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Sample records for 2-18ffluoro-2-deoxy-d-glucose 18fdg stored

  1. Stability study of 2-[18F]Fluoro-2-Deoxy-D-Glucose (18FDG) stored at room temperature by physicochemical and microbiological assays

    The most widely used radiopharmaceutical in the expanding medical imaging technology of Positron Emission Tomography (PET) is 2-[18F]fluoro-2-deoxy-D-glucose (18FDG). The increasing demand for 18FDG requires reliable production in large amounts. The synthesis of 18FDG is based on a nucleophilic substitution of the triflate-leaving group from the precursor, mannose triflate, in the presence of Crypt and 2.2.2, as a phase-transfer agent. After labeling, the removal of the acetyl protecting groups from resulting 2-[18F]fluoro-1,3,4,6-tetra-Oacetyl- D-glucose is performed by alkaline hydrolysis, followed by purification and final filtration (0.22 μm). It was reported that 18FDG decomposes in vitro, resulting in the degradation of the radiochemical purity with time. The aim of this study was to evaluate physicochemical and microbiological stability of 18FDG, stored at room temperature (15-30 deg C), at different time intervals. It was investigated how the quality of this radiopharmaceutical varies with time under the influence of environmental factors. 18FDG pH, radionuclidic identity and purity, radiochemical identity and purity, chemical purity, residual solvents, bacterial endotoxins and sterility were evaluated according to the United States Pharmacopeia 31th edition analytical methods and acceptance criteria. The results suggest that 18FDG has physicochemical and microbiological stability up to 10 hours after the end of synthesis, under experimental conditions. (author)

  2. Stability study of 2-[{sup 18}F]Fluoro-2-Deoxy-D-Glucose ({sup 18}FDG) stored at room temperature by physicochemical and microbiological assays

    Ferreira, Soraya Z.; Silva, Juliana B. da; Waquil, Samira S.; Correia, Ricardo F. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil). Unidade de Pesquisa e Producao de Radiofarmacos], e-mail: radiofarmacoscdtn@cdtn.br

    2009-07-01

    The most widely used radiopharmaceutical in the expanding medical imaging technology of Positron Emission Tomography (PET) is 2-[{sup 18}F]fluoro-2-deoxy-D-glucose ({sup 18}FDG). The increasing demand for {sup 18}FDG requires reliable production in large amounts. The synthesis of {sup 18}FDG is based on a nucleophilic substitution of the triflate-leaving group from the precursor, mannose triflate, in the presence of Crypt and 2.2.2, as a phase-transfer agent. After labeling, the removal of the acetyl protecting groups from resulting 2-[{sup 18}F]fluoro-1,3,4,6-tetra-Oacetyl- D-glucose is performed by alkaline hydrolysis, followed by purification and final filtration (0.22 {mu}m). It was reported that {sup 18}FDG decomposes in vitro, resulting in the degradation of the radiochemical purity with time. The aim of this study was to evaluate physicochemical and microbiological stability of {sup 18}FDG, stored at room temperature (15-30 deg C), at different time intervals. It was investigated how the quality of this radiopharmaceutical varies with time under the influence of environmental factors. {sup 18}FDG pH, radionuclidic identity and purity, radiochemical identity and purity, chemical purity, residual solvents, bacterial endotoxins and sterility were evaluated according to the United States Pharmacopeia 31{sup th} edition analytical methods and acceptance criteria. The results suggest that {sup 18}FDG has physicochemical and microbiological stability up to 10 hours after the end of synthesis, under experimental conditions. (author)

  3. 18-FDG in diabetes mellitus

    Fares, Y. (Dept. of Biophysics, Faculty of Medicine, UAE Univ., Al Ain (United Arab Emirates)); Itoh, M. (Cyclotron and Radioisotope Centre, Tohoku Univ., Sendai (Japan)); Watabe, H. (Cyclotron and Radioisotope Centre, Tohoku Univ., Sendai (Japan)); Ghista, D.N. (Dept. of Biophysics, Faculty of Medicine, UAE Univ., Al Ain (United Arab Emirates))

    1993-06-01

    The intravenous glucose tolerance test, IVGTT, has been used to evaluate patients in whom abnormalities in carbohydrate metabolism and diabetes mellitus are suspected. IVGTT, if analyzed using 'minimal models', or discrete-time methods, provides information on the sensitivity of glucose disappearance to insulin and on pancreatic sensitivity to glucose, information that cannot be obtained from direct analysis of the dynamic response alone. In a preliminary study, data obtained by intravenously injecting 18-FDG in four subjects was analyzed using a discrete-time model. The experimental details, the results and their implications will be discussed. (orig.)

  4. Estimation of 18FDG doses's cost

    The cyclotron facility, essentially for medical use, is far from being a simple establishment of a dedicated device to accelerate particles producing a beta plus emitter radioelement. The cyclotron site encompasses more over all necessary equipments for the production and the quality control of considered radiotracer that 18FDG is just one example. This facility is subject to strict standards in terms of radiopharmaceutical production, radiation level, pressure level and airflow resulting in the production of a drug submitted to the MA (Marketing Authorization). These multiple factors directly influence the final cost of the dose that remains to be reachable by the patient. The aim of this work is to estimate the cost of a dose of 18FDG to ensure financial viability of the project while accessible to the patient. The cost of the facility will entail the following: buildings and utilities, equipment and operational cost. This calculation is possible only if we define in advance the type of cyclotron, which is bound to the market needs in particular the number of PET facilities, the number of scans per day and the radioactive decay of radioelement. Our study represents a simulation that considers some hypothesis. We assumed that the cyclotron is installed in Sousse and that the PET facilities number (positon emission tomography) is 6 in which 4 are located 2 hours away. For a PET scan, the average dose per patient is about 350 MBq (5 MBq/kg) and the exam duration is about 45 minutes. Each center performs 10 tests per day. In terms of fees, we considered device and building's cost, facility amortization, consumables (target, marking accessories), maintenance, remuneration expense and the annual electricity consumption. All our calculations have been reported to the number of working days per year. The estimates were made outside the customs duties and technical assistance that may last up to 2 years. Requirements and needs were estimated at 5.4 curies per day. For

  5. The modular synthesis production of 18FDG in Chile

    It is widely recognized, since past several years, that 18FDG (18F-2-deoxy-2-fluoro-D-glucose) is the most attractive positron emitter radiopharmaceutical used in imaging and clinical diagnostic nowadays. Its unique chemical behavior and decay properties (t1/2 = 109.7 min, β+ 96.9% and EC 3.1%) makes of 18F a most desirable radionuclide for human IV administration. Accordingly, it has been observed, during the past decade, a world wide increasing demand for 18FDG and new 18F-radiopharmaceuticals are appearing on the market. Such availability did became reality in our country but, only when the Chilean Nuclear Energy Commission decided to assume its leadership on neutron deficient radionuclides developments. The acquisition of a Cyclone 18/9 accelerator is intended to boost a new frontier in our national nuclear medicine practice and to fulfill any internal positron emitter demand, specially 18F, may growth in the near future. A review of procedures for 18FDG formulation shows that labeling of mannose triflate, as specific FDG precursor, with cyclotron produced 18F, as the fluoride specie, is the most successful approach. In this work the procedure for producing 18FDG using a commercial modular synthesizer, computer driven system, to perform the labeling and some quality controls requirements are reviewed (author)

  6. F-18 FDG PET in Detecting Renal Cell Carcinoma

    Purpose: To assess the role of F-18 FDG imaging with a dual head coincidence mode gamma camera (Co-PET) in the detection of renal cell carcinoma (RCC) in patients with renal masses. Material and Methods: An F-18 FDG Co-PET study was performed in 19 patients (7 F, 12 M; mean age 58.15±2.5 years, age range 45-79 years) with suspected primary renal tumors based on conventional imaging techniques, including computed tomography (CT) and ultrasonography (US) before nephrectomy or surgical resection of the mass. Results: Histologically documented RCC was present in 15 patients. Of the 19 patients with suspected primary renal tumors, F-18 FDG Co-PET was true-positive in 13, false-negative in 2, true-negative in 3, and false-positive in 1 patient. Twangiomyolipomas and one renal mass due to infarction and hemorrhage showed a true-negative Co-PET result. The patient with false-positive FDG Co-PET study was diagnosed as xantogranulomatous pyelonephritis. Overall sensitivity, specificity, and accuracy of FDG Co-PET for RCC were 86% (13/15), 75% (3/4), and 84% (16/19), respectively. Positive predictive value for RCC was 92% and negative predictive value 60%. Conclusion: These findings suggest that F-18 FDG Co-PET may have a role in the diagnostic evaluation of patients with RCC and primary staging of disease. Positive F-18 FDG study may be predictive of the presence of RCC. However, a negative study does not exclude the RCC

  7. F 18 FDG PET/CT of a Gastric Schwannoma

    Hong, Il Ki; Kim, Deog Yoon [Kyung Hee Univ. School of Medicine, Seoul (Korea, Republic of)

    2011-09-15

    Schwannomas, also known as neurilemmomas, are tumors originating from nervous tissue; they have Schwann cell sheaths. According to a recent classification, about 80% of gastrointestinal mesenchymal tumors are gastrointestinal stromal tumors (GISTs). Gastrointestinal (GI) Schwannomas have been reported to represent only 3% of all GI mesenchymal tumors. These tumors make up only 0.2% of all gastric neoplasms. Schwannomas of the GI tract are distinctive from conventional Schwannomas that arise in soft tissue of the central nervous system. GI Schwannomas are hypothesized to arise from the myenteric plexus within the GI tract wall. These tumors are usually benign, slow growing and asymptomatic, and therefore most are discovered incidentally. The differentiation of Schwannomas from other submucosal tumors is very difficult. The main differential diagnosis for a mass arising in the wall of the gastointestinal tract is a GIST, which is a potentially malignant mesenchymal GI tumor that arises from the interstitial cells of Cajal, which help regulate peristalsis. The diagnostic determination of Schwannomas requires positive histological tests for S 100 protein and vimentin, but negative histological tests for smooth muscle actin and c KIT. In contrast, GISTs are C KIT positive and can be S 100 positive if they are located in small bowel. Because most patients with Schwannomas have excellent prognoses, surgical removal is sufficient for treatment. Gastric Schwannomas are normally benign, and malignant transformation is extremely rare. However, the current case illustrates that these tumors may exhibit avid F 18 FDG uptake. It remains unclear why high F 18 FDG uptake is found in benign tumors such as Schwannomas. F 18 FDG uptake in soft tissue and neural Schwannomas is variable but is frequently high, possibly due to over expression of the glucose transporter by tumor cells. In particular, glucose transporter type 3 is found in all human tissues and is the major glucose

  8. 18FDG PET scanning of benign and malignant musculoskeletal lesions

    To describe the technique, applications and advantages of 18FDG PET scanning in detection, analysis and management of musculoskeletal lesions.Design and patients Forty-five patients (19 males,26 females) aged 9 to 81 years had radiographs, routine radionuclide scans, CT and/or MRI of clinically suspected active benign or malignant musculoskeletal lesions. 18FDG scans with a Siemens ECAT EXACT 921 dedicated PET unit (Knoxville, Tenn.) and FWH=6 mm images acquired as a 5-6 bed examination (6 min emission and 4 min transmission) used OSEM iterative reconstruction with segmented transmission attenuation correction and a Gaussian filter (cutoff 6.7 mm). Region of interest (ROI) 3 x 3 pixel image analysis based on transverse whole body images (slice thickness 3.37 mm) generated Maximum Standard Uptake Values (Max SUV) with a cutoff of 2.0 used to distinguish benign and malignant lesions. Thirty-nine studies were available for SUV ROI analysis. Overall sensitivity for differentiating malignant from benign osseous and non-osseous lesions was 91.7% (22/24), overall specificity was 100% (11/11) with an accuracy of 91.7%. All aggressive lesions had a Max SUV >2.0. Data separating benign from malignant lesions and aggressive from benign lesions were statistically significant (P18FDG PET contributes unique information regarding metabolism of musculoskeletal lesions. By supplying a physiologic basis for more informed treatment and management, it influences prognosis and survival. Moreover, since residual, recurrent or metastatic tumors can be simultaneously documented on a single whole body scan, PET may theoretically prove to be cost-effective. (orig.)

  9. Cerebral metabolic changes (F-18-FDG PET) during selective anterior temporal lobe amobarbital test

    Khan, N; Hajek, M; Antonini, A; Maguire, P; Muller, S; Valavanis, A; Leenders, KL; Regard, M; Schiess, R; Wieser, HG

    1997-01-01

    Cerebral glucose utilisation using F-18-fluorodeoxyglucose positron emission tomography (F-18-FDG PET) was measured in 4 patients with temporal lobe epilepsy during a selective anterior temporal lobe (TL) amobarbital test (ATLAT) and compared with their baseline values. F-18-FDG was injected intrave

  10. Integrated 18FDG PET/CT: Utility and Applications in Clinical Oncology

    Nieves Gómez-León

    2008-01-01

    Full Text Available Accurate diagnosis and staging are essential for an optimal management of cancer patients. Positron emision tomography with 2-deoxy-2-fluorine-18-fluoro-D-glucose (18FDG-PET and, more recently, 18FDG-PET/computed tomography (18FDG-PET/CT have emerged as powerful imaging tools in oncology, because of the valuable functional information they provide. The combined acquisition of PET and CT has synergistic advantages over its isolated constituents and minimizes their limitations. It decreases examination times by 25%–40%, leads to a higher patient throughput and unificates two imaging procedures in a single session. There is evidence that 18FDG-PET/CT is a more accurate test than either of its components for the evaluation of various tumors. It is a particularly valuable tool for detection of recurrence, especially in asymptomatic patients with rising tumor markers and those with negative or equivocal findings on conventional imaging tests. Yet, there are some limitations and areas of uncertainty, mainly regarding the lack of specificity of the 18FDG uptake and the variable 18FDG avidity of some cancers. This article reviews the advantages, limitations and main applications of 18FDG-PET/CT in oncology, with especial emphasis on lung cancer, colorectal cancer, lymphomas, melanoma and head and neck cancers.

  11. Two Cases of Peritoneal Tuberculosis Mimicking Peritoneal Carcinomatosis on F-18 FDG PET/CT

    Choi, Soon Uk; Kim, Eun Sil; Kim, So Yon; Yu, Chang Min; Lee, Se Han; Hyun, Hee Jae; Lee, Hyo Jin; Kim, Seung Yup [National Police Hospital, Seoul (Korea, Republic of)

    2009-10-15

    F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET/CT) plays an important role in diagnosis of malignant tumors and adds to conventional imaging in the staging of pertoneal carcinomatosis. However, false positive cases resulting from benign disease such as tuberculosis may occur. We report two cases of peritoneal tuberculosis on F-18 FDG PET/CT which showed multiple hypermetabolic foci in the mesentery and peritoneum with increased serum cancer antigen 125 (CA 125). Subsequent F-18 FDG PET/CT showed a disappearance of pathologic uptake following treatment with anti-tuberculosis drugs.

  12. Two Cases of Peritoneal Tuberculosis Mimicking Peritoneal Carcinomatosis on F-18 FDG PET/CT

    F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET/CT) plays an important role in diagnosis of malignant tumors and adds to conventional imaging in the staging of pertoneal carcinomatosis. However, false positive cases resulting from benign disease such as tuberculosis may occur. We report two cases of peritoneal tuberculosis on F-18 FDG PET/CT which showed multiple hypermetabolic foci in the mesentery and peritoneum with increased serum cancer antigen 125 (CA 125). Subsequent F-18 FDG PET/CT showed a disappearance of pathologic uptake following treatment with anti-tuberculosis drugs

  13. Recurrent giant cell tumor of foot detected by F18-FDG PET/CT

    Detection of recurrence of tumors with conventional imaging like computed tomography (CT) and magnetic resonance imaging (MRI) can be difficult because of distorted anatomy and implants in situ. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) has been shown to be very useful in detection of recurrent tumors with higher accuracy than conventional imaging method. Giant cell tumors of foot though rare have high recurrence potential after initial curative treatment. However, currently there is no literature addressing the role of F-18 FDG PET/CT in evaluation of these tumors. We report a case of post excisional recurrent giant cell tumor of foot diagnosed on F-18 FDG PET/CT. In addition, to detection of recurrence F-18 FDG PET/CT also aided in accurate management of the patient. (author)

  14. A simple method for the quality control of [F-18]FDG

    Koziorowski, J.

    2010-01-01

    Most automated synthesis modules produce [F-18]FDG within half an hour, but the quality control involving up to three separate methods and three different analytical systems is time consuming. The use of HPLC, TLC, and GC for the quality control of [F-18]FDG is both time consuming and expensive...... (high purchase costs). Presented here is a method using a single HPLC system for all three analyses. (C) 2010 Elsevier Ltd. All rights reserved...

  15. A clinical positron emission tomography facility. 2-18FDG studies: Development and results

    Two different types of accelerators have been used for production of (18F)fluoride, and the isotope produced has been used for radiolabelling of 2-fluoro-2-deoxy-D-glucose (2-18FDG). A rotating PET scanner, based on two scintillation camera heads, has been developed and used for human 2-18FDG studies. The suitability of an energy window in the Compton region for imaging 511 keV photons in scintillation camera systems has been evaluated. A new simplified method for normalizing clinical 2-18FDG results has been developed and validated, using erythrocytes as a reference tissue, requiring only one blood sample in the middle of the PET scan to calculate the integrated 2-18FDG input function with an accuracy better than 8 percent. An investigation using 2-18FDG PET to monitor the effect of therapy in advanced head and neck cancer patients has been performed. We found that low initial metabolic rate of glucose (MRG) predicted a complete local response. The second PET examination gave no further information for this group. In the group of primary tumours and lymph node metastases representing a combination of high initial MRG and small decrease in MRG at he second PET examination, the outcome was unfavourable. An accurate normalization of 2-18FDG uptake was essential to evaluate the results of this study. 239 refs, 10 tabs

  16. A clinical positron emission tomography facility. 2-{sup 18}FDG studies: Development and results

    Ohlsson, Tomas

    1996-10-01

    Two different types of accelerators have been used for production of ({sup 18}F)fluoride, and the isotope produced has been used for radiolabelling of 2-fluoro-2-deoxy-D-glucose (2-{sup 18}FDG). A rotating PET scanner, based on two scintillation camera heads, has been developed and used for human 2-{sup 18}FDG studies. The suitability of an energy window in the Compton region for imaging 511 keV photons in scintillation camera systems has been evaluated. A new simplified method for normalizing clinical 2-{sup 18}FDG results has been developed and validated, using erythrocytes as a reference tissue, requiring only one blood sample in the middle of the PET scan to calculate the integrated 2-{sup 18}FDG input function with an accuracy better than 8 percent. An investigation using 2-{sup 18}FDG PET to monitor the effect of therapy in advanced head and neck cancer patients has been performed. We found that low initial metabolic rate of glucose (MRG) predicted a complete local response. The second PET examination gave no further information for this group. In the group of primary tumours and lymph node metastases representing a combination of high initial MRG and small decrease in MRG at he second PET examination, the outcome was unfavourable. An accurate normalization of 2-{sup 18}FDG uptake was essential to evaluate the results of this study. 239 refs, 10 tabs.

  17. The findings of F-18 FDG camera-based coincidence PET in acute leukemia

    We evaluated the usefulness of F-18 FDG coincidence PET (CoDe-PET) using a dual-head gamma camera in the assessment of patients with acute leukemia. F-18 FDG CoDE-PET studies were performed in 5 patients with acute leukemia (6 ALL and 2 AML) before or after treatment. CoDe-PET was performed utilizing a dual-head gamma camera equipped with 5/8 inch NaI(Tl) crystal. Image acquisition began 60 minutes after the injection of F-18 FDG in the fasting state. A whole trunk from cervical to inguinal regions or selected region were scanned. No attenuation correction was made and image reconstruction was done using filtered back-projection. CoDe-PET studies were evaluated visually. F-18 FDG image performed in 5 patients with ALL before therapy depicted multiple lymph node involvement and diffuse increased uptake involving axial skeleton, pelvis and femurs. F-18 FDG image done in 2 AML after chemotherapy showed only diffuse increased uptake in sternum, ribs, spine, pelvis and proximal femur and these may be due to G-CSF stimulation effect in view of drug history. But bone marrow histology showed scattered blast cell suggesting incomplete remission in one and completer remission in another. F-18 image done in 1 ALL after therapy showed no abnormal uptake. CoDe-PET with F-18 FDG in acute lymphoblastic lymphoma showed multiple lymphnode and bone marrow involvement in whole body. Therefore we conclude that CoDe-PET with F-18 FDG usefulness for evaluation of extent in acute lymphoblastic leukemia. But there was a limitation to assess therapy effectiveness during therapy due to reactive bone marrow

  18. The findings of F-18 FDG camera-based coincidence PET in acute leukemia

    Yoon, S. N.; Joh, C. W.; Lee, M. H. [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2002-07-01

    We evaluated the usefulness of F-18 FDG coincidence PET (CoDe-PET) using a dual-head gamma camera in the assessment of patients with acute leukemia. F-18 FDG CoDE-PET studies were performed in 5 patients with acute leukemia (6 ALL and 2 AML) before or after treatment. CoDe-PET was performed utilizing a dual-head gamma camera equipped with 5/8 inch NaI(Tl) crystal. Image acquisition began 60 minutes after the injection of F-18 FDG in the fasting state. A whole trunk from cervical to inguinal regions or selected region were scanned. No attenuation correction was made and image reconstruction was done using filtered back-projection. CoDe-PET studies were evaluated visually. F-18 FDG image performed in 5 patients with ALL before therapy depicted multiple lymph node involvement and diffuse increased uptake involving axial skeleton, pelvis and femurs. F-18 FDG image done in 2 AML after chemotherapy showed only diffuse increased uptake in sternum, ribs, spine, pelvis and proximal femur and these may be due to G-CSF stimulation effect in view of drug history. But bone marrow histology showed scattered blast cell suggesting incomplete remission in one and completer remission in another. F-18 image done in 1 ALL after therapy showed no abnormal uptake. CoDe-PET with F-18 FDG in acute lymphoblastic lymphoma showed multiple lymphnode and bone marrow involvement in whole body. Therefore we conclude that CoDe-PET with F-18 FDG usefulness for evaluation of extent in acute lymphoblastic leukemia. But there was a limitation to assess therapy effectiveness during therapy due to reactive bone marrow.

  19. Clinical Significance of Myocardial Uptake on F-18 FDG PET/CT Performed in Oncologic Patients

    F-18 fluorodeoxyglucose (FDG) uptake of myocardium is influenced by various factors. Increased glycolysis, and subsequent increased F-18 FDG uptake has been reported in ischemic cardiomyopathy. However, clinical significance of incidentally found myocardial F-18 FDG uptake has not been clarified. We retrospectively reviewed the degree and pattern of myocardial uptake in patients without history of ischemic heart disease who underwent torso F-18 FDG PET/CT for evaluation of neoplastic disease. From January 2005 to June 2009, 77 patients who underwent F-18 FDG PET/CT and Tc-99m sestamibi stress/rest SPECT within 3 months were enrolled. Of 77 patients, 55 (71.4%) showed increased F-18 FDG uptake in the myocardium. In this population, 40 showed uniform uptake pattern, while 15 showed focal uptake. In patients with uniform uptake, 17 showed decreased uptake in the septum without perfusion defect on myocardial SPECT. Remaining 23 patients showed uniform uptake, with 1 reversible perfusion defect and 1 fixed perfusion defect. In 15 patients with focal uptake, 9 showed increased F-18 FDG uptake in the base, and only 1 of them showed reversible perfusion defect on myocardial SPECT. In the remaining 6 focal uptake group, 4 had reversible perfusion defect in the corresponding wall, and 1 had apical hypertrophy. We demonstrated that septal defect pattern and basal uptake pattern in the myocardium may represent normal variants. Focal myocardial uptake other than normal variants on oncologic torso F-18 FDG PET/CT with routine fasting protocol may suggest ischemic heart disease, thus further evaluation is warranted

  20. The Clinical Utility of Rectal Gas Distension F-18 FDG PET/CT

    Kim, Jin Suk; Lim, Seok Tae; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Sohn, Myung Hee [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2009-12-15

    The aim of this study was to evaluate the clinical value of rectal gas distension F-18 FDG PET/CT imaging for the differentiation of the rectal focal uptake lesions. Twenty four patients (M:F=11:13, Age 62.8{+-}12.4 years) underwent rectal gas distension F-18 FDG PET/CT, prospectively: initial image at 50-60 min after the intravenous injection of F-18 FDG and rectal distension image after the infusion of air through the anus. Focally increased uptake lesions on initial images but disappeared on rectal distension images defined a physiological uptake. For the differential evaluation of persistent focal uptake lesions on rectal distension images, colonoscopy and histopathologic examination were performed. Among the 24 patients, 27 lesions of focal rectal uptake were detected on initial images of F-18 FDG PET/CT. Of these, 7 lesions were able to judge with physiological uptake because the focal increased uptake disappeared from rectal distension image. Remaining 3 lesions were non-rectal lesions (2 lesions: rectovesical space, 1 lesion: uterine myoma). Among 17 lesions which was showed persistent increased uptake in rectal distension image, 15 lesions were confirmed as the malignant tumor (SUVmax=15.9{+-}6.8) and 2 lesions were confirmed as the benign lesions including adenoma and inflammatory disease. The rectal distension F-18 FDG PET/CT imaging could be an important noninvasive method for the differentiation of malignant and benign focal rectal uptake lesions including physiologic uptake.

  1. Growing cardiac hemangioma on serial F18 FDG PET/CT

    Cardiac hemangiomas are extremely rare, benign tumors, which can occur anywhere in the heart. Symptoms are variable according to the size, extension and tumor location, but most cases are asymptomatic and are detected incidentally. They may grow, remain stable and regress; therefore, the natural course of the tumors is unpredictable. Diagnosis mainly depends upon echocardiography, CT, MRI and angiography. Reports of detection by F18 FDG PET/CT are very limited. We report a case of cardiac hemangioma attached to the right ventricle, compressing the ventricle. It was revealed incidentally on F18 FDG PET/CT for routine evaluation of thyroid cancer. During two serial F18 FDG PET/CTs, it grew from 2.8cm to 4.0cm with mild FDG uptake. After surgery, the patient remained stable without any complications

  2. Primary Malignant Peritoneal Mesothelioma Mimicking Peritoneal Carcinomatosis on F-18 FDG PET/CT

    Kim, Jin Suk; Lim, Seok Tae; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Sohn, Myung Hee [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2009-08-15

    Malignant mesothelioma of the peritoneum is a rare neoplasm with a rapidly fatal course. The tumour arises from the mesothelial cells lining the pleura and peritoneum or, rarely, in the pericardium or tunica vaginalis. This neoplasm is characterized by being difficult to diagnose, having a rapid evolution and a poor response to therapy. Mesothelioma is very glucose avid, and malignant pleural mesothelioma has been reported concerning the utility of F-18 FDG PET or PET/CT. But little has been known about the imaging finding of malignant peritoneal mesothelioma on F-18 FDG PET/CT. We report a case of malignant peritoneal mesothelioma mimicking peritoneal carcinomatosis of F-18 FDG PET/CT.

  3. Primary Malignant Peritoneal Mesothelioma Mimicking Peritoneal Carcinomatosis on F-18 FDG PET/CT

    Malignant mesothelioma of the peritoneum is a rare neoplasm with a rapidly fatal course. The tumour arises from the mesothelial cells lining the pleura and peritoneum or, rarely, in the pericardium or tunica vaginalis. This neoplasm is characterized by being difficult to diagnose, having a rapid evolution and a poor response to therapy. Mesothelioma is very glucose avid, and malignant pleural mesothelioma has been reported concerning the utility of F-18 FDG PET or PET/CT. But little has been known about the imaging finding of malignant peritoneal mesothelioma on F-18 FDG PET/CT. We report a case of malignant peritoneal mesothelioma mimicking peritoneal carcinomatosis of F-18 FDG PET/CT

  4. A Case of Acute Q Fever Hepatitis Diagnosed by F-18 FDG PET/CT

    A 53-year-old man with fever of unknown origin underwent F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) as a workup for a fever of unknown origin. On presentation, he complained of fever, chills, and myalgia. The F-18 FDG PET/CT scan showed diffusely increased uptake of the liver with mild hepatomegaly. A liver biopsy then revealed fibrin-ring granulomas typically seen in Q fever. The patient was later serologically diagnosed as having acute Q fever as the titers for C. IgM and IgG were 64:1 and -16:1, respectively. He recovered completely following administration of doxycycline. This indicates that F-18 FDG PET/CT may be helpful for identifying hepatic involvement in Q fever as a cause of fever of unknown origin.

  5. Internal dosimetry for intake of 18FDG using spot urine sample

    In nuclear medicine, workers handle unsealed radioactive materials. Among the materials, 18FDG is the most widely used in PET/CT technique. Because of the short half-life of 18F, it is very challenging to monitor internal exposure of nuclear medicine workers using in vitro bioassay. Thus, the authors developed the new in vitro bioassay methodology for short half-life nuclides. In the methodology, spot urine sample is directly used without normalisation to 1-d urine sample and the spot urinary excretion function was newly proposed. In order to estimate the intake and committed dose for workers dealing 18FDG, biokinetic models for FDG was also developed. Using the new methodology and biokinetic model, the in vitro bioassay for workers dealing 18FDG was successfully performed. The authors expect that this methodology will be very useful for internal monitoring of workers who deal short-lived radionuclides in the all field as well as the nuclear medicine field. (authors)

  6. Growing cardiac hemangioma on serial F18 FDG PET/CT

    Jeong, Young Jin; Yoon, Hyun Jin; Kang, Do Young [Dong A Univ. Medical Center, Busan (Korea, Republic of)

    2012-09-15

    Cardiac hemangiomas are extremely rare, benign tumors, which can occur anywhere in the heart. Symptoms are variable according to the size, extension and tumor location, but most cases are asymptomatic and are detected incidentally. They may grow, remain stable and regress; therefore, the natural course of the tumors is unpredictable. Diagnosis mainly depends upon echocardiography, CT, MRI and angiography. Reports of detection by F18 FDG PET/CT are very limited. We report a case of cardiac hemangioma attached to the right ventricle, compressing the ventricle. It was revealed incidentally on F18 FDG PET/CT for routine evaluation of thyroid cancer. During two serial F18 FDG PET/CTs, it grew from 2.8cm to 4.0cm with mild FDG uptake. After surgery, the patient remained stable without any complications.

  7. A Case of Acute Q Fever Hepatitis Diagnosed by F-18 FDG PET/CT

    Beak, Sora [Hallym Univ. College of Medicine, Seoul (Korea, Republic of); Oh, Minyoung; Lee, Sand-Oh; Yu, Eunsil; Ryu Jin-Sook [Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    A 53-year-old man with fever of unknown origin underwent F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) as a workup for a fever of unknown origin. On presentation, he complained of fever, chills, and myalgia. The F-18 FDG PET/CT scan showed diffusely increased uptake of the liver with mild hepatomegaly. A liver biopsy then revealed fibrin-ring granulomas typically seen in Q fever. The patient was later serologically diagnosed as having acute Q fever as the titers for C. IgM and IgG were 64:1 and -16:1, respectively. He recovered completely following administration of doxycycline. This indicates that F-18 FDG PET/CT may be helpful for identifying hepatic involvement in Q fever as a cause of fever of unknown origin.

  8. Factors Associated with Diffusely Increased Splenic F-18 FDG Uptake in Patients with Cholangiocarcinoma

    Kim, Keunyoung; Kim, Seongjang; Kim, Injoo; Kim, Dong Uk; Kim, Heeyoung; Kim, Sojung; Ahn, Sang Hyun [Pusan National Univ. Hospital, Busan (Korea, Republic of)

    2014-06-15

    Although diffuse splenic {sup 18}F-fluorodeoxyglucose (F-18 FDG) uptake exceeding hepatic activity, is considered abnormal, its clinical significance is rarely discussed in the literature. The aim of this study was to determine the contributing factors causing diffusely increased splenic FDG uptake in patients with cholangiocarcinoma. From January 2010 to March 2013, 140 patients (84 men, 56 women) were enrolled in this study. All patients had been diagnosed with cholangiocarcinoma and underwent F-18 FDG positron emission tomography/computed tomography (PET/CT) for the pretreatment staging work up. Clinical records were reviewed retrospectively. Various hematological parameters, C-reactive protein (CRP) level, CEA, CA19-9, pancreatic enzymes and liver function tests were conducted within 2 days after the F-18 FDG PET/CT study. Diffuse splenic uptake was observed in 23 patients (16.4%). Of those, 19 patients (82.6%) underwent endoscopic retrograde cholangiopancreastography (ERCP) 7 days before F-18 FDG PET/CT. The CRP level (p <0.001) and white blood cell count (p =0.023) were significantly higher in the group of patients with diffuse splenic FDG uptake. The hemoglobin (p <0.001) and the hematocrit (p <0.001) were significantly lower in patients with diffuse splenic FDG uptake. Pancreatic enzymes, liver function test results, and tumor markers were not significantly different between the patients who did or did not have diffusely increased splenic FDG uptake. The significant factors for diffuse splenic F-18 FDG uptake exceeding hepatic F-18 FDG uptake on multivariate analysis included: performing ERCP before F-18 FDG PET-CT (odds ratio [OR], 77.510; 95% CI, 7.624-132.105), and the presence of leukocytosis (OR, 12.436; 95% CI, 2.438-63.445) or anemia (OR, 1.211; 95% CI, 1.051-1.871). In conclusion, our study demonstrated that concurrent inflammation could be associated with diffusely increased splenic FDG uptake. We suggest that performing ERCP before F-18 FDG PET

  9. Chorea in systemic lupus erythematosus: evidence for bilateral putaminal hypermetabolism on F-18 FDG PET

    We describe a 54-year-old woman with systemic lupus erythematosus (SLE) who suddenly presented with chorea and had positive antiphospholipid antibodies. F-18 FDG PET showed abnormally increased glucose metabolism in bilateral putamen and primary motor cotex. Tc-99m ECD SPECT also showed abnormally increased regional cerebral blood flow in bilateral putamen. She was treated with corticosteroid and aspirin after which the symptoms improved. Four months later, follow up F-18 FDG PET showed improvement with resolution of hypermetabolism in bilateral putamen. This case suggests that striatal hypermetabolism is associated with chorea in SLE

  10. Surgical outcome of patients with ischemic cardiomyopathy selected by the results of myocardial viability by preoperative F-18 FDG PET

    Kim, Jae Sung; Hong, Suk Keun; Lee, Young Tak; Kim, Youn Jung; Moon, Keon Sik; Won, Tae Kyoung; Hwang, Hweung Kon [Sejong Hospital, Puchon (Korea, Republic of); Lee, Dong Soo; Kim, Yu Kyeong [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2000-08-01

    We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.

  11. Synchronous primary neoplasms detected on F-18-FDG PET in staging of patients with esophageal cancer

    van Westreenen, HL; Westerterp, M; Jager, PL; van Dullemen, HM; Sloof, GW; Comans, EFI; van Lanschot, JJB; Wiggers, T; Plukker, JTM

    2005-01-01

    Because of improvements in diagnostic technology, the incidental detection of synchronous primary tumors during the preoperative work-up of patients with esophageal cancer has increased. The aim of this study was to determine the rate and clinical relevance of synchronous neoplasms seen on F-18-FDG

  12. [F-18] FDG-PET/CT parameters as predictors of outcome in inoperable NSCLC patients

    Nappi Antonio

    2015-12-01

    Full Text Available Background. We evaluated the prognostic significance of standardized uptake value (SUVmax, metabolic tumour volume (MTV, and total lesion glycolysis (TLG in [F-18] FDG PET/CT findings in patients with inoperable non-small-cell lung cancer (NSCLC.

  13. Quantitative dynamic 18FDG-PET and tracer kinetic analysis of soft tissue sarcomas

    Rusten, Espen; Roedal, Jan [Dept. of Medical Physics, The Norwegian Radium Hospital, Oslo Univ. Hospital, Oslo (Norway); Revheim, Mona E.; Skretting, Arne [Dept. of Radiology and Nuclear Medicine, The Norwegian Radium Hospital, Oslo Univ. Hospital, Oslo (Norway); Bruland, Oevind S. [Dept. of Oncology, The Norwegian Radium Hospital, Oslo Univ. Hospital, Oslo (Norway); Faculty of Medicine, Univ. of Oslo., Oslo (Norway); Malinen, Eirik [Dept. of Medical Physics, The Norwegian Radium Hospital, Oslo Univ. Hospital, Oslo (Norway); Dept. of Medical Physics, Univ. of Oslo, Oslo (Norway)], e-mail: eirik.malinen@fys.uio.no

    2013-08-15

    Purpose: To study soft tissue sarcomas using dynamic positron emission tomography (PET) with the glucose analog tracer [18F]fluoro-2-deoxy-D-glucose (18FDG), to investigate correlations between derived PET image parameters and clinical characteristics, and to discuss implications of dynamic PET acquisition (D-PET). Material and methods: D-PET images of 11 patients with soft tissue sarcomas were analyzed voxel-by-voxel using a compartment tracer kinetic model providing estimates of transfer rates between the vascular, non-metabolized, and metabolized compartments. Furthermore, standard uptake values (SUVs) in the early (2 min p.i.; SUV{sub E}) and late (45 min p.i.; SUV{sub L}) phases of the PET acquisition were obtained. The derived transfer rates K{sub 1}, k{sub 2} and k{sub 3}, along with the metabolic rate of 18FDG (MRFDG) and the vascular fraction np, was fused with the computed tomography (CT) images for visual interpretation. Correlations between D-PET imaging parameters and clinical parameters, i.e. tumor size, grade and clinical status, were calculated with a significance level of 0.05. Results: The temporal uptake pattern of 18FDG in the tumor varied considerably from patient to patient. SUV{sub E} peak was higher than SUV{sub L} peak for four patients. The images of the rate constants showed a systematic pattern, often with elevated intensity in the tumors compared to surrounding tissue. Significant correlations were found between SUV{sub E/L} and some of the rate parameters. Conclusions: Dynamic 18FDG-PET may provide additional valuable information on soft tissue sarcomas not obtainable from conventional 18FDG-PET. The prognostic role of dynamic imaging should be investigated.

  14. Value of f-18 FDG PET/CT in preoperative staging of head and neck cancer

    Choi, Seung Jin; Byun, Sung Su; Park, Sun Won; Kim, Mi Young; Hyun, In Young [lnha University College of Medicine, lncheon (Korea, Republic of)

    2005-07-01

    The current study examined the value of F-18 FDG PET/CT for preoperative staging of head and neck cancer. Nineteen patients (M/F=17/2, 59{+-}12 yr) with histologically proven head and neck cancer (squamous cell carcinoma:18, adenocarcinoma:1) were studied by F-18 FDG PET/CT imaging before surgery. Preoperative CT/MRI were performed in all patients within 1 months preceding FDG PET/CT. The degree of FDG uptake was scored as grade 1 (no enhanced uptake), grade 2(equal to liver), grade 3(lower than cerebellum, but higher than liver), grade 4 (equal to cerebellum). Grade 3, 4 were considered malignant. Standardized uptake values(SUV) were also calculated. SUV > 2.0 was considered malignant. The diagnostic sensitivity and specificity of FDG PET/CT by visual and semiquantitative methods for the detection of cervical lymph node metastasis were compared with CT/MRI. In the 19 patients, a total of 138 lymph node levels were dissected, 37 of which showed metastatic involvement. On visual analysis, the sensitivity and specificity of F-18 FDG PET/CT were 73% (27/37) and 95% (96/101), those for semiquantitative analysis were 70% (26/37) and 91% (92/101), respectively. The sensitivity and specificity of CT/MRI were 78% (29/37) and 93% (94/101). Visual analysis showed similar diagnostic values compared to semiquantitative analysis. There was no significant difference in detecting cervical lymph node metastasis between FDG PET/CT and CT/MRI (p=0.5). In contrast to CT/MRI, FDG PET/CT detected double primary tumor (hepatocellular carcinoma) and bone metastasis in two patients, respectively. The diagnostic accuracy of F-18 FDG PET/CT in detecting cervical lymph node metastasis in patients with head and neck cancer was similar to CT/MRI. However, F-18 FDG PET/CT provides important additional information in preoperative M staging.

  15. [F-18]FDG PET metabolic indices for the evluation of glioma

    [F-18]FDG PET brain imaging is an accurate predictor of primary brain tumor grading and prognosis. The purpose of this study was to evaluate simplified [F-18]FDG PET metabolic indices as indicators of proliferative activity of brain tumor cells. Twenty-five patients with glioma were studied with [F-18]FDG PET. From the tissue radioactivity ratios, following tumor metabolic indices were calculated: 1) the tumor-to-whole brain ratio (T/WB), 2) the ratio of tumor-to-contralateral gray matter at the level of centrum semiovale (T/GM), 3) the ratio of tumor-to-contralateral white matter at the level of centrum semiovale (T/WM), 4) the tumor-to-ipsilateral cerebella ratio (T/iCB) and 5) the tumor-to-contralateral cerebellar ratio (T/cCB). A standardized threshold method was used to define ROIs in the tumor areas having representative metabolic activites. Correlations of the tumor metabolic indices with histologic grade, Ki-67 labeling index (Ki-67 LI), p53, DNA ploidy, DNA index, cytometric proliferating index and cytometric S-phase fraction were examined. There were significant correlations among the five tumor metabolic indices (r=0.948-0.990, p<0.0001). All of the indices were significantly correlated with histologic grade and Ki-67 LI (Table 1); the T/GM and T/WB provided a better indication of histologic grade and Ki-67 LI, respectively. None of the indices had a significant correlation with either p53, DNA ploidy, DNA index, cytometric proliferating index or cytometric S-phase fraction. The results indicate that simplified [F-18]FDG PET metabolic indices may be clinically useful for assessing tumor biology and monitoring metabolic changes in glioma. The indices, T/WB and T/GM appear to be more adequate parameters. In addition, [F-18]FDG PET metabolism in glioma may predict cell proliferative activities more closely related to the Ki-67 labeling index

  16. Role of 18FDG-PET imaging in management of recurrent ovarian carcinoma

    Introduction: Serial assays of CA-125 have been established as a tumor marker for monitoring recurrent epithelial ovarian carcinoma following initial surgery and chemotherapy. The anatomical imaging is performed to localize the tumor site for possible resection. This retrospective study analyzed the efficacy of 18FDG-PET to detect suspected recurrent ovarian carcinoma. Materials and methods: Sixty consecutive patients, age range 40-83 years, mean age 55.8 years with known Ovarian Carcinoma underwent 76 PET-FDG studies. All patients were status post total abdominal Hysterectomy and bilateral salpingo- oopherectomy and were treated with chemo and/or radiation therapy. The imaging was performed at approximately 60 minutes following intravenous injection of average dose of 5.7 mCi 18FDG. Fifty concomitant CA-125 serum assays and 58 anatomical imaging (CT/MRI) were available for comparison. Thirty-eight combined PET, CA-125 and CT/MRI studies were available for evaluation. In addition to ovarian carcinoma in fifteen patients secondary tumors including lung, breast and colon carcinoma and lymphoma were diagnosed. The final diagnoses were based on clinical follow up and other relevant findings. Results: The comparison of the three studies including CA-125, 18FDG-PET and anatomical imaging Revealed. There was no significant difference among all three studies with regard to the diagnosis of recurrent ovarian carcinoma (p=ns). The combined studies improved the sensitivity to 0.98. Among 18 patients with normal CA-125 level, 5 had negative PET and 13 had positive PET studies. Conclusion: 18FDG-PET studies play a major role in detection of recurrent ovarian carcinoma. The Combination of all three studies improves the sensitivity. We recommend routine use of 18FDG- PET in the management of recurrent ovarian carcinoma especially when anatomical imaging is inconclusive. (authors)

  17. The value of 18FDG-PET for the detection of infected hip prosthesis

    We compared the accuracy of fluorine-18 labelled 2-fluoro-2-deoxy-d-glucose positron emission tomography (18FDG PET) with that of technetium-99m hexamethylpropylene amine oxime leucocyte scintigraphy (LS) in the detection of infected hip prosthesis. Seventeen patients with a hip prosthesis suspected for infection were prospectively included and underwent 99mTc-methylene diphosphonate bone scintigraphy (BS), LS and an 18FDG-PET scan within a 2-week period. Seven volunteers with ten asymptomatic hip prostheses were used as a control group and underwent BS and an 18FDG-PET scan. Bacteriology of samples obtained by surgery or by needle aspiration and/or clinical follow-up for up to 6 months were used as the gold standard. Planar images of BS and LS (4 and 24 h p.i.) were acquired, followed by single-photon emission tomography (SPET) LS images (after 4 h). These images were scored as positive or negative by two experienced readers. The 18FDG-PET scans of the patients were compared with the tracer distribution pattern in the asymptomatic control group and with BS. A phantom study was performed in order to identify artefacts. For this purpose, three different attenuation correction methods were tested. The combined analysis of the planar BS and LS resulted in a 75% sensitivity and a 78% specificity. The SPET LS images showed a better lesion contrast, resulting in an 88% sensitivity and a 100% specificity, while 24-h planar images were of no additional value. The analysis of PET images alone resulted in an 88% sensitivity and a 78% specificity. The combination of 18FDG-PET and BS images resulted in an 88% sensitivity and a 67% specificity. Given the presence of small errors near the edge of the metal, which can induce significant artefacts in the corrected emission image, we decided to use the data without attenuation correction. In this preliminary study, 18FDG-PET scans alone showed the same sensitivity as combined BS and LS, although the specificity was slightly lower

  18. Usefulness of {sup 18}FDG-PET in epilepsy. Methods and indications; Utilite de la TEP au {sup 18}FDG dans l'epilepsie. Methodes et indications

    Chassoux, F. [Centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, (France); Service hospitalier Frederic-Joliot, I2BM-CEA, 4, place du General Leclerc, 91401 Orsay cedex, (France)

    2009-05-15

    Positron emission tomography (PET) using 18-fluorodeoxyglucose ({sup 18}FDG) is currently used in pre surgical work-up for drug-resistant partial epilepsies in children as in adults, in addition to MRI. Recent cameras with less than 5 mm spatial resolution allow to obtain thin slices (about 2 mm thickness) in 3D planes. {sup 18}FDG is intravenously injected at the mean dose of 3 MBq/kg of body weight in inter-ictal and resting state, in a quiet, dimly lit environment and careful monitoring for head movements and ictal events. In children, sedation may be necessary. Image acquisition starts 30 min after injection and ended 15 to 20 min later. Semiquantitative analysis is visually assessed in clinical practice using colour scales. PET sensibility is improved by superimposition of metabolic imaging on MRI. Statistical analysis with S.P.M. may be useful but comparison with health subjects database is required. In medial temporal lobe epilepsy associated with hippocampal sclerosis, hypo metabolism ipsilateral to the epileptogenic focus is found in 70 to 90% of the cases and is predictive of surgical outcome. In other types of temporal and extra temporal epilepsy with negative MRI, focal hypo metabolism can be detected, allowing identification of minor gyral abnormalities corresponding to focal cortical dysplasia. In such MRI negative cases, PET findings may improve surgical outcome. (author)

  19. Cerebral Toxoplasmosis in a Patient with AIDS on F-18 FDG PET/CT

    The distinction between primary central nervous system (CNS) lymphoma and nonmalignant lesions due to opportunistic infections, in particular cerebral toxoplasmosis, is important because of the different treatments involved. A 32-year-old patient with AIDS was hospitalized for intermittent headaches. Brain magnetic resonance imaging (MRI) showed a small well-enhanced nodular lesion in the right frontal lobe. A fluorine-18 fluorodeoxyglucose (F-18 FDG) position emission tomography (PET)/ computed tomography (CT) scan showed moderate FDG uptake in the nodular lesion of the right frontal lobe. We present a case of cerebral toxoplasmosis in a patient with acquired immunodeficiency syndrome (AIDS) and the usefulness of F-18 FDG PET/CT in the differential diagnosis of the cerebral toxoplasmosis will be discussed.

  20. Cerebral Toxoplasmosis in a Patient with AIDS on F-18 FDG PET/CT

    Kim, Hae Won; Won, Kyung Sook; Choi, Byung Wook; Zeon, Seok Kil [Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2010-04-15

    The distinction between primary central nervous system (CNS) lymphoma and nonmalignant lesions due to opportunistic infections, in particular cerebral toxoplasmosis, is important because of the different treatments involved. A 32-year-old patient with AIDS was hospitalized for intermittent headaches. Brain magnetic resonance imaging (MRI) showed a small well-enhanced nodular lesion in the right frontal lobe. A fluorine-18 fluorodeoxyglucose (F-18 FDG) position emission tomography (PET)/ computed tomography (CT) scan showed moderate FDG uptake in the nodular lesion of the right frontal lobe. We present a case of cerebral toxoplasmosis in a patient with acquired immunodeficiency syndrome (AIDS) and the usefulness of F-18 FDG PET/CT in the differential diagnosis of the cerebral toxoplasmosis will be discussed.

  1. Retroperitoneal Pleomorphic Lipo sarcoma Mimicking Adrenal Cancer in F-18 FDG PET/CT

    Lipo sarcoma is the second most common type of soft tissue sarcoma, but pleomorphic lipo sarcoma is the least common subtype. We present the case of a 42-year-old man who had experienced intermittent left flank pain for a month. A large soft-tissue mass was detected by ultrasonography in a local clinic, and he was referred for further evaluation. Positron emission tomography/computed tomography (PET/CT) with F-18 fluoro-2-deoxy-D-glucose (F-18 FDG) showed intense uptake in the retroperitoneal mass, which mimicked an adrenal cancer. The patient underwent left radical nephroadrenalectomy, and the tumor was revealed to be a pleomorphic lipo sarcoma upon pathological examination. When there is a large retroperitoneal mass with intense F-18 FDG activity, the possibility of a pleomorphic lipo sarcoma should be considered.

  2. Retroperitoneal Pleomorphic Lipo sarcoma Mimicking Adrenal Cancer in F-18 FDG PET/CT

    Yoon, Minki; Kim, Seogjoon [Good Samaritan Hospital, Pohang (Korea, Republic of)

    2010-09-15

    Lipo sarcoma is the second most common type of soft tissue sarcoma, but pleomorphic lipo sarcoma is the least common subtype. We present the case of a 42-year-old man who had experienced intermittent left flank pain for a month. A large soft-tissue mass was detected by ultrasonography in a local clinic, and he was referred for further evaluation. Positron emission tomography/computed tomography (PET/CT) with F-18 fluoro-2-deoxy-D-glucose (F-18 FDG) showed intense uptake in the retroperitoneal mass, which mimicked an adrenal cancer. The patient underwent left radical nephroadrenalectomy, and the tumor was revealed to be a pleomorphic lipo sarcoma upon pathological examination. When there is a large retroperitoneal mass with intense F-18 FDG activity, the possibility of a pleomorphic lipo sarcoma should be considered.

  3. Investigation with 18FDG and high resolution PET for cervical compressive myelopathy

    In the case of cervical spine myelopathy, alteration of glucose metabolism rate, image findings and clinical manifestation were compared with those of healthy volunteer by high resolution 18FDG-PET. Authors investigated in 21 healthy volunteers, and 22 patients with cervical spine myelopathy. Patients had cervical spondylosis myelopathy (12 cases), cervical spine herniated disk (8 cases), posterior longitudinal ligament osteosis (2 cases). MRI image was observed after and before surgery, medulla spinalis configuration and brightness alteration after decomposition were checked. Standardized uptake value (SUV) of glucose by cervical spinal cord in radiculopathy group (n=4) was similar to that in normal group but that in myelopathy group (n=14) was decreased significantly (p18FDG represents degree of a critical condition of cervical myelopathy, and consequence assessment of cervical myelopathy is possible by SUV. (K.H.)

  4. Influence of radiation on endotoxin test using the PTSTM for 18-FDG radiopharmaceutical

    Santos-Oliveira, Ralph, E-mail: roliveira@ien.gov.br [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Div. de Radiofarmacia

    2010-07-15

    F-18 FDG (2-[18-F] fluoro-2-deoxy-D-glucose) is the most frequently used radiopharmaceutical for PET and PET CT imaging exams. The FDA recently approved the use of the PTS{sup TM} (Portable Test System) as an alternative to the standard test proposed by the United States Pharmacopeia using the LAL (Limulus Amebocyte Lysates), that takes longer to perform (about 1h) than the PTS{sup TM} (15 min). Recent studies have demonstrated that radiation could interfere with the PTS{sup TM} test. In order to study the effects of radiation on the PTS{sup TM} test and/or equipment, 27 batches of F-18 FDG produced in the Nuclear Engineering Institute were analyzed. The results showed that no direct correlation with radiation was found in any of the cases. (author)

  5. [F18]-FDG imaging of experimental animal tumours using a hybrid gamma-camera

    Positron emission tomography (PET) has been widely used in clinical studies. This technology permits detection of compounds labelled with positron emitting radionuclides and in particular, [F18]-fluorodeoxyglucose ([F18]-FDG).[F18]-FDG uptake and accumulation is generally related to malignancy; some recent works have suggested the usefulness of PET camera dedicated to small laboratory animals (micro-PET). Our study dealt with the feasibility of [F18]-FDG imaging of malignant tumours in animal models by means of an hybrid camera dedicated for human scintigraphy. We evaluated the ability of coincidence detection emission tomography (CDET) using this hybrid camera to visualize in vivo subcutaneous tumours grafted to mice or rats. P815 murine mastocytoma grafted in syngeneic DBA/2 mice resulted with foci of very high FDG uptake. Tumours with a diameter of only 3 mm were clearly visualized. Medullary thyroid cancer provoked by rMTC 6/23 and CA77 lines in syngeneic Wag/Rij rat was also detected. The differentiated CA77 tumours exhibited avidity for [F18]-FDG and a tumour, which was just palpable (diameter lower than 2 mm), was identified. In conclusion, CDET-FDG is a non-invasive imaging tool which can be used to follow grafted tumours in the small laboratory animal, even when their size is smaller than 1 cm. It has the potential to evaluate experimental anticancer treatments in small series of animals by individual follow-up. It offers the opportunity to develop experimental PET research within a nuclear medicine or biophysics department, the shift to a dedicated micro-PET device being subsequently necessary. It is indeed compulsory to strictly follow the rules for non contamination and disinfection of the hybrid camera. (authors)

  6. Demand of radiopharmaceutical Fluoride 18-FDG (fluorodeoxyglucose) in the Sao Paulo State metropolitan area

    This research presents partial results from the development of a Masters Dissertation for the Post-Graduation in Nuclear Technology Program - IPEN/USP, aiming to study the demand of radiopharmaceutical Fluoride 18-FDG (fluorodeoxyglucose) in the Sao Paulo State metropolitan area, as a subsidiary for the establishment of distribution strategy within the State. This study presented the results of a bibliographic review as well as the market evolution for FDG in Sao Paulo. Studies pointed to a tendency of an increase in the international and national nuclear medicine market; while the United States of America participate in 47% of the world profit, South America shares only 2.5% of the global market. This market will tend to grow in 2006 to 2020 up to 776% for diagnosis and 760% for therapy. Partial results are presented in this study from researching medical centers that use PET in the city of Sao Paulo, as well as companies that commercialize the equipment and the manufacturer center. There is an increase of sales for IPEN's Fluoride 18-FDG and its representation on the total radiopharmaceutical profit surpassed 5.3% in 2003 to 8.2% in 2004. The dissemination of this technology in Brazil is lately being discussed especially due to the acquisition price of the equipment as well as the viability of the resources (Fluoride 18- FDG; implementation strategies of regional cyclotron accelerators) and the question of remuneration of the PET produced exams for health care plans and national health care system (SUS). IPEN is developing yet another study to grasp possible demand for this product in the Southern and Southeastern regions, allowing better view of the necessity of the supplement, and in study the implementation of a new cyclotron in the institute dedicated for the production of Fluoride 18-FDG. (author)

  7. The Role of F-18- FDG PET and PET/CT in Lung Cancer

    Tümkaya, Evren; Büyükdereli, Gülgün

    2013-01-01

    Positron emission tomography (PET) has the unique ability to image bodily functions, such as blood flow, oxygen use, and glucose metabolism. PET imaging in combination with computerized tomography (CT) offers a high sensitivity scan for metabolic activity with precise anatomical localization. PET/CT with the glucose analog 18F-fluorodeoxyglucose (FDG) has become an essential tool for the work-up of patients with cancer for clinical practice. F-18-FDG PET/CT provides valuable information about...

  8. F18-FDG PET/CT Scanning in Angiosarcoma: Report of Two Cases

    Emel TOKMAK

    2011-08-01

    Full Text Available Angiosarcomas are uncommon tumors and constitute less than 5% of all soft tissue sarcomas. They are aggressive tumors with poor prognosis, therefore, it is quite important to determine disease extension and detect local recurrence and/or distant metastases for appropriate therapy management. In this paper, we aimed to demonstrate the potential role of 1F18-FDG PET/CT imaging by reporting two cases with angiosarcoma (MIRT 2011;20:63-66

  9. Assessing the value of 18FDG-PET in lung cancer: drom theory to practice : From theory to practice

    Tinteren, van H.

    2006-01-01

    Positron emission tomography (PET) allows noninvasive visualization and quantitative assessment of physiologic and biochemical processes within the human body. In cancer, the glucose analog fluorodeoxyglucose (18FDG) is the most commonly applied radioisotope and its uptake reflects cellular metabol

  10. HYNIC a bifunctional prosthetic group for the labelling of peptides with 99mTc and 18FDG

    With regard to high reactivity and chemoselectivity of HYNIC towards carbonyl of acyclic form of 18FDG and its stable complexes with 99mTc, in this study, LIKKPF as the model peptide was conjugated with HYNIC and labelled with 99mTc (RCP[90 %) and 18FDG for the first time. The RCP of [70 % was achieved for labelling with 18FDG, in the presence of glucose (50-250 lg/mL). Our results showed the high potential of HYNIC conjugated peptides for labelling with 99mTc and 18FDG as 18F-fluorinated prosthetic group, to be clinically accepted for the radiolabelling of peptides. (author)

  11. Clinical usefulness of {sup 18}FDG-PET in primary lung cancer. Comparison with {sup 201}Tl-SPECT

    Nishikawa, Takahiro [Kanazawa Medical Univ., Uchinada, Ishikawa (Japan)

    1997-03-01

    Forty patients with pulmonary nodular lesions had PET imaging performed. Within a week, all patients were investigated with the triple-headed SPECT system and by CT. The PET and SPECT images were compared qualitatively and quantitatively. For quantitative analysis, ROIs were selected in areas of the tumor showing the highest tracer accumulation and in the normal areas of contralateral lung. The tumor to nontumor activity ratio (T/N ratio) was calculated. In thirty-three patients with primary lung cancer, the sensitivity of {sup 18}FDG-PFT, {sup 201}Tl-SPECT were 93.6%, 84.8%, respectively. In the detection of lung cancer, {sup 18}FDG-PET provided a higher sensitivity than {sup 201}Tl-SPECT. Neither techniques visualized any lesion in two patients who had bronchioloalveolar carcinoma. Among the patients showing increased tracer accumulation, the T/N ratio was significantly higher with {sup 18}FDG-PET than with {sup 201}Tl-SPECT. However, there was significant positive correlation between the {sup 18}FDG T/N ratio and the {sup 201}Tl delayed ratio. We assessed the association between cell differentiation and {sup 18}FDG or {sup 201}Tl uptake in 17 patients with adenocarcinoma of the lung. Only {sup 18}FDG uptake might be associated with cell differentiation of adenocarcinoma. Thirty patients with pulmonary nodular lesion underwent an operation and the results of {sup 18}FDG-PET, {sup 201}Tl-SPECT were compared between malignant and benign nodules in {sup 18}FDG uptake and {sup 201}Tl uptake. {sup 18}FDG uptake and {sup 201}Tl uptake showed no significant differences in malignant nodules or benign nodules. Twenty-one patients underwent thoracotomy and the results of {sup 18}FDG-PET, {sup 201}Tl-SPECT and CT were compared with the pathological findings of the mediastinal lymph nodes. In the detection of mediastinal lymph node metastasis from lung cancer, sensitivity and specificity were 33.3% and 77.8% for CT, 33.3% and 94.4% for {sup 201}Tl SPECT and 66.7% and 88

  12. F-18-FDG-PET in a patient with Hashimoto's thyroiditis and MALT lymphoma recurrence of the thyroid

    We report on the case of a 86-year-old male patient with a rapidly growing nodule within the right lobe of the thyroid gland, which after hemithyroidectomy, turned out to be a mucosa-associated lymphoid tissue (MALT) lymphoma of the thyroid gland. In addition, Hashimoto's thyroiditis was reported in the thyroid tissue adjacent to the MALT lymphoma. During follow-up a second nodule emerged within the left lobe and, because of evidence of MALT lymphoma recurrence, F-18-FDG-PET was performed. F-18-FDG-PET imaged a clearly in-creased accumulation within the whole left lobe and isthmus. Thus, no differences in the degree of hypermetabolism could be imaged between the nodule and the adjacent thyroid tissue. To our knowledge, this is the first report about F-18-FDG-PET in a patient with MALT lymphoma of the thyroid. Literature search revealed only a few cases of MALT lymphomas in locations other than the thyroid gland that were studied with F-18-FDG-PET. In no case was F-18 FDG accumulation seen in the MALT lesions. However, clear F-18 FDG accumulation was reported in some patients with Hashimoto's thyroiditis. It is concluded that the intensive F-18-FDG accumulation within the whole left lobe and isthmus of the presented case was due to the coexisting Hashimoto's thyroiditis. Consequently, F-18-FDG-PET imaging does not seem to be indicated in a patient with MALT lymphoma and known Hashimoto's thyroiditis in order to evaluate the status of the MALT lymphoma. (author)

  13. Medial thalamic 18-FDG uptake following inescapable shock correlates with subsequent learned helpless behavior

    Mirrione,M.M.; Mirrione, M.M.; Schulz, D.; Dewey, S.L.; Henn, F.A.

    2009-12-06

    The learned helplessness paradigm has been repeatedly shown to correlate with neurobiological aspects of depression in humans. In this model, rodents are exposed inescapable foot-shock in order to reveal susceptibility to escape deficit, defined as 'learned helplessness' (LH). Few methods are available to probe the neurobiological aspects underlying the differences in susceptibility in the living animal, thus far being limited to studies examining regional neurochemical changes with microdialysis. With the widespread implementation of small animal neuroimaging methods, including positron emission tomography (PET), it is now possible to explore the living brain on a systems level to define regional changes that may correlate with vulnerability to stress. In this study, 12 wild type Sprague-Dawley rats were exposed to 40 minutes of inescapable foot-shock followed by metabolic imaging using 2-deoxy-2[{sup 18}F]fluoro-D-glucose (18-FDG) 1 hour later. The escape test was performed on these rats 48 hours later (to accommodate radiotracer decay), where they were given the opportunity to press a lever to shut off the shock. A region of interest (ROI) analysis was used to investigate potential correlations (Pearson Regression Coefficients) between regional 18-FDG uptake following inescapable shock and subsequent learned helpless behavior (time to finish the test; number of successful lever presses within 20 seconds of shock onset). ROI analysis revealed a significant positive correlation between time to finish and 18-FDG uptake, and a negative correlation between lever presses and uptake, in the medial thalamic area (p=0.033, p=0.036). This ROI included the paraventricular thalamus, mediodorsal thalamus, and the habenula. In an effort to account for possible spillover artifact, the posterior thalamic area (including ventral medial and lateral portions) was also evaluated but did not reveal significant correlations (p=0.870, p=0.897). No other significant

  14. Medial thalamic 18-FDG uptake following inescapable shock correlates with subsequent learned helpless behavior

    The learned helplessness paradigm has been repeatedly shown to correlate with neurobiological aspects of depression in humans. In this model, rodents are exposed inescapable foot-shock in order to reveal susceptibility to escape deficit, defined as 'learned helplessness' (LH). Few methods are available to probe the neurobiological aspects underlying the differences in susceptibility in the living animal, thus far being limited to studies examining regional neurochemical changes with microdialysis. With the widespread implementation of small animal neuroimaging methods, including positron emission tomography (PET), it is now possible to explore the living brain on a systems level to define regional changes that may correlate with vulnerability to stress. In this study, 12 wild type Sprague-Dawley rats were exposed to 40 minutes of inescapable foot-shock followed by metabolic imaging using 2-deoxy-2[18F]fluoro-D-glucose (18-FDG) 1 hour later. The escape test was performed on these rats 48 hours later (to accommodate radiotracer decay), where they were given the opportunity to press a lever to shut off the shock. A region of interest (ROI) analysis was used to investigate potential correlations (Pearson Regression Coefficients) between regional 18-FDG uptake following inescapable shock and subsequent learned helpless behavior (time to finish the test; number of successful lever presses within 20 seconds of shock onset). ROI analysis revealed a significant positive correlation between time to finish and 18-FDG uptake, and a negative correlation between lever presses and uptake, in the medial thalamic area (p=0.033, p=0.036). This ROI included the paraventricular thalamus, mediodorsal thalamus, and the habenula. In an effort to account for possible spillover artifact, the posterior thalamic area (including ventral medial and lateral portions) was also evaluated but did not reveal significant correlations (p=0.870, p=0.897). No other significant correlations were found

  15. Stores

    2004-01-01

    Following the introduction of Condensators, resistors and potentiometers from the Farnell electronic-catalogue into CERN Stores' catalogue, following products are now available: PRODUCT FAMILY GROUP SCEM Oscillators and quartz crystals 07.94.10 / 07.94.12 Diodes 08.51.14 / 08.51.54 Thyristors 08.51.60 / 08.51.66 Opto-electronics 08.52 Transistors 08.53 Integrated circuits 08.54 / 08.55 These articles can be procured in the same way as any other stores item, by completing a Material Request. N.B. Individual Farnell order codes can be used as keywords to facilitate searches in the CERN Stores Catalogue.

  16. In vivo monitoring of occupationally exposed individuals to 18FDG in CRCN/NE

    The increasing demand for PET radiopharmaceuticals in Brazil results in increasing of the number of occupationally exposed individuals (OEI) to the radiopharmaceutical 18F in the form of 18FDG, increasing thereby the risk of accidental incorporation. This work aims to implement an in vivo internal monitoring technique applied to 18FDG radiopharmaceutical at the Divisao de Producao de Radiofarmacos (DIPRA) of the Centro Regional de Ciencias Nucleares do Nordeste (CRCN/NE). The detection system used was a NaI(Tl) 3'' x 3'' detector connected to a compact electronic module operated by the Genie 2000 software. It was calibrated using a brain phantom containing a standard source of 22Na which simulates a contaminated individual. Based on the calibration factor it was possible to determine the minimum detectable activity (MDA) of the detection system and then, through use of biokinetic models provided by the ICRP in its publication 53 and edited by the AIDE version 6.0 software, it was possible to calculate the minimum detectable effective dose (MDED) which is an indication of the technique sensitivity. The MDED was estimated for the in vivo measurements performed up to 0.1 day after the occurrence of an intake by ingestion. The value obtained was compared to the Recording level of 1 mSv recommended by the IAEA. After validation of the in vivo monitoring technique, a series of measurements were performed on a group of occupationally exposed workers from DIPRA shortly after completion of production and quality control of 18FDG radiopharmaceutical procedures. It is concluded that the proposed technique is sufficiently sensitive for its application in internal occupational monitoring. (author)

  17. 18-FDG PET/CT assessment of basal cell carcinoma with vismodegib

    The use of 18-fluorodeoxyglucose (FDG) positron emission tomography with computed tomography (PET/CT) in subjects with advanced basal cell carcinoma (BCC) has not been fully explored due to the rarity of disease presentation. This study evaluated PET/CTs from subjects with advanced BCC participating in a phase I dose-escalation clinical trial of vismodegib. Fourteen subjects with BCC were imaged with 18-FDG PET/CT for lesion identification and response categorizing (European Organisation for Research and Treatment for Cancer [EORTC] and PET response criteria in solid tumors [PERCIST] 1.0). Several parameters including metabolic activity of target lesions, site of disease presentation and spread, treatment response, and prognostic significance of metabolic activity following therapy were evaluated. All subjects exhibited at least one hypermetabolic lesion. Most subjects had only four organ systems involved at study enrollment: skin–muscle (93%), lung (57%), lymph nodes (29%), and bone (21%). SUVmax measured across all lesions decreased (median 33%, SD ± 45%) following therapy with metabolic activity normalizing or disappearing in 42% of lesions. No significant difference was observed between EORTC and PERCIST 1.0. Subjects that demonstrated at least a 33% reduction in SUVmax from baseline had a significantly longer progression-free survival (PFS) (median 17 months, 95% confidence interval [CI] ±4 months vs. 9 months, 95% CI ±5 months, P = 0.038) and overall survival (OS) (median 24 months, 95% CI ±4 months vs. 17 months, 95% CI ±13 months, P = 0.019). BCC lesions are hypermetabolic on 18-FDG PET/CT. A decrease in SUVmax was associated with improved PFS and OS. These results further support the incorporation of 18-FDG PET/CT scans in advanced BCC management

  18. Influence of radiation on endotoxin test using the PTS TM for 18-FDG radiopharmaceutical

    Ralph Santos-Oliveira

    2010-09-01

    Full Text Available F-18 FDG (2-[18-F] fluoro-2-deoxy-D-glucose is the most frequently used radiopharmaceutical for PET and PET CT imaging exams. The FDA recently approved the use of the PTS TM (Portable Test System as an alternative to the standard test proposed by the United States Pharmacopeia using the LAL (Limulus Amebocyte Lysates, that takes longer to perform (about 1h than the PTS TM (15 min. Recent studies have demonstrated that radiation could interfere with the PTS TM test. In order to study the effects of radiation on the PTS TM test and/or equipment, 27 batches of F-18 FDG produced in the Nuclear Engineering Institute were analyzed. The results showed that no direct correlation with radiation was found in any of the cases.O FDG-18 é o radiofármaco mais utilizado nos exames de PET e PET CT. O FDA recentemente aprovou o uso do PTS TM (Portable Test System como método alternativo ao teste padrão de endotoxina, proposto pela Farmacopéia Americana, considerando que no primeiro há um tempo de espera de 1 hora frente a somente 15 minutos do segundo. Estudo recentes demonstram que a radiação poderia interferir no teste do PTS TM. De modo a avaliar os efeitos da radiação no teste PTS TM foram analisados 27 lotes de F-18 FDG produzidos no Instituto de Engenharia Nuclear. Os resultados demonstraram que em todos os casos nenhuma correlação direta com a radiação foi observada.

  19. Incidental finding of appendiceal adenocarcinoma in F 18 FDG PET/CT for health screening

    F 18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) that simultaneously offers anatomic and metabolic information is widely used and has become an effective modality in many clinical fields, especially oncology, and also may detect an unexpected primary cancer. Appendiceal carcinoma is relatively uncommon and not associated with characteristic symptoms. We report the case of a 53 year old man with appendiceal adenocarcinoma, who had only mild fever. The tumor was detected early on F 18 FDG PET/CT for health screening

  20. Development of methodologies for internal exposure assessment due to the radiopharmaceutical 18FDG

    The production of 18F has increased in the last decade. It is produced basically for the synthesis of 18F- fluorodeoxyglucose (18FDG), the main radiopharmaceutical used in PET (Positron Emission Tomography) scans. The growth in the frequency of these tests resulted in rise of the number of occupationally exposed individuals (OEI) to the radionuclide 18F as 18FDG, increasing thereby the probability of its accidental incorporation. This study aimed to implement optimized techniques for assessing internal exposures of individuals occupationally exposed through both in vivo and in vitro bioassay methods during production and handling of 18FDG at the Divisao de Producao de Radiofarmacos (DIPRA), Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE/CNEN). The in vivo monitoring was conducted at the Laboratorio de Dosimetria Interna, Divisao de Laboratorios Tecnico-Cientificos (DILAB). For this bioassay method, measurements were done with a 3x3' NaI(Tl) scintillation detector coupled to Genie 2000 software. The calibration of the system was performed with a brain phantom containing a standard liquid source of 22Na to simulate a contaminated individual. The calibration of the HPGe coaxial detector for in vitro monitoring was performed at the Laboratorio de Medidas de Atividade de Radionuclideos (DIPRA/CRCN-NE/CNEN) with a standard source of 22Na. Base on the calibration factors, it was possible to determine the minimum detectable activities (MDA) for the systems by using direct measurements and simulation of uncontaminated urine. Then, through the biokinetic models published by ICRP 106 and edited by the AIDE software (version 6.0), it was possible to estimate the minimum detectable effective dose (MDED), which evaluates the detection sensitivity of the techniques developed. The MDED was estimated for in vivo and in vitro measurements performed 2.4 hours after the occurrence of incorporation by ingestion, since this is the period of higher retention fraction of

  1. The role of 18FDG TEP in ganglionic extension account and the detection of recurrences of head and neck cancers

    We have studied 37 patients presenting head or neck cancers: 25 at the moment of initial extension account, prior to any treatment and 12 presenting a confirmed recurrence. The ensemble of palpation, TDM and TEP with 18FDG data could been correlated with the results of histopathological examination of the operation piece. The initial extension account had the following results: all the primitive tumors got detected in 25 patients, among whose 10 presented an ganglionic invasion, confirmed in the histopathologic examination. The TEP with 18FDG permitted identifying a counter-lateral ganglion, not evidenced by palpation and structural imaging. We report unfortunately 5 false negatives results (microscopical or of small size lesions) and two false negative examinations. Recurrences were also made evident: 11/12 patients were correctly identified by TEP with 18FDG. A falsely positive result was related to the presence of a granulomatous reaction on strange body. The TEP with 18FDG permitted making evident two local recurrences and two other cases of ganglionic invasion, un-detected by other techniques. The clinical utility of TEP with 18FDG appeared essential in the detection of recurrences in operated and irradiated territories but in a lesser extension in the definition of ganglionic extension account

  2. Role of F-18 FDG PET/CT in assessing bone marrow involvement in pediatric Hodgkin's lymphoma

    The aim of the current study was to assess the utility of F-18-fluoro-2-deoxy-D-glucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) in assessing bone marrow involvement (BMI) compared to bone marrow biopsy (BMB) in initial staging of Hodgkin's lymphoma (HL) in pediatric patients. Data of 38 pediatric patients (mean age 9.8 years, range 3-18 years) with HL were analyzed for the involvement of bone marrow. All patients underwent non-contrast F-18 FDG PET/CT study. BMB was done in 31 patients from the bilateral iliac crests. Scans were interpreted by two nuclear medicine physicians blinded to the details of BMB. Of the 31 patients who underwent BMB, 5 patients had lymphomatous involvement on BMB. PET/CT was positive in four of these five patients. In 26 patients negative on BMB, PET was negative in 23 patients and positive in 3 patients for BMI. The sensitivity and negative predictive value of F-18 FDG PET/CT was 87.5 and 96%, respectively, for BMI. F-18 FDG PET/CT can predict BMB results with high accuracy. F-18 FDG PET/CT may be used at initial staging of pediatric Hodgkin's lymphoma as it uncovers unsuspected BMI and BMB may be omitted in patients with PET-positive BMI. (author)

  3. Usefulness of 18FDG-PET in epilepsy. Methods and indications

    Positron emission tomography (PET) using 18-fluorodeoxyglucose (18FDG) is currently used in pre surgical work-up for drug-resistant partial epilepsies in children as in adults, in addition to MRI. Recent cameras with less than 5 mm spatial resolution allow to obtain thin slices (about 2 mm thickness) in 3D planes. 18FDG is intravenously injected at the mean dose of 3 MBq/kg of body weight in inter-ictal and resting state, in a quiet, dimly lit environment and careful monitoring for head movements and ictal events. In children, sedation may be necessary. Image acquisition starts 30 min after injection and ended 15 to 20 min later. Semiquantitative analysis is visually assessed in clinical practice using colour scales. PET sensibility is improved by superimposition of metabolic imaging on MRI. Statistical analysis with S.P.M. may be useful but comparison with health subjects database is required. In medial temporal lobe epilepsy associated with hippocampal sclerosis, hypo metabolism ipsilateral to the epileptogenic focus is found in 70 to 90% of the cases and is predictive of surgical outcome. In other types of temporal and extra temporal epilepsy with negative MRI, focal hypo metabolism can be detected, allowing identification of minor gyral abnormalities corresponding to focal cortical dysplasia. In such MRI negative cases, PET findings may improve surgical outcome. (author)

  4. Myocardial Fibrosis in Hypertrophic Cardiomyopathy Demonstrated by Integrated Cardiac F-18 FDG PET/MR

    Hypertrophic cardiomyopathy (HCM) is a common condition defined as a diffuse or segmental left ventricular (LV) hypertrophy with a nondilated and hyperdynamic chamber as well as cardiac arrhythmias. Cardiac MR (CMR) imaging is a key modality for evaluation of HCM. In addition to the assessment of LV wall thickness, LV function and aortic flow, CMR is capable of estimation of late gadolinium enhancement (LGE) in affected myocardium which has been shown to have a direct correlation with incidence and severity of arrhythmias in HCM. In patients with HCM, LGE on CMR is presumed to represent intramyocardial fibrosis. Meanwhile, F-18 FDG myocardial PET has been sporadically studied in HCM, mostly for evaluation of the metabolic status of a hypertrophic myocardial segment, especially after interventions or to demonstrate partial myocardial fibrosis. We presented here the case of a 25-year-old male patient referred for simultaneous F-18 FDG cardiac PET/MR for the evaluation of septal hypertrophy. The PET/MR revealed myocardial fibrosis in the septum associated with FDG-defect and LGE

  5. The clinical usefulness of F-18-FDG CoDe PET in lung cancer staging

    This study was undertaken to assess clinical usefulness of D-18-FDG CoDe PET in nodal staging of lung cancer by comparing with computed tomography (CT) and surgical findings. We performed prospective study comparing CoDe PET and CT of thorax in the presurgical assessment of mediastinum in 24 patients with NSCLC and 1 patient with bronchoaveolar cell ca (BAC). CoDe PET was performed using a dual-head gamma camera (Varicam, Elscint) equipped with 5/8 inch thick NaI(Tl) crystals. Data was acquired at about 1 hour after IV injection of 111-370 MBq of F-18-FDG. An areal scan of the thorax was performed using a slip ring gantry for 30 min. After rebinning, routine tomographic slices were reconstructed without attenuation correction. The images were analyzed visually and compared with CT and pathologic results. CoDe PET detected all surgically proven malignant lesions (12 adenocarcinoma, 11 squamous cell ca of, 1 adenosquamous cell ca, 1 BAC). Hilar and mediastinal lymph node involvement was present in 20%. In nodal staging, 19 CoDe PET studies agreed with pathologic findings, whereas 14 of 25 patients CT agreed with pathologic results. The accuracy of CoDe PET in nodal staging was better than that of CT in a limited number of patients studied thus far. FDG CoDe PET appears to be a supplementary modality in prompt diagnosis, staging and successful management of lung cancer

  6. Myocardial Fibrosis in Hypertrophic Cardiomyopathy Demonstrated by Integrated Cardiac F-18 FDG PET/MR

    Kong, Eunjung; Lee, Sanghee; Cho, Ihnho [Yeungnam Univ., Daegu (Korea, Republic of)

    2013-09-15

    Hypertrophic cardiomyopathy (HCM) is a common condition defined as a diffuse or segmental left ventricular (LV) hypertrophy with a nondilated and hyperdynamic chamber as well as cardiac arrhythmias. Cardiac MR (CMR) imaging is a key modality for evaluation of HCM. In addition to the assessment of LV wall thickness, LV function and aortic flow, CMR is capable of estimation of late gadolinium enhancement (LGE) in affected myocardium which has been shown to have a direct correlation with incidence and severity of arrhythmias in HCM. In patients with HCM, LGE on CMR is presumed to represent intramyocardial fibrosis. Meanwhile, F-18 FDG myocardial PET has been sporadically studied in HCM, mostly for evaluation of the metabolic status of a hypertrophic myocardial segment, especially after interventions or to demonstrate partial myocardial fibrosis. We presented here the case of a 25-year-old male patient referred for simultaneous F-18 FDG cardiac PET/MR for the evaluation of septal hypertrophy. The PET/MR revealed myocardial fibrosis in the septum associated with FDG-defect and LGE.

  7. Isolated metastasis of breast cancer: CA 15-3 dose value and 18-FDG mapping; Metastase isolada de cancer da mama: valor da dosagem do CA 15-3 e do mapeamento com 18-FDG

    Spirandeli, Julia M. B.; Oliveira Filho, Juvenal Antunes [Centro Medico de Campinas, SP (Brazil). Dept. Clinica Medica; Oncocamp - Oncologia Campinas, SP (Brazil); Cazone, Alejandro Enzo [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Setor de Tumores Musculo-Esqueleticos; Hanaoka, Nilton Massaki [Grupo Dimen, Campinas, SP (Brazil); Alvarenga, Marcelo [Instituto de Patologia de Campinas, SP (Brazil)]. E-mail: oncocamp@hawk.com.br

    2003-07-01

    A case of breast cancer with progressive increase of the tumor marker C A 15-3 is presented, with exhaustive investigation of the possible metastasis. After the fluorine-18-FDG tomography was performed, an area of increased tracer uptake was demonstrated in the sternal manubrium. The computerized tomography demonstrated a small lytic area and subsequent biopsy confirmed the solitary bone metastasis. The objective of this case report is to call attention for the need to pursue the diagnosis of a relapsing lesion when there is an increase of a tumor marker and the possible benefit of the fluorine-18-FDG tomography for the early detection. (author)

  8. F-18 FDG PET/CT Findings of a Patient with Takayasu Arteritis Before and After Therapy

    Sait Sağer

    2012-04-01

    Full Text Available Vasculitis is defined as inflammation and necrosis with leukocytic infiltration of the blood vessel wall. Takayasu arteritis is a chronic inflammatory arteritis that primarily involves the aorta and its main branches. A 64-year-old female patient with a 2-month history of fever of unknown origin was presented to our clinic for F-18 FDG PET/CT imaging. Baseline PET/CT images demonstrated intense F-18 FDG uptake in the aorta, bilateral subclavian and brachiocephalic arteries consistent with Takayasu arteritis. After 2 months of immunosuppressive therapy, she was asymptomatic and follow-up FDG PET/CT scan showed almost complete disappearance of large vessels’ F-18 FDG uptake. FDG PET/CT is a sensitive technique for assessing presence of large-vessel vasculitis such as Takayasu arteritis, extent of large-vessel inflammation and disease activity after therapy. (MIRT 2012;21:32-34

  9. F-18 FDG-PET imaging and correlation with CT in staging and follow-up of pediatric lymphomas

    Hernandez-Pampaloni, Miguel [Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Takalkar, Amol; Yu, Jian Q.; Zhuang, Hongming; Alavi, Abass [Hospital of the University of Pennsylvania, Division of Nuclear Medicine, Department of Radiology, Philadelphia, PA (United States)

    2006-06-15

    We hypothesized that F-18 FDG-PET could be a useful, functional imaging modality for assessing the initial staging, response to therapy and follow-up of children diagnosed with lymphoma. To assess the role of whole-body F-18 FDG-PET imaging in patients with lymphoma as an initial staging modality and to measure its predictive value for monitoring the response to therapy and disease recurrence compared to CT and clinical follow-up studies. As part of their routine clinical care, 24 patients with histologically proven lymphoma (18 Hodgkin disease and 6 non-Hodgkin lymphoma) underwent an F-18 FDG-PET and a CT scan. A total of 28 studies were performed and the entire set of scans retrospectively reviewed. Seven studies were performed for initial staging, 12 for monitoring therapy response and 9 for detecting recurrence. Initial diagnosis was confirmed by histopathology while the gold standard at follow-up was established by clinical follow-up, additional imaging modalities and/or biopsy. F-18 FDG-PET was visually compared to CT on a lesion-by-lesion basis. Fifteen anatomic regions (seven nodal and eight extranodal) were analyzed. Of the 414 regions analyzed, PET and CT were concordant in 366 (positive in 16 and negative in 350). Discordance was found in 48 regions. Overall sensitivities, specificities, and positive and negative predictive values were 78%, 98%, 94% and 90% for F-18 FDG-PET and 79%, 88%, 90% and 46% for CT, respectively. F-18 FDG-PET imaging is a useful technique for the staging and follow-up of pediatric patients with lymphoma. (orig.)

  10. F-18 FDG-PET imaging and correlation with CT in staging and follow-up of pediatric lymphomas

    We hypothesized that F-18 FDG-PET could be a useful, functional imaging modality for assessing the initial staging, response to therapy and follow-up of children diagnosed with lymphoma. To assess the role of whole-body F-18 FDG-PET imaging in patients with lymphoma as an initial staging modality and to measure its predictive value for monitoring the response to therapy and disease recurrence compared to CT and clinical follow-up studies. As part of their routine clinical care, 24 patients with histologically proven lymphoma (18 Hodgkin disease and 6 non-Hodgkin lymphoma) underwent an F-18 FDG-PET and a CT scan. A total of 28 studies were performed and the entire set of scans retrospectively reviewed. Seven studies were performed for initial staging, 12 for monitoring therapy response and 9 for detecting recurrence. Initial diagnosis was confirmed by histopathology while the gold standard at follow-up was established by clinical follow-up, additional imaging modalities and/or biopsy. F-18 FDG-PET was visually compared to CT on a lesion-by-lesion basis. Fifteen anatomic regions (seven nodal and eight extranodal) were analyzed. Of the 414 regions analyzed, PET and CT were concordant in 366 (positive in 16 and negative in 350). Discordance was found in 48 regions. Overall sensitivities, specificities, and positive and negative predictive values were 78%, 98%, 94% and 90% for F-18 FDG-PET and 79%, 88%, 90% and 46% for CT, respectively. F-18 FDG-PET imaging is a useful technique for the staging and follow-up of pediatric patients with lymphoma. (orig.)

  11. Estimation of radiation dose to patients from 18FDG whole body PET/CT investigations using dynamic PET scan protocol

    Kaushik, Aruna; Jaimini, Abhinav; Tripathi, Madhavi; D’Souza, Maria; Sharma, Rajnish; Mondal, Anupam; Mishra, Anil K.; Dwarakanath, Bilikere S.

    2015-01-01

    Background & objectives: There is a growing concern over the radiation exposure of patients from undergoing 18FDG PET/CT (18F-fluorodeoxyglucose positron emission tomography/computed tomography) whole body investigations. The aim of the present study was to study the kinetics of 18FDG distributions and estimate the radiation dose received by patients undergoing 18FDG whole body PET/CT investigations. Methods: Dynamic PET scans in different regions of the body were performed in 49 patients so as to measure percentage uptake of 18FDG in brain, liver, spleen, adrenals, kidneys and stomach. The residence time in these organs was calculated and radiation dose was estimated using OLINDA software. The radiation dose from the CT component was computed using the software CT-Expo and measured using computed tomography dose index (CTDI) phantom and ionization chamber. As per the clinical protocol, the patients were refrained from eating and drinking for a minimum period of 4 h prior to the study. Results: The estimated residence time in males was 0.196 h (brain), 0.09 h (liver), 0.007 h (spleen), 0.0006 h (adrenals), 0.013 h (kidneys) and 0.005 h (stomach) whereas it was 0.189 h (brain), 0.11 h (liver), 0.01 h (spleen), 0.0007 h (adrenals), 0.02 h (kidneys) and 0.004 h (stomach) in females. The effective dose was found to be 0.020 mSv/MBq in males and 0.025 mSv/MBq in females from internally administered 18FDG and 6.8 mSv in males and 7.9 mSv in females from the CT component. For an administered activity of 370 MBq of 18FDG, the effective dose from PET/CT investigations was estimated to be 14.2 mSv in males and 17.2 mSv in females. Interpretation & conclusions: The present results did not demonstrate significant difference in the kinetics of 18FDG distribution in male and female patients. The estimated PET/CT doses were found to be higher than many other conventional diagnostic radiology examinations suggesting that all efforts should be made to clinically justify and

  12. Baker’s Cyst on F-18 FDG PET/CT in a Patient with Ocular Melanoma

    Hakan Cayvarlı

    2012-08-01

    Full Text Available We present the case of a 56-year-old man with the clinical diagnosis of ocular melanoma. As a part of staging, he underwent an F-18 FDG PET/CT scan for investigating distant metastasis. On PET scan, an increased focal area of F-18 FDG uptake was seen behind patient's right knee that can be confused with distant metastasis. On CT scan, there was a fluid density in the same location. The probable diagnosis was Baker’s cyst. Later, USG and MRI confirmed this diagnosis. (MIRT 2012;21:75-76

  13. Baker’s Cyst on F-18 FDG PET/CT in a Patient with Ocular Melanoma

    Hakan Cayvarlı; Erkan Derebek

    2012-01-01

    We present the case of a 56-year-old man with the clinical diagnosis of ocular melanoma. As a part of staging, he underwent an F-18 FDG PET/CT scan for investigating distant metastasis. On PET scan, an increased focal area of F-18 FDG uptake was seen behind patient's right knee that can be confused with distant metastasis. On CT scan, there was a fluid density in the same location. The probable diagnosis was Baker’s cyst. Later, USG and MRI confirmed this diagnosis. Conflict of interest:None ...

  14. Estimation of radiation dose to patients from 18 FDG whole body PET/CT investigations using dynamic PET scan protocol

    Aruna Kaushik

    2015-01-01

    Full Text Available Background & objectives: There is a growing concern over the radiation exposure of patients from undergoing 18FDG PET/CT (18F-fluorodeoxyglucose positron emission tomography/computed tomography whole body investigations. The aim of the present study was to study the kinetics of 18FDG distributions and estimate the radiation dose received by patients undergoing 18FDG whole body PET/CT investigations. Methods: Dynamic PET scans in different regions of the body were performed in 49 patients so as to measure percentage uptake of 18FDG in brain, liver, spleen, adrenals, kidneys and stomach. The residence time in these organs was calculated and radiation dose was estimated using OLINDA software. The radiation dose from the CT component was computed using the software CT-Expo and measured using computed tomography dose index (CTDI phantom and ionization chamber. As per the clinical protocol, the patients were refrained from eating and drinking for a minimum period of 4 h prior to the study. Results: The estimated residence time in males was 0.196 h (brain, 0.09 h (liver, 0.007 h (spleen, 0.0006 h (adrenals, 0.013 h (kidneys and 0.005 h (stomach whereas it was 0.189 h (brain, 0.11 h (liver, 0.01 h (spleen, 0.0007 h (adrenals, 0.02 h (kidneys and 0.004 h (stomach in females. The effective dose was found to be 0.020 mSv/MBq in males and 0.025 mSv/MBq in females from internally administered 18FDG and 6.8 mSv in males and 7.9 mSv in females from the CT component. For an administered activity of 370 MBq of 18FDG, the effective dose from PET/CT investigations was estimated to be 14.2 mSv in males and 17.2 mSv in females. Interpretation & conclusions: The present results did not demonstrate significant difference in the kinetics of 18FDG distribution in male and female patients. The estimated PET/CT doses were found to be higher than many other conventional diagnostic radiology examinations suggesting that all efforts should be made to clinically justify and

  15. Conditioned Place Preference to Acetone Inhalation and the Effects on Locomotor Behavior and 18FDG Uptake

    Pai, J.C.; Dewey, S.L.; Schiffer, W.; Lee, D.

    2006-01-01

    Acetone is a component in many inhalants that have been widely abused. While other solvents have addictive potential, such as toluene, it is unclear whether acetone alone contains addictive properties. The locomotor, relative glucose metabolism and abusive effects of acetone inhalation were studied in animals using the conditioned place preference (CPP) paradigm and [18F]2-fluorodeoxy-D-glucose (18FDG) imaging. The CPP apparatus contains two distinct conditioning chambers and a middle adaptation chamber, each lined with photocells to monitor locomotor activity. Adolescent Sprague-Dawley rats (n=16; 90-110 g) were paired with acetone in least preferred conditioning chamber, determined on the pretest day. The animals were exposed to a 10,000 ppm dose for an hour, alternating days with air. A CPP test was conducted after the 3rd, 6th and 12th pairing. In these same animals, the relative glucose metabolism effects were determined using positron emission tomography (PET) imaging with 18FDG. Following the 3rd pairing, there was a significant aversion to the acetone paired chamber (190.9 ± 13.7 sec and 241.7 ± 16.9 sec, acetone and air, respectively). After the 6th pairing, there was no significant preference observed with equal time spent in each chamber (222 ± 21 sec and 207 ± 20 sec, acetone and air-paired, respectively). A similar trend was observed after the 12th pairing (213 ± 21 sec and 221 ± 22 sec, acetone and air-paired, respectively). Locomotor analysis indicated a significant decrease (p<0.05) from air pairings to acetone pairings on the first and sixth pairings. The observed locomotor activity was characteristic of central nervous system (CNS) depressants, without showing clear abusive effects in this CPP model. In these studies, acetone vapors were not as reinforcing as other solvents, shown by overall lack of preference for the acetone paired side of the chamber. PET imaging indicated a regionally specific distribution of 18FDG uptake following

  16. Clinical relevance of F-18 FDG PET for imaging of neuroendocrine tumors; Wertigkeit der F-18-FDG-PET bei neuroendokrinen Tumoren

    Adams, S. [Klinikum der Ruhr-Univ. Bochum - Marienhospital, Herne (Germany). Klinik fuer Radiologie und Nuklearmedizin; Baum, R.P. [Zentralklinik Bad Berka (Germany). Klinik fuer Nuklearmedizin/PET-Zentrum; Hoer, G. [Frankfurt Univ., Frankfurt am Main (Germany). Klinik fuer Nuklearmedizin

    2001-04-01

    Neuroendocrine tumors are characterized immunocytochemically by the expression of different peptides and biogenic amines. Hormones induce their biological action by binding to and stimulating specific membrane-associated receptors for e.g. somatostatin. The presence of somatostatin receptors (SR) has been described mainly in endocrine glands and the central nervous system. Interestingly, a large variety of human tumors, including gastroenteropancreatic (GEP) tumors and medullary thyroid carcinomas (MTC) also express a high density of SR and can be imaged with [{sup 111}In-DTPA-D-Phe{sup 1}]-pentetreotide. Cell proliferative activity is an important indicator of the growth of various malignant tumors associated with a poorer prognosis and Ki-67 expression. {sup 18}F-FDG is a marker of tumor viability, based upon the increased glycolysis that is associated with malignancy as compared with normal tissue. SR-containing neuroendocrine tumors are well-differentiated and tend to grow slowly. Furthermore, these tumors demonstrate inverse relationship between in vivo SR expression, cell proliferation (low Ki-67 expression) and FDG uptake (normal biodistribution). In comparison, less differentiated tumors, e.g. atypical carcinoids or MTC with increasing CEA levels show mitotic activity (high levels of Ki-67 immunoreactivity and increased FDG uptake) and often lack of SR. In conclusion, SR scintigraphy has been shown to localize well-differentiated neuroendocrine tumors. In contrast, PET imaging is valuable for predicting malignancy only in less differentiated tumors with incresed glucose metabolism. Therefore, an additional F-18 FDG PET should be performed if SR scintigraphy (GEP tumors) or combined imaging using [{sup 111}In-DTPA-D-Phe{sup 1}]-pentetreotide and {sup 99m}Tc(V)-DMSA (MTC) is negative. (orig.) [German] Neuroendokrine Tumoren werden durch die spezifische Produktion von Polypeptidhormonen und biogenen Aminen klassifiziert. Die Informationsuebertragung der

  17. Verbal memory deficits are correlated with prefrontal hypometabolism in (18FDG PET of recreational MDMA users.

    Oliver G Bosch

    Full Text Available INTRODUCTION: 3,4-Methylenedioxymethamphetamine (MDMA, "ecstasy" is a recreational club drug with supposed neurotoxic effects selectively on the serotonin system. MDMA users consistently exhibit memory dysfunction but there is an ongoing debate if these deficits are induced mainly by alterations in the prefrontal or mediotemporal cortex, especially the hippocampus. Thus, we investigated the relation of verbal memory deficits with alterations of regional cerebral brain glucose metabolism (rMRGlu in recreational MDMA users. METHODS: Brain glucose metabolism in rest was assessed using 2-deoxy-2-((18Ffluoro-D-glucose positron emission tomography ((18FDG PET in 19 male recreational users of MDMA and 19 male drug-naïve controls. (18FDG PET data were correlated with memory performance assessed with a German version of the Rey Auditory Verbal Learning Test. RESULTS: As previously shown, MDMA users showed significant impairment in verbal declarative memory performance. PET scans revealed significantly decreased rMRGlu in the bilateral dorsolateral prefrontal and inferior parietal cortex, bilateral thalamus, right hippocampus, right precuneus, right cerebellum, and pons (at the level of raphe nuclei of MDMA users. Among MDMA users, learning and recall were positively correlated with rMRGlu predominantly in bilateral frontal and parietal brain regions, while recognition was additionally related to rMRGlu in the right mediotemporal and bihemispheric lateral temporal cortex. Moreover, cumulative lifetime dose of MDMA was negatively correlated with rMRGlu in the left dorsolateral and bilateral orbital and medial PFC, left inferior parietal and right lateral temporal cortex. CONCLUSIONS: Verbal learning and recall deficits of recreational MDMA users are correlated with glucose hypometabolism in prefrontal and parietal cortex, while word recognition was additionally correlated with mediotemporal hypometabolism. We conclude that memory deficits of MDMA users

  18. Investigations on the effects of ''Ecstasy'' on cerebral glucose metabolism: an 18-FDG PET study

    Purpose: The aim of the present study was to determine the acute effects of the 'Ecstasy' analogue MDE (3,4-methylendioxyethamphetamine) on the cerebral glucose metabolism (rMRGlu) of healthy volunteers. Method: In a randomised double-blind trial, 16 healthy volunteers without a history of drug abuse were examined with 18-FDG PET 110-120 minutes after oral administration of 2 mg/kg MDE (n=8) or placebo (n=8). Beginning two minutes prior to radiotracer injection, a constant cognitive stimulation was maintained for 32 minutes using a word repetition paradigm in order to ensure constant and comparable mental conditions during cerebral 18-FDG uptake. Individual brain anatomy was represented using T1-weighted 3D flash MRI, followed by manual regionalisation into 108 regions-of-interest and PET/MRI overlay. Absolute quantification of rMRGlu and comparison of glucose metabolism under MDE versus placebo were performed using Mann-Whitney U-test. Results: Absolute global MRGlu was not significantly changed under MDE versus placebo (MDE: 41,8±11,1 μmol/min/100 g, placebo: 50,1±18,1 μmol/min/100 g, p=0,298). The normalised regional metabolic data showed a significantly decreased rMRGlu in the bilateral frontal cortex: Left frontal posterior (-7.1%, p<0.05) and right prefrontal superior (-4.6%, p<0.05). On the other hand, rMRGlu was significantly increased in the bilateral cerebellum (right: +10.1%, p<0.05; left: +7.6%, p<0.05) and in the right putamen (+6.2%, p<0.05). Conclusions: The present study revealed acute neurometabolic changes under the 'Ecstasy' analogon MDE indicating a fronto-striato-cerebellar dysbalance with parallels to other psychotropic substances and various endogenous psychoses respectively. (orig.)

  19. Myocardial glucose metabolism in patients with hypertrophic cardiomyopathy. Assessment by F-18-FDG PET study

    In an investigation of myocardial metabolic abnormalities in hypertrophic myocardium, the myocardial glucose metabolism was evaluated with F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) in 32 patients with hypertrophic cardiomyopathy, and the results were compared with those in 9 patients with hypertensive heart disease. F-18-FDG PET study was performed in the fasting and glucose-loading states. The myocardial regional %dose uptake was calculated quantitatively. The average regional %dose uptake in the fasting state in the patients with asymmetric septal hypertrophy and dilated-phase hypertrophic cardiomyopathy was significantly higher than that in the patients with hypertensive heart disease (0.75±0.34%, 0.65±0.25%, and 0.43±0.22%/100 g myocardium, respectively). In contrast, the average %dose uptake in the glucose-loading state in the patients with asymmetric septal hypertrophy and dilated-phase hypertrophic cardiomyopathy was not significantly different from that in patients with hypertensive heart disease (1.17±0.49%, 0.80±0.44% and 0.99±0.45%, respectively). The patients with apical hypertrophy had also low %dose uptake in the fasting state (0.38±0.21%) as in the hypertensive heart disease patients, so that the characteristics of asymmetric septal hypertrophy and dilated-phase hypertrophic cardiomyopathy are considered to be high FDG uptake throughout the myocardium in the fasting state. Patients with apical hypertrophy are considered to belong to other disease categories metabolically. F-18-FDG PET study is useful in the evaluation of the pathophysiologic diagnosis of patients with hypertrophic cardiomyopathy. (author)

  20. Relation Between Metabolic Activity of the Broca Region and F-18 FDG Uptake in Vocal Cords

    Mine Şencan Eren

    2012-08-01

    Full Text Available Objective: We aimed to investigate if increased F-18 Fluoro Deoxyglucose (F-18 FDG uptake observed in vocal cords (VC of the patients on Positron Emission Tomography/Computarize Tomography (PET/CT scans is connected to speaking of the patients or not. If so, we expected to detect an increased metabolic activity in Broca's area. In this study, we have retrospectively searched for a correlation between the activity in the Broca's area and vocal cords of patients who had undergone FDG PET for different indications. Material and Methods: FDG PET/CT scans of 30 patients with (VC [+] and 30 patients without (VC [-] bilateral F-18 FDG uptake on their vocal cords were retrospectively evaluated. Brain quantification was carried out on NeuroQ software with 20 iterations using patients' transaxial brain cross sections. On the 20th-23rd-26th-29th cross sections, area/whole brain ratios of the right (R and left (L for Broca’s area were calculated. VC (+ and VC (- patients' R and L Broca's areas were compared using Student's t-test. Results: There was no significant difference between the Broca's areas of VC (+ and VC (- patients. L Broca's areas of both VC (+ and VC (- patients were more active than R Broca's areas (p<0.05. There was a negative correlation between VC (+ patients' SUVmax values in the vocal cords and the activity in their R Broca's region. Conclusion: In our study, we did not find a significant difference between Broca's areas of VC (+ patients and VC (- patients, so the activity in their vocal cords does not seem to be related to increased metabolic activity in Broca's areas. We have concluded that the vocal cord activity is not related to speaking of the patients. The activity in the vocal cord might be due to inflammation or, as in the eye muscles, may be associated with high metabolism in laryngeal muscles. (MIRT 2012;21:42-46

  1. 18FDG synthesis and supply: a journey from existing centralized to future decentralized models.

    Uz Zaman, Maseeh; Fatima, Nosheen; Sajjad, Zafar; Zaman, Unaiza; Tahseen, Rabia; Zaman, Areeba

    2014-01-01

    Positron emission tomography (PET) as the functional component of current hybrid imaging (like PET/ CT or PET/MRI) seems to dominate the horizon of medical imaging in coming decades. 18Flourodeoxyglucose (18FDG) is the most commonly used probe in oncology and also in cardiology and neurology around the globe. However, the major capital cost and exorbitant running expenditure of low to medium energy cyclotrons (about 20 MeV) and radiochemistry units are the seminal reasons of low number of cyclotrons but mushroom growth pattern of PET scanners. This fact and longer half-life of 18F (110 minutes) have paved the path of a centralized model in which 18FDG is produced by commercial PET radiopharmacies and the finished product (multi-dose vial with tungsten shielding) is dispensed to customers having only PET scanners. This indeed reduced the cost but has limitations of dependence upon timely arrival of daily shipments as delay caused by any reason results in cancellation or rescheduling of the PET procedures. In recent years, industry and academia have taken a step forward by producing low energy, table top cyclotrons with compact and automated radiochemistry units (Lab- on-Chip). This decentralized strategy enables the users to produce on-demand doses of PET probe themselves at reasonably low cost using an automated and user-friendly technology. This technological development would indeed provide a real impetus to the availability of complete set up of PET based molecular imaging at an affordable cost to the developing countries. PMID:25556425

  2. (64)Cu-ATSM and (18)FDG PET uptake and (64)Cu-ATSM autoradiography in spontaneous canine tumors

    Hansen, Anders E; Kristensen, Annemarie T; Jørgensen, Jesper T;

    2012-01-01

    The aim of this study was to compare (64)Cu-diacetyl-bis(N(4)-methylsemicarbazone) ((64)Cu-ATSM) and (18)FDG PET uptake characteristics and (64)Cu-ATSM autoradiography to pimonidazole immunohistochemistry in spontaneous canine sarcomas and carcinomas....

  3. In Vivo Responses of Human A375M Melanoma to a sigma Ligand : F-18-FDG PET Imaging

    Rybczynska, Anna A.; de Bruyn, Marco; K. Ramakrishnan, Nisha; de Jong, Johan R.; Elsinga, Philip H.; Helfrich, Wijnand; Dierckx, Rudi A. J. O.; van Waarde, Aren

    2013-01-01

    sigma-ligands can kill tumor cells. Previously we have shown that a short in vitro incubation of C6 tumor cells with sigma-ligands (24 h) results in a dose-dependent increase of cellular F-18-FDG uptake and that the magnitude of this increase is predictive of subsequent cell death. Here, we aimed to

  4. A case of central pontine and extrapontine myelinolysis with early hypermetabolism on 18FDG-PET scan.

    Roh, J. K.; Nam, H; Lee, M. C.

    1998-01-01

    We report a 63 year-old woman who developed central pontine and extrapontine myelinolysis after rapid correction of hyponatremia. Lesions on brain MRI showed hypermetabolism on 18FDG-PET scan in the early stage of the disease and became hypometabolic on the follow-up scan. We suggest that active microglia and astrocytes are the main cause of the increased glucose metabolism.

  5. Positron emission tomography in Huntington's chorea using C15O2, 15O2 and 18 FDG

    Positron emission tomography (PET) using C15 O2, 15O2 and 18FDG was performed in a father and his son with Huntington's chorea. It was suggested that striatal atrophy occurred before the extensive atrophy of the cerebral cortex and that the progression of atrophy of the right and left cerebral hemispheric cortexes was not uniform. (Namekawa, K.)

  6. Evaluation of radiographic and metabolic changes in bone metastases in response to systemic therapy with 18FDG-PET/CT

    Gunalp Bengul

    2015-06-01

    Full Text Available Background. The aim of the study was to retrospectively evaluate radiographic and metabolic changes in bone metastases in response to systemic therapy with 18FDG-PET/CT and determine their roles on the evaluation of therapy response.

  7. Solitary Plasmacytoma of the Sternum Mimicking Bone Metastasis in a Patient with a History of Breast Cancer Evaluated by F-18-FDG PET/CT

    A 65-year-old woman with a history of breast cancer (stage T2N0M0 treated with left breast conservative therapy 7 years previously followed by hormone therapy) underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for restaging due to increased serum tumour markers levels (CA15-3, 37 U/ml and CEA, 8 ng/ml). The patient presented thoracic pain before performing F-18-FDG PET/CT. PET/CT demonstrated an area of increased F-18-FDG uptake corresponding to an osteolytic lesion occupying the upper sternum suspicious for bone metastasis. No other areas of abnormal F-18-FDG uptake were detected in the rest of the body. Based on this PET/CT finding, the patient performed biopsy of the sternal lesion. Histology demonstrated the presence of a sternal plasmacytoma and the patient was addressed to radiation therapy. The role of F-18-FDG PET/CT in patients with multiple myeloma is well known, whereas only some articles evaluated the usefulness of this method in patients with solitary plasmacytomas. In particular, F-18-FDG PET/CT may be useful in demonstrating the evolution of solitary plasmacytomas in multiple myeloma. In our case F-18-FDG PET/CT was useful in detecting a solitary plasmacytoma of the sternum mimicking bone metastasis in a patient with history of breast cancer, correctly addressing to further histological evaluation

  8. Solitary Plasmacytoma of the Sternum Mimicking Bone Metastasis in a Patient with a History of Breast Cancer Evaluated by F-18-FDG PET/CT

    Treglia, Giorgio; Luca, Giovanella [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Barbara, Muoio; Carmelo, Caldarella [Catholic Univ., Rome (Italy)

    2014-06-15

    A 65-year-old woman with a history of breast cancer (stage T2N0M0 treated with left breast conservative therapy 7 years previously followed by hormone therapy) underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for restaging due to increased serum tumour markers levels (CA15-3, 37 U/ml and CEA, 8 ng/ml). The patient presented thoracic pain before performing F-18-FDG PET/CT. PET/CT demonstrated an area of increased F-18-FDG uptake corresponding to an osteolytic lesion occupying the upper sternum suspicious for bone metastasis. No other areas of abnormal F-18-FDG uptake were detected in the rest of the body. Based on this PET/CT finding, the patient performed biopsy of the sternal lesion. Histology demonstrated the presence of a sternal plasmacytoma and the patient was addressed to radiation therapy. The role of F-18-FDG PET/CT in patients with multiple myeloma is well known, whereas only some articles evaluated the usefulness of this method in patients with solitary plasmacytomas. In particular, F-18-FDG PET/CT may be useful in demonstrating the evolution of solitary plasmacytomas in multiple myeloma. In our case F-18-FDG PET/CT was useful in detecting a solitary plasmacytoma of the sternum mimicking bone metastasis in a patient with history of breast cancer, correctly addressing to further histological evaluation.

  9. Prognostic value and clinical impact of 18FDG-PET in the management of children with Burkitt lymphoma after induction chemotherapy.

    clement eBailly

    2014-12-01

    Full Text Available Objective: Burkitt Lymphoma (BL is a rare and aggressive form of B cell lymphoma that is curable using intensive chemotherapy. Obtaining a complete response (CR at the end of induction chemotherapy is a major prognostic factor. This study retrospectively evaluates the potential impact of 18FDG-PET in the management of children with BL after induction chemotherapy, and the prognostic performance of the Deauville criteria.Methods: 19 children with BL treated according to the French LMB2001 protocol between 2005 and 2012 were included. 18FDG-PET and conventional imaging (CI were performed after induction chemotherapy to confirm CR. 18FDG-PET was interpreted according to Deauville criteria with follow up and/or histology as the gold standard.Results: 18FDG-PET was negative in 15 cases, in agreement with CI in 9/15 cases. The six discordant cases confirmed to be negative by histology, were considered as true negative for 18FDG-PET. Negative predictive value (NPV of CI and 18FDG-PET were 73 and 93% respectively. The five-year PFS was significantly higher in patients with negative 18FDG-PET than those with positive 18FDG-PET (p=0.011. Conclusion: 18FDG-PET interpreted using Deauville criteria can help confirm CR at the end of induction chemotherapy, with a prognostic impact on five-year PFS. Its high NPV could limit the use of residual mass biopsy. Given the small size of our population, these results need to be confirmed by future prospective studies on a larger population.

  10. Maxillofacial carcinomas: F-18-FDG PET versus CT in preoperative staging

    Full text: Diagnosis of maxillofacial malignancies remains a special problem for the diverse radiological imaging modalities, even in the preoperative stage. MRI and CT are limited because of artifacts caused by metal implants, metallic crowns and dental implants. We analyzed the diagnostic value of F-18-FDG PET as an alternative method for preoperative evaluation. The series consisted of 25 patients. All carcinomas were diagnosed clinically and histologically verified before the PET and CT-studies were performed. The serum glucose levels ranged between 80-110 mg/dl. F-18-FDG was injected intravenously in a dose of 333 - 370 MBq. Acquisition started between 70-90 min. post injection on a full ring PET scanner (ECAT EXACT HR+, Siemens, Medical Systems/CTI). Cervical CT was done in all patients, too. Thoracic CT was performed if there were pathological findings on the PET studies. FDG-PET: localized pathological FDG-uptake indicating the primary was observed in 25/25 patients. Pathological FDG-uptake in ipsilateral lymph node sites was seen in 8/25 patients, in ipsi- and contralateral lymph node sites in 1/25 patients. Lung-metastases were found in 2/25 patients. Cervical CT: the primary was recognized in all cases, but multiple artifacts did not allow to visualize the extension of the tumor in all patients. Ipsilateral lymph node sites were seen in 7/25 patients (seize: 0.9-1.6 cm), ipsi- and contralateral lymph node sites in 7/25 patients (seize: 0.8-1.8 cm). Radiological unsuspected lymph nodes 1 cm were inactive an the PET study in 2 patients. Thoracic CT was done after the PET study in 2/25 patients: the lung metastases recognized with FDG were identified with CT in both patients, too. Preoperative lymph node staging is essential in patients with maxillofacial malignancies in order to choose the individual therapeutic regime. We found FDG-PET favorably for the visualization of active, i.e. suspicious malignant lymph nodes. Our patients are a further example that

  11. Evaluation of acetazolamine response in patients with cerebellar ataxia using dynamic quantitative F-18-FDG PET

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

    2001-07-01

    Cerebellar Ataxia (CA) usually shows dramatic response to acetazolamide treatment. But few cases of acetazolamide unresponse CA were reported recently. Using dynamic FDG PET, we tried to evaluate the metabolic abnormality and its drug response in CA. Quantitative F-18-FDG PET was performed prior and after treatment of acetazolamide (250 mg qid for 10 days) in two patient suspected episodic cerebellar ataxia. Using Model-based clustering method, the regional cerebral glucose metabolic rate (rCMRglu) was calculated. Two patients showed different treatment response to acetazolamide. In one patient who showed markedly reduced frequency of the ataxic attack after treatment. FDG PET showed that mean cerebellar glucose metabolism was increased after treatment ({delta}rCMRglu:9%). However, in the other who showed poor response to acetazolamide, FDG PET showed the more decrease metabolism in cerebellar metabolism after treatment ({delta}rCMRglu:-17%). The change of the cerebellar glucose metabolism on FDG PET reflected the symptomatic improvement after acetazolamide in these two CA patients. We could expected that FDG PET might be a very useful tool to quantitatively predict the treatment response in CA and other neurologic disorder.

  12. Computed tomography and F-18-FDG-positron emission tomography for staging lymphomas: a comparison

    Purpose: To determine the value of F-18-FDG-positron emission tomography (FDG-PET) compared with computed tomography (CT) in the staging of malignant lymphomas. Material and method: 50 patients with biopsy-proven lymphoma were studied with FDG-PET and CT. The results in initial, posttherapeutic and staging of recurrence were compared. Results: 37 of 65 FDG-PET were identical with CT. 28 studies showed differences. 14 posttherapeutically and one of the initial studies led to downstaging by FDG-PET whereas upstaging resulted in one case of initial staging. In two cases false positive pulmonary FDG accumulations caused an upstaging. Conclusion: FDG-PET was at least comparable to CT in recording the extension of a newly diagnosed lymphoma or its recurrence. Upstaging according to FDG-PET occurred only once in initial staging. FDG-PET plays its most important role in the evaluation of residual mass in CT after therapy by accumulating FDG in viable tumour rather than in fibrotic tissue. 14 cases of downstaging according to FDG-PET resulted. (orig.)

  13. Carcinome cutané de Merkel: apport de la TEP-TDM au18FDG

    Amal, Guensi; Sara, Taleb; Ghofrane, Cherkaoui Salhi; Malika, Ait Idir; Majdouline, Houjami; Souha, Sahraoui; Abdelatif, Benider; Najoua, Touil; Ghita, Benmoussa; Zineb, Baroudi; Nabil, Chikhaoui

    2016-01-01

    Le carcinome à cellules de Merkel (CCM) est une tumeur cutanée neuroendocrinerare d’évolution imprévisible et à grand potentiel métastatique. Ce néoplasme survient habituellement chez le sujet âgé au niveau des zones photo exposées. L'avidité constante du CCM au 18 fluorodésoxyglucose (FDG) justifie l'intérêt de la tomographie par émission de positon (TEP) au cours de cette pathologie. Toutefois, aucun consensus n'est établi à ce jour. Cette étude rapporte le cas d'une patiente de 25 ans suivie pour CCM métastatique, afin d'attirer l'attention sur cette tumeur particulière et d'illustrer l'intérêt de la TEP au 18 FDG dans la prise en charge de cette entité rare. PMID:27303574

  14. Evaluation of acetazolamine response in patients with cerebellar ataxia using dynamic quantitative F-18-FDG PET

    Cerebellar Ataxia (CA) usually shows dramatic response to acetazolamide treatment. But few cases of acetazolamide unresponse CA were reported recently. Using dynamic FDG PET, we tried to evaluate the metabolic abnormality and its drug response in CA. Quantitative F-18-FDG PET was performed prior and after treatment of acetazolamide (250 mg qid for 10 days) in two patient suspected episodic cerebellar ataxia. Using Model-based clustering method, the regional cerebral glucose metabolic rate (rCMRglu) was calculated. Two patients showed different treatment response to acetazolamide. In one patient who showed markedly reduced frequency of the ataxic attack after treatment. FDG PET showed that mean cerebellar glucose metabolism was increased after treatment (ΔrCMRglu:9%). However, in the other who showed poor response to acetazolamide, FDG PET showed the more decrease metabolism in cerebellar metabolism after treatment (ΔrCMRglu:-17%). The change of the cerebellar glucose metabolism on FDG PET reflected the symptomatic improvement after acetazolamide in these two CA patients. We could expected that FDG PET might be a very useful tool to quantitatively predict the treatment response in CA and other neurologic disorder

  15. Radiation assessment to paediatric with F-18-FDG undergo whole-body PET/CT examination

    Dhalisa, H.; Mohamad, A. S.; Rafidah, Z.

    2016-01-01

    This study was carried out on wholebody radiation dose assessment to paediatrics patient who undergo PET/CT scanner at Institut Kanser Negara. Consist of 68 patients with varies of malignancies and epilepsy disease case covering age between 2 years to 12 years old. This is a retrospective study from 2010-2014. The use of PET/CT scanner as an advanced tool has been proven to give an extra radiation dose to the patient. It is because of the radiation exposure from the combination of both CT and PET scans rather than a single CT or PET scan. Furthermore, a study on radiation dose to paediatric patient undergoing PET/CT is rare in Malaysia. So, the aim of this study is to estimate the wholebody effective dose to paediatric patient in Malaysia. Effective dose from PET scan was calculated based on the activity of F18 FDG and dose coefficient reported in International Commission on Radiological Protection (ICRP) Publication 106. Effective dose from CT was determined using k coefficient as reported in ICRP publication 102 and Dose Length Product (DLP) value. The average effective dose from PET and CT were found to be 7.05mSv and 5.77mSv respectively. The mean wholebody effective dose received by a patient with combined PETCT examination was 12.78mSv. These results could be used as reference for dosimetry of a patient undergoing PETCT examination in Malaysia.

  16. 18 FDG-PET/CT: 21st century approach to leukemic tumors in 124 cases.

    Cunningham, Isabel; Kohno, Brigett

    2016-06-01

    Extramedullary tumors remain an obstacle to curing more acute leukemia patients. Their incidence is unknown because the presence of occult tumors that contribute to relapse is not routinely sought as in other cancers. No standard approach exists for treating tumors at most sites, apparent clinical response is typically followed by further tumors, and achievement of lengthy remission is uncommon. Body scanning with (18) FDG PET/CT now provides a means to identify the extent of occult tumors that enables directed tumor eradication and a way to evaluate tumor response. To evaluate its potential benefits, analysis was undertaken of 124 published cases scanned after apparent tumors were diagnosed. Clinical and radiologic exams underestimated extent of disease in over half of 100 cases. Among 70 cases that reported scans after various treatments, 70% achieved negative scans. Half relapsed subsequently but disease-free survivals up to 6 years were documented. These reported cases add to our knowledge of extramedullary leukemia in showing that further tumors are more likely than marrow relapse, clinical and radiologic evaluation of response is inadequate, intensive chemotherapy alone generally does not prevent progression and is associated with significant mortality, and tumor-directed plus systemic therapies appears the most effective approach, particularly to AML tumors. This analysis suggests this technology could increase our ability to eradicate all foci of leukemia, and identify tumors responsible for refractory, residual, and relapsed disease. PMID:26718745

  17. Current concepts in F18 FDG PET/CT-based Radiation Therapy planning for Lung Cancer

    Percy eLee

    2012-07-01

    Full Text Available Radiation therapy is an important component of cancer therapy for early stage as well as locally advanced lung cancer. The use of F18 FDG PET/CT has come to the forefront of lung cancer staging and overall treatment decision-making. FDG PET/CT parameters such as standard uptake value and metabolic tumor volume provide important prognostic and predictive information in lung cancer. Importantly, FDG PET/CT for radiation planning has added biological information in defining the gross tumor volume as well as involved nodal disease. For example, accurate target delineation between tumor and atelectasis is facilitated by utilizing PET and CT imaging. Furthermore, there has been meaningful progress in incorporating metabolic information from FDG PET/CT imaging in radiation treatment planning strategies such as radiation dose escalation based on standard uptake value thresholds as well as using respiratory gated PET and CT planning for improved target delineation of moving targets. In addition, PET/CT based follow-up after radiation therapy has provided the possibility of early detection of local as well as distant recurrences after treatment. More research is needed to incorporate other biomarkers such as proliferative and hypoxia biomarkers in PET as well as integrating metabolic information in adaptive, patient-centered, tailored radiation therapy.

  18. Radiation assessment to paediatric with F-18-FDG undergo whole-body PET/CT examination

    This study was carried out on wholebody radiation dose assessment to paediatrics patient who undergo PET/CT scanner at Institut Kanser Negara. Consist of 68 patients with varies of malignancies and epilepsy disease case covering age between 2 years to 12 years old. This is a retrospective study from 2010-2014. The use of PET/CT scanner as an advanced tool has been proven to give an extra radiation dose to the patient. It is because of the radiation exposure from the combination of both CT and PET scans rather than a single CT or PET scan. Furthermore, a study on radiation dose to paediatric patient undergoing PET/CT is rare in Malaysia. So, the aim of this study is to estimate the wholebody effective dose to paediatric patient in Malaysia. Effective dose from PET scan was calculated based on the activity of F18 FDG and dose coefficient reported in International Commission on Radiological Protection (ICRP) Publication 106. Effective dose from CT was determined using k coefficient as reported in ICRP publication 102 and Dose Length Product (DLP) value. The average effective dose from PET and CT were found to be 7.05mSv and 5.77mSv respectively. The mean wholebody effective dose received by a patient with combined PETCT examination was 12.78mSv. These results could be used as reference for dosimetry of a patient undergoing PETCT examination in Malaysia

  19. Radiation assessment to paediatric with F-18-FDG undergo whole-body PET/CT examination

    Dhalisa, H., E-mail: dhalisa82@gmail.com; Rafidah, Z. [Kluster Oncology Science and Radiology, Advanced Medical Dental Institute, Universiti Sains Malaysia (USM), Bertam, Penang (Malaysia); Mohamad, A. S. [Department of Nuclear Medicine, National Cancer Institute, No 4 Jalan P7, Presint 7, Putrajaya (Malaysia)

    2016-01-22

    This study was carried out on wholebody radiation dose assessment to paediatrics patient who undergo PET/CT scanner at Institut Kanser Negara. Consist of 68 patients with varies of malignancies and epilepsy disease case covering age between 2 years to 12 years old. This is a retrospective study from 2010-2014. The use of PET/CT scanner as an advanced tool has been proven to give an extra radiation dose to the patient. It is because of the radiation exposure from the combination of both CT and PET scans rather than a single CT or PET scan. Furthermore, a study on radiation dose to paediatric patient undergoing PET/CT is rare in Malaysia. So, the aim of this study is to estimate the wholebody effective dose to paediatric patient in Malaysia. Effective dose from PET scan was calculated based on the activity of F18 FDG and dose coefficient reported in International Commission on Radiological Protection (ICRP) Publication 106. Effective dose from CT was determined using k coefficient as reported in ICRP publication 102 and Dose Length Product (DLP) value. The average effective dose from PET and CT were found to be 7.05mSv and 5.77mSv respectively. The mean wholebody effective dose received by a patient with combined PETCT examination was 12.78mSv. These results could be used as reference for dosimetry of a patient undergoing PETCT examination in Malaysia.

  20. Impact of F-18 FDG-PET for the Clinical Multidisciplinary Evaluation of Dementia

    Prakash, Vineet; Vestergård, Karsten; Frost, Majbritt; Iyer, Victor Vishwanath; Steffensen, Elena; Larsson, Elna Boel-Marie

    PURPOSE            Dementia is a challenging clinical diagnosis. Compared with conventional clinical evaluations, F-18 Fluorodeoxyglucose (FDG) PET has been reported to improve not only the diagnostic accuracy of dementia but also help better define the underlying  type. This is because FDG PET d...... or Frontotemporal dementia.                       CLINICAL RELEVANCE/APPLICATION            F18-FDG Brain PET with visual and automated analyses can be valuable  in a diagnostic algorithim for the work up of dementia when the cause is uncertain.......PURPOSE            Dementia is a challenging clinical diagnosis. Compared with conventional clinical evaluations, F-18 Fluorodeoxyglucose (FDG) PET has been reported to improve not only the diagnostic accuracy of dementia but also help better define the underlying  type. This is because FDG PET...... demonstrates metabolic patterns reflecting neuronal function specific to different dementias.To assess the impact of PET on a multidisciplinary  dementia clinic for patients with suspected dementia by comparing it with the initial clinical evaluation and paraclinical tests.                       METHOD AND...

  1. A Case of Urethral Metastasis from Sigmoid Colon Cancer Diagnostically and Prognostically Indicated by F 18 FDG PET/CT

    Seo, Han Seok; Kim, Eun Sil; Kim, Soyon; Im, Su Jin; Park, Yong Hyun; Lee, Ju Hyoung; Hur, So Chong [National Police Hospital, Seoul (Korea, Republic of)

    2011-12-15

    Urethral metastasis from colorectal cancer is rare and is known to have a poor prognosis. A 72 year old man with a history of colectomy and colostomy due to sigmoid colon cancer was admitted to the emergency room with bowel distension, rectal bleeding and urinary symptoms. Computed tomography of the abdominopelvis showed sigmoid colon cancer with multiple metastases involving the liver. Positron emission tomography with F 18 fluorodeoxyglucose (FDG) showed multiple hypermetabolic foci in the liver, penis and pubic bone, which otherwise could not be diagnosed. The lesions revealed no improvement with chemotherapy and urological surgery on follow up F 18 FDG PET/CT. We present a case of urethral metastasis of sigmoid colon cancer diagnostically and prognostically indicated by F 18 FDG PET/CT.

  2. Predictive values of F-18-FDG PET and ictal SPECT to find epileptogenic zones in cryptogenic neocortical epilepsies

    Though cumulated reported sensitivity were 33% (F-18-FDG PET) and 81%(ictal SPECT) in neocortical epilepsy, positive predictive values rather than sensitivity should be referred if we wish to know the reliability of positive findings to predict epileptogenic zones. In cryptogenic neocortical epilepsy which did not have structural lesions on MR, we tried to find performance of F-18-FDG PET and ictal SPECT to find epileptogenic zones. In 77 patients who had no lesion on MR and who were suspected to have neocortical epilepsy on video monitored EEG, ictal SPECT were done in 44 patients and F-18-FDG PET were done in 70 patients. Invasive study and operation was done in 24 patients. The most hyper perfused area or prominently hypometabolic area was suspected to be epileptogenic on ictal SPECT or F-18-FDG PET, respectively. We could find zones of ictal hyperperfusion in 34/44(78%) patients. Positive predictive values of ictal hyperperfusion were 58%, 60%, and 12.5% in frontal lobes (n=12), lateral temporal lobes (20), and parietal lobes (8). We could find hypometabolic areas in 50/70(76%) patients. Positive predictive values of hypometabolism were 78%, 71%, 33%, and 25% in frontal lobes (9), lateral temporal lobes (28), parietal lobes (3) and occipital lobes (4). Among 24 patients who were operated, 17 patients were followed up more than 7 months (15 ± 5). Thirteen patients improved (10 : Engel class I or II, 2: 90% reduction, 1: 75% reduction but multifocal). Five among 11 PET studies were correct, 3 among 10 SPECT studies, and 6 among 11 PET/SPECT studies (55%) were correct for localization. In conclusion, three fourths of patients gave positive results to localized epileptogenic zones in cryptogenic neocortical epilepsy, and predictive values of ictal hyperperfusion or interictal hypometabolism were highest in frontal or lateral temporal lobes if these lobes were found to be culprit though rapid ictal propagation of cortical hyperperfusion confounded the exact

  3. Inter-modality variation in gross tumor volume delineation in 18FDG-PET guided IMRT treatment planning for lung cancer.

    Song, Yulin; Chan, Maria; Burman, Chandra; Cann, Donald

    2006-01-01

    Rapid advances in 18FDG-PET/CT technology and novel co-registration algorithms have created a strong interest in 18FDG-PET/CT's application in intensity modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT). Accurate target volume delineation, particularly identification of pathologically positive lymph nodes, could translate into favorable treatment outcome. However, gross tumor volume (GTV) delineation on both CT and 18FDG-PET is very sensitive to observer variation. The objectives of the study were to investigate the inter-modality variation in gross tumor volume delineation defined by two imaging modalities for lung cancer: CT and 18FDG-PET/CT and its dosimetric implications in intensity modulated radiation therapy (IMRT). PMID:17946204

  4. Bone metastasis in patients with non-small cell lung cancer: The diagnostic role of F-18 FDG PET/CT

    Purpose: To evaluate the performance of F-18 FDG PET/CT in the detection of bone metastasis in non-small cell lung cancer (NSCLC) patients. Materials and methods: Three hundred and sixty-two consecutive NSCLC patients who underwent F-18 FDG PET/CT scanning were retrospectively analyzed. Each image of PET/CT, combined CT, and PET was performed at 10 separate areas and interpreted blindly and separately. The sensitivity, specificity and accuracy of F-18 FDG PET/CT, combined CT and F-18 FDG PET were calculated and the results were statistically analyzed. Results: Bone metastasis was confirmed in 82 patients with 331 positive segments based on the image findings and clinical follow-up. On patient-based analysis, the sensitivity of F-18 FDG PET/CT (93.9%) was significantly higher than those of combined CT (74.4%) and F-18 FDG PET (84.1%), respectively (p < 0.05). The overall specificity and accuracy of combined CT, F-18 FDG PET, and F-18 FDG PET/CT were 90.7%, 93.2%, 98.9% and 87.0%, 91.2%, and 97.8%, respectively (compared with PET/CT, p < 0.05). On segment-based analysis, the sensitivity of the three modalities were 79.5%, 94.3%, and 98.8%, respectively (compared with PET/CT, p < 0.05). The overall specificity and accuracy of the three modalities were 87.9%, 89.2%, 98.6% and 84.5%, 91.2%, 98.7%, respectively (compared with PET/CT, p < 0.05). Conclusion: F-18 FDG PET/CT is superior to F-18 FDG PET or combined CT in detecting bone metastasis of NSCLC patients because of the complementation of CT and PET. It is worth noting that the added value of F-18 FDG PET/CT may beneficially impact the clinical management of NSCLC.

  5. Construction and evaluation of F-18 FDG PET probabilistic MAP for voxel based analysis of the rat brain

    Im, K. C.; Kim, J. S.; Na, Y. S.; Moon, D. H.; Ryu, J. S. [Asan Medical Center, Seoul (Korea, Republic of)

    2007-07-01

    The purpose of this study was to develop F-18 FDG PET and MRI template for normal rat brain. Also, feasibility of SPM in detailed regional analysis of molecular changes in the rat brain was explored for F-18 FDG PET imaging of a model of traumatic brain injury (TBI). Ten normal rats were scanned with PET and MRI. The PET images were acquired with 3D mode using microPET focus 120 scanner after injection of 37 MBq F-18 FDG. T2-weighted MR images were acquired using 4.7T MRI system. A MRI-based spatial normalization was used. The PET images were coregistered to T2-weighted MR images. Maximum mutual information (MMI) registrations and affine spatial normalizations were performed using SPM2. The spatial normalization of the MRI to the standard MRI was applied to the integral images. The normalized PET images were averaged voxel wise to create PET template. Eight TBI model rats were subjected to a moderate lateral fluid percussion injury. At 2 days, 1 week, 3 weeks and 5 weeks post FPI, PET images of 8 TBI rats were acquired 4 times. TBI PET images were realigned, spatially normalized to a created PET-template and smoothed (8 mm FWHM). To assess the extent and severity of significant hypo metabolic lesions in TBI compared to normal controls were obtained by a two-sided t-test of SPM (uncorrected p < 0.001, 50 voxels). Visually acceptable PET and MRI templates were created. Registration errors were negligible when MMI procedure was used to register a translated or rotated image volume. Thirty-two PET studies of 8 TBI model subjects were obtained. SPM analysis showed injured distribution of decrease F-18 FDG uptake in TBI rats compared with normal rats. In SPM analysis, the extent and severity of significant hypo metabolic lesions were decreased according to a significant effect of time. At 5 weeks injured animals showed F-18 FDG uptake recovery using SPM analysis. These results indicate that voxel-based method will be useful for future longitudinal studies of rat brain.

  6. Pyelo-cystic Reflux in F-18 FDG PET Scan Due to Ureteral Obstruction

    Reyhan, Mehmet [Baskent Univ., Adana (Turkmenistan)

    2013-09-15

    A 72-year-old woman with a history of cervical cancer was treated with brachytherapy and chemotherapy. Combined F-18 FDG PET/CT performed for restaging demonstrated increased FDG uptake in a hypodense cystic lesion at the posterior part of the right renal cortex and a hypermetabolic soft tissue mass at the right parailiac region suggestive of a metastatic lymph node causing ureteral obstruction. There had been no FDG uptake in the cystic lesion on the FDG PET/CT study performed 1 year before. These findings suggest that the increased FDG uptake in the cystic lesion was caused by pyelocystic reflux due to ureteral obstruction secondary to parailiac lymph node metastasis (Figs. 1 and 2). Several renal lesions may have increased metabolism, such as renal cell carcinoma, lymphoma, oncocytoma, adult Wilms' tumor, angiomyolipoma, metastatic lesions, xanthogranulo-matous pyelonephritis and infected cyst. Most of these lesions are solid. Some infected renal cysts may be FDG avid, but in this situation increased FDG uptake is observed on the wall of the cyst. In our case, FDG uptake was seen in the entire cystic lesion. The patient had no symptoms or laboratory findings related to infection. Cysts are the most common space-occupying lesions of the kidney. The vast majority of these are simple cysts that are usually unilateral and solitary. Simple cysts are asymptomatic, except when complications exist such as hemorrhage, infection or rupture. There have been a few reports on spontaneous communications between renal cysts and the pyelocaliceal system, in most cases involving ruptures of the cysts into the pyelocaliceal system due to increased intracystic pressure caused by bleeding or infection of the cyst. In the present case, the cause of the connection between the cystic cavity and the pyelocaliceal system is the increased pressure in the renal pelvic cavity due to the ureteral obstruction secondary to parailiac lymph node metastasis.

  7. Evaluation of Adrenal Masses in Lung Cancer Patients Using F 18 FDG PET/CT

    The aim of this study was to assess the diagnostic efficacy of PET/CT using various parameters for the characterization of adrenal nodules in lung cancer patients. Sixty one adrenal nodules in 51 lung cancer patients were evaluated. The final diagnosis was based on histology (n=2) or imaging follow up (n=59, range of follow up: 7-57 months, median 27 months). Each adrenal nodule was analyzed using four parameters of PET/CT: the maximum standardized uptake value (SUVmax), the adrenal nodule/liver ratio of the SUV (SUV ratio), Hounsfield units (HU) and size. The optimal cutoff of each parameter for the identification of metastatic nodule was determined by ROC analysis and then the diagnostic efficacy was compared among the parameters. Of the 61 adrenal nodules, 45 (73%) were considered metastasis. The optimal cutoff values of the parameters were SUVmax>2.7, SUV radio>1.3, HU>18 and size>20mm, respectively. The sensitivity, specificity and accuracy by SUVmax>2.7 were 88.9%, 87.5% and 88.5%, respectively. The combination of SUV ratio>1.3 and HU>18 had sensitivity of 97.7%, specificity of 81.2% and accuracy of 93.4% to predict adrenal metastasis in patients with lung cancer. SUV ratio from F 18 FDG PET/CT could identify the adrenal metastasis in lung cancer patients. The combination of SUV ratio and HU can improve the accuracy of differentiating benign and metastatic adrenal lesions in lung cancer patients

  8. Pyelo-cystic Reflux in F-18 FDG PET Scan Due to Ureteral Obstruction

    A 72-year-old woman with a history of cervical cancer was treated with brachytherapy and chemotherapy. Combined F-18 FDG PET/CT performed for restaging demonstrated increased FDG uptake in a hypodense cystic lesion at the posterior part of the right renal cortex and a hypermetabolic soft tissue mass at the right parailiac region suggestive of a metastatic lymph node causing ureteral obstruction. There had been no FDG uptake in the cystic lesion on the FDG PET/CT study performed 1 year before. These findings suggest that the increased FDG uptake in the cystic lesion was caused by pyelocystic reflux due to ureteral obstruction secondary to parailiac lymph node metastasis (Figs. 1 and 2). Several renal lesions may have increased metabolism, such as renal cell carcinoma, lymphoma, oncocytoma, adult Wilms' tumor, angiomyolipoma, metastatic lesions, xanthogranulo-matous pyelonephritis and infected cyst. Most of these lesions are solid. Some infected renal cysts may be FDG avid, but in this situation increased FDG uptake is observed on the wall of the cyst. In our case, FDG uptake was seen in the entire cystic lesion. The patient had no symptoms or laboratory findings related to infection. Cysts are the most common space-occupying lesions of the kidney. The vast majority of these are simple cysts that are usually unilateral and solitary. Simple cysts are asymptomatic, except when complications exist such as hemorrhage, infection or rupture. There have been a few reports on spontaneous communications between renal cysts and the pyelocaliceal system, in most cases involving ruptures of the cysts into the pyelocaliceal system due to increased intracystic pressure caused by bleeding or infection of the cyst. In the present case, the cause of the connection between the cystic cavity and the pyelocaliceal system is the increased pressure in the renal pelvic cavity due to the ureteral obstruction secondary to parailiac lymph node metastasis

  9. Clinical relevance of F-18 FDG PET for imaging of neuroendocrine tumors

    Neuroendocrine tumors are characterized immunocytochemically by the expression of different peptides and biogenic amines. Hormones induce their biological action by binding to and stimulating specific membrane-associated receptors for e.g. somatostatin. The presence of somatostatin receptors (SR) has been described mainly in endocrine glands and the central nervous system. Interestingly, a large variety of human tumors, including gastroenteropancreatic (GEP) tumors and medullary thyroid carcinomas (MTC) also express a high density of SR and can be imaged with [111In-DTPA-D-Phe1]-pentetreotide. Cell proliferative activity is an important indicator of the growth of various malignant tumors associated with a poorer prognosis and Ki-67 expression. 18F-FDG is a marker of tumor viability, based upon the increased glycolysis that is associated with malignancy as compared with normal tissue. SR-containing neuroendocrine tumors are well-differentiated and tend to grow slowly. Furthermore, these tumors demonstrate inverse relationship between in vivo SR expression, cell proliferation (low Ki-67 expression) and FDG uptake (normal biodistribution). In comparison, less differentiated tumors, e.g. atypical carcinoids or MTC with increasing CEA levels show mitotic activity (high levels of Ki-67 immunoreactivity and increased FDG uptake) and often lack of SR. In conclusion, SR scintigraphy has been shown to localize well-differentiated neuroendocrine tumors. In contrast, PET imaging is valuable for predicting malignancy only in less differentiated tumors with increased glucose metabolism. Therefore, an additional F-18 FDG PET should be performed if SR scintigraphy (GEP tumors) or combined imaging using [111In-DTPA-D-Phe1]-pentetreotide and 99mTc(V)-DMSA (MTC) is negative. (orig.)

  10. Dynamic respiratory gated 18FDG-PET of lung tumors - a feasibility study

    Background. 18FDG-PET/CT imaging is well established for diagnosis and staging of lung tumors. However, more detailed information regarding the distribution of FDG within the tumor, also as a function of time after injection may be relevant. In this study we explore the feasibility of a combined dynamic and respiratory gated (DR) PET protocol. Material and methods. A DR FDG-PET protocol for a Siemens Biograph 16 PET/CT scanner was set up, allowing data acquisition from the time of FDG injection. Breath-hold (BH) respiratory gating was performed at four intervals over a total acquisition time of 50 minutes. Thus, the PET protocol provides both motion-free images and a spatiotemporal characterization of the glucose distribution in lung tumors. Software tools were developed in-house for tentative tumor segmentation and for extracting standard uptake values (SUVs) voxel by voxel, tumor volumes and SUV gradients in all directions. Results. Four pilot patients have been investigated with the DR PET protocol. The procedure was well tolerated by the patients. The BH images appeared sharper, and SUVmax/SUVmean was higher, compared to free breathing (FB) images. Also, SUV gradients in the periphery of the tumor in the BH images were in general greater than or equal to the gradients in the FB PET images. Conclusion. The DR FDG-PET protocol is feasible and the BH images have a superior quality compared to the FB images. The protocol may also provide information of relevance for radiotherapy planning and follow-up. A patient trial is needed for assessing the clinical value of the imaging protocol

  11. Comparisons of 13NH3, 18FDG PET and MRS in the presurgical evaluation of intractable epilepsy

    Purpose: Surgery offers a high chance of seizure-free outcome in patients with intractable epilepsy. Other than EEG, several functional and morphologic imaging Methods are used to define the spatial seizure origin. Blood flow perfusion and metabolic abnormalities in those patients are well described respectively. Proton MR spectroscopy (MRS) is still in the early stages in the evaluation of epilepsy. Comparisons with 13NH3 perfusion, 18FDG metabolic PET imaging and MRS in the same patients have rarely been documented. The present study was undertaken to compare the merits of 13NH3 PET, 18FDG PET, magnetic resonance imaging (MRI) and MRS for the lateralization of seizure foci. Methods: Preoperative long-term-EEG, Video-EEG, 13NH3 perfusion PET, 18FDG metabolic PET, MRI, MRS and neuropsychological assessment were performed in 15 patients with intractable epilepsy within 2 weeks(mean age=24.8 years, range 4 to 44 years; mean epilepsy duration=11 years, range 2 to 36 years), who received electrocorticography (ECoG). Antiepileptic drug (AED) was stopped taking at least 2 days before PET scanning. 13NH3 and FDG PET was performed in one day and analyzed with a region of interest template. An absolute asymmetry index, |AI|, greater than 0.15 was considered abnormal. 13 subjects were underwent MRS obtained from the hippocampus bilaterally, who had a presumptive temporal seizure focus based on seizure semiology, video-EEG and MRI. Metabolite ratio of NAA/Cho+Cr was calculated from the relative peak height measurements. An NAA/Cho+Cr ratio of 0.72 or less was regarded as abnormal. All the examination Results were compared with EcoG to evaluate their values of seizure foci lateraliaztion. Results: 1. The results were divided into ictal (n=4) and interictal (n= 11) groups. In the ictal group, the sensitivity of 13NH3 PET and 18FDG PET were both 100%(4/4), and 13NH3 PET showed bilateral hippocampus hyperfusion foci in one case. In the interictal group, 13NH3 PET correctly

  12. Development of methodologies for internal exposure assessment due to the radiopharmaceutical {sup 18}FDG; Desenvolvimento de metodologias para avaliacao da exposicao ocupational interna devido ao radiofarmaco {sup 18}FDG

    Lacerda, Isabelle Viviane Batista de

    2013-07-01

    The production of {sup 18}F has increased in the last decade. It is produced basically for the synthesis of {sup 18}F- fluorodeoxyglucose ({sup 18}FDG), the main radiopharmaceutical used in PET (Positron Emission Tomography) scans. The growth in the frequency of these tests resulted in rise of the number of occupationally exposed individuals (OEI) to the radionuclide {sup 18}F as {sup 18}FDG, increasing thereby the probability of its accidental incorporation. This study aimed to implement optimized techniques for assessing internal exposures of individuals occupationally exposed through both in vivo and in vitro bioassay methods during production and handling of {sup 18}FDG at the Divisao de Producao de Radiofarmacos (DIPRA), Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE/CNEN). The in vivo monitoring was conducted at the Laboratorio de Dosimetria Interna, Divisao de Laboratorios Tecnico-Cientificos (DILAB). For this bioassay method, measurements were done with a 3x3' NaI(Tl) scintillation detector coupled to Genie 2000 software. The calibration of the system was performed with a brain phantom containing a standard liquid source of {sup 22}Na to simulate a contaminated individual. The calibration of the HPGe coaxial detector for in vitro monitoring was performed at the Laboratorio de Medidas de Atividade de Radionuclideos (DIPRA/CRCN-NE/CNEN) with a standard source of {sup 22}Na. Base on the calibration factors, it was possible to determine the minimum detectable activities (MDA) for the systems by using direct measurements and simulation of uncontaminated urine. Then, through the biokinetic models published by ICRP 106 and edited by the AIDE software (version 6.0), it was possible to estimate the minimum detectable effective dose (MDED), which evaluates the detection sensitivity of the techniques developed. The MDED was estimated for in vivo and in vitro measurements performed 2.4 hours after the occurrence of incorporation by ingestion, since

  13. Effect of the dilution factor on 18FDG and Na18F samples for bacterial endotoxin test using PTS (portable test system)

    18FDG and Na18F are radiopharmaceuticals produced as sterile solutions suitable for intravenous administration, which must contain no more than 175 EV/V. The most commonly used approach to detect endotoxins is the gelclot technique that requires 60 minutes for results. For radiopharmaceuticals containing short-life radionuclides, such as 18F, there is an increasing interest for faster quality control methods. FDA licensed the Endosafe, PTS, a kinetic chromogenic endotoxin detection system that takes about 15 minutes for results. As other techniques, PTS test is susceptible to interferences which can be solved by product dilution. The aim of this study was to establish the best dilution of 18FDG and Na18F for PTS analysis. Two different dilution factors for 18FDG and 1:10 for Na18F were essayed: 1:10 and 1:100. 18FDG and Na18 solutions were prepared by the addition of LAL reagent water. Considering the assay acceptance criteria, the best dilution factor was 1:100 for 18FDG and 1:10 for Na18F. The recovery of the product positive control was 98-12% for 18FDG 1:100 and 104-120% for Na18F 1:10, which were, in both cases, within the specification (50-200%) and very close to 100%. Results obtained with these dilution studies were important to establish the most appropriate and non-interfering dilution factor for 18FDG and Na18F routine endotoxin test. (author)

  14. Effect of the dilution factor on {sup 18}FDG and Na{sup 18}F samples for bacterial endotoxin test using PTS (portable test system)

    Silveira, Marina B.; Costa, Flavia M.; Ferreira, Soraya Z., E-mail: mbs@cdtn.b [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil). Unidade de Pesquisa e Producao de Radiofarmacos

    2011-07-01

    {sup 18}FDG and Na{sup 18}F are radiopharmaceuticals produced as sterile solutions suitable for intravenous administration, which must contain no more than 175 EV/V. The most commonly used approach to detect endotoxins is the gelclot technique that requires 60 minutes for results. For radiopharmaceuticals containing short-life radionuclides, such as {sup 18}F, there is an increasing interest for faster quality control methods. FDA licensed the Endosafe, PTS, a kinetic chromogenic endotoxin detection system that takes about 15 minutes for results. As other techniques, PTS test is susceptible to interferences which can be solved by product dilution. The aim of this study was to establish the best dilution of {sup 18}FDG and Na{sup 18}F for PTS analysis. Two different dilution factors for {sup 18}FDG and 1:10 for Na{sup 18}F were essayed: 1:10 and 1:100. {sup 18}FDG and Na{sup 18} solutions were prepared by the addition of LAL reagent water. Considering the assay acceptance criteria, the best dilution factor was 1:100 for {sup 18}FDG and 1:10 for Na{sup 18}F. The recovery of the product positive control was 98-12% for {sup 18}FDG 1:100 and 104-120% for Na{sup 18}F 1:10, which were, in both cases, within the specification (50-200%) and very close to 100%. Results obtained with these dilution studies were important to establish the most appropriate and non-interfering dilution factor for {sup 18}FDG and Na{sup 18}F routine endotoxin test. (author)

  15. The role of F18-FDG PET scans in predicting micropapillary thyroid cancer aggressiveness

    The purpose is to evaluate F18-FDG PET in predicting micropapillary thyroid cancer aggressiveness. 41 patients (38 female, mean age 50y) who had PET before total thyroidectomy between 2002.1∼2007.8 were reviewed. Patients with thyroiditis and multiple nodules were excluded. Thyroid nodules were visually analyzed into groups with increased and no FDG uptake. Peak SUV ratio of liver-to-nodule (pSUV ratio) was taken. pSUV ratio was correlated with nodule size and micropapillary cancer aggressiveness. Perithyroid extension and/or LN metastasis was used as an indicator of micropapillary cancer aggressiveness 20 patients had 0.89 and nodules with increased FDG uptake, with an average pSUV ratio of 1.67 0.15. 21 patients had nodules that were not visible, average size of 0.66 cm 0.24. FDG uptake and nodule size correlation was with an average size of 0.52 cm significant (p=0.051). The nodules were divided into two groups using a cut-off value of pSUV ratio of 0.9. 19 patients had nodules with a pSUV ratio of 0.9 or higher, and 15 of the 19 patients had perithyroid extension and/or LN metastasis. 22 patients had nodules with pSUV ratio lower than 0.9 and 7 of these patients had perithyroid extension and/or LN metastasis. Patients with higher pSUV ratio showed more perithyroid extension or LN metastasis than those with lower pSUV ratio (p=0.01). A total of 8 patients had LN metastasis, but none were visualized on PET. Higher FDG uptake seems to be significantly correlated with tumor aggressiveness in micropapillary thyroid carcinomas. But FDG uptakes in primary tumors were also correlated with tumor size. In other words, larger nodules tend to show aggressive behavior in micropapillary thyroid carcinomas and FDG it self may not be an independent factor for tumor aggressiveness. Also, PET shows an extremely poor sensitivity for the detection of LN metastasis. Therefore, PET may not have any role in the evaluation of patients with micropapillary thyroid carcinomas

  16. Diagnostic evaluation of malignant head and neck cancer by F-18-FDG PET compared to CT/MRI

    Nowak, B.; Cremerius, U.; Zimny, M.; Reinartz, P.; Buell, U. [Technische Hochschule Aachen (Germany). Klinik fuer Nuklearmedizin; Di Martino, E. [Aachen Univ. (Germany). Abt. Otorhinolaryngology; Jaenicke, S. [Technische Hochschule Aachen (Germany). Lehrstuhl fuer Zahn-, Mund-, Kiefer- und Plastische Gesichtschirurgie, Abt. Zahn-, Mund-, Kiefer- und Plastische Gesichtschirurgie; Adam, G. [Technische Hochschule Aachen (Germany). Klinik fuer Radiologische Diagnostik

    1999-07-01

    Aim: Evaluation of F-18-FDG PET in comparison to CT/MRI as diagnostic tool in primary and recurrent head and neck cancer. Methods: 78 F-18-FDG PET studies were performed in 71 patients with known or suspected primary (n=48) or recurrent (n=30) head and neck cancer and compared to CT (n=75) or MRI investigations (n=3) concerning detection of the primary or recurrent tumor and detection of regional lymph node metastases in the ipsilateral and contralateral neck sides. Glucose uptake (SUV) of PET findings was correlated to tumor location, grading and dignity of the lesion. Results: Sensitivity and specificity for PET in detection of primary tumors were 87%* and 67%, respectively (CT/MRI 67%* and 44%) ({sup *}p<0.05), in detection of local recurrence 86% and 75%, respectively (CT/MRI 57% and 92%), in detection of necks affected by lymph node metastases 80% and 92%, respectively (CT/MRI 80% and 84%). Laryngeal, buccal (cheek) and salivary gland tumors had significant lower glucose uptake (SUV) when compared to tumors of the hypopharynx (p<0.05). G1-tumors (mean SUV 4.26) had significant (p<0.05) lower glucose uptake when compared to G2- and G3-tumors (mean SUV 7.73 and 8.19, respectively). Mean SUV of malignant PET findings (7.88) was significant (p<0.05) higher than mean SUV of benign PET findings (5.70). However, a SUV threshold to improve diagnostic accuracy could not be defined. Conclusion: F-18-FDG PET is significantly more accurate than CT/MRI for detection of head and neck cancer. Both methods are valuable for detection of cervical lymph node metastases. Glucose uptake shows correlation to histological grading. A quantitative SUV analysis does not improve diagnostic accuracy. (orig.) [German] Ziel: Evaluation der F-18-FDG-PET in der Primaer- und Rezidivdiagnostik von Kopf-Hals-Tumoren im Vergleich zur CT/MRT. Methoden: Es wurden 78 F-18-FDG-PET-Untersuchungen bei 71 Patienten mit gesichertem oder vermutetem primaerem (n=48) oder rezidiviertem (n=30) Kopf

  17. Usefulness of F-18 FDG PET/CT in Adrenal Incidentaloma: Differential Diagnosis of Adrenal Metastasis in Oncologic Patients

    Lee, Hong Je; Song, Bong Il; Kang, Sung Min; Jeong, Shin Young; Seo, Ji Hyoung; Lee, Sang Woo; Yoo, Jeong Soo; Ahn, Byeong Cheol; Lee, Jae Tae [Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2009-10-15

    We have evaluated characteristics of adrenal masses incidentally observed in nonenhanced F-18 FDG PET/CT of the oncologic patients and the diagnostic ability of F-18 FDG PET/CT to differentiate malignant from benign adrenal masses. Between Mar 2005 and Aug 2008, 75 oncologic patients (46 men, 29 women; mean age, 60.8{+-}10.2 years; range, 35-87 years) with 89 adrenal masses incidentally found in PET/CT were enrolled in this study. For quantitative analysis, size (cm), Hounsfield unit (HU), maximum standardized uptake value (SUVmax), SUVratio of all 89 adrenal masses were measured. SUVmax of the adrenal mass divided by SUVliver, which is SUVmax of the segment 8, was defined as SUVratio. The final diagnosis of adrenal masses was based on pathologic confirmation, radiologic evaluation (HU<0 : benign), and clinical decision. Size, HU, SUVmax, and SUVratio were all significantly different between benign and malignant adrenal masses.(P < 0.05) And, SUVratio was the most accurate parameter. A cut-off value of 1.0 for SUVratio provided 90.9% sensitivity and 75.6% specificity. In small adrenal masses (1.5 cm or less), only SUVratio had statistically significant difference between benign and malignant adrenal masses. Similarly a cut-off value of 1.0 for SUVratio provided 80.0% sensitivity and 86.4% specificity. F-18 FDG PET/CT can offer more accurate information with quantitative analysis in differentiating malignant from benign adrenal masses incidentally observed in oncologic patients, compared to nonenhanced CT.

  18. Usefulness of F-18 FDG PET/CT in Adrenal Incidentaloma: Differential Diagnosis of Adrenal Metastasis in Oncologic Patients

    We have evaluated characteristics of adrenal masses incidentally observed in nonenhanced F-18 FDG PET/CT of the oncologic patients and the diagnostic ability of F-18 FDG PET/CT to differentiate malignant from benign adrenal masses. Between Mar 2005 and Aug 2008, 75 oncologic patients (46 men, 29 women; mean age, 60.8±10.2 years; range, 35-87 years) with 89 adrenal masses incidentally found in PET/CT were enrolled in this study. For quantitative analysis, size (cm), Hounsfield unit (HU), maximum standardized uptake value (SUVmax), SUVratio of all 89 adrenal masses were measured. SUVmax of the adrenal mass divided by SUVliver, which is SUVmax of the segment 8, was defined as SUVratio. The final diagnosis of adrenal masses was based on pathologic confirmation, radiologic evaluation (HU<0 : benign), and clinical decision. Size, HU, SUVmax, and SUVratio were all significantly different between benign and malignant adrenal masses.(P < 0.05) And, SUVratio was the most accurate parameter. A cut-off value of 1.0 for SUVratio provided 90.9% sensitivity and 75.6% specificity. In small adrenal masses (1.5 cm or less), only SUVratio had statistically significant difference between benign and malignant adrenal masses. Similarly a cut-off value of 1.0 for SUVratio provided 80.0% sensitivity and 86.4% specificity. F-18 FDG PET/CT can offer more accurate information with quantitative analysis in differentiating malignant from benign adrenal masses incidentally observed in oncologic patients, compared to nonenhanced CT

  19. Evaluation of radiographic and metabolic changes in bone metastases in response to systemic therapy with 18FDG-PET/CT

    The aim of the study was to retrospectively evaluate radiographic and metabolic changes in bone metastases in response to systemic therapy with 18FDG-PET/CT and determine their roles on the evaluation of therapy response. We retrospectively evaluated radiographic and metabolic characteristics of bone metastases in 30 patients who were referred for the evaluation of response to systemic therapy with 18FDG-PET/CT. All patients underwent integrated 18FDG-PET/CT before and after treatment. The baseline radiographic patterns of the target lesions in responders group were lytic, sclerotic, mixed and CT negative; after treatment the radiographic patterns of all target lesions changed to a sclerotic pattern and attenuation increased (p = 0.012) and metabolic activity decreased (p = 0.012). A correlation was found between decreasing metabolic activity and increasing attenuation of the target lesions (r = −0.55) (p = 0.026). However, in nonresponders group, the baseline radiologic patterns of the target lesions were lytic, blastic, mixed and CT negative; after treatment all lytic target lesions remained the same and one CT negative lesion turned to lytic pattern and the attenuation of the target lesions decreased (p ± 0.12) and metabolic activity increased (p = 0.012). A correlation was found between increasing metabolic activity and decreasing attenuation (r = −0.65) (p = 0.032). An exception of this rule was seen in baseline blastic metastases which progressed with increasing in size, metabolic activity and attenuation. This study shows that the metabolic activity of lesions is a more reliable parameter than the radiographic patterns for the evaluation of therapy response

  20. Monitoring Therapeutic Response in a Case of Extrapulmonary Tuberculosis by Serial F 18 FDG PET/CT

    Due to the low yield of AFB smear and culture in extrapulmonary tuberculosis, therapeutic responses of patients with extrapulmonary tuberculosis are usually monitored clinically and/or radiographically. Such monitoring techniques, however, are not enough to provide effective diagnosis if a remnant lesion exists after treatment. Tuberculosis presents hypermetabolic activity on F 18 fluorodeoxyglucose positron emission tomography/computed tomography (F 18 FDG PET/CT) scanning. Reported herein is a case of extrapulmonary tuberculosis where the therapeutic response was useful for detecting the extent of extrapulmonary tuberculosis and for estimating the patient's therapeutic response

  1. Response Assessment and Prediction in Esophageal Cancer Patients via F-18 FDG PET/CT Scans

    Higgins, Kyle J.

    Purpose: The purpose of this study is to utilize F-18 FDG PET/CT scans to determine an indicator for the response of esophageal cancer patients during radiation therapy. There is a need for such an indicator since local failures are quite common in esophageal cancer patients despite modern treatment techniques. If an indicator is found, a patient's treatment strategy may be altered to possibly improve the outcome. This is investigated with various standard uptake volume (SUV) metrics along with image texture features. The metrics and features showing the most promise and indicating response are used in logistic regression analysis to find an equation for the prediction of response. Materials and Methods: 28 patients underwent F-18 FDG PET/CT scans prior to the start of radiation therapy (RT). A second PET/CT scan was administered following the delivery of ~32 Gray (Gy) of dose. A physician contoured gross tumor volume (GTV) was used to delineate a PET based GTV (GTV-pre-PET) based on a threshold of >40% and >20% of the maximum SUV value in the GTV. Deformable registration was used in VelocityAI software to register the pre-treatment and intra-treatment CT scans so that the GTV-pre-PET contours could be transferred from the pre to intra scans (GTV-intra-PET). The fractional decrease in the maximum, mean, volume to the highest intensity 10%-90%, and combination SUV metrics of the significant previous SUV metrics were compared to post-treatment pathologic response for an indication of response. Next for the >40% threshold, texture features based on a neighborhood gray-tone dimension matrix (NGTDM) were analyzed. The fractional decrease in coarseness, contrast, busyness, complexity, and texture strength were compared to the pathologic response of the patients. From these previous two types of analysis, SUV and texture features, the two most significant results were used in logistic regression analysis to find an equation to predict the probability of a non

  2. Direct comparison of F-18-FDG PET and ultrasound in the follow-up of patients with squamous cell cancer of the head and neck

    Goerres, G.W. [Univ Hospital Zurich (Switzerland). Div. of Nuclear Medicine; Haenggeli, C.A.; Dulguerov, P.; Lehmann, W. [ENT Clinics, Geneva (Switzerland); Allaoua, M.; Albrecht, S.R.; Slosman, D.O. [Div. of Nuclear Medicine, Geneva (Switzerland); Becker, M. [Dept. of Radiology, Geneva (Switzerland); Allal, A.S. [Div. of Radiooncology, Univ. Hospitals, Geneva (Switzerland)

    2000-12-01

    28 patients were prospectively included in the study (7 females and 21 males; range: 28-82 years). All had one follow-up examination after surgical treatment and/or radiotherapy using a combination of US and F-18-FDG PET on the same day (6-35 months after the end of treatment). Outcome was determined by either biopsy-proven cancer recurrence or negative clinical follow-up for additional 6 months after this examination. Results: Regarding only the regions of the neck evaluated with both methods, US detected 25 suspect lesions vs. 9 lesions detected by F-18-FDG PET. Descriptive statistical analysis showed better sensitivity, specificity and accuracy of F-18-FDG PET. Only in 3 patients a lesion was detected in the same anatomical region using both methods. One patient was false positive with both methods. In another patient US detected a calcified right carotid artery plaque that lead to surgical therapy. Conclusion: F-18-FDG PET is better for the detection of clinically relevant lesions in the follow-up of patients with squamous cell carcinoma of the head and neck. In this study, the additional value of morphological information obtained by screening US performed before the PET scan is limited. US may not be a suitable test to improve interpretation of PET examinations. (orig.) [German] 28 Patienten wurden prospektiv in die Studie eingeschlassen (7 Frauen, 21 Maenner; Alter zwischen 28 und 82 Jahren). Saemtliche Patienten kamen nach erfolgter Chirurgie/Strahlentherapie zu einer kombinierten Untersuchung, die aus US und F-18-FDG PET bestand und gleichentags durchgefuehrt wurde (6-35 Monate nach Ende der Therapie). Als Vergleich diente entweder die histologische Bestaetigung eines Rezidivs oder eine negative Nachsorgekontrolle mindestens 6 Monate nach erfolgter Untersuchung. Ergebnisse: Bei Vergleich nur derjenigen Regionen am Hals, welche sowohl mit US als auch mit F-18-FDG PET untersucht wurden, fanden sich mit US 25 weiter abklaerungsbeduerftige Veraenderungen

  3. Brain F-18 FDG PET for localization of epileptogenic zones in frontal lobe epilepsy: visual assessment and statistical parametric mapping analysis

    We evaluated the sensitivity of the F-18 FDG PET by visual assessment and statistical parametric mapping (SPM) analysis for the localization of the epileptogenic zones in frontal lobe epilepsy. Twenty-four patients with frontal lobe epilepsy were examined. All patients exhibited improvements after surgical resection (Engel class I or II). Upon pathological examination, 18 patients revealed cortical dysplasia, 4 patients revealed tumor, and 2 patients revealed cortical scar. The hypometabolic lesions were found in F-18 FDG PET by visual assessment and SPM analysis. On SPM analysis, cutoff threshold was changed. MRI showed structural lesions in 12 patients and normal results in the remaining 12. F-18 FDG PET correctly localized epileptogenic zones in 13 patients (54%) by visual assessment. Sensitivity of F-18 FDG PET in MR-negative patients (50%) was similar to that in MR-positive patients (67%). On SPM analysis, sensitivity deceased according to the decrease of p value. Using uncorrected p value of 0.05 as threshold, sensitivity of SPM analysis was 63%, which was not statistically different from that of visual assessment. F-18 FDG PET was sensitive in finding epileptogenic zones by revealing hypometabolic areas even in MR-negative patients with frontal lobe epilepsy as well as in MR-positive patients. SPM analysis showed comparable sensitivity to visual assessment and could be used as an aid in the diagnosis of epileptogenic zones in frontal lobe epilepsy

  4. Comparison of diagnostic performance between interictal F-18-FDG PET and ictal Tc-99m-HMPAO SPECT in occipital lobe epilepsy

    Interictal F-18-fluorodeoxyglucose (FDG) PET and ictal Tc-99m-HMPAO SPECT are found to be useful in localizing epileptogenic zones in neocortical lateral temporal or frontal lobe epilepsy. We investigated whether interictal F-18-FDG PET or ictal Tc-99m-HMPAO SPECT was useful to find epileptogenic zones in occipital lobe epilepsy (OLE). We reviewed patterns of hypometabolism in interictal F-18 FDG PET and of hyperfusion in ictal Tc-99m-HMPAO SPECT in 17 OLE patients (mean age=27±6.8 year, M : F=10:7, injection time =30±17 sec). OLE was diagnosed based on invasive electroencephalography (EEG) study, surgery and post-surgical outcome (Engel class I in all for average 14 months). Epileptogenic zones were correctly localized in 9 (60%) out of 15 patients by interictal F-18-FDG PET. Epiletogenic hemispheres were correctly lateralized in 14 patients (93%) . By ictal Tc-99m-HMPAO SPECT, epileptogenic hemispheres were correctly lateralized in 13 patients (76%), but localization was possible only in 3 patients (18%). Among patients who showed no abnormality with MR imaging and no correct localization with ictal Tc-99m-HMPAO SPECT, interictal F-18-FDG PET was helpful in 2 patients. Ictal Tc-99m-HMPAO SPECT was helpful in lateralization but not in localization in OLE. Interictal F-18-FDG PET was helpful for localization of epileptogenic zones even in patients with ambiguous MR of ictal SPECT findings

  5. Comparative study of 18F-DOPA, 13N-Ammonia and F18-FDG PET/CT in primary brain tumors

    Jacob, Mattakarottu J; Pandit, Aniruddha G; Jora, Charu; Mudalsha, Ravina; Sharma, Amit; Pathak, Harish C

    2011-01-01

    Aim: To determine the diagnostic reliability of 18F-FDOPA, 13N-Ammonia and F18-FDG PET/CT in primary brain tumors. We evaluated the amino acid and glucose metabolism of brain tumors by using PET with 18F-FDOPA, 13N-Ammonia and F18-FDG PET/CT. Materials and Methods: Nine patients undergoing evaluation for brain tumors were studied. Tracer uptake was quantified by the use of standardized uptake values and the ratio of tumor uptake to normal identical area of contra lateral hemisphere (T/N). In addition, PET uptake with 18F-FDOPA was quantified by use of ratio of tumor uptake to striatum uptake (T/S). The results were correlated with the patient's clinical profile. Results: Both high-grade and low-grade tumors were well visualized with 18F-FDOPA. The sensitivity for identifying tumors was substantially higher with 18F-FDOPA PET than with F18-FDG and 13N-Ammonia PET as determined by simple visual inspection. The sensitivity for identifying recurrence in low grade gliomas is higher with 13N-Ammonia than with F18-FDG. Conclusion: 18F-FDOPA PET is more reliable than F18-FDG and 13N-Ammonia PET for evaluating brain tumors. PMID:23326065

  6. Meta-analysis of diagnosis of liver metastatic cancers; comparison of 18FDG PET-CT and gadolinium-enhanced MRI

    We performed a meta-analysis to compare the performance of 18F-fluorodeoxyglucose (18FDG) positron emission tomography-CT (PET-CT) with that of gadolinium-enhanced MRI for the detection of liver metastatic cancers. The MEDLINE and EMBASE databases were searched for relevant original articles. The histology and/or imaging follow-up data served as the reference standard. We calculated the pooled sensitivities, specificities, positive likelihood ratios, negative likelihood ratios and constructed summary receiver operating characteristic curves for 18FDG PET-CT and gadolinium-enhanced MRI, respectively. Ten studies (1105 patients) were included for this meta-analysis. 18FDG PET-CT has similar patient-based specificity (1.00 and 0.99), positive likelihood ratios (253.1 and 138.2), negative likelihood ratios (0.16 and 0.10) and area under curves (0.99 and 0.99) with gadolinium-enhanced MRI. Gadolinium-enhanced MRI tends to have higher sensitivity (0.91 and 0.84) than 18FDG PET-CT. Both 18FDG PET-CT and gadolinium-enhanced MRI have excellent diagnostic performance for the detection of liver metastatic cancer.

  7. Clinical implication of F-18 FDG PET/CT for differentiated thyroid cancer in patients with negative diagnostic iodine-123 scan and elevated thyroglobulin

    This study aims to investigate the usefulness of F-18 FDG PET/CT in differentiated thyroid cancer (DTC) with elevated serum thyroglobulin (Tg) but negative iodine-123 (I-123) scan. Methods: Twenty patients with histopathologically proven DTC, negative diagnostic I-123 scan, and elevated serum Tg levels were prospectively submitted to F-18 FDG PET/CT evaluation. The histopathologic findings consisted of 19 papillary thyroid cancers, 1 follicular thyroid cancer. Results: F-18 FDG PET/CT identified lesions in 18 out of 20 patients, giving a sensitivity of 90%. Thirteen of the 18 patients revealed limited loco-regional disease. Remaining 5 patients showed distant metastases, consisting of 4 patients with lung metastases and 1 patient with bone metastasis. Two patients revealed negative F-18 FDG PET/CT findings. Conclusion: F-18 FDG PET/CT is suitable for the detection and precise localization of loco-regional recurrences and distant metastases of DTC in patients with elevated serum Tg but negative I-123 whole body scan.

  8. Epileptic patterns of local cerebral metabolism and perfusion in man determined by emission computed tomography of 18FDG and 13NH3

    Seventeen patients with partial epilepsy had EEG monitoring concurrent with cerebral emission computed tomography (ECT) after 18F-fluorodeoxyglucose (18FDG) and 13N-ammonia were given intravenously as indicators of local cerebral glucose utilization (LCMR/sub glc/) and relative perfusion, respectively. In 12 of 15 patients 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. These hypometabolic zones appeared normal on x-ray computed tomography in all but three patients and were unchanged on scans repeated on different days. In 5 of 6 patients who underwent temporal lobectomy, the interictal 18FDG scan correctly detected the pathologically confirmed lesion as a hypometabolic zone, and removal of the lesion site resulted in marked clinical improvement. In contrast, the ictal 18FDG scan patterns clearly showed foci of increased (82% to 130%) LCMR/sub glc/, which correlated temporally and anatomically with ictal EEG spike foci and were within the zones of interictal hypometabolism (3 studies in 2 patients). 13NH3 distributions paralleled 18FDG increases and decreases in abnormal zones, but 13NH3 differences were of lesser magnitude. When the relationship of 13NH3 uptake to local blood flow found in dog brain was applied as a correction to the patients' 13NH3 scan data, local alterations in perfusion and glucose utilization were usually matched, both in the interictal and ictal states

  9. Incidental tenosynovial huge cell tumors of the flexor hallucis longus muscle: seldom differential diagnosis of metabolic lesions using F18-FDG PET/CT; Inzidenteller tenosynovialer Riesenzelltumor des Musculus flexor hallucis longus. Seltene Differenzialdiagnose stoffwechselaktiver Laesionen in der F-18-FDG PET/CT

    Koestner, W.; Daemmrich, M.; Derlin, T.

    2016-03-15

    Tenosynovial huge cell tumors are seldom benign tumors in extremities originating from bone joint synovia and tendon sheats. In F18-FDG PET/CT imaging the tenosynovial huge cell tumors show increased metabolic activity and can trigger false diagnoses.

  10. Evaluation of glucose metabolic abnormality in postlingually deaf patients using F-18-FDG positron emission tomography and statistical parametric mapping

    We have previously reported the prognostic relevance of cross-modal cortical plasticity in prelingual deaf patients revealed by F-18-FDG PET and SPM analysis. In this study, we investigated metabolic abnormality in postlingual deaf patients, whose clinical features are different from prelingual deafness. Nine postlingual deaf patients (age: 30.5 ±14.0) were performed on F-18-FDG brain PET. We compared their PET images with those of age-matched 20 normal controls (age: 27.1 ±8.6), and performed correlation analysis to investigate the relationship between glucose metabolism and deaf duration using SPM99. Glucose metabolism of deaf patients was significantly (p<0.05, corrected) decreased in both anterior cingulate, inferior frontal cortices, and superior temporal cortices, and left hippocampus. Metabolism in both superior temporal cortices and association area in inferior parietal cortices showed significant (p<0.01, uncorrected) positive correlation with deaf duration. Decreased metabolism in hippocampus accompanied with hypometabolism in auditory related areas can be explained by recent finding of anatomical connectivity between them, and may be the evidence indicating their functional connectivity. Metabolism recovery in auditory cortex after long deaf duration suggests that cortical plasticity takes place also in postlingual deafness

  11. GABA-A stimulation in normal volunteers and during temporal epilepsy measured by 18FDG with positron emission tomography

    The γ-amino butyric acid (GABA) is the principal inhibitory neurotransmitter of the brain and it has been evoked in epilepto-genesis. Using a GABA analog, the THIP, we tried to establish if the gabaergic neurotransmission was modified in the epileptic focus. For this purpose, we measured the effects of this specific GABA agonist on the cerebral glucose consumption (CMRGlu) as measured by 18F-fluoro-deoxyglucose (18FDG) with positron emission tomography (PET). Eight patients presenting temporal epilepsy and three normal volunteers received two 18FDG PET studies, after placebo and THIP injection, in random order. Clinical symptoms and electroencephalographic data demonstrated a trend towards sleepiness and a diminution of alpha waves after THIP injection. CMRGlu was globally increased with THIP in cortical regions, cerebellum and caudate nuclei. The average increase was 17% in grey matter while it did not reach significancy in white matter. Under the placebo condition, the asymmetry between the focus and the controlateral internal temporal zone was 18% as an average, and reduced significantly to 11% after THIP injection. In the external temporal zones, the asymmetry decreased from 28% to 14%. These results suggest that gabaergic inhibition requires energy in the normal brain tissue and in this with temporal epilepsy. Since the asymmetry of glucose consumption tends to diminish, the inhibitory GABA system appears preserved in temporal epilepsy with an enhanced sensitivity in the focus. (Authors). 6 refs., 4 figs

  12. Evaluation of glucose metabolic abnormality in postlingually deaf patients using F-18-FDG positron emission tomography and statistical parametric mapping

    Lee, Jae Sung; Lee, Dong Soo; Oh, Seung Ha; Kim, Chong Sun; Park, Kwang Suk; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2000-07-01

    We have previously reported the prognostic relevance of cross-modal cortical plasticity in prelingual deaf patients revealed by F-18-FDG PET and SPM analysis. In this study, we investigated metabolic abnormality in postlingual deaf patients, whose clinical features are different from prelingual deafness. Nine postlingual deaf patients (age: 30.5 {+-}14.0) were performed on F-18-FDG brain PET. We compared their PET images with those of age-matched 20 normal controls (age: 27.1 {+-}8.6), and performed correlation analysis to investigate the relationship between glucose metabolism and deaf duration using SPM99. Glucose metabolism of deaf patients was significantly (p<0.05, corrected) decreased in both anterior cingulate, inferior frontal cortices, and superior temporal cortices, and left hippocampus. Metabolism in both superior temporal cortices and association area in inferior parietal cortices showed significant (p<0.01, uncorrected) positive correlation with deaf duration. Decreased metabolism in hippocampus accompanied with hypometabolism in auditory related areas can be explained by recent finding of anatomical connectivity between them, and may be the evidence indicating their functional connectivity. Metabolism recovery in auditory cortex after long deaf duration suggests that cortical plasticity takes place also in postlingual deafness.

  13. Malignant transformation to schwannoma in a patient affected by type 1 neurofibromatosis as demonstrated by F-18-FDG-PET/CT

    Neurofibromatosis type I (NF1) is an autosomal dominant multisystem disorder. Patients with NF1 are at increased risk for developing both benign and malignant tumours. We report the case of a patient with histologically documented NF1, who underwent F18-FDG-PET/CT for staging purposes. The study revealed intense uptake at multiple masses located at the thighs (the largest presented SUV max of 6.8), popliteal regions, legs, left foot, left supraclavicular region, and at the thoracic wall between the 11th and 12th right ribs. The surgical biopsy of the largest popliteal lesion with higher uptake at F18-FDG-PET/CT documented the presence of a malignant schwannoma at histological examination. In conclusion, F18-FDG-PET/CT was probably able to help the discrimination between benign lesions related to known NF1 and the malignant transformed ones, and to assist clinical decision making. (authors)

  14. Costo-efectividad de 18fdg-pet/ct vs ct al final del tratamiento en pacientes pediátricos con linfoma hodgkin

    García Molina, Mario; Chicaiza-Becerra, Liliana; Moreno-Calderón, Alexánder; Prieto Martínez, Víctor; Sarmiento Urbina, Isabel; Linares Ballesteros, Adriana

    2014-01-01

    Objetivo Estimar la costo-efectividad de 18FDG-PET/CT comparado con CT seguido de 18FDG-PET/CT como prueba confirmatoria de un caso positivo en la evaluación al final del tratamiento en pacientes menores de 18 años con Linfoma Hodgkin (LH).Métodos Se construyó un árbol de decisión donde se comparó el uso de 18FDGPET/CT con CT seguido de 18FDG-PET/CT como prueba confirmatoria de un caso positivo en la detección de lesión residual. El resultado se midió en Años de Vida Ganados (AVG). Se calculó...

  15. Unexpected second primary malignancies detected by f-18 FDG PET/CT during follow-up for primary malignancy: Two case report

    Bang, Ji In; Lee, Eun Seong; Kim, Tae Sung; Kim, Seok Ki [Nuclear Medicine, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)

    2015-03-15

    As the survival rate of cancer patients has increased over the last few decades, the risk of cancer survivors developing second primary malignancies has gained attention. We report two rare cases of second primary hematologic malignancy detected by 18F-fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) during follow-up for primary solid malignancies. Acute lymphoblastic leukemia developed in a breast cancer patient and non-Hodgkin lymphoma in an anal cancer patient. F-18 FDG PET/CT findings led to the diagnosis of unexpected second primary hematologic malignancy in cancer survivors in these two cases.

  16. TH-E-BRF-10: Interim Esophageal Cancer Response Assessment Via 18FDG-PET Scanning During Radiation Therapy

    Purpose: Local failure occurs in a large proportion of esophageal cancer patients treated with chemoradiation. The treatment strategy for non-responders could potentially be modified if they are identified during therapy. This work investigates the utility of an interim 18FDG-PET scan acquired during the course of therapy as a predictor of pathological response post-therapy. Methods: Fifteen patients underwent 18FDG-PET scanning prior to radiation therapy (RT) and once during RT, after delivery of ∼32 Gy. The physician-contoured GTV on the planning CT scan was used to automatically segment a PET-based GTV on the pre-RT PET (GTV-pre-PET) as the volume with >40% of the maximum GTV PET SUV value. The pre- and intra-RT CTs were deformably registered to each other to transfer the GTV-pre-PET to the intra-RT PET (GTV-intra-PET). The fractional decrease in the maximum SUV, mean SUV and the SUV to the highest intensity 10% – 90% volumes from GTV-pre-PET to GTV-intra-PET were compared to pathological response assessed at the time of post-RT surgery. Results: Based on post-treatment pathology of 15 patients, 7 were classified as achieving favorable response (treatment effect grade ≤ 1) and 8 as unfavorable response (treatment effect grade > 1). Neither fractional decrease in maximum SUV nor mean SUV were significant between the favorable and unfavorable groups. However, the fractional decrease in SUV20% (SUV to the highest 20% volume) was significant (p = 0.02), with an area under the Receiver Operating Characteristics (ROC) curve of 0.84. An optimal cutoff value of 0.46 for this metric was able to distinguish between the two groups with 71% sensitivity (favorable) and 88% specificity (unfavorable). Conclusion: The fractional decrease in SUV to the volume with highest 20% intensity from pre- to intra-RT 18FDG-PET imaging may be used to distinguish between favorable and unfavorable responders with high sensitivity and specificity

  17. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    Yoon, Seok Nam [Kwandong Univ. College of Medicine, Seoul (Korea, Republic of)

    2012-09-15

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass

  18. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass from

  19. Pretreatment F-18 FDG PET/CT Parameters to Evaluate Progression-Free Survival in Gastric Cancer

    Kim, Jeonghun; Lim, Seok Tae; Na, Chang Ju; Han, Yeonhee; Kim, Chanyoung; Jeong, Hwanjeong; Sohn, Myunghee [Chonbuk National Univ., Jeonju (Korea, Republic of)

    2014-03-15

    We performed this study to evaluate the predictive value of pretreatment F-18 FDG PET/CT for progression-free survival (PFS) in patients with gastric cancer. Of 321 patients with a diagnosis of gastric cancer, we retrospectively enrolled 97 patients (men:women = 61:36, age 59.8±13.2 years), who underwent pretreatment F-18 fluoro-2-deoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) from January 2009 to December 2009. Maximum standardized uptake value (SUVmax) was measured for each case with detectable primary lesions. In the remaining non-detectable cases, SUVmax was measured from the corresponding site seen on gastroduodenoscopy for analysis. In subgroup analysis, metabolic tumor volume (MTV) was measured in 50 patients with clearly distinguishable primary lesions. SUVmax, stage, depth of tumor invasion and presence of lymph node metastasis were analyzed in terms of PFS. Receiver operating characteristic (ROC) curves were used to find optimal cutoff values of SUVmax and MTV for disease progression. The relationship between SUVmax, MTV and PFS was analyzed using the Kaplan-Meier with log-rank test and Cox's proportional hazard regression methods. Of 97 patients, 15 (15.5 %) had disease progression. The mean follow-up duration was 29.6±10.2 months. The mean PFS of low SUVmax group (≤5.74) was significantly longer than that of the high SUVmax group (>5.74) (30.9±8.0 vs 24.3±13.6 months, p =0.008). In univariate analysis, stage (I vs II, III, IV), depth of tumor invasion (T1 vs T2, T3, T4), presence of lymph node metastasis and SUVmax (>5.74 vs ≤5.74) were significantly associated with recurrence. In multivariate analysis, high SUVmax (>5.74) was the only poor prognostic factor for PFS (p =0.002, HR 11.03, 95% CI 2.48.49.05). Subgroup multivariate analysis revealed that high MTV (>16.42) was the only poor prognostic factor for PFS (p =0.034, HR 3.59, 95 % CI 1.10.11.71). In gastric cancer, SUVmax measured by pretreatment F-18

  20. Correlating metabolic and anatomic responses of primary lung cancers to radiotherapy by combined F-18 FDG PET-CT imaging

    Grills Inga

    2007-05-01

    Full Text Available Abstract Background To correlate the metabolic changes with size changes for tumor response by concomitant PET-CT evaluation of lung cancers after radiotherapy. Methods 36 patients were studied pre- and post-radiotherapy with18FDG PET-CT scans at a median interval of 71 days. All of the patients were followed clinically and radiographically after a mean period of 342 days for assessment of local control or failure rates. Change in size (sum of maximum orthogonal diameters was correlated with that of maximum standard uptake value (SUV of the primary lung cancer before and after conventional radiotherapy. Results There was a significant reduction in both SUV and size of the primary cancer after radiotherapy (p Conclusion Correlating and incorporating metabolic change by PET into size change by concomitant CT is more sensitive in assessing therapeutic response than CT alone.

  1. Normal uptake of F-18 FDG in the testis as assessed by PET/CT in a pediatric study population

    The objective of this study was to investigate the correlation between the F-18 fluorodeoxyglucose (FDG) uptake in the normal testis as assessed by positron emission tomography (PET)-CT and patient age in a pediatric study population. The study population consisted of 22 subjects aged between 9 and 17 years. For these subjects 42 PET-CT scans were available for analysis. The testis was identified on the CT images. Mean standard uptake values and testicular volume were calculated based on manually drawn regions-of-interest over the organ. The correlation between mean standardized uptake value (SUV) and age as well as between testicular volume and age was calculated using Pearson's correlation coefficient. A strong and statistically significant positive correlation between F-18 FDG uptake in the testis and age was documented. The correlation coefficient was 0.406 in the analysis based on 42 PET-CT studies (p=0.005). The correlation between tracer uptake and age was reassessed based on 22 PET-CT studies including the last recorded PET-CT scan per patient. The correlation coefficient was 0.409 (p=0.05). In addition, based on 22 PET-CT scans, a strong and statistically significant positive correlation between testicular volume and age was documented (r=0.67, p<0.001). Whereas it was previously shown that in adult men there was a weak but statistically significant negative correlation between F-18 FDG uptake in the normal testis and age, we found a strong and statistically significant positive correlation in children and teenage boys. (author)

  2. F 18 FDG PET/CT Findings of Spontaneous Mesenteric Fibromatosis in a Patient with Gardner's Syndrome

    Sohn, Myung Hee; Jeong, Young Jin; Lim, Seok Tae; Kim, Dong Wook; Jeong, Hwan Jeong; Yim, Chang Yeol [Chonbuk National Univ. Medical School and Hospital, Jeonju (Korea, Republic of)

    2011-06-15

    Gardner's syndrome (GS), a variant of familial adenomatous polyposis, is an autosomal dominant disease. Originally, Gardner described a syndrome consisting of hereditary intestinal polyposis With osteomas and multiple cutaneous and subcutaneous lesions. The syndrome was later modified by the addition of other features, such as dental abnormalities, abdominal fibromatosis, and a number of malignant tumors. the principal cutaneous lesions that have been described in GS are epidermoid cysts. Other cutaneous lesions include fibromas, lipomas, leiomyomas, neurofibromas, and pigmented skin lesions. Fibromatoses are histologically benign, but locally aggressive fibrous tumors consisting of mature fibroblasts within an extensive collagen matrix. Most cases are sporadic, but there is a clear association with familial adenomatous polyposis and GS, suggesting a link with a mutation of the APC gene on chromosome 5q22. Fibromatosis occurs in 3.5%-29% of patients with GS, and is more likely to be multiple and to involve the mesentery and abdominal wall rather than being an isolated form. Clinically, fibromatosis presents as a painless firm soft tissue mass. Most cases of fibromatosis are believed to be precipitated by surgical trauma, however, a few cases of spontaneous occurrence have been reported. In our patient, no history of abdominal surgery or trauma was present. In addition, an abdominal CT obtained 2 years ago revealed no abnormality. Although the radiological features of fibromatosis on CT or MR have been described in the literature, F 18 FDG PET or PET/CT findings are rarely reported. The F 18 FDG uptake in patients with fibromatosis ranged from low to moderate grade and was generally heterogenous with a few tiny foci of relatively intense uptake or relatively homogenous. The areas of higher FDG metabolism are likely to represent more cellular and mitotically active areas. Mesenteric fibromatosis has similar findings to extra abdominal lesions.

  3. Detection of unsuspected myocardial ishemia during F-18 FDG PET in the evaluation of a solitary pulmonary nodule

    Enhanced F-18 FDG uptake at rest after an overnight fast occurs in myocardial ischemia and is associated with functional improvement after PTCA or CABG. For more pronounced regional differences of FDG uptake in the fasting state occur, the detection of dysfunctional myocardium during oncologic application of FDG PET has not been productive. A case of unsuspected myocardial ischemia indicated by focal FDG uptake during camera based (CB) FDG PET in the evaluation of a solitary pulmonary nodule is described. A 58-year-old male patient was admitted to the hospital for the evaluation of a solitary pulmonary nodule (SPN) measuring 1.7 cm in diameter in the right upper lobe. CB FDG PET for diagnosis of lung cancer and staging depicted lung cancer without nodal involvement but there was increased FDG uptake in the region of inferior wall of LV. CB FDG PET without attenuation correction always depicts decreased FDG uptake in the inferior wall when LV is visualized. Therefore, only FDG uptake in inferior wall in this case was indicative of myocardial ischemia and next day stress Tl-201 myocardial SPECT was performed. This demonstrated inferior wall ischemia which was confirmed by coronary angiogram. Then he underwent PTCA for 80% stenosis of mid RCA and right ventricular branch followed by right upper lobectomy one month after the PTCA. In conclusion, a rare finding of enhanced myocardial uptake of F-18 FDG at rest during CD FDG PET for SPN was associated with myocardial ischemia. Clinically unsuspected myocardial ischemia was treated successfully by PTCA before lobectomy for NSCLC for the patient

  4. Detection of unsuspected myocardial ishemia during F-18 FDG PET in the evaluation of a solitary pulmonary nodule

    Park, Chan H.; Park, Kwang J.; Lee, Myoung Hoon [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    2001-07-01

    Enhanced F-18 FDG uptake at rest after an overnight fast occurs in myocardial ischemia and is associated with functional improvement after PTCA or CABG. For more pronounced regional differences of FDG uptake in the fasting state occur, the detection of dysfunctional myocardium during oncologic application of FDG PET has not been productive. A case of unsuspected myocardial ischemia indicated by focal FDG uptake during camera based (CB) FDG PET in the evaluation of a solitary pulmonary nodule is described. A 58-year-old male patient was admitted to the hospital for the evaluation of a solitary pulmonary nodule (SPN) measuring 1.7 cm in diameter in the right upper lobe. CB FDG PET for diagnosis of lung cancer and staging depicted lung cancer without nodal involvement but there was increased FDG uptake in the region of inferior wall of LV. CB FDG PET without attenuation correction always depicts decreased FDG uptake in the inferior wall when LV is visualized. Therefore, only FDG uptake in inferior wall in this case was indicative of myocardial ischemia and next day stress Tl-201 myocardial SPECT was performed. This demonstrated inferior wall ischemia which was confirmed by coronary angiogram. Then he underwent PTCA for 80% stenosis of mid RCA and right ventricular branch followed by right upper lobectomy one month after the PTCA. In conclusion, a rare finding of enhanced myocardial uptake of F-18 FDG at rest during CD FDG PET for SPN was associated with myocardial ischemia. Clinically unsuspected myocardial ischemia was treated successfully by PTCA before lobectomy for NSCLC for the patient.

  5. Normal physiologic and Benign foci with F-18 FDG avidity on PET/CT in patients with breast cancer

    The aim of this study was to evaluate the physiologic and benign F-18 fluorodeoxyglucose (FDG) avid foci in patients with breast cancer. On 309 F-18 FDG PET/CT scans of 241 women with breast cancer, the hypermetabolic lesions compared with the surrounding normal region were evaluated retrospectively. Available reports of other relevant radiological imaging medical records, and follow-up PET/CT were reviewed for explanations of the abnormal uptake. Among the 70 physiologic foci, muscular uptake of the lower neck following the surgical and/or radiation therapy of ipsilateral breast (29%), hypermetabolic ovaries (16%) and uterine (10%) uptake during the ovulatory and menstrual phases during the normal menstrual cycle were identified, and also hypermetabolic brown fat in cold-induced thermogenesis (7%), non-specific bowel uptake (35%) were observed. Among the 147 benign lesions, sequelae of the chest wall and breasts following surgical and/or radiation therapy, were often observed (27%). Hypermetabolic thyroid glands were noted as adenomas and chronic thyroiditis (18%). Reactive hyperplasia of cervical or mediastinal lymph nodes (32%), degenerative osteoarthritis and healed fractures (15%), hypermetabolic benign lung lesions (6%) were observed. Altered physiologic and benign F-18 FDG uptake in the cervical muscle and chest wall following ipsilateral breast surgery or radiotherapy were common, and also normal physiologic uptake in ovary and uterus, brown fat, thyroid were considered as predominant findings in women patients with breast cancer. Knowledge of these findings might aid in the interpretation of FDG PET/CT in patients with breast cancer

  6. Normal physiologic and Benign foci with F-18 FDG avidity on PET/CT in patients with breast cancer

    Park, Soon Ah; Lee, Kwang Man; Choi, Un Jong; Kim, Hun Soo; Kim, Hye Won; Song, Jeong Hoon [College of Medicine, Wonkwnag University, Iksan (Korea, Republic of)

    2010-12-15

    The aim of this study was to evaluate the physiologic and benign F-18 fluorodeoxyglucose (FDG) avid foci in patients with breast cancer. On 309 F-18 FDG PET/CT scans of 241 women with breast cancer, the hypermetabolic lesions compared with the surrounding normal region were evaluated retrospectively. Available reports of other relevant radiological imaging medical records, and follow-up PET/CT were reviewed for explanations of the abnormal uptake. Among the 70 physiologic foci, muscular uptake of the lower neck following the surgical and/or radiation therapy of ipsilateral breast (29%), hypermetabolic ovaries (16%) and uterine (10%) uptake during the ovulatory and menstrual phases during the normal menstrual cycle were identified, and also hypermetabolic brown fat in cold-induced thermogenesis (7%), non-specific bowel uptake (35%) were observed. Among the 147 benign lesions, sequelae of the chest wall and breasts following surgical and/or radiation therapy, were often observed (27%). Hypermetabolic thyroid glands were noted as adenomas and chronic thyroiditis (18%). Reactive hyperplasia of cervical or mediastinal lymph nodes (32%), degenerative osteoarthritis and healed fractures (15%), hypermetabolic benign lung lesions (6%) were observed. Altered physiologic and benign F-18 FDG uptake in the cervical muscle and chest wall following ipsilateral breast surgery or radiotherapy were common, and also normal physiologic uptake in ovary and uterus, brown fat, thyroid were considered as predominant findings in women patients with breast cancer. Knowledge of these findings might aid in the interpretation of FDG PET/CT in patients with breast cancer

  7. Direct comparison of F-18-FDG PET and ultrasound in the follow-up of patients with squamous cell cancer of the head and neck

    28 patients were prospectively included in the study (7 females and 21 males; range: 28-82 years). All had one follow-up examination after surgical treatment and/or radiotherapy using a combination of US and F-18-FDG PET on the same day (6-35 months after the end of treatment). Outcome was determined by either biopsy-proven cancer recurrence or negative clinical follow-up for additional 6 months after this examination. Results: Regarding only the regions of the neck evaluated with both methods, US detected 25 suspect lesions vs. 9 lesions detected by F-18-FDG PET. Descriptive statistical analysis showed better sensitivity, specificity and accuracy of F-18-FDG PET. Only in 3 patients a lesion was detected in the same anatomical region using both methods. One patient was false positive with both methods. In another patient US detected a calcified right carotid artery plaque that lead to surgical therapy. Conclusion: F-18-FDG PET is better for the detection of clinically relevant lesions in the follow-up of patients with squamous cell carcinoma of the head and neck. In this study, the additional value of morphological information obtained by screening US performed before the PET scan is limited. US may not be a suitable test to improve interpretation of PET examinations. (orig.)

  8. Diagnostic Performance of F-18 FDG PET/CT in Patients with Cancer of Unknown Primary: Additional Benefit over CT-Based Conventional Work up

    Mehrdad Bakhshayeshkaram

    2016-01-01

    Full Text Available Background: In the era of well-developed site-specific treatment strategies in cancer, identification of occult primary is of paramount importance in CUP patients. Furthermore, exact determination of the extent of the disease may help in optimizing treatment planning. The aim of the present study was to investigate additional value of F-18 FDG PET/CT in patients with cancer of unknown primary (CUP as an appropriate imaging tool in early phase of initial standard work up.Materials and Methods: Sixty-two newly diagnosed CUP patients with inconclusive diagnostic CT scan of chest, abdomen and pelvis referring for F-18 FDG PET/CT were enrolled in this study. Standard of reference was defined as histopathology, other diagnostic procedures and a 3-month formal clinical follow up. The results of PET/CT were categorized as suggestion for primary site and additional metastasis and classified as true positive, false positive, false negative and true negative. The impact of additional metastasis revealed by F-18 FDG PET/CT on treatment planning and the time contribution of F-18 FDG PET/CT in diagnostic pathway was investigated.Results: Sixty-two patients with mean age of 62 (30 men, 32 women, PET/CT correctly identified primary origin in 32% with false positive rate of 14.8%. No primary lesion was detected after negative PET/CT according to standard of reference. Sensitivity, Specificity and accuracy were 100%, 78% and 85%, respectively. Additional metastatic site was found in 56% with 22% impact on treatment planning. Time contribution for PET/CT was 10% of total diagnostic pathway.Conclusion: Providing higher detection rate of primary origin with excellent diagnostic performance, shortening the diagnostic pathway and improving treatment planning, F-18 FDG PET/CT may play a major role in diagnostic work up of CUP patients and may be recommended as an alternative imaging tool in early phase of investigation.

  9. Epileptic patterns of local cerebral metabolism and perfusion in man determined by emission computed tomography of /sup 18/FDG and /sup 13/NH/sub 3/

    Kuhl, D.E.; Engel, J. Jr.; Phelps, M.E.; Selin, C.

    1979-01-01

    Seventeen patients with partial epilepsy had EEG monitoring concurrent with cerebral emission computed tomography (ECT) after /sup 18/F-fluorodeoxyglucose (/sup 18/FDG) and /sup 13/N-ammonia were given intravenously as indicators of local cerebral glucose utilization (LCMR/sub glc/) and relative perfusion, respectively. In 12 of 15 patients who had unilateral or focal electrical abnormalities, interictal /sup 18/FDG scan patterns clearly showed localized regions of decreased (20% to 50%) LCMR/sub glc/, which correlated anatomically with the eventual EEG localization. These hypometabolic zones appeared normal on x-ray computed tomography in all but three patients and were unchanged on scans repeated on different days. In 5 of 6 patients who underwent temporal lobectomy, the interictal /sup 18/FDG scan correctly detected the pathologically confirmed lesion as a hypometabolic zone, and removal of the lesion site resulted in marked clinical improvement. In contrast, the ictal /sup 18/FDG scan patterns clearly showed foci of increased (82% to 130%) LCMR/sub glc/, which correlated temporally and anatomically with ictal EEG spike foci and were within the zones of interictal hypometabolism (3 studies in 2 patients). /sup 13/NH/sub 3/ distributions paralleled /sup 18/FDG increases and decreases in abnormal zones, but /sup 13/NH/sub 3/ differences were of lesser magnitude. When the relationship of /sup 13/NH/sub 3/ uptake to local blood flow found in dog brain was applied as a correction to the patients' /sup 13/NH/sub 3/ scan data, local alterations in perfusion and glucose utilization were usually matched, both in the interictal and ictal states.

  10. 18FDG-PET测定红骨髓代谢及分布随年龄增长的变化

    范成中

    2008-01-01

    目的 探讨18F-脱氧葡萄糖正电子断层体层摄影(18FDG-PET)全身显像检测人红骨髓分布和代谢活性随年龄增长的变化.方法 回顾性分析112例不同年龄段接受18FDG-PET全身显像但排除红骨髓活性受累患者.所有患者静脉注射18FDG 0.14 mCi/kg 60 min后进行18FDG-PET 全身显像.分别在肱骨和股骨上2/3段、胸骨柄、第12胸椎椎体、第5腰椎椎体、双侧髂前上棘区的连续3个横断面画感兴趣区,测定并计算各区的最大18FDG标准摄取值(SUVmax).复习患者所有其它影像学检查(核磁共振、CT和常规X线诊断)、实验室检查、组织活检及临床病史的结果以排除任何病变累及患者所测定区域的红骨髓.结果 四肢长骨红骨髓的18FDG SUVmax 随年龄的增长而降低,两者呈显著相关(相关系数r:-0.60~-0.67,P<0.01);而中轴骨红骨髓的18FDG SUVmax 随年龄的增长而降低仅呈微弱相关(r:-0.28~-0.48,P<0.05).结论 四肢长骨红骨髓的葡萄糖代谢活性随着生理年龄的增长显著减低,而中轴骨红骨髓的葡萄糖代谢活性随着生理年龄的增长仅轻微降低.

  11. Correlating metabolic and anatomic responses of primary lung cancers to radiotherapy by combined F-18 FDG PET-CT imaging

    To correlate the metabolic changes with size changes for tumor response by concomitant PET-CT evaluation of lung cancers after radiotherapy. 36 patients were studied pre- and post-radiotherapy with18FDG PET-CT scans at a median interval of 71 days. All of the patients were followed clinically and radiographically after a mean period of 342 days for assessment of local control or failure rates. Change in size (sum of maximum orthogonal diameters) was correlated with that of maximum standard uptake value (SUV) of the primary lung cancer before and after conventional radiotherapy. There was a significant reduction in both SUV and size of the primary cancer after radiotherapy (p < 0.00005). Among the 20 surviving patients, the sensitivity, specificity, and accuracy using PET (SUV) were 94%, 50%, 90% respectively and the corresponding values using and CT (size criteria) were 67%, 50%, and 65% respectively. The metabolic change (SUV) was highly correlated with the change in size by a quadratic function. In addition, the mean percentage metabolic change was significantly larger than that of size change (62.3 ± 32.7% vs 47.1 ± 26.1% respectively, p = 0.03) Correlating and incorporating metabolic change by PET into size change by concomitant CT is more sensitive in assessing therapeutic response than CT alone

  12. Computer-assisted lateralization of unilateral temporal lobe epilepsy using Z-score parametric F-18 FDG PET images

    To evaluate the use of unbiased computer-assisted lateralization of temporal lobe epilepsy (TLE) by z-score parametric PET imaging (ZPET). 38 patients with histologically proven unilateral TLE due to pure hippocampal sclerosis, referred for pre-surgical PET evaluation of intractable seizure over a 5-year period, were included. The F-18 FDG images were oriented along temporal long axis and then transformed into ZPET images on a voxel by voxel basis. Multiple regions of interests (21 in total) were placed on cortical, subcortical and cerebellar structures on twenty-eight out of 38 patients with totally seizure-free (class I) outcome. Paired t-tests with Bonferroni correction were used to determine the location of the most asymmetric regions as variables for subsequent discriminant analysis of the entire group of the patients. The computer program identified the anterior half of the temporal lobe (p < 0.0005) and thalami (p = 0.021) as the most asymmetric regions in TLE patients with Class I outcome. Discriminant analysis using z-scores from a total of 8 ROIs (in 4 pairs) on these structures correctly lateralized thirty-seven out of 38 (97%) patients (sensitivity = 94%; specificity = 100%). The only false localization came from a patient with equivocal z-scores on the temporal lobes and this patient turned out to have poor outcome. The computer-assisted lateralization of TLE using ZPET provides an accurate, fast and objective way of seizure evaluation

  13. Implications of Pericardial, Visceral and Subcutaneous Adipose Tissue on Vascular Inflammation Measured Using 18FDG-PET/CT.

    Ho Cheol Hong

    Full Text Available Pericardial adipose tissue (PAT is associated with adverse cardiometabolic risk factors and cardiovascular disease (CVD. However, the relative implications of PAT, abdominal visceral and subcutaneous adipose tissue on vascular inflammation have not been explored.We compared the association of PAT, abdominal visceral fat area (VFA, and subcutaneous fat area (SFA with vascular inflammation, represented as the target-to-background ratio (TBR, the blood-normalized standardized uptake value measured using 18F-Fluorodeoxyglucose Positron Emission Tomography (18FDG-PET in 93 men and women without diabetes or CVD. Age- and sex-adjusted correlation analysis showed that PAT, VFA, and SFA were positively associated with most cardiometabolic risk factors, including systolic blood pressure, LDL-cholesterol, triglycerides, glucose, insulin resistance and high sensitive C-reactive proteins (hsCRP, whereas they were negatively associated with HDL-cholesterol. In particular, the maximum TBR (maxTBR values were positively correlated with PAT and VFA (r = 0.48 and r = 0.45, respectively; both P <0.001, whereas SFA showed a relatively weak positive relationship with maxTBR level (r = 0.31, P = 0.003.This study demonstrated that both PAT and VFA are significantly and similarly associated with vascular inflammation and various cardiometabolic risk profiles.

  14. Malignant extrarenal rhabdoid tumor of the spine: staging and evaluation of response to therapy with F-18 FDG PET/CT.

    Makis, William; Ciarallo, Anthony; Hickeson, Marc

    2011-07-01

    Malignant extrarenal rhabdoid tumor (ERRT) is a very rare type of soft-tissue sarcoma with a reported incidence of 0.3% of all soft-tissue sarcomas. Only 7 cases of spinal malignant ERRT have been reported in the literature, and to our knowledge, F-18 FDG PET/CT imaging for staging and evaluation of response to therapy for these tumors has not been previously described. This is a case of an 8-month-old boy with malignant ERRT of the spine, who was staged with F-18 FDG PET/CT, and had his tumor burden assessed with PET/CT after chemotherapy, which altered the subsequent chemotherapy regimen. PMID:21637073

  15. Isolated thymic Langerhans cell histiocytosis discovered on F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT)

    Turpin, Sophie [CHU Sainte-Justine, Nuclear Medicine, Montreal (Canada); Carret, Anne-Sophie [CHU Sainte-Justine, Hemato-Oncology, Montreal (Canada); Dubois, Josee [CHU Sainte-Justine, Radiology, Montreal (Canada); Buteau, Chantal [CHU Sainte-Justine, Infectious Diseases, Montreal (Canada); Patey, Natalie [CHU Sainte-Justine, Pathology, Montreal (Canada)

    2015-11-15

    The thymic infiltration in young patients with multisystemic Langerhans cell histiocytosis and its radiologic features are well known. However, isolated thymic disease has seldom been reported in the literature. We report the case of a 10-month-old child admitted for fever of unknown origin. Whole-body F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) was performed to identify a focus of infection. It demonstrated an unusual aspect of the thymus, which led to further investigation and revealed isolated infiltration of the thymus by Langerhans cell histiocytosis. The patient was treated accordingly and is now disease free. As evaluation of Langerhans cell histiocytosis patients with F-18 FDG PET/CT is becoming more frequent, it is important to be aware of the scintigraphical characteristics of thymic Langerhans cell histiocytosis. (orig.)

  16. Isolated thymic Langerhans cell histiocytosis discovered on F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT)

    The thymic infiltration in young patients with multisystemic Langerhans cell histiocytosis and its radiologic features are well known. However, isolated thymic disease has seldom been reported in the literature. We report the case of a 10-month-old child admitted for fever of unknown origin. Whole-body F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) was performed to identify a focus of infection. It demonstrated an unusual aspect of the thymus, which led to further investigation and revealed isolated infiltration of the thymus by Langerhans cell histiocytosis. The patient was treated accordingly and is now disease free. As evaluation of Langerhans cell histiocytosis patients with F-18 FDG PET/CT is becoming more frequent, it is important to be aware of the scintigraphical characteristics of thymic Langerhans cell histiocytosis. (orig.)

  17. Assessment of relapse in patients with peritoneal carcinomatosis after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy using F-18-FDG-PET/CT

    Klumpp, B.; Schwenzer, N.F.; Gatidis, S.; Claussen, C.D.; Pfannenberg, C. [Tuebingen Univ. (Germany). Diagnostic and Interventional Radiology; Koenigsrainer, I.; Koenigsrainer, A.; Beckert, S. [Tuebingen Univ. (Germany). General, Visceral and Transplantation Surgery; Mueller, M. [Tuebingen Univ. (Germany). Nuclear Medicine

    2014-04-15

    Purpose: In patients with peritoneal carcinomatosis (PC), cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is an evolving therapeutic approach with curative intention. The differentiation between posttherapeutic findings after HIPEC and relapse of PC is challenging. We evaluated the diagnostic value of F-18-FDG-PET/CT in patients with relapse of PC after HIPEC. Materials and Methods: 36 patients with recurring PC after HIPEC were examined on a wholebody PET/CT system (44 examinations). The examination included 3 D F-18-FDG-PET and contrast-enhanced CT. Images were assessed by two experienced readers regarding the presence and the extent of PC using the peritoneal carcinomatosis index (PCI). Imaging results were correlated with surgical findings or follow-up. Results: Relapse was suspected in 40 of 44 examinations. Relapse was missed by F-18-FDG PET/CT in 4 patients and significantly underestimated in 8 patients. The diagnostic accuracy for the detection of PC on a patient basis was 91 %, the sensitivity was 91 % and the positve predictive value was 100 %. The mean PCI was 11.4 ± 11.9 for PET/CT, 8.4 ± 10.3 for CT and 16.6 ± 15.0 in the case of surgical exploration. The extent of PC was underestimated by PET/CT and even more by CT alone (p < 0.05). Conclusion: The diagnostic value of F-18-FDG PET/CT after cytoreductive surgery and HIPEC in the detection of recurring PC is superior to contrast-enhanced CT. However, the quantification of the extent of PC is limited due to post-therapeutic tissue alterations. (orig.)

  18. Assessment of relapse in patients with peritoneal carcinomatosis after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy using F-18-FDG-PET/CT

    Purpose: In patients with peritoneal carcinomatosis (PC), cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is an evolving therapeutic approach with curative intention. The differentiation between posttherapeutic findings after HIPEC and relapse of PC is challenging. We evaluated the diagnostic value of F-18-FDG-PET/CT in patients with relapse of PC after HIPEC. Materials and Methods: 36 patients with recurring PC after HIPEC were examined on a wholebody PET/CT system (44 examinations). The examination included 3 D F-18-FDG-PET and contrast-enhanced CT. Images were assessed by two experienced readers regarding the presence and the extent of PC using the peritoneal carcinomatosis index (PCI). Imaging results were correlated with surgical findings or follow-up. Results: Relapse was suspected in 40 of 44 examinations. Relapse was missed by F-18-FDG PET/CT in 4 patients and significantly underestimated in 8 patients. The diagnostic accuracy for the detection of PC on a patient basis was 91 %, the sensitivity was 91 % and the positve predictive value was 100 %. The mean PCI was 11.4 ± 11.9 for PET/CT, 8.4 ± 10.3 for CT and 16.6 ± 15.0 in the case of surgical exploration. The extent of PC was underestimated by PET/CT and even more by CT alone (p < 0.05). Conclusion: The diagnostic value of F-18-FDG PET/CT after cytoreductive surgery and HIPEC in the detection of recurring PC is superior to contrast-enhanced CT. However, the quantification of the extent of PC is limited due to post-therapeutic tissue alterations. (orig.)

  19. Focal colorectal uptake in 18FDG-PET/CT: maximum standard uptake value as a trigger in a semi-automated screening setting

    Luboldt, Wolfgang; Wiedemann, Baerbel; Fischer, Sebastian; Bodelle, Boris; Luboldt, Hans Joachim; Grünwald, Frank; Vogl, Thomas J

    2016-01-01

    Background Focal colorectal uptake in 18FDG-PET/CT may be associated with a malignancy and can be quantified. This provides the basis for an automatic trigger threshold above which cases are flagged for colonoscopic evaluation and below which for individual assessment. Purpose To determine the lowest maximum standard uptake (SUVmax) in colorectal cancer that could be used as a threshold to trigger endoscopic evaluation and to evaluate whether the SUVmax needs to be further normalised to a pri...

  20. Diffuse pulmonary metastases with negative 18FDG positron emission tomography/computed tomography and positive post-radioiodine therapy scan of papillary thyroid cancer

    LIN Yan-song; LIANG Zhi-yong; QIU Li-heng; CHENG Xin

    2012-01-01

    A female papillary thyroid cancer patient with diffuse micronodular pulmonary metastases was confirmed only by post radioactive iodine (RAI) therapy whole body scan (RxWBS).Her diagnostic iodine-131 whole body scan (DxWBS),chestCT and 18FDG PET/CT scan were all negative.Attention and pitfalls of this case concerning surgical and RAI dosemanagement are against current international guidelines on thyroid cancer.

  1. Logistics for evaluation of doses received by IOE due to handling 18FDG-radiopharmaceutical during processing (IEN/CNEN) and in radiodiagnostic (clinical)

    The objective of this study is to propose an improvement in radiological practices involving production, transportation and application of radiopharmaceutical 18F, by tracking the radiation doses received by occupationally exposed individuals (OEI) that develop production practices, transportation and application of some patients in hospitals and clinics in Rio de Janeiro, the radiopharmaceutical 18FDG. In light of the results and observations of how these practices are developed, it's necessary to evaluate and suggest a logistics to minimize the doses received by OEI during these practices, seeking improvements in the actions and procedures for radiological protection. In practice the production of the radiopharmaceutical, the study focuses on the time of withdrawal of 18FDG cell processing, where the technician is exposed to higher dose rates. At this stage, we take to accomplish, yet two other reviews: the first is the placement of electronic dosimeters inside and outside the lead apron, whose objective is to assess the attenuation capacity of the apron. This last procedure refers to the use of a phantom cylindrical containing TLD 700 dosimeter in order to evaluate, using a mathematical model (MCNP), the doses ends (hand) of the technician, the process of removing the radiopharmaceutical of the cell and to compare the dosimetric dose recorded in the ring. Regarding the transport of 18FDG, we take into account the doses recorded in the cabin of the vehicle and the doses recorded in the dosimeter of the carrier. Finally, the doses received by health professionals who handle 18FDG are analyzed, since its withdrawal from the packing until administration to the patient. (author)

  2. 64Cu-ATSM and 18FDG PET uptake and 64Cu-ATSM autoradiography in spontaneous canine tumors: comparison with pimonidazole hypoxia immunohistochemistry

    The aim of this study was to compare 64Cu-diacetyl-bis(N4-methylsemicarbazone) (64Cu-ATSM) and 18FDG PET uptake characteristics and 64Cu-ATSM autoradiography to pimonidazole immunohistochemistry in spontaneous canine sarcomas and carcinomas. Biopsies were collected from individual tumors between approximately 3 and 25 hours after the intravenous injection of 64Cu-ATSM and pimonidazole. 64Cu-ATSM autoradiography and pimonidazole immunostaining was performed on sectioned biopsies. Acquired 64Cu-ATSM autoradiography and pimonidazole images were rescaled, aligned and their distribution patterns compared. 64Cu-ATSM and 18FDG PET/CT scans were performed in a concurrent study and uptake characteristics were obtained for tumors where available. Maximum pimonidazole pixel value and mean pimonidazole labeled fraction was found to be strongly correlated to 18FDG PET uptake levels, whereas more varying results were obtained for the comparison to 64Cu-ATSM. In the case of the latter, uptake at scans performed 3 h post injection (pi) generally showed strong positive correlated to pimonidazole uptake. Comparison of distribution patterns of pimonidazole immunohistochemistry and 64Cu-ATSM autoradiography yielded varying results. Significant positive correlations were mainly found in sections displaying a heterogeneous distribution of tracers. Tumors with high levels of pimonidazole staining generally displayed high uptake of 18FDG and 64Cu-ATSM (3 h pi.). Similar regional distribution of 64Cu-ATSM and pimonidazole was observed in most heterogeneous tumor regions. However, tumor and hypoxia level dependent differences may exist with regard to the hypoxia specificity of 64Cu-ATSM in canine tumors

  3. The Effect of Patient Age on Standardized Uptake Value-Hounsfield Unit Values of Male Genitourinery Structures In F-18 FDG PET/CT

    Berrin Çavuşoğlu

    2011-12-01

    Full Text Available Objective: Relation between patient age and Hounsfield Unit (HU,which is the linear attenuation coefficient, and Standardized Uptake Values (SUV which is the amount of 18F-fluorodeoxyglucose (F-18 FDG uptake, measured in the areas of interest drawn to prostate, seminal vesicles and testicles in F-18 FDG Positron Emission Tomography/Computed Tomography (PET/CT images was investigated. Material and Methods: Mean and maximum SUV and HU values were recorded from the areas of interest (min 12 mm in diameter which showed FDG uptake in prostate, seminal vesicles and testicles from F-18 FDG PET-CT images of 21 male patients under 40 years without genitourinary cancer. The effect of patient age to SUV and HU values was examined with Pearson correlation test using SPSS program. Results: There was a negative insignificant correlation between patient age and SUV and HU values for prostate. For seminal vesicles, correlation between patient age and SUV values and HUmax were positive but insignificant, while correlation with HUmean was significant (r=0.459, p=0.00. Correlation between patient age and SUVmax and SUVmean values were significant for testicles (r=0.506, p=0.002 and r=0.467, p=0.005, respectively but the correlation between patient age and HUmax and HUmean values was not significant. Conclusion: F-18 FDG uptake in testicles in males increases with age until 40, suggesting an increase in metabolic rate. The significant correlation between age and mean HU values is probably caused by thickening of the tissue without an increase in glucose metabolism in seminal vesicles. In prostate, the effect of patient age to SUV and HU values was not observed until the age 40. (MIRT 2011;20:104-107

  4. Comparison of relative 18FDG uptake to metabolic rate (MRGlucose) in the myocardium in CAD, classified by 99mTc MIBI

    In 55 non-diabetic patients with CAD, relative myocardial perfusion (99mTc MIBI SPECT at rest) and relative 18FDG uptake (PET after glucose load) were used to separate for various flow/metabolism constellations. In addition, regional glucose metabolic rate (rMRGlu in μmol/100 g/min; dynamic-graphic analysis from Gambhir/Patlak) was determined in 13 segments of the left ventricle each (i.e., in a total of 715 segments). rMRGlu revealed wide standard deviations (up to 51%). It decreased from normal (52.7±27.3 μmol/100 g/min), mismatch (45.3±17.3) and intermediate (35.2±12.4) to match ('non viable'; 26.7±13.3) significantly (p18FDG uptake. Thus, the higher efforts employed to compute rMRGlu do not yield diagnostic advantage. The segmental perfusion maximum, used for normalization of relative 18FDG uptake (100% MIBI uptake=100% FDG uptake) was reliable in euglycemic patients even with 3-vessel disease. (orig.)

  5. SPM analysis of brain perfusion SPECT and F-18 FDG PET in the Korean autosomal dominant nocturnal frontal lobe epilepsy family

    This study attempted to investigate the specific pattern of brain perfusion and glucose metabolism in the Korean autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) family. Using Tc-99m ECD brain perfusion SPECT. we assessed brain perfusion in 6 patients at interictal period and 5 patients at ictal period. Interictal F-18 FDG PET was performed on 6 affected family members. The scans were statistically analyzed by using statistical parametric mapping (SPM99). The data of the affected family members were compared to those of the control subjects. Interictal F-18 FDG PET SPM group analysis showed decreased glucose metabolism over the left middle and superior frontal gyri and the left central regions including the anterior parietal lobe. There was a less pronounced decrease in glucose uptake in the right anterior superior frontal gyrus. Interictal brain perfusion SPECT SPM group analysis showed similar pattern of decreased perfusion compared to those of interictal F-18 FDG PET. Ictal brain perfusion SPECT SPM group analysis revealed increased perfusion over the left pre-and postcentral gyri and less pronounced increased perfusion in the right postcentral gyrus. lnterictal F -18 PET and brain perfusion SPECT SPM group analysis suggest that major abnormalities of ADNFLE family are in the left frontal lobe. These findings may be helpful to elucidate the pathophysiological mechanism of this rare disease entity

  6. The potential advantages of 18FDG PET/CT-based target volume delineation in radiotherapy planning of head and neck cancer

    Purpose: This study investigated two fixed threshold methods to delineate the target volume using 18FDG PET/CT before and during a course of radical radiotherapy in locally advanced squamous cell carcinoma of the head and neck. Materials and methods: Patients were enrolled into the study between March 2006 and May 2008. 18FDG PET/CT scans were carried out 72 h prior to the start of radiotherapy and then at 10, 44 and 66 Gy. Functional volumes were delineated according to the SUV Cut Off (SUVCO) (2.5, 3.0, 3.5, and 4.0 bwg/ml) and percentage of the SUVmax (30%, 35%, 40%, 45%, and 50%) thresholds. The background 18FDG uptake and the SUVmax within the volumes were also assessed. Results: Primary and lymph node volumes for the eight patients significantly reduced with each increase in the delineation threshold (for example 2.5-3.0 bwg/ml SUVCO) compared to the baseline threshold at each imaging point. There was a significant reduction in the volume (p ≤ 0.0001-0.01) after 36 Gy compared to the 0 Gy by the SUVCO method. There was a negative correlation between the SUVmax within the primary and lymph node volumes and delivered radiation dose (p ≤ 0.0001-0.011) but no difference in the SUV within the background reference region. The volumes delineated by the PTSUVmax method increased with the increase in the delivered radiation dose after 36 Gy because the SUVmax within the region of interest used to define the edge of the volume was equal or less than the background 18FDG uptake and the software was unable to effectively differentiate between tumour and background uptake. Conclusions: The changes in the target volumes delineated by the SUVCO method were less susceptible to background 18FDG uptake compared to those delineated by the PTSUVmax and may be more helpful in radiotherapy planning. The best method and threshold have still to be determined within institutions, both nationally and internationally.

  7. The influence of 18FDG-PET on conformal radiotherapy planning for patients with non-small cell lung cancer (NSCLC)

    To determine how 18FDG-PET has influenced treatment intent and lung radiotherapy planning parameters(V20Gy and Mean Lung Dose [MLD]) in patients with NSCLC referred for radical radiotherapy. Thirteen patients with inoperable NSCLC, staged by 18FDG-PET, were referred for radical radiotherapy to Liverpool Hospital, Sydney between September 2002 and February 2003. All patients were contoured according to a departmental protocol and underwent CT planning. The primary lung tumour and radiologically enlarged lymph nodes were contoured using both lung and mediastinal settings (GTV1). Any additional nodal areas identified by 18FDG-PET were outlined as a separate volume (GTV2), unless the primary was in close proximity. The PTV was created using 3-D autoexpansion to encompass GTV1 +GTV2 , adding a margin of 2cm (Plan 1). Plans were appraised to ensure a homogeneous radiation dose distribution to 60Gy throughout the PTV as per ICRU 62 guidelines. The patients were replanned to treat only radiologically visible disease (Plan 2: PTV2 = GTV1 +2cm margin). The lung parameters for Plan 2 were compared to Plan 1. 18FDG -PET influenced the TNM stage of 8 (61%) patients when compared to conventional imaging, upstaging 7 patients (N0 to N2) and downstaging 1 patient (M1 to M0). For the 13 patients the median V20Gy = 22% (range 10-45%) and median MLD1519cGy (range 626-2441cGy) for Plan 1. GTV2 was contoured on 6 patients. For these patients the median V20Gy and median MLD were 17% and 1134cGy for Plan 2 compared to 29% and 1755cGy for Plan 1. Only one patient was excluded from radical treatment due to a combination of adverse lung parameters and poor pulmonary function. 18FDG -PET has an important role in the management of patients with NSCLC. In this study it influenced both the stage and PTV. It adversely influenced lung parameters in 6 (46%) patients although it only excluded 1(8%) patient from radical treatment

  8. Five year experience in the detection of recurrence of ovarian cancer with [F18]-FDG using an hybrid (CDET) gamma camera

    Objective: The aim of this study was to evaluate the role of [F18]-FDG-CDET in the detection of recurrence of ovarian cancer. Methods and patients: After a fast of 6 hours, the patient (pt) was injected I. V. with 150-250 MBq of [F18]-FDG and imaging (whole-body scan and at least a tomoscintigram) was started 60 min. later, using a PICKER-MARCONI dual-head or triple-head CDET gamma camera. Between July 1997 and July 2001, 81 pts were studied for suspected recurrence of ovarian carcinoma. To date, the results of 62 pts are evaluable with reference to histology after surgery or concordance with conventional imaging and long-term follow-up. From these, 27 pts were referred for occult recurrence (OR) defined by an increase in serum CA-125 levels with negative CI and the remaining 35 pts for equivocal aspect at conventional imaging (ECI). Results: [F18]-FDG-CDET was true positive in 47 cases, 27 confirmed by histology after surgery (13 OC, 14 ECI) and the remaining 20 confirmed by evolution and concordance with CI. [F18]-FDG-CDET was true negative in 13 cases (6 OC, 7 ECI) as confirmed by spontaneous normalisation of CA-125 levels and no events during a 20-month follow-up for 11 pts and histology after surgery for 2 pts. [F18]-FDG CDET was false negative (FN) in 2 pts with ECI, 1 pt with a lymph node metastasis of less than 10 mm in size and 1 pt with continuing increase of CA-125 levels and still negative conventional imaging during a 8 month follow-up. No false positive results was reported in our study. In summary, the overall sensitivity, specificity and accuracy on a per patient basis were respectively 47/49 (96%), 13/13 (100%) and 60/62 (97%). The positive and negative predictive values were respectively 47/47 (100%) and 13/15 ( 87%). Conclusion: The present series of 62 patients gives valuable experience in CDET as compared to the cumulated data by Gambhir et al (J Nucl Med May 2001) reporting on a total of 357 patients using dedicated PET. Our CDET results are

  9. Differentiation of cryptogenic lateral from mesial temporal lobe epilepsy using regional asymmetric index of F-18-FDG PET

    We tried to find the possibility of utilization of F-18-FDG PET to differentiate lateral (neocortical) from mesial temporal lobe epilepsy(TLE) if we adopted quantitative comparison of regional metabolic activities using asymmetric index. We studied 22 pathologically proven mesial TLE(group C in Figure), and 27 lateral TLE patients. Lateral TLE patients were normal on MR(cryptogenic: 15; group A) or had structural lesions (12: group B). Asymmetric index (AI) was calculated as (ipsilateral -contralateral) / (ipsilateral + contralateral ) x 200. AI of medial lobe of cryptogenic lateral TLE was not decreased (-4.66.2, > 0.05) and AI of medial lobe of cryptogenic lateral TLE was not decreased (-4.66.2, >0.05) and AI of lateral lobe was decreased (-13.68.9). AI of medial and lateral lobes of mesial TLE was decreased (-3.44.7 and -16.58.9, respectively). AI of medial lobe of lesional lateral TLE was -7.39.1 (p<0.05 compared with mesial TEL). It was evident that lateral lobe of lesional lateral TLE had metabolic defect or decrease (AI: -21.410.4). While we could not find difference of metabolic activity in lateral temporal lobes between cryptogenic lateral TLE and mesial TLE patients, the difference of metabolic activity was significant in medial temporal lobes which was revealed by AI quantitation. An AI value larger than -10 (cutoff: AI) predicted positively for lateral TLE(PPV:80%) and negatively for mesial TLE(NPV:77%). Asymmetry of metabolic activity in medial and not in lateral lobe of temporal lobe could give hints about whether the epileptogenic zones were mesial or lateral

  10. Automatic interpretation of F-18-FDG brain PET using artificial neural network: discrimination of medial and lateral temporal lobe epilepsy

    We developed a computer-aided classifier using artificial neural network (ANN) to discriminate the cerebral metabolic pattern of medial and lateral temporal lobe epilepsy (TLE). We studied brain F-18-FDG PET images of 113 epilepsy patients surgically and pathologically proven as medial TLE (left 41, right 42) or lateral TLE (left 14, right 16). PET images were spatially transformed onto a standard template and normalized to the mean counts of cortical regions. Asymmetry indices for predefined 17 mirrored regions to hemispheric midline and those for medial and lateral temporal lobes were used as input features for ANN. ANN classifier was composed of 3 independent multi-layered perceptions (1 for left/right lateralization and 2 for medial/lateral discrimination) and trained to interpret metabolic patterns and produce one of 4 diagnoses (L/R medial TLE or L/R lateral TLE). Randomly selected 8 images from each group were used to train the ANN classifier and remaining 81 images were used as test sets. The accuracy of the diagnosis with ANN was estimated by averaging the agreement rates of independent 50 trials and compared to that of nuclear medicine experts. The accuracy in lateralization was 89% by the human experts and 90% by the ANN classifier. Overall accuracy in localization of epileptogenic zones by the ANN classifier was 69%, which was comparable to that by the human experts (72%). We conclude that ANN classifier performed as well as human experts and could be potentially useful supporting tool for the differential diagnosis of TLE

  11. Automatic interpretation of F-18-FDG brain PET using artificial neural network: discrimination of medial and lateral temporal lobe epilepsy

    Lee, Jae Sung; Lee, Dong Soo; Kim, Seok Ki; Park, Kwang Suk; Lee, Sang Kun; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2004-06-01

    We developed a computer-aided classifier using artificial neural network (ANN) to discriminate the cerebral metabolic pattern of medial and lateral temporal lobe epilepsy (TLE). We studied brain F-18-FDG PET images of 113 epilepsy patients surgically and pathologically proven as medial TLE (left 41, right 42) or lateral TLE (left 14, right 16). PET images were spatially transformed onto a standard template and normalized to the mean counts of cortical regions. Asymmetry indices for predefined 17 mirrored regions to hemispheric midline and those for medial and lateral temporal lobes were used as input features for ANN. ANN classifier was composed of 3 independent multi-layered perceptions (1 for left/right lateralization and 2 for medial/lateral discrimination) and trained to interpret metabolic patterns and produce one of 4 diagnoses (L/R medial TLE or L/R lateral TLE). Randomly selected 8 images from each group were used to train the ANN classifier and remaining 81 images were used as test sets. The accuracy of the diagnosis with ANN was estimated by averaging the agreement rates of independent 50 trials and compared to that of nuclear medicine experts. The accuracy in lateralization was 89% by the human experts and 90% by the ANN classifier. Overall accuracy in localization of epileptogenic zones by the ANN classifier was 69%, which was comparable to that by the human experts (72%). We conclude that ANN classifier performed as well as human experts and could be potentially useful supporting tool for the differential diagnosis of TLE.

  12. Initial Polish experience in the diagnostic utility of 18-FDG PET in the assessment of patients with multiple myeloma

    Objective: The role of whole-body PET with 18-FDG in detection of bone marrow involvement in patients with multiple myeloma was evaluated. The presence of extramedullary plasmocytomas and distribution of diffuse or focal lesions in the bones was also detected. Materials and methods: Between November 2006 and February 2007 the whole-body FDG PET scans (60 min after intravenous administration of 370-555 MBq FDG) were performed in 15 patients (age 51-71, median 59 years, 5 males) with multiple myeloma. Five patients were referred before therapy and ten patients were referred for evaluation of therapy response (chemotherapy, radiation therapy, bone marrow transplant). Standardized uptake values were calculated to quantify FDG uptake. Results of other imaging examinations (MRI, CT, radiography), laboratory data, bone marrow biopsies and the clinical course were used for verification of detected lesions. Results: FDG PET was able to detect medullary involvement of multiple myeloma and was helpful in differentiating between post therapeutic changes and residual/recurrent tumor cells also in assessing response to therapy. In six patients PET demonstrated a favorable treatment response by showing a decline in lesion metabolic activity. In another patients PET showed progression of disease, by demonstrating diffuse or focal bone lesions or higher lesion glucose metabolism, concordant with the clinical evaluation. Conclusion: FDG PET is able to detect bone marrow involvement in patients with multiple myeloma. FDG PET is useful in assessing the extent of the disease at the time of initial diagnosis, contributing to more accurate staging. FDG PET is also useful for evaluating therapy response. PET can detect the extent of marrow involvement in multiple myeloma patients and could be useful in monitoring the treatment results. (author)

  13. Prevalence and patterns of soft tissue metastasis: detection with true whole-body F-18 FDG PET/CT

    Osman Medhat M

    2007-12-01

    Full Text Available Abstract Background The aim of this retrospective study was to report the prevalence and patterns of soft tissue (ST metastasis detected with true whole-body (TWB F-18 FDG PET/CT acquired from the top of the skull through the bottom of the feet and to compare such findings to that of the typically acquired skull-base to upper-thigh, thus limited whole-body (LWB field of view (FOV. Methods TWB FDG-PET/CT scans were performed in 500 consecutive cancer patients. Suspected ST metastasis was verified by correlation with surgical pathology, other imaging modalities, or clinical follow-up. Results Nine out of 500 patients (1.8 % had ST metastasis with a prevalence of 4/41 (9.8% for melanoma, 2/60 (3.3% for lung carcinoma, 2/88 (2.3% for lymphoma and 1/13 (77% for esophageal cancer. Those nine patients had a total of 41 ST lesions: 22 lesions within and 19 outside of LWB FOV. Of those 41 lesions, 19 (46% were subcutaneous and 22 (54% were muscular lesions. The presence of ST metastasis neither changed the staging nor the treatment in any of these patients. However, the ST lesions provided a biopsy site in 4 of the 9 patients (44%. Seven out of nine studied patients died of their disease within 1–22 months after ST metastasis was diagnosed. Conclusion The detection of ST metastasis may have prognostic implications, provide more accessible biopsy sites and help avoid invasive procedures. A LWB scanning may underestimate the true extent of ST metastasis since a significant percentage of ST metastasis (46% occurred outside the typical LWB FOV.

  14. The role of 18FDG, 18FDOPA PET/CT and 99mTc bone scintigraphy imaging in Erdheim–Chester disease

    García-Gómez, F.J., E-mail: javier191185@gmail.com [Department of Nuclear Medicine, Virgen del Rocío Universitary Hospital, Seville (Spain); Acevedo-Báñez, I.; Martínez-Castillo, R.; Tirado-Hospital, J.L.; Cuenca-Cuenca, J.I.; Pachón-Garrudo, V.M.; Álvarez-Pérez, R.M.; García-Jiménez, R. [Department of Nuclear Medicine, Virgen del Rocío Universitary Hospital, Seville (Spain); Rivas-Infante, E. [Department of Pathology, Virgen del Rocío Universitary Hospital, Seville (Spain); García-Morillo, J.S. [Department of Internal Medicine, Virgen del Rocío Universitary Hospital, Seville (Spain); Borrego-Dorado, I. [Department of Nuclear Medicine, Virgen del Rocío Universitary Hospital, Seville (Spain)

    2015-08-15

    Highlights: • Erdheim–Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. • Multifocal nature of involvement in ECD can produce a wide variety of clinical signs. In our experience, neurological involvement is associated with mortality in all cases. Characteristic long bone osteosclerosis was a quasi-pathognomonic finding in bone scintigraphy. • To the best of our knowledge, the 18FDOPA-PET/CT not seem useful in the initial staging of ECD based on a single case report. • Bone scintigraphy and the 18FDG-PET/CT that were particularly useful in despite systemic involvement, locate the optimum site for biopsy and treatment response evaluation. In this context, a baseline 18FDG-PET/CT with an optional bone scintigraphy may help in monitoring the disease and could be considered when patients were incidentally diagnosed and periodically follow-up 18FDG-PET/CT must be performed in the follow up to evaluate the treatment response. - Abstract: Erdheim–Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes that stain positively for CD68 marker but not express CD1a and S100 proteins. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. Multisystemic involvement leads to a wide variety of clinical manifestations that results in a poor prognosis although recent advances in treatment. We present the clinical, nuclear medicine findings and therapeutic aspects of a serie of 6 patients with histopathological diagnosis of ECD, who have undergone both bone scintigraphy (BS) and 18F-fluorodeoxyglucose (18FDG)-PET/CT scans in our institution. A complementary 18F-fluorodopa (18FDOPA)-PET/CT was performed in one case. Three different

  15. The role of 18FDG, 18FDOPA PET/CT and 99mTc bone scintigraphy imaging in Erdheim–Chester disease

    Highlights: • Erdheim–Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. • Multifocal nature of involvement in ECD can produce a wide variety of clinical signs. In our experience, neurological involvement is associated with mortality in all cases. Characteristic long bone osteosclerosis was a quasi-pathognomonic finding in bone scintigraphy. • To the best of our knowledge, the 18FDOPA-PET/CT not seem useful in the initial staging of ECD based on a single case report. • Bone scintigraphy and the 18FDG-PET/CT that were particularly useful in despite systemic involvement, locate the optimum site for biopsy and treatment response evaluation. In this context, a baseline 18FDG-PET/CT with an optional bone scintigraphy may help in monitoring the disease and could be considered when patients were incidentally diagnosed and periodically follow-up 18FDG-PET/CT must be performed in the follow up to evaluate the treatment response. - Abstract: Erdheim–Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes that stain positively for CD68 marker but not express CD1a and S100 proteins. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. Multisystemic involvement leads to a wide variety of clinical manifestations that results in a poor prognosis although recent advances in treatment. We present the clinical, nuclear medicine findings and therapeutic aspects of a serie of 6 patients with histopathological diagnosis of ECD, who have undergone both bone scintigraphy (BS) and 18F-fluorodeoxyglucose (18FDG)-PET/CT scans in our institution. A complementary 18F-fluorodopa (18FDOPA)-PET/CT was performed in one case. Three different

  16. ''Ecstasy''-induced changes of cerebral glucose metabolism and their correlation to acute psychopathology. A 18-FDG PET study

    The aim of this study was to determine the acute effects of the 'Ecstasy' analogue MDE (3,4-methylene dioxyethamphetamine) on cerebral glucose metabolism (rMRGlu) of healthy volunteers and to correlate neurometabolism with acute psychopathology. In a radomized double-blind trial, 15 healthy volunteers without a history of drug abuse were examined with fluorine-18-deoxyglucose (18FDG) positron emission tomography (PET) 110-120 min after oral administration of 2 mg/kg MDE (n=7) or placebo (n=8). Two minutes prior to radiotracer injection, constant cognitive stimulation was started and maintained for 32 min using a word repetition paradigm to ensure constant and comparable mental conditions during cerebral glucose uptake. Individual brain anatomy was represented using T1-weighted 3D flash magnetic resonance imaging (MRI), followed by manual regionalization into 108 regions of interest and PET/MRI overlay. After absolute quantification of rMR-Glu and normalization to global metabolism, normalized rMRGlu under MDE was compared to placebo using the Mann-Whitney U-test. Acute psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS) and rMRGlu was correlated to PANSS scores according to Spearman. MDE subjects showed significantly decreased rMRGlu in the bilateral frontal cortex: left frontal posterior (-7.1%, P<0.05) and right prefrontal superior (-4.6%, P<0.05). On the other hand, rMR-Glu was significantly increased in the bilateral cerebellum (right: +10.1%, P<0.05; left: +7.6%, P<0.05) and in the right putamen (+6.2%, P<0.05). There were positive correlations between rMRGlu in the middle right cingulate and grandiosity (r=0.87; P<0.05), both the right amygadala (r=0.90, P<0.01) and the left posterior cingulate (r=0.90, P<0.01) to difficulties in abstract thinking, and the right frontal inferior (r=0.85, P<0.05), right anterior cingulate (r=0.93, P<0.01), and left anterior cingulate (r=0.85, P<0.05) to attentional deficits. A negative

  17. A meta-analysis of 18FDG-PET, MRI and bone scintigraphy for diagnosis of bone metastases in patients with breast cancer

    To perform a meta-analysis comparing the diagnostic value of 18FDG-PET, MRI, and bone scintigraphy (BS) in detecting bone metastases in patients with breast cancer. MEDLINE, EMBASE, Scopus, ScienceDirect, SpringerLink, Web of Knowledge, EBSCO, and the Cochrane Database of Systematic Review databases were searched for relevant original articles published from January 1995 to January 2010. Inclusion criteria was as follows: 18FDG-PET, MRI or 99mTc-MDP BS was performed to detect bone metastases (the number of published CT studies was inadequate for meta-analysis and therefore could not be included in this study); sufficient data were presented to construct a 2 x 2 contingency table; histopathological analysis and/or close clinical and imaging follow-up for at least 6 months were used as the reference standard. Two reviewers independently assessed potentially eligible studies and extracted relevant data. A software program called ''META-DiSc'' was used to obtain the pooled estimates for sensitivity, specificity, diagnostic odds ratio (DOR), summary receiver operating characteristic (SROC) curves, and the *Q index for each modality. Thirteen articles consisting of 23 studies fulfilled all inclusion criteria. On a per-patient basis, the pooled sensitivity estimates for MRI (97.1%) were significantly higher than those for PET (83.3%) and BS (87.0%; P 0.05). The pooled DOR estimates for MRI (298.5) were significantly higher than those for PET (82.1%) and BS (49.3%; P 0.05). The SROC curve for MRI showed better diagnostic accuracy than those for PET and BS. The SROC curve for PET was better than that for BS. The*Q index for MRI (0.935), PET (0.922), and BS (0.872) showed no significant difference (P ≥0.05). On a per-lesion basis, the pooled sensitivity estimates for BS (87.8%) were significantly higher than those for PET (52.7%; P 18FDG-PET and BS for diagnosis of bone metastases in patients with breast cancer on a per-patient basis. On a per-lesion basis, 18FDG-PET had

  18. Correlation between joint [F-18] FDG PET uptake and synovial TNF-{alpha} concentration: A study with two rabbit models of acute inflammatory arthritis

    Lin, P.-W. [Department of Physical Medicine and Rehabilitation, Taipei Medical University-Wan Fang Hospital, 111 Hsing-Long Road Sec. 3, Taipei 11696, Taiwan (China); Liu, R.-S. [Department of Nuclear Medicine, Taipei Veterans General Hospital, 201 Shih-Pai Road Sec. 2, Taipei 11217, Taiwan (China); Liou, T.-H. [Department of Physical Medicine and Rehabilitation, Taipei Medical University-Wan Fang Hospital, 111 Hsing-Long Road Sec. 3, Taipei 11696, Taiwan (China); Pan, L.-C. [Department of General Education, Taipei Medical University, 250 Wu-Hsing Street, Taipei 11031, Taiwan (China); Chen, C.-H. [Department of Physical Medicine and Rehabilitation, Taipei Medical University-Wan Fang Hospital, 111 Hsing-Long Road Sec. 3, Taipei 11696, Taiwan (China); Graduate Institute of Medical Informatics, Taipei Medical University, 250 Wu-Hsing Street, Taipei 11031, Taiwan (China)], E-mail: chihsen.chen@msa.hinet.net

    2007-11-15

    The objective of this study was to verify that the [F-18]FDG PET synovial uptake is correlated with the synovial fluid (SF) TNF-{alpha} concentration. Two rabbit models of acute inflammatory arthritis induced by human interleukin-8 and lipopolysaccharide were used. Modified standard uptake values (MSUVs) obtained from PET images of the animals were compared with results of SF TNF-{alpha} measurements. Statistically significant correlations were found between the MSUVs and the SF TNF-{alpha} ratios. An equation to estimate the TNF-{alpha} ratio from a MSUV was also derived.

  19. Factors influencing [F-18]2-fluoro-2-deoxy-D-glucose (F-18 FDG) accumulation in melanoma cells. Is FDG a substrate of multidrug resistance (MDR)?

    In order to specify the influence of multidrug-resistance (MDR) on the accumulation of the PET tracer, F-18 FDG ([Fluorine-18]2-fluoro-2-deoxy-D-glucose, in melanoma cells, both the MDR function and expression of two human melanoma cell lines SK-MEL 23 and 24, were evaluated. The effects of MDR modulators on FDG accumulation and efflux were also investigated. A functional analysis using representative MDR fluorescent substrates and inhibitors clarified the following characteristics: SK-MEL 23 possesses a highly active function of multidrug resistance-associated protein (MRP), but not P-gp. SK-MEL 24 possesses weak functions of both MRP and P-gp. Western blot analysis using monoclonal antibodies for MDR expression demonstrated an exceedingly high MRP expression of SK-MEL 23 and only slight P-gp and MRP expression of SK-MEL 24, corresponding to the functional data. The efflux inhibition assay using F-18 FDG revealed a considerable retention of FDG in SK-MEL 23 in the presence of the MRP inhibitor probenecid. It was also found that the P-gp inhibitor verapamil depressed the FDG efflux of SK-MEL 24. Our present in vitro study suggests that FDG may be a substrate of MDR in some melanoma cells and further MDR may be one of the important factors affecting FDG-PET melanoma imaging. (author)

  20. F18-FDG-PET/CT thyroid incidentalomas: a wide retrospective analysis in three Italian centres on the significance of focal uptake and SUV value.

    Bertagna, Francesco; Treglia, Giorgio; Piccardo, Arnoldo; Giovannini, Elisabetta; Bosio, Giovanni; Biasiotto, Giorgio; Bahij, El Khayat; Maroldi, Roberto; Giubbini, Raffaele

    2013-06-01

    Thyroid incidental uptake is defined as a thyroid uptake incidentally and newly detected by imaging techniques performed for an unrelated purpose and especially for non-thyroid diseases. Aim of the study was to establish the prevalence and pathological nature of focal thyroid incidentalomas detected at F18-FDG-PET/CT in patients studied for oncological purposes and not for thyroid disease. Secondary end point was to establish a possible maximum standardised uptake value cut-off over which a malignant lesion should be suspected. We have retrospectively evaluated 49519 patients who underwent F18-FDG-PET/CT for oncologic purposes in three Nuclear Medicine Centres (N.1 = 11278, N.2 = 31076, N.3 = 7165). A focal incidental thyroid uptake was diagnosed in 729 (1.5 %) patients (287-39.4 % male and 442-60.6 % female; average age: 65.26). Of 729 thyroid incidentalomas 211 (28.9 %) underwent further investigation to determine the nature of the nodule; 124/211 (58.8 %) incidentalomas were benign, 72/211 (34.1 %) malignant, 4/211 (1.9 %) non-diagnostic at cytological examination in the absence of surgery and histological evaluation and 11/211 (5.2 %) were indeterminate at cytological examination. A centre-based receiver operating curve (ROC) analysis of the patients with a definitive diagnosis was performed to identify a SUVmax cut-off useful in differentiating benign from malignant incidentalomas. In the centre N.1 it was 4.8 (sensitivity = 95.7 %, specificity = 46.4 %, area under the curve = 0.758); 5.3 in the centre N.2 (sensitivity = 76.3 %, specificity = 72.5 %, area under the curve = 0.815); 7 in the centre N.3 (sensitivity = 57.1 %, specificity = 79.3 %, area under the curve = 0.627). F18-FDG-PET/CT thyroid incidentalomas are a relevant diagnostic reality which requires further investigations and clinical management especially considering that, despite mainly benign, approximately one third of focal thyroid uptakes are malignant. PMID:23179777

  1. Monitoring of the Formation and Development Process for Infection and Inflammation Using F-18 FDG, PET/CT

    Türkan Ertay

    2015-02-01

    Full Text Available Objective: Many radiopharmaceuticals have been evaluated extensively in both preclinical and clinical studies as potential diagnostic agents to identify the sites of infection. There is a definite role of FDG-PET in diagnosis, extent of assessing the disease, evaluation of treatment response and disease activity in patients with infections and inflammation. The aim of the study, the process of formation and development of infection and inflammation is monitored using (18 F 2’-deoxy-2-fluoroD-glucose (F-18 FDG by Positron Emission Computed Tomography (PET-CT. Methods: In this study, sterile abscess was induced by using turpentine and infected abscess was induced by using Staphylococcus aureus atcc 25923 strain on rats. In the abscess formation on rats, three grups rats were used as sterile, infected and control grups. There were examined male White Wistar Rats, the clinical healthy animals were 150-220 gr body weight. Bacterial strain and rat model for abscess formation for infected abscess formation on rats (n=7, S. aureus 0.5 ml 107 CFU/ml was inoculated in the right arm of the rats as subcutaneous. For sterile abscess formation on rats (n=7 0.2-0.4 ml turpentine (sigma-aldrich was injected into the right arm of the rats as subcutaneous. In control group (n=6, 0.5 ml 0.9% NaCl was injected into the right arm of the rats as subcutaneous. First day imsaging was acquired 24 hours after inoculation of S.aureus and turpentine. 1 mCi 18F-FDG was injected intravenously via the tail vein. Prior to 18F-FDG injection, rats fasted at least 4 hours and well hydrated. Imaging was done using PET-CT (PHILIPS Gemini TF, beginning 1 hour following injection of 18F-FDG IV in the first day and at intervals of 24 hours for five days. First day imaging was performed 1. hour after IV injection of 18F-FDG to obtain optimum imaging time. PET/CT images were visually and semiquantitatively assessed. For semiquantitative analysis of the PET images, a region of interest

  2. A meta-analysis of {sup 18}FDG-PET, MRI and bone scintigraphy for diagnosis of bone metastases in patients with breast cancer

    Liu, Tao; Yang, Hui-Lin [The First Affiliated Hospital of Soochow University, Department of Orthopaedic Surgery, Suzhou (China); Cheng, Tao [Shanghai Jiaotong University School of Medicine, Department of Orthopaedic Surgery, Shanghai Sixth People' s Hospital, Shanghai (China); Xu, Wen [Public Health School of Soochow University, Department of Epidemiology and Biostatistics, Suzhou (China); Yan, Wei-Li [Shanghai Jiaotong University School of Medicine, Departments of Nuclear Medicine, Shanghai Renji Hospital, Shanghai (China); Liu, Jia [Shanghai Jiaotong University School of Medicine, Departments of Radiology, Shanghai Renji Hospital, Shanghai (China)

    2011-05-15

    To perform a meta-analysis comparing the diagnostic value of {sup 18}FDG-PET, MRI, and bone scintigraphy (BS) in detecting bone metastases in patients with breast cancer. MEDLINE, EMBASE, Scopus, ScienceDirect, SpringerLink, Web of Knowledge, EBSCO, and the Cochrane Database of Systematic Review databases were searched for relevant original articles published from January 1995 to January 2010. Inclusion criteria was as follows: {sup 18}FDG-PET, MRI or {sup 99m}Tc-MDP BS was performed to detect bone metastases (the number of published CT studies was inadequate for meta-analysis and therefore could not be included in this study); sufficient data were presented to construct a 2 x 2 contingency table; histopathological analysis and/or close clinical and imaging follow-up for at least 6 months were used as the reference standard. Two reviewers independently assessed potentially eligible studies and extracted relevant data. A software program called ''META-DiSc'' was used to obtain the pooled estimates for sensitivity, specificity, diagnostic odds ratio (DOR), summary receiver operating characteristic (SROC) curves, and the *Q index for each modality. Thirteen articles consisting of 23 studies fulfilled all inclusion criteria. On a per-patient basis, the pooled sensitivity estimates for MRI (97.1%) were significantly higher than those for PET (83.3%) and BS (87.0%; P <0.05). There was no significant difference between PET and BS (P <0.05). The pooled specificity estimates for PET (94.5%) and MRI (97.0%) were both significantly higher than those for BS (88.1%; P <0.05). There was no significant difference between PET and MRI (P >0.05). The pooled DOR estimates for MRI (298.5) were significantly higher than those for PET (82.1%) and BS (49.3%; P <0.05). There was no significant difference between PET and BS (P >0.05). The SROC curve for MRI showed better diagnostic accuracy than those for PET and BS. The SROC curve for PET was better than that for BS

  3. A statistical investigation of normal regional intra-subject heterogeneity of brain metabolism and perfusion by F-18 FDG and O-15 H2O PET imaging

    The definite evaluation of the regional cerebral heterogeneity using perfusion and metabolism by a single modality of PET imaging has not been well addressed. Thus a statistical analysis of voxel variables from identical brain regions on metabolic and perfusion PET images was carried out to determine characteristics of the regional heterogeneity of F-18 FDG and O-15 H2O cerebral uptake in normal subjects. Fourteen normal subjects with normal CT and/or MRI and physical examination including MMSE were scanned by both F-18 FDG and O-15 H2O PET within same day with head-holder and facemask. The images were co-registered and each individual voxel counts (Q) were normalized by the gloabl maximal voxel counts (M) as R = Q/M. The voxel counts were also converted to z-score map by z = (Q - mean)/SD. Twelve pairs of ROIs (24 total) were systematically placed on the z-score map at cortical locations 15-degree apart and identically for metabolism and perfusion. Inter- and intra-subject correlation coefficients (r) were computed, both globally and hemispherically, from metabolism and perfusion: between regions for the same tracer and between tracers for the same region. Moments of means and histograms were computed globally along with asymmetric indices as their hemispherical differences. Statistical investigations verified with data showed that, for a given scan, correlation analyses are expectedly alike regardless of variables (Q, R, z) used. The varieties of correlation (r's) of normal subjects, showing symmetry, were mostly around 0.8 and with coefficient of variations near 10%. Analyses of histograms showed non-Gaussian behavior (skew = -0.3 and kurtosis = 0.4) of metabolism on average, in contrast to near Gaussian perfusion. The co-registered cerebral metabolism and perfusion z maps demonstrated regional heterogeneity but with attractively low coefficient of variations in the correlation markers

  4. The differentiation of malignant and benign musculoskeletal tumors by F-18 FDG PET/CT studies-determination of maxSUV by analysis of ROC curve

    Kong, Eun Jung; Cho, Ihn Ho; Chun, Kyung Ah; Won, Kyu Chang; Lee, Hyung Woo; Choi, Jun Heok; Shin, Duk Seop [Yeungnam University College of Medicine, Daegu (Korea, Republic of)

    2007-12-15

    We evaluated the standard uptake value (SUV) of F-18 FDG at PET/CT for differentiation of benign from malignant tumor in primary musculoskeletal tumors. Forty-six tumors (11 benign and 12 malignant soft tissue tumors, 9 benign and 14 malignant bone tumors) were examined with F-18 FDG PET/CT (Discovery ST, GE) prior to tissue diagnosis. The maxSUV(maximum value of SUV) were calculated and compared between benign and malignant lesions. The lesion analysis was based on the transverse whole body image. The maxSUV with cutoff of 4.1 was used in distinguishing benign from malignant soft tissue tumor and 3.05 was used in bone tumor by ROC curve. There was a statistically significant difference in maxSUV between benign (n = 11; maxSUV 3.4 {+-} 3.2) and malignant (n = 12; maxSUV 14.8 {+-} 12.2) lesion in soft tissue tumor ({rho} = 0.001). Between benign bone tumor (n = 9; maxSUV 5.4 {+-} 4.0) and malignant bone tumor (n = 14; maxSUV 7.3 {+-} 3.2), there was not a significant difference in maxSUV. The sensitivity and specificity for differentiating malignant from benign soft tissue tumor was 83% and 91%, respectively. There were four false positive malignant bone tumor cases to include fibrous dysplasia, Langerhans-cell histiocytosis (n = 2) and osteoid osteoma. Also, one false positive case of malignant soft tissue tumor was nodular fasciitis. The maxSUV was useful for differentiation of benign from malignant lesion in primary soft tissue tumors. In bone tumor, the low maxSUV correlated well with benign lesions but high maxSUV did not always mean malignancy.

  5. The role of F-18 FDG-PET for 3-D radiation treatment planning of non-small cell lung cancer - first results of a prospective study

    To determine the role of F-18 FDG-PET in 3-D-radiation therapy planning, findings in 27 patients, studied by both, PET and CT, were analyzed prospectively. All patients were first examined by helical CT and F-18 FDG-PET. The PET data were iteratively reconstructed into 3-D images and image fusion with CT data was applied. First, based on CT data, the planning target volumes (PTV) and the volumes of organs at risk were generated. In a second step, the transversal slices of CT and PET were matched. Then, based on PET data, new target volumes were generated. Treatment plans for radiation therapy were calculated on CT-based and PET-based planning target volumes. If PET results were used additionally for the 3-D-planning procedure of radiation therapy, the planning target volume could be reduced in a range of 3-21% as compared with conventional imaging methods, e.g., PET allowed differentiation between tumor and atelectasis resulting in smaller PTV. The dose volume histograms of the PET-based treatment plans showed a reduction of dose to the organs at risk, e.g., Vlung (20 Gy) could be reduced by 5% to 17%. In 2 patients, the boost volume based on PET findings was larger than the one based on CT, since PET detected lymph node metastases being of normal size in CT (<1 cm). PET can provide important complementary metabolic information to morphological imaging modalities for an exact localization of nodal involvement and the extent of the primary tumor. Due to smaller PTV, radiation therapy could be delivered with less toxicity in most patients. Using metabolic tumor localization by PET additionally to anatomic delineation by CT scan, a better tumor control may be achieved. Further studies are required to proof this concept. (orig.)

  6. Usefulness of partial volume effect-corrected F-18 FDG PET/CT for predicting I-131 accumulation in the metastatic lymph nodes of patients with thyroid carcinoma

    The purpose of this study was to evaluate the clinical usefulness of partial volume effect (PVE)-corrected F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT for predicting I-131 accumulation in metastatic lymph nodes (mLNs) during I-131 therapy for papillary thyroid carcinoma (PTC). Sixty-five mLNs in 31 PTC patients who underwent F-18 FDG PET/CT in an initial radioiodine therapy (RIT) were retrospectively evaluated. Of these, 25 mLNs were I-131-positive and 40 were I-131-negative. standardized uptake value (SUV)max and SUVmax with PVE correction (cSUVmax) were measured for each mLN, where PVE correction was performed utilizing a simple table lookup correction method. Then, SUVmax/cSUVmax was compared between I-131-positive and I-131-negative mLNs, including the analyses for the mLNs with small-sized (<1 cm) and weak FDG accumulation (SUVmax<3.5). The predictability for I-131 accumulation with SUVmax/cSUVmax was also compared. For all 65 mLNs, SUVmax/cSUVmax was significantly higher in I-131-negative than I-131-positive mLNs (p<0.0001). Only in cSUVmax, I-131-negative mLNs were significantly higher than I-131-positive, in terms of the 30 small-sized mLNs (p=0.0001) and 14 mLNs with weak FDG uptake (p=0.007). The highest accuracy in predictability for I-131 accumulation was significantly better with cSUVmax (92%) than SUVmax (62%) (p<0.0001). PVE-corrected F-18 FDG PET/CT is a valuable predictor of I-131 accumulation in mLNs during RIT. (author)

  7. Disturbed neural circuits in a subtype of chronic catatonic schizophrenia demonstrated by F-18-FDG-PET and F-18-DOPA-PET

    Permanent verbal, visual scenic and coenaestetic hallucinations are the most prominent psychopathological symptoms aside from psychomotor disorders in speech-sluggish catatonia, a subtype of chronic catatonic schizophrenia according to Karl Leonhard. These continuous hallucinations serve as an excellent paradigm for the investigation of the assumed functional disturbances of cortical circuits in schizophrenia. Data from positron emission tomography (F-18-FDG-PET and F-18-DOPA-PET) from three patients with this rare phenotype were available (two cases of simple speech-sluggish catatonia, one case of a combined speech-prompt/speech-sluggish subtype) and were compared with a control collective. During their permanent hallucinations, all catatonic patients showed a clear bitemporal hypometabolism in the F-18-FDG-PET. Both patients with the simple speech-sluggish catatonia showed an additional bilateral thalamic hypermetabolism and an additional bilateral hypometabolism of the frontal cortex, especially on the left side. In contrast, the patient with the combined speech-prompt/speech-sluggish catatonia showed a bilateral thalamic hypo-metabolism combined with a bifrontal cortical hypermetabolism. However, the left/right ratio of the frontal cortex also showed a lateralization effect with a clear relative hypometabolism of the left frontal cortex. The F-18-DOPA-PET of both schizophrenic patients with simple speech-sluggish catatonia showed a normal F-18-DOPA storage in the striatum, whereas in the right putamen of the patient with the combined form a higher right/left ratio in F-DOPA storage was discernible, indicating an additional lateralized influence of the dopaminergic system in this subtype of chronic catatonic schizophrenia. (author)

  8. Comparison of relative {sup 18}FDG uptake to metabolic rate (MRGlucose) in the myocardium in CAD, classified by {sup 99m}Tc MIBI; Vergleich von relativer {sup 18}FDG-Aufnahme mit metabolischer Rate (MRGlukose) im Myokard bei KHK, klassifiziert mit {sup 99m}Tc-MIBI

    Buell, U. [RWTH, Klinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Foroutan, Y. [RWTH, Klinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Hellwig, D. [RWTH, Klinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Kaiser, H.J. [RWTH, Klinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Schulz, G. [RWTH, Klinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Sabri, O. [RWTH, Klinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Schreckenberger, M. [RWTH, Klinikum Aachen (Germany). Klinik fuer Nuklearmedizin; Vom Dahl, J. [RWTH, Klinikum Aachen (Germany). Medizinische Klinik 1

    1995-12-01

    In 55 non-diabetic patients with CAD, relative myocardial perfusion ({sup 99m}Tc MIBI SPECT at rest) and relative {sup 18}FDG uptake (PET after glucose load) were used to separate for various flow/metabolism constellations. In addition, regional glucose metabolic rate (rMRGlu in {mu}mol/100 g/min; dynamic-graphic analysis from Gambhir/Patlak) was determined in 13 segments of the left ventricle each (i.e., in a total of 715 segments). rMRGlu revealed wide standard deviations (up to 51%). It decreased from normal (52.7{+-}27.3 {mu}mol/100 g/min), mismatch (45.3{+-}17.3) and intermediate (35.2{+-}12.4) to match (`non viable`; 26.7{+-}13.3) significantly (p<0.01). In 26% of the perfusion maxima, MRGlu was <40 {mu}mol/100 g/min. Out of these, only in five patients (of 28) with 3-vesell disease, it was even smaller (<30 {mu}mol). In three out of the latter, glucose blood levels were below euglycemia. rMRGlu in CAD revealed an identical perfusion/metabolism pattern as relative {sup 18}FDG uptake. Thus, the higher efforts employed to compute rMRGlu do not yield diagnostic advantage. The segmental perfusion maximum, used for normalization of relative {sup 18}FDG uptake (100% MIBI uptake=100% FDG uptake) was reliable in euglycemic patients even with 3-vessel disease. (orig.) [Deutsch] Bei 55 Patienten mit KHK wurden die relative myokardiale Speicherung von {sup 99m}Tc-MB (in Ruhe; SPECT) und von {sup 18}FDG (nach Glukoseladung, PET) vergleichend zu rMRGlu (in {mu}mol/100 g/min) in je 13 Segmenten des linken Ventrikels (insgesamt 715 Segmente) bestimmt. Die rMRGlu zeigte Streubreiten von bis zu 51%. Sie nahm in der Reihenfolge normal (52,7{+-}27,3 {mu}mol/100 g/min), mismatch (p<0,01) ab. In 26% der Perfusionsmaxima war MRGlu <40 {mu}mol/100 g/min, darunter nur bei fuenf Dreigefaesserkrankungen (von 28) <30 {mu}mol. Die Serumglukosewerte zeigten bei drei dieser fuenf Patienten eine ungenuegende Antwort auf die orale Glukosebelastung. rMRGlu erbrachte bei KHK die gleichen

  9. Estimation of genotoxic damage in irradiated patients (l8fdg) in positron emission tomography; Estimacion del dano genotoxico en pacientes irradiados con (18fdg) en tomografia por emision de positrones

    Alcaraz Banos, M.; Villena Garcia, C.; Moreno Capdevila, C.; Navarro Fernandez, J. L.; Alcaraz Saura, M.; Achel, D. G.; Clver Valderas, M. A.; Olivares Rueda, A.; Olmos Ortiz, E.

    2011-07-01

    The aim of this study is to determine the genotoxic (mutagenic) by the MN assay, the radiation dose administered to the patient undergoing medical radiological examinations, with special emphasis on cancer patients referred to our unit for studies of PET-CT with 2 - (18F)-Fluoro-2-deoxy-d-glucose (18FDG).

  10. Volume-Based F-18 FDG PET/CT Imaging Markers Provide Supplemental Prognostic Information to Histologic Grading in Patients With High-Grade Bone or Soft Tissue Sarcoma

    Andersen, Kim Francis; Fuglo, Hanna Maria; Rasmussen, Sine Hvid;

    2015-01-01

    The aim of the study is to assess the prognostic value of different volume-based calculations of tumor metabolic activity in the initial assessment of patients with high-grade bone sarcomas (BS) and soft tissue sarcomas (STS) using F-18 FDG PET/CT.A single-site, retrospective study from 2002 to...

  11. A Prospective Evaluation of Staging and Target Volume Definition of Lymph Nodes by 18FDG PET/CT in Patients With Squamous Cell Carcinoma of Thoracic Esophagus

    Purpose: To determine an optimal standardized uptake value (SUV) threshold for detecting lymph node (LN) metastases in esophageal cancer using 18F-Fluorodeoxyglucose positron emission tomography/computer tomography (18FDG PET/CT) and to define the resulting nodal target volume, using histopathology as a “gold standard.” Methods: Sixteen patients with esophageal squamous cell carcinoma who underwent radical esophagectomy and three-field LN dissection after 18FDG PET/CT and CT scans were enrolled into this study. Locations of LN groups were recorded according to a uniform LN map. Diagnostic performance of different SUV thresholds was assessed by receiver operating characteristic analysis. The optimal cutoff SUV was determined by plotting the false-negative rate (FNR) and false-positive rate (FPR), the sum of both error rates (FNR+FPR), and accuracy against a hypothetical SUV threshold. For each patient, nodal gross tumor volumes (GTVNs) were generated with CT alone (GTVNCT), PET/CT (GTVNPET), and pathologic data (GTVNpath). GTVNCT or GTVNPET was compared with GTVNpath by means of a conformity index (CI), which is the intersection of the two GTVNs divided by the sum of them minus the intersection, e.g., CICT and path = GTVNCT and path/(GTVNCT+ GTVNpath – GTVNCT and path). Results: LN metastases occurred in 21 LN groups among the 144 specimens taken from the 16 patients. The area under the receiver operating characteristic curve was 0.9017 ± 0.0410. The plot of error rates showed a minimum of FNR+FPR for an SUV of 2.36, at which the sensitivity, specificity, and accuracy were 76.19%, 95.93%, and 93.06%, respectively, whereas those of CT were 33.33%, 94.31%, and 85.42% (p values: 0.0117, 0.7539, and 0.0266). Mean GTVNCT, GTVNPET, and GTVNpath were 1.52 ± 2.38, 2.82 ± 4.51, and 2.68 ± 4.16cm3, respectively. Mean CICT and path and CIPET and path were 0.31 and 0.65 (p value = 0.0352). Conclusions: Diagnostic superiority of PET/CT at an SUV threshold of 2.36 over

  12. Effect of duration of fasting and diet on the myocardial uptake of F-18-2-fluoro-2-deoxyglucose (F-18 FDG) at rest

    Patterns of myocardial fluoro-2-deoxyglucose (FDG) uptake with respect to duration of fasting and dietary modifications. We observed the effect of duration of fasting and diet on the myocardial uptake pattern of F-18 FDG in patients routinely referred for oncological evaluation and no previous history of Coronary Artery Disease (CAD). Prospective study. A total of 153 patients (M: 81, F: 72; mean age: 47 ± 15 years; mean blood glucose level (mBG) 105 ± 23 mg/dl) were randomly divided in three groups. Group A: 4-6 h fasting; Group B: Overnight fasting (12–14 h); Group C: Low carbohydrate and fat rich diet for 2 days coupled with overnight fasting prior to the positron emission tomography (PET) scan. FDG uptake was classified as following: 1) homogeneous uptake, 2) heterogeneous uptake, and 3) ‘no uptake’ in the left ventricular (LV) myocardium. FDG PET study was performed as standard protocol for oncological conditions. Descriptive statistics, Chi-square test or Fisher's exact test, and Spearman's rank correlation tests were applied. We observed the ‘no uptake’ pattern in five (10%), 28 (55%), and 39 (77%), ‘heterogeneous’ pattern in 20 (39%), 14 (28%), and seven (14%), and ‘homogeneous’ pattern in 26 (51%), nine (18%), and five (10%) patients in Group A, B, and C, respectively. There was statistically significant difference of myocardial uptake pattern between group A and B (P < 0.0001), between group A and C (P < 0.0001), and between Group B and C (P = 0.023). The mBG was 102, 105, and 111 mg/dl in ‘no uptake’, heterogeneous, and homogeneous uptake pattern, respectively, (P = 0.103). Also, within each group the mBG was not related to the uptake pattern. Both restricted diet and duration of fasting play an important role in determining the pattern and suppression of myocardial F-18 FDG uptake. Overnight fasting and restricted diet together suppress myocardial FDG uptake more than overnight fasting alone, which suppresses uptake

  13. Characteristics of Metastatic Mediastinal Lymph Nodes of Non-Small Cell Lung Cancer on Preoperative F-18 FDG PET/CT

    Lee, Ah Young; Choi, Su Jung; Jung, Kyung Pyo; Park, Ji Sun; Lee, Seok Mo; Bae, Sang Kyun [Inje Univ. College of Medicine, Gimhae (Korea, Republic of)

    2014-03-15

    The aim of this study was to evaluate the characteristics of PET and CT features of mediastinal metastatic lymph nodes on F-18 FDG PET/CT and to determine the diagnostic criteria in nodal staging of non-small cell lung cancer. One hundred four non-small cell lung cancer patients who had preoperative F-18 FDG PET/CT were included. For quantitative analysis, the maximum SUV of the primary tumor, maximum SUV of the lymph nodes (SUVmax), size of the lymph nodes, and average Hounsfield units (aHUs) and maximum Hounsfield units (mHUs) of the lymph nodes were measured. The SUVmax, SUV ratio of the lymph node to blood pool (LN SUV/blood pool SUV), SUV ratio of the lymph node to primary tumor (LN SUV/primary tumor SUV), size, aHU, and mHU were compared between the benign and malignant lymph nodes. Among 372 dissected lymph node stations that were pathologically diagnosed after surgery, 49 node stations were malignant and 323 node stations benign. SUVmax, LN SUV/blood pool SUV, and size were significantly different between the malignant and benign lymph node stations (P <0.0001). However, there was no significant difference in LN SUV/primary tumor SUV (P =0.18), mHU (P =0.42), and aHU (P =0.98). Using receiver-operating characteristic curve analyses, there was no significant difference among these three variables (SUVmax, LN SUV/blood pool SUV, and size). The optimal cutoff values were 2.9 for SUVmax, 1.4 for LN SUV/blood pool SUV, and 5 mm for size. When the cutoff value of SUVmax≥2.9 and size≥5 mm were used in combination, the positive predictive value was 44.2%, and the negative predictive value was 90.9 %. When we evaluated the results based on the histology of the primary tumor, the negative predictive value was 92.3 % in adenocarcinoma (cutoff values of SUVmax≥2.3 and size≥5 mm) and 97.2 % in squamous cell carcinoma (cutoff values of SUVmax≥3.6 and size≥8 mm), separately. In the lymph node staging of non-small cell lung cancer, SUVmax, LN SUV/blood pool SUV

  14. Diffuse Hypermetabolism at Bone Marrow in F-18 FDG PET/CT: Correlation with Bone Marrow Biopsy and Complete Blood Cell Counts

    Kang, Yun Hee; Lim, Seok Tae; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Sohn, Myung Hee [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2009-02-15

    Increased FDG uptake in the bone marrow has been reported in patients taking erythropoietin or granulocyte-colony stimulating factor (G-CSF). The aim of this study is to investigate the correlation between F-18 FDG uptake in the bone marrow and bone marrow finding, hematological parameters. Twenty patients who had diffuse FDG uptake at the bone marrow and received hematological examinations, bone marrow biopsy within 10 days before or after PET/CT were enrolled in this study. Among them, 11 patients were excluded; 4 patients received G-CSF or erythropoietin before PET/CT. Seven patients showed definite pathology in a bone marrow biopsy. The parameters included the measurement of WBC, hemoglobin, platelet and cellularity of the bone marrow. Bone marrow FDG uptake was correlated with a low hemoglobin but not WBC, platelet. Histopathologic findings in marrow biopsies were various: normal finding (n=3), hyperplasia of granulocytic cells (n=2), eosinophilic hyperplasia (n=1), reactive lymphoid nodules (n=1), hypercelluar marrow (n=1), hypocelluar marrow (n=1). All patients except two, showed normal marrow celluarity. FDG uptake by bone marrow correlated with anemia but not WBC, platelet, bone marrow cellularity.

  15. Imaging with F-18 FDG PET is superior to TI-201 SPECT in the staging of non-small cell lung cancer for radical radiation therapy

    Thallium-201 (TI-201) single photon emission computed tomography (SPECT) is funded for evaluation of malignancy in Australia and may have utility for staging of non-small cell lung cancer (NSCLC) if CT results are equivocal. Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) is superior to CT for staging NSCLC but is more expensive and less widely available than TI-201 SPECT. Therefore, these techniques were prospectively compared in 27 radical radiation therapy candidates. Tumour to background ratios (TBR) were recorded for the primary on both techniques. Metastatic disease was confirmed by surgical pathology, serial imaging or clinical follow up. Tumour to background ratios were consistently higher for FDG PET than TI-201 SPECT (P < 0.0001). Positron emission tomography detected all known primary tumours but TI-201 failed to image four primary tumours (15%). In 10 of 18 cases of discordance between PET and TI-201 SPECT regarding stage, corroboration was available from pathology or disease progression. Positron emission tomography was shown to have a 100% positive predictive value, including all three patients with PET-detected distant metastases (P0.002). Results indicate that PET is superior to TI-201 SPECT scanning in the staging of NSCLC for radical radiation therapy, and that the low sensitivity for detection of local and metastatic disease is likely to limit the clinical impact and cost-effectiveness of this technique despite its lower cost. Copyright (2001) Blackwell Science Pty Ltd

  16. The retention index calculated with dual-phase F-18 FDG PET by the primary tumor as a predictor for lymph node involvement in patients with non small cell lung cancer

    Kim, S. E.; Chung, H. C.; Lee, S. Y. [Korea University College of Medicine, Seoul (Korea, Republic of)] (and others)

    2005-07-01

    F-18 FDG uptake within primary tumor has been shown to correlate with aggressiveness and survival on PET studies of patients with NSCLC (Vesselle H, 2003). We investigated whether F-18 FDG uptake by primary tumor is a predictor of lymph node (LN) involvement in patients with non small cell lung cancer (NSCLC). A total of 51 consecutive patients with pathologically proven NSCLC were underwent dual-phase FDG PET. All of patients was underwent a thoracotomy within 1 month of F-18 FDG PET study. Maximum standard uptake values at 1 hour (SUV1) and 2 hour (SUV 2) following the injection of F-18 FDG were determined, and the retention index (RI) was calculated by dividing the difference between SUV2 and SUV1 by SUV1 (RI=(SUV2-SUV1)/SUV X 100%). The predictive values of SUV1, SUV2 and RI were analyzed, along with the clinical parameters. (age(=60 vs 60<), Sex(M vs F), tumor size(>3cm vs 3cm<), histology (adenocarcinoma vs nondenocaricnoma), and tumor differentiation (well/moderately vs poorly). The LN involvements were founded in 49%. In univariate analysis the tumor size, RI and histology were factors significantly associated with LN involvement (p<0.05). The best cut-off value for RI was 17. In multivariate analysis the tumor size and RI (>17) were factors significantly associated with LN involvement (P<0.001). SUV2 and RI from dual-phase FDG-PET by the primary tumor was significant predictors for LN involvement. High RI in the primary tumor at presentation should prompt high suspicion and an aggressive search for lymph node metastasis.

  17. Detection of an Infected N-butyl-2-cyanoacrylate Plug by F-18 FDG PET/CT Scan in a Patient Who Received Endoscopic Intervention for Gastric Variceal Bleeding

    Joo, Kowoon; Hyun, In Young; Baek, Ji Hyeon; Chung, Moon-Hyun; Lee, Jin-Soo

    2013-01-01

    Injection of N-butyl-2-cyanoacrylate has been used successfully for treatment of gastric variceal bleeding. Bacteremia after injection of N-butyl-2-cyanoacrylate is well known, however, the method for diagnosis of infected endovascular injected material has remained uncertain. This is the first case reporting use of F-18 FDG PET/CT in detection of the source of infection after control of endoscopic bleeding with N-butyl-2-cyanoacrylate.

  18. 18FDG-PET在诊断头颈部鳞状细胞癌复发中的价值%Evaluation of Recurrent Squamous Cell Carcinoma at Head and Neck with FDG PET

    2001-01-01

    目的:了解18FDG-PET在诊断头颈部鳞状细胞癌复发中的价值,确定标准吸收值(SUV)来鉴别放疗后的炎症与肿瘤复发.材料和方法:头颈部鳞状细胞癌患者43例,在放疗后至少4个月(平均11个月)进行18FDG-PET检查.计算感兴趣区的SUV值.肿瘤复发诊断依赖组织病理学检查或6个月以上的临床随访.结果:43例患者中,FDG-PET阳性23例,其中3例为假阳性;20例为阴性,其中假阴性2例.FDG-PET的诊断准确性是88%(38/43),而CT/MRI的诊断准确性则为66%(25/38).肿瘤复发病灶和炎症病灶的SUV有部分重叠,无统计学上差异(p=0.31).结论:18FDG-PET检测头颈部鳞状细胞癌复发中肉眼分析更有价值;18FDG-PET较CT/MRI更为准确.valuation of Recurrent Squamous Cell Carcinoma at Head and Neck with FDG PET

  19. Multiphase CT scanning and different intravenous contrast media concentrations in combined F-18-FDG PET/CT: Effect on quantitative and clinical assessment

    Rebiere, Marilou, E-mail: Marilou.Rebiere@rwth-aachen.de [Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Verburg, Frederik A., E-mail: fverburg@ukaachen.de [Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Department of Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, 6202 AZ Maastricht (Netherlands); Palmowski, Moritz, E-mail: mpalmowski@ukaachen.de [Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Department of Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Department of Experimental Molecular Imaging, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Krohn, Thomas, E-mail: tkrohn@ukaachen.de [Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Pietsch, Hubertus, E-mail: hubertus.pietsch@bayer.com [Contrast Media Research, Bayer Pharma AG, Muellerstr. 178, 13353 Berlin (Germany); Kuhl, Christiane K., E-mail: ckuhl@ukaachen.de [Department of Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Mottaghy, Felix M., E-mail: fmottaghy@ukaachen.de [Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Department of Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, 6202 AZ Maastricht (Netherlands); Behrendt, Florian F., E-mail: fbehrendt@ukaachen.de [Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany)

    2012-08-15

    Purpose: To evaluate the influence of multiphase CT scanning and different intravenous contrast media on contrast enhancement, attenuation correction and image quality in combined PET/CT. Material and methods: 140 patients were prospectively enrolled for F-18-FDG-PET/CT including a low-dose unenhanced, arterial and venous contrast enhanced CT. The first (second) 70 patients, received contrast medium with 370 (300) mg iodine/ml. The iodine delivery rate (1.3 mg/s) and total iodine load (44.4 g) were identical for both groups. Contrast enhancement and maximum and mean standardized FDG uptake values (SUVmax and SUVmean) were determined for the un-enhanced, arterial and venous PET/CT at multiple anatomic sites and PET reconstructions were visually evaluated. Results: Arterial contrast enhancement was significantly higher for the 300 mg/ml contrast medium compared to 370 mg I/ml at all anatomic sites. Venous enhancement was not different between the two contrast media. SUVmean and SUVmax were significantly higher for the contrast enhanced compared to the non-enhanced PET/CT at all anatomic sites (all P < 0.001). Tracer uptake was significantly higher in the arterial than in the venous PET/CT in the arteries using both contrast media (all P < 0.001). No differences in tracer uptake were found between the contrast media (all P > 0.05). Visual assessment revealed no relevant differences between the different PET reconstructions. Conclusions: There is no relevant qualitative influence on the PET scan from the use of different intravenous contrast media in its various phases in combined multiphase PET/CT. For quantitative analysis of tracer uptake it is required to use an identical PET/CT protocol.

  20. Optimal CT Number range for adipose tissue when determining lean body mass in whole body F 18 FDG PET/CT Studies

    Kim, Woo Hyoung; Kim Chang Guhn; Kim, Dae Weung [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of)

    2012-12-15

    The aim of this study was to define an optimal CT number range applicable to adipose tissue (AT) measurement in modern PET/CT systems. CT number (in Hounsfield units, HU) was measured in three different pure AT compartments in 53 patients. CT number range for AT was determined in three different ways, including pixel histogram analysis, to take the effect of partial volume averaging into account. The effect of changing the CT number range for AT on the total AT volume was investigated. The lower limits for CT number for pure subcutaneous AT, retroperitoneal AT, and visceral AT were 140, 140, and 130 HU, respectively. the corresponding upper limits were -70, -71,and -52 HU. the CT number range for at using three methods when considering partial volume averaging was -144 to -141 HU to -30 to -33 HU, show ing similar values between the three methods. The optimal ing similar values between the three methods. the optimal CT number range for AT based on these data was -140 to -30 HU. increases in total AT volume of 7.5% and 1.8 were found when the upper or lower limit was extended using 10 HU intervals, respectively, compared with the reference range of -140 to -30 HU. This study demonstrated that the optimal CT number range of AT that the optimal CT number range of at that is applicable to modern PET/CT systems can be defined as -140 to -30 HU. The use of this CT number range of AT allowed lean body mass to be determined in whole body F 18 FDG PET/CT studies.

  1. Optimizing the interval between G-CSF therapy and F-18 FDG PET imaging in children and young adults receiving chemotherapy for sarcoma

    Trout, Andrew T.; Sharp, Susan E.; Gelfand, Michael J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Turpin, Brian K. [Cincinnati Children' s Hospital Medical Center, Cancer and Blood Diseases Institute, Division of Oncology, Cincinnati, OH (United States); Zhang, Bin [Cincinnati Children' s Hospital Medical Center, Division of Biostatistics and Epidemiology, Cincinnati, OH (United States)

    2015-07-15

    Granulocyte colony-stimulating factors (G-CSF) speed recovery from chemotherapy-induced myelosuppression but the marrow stimulation they cause can interfere with interpretation of F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) exams. To assess the frequency of interfering G-CSF-induced bone marrow activity on FDG PET imaging in children and young adults with Ewing sarcoma and rhabdomyosarcoma and to define an interval between G-CSF administration and FDG PET imaging that limits marrow interference. Blinded, retrospective review of FDG PET exams performed in patients treated with long-acting G-CSF as part of their chemotherapeutic regimen. Exams were subjectively scored by two reviewers (R1 and R2) who assessed the level of marrow uptake of FDG and measured standardized uptake values in the marrow, liver, spleen and blood pool. FDG PET findings were correlated with time since G-CSF administration and with blood cell counts. Thirty-eight FDG PET exams performed in 17 patients were reviewed with 47.4% (18/38) of exams having marrow uptake of FDG sufficient to interfere with image interpretation. Primary predictors of marrow uptake of FDG were patient age (P = 0.0037) and time since G-CSF exposure (P = 0.0028 for subjective marrow uptake of FDG, P = 0.008 [R1] and P = 0.004 [R2] for measured maximum standardized uptake value (SUVmax)). The median interval between G-CSF administration and PET imaging in cases with marrow activity considered normal or not likely to interfere was 19.5 days (range: 7-55 days). In pediatric and young adult patients with Ewing sarcoma and rhabdomyosarcoma, an interval of 20 days between administration of the long-acting form of G-CSF and FDG PET imaging should limit interference by stimulated marrow. (orig.)

  2. Optimal CT Number range for adipose tissue when determining lean body mass in whole body F 18 FDG PET/CT Studies

    The aim of this study was to define an optimal CT number range applicable to adipose tissue (AT) measurement in modern PET/CT systems. CT number (in Hounsfield units, HU) was measured in three different pure AT compartments in 53 patients. CT number range for AT was determined in three different ways, including pixel histogram analysis, to take the effect of partial volume averaging into account. The effect of changing the CT number range for AT on the total AT volume was investigated. The lower limits for CT number for pure subcutaneous AT, retroperitoneal AT, and visceral AT were 140, 140, and 130 HU, respectively. the corresponding upper limits were -70, -71,and -52 HU. the CT number range for at using three methods when considering partial volume averaging was -144 to -141 HU to -30 to -33 HU, show ing similar values between the three methods. The optimal ing similar values between the three methods. the optimal CT number range for AT based on these data was -140 to -30 HU. increases in total AT volume of 7.5% and 1.8 were found when the upper or lower limit was extended using 10 HU intervals, respectively, compared with the reference range of -140 to -30 HU. This study demonstrated that the optimal CT number range of AT that the optimal CT number range of at that is applicable to modern PET/CT systems can be defined as -140 to -30 HU. The use of this CT number range of AT allowed lean body mass to be determined in whole body F 18 FDG PET/CT studies

  3. Correlation of F-18 FDG PET with morphometric tumor response after neoadjuvant chemoradiation in locally advanced (stage III) non-small cell lung cancer (NSCLC)

    Aim: To determine the role of 2-[(18)F] fluoro-2- deoxy-D-glucose (FDG) positron emission tomography (PET) in morphometric tumor response after neoadjuvant chemoradiation, findings in 32 patients were analyzed prospectively in an ongoing multicenter trial (LUCAS-MD, Germany). Material and Methods: Inclusion criteria was histologically confirmed NSCLC stage IIIA/IIIB. For staging all patients received a PET scan in addition to a spiral CT and/or MRI before therapy. Neoadjuvant treatment consisted of 2-3 cycles of chemotherapy with paclitaxel (225 mg/m2) and carboplatin (AUC 6), each d1 q22 and a block of chemoradiation (45Gy, 1.5Gy b.i.d., concomitant with paclitaxel (50 mg/m2) and carboplatin (AUC = 2), each d1, d8, d15) followed by surgery. All patients received a second PET after completion of neoadjuvant therapy prior to surgery. Whole-body PET (ECAT Exact 47) studies (attenuation corrected, iteratively reconstructed) were obtained 60 min. after injection of 6 MBq/kg body weight F-18 FDG. For semi-quantitative analysis, the tumor standardized uptake values (SUV), the tumor to background SUV ratio (T/B ratio), the metabolic tumor diameter (MTD) and the metabolic tumor index (MTI = SUV x MTD) were assessed in all primary tumors and in metastatic lymph nodes. Additionally, image fusion of PET with CT data was applied (using a HERMES Computer, Nuclear Diagnostics, Sweden). Results: So far, all patients (7/32) with complete metabolic response in lymph node metastases detected by PET, had no vital tumor cells (morphometric regression grade III). In primary tumors showing complete metabolic response, the regression grade was IIB (less than 10% vital tumor cells) or III. Conclusion: Morphometric tumor response after neoadjuvant therapy correlates strongly with metabolic remission by FDG-PET. PET precedes the tumor response as measured by CT after neoadjuvant treatment and may predict the long term therapeutic outcome in stage III NSCLC

  4. Impact of 4D-18FDG-PET/CT imaging on target volume delineation in SBRT patients with central versus peripheral lung tumors. Multi-reader comparative study

    Purpose: Evaluation of the effect of co-registered 4D-18FDG-PET/CT for SBRT target delineation in patients with central versus peripheral lung tumors. Methods: Analysis of internal target volume (ITV) delineation of central and peripheral lung lesions in 21 SBRT-patients. Manual delineation was performed by 4 observers in 2 contouring phases: on respiratory gated 4DCT with diagnostic 3DPET available aside (CT-ITV) and on co-registered 4DPET/CT (PET/CT-ITV). Comparative analysis of volumes and inter-reader agreement. Results: 11 cases of peripheral and 10 central lesions were evaluated. In peripheral lesions, average CT-ITV was 6.2 cm3 and PET/CT-ITV 8.6 cm3, resembling a mean change in hypothetical radius of 2 mm. For both CT-ITVs and PET/CT-ITVs inter reader agreement was good and unchanged (0.733 and 0.716; p = 0.58). All PET/CT-ITVs stayed within the PTVs derived from CT-ITVs. In central lesions, average CT-ITVs were 42.1 cm3, PET/CT-ITVs 44.2 cm3, without significant overall volume changes. Inter-reader agreement improved significantly (0.665 and 0.750; p < 0.05). 2/10 PET/CT-ITVs exceeded the PTVs derived from CT-ITVs by >1 ml in average for all observers. Conclusion: The addition of co-registered 4DPET data to 4DCT based target volume delineation for SBRT of centrally located lung tumors increases the inter-observer agreement and may help to avoid geographic misses

  5. Metabolic tumor volume measured by F 18 FDG PET/CT can further stratify the prognosis of patients with stage IV Non Small Cell Lung Cancer

    This study aimed to further stratify prognostic factors in patients with stage IV non small cell lung cancer (NSCLC) by measuring their metabolic tumor volume (MTV) using F 18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). The subjects of this retrospective study were 57 patients with stage IV NSCLC. MTV, total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) were measured on F 18 FDG PET/CT in both the primary lung lesion as well as metastatic lesions in torso. Optimal cutoff values of PET parameters were mea measured by receiver operating characteristic (ROC) curve anal analysis. Kaplan Meier survival (PET). The univariate and multivariate cox proportional hazards models were used to select the significant prognostic factors. Univariate analysis showed that both MTV and TLG of primary lung lesion (MTV lung and TLG lung) were significant factors for prediction of PFS ( <0.001 =0.038, respectively). Patients showing lower values of MTV lung and TLG lung than the cutoff values had significantly longer mean PFS than those with higher values. hazard ratios (95% confidence interval) of MTV lung and TLG lung measured by univariate analysis were 6.4 (2.5 16.3) and 2.4 (1.0 5.5), respectively. multivariate analysis revealed that MTV lung was the only significant factor for prediction of prognosis. Hazard ratio was 13,5 (1.6 111.1, =0,016). patients with stage IV NSCLC could be further stratified into subgroups of significantly better and worse prognosis by MTV of primary lung lesion

  6. Optimizing the interval between G-CSF therapy and F-18 FDG PET imaging in children and young adults receiving chemotherapy for sarcoma

    Granulocyte colony-stimulating factors (G-CSF) speed recovery from chemotherapy-induced myelosuppression but the marrow stimulation they cause can interfere with interpretation of F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) exams. To assess the frequency of interfering G-CSF-induced bone marrow activity on FDG PET imaging in children and young adults with Ewing sarcoma and rhabdomyosarcoma and to define an interval between G-CSF administration and FDG PET imaging that limits marrow interference. Blinded, retrospective review of FDG PET exams performed in patients treated with long-acting G-CSF as part of their chemotherapeutic regimen. Exams were subjectively scored by two reviewers (R1 and R2) who assessed the level of marrow uptake of FDG and measured standardized uptake values in the marrow, liver, spleen and blood pool. FDG PET findings were correlated with time since G-CSF administration and with blood cell counts. Thirty-eight FDG PET exams performed in 17 patients were reviewed with 47.4% (18/38) of exams having marrow uptake of FDG sufficient to interfere with image interpretation. Primary predictors of marrow uptake of FDG were patient age (P = 0.0037) and time since G-CSF exposure (P = 0.0028 for subjective marrow uptake of FDG, P = 0.008 [R1] and P = 0.004 [R2] for measured maximum standardized uptake value (SUVmax)). The median interval between G-CSF administration and PET imaging in cases with marrow activity considered normal or not likely to interfere was 19.5 days (range: 7-55 days). In pediatric and young adult patients with Ewing sarcoma and rhabdomyosarcoma, an interval of 20 days between administration of the long-acting form of G-CSF and FDG PET imaging should limit interference by stimulated marrow. (orig.)

  7. 18FDG-PET in 733 consecutive patients with or without side-by-side CT evaluation. Analysis of 921 lesions

    Side-by-side analysis of CT and conventional 18FDG-PET in oncological imaging is well established. Aim of this study was to find out which patients or diagnostic groups may benefit the most from the newly introduced integrated PET/CT scanners. Patients, methods: 407 consecutively admitted oncological patients with accompanying CT (groups A-D) and 326 patients without CT (groups E-G) were examined by conventional ring PET. Two nuclear medicine physicians and two radiologists assessed each patient's PET and CT scans for pathological lesions with regard to localisation and infiltration of adjacent anatomical structures. Patients without pathological PET findings were assigned to groups A (with CT) or E (without CT). If the localisation and/or extent of a pathological PET focus could only be assessed by taking into account the CT scan, the patient was assigned to group C (with CT) or G (without CT). If PET alone was sufficient for both questions the patient was assigned to groups B (with CT) or F (without CT). If neither method allowed for a precise lesion characterisation, the patient was assigned to group D. Results: 38.6% (A, E) of all patients were PET-negative. PET alone sufficed in 20.6% (B, F). Side-by-side reading of PET and CT was needed for 43.5% (C) of patients referred to PET with a current CT. Side-by-side reading of CT and PET did not suffice for 7.3% (D) of patients in that cohort. A total of 28.2% (G) of the cases without CT would have profited from it. The most frequent oncological diagnoses in group D (PET and conventional CT not sufficient) were bronchial carcinoma with abdominal lesions, while in group G (without CT but CT required) head/neck cancer with thoracic lesions was predominant. Conclusions: Side-by-side reading of PET and already existing conventional CT failed to yield conclusive data with regard to lesion characterisation in only 7.4% of patients so that PET/CT might have been helpful in these cases. 28.2% of the patients without current

  8. The Clinical Value of Dual Time Point F-18 FDG PET/CT Imaging for the Differentiation of Colonic Focal Uptake Lesions

    F-18 FDG can be accumulated in the liver, bowel, kidney, urinary tract, and muscles physiologically. The aim of this study was to evaluate the clinical value of dual time point 18F-FDG PET/CT imaging for the differentiation of the colonic focal uptake lesions. One hundred thirty two patients (M:F=77:55, Age 62.8±11.6 years) underwent 18F-FDG PET/CT at two time points, prospectively: early image at 50-60 min and delayed image at 4-4.5 hours after the intravenous injection of 18F-FDG. Focally increased uptake lesions on early images but disappeared or shifted on delayed images defined a physiological uptake. For the differential evaluation of persistent focal uptake lesions on delayed images, colonoscopy and histopathologic examination were performed. SUVmax changes between early and delayed images were also compared. Among the 132 patients, 153 lesions of focal colonic uptake were detected on early images of 18F-FDG PET/CT. Of these, 72 (47.1%) lesions were able to judge with physiological uptake because the focal increased uptake disappeared from delayed image. Among 81 lesions which was showed persistent increased uptake in delayed image, 61 (75.3%) lesions were confirmed as the malignant tumor and 14 (17.3%) lesions were confirmed as the benign lesions including adenoma and inflammatory disease. Remaining 6 (7.4%) lesions were confirmed as the physiological uptake because there was no particular lesion in the colonoscopy. In the malignant lesions, the calculated dual time point change for SUVmax (Δ%SUVmax) was 20.8%±18.7%, indicating a significant increase in SUVmax between the two point (p<0.01). In contrast, the change in SUVmax for the non-malignant lesions including benign lesions and physiological uptake was -13.7%±24.2%. For the differentiation of the malignant and non-malignant focal colonic uptake lesions, Δ%SUVmax was the most effective parameter, and the cut-off value using -5% provided the best sensitivity, specificity, and accuracy. The dual time

  9. The Clinical Value of Dual Time Point F-18 FDG PET/CT Imaging for the Differentiation of Colonic Focal Uptake Lesions

    Kim, Jin Suk; Lim, Seok Tae; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Sohn, Myung Hee [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2009-08-15

    F-18 FDG can be accumulated in the liver, bowel, kidney, urinary tract, and muscles physiologically. The aim of this study was to evaluate the clinical value of dual time point 18F-FDG PET/CT imaging for the differentiation of the colonic focal uptake lesions. One hundred thirty two patients (M:F=77:55, Age 62.8{+-}11.6 years) underwent {sup 18}F-FDG PET/CT at two time points, prospectively: early image at 50-60 min and delayed image at 4-4.5 hours after the intravenous injection of {sup 18}F-FDG. Focally increased uptake lesions on early images but disappeared or shifted on delayed images defined a physiological uptake. For the differential evaluation of persistent focal uptake lesions on delayed images, colonoscopy and histopathologic examination were performed. SUVmax changes between early and delayed images were also compared. Among the 132 patients, 153 lesions of focal colonic uptake were detected on early images of {sup 18}F-FDG PET/CT. Of these, 72 (47.1%) lesions were able to judge with physiological uptake because the focal increased uptake disappeared from delayed image. Among 81 lesions which was showed persistent increased uptake in delayed image, 61 (75.3%) lesions were confirmed as the malignant tumor and 14 (17.3%) lesions were confirmed as the benign lesions including adenoma and inflammatory disease. Remaining 6 (7.4%) lesions were confirmed as the physiological uptake because there was no particular lesion in the colonoscopy. In the malignant lesions, the calculated dual time point change for SUVmax ({delta}%SUVmax) was 20.8%{+-}18.7%, indicating a significant increase in SUVmax between the two point (p<0.01). In contrast, the change in SUVmax for the non-malignant lesions including benign lesions and physiological uptake was -13.7%{+-}24.2%. For the differentiation of the malignant and non-malignant focal colonic uptake lesions, {delta}%SUVmax was the most effective parameter, and the cut-off value using -5% provided the best sensitivity

  10. ''Ecstasy''-induced changes of cerebral glucose metabolism and their correlation to acute psychopathology. A 18-FDG PET study

    Schreckenberger, M.; Sabri, O.; Arning, C.; Zimny, M.; Zeggel, T.; Wagenknecht, G.; Kaiser, H.J.; Buell, U. [Technische Hochschule Aachen (Germany). Klinik fuer Nuklearmedizin; Gouzoulis-Mayfrank, E.; Sass, H. [Technische Hochschule Aachen (Germany). Dept. of Psychiatry

    1999-12-01

    The aim of this study was to determine the acute effects of the 'Ecstasy' analogue MDE (3,4-methylene dioxyethamphetamine) on cerebral glucose metabolism (rMRGlu) of healthy volunteers and to correlate neurometabolism with acute psychopathology. In a radomized double-blind trial, 15 healthy volunteers without a history of drug abuse were examined with fluorine-18-deoxyglucose ({sup 18}FDG) positron emission tomography (PET) 110-120 min after oral administration of 2 mg/kg MDE (n=7) or placebo (n=8). Two minutes prior to radiotracer injection, constant cognitive stimulation was started and maintained for 32 min using a word repetition paradigm to ensure constant and comparable mental conditions during cerebral glucose uptake. Individual brain anatomy was represented using T1-weighted 3D flash magnetic resonance imaging (MRI), followed by manual regionalization into 108 regions of interest and PET/MRI overlay. After absolute quantification of rMR-Glu and normalization to global metabolism, normalized rMRGlu under MDE was compared to placebo using the Mann-Whitney U-test. Acute psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS) and rMRGlu was correlated to PANSS scores according to Spearman. MDE subjects showed significantly decreased rMRGlu in the bilateral frontal cortex: left frontal posterior (-7.1%, P<0.05) and right prefrontal superior (-4.6%, P<0.05). On the other hand, rMR-Glu was significantly increased in the bilateral cerebellum (right: +10.1%, P<0.05; left: +7.6%, P<0.05) and in the right putamen (+6.2%, P<0.05). There were positive correlations between rMRGlu in the middle right cingulate and grandiosity (r=0.87; P<0.05), both the right amygadala (r=0.90, P<0.01) and the left posterior cingulate (r=0.90, P<0.01) to difficulties in abstract thinking, and the right frontal inferior (r=0.85, P<0.05), right anterior cingulate (r=0.93, P<0.01), and left anterior cingulate (r=0.85, P<0.05) to attentional deficits. A

  11. Urinary bladder carcinoma associated with Paget's disease of skull: Imaging findings on Tc99m-MDP bone scintigraphy, F18-Fluoride PET/CT and F18-FDG PET/CT

    Chakraborty, Dhritiman; Mittal, Bhagwant Rai; Kamaleshwaran, Koramadai Karuppuswamy; Kashyap, Raghava; Bhattacharya, Anish; Kumar, Santosh

    2011-01-01

    We report the imaging findings of a patient with Paget's disease in metastatic carcinoma bladder evaluated by Tc99m-Methylene diphosphonate (MDP) bone scintigraphy, F18-Fluoride positron emission tomography/computed tomography (PET/CT) and F18-fluorodeoxy glucose (FDG) PET/CT. Tc99m-MDP bone scan showed intense uptake in the skull bones without any other abnormal tracer distribution. F18-Fluoride PET/CT revealed intense uptake in the pelvic bones along with skull bones, but F18-FDG PET/CT sho...

  12. The usefulness of F-18 FDG PET/CT-mammography for preoperative staging of breast cancer: comparison with conventional PET/CT and MR-mammography

    The objective of the study was to compare the diagnostic efficacy of an integrated Fluorine-18 fluorodeoxyglucose (F-18 FDG) PET/CT-mammography (mammo-PET/CT) with conventional torso PET/CT (supine-PET/CT) and MR-mammography for initial assessment of breast cancer patients. Forty women (52.0 ± 12.0 years) with breast cancer who underwent supine-PET/CT, mammo-PET/CT, and MR-mammography from April 2009 to August 2009 were enrolled in the study. We compared the size of the tumour, tumour to chest wall distance, tumour to skin distance, volume of axillary fossa, and number of meta-static axillary lymph nodes between supine-PET/CT and mammo-PET/CT. Next, we assessed the difference of focality of primary breast tumour and tumour size in mammo-PET/CT and MR-mammography. Histopathologic findings served as the standard of reference. In the comparison between supine-PET/CT and mammo-PET/CT, significant differences were found in the tumour size (supine-PET/CT: 1.3 ± 0.6 cm, mammo-PET/CT: 1.5 ± 0.6 cm, p < 0.001), tumour to thoracic wall distance (1.8 ± 0.9 cm, 2.2 ± 2.1 cm, p < 0.001), and tumour to skin distance (1.5 ± 0.8 cm, 2.1 ± 1.4 cm, p < 0.001). The volume of axillary fossa was significantly wider in mammo-PET/CT than supine-PET/CT (21.7 ± 8.7 cm3vs. 23.4 ± 10.4 cm3, p = 0.03). Mammo-PET/CT provided more correct definition of the T-stage of the primary tumour than did supine-PET/CT (72.5% vs. 67.5%). No significant difference was found in the number of metastatic axillary lymph nodes. Compared with MR-mammography, mammo-PET/CT provided more correct classification of the focality of lesion than did MR-mammography (95% vs. 90%). In the T-stage, 72.5% of cases with mammo-PET/CT and 70% of cases with MR-mammography showed correspondence with pathologic results. Mammo-PET/CT provided more correct definition of the T-stage and evaluation of axillary fossa may also be delineated more clearly than with supine-PET/CT. The initial assessment of mammo-PET/CT would be

  13. [Role of 18FDG-PET/CT in the management and gross tumor volume definition for radiotherapy of head and neck cancer; single institution experiences based on long-term follow-up].

    Hideghéty, Katalin; Cserháti, Adrienne; Besenyi, Zsuzsanna; Zag, Levente; Gaál, Szilvia; Együd, Zsófia; Mózes, Petra; Szántó, Erika; Csenki, Melinda; Rusz, Orsolya; Varga, Zoltán; Dobi, Ágnes; Maráz, Anikó; Pávics, László; Lengyel, Zsolt

    2015-06-01

    The purpose of our work is evaluation of the impact of 18FDG-PET/CT on the complex management of locoregionally advanced (T3-4N1-3) head and neck squamous cell cancer (LAHNSC), and on the target definition for 3D conformal (3DCRT) and intensity-modulated radiotherapy (IMRT). 18FDG-PET/CT were performed on 185 patients with LAHNSC prior to radiotherapy/chemoradiation in the treatment position between 2006 and 2011. Prior to it 91 patients received induction chemotherapy (in 20 cases of these, baseline PET/CT was also available). The independently delineated CT-based gross tumor volume (GTVct) and PET/CT based ones (GTVpet) were compared. Impact of PET/CT on the treatment strategy, on tumor response evaluation to ICT, on GTV definition furthermore on overall and disease-specific survival (OS, DSS) was analysed. PET/CT revealed 10 head and neck, 2 lung cancers for 15 patients with carcinoma of unknown primary (CUP) while 3 remained unknown. Second tumors were detected in 8 (4.4%), distant metastasis in 15 (8.2%) cases. The difference between GTVct and GTVpet was significant (p=0.001). In 16 patients (14%) the GTVpet were larger than GTVct due to multifocal manifestations in the laryngo-pharyngeal regions (4 cases) or lymph node metastases (12 cases). In the majority of the cases (82 pts, 72%) PET/CT-based conturing resulted in remarkable decrease in the volume (15-20%: 4 cases, 20-50%: 46 cases, >50%: 32 cases). On the basis of the initial and post-ICT PET/CT comparison in 15/20 patients more than 50% volume reduction and in 6/20 cases complete response were achieved. After an average of 6.4 years of follow-up the OS (median: 18.3±2.6 months) and DSS (median: 25.0±4.0 months) exhibited close correlation (p=0.0001) to the GTVpet. In cases with GTVpet 40 cm3 the median DSS was 8.4±0.96 months (HR= 11.48; 95% CI: 5.3-24.9). Our results suggest that 18FDG-PET/CT plays an important role for patient with LAHNSC, by modifying the treatment concept and improving the target

  14. Long-Term Survival, Toxicity Profile, and role of F-18 FDG PET/CT scan in Patients with Progressive Neuroendocrine Tumors Following Peptide Receptor Radionuclide Therapy with High Activity In-111 Pentetreotide

    Ebrahim S. Delpassand, Amin Samarghandi, Jennifer Sims Mourtada, Sara Zamanian, Gregory D. Espenan, Roozbeh Sharif, Shawn MacKenzie, Kambiz Kosari, Omar Barakat, Shagufta Naqvi, John E. Seng, Lowell Anthony

    2012-01-01

    Full Text Available Aim: To study the long term benefits, toxicity and survival rate in patients with neuroendocrine tumors receiving multiple cycles of high activity In-111 Pentetreotide therapy. Moreover, our secondary aim was to evaluate the value of F-18 FDG PET-CT scan as prognostic indicator in this group of patients.Background: Neuroendocrine tumors are a heterogeneous group of malignancies which are usually metastatic at diagnosis. Standard chemotherapy in these patients is associated with appreciable adverse events and low effectiveness. Since 1990s, Peptide receptor radionuclide therapy (PRRT with radio-labeled somatostatin analogues has been introduced as a new method of treatment in patients with unresectable and/or metastatic neuroendocrine tumors expressing high levels of Somatostatin receptors.Methods: 112 patients with progressive disseminated and unresectable neuroendocrine tumor (stage III and stage IV were enrolled in a non-randomized trial in an out-patient setting. High activity In-111 Pentetreotide (500 mCi (18.5 GBq per cycle was administered as an intravenous infusion over 3 hours and repeated therapy cycles every 9-12 weeks in eligible patients up to maximum of 4 cycles. Response to therapy was evaluated by clinical imaging using the RECIST criteria, metabolic criteria and patient's quality of life questionnaire. Dosimetry and biodistribution studies were also performed. Finally, Kaplan-Meier survival analysis was performed for patients followed for greater than 12 months. The relationship between pretreatment F-18 FDG PET-CT scan status and survival was determined by two-tailed Student's t-test in 42 patients who underwent pre-therapy PET scans.Results: For an average of 25 (median 18.65 months following the therapy, patients were evaluated for any evidence of toxicity. No significant acute toxicity was observed in patients. Grade II or III hematological toxicity (7.6% of patients, liver toxicity (18.4% and also grade I renal toxicity (6

  15. Double tracer / double isotope gives Ga-68 dota-noc and F-18 FDG PET / CT. Protocol 1 day in a child with neuroblastoma to determine the clinical state and tumor metabolic state

    We report on a 6-year-old carrier of a neuroblastoma. The tumor was diagnosed in March 2004, under the right adrenal gland and confirmed by FNAB, ultrasound, CT and tumor markers. Because of its size and extent of the tumor was inoperable at the time due to which was subject to two cycles of chemotherapy (vincristine, cisplatin, etoposide and cyclophosphamide alternating with vincristine, carboplatin, etoposide and cyclophosphamide). After these two cycles of chemotherapy the patient underwent retroperitoneal surgery getting totally dry right adrenal gland and tumor. After surgery the patient received four additional cycles of chemotherapy until March 2005. During the months of August and September 2005 the patient complained of abdominal pain and were suspected of recurrence. She received ultrasound and CT scan were not conclusive. In December 2005 he made a scan with I-131-MIBG (148 MBq, 4 mCi intravenous, is flat and SPECT imaging performed 24 hours to 6 days after injection) showing only the normal left adrenal gland but not recurrence was visualized, which showed that the tumor did not grasp MIBG. In January 2006 the boy (121 cm.'s Height, weight 21 kg) was referred to the Centre for PET / CT of the Bad Berka Central Clinic in Germany for a PET / CT using Ga-68/DOTA- receptor NOC, a high affinity analogue of somatostatin. The tumor marker NSE was determined in serum before the PET / CT whose outcome was high (24.8 ng / ml, cutoff 15). The patient received 46 MBq (1.24 mCi) of Ga-68 DOTA-NOC intravenous and PET / CT whole body was performed at 75 minutes post-injection. No abnormal uptake was observed which indicated that the appellants had no somatostatin receptors. By having this negative result was decided to perform an additional PET / CT with F-18 FDG (with a low dose of contrast to improve the TAC). After fasting for 6 hours, the patient received 151 MBq (4.1 mCi) of F-18 FDG. A PET / CT whole body was performed at 75 minutes after administration of

  16. Dual tracer/dual isotope Ga-68 DOTA-NOC and F-18 FDG PET/CT - A one day protocol in a child with neuroblastoma for determining the receptor status and the metabolic tumor state

    We report on a 6-year-old boy with a history of neuroblastoma. The tumor was first diagnosed in March 2004, arising from the right adrenal gland as confirmed by fine needle aspiration biopsy, ultrasound, CT scan as well as tumor markers. Due to the size and extension, the tumor was inoperable at this time and two cycles of chemotherapy (vincristin, cisplatin, etopoxid and cyclophosphamid alternating with vincristin, carboplatin, etopoxid and cyclophosphamid) were given. Then, the patient underwent retroperitoneal surgery and the right adrenal gland and the tumor were completely resected. After the operation, the patient received 4 additional cycles of chemotherapy until March 2005. During August and September 2005 the patient complained about abdominal pain and recurrence was suspected. Ultrasound and CT scan were repeatedly performed, but were unclear. In December 2005, a 1-131 MIBG scan (148 MBq, 4 mCi iv, planar images and SPECT from 24 hrs until 6 d p.i.) revealed only a normal left adrenal gland but no recurrence, proving that the tumor had no MIBG uptake. In January 2006 the child (121 cm height, weight 21 kg) was submitted to the PET/CT Center of the Zentralklinic Bad Berka, Germany for receptor PET/CT using Ga-68/DOTA-NOC, a high affinity pansomatostatin analogue. NSE was determined in serum prior to the PET/CT study and was elevated (24.8 ng/ml, cutoff 15). The patient received 46 MBq (1.24 mC) Ga-68 DOTA-NOC i.v. and a wholebody PET/CT was performed 75 min. p.i.. There was no abnormal uptake proving that the recurrence had no somatostatin receptors. After this negative result it was decided to perform additionally a F-18 FDG PET/CT study (with contrast enhanced low dose CT scan). After a fasting time of 6 hours, the patient received 151 MBq (4.1 mCi) F-18 FDG. Whole-body PET/CT was performed 75 min. p.1. and a recurrence was clearly depicted as hypermetabolic tumor (SUVmax. 8.1, molecular tumor volume (MTV) 15,2 cm3, 27 x 27 x 40 mm in diameter

  17. SU-D-9A-02: Relative Effects of Threshold Choice and Spatial Resolution Modeling On SUV and Volume Quantification in F18-FDG PET Imaging of Anal Cancer Patients

    Purpose: PET imaging with F18-FDG is utilized for treatment planning, treatment assessment, and prognosis. A region of interest (ROI) encompassing the tumor may be determined on the PET image, often by a threshold T on the PET standard uptake values (SUVs). Several studies have shown prognostic value for relevant ROI properties including maximum SUV value (SUVmax), metabolic tumor volume (MTV), and total glycolytic activity (TGA). The choice of threshold T may affect mean SUV value (SUVmean), MTV, and TGA. Recently spatial resolution modeling (SRM) has been introduced on many PET systems. SRM may also affect these ROI properties. The purpose of this work is to investigate the relative influence of SRM and threshold choice T on SUVmean, MTV, TGA, and SUVmax. Methods: For 9 anal cancer patients, 18F-FDG PET scans were performed prior to treatment. PET images were reconstructed by 2 iterations of Ordered Subsets Expectation Maximization (OSEM), with and without SRM. ROI contours were generated by 5 different SUV threshold values T: 2.5, 3.0, 30%, 40%, and 50% of SUVmax. Paired-samples t tests were used to compare SUVmean, MTV, and TGA (a) for SRM on versus off and (b) between each pair of threshold values T. SUVmax was also compared for SRM on versus off. Results: For almost all (57/60) comparisons of 2 different threshold values, SUVmean, MTV, and TGA showed statistically significant variation. For comparison of SRM on versus off, there were no statistically significant changes in SUVmax and TGA, but there were statistically significant changes in MTV for T=2.5 and T=3.0 and in SUVmean for all T. Conclusion: The near-universal statistical significance of threshold choice T suggests that, regarding harmonization across sites, threshold choice may be a greater concern than choice of SRM. However, broader study is warranted, e.g. other iterations of OSEM should be considered

  18. TO STORES USERS

    SPL Division

    2001-01-01

    Stores users are informed that the Stores (Central, Emergency window, Raw materials, Chemical products and Prévessin Self service stores) will be closed on Friday, 7 December owing to migration of the Stores computers to Windows 2000. Thank you for your understanding.

  19. 18FDG, [18F]FLT, [18F]FAZA, and 11C-Methionine Are Suitable Tracers for the Diagnosis and In Vivo Follow-Up of the Efficacy of Chemotherapy by miniPET in Both Multidrug Resistant and Sensitive Human Gynecologic Tumor Xenografts

    György Trencsényi

    2014-01-01

    Full Text Available Expression of multidrug pumps including P-glycoprotein (MDR1, ABCB1 in the plasma membrane of tumor cells often results in decreased intracellular accumulation of anticancer drugs causing serious impediment to successful chemotherapy. It has been shown earlier that combined treatment with UIC2 anti-Pgp monoclonal antibody (mAb and cyclosporine A (CSA is an effective way of blocking Pgp function. In the present work we investigated the suitability of four PET tumor diagnostic radiotracers including 2-[18F]fluoro-2-deoxy-D-glucose (18FDG, 11C-methionine, 3′-deoxy-3′-[18F]fluorothymidine (18F-FLT, and [18F]fluoroazomycin-arabinofuranoside (18FAZA for in vivo follow-up of the efficacy of chemotherapy in both Pgp positive (Pgp+ and negative (Pgp− human tumor xenograft pairs raised in CB-17 SCID mice. Pgp+ and Pgp− A2780AD/A2780 human ovarian carcinoma and KB-V1/KB-3-1 human epidermoid adenocarcinoma tumor xenografts were used to study the effect of the treatment with an anticancer drug doxorubicin combined with UIC2 and CSA. The combined treatment resulted in a significant decrease of both the tumor size and the accumulation of the tumor diagnostic tracers in the Pgp+ tumors. Our results demonstrate that 18FDG, 18F-FLT, 18FAZA, and 11C-methionine are suitable PET tracers for the diagnosis and in vivo follow-up of the efficacy of tumor chemotherapy in both Pgp+ and Pgp− human tumor xenografts by miniPET.

  20. Positioning of Store Brands

    Serdar Sayman; Hoch, Stephen J; Jagmohan S. Raju

    2002-01-01

    We examine the retailer's store brand positioning problem. Our game-theoretic model helps us identify a set of conditions under which the optimal strategy for the retailer is to position the store brand as close as possible to the stronger national brand. In three empirical studies, we examined whether market data are consistent with some of the implications of our model. In the first study, using observational data from two US supermarket chains, we found that store brands are more likely to...

  1. Hybrid data storing system

    A method for improving the efficiency of data storing systems has been proposed in the paper. It has been also proposed to consider the inquiry processing model in terms of queuing theory. Criteria of the efficiency of the data storing systems have been presented

  2. Information for stores users

    2007-01-01

    From next week, the SFS UNIMARKET (tooling) catalogue will be accessible using the Material Request form on EDH in addition to the CERN Stores catalogue and those of existing suppliers. Users will now be able to place orders from the SFS catalogue using the Material Request form on EDH. Note: The system automatically forwards orders for standard Stores equipment and those for SFS equipment, placed using the same Material Request form, to the CERN Stores and SFS respectively. In both cases, the maximum delivery time will be 48 hours. Requests for equipment will be routed for approval in accordance with standard EDH routing procedures. Logistics Group FI Department

  3. INFORMATION FOR STORES USERS

    2007-01-01

    From next week, the SFS UNIMARKET (tooling) catalogue will be accessible using the Material Request form on EDH in addition to the CERN Stores catalogue and those of existing suppliers. Users will now be able to place orders from the SFS catalogue using the Material Request form on EDH. Note: The system automatically forwards orders for standard Stores equipment and those for SFS equipment, placed using the same Material Request form, to the CERN Stores and SFS respectively. In both cases, the maximum delivery time will be 48 hours. Requests for equipment will be routed for approval in accordance with standard EDH routing procedures. Logistics Group FI Department

  4. INFORMATION FOR STORES USERS

    SPL Division

    1999-01-01

    You can now make Material Request from CERN Stores over the WEB :CERN Home/Administrative Tools/EDH/Material Requestor https://edh.cern.ch/Document/MAGVia the Stores Catalogue : CERN Home/Administrative Tools/Stores Catalogueor http://edhcat.cern.ch/In both cases, you need to enter your EDH login and password.For more details, you can consult the Quick Reference Guide on :http://edh.cern.ch/doc/quickrefguides.htmlor obtain a printed version from AIS Support at tel: 79933or e-mail to: ais.support@cern.chSPL DivisionLogistics Group

  5. Information for stores users

    2006-01-01

    The Bossard catalogue is now accessible alongside the CERN Stores catalogue from the Material Request form on EDH. Users will thus be able to order Bossard equipment using the EDH Materials Request form. As a reminder, the system automatically forwards orders for standard Stores equipment to the CERN Stores and those for Bossard equipment to Bossard. In both cases the delivery time will be a maximum of 48 hours. Requests for materials will be routed for approval in accordance with the standard EDH routing procedures. Some items will remain available from the emergency desk in the event of urgent requests. These items will be visible in the Stores catalogue even if they cannot be purchased via the EDH material request form. Logistics Group FI Department

  6. Information for Stores users

    FI Department

    2008-01-01

    The DISTRELEC catalogue (IT) is now available in EDH in addition to the CERN Stores catalogue and the catalogues of existing suppliers. Using an EDH materials request form, users can now order DISTRELEC equipment from amongst the following product groups: peripherals, multimedia, PC components, data media, communication and data cables and adapters. Non-authorised materials will be clearly indicated. As a reminder, the system automatically manages the distribution of standard Stores equipment and punch out equipment ordered on the same request form. In both cases, delivery will take a maximum of 48 hours. The approval of the EDH document will follow the usual EDH routing procedures. Logistics Group FI Department

  7. Den store skandinaviske redningsaktion

    Christensen, Claus Bundgård

    2015-01-01

    Historikeren Bo Lidegaard fortæller flot den store historie om den forbløffende og komplicerede skandinaviske redning af fanger fra Hitlers koncentrationslejre. En historie, der samtidig berører alvorlige moralske spørgsmål.......Historikeren Bo Lidegaard fortæller flot den store historie om den forbløffende og komplicerede skandinaviske redning af fanger fra Hitlers koncentrationslejre. En historie, der samtidig berører alvorlige moralske spørgsmål....

  8. Store Lagre 5

    Åge, Jensen Niels; Leo, Holm; Mogens, Posvig; Brink, Clausen Jens; Heller, Alfred; Uffe, Nielsen; Flemming, Ulbjerg; Leif, Tambjerg; Alex, Sørensen Per

    1999-01-01

    A seasonal thermal storage, consisting of a pit store with gravel-sand fill and pipe heat exchanger is designed and conducted at the Central Solar Heating Plant in Marstal, Aeroe.The task, by DTU was to carrie out experiments to determine the heat transport from the polymer pipes to the storage...

  9. Information for stores users

    FI Department

    2008-01-01

    From the beginning of March onwards, the LYRECO (stationery) catalogue will be accessible from the Material Request form on EDH in the same way as the CERN Stores catalogue and the existing individual supplier catalogues. Items will be delivered within a maximum of 48 hours. Logistics Group FI Department

  10. Shopping in discount stores

    Zielke, Stephan

    2014-01-01

    quarters of intentions to shop in discount stores. Value perception has the strongest total effect, which is partly mediated by enjoyment, shame and guilt. Attributions influence the shopping intention indirectly via value perception and emotions. The inferior quality attribution has the strongest total...

  11. Relationships among Store Image and Store Loyalty in Slovenia

    Grah Miran; Tominc Polona

    2015-01-01

    Image has become one of the most important factors of stores’ survival and development. In this paper, a model of relationships among the multidimensional variables of store image, positive affect, satisfaction with the store, trust and commitment to the store is formed and tested with a sample of 209 customers in three stores in the Pomurje region of Slovenia. The important conclusion of the research is that several interrelations among store image, positive affect, satisfaction, trust and s...

  12. Store and forward teledermatology

    Kanthraj Garehatty

    2007-01-01

    Full Text Available Store and forward and real time or videoconferences are the two types of teledermatology services practiced. Dermatology and radio-diagnosis are visual specialties suited for store-and-forward teledermatology (SAFT. Advances in information technology, electronic instruments and biotechnology have revolutionized and brought changes in SAFT. Cellular phone, digital camera, personal digital assistants, Wi-Fi, Wi-Max and computer- aided-design software are incorporated to deliver the quality health care to remote geographic regions. Complete SAFT care equivalent to face-to-face consultation (Gold standard is essential. Health care providers in rural areas are the ′eyes′ for the consultants. Consultants to guide them should have a rapid periodic audit of visual parameters and dimensions of lesions. Given this background, this article reviews advances in 1 capture, store and transfer of images. 2 Computer Aided measurements of generalized and localized lesions and 3 the integration model to meet all the above two requirements in a centralized location. This process enables diagnosis, management, periodic assessment and complete follow-up care to achieve patient and physician satisfaction. Preservation of privacy and confidentiality of digital images is important. Uniform rules and regulations are required. Indian space research organization (ISRO, Government of India has demonstrated telemedicine pilot projects utilizing the satellite communication and mobile telemedicine units to be useful in meeting the health care needs of remote and rural India. we have to join hands with them to meet dermatology problems in rural areas.

  13. Cask storing facility

    The present invention provides a facility suitable to keeping and storing of casks for transporting and storing spent fuels generated from power plants and radioactive wastes generated from spent fuel reprocessing plants. Namely, the casks are transported in and out by a portal crane when they are stored. The cask storage space is disposed underground and soils are used as a portion of shielding materials. Then, a portal crane gives less load on the storage building when it is used compared with a case of using an overhead traveling crane. Since the storage pits are disposed underground, the radiation released from the casks in lateral and downward directions can be shielded by the soils. If shielding lids are disposed on the upper portion of the cask storage pits, upward radiation released from the casks can be shielded. Accordingly, there is no need to ensure thickness of walls of the building and ceilings for shielding. As a result, construction cost for the building can be reduced. (I.S.)

  14. Stored Luminescence Computed Tomography

    Cong, Wenxiang; Wang, Ge

    2013-01-01

    The phosphor nanoparticles made of doped semiconductors, pre-excited by well-collimated X-ray radiation, were recently reported for their light emission upon NIR light stimulation. The characteristics of X-ray energy storage and NIR stimulated emission is highly desirable to design targeting probes and improve molecular and cellular imaging. Here we propose stored luminescence computed tomography (SLCT), perform realistic numerical simulation, and demonstrate a much-improved spatial resolution in a preclinical research context. The future opportunities are also discussed along this direction.

  15. Store manager performance and satisfaction: effects on store employee performance and satisfaction, store customer satisfaction, and store customer spending growth.

    Netemeyer, Richard G; Maxham, James G; Lichtenstein, Donald R

    2010-05-01

    Based on emotional contagion theory and the value-profit chain literatures, the present study posits a number of hypotheses that show how managers in the small store, small number of employees retail context may affect store employees, customers, and potentially store performance. With data from 306 store managers, 1,615 store customer-contact employees, and 57,656 customers of a single retail chain, the authors examined relationships among store manager job satisfaction and job performance, store customer-contact employee job satisfaction and job performance, customer satisfaction with the retailer, and a customer-spending-based store performance metric (customer spending growth over a 2-year period). Via path analysis, several hypothesized direct and interaction relations among these constructs are supported. The results suggest implications for academic researchers and retail managers. PMID:20476831

  16. Queues, stores, and tableaux

    Draief, Moez; O'Connell, Neil

    2005-01-01

    Consider the single server queue with an infinite buffer and a FIFO discipline, either of type M/M/1 or Geom/Geom/1. Denote by A the arrival process and by s the services. Assume the stability condition to be satisfied. Denote by D the departure process in equilibrium and by r the time spent by the customers at the very back of the queue. We prove that (D,r) has the same law as (A,s) which is an extension of the classical Burke Theorem. In fact, r can be viewed as the departures from a dual storage model. This duality between the two models also appears when studying the transient behavior of a tandem by means of the RSK algorithm: the first and last row of the resulting semi-standard Young tableau are respectively the last instant of departure in the queue and the total number of departures in the store.

  17. Relationships among Store Image and Store Loyalty in Slovenia

    Grah Miran

    2015-12-01

    Full Text Available Image has become one of the most important factors of stores’ survival and development. In this paper, a model of relationships among the multidimensional variables of store image, positive affect, satisfaction with the store, trust and commitment to the store is formed and tested with a sample of 209 customers in three stores in the Pomurje region of Slovenia. The important conclusion of the research is that several interrelations among store image, positive affect, satisfaction, trust and store commitment exist. The results also show significant gender differences in perceptions of store image. These results provide several important insights for managing supermarkets in the Slovenian market and are also important for future research.

  18. Peritoneal Lymphomatosis Imaged by F-18 FDG PET/CT

    Park, Eun Kyung; Lee, Se Ryeon; Kim, Young Chul; Oh, Sun Young; Choe, Jae Gol [Korea University Anam Hospital, Seoul (Korea, Republic of)

    2010-06-15

    Peritoneal lymphomatosis is uncommon, but when encountered is associated with aggressive histological subtypes of high-grade lymphoma, such as small-cell, large-cell, mixed large and small cell, non-cleaved, lymphoblastic Burkitt-like, and diffuse large B-cell lymphomas. The CT findings of peritoneal lymphomatosis are linear or nodular peritoneal thickening, retroperitoneal lymphadenopathy, omental and mesenteric involvement with streak-like infiltrations or a bulky mass, bowel wall thickening, hepatosplenomegaly, and ascites. The authors reports report the first FDG PET/CT images of diffuse large B-cell lymphoma of small bowel origin associated with peritoneal lymphomatosis in a 69-year-old man. The lesions demonstrated intense FDG uptake in PET/CT images.

  19. Crossed cerebellar diaschisis on F-18 FDG PET/CT

    Diaschisis is the inhibition of function produced by focal disturbances in a portion of the brain at a distance from original site of injury. Many studies using brain SPECT (single-photon emission computed tomography) have demonstrated crossed cerebellar diaschisis (CCD) in patients with cerebral cortical infarct. We report a case of cerebrovascular accident involving the left middle cerebral artery territory. PET/CT performed one month after stroke showed hypometabolism in the left cerebral hemisphere with hypometabolism of the contralateral cerebellum. The finding of diminished glucose metabolism in the contralateral cerebellum represents CCD

  20. Peritoneal Lymphomatosis Imaged by F-18 FDG PET/CT

    Peritoneal lymphomatosis is uncommon, but when encountered is associated with aggressive histological subtypes of high-grade lymphoma, such as small-cell, large-cell, mixed large and small cell, non-cleaved, lymphoblastic Burkitt-like, and diffuse large B-cell lymphomas. The CT findings of peritoneal lymphomatosis are linear or nodular peritoneal thickening, retroperitoneal lymphadenopathy, omental and mesenteric involvement with streak-like infiltrations or a bulky mass, bowel wall thickening, hepatosplenomegaly, and ascites. The authors reports report the first FDG PET/CT images of diffuse large B-cell lymphoma of small bowel origin associated with peritoneal lymphomatosis in a 69-year-old man. The lesions demonstrated intense FDG uptake in PET/CT images.

  1. Gene expression and 18FDG uptake in atherosclerotic carotid plaques

    Pedersen, Sune Folke; Græbe, Martin; Hag, Anne Mette Fisker;

    2010-01-01

    PURPOSE: Metabolic assessment of vascular inflammation by 2-[F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG)-PET is a promising new approach for the evaluation of the vulnerability of atherosclerotic plaques. Quantitative real-time PCR allows measurement of gene expression of markers...... of atherosclerotic plaque vulnerability. These techniques were applied in advanced atherosclerotic disease to relate metabolism and inflammatory activity to the gene expression profile of the vulnerable atherosclerotic plaque. METHODS: Seventeen patients with clinical symptoms of cerebral vascular...... subsequently recovered by carotid endarterectomy. The gene expression of markers of vulnerability - CD68, IL-18, matrix metalloproteinase 9, cathepsin K, GLUT-1, and hexokinase type II (HK2) - were measured in plaques by quantitative PCR. RESULTS: In a multivariate linear regression model, GLUT-1, CD68...

  2. Pathologically proven benign chest lesion on F-18 FDG PET

    FDG PET is good diagnostic tool for oncologic staging work-up, but it has been reported that PET has a difficult in differential diagnosis between some benign diseases and malignancy. We would report benign lung lesion of FDG PET in our center based on pathologic findings. 107 cases of lung cancer which performed lung surgery and 2 cases of pneumoconiosis which performed PCNA were analyzed from Dec 1997 to Mar 2000. Obstructive pneumonitis were proven pathologically in seven cases and hypermetabolic area were seen where proven as obstructive pneumonitis in five of seven cases. Wedge shaped peripherally increased metabolic area with irregular hypermetabolism were seen in 4 of 5 cases. Collapse was proven in 4 cases and only in one case, faintly increased metabolic area was seen in PET where proven as collapse. Radiation fibrosis was proven in one case, which show hypermetabolism in pleural space limited to previous RT field and Empyema with lung cancer was proven in one case, which show increased metabolism in ipsilateral pleural space with focal hypermetabolism. Pulmonary tbc was proven in one case, which show hypermetabolic lesion with central necrosis. Pneumoconiosis were diagnosed in two cases, one of them was combined with lung cancer and the other case was combined with lung cancer and pulmonary tbc at the same time, showing difficult in distinguish scattered small hypermetabolic lesions by pneumoconiosis from metastasis of lung cancer or pulmonary tbc. FDG PET has a difficult in differential diagnosis between some benign disease and malignancy, and more variant and numerous case experience is expected to give help in improving of diagnostic efficiency

  3. 18FDG PET and ultrasound echolucency in carotid artery plaques

    Graebe, Martin; Pedersen, Sune F; Højgaard, Liselotte;

    2010-01-01

    ultrasound and PET imaging. Plaque standardized gray scale medians (GSM) were measured in longitudinal ultrasound images to quantitate echolucency, and GSM values were compared with FDG PET uptake quantified by maximum standardized uptake values (SUV). Symptomatic plaques were compared with contralateral...... carotid artery plaques considered asymptomatic, and in 17 symptomatic patients, endarterectomized plaque specimens were analyzed for CD68 expression. RESULTS: There was a negative correlation between GSM and FDG SUV (r = -0.56, p < 0.01). Whereas echo-rich plaques tended to show low FDG uptake, echolucent...... plaques ranged from high to low inflammatory activity, as depicted with PET. Quantitative FDG SUV differentiated asymptomatic from symptomatic plaques, whereas GSM values did not. There was a positive correlation between CD68 expression and FDG uptake (r = 0.50, p = 0.04). CONCLUSIONS: Our results...

  4. Evaluation of intrahepatic cholangiocarcinoma (CC) using F-18 FDG PET

    Surgical resection is the only curative treatment strategy and accurate staging is essential in patients with CC. We have assessed the usefulness of FDG PET in the diagnosis and staging of intrahepatic CC. We have undertaken a retrospective review of FDG PET images in 21 patients (F:M = 10:11, a mean age of 57) whose diagnosis of CC was mode by biopsy (10), surgery (5), or clinical follow up (6). 10 patients had hilar CC and 11 patients had peripheral CC. A lesion with FDG uptake more than the liver was considered malignant. Image analysis was based only on the lesions that were confirmed by histopathological specimen or clinical follow up. All peripheral CCs showed intensely increased FDG uptake. Hilar CCs demonstrated increased FDG uptake of focal nodular or linear branching appearance in 9 of the 10 patients. The remaining one was false negative. Among the 10 hilar CCs, FDG uptake was intense only in 3 patients and was slightly higher than the liver in the rest. The 3 patients with intense FDG uptake showed a mass forming type on CT or MR. For LN metastasis, FDG PET detected 3 more than CT or MR, but it missed 3 detected on CT or MR. FDG PET identified unsuspected distant metastases in 5 of the 21 patients. FDG PET is useful in detecting primary intrahepatic CCs and is of value in discovering unsuspected distant metastasis. Different from peripheral CC, FDG uptake of hilar CC tends to be low unless it is a mass forming type. The role of FDG PET appears complimentary to CT or MRI in the identification of LN metastasis

  5. Evaluation of intrahepatic cholangiocarcinoma (CC) using F-18 FDG PET

    Kim, Y. J.; Yun, M.; Kim, M. J.; Ryu, Y. H.; Lee, J. D [Yonsei University Medical Center, Seoul (Korea, Republic of)

    2002-07-01

    Surgical resection is the only curative treatment strategy and accurate staging is essential in patients with CC. We have assessed the usefulness of FDG PET in the diagnosis and staging of intrahepatic CC. We have undertaken a retrospective review of FDG PET images in 21 patients (F:M = 10:11, a mean age of 57) whose diagnosis of CC was mode by biopsy (10), surgery (5), or clinical follow up (6). 10 patients had hilar CC and 11 patients had peripheral CC. A lesion with FDG uptake more than the liver was considered malignant. Image analysis was based only on the lesions that were confirmed by histopathological specimen or clinical follow up. All peripheral CCs showed intensely increased FDG uptake. Hilar CCs demonstrated increased FDG uptake of focal nodular or linear branching appearance in 9 of the 10 patients. The remaining one was false negative. Among the 10 hilar CCs, FDG uptake was intense only in 3 patients and was slightly higher than the liver in the rest. The 3 patients with intense FDG uptake showed a mass forming type on CT or MR. For LN metastasis, FDG PET detected 3 more than CT or MR, but it missed 3 detected on CT or MR. FDG PET identified unsuspected distant metastases in 5 of the 21 patients. FDG PET is useful in detecting primary intrahepatic CCs and is of value in discovering unsuspected distant metastasis. Different from peripheral CC, FDG uptake of hilar CC tends to be low unless it is a mass forming type. The role of FDG PET appears complimentary to CT or MRI in the identification of LN metastasis.

  6. Electrically actuated multiple store launcher

    Marshall, Frank P.; Travor, Bruce W.

    1991-12-01

    This invention comprises a multi-store, electrical pulse initiated launcher that fits into, and is electrically connected with a transporting vehicle and that contains sequentially stacked assemblies. An electrical pulse from the transporting vehicle causes a resistor with the least value to transfer the electric sufficient gas pressure to force the store out of the launcher. The present invention discloses an electrically-actuated, multi-store dispenser wherein an initial electrical charge ignites gas cartridges causing sequential launching of stores from their tandem position inside a launch container. In some environments, it is desirable to dispense multiple stores from a launch vehicle, for instance sonobuoys, in dense patterns. Due to physical limitations of space in the dispensing vehicle, an effort was made to miniaturize the active components inside the store and therefore reduce the overall outer dimensions thereof. Once the size of the store was reduced, in order to meet the demands of the denser patterns, the inside of the individual launch containers were modified to allow each to hold and dispense more than one store. This new type of launch container, in addition to maintaining the size requirement dictated by the transporting vehicle, is operated by the vehicle's electrical system.

  7. Information from the central stores

    GS Department

    2010-01-01

    All items sold in the CERN shop (Bldg. 33) are now available in the central stores (Bldg. 73) and can be purchased on-line via EDH “Material Request” or at the “Emergency Desk” of the stores on the ground floor of Bldg. 73. These items are visible in the CERN catalogue under the “SCEM” codes beginning with 92. Department of General Infrastructure Services (GS) GS-SEM Group

  8. TruStore: Implementing a Trusted Store for Android

    Yury, Zhauniarovich; Olga, Gadyatskaya; Bruno, Crispo

    2013-01-01

    In the Android ecosystem, the process of verifying the integrity of downloaded apps is left to the user. Different from other systems, e.g., Apple, App Store, Google does not provide any certified vetting process for the Android apps. This choice has a lot of advantages but it is also the open door to possible attacks as the recent one shown by Bluebox. To address this issue, we present how to enable the deployment of application certification service, we called TruStores, for the Android pla...

  9. Stores, Weight and Inertial System Facility

    Federal Laboratory Consortium — This facility provides stores weight, center of gravity, and inertia measurements in support of weapon/aircraft compatibility testing. System provides store weight...

  10. Specialty Store and Multi-Brand Store loyalty: An Indian consumer perspective

    Sarabjot Singh; Piyush Kumar Sinha; Hari Govind Mishra

    2013-01-01

    In the competitive era of retailing, retailers need to understand the importance of store format preferences. The study aimed to understand consumer store loyalty; in-depth interview was conducted to examine consumer store loyalty antecedents for two retail formats: specialty stores and multi brand stores. The study conceptualizes store loyalty factors like program loyalty, trust and brand commitment. Trust and brand commitment act as mediating factors between store image and store loyalty f...