suggest other pathologies, such as granulomatous inflammation, and because of the significant differences in prognosis and management, clinicians should maintain a low threshold of confidence for basing their diagnosis on histopathological evaluations when PET/CT results appear to be incongruent with the patient's clinical response.

  3. Dynamic 18F-fluorodeoxyglucose positron emission tomography/CT in hibernoma: enhanced tracer uptake mimicking liposarcoma

    Christos; Sachpekidis; Safwan; Roumia; Matthias; Schwarzbach; Antonia; Dimitrakopoulou-Strauss

    2013-01-01

    We report on two cases of patients with fat-equivalent masses in computed tomography(CT),referred to our department for dynamic positron emission tomography/CT(dPET/CT)with18F-fluorodeoxyglucose(18FFDG)in order to investigate their dignity.Both qualitative and quantitative information,as derived from dPET/CTs,couldn’t exclude a high-grade liposarcoma:Visual evaluation,revealed a large hypermetabolic focus of intense18F-FDG uptake in each patient(average SUVs 8.3 and 11.3).Regression-based parametric imaging demonstrated an enhanced distribution volume,which correlates to perfusion,and a high phosphorylation rate that correlates to cell viability.Kinetic analysis,based on a two-tissue compartment model demonstrated an enhanced FDG transport k1and an enhanced phosphorylation rate k3.A non-compartmental approach based on fractal dimension revealed also enhanced values.However,final diagnosis was based on biopsy,which revealed hibernoma,a benign brown fat tumor.Brown adipose contains increased numbers of mitochondria and a high-rate of glucose metabolism.Therefore,they have increased FDG uptake.The evaluation of lipomatous lesions on CT,with high FDG uptake,should include the possibility of hibernoma as a differential diagnosis.

  4. Metabolic patterns of the shoulder joint on 18F-fluorodeoxyglucose positron emission tomography/computed tomography in adhesive capsulitis

    The purpose of our study was to demonstrate metabolic patterns on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with adhesive capsulitis (AC). We retrospectively reviewed 18F-FDG PET/CT performed on 22 shoulders of 21 patients diagnosed with AC: 2 shoulders with stage I, 14 with stage II, and 6 with stage III. A clinical diagnosis of AC was retrospectively made based on clinical examination, clinical course, and imaging. The pattern of radiotracer uptake was analyzed. Standardized uptake values in rotator interval (RI), anterior joint capsule (AJC), axillary recess (AR), and greater tuberosity were measured and compared to those of the contralateral side and the control group consisting of 40 shoulders in 20 subjects without shoulder pain. Four patterns of uptake were noted: (1) glenoid type I (n=16), with uptake in RI. AJC, and AR; (2) glenoid type II (n=2), with uptake in AJC and AR; (3) glenoid type III (n=2), with uptake in RI and AJC; (4) focal type (n=2), with uptake in RI or AR. Affected side SUVmax for RI, AJC, and AR was significantly higher compared with the unaffected side and the control group. Two shoulders with stage I AC had patterns similar to the ones with stage II or III. Specific patterns of 18F-FDG uptake with dominant uptake in RI, AJC, or AR may be related to AC. (author)

  5. 18F-fluorodeoxyglucose positron emission tomography immediately after chemoradiotherapy predicts prognosis in patients with locoregional postoperative recurrent esophageal cancer

    The objectives of this study were to reveal the utility of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) within 7 days after chemoradiotherapy to predict prognosis in patients with postoperative recurrent esophageal cancer. Patients scheduled to undergo concurrent chemoradiotherapy for postoperative locoregional recurrence of esophageal cancer were recruited. Selection criteria were: locoregional recurrence, no previous radiation therapy, planning treatment with concurrent chemoradiotherapy, FDG-PET performed max) after chemoradiotherapy was 2.4, and median SUVmax before chemoradiotherapy was 8.4. Cause-specific survival and local control rates were significantly better for patients with SUVmax ≤2.4 after chemoradiotherapy (log-rank test, P=0.033 and 0.010, respectively). SUVmax before chemoradiotherapy tended to be correlated only with cause-specific survival rate (log-rank test, P=0.076). Change in metabolic activity of FDG was significantly correlated with local control rate (log-rank test, P=0.042). FDG-PET performed even <7 days after chemoradiotherapy predicts prognosis in patients with postoperative recurrent esophageal cancer. (author)

  6. Segmental acquisition method for stationary objects in 18F-fluorodeoxyglucose positron emission tomography tests

    We investigated whether images of stationary objects obtained by segmental acquisition with positron emission tomography using 2-deoxy-2-[18F]-fluoro-D-glucose (FDG-PET) are of a quality equivalent to those obtained by conventional continuous acquisition. Phantoms filled with FDG and mid-abdominal regions of 18 patients who underwent FDG-PET tests were imaged by both continuous and segmental acquisition methods. The total acquisition time was set to 3 min; in the segmental acquisition mode, imaging for 15 s was repeated 12 times. Segmental images (SIs) obtained by superimposition of the reconstructed images were compared quantitatively and visually with continuous images (CIs). In all the phantom and clinical studies, SIs were never worse than CIs. The variances of the background counts of SIs were 9.8% and 13.0% less those of CIs in phantom and clinical studies, respectively. Visual assessments showed that SIs provided better detection of hot areas and superior image quality when compared to CIs. For stationary objects, the quality of images obtained by the segmental method is equivalent to that of images obtained conventionally by continuous acquisition. Moreover, under some conditions SIs provide better results than CIs. (author)

  7. 18F-fluorodeoxyglucose positron emission tomography might be useful for diagnosis of hepatic amyloidosis

    Tawada A

    2014-06-01

    Full Text Available Akinobu Tawada,1 Tatsuo Kanda,1 Takashi Oide,2 Toshio Tsuyuguchi,1 Fumio Imazeki,1,3 Yukio Nakatani,2 Osamu Yokosuka11Department of Gastroenterology, 2Department of Diagnostic Pathology, Chiba University Hospital, Chuo-ku, Chiba, Japan; 3Safety and Health Organization, Chiba University, Inage-ku, Chiba, JapanAbstract: We report on a woman with hepatic involvement of primary systemic (immunoglobulin light chain, AL amyloidosis. Her diagnosis was confirmed by liver biopsy. Clinical symptoms of hepatic amyloidosis are generally mild at its first stage, with most frequent findings being hepatomegaly and alkaline phosphatase elevation. Recent advances in the understanding of the pathophysiology of systemic amyloidosis have made several treatments available. However, its prognosis is occasionally poor. Because liver biopsy is not always safe, other modalities for the diagnosis are needed. Of interest was that fluorodeoxyglucose (FDG uptake into the liver was observed, compared with that into the spleen, in this patient, indicating that FDG positron emission tomography and computed tomography might be useful for the diagnosis of hepatic amyloidosis with mild liver dysfunction.Keywords: amyloidosis, diagnosis, hepatic involvement, FDG PET

  8. Heterogeneous bone marrow uptake on interim 18F-fluorodeoxyglucose positron emission tomography for lymphoma mimicking disease progression: a case report

    Cherk, Martin H; Patil, Sushrut; Beech, Paul; Kalff, Victor

    2014-01-01

    Introduction The use of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) scanning for baseline staging and assessment of treatment response for higher grade lymphomas is considered to be the standard of care. Evaluation of lymphomatous bone marrow infiltration on 18F-FDG PET can usually distinguish between normal regenerating marrow following chemotherapy by a characteristic pattern of uptake. Case presentation Here we report the case of a 51-year-old Caucasian woman with mix...

  9. Comparison between 18F-Fluorodeoxyglucose Positron Emission Tomography and Sentinel Lymph Node Biopsy for Regional Lymph Nodal Staging in Patients with Melanoma: A Review of the Literature

    Aim. to compare 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) to sentinel lymph node biopsy (SLNB) for regional lymph nodal staging in patients with melanoma. Methods. We performed a literature review discussing original articles which compared FDG-PET to SLNB for regional lymph nodal staging in patients with melanoma. Results and Conclusions. There is consensus in the literature that FDG-PET cannot replace SLNB for regional lymph nodal staging in patients with melanoma

  10. Diagnostic value of 18F-fluorodeoxyglucose positron emission tomography for pancreatic neuroendocrine tumors with reference to the World Health Organization classification

    Masui, Toshihiko; Doi, Ryuichiro; Ito, Tatsuo; KAMI, KAZUHIRO; Ogawa, Kohei; Harada, Daisuke; Uemoto, Shinji

    2010-01-01

    The 2004 classification of the World Health Organization (WHO) has demonstrated an efficacy for prediction of the prognosis of pancreatic neuroendocrine tumors. This study aimed to assess the predictive value of preoperative 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in relation to the 2004 WHO criteria. The histology of 21 pancreatic endocrine tumors resected at our hospital was reviewed and the tumors were classified according to the 2004 WHO criteria. FDG-PET findings we...

  11. The use of molecular sieves to simulate hot lesions in (18)F-fluorodeoxyglucose--positron emission tomography imaging.

    Matheoud, R; Secco, C; Ridone, S; Inglese, E; Brambilla, M

    2008-04-21

    We investigated the use of a kind of zeolite, the Bowie chabazite, to produce radioactive sources of different shapes, dimensions and activity concentrations that can be used for lesion simulation in positron emission tomography (PET) imaging. The (18)F-fluorodeoxyglucose ((18)F-FDG) uptake of a group of 12 zeolites was studied as a function of their weight (120-1,520 mg) and of the activity concentration of the (18)F-FDG solution (1-37 MBq ml(-1)), using a multiple linear regression model. The reproducibility, homogeneity and stability over time of the (18)F-FDG uptake were assessed. The fit of the regression model is good (r(2) = 0.83). This relation allows the production of zeolites of a desired (18)F-FDG activity using knowledge of the concentration of the soaking solution and the weight of the zeolite. The reproducibility of the (18)F-FDG uptake after heating the zeolites is elevated (CV% = 3.68). The almost complete regeneration of the zeolites allows us to reuse them in successive experiments. The stability of the (18)F-FDG uptake on zeolites is far from ideal. When placed in a saline solution the 'activated' zeolites release the (18)F-FDG with an effective half-time of 53 min. The sealing of the zeolites in plastic film bags has been demonstrated to be effective in preventing any release of (18)F-FDG. These features, together with their variable dimensions and shapes, make them ideal (18)F-FDG sources with a fixed target-to-background ratio that can be placed anywhere in a phantom to study lesion detectability in PET imaging. PMID:18379022

  12. Influence of [18F] fluorodeoxyglucose positron emission tomography on salvage treatment decision making for locally persistent nasopharyngeal carcinoma

    Purpose: The purpose of this study was to evaluate the role of [18F] fluorodeoxyglucose positron emission tomography (FDG-PET) in influencing salvage treatment decision making for locally persistent nasopharyngeal carcinoma (NPC). Methods and Materials: A total of 33 NPC patients with histologic persistence at nasopharynx 1 to 6 weeks after a full course of radiotherapy underwent both computed tomography (CT) and FDG-PET/CT simulation at the same treatment position. The salvage treatment decisions, with regard to the decision to offer salvage treatment and the definition of gross tumor volume (GTV), were made before knowledge of the FDG-PET findings. Subsequently the salvage treatment decisions were made again based on the FDG-PET findings and compared with the pre-FDG-PET decisions. Results: All 33 patients were referred for salvage treatment in the pre-FDG-PET decision. After knowledge of the FDG-PET results, the decision to offer salvage treatment was withdrawn in 4 of 33 patients (12.1%), as no abnormal uptake of FDG was found at nasopharynx. Spontaneous remission was observed in repeat biopsies and no local recurrence was found in these 4 cases. For the remaining 29 patients, GTV based on FDG-PET was smaller than GTV based on CT in 24 (82.8%) cases and was greater in 5 (17.2%) cases, respectively. The target volume had to be significantly modified in 9 of 29 patients (31%), as GTV based on FDG-PET images failed to be enclosed by the treated volume in the salvage treatment plan performed based on GTV based on CT simulation images. Conclusion: Use of FDG-PET was found to influence the salvage treatment decision making for locally persistent NPC by identifying patients who were not likely to benefit from additional treatment and by improving accuracy of GTV definition in salvage treatment planning

  13. Role of 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Evaluation of Cytologically Indeterminate Thyroid Nodules

    Buyukdereli

    2016-01-01

    Full Text Available Background Thyroid nodules with indeterminate fine-needle aspiration biopsy (FNAB results remain a diagnostic dilemma, because 70 - 85% of these nodules have been found to be benign after thyroid surgery. Objectives The purpose of this study was to evaluate the usefulness of 18F-fluorodeoxyglucose (FDG positron emission tomography/computed tomography (PET/CT in the preoperative diagnosis of cytologically indeterminate nodules. Patients and Methods Forty-six patients were included in this study. These individuals had undergone FDG PET/CTs for the preoperative evaluation of thyroid nodules with indeterminate FNAB results. The results of the preoperative PET/CT scans were compared with the postoperative pathological results and statistically analyzed. Results Of the 46 patients included in our study, the histopathology of the surgical specimens revealed thyroid cancer in 17 individuals (37%, 17/46. The PET/CT scan showed a positive result in 27 patients. Of these, 16 patients (59.3% were found to have thyroid carcinomas. In addition, the PET/CT scan was considered to be negative in 19 patients, 18 (94.7% of whom had benign lesions. For the detection of malignant lesions, the values for the sensitivity and specificity, and the positive predictive and negative predictive values were 94%, 62%, 59%, and 95%, respectively. Conclusion The FDG PET/CT showed a high sensitivity and a high negative predictive value for identifying malignancies in thyroid nodules with indeterminate FNAB results. Therefore, the FDG PET/CT may be a helpful tool in the clinical management of these nodules. When an FDG positive lesion is detected, further examination is recommended.

  14. Clinical applications of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in carcinoma of unknown primary

    HU Man; YU Jin-ming; ZHAO Wei; ZHANG Pin-liang; JU Gui-fang; FU Zheng; ZHANG Guo-li; KONG Li; YANG Yan-qin; MA Yi-dong

    2011-01-01

    Background Carcinoma of unknown primary (CUP) encompasses a heterogeneous group of tumors with varying clinical features. The management of patients of CUP remains a clinical challenge. The purpose of this study was to evaluate the clinical applications of integrated 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) information in patients with CUP,including detecting the occult primary tumor and effecting on disease therapy.Methods One hundred and forty-nine patients with histologically-proven metastases of CUP were included. For all patients,the conventional diagnostic work-up was unsuccessful in localizing the primary site. Whole-body PET/CT images were obtained approximately 60 minutes after intravenous injection of 350-425 MBq of 18F-FDG.Results In 24.8% of patients,FDG PET/CT detected primary tumors that were not apparent after conventional workup.In this group of patients,the overall sensitivity,specificity,and accuracy rates of FDG PET/CT in detecting unknown primary tumors were 86.0%,87.7%,and 87.2%,respectively. FDG PET/CT imaging also led to the detection of previously unrecognized metastases in 29.5% of patients. Forty-seven (31.5%,47 of 149) patients underwent a change in therapeutic management.Conclusions FDG PET/CT is a valuable tool in patients with CUP,because it assisted in detecting unknown primary tumors and previously unrecognized distant metastases,and optimized the mangement of these patients.

  15. The role of {sup 18}F-fluorodeoxyglucose positron emission tomography in gestational trophoblastic tumours: a pilot study

    Chang, Ting Chang; Wu, Yen Ching; Wu, Tzu I. [University College of Medicine, Division of Gynecologic Oncology, Taoyuan (Taiwan); Yen, Tzu Chen; Chang, Yu.Cheng [Chang Gung Memorial Hospital, Department of Nuclear Medicine, Taoyuan (Taiwan); Li, Yiu Tai [Kuo General Hospital, Department of Obstetrics and Gynecology, Tainan (Taiwan); Ng, Koon Kwan [Chang Gung University College of Medicine, Departments of Diagnostic Radiology, Taoyuan (Taiwan); Jung, Shih Ming [Chang Gung Memorial Hospital, Anatomic Pathology, Taoyuan (Taiwan); Lai, Chyong Huey [University College of Medicine, Division of Gynecologic Oncology, Taoyuan (Taiwan); Chang Gung Memorial Hospital Linkou Medical Center, Department of Obstetrics and Gynecology, Taoyuan (Taiwan)

    2006-02-01

    We conducted a pilot trial to evaluate the value of {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET) in gestational trophoblastic tumours (GTTs). Patients with placental site trophoblastic tumour (PSTT), high-risk GTT (World Health Organisation score {>=}8, disease onset at postpartum or greater than 6 months after antecedent pregnancy), metastatic GTT, recurrent/resistant GTT after chemotherapy, or post-molar GTT with unexplained abnormal {beta}-hCG regression and patients undergoing re-evaluation after salvage treatment were enrolled. PET was undertaken within 1 week after computed tomography (CT). Clinical impacts of additional PET were determined on a scan basis. A total of 14 patients were recruited. Sixteen PET scans were performed, with one patient having three serial studies. Benefits of additional PET were seen in 7 of 16 (43.8%) scans; these benefits included disclosure of chemotherapy-resistant lesions (n=2), exclusion of false-positive CT lesions (n=1), detection of an additional lesion not found by conventional imaging (n=1) in high-risk GTT at the start of primary chemotherapy, and confirmation of complete response to treatment for PSTT or to salvage therapy for recurrent/resistant GTT (n=3). On the other hand, in two instances there were false-negative PET findings, six scans yielded no benefit, and one showed an indeterminate lesion. Our preliminary results suggest that {sup 18}F-FDG PET is potentially useful in selected patients with GTT by providing precise mapping of metastases and tumour extent upfront, by monitoring treatment response and by localising viable tumours after chemotherapy. A larger study is necessary to further define the role of {sup 18}F-FDG PET in GTT. (orig.)

  16. The role of 18F-fluorodeoxyglucose positron emission tomography in gestational trophoblastic tumours: a pilot study

    We conducted a pilot trial to evaluate the value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in gestational trophoblastic tumours (GTTs). Patients with placental site trophoblastic tumour (PSTT), high-risk GTT (World Health Organisation score ≥8, disease onset at postpartum or greater than 6 months after antecedent pregnancy), metastatic GTT, recurrent/resistant GTT after chemotherapy, or post-molar GTT with unexplained abnormal β-hCG regression and patients undergoing re-evaluation after salvage treatment were enrolled. PET was undertaken within 1 week after computed tomography (CT). Clinical impacts of additional PET were determined on a scan basis. A total of 14 patients were recruited. Sixteen PET scans were performed, with one patient having three serial studies. Benefits of additional PET were seen in 7 of 16 (43.8%) scans; these benefits included disclosure of chemotherapy-resistant lesions (n=2), exclusion of false-positive CT lesions (n=1), detection of an additional lesion not found by conventional imaging (n=1) in high-risk GTT at the start of primary chemotherapy, and confirmation of complete response to treatment for PSTT or to salvage therapy for recurrent/resistant GTT (n=3). On the other hand, in two instances there were false-negative PET findings, six scans yielded no benefit, and one showed an indeterminate lesion. Our preliminary results suggest that 18F-FDG PET is potentially useful in selected patients with GTT by providing precise mapping of metastases and tumour extent upfront, by monitoring treatment response and by localising viable tumours after chemotherapy. A larger study is necessary to further define the role of 18F-FDG PET in GTT. (orig.)

  17. Simultaneous whole body 18F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging for evaluation of pediatric cancer: Preliminary experience and comparison with 18F-fluorodeoxyglucose positron emission tomography computed tomography

    Pugmire, Brian S; Guimaraes, Alexander R; Lim, Ruth; Friedmann, Alison M; Huang, Mary; Ebb, David; Weinstein, Howard; Catalano, Onofrio A; Mahmood, Umar; Catana, Ciprian; Gee, Michael S

    2016-01-01

    AIM: To describe our preliminary experience with simultaneous whole body 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography and magnetic resonance imaging (PET-MRI) in the evaluation of pediatric oncology patients. METHODS: This prospective, observational, single-center study was Health Insurance Portability and Accountability Act-compliant, and institutional review board approved. To be eligible, a patient was required to: (1) have a known or suspected cancer diagnosis; (2) be under the care of a pediatric hematologist/oncologist; and (3) be scheduled for clinically indicated 18F-FDG positron emission tomography-computed tomography (PET-CT) examination at our institution. Patients underwent PET-CT followed by PET-MRI on the same day. PET-CT examinations were performed using standard department protocols. PET-MRI studies were acquired with an integrated 3 Tesla PET-MRI scanner using whole body T1 Dixon, T2 HASTE, EPI diffusion-weighted imaging (DWI) and STIR sequences. No additional radiotracer was given for the PET-MRI examination. Both PET-CT and PET-MRI examinations were reviewed by consensus by two study personnel. Test performance characteristics of PET-MRI, for the detection of malignant lesions, including FDG maximum standardized uptake value (SUVmax) and minimum apparent diffusion coefficient (ADCmin), were calculated on a per lesion basis using PET-CT as a reference standard. RESULTS: A total of 10 whole body PET-MRI exams were performed in 7 pediatric oncology patients. The mean patient age was 16.1 years (range 12-19 years) including 6 males and 1 female. A total of 20 malignant and 21 benign lesions were identified on PET-CT. PET-MRI SUVmax had excellent correlation with PET-CT SUVmax for both benign and malignant lesions (R = 0.93). PET-MRI SUVmax > 2.5 had 100% accuracy for discriminating benign from malignant lesions using PET-CT reference. Whole body DWI was also evaluated: the mean ADCmin of malignant lesions (780.2 + 326.6) was

  18. {sup 18}F-fluorodeoxyglucose positron emission tomography for predicting tumor response to radiochemotherapy in nasopharyngeal carcinoma

    Su, Meng; Wei, Hangping; Lin, Ruifang; Zhang, Xuebang; Zou, Changlin [The First Affiliated Hospital of Wenzhou Medical University, Department of Radiation Oncology and Chemotherapy, Wenzhou, Zhejiang province (China); Zhao, Liang [The First Affiliated Hospital of Wenzhou Medical University, Department of Positron Emission Tomography, Wenzhou, Zhejiang province (China)

    2015-08-15

    The aim of this study was to evaluate the value of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in predicting tumor response to radiochemotherapy in nasopharyngeal carcinoma (NPC). From July 2012 to March 2014, 46 NPC patients who had undergone PET scanning before receiving definitive intensity-modulated radiotherapy (IMRT) treatment in our hospital were enrolled. Factors potentially affecting tumor response to treatment were studied by multiple logistic regression analysis. After radiochemotherapy, 32 patients had a clinical complete response (CR), making the CR rate 69.6 %. Multiple logistic regression analysis demonstrated that the maximal standard uptake value (SUV{sub max}) of the primary tumor was the only factor related to tumor response (p = 0.001), and that the logistic model had a high positive predictive value (90.6 %). The area under the receiver operating characteristic (ROC) curve was 0.809, with a best cutoff threshold at 10.05. Patients with SUV{sub max} ≤ 10 had a higher CR rate than those with SUV{sub max} > 10 (p < 0.001). The SUV{sub max} of the primary tumor before treatment is an independent predictor of tumor response in NPC. (orig.) [German] Das Ziel der Arbeit bestand darin, den Wert der {sup 18}F-Fluordesoxyglukose-Positronenemissionstomographie ({sup 18}F-FDG-PET) zur Vorhersage des Tumoransprechens auf eine Radiochemotherapie beim Nasopharynxkarzinom (NPC) zu beurteilen. Von Juli 2012 bis Maerz 2014 wurden 46 NPC-Patienten, die sich vor definitiver intensitaetsmodulierter Strahlentherapie (IMRT) in unserem Krankenhaus einem PET-Scan unterzogen hatten, in die Studie aufgenommen. Faktoren, die moeglicherweise das Tumoransprechen auf die Behandlung beeinflussen, wurden mittels multipler logistischer Regressionsanalyse untersucht. Nach der Radiochemotherapie hatten 32 Patienten eine klinisch komplette Remission (CR), so dass eine CR-Rate von 69,6 % erreicht wurde. Die multiple logistische Regressionsanalyse zeigte

  19. A case of skeletal tuberculosis and psoas abscess: disease activity evaluated using 18 F-fluorodeoxyglucose positron emission tomography-computed tomography

    Psoas abscess complicating tuberculous spondylitis is a rare morbidity in extrapulmonary tuberculosis. There are no established guidelines for evaluating the clinical response of psoas abscess. Although several studies have shown that positron emission tomography-computed tomography with 18 F-fluorodeoxyglucose can play a potential role in diagnosing multifocal tuberculosis and monitoring the clinical response of pulmonary tuberculosis, to our knowledge, this is the first report demonstrating that positron emission tomography-computed tomography is useful for evaluating local inflammation and disease activity of a tuberculous psoas abscess. We report a case of multifocal bone and lymph node tuberculosis with concomitant lumbar psoas abscess in a 77-year-old man, along with a literature review. An initial positron emission tomography-computed tomography scan showed intense 18 F-fluorodeoxyglucose accumulation in the sternum, ribs, vertebrae, and lymph nodes. The patient was successfully treated with antitubercular agents and computed tomography-guided drainage therapy. A follow-up positron emission tomography-computed tomography after abscess drainage and 9 months of antitubercular drug treatment revealed that the majority of lesions improved; however, protracted inflammation surrounding the psoas abscess was still observed. These results indicate that disease activity of psoas abscess can remain, even after successful drainage and antitubercular medication regime of appropriate duration. We have successfully followed up the extent of skeletal tuberculosis complicated with psoas abscess by positron emission tomography-computed tomography. In this patient, positron emission tomography-computed tomography is useful for evaluating the disease activity of tuberculous psoas abscess and for assessing the appropriate duration of antitubercular drug therapy in psoas abscess

  20. Diagnostic role of fluorine-18 (18F fluorodeoxyglucose positron emission tomography computed tomography in detecting recurrent disease in patients with colorectal cancer and elevated carcinoembryonic antigen

    Matovina Emil

    2015-01-01

    Full Text Available Introduction. Early detection of recurrence is an important factor for long term survival of patients with colorectal cancer. Measurement of serum levels of carcinoembryonic antigen has been commonly used in the postoperative surveillance of colorectal cancer. The purpose of this study was to evaluate the ability of positron emission tomography-computed tomography to detect pathological substrate of elevated serum carcinoembryonic antigen in patients with colorectal cancer. Material and Methods. The patients with colorectal cancer who underwent curative surgical resection and/ or chemotherapy, who were found in our database, were analyzed retrospectively. Forty-eight 18F- fluorodeoxyglucose positron emission tomography-computed tomography studies including 45 patients (14 women, 31 men; mean age: 62.93 years with elevated serum, carcinoembryonic antigen levels, which had been performed between January 2011 and January 2014, were evaluated. Serum levels of carcinoembryonic antigen were measured within 3 months after positron emission tomography-computed tomography examination. Final diagnosis of recurrence was made by histopathological findings, radiology studies or clinical follow-up. Results. Recurrences were diagnosed in 37 patients, the prevalence being 77.1%. Liver metastases were found in 18 patients, abdominal, pelvic and/or mediastinal lymph nodes were positive in 19 patients, 11 patients had loco regional recurrences and 4 patients had pulmonary metastasis, and bone metastases were found in one patient. One patient was diagnosed with metastasis in scar tissue. The overall sensitivity and specificity of positron emission tomography-computed tomography was 90.24% and 71.42%, respectively. The positive and negative predictive values were 94.87% and 55.56%, respectively. Conclusion. 18F- fluorodeoxyglucose positron emission tomography-computed tomography is a powerful tool that could be used in determining colorectal cancer recurrence in

  1. 18F-fluorodeoxyglucose positron emission tomography imaging in brain tumours : The Western Australia positron emission tomography/cyclotron service experience

    Full text: 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) scans in the first 49 patients referred with either possible brain tumour or brain tumour recurrence were reviewed. FDG-PET imaging was reported with reference to anatomical imaging. Based on the report the FDG study was classified as either positive or negative for the presence of tumour. Thirty-eight cases were included in the analysis, 21 having pathological data and 17 with diagnostic clinical follow up. Eleven were excluded, as they had inadequate follow-up data. Of the 21 cases with pathology, 18 were shown to have tumour. In this group there were five false-negative scans and two false-positive PET scans. Seventeen cases were assessed by clinical follow up, nine were considered to have been tumour. There were two false negatives with one false positive. The overall sensitivity, specificity and positive and negative predictive values were 74, 73, 87 and 53% respectively. This is similar to figures previously quoted in published work. Despite relatively limited numbers, the utility of FDG PET imaging in our hands is similar to published reports. With a positive predictive value of 87%, a positive FDG study indicates a high likelihood that there is brain tumour present. A negative study does not exclude the presence of tumour

  2. Paradoxal metabolic flare detected by 18F-fluorodeoxyglucose positron emission tomography in a patient with metastatic breast cancer treated with aromatase inhibitor and biphosphonate

    Patients with estrogen-receptor-positive advanced breast cancer are treated with endocrine therapy. The majority of breast cancer localizations show 18F-fluorodeoxyglucose (FDG) uptake at positron emission tomography (PET) examination. In these patients, the metabolic flare after therapy is common and was proposed as an index of therapy efficacy. Nevertheless, prolonged persistence of flare can lead to misinterpretation. We describe a case of a patient with invasive ductal breast cancer with bone metastases at bone scintigraphy and FDG PET scan and with expression of estrogen receptors. Initially, the patient underwent endocrine therapy in addition to a biphosfonate. Owing to progression observed in a bone scan, Tamoxifen was substituted with aromatase inhibitors. Successive bone scan examinations showed stabilization with a marked clinical improvement. A second FDG PET was performed 28 months after the first examination and showed a metabolic flare phenomenon with concomitant partial calcification of osteolitic lesions. This is an unusual case of prolonged metabolic flare

  3. Detection of recurrent cutaneous angiosarcoma of lower extremity with 18 F-fluorodeoxyglucose positron emission tomography-computed tomography: Report of three cases

    Punit Sharma

    2013-01-01

    Full Text Available Cutaneous angiosarcomas (CAS are uncommon, aggressive tumours. Very rarely, they arise from the lower extremity. Such tumours are usually associated with chronic lymphedema, a phenomenon known as Stewart-Treves Syndrome. Treatment is usually radical surgery with adjuvant therapy (radiotherapy/chemotherapy. Recurrence rate after primary treatment is high. Because of post therapy changes, conventional imaging has limited specificity for diagnosing recurrence. 18 F-Fluorodeoxyglucose ( 18 F-FDG positron emission tomography-computed tomography (PET-CT might be useful in such patients. It can demonstrate local recurrence along with distant metastasis, if any and can have significant impact on patient management. We here present three cases of recurrent CAS of lower extremity diagnosed with 18 F-FDG PET-CT.

  4. 18F-fluorodeoxyglucose positron emission tomography/computed tomography in a case of malignant peripheral nerve sheath tumor: an unusual presentation

    Malignant peripheral nerve sheath tumors (MPNSTs) are rare tumors, with an estimated incidence of 0.1/100,000/year. They are regarded as a rare variety of soft-tissue sarcomas that derive from peripheral nerves or from cells associated with the nerve sheath. Until 50% of observed MPNSTs occur in patients with neurofibromatosis 1 (NF1). The typical presenting signs and symptoms of a PNST are a palpable mass involving a peripheral nerve, loss of nerve function and/or pain. Recently, positron emission tomography (PET) has been used to detect 18F-fluorodeoxyglucose uptake in these tumors. Most of the PET studies have been reported in patients with NF1. We report a case of sporadic MPNST masquerading as infectious dermatoses, with an unusual PET/computed tomography presentation. (author)

  5. Detection of infectious colitis by 18F-fluorodeoxyglucose-positron emission tomography in a child receiving intensive care after cardiac surgery

    Pyrexia of unknown origin (PUO) and suspected focal infection/inflammation are challenging medical problems. Nuclear medicine methods using scintigraphy with 111In- or 99mTc-labelled antibodies or 67Ga-citrate have been validated for the diagnosis and detection of inflammatory processes. Recently, positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) has been described as a promising imaging method, especially for PUO. We report the use of FDG-PET in an 18-month-old boy that revealed unexpected infectious colitis after cardiac surgery. This case suggests that FDG-PET is a valuable tool for the detection of unknown inflammatory foci in childhood, especially when the time needed for examination and radiation exposure are to be considered. (orig.)

  6. Patterns of brown fat uptake of 18F-fluorodeoxyglucose in positron emission tomography/computed tomography scan

    Chakraborty, Dhritiman; Bhattacharya, Anish; Mittal, Bhagwant Rai

    2015-01-01

    Fluorodeoxyglucose (FDG) positron emission tomography (PET) has become the common imaging modality in oncological practice. FDG uptake is seen in brown adipose tissue in a significant number of patients. Recognizing the uptake patterns is important for optimal FDG PET interpretation. The introduction of PET/computed tomography (PET/CT) revolutionized PET imaging, bringing much-needed anatomical information. Careful review and correlation of FDG PET images with anatomical imaging should be per...

  7. State of the art and prospects of clinical applications of positron emission tomography and examination with 18F-fluorodeoxyglucose

    Positron emission tomography attains a 95% precision in oncological diagnosis. The use of fluorine 18-labelled fluorodeoxyglucose during in vivo tumor imaging is based on the finding that neoplasm cells exhibit elevated glycolytic activity. The share of oncological examinations is 70% to 80%, the share of neurological and cardiological examinations is 20% to 30%. The detecting systems make for in vivo resolution at the level of 2 mm. (M.D.)

  8. Patterns of brown fat uptake of 18F-fluorodeoxyglucose in positron emission tomography/computed tomography scan

    Fluorodeoxyglucose (FDG) positron emission tomography (PET) has become the common imaging modality in oncological practice. FDG uptake is seen in brown adipose tissue in a significant number of patients. Recognizing the uptake patterns is important for optimal FDG PET interpretation. The introduction of PET/computed tomography (PET/CT) revolutionized PET imaging, bringing much-needed anatomical information. Careful review and correlation of FDG PET images with anatomical imaging should be performed to characterize accurately any lesion having high FDG uptake

  9. Evaluation of mild hypothermia therapy for neonatal hypoxic-ischaemic encephalopathy on brain energy metabolism using 18F-fluorodeoxyglucose positron emission computed tomography

    Luo, Mei; Li, Qingping; DONG, WENBIN; Zhai, Xuesong; Kang, Lan

    2014-01-01

    It remains unclear whether mild hypothermia affects energy metabolism in the brain tissue of newborns with hypoxic-ischaemic encephalopathy (HIE). The current study aimed to investigate the effect of mild hypothermia on energy metabolism in neonatal HIE and assess brain energy metabolism using position emission tomography/computed tomography (PET/CT) scanning. The mean standardised uptake values of 18F-fluorodeoxyglucose (18F-FDG) were used to determine the glucose metabolic rate in various b...

  10. Impact of 18F-Fluorodeoxyglucose Positron Emission Tomography Before and After Definitive Radiation Therapy in Patients With Apparently Solitary Plasmacytoma

    Purpose: To evaluate the impact of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) on management of patients with apparently isolated plasmacytoma. Methods and Materials: Twenty-one patients with apparently solitary plasmacytoma who underwent FDG-PET for staging or restaging were identified from a central PET database. They were either candidates for or had received definitive radiation therapy (RT). Results: Seventeen patients had initial staging scans for bone (n = 11) or soft tissue (n = 6) plasmacytomas, and 11 had PET scans after RT. Only 1 of 14 known untreated sites of plasmacytoma was not identified on staging PET (lesion sensitivity = 93%). Three plasmacytomas were excised before PET. Staging PET influenced management in 6 of 17 patients (35%) by showing multiple myeloma (n = 1), discouraging RT after complete resection (n = 1), excluding plasmacytoma at a second site (n = 1), by increasing RT fields (n = 2), or by suggesting sarcoidosis (n = 1). Fifteen of 17 patients with initial staging PET scans received definitive RT. Restaging PET scans after RT showed complete metabolic response in 8 of 11 cases and progressive disease in 2. Two patients with either no response or partial metabolic response had late responses. Staging sestamibi and PET scans were concordant in five of six occasions (one sestamibi scan was false negative). Conclusions: FDG-PET has value for staging and RT planning in plasmacytoma and potentially could have a role in response-assessment after RT. Slow resolution of FDG uptake posttreatment does not necessarily imply an adverse prognosis.

  11. 18F-fluorodeoxyglucose positron emission tomography in patients with recurrent ovarian cancer: in comparison with vascularity, Ki-67, p53, and histologic grade

    The aim of this study was to assess the correlation between 18F-fluorodeoxyglucose positron emission tomography (FDG PET) positivity of tumor recurrence and vascularity, Ki-67, p53, and histologic grade in patients with ovarian cancer. Nineteen patients with recurrent ovarian cancer underwent FDG PET before second-look surgery. Archival paraffin-embedded tissue materials were used to assess histologic grade including architectural pattern, mitotic activity, and nuclear pleomorphism; intratumor microvessel density (MVD); Ki-67; and p53. Univariate analysis was used to evaluate the correlation between FDG PET positivity and each biomarker. Stepwise logistic regression analysis was used to determine the best parameter to explain FDG PET positivity. MVD revealed significant positive correlation with FDG PET positivity (p=0.0341). There was no significant correlation between FDG PET positivity and Ki-67 or p53 (p=0.4040, p=0.6027). Mitotic activity yielded statistically significant positive correlations with FDG PET positivity (p=0.0448) although histologic grade revealed no positive correlation (p=1). Stepwise logistic regression analysis revealed MVD to be the strongest parameter for FDG PET positivity (OR=0.696, 95% CI 0.487-0.993, p=0.0458). In conclusion, FDG PET positivity revealed positive correlation with MVD and mitotic activity. MVD was the strongest parameter in predicting positive tumor recurrence on FDG PET. (orig.)

  12. Prevalence and risk of cancer of focal thyroid incidentaloma identified by 18F-fluorodeoxyglucose positron emission tomography for cancer screening in healthy subjects

    The aim of this study was to define the clinical prevalence and rate of malignancy of focal thyroid incidentaloma in a relatively large number of examinees with application of 18F-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) in asymptomatic individuals. The subjects consisted of 4803 physical check up examinees (2638 men, 2165 women; mean age ±SD, 52.8±9 y) with non-specific medical history. Whole-body FDG PET was performed on all patients. Focal hypermetabolic areas of thyroid with an intensity equal to or exceeding the level of FDG uptake in the liver were considered abnormal and interpreted as thyroid incidentaloma. Among the 4803 FDG PET examinations, thyroid incidentalomas was present in 60 examinations, among which, 50 had further examination with ultrasound-guided fine-needle aspiration (FNA), including 43 benign lesions and 7 papillary carcinomas. Of 7 examinees diagnosed with cancer, two had lymph nodes metastasis. The mean and standard deviation of standard uptake value (SUV) in benign and carcinoma is 2.6±1.01 and 6.7±3.66, respectively. Thyroid incidentaloma identified by FDG-PET occurred with a frequency of 1.2%. Of the thyroid incidentalomas that underwent FNA and surgery, 14% were found to be malignant. It is possible to differentiate benign from carcinoma of thyroid incidentalomas by an increased rate of glycolysis (SUV) in carcinoma. The small size of thyroid incidentalomas perse cannot guarantee low risk in incidentally found thyroid cancers. (authors)

  13. The impact of 18F-fluorodeoxyglucose positron emission tomography on the 3D conformal radiotherapy planning in patients with non-small cell lung cancer

    Traditional radiation treatment planning relies on density imaging such as Computed Tomography for anatomic information of various structures of interest including target and normal tissues. However, the difficulties to distinguish malignant from normal tissue on CT slides often leads to inaccurate outlining of the GTV and/or to geographic misses. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) has shown an increase in both sensitivity and specificity over CT in locoregional staging of patients with non-small cell lung cancer (NSCLC). The co registration of FDG-PET images to the data of the CT planning offers the radiation oncologist the possibility to include functional information into the target outlining. For the treatment of patients with NSCLC, it has been shown that the use of FDG-PET images: 1) modified the shape and volume of radiation fields in 22-62% of cases, mainly due to a better nodal staging and distinction of atelectasis from tumor and; 2) significantly reduced the interobserver and intra-observer variability. This paper reviews the results reported in the literature. Challenges and proposed solutions are discussed. (author)

  14. 18F-fluorodeoxyglucose positron emission tomography/computed tomography for primary thyroid langerhans histiocytosis: A case report and literature review

    Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disease, with an incidence rate of 4.0–5.4/1 million individuals. LCH encompasses a spectrum of disorders with diverse clinical presentations ranging from a single organ to multiple organ involvement. LCH rarely involves the thyroid gland. We presented a case with LCH of thyroid gland. The patient had painless progressive neck enlargement and then diabetes insipidus. Ultrasonic scan and magnetic resonance imaging scan revealed nodular goiter and pituitary stalk enlargement, respectively. Histopathological analysis revealed features of histiocytoid cells. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was performed in order to rule out the presence of whole body infiltration. 18F-FDG PET/CT also demonstrated increased uptake in the thickening pituitary stalk and maxillofacial skin lesion, in addition to the bilateral thyroid nodules, CT showed the left lung nodule and the skull destruction without 18F-FDG uptake. This report emphasizes the role of 18F-FDG PET/CT in multiple organs involvement of patients with LCH

  15. Supraclavicular Lymph Node Metastasis from Various Malignancies: Assessment with 18F-Fluorodeoxyglucose Positron Emission Tomography/CT, Contrast-Enhanced CT and Ultrasound

    Ryu, Eun Bi; Oh, Kyung Seung; Jeong, Kyung Soon [Dept. of Radiology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan (Korea, Republic of)

    2012-01-15

    The purpose of this study is to compare the usefulness of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET)/CT, contrast-enhanced CT and ultrasound (US) for diagnosing metastatic supraclavicular lymph nodes. This study included 53 supraclavicular lymph nodes of 48 consecutive patients with various malignancies observed on 18F-FDG PET/CT, contrast-enhanced CT and US. Detection of supraclavicular lymph nodes was determined by 18F-FDG PET/CT where uptake was greater than that of surrounding tissue and contrast-enhanced CT with a node short-axis diameter of 5 mm or more. On US, we classified the supraclavicular lymph node as benign or malignant by sonographic criteria. The diagnostic values of these modalities were compared in the detection of metastatic supraclavicular lymph nodes. Metastatic supraclavicular lymph nodes were diagnosed cytologically in 44 (83%) of 53 lesions. In the detection of metastatic supraclavicular lymph nodes, the diagnostic accuracies of 18F-FDG PET/CT, contrast-enhanced CT, and US were 92%, 89%, and 91%, respectively. The specificity (67%) and negative predictive value (86%) of 18F-FDG PET/CT were higher than those of contrast-enhanced CT and US. 18F-FDG PET/CT is more useful for detecting and characterizing supraclavicular lymph nodes in patients with cancer, because of its high specificity and negative predictive value.

  16. 18F-fluorodeoxyglucose-positron-emission tomography/computed tomography staging of mucinous tubular and spindle cell carcinoma of the kidney

    Mucinous tubular and spindle cell carcinoma of the kidney (MTSCC-K) is an extremely rare carcinoma of the kidney, which develops by malignant differentiation of the collecting ducts or the loop of Henle. The tumor can occur at all ages, with 4 times higher prevalence in females than in males. A 62-year-old female patient presented with an asymptomatic mass lesion in the left kidney. The ultrasound revealed a hyperechogenic mass lesion measuring 4 cm in diameter and centrally located in the left kidney. Computed tomography (CT) revealed an isodense mass lesion measuring 4 cm in diameter and posterolaterally located in the left kidney. Magnetic resonance imaging revealed a renal mass of 4 cm in diameter with hypervascular contrast uptake. For primary staging, 18F-fluorodeoxyglucose-positron-emission tomography (18FDG-PET)/CT revealed left renal cell carcinoma (RCC) with a maximum standard uptake value of 6.7. The patient underwent transperitoneal radical nephrectomy. The immunohistochemical examination revealed MTSCC-K. 18FDG-PET/CT provides 81-89% sensitivity and 83-100% specificity in primary staging of the renal cancers, in diagnosing metastatic RCC, and monitoring the response to therapy. Its use in the staging of MTSCC of the kidney has not been previously described in the literature. This case highlights the usefulness of 18FDG-PET/CT in the staging of this rare tumor

  17. Detection of bone marrow involvement in newly diagnosed post-transplant lymphoproliferative disorder: (18)F-fluorodeoxyglucose positron emission tomography/computed tomography versus bone marrow biopsy.

    Gheysens, Olivier; Thielemans, Sanne; Morscio, Julie; Boeckx, Nancy; Goffin, Karolien E; Deroose, Christophe M; Sagaert, Xavier; Wlodarska, Iwona; Verhoef, Gregor; Dierickx, Daan; Tousseyn, Thomas

    2016-10-01

    Detecting bone marrow involvement (BMI) in lymphoma is important as it adversely affects stage. Bone marrow biopsy (BMB) remains the standard to detect BMI but is prone to sampling error. We retrospectively investigated whether (18)F-fluorodeoxyglucose positron emission tomography with computed tomography ((18)F-FDG-PET/CT) could identify BMI in patients with post-transplant lymphoproliferative disorder (PTLD) with sufficient accuracy in comparison with staging BMB. Twenty-five patients diagnosed with PTLD who underwent (18)F-FDG-PET/CT and BMB within one month were evaluated. Based on our criteria, six patients (24%) were considered positive for BMI on (18)F-FDG-PET/CT compared to one by BMB. Although we cannot completely exclude false positive results on (18)F-FDG-PET/CT, our data indicate a significantly higher sensitivity of (18)F-FDG-PET/CT compared to BMB (100% vs 17%) but similar specificity. These data confirm the high diagnostic performance of (18)F-FDG-PET/CT for detecting BMI, but prospective studies are needed to determine whether (18)F-FDG-PET/CT could indeed replace staging BMB in PTLD. PMID:26854937

  18. Correlation of 18F-fluorodeoxyglucose uptake on positron emission tomography with Ki-67 index and pathological invasive area in lung adenocarcinomas 30 mm or less in size

    Background: 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is commonly used to distinguish benign from malignant lesion. Recently, maximum standardized uptake value (SUVmax) on FDG-PET has found to have prognostic value. We examined the relationship between SUVmax and proliferative activities as indicated by maximum diameter of tumor opacity on mediastinal-window images (TOM), Ki-67 index, and diameter of the pathological invasive area in lung adenocarcinomas ≤30 mm. Methods: Thin-section computed tomography (TS-CT) and FDG-PET were performed on 140 patients with resectable lung adenocarcinomas ≤30 mm between March 2006 and May 2008. Tumors were classified as air-type or solid-type based on TS-CT findings. In all resected specimens, diameter of the pathological invasive area and Ki-67 index were assessed. Results: SUVmax was significantly lower for air-type than for solid-type tumors (0.97 vs. 3.96, p 5 mm was determined as 2.15 by ROC analysis, with sensitivity of 88.3% and specificity of 84.6%. Conclusions: SUVmax correlated significantly with Ki-67 index and diameter of the pathological invasive area. The present results suggest the potential role of FDG-PET in predicting adenocarcinomas with invasive characteristics.

  19. Quantification of the activity of tritium produced during the routine synthesis of (18)F fluorodeoxyglucose for positron emission tomography.

    Marshall, C; Talboys, M A; Bukhari, S; Evans, W D

    2014-06-01

    Gamma emitting radioactive by-products generated during the cyclotron irradiation of (18)O labelled water by protons to produce (18)FDG (fluorodeoxyglucose) for positron emission tomography are well characterised. However, the production of tritium ((3)H) through the (18)O(p,t)(16)O nuclear reaction has not been investigated in detail. The aim of this study was to measure tritium activity produced during a large number of (18)FDG production runs in order to obtain a better perspective on its impact on radioactive waste management, particularly as regards storage and disposal. Tritium was assayed by liquid scintillation counting in recovered (18)O water from 24 separate production runs. The mean (SD) values of activity and activity concentration were 170 (20) kBq and 81 (8) kBq ml(-1) respectively. Both quantities were positively correlated with the activity of (18)F. Tritium was detected in much lower concentration in water used to rinse the target vessel. The activity of tritium is such that it is exempt from regulatory control and may be combined with bulk non-active waste for disposal as Very Low Level Waste. However, variations in the irradiation conditions or the procedures for the collection of recovered water might result in its classification as Low Level Waste, necessitating a more complex disposal regime. PMID:24894021

  20. 18-F fluorodeoxyglucose uptake in positron emission tomography as a pathological grade predictor for renal clear cell carcinomas

    To evaluate the usefulness of Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18-F FDG-PET/CT) in the prediction of Fuhrman pathological grades of renal clear cell carcinoma (cRCC). This retrospective study was approved by our institutional review board, and written informed consent was waived. Thirty-one patients with pathologically proven cRCC underwent 18-F FDG-PET/CT for tumour staging. Maximum standardized uptake value of cRCC (tumour SUVmax) and mean SUV of the liver and spleen (liver and spleen SUVmean) were measured by two independent observers. Tumour SUVmax, tumour-to-liver SUV ratio, and tumour-to-spleen SUV ratio were correlated with the pathological grades. Logistic analysis demonstrated that only the tumour-to-liver SUV ratio was a significant parameter for differentiating high-grade (Fuhrman grades 3 and 4) tumours from low-grade (Fuhrman grades 1 and 2) tumours (P = 0.007 and 0.010 for observers 1 and 2, respectively). Sensitivity, specificity, and positive and negative predictive values for detecting tumours of Fuhrman grades 3 and 4 were 64, 100, 100, and 77 %, respectively, for observer 1, and 79, 88, 85, and 83 %, respectively, for observer 2. The tumour-to-liver SUV ratio with 18-F FDG-PET/CT appeared to be a valuable imaging biomarker in the prediction of high-grade cRCC. (orig.)

  1. 18-F fluorodeoxyglucose uptake in positron emission tomography as a pathological grade predictor for renal clear cell carcinomas

    Noda, Yoshifumi; Goshima, Satoshi; Kondo, Hiroshi; Watanabe, Haruo; Kawada, Hiroshi; Kawai, Nobuyuki; Tanahashi, Yukichi [Gifu University Hospital, Department of Radiology, Gifu (Japan); Kanematsu, Masayuki [Gifu University Hospital, Department of Radiology, Gifu (Japan); Gifu University Hospital, Department of Radiology Services, Gifu (Japan); Suzui, Natsuko [Gifu University Hospital, Department of Pathology, Gifu (Japan); Hirose, Yoshinobu [Osaka Medical College, Department of Pathology, Osaka (Japan); Matsunaga, Kengo [Kizawa Memorial Hospital, Department of Pathology, Minokamo (Japan); Nishibori, Hironori [Kizawa Memorial Hospital, Department of Radiology, Minokamo (Japan); Bae, Kyongtae T. [University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States)

    2015-10-15

    To evaluate the usefulness of Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18-F FDG-PET/CT) in the prediction of Fuhrman pathological grades of renal clear cell carcinoma (cRCC). This retrospective study was approved by our institutional review board, and written informed consent was waived. Thirty-one patients with pathologically proven cRCC underwent 18-F FDG-PET/CT for tumour staging. Maximum standardized uptake value of cRCC (tumour SUV{sub max}) and mean SUV of the liver and spleen (liver and spleen SUV{sub mean}) were measured by two independent observers. Tumour SUV{sub max}, tumour-to-liver SUV ratio, and tumour-to-spleen SUV ratio were correlated with the pathological grades. Logistic analysis demonstrated that only the tumour-to-liver SUV ratio was a significant parameter for differentiating high-grade (Fuhrman grades 3 and 4) tumours from low-grade (Fuhrman grades 1 and 2) tumours (P = 0.007 and 0.010 for observers 1 and 2, respectively). Sensitivity, specificity, and positive and negative predictive values for detecting tumours of Fuhrman grades 3 and 4 were 64, 100, 100, and 77 %, respectively, for observer 1, and 79, 88, 85, and 83 %, respectively, for observer 2. The tumour-to-liver SUV ratio with 18-F FDG-PET/CT appeared to be a valuable imaging biomarker in the prediction of high-grade cRCC. (orig.)

  2. Characteristics of myocardial 18F-fluorodeoxyglucose positron emission computed tomography in dilated cardiomyopathy and ischemic cardiomyopathy

    Myocardial 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) has been used to assess myocardial ischemia and viability, but few studies have conducted on FDG-PET for dilated cardiomyopathy (DCM). We investigated myocardial FDG uptake in patients with DCM in comparison with ischemic cardiomyopathy (ICM). Twenty-four patients with heart failure were included in this study. Fourteen of them were diagnosed as DCM and the other 10 were ICM. All of them underwent myocardial FDG-PET at fasting and after glucose loading the same day. FDG uptake was quantified by the ratio of the counts at the heart to those at the liver (H/L ratio). Left ventricular (LV) function was measured by echocardiography. We classified FDG distribution patterns in the myocardium in the fasting state into 3 types (faint uptake, regional uptake and diffuse uptake). In DCM patients, 5 had faint uptake, 7 had regional uptake, and the other 2 had diffuse uptake. On the other hand, all ICM patient had regional uptake (p<0.05). In DCM, there were no significant relationships between the patterns and LV functions. On the other hand, there were close correlation between the H/L ratio after glucose loading and the left ventricular ejection fraction (r=0.680, p<0.01). The changes in PET images caused by glucose loading were classified into 2 types (non-reversing and reversing patterns). DCM significantly showed a non-reversing pattern (86%, 12 of 14 patients) whereas ICM showed mainly a reversing pattern (70%, 7 of 10 patients; p<0.05). In conclusion, myocardial FDG uptake after glucose loading may indicate a myocardial viable mass although FDG uptake at fasting was not evidently related to LV function. The change in the pattern of the FDG image from fasting to glucose loading may be useful in differentiating DCM form ICM. (author)

  3. Thoracic [18F]fluorodeoxyglucose uptake measured by positron emission tomography/computed tomography in pulmonary hypertension.

    Frille, Armin; Steinhoff, Karen Geva; Hesse, Swen; Grachtrup, Sabine; Wald, Alexandra; Wirtz, Hubert; Sabri, Osama; Seyfarth, Hans-Juergen

    2016-06-01

    Positron emission tomography (PET) visualizes increased cellular [F]fluorodeoxyglucose ([F]FDG) uptake. Pulmonary hypertension (PH) is conceived of a proliferative disease of the lung vessels. Increased glucose uptake can be quantified as pulmonary [F]FDG uptake via PET imaging. Because the angioproliferative mechanisms in PH are still in need of further description, the aim of the present study was to investigate whether [F]FDG PET/CT imaging can elucidate these pathophysiologic mechanisms in different etiologies of PH.Patients (n = 109) with end-stage pulmonary disease being evaluated for lung transplant were included in this observational study. Mean standardized uptake value (SUVmean) of predefined regions of interest in lung parenchyma (LP), left (LV), and right ventricle (RV) of the heart, and SUVmax in pulmonary artery (PA) were determined and normalized to liver uptake. These SUV ratios (SUVRs) were compared with results from right heart catheterization (mean pulmonary artery pressure [mPAP], pulmonary vascular resistance [PVR]), and serum N-terminal pro-brain natriuretic peptide. Group comparisons were performed and Pearson correlation coefficients (r) were calculated.The [F]FDG uptake ratios in LP, RV, RV/LV, and PA, but not in LV, were found to be significantly higher in both patients with mPAP ≥25 mm Hg (P = 0.013, P = 0.006, P = 0.049, P = 0.002, P = 0.68, respectively) and with PVR ≥480 dyn·s/cm (P < 0.001, P = 0.045, P < 0.001, P < 0.001, P = 0.26, respectively). The [F]FDG uptake in these regions positively correlated also with mPAP, PVR, and N-terminal pro-brain natriuretic peptide. The SUVR of PA positively correlated with the SUVR of LP and RV (r = 0.55, r = 0.42, respectively).Pulmonary and cardiac [F]FDG uptake in PET imaging positively correlated with the presence and severity of PH in patients with end-stage pulmonary disease. Increased glucose metabolism in the central PAs seems to

  4. Impact of 18F-fluorodeoxyglucose positron emission tomography in the staging and treatment response assessment of extra-pulmonary small-cell cancer

    Full text: The aim of this study was to retrospectively evaluate the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in extrapulmonary small-cell cancer (EPSCC). Patients with EPSCC who underwent PET for staging or response assessment between 1996 and 2007 were identified from a database. Patient records were reviewed. PET-based, and conventional staging and restaging results were compared. The binary staging classification of limited disease (LD) versus extensive disease (ED) was used. Patients with LD had tumours that could be encompassed within a tolerable radiation therapy (RT) volume. Of 33 eligible patients, 12 had staging PET scans, 11 had restaging scans and 10 had both. All known gross disease sites were FDG-avid. PET and conventional stage groupings were concordant in 21 of 22 cases. One patient was appropriately upstaged from LD to ED by PET. PET detected additional disease sites, without causing upstaging in three further patients. Restaging PET scans identified previously unrecognised persistent or progressive disease in 4 of 21 cases. In four further cases, persistent FDG uptake after treatment was either false positive (n = 2) or of uncertain (n = 2) aetiology. PPV was 100% for staging and 82% for restaging. In 8 of 43 imaging episodes (19%), PET appropriately influenced management in five cases by changing treatment intent from radical to palliative, and in three cases by altering the RT volume. PET has incremental value compared to conventional imaging for staging EPSCC, and may also be useful for restaging after therapy. PET influenced patient management in 19% of 43 imaging episodes.

  5. {sup 18}F-fluorodeoxyglucose positron emission tomography combined with whole-body computed tomographic angiography in critically ill patients with suspected severe sepsis with no definite diagnosis

    Mandry, Damien [CHU Nancy, Pole d' imagerie, Nancy (France); University of Lorraine, Faculty of Medicine, Nancy (France); INSERM, UMR 947, Nancy (France); Tatopoulos, Alexis; Lemarie, Jeremie; Bollaert, Pierre-Edouard; Gibot, Sebastien [University of Lorraine, Faculty of Medicine, Nancy (France); CHU de Nancy - Hopital Central, Service de Reanimation Medicale, Nancy (France); INSERM, UMR 1116, Nancy (France); Chevalier-Mathias, Elodie [CHU Nancy, Pole d' imagerie, Nancy (France); INSERM, UMR 947, Nancy (France); Nancyclotep, Experimental Imaging Platform, Nancy (France); Roch, Veronique [CHU Nancy, Pole d' imagerie, Nancy (France); Nancyclotep, Experimental Imaging Platform, Nancy (France); Olivier, Pierre [CHU Nancy, Pole d' imagerie, Nancy (France); University of Lorraine, Faculty of Medicine, Nancy (France); Nancyclotep, Experimental Imaging Platform, Nancy (France); Marie, Pierre-Yves [CHU Nancy, Pole d' imagerie, Nancy (France); University of Lorraine, Faculty of Medicine, Nancy (France); INSERM, UMR 1116, Nancy (France); Nancyclotep, Experimental Imaging Platform, Nancy (France)

    2014-10-15

    Timely identification of septic foci is critical in patients with severe sepsis or septic shock of unknown origin. This prospective pilot study aimed to assess {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET), combined with whole-body computed tomographic angiography (CTA), in patients with suspected severe sepsis and for whom the prior diagnostic workup had been inconclusive. Patients hospitalized in an intensive care unit with a suspected severe sepsis but no definite diagnosis after 48 h of extensive investigations were prospectively included and referred for a whole body FDG-PET/CTA. Results from FDG-PET/CTA were assessed according to the final diagnosis obtained after follow-up and additional diagnostic workup. Seventeen patients were prospectively included, all on mechanical ventilation and 14 under vasopressor drugs. The FDG-PET/CTA exam 1) was responsible for only one desaturation and one hypotension, both quickly reversible under treatment; 2) led to suspect 16 infectious sites among which 13 (81 %) could be confirmed by further diagnostic procedures; and 3) triggered beneficial changes in the medical management of 12 of the 17 study patients (71 %). The FDG-PET/CTA images showed a single or predominant infectious focus in two cases where CTA was negative and in three cases where CTA exhibited multiple possible foci. Whole-body FDG-PET/CTA appears to be feasible, relatively safe, and provides reliable and useful information, when prospectively planned in patients with suspected severe sepsis and for whom prior diagnostic workup had been inconclusive. The FDG-PET images are particularly helpful when CTA exhibits no or multiple possible sites. (orig.)

  6. 18F-fluorodeoxyglucose positron emission tomography combined with whole-body computed tomographic angiography in critically ill patients with suspected severe sepsis with no definite diagnosis

    Timely identification of septic foci is critical in patients with severe sepsis or septic shock of unknown origin. This prospective pilot study aimed to assess 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), combined with whole-body computed tomographic angiography (CTA), in patients with suspected severe sepsis and for whom the prior diagnostic workup had been inconclusive. Patients hospitalized in an intensive care unit with a suspected severe sepsis but no definite diagnosis after 48 h of extensive investigations were prospectively included and referred for a whole body FDG-PET/CTA. Results from FDG-PET/CTA were assessed according to the final diagnosis obtained after follow-up and additional diagnostic workup. Seventeen patients were prospectively included, all on mechanical ventilation and 14 under vasopressor drugs. The FDG-PET/CTA exam 1) was responsible for only one desaturation and one hypotension, both quickly reversible under treatment; 2) led to suspect 16 infectious sites among which 13 (81 %) could be confirmed by further diagnostic procedures; and 3) triggered beneficial changes in the medical management of 12 of the 17 study patients (71 %). The FDG-PET/CTA images showed a single or predominant infectious focus in two cases where CTA was negative and in three cases where CTA exhibited multiple possible foci. Whole-body FDG-PET/CTA appears to be feasible, relatively safe, and provides reliable and useful information, when prospectively planned in patients with suspected severe sepsis and for whom prior diagnostic workup had been inconclusive. The FDG-PET images are particularly helpful when CTA exhibits no or multiple possible sites. (orig.)

  7. Prognostic value of 18F-fluorodeoxyglucose positron emission tomography, computed tomography and magnetic resonance imaging in oral cavity squamous cell carcinoma with pathologically positive neck lymph node

    To evaluate the prognostic value of preoperative neck lymph node (LN) assessment with 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET), computed tomography (CT), and magnetic resonance imaging (MRI) in oral cavity squamous cell carcinoma (OSCC) patients with pathologically positive LN. In total, 47 OSCC patients with pathologically positive LN were retrospectively reviewed with preoperative 18F-FDG PET and CT/MRI. All patients underwent surgical resection, neck dissection and postoperative adjuvant radiotherapy and/or chemotherapy between March 2002 and October 2010. Histologic correlation was performed for findings of 18F-FDG PET and CT/MRI. Thirty-six (76.6%) of 47 cases were correctly diagnosed with neck LN metastasis by 18F-FDG PET and 32 (68.1%) of 47 cases were correctly diagnosed by CT/MRI. Follow-up ranged from 20 to 114 months (median, 56 months). Clinically negative nodal status evaluated by 18F-FDG PET or CT/MRI revealed a trend toward better clinical outcomes in terms of overall survival, disease-free survival, local recurrence-free survival, regional nodal recurrence-free survival, and distant metastasis-free survival rates even though the trends were not statistically significant. However, there was no impact of neck node standardized uptake value (SUVmax) on clinical outcomes. Notably, SUVmax showed significant correlation with tumor size in LN (p 2 = 0.62). PET and CT/MRI status of LN also had significant correlation with the size of intranodal tumor deposit (p 2 = 0.37 and p 2 = 0.48, respectively). 18F-FDG PET and CT/MRI at the neck LNs might improve risk stratification in OSCC patients with pathologically positive neck LN in this study, even without significant prognostic value of SUVmax.

  8. [18F]-fluorodeoxyglucose positron emission tomography can contribute to discriminate patients with poor prognosis in hormone receptor-positive breast cancer.

    Sung Gwe Ahn

    Full Text Available Patients with hormone receptor-positive breast cancer typically show favorable survival. However, identifying individuals at high risk of recurrence among these patients is a crucial issue. We tested the hypothesis that [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET scans can help predict prognosis in patients with hormone receptor-positive breast cancer.Between April 2004 and December 2008, 305 patients with hormone receptor-positive breast cancer who underwent FGD-PET were enrolled. Patients with luminal B subtype were identified by positivity for human epidermal growth factor receptor-2 (HER2 or high Ki67 (≥14% according to criteria recently recommended by the St. Gallen panelists. The cut-off value of SUVmax was defined using the time-dependent receiver operator characteristic curve for recurrence-free survival (RFS.At a median follow up of 6.23 years, continuous SUVmax was a significant prognostic factor with a hazard ratio (HR of 1.21 (p = 0.021. The cut-off value of SUVmax was defined as 4. Patients with luminal B subtype (n = 82 or high SUVmax (n = 107 showed a reduced RFS (p = 0.031 and 0.002, respectively. In multivariate analysis for RFS, SUVmax carried independent prognostic significance (p = 0.012 whereas classification with immunohistochemical markers did not (p = 0.274. The Harell c-index was 0.729. High SUVmax was significantly associated with larger tumor size, positive nodes, HER2 positivity, high Ki67 (≥14%, high tumor grade, and luminal B subtype.Among patients with hormone receptor-positive breast cancer, FDG-PET can help discriminate patients at high risk of tumor relapse.

  9. 18F-Fluorodeoxyglucose Positron Emission Tomography/CT Scan Findings for Ductal Carcinomas of Breast: Association of Standardized Uptake Value and Histological Findings

    Bae, So Young; Lee, Eun Hye [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Park, Jung Mi [Dept. of Nuclear Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Kwak, Jeong Ja [Dept. of Pathology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2012-02-15

    To evaluate the factors associated with variations in 18F-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) uptake in ductal carcinomas of the breast. We enrolled 216 ductal carcinoma cases that underwent 18F-FDG PET/CT. We evaluated the positivity and measured peak standardized uptake value (pSUV) of lesions that underwent 18F-FDG PET/CT. We analyzed the correlation between pSUV and invasiveness, lesion size, and the histologic factors of invasive ductal carcinoma (IDC). In the 18F-FDG PET/CT of ductal carcinomas, sensitivity was 90.2%, positive and negative predictive values were 99.5% and 25.0%, respectively. In ductal carcinoma in situ (DCIS) and IDC, the sensitivities were 68.8% and 92.0%, respectively. The mean pSUV of true positive (TP) DCIS and IDC were 2.6 and 5.1 (p < 0.05), respectively, whereas the false negative (FN) were 1.3 and 1.2 (p > 0.05), respectively, and that of false positive (FP) and true negative (TN) lesions were 2.2 and 0.9, respectively. The mean size of TP DCIS and IDC were 4.5 cm and 2.7 cm (p < 0.05), respectively, whereas the mean size of FN DCIS and IDC were 1.5 cm and 1.4 cm (p > 0.05), respectively, and that of FP and TN lesions were 1.8 cm and 1.2 cm respectively. Among the histological factors affecting IDC, mitosis showed the best correlation with pSUV (rho = 0.5). For 18F-FDG PET/CT of ductal carcinomas, the positive predictive value was 99.5% and the FN rate was 9.7%. False negative factors included DCIS and an IDC < 1.5 cm, whereas mitosis was the TP factor.

  10. Visual and semiquantitative analysis of 18F-fluorodeoxyglucose positron emission tomography using a partial-ring tomograph without attenuation correction to differentiate benign and malignant pulmonary nodules

    Many studies have reported the use of attenuation-corrected positron emission tomography with 18F-fluorodeoxyglucose (FDG PET) with full-ring tomographs to differentiate between benign and malignant pulmonary nodules. We sought to evaluate FDG PET using a partial-ring tomograph without attenuation correction. A retrospective review of PET images from 77 patients (range 38-84 years of age) with proven benign or malignant pulmonary nodules was undertaken. All images were obtained using a Siemens/CTI ECAT ART tomograph, without attenuation correction, after 185 MBq 18F-FDG was injected. Images were visually graded on a 5-point scale from 'definitely malignant' to 'definitely benign,' and lesion-to-background (LB) ratios were calculated using region of interest analysis. Visual and semiquantitative analyses were compared using receiver operating characteristic analysis. Twenty lesions were benign and 57 were malignant. The mean LB ratio for benign lesions was 1.5 (range 1.0-5.7) and for malignant lesions 5.7 (range 1.2-14.1) (p < 0.001). The area under the ROC curve for LB ratio analysis was 0.95, and for visual analysis 0.91 (p = 0.39). The optimal cut-off ratio with LB ratio analysis was 1.8, giving a sensitivity of 95% and a specificity of 85%. For lesions thought to be 'definitely malignant' on visual analysis, the sensitivity was 93% and the specificity 85%. Three proven infective lesions were rated as malignant by both techniques (LB ratio 2.6-5.7). FDG PET without attenuation correction is accurate for differentiating between benign and malignant lung nodules. Results using simple LB ratios without attenuation correction compare favourably with the published sensitivity and specificity for standard uptake ratios. Visual analysis is equally accurate. (author)

  11. Combination of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and magnetic resonance imaging is an optimal way to evaluate rheumatoid arthritis in rats dynamically

    ZHANG Wei-tao; DU Xiang-ke; HUO Tian-long; WEI Zheng-mao; HAO Chuan-xi; AN Bei

    2013-01-01

    Background Rheumatoid arthritis (RA) is a chronic,systemic autoimmune inflammatory disorder.Many methods have been used to observe the progress of RA.The purpose of this study was to observe the progress of RA in rats with 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT),magnetic resonance (MR) imaging and arthritis score,and analyze the relationships among different methods in evaluation of RA.Methods Sixteen healthy Sprague Dawley (SD) rats about 8-week old were randomly assigned to a RA group and a control group.Bovine type Ⅱ emulsified incomplete Freud's adjuvant was used to induce arthritis in the RA group.Arthritis score of the rats in two groups were recorded,and 18F-FDG PET/CT,MR imaging were performed both on the corresponding rats every 3 days.All the rats were sacrificed at week 5,and histopathological examination was performed on rat knees stained with haematoxylin and eosin.Results The arthritis score and the standard uptake value (SUV) of knee joints in RA rats increased with the progression of arthritis gradually.Both peaks of arthritis score and SUV appeared at 21 days after the first immune injection,then the arthritis score and SUV of knee joints decreased slowly.The arthritis scores of knee joints in RA rats were positively correlated with their SUV changes.The MR images were confirmed by the histopathological studies.Conclusion PET/CT can detect the earliest molecular metabolism changes of RA,and MR imaging can follow up the dynamical anatomical changes of RA,all of which indicated that PET/CT and MR imaging may be applied as useful tools to monitor the progress of RA.

  12. 18F-Fluorodeoxyglucose Positron Emission Tomography/CT Scan Findings for Ductal Carcinomas of Breast: Association of Standardized Uptake Value and Histological Findings

    To evaluate the factors associated with variations in 18F-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) uptake in ductal carcinomas of the breast. We enrolled 216 ductal carcinoma cases that underwent 18F-FDG PET/CT. We evaluated the positivity and measured peak standardized uptake value (pSUV) of lesions that underwent 18F-FDG PET/CT. We analyzed the correlation between pSUV and invasiveness, lesion size, and the histologic factors of invasive ductal carcinoma (IDC). In the 18F-FDG PET/CT of ductal carcinomas, sensitivity was 90.2%, positive and negative predictive values were 99.5% and 25.0%, respectively. In ductal carcinoma in situ (DCIS) and IDC, the sensitivities were 68.8% and 92.0%, respectively. The mean pSUV of true positive (TP) DCIS and IDC were 2.6 and 5.1 (p 0.05), respectively, and that of false positive (FP) and true negative (TN) lesions were 2.2 and 0.9, respectively. The mean size of TP DCIS and IDC were 4.5 cm and 2.7 cm (p 0.05), respectively, and that of FP and TN lesions were 1.8 cm and 1.2 cm respectively. Among the histological factors affecting IDC, mitosis showed the best correlation with pSUV (rho = 0.5). For 18F-FDG PET/CT of ductal carcinomas, the positive predictive value was 99.5% and the FN rate was 9.7%. False negative factors included DCIS and an IDC < 1.5 cm, whereas mitosis was the TP factor.

  13. Clinical Usefulness of {sup 18}F-Fluorodeoxyglucose-Positron Emission Tomography in Patients With Locally Advanced Pancreatic Cancer Planned to Undergo Concurrent Chemoradiation Therapy

    Chang, Jee Suk; Choi, Seo Hee; Lee, Youngin; Kim, Kyung Hwan [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Park, Jeong Youp; Song, Si Young [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Cho, Arthur; Yun, Mijin; Lee, Jong Doo [Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Seong, Jinsil, E-mail: jsseong@yuhs.ac [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-09-01

    Purpose: To assess the role of coregistered {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) in detecting radiographically occult distant metastasis (DM) at staging in patients with locally advanced pancreatic cancer (LAPC) and to study whether FDG-PET parameters can predict relatively long-term survival in patients who are more likely to benefit from chemoradiation therapy (CRT). Methods and Materials: From our institutional database, we identified 388 LAPC patients with M0 on conventional computed tomography (CT) who were planned to undergo CRT. Coregistered FDG-PET staging was offered to all patients, and follow-up FDG-PET was used at the clinical discretion of the physician. Results: FDG-PET detected unsuspected CT-occult DM in 33% of all 388 patients and allowed them to receive systemic therapy immediately. The remaining 260 patients (PET-M0) underwent CRT selectively as an initial treatment. Early DM arose in 13.1% of 260 patients, and the 1-year estimated locoregional recurrence rate was 5.4%. Median overall survival (OS) and progression-free survival (PFS) were 14.6 and 9.3 months, respectively, at a median follow-up time of 32.3 months (range, 10-99.1 months). Patients with a baseline standardized uptake value (SUV) <3.5 and/or SUV decline ≥60% had significantly better OS and PFS than those having none, even after adjustment for all potential confounding variables (all P<.001). Conclusions: FDG-PET can detect radiographically occult DM at staging in one-third of patients and spare them from the potentially toxic therapy. Additionally, FDG-PET parameters including baseline SUV and SUV changes may serve as useful clinical markers for predicting the prognosis in LAPC patients.

  14. Impact of Pretreatment Combined {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Staging on Radiation Therapy Treatment Decisions in Locally Advanced Breast Cancer

    Ng, Sweet Ping, E-mail: sweet.ng@petermac.org [Peter MacCallum Cancer Centre, Melbourne (Australia); David, Steven [Peter MacCallum Cancer Centre, Melbourne (Australia); Alamgeer, Muhammad; Ganju, Vinod [Monash Cancer Centre, Melbourne (Australia)

    2015-09-01

    Purpose: To assess the diagnostic performance of pretreatment {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) and its impact on radiation therapy treatment decisions in patients with locally advanced breast cancer (LABC). Methods and Materials: Patients with LABC with Eastern Cooperative Oncology Group performance status <2 and no contraindication to neoadjuvant chemotherapy, surgery, and adjuvant radiation therapy were enrolled on a prospective trial. All patients had pretreatment conventional imaging (CI) performed, including bilateral breast mammography and ultrasound, bone scan, and CT chest, abdomen, and pelvis scans performed. Informed consent was obtained before enrolment. Pretreatment whole-body {sup 18}F-FDG PET/CT scans were performed on all patients, and results were compared with CI findings. Results: A total of 154 patients with LABC with no clinical or radiologic evidence of distant metastases on CI were enrolled. Median age was 49 years (range, 26-70 years). Imaging with PET/CT detected distant metastatic disease and/or locoregional disease not visualized on CI in 32 patients (20.8%). Distant metastatic disease was detected in 17 patients (11.0%): 6 had bony metastases, 5 had intrathoracic metastases (pulmonary/mediastinal), 2 had distant nodal metastases, 2 had liver metastases, 1 had pulmonary and bony metastases, and 1 had mediastinal and distant nodal metastases. Of the remaining 139 patients, nodal disease outside conventional radiation therapy fields was detected on PET/CT in 15 patients (10.8%), with involvement of ipsilateral internal mammary nodes in 13 and ipsilateral level 5 cervical nodes in 2. Conclusions: Imaging with PET/CT provides superior diagnostic and staging information in patients with LABC compared with CI, which has significant therapeutic implications with respect to radiation therapy management. Imaging with PET/CT should be considered in all patients undergoing primary

  15. Changes in 18F-Fluorodeoxyglucose Uptake in the Spinal Cord in a Healthy Population on Serial Positron Emission Tomography/Computed Tomography

    Chong, Ari; Byun, Byung-Hyun; Hong, Sun-Pyo; Min, Jung-Joon; Bom, Hee-Seung; Ha, Jung-Min; Lee, Jung-Kil

    2013-01-01

    We aimed to determine the changes in 18F-fluorodeoxyglucose (FDG) uptake in the spinal cord on two serial positron emission tomography/computed tomography (PET/CT) scans in a healthy population. We retrospectively enrolled healthy people who underwent PET/CT twice for cancer screening. We excluded those who had degenerative vertebral disease, neurologic disease, or a history of a vertebral operation. The standardized uptake value (SUVmax) of the spinal cord of each mid-vertebral body was obtained by drawing a region of interest on an axial image of PET/CT. For analysis, the cord-to-background ratio (CTB) was used (CTB=SUVmax of each level/SUVmax of L5 level). Differences in pattern, sex, age, and intervals of the two serial PET/CT scans were analyzed. A total of 60 PET/CT images of 30 people were analyzed. The mean interval between the two PET/CT imaging studies was 2.80±0.94 years. On the follow-up PET/CT, significant change was shown only at the level of the C6 and T10 vertebrae (p<0.005). Mean CTB showed a decreasing pattern from cervical to lumbar vertebrae. There were two peaks at the lower cervical level (C4-6) and at the lower thoracic level (T12). Neither sex nor age significantly affected CTB. The FDG uptake of the spinal cord changed significantly on follow-up PET/CT only at the level of the C6 and T10 vertebrae. This finding is valuable as a baseline reference in the follow-up of metabolic changes in the spinal cord. PMID:23678476

  16. Parametric images via dynamic {sup 18}F-fluorodeoxyglucose positron emission tomographic data acquisition in predicting midterm outcome of liver metastases secondary to gastrointestinal stromal tumours

    Apostolopoulos, Dimitris J. [German Cancer Research Center (DKFZ), Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany); University of Patras Medical School, University of Patras, Department of Nuclear Medicine, University Hospital of Patras, Rion, Patras (Greece); Dimitrakopoulou-Strauss, Antonia; Roumia, Safwan; Strauss, Ludwig G. [German Cancer Research Center (DKFZ), Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany); Hohenberger, Peter [University of Heidelberg, Division of Surgical Oncology and Thoracic Surgery, Department of Surgery, Medical Faculty Mannheim, Mannheim (Germany)

    2011-07-15

    {sup 18}F-Fluorodeoxyglucose positron emission tomography (FDG PET) may underestimate viable tumour tissue in patients with gastrointestinal stromal tumours (GIST) treated with molecular targeted agents. The aim of the present study was to investigate the value of parametric images generated after dynamic data acquisition for the detection of active liver metastases. The analysis included 65 dynamic FDG PET studies in 34 patients with liver metastases from GIST who were treated with imatinib or sunitinib. Parametric images of intercept and slope were calculated by dedicated software using a voxel-based linear regression of time-activity data. Intercept images represent the tracer's distribution volume and the slope its overall metabolic turnover. All images were assessed visually and semi-quantitatively. Liver disease status was established 12 months after each PET study. Dichotomous variables of visual interpretation and various quantitative parameters were entered in a statistical model of linear discriminant analysis. Visual analysis of slope images was more sensitive than the standard 1-h FDG uptake evaluation (70.6 vs 51.0%, p = 0.016) in detecting cases with liver disease progression (n = 51). Specificity did not differ. Combination of all variables in the discriminant analysis model correctly classified 87.7% of cases as progressive or non-progressive disease. Sensitivity was raised to 88.2%. Parametric images of intercept and slope add a new dimension to the interpretation of FDG PET studies, by isolating visually and quantifying the perfusion and phosphorylation-dependent part of tracer uptake. In treated GIST patients, integration of this information with the 1-h uptake data achieves better characterization of hepatic lesions with respect to disease activity. (orig.)

  17. Impact of Pretreatment Combined 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Staging on Radiation Therapy Treatment Decisions in Locally Advanced Breast Cancer

    Purpose: To assess the diagnostic performance of pretreatment 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and its impact on radiation therapy treatment decisions in patients with locally advanced breast cancer (LABC). Methods and Materials: Patients with LABC with Eastern Cooperative Oncology Group performance status <2 and no contraindication to neoadjuvant chemotherapy, surgery, and adjuvant radiation therapy were enrolled on a prospective trial. All patients had pretreatment conventional imaging (CI) performed, including bilateral breast mammography and ultrasound, bone scan, and CT chest, abdomen, and pelvis scans performed. Informed consent was obtained before enrolment. Pretreatment whole-body 18F-FDG PET/CT scans were performed on all patients, and results were compared with CI findings. Results: A total of 154 patients with LABC with no clinical or radiologic evidence of distant metastases on CI were enrolled. Median age was 49 years (range, 26-70 years). Imaging with PET/CT detected distant metastatic disease and/or locoregional disease not visualized on CI in 32 patients (20.8%). Distant metastatic disease was detected in 17 patients (11.0%): 6 had bony metastases, 5 had intrathoracic metastases (pulmonary/mediastinal), 2 had distant nodal metastases, 2 had liver metastases, 1 had pulmonary and bony metastases, and 1 had mediastinal and distant nodal metastases. Of the remaining 139 patients, nodal disease outside conventional radiation therapy fields was detected on PET/CT in 15 patients (10.8%), with involvement of ipsilateral internal mammary nodes in 13 and ipsilateral level 5 cervical nodes in 2. Conclusions: Imaging with PET/CT provides superior diagnostic and staging information in patients with LABC compared with CI, which has significant therapeutic implications with respect to radiation therapy management. Imaging with PET/CT should be considered in all patients undergoing primary staging for LABC

  18. 18F-fluorodeoxyglucose positron emission tomography for evaluation of thymic epithelial tumors. Utility for World Health Organization classification and predicting recurrence-free survival

    18F-fluorodeoxyglucose positron emission tomography (FDG-PET) plays an important role in many oncological settings. In this study, we assessed the utility of 18F-FDG-PET for predicting the histological classification, stage and survival of thymic epithelial tumors. We retrospectively analyzed 37 patients with thymic epithelial tumors who underwent PET before surgical resection and investigated the relationship between the maximum of standardized uptake value (SUVmax) of each tumor and the WHO classification, recurrence-free survival, and tumor-related gene expressions. The study included 15 males and 22 females, ranging in age from 22 to 81 years (mean 64 years). The tumor histology of 31 tumors was thymoma and that of the remaining tumors was thymic carcinoma. The Masaoka tumor stage was as follows: stage I in 18, II in 9, III in 5 and IV in 5 patients. The patients were divided into three groups according to a simplified histologic classification: low-risk thymoma (types A, AB and B1, n=21), high-risk thymoma (types B2 and B3, n=10) and thymic carcinoma (n=6). The SUVmax of low-risk group (SUVmax ≤ 4.27) was significantly lower than that of high-risk group (p=0.0114) and that of thymic carcinomas (SUVmax > 4.27) was also significantly higher than that of thymomas (p 4.27) had significantly inferior recurrence-free survival to that of less value (SUVmax ≤ 4.27) (p=0.0009). The SUVmax were not correlated with tumor-related gene expressions. The SUVmax of 18F-FDG-PET reflects WHO classification of thymic epithelial tumors. High SUVmax predicts lower recurrence-free survival of the tumors. (author)

  19. [18F]-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography of LAPC4-CR Castration-Resistant Prostate Cancer Xenograft Model in Soft Tissue Compartments

    Keisha C. McCall

    2015-06-01

    Full Text Available Preclinical xenograft models have contributed to advancing our understanding of the molecular basis of prostate cancer and to the development of targeted therapy. However, traditional preclinical in vivo techniques using caliper measurements and survival analysis evaluate the macroscopic tumor behavior, whereas tissue sampling disrupts the microenvironment and cannot be used for longitudinal studies in the same animal. Herein, we present an in vivo study of [18F]-fluorodeoxyglucose (FDG positron emission tomography (PET/computed tomography (CT designed to evaluate the metabolism within the microenvironment of LAPC4-CR, a unique murine model of castration-resistant prostate cancer. Mice bearing LAPC4-CR subcutaneous tumors were administered [18F]-FDG via intravenous injection. After a 60-minute distribution phase, the mice were imaged on a PET/CT scanner with submillimeter resolution; and the fused PET/CT images were analyzed to evaluate tumor size, location, and metabolism across the cohort of mice. The xenograft tumors showed [18F]-FDG uptake that was independent of tumor size and was significantly greater than uptake in skeletal muscle and liver in mice (Wilcoxon signed-rank P values of .0002 and .0002, respectively. [18F]-FDG metabolism of the LAPC4-CR tumors was 2.1 ± 0.8 ID/cm3*wt, with tumor to muscle ratio of 7.4 ± 4.7 and tumor to liver background ratio of 6.7 ± 2.3. Noninvasive molecular imaging techniques such as PET/CT can be used to probe the microenvironment of tumors in vivo. This study showed that [18F]-FDG-PET/CT could be used to image and assess glucose metabolism of LAPC4-CR xenografts in vivo. Further work can investigate the use of PET/CT to quantify the metabolic response of LAPC4-CR to novel agents and combination therapies using soft tissue and possibly bone compartment xenograft models.

  20. Detection of internal mammary lymph node metastasis with 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with stage III breast cancer

    The present study assessed the positive predictive value (PPV) of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the detection of internal mammary node (IMN) metastasis in patients with clinical stage III breast cancer. Patients who were diagnosed with clinical stage III breast cancer and underwent pretreatment 18F-FDG PET/CT were retrospectively analyzed. The 18F-FDG PET/CT scans were prospectively reviewed by two board-certified nuclear medicine physicians in a blinded manner. The intensities of IMNs were graded into four categories (no activity and lower, similar, and higher activities than that of the mediastinal blood pool). IMNs were measured from the combined CT (largest diameter of the short axis). Histologic data of the IMNs were obtained by ultrasonography-guided fine-needle aspiration biopsy or surgical excision. The PPV was calculated for pathologically confirmed IMNs. Visual grade, maximum standardized uptake values (SUVmax), and sizes were analyzed according to the pathology results. There were 249 clinical stage III breast cancer patients (age 48.0 ± 10.1 years, range 26-79 years) who had undergone initial 18F-FDG PET/CT prior to treatment. Excluding 33 cases of stage IV breast cancer, 62 of 216 patients had visible IMNs on 18F-FDG PET/CT, and histologic confirmation was obtained in 31 patients. There were 27 metastatic and four nonmetastatic nodes (PPV 87.1 %). Metastatic nodes mostly presented with visual grade 3 (83.9 %), and SUVmax and size were 3.5 ± 4.3 and 5.6 ± 2.0 mm, respectively. 18F-FDG PET/CT has a high PPV for IMN metastasis in clinical stage III breast cancer, indicating the possibility of metastasis in IMNs with FDG uptake similar to/lower than that of the blood pool or small-sized nodes. (orig.)

  1. Impact of Pretransplantation (18)F-Fluorodeoxyglucose-Positron Emission Tomography on Survival Outcomes after T Cell-Depleted Allogeneic Transplantation for Hodgkin Lymphoma.

    Reyal, Yasmin; Kayani, Irfan; Bloor, Adrian J C; Fox, Christopher P; Chakraverty, Ronjon; Sjursen, Ann-Marie; Fielding, Adele K; Ben Taylor, Marcus; Bishton, Mark J; Morris, Emma C; Thomson, Kirsty J; Russell, Nigel; Mackinnon, Stephen; Peggs, Karl S

    2016-07-01

    Pretransplant (18)F-fluorodeoxyglucose (FDG) positron emission tomography status is an important prognostic factor for outcomes after autologous stem cell transplantation (SCT) in Hodgkin lymphoma (HL), but its impact on outcomes after allogeneic SCT remains unclear. We retrospectively evaluated outcomes after T cell-depleted allogeneic SCT of 116 patients with nonprogressive HL according to pretransplant Deauville scores. Endpoints were overall survival (OS), progression-free survival (PFS), relapse rate (RR), and nonrelapse-related mortality (NRM). OS, PFS, and RR did not differ significantly between the Deauville 1 to 2 and Deauville 3 to 5 cohorts (OS: 77.5% versus 67.3%, P = .49; PFS: 59.4% versus 55.7%, P = .43; RR: 20.9% versus 22.6%, P = .28 at 4 years). Differences in PFS remained statistically nonsignificant when comparisons were made between Deauville 1 to 3 and Deauville 4 to 5 cohorts (60.9% versus 51.4%, P = .10), and RR remained very similar (21.5% versus 23.8%, P = .42). Multivariate analyses demonstrated trends toward significance for an effect of Deauville score on PFS (hazard ratio 1.82 for Deauville 4 to 5, P = .06) and for number of lines of prior therapy on OS (hazard ratio 2.34 for >5 lines, P = .10). The latter effect appeared to be driven by higher NRM rather than increased RR. Our findings suggest that Deauville score before allogeneic SCT in patients with nonprogressive HL has a relatively modest impact on survival outcomes in comparison with the impact in autologous SCT and that predictive values for the individual patient remain low, indicating that residual FDG-avid disease should not preclude allogeneic SCT. Furthermore, our findings bring into question the importance of attainment of metabolic complete response in this setting if it is at the expense of increasing NRM risk. PMID:27095691

  2. [18F]Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (PET/CT) Physiologic Imaging of Choroidal Melanoma: Before and After Ophthalmic Plaque Radiation Therapy

    Purpose: To evaluate changes in [18F]fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) standardized uptake values (SUV) in uveal melanoma before and after plaque brachytherapy. Methods and Materials: A cohort of 217 patients diagnosed with uveal melanoma and eligible for ophthalmic plaque brachytherapy underwent preoperative PET/CT to evaluate their intraocular tumor and screen for metastasis. Subsequent to undergoing plaque brachytherapy, patients' PET/CT SUV were periodically reevaluated over 42 months. Results: In this series, 37 (17%) choroidal melanoma patients were found to have an SUV of >2.0. Of these, 18 patients were able to undergo interval follow-up PET/CT scanning. There were 3 patients with T2, 11 patients with T3, and 4 patients with T4 melanomas according to 7th edition AJCC-UICC criteria. Mean apical thickness was 8.8 mm (range, 3-12.3 mm), and the largest mean tumor diameter was 15.1 mm (range, 12-19.9 mm). The mean initial SUV was 3.7 (range, 2.1-7.3). Patients were followed for a median 16 months (range, 6-42 months). The median time to a tumor SUV of 0 was 8.0 months (range, 6-18 months). There was one case of one interval increase in SUV that diminished after circumferential laser treatment. Conclusions: Intraocular PET/CT imaging provides a physiological assessment of tumor metabolism that can be used to evaluate changes after treatment. In this study, ophthalmic plaque radiation therapy was associated with extinguished tumor PET/CT SUV over time. PET/CT imaging can be used to assess choroidal melanomas for their response to treatment.

  3. Usefulness of {sup 18}F-fluorodeoxyglucose positron emission tomography in follicular lymphoma management; Apport de la tomographie a emission de positons au {sup 18}F-fluorodeoxyglucose dans la prise en charge des lymphomes folliculaires

    Le Dortz, L.; Devillers, A.; Prigent, F.; Bahri, H.; Hervouet, T.; Garin, E. [Centre Eugene-Marquis, Service de Medecine Nucleaire, 35 - Rennes (France); Guibert, S. de.; Lamy, T. [CHU de Rennes, Service d' Hematologie, 35 - Rennes (France); Rolland, Y. [Centre Eugene-Marquis, Service de Radiologie, 35 - Rennes (France); Bayat, S. [CHU de Rennes, Dept. d' Information Medicale, 35 - Rennes (France)

    2009-06-15

    Purpose To assess the usefulness of positron emission tomography/computed tomography in staging, prognosis evaluation and re staging of patients with follicular lymphoma. Patients and methods a retrospective study was performed on 45 patients with untreated biopsy-proven follicular lymphoma who underwent F.D.G.-PET/CT and CT before and after chemo-immunotherapy induction treatment (rituximab combined with cyclophosphamide, doxorubicin, vincristine and prednisone). Results PET/CT detected more nodal (+51%) and extra nodal (+89%) lesions than CT. PET/CT changed Ann Arbor stage in eight patients (18%). Five patients (11%) initially considered with early stage (I/II) were finally managed as advanced stage (III/IV). In this study, initial PET/CT was significantly more accurate to identify patients with poor prognosis than F.L.I.P.I.. Poor prognosis was defined as incomplete therapeutic response or early relapse. Accuracy of PET/CT for therapeutic response assessment was significantly higher than that of CT (0.97 vs 0.64), especially because of its ability to identify inactive residual masses. Beside, post-treatment PET/CT was able to predict patients outcome. The median progression free survival (P.F.S.) was 48 months in the PET/CT negative group as compared to 17.2 months for the group with residual uptake (P < 10-4). Conclusion F.D.G.-PET/CT is a very useful tool for staging, assessing prognosis and therapeutic response of patients with follicular lymphoma. (authors)

  4. Cervical lymph node hyperplasia on [{sup 18}F]-fluorodeoxyglucose positron emission tomography/computed tomography scan after treatment of children and adolescents with malignant lymphoma

    Hu, Ying-Ying, E-mail: huyy@sysucc.org.cn; Zhang, Xu, E-mail: zhangxu2@sysucc.org.cn; Long, Wen, E-mail: longwen2@sysucc.org.cn; Lin, Xiao-Ping, E-mail: linxp@sysucc.org.cn; Zhang, Ya-Rui, E-mail: zhangyr@sysucc.org.cn; Li, Yuan-Hua, E-mail: liyh@sysucc.org.cn; Xiao, Zi-Zheng, E-mail: xiaozzh@sysucc.org.cn; Zheng, Rong-Liang, E-mail: zhengrl@sysucc.org.cn; Liang, Pei-Yan, E-mail: liangpy@sysucc.org.cn; Fan, Wei, E-mail: fanwei@sysucc.org.cn

    2015-07-15

    Highlights: • Cervical lymph node hyperplasia is a benign processes. • Lymph node hyperplasia found in treated children and adolescents with lymphoma. • We define imaging manifestations of cervical lymph node hyperplasia in PET/CT. • Awareness of lymph node hyperplasia avoid invasive procedures and over-treatment. - Abstract: Purpose: To define imaging manifestations and clinical prognosis of cervical lymph node hyperplasia using [{sup 18}F]-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scanning after treatment of children and adolescents with malignant lymphoma. Methods: Children and adolescent patients with malignant lymphoma who had high FDG uptake in their cervical lymph nodes via PET/CT after treatment, which was not due to tumor recurrence or residue, were retrospectively analyzed. Results: Twenty-seven patients with a median age of 12 years were included; 11 had Hodgkin's disease and 16 had non-Hodgkin's lymphoma. The time from PET/CT scan to completion of therapy was 1–36 months, 85.2% (23/27) of which took place within 12 months. Three patients had confirmed lymph node follicular hyperplasia by biopsy, while all 27 patients achieved disease-free survival during the follow-up period. The maximum standardized uptake values (SUV{sub max}) of cervical lymph nodes were 2.2–16.2 and the maximum short axis ranged from 0.3 to 1.2 cm. Cervical lymph node hyperplasia was noted in neck levels I–V, and neck level II bilaterally had the highest incidence (100%). Bilateral cervical lymph node hyperplasia was symmetrical in terms of both the SUV{sub max} and affected locations. Thymic hyperplasia and nasopharyngeal lymphoid hyperplasia were both observed in 24 patients (88.9%). There was no relationship in terms of the SUV{sub max} between cervical lymph nodes and thymic tissue, cervical nodes or nasopharyngeal lymphoid tissue. Conclusion: Cervical lymph node hyperplasia with high FDG uptake on PET/CT scans found

  5. Cervical lymph node hyperplasia on [18F]-fluorodeoxyglucose positron emission tomography/computed tomography scan after treatment of children and adolescents with malignant lymphoma

    Highlights: • Cervical lymph node hyperplasia is a benign processes. • Lymph node hyperplasia found in treated children and adolescents with lymphoma. • We define imaging manifestations of cervical lymph node hyperplasia in PET/CT. • Awareness of lymph node hyperplasia avoid invasive procedures and over-treatment. - Abstract: Purpose: To define imaging manifestations and clinical prognosis of cervical lymph node hyperplasia using [18F]-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scanning after treatment of children and adolescents with malignant lymphoma. Methods: Children and adolescent patients with malignant lymphoma who had high FDG uptake in their cervical lymph nodes via PET/CT after treatment, which was not due to tumor recurrence or residue, were retrospectively analyzed. Results: Twenty-seven patients with a median age of 12 years were included; 11 had Hodgkin's disease and 16 had non-Hodgkin's lymphoma. The time from PET/CT scan to completion of therapy was 1–36 months, 85.2% (23/27) of which took place within 12 months. Three patients had confirmed lymph node follicular hyperplasia by biopsy, while all 27 patients achieved disease-free survival during the follow-up period. The maximum standardized uptake values (SUVmax) of cervical lymph nodes were 2.2–16.2 and the maximum short axis ranged from 0.3 to 1.2 cm. Cervical lymph node hyperplasia was noted in neck levels I–V, and neck level II bilaterally had the highest incidence (100%). Bilateral cervical lymph node hyperplasia was symmetrical in terms of both the SUVmax and affected locations. Thymic hyperplasia and nasopharyngeal lymphoid hyperplasia were both observed in 24 patients (88.9%). There was no relationship in terms of the SUVmax between cervical lymph nodes and thymic tissue, cervical nodes or nasopharyngeal lymphoid tissue. Conclusion: Cervical lymph node hyperplasia with high FDG uptake on PET/CT scans found after treating children

  6. Positron emission tomography imaging of adrenal masses: 18F-fluorodeoxyglucose and the 11β-hydroxylase tracer 11C-metomidate

    11C-metomidate (MTO), a marker of 11β-hydroxylase, has been suggested as a novel positron emission tomography (PET) tracer for adrenocortical imaging. Up to now, experience with this very new tracer is limited. The aims of this study were (1) to evaluate this novel tracer, (2) to point out possible advantages in comparison with18F-fluorodeoxyglucose (FDG) and (3) to investigate in vivo the expression of 11β-hydroxylase in patients with primary aldosteronism. Sixteen patients with adrenal masses were investigated using both MTO and FDG PET imaging. All patients except one were operated on. Five patients had non-functioning adrenal masses, while 11 had functioning tumours(Cushing's syndrome, n=4; Conn's syndrome, n=5; phaeochromocytoma, n=2). Thirteen patients had benign disease, whereas in three cases the adrenal mass was malignant (adrenocortical cancer, n=1; malignant phaeochromocytoma, n=1; adrenal metastasis of renal cancer, n=1). MTO imaging clearly distinguished cortical from non-cortical adrenal masses (median standardised uptake values of 18.6 and 1.9, respectively, p<0.01). MTO uptake was slightly lower in patients with Cushing's syndrome than in those with Conn's syndrome, but the difference did not reach statistical significance. The expression of 11β-hydroxylase was not suppressed in the contralateral gland of patients with Conn's syndrome, whereas in Cushing's syndrome this was clearly the case. The single patient with adrenocortical carcinoma had MTO uptake in the lower range. MTO could not definitely distinguish between benign and malignant disease. FDG PET, however, identified clearly all three study patients with malignant adrenal lesions. We conclude: (1) MTO is an excellent imaging tool to distinguish adrenocortical and non-cortical lesions; (2) the in vivo expression of 11β-hydroxylase is lower in Cushing's syndrome than in Conn's syndrome, and there is no suppression of the contralateral gland in primary aldosteronism; (3) for the purpose of

  7. Positron emission tomography imaging of adrenal masses: {sup 18}F-fluorodeoxyglucose and the 11{beta}-hydroxylase tracer {sup 11}C-metomidate

    Zettinig, Georg; Becherer, Alexander; Pirich, Christian; Dudczak, Robert [Department of Nuclear Medicine, University of Vienna, Waehringer Guertel 18-20, 1090, Vienna (Austria); Ludwig Boltzmann Institute for Nuclear Medicine, University of Vienna, Vienna (Austria); Mitterhauser, Markus [Department of Nuclear Medicine, University of Vienna, Waehringer Guertel 18-20, 1090, Vienna (Austria); Department of Pharmaceutic Technology and Biopharmaceutics, University of Vienna, Vienna (Austria); Wadsak, Wolfgang; Kletter, Kurt [Department of Nuclear Medicine, University of Vienna, Waehringer Guertel 18-20, 1090, Vienna (Austria); Vierhapper, Heinrich [Department of Internal Medicine III, University of Vienna, Vienna (Austria); Niederle, Bruno [Department of Surgery, University of Vienna, Vienna (Austria)

    2004-09-01

    {sup 11}C-metomidate (MTO), a marker of 11{beta}-hydroxylase, has been suggested as a novel positron emission tomography (PET) tracer for adrenocortical imaging. Up to now, experience with this very new tracer is limited. The aims of this study were (1) to evaluate this novel tracer, (2) to point out possible advantages in comparison with{sup 18}F-fluorodeoxyglucose (FDG) and (3) to investigate in vivo the expression of 11{beta}-hydroxylase in patients with primary aldosteronism. Sixteen patients with adrenal masses were investigated using both MTO and FDG PET imaging. All patients except one were operated on. Five patients had non-functioning adrenal masses, while 11 had functioning tumours(Cushing's syndrome, n=4; Conn's syndrome, n=5; phaeochromocytoma, n=2). Thirteen patients had benign disease, whereas in three cases the adrenal mass was malignant (adrenocortical cancer, n=1; malignant phaeochromocytoma, n=1; adrenal metastasis of renal cancer, n=1). MTO imaging clearly distinguished cortical from non-cortical adrenal masses (median standardised uptake values of 18.6 and 1.9, respectively, p<0.01). MTO uptake was slightly lower in patients with Cushing's syndrome than in those with Conn's syndrome, but the difference did not reach statistical significance. The expression of 11{beta}-hydroxylase was not suppressed in the contralateral gland of patients with Conn's syndrome, whereas in Cushing's syndrome this was clearly the case. The single patient with adrenocortical carcinoma had MTO uptake in the lower range. MTO could not definitely distinguish between benign and malignant disease. FDG PET, however, identified clearly all three study patients with malignant adrenal lesions. We conclude: (1) MTO is an excellent imaging tool to distinguish adrenocortical and non-cortical lesions; (2) the in vivo expression of 11{beta}-hydroxylase is lower in Cushing's syndrome than in Conn's syndrome, and there is no suppression of the

  8. Assessment of Collagen-Induced Arthritis Using Cyanine 5.5 Conjugated with Hydrophobically Modified Glycol Chitosan Nanoparticles: Correlation with 18F-Fluorodeoxyglucose Positron Emission Tomography Data

    Cha, Ji Hyeon; Lee, Sang Hoon; Lee, Sheen Woo; Moon, Dae Huk [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of); Park, Kyoung Soon [Biomedical Research Center, Seoul (Korea, Republic of); Biswal, Sandip [Stanford University School of Medicine, Stanford (United States)

    2012-07-15

    To evaluate the potential and correlation between near-infrared fluorescence (NIRF) imaging using cyanine 5.5 conjugated with hydrophobically modified glycol chitosan nanoparticles (HGC-Cy5.5) and {sup 18}F-fluorodeoxyglucose-positron emission tomography ({sup 18}F-FDG-PET) imaging of collagen-induced arthritis (CIA). We used 10 CIA and 3 normal mice. Nine days after the injecting collagen twice, microPET imaging was performed 40 minutes after the intravenous injection of 9.3 MBq {sup 18}F-FDG in 200 {mu}L PBS. One day later, NIRF imaging was performed two hours after the intravenous injection of HGC-cy5.5 (5 mg/kg). We assessed the correlation between these two modalities in the knees and ankles of CIA mice. The mean standardized uptake values of {sup 18}F-FDG for knees and ankles were 1.68 {+-} 0.76 and 0.79 {+-} 0.71, respectively, for CIA mice; and 0.57 {+-} 0.17 and 0.54 {+-} 0.20 respectively for control mice. From the NIRF images, the total photon counts per 30 mm{sup 2} for knees and ankles were 2.32 {+-} 1.54 X 10{sup 5} and 2.75 {+-} 1.51 X 10{sup 5}, respectively, for CIA mice, and 1.22 {+-} 0.27 X 10{sup 5} and 0.88 {+-} 0.24 X 10{sup 5}, respectively, for control mice. These two modalities showed a moderate correlation for knees (r = 0.604, p = 0.005) and ankles (r = 0.464, p = 0.039). Moreover, both HGC-Cy5.5 (p = 0.002) and {sup 18}F-FDG-PET (p = 0.005) imaging also showed statistically significant differences between CIA and normal mice. NIRF imaging using HGC-Cy5.5 was moderately correlated with {sup 18}F-FDG-PET imaging in the CIA model. As such, HGC-Cy5.5 imaging can be used for the early detection of rheumatoid arthritis.

  9. Highly metabolic thrombus of the portal vein: 18F fluorodeoxyglucose positron emission tomography/computer tomography demonstration and clinical significance in hepatocellular carcinoma

    2008-01-01

    AIM: To assess the ability of 18F-fluorodeoxyglucose positron emission tomography/computer tomography (18F-FDG PET/CT) to differentiate between benign and malignant portal vein thrombosis in hepatocellular carcinoma (HCC) patients. METHODS: Five consecutive patients who had HBV cirrhosis, biopsy-proven HCC, and thrombosis of the main portal vein and/or left/right portal vein on ultrasound (US), computer tomography (CT) or magnetic resonance imaging (MRI) were studied with 18F-FDG PET/CT. The presence or absence of a highly metabolic thrombus on 18F-FDG PET/CT was considered diagnostic for malignant or benign portal vein thrombosis, respectively. All patients were followed-up monthly with US, CT or MRI. Shrinkage of the thrombus or recanalization of the vessels on US, CT or MRI during follow-up was considered to be definitive evidence of the benign nature of the thrombosis, whereas enlargement of the thrombus, disruption of the vessel wall, and parenchymal infiltration over follow-up were considered to be consistent with malignancy 18F-FDG PET/CT, and US, CT or MRI results were compared. RESULTS: Follow-up (1 to 10 mo) showed signs of malignant thrombosis in 4 of the 5 patients. US, CT or MRI produced a true-positive result for malignancy in 4of the patients, and a false-positive result in 1.18F-FDG PET/CT showed a highly metabolic thrombus in 4 of the 5 patients.18F-FDG PET/CT achieved a true-positive result in all 4 of these patients, and a true-negative result in the other patient. No false-positive result was observed using 18F-FDG PET/CT.CONCLUSION: 18F-FDG PET/CT may be helpful in discriminating between benign and malignant portal vein thrombi. Patients may benefit from 18F-FDG PET/OT when portal vein thrombi can not be diagnosed exactly by US, CT or MRI.

  10. Serum Inflammatory Biomarkers and Plaque Inflammation Assessed by 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the dal-PLAQUE Study

    Duivenvoorden, Raphaël; Mani, Venkatesh; Woodward, Mark; Kallend, David; Suchankova, Gabriela; Fuster, Valentin; Rudd, James H.F.; Tawakol, Ahmed; Farkouh, Michael E.; Fayad, Zahi A.

    2013-01-01

    OBJECTIVES To longitudinally investigate the relationship between a broad spectrum of serum inflammatory biomarkers and plaque inflammation assessed by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). BACKGROUND Both plaque inflammation and serum biomarkers of inflammation are associated with atherothrombotic events; however, the relationship between them is unclear. METHODS We conducted a post-hoc analysis of the dal-PLAQUE study – a randomized, placebo-controlled study of dalcetrapib, a cholesteryl ester transfer protein inhibitor, in 130 patients with coronary heart disease, or coronary heart disease risk equivalents on stable lipid-lowering therapy. Baseline and change after 3 months’ follow-up in inflammatory biomarker levels, and baseline and change after 3 months’ follow-up in aorta and carotid 18F-FDG PET/CT (mean maximum target to background ratio of the most diseased segment (TBRmds), were analyzed. RESULTS Baseline myeloperoxidase (MPO) positively correlated with baseline carotid TBRmds (rho 0.25, p = 0.02). This correlation remained at 3 months’ and was independent of traditional cardiovascular disease risk factors. Baseline lipoprotein-associated phospholipase A2 mass correlated with aorta TBRmds (rho 0.21, p = 0.03). However, this correlation disappeared at 3 months’ and was not independent of cardiovascular disease risk factors. There was no association between change from baseline in MPO or lipoprotein-associated phospholipase A2 mass and change from baseline in aorta and carotid TBRmds. Baseline and change from baseline in high sensitivity C-reactive protein, interleukin 6, soluble P-selectin, soluble E-selectin, soluble intracellular adhesion molecule 1, soluble vascular cell adhesion molecule 1, and matrix-metalloproteinase 3 and 9 did not correlate with baseline or change from baseline in carotid or aorta TBRmds. CONCLUSION Our data show that, in patients with coronary heart disease or at high

  11. Positron emission tomography response criteria in solid tumours criteria for quantitative analysis of [18F]-fluorodeoxyglucose positron emission tomography with integrated computed tomography for treatment response assessment in metastasised solid tumours: All that glitters is not gold.

    Willemsen, Annelieke E C A B; Vlenterie, Myrella; van Herpen, Carla M L; van Erp, Nielka P; van der Graaf, Winette T A; de Geus-Oei, Lioe-Fee; Oyen, Wim J G

    2016-03-01

    For solid tumours, quantitative analysis of [(18)F]-fluorodeoxyglucose positron emission tomography with integrated computed tomography potentially can have significant value in early response assessment and thereby discrimination between responders and non-responders at an early stage of treatment. Standardised strategies for this analysis have been proposed, and the positron emission tomography response criteria in solid tumours (PERCIST) criteria can be regarded as the current standard to perform quantitative analysis in a research setting, yet is not implemented in daily practice. However, several exceptions and limitations limit the feasibility of PERCIST criteria. In this article, we point out dilemmas that arise when applying proposed criteria like PERCIST on an expansive set of patients with metastasised solid tumours. Clinicians and scientists should be aware of these limitations to prevent that methodological issues impede successful introduction of research data into clinical practice. Therefore, to deliver on the high potential of quantitative imaging, consensus should be reached on a standardised, feasible and clinically useful analysis methodology. This methodology should be applicable in the majority of patients, tumour types and treatments. PMID:26808297

  12. Oncocytic Schneiderian Papilloma Presenting as an Intensely Hypermetabolic Lesion of the Maxillary Sinus on {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography/CT: A Case Report and Literature Review

    Lee, Sang Kwon; Rho, Byung Hak [Dept. of Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of); Kwon, Sun Young [Dept. of Pathology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2011-11-15

    A 54-year-old man presented with an incidentally identified intensely hypermetabolic lesion (SUVmax: 22.2 g/mL) in the left maxillary sinus on {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) performed for cancer screening. The mass was well circumscribed and showed solid enhancement on contrast-enhanced CT. Histological examination of the mass was consistent with oncocytic schneiderian papilloma. It is of prime importance to recognize that a sinonasal lesion with intense hypermetabolism on {sup 18}F-FDG PET/CT does not necessarily signify malignancy. Oncocytic schneiderian papilloma should be included in the differential diagnosis of an intensely hypermetabolic and solidly enhancing mass of the nasal cavities or paranasal sinuses.

  13. Contrast-enhanced [18F] fluorodeoxyglucose-positron emission tomography-computed tomography as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin

    Jain, Avani; Srivastava, Madhur Kumar; Pawaskar, Alok Suresh; Shelley, Simon; Elangovan, Indirani; Jain, Hasmukh; Pandey, Somnath; Kalal, Shilpa; Amalachandran, Jaykanth

    2015-01-01

    Background: To evaluate the advantages of contrast enhanced F-18-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-contrast enhanced CT [CECT]) when used as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin (MUO). Materials and Methods: A total of 243 patients with fine needle aspiration cytology/biopsy proven MUO were included in this prospective study. Patients who were thoroughly evaluated for primary or p...

  14. Malaria masquerading as relapse of Hodgkin's lymphoma on contrast enhanced 18F-fluorodeoxyglucose positron emission tomography/computed tomography: A diagnostic dilemma

    18Flurodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is nowadays routinely used in management of lymphoma patients. We here present a case of Hodgkin's lymphoma which showed 18F-FDG avid splenomegaly on PET/CT done for clinically suspected relapse. Further evaluation by peripheral smear examination revealed malaria. The patient was then started on anti-malarial medications and follow-up PET/CT revealed resolution of hypermetabolic splenomegaly. This report highlights that in endemic regions malaria can cause 18F-FDG avid splenomegaly and might mimic relapse of lymphoma

  15. Prostate cancer with lytic bone metastases: 18F-fluorodeoxyglucose positron emission tomography-computed tomography for diagnosis and monitoring response to medical castration therapy

    Lytic bone metastases are rare in prostate cancer. We here present 18 fluorine fluorodeoxyglucose (18F-FDG) positron emission tomography computed tomography (PET-CT) images of a 67-year-old male patient with lytic metastases from prostate cancer. Repeat 18F-FDG PET-CT done 6 months later showed response to medical castration therapy. While the role of 18F-FDG PET-CT for sclerotic bone metastases in prostate cancer remains controversial, it appears to be useful for detection and response assessment of lytic prostate cancer metastases. (author)

  16. Hypertrophic pulmonary osteoarthropathy on bone scintigraphy and 18F-fluorodeoxyglucose positron emission tomography/computed tomography in a patient with lung adenocarcinoma.

    Cengiz, Arzu; Eren, Mine Şencan; Polatli, Mehmet; Yürekli, Yakup

    2015-01-01

    Hypertrophic pulmonary osteoarthropathy (HPOA) is not an uncommon paraneoplastic syndrome that is frequently associated with lung cancer. A 54-year-old male patient with lung adenocarcinoma underwent bone scintigraphy and fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scanning for initial staging. Bone scintigraphy revealed increased periosteal activity in lower extremities. FDG PET/CT revealed hypermetabolic right lung mass, mediastinal lymph nodes, and mildly increased periosteal FDG uptake in both femurs and tibias. The findings in lower extremities on bone scan and FDG PET/CT were interpreted as HPOA. PMID:26170569

  17. Hypertrophic pulmonary osteoarthropathy on bone scintigraphy and 18F-fluorodeoxyglucose positron emission tomography/computed tomography in a patient with lung adenocarcinoma

    Hypertrophic pulmonary osteoarthropathy (HPOA) is not an uncommon paraneoplastic syndrome that is frequently associated with lung cancer. A 54-year-old male patient with lung adenocarcinoma underwent bone scintigraphy and fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scanning for initial staging. Bone scintigraphy revealed increased periosteal activity in lower extremities. FDG PET/CT revealed hypermetabolic right lung mass, mediastinal lymph nodes, and mildly increased periosteal FDG uptake in both femurs and tibias. The findings in lower extremities on bone scan and FDG PET/CT were interpreted as HPOA

  18. Comparison of {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography, hydro-stomach computed tomography, and their combination for detecting primary gastric cancer

    Jang, Hye Young; Chung, Woo Suk; Song, E Rang; Kim, Jin Suk [Konyang University Myunggok Medical Research Institute, Konyang University Hospital, Konyang University College of Medicine, Daejeon (Korea, Republic of)

    2015-01-15

    To retrospectively compare the diagnostic accuracy for detecting primary gastric cancer on positron emission tomography/computed tomography (PET/CT) and hydro-stomach CT (S-CT) and determine whether the combination of the two techniques improves diagnostic performance. A total of 253 patients with pathologically proven primary gastric cancer underwent PET/CT and S-CT for the preoperative evaluation. Two radiologists independently reviewed the three sets (PET/CT set, S-CT set, and the combined set) of PET/CT and S-CT in a random order. They graded the likelihood for the presence of primary gastric cancer based on a 4-point scale. The diagnostic accuracy of the PET/CT set, the S-CT set, and the combined set were determined by the area under the alternative-free receiver operating characteristic curve, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Diagnostic accuracy, sensitivity, and NPV for detecting all gastric cancers and early gastric cancers (EGCs) were significantly higher with the combined set than those with the PET/CT and S-CT sets. Specificity and PPV were significantly higher with the PET/CT set than those with the combined and S-CT set for detecting all gastric cancers and EGCs. The combination of PET/CT and S-CT is more accurate than S-CT alone, particularly for detecting EGCs.

  19. 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Accuracy in the Staging of Non-Small Cell Lung Cancer: Review and Cost-Effectiveness

    Aim of the performed clinical study was to compare the accuracy and cost-effectiveness of PET/CT in the staging of non-small cell lung cancer (NSCLC). Material and Methods. Cross-sectional and prospective study including 103 patients with histologically confirmed NSCLC. All patients were examined using PET/CT with intravenous contrast medium. Those with disease stage ≤IIB underwent surgery (n = 40). Disease stage was confirmed based on histology results, which were compared with those of PET/CT and positron emission tomography (PET) and computed tomography (CT) separately. 63 patients classified with ≥IIIA disease stage by PET/CT did not undergo surgery. The cost-effectiveness of PET/CT for disease classification was examined using a decision tree analysis. Results. Compared with histology, the accuracy of PET/CT for disease staging has a positive predictive value of 80%, a negative predictive value of 95%, a sensitivity of 94%, and a specificity of 82%. For PET alone, these values are 53%, 66%, 60%, and 50%, whereas for CT alone they are 68%, 86%, 76%, and 72%, respectively. Incremental cost-effectiveness of PET/CT over CT alone was €17,412 quality-adjusted life-year (QALY). Conclusion. In our clinical study, PET/CT using intravenous contrast medium was an accurate and cost-effective method for staging of patients with NSCLC

  20. Role of 18F fluorodeoxyglucose positron emission tomography/computed tomography in the detection of recurrence in patients with cervical cancer

    Treatment of cervical cancer is usually surgery in the early stages and radiotherapy or chemoradiotherapy in more advanced stages of the disease. Recurrence may occur in multiple sites following primary treatment. Although recurrent metastatic disease is not curable, surgical treatment may be of great help if locoregional recurrence is detected early. Fluorine-18 Fluorodeoxyglucose positron emission tomography - computed tomography (18F FDG PET/CT) forms an important part of investigations in the diagnosis of clinically suspicious recurrent cervical cancer. To assess the role of 18F FDG PET/CT in diagnosing recurrence in patients with clinical suspicion of recurrent cervical cancer. We retrospectively evaluated 53 histopathologically proved patients of cervical cancer. All the patients had been treated with either surgery/radiation therapy with or without chemotherapy. The standard PET/CT acquisition protocol, with delayed post void static pelvic images, wherever required, was followed in all patients. Significant uptake of FDG in the lymph nodes was considered to be a recurrence suggestive of metastasis. Para-aortic lymph nodal involvement was considered to be distant metastasis. Any significant uptake in the lung nodule on FDG PET was evaluated either by histological confirmation, by taking fine needle aspiration cytology (FNAC), or by a follow-up chest CT done after three months. Of the 53 patients with clinically equivocal recurrence, FDG PET/CT suggested recurrence in 41 patients (local recurrence in 14 patients and distant recurrence/metastasis with or without local recurrence in 27 patients). It had a sensitivity of 97.5%, a specificity of 63.6%, positive predictive value of 90.9%, and negative predictive value of 87.5%. PET/CT appears to have an important role in detecting recurrence following primary treatment of cervical cancer. The high positive and negative predictive values of PET/CT may be helpful in planning management of recurrent cervical cancer

  1. Contrast-enhanced [18F] fluorodeoxyglucose-positron emission tomography-computed tomography as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin

    To evaluate the advantages of contrast enhanced F-18-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-contrast enhanced CT [CECT]) when used as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin (MUO). A total of 243 patients with fine needle aspiration cytology/biopsy proven MUO were included in this prospective study. Patients who were thoroughly evaluated for primary or primary tumor was detected by any other investigation were excluded from the analysis. Totally, 163 patients with pathological diagnosis of malignancy but no apparent sites of the primary tumor were finally selected for analysis. The site of probable primary malignancy suggested by PET-CECT was confirmed by biopsy/follow-up. PET-CECT suggested probable site of primary in 128/163 (78.52%) patients. In 30/35 remaining patients, primary tumor was not detected even after extensive work-up. In 5 patients, where PET-CECT was negative, primary was found on further extensive investigations or follow-up. The sensitivity, specificity, positive predictive value and negative predictive value of the study were 95.76%, 66.67%, 88.28% and 85.71% respectively. F-18 FDG PET-CECT aptly serves the purpose of initial imaging modality owing to high sensitivity, negative and positive predictive value. PET-CECT not only surveys the whole body for the primary malignancy but also stages the disease accurately. Use of contrast improves the diagnostic utility of modality as well as help in staging of the primary tumor. Although benefits of using PET-CECT as initial diagnostic modality are obvious from this study, there is a need for a larger study comparing conventional methods for diagnosing primary in patients with MUO versus PET-CECT

  2. 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) Imaging in the Staging and Prognosis of Inflammatory Breast Cancer

    Background: To prospectively assess fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) staging and prognosis value in patients with suspected inflammatory breast cancer (IBC). Methods: Sixty-two women (mean age 50.7 ± 11.4 years) presenting with unilateral inflammatory breast tumors (59 invasive carcinomas; 3 mastitis) underwent a PET/CT scan before biopsy. Results: PET/CT scan was positive for the primary malignant tumor in 100% and false positive in 2 of 3 benign mastitis. In 59 IBC patients, FDG nodal foci were detected in axillary (90%; n = 53) and extra-axillary areas (56%; n = 33) ipsilateral to the cancer. Compared with clinical examination, the axillary lymph node status by PET/CT was upstaged and down staged in 35 and 5 patients, respectively. In 7 of 9 N0 patients, the axillary lymph node positivity on PET/CT was correct, as revealed by pathological post surgery assessment (not available in the 2 remaining patients). The nodal foci were compared with preoperative fine needle aspiration and/or pathological post chemotherapy findings available in 44 patients and corresponded to 38 true positive, 4 false-negative, and 2 false-positive cases. In 18 of 59 IBC patients (31%), distant lesions were found. On the basis of a univariate analysis of the first enrolled patients (n = 42), among 28 patients who showed intense tumoral uptake (standard uptake value(max)≥5), the 11 patients with distant lesions had a worse prognosis than the 17 patients without distant lesions (P =.04). Conclusions: FDG-PET/CT imaging provides additional invaluable information regarding nodal status or distant metastases in IBC patients and should be considered in the initial staging. It seems also that some prognostic information can be derived from FDG uptake characteristics. (authors)

  3. {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) Imaging in the Staging and Prognosis of Inflammatory Breast Cancer

    Alberini, J.L.; Wartski, M.; Gontier, E.; Madar, O.; Pecking, A.P. [Nuclear Medicine Department, Cancer Research Center Rene Huguenin, Saint-Cloud (France); Lerebours, F. [Oncology Department, Cancer Research Center Rene Huguenin, Saint-Cloud (France); Fourme, E. [Biostatistics Department, Cancer Research Center Rene Huguenin, Saint-Cloud (France); Le Stanc, E. [Nuclear Medicine Department, Foch Hospital, Suresnes (France); Cherel, P. [Radiology Department, Cancer Research Center Rene Huguenin, Saint-Cloud (France); Alberini, J.L. [School of Medicine, Versailles Saint-Quentin University (France)

    2009-07-01

    Background: To prospectively assess fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) staging and prognosis value in patients with suspected inflammatory breast cancer (IBC). Methods: Sixty-two women (mean age 50.7 {+-} 11.4 years) presenting with unilateral inflammatory breast tumors (59 invasive carcinomas; 3 mastitis) underwent a PET/CT scan before biopsy. Results: PET/CT scan was positive for the primary malignant tumor in 100% and false positive in 2 of 3 benign mastitis. In 59 IBC patients, FDG nodal foci were detected in axillary (90%; n = 53) and extra-axillary areas (56%; n = 33) ipsilateral to the cancer. Compared with clinical examination, the axillary lymph node status by PET/CT was upstaged and down staged in 35 and 5 patients, respectively. In 7 of 9 N0 patients, the axillary lymph node positivity on PET/CT was correct, as revealed by pathological post surgery assessment (not available in the 2 remaining patients). The nodal foci were compared with preoperative fine needle aspiration and/or pathological post chemotherapy findings available in 44 patients and corresponded to 38 true positive, 4 false-negative, and 2 false-positive cases. In 18 of 59 IBC patients (31%), distant lesions were found. On the basis of a univariate analysis of the first enrolled patients (n = 42), among 28 patients who showed intense tumoral uptake (standard uptake value(max){>=}5), the 11 patients with distant lesions had a worse prognosis than the 17 patients without distant lesions (P =.04). Conclusions: FDG-PET/CT imaging provides additional invaluable information regarding nodal status or distant metastases in IBC patients and should be considered in the initial staging. It seems also that some prognostic information can be derived from FDG uptake characteristics. (authors)

  4. Rationale and design of dal-PLAQUE: A study assessing efficacy and safety of dalcetrapib on progression or regression of atherosclerosis using magnetic resonance imaging and 18F-fluorodeoxyglucose positron emission tomography/computed tomography

    Fayad, Zahi A.; Mani, Venkatesh; Woodward, Mark; Kallend, David; Bansilal, Sameer; Pozza, Joseph; Burgess, Tracy; Fuster, Valentin; Rudd, James H. F.; Tawakol, Ahmed; Farkouh, Michael E.

    2014-01-01

    dal-PLAQUE is a placebo-controlled multicenter study designed to assess the effect of dalcetrapib on imaging measures of plaque inflammation and plaque burden. dal-PLAQUE is a multimodality imaging study in the context of the large dal-HEART Program. Decreased high-density lipoprotein cholesterol is linked to increased risk of coronary heart disease (CHD). Dalcetrapib, a compound that increases high-density lipoprotein cholesterol by modulating cholesteryl ester transfer protein, is being studied to assess if it can reduce the progression of atherosclerotic disease and thereby decrease cardiovascular morbidity and mortality. Patients with CHD or CHD-risk equivalents were randomized to receive 600 mg dalcetrapib or placebo daily for 24 months, in addition to conventional lipid-lowering medication and other medications for cardiovascular risk factors. The primary outcomes are the effect of dalcetrapib on 18F-fluorodeoxyglucose positron emission tomography target-to-background ratio after 6 months and magnetic resonance imaging (MRI) plaque burden (wall area, wall thickness, total vessel area, and wall area/total vessel area ratio) after 12 months. Secondary objectives include positron emission tomography target-to-background ratio at 3 months and MRI plaque burden at 6 and 24 months; plaque composition at 6, 12, and 24 months; and aortic compliance at 6 months. A tertiary objective is to examine the dynamic contrast-enhanced MRI parameters of plaque neovascularization. In total, 189 subjects entered screening, and 130 were randomized. dal-PLAQUE will provide important information on the effects of dalcetrapib on markers of inflammation and atherosclerotic plaque burden and, thereby, on the safety of cholesteryl ester transfer protein modulation with dalcetrapib. Results are expected in 2011. PMID:21835280

  5. Prognostic Significance of Tumor Response as Assessed by Sequential 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography During Concurrent Chemoradiation Therapy for Cervical Cancer

    Purpose: To investigate the prognostic role of metabolic response by the use of serial sets of positron emission tomography/computed tomography (PET/CT) in patients with cervical cancer who were treated with concurrent chemoradiation therapy (CCRT). Methods and Materials: A total of 60 patients who were treated with CCRT between February 2009 and December 2010 were analyzed. Three sequential PET/CT images were acquired for each patient: pre-CCRT, during-CCRT at 4 weeks of CCRT, and 1 month post-CCRT PET/CT. Metabolic responses were assessed qualitatively. The percentage changes in the maximum values of standardized uptake value (ΔSUVmax%) from the PET/CT images acquired pre-CCRT and during-CCRT were calculated. Receiver operating characteristic (ROC) curve analysis was performed to evaluate whether ΔSUVmax% could predict complete response (CR) on the post-CCRT PET/CT and to identify the best cutoff value. Prognostic factors of progression-free survival (PFS) were analyzed. Results: During-CCRT PET/CT showed that 8 patients (13%) had CR, and the other 52 patients (87%) had partial response (PR). On the post-CCRT PET/CT, 43 patients (73%) had CR, 12 patients (20%) had PR, and 4 patients (7%) had progressive disease. The average SUVmax in primary tumors was 16.3 (range, 6.4-53.0) on the pre-CCRT PET/CT images and 5.3 (range, 0-19.4) on the during-CCRT PET/CT images. According to ROC curve analysis, ΔSUVmax% could predict CR response on post-CCRT PET/CT (Pmax% ≥60% (P=.045) and CR response on the post-CCRT PET/CT (P=.012) were statistically significant predictors of PFS. Conclusion: Metabolic responses on the during-CCRT images at 4 weeks of treatment and 1-month post-CCRT PET/CT images may predict treatment outcomes in patients with cervical cancer. ΔSUVmax% ≥60% at 4 weeks of CCRT may predict CR response on 1-month post-CCRT PET/CT and also PFS

  6. A comparison study of 11C-methionine and 18F-fluorodeoxyglucose positron emission tomography-computed tomography scans in evaluation of patients with recurrent brain tumors

    Sharma, Rajnish; D’Souza, Maria; Jaimini, Abhinav; Hazari, Puja Panwar; Saw, Sanjeev; Pandey, Santosh; Singh, Dinesh; Solanki, Yachna; Kumar, Nitin; Mishra, Anil K.; Mondal, Anupam

    2016-01-01

    Introduction: 11C-methonine ([11C]-MET) positron emission tomography-computed tomography (PET-CT) is a well-established technique for evaluation of tumor for diagnosis and treatment planning in neurooncology. [11C]-MET reflects amino acid transport and has been shown to be more sensitive than magnetic resonance imaging (MRI) in stereotactic biopsy planning. This study compared fluorodeoxyglucose (FDG) PET-CT and MET PET-CT in the detection of various brain tumors. Materials and Methods: Sixty-four subjects of brain tumor treated by surgery, chemotherapy, and/or radiotherapy were subjected to [18F]-FDG, [11C]-MET, and MRI scan. The lesion was analyzed semiquantitatively using tumor to normal contralateral ratio. The diagnosis was confirmed by surgery, stereotactic biopsy, clinical follow-up, MRI, or CT scans. Results: Tumor recurrence was found in 5 out of 22 patients on [F-18] FDG scan while [11C]-MET was able to detect recurrence in 18 out of 22 patients in low-grade gliomas. Two of these patients were false positive for the presence of recurrence of tumor and later found to be harboring necrosis. Among oligodendroglioma, medulloblastoma and high-grade glioma out of 42 patients 39 were found to be concordant MET and FDG scans. On semiquantitative analysis, mean T/NT ratio was found to be 2.96 ± 0.94 for lesions positive for recurrence of tumors and 1.18 ± 0.74 for lesions negative for recurrence of tumor on [11C]-MET scan. While the ratio for FDG scan on semiquantitative analysis was found to be 2.05 ± 1.04 for lesions positive for recurrence of tumors and 0.52 ± 0.15 for lesions negative for recurrence of tumors. Conclusion: The study highlight that [11C]-MET is superior to [18F]-FDG PET scans to detect recurrence in low-grade glioma. A cut-off value of target to nontarget value of 1.47 is a useful parameter to distinguish benign from malignant lesion on an [11C]-MET Scan. Both [18F]-FDG and [11C]-MET scans were found to be useful in high-grade astrocytoma

  7. Value of {sup 18}F-fluorodeoxyglucose uptake in positron emission tomography/computed tomography in predicting survival in multiple myeloma

    Haznedar, Rauf; Aki, Sahika Z.; Oezkurt, Zuebeyde N.; Yagci, Muenci; Sucak, Gulsan T. [Gazi University Faculty of Medicine, Department of Hematology, Ankara (Turkey); Akdemir, Oezguer U. [Gazi University Faculty of Medicine, Department of Nuclear Medicine, Ankara (Turkey); Ceneli, Oezcan [Kirikkale University Sueleyman Demirel Hospital, Department of Hematology, Kirikkale (Turkey); Uenlue, Mustafa [Gazi University Faculty of Medicine, Department of Nuclear Medicine, Ankara (Turkey); Gazi University Faculty of Medicine, Ankara (Turkey)

    2011-06-15

    We assessed the role of the maximum standardized uptake value (SUV{sub max}) of bone marrow and the extramedullary lesion with the highest SUV{sub max} in positron emission tomography/computed tomography (PET/CT) of newly diagnosed multiple myeloma (MM) patients in predicting overall survival (OS). A total of 61 newly diagnosed patients (55 MM and 6 plasmacytoma) were enrolled in the study [37 men and 24 women with a median age of 57 years (range 28-80 years)]. The SUV{sub max} of bone marrow and the extramedullary lesion in PET/CT was correlated with the levels of {beta}{sub 2}-microglobulin, C-reactive protein (CRP), albumin, creatinine, per cent of bone marrow plasma cells, serum free light chain (FLC) ratio, International Staging System (ISS) score and Durie-Salmon stage. The extramedullary lesion with the highest SUV{sub max} showed significant correlation with bone marrow fluorodeoxyglucose (FDG) uptake (p = 0.027) and near significant correlation with ISS (p = 0.048). Bone marrow SUV{sub max} correlated significantly with the per cent of bone marrow plasma cell count (p = 0.024), CRP (p = 0.012) and ISS (p = 0.013). In stage III MM the mean values of SUV{sub max} in extramedullary lesions were significantly higher than stages I and II (6.23 {+-} 6.32 vs 2.85 {+-} 3.44, p = 0.023). The serum FLC ratio did not show any correlation with SUV{sub max} of lesions and bone marrow (p > 0.05). Forty-four MM patients with FDG-positive lesions in PET/CT showed inferior 5-year estimated survival (61.73%) when compared to 11 patients without FDG-positive lesions, all of whom were alive (p = 0.01). In multivariate analysis an extramedullary lesion with the highest SUV{sub max} was the only independent predictor of OS (p = 0.03). PET/CT allows identification of high-risk myeloma patients, and extramedullary lesions with the highest SUV{sub max} independently predict inferior OS. (orig.)

  8. Preoperative [18F]Fluorodeoxyglucose Positron Emission Tomography Standardized Uptake Value of Neck Lymph Nodes Predicts Neck Cancer Control and Survival Rates in Patients With Oral Cavity Squamous Cell Carcinoma and Pathologically Positive Lymph Nodes

    Purpose: Survival in oral cavity squamous cell carcinoma (OSCC) depends heavily on locoregional control. In this prospective study, we sought to investigate whether preoperative maximum standardized uptake value of the neck lymph nodes (SUVnodal-max) may predict prognosis in OSCC patients. Methods and Materials: A total of 120 OSCC patients with pathologically positive lymph nodes were investigated. All subjects underwent a [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) scan within 2 weeks before radical surgery and neck dissection. All patients were followed up for at least 24 months after surgery or until death. Postoperative adjuvant therapy was performed in the presence of pathologic risk factors. Optimal cutoff values of SUVnodal-max were chosen based on 5-year disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS). Independent prognosticators were identified by Cox regression analysis. Results: The median follow-up for surviving patients was 41 months. The optimal cutoff value for SUVnodal-max was 5.7. Multivariate analyses identified the following independent predictors of poor outcome: SUVnodal-max ≥5.7 for the 5-year neck cancer control rate, distant metastatic rate, DFS, DSS, and extracapsular spread (ECS) for the 5-year DSS and OS. Among ECS patients, the presence of a SUVnodal-max ≥5.7 identified patients with the worst prognosis. Conclusion: A SUVnodal-max of 5.7, either alone or in combination with ECS, is an independent prognosticator for 5-year neck cancer control and survival rates in OSCC patients with pathologically positive lymph nodes.

  9. A comparative study of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and 99mTc-MDP whole-body bone scanning for imaging osteolytic bone metastases

    The objective of this study was to evaluate the feasibility and diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and 99mTc-methylenediphosphonate (MDP) whole-body bone scanning (BS) for the detection of osteolytic bone metastases. Thirty-four patients with pathologically confirmed malignancies and suspected osteolytic bone metastases underwent 18F-FDG PET/CT and 99mTc-MDP whole-body BS within 30 days. The sensitivity, specificity, and accuracy with respect to the diagnosis of osteolytic bone metastases and bone lesions were compared between the two imaging methods. The sensitivity, specificity, and accuracy of 18F-FDG PET/CT for the diagnosis of osteolytic bone metastases were 94.3% (95% confidence interval [CI], 91.6–96.2%), 83.3% (95% CI, 43.6–96.9%), and 94.2% (95% CI, 91.5–96.1%), respectively. It was found that 99mTc-MDP whole-body BS could discriminate between patients with 50.2% (95% CI, 45.4–55.1%) sensitivity, 50.0% (95% CI, 18.8–81.2%) specificity, and 50.2% (95% CI, 45.5–55.1%) accuracy. 18F-FDG PET/CT achieved higher sensitivity, specificity, and accuracy in detecting osteolytic bone metastases than 99mTc-MDP whole-body BS (p<0.001). F-FDG PET/CT has a higher diagnostic value than 99mTc-MDP whole-body BS in the detection of osteolytic bone metastases, especially in the vertebra

  10. Comparison of 18F-fluorodeoxyglucose positron emission tomography (FDG PET) and cardiac magnetic resonance (CMR) in corticosteroid-naive patients with conduction system disease due to cardiac sarcoidosis

    Cardiac sarcoidosis (CS) is a cause of conduction system disease (CSD). 18F-Fluorodeoxyglucose-positron emission tomography (FDG PET) and cardiac magnetic resonance (CMR) are used for detection of CS. The relative diagnostic value of these has not been well studied. The aim was to compare these imaging modalities in this population. We recruited steroid-naive patients with newly diagnosed CSD due to CS. All CS patients underwent both imaging studies within 12 weeks of each other. Patients were classified into two groups: group A with chronic mild CSD (right bundle branch block and/or axis deviation), and group B with new-onset atrioventricular block (AVB, Mobitz type II or third-degree AVB). Thirty patients were included. Positive findings on both imaging studies were seen in 72 % of patients (13/18) in group A and in 58 % of patients (7/12) in group B. The remainder (28 %) of the patients in group A were positive only on CMR. Of the patients in group B, 8 % were positive only on CMR and 33 % were positive only on FDG PET. Patients in group A were more likely to be positive only on CMR, and patients in group B were more likely to be positive only on FDG PET (p = 0.02). Patients in group B positive only on FDG PET underwent CMR earlier relative to their symptomatology than patients positive only on CMR (median 7.0, IQR 1.5 - 34.3, vs. 72.0, IQR 25.0 - 79.5 days; p = 0.03). The number of positive FDG PET and CMR studies was different in patients with CSD depending on their clinical presentation. This study demonstrated that CMR can adequately detect cardiac involvement associated with chronic mild CSD. In patients presenting with new-onset AVB and a negative CMR study, FDG PET may be useful for detecting cardiac involvement due to CS. (orig.)

  11. Comparison of {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG PET) and cardiac magnetic resonance (CMR) in corticosteroid-naive patients with conduction system disease due to cardiac sarcoidosis

    Ohira, Hiroshi; Birnie, David H.; Mc Ardle, Brian; Dick, Alexander; Klein, Ran; Renaud, Jennifer; DeKemp, Robert A.; Davies, Ross; Hessian, Renee; Liu, Peter; Nery, Pablo B. [University of Ottawa Heart Institute, Molecular Function and Imaging Program, National Cardiac PET Centre, Ottawa, ON (Canada); University of Ottawa Heart Institute, Arrhythmia Service, Division of Cardiology, Department of Medicine, Ottawa, ON (Canada); Pena, Elena; Dennie, Carole [The Ottawa Hospital, Medical Imaging Department, Ottawa, ON (Canada); University of Ottawa, Department of Radiology, Ottawa, ON (Canada); Bernick, Jordan; Wells, George A. [University of Ottawa Heart Institute, Cardiovascular Research Methods Center, Ottawa, ON (Canada); Leung, Eugene [The Ottawa Hospital, Division of Nuclear Medicine, Department of Medicine, Ottawa, Ontario (Canada); Yoshinaga, Keiichiro [Hokkaido University School of Medicine, Department of Molecular Imaging, Hokkaido (Japan); Tsujino, Ichizo; Sato, Takahiro; Nishimura, Masaharu [Hokkaido University School of Medicine, First Department of Medicine, Hokkaido (Japan); Manabe, Osamu; Tamaki, Nagara [Hokkaido University School of Medicine, Department of Nuclear Medicine, Hokkaido (Japan); Oyama-Manabe, Noriko [Hokkaido University Hospital, Diagnostic and Interventional Radiology, Hokkaido (Japan); Ruddy, Terrence D.; Beanlands, Rob S.B. [University of Ottawa Heart Institute, Molecular Function and Imaging Program, National Cardiac PET Centre, Ottawa, ON (Canada); University of Ottawa Heart Institute, Arrhythmia Service, Division of Cardiology, Department of Medicine, Ottawa, ON (Canada); The Ottawa Hospital, Medical Imaging Department, Ottawa, ON (Canada); University of Ottawa, Department of Radiology, Ottawa, ON (Canada); The Ottawa Hospital, Division of Nuclear Medicine, Department of Medicine, Ottawa, Ontario (Canada); Chow, Benjamin J.W. [University of Ottawa Heart Institute, Molecular Function and Imaging Program, National Cardiac PET Centre, Ottawa, ON (Canada); University of Ottawa Heart Institute, Arrhythmia Service, Division of Cardiology, Department of Medicine, Ottawa, ON (Canada); The Ottawa Hospital, Medical Imaging Department, Ottawa, ON (Canada); University of Ottawa, Department of Radiology, Ottawa, ON (Canada)

    2016-02-15

    Cardiac sarcoidosis (CS) is a cause of conduction system disease (CSD). {sup 18}F-Fluorodeoxyglucose-positron emission tomography (FDG PET) and cardiac magnetic resonance (CMR) are used for detection of CS. The relative diagnostic value of these has not been well studied. The aim was to compare these imaging modalities in this population. We recruited steroid-naive patients with newly diagnosed CSD due to CS. All CS patients underwent both imaging studies within 12 weeks of each other. Patients were classified into two groups: group A with chronic mild CSD (right bundle branch block and/or axis deviation), and group B with new-onset atrioventricular block (AVB, Mobitz type II or third-degree AVB). Thirty patients were included. Positive findings on both imaging studies were seen in 72 % of patients (13/18) in group A and in 58 % of patients (7/12) in group B. The remainder (28 %) of the patients in group A were positive only on CMR. Of the patients in group B, 8 % were positive only on CMR and 33 % were positive only on FDG PET. Patients in group A were more likely to be positive only on CMR, and patients in group B were more likely to be positive only on FDG PET (p = 0.02). Patients in group B positive only on FDG PET underwent CMR earlier relative to their symptomatology than patients positive only on CMR (median 7.0, IQR 1.5 - 34.3, vs. 72.0, IQR 25.0 - 79.5 days; p = 0.03). The number of positive FDG PET and CMR studies was different in patients with CSD depending on their clinical presentation. This study demonstrated that CMR can adequately detect cardiac involvement associated with chronic mild CSD. In patients presenting with new-onset AVB and a negative CMR study, FDG PET may be useful for detecting cardiac involvement due to CS. (orig.)

  12. Change of Maximum Standardized Uptake Value Slope in Dynamic Triphasic [18F]-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Distinguishes Malignancy From Postradiation Inflammation in Head-and-Neck Squamous Cell Carcinoma: A Prospective Trial

    Purpose: To evaluate dynamic [18F]-fluorodeoxyglucose (FDG) uptake methodology as a post–radiation therapy (RT) response assessment tool, potentially enabling accurate tumor and therapy-related inflammation differentiation, improving the posttherapy value of FDG–positron emission tomography/computed tomography (FDG-PET/CT). Methods and Materials: We prospectively enrolled head-and-neck squamous cell carcinoma patients who completed RT, with scheduled 3-month post-RT FDG-PET/CT. Patients underwent our standard whole-body PET/CT scan at 90 minutes, with the addition of head-and-neck PET/CT scans at 60 and 120 minutes. Maximum standardized uptake values (SUVmax) of regions of interest were measured at 60, 90, and 120 minutes. The SUVmax slope between 60 and 120 minutes and change of SUVmax slope before and after 90 minutes were calculated. Data were analyzed by primary site and nodal site disease status using the Cox regression model and Wilcoxon rank sum test. Outcomes were based on pathologic and clinical follow-up. Results: A total of 84 patients were enrolled, with 79 primary and 43 nodal evaluable sites. Twenty-eight sites were interpreted as positive or equivocal (18 primary, 8 nodal, 2 distant) on 3-month 90-minute FDG-PET/CT. Median follow-up was 13.3 months. All measured SUV endpoints predicted recurrence. Change of SUVmax slope after 90 minutes more accurately identified nonrecurrence in positive or equivocal sites than our current standard of SUVmax ≥2.5 (P=.02). Conclusions: The positive predictive value of post-RT FDG-PET/CT may significantly improve using novel second derivative analysis of dynamic triphasic FDG-PET/CT SUVmax slope, accurately distinguishing tumor from inflammation on positive and equivocal scans

  13. 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography-Based Radiotherapy Target Volume Definition in Non-Small-Cell Lung Cancer: Delineation by Radiation Oncologists vs. Joint Outlining With a PET Radiologist?

    Purpose: 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has benefits in target volume (TV) definition in radiotherapy treatment planning (RTP) for non-small-cell lung cancer (NSCLC); however, an optimal protocol for TV delineation has not been determined. We investigate volumetric and positional variation in gross tumor volume (GTV) delineation using a planning PET/CT among three radiation oncologists and a PET radiologist. Methods and Materials: RTP PET/CT scans were performed on 28 NSCLC patients (Stage IA-IIIB) of which 14 patients received prior induction chemotherapy. Three radiation oncologists and one PET radiologist working with a fourth radiation oncologist independently delineated the GTV on CT alone (GTVCT) and on fused PET/CT images (GTVPETCT). The mean percentage volume change (PVC) between GTVCT and GTVPETCT for the radiation oncologists and the PVC between GTVCT and GTVPETCT for the PET radiologist were compared using the Wilcoxon signed-rank test. Concordance index (CI) was used to assess both positional and volume change between GTVCT and GTVPETCT in a single measurement. Results: For all patients, a significant difference in PVC from GTVCT to GTVPETCT exists between the radiation oncologist (median, 5.9%), and the PET radiologist (median, -0.4%, p = 0.001). However, no significant difference in median concordance index (comparing GTVCT and GTVFUSED for individual cases) was observed (PET radiologist = 0.73; radiation oncologists = 0.66; p = 0.088). Conclusions: Percentage volume changes from GTVCT to GTVPETCT were lower for the PET radiologist than for the radiation oncologists, suggesting a lower impact of PET/CT in TV delineation for the PET radiologist than for the oncologists. Guidelines are needed to standardize the use of PET/CT for TV delineation in RTP.

  14. High incidence of thyroid cancer in focal thyroid incidentaloma detected by 18F-fluorodeoxyglucose positron emission tomography in relatively young healthy subjects. Results of 3-year follow-up

    As 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is becoming a common imaging modality, the number of thyroid incidentalomas identified by FDG-PET (PET incidentaloma) is increasing. The purpose of this study was to elucidate the risk of cancer in focal thyroid PET incidentaloma in healthy subjects of relatively younger age as well as the usefulness of repeated FDG-PET. The study was conducted with an observation period of three years. A total of 1,501 healthy volunteers (mean age, 43.5±9.7 years) underwent the first FDG-PET from August 2003 to July 2004. When focal thyroid PET incidentaloma was found, further diagnostic examination was conducted. When thyroid cancer was suspected, surgical resection was performed with the patient's agreement. Patients with PET incidentaloma without surgery were offered annual ultrasonography (US) and FDG-PET and finally fine-needle aspiration biopsy (FNAB) was performed in the fourth year. Focal thyroid PET incidentaloma was observed in 20 subjects. The final diagnoses in 20 subjects were malignant in 11 (ten papillary thyroid carcinoma (PTC) and one thyroid carcinoma showing thymus-like differentiation), indeterminate in one, and benign in eight subjects. Seven patients not treated surgically at the first examination had annual FDG-PET. One patient with PTC showed increasing standardized uptake value (SUV)max, but another with a benign nodule exhibited a similar increase. Others (one with PTC, one with an indeterminate nodule, and three with benign nodules) exhibited negligible SUVmax changes. When closely examined, focal thyroid PET incidentaloma in relatively young healthy adults has a high probability of malignancy. Repeated FDG-PET to follow up patients with thyroid nodules is ineffective. (author)

  15. Preoperative staging of non-small-cell lung cancer: comparison of whole-body diffusion-weighted magnetic resonance imaging and {sup 18}F-fluorodeoxyglucose-positron emission tomography/computed tomography

    Sommer, Gregor; Winter, Leopold; Forrer, Flavio; Bremerich, Jens [University of Basel Hospital, Clinic of Radiology and Nuclear Medicine, Basel (Switzerland); Wiese, Mark; Lardinois, Didier [University of Basel Hospital, Clinic of Thoracic Surgery, Basel (Switzerland); Lenz, Claudia [University of Basel Hospital, Division of Radiological Physics, Clinic of Radiology and Nuclear Medicine, Basel (Switzerland); Klarhoefer, Markus [University of Basel Hospital, Division of Radiological Physics, Clinic of Radiology and Nuclear Medicine, Basel (Switzerland); Healthcare Sector, Siemens Switzerland Ltd., Zurich (Switzerland)

    2012-12-15

    To investigate the diagnostic value of whole-body magnetic resonance imaging (MRI) including diffusion-weighted imaging with background signal suppression (DWIBS) for preoperative assessment of non-small-cell lung cancer (NSCLC) in comparison to {sup 18}F-fluorodeoxyglucose {sup 18}(FDG) positron emission tomography/computed tomography (PET/CT). Thirty-three patients with suspected NSCLC were enrolled. Patients were examined before surgery with PET/CT and whole-body MRI including T1-weighted turbo spin echo (TSE), T2-weighted short tau inversion recovery (STIR) and DWIBS sequences (b = 0/800). Histological or cytological specimens were taken as standard of reference. Whole-body MRI with DWIBS as well as PET/CT provided diagnostic image quality in all cases. Sensitivity for primary tumour detection: MRI 93%, PET/CT 98%. T-staging accuracy: MRI 63%, PET/CT 56%. N-staging accuracy: MRI 66%, PET/CT 71%. UICC staging accuracy: MRI 66%, PET/CT 74%. Sensitivity for metastatic involvement of individual lymph node groups: MRI 44%, PET/CT 47%. Specificity for individual non-metastatic lymph node groups: MRI 93%, PET/CT 96%. Assessment accuracy for individual lymph node groups: MRI 85%, PET/CT 88%. Observer agreement rate for UICC staging: MRI 74%, PET/CT 90%. Whole-body MRI with DWIBS provides comparable results to PET/CT in staging of NSCLC, but shows no superiority. Most relevant challenges for both techniques are T-staging accuracy and sensitivity for metastatic lymph node involvement. (orig.)

  16. [18F] fluoromisonidazole and [18F] fluorodeoxyglucose positron emission tomography in response evaluation after chemo-/radiotherapy of non-small-cell lung cancer: a feasibility study

    Asadpour Branka

    2006-03-01

    Full Text Available Abstract Background Experimental and clinical evidence suggest that hypoxia in solid tumours reduces their sensitivity to conventional treatment modalities modulating response to ionizing radiation or chemotherapeutic agents. The aim of the present study was to show the feasibility of determining radiotherapeutically relevant hypoxia and early tumour response by ([18F] Fluoromisonidazole (FMISO and [18F]-2-fluoro-2'-deoxyglucose (FDG PET. Methods Eight patients with non-small-cell lung cancer underwent PET scans. Tumour tissue oxygenation was measured with FMISO PET, whereas tumour glucose metabolism was measured with FDG PET. All PET studies were carried out with an ECAT EXACT 922/47® scanner with an axial field of view of 16.2 cm. FMISO PET consisted of one static scan of the relevant region, performed 180 min after intravenous administration of the tracer. The acquisition and reconstruction parameters were as follows: 30 min emission scanning and 4 min transmission scanning with 68-Ge/68-Ga rod sources. The patients were treated with chemotherapy, consisting of 2 cycles of gemcitabine (1200 mg/m2 and vinorelbine (30 mg/m2 followed by concurrent radio- (2.0 Gy/d; total dose 66.0 Gy and chemotherapy with gemcitabine (300–500 mg/m2 every two weeks. FMISO PET and FDG PET were performed in all patients 3 days before and 14 days after finishing chemotherapy. Results FMISO PET allowed for the qualitative and quantitative definition of hypoxic sub-areas which may correspond to a localization of local recurrences. In addition, changes in FMISO and FDG PET measure the early response to therapy, and in this way, may predict freedom from disease, as well as overall survival. Conclusion These preliminary results warrant validation in larger trials. If confirmed, several novel treatment strategies may be considered, including the early use of PET to evaluate the effectiveness of the selected therapy.

  17. 18F-fluorodeoxyglucose Positron Emisson Tomography/Computed Tomography Guided Conformal Brachytherapy for Cervical Cancer

    Purpose: To evaluate the feasibility of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT)-guided conformal brachytherapy treatment planning in patients with cervical cancer. Methods and Materials: Pretreatment FDG-PET/CT was performed for 12 patients with cervical cancer. Brachytherapy simulation was performed after an external-beam radiation therapy median dose of 4140 cGy. Patients underwent FDG-PET/CT scans with placement of tandem and ovoid applicators. The gross tumor volume (GTV) was determined by adjusting the window and level to a reasonable value and outlining the edge of the enhancing area, which was done in consultation with a nuclear medicine physician. A standardized uptake value profile of the tumor margin was taken for each patient relative to the maximum uptake value of each tumor and analyzed. The plan was designed to deliver 400 cGy to point A (point A plan) or to cover the clinical target volume (CTV) (PET/CT plan). Results: The median dose that encompassed 95% of the target volume (D95) of the CTV was 323.0 cGy for the point A plan vs 399.0 cGy for the PET/CT plan (P=.001). The maximum standardized uptake values (SUVmax) of the tumors were reduced by a median of 57% (range, 13%-80%). All but 1 patient presented with discernable residual uptake within the tumors. The median value of the thresholds of the tumors contoured by simple visual analysis was 41% (range, 23%-71%). Conclusions: In this study, the PET/CT plan was better than the conventional point A plan in terms of target coverage without increasing the dose to the normal tissue, making optimized 3-dimensional brachytherapy treatment planning possible. In comparison with the previously reported study with PET or CT alone, we found that visual target localization was facilitated by PET fusion on indeterminate CT masses. Further studies are needed to characterize the metabolic activity detected during radiation therapy for more reliable targeting.

  18. 18F-fluorodeoxyglucose Positron Emisson Tomography/Computed Tomography Guided Conformal Brachytherapy for Cervical Cancer

    Nam, Heerim [Department of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Huh, Seung Jae, E-mail: sj5201.huh@samsung.com [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Ju, Sang Gyu; Park, Won; Lee, Jeong Eun [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Choi, Joon Young; Kim, Byung-Tae [Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Chan Kyo; Park, Byung Kwan [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2012-09-01

    Purpose: To evaluate the feasibility of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT)-guided conformal brachytherapy treatment planning in patients with cervical cancer. Methods and Materials: Pretreatment FDG-PET/CT was performed for 12 patients with cervical cancer. Brachytherapy simulation was performed after an external-beam radiation therapy median dose of 4140 cGy. Patients underwent FDG-PET/CT scans with placement of tandem and ovoid applicators. The gross tumor volume (GTV) was determined by adjusting the window and level to a reasonable value and outlining the edge of the enhancing area, which was done in consultation with a nuclear medicine physician. A standardized uptake value profile of the tumor margin was taken for each patient relative to the maximum uptake value of each tumor and analyzed. The plan was designed to deliver 400 cGy to point A (point A plan) or to cover the clinical target volume (CTV) (PET/CT plan). Results: The median dose that encompassed 95% of the target volume (D95) of the CTV was 323.0 cGy for the point A plan vs 399.0 cGy for the PET/CT plan (P=.001). The maximum standardized uptake values (SUV{sub max}) of the tumors were reduced by a median of 57% (range, 13%-80%). All but 1 patient presented with discernable residual uptake within the tumors. The median value of the thresholds of the tumors contoured by simple visual analysis was 41% (range, 23%-71%). Conclusions: In this study, the PET/CT plan was better than the conventional point A plan in terms of target coverage without increasing the dose to the normal tissue, making optimized 3-dimensional brachytherapy treatment planning possible. In comparison with the previously reported study with PET or CT alone, we found that visual target localization was facilitated by PET fusion on indeterminate CT masses. Further studies are needed to characterize the metabolic activity detected during radiation therapy for more reliable targeting.

  19. Breast imaging. Preoperative breast cancer staging: comparison of USPIO-enhanced MR imaging and 18F-fluorodeoxyglucose (FDC) positron emission tomography (PET) imaging for axillary lymph node staging - initial findings

    Magnetic resonance (MR) imaging after ultra-small super paramagnetic iron oxide (USPIO) injection and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for preoperative axillary lymph node staging in patients with breast cancer were evaluated using histopathologic findings as the reference standard. USPIO-enhanced MR and FDG-PET were performed in ten patients with breast cancer who were scheduled for surgery and axillary node resection. T2-weighted fast spin echo, T1-weighted three-dimensional (3D) gradient echo, T2*-weighted gradient echo and gadolinium-enhanced T1-weighted 3D gradient echo with spectral fat saturation were evaluated. MR imaging before USPIO infusion was not performed. The results were correlated with FDG-PET (acquired with dedicated PET camera, visual analysis) and histological findings. The histopathologic axillary staging was negative for nodal malignancy in five patients and positive in the remaining five patients. There was one false positive finding for USPIO-enhanced MR and one false negative finding for FDG-PET. A sensitivity (true positive rate) of 100%, specificity (true negative rate) of 80%, positive predictive value of 80%, and negative predictive value of 100% were achieved for USPIO-enhanced MR and of 80%, 100%, 100%, 80% for FDG-PET, respectively. The most useful sequences in the detection of invaded lymph nodes were in the decreasing order: gadolinium-enhanced T1-weighted 3D gradient echo with fat saturation, T2*-weighted 2D gradient echo, T1-weighted 3D gradient echo and T2-weighted 2D spin echo. In our study, USPIO-enhanced T1 gradient echo after gadolinium injection and fat saturation emerged as a very useful sequence in the staging of lymph nodes. The combination of USPIO-enhanced MR and FDG-PET achieved 100% sensitivity, specificity, PPV and NPV. If these results are confirmed, the combination of USPIO MR with FDG-PET has the potential to identify the patient candidates for axillary dissection versus sentinel node

  20. Metabolic Response of Lymph Nodes Immediately After RT Is Related With Survival Outcome of Patients With Pelvic Node-Positive Cervical Cancer Using Consecutive [{sup 18}F]fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

    Yoon, Mee Sun; Ahn, Sung-Ja; Nah, Byung-Sik; Chung, Woong-Ki [Department of Radiation Oncology, Chonnam National University Medical School, Gwangju (Korea, Republic of); Song, Ho-Chun; Yoo, Su Woong [Department of Nuclear Medicine, Chonnam National University Medical School, Gwangju (Korea, Republic of); Song, Ju-Young; Jeong, Jae-Uk [Department of Radiation Oncology, Chonnam National University Medical School, Gwangju (Korea, Republic of); Nam, Taek-Keun, E-mail: tknam@chonnam.ac.kr [Department of Radiation Oncology, Chonnam National University Medical School, Gwangju (Korea, Republic of)

    2012-11-15

    Purpose: To evaluate the metabolic response of uterine cervix and pelvic lymph nodes (LNs) using consecutive {sup 18}F-fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) immediately after RT and to correlate survival outcome with the metabolic response. Methods and Materials: We retrospectively reviewed 48 patients with cervical cancer who had positive pelvic LNs by preradiation therapy (pre-RT) PET/CT. All patients underwent PET/CT scans immediately after RT (inter-RT PET/CT) after median 63 Gy to the gross LNs. The metabolic response of the LNs was assessed quantitatively and semiquantitatively by measurement of the maximal standardized uptake value (SUV{sub max}). Results: Classifying the metabolic response of all nodal lesions, 37 patients (77%) had LNs with complete metabolic response on the inter-RT PET/CT (LNCMRi), and 11 patients had a non-LNCMRi, including 4 patients with progressive metabolic disease. The overall 3-year survival rates were 83% for the patients with LNCMRi and 73% for the non-LNCMRi group (P=.038). The disease-free survival for patients with LNCMRi were significantly better than that for the non-LNCMRi group (71% vs 18%, respectively, P<.001). The 3-year distant metastasis-free survival rates were 79% for the patients with LNCMRi and 27% for the non-LNCMRi group (P<.001). There were no statistically significant differences in overall survival (76% vs 86%, respectively, P=.954) and disease-free survival rates (58% vs 61%, respectively, P=.818) between the CMR of primary cervical tumor and the non-CMR groups. Conclusions: The results showed a significant correlation between survival outcome and the interim metabolic response of pelvic LNs. CMR of nodal lesion on inter-RT PET/CT had excellent overall survival, disease-free survival and distant metastasis-free survival rates. This suggested that PET/CT immediately after RT can be a useful tool for the evaluation of the interim response of the LNs and identify a subset

  1. Multiparametric [18F]Fluorodeoxyglucose/ [18F]Fluoromisonidazole Positron Emission Tomography/ Magnetic Resonance Imaging of Locally Advanced Cervical Cancer for the Non-Invasive Detection of Tumor Heterogeneity: A Pilot Study

    Andrzejewski, Piotr; Baltzer, Pascal; Polanec, Stephan H.; Sturdza, Alina; Georg, Dietmar; Helbich, Thomas H.; Karanikas, Georgios; Grimm, Christoph; Polterauer, Stephan; Poetter, Richard; Wadsak, Wolfgang; Mitterhauser, Markus; Georg, Petra

    2016-01-01

    Objectives To investigate fused multiparametric positron emission tomography/magnetic resonance imaging (MP PET/MRI) at 3T in patients with locally advanced cervical cancer, using high-resolution T2-weighted, contrast-enhanced MRI (CE-MRI), diffusion-weighted imaging (DWI), and the radiotracers [18F]fluorodeoxyglucose ([18F]FDG) and [18F]fluoromisonidazol ([18F]FMISO) for the non-invasive detection of tumor heterogeneity for an improved planning of chemo-radiation therapy (CRT). Materials and Methods Sixteen patients with locally advanced cervix were enrolled in this IRB approved and were examined with fused MP [18F]FDG/ [18F]FMISO PET/MRI and in eleven patients complete data sets were acquired. MP PET/MRI was assessed for tumor volume, enhancement (EH)-kinetics, diffusivity, and [18F]FDG/ [18F]FMISO-avidity. Descriptive statistics and voxel-by-voxel analysis of MRI and PET parameters were performed. Correlations were assessed using multiple correlation analysis. Results All tumors displayed imaging parameters concordant with cervix cancer, i.e. type II/III EH-kinetics, restricted diffusivity (median ADC 0.80x10-3mm2/sec), [18F]FDG- (median SUVmax16.2) and [18F]FMISO-avidity (median SUVmax3.1). In all patients, [18F]FMISO PET identified the hypoxic tumor subvolume, which was independent of tumor volume. A voxel-by-voxel analysis revealed only weak correlations between the MRI and PET parameters (0.05–0.22), indicating that each individual parameter yields independent information and the presence of tumor heterogeneity. Conclusion MP [18F]FDG/ [18F]FMISO PET/MRI in patients with cervical cancer facilitates the acquisition of independent predictive and prognostic imaging parameters. MP [18F]FDG/ [18F]FMISO PET/MRI enables insights into tumor biology on multiple levels and provides information on tumor heterogeneity, which has the potential to improve the planning of CRT. PMID:27167829

  2. Immune reconstitution inflammatory syndrome due to Mycobacterium avium complex successfully followed up using 18 F-fluorodeoxyglucose positron emission tomography-computed tomography in a patient with human immunodeficiency virus infection: A case report

    In human immunodeficiency virus (HIV)-infected patients, immune reconstitution inflammatory syndrome (IRIS) due to nontuberculous mycobacteria (NTM) infection is one of the most difficult types of IRIS to manage. 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) has been suggested as a useful tool for evaluating the inflammatory status of HIV-infected patients. We present the first case of Mycobacterium avium complex (MAC)-associated IRIS (MAC-IRIS) that was successfully followed up using 18 F-FDG PET/CT. A 44-year-old homosexual Japanese man was referred to our hospital with fever and dyspnea. He was diagnosed with Pneumocystis jiroveci pneumonia and found to be HIV positive. After the initiation of combined antiretroviral therapy (cART), the patient’s mediastinal and bilateral hilar lymphadenopathy gradually enlarged, and bilateral infiltrates appeared in the upper lung fields. 18 F-FDG PET/CT was performed five months after the initiation of cART and showed intense accumulation of fluorodeoxyglucose (FDG) corresponding to the lesions of infiltration as well as the mediastinal and bilateral hilar lymphadenopathy. A bronchial wash culture and pathology findings led to a diagnosis of MAC-IRIS. Anti-mycobacterial chemotherapy with rifampicin, ethambutol, clarithromycin, and levofloxacin was started. One year after the chemotherapy was initiated, there was a significant reduction in FDG uptake in the area of the lesions except in the mediastinal lymph node. This implied incomplete resolution of the MAC-IRIS-related inflammation. Anti-mycobacterial chemotherapy was continued because of the residual lesion. To date, the patient has not experienced a recurrence of MAC-IRIS, a period of nine months. We present a case of MAC-IRIS in an HIV-infected patient whose disease activity was successfully followed up using 18 F-FDG PET/CT. Our data suggest that 18 F-FDG PET/CT is useful for evaluating the disease activity of NTM-IRIS and

  3. CAE of pulmonary cryptococcosis mimicking hematogenous metastases in an immunocompetent patient: Value of absent 18F- fluorodeoxyglucose uptake on position emission tomography/CT scan

    The radiologic appearance of multiple discrete pulmonary nodules in immunocompetent patients, with cryptococcal infection, has been rarely described. We describe a case of pulmonary cryptococcosis, presenting with bilaterally and randomly distributed nodules on a computed tomography, mimicking hematogeneous metastases. Positron emission tomography does not demonstrate 18F-fluorodeoxyglucose (FDG) uptake, suggesting a low probability for malignancy, which is a crucial piece of information for clinicians when making a management decision. We find the absence of FDG uptake correlates with the pathologic finding of an infectious nodule, composed of fibrosis and necrosis.

  4. Tomografia por emissão de pósitrons com 18F fluordesoxiglicose como exame não invasivo para o diagnóstico de sarcomas primários de artéria pulmonar 18F-fluorodeoxyglucose positron emission tomography as a noninvasive method for the diagnosis of primary pulmonary artery sarcoma

    Olívia Meira Dias

    2011-12-01

    Full Text Available Os sarcomas de artéria pulmonar são tumores raros e de difícil diagnóstico, simulando frequentemente o tromboembolismo pulmonar crônico. Relatamos dois casos de pacientes do sexo feminino com quadro clínico de dispneia e massas pulmonares associadas a falhas de enchimento na artéria pulmonar em angiotomografia de tórax. A tomografia por emissão de pósitrons com 18F fluordesoxiglicose mostrou hipercaptação das respectivas lesões. O sarcoma de artéria pulmonar foi confirmado posteriormente por exame anatomopatológico. Ressaltamos a importância do uso desse tipo de tomografia como exame não invasivo no auxílio diagnóstico desses tumoresPulmonary artery sarcomas are rare, difficult-to-diagnose tumors that frequently mimic chronic pulmonary thromboembolism. We report the cases of two female patients with clinical signs of dyspnea and lung masses associated with pulmonary artery filling defects on chest CT angiography. We performed 18F-fluorodeoxyglucose positron emission tomography, which revealed increased radiotracer uptake in those lesions. Pulmonary artery sarcoma was subsequently confirmed by anatomopathological examination. We emphasize the importance of this type of tomography as a noninvasive method for the diagnosis of these tumors

  5. Exploring Spatial Overlap of High-Uptake Regions Derived From Dual Tracer Positron Emission Tomography–Computer Tomography Imaging Using 18F-Fluorodeoxyglucose and 18F-Fluorodeoxythymidine in Nonsmall Cell Lung Cancer Patients

    Liu, Jing; Li, Chengqiang; Hu, Man; Lu, Jie; Shi, Xiaorong; XING, LIGANG; Sun, Xindong; FU, ZHENG; YU, JINMING; MENG, XUE

    2015-01-01

    Abstract Interest is growing in radiotherapy to nonuniformly boost radioresistant regions within nonsmall cell lung cancer (NSCLC) using molecular imaging techniques. The complexity of tumor behavior is beyond the ability of any single radiotracer to reveal. We hold dual tracer positron emission tomography–computer tomography (PET/CT) imaging with fluorodeoxyglucose (FDG) and fluorodeoxythymidine (FLT) for NSCLC patients to offer an integrated overlook of tumor biological behaviors quantitati...

  6. Efficiency of Positron Emission Tomography with 18F-Fluorodeoxyglucose, 11С-Methionine and 82Rb-Chloride in Differential Diagnosis of Lung Tumors and Some Inflammatory Pulmonary Diseases

    Tlostanova М.S.

    2014-09-01

    Full Text Available The aim of the investigation was to study the informativeness of positron emission tomography (PET using 18F-FDG, 11С-methionine and 82Rb-chloride in differential diagnosis of tumor and some inflammatory pulmonary diseases. Materials and Methods. PET findings of 378 patients with lung tumors and inflammatory pulmonary diseases were studied. PET with 18F-FDG and 11С-methionine were performed 120 and 15 min, respectively, after their intravenous administration. PET with 82Rb-chloride was performed 1 min after distant intravenous administration. Quantitative processing of PET findings regardless the medication used included visual image analysis and calculation of Standardized Uptake Value (SUV in healthy pulmonary parenchyma and in lesion. Results. SUV in patients with lung cancer in PET with 18F-FDG and 11С-methionine were higher than metabolic activity in an inflammation region, while in PET with 82Rb-chloride, SUV levels were significantly higher in the foci of inflammation than in malignant tumors. The patients with benign tumors and most patients with focal pneumofibrosis in pulmonary tissue consolidation area were recorded to have background distribution of radiopharmaceuticals. It enabled to reliably differentiate benign tumors and focal pneumofibrosis from lung cancer regardless the medications used. Conclusion. The obtained data on the informativeness of positron emission tomography performed using 11С-methionine suggest high diagnostic value of the technique in the differential diagnosis of lung cancer, neuroendocrine tumors, benign tumors and inflammatory diseases. Despite good imaging potential PET with 82Rb-chloride is unreasonable in differentiation of lung tumors and inflammatory pulmonary diseases.

  7. Significance of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for detection of renal cell carcinoma and immunohistochemical glucose transporter 1 (GLUT-1) expression in the cancer

    Positron emission tomography (PET) is now primarily used in oncological indication owing to the successful application of fluorine-18 fluorodeoxyglucose (FDG) in an increasing number of clinical indications. Glucose transporter 1 (GLUT-1) is recognized as a major early marker of cellular malignant transformation. The aims of this study were to assess whether FDG-PET is a useful diagnostic tool for renal cell carcinoma and to compare the pathologic characteristics. Nineteen consecutive patients who had renal cell carcinoma were examined using FDG-PET preoperatively. The results of PET were then compared to the histology obtained after radical surgery and the immunoreactivity of GLUT-1 was also studied. Pathologic examination confirmed that all 19 patients suffered from renal cell carcinoma. Increased FDG uptake was found in six of the 19 patients (31.5%). The immmunohistochemical examination of GLUT-1 in renal cell carcinoma produced different results in each patient. There was no correlation with GLUT-1 immunoreactivity and FDG-PET positivity. These results suggest that FDG-PET may not be a useful diagnostic tool for renal cell carcinoma. (author)

  8. Preoperative [18F]-fluorodeoxyglucose positron emission tomography standardized uptake value of neck lymph nodes may aid in selecting patients with oral cavity squamous cell carcinoma for salvage therapy after relapse

    Relapse of tumours in patients with oral cavity squamous cell carcinoma (OSCC) is associated with a dismal outcome. In this prospective study, we sought to investigate the clinical significance of the preoperative maximal standardized uptake value (SUVmax) at the neck lymph nodes in selecting patients with OSCC for salvage therapy after relapse. Between 2002 and 2007, 108 patients with early relapse of OSCC (n=75) or late relapse of OSCC (n=33) were identified. Salvage therapy was performed in 47 patients. All patients underwent 2-deoxy-2[18F]-fluoro-d-glucose positron emission tomography during the 2 weeks before surgery and neck dissection. All patients were followed for 12 months or more after surgery or until death. The optimal cut-off value for the neck lymph node SUVmax (SUVnodal-max) was selected according to the 5-year disease-specific survival (DSS) rate. Independent risk factors were identified by Cox regression analysis. The mean follow-up for all patients was 20.3 months (41.1 months for surviving patients). In the early relapse group, several prognostic factors were identified in univariate and multivariate analyses, including a SUVnodal-max value of ≥4.2. A scoring system based on univariate analysis was formulated. Patients with a score of 0 had a better 5-year DSS than those with scores of 1 or higher (58% vs. 5%, p=0.0003). In patients with late relapse, a SUVnodal-max value of ≥4.2 had the highest prognostic value for predicting the 5-year DSS (45% vs. 0%, p=0.0005). Among patients with relapsed OSCC, the SUVnodal-max value may aid in selecting patients for salvage therapy. (orig.)

  9. Pelvic Lymph Node Status Assessed by 18F-Fluorodeoxyglucose Positron Emission Tomography Predicts Low-Risk Group for Distant Recurrence in Locally Advanced Cervical Cancer: A Prospective Study

    Purpose: To develop a prediction model to identify a low-risk group for distant recurrence in patients with locally advanced cervical cancer treated by concurrent chemoradiation. Methods and Materials: Prospectively, 62 patients with locally advanced cervical cancer were recruited as a training cohort. Clinical variables and parameters obtained from positron emission tomography (PET) and magnetic resonance imaging were analyzed by logistic regression. For the test set, 54 patients were recruited independently. To identify the low-risk group, negative likelihood ratio (LR) less than 0.2 was set to be a cutoff. Results: Among the training cohort, multivariate logistic analysis revealed that advanced International Federation of Gynecology and Obstetrics (FIGO) stage and a high serum squamous cancer cell (SCC) antigen level were significant risk factors (p = 0.015 and 0.025, respectively). Using the two parameters, criteria to determine a low-risk subset for distant recurrence were postulated: (1) FIGO Stage IIB or less and (2) pretreatment SCC < 2.4 (Model A). Positive pelvic node on PET completely predicted all cases with distant recurrence and thus was considered as another prediction model (Model B). In the test cohort, although Model A did not showed diagnostic performance, Model B completely predicted all cases with distant recurrence and showed a sensitivity of 100% with negative LR of 0. Across the training and test cohort (n = 116), the false negative rate was 0 (95% confidence interval 0%-7.6%). Conclusions: Positive pelvic node on PET is a useful marker in prediction of distant recurrence in patients with locally advanced cervical cancer who are treated with concurrent chemoradiation.

  10. Preoperative [{sup 18}F]-fluorodeoxyglucose positron emission tomography standardized uptake value of neck lymph nodes may aid in selecting patients with oral cavity squamous cell carcinoma for salvage therapy after relapse

    Liao, Chun-Ta; Huang, Shiang-Fu; Chen, I. How [Chang Gung Memorial Hospital and Chang Gung Univ., Dept. of Otorhinolaryngology, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Dept. of Head and Neck Surgery, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Head and Neck Oncology Group, Cancer Center, Taoyuan, Taiwan (China); Chang, Joseph Tung-Chieh [Chang Gung Memorial Hospital and Chang Gung Univ., Head and Neck Oncology Group, Cancer Center, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Radiation Oncology, Taoyuan, Taiwan (China); Wang, Hung-Ming [Chang Gung Memorial Hospital and Chang Gung Univ., Head and Neck Oncology Group, Cancer Center, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Hema-Oncology, Taoyuan, Taiwan (China); Ng, Shu-Hang [Chang Gung Memorial Hospital and Chang Gung Univ., Head and Neck Oncology Group, Cancer Center, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Diagnostic Radiology, Taoyuan, Taiwan (China); Hsueh, Chuen; Lee, Li-Yu. [Chang Gung Memorial Hospital and Chang Gung Univ., Head and Neck Oncology Group, Cancer Center, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Pathology, Taoyuan, Taiwan (China); Lin, Chih-Hung [Chang Gung Memorial Hospital and Chang Gung Univ., Head and Neck Oncology Group, Cancer Center, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Plastic and Reconstructive Surgery, Taoyuan, Taiwan (China); Cheng, Ann-Joy [Chang Gung Memorial Hospital and Chang Gung Univ., Head and Neck Oncology Group, Cancer Center, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Medical Biotechnology, Biostatistics Consulting Center/Dept. of Public Health, Taoyuan, Taiwan (China); Yen, Tzu-Chen [Chang Gung Memorial Hospital and Chang Gung Univ., Taoyuan, Taiwan (China)

    2009-11-15

    Relapse of tumours in patients with oral cavity squamous cell carcinoma (OSCC) is associated with a dismal outcome. In this prospective study, we sought to investigate the clinical significance of the preoperative maximal standardized uptake value (SUVmax) at the neck lymph nodes in selecting patients with OSCC for salvage therapy after relapse. Between 2002 and 2007, 108 patients with early relapse of OSCC (n=75) or late relapse of OSCC (n=33) were identified. Salvage therapy was performed in 47 patients. All patients underwent 2-deoxy-2[{sup 18}F]-fluoro-d-glucose positron emission tomography during the 2 weeks before surgery and neck dissection. All patients were followed for 12 months or more after surgery or until death. The optimal cut-off value for the neck lymph node SUVmax (SUVnodal-max) was selected according to the 5-year disease-specific survival (DSS) rate. Independent risk factors were identified by Cox regression analysis. The mean follow-up for all patients was 20.3 months (41.1 months for surviving patients). In the early relapse group, several prognostic factors were identified in univariate and multivariate analyses, including a SUVnodal-max value of {>=}4.2. A scoring system based on univariate analysis was formulated. Patients with a score of 0 had a better 5-year DSS than those with scores of 1 or higher (58% vs. 5%, p=0.0003). In patients with late relapse, a SUVnodal-max value of {>=}4.2 had the highest prognostic value for predicting the 5-year DSS (45% vs. 0%, p=0.0005). Among patients with relapsed OSCC, the SUVnodal-max value may aid in selecting patients for salvage therapy. (orig.)

  11. Emission computed tomography of 18F-fluorodeoxyglucose and 13N-ammonia in stroke and epilepsy

    The ECAT Positron Tomograph was used to scan normal control subjects, stroke patients at various times during recovery, and patients with partial epilepsy during EEG monitoring. 18F-fluorodeoxyglucose (18FDG) and 13N-Ammonia (13NH3) were used as indicators of abnormalities in local cerebral glucose utilization (LCMR/sub glc/) and relative perfusion, respectively. Hypometabolism, due to deactivation or minimal damage, was demonstrated with the 18FDG scan in deep structures and broad zones of cerebral cortex which appeared normal on x-ray CT (XCT) and /sup 99m/Tc pertechnetate scans. In patients with partial epilepsy, who had unilateral or focal electrical abnormalities, interictal 18FDG scan patterns clearly showed localized regions of decreased (20 to 50%) LCMR/sub glc/, which correlated anatomically with the eventual EEG localization

  12. Change of Maximum Standardized Uptake Value Slope in Dynamic Triphasic [{sup 18}F]-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Distinguishes Malignancy From Postradiation Inflammation in Head-and-Neck Squamous Cell Carcinoma: A Prospective Trial

    Anderson, Carryn M., E-mail: carryn-anderson@uiowa.edu [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Chang, Tangel [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Graham, Michael M. [Department of Nuclear Medicine, University of Iowa, Iowa City, Iowa (United States); Marquardt, Michael D. [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Button, Anna; Smith, Brian J. [Department of Biostatistics, University of Iowa, Iowa City, Iowa (United States); Menda, Yusuf [Department of Nuclear Medicine, University of Iowa, Iowa City, Iowa (United States); Sun, Wenqing [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Pagedar, Nitin A. [Department of Otolaryngology—Head and Neck Surgery, University of Iowa, Iowa City, Iowa (United States); Buatti, John M. [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States)

    2015-03-01

    Purpose: To evaluate dynamic [{sup 18}F]-fluorodeoxyglucose (FDG) uptake methodology as a post–radiation therapy (RT) response assessment tool, potentially enabling accurate tumor and therapy-related inflammation differentiation, improving the posttherapy value of FDG–positron emission tomography/computed tomography (FDG-PET/CT). Methods and Materials: We prospectively enrolled head-and-neck squamous cell carcinoma patients who completed RT, with scheduled 3-month post-RT FDG-PET/CT. Patients underwent our standard whole-body PET/CT scan at 90 minutes, with the addition of head-and-neck PET/CT scans at 60 and 120 minutes. Maximum standardized uptake values (SUV{sub max}) of regions of interest were measured at 60, 90, and 120 minutes. The SUV{sub max} slope between 60 and 120 minutes and change of SUV{sub max} slope before and after 90 minutes were calculated. Data were analyzed by primary site and nodal site disease status using the Cox regression model and Wilcoxon rank sum test. Outcomes were based on pathologic and clinical follow-up. Results: A total of 84 patients were enrolled, with 79 primary and 43 nodal evaluable sites. Twenty-eight sites were interpreted as positive or equivocal (18 primary, 8 nodal, 2 distant) on 3-month 90-minute FDG-PET/CT. Median follow-up was 13.3 months. All measured SUV endpoints predicted recurrence. Change of SUV{sub max} slope after 90 minutes more accurately identified nonrecurrence in positive or equivocal sites than our current standard of SUV{sub max} ≥2.5 (P=.02). Conclusions: The positive predictive value of post-RT FDG-PET/CT may significantly improve using novel second derivative analysis of dynamic triphasic FDG-PET/CT SUV{sub max} slope, accurately distinguishing tumor from inflammation on positive and equivocal scans.

  13. A computer tomography-based spatial normalization for the analysis of [{sup 18}F]fluorodeoxyglucose position emission tomography of the brain

    Cho, Hanna; Choi, Jae Yong; Ryu, Young Hoon; Lyoo, Chul Hyoung [Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Jin Su [Molecular Imaging Research Center, Korea Institute Radiological and Medical Science, Seoul(Korea, Republic of)

    2014-12-15

    We developed a new computed tomography (CT)-based spatial normalization method and CT template to demonstrate its usefulness in spatial normalization of positron emission tomography (PET) images with [{sup 18}F] fluorodeoxyglucose (FDG) PET studies in healthy controls. Seventy healthy controls underwent brain CT scan (120 KeV, 180 mAs, and 3 mm of thickness) and [{sup 18}F] FDG PET scans using a PET/CT scanner. T1-weighted magnetic resonance (MR) images were acquired for all subjects. By averaging skull-stripped and spatially-normalized MR and CT images, we created skull-stripped MR and CT templates for spatial normalization. The skull-stripped MR and CT images were spatially normalized to each structural template. PET images were spatially normalized by applying spatial transformation parameters to normalize skull-stripped MR and CT images. A conventional perfusion PET template was used for PET-based spatial normalization. Regional standardized uptake values (SUV) measured by overlaying the template volume of interest (VOI) were compared to those measured with FreeSurfer-generated VOI (FSVOI). All three spatial normalization methods underestimated regional SUV values by 0.3-20% compared to those measured with FSVOI. The CT-based method showed slightly greater underestimation bias. Regional SUV values derived from all three spatial normalization methods were correlated significantly (p < 0.0001) with those measured with FSVOI. CT-based spatial normalization may be an alternative method for structure-based spatial normalization of [18F] FDG PET when MR imaging is unavailable. Therefore, it is useful for PET/CT studies with various radiotracers whose uptake is expected to be limited to specific brain regions or highly variable within study population.

  14. Tomografia por emissão de pósitrons com 18F fluordesoxiglicose como exame não invasivo para o diagnóstico de sarcomas primários de artéria pulmonar 18F-fluorodeoxyglucose positron emission tomography as a noninvasive method for the diagnosis of primary pulmonary artery sarcoma

    Olívia Meira Dias; Elisa Maria Siqueira Lombardi; Mauro Canzian; José Soares Júnior; Lucas de Oliveira Vieira; Mário Terra Filho

    2011-01-01

    Os sarcomas de artéria pulmonar são tumores raros e de difícil diagnóstico, simulando frequentemente o tromboembolismo pulmonar crônico. Relatamos dois casos de pacientes do sexo feminino com quadro clínico de dispneia e massas pulmonares associadas a falhas de enchimento na artéria pulmonar em angiotomografia de tórax. A tomografia por emissão de pósitrons com 18F fluordesoxiglicose mostrou hipercaptação das respectivas lesões. O sarcoma de artéria pulmonar foi confirmado posteriormente por ...

  15. Evaluation of the response chemotherapy for penile metastasis of bladder cancer using 18F-fluorodeoxyglucose-PET/CT

    Hakan Öztürk

    2015-01-01

    Background: Metachronous penile metastasis of bladder cancer occurs very rarely. The clinical management of the disease involves complex problems, and the disease is associated with a poor prognosis. The common mode of spread to the penis is by the retrograde venous route. Patients and methods: A 68-year-old patient who was diagnosed with invasive bladder cancer underwent 18F-fluorodeoxyglucose (FDG)-positron-emission tomography/computed tomography (PET/CT) for staging purposes. An 18 mm i...

  16. New type PET imaging agent excluding 18F-fluorodeoxyglucose in oncology

    18F-fluorodeoxyglucose PET is a very sensitive technology, yet it still has limitation such as low specificity. In this way, tracers used to study amino acid uptake, protein synthesis, DNA synthesis, cell proliferation, changes of other substrates of tricarboxylic aciol cycle metabolism, tumor hypoxia, immunological activity and receptor are expected to be new tumor imaging agent. The study and possible use of short half-life radiopharmaceuticals (excluding FDG) in oncology with positron emission tomography are reviewed in this article, those that include 18F and 11C labeled compounds. (authors)

  17. HIV infection and arterial inflammation assessed by (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)

    Knudsen, Andreas; Hag, Anne Mette Fisker; Loft, Annika;

    2015-01-01

    -treated HIV-infected patients without cardiovascular disease (CVD) and healthy controls. METHODS AND RESULTS: We prospectively scanned 26 HIV-infected patients on stable antiretroviral therapy and 25 healthy volunteers with FDG PET/CT, measuring standardized uptake values (SUV) in the carotid arteries, the...... target-to background ratio in the carotid region, the ascending aorta, the descending aorta, or the abdominal aorta. Correlations between SUV, IMT, and soluble biomarkers were scarce in both groups. CONCLUSION: In a group of optimally treated HIV-infected patients with full viral suppression, low...

  18. {sup 18}F-fluorodeoxyglucose positron emission tomography and computed tomography in anaplastic thyroid cancer

    Poisson, Thomas [Institut Gustave Roussy and University Paris-Sud XI, Department of Nuclear Medicine and Endocrine Oncology, Villejuif Cedex (France); Service de Medecine Nucleaire, Hopital Bichat, Paris (France); Deandreis, Desiree; Leboulleux, Sophie; Lumbroso, Jean; Baudin, Eric [Institut Gustave Roussy and University Paris-Sud XI, Department of Nuclear Medicine and Endocrine Oncology, Villejuif Cedex (France); Bidault, Francois [Institut Gustave Roussy and University Paris-Sud XI, Department of Radiology, Villejuif Cedex (France); Bonniaud, Guillaume [Institut Gustave Roussy and University Paris-Sud XI, Department of Medical Physics, Villejuif Cedex (France); Baillot, Sylvain; Auperin, Anne [Institut Gustave Roussy and University Paris-Sud XI, Department of Epidemiology, Villejuif Cedex (France); Ghuzlan, Abir Al [Institut Gustave Roussy and University Paris-Sud XI, Department of Pathology, Villejuif Cedex (France); Travagli, Jean-Paul [Institut Gustave Roussy and University Paris-Sud XI, Department of Endocrine Surgery, Villejuif Cedex (France); Schlumberger, Martin [Institut Gustave Roussy and University Paris-Sud XI, Department of Nuclear Medicine and Endocrine Oncology, Villejuif Cedex (France); Institut Gustave Roussy, Service de Medecine Nucleaire et de Cancerologie Endocrinienne, Villejuif (France)

    2010-12-15

    Our aim was to evaluate in anaplastic thyroid carcinoma (ATC) patients the value of {sup 18}F-FDG PET/CT compared with total body computed tomography (CT) using intravenous contrast material for initial staging, prognostic assessment, therapeutic monitoring and follow-up. Twenty consecutive ATC patients underwent PET/CT for initial staging. PET/CT was performed again during follow-up. The gold standard was progression on imaging follow-up (CT or PET/CT) or confirmation with another imaging modality. A total of 265 lesions in 63 organs were depicted in 18 patients. Thirty-five per cent of involved organs were demonstrated only with PET/CT and one involved organ only with CT. In three patients, the extent of disease was significantly changed with PET/CT that demonstrated unknown metastases. Initial treatment modalities were modified by PET/CT findings in 25% of cases. The volume of FDG uptake ({>=}300 ml) and the intensity of FDG uptake (SUV{sub max} {>=}18) were significant prognostic factors for survival. PET/CT permitted an earlier assessment of tumour response to treatment than CT in 4 of the 11 patients in whom both examinations were performed. After treatment with combined radiotherapy and chemotherapy, only the two patients with a negative control PET/CT had a confirmed complete remission at 14 and 38 months; all eight patients who had persistent FDG uptake during treatment had a clinical recurrence and died. FDG PET/CT appears to be the reference imaging modality for ATC at initial staging and seems promising in the early evaluation of treatment response and follow-up. (orig.)

  19. 18F-fluorodeoxyglucose positron emission tomography and computed tomography in anaplastic thyroid cancer

    Our aim was to evaluate in anaplastic thyroid carcinoma (ATC) patients the value of 18F-FDG PET/CT compared with total body computed tomography (CT) using intravenous contrast material for initial staging, prognostic assessment, therapeutic monitoring and follow-up. Twenty consecutive ATC patients underwent PET/CT for initial staging. PET/CT was performed again during follow-up. The gold standard was progression on imaging follow-up (CT or PET/CT) or confirmation with another imaging modality. A total of 265 lesions in 63 organs were depicted in 18 patients. Thirty-five per cent of involved organs were demonstrated only with PET/CT and one involved organ only with CT. In three patients, the extent of disease was significantly changed with PET/CT that demonstrated unknown metastases. Initial treatment modalities were modified by PET/CT findings in 25% of cases. The volume of FDG uptake (≥300 ml) and the intensity of FDG uptake (SUVmax ≥18) were significant prognostic factors for survival. PET/CT permitted an earlier assessment of tumour response to treatment than CT in 4 of the 11 patients in whom both examinations were performed. After treatment with combined radiotherapy and chemotherapy, only the two patients with a negative control PET/CT had a confirmed complete remission at 14 and 38 months; all eight patients who had persistent FDG uptake during treatment had a clinical recurrence and died. FDG PET/CT appears to be the reference imaging modality for ATC at initial staging and seems promising in the early evaluation of treatment response and follow-up. (orig.)

  20. The Role of {sup 18}F-fluorodeoxyglucose Positron Emission Tomography in Gastrointestinal Stromal Tumors

    Yoo, Ie Ryung [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2008-12-15

    Gastrointestinal stromal tumors (GIST) are the most common mesenchymal neoplasm of the gastrointestinal tract, and can be distinguished from the smooth muscle or neural tumors in approximately 95% of patients by expression of the KIT receptor tyrosine kinase (CD117). GISTs are known to have high malignant potential and none can be labeled definitely as benign. However, GISTs are unresponsive to standard sarcoma chemotherapy, and only complete surgical resection provides chance for cure. Although the imaging modality of choice is enhanced CT scan in patients with GIST, FDG PET can reflect the malignant potential of GIST. Clinical management of patients with GISTs has dramatically changed with the introduction of novel therapeutics, such as imatinib mesylate (Glivec). This has created a need to re-evaluate the existing criteria used to assess treatment response. FDG PET as functional imaging modality proved to be significantly more accurate than CT alone when assessing GIST response to imatinib. And, FDG PET and PET/CT have been found to be highly sensitive in detecting early response, and to be useful in predicting long-term response to imatinib in patients with recurrent or metastatic GISTs.

  1. Diagnostic value for extrahepatic metastases of hepatocellular carcinoma in positron emission tomography/computed tomography scan

    2012-01-01

    AIM: To evaluated the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) scan in diagnosis of hepatocellular carcinoma (HCC) and extrahepatic metastases.

  2. Recommendations for 18F-fluorodeoxyglucose positron emission tomography imaging for cardiac sarcoidosis. Japanese society of nuclear cardiology recommendations

    Sarcoidosis is a systemic granulomatous disease and generally the prognosis is good. However the prognosis of cardiac sarcoidosis (CS) is extremely poor and careful management is required. Guidelines for the diagnosis of CS were published in 1992 and modified in 2006 in Japan. Because the capability to diagnose CS has been improved through the use of 18F-FDG PET, The Japan Society of Sarcoidosis and other Granulomatous Diseases is currently updating its guidelines for the diagnosis of CS and positive 18F-FDG PET findings would be added for one of the criteria for the diagnosis. FDG PET Guidelines about preparation, scan protocol, image processing and image interpretation are described dealing with recommendations about dietary modification and fasting time before imaging, heparin preadministration, 18F-FDG administration dose, cardiac spot imaging, attenuation collection, use of bull's-eye map display, use of systemic MIP imaging and use of standardized uptake value. (K.S.)

  3. Feasibility of iodine contrast enhanced CT-scan during a 18F-fluorodeoxyglucose Positron Emission Tomography

    Houzard, C.; Tychyj, C.; Morelec, I.; Ricard, F.; Got, P.; Cotton, F.; Giammarile, F.; Maintas, D.

    2009-06-01

    OBJECTIVE: this prospective study evaluates the feasibility in current clinical practice of contrast enhanced CT-scan for diagnosis purpose, performed during 18FDG PET-CT study with a PET/CT tomography. METHOD: 25 patients underwent FDG imaging for lymphoma staging. The PET scan was done immediately after the usual low dose CT (lCT). A second CT scan was consequently acquired, by using classical diagnosis CT parameters (dCT) and iodinated contrast. For each patient, all CT attenuation correction (CTAC) PET images were visually compared. Density in Hounsfield units (HU) and maximum Standardized Uptake Value (SUVmax) were then measured on different organs and up to 5 specific lymphoma localizations (total of 294 measurements). RESULTS: Visual analysis was similar for the 2 modalities, without discordant interpretation for the pathologic sites. SUVmax means and standard deviation of each organ for lCTAC and dCTAC were comparable. The equation of the fitted multiple linear regression model was: dCT=0.0748191 + 1.17024*lCT (98.71%; p CT scan, before the PET scan acquisition for lymphoma staging with this PET-CT scan, not affected by the height atomic number and elevated density. A great benefit is therefore obtained on diagnostic, logistic and radioprotection purposes.

  4. Usefulness of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in dermatofibrosarcoma protuberans on treatment with imatinib

    Kashyap, Raghava; Muddu, Vamshi Krishna; Anantamakula, Sameera; Sri, Satya

    2016-01-01

    Dermatofibrosarcoma protuberans (DFSP) is a rare locally aggressive tumor with distant metastases being unusual. We present a case of metastatic DFSP treated with imatinib showing complete metabolic response to treatment. PMID:27385888

  5. 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging of extra-medullary plasmacytoma of the ovary

    Extrameduallary plasmacytoma of ovary is extremely rare. We report a case of involvement of ovary in a treated case of plasmacytoma of 2nd part of duodenum, which was initially thought to be physiological luteal activity. However, follow up whole body FDG PET-CT scan shows appearance of metabolically active soft tissue mass in left adnexal region which confirmed to be extra-medullary plasmacytoma of ovary on histopathology

  6. 18F-Fluorodeoxyglucose Positron Emission Tomography for Primary Thyroid Cancer: Correlation with the Clinical, Pathologic and Sonographic Findings

    Kim, Kyung Eun; Kim, Eun Kyung; Moon, Hee Jung; Kwak, Jin Young [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-06-15

    We wanted to investigate the incidence and the clinicopathologic and sonographic characteristics of thyroid cancers that exhibit positive PET scans. From January 2007 to February 2008, 156 patients with thyroid cancer underwent both sonography and FDG-PET for the purpose of staging the cancer. We conducted a retrospective review of their clinical, radiologic and pathologic records and we evaluated the incidence of PET-positive thyroid cancer, as well as the associated clinicopathologic aggressiveness and the sonographic features. The incidence of PET-positive thyroid carcinoma was 78.2% (122/156). On univariate analysis, PET-positive thyroid cancer was significantly associated with tumor size, extracapsular invasion and central lymph node metastasis, but there was no association between the sonographic features of the thyroid cancer or the sonographic features of the 2 groups of tumor (1. probably benign and 2. suspicious for malignancy) and the FDG uptake. Multivariate logistic regression analysis showed a significant association between PET positivity and both extrathyroidal extension and a higher cancer stage (III/IV) (p < 0.05). The incidence of PET positive thyroid carcinoma is high (78.2%) and PET positivity is significantly associated with tumor size, extracapsular extension and a higher stage. However, there is no significant association between PET positivity and the sonographic features of thyroid carcinoma

  7. 18F-Fluorodeoxyglucose positron emission tomography pulmonary imaging in idiopathic pulmonary fibrosis is reproducible: implications for future clinical trials

    Noninvasive markers of disease activity in patients with idiopathic pulmonary fibrosis (IPF) are lacking. We performed this study to investigate the reproducibility of pulmonary 18F-FDG PET/CT in patients with IPF. The study group comprised 13 patients (11 men, 2 women; mean age 71.1 ± 9.9 years) with IPF recruited for two thoracic 18F-FDG PET/CT studies performed within 2 weeks of each other. All patients were diagnosed with IPF in consensus at multidisciplinary meetings as a result of typical clinical, high-resolution CT and pulmonary function test features. Three methods for evaluating pulmonary 18F-FDG uptake were used. The maximal 18F-FDG pulmonary uptake (SUVmax) in the lungs was determined using manual region-of-interest placement. An 18F-FDG uptake intensity histogram was automatically constructed from segmented lungs to evaluate the distribution of SUVs. Finally, mean SUV was determined for volumes-of-interest in pulmonary regions with interstitial lung changes identified on CT scans. Processing included correction for tissue fraction effects. Bland-Altman analysis was performed and interclass correlation coefficients (ICC) were determined to assess the reproducibility between the first and second PET scans, as well as the level of intraobserver and interobserver agreement. The mean time between the two scans was 6.3 ± 4.3 days. The interscan ICCs for pulmonary SUVmax analysis and mean SUV corrected for tissue fraction effects were 0.90 and 0.91, respectively. Intensity histograms were different in only 1 of the 13 paired studies. Intraobserver agreement was also excellent (0.80 and 0.85, respectively). Some bias was observed between observers, suggesting that serial studies would benefit from analysis by the same observer. This study demonstrated that there is excellent short-term reproducibility in pulmonary 18F-FDG uptake in patients with IPF. (orig.)

  8. 18F-fluorodeoxyglucose positron emission tomography in restaging of colorectal cancer. Evidence-based recommendations and cost-effectiveness

    Aim, method: Recommendations for the use of FDG-PET in relapsed colorectal cancer and the decision of reimbursement should base on published studies and on their level of evidence. Therefore, the PET-studies published between 1997 and 2002 were graded by the bias-criteria, by two rating-systems and by two classification-systems for the level of evidence according to AHCPR (Agency for Health Care Policy and Research) and VHA (Veterans Health Administration). Results: The recommendation for the use of PET in relapsed colorectal cancer reached the level IIa according to the AHCPR, corresponding to level B according to the VHA. The sensitivity and specificity of FDG-PET were 94% (95% CI: 91-96%) and 78% (95% CI: 69-86%), respectively. Staging was changed correctly in 27% of patients (95% CI: 24-30%). Staging by FDG-PET was incorrect in 4% of the patients (95% CI: 2-5%) compared with the conventionel methods. The additional use of PET changed the prospectively defined management plan for 34% of patients (95% CI: 31-38%). Either potentially curative operations were initiated in case of resectable tumour or futile operations were cancelled in case of multiple metastases. Conclusion: The 3-years-survival-rate following surgery would have exceeded 70% if the selection of patients had included an additional PET-examination. The correct selection of patients is requested in the daily routine as well as in the clinical implementation of neoadjuvant therapies to prevent a selection-bias from a suboptimal restaging without PET. (orig.)

  9. Primary spindle cell sarcoma of the prostate and 18 F-fluorodeoxyglucose-positron-emission tomography/computed tomography findings

    Hakan Öztürk

    2015-01-01

    Conclusion: Spindle sarcomas of the prostate have quite aggressive nature and they have high potential to metastase. Average life expectancy is <1 year and the prognosis is poor. CTx and radiation therapy can′t yield curative effects due to poor differentiation.

  10. Glucose Metabolism Gene Expression Patterns and Tumor Uptake of {sup 18}F-Fluorodeoxyglucose After Radiation Treatment

    Wilson, George D., E-mail: george.wilson@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Beaumont BioBank, William Beaumont Hospital, Royal Oak, Michigan (United States); Thibodeau, Bryan J.; Fortier, Laura E.; Pruetz, Barbara L. [Beaumont BioBank, William Beaumont Hospital, Royal Oak, Michigan (United States); Galoforo, Sandra; Baschnagel, Andrew M.; Chunta, John [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Oliver Wong, Ching Yee [Department of Diagnostic Radiology and Molecular Imaging Medicine, William Beaumont Hospital, Royal Oak, Michigan (United States); Yan, Di; Marples, Brian [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Huang, Jiayi [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States)

    2014-11-01

    Purpose: To investigate whether radiation treatment influences the expression of glucose metabolism genes and compromises the potential use of {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) as a tool to monitor the early response of head and neck cancer xenografts to radiation therapy (RT). Methods and Materials: Low passage head and neck squamous cancer cells (UT14) were injected to the flanks of female nu/nu mice to generate xenografts. After tumors reached a size of 500 mm{sup 3} they were treated with either sham RT or 15 Gy in 1 fraction. At different time points, days 3, 9, and 16 for controls and days 4, 7, 12, 21, 30, and 40 after irradiation, 2 to 3 mice were assessed with dynamic FDG-PET acquisition over 2 hours. Immediately after the FDG-PET the tumors were harvested for global gene expression analysis and immunohistochemical evaluation of GLUT1 and HK2. Different analytic parameters were used to process the dynamic PET data. Results: Radiation had no effect on key genes involved in FDG uptake and metabolism but did alter other genes in the HIF1α and glucose transport–related pathways. In contrast to the lack of effect on gene expression, changes in the protein expression patterns of the key genes GLUT1/SLC2A1 and HK2 were observed after radiation treatment. The changes in GLUT1 protein expression showed some correlation with dynamic FDG-PET parameters, such as the kinetic index. Conclusion: {sup 18}F-fluorodeoxyglucose positron emission tomography changes after RT would seem to represent an altered metabolic state and not a direct effect on the key genes regulating FDG uptake and metabolism.

  11. Factors Affecting 18F-Fluorodeoxyglucose (FDG) Uptake in Breast Cancer

    To evaluate factors affecting 18F-Fluorodeoxyglucose (FDG) uptake in breast cancer. For 3 years from 2006, 180 patients (mean age 48-years-old) with 187 breast cancers underwent positron emission tomography-computed tomography (PET/CT; biograph2, Siemens) at our institute and were enrolled in this study. We evaluated whether there was a correlation between the peak standardized uptake value (pSUV) of PET/CT and the histologic type of the breast cancers (n=187), grade of the invasive ductal cancers (n=142), and tumor size (n=153). The different histologic types of breast cancers include IDCs (n=156), in situ ductal carcinoma (n=10), papillary cancer (n=6), mucinous cancer (n=6), invasive lobular cancer (n=4), medullary cancer (n=3), metaplastic cancer (n=1), and neuroendocrine cancer (n=1). pSUV showed significant differences according to histologic type (p0.001). Regardless of histologic type, the larger the breast cancer, the higher the pSUV; in addition, the higher the grade of IDCs, the higher the pSUV. For the low grade IDCs, pSUV is correlated with tumor size; however, this is not the case in high grade IDCs

  12. ({sup 18}F)-fluorodeoxyglucose PET/CT in cervix cancer: Lymph node assessment and prognostic/predictive value of primary tumour analysis; Tomographie par emission de positons au ({sup 18}F)-fluorodesoxyglucose dans les cancers du col uterin: evaluation ganglionnaire et valeur pronostique/predictive des donnees de la tumeur primitive

    Leseur, J.; Williaume, D.; Le Prise, E.; De Crevoisier, R. [Departement des radiations, centre Eugene-Marquis, rue de la Bataille-Flandres-Dunkerque, CS 44229, 35042 Rennes cedex (France); Devillers, A.; Garin, E. [Service de medecine nucleaire, centre Eugene-Marquis, rue de la Bataille-Flandres-Dunkerque, CS 44229, 35042 Rennes cedex (France); Fougerou, C. [Service de pharmacologie, CHU de Rennes, 35033 Rennes cedex 09 (France); Inserm 0203, centre d' investigations cliniques, CHU de Rennes, 35033 Rennes cedex 09 (France); Universite de Rennes 1, CS 46510, 35065 Rennes cedex (France); Bouriel, C. [Service de radiologie, centre Eugene-Marquis, rue de la Bataille-Flandres-Dunkerque, CS 44229, 35042 Rennes cedex (France); Leveque, J. [Departement de gynecologie et obstetrique, CHU Anne-de-Bretagne, 16, boulevard de Bulgarie, 35203 Rennes cedex 2 (France); Monpetit, E. [Departement des radiations, clinique Oceane, 11, rue du Docteur-Joseph-Audic, Le Tenenio, BP 50020, 56001 Vannes cedex (France); Blanchot, J. [Departement de gynecologie et obstetrique, clinique mutualiste La Sagesse, 4, place Saint-Guenole, CS 44345, 35043 Rennes cedex (France)

    2011-12-15

    Purpose. - In cervix carcinoma: (a) to evaluate the ability of ({sup 18}F)-fluorodeoxyglucose (FDG) positron emission tomography (PET) in the lymph node detection; (b) to investigate the prognostic and predictive value of the primary cervical PET parameters. Patients and methods. - Ninety patients treated for cervix carcinoma and evaluated initially by MRI and FDG PET were included. The performances of FDG-PET for lymph node detection (relatively to the lymph node dissection) have been described (sensitivity, specificity, positive predictive value and negative predictive value). PET tumour parameters analyzed were: maximum standard uptake value (SUV{sub max}), the volume and the maximum diameter. The prognostic and predictive values of these parameters were investigated. The tumour response was evaluated on surgical specimens. Results. - PET detected the cervical tumour with a sensitivity of 97% (mean values: SUV{sub max} = 15.8, volume = 27 mm{sup 3}, maximum diameter = 47). For the detection of the lymph nodes, the values of sensibility, specificity, positive predictive value and negative predictive value were: 86, 56, 69 and 78% in the pelvic, and 90, 67, 50 and 95% for the para-aortic area, respectively. The SUV{sub max} was correlated with histologic response (P = 0.04). The frequency of partial histological response was significantly higher for tumour SUV{sub max}> 10.9 (P = 0.017). The maximum PET diameter and pathologic response had an impact on disease-free survival and overall survival in multivariate analysis (P < 0.05). Conclusion. - PET has high sensitivity in detecting pelvic and para-aortic lymph nodes. Some primary cervical tumour PET parameters are useful as prognostic and predictive factors. (authors)

  13. A case of multiple hepatic angiomyolipomas with high 18 F-fluorodeoxyglucose uptake

    Hepatic angiomyolipoma is a rare benign mesenchymal tumor. We report an unusual case of a patient with multiple hepatic angiomyolipomas exhibiting high 18 F-fluorodeoxyglucose (FDG) uptake. A 29-year-old man with a medical history of tuberous sclerosis was admitted to our hospital for fever, vomiting, and weight loss. Abdominal dynamic computed tomography revealed faint hypervascular hepatic tumors in segments 5 (67 mm) and 6 (10 mm), with rapid washout and clear borders; however, the tumors exhibited no definite fatty density. Abdominal magnetic resonance imaging revealed that the hepatic lesions were slightly hypointense on T1-weighted imaging, slightly hyperintense on T2-weighted imaging, and hyperintense with no apparent fat component on diffusion-weighted imaging. FDG-positron emission tomography (PET) imaging revealed high maximum standardized uptake values (SUVmax) of 6.27 (Segment 5) and 3.22 (Segment 6) in the hepatic tumors. A right hepatic lobectomy was performed, and part of the middle hepatic vein was also excised. Histological examination revealed that these tumors were characterized by the background infiltration of numerous inflammatory cells, including spindle-shaped cells, and a resemblance to an inflammatory pseudotumor. Immunohistochemical evaluation revealed that the tumor stained positively for human melanoma black-45. The tumor was therefore considered an inflammatory pseudotumor-like angiomyolipoma. Although several case reports of hepatic angiomyolipoma have been described or reviewed in the literature, only 3 have exhibited high 18 F-FDG uptake on PET imaging with SUVmax ranging from 3.3–4.0. In this case, increased 18 F-FDG uptake is more likely to appear, particularly if the inflammation is predominant. Although literature regarding the role of 18 F-FDG-PET in hepatic angiomyolipoma diagnosis is limited and the diagnostic value of 18 F-FDG-PET has not yet been clearly defined, the possibility that hepatic angiomyolipoma might exhibit

  14. Factors Affecting 18F-Fluorodeoxyglucose (FDG) Uptake in Breast Cancer

    Jeong, Sun Hye; Lee, Eun Hye; Park, Jung Mi; Lee, Hae Kyung; Yi, Boem Ha [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Choi, Na Mi [Konkuk University Medical Center, Seoul (Korea, Republic of)

    2010-06-15

    To evaluate factors affecting 18F-Fluorodeoxyglucose (FDG) uptake in breast cancer. For 3 years from 2006, 180 patients (mean age 48-years-old) with 187 breast cancers underwent positron emission tomography-computed tomography (PET/CT; biograph2, Siemens) at our institute and were enrolled in this study. We evaluated whether there was a correlation between the peak standardized uptake value (pSUV) of PET/CT and the histologic type of the breast cancers (n=187), grade of the invasive ductal cancers (n=142), and tumor size (n=153). The different histologic types of breast cancers include IDCs (n=156), in situ ductal carcinoma (n=10), papillary cancer (n=6), mucinous cancer (n=6), invasive lobular cancer (n=4), medullary cancer (n=3), metaplastic cancer (n=1), and neuroendocrine cancer (n=1). pSUV showed significant differences according to histologic type (p<0.005). For the available cases (n=142), IDCs were classified as grade 1 (n=25), grade 2 (n=66), and grade 3 (n=51) and correlated with the histologic grade of IDCs (rho=0.41, p<0.001). pSUV was correlated with tumor size regardless of histologic type (rho=0.525, p<0.001). In low grade IDCs, pSUV was correlated with tumor size (rho=0.48-0.86, p<0.001), but not in high grade IDCs (p>0.001). Regardless of histologic type, the larger the breast cancer, the higher the pSUV; in addition, the higher the grade of IDCs, the higher the pSUV. For the low grade IDCs, pSUV is correlated with tumor size; however, this is not the case in high grade IDCs

  15. Nasopharyngeal cancer pathology - correlation with 18F-Fluorodeoxyglucose PETCT derived standardized uptake values

    Full text: Objective: To investigate the relationship between nasopharyngeal cancer (NPC) pathological type, EBY positivity and uptake of 18F-Fluorodeoxyglucose (FDG) as measured on PETCT Methods: This retrospective investigation included 15 patients consisting of 10 males and 5 females (age range: 18-84 years old) who were referred to our department for whole-body positron emission tomography-computed tomography (PETCT) with newly diagnosed, biopsy-proven nasopharyngeal carcinoma (NPC). Medical records and PETCT images were reviewed to obtain the histological subtypes, the tumour staging (T), EBV positivity and the FDG uptake, measured as maximum standardized uptake value (SUY) of the primary tumour. Results: The histopthologic subtypes were: squamous keratinizing WHO Type I (n=3), n=1 in each of T2, T3 and T4; non-keratinizing squamous WHO Type II (n=4), all 4 are of T I; and undifferentiated WHO Type III (n=8), Tl(n=3), T3(n=3) and T4(n=2). The SUY of the primary tumour ranges from 4.5-32.8. The mean SUV is 12.3, 15.2 and 11.1 for histological type I, II and III respectively (p=0.49). There is also no significant association between SUY and tumour grade (p=0.71). 6 (Type II: n=3; Type Ill: n=3) out of 15 patients are positive for EBV The mean SUV for positive and negative EBV group is 14.6+/-10.1 and 11.0+/-7.2 respectively (p=0.43). Conclusions: Our study observed that Type II NPC exhibited a higher FDG uptake than either Type I or Type Ill; also higher SUY is found in EBY positive tumour. However, the difference do not reach statistical significant. Further study with bigger sample size is necessary.

  16. Positron emission tomography/computerized tomography imaging of multiple focus of neurolymphomatosis

    Neurolymphomatosis is defined as infiltration of the peripheral nervous system by malignant lymphocytes in the presence of lymphoma. In this case, we described multiple neurol involvement and findings of 18F-fluorodeoxyglucose positron emission tomography/computerized tomography in a 35-year-old female diagnosed with B-cell lymphoma

  17. Adding maximum standard uptake value of primary lesion and lymph nodes in 18F-fluorodeoxyglucose PET helps predict distant metastasis in patients with nasopharyngeal carcinoma.

    Qi Shi

    Full Text Available To find out the most valuable parameter of 18F-Fluorodeoxyglucose positron emission tomography for predicting distant metastasis in nasopharyngeal carcinoma.From June 2007 through December 2010, 43 non-metastatic NPC patients who underwent 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT before radical Intensity-Modulated Radiation Therapy were enrolled and reviewed retrospectively. PET parameters including maximum standardized uptake value (SUV max, mean standardized uptake value (SUV mean, metabolic tumor volume (MTV, and total lesion glucose (TLG of both primary tumor and cervical lymph nodes were calculated. Total SUV max were recorded as the sum of SUV max of primary tumor and cervical lymph nodes. Total SUV mean, Total MTV and Total TLG were calculated in the same way as Total SUV max.The median follow-up was 32 months (range, 23-68 months. Distant metastasis was the main pattern of treatment failure. Univariate analysis showed higher SUV max, SUV mean, MTV, and TLG of primary tumor, Total SUV max, Total MTV, Total TLG, and stage T3-4 were factors predicting for significantly poorer distant metastasis-free survival (p = 0.042, p = 0.008, p = 0.023, p = 0.023, p = 0.024, p = 0.033, p = 0.016, p = 0.015. In multivariate analysis, Total SUV max was the independent predictive factor for distant metastasis (p = 0.046. Spearman Rank correlation analysis showed mediate to strong correlationship between Total SUV max and SUV max-T, and between Total SUV max and SUV max-N(Spearman coefficient: 0.568 and 0.834; p = 0.000 and p = 0.000.Preliminary results indicated that Total SUV max was an independently predictive factor for distant metastasis in patients of nasopharyngeal carcinoma treated with Intensity-Modulated Radiation Therapy.

  18. [Clinicopathological study of small lung cancer (diameter of 2 cm or less) by uptake value of 18F-fluorodeoxyglucose].

    Nakano, Tomoyuki; Endo, Shunsuke; Mitsuda, Sayaka; Endo, Tetsuya; Tezuka, Yasuhiro; Kanai, Yoshihiko; Otani, Shin-ichi; Yamamoto, Shin-ichi; Tetsuka, Kenji; Hasegawa, Tsuyoshi; Ishikawa, Shigemi; Saito, Noriko

    2012-01-01

    18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) for lung cancer may be a biomarker for malignancy as well as a useful tool for detection of nodal involvement and distant metastasis. The goal of this study was to clarify a relationship between clinicopathological findings and maximum standardized uptake value( SUVmax) obtained by preoperative PET in patients with non-small cell lung cancer in diameter of 2 cm or less. Between January 2008 and April 2011, 124 patients( 54 men and 70 women) with non-small cell lung cancer in diameter of 2 cm or less undergoing lobectomy or segmentectomy were enrolled. The relationship between SUVmax and clinicopathological findings as tumor diameter, histological type, pleural invasion, vascular invasion, lymphatic permeation and nodal involvement were analyzed. Correlation between SUVmax and findings such as vascular invasion and lymphatic permeation showed relatively strong in the patients with adenocarcinoma, on the contrary to the correlation in the patients with non-adenocarcinoma. No tumor showing SUVmax of 2 or less showed vascular invasion and/or lymphatic permeation as well as nodal involvement in any patients with adenocarcinoma. SUVmax of the primary tumor in diameter of 2 cm or less, can be a useful biomarker which indicates a surgical candidate for sublobar pulmonary resection as well as mediastinal nodal dissection, especially in patients with adenocarcinoma. PMID:22314152

  19. Localized 18F-fluorodeoxyglucose uptake at the pancreatic head during remission phase of autoimmune pancreatitis: A case report

    Yonenaga, Yoshikuni; Kushihata, Fumiki; Watanabe, Jota; Tohyama, Taiji; Inoue, Hitoshi; Sugita, Atsuro; Takada, Yasutsugu

    2016-01-01

    Autoimmune pancreatitis (AIP) is a unique form of pancreatitis, histopathologically characterized by dense lymphoplasmacytic infiltration and fibrosis of the pancreas with obliterative phlebitis. AIP is associated with a good response to steroid therapy. Differentiation between AIP and pancreatic cancer to determine a preoperative diagnosis is often challenging, despite the use of various diagnostic modalities, including computed tomography (CT), magnetic resonance imaging and endoscopic retrograde cholangiopancreatography. It has been reported that 18F-fluorodeoxyglucose (18F-FDG)-positron emission tomography (PET)/CT may be a useful tool for distinguishing between the two diseases. In the present case report, a 71-year-old male patient presented with a well-circumscribed, solitary, nodular and homogenous 18F-FDG uptake at the pancreatic head, while receiving maintenance steroid therapy in the remission phase of AIP; preoperatively, the patient had been strongly suspected of having pancreatic cancer. Pathological examination revealed post-treatment relapse of AIP. The present case highlights the diagnostic and management difficulties with AIP in the remission phase. In certain cases, it remains challenging to differentiate the two diseases, even using the latest modalities.

  20. In Vivo Treatment Sensitivity Testing With Positron Emission Tomography/Computed Tomography After One Cycle of Chemotherapy for Hodgkin Lymphoma

    Hutchings, Martin; Kostakoglu, Lale; Zaucha, Jan Maciej;

    2014-01-01

    PURPOSE: Negative [(18)F]fluorodeoxyglucose (FDG) -positron emission tomography (PET)/computed tomography (CT) after two cycles of chemotherapy indicates a favorable prognosis in Hodgkin lymphoma (HL). We hypothesized that the negative predictive value would be even higher in patients responding...

  1. Positron Emission Tomography Imaging of Pancreatic Cancer

    Saravanan Kokila Krishnamoorthy

    2014-03-01

    Full Text Available Positron emission tomography (PET using 18F-fluorodeoxyglucose (FDG is increasingly used for the staging of solidmalignancies, including lung and esophagus. However, controversy still exists in relation to the application of PET inpancreatic cancer. The authors review seven studies (Abstracts #183, #189, #190, #254, #357, #375, #378 presented at the2014 ASCO Gastrointestinal Cancers Symposium and discuss on the role of PET in this disease. As the limitations of theResponse Evaluation Criteria In Solid Tumors (RECIST continue to become evident, FDG-PET may identify changes in themetabolic activity within pancreatic adenocarcinoma, and can provide both diagnostic and prognostic information.

  2. Functional evaluation of myocardial viability by 99mTc tetrofosmin gated SPECT. A quantitative comparison with 18F fluorodeoxyglucose positron emission CT (18F FDG PET)

    To validate functional analysis of gated SPECT in detecting myocardial viability, seventeen patients (male 15, female 2, mean age 58) with angiographically proven chronic ischemic heart disease (RCA 6, LAD 10, LCX 1) and eight normal volunteers (all male) were studied. All patients underwent 18F FDG PET and 99mTc tetrofosmin (TF) gated SPECT within a week. After being displayed in a polar map, myocardial perfusion was regionally determined by the mean count in 9 segments at end diastole (ED) and end systole (ES) in gated SPECT. Systolic function was determined by the count increase ratio from ED to ES (WTI: ES-ED/ED). Glucose metabolism was assessed by 18F FDG PET in the segments correspondent to those defined for SPECT. TF %uptake of <60% was defined as hypoperfusion, and FDG %uptake of <50% was defined as reduced glucose metabolism. The myocardial segments were classified into 3 categories: ''normal'' perfusion (n=85), ''mismatch'' (reduced perfusion with reserved FDG uptake, n=25) and ''matched'' reduced perfusion and metabolic reduction (n=26). Mean WTI in ''mismatch'' segment was 0.38±0.21, and was significantly greater than that in ''matched reduced'' segments, 0.15±0.20 (p<0.001). It was also greater than that in normal'' segments, 0.27±0.16. Regression analysis showed that association between WTI and FDG %uptake was significant (r=0.57, p<0.0005) for the ischemic segments (''mismatch''+''matched'', n=51), but the association was weak for the entire segments although it was statistically significant (r=0.26, p=0.02, n=136). For the segments determined as infarct by perfusion image, systolic functional analysis by gated SPECT is helpful in differentiation of a viable myocardial region or artifact from a scar. Nevertheless, further clinical and technical assessment is required for ECG gating to eliminate overestimation of viability and to warrant clinical use. (author)

  3. Assessment of tumour response with 18F-fluorodeoxyglucose positron emission tomography using three-dimensional measures compared to SUVmax—a phantom study

    Boucek, J. A.; Francis, R. J.; Jones, C. G.; Khan, N.; Turlach, B. A.; Green, A. J.

    2008-08-01

    SUVmax is currently the most common semi-quantitative method of response assessment on FDG PET. By defining the tumour volume of interest (VOI), a measure of total glycolytic volume (TGV) may be obtained. We aimed to comprehensively examine, in a phantom setting, the accuracy of TGV in reflecting actual lesion activity and to compare TGV with SUVmax for response assessment. The algorithms for VOI generation from which TGV was derived included fixed threshold techniques at 50% of maximum (MAX50), 70% of maximum (MAX70), an adaptive threshold of 50% of (maximum + background)/2 (BM50) and a semi-automated iterative region-growing algorithm, GRAB. Comparison with both actual lesion activity and response scenarios was performed. SUVmax correlated poorly with actual lesion activity (r = 0.651) and change in lesion activity (r = 0.605). In a response matrix scenario SUVmax performed poorly when all scenarios were considered, but performed well when only clinically likely scenarios were included. The TGV derived using MAX50 and MAX70 algorithms performed poorly in evaluation of lesion change. The TGV derived from BM50 and GRAB algorithms however performed extremely well in correlation with actual lesion activity (r = 0.993 and r = 0.982, respectively), change in lesion activity (r = 0.972 and r = 0.963, respectively) and in the response scenario matrix. TGVGRAB demonstrated narrow confidence bands when modelled with actual lesion activity. Measures of TGV generated by iterative algorithms such as GRAB show potential for increased sensitivity of metabolic response monitoring compared to SUVmax, which may have important implications for improved patient care.

  4. Usefulness of 18F-fluorodeoxyglucose positron emission tomography for diagnosing disease activity and monitoring therapeutic response in patients with pulmonary mycobacteriosis

    To evaluate the usefulness of 18F-FDG PET in the imaging of pulmonary lesions related to disease activity and in monitoring responses to treatment in patients with pulmonary mycobacteriosis (PM). We used high-resolution computed tomography (HRCT) and 18F-FDG PET to evaluate 47 consecutive untreated patients with PM, 25 with tuberculosis (TB) and 22 with Mycobacterium avium-intracellulare complex (MAC), who presented with small peripheral pulmonary nodules ≤3 cm, and compared the findings. The diagnosis of mycobacteriosis was confirmed by bacteriological examinations of bronchoscopic or surgically resected specimens. PET scans were visually and quantitatively analysed using SUVmax. In addition, 14 patients with PM underwent repeat PET scanning during antimycobacterial therapy, and changes in 18F-FDG uptake were clinically evaluated (6 during treatment and 12 after treatment). Of all the lesions, 87.2% had SUVmax levels ranging from 3 to 7 (5.05±1.56, range 2.5-7.6, n=47). Further, SUV levels in patients with PM reflected disease activity as estimated by HRCT, but did not differ significantly between those with TB (4.96±1.61, n=25) and MAC (5.15±1.53, n=22). 18F-FDG uptake was significantly decreased in all 14 patients who received chemotherapy, indicating a positive response to treatment. 18F-FDG PET is considered to be useful for the diagnosis and evaluation of disease activity along with HRCT findings, and in monitoring response to chemotherapy in patients with PM. (orig.)

  5. 18F fluorodeoxyglucose positron emission tomography/computed tomography in tuberculosis of the hip: a case report and brief review of literature

    Tuberculosis (TB) has become a global health concern. Cross-sectional imaging modalities like ultrasound, computed tomography and magnetic resonance imaging play an important role in the diagnosis, assessment of disease extent and response to treatment. PET/CT, a unique molecular imaging technique, allows the most accurate correlation of anatomic and metabolic information. We report a case wherein PET/CT played a significant role and contributed valuable information in the evaluation of a patient with TB of the hip. A brief review of the existing literature on the role of PET/CT in musculoskeletal TB is also discussed. (author)

  6. Assessment of tumour response with {sup 18}F-fluorodeoxyglucose positron emission tomography using three-dimensional measures compared to SUVmax-a phantom study

    Boucek, J A; Jones, C G [WA PET Service, Sir Charles Gairdner Hospital, Verdun Street, Nedlands, Western Australia (Australia); Francis, R J [Department of Nuclear Medicine, Sir Charles Gairdner Hospital, Verdun Street, Nedlands, Western Australia (Australia); Khan, N; Turlach, B A [School of Mathematics and Statistics, University of Western Australia (Australia); Green, A J [Cancer Research UK Targeting and Imaging Group, Royal Free Hospital, University College London, London (United Kingdom)], E-mail: Ros.Francis@health.wa.gov.au

    2008-08-21

    SUVmax is currently the most common semi-quantitative method of response assessment on FDG PET. By defining the tumour volume of interest (VOI), a measure of total glycolytic volume (TGV) may be obtained. We aimed to comprehensively examine, in a phantom setting, the accuracy of TGV in reflecting actual lesion activity and to compare TGV with SUVmax for response assessment. The algorithms for VOI generation from which TGV was derived included fixed threshold techniques at 50% of maximum (MAX50), 70% of maximum (MAX70), an adaptive threshold of 50% of (maximum + background)/2 (BM50) and a semi-automated iterative region-growing algorithm, GRAB. Comparison with both actual lesion activity and response scenarios was performed. SUVmax correlated poorly with actual lesion activity (r = 0.651) and change in lesion activity (r = 0.605). In a response matrix scenario SUVmax performed poorly when all scenarios were considered, but performed well when only clinically likely scenarios were included. The TGV derived using MAX50 and MAX70 algorithms performed poorly in evaluation of lesion change. The TGV derived from BM50 and GRAB algorithms however performed extremely well in correlation with actual lesion activity (r = 0.993 and r = 0.982, respectively), change in lesion activity (r = 0.972 and r = 0.963, respectively) and in the response scenario matrix. TGV{sub GRAB} demonstrated narrow confidence bands when modelled with actual lesion activity. Measures of TGV generated by iterative algorithms such as GRAB show potential for increased sensitivity of metabolic response monitoring compared to SUVmax, which may have important implications for improved patient care.

  7. Assessment of tumour response with 18F-fluorodeoxyglucose positron emission tomography using three-dimensional measures compared to SUVmax-a phantom study

    SUVmax is currently the most common semi-quantitative method of response assessment on FDG PET. By defining the tumour volume of interest (VOI), a measure of total glycolytic volume (TGV) may be obtained. We aimed to comprehensively examine, in a phantom setting, the accuracy of TGV in reflecting actual lesion activity and to compare TGV with SUVmax for response assessment. The algorithms for VOI generation from which TGV was derived included fixed threshold techniques at 50% of maximum (MAX50), 70% of maximum (MAX70), an adaptive threshold of 50% of (maximum + background)/2 (BM50) and a semi-automated iterative region-growing algorithm, GRAB. Comparison with both actual lesion activity and response scenarios was performed. SUVmax correlated poorly with actual lesion activity (r = 0.651) and change in lesion activity (r = 0.605). In a response matrix scenario SUVmax performed poorly when all scenarios were considered, but performed well when only clinically likely scenarios were included. The TGV derived using MAX50 and MAX70 algorithms performed poorly in evaluation of lesion change. The TGV derived from BM50 and GRAB algorithms however performed extremely well in correlation with actual lesion activity (r = 0.993 and r = 0.982, respectively), change in lesion activity (r = 0.972 and r = 0.963, respectively) and in the response scenario matrix. TGVGRAB demonstrated narrow confidence bands when modelled with actual lesion activity. Measures of TGV generated by iterative algorithms such as GRAB show potential for increased sensitivity of metabolic response monitoring compared to SUVmax, which may have important implications for improved patient care

  8. Assessment of tumour response with (18)F-fluorodeoxyglucose positron emission tomography using three-dimensional measures compared to SUVmax--a phantom study.

    Boucek, J A; Francis, R J; Jones, C G; Khan, N; Turlach, B A; Green, A J

    2008-08-21

    SUVmax is currently the most common semi-quantitative method of response assessment on FDG PET. By defining the tumour volume of interest (VOI), a measure of total glycolytic volume (TGV) may be obtained. We aimed to comprehensively examine, in a phantom setting, the accuracy of TGV in reflecting actual lesion activity and to compare TGV with SUVmax for response assessment. The algorithms for VOI generation from which TGV was derived included fixed threshold techniques at 50% of maximum (MAX50), 70% of maximum (MAX70), an adaptive threshold of 50% of (maximum + background)/2 (BM50) and a semi-automated iterative region-growing algorithm, GRAB. Comparison with both actual lesion activity and response scenarios was performed. SUVmax correlated poorly with actual lesion activity (r = 0.651) and change in lesion activity (r = 0.605). In a response matrix scenario SUVmax performed poorly when all scenarios were considered, but performed well when only clinically likely scenarios were included. The TGV derived using MAX50 and MAX70 algorithms performed poorly in evaluation of lesion change. The TGV derived from BM50 and GRAB algorithms however performed extremely well in correlation with actual lesion activity (r = 0.993 and r = 0.982, respectively), change in lesion activity (r = 0.972 and r = 0.963, respectively) and in the response scenario matrix. TGV(GRAB) demonstrated narrow confidence bands when modelled with actual lesion activity. Measures of TGV generated by iterative algorithms such as GRAB show potential for increased sensitivity of metabolic response monitoring compared to SUVmax, which may have important implications for improved patient care. PMID:18653927

  9. {sup 18}F-Fluorodeoxyglucose positron emission tomography pulmonary imaging in idiopathic pulmonary fibrosis is reproducible: implications for future clinical trials

    Win, Thida [Lister Hospital, Respiratory Medicine, Stevenage (United Kingdom); Lambrou, Tryphon; Hutton, Brian F.; Kayani, Irfan; Endozo, Raymondo; Shortman, Robert I.; Groves, Ashley M. [UCL/UCH, Institute of Nuclear Medicine, London (United Kingdom); Screaton, Nicholas J. [Papworth Hospital, Radiology Department, Cambridge (United Kingdom); Porter, Joanna C. [UCL/UCH, Centre for Respiratory Diseases, London (United Kingdom); Maher, Toby M. [Royal Brompton Hospital, Interstitial Lung Disease Unit, London (United Kingdom); Lukey, Pauline [GSK, Fibrosis DPU, Research and Development, Stevenage (United Kingdom)

    2012-03-15

    Noninvasive markers of disease activity in patients with idiopathic pulmonary fibrosis (IPF) are lacking. We performed this study to investigate the reproducibility of pulmonary {sup 18}F-FDG PET/CT in patients with IPF. The study group comprised 13 patients (11 men, 2 women; mean age 71.1 {+-} 9.9 years) with IPF recruited for two thoracic {sup 18}F-FDG PET/CT studies performed within 2 weeks of each other. All patients were diagnosed with IPF in consensus at multidisciplinary meetings as a result of typical clinical, high-resolution CT and pulmonary function test features. Three methods for evaluating pulmonary {sup 18}F-FDG uptake were used. The maximal {sup 18}F-FDG pulmonary uptake (SUVmax) in the lungs was determined using manual region-of-interest placement. An {sup 18}F-FDG uptake intensity histogram was automatically constructed from segmented lungs to evaluate the distribution of SUVs. Finally, mean SUV was determined for volumes-of-interest in pulmonary regions with interstitial lung changes identified on CT scans. Processing included correction for tissue fraction effects. Bland-Altman analysis was performed and interclass correlation coefficients (ICC) were determined to assess the reproducibility between the first and second PET scans, as well as the level of intraobserver and interobserver agreement. The mean time between the two scans was 6.3 {+-} 4.3 days. The interscan ICCs for pulmonary SUVmax analysis and mean SUV corrected for tissue fraction effects were 0.90 and 0.91, respectively. Intensity histograms were different in only 1 of the 13 paired studies. Intraobserver agreement was also excellent (0.80 and 0.85, respectively). Some bias was observed between observers, suggesting that serial studies would benefit from analysis by the same observer. This study demonstrated that there is excellent short-term reproducibility in pulmonary {sup 18}F-FDG uptake in patients with IPF. (orig.)

  10. 18F fluorodeoxyglucose (FDG) positron emission tomography (PET) for primary staging of non small cell lung cancer (NSCLC): analysis of management change and survival in 153 consecutive patients

    Full text: Lung cancer is an increasing public health problem and survival is poor despite increasingly aggressive and expensive treatment protocols. Conventional staging protocols have well recognised limitations. This study assessed the effects of incorporating the results of FDG PET on staging, management and subsequent survival rate in patients undergoing primary staging of newly diagnosed NSCLC. The study contained 153 consecutive NSCLC patients undergoing FDG PET scans between 9/96 and 12/98 using broad stage groupings (stage I,II,III and IV), 10% of patients were down-staged and 33% were upstaged by PET. The probability of stage migration did not depend on the original stage (p = 0.93 for trend). Additional information provided by PET influenced management in 93 patients (61%) with 37 patients changed from curative to palliative therapy, 6 patients changed from palliative to curative treatment and in 1 patient treatment modality, but not intent, changed. PET altered delivery of a previously selected therapy in 39 cases. PET did not alter the initial treatment plan in 60 patients (39%). Cox regression analysis, corrected for the treatment delivered, indicated that each conventional stage increment was associated with an estimated 14% increase in the rate of death (95% CI - 11 % to 45%, p NS). Each post-PET stage increment was associated with an estimated 46% increase in death rate (95% CI 10% to 94%, p = 0.0035). Thus, addition of FDG PET to conventional staging in NSCLC resulted in significant stage migration, a large impact on patient management and more accurate prognostic stratification. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  11. THE USE OF 18F-FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY TO ASSESS CLINICAL OUTCOMES OF PATIENTS WITH BORDERLINE RESECTABLE PANCREATIC CANCER.

    Durmus, A; Yilmaz, A; Malya, F; Ozturk, G; Bektasoglu, H; Ertugrul, G; Karyagar, S; Karatepe, O

    2016-04-01

    The aim of this study is to evaluate the effect of 18FDG PET on preoperative staging and clinical management of pancreatic cancer. Between December 2011 and February 2015, 28 consecutive patients with borderline resectable pancreatic cancer were evaluated with both 18FDG PET scans and conventional preoperative imaging studies. Medical records of all patients were noted prospectively. 18FDG PET findings were compared with conventional imaging studies and over-staging or down-staging rates with changes in clinical management were evaluated. The correlation of 18FDG PET with conventional imaging studies was evaluated with a kappa agreement coefficient. A number of 22 (78.5%) patients had pancreatic head cancer and 6 (21.4%) patients had pancreatic body and tail cancers. Based on 18FDG PET, additional lesions were found in 4 (14.28%) of the patients which were lung and peritoneal lesions as metastasis. No hepatic metastasis or supraclavicular lymph node involvement was confirmed in patients. Routine use of 18FDG PET for preoperative staging has not an effect on cancer management in 96.8% of our patients. In conclusion, 18FDG PET has additional value over conventional radiologic techniques for monitoring the treatment response in locally advanced pancreatic cancer patients. It is feasible to predict early metastasis and patient outcome early (after one course of IC) during therapy. PMID:27249430

  12. Modest utility of quantitative measures in (18)F-fluorodeoxyglucose positron emission tomography scanning for the diagnosis of aortic prosthetic graft infection

    Saleem, Ben R.; Berger, Paul; Vaartjes, Ilonca; de Keizer, Bart; Vonken, Evert-Jan P. A.; Slart, Riemer H. J. A.; de Borst, Gert Jan; Zeebregts, Clark J.

    2015-01-01

    Background: The clinical dilemma in suspected aortic graft infection (AGI) is how to noninvasively obtain a reliable proof of infection. In addition to confirming the presence of infection, obtaining information regarding the extent of infection to select a proper strategy for reoperation is also ne

  13. Clinical use of sentinel node (SN) mapping and 18F-fluorodeoxyglucose (FDG) positron emission tomography (TEP) in the management of cutaneous melanoma

    In France, there is a new case of melanoma for 10.000 inhabitants per year. This incidence has doubled in 10 years. Surgery of the primary site is the main treatment of this disease: however thanks to the concept of sentinel node (SN) the management of melanoma changes, it tends to include adjuvant treatments. Because of the isotopic detection of SN and the use of PET FDG, nuclear medicine plays a key role in melanoma. This paper aims to discuss the place of isotopic SN mapping and TEP FDG in clinical practice. (authors)

  14. Importance of fluorodeoxyglucose-positron emission tomography (FDG-PET) and endoscopic ultrasonography parameters in predicting survival following surgery for esophageal cancer

    Omloo, J. M. T.; Sloof, G. W.; Boellaard, R.; Hoekstra, O. S.; Jager, P. L.; van Dullemen, H. M.; Fockens, P.; Plukker, J. T. M.; van Lanschot, J. J. B.

    2008-01-01

    Background and study aims: To assess the prognostic importance of standardized uptake value (SUV) for 18F-fluorodeoxyglucose (FDG) at positron emission tomography (PET) and of EUS parameters, in esophageal cancer patients primarily treated by surgery. Patients and methods: Between October 2002 and A

  15. Effects of human aging on patterns of local cerebral glucose utilization determined by the [18F]fluorodeoxyglucose method

    The [18F]fluorodeoxyglucose (FDG) scan method with positron emission computed tomography was used to determine patterns of local cerebral glucose utilization (LCMRglu) in 40 normal volunteer subjects aged 18 to 78 years. Throughout all the studies, each subject was quiet, without movement, with eyes open and ears unplugged, exposed only to ambient room light and sound. For the entire group, whole brain mean CMRglu was 26.1 +/- 6.1 mumol 100 g-1 min-1 (mean +/- SD, n . 40). At age 78, mean CMRglu was, on the average, 26% less than at age 18, an alteration of the same order as the variance among subjects at any age. The gradual decline of mean CMRglu with advancing age occurred at a faster rate than was reported for mean cerebral oxygen utilization, possibly due to increasingly altered pathways for glucose utilization, or to increasing oxidation of ketone bodies or other alternative substrates. Glucose utilization in the hemispheres was symmetrical and mean CMRglu of overall cortex, caudate, and thalamus was equal in individuals at all ages. The slopes of decline with age were similar when LCMRglu was averaged over zones corresponding to centrum semiovale, caudate, putamen, and frontal, temporal, parietal, occipital, and primary visual cortex. However, the metabolic ratio of superior frontal cortex to superior parietal cortex declined with age, possibly due to selective degeneration of superior frontal cortex or to differences between age groups in the sensory and cognitive response to the study. These results should be useful in distinguishing age from disease effects when the FDG scan method is used

  16. Diffusion-weighted MRI, {sup 11}C-choline PET and {sup 18}F-fluorodeoxyglucose PET for predicting the Gleason score in prostate carcinoma

    Chang, Joe H. [Austin Health, Radiation Oncology Centre, Heidelberg, VIC (Australia); University of Melbourne, Parkville, VIC (Australia); Lim Joon, Daryl; Wada, Morikatsu [Austin Health, Radiation Oncology Centre, Heidelberg, VIC (Australia); Lee, Sze Ting; Scott, Andrew M. [Austin Health, Centre for PET, Heidelberg, VIC (Australia); University of Melbourne, Parkville, VIC (Australia); Ludwig Institute for Cancer Research, Heidelberg, VIC (Australia); Hiew, Chee-Yan; Esler, Stephen [Austin Health, Department of Radiology, Heidelberg, VIC (Australia); Gong, Sylvia J.; Tochon-Danguy, Henri; Chan, J.G. [Austin Health, Centre for PET, Heidelberg, VIC (Australia); Clouston, David [Tissupath, Mt Waverley, VIC (Australia); O' Sullivan, Richard [Epworth Hospital, Healthcare Imaging, Richmond, VIC (Australia); Goh, Yin P. [Diagnostic Imaging, Monash Health, Clayton, VIC (Australia); Bolton, Damien [Austin Health, Department of Urology, Heidelberg, VIC (Australia); University of Melbourne, Parkville, VIC (Australia); Khoo, Vincent [Austin Health, Radiation Oncology Centre, Heidelberg, VIC (Australia); University of Melbourne, Parkville, VIC (Australia); The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Department of Clinical Oncology, London (United Kingdom); Davis, Ian D. [Monash University Eastern Health Clinical School, Box Hill, VIC (Australia)

    2014-03-15

    To evaluate the accuracy of transrectal ultrasound-guided (TRUS) biopsy, diffusion-weighted (DW) magnetic resonance imaging (MRI), {sup 11}C-choline (CHOL) positron emission tomography (PET), and {sup 18}F-fluorodeoxyglucose (FDG) PET in predicting the prostatectomy Gleason risk (GR). The study included 21 patients who underwent TRUS biopsy and multi-technique imaging before radical prostatectomy. Values from five different tests (TRUS biopsy, DW MRI, CHOL PET, FDG PET, and combined DW MRI/CHOL PET) were correlated with the prostatectomy GR using Spearman's ρ. Tests that were found to have significant correlations were used to classify patients into GR groups. The following tests had significant correlations with prostatectomy GR: TRUS biopsy (ρ = 0.617, P = 0.003), DW MRI (ρ = -0.601, P = 0.004), and combined DW MRI/CHOL PET (ρ = -0.623, P = 0.003). CHOL PET alone and FDG PET only had weak correlations. The correct GR classification rates were 67 % with TRUS biopsy, 67 % with DW MRI, and 76 % with combined DW MRI/CHOL PET. DW MRI and combined DW MRI/CHOL PET have significant correlations and high rates of correct classification of the prostatectomy GR, the strength and accuracy of which are comparable with TRUS biopsy. (orig.)

  17. Functional imaging of the brain with18F-fluorodeoxyglucose

    A techniques is reported by which it is possible to determine which regions of the human brain become functionally active in response to a specific stimulus. The method utilizes 18F-2-fluoro-2-deoxyglucose ([18F]-FDG) administered as a bolus. [18F]-FDG is used as a tracer for the exchange of glucose between plasma and brain and its phosphorylation. The subject is then scanned during administration of a physiologic stimulus by position emission tomography and the three-dimensional distribution of 18F activity in the brain determined

  18. Fluorodeoxyglucose positron emission tomography/computed tomography and magnetic resonance imaging of uterine leiomyosarcomas: 2 cases report

    ZHANG Hui-juan; ZHAN Feng-hua; LI Ya-jun; SUN Hao-ran; BAI Ren-ju; GAO Shuo

    2011-01-01

    Uterine leiomyosarcoma is an uncommon malignant neoplasm of smooth muscle origination and is associated with a poor prognosis. We report two cases of uterine leiomyosarcoma that presented with pulmonary metastases.2-deoxy-2-(18F)fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) was performed to identify the primary carcinoma and found the focus located in the uterus. The follow-up magnetic resonance imaging (MRI) confirmed the diagnosis was uterine leiomyosarcoma.

  19. (18)F-Fluorodeoxyglucose PET/Computed Tomography for Primary Brain Tumors

    Antonsen Segtnan, Eivind; Hess, Søren; Grupe, Peter;

    2015-01-01

    Structural imaging with computed tomography (CT) and MR imaging is the mainstay in primary diagnosis of primary brain tumors, but these modalities depend on morphologic appearance and an intact blood-brain barrier, and important aspects of tumor biology are not addressed. Such issues may be...... alleviated by (18)F-fluorodeoxyglucose (FDG)-PET and FDG-PET/CT imaging, which may provide clinically important information with regard to primary differentiation between tumor types, initial staging and risk stratification, therapy planning, response evaluation, and recurrence detection. This article...

  20. Clusters of Low (18)F-Fluorodeoxyglucose Uptake Voxels in Combat Veterans with Traumatic Brain Injury and Post-Traumatic Stress Disorder.

    Buchsbaum, Monte S; Simmons, Alan N; DeCastro, Alex; Farid, Nikdokht; Matthews, Scott C

    2015-11-15

    Individuals with mild traumatic brain injury (TBI) show diminished metabolic activity when studied with positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG). Since blast injury may not be localized in the same specific anatomical areas in every patient or may be diffuse, significance probability mapping may be vulnerable to false-negative detection of abnormalities. To address this problem, we used an anatomically independent measure to assess PET scans: increased numbers of contiguous voxels that are 2 standard deviations below values found in an uninjured control group. We examined this in three age-matched groups of male patients: 16 veterans with a history of mild TBI, 17 veterans with both mild TBI and post-traumatic stress disorder (PTSD), and 15 veterans without either condition. After FDG administration, subjects performed a modified version of the California Verbal Learning Task. Clusters of low uptake voxels were identified by computing the mean and standard deviation for each voxel in the healthy combat veteran group and then determining the voxel-based z-score for the patient groups. Abnormal clusters were defined as those that contained contiguous voxels with a z-score clusters of low uptake voxels, and cluster size significantly differentiated the mild TBI groups from combat controls. Clusters were more irregular in shape in patients, and patients also had a larger number of low-activity voxels throughout the brain. In mild TBI and TBI+PTSD patients, but not healthy subjects, cluster volume was significantly correlated with verbal learning during FDG uptake. PMID:25915799

  1. Prognostic Value of Volume-Based {sup 18}F-Fluorodeoxyglucose PET/CT Parameters in Patients with Clinically Node-Negative Oral Tongue Squamous Cell Carcinoma

    Lee, Su Jin [Dept. of Nuclear Medicine, Ajou University School of Medicine, Suwon (Korea, Republic of); Choi, Joon Young; Lee, Hwan Joo; Hyun, Seung Hyup; Moon, Seung Hwan; Kim, Byung Tae [Dept. of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Baek, Chung Hwan; Son, Young Ik [Dept. of Otorhinolaryngology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2012-11-15

    To evaluate the prognostic value of volume-based metabolic parameters measured with {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET) in patients with clinically node-negative (cN0) oral tongue squamous cell carcinoma (OTSCC) as compared with other prognostic factors. In this study, we included a total of 57 patients who had been diagnosed with cN0 tongue cancer by radiologic, ({sup 18}F-FDG PET/CT, and physical examinations. The maximum standardized uptake value (SUVmax), average SUV (SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for primary tumors were measured with ({sup 18}F-FDG PET. The prognostic significances of these parameters and other clinical variables were assessed by Cox proportional hazards regression analysis. In the univariate analysis, pathological node (pN) stage, American Joint Committee on Cancer (AJCC) stage, SUVmax, SUVavg, MTV, and TLG were significant predictors for survival. On a multivariate analysis, pN stage (hazard ratio = 10.555, p = 0.049), AJCC stage (hazard ratio = 13.220, p = 0.045), and MTV (hazard ratio = 2.698, p 0.033) were significant prognostic factors in cN0 OTSCC patients. The patients with MTV {>=} 7.78 cm{sup 3} showed a worse prognosis than those with MTV < 7.78 cm{sup 3} (p = 0.037). The MTV of primary tumor as a volumetric parameter of ({sup 18}F-FDG PET, in addition to pN stage and AJCC stage, is an independent prognostic factor for survival in cN0 OTSCC.

  2. Prognostic Value of Volume-Based 18F-Fluorodeoxyglucose PET/CT Parameters in Patients with Clinically Node-Negative Oral Tongue Squamous Cell Carcinoma

    To evaluate the prognostic value of volume-based metabolic parameters measured with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in patients with clinically node-negative (cN0) oral tongue squamous cell carcinoma (OTSCC) as compared with other prognostic factors. In this study, we included a total of 57 patients who had been diagnosed with cN0 tongue cancer by radiologic, (18F-FDG PET/CT, and physical examinations. The maximum standardized uptake value (SUVmax), average SUV (SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for primary tumors were measured with (18F-FDG PET. The prognostic significances of these parameters and other clinical variables were assessed by Cox proportional hazards regression analysis. In the univariate analysis, pathological node (pN) stage, American Joint Committee on Cancer (AJCC) stage, SUVmax, SUVavg, MTV, and TLG were significant predictors for survival. On a multivariate analysis, pN stage (hazard ratio = 10.555, p = 0.049), AJCC stage (hazard ratio = 13.220, p = 0.045), and MTV (hazard ratio = 2.698, p 0.033) were significant prognostic factors in cN0 OTSCC patients. The patients with MTV ≥ 7.78 cm3 showed a worse prognosis than those with MTV 3 (p = 0.037). The MTV of primary tumor as a volumetric parameter of (18F-FDG PET, in addition to pN stage and AJCC stage, is an independent prognostic factor for survival in cN0 OTSCC.

  3. Physiological Uptake of 18F-Fluorodeoxyglucose in Uterine Endometrium and Myometrium: Correlation with Uterine Motility Evaluated by Cine Magnetic Resonance Imaging

    Background: Accumulation of 18F-fluorodeoxyglucose (18F-FDG) in the uterine endometrium and uterine motility are dependent on menstrual cycle. However, the relationship between them remains unknown. Purpose: To investigate the relationship between radiometabolic activity of 18F-FDG in the uterus and uterine motility observed by cine magnetic resonance imaging (MRI). Material and Methods: The study population consisted of 65 healthy, fertile women, selected from 229 women who underwent positron emission tomography (PET), computed tomography (CT), and MRI for cancer screening at our facility. They were divided into three groups according to their menstrual cycle phases: menstrual, follicular-periovulatory, and luteal. Regions of interest (ROIs) were placed over the endometrium and myometrium to calculate the standardized uptake value (SUV). Uterine peristalsis and contraction shown by cine MR imaging were evaluated visually, and the correlation between FDG uptake and uterine movements was assessed. Results: After excluding nine patients due to inadequate images, 56 patients (19 follicular-periovulatory, 27 luteal, and 10 menstrual) were analyzed. FDG uptake of the endometrium, frequency of peristalsis, and the presence of sustained contraction varied according to the menstruation cycle, with a tendency toward greater uptake in the menstrual phase, but there was little relationship between the frequency of uterine peristalsis and FDG accumulation in the uterus. Significantly higher FDG accumulation in the endometrium was observed in patients with sustained contractions (3.32±1.47) than in those without contractions (2.45±0.66). Conclusion: Our preliminary data suggest that FDG accumulation in the endometrium tends to be higher in patients with uterine contraction, although there was no significant correlation between uterine peristalsis and FDG uptake in the uterine myometrium or endometrium

  4. Automatic synthesis of 16{alpha}-[{sup 18}F]fluoro-17{beta}-estradiol using a cassette-type [{sup 18}F]fluorodeoxyglucose synthesizer

    Mori, Tetsuya [Biomedical Imaging Research Center, University of Fukui, Matsuoka, Fukui 910-1193 (Japan)]. E-mail: morit@fmsrsa.fukui-med.ac.jp; Kasamatsu, Shingo [JFE P and S Fukui Branch, University of Fukui, Matsuoka, Fukui 910-1193 (Japan); Mosdzianowski, Christoph [GE Healthcare Technologies, Parc Scientifique du Sart Tilman Av. Pre-Aliy (c/o Socran) B-4031 Liege (Belgium); Welch, Michael J. [Mallinckrodt Institute of Radiology, Washington University Medical Center, St. Louis, MO 63110 (United States); Yonekura, Yoshiharu [Biomedical Imaging Research Center, University of Fukui, Matsuoka, Fukui 910-1193 (Japan); Fujibayashi, Yasuhisa [Biomedical Imaging Research Center, University of Fukui, Matsuoka, Fukui 910-1193 (Japan)

    2006-02-15

    16{alpha}-[{sup 18}F]fluoro-17{beta}-estradiol ([{sup 18}F]FES) is a radiotracer for imaging estrogen receptors by positron emission tomography. We developed a clinically applicable automatic preparation system for [{sup 18}F]FES by modifying a cassette-type [{sup 18}F]fluorodeoxyglucose synthesizer. Two milligrams of 3-O-methoxymethyl-16,17-O-sulfuryl-16-epiestriol in acetonitrile was heated at 105{sup o}C for 10 min with dried [{sup 18}F]fluoride. The resultant solution was evaporated and hydrolyzed with 0.2 N HCl in 90% acetonitrile/water at 95{sup o}C for 10 min under pressurized condition. The neutralization was carried out with 2.8% NaHCO{sub 3}, and then the high-performance liquid chromatography (HPLC) purification was performed. The desired radioactive fraction was collected and the solvent was replaced by 10 ml of saline, and then passed through a 0.22-{mu}m filter into a pyrogen-free vial as the final product. The HPLC purification data demonstrated that [{sup 18}F]FES was synthesized with a yield of 76.4{+-}1.9% (n=5). The yield as the final product for clinical use was 42.4{+-}3.2% (n=5, decay corrected). The total preparation time was 88.2{+-}6.4 min, including the HPLC purification and the solvent replacement process. The radiochemical purity of the final product was >99%, and the specific activity was more than 111 GBq/{mu}mol. The final product was stable for more than 6 h in saline containing sodium ascorbate. This new preparation system enables us to produce [{sup 18}F]FES safe for clinical use with high and reproducible yield.

  5. A 24-hour temporal profile of in vivo brain and heart pet imaging reveals a nocturnal peak in brain 18F-fluorodeoxyglucose uptake.

    Daan R van der Veen

    Full Text Available Using positron emission tomography, we measured in vivo uptake of (18F-fluorodeoxyglucose (FDG in the brain and heart of C57Bl/6 mice at intervals across a 24-hour light-dark cycle. Our data describe a significant, high amplitude rhythm in FDG uptake throughout the whole brain, peaking at the mid-dark phase of the light-dark cycle, which is the active phase for nocturnal mice. Under these conditions, heart FDG uptake did not vary with time of day, but did show biological variation throughout the 24-hour period for measurements within the same mice. FDG uptake was scanned at different times of day within an individual mouse, and also compared to different times of day between individuals, showing both biological and technical reproducibility of the 24-hour pattern in FDG uptake. Regional analysis of brain FDG uptake revealed especially high amplitude rhythms in the olfactory bulb and cortex, while low amplitude rhythms were observed in the amygdala, brain stem and hypothalamus. Low amplitude 24-hour rhythms in regional FDG uptake may be due to multiple rhythms with different phases in a single brain structure, quenching some of the amplitude. Our data show that the whole brain exhibits significant, high amplitude daily variation in glucose uptake in living mice. Reports applying the 2-deoxy-D[(14C]-glucose method for the quantitative determination of the rates of local cerebral glucose utilization indicate only a small number of brain regions exhibiting a day versus night variation in glucose utilization. In contrast, our data show 24-hour patterns in glucose uptake in most of the brain regions examined, including several regions that do not show a difference in glucose utilization. Our data also emphasizes a methodological requirement of controlling for the time of day of scanning FDG uptake in the brain in both clinical and pre-clinical settings, and suggests waveform normalization of FDG measurements at different times of the day.

  6. Distribution and separation of metallic and radionuclidic impurities in the production of 18F-fluorodeoxyglucose

    In this study the identification, determination and distribution of metallic and radionuclidic contaminants in the synthesis of 18F-fluorodeoxyglucose are presented. Samples of irradiated 18O-enriched water, purification columns (anionic, C18, Al2O3), final product and wastes were examined. Metallic contaminants were determined by ICP-MS and the radionuclide impurities by high resolution germanium gamma-spectrometry. Fifteen radionuclides were identified in the samples. The enriched water contained cationic contaminants (55Co, 56Co, 57Co, 58Co, 57Ni, 52Mn, 7Be) while the anionic (95Tc, 95mTc, 96Tc, 183Re) were mostly retained in the QMA column. The sources of contamination by metals and radionuclides were determined. Results obtained by ICP-MS generally confirmed the radionuclide distribution obtained by gamma spectrometry. (author)

  7. Whole Body Muscle Activity during the FIFA 11+ Program Evaluated by Positron Emission Tomography

    Nakase, Junsuke; Inaki, Anri; Mochizuki, Takafumi; Toratani, Tatsuhiro; Kosaka, Masahiro; Ohashi, Yoshinori; Taki, Junichi; Yahata, Tetsutaro; Kinuya, Seigo; Tsuchiya, Hiroyuki

    2013-01-01

    Purpose This study investigated the effect of the FIFA 11+ warm-up program on whole body muscle activity using positron emission tomography. Methods Ten healthy male volunteers were divided into a control group and a group that performed injury prevention exercises (The 11+). The subjects of the control group were placed in a sitting position for 20 min and 37 MBq of 18F-fluorodeoxyglucose (FDG) was injected intravenously. The subjects then remained seated for 45 min. The subjects of the exer...

  8. The metabolic landscape of cortico-basal ganglionic degeneration: regional asymmetries studied with positron emission tomography.

    Eidelberg, D.; Dhawan, V; Moeller, J R; Sidtis, J.J.; Ginos, J Z; Strother, S C; Cederbaum, J.; Greene, P; Fahn, S; Powers, J M

    1991-01-01

    Regional metabolic rate for glucose (rCMRGlc) was estimated using [18F]fluorodeoxyglucose (FDG) and positron emission tomography (PET) in five patients (four men, one woman; mean age 68; mean disease duration 2.4 years) with clinical findings consistent with the syndrome of cortico-basal ganglionic degeneration (CBGD). Left-right rCMRGlc asymmetry, (L-R)/(L + R) x 100, was calculated for 13 grey matter regions and compared with regional metabolic data from 18 normal volunteers and nine patien...

  9. Benign breast lesions detected by positron emission tomography-computed tomography

    Benveniste, Ana P., E-mail: apbenveniste@mdanderson.org [Department of Diagnostic Radiology,The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Yang, Wei, E-mail: wyang@mdanderson.org [Department of Diagnostic Radiology,The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Benveniste, Marcelo F., E-mail: mfbenveniste@mdanderson.org [Department of Diagnostic Radiology,The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Mawlawi, Osama R., E-mail: omawlawi@mdanderson.org [Department of imaging physics, The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Marom, Edith M., E-mail: emarom@mdanderson.org [Department of Diagnostic Radiology,The University of Texas MD Anderson Cancer Center, Houston, TX (United States)

    2014-06-15

    {sup 18}F-fluorodeoxyglucose positron emission computed tomography (FDG PET-CT) is widely used in the initial staging and response evaluation of patients with malignancy. This review describes a spectrum of benign breast findings incidentally detected by FDG PET-CT at staging that may be misinterpreted as malignancy. We describe the pattern of distribution and intensity of FDG uptake in a spectrum of benign breast diseases with their corresponding typical morphological imaging characteristics to help the nuclear medicine physician and/or general radiologist identify benign lesions, avoiding unnecessary breast imaging work-up and biopsies.

  10. Michaelis-Menten constraints improved cerebral glucose metabolism and regional lumped constant measurements with [18F]fluorodeoxyglucose

    In the three-compartment model of transfer of native glucose and [18F]fluorodeoxyglucose (FDG) into brain, both transport across the blood-brain barrier and phosphorylation by hexokinase can be described by the Michaelis-Menten equation. This permits the use of fixed transport (tau = K*1/K1) and phosphorylation (psi = k*3/k3) ratios and a common partition volume (Ve = K1/k2) for tracer and glucose. By substituting transfer constants of FDG for those of glucose, using tau and psi, the lumped constant was determined directly by positron tomography. The same constraints also eliminated k*2 and k*3 from the model, thus limiting the parameters to K* [equivalent to K*1k*3/(k*2 + k*3)], K*1, and the cerebral vascular volume (Vo). In six healthy elderly men (aged 61 +/- 5 years), time-activity records of cerebral cortical regions were analyzed with tau = 1.1 and psi = 0.3. The results were compared with those of the conventional FDG method. At 20 min, the goodness of fit by the new equation was as good as that of the conventional method at 45 min. The estimates obtained by the constrained method had stable coefficients of variation. After 20 min, regional differences between the estimates were independent of time, although we observed steady decreases of K* and (k*3). The decrease strongly suggested dephosphorylation of FDG-6-phosphate, particularly after 20 min. All estimates of variables with the constrained method were more accurate than those of the conventional method, including the cerebral glucose metabolic rate itself, as well as physiologically more meaningful, particularly with respect to k*2 and k*3

  11. Can an alternative backround-corrected [18F] fluorodeoxyglucose (FDG standard uptake value (SUV be used for monitoring tumor local control following lung cancer stereotactic body radiosurgery?

    Charles Shang

    2014-08-01

    assessing local tumor control after lung SBRT......................................................Cite this article as: Shang CY, Kasper ME, Kathriarachchi V, Benda RK, Kleinman JH, Cole J, Williams TR. Can an alternative backround-corrected [18F] fluorodeoxyglucose (FDG standard uptake value (SUV be used for monitoring tumor local control following lung cancer stereotactic body radiosurgery? Int J Cancer Ther Oncol 2014; 2(4:020317.DOI: 10.14319/ijcto.0203.17

  12. PET with 18F-fluorodeoxyglucose for staging of non-small cell lung cancer. Evidence-based recommendations and cost-effectiveness

    Aims: To evaluate studies on the use of positron emission tomography with the glucose analog 18F-fluorodeoxyglucose (FDG-PET) for the preoperative staging of patients with non-small cell lung cancer (NSCLC) according to the criteria of evidence based medicine and to discuss the cost-effectiveness of the technique. Methods: Clinical studies published between 1995 and 2002 on the preoperative staging of non-small cell lung cancer were used for this analysis. Studies that did not meet the criteria published by the European Agency for the Evaluation of Medicinal Products (EMEA) were excluded. The validity of the studies was evaluated by a standardized rating system developed by the Agency for Health Care Policy and Research (AHCPR). Results: For the detection of mediastinal lymph node metastases the mean sensitivity and specificity of FDG-PET on a patient basis is 85% and 87% (16 studies, 1355 patients). In studies that compared FDG-PET and computed tomography (CT) the mean sensitivity of CT was 66% at a specificity of 71%. In the detection of distant metastases FDG-PET correctly changed the tumor stage in 18% of the patients when compared to CT based staging (10 studies, 1073 patients). Five cost effectiveness analyses from the USA, Japan, and Germany concluded that FDG-PET improves the outcome of treatment at reduced or only slightly increased overall costs. Improvement of patient outcome was also demonstrated in a randomized trial, which found that the risk of a futile thoracotomy was reduced by 51% (p=0.003) when FDG-PET was added to the preoperative staging. Conclusion: According to the criteria of the AHCPR the use of FDG-PET for detection of mediastinal lymph node and distant metastases is documented at a level of evidence Ia and Ib, respectively. Since systematic analyses also indicate a favourable cost-effectiveness ratio FDG-PET has to be considered as 'strictly indicated' for the preoperative staging of a non-small cell lung cancer. (orig.)

  13. The Complementary Roles of Dynamic Contrast Enhanced MRI and 18F-Fluorodeoxyglucose PET/CT for Imaging of Carotid Atherosclerosis

    Calcagno, Claudia; Ramachandran, Sarayu; Izquierdo-Garcia, David; Mani, Venkatesh; Millon, Antoine; Rosenbaum, David; Tawakol, Ahmed; Woodward, Mark; Bucerius, Jan; Moshier, Erin; Godbold, James; Kallend, David; Farkouh, Michael E; Fuster, Valentin; Rudd, James HF; Fayad, Zahi A

    2013-01-01

    Background Inflammation and neovascularization in vulnerable atherosclerotic plaques are key risk factors for severe clinical events. Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) are two non-invasive imaging techniques capable of quantifying plaque neovascularization and inflammatory infiltrate respectively. However, their mutual role in defining plaque vulnerability and their possible overlap has not been thoroughly investigated. Here, we study the relationship between DCE-MRI and 18F-FDG PET in the carotid arteries of 40 subjects with coronary heart disease (CHD) or CHD equivalent, recruited as a substudy of the dal-PLAQUE trial (NCT00655473). Methods The dal-PLAQUE trial was a multicenter study that evaluated dalcetrapib, a cholesteryl ester transfer protein modulator. Subjects underwent anatomical MRI, DCE-MRI and 18F-FDG PET. Only baseline imaging and biomarkers data (before randomization) from dal-PLAQUE were used as part of this substudy. Our primary goal was to evaluate the relationship between DCE-MRI and 18F-FDG PET data. As secondary endpoints, we evaluated the relationship between a) PET data and whole vessel anatomical MRI data, and b) DCE-MRI and matching anatomical MRI data. All correlations were estimated using a mixed linear model. Results We found a significant inverse relationship between several perfusion indices by DCE-MRI and 18F-FDG uptake by PET. Regarding our secondary endpoints, there was a significant relationship between plaque burden measured by anatomical MRI with several perfusion indices by DCE-MRI and 18F-FDG uptake by PET. No relationship was found between plaque composition by anatomical MRI with DCEMRI or 18F-FDG PET metrics. Conclusions In this study we observed a significant, weak inverse relationship between inflammation measured as 18F-FDG uptake by PET and plaque perfusion by DCE-MRI. Our findings suggest that there may be a complex

  14. [18F]fluorodeoxyglucose Uptake Patterns in Lung Before Radiotherapy Identify Areas More Susceptible to Radiation-Induced Lung Toxicity in Non-Small-Cell Lung Cancer Patients

    Purpose: Our hypothesis was that pretreatment inflammation in the lung makes pulmonary tissue more susceptible to radiation damage. The relationship between pretreatment [18F]fluorodeoxyglucose ([18F]FDG) uptake in the lungs (as a surrogate for inflammation) and the delivered radiation dose and radiation-induced lung toxicity (RILT) was investigated. Methods and Materials: We retrospectively studied a prospectively obtained cohort of 101 non-small-cell lung cancer patients treated with (chemo)radiation therapy (RT). [18F]FDG-positron emission tomography-computed tomography (PET-CT) scans used for treatment planning were studied. Different parameters were used to describe [18F]FDG uptake patterns in the lungs, excluding clinical target volumes, and the interaction with radiation dose. An increase in the dyspnea grade of 1 (Common Terminology Criteria for Adverse Events version 3.0) or more points compared to the pre-RT score was used as an endpoint for analysis of RILT. The effect of [18F]FDG and CT-based variables, dose, and other patient or treatment characteristics that effected RILT was studied using logistic regression. Results: Increased lung density and pretreatment [18F]FDG uptake were related to RILT after RT with univariable logistic regression. The 95th percentile of the [18F]FDG uptake in the lungs remained significant in multivariable logistic regression (p = 0.016; odds ratio [OR] = 4.3), together with age (p = 0.029; OR = 1.06), and a pre-RT dyspnea score of ≥1 (p = 0.005; OR = 0.20). Significant interaction effects were demonstrated among the 80th, 90th, and 95th percentiles and the relative lung volume receiving more than 2 and 5 Gy. Conclusions: The risk of RILT increased with the 95th percentile of the [18F]FDG uptake in the lungs, excluding clinical tumor volume (OR = 4.3). The effect became more pronounced as the fraction of the 5%, 10%, and 20% highest standardized uptake value voxels that received more than 2 Gy to 5 Gy increased. Therefore

  15. Characteristics of [18F] fluorodeoxyglucose uptake in human colon cancer cells

    Cancer tissues are characterized by increased glucose uptake. 18F-fluorodeoxyglucose(FDG), a glucose analogue is used for the diagnosis of cancer in PET studies. This study was aimed to compare the glucose uptake and glucose transporter 1(GLUT1) expression in various human colon cancer cells. We measured FDG uptake by cell retention study and expression of GLUT1 using Western blotting. Human colon cancer cells, SNU-C2A, SNU-C4 and SNU-C5, were used. The cells were incubated with 1μ Ci/ml of FDG in HEPES- buffered saline for one hour. The FDG uptake of SNU-C2A, SNU-C4 and SNU-C5 were 16.8±1.36, 12.3±5.55 and 61.0±2.17 cpm/μg of protein, respectively. Dose-response and time-course studies represent that FDG uptake of cancer cells were dose dependent and time dependent. The rate of FDG uptake of SNU-C2A, SNU-C4 and SNU-C5 were 0.29±0.03, 0.21±0.09 and 1.07±0.07 cpm/min/μg of protein, respectively. Western blot analysis showed that the GLUT1 expression of SNU-C5 was significantly higher than those of SNU-C2A and SNU-C4. These results represent that FDG uptake into human colon cancer cells are different from each other. In addition, FDG uptake and expression of GLUT1 are closely related in human colon cancer cells

  16. Long-term quality assurance of [(18)F]-fluorodeoxyglucose (FDG) manufacturing.

    Gaspar, Ludovit; Reich, Michal; Kassai, Zoltan; Macasek, Fedor; Rodrigo, Luis; Kruzliak, Peter; Kovac, Peter

    2016-01-01

    Nine years of experience with 2286 commercial synthesis allowed us to deliver comprehensive information on the quality of (18)F-FDG production. Semi-automated FDG production line using Cyclone 18/9 machine (IBA Belgium), TRACERLab MXFDG synthesiser (GE Health, USA) using alkalic hydrolysis, grade "A" isolator with dispensing robotic unit (Tema Sinergie, Italy), and automatic control system under GAMP5 (minus2, Slovakia) was assessed by TQM tools as highly reliable aseptic production line, fully compliant with Good Manufacturing Practice and just-in-time delivery of FDG radiopharmaceutical. Fluoride-18 is received in steady yield and of very high radioactive purity. Synthesis yields exhibited high variance connected probably with quality of disposable cassettes and chemicals sets. Most performance non-conformities within the manufacturing cycle occur at mechanical nodes of dispensing unit. The long-term monitoring of 2286 commercial synthesis indicated high reliability of automatic synthesizers. Shewhart chart and ANOVA analysis showed that minor non-compliances occurred were mostly caused by the declinations of less experienced staff from standard operation procedures, and also by quality of automatic cassettes. Only 15 syntheses were found unfinished and in 4 cases the product was out-of-specification of European Pharmacopoeia. Most vulnerable step of manufacturing was dispensing and filling in grade "A" isolator. Its cleanliness and sterility was fully controlled under the investigated period by applying hydrogen peroxide vapours (VHP). Our experience with quality assurance in the production of [(18)F]-fluorodeoxyglucose (FDG) at production facility of BIONT based on TRACERlab MXFDG production module can be used for bench-marking of the emerging manufacturing and automated manufacturing systems. PMID:27508102

  17. pO polarography, contrast enhanced color duplex sonography (CDS, [18F] fluoromisonidazole and [18F] fluorodeoxyglucose positron emission tomography: validated methods for the evaluation of therapy-relevant tumor oxygenation or only bricks in the puzzle of tumor hypoxia?

    Hamacher Kurt

    2007-06-01

    Full Text Available Abstract Background The present study was conducted to analyze the value of ([18F] fluoromisonidazole (FMISO and [18F]-2-fluoro-2'-deoxyglucose (FDG PET as well as color pixel density (CPD and tumor perfusion (TP assessed by color duplex sonography (CDS for determination of therapeutic relevant hypoxia. As a standard for measuring tissue oxygenation in human tumors, the invasive, computerized polarographic needle electrode system (pO2 histography was used for comparing the different non invasive measurements. Methods Until now a total of 38 Patients with malignancies of the head and neck were examined. Tumor tissue pO2 was measured using a pO2-histograph. The needle electrode was placed CT-controlled in the tumor without general or local anesthesia. To assess the biological and clinical relevance of oxygenation measurement, the relative frequency of pO2 readings, with values ≤ 2.5, ≤ 5.0 and ≤ 10.0 mmHg, as well as mean and median pO2 were stated. FMISO PET consisted of one static scan of the relevant region, performed 120 min after intravenous administration. FMISO tumor to muscle ratios (FMISOT/M and tumor to blood ratios (FMISOT/B were calculated. FDG PET of the lymph node metastases was performed 71 ± 17 min after intravenous administration. To visualize as many vessels as possible by CDS, a contrast enhancer (Levovist®, Schering Corp., Germany was administered. Color pixel density (CPD was defined as the ratio of colored to grey pixels in a region of interest. From CDS signals two parameters were extracted: color hue – defining velocity (v and color area – defining perfused area (A. Signal intensity as a measure of tissue perfusion (TP was quantified as follows: TP = vmean × Amean. Results In order to investigate the degree of linear association, we calculated the Pearson correlation coefficient. Slight (|r| > 0.4 to moderate (|r| > 0.6 correlation was found between the parameters of pO2 polarography (pO2 readings with values ≤ 2.5, ≤ 5.0 and ≤ 10.0 mmHg, as well as median pO2, CPD and FMISOT/M. Only a slight correlation between TP and the fraction of pO2 values ≤ 10.0 mmHg, median and mean pO2 could be detected. After exclusion of four outliers the absolute values of the Pearson correlation coefficients increased clearly. There was no relevant association between mean or maximum FDG uptake and the different polarographic- as well as the CDS parameters. Conclusion CDS and FMISO PET represent different approaches for estimation of therapy relevant tumor hypoxia. Each of these approaches is methodologically limited, making evaluation of clinical potential in prospective studies necessary.

  18. {sup 18}F-Fluorodeoxyglucose PET/CT in a Patient with Esophageal and Genital Leiomyomatosis

    An, Young Sil; Kim, Deog Yoon [Kyung Hee University, Seoul (Korea, Republic of)

    2009-12-15

    Diffuse esophageal leiomyomatosis is a rare benign tumor, which can be associated with leiomyoma in female genital tracts involving the uterus, vagina, and vulva. Alport syndrome, an inherited disorder that includes the kidneys, eyes, and sensorineural hearing loss, is also rarely associated with these multiple leiomyomatosis. In our case, {sup 18}F-fluoroseoxyglucose positron emission tomography/ computed tomography was used to distinguish esophageal and genital leiomyomatosis from malignant masses.

  19. 18F-Fluorodeoxyglucose PET/CT in a Patient with Esophageal and Genital Leiomyomatosis

    Diffuse esophageal leiomyomatosis is a rare benign tumor, which can be associated with leiomyoma in female genital tracts involving the uterus, vagina, and vulva. Alport syndrome, an inherited disorder that includes the kidneys, eyes, and sensorineural hearing loss, is also rarely associated with these multiple leiomyomatosis. In our case, 18F-fluoroseoxyglucose positron emission tomography/ computed tomography was used to distinguish esophageal and genital leiomyomatosis from malignant masses

  20. Incidental gastrointestinal 18F-Fluorodeoxyglucose uptake associated with lung cancer

    Vella-Boucaud, Juliette; Papathanassiou, Dimitri; Bouche, Olivier; Prevost, Alain; Lestra, Thibault; Dury, Sandra; Vallerand, Hervé; Perotin, Jeanne-Marie; Launois, Claire; Boissiere, Louis; Brasseur, Mathilde; Lebargy, François; Deslee, Gaëtan

    2015-01-01

    Background F-Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is increasingly used for the initial staging and restaging of lung cancer. Incidental gastrointestinal findings are often observed on 18F-FDG PET/CT. The objective of this study was to assess incidental 18F-FDG uptake by the gastrointestinal tract (GIT) in patients with lung cancer. Methods Two hundred thirty consecutive 18F-FDG PET/CT examinations performed for lung cancer over a 3-year period w...

  1. Beyond FDG positron emission tomography imaging

    At present, positron emission tomography/computed tomography (PET/CT) is one of the most rapidly growing areas of medical imaging, with many applications in the clinical management of patients with cancer. Although ((18)F) fluorodeoxyglucose (FDG)-PET/CT imaging provides high specificity and sensitivity in several kinds of cancer and has many applications, it is important to recognize that FDG is not a 'specific' radiotracer for imaging malignant disease. Highly 'tumor-specific' PET radiopharmaceuticals are essential to meet the growing demand of radioisotope-based molecular imaging technology. C-11 Methionine PET has been used to better define the radiotherapy field both for CNS tumors and head and neck (H and N) tumors to localize the most metabolic area inside a brain mass to guide the biopsy or in early evaluation of radiotherapy effect on H and N cancer. Flurodihydroxyphenylalanine (FDOPA) is an aromatic amino acid labelled with 18F. Besides it has also been introduced into oncological practice, in particular for malignant tumors of neural crest origin

  2. Effect of blood glucose levels on image quality in 18F fluorodeoxyglucose scanning - a case report

    Full text: In December last year, a 71-year-old gentleman presented to the Nuclear Medicine Department at St Vincent's Hospital, Sydney for an FDG coincidence detection positron emission scan. The patient had cancer of the lung with a large lesion in the left upper lobe and a small lesion in the right middle lobe. On initial investigation, this patient had a blood sugar level of 17mmol/L which was eventually reduced to 6.7mmol/L just prior to scanning. The patient was then asked to return to be rescanned without his blood sugar levels being adjusted. Just prior to his second scan, his blood sugar level was 15.4mmollL. The aim of the initial scan being repeated was to see just how important a role blood sugar levels play in the quality of a Co Pet scan. The first scan showed excellent image quality while the repeated scan showed markedly inferior image quality due to unwanted soft tissue FDG uptake. In conclusion, blood sugar levels play a significant role in output image quality in FDG coincidence detection positron emission scanning. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  3. Cyclotron Produced Radionuclides: Guidance on Facility Design and Production of [18F]Fluorodeoxyglucose (FDG)

    Positron emission tomography (PET) has advanced rapidly in recent years and is becoming an indispensable imaging modality for the evaluation and staging of cancer patients. A key component of the successful operation of a PET centre is the on-demand availability of radiotracers (radiopharmaceuticals) labelled with suitable positron emitting radioisotopes. Of the hundreds of positron labelled radiotracers, 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) is the most successful and widely used imaging agent in PET today. While FDG is utilized largely in oncology for the management of cancer patients, its applications in neurology and cardiology are also steadily growing. A large number of PET facilities have been established in Member States over the past few years, and more are being planned. The design and operation of a facility for the production of FDG requires attention to detail, in particular the application of good manufacturing practices (GMP) guidelines and quality assurance. The product must conform to the required quality specifications and must be safe for human use. This book is intended to be a resource manual with practical information for planning and operating an FDG production facility, including design and implementation of the laboratories, facility layout, equipment, personnel and FDG quality assessment. GMP and quality management are discussed only briefly, since these topics are covered extensively in the IAEA publication Cyclotron Produced Radionuclides: Guidelines for Setting up a Facility (Technical Reports Series No. 471). It should be noted that manufacturing processes and quality specifications for FDG are not currently globally harmonized, and these do vary to some extent. However, there is no disagreement over the need to ensure that the product is manufactured in a controlled manner, that it conforms to applicable quality specifications and that it is safe for human use. Administrators, managers, radiopharmaceutical scientists, production

  4. 18F - fluorodeoxyglucose (FDG) and broncho-pulmonary cancer. Preliminary results

    The metabolic imaging allowed by emission positron tomography (EPT) represents a new approach in the cancer diagnosis. The augmentation of glycoprotein metabolism in malignant lesions can be evidenced by FDG. The broncho-pulmonary cancer (BPC) poses clinical problems of tissue characterization which are not solved optimally by radiological imaging, so that the new technique presents a major interest. The authors report the first data obtained in France with a positron chamber in 12 patients studied since June 1996, namely 10 cases of pulmonary nodules and two of mediastinal ganglionic extension of BPC. Cross sections from skull to pelvis were achieved 45 minutes after the IV injection of 37 MBq of FDG per 10 kg of weight. The anatomical-pathological examination was systematic and the agreement with EPT was good in 10 cases of 12 (9 positive trues and 1 negative true), in addition, new sites were evidenced, 3 times of 12. They were overlooked by the radiological technique and thus, susceptible of modifying the treatment. These preliminary results are coherent with those reported in the international literature. They incited starting a prospective large-scale study of measuring the diagnosis performances of FDG in EPT in determining the malignity of solitary nodules and mediastinal extension of primary tumors

  5. A Novel Method to Evaluate Local Control of Lung Cancer in Stereotactic Body Radiation Therapy (SBRT) Treatment Using 18F-FDG Positron Emission Tomography (PET)

    Kathriarachchi, Vindu Wathsala

    An improved method is introduced for prediction of local tumor control following lung stereotactic body radiation therapy (SBRT) for early stage non-small cell lung cancer (NSCLC) patients using 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET). A normalized background-corrected tumor maximum Standard Uptake Value (SUVcmax) is introduced using the mean uptake of adjacent aorta (SUVref), instead of the maximum uptake of lung tumor (SUVmax). This method minimizes the variations associated with SUVmax and objectively demonstrates a strong correlation between the low SUVcmax (PET scans, therefore such inclusion is not recommended for assessing local tumor control of post lung SBRT.

  6. Case of Pulmonary Cryptococcosis Mimicking Hematogeneous Metastases in an Immuocompetent Patient: Value of Absent 18F-Fluorodeoxylucose Uptake on Positron Emission Tomography/CT Scan

    The radiologic appearance of multiple discrete pulmonary nodules in immunocompetent patients, with cryptococcal infection, has been rarely described. We describe a case of pulmonary cryptococcosis, presenting with bilaterally and randomly distributed nodules on a computed tomography, mimicking hematogeneous metastases. Positron emission tomography does not demonstrate 18F-fluorodeoxyglucose (FDG) uptake, suggesting a low probability for malignancy, which is a crucial piece of information for clinicians when making a management decision. We find the absence of FDG uptake correlates with the pathologic finding of an infectious nodule, composed of fibrosis and necrosis

  7. Case of Pulmonary Cryptococcosis Mimicking Hematogeneous Metastases in an Immuocompetent Patient: Value of Absent 18F-Fluorodeoxylucose Uptake on Positron Emission Tomography/CT Scan

    Lee, Chiao-Hua [Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei 114, Taiwan (China); Tzao, Ching [Department of Thoracic Surgery, Tri-Service General Hospital and National Defense Medical Center, Taipei 114, Taiwan (China); Chang, Tsun-Hou; Chang, Wei-Chou; Huang, Guo-Shu [Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei 114, Taiwan (China); Lin, Chih-Kung; Lin, Hsin-Chung [Department of Pathology, Tri-Service General Hospital and National Defense Medical Center, Taipei 114, Taiwan (China); Hsu, Hsian-He [Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei 114, Taiwan (China)

    2013-07-01

    The radiologic appearance of multiple discrete pulmonary nodules in immunocompetent patients, with cryptococcal infection, has been rarely described. We describe a case of pulmonary cryptococcosis, presenting with bilaterally and randomly distributed nodules on a computed tomography, mimicking hematogeneous metastases. Positron emission tomography does not demonstrate 18F-fluorodeoxyglucose (FDG) uptake, suggesting a low probability for malignancy, which is a crucial piece of information for clinicians when making a management decision. We find the absence of FDG uptake correlates with the pathologic finding of an infectious nodule, composed of fibrosis and necrosis.

  8. PET/CT with 18F-fluorodeoxyglucose as metabolic alternative to biopsy for gastrointestinal stromal tumor?

    The usefulness of 18F-fluorodeoxyglucose (FDG) PET/CT in different clinical settings of many malignancies is well documented. Early evaluation of therapeutic response by means of functional imaging providing important predictive and prognostic information is particularly interesting. Furthermore, certain anticancer agents show significant therapeutic specificity for certain types of malignancies and therapeutic test evaluated by functional imaging my serve as metabolic surrogate for histology (metabolic biopsy). Gastrointestinal stromal tumours are FDG avid mesenchymal tumours, in most cases well responding to treatment by tyrosine-kinase inhibitors (imatinib mesylate, sunitinib maleate). Therapeutic test by imatinib mesylate evaluated by FDG PET/CT may potentially serve as metabolic biopsy in patients presenting tumour evocative of GIST. This article illustrates the potential role of metabolic biopsy in routine management of patients with abdominal tumour evocative of GIST. (author)

  9. Correlation between 18F Fluorodeoxyglucose uptake and epidermal growth factor receptor mutations in advanced lung cancer

    Mutations in the epidermal growth factor receptor (EGFR)gene have been identified as potential targets for the treatment and prognostic factors for non small cell lung cancer (NSCLC). We assessed the correlation between fluorodeoxyglucose (FDG) uptake and EGFR mutations, as well as their prognostic implications. A total of 163 patients with pathologically confirmed NSCLC were enrolled (99 males and 64 females; median age, 60 years). All patients underwent FDG positron emission tomography before treatment, and genetic studies of EGFR mutations were performed. The maximum standardized uptake value (SUVmax)of the primary lung cancer was measured and normalized with regard to liver uptake. The SUVmax between the wild type and EGFR mutant groups was compared. Survival was evaluated according to SUVmax and EGFR mutation status. EGFR mutations were found in 57 patients (60.8%). The SUVmax tended to be higher in wild type than mutant tumors, but was not significantly different (11.1±5.7 vs. 9.8±4.4, P=0.103). The SUVmax was significantly lower in patients with an exon 19 mutation than in those with either an exon 21 mutation or wild type (P=0.003 and 0.009, respectively). The EGFR mutation showed prolonged overall survival (OS) compared to wild type tumors (P=0.004). There was no significant difference in survival according to SUVmax. Both OS and progression free survival of patients with a mutation in exon 19 were significant longer than in patients with wild type tumors. In patients with NSCLC, a mutation in exon 19 was associated with a lower SUVmax and is a reliable predictor for good survival

  10. Influence of rhTSH on [18F]fluorodeoxyglucose uptake by differentiated thyroid carcinoma

    The influence of serum TSH levels on fluorine-18 fluorodeoxyglucose (FDG) uptake by recurrences or metastases of differentiated thyroid carcinomas has not yet been clarified. The aim of this study was to ascertain whether the administration of recombinant human thyrotropin (rhTSH) stimulates FDG uptake by such lesions. In this prospective study, 30 patients with positive or equivocal thyroglobulin (Tg) levels and negative or equivocal iodine-131 and/or morphological imaging results (ultrasound, MRI, CT) underwent FDG positron emission tomography (PET) under exogenous TSH suppression and under exogenous TSH stimulation of serum levels by injection of rhTSH. The mean interval between the FDG-PET studies under these two conditions was 9.3±8.8 weeks. Serum TSH levels and free thyroid hormones were determined on each occasion. FDG uptake was quantitated using tumour to background ratios (TBRs) and standardised uptake values (SUVs). Under TSH suppression there was focal FDG accumulation in nine subjects (22 tumour-like lesions). The total number of foci was 45. After exogenous TSH stimulation, the number of patients in whom FDG foci were detected was 19, and the number of foci identified was 82 (78 tumour-like lesions). TBR of regions showing positive FDG contrast with either of the modalities averaged 2.54±1.89, and under stimulated TSH levels, 5.51±2.99 (P<0.0001). Corresponding SUVs were 2.05±1.45 versus 2.77±1.58 (P<0.001). In a small number (n=4) of foci related to inflammatory lymph nodes, TBR and SUV were only marginally increased under TSH stimulation (2.01±0.38 and 1.07±0.38, respectively), and the values did not differ significantly from those obtained under suppression. These results provide the first direct evidence that TSH stimulates FDG uptake by differentiated thyroid carcinoma and that, therefore, FDG-PET is more accurate under rhTSH than under suppression. (orig.)

  11. 18F-fluorodeoxyglucose and PET/CT for noninvasive study of exercise-induced glucose uptake in rat skeletal muscle and tendon

    Skovgaard, Dorthe; Kjaer, Michael; El-Ali, Henrik;

    2009-01-01

    unilateral isometric contractions of the calf muscle. (18)F-Fluorodeoxyglucose was administered and a PET/CT scan of the hindlimbs was performed. SUVs were calculated in both Achilles tendons and the triceps surae muscles. To exclude a spill-over effect the tendons and muscles from an ex vivo group of eight...

  12. Greater left cerebral hemispheric metabolism in bulimia assessed by positron emission tomography

    Wu, J.C.; Hagman, J.; Buchsbaum, M.S.; Blinder, B.; Derrfler, M.; Tai, W.Y.; Hazlett, E.; Sicotte, N. (Univ. of California, Irvine (USA))

    1990-03-01

    Eight women with bulimia and eight age- and sex-matched normal control subjects were studied with positron emission tomography using (18F)-fluorodeoxyglucose (FDG) as a tracer of brain metabolic rate. Subjects performed a visual vigilance task during FDG uptake. In control subjects, the metabolic rate was higher in the right hemisphere than in the left, but patients with bulimia did not have this normal asymmetry. Lower metabolic rates in the basal ganglia, found in studies of depressed subjects, and higher rates in the basal ganglia, reported in a study of anorexia nervosa, were not found. This is consistent with the suggestion that bulimia is a diagnostic grouping distinct from these disorders.

  13. Methods and applications of positron-based medical imaging

    Herzog, H.

    2007-02-01

    Positron emission tomography (PET) is a diagnostic imaging method to examine metabolic functions and their disorders. Dedicated ring systems of scintillation detectors measure the 511 keV γ-radiation produced in the course of the positron emission from radiolabelled metabolically active molecules. A great number of radiopharmaceuticals labelled with 11C, 13N, 15O, or 18F positron emitters have been applied both for research and clinical purposes in neurology, cardiology and oncology. The recent success of PET with rapidly increasing installations is mainly based on the use of [ 18F]fluorodeoxyglucose (FDG) in oncology where it is most useful to localize primary tumours and their metastases.

  14. Comparison of 18F-Fluorothymidine and 18F-Fluorodeoxyglucose PET/CT in Delineating Gross Tumor Volume by Optimal Threshold in Patients With Squamous Cell Carcinoma of Thoracic Esophagus

    Purpose: To determine the optimal method of using 18F-fluorothymidine (FLT) positron emission tomography (PET)/computed tomography (CT) simulation to delineate the gross tumor volume (GTV) in esophageal squamous cell carcinoma verified by pathologic examination and compare the results with those using 18F-fluorodeoxyglucose (FDG) PET/CT. Methods and Materials: A total of 22 patients were enrolled and underwent both FLT and FDG PET/CT. The GTVs with biologic information were delineated using seven different methods in FLT PET/CT and three different methods in FDG PET/CT. The results were compared with the pathologic gross tumor length, and the optimal threshold was obtained. Next, we compared the simulation plans using the optimal threshold of FLT and FDG PET/CT. The radiation dose was prescribed as 60 Gy in 30 fractions with a precise radiotherapy technique. Results: The mean ± standard deviation pathologic gross tumor length was 4.94 ± 2.21 cm. On FLT PET/CT, the length of the standardized uptake value 1.4 was 4.91 ± 2.43 cm. On FDG PET/CT, the length of the standardized uptake value 2.5 was 5.10 ± 2.18 cm, both of which seemed more approximate to the pathologic gross tumor length. The differences in the bilateral lung volume receiving ≥20 Gy, heart volume receiving ≥40 Gy, and the maximal dose received by spinal cord between FLT and FDG were not significant. However, the values for mean lung dose, bilateral lung volume receiving ≥5, ≥10, ≥30, ≥40, and ≥50 Gy, mean heart dose, and heart volume receiving ≥30 Gy using FLT PET/CT-based planning were significant lower than those using FDG PET/CT. Conclusion: A standardized uptake value cutoff of 1.4 on FLT PET/CT and one of 2.5 on FDG PET/CT provided the closest estimation of GTV length. Finally, FLT PET/CT-based treatment planning provided potential benefits to the lungs and heart.

  15. Clinical significance of 18F-fluorodeoxyglucose PET/CT whole body imaging in detecting thyroid incidentaloma

    Objective: 18F-fluorodeoxyglucose (FDG) PET/CT is a noninvasive whole-body imaging technique used to evaluate various types of malignancies. Recent advances have rapidly developed it into a diagnostic imaging modality in ontology. The aims of this study were two. One was to estimate the detection rate of thyroid indoleacetamide and the risk of thyroid malignancy by 18F-FDG PET/CT scan and the other Was to further understand whether the maximum standardized uptake value (SUVmax) would be helpful in differentiating benign from malignant thyroid tumor. Methods: From June 2007 to January 2008, a total of 1190 subjects who had no previous history of thyroid cancer and had 18F-FDG PET/CT scan were included. All had visual interpretation and semiquantitative analyses by SUVmax at thyroid incidentalomas detected by FDG PET/CT. Kruskal-Wallis test and Spearman relation analysis were used. Results: The prevalence of thyroid incidentaloma on 18F-FDG PET/CT wag 2.1% (25/1190). Of these 25 tumors, 20 had histologically proven. Of these 20 tumors, 9 were benign and 11 were malignant (papillary carcinoma of thyroid gland in 9, follicular carcinoma of thyroid gland in 1, metastatic squamous cell carcinoma from lung cancer in 1). Therefore,the cancer risk of thyroid incidentaloma was 55% (11/20). Significantly higher SUVmax in malignant than in benign nodules were observed (Kruskal-Wallis test,χ2=8.8, Pmax (3.0-46.0) and maximal diameter (1.0-4.2 cm) of nodule findings was insignificant (r=0.25, P>0.01). Conclusion: Thyroid incidentaloma detected by 18F-FDG PET/CT has higher risk rate for thyroid malignancy.(authors)

  16. Risk stratification of solitary pulmonary nodules by means of PET using {sup 18}F-fluorodeoxyglucose and SUV quantification

    Grgic, Aleksandar; Yueksel, Yildirim; Kirsch, Carl-Martin; Hellwig, Dirk [Saarland University Medical Center, Department of Nuclear Medicine, Homburg/Saar (Germany); Groeschel, Andreas; Sybrecht, Gerhard W. [Saarland University Medical Center, Department of Internal Medicine V (Pneumology), Homburg/Saar (Germany); Schaefers, Hans-Joachim [Saarland University Medical Center, Department of Cardiovascular and Thoracic Surgery, Homburg/Saar (Germany)

    2010-06-15

    {sup 18}F-fluorodeoxyglucose (FDG) PET is the most accurate imaging modality in characterizing a solitary pulmonary nodule (SPN). Besides visual image interpretation, semiquantitative analysis using standardized uptake values (SUV) is performed to improve diagnostic accuracy. Mostly, an SUV threshold of 2.5 is applied to differentiate between benign and malignant lesions. In this study we analysed the use different SUV thresholds to predict the post-test probability of malignancy for the individual patient considering his pre-test probability. Furthermore, we investigated the prognostic value of SUV in SPN for survival. This retrospective study included 140 consecutive patients who underwent FDG PET for evaluation of SPN. Visual interpretation was performed by two readers. For semiquantitative analysis, maximum SUV (SUV{sub max}) was measured in all SPN. A final diagnosis was obtained by pathological examination or follow-up of more than 2 years. In a nomogram, positive and negative predictive values (PPV and NPV) were plotted against the hypothetical SUV threshold to determine the optimum SUV threshold. Survival was analysed using the Kaplan-Meier method and log-rank test. The prevalence of malignancy was 57%. The FDG uptake in malignant SPNs was higher than in benign SPNs (SUV 9.7 {+-} 5.5 vs 2.6 {+-} 2.5, p < 0.01). More than 90% of SPNs with an SUV below 2.0 were benign (sensitivity, specificity, NPV of 96, 55 and 92%). The highest diagnostic accuracy was achieved with an SUV of 4.0 (sensitivity, specificity and accuracy of 85%). Visual interpretation achieved corresponding values of 94, 70 and 84%, respectively. In lung cancer higher FDG uptake (SUV{sub max} {>=} 9.5) was associated with shorter survival (median survival 20 months) and low FDG uptake with longer survival (>75 months). FDG PET allows assessment of the individual risk for malignancy in SPNs by considering tumoural SUV and pre-test probability. Higher FDG uptake in lung cancer as measured by SUV

  17. Suivi in situ de cultures tridimensionnelles en bioreacteur a perfusion grace a la tomographie d'emission par positrons

    Chouinard, Julie

    The continuous assessment of developing tissue substitutes is crucial to understand their evolution over time. However, this represents quite a challenge when thick samples must be evaluated with standard microscopy techniques. Common characterization methods are time consuming and usually result in the destruction of the culture. Real-time, in situ, non-invasive and non-destructives methods are needed to monitor the growth of large non-transparent constructs in tissue engineering. Medical imaging modalities, which can provide information on the structure and function of internal organs and tissues in living organisms, have the potential of allowing repetitive monitoring of these 3D cultures in vitro. The working hypothesis of this thesis was to establish standard noninvasive and nondestructive real-time bioreactor imaging protocols for in situ monitoring of the viability and metabolism of endothelial cells when grown in perfused 3D fibrin gel scaffolds. To achieve this goal, a culture chamber with hollow fibers was designed and a pulsatile perfusion bioreactor system, able to promote cell survival and proliferation, was constructed and validated. Standard imaging protocols in Positron Emission Tomography (PET) are not adapted to image bioreactor systems. A suitable method had to be devised using the well-known radiotracer 18F-fluorodeoxyglucose ( 18FDG), a marker of glucose metabolism. Optimal uptake conditions were determined using cell monolayers and the best parameters were then applied on perfused 3D cultures to evaluate perfusion, cell viability and emerging cell structures. After only 12 hours of culture, the cell density could be estimated and cell structures were localized within the fibrin gels after 1-2 weeks of culture. PET is a promising tool for tissue engineering with many specific tracers available that might eventually be able to reveal new information on tissue development. Key words: Endothelial cells, Perfusion bioreactor, Positron Emission

  18. Positron emission tomography/computed tomography.

    Townsend, David W

    2008-05-01

    Accurate anatomical localization of functional abnormalities obtained with the use of positron emission tomography (PET) is known to be problematic. Although tracers such as (18)F-fluorodeoxyglucose ((18)F-FDG) visualize certain normal anatomical structures, the spatial resolution is generally inadequate for accurate anatomic localization of pathology. Combining PET with a high-resolution anatomical imaging modality such as computed tomography (CT) can resolve the localization issue as long as the images from the two modalities are accurately coregistered. However, software-based registration techniques have difficulty accounting for differences in patient positioning and involuntary movement of internal organs, often necessitating labor-intensive nonlinear mapping that may not converge to a satisfactory result. Acquiring both CT and PET images in the same scanner obviates the need for software registration and routinely provides accurately aligned images of anatomy and function in a single scan. A CT scanner positioned in line with a PET scanner and with a common patient couch and operating console has provided a practical solution to anatomical and functional image registration. Axial translation of the couch between the 2 modalities enables both CT and PET data to be acquired during a single imaging session. In addition, the CT images can be used to generate essentially noiseless attenuation correction factors for the PET emission data. By minimizing patient movement between the CT and PET scans and accounting for the axial separation of the two modalities, accurately registered anatomical and functional images can be obtained. Since the introduction of the first PET/CT prototype more than 6 years ago, numerous patients with cancer have been scanned on commercial PET/CT devices worldwide. The commercial designs feature multidetector spiral CT and high-performance PET components. Experience has demonstrated an increased level of accuracy and confidence in the

  19. [18F]Fluorodeoxyglucose accumulation as a biological marker of hypoxic status but not glucose transport ability in gastric cancer

    Takebayashi, Ryusuke; IZUISHI, KUNIHIKO; Yamamoto, Yuka; Kameyama, Reiko; Mori, Hirohito; Masaki, Tsutomu; Suzuki, Yasuyuki

    2013-01-01

    Background The use of [18F] 2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) for detection of gastric cancer is often debated because FDG uptake varies for each patient. The purpose of this study was to clarify the molecular mechanisms involved in FDG uptake. Material and methods Fifty patients with gastric cancer who underwent FDG-PET and gastrectomy were studied. Snap-frozen tumor specimens were collected and examined by real-time PCR for relationships between maximum stand...

  20. Forced diuresis and dual-phase 18F-fluorodeoxyglucose-PET/CT scan for restaging of urinary bladder cancers

    Harkirat S

    2010-01-01

    Full Text Available Context: The results of 18 F-fluorodeoxyglucose (FDG-PET imaging carried out with the current standard techniques for assessment of urinary tract cancers have been reported to be less than satisfactory because of the urinary excretion of the tracer. Aims: To investigate the role of dual-phase FDG-PET/CT in the restaging of invasive cancers of the urinary bladder, with delayed imaging after forced diuresis and oral hydration as the scanning protocol. Settings and Design: FDG-PET has been considered to be of limited value for the detection of urinary tract cancers because of interference by the FDG excreted in urine. We investigated the efficacy of delayed FDG-PET/CT in the restaging of invasive bladder cancer, with imaging performed after intravenous (IV administration of a potent diuretic and oral hydration. Materials and Methods: Twenty-nine patients with invasive cancer of the urinary bladder were included in this study. Patients were divided into two groups: Group I (22 patients included cases with invasive bladder cancer who had not undergone cystectomy and group II (seven patients included cases with invasive bladder cancer who had undergone cystectomy and urinary diversion procedure. All patients underwent FDG-PET/CT scan from the skull base to the mid-thighs 60 min after IV injection of 370 mega-Becquerel (MBq of FDG. Additional delayed images were acquired 60-90 min after IV furosemide and oral hydration. PET/CT data were analyzed as PET and CT images studied separately as well as fused PET/CT images and the findings were recorded. The imaging findings were confirmed by cystoscopy, biopsy or follow-up PET/CT. Results: The technique was successful in achieving adequate washout of urinary FDG and overcame the problems posed by the excess FDG in the urinary tract. Hypermetabolic lesions could be easily detected by PET and precisely localized to the bladder wall, perivesical region and pelvic lymph nodes. PET/CT delayed images were able to

  1. Forced diuresis and dual-phase 18F-fluorodeoxyglucose-PET/CT scan for restaging of urinary bladder cancers

    The results of 18F-fluorodeoxyglucose (FDG)-PET imaging carried out with the current standard techniques for assessment of urinary tract cancers have been reported to be less than satisfactory because of the urinary excretion of the tracer. To investigate the role of dual-phase FDG-PET/CT in the restaging of invasive cancers of the urinary bladder, with delayed imaging after forced diuresis and oral hydration as the scanning protocol. FDG-PET has been considered to be of limited value for the detection of urinary tract cancers because of interference by the FDG excreted in urine. We investigated the efficacy of delayed FDG-PET/CT in the restaging of invasive bladder cancer, with imaging performed after intravenous (IV) administration of a potent diuretic and oral hydration. Twenty-nine patients with invasive cancer of the urinary bladder were included in this study. Patients were divided into two groups: Group I (22 patients) included cases with invasive bladder cancer who had not undergone cystectomy and group II (seven patients) included cases with invasive bladder cancer who had undergone cystectomy and urinary diversion procedure. All patients underwent FDG-PET/CT scan from the skull base to the mid-thighs 60 min after IV injection of 370 mega-Becquerel (MBq) of FDG. Additional delayed images were acquired 60-90 min after IV furosemide and oral hydration. PET/CT data were analyzed as PET and CT images studied separately as well as fused PET/CT images and the findings were recorded. The imaging findings were confirmed by cystoscopy, biopsy or follow-up PET/CT. The technique was successful in achieving adequate washout of urinary FDG and overcame the problems posed by the excess FDG in the urinary tract. Hypermetabolic lesions could be easily detected by PET and precisely localized to the bladder wall, perivesical region and pelvic lymph nodes. PET/CT delayed images were able to demonstrate 16 intravesical lesions (in 13 patients), with excellent clarity. Lymph

  2. Comparison of pharmacokinetic MRI and [18F] fluorodeoxyglucose PET in the diagnosis of breast cancer: initial experience

    It was the aim of this methodology-oriented clinical pilot study to compare the potential of dynamic MRI and 2-[18F]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) for the detection and characterization of breast cancer. Fourteen women with suspicious breast lesions were examined. The MRI data were acquired with a turbo fast low-angle shot sequence and analyzed using a pharmacokinetic model. Emission data were detected in the sensitive 3D modus, iteratively reconstructed, and superimposed onto corresponding transmission images. In the 14 patients, 13 breast masses with a suspicious contrast enhancement and FDG uptake were detected. For these lesions, no statistically significant correlation between evaluated MR and PET parameters was found. Of the 9 histologically confirmed carcinomas, 8 were correctly characterized with MRI and PET. Two inflammatory lesions were concordantly classified as cancer. Moreover, dynamic MRI yielded another false-positive finding. In 6 patients, PET detected occult lymph node and/or distant metastases. Although both functional imaging techniques provide independent tissue information, the results concerning the diagnosis of primary breast lesions were almost identical. An advantage of PET, however, is its ability to localize lymph node involvement and distant metastases as an integral part of the examination. (orig.)

  3. Whole body muscle activity during the FIFA 11+ program evaluated by positron emission tomography.

    Junsuke Nakase

    Full Text Available PURPOSE: This study investigated the effect of the FIFA 11+ warm-up program on whole body muscle activity using positron emission tomography. METHODS: Ten healthy male volunteers were divided into a control group and a group that performed injury prevention exercises (The 11+. The subjects of the control group were placed in a sitting position for 20 min and 37 MBq of (18F-fluorodeoxyglucose (FDG was injected intravenously. The subjects then remained seated for 45 min. The subjects of the exercise group performed part 2 of the 11+for 20 min, after which FDG was injected. They then performed part 2 of the 11+for 20 min, and rested for 25 min in a sitting position. Positron emission tomography-computed tomography images were obtained 50 min after FDG injection in each group. Regions of interest were defined within 30 muscles. The standardized uptake value was calculated to examine the FDG uptake of muscle tissue per unit volume. RESULTS: FDG accumulation within the abdominal rectus, gluteus medius and minimus were significantly higher in the exercise group than in the control group (P<0.05. CONCLUSION: The hip abductor muscles and abdominal rectus were active during part 2 of the FIFA 11+ program.

  4. Routine bone marrow biopsy has little or no therapeutic consequence for positron emission tomography/computed tomography-staged treatment-naive patients with Hodgkin lymphoma

    El-Galaly, Tarec Christoffer; D'Amore, F.; Mylam, K.J.;

    2012-01-01

    PURPOSETo investigate whether bone marrow biopsy (BMB) adds useful information to [(18)F]fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) staging in patients with Hodgkin lymphoma (HL). PATIENTS AND METHODSNewly diagnosed patients with HL undergoing a...... pretherapeutic staging that encompasses both PET/CT and BMB were included in this retrospective study. The pattern of skeletal FDG uptake was categorized as uni-, bi-, or multifocal (≥ three lesions). Clinical stage, risk assessment, and treatment plan were determined with and without the contribution of BMB...... results according to the Ann Arbor classification and the guidelines from the German Hodgkin Study Group.ResultsA total of 454 patients with HL were included of whom 82 (18%) had focal skeletal PET/CT lesions and 27 (6%) had positive BMB. No patients with positive BMB were assessed as having stage I to II...

  5. Positron emission tomography.

    Hoffman, E J; Phelps, M E

    1979-01-01

    Conventional nuclear imaging techniques utilizing lead collimation rely on radioactive tracers with little role in human physiology. The principles of imaging based on coincidence detection of the annihilation radiation produced in positron decay indicate that this mode of detection is uniquely suited for use in emission computed tomography. The only gamma-ray-emitting isotopes of carbon, nitrogen, and oxygen are positron emitters, which yield energies too high for conventional imaging techniques. Thus development of positron emitters in nuclear medicine imaging would make possible the use of a new class of physiologically active, positron-emitting radiopharmaceuticals. The application of these principles is described in the use of a physiologically active compound labeled with a positron emitter and positron-emission computed tomography to measure the local cerebral metabolic rate in humans. PMID:440173

  6. Positron Emission Tomography and head and neck cancers: Recurrence and post-treatment surveillance

    Recurrence of head and neck squamous cell carcinomas occurs early and currently, with poor prognosis. Post-therapeutic surveillance aims to diagnose a recurrence as early as possible in order to perform curative salvage therapy. The risk of recurrence is highest in locally advanced cancers. Morphological imaging, including Computed Tomography (CT Scan) and magnetic resonance imaging, can be limited by the anatomic changes following surgery and radiotherapy, and sometimes cannot provide early diagnosis of recurrence. Histology presents some risk of morbidity, especially in irradiated tissues, and sampling error. Positron Emission Tomography (PET) with 18F-fluorodeoxyglucose (F.D.G.) is superior to conventional imaging for the diagnosis and staging of recurrence, especially when it is performed three months after the end of treatments. F.D.G.-PET has high sensitivity and negative predictive value for recurrence, so that further morphological and invasive investigations should not be performed in case of negative examination. On the other hand, because of its limited specificity and positive predictive value, any positive PET finding should be documented, in order to avoid false positives findings. The diagnosis of recurrence is the field of application in which F.D.G.-PET has the greatest impact on head and neck cancer management: it is considered as a standard. However, the interest of F.D.G.-PET during systematic follow-up has not yet been confirmed. PET should only be performed in difficult cases and within evaluation protocols. (authors)

  7. Positron emission tomography/computer tomography in guidance of extrahepatic hepatocellular carcinoma metastasis management

    2007-01-01

    Hepatocellular carcinoma (HCC) is one of the most common primary cancers in the world. Surgery is the gold standard for treatment of patients with HCC. Recurrence and metastasis are the major obstacles to further improve the prognosis of HCC. Most recurrences are intrahepatic. However, 30% of the recurrences are extrahepatic. The role of resection in intrahepatic recurrences is widely accepted. The role of resection in extrahepatic HCC recurrence and metastasis is not well established. 18F fluorodeoxyglucose (18F-FDG) positron emission tomography/computer tomography (PET/CT) is useful in detecting distant metastasis from a variety of malignancies and shows superior accuracy to conventional imaging modalities in identification of intrahepatic and extrahepatic metastasis. We present one patient with one new isolated omental lymph node metastasis, who had a history of huge HCC resected six years ago. The metastatic focus was identified with 18 F-FDG PET/CT and resected. The follow-up revealed good prognosis with a long-term survival potential after resection of the omental lymphatic metastasis.

  8. Regional Cerebral Glucose Metabolism in Novelty Seeking and Antisocial Personality: A Positron Emission Tomography Study

    Park, So Hyeon; Park, Hyun Soo

    2016-01-01

    Novelty seeking (NS) and antisocial personality (ASP) are commonly exhibited by those who suffer from addictions, such as substance abuse. NS has been suggested to be a fundamental aspect of ASP. To investigate the neurobiological substrate of NS and ASP, we tested the relationship between regional cerebral glucose metabolism and the level of NS, determining the differences between individuals with and without ASP. Seventy-two healthy adults (43 males, mean age±SD=38.8±16.6 years, range=20~70 years; 29 females, 44.2±20.1 years, range=19~72 years) underwent resting-state brain positron emission tomography (PET) 40 minutes after 18F-fluorodeoxyglucose (FDG) injection. Within 10 days of the FDG PET study, participants completed Cloninger's 240-item Temperament and Character Inventory (TCI) to determine NS scores. Participants with and without ASP were grouped according to their TCI profiles. Statistical parametric mapping analysis was performed using the FDG PET and TCI profile data. NS scores positively correlated with metabolism in the left anterior cingulate gyrus and the insula on both sides of the brain and negatively correlated with metabolism in the right pallidum and putamen. Participants with ASP showed differences in cerebral glucose metabolism across various cortical and subcortical regions, mainly in the frontal and prefrontal areas. These data demonstrate altered regional cerebral glucose metabolism in individuals with NS and ASP and inform our understanding of the neurobiological substrates of problematic behaviors and personality disorders. PMID:27574485

  9. Positron emission tomography neuroimaging in amyotrophic lateral sclerosis: what is new?

    Amyotrophic lateral sclerosis (ALS) is a neuro degenerative disease involving upper and lower motor neurons, extra-motor neurons, microglia and astrocytes. The neuro degenerative process results in progressive muscle paralysis and even in cognitive impairment. Within the complex diagnostic work-up, positron emission tomography (PET) represents a valuable imaging tool in the assessment of patients with ALS. PET, by means of different radiotracers (i.e. 18F-fluorodeoxyglucose, 6-[18F]fluoro-L-dopa, [11C]flumazenil) can assess the status of the wide range of brain regions and neural circuits, which can be affected by ALS. Furthermore, experimental radio compounds have been developed for the evaluation of white matter, which plays a role in the progression of the disease. Here we present a comprehensive review including in different sections the most relevant PET studies: studies investigating ALS and ALS-mimicking conditions (especially primary lateral sclerosis and other neuro degenerative diseases), articles selecting specific subsets of patients (with bulbar or spinal onset), studies investigating patients with familial type of ALS, studies evaluating the role of the white matter in ALS and papers evaluating the diagnostic sensitivity of PET in ALS patients

  10. Positron emission tomography neuroimaging in amyotrophic lateral sclerosis: what is new?

    Quartuccio, N; Van Weehaeghe, D; Cistaro, A; Jonsson, C; Van Laere, K; Pagani, M

    2014-12-01

    Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease involving upper and lower motor neurons, extra-motor neurons, microglia and astrocytes. The neurodegenerative process results in progressive muscle paralysis and even in cognitive impairment. Within the complex diagnostic work-up, positron emission tomography (PET) represents a valuable imaging tool in the assessment of patients with ALS. PET, by means of different radiotracers (i.e. 18F-fluorodeoxyglucose, 6-[18F]fluoro-L-dopa, [11C]flumazenil) can assess the status of the wide range of brain regions and neural circuits, which can be affected by ALS. Furthermore, experimental radiocompounds have been developed for the evaluation of white matter, which plays a role in the progression of the disease. Here we present a comprehensive review including in different sections the most relevant PET studies: studies investigating ALS and ALS-mimicking conditions (especially primary lateral sclerosis and other neurodegenerative diseases), articles selecting specific subsets of patients (with bulbar or spinal onset), studies investigating patients with familial type of ALS, studies evaluating the role of the white matter in ALS and papers evaluating the diagnostic sensitivity of PET in ALS patients. PMID:25375229

  11. Positron emission tomography in aging and dementia: effect of cerebral atrophy

    The spatial resolution of current positron emission tomography (PET) scanners does not allow a distinction between cerebrospinal fluid (CSF) containing spaces and contiguous brain tissue. Data analysis strategies which therefore purport to quantify cerebral metabolism per unit mass brain tissue are in fact measuring a value which may be artifactually reduced due to contamination by CSF. We studied cerebral glucose metabolism (CMRglc) in 17 healthy elderly individuals and 24 patients with Alzheimer's dementia using [18F]fluorodeoxyglucose and PET. All subjects underwent x-ray computed tomography (XCT) scanning at the time of their PET study. The XCT scans were analyzed volumetrically, in order to determine relative areas for ventricles, sulci, and brain tissue. Global CMRglc was calculated before and after correction for contamination by CSF (cerebral atrophy). A greater increase in global CMRglc after atrophy correction was seen in demented individuals compared with elderly controls (16.9% versus 9.0%, p less than 0.0005). Additional preliminary data suggest that volumetric analysis of proton-NMR images may prove superior to analysis of XCT data in quantifying the degree of atrophy. Appropriate corrections for atrophy should be employed if current PET scanners are to accurately measure actual brain tissue metabolism in various pathologic states

  12. Positron-emission tomography

    Positron-emission tomography (PET) combines early biochemical assessment of pathology achieved by nuclear medicine with the precise localization achieved by computerized image reconstruction. In this technique a chemical compound with the desired biological activity is labeled with a radioactive isotope that decays by emitting a positron, or positive electron. With suitable interpretation PET images can provide a noninvasive, regional assessment of many biochemical processes that are essential to the functioning of the organ that is being visualized

  13. Carcinoma of unknown primary of neuroendocrine origin: Accurate detection of primary with 68Ga-labelled [1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid]-1-NaI3-Octreotide positron emission tomography/computed tomography enterography

    68Ga-labelled [1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid]-1-NaI3-Octreotide (68Ga-DOTANOC) positron emission tomography/computed tomography (PET/CT) is an excellent modality in patients with carcinoma of unknown primary of neuroendocrine origin. Most of the primary lesions are located in mid gut region where the lesions have poor resolution due to undistended and overlapping intestinal loops and motility-related artifacts. Although PET/CT enteroclysis, enterography and colonography have been described with 18F-fluorodeoxyglucose, PET/CT enterography with68Ga-DOTANOC has not been described in the literature. Here, we present a case where68Ga-DOTANOC PET/CT enterography was useful in identifying the primary neuroendocrine tumor lesion in small intestine with accurate delineation

  14. Multiple bone metastases detected on 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography in a breast cancer patient: Case report and literature review

    Zeki Dostbil

    2012-09-01

    Full Text Available Bone scintigraphy has been widely used to assess skeletal metastasis in patients with breast cancer. 18F-FDGPET/CT is another imaging modality that has gained previously wide use to determine metastasis based on increased glucose metabolism in malignant cells. Generally, these two modalities give similar results in evaluation of bone metastasis of breast cancer. In this breast cancer case, 99mTc-MDP bone scintigraphy showed normal findings in regards to skeletal metastasis while 18FFDG-PET/CT, contrast-enhanced CT and MRI revealed multiple metastatic focuses. J Clin Exp Invest 2012; 3 (3: 426-429Key words: 18F-fluorodeoxyglucose, bone metastasis, bone scintigraphy, positron emission tomography

  15. {sup 18}F-fluorodeoxyglucose and PET/CT for noninvasive study of exercise-induced glucose uptake in rat skeletal muscle and tendon

    Skovgaard, Dorthe [University of Copenhagen, Cluster for Molecular Imaging, Faculty of Health Sciences, Copenhagen (Denmark); Bispebjerg Hospital, Institute of Sports Medicine, Copenhagen, NV (Denmark); Kjaer, Michael [Bispebjerg Hospital, Institute of Sports Medicine, Copenhagen, NV (Denmark); El-Ali, Henrik [University of Copenhagen, Cluster for Molecular Imaging, Faculty of Health Sciences, Copenhagen (Denmark); Kjaer, Andreas [University of Copenhagen, Cluster for Molecular Imaging, Faculty of Health Sciences, Copenhagen (Denmark); Rigshospitalet, Department Clinical Physiology, Nuclear Medicine and PET, Center of Diagnostic Investigations, Copenhagen (Denmark)

    2009-05-15

    To investigate exercise-related glucose uptake in rat muscle and tendon using PET/CT and to study possible explanatory changes in gene expression for the glucose transporters (GLUT1 and GLUT4). The sciatic nerve in eight Wistar rats was subjected to electrostimulation to cause unilateral isometric contractions of the calf muscle. {sup 18}F-Fluorodeoxyglucose was administered and a PET/CT scan of the hindlimbs was performed. SUVs were calculated in both Achilles tendons and the triceps surae muscles. To exclude a spill-over effect the tendons and muscles from an ex vivo group of eight rats were cut out and scanned separately (distance{>=}1 cm). Muscle contractions increased glucose uptake approximately sevenfold in muscles (p<0.001) and 36% in tendons (p<0.01). The ex vivo group confirmed the increase in glucose uptake in intact animals. GLUT1 and GLUT4 were expressed in both skeletal muscle and tendon, but no changes in mRNA levels could be detected. PET/CT can be used for studying glucose uptake in rat muscle and tendon in relation to muscle contractions; however, the increased uptake of glucose was not explained by changes in gene expression of GLUT1 and GLUT4. (orig.)

  16. 18F-fluorodeoxyglucose and PET/CT for noninvasive study of exercise-induced glucose uptake in rat skeletal muscle and tendon

    To investigate exercise-related glucose uptake in rat muscle and tendon using PET/CT and to study possible explanatory changes in gene expression for the glucose transporters (GLUT1 and GLUT4). The sciatic nerve in eight Wistar rats was subjected to electrostimulation to cause unilateral isometric contractions of the calf muscle. 18F-Fluorodeoxyglucose was administered and a PET/CT scan of the hindlimbs was performed. SUVs were calculated in both Achilles tendons and the triceps surae muscles. To exclude a spill-over effect the tendons and muscles from an ex vivo group of eight rats were cut out and scanned separately (distance≥1 cm). Muscle contractions increased glucose uptake approximately sevenfold in muscles (p<0.001) and 36% in tendons (p<0.01). The ex vivo group confirmed the increase in glucose uptake in intact animals. GLUT1 and GLUT4 were expressed in both skeletal muscle and tendon, but no changes in mRNA levels could be detected. PET/CT can be used for studying glucose uptake in rat muscle and tendon in relation to muscle contractions; however, the increased uptake of glucose was not explained by changes in gene expression of GLUT1 and GLUT4. (orig.)

  17. Hypoxia stimulates 18F-Fluorodeoxyglucose uptake in breast cancer cells via Hypoxia inducible Factor-1 and AMP-activated protein kinase

    Introduction: Hypoxia can stimulate 18F-fluorodeoxyglucose (FDG) uptake in cultured cells. A better understanding of the underlying molecular mechanism is required to determine the value of FDG for studying tumour hypoxia. Methods: The effect of hypoxia on FDG uptake, and key proteins involved in glucose transport and glycolysis, was studied in MCF7 and MDA231 breast cancer cell lines. Results: Hypoxia induced a dose- and time-dependent increase in FDG uptake. The FDG increase was transient, suggesting that FDG uptake is only likely to be increased by acute hypoxia (< 24 h). Molecular analysis indicated that hypoxia upregulated glut1 and 6-phosphofructo-2-kinase, key proteins involved in regulating glucose transport and glycolysis, and that these changes were induced by Hypoxia-Inducible factor 1 (HIF1) upregulation and/or AMP-activated protein kinase activation. Conclusions: FDG may provide useful information about the oxygenation status of cells in hypoxic regions where HIF1 upregulation is hypoxia-driven

  18. Positron emission tomography

    The aim of this project is to provide a simple summary of new trends in positron emission tomography and its basic physical principles. It provides thereby compendious introduction of the trends of the present development in diagnostics using PET systems. A review of available literature was performed. (author)

  19. Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Patients With Carcinoma of the Nasopharynx: Diagnostic Accuracy and Impact on Clinical Management

    Purpose: To assess the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with nasopharyngeal carcinoma as compared with PET and conventional imaging (CI) alone, and to assess the impact of PET/CT on further clinical management. Methods and Materials: Thirty-three patients with nasopharyngeal carcinoma had 45 PET/CT examinations. The study was a retrospective analysis. Changes in patient care resulting from the PET/CT studies were recorded. Results: Positron emission tomography/computed tomography had sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 92%, 90%, 90%, 90%, and 91%, respectively, as compared with 92%, 65%, 76%, 86%, and 80% for PET and 92%, 15%, 60%, 60%, and 60% for CI. Imaging with PET/CT altered further management of 19 patients (57%). Imaging with PET/CT eliminated the need for previously planned diagnostic procedures in 11 patients, induced a change in the planned therapeutic approach in 5 patients, and guided biopsy to a specific metabolically active area inside an edematous region in 3 patients, thus decreasing the chances for tissue sampling errors and avoiding damage to nonmalignant tissue. Conclusions: In cancer of the nasopharynx, the diagnostic performance of PET/CT is better than that of stand-alone PET or CI. Positron emission tomography/computed tomography had a major impact on further clinical management in 57% of patients

  20. Positron emission tomography

    Paans, A M J

    2006-01-01

    Positron Emission Tomography (PET) is a method for measuring biochemical and physiological processes in vivo in a quantitative way by using radiopharmaceuticals labelled with positron emitting radionuclides such as 11C, 13N, 15O and 18F and by measuring the annihilation radiation using a coincidence technique. This includes also the measurement of the pharmacokinetics of labelled drugs and the measurement of the effects of drugs on metabolism. Also deviations of normal metabolism can be measured and insight into biological processes responsible for diseases can be obtained. At present the combined PET/CT scanner is the most frequently used scanner for whole-body scanning in the field of oncology.

  1. Tomography by positrons emission

    The tomography by positrons emission is a technology that allows to measure the concentration of positrons emission in a tri dimensional body through external measurements. Among the isotope emissions have carbon isotopes are (11C), of the oxygen (15O), of the nitrogen (13N) that are three the element that constitute the base of the organic chemistry. Theses have on of the PET's most important advantages, since many biological interesting organic molecules can be tracer with these isotopes for the metabolism studies 'in vivo' through PET, without using organic tracers that modify the metabolism. The mentioned isotopes, also possess the characteristic of having short lifetime, that constitute on of PET's advantages from the dosimetric point of view. Among 11C, 15O, and 13N, other isotopes that can be obtained of a generator as the 68Ga and 82Rb

  2. Positron emission tomography

    Positron emission tomography (PET) is a method for quantitative imaging of regional physiological and biochemical parameters. Positron emitting radioactive isotopes can be produced by a cyclotron, eg. the biologically important carbon (11C), oxygen (15O), and nitrogen (13N) elements. With the tomographic principles of the PET scanner the quantitative distribution of the administered isotopes can be determined and images can be provided as well as dynamic information on blood flow, metabolism and receptor function. In neurology PET has been used for investigations on numerous physiological processes in the brain: circulation, metabolism and receptor studies. In Parkinson's disease PET studies have been able to localize the pathology specifically, and in early stroke PET technique can outline focal areas with living but non-functioning cells, and this could make it possible to intervene in this early state. With positron emission tomography a quantitative evaluation of myocardial blood flow, glucose and fatty acid metabolism can be made as well as combined assessments of blood flow and metabolism. Combined studies of blood flow and metabolism can determine whether myocardial segments with abnormal motility consist of necrotic or viable tissue, thereby delineating effects of revascularisation. In the future it will probably be possible to characterize the myocardial receptor status in different cardiac diseases. The PET technique is used in oncology for clinical as well as more basic research on tumor perfusion and metabolism. Further, tumor uptake of positron labelled cytotoxic drugs might predict the clinical benefit of treatment. (au) (19 refs.)

  3. Perfusion-metabolism coupling in recurrent gliomas: a prospective validation study with {sup 13}N-ammonia and {sup 18}F-fluorodeoxyglucose PET/CT

    Khangembam, Bangkim Chandra; Karunanithi, Sellam; Sharma, Punit; Kc, Sudhir Suman; Kumar, Rajeev; Kumar, Rakesh; Bal, Chandrasekhar [All India Institute of Medical Sciences, Department of Nuclear Medicine, Ansari Nagar, New Delhi (India); Julka, Pramod Kumar [All India Institute of Medical Sciences, Department of Radiation Oncology, New Delhi (India)

    2014-10-15

    We assessed the validity of ''perfusion-metabolism coupling'' hypothesis in recurrent glioma with {sup 13}N-ammonia ({sup 13}N-NH{sub 3}) PET/CT and {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) PET/CT. Fifty-six consecutive patients (age, 38.8 ± 12.1 years; 62.5 % males) with histologically proven and previously treated glioma presenting with clinical suspicion of recurrence were prospectively enrolled and evaluated with {sup 13}N-NH{sub 3} PET/CT and {sup 18}F-FDG PET/CT. PET/CT images were evaluated both qualitatively and semiquantitatively. Tumor to white matter uptake ratio (T/W) and tumor to gray matter uptake ratio (T/G) were calculated and analyzed for both the modalities. A combination of clinico-radiological follow-up, repeated imaging, and biopsy (when available) were considered as the reference standard. Based on the reference standard, 27/56 patients had recurrence. {sup 13}N-NH{sub 3} PET/CT and {sup 18}F-FDG PET/CT were concordant in 55/56 patients. Overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of {sup 13}N-NH{sub 3}PET/CT were 77.8, 86.2, 84.0, 80.7, and 82.1 %, respectively, and for {sup 18}F-FDG PET/CT were 77.8, 89.7, 87.5, 81.2, and 83.9 %, respectively. There was excellent agreement between results of {sup 13}N-NH{sub 3} PET/CT and {sup 18}F-FDG PET/CT (k = 0.964; P < 0.001). The performances of {sup 13}N-NH{sub 3} PET/CT and {sup 18}F-FDG PET/CT were not significantly different between high-grade and low-grade glioma (P = 1.000). A strong positive correlation was noted between the uptake ratios derived on the two modalities (ρ = 0.866, P < 0.001 for T/W; ρ = 0.918, P < 0.001 for T/G). A combination of {sup 13}N-NH{sub 3} PET/CT and {sup 18}F-FDG PET/CT demonstrates that perfusion and metabolism are coupled in recurrent gliomas. These tracers target two different but interrelated aspects of the same pathologic process and can be used as surrogates for each other. (orig.)

  4. Influence of the partial volume correction method on 18F-fluorodeoxyglucose brain kinetic modelling from dynamic PET images reconstructed with resolution model based OSEM

    Kinetic parameters estimated from dynamic 18F-fluorodeoxyglucose (18F-FDG) PET acquisitions have been used frequently to assess brain function in humans. Neglecting partial volume correction (PVC) for a dynamic series has been shown to produce significant bias in model estimates. Accurate PVC requires a space-variant model describing the reconstructed image spatial point spread function (PSF) that accounts for resolution limitations, including non-uniformities across the field of view due to the parallax effect. For ordered subsets expectation maximization (OSEM), image resolution convergence is local and influenced significantly by the number of iterations, the count density, and background-to-target ratio. As both count density and background-to-target values for a brain structure can change during a dynamic scan, the local image resolution may also concurrently vary. When PVC is applied post-reconstruction the kinetic parameter estimates may be biased when neglecting the frame-dependent resolution. We explored the influence of the PVC method and implementation on kinetic parameters estimated by fitting 18F-FDG dynamic data acquired on a dedicated brain PET scanner and reconstructed with and without PSF modelling in the OSEM algorithm. The performance of several PVC algorithms was quantified with a phantom experiment, an anthropomorphic Monte Carlo simulation, and a patient scan. Using the last frame reconstructed image only for regional spread function (RSF) generation, as opposed to computing RSFs for each frame independently, and applying perturbation geometric transfer matrix PVC with PSF based OSEM produced the lowest magnitude bias kinetic parameter estimates in most instances, although at the cost of increased noise compared to the PVC methods utilizing conventional OSEM. Use of the last frame RSFs for PVC with no PSF modelling in the OSEM algorithm produced the lowest bias in cerebral metabolic rate of glucose estimates, although by less than 5% in most

  5. Pioglitazone modulates vascular inflammation in atherosclerotic rabbits monitored non-invasively with 18F-fluorodeoxyglucose-PET/CT and black blood dynamic contrast enhanced-MRI

    Vucic, Esad; Dickson, Stephen D.; Calcagno, Claudia; Rudd, James H.F.; Moshier, Erin; Hayashi, Katsumi; Mounessa, Jessica S.; Roytman, Michelle; Moon, Matthew J.; Lin, James; Tsimikas, Sotirios; Fisher, Edward A.; Nicolay, Klaas; Fuster, Valentin; Fayad, Zahi A.

    2011-01-01

    Objectives We sought to determine the anti-atherosclerotic properties of pioglitazone using multi-modality non-invasive imaging techniques. Background Inflammation is an essential component of vulnerable or high risk atheromas. Pioglitazone, a peroxisome proliferator–activated receptor-gamma (PPAR-γ)agonist possesses potent anti-inflammatory properties. We aimed to non-invasively to quantify the anti-inflammatory effects of pioglitazone on atheroma using 18F-fluorodeoxyglucose (18F-FDG)-PET/CT and dynamic contrast enhanced MRI (DCE-MRI). Methods Atherosclerotic plaques were induced in the aorta of fifteen New Zealand White (NZW) rabbits by a combination of hyperlipidemic diet and two balloon endothelial denudations. Nine rabbits continued the same diet whereas six received pioglitazone (10mg/kg orally) in addition to the diet. Twelve animals underwent 18F-FDG-PET/CT and fifteen animals underwent DCE-MRI at baseline, one and three months after treatment initiation. Concomitantly, serum metabolic parameters were monitored. After imaging was completed aortic histological analysis and correlation analysis was performed. Results 18F-FDG-PET/CT detected an increase in average standardized uptake value (SUV) in the control group (p<0.01), indicating progressive inflammation, while stable SUV values were observed in the treatment group, indicating no progression. DCE-MRI detected a significant decrease in area under the curve (AUC) for the pioglitazone group (p<0.01). Immunohistology of the aortas demonstrated a significant decrease in macrophage and oxidized phospholipid immunoreactivity in the pioglitazone group (p=0.04 and p=0.01, respectively) with respect to control animals, underlining the imaging results. Serum metabolic parameters showed no difference between groups. A strong positive correlation between SUV and macrophage density and AUC and neovessels was detected ( r2=0.86, p<0.0001 and r2=0.66, p=0.004, respectively). Conclusions 18F-FDG-PET/CT and DCE

  6. Positron emission tomography/computer tomography:Challenge to conventional imaging modalities in evaluating primary and metastatic liver malignancies

    Long Sun; Hua Wu; Yong-Song Guan

    2007-01-01

    Computer tomography (CT) and magnetic resonance imaging (MRI), as conventional imaging modalities,are the preferred methodology for tumor, nodal and systemic metastasis (TNM) staging. However, all the noninvasive techniques in current use are not sufficiently able to identify primary tumors and even unable to define the extent of metastatic spread. In addition, relying exclusively on macromorphological characteristics to make a conclusion runs the risk of misdiagnosis due mainly to the intrinsic limitations of the imaging modalities themselves. Solely based on the macromorphological characteristics of cancer, one cannot give an appropriate assessment of the biological characteristics of tumors. Currently, positron emission tomography/computer tomography (PET/CT) are more and more widely available and their application with 18F-fluorodeoxyglucose (18F-FDG) in oncology has become one of the standard imaging modalities in diagnosing and staging of tumors, and monitoring the therapeutic efficacy in hepatic malignancies. Recently, investigators have measured glucose utilization in liver tumors using 18F-FDG, PET and PET/CT in order to establish diagnosis of tumors, assess their biologic characteristics and predict therapeutic effects on hepatic malignancies. PET/CT with 18F-FDG as a radiotracer may further enhance the hepatic malignancy diagnostic algorithm by accurate diagnosis, staging, restaging and evaluating its biological characteristics, which can benefit the patients suffering from hepatic metastases, hepatocellular carcinoma and cholangiocarcinoma.

  7. Positron emission tomography with (18F)methylspiperone demonstrates D2 dopamine receptor binding differences of clozapine and haloperidol

    Four schizophrenic patients were investigated with dynamic positron emission tomography (PET) using (18F)fluorodeoxyglucose (FDG) and (18F)methylspiperone (MSP) as tracers. Two schizophrenics were on haloperidol therapy at the time of MSP PET. The other two schizophrenics were treated with clozapine, in one of them MSP PET was carried out twice with different daily doses (100 mg and 450mg respectively). Neuroleptic serum levels were measured in all patients. Results were compared with MSP PET of two drugfree male control subjects and with a previous fluoroethylspiperone (FESP) study of normals. Three hours after tracer injection specific binding of MSP was observed in the striatum in all cases. The striatum to cerebellum ratio was used to estimate the degree of neuroleptic-caused striatal D2 dopamine receptor occupancy. In the haloperidol treated patients MSP binding was significantly decreased, whereas in the clozapine treated patients striatum to cerebellum ratio was normal. Even the increase of clozapine dose in the same patient had no influence on this ratio. Despite the smaller number of patients the study shows for the first time in humans that striatal MSP binding reflects the different D2 dopamine receptor affinities of clozapine and haloperidol. (authors)

  8. Radiation Dose from Whole-Body F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: Nationwide Survey in Korea.

    Kwon, Hyun Woo; Kim, Jong Phil; Lee, Hong Jae; Paeng, Jin Chul; Lee, Jae Sung; Cheon, Gi Jeong; Lee, Dong Soo; Chung, June-Key; Kang, Keon Wook

    2016-02-01

    The purpose of this study was to estimate average radiation exposure from (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) examinations and to analyze possible factors affecting the radiation dose. A nation-wide questionnaire survey was conducted involving all institutions that operate PET/CT scanners in Korea. From the response, radiation doses from injected FDG and CT examination were calculated. A total of 105 PET/CT scanners in 73 institutions were included in the analysis (response rate of 62.4%). The average FDG injected activity was 310 ± 77 MBq and 5.11 ± 1.19 MBq/kg. The average effective dose from FDG was estimated to be 5.89 ± 1.46 mSv. The average CT dose index and dose-length product were 4.60 ± 2.47 mGy and 429.2 ± 227.6 mGy∙cm, which corresponded to 6.26 ± 3.06 mSv. The radiation doses from FDG and CT were significantly lower in case of newer scanners than older ones (P related to low radiation dose (P < 0.001). In conclusion, the average radiation dose from FDG PET/CT is estimated to be 12.2 mSv. The radiation dose from FDG PET/CT is reduced with more recent scanners equipped with image-enhancing algorithms. PMID:26908992

  9. Positron Emission Tomography (PET)

    Positron emission tomography (PET) assesses biochemical processes in the living subject, producing images of function rather than form. Using PET, physicians are able to obtain not the anatomical information provided by other medical imaging techniques, but pictures of physiological activity. In metaphoric terms, traditional imaging methods supply a map of the body's roadways, its, anatomy; PET shows the traffic along those paths, its biochemistry. This document discusses the principles of PET, the radiopharmaceuticals in PET, PET research, clinical applications of PET, the cost of PET, training of individuals for PET, the role of the United States Department of Energy in PET, and the futures of PET. 22 figs

  10. Contribution of positron computed tomography with 18F fluorodeoxyglucose (PET-F.D.G.) in the taking over the anal channel cancer

    The PET presents an interest in the management of the anal canal cancer, particularly in the ambiguous diagnosis situations where the metabolic information brought allow to influence the therapy choice in about the half of cases. (N.C.)

  11. Diagnostic value for extrahepatic metastases of hepatocellular carcinoma in positron emission tomography/computed tomography scan

    Ji Eun Lee; Jae Young Jang; Soung Won Jeong; Sae Hwan Lee; Sang Gyune Kim; Sang-Woo Cha; Young Seok Kim

    2012-01-01

    AIM:To evaluated the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) scan in diagnosis of hepatocellular carcinoma (HCC) and extrahepatic metastases.METHODS:A total of 138 patients with HCC who had both conventional imaging modalities and 18F-FDG PET/CT scan done between November 2006 and March 2011 were enrolled.Diagnostic value of each imaging modality for detection of extrahepatic metastases was evaluated.Clinical factors and tumor characteristics including PET imaging were analyzed as indicative factors for metastases by univariate and multivariate methods.RESULTS:The accuracy of chest CT was significantly superior compared with the accuracy of PET imaging for detecting lung metastases.The detection rate of metastatic pulmonary nodule ≥ 1 cm was 12/13(92.3%),when < 1 cm was 2/10 (20%) in PET imaging.The accuracy of PET imaging was significantly superior compared with the accuracy of bone scan for detecting bone metastases.In multivariate analysis,increased tumor size (≥ 5 cm) (P =0.042) and increased average standardized uptake value (SUV)uptake (P =0.028) were predictive factors for extrahepatic metastases.Isometabolic HCC in PET imaging was inversely correlated in multivariate analysis (P =0.035).According to the receiver operating characteristic curve,the optimal cutoff of average SUV to predict extrahepatic metastases was 3.4.CONCLUSION:18F-FDG PET/CT scan is invaluable for detection of lung metastases larger than 1 cm and bone metastases.Primary HCC having larger than 5 cm and increased average SUV uptake more than 3.4should be considered for extrahepatic metastases.

  12. Evaluation of recurrent gastric malignancy with [F-18]-FDG positron emission tomography

    Jadvar, H.; Tatlidil, R.; Garcia, A.A.; Conti, P.S

    2003-03-01

    AIM: We retrospectively assessed the use of [{sup 18}F] fluorodeoxyglucose positron emission tomography (FDG PET) in the evaluation of recurrent disease in patients with history of gastric malignancy. MATERIALS AND METHODS: Eighteen patients were referred for FDG PET for evaluation of recurrent gastric cancer. Prior treatments included total (n=4) or partial gastrectomy (n=14) followed by chemotherapy alone (n=7) or combined chemoradiation therapy (n=2). The interval between the most recent treatment and PET ranged from 3 months to 2 years. Correlative diagnostic data were available in 16 patients and were all obtained within 3 months of the PET study. Validation was by clinical or imaging follow-up (2-45 months) in 16 patients and histology in two patients. RESULTS: PET was concordant with computed tomography (CT) in 12 patients (5 TP, 6 TN, 1 FN). In one patient with negative imaging studies, an incidental finding of left obstructive uropathy was determined to be due to metastatic ureteral stricture. Discordant imaging findings were present in four patients (22% of total). PET-detected diffuse metastatic lesions in three of these patients with rising serum tumour markers while other imaging studies were negative. Additional chemotherapy was initiated in these three patients (17% of total) based on PET localization of disease. PET and a gastric anastomosis biopsy were negative in another patient with positive CT. The remaining two patients without correlative imaging studies died shortly after positive PET studies with presumed recurrent cancer. CONCLUSION: FDG PET may be useful in the evaluation of recurrent gastric cancer, and can localize the disease when CT is non-diagnostic. Imaging evaluation with PET may also impact on the clinical management of patients with recurrent gastric cancer.

  13. Pitfalls in Positron Emission Tomography/Computed Tomography Imaging: Causes and Their Classifications

    Tian-ran Li; Jia-he Tian; Hui Wang; Zi-qian Chen; Chun-lei Zhao

    2009-01-01

    Objective To describe the pitfalls in positron emission tomography/computed tomography (PET/CT) imaging and classify them according to the principles of their generation. Methods We summarized retrospectively the 18F-fluorodeoxyglucose (FDP) PET/CT imaging pitfalls through reviewing the PET/CT images of 872 patients. The pitfalls were divided into artifacts and infrequent physiological uptake, and the artifacts were further classified according to their causes. Meanwhile, we calculated the incidences of various pitfalls. Whether the PET/CT pitfalls influenced the diagnostic decision was analyzed. The appearances of pitfalls in PET were also described. Results Pitfalls could be found in PET/CT images of 684 (78.4%) patients. Artifacts were found in 664 (76.15%) patients, and could be classified into self-factor artifacts and equipment- or technology- related artifacts. Among self-factor artifacts, respiratory motion (57.5%), postprandial or hyperglycemia artifacts (2.41%), and metal or high density matter artifacts (1.38%) were frequent. As for equipment- or technology-related factors, injection point outleakage or radiotracer contamination (13.88%) and truncation artifacts (1.83%) were most common ones. Infrequent physiological FDG uptakes, including fatty uptake, endometrial uptake, and bilateral breast feeding period uptake, were found in 20 (2.29%) patients. Among all pitfalls, the artifacts in 92 (13.4%) patients and infrequent physiological uptakes in 6 (0.88%) patients affected the diagnostic results. Artifact images in PET could be described as hot or cold area and the images of infrequent physiological uptake were always shown as hot area. Conclusions The incidence of pitfall in PET/CT imaging was high and the causes of pitfalls are various. Among all causes that artifacts generated, respiratory motion is the most common. Some pitfalls may disturb clinical physicians' decision, so it is important to recognize artifacts and physiological uptake, and

  14. An occupational dose distribution study in a positron emission tomography service

    Kubo, Ana Luiza S.L.; Mauricio, Claudia Lucia P., E-mail: analuslima@yahoo.com.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Servico de Monitoracao Individual Externa

    2011-07-01

    Positron emission tomography (PET) is a powerful diagnostic tool, especially for Oncology. In PET procedures, the hands exposition of the workers is potentially higher than the thorax exposition due to the direct handling of the high-energy photons radionuclide. As the dose distribution in the extremities is non-uniform, the conventional monitoring methods (dosimetric ring and bracelet) may underestimate the skin dose equivalent in the most exposed part of the hand, which usually are the fingertips. In this study, two PET services had their workers monitored during the tasks of preparation and injection of the radiopharmaceutical {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) in patients, using chips of LiF:Mg,Cu,P thermoluminescent dosimeters (TLD-100H). Each employee worn TLD sets attached on the wrist and fingers of the dominant hand, and on the thorax. The highest dose values were measured on the index finger, which received doses up to 0.4 mSv in a single procedure of {sup 18}F-FDG dose preparation and 0.27 mSv in one injection. In a potential annual dose extrapolation, assuming that this technician performs 840 PET scans (preparation and injection), with these doses values, in one year, his skin dose equivalent on the index finger would be 564 mSv, exceeding the annual skin dose equivalent limit of 500 mSv. Despite the hands dose distribution is very sensitive of how to hold the syringe, the dose near to the index fingertip are always the highest, can be, respectively, 4 and 12 times greater than in the position where dosimetric rings and bracelets are commonly used for routine individual monitoring. Thus, extremity individual monitoring, in addition to the mandatory whole body individual monitoring with thorax dosemeters, are important tools for occupational dose optimization and should also be mandatory for PET technician. (author)

  15. Pioneering and fundamental achievements on the development of positron emission tomography (PET) in oncology

    Positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG), a glucose analog, is widely used throughout the world as an indispensable imaging modality for the management of cancer treatment. This article reviews the pioneering achievements of PET in oncology with a focus on the development of PET that occurred from 1980 through the early-1990s. 18F-FDG was first applied for imaging of animal tumors in 1980 and for brain tumor imaging clinically in 1982. 18F-FDG enabled to visualize liver metastasis as clear positive image that could not be obtained by conventional nuclear imaging. Subsequently, 18F-FDG was used for imaging various cancers, such as lung, pancreas, colorectal and hepatoma. 11C-L-methionine (11C-MET) that reflects amino acid transport of cancers has an advantage that its uptake is lower in the brain and inflammatory tissue compared to 18F-FDG, and was first applied for imaging lung cancer and brain tumor. 18F-FDG and 11C-MET were proved to be sensitive tracers that can be used to objectively evaluate the effectiveness of cancer treatment. The diagnostic accuracy of PET, which is critical in clinical practice, was evaluated for the differential diagnosis of malignant and benign lung nodules using 18F-FDG or 11C-MET. In addition to 18F-FDG and 11C-MET, many radiopharmaceuticals were developed, such as 18F-labled thymidine analogs for evaluating proliferative activity, 18F-fluoromisonidazole for imaging of hypoxia, and 18F-fluorodeoxygalactose for evaluating liver-specific galactose metabolism and for imaging of hepatoma that retains galactose metabolic activity. These early efforts and achievements have greatly contributed to the development and clinical application of 18F-FDG PET in oncology. (author) 113 refs.

  16. Localized fetomaternal hyperglycemia: spatial and kinetic definition by positron emission tomography.

    Jianrong Yao

    Full Text Available BACKGROUND: Complex but common maternal diseases such as diabetes and obesity contribute to adverse fetal outcomes. Understanding of the mechanisms involved is hampered by difficulty in isolating individual elements of complex maternal states in vivo. We approached this problem in the context of maternal diabetes and sought an approach to expose the developing fetus in vivo to isolated hyperglycemia in the pregnant rat. METHODOLOGY AND PRINCIPAL FINDINGS: We hypothesized that glucose infused into the arterial supply of one uterine horn would more highly expose fetuses in the ipsilateral versus contralateral uterine horn. To test this, the glucose tracer [18F]fluorodeoxyglucose (FDG was infused via the left uterine artery. Regional glucose uptake into maternal tissues and fetuses was quantified using positron emission tomography (PET. Upon infusion, FDG accumulation began in the left-sided placentae, subsequently spreading to the fetuses. Over two hours after completion of the infusion, FDG accumulation was significantly greater in left compared to right uterine horn fetuses, favoring the left by 1.9+/-0.1 and 2.8+/-0.3 fold under fasted and hyperinsulinemic conditions (p<10(-11 n=32-35 and p<10(-12 n=27-45 respectively. By contrast, centrally administered [3H]-2-deoxyglucose accumulated equally between the fetuses of the two uterine horns. Induction of significant hyperglycemia (10(3 mg/dL localized to the left uterine artery was sustained for at least 48 hours while maternal euglycemia was maintained. CONCLUSIONS AND SIGNIFICANCE: This approach exposes selected fetuses to localized hyperglycemia in vivo, minimizing exposure of the mother and thus secondary effects. Additionally, a set of less exposed internal control fetuses are maintained for comparison, allowing direct study of the in vivo fetal effects of isolated hyperglycemia. Broadly, this approach can be extended to study a variety of maternal-sided perturbations suspected to directly

  17. Ischemic myocardial injury evaluated using positron emission tomography in children with coronary artery disease

    Regional myocardial perfusion and glucose metabolism were evaluated by positron emission tomography (PET) in children with coronary artery disease. PET findings were compared with those of thallium-201 myocardial single photon computed tomography (SPECT). The study patients consisted of 11 children ranging in age from 3 to 14 years. Ten patients had significantly stenotic coronary arterial lesions due to Kawasaki disease, and one patient had a left coronary artery with an anomalous origin from the pulmonary artery. Evaluation was made before and after surgical revascularization in 3 patients. Regional myocardial perfusion was assessed at rest using 13N-ammonia, and regional myocardial glucose metabolism was assessed at rest under fasting conditions using 18F-fluorodeoxyglucose (18FDG). SPECT was performed after dipyridamole infusion. Initial and delayed images were obtained 7 min and 3 hrs after dipyridamole infusion, respectively. Left ventricular myocardial images were categorized as the septal, anterior, lateral, apical, and inferior segments, and evaluation was made for each segment. A total of 70 myocardial segments in 11 patients were classified into 4 groups according to the PET findings: segments with normal perfusion and without enhanced 18FDG uptake (normal segments; n=55); normal perfusion with enhanced 18FDG uptake (metabolically abnormal segments; n=3); hypoperfusion with enhanced 18FDG uptake (ischemic but viable segments; n=9); and hypoperfusion without enhanced 18FDG uptake (non-viable segments; n=3). On SPECT, the numbers of myocardial segments showing no perfusion defects, complete redistribution, incomplete redistribution, and persistent perfusion defects were 38, 12, 14, and 6, respectively. Segments with complete and incomplete redistribution were equally viable on SPECT and PET; while 50% of the segments with persistent perfusion defects detected on SPECT were missed on PET. (author)

  18. Positron emission mammography imaging

    Moses, William W.

    2003-10-02

    This paper examines current trends in Positron Emission Mammography (PEM) instrumentation and the performance tradeoffs inherent in them. The most common geometry is a pair of parallel planes of detector modules. They subtend a larger solid angle around the breast than conventional PET cameras, and so have both higher efficiency and lower cost. Extensions to this geometry include encircling the breast, measuring the depth of interaction (DOI), and dual-modality imaging (PEM and x-ray mammography, as well as PEM and x-ray guided biopsy). The ultimate utility of PEM may not be decided by instrument performance, but by biological and medical factors, such as the patient to patient variation in radiotracer uptake or the as yet undetermined role of PEM in breast cancer diagnosis and treatment.

  19. PET with {sup 18}F-fluorodeoxyglucose for staging of non-small cell lung cancer. Evidence-based recommendations and cost-effectiveness; PET mit {sup 18}F-Fluordeoxyglukose in der Diagnostik des nicht kleinzelligen Bronchialkarzinoms: evidenzbasierte Empfehlungen und Kosten/Nutzenabwaegungen

    Weber, W.A.; Schwaiger, M. [Techn. Universitaet Muenchen (Germany). Nuklearmedizinische Klinik und Poliklinik; Dietlein, M.; Schicha, H. [Univ. Koeln (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Hellwig, D.; Kirsch, C.M. [Radiologische Universitaetsklinik, Homburg/Saar (Germany). Abt. fuer Nuklearmedizin

    2003-08-01

    Aims: To evaluate studies on the use of positron emission tomography with the glucose analog {sup 18}F-fluorodeoxyglucose (FDG-PET) for the preoperative staging of patients with non-small cell lung cancer (NSCLC) according to the criteria of evidence based medicine and to discuss the cost-effectiveness of the technique. Methods: Clinical studies published between 1995 and 2002 on the preoperative staging of non-small cell lung cancer were used for this analysis. Studies that did not meet the criteria published by the European Agency for the Evaluation of Medicinal Products (EMEA) were excluded. The validity of the studies was evaluated by a standardized rating system developed by the Agency for Health Care Policy and Research (AHCPR). Results: For the detection of mediastinal lymph node metastases the mean sensitivity and specificity of FDG-PET on a patient basis is 85% and 87% (16 studies, 1355 patients). In studies that compared FDG-PET and computed tomography (CT) the mean sensitivity of CT was 66% at a specificity of 71%. In the detection of distant metastases FDG-PET correctly changed the tumor stage in 18% of the patients when compared to CT based staging (10 studies, 1073 patients). Five cost effectiveness analyses from the USA, Japan, and Germany concluded that FDG-PET improves the outcome of treatment at reduced or only slightly increased overall costs. Improvement of patient outcome was also demonstrated in a randomized trial, which found that the risk of a futile thoracotomy was reduced by 51% (p=0.003) when FDG-PET was added to the preoperative staging. Conclusion: According to the criteria of the AHCPR the use of FDG-PET for detection of mediastinal lymph node and distant metastases is documented at a level of evidence Ia and Ib, respectively. Since systematic analyses also indicate a favourable cost-effectiveness ratio FDG-PET has to be considered as 'strictly indicated' for the preoperative staging of a non-small cell lung cancer. (orig

  20. Positron emission tomography. Basic principles

    The basic principles of positron emission tomography (PET) technique are reviewed. lt allows to obtain functional images from gamma rays produced by annihilation of a positron, a positive beta particle. This paper analyzes positron emitters production in a cyclotron, its general mechanisms, and the various detection systems. The most important clinical applications are also mentioned, related to oncological uses of fluor-l8-deoxyglucose

  1. Dipyridamole-dobutamine-stress-magnetic resonance imaging for the assessment of myocardial viability in patients with chronic coronary artery disease and comparison to positron emission tomography

    Kaiser, B

    2000-01-01

    The purpose of this study was to evaluate the diagnostic value of (infra-low-dose)dipyridamole-(low-dose)-dobutamine-stress-MRI (DDS-MRI) for the assessment of myocardial viability by comparing the results to those of positron emission tomography (PET). Multisectional baseline- and stress-CINE-MRI as well as (18F)-fluorodeoxyglucose (18F-FDG)and (13N)-ammonia-PET were performed in 8 patients with chronic coronary artery disease and left ventricular dysfunction. MRI data analysis included the quantitative assessment of enddiastolic wall thickness (EDWT) and systolic wall thickening (SWT) for both baseline and stress examination in a total of 864 myocardial segments (6 slices, 18 seg./slice). MRI- and PET-results were compared in 128 corresponding myocardial regions following a 16-regions-model covering the entire left ventricle from apex to base. MRI viability criterions were a mean regional EDWT > 5.5 mm or a mean regional stress-induced SWT > 1.5 mm. PET defined regional myocardial viability either by a norm...

  2. Comparison of Positron Emission Tomography Scanning and Sentinel Node Biopsy in the Detection of Inguinal Node Metastases in Patients With Anal Cancer

    Background: Inguinal lymph node metastases in patients with anal cancer are an independent prognostic factor for local failure and overall mortality. Inguinal lymph node status can be adequately assessed with sentinel node biopsy, and the radiotherapy strategy can subsequently be changed. We compared this technique vs. dedicated 18F-fluorodeoxyglucose positron emission tomography (PET) to determine which was the better tool for staging inguinal lymph nodes. Methods and Materials: In our department, 27 patients (9 men and 18 women) underwent both inguinal sentinel node biopsy and PET-CT. PET-CT was performed before treatment and then at 1 and 3 months after treatment. Results: PET-CT scans detected no inguinal metastases in 20 of 27 patients and metastases in the remaining 7. Histologic analysis of the sentinel lymph node detected metastases in only three patients (four PET-CT false positives). HIV status was not found to influence the results. None of the patients negative at sentinel node biopsy developed metastases during the follow-up period. PET-CT had a sensitivity of 100%, with a negative predictive value of 100%. Owing to the high number of false positives, PET-CT specificity was 83%, and positive predictive value was 43%. Conclusions: In this series of patients with anal cancer, inguinal sentinel node biopsy was superior to PET-CT for staging inguinal lymph nodes.

  3. Potential time benefit in the assessment of recurrent rat rhabdomyosarcoma using positron emission tomography (PET) with 18fluorodeoxyglucose depends on therapy-specific growth delay

    Purpose: to correlate the potential time benefit of 18F-fluorodeoxyglucose positron emission tomography (18FDG-PET) in terms of early detection of recurrences of subcutaneously growing R1H tumors with therapy-specific parameters of recurrent tumor. Material and methods: twelve, eleven, and seven recurrences were followed after fractionated radiotherapy, surgery, and chemotherapy for 6 months, respectively, and 18FDG-PET was performed weekly using a conventional full-ring whole-body PET scanner. By comparing PET results and actual tumor volume, the time benefit of 18FDG-PET in detection of recurrent tumors of 0.1, 0.2, and 0.5 cm3 was determined for the different treatment strategies. Results: a significant time benefit of 18FDG-PET of 26.9 days and 67 days was solely determined for recurrences after radiotherapy of 0.2 cm3 and 0.5 cm3, respectively. The potential time benefit showed a strong correlation with growth delay, which was increased after radiotherapy due to a pronounced tumor-bed effect. Conclusion: the potential time benefit of 18FDG-PET is strongly determined by the growth kinetics of the recurrence. A tumor-bed effect, which is a phenomenon solely seen after radiotherapy, favors early detection by 18FDG-PET. The experimental data, clinical experience and theoretical consideration all indicate a noticeable benefit of 18FDG-PET especially after radiotherapeutic treatment. (orig.)

  4. Quantifying [{sup 18}F]fluorodeoxyglucose uptake in the arterial wall: the effects of dual time-point imaging and partial volume effect correction

    Blomberg, Bjoern A. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark); Bashyam, Arjun; Ramachandran, Abhinay; Gholami, Saeid; Houshmand, Sina; Salavati, Ali; Werner, Tom; Alavi, Abass [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Zaidi, Habib [Geneva University Hospital, Division of Nuclear Medicine and Molecular Imaging, Geneva (Switzerland); University of Groningen, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen (Netherlands)

    2015-08-15

    The human arterial wall is smaller than the spatial resolution of current positron emission tomographs. Therefore, partial volume effects should be considered when quantifying arterial wall {sup 18}F-FDG uptake. We evaluated the impact of a novel method for partial volume effect (PVE) correction with contrast-enhanced CT (CECT) assistance on quantification of arterial wall {sup 18}F-FDG uptake at different imaging time-points. Ten subjects were assessed by CECT imaging and dual time-point PET/CT imaging at approximately 60 and 180 min after {sup 18}F-FDG administration. For both time-points, uptake of {sup 18}F-FDG was determined in the aortic wall by calculating the blood pool-corrected maximum standardized uptake value (cSUV{sub MAX}) and cSUV{sub MEAN}. The PVE-corrected SUV{sub MEAN} (pvcSUV{sub MEAN}) was also calculated using {sup 18}F-FDG PET/CT and CECT images. Finally, corresponding target-to-background ratios (TBR) were calculated. At 60 min, pvcSUV{sub MEAN} was on average 3.1 times greater than cSUV{sub MAX} (P <.0001) and 8.5 times greater than cSUV{sub MEAN} (P <.0001). At 180 min, pvcSUV{sub MEAN} was on average 2.6 times greater than cSUV{sub MAX} (P <.0001) and 6.6 times greater than cSUV{sub MEAN} (P <.0001). This study demonstrated that CECT-assisted PVE correction significantly influences quantification of arterial wall {sup 18}F-FDG uptake. Therefore, partial volume effects should be considered when quantifying arterial wall {sup 18}F-FDG uptake with PET. (orig.)

  5. Linear Correlation Between Patient Survival and Decreased Percentage of Tumor [18F]Fluorodeoxyglucose Uptake for Late-Course Accelerated Hyperfractionated Radiotherapy for Esophageal Cancer

    Purpose: The aims of this trial were to study whether a decreased percentage of tumor fluorodeoxyglucose (FDG) uptake (%DeltaSUVmax) correlated with overall survival and local control times for patients with esophageal cancer and which patients would benefit from a late-course accelerated hyperfractionated (LCHF) radiation scheme. Methods and Materials: A total of 50 eligible patients with squamous esophageal cancer received positron-emission tomography examinations three times and were treated with the LCHF radiation scheme, with a dose of 68.4 Gy/41 fractions in 6.5 weeks. A %DeltaSUVmax value was calculated, and patients were stratified as highly radiosensitive (HR), moderately radiosensitive (MR), and low radiosensitivity (LR) according to %DeltaSUVmax values in the conventional fraction (CF) scheme. Then, a linear correlation was calculated between patients’ survival time and %DeltaSUVmax. Local control and overall survival rates were compared after stratification. Results: In the MR subgroup, there was no linear correlation between %DeltaSUVmax and the CF and LCHF schemes (correlation coefficient, R 0.05). In the other subgroups (HR and LR), %DeltaSUVmax values between the CF and LCHF schemes were correlated. Also, in the HR and LR subgroups, %DeltaSUVmax after radiation correlated with overall survival or local control rates (correlation coefficient, R >0.5, and p < 0.05). Three-year local control rates in the HR, MR, and LR subgroups were 100%, 81.5%, and 0%, respectively (p < 0.001). Also, 3-year overall survival rates were 92.4%, 58.8%, and 0% for HR, MR, and LR subgroups, respectively (p < 0.001). Conclusions: Postradiation %DeltaSUVmax was positively correlated with survival time for patients’ with esophageal cancer. Patients who benefited from LCHF schedules were those with a decrease of 30% to 60% in tumor FDG uptake after the completion of CF radiation.

  6. Quantifying [18F]fluorodeoxyglucose uptake in the arterial wall: the effects of dual time-point imaging and partial volume effect correction

    The human arterial wall is smaller than the spatial resolution of current positron emission tomographs. Therefore, partial volume effects should be considered when quantifying arterial wall 18F-FDG uptake. We evaluated the impact of a novel method for partial volume effect (PVE) correction with contrast-enhanced CT (CECT) assistance on quantification of arterial wall 18F-FDG uptake at different imaging time-points. Ten subjects were assessed by CECT imaging and dual time-point PET/CT imaging at approximately 60 and 180 min after 18F-FDG administration. For both time-points, uptake of 18F-FDG was determined in the aortic wall by calculating the blood pool-corrected maximum standardized uptake value (cSUVMAX) and cSUVMEAN. The PVE-corrected SUVMEAN (pvcSUVMEAN) was also calculated using 18F-FDG PET/CT and CECT images. Finally, corresponding target-to-background ratios (TBR) were calculated. At 60 min, pvcSUVMEAN was on average 3.1 times greater than cSUVMAX (P <.0001) and 8.5 times greater than cSUVMEAN (P <.0001). At 180 min, pvcSUVMEAN was on average 2.6 times greater than cSUVMAX (P <.0001) and 6.6 times greater than cSUVMEAN (P <.0001). This study demonstrated that CECT-assisted PVE correction significantly influences quantification of arterial wall 18F-FDG uptake. Therefore, partial volume effects should be considered when quantifying arterial wall 18F-FDG uptake with PET. (orig.)

  7. Fundamentals of positron emission tomography

    Positron emission tomography is a modern radionuclide method of measuring physiological quantities or metabolic parameters in vivo. The methods is based on: (1) Radioactive labelling with positron emitters; (2) the coincidence technique for the measurement of the annihilation radiation following positron decay; (3) analysis of the data measured using biological models. The basic aspects and problems of the method are discussed. The main fields of future research are the synthesis of new labelled compounds and the development of mathematical models of the biological processes to be investigated. (orig.)

  8. [Fundamentals of positron emission tomography].

    Ostertag, H

    1989-07-01

    Positron emission tomography is a modern radionuclide method of measuring physiological quantities or metabolic parameters in vivo. The method is based on: (1) radioactive labelling with positron emitters; (2) the coincidence technique for the measurement of the annihilation radiation following positron decay; (3) analysis of the data measured using biological models. The basic aspects and problems of the method are discussed. The main fields of future research are the synthesis of new labelled compounds and the development of mathematical models of the biological processes to be investigated. PMID:2667029

  9. NMF on positron emission tomography

    Bödvarsson, Bjarni; Hansen, Lars Kai; Svarer, Claus;

    2007-01-01

    In positron emission tomography, kinetic modelling of brain tracer uptake, metabolism or binding requires knowledge of the cerebral input function. Traditionally, this is achieved with arterial blood sampling in the arm or as shown in (Liptrot, M, et al., 2004) by non-invasive K-means clustering....... We propose another method to estimate time-activity curves (TAC) extracted directly from dynamic positron emission tomography (PET) scans by non-negative matrix factorization (NMF). Since the scaling of the basis curves is lost in the NMF the estimated TAC is scaled by a vector alpha which is...

  10. Instrumentation in positron emission tomography

    Positron emission tomography (PET) is a three-dimensional medical imaging technique that noninvasively measures the concentration of radiopharmaceuticals in the body that are labeled with positron emitters. With the proper compounds, PET can be used to measure metabolism, blood flow, or other physiological values in vivo. The technique is based on the physics of positron annihilation and detection and the mathematical formulations developed for x-ray computed tomography. Modern PET systems can provide three-dimensional images of the brain, the heart, and other internal organs with resolutions on the order of 4 to 6 mm. With the selectivity provided by a choice of injected compounds, PET has the power to provide unique diagnostic information that is not available with any other imaging modality. This is the first five reports on the nature and uses of PET that have been prepared for the American Medical Association's Council on Scientific Affairs by an authoritative panel

  11. Studies of cerebral blood flow, cerebral oxygen metabolism, cerebral glucose metabolism, and tissue pH in human acute cerebral infarction using positron emission tomography

    This preliminary PET study was designed to investigate physiological and biochemical changes in acute cerebral infarction by positron emission tomography (PET). PET studies were performed in six patients with acute cerebral infarction within 48 hours after onset of stroke using continuous inhalation of C15O2 for cerebral blood flow (CBF), 15O2 for cerebral metabolic rate for oxygen (CMRO2), 11CO for cerebral blood volume, the intravenous injection of 11C-dimethyloxazolidinedione for tissue pH and the intravenous injection of 18F-fluorodeoxyglucose for cerebral metabolic rate for glucose (CMRGlu). Metabolic coupling index (MCI) image was made from CBF image and CMRGlu image to investigate relation between CBF and CMRGlu. Aslo oxygen glucose index (OGI) image was made from CMRO2 image and CMRG lu image to investigate relation between CMRO2 and CMRGlu. Preliminary resul ts demonstrate that reduction of CBF, CMRO2, and CMRGlu in the affected co rtex except for reperfusion case. Increase of OER was recognized four of six cases. Patterns of MCI and OGI in the cortex which CMRO2 value is less than 65 μmol/100g/min were different from those in the cortex which CMRO2 value is more than 65. MCI of the affected cortex (CMRO22>=65). OGI of the affected cortex (CMRO22>=65). Two patients showed decrease of tissue pH and reperfusion case showed increase of tissue pH in infarcted area as compared to contralateral cortex. In addition it was suggested that threshold of CBF for tissue pH was approximately 14ml/100g/min. (J.P.N.)

  12. ⁶⁴Cu-Doped PdCu@Au Tripods: A Multifunctional Nanomaterial for Positron Emission Tomography and Image-Guided Photothermal Cancer Treatment.

    Pang, Bo; Zhao, Yongfeng; Luehmann, Hannah; Yang, Xuan; Detering, Lisa; You, Meng; Zhang, Chao; Zhang, Lei; Li, Zhi-Yuan; Ren, Qiushi; Liu, Yongjian; Xia, Younan

    2016-03-22

    This article reports a facile synthesis of radiolabeled PdCu@Au core-shell tripods for use in positron emission tomography (PET) and image-guided photothermal cancer treatment by directly incorporating radioactive (64)Cu atoms into the crystal lattice. The tripod had a unique morphology determined by the PdCu tripod that served as a template for the coating of Au shell, in addition to well-controlled specific activity and physical dimensions. The Au shell provided the nanostructure with strong absorption in the near-infrared region and effectively prevented the Cu and (64)Cu atoms in the core from oxidization and dissolution. When conjugated with D-Ala1-peptide T-amide (DAPTA), the core-shell tripods showed great enhancement in targeting the C-C chemokine receptor 5 (CCR5), a newly identified theranostic target up-regulated in triple negative breast cancer (TNBC). Specifically, the CCR5-targeted tripods with an arm length of about 45 nm showed 2- and 6-fold increase in tumor-to-blood and tumor-to-muscle uptake ratios, respectively, relative to their nontargeted counterpart in an orthotopic mouse 4T1 TNBC model at 24 h postinjection. The targeting specificity was further validated via a competitive receptor blocking study. We also demonstrated the use of these targeted, radioactive tripods for effective photothermal treatment in the 4T1 tumor model as guided by PET imaging. The efficacy of treatment was confirmed by the significant reduction in tumor metabolic activity revealed through the use of (18)F-fluorodeoxyglucose PET/CT imaging. Taken together, we believe that the (64)Cu-doped PdCu@Au tripods could serve as a multifunctional platform for both PET imaging and image-guided photothermal cancer therapy. PMID:26824412

  13. Spreadsheet program for estimating recovery coefficient to get partial volume corrected standardized uptake value in clinical positron emission tomography-computed tomography studies

    To develop a spreadsheet program for estimation of recovery coefficient (RC) to get partial volume corrected (PVC) standardized uptake value (SUV) in clinical positron emission tomography-computed tomography (PET-CT) studies. For formulation of this program we used data from a phantom study conducted at our center in which a phantom with a sphere assembly (seven spheres-different diameters) was filled with 18F-Fluorodeoxyglucose solution to get a sphere/background ratio of 8:1, 10:1 and 12:1. PET-CT images were acquired. RC was then calculated from processed PET-CT images. We plotted graph of RC versus lesion-size at different sphere/background ratio using MS Excel function. There was logarithmic increase in RC with increase in lesion size. We fitted the data with a logarithmic equation and found optimum fit (least-square fit). We then validated this program with clinical data using 42 lung nodules in five patients. The program estimates the value of RC and object to background ratio in PET-CT for the input lesion-size and displays graph with trendline. When the user enters SUV and background activity measured in clinical PET-CT, it provides the value of RC and PVC SUV. It also validates the data entry and displays appropriate message. It is consistent, reproducible, accurate and provides output for wide range of lesion-sizes (71% of lesions evaluated); however, program does not give output for lesion-size < 9 mm. The present spreadsheet program is a useful and easy tool for calculating PVC SUV of clinical PET-CT lesions

  14. Fluorine-18-fluorodeoxyglucose positron emission tomography to evaluate recurrent gastric cancer after surgical resection: a systematic review and meta-analysis.

    Li, Panli; Liu, Qiufang; Wang, Chen; Wang, Tongbo; Liu, Jianjun; Huang, Gang; Song, Shaoli

    2016-04-01

    We aimed to explore the diagnostic accuracy of (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) for detection of gastric cancer recurrence after surgical resection through a systematic review and meta-analysis. "PubMed", EMBASE, Web of Knowledge and Springer, from the beginning of 2002 to Feb 2015, were searched for studies evaluating the diagnostic performance of 18F-FDG PET in detecting recurrent gastric cancer. We calculated sensitivities, specificities, diagnostic odds ratios and likelihood ratios, and constructed summary receiver operating characteristic curves. Fourteen studies (828 patients) were included. On a per-patient basis, the forest plots showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of (18)F-FDG PET or PET/CT were 0.85 [95 % confidence interval (CI) 0.75-0.92], 0.78 (95 % CI 0.72-0.84), 3.9 (95 % CI 2.9-5.4), 0.19 (95 % CI 0.11-0.34), and 21 (95 % CI 9-47), respectively. On a per-lesion basis, the pooled sensitivity was 0.75 (95 % CI 0.61-0.86). The area under the SROC curve of PET/CT on the basis of per-patient was 0.86. (18)F-FDG PET had great value in the detection of gastric cancer recurrence after surgical resection. The sensitivities of (18)F-FDG PET were 85 and 75 %, respectively, on per-patient basis and on per-lesion basis. PMID:26830546

  15. A New Brain Positron Emission Tomography Scanner With Semiconductor Detectors for Target Volume Delineation and Radiotherapy Treatment Planning in Patients With Nasopharyngeal Carcinoma

    Purpose: We compared two treatment planning methods for stereotactic boost for treating nasopharyngeal carcinoma (NPC): the use of conventional whole-body bismuth germanate (BGO) scintillator positron emission tomography (PETCONVWB) versus the new brain (BR) PET system using semiconductor detectors (PETNEWBR). Methods and Materials: Twelve patients with NPC were enrolled in this study. [18F]Fluorodeoxyglucose-PET images were acquired using both the PETNEWBR and the PETCONVWB system on the same day. Computed tomography (CT) and two PET data sets were transferred to a treatment planning system, and the PETCONVWB and PETNEWBR images were coregistered with the same set of CT images. Window width and level values for all PET images were fixed at 3000 and 300, respectively. The gross tumor volume (GTV) was visually delineated on PET images by using either PETCONVWB (GTVCONV) images or PETNEWBR (GTVNEW) images. Assuming a stereotactic radiotherapy boost of 7 ports, the prescribed dose delivered to 95% of the planning target volume (PTV) was set to 2000 cGy in 4 fractions. Results: The average absolute volume (±standard deviation [SD]) of GTVNEW was 15.7 ml (±9.9) ml, and that of GTVCONV was 34.0 (±20.5) ml. The average GTVNEW was significantly smaller than that of GTVCONV (p = 0.0006). There was no statistically significant difference between the maximum dose (p = 0.0585) and the mean dose (p = 0.2748) of PTV. The radiotherapy treatment plan based on the new gross tumor volume (PLANNEW) significantly reduced maximum doses to the cerebrum and cerebellum (p = 0.0418) and to brain stem (p = 0.0041). Conclusion: Results of the present study suggest that the new brain PET system using semiconductor detectors can provide more accurate tumor delineation than the conventional whole-body BGO PET system and may be an important tool for functional and molecular radiotherapy treatment planning.

  16. The value of F-18 fluorodeoxyglucose positron emission tomography/computed tomography in asymptomatic examinees with unexplained elevated blood carcinoembryonic antigen levels

    Li, Wenfeng [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Department of Radiation Oncology, Wenzhou (China); Yin, Weiwei [The First Affiliated Hospital of Wenzhou Medical University, Division of PET/CT, Department of Radiology, Wenzhou (China); Ou, Rongying [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Department of Gynaecology and Obstetrics, Wenzhou (China); Chen, Ting; Xiong, Lingling; Xu, Yunsheng [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Department of Dermatovenereology, Wenzhou (China); Cheng, Dezhi; Xie, Deyao [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Department of Cardiothoracic Surgery, Wenzhou (China); Zheng, Xiangwu; Zhao, Liang [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Division of PET/CT, Department of Radiology, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Institutes of Intelligent and Molecular Imaging, Wenzhou (China)

    2016-04-15

    Cancer is still a clinical challenge, with many efforts invested in order to achieve timely detection. Unexplained elevated blood carcinoembryonic antigen levels are occasionally observed in an asymptomatic population and considered as a risk factor of cancers. The purpose of this study was to determine the validity of 18 F-fluorodeoxyglucose-positron emission tomography/computed tomography (F-18 FDG-PET/CT) for detecting cancer in an asymptomatic population with an unexplained elevation in blood carcinoembryonic antigen (CEA) levels. This retrospective study included a total of 1920 asymptomatic examinees conducted from August 2011 through September 2013. The participants underwent CEA assay and conventional medical imaging (CEA-conventional), or CEA assay and F-18 FDG-PET/CT (CEA-PET/CT). The validity of conventional medical imaging and CEA-PET/CT scanning for detecting cancer and early-stage cancer in an asymptomatic population with an unexplained elevation in blood CEA levels were evaluated. Sensitivity, specificity, cancer detection rate, missed cancer detection rate, early-stage cancer detection rate, and early-stage cancer ratio using the CEA-PET/CT scanning were 96.6 %, 100 %, 10.4 %, 0.4 %, 3.7 %, and 34.5 %, respectively. In contrast, the corresponding values obtained using the conventional medical imaging were 50.6 % (P < 0.0001), 100 % (P > 0.9999), 50.6 % (P < 0.0001), 99.9 % (P = 0.055), 2.6 % (P < 0.0001), 2.5 % (P = 0.04), 0.7 % (P = 0.0004), and 14.5 % (P = 0.002), respectively. The F-18 FDG-PET/CT scanning significantly improved the validity of the cancer detection program in the asymptomatic population with an unexplained elevation in CEA levels. (orig.)

  17. Positron emission tomography with selected mediastinoscopy compared to routine mediastinoscopy offers cost and clinical outcome benefits for pre-operative staging of non-small cell lung cancer

    18F-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging is an important staging procedure in patients with non-small cell lung cancer (NSCLC). We aimed to demonstrate, through a decision tree model and the incorporation of real costs of each component, that routine FDG-PET imaging as a prelude to curative surgery will reduce requirements for routine mediastinoscopy and overall hospital costs. A decision tree model comparing routine whole-body FDG-PET imaging to routine staging mediastinoscopy was used, with baseline variables of sensitivity, specificity and prevalence of non-operable and metastatic disease obtained from institutional data and a literature review. Costings for hospital admissions for mediastinoscopy and thoracotomy of actual patients with NSCLC were determined. The overall and average cost of managing patients was then calculated over a range of FDG-PET costs to derive projected cost savings to the community. The prevalence of histologically proven mediastinal involvement in patients with NSCLC presenting for surgical assessment at our institution is 20%, and the prevalence of distant metastatic disease is 6%. Based on literature review, the pooled sensitivity and specificity of FDG-PET for detection of mediastinal spread are 84% and 89% respectively, and for mediastinoscopy, 81% and 100%. The average cost of mediastinoscopy for NSCLC in our institution is AUD$4,160, while that of thoracotomy is AUD$15,642. The cost of an FDG-PET scan is estimated to be AUD$1,500. Using these figures and the decision tree model, the average cost saving is AUD$2,128 per patient. Routine FDG-PET scanning with selective mediastinoscopy will save AUD$2,128 per patient and will potentially reduce inappropriate surgery. These cost savings remain robust over a wide range of disease prevalence and FDG-PET costs. (orig.)

  18. The value of F-18 fluorodeoxyglucose positron emission tomography/computed tomography in asymptomatic examinees with unexplained elevated blood carcinoembryonic antigen levels

    Cancer is still a clinical challenge, with many efforts invested in order to achieve timely detection. Unexplained elevated blood carcinoembryonic antigen levels are occasionally observed in an asymptomatic population and considered as a risk factor of cancers. The purpose of this study was to determine the validity of 18 F-fluorodeoxyglucose-positron emission tomography/computed tomography (F-18 FDG-PET/CT) for detecting cancer in an asymptomatic population with an unexplained elevation in blood carcinoembryonic antigen (CEA) levels. This retrospective study included a total of 1920 asymptomatic examinees conducted from August 2011 through September 2013. The participants underwent CEA assay and conventional medical imaging (CEA-conventional), or CEA assay and F-18 FDG-PET/CT (CEA-PET/CT). The validity of conventional medical imaging and CEA-PET/CT scanning for detecting cancer and early-stage cancer in an asymptomatic population with an unexplained elevation in blood CEA levels were evaluated. Sensitivity, specificity, cancer detection rate, missed cancer detection rate, early-stage cancer detection rate, and early-stage cancer ratio using the CEA-PET/CT scanning were 96.6 %, 100 %, 10.4 %, 0.4 %, 3.7 %, and 34.5 %, respectively. In contrast, the corresponding values obtained using the conventional medical imaging were 50.6 % (P < 0.0001), 100 % (P > 0.9999), 50.6 % (P < 0.0001), 99.9 % (P = 0.055), 2.6 % (P < 0.0001), 2.5 % (P = 0.04), 0.7 % (P = 0.0004), and 14.5 % (P = 0.002), respectively. The F-18 FDG-PET/CT scanning significantly improved the validity of the cancer detection program in the asymptomatic population with an unexplained elevation in CEA levels. (orig.)

  19. Positron emission tomography and migraine

    Positron emission tomography (PET) is a brain imaging technique that allows in vivo studies of numerous physiological parameters. There have been few PET studies in migraine patients. Cerebral blood flow changes with no variations in brain oxygen consumption have been reported in patients with prolonged neurologic manifestations during migraine attacks. Parenteral administration of reserpine during migraine headache has been followed by a fall in the overall cerebral uptake of glucose. The small sample sizes and a number of methodologic problems complicate the interpretation of these results. Recent technical advances and the development of new PET tracers can be expected to provide further insight into the pathophysiology of migraine. Today cerebral cortex 5 HT2 serotonin receptors can be studied in migraine patients with PET

  20. Positron emission tomography wrist detector

    Schlyer, David J.; O'Connor, Paul; Woody, Craig; Junnarkar, Sachin Shrirang; Radeka, Veljko; Vaska, Paul; Pratte, Jean-Francois

    2006-08-15

    A method of serially transferring annihilation information in a compact positron emission tomography (PET) scanner includes generating a time signal representing a time-of-occurrence of an annihilation event, generating an address signal representing a channel detecting the annihilation event, and generating a channel signal including the time and address signals. The method also includes generating a composite signal including the channel signal and another similarly generated channel signal concerning another annihilation event. An apparatus that serially transfers annihilation information includes a time signal generator, address signal generator, channel signal generator, and composite signal generator. The time signal is asynchronous and the address signal is synchronous to a clock signal. A PET scanner includes a scintillation array, detection array, front-end array, and a serial encoder. The serial encoders include the time signal generator, address signal generator, channel signal generator, and composite signal generator.

  1. Positron emission tomography basic sciences

    Townsend, D W; Valk, P E; Maisey, M N

    2003-01-01

    Essential for students, science and medical graduates who want to understand the basic science of Positron Emission Tomography (PET), this book describes the physics, chemistry, technology and overview of the clinical uses behind the science of PET and the imaging techniques it uses. In recent years, PET has moved from high-end research imaging tool used by the highly specialized to an essential component of clinical evaluation in the clinic, especially in cancer management. Previously being the realm of scientists, this book explains PET instrumentation, radiochemistry, PET data acquisition and image formation, integration of structural and functional images, radiation dosimetry and protection, and applications in dedicated areas such as drug development, oncology, and gene expression imaging. The technologist, the science, engineering or chemistry graduate seeking further detailed information about PET, or the medical advanced trainee wishing to gain insight into the basic science of PET will find this book...

  2. Diagnostic performance of {sup 18}F-fluorothymidine PET/CT for primary colorectal cancer and its lymph node metastasis: comparison with {sup 18}F-fluorodeoxyglucose PET/CT

    Nakajo, Masatoyo [Kagoshima University, Graduate School of Medical and Dental Sciences, Department of Radiology, Kagoshima (Japan); Nanpuh Hospital, Department of Radiology, Kagoshima (Japan); Nakajo, Masayuki; Jinguji, Megumi; Fukukura, Yoshihiko [Kagoshima University, Graduate School of Medical and Dental Sciences, Department of Radiology, Kagoshima (Japan); Kajiya, Yoriko; Tani, Atushi [Nanpuh Hospital, Department of Radiology, Kagoshima (Japan); Nishimata, Nobuaki; Shimaoka, Shunji; Nihara, Tohru [Nanpuh Hospital, Department of Gastroenterology, Kagoshima (Japan); Aridome, Kuniaki [Nanpuh Hospital, Department of Surgery, Kagoshima (Japan); Tanaka, Sadao [Nanpuh Hospital, Department of Pathology, Kagoshima (Japan); Koriyama, Chihaya [Kagoshima University, Graduate School of Medical and Dental Sciences, Department of Epidemiology and Preventive Medicine, Kagoshima (Japan)

    2013-08-15

    To examine the diagnostic performance of {sup 18}F-fluorothymidine (FLT) PET/CT in primary and metastatic lymph node colorectal cancer foci in comparison with {sup 18}F-fluorodeoxyglucose (FDG) PET/CT. The study population comprised 28 patients with 30 newly diagnosed colorectal cancers who underwent surgical resection of the primary lesion and regional lymph nodes after both FLT and FDG PET/CT. The associations between SUVmax levels and pathological factors were evaluated using the Mann-Whitney U or Kruskal-Wallis test. Differences in diagnostic indexes for detecting nodal metastasis between the two tracers were estimated using the McNemar exact or {chi} {sup 2} test. All 30 primary cancers (43.0 {+-} 20.0 mm, range 14 - 85 mm) were visualized by both tracers, but none of the FLT SUVmax values exceeded the FDG SUVmax values in any of the primary cancers (6.6 {+-} 2.4 vs. 13.6 {+-} 5.8, p < 0.001). The sensitivity, specificity and accuracy for detecting nodal metastasis were 41 % (15/37), 98.8 % (493/499) and 94.8 % (508/536) for FDG PET/CT, and 32 % (12/37), 98.8 % (493/499) and 94.2 % (505/536) for FLT PET/CT, respectively. The sensitivity (p = 0.45), specificity (p = 0.68) and accuracy (p = 0.58) were not different between the tracers. Nodal uptake of FLT and FDG was discordant in 7 (19 %) of 37 metastatic nodes. There were ten concordant true-positive nodes of which six showed higher FDG SUVmax and four showed higher FLT SUVmax, but the difference between FDG and FLT SUVmax was not significant (5.56 {+-} 3.55 and 3.62 {+-} 1.45, respectively; p = 0.22). FLT has the same potential as FDG in PET/CT for the diagnosis of primary and nodal foci of colorectal cancer despite significantly lower FLT uptake in primary foci. (orig.)

  3. Predictive value of early and late residual 18F-fluorodeoxyglucose and 18F-fluorothymidine uptake using different SUV measurements in patients with non-small-cell lung cancer treated with erlotinib

    To evaluate the predictive value of early and late residual 18F-fluorodeoxyglucose (FDG) and 18F-fluorothymidine (FLT) uptake using different SUV measurements in PET in patients with advanced non-small-cell lung cancer (NSCLC) treated with erlotinib. We retrospectively reviewed data from 30 patients with untreated stage IV NSCLC who had undergone a combined FDG PET and FLT PET scan at 1 week (early) and 6 weeks (late) after the start of erlotinib treatment. Early and late residual FDG and FLT uptake were measured in up to five lesions per scan with different quantitative standardized uptake values (SUVmax, SUV2Dpeak, SUV3Dpeak, SUV50, SUVA50, SUVA41) and compared with short-term outcome (progression vs. nonprogression after 6 weeks of erlotinib treatment). Receiver-operating characteristics (ROC) curve analysis was used to determine the optimal cut-off value for detecting nonprogression after 6 weeks. Kaplan-Meier analysis and the log-rank test were used to evaluate the association between residual uptake and progression-free survival (PFS). Nonprogression after 6 weeks was associated with a significantly lower early and late residual FDG uptake, measured with different quantitative parameters. In contrast, nonprogression after 6 weeks was not associated with early and late residual FLT uptake. Furthermore, patients with a lower early residual FDG uptake measured in terms of SUVmax and SUV2Dpeak had a significantly prolonged PFS (282 days vs. 118 days; p = 0.022) than patients with higher values. Similarly, lower late residual FDG uptake and early residual FLT uptake measured in terms of SUV3Dpeak, SUVA50 and SUVA41, and late FLT uptake measured in terms of SUV3Dpeak and SUVA50 was associated with an improved PFS. Early and late residual FDG uptake, measured using different quantitative SUV parameters, are predictive factors for short-term outcome in patients with advanced NSCLC treated with erlotinib. Additionally, low residual FDG and FLT uptake early and late in

  4. Combined measurement of tumor perfusion and glucose metabolism for improved tumor characterization in advanced cervical carcinoma. A PET/CT pilot study using [15O]water and [18F]fluorodeoxyglucose

    The aim of this pilot study was (1) to evaluate the combination of [18F]fluorodeoxyglucose (FDG) and [15O]water for detection of flow-metabolism mismatch in advanced cervical carcinomas, i.e., increased glycolysis at low blood flow, as a possible parameter for prediction of response to treatment, and (2) to propose a method for automated quantification of its spatial extent. The study retrospectively included 10 women with advanced cervical carcinoma in whom PET with both FDG and [15O]water had been performed prior to therapy. The metabolically active tumor volume was delineated automatically in the FDG images. For computation of the regional blood flow in the tumor, a recovery corrected image-derived arterial input function was used. A tumor voxel was classified as mismatched when the voxel SUV of FDG was larger than the median tumor SUV and the voxel perfusion (K1) was smaller than the median perfusion. The absolute mismatch volume (aMMV) was defined as the volume of all mismatched voxels in ml, and the relative mismatch volume (rMMV) as the ratio of the aMMV to the metabolic tumor volume in percent. The tumors were quite heterogeneous with respect to both FDG uptake and perfusion. The aMMV clustered into 2 groups: ''large aMMV'' ≥ 10 ml in 40 % of patients and ''small aMMV'' ≤ 5 ml in 60 % of patients. The rMMV ranged from 12.7-24.9 %. There was no correlation between rMMV and metabolic tumor volume. There was a tendency (p = 0.126) for an association between rMMV and histological grading, rMMV being about 20 % higher in G3 than in G2 tumors. rMMV did not correlate with SUV or perfusion. These results suggest that combined PET with FDG and [15O]water allows detection and quantitative characterization of flow-metabolism mismatch in advanced cervical carcinomas. (orig.)

  5. Scintillators for positron emission tomography

    Like most applications that utilize scintillators for gamma detection, Positron Emission Tomography (PET) desires materials with high light output, short decay time, and excellent stopping power that are also inexpensive, mechanically rugged, and chemically inert. Realizing that this ''ultimate'' scintillator may not exist, this paper evaluates the relative importance of these qualities and describes their impact on the imaging performance of PET. The most important PET scintillator quality is the ability to absorb 511 keV photons in a small volume, which affects the spatial resolution of the camera. The dominant factor is a short attenuation length (≤ 1.5 cm is required), although a high photoelectric fraction is also important (> 30% is desired). The next most important quality is a short decay time, which affects both the dead time and the coincidence timing resolution. Detection rates for single 511 keV photons can be extremely high, so decay times ≤ 500 ns are essential to avoid dead time losses. In addition, positron annihilations are identified by time coincidence so ≤5 ns fwhm coincidence pair timing resolution is required to identify events with narrow coincidence windows, reducing contamination due to accidental coincidences. Current trends in PET cameras are toward septaless, ''fully-3D'' cameras, which have significantly higher count rates than conventional 2-D cameras and so place higher demands on scintillator decay time. Light output affects energy resolution, and thus the ability of the camera to identify and reject events where the initial 511 keV photon has undergone Compton scatter in the patient. The scatter to true event fraction is much higher in fully-3D cameras than in 2-D cameras, so future PET cameras would benefit from scintillators with a 511 keV energy resolution < 10--12% fwhm

  6. Positron emission mammography in breast cancer presurgical planning: comparisons with magnetic resonance imaging

    Schilling, Kathy; The, Juliette; Velasquez, Maria Victoria; Kahn, Simone; Saady, Matthew; Mahal, Ravinder; Chrystal, Larraine [Boca Raton Regional Hospital, Radiology Department, Boca Raton, FL (United States); Narayanan, Deepa [Naviscan, Inc., San Diego, CA (United States); National Cancer Institute, Bethesda, MD (United States); Kalinyak, Judith E. [Naviscan, Inc., San Diego, CA (United States)

    2011-01-15

    The objective of this study was to compare the performance characteristics of {sup 18}F-fluorodeoxyglucose (FDG) positron emission mammography (PEM) with breast magnetic resonance imaging (MRI) as a presurgical imaging and planning option for index and ipsilateral lesions in patients with newly diagnosed, biopsy-proven breast cancer. Two hundred and eight women >25 years of age (median age = 59.7 {+-} 14.1 years) with biopsy-proven primary breast cancer enrolled in this prospective, single-site study. MRI, PEM, and whole-body positron emission tomography (WBPET) were conducted on each patient within 7 business days. PEM and WBPET images were acquired on the same day after intravenous administration of 370 MBq of FDG (median = 432.9 MBq). PEM and MRI images were blindly evaluated, compared with final surgical histopathology, and the sensitivity determined. Substudy analysis compared the sensitivity of PEM versus MRI in patients with different menopausal status, breast density, and use of hormone replacement therapy (HRT) as well as determination of performance characteristics for additional ipsilateral lesion detection. Two hundred and eight patients enrolled in the study of which 87% (182/208) were analyzable. Of these analyzable patients, 26.4% (48/182), 7.1% (13/182), and 64.2% (120/182) were pre-, peri-, and postmenopausal, respectively, and 48.4% (88/182) had extremely or heterogeneously dense breast tissue, while 33.5% (61/182) had a history of HRT use. Ninety-two percent (167/182) underwent core biopsy for index lesion diagnosis. Invasive cancer was found in 77.5% (141/182), while ductal carcinoma in situ (DCIS) and/or Paget's disease were found in 22.5% (41/182) of patients. Both PEM and MRI had index lesion depiction sensitivity of 92.8% and both were significantly better than WBPET (67.9%, p < 0.001, McNemar's test). For index lesions, PEM and MRI had equivalent sensitivity of various tumors, categorized by tumor stage as well as similar invasive

  7. Positron emission tomography in epilepsy

    Positron emission tomography (PET) was performed with the 18F-fluoro-deoxy-glucose method on 29 patients with epilepsy (generalized epilepsy, 4; partial epilepsy, 24; undetermined type, 1). The subjects were restricted to patients with epilepsy without focal abnormality on X-CT. All the patients with generalized epilepsy showed a normal pattern on PET. Fourteen out of the 24 patients with partial epilepsy and the 1 with epilepsy of undermined type showed focal hypometabolism on PET. The hypometabolic zone was localized in areas including the temporal cortex in 11 patients, frontal in 2 and thalamus in 1. The location of hypometabolic zone and that of interictal paroxysmal activity on EEG were well correlated in most patients. The patients with poorly-controlled seizure showed a higher incidence of PET abnormality (12 out of 13) than those with well-controlled seizures (2 out of 11). The incidence of abnormality on PET and MRI and the location of both abnormality were not necessarily coincident. These results indicated that the PET examination in epilepsy provides valuable information about the location of epileptic focus, and that the findings on PET in patients with partial epilepsy may be one of the good indicators about the intractability of partial epilepsy, and that PET and MRI provide complementary information in the diagnosis of epilepsy. (author)

  8. Regional kinetic constants and cerebral metabolic rate for glucose in normal human volunteers determined by dynamic positron emission tomography of [18F]-2-fluoro-2-deoxy-D-glucose

    Using dynamic [18F]fluorodeoxyglucose (FDG) positron emission tomography with a high-resolution, seven-slice positron camera, the kinetic constants of the original three-compartment model of Sokoloff and co-workers (1977) were determined in 43 distinct topographic brain regions of seven healthy male volunteers aged 28-38 years. Regional averages of the cerebral metabolic rate for glucose (CMRglu) were calculated both from individually fitted rate constants (CMRglukinetic) and from activity maps recorded 30-40 min after FDG injection, employing a four-parameter operational equation with standard rate constants from the literature (CMRgluautoradiographic). Metabolic rates and kinetic constants varied significantly among regions and subjects, but not between hemispheres. k1 ranged between 0.0485 +/- 0.00778 min-1 in the oval center and 0.0990 +/- 0.01347 min-1 in the primary visual cortex. k2 ranged from 0.1198 +/- 0.01533 min-1 in the temporal white matter to 0.1472 +/- 0.01817 min-1 in the cerebellar dentate nucleus. k3 was lowest (0.0386 +/- 0.01482 min-1) in temporal white matter and highest (0.0823 +/- 0.02552 min-1) in the caudate nucleus. Maximum likelihood cluster analysis revealed four homogeneous groups of brain regions according to their respective kinetic constants: (1) white matter and mixed brainstem structures; (2) cerebellar gray matter and hippocampal formations; (3) basal ganglia and frontolateral and primary visual cortex; and (4) other cerebral cortex and thalamus. Across the entire brain, k1 and k2 were positively correlated (r . 0.79); k1 and k3 showed some correlation (r . 0.59); but no significant linear association was found between k2 and k3. A strong correlation with CMRglu could be demonstrated for k1 (r . 0.88) and k3 (r . 0.90), but k2 was loosely correlated (r . 0.56)

  9. Diffusion-weighted magnetic resonance imaging with short T1 inversion recovery-echo planar imaging combined with dual-head coincidence single photon emission computed tomography for diagnosing solitary pulmonary nodule

    WANG Wei; XU Jin-zhi; ZHANG Tong; SHEN Bao-zhong

    2010-01-01

    @@ Positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) has not been widely used in China for expensive cost ($1200). Dual-head coincidence single photon emission computed tomography (DHC-SPECT) can depict many of the lesions depicted with a PET scanner in the lungs, which is used in place of PET-CT for discriminating malignant from benign pulmonary nodules in many studies. However, DHC-SPECT has inevitable false-negative results because the sensitivity for small lesions less than 2.0 cm is limited, and has high false-positive rate for active inflammatory nodules. Furthermore,DHC-SPECT also has a considerably higher cost ($300 in China) than other imaging examination.

  10. 18F-Fluoromisonidazole positron emission tomography may differentiate glioblastoma multiforme from less malignant gliomas

    Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor and its prognosis is significantly poorer than those of less malignant gliomas. Pathologically, necrosis is one of the most important characteristics that differentiate GBM from lower grade gliomas; therefore, we hypothesized that 18F fluoromisonidazole (FMISO), a radiotracer for hypoxia imaging, accumulates in GBM but not in lower grade gliomas. We aimed to evaluate the diagnostic value of FMISO positron emission tomography (PET) for the differential diagnosis of GBM from lower grade gliomas. This prospective study included 23 patients with pathologically confirmed gliomas. All of the patients underwent FMISO PET and 18F-fluorodeoxyglucose (FDG) PET within a week. FMISO images were acquired 4 h after intravenous administration of 400 MBq of FMISO. Tracer uptake in the tumor was visually assessed. Lesion to normal tissue ratios and FMISO uptake volume were calculated. Of the 23 glioma patients, 14 were diagnosed as having GBM (grade IV glioma in the 2007 WHO classification), and the others were diagnosed as having non-GBM (5 grade III and 4 grade II). In visual assessment, all GBM patients showed FMISO uptake in the tumor greater than that in the surrounding brain tissues, whereas all the non-GBM patients showed FMISO uptake in the tumor equal to that in the surrounding brain tissues (p ≤ 0.001). One GBM patient was excluded from FDG PET study because of hyperglycemia. All GBM patients and three of the nine (33%) non-GBM patients showed FDG uptake greater than or equal to that in the gray matter. The sensitivity and specificity for diagnosing GBM were 100 and 100% for FMISO, and 100 and 66% for FDG, respectively. The lesion to cerebellum ratio of FMISO uptake was higher in GBM patients (2.74 ± 0.60, range 1.71-3.81) than in non-GBM patients (1.22 ± 0.06, range 1.09-1.29, p ≤ 0.001) with no overlap between the groups. The lesion to gray matter ratio of FDG was also higher in GBM patients

  11. Cyclotron, positrons and PET [positron emission tomography]. An overview

    PET (positron emission tomography) is a powerful new scientific tool which is capable of revealing biochemical transformations while they are occurring in the brain and other organs in the living human body. The application of PET to problems in biology and medicine is dominated by the short half-life of the isotopes used to prepare the radiotracers. The most commonly used positron emitting isotopes are carbon-11, fluorine-18, nitrogen-13, and oxygen-15 which have half-lives of 20.4, 110, 10 and 2 minutes, respectively. Their incorporation into radiotracers having diverse chemical structures and biochemical specificities has allowed the study of blood flow, sugar metabolism, oxygen metabolism, neurotransmission, enzyme activity and binding sites for therapeutic drugs and substances of abuse. PET research is most commonly carried out at a Cyclotron-PET Center (cyclotron, positron emission tomography, chemistry laboratory) where the short-lived isotopes can be produced and used efficiently. The number of Cyclotron-PET Centers has grown from 4 in 1976 to several dozen in 1988 and the number is expected to double in the next five years attesting to the vitality of the field and the current and anticipated contributions to research in biology and medicine

  12. Ionization and positron emission in giant quasiatoms

    Electron excitation processes in superheavy quasiatoms are treated within a relativistic framework. Theoretical results on K-hole production rates as well as delta-electron and positron spectra are compared with experimental data. It is demonstrated that the study of heavy ion collisions with nuclear time delay promises a signature for the spontaneous positron formation in overcritical systems. Corresponding experimental results are confronted with our theoretical hypothesis. Recent speculations on the origin of the observed peak structures in positron spectra are critically reviewed. Atomic excitations are also employed to obtain information on the course of a nuclear reaction. Using a semiclassical picture we calculate the emission of delta-electrons and positrons in deep-inelastic nuclear reactions. Furthermore some consequences of conversion processes in giant systems are investigated. (orig.)

  13. Positron emission tomography imaging of gene expression

    The merging of molecular biology and nuclear medicine is developed into molecular nuclear medicine. Positron emission tomography (PET) of gene expression in molecular nuclear medicine has become an attractive area. Positron emission tomography imaging gene expression includes the antisense PET imaging and the reporter gene PET imaging. It is likely that the antisense PET imaging will lag behind the reporter gene PET imaging because of the numerous issues that have not yet to be resolved with this approach. The reporter gene PET imaging has wide application into animal experimental research and human applications of this approach will likely be reported soon

  14. Blood flow-metabolic relationships are dependent on tumour size in non-small cell lung cancer: a study using quantitative contrast-enhanced computer tomography and positron emission tomography

    The purpose of this study was to undertake dual assessment of tumour blood flow and glucose metabolism in non-small cell lung cancer (NSCLC) using contrast-enhanced computed tomography (CE-CT) and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in order to assess how the relationships between these parameters vary with tumour size and stage. Tumour blood flow and glucose metabolism were assessed in 18 NSCLCs using quantitative CE-CT and FDG-PET respectively. Contrast enhancement and FDG uptake were both normalised to injected dose and patient weight to yield correspondingly the standardised perfusion value (SPV) and standardised uptake value (SUV). Tumour area was measured from conventional CT images. The ratio of SUV to SVP and the metabolic-flow difference (SUV-SVP) correlated with tumour size (r=0.56, p=0.015 and r=0.60 and p=0.008 respectively). A metabolic-flow difference of greater than 4 was more common amongst tumours of stages III and IV (odds ratio 10.5; 95% confidence limits 0.24-32.1). A significant correlation between SUV and SPV was found only for tumours smaller than 4.5 cm2 (r=0.85, p=0.03). Blood flow-metabolic relationships are not consistent in NSCLC but depend upon tumour size and stage. Quantitative CE-CT as an adjunct to an FDG study undertaken using integrated PET-CT offers an efficient way to augment the assessment of tumour biology with possible future application as part of clinical care. (orig.)

  15. Advanced instrumentation for Positron Emission Tomography

    This paper summarizes the physical processes and medical science goals that underly modern instrumentation design for Positron Emission Tomography. The paper discusses design factors such as detector material, crystalphototube coupling, shielding geometry, sampling motion, electronics design, time-of-flight, and the interrelationships with quantitative accuracy, spatial resolution, temporal resolution, maximum data rates, and cost. 71 refs., 3 figs., 3 tabs

  16. Advanced Instrumentation for Positron Emission Tomography [PET

    Derenzo, S. E.; Budinger, T. F.

    1985-04-01

    This paper summarizes the physical processes and medical science goals that underlay modern instrumentation design for Positron Emission Tomography. The paper discusses design factors such as detector material, crystalphototube coupling, shielding geometry, sampling motion, electronics design, time-of-flight, and the interrelationships with quantitative accuracy, spatial resolution, temporal resolution, maximum data rates, and cost.

  17. PET studies with L-(1- sup 11 C)tyrosine, L-(methyl- sup 11 C)methionine and sup 18 F-fluorodeoxyglucose in relation to bromocryptine treatment

    Daemen, B.J.G.; Elsinga, P.H.; Paans, A.M.J.; Vaalburg, W. (Rijksuniversiteit Groningen (Netherlands). Dept. of Nuclear Medicine); Zwertbroek, R.; Doorenbos, H. (Rijksuniversiteit Groningen (Netherlands). Dept. of Endocrinology)

    1991-07-01

    Aspects of metabolism in prolactinomas were investigated by positron emission tomography using L-(1-{sup 11}C)tyrosine, L-(methyl-{sup 11}C)methionine and fluorodeoxyl glucose 18. Using L-(1-{sup 11}C)tyrosine, four patients were monitored prior to and 18 h after an injection of 50 mg bromocryptine. At 18 h after bromocryptine intervention L-(1-{sup 11}C)tyrosine uptake into tumour was reduced with 28% (P<0.07). A correlation analysis of the bromocryptine-induced decrease in L-(1-{sup 11}C)tyrosine uptake and the reduction of serum prolactin levels indicated that the action of bromocryptine on prolactin synthesis and prolactin release is not coupled. In the untreated situation, the four patients were investigated with {sup 18}FDG as well, but the prolactinomas could not be visualized. Three untreated patients were studied with L-(methyl-{sup 11}C)methionine. The tumour-imaging potential of L-(methyl-{sup 11}C)methionine and L-(1-{sup 11}C)tyrosine appeared to be nearly equivalent for prolactinomas. Unlike prolactinoma tissue, the salivary glands showed a pronounced preference for L-(1-{sup 11}C)tyrosine as compared to L-(methyl-{sup 11}C)methionine. L-(1-{sup 11}C)tyrosine is a valuable tool to obtain information on the metabolism and treatment of prolactinomas. (orig.).

  18. Positron emission tomography of the lung

    Positron emission tomography enables the distribution of positron emitting isotopes to be imaged in a transverse plane through the body and the regional concentration of the isotope to be measured quantitatively. This thesis reports some applications of positron emission tomography to studies of pulmonary pathophysiology. Measurements in lung phantoms showed that regional lung density could be measured from a transmission tomogram obtained with an external source of positron emitting isotope. The regional, fractional blood volume was measured after labelling the blood with carbon-11-monoxide. Regional extravascular lung density (lung tissue and interstitial water per unit thoracic volume) was obtained by subtracting fractional blood volume from lung density. Measurements in normal subjects revealed large regional variations in lung density and fractional blood volume in the supine posture. Extravascular lung density showed a more uniform distribution. The technique has been used to study patients with chronic interstitial pulmonary oedema, pulmonary sarcoidosis and fibrosis, pulmonary arterial hypertension and patients with intracardiac, left-to-right shunt. Tomographic measurements of pulmonary tissue concentration of radionuclides are difficult, since corrections for the blood content and the inflation of the lung must be applied. A simultaneous measurement of lung density and fractional blood volume allows such corrections to be made and the extravascular tracer concentration to be calculated. This has been applied to measurements of the tissue penetration of carbon-11-labelled erythromycin in patients with lobar pneumonia. (author)

  19. Clinical implications of determination of safe surgical margins by using a combination of CT and 18FDG-positron emission tomography in soft tissue sarcoma

    Yoshioka Takako

    2011-07-01

    Full Text Available Abstract Background To determine safe surgical margins for soft tissue sarcoma, it is essential to perform a general evaluation of the extent of tumor, responses to auxiliary therapy, and other factors preoperatively using multiple types of diagnostic imaging. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT is a tool for diagnostic imaging that has recently spread rapidly in clinical use. At present, the roles played by FDG-PET/CT in determination of margins for surgical resection of sarcoma are unclear. The present study was undertaken to explore the roles of FDG-PET/CT in determination of surgical margins for soft tissue sarcoma and to examine whether PET can serve as a standard means for setting the margins of surgical resection during reduced surgery. Methods The study involved 7 patients with sarcoma who underwent surgery in our department and in whom evaluation with FDG-PET/CT was possible. Sarcoma was histologically rated as MFH in 6 cases and leiomyosarcoma in 1 case. In all cases, sarcoma was superficial (T1a or T2a. The tumor border was defined by contrast-enhanced MRI, and SUVs were measured at intervals of 1 cm over a 5-cm long area from the tumor border. Mapping of viable tumor cells was carried out on whole-mount sections of resected tissue, and SUVs were compared with histopathological findings. Results Preoperative maximum SUVs (SUV-max of the tumor averaged 11.7 (range: 3.8-22.1. Mean SUV-max was 2.2 (range: 0.3-3.8 at 1 cm from the tumor border, 1.1 (0.85-1.47 at 2 cm, 0.83 (0.65-1.15 at 3 cm, 0.7 (0.42-0.95 at 4 cm, and 0.64 (0.45-0.82 at 5 cm. When resected tissue was mapped, tumor cells were absent in the areas where SUV-max was below 1.0. Conclusions Our findings suggest that a safe surgical margin free of viable tumor cells can be ensured if the SUV cut-off level is set at 1.0. FDG-PET/CT is promising as a diagnostic imaging technique for setting of safe minimal margins for surgical

  20. Incidental colorectal polyps in positron emission tomography

    Fluorodeoxy glucose positron emission tomography/computed tomography (FDG PET/CT) is increasingly being used for diagnosing various malignancies and surveillance of cancer recurrence, staging and screening in high-risk individuals. Due to its high sensitivity in picking up small dysplastic lesions, incidental lesions are detected frequently. We present two patients who underwent PET CT as part of cancer screening and were incidentally detected with adenomatous colonic polyps. Colonoscopy and biopsy confirmed the diagnosis

  1. Positron emission tomography (PET) for cholangiocarcinoma

    Breitenstein, S; Apestegui, C.; Clavien, P.-A.

    2008-01-01

    The combination of positron emission tomography (PET) with computed tomography (PET-CT) provides simultaneous metabolic and anatomic information on tumors in the same imaging session. Sensitivity of PET/PET-CT is higher for intrahepatic (>90%) than for extrahepatic cholangiocarcinoma (CCA) (about 60%). The detection rate of distant metastasis is 100%. PET, and particularly PET-CT, improves the results and impacts on the oncological management in CCA compared with other imaging modalities. The...

  2. 18F-fluoromethylcholine (FCho), 18F-fluoroethyltyrosine (FET), and 18F-fluorodeoxyglucose (FDG) for the discrimination between high-grade glioma and radiation necrosis in rats: A PET study

    Introduction: Discrimination between (high-grade) brain tumor recurrence and radiation necrosis (RN) remains a diagnostic challenge because both entities have similar imaging characteristics on conventional magnetic resonance imaging (MRI). Metabolic imaging, such as positron emission tomography (PET) could overcome this diagnostic dilemma. In this study, we investigated the potential of 2-[18F]-fluoro-2-deoxy-D-glucose (18F-FDG), O-(2-[18F]-fluoroethyl)-L-tyrosine (18F-FET), and [18F]-Fluoromethyl-dimethyl-2-hydroxyethylammonium (18F-fluoromethylcholine, 18F-FCho) PET in discriminating high-grade tumor from RN. Methods: We developed a glioblastoma (GB) rat model by inoculating F98 GB cells into the right frontal region. Induction of RN was achieved by irradiating the right frontal region with 60 Gy using three arcs with a beam aperture of 3 × 3 mm (n = 3). Dynamic PET imaging with 18F-FDG, 18F-FET, and 18F-FCho, as well as 18F-FDG PET at a delayed time interval (240 min postinjection), was acquired. Results: MRI revealed contrast-enhancing tumors at 15 days after inoculation (n = 4) and contrast-enhancing RN lesions 5–6 months postirradiation (n = 3). On 18F-FDG PET, the mean lesion-to-normal ratio (LNRmean) was significantly higher in GB than in RN (p = 0.034). The difference in the LNRmean between tumors and RN was higher on the late 18F-FDG PET images than on the PET images reconstructed from the last time frame of the dynamic acquisition (this is at a conventional time interval). LNRs obtained from 18F-FCho PET were not significantly different between GB and RN (p = 1.000). On 18F-FET PET, the LNRmean was significantly higher in GB compared to RN (p = 0.034). Conclusions: Unlike 18F-FCho, 18F-FDG and 18F-FET PET were effective in discriminating GB from RN. Interestingly, in the case of 18F-FDG, delayed PET seems particularly useful. Advances in knowledge and implications for patient care: Our results suggest that (delayed) 18F-FDG and 18F-FET PET can be

  3. Impact of [18F]Fluorodeoxyglucose PET-CT Staging on Treatment Planning in Radiotherapy Incorporating Elective Nodal Irradiation for Non-Small-Cell Lung Cancer: A Prospective Study

    Purpose: To evaluate prospectively how positron emission tomography (PET) information changes treatment plans for non-small-cell lung cancer (NSCLC) patients receiving or not receiving elective nodal irradiation (ENI). Methods and Materials: One hundred consecutive patients referred for curative radiotherapy were included in the study. Treatment plans were carried out with CT data sets only. For stage III patients, mediastinal ENI was planned. Then, patients underwent PET-CT for diagnostic/planning purposes. PET/CT was fused with the CT data for final planning. New targets were delineated. For stage III patients with minimal N disease (N0-N1, single N2), the ENI was omitted in the new plans. Patients were treated according to the PET-based volumes and plans. The gross tumor volume (GTV)/planning tumor volume (PTV) and doses for critical structures were compared for both data sets. The doses for areas of potential geographical misses derived with the CT data set alone were compared in patients with and without initially planned ENI. Results: In the 75 patients for whom the decision about curative radiotherapy was maintained after PET/CT, there would have been 20 cases (27%) with potential geographical misses by using the CT data set alone. Among them, 13 patients would receive ENI; of those patients, only 2 patients had the PET-based PTV covered by 90% isodose by using the plans based on CT alone, and the mean of the minimum dose within the missed GTV was 55% of the prescribed dose, while for 7 patients without ENI, it was 10% (p = 0.006). The lung, heart, and esophageal doses were significantly lower for plans with ENI omission than for plans with ENI use based on CT alone. Conclusions: PET/CT should be incorporated in the planning of radiotherapy for NSCLC, even in the setting of ENI. However, if PET/CT is unavailable, ENI may to some extent compensate for an inadequate dose coverage resulting from diagnostic uncertainties.

  4. Positron Emission Tomography: Its 65 years

    Del Guerra, A.; Belcari, N.; Bisogni, M.

    2016-04-01

    Positron Emission Tomography (PET) is a well-established imaging technique for in vivo molecular imaging. In this review after a brief history of PET there are presented its physical principles and the technology that has been developed for bringing PET from a bench experiment to a clinical indispensable instrument. The limitations and performance of the PET tomographs are discussed, both as for the hardware and software aspects. The status of art of clinical, pre-clinical and hybrid scanners (, PET/CT and PET/MR) is reported. Finally the actual trend and the recent and future technological developments are fully illustrated.

  5. Positron emission tomography of FDG in schizophrenia

    The use of the Donner dynamic positron emission tomograph to study fluorodeoxyglucose labelled 18F uptake in the brain of six patients with schizophrenia is reported. The glucose metabolic rate and the local cerebral metabolic rate were calculated. The dynamic brain uptake data and the blood input function were used to calculate rate constants by an iterative least squares fitting program for all regions of interest chosen in the brain. Although the number of patients was small, differences in k3 were statistically significant in several brain regions compared with normal controls

  6. Perspectives for positron emission tomography with RPCs

    In this study, we address the feasibility and main properties of a positron emission tomograph (PET) based on RPCs. The concept, making use of the converter-plate principle, takes advantage of the intrinsic layered structure of RPCs and its simple and economic construction. The extremely good time and position resolutions of RPCs also allow the TOF-PET imaging technique to be considered. Monte-Carlo simulations, supported by experimental data, are presented and the main advantages and drawbacks for applications of potential interest are discussed

  7. Positron emission tomography tracers for imaging angiogenesis

    Position emission tomography imaging of angiogenesis may provide non-invasive insights into the corresponding molecular processes and may be applied for individualized treatment planning of antiangiogenic therapies. At the moment, most strategies are focusing on the development of radiolabelled proteins and antibody formats targeting VEGF and its receptor or the ED-B domain of a fibronectin isoform as well as radiolabelled matrix metalloproteinase inhibitors or αvβ3 integrin antagonists. Great efforts are being made to develop suitable tracers for different target structures. All of the major strategies focusing on the development of radiolabelled compounds for use with positron emission tomography are summarized in this review. However, because the most intensive work is concentrated on the development of radiolabelled RGD peptides for imaging αvβ3 expression, which has successfully made its way from bench to bedside, these developments are especially emphasized. (orig.)

  8. (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....

  9. Single-photon emission tomography.

    Goffin, Karolien; van Laere, Koen

    2016-01-01

    Single-photon emission computed tomography (SPECT) is a functional nuclear imaging technique that allows visualization and quantification of different in vivo physiologic and pathologic features of brain neurobiology. It has been used for many years in diagnosis of several neurologic and psychiatric disorders. In this chapter, we discuss the current state-of-the-art of SPECT imaging of brain perfusion and dopamine transporter (DAT) imaging. Brain perfusion SPECT imaging plays an important role in the localization of the seizure onset zone in patients with refractory epilepsy. In cerebrovascular disease, it can be useful in determining the cerebrovascular reserve. After traumatic brain injury, SPECT has shown perfusion abnormalities despite normal morphology. In the context of organ donation, the diagnosis of brain death can be made with high accuracy. In neurodegeneration, while amyloid or (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) are the nuclear diagnostic tools of preference for early and differential diagnosis of dementia, perfusion SPECT imaging can be useful, albeit with slightly lower accuracy. SPECT imaging of the dopamine transporter system is widely available in Europe and Asia, but since recently also in the USA, and has been accepted as an important diagnostic tool in the early and differential diagnosis of parkinsonism in patients with unclear clinical features. The combination of perfusion SPECT (or FDG-PET) and DAT imaging provides differential diagnosis between idiopathic Parkinson's disease, Parkinson-plus syndromes, dementia with Lewy bodies, and essential tremor. PMID:27432669

  10. Use of micro-positron emission tomography with (18)F-fallypride to measure the levels of dopamine receptor-D2 and (18)F-FDG as molecular imaging tracer in the pituitary glands and prolactinomas of Fischer-344 rats.

    Li, Ping; Gui, Songbai; Cao, Lei; Gao, Hua; Bai, Jiwei; Li, Chuzhong; Zhang, Yazhuo

    2016-01-01

    Dopamine receptor-D2 (DRD2) is the most important drug target in prolactinoma. The aim of this current study was to investigate the role of using micro-positron emission tomography (micro-PET) with (18)F-fallypride and (18)F-fluorodeoxyglucose ((18)F-FDG) as molecular imaging tracer in the pituitary glands and prolactinomas of Fischer-344 (F344) rats and detect the difference of the levels of DRD2 in the pituitary glands and prolactinomas of F344 rat prolactinoma models. Female F344 rat prolactinoma models were established by subcutaneous administration of 15 mg 17β-estradiol for 8 weeks. The growth of tumors was monitored by the small-animal magnetic resonance imaging and micro-PET. A series of molecular biological experiments were also performed 4 and 6 weeks after pump implantation. The micro-PET molecular imaging with (18)F-fallypride revealed a decreased expression of DRD2 in F344 rat prolactinoma models, but the micro-PET molecular imaging with (18)F-FDG presented an increased uptake in the prolactinoma compared with the pituitary gland. A decreasing trend of levels of DRD2 in F344 rat prolactinoma models was also detected by molecular biological experiments. From this, we can conclude that micro-PET with (18)F-fallypride and (18)F-FDG can be used to assess tumorigenesis of the prolactinomas in vivo and molecular imaging detection of DRD2 level in prolactinoma may be an indication of treatment effect in the animal experiment. PMID:27103832

  11. Use of micro-positron emission tomography with 18F-fallypride to measure the levels of dopamine receptor-D2 and 18F-FDG as molecular imaging tracer in the pituitary glands and prolactinomas of Fischer-344 rats

    Li, Ping; Gui, Songbai; Cao, Lei; Gao, Hua; Bai, Jiwei; Li, Chuzhong; Zhang, Yazhuo

    2016-01-01

    Dopamine receptor-D2 (DRD2) is the most important drug target in prolactinoma. The aim of this current study was to investigate the role of using micro-positron emission tomography (micro-PET) with 18F-fallypride and 18F-fluorodeoxyglucose (18F-FDG) as molecular imaging tracer in the pituitary glands and prolactinomas of Fischer-344 (F344) rats and detect the difference of the levels of DRD2 in the pituitary glands and prolactinomas of F344 rat prolactinoma models. Female F344 rat prolactinoma models were established by subcutaneous administration of 15 mg 17β-estradiol for 8 weeks. The growth of tumors was monitored by the small-animal magnetic resonance imaging and micro-PET. A series of molecular biological experiments were also performed 4 and 6 weeks after pump implantation. The micro-PET molecular imaging with 18F-fallypride revealed a decreased expression of DRD2 in F344 rat prolactinoma models, but the micro-PET molecular imaging with 18F-FDG presented an increased uptake in the prolactinoma compared with the pituitary gland. A decreasing trend of levels of DRD2 in F344 rat prolactinoma models was also detected by molecular biological experiments. From this, we can conclude that micro-PET with 18F-fallypride and 18F-FDG can be used to assess tumorigenesis of the prolactinomas in vivo and molecular imaging detection of DRD2 level in prolactinoma may be an indication of treatment effect in the animal experiment. PMID:27103832

  12. 77 FR 8262 - Draft Guidance on Investigational New Drug Applications for Positron Emission Tomography Drugs...

    2012-02-14

    ... Positron Emission Tomography Drugs; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice... entitled ``Investigational New Drug Applications for Positron Emission Tomography (PET) Drugs.'' The draft... Applications for Positron Emission Tomography (PET) drugs.'' The draft guidance summarizes the IND process...

  13. Positron emission tomography: radioisotope and radiopharmaceutical production

    A Centre for Positron Emission Tomography (PET) has been operational within the Department of Nuclear Medicine at the Austin and Repatriation Medical Centre (A and RMC) in Melbourne for seven years. PET is a non-invasive imaging technique based on the use of biologically relevant compounds labelled with short-lived positron-emitting radionuclides such as carbon-11, nitrogen-13, oxygen-15 and fluorine-18. The basic facility consists of a medical cyclotron (10 MeV proton and 5 MeV deuteron), six lead-shielded hot cells with associated radiochemistry facilities, radiopharmacy and a whole body PET scanner. A strong radiolabelling development program, including the production of 15O-oxygen, 15O-carbon monoxide, 15O-carbon dioxide, 15O-water, 13N-ammonia, 18F-FDG, 18F-FMISO, 11C-SCH23390 and 11C-flumazenil has been pursued to support an ambitious clinical and research program in neurology, oncology, cardiology and psychiatry. Copyright (1999) Australasian Physical and Engineering Sciences in Medicine and the College of Biomedical Engineers

  14. Pulmonary studies using positron emission tomography

    The detailed investigation of regional differences in lung function at a local level began when suitable γ-ray emitting isotopes and focused external radiation detectors (especially the Anger γ-camera) became available. A major recent advance has been the development of positron emission tomography (PET), which provides a powerful combination of highly accurate tomographic reconstruction of radioisotope concentration with a potentially unlimited list of biological compounds to be labelled with the positron emitting isotopes of oxygen, carbon and fluorine. Early studies using PET focused on the inhalation of 11CO (or C15O) and 19Ne gases and the intravenous injection of 13N in saline and H215O for the measurement of relatively simple aspects of regional lung function, such as tissue, blood and gas volumes, blood flow, ventilation and ventilation/perfusion (V'A/Q'). More recent work has been directed towards the more challenging areas of regional endothelial permeability, carbohydrate utilization, enzyme and receptor binding assays, and in vivo pharmacokinetics. The short physical half-lives of the isotopes (17 s to 2 h) and the noninvasive nature of PET allows serial measurements to be made on patients (within the constraints of permitted radiation doses) to assess the effect of physiological and therapeutic interventions. (au) 80 refs

  15. Motion correction in thoracic positron emission tomography

    Gigengack, Fabian; Dawood, Mohammad; Schäfers, Klaus P

    2015-01-01

    Respiratory and cardiac motion leads to image degradation in Positron Emission Tomography (PET), which impairs quantification. In this book, the authors present approaches to motion estimation and motion correction in thoracic PET. The approaches for motion estimation are based on dual gating and mass-preserving image registration (VAMPIRE) and mass-preserving optical flow (MPOF). With mass-preservation, image intensity modulations caused by highly non-rigid cardiac motion are accounted for. Within the image registration framework different data terms, different variants of regularization and parametric and non-parametric motion models are examined. Within the optical flow framework, different data terms and further non-quadratic penalization are also discussed. The approaches for motion correction particularly focus on pipelines in dual gated PET. A quantitative evaluation of the proposed approaches is performed on software phantom data with accompanied ground-truth motion information. Further, clinical appl...

  16. Positron emission tomography in urological cancer

    In staging cancer of the urinary bladder, the kidneys and the prostate and of testicular cancer there is a need for detecting tumor involvement of the lymph nodes to avoid surgical exploration. Positron emission tomography (PET) using fluorodeoxyglucose (FDG) can detect tumorous lymph nodes (sensitivity: 70%, specificity: 85%) which is helpful for several patients. In carcinoma of the prostate, other radiotracers than FDG (e.g. C-11-choline) might be more sensitive to detect tumorous lymph nodes. Up to now no diagnostical benefit of PET in germ cell tumors could be demonstrated in the published small series. In principle FDG-PET is useful in diagnosis of recurrence. In germ cell cancer FDG-PET seems to identify effectively persistent vital tumor tissue after chemotherapy. A multicenter study was initiated to demonstrate the potential of FDG-PET in a sufficient number of patients with germ cell tumor. (orig.)

  17. Compact conscious animal positron emission tomography scanner

    Schyler, David J.; O'Connor, Paul; Woody, Craig; Junnarkar, Sachin Shrirang; Radeka, Veljko; Vaska, Paul; Pratte, Jean-Francois; Volkow, Nora

    2006-10-24

    A method of serially transferring annihilation information in a compact positron emission tomography (PET) scanner includes generating a time signal for an event, generating an address signal representing a detecting channel, generating a detector channel signal including the time and address signals, and generating a composite signal including the channel signal and similarly generated signals. The composite signal includes events from detectors in a block and is serially output. An apparatus that serially transfers annihilation information from a block includes time signal generators for detectors in a block and an address and channel signal generator. The PET scanner includes a ring tomograph that mounts onto a portion of an animal, which includes opposing block pairs. Each of the blocks in a block pair includes a scintillator layer, detection array, front-end array, and a serial encoder. The serial encoder includes time signal generators and an address signal and channel signal generator.

  18. Positron emission tomography of the heart

    Positron emission computed tomography (PCT) represents an important new tool for the noninvasive evaluation and, more importantly, quantification of myocardial performance. Most currently available techniques permit assessment of only one aspect of cardiac function, i.e., myocardial perfusion by gamma scintillation camera imaging with Thallium-201 or left ventricular function by echocardiography or radionuclide angiocardiography. With PCT it may become possible to study all three major segments of myocardial performance, i.e., regional blood flow, mechanical function and, most importantly, myocardial metabolism. Each of these segments can either be evaluated separately or in combination. This report briefly describes the principles and technological advantages of the imaging device, reviews currently available radioactive tracers and how they can be employed for the assessment of flow, function and metabolism; and, lastly, discusses possible applications of PCT for the study of cardiac physiology or its potential role in the diagnosis of cardiac disease

  19. Positron emission tomography and basal ganglia functions

    With the advent of positron emission tomography (PET), studies on the human brain function and pathophysiology of brain damage have been extremely progressed. It is well-known that the basal ganglia plays an important role as one of the central nervous system involved in exercise regulation. More recently, the potential involvement of the basal ganglia in psychological processes, such as cognitive function, has been pointed out, receiving much attention. In spite of such a lot of studies, however, basal ganglia function remains unclear. This paper describes the relationships between PET findings and basal ganglia function. PET findings are discussed in relation to brain energy metabolism and striatal dopamine function. Pathophysiology of the basal ganglia are described in terms of the following diseases: Parkinson's disease, Parkinson's syndrome, progressive supranuclear palsy, Huntington's disease, and dystonia. Physiological backgrounds of the basal ganglia for PET images are also referred to. (N.K.) 75 refs

  20. Positron emission tomography of the heart

    Schelbert, H.R.; Phelps, M.E.; Kuhl, D.E.

    1979-01-01

    Positron emission computed tomography (PCT) represents an important new tool for the noninvasive evaluation and, more importantly, quantification of myocardial performance. Most currently available techniques permit assessment of only one aspect of cardiac function, i.e., myocardial perfusion by gamma scintillation camera imaging with Thallium-201 or left ventricular function by echocardiography or radionuclide angiocardiography. With PCT it may become possible to study all three major segments of myocardial performance, i.e., regional blood flow, mechanical function and, most importantly, myocardial metabolism. Each of these segments can either be evaluated separately or in combination. This report briefly describes the principles and technological advantages of the imaging device, reviews currently available radioactive tracers and how they can be employed for the assessment of flow, function and metabolism; and, lastly, discusses possible applications of PCT for the study of cardiac physiology or its potential role in the diagnosis of cardiac disease.

  1. Recent developments in positron emission tomography (PET) instrumentation

    This paper presents recent detector developments and perspectives for positron emission tomography (PET) instrumentation used for medical research, as well as the physical processes in positron annihilation, photon scattering and detection, tomograph design considerations, and the potentials for new advances in detectors. 117 refs., 4 figs., 4 tabs

  2. Simultaneous emission and transmission scanning in positron emission tomography

    Examination by PET (positron emission tomography) scanning, following the dosage of 2-deoxy-18F fluoro-D-glucose (FDG), is positively utilized for the diagnosis of cancers, rather than for the purpose of studies. This is because the examination by FDG-PET (PET scanning following the dosage of FDG) ensures higher efficiency in discrimination of cancers, than conventional CT and PET. The method of whole body scanning by PET scanning following the dosage of FDG is effectively utilized not only for discrimination cancers, but also for determining the degree of malignancy of tumors and evaluating the methods of treatment of cancers. In conventional methods for examining the degree of malignancy of tumors and evaluating the methods of cancer treatment, it is necessary to correct for the gamma-ray attenuation, which requires a longer time for examination, increasing the physical and psychological pains of the patients. We have installed the simultaneous emission and transmission scanning capability into the HEADTOME-V of the Shimadzu SET-2000W Series positron emission tomographic scanning instruments, to establish an instrument that permits FDG-PET whole body scanning in actual clinical fields, with minimized physical and psychological pains of patients concerned, yet ensuring an outstandingly high examination efficiency. This report also presents some data obtained by this newly developed instrument and those obtained in practical applications. (author)

  3. Cervical Gross Tumor Volume Dose Predicts Local Control Using Magnetic Resonance Imaging/Diffusion-Weighted Imaging—Guided High-Dose-Rate and Positron Emission Tomography/Computed Tomography—Guided Intensity Modulated Radiation Therapy

    Purpose: Magnetic resonance imaging/diffusion weighted-imaging (MRI/DWI)-guided high-dose-rate (HDR) brachytherapy and 18F-fluorodeoxyglucose (FDG) — positron emission tomography/computed tomography (PET/CT)-guided intensity modulated radiation therapy (IMRT) for the definitive treatment of cervical cancer is a novel treatment technique. The purpose of this study was to report our analysis of dose-volume parameters predicting gross tumor volume (GTV) control. Methods and Materials: We analyzed the records of 134 patients with International Federation of Gynecology and Obstetrics stages IB1-IVB cervical cancer treated with combined MRI-guided HDR and IMRT from July 2009 to July 2011. IMRT was targeted to the metabolic tumor volume and lymph nodes by use of FDG-PET/CT simulation. The GTV for each HDR fraction was delineated by use of T2-weighted or apparent diffusion coefficient maps from diffusion-weighted sequences. The D100, D90, and Dmean delivered to the GTV from HDR and IMRT were summed to EQD2. Results: One hundred twenty-five patients received all irradiation treatment as planned, and 9 did not complete treatment. All 134 patients are included in this analysis. Treatment failure in the cervix occurred in 24 patients (18.0%). Patients with cervix failures had a lower D100, D90, and Dmean than those who did not experience failure in the cervix. The respective doses to the GTV were 41, 58, and 136 Gy for failures compared with 67, 99, and 236 Gy for those who did not experience failure (P<.001). Probit analysis estimated the minimum D100, D90, and Dmean doses required for ≥90% local control to be 69, 98, and 260 Gy (P<.001). Conclusions: Total dose delivered to the GTV from combined MRI-guided HDR and PET/CT-guided IMRT is highly correlated with local tumor control. The findings can be directly applied in the clinic for dose adaptation to maximize local control

  4. Cervical Gross Tumor Volume Dose Predicts Local Control Using Magnetic Resonance Imaging/Diffusion-Weighted Imaging—Guided High-Dose-Rate and Positron Emission Tomography/Computed Tomography—Guided Intensity Modulated Radiation Therapy

    Dyk, Pawel; Jiang, Naomi; Sun, Baozhou; DeWees, Todd A. [Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri (United States); Fowler, Kathryn J.; Narra, Vamsi [Department of Diagnostic Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri (United States); Garcia-Ramirez, Jose L.; Schwarz, Julie K. [Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri (United States); Grigsby, Perry W., E-mail: pgrigsby@wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri (United States); Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri (United States); Division of Gynecologic Oncology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri (United States); Alvin J. Siteman Cancer Center, Washington University School of Medicine, St Louis, Missouri (United States)

    2014-11-15

    Purpose: Magnetic resonance imaging/diffusion weighted-imaging (MRI/DWI)-guided high-dose-rate (HDR) brachytherapy and {sup 18}F-fluorodeoxyglucose (FDG) — positron emission tomography/computed tomography (PET/CT)-guided intensity modulated radiation therapy (IMRT) for the definitive treatment of cervical cancer is a novel treatment technique. The purpose of this study was to report our analysis of dose-volume parameters predicting gross tumor volume (GTV) control. Methods and Materials: We analyzed the records of 134 patients with International Federation of Gynecology and Obstetrics stages IB1-IVB cervical cancer treated with combined MRI-guided HDR and IMRT from July 2009 to July 2011. IMRT was targeted to the metabolic tumor volume and lymph nodes by use of FDG-PET/CT simulation. The GTV for each HDR fraction was delineated by use of T2-weighted or apparent diffusion coefficient maps from diffusion-weighted sequences. The D100, D90, and Dmean delivered to the GTV from HDR and IMRT were summed to EQD2. Results: One hundred twenty-five patients received all irradiation treatment as planned, and 9 did not complete treatment. All 134 patients are included in this analysis. Treatment failure in the cervix occurred in 24 patients (18.0%). Patients with cervix failures had a lower D100, D90, and Dmean than those who did not experience failure in the cervix. The respective doses to the GTV were 41, 58, and 136 Gy for failures compared with 67, 99, and 236 Gy for those who did not experience failure (P<.001). Probit analysis estimated the minimum D100, D90, and Dmean doses required for ≥90% local control to be 69, 98, and 260 Gy (P<.001). Conclusions: Total dose delivered to the GTV from combined MRI-guided HDR and PET/CT-guided IMRT is highly correlated with local tumor control. The findings can be directly applied in the clinic for dose adaptation to maximize local control.

  5. Positron emission tomography-guided conformal fast neutron therapy for glioblastoma multiforme

    Stelzer, Keith J.; Douglas, James G.; Mankoff, David A.; Silbergeld, Daniel L.; Krohn, Kenneth A.; Laramore, George E.; Spence, Alexander M.

    2008-01-01

    Glioblastoma multiforme (GBM) continues to be a difficult therapeutic challenge. Our study was conducted to determine whether improved survival and tumor control could be achieved with modern delivery of fast neutron radiation using three-dimensional treatment planning. Ten patients were enrolled. Eligibility criteria included pathologic diagnosis of GBM, age ≥ 18 years, and KPS ≥60. Patients underwent MRI and 18F-fluorodeoxyglucose PET (FDG PET) as part of initial three-dimensional treatment...

  6. Simulation of the annihilation emission of galactic positrons

    Positrons annihilate in the central region of our Galaxy. This has been known since the detection of a strong emission line centered on an energy of 511 keV in the direction of the Galactic center. This gamma-ray line is emitted during the annihilation of positrons with electrons from the interstellar medium. The spectrometer SPI, onboard the INTEGRAL observatory, performed spatial and spectral analyses of the positron annihilation emission. This thesis presents a study of the Galactic positron annihilation emission based on models of the different interactions undergone by positrons in the interstellar medium. The models are relied on our present knowledge of the properties of the interstellar medium in the Galactic bulge, where most of the positrons annihilate, and of the physics of positrons (production, propagation and annihilation processes). In order to obtain constraints on the positrons sources and physical characteristics of the annihilation medium, we compared the results of the models to measurements provided by the SPI spectrometer. (author)

  7. Amorphous silicon detectors in positron emission tomography

    Conti, M. (Istituto Nazionale di Fisica Nucleare, Pisa (Italy) Lawrence Berkeley Lab., CA (USA)); Perez-Mendez, V. (Lawrence Berkeley Lab., CA (USA))

    1989-12-01

    The physics of the detection process is studied and the performances of different Positron Emission Tomography (PET) system are evaluated by theoretical calculation and/or Monte Carlo Simulation (using the EGS code) in this paper, whose table of contents can be summarized as follows: a brief introduction to amorphous silicon detectors and some useful equation is presented; a Tantalum/Amorphous Silicon PET project is studied and the efficiency of the systems is studied by Monte Carlo Simulation; two similar CsI/Amorphous Silicon PET projects are presented and their efficiency and spatial resolution are studied by Monte Carlo Simulation, light yield and time characteristics of the scintillation light are discussed for different scintillators; some experimental result on light yield measurements are presented; a Xenon/Amorphous Silicon PET is presented, the physical mechanism of scintillation in Xenon is explained, a theoretical estimation of total light yield in Xenon and the resulting efficiency is discussed altogether with some consideration of the time resolution of the system; the amorphous silicon integrated electronics is presented, total noise and time resolution are evaluated in each of our applications; the merit parameters {epsilon}{sup 2}{tau}'s are evaluated and compared with other PET systems and conclusions are drawn; and a complete reference list for Xenon scintillation light physics and its applications is presented altogether with the listing of the developed simulation programs.

  8. Resistive plate chambers in positron emission tomography

    Crespo, Paulo; Blanco, Alberto; Couceiro, Miguel; Ferreira, Nuno C.; Lopes, Luís; Martins, Paulo; Ferreira Marques, Rui; Fonte, Paulo

    2013-07-01

    Resistive plate chambers (RPC) were originally deployed for high energy physics. Realizing how their properties match the needs of nuclear medicine, a LIP team proposed applying RPCs to both preclinical and clinical positron emission tomography (RPC-PET). We show a large-area RPC-PET simulated scanner covering an axial length of 2.4m —slightly superior to the height of the human body— allowing for whole-body, single-bed RPC-PET acquisitions. Simulations following NEMA (National Electrical Manufacturers Association, USA) protocols yield a system sensitivity at least one order of magnitude larger than present-day, commercial PET systems. Reconstruction of whole-body simulated data is feasible by using a dedicated, direct time-of-flight-based algorithm implemented onto an ordered subsets estimation maximization parallelized strategy. Whole-body RPC-PET patient images following the injection of only 2mCi of 18-fluorodesoxyglucose (FDG) are expected to be ready 7 minutes after the 6 minutes necessary for data acquisition. This compares to the 10-20mCi FDG presently injected for a PET scan, and to the uncomfortable 20-30minutes necessary for its data acquisition. In the preclinical field, two fully instrumented detector heads have been assembled aiming at a four-head-based, small-animal RPC-PET system. Images of a disk-shaped and a needle-like 22Na source show unprecedented sub-millimeter spatial resolution.

  9. Utility of positron emission tomography in schwannomatosis.

    Lieber, Bryan; Han, ByoungJun; Allen, Jeffrey; Fatterpekar, Girish; Agarwal, Nitin; Kazemi, Noojan; Zagzag, David

    2016-08-01

    Schwannomatosis is characterized by multiple non-intradermal schwannomas with patients often presenting with a painful mass in their extremities. In this syndrome malignant transformation of schwannomas is rare in spite of their large size at presentation. Non-invasive measures of assessing the biological behavior of plexiform neurofibromas in neurofibromatosis type 1 such as positron emission tomography (PET), CT scanning and MRI are well characterized but little information has been published on the use of PET imaging in schwannomatosis. We report a unique clinical presentation portraying the use of PET imaging in schwannomatosis. A 27-year-old woman presented with multiple, rapidly growing, large and painful schwannomas confirmed to be related to a constitutional mutation in the SMARCB1 complex. Whole body PET/MRI revealed numerous PET-avid tumors suggestive of malignant peripheral nerve sheath tumors. Surgery was performed on multiple tumors and none of them had histologic evidence of malignant transformation. Overall, PET imaging may not be a reliable predictor of malignant transformation in schwannomatosis, tempering enthusiasm for surgical interventions for tumors not producing significant clinical signs or symptoms. PMID:26960263

  10. Physiologic signal detection in positron emission tomography

    Positron emission tomography enables the noninvasive quantification in vivo of three-dimensional radionuclide distributions throughout the human body. Estimation of neurotransmitter and receptor function is performed through the application of tracer kinetic models and non-linear multiple regression parameter estimation methods. These quantitative estimates are often limited by the interaction between imaging characteristics of the PET scanner and the three-dimensional radionuclide distribution within the organ of interest. In order to assess the potential of PET to detect subtle changes in the function of the central nervous system, a three-dimensional PET simulation procedure based upon a digital brain phantom and tomograph detector response functions has been performed. Radiopharmaceutical kinetics for individual structures of the brain phantom (cortex, white matter, basal ganglia, etc.) have been assigned based upon in vitro autoradiography of human postmortem tissue and animal biodistribution studies. The recovery of the PET signals which originate from anatomic structures of interest has been evaluated for studies of the benzodiazepine, muscarinic, opiate, and GABA systems of the human brain. Typical results and the limitations of signal detection in PET neurotransmitter and receptor studies are discussed

  11. Amorphous silicon detectors in positron emission tomography

    The physics of the detection process is studied and the performances of different Positron Emission Tomography (PET) system are evaluated by theoretical calculation and/or Monte Carlo Simulation (using the EGS code) in this paper, whose table of contents can be summarized as follows: a brief introduction to amorphous silicon detectors and some useful equation is presented; a Tantalum/Amorphous Silicon PET project is studied and the efficiency of the systems is studied by Monte Carlo Simulation; two similar CsI/Amorphous Silicon PET projects are presented and their efficiency and spatial resolution are studied by Monte Carlo Simulation, light yield and time characteristics of the scintillation light are discussed for different scintillators; some experimental result on light yield measurements are presented; a Xenon/Amorphous Silicon PET is presented, the physical mechanism of scintillation in Xenon is explained, a theoretical estimation of total light yield in Xenon and the resulting efficiency is discussed altogether with some consideration of the time resolution of the system; the amorphous silicon integrated electronics is presented, total noise and time resolution are evaluated in each of our applications; the merit parameters ε2τ's are evaluated and compared with other PET systems and conclusions are drawn; and a complete reference list for Xenon scintillation light physics and its applications is presented altogether with the listing of the developed simulation programs

  12. Myocardial energy metabolism by positron emission tomography

    Positron emission tomography (PET) permits quantitative measurement of myocardial blood flow and metabolism in vivo in the cardiovascular areas. F-18 fluorodeoxyglucose (FDG) and C-11 palmitate have been used for energy metabolism in the cardiac PET. In fasting condition, beta-oxydation of fatty acids is the major energy source in the normal myocardium, whereas glucose metabolism is enhanced in the ischemic myocardium. No metabolic substrate is used in the necrotic myocardium. Thus, quantitative measurement of substrate utilization enables differentiation of ischemic from normal or infarcted myocardium and precise assessment of tissue abnormalities in vivo. FDG is administrated in fasting condition in our institute in order to delineate ischemic myocardium as a hot spot with suppression of the FDG uptake in the normal myocardium. However, when compared to the postprandial condition, FDG uptake may be enhanced even in the infarcted tissue, and thus, may possibly overestimate the tissue viability. A certain quantification of FDG uptake may be warranted for an accurate evaluation of FDG uptake. We have been measured FDG uptake index as a fraction of injected dose (% dose/100g tissue). This index correlated well with myocardial metabolic rate of glucose by Phelps method in the fasting condition. Dynamic PET study after C-11 palmitate injection has been used for estimate of fatty acid utilization. The first component of the washout from the myocardium is considered as rate of beta-oxydation. However, the washout of this tracer seems to be strikingly different between the fasting and postprandial conditions. (J.P.N.)

  13. Patient radiation protection in positron emission tomography

    Patient radiation protection in Positron Emission Tomography (PET) is closely related to the correct execution of studies: proper scanner performance, and optimization of both image quality and patient dose. We describe the quality control tests considered as essential: scanner stability, spatial resolution, sensitivity and tomographic uniformity. Knowledge of the dose received by the critical organ and the effective dose for each radiopharmaceutical allows the establishment of strategies for dose optimization. Although a great variety of PET tracers exist, we review the dose produced by F-FDG, the most widely used tracer, and those used in our PET Center O-Water, N-Ammonia, C-Methionine, C-Choline, F-Choline, F-Dopa, and F-FHBG. Reduction of administered activity to the patient is the direct way to reduce the dose. Thus, PET acquisition in the 3D mode, with higher sensitivity, is a determining factor. In order to reduce the dose to different organs, efforts should be directed to the critical organs, mainly the urinary bladder wall. Finally, correct patient preparation improves, PET image quality, due to an optimum tracer uptake, which optimizes the dose to different organs. (Author) 25 refs

  14. Shielding design for positron emission tomography facility

    With the recent advent of readily available tracer isotopes, there has been marked increase in the number of hospital-based and free-standing positron emission tomography (PET) clinics. PET facilities employ relatively large activities of high-energy photon emitting isotopes, which can be dangerous to the health of humans and animals. This coupled with the current dose limits for radiation worker and members of the public can result in shielding requirements. This research contributes to the calculation of the appropriate shielding to keep the level of radiation within an acceptable recommended limit. Two different methods were used including measurements made at selected points of an operating PET facility and computer simulations by using Monte Carlo Transport Code. The measurements mainly concerned the radiation exposure at different points around facility using the survey meter detectors and Thermoluminescent Dosimeters (TLD). Then the set of manual calculation procedures were used to estimate the shielding requirements for a newly built PEF facility. The results from the measurement and the computer simulation were compared to the results obtained from the set manual calculation procedure. In general, the estimated weekly dose at the points of interest is lower than the regulatory limits for the little company of Mary Hospital. Furthermore, the density and the HVL for normal strength concrete and clay bricks are almost similar. In conclusion, PET facilities present somewhat different design requirements and are more likely to require additional radiation shielding. Therefore, existing shields at the little Company of Mary Hospital are in general found to be adequate and satisfactory and additional shielding was found necessary at the new PET facility in the department of Nuclear Medicine of the Dr. George Mukhari Hospital. By use of appropriate design, by implying specific shielding requirements and by maintaining good operating practices, radiation doses to

  15. Positron Emission Mammography with Multiple Angle Acquisition

    Positron emission mammography (PEM) of F-18 fluorodeoxyglucose (FDG) uptake in breast tumors with dedicated detectors typically has been accomplished with two planar detectors in a fixed position with the breast under compression. The potential use of PEM imaging at two detector positions to guide stereotactic breast biopsy has motivated us to use PEM coincidence data acquired at two or more detector positions together in a single image reconstruction. Multiple angle PEM acquisition and iterative image reconstruction were investigated using point source and compressed breast phantom acquisitions with 5, 9, 12 and 15 mm diameter spheres and a simulated tumor:background activity concentration ratio of 6:1. Image reconstruction was performed with an iterative MLEM algorithm that used coincidence events between any two detector pixels on opposed detector heads at each detector position. This present study compared two acquisition protocols: 2 angle acquisition with detector angular positions of -15 and +15 degrees and 11 angle acquisition with detector positions spaced at 3 degree increments over the range -15 to +15 degrees. Three- dimensional image resolution was assessed for the point source acquisitions, and contrast and signal-to-noise metrics were evaluated for the compressed breast phantom with different simulated tumor sizes. Radial and tangential resolutions were similar for the two protocols, while normal resolution was better for the 2 angle acquisition. Analysis is complicated by the asymmetric point spread functions. Signal- to-noise vs. contrast tradeoffs were better for 11 angle acquisition for the smallest visible 9 mm sphere, while tradeoff results were mixed for the larger and more easily visible 12 mm and 15 mm diameter spheres. Additional study is needed to better understand the performance of limited angle tomography for PEM. PEM tomography experiments with complete angular sampling are planned

  16. The introduction of positron emission tomography in Australia

    Positron Emission Tomography (PET) is a relatively new medical imaging modality based on images of the distribution of positron emitting radioisotopes in the human body. A PET scan can non-invasively provide quantitative information on the in vivo function performance of an organ, part thereof, or a bodily process. Two PET centres currently being established in Melbourne and in Sydney are introduced. 18 refs., 1 tab., 5 figs

  17. Human cerebral circulation. Positron emission tomography studies

    We reviewed the literature on human cerebral circulation and oxygen metabolism, as measured by positron emission tomography (PET), with respect to normal values and of regulation of cerebral circulation. A multicenter study in Japan showed that between-center variations in cerebral blood flow (CBF), cerebral blood volume (CBV), cerebral oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2) values were not considerably larger than the corresponding within-center variations. Overall mean±SD values in cerebral cortical regions of normal human subjects were as follows: CBF=44.4±6.5 ml/100 ml/min; CBV=3.8±0.7 ml/100 ml; OEF=0.44±0.06; CMRO2=3.3±0.5 ml/100 ml/min (11 PET centers, 70 subjects). Intrinsic regulation of cerebral circulation involves several factors. Autoregulation maintains CBF in response to changes in cerebral perfusion pressure; chemical factors such as PaCO2 affect cerebral vascular tone and alter CBF; changes in neural activity cause changes in cerebral energy metabolism and CBF; neurogenic control of CBF occurs by sympathetic innervation. Regional differences in vascular response to changes in PaCO2 have been reported, indicating regional differences in cerebral vascular tone. Relations between CBF and CBV during changes in PaCO2 and during changes in neural activity were in good agreement with Poiseuille's law. The mechanisms of vascular response to neural activation and deactivation were independent on those of responses to PaCO2 changes. CBV in a brain region is the sum of three components: arterial, capillary and venous blood volumes. It has been reported that the arterial blood volume fraction is approximately 30% in humans and that changes in human CBV during changes in PaCO2 are caused by changes in arterial blood volume without changes in venous blood volume. These findings should be considered in future studies of the pathophysiology of cerebrovascular diseases. (author) 136 refs

  18. Application of positron emission tomography in neurophysiology

    PET measures the distribution of positron-emitting radiotracers in the organs of living subjects, by means of the angular correlation of the gamma-rays originating from positron annihilation. The UBC/TRIUMF Program focusses the technique on measurements of brain physiology, and radio-labelled tracers have been developed for measurements of regional cerebral glucose metabolism, regional cerebral blood flow, regional synthesis of dopamine neurotransmitter, and regional density and kinetics of dopamine receptor sites. Data have been obtained on normal physiology, and deranged physiology in Alzheimer's disease, Huntington's disease, Parkinson's disease, and astrocytoma brain tumors undergoing pion radiation treatment

  19. Perspectives for positron emission tomography with RPCs

    Full text: The basis of PET (Positron Emission Tomography) consists on the administration of a radioactive isotope attached to a tracer that permits to reveal its molecular pathways in a human body. A 3-D Complete-Body-Scan is desired in order to minimize the radiation dose to the patient and to increase the sensitivity of the axial field of view (FOV). A major candidate for gamma pair detection in 3-D Complete- Body-Scan are the RPCs (Resistive Plate Counters). They consist in a longitudinal microstrip grid 1.5 mm thick, spaced at 1 mm. The grid is placed between a large electric resistive glass anode and an aluminum cathode. The gap, around 300 m, is filled with a special gas and is polarized at around 6 kV. Every microstrip is equipped with high-speed preamplifier at both ends, allowing time of flight measurements. The RPC are solely tracking devices enjoying a large density of detection units. By construction they are able to provide an extremely large transverse resolution, the collecting leads being some 2.5 mm spaced. The longitudinal resolution is less sensitive, depending on the speed of the time of flight electronics. At this moment we estimate a 20 mm resolution. The RPCs present two main features: large longitudinal dimension and large transversal resolution which made them ideal for complete-body-scan devices. These peculiar features are the keys of a RPCs tomographic device. The evaluation of RPCs for 3-D Complete-Body-Scan followed two steps, the simulation of data acquisition and the image reconstruction. We choose the detecting base unit like a RPC, 2 meters long and 0.5 meters wide. According to previous assumptions this plate has a transverse resolution of 256 detection units and a longitudinal resolution of 100. (The transversal step is around 2 mm and the longitudinal step about 20 mm). Several base units are assembled to form different detecting structures. Two plates form an open detection structure like a sandwich. Four and six plates are

  20. Positron emission tomography in colorectal cancer;Tomografia por emissao de positron no cancer colorretal

    Gabure, Jose Luiz de Carvalho; Bacega, Marcelle Francine [Universidade Cidade de Sao Paulo (UNICID), Sao Paulo, SP (Brazil); Racy, Douglas Jorge; Lima, Rodrigo Vaz de; Rigo, Leticia, E-mail: letirigo3@hotmail.co [Med Imagem Diagnosticos por Imagem, Sao Paulo, SP (Brazil)

    2009-12-15

    After an introduction on the physical and biological basics of positron emission tomography, this paper reviews the current status of PET imaging using the glucose analogue FDG in colorectal cancer. The use of PET-FDG is reviewed for detection, initial staging, therapy monitoring and staging of disease relapse. (author)

  1. Physical and technical basis of positron emission tomography (PET)

    Positron emission tomography utilizes the annihilation of positrons, generating pairs of gamma quanta which are emitted in opposing directions. 'Electronic collimation' is performed by coincident detection of both quanta. Thus, there is no need for mechanical collimators and no limiting connection between sensitivity and spatial resolution. Transversal tomograms are reconstructed from the projection data by means of highly sophisticated data processing. The half life of the most positron emitters used in medical applications is short and of the order of some minutes. Therefore, many positron emitters have to be produced on-side by means of a cyclotron. PET is superior to SPECT with respect to physical and technical aspects, but the high costs of PET limit its wide-spread use up to now. (orig.)

  2. Improved sampling in positron emission tomography

    The biomedical research performed with the Donner 280-Crystal Positron Tomograph requires data acquisition times of five seconds or less and the ability to gate the data acquisition for periods during the cardiac cycle when the heart is nearly at rest. These requirements pose severe restrictions on the amount of detector movement and have motivated the search for a scheme that improves lateral sampling with a minimum number of detector positions. A new approach, developed by our group, involves only two positions of the detector assembly and increases lateral sampling uniformly by a factor of two. This new approach is referred as clamshell sampling. To test clamshell sampling we performed Monte Carlo computer simulations of data acquisition with the new geometry. Hot spots of varying sizes and separation comprise the model used in a geometry scaled to test imaging the human head with the Donner 280-Crystal Positron Tomograph

  3. Liquid Xenon Detectors for Positron Emission Tomography

    Miceli, A.; Amaudruz, P.; Benard, F.; Bryman, D. A.; Kurchaninov, L.; Martin, J. P.; Muennich, A.; Retiere, F.; Ruth, T J.; Sossi, V.; A.J. Stoessl

    2011-01-01

    PET is a functional imaging technique based on detection of annihilation photons following beta decay producing positrons. In this paper, we present the concept of a new PET system for preclinical applications consisting of a ring of twelve time projection chambers filled with liquid xenon viewed by avalanche photodiodes. Simultaneous measurement of ionization charge and scintillation light leads to a significant improvement to spatial resolution, image quality, and sensitivity. Simulated per...

  4. Liquid Xenon Detectors for Positron Emission Tomography

    PET is a functional imaging technique based on detection of annihilation photons following beta decay producing positrons. In this paper, we present the concept of a new PET system for preclinical applications consisting of a ring of twelve time projection chambers filled with liquid xenon viewed by avalanche photodiodes. Simultaneous measurement of ionization charge and scintillation light leads to a significant improvement to spatial resolution, image quality, and sensitivity. Simulated performance shows that an energy resolution of < 10% (FWHM) and a sensitivity of 15% are achievable. First tests with a prototype TPC indicate position resolution < 1 mm (FWHM).

  5. Liquid Xenon Detectors for Positron Emission Tomography

    Miceli, A; Benard, F; Bryman, D A; Kurchaninov, L; Martin, J P; Muennich, A; Retiere, F; Ruth, T J; Sossi, V; Stoessl, A J

    2011-01-01

    PET is a functional imaging technique based on detection of annihilation photons following beta decay producing positrons. In this paper, we present the concept of a new PET system for preclinical applications consisting of a ring of twelve time projection chambers filled with liquid xenon viewed by avalanche photodiodes. Simultaneous measurement of ionization charge and scintillation light leads to a significant improvement to spatial resolution, image quality, and sensitivity. Simulated performance shows that an energy resolution of <10% (FWHM) and a sensitivity of 15% are achievable. First tests with a prototype TPC indicate position resolution <1 mm (FWHM).

  6. Positron-emission tomography and cerebral metabolism

    In addition to the fact that radio-isotopes allow iso-atom labelling, they are short-lived and consequently may be injected into humans without serious problems of radiation damage. They disintegrate by emitting positrons which can be detected by external counting by virtue of the two 511 keV gamma rays emitted at the same time in opposite directions. These properties are used for tomographic detection and permit quantitative measurements of the radio-activity method will be described. The first concerns the transport of amino-acids into the brain, the second, the metabolism of psychoactive drugs. (orig./VJ)

  7. MR imaging and positron emission tomography of cortical heterotopia

    Heterotopia of the gray matter is a developmental malformation in which ectopic cortex is found in the white matter of the brain. A case of a 33-year-old man with cortical heterotopia who had a lifelong history of seizures and psychomotor retardation is reported, including the results of cerebral CT, magnetic resonance imaging, and positron emission tomography using 18F-2-deoxyglucose

  8. Physiopathology of ischemic strokes: the input of positron emission tomography

    The tomography by positrons emissions has brought essential physiological and pathological knowledge relative to cerebral vascular accidents in the acute phase, because it is possible to measure the cerebral blood flow, the oxygen extraction rate and the local oxygen consumption. (N.C.)

  9. Advance of molecular imaging with positron emission tomography

    Molecular imaging with positron emission tomography (PET) is an important field of molecular imaging. This article summarizes the fundamental of PET molecular imaging technique and its application in protein function, gene expression and gene therapy, receptor imaging, and blood-flow infusion and metabolism imaging. (authors)

  10. Amyloid-β positron emission tomography imaging probes

    Kepe, Vladimir; Moghbel, Mateen C; Långström, Bengt;

    2013-01-01

    number of factors appear to preclude these probes from clinical utilization. As the available "amyloid specific" positron emission tomography imaging probes have failed to demonstrate diagnostic value and have shown limited utility for monitoring therapeutic interventions in humans, a debate on their...

  11. Skeletal muscle perfusion measured by positron emission tomography during exercise

    Ament, W; Lubbers, J; Rakhorst, G; Vaalburg, W; Verkerke, GJ; Paans, AMJ; Willemsen, ATM

    1998-01-01

    The applicability of (H2O)-O-15-positron emission tomographic (PET) imaging for the assessment of skeletal muscle perfusion during exercise was investigated in five healthy subjects performing intermittent isometric contractions on a calf ergometer. The workload of the left calf muscles was kept con

  12. Positron emission tomography/computerized tomography in lung cancer

    Sahiner, Ilgin; Vural, Gulin Ucmak

    2014-01-01

    Positron emission tomography (PET) using 2-(18F)-flouro-2-deoxy-D-glucose (FDG) has emerged as a useful tool in the clinical work-up of lung cancer. This review article provides an overview of applications of PET in diagnosis, staging, treatment response evaluation, radiotherapy planning, recurrence assessment and prognostication of lung cancer.

  13. 3D fast reconstruction in positron emission tomography

    The issue of long reconstruction times in positron emission tomography (PET) has been addressed from several points of view, resulting in an affordable dedicated system capable of handling routine 3D reconstructions in a few minutes per frame : on the hardware side using fast processors and a parallel architecture, and on the software side, using efficient implementation of computationally less intensive algorithms

  14. Positron emission particle tracking-Application and labelling techniques

    David J.Parker; Xianfeng Fan

    2008-01-01

    The positron emission particle tracking (PEPT) technique has been widely used in science and engineering to obtain detailed information on the motion and flow fields of fluids or granular materials in multiphase systems, for example, fluids in rock cracks, chemical reactors and food processors; dynamic behaviour of granular materials in chemical reactors, granulators, mixers, dryers, rotating kilns and ball mills. The information obtained by the PEPT technique can be used to optimise the design, operational conditions for a wide range of industrial process systems, and to evaluate modelling work. The technique is based on tracking radioactively labelled particles (up to three particles) by detecting the pairs of back-to-back 511 ke V -γ-rays arising from annihilation of emitted positrons. It therefore involves a positron camera, location algorithms for calculating the tracer location and speed, and tracer labelling techniques. This paper will review the particle tracking technique from tracking algorithm, tracer labelling to their application.

  15. Positron emission tomography: a new paradigm in cancer management

    The National Cancer Institute (NCI) is currently building a positron emission tomography facility that will house a cyclotron and a PET fusion scanner. lt should be operational as of december 2007, being a cancer dedicated national referral center, the NCI should provide both positron-emitting radiopharmaceuticals and medical services to institutions and patients nationwide. PET technology provides metabolic information that has been documented to be useful in patient care. The properties of positron decay allow accurate imaging of the in vivo distribution of positron-emitting radiopharmaceuticals. a wide array of positron-emitting radiopharmaceuticals has been used to characterize multiple physiologic and pathologic states. The major clinical PET applications are in cancer patients using fluorine-18 fluorodeoxyglucose (FDG). FDG, an analogue of glucose, accumulates in most tumors in a greater amount than it does in normal tissue. PET is being used in diagnosis and follow-up of several malignancies, and the list of articles supporting its use continues to grow. in this article, the instrumentation aspects of PET are described and most of the clinical applications in oncology are described

  16. Use of micro-positron emission tomography with 18F-fallypride to measure the levels of dopamine receptor-D2 and 18F-FDG as molecular imaging tracer in the pituitary glands and prolactinomas of Fischer-344 rats

    Li P

    2016-04-01

    Full Text Available Ping Li,1–3,* Songbai Gui,2,* Lei Cao,2 Hua Gao,1 Jiwei Bai,2 Chuzhong Li,1 Yazhuo Zhang1 1Beijing Neurosurgical Institute, 2Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 3Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Cerebral Vascular Disease Research Center, Anhui Medical University, Hefei, People’s Republic of China *These authors contributed equally to this work Abstract: Dopamine receptor-D2 (DRD2 is the most important drug target in prolactinoma. The aim of this current study was to investigate the role of using micro-positron emission tomography (micro-PET with 18F-fallypride and 18F-fluorodeoxyglucose (18F-FDG as molecular imaging tracer in the pituitary glands and prolactinomas of Fischer-344 (F344 rats and detect the difference of the levels of DRD2 in the pituitary glands and prolactinomas of F344 rat prolactinoma models. Female F344 rat prolactinoma models were established by subcutaneous administration of 15 mg 17β-estradiol for 8 weeks. The growth of tumors was monitored by the small-animal magnetic resonance imaging and micro-PET. A series of molecular biological experiments were also performed 4 and 6 weeks after pump implantation. The micro-PET molecular imaging with 18F-fallypride revealed a decreased expression of DRD2 in F344 rat prolactinoma models, but the micro-PET molecular imaging with 18F-FDG presented an increased uptake in the prolactinoma compared with the pituitary gland. A decreasing trend of levels of DRD2 in F344 rat prolactinoma models was also detected by molecular biological experiments. From this, we can conclude that micro-PET with 18F-fallypride and 18F-FDG can be used to assess tumorigenesis of the prolactinomas in vivo and molecular imaging detection of DRD2 level in prolactinoma may be an indication of treatment effect in the animal experiment. Keywords: pituitary prolactin, dopamine agonists, prolactinoma

  17. A novel clustering approach to positron emission particle tracking

    Wiggins, Cody; Santos, Roque; Ruggles, Arthur

    2016-03-01

    A novel approach to positron emission particle tracking is presented based on determining regions of space with high density of line of response crossing via clustering. The method is shown to be able to accurately track multiple particles in systems where the number of particles is unknown and in which particles can enter and leave the field of view of the scanning system. This method is explored in various environments and its parametric dependence is studied.

  18. Microfluidics for Positron Emission Tomography (PET) Imaging Probe Development

    Wang, Ming-Wei; Lin, Wei-Yu; Liu, Kan; Masterman-Smith, Michael; Shen, Clifton Kwang-Fu

    2010-01-01

    Due to increased needs for Positron Emission Tomography (PET) scanning, high demands for a wide variety of radiolabeled compounds will have to be met by exploiting novel radiochemistry and engineering technologies to improve the production and development of PET probes. The application of microfluidic reactors to perform radiosyntheses is currently attracting a great deal of interest because of their potential to deliver many advantages over conventional labeling systems. Microfluidic-based r...

  19. Positron emission tomography (PET) evaluation of abdominal aortic aneurysm (AAA)

    SakalihasanN, Natzi; Van Damme, Hendrik; Gomez, P.; RIGO, PIERRE; Lapiere, C. M.; Nusgens, Betty; Limet, Raymond

    2002-01-01

    Background: aneurysmal disease is associated with all inflammatory Cell infiltrate and enzymatic degradation of the vessel wall. Aim of the study: to detect increased metabolic activity in abdominal aortic aneurysms (AAA) by means of positron emission tomography (PET-imaging). Study design: twenty-six patients with AAA underwent PET-imaging Results: in tell patients, PET-imaging revealed increased, fluoro-deoxy-glucose (18-FDG) uptake at the level of the aneurysm. Patients with positive PET-i...

  20. A Case of Corticobasal Degeneration Studied with Positron Emission Tomography

    Nagasawa, H; T. Imamura; Nomura, H; Itoh, M; Ido, T.

    1993-01-01

    We measured cerebral blood flow, oxygen metabolism, glucose utilization, and dopamine metabolism in the brain of a patient with corticobasal degeneration using positron emission tomography (PET). The clinical picture is distinctive, comprising features referable to both cortical and basal ganglionic dysfunction. Brain imagings of glucose and dopamine metabolism can demonstrate greater abnormalities in the cerebral cortex and in the striatum contralateral to the more affected side than those o...

  1. Introducing Positron Emission Tomography (PET) in Clinical Practice

    Janevik-Ivanovska, Emilija; Avmedovski, Fatmir; Yamamoto, Mayumi; Bhonsle, Uday

    2009-01-01

    Positron emission tomography (PET) is a major diagnostic imaging technique predominantly used in determining the presence and severity of cancers, neurological conditions, and cardiovascular diseases. It is currently the most effective way to check for cancer recurrences and it offers significant advantages over other forms of imaging such as computed tomography (CT) or magnetic resonance imaging (MRI) scans in detecting disease in many patients. In the USA, an estimated 1 129 900 clinical PE...

  2. ENVISION, developing Positron Emission Tomography for particle therapy

    2013-01-01

    Particle therapy is an advanced technique of cancer radiation therapy, using protons or other ions to target the cancerous mass. ENVISION aims at developing medical imaging tools to improve the dose delivery to the patient, to ensure a safer and more effective treatment. The animation illustrates the use of Positron Emission Tomography (PET) for monitoring the dose during treatment. Produced by: CERN KT/Life Sciences and ENVISION Project Management: Manuela Cirilli 3D animation: Jeroen Huijben, Nymus3d

  3. Nonhuman Primate Positron Emission Tomography Neuroimaging in Drug Abuse Research

    Howell, Leonard Lee; Murnane, Kevin Sean

    2011-01-01

    Positron emission tomography (PET) neuroimaging in nonhuman primates has led to significant advances in our current understanding of the neurobiology and treatment of stimulant addiction in humans. PET neuroimaging has defined the in vivo biodistribution and pharmacokinetics of abused drugs and related these findings to the time course of behavioral effects associated with their addictive properties. With novel radiotracers and enhanced resolution, PET neuroimaging techniques have also charac...

  4. Positron emission holography: A new method of creating positron camera images

    By simulating the presence of a Fresnel zone plate in a camera designed for positron emission tomography (PET), a hologram can be synthesized which permits full three-dimensional images of the positron distribution in the original object to be rapidly constructed. The method requires no additional apparatus to a standard PET system, which is also operated in the usual way. The trajectory of each photon pair, detected in coincidence, is weighted as if it had passed through a zone plate optimised to suit the problem, before recording its intercept with a (single) plane to produce the hologram. The final image is created by calculating the diffraction pattern of monochromatic light passed through this hologram; it may also be created optically. The method is described in detail and its attractions discussed. Results are presented of some simple objects obtained from holograms produced from PET camera data, in comparison with images created by conventional back-projection processing of the same data. (orig.)

  5. Positron emission tomography and cerebral metabolism

    The association of new methods of labelling with short lived radioisotopes and of visualisation 'in vivo' of these labelled molecules by emission tomography, provide the possibility of studying brain metabolism at different levels. Two examples will illustrate the possibilities of this methodology. Cerebral metabolism of methionine-11C in phenylketonutic patients: The cerebral uptake of methionine was measured in 24 PKU children aged 1 to 40 months on a low protein diet. Ten of them were examined twice at intervals of several months. Stopping the diet for one week leads to an increase in blood phenylalanine and to a significant important decrease in brain uptake of labelled methionine. Futhermore, for children under treatment having a low phenylalanine blood concentration, brain uptake of methionine decreases with age between 1 and 40 months. These results suggest that the treatment of this disease should be started as soon as possible after birth. Cerebral metabolism of psychoactive drugs: The study of the brain distribution and kinetics of psychoactive drugs may help in understanding their mode of action. Chlorpromazine- 11C was administered i.v. to schyzophrenic patients not previously treated with neuroleptics. In all patients the brain uptake of the drug was high and rapid, and was localized mainly in the grey matter, probably in proportion to the blood flow. Non-specific binding of this drug to brain proteins prevented visualization of specific binding to dopaminergic or αnor-adrenergic receptors. Specific receptor binding of benzodiazepines was however visualized in the brain of baboons after injection of 11C-flunitrazepam (specific activity = 600 Ci/μmole) and subsequent displacement of this radioactive ligand by a pharmacological dose of Lorazepam

  6. Clinical cardiac positron emission tomography: State of the art

    Cardiac positron emission tomography (PET) has evolved rapidly from a relatively esoteric research tool into clinical applications providing unique, quantitative information on myocardial perfusion, metabolism, and cell membrane function and having a potentially significant impact on cardiovascular medicine. Although there are many different positron radionuclides for imaging diverse myocardial behavior, three radionuclides have reached accepted clinical utility. Cardiac PET using nitrogen-13-ammonia, rubidium-82, and fluoro-18-deoxyglucose has proved accurate and definitive in multiple university and private-practice sites for diagnosing and assessing severity and location of coronary artery disease in symptomatic or asymptomatic patients, for identifying injured but viable myocardium potentially salvageable by revascularization, and for ruling out clinically significant coronary artery stenosis with a high specificity in patients who might otherwise undergo coronary arteriography to document the absence of significant disease. 89 references

  7. Investigation of granular impact using positron emission particle tracking

    Marston, Jeremy O.

    2015-04-01

    We present results from an experimental study of granular impact using a combination of high-speed video and positron emission particle tracking (PEPT). The PEPT technique exploits the annihilation of photons from positron decay to determine the position of tracer particles either inside a small granular bed or attached to the object which impacts the bed. We use dense spheres as impactors and the granular beds are comprised of glass beads which are fluidised to achieve a range of different initial packing states. For the first time, we have simultaneously investigated both the trajectory of the sphere, the motion of particles in a 3-D granular bed and particles which jump into the resultant jet, which arises from the collapse of the cavity formed by the impacting sphere.

  8. Methods and clinical applications of positron emission tomography in endocrinology

    Positron emission tomography (PET) allows to detect in coincidence photons issued from annihilation between positrons and electrons nearby situated. Tomographic detection (plane by plane) and tomographic reconstruction will lead to the quantitation of radioactive distribution per voxel, in the organ of interest. Recent tomographs can acquire simultaneously several transaxial slices, with a high sensitivity and a spatial resolution of 3-5 mm. Commonly used positron emitters have a short half-life: 2, 10, 20 and 110 min for 150, 13N, 11C and 18F, respectively. The use of these isotopes requires on line production of radionuclides and synthesis of selected molecules. In endocrinology, PET allows among others to study noninvasively the receptor density of hormonodependent neoplasms such as breast, uterus, prostate tumors and prolactinomas. These last tumors represent a particular entity because of several combined characteristics: high turnover rate of amino acids, high density of dopaminergic receptors and response to bromocriptine (analogue of dopamine inhibiting the secretion of prolactine) in relation to the level of receptors. Because PET permits to evaluate the density of dopaminergic receptors and the metabolism of amino acids, theoretical response of the prolactinoma to bromocriptin can be predicted, the achieved therapeutic efficacy can be estimated and the long-term follow up of tumor growth can be assessed. This example illustrates the clinical value of PET in endocrinology

  9. The investigation of cerebrovascular disorders with positron emission tomography

    Positron emission tomography (PET) provides a non-invasive, regional, in vivo method to measure physiological parameters including cerebral blood flow, glucose and oxygen metabolism, blood volume, and pH. Measurement of these parameters not only enables a more complete understanding of the pathophysiology of acute cerebral ischemia and infarction, but provides objective criteria with which to better manage patients. This chapter will first discuss PET methodology and tracer techniques used in the investigation of patients with cerebrovascular disease and then describe the progress that has already resulted from applying these methods. 73 refs.; 7 figs

  10. Positron emission tomography: diagnostic imaging on a molecular level

    In human medicine positron emission tomography (PET) is a modern diagnostic imaging method. In the present paper we outline the physical principles of PET and give an overview over the main clinic fields where PET is being used, such as neurology, cardiology and oncology. Moreover, we present a current project in veterinary medicine (in collaboration with the Paul Scherrer Institute and the University Hospital Zurich), where a hypoxia tracer is applied to dogs and cats suffering from spontaneous tumors. Finally new developments in the field of PET were discussed

  11. Kinetic modeling in pre-clinical positron emission tomography

    Kuntner, Claudia [AIT Austrian Institute of Technology GmbH, Seibersdorf (Austria). Biomedical Systems, Health and Environment Dept.

    2014-07-01

    Pre-clinical positron emission tomography (PET) has evolved in the last few years from pure visualization of radiotracer uptake and distribution towards quantification of the physiological parameters. For reliable and reproducible quantification the kinetic modeling methods used to obtain relevant parameters of radiotracer tissue interaction are important. Here we present different kinetic modeling techniques with a focus on compartmental models including plasma input models and reference tissue input models. The experimental challenges of deriving the plasma input function in rodents and the effect of anesthesia are discussed. Finally, in vivo application of kinetic modeling in various areas of pre-clinical research is presented and compared to human data.

  12. Development of radioisotopically labeled compounds for clinical positron emission tomography

    It is its quantitative imaging capacity with high spatial resolution that makes positron emission tomography a unique tool for the development of quantitative tracer kinetic studies for the measurement of physiological processes in man. Research success in this area will depend on the ingenuity of biomedical scientists in prioritizing the development of tracers. Choices must be made based on the importance of different physiological measurements, the capacity to synthesize an appropriate radioisotopically labeled compound for this measurement and the ability to determine an adequate kinetic model for its interpretation. Examples are given of these steps in the development of PET tracers at the NIMH. 17 refs.; 1 table

  13. Design of a volume-imaging positron emission tomograph

    Progress is reported in several areas of design of a positron volume imaging tomograph. As a means of increasing the volume imaged and the detector packing fraction, a lens system of detector light coupling is considered. A prototype layered scintillator detector demonstrates improved spatial resolution due to a unique Compton rejection capability.The conceptual design of a new mechanism for measuring scattered radiation during emission scans has been tested by Monte Carlo simulation. The problem of how to use effectively the resulting sampled scattered radiation projections is presented and discussed

  14. Positron Emission Tomography Imaging of Regional Pulmonary Perfusion and Ventilation

    Musch, Guido; Venegas, Jose G.

    2005-01-01

    Positron emission tomography (PET) imaging is a noninvasive, quantitative method to assess pulmonary perfusion and ventilation in vivo. The core of this article focuses on the use of [13N]nitrogen (13N2) and PET to assess regional gas exchange. Regional perfusion and shunt can be measured with the 13N2–saline bolus infusion technique. A bolus of 13N2, dissolved in saline solution, is injected intravenously at the start of a brief apnea, while the tracer kinetics in the lung is measured by a s...

  15. Use of positron emission tomography in colorectal cancer

    The value of PET (Positron Emission Tomography) in colorectal cancer is presented. PET is a novel technique that uses F-18-FDG (fluorodeoxiglucose) to assess glucose metabolism by whole body imaging. It has been demonstrated that malignant cells have both increase of glucose uptake and utilization. In colorectal cancer, PET is indicated for staging, assess recurrence, liver metastasis and treatment follow-up. PET is more sensitive and specific than CT (Computed Tomography) and is cost effective. In 30% of cases PET may change patient management, avoiding unnecessary procedures (au)

  16. Imaging of brain activity by positron emission tomography

    Brain function is associated with regional energy metabolism and blood flow increase. Such brain activity is visualized by using external scintigraphy. Positron emission tomography (PET) is the currently available most superior technique, allowing three-dimensional imaging of subtle blood flow. In this article, imaging methods and application of PET are discussed in terms of the following items: (1) measurement of cerebral glucose consumption, (2) PET in persons with visual impairment, (3) association between brain function and regional cerebral blood flow, (4) measurement of cerebral blood flow, (5) method for decreasing noise in PET imaging, (6) anatomic standardization of PET images, and (7) speech load and regional cerebral activity images. (N.K.)

  17. Positron emission tomography. Present status and Romanian perspectives

    Basic principles of the positron emission tomography (PET) are summarised. The main PET methods using short-lived radioisotopes (i.e.11 C, 13 N, 15 O, 18 F) are briefly reviewed. Three types of particle accelerators for radioisotopes production and medical uses (including radiotherapy), corresponding to the proton energy (Ep p p < 200 MeV) are presented. PET imaging equipment and procedures are discussed. Main radiopharmaceuticals based on beta decay for PET studies and their role in medicine is also described. Finally, perspectives for a PET program in Romania (Cyclotron + Radiochemistry + Tomograph ) are discussed. (author)

  18. Application of positron emission tomography in industrial research

    Positron Emission computed Tomography (PET) is a relatively new imaging technique, exploiting the 511 keV annihilation radiation characteristic of positron emitters. Although exclusively used till now in the field of nuclear medicine, the application of PET for the non-invasive, in-situ visualisation of processes of industrial interest is challenging, because PET can in principle be used to obtain quantitative, 2D/3D images of the flow and distribution of fluids inside process units, whose steel walls may be up to several centimeters thick. With the aid of a NeuroECAT positron tomographer the PET technique has been utilised to image important (model) processes in the petrochemical industry, using physical labelling of the phase to be imaged. First, the displacement of a brine/surfactant phase, labelled with 66Ga-EDTA, in a piece of reservoir rock was imaged. Secondly, the dehydration of water-in-oil emulsions was monitored dynamically by labelling the water phase with 68Ga-EDTA. The second study in particular demonstrates that in the presence of noisy data the image reconstruction method utilised strongly influences the results obtained. With the advent of PET in nuclear medicine the availability of short-lived positron emitting nuclides like 11C (t1/2 = 20 min), 13N (t1/2 = 10 min) and 150 (t1/2 = 2 min) has increased considerably, allowing the investigation of industrially important reactions by chemical labelling. Utilising the NeuroECAT in a special mode, the catalytic oxidation of carbon monoxide could be imaged in a model tubular reactor by using 11C-labelled CO, providing information about the kinetics of the individual reaction steps and interactions and about the degree of occupation of catalytically active sites. (author)

  19. Positron emission tomography: physics, instrumentation, and image analysis.

    Porenta, G

    1994-01-01

    Positron emission tomography (PET) is a noninvasive diagnostic technique that permits reconstruction of cross-sectional images of the human body which depict the biodistribution of PET tracer substances. A large variety of physiological PET tracers, mostly based on isotopes of carbon, nitrogen, oxygen, and fluorine is available and allows the in vivo investigation of organ perfusion, metabolic pathways and biomolecular processes in normal and diseased states. PET cameras utilize the physical characteristics of positron decay to derive quantitative measurements of tracer concentrations, a capability that has so far been elusive for conventional SPECT (single photon emission computed tomography) imaging techniques. Due to the short half lives of most PET isotopes, an on-site cyclotron and a radiochemistry unit are necessary to provide an adequate supply of PET tracers. While operating a PET center in the past was a complex procedure restricted to few academic centers with ample resources, PET technology has rapidly advanced in recent years and has entered the commercial nuclear medicine market. To date, the availability of compact cyclotrons with remote computer control, automated synthesis units for PET radiochemistry, high-performance PET cameras, and user-friendly analysis workstations permits installation of a clinical PET center within most nuclear medicine facilities. This review provides simple descriptions of important aspects concerning physics, instrumentation, and image analysis in PET imaging which should be understood by medical personnel involved in the clinical operation of a PET imaging center. PMID:7941595

  20. Positron emission tomography: Physics, instrumentation, and image analysis

    Positron emission tomography (PET) is a noninvasive diagnostic technique that permits reconstruction of cross-sectional images of the human body which depict the biodistribution of PET tracer substances. A large variety of physiological PET tracers, mostly based on isotopes of carbon, nitrogen, oxygen, and fluorine is available and allows the in vivo investigation of organ perfusion, metabolic pathways and biomolecular processes in normal and diseased states. PET cameras utilize the physical characteristics of positron decay to derive quantitative measurements of tracer concentrations, a capability that has so far been elusive for conventional SPECT (single photon emission computed tomography) imaging techniques. Due to the short half lives of most PET isotopes, an on-site cyclotron and a radiochemistry unit are necessary to provide an adequate supply of PET tracers. While operating a PET center in the past was a complex procedure restricted to few academic centers with ample resources. PET technology has rapidly advanced in recent years and has entered the commercial nuclear medicine market. To date, the availability of compact cyclotrons with remote computer control, automated synthesis units for PET radiochemistry, high-performance PET cameras, and userfriendly analysis workstations permits installation of a clinical PET center within most nuclear medicine facilities. This review provides simple descriptions of important aspects concerning physics, instrumentation, and image analysis in PET imaging which should be understood by medical personnel involved in the clinical operation of a PET imaging center. (author)

  1. Basic principles of 18F-fluoro-deoxyglucose positron emission tomography

    Positron emission tomography uses photons to receive regional information about dynamic, physiologic, and biochemical processes in the living body. A positron decay is measured indirectly by the simultaneous registration of both gamma rays created by the annihilation. The event is counted, if two directly opposite located detectors register gamma rays in coincidence. Unfortunately the detectors of a positron emission tomography system do not register only true coincident events. There are also scattered and random coincidences. Different types of positron tomographs are presented and scintillation crystals, which are in use for positron emission tomography are discussed. The 2D- and 3D-acquisition methods are described as well as preprocessing methods, such as correction for attenuation, scatter and dead time. For quantification the relative parameter standard uptake value (SUV) is explained. Finally hybrid systems, such as combined positron emission tomography/computed tomography scanners and the use of computed tomography data for attenuation correction are introduced. (author)

  2. Mapping of brain function with positron emission tomography for pathophysiological analysis of neurological disorders

    Nariai, Tadashi [Tokyo Medical and Dental Univ. (Japan). Graduate School

    2001-02-01

    The role of PET is discussed mainly through author's clinical experience in patients with brain lesions from the view of mapping of brain function. Procedure for PET concept in clinical practice is summarized. PET using tracers like [{sup 15}O]water and [{sup 18}F]fluorodeoxyglucose for mapping of the function has been used in combination with MRI, MEG (magnetoencephalography), SPECT and other imaging means for morphological identification. Actual those images before and after surgery are presented in cases of epilepsy, moyamoya disease, stegnosis of cervical artery, arteriovenous malformation and oligodendroglioma. Images of [{sup 11}C]flumazenil in epilepsies are also presented to show the neurological dysfunctions. PET evaluation of neurological functions is concluded to become more important in parallel with the advancement of therapeutics. (K.H.)

  3. Mapping of brain function with positron emission tomography for pathophysiological analysis of neurological disorders

    The role of PET is discussed mainly through author's clinical experience in patients with brain lesions from the view of mapping of brain function. Procedure for PET concept in clinical practice is summarized. PET using tracers like [15O]water and [18F]fluorodeoxyglucose for mapping of the function has been used in combination with MRI, MEG (magnetoencephalography), SPECT and other imaging means for morphological identification. Actual those images before and after surgery are presented in cases of epilepsy, moyamoya disease, stegnosis of cervical artery, arteriovenous malformation and oligodendroglioma. Images of [11C]flumazenil in epilepsies are also presented to show the neurological dysfunctions. PET evaluation of neurological functions is concluded to become more important in parallel with the advancement of therapeutics. (K.H.)

  4. Simulation of the annihilation emission of galactic positrons; Modelisation de l'emission d'annihilation des positrons Galactiques

    Gillard, W

    2008-01-15

    Positrons annihilate in the central region of our Galaxy. This has been known since the detection of a strong emission line centered on an energy of 511 keV in the direction of the Galactic center. This gamma-ray line is emitted during the annihilation of positrons with electrons from the interstellar medium. The spectrometer SPI, onboard the INTEGRAL observatory, performed spatial and spectral analyses of the positron annihilation emission. This thesis presents a study of the Galactic positron annihilation emission based on models of the different interactions undergone by positrons in the interstellar medium. The models are relied on our present knowledge of the properties of the interstellar medium in the Galactic bulge, where most of the positrons annihilate, and of the physics of positrons (production, propagation and annihilation processes). In order to obtain constraints on the positrons sources and physical characteristics of the annihilation medium, we compared the results of the models to measurements provided by the SPI spectrometer. (author)

  5. A controlled study of positron-emission-tomography and positron-emission-tomography/computed tomography in differential diagnosis of solitary pulmonary nodules-report of 60 cases

    DING Qi-yong; HUA Yan-qing; ZHANG Guo-zhen; ZHAO Jun; GUAN Yi-hui; GE Xiao-jun; MAO Ding-biao; ZUO Chuan-tao

    2005-01-01

    @@ The differential diagnosis of solitary pulmonary nodules (SPNs) remains a challenge. It is acknowledged that combining positron-emission tomography (PET) and computed tomography (CT) offers the most reliable noninvasive method for the diagnosis of SPNs.

  6. 4.5 Tesla magnetic field reduces range of high-energy positrons -- Potential implications for positron emission tomography

    The authors have theoretically and experimentally investigated the extent to which homogeneous magnetic fields up to 7 Tesla reduce the spatial distance positrons travel before annihilation (positron range). Computer simulations of a noncoincident detector design using a Monte Carlo algorithm calculated the positron range as a function of positron energy and magnetic field strength. The simulation predicted improvements in resolution, defined as full-width at half-maximum (FWHM) of the line-spread function (LSF) for a magnetic field strength up to 7 Tesla: negligible for F-18, from 3.35 mm to 2.73 mm for Ga-68 and from 3.66 mm to 2.68 mm for Rb-82. Also a substantial noise suppression was observed, described by the full-width at tenth-maximum (FWTM) for higher positron energies. The experimental approach confirmed an improvement in resolution for Ga-68 from 3.54 mm at 0 Tesla to 2.99 mm FWHM at 4.5 Tesla and practically no improvement for F-18 (2.97 mm at 0 Tesla and 2.95 mm at 4.5 Tesla). It is concluded that the simulation model is appropriate and that a homogeneous static magnetic field of 4.5 Tesla reduces the range of high-energy positrons to an extent that may improve spatial resolution in positron emission tomography

  7. 77 FR 21783 - Guidance on Media Fills for Validation of Aseptic Preparations for Positron Emission Tomography...

    2012-04-11

    ... the same title was announced in the Federal Register on September 30, 2011 (76 FR 60847), and Docket... Preparations for Positron Emission Tomography Drugs; Availability AGENCY: Food and Drug Administration, HHS... guidance entitled ``Media Fills for Validation of Aseptic Preparations for Positron Emission...

  8. 77 FR 71802 - Guidance on Investigational New Drug Applications for Positron Emission Tomography Drugs...

    2012-12-04

    ... announced in the Federal Register on February 14, 2012 (77 FR 8262), and Docket No. FDA-2012-D- 0081 was... Positron Emission Tomography Drugs; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice... ``Investigational New Drug Applications for Positron Emission Tomography (PET) Drugs.'' The guidance is intended...

  9. Positron Emission Tomography (PET) and breast cancer in clinical practice

    Lavayssiere, Robert [Centre d' Imagerie Paris-Nord, 1, avenue Charles Peguy, 95200 Sarcelles (France); Institut du Sein Henri Hartmann (ISHH), 1, rue des Dames Augustines, 92200 Neuilly sur Seine (France)], E-mail: cab.lav@wanadoo.fr; Cabee, Anne-Elizabeth [Centre d' Imagerie Paris-Nord, 1, avenue Charles Peguy, 95200 Sarcelles (France); Institut du Sein Henri Hartmann (ISHH), 1, rue des Dames Augustines, 92200 Neuilly sur Seine (France); Centre RMX, 80, avenue Felix Faure, 75105 Paris (France); Filmont, Jean-Emmanuel [Institut du Sein Henri Hartmann (ISHH), 1, rue des Dames Augustines, 92200 Neuilly sur Seine (France); American Hospital of Paris, Nuclear Medicine, 63, boulevard Victor Hugo - BP 109, 92202 Neuilly sur Seine Cedex (France)

    2009-01-15

    The landscape of oncologic practice has changed deeply during the past few years and there is now a need, through a multidisciplinary approach, for imaging to provide accurate evaluation of morphology and function and to guide treatment (Image Guided Therapy). Increasing emphasis has been put on Position Emission Tomography (PET) role in various cancers among clinicians and patients despite a general context of healthcare expenditure limitation. Positron Emission Tomography has currently a limited role in breast cancer, but also general radiologists and specialists should be aware of these indications, especially when staging aggressive cancers and looking for recurrence. Currently, the hybrid systems associating PET and Computed Tomography (CT) and in the same device [Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology. Radiology 2004;231:305-32; Blodgett TM, Meltzer CM, Townsend DW. PET/CT: form and function. Radiology 2007;242:360-85; von Schulthess GK, Steinert HC, Hany TF. Integrated PET/CT: current applications and futures directions. Radiology 2006;238(2):405-22], or PET-CT, are more commonly used and the two techniques are adding their potentialities. Other techniques, MRI in particular, may also compete with PET in some instance and as far as ionizing radiations dose limitation is considered, some breast cancers becoming some form of a chronic disease. Breast cancer is a very complex, non-uniform, disease and molecular imaging at large may contribute to a better knowledge and to new drugs development. Ongoing research, Positron Emission Mammography (PEM) and new tracers, are likely to bring improvements in patient care [Kelloff GJ, Hoffman JM, Johnson B, et al. Progress and promise of FDG-PET Imaging for cancer patient management and oncologic drug development. Clin Cancer Res 2005;1(April (8)): 2005].

  10. Positron Emission Tomography (PET) and breast cancer in clinical practice

    The landscape of oncologic practice has changed deeply during the past few years and there is now a need, through a multidisciplinary approach, for imaging to provide accurate evaluation of morphology and function and to guide treatment (Image Guided Therapy). Increasing emphasis has been put on Position Emission Tomography (PET) role in various cancers among clinicians and patients despite a general context of healthcare expenditure limitation. Positron Emission Tomography has currently a limited role in breast cancer, but also general radiologists and specialists should be aware of these indications, especially when staging aggressive cancers and looking for recurrence. Currently, the hybrid systems associating PET and Computed Tomography (CT) and in the same device [Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology. Radiology 2004;231:305-32; Blodgett TM, Meltzer CM, Townsend DW. PET/CT: form and function. Radiology 2007;242:360-85; von Schulthess GK, Steinert HC, Hany TF. Integrated PET/CT: current applications and futures directions. Radiology 2006;238(2):405-22], or PET-CT, are more commonly used and the two techniques are adding their potentialities. Other techniques, MRI in particular, may also compete with PET in some instance and as far as ionizing radiations dose limitation is considered, some breast cancers becoming some form of a chronic disease. Breast cancer is a very complex, non-uniform, disease and molecular imaging at large may contribute to a better knowledge and to new drugs development. Ongoing research, Positron Emission Mammography (PEM) and new tracers, are likely to bring improvements in patient care [Kelloff GJ, Hoffman JM, Johnson B, et al. Progress and promise of FDG-PET Imaging for cancer patient management and oncologic drug development. Clin Cancer Res 2005;1(April (8)): 2005

  11. Functional images analysis and visualization in positron emission tomography

    Essentially new information on the metabolism and pathophysiology is available since the recent past using techniques combining the use of positron emitters labelling radiopharmaceuticals, models correctly describing the process studied and system for the in vivo external detection of transverse section of the body. This method is currently called Positron Emission Tomography (PET). At the Service Hospitalier Frederic Joliot of the C.E.A. Departement of Biology, a system was developed for data analysis and colour-coded representation as a tool for functional interpretation. Indeed, the tomographic images, i.e. the radioactive concentration in the transverse section is often but the first step of the study, the actual goal being the regional distribution of a metabolic or physiologic parameter, itself derived from the former distribution by assumption of a model. Such a quantification assumes an accurate analysis of the factors involved in the obtention of the functional image, and the development of the software actually adapted to the clinician's needs. Special attention was given to the representation of graphs and images as a man-machine interface, a tool for model fitting and output of final results in pseudo-color scales adapted to the studied parameter

  12. 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

  13. FDG positron emission computed tomography in a study of aphasia

    Positron emission computed tomography (PECT) using 18F-2-fluoro-2-deoxy-D-glucose (FDG) was used to investigate the correlations between clinical status, anatomy (as described by CT), and metabolism in five patients with stable aphasia resulting from ischemic cerebral infarction. Local cerebral metabolic activity was diminished in an area larger than the area of infarction demonstrated by CT. In one patient, FDG PECT revealed a metabolic lesion that probably caused the aphasic syndrome and was not apparent by CT. The data suggest that reliance on CT in delineating the extent of the brain lesion in aphasia or other neuropsychological defects can be misleading; FDG PECT may provide important additional information. Two patients with similar metabolic lesions had very different clinical syndromes, showing that even when currently available methods are combined, major gaps remain in clinicoanatomical correlations in aphasia

  14. Methodological review on functional neuroimaging using positron emission tomography

    Park, Hae Jeong [Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    2007-04-15

    Advance of neuroimaging technique has greatly influenced recent brain research field. Among various neuroimaging modalities, positron emission tomography has played a key role in molecular neuroimaging though functional MRI has taken over its role in the cognitive neuroscience. As the analysis technique for PET data is more sophisticated, the complexity of the method is more increasing. Despite the wide usage of the neuroimaging techniques, the assumption and limitation of procedures have not often been dealt with for the clinician and researchers, which might be critical for reliability and interpretation of the results. In the current paper, steps of voxel-based statistical analysis of PET including preprocessing, intensity normalization, spatial normalization, and partial volume correction will be revisited in terms of the principles and limitations. Additionally, new image analysis techniques such as surface-based PET analysis, correlational analysis and multimodal imaging by combining PET and DTI, PET and TMS or EEG will also be discussed.

  15. Studies of the brain cannabinoid system using positron emission tomography

    Studies using radiolabeled psychoactive drugs in conjunction with positron emission tomography (PET) have permitted the imaging of binding sites in the human brain. Similar studies of marijuana have been hampered by the unsuitability of radiolabeled THC for PET studies, and the current unavailability of other in vivo imaging agents for cannabinoid receptors. Recent developments in medicinal chemistry suggest that a PET radiotracer for cannabinoid receptors will soon become available. This chapter briefly reviews these developments, together with the results of PET studies of the effects of marijuana and other abused drugs on brain metabolism. It also reviews PET studies of cocaine binding sites, to demonstrate the kind of investigations that will be possible when a cannabinoid receptor PET radioligand becomes available

  16. Positron emission tomography with gamma camera in coincidence mode

    Positron emission tomography using F-18 FDG has been estbalished in clinical diagnostics with first indications especially in oncology. To install a conventional PET tomography (dedicated PET) is financially costly and restricted to PET examinations only. Increasing demand for PET diagnostics on one hand and restricted financial resources in the health system on the other hand led industry to develop SPECT cameras to be operated in coincidence mode (camera PET) in order to offer nuclear medicine physicians cost-effective devices for PET diagnostic. At the same time camera PET is inferior to conventional PET regarding sensitivity and detection-efficiency for 511 keV photons. Does camera-PET offer a reliable alternative to conventional PET? The first larger comparative studies are now available, so a first apraisal about the technical clinical performance of camera-PET can be done. (orig.)

  17. Studies of the brain cannabinoid system using positron emission tomography

    Gatley, S.J.; Volkow, N.D.

    1995-10-01

    Studies using radiolabeled psychoactive drugs in conjunction with positron emission tomography (PET) have permitted the imaging of binding sites in the human brain. Similar studies of marijuana have been hampered by the unsuitability of radiolabeled THC for PET studies, and the current unavailability of other in vivo imaging agents for cannabinoid receptors. Recent developments in medicinal chemistry suggest that a PET radiotracer for cannabinoid receptors will soon become available. This chapter briefly reviews these developments, together with the results of PET studies of the effects of marijuana and other abused drugs on brain metabolism. It also reviews PET studies of cocaine binding sites, to demonstrate the kind of investigations that will be possible when a cannabinoid receptor PET radioligand becomes available.

  18. Timing performance comparison of digital methods in positron emission tomography

    Accurate timing information is essential in positron emission tomography (PET). Recent improvements in high speed electronics made digital methods more attractive to find alternative solutions to create a time mark for an event. Two new digital methods (mean PMT pulse model, MPPM, and median filtered zero crossing method, MFZCM) were introduced in this work and compared to traditional methods such as digital leading edge (LE) and digital constant fraction discrimination (CFD). In addition, the performances of all four digital methods were compared to analog based LE and CFD. The time resolution values for MPPM and MFZCM were measured below 300 ps at 1.6 GS/s and above that was similar to the analog based coincidence timing results. In addition, the two digital methods were insensitive to the changes in threshold setting that might give some improvement in system dead time.

  19. Magnet development for the BRF positron emission tomography accelerator

    A collaboration involving the Biomedical Research Foundation, Science Applications International Corporation, Fermi National Accelerator Laboratory, and the University of Washington is developing an accelerator for producing isotopes for Positron Emission Tomography (PET) scans. The Medium Energy Beam Transport (MEBT) section of this accelerator takes a small beam from a first RFQ acceleration device and matches it into a small 3D-acceptance at a second RFQ section. The beam transport system was designed to prevent beam losses due to emittance growth. The system includes two bending dipoles and seven quadrupoles of three different types. This report contains a brief description of the MEBT magnets and their electric, magnetic and thermal properties. The magnet measurements show that each of the magnets meets the system requirements

  20. Knowledge-based automated radiopharmaceutical manufacturing for Positron Emission Tomography

    This article describes the application of basic knowledge engineering principles to the design of automated synthesis equipment for radiopharmaceuticals used in Positron Emission Tomography (PET). Before discussing knowledge programming, an overview of the development of automated radiopharmaceutical synthesis systems for PET will be presented. Since knowledge systems will rely on information obtained from machine transducers, a discussion of the uses of sensory feedback in today's automated systems follows. Next, the operation of these automated systems is contrasted to radiotracer production carried out by chemists, and the rationale for and basic concepts of knowledge-based programming are explained. Finally, a prototype knowledge-based system supporting automated radiopharmaceutical manufacturing of 18FDG at Brookhaven National Laboratory (BNL) is described using 1stClass, a commercially available PC-based expert system shell

  1. Non-oncological positron emission tomography (PET): brain imaging

    Positron emission tomography (PET) allows evaluation of the central nervous system function. Imaging of regional cerebral blood flow and metabolism, and of several neurotransmission systems may be obtained using PET. PET quantification is accurate and has good test-retest reliability. For research purposes, PET has been used to study brain physiology, to explore neurological and psychiatric diseases pathophysiology and for the new drugs research and development. F.D.G. is the only PET radioligand with clinical application. Following criteria of evidence-based medicine, the clinical indications of F.D.G.-PET are: evaluation of treated gliomas, pre surgical study of partial refractory epilepsy and diagnosis of Alzheimer's disease when it is impossible to differentiate clinically from fronto-temporal dementia

  2. Radiopharmaceuticals for positron emission tomography investigations of Alzheimer's disease

    Alzheimer's disease (AD) is a common degenerative neurological disease that is an increasing medical, economical, and social problem. There is evidence that a long ''asymptomatic'' phase of the disease exists where functional changes in the brain are present, but structural imaging for instance with magnetic resonance imaging remains normal. Positron emission tomography (PET) is one of the tools by which it is possible to explore changes in cerebral blood flow and metabolism and the functioning of different neurotransmitter systems. More recently, investigation of protein aggregations such as amyloid deposits or neurofibrillary tangles containing tau-protein has become possible. The purpose of this paper is to review the current knowledge on various 18F- and 11C-labelled PET tracers that could be used to study the pathophysiology of AD, to be used in the early or differential diagnosis or to be used in development of treatment and in monitoring of treatment effects. (orig.)

  3. Development of the LBNL positron emission mammography camera

    We present the construction status of the LBNL Positron Emission Mammography (PEM) camera, which utilizes a PET detector module with depth of interaction measurement consisting of 64 LSO crystals (3x3x30 mm3) coupled on one end to a single photomultiplier tube (PMT) and on the opposite end to a 64 pixel array of silicon photodiodes (PDs). The PMT provides an accurate timing pulse, the PDs identify the crystal of interaction, the sum provides a total energy signal, and the PD/(PD+PMT) ratio determines the depth of interaction. We have completed construction of all 42 PEM detector modules. All data acquisition electronics have been completed, fully tested and loaded onto the gantry. We have demonstrated that all functions of the custom IC work using the production rigid-flex boards and data acquisition system. Preliminary detector module characterization and coincidence data have been taken using the production system, including initial images

  4. Guideline for performance evaluation of positron emission tomographs

    This supplement presents guideline for performance evaluation of positron emission tomographies (PET). The purpose of this guideline is to define measurement methods for evaluating both the performance of PET equipment and the accuracy of various data corrections in the clinical setting. The guideline has 8 items. The first four items, consisting of spatial dose distributions, scattering fraction, sensitivity, and counting loss and accidental coincidence counting, deals with the basic performance of PET equipment. The next three items, including image uniformity, accuracy of absorption and scattering correction, and characteristics of high counting rate (accuracy of counting loss corrections and S/N ratio), are designed to provide the quantitative evaluation of images reconstructed by various data corrections for absorption, scattering, counting loss, and others. The last item is partial volume effect (recovery coefficient), which is important for the quantitative analysis of PET images, with the aim of both the measurement method of partial volume effect and the definition of phantoms required. (N.K.)

  5. Axial positrons emission tomography: from mouse to human brain imaging

    Positrons emission tomography is a nuclear imaging technics using nuclear decays. It is used both in clinical and preclinical studies. The later requires the use of small animals such as the mouse. The objective is to obtain the best signal with the best spatial resolution. Yet, a weight ratio between humans and mice indicates the need of a sub-millimeter resolution. A conventional scanner is based on detection modules surrounding the object to image and arranged perpendicularly. This implies a strong relationship between efficiency and spatial resolution. This work focuses on the axial geometry in which detection modules are arranged parallel to the object. This limits the relationship between the figures of merit, leading to both high spatial resolution and efficiency. The simulations of prototypes showed great perspectives in term of sub-millimeter resolution with efficiencies of 15 or 40% according to the scanner's axial extension. These results indicate great perspectives for both clinical and preclinical imaging. (author)

  6. Methodological review on functional neuroimaging using positron emission tomography

    Advance of neuroimaging technique has greatly influenced recent brain research field. Among various neuroimaging modalities, positron emission tomography has played a key role in molecular neuroimaging though functional MRI has taken over its role in the cognitive neuroscience. As the analysis technique for PET data is more sophisticated, the complexity of the method is more increasing. Despite the wide usage of the neuroimaging techniques, the assumption and limitation of procedures have not often been dealt with for the clinician and researchers, which might be critical for reliability and interpretation of the results. In the current paper, steps of voxel-based statistical analysis of PET including preprocessing, intensity normalization, spatial normalization, and partial volume correction will be revisited in terms of the principles and limitations. Additionally, new image analysis techniques such as surface-based PET analysis, correlational analysis and multimodal imaging by combining PET and DTI, PET and TMS or EEG will also be discussed

  7. Positron Emission Tomography in the Differential Diagnosis of Parkinsonism

    Juha O Rinne

    2009-10-01

    Full Text Available Positron emission tomography (PET studies on presynaptic dopaminergic function can reveal hypofunction in early Parkinson’s disease (PD which may help in the early diagnosis especially in patients with mild symptoms. This hypofunction can be detected with fluorodopa (reflecting mainly aromatic amino acid decarboxylase activity of nigrostriatal terminals or dopamine transporter ligands. These studies can also help to distinguish PD from essential tremor. However, investigations of presynaptic dopaminergic function are not useful in the differential diagnosis of parkinsonian syndromes. PET ligands, such as fluorodeoxyglucose (reflecting glucose metabolism and dopamine receptor ligands, reflecting striatal neuronal function are better in this respect. Cardiac sympathetic function studies represent a new and interesting approach to improve differential diagnosis of parkinsonian syndromes but more studies are needed in larger patient populations with longer follow-up to evaluate the usefulness of these investigations. Multitracer approach combining ligands reflecting different aspects of dopaminergic neurotransmission and other physiological function will increase differential diagnostic accuracy.

  8. Differential diagnosis of depression: relevance of positron emission tomography

    The proper differential diagnosis of depression is important. A large body of research supports the division of depressive illness into bipolar and unipolar subtypes with respect to demographics, genetics, treatment response, and neurochemical mechanisms. Optimal treatment is different for unipolar and bipolar depressions. Treating a patient with bipolar depression as one would a unipolar patient may precipitate a serious manic episode or possibly even permanent rapid cycling disorder. The clinical distinction between these disorders, while sometimes difficult, can often be achieved through an increased diagnostic suspicion concerning a personal or family history of mania. Positron emission tomography and the FDG method, which allow in vivo study of the glucose metabolic rates for discrete cerebral structures, provide new evidence that bipolar and unipolar depression are two different disorders

  9. Investigation of language lateralization mechanism by Positron Emission Tomography

    As language lateralization in the brain left hemisphere is one of the most well known but less understood characteristics of the human brain, this research thesis reports the use of brain functional imaging to address some specific aspects of this lateralization. In a first part, the author reports the study of mechanisms of recovery from aphasia after a left hemisphere lesion within a population of aphasic right-handers. Based on a contrast between patients with a persistent aphasia despite usual language therapies, and patients with a significant recovery after a melodic and rhythmic therapy (TMR), a PET-based (positron emission tomography) activation study has been developed, based on the opposition between usual language stimuli and stimuli accentuated by TMR. In the second part, the author explored more systematically on sane patients the influence of some physical characteristics of auditory stimulation on the induced functional asymmetry

  10. Positron Emission Tomography: state of the art and future developments

    Pizzichemi, M.

    2016-08-01

    Positron emission tomography (PET) plays a fundamental role in medical imaging, with a wide range of applications covering, among the others, oncology, neurology and cardiology. PET has undergone a steady technological evolution since its introduction in mid 20th century, from the development of 3D PET in the late 1980s, to the invention of PET/CT in the 1990s and more recently with the introduction of PET/MR scanners. The current research topics aiming to develop the next generation of PET scanners are summarized in this paper, focusing on the efforts to increase the sensitivity of the detectors, as long as improving their timing, spatial and energy resolutions, with the final goal of reducing the amount of radioactive dose received by the patients and the duration of the exams while improving at the same time the detectability of lesions.

  11. Calculation of Positron Distribution in the Presence of a Uniform Magnetic Field for the Improvement of Positron Emission Tomography (PET) Imaging Using GEANT4 Toolkit

    Mohsen Mashayekhi; Ali Asghar Mowlavi

    2015-01-01

    Introduction Range and diffusion of positron-emitting radiopharmaceuticals are important parameters for image resolution in positron emission tomography (PET). In this study, GEANT4 toolkit was applied to study positron diffusion in soft tissues with and without a magnetic field for six commonly used isotopes in PET imaging including 11C, 13N, 15O, 18F, 68Ga, and 82Rb. Materials and Methods GEANT4 toolkit was used to simulate the transport and interactions of positrons. Calculations ...

  12. Scintillation crystals for positron emission tomography having a non reflecting band

    This invention relates generally to positron emission tomography, a sub-field of the class of medical imaging techniques using ionizing radiation and image reconstruction techniques; and more particularly to devices which use an array of scintillation detectors to detect the annihilation radiation from positron disintegration and use this information to reconstruct an image of the distribution of positron emitting isotope within a body section. 6 figs

  13. Spatial registration of echocardiographic and positron emission tomographic heart studies

    A method has been developed to match corresponding heart regions from functional echocardiographic (Echo) and metabolic fluorine-18-fluoro-2-deoxy-D-glucose ([18F]FDG) positron emission tomography (PET) studies in individual patients. Echo and PET images are spatially correlated by determining homologous anatomical landmarks (the two papillary muscles and the inferior junction of the right ventricle), identifiable in images obtained by both acquisition modalities. Echo-PET image registration is first performed in the plane identified by the three landmarks, using a rigid rotate-translate scale model. The registration parameters are then used to transform the whole PET volume. This allows a consistent Echo-PET regional analysis, according to a segmental subdivision of the heart. The technique was tested on patients. The overlay of Echo and PET registered images proved the reliability of realignment of the three markers and a good spatial correlation of myocardial walls. This approach to image registration could be applied to other acquisition modalities (such as magnetic resonance imaging and single-photon emission tomography), provided that the three anatomical landmarks are visualized. (orig.)

  14. Dynamic Positron Emission Tomography Imaging of Renal Clearable Gold Nanoparticles.

    Chen, Feng; Goel, Shreya; Hernandez, Reinier; Graves, Stephen A; Shi, Sixiang; Nickles, Robert J; Cai, Weibo

    2016-05-01

    Optical imaging has been the primary imaging modality for nearly all of the renal clearable nanoparticles since 2007. Due to the tissue depth penetration limitation, providing accurate organ kinetics non-invasively has long been a huge challenge. Although a more quantitative imaging technique has been developed by labeling nanoparticles with single-photon emission computed tomography (SPECT) isotopes, the low temporal resolution of SPECT still limits its potential for visualizing the rapid dynamic process of renal clearable nanoparticles in vivo. The dynamic positron emission tomography (PET) imaging of renal clearable gold (Au) nanoparticles by labeling them with copper-64 ((64) Cu) to form (64) Cu-NOTA-Au-GSH is reported. Systematic nanoparticle synthesis and characterizations are performed to demonstrate the efficient renal clearance of as-prepared nanoparticles. A rapid renal clearance of (64) Cu-NOTA-Au-GSH is observed (>75%ID at 24 h post-injection) with its elimination half-life calculated to be less than 6 min, over 130 times shorter than previously reported similar nanoparticles. Dynamic PET imaging not only addresses the current challenges in accurately and non-invasively acquiring the organ kinetics, but also potentially provides a highly useful tool for studying renal clearance mechanism of other ultra-small nanoparticles, as well as the diagnosis of kidney diseases in the near future. PMID:27062146

  15. Correlated electron-positron emission in heavy-ion collisions

    A group of narrow electron-positron sum-energy lines with similar mean energies around 610, 750 and 810 keV has been observed with the EPOS spectrometer in both collision systems 238U + 232Th and 238U + 181Ta studied so far at the UNILAC heavy ion accelerator of GSI, Darmstadt. The intensities of the three lines vary with the beam-energy, the variation being most clearly observed for the 748-keV line in 238U + 181Ta. On the basis of our present understanding Internal Pair Conversion in a collision product at rest or in flight as well as coincident lepton emission during the quasiatomic phase of the collision can be excluded as the origin. The very narrow widths of the sum-energy lines as compared to the widths of the associated broad structure in the difference spectrum of the lepton energies seem to argue for a mutual cancellation of kinematical shifts. Such correlation is expected for two leptons emitted back-to-back in a two-body decay of objects being at rest in the heavy-ion c.m. frame. This speculative hypothesis is confronted with the actual dependence of the lines on the individual lepton energy and the lepton emission angle, as well as on the opening angle of the pair. In fact, the back-to-back decay could not be proved to be a general feature of these lines. (orig.)

  16. Development of radiotracers for imaging NR2B subtype NMDA receptors with positron emission tomography

    The aim of this thesis was to develop new radioactive tracers for imaging NR2B subtype NMDA receptors with positron emission tomography. Several compounds including 4-(4-fluoro-benzyl)piperidine and presenting interesting in vivo biological properties were the object of a labelling with a positrons emitter atom (11C or 18F)

  17. Utilisation of spatial and temporal correlations in positron emission tomography

    In this thesis we propose, implement, and evaluate algorithms improving spatial resolution in reconstructed images and reducing data noise in positron emission tomography imaging. These algorithms have been developed for a high resolution tomograph (HRRT) and applied to brain imaging, but can be used for other tomographs or studies. We first developed an iterative reconstruction algorithm including a stationary and isotropic model of resolution in image space, experimentally measured. We evaluated the impact of such a model of resolution in Monte-Carlo simulations, physical phantom experiments and in two clinical studies by comparing our algorithm with a reference reconstruction algorithm. This study suggests that biases due to partial volume effects are reduced, in particular in the clinical studies. Better spatial and temporal correlations are also found at the voxel level. However, other methods should be developed to further reduce data noise. We then proposed a maximum a posteriori de-noising algorithm that can be used for dynamic data to de-noise temporally raw data (sino-grams) or reconstructed images. The a priori modeled the coefficients in a wavelet basis of all the signals without noise (in an image or sinogram). We compared this technique with a reference de-noising method on replicated simulations. This illustrates the potential benefits of our approach of sinogram de-noising. (author)

  18. Positron Emission Tomography with Three-Dimensional Reconstruction

    The development of two different low-cost scanners for positron emission tomography (PET) based on 3D acquisition are presented. The first scanner consists of two rotating scintillation cameras, and produces quantitative images, which have shown to be clinically useful. The second one is a system with two opposed sets of detectors, based on the limited angle tomography principle, dedicated for mammographic studies. The development of low-cost PET scanners can increase the clinical impact of PET, which is an expensive modality, only available at a few centres world-wide and mainly used as a research tool. A 3D reconstruction method was developed that utilizes all the available data. The size of the data-sets is considerably reduced, using the single-slice rebinning approximation. The 3D reconstruction is divided into 1D axial deconvolution and 2D transaxial reconstruction, which makes it relatively fast. This method was developed for the rotating scanner, but was also implemented for multi-ring scanners with and without inter plane septa. An iterative 3D reconstruction method was developed for the limited angle scanner, based on the new concept of 'mobile pixels', which reduces the finite pixel errors and leads to an improved signal to noise ratio. 100 refs

  19. Characterization of time resolved photodetector systems for Positron Emission Tomography

    Powolny, François

    The main topic of this work is the study of detector systems composed of a scintillator, a photodetector and readout electronics, for Positron Emission Tomography (PET). In particular, the timing properties of such detector systems are studied. The first idea is to take advantage of the good timing properties of the NINO chip, which is a fast preamplifier-discriminator developed for the ALICE Time of flight detector at CERN. This chip uses a time over threshold technique that is to be applied for the first time in medical imaging applications. A unique feature of this technique is that it delivers both timing and energy information with a single digital pulse, the time stamp with the rising edge and the energy from the pulse width. This entails substantial simplification of the entire readout architecture of a tomograph. The scintillator chosen in the detector system is LSO. Crystals of 2x2x10mm3 were used. For the photodetector, APDs were first used, and were then replaced by SiPMs to make use of their highe...

  20. Silicon as an unconventional detector in positron emission tomography

    Clinthorne, Neal; Brzezinski, Karol; Chesi, Enrico; Cochran, Eric; Grkovski, Milan; Grošičar, Borut; Honscheid, Klaus; Huh, Sam; Kagan, Harris; Lacasta, Carlos; Linhart, Vladimir; Mikuž, Marko; Smith, D. Shane; Stankova, Vera; Studen, Andrej; Weilhammer, Peter; Žontar, Dejan

    2013-01-01

    Positron emission tomography (PET) is a widely used technique in medical imaging and in studying small animal models of human disease. In the conventional approach, the 511 keV annihilation photons emitted from a patient or small animal are detected by a ring of scintillators such as LYSO read out by arrays of photodetectors. Although this has been successful in achieving ˜5 mm FWHM spatial resolution in human studies and ˜1 mm resolution in dedicated small animal instruments, there is interest in significantly improving these figures. Silicon, although its stopping power is modest for 511 keV photons, offers a number of potential advantages over more conventional approaches including the potential for high intrinsic spatial resolution in 3D. To evaluate silicon in a variety of PET "magnifying glass" configurations, an instrument was constructed that consists of an outer partial-ring of PET scintillation detectors into which various arrangements of silicon detectors are inserted to emulate dual-ring or imaging probe geometries. Measurements using the test instrument demonstrated the capability of clearly resolving point sources of 22Na having a 1.5 mm center-to-center spacing as well as the 1.2 mm rods of a 18F-filled resolution phantom. Although many challenges remain, silicon has potential to become the PET detector of choice when spatial resolution is the primary consideration.

  1. The natural history of misery perfusion in positron emission tomography

    This report reviews the natural courses of misery perfusion in 5 patients with atherosclerotic cerebrovascular occlusion diseases. Cases 1 showed partial improvement and Case 2 showed deterioration of misery perfusion on positron emission tomography (PET). These 2 patients did not show any clinical changes during the follow-up periods. Case 3 showed remarkable improvement of misery perfusion during the 2-year follow-ups, but his neurological condition worsened. The EC-IC bypass improved both in PET and clinical symptoms. Case 4 had a stroke at the region of misery perfusion in PET. Case 5 had a lacunar infarction 2 years after the EC-IC bypass on the opposite side. PET taken one month before the stroke did not show any signs of hypoperfusion in the area of the lacunar infarction. Misery perfusion seems not to be a static but a dynamic condition that can develop into cerebral infarction by some hemodynamic stresses. Cerebral cortical or lobar infarction may occur in the region of severe misery perfusion. EC-IC bypass may prevent impending infarction of the cerebral cortex by improving the regional cerebral blood flow. However, EC-CI bypass will not prevent the lacunar infarction of the basal ganglia or internal capsule. (author)

  2. European health telematics networks for positron emission tomography

    A pilot network of positron emission tomography centers across Europe has been setup employing telemedicine services. The primary aim is to bring all PET centers in Europe (and beyond) closer, by integrating advanced medical imaging technology and health telematics networks applications into a single, easy to operate health telematics platform, which allows secure transmission of medical data via a variety of telecommunications channels and fosters the cooperation between professionals in the field. The platform runs on PCs with Windows 2000/XP and incorporates advanced techniques for image visualization, analysis and fusion. The communication between two connected workstations is based on a TCP/IP connection secured by secure socket layers and virtual private network or jabber protocols. A teleconsultation can be online (with both physicians physically present) or offline (via transmission of messages which contain image data and other information). An interface sharing protocol enables online teleconsultations even over low bandwidth connections. This initiative promotes the cooperation and improved communication between nuclear medicine professionals, offering options for second opinion and training. It permits physicians to remotely consult patient data, even if they are away from the physical examination site

  3. Clinical application of positron emission tomography imaging in urologic tumors

    Positron emission tomography (PET) is an advanced noninvasive molecular imaging modality that is being investigated for use in the differentiation, diagnosis, and guiding therapy ora variety of cancer types. FDG PET has the unique clinical value in the differentiation, diagnosis, and monitoring therapy of prostate, such as bladder, renal, and testicle cancer. However, high false-positive and false-negative findings are observed in the detection of these tumors with FDG PET. 11C-Choline (CH) and 11C-acetate (AC) can overcome the pitfall of FDG, and appear to be more successful than FGD in imaging prostate cancer and bladder cancer. The short half-life of 11C prevents the widespread use of CH and AC and 18F-fluorocholine (FCH) and 18F-fluoroacetate (FAC) seem to be potential tracers. Potential clinical value of the new PET tracers, such as 3'-deoxy-3'-18F-fluorothymidine (FLT), 18F-fluorodihydrotestosterone (FDHT), and 9-(4-18F-3-hydroxymethylbutyl)-guanine(18F-FHBG) in the detection of urologic tumors, can deserve further study. (authors)

  4. Diagnosis of intrahepatic cholangiocarcinoma with positron emission tomography

    Diagnosis of intrahepatic cholangiocarcinoma (IC) by positron emission tomography (PET) has been scarcely reported and this paper reviews authors' experience of PET diagnosis of IC with [18F]deoxy-glucose (FDG). Subjects are 20 cases with IC who received FDG-PET diagnosis for evaluating the disease progression and 16 cases with suspicious recurrent IC. PET was done with Advance NXi machine (GE Medical System) 60 min after intravenous 200-250 MBq of FDG. Compared were images by PET and CT. For the IC, diagnostic sensitivities by CT and PET were found to be 95-100% and for metastatic lymph nodes, the sensitivity, specificity and overall accuracy of PET were 38, 100 and 74%, respectively, whereas those of CT, 75, 73 and 74%. For recurrence, those of PET were 77, 67 and 75%. In conclusion, PET images have a compensatory role for CT images, especially for lymphatic metastasis with higher specificity and for recurrence with higher overall accuracy. (R.T.)

  5. Predicting count loss in modern positron-emission tomography systems

    The purpose of the data-acquisition electronics for any positron-emission tomography (PET) system is to detect and digitally encode annihilation events as they occur. Individual elements of the electronics are placed in parallel or cascade to organize the event information for subsequent processing. Each element is parameterized with a count loss L which is the fraction of events lost due to dead time (encoding delays, etc.) or data overflow in queueing circuits. This is an important parameter because the sensitivity of the tomograph in proportional to (1-L). The authors have categorized processing elements according to five device types. For each type, they find an expression for count loss. Some mathematical models that have appeared in the literature are applicable. These are extended here to include other devices, such as bank encoders and time-to-digital converters (TDC), with coincidence time resolving circuitry. Because some PET systems will have devices that do not fall into these categories, the authors show the derivations of the loss expressions so that one could easily extend their models with parallel derivations for other device types. In addition to PET systems, one should also be able to apply their results to other types of instruments which count random events. Although they concentrate mainly on count loss, they also briefly discuss the evaluation of other metrics of counting efficiency, which are the fraction of miscoded events and the fraction of ''random coincidence'' events

  6. European health telematics networks for positron emission tomography

    Kontaxakis, George [Universidad Politecnica de Madrid, ETSI Telecomunicacion, Madrid 28040 (Spain)]. E-mail: g.kontaxakis@upm.es; Pozo, Miguel Angel [Centro PET Complutense, Madrid 28040 (Spain); Universidad Complutense de Madrid, Instituto Pluridisciplinar, Madrid 28040 (Spain); Ohl, Roland [MedCom Gesellschaft fuer medizinische Bildverarbeitung mbH, Darmstadt 64283 (Germany); Visvikis, Dimitris [U650 INSERM, Lab. du Traitement de L' Information Medicale, University of Brest Occidentale, CHU Morvan, Brest 29609 (France); Sachpazidis, Ilias [Fraunhofer Institute for Computer Graphics, Darmstadt 64283 (Germany); Ortega, Fernando [Fundacion Instituto Valenciano de Oncologia, Valencia 46009 (Spain); Guerra, Pedro [Universidad Politecnica de Madrid, ETSI Telecomunicacion, Madrid 28040 (Spain); Cheze-Le Rest, Catherine [Dept. Medicine Nucleaire, CHU Morvan, Brest 29609 (France); Selby, Peter [MedCom Gesellschaft fuer medizinische Bildverarbeitung mbH, Darmstadt 64283 (Germany); Pan, Leyun [German Cancer Research Centre, Clinical Cooperation Unit Nuclear Medicine, Heidelberg 69120 (Germany); Diaz, Javier [Fundacion Instituto Valenciano de Oncologia, Valencia 46009 (Spain); Dimitrakopoulou-Strauss, Antonia [German Cancer Research Centre, Clinical Cooperation Unit Nuclear Medicine, Heidelberg 69120 (Germany); Santos, Andres [Universidad Politecnica de Madrid, ETSI Telecomunicacion, Madrid 28040 (Spain); Strauss, Ludwig [German Cancer Research Centre, Clinical Cooperation Unit Nuclear Medicine, Heidelberg 69120 (Germany); Sakas, Georgios [MedCom Gesellschaft fuer medizinische Bildverarbeitung mbH, Darmstadt 64283 (Germany); Fraunhofer Institute for Computer Graphics, Darmstadt 64283 (Germany)

    2006-12-20

    A pilot network of positron emission tomography centers across Europe has been setup employing telemedicine services. The primary aim is to bring all PET centers in Europe (and beyond) closer, by integrating advanced medical imaging technology and health telematics networks applications into a single, easy to operate health telematics platform, which allows secure transmission of medical data via a variety of telecommunications channels and fosters the cooperation between professionals in the field. The platform runs on PCs with Windows 2000/XP and incorporates advanced techniques for image visualization, analysis and fusion. The communication between two connected workstations is based on a TCP/IP connection secured by secure socket layers and virtual private network or jabber protocols. A teleconsultation can be online (with both physicians physically present) or offline (via transmission of messages which contain image data and other information). An interface sharing protocol enables online teleconsultations even over low bandwidth connections. This initiative promotes the cooperation and improved communication between nuclear medicine professionals, offering options for second opinion and training. It permits physicians to remotely consult patient data, even if they are away from the physical examination site.

  7. Positron emission tomography scans on kanji and kana

    We reanalyzed our positron emission tomography (PET) study on reading of Japanese kanji (morphogram) words, kana (phonogram) words and kana nonwords, using Statistical Parametric Mapping (SPM). The basal occipital and occipito-temporal areas were activated in common, among which activity was most pronounced in the fusiform/inferior temporal gyri with kanji and in the inferior occipital gyrus with kana. The results were consistent with the clinical observations that damage to the posterior inferior temporal cortex including the fusiform/inferior temporal gyri causes alexia with agraphia for kanji, whereas damage to the posterior occipital area including the inferior occipital gyrus causes pure alexia for kana. Bases on the present results and the lesion studies, a dual-route hypothesis that modifies Iwata's model of reading about the Japanese language was proposed. That is, the middle occipital gyrus, deep perisylvian temporoparietal cortex and posterior temporal gyrus constitute a dorsal route for reading and process phonology for words, whereas the inferior occipital, fusiform and posterior inferior temporal gyri constitute a ventral route for reading and process orthography and lexico-semantics for words. The ventral route may gain dominance in reading, according as a word is repeatedly presented. (author)

  8. Characterization of nontransmural myocardial infarction by positron-emission tomography

    The present study was performed to determine whether positron emission tomography (PET) performed after i.v. 11C-palmitate permits detection and characterization of nontransmural myocardial infarction. PET was performed after the i.v. injection of 11C-palmitate in 10 normal subjects, 24 patients with initial nontransmural myocardial infarction (defined electrocardiographically), and 22 patients with transmural infarction. Depressed accumulation of 11C-palmitate was detected with sagittal, coronal and transverse reconstructions, and quantified based on 14 contiguous transaxial reconstructions. Defects with homogeneously intense depression of accumulation of tracer were detected in all 22 patients with transmural infarction (100%). Abnormalities of the distribution of 11C-palmitate in the myocardium were detected in 23 patients with nontransmural infarction (96%). Thallium scintigrams were abnormal in only 11 of 18 patients with nontransmural infarction (61%). Tomographically estimated infarct size was greater among patients with transmural infarction (50.4 +/- 7.8 PET-g-Eq/m2 [+/- SEM SEM]) compared with those with nontransmural infarction (19 +/- 4 PET-g-Eq, p less than 0.01). Residual accumulation of 11C-palmitate within regions of infarction was more intensely depressed among patients with transmural compared to nontransmural infarction (33 +/- 1 vs 39 +/- 1% maximal myocardial radioactivity, p less than 0.01). Thus, PET and metabolic imaging with 11C-palmitate is a sensitive means of detecting, quantifying and characterizing nontransmural and transmural myocardial infarction

  9. Positron emission tomography in degenerative disorders of the dopaminergic system

    21 patients who had Parkinson's disease (PD), PD plus dementia of Alzheimer type (PDAT) or progressive supranuclear palsy (PSP), were studied with positron emission tomography (PET) using (18F)-2-fluoro-2-deoxy-D-glucose (FDG). In one patient with strictly unilateral PD side differences in striatal dopa uptake were studied with 6-(18F)fluoro-L-dopa (F-dopa). In patients with PD PET with FDG did not show any significant change in regional cerebral metabolic rates for glucose (rCMR(Glu)). In PDAT glucose metabolism was generally reduced, the most severe decrease was found in parietal cortex. The matebolic pattern was similar to that typically found in patients with Alzheimer's disease (AD). In the patients with strictly unilateral PD rCMR(Glu) was normal, F-dopa PET, however, revealed a distinct reduction of dopa uptake in the contralateral putamen. In PSP glucose metabolism was significantly decreased in subcortical regions (caudatum, putamen and brainstem) and in frontal cortex. Thus PET demonstrated a clear difference of metabolic pattern between PDAT and PSP

  10. Photon time-of-flight-assisted positron emission tomography

    In positron emission tomography (PET), the annihilation radiation is usually detected as a coincidence occurrence that localizes the position of the annihilation event to a straight line joining the detectors. The measure of the difference between the time of flight (TOF) of the annihilation photons between their inception and their detection permits the localization of the position of the annihilation event along the coincidence line. The incorporation of TOF information into the PET reconstruction process improves the signal-to-noise ratio in the image obtained. The utilization of scintillation detectors utilizing cesium fluoride scintillators, fast photomultiplier tubes, and fast timing circuits allows sub-nanosecond coincidence timing resolution needed for the effective use of TOF in PET. Mathematical considerations and pilot experiments show that with state-of-the-art electronic components and through the application of proper reconstruction algorithms, the combination of TOF and PET positional data improves severalfold the signal-to-noise ratio with respect to conventional PET image reconstruction at the cost of increasing the amount of data to be processed. The construction of a TOF-assisted PET device is within the capability of state-of-the-art technology

  11. Anaesthesia for positron emission tomography scanning of animal brains.

    Alstrup, Aage Kristian Olsen; Smith, Donald F

    2013-01-01

    Positron emission tomography (PET) provides a means of studying physiological and pharmacological processes as they occur in the living brain. Mice, rats, dogs, cats, pigs and non-human primates are often used in studies using PET. They are commonly anaesthetized with ketamine, propofol or isoflurane in order to prevent them from moving during the imaging procedure. The use of anaesthesia in PET studies suffers, however, from the drawback of possibly altering central neuromolecular mechanisms. As a result, PET findings obtained in anaesthetized animals may fail to correctly represent normal properties of the awake brain. Here, we review findings of PET studies carried out either in both awake and anaesthetized animals or in animals given at least two different anaesthetics. Such studies provide a means of estimating the extent to which anaesthesia affects the outcome of PET neuroimaging in animals. While no final conclusion can be drawn concerning the 'best' general anaesthetic for PET neuroimaging in laboratory animals, such studies provide findings that can enhance an understanding of neurobiological mechanisms in the living brain. PMID:23349451

  12. European health telematics networks for positron emission tomography

    Kontaxakis, George; Pozo, Miguel Angel; Ohl, Roland; Visvikis, Dimitris; Sachpazidis, Ilias; Ortega, Fernando; Guerra, Pedro; Cheze-Le Rest, Catherine; Selby, Peter; Pan, Leyun; Diaz, Javier; Dimitrakopoulou-Strauss, Antonia; Santos, Andres; Strauss, Ludwig; Sakas, Georgios

    2006-12-01

    A pilot network of positron emission tomography centers across Europe has been setup employing telemedicine services. The primary aim is to bring all PET centers in Europe (and beyond) closer, by integrating advanced medical imaging technology and health telematics networks applications into a single, easy to operate health telematics platform, which allows secure transmission of medical data via a variety of telecommunications channels and fosters the cooperation between professionals in the field. The platform runs on PCs with Windows 2000/XP and incorporates advanced techniques for image visualization, analysis and fusion. The communication between two connected workstations is based on a TCP/IP connection secured by secure socket layers and virtual private network or jabber protocols. A teleconsultation can be online (with both physicians physically present) or offline (via transmission of messages which contain image data and other information). An interface sharing protocol enables online teleconsultations even over low bandwidth connections. This initiative promotes the cooperation and improved communication between nuclear medicine professionals, offering options for second opinion and training. It permits physicians to remotely consult patient data, even if they are away from the physical examination site.

  13. Positron emission tomography scans on kanji and kana

    Sakurai, Yasuhisa [Mitsui Memorial Hospital, Tokyo (Japan)

    2002-12-01

    We reanalyzed our positron emission tomography (PET) study on reading of Japanese kanji (morphogram) words, kana (phonogram) words and kana nonwords, using Statistical Parametric Mapping (SPM). The basal occipital and occipito-temporal areas were activated in common, among which activity was most pronounced in the fusiform/inferior temporal gyri with kanji and in the inferior occipital gyrus with kana. The results were consistent with the clinical observations that damage to the posterior inferior temporal cortex including the fusiform/inferior temporal gyri causes alexia with agraphia for kanji, whereas damage to the posterior occipital area including the inferior occipital gyrus causes pure alexia for kana. Bases on the present results and the lesion studies, a dual-route hypothesis that modifies Iwata's model of reading about the Japanese language was proposed. That is, the middle occipital gyrus, deep perisylvian temporoparietal cortex and posterior temporal gyrus constitute a dorsal route for reading and process phonology for words, whereas the inferior occipital, fusiform and posterior inferior temporal gyri constitute a ventral route for reading and process orthography and lexico-semantics for words. The ventral route may gain dominance in reading, according as a word is repeatedly presented. (author)

  14. Fluorodeoxyglucose positron emission tomography in pancreatic cancer: an unsolved problem

    Kato, Takashi [Dept. of Radiology, Nagoya Univ. School of Medicine (Japan); Fukatsu, Hiroshi [Dept. of Radiology, Nagoya Univ. School of Medicine (Japan); Ito, Kengo; Tadokoro, Masanori [Dept. of Radiology, Nagoya Univ. School of Medicine (Japan); Ota, Toyohiro [Dept. of Radiology, Nagoya Univ. School of Medicine (Japan); Ikeda, Mitsuru [Dept. of Medical Information and Medical Records, Nagoya Univ. School of Medicine (Japan); Isomura, Takayuki [Dept. of Radiology, Nagoya Univ. School of Medicine (Japan); Ito, Shigeki [Dept. of Radiology, Nagoya Univ. School of Medicine (Japan); Nishino, Masanari [Dept. of Radiology, Nagoya Univ. School of Medicine (Japan); Ishigaki, Takeo [Dept. of Radiology, Nagoya Univ. School of Medicine (Japan)

    1995-01-01

    The aim of this study was to examine the significance and problems of 2-[fluorine-18]-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in diagnosing pancreatic cancer and mass-forming pancreatitis (MFP). PET, X-ray computed tomography (CT) and magnetic resonance (MR) imaging were performed in 15 patients with pancreatic cancer and nine patients with MFP. The areas of the PET scan were determined according to the markers drawn on the patients at CT or MR imaging. Regions of interests (ROIs) were placed by reference to the CT or MR images corresponding to the PET images. Tissue metabolism was evaluated by the differential absorption ratio (DAR) at 50 min after intravenous injection of FDG [DAR = tissue tracer concentration/(injected dose/body weight)]. The DAR value differed significantly in pancreatic cancer (mean{+-}SD, 4.64{+-}1.94) and MFP (mean{+-}SD, 2.84{+-}2.22) (P<0.05). In one false-negative case (mucinous adenocarcinoma), the tumour contained a small number of malignant cells. In one false-positive case, lymphocytes accumulated densely in the mass in the pancreatic head. Further studies are necessary to investigate the histopathological characteristics (especially the cellularity) and other factors affecting the FDG DAR on PET images. (orig.)

  15. Cerebral perfusion reserve indexes determined by fluoromethane positron emission scanning

    An index of cerebral perfusion reserve (RES%), defined as the percent change of regional cerebral blood flow over baseline per mm Hg of end-tidal CO2 tension, was determined for each middle cerebral artery (MCA) territory in patients with unilateral carotid distribution transient ischemic attacks or minor cerebrovascular accidents and was compared with that of age-matched, neurologically normal volunteers. Vasodilator responses to induced hypercapnia were tested during inhalation of 5% CO2 in 95% O2 while regional cerebral blood flow was measured by fluoromethane inhalation positron emission tomography. Mean RES% for 24 normal MCA territories was 5.2 +/- 0.8%. Mean RES% for 15 patient nonischemic MCA territories was 3.8 +/- 1.3% and for 15 ischemic MCA territories was 2.8 +/- 1.9% (both p less than 0.001). Individual RES% values and symmetry ratios between ischemic and nonischemic regions were also determined and compared with angiographic data. Areas of diminished, asymmetric, or paradoxical (two patients) CO2 reactivity appear to correspond to areas of compensatory vasodilation. We found this technique to be a safe and reproducible method for defining and recording localized areas of cerebral tissue at apparent risk for hemodynamically related damage

  16. Positron emission tomography in degenerative disorders of the dopaminergic system

    21 patients who had Parkinson's disease (PD), PD plus dementia of Alzheimer type (PDAT) or progressive supranuclear palsy (PSP), were studied with positron emission tomography (PET) using (18F)-2-fluoro-2-deoxy-D-glucose (FDG). In one patient with strictly unilateral PD side differences in striatal dopa uptake were studied with 6-(18F)fluoro-L-dopa (F-dopa). In patients with PD PET with FDG did not show any significant change in regional cerebral metabolic rates for glucose (rCMR(Glu)). In PDAT glucose metabolism was generally reduced, the most severe decrease was found in parietal cortex. The metabolic pattern was similar to that typically found in patients with Alzheimer's disease (AD). In the patient with strictly unilateral PD rCMR(Glu) was normal, F-dopa PET, however, revealed a distinct reduction of dopa uptake in the contralateral putamen. In PSP glucose metabolism was significantly decreased in subcortical regions (caudatum, putamen and brainstem) and in frontal cortex. Thus PET demonstrated a clear difference of metabolic pattern between PDAT and PSP. (authors)

  17. Recent innovations in the detection systems of Positron Emission Tomography

    Since the recognition of the clinical value of Positron Emission Tomography (PET) for the diagnosis and staging of several cancers, the PET systems have evolved to systems associating PET and Computed Tomography (CT). The main constraint for clinical imaging is to reduce the acquisition duration. As a consequence, PET detectors are faster and emit more light than the BGO crystal used previously. These detectors allow an improvement of the count rate performance of the PET systems, reducing the scattered and the random events while increasing the true events at high activity concentration. Among the new crystals, some allow measuring the time of flight of the annihilation photons. This measurement further improves the performance of the systems. The spatial resolution of clinical PET systems is still equal to 5 mm at best. High spatial resolution PET systems dedicated to small animal imaging have been developed. These systems use similar crystal materials as the clinical systems. However, in order to permit spatial resolution close to 1 mm, the crystal elements have much smaller transverse dimensions than that of clinical systems. The detectors are compact using position sensitive photomultipliers or photodiodes. In order to preserve the uniformity of the spatial resolution over the transverse field of view of the tomography, solutions allowing the measurement of the depth of interaction of the photons in the crystal have been designed. New compact detectors based on semi conductors are currently investigated. (author)

  18. Biological imaging in radiation therapy: role of positron emission tomography

    In radiation therapy (RT), staging, treatment planning, monitoring and evaluation of response are traditionally based on computed tomography (CT) and magnetic resonance imaging (MRI). These radiological investigations have the significant advantage to show the anatomy with a high resolution, being also called anatomical imaging. In recent years, so called biological imaging methods which visualize metabolic pathways have been developed. These methods offer complementary imaging of various aspects of tumour biology. To date, the most prominent biological imaging system in use is positron emission tomography (PET), whose diagnostic properties have clinically been evaluated for years. The aim of this review is to discuss the valences and implications of PET in RT. We will focus our evaluation on the following topics: the role of biological imaging for tumour tissue detection/delineation of the gross tumour volume (GTV) and for the visualization of heterogeneous tumour biology. We will discuss the role of fluorodeoxyglucose-PET in lung and head and neck cancer and the impact of amino acids (AA)-PET in target volume delineation of brain gliomas. Furthermore, we summarize the data of the literature about tumour hypoxia and proliferation visualized by PET. We conclude that, regarding treatment planning in radiotherapy, PET offers advantages in terms of tumour delineation and the description of biological processes. However, to define the real impact of biological imaging on clinical outcome after radiotherapy, further experimental, clinical and cost/benefit analyses are required. (topical review)

  19. Measurement of regional cerebral blood flow by positron emission tomography

    The principal advantage of positron emission tomography over other methods for measuring cerebral blood flow stems from the accurate, quantitative three-dimensional measurements of regional brain radioactivity that are possible with this technique. As a result, accurate quantitative measurements of regional cerebral blood flow can be obtained for both superficial and deep cerebral structures. The value of PET for investigating central nervous system physiology and pathology extends far beyond this, however. Through the use of different radiotracers and appropriate mathematical models, PET can be applied to the measurement of a wide variety of physiologic variables. Measurements of rCBF tell only part of the story. Experience with PET and with a variety of other techniques has taught us that rCBF is at times a poor indicator of the metabolic, functional, and biochemical status of cerebral tissue. It is only by understanding the interaction of all of these factors that our understanding of neurologic disease can advance. It is in the investigation of these complex relationships that the real value of PET resides

  20. 76 FR 47593 - Guidance for Small Business Entities on Current Good Manufacturing Practice for Positron Emission...

    2011-08-05

    ... a guidance for small business entities entitled ``PET Drugs--Current Good Manufacturing Practice... entitled ``PET Drugs--Current Good Manufacturing Practice (CGMP); Small Entity Compliance Guide.'' This... Manufacturing Practice for Positron Emission Tomography Drugs; Availability AGENCY: Food and Drug...

  1. Molecular pathology in vulnerable carotid plaques: correlation with [18]-fluorodeoxyglucose positron emission tomography (FDG-PET)

    Graebe, M; Pedersen, Sune Folke; Borgwardt, L;

    2008-01-01

    OBJECTIVES: Atherosclerosis is recognised as an inflammatory disease, and new diagnostic tools are warranted to evaluate plaque inflammatory activity and risk of cardiovascular events. We investigated [18]-fluorodeoxyglucose (FDG) uptake in vulnerable carotid plaques visualised by positron emission...

  2. Measurement of regional cerebral glucose utilization in man by positron emission tomography

    The various methods available for the study of regional cerebral glucose consumption in man by positron emission tomography are described and their applications, limitations and principal physiopathological results are presented

  3. Synthesis of the radiopharmaceuticals for positron emission tomography

    In this paper is shown a short overview of the biogenic positron radiopharmaceuticals production and a brief summary of some PET preparation synthesis. At the end the overview of some forward-looking positron radionuclides, which can be used for a preparation of the PET radiopharmaceuticals is said. A short review of diagnostic use of PET radiopharmaceuticals is presented (authors)

  4. Software development for modeling positrons emission tomograph scanners

    The Geant4 Application for Tomographic Emission (GATE) is an international platform recognized and used to develop Computational Model Exposure (CME) in the context of Nuclear Medicine, although currently there are dedicated modules for applications in Radiotherapy and Computed Tomography (CT). GATE uses Monte Carlo (MC) methods, and has a scripting language of its own. The writing of scripts for simulation of a PET scanner in GATE involves a number of interrelated steps, and the accuracy of the simulation is dependent on the correct setup of the geometries involved, since the physical processes depend on them, as well as the modeling of electronic detectors in module Digitizer, for example. The manual implementation of this setup can be a source of errors, especially for users without experience in the field of simulations or without any previous knowledge of a programming language, and also due to the the fact that the modeling process in GATE still remains bounded to LINUX / UNIX based systems, an environment only familiar to a few. This becomes an obstacle for beginners and prevents the use of GATE by a larger number of users interested in optimizing their experiments and/or clinical protocols through a more accessible, fast and friendly application. The objective of this work is therefore to develop a user-friendly software for the modeling of Positron Emission Tomography called GUIGATE (Graphical User Interface for GATE), with specific modules dedicated to quality control in PET scanners. The results exhibit the features available in this first version of GUIGATE, present in a set of windows that allow users to create their input files, perform and display in real time the model and analyze its output file in a single environment, allowing so intuitively access the entire architecture of the GATE simulation and to CERN's data analyzer, the ROOT. (author)

  5. Positron emission tomography, physical bases and comparaison with other techniques

    Positron emission tomography (PET) is a medical imaging technique that measures the three-dimensional distribution of molecules marked by a positron-emitting particle. PET has grown significantly in clinical fields, particularly in oncology for diagnosis and therapeutic follow purposes. The technical evolutions of this technique are fast. Among the technical improvements, is the coupling of the PET scan with computed tomography (CT). PET is obtained by intravenous injection of a radioactive tracer. The marker is usually fluorine (18F) embedded in a glucose molecule forming the 18-fluorodeoxyglucose (FDG-18). This tracer, similar to glucose, binds to tissues that consume large quantities of the sugar such cancerous tissue, cardiac muscle or brain. Detection using scintillation crystals (BGO, LSO, LYSO) suitable for high energy (511keV) recognizes the lines of the gamma photons originating from the annihilation of a positron with an electron. The electronics of detection or coincidence circuit is based on two criteria: a time window, of about 6 to 15 ns, and an energy window. This system measures the true coincidences that correspond to the detection of two photons of 511 kV from the same annihilation. Most PET devices are constituted by a series of elementary detectors distributed annularly around the patient. Each detector comprises a scintillation crystal matrix coupled to a finite number (4 or 6) of photomultipliers. The electronic circuit, or the coincidence circuit, determines the projection point of annihilation by means of two elementary detectors. The processing of such information must be extremely fast, considering the count rates encountered in practice. The information measured by the coincidence circuit is then positioned in a matrix or sinogram, which contains a set of elements of a projection section of the object. Images are obtained by tomographic reconstruction by powerful computer stations equipped with a software tools allowing the analysis and

  6. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0

    Boellaard, Ronald; O'Doherty, Mike J; Weber, Wolfgang A; Mottaghy, Felix M; Lonsdale, Markus N; Stroobants, Sigrid G; Oyen, Wim J G; Kotzerke, Joerg; Hoekstra, Otto S; Pruim, Jan; Marsden, Paul K; Tatsch, Klaus; Hoekstra, Corneline J; Visser, Eric P; Arends, Bertjan; Verzijlbergen, Fred J; Zijlstra, Josee M; Comans, Emile F I; Lammertsma, Adriaan A; Paans, Anne M; Willemsen, Antoon T; Beyer, Thomas; Bockisch, Andreas; Schaefer-Prokop, Cornelia; Delbeke, Dominique; Baum, Richard P; Chiti, Arturo; Krause, Bernd J

    2010-01-01

    The aim of this guideline is to provide a minimum standard for the acquisition and interpretation of PET and PET/CT scans with [18F]-fluorodeoxyglucose (FDG). This guideline will therefore address general information about[18F]-fluorodeoxyglucose (FDG) positron emission tomography......-computed tomography (PET/CT) and is provided to help the physician and physicist to assist to carrying out,interpret, and document quantitative FDG PET/CT examinations,but will concentrate on the optimisation of diagnostic quality and quantitative information....

  7. Silicon as an unconventional detector in positron emission tomography

    Positron emission tomography (PET) is a widely used technique in medical imaging and in studying small animal models of human disease. In the conventional approach, the 511 keV annihilation photons emitted from a patient or small animal are detected by a ring of scintillators such as LYSO read out by arrays of photodetectors. Although this has been successful in achieving ∼5mm FWHM spatial resolution in human studies and ∼1mm resolution in dedicated small animal instruments, there is interest in significantly improving these figures. Silicon, although its stopping power is modest for 511 keV photons, offers a number of potential advantages over more conventional approaches including the potential for high intrinsic spatial resolution in 3D. To evaluate silicon in a variety of PET “magnifying glass” configurations, an instrument was constructed that consists of an outer partial-ring of PET scintillation detectors into which various arrangements of silicon detectors are inserted to emulate dual-ring or imaging probe geometries. Measurements using the test instrument demonstrated the capability of clearly resolving point sources of 22Na having a 1.5 mm center-to-center spacing as well as the 1.2 mm rods of a 18F-filled resolution phantom. Although many challenges remain, silicon has potential to become the PET detector of choice when spatial resolution is the primary consideration. -- Highlights: ► We examine the use of position-sensitive silicon detectors in magnifying PET geometries. ► A demonstrator using silicon detectors and BGO scintillation detectors was constructed. ► Both single-slice and volume PET configurations were tested. ► For a 4.5 cm field-of-view, resolutions <1mm were achievable. ► Resolution will improve further with higher resolution silicon detectors.

  8. Study of patients with spinocerebellar degeneration using positron emission tomography

    Kondo, Susumu; Tanaka, Makoto; Sun, X.; Sakai, Yasujiro; Hirai, Shunsaku (Gunma Univ., Maebashi (Japan). School of Medicine)

    1993-10-01

    We studied cerebral blood flow, oxygen metabolism and their relation to clinical symptoms in 45 patients with spinocerebellar degeneration (SCD) and 12 normal control subjects using positron emission tomography (PET). Regions of interest were acquired for the cerebellar hemispheres, cerebellar vermis, brainstem, thalami, and cerebral cortices. PET studies revealed that regional cerebral blood flow (CBF), regional cerebral oxygen metabolic rate (CMRO[sub 2]), CBF/mean CBF of each cerebral cortex (CBF/mCBF) and CMRO[sub 2]/mean CMRO[sub 2] of each cerebral cortex (CMRO[sub 2]/mCMRO[sub 2]) in the cerebellar hemispheres, cerebellar vermis, and brainstem showed a significant decrease in comparison with the normal control subjects, while in the cerebral cortices and thalami, SCD patients showed normal values. CBF/mCBF and CMRO[sub 2]/mCMRO[sub 2] were significantly decreased in patients with olivo-pontocerebellar atrophy (OPCA) and Menzel type of hereditary ataxia (Menzel type) in the cerebellar hemispheres, cerebellar vermis, and brainstem, whereas patients with late cortical cerebellar atrophy (LCCA) and Holmes type of hereditary ataxia (Holmes type) revealed a significant decrease of CBF/mCBF and CMRO[sub 2]/mCMRO[sub 2] in the cerebellar hemispheres and cerebellar vermis, but not in the brainstem. Patients with OPCA showed a significant decrease of CBF in the cerebellar hemispheres, cerebellar vermis, brainstem and that of CMRO[sub 2] in the cerebellar hemispheres and cerebellar vermis. Patients with LCCA showed a significant decrease of CBF in the right cerebellar hemisphere and cerebellar vermis. In patients with LCCA and Holmes type, the severity of upper limb ataxia and dysdiadochocinesis were significantly correlated with CBF/mCBF and CMRO[sub 2]/mCMRO[sub 2] in the cerebellar hemispheres and brainstem. PET may be useful for diagnosing SCD and understanding its pathogenesis. (author).

  9. Positron emission tomography in patients with drug-resistant epilepsy

    Positron emission tomography with 18Fluor-deoxyglucose (18FDG PET) was introduced as method of evaluation of the cerebral metabolism in the early 80s. 18FDG PET/computed tomography (PET/CT) has rapidly become a method of epileptogenic zone localization because of the hypometaboilsm of this zone during the interictal period. This paper represents the first Bulgarian series of patients with drug- resistant epilepsy who were evaluated with 18FDG PET as part of the presurgical work-up. Our study has included 21 patients with drug-resistant epilepsy who were evaluated with 18FDG PET/CT from January 2010 to May 2013. All patients were evaluated with dedicated MRI epilepsy protocol. PET/CT study was fused with 3D MRI study using FSL or GE software. Video EEG monitoring was performed in all 21 patients and seizures were recorded in 18 patients. Hypometabolic zones were found in 15 patients. The hypometabolism was focal in 5 patients, multilobar in 9 patients and hemispheric in 1 patient. The MRI was normal in 8 patients. Hypometabolic zones were found in 3 of these 8 patients with cryptogenic epilepsy. Epilepsy surgery was performed in 6 cases. All operated patients were with hypometabolic zones. Significant seizure reduction after surgery was observed in 5 of 6 operated patients. 18FDG PET/CT is a valuable method for epileptogenic zone localization in patients with drug-resistant epilepsy. The introduction of this method in the bulgarian epilepsy surgery program increases the chances for successful resective surgery. (authors)

  10. Positron Emission Tomography in the Management of Lung Cancer (NSCLC)

    Lung cancer is the leading cause of cancer deaths in men and the second most common cancer in women. Globally it remains the most commonly diagnosed cancer at 1.35 million, representing 12.4% of all new cancers. Almost half (49.9%) of the lung cancer cases occur in the developing countries of the world, which is a big change since 1980, when it was estimated that 69% were in developed countries. Although lung cancer is the most deadly of all the cancers, it is the only major cancer that does not have a widely accepted screening test. Lung cancer often presents as a solitary pulmonary nodule on chest radiographs, which are usually performed on patients as a preoperative screening test, or as a part of routine health screening, often in the absence of symptoms. Incidental detection can occur in up to 12% of cases in asymptomatic cases. It is clear that there is a need for the accurate diagnosis of these lesions. In recent years Positron early and Emission Tomography (PET) holds early and promise as a noninvasive investigative tool for the evaluation of lung cancer. 18F-FDG PET is currently indicated for the characterization of lung lesions, staging of non-small cell lung carcinoma (NSCLC), detection of distant metastases, and diagnosis of recurrent disease. PET/CT studies are also being increasingly employed in radiotherapy treatment also planning. Furthermore PET also plays an important role in monitoring of treatment response. On the face of it a PET-CT study may appear expensive. But in the overall context, PET/CT is cost-effective in the treatment of Lung cancer. The modality is the best discriminator of disease load if used in the correct clinical setting. It can do away with the need for multiple, many times needless investigations. It can reduce the number of futile operations, unwarranted interventions, as well as over and under treatments of lung cancer. (author)

  11. Positron emission tomography in urological cancer; Positronenemissionstomographie bei urologischen Tumoren

    Wit, M. de [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. Onkologie/Haematologie, Medizinische Klinik; Kotzerke, J. [Universitaetsklinikum Ulm (DE). Radiologie III (Nuklearmedizin)

    2000-09-01

    In staging cancer of the urinary bladder, the kidneys and the prostate and of testicular cancer there is a need for detecting tumor involvement of the lymph nodes to avoid surgical exploration. Positron emission tomography (PET) using fluorodeoxyglucose (FDG) can detect tumorous lymph nodes (sensitivity: 70%, specificity: 85%) which is helpful for several patients. In carcinoma of the prostate, other radiotracers than FDG (e.g. C-11-choline) might be more sensitive to detect tumorous lymph nodes. Up to now no diagnostical benefit of PET in germ cell tumors could be demonstrated in the published small series. In principle FDG-PET is useful in diagnosis of recurrence. In germ cell cancer FDG-PET seems to identify effectively persistent vital tumor tissue after chemotherapy. A multicenter study was initiated to demonstrate the potential of FDG-PET in a sufficient number of patients with germ cell tumor. (orig.) [German] Bei Harnblasen-, Nieren-, Prostata- und Hodenkarzinomen besteht aus klinischer Sicht ein Bedarf an verbessertem Lymphknoten-Staging, um die operative Evaluation zu vermeiden. Die Positronenemissionstomographie (PET) mit Fluordeoxyglukose (FDG) kann daher im Einzelfall bei Harnblasen- und Nierenkarzinomen hilfreich sein (bei Sensitivitaet um 70% und Spezifitaet um 85%). Beim Prostatakarzinom koennten sich andere Radiotracer (z.B. C-11-Cholin) bei der Detektion von tumoroesen Lymphknoten ueberlegen erweisen. Bei Keimzelltumoren konnte ein Nutzen der PET im primaeren Staging bei den bisher publizierten kleinen Studien nicht nachgewiesen werden. Fuer die Rezidivdiagnostik ist bei den genannten Tumoren aus grundsaetzlicher Ueberlegung der Einsatz von DFG-PET sinnvoll. Die Erkennung von vitalem malignen Tumorgewebe nach Chemotherapie erscheint bei Keimzelltumoren mit FDG-PET weitgehend sicher zu gelingen. Eine multizentrische Studie wurde begonnen, die hierueber Aufschluss geben wird. (orig.)

  12. Noninvasive alternatives to arterial blood sampling in positron emission tomography

    Positron emission tomography is commonly employed for the quantitative assessment of regional biochemistry. The determination of glucose and oxygen utilization rates using [F-18] 2FDG and [0-15] 0/sub 2/ demand accurate measurement of the driving function producing the observed tissue response. Conventional techniques consist of an arterial or venous puncture with either discrete or continuous sampling of blood label concentrations. A time-of-flight (TOF) probe and expired gas detector have been developed as alternatives to these invasive techniques. The acquisition of serial spectra with the TOF pair (4 x 4cm BaF/sub 2/;XP2020Q;380 psec FWHM), sampling a line through the cardiac chambers, reveals the spatial distribution of activity in the heart and surrounding tissue as a function of time. Region-of-interest analysis of the temporally resolved spectra produce the activity time courses required for analysis of tissue response data. Multigated TOF acquisition using a pulsewatch (LED-phototransistor pair which detects finger-tip blood volume changes) as the gating mechanism promises to provide an easy and accurate method for positioning the TOF probe. Dynamic techniques for the measurement of oxygen utilization rates require both the arterial [0-15] 0/sub 2/ and [0-15] H/sub 2/O concentrations. A heated flow-through plastic (NE 102) beta detector was developed to measure the concentration of label in the alveolar gas which was equilibrated with the blood in the pulmonary capillaries. Combining the TOF probe and expired gas data allows the separation of the oxygen and water components of the input function

  13. Analysis of Factors Affecting Positron Emission Mammography (PEM) Image Formation

    Image reconstruction for positron emission mammography (PEM) with the breast positioned between two parallel, planar detectors is usually performed by backprojection to image planes. Three important factors affecting PEM image reconstruction by backprojection are investigated: (1) image uniformity (flood) corrections, (2) image sampling (pixel size) and (3) count allocation methods. An analytic expression for uniformity correction is developed that incorporates factors for spatial-dependent detector sensitivity and geometric effects from acceptance angle limits on coincidence events. There is good agreement between experimental floods from a PEM system with a pixellated detector and numerical simulations. The analytic uniformity corrections are successfully applied to image reconstruction of compressed breast phantoms and reduce the necessity for flood scans at different image planes. Experimental and simulated compressed breast phantom studies show that lesion contrast is improved when the image pixel size is half of, rather than equal to, the detector pixel size, though this occurs at the expense of some additional image noise. In PEM reconstruction counts usually are allocated to the pixel in the image plane intersected by the line of response (LOR) between the centers of the detection pixels. An alternate count allocation method is investigated that distributes counts to image pixels in proportion to the area of the tube of response (TOR) connecting the detection pixels that they overlay in the image plane. This TOR method eliminates some image artifacts that occur with the LOR method and increases tumor signal-to-noise ratios at the expense of a slight decrease in tumor contrast. Analysis of image uniformity, image sampling and count allocation methods in PEM image reconstruction points to ways of improving image formation. Further work is required to optimize image reconstruction parameters for particular detection or quantitation tasks

  14. Study of brain metabolism using positron emission computed tomography

    Positron emission tomography permits the three-dimensional regional measurement of metabolism and blood flow in the brain. For the determination of cerebral metabolic rates of glucose by PET 18fluordeoxyglucose is usually applied: cerebral metabolic rate of glucose was found to be 36 to 47 μmol/100 g/min in the grey matter and 23 to 29 μmol/100 g/min in the white matter of normal volunteers. During physiologic activation metabolic rate of glucose is increased in the respective brain areas in relation to the strength and complexity of the stimulation. In patients suffering from ischaemic stroke glucose metabolism is markedly decreased within the infarction. Additonally, glucose metabolism is reduced by 20% in morphologically intact areas of the homolateral cortex, in the basal ganglia, in the cortical area contralateral to the infarction and in the contralateral cerebellum. This remote reduction of glucose utilization is probably caused by functional inactivation of these brain structures; it could be responsible for the diffuse organic syndrome in stroke victims not caused by the focal lesion. In patients suffering from dementia of the multi-infarct type and of the Alzheimer type glucose metabolism is reduced; the lesions in Alzheimer cases are most prominent in partietal and frontal cortical areas. In Chorea Huntington cases glucose metabolism is primarily disturbed in the striate, especially in the caudate nucleus; in these cases the metabolic disturbance can be detected earlier than the atrophy in computed tomograms. Disturbances of glucose and oxygen utilization are not necessary causes, but may also be sequelae od functional impairment. Additional information on pathogentic mechanisms may be obtained by the investigation of the protein synthesis. (orig.)

  15. Effect of tissue heterogeneity on quantification in positron emission tomography

    As a result of the limited spatial resolution of positron emission tomographic scanners, the measurements of physiological parameters are compromised by tissue heterogeneity. The effect of tissue heterogeneity on a number of parameters was studied by simulation and an analytical method. Five common tracer models were assessed. The input and tissue response functions were assumed to be free from noise and systematic errors. The kinetic model was assumed to be perfect. Two components with different kinetics were mixed in different proportions and contrast with respect to the model parameters. Different experimental protocols were investigated. Of three methods investigated for the measurement of cerebral blood flow (CBF) (steady state, dynamic, integral), the second one was least sensitive to errors caused by tissue heterogeneity and the main effect was an underestimation of the distribution volume. With the steady state method, errors in oxygen extraction fraction caused by tissue heterogeneity were always found to be less than the corresponding errors in CBF. For myocardial blood flow the steady state method was found to perform better than the bolus method. The net accumulation of substrate (i.e. rCMRglc in the case of glucose analogs) was found to be comparatively insensitive to tissue heterogeneity. Individual rate constans such as k2 and k3 for efflux and metabolism of the substrate in the pool of unmetabolized substrate in the tissue, respectively, were found to be more sensitive. In studies of radioligand binding, using only tracer doses, the effect of tissue heterogeneity on the parameter kon.Bmax could be considerable. In studies of radioligand binding using a protocol with two experiments, one with high and one with low specific activity, Bmax was found to be insensitive while Kd was very sensitive to tissue heterogeneity. (orig.)

  16. Effect of tissue heterogeneity on quantification in positron emission tomography

    Blomqvist, G. [Dept. of Clinical Neuroscience, Experimental Alcohol and Drug Addiction Research Section, Karolinska Hospital, Stockholm (Sweden); Lammertsma, A.A. [PET Methodology Group, Cyclotron Unit, MRC Clinical Sciences Centre, Royal Postgraduate Medical School, Hammersmith Hospital, London (United Kingdom); Mazoyer, B. [Service Hospitalier Frederic Joliot CEA/Dept. de Biologie, Hopital d`Orsay and Antenne d`Informatique Medicale, Hopital Robert Debre, Paris (France); Wienhard, K. [Max-Planck-Inst. fuer Neurologische Forschung, Koeln (Germany)

    1995-07-01

    As a result of the limited spatial resolution of positron emission tomographic scanners, the measurements of physiological parameters are compromised by tissue heterogeneity. The effect of tissue heterogeneity on a number of parameters was studied by simulation and an analytical method. Five common tracer models were assessed. The input and tissue response functions were assumed to be free from noise and systematic errors. The kinetic model was assumed to be perfect. Two components with different kinetics were mixed in different proportions and contrast with respect to the model parameters. Different experimental protocols were investigated. Of three methods investigated for the measurement of cerebral blood flow (CBF) (steady state, dynamic, integral), the second one was least sensitive to errors caused by tissue heterogeneity and the main effect was an underestimation of the distribution volume. With the steady state method, errors in oxygen extraction fraction caused by tissue heterogeneity were always found to be less than the corresponding errors in CBF. For myocardial blood flow the steady state method was found to perform better than the bolus method. The net accumulation of substrate (i.e. rCMR{sub glc} in the case of glucose analogs) was found to be comparatively insensitive to tissue heterogeneity. Individual rate constans such as k{sub 2} and k{sub 3} for efflux and metabolism of the substrate in the pool of unmetabolized substrate in the tissue, respectively, were found to be more sensitive. In studies of radioligand binding, using only tracer doses, the effect of tissue heterogeneity on the parameter k{sub on}.B{sub max} could be considerable. In studies of radioligand binding using a protocol with two experiments, one with high and one with low specific activity, B{sub max} was found to be insensitive while K{sub d} was very sensitive to tissue heterogeneity. (orig.)

  17. Detection of penile metastasis from bladder cancer using F 18 FDG PET/CT

    Lee, Dong Yun; Lee, Jong Jin [Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2012-12-15

    A 74 year old man who had experienced priapism for 2 months after radical cystectomy for bladder cancer visited our hospital, and underwent metastatic work up {sup 18}F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography(PET/CT)showed diffuse hypermetabolic activity along the penis shaft, which was confirmed as a penile metastasis.

  18. (18)F-FDG PET during stereotactic body radiotherapy for stage I lung tumours cannot predict outcome : a pilot study

    Wiegman, Erwin M.; Pruim, Jan; Ubbels, Jan F.; Groen, Harry J. M.; Langendijk, Johannes A.; Widder, Joachim

    2011-01-01

    (18)F-Fluorodeoxyglucose positron emission tomography (FDG PET) has been used to assess metabolic response several months after stereotactic body radiotherapy (SBRT) for early-stage non-small cell lung cancer. However, whether a metabolic response can be observed already during treatment and thus ca

  19. Reproducibility of functional volume and activity concentration in (18)F-FDG PET/CT of liver metastases in colorectal cancer

    Heijmen, L.; Geus-Oei, L.F. de; Wilt, J.H. de; Visvikis, D.; Hatt, M.; Visser, E.P.; Bussink, J.; Punt, C.J.A.; Oyen, W.J.G.; Laarhoven, H.W.M. van

    2012-01-01

    PURPOSE: Several studies showed potential for monitoring response to systemic therapy in metastatic colorectal cancer patients with (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET). Before (18)F-FDG PET can be implemented for response evaluation the repeatability should be known. Th

  20. FDG-PET/CT based response-adapted treatment

    de Geus-Oei, Lioe-Fee; Vriens, Dennis; Arens, Anne I J;

    2012-01-01

    It has been shown that [(18)F]fluorodeoxyglucose (FDG)-positron emission tomography (PET) provides robust and reproducible data for early metabolic response assessment in various malignancies. This led to the initiation of several prospective multicenter trials in malignant lymphoma and adenocarc...

  1. Recurrences after intensity modulated radiotherapy for head and neck squamous cell carcinoma more likely to originate from regions with high baseline [18F]-FDG uptake

    Due, Anne K.; Vogelius, Ivan R.; Aznar, Marianne C.;

    2014-01-01

    Background and purpose: To analyze the recurrence pattern in relation to target volumes and 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography in head and neck squamous cell carcinoma (HNSCC) patients treated with definitive chemoradiation. Material and methods: 520 patients rece...

  2. Neural estimation of kinetic rate constants from dynamic PET-scans

    Fog, Torben L.; Nielsen, Lars Hupfeldt; Hansen, Lars Kai;

    1994-01-01

    A feedforward neural net is trained to invert a simple three compartment model describing the tracer kinetics involved in the metabolism of [18F]fluorodeoxyglucose in the human brain. The network can estimate rate constants from positron emission tomography sequences and is about 50 times faster...... than direct fitting of rate constants using the parametrized transients of the compartment model...

  3. FDG-PET parameters as prognostic factor in esophageal cancer patients: a review

    J.M.T. Omloo; M. van Heijl; O.S. Hoekstra; M.I. van Berge Henegouwen; J.J.B. van Lanschot; G.W. Sloof

    2011-01-01

    (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) has been used extensively to explore whether FDG Uptake can be used to provide prognostic information for esophageal cancer patients. The aim of the present review is to evaluate the literature available to date concerning the potential

  4. Comparison between CT- and FDG-PET-defined target volumes for radiotherapy planning in head-and-neck cancers

    Nine patients with head-and-neck cancer underwent computerized tomography (CT) simulation and [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) to compare the radiotherapy target volumes. The PET volumes were delineated with an automatic segmentation based on the source-to-background ratio. The volume comparison showed a reduction and qualitative discrepancies between the PET- and CT-volumes.

  5. Positron emission tomography displacement sensitivity: predicting binding potential change for positron emission tomography tracers based on their kinetic characteristics.

    Morris, Evan D; Yoder, Karmen K

    2007-03-01

    There is great interest in positron emission tomography (PET) as a noninvasive assay of fluctuations in synaptic neurotransmitter levels, but questions remain regarding the optimal choice of tracer for such a task. A mathematical method is proposed for predicting the utility of any PET tracer as a detector of changes in the concentration of an endogenous competitor via displacement of the tracer (a.k.a., its 'vulnerability' to competition). The method is based on earlier theoretical work by Endres and Carson and by the authors. A tracer-specific predictor, the PET Displacement Sensitivity (PDS), is calculated from compartmental model simulations of the uptake and retention of dopaminergic radiotracers in the presence of transient elevations of dopamine (DA). The PDS predicts the change in binding potential (DeltaBP) for a given change in receptor occupancy because of binding by the endogenous competitor. Simulations were performed using estimates of tracer kinetic parameters derived from the literature. For D(2)/D(3) tracers, the calculated PDS indices suggest a rank order for sensitivity to displacement by DA as follows: raclopride (highest sensitivity), followed by fallypride, FESP, FLB, NMSP, and epidepride (lowest). Although the PDS takes into account the affinity constant for the tracer at the binding site, its predictive value cannot be matched by either a single equilibrium constant, or by any one rate constant of the model. Values for DeltaBP have been derived from published studies that employed comparable displacement paradigms with amphetamine and a D(2)/D(3) tracer. The values are in good agreement with the PDS-predicted rank order of sensitivity to displacement. PMID:16788713

  6. Catecholaminergic neurotransmission in heart and brain, development of tracers for positron emission tomography

    Langer, Claus Oliver

    2000-01-01

    The catecholamines norepinephrine and its biosynthetic precursor dopamine are two principal neurotransmitters in the human central nervous system (CNS). Moreover, norepinephrine is a major transmitter substance in the peripheral, autonomic nervous system. Positron emission tomography (PET) is a non-invasive imaging technique that uses positron-labeled molecules to image and measure the function of biological processes in vivo. Neuronal catecholaminergic pathways, both in CNS...

  7. In vivo monitoring of tissue function and metabolism using positron emission tomography

    Positron emission tomography (PET) relies on a combination of the use of positron-emitting radioactive tracers and computerized tomography to monitor certain physiological and functional characteristics in vivo and noninvasively. Its special and most powerful applications to date are in brain physiology and neurology. There are many potential research applications in farm animals, such as the mapping of neuro-humoral pathways, but cost and the need for special facilities are likely to be prohibitive

  8. Reconstruction Algorithms for Positron Emission Tomography and Single Photon Emission Computed Tomography and their Numerical Implementation

    Fokas, A S; Marinakis, V

    2004-01-01

    The modern imaging techniques of Positron Emission Tomography and of Single Photon Emission Computed Tomography are not only two of the most important tools for studying the functional characteristics of the brain, but they now also play a vital role in several areas of clinical medicine, including neurology, oncology and cardiology. The basic mathematical problems associated with these techniques are the construction of the inverse of the Radon transform and of the inverse of the so called attenuated Radon transform respectively. We first show that, by employing mathematical techniques developed in the theory of nonlinear integrable equations, it is possible to obtain analytic formulas for these two inverse transforms. We then present algorithms for the numerical implementation of these analytic formulas, based on approximating the given data in terms of cubic splines. Several numerical tests are presented which suggest that our algorithms are capable of producing accurate reconstruction for realistic phanto...

  9. Positron emission tomography in patients with head and neck carcinoma

    PURPOSE: To examine the role of positron emission tomography (PET) with labeled fluorodeoxyglucose (FDG) in patients with primary neoplasms of the head and neck. MATERIALS and METHODS: Between (9(92)) and (9(94)), forty-four FDG PET scans were performed on 27 patients with head and neck neoplasms. FDG uptake at the tumor sites was quantified with standardized uptake values (SUV). There were seven women and 20 men. Median age was 70 (37 - 85). All patients had squamous cell carcinoma except two with esthesioneuroblastoma. In six patients the primary site was occult and treatment consisted of surgery followed by radiation. In the other patients, primary sites included nasopharynx (2), base of tongue (6), tonsil (4), larynx (2), piriform sinus (3) paranasal sinuses (3) and multiple (1). Three were Stage II, four were Stage III, 11 were Stage IV and three had recurrent disease. Gross disease was treated by radiation (2), twice daily radiation (8) or concurrent chemotherapy and radiation (11). The median follow-up of survivors is 12 months (6 - 30). RESULTS: All patients had baseline scans prior to radiation therapy. In the six patients with occult primaries, no primary lesions were discovered by PET scans. In the other 21 patients, all known primary sites, regional node metastases and distant metastases demonstrated increased uptake on PET imaging. In one patient distant metastases were suggested on PET (but without corroborating clinical or radiographic evidence) and in two patients additional regional node metastases were discovered. Eleven patients had PET scans at the conclusion of radiation therapy. Five patients had complete responses by PET, two had major responses and four had partial responses. However, all these patients had good clinical responses and none have failed locally. Five patients had six scans during follow-up (at 3 to 12 months) to differentiate radiation changes from persistent disease. In four patients the PET scans were negative and they are

  10. Fabrication of polycrystalline scintillators for the positron emission tomography (PET)

    Transparent ceramics are becoming more and more important for two new types of applications. On the one hand in cases where high mechanical and thermal demands in combination with optical properties are required, on the other hand where the optical properties of transparent materials like glass are not sufficient e.g. in positron-emission-tomography (PET) diagnostics. Most state of the art PET-scanners are using high-priced single crystals as scintillator material. The technological challenge is to replace single crystal by cost-efficient transparent ceramics. Producing transparent ceramics is ordered in synthesis of the powders and in manufacturing of these into transparent ceramics. The aim of this work was to synthesize single phase yttrium-alumina-and Luthetiumalumina-garnet (YAG, LuAG) powders partially doped with neodymium or praseodymium by four different synthesis routes (Pechini-synthesis, sol-gel-route, coprecipitation and solid state reactions). Additionally industrial LuAG and LuPO4 powders were characterized and manufactured. The powders were processed as submicron- and nanopowders. The compaction of nanopowder greenbodies sintered at high temperatures leads to a ''cross-over'' between both manufacturing route. Newly produced single-phase powders were homogenized with additions of sintering additives like tetraethyl orthosilicate (TEOS) and binders like polyvinyl alcohol (PVA). Moulding the powders were carried out by uniaxial pressing, cold isostatic pressing and in individual cases also by slip casting. The achieved green densities were in a range of 25-42 %. Examination of calcination behaviour leads to a calcination temperature of 1000 C with 2 hours dwell time in air atmosphere. Only solid state reactions resulted into transparent YAG, YAG:Pr, LuAG, LuAG:Pr ceramics. Solid state reactions of nanopowders resulted in heterogeneously transparent samples. Ceramics made by powders of other synthetic routes gave nontransparent ceramics due to porosity

  11. Laparoscopic Scar: a mimicker of Sister Mary Joseph's nodule on positron emission tomography/CT

    Positron emission tomography/CT is an established imaging method in the diagnosis and staging of cancers. 18F-fluoro-2-deoxy-D-glucose (FDG) is the most commonly used radiotracer in positron emission tomography/CT. It is a tumour viability agent and usually its uptake within a lesion reflects the presence of a viable tumour tissue. However, false-positive FDG uptake is known to occur in benign processes of either inflammatory or infectious aetiology. We describe FDG uptake at the site of laparoscopic scar that mimicked Sister Mary Joseph's nodule in a patient with gastric adenocarcinoma. Here, the knowledge of the patient's history and subtle imaging findings helped in accurate staging of the patient. In this case report, we emphasize the value of the knowledge of the patient history and awareness of different pitfalls of FDG to achieve a correct diagnosis on positron emission tomography/CT

  12. The 511 keV emission from positron annihilation in the Galaxy

    Prantzos, N.; Boehm, C.; Bykov, A. M.; Diehl, R.; Ferriere, K.; Guessoum, N.; Jean, P.; Knoedlseder, J.; Marcowith, A.; Moskalenko, I. V.; Strong, A.; Weidenspointner, G. [CNRS, UMR7095, UMPC and Institut d' Astrophysique de Paris, F-75014, Paris (France) and LAPP, 9 Chemin de Bellevue, BP 110 F-74941 Annecy-le-Vieux (France); A. F. Ioffe Institute of Physics and Technology, Russian Academy of Sciences, 194021, St. Petersburg (Russian Federation); Max Planck Institut fuer Extraterrestrische Physik, D-85741 Garching (Germany); Laboratoire d' Astrophysique de Toulouse-Tarbes, Universite de Toulouse, CNRS, 14 avenue Edouard Belin, F-31400 Toulouse (France); American University of Sharjah, College of Arts and Sciences/Physics Department, P.O. Box 26666, Sharjah (United Arab Emirates); CESR, Universite de Toulouse, CNRS, 9, Avenue du Colonel Roche, Boite Postal 4346, F-31028 Toulouse Cedex 4 (France); L.U.P.M., Universite Montpellier II, CNRS, Place Eugene Bataillon, F-34095 Montpellier (France); Hansen Experimental Physics Laboratory and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305 (United States); Max Planck Institut fuer Extraterrestrische Physik, D-85741, Garching (Germany); Max Planck Institut fur Extraterrestrische Physik, Garching, D-85741 Germany, and MPI Halbleiterlabor, Otto-Hahn-Ring 6, D-81739 Muenchen (Germany)

    2011-07-01

    The first {gamma}-ray line originating from outside the Solar System that was ever detected is the 511 keV emission from positron annihilation in the Galaxy. Despite 30 years of intense theoretical and observational investigation, the main sources of positrons have not been identified up to now. Observations in the 1990s with OSSE/CGRO (Oriented Scintillation Spectrometer Experiment on GRO satellite/Compton Gamma Ray Observatory) showed that the emission is strongly concentrated toward the Galactic bulge. In the 2000s, the spectrometer SPI aboard the European Space Agency's (ESA) International Gamma Ray Astrophysics Laboratory (INTEGRAL) allowed scientists to measure that emission across the entire Galaxy, revealing that the bulge-to-disk luminosity ratio is larger than observed at any other wavelength. This mapping prompted a number of novel explanations, including rather ''exotic'' ones (e.g., dark matter annihilation). However, conventional astrophysical sources, such as type Ia supernovae, microquasars, or x-ray binaries, are still plausible candidates for a large fraction of the observed total 511 keV emission of the bulge. A closer study of the subject reveals new layers of complexity, since positrons may propagate far away from their production sites, making it difficult to infer the underlying source distribution from the observed map of 511 keV emission. However, in contrast to the rather well-understood propagation of high-energy (>GeV) particles of Galactic cosmic rays, understanding the propagation of low-energy ({approx}MeV) positrons in the turbulent, magnetized interstellar medium still remains a formidable challenge. The spectral and imaging properties of the observed 511 keV emission are reviewed and candidate positron sources and models of positron propagation in the Galaxy are critically discussed.

  13. Molecular Imaging of Transporters with Positron Emission Tomography

    Antoni, Gunnar; Sörensen, Jens; Hall, Håkan

    Positron emission tomography (PET) visualization of brain components in vivo is a rapidly growing field. Molecular imaging with PET is also increasingly used in drug development, especially for the determination of drug receptor interaction for CNS-active drugs. This gives the opportunity to relate clinical efficacy to per cent receptor occupancy of a drug on a certain targeted receptor and to relate drug pharmacokinetics in plasma to interaction with target protein. In the present review we will focus on the study of transporters, such as the monoamine transporters, the P-glycoprotein (Pgp) transporter, the vesicular monoamine transporter type 2, and the glucose transporter using PET radioligands. Neurotransmitter transporters are presynaptically located and in vivo imaging using PET can therefore be used for the determination of the density of afferent neurons. Several promising PET ligands for the noradrenaline transporter (NET) have been labeled and evaluated in vivo including in man, but a really useful PET ligand for NET still remains to be identified. The most promising tracer to date is (S,S)-[18F]FMeNER-D2. The in vivo visualization of the dopamine transporter (DAT) may give clues in the evaluation of conditions related to dopamine, such as Parkinson's disease and drug abuse. The first PET radioligands based on cocaine were not selective, but more recently several selective tracers such as [11C]PE2I have been characterized and shown to be suitable as PET radioligands. Although there are a large number of serotonin transporter inhibitors used today as SSRIs, it was not until very recently, when [11C]McN5652 was synthesized, that this transporter was studied using PET. New candidates as PET radioligands for the SERT have subsequently been developed and [11C]DASB and [11C]MADAM and their analogues are today the most promising ligands. The existing radioligands for Pgp transporters seem to be suitable tools for the study of both peripheral and central drug

  14. Value of positron emission tomography and computer tomography (PET/CT) for urologic malignancies

    Positron emission tomography is a functional imaging technique that allows the detection of the regional metabolic rate, and is often coupled with other morphological imaging technique such as computed tomography. The rationale for its use is based on the clearly demonstrated fact that functional changes in tumor processes happen before morphological changes. Its introduction to the clinical practice added a new dimension in conventional imaging techniques. This review presents the current and proposed indications of the use of positron emission/computed tomography for prostate, bladder and testes, and the potential role of this exam in radiotherapy planning. (authors)

  15. [Value of positron emission tomography and computer tomography (PET/CT) for urologic malignancies].

    Boujelbene, N; Prior, J O; Boubaker, A; Azria, D; Schaffer, M; Gez, E; Jichlinski, P; Meuwly, J-Y; Mirimanoff, R O; Ozsahin, M; Zouhair, A

    2011-07-01

    Positron emission tomography is a functional imaging technique that allows the detection of the regional metabolic rate, and is often coupled with other morphological imaging technique such as computed tomography. The rationale for its use is based on the clearly demonstrated fact that functional changes in tumor processes happen before morphological changes. Its introduction to the clinical practice added a new dimension in conventional imaging techniques. This review presents the current and proposed indications of the use of positron emission/computed tomography for prostate, bladder and testes, and the potential role of this exam in radiotherapy planning. PMID:21507695

  16. Positron emission tomography alone, positron emission tomography-computed tomography and computed tomography in diagnosing recurrent cervical carcinoma: a systematic review and meta-analysis

    Xiao, Yi; Wei, Jia; Zhang, Yicheng; Xiong, Weining

    2014-01-01

    Introduction The aim of the study was to assess systematically the accuracies of positron emission tomography (PET), PET/computed tomography (CT), and CT in diagnosing recurrent cervical cancer. Material and methods We searched for articles published from January 1980 to June 2013 using the following inclusion criteria: articles were reported in English; the use of PET, interpreted with or without the use of CT; use of CT to detect recurrent cervical cancer; and histopathologic analysis and/o...

  17. Positron emission tomography and migraine. Tomographie par emission de positons et migraine

    Chabriat, H. (CEA, 91 - Orsay (France). Service Hospitalier Frederic Joliot)

    1992-04-01

    Positron emission tomography (PET) is a brain imaging technique that allows in vivo studies of numerous physiological parameters. There have been few PET studies in migraine patients. Cerebral blood flow changes with no variations in brain oxygen consumption have been reported in patients with prolonged neurologic manifestations during migraine attacks. Parenteral administration of reserpine during migraine headache has been followed by a fall in the overall cerebral uptake of glucose. The small sample sizes and a number of methodologic problems complicate the interpretation of these results. Recent technical advances and the development of new PET tracers can be expected to provide further insight into the pathophysiology of migraine. Today cerebral cortex 5 HT{sub 2} serotonin receptors can be studied in migraine patients with PET.

  18. Cerebral metabolic data obtained by positron emission tomography in physiological aging. A review of the literature

    Following a summary of the general principles and limitations of metabolic measurements by positron emission tomography and of the different indices used to interpret the data, the authors review the results of published studies on physiological aging. Globally, with strict inclusion criteria absolute metabolic values at rest and under partial sensorial deprivation are little or not modified by age. In contrast, functional interactions between regions, as deduced from metabolic intercorrelations, are perhaps different in elderly people. In any case, positron emission tomography seems to discriminate between normal aging and different patterns of pathological aging. Technical improvements, more refined neuropsychological correlations and the use of dynamic activation paradigms will no doubt provide, in the future, a better definition of normal and pathological aging as positron tomography

  19. Cerebral metabolic data obtained by positron emission tomography in physiological aging. A review of the literature

    Pellat, J.; Hommel, M.

    1987-06-18

    Following a summary of the general principles and limitations of metabolic measurements by positron emission tomography and of the different indices used to interpret the data, the authors review the results of published studies on physiological aging. Globally, with strict inclusion criteria absolute metabolic values at rest and under partial sensorial deprivation are little or not modified by age. In contrast, functional interactions between regions, as deduced from metabolic intercorrelations, are perhaps different in elderly people. In any case, positron emission tomography seems to discriminate between normal aging and different patterns of pathological aging. Technical improvements, more refined neuropsychological correlations and the use of dynamic activation paradigms will no doubt provide, in the future, a better definition of normal and pathological aging as positron tomography.

  20. Use of transputers in a 3-D positron emission tomograph

    This paper discusses the use of a VME-based transputer system as a front-end parallel processing engine for Positron Volume Imaging. The authors model different topologies with different numbers of nodes, using the Master/Worker software paradigm called a Processor Farm, and determine optimum configuration parameters for different computation requirements. The versatility and scalability of transputers makes them very suitable for use in PVI tomographs in that the same transputers can be used for speeding up data acquisition, image reconstruction and display

  1. Stability of regional cerebral glucose metabolism in the normal brain measured by positron emission tomography

    Cerebral glucose utilization (LCMRGI) was measured using the [18F]fluorodeoxyglucose method with PET in two groups of ten healthy young volunteers, each scanned in a resting state under different methodological conditions. In addition, five subjects had a second scan within 48 hr. Mean hemispheric values averaged 45.8 +/- 3.3 mumol/100 g/min in the right cerebral hemisphere and 47.0 +/- 3.7 mumol/100 g/min in the left hemisphere. A four-way analysis of variance (group, sex, region, hemisphere) was carried out on the results using three different methods of data manipulation: (a) the raw values of glucose utilization, (b) LCMRGI values normalized by the mean hemispheric gray matter LCMRGI value, and (c) log transformed LCMRGI values. For all analysis techniques, significantly higher LCMRGI values were consistently seen in the left mid and posterior temporal area and caudate nucleus relative to the right, and in the right occipital region relative to the left. The coefficient of variation of intrasubject regional differences (9.9%) was significantly smaller than the coefficient of variation for regions between subjects (16.5%). No differences were noted between the sexes and no effect of repeat procedures was seen in subjects having multiple scans. In addition, inter-regional LCMRGI correlations were examined both in values from the 20 normal subjects, as well as in a set of hypothetical abnormal values. Results were compared with those reported from other PET centers; despite certain methodological differences, the intersubject and inter-regional variation of LCMRGI is fairly constant

  2. Time resolution in scintillator based detectors for positron emission tomography

    In the domain of medical photon detectors L(Y)SO scintillators are used for positron emission tomography (PET). The interest for time of flight (TOF) in PET is increasing since measurements have shown that new crystals like L(Y)SO coupled to state of the art photodetectors, e.g. silicon photomultipliers (SiPM), can reach coincidence time resolutions (CTRs) of far below 500ps FWHM. To achieve these goals it is important to study the processe in the whole detection chain, i.e. the high energy particle or gamma interaction in the crystal, the scintillation process itself, the light propagation in the crystal with the light transfer to the photodetector, and the electronic readout. In this thesis time resolution measurements for a PET like system are performed in a coincidence setup utilizing the ultra fast amplifier discriminator NINO. We found that the time-over-threshold energy information provided by NINO shows a degradation in energy resolution for higher SiPM bias voltages. This is a consequence of the increasing dark count rate (DCR) of the SiPM with higher bias voltages together with the exponential decay of the signal. To overcome this problem and to operate the SiPM at its optimum voltage in terms of timing we developed a new electronic board that employs NINO only as a low noise leading edge discriminator together with an analog amplifier which delivers the energy information. With this new electronic board we indeed improved the measured CTR by about 15%. To study the limits of time resolution in more depth we measured the CTR with 2x2x3mm3 LSO:Ce codoped 0.4%Ca crystals coupled to commercially available SiPMs (Hamamatsu S10931-50P MPPC) and achieved a CTR of 108±5ps FWHM at an energy of 511keV. We determined the influence of the data acquisition system and the electronics on the CTR to be 27±2ps FWHM and thus negligible. To quantitatively understand the measured values, we developed a Monte Carlo simulation tool in MATLAB that incorporates the timing

  3. Recurrent ovarian endodermal sinus tumor: demonstration by computed tomography, magnetic resonance imaging, and positron emission tomography

    We report a case of recurrent endodermal sinus tumor of the ovary that was identified and/or clearly depicted by computed tomography, magnetic resonance imaging, and positron emission tomography. The potential roles of various imaging modalities in the detection of recurrent endodermal sinus tumor are discussed. (orig.)

  4. Fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography in evaluation of residual intramuscular myxoma

    Intramuscular myxoma (IM) is a rare benign neoplasm. In a patient diagnosed with IM of left thigh, we report the utility of a postoperative fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography scan in assessing the efficacy of surgical excision

  5. Monitoring liver tumor therapy with [18F]FDG positron emission tomography

    Positron emission tomography (PET) with [18F]-2-flurodeoxy-glucose (FDG) can be utilized as a functional imaging modality for monitoring liver tumor therapy. We report three cases in which PET-FDG was more useful for this purpose than other imaging methods and tumor markers

  6. Tomography by positrons emission: integral unit to the service of Mexico

    The applications of the Positron emission tomography (PET) together with the one radiopharmaceutical 2 - [18 F]-fluoro-2-deoxy-D-glucose in the area of the medical imaging is expanding quickly and it possesses a bigger impact at the moment in favor of those patient to who suffers an oncological, cardiac or neurological illness in Mexico. (Author)

  7. On the possible mixing of the electron capture and the positron emission channels in nuclear decay

    Isakov, V. I.

    2009-01-01

    On the basis of the idea of mixing (interaction) between the electron capture and the positron emission channels in the \\beta^+ decay in the cases when both channels are energetically allowed, we attempt to explain oscillations of the K-capture rates that were possibly seen in the recent experiment.

  8. Positron emission tomography-computed tomography has a clinical impact for patients with cervical cancer

    Sandvik, Rikke Mulvad; Jensen, Pernille Tine; Hendel, Helle Westergren;

    2011-01-01

    Many studies have found that positron emission tomography-computed tomography (PET-CT) has a high sensitivity and specificity in the identification of metastasis in cervical cancer. Herlev Hospital, Denmark, has been performing PET-CTs in stage I-IV cervical cancer since 1 May 2006. The present...

  9. Small animal positron emission tomography imaging and in vivo studies of atherosclerosis

    Hag, Anne Mette Fisker; Ripa, Rasmus Sejersten; Pedersen, Sune Folke;

    2013-01-01

    Atherosclerosis is a growing health challenge globally, and despite our knowledge of the disease has increased over the last couple of decades, many unanswered questions remain. As molecular imaging can be used to visualize, characterize and measure biological processes at the molecular and cellu...... knowledge obtained from in vivo positron emission tomography studies of atherosclerosis performed in small animals....

  10. Characterisation of beta(2)-adrenoceptors, using the agonist [C-11]formoterol and positron emission tomography

    Visser, T.J; van Waarde, Aaren; Doze, P; Elsinga, P.H; van der Mark, Thomas W.; Kraan, Jan; Ensing, Kees; Vaalburg, W.

    1998-01-01

    The agonist radioligand N-[2-hydroxy-5-[1-hydroxy-2-[[2-(4-[C-11]-methoxyphenyl)-1-methylethyl]amino]ethyl]phenyl]formamide ([C-11]formoterol) was synthesised in order to test its ability to visualise pulmonary beta(2)-adrenoceptors in vivo, with positron emission tomography (PET). Formoterol was la

  11. Capillaries within compartments: microvascular interpretation of dynamic positron emission tomography data

    Munk, O L; Keiding, S; Bass, L

    2003-01-01

    Measurement of exchange of substances between blood and tissue has been a long-lasting challenge to physiologists, and considerable theoretical and experimental accomplishments were achieved before the development of the positron emission tomography (PET). Today, when modeling data from modern PE...

  12. Diffuse nesidioblastosis diagnosed on a Ga-68 DOTATATE positron emission tomography/computerized tomography.

    Arun, Sasikumar; Rai Mittal, Bhagwant; Shukla, Jaya; Bhattacharya, Anish; Kumar, Praveen

    2013-07-01

    The authors describe a 50 days old pre-term infant with persistent hyperinsulinemic hypoglycemia of infancy in whom Ga-68 DOTATATE positron emission tomography/computerized tomography scan showed diffusely increased tracer uptake in the entire pancreas with no abnormal tracer uptake anywhere else in the body, suggestive of a diffuse variant of nesidioblastosis. PMID:24250024

  13. Positron emission imaging device and method of using the same

    Bingham, Philip R.; Mullens, James Allen

    2013-01-15

    An imaging system and method of imaging are disclosed. The imaging system can include an external radiation source producing pairs of substantially simultaneous radiation emissions of a picturization emission and a verification emissions at an emission angle. The imaging system can also include a plurality of picturization sensors and at least one verification sensor for detecting the picturization and verification emissions, respectively. The imaging system also includes an object stage is arranged such that a picturization emission can pass through an object supported on said object stage before being detected by one of said plurality of picturization sensors. A coincidence system and a reconstruction system can also be included. The coincidence can receive information from the picturization and verification sensors and determine whether a detected picturization emission is direct radiation or scattered radiation. The reconstruction system can produce a multi-dimensional representation of an object imaged with the imaging system.

  14. The review of myocardial positron emission computed tomography and positron imaging by gamma camera

    Ohtake, Tohru [Tokyo Univ. (Japan). Faculty of Medicine

    1998-04-01

    To measure myocardial blood flow, Nitrogen-13 ammonia, Oxygen-15 water, Rubidium-82 and et al. are used. Each has merit and demerit. By measuring myocardial coronary flow reserve, the decrease of flow reserve during dipyridamole in patients with hypercholesterolemia or diabetes mellitus without significant coronary stenosis was observed. The possibility of early detection of atherosclerosis was showed. As to myocardial metabolism, glucose metabolism is measured by Fluorine-18 fluorodeoxyglucose (FDG), and it is considered as useful for the evaluation of myocardial viability. We are using FDG to evaluate insulin resistance during insulin clamp in patients with diabetes mellitus by measuring glucose utilization rate of myocardium and skeletal muscle. FFA metabolism has been measured by {sup 11}C-palmitate, but absolute quantification has not been performed. Recently the method for absolute quantification was reported, and new radiopharmaceutical {sup 18}F-FTHA was reported. Oxygen metabolism has been estimated by {sup 11}C-acetate. Myocardial viability, cardiac efficiency was evaluated by oxygen metabolism. As to receptor or sympathetic nerve end, cardiac insufficiency or cardiac transplantation was evaluated. Imaging of positron emitting radiopharmaceutical by gamma camera has been performed. Collimator method is clinically useful for cardiac imaging of viability study. (author). 54 refs.

  15. The review of myocardial positron emission computed tomography and positron imaging by gamma camera

    To measure myocardial blood flow, Nitrogen-13 ammonia, Oxygen-15 water, Rubidium-82 and et al. are used. Each has merit and demerit. By measuring myocardial coronary flow reserve, the decrease of flow reserve during dipyridamole in patients with hypercholesterolemia or diabetes mellitus without significant coronary stenosis was observed. The possibility of early detection of atherosclerosis was showed. As to myocardial metabolism, glucose metabolism is measured by Fluorine-18 fluorodeoxyglucose (FDG), and it is considered as useful for the evaluation of myocardial viability. We are using FDG to evaluate insulin resistance during insulin clamp in patients with diabetes mellitus by measuring glucose utilization rate of myocardium and skeletal muscle. FFA metabolism has been measured by 11C-palmitate, but absolute quantification has not been performed. Recently the method for absolute quantification was reported, and new radiopharmaceutical 18F-FTHA was reported. Oxygen metabolism has been estimated by 11C-acetate. Myocardial viability, cardiac efficiency was evaluated by oxygen metabolism. As to receptor or sympathetic nerve end, cardiac insufficiency or cardiac transplantation was evaluated. Imaging of positron emitting radiopharmaceutical by gamma camera has been performed. Collimator method is clinically useful for cardiac imaging of viability study. (author). 54 refs

  16. Doses to nuclear technicians in a dedicated PET/CT centre utilising 18F fluorodeoxyglucose (FDG)

    The first dedicated PET/CT centre in Norway was established at the Norwegian Radiumhospital in Oslo in 2005. Knowing that the introductions of PET-isotopes in nuclear medicine give increased occupational radiation dose to the technicians, a study was carried out in order to map the doses to staff members during different working operations and to see if any dose reducing measures were needed. The results of the study are in good agreement with other studies, and a technician dose of 20-25 nSv per injected MBq of 18F seems to be representative for such centres. For an average injected activity of 350 MBq per patient, the dose limit is reached after handling around 3000 patients annually. For an annual number of less than 500 patients at the centre and rotation of the staff, an annual individual dose for the technicians would realistically be less than 2-3 mSv. Even a major increase in the number of patients will not result in individual doses near the ICRP dose limit. (authors)

  17. Role of high 18-F-fluorodeoxyglucose uptake values with histopathological factors in primary breast cancer

    18F FDG uptake is an independent prognostic factor for relapse-free survival and histological grade. High FDG uptake can be used as a potential tool to select patients for aggressive chemotherapy and prognosticate the patients accordingly

  18. In vivo imaging of monocyte trafficking with 18F-fluorodeoxyglucose labeled monocytes

    Since the ability to monitor in vivo monocyte trafficking would contribute to our understanding of the pathophysiology of various inflammatory disorders, we investigated the feasibility of labeling human monocytes with 18F-FDG. Human monocytes were separated by Ficoll/Hypaque gradient and purity was assessed by flow cytometry. The influence of insulin and/or glucose on labeling efficiency was evaluated. Cell viability and activation was measured with trypan blue exclusion and hydrogen peroxide assays, respectively. Label stability was measured for up to 18 hr, and the effect of insulin pre-incubation on FDG washout was investigated. PET images were acquired in SD rats at various time points after injection of FDG labeled monocytes. Monocytes were >85% pure, and labeling efficiency was 35% for 1x106 cells after 40 min incubation with 2 mCi 18F-FDG without insulin. Pre-incubation with 10∼100 nM insulin significantly increased FDG uptake which reached 400% of baseline levels, whereas presence of glucose or serum decreased FDG uptake. Labeled cells were >90% viable for up to 22 hr, and the labeling process did appear to significantly activate cells, Washout studies however, demonstrated gradual washout of the FDG from monocytes after initial uptake PET images of FDG labeled monocytes in SD rats showed consistent findings. Utilizing insulin effects on cellular glucose metabolism may be a feasible way of labeling monocytes with 18F-FDG for PET imaging. However, gradual washout of FDG after initial uptake poses as a potential problem which needs to be addressed before practical application

  19. Estradiol stimulation enhances 18F-fluorodeoxyglucose uptake in breast cancer cells

    While 18F-FDG PET has an important role for detecting and monitoring breast carcinoma, the metabolic effects of estrogen stimulation on breast cancer cells may potentially affect their glucose handling. We therefore investigated the effect of estrogen stimulation on FDG uptake in a breast cancer cell line. Estrogen responsive human breast cancer MCF-7 cells were cultured in estrogen free media and were stimulated with 10-6∼10-11 M 17β-estradial (E2) for 2 to 72 hours. Levels of 18F-FDG uptake was measured after 40 min incubation. Cell number was assessed with MTT assays. The effect of P13-kinase inhibition was evaluated with 200 nM wortmannin added immediately before E2 stimulation. FDG uptake was significantly augmentated after 48 ∼ 72 hr stimulation by E2, with peak effects at concentrations of 10-8∼10-10M. After 48 hr stimulation with 10-9 M E2. FDG uptake averaged 176 ±6% of control levels (p<0.000). MTT assays did not show significant differences in cell number between groups at this stage. FDG uptake was also increased to 140±16% of controls after 24 hr stimulation (p<0.02), but the effect was significantly inhibited by wortmannin. Estradiol stimulation significantly enhances FDG uptake in estrogen responsive breast cancer cells, which appears to be at least partially mediated by the P13 kinase pathway. This phenomena may have important implication in interpretation of FDG uptake values for monitoring treatment response, since the patient may have different estrogen levels or may undergo antiestrogen treatment

  20. Functional testicular evaluation using PET/CT with 18F-fluorodeoxyglucose

    PET/CT using 18F-FDG is a well-established diagnostic examination in oncology, cardiology and neurology. The clinical significance of nontumoral testicular uptake of FDG is unknown. Functional testicular imaging may have important clinical applications in the diagnosis and prognosis of male infertility. The aim of this study was to determine the andrological value of a FDG PET/CT in analysing testicular function, by correlating the PET/CT data with the sperm parameters. Retrospective analysis of FDG PET/CT in 20 consecutive cancer patients without testicular pathology in whom two semen samples had been obtained for analysis before any chemotherapy. FDG PET/CT parameters were the mean standardized uptake value (SUVmean), used for measuring the intensity of uptake, and the functional testicular volume (FV). For statistical analysis, a Spearman's rank correlation test and a Mann-Whitney test were used. Of 20 patients (mean age 22 years), 18 had provided two sperm samples for cryopreservation. Sperm concentration was above 20 x 106/ml in 55% of the patients. The intensity of uptake and the FV were correlated with the total sperm count, the sperm concentration and motility (p < 0.05). The difference in SUVmean between the two testes showed an inverse correlation with sperm concentration (p = 0.036). Normospermic and oligospermic men had significant differences in: (1) mean SUVmean, (2) mean FV, and (3) the difference in intensity of uptake between the testes (p < 0.05). This is the first report on the andrological value of FDG PET/CT in analysing nontumoral testicular function. This pilot study showed a significant correlation between intensity of uptake of FDG and testicular FV with the main sperm parameters. PET/CT with FDG could become a useful new tool in assisted reproductive technologies and other andrological or urological applications. (orig.)