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  1. Analyza CSR v podniku

    OpenAIRE

    Kasl, Michael

    2015-01-01

    The Bachelor thesis deals with the analysis of corporate social responsibility (CSR) at PwC. The thesis is divided into theoretical and practical part. The theoretical part explains basic concepts concerning the corporate social responsibility, as well as the history of CSR and reasons for implementing it. The practical part of the thesis is focused on the PwC network, mainly on PwC Czech Republic. Mentioned CSR activities done by PwC CZ and international strategy are used for comparison and ...

  2. FDG PET imaging dementia

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Byeong Cheol [Kyungpook National University Medical School and Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2007-04-15

    Dementia is a major burden for many countries including South Korea, where life expectancy is continuously growing and the proportion of aged people is rapidly growing. Neurodegenerative disorders, such as, Alzheimer disease, dementia with Lewy bodies, frontotemporal dementia. Parkinson disease, progressive supranuclear palsy, corticobasal degeneration, Huntington disease, can cause dementia, and cerebrovascular disease also can cause dementia. Depression or hypothyroidism also can cause cognitive deficits, but they are reversible by management of underlying cause unlike the forementioned dementias. Therefore these are called pseudodementia. We are entering an era of dementia care that will be based upon the identification of potentially modifiable risk factors and early disease markers, and the application of new drugs postpone progression of dementias or target specific proteins that cause dementia. Efficient pharmacologic treatment of dementia needs not only to distinguish underlying causes of dementia but also to be installed as soon as possible. Therefore, differential diagnosis and early diagnosis of dementia are utmost importance. F-18 FDG PET is useful for clarifying dementing diseases and is also useful for early detection of the disease. Purpose of this article is to review the current value of FDG PET for dementing diseases including differential diagnosis of dementia and prediction of evolving dementia.

  3. FDG PET imaging dementia

    International Nuclear Information System (INIS)

    Dementia is a major burden for many countries including South Korea, where life expectancy is continuously growing and the proportion of aged people is rapidly growing. Neurodegenerative disorders, such as, Alzheimer disease, dementia with Lewy bodies, frontotemporal dementia. Parkinson disease, progressive supranuclear palsy, corticobasal degeneration, Huntington disease, can cause dementia, and cerebrovascular disease also can cause dementia. Depression or hypothyroidism also can cause cognitive deficits, but they are reversible by management of underlying cause unlike the forementioned dementias. Therefore these are called pseudodementia. We are entering an era of dementia care that will be based upon the identification of potentially modifiable risk factors and early disease markers, and the application of new drugs postpone progression of dementias or target specific proteins that cause dementia. Efficient pharmacologic treatment of dementia needs not only to distinguish underlying causes of dementia but also to be installed as soon as possible. Therefore, differential diagnosis and early diagnosis of dementia are utmost importance. F-18 FDG PET is useful for clarifying dementing diseases and is also useful for early detection of the disease. Purpose of this article is to review the current value of FDG PET for dementing diseases including differential diagnosis of dementia and prediction of evolving dementia

  4. Quantitative FDG in depression

    International Nuclear Information System (INIS)

    Full text: Studies of regional cerebral glucose metabolism (rCMRGlu) using positron emission tomography (PET) in patients with affective disorders have consistently demonstrated reduced metabolism in the frontal regions. Different quantitative and semi-quantitative rCMRGlu regions of interest (ROI) comparisons, e.g. absolute metabolic rates, ratios of dorsolateral prefrontal cortex (DLPFC) to ipsilateral hemisphere cortex, have been reported. These studies suffered from the use of a standard brain atlas to define ROls, whereas in this case study, the individual''s magnetic resonance imaging (MRI) scan was registered with the PET scan to enable accurate neuroanatomical ROI definition for the subject. The patient is a 36-year-old female with a six-week history of major depression (HAM-D = 34, MMSE = 28). A quantitative FDG PET study and an MRI scan were performed. Six MRI-guided ROls (DLPFC, PFC, whole hemisphere) were defined. The average rCMRGlu in the DLPFC (left = 28.8 + 5.8 mol/100g/min; right = 25.6 7.0 mol/100g/min) were slightly reduced compared to the ipsilateral hemispherical rate (left = 30.4 6.8 mol/100g/min; right = 29.5 7.2 mol/100g/min). The ratios of DLPFC to ipsilateral hemispheric rate were close to unity (left = 0.95 0.29; right 0.87 0.32). The right to left DLPFC ratio did not show any significant asymmetry (0.91 0.30). These results do not correlate with earlier published results reporting decreased left DLPFC rates compared to right DLPFC, although our results will need to be replicated with a group of depressed patients. Registration of PET and MRI studies is necessary in ROI-based quantitative FDG PET studies to allow for the normal anatomical variation among individuals, and thus is essential for accurate comparison of rCMRGlu between individuals

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

    International Nuclear Information System (INIS)

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

  6. VEGF expression and FDG kinetics

    International Nuclear Information System (INIS)

    Aim: The kinetics of dynamic PET FDG studies in musculoskeletal tumors was compared with the quantitative measurements of VEGF expression. Methods: Dynamic PET FDG studies were performed in 35 patients with sarcomas prior to surgery. The PET data were acquired for 60 minutes using a dedicated PET ring system. Following iterative image reconstruction, the data were quantified using a dedicated software program. Besides the calculation of SUV, a two compartment model was used to retrieve the parameters VB (vessel density) and the FDG transport constants K1-k4. Furthermore, a non-compartment model was applied to gain information about the tumor heterogeneity using the fractal dimension (FD). Following surgery, tissue samples were processed by quantitative RT-PCR using a lightcycler system for VEGF, the vascular endothelial growth factor, important for the tumor angiogenesis. Results: Scatter plots demonstrate, that the VEGF expression was generally associated with higher K1 values. The vessel density was independent from the VEGF expression. While the VEGF expression was variable at low SUV, the expression of VEGF was generally increased when the SUV exceeded 4.0. The simple linear correlation analysis of the parameters provided no significant correlations. A multi-factorial regression function was calculated, using SUV, K1-k4, VB and FD as predictor variables and the measured VEGF expression as the target variable. We noted a correlation of r=0.88 for these parameters, demonstrating that the dynamic of FDG accumulation is associated with angiogenetic activity. Conclusion: The results demonstrate, that tumor angiogenesis modulate the kinetics of FDG accumulation

  7. FDG-PET imaging in hematological malignancies.

    Science.gov (United States)

    Valls, L; Badve, C; Avril, S; Herrmann, K; Faulhaber, P; O'Donnell, J; Avril, N

    2016-07-01

    The majority of aggressive lymphomas is characterized by an up regulated glycolytic activity, which enables the visualization by F-18 FDG-PET/CT. One-stop hybrid FDG-PET/CT combines the functional and morphologic information, outperforming both, CT and FDG-PET as separate imaging modalities. This has resulted in several recommendations using FDG-PET/CT for staging, restaging, monitoring during therapy, and assessment of treatment response as well as identification of malignant transformation. FDG-PET/CT may obviate the need for a bone marrow biopsy in patients with Hodgkin's lymphoma and diffuse large B cell lymphoma. FDG-PET/CT response assessment is recommended for FDG-avid lymphomas, whereas CT-based response evaluation remains important in lymphomas with low or variable FDG avidity. The treatment induced change in metabolic activity allows for assessment of response after completion of therapy as well as prediction of outcome early during therapy. The five-point scale Deauville Criteria allows the assessment of treatment response based on visual FDG-PET analysis. Although the use of FDG-PET/CT for prediction of therapeutic response is promising it should only be conducted in the context of clinical trials. Surveillance FDG-PET/CT after complete remission is discouraged due to the relative high number of false-positive findings, which in turn may result in further unnecessary investigations. Future directions include the use of new PET tracers such as F-18 fluorothymidine (FLT), a surrogate biomarker of cellular proliferation and Ga-68 CXCR4, a chemokine receptor imaging biomarker as well as innovative digital PET/CT and PET/MRI techniques. PMID:27090170

  8. FDG PET/CT of Intercostal Schwannoma.

    Science.gov (United States)

    Wang, Si-Yun; Luo, Dong-Lan; Chen, Gang; Liu, En-Tao; Wang, Shu-Xia

    2016-06-01

    Intercostal schwannoma is rare. We report FDG PET/CT findings of intercostal schwannoma in a 66-year-old woman. The tumor contains both solid and cystic components with intense FDG activity in the solid component. Postsurgical pathology diagnosis revealed schwannoma. PMID:26859215

  9. 18-FDG in diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  10. FDG-PET in gynecologic cancer

    International Nuclear Information System (INIS)

    Whole-body positron emission tomography (PET) imaging with 18-F deoxyglucose (FDG) is a molecular imaging modality that detects metabolic alternation in tumor cells. In various human cancers, FDG-PET shows a potential clinical benefit in screening, tumor characterization, staging, therapeutic follow-up and detecting recurrence. In gynecologic cancers, FDG-PET is also known to be effective in characterization of adnexal masses, detection of recurrence, and lymph node invasion. This review discusses the clinical feasibility and future clinical application of this imaging modality in patients with cervical cancer, ovarian cancer and other gynecologic cancers

  11. FDG-PET response-adapted therapy

    DEFF Research Database (Denmark)

    Hutchings, Martin

    2014-01-01

    Fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is the most accurate tool for staging, treatment monitoring, and response evaluation in Hodgkin lymphoma (HL). Early determination of treatment sensitivity by FDG-PET is the best tool to guide individualized......, response-adapted treatment. Several ongoing or recently completed trials have investigated the use of FDG-PET/CT for early response-adapted HL therapy. The results are encouraging, but the data are immature, and PET response-adapted HL therapy is discouraged outside the setting of clinical trials. PET...

  12. Kidney Modelling for FDG Excretion with PET

    Directory of Open Access Journals (Sweden)

    Huiting Qiao

    2007-07-01

    Full Text Available The purpose of this study was to detect the physiological process of FDG's filtration from blood to urine and to establish a mathematical model to describe the process. Dynamic positron emission tomography scan for FDG was performed on seven normal volunteers. The filtration process in kidney can be seen in the sequential images of each study. Variational distribution of FDG in kidney can be detected in dynamic data. According to the structure and function, kidney is divided into parenchyma and pelvis. A unidirectional three-compartment model is proposed to describe the renal function in FDG excretion. The time-activity curves that were picked up from the parenchyma, pelvis, and abdominal aorta were used to estimate the parameter of the model. The output of the model has fitted well with the original curve from dynamic data.

  13. Normal cerebral FDG uptake during childhood

    Energy Technology Data Exchange (ETDEWEB)

    London, Kevin [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, NSW (Australia); Howman-Giles, Robert [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Disciplines of Imaging and Paediatrics and Child Health, Sydney Medical School, Sydney, NSW (Australia)

    2014-04-15

    Current understanding of cerebral FDG uptake during childhood originates from a small number of studies in patients with neurological abnormalities. Our aim was to describe cerebral FDG uptake in a dataset of FDG PET scans in children more likely to represent a normal population. We reviewed cerebral FDG PET scans in children up to 16 years of age with suspected/proven extracranial malignancies and the following exclusions: central nervous system metastases, previous malignancies, previous chemotherapy or radiotherapy, development of cerebral metastases during therapy, neurological conditions, taking antiepileptic medication or medications likely to interfere with cerebral metabolism, and general anaesthesia within 24 h. White matter, basal ganglia, thalamus and the cerebellar cortex were analysed using regional SUV{sub max}, and the cerebral cortex, basal ganglia, thalamus and cerebellum were analysed using a regional relative uptake analysis in comparison to maximal cortical uptake. Scans from 30 patients (age range 11 months to 16 years, mean age 10 years 5 months) were included. All regions showed increasing SUV{sub max} with age. The parietal, occipital, lateral temporal and medial temporal lobes showed lower rates of increasing FDG uptake causing changing patterns of regional FDG uptake during childhood. The cortical regions showing the most intense uptake in early childhood were the parietal and occipital lobes. At approximately 7 years of age these regions had relatively less uptake than the frontal lobes and at approximately 10 years of age these regions had relatively less uptake than the thalamus. Relative FDG uptake in the brain has not reached an adult pattern by 1 year of age, but continues to change up to 16 years of age. The changing pattern is due to different regional rates of increasing cortical FDG uptake, which is less rapid in the parietal, occipital and temporal lobes than in the frontal lobes. (orig.)

  14. Normal cerebral FDG uptake during childhood

    International Nuclear Information System (INIS)

    Current understanding of cerebral FDG uptake during childhood originates from a small number of studies in patients with neurological abnormalities. Our aim was to describe cerebral FDG uptake in a dataset of FDG PET scans in children more likely to represent a normal population. We reviewed cerebral FDG PET scans in children up to 16 years of age with suspected/proven extracranial malignancies and the following exclusions: central nervous system metastases, previous malignancies, previous chemotherapy or radiotherapy, development of cerebral metastases during therapy, neurological conditions, taking antiepileptic medication or medications likely to interfere with cerebral metabolism, and general anaesthesia within 24 h. White matter, basal ganglia, thalamus and the cerebellar cortex were analysed using regional SUVmax, and the cerebral cortex, basal ganglia, thalamus and cerebellum were analysed using a regional relative uptake analysis in comparison to maximal cortical uptake. Scans from 30 patients (age range 11 months to 16 years, mean age 10 years 5 months) were included. All regions showed increasing SUVmax with age. The parietal, occipital, lateral temporal and medial temporal lobes showed lower rates of increasing FDG uptake causing changing patterns of regional FDG uptake during childhood. The cortical regions showing the most intense uptake in early childhood were the parietal and occipital lobes. At approximately 7 years of age these regions had relatively less uptake than the frontal lobes and at approximately 10 years of age these regions had relatively less uptake than the thalamus. Relative FDG uptake in the brain has not reached an adult pattern by 1 year of age, but continues to change up to 16 years of age. The changing pattern is due to different regional rates of increasing cortical FDG uptake, which is less rapid in the parietal, occipital and temporal lobes than in the frontal lobes. (orig.)

  15. FDG and FDG-labelled leucocyte PET/CT in the imaging of prosthetic joint infection

    International Nuclear Information System (INIS)

    The demand for arthroplasty is rapidly growing as a result of the ageing of the population. Although complications such as heterotrophic ossification, fracture and dislocation are relatively rare, differentiating aseptic loosening, the most common complication of arthroplasty from infection, is a major challenge for clinicians. Radionuclide imaging is currently the imaging modality of choice since it is not affected by orthopaedic hardware. Whereas FDG PET/CT imaging has been widely used in periprosthetic infection, it cannot discriminate aseptic from septic inflammation. In this study we aimed to evaluate the role of FDG PET/CT and FDG-labelled leucocyte PET/CT in the diagnosis of periprosthetic infection. Of 54 patients with painful joint arthroplasty who were imaged by FDG PET/CT for diagnosis of periprosthetic infection examined, 46 (36 women, 10 men; mean age 61.04 ± 12.2 years, range 32 - 89 years) with 54 painful joint prostheses (19 hip, 35 knee) with grade 2 (above liver uptake) FDG accumulation on FDG PET/CT were included in the study and these 46 patients also underwent FDG-labelled leucocyte PET/CT. Final diagnoses were made by histopathological-microbiological culture or clinical follow-up. The final diagnosis showed infection in 15 (28 %) and aseptic loosening in 39 (72 %) of the 54 prostheses. FDG PET/CT was found to have a positive predictive value of 28 % (15/54). Since patients with no FDG uptake on FDG PET/CT were excluded from the study, the sensitivity, specificity, negative predictive value and accuracy could not be calculated. The sensitivity, specificity, and positive and negative predictive values of FDG-labelled leucocyte PET/CT were 93.3 % (14/15), 97.4 % (38/39), 93.3 % and 97.4 %, respectively. Since FDG is not specific to infection, the specificity of FDG PET/CT was very low. FDG-labelled leucocyte PET/CT with its high specificity may be a useful method and better than labelled leucocyte scintigraphy in periprosthetic infection

  16. FDG and FDG-labelled leucocyte PET/CT in the imaging of prosthetic joint infection

    Energy Technology Data Exchange (ETDEWEB)

    Aksoy, Sabire Yilmaz; Asa, Sertac; Ozhan, Meftune; Sager, M.S.; Halac, Metin; Kabasakal, Levent; Soenmezoglu, Kerim; Kanmaz, Bedii [University of Istanbul, Department of Nuclear Medicine, Cerrahpasa Medical Faculty, Aksaray, Istanbul (Turkey); Ocak, Meltem [University of Istanbul, Department of Pharmaceutical Technology, Faculty of Pharmacy, Istanbul (Turkey); Erkan, Melih Engin [Duzce University School of Medicine, Department of Nuclear Medicine, Duzce (Turkey)

    2014-03-15

    The demand for arthroplasty is rapidly growing as a result of the ageing of the population. Although complications such as heterotrophic ossification, fracture and dislocation are relatively rare, differentiating aseptic loosening, the most common complication of arthroplasty from infection, is a major challenge for clinicians. Radionuclide imaging is currently the imaging modality of choice since it is not affected by orthopaedic hardware. Whereas FDG PET/CT imaging has been widely used in periprosthetic infection, it cannot discriminate aseptic from septic inflammation. In this study we aimed to evaluate the role of FDG PET/CT and FDG-labelled leucocyte PET/CT in the diagnosis of periprosthetic infection. Of 54 patients with painful joint arthroplasty who were imaged by FDG PET/CT for diagnosis of periprosthetic infection examined, 46 (36 women, 10 men; mean age 61.04 ± 12.2 years, range 32 - 89 years) with 54 painful joint prostheses (19 hip, 35 knee) with grade 2 (above liver uptake) FDG accumulation on FDG PET/CT were included in the study and these 46 patients also underwent FDG-labelled leucocyte PET/CT. Final diagnoses were made by histopathological-microbiological culture or clinical follow-up. The final diagnosis showed infection in 15 (28 %) and aseptic loosening in 39 (72 %) of the 54 prostheses. FDG PET/CT was found to have a positive predictive value of 28 % (15/54). Since patients with no FDG uptake on FDG PET/CT were excluded from the study, the sensitivity, specificity, negative predictive value and accuracy could not be calculated. The sensitivity, specificity, and positive and negative predictive values of FDG-labelled leucocyte PET/CT were 93.3 % (14/15), 97.4 % (38/39), 93.3 % and 97.4 %, respectively. Since FDG is not specific to infection, the specificity of FDG PET/CT was very low. FDG-labelled leucocyte PET/CT with its high specificity may be a useful method and better than labelled leucocyte scintigraphy in periprosthetic infection

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  18. FDG PET/CT imaging in canine cancer patients

    DEFF Research Database (Denmark)

    Hansen, Anders Elias; McEvoy, Fintan; Engelholm, Svend Aage;

    2011-01-01

    and organs in canine cancer patients. FDG PET/CT was performed in 14 dogs including, nine mesenchymal tumors, four carcinomas, and one incompletely excised mast cell tumor. A generally higher FDG uptake was observed in carcinomas relative to sarcomas. Maximum SUV of carcinomas ranged from 7.6 to 27.......0, and for sarcomas from 2.0 to 10.6. The FDG SUV of several organs and tissues, including regional brain uptake is reported, to serve as a reference for future FDG PET studies in canine cancer patients. Several potential pitfalls have been recognized in interpretation of FDG PET images of human patients, a number...

  19. Peritoneal carcinomatosis - the role of FDG PET

    International Nuclear Information System (INIS)

    Full text: Peritoneal carcinomatosis can be difficult to diagnose, as CT is insensitive, with peritoneal biopsy and lavage often subject to problems of sampling error. The aim of our study was to evaluate the role of FDG PET in detecting peritoneal carcinomatosis in patients with biopsy-proven metastases from stomach, ovarian and adrenal cancer and mesothelioma. 92 FDG-PET scans of patients with stomach (49), ovarian (14) adrenal cancer (7) and mesothelioma (22) were reviewed. Studies were performed 45 minutes following IV injection of 10 mCi of 18F-FDG. Of this group 15 patients had biopsy-proven findings of peritoneal disease while 14 had PET studies reported as suspicious for peritoneal metastasis. Of the 15 biopsy-positive patients, FDG PET was positive in 7, CT in 6 and either PET or CT in 10 (sensitivities 46.6,40.0 and 66.6% respectively). In a further 4 patients without biopsies, where other imaging studies confirmed peritoneal disease, PET was also positive. 2 distinct abnormal scintigraphic patterns of focal and uniform FDG uptake were identified corresponding to nodular and diffuse peritoneal disease at pathology. Our study demonstrates that FDG PET adds to conventional imaging in the staging of peritoneal carcinomatosis. It is also a useful diagnostic tool when peritoneal biopsy is either unavailable or inappropriate. We have identified 2 distinct scintigraphic patterns which appear to predict the presence of either nodular or diffuse peritoneal pathology.Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  20. Evaluation of arterial FDG uptake and calcification in healthy subjects with serial FDG PET/CT

    International Nuclear Information System (INIS)

    Increased FDG uptake and calcium deposit have been suggested to indicate active inflammation and mature calcification of atheroma respectively. However, little is known regarding the natural course of FDG uptake and whether they may latter evolve into calcified lesions. Thus we investigated this issue using FDG PET/CT with serial follow-up studies in healthy subjects. Subjects were 17 adults (M:F=12:5, mean age 58 yrs) who checked PET/CT as part of a general medical examination, and all had follow-up PET/CT about 1 year later. We reviewed all studies for the presence of arterial FDG uptake and calcification. Sites in the ascending and descending aorta, the carotid and iliac arteries were examined on the PET, CT, and fusion images. Lesion to blood pool ratio (peak SUV of lesion/peak SUV of luminal activity at the aortic arch) greater than 1.5 was considered increased FDG uptake. Calcification was assessed visually. Changes of each lesion were evaluated on follow-up studies. A total of 108 and 71 abnormal sites were noted on CT or PET in the initial and follow-up studies, respectively. Increased FDG uptake only was observed at 45 sites (42%) in the initial studies. A majority of these sites disappeared spontaneously in the follow-up studies, when a total of 14 (20% ) increased FDG uptake sites were found. Calcifications without FDG uptake were noted at 55 (51%) and 56 (79%) sites in the initial and follow-up studies, respectively. Increased arterial FDG uptake and calcification overlapped at 8 sites (7%) and only 1 site (1%) in the initial and follow-up studies, respectively. Arterial regions of focally increased FDG uptake and calcification are relatively frequent findings in healthy adults. However, these lesions rarely overlapped, which indicates that they represent different phases of atherosclerosis development. Furthermore, the lack of persistence of the majority of the FDG uptake suggests that focal inflammation in arteries may frequently occur as transient

  1. FDG-PET identification of intraperitoneal metastases

    International Nuclear Information System (INIS)

    Aim: Peritoneal metastases (PM) are usually from intra-abdominal primary neoplasms, such as carcinoma of the stomach, colon, ovary, and pancreas, or from intra-abdominal lymphoma. Metastases disseminate throughout the peritoneum in four ways: 1) direct spread along peritoneal ligaments, mesenteries and omenta; 2) via the flow of ascitis fluid. 3) lymphatic extension, and 4) embolic hematogenous spread. Although CT is quite specific in identifying PM it is not very sensitive, and peritoneal lavage or biopsy can be very useful but have sampling errors. This study assessed the clinical value of FDG-PET for the detection of PM of malignant diseases. Materials and Methods: 15 FDG-PET scans of patients referred for recurrence (mean age = 54 y/o, sex = 6M, 9F), with metabolic abnormalities suspicious findings of PM from carcinoma of the colon (7), ovary (3), lymphoma (2), pancreas (1), gastrointestinal stromal tumor (1) and melanoma (1) were reviewed. The whole-body studies were performed 50 min following the intravenous administration of 370 MBq of 18F-FDG, in a high resolution dedicated PET scanner (Advance, GEMS), with images reconstructed using a iterative algorithm with segmented attenuation correction. Visual interpretation and SUV values were correlated with CT/MRI findings and biopsy/follow-up. Results: Of the 15 patients, 7 showed <3 sites of focal uptake and 8 presented multiple foci or a diffuse hypermetabolism in the abdomen (SUVmax3.04-18.83 g/ml). 6 patients had biopsy confirmation by PET-directed surgery (6 proven PM, 0 negative biopsies). 11 FDG-PET scans had correspondence with the CT/MRI findings and 4 showed discrepancies (PET positive-CT/MRI negative in patients with isolated raising tumor markers levels or unsuspected PM). FDG-PET influenced the therapeutic management in 2 patients as presented multiple metastases leading them from surgery to chemotherapy. Conclusion: When used as a complementary imaging tool to the conventional work up, FDG-PET is

  2. Experience with PET FDG - Preliminary analysis

    International Nuclear Information System (INIS)

    Full text: The objective of this preliminary communication was to analyse the indications and data in initial group of patients studied with first dedicated PET scanner in the country at Hospital Militar in Santiago Chile. The main application of positron emission tomography (PET) with 18-Fluoro deoxyglucose (FDG) is related with oncological patients management. We studied 136 patients, 131 (97%) with known or suspected malignant disease and remaining 5 for cardiological or neuropsychiatric disease. Ten patients were controlled diabetics (1 insulin dependent). Their mean age was 51.6±18 years ranging from 6 to 84 years and 65% were females. A total of 177 scans were acquired using a dedicated PET (Siemens HR + with 4mm resolution) system. Mean F18-FDG injected dose was 477±107 MBq (12.9±2.9 mCi). Mean blood glucose levels, performed prior the injection, were 94±17mg/dl (range 62-161). F18-FDG was obtained from the cyclotron IBA Cyclone 18/9 installed in the Chilean Agency of Nuclear Energy, distant about 15 miles away from the clinical PET facility. PET studies were analyzed by at least 4 independent observers visually. Standardized uptake value (SUV) was calculated in some cases. Image fusion of FDG images with recent anatomical (CT, MRI) studies was performed where available. Data acquisition protocol consisted in 7-8 beds/study from head to mid-thighs, with 6-7-min/bed acquisitions, 36% transmission with germanium 68 rods. Data was reconstructed with standard OSEM protocol. The main indications included pulmonary lesions in 31%, gastrointestinal cancers in 21%, melanoma in 13% and lymphoma in 9% patients. The remaining were of breast, thyroid, testes, ovary, musculoskeletal (soft tissue and bone), brain tumour etc. Abnormal focal tracer uptake was observed in 83/131 oncological patients, 54% corroborating with clinical diagnosis of primary tumor or recurrence while 46% showed new metastatic localization. FDG scans were normal 36/131 patients. In 9 patients

  3. Factors influencing physiological FDG uptake in the intestine

    International Nuclear Information System (INIS)

    The intestine is a well-known site of physiological 18F-fluorodeoxyglucose (FDG) accumulation in positron emission tomography (PET). To identify factors influencing physiological FDG uptake in the intestine, the intensity of FDG uptake was evaluated in a total of 1,068 healthy adults. Non-attenuation-corrected whole-body PET images were obtained for all subjects and visually evaluated. Subjects were then classified into two groups according to the intensity of intestinal FDG uptake. Sex, age, presence or absence of constipation, and serum glucose, hemoglobin A1c, and free fatty acid levels were compared between the two groups. High intestinal FDG uptake was observed at an overall rate of 11.0%. Sex (female), age, and bowel condition (constipation) were found to affect intestinal FDG uptake. The factors we identified lead to further questions the relationship between intestinal motility and glucose uptake that warrant further study. (author)

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

    International Nuclear Information System (INIS)

    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

    Energy Technology Data Exchange (ETDEWEB)

    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. Baastrup's disease (kissing spine) demonstrated by FDG PET/CT

    International Nuclear Information System (INIS)

    18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) is a widely used imaging modality in cancer patients. However, there are many potential non-neoplastic causes of FDG uptake. We report a case of FDG uptake between the spinous processes, secondary to Baastrup's disease. Knowledge of this pattern of uptake is helpful in diagnosing Baastrup's disease and avoiding false-positive diagnoses. (orig.)

  7. Patterns of FDG uptake in stomach on FDG PET: correlation with endoscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Chae, Min Jeong; Cheon, Gi Jeong; Kim, Seong Eun; Choi, Chang Woon; Lim, Sang Moo [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2004-07-01

    The purpose of our study was to find out the significant findings of stomach on FDG PET. Thirty-nine patients who underwent both FDG PET and endoscopy from Jun. 2003, to Aug. 2004 were included in our study. In all of them, FDG PET and gastrofibroscopy were performed within one week. One man who had undergone subtotal gastrectomy was excluded. We reviewed 38 cases (18 for medical check up, 15 for work up of other malignancies, and 5 for the evaluation of stomach lesion). Their mean age was 56 years old (range:32{approx}79), men and women were 28 and 10, respectively. On interpretation of FDG PET scan, two nuclear physician evaluated five parameters on FDG-PET findings of stomach with a concensus : 1) visual grades 2) maximum SUV (SUVmax), 3) focality, 4) asymmetry, and 5) gross appearance. We correlated FDG PET findings of stomach with those of endoscopy. On endoscopy, six of 38 patients were proven as gastric cancer, and others had inflammatory lesion (ulcer in 3, chronic gastritis in 12, uncommon from gastritis in 5) or benign noninflammatory lesions (polyp and varix in 3, and normal limit). On the visual analysis, FDG uptake of stomach cancer had the tendency of higher uptake than the other lesions. SUVmax of gastric cancer was 7.95{+-}4.83 which was significantly higher than the other benign lesions (2.9{+-}0.69 in ulcer, 3.08{+-}1.2 in chronic gastritis 3.2{+-}1.49 in uncommon from gastritis). In the appearance of stomach on PET, gastric cancer was shown as focal lesion (5 of 6), and those of benign inflammatory lesions were asymmetric (14 of 20), and diffuse (9 of 20). Some cases of chronic inflammatory lesions, such as ulcer, and chronic gastritis, showed focal appearance and mimicked cancerous lesion (4 of 15). On FDG PET, the lesions of stomach cancer had higher FDG uptake and focal appearance comparing with the other benign inflammatory lesions. However, ulcer, and chronic gastritis showed focal appearance on PET, which could be mimicked as cancerous

  8. Patterns of FDG uptake in stomach on FDG PET: correlation with endoscopic findings

    International Nuclear Information System (INIS)

    The purpose of our study was to find out the significant findings of stomach on FDG PET. Thirty-nine patients who underwent both FDG PET and endoscopy from Jun. 2003, to Aug. 2004 were included in our study. In all of them, FDG PET and gastrofibroscopy were performed within one week. One man who had undergone subtotal gastrectomy was excluded. We reviewed 38 cases (18 for medical check up, 15 for work up of other malignancies, and 5 for the evaluation of stomach lesion). Their mean age was 56 years old (range:32∼79), men and women were 28 and 10, respectively. On interpretation of FDG PET scan, two nuclear physician evaluated five parameters on FDG-PET findings of stomach with a concensus : 1) visual grades 2) maximum SUV (SUVmax), 3) focality, 4) asymmetry, and 5) gross appearance. We correlated FDG PET findings of stomach with those of endoscopy. On endoscopy, six of 38 patients were proven as gastric cancer, and others had inflammatory lesion (ulcer in 3, chronic gastritis in 12, uncommon from gastritis in 5) or benign noninflammatory lesions (polyp and varix in 3, and normal limit). On the visual analysis, FDG uptake of stomach cancer had the tendency of higher uptake than the other lesions. SUVmax of gastric cancer was 7.95±4.83 which was significantly higher than the other benign lesions (2.9±0.69 in ulcer, 3.08±1.2 in chronic gastritis 3.2±1.49 in uncommon from gastritis). In the appearance of stomach on PET, gastric cancer was shown as focal lesion (5 of 6), and those of benign inflammatory lesions were asymmetric (14 of 20), and diffuse (9 of 20). Some cases of chronic inflammatory lesions, such as ulcer, and chronic gastritis, showed focal appearance and mimicked cancerous lesion (4 of 15). On FDG PET, the lesions of stomach cancer had higher FDG uptake and focal appearance comparing with the other benign inflammatory lesions. However, ulcer, and chronic gastritis showed focal appearance on PET, which could be mimicked as cancerous lesion on PET

  9. Review of 18F-FDG Synthesis and Quality Control

    OpenAIRE

    Yu, S.

    2006-01-01

    This review article covers a concise account on fludeoxyglucose (18F–FDG) synthesis and quality control procedures with emphasis on practical synthesis Currently, 18F–FDG is the most successful PET radiopharmaceutical so far. The advancement in synthesis and quality control of 18F–FDG, together with its approval by the US FDA and the availability of reimbursement, are probably the main reasons for the flourish of clinical PET over the last 20 years. 18F–FDG can be synthesised by either electr...

  10. FDG-avid portal vein tumor thrombosis from hepatocellular carcinoma in contrast-enhanced FDG PET/CT

    OpenAIRE

    Canh Nguyen; Huy Nguyen; Tan Ngo; Simone Maurea

    2015-01-01

    Objective(s): In this study, we aimed to describe the characteristics of portal vein tumor thrombosis (PVTT), complicating hepatocellular carcinoma (HCC) in contrast-enhanced FDG PET/CT scan. Methods: In this retrospective study, 9 HCC patients with FDG-avid PVTT were diagnosed by contrast-enhanced fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), which is a combination of dynamic liver CT scan, multiphase imaging, and whole-body PET sca...

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

    International Nuclear Information System (INIS)

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

  12. Logistics of long distance FDG supply

    International Nuclear Information System (INIS)

    Full text: The short half-life of 18F-FDG (110 mins) presents a logistical problem when transport over long distances is involved. Our facility was presented with such a problem when we were contracted to supply FDG on a regular basis to the Royal Adelaide Hospital over 700 km away. The principal difficulties to be overcome were providing a quick, reliable and efficient transport system, the development of a safe and efficacious transport packaging system, production and supply of sufficient product and the scheduling of the operations of the cyclotron, radiochemistry and radiopharmacy services, so as not to interfere with the existing clinical program of the PET centre. Together with the assistance of Gammasonics, an FDG transport and packaging system was developed which complied with transport regulations and was recyclable. A door-to-door courier system was established which, on average, takes four hours but has occasionally been hampered by the unreliability of the airline service. A schedule for early operation of the cyclotron and radio-chemistry was established to meet with transport schedules. A system of quality control of the FDG was instituted (while the product is in transit) with the QC release results being faxed to the recipient prior to the product's arrival. We have supplied 51 deliveries since mid-September 2000 to the end of February 2001. During this period there have been 6 (11.7%) delayed deliveries of which 2 (3.9%) have been due to cyclotron operational problems and 4 (7.8%) have been due to flight delays beyond our control. There have been no completely failed deliveries. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

  13. Clinical Application of 18F-FDG PET in Epilepsy

    International Nuclear Information System (INIS)

    FDG PET has been used as a diagnostic tool for localization of seizure focus for last 2-3 decades. In this article, the clinical usefulness of FDG PET in the management of patients with epilepsy has been reviewed, which provided the evidences to justify the medicare reimbursement for FDG PET in management of patients with epilepsy. Literature review demonstrated that FDG PET provides an important information in localization of seizure focus and determination whether a patients is a surgical candidate or not. FDG PET has been reported to have high diagnostic performance in localization of seizure focus in neocortical epilepsy as well as temporal lobe epilepsy regardless of the presence of structural lesion on MRI. Particularly, FDG PET can provide the additional information when the results from standard diagnositic modality such as interictal or video-monitored EEG, and MRI are inconclusive or discordant, and make to avoid invasive study. Furthermore, the presence of hypometabolism and extent of metabolic extent has been reported as an important predictor for seizure free outcome. However, studies suggested that more accurate localization and better surgical outcome could be expected with multimodal approach by combination of EEG, MRI, and functional studies using FDG PET or perfusion SPECT rather than using a single diagnostic modality in management of patients with epilepsy. Complementary use of FDG PET in management of epilepsy is worth for good surgical outcome in epilepsy patients

  14. Qualification of the GMP compliant FDG production and distribution unit

    International Nuclear Information System (INIS)

    Recently we installed in our laboratory a GMP-compliant compact combined FDG production and dose distribution unit. This unit, constructed by HWM, Rossendorf, consists of the mini-cell, housing the FDG synthesis module from GE, standing side-by-side with the class A shielded isolator containing remotelly controlled dose distribution module. Use of the isolator technology combined with laminar flow HEPA filtered air inside the dose distribution hot-cell allows to achieve class A environment for the aseptic filing of FDG into the opened sterile vials. Synthesis of FDG and preparation of the mother batch solution is achieved inside the hot-cells providing class C clean room environement. The whole production unit is standing in the class D laboratory. The complete set of IQ-OQ-PQ tests was performed to assure that the FDG production and distribution unit is performing accordingly to GMP requirements and is providing the product of consistent quality. The majour component in the qualification tests are the aseptic procedure validations, which consisted of the procedures recommended by GMP guidelines and adapted for the specificity of the FDG production. As a minimum for the aseptic validation we considered the Mediafil Test, Bioburden Test and test productions. All the test results assure that the FDG production unit allows to produce FDG for central distribution in accordance with the requirements of European pharmacopoeia and GMP guidelines. (author)

  15. 18FDG PET and ultrasound echolucency in carotid artery plaques

    DEFF Research Database (Denmark)

    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...

  16. FDG PET/CT imaging as a biomarker in lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Meignan, Michel; Itti, Emmanuel [Hopitaux Universitaires Henri Mondor, Paris-Est Creteil University, LYSA Imaging, Department of Nuclear Medicine, Creteil (France); Gallamini, Andrea [Nice University, Research, Innovation and Statistic Department, Antoine Lacassagne Cancer Center, Nice (France); Scientific Research Committee, S. Croce Hospital, Cuneo (Italy); Younes, Anas [Memorial Sloan Kettering Cancer Center, Lymphoma Service, New York, NY (United States)

    2015-04-01

    FDG PET/CT has changed the management of FDG-avid lymphoma and is now recommended as the imaging technique of choice for staging and restaging. The need for tailoring therapy to reduce toxicity in patients with a favourable outcome and for improving treatment in those with high-risk factors requires accurate diagnostic methods and a new prognostic algorithm to identify different risk categories. New drugs are used in relapsed/refractory patients. The role of FDG PET/CT as a biomarker in this context is summarized in this review. New trends in FDG metabolic imaging in lymphoma are addressed including metabolic tumour volume measurement at staging and integrative PET which combines PET data with clinical and molecular markers or other imaging techniques. The quantitative approach for response assessment which is under investigation and is used in large ongoing trials is compared with visual criteria. The place of FDG in the era of targeted therapy is discussed. (orig.)

  17. FDG-PET/CT in oncology. German guideline

    International Nuclear Information System (INIS)

    FDG-PET/CT examinations combine metabolic and morphologic imaging within an integrated procedure. Over the past decade PET/CT imaging has gained wide clinical acceptance in the field of oncology. This FDG-PET/CT guideline focuses on indications, data acquisition and processing as well as documentation of FDG-PET/CT examinations in oncologic patients within a clinical and social context specific to Germany. Background information and definitions are followed by examples of clinical and research applications of FDG-PET/CT. Furthermore, protocols for CT scanning (low dose and contrast-enhanced CT) and PET emission imaging are discussed. Documentation and reporting of examinations are specified. Image interpretation criteria and sources of errors are discussed. Quality control for FDG and PET/CT-systems, qualification requirements of personnel as well as legal aspects are presented. (orig.)

  18. 细支气管肺泡癌的FDG-PET影像特点%FDG-PET in Bronchial Alveolar Carcinoma

    Institute of Scientific and Technical Information of China (English)

    汪涛; 孙玉鹗; 常平; 于长海; 姚树林; 田嘉禾; 尹大一

    2006-01-01

    Objective: The purpose of this study was to assess the features of bronchial alveolar carcinomain fluorine-18 fluorodeoxyglucose (FDG) uptake by Positron emission tomography(PET). Methods: FromDecember 1998 to October 2004, 35 patients with bronchial alveolar carcinoma (BAC) were imaged withFDG-PET before surgery. The PET results were interpreted using visual and semiquantitative assessment.For semiquantitative analysis, standardized uptake value (SUV) was calculated. Results: All tumors of the patients could be detected by FDG-PET and identified by visual method. By semiquantitative analysis, FDG uptake of the tumor (SUVmax and SUVmean) was higher than that of normal lung (SUVlung) (P<0.001), SUVmax, SUVmean of the tumor and SUVlung were 3.14±1.65, 2.40±1.34 and 0.38±0.08respectively. Correlations were found between FDG uptake and tumor size (P<0.05). SUVmean in 21 tumors (21/35, 60.0%) and SUVmax in 15 tumors (15/35, 42.9%) were lower than 2.5. These 21 tumors were all considered as benign by visual method and semiquantitative analysis. Conclusion: (1) FDG uptake was higher in bronchial alveolar carcinoma than that in normal lung tissue. (2) FDG uptake and tumor size appear to be correlated with each other. (3) Bronchial alveolar carcinomas lead to many false negative cases in FDG-PET.

  19. Photon-deficient Mass on FDG-PET Scan in Renal Cell Carcinoma: A Case Report

    OpenAIRE

    George Shih; Wei-Jen Shih; Bonnie Mitchell; Milan, Primo P

    2008-01-01

    F-18 Fluorodeoxyglucose Positron Emission Tomography imaging (F-18 FDG PET) detects malignancies depending on the uptake profile of glycolysis of tumors; however, the role of FDG PET is limited in the evaluation of primary renal malignancy because of low FDG uptake by renal cell carcinoma and also because normal urinary excretion of FDG seen in the images. A patient with renal cell carcinoma whose FDG PET imaging study incidentally shows a photon-deficient mass in the upper pole of the right ...

  20. FDG PET in early stage cutaneous malignant melanoma

    International Nuclear Information System (INIS)

    Fluorodeoxyglucose positron emission tomography (FDG PET) is not recommended in early stage melanoma; however, a significant number of cases are referred to our institution for FDG PET. We refer to early stage disease as American Joint Committee on Cancer (AJCC) stage I and II, which includes all cases without metastases. A retrospective review was undertaken to determine the clinical utility of FDG PET in this patient group. A retrospective study of FDG scans on all patients presenting to the WA PET Centre with early stage melanoma over a 5½ year period was undertaken. The positivity rate of the initial study for detection of malignant melanoma was determined. In patients with an initially negative FDG PET, the time from initial diagnosis to a positive surveillance study was determined. Both the initial positivity rate and time to a positive study were correlated with Breslow staging. Three hundred twenty-two patients were included in the study, of which 74 had initial positive FDG PET scans (23%). Adequate follow-up was available in 51 patients with the PET result confirmed as true positive in 37 (positive predictive value 73%). One hundred eight of 248 patients initially negative had follow-up scans during the follow-up period, of which 48 became positive. The 73% of recurrences were over 12 months post-diagnosis. No correlation with Breslow thickness was demonstrated. Despite FDG PET not being recommended for early cutaneous malignant melanoma, 27% of melanoma cases referred for FDG PET during the study period were AJCC stage I or II. Our results suggest FDG PET in early stage melanoma demonstrates occult disease in 17% of cases.

  1. Comparison of dynamic FDG PET and gene chip data

    International Nuclear Information System (INIS)

    Objectives: The kinetics of dynamic PET FDG studies in colorectal tumors and bone tumors was compared with results obtained from tumor samples and gene chip analysis. Methods: Dynamic PET FDG studies were performed in 9 patients prior to surgery. The PET data were acquired for 60 minutes using a dedicated PET ring system. Following iterative image reconstruction, the data were quantified using a dedicated software program. Besides the calculation of SUV, a two compartment model was used to retrieve the parameters VB (vessel density) and the FDG transport constants K1-k4. Furthermore, a non-compartment model was applied to gain information about the tumor heterogeneity using the fractal dimension (FD). Following surgery, tissue samples were processed and gene expression was measured using gene chips (U92A, Affymetrix Co.). The U92A chip provides semiquantitative information about the expression of 12276 genes. The quantitative gene chip data were analysed with respect to the parameters of the FDG metabolism in the individual patients. Results: FDG uptake, as measured by SUV, showed a low correlation to GLUT-1, GLUT-2 and GLUT-3, while no correlation was observed for GLUT-4 and GLUT-5. Interestingly, higher correlations were observed for FDG SUV and the SGLT transporter family. A multiple linear regression function was calculated and demonstrated a high correlation for GLUT-1, GLUT-2, GLUT-3 and FDG SUV. Similar results were obtained for SGLT transporters and SUV. Oncogenes, e.g. k-ras, showed a nonlinear correlation of r=0.50. The FDG SUV was associated with the expression of the gastrointestinal peptide in colorectal tumors. The results will be discussed in detail, also with respect to the kinetic data. Conclusion: Gene chip analysis provides superior information about the association of gene expression and FDG kinetics

  2. Beyond FDG positron emission tomography imaging

    International Nuclear Information System (INIS)

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

  3. Gamma camera based FDG PET in oncology

    International Nuclear Information System (INIS)

    Positron Emission Tomography(PET) was introduced as a research tool in the 1970s and it took about 20 years before PET became an useful clinical imaging modality. In the USA, insurance coverage for PET procedures in the 1990s was the turning point, I believe, for this progress. Initially PET was used in neurology but recently more than 80% of PET procedures are in oncological applications. I firmly believe, in the 21st century, one can not manage cancer patients properly without PET and PET is very important medical imaging modality in basic and clinical sciences. PET is grouped into 2 categories; conventional (c) and gamma camera based (CB) PET. CBPET is more readily available utilizing dual-head gamma cameras and commercially available FDG to many medical centers at low cost to patients. In fact there are more CBPET in operation than cPET in the USA. CBPET is inferior to cPET in its performance but clinical studies in oncology is feasible without expensive infrastructures such as staffing, rooms and equipments. At Ajou university Hospital, CBPET was installed in late 1997 for the first time in Korea as well as in Asia and the system has been used successfully and effectively in oncological applications. Our was the fourth PET operation in Korea and I believe this may have been instrumental for other institutions got interested in clinical PET. The following is a brief description of our clinical experience of FDG CBPET in oncology

  4. Usefulness of 18F-FDG PET in intrahepatic cholangiocarcinoma

    International Nuclear Information System (INIS)

    Surgical resection is the only curative treatment strategy for intrahepatic cholangiocarcinoma (CC). Therefore, accurate staging is essential for appropriate management of patients with CC. We assessed the usefulness of 2-[18F]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in the staging of CC. We undertook a retrospective review of FDG PET images in 21 patients (10 female, 11 male; mean age 57 years) diagnosed with CC. Ten patients had hilar CC and 11, peripheral CC. Patients underwent abdominal magnetic resonance imaging (MRI) (n=20) and computed tomography (CT) (n=12) for the evaluation of primary tumours, and chest radiography and whole-body bone scintigraphy for work-up of distant metastases. For semi-quantitative analysis, the maximum voxel standardised uptake value (SUVmax) was obtained from the primary tumour. All peripheral CCs showed intensely increased FDG uptake, and some demonstrated ring-shaped uptake corresponding to peripheral rim enhancement on CT and/or MRI. In nine of the ten patients, hilar CCs demonstrated increased FDG uptake of a focal nodular or linear branching appearance. The remaining case was false negative on FDG PET. One patient with a false negative result on MRI demonstrated increased uptake on FDG PET. Among the ten hilar CCs, FDG uptake was intense in only two patients and was slightly higher than that of the hepatic parenchyma in the remaining patients. For the detection of lymph node metastasis, FDG PET and CT/MRI were concordant in 16 patients, and discordant in five (FDG PET was positive in three, and CT and MRI in two). FDG PET identified unsuspected distant metastases in four of the 21 patients; all of these patients had peripheral CC. FDG PET is useful in detecting the primary lesion in both hilar and peripheral CC and is of value in discovering unsuspected distant metastases in patients with peripheral CC. FDG PET could be useful in cases of suspected hilar CC with non-confirmatory biopsy and radiological

  5. FDG PET/CT in children and adolescents with lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Kluge, Regine; Kurch, Lars [University Hospital Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Montravers, Francoise [Hospital Tenon, Department of Nuclear Medicine, Paris (France); Mauz-Koerholz, Christine [University Hospital Halle, Department of Paediatrics, Halle (Saale) (Germany)

    2013-04-15

    The aim of this review is to give an overview of FDG PET/CT applications in children and adolescents with lymphoma. Today, FDG PET is used for tailoring treatment intensity in children with Hodgkin lymphoma within the framework of international treatment optimisation protocols. In contrast, the role of this method in children with Non-Hodgkin lymphoma is not well defined. This paper overviews clinical appearance and metabolic behaviour of the most frequent lymphoma subtypes in childhood. The main focus of the review is to summarise knowledge about the role of FDG PET/CT for initial staging and early response assessment. (orig.)

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

    International Nuclear Information System (INIS)

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

  7. Non-FDG PET imaging of brain tumors

    Institute of Scientific and Technical Information of China (English)

    HUANG Zemin; GUAN Yihui; ZUO Chuantao; ZHANG Zhengwei; XUE Fangping; LIN Xiangtong

    2007-01-01

    Due to relatively high uptake of glucose in the brain cortex, the use of FDG PET imaging is greatly limited in brain tumor imaging, especially for low-grade gliomas and some metastatic tumours. More and more tracers with higher specificity were developed lately for brain tumor imaging. There are 3 main types of non-FDG PET tracers:amino acid tracers, choline tracers and nucleic acid tracers. These tracers are now widely applied in many aspects of brain tumor imaging. This article summarized the general use of non-FDG PET in different aspects of brain tumor imaging.

  8. FDG PET/CT in children and adolescents with lymphoma

    International Nuclear Information System (INIS)

    The aim of this review is to give an overview of FDG PET/CT applications in children and adolescents with lymphoma. Today, FDG PET is used for tailoring treatment intensity in children with Hodgkin lymphoma within the framework of international treatment optimisation protocols. In contrast, the role of this method in children with Non-Hodgkin lymphoma is not well defined. This paper overviews clinical appearance and metabolic behaviour of the most frequent lymphoma subtypes in childhood. The main focus of the review is to summarise knowledge about the role of FDG PET/CT for initial staging and early response assessment. (orig.)

  9. FDG-avid portal vein tumor thrombosis from hepatocellular carcinoma in contrast-enhanced FDG PET/CT

    Directory of Open Access Journals (Sweden)

    Canh Nguyen

    2015-01-01

    Full Text Available Objective(s: In this study, we aimed to describe the characteristics of portal vein tumor thrombosis (PVTT, complicating hepatocellular carcinoma (HCC in contrast-enhanced FDG PET/CT scan. Methods: In this retrospective study, 9 HCC patients with FDG-avid PVTT were diagnosed by contrast-enhanced fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT, which is a combination of dynamic liver CT scan, multiphase imaging, and whole-body PET scan. PET and CT DICOM images of patients were imported into the PET/CT imaging system for the re-analysis of contrast enhancement and FDG uptake in thrombus, the diameter of the involved portal vein, and characteristics of liver tumors and metastasis. Results: Two patients with previously untreated HCC and 7 cases with previously treated HCC had FDG-avid PVTT in contrast-enhanced FDG PET/CT scan. During the arterial phase of CT scan, portal vein thrombus showed contrast enhancement in 8 out of 9 patients (88.9%. PET scan showed an increased linear FDG uptake along the thrombosed portal vein in all patients. The mean greatest diameter of thrombosed portal veins was 1.8 ± 0.2 cm, which was significantly greater than that observed in normal portal veins (P<0.001. FDG uptake level in portal vein thrombus was significantly higher than that of blood pool in the reference normal portal vein (P=0.001. PVTT was caused by the direct extension of liver tumors. All patients had visible FDG-avid liver tumors in contrast-enhanced images. Five out of 9 patients (55.6% had no extrahepatic metastasis, 3 cases (33.3% had metastasis of regional lymph nodes, and 1 case (11.1% presented with distant metastasis. The median estimated survival time of patients was 5 months. Conclusion: The intraluminal filling defect consistent with thrombous within the portal vein, expansion of the involved portal vein, contrast enhancement, and linear increased FDG uptake of the thrombus extended from liver tumor are

  10. FDG-PET in monitoring therapy of breast cancer

    International Nuclear Information System (INIS)

    Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been used successfully for the staging and re-staging of breast cancer. Another significant indication is the evaluation of therapy response. Only limited data are available on the use of FDG-PET in breast cancer after radiation therapy. The same holds true for chemotherapy. Only the therapy response in locally advanced breast cancer after chemotherapy has been investigated thoroughly. Histopathological response could be predicted with an accuracy of 88-91% after the first and second courses of therapy. A quantitative evaluation is, of course, a prerequisite when FDG-PET is used for therapy monitoring. Only a small number of studies have focussed on hormone therapy. In this context, a flare phenomenon with increasing standardised uptake values after initiation of tamoxifen therapy has been observed. More prospective multicentre trials will be needed to make FDG-PET a powerful tool in monitoring chemotherapy in breast cancer. (orig.)

  11. FDG-PET in monitoring therapy of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Biersack, H.J.; Bender, H.; Palmedo, H. [Department of Nuclear Medicine, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn (Germany)

    2004-06-01

    Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been used successfully for the staging and re-staging of breast cancer. Another significant indication is the evaluation of therapy response. Only limited data are available on the use of FDG-PET in breast cancer after radiation therapy. The same holds true for chemotherapy. Only the therapy response in locally advanced breast cancer after chemotherapy has been investigated thoroughly. Histopathological response could be predicted with an accuracy of 88-91% after the first and second courses of therapy. A quantitative evaluation is, of course, a prerequisite when FDG-PET is used for therapy monitoring. Only a small number of studies have focussed on hormone therapy. In this context, a flare phenomenon with increasing standardised uptake values after initiation of tamoxifen therapy has been observed. More prospective multicentre trials will be needed to make FDG-PET a powerful tool in monitoring chemotherapy in breast cancer. (orig.)

  12. FDG PET IN THE MANAGEMENT OF LUNG CANCER

    OpenAIRE

    Kevin KM Tse; Helene Reich; Jane Alavi; Abass Alavi

    1997-01-01

    We describe a patient with newly diagnosed limy cancer. Staging was performed with CT and mediastinoscopy. FDG PET scan was performed and confirmed increased metabolic activity in the primary tumor as well as the hilar lymph node. Seven months after initial presentation, the patient was found to have two lytic lesions in the pelvis on plain radiograph. Hone scan was negative but PET demonstrated FOG uptake in one lesion. The possible utility of whole body FDG PET in detecting osseous metastas...

  13. Physiological FDG uptake in the ovaries after hysterectomy

    International Nuclear Information System (INIS)

    It is known that focal 18F-fluorodeoxyglucose (FDG) uptake is physiologically seen in the ovaries and uterus of premenopausal women in correlation with the menstrual cycle, which may cause false-positive diagnoses on the images of FDG positron emission tomography (PET). The objective of this study was to clarify whether women of reproductive age after hysterectomy whose ovaries were preserved, also showed physiological ovarian FDG uptake. We reviewed 26 women after hysterectomy (age 51.1±5.0 years), who underwent annual cancer screening, including FDG-PET and pelvic magnetic resonance (MR) imaging, three times. Seven women (age 45.9±5.8 years, range 34-52 years) had at least one ovary, showing changes in its appearance including the size and number of follicles on MR images each year, which suggested that the ovary was functioning. Four of the seven women showed focal FDG uptake (standardized uptake value 4.2±1.1) that corresponded to the normal ovaries on five PET examinations. Another group of 19 women (age 53.1±3.1 years, range 47-59 years) who had small ovaries without changes on MR images each year did not show FDG uptake in the ovaries. Physiological FDG uptake observed in the ovaries of women of reproductive age even after hysterectomy is reasonably common. As it is not easy to determine the hormonal cycle in these women, it is essential to correlate focal FDG uptake in the pelvis with anatomical and morphological findings on MR images to avoid false-positive diagnoses. (author)

  14. Detection of Unknown Primary Tumors Using Whole Body FDG PET

    Institute of Scientific and Technical Information of China (English)

    ZHAOJun; LINXiangtong; GUANYihui; ZUOChuantao; HUAFengchun; SHENGXiaofang; WANGYang

    2003-01-01

    Objective: To assess the usefulness of 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in locating occult primary lesions. Methods: 50 patients with varying hetero-geneous metastases of unknown primary origin were referred for FDG PET. The locations of the known metastatic tumor manifestations were distributed as follows: cervical lymph nodes metastases (n=18),skeletal metastases (n=15), cerebral metastases (n=12), others (n=5). All patients underwent whole body 18F-FDG PET imaging. The images were interpreted by visual inspection and semi-quantitative analysis(standardized uptake value, SUV). The patients had undergone conventional imaging within 2 weeks of FDG PET. Surgical, clinical and histopathologic findings were used to assess the performance of FDG PET.Results: FDG PET was able to detect the location of the primary tumor in 32/50 patients (64%). The primary tumors were proved by histopathologic results, and located in the lungs (n=17), the nasopharynx(n=9), the breast (n=2), the ovary (n=l), the colon(n=l), the prostate(n=l),the thyroid (n=l). FDG PET were proved false positive in 2 patients (4%), and the suspicious primary tumors were in uterus and colon respectively. During the clinical follow-up of 2 to 26 months, the primary tumor was found in only 2 patients ( prostate cancer, gastric cancer). Conclusion: PET imaging allows identification of the primary site and metastatic lesions(including bone and soft tissue metastases) at a single examination.Whole body lSF-FDG PET allows effective localization of the unknown primary site of origin and can contribute substantially to patient care.

  15. Functional neuroimaging in epilepsy: FDG-PET and SPECT

    International Nuclear Information System (INIS)

    Finding epileptogenic zone is the most important step for the successful epilepsy surgery. F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and single photon emission computed tomography (SPECT) can be used in the localization of epileptogenic foci. In medial temporal lobe epilepsy, the diagnostic sensitivity of FDG-PET and ictal SPECT is excellent. However, detection of hippocampal sclerosis by MRI is so certain that use of FDG-PET and ictal SPECT in medial temporal lobe epilepsy is limited for some occasions. In neocortical epilepsy, the sensitivities of FDG-PET or ictal SPECT are fair. However, FDG-PET and ictal SPECT can have a crucial role in the localization of epileptogenic foci for non-lesional neocortical epilepsy. Interpretation of FDG-PET has been recently advanced by voxel-based analysis and automatic volume of interest analysis based on a population template. Both analytical methods can aid the objective diagnosis of epileptogenic foci. lctal SPECT was analyzed using subtraction methods and voxel-based analysis. Rapidity of injection of tracers, ictal EEG findings during injection of tracer, and repeated ictal SPECT were important technical issues of ictal SPECT. SPECT can also be used in the evaluation of validity of Wada test

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-06-15

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

    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

  19. Patterns of FDG uptake in stomach on F-18 FDG positron emission tomography: correlation with endoscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Chae, Min Jeong; Cheon, Gi Jeong; Lee, Sang Woo; Byun, Byung Hyun; Kim, Sung Eun; Kim, Yu Chul; Choi, Chang Woon; Lim, Sang Moo [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2005-10-15

    We often find variable degrees of FDG uptake and patterns in stomach, which can make difficult to distinguish physiologic uptake from pathologic uptake on FDG PET. The purpose of this study was to find out the significant findings of stomach on FDG PET. Thirty-eight patients who underwent both FDG PET and endoscopy within one week from Jun. 2003, to Aug. 2004 were included in this study. We reviewed 38 patients (18 for medical check up, 15 for work up of other malignancies, and 5 for the evaluation of stomach lesion). Their mean age was 56 years old (range:32 {approx} 79), men and women were 28 and 10, respectively. Two nuclear physicians evaluated five parameters on FDG PET findings of stomach with a consensus: 1) visual grades 2) maximum SUV (max.SUV) 3) focal 4) diffuse and 5) asymmetric patterns. We correlated the lesions of FDG PET findings of stomach with those of endoscopy. We considered more than equivocal findings on FDG PET as positive. The six of 38 patients were proven as malignant lesions by endoscopic biopsy and others were inflammatory lesions (ulcer in 3, chronic atrophic gastritis in 12, uncommon forms of gastritis in 5), non-inflammatory lesions (n=3), and normal stomach (n=9). By the visual analysis, malignant lesions had higher FDG uptake than the others. The max.SUV of malignant lesions was 7.95 {+-} 4.83 which was significantly higher than the other benign lesions (2.9 {+-} 0.69 in ulcer, 3.08 {+-} 1.2 in chronic atrophic gastritis, 3.2 {+-} 1.49 in uncommon forms of gastritis ( {rho} =0.044). In the appearance of stomach on FDG PET, malignant lesions were shown focal (5 of 6) and benign inflammatory lesions were shown diffuse (9 of 20) and asymmetric (14 of 20). Benign lesions and normal stomach were shown variable degrees of uptake and patterns. Some cases of benign inflammatory lesions such as ulcer and gastritis were shown focal and mimicked cancerous lesions (4 of 15). Gastric malignant lesions had higher FDG uptake and focal pattern

  20. Patterns of FDG uptake in stomach on F-18 FDG positron emission tomography: correlation with endoscopic findings

    International Nuclear Information System (INIS)

    We often find variable degrees of FDG uptake and patterns in stomach, which can make difficult to distinguish physiologic uptake from pathologic uptake on FDG PET. The purpose of this study was to find out the significant findings of stomach on FDG PET. Thirty-eight patients who underwent both FDG PET and endoscopy within one week from Jun. 2003, to Aug. 2004 were included in this study. We reviewed 38 patients (18 for medical check up, 15 for work up of other malignancies, and 5 for the evaluation of stomach lesion). Their mean age was 56 years old (range:32 ∼ 79), men and women were 28 and 10, respectively. Two nuclear physicians evaluated five parameters on FDG PET findings of stomach with a consensus: 1) visual grades 2) maximum SUV (max.SUV) 3) focal 4) diffuse and 5) asymmetric patterns. We correlated the lesions of FDG PET findings of stomach with those of endoscopy. We considered more than equivocal findings on FDG PET as positive. The six of 38 patients were proven as malignant lesions by endoscopic biopsy and others were inflammatory lesions (ulcer in 3, chronic atrophic gastritis in 12, uncommon forms of gastritis in 5), non-inflammatory lesions (n=3), and normal stomach (n=9). By the visual analysis, malignant lesions had higher FDG uptake than the others. The max.SUV of malignant lesions was 7.95 ± 4.83 which was significantly higher than the other benign lesions (2.9 ± 0.69 in ulcer, 3.08 ± 1.2 in chronic atrophic gastritis, 3.2 ± 1.49 in uncommon forms of gastritis ( ρ =0.044). In the appearance of stomach on FDG PET, malignant lesions were shown focal (5 of 6) and benign inflammatory lesions were shown diffuse (9 of 20) and asymmetric (14 of 20). Benign lesions and normal stomach were shown variable degrees of uptake and patterns. Some cases of benign inflammatory lesions such as ulcer and gastritis were shown focal and mimicked cancerous lesions (4 of 15). Gastric malignant lesions had higher FDG uptake and focal pattern. However, benign

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  2. Optimizing 18F-FDG PET/CT imaging of vessel wall inflammation: the impact of 18F-FDG circulation time, injected dose, uptake parameters, and fasting blood glucose levels

    International Nuclear Information System (INIS)

    18F-FDG PET is increasingly used for imaging of vessel wall inflammation. However, limited data are available on the impact of methodological variables, i.e. prescan fasting glucose, FDG circulation time and injected FDG dose, and of different FDG uptake parameters, in vascular FDG PET imaging. Included in the study were 195 patients who underwent vascular FDG PET/CT of the aorta and the carotids. Arterial standardized uptake values (meanSUVmax), target-to-background ratios (meanTBRmax) and FDG blood-pool activity in the superior vena cava (SVC) and the jugular veins (JV) were quantified. Vascular FDG uptake values classified according to the tertiles of prescan fasting glucose levels, the FDG circulation time, and the injected FDG dose were compared using ANOVA. Multivariate regression analyses were performed to identify the potential impact of all variables described on the arterial and blood-pool FDG uptake. Tertile analyses revealed FDG circulation times of about 2.5 h and prescan glucose levels of less than 7.0 mmol/l, showing a favorable relationship between arterial and blood-pool FDG uptake. FDG circulation times showed negative associations with aorticmeanSUVmax values as well as SVC and JV FDG blood-pool activity, but positive correlations with aortic and carotidmeanTBRmax values. Prescan glucose levels were negatively associated with aortic and carotidmeanTBRmax and carotidmeanSUVmax values, but were positively correlated with SVC blood-pool uptake. The injected FDG dose failed to show any significant association with vascular FDG uptake. FDG circulation times and prescan blood glucose levels significantly affect FDG uptake in the aortic and carotid walls and may bias the results of image interpretation in patients undergoing vascular FDG PET/CT. The injected FDG dose was less critical. Therefore, circulation times of about 2.5 h and prescan glucose levels less than 7.0 mmol/l should be preferred in this setting. (orig.)

  3. Estimation of 18FDG doses's cost

    International Nuclear Information System (INIS)

    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

  4. FDG PET/CT imaging of lung tumor

    International Nuclear Information System (INIS)

    PET/CT imaging combines PET for functional information and CT for morphological information in a single examination, and has shown how the initial staging with lung cancer. [18F]fluoro-deoxy-glucose (FDG) PET/CT imaging has a higher diagnostic accuracy for lung cancer except so-called bronchioloalveolar carcinoma and acute inflammatory lesion such as tuberculosis, pneumonia etc, compared with the conventional diagnostic modalities. FDG PET/CT imaging can demonstrate unexpected sites of mediastinal lymph node metastases (N factor), distant metastases (M factor) in initial staging and influence treatment plans for lung cancer. Furthermore, the grade of FDG uptake on PET/CT predicts prognosis of lung cancer and evaluates tumor response to treatment. Recurrences or metastases of lung cancer, and pleural disease can be detected correctly on FDG PET/CT. It is important that interpreting physicians understand the role of FDG PET/CT in staging, assessing of treatment and observing after therapy on the multidisciplinary managements of lung cancer. The clinical applications of PET/CT are still evolving, and future researches will determine the precise role that combined metabolic and morphological imaging has to play in the management of patients with lung cancer. (author)

  5. Clinical usefulness of FDG-PET for biliary cancer

    International Nuclear Information System (INIS)

    Forty-one patients with biliary cancer (22 extrahepatic bile duct cancer, 11 gall bladder cancer, 8 ampullary cancer) who underwent 18F-fluorodeoxy-glucose positron emission tomography (FDG-PET) before treatment were enrolled in the present study. We investigated the clinical significance of PET for primary tumor, metastases and the other cancers. We also analyzed the relationship between the maximum standardized uptake value (SUVmax) and clinicopathologic factors. The accumulation of FDG to primary tumor was observed in 28 of 41 patients (68.3%). The sensitivity of FDG-PET was 100% for gallbladder cancer, 87.5% for ampullary cancer, and 45.4% for bile duct cancer, respectively. The SUVmax levels in primary tumor were significantly correlated with M-category in tumor, nodes and metastasis (TNM) classification (p=0.033). Meanwhile, 21 patients (51%) showed the FDG accumulation except for the primary tumor. The sensitivity for lymph node metastasis, liver metastasis, and peritoneal dissemination was 89%, 75%, and 100%, respectively. In the abnormal accumulations of the other regions in 8 patients, colon cancer was newly found in 3 patients. FDG-PET has a low sensitivity for detecting the primary tumor in biliary cancer, but it is useful for detection of distant metastasis and occult malignant disease. (author)

  6. The modular synthesis production of 18FDG in Chile

    International Nuclear Information System (INIS)

    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)

  7. FDG-PET of autoimmune-related pancreatitis: preliminary results

    International Nuclear Information System (INIS)

    The purpose of this retrospective study was to elucidate the fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) findings in autoimmune-related pancreatitis (AIP), which is a reversible chronic pancreatitis with an autoimmune cause. The study group comprised six patients with clinically diagnosed AIP. After 370 MBq (10 mCi) of FDG had been injected intravenously, the abdomen and/or the whole body was scanned at 1 h post injection in all patients, and scanning was repeated at 2 h in four patients. PET findings were evaluated visually and/or semiquantitatively using the standardized uptake value (SUV). In four of the six patients, PET demonstrated intense uptake in the whole pancreas, which appeared swollen on computed tomography, and the accumulation increased with time in three patients. In one patient, intense focal uptake in the pancreatic head was observed, and the accumulation decreased over time. In the remaining patient, no abnormal accumulation in the pancreas was observed. Follow-up PET scanning after steroid therapy was performed in three patients, and intense FDG uptake was no longer observed. Our preliminary data show that AIP can cause intense FDG uptake in the pancreas. This fact, and the benign status of the condition, should be kept in mind when making a diagnosis with FDG-PET in patients with pancreatic disorders. (orig.)

  8. [18F]FDG PET/CT outperforms [18F]FDG PET/MRI in differentiated thyroid cancer

    International Nuclear Information System (INIS)

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

  9. Utility of PET-FDG in renal cell carcinoma: evaluation in our habitat

    International Nuclear Information System (INIS)

    The great utility of FDG-PET in most oncologic diseases is well known. One of the limitations of the FDG-PET is for the evaluation of renal carcinoma. For better evaluation of the usefulness of FDG-PET in renal cell carcinoma, we reviewed several studies about the subject and compared the results with our own FDG-PET study on patients with renal carcinoma. Results of most studies are clearly influenced by the reason for which the FDG-PET study was requested: initial diagnosis, staging or re-staging. Our results demonstrate that optimizing patient preparation and using flexible study protocols, better results than reported can be achieved

  10. FDG positron emission computed tomography in a study of aphasia

    International Nuclear Information System (INIS)

    Positron emission computed tomography (PECT) using 18F-2-fluoro-2-deoxy-D-glucose (FDG) was used to investigate the correlations between clinical status, anatomy (as described by CT), and metabolism in five patients with stable aphasia resulting from ischemic cerebral infarction. Local cerebral metabolic activity was diminished in an area larger than the area of infarction demonstrated by CT. In one patient, FDG PECT revealed a metabolic lesion that probably caused the aphasic syndrome and was not apparent by CT. The data suggest that reliance on CT in delineating the extent of the brain lesion in aphasia or other neuropsychological defects can be misleading; FDG PECT may provide important additional information. Two patients with similar metabolic lesions had very different clinical syndromes, showing that even when currently available methods are combined, major gaps remain in clinicoanatomical correlations in aphasia

  11. Guidance for reading FDG PET scans in dementia patients

    International Nuclear Information System (INIS)

    18F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) is a powerful method for detection of disease-related impairment of cerebral glucose metabolism in neuro degenerative diseases. It is of particular interest for early and differential diagnosis of dementia. Reading FDG PET scans requires training to recognise deviations from normal functional brain anatomy and its variations. This paper provides guidance for displaying FDG PET brain scans in a reproducible manner that allows reliable recognition of characteristic disease-related metabolic changes. It also describes typical findings in Alzheimer’s disease, Frontotemporal Dementia and Dementia with Lewy Bodies and possible confounding factors, such as vascular changes and brain atrophy. It provides a brief overview on findings in other neuro degenerative diseases and addresses the potential and limitations of software packages for comparison of individual scans with reference data.

  12. A Case of Paranasal Sinus Papilloma with Increased FDG Uptake

    Energy Technology Data Exchange (ETDEWEB)

    An, Young Sil; Park, Yong Koo; Kim, Deog Yoon [Kyung Hee University School of Medicine, Seoul (Korea, Republic of)

    2008-10-15

    The false-positive FDG uptakes on head and neck areas are common due to benign lesion, iatrogenic and physiologic changes. The Schneiderian papilloma is uncommon benign tumor arising from the mucosa of the paranasal sinuses and nasal cavity. The findings of paranasal papilloma on conventional modality such as CT and MRI are non-specific and they could be confused with inflammatory polyp or retention cyst. Despite of benign tumor, the papilloma usually shows locally aggressive growth with malignant potential, therefore the FDG can be actively accumulated in this lesion. We describe the case of 18F-FDG PET/CT finding in a 77-year-old woman who demonstrates oncocytic papilloma in maxillary sinus.

  13. Hepatic steatosis is associated with increased hepatic FDG uptake

    International Nuclear Information System (INIS)

    Objective: The use of liver as a reference tissue for semi-quantification of tumour FDG uptake may not be valid in hepatic steatosis (HS). Previous studies on the relation between liver FDG uptake and HS have been contradictory probably because they ignored blood glucose (BG). Because hepatocyte and blood FDG concentrations equalize, liver FDG uptake parallels BG, which must therefore be considered when studying hepatic FDG uptake. We therefore re-examined the relation between HS and liver uptake taking BG into account. Methods: This was a retrospective study of 304 patients undergoing routine PET/CT with imaging 60 min post-FDG. Average standard uptake value (SUVave), maximum SUV (SUVmax) and CT density (index of HS) were measured in a liver ROI. Blood pool SUV was based on the left ventricular cavity (SUVLV). Correlations were assessed using least squares fitting of continuous data. Patients were also divided into BG subgroups (<4, 4–5, 5–6, 6–8, 8–10 and 10+ mmol/l). Results: SUVave, SUVmax and SUVLV displayed similar relations with BG. SUVmax/SUVLV, but not SUVave/SUVLV, correlated significantly with BG. SUVmax, but not SUVave, correlated inversely with CT density before and after adjusting for BG. SUVmax/SUVave correlated more strongly with CT density than SUVmax. CT density correlated inversely with SUVmax/SUVLV but positively with SUVave/SUVLV. Conclusions: Hepatic SUV is more influenced by BG than by HS. Its relation with BG renders it unsuitable as a reference tissue. Nevertheless, hepatic fat does correlate positively with liver SUV, although this is seen only with SUVmax because SUVave is ‘diluted’ by hepatic fat

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

    International Nuclear Information System (INIS)

    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.)

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

    Directory of Open Access Journals (Sweden)

    K. D. F. Lensen

    2015-01-01

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

  16. PET/FDG EB GastroIntestinal Stromal Tumors (GIST)

    International Nuclear Information System (INIS)

    Objectives: Review the results of PET / FDG in patients diagnosed with GIST, to establish whether there is active tumor requiring treatment with imatinib or to evaluate the response to it; Imatinib is a tyrosine kinase inhibitor which in turn, by a mutation of a proto-oncogene leads to uncontrolled cell proliferation. Methods: Practical PET / CT from the vertex to the middle third of the thighs, 90 minutes after IV administration of FDG (0.42 mCi / Kgrm) with Discovery LS PET / CT GE

  17. Dynamic FDG PET in characterizing and staging lung cancer

    International Nuclear Information System (INIS)

    CT has proven inadequate for staging lung cancer. This study evaluates F-18 deoxyglucose (FDG) positron emission tomography (PET) in assessing mediastinal metastases of lung tumors, differentiating benign from malignant parenchymal masses, and complementing radiographic and laboratory findings in lymphoma. The authors of this paper examined 13 patients with pulmonary masses as determined by chest radiographs and CT scans. PET scans were obtained with 255.3-592 MBq FDG scanned in dynamic mode at 5 minutes per frame for 45 minutes and one 15 minutes per frame. Image analysis included visual inspection, time activity curves (TAC), and calculation of differential uptake ratio (DUR) in regions of interest versus normal tissue

  18. FDG PET/CT in carcinoma of unknown primary

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-03-15

    Carcinoma of unknown primary (CUP) is a heterogeneous group of metastatic malignancies in which a primary tumor could not be detected despite thorough diagnostic evaluation. Because of its high sensitivity for the detection of lesions, combined {sup 18}F-fluoro-2-deoxyglucose positron emission tomography (FDG PET)/computed tomography (CT) may be an excellent alternative to CT alone and conventional magnetic resonance imaging in detecting the unknown primary tumor. This article will review the use, diagnostic performance, and utility of FDG PET/CT in CUP and will discuss challenges and future considerations in the diagnostic management of CUP. (orig.)

  19. Non-FDG PET in the practice of oncology

    OpenAIRE

    P Caroli; C. Nanni; Rubello, D; A. Alavi; S. Fanti

    2010-01-01

    Fluoro-2-deoxy-d-glucose-positron emission tomography (FDG-PET) is utilized in more than 90% of cancers in staging, re-staging, assessing therapy response and during the follow-up. However, not all tumors show significant increase of metabolic activity on FDG-PET imaging. This is particularly true for prostate cancer, neuroendocrine tumors and hepatic tumors. In this review we have considered those already used for clinical applications such as 11C- and 18F-Choline, 11C-Methionine and 18F-FET...

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

    International Nuclear Information System (INIS)

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

  1. Hyperglycemia-induced stimulation of glucose transport in skeletal muscle measured by PET- [18F]6FDG and [18F]2FDG

    International Nuclear Information System (INIS)

    A physiologically based model proposed by our group has been developed to assess glucose transport and phosphorylation in skeletal muscle. In this study, we investigated whether our model has the ability to detect a glucose-induced increase in glucose transport in skeletal muscle. In particular, we used small-animal positron emission tomography (PET) data obtained from [18F]6-fluoro-6-deoxy-D-glucose ([18F]6FDG). A 2 h PET scan was acquired following a bolus injection of [18F]6FDG in rats currently under euglycemic or hyperglycemic conditions, while somatostatin was infused during both conditions in order to prevent a rise in the endogenous plasma insulin concentration. We were thus able to assess the effect of hyperglycemia per se. For a comparison of radiopharmaceuticals, additional rats were studied under the same conditions, using [18F]2-fluoro-2-deoxy-D-glucose ([18F]2FDG). When [18F]6FDG was used, the time-activity curves (TACs) for skeletal muscle had distinctly different shapes during euglycemic and hyperglycemic conditions. This was not the case with [18F]2FDG. For both [18F]6FDG and [18F]2FDG, the model detects increases in both interstitial and intracellular glucose concentrations, increases in the maximal velocity of glucose transport and increases in the rate of glucose transport, all in response to hyperglycemia. In contrast, there was no increase in the maximum velocity of glucose phosphorylation or in the glucose phosphorylation rate. Our model-based analyses of the PET data, obtained with either [18F]6FDG or [18F]2FDG, detect physiological changes consistent with established behavior. Moreover, based on differences in the TAC shapes, [18F]6FDG appears to be superior to [18F]2FDG for evaluating the effect of hyperglycemia on glucose metabolism in skeletal muscle. (paper)

  2. FDG-PET/CT based response-adapted treatment

    DEFF Research Database (Denmark)

    de Geus-Oei, Lioe-Fee; Vriens, Dennis; Arens, Anne I J;

    2012-01-01

    It has been shown that [(18)F]fluorodeoxyglucose (FDG)-positron emission tomography (PET) provides robust and reproducible data for early metabolic response assessment in various malignancies. This led to the initiation of several prospective multicenter trials in malignant lymphoma and adenocarc...

  3. FDG PET/CT in Hepatoid Adenocarcinoma of the Lung.

    Science.gov (United States)

    Wang, Shouyang; Li, Mengxi; Chen, Huai; Li, Jianyu; Zeng, Qingsi

    2016-07-01

    A right upper lung mass was incidentally found on a chest radiograph in a routine health examination in a 56-year-old man. The mass showed mild heterogeneous enhancement on contrast chest CT images and intense FDG uptake on PET/CT images. Pathological examination demonstrated hepatoid adenocarcinoma in the lung. PMID:27124679

  4. Estimating the amount of FDG uptake in physiological tissues

    International Nuclear Information System (INIS)

    Introduction: It is known that for a fixed amount of injected tracer, the amount available for a tissue of interest will be less if other tissues show intense uptake. The aim of this study was to estimate the magnitude of 2-deoxy-2-[18F]fluoro-D-glucose (18FDG) uptake amount in physiological tissues that may show an intense uptake in current clinical practice. Methods: A formula was established providing an estimate of the percentage of injected 18FDG molecules (P; in %) that are irreversibly trapped in an 18FDG-positive tissue during a PET examination. Results: P ≅ 0.17*exp(−λtacq)*TLG/W, where λ is the 18F physical decay constant, tacq is the injection-acquisition time delay, TLG is total lesion glycolysis (g) and W is the patient weight (kg). The magnitude of P was calculated in two patients showing an intense uptake in brown fat, myocardium and bowels: 0.5, 3.5, and 4.2% respectively. Conclusions: A formula is available to quickly estimate the amount of 18FDG uptake in tissues. We suggest that the accumulation of different physiological uptakes may actually affect SUV quantification in a tissue of interest

  5. Role of cardiac FDG PET-CT in inflammatory cardiomyopathy

    International Nuclear Information System (INIS)

    Full text: Role of cardiac FDG PET-CT in the diagnosis and monitoring treatment response of inflammatory cardiomyopathy. Materials and Methods: This is a retrospective analysis of 72 patients (over a period of 3 years) referred for cardiac PET-CT with dilated cardiomyopathy (DCM) or idiopathic ventricular tachycardia (VT), to rule out inflammatory cardiomyopathy. FDG cardiac PET was done with patients following very high fat low carbohydrate protein preferred diet (VHFLCPPD) protocol one day prior to scan. Myocardial perfusion scan with 99mTc-tetrofosmin or 13N-NH3 was done prior to FDG PET. All patients underwent breathhold CECT, chest PET-CT and cardiac PET-CT 45 min post FDG injection. Scans were reported jointly by a radiologist and nuclear medicine physician. Clinical/pathological follow-up was obtained where possible. Results: 50(69.4%) patients had positive myocardial FDG uptake with matched perfusion defect on NH3/Tc scan in the absence of CAD. 30(42%) patients had associated metabolically active lymphadenopathy and organ lesions. 4 patients had metabolically active lymphnodes with no myocardial inflammation. 18 patients had no abnormality detected on the scan. Patients with positive lymphnodes underwent biopsy and proven to have granulomatous disease either sarcoidosis and with TB or TB alone. 15 patients had post treatment scan which showed complete metabolic response in 7, partial response in 6 and stable disease in 2. Conclusion: Evaluating patients with DCM or idiopathic VT secondary to inflammatory myocarditis is challenging. Cardiac PET scan with VHFLCPPD protocol is the most sensitive modality available for assessment of disease activity in inflammatory cardiomyopathy and monitoring the treatment response especially in patients with ICD

  6. [18F] FDG PET in gastric non-Hodgkin's lymphoma

    International Nuclear Information System (INIS)

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

  7. Uptake of FDG (2-fluoro-2-deoxy-D-glucose) as a tumor imaging agent into erythrocytes and accumulation of FDG in tumor cells

    Energy Technology Data Exchange (ETDEWEB)

    Minosako, Yoshihito; Ino, Sento; Shirakami, Yoshifumi; Kurami, Miki [Nihon Medi-physics Co., Ltd., Sodegaura, Chiba (Japan). Research Centre; Nemoto, Masahiro [Japanese Red Cross Hokkaido Coll. of Nursing, Kitami (Japan)

    2003-02-01

    Fluorine-18-2-fluoro-2-deoxy-D-glucose ({sup 18}F-FDG) injectable was developed as a tumor imaging agent reflecting glucose metabolism. In membrane transportation studies, the uptake of {sup 14}C-FDG into erythrocytes decreased with an increase in glucose concentration, and Cytochalasin B, inhibitor of glucose transporter (GLUT), blocked the uptake about 75%. The results means FDG is transported into tumor cells mainly by GLUT as glucose analogues. {sup 18}F-FDG is recognized to be phosphorylated to {sup 18}F-FDG-6-phosphate with hexokinase. We found that FDG-6-phosphate was further isomerized to {sup 18}F-FDM-6-phosphate by phosphoglucose isomerase (PGI) in vitro. About 27% {sup 18}F-FDM-6-phosphate was generated at the reaction with 70 U PGI for 90 mm. These results show that the {sup 18}F-FDG injectable manufactured by the commercial supply system has equivalent properties; membrane transportation characteristic and enzyme affinity, to FDG synthesized at each PET institution. (author)

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

    International Nuclear Information System (INIS)

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

  9. Cancer-associated stroma affects FDG uptake in experimental carcinomas. Implications for FDG-PET delineation of radiotherapy target

    Energy Technology Data Exchange (ETDEWEB)

    Farace, Paolo; Merigo, Flavia; Galie, Mirco; Sbarbati, Andrea; Marzola, Pasquina [University of Verona, Department of Morphological-Biomedical Sciences, Section of Anatomy and Histology, Verona (Italy); D' Ambrosio, Daniela; Nanni, Cristina; Spinelli, Antonello; Fanti, Stefano [Policlinico ' S. Orsola-Malpighi' , Department of Nuclear Medicine, Bologna (Italy); Degrassi, Anna [Nerviano Medical Sciences, Milan (Italy); Rubello, Domenico [' S. Maria della Misericordia' Hospital, PET Centre, Department of Nuclear Medicine, Rovigo (Italy)

    2009-04-15

    To analyse the influence of cancer-associated stroma on FDG-uptake in two carcinoma models characterized by different stromal degrees. Eight nude mice were subcutaneously injected with DU-145 prostate cancer cells or BXPC-3 pancreatic cancer cells, and underwent FDG-PET imaging about 2 weeks after implantation. After the mice were killed, histology, and CD31 and GLUT1 immunohistochemistry were performed. To further evaluate the highly stromalized carcinoma using perfusion-sensitive imaging, four BXPC-3 tumours underwent two successive albumin-binding (MS-325) MRI scans during tumour growth. FDG uptake was significantly higher in the DU-145 than in the BXPC-3 tumours, which were hardly distinguishable from adjacent normal tissue. In the BXPC-3 tumours, histology confirmed the widespread presence of aberrant infiltrated stroma, embedded with numerous vessels marked by CD31. In both tumour types, the stromal matrix was negative for GLUT1. In DU-145 tumour cells, GLUT1 immunostaining was greater than in BXPC-3 tumour cells, but not homogeneously, since it was less evident in the tumour cells which were nearer to vessels and stroma. Finally, MS-325 MRI always clearly showed areas of enhancement in the BXPC-3 tumours. Cancer-associated stroma has been reported to be capable of aerobic metabolism with low glucose consumption. Furthermore, it has been proposed that regions with high vascular perfusion exhibit a significantly lower FDG uptake, suggesting some vascular/metabolic reciprocity. Since our results are consistent with these recent findings, they signal a risk of tumour volume underestimation in radiotherapy if FDG uptake alone is used for target delineation of carcinomas, which suggests that additional evaluation should be performed using vasculature/perfusion-sensitive imaging. (orig.)

  10. Pulmonary FDG uptake without a CT counterpart - a pitfall in interpreting PET/CT images

    Energy Technology Data Exchange (ETDEWEB)

    Schreiter, Nils; Buchert, Ralph; Brenner, Winfried; Diekmann, Felix (Charite, Klinik fuer Nuklearmedizin, Berlin (Germany)), email: nils.schreiter@charite.de; Nogami, Munenobu (Dept. of Radiology, Kochi Univ. Hospital, Kochi (Japan)); Froeling, Vera (Charite, Klinik fuer Strahlenheilkunde, Berlin (Germany))

    2011-06-15

    Abnormal pulmonary 18F-FDG foci may occur with benign lesions like pneumonia but seldomly without any pathological CT findings. We report the case of a focal pulmonary 18F-FDG uptake without CT correlate in an initial staging examination of a patient with squamous cell carcinoma of the base of the tongue. A follow-up study did not show any suspicious lesion in this area, but pneumonia with 18F-FDG uptake in another region of the lung. 18F-FDG foci without pathological CT are a rare finding and have been associated with emboli. In the literature two main mechanisms underlying focal 18F-FDG uptake in pulmonary embolism are mentioned: an inflammatory reaction of a pre-existing vascular thrombus and an iatrogenic microembolism caused during injection. In our case the 18F-FDG accumulation was assessed as an iatrogenic pulmonary microembolism

  11. Postoperative reactive lymphadenitis: A potential cause of false-positive FDG PET/CT

    Institute of Scientific and Technical Information of China (English)

    Yiyan; Liu

    2014-01-01

    A wide variety of surgical related uptake has been reported on F18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography(FDG PET/CT) scan, most of which can be differentiated from neoplastic process based on the pattern of FDG uptake and/or anatomic appearance on the integrated CT in image interpretation. A more potential problem we may be aware is postoperative reactive lymphadenitis, which may mimic regional nodal metastases on FDG PET/CT. This review presents five case examples demonstrating that postoperative reactive lymphadenitis could be a false-positive source for regional nodal metastasis on FDG PET/CT. Surgical oncologists and radiologists should be aware of reactive lymphadenitis in interpreting postoperative restaging FDG PET/CT scan when FDG avid lymphadenopathy is only seen in the lymphatic draining location from surgical site.

  12. Assessment of Chemotherapy Response Using FDG-PET in Pediatric Bone Tumors: A Single Institution Experience

    OpenAIRE

    Kim, Dong Hwan; Kim, Seung Yeon; Lee, Hyeon Jeong; Song, Bong Sup; Kim, Dong Ho; Cho, Joong Bum; Lim, Jung Sub; Lee, Jun Ah

    2011-01-01

    Purpose Response to neo-adjuvant chemotherapy is an important prognostic factor for osteosarcoma (OS) and the Ewing sarcoma family of tumors (ESFT). [F-18]-fluorodeoxy-D-glucose (FDG)-positron emission tomography (PET) is a non-invasive imaging modality that predicts histologic response to chemotherapy of various malignancies; however, limited data exist about the usefulness of FDG-PET in predicting the histologic response of pediatric bone tumors to chemotherapy. We analyzed the FDG-PET imag...

  13. Potential F-FDG PET/CT in the evaluation of ocular prosthesis MEDPOR

    International Nuclear Information System (INIS)

    We report a patient with a history of choroidal melanoma, which was studied with F-FDG PET-CT for staging and then for followup after enucleation and placement of a MEDPOR prosthesis, in which we found FDG uptake within the prosthesis after 17 months due to inflammatory changes. F-FDG PET-CT could be an alternative imaging technique of MRI in the evaluation of these patients

  14. Baastrup's disease (kissing spine) demonstrated by FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Eugene [Virginia Mason Medical Center, Department of Radiology, Seattle, WA (United States)

    2008-02-15

    18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) is a widely used imaging modality in cancer patients. However, there are many potential non-neoplastic causes of FDG uptake. We report a case of FDG uptake between the spinous processes, secondary to Baastrup's disease. Knowledge of this pattern of uptake is helpful in diagnosing Baastrup's disease and avoiding false-positive diagnoses. (orig.)

  15. FDG-PET/CT pitfalls in oncological head and neck imaging

    OpenAIRE

    Purohit, Bela S.; Ailianou, Angeliki; Dulguerov, Nicolas; Becker, Christoph D; Ratib, Osman; Becker, Minerva

    2014-01-01

    Objectives Positron emission tomography-computed tomography (PET/CT) with fluorine-18-fluorodeoxy-D-glucose (FDG) has evolved from a research modality to an invaluable tool in head and neck cancer imaging. However, interpretation of FDG PET/CT studies may be difficult due to the inherently complex anatomical landmarks, certain physiological variants and unusual patterns of high FDG uptake in the head and neck. The purpose of this article is to provide a comprehensive approach to key imaging f...

  16. Detection of Thyroid Metastasis of Renal Transitional Cell Carcinoma Using FDG PET/CT

    OpenAIRE

    Kim, Yong-il; Lee, Jong Jin; Paik, Jin Ho; Kim, Yu Kyeong; Kim, Sang Eun

    2011-01-01

    A 69-year-old man who was diagnosed with renal transitional cell carcinoma (TCC) underwent F-18 fluorodeoxyglucose (FDG) positron emission tomography with computed tomography (PET/CT) for detecting recurrence after chemotherapy. FDG PET/CT revealed multiple new hypermetabolic lesions in many places, including the right thyroid gland. Biopsy of the thyroid lesion was performed, and a diagnosis of metastatic TCC was made. We could detect thyroid metastasis of renal TCC by FDG PET/CT.

  17. Detection of Thyroid Metastasis pf Renal Transitional Cell Carcinoma Using FDG PET/CT

    International Nuclear Information System (INIS)

    A 69 year old man who was diagnosed with renal transitional cell carcinoma (TCC) underwent F 18 fluorodeoxyglucose (FDG) positron emission tomography with computed tomography (PET/CT) for detecting recurrence after chemotherapy. FDG PET/CT revealed multiple new hypermetabolic lesions in many places, including the right thyroid gland. Biopsy of the thyroid lesion was performed,and a diagnosis of metastatic TCC was made. We could detect thyroid metastasis of renal TCC by FDG PET/CT.

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-12-15

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

  20. Characterizing bone marrow involvement in Hodgkin's lymphoma by FDG-PET/CT

    International Nuclear Information System (INIS)

    Fluoro-deoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) is superior to iliac bone marrow biopsy (iBMB) for detection of bone marrow involvement (BMI) in staging of Hodgkin's lymphoma (HL). The present study aims to characterize the patterns and distribution of BMI in HL as determined by FDG-PET/CT. Reports of FDG-PET/CT studies performed for staging of HL were reviewed. BMI was defined as positive iBMB and/or foci of pathological FDG uptake in the skeleton that behaved in concordance with other sites of lymphoma in studies following chemotherapy. Number of FDG uptake foci, their specific location in the skeleton and the presence of corresponding lesions in the CT component of the study, and stage according to the Ann Arbor staging system, were recorded. The study included 473 patients. iBMB was performed in 336 patients. Nine patients had positive iBMB (9/336, 3 %). Seventy-three patients (73/473, 15 %) had FDG-PET/CT-defined BMI. The BM was the only extranodal site of HL in 52/473 patients (11 %). Forty-five patients had three or more foci of pathological skeletal FDG uptake (45/73, 62 %). Sixty-four patients (64/73, 88 %) had at least one uptake focus in the pelvis or vertebrae. In 60 patients (60/73, 82 %), the number of skeletal FDG uptake foci without corresponding CT lesions was equal to or higher than the number of foci with morphological abnormalities. FDG-PET/CT demonstrated BMI in 15 % of patients with newly diagnosed HL. Diagnosis of BMI in HL by FDG-PET/CT was more sensitive than iBMB with potential upstage in 11 % of patients. The most common pattern of FDG-PET/CT BMI was multifocal (at least three foci) skeletal FDG uptake, with at least one focus in the pelvis or vertebrae and no corresponding CT lesions. (orig.)

  1. Diagnostic usefulness of FDG PET for pancreatic mass lesions

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the feasibility of [18F]2-deoxy-2-fluoro-D-glucose (FDG) positron emission tomography (PET) in patients with a pancreatic mass by comparing the results with those of X-ray computed tomography (CT) and magnetic resonance (MR) imaging. Eighty-six patients with pancreatic lesions, included 65 malignant tumors and 21 benign masses (55 masses were proven histologically and the others were diagnosed clinically), were studied. The diagnostic factors of CT and MR imaging were evaluated, and those of FDG PET were also evaluated for malignant and benign masses by visual interpretation and quantitative interpretation with the standardized uptake value (SUV) and SUVgluc which was designed to reduce the effects of a high blood sugar level. Visual interpretations were evaluated only in FDG PET images, and quantitative interpretations were evaluated by referring to CT and/or MR imaging. The correlation between SUV and the degree of histological differentiation in pancreatic ductal adenocarcinoma was investigated. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for CT imaging were 91, 62, 88, 68 and 84%, and for MR imaging 78, 70, 88, 54 and 76%, respectively. In visual interpretation of FDG PET images, the sensitivity, specificity, PPV, NPV and accuracy were 82, 81, 93, 59 and 81%, respectively. Significant differences between malignant and benign lesions existed in SUV and SUVgluc (p<0.0001, each). With the cutoff value of SUV as 2.1 and SUVgluc as 2.2, the accuracy of diagnosis was maximal. With that cutoff value, the sensitivity, specificity, PPV, NPV and accuracy for SUV were 89, 76, 92, 70 and 86%, and for SUVgluc 91, 76, 92, 73 and 87%, respectively. The sensitivity and NPV of SUVgluc were higher than those of SUV, which suggests that SUVgluc may be more useful in reducing the number of overlooked malignant tumors. The specificity and PPV of FDG PET were superior to those of

  2. Incremental diagnostic utility of gastric distension FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Le Roux, Pierre-Yves [Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia); Brest University Hospital, Department of Nuclear Medicine, Brest (France); Duong, Cuong P.; Cabalag, Carlos S. [Peter MacCallum Cancer Centre, Department of Surgical Oncology, East Melbourne, VIC (Australia); Parameswaran, Bimal K.; Callahan, Jason [Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia); Hicks, Rodney J. [Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia); The University of Melbourne, Parkville (Australia)

    2016-04-15

    To assess the diagnostic utility of gastric distension (GD) FDG PET/CT in both patients with known gastric malignancy and those not known to have gastric malignancy but with incidental focal FDG uptake in the stomach. This retrospective analysis included 88 patients who underwent FDG PET/CT following GD with hyoscine N-butylbromide (Buscopan registered) and water ingestion as part of routine clinical evaluation between 2004 and 2014. FDG PET/CT scans before and after GD were reported blinded to the patient clinical details in 49 patients undergoing pretreatment staging of gastric malignancy and 39 patients who underwent GD following incidental suspicious gastric uptake. The PET findings were validated by a composite clinical standard. In the 49 patients undergoing pretreatment staging of gastric malignancy, GD improved PET detection of the primary tumour (from 80 % to 90 %). PET evaluation of tumour extent was concordant with endoscopic/surgical reports in 31 % (interpreter 1) and 45 % (interpreter 2) using pre-GD images and 73 % and 76 % using GD images. Interobserver agreement also improved with GD (κ = 0.29 to 0.69). Metabolic and morphological quantitative analysis demonstrated a major impact of GD in normal gastric wall but no significant effect in tumour, except a minor increase in SUV related to a delayed acquisition time. The tumour to normal stomach SUVmax ratio increased from 3.8 ± 2.9 to 9.2 ± 8.6 (mean ± SD) with GD (p < 0.0001), facilitating detection and improved assessment of the primary tumour. In 25 (64 %) of the 39 patients with incidental suspicious gastric uptake, acquisition after GD correctly excluded a malignant process. In 10 (71 %) of the remaining 14 patients with persistent suspicious FDG uptake despite GD, malignancy was confirmed and in 3 (21 %) an active but benign pathology was diagnosed. GD is a simple way to improve local staging with FDG PET in patients with gastric malignancy. In the setting of incidental suspicious gastric

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  5. The clinical contribution of FDG-PET in the peritoneal metastasis from colorectal or ovarian cancer

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the clinical contribution of fluorodeoxyglucose-positron emission tomography (FDG-PET) for detecting peritoneal metastasis and therapeutic decision in patients with colorectal or ovarian cancer. Twenty patients with abnormal FDG uptake in the peritoneum were enrolled in this study. We could distinct the peritoneum from the enteric loop by PET/CT. Clinical management was altered by FDG-PET in 11 patients that were performed operation or chemotherapy. FDG-PET/CT has a clinical contribution in the peritoneal metastasis from colorectal or ovarian cancer. (author)

  6. Decreased brain FDG uptake in patients with extensive non-Hodgkin's lymphoma lesions

    International Nuclear Information System (INIS)

    Faint brain [18F]fluoro-2-deoxyglucose (FDG) uptake has sporadically been reported in patients with FDG-avid large or diffusely extended tumors. The purpose of this study was to investigate whether there is a correlation between massive tumor uptake and decreased brain uptake on FDG positron emission tomography/computed tomography (PET/CT). Sixty-five patients with histologically confirmed non-Hodgkin's lymphoma who underwent FDG-PET/CT were enrolled. Thirty control subjects were also included to evaluate normal brain FDG uptake. PET/CT examinations were retrospectively reviewed. The volumetric regions of interest were placed over lesions by referring to CT and PET/CT fusion images to measure mean standardized uptake value (SUVavg). The products of SUVavg and tumor volume were calculated as total glycolytic volume (TGV). The maximum SUV (SUVmax) and SUVavg were measured in the cerebrum and cerebellum. The values of TGV and brain FDG uptake were plotted and analyzed with a linear regression method. In the lymphoma patients, there were statistically significant negative correlations between TGV and brain SUVs. Demonstrating a significant negative correlation between TGV and brain uptake validated the phenomenon of decreased brain FDG uptake. Diversion of FDG from the brain to the lymphoma tissue may occur during the FDG accumulation process. Recognition of this phenomenon prevents unnecessary further neurological examinations in such cases. (author)

  7. Suture Granuloma Showing False-Positive Findings on FDG-PET

    Directory of Open Access Journals (Sweden)

    Kohei Takahara

    2013-01-01

    Full Text Available We report a case of a 33-year-old male with a mixed germ-cell testicular tumor. Postoperative follow-up FDG-PET revealed concentration of FDG in the left inguinal area which is not tumor metastasis or local recurrence but suture reactivity granuloma. In this paper, we reviewed suture granulomas associated with false-positive findings on FDG-PET after surgery. If FDG-PET will be used more frequently in the future, it will be necessary to refrain from using silk thread in order to prevent any unnecessary surgery.

  8. Value of whole-body FDG PET in management of lung cancer

    International Nuclear Information System (INIS)

    18F-fluorodeoxyglucose (FDG) PET imaging provides physiologic and metabolic information that characterizes lesions that are indeterminate by CT. FDG PET imaging is sensitive to the detection of lung cancer in patients who have indeterminate lesions on CT, whereas low grade malignancy such as bronchioloalveolar carcinoma and carcinoid may be negative on FDG PET. The specificity of PET imaging is less than its sensitivity because some inflammatory processes, such as active granulomatous infections, avidly accumulate FDG. This possibility should be kept in mind in the analysis of PET studies of glucose metabolism aimed at differentiating malignant from benign solitary pulmonary nodules. FDG uptake is considered to be a good marker of cell differentiation, proliferative potential, aggressiveness, and the grade of malignancy in patients with lung cancer. FDG PET accurately stages the distribution of lung cancer. Several studies have documented the increased accuracy of PET compared with CT in the evaluation of the hilar and mediastinal lymphnode status in patients with lung cancer. Whole-body PET studies detect metastatic disease that is unsuspected by conventional imaging. Management changes have been reported in up to 41% of patients on the basis of the results of whole-body studies. Whole-body FDG PET is also useful for the detection of recurrence. Several studies have indicated that the degree of FDG uptake in primary lung cancer can be used as an independent prognostic factor. Thus, whole-body FDG PET is clinically very useful in the management of lung cancer. (author)

  9. Molecular cardiac PET besides FDG viability imaging; Molekulare Kardiale PET jenseits der FDG-Vitalitaetsdiagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Lindner, O.; Burchert, W. [Universitaetsklinik der Ruhr-Univ. Bochum (Germany). Inst. fuer Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabetszentrum NRW

    2009-06-15

    Molecular cardiac non F-18-FDG PET is currently based on perfusion imaging. It is of excellent diagnostic accuracy to detect coronary artery disease (CAD) and superior to perfusion SPECT. There is also evidence for its incremental prognostic value. The unique feature of PET to measure myocardial perfusion in absolute terms and in short time periods define its impact on cardiac imaging enabling both the evaluation of early changes in CAD and the accurate characterization of multivessel disease. Currently, all available PET perfusion tracers in Europe are cyclotron products. Rb-82, a generator product, is the most frequently employed perfusion tracer in the United States and cyclotron independent. This tracer has the potential to become an alternative in Europe soon. Nowadays, PET systems are manufactured as hybrid PET-CT scanners. In oncology, hybrid imaging revealed, that the combination of functional and morphological imaging is superior to the single components. In cardiology, the integration of perfusion PET imaging with CT calcium scoring and CT anatomy of the coronary arteries represents a similar constellation. Atherosclerotic plaque evaluation by combined PET-CT technique will be one of the most promising future applications with a potential immense impact on prophylaxis, diagnosis and therapy of CAD in the future. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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.

  12. [18F]FDG-PET in lung cancer: current status

    OpenAIRE

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

    2005-01-01

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

  13. 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)?

    International Nuclear Information System (INIS)

    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)

  14. Ten years summary: FDG-PET on irradiated brain tumour

    International Nuclear Information System (INIS)

    Purpose: To retrospectively evaluate FDG-PET in differentiation of post-radiotherapy status: recurrence, radiation necrosis, malignant regression of low grade primary brain tumour, and to evaluate PET in terms of survival prediction. Material and methods: 117 irradiated patients (156 PET) were consecutively included. PET results were judged by a set of rigid follow-up standards. Brain metastases from lung carcinoma were further studied. Survival time was analysed with Kaplan-Meier method. Results: There were 61 true-positive, 2 false-positive, 15 false-negative, 51 true-negative PET; leaving 5 positive and 22 negative PET results indeterminate. PET positive predictive value was 96% in all and 100% in brain metastasis from lung carcinoma. PET negative predictive value was 55.6% among surgically selected cases. Survival time was significantly longer in patient's with negative PET, both brain metastasis and primary brain tumour. Conclusions: FDG-PET was a good method to pick up tumour recurrence from radiation necrosis, especially metastasis from lung carcinoma. FDG uptake could be used as a non-invasive parameter to predict patient's prognosis. (authors)

  15. Clinical application of FDG-PET for cancer diagnosis

    International Nuclear Information System (INIS)

    Positron emission tomography using 18F-FDG is accepted in clinical medicine as an imaging tool for the diagnosis and assessment of a large variety of cancers. Medicare reimbursement for these studies has been accepted in Japan since 2002. The number of requests for FDG-PET examinations has been increasing in institutions where a PET device is installed. PET is considered to be especially effective in re-staging and detecting recurrence of disease. In order to evaluate PET images properly, it is important to be familiar with the various physiological uptake patterns of FDG, and also to be alert to the possibility of false-positive and false-negative findings. Quantitative values obtained in PET images are widely used for the differentiation of benign and malignant tumors and for monitoring treatment; however, it should be kept in mind that these values may be influenced by many factors. To complement the poorer spatial resolution of PET, a combined PET/CT scanner has been created and its clinical application has begun. It is expected that this imaging tool will be useful and have a great effect on patient management. (author)

  16. FDG-PET using coincidence gamma cameras - an update

    International Nuclear Information System (INIS)

    PET imaging with F-18 labeled tracers - mainly FDG - is on the verge to be applied in a broad clinical setting with a multitude of indications in oncology, neurology and cardiology. Main obstacles for a more widespread distribution of PET technology are the high costs of cyclotron products (350-500 Euro for FDG in satellite distribution) and of dedicated PET tomographs (1.5 Mio Euro). As a consequence, dual head gamma cameras were equipped for coincidence detection and tested as 'small PET'. Meanwhile a few studies have been published allowing a new evaluation of coincidence gamma cameras for FDG imaging. Decisive criteria should be the better diagnostic performance in comparison with CT and MRI. Applying restrictive indications these systems might be useful for staging head and neck tumors, and for evaluation of solitary pulmonary nodules larger than 1 cm. In the future, the option for camera PET most likely will be the control of ongoing therapy of known lesions (chemo- or radiotherapy). (orig.)

  17. The gender difference in the brain FDG distribution with aging

    International Nuclear Information System (INIS)

    The purpose of this study is to examine the change in brain fluorodeoxyglucose (FDG) distribution with aging. Subjects were 85 men and 116 women who had no mental abnormality and no evidence of cancer in the whole body FDG-positron emission tomography (PET) study for cancer checkup. The brain data were extracted from whole body data, and stratified according to the age: 30-39 (M: 10, F: 18), 40-49 (M: 11, F: 14), 50-59 (M: 10, F: 27), 60-64 (M: 11, F: 13), 65-69 (M: 11, F: 11), 70-74 (M: 11, F: 10), 75-79 (M: 13, F: 11), over 80 (M: 8, F: 12) years. Forties or more male and female stratified age groups were compared with each gender 30's age data using Statistical Parametric Mapping (SPM)2. In the man, the FDG activity of the bilateral temporal and frontal lobes decreased and the decreased domains were expanded with aging. But in the females, the decreased domains were complicated in 40-69 years old. Dynamic changes of sex hormones in the individual female menopause may affect the complicated results in the females. Further studies are needed to confirm it. (author)

  18. Estimate of FDG Excretion by means of Compartmental Analysis and Ant Colony Optimization of Nuclear Medicine Data

    OpenAIRE

    Sara Garbarino; Giacomo Caviglia; Massimo Brignone; Michela Massollo; Gianmario Sambuceti; Michele Piana

    2013-01-01

    [18F]fluoro-2-deoxy-D-glucose (FDG) is one of the most utilized tracers for positron emission tomography (PET) applications in oncology. FDG-PET relies on higher glycolytic activity in tumors compared to normal structures as the basis of image contrast. As a glucose analog, FDG is transported into malignant cells which typically exhibit an increased radioactivity. However, different from glucose, FDG is not reabsorbed by the renal system and is excreted to the bladder. The present paper de...

  19. 18F-FDG PET/CT features of pulmonary sclerosing hemangioma

    International Nuclear Information System (INIS)

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

  20. Altered biodistribution of FDG in patients with type-2 diabetes mellitus

    International Nuclear Information System (INIS)

    Positron emission tomography-computed tomography (PET-CT) imaging of patients with diabetes can be problematic because elevated glucose levels may cause competitive inhibition of [F-18]-2-deoxy-2-fluoro-D-glucose (FDG) uptake in different tissues. Therefore, the aim of the study was to evaluate the biodistribution of FDG in patients with type-2 diabetes mellitus. Two hundred forty patients were retrospectively enrolled to the study. Study population was divided into three subgroups, named as the normal (group 1), the insulin (group 2) and the oral anti-diabetic (group 3). Unenhanced low-dose CT and PET emission data were acquired from the mid-thigh to the vertex of the skull. FDG uptakes in different organs were evaluated qualitatively or semi-quantitatively. In the diabetic groups, diffuse FDG uptake of the colon was increased (p > 0.001) but segmental FDG uptake was decreased (p > 0.001). Intestinal FDG uptake was detected in 20% of the study population and only 3% of these uptakes were in diffuse pattern. Segmental FDG uptake in the bowel was increased significantly in the groups of patients with diabetes (p = 0.002). Maximum standardized uptake values of the liver in the groups 1, 2, and 3 were 2.66 ± 0.6, 3.25 ± 0.9 and 3.16 ± 0.8, respectively, and the difference between the groups was not statistically significant (p = 0.083). Cardiac FDG uptake was decreased significantly in the groups of patients with diabetes (p < 0.001). According to our results, whole body bio-distribution of FDG uptake seems to be changed in patients with type-2 diabetes who were using insulin or oral anti-diabetic drugs. Although the use of oral antidiabetic drugs was known to change the biodistribution of FDG, insulin use also seems to change FDG uptake in different organs of diabetic patients. (author)

  1. Kinetic characterization of hexokinase isoenzymes from glioma cells: Implications for FDG imaging of human brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Muzi, Mark E-mail: muzi@u.washington.edu; Freeman, Scott D.; Burrows, Robert C.; Wiseman, Robert W.; Link, Jeanne M.; Krohn, Kenneth A.; Graham, Michael M.; Spence, Alexander M

    2001-02-01

    Quantitative imaging of glucose metabolism of human brain tumors with PET utilizes 2-[{sup 18}F]-fluorodeoxy-D-glucose (FDG) and a conversion factor called the lumped constant (LC), which relates the metabolic rate of FDG to glucose. Since tumors have greater uptake of FDG than would be predicted by the metabolism of native glucose, the characteristic of tumors that governs the uptake of FDG must be part of the LC. The LC is chiefly determined by the phosphorylation ratio (PR), which is comprised of the kinetic parameters (Km and Vmax) of hexokinase (HK) for glucose as well as for FDG (LC {proportional_to} (Km{sub glc} {center_dot} Vmax{sub FDG})/(Km{sub FDG} {center_dot} Vmax{sub glc})). The value of the LC has been estimated from imaging studies, but not validated in vitro from HK kinetic parameters. In this study we measured the kinetic constants of bovine and 36B-10 rat glioma HK I (predominant in normal brain) and 36B-10 glioma HK II (increased in brain tumors) for the hexose substrates glucose, 2-deoxy-D-glucose (2DG) and FDG. Our principal results show that the KmGlc < KmFDG << Km2DG and that PR2DG < PRFDG. The FDG LC calculated from our kinetic parameters for normal brain, possessing predominantly HK I, would be higher than the normal brain LC predicted from animal studies using 2DG or human PET studies using FDG or 2DG. These results also suggest that a shift from HK I to HK II, which has been observed to increase in brain tumors, would have little effect on the value of the tumor LC.

  2. Feasibility of FDG-PET/CT for the initial diagnosis of papillary thyroid cancer.

    Science.gov (United States)

    Kim, Heejin; Na, Kyung Jin; Choi, Jae Hyuk; Ahn, Byeong-Cheol; Ahn, Dongbin; Sohn, Jin Ho

    2016-06-01

    To assess the role of [18F]-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) as a preoperative diagnostic tool in papillary thyroid carcinoma (PTC). From 2011 to 2014, 197 patients with PTC (246 tumor foci in all) underwent FDG-PET. Among these patients, 46 underwent neck dissection for lateral neck metastasis. According to the FDG avidity of the tumor foci or lateral neck metastasis, factors associated with the prognostic value were evaluated by univariate and multivariate logistic regression analyses. Among the 197 patients, 7 (3.6 %) were incidentally found to have non-thyroid origin malignancy. Additionally, 63.0 % (155/246) of PTC foci showed FDG uptake on PET/CT. Univariate analysis showed that the tumor size, the presence of extrathyroidal extension, BRAF mutation, and Hashimoto thyroiditis were associated with FDG avidity. However, except for pathological extrathyroidal extension, the other factors showed statistically significant correlations with FDG avidity (p < 0.001, p = 0.008, and p = 0.009, respectively). FDG uptake in lateral neck node metastasis showed high specificity and negative predictive value (NPV). In four cases of nonspecific findings on ultrasonography (USG)/CT, FDG avidity was helpful to diagnose the presence of lateral neck metastasis. The maximum standardized uptake value (SUVmax) of PET/CT was correlated with the maximum diameter of the involved lateral node. FDG avidity did not show any significance in the recurrence-free survival of both the thyroid tumor and lateral neck metastasis. The FDG avidity of PTC did not show prognostic predictive meaning. However, in the case of lateral neck metastasis, FDG avidity showed high sensitivity and NPV, and could provide better information in cases of nonspecific findings on USG and CT. PMID:25971994

  3. Kinetic characterization of hexokinase isoenzymes from glioma cells: Implications for FDG imaging of human brain tumors

    International Nuclear Information System (INIS)

    Quantitative imaging of glucose metabolism of human brain tumors with PET utilizes 2-[18F]-fluorodeoxy-D-glucose (FDG) and a conversion factor called the lumped constant (LC), which relates the metabolic rate of FDG to glucose. Since tumors have greater uptake of FDG than would be predicted by the metabolism of native glucose, the characteristic of tumors that governs the uptake of FDG must be part of the LC. The LC is chiefly determined by the phosphorylation ratio (PR), which is comprised of the kinetic parameters (Km and Vmax) of hexokinase (HK) for glucose as well as for FDG (LC ∝ (Kmglc · VmaxFDG)/(KmFDG · Vmaxglc). The value of the LC has been estimated from imaging studies, but not validated in vitro from HK kinetic parameters. In this study we measured the kinetic constants of bovine and 36B-10 rat glioma HK I (predominant in normal brain) and 36B-10 glioma HK II (increased in brain tumors) for the hexose substrates glucose, 2-deoxy-D-glucose (2DG) and FDG. Our principal results show that the KmGlc < KmFDG << Km2DG and that PR2DG < PRFDG. The FDG LC calculated from our kinetic parameters for normal brain, possessing predominantly HK I, would be higher than the normal brain LC predicted from animal studies using 2DG or human PET studies using FDG or 2DG. These results also suggest that a shift from HK I to HK II, which has been observed to increase in brain tumors, would have little effect on the value of the tumor LC

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

    International Nuclear Information System (INIS)

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

  5. Optimizing 18F-FDG PET/CT Imaging of Vessel Wall Inflammation –The Impact of 18F-FDG Circulation Time, Injected Dose, Uptake Parameters, and Fasting Blood Glucose Levels

    Science.gov (United States)

    Bucerius, Jan; Mani, Venkatesh; Moncrieff, Colin; Machac, Josef; Fuster, Valentin; Farkouh, Michael E.; Tawakol, Ahmed; Rudd, James H. F.; Fayad, Zahi A.

    2014-01-01

    Purpose 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is increasingly used for imaging of vessel wall inflammation. However, limited data is available regarding the impact of methodological variables, i. e. patient’s pre-scan fasting glucose, the FDG circulation time, the injected FDG dose, and of different FDG uptake parameters, in vascular FDG-PET imaging. Methods 195 patients underwent vascular FDG-PET/CT of the aorta and the carotids. Arterial standard uptake values (meanSUVmax) as well as target-to-background-ratios (meanTBRmax) and the FDG blood pool activity in the superior vein cava (SVC) and the jugular veins (JV) were quantified. Vascular FDG uptake classified according to tertiles of patient’s pre-scan fasting glucose levels, the FDG circulation time, and the injected FDG dose was compared using ANOVA. Multivariate regression analyses were performed to identify the potential impact of all variables described on the arterial and blood pool FDG uptake. Results Tertile analyses revealed FDG circulation times of about 2.5 h and prescan glucose levels of less than 7.0 mmol/l showing favorable relations between the arterial and blood pool FDG uptake. FDG circulation times showed negative associations with the aortic meanSUVmax values as well as SVC- and JV FDG blood pool activity but a positive correlation with the aortic- and carotid meanTBRmax values. Pre-scan glucose was negatively associated with aortic- and carotid meanTBRmax and carotid meanSUVmax values, but correlated positively with the SVC blood pool uptake. Injected FDG dose failed to show any significant association with the vascular FDG uptake. Conclusion FDG circulation times and pre-scan blood glucose levels significantly impact FDG uptake within the aortic and carotid wall and may bias the results of image interpretation in patients undergoing vascular FDG-PET/CT. FDG dose injected was less critical. Therefore, circulation times of about 2.5 h and pre-scan glucose levels

  6. Optimizing {sup 18}F-FDG PET/CT imaging of vessel wall inflammation: the impact of {sup 18}F-FDG circulation time, injected dose, uptake parameters, and fasting blood glucose levels

    Energy Technology Data Exchange (ETDEWEB)

    Bucerius, Jan [Icahn School of Medicine at Mount Sinai, Translational and Molecular Imaging Institute, One Gustave L. Levy Place, P.O. Box 1234, New York, NY (United States); Mount Sinai School of Medicine, Department of Radiology, New York, NY (United States); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); Maastricht University Medical Center, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); University Hospital, RWTH Aachen, Department of Nuclear Medicine, Aachen (Germany); Mani, Venkatesh; Fayad, Zahi A. [Icahn School of Medicine at Mount Sinai, Translational and Molecular Imaging Institute, One Gustave L. Levy Place, P.O. Box 1234, New York, NY (United States); Mount Sinai School of Medicine, Department of Radiology, New York, NY (United States); Mount Sinai School of Medicine, Department of Cardiology, Zena and Michael A. Weiner Cardiovascular Institute and Marie-Josee and Henry R. Kravis Cardiovascular Health Center, New York, NY (United States); Moncrieff, Colin [Icahn School of Medicine at Mount Sinai, Translational and Molecular Imaging Institute, One Gustave L. Levy Place, P.O. Box 1234, New York, NY (United States); Mount Sinai School of Medicine, Department of Radiology, New York, NY (United States); Machac, Josef [Mount Sinai School of Medicine, Division of Nuclear Medicine, Department of Radiology, New York, NY (United States); Fuster, Valentin [Mount Sinai School of Medicine, Department of Cardiology, Zena and Michael A. Weiner Cardiovascular Institute and Marie-Josee and Henry R. Kravis Cardiovascular Health Center, New York, NY (United States); The Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid (Spain); Farkouh, Michael E. [Mount Sinai School of Medicine, Department of Cardiology, Zena and Michael A. Weiner Cardiovascular Institute and Marie-Josee and Henry R. Kravis Cardiovascular Health Center, New York, NY (United States); Mount Sinai School of Medicine, Cardiovascular Imaging Clinical Trials Unit, New York, NY (United States); Tawakol, Ahmed [Massachusetts General Hospital, Harvard University, Cardiac MR PET CT Program, Boston, MA (United States); Rudd, James H.F. [Cambridge University, Division of Cardiovascular Medicine, Cambridge (United Kingdom)

    2014-02-15

    {sup 18}F-FDG PET is increasingly used for imaging of vessel wall inflammation. However, limited data are available on the impact of methodological variables, i.e. prescan fasting glucose, FDG circulation time and injected FDG dose, and of different FDG uptake parameters, in vascular FDG PET imaging. Included in the study were 195 patients who underwent vascular FDG PET/CT of the aorta and the carotids. Arterial standardized uptake values ({sub mean}SUV{sub max}), target-to-background ratios ({sub mean}TBR{sub max}) and FDG blood-pool activity in the superior vena cava (SVC) and the jugular veins (JV) were quantified. Vascular FDG uptake values classified according to the tertiles of prescan fasting glucose levels, the FDG circulation time, and the injected FDG dose were compared using ANOVA. Multivariate regression analyses were performed to identify the potential impact of all variables described on the arterial and blood-pool FDG uptake. Tertile analyses revealed FDG circulation times of about 2.5 h and prescan glucose levels of less than 7.0 mmol/l, showing a favorable relationship between arterial and blood-pool FDG uptake. FDG circulation times showed negative associations with aortic{sub mean}SUV{sub max} values as well as SVC and JV FDG blood-pool activity, but positive correlations with aortic and carotid{sub mean}TBR{sub max} values. Prescan glucose levels were negatively associated with aortic and carotid{sub mean}TBR{sub max} and carotid{sub mean}SUV{sub max} values, but were positively correlated with SVC blood-pool uptake. The injected FDG dose failed to show any significant association with vascular FDG uptake. FDG circulation times and prescan blood glucose levels significantly affect FDG uptake in the aortic and carotid walls and may bias the results of image interpretation in patients undergoing vascular FDG PET/CT. The injected FDG dose was less critical. Therefore, circulation times of about 2.5 h and prescan glucose levels less than 7.0 mmol

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Potential Pitfall in the Assessment of Lung Cancer with FDG-PET/CT: Talc Pleurodesis Causes Intrathoracic Nodal FDG Avidity

    Directory of Open Access Journals (Sweden)

    Yingbing Wang

    2013-01-01

    Full Text Available Objective. Talc pleurodesis is a common procedure performed to treat complications related to lung cancer. The purpose of our study was to characterize any thoracic nodal findings on FDG PET/CT associated with prior talc pleurodesis. Materials and Methods. The electronic medical record identified 44 patients who underwent PET/CT between January 2006 and December 2010 and had a history of talc pleurodesis. For each exam, we evaluated the distribution pattern, size, and attenuation of intrathoracic lymph nodes and the associated standardized uptake value. Results. High-attenuation intrathoracic lymph nodes were noted in 11 patients (25%, and all had corresponding increased FDG uptake (range 2–9 mm. Involved nodal groups were anterior peridiaphragmatic (100%, paracardiac (45%, internal mammary (25%, and peri-IVC (18% nodal stations. Seven of the 11 patients (63% had involvement of multiple lymph nodal groups. Mean longitudinal PET/CT and standalone CT followups of 15±11 months showed persistence of both high-attenuation and increased uptake at these sites, without increase in nodal size suggesting metastatic disease involvement. Conclusions. FDG avid, high-attenuation lymph nodes along the lymphatic drainage pathway for parietal pleura are a relatively common finding following talc pleurodesis and should not be mistaken for nodal metastases during the evaluation of patients with history of lung cancer.

  9. Association between FDG uptake, CSF biomarkers and cognitive performance in patients with probable Alzheimer's disease

    International Nuclear Information System (INIS)

    Brain imaging of FDG uptake and cerebrospinal fluid (CSF) concentration of amyloid-beta 1-42 (Aβ1-42) or tau proteins are promising biomarkers in the diagnosis of Alzheimer's disease (AD). There is still uncertainty regarding any association between decreased FDG uptake and alterations in CSF markers. The relationship between FDG uptake, CSF Aβ1-42 and total tau (T-tau), as well as the Mini-Mental State Examination (MMSE) score was investigated in 34 subjects with probable AD using step-wise linear regression. FDG uptake was scaled to the pons. Scaled FDG uptake was significantly reduced in the probable AD subjects compared to 17 controls bilaterally in the precuneus/posterior cingulate area, angular gyrus/inferior parietal cortex, inferior temporal/midtemporal cortex, midfrontal cortex, and left caudate. Voxel-based single-subject analysis of the probable AD subjects at p 1-42. Scaled FDG uptake in the caudate was positively correlated with CSF T-tau. The extent and local severity of the reduction in FDG uptake in probable AD subjects are associated with cognitive impairment. In addition, there appears to be a relationship between local FDG uptake and CSF biomarkers which differs between different brain regions. (orig.)

  10. Contribution of whole body FDG-PET to the detection of distant metastasis in pancreatic cancer

    International Nuclear Information System (INIS)

    Accurate baseline staging is necessary to appropriately treat pancreatic cancer. The present study was undertaken to evaluate the clinical contribution of whole body fluorodeoxyglucose (FDG)-PET to the detection of distant metastasis in pancreatic cancer. A total of consecutive 42 patients with previously untreated pancreatic cancer were examined. Whole body FDG-PET imaging for initial staging was performed with a 3D acquisition and iterative reconstruction on Siemens ECAT HR+ scanner at 1 hour post 185-200 MBq 18F-FDG injection. PET findings were correlated with clinical and radiological data to determine the impact of PET on staging. In 16 patients, there were one or more sites of metastasis based on clinical data. FDG-PET correctly identified the presence of metastasis in 13 of 16 patients and its absence in 23 of the remaining 26 patients. Thus, FDG-PET missed 4 metastatic sites in 4 patients (liver and lung metastasis). FDG-PET correctly identified 8 metastatic sites in 7 patients (peritoneal dissemination and liver, bone and supraclavicular lymph node metastasis), which were missed on CT imaging. Based on whole body FDG-PET, the clinical stage was changed in 5 of 42 patients (11.9%). These results suggest that FDG-PET and CT appear to have a complementary role in the detection of distant metastasis in patients with pancreatic cancer. (author)

  11. The pivotal role of FDG-PET/CT in modern medicine

    DEFF Research Database (Denmark)

    Hess, Søren; Blomberg, Björn Alexander; Zhu, Hongyun June;

    2014-01-01

    to the emergence of hybrid scanners combining PET with computed tomography (PET/CT). Molecular imaging has enormous potential for advancing biological research and patient care, and FDG-PET/CT is currently the most widely used technology in this domain. In this review, we discuss contemporary applications of FDG...

  12. Monitoring liver tumor therapy with [18F]FDG positron emission tomography

    International Nuclear Information System (INIS)

    Positron emission tomography (PET) with [18F]-2-flurodeoxy-glucose (FDG) can be utilized as a functional imaging modality for monitoring liver tumor therapy. We report three cases in which PET-FDG was more useful for this purpose than other imaging methods and tumor markers

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-03-15

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

  14. A new dimension of FDG-PET interpretation: assessment of tumor biology

    Energy Technology Data Exchange (ETDEWEB)

    Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Basu, Sandip [Tata Memorial Center Annexe, Radiation Medicine Center (Bhabha Atomic Research Center), Bombay (India); Hospital of the University of Pennsylvania, Division of Nuclear Medicine, Philadelphia, PA (United States); Saboury, Babak; Torigian, Drew A.; Alavi, Abass [Hospital of the University of Pennsylvania, Division of Nuclear Medicine, Philadelphia, PA (United States); Ambrosini, Valentina [Sant' Orsola-Malpighi University Hospital, Department of Nuclear Medicine, Bologna (Italy)

    2011-06-15

    {sup 18}F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is increasingly being used for the evaluation of several malignancies. Key to the correct interpretation of oncological FDG-PET studies is awareness of the concept that the degree of FDG uptake reflects the biology of the tumor in many cancers. More specifically, cancers with high FDG uptake are often histologically and clinically more aggressive than those with low or no FDG uptake. Therefore, although a negative FDG-PET scan in a patient with a cancer that has a size above the spatial resolution of PET may be interpreted as false-negative in terms of tumor detectability, it should in fact be regarded as true-negative from the view-point of tumor biology. This nonsystematic review will give examples of several major cancers in which the relationship between FDG avidity and tumor biology is applicable, and emphasizes the need to reconsider the definition of a ''false-negative'' FDG-PET scan in clinical oncology. (orig.)

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

    NARCIS (Netherlands)

    Lensen, K. D. F.; Comans, E. F. I.; Voskuyl, A. E.; van der Laken, C. J.; Brouwer, E.; Zwijnenburg, A. T.; Arias-Bouda, L. M. Pereira; Glaudemans, A. W. J. M.; Slart, R. H. J. A.; Smulders, Y. M.

    2015-01-01

    Introduction. F-18-FDG-PET visualises inflammation. Both atherosclerosis and giant cell arteritis cause vascular inflammation, but distinguishing the two may be difficult. The goal of this study was to assess interobserver agreement and diagnostic accuracy of F-18-FDG-PET for the detection of large

  16. FDG-PET parameters as prognostic factor in esophageal cancer patients: a review

    NARCIS (Netherlands)

    J.M.T. Omloo; M. van Heijl; O.S. Hoekstra; M.I. van Berge Henegouwen; J.J.B. van Lanschot; G.W. Sloof

    2011-01-01

    (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) has been used extensively to explore whether FDG Uptake can be used to provide prognostic information for esophageal cancer patients. The aim of the present review is to evaluate the literature available to date concerning the potential

  17. A new dimension of FDG-PET interpretation: assessment of tumor biology

    International Nuclear Information System (INIS)

    18F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is increasingly being used for the evaluation of several malignancies. Key to the correct interpretation of oncological FDG-PET studies is awareness of the concept that the degree of FDG uptake reflects the biology of the tumor in many cancers. More specifically, cancers with high FDG uptake are often histologically and clinically more aggressive than those with low or no FDG uptake. Therefore, although a negative FDG-PET scan in a patient with a cancer that has a size above the spatial resolution of PET may be interpreted as false-negative in terms of tumor detectability, it should in fact be regarded as true-negative from the view-point of tumor biology. This nonsystematic review will give examples of several major cancers in which the relationship between FDG avidity and tumor biology is applicable, and emphasizes the need to reconsider the definition of a ''false-negative'' FDG-PET scan in clinical oncology. (orig.)

  18. Postoperative FDG-PET/CT staging in GIST: Is there a benefit following R0 resection?

    International Nuclear Information System (INIS)

    Aim: Resection of the primary tumor with intraoperative staging is the standard procedure in patients with gastrointestinal stromal tumors (GIST). FDG-PET/CT has shown high accuracy when assessing treatment response in GIST patients. This study was designed to assess the accuracy of postoperative FDG-PET/CT to stage for occult tumor seeding in patients with R0 resection and without intraoperative detection of metastases. Patients and methods: 48 consecutive patients (mean age: 59 y) with histologically proven GIST underwent whole-body FDG-PET/CT after R0-resection without intraoperative detection of metastases. Fused data sets were assessed for metastases by a nuclear medicine physician and a radiologist. Histology of potential lesions and a clinical/radiological follow-up with a mean of 614 ± 415 d served as standards of reference. Results: FDG-PET/CT detected occult peritoneal metastases in 2 patients (4%). In 6 patients (13%) who later developed metastases postoperative FDG-PET/CT was falsely negative. False-positive findings were detected in 5 cases (10%) caused by increased FDG-uptake due to tissue regeneration postoperatively. In 3 patients (6%) other, formerly unknown malignancies were detected. The sensitivity and specificity of FDG-PET/CT for the detection of intraoperatively occult GIST metastases were 25% and 88%, respectively. Conclusion: FDG-PET/CT performed immediately after R0-resection of GIST without intraoperative detection of metastases does not seem to be a sufficient tool to detect clinically occult metastases.

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2007-01-01

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

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

    NARCIS (Netherlands)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  3. Evolving role of FDG PET imaging in assessing joint disorders: a systematic review

    International Nuclear Information System (INIS)

    Assessing joint disorders has been a relatively recent and evolving application of 18F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) imaging. FDG is taken up by inflammatory cells, particularly when they are active as part of an ongoing inflammatory process. Hence FDG PET has been employed to assess a wide array of arthritic disorders. FDG PET imaging has been investigated in various joint diseases for diagnostic purposes, treatment monitoring, and as a prognostic indicator as in other disorders. In some of the diseases the ancillary findings in FDG PET have provided important clues about the underlying pathophysiology and pathogenesis processes. While substantial promise has been demonstrated in a number of studies, it is clear that the potential utility of PET in this clinical realm far outweighs that which has been established to date. (orig.)

  4. Spectrum of physiological and pathological cardiac and pericardial uptake of FDG in oncology PET-CT

    International Nuclear Information System (INIS)

    Cardiac uptake of 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) is frequently observed on FDG positron-emission tomography combined with computed tomography (PET-CT) performed for diagnosis, staging, and assessment of therapeutic response of lymphoma and solid cancers, despite careful patient preparation to limit myocardial glucose substrate utilisation. We illustrate the varied physiological patterns of cardiac FDG uptake, and show a spectrum of pathological conditions causing FDG uptake within myocardial and pericardial structures, due to clinically important benign and malignant diseases. Recognition and awareness of these various causes of FDG uptake in the heart, along with the appropriate use of correlative contrast-enhanced CT and magnetic resonance imaging (MRI) will facilitate correct interpretation.

  5. A Neurofibroma Confused with Sarcomatous Transformation on F-18 FDG PET/CT in Neurofibromatosis-1

    International Nuclear Information System (INIS)

    We present a patient with high 18F-fluorodeoxyglucose (FDG) uptake detected in a neurofibroma that was confused with sarcomatous transformation on a positron emission tomography/computed tomography (PET/CT) scan. A 39-year-old male patient with a 20-year history of neurofibromatosis-1 (NF-1) performed FDG PET/CT scan for the evaluation of lesions with sarcomatous transformation. The FDG PET/CT images demonstrated varying degrees of increased FDG uptake in the multiple nodules throughout whole body. The left pelvic mass with the highest FDG uptake had a maximum standardized uptake values (maxSUV) 5.0 and surgical resection was performed. Histological analysis confirmed the presence of a benign neurofibroma infiltrated with inflammatory cells

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

    International Nuclear Information System (INIS)

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

  7. A novel description of FDG excretion in the renal system: application to metformin-treated models

    Science.gov (United States)

    Garbarino, S.; Caviglia, G.; Sambuceti, G.; Benvenuto, F.; Piana, M.

    2014-05-01

    This paper introduces a novel compartmental model describing the excretion of 18F-fluoro-deoxyglucose (FDG) in the renal system and a numerical method based on the maximum likelihood for its reduction. This approach accounts for variations in FDG concentration due to water re-absorption in renal tubules and the increase of the bladder’s volume during the FDG excretion process. From the computational viewpoint, the reconstruction of the tracer kinetic parameters is obtained by solving the maximum likelihood problem iteratively, using a non-stationary, steepest descent approach that explicitly accounts for the Poisson nature of nuclear medicine data. The reliability of the method is validated against two sets of synthetic data realized according to realistic conditions. Finally we applied this model to describe FDG excretion in the case of animal models treated with metformin. In particular we show that our approach allows the quantitative estimation of the reduction of FDG de-phosphorylation induced by metformin.

  8. Spectrum of the Breast Lesions With Increased 18F-FDG Uptake on PET/CT.

    Science.gov (United States)

    Dong, Aisheng; Wang, Yang; Lu, Jianping; Zuo, Changjing

    2016-07-01

    Interpretation of F-FDG PET/CT studies in breast is challenging owing to nonspecific FDG uptake in various benign and malignant conditions. Benign conditions include breast changes in pregnancy and lactation, gynecomastia, mastitis, fat necrosis, fibroadenoma, intraductal papilloma, and atypical ductal hyperplasia. Among malignancies, invasive ductal carcinoma and invasive lobular carcinoma are common histological types of breast carcinoma. Rarely, other unusual histological types of breast carcinomas (eg, intraductal papillary carcinoma, invasive micropapillary carcinoma, medullary carcinoma, mucinous carcinoma, and metaplastic carcinoma), lymphoma, and metastasis can be the causes. Knowledge of a wide spectrum of hypermetabolic breast lesions on FDG PET/CT is essential in accurate reading of FDG PET/CT. The purpose of this atlas article is to demonstrate features of various breast lesions encountered at our institution, both benign and malignant, which can result in hypermetabolism on FDG PET/CT imaging. PMID:26975010

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  10. The pitfalls of FDG-PET for managing the patients with primary lung cancer

    International Nuclear Information System (INIS)

    Recently positron emission tomography (PET)/CT systems have become popular and been introduced at many institutions throughout Japan and the clinical importance should increase for managing many kinds of malignant diseases including lung cancers. A 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG) has been the most important tracer in clinical usage and seems to play a major role during these several years. Since March 2004 we began operating the first PET/CT scanner in Japan with a 4-slice multi-detector CT (MDCT) and we have now introduced a second PET/CT scanner with 8-slice MDCT and have been performing 25 to 30 PET studies per day. Although some problems have been reported based on extensive experience, the ability of FDG-PET for staging lung cancers is still indispensable, like other conventional modalities such as CT, MRI and single photon emission computed tomography (SPECT). It is usually hard to differentiate malignant from benign lesions except for lesions with markedly elevated FDG accumulation. FDG accumulation in macrophages and sarcoid reaction may lead to false positive results. It is essential to interpret FDG-PET findings with the morphological characteristics of CT and/or MRI. FDG-PET has been considered superior to CT for evaluating N factor. However recent studies mention that FDG-PET might show considerable both false-positive and false-negative results particularly in patients with small primary nodules. FDG-PET is useful for integrating and simplifying many kinds of examination methods to determine the existence of distant metastases. Physiological FDG accumulation in brown fat and skeletal muscles, misregistration artifacts between CT and PET and metal devices such as pace-makers might cause incorrect results. In this paper we demonstrate the pitfalls of FDG-PET in managing patients with lung cancer. (author)

  11. {sup 18}F-FDG PET and PET/CT in Burkitt's lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Karantanis, Dimitrios, E-mail: dkarantanis@nuclmed.ne [Division of Nuclear Medicine, Department of Radiology, Mayo Clinic, Rochester, MN (United States); Durski, Jolanta M.; Lowe, Val J.; Nathan, Mark A.; Mullan, Brian P. [Division of Nuclear Medicine, Department of Radiology, Mayo Clinic, Rochester, MN (United States); Georgiou, Evangelos [Medical Physics Department, Medical School, University of Athens (Greece); Johnston, Patrick B. [Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN (United States); Wiseman, Gregory A. [Division of Nuclear Medicine, Department of Radiology, Mayo Clinic, Rochester, MN (United States)

    2010-07-15

    Objective: To explore the value of {sup 18}F fluorodeoxy-glucose (FDG) positron emission tomography (PET) in Burkitt's lymphoma. Methods: All Burkitt's lymphoma patients referred for FDG PET or FDG PET/computed tomography (CT) exams at our institution from June 2003 to June 2006 were included. Selected patients were followed and clinical information was reviewed retrospectively. Results from FDG PET-PET/CT, as blindly reviewed by a consensus of two experienced readers, were compared with the status of the disease as determined by other laboratory, clinical and imaging exams and clinical follow-up. FDG PET-PET/CT results were classified as true positive or negative and false positive or negative. The degree of FDG uptake in the positive lesions was semiquantified as maximum standard uptake value (SUVmax). Results: Fifty-seven FDG PET-PET/CT exams were done in 15 patients. Seven exams were done for initial staging, 8 during and 14 after the completion of therapy, and 28 for disease surveillance. For nodal disease FDG PET-PET/CT was true positive in 8, true negative in 47 and false positive in 2 exams (sensitivity 100%, specificity 96%). For extranodal disease FDG PET-PET/CT was true positive in 6, true negative in 48 and false positive in 3 exams (sensitivity 100%, specificity 94%). The mean SUVmax for the positive nodal lesions was 15.7 (range 6.9-21.7, median 18.5) and for extranodal lesions was 14.2 (range 6.2-24.3, median 12.4). Conclusions: FDG PET-PET/CT is sensitive for the detection of viable disease in Burkitt's lymphoma. Affected areas demonstrated high degree of uptake that was reversible upon successful implementation of treatment.

  12. FDG scan on an ordinary coincidence gamma camera (CDET) -preliminary data in pulmonary or colorectal cancer

    International Nuclear Information System (INIS)

    Full text. The purpose of this study to evaluate the impact of FDG scan performed on an ordinary CDET gamma camera on the therapeutic management of patients with pulmonary nodules or with suspicion of recurrent colorectal carcinoma. Methods: two tomoscintigrams (thorax and abdomen) were acquired, using a PICKER Prism XP 2000 coincidence gamma camera, 45 m after i.v. injection of 100-150 MBq of 18 F-FDG in fasting patients. The 21 pts were explored in July or August 1997. Preliminary results: among 12 patients with pulmonary nodules, the planed surgery was replaced by chemotherapy after visualization of unknown metastases accumulating FDG in 3 patients. In another one, the high uptake of FDG by a lung nodule which has been known for 6 years, led to surgery and objectivation of an adenocarcinoma. In one case, the absence of FDG uptake corresponded to an abscess (true negative result). In the other 7 patients, the indication of surgery was confirmed but the procedure was modified in 2 cases. In case of suspicion of recurrent colorectal carcinoma (9 patients), the finding of a single focus of FDG uptake whereas CT scan was negative or inconclusive let do the decision of surgery in 3 patients. In one patient with pelvic pain without increase of tumor markers levels and with normal CT scan, a normal FDG scan confirmed the physician's hypothesis of pain due to the previous therapy but do not recurrence. In one patient, the finding of 3 foci of uptake of FDG whereas CT scan was inconclusive confirmed the indication of chemotherapy. In 2 patients with FDG abdominal foci without morphologic abnormalities, the therapeutic strategy is not yet decided in 2 patients, no foci could be found. In conclusion, these preliminary results show that FDG scan has provided a help to the physician indecision-making for therapeutic strategy in 8 patients on 21 (38%) and a help to the surgeon in 2 more cases (48% as a whole)

  13. 18F-FDG PET and PET/CT in Burkitt's lymphoma

    International Nuclear Information System (INIS)

    Objective: To explore the value of 18F fluorodeoxy-glucose (FDG) positron emission tomography (PET) in Burkitt's lymphoma. Methods: All Burkitt's lymphoma patients referred for FDG PET or FDG PET/computed tomography (CT) exams at our institution from June 2003 to June 2006 were included. Selected patients were followed and clinical information was reviewed retrospectively. Results from FDG PET-PET/CT, as blindly reviewed by a consensus of two experienced readers, were compared with the status of the disease as determined by other laboratory, clinical and imaging exams and clinical follow-up. FDG PET-PET/CT results were classified as true positive or negative and false positive or negative. The degree of FDG uptake in the positive lesions was semiquantified as maximum standard uptake value (SUVmax). Results: Fifty-seven FDG PET-PET/CT exams were done in 15 patients. Seven exams were done for initial staging, 8 during and 14 after the completion of therapy, and 28 for disease surveillance. For nodal disease FDG PET-PET/CT was true positive in 8, true negative in 47 and false positive in 2 exams (sensitivity 100%, specificity 96%). For extranodal disease FDG PET-PET/CT was true positive in 6, true negative in 48 and false positive in 3 exams (sensitivity 100%, specificity 94%). The mean SUVmax for the positive nodal lesions was 15.7 (range 6.9-21.7, median 18.5) and for extranodal lesions was 14.2 (range 6.2-24.3, median 12.4). Conclusions: FDG PET-PET/CT is sensitive for the detection of viable disease in Burkitt's lymphoma. Affected areas demonstrated high degree of uptake that was reversible upon successful implementation of treatment.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-05-01

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

  15. F.D.G. PET role in the management of refractory epilepsy; Place de la TEP au FDG dans le bilan des epilepsies pharmacoresistantes

    Energy Technology Data Exchange (ETDEWEB)

    Papathanassiou, D.; Domange-Testard, A.; Bruna-Muraille, C.; Cuif-Job, A.; Liehn, J.C. [Institut Jean-Godinot, Service de Medecine Nucleaire, 51 - Reims (France); Thiriaux, A. [CHU de Reims, Service de Neurologie, 51 - Reims (France); Motte, J. [CHU de Reims, Service de Pediatrie, 51 - Reims (France)

    2009-06-15

    The work-up of drug-resistant partial epilepsy is intended to localize epileptogenic foci in the purpose of a possible surgery. We aimed to assess the role of fluorodeoxyglucose Positron Emission Tomography (F.D.G. PET) in this scope. This study involved 34 patients who underwent brain F.D.G. PET, with a final diagnosis in 21. The value of F.D.G. PET for lateralization and localisation of the epileptogenic focus was evaluated by a blinded interpretation, and compared with the value of standard investigations. The impact of F.D.G. PET was assessed by the means of questions intended for the neurologist in each case. All the epilepsy types together, F.D.G. PET lateralized and localised the foci in 65 and 47% of the 34 subjects respectively. Among the 19 subjects with final diagnosis (patients with bilateral foci excluded), lateralization was correct in 84% and localisation in 63% (and the values were greater for temporal epilepsy than for extra temporal foci). PET frequently provided additional information compared with MRI, but not with EEG. F.D.G. PET was useful in 82.5% of cases (confirming management in 65% and changing it in 17.5% of the patients). Our experience corroborated the value of F.D.G. PET for lateralization and localisation of epileptogenic foci, and its role in case of normal MRI. However, F.D.G. PET appears as a confirmation tool rather than an examination resulting in a change in management rate. (authors)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-12-15

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

  17. Rare solitary focal tuberculous involvement of liver masquerading as hepatic metastasis on FDG PET/CT in a case of fibular round cell tumor

    International Nuclear Information System (INIS)

    Finding of focal 18F-fluoro-deoxyglucose (FDG) uptake in liver on FDG positron emission tomography/computed tomography (FDG PET/CT) in a known case of malignancy is often considered to be metastases. We report a similar finding on FDG PET/CT in a case of Ewing's sarcoma of thigh, which turned out to be of tuberculous etiology, an unusual cause of false positive FDG uptake in the liver

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-03-15

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

  19. The effect of steroid on FDG uptake in experimental tumors, granulomatous and inflammatory lesions

    International Nuclear Information System (INIS)

    Objectives: FDG accumulates not only in malignant tumors but also inflammatory lesions, especially in granulomatous lesions, which makes differentiate malignant tumors from benign lesions difficult. To obtain a clue for differentiating malignant lesions from benign ones by FDG-PET, we determined the effect of steroid on FDG uptake in granulomatous and inflammatory lesions, and compared them with those in malignant tumors in rats. Methods: Rats were inoculated with a suspension of allogenic hepatoma cells (KDH-8), Bacille bili e de Calmette-Guerin-(BCG) or Staphylococcus aureus (S. aureus), or with turpentine oil into the left calf muscle. Two weeks after KDH-8, 19 days after BCG, or one week after S. aureus or turpentine oil inoculations, the rats were fasted overnight and divided into two subgroups (n=5-6, in each group): Prednisolone (PRE)-pretreated (Methylprednisolone acetate, 8 mg/kg body weight, i.m. injection 20 hour before the FDG intravenous injection) and control (untreated) groups. Radioactivity in tissues was determined one hour after i.v. injection of FDG. FDG uptake in tissues were expressed as the percentage of injected dose per gram of tissue after normalization to animal's weight (%ID/g tissue/kg body weight). Results: FDG uptake in the tumor, granulomatous and inflammatory lesions were shown in Table. In the untreated animals, remarkably higher accumulations of FDG were observed in the tumor and granulomatous lesions, compared with those in the inflammatory lesions induced by S. aureus and turpentine oil. There was no significant difference in the level of FDG uptake between the tumor and granulomatous lesions, and between the two inflammatory lesions. PRE pre-treatment significantly decreased the level of FDG uptake in granulomatous lesions induced by BCG, inflammatory lesions induced by S. aureus and turpentine oil to 52%, 73% and 76% of the control value, respectively. The level of FDG uptake in the tumor was not significantly decreased by PRE

  20. Effects of insulin and glucose loading on FDG uptake in experimental malignant tumours and inflammatory lesions

    International Nuclear Information System (INIS)

    Fluorine-18 2-deoxy-2-fluoro-D-glucose (FDG) accumulation in tumours has been well investigated, but much less is known regarding FDG accumulation in inflammatory lesions. In this study, we determined the effects of hypo- and hyperglycaemia on FDG uptake in inflammatory lesions of infectious and non-infectious origin and compared them with those in malignant tumours in rats, to provide a biological basis for differentiating malignant lesions from benign lesions by means of FDG-PET. Rats were inoculated with a suspension of allogenic hepatoma cells (KDH-8) or Staphylococcus aureus, or with turpentine oil into the left calf muscle. Two weeks after KDH-8 inoculation and 1 week after S. aureus and turpentine oil inoculations, the rats were divided into three subgroups: insulin-loaded (2 U/kg body weight, i.p.), glucose-loaded (1.2 g/kg body weight, p.o.) and control groups. Radioactivity in tissues was determined 1 h after i.v. injection of FDG. Intraperitoneal injection of insulin and oral administration of glucose induced hypoglycaemia and hyperglycaemia, respectively. In the control animals, tumours showed a level of FDG uptake which was 2.2 and 3.0 times higher than the levels in the inflammatory lesions induced by S. aureus and turpentine oil, respectively (P<0.0001). There was no significant difference in the level of FDG uptake between the two inflammatory lesions of infectious and non-infectious origin. Insulin loading significantly decreased the level of FDG uptake in tumours and in both types of inflammatory lesion to approximately one-half of the control values (P=0.001 in the tumour group and P<0.0001 in the two inflammatory lesion groups). In the glucose-loaded group, the level of FDG uptake in both types of inflammatory lesion decreased significantly to 50%-61% of the control value (P=0.0002 in the S.aureus group and P<0.0001 in the turpetine group), while the tumour uptake did not decrease significantly (86% of the control value) (P=NS). It is concluded

  1. FDG-PET imaging in HIV-infected subjects: relation with therapy and immunovirological variables

    International Nuclear Information System (INIS)

    To characterise tissue sites of immune activation and HIV replication we performed FDG-PET in ART-treated and ART-naive HIV-infected individuals. Specific aims were to establish whether HIV-infected patients can be differentiated on the basis of the detection of specific locations of viral replication, even in the presence of an apparently optimal immunovirological response to ART, and whether these FDG-PET findings can be related to immunovirological variables and AIDS history status. Patients were divided into five groups as follows: subgroup A1 (full responders, n=8): current ART treatment, CD4+ T lymphocytes >500/mL, viral load 50,000 copies/mL; group C (ART-naive, n=5): no current or previous ART treatment, increased viral load. PET images revealed different patterns of FDG uptake. All ART-treated patients with either suppressed (<50 copies/mL; Group A) or high viremia (group B) showed a normal pattern of FDG uptake. On the contrary, the ART-naive subjects with high viraemia (group C) displayed multiple foci of increased glucose metabolism in the lymph nodes. In the ART-naive subjects, FDG uptake, apparently related to viraemia level, was observed in the upper torso mainly in the axillary nodes bilaterally in patients with viraemia below 100,000 copies/mL; in those with viraemia higher than 100,000 copies/mL, FDG uptake was also observed in the inguinal lymph nodes. The emergence, in our study, of a correlation between the percentage of CD8+/CD38+/RO+ T cells (well established markers of progression to AIDS independently of CD4+ T lymphocytes) and positive FDG-PET in ART-naive patients is a novel finding that seems to confer prognostic value on FDG uptake. FDG uptake is strongly associated with response to ART independently of a previous AIDS diagnosis. Notably, no differences were observed between ART-treated subjects classed as immunological responders and those classed as non responders. Data herewith indicate that FDG uptake and immunological variables are

  2. Patterns of pulmonary tuberculosis on FDG-PET/CT

    International Nuclear Information System (INIS)

    Objective: This study aims to describe patterns of pulmonary tuberculosis (TB) on FDG-PET/CT. Methods: All patients with a diagnosis of TB and who underwent FDG-PET/CT between January 2009 and June 2010 were included. Clinical, biological and imaging data were reviewed. TB was proven either on bacteriological or histopathological studies (n = 13) or on a clinical and imaging basis (n = 3). Results: Sixteen patients (11 men; median age 56, range 22–84 years) were included. Two distinct patterns were identified. In the lung pattern (9/16), patients had predominantly pulmonary symptoms (6/9 patients, 67%) with a parenchymal involvement: uptakes on lung consolidation ± cavitation surrounded by micronodules. Mediastino-hilar lymph nodes were slightly enlarged (15 mm, 10–27) with moderate uptake (3.9, 2.5–13.4). In the lymphatic pattern (7/16), patients had predominantly systemic symptoms (5/7 cases, 71%) and all had extra-thoracic involvement. Mediastino-hilar lymph nodes were more enlarged (30 mm, 18–35, p = 0.03) and with higher uptake (6.8, 5.7–16.8, p = 0.034) than in the lung pattern. Conclusion: We identified two distinct patterns of pulmonary TB on FDG-PET/CT. The lung pattern related to a restricted and slight hypermetabolic infection and the lymphatic pattern related to a systemic and intense infection. Combined interpretation of PET and CT findings improves the specificity of images, especially for the lung pattern

  3. Principal component analysis of FDG PET in amnestic MCI

    Energy Technology Data Exchange (ETDEWEB)

    Nobili, Flavio; Girtler, Nicola; Brugnolo, Andrea; Dessi, Barbara; Rodriguez, Guido [University of Genoa, Clinical Neurophysiology, Department of Endocrinological and Medical Sciences, Genoa (Italy); S. Martino Hospital, Alzheimer Evaluation Unit, Genoa (Italy); S. Martino Hospital, Head-Neck Department, Genoa (Italy); Salmaso, Dario [CNR, Institute of Cognitive Sciences and Technologies, Rome (Italy); CNR, Institute of Cognitive Sciences and Technologies, Padua (Italy); Morbelli, Silvia [University of Genoa, Nuclear Medicine Unit, Department of Internal Medicine, Genoa (Italy); Piccardo, Arnoldo [Galliera Hospital, Nuclear Medicine Unit, Department of Imaging Diagnostics, Genoa (Italy); Larsson, Stig A. [Karolinska Hospital, Department of Nuclear Medicine, Stockholm (Sweden); Pagani, Marco [CNR, Institute of Cognitive Sciences and Technologies, Rome (Italy); CNR, Institute of Cognitive Sciences and Technologies, Padua (Italy); Karolinska Hospital, Department of Nuclear Medicine, Stockholm (Sweden)

    2008-12-15

    The purpose of the study is to evaluate the combined accuracy of episodic memory performance and {sup 18}F-FDG PET in identifying patients with amnestic mild cognitive impairment (aMCI) converting to Alzheimer's disease (AD), aMCI non-converters, and controls. Thirty-three patients with aMCI and 15 controls (CTR) were followed up for a mean of 21 months. Eleven patients developed AD (MCI/AD) and 22 remained with aMCI (MCI/MCI). {sup 18}F-FDG PET volumetric regions of interest underwent principal component analysis (PCA) that identified 12 principal components (PC), expressed by coarse component scores (CCS). Discriminant analysis was performed using the significant PCs and episodic memory scores. PCA highlighted relative hypometabolism in PC5, including bilateral posterior cingulate and left temporal pole, and in PC7, including the bilateral orbitofrontal cortex, both in MCI/MCI and MCI/AD vs CTR. PC5 itself plus PC12, including the left lateral frontal cortex (LFC: BAs 44, 45, 46, 47), were significantly different between MCI/AD and MCI/MCI. By a three-group discriminant analysis, CTR were more accurately identified by PET-CCS + delayed recall score (100%), MCI/MCI by PET-CCS + either immediate or delayed recall scores (91%), while MCI/AD was identified by PET-CCS alone (82%). PET increased by 25% the correct allocations achieved by memory scores, while memory scores increased by 15% the correct allocations achieved by PET. Combining memory performance and {sup 18}F-FDG PET yielded a higher accuracy than each single tool in identifying CTR and MCI/MCI. The PC containing bilateral posterior cingulate and left temporal pole was the hallmark of MCI/MCI patients, while the PC including the left LFC was the hallmark of conversion to AD. (orig.)

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

    International Nuclear Information System (INIS)

    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

  5. 18FDG PET scanning of benign and malignant musculoskeletal lesions

    International Nuclear Information System (INIS)

    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.)

  6. Principal component analysis of FDG PET in amnestic MCI

    International Nuclear Information System (INIS)

    The purpose of the study is to evaluate the combined accuracy of episodic memory performance and 18F-FDG PET in identifying patients with amnestic mild cognitive impairment (aMCI) converting to Alzheimer's disease (AD), aMCI non-converters, and controls. Thirty-three patients with aMCI and 15 controls (CTR) were followed up for a mean of 21 months. Eleven patients developed AD (MCI/AD) and 22 remained with aMCI (MCI/MCI). 18F-FDG PET volumetric regions of interest underwent principal component analysis (PCA) that identified 12 principal components (PC), expressed by coarse component scores (CCS). Discriminant analysis was performed using the significant PCs and episodic memory scores. PCA highlighted relative hypometabolism in PC5, including bilateral posterior cingulate and left temporal pole, and in PC7, including the bilateral orbitofrontal cortex, both in MCI/MCI and MCI/AD vs CTR. PC5 itself plus PC12, including the left lateral frontal cortex (LFC: BAs 44, 45, 46, 47), were significantly different between MCI/AD and MCI/MCI. By a three-group discriminant analysis, CTR were more accurately identified by PET-CCS + delayed recall score (100%), MCI/MCI by PET-CCS + either immediate or delayed recall scores (91%), while MCI/AD was identified by PET-CCS alone (82%). PET increased by 25% the correct allocations achieved by memory scores, while memory scores increased by 15% the correct allocations achieved by PET. Combining memory performance and 18F-FDG PET yielded a higher accuracy than each single tool in identifying CTR and MCI/MCI. The PC containing bilateral posterior cingulate and left temporal pole was the hallmark of MCI/MCI patients, while the PC including the left LFC was the hallmark of conversion to AD. (orig.)

  7. FDG-PET for preoperative staging of bladder cancer

    International Nuclear Information System (INIS)

    The presence of lymph node involvement (N) and distant metastasis (M) in patients with invasive bladder carcinoma is a major determinant of survival and, therefore, a pivotal element in the therapeutic management. The aim of this prospective study was to evaluate the use of18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in this indication. Whole-body FDG-PET and computed tomography (CT) were performed in 55 patients with non-metastatic invasive bladder cancer for preoperative staging. Correlative imaging of PET with CT was performed, leading to a PET(CT) result. The imaging results were compared with the gold standard, consisting of histopathology (lymphadenectomy, guided biopsy) or clinical follow-up for 12 months, and related to overall survival using the Kaplan-Meier method. The gold standard was available in 40 patients and indicated NM-positive disease in 15 patients (12 N lesions, 8 M lesions), and NM-negative disease in 25 patients. For the diagnosis of NM-positive disease, the sensitivity, specificity and accuracy of PET(CT) were 60%, 88% and 78%, respectively. Diagnostic discordances between PET(CT) and CT alone were found in 9/40 patients, among whom PET was correct in six (15%): three with true-positive and one with true-negative distant metastases, and two with true-negative lymph nodes. Median survival time of patients in whom PET(CT) indicated NM-positive disease was 13.5 months, compared with 32.0 months in the patients with a NM-negative PET(CT) (p=0.003). Addition of metabolism-based information provided by FDG-PET to CT in the preoperative staging of invasive bladder carcinoma yields a high diagnostic and prognostic accuracy. (orig.)

  8. Acute and subacute toxicity of 18F-FDG

    International Nuclear Information System (INIS)

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

  9. Evaluation of FDG uptake in pulmonary hila with FDG PET/CT and contrast-enhanced CT in patients with thoracic and non-thoracic tumors

    International Nuclear Information System (INIS)

    Fluorine-18 fluorodeoxyglucose (FDG) uptake is frequently observed in lung hilus. This finding causes difficulties during the interpretation. Our objective was to evaluate the features of FDG uptake in lung hilus associated with benign or malignant etiology in patients with thoracic and non-thoracic tumors. We retrospectively evaluated the files of 1172 patients who had undergone FDG positron emission tomography (PET)/computed tomography (CT) examination between January 2008 and June 2009. Forty-eight patients (21 males, 27 females, age range 12-80 years, mean 60.9±15.82 years) with either unilateral or bilateral hilar FDG uptake and who had thorax contrast-enhanced computed tomography (CECT) performed within 1 month of the FDG PET/CT scan were enrolled in the study. Characteristics of FDG uptake were classified according to the pathology and CECT or PET/CT follow-up over 12 months. The characteristics of 71 hilar regions with FDG uptake could be classified. In 30 of 71 (42.3%) hilar regions, FDG uptake was considered to be physiological because no lymph node was observed on CECT. In 19 of 71 (26.8%), FDG uptake was secondary to benign lymph nodes and in 22 (30.9%) to malignant lymph nodes. Significant differences were observed between benign and malignant lymph nodes for standardized uptake value of hilus (SUVhilus) and SUVhilus to the mean SUV of liver (SUVhilus/SUVliver) ratio. Using 4.49 as the cut-off value for SUVhilus, a sensitivity of 85.7% and a specificity of 86.4% were achieved (area under curve, AUC: 0.956). For SUVhilus/SUVliver ratio, sensitivity and specificity to detect malignant lymph nodes were 77.6 and 77.3% (AUC: 0.885), respectively, at a cut-off value of 1.75. SUVhilus and SUVhilus/SUVliver ratio were found to be significant parameters for determining malignancy in lung hilus. Combined interpretation with CECT is warranted during the evaluation of lung hilus with FDG PET/CT. (author)

  10. FDG-PET/CT in staging of clear cell odontogenic carcinoma.

    Science.gov (United States)

    Krishnamoorthy, R; Ravi Kumar, A S; Batstone, M

    2014-11-01

    Clear cell odontogenic carcinoma (CCOC) is a rare neoplasm; only 75 cases have been reported in the English language literature. They have a tendency for recurrence and a capacity to metastasize. There is very little known regarding the metabolic features of this tumour or the utility of fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans in the staging and follow-up of these tumours. We present two cases of CCOC with their relevant FDG-PET/CT scan findings. The first patient had primary CCOC of the mandible that was FDG-avid, and the other had recurrence of CCOC of the anterior mandible and superomedial orbit that was not FDG-avid. FDG uptake in CCOC appears to be variable. Although FDG-PET/CT is useful in other head and neck cancers and has benefits compared to other imaging modalities, further studies are needed to investigate the sensitivity of FDG-PET/CT in CCOC. PMID:25015905

  11. Radionuclide imaging of spinal osteomyelitis: prospective comparison of FDG-PET and Ga-SPECT

    International Nuclear Information System (INIS)

    Aim: MRI is currently recognized as the imaging modality of choice for diagnosing spinal osteomyelitis. Radionuclide imaging with 67Ga citrate (Ga) is usually reserved for those situations in which the MRI cannot be performed or is inconclusive. The delay between injection of radiogallium and imaging, typically 48 -72 hours, as well as the unfavorable imaging characteristics of this radionuclide are disadvantages of the procedure. There are data that suggest that 18F-FDG-PET (FDG-PET) imaging may be useful for diagnosing spinal osteomyelitis. We are prospectively studying the role of FDG-PET in the diagnosis of spinal osteomyelitis, and comparing it to Ga for this purpose. Materials and Methods: To date, 8 patients, 5 males and 3 females, 44 - 74 years old have undergone Ga-SPECT and FDG-PET imaging within 48 hours of each other. The regions of concern were: cervical spine (n=1), thoracic spine (n=2), and lumbar spine (n=5). Results: Five patients had spinal osteomyelitis; one patient also had an adjacent psoas abscess. Final diagnoses in the 3 remaining patients were degenerative joint disease, soft tissue infection, and chronic demyelinating polyneuropathy. Imaging results are presented. FDG-PET vs Gallium-SPECT. Results of FDG-PET and Ga-SPECT were concordant in all 8 patients. Conclusion: Although further study in a larger population is needed, FDG-PET, which is rapidly completed and has superior image quality, may emerge as the radionuclide imaging procedure of choice for diagnosing spinal osteomyelitis

  12. Impact of FDG-PET/CT in the management of lymphoma

    International Nuclear Information System (INIS)

    Since the introduction of 67Gallium-citrate 30 years ago, nuclear medicine has played an important role in the evaluation of malignant lymphoma. During that time, several radiotracers were evaluated as potential alternatives for the diagnosis of lymphoma, but the introduction of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) marked a major turning point. FDG-PET took over most of the role of gallium, and is now an essential tool in the diagnosis of lymphoma. FDG-PET is increasingly being used for assessment of the tumor staging prior to treatment, for evaluating the response to treatment, and for monitoring the early reactions to therapy to predict the final outcome. FDG-PET has been shown to have more accurate diagnostic capability than conventional CT and MRI for distinguishing the tumor necrosis and residual masses frequently seen after therapy in lymphoma patients without any clinical and biochemical manifestation. Malignant lymphoma is the first disease for which FDG-PET was adopted as a tool for response assessment in the international standard criteria. However, lymphoma does not always display a clear high uptake, and there are some pitfalls in assessing the response to therapy. This review will highlight the most important applications of FDG-PET in lymphoma, focusing on the advantages and pitfalls of this imaging, and past and ongoing efforts to standardize the use of FDG-PET, particularly in response to assessment and therapy monitoring. (author)

  13. Evaluation of patients with gall bladder (GB) cancer using FDG PET

    International Nuclear Information System (INIS)

    Even with advanced diagnostic imaging, difficulties have been encountered in correct evaluation of GB malignancy. This study was undertaken to assess the role of FDG PET in patients with GB cancer. Twenty-seven pts (13 F, 14 M, a mean age of 60 yr.) were included in this study. Fourteen pts were evaluated for staging and 13 pts were for suspected recurrent or residual tumors. All pts underwent FDG PET and other conventional imaging such as radiography, US, CT, MRI, or bone scintigraphy within a month of period. Of the 14 pts at staging, FDG PET was concordant with conventional imaging in 9 pts. In the rest of 5 pts with discordant results, PET identified extra-abdominal metastasis in 4 pts whereas conventional imaging detected peritoneal carcinomatosis in 1 pt. Of the 13 pts with suspected recurrent or residual tumors, findings on PET were concordant with those on conventional imaging in 6 pts (4 concordant positive, 1 concordant negative, 1 concordant false positive). Discordant results were found in 7 of the 13 pts. FDG PET was superior to conventional imaging in detecting local and distant diseases in 6 of 7 pts. FDG PET has an advantage of detecting unsuspected distant metastasis at staging. During follow-up, FDG PET is useful in identifying both local and distant residual and/or recurrent diseases. The use of FDG PET appears to have significant diagnostic and therapeutic implication in the evaluation of this aggressive malignancy in the GB

  14. Brain FDG PET study of normal aging in Japanese: effect of atrophy correction

    International Nuclear Information System (INIS)

    The aim of this study was to investigate the effects of atrophy correction on the results of 18F-fluorodeoxyglucose positron emission tomography (FDG PET) in the context of normal aging. Before the human study was performed, a Hoffman 3D brain phantom experiment was carried out in order to validate a newly developed correction method for partial volume effects (PVEs). Brain FDG PET was then performed in 139 healthy Japanese volunteers (71 men, 68 women; age 24-81 years). PET images were corrected for PVEs using grey matter volume, which was segmented from co-registered magnetic resonance images and convoluted with the spatial resolution of the PET scanner. We investigated the correlation between advancing age and relative regional FDG activity, which was normalised to the global activity before and after PVE correction using Statistical Parametric Mapping 99. The PET image, when corrected for PVEs, provided more homogeneous tracer distribution in the whole phantom than in the original PET image. The human PET study of both sexes revealed significant negative correlations between age and relative FDG activity in the bilateral perisylvian and medial frontal areas before PVE correction. However, these negative correlations were largely resolved after PVE correction. Correction for PVEs was effective in our FDG PET study. The reduction in FDG uptake with advancing age that was detected by FDG PET without PVE correction could be accounted for largely by an age-related cerebral volume loss in the bilateral perisylvian and medial frontal areas. (orig.)

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

    Directory of Open Access Journals (Sweden)

    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.

  16. FDG-PET improves accuracy in distinguishing frontotemporal dementia and Alzheimer's disease.

    Science.gov (United States)

    Foster, Norman L; Heidebrink, Judith L; Clark, Christopher M; Jagust, William J; Arnold, Steven E; Barbas, Nancy R; DeCarli, Charles S; Turner, R Scott; Koeppe, Robert A; Higdon, Roger; Minoshima, Satoshi

    2007-10-01

    Distinguishing Alzheimer's disease (AD) and frontotemporal dementia (FTD) currently relies on a clinical history and examination, but positron emission tomography with [(18)F] fluorodeoxyglucose (FDG-PET) shows different patterns of hypometabolism in these disorders that might aid differential diagnosis. Six dementia experts with variable FDG-PET experience made independent, forced choice, diagnostic decisions in 45 patients with pathologically confirmed AD (n = 31) or FTD (n = 14) using five separate methods: (1) review of clinical summaries, (2) a diagnostic checklist alone, (3) summary and checklist, (4) transaxial FDG-PET scans and (5) FDG-PET stereotactic surface projection (SSP) metabolic and statistical maps. In addition, we evaluated the effect of the sequential review of a clinical summary followed by SSP. Visual interpretation of SSP images was superior to clinical assessment and had the best inter-rater reliability (mean kappa = 0.78) and diagnostic accuracy (89.6%). It also had the highest specificity (97.6%) and sensitivity (86%), and positive likelihood ratio for FTD (36.5). The addition of FDG-PET to clinical summaries increased diagnostic accuracy and confidence for both AD and FTD. It was particularly helpful when raters were uncertain in their clinical diagnosis. Visual interpretation of FDG-PET after brief training is more reliable and accurate in distinguishing FTD from AD than clinical methods alone. FDG-PET adds important information that appropriately increases diagnostic confidence, even among experienced dementia specialists. PMID:17704526

  17. FDG-PET changes in brain glucose metabolism from normal cognition to pathologically verified Alzheimer's disease

    International Nuclear Information System (INIS)

    We report the first clinicopathological series of longitudinal FDG-PET scans in post-mortem (PM) verified cognitively normal elderly (NL) followed to the onset of Alzheimer's-type dementia (DAT), and in patients with mild DAT with progressive cognitive deterioration. Four NL subjects and three patients with mild DAT received longitudinal clinical, neuropsychological and dynamic FDG-PET examinations with arterial input functions. NL subjects were followed for 13 ± 5 years, received FDG-PET examinations over 7 ± 2 years, and autopsy 6 ± 3 years after the last FDG-PET. Two NL declined to mild cognitive impairment (MCI), and two developed probable DAT before death. DAT patients were followed for 9 ± 3 years, received FDG-PET examinations over 3 ± 2 years, and autopsy 7 ± 1 years after the last FDG-PET. Two DAT patients progressed to moderate-to-severe dementia and one developed vascular dementia. The two NL subjects who declined to DAT received a PM diagnosis of definite AD. Their FDG-PET scans indicated a progression of deficits in the cerebral metabolic rate for glucose (CMRglc) from the hippocampus to the parietotemporal and posterior cingulate cortices. One DAT patient showed AD with diffuse Lewy body disease (LBD) at PM, and her last in vivo PET was indicative of possible LBD for the presence of occipital as well as parietotemporal hypometabolism. Progressive CMRglc reductions on FDG-PET occur years in advance of clinical DAT symptoms in patients with pathologically verified disease. The FDG-PET profiles in life were consistent with the PM diagnosis. (orig.)

  18. Incidental benign parotid lesions on FDG-PET: prevalence and clinico-pathologic findings

    International Nuclear Information System (INIS)

    Incidental parotid lesions on F-18 FDG-PET can mimic distant metastasis of underlying malignancy. The prevalence and the clinico-pathologic findings of PET positive parotid lesions have not been known. We investigated how often incidental parotid lesions are found on clinical FDG-PET studies and what the clinico-pathologic characteristics of those parotid lesions are in the present study. We retrospectively reviewed 3,344 cases of FDG-PET which had been obtained in our hospital from May 2003 to Dec 2006. The indications of FDG-PET were: evaluation of known/suspected cancer (n = 3,212) or screening of cancer in healthy subjects (n = 132). Incidental parotid lesion on FDG-PET was defined as an un-expected FDG uptake in one of parotid glands which was not primary target lesion of current FDG/PET. FDG uptake was represented by maximum standardized uptake value (maxSUV). Final diagnosis was made by pathologic analysis or clinical follow-up assessment. Fifteen (0.45% = 15/3,344) incidental parotid lesions were found and they were all benign lesions. The maxSUV ranged from 1.7 to 8.6 (mean ± s.d. = 3.7 ± 1.9). Final diagnoses of the incidental parotid lesions were; Warthin's tumor (n = 2), pleomorphic adenoma (n = 1), other un-specified benign lesion (n 1), and benign lesions under bases of imaging studies (n = 3) and of clinical follow-up (n = 8). All of incidentally found parotid lesions in clinical FDG-PET studies were confirmed as benign lesions with prevalence of 0.45%. Close follow up using PET or CT might be a reasonable approach for determining the nature of incidentally found parotid lesions

  19. Role of FDG PET/CT in Baastrup's disease.

    Science.gov (United States)

    Subramanyam, Padma; Palaniswamy, Shanmuga Sundaram

    2016-01-01

    Baastrup's disease is a benign condition, which presents as chronic low back pain. It is also known as "kissing spine syndrome" and refers to close approximation of adjacent spinous processes producing inflammation and back pain. This condition is often misdiagnosed, resulting in incorrect treatment and persistence of symptoms. Diagnosis of Baastrup's disease is verified with clinical examination and imaging studies. Conventionally, clinicians resort to magnetic resonance imaging (MRI) of spine rather than X-ray or computed tomography (CT) in the evaluation of back pain. MRI can additionally identify flattening, sclerosis, enlargement, cystic lesions, and bone edema at the articulating surfaces of the two affected spinous processes. Studies have reported that (18)Fluorine fluorodeoxyglucose-positron emission tomography/CT (FDG-PET/CT) can detect a bursitis or an inflammation as a form of stress reaction despite a negative MRI and (99m)Tc Methylene diphosphonate (MDP) bone scan. PET/CT is usually not a recommended investigation for this condition. However, this case report highlights the benefit of FDG-PET/CT in identifying the site of inflammatory pathology. It is also known to identify the exact site of inflammation where steroid or local anesthetic injection can be administered to alleviate pain, especially in patients with multilevel vertebral involvement. PMID:27385901

  20. Acute and subacute toxicity of 18F-FDG

    International Nuclear Information System (INIS)

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

  1. FDG-PET for the detection of infected vascular grafts

    International Nuclear Information System (INIS)

    Graft infection following prosthetic vascular reconstruction is an uncommon but severe complication. The clinical presentation is often subtle and non-specific and may occur long after surgery. While defining a prosthetic vascular graft infection can be difficult, early diagnosis and treatment are essential for the correct choice of treatment in order to prevent further complications as well as the high morbidity and mortality associated with repeat surgery and removal of infected grafts. False positive results may lead to unnecessary surgery while failure to diagnose graft infection may have life-threatening sequels. Scarce literature that is currently available regarding the role of fluorodeoxyglucose (FDG) imaging for assessment of vascular graft infection suggests that this modality may represent reliable non-invasive imaging modality in this specific clinical setting. Hybrid positron emission tomography (PET)/computed tomography (CT), combining CT with PET, increases the test specificity and thus improves diagnostic accuracy. The precise anatomic localization of increased FDG uptake provided by PET/CT enables accurate differentiation between graft and adjacent soft tissue infection leading to more accurate diagnosis and subsequent optimized therapeutic strategy.

  2. Focal Inflammatory Myositis on 18F-FDG PET/CT.

    Science.gov (United States)

    Bennett, Olivia; Ravi Kumar, Aravind S; Agnew, Julie

    2016-06-01

    Focal myositis is a rare benign inflammatory pseudotumor that can mimic malignancy, clinically and on imaging. A 34-year-old man presented with a 3-week history of sudden-onset, nontender, left upper neck mass that was nonresolving with antibiotics. Anatomical imaging was concerning for a sarcoma of the sternocleidomastoid muscle with possible regional nodal metastases and surrounding inflammatory change. F-FDG PET/CT showed marked FDG uptake extending around the anterior border of the sternocleidomastoid muscle with no FDG-avid local nodal disease. Core biopsy of the sternocleidomastoid muscle and adjacent node revealed inflammatory changes. A diagnosis of focal inflammatory myositis was made. PMID:27055132

  3. FDG-PET/CT findings in systemic mastocytosis: a French multicentre study

    Energy Technology Data Exchange (ETDEWEB)

    Djelbani-Ahmed, S. [Assistance Publique - Hopitaux de Paris (APHP), Department of Nuclear Medicine, Avicenne Hospital, Bobigny (France); Paris 13 University, Sorbonne Paris Cite, Bobigny (France); Chandesris, M.O. [Necker Children' s Hospital, APHP, French Reference center for Mastocytosis (Centre de Reference des Mastocytoses, CEREMAST), Paris (France); Necker Children' s Hospital, APHP, Department of Haematology, Paris (France); Paris Descartes University, Sorbonne Paris Cite, Imagine Institute, Paris (France); Mekinian, A.; Fain, O. [Saint Antoine Hospital, Department of Internal Medicine and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), AP-HP, Paris (France); Canioni, D. [Necker Children' s Hospital, APHP, French Reference center for Mastocytosis (Centre de Reference des Mastocytoses, CEREMAST), Paris (France); Paris Descartes University, Sorbonne Paris Cite, Imagine Institute, Paris (France); Necker Children' s Hospital, APHP, Department of Pathology, Paris (France); Brouzes, C. [Necker Children' s Hospital, APHP, French Reference center for Mastocytosis (Centre de Reference des Mastocytoses, CEREMAST), Paris (France); Paris Descartes University, Sorbonne Paris Cite, Imagine Institute, Paris (France); Necker Children' s Hospital, APHP, Laboratory of Haematology, Paris (France); Hanssens, K. [Necker Children' s Hospital, APHP, French Reference center for Mastocytosis (Centre de Reference des Mastocytoses, CEREMAST), Paris (France); Aix-Marseille University, INSERM U1068, Centre de Recherche en Cancerologie de Marseille (Signaling, Hematopoiesis and Mechanism of Oncogenesis), Paoli Calmettes Institute, Marseille (France); Pop, G.; Eder, V. [Assistance Publique - Hopitaux de Paris (APHP), Department of Nuclear Medicine, Avicenne Hospital, Bobigny (France); Durieu, I.; Durupt, S. [Universite de Lyon, Department of Internal and Vascular Medicine, Hospices Civils de Lyon, Groupe Hopitalier Sud, Pierre-Benite (France); Grosbois, B.; Besnard, S. [Rennes University Hospital, Department of Internal Medicine, Rennes (France); Tournilhac, O. [Clermont-Ferrand University Hospital, Department of Internal Medicine, Clermont-Ferrand (France); Beyne-Rauzy, O. [Purpan University Hospital, Department of Internal Medicine, Toulouse (France); Agape, P. [Saint-Denis University Hospital, Department of Oncology and Haematology, Saint-Denis de la Reunion (France); Delmer, A. [Reims University Hospital, Department of Haematology, Reims (France); Ranta, D. [Brabois University Hospital, Department of Haematology, Vandoeuvre les Nancy (France); Jeandel, P.Y. [Nice University Hospital, Department of Internal Medicine, Nice (France); Georgin-Lavialle, S. [Tenon Hospital, Department of Internal Medicine, Paris (France); Frenzel, L.; Hermine, O. [Necker Children' s Hospital, APHP, French Reference center for Mastocytosis (Centre de Reference des Mastocytoses, CEREMAST), Paris (FR); Necker Children' s Hospital, APHP, Department of Haematology, Paris (FR); Paris Descartes University, Sorbonne Paris Cite, Imagine Institute, Paris (FR); Damaj, G. [Necker Children' s Hospital, APHP, French Reference center for Mastocytosis (Centre de Reference des Mastocytoses, CEREMAST), Paris (FR); Caen University Hospital, Department of Haematology, Caen (FR); Lortholary, O. [Necker Children' s Hospital, APHP, French Reference center for Mastocytosis (Centre de Reference des Mastocytoses, CEREMAST), Paris (FR); Paris Descartes University, Sorbonne Paris Cite, Imagine Institute, Paris (FR); Pasteur Institute, Department of Infectious Diseases and Tropical Medicine, Necker Children' s Hospital, APHP, Paris (FR); Soussan, M. [Assistance Publique - Hopitaux de Paris (APHP), Department of Nuclear Medicine, Avicenne Hospital, Bobigny (FR); Paris 13 University, Sorbonne Paris Cite, Bobigny (FR)

    2015-12-15

    Mastocytosis is a clonal haematological disease characterized by uncontrolled proliferation and the activation of mast cells. The value of FDG-PET/CT (FDG-PET) in mastocytosis has yet to be determined. We retrospectively identified patients with an established diagnosis of systemic mastocytosis (SM), according to the WHO criteria, who underwent PET using the French Reference Centre for Mastocytosis database. Semi-quantitative and visual analysis of FDG-PET was performed and compared to the clinico-biological data. Our cohort included 19 adult patients, median age 65 years [range 58-74], including three with smouldering SM (SSM), three with aggressive SM (ASM), 10 with an associated clonal haematological non-mast-cell lineage disease (SM-AHNMD), and three with mast cell sarcoma (MCS). FDG-PET was performed at the time of the SM diagnosis (15/19), to evaluate lymph node (LN) activity (3/19) or the efficacy of therapy (1/19). FDG uptake was observed in the bone marrow (BM) (9/19, 47 %), LN (6/19, 32 %), spleen (12/19, 63 %), or liver (1/19, 5 %). No significant FDG uptake was observed in the SSM and ASM patients. A pathological FDG uptake was observed in the BM of 6/10 patients with SM-AHNMD, appearing as diffuse and homogeneous, and in the LN of 5/10 patients. All 3 MCS patients showed intense and multifocal BM pathological uptake, mimicking metastasis. No correlation was found between the FDG-PET findings and serum tryptase levels, BM mast cell infiltration percentage, and CD30 and CD2 expression by mast cells. FDG uptake does not appear to be a sensitive marker of mast cell activation or proliferation because no significant FDG uptake was observed in most common forms of mastocytosis (notably purely aggressive SM). However, pathological FDG uptake was observed in the SM-AHNMD and in MCS cases, suggesting a role of FDG-PET in their early identification and as a tool of therapeutic assessment in this subgroup of patients. (orig.)

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

    OpenAIRE

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

    2015-01-01

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

  5. A Case of Asymptomatic Venous Air Embolism Demonstrated on 18F FDG PET/CT

    DEFF Research Database (Denmark)

    Dejanović, Danijela; Alslev, Louise; Abrahamsson, Elisabeth; Costa, Junia; Loft, Annika

    2016-01-01

    We present the findings on F FDG PET/CT in connection with iatrogenic venous air embolism. The patient was referred for a posttreatment evaluation PET/CT for peripheral T-cell lymphoma. On the PET images, an intense FDG-uptake was seen in the injected vein. Simultaneous non-contrast-enhanced CT...... showed air bubbles of various sizes within the affected veins. Because no intravenous contrast was administered, we conclude that the source of venous air embolism was either the insertion of the peripheral intravenous cannula and/or the injection of F FDG, via a power injector, 1 hour before the scan....

  6. When to image carotid plaque inflammation with FDG PET/CT

    DEFF Research Database (Denmark)

    Græbe, Martin; Borgwardt, Lise; Højgaard, Liselotte; Sillesen, Henrik Hegaard; Kjær, Andreas

    2010-01-01

    Quantification of 18-fluorodeoxyglucose (FDG) uptake in inflamed high-risk carotid atherosclerotic plaques is challenged by the spatial resolution of positron emission tomography (PET) and luminal blood activity. Late acquisition protocols have been used to overcome these challenges to enhance th...... methods of FDG uptake in carotid artery plaques between early and late PET scans.......Quantification of 18-fluorodeoxyglucose (FDG) uptake in inflamed high-risk carotid atherosclerotic plaques is challenged by the spatial resolution of positron emission tomography (PET) and luminal blood activity. Late acquisition protocols have been used to overcome these challenges to enhance the...

  7. A Case of Asymptomatic Venous Air Embolism Demonstrated on 18F FDG PET/CT.

    Science.gov (United States)

    Dejanović, Danijela; Alslev, Louise; Abrahamsson, Elisabeth; Costa, Junia; Loft, Annika

    2016-05-01

    We present the findings on F FDG PET/CT in connection with iatrogenic venous air embolism. The patient was referred for a posttreatment evaluation PET/CT for peripheral T-cell lymphoma. On the PET images, an intense FDG-uptake was seen in the injected vein. Simultaneous non-contrast-enhanced CT showed air bubbles of various sizes within the affected veins. Because no intravenous contrast was administered, we conclude that the source of venous air embolism was either the insertion of the peripheral intravenous cannula and/or the injection of F FDG, via a power injector, 1 hour before the scan. PMID:26673234

  8. Clinical utility of 18 Fluorodeoxyglucose (FDG)-PET/CT scans in patients with suspect ocular tuberculosis

    OpenAIRE

    Salil Mehta

    2013-01-01

    Systemic imaging of patients with suspect ocular tuberculosis include chest X-rays and computed tomography (CT) scans. Reports have suggested a role for 18 fluorodeoxyglucose-positron emission tomography/CT (FDG-PET/CT) scans. We report on the clinical utility of 18 FDG PET/CT in two patients. Case 1: A 38-year-old female patient presented with recurrent anterior uveitis. A 18 FDG-PET scan revealed metabolically active supraclavicular and chest lymph nodes. An aspiration cytology of the cervi...

  9. FDG PET or PET/CT in Evaluation of Renal Angiomyolipoma

    OpenAIRE

    Lin, Chun-Yi; Chen, Hui-Yi; Ding, Hueisch-Jy; Yen, Kuo-Yang; Kao, Chia-Hung

    2013-01-01

    Objective Angiomyolipoma is the most common benign kidney tumor. However, literature describing FDG PET findings on renal angiomyolipoma (AML) is limited. This study reports the FDG PET and PET/CT findings of 21 cases of renal AML. Materials and Methods The study reviews FDG PET and PET/CT images of 21 patients diagnosed with renal AML. The diagnosis is based on the classical appearance of an AML on CT scan with active surveillance for 6 months. The study is focused on the observation of clin...

  10. F-18 FDG PET in the initial evaluation of high risk melanoma

    International Nuclear Information System (INIS)

    Introduction. - Localized melanoma is a potentially aggressive tumor. Its prognosis depends mainly on pathologic factors, namely: thickness (Breslow index), presence of ulceration and microscopic nodal metastasis. FDG PET is the modality of choice for evaluation of advanced melanoma and has proven its superiority in terms of sensitivity, specificity and accuracy compared to conventional imaging. Early stages of melanoma do not seem to benefit from PET FDG. However the value of PET FDG in staging localized high risk melanoma is yet to be determined. Patients and methods. - We have evaluated 87 patients with high risk melanoma with PET FDG. 32 patients presented with a Breslow index superior or equal to 4 mm, 21 with a Breslow index inferior to 4 mm and ulceration and 34 with a positive sentinel lymphadenectomy. PET FDG was realized after at least 6 h of fasting on a hybrid PET-CT G.E. Discovery S.T. scan for 65 of them. The rest of the patients were evaluated on a Siemens Ecat H.R. + scan. Scans were interpreted by an experimented nuclear medicine physician and were classified as positive or negative. All equivocal scans or cases for which there was discordance between the scan result and follow up were reviewed by 2 experimented nuclear medicine physicians and a consensus was reached. Results. - FDG PET was positive in seven patients, four scans were true positive and identified regional metastatic disease. No distant metastatic visceral disease was found. The three false positive scans consisted of a cyst adeno-lymphoma in one case, mediastinal and axillary uptake in the other two cases and no sign of evolution more than six months after the scan. Four patients with a negative scan showed metastatic disease in the six months following the PET scan. FDG PET had an impact on therapeutic management on two patients (2%). When evaluating FDG PET for regional disease with sentinel node biopsy as a reference, we found values of sensitivity, specificity, predictive

  11. Diffuse Intense 18F-FDG Uptake at PET in Unilateral Breast Related to Breastfeeding Practice

    International Nuclear Information System (INIS)

    We present an interesting case of incidental diffuse fluorodeoxyglucose (FDG) uptake at PET in her left breast, related to atypical breastfeeding practice. Clinically, differential diagnoses of diffuse intense FDG uptake in unilateral breast include advanced breast cancer, breast lymphoma and inflammatory condition. However, normal physiologic lactation may also show increased FDG uptake in the breasts. Therefore, if we encounter that finding in daily practice, we should question the patient regarding unilateral breastfeeding. In addition, mammography and ultrasound would be helpful to confirm the diagnosis

  12. Usefulness of {sup 18}F-FDG PET in intrahepatic cholangiocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young-Jin [Department of Diagnostic Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea); Yun, Mijin; Lee, Jong Doo [Division of Nuclear Medicine, Department of Radiology, Yonsei University College of Medicine, 134 Shinchon-dong, 120-752, Seodaemoon-ku, Seoul (Korea); Lee, Woo Jung; Kim, Kyung Sik [Department of Surgery, Yonsei University College of Medicine, Seoul (Korea)

    2003-11-01

    Surgical resection is the only curative treatment strategy for intrahepatic cholangiocarcinoma (CC). Therefore, accurate staging is essential for appropriate management of patients with CC. We assessed the usefulness of 2-[{sup 18}F]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in the staging of CC. We undertook a retrospective review of FDG PET images in 21 patients (10 female, 11 male; mean age 57 years) diagnosed with CC. Ten patients had hilar CC and 11, peripheral CC. Patients underwent abdominal magnetic resonance imaging (MRI) (n=20) and computed tomography (CT) (n=12) for the evaluation of primary tumours, and chest radiography and whole-body bone scintigraphy for work-up of distant metastases. For semi-quantitative analysis, the maximum voxel standardised uptake value (SUV{sub max}) was obtained from the primary tumour. All peripheral CCs showed intensely increased FDG uptake, and some demonstrated ring-shaped uptake corresponding to peripheral rim enhancement on CT and/or MRI. In nine of the ten patients, hilar CCs demonstrated increased FDG uptake of a focal nodular or linear branching appearance. The remaining case was false negative on FDG PET. One patient with a false negative result on MRI demonstrated increased uptake on FDG PET. Among the ten hilar CCs, FDG uptake was intense in only two patients and was slightly higher than that of the hepatic parenchyma in the remaining patients. For the detection of lymph node metastasis, FDG PET and CT/MRI were concordant in 16 patients, and discordant in five (FDG PET was positive in three, and CT and MRI in two). FDG PET identified unsuspected distant metastases in four of the 21 patients; all of these patients had peripheral CC. FDG PET is useful in detecting the primary lesion in both hilar and peripheral CC and is of value in discovering unsuspected distant metastases in patients with peripheral CC. FDG PET could be useful in cases of suspected hilar CC with non-confirmatory biopsy and

  13. Characterizing bone marrow involvement in Hodgkin's lymphoma by FDG-PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Weiler-Sagie, Michal; Kagna, Olga [Rambam Health Care Campus, Nuclear Medicine Department, Haifa (Israel); Dann, Eldad J. [Rambam Health Care Campus and B. and R. Rappaport Faculty of Medicine, Technion, Hematology Department, Haifa (Israel); Ben-Barak, Ayelet [Rambam Health Care Campus and B. and R. Rappaport Faculty of Medicine, Technion, Pediatric Hemato-Oncology Department, Haifa (Israel); Israel, Ora [Rambam Health Care Campus and B. and R. Rappaport Faculty of Medicine, Technion, Nuclear Medicine Department, Haifa (Israel)

    2014-06-15

    Fluoro-deoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) is superior to iliac bone marrow biopsy (iBMB) for detection of bone marrow involvement (BMI) in staging of Hodgkin's lymphoma (HL). The present study aims to characterize the patterns and distribution of BMI in HL as determined by FDG-PET/CT. Reports of FDG-PET/CT studies performed for staging of HL were reviewed. BMI was defined as positive iBMB and/or foci of pathological FDG uptake in the skeleton that behaved in concordance with other sites of lymphoma in studies following chemotherapy. Number of FDG uptake foci, their specific location in the skeleton and the presence of corresponding lesions in the CT component of the study, and stage according to the Ann Arbor staging system, were recorded. The study included 473 patients. iBMB was performed in 336 patients. Nine patients had positive iBMB (9/336, 3 %). Seventy-three patients (73/473, 15 %) had FDG-PET/CT-defined BMI. The BM was the only extranodal site of HL in 52/473 patients (11 %). Forty-five patients had three or more foci of pathological skeletal FDG uptake (45/73, 62 %). Sixty-four patients (64/73, 88 %) had at least one uptake focus in the pelvis or vertebrae. In 60 patients (60/73, 82 %), the number of skeletal FDG uptake foci without corresponding CT lesions was equal to or higher than the number of foci with morphological abnormalities. FDG-PET/CT demonstrated BMI in 15 % of patients with newly diagnosed HL. Diagnosis of BMI in HL by FDG-PET/CT was more sensitive than iBMB with potential upstage in 11 % of patients. The most common pattern of FDG-PET/CT BMI was multifocal (at least three foci) skeletal FDG uptake, with at least one focus in the pelvis or vertebrae and no corresponding CT lesions. (orig.)

  14. FDG PET/CT Findings in Abdominal Fat Necrosis After Treatment for Lymphoma.

    Science.gov (United States)

    Dubreuil, Julien; Moreau, Aurélie; Sarkozy, Clémentine; Traverse-Glehen, Alexandra; Skanjeti, Andrea; Salles, Gilles; Giammarile, Francesco

    2016-05-01

    FDG PET/CT is now validated in non-Hodgkin lymphoma for response assessment in interim and posttreatment lymphoma. We report the case of a 62-year-old man followed by FDG PET/CT for a diffuse large B-cell lymphoma, with initial stage III. The interim FDG PET/CT examination concluded in complete metabolic and morphological response of subdiaphragmatic lymphadenopathy but a persistent abnormal subdiaphragmatic uptake (SUVmax at 9 and Deauville 5-point scale at 5). Therefore, an abdominal biopsy of the corresponding nodules was conducted with a final diagnosis of diffuse fat necrosis. PMID:26825213

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2015-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  20. Postoperative reactive lymphadenitis: A potential cause of false-positive FDG PET/CT

    OpenAIRE

    Liu, Yiyan

    2014-01-01

    A wide variety of surgical related uptake has been reported on F18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG PET/CT) scan, most of which can be differentiated from neoplastic process based on the pattern of FDG uptake and/or anatomic appearance on the integrated CT in image interpretation. A more potential problem we may be aware is postoperative reactive lymphadenitis, which may mimic regional nodal metastases on FDG PET/CT. This review presents five case...

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  3. FDG-PET/CT findings in systemic mastocytosis: a French multicentre study

    International Nuclear Information System (INIS)

    Mastocytosis is a clonal haematological disease characterized by uncontrolled proliferation and the activation of mast cells. The value of FDG-PET/CT (FDG-PET) in mastocytosis has yet to be determined. We retrospectively identified patients with an established diagnosis of systemic mastocytosis (SM), according to the WHO criteria, who underwent PET using the French Reference Centre for Mastocytosis database. Semi-quantitative and visual analysis of FDG-PET was performed and compared to the clinico-biological data. Our cohort included 19 adult patients, median age 65 years [range 58-74], including three with smouldering SM (SSM), three with aggressive SM (ASM), 10 with an associated clonal haematological non-mast-cell lineage disease (SM-AHNMD), and three with mast cell sarcoma (MCS). FDG-PET was performed at the time of the SM diagnosis (15/19), to evaluate lymph node (LN) activity (3/19) or the efficacy of therapy (1/19). FDG uptake was observed in the bone marrow (BM) (9/19, 47 %), LN (6/19, 32 %), spleen (12/19, 63 %), or liver (1/19, 5 %). No significant FDG uptake was observed in the SSM and ASM patients. A pathological FDG uptake was observed in the BM of 6/10 patients with SM-AHNMD, appearing as diffuse and homogeneous, and in the LN of 5/10 patients. All 3 MCS patients showed intense and multifocal BM pathological uptake, mimicking metastasis. No correlation was found between the FDG-PET findings and serum tryptase levels, BM mast cell infiltration percentage, and CD30 and CD2 expression by mast cells. FDG uptake does not appear to be a sensitive marker of mast cell activation or proliferation because no significant FDG uptake was observed in most common forms of mastocytosis (notably purely aggressive SM). However, pathological FDG uptake was observed in the SM-AHNMD and in MCS cases, suggesting a role of FDG-PET in their early identification and as a tool of therapeutic assessment in this subgroup of patients. (orig.)

  4. 18F-DG PET and RCBF SPECT in epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Menzel, C. [Dept. of Nuclear Medicine, Univ. Bonn (Germany); Gruenwald, F. [Dept. of Nuclear Medicine, Univ. Bonn (Germany); Shih, W.J. [Dept. of Diagnostic Radiology, Nuclear Medicine Div., Kentucky Univ., KY (United States); Biersack, H.J. [Dept. of Nuclear Medicine, Univ. Bonn (Germany)

    1994-12-31

    Functional imaging of cortical metabolism and perfusion is of growing importance in the presurgical evaluation of patients suffering from intractable epilepsy. PET and SPECT are of proven value in functional imaging prior to epilepsy surgery. To date the best clinical experience was gained by using 18-fluorodeoxyglucose for PET and tracers for measurement of regional cerebral blood flow (rCBF) like 99mTc-HMPO or 99mTc-ECD for SPECT respectively. Their relative contribution towards detection of a probable focus site in epilepsy is still controversial. To determine the relative value of both procedures the literature has been reviewed with special respect to ictal SPECT studies. With regard to different standards used for correlation a relative sensitivity of 62.4% was found for interictal rCBF SPECT. 71% for 18-FDG-PET and 87% for ictal rCBF SPECT studies. In conclusion, earlier reported advantages of PET over SPECT seem to closely reflect the better spatial resolution of PET. Modern SPECT systems, dedicated for brain SPECT, provide appropriate and almost equal sensitivity. Regarding the limited specificity of interictal studies, both rCBF SPECT and FDG-PET need precise indications. However, further to detection of a probable focus site, metabolism and rCBF studies seem to be of value to predicit the post-surgical patients outcome as to seizure frequency and mental functions secondarily affected by epilepsy surgery such as memory impairment. Ictal rCBF SPECT provides higher sensitivity and specificity and virtually allows the detection lateralisation in almost every case. This means that a relatively precise anatomical localisation of an epileptogenic focus is being found in a rising number of patients. (orig.) [Deutsch] Die Bedeutung der funktionellen Bildgebung unter Verwendung der PET und der SPECT zum Nachweis einer gestoerten regionalen Durchblutung oder eines Zerebralen Hyopmetabolismus von Glukose hat heute einen festen Platz in der praechirurgischen

  5. 18F-FDG SPECT myocardial imaging of right ventricle in patients with idiopathic pulmonary hypertension

    International Nuclear Information System (INIS)

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

  6. Colorectal cancer patients before resection of hepatic metastases. Impact of 18F-FDG PET on detecting extrahepatic disease

    International Nuclear Information System (INIS)

    Aim: Evaluation of the role of FDG-PET in comparison to conventional staging methods for detecting extrahepatic tumour deposits prior to resection of liver metastases. Patients, methods: In our prospective study, 58 patients (24 women, 34 men; age 33-81 years) with liver metastases of colorectal carcinoma underwent FDG-PET. Images were acquired in 3D-mode including transmission scans and reconstructed iteratively. For conventional staging all patients underwent abdominal ultrasound, helical computed tomography (CT) of the thorax and abdomen, and colonoscopy/rectoscopy. A preliminary therapeutic decision was established without knowledge of the FDG-PET findings. Thereafter, it was revised or confirmed according to the results of FDG-PET. Results: In 3/58 patients extrahepatic tumour deposits were concordantly identified with both conventional staging methods and FDG-PET. However, in one case, both conventional methods and FDG-PET were false positive regarding pulmonary metastases. In 12/58 patients, nothing but FDG-PET detected extrahepatic tumour masses, which were later confirmed either by histology or follow-up. Conclusion: Our study suggests than in 21% of patients exclusively FDG-PET is an appropriate diagnostic tool to reveal extrahepatic metastases or local recurrence of colorectal carcinoma. Our results demonstrate that FDG-PET provides relevant additional information for accurate therapeutic planning as compared to the conventional combination of staging methods. Therefore, FDG-PET has to exert a decisive influence on the decision for resection of hepatic metastases. (orig.)

  7. Integrated FDG-PET/CT for detection, therapy monitoring and follow-up of granulocytic sarcoma. Initial results

    Energy Technology Data Exchange (ETDEWEB)

    Aschoff, Philip; Werner, M.K.; Lichy, M.; Pfannenberg, C. [Dept. of Diagnostic and Interventional Radiology, Univ. Hospital, Eberhard-Karls-Univ. Tuebingen (Germany); Haentschel, M.; Vogel, W. [Dept. of Internal Medicine, Univ. Hospital, Eberhard-Karls-Univ. Tuebingen (Germany); Oeksuez, M. [Dept. of Nuclear Medicine, Univ. Hospital, Eberhard-Karls-Univ. Tuebingen (Germany)

    2009-07-01

    Granulocytic sarcomas (GS) are rare extramedullary manifestations of myeloid or lymphoblastic leukaemia. Laboratory examinations are of limited use for diagnosis of extramedullary disease. Radiological imaging based on morphology is challenging. To date, the possible role of FDG-PET/CT as a method for combined metabolic and morphologic imaging is unclear. We present a series of 10 patients to evaluate the potential role of FDG-PET/CT in the management of GS. Patients, materials, methods: a retrospective evaluation of 18 FDG-PET/CT exams in 10 patients with histologically proven GS was performed. All scans included a contrast enhanced CT. The FDG uptake of GS was analyzed and the sensitivity of lesion detection was compared to PET and CT alone. The changes in FDG uptake after therapy were compared to morphological changes detected by CT and follow-up/clinical outcome. Results: 52 untreated or recurrent GS lesions were detected by FDG-PET/CT and all showed an increased FDG uptake with a mean SUVmax and SUVavg of 5.1 and 3.4, respectively. GS was multifocal in 8/10 patients. Combined PET/CT avoided 5 false positive findings compared to PET alone and 13 false negative findings and 1 false positive compared to CT alone. Changes in FDG uptake after therapy correlated with clinical outcome and were more reliable than CT assessment alone. PET/CT identified recurrent GS in 3 patients. Conclusion: viable GS are FDG-avid. Using this metabolic information and morphologic CT criteria, combined FDG-PET/CT was more accurate in lesion detection than FDG-PET or CT alone. Changes in FDG uptake after therapy might be a useful additional parameter for therapy monitoring. Therefore, FDG-PET/CU appears to be a promising diagnostic and monitoring tool in the management of patients with GS. (orig.)

  8. FDG-PET during Therapy of Head and Neck Carcinomas. Prediction of tumor response and associations to tumor cell properties

    International Nuclear Information System (INIS)

    Introduction: Correlations between FDG uptake to single tumor properties, such as tumor grade, tumor cell proliferation or DNA ploidy have failed. Association between FDG metabolism during cytotoxic therapy, treatment outcome and tumor cell properties were evaluated in a prospective study of 47 patients with locally advanced head neck carcinomas (HNSCC) receiving radical treatment, radiotherapy with or without neoadjuvant cisplatinum-based chemotherapy. Methods: Repeated FDG PET scans with evaluation of metabolic rate of FDG (MR FDG) before and early during, either radiotherapy or initial chemotherapy. Fine needle aspiration of palpable node metastasis was performed in 31 patients immediately after each PET scan for analysis of S-phase (SPF), and DNA ploidy (analyzed by FCM and Image Cytometry; ICM). The associations between MR FDG and therapy outcome, and MR FDG and ploidy and s-phase were evaluated. We also studied changes in these properties during therapy. Results: Early changes in MR FDG were associated to treatment outcome, both survival and locoregional control. MR FDG below the median value during therapy was associated to a significantly better outcome, compared to MR FDG above the median value. This regards both 5 year-survival (72 % and 35% resp., p 0.0042) and locoregional control (96% and 55% resp., p 0.002). Analysis of DNA ploidy revealed differences depending on analyses used. ICM identified primarily more non-diploid tumors than FCM did, as well as more persisting non-diploid clones during treatment. No significant association to treatment outcome depending on DNA ploidy or SPF was seen.There was neither any significant association between DNA ploidy nor SPF to MR FDG. Conclusions: MR FDG during therapy was associated to therapy outcome, and thus enabling in vivo monitoring of metabolic response. Ploidy and SPF was not associated to FDG-metabolism

  9. Impact of [18F]FDG-PET on the primary staging of small-cell lung cancer

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the impact of [18F]fluorodeoxy-d-glucose positron emission tomography (FDG-PET) on the primary staging of patients with small-cell lung cancer (SCLC). FDG-PET was performed in 120 consecutive patients with SCLC during primary staging. In addition, brain examinations with both FDG-PET and cranial magnetic resonance imaging (MRI) or computed tomography (CT) were performed in 91 patients. Results of FDG-PET were compared with those of conventional staging procedures. FDG-PET detected markedly increased FDG uptake in the primary tumours of all 120 patients (sensitivity 100%). Complete agreement between FDG-PET results and other staging procedures was observed in 75 patients. Differences occurred in 45 patients at 65 sites. In 47 sites the FDG-PET results were proven to be correct, and in ten, incorrect. In the remaining eight sites, the discrepancies could not be clarified. In 14/120 patients, FDG-PET caused a stage migration, correctly upstaging ten patients to extensive disease and downstaging three patients by not confirming metastases of the adrenal glands suspected on the basis of CT. Only 1/120 patients was incorrectly staged by FDG-PET, owing to failure to detect brain metastases. In all cases the stage migration led to a significant change in the treatment protocol. Sensitivity of FDG-PET was significantly superior to that of CT in the detection of extrathoracic lymph node involvement (100% vs 70%, specificity 98% vs 94%) and distant metastases except to the brain (98% vs 83%, specificity 92% vs 79%). However, FDG-PET was significantly less sensitive than cranial MRI/CT in the detection of brain metastases (46% vs 100%, specificity 97% vs 100%). The introduction of FDG-PET in the diagnostic evaluation of SCLC will improve the staging results and affect patient management, and may reduce the number of tests and invasive procedures. (orig.)

  10. Discussion on the alteration of FDG uptake by the breast according to the menstrual cycle in 18F-FDG PET/CT

    Science.gov (United States)

    Park, H. H.; Park, M. S.; Lee, C. H.; Cho, J. H.; Dong, K. R.; Chung, W. K.

    2012-09-01

    18F-FDG (fluorodeoxyglucose) PET (positron emission tomography)/CT (computed tomography) is a useful modality for identifying high-glucose-consuming cells, such as cancer cells, by the glucose metabolism of FDG. FDG is taken up by cancer and inflammatory cells, but occasionally there is also some FDG uptake by normal tissues as a result of their individual physiological characteristics. In particular, in fertile females, unusual FDG uptake in the breast changes according to the stages in the menstrual cycle, which can adversely affect a diagnosis. Therefore, this study examined the change in breast FDG uptake in the menstrual cycle on 18F-FDG PET/CT. One hundred and sixty females (34±3.5 years old), who had not undergone a gynecologic anamnesis and had a regular menstrual cycle over the previous 6 months, were examined from March 2010 to February 2011. The subjects were divided into the following four groups (each with 40 patients): flow phase, proliferative phase, ovulatory phase and secretory phase using Pregnancy Calculator Ver. 0.14 and history taking. Discovery Ste was used as the PET/CT. The standardized uptake values (SUVs) on the accumulated region on the breast were analyzed, and three nuclear medicine specialists performed a blind test. The SUVs on the breast were the flow phase (1.64±0.25), proliferative phase (0.93±0.28), ovulatory phase (1.66±0.26) and secretory phase (1.77±0.28). A high uptake value was observed in the secretory, flow and ovulatory phases. The FDG accumulation of the breast was divided into the following three grades compared with the lung and liver by gross analysis: the breast uptake was equal to the lung (Grade I), between the lung and liver (Grade II) and equal to or greater than the liver (Grade III). These results showed a high uptake value in the secretory, flow and ovulatory phases. In fertile females, the FDG uptake of the breast showed changes according to the menstrual cycle, which can be used to improve the diagnosis

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-02-15

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

  12. Clinical application of FDG PET to lung and esophageal cancer. The use of FDG PET for nodal staging of non-small-cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Back, Hee Jong

    1998-12-01

    Positron tomography (PET) using fluorine-18 deoxyglucose (FDG), showing increased FDG uptake and retention in malignancy cells, has been proven useful to differentiate malignant from benign tissue. We undertook the prospective study to compare the accuracy of whole-bocy FDG PET with that of conventional chest computed tomography (CT) for the nodal staging of non-small-cell lung cancer (NSCLC). FDG PET and contrast enhanced CT were performed in 36 patients with potentially resectable NSCLC. Each imaging study was evaluated independently, and nodal stations were localized according to American Thoracic Society mapping system. Extensive lymph node dissection (1101 nodes) of ipsi- and contralateral mediastinal nodal stations was performed at thoracotomy and /or mediastinoscopy. Imaging findings were correlated with histopathologic staging results and analyzed with McNema test (p) and Kappa value(k). The sensitivity, specificity, positive predictive value, and negative predictive value of CT for ipsilatreal mediastinal nodal staging were 38 % , 68 % , 25%, 79%, 61% and those of PET were 88%, 71%, 47%, 95%, 75% (p>0.05, K=0.29). When analyzed by individual nodal group (superior, aortopulmonary window, and inferior), the sensitivity, specificity, positive predictive value and negative predictive value of CT were 27%, 82%, 22%, 85%, 73% and those of PET were 60%, 87%, 92%, 82% (p<0.05, k=0.27). FDG PET in addition to CT appears to be superior to CT alone for mediastinal staging of non-small cell lung cancer.

  13. Persistent non-specific FDG uptake on PET imaging following hip arthroplasty

    International Nuclear Information System (INIS)

    Hip arthroplasty is a common surgical procedure, but the diagnosis of infection associated with hip arthroplasty remains challenging. Fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) has been shown to be a promising imaging modality in settings where infection is suspected. However, inflammatory reaction to surgery can result in increased FDG uptake at various anatomic locations, which may erroneously be interpreted as sites of infection. The purpose of this study was to assess the patterns and time course of FDG accumulation following total hip replacement over an extended period of time. Firstly, in a prospective study nine patients with total hip replacement were investigated to determine the patterns of FDG uptake over time. Three FDG-PET scans were performed in each patient at about 3, 6 and 12 months post arthroplasty. Secondly, in a retrospective analysis, the medical and surgical history and FDG-PET imaging results of 710 patients who had undergone whole-body scans for the evaluation of possible malignant disorders were reviewed. The history of arthroplasty and FDG-PET findings in the hip region were reviewed for this study. Patients with symptomatic arthroplasties or related complaints during FDG-PET scanning were excluded from the analysis. During the entire study period, all nine patients enrolled in the prospective study were demonstrated to have increased FDG uptake around the femoral head or neck portion of the prosthesis that extended to the soft tissues surrounding the femur. Among the patients reviewed in the retrospective study, 18 patients with a history of 21 hip arthroplasties who were asymptomatic at the time of FDG-PET scan met the criteria for inclusion. The time interval between the hip arthroplasty and the FDG-PET study ranged from 3 months to 288 months (mean±SD: 80.4±86.2 months). In 81% (17 of 21) of these prostheses, increased FDG uptake could be noted around the femoral head or neck portion of the

  14. The Values and Limitations of FDG-PET/CT for Diagnosis of Hibernoma

    Directory of Open Access Journals (Sweden)

    Jong Hoon Park

    2015-01-01

    Full Text Available Hibernoma is a rare benign lipogenic tumor of brown fat that develops in a wide variety of locations. Although the features of hibernoma demonstrated by MRI resemble those of liposarcoma, recent FDG-PET/CT studies have documented higher radiotracer uptake than liposarcoma, suggesting that FDG/PET/CT is useful for differentiating hibernoma from liposarcoma. Here we report two cases of hibernoma that showed relatively lower SUVs than those reported previously, lying within the range for liposarcoma. Our findings emphasize that hibernoma needs to be included in the differential diagnosis of any fat-containing tumor showing intense accumulation by FDG-PET/CT. Although it is unlikely that such a rare condition could be reasonably diagnosed on the basis of MRI and FDG-PET/CT alone due to possible SUV overlap between hibernoma and liposarcoma, it is important to recognize this extremely rare lipogenic tumor for accurate diagnosis and appropriate management.

  15. Peripheral nerve schwannoma: two cases exhibiting increased FDG uptake in early and delayed PET imaging

    International Nuclear Information System (INIS)

    We present two cases of peripheral nerve schwannoma which showed an increased accumulation of 2-deoxy-[18F] fluoro-D-glucose (FDG) in the tumors on positron emission tomography (PET) imaging acquired at both 1 h (early phase) and 2 h (delayed phase) after FDG injection. FDG-PET scans were performed with a dedicated PET scanner (HeadtomeV/ SET2400 W, Shimadzu, Kyoto, Japan) and the PET data analyzed the most metabolically active region of interest (ROI). We set the maximum standardized uptake value (SUV max) with a cut-off point of 3.0 to distinguish benign and malignant lesions. Although the mechanism responsible for the increased FDG uptake in benign schwannomas remains unknown, we discuss our findings in the context of tumor cellularity and briefly review other studies on the subject. (orig.)

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

    International Nuclear Information System (INIS)

    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)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

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

  19. Iatrogenic FDG foci in the lungs: a pitfall of PET image interpretation

    International Nuclear Information System (INIS)

    2-[F-18]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) has become an important staging modality for many tumors, including bronchial carcinoma; however it is important to know that there are several pitfalls in PET image interpretation. In this report we demonstrate three cases in which focal intrapulmonary FDG uptake could possibly represent iatrogenic microembolism. These FDG accumulations would have been interpreted as malignant tumor mass in the lung if no anatomic correlation would have been performed. For this reason, we further present an integrated PET/CT scanner, which recently has been introduced. This correlation of molecular and morphological information enables the specification of the FDG-PET findings. (orig.)

  20. A Pilot Study Treatment of Malignant Tumors Using [18F] Fluorodeoxyglucose (FDG)

    Science.gov (United States)

    2015-10-19

    Radiosensitive Stage IV Solid and Hematological Tumors With High FDG Uptake Not Responding to Standard of Care; Lung Cancer, Head and Neck Cancer, Breast Cancer, Gastric Cancer, Pancreatic Cancer, Colon Cancer, Lymphomas, Sarcomas, Etc

  1. False positivity of FDG-PET/CT in a child with Hodgkin disease.

    Science.gov (United States)

    Beker, Dildar Bahar; Berrak, Su Gulsun; Canpolat, Cengiz; Tugtepe, Halil; Ones, Tunc; Tecimer, Tulay

    2008-04-01

    Role of Positron Emission Tomography (PET) with F-18-2-fluoro-2-deoxy-D-glucose (FDG) in staging of Hodgkin disease is well established despite several controversies. We report a Stage III Hodgkin lymphoma patient with false positive FDG-PET/CT results. Seven-year-old male with Hodgkin lymphoma was in remission at end of chemotherapy. At third and fourth month of postchemotherapy follow-up, increased Gallium uptake and positive FDG-PET/CT in right lower quadrant of abdomen was observed. Open biopsy revealed lymphoid hyperplasia. He has been followed for 21 months without any evidence of disease. Despite its documented benefit, we believe that results of FDG-PET/CT should be interpreted with great caution in order to avoid unnecessary interventions. PMID:17417791

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-02-15

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

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

    International Nuclear Information System (INIS)

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

  4. Report of the investigation on usefulness of FDG-PET examinations published in literatures

    International Nuclear Information System (INIS)

    This paper described results of the investigation in the title done for future application of FDG-PET (2-deoxy-18F-fluoro-D-glucose/positron emit tomography) into the public health insurance together with present state of clinical PET. With reference to the US FDA public announcements of its 2 home pages and Federal Register, the author investigated 40 literatures of well-evidenced clinical studies of FDG-PET concerning lung cancer, rectal cancer, malignant lymphoma, malignant melanoma, head and neck cancer, esophageal cancer, myocardial viability and refractory epilepsy, and evaluated the effectiveness (sensitivity, specificity and comparison with other means) and safety. The investigation revealed the usefulness of the technology. In Japan, efforts for FDG-PET to be applied into the insurance are being made such as making various guidelines for FDG manufacturing and clinical use. (K.H.)

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

    International Nuclear Information System (INIS)

    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)

  6. Molecular pathology in vulnerable carotid plaques: correlation with [18]-fluorodeoxyglucose positron emission tomography (FDG-PET)

    DEFF Research Database (Denmark)

    Graebe, M; Pedersen, Sune Folke; Borgwardt, L;

    2008-01-01

    OBJECTIVES: Atherosclerosis is recognised as an inflammatory disease, and new diagnostic tools are warranted to evaluate plaque inflammatory activity and risk of cardiovascular events. We investigated [18]-fluorodeoxyglucose (FDG) uptake in vulnerable carotid plaques visualised by positron emission...

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-12-15

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

  9. The Semi-automatic Synthesis of 18F-fluoroethyl-choline by Domestic FDG Synthesizer

    Directory of Open Access Journals (Sweden)

    ZHOU Ming

    2016-02-01

    Full Text Available As an important complementary imaging agent for 18F-FDG, 18F-fluoroethyl-choline (18F-FECH has been demonstrated to be promising in brain and prostate cancer imaging. By using domestic PET-FDG-TI-I CPCU synthesizer, 18F-FECH was synthesized by different reagents and consumable supplies. The C18 column was added before the product collection bottle to remove K2.2.2. The 18F-FECH was synthesized by PET-FDG-IT-I synthesizer efficiently about 30 minutes by radiochemical yield of 42.0% (no decay corrected, n=5, and the radiochemical purity was still more than 99.0% after 6 hours. The results showed the domestic PET-FDG-IT-I synthesizer could semi-automatically synthesize injectable 18F-FECH in high efficiency and radiochemical purity

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

    International Nuclear Information System (INIS)

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

  11. Evaluation of FDG-PET in the diagnosis of neck lymph node swelling on children

    International Nuclear Information System (INIS)

    Usefulness and limitation of fluorodeoxyglucose (FDG)-position emission tomography (PET) examination were evaluated in children with cervical lymph node tumors. Subjects were 14 pediatric patients (3 months to 18FDG concentration/18FDG dose/body wt.), and on other clinical findings involving the process, lymph node biopsy and surgery. For diagnosing the malignant tumor, sensitivity of PET was found to be 100% at SUV=4 or 10, but specificity, 78% at SUV 10 and 22% at 4. Thus the FDG distribution in the tumor was not always an indication of the presence of malignant one; however, it surely indicated the presence of lesion necessary for treatment. Clinical, ultrasonographic, CT and MRI findings together with PET were thought important for precise diagnosis. (R.T.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-12-15

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

  13. Nuclear medicine and lymphoma: the role of the FDG PET in non Hodgkin's lymphoma in children

    International Nuclear Information System (INIS)

    As for adult population, FDG PET is recognized as an efficient tool for staging, adaptation of therapy and follow-up of Hodgkin's disease in children. The interpretation of PET needs however to take into account some specificities of imaging as the frequent brown fat activation and the physiologic thymic uptake. The role of FDG PET in non Hodgkin's lymphoma (NHL) in children is less established. Although LNH are more frequent than Hodgkin 's lymphoma in children, FDG PET is rarely performed at diagnosis, probably due to the therapeutic emergency of these aggressive pediatric forms. During follow-up, FDG PET has been however shown to be useful, especially for the characterization of residual masses. (authors)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-11-15

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  17. Clinical value of FDG-PET in cutaneous malignant melanoma: First experience in Estonia

    International Nuclear Information System (INIS)

    Full text: In November 2002 first 18F-FDG-PET was performed in Estonia using a mobile truck-mounted scanning technology (Accel, Siemens) provided by the International Healthcare Group (IHG, Amersfoort, Netherlands). The FDG was provided by MAP Medical Technologies, Schering, (Helsinki, Finland). In 2003 this scheme was repeated for further scanning sessions. Evaluation of cutaneous malignant melanoma (CMM) using nuclear technique is of particular interest in Estonia as its incidence is on the rise. F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in CMM has a well-documented high diagnostic accuracy, especially in staging of the disease. The aim of the current study was to assess the impact of 18F-FDG-PET on detailed staging and clinical management in CMM. 30 patients of CMM, 16 males and 14 females, all non-diabetic, in the age range of 26 to 69 years were studied. Of these 30 patients, 12 were of high risk primary CMM, 7 had regional lymph node metastases and 11 had distant metastases. Patients were asked to consume a low-carbohydrate diet 3 days prior to the FDG-PET scan. 194 to 410 MBq (average 335 MBq) 18F-FDG was administered to the patients who were asked to come fasting for a minimum of 6 hours. Whole body scan was performed 40 to 65 minutes after the administration of FDG on the mobile PET. In 13 of the 30 patients (43%) 18F-FDG-PET changed the staging. In remaining 17 patients (57%) 18F-FDG-PET increased confidence level for the chosen treatment. Lymphadenectomy was planned in 2 patients showing lymph node involvement on FDG-PET. In other 2 patients, one with small pulmonary and other with a liver lesions found on PET but negative on radiological examination 'wait-and-watch' strategy was chosen. An unexpected hypermetabolic lesion seen in 1 case turned out to be a benign focus of connective tissue. One patient shown to have multiple distant metastases was started on chemotherapy. Finally in 8 of the 30 (27%) patients an immediate positive

  18. FDG avidity and PET/CT patterns in primary gastric lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Radan, Lea [Rambam Health Care Campus, Department of Nuclear Medicine, Haifa (Israel); Fischer, Doron [Rambam Health Care Campus, Department of Diagnostic Imaging, Haifa (Israel); Bar-Shalom, Rachel; Israel, Ora [Technion - Israel Institute of Technology, Department of Nuclear Medicine, Rambam Health Care Campus and R. and B. Rappaport School of Medicine, Haifa (Israel); Dann, Eldad J. [Technion - Israel Institute of Technology, Department of Hematology, Rambam Health Care Campus, and R. and B. Rappaport School of Medicine, Haifa (Israel); Epelbaum, Ron; Haim, Nissim [Technion - Israel Institute of Technology, Department of Oncology, Rambam Health Care Campus, and R. and B. Rappaport School of Medicine, Haifa (Israel); Gaitini, Diana [Rambam Health Care Campus, and R. and B. Rappaport School of Medicine, Technion - Israel Institute of Technology, Department of Diagnostic Imaging, Haifa (Israel)

    2008-08-15

    The use of 18F-fluoro-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in primary gastric lymphoma (PGL) is challenging due to physiologic FDG activity in the stomach and variability in the degree of uptake in various histologic subtypes. This study assesses FDG avidity and PET/CT patterns in newly diagnosed PGL. Sixty-two PET/CT studies of newly diagnosed PGL were reviewed (24 low-grade mucosa-associated lymphoid tissue [MALT], 38 aggressive non-Hodgkin's lymphoma [AGNHL]). FDG avidity, patterns (focal/diffuse), and intensity (visually vs. the liver and SUVmax) were assessed and compared to 27 controls. Gastric CT abnormalities and extragastric sites were recorded. Gastric FDG uptake was found in 55/62 (89%) PGL (71% MALT vs. 100% AGNHL, p < 0.001) and 63% controls. A diffuse pattern was found in 60% PGL (76% MALT vs. 53% AGNHL, p = NS) and 47% controls. FDG uptake higher than liver was found in 82% PGL (58% MALT vs. 97% AGNHL, p < 0.05) and 63% controls. SUVmax in FDG-avid PGLs was 15.3 {+-} 11.7 (5.4 {+-} 2.9 MALT vs. 19.7 {+-} 11.5 AGNHL, p < 0.001) and 4.6 {+-} 1.4 in controls. CT abnormalities were found in 79% PGL (thickening, n = 49; ulcerations, n = 22). Extra-gastric FDG-avid sites were seen in none of MALT, but 61% of AGNHL (nodal, n = 18; nodal and extranodal, n = 5). FDG avidity was present in 89% of PGLs, including all patients with AGNHL but only 71% of MALT. FDG uptake can be differentiated, in particular in AGNHL-PGL, from physiologic tracer activity by intensity but not by pattern. Extragastric foci on PET and structural CT abnormalities are additional parameters that can improve PET/CT assessment of PGL. Defining FDG avidity and PET/CT patterns in AGNHL and a subgroup of MALT-PGL before treatment may be important for further monitoring therapy response. (orig.)

  19. Recurrent renal cell carcinoma: clinical and prognostic value of FDG PET/CT

    International Nuclear Information System (INIS)

    The purpose of our study was 1) to evaluate the diagnostic performance of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT), 2) to assess the impact of FDG PET/CT on treatment decision-making, and 3) to estimate the prognostic value of FDG PET/CT in the restaging process among patients with renal cell carcinoma (RCC). From the FDG PET/CT databases of San Raffaele Hospital in Milan, Italy, and the Veneto Institute of Oncology in Padua, Italy, we selected 104 patients with a certain diagnosis of RCC after surgery, and for whom at least 24 months of post-surgical FDG PET/CT, clinical, and instrumental follow-up data was available. The sensitivity and specificity of FDG PET/CT were assessed by histology and/or other imaging as standard of reference. Progression-free survival (PFS) and overall survival (OS) were computed using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards models were used to identify predictors of outcome. FDG PET/CT resulted in a positive diagnosis in 58 patients and a negative diagnosis in 46 patients. Sensitivity and specificity were 74 % and 80 %, respectively. FDG PET/CT findings influenced therapeutic management in 45/104 cases (43 %). After a median follow-up period of 37 months (± standard deviation 12.9), 51 (49 %) patients had recurrence of disease, and 26 (25 %) had died. In analysis of OS, positive versus negative FDG PET/CT was associated with worse cumulative survival rates over a 5-year period (19 % vs. 69 %, respectively; p <0.05). Similarly, a positive FDG PET/CT correlated with a lower 3-year PFS rate. In addition, univariate and multivariate analysis revealed that a positive scan, alone or in combination with disease stage III-IV or nuclear grading 3-4, was associated with high risk of progression (multivariate analysis = hazard ratios [HRs] of 4.01, 3.7, and 2.8, respectively; all p < 0.05). FDG PET/CT is a valuable tool both in treatment decision-making and for

  20. Recurrent renal cell carcinoma: clinical and prognostic value of FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Alongi, Pierpaolo; Picchio, Maria; Gianolli, Luigi [IRCCS San Raffaele Scientific Institute, Nuclear Medicine Department, Milan (Italy); Zattoni, Fabio [University of Padua, Department of Oncological and Surgical Sciences, Urology Clinic, Padua (Italy); Spallino, Marianna [University of Milano-Bicocca, Milan (Italy); Saladini, Giorgio; Evangelista, Laura [Veneto Institute of Oncology IOV - IRCCS, Padua, Italy, Radiotherapy and Nuclear Medicine Unit, Padua (Italy)

    2016-03-15

    The purpose of our study was 1) to evaluate the diagnostic performance of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT), 2) to assess the impact of FDG PET/CT on treatment decision-making, and 3) to estimate the prognostic value of FDG PET/CT in the restaging process among patients with renal cell carcinoma (RCC). From the FDG PET/CT databases of San Raffaele Hospital in Milan, Italy, and the Veneto Institute of Oncology in Padua, Italy, we selected 104 patients with a certain diagnosis of RCC after surgery, and for whom at least 24 months of post-surgical FDG PET/CT, clinical, and instrumental follow-up data was available. The sensitivity and specificity of FDG PET/CT were assessed by histology and/or other imaging as standard of reference. Progression-free survival (PFS) and overall survival (OS) were computed using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards models were used to identify predictors of outcome. FDG PET/CT resulted in a positive diagnosis in 58 patients and a negative diagnosis in 46 patients. Sensitivity and specificity were 74 % and 80 %, respectively. FDG PET/CT findings influenced therapeutic management in 45/104 cases (43 %). After a median follow-up period of 37 months (± standard deviation 12.9), 51 (49 %) patients had recurrence of disease, and 26 (25 %) had died. In analysis of OS, positive versus negative FDG PET/CT was associated with worse cumulative survival rates over a 5-year period (19 % vs. 69 %, respectively; p <0.05). Similarly, a positive FDG PET/CT correlated with a lower 3-year PFS rate. In addition, univariate and multivariate analysis revealed that a positive scan, alone or in combination with disease stage III-IV or nuclear grading 3-4, was associated with high risk of progression (multivariate analysis = hazard ratios [HRs] of 4.01, 3.7, and 2.8, respectively; all p < 0.05). FDG PET/CT is a valuable tool both in treatment decision-making and for

  1. [{sup 18}F]FDG in childhood lymphoma: clinical utility and impact on management

    Energy Technology Data Exchange (ETDEWEB)

    Montravers, F.; McNamara, D.; Grahek, D.; Kerrou, K.; Younsi, N.; Talbot, J.N. [Department of Nuclear Medicine and PET Centre, Hopital Tenon, 4 rue de la Chine, 75020 Paris (France); Landman-Parker, J.; Leverger, G. [Department of Paediatric Oncology, Hopital d' enfants Armand-Trousseau, Paris (France); Wioland, M. [Department of Nuclear Medicine, Hopital d' enfants Armand-Trousseau, Paris (France)

    2002-09-01

    Positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose (FDG) is a very useful technique for the imaging of lymphomas in the adult population. It provides unique information about the behaviour of malignant cells and contributes to more accurate staging of the illness and better assessment of response to therapy. The purpose of this study was to evaluate the usefulness of FDG PET in childhood lymphoma compared with conventional imaging methods (CIMs) and clinical data. Between July 1998 and August 2001, 42 FDG PET examinations were performed using a dedicated PET system (27 examinations) or a hybrid coincidence PET system (15 examinations) for initial tumour staging (n=7), restaging (n=5) or assessment of response to therapy or residual masses (n=30) in 27 children with Hodgkin's disease (HD) (n=20) or non-Hodgkin's lymphoma (NHL) (n=7). FDG PET results were compared with CIM findings and clinical data. Since 2000, a standardised questionnaire for evaluation of the clinical impact of FDG PET on both staging and therapy has been sent to the 16 referring physicians and 13 have replied. In all children, FDG PET was performed without any side-effects. FDG PET was found to be very sensitive (Se=12/12) for staging and restaging of the illness, showing more lesions than CIMs, with a 50% patient upstaging rate (6/12). It was very accurate for monitoring response to therapy and for characterisation of residual masses. False-positive results were observed in two NHL patients with thymic uptake and one false-negative result was obtained in a patient whose NHL relapsed 1 month after a negative FDG PET. The questionnaire emphasised the impact of FDG PET on clinical management, which was modified on the basis of the FDG PET results in 23% of patients. As previously demonstrated in the adult population, FDG PET appeared to be a very sensitive imaging technique for staging and restaging of lymphoma in children and was very useful for monitoring the

  2. [18F]FDG in childhood lymphoma: clinical utility and impact on management

    International Nuclear Information System (INIS)

    Positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose (FDG) is a very useful technique for the imaging of lymphomas in the adult population. It provides unique information about the behaviour of malignant cells and contributes to more accurate staging of the illness and better assessment of response to therapy. The purpose of this study was to evaluate the usefulness of FDG PET in childhood lymphoma compared with conventional imaging methods (CIMs) and clinical data. Between July 1998 and August 2001, 42 FDG PET examinations were performed using a dedicated PET system (27 examinations) or a hybrid coincidence PET system (15 examinations) for initial tumour staging (n=7), restaging (n=5) or assessment of response to therapy or residual masses (n=30) in 27 children with Hodgkin's disease (HD) (n=20) or non-Hodgkin's lymphoma (NHL) (n=7). FDG PET results were compared with CIM findings and clinical data. Since 2000, a standardised questionnaire for evaluation of the clinical impact of FDG PET on both staging and therapy has been sent to the 16 referring physicians and 13 have replied. In all children, FDG PET was performed without any side-effects. FDG PET was found to be very sensitive (Se=12/12) for staging and restaging of the illness, showing more lesions than CIMs, with a 50% patient upstaging rate (6/12). It was very accurate for monitoring response to therapy and for characterisation of residual masses. False-positive results were observed in two NHL patients with thymic uptake and one false-negative result was obtained in a patient whose NHL relapsed 1 month after a negative FDG PET. The questionnaire emphasised the impact of FDG PET on clinical management, which was modified on the basis of the FDG PET results in 23% of patients. As previously demonstrated in the adult population, FDG PET appeared to be a very sensitive imaging technique for staging and restaging of lymphoma in children and was very useful for monitoring the response to

  3. Increased FDG bone marrow uptake after intracoronary progenitor cell therapy

    International Nuclear Information System (INIS)

    Patients with coronary artery disease who undergo FDG PET for therapy monitoring after intracoronary progenitor cell infusion (PCT) show an increased bone marrow uptake in some cases. Aim of the study was to evaluate the systemic bone marrow glucose metabolism in this patient group after PCT. Patients, methods: FDG bone marrow uptake (BMU), measured as standardized uptake value (SUVmax) in the thoracic spine, was retrospectively evaluated in 23 control patients who did not receive PCT and in 75 patients who received PCT 3±2.2 days before PET scanning. Five out of them were pretreated with granulocyte colony-stimulating factor (G-CSF) 5 days prior to PCT and 10±1.2 days before PET scanning. In 39 patients who received only PCT without G-CSF and underwent PET therapy monitoring 4 months later, baseline and follow up bone marrow uptake were measured. Leucocytes, C-reactive protein (CRP) levels and the influence of nicotine consumption were compared with the BMU. Results: In patients (n=70) who received PCT without G-CSF, BMU media (1.3) was slightly, but significantly higher than in the controls (1.0) (p=0.02) regardless nicotine consumption. BMU did not change significantly 4 months later (1.2) (p=0.41, n.s.). After G-CSF pretreatment, patients showed a significantly higher bone marrow uptake (3.7) compared to patients only treated with PCT (1.3) (p=0.023). Leucocyte blood levels were significantly higher in patients with a BMU ≥2.5 compared to patients with a bone marrow SUVmax<2.5 (p<0.001). CRP values did not correlate with the BMU (rho -0.02, p=0.38). Conclusion: Monitoring PCT patients, a slightly increased FDG BMU may be observed which remains unchanged for several months. Unspecific bone marrow reactions after PCT may be associated with increased leucocyte blood levels and play a role in the changed systemic glucose BMU. In addition, pretreatment with G-CSF shows an intense amplitifcation of BMU. (orig.)

  4. Increased FDG bone marrow uptake after intracoronary progenitor cell therapy

    Energy Technology Data Exchange (ETDEWEB)

    Doebert, N.; Menzel, C.; Diehl, M.; Hamscho, N.; Zaplatnikov, K.; Gruenwald, F. [Dept. of Nuclear Medicine, Univ. of Frankfurt (Germany)

    2005-02-01

    Patients with coronary artery disease who undergo FDG PET for therapy monitoring after intracoronary progenitor cell infusion (PCT) show an increased bone marrow uptake in some cases. Aim of the study was to evaluate the systemic bone marrow glucose metabolism in this patient group after PCT. Patients, methods: FDG bone marrow uptake (BMU), measured as standardized uptake value (SUVmax) in the thoracic spine, was retrospectively evaluated in 23 control patients who did not receive PCT and in 75 patients who received PCT 3{+-}2.2 days before PET scanning. Five out of them were pretreated with granulocyte colony-stimulating factor (G-CSF) 5 days prior to PCT and 10{+-}1.2 days before PET scanning. In 39 patients who received only PCT without G-CSF and underwent PET therapy monitoring 4 months later, baseline and follow up bone marrow uptake were measured. Leucocytes, C-reactive protein (CRP) levels and the influence of nicotine consumption were compared with the BMU. Results: In patients (n=70) who received PCT without G-CSF, BMU media (1.3) was slightly, but significantly higher than in the controls (1.0) (p=0.02) regardless nicotine consumption. BMU did not change significantly 4 months later (1.2) (p=0.41, n.s.). After G-CSF pretreatment, patients showed a significantly higher bone marrow uptake (3.7) compared to patients only treated with PCT (1.3) (p=0.023). Leucocyte blood levels were significantly higher in patients with a BMU {>=}2.5 compared to patients with a bone marrow SUVmax<2.5 (p<0.001). CRP values did not correlate with the BMU (rho -0.02, p=0.38). Conclusion: Monitoring PCT patients, a slightly increased FDG BMU may be observed which remains unchanged for several months. Unspecific bone marrow reactions after PCT may be associated with increased leucocyte blood levels and play a role in the changed systemic glucose BMU. In addition, pretreatment with G-CSF shows an intense amplitifcation of BMU. (orig.)

  5. Analysis of metabolism of 6FDG: a PET glucose transport tracer

    International Nuclear Information System (INIS)

    Introduction: We are developing 18F-labeled 6-fluoro-6-deoxy-D-glucose ([18F]6FDG) as a tracer of glucose transport. As part of this process it is important to characterize and quantify putative metabolites. In contrast to the ubiquitous positron emission tomography (PET) tracer 18F-labeled 2-fluoro-2-deoxy-D-glucose ([18F]2FDG) which is phosphorylated and trapped intracellularly, the substitution of fluorine for a hydroxyl group at carbon-6 in [18F]6FDG should prevent its phosphorylation. Consequently, [18F]6FDG has the potential to trace the transport step of glucose metabolism without the confounding effects of phosphorylation and subsequent steps of metabolism. Herein the focus is to determine whether, and the degree to which, [18F]6FDG remains unchanged following intravenous injection. Methods: Biodistribution studies were performed using 6FDG labeled with 18F or with the longer-lived radionuclides 3H and 14C. Tissues were harvested at 1, 6, and 24 h following intravenous administration and radioactivity was extracted from the tissues and analyzed using a combination of ion exchange columns, high-performance liquid chromatography, and chemical reactivity. Results: At the 1 h time-point, the vast majority of radioactivity in the liver, brain, heart, skeletal muscle, and blood was identified as 6FDG. At the 6-h and 24-h time points, there was evidence of a minor amount of radioactive material that appeared to be 6-fluoro-6-deoxy-D-sorbitol and possibly 6-fluoro-6-deoxy-D-gluconic acid. Conclusion: On the time scale typical of PET imaging studies radioactive metabolites of [18F]6FDG are negligible.

  6. FDG PET/CT and MR imaging of intramuscular myxoma in the gluteus maximus

    OpenAIRE

    Nishio Jun; Naito Masatoshi

    2012-01-01

    Abstract Intramuscular myxoma is a rare benign soft tissue tumor which may be mistaken for other benign and low-grade malignant myxoid neoplasms. We present the case of a 63-year-old woman with an asymptomatic intramuscular myxoma discovered incidentally on a whole-body F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography. PET images showed a mild FDG uptake (maximum standardized uptake value, 1.78) in the left gluteus maximus. Subsequent magnetic resonance (MR...

  7. FDG PET/CT imaging in the diagnosis of osteomyelitis in the diabetic foot

    International Nuclear Information System (INIS)

    Osteomyelitis, the most serious complication of the diabetic foot, occurs in about 20 % of patients. Early diagnosis is crucial. Appropriate treatment will avoid or decrease the likelihood of amputation. The objective of this study was to assess the value of FDG PET/CT in diabetic patients with clinically suspected osteomyelitis. Enrolled in this prospective study were 39 consecutive diabetic patients (29 men and 10 women, mean age 57 years, range 28-71 years) with 46 suspected sites of foot infection. Of these 39 patients, 38 had type 2 and 1 type 1 diabetes for 4-25 years, and 28 were receiving treatment with insulin. FDG PET/CT was interpreted for the presence, intensity (SUVmax) and localization of increased FDG foci. Final diagnosis was based on histopathology and bacteriology of surgical samples, or clinical and imaging follow-up. Osteomyelitis was correctly diagnosed in 18 and excluded in 21 sites. Of 20 lesions with focal bone FDG uptake, 2 were false-positive with no further evidence of osteomyelitis. Five sites of diffuse FDG uptake involving more than one bone on CT were correctly diagnosed as diabetic osteoarthropathy. FDG PET/CT had a sensitivity, specificity and accuracy of 100 %, 92 % and 95 % in a patient-based analysis and 100 %, 93 % and 96 % in a lesion-based analysis, respectively, for the diagnosis of osteomyelitis in the diabetic foot. FDG PET/CT was found to have high performance indices for evaluation of the diabetic foot. The PET component identified FDG-avid foci in sites of acute infection which were precisely localized on fused PET/CT images allowing correct differentiation between osteomyelitis and soft-tissue infection. (orig.)

  8. Correlation of primary tumor FDG uptake with histopathologic features of advanced gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hae Won; Won, Kyoung Sook; Song, Bong Il; Kang, Yu Na [Keimyung University Dongsan Medical Center, Daegu (Korea, Republic of)

    2015-06-15

    Histopathologic features could affect the FDG uptake of primary gastric cancer and detection rate on FDG PET/CT. The aim of this study was to evaluate the FDG uptake of primary gastric cancer by correlating it with the histopathologic features of the tumors. Fifty patients with locally advanced gastric adenocarcinoma who were referred for preoperative FDG-PET/CT scans were enrolled in this study. The detection rate of PET/CT and maximum standardized uptake values (SUV{sub max}) of the primary tumor were compared using the WHO, Lauren, Ming and Borrmann classifications and tumor size and location. In 45 of the 50 patients (90 %), the primary gastric tumors were detected by FDG PET/CT. On comparison using the WHO classification, the detection rate and SUV{sub max} of the tubular type were significantly higher than those of the poorly cohesive type. On comparison using the Lauren and Ming classifications, the SUV{sub maxs} of the intestinal type and expanding type were significantly higher than those of the diffuse and infiltrative type, respectively. On comparison using the Borrmann classification and tumor size and location, there was no significant difference in the detection rate and SUV{sub max} of primary gastric tumors. This study demonstrates that the poorly cohesive type according to the WHO classification, diffuse type according to the Lauren classification and infiltrative type according to the Ming classification have low FDG uptake in patients with locally advanced gastric carcinoma. Understanding the relationship between primary tumor FDG uptake and histopathologic features would be helpful in detecting the primary tumor by FDG PET/CT in patients with gastric cancer.

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

    OpenAIRE

    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...

  10. False Positive and False Negative FDG-PET Scans in Various Thoracic Diseases

    OpenAIRE

    Chang, Jung Min; Lee, Hyun Ju; Goo, Jin Mo; Lee, Ho-Young; Lee, Jong Jin; Chung, June-Key; Im, Jung-Gi

    2006-01-01

    Fluorodeoxyglucose (FDG)-positron emission tomography (PET) is being used more and more to differentiate benign from malignant focal lesions and it has been shown to be more efficacious than conventional chest computed tomography (CT). However, FDG is not a cancer-specific agent, and false positive findings in benign diseases have been reported. Infectious diseases (mycobacterial, fungal, bacterial infection), sarcoidosis, radiation pneumonitis and post-operative surgical conditions have show...

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

    OpenAIRE

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

    2010-01-01

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

  12. Advanced adenoma diagnosis with FDG PET in a visibly normal mucosa: a case report

    OpenAIRE

    Rehani Bhavya; Chasen Richard M; Dowdy Yvonne; Bharija Ankur; Satter Martin; Strohmeyer Pamela; Mantil Joseph

    2007-01-01

    Abstract Background An accurate, early diagnosis and treatment of adenomatous polyp can curtail progression to colorectal cancer. F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) reveals the biochemical changes associated with the development of many cancers which precede the appearance of gross anatomical changes that may be visualized during surgical resection or via imaging with MR or CT. Intervention We detail the history of a 64 year old female who had a whole-body FDG...

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

    International Nuclear Information System (INIS)

    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

  14. The impact of FDG-PET in the management of patients with salivary gland malignancy

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the impact of fluorodeoxyglucose (FDG)-PET in the management of patients with salivary gland malignancy. We performed 45 FDG PET studies in 31 patients with salivary malignant tumors, using PET (33 studies) and PET/CT (12 studies). Patients comprised 21 males and 10 females with a mean age of 69 y (range 38-89). Nineteen patients had a single study, ten patients had 2 and two patients had 3 studies. Twelve studies were performed for initial staging and 33 studies for restaging. Four patients of the initial staging group were restaged with PET after therapy. Histology consisted of 8 adenocarcinomas, 8 squamous cell carcinomas, 4 adenoid cystic carcinomas, 4 carcinoma ex pleomorphic adenomas, 2 mucoepidermoid carcinomas, 2 poorly differentiated carcinomas, 1 salivary duct carcinoma, 1 lymphoepithelial carcinoma and 1 melanoma. PET findings were reviewed with the clinical and radiologic findings and the impact of PET on staging and patient management was determined. In the initial staging group, all 12 primary lesions (100%) showed positive FDG uptake (5 squamous cell carcinomas, 2 adenocarcinomas, 2 poorly differentiated carcinomas, 1 carcinoma ex pleomorphic adenoma, 1 salivary duct carcinoma, 1 lymphoepithelial carcinoma). Three patients (25%) had FDG positive distant disease (liver, bone, lymph nodes); surgery was canceled and therapy changed to chemoradiation. One patient (9%) with no FDG uptake in the neck nodes avoided a planned neck dissection. In the restaging group (33 studies in 23 patients), 5 patients (22%) had FDG positive distant disease, which changed the treatment from surgery to chemoradiation or other. A second primary lesion was detected in one patient (4%). One patient (4%) with clinically suspected recurrence was able to avoid other invasive procedures because of the negative PET. Overall, FDG PET resulted in a major change in management in 11 of 31 patients (35%). This study shows that FDG PET has a

  15. The CT and F-FDG PET/CT appearance of Primary renal malignant fibrous histiocytoma

    International Nuclear Information System (INIS)

    Full text: Renal malignant fibrous histiocytoma (MFH) is a rare, primary renal tumour. Imaging findings of renal MFH, including ultrasound, CT and MRI, have, however, been reported. As to the best of our knowledge 18F-FDG PETjCT imaging of renal MFH has not been previously reported, we present the CT and 18F-FDG PETjCT appearance of a pathologically proven primary renal MFH.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  17. F.D.G. PET role in the management of refractory epilepsy

    International Nuclear Information System (INIS)

    The work-up of drug-resistant partial epilepsy is intended to localize epileptogenic foci in the purpose of a possible surgery. We aimed to assess the role of fluorodeoxyglucose Positron Emission Tomography (F.D.G. PET) in this scope. This study involved 34 patients who underwent brain F.D.G. PET, with a final diagnosis in 21. The value of F.D.G. PET for lateralization and localisation of the epileptogenic focus was evaluated by a blinded interpretation, and compared with the value of standard investigations. The impact of F.D.G. PET was assessed by the means of questions intended for the neurologist in each case. All the epilepsy types together, F.D.G. PET lateralized and localised the foci in 65 and 47% of the 34 subjects respectively. Among the 19 subjects with final diagnosis (patients with bilateral foci excluded), lateralization was correct in 84% and localisation in 63% (and the values were greater for temporal epilepsy than for extra temporal foci). PET frequently provided additional information compared with MRI, but not with EEG. F.D.G. PET was useful in 82.5% of cases (confirming management in 65% and changing it in 17.5% of the patients). Our experience corroborated the value of F.D.G. PET for lateralization and localisation of epileptogenic foci, and its role in case of normal MRI. However, F.D.G. PET appears as a confirmation tool rather than an examination resulting in a change in management rate. (authors)

  18. Imaging with non-FDG PET tracers: outlook for current clinical applications

    OpenAIRE

    Lopci, Egesta; Nanni, Cristina; Castellucci, Paolo; Montini, Gian Carlo; Allegri, Vincenzo; Rubello, Domenico; Chierichetti, Franca; Ambrosini, Valentina; Fanti, Stefano

    2010-01-01

    Apart from the historical and clinical relevance of positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG), various other new tracers are gaining a remarkable place in functional imaging. Their contribution to clinical decision-making is irreplaceable in several disciplines. In this brief review we aimed to describe the main non-FDG PET tracers based on their clinical relevance and application for patient care.

  19. Steam sterilization and automatic dispensing of [18F]fludeoxyglucose (FDG) for injection

    International Nuclear Information System (INIS)

    For the purpose of implementing steam sterilization of 2-[18F]FDG (FDG) in the final container into routine production, we have validated and established a fully automated dispensing and sterilization system, thereby considerably reducing the radiation burden to the personnel. Methods: The commercially available system combines aseptic dispensing of the product solution under a miniaturized laminar flow unit with subsequent steam sterilization, realized by heating of the product in the final containers by an autoclave included in the dispensing unit, thus incorporating current pharmaceutical manufacturing standards for the production of parental radiopharmaceuticals. The efficiency of the used sterilization cycle, the stability of FDG under the conditions of sterilization and the stability of the final product towards radiolysis was investigated with respect to various pH-formulations. Results: The system was found to be fully valid for filling of vials in a laminar flow class A (US-class 100) environment and for sterilization of FDG in the final container. The pH for sterilizing FDG solutions must be slightly acidic to avoid decomposition. A pH of 5.5 appears to be optimal and gives FDG of very high radiochemical purity (∼99%). In addition, radiolysis of FDG in solutions of high activity concentration was significantly lower at pH 5.5 than at neutral pH. Conclusion: Terminal sterilization enables the production of FDG in full compliance with GMP-regulations even in Class C or D (US class 10,000 or 100,000) laboratories

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  1. Analysis of metabolism of 6FDG: a PET glucose transport tracer

    Energy Technology Data Exchange (ETDEWEB)

    Muzic, Raymond F., E-mail: raymond.muzic@case.edu [Department of Radiology, Case Western Reserve University, Cleveland, OH 44106 (United States); Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106 (United States); Chandramouli, Visvanathan [Department of Radiology, Case Western Reserve University, Cleveland, OH 44106 (United States); Huang, Hsuan-Ming [Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106 (United States); Wu Chunying; Wang Yanming [Department of Radiology, Case Western Reserve University, Cleveland, OH 44106 (United States); Ismail-Beigi, Faramarz [Department of Medicine, Case Western Reserve University, Cleveland, OH 44106 (United States)

    2011-07-15

    Introduction: We are developing {sup 18}F-labeled 6-fluoro-6-deoxy-D-glucose ([{sup 18}F]6FDG) as a tracer of glucose transport. As part of this process it is important to characterize and quantify putative metabolites. In contrast to the ubiquitous positron emission tomography (PET) tracer {sup 18}F-labeled 2-fluoro-2-deoxy-D-glucose ([{sup 18}F]2FDG) which is phosphorylated and trapped intracellularly, the substitution of fluorine for a hydroxyl group at carbon-6 in [{sup 18}F]6FDG should prevent its phosphorylation. Consequently, [{sup 18}F]6FDG has the potential to trace the transport step of glucose metabolism without the confounding effects of phosphorylation and subsequent steps of metabolism. Herein the focus is to determine whether, and the degree to which, [{sup 18}F]6FDG remains unchanged following intravenous injection. Methods: Biodistribution studies were performed using 6FDG labeled with {sup 18}F or with the longer-lived radionuclides {sup 3}H and {sup 14}C. Tissues were harvested at 1, 6, and 24 h following intravenous administration and radioactivity was extracted from the tissues and analyzed using a combination of ion exchange columns, high-performance liquid chromatography, and chemical reactivity. Results: At the 1 h time-point, the vast majority of radioactivity in the liver, brain, heart, skeletal muscle, and blood was identified as 6FDG. At the 6-h and 24-h time points, there was evidence of a minor amount of radioactive material that appeared to be 6-fluoro-6-deoxy-D-sorbitol and possibly 6-fluoro-6-deoxy-D-gluconic acid. Conclusion: On the time scale typical of PET imaging studies radioactive metabolites of [{sup 18}F]6FDG are negligible.

  2. MRI and FDG-PET/CT imaging in gynecological malignancies: the radiation oncology perspective.

    Science.gov (United States)

    Fennell, Jamina; Scholber, Jutta; Grosu, Anca L; Volegova-Neher, Natalja; Henne, Karl; Langer, Mathias; Meyer, Philipp T; Gitsch, Gerald; Bartl, Nico

    2016-06-01

    MRI and FDG-PET imaging plays an important role in diagnosis, monitoring and follow-up of gynecological cancer. The goal of this paper was to summarize data of the literature about sensitivity and specificity of MRI and FDG-PET/CT for detection of primary tumor, lymph nodes invasion and metastases in cervix and endometrial cancer and to discuss their implication for radiation treatment planning and monitoring. PMID:26957003

  3. F18-FDG-PET for recurrent differentiated thyroid cancer: a systematic meta-analysis

    OpenAIRE

    Haslerud, Torjan Magne; Brauckhoff, Katrin; Reisæter, Lars Anders Rokne; Lein, Regina Küfner; Heinecke, A; Varhaug, Jan Erik; Biermann, Martin

    2015-01-01

    Background Positron emission tomography (PET) with fluor-18-deoxy-glucose (FDG) is widely used for diagnosing recurrent or metastatic disease in patients with differentiated thyroid cancer (DTC). Purpose To assess the diagnostic accuracy of FDG-PET for DTC in patients after ablative therapy. Material and Methods A systematic search was conducted in Medline/PubMed, EMBASE, Cochrane Library, Web of Science, and Open Grey looking for all English-language original articles on the performanc...

  4. Exogenous lipoid pneumonia with unusual CT pattern and FDG positron emission tomography scan findings

    International Nuclear Information System (INIS)

    We report a case of an exogenous lipoid pneumonia that appeared as a spiculated calcified mass on CT scan in which a positron emission tomography (PET) scan was performed before histological analysis. The F-18 fluoro-deoxy-D-glucose (FDG) PET showed a pattern highly suggestive of malignancy which, to our knowledge, has not yet been described. Similar to inflammatory and infectious lung diseases, lipoid pneumonia may be a false-positive case of F-18 FDG uptake. (orig.)

  5. Exogenous lipoid pneumonia with unusual CT pattern and FDG positron emission tomography scan findings

    Energy Technology Data Exchange (ETDEWEB)

    Tahon, Florence; Berthezene, Yves; Blineau, Nadine; Marchand, Bruno [Department of Radiology, Hopital de la Croix-Rousse, 103 grande rue de la Croix-Rousse, 69317 Lyon Cedex (France); Hominal, Stephane; Guerin, Jean-Claude [Department of Chest, Hopital de la Croix-Rousse, 103 grande rue de la Croix-Rousse, 69317 Lyon Cedex (France); Cinotti, Luc [CERMEP, 59 bd Pinel, 69003 Lyon Cedex (France)

    2002-07-01

    We report a case of an exogenous lipoid pneumonia that appeared as a spiculated calcified mass on CT scan in which a positron emission tomography (PET) scan was performed before histological analysis. The F-18 fluoro-deoxy-D-glucose (FDG) PET showed a pattern highly suggestive of malignancy which, to our knowledge, has not yet been described. Similar to inflammatory and infectious lung diseases, lipoid pneumonia may be a false-positive case of F-18 FDG uptake. (orig.)

  6. FDG PET/CT imaging in the diagnosis of osteomyelitis in the diabetic foot

    Energy Technology Data Exchange (ETDEWEB)

    Kagna, Olga; Keidar, Zohar [Rambam Health Care Campus, Department of Nuclear Medicine, POB 9602, Haifa (Israel); Srour, Saher; Militianu, Daniela [Rambam Health Care Campus, Department of Diagnostic Imaging, Haifa (Israel); Melamed, Eyal [Rambam Health Care Campus, Department of Orthopedics, Haifa (Israel)

    2012-10-15

    Osteomyelitis, the most serious complication of the diabetic foot, occurs in about 20 % of patients. Early diagnosis is crucial. Appropriate treatment will avoid or decrease the likelihood of amputation. The objective of this study was to assess the value of FDG PET/CT in diabetic patients with clinically suspected osteomyelitis. Enrolled in this prospective study were 39 consecutive diabetic patients (29 men and 10 women, mean age 57 years, range 28-71 years) with 46 suspected sites of foot infection. Of these 39 patients, 38 had type 2 and 1 type 1 diabetes for 4-25 years, and 28 were receiving treatment with insulin. FDG PET/CT was interpreted for the presence, intensity (SUVmax) and localization of increased FDG foci. Final diagnosis was based on histopathology and bacteriology of surgical samples, or clinical and imaging follow-up. Osteomyelitis was correctly diagnosed in 18 and excluded in 21 sites. Of 20 lesions with focal bone FDG uptake, 2 were false-positive with no further evidence of osteomyelitis. Five sites of diffuse FDG uptake involving more than one bone on CT were correctly diagnosed as diabetic osteoarthropathy. FDG PET/CT had a sensitivity, specificity and accuracy of 100 %, 92 % and 95 % in a patient-based analysis and 100 %, 93 % and 96 % in a lesion-based analysis, respectively, for the diagnosis of osteomyelitis in the diabetic foot. FDG PET/CT was found to have high performance indices for evaluation of the diabetic foot. The PET component identified FDG-avid foci in sites of acute infection which were precisely localized on fused PET/CT images allowing correct differentiation between osteomyelitis and soft-tissue infection. (orig.)

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

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

    Koziorowski, J

    2010-01-01

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

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

    DEFF Research Database (Denmark)

    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...

  10. Steam sterilization and automatic dispensing of [{sup 18}F]fludeoxyglucose (FDG) for injection

    Energy Technology Data Exchange (ETDEWEB)

    Karwath, Pascal [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany) and MC-Pharma GmbH (MCP), Bonn (Germany)]. E-mail: p.karwath@uni-bonn.de; Sartor, Johannes [MC-Pharma GmbH (MCP), Bonn (Germany); Gries, Wolfgang [MC-Pharma GmbH (MCP), Bonn (Germany); Wodarski, Christine [MC-Pharma GmbH (MCP), Bonn (Germany); Dittmar, Claus [MC-Pharma GmbH (MCP), Bonn (Germany); Biersack, Hans J. [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany); Guhlke, Stefan [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany) and MC-Pharma GmbH (MCP), Bonn (Germany)]. E-mail: stefan.guhlke@ukb.uni-bonn.de

    2005-04-01

    For the purpose of implementing steam sterilization of 2-[{sup 18}F]FDG (FDG) in the final container into routine production, we have validated and established a fully automated dispensing and sterilization system, thereby considerably reducing the radiation burden to the personnel. Methods: The commercially available system combines aseptic dispensing of the product solution under a miniaturized laminar flow unit with subsequent steam sterilization, realized by heating of the product in the final containers by an autoclave included in the dispensing unit, thus incorporating current pharmaceutical manufacturing standards for the production of parental radiopharmaceuticals. The efficiency of the used sterilization cycle, the stability of FDG under the conditions of sterilization and the stability of the final product towards radiolysis was investigated with respect to various pH-formulations. Results: The system was found to be fully valid for filling of vials in a laminar flow class A (US-class 100) environment and for sterilization of FDG in the final container. The pH for sterilizing FDG solutions must be slightly acidic to avoid decomposition. A pH of 5.5 appears to be optimal and gives FDG of very high radiochemical purity ({approx}99%). In addition, radiolysis of FDG in solutions of high activity concentration was significantly lower at pH 5.5 than at neutral pH. Conclusion: Terminal sterilization enables the production of FDG in full compliance with GMP-regulations even in Class C or D (US class 10,000 or 100,000) laboratories.

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-12-15

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

  13. Staging in childhood lymphoma. Differences between FDG-PET and CT

    International Nuclear Information System (INIS)

    Aim: The clinical value of positron emission tomography using fluorine-18 fluoro-deoxy-glucose (FDG-PET) in the staging of adult lymphoma has been shown in many studies. However, there are only few data regarding childhood lymphoma. The purpose of this retrospective study was to compare the staging of childhood lymphoma using FDG-PET and the established computed tomography (CT). Method: Whole-body FDG-PET was performed in 25 children with histologically proven Hodgkin's disease (n=18) and non-Hodgkin's lymphoma (n=7) using a dedicated PET. The findings were compared with the CT results. Both examinations, FDG-PET and CT, were assessed by two experienced physicians. In each patient, 30 regions were analysed (22 nodal, 8 extranodal). Each region was assessed using a five-value scale (definitely/probably positive, equivocal, probably/definitely negative). Results: 662 regions (470 nodal, 192 extranodal) were compared. 91 regions (81 nodal, 10 extranodal; 14%) were concordant positive and 517 regions (347 nodal, 170 extranodal; 78%) were concordant negative. In 47 regions, 48 discordant findings (7%) were described: 27 findings (22 nodal, 5 extranodal) were positive using FDG-PET and negative using CT whereas 21 findings (17 nodal, 4 extranodal) were positive using CT and negative using PET. A total of 7 regions (1%) were judged equivocal in one imaging modality (1 FDG/PET, 6 CT). Using FDG-PET as compared to CT, resulted in a higher staging in 4 of 25 patients and in a lower staging in 2 of 25 patients. Conclusion: Staging of childhood lymphoma using FDG-PET shows differences compared with CT resulting in a different staging in 6 of 25 patients. Prospective studies are required to evaluate the impact of these discrepancies on the clinical management of pediatric patients. (orig.)

  14. Staging in childhood lymphoma. Differences between FDG-PET and CT

    Energy Technology Data Exchange (ETDEWEB)

    Hermann, S.; Pixberg, M.; Schober, O.; Franzius, C. [Dept. of Nuclear Medicine, Univ. Hospital, Muenster (Germany); Wormanns, D.; Heindel, W. [Dept. of Clinical Radiology, Univ. Hospital, Muenster (Germany); Hunold, A.; Juergens, H. [Dept. of Pediatric Hematology/Oncology, Univ. Hospital, Muenster (Germany)

    2005-02-01

    Aim: The clinical value of positron emission tomography using fluorine-18 fluoro-deoxy-glucose (FDG-PET) in the staging of adult lymphoma has been shown in many studies. However, there are only few data regarding childhood lymphoma. The purpose of this retrospective study was to compare the staging of childhood lymphoma using FDG-PET and the established computed tomography (CT). Method: Whole-body FDG-PET was performed in 25 children with histologically proven Hodgkin's disease (n=18) and non-Hodgkin's lymphoma (n=7) using a dedicated PET. The findings were compared with the CT results. Both examinations, FDG-PET and CT, were assessed by two experienced physicians. In each patient, 30 regions were analysed (22 nodal, 8 extranodal). Each region was assessed using a five-value scale (definitely/probably positive, equivocal, probably/definitely negative). Results: 662 regions (470 nodal, 192 extranodal) were compared. 91 regions (81 nodal, 10 extranodal; 14%) were concordant positive and 517 regions (347 nodal, 170 extranodal; 78%) were concordant negative. In 47 regions, 48 discordant findings (7%) were described: 27 findings (22 nodal, 5 extranodal) were positive using FDG-PET and negative using CT whereas 21 findings (17 nodal, 4 extranodal) were positive using CT and negative using PET. A total of 7 regions (1%) were judged equivocal in one imaging modality (1 FDG/PET, 6 CT). Using FDG-PET as compared to CT, resulted in a higher staging in 4 of 25 patients and in a lower staging in 2 of 25 patients. Conclusion: Staging of childhood lymphoma using FDG-PET shows differences compared with CT resulting in a different staging in 6 of 25 patients. Prospective studies are required to evaluate the impact of these discrepancies on the clinical management of pediatric patients. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-02-01

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

  16. Deep venous thrombosis and pulmonary embolism detected by FDG PET/CT in a patient with bacteremia

    DEFF Research Database (Denmark)

    Nielsen, Anne Lerberg; Thomassen, Anders; Hess, Søren; Alavi, Abass; Høilund-Carlsen, Poul Flemming

    2013-01-01

    We report incidental FDG PET/CT findings of deep venous thrombosis and pulmonary embolism in a patient with bacteremia. In this patient, diagnosis of thromboembolism was not considered until FDG PET/CT imaging was performed, and the findings prompted immediate anticoagulant therapy. The role of F...... PET/CT in venous thromboembolism is not yet well established, but the potential benefit must be kept in mind when interpreting FDG PET/CT images regardless of the underlying disease.......We report incidental FDG PET/CT findings of deep venous thrombosis and pulmonary embolism in a patient with bacteremia. In this patient, diagnosis of thromboembolism was not considered until FDG PET/CT imaging was performed, and the findings prompted immediate anticoagulant therapy. The role of FDG...

  17. Multifoci Bone Tuberculosis and Lymphadenitis in Mediastinum Mimics Malignancy on FDG-PET/CT: A Case Report

    Directory of Open Access Journals (Sweden)

    Nalan Alan Selçuk

    2014-02-01

    Full Text Available Positron Emission Tomography with 2-deoxy-[F-18]-fluoro-D-glucose (FDG-PET has become a reliable diagnostic tool in clinical practice similar to Magnetic Resonance (MR imaging and Computed Tomography (CT. FDG-PET has especially been used to differentiate malignant from benign lesions, and for staging and follow- up malignant tumors. However, FDG-PET has some pitfalls in cancer screening and FDG tracer accumulates at sites of infection and inflammation. Bone tuberculosis may be confused with malignant tumors of bone and its metastases, and can accumulate focally increased FDG in active period. We present a 60-year-old woman with lytic bone lesions and mediastinal hypermetabolic foci, initially suspected to be malignant by means of FDG-PET and the other imaging modalities; however, bone biopsy confirmed the diagnosis of bone tuberculosis

  18. FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphoma

    DEFF Research Database (Denmark)

    Hutchings, Martin; Loft, Annika; Hansen, Mads;

    2005-01-01

    Risk-adapted lymphoma treatment requires early and accurate assessment of prognosis. This investigation prospectively assessed the value of positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose (FDG-PET) after two cycles of chemotherapy for prediction of progression-free survival (PFS......) and overall survival (OS) in Hodgkin lymphoma (HL). Seventy-seven consecutive, newly diagnosed patients underwent FDG-PET at staging, after two and four cycles of chemotherapy, and after completion of chemotherapy. Median follow-up was 23 months. After two cycles of chemotherapy, 61 patients had...... negative FDG-PET scans and 16 patients had positive scans. Eleven of 16 FDG-PET-positive patients progressed and 2 died. Three of 61 FDG-PET-negative patients progressed; all were alive at latest follow-up. Survival analyses showed strong associations between early FDG-PET after two cycles and PFS (P...

  19. Use of lasilix to explore pelvis pathologies in F.D.G. PET; Utilisation du lasilix pour l'exploration des pathologies pelviennes en TEP au FDG

    Energy Technology Data Exchange (ETDEWEB)

    Bruna-Muraille, C.; Papathanassiou, D.; Cuif-Job, A.; Moussa-Bouharati, K.; Guedec-Ghelfi, R.; Liehn, J.C. [Institut Jean-Godinot, 51 - Reims (France)

    2010-07-01

    Purpose: F.D.G. accumulations in ureters and bladder can be annoying to interpret PET examinations in case of pelvis pathology, especially for uterine cervix tumors and for some ganglions localizations. The aim of this study was to confirm that the injection of furosemide before F.D.G. scintigraphy leads to a noticed concentration reduction of the tracer in urine, what can allow a better analysis of pelvis pathology and to evaluate the possibility of using this technique in practice. Conclusions: the Lasilix injection before a PET with F.D.G. in patients suffering of a pelvis pathology allows a noticed reduction of urine intensity, making easier the interpretation for a number of pelvic disorders. however, on 26 studied patients, 3 presented urged incontinence during examination, that poses a limitation of the technique and requires the selection, when a prior medical examination, of patients susceptible to receive this protocol. (N.C.)

  20. Evaluation of malignant solid tumor in childhood with FDG-PET

    International Nuclear Information System (INIS)

    Usefulness of FDG-PET (18F-deoxyglucose PET) was examined in evaluation of diagnosis and therapeutic efficacy of childhood malignant solid tumors. Subjects were 32 patients (16 males) of the median age of 7 y (1 - 27 y), involving those with neuroblastoma (9 cases), hepatoblastoma (4), chronic granulomatous disorder (4) and others (each ≤2). They underwent 75 FDG-PET examinations for diagnosis before and during treatment in authors' hospital in the period from May 2001 to December 2003. Standard uptake value (SUV), 1 x 1 cm region of interest (ROI) of abnormally high distribution area of radioactivity in the lesion/FDG dose/kg body wt., was used for evaluation: SUV>1.5 was defined positive. In neuroblastoma, FDG was found to be highly distributed and kinetics of SUV, to be useful for evaluation of therapeutic efficacy and early metastasis detection. In some cases of hepatoblastoma, the therapeutic effectiveness and recurrence were not satisfactorily evaluative. The distribution of FDG was not satisfactory in Wilms' tumor relative to other tumors. The PET was thought to be useful, despite their small case number examined, for those evaluations of Ewing's tumor, dysgerminoma and Langerhans cell histiocytosis. Thus FDG-PET was found useful for detection, evaluation of therapeutic efficacy and early metastasis detection of pediatric malignant solid tumors. (T.I.)

  1. F-18-FDG positron emission tomography findings correlate pathological proliferative activity of oral squamous cell carcinoma

    International Nuclear Information System (INIS)

    It is still controversial whether fluorodeoxyglucose (FDG) uptake is correlated with cellular proliferation and prognosis of oral squamous cell carcinoma (OSC). In this study, we performed positron emission tomography (PET) study and immunohistochemical analysis to elucidate the relationship between FDG uptake and expression of cellular proliferative markers and pathological prognostic markers in patients with OSC. FDG PET and immunohistochemical staining have been carried out in sixteen patients with OSC. Tumor uptake of FDG was expressed with standardized uptake value (SUV). The expression of Ki-67, Topoisomerase IIα (Topo IIα), p53, and p63 in cancer cells was quantitatively assessed with positivity of the immunohistochemical staining. SUV was compared with the results of immunohistochemical analysis. FDG PET study revealed that SUV ranged from 3.6 to 22.1 with average of 10.4. Average positive rate of Ki-67, Topo IIα, p53, and p63 was 68.9%, 58.9%, 72.0%, and 65.2%, respectively. Pearson product-moment correlation coefficient analysis revealed that SUV was significantly correlated with Ki-67 (r=0.616, p=0.01), Topo IIα (r=0.677, p=0.004), p53 (r=0.613, p=0.01), and p63 (r=0.710, p=0.002), respectively. The present preliminary study indicated that FDG uptake was closely correlated with pathological cellular proliferative and prognostic markers in patients with OSC. (author)

  2. Distinguishing benign from malignant gallbladder wall thickening using FDG-PET

    International Nuclear Information System (INIS)

    Because thickening of the gallbladder wall is observed not only in patients with gallbladder cancer but also in those with benign diseases such as chronic cholecystitis and gallbladder adenomyosis, it is difficult to distinguish between benign and malignant gallbladder wall thickening by conventional techniques of diagnostic imaging such as computed tomography (CT), magnetic resonance imaging (MRI), and abdominal ultrasonography (US). In the present study, we attempted to distinguish between benign and malignant gallbladder wall thickening by means of fluorine-18-fluorodeoxyglucose (FDG)-Positron emission tomography (PET). FDG-PET was performed in 12 patients with gallbladder wall thickening detected by CT or US, to determine whether it was benign or malignant. Emission scans were taken, beginning 45 minutes after intravenous administration of FDG, and standardized uptake value (SUV) was calculated as an indicator of glucose metabolism. Of the 12 patients, 4 showed positive uptake of FDG in the gallbladder wall. Of these 4 patients, 3 had gallbladder cancer. The remaining one, who had chronic cholecystitis, had false-positive findings. The other 8 patients had negative uptake of FDG in the gallbladder wall. Two of these 8 underwent surgical resection, which yielded a diagnosis of chronic cholecystitis. The other 6 patients exhibited no sign of gallbladder malignancy and have been followed without active treatment. FDG-PET appears able to distinguish between benign and malignant gallbladder wall thickening. (author)

  3. Hexokinase-II expression in untreated oral squamous cell carcinoma. Comparison with FDG PET imaging

    International Nuclear Information System (INIS)

    Hexokinase is thought to be one of the key factors of glucose catabolism in the cell. The aim of this study was to investigate the relationship between hexokinase-II (HK-II) expression and 18F-fluoro-2-deoxy-D-glucose (FDG) uptake in human untreated oral squamous cell carcinoma (OSCC). Pre-operatively FDG positron emission tomography (PET) was performed 60 min after FDG injection in all the patients. Maximum standardized uptake value (SUV) was used for evaluation of tumor PDG uptake. Tumor sections were stained immunohistochemically for HK-II. All the tumor sections stained positive for HK-II. Eighteen (95%) tumors in HK-II showed immunostained positive area≥50%. HK-II findings revealed eleven (58%) tumors with strong intensity, six (32%) with moderate intensity and two with weak intensity (10%). There was no statistically significant correlation between SUV and the expression of HK-II (p=0.46). In conclusion, OSCC showed increased FDG accumulation and overexpression of HK-II. However, we did not find any significant relationship between high FDG uptake and overexpression of HK-II in this patient population, and thus other properties need to be evaluated in order to elucidate key factors responsible for FDG activity in OSCC. (author)

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    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

  8. FDG-PET/CT response evaluation during EGFR-TKI treatment in patients with NSCLC

    Institute of Scientific and Technical Information of China (English)

    Matthijs; H; van; Gool; Tjeerd; S; Aukema; Koen; J; Hartemink; Renato; A; Valdés; Olmos; Houke; M; Klomp; Harm; van; Tinteren

    2014-01-01

    Over recent years,[18F]-fluorodeoxyglucose positron emission tomography acquired together with low dose computed tomography(FDG-PET/CT)has proven its role as a staging modality in patients with non-small cell lung cancer(NSCLC).The purpose of this review was to present the evidence to use FDG-PET/CT for response evaluation in patients with NSCLC,treated with epidermal growth factor receptor(EGFR)-tyrosine kinase inhibitors(TKI).All published articles from 1November 2003 to 1 November 2013 reporting on 18FFDG-PET response evaluation during EGFR-TKI treatment in patients with NSCLC were collected.In total 7studies,including data of 210 patients were eligible for analyses.Our report shows that FDG-PET/CT responseduring EGFR-TKI therapy has potential in targeted treatment for NSCLC.FDG-PET/CT response is associated with clinical and radiologic response and with survival.Furthermore FDG-PET/CT response monitoring can be performed as early as 1-2 wk after initiation of EGFR-TKI treatment.Patients with substantial decrease of metabolic activity during EGFR-TKI treatment will probably benefit from continued treatment.If metabolic response does not occur within the first weeks of EGFR-TKI treatment,patients may be spared(further)unnecessary toxicity of ineffective treatment.Refining FDG-PET response criteria may help the clinician to decide on continuation or discontinuation of targeted treatment.

  9. Clinical role of early dynamic FDG-PET/CT for the evaluation of renal cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Reiko; Abe, Koichiro; Sakai, Shuji [Tokyo Women' s Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo (Japan); Kondo, Tsunenori; Tanabe, Kazunari [Tokyo Women' s Medical University, Department of Urology, Tokyo (Japan)

    2016-06-15

    We studied the usefulness of early dynamic (ED) and whole-body (WB) FDG-PET/CT for the evaluation of renal cell carcinoma (RCC). One hundred patients with 107 tumours underwent kidney ED and WB FDG-PET/CT. We visually and semiquantitatively evaluated the FDG accumulation in RCCs in the ED and WB phases, and compared the accumulation values with regard to histological type (clear cell carcinoma [CCC] vs. non-clear cell carcinoma [N-CCC]), the TNM stage (high stage [3-4] vs. low stage [1-2]), the Fuhrman grade (high grade [3-4] vs. low grade [1-2]) and presence versus absence of venous (V) and lymphatic (Ly) invasion. In the ED phase, visual evaluation revealed no significant differences in FDG accumulation in terms of each item. However, the maximum standardized uptake value and tumour-to-normal tissue ratios were significantly higher in the CCCs compared to the N-CCCs (p < 0.001). In the WB phase, in contrast, significantly higher FDG accumulation (p < 0.001) was found in RCCs with a higher TNM stage, higher Furman grade, and the presence of V and Ly invasion in both the visual and the semiquantitative evaluations. ED and WB FDG-PET/CT is a useful tool for the evaluation of RCCs. (orig.)

  10. Detection of lymphomatous marrow infiltration using F-18 FDG PET at initial staging and after chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Mi Jin; Kim, Young Jin; Moon, Jin Wook; Park, Sang Joon; Lee, Jong Doo [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2003-06-01

    To assess the ability of FDG PET for the detection of bone marrow infiltration compared to iliac crest biopsy in patients with lymphoma. Seventy-three patients (30 females and 43 males, mean age 47 years old) with malignant lymphoma (4 Hodgkin's disease, HD and 69 non-Hodgkin's lymphoma, NHL) were included. FDG PET was performed for staging in 53 patients and to assess treatment response after the completion of chemotherapy in 20 patients. Final conclusions were based on biopsy, other imaging studies, or clinical follow-up. There were 54 (74%) of the 73 patients in whom FDG PET and iliac crest biopsy were concordant. Forty-seven of the 54 patients showed concordant negative results while the remaining 7 patients had concordant positive results. Of 19 patients with discordant results, FDG PET accurately detected bone marrow infiltration in 6 patients with negative iliac crest biopsy. On the contrary, iliac biopsy identified bone marrow infiltration in 6 patients with negative iliac crest biopsy was true negative but FDG PET was falsely positive. FDG PET seems to be an adjunct in detecting marrow infiltration that may not be revealed by iliac crest biopsy at staging. For the assessment of treatment response, it may be less helpful than biopsy in detecting microscopic residual disease in the bone marrow.

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  13. FDG uptake as a factor for recurrence of non-small cell lung cancer

    International Nuclear Information System (INIS)

    The purpose of this study is to examine the prognostic significance for recurrence of FDG uptake in comparison with different biomarkers (DNA ploidy pattern, Proliferating cell nuclear antigen labeling index (PCNA-LI), pathologic differentiation and histologic type) in patients with non-small cell lung cancer (NSCLC). We analyzed the follow-up findings of 57 surgically resected NSCLC patients. Before surgery, FDG PET was performed 40 min after injection. Tumor FDG uptake was quantitated with the standardized uptake value (SUV). Tumor FDG uptake (SUV), ploidy estimated by DNA flow cytometry, PCNA-LI determined by immunohistochemistry, pathologic stage, pathologic differentiation and historogic type were analyzed for any possible association with disease-free survival. Treatment was complete resection in all 57 cases. In a univariate analysis SUV greater than 5 (p<0.0001), pathologic stage (p<0.0001) and pathologic differentiation were correlated with disease-free survival, whereas ploidy and PCNA-LI were not correlated. A multivariate Cox analysis identified SUV as most important for the disease-free survival (0.042). Patients with pathologic stage I had an expected 5-year disease-free survival of 88%, if the SUV was below 5, and 17%, if above 5. We conclude that the FDG uptake in primary NSCLC PET is of important post-operative prognostic value for recurrence, especially in patients with pathologic stage I NSCLC. FDG uptake could supplant other well-known biomarkers in determining individual patients' treatments. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-05-15

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

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

    International Nuclear Information System (INIS)

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

  16. F-18 FDG PET-CT in patients with recurrent glioma: Comparison with contrast enhanced MRI

    International Nuclear Information System (INIS)

    Abstarct: Purpose: The purpose of the study was to compare the efficacies of FDG PET-CT and contrast enhanced MRI in detection of recurrent gliomas. Methods: Ninety histopathologically proven glioma patients with clinical suspicion of recurrence were evaluated. All patients underwent FDG PET-CT scan and contrast enhanced MRI. Combination of clinical follow up, repeat imaging and biopsy (when available) was taken as gold standard. Results: Based on gold standard criteria, 59 patients were positive and 31 patients were negative for recurrence. Overall sensitivity and specificity of FDG PET-CT were 70% and 97% respectively whereas that for contrast enhanced MRI was 95% and 23%. FDG PET-CT also has higher accuracy (80%) as compared to MRI (70%). FGD PET-CT has lower sensitivity than MRI in all grades, except for Grade II gliomas where their sensitivities are comparable (95% and 90%). Very low specificity of MRI was observed in all grades of tumour (18–33%). In contrast the specificity of FDG PET-CT was high across all grades (83–100%). Conclusion: FDG PET-CT is a highly specific modality for detecting recurrence in patients with gliomas and can effectively exclude post therapy changes.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  18. Clinical Application of 18F-FDG PET in Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    Hepatocellular carcinoma is the most common primary tumor in the liver. FDG PET has been applied for staging and treatment planning of hepatocellular carcinoma. It could reflect tumor prognosis because glucose metabolism assessed by FDG PET is known to have correlations with the differentiation and aggressiveness of the tumor. Although the ability of FDG PET to detect well-differentiated or low grade tumors and intra-hepatic lesions is not good, it is expected to play a major role in pre-surgical assessments for liver transplantation because it is useful in detecting extra-hepatic lesions and unexpected distant metastases with a better diagnostic performance than other conventional imaging modalities. Additionally, FDG PET has an advantage to screen other cancers through whole body scanning. As a new tracer for PET, Acetate demonstrates higher sensitivity and specificity to FDG in evaluating hepatocellular carcinoma. It thus seems that simultaneous use of Acetate PET with FDG PET could be helpful in diagnosis, especially detecting extra-hepatic metastases

  19. Comparison of FDG-PET and IMP-SPECT in patients with dementia with Lewy bodies

    International Nuclear Information System (INIS)

    To investigate regional differences in cerebral glucose metabolism and blood flow of dementia with Lewy bodies (DLB), we studied 7 subjects with DLB and 20 normal controls using F-18 fluorodeoxyglucose (FDG) and positron emission tomography (PET) and then examined the same 7 subjects and 20 other normal controls with I-123 iodoamphetamine (IMP) and single photon emission computed tomography (SPECT). The anatomically standardized images were produced with NEUROSTAT and the regional relative metabolic and perfusional values were calculated. The mean reduction ratios of FDG uptake in the DLB group relative to the mean normal controls in the parietal lobe and occipital lobe were 0.72 and 0.83, respectively, while the corresponding mean reduction ratios of IMP uptake were 0.81 and 0.88, respectively. In the DLB group, parietal FDG uptake was significantly lower than parietal IMP uptake (p<0.05), occipital FDG uptake was significantly lower than occipital IMP uptake (p<0.05), and parietal IMP uptake was significantly lower than occipital IMP uptake (p<0.01), but there was no difference between parietal and occipital FDG uptake. Our findings suggest that parietal metabolism and perfusion are severely affected in DLB patients, though the occipital metabolic and perfusional reduction is thought to be a feature of DLB. FDG-PET is thought to be superior to IMP-SPECT in detecting functional changes in the DLB brain. (author)

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

    International Nuclear Information System (INIS)

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

  1. Current role of FDG PET/CT in lymphoma

    International Nuclear Information System (INIS)

    The management approach in Hodgkin's (HL) and high-grade non-Hodgkin's lymphomas (NHL) has shifted towards reducing the toxicity and long-term adverse effects associated with treatment while maintaining favorable outcomes in low-risk patients. The success of an individualized treatment strategy depends largely on accurate diagnostic tests both at staging and during therapy. In this regard, positron emission tomography (PET) using fluorodeoxyglucose (FDG) with computed tomography (CT) has proved effective as a metabolic imaging tool with compelling evidence supporting its superiority over conventional modalities, particularly in staging and early evaluation of response. Eventually, this modality was integrated into the routine staging and restaging algorithm of lymphomas. This review will summarize the data on the proven and potential utility of PET/CT imaging for staging, response assessment, and restaging, describing current limitations of this imaging modality. (orig.)

  2. Current role of FDG PET/CT in lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Kostakoglu, Lale [Icahn School of Medicine at Mount Sinai, Department of Radiology, One Gustave Levy Place, Box 1141, New York, NY (United States); Cheson, Bruce D. [Georgetown University Hospital, Division of Hematology-Oncology, Lombardi Comprehensive Cancer Center, Washington, DC (United States)

    2014-05-15

    The management approach in Hodgkin's (HL) and high-grade non-Hodgkin's lymphomas (NHL) has shifted towards reducing the toxicity and long-term adverse effects associated with treatment while maintaining favorable outcomes in low-risk patients. The success of an individualized treatment strategy depends largely on accurate diagnostic tests both at staging and during therapy. In this regard, positron emission tomography (PET) using fluorodeoxyglucose (FDG) with computed tomography (CT) has proved effective as a metabolic imaging tool with compelling evidence supporting its superiority over conventional modalities, particularly in staging and early evaluation of response. Eventually, this modality was integrated into the routine staging and restaging algorithm of lymphomas. This review will summarize the data on the proven and potential utility of PET/CT imaging for staging, response assessment, and restaging, describing current limitations of this imaging modality. (orig.)

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

    DEFF Research Database (Denmark)

    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...

  4. FDG PET-CT Finding in Bilateral Renal and Bone Involvement of Diffuse Large B-Cell Lymphoma

    OpenAIRE

    Yusuf Ziya Tan; Sabire Yılmaz; Meftune Özhan

    2014-01-01

    Thirty-six year old male patient with pathological fracture of the left tibia underwent intramedullary and soft tissue curettage. The histopathological examination revealed diffuse large B cell lymphoma. The patient underwent F18-FDG PET-CT scanning for initial staging. FDG PET-CT scan revealed hypermetabolic lesions at the left tibia and in bilateral kidneys. After the systemic chemotherapy and local radiotherapy to the tibia, repeated FDG PET/CT scan showed improvement of the previous hyper...

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

    International Nuclear Information System (INIS)

    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

  6. Arterial and fat tissue inflammation are highly correlated: a prospective {sup 18}F-FDG PET/CT study

    Energy Technology Data Exchange (ETDEWEB)

    Bucerius, Jan [Mount Sinai School of Medicine, Translational and Molecular Imaging Institute, One Gustave L. Levy Place, P. O. Box 1234, New York, NY (United States); Mount Sinai School of Medicine, Department of Radiology, New York, NY (United States); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); Maastricht University Medical Center, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); University Hospital RWTH Aachen, Department of Nuclear Medicine, Aachen (Germany); Mani, Venkatesh; Fayad, Zahi A. [Mount Sinai School of Medicine, Translational and Molecular Imaging Institute, One Gustave L. Levy Place, P. O. Box 1234, New York, NY (United States); Mount Sinai School of Medicine, Department of Radiology, New York, NY (United States); Mount Sinai School of Medicine, Department of Cardiology, Zena and Michael A. Weiner Cardiovascular Institute and Marie-Josee and Henry R. Kravis Cardiovascular Health Center, New York, NY (United States); Wong, Stephanie; Moncrieff, Colin; Izquierdo-Garcia, David [Mount Sinai School of Medicine, Translational and Molecular Imaging Institute, One Gustave L. Levy Place, P. O. Box 1234, New York, NY (United States); Mount Sinai School of Medicine, Department of Radiology, New York, NY (United States); Machac, Josef [Mount Sinai School of Medicine, Division of Nuclear Medicine, Department of Radiology, New York, NY (United States); Fuster, Valentin [Mount Sinai School of Medicine, Department of Cardiology, Zena and Michael A. Weiner Cardiovascular Institute and Marie-Josee and Henry R. Kravis Cardiovascular Health Center, New York, NY (United States); The Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid (Spain); Farkouh, Michael E. [Mount Sinai School of Medicine, Department of Cardiology, Zena and Michael A. Weiner Cardiovascular Institute and Marie-Josee and Henry R. Kravis Cardiovascular Health Center, New York, NY (United States); Mount Sinai School of Medicine, Cardiovascular Imaging Clinical Trials Unit, New York, NY (United States); Rudd, James H.F. [University of Cambridge, Division of Cardiovascular Medicine, Cambridge (United Kingdom)

    2014-05-15

    There is evidence that the link between obesity and cardiovascular disease might relate to inflammation in both fat tissue and the arterial wall. {sup 18}F-FDG uptake on PET is a surrogate marker of vessel wall inflammation. The aim of the study was to measure FDG uptake in both regions using PET and identify links between adipose and arterial inflammation. Included in the study were 173 cardiovascular patients who were prospectively imaged with FDG PET/CT. Arterial FDG uptake was measured in the carotid arteries and ascending aorta. The same was done in fat tissue in the neck, the presternal region (both subcutaneous) and the pericardium. FDG uptake was quantified as average maximal target-to-background ratio ({sub mean}TBR{sub max}). Multivariate regression analyses were performed to identify significant associations between arterial and adipose tissue FDG uptake and clinical variables as given by the standardized correlation coefficient (β). FDG uptake values in all fat tissue regions were highly predictive of vascular FDG uptake in both the carotids (β 0.262, p < 0.0001, in the neck subcutaneous region) and aorta (β 0.22, p = 0.008, in the chest pericardial region; β 0.193, p = 0.019, in the chest subcutaneous region). Obesity was significantly associated with elevated FDG uptake in adipose tissue (β 0.470, p < 0.0001, in the neck subcutaneous region; β 0.619, p = 0.028, in the chest subcutaneous region; β 0.978, p = 0.035, in the chest pericardial region). FDG uptake in diverse fat tissue regions was significantly associated with arterial FDG uptake, a reasonable surrogate of inflammation. Increasing body weight significantly predicted the level of fatty inflammation. FDG PET therefore provides imaging evidence of an inflammatory link between fat tissue and the vasculature in patients with cardiovascular disease. (orig.)

  7. Arterial and Fat Tissue Inflammation are Highly Correlated - A Prospective 18F-FDG PET/CT Study

    Science.gov (United States)

    Bucerius, Jan; Mani, Venkatesh; Wong, Stephanie; Moncrieff, Colin; Izquierdo-Garcia, David; Machac, Josef; Fuster, Valentin; Farkouh, Michael E.; Rudd, James H. F.; Fayad, Zahi A.

    2014-01-01

    Purpose There is evidence that the link between obesity and cardiovascular disease might relate to inflammation in both fat tissue and the arterial wall. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) uptake is a surrogate marker of vessel wall inflammation. The aim of the study was to measure FDG uptake in both regions using PET and identify links between adipose and arterial inflammation. Methods 173 cardiovascular patients were prospectively imaged with FDG-PET/CT. Arterial FDG uptake was measured in the carotid arteries and ascending aorta. The same was done in fat tissue in the neck, the pre-sternal region (all subcutaneous) and the pericardium. FDG uptake wasquantified as average maximal target-to-background ratio (meanTBRmax).Multivariate regression analyses were performed to identify significant associations between arterial and adipose tissue FDG uptake and clinical variables as given by the standardized correlation coefficient (β). Results FDG uptake values within all fat tissue regions were highly predictive of vascular FDG uptake in both the carotids (neck subcutaneous: β:0.262, p<0.0001) and aorta (chest pericardial: β:0.220, p=0.008 and chest subcutaneous: β:0.193, p=0.019). Obesity was significantly associated with elevated FDG uptake in adipose tissue (neck subcutaneous: β:0.470, p<0.0001; chest subcutaneous: β:0.619, p=0.028; chest pericardial: β:0.978, p=0.035). Conclusion FDG uptake in diverse fat tissue regions was significantly associated with arterial FDG uptake, a reasonable surrogate of inflammation. Increasing body weight significantly predicted the level of fatty inflammation. FDG-PET therefore provides imaging evidence for an inflammatory link between fat tissue and the vasculature in patients with cardiovascular disease. PMID:24442596

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  9. Comparison of Tl SPECT and FDG PET in the diagnosis of lymph node metastases from lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Higashi, Kohtaro; Ueda, Yoshimichi; Yagishita, Masami [Kanazawa Medical Univ., Uchinada, Ishikawa (Japan)] [and others

    1999-01-01

    This study compared FDG PET with Tl SPECT in the diagnosis of lymph node metastases from lung cancer. FDG PET and Tl SPECT were performed in the 42 patients with lung cancer. All patients had thoracotomy. FDG PET detected mediastinal lymph node metastasis that was negative on Tl SPECT, whereas both techniques excluded tumor involvement in enlarged node at CT. However, both techniques may show false-negative results for microscopic metastases in normal-sized lymph node. (author)

  10. Arterial and fat tissue inflammation are highly correlated: a prospective 18F-FDG PET/CT study

    International Nuclear Information System (INIS)

    There is evidence that the link between obesity and cardiovascular disease might relate to inflammation in both fat tissue and the arterial wall. 18F-FDG uptake on PET is a surrogate marker of vessel wall inflammation. The aim of the study was to measure FDG uptake in both regions using PET and identify links between adipose and arterial inflammation. Included in the study were 173 cardiovascular patients who were prospectively imaged with FDG PET/CT. Arterial FDG uptake was measured in the carotid arteries and ascending aorta. The same was done in fat tissue in the neck, the presternal region (both subcutaneous) and the pericardium. FDG uptake was quantified as average maximal target-to-background ratio (meanTBRmax). Multivariate regression analyses were performed to identify significant associations between arterial and adipose tissue FDG uptake and clinical variables as given by the standardized correlation coefficient (β). FDG uptake values in all fat tissue regions were highly predictive of vascular FDG uptake in both the carotids (β 0.262, p < 0.0001, in the neck subcutaneous region) and aorta (β 0.22, p = 0.008, in the chest pericardial region; β 0.193, p = 0.019, in the chest subcutaneous region). Obesity was significantly associated with elevated FDG uptake in adipose tissue (β 0.470, p < 0.0001, in the neck subcutaneous region; β 0.619, p = 0.028, in the chest subcutaneous region; β 0.978, p = 0.035, in the chest pericardial region). FDG uptake in diverse fat tissue regions was significantly associated with arterial FDG uptake, a reasonable surrogate of inflammation. Increasing body weight significantly predicted the level of fatty inflammation. FDG PET therefore provides imaging evidence of an inflammatory link between fat tissue and the vasculature in patients with cardiovascular disease. (orig.)

  11. Correlation of 18F-FDG Avid Volumes on Pre–Radiation Therapy and Post–Radiation Therapy FDG PET Scans in Recurrent Lung Cancer

    International Nuclear Information System (INIS)

    Purpose: To investigate the spatial correlation between high uptake regions of 2-deoxy-2-[18F]-fluoro-D-glucose positron emission tomography (18F-FDG PET) before and after therapy in recurrent lung cancer. Methods and Materials: We enrolled 106 patients with inoperable lung cancer into a prospective study whose primary objectives were to determine first, the earliest time point when the maximum decrease in FDG uptake representing the maximum metabolic response (MMR) is attainable and second, the optimum cutoff value of MMR based on its predicted tumor control probability, sensitivity, and specificity. Of those patients, 61 completed the required 4 serial 18F-FDG PET examinations after therapy. Nineteen of 61 patients experienced local recurrence at the primary tumor and underwent analysis. The volumes of interest (VOI) on pretherapy FDG-PET were defined by use of an isocontour at ≥50% of maximum standard uptake value (SUVmax) (≥50% of SUVmax) with correction for heterogeneity. The VOI on posttherapy images were defined at ≥80% of SUVmax. The VOI of pretherapy and posttherapy 18F-FDG PET images were correlated for the extent of overlap. Results: The size of VOI at pretherapy images was on average 25.7% (range, 8.8%-56.3%) of the pretherapy primary gross tumor volume (GTV), and their overlap fractions were 0.8 (95% confidence interval [CI]: 0.7-0.9), 0.63 (95% CI: 0.49-0.77), and 0.38 (95% CI: 0.19-0.57) of VOI of posttherapy FDG PET images at 10 days, 3 months, and 6 months, respectively. The residual uptake originated from the pretherapy VOI in 15 of 17 cases. Conclusions: VOI defined by the SUVmax-≥50% isocontour may be a biological target volume for escalated radiation dose

  12. Correlation of {sup 18}F-FDG Avid Volumes on Pre–Radiation Therapy and Post–Radiation Therapy FDG PET Scans in Recurrent Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shusharina, Nadya, E-mail: nshusharina@partners.org; Cho, Joseph; Sharp, Gregory C.; Choi, Noah C.

    2014-05-01

    Purpose: To investigate the spatial correlation between high uptake regions of 2-deoxy-2-[{sup 18}F]-fluoro-D-glucose positron emission tomography ({sup 18}F-FDG PET) before and after therapy in recurrent lung cancer. Methods and Materials: We enrolled 106 patients with inoperable lung cancer into a prospective study whose primary objectives were to determine first, the earliest time point when the maximum decrease in FDG uptake representing the maximum metabolic response (MMR) is attainable and second, the optimum cutoff value of MMR based on its predicted tumor control probability, sensitivity, and specificity. Of those patients, 61 completed the required 4 serial {sup 18}F-FDG PET examinations after therapy. Nineteen of 61 patients experienced local recurrence at the primary tumor and underwent analysis. The volumes of interest (VOI) on pretherapy FDG-PET were defined by use of an isocontour at ≥50% of maximum standard uptake value (SUV{sub max}) (≥50% of SUV{sub max}) with correction for heterogeneity. The VOI on posttherapy images were defined at ≥80% of SUV{sub max}. The VOI of pretherapy and posttherapy {sup 18}F-FDG PET images were correlated for the extent of overlap. Results: The size of VOI at pretherapy images was on average 25.7% (range, 8.8%-56.3%) of the pretherapy primary gross tumor volume (GTV), and their overlap fractions were 0.8 (95% confidence interval [CI]: 0.7-0.9), 0.63 (95% CI: 0.49-0.77), and 0.38 (95% CI: 0.19-0.57) of VOI of posttherapy FDG PET images at 10 days, 3 months, and 6 months, respectively. The residual uptake originated from the pretherapy VOI in 15 of 17 cases. Conclusions: VOI defined by the SUV{sub max}-≥50% isocontour may be a biological target volume for escalated radiation dose.

  13. 18F-DG PET and RCBF SPECT in epilepsy

    International Nuclear Information System (INIS)

    Functional imaging of cortical metabolism and perfusion is of growing importance in the presurgical evaluation of patients suffering from intractable epilepsy. PET and SPECT are of proven value in functional imaging prior to epilepsy surgery. To date the best clinical experience was gained by using 18-fluorodeoxyglucose for PET and tracers for measurement of regional cerebral blood flow (rCBF) like 99mTc-HMPO or 99mTc-ECD for SPECT respectively. Their relative contribution towards detection of a probable focus site in epilepsy is still controversial. To determine the relative value of both procedures the literature has been reviewed with special respect to ictal SPECT studies. With regard to different standards used for correlation a relative sensitivity of 62.4% was found for interictal rCBF SPECT. 71% for 18-FDG-PET and 87% for ictal rCBF SPECT studies. In conclusion, earlier reported advantages of PET over SPECT seem to closely reflect the better spatial resolution of PET. Modern SPECT systems, dedicated for brain SPECT, provide appropriate and almost equal sensitivity. Regarding the limited specificity of interictal studies, both rCBF SPECT and FDG-PET need precise indications. However, further to detection of a probable focus site, metabolism and rCBF studies seem to be of value to predicit the post-surgical patients outcome as to seizure frequency and mental functions secondarily affected by epilepsy surgery such as memory impairment. Ictal rCBF SPECT provides higher sensitivity and specificity and virtually allows the detection lateralisation in almost every case. This means that a relatively precise anatomical localisation of an epileptogenic focus is being found in a rising number of patients. (orig.)

  14. 18F-FDG PET in children with lymphomas

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-07-01

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

  16. Imaging with FDG labelled leukocytes: is it clinically useful?

    International Nuclear Information System (INIS)

    In vivo and in vitro labeled leukocytes have been shown to be very effective in detecting different infectious and inflammatory conditions. The model of labeled leukocyte imaging is based on the powerful mechanisms of chemotaxis exerted on activated leukocytes by chemo-attractants. The avidity of inflammatory cells for fluorodeoxyglucose (FDG) has led to the concept of labeling leukocytes with [18 F]FDG ex vivo. This concept combines cell-bound radionuclide trafficking from the blood pool compartment to the lesion with the high resolution of positron emission tomography (PET) imaging. The further benefits of having a correlated anatomical map by implementing the acquisition on a hybrid PET/computed tomography (CT) device are obvious. The feasibility and the potential value of leukocyte PET(/CT) imaging in infection have been demonstrated. The available data suggest a high accuracy of the method. Still, leukocyte PET/CT should not be considered as the endpoint of infection imaging, since it only meets a part of the criteria of the ideal infection imaging agent. However, the common clinical need for specific detection of infection with anatomical precision, the availability of the components necessary for performing leukocyte PET/CT, their lack of toxicity or adverse effects and the absence of more superior tracers on the commercial market make it worthwhile to further investigate leukocyte PET/CT imaging in larger prospective series. The advantages of leukocyte PET/CT over the more conventional nuclear medicine and radiological methods makes this imaging tool likely to be useful in certain subsets of infected patients.

  17. Infection imaging using whole-body FDG-PET

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) for the detection of soft tissue and bone infections. Forty-five PET examinations in 39 patients (26 male, 13 female, age range 27-86 years) with suspected infectious foci were examined with whole- or partial-body PET scans using FDG. Twenty-seven scans were done in patients with soft tissue and 18 in patients with bone infections. Corrected and uncorrected transaxial PET images were acquired. Seven hundred and twelve body regions in these 45 PET scans were evaluated. Pathological findings were graded using a confidence scale from A to E (A, definitive infection; E, no infection). Disease status was defined in all patients by culture, biopsy or surgery and clinical follow-up. In 45 PET scans there were 40 true-positive, four false-positive and one false-negative findings. Twelve foci suspected to be infectious in nature on the basis of other imaging examinations were identified as negative by PET, thus representing true-negative findings. Sensitivities for the patients with soft tissue (STI) and bone infections (BI) and for the pooled data were 96%, 100% and 98%, respectively. As the calculation of specificity is not straightforward, it was calculated on a per lesion as well as on a per body region basis to permit estimation of an upper and a lower limit. On a per lesion basis, specificities were 70% (STI), 83% (BI) and 75% for the pooled data and on a per body region basis (dividing the body into 22 regions) they were 99% (STI), 99% (BI) and 99% for the pooled data. One false-negative result was found in a patient with cholangitis. It is concluded that PET appears to be a highly sensitive method to detect infectious foci. Specificity is more difficult to estimate, but is probably in the range from 70% to above 90%. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-01-01

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

  19. Applications of 2-deoxy-2-fluoro-D-glucose (FDG) in Plant Imaging: Past, Present, and Future.

    Science.gov (United States)

    Fatangare, Amol; Svatoš, Aleš

    2016-01-01

    The aim of this review article is to explore and establish the current status of 2-deoxy-2-fluoro-D-glucose (FDG) applications in plant imaging. In the present article, we review the previous literature on its experimental merits to formulate a consistent and inclusive picture of FDG applications in plant-imaging research. 2-deoxy-2-fluoro-D-glucose is a [(18)F]fluorine-labeled glucose analog in which C-2 hydroxyl group has been replaced by a positron-emitting [(18)F] radioisotope. As FDG is a positron-emitting radiotracer, it could be used in in vivo imaging studies. FDG mimics glucose chemically and structurally. Its uptake and distribution are found to be similar to those of glucose in animal models. FDG is commonly used as a radiotracer for glucose in medical diagnostics and in vivo animal imaging studies but rarely in plant imaging. Tsuji et al. (2002) first reported FDG uptake and distribution in tomato plants. Later, Hattori et al. (2008) described FDG translocation in intact sorghum plants and suggested that it could be used as a tracer for photoassimilate translocation in plants. These findings raised interest among other plant scientists, which has resulted in a recent surge of articles involving the use of FDG as a tracer in plants. There have been seven studies describing FDG-imaging applications in plants. These studies describe FDG applications ranging from monitoring radiotracer translocation to analyzing solute transport, root uptake, photoassimilate tracing, carbon allocation, and glycoside biosynthesis. Fatangare et al. (2015) recently characterized FDG metabolism in plants; such knowledge is crucial to understanding and validating the application of FDG in plant imaging research. Recent FDG studies significantly advance our understanding of FDG translocation and metabolism in plants but also raise new questions. Here, we take a look at all the previous results to form a comprehensive picture of FDG translocation, metabolism, and applications in

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

    International Nuclear Information System (INIS)

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

  1. Role and interpretation of FDG-PET/CT in HIV patients with fever of unknown origin: a prospective study

    OpenAIRE

    Martin, C.; C Castaigne; Tondeur, M; Flamen, P; S. De Wit

    2012-01-01

    Purpose of the study: Fever of unknown origin (FUO) is a challenging clinical entity in HIV patients. FDG-PET/CT is well validated in the work-up of FUO in HIV-negative patients but in HIV viremic patients, metabolism of HIV reactive lymph nodes could decrease its specificity. We prospectively evaluated the usefulness of FDG-PET/CT in FUO in HIV-positive patients and in particular whether HIV viremia impacts on FDG-PET/CT performance. Methods: FDG-PET/CT was performed in 20 HIV patients with ...

  2. Modification of staging and treatment of head and neck cancer by FDG-PET/CT prior to radiotherapy

    International Nuclear Information System (INIS)

    Background and purpose: Reliable tumor staging is a fundamental pre-requisite for efficient tumor therapy and further prognosis. The aim of this study was to compare head and neck cancer (HNC) staging before and after FDG-PET/CT, evaluating the stage modifications for radiotherapy (RT) planning. Patients and methods: A total of 102 patients with untreated primary HNC, who underwent conventional staging and staging including FDG-PET/CT before RT, were enrolled in this retrospective study. Blinded pre-FDG-PET/CT and post-FDG-PET/CT staging data were compared. The impact on patient management was tested by comparing the intention before and after FDG-PET/CT. Results: Significant modifications of T, N, and M stage as well as clinical stage were detected after inclusion of FDG-PET/CT data (p = 0.002, 0.0006, 0.001, 0.03, respectively). Overall, the implementation of FDG-PET/CT led to modification of RT intention decision in 14 patients. Conclusions: FDG-PET/CT demonstrates essential influence on tumor staging in HNC patients scheduled for irradiation. Implementation of FDG-PET/CT in imaging protocol improves selection of candidates for curative and palliative RT and allows further optimization of treatment management and therapy intention. (orig.)

  3. PET/CT evaluation of the physiologic accumulation of 18F-FDG within the gallbladder vesicle

    International Nuclear Information System (INIS)

    The aim of this study was to investigate physiological fluorine 18-labeled fluourodeoxyglucose accumulation in the gallbladder (GB) during clinical positron emission tomography (PET) examinations. Three patient groups were included. In Group 1, nine patients with higher fluourodeoxyglucose (FDG) accumulation in the GB than in the liver were examined, followed up and finally diagnosed. In Group 2, the correlations between FDG GB accumulation and various parameters in 286 patients were investigated. In Group 3, changes in FDG GB accumulation between early and delayed PET scans were analyzed in 12 patients. In Group 1, all nine patients who exhibited a high FDG GB accumulation had no evidence of GB disease. In Group 2, FDG GB accumulation was significantly correlated with the injection-scan time interval and inversely correlated with the GB size index. Group 3 showed a significant increase in FDG accumulation in the GB on delayed PET scans, compared with that seen on early scans. In clinical PET studies, FDG accumulation within the GB is infrequently observed but may be due to FDG excretion into the bile. Recognition of this phenomenon may be important to avoid misdiagnosing physiological GB FDG accumulation as indicating a pathologic status and preventing unnecessary examinations

  4. PET/CT evaluation of the physiologic accumulation of {sup 18}F-FDG within the gallbladder vesicle

    Energy Technology Data Exchange (ETDEWEB)

    Murata, Yuji [Department of Radiology, Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519 (Japan)], E-mail: mrtmrad@tmd.ac.jp; Watanabe, Hiroshige; Kubota, Kazunori; Toda, Kazuma [Department of Radiology, Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519 (Japan); Nakamura, Shin; Okouchi, Kiyoshi [Department of Dental Radiology, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo 113-8519 (Japan); Shibuya, Hitoshi [Department of Radiology, Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519 (Japan)

    2007-11-15

    The aim of this study was to investigate physiological fluorine 18-labeled fluourodeoxyglucose accumulation in the gallbladder (GB) during clinical positron emission tomography (PET) examinations. Three patient groups were included. In Group 1, nine patients with higher fluourodeoxyglucose (FDG) accumulation in the GB than in the liver were examined, followed up and finally diagnosed. In Group 2, the correlations between FDG GB accumulation and various parameters in 286 patients were investigated. In Group 3, changes in FDG GB accumulation between early and delayed PET scans were analyzed in 12 patients. In Group 1, all nine patients who exhibited a high FDG GB accumulation had no evidence of GB disease. In Group 2, FDG GB accumulation was significantly correlated with the injection-scan time interval and inversely correlated with the GB size index. Group 3 showed a significant increase in FDG accumulation in the GB on delayed PET scans, compared with that seen on early scans. In clinical PET studies, FDG accumulation within the GB is infrequently observed but may be due to FDG excretion into the bile. Recognition of this phenomenon may be important to avoid misdiagnosing physiological GB FDG accumulation as indicating a pathologic status and preventing unnecessary examinations.

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  7. Factors affecting gastric uptake in whole body FDG-PET imaging

    International Nuclear Information System (INIS)

    Positron emission tomography (PET) using 2-deoxy-2-[18F]-fluoro-D-glucose (FDG) is very useful for the detection and staging of tumors. However, FDG is also accumulated in the normal tissues in various degrees. This physiological FDG uptake is often seen in intestine, making confusion with malignant tumor. The aim of this study was to identify factors influencing physiological FDG uptake in the stomach. A total of 136 people who underwent cancer screening or staging of tumors except for gastric cancer using FDG whole-body PET was examined (mean age: 55.6 yrs). All subjects fasted for at least 4 hours before the PET study and were administrated with FDG intravenously (mean FDG dose: 308.9 MBq). Emission images were acquired on a whole-body PET scanner and images were reconstructed without attenuation correction. The intensity of gastric uptake of FDG whole-body PET image was visually classified into 3 grades; grade 2 = the intensity of gastric uptake more than pulmonary uptake, grade 1 = the intensity of gastric uptake equal to or less than pulmonary uptake, grade 0 = no contrast between gastric uptake and background. Twenty-eight subjects (20.6%) were classified into grade 2, 42 subjects (30.9%) were grade 1 and 66 subjects (48.5%) were grade 0. Subjects' age, fasting time, FDG dose, serum glucose level, free fatty acid level and insulin level were not significantly correlated with the intensity of gastric uptake. But the subjects with higher gastric uptake tended to have anti-Helicobactor pylori (H. pylori) antibodies. The rate of having anti-H.pylori antibodies in the grade 2 group is significantly higher than the grade 1 group (85.7% vs. 72.5%, p<0.05), and that of the grade 1 group is significantly higher than the grade 0 group (72.5% vs. 42.2%, p<0.01). Gastric uptake was observed in about half of subjects. Especially, approximately 20% of all showed high gastric uptake, which was associated with H.pylori infection. Therefore, most of the subjects with high

  8. Factors affecting gastric uptake in whole body FDG-PET imaging

    Energy Technology Data Exchange (ETDEWEB)

    Tomemori, Takashi; Kitagawa, Mami; Nakahara, Tadaki; Wu, Jin; Nakagawa, Keiichi; Uno, Kimiichi; Abe, Kinji; Tomiyoshi, Katsumi [Nishidai Clinic Diagnostic Imaging Center, Tokyo (Japan)

    2001-06-01

    Positron emission tomography (PET) using 2-deoxy-2-[{sup 18}F]-fluoro-D-glucose (FDG) is very useful for the detection and staging of tumors. However, FDG is also accumulated in the normal tissues in various degrees. This physiological FDG uptake is often seen in intestine, making confusion with malignant tumor. The aim of this study was to identify factors influencing physiological FDG uptake in the stomach. A total of 136 people who underwent cancer screening or staging of tumors except for gastric cancer using FDG whole-body PET was examined (mean age: 55.6 yrs). All subjects fasted for at least 4 hours before the PET study and were administrated with FDG intravenously (mean FDG dose: 308.9 MBq). Emission images were acquired on a whole-body PET scanner and images were reconstructed without attenuation correction. The intensity of gastric uptake of FDG whole-body PET image was visually classified into 3 grades; grade 2 = the intensity of gastric uptake more than pulmonary uptake, grade 1 = the intensity of gastric uptake equal to or less than pulmonary uptake, grade 0 = no contrast between gastric uptake and background. Twenty-eight subjects (20.6%) were classified into grade 2, 42 subjects (30.9%) were grade 1 and 66 subjects (48.5%) were grade 0. Subjects' age, fasting time, FDG dose, serum glucose level, free fatty acid level and insulin level were not significantly correlated with the intensity of gastric uptake. But the subjects with higher gastric uptake tended to have anti-Helicobactor pylori (H. pylori) antibodies. The rate of having anti-H.pylori antibodies in the grade 2 group is significantly higher than the grade 1 group (85.7% vs. 72.5%, p<0.05), and that of the grade 1 group is significantly higher than the grade 0 group (72.5% vs. 42.2%, p<0.01). Gastric uptake was observed in about half of subjects. Especially, approximately 20% of all showed high gastric uptake, which was associated with H.pylori infection. Therefore, most of the subjects

  9. [18-F]-FDG in childhood lymphoma: clinical utility and impact on management

    International Nuclear Information System (INIS)

    Positron emission tomography (PET) with [18F]-fluorodeoxyglucose is a very useful imaging technique in lymphomas occurring in the adult population. But there are very few data concerning its utility in childhood lymphoma, if it contributes to a more accurate staging of the illness and a better assessment of therapy. The purpose of our study was to evaluate the usefulness of performing FDG PET in childhood lymphoma compared to conventional imaging (CIM) and clinical data. Methods: From July 1998 to August 2001, 42 FDG PET examinations were performed using a dedicated PET system (27 examinations) or an hybrid coincidence PET system (15 examinations) for initial tumor staging (n=7), re-staging (n=5), assessment of therapy or residual masses (n=30) in 27 children with Hodgkin's disease (HD) (n=20) or non-Hodgkin's lymphoma (NHL) (n=7). FDG PET results were compared to CIM and clinical data. Since 2000, a standardized questionnaire for evaluation of the clinical impact of FDG-PET both on staging and on therapy has been sent to the 16 referring physicians and 13 replied. Results: FDG PET was performed in all children without any inconvenience. FDG PET was found to be very sensitive (Se=12/12) for staging and re-staging of the illness, showing more lesions than CIM with a 50% patient upstaging rate (6/12). It was very accurate for monitoring response to therapy and for characterisation of residual masses. False-positive results were observed in 2 NHL patients with thymic uptake and 1 false-negative result was observed in a patient with relapse of NHL, one month after a negative FDG PET. The questionnaire emphasized the impact of FDG PET on clinical management, as it was modified on the basis of the FDG PET results in 23% of patients. Conclusion: As previously demonstrated in the adult population, FDG PET appeared to be a very sensitive imaging technique for staging and re-staging of lymphoma in children and could be very useful to monitor response to therapy

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

    International Nuclear Information System (INIS)

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

  11. Detectability of T Measurable diseases in advanced gastric cancer in FDG PET CT

    International Nuclear Information System (INIS)

    Usefulness of FDG PET CT in monitoring response in locally advanced gastric cancer has been reported. The purpose of this study was to evaluate the related factors to detect measurable diseases in advanced gastric cancer on FDG PET CT. We retrospectively reviewed 38 patients diagnosed as having advanced gastric cancer. We defined the measurable diseases when there was visualized tumor of which maximum standardized uptake value(SUVmax) was higher than 1.35*SUVmax of liver + 2*SD of liver SUV. We evaluated what kinds of factors from the clinicopathologic features were related to identifying measurable diseases. Of 38 patients with advanced gastric cancer, 18 (50%) had measurable tumors on FDG PET CT. Measurable tumors were significantly more frequent in well or moderately differentiated adenocarcinoma (70.5% vs 35.3%, p<0.05), in the tumors located at antrum or angle (66.7% vs 29.4%, p<0.05) and in the elderly group (age of 55 years old or more, 72.0% vs 8.3%, p<0.001) than the others, respectively. By multivariate analysis, age at diagnosis was the only independent predictor for the measurable disease on FDG PET CT. We found that age at diagnosis, as well as histologic types and location of tumors, were the affecting factors to detect measurable disease on FDG PET CT in patients with advanced gastric cancer. Our study suggests that elderly patients of age of 55 years old or more can frequently have T measurable disease on FDG PET CT in advanced gastric cancer and FDG PET CT will be helpful to monitor measurable disease

  12. Biologic correlation between glucose transporters, hexokinase-II, Ki-67 and FDG uptake in malignant melanoma

    International Nuclear Information System (INIS)

    Introduction: The purpose of this study was to investigate the correlative association between tumoral 2-deoxy-2-[18 F]-fluoro-D-glucose (FDG) uptake, and the expressions of glucose transporter 1 (GLUT-1), glucose transporter 3 (GLUT-3), hexokinase II (HK-2), and Ki-67 expression in malignant melanoma. Methods: Nineteen patients with histologically proven malignant melanoma and pretreatment FDG PET/CT performance were involved in this preliminary study. For semi-quantitative analysis of FDG PET/CT, maximal standardized uptake values (SUVmax) were estimated. Immunohistochemical staining of tumor sections was performed for GLUT-1, GLUT-3, and HK-2, and for the cell proliferation maker Ki-67. Especially, by combining proportions and intensity of immunochemical staining, we evaluated modified immunohistologic scores of GLUT-1 and GLUT-3. Results: The SUVmax of malignant melanoma lesions ranged from 2 to 18.7 (average; 9.1 ± 5.4). Comparison between nodal and extranodal lesions revealed no significant difference of SUVmax (p = 0.97). GLUT-1 staining showed the most positive expression level (89.5%, 17/19) among the diverse immunohistochemical markers. There were significant relationships between FDG uptake of malignant melanoma and GLUT-1 proportion (p < 0.0001), GLUT-1 intensity (p < 0.0001), GLUT-3 proportion (p = 0.031), GLUT-3 intensity (p = 0.009), GLUT-1 immunohistologic scores (p < 0.0001), and GLUT-3 immunohistologic scores (p = 0.028). HK-2 was not expressed in all melanoma samples. Although Ki-67 expression showed a high grade in all staining, there was no significant link between FDG uptake and Ki-67 grades (p = 0.38). Conclusions: The data in this preliminary study indicate that FDG uptake in malignant melanoma is determined by GLUT-1 and GLUT-3, whereas HK-2 and Ki-67 play no role in FDG uptake of malignant melanoma.

  13. Extended staging of oesophageal cancer using FDG-PET – A critical appraisal

    International Nuclear Information System (INIS)

    Background and aim: Oesophageal cancer (OC) is a highly aggressive tumour with unfavorable prognosis due to early stages metastases. Treatment and survival rates are highly correlated with tumour wall invasion, lymphatic involvement and metastatic spread. Thus, an accurate staging at initial diagnosis is fundamental for optimal management. In the present review article the potential role of the FDG-PET in the staging of OC is discussed. Methods: A systematic review of all papers published in PubMed until June 2010 was performed. Results: Endoscopic ultrasound (EUS) is helpful for T and N staging but not for M staging. CT plays a complementary role to EUS in T staging, especially in excluding T4 disease. However, in N staging, CT relies on “size criteria” (1cm = malignant) which reduces its sensitivity and specificity. FDG-PET has been demonstrated to be a very helpful tool in staging and re-staging OC. Most OCs demonstrate high FDG accumulation and are usually well detected with PET. Unfortunately, PET cannot reveal very small lesions due to its limited spatial resolution, therefore limiting the usefulness of PET in T staging. In N staging, an FDG positive node is highly likely to contain disease. However, FDG-PET cannot reliably separate the primary site from closely adjacent nodes. The real and unquestionable additional diagnostic value of FDG-PET in comparison to CT and EUS is in evaluating distant metastases. Conclusions: It appears reasonable to include FDG PET/CT in the diagnostic algorithm of patients with OC in order to better define the optimal therapeutic approach.

  14. Initial experience with sodium iodine FDG-PET in pancreatic cancer

    International Nuclear Information System (INIS)

    Full text: Previous studies of FDG-PET in pancreatic cancer have used Bismuth Germinate detector systems. The purpose of this preliminary study was to confirm the accuracy of FDG-PET in pancreatic cancer using a dedicated sodium iodine (Nal) PET system. Fifteen consecutive patients with known or suspected pancreatic cancer underwent FDG-PET using a GE QUEST dedicated Nal PET scanner (GE Medical, Milwaukee). The indications were characterisation of a pancreatic mass seen on CT or US imaging (9 cases), diagnosis or exclusion of recurrent disease following surgery and adjuvant therapy (4 cases), and pre-surgical staging of primary pancreatic cancer (2 cases). Patients were fasted for 6 hours prior to their scan with estimation of blood sugar level (BSL) performed prior to intravenous administration of 74-200 MBq F-18 FDG. Whole-body imaging with and without attenuation correction was performed 45 minutes after injection. Focal accumulation of FDG greater than background uptake was regarded as a sign of malignancy. The final diagnosis was determined from histology or, when no histology was available, by radiological and clinical follow-up of at least 8 months. FDG-PET accurately characterised 8/9 pancreatic masses, of these seven were true negative, one was true positive and one was false positive. Of the four cases performed to determine recurrent disease, three were accurately diagnosed (2 true negatives and one true positive). In the fourth case, PET accurately detected a liver metastasis but did not detect the local recurrence. Results in the two cases where PET was performed for pre-operative staging comprised one true positive and one false negative. Only one patient had a BSL of greater than 8 mmol/1 (11.2mmol/l), but with no effect on diagnostic accuracy. Nal FDG-PET is useful in pancreatic cancer, particularly in the presence of a previously detected mass. Copyright (2002) Blackwell Science Pty Ltd

  15. FDG Co-PET imaging of occult primary tumour presenting with metastatic disease

    International Nuclear Information System (INIS)

    Full text: The management of patients with known metastatic disease but no clinically apparent primary site remains a challenge. We assessed Coincidence Positron Emission Tomography (Co-PET) with Fluorodeoxyglucose (FDG) in the detection of occult primary tumour in patients with proven metastatic disease. Nineteen patients with biopsy proven metastatic cervical adenopathy (7) or extracervical metastases (12) from occult primary tumours were evaluated with FDG Co-PET. All patients had appropriate conventional anatomical imaging within one month of FDG Co-PET during the period of December 1997 to December 2001. Whole body imaging was performed with an ADAC Solus Co-PET scanner 60 minutes after 185 MBq FDG administration. The results of Co-PET imaging were correlated with conventional anatomical imaging. FDG Co-PET suggested the primary tumour sites in 7 of the 19 patients (37%): pancreas (1), hypopharynx (1), oropharynx (1) lung (1), oesophagus (1), right kidney (1) and ascending colon (1). Three of these cases were confirmed either with serological tumour marker (1) or clinical course of disease (2) with potential management impacts. Compared with conventional anatomical imaging for detection of metastatic sites, FDG Co-PET was concordant in 9 patients (47%). Co-PET detected extra sites in 8 patients (42%), and detected fewer sites in 2 patients (11%) both whom had excision biopsies. FDG Co-PET was successful in localizing occult primary tumour in a limited number of patients presenting with metastatic disease with potential management impact. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  16. Benign and malignant neurogenic tumors of nerve sheath origin on FDG PET

    International Nuclear Information System (INIS)

    The differentiation between benign and malignant nerve sheath tumors is difficult based on conventional radiological imaging. This study was undertaken to investigate the value of FDG PET in distinguishing benign from malignant neurogenic tumors of nerve sheath origin. We performed a retrospective review of the medical record to select patients with nerve sheath tumors who had underdone FDG PET imaging. Fifteen patients (7F: 8M) with benign or malignant nerve sheath tumors were included in this study. Of the 15 patients, 9 were diagnosed with the known neurofibromatosis type I. A total of 19 nerve sheath tumors were included from the 15 patients. All patients had undergone FDG PET to evaluate for malignant potential of the known lesions. Images of FDG PET were semi-quantitatively analyzed and a region of interest (ROI) was placed over the area of the maximum FDG uptake and an average standardized uptake value was taken for final analysis. There were 5 malignant peripheral nerve sheath tumors, 5 schwannomas, and 9 neurofibromas. The mean SUV was 2 (ranged from 1.6 to 3.3) for schwannomas, 1.3 (0.7 to 2.5) for neurofibromas, and 8.4 (4.6 to 12.2) for malignant peripheral nerve sheath tumors. Of 14 benign tumors, all except one schwannoma showed a SUV less than 3. When a cutoff SUV of 4 was used to differentiate the nerve sheath tumors, all tumors were correctly classified as benign or malignant, respectively. Among the 9 patients diagnosed with neurofibromatosis type I. 4 had malignant peripheral nerve sheath tumors and FDG PET accurately detected all the 4 lesions with malignant transformation. According to our results, FDG PET seems to have a great potential for accurately characterizing benign versus malignant nerve sheath tumors. It appears to be extremely useful for patients with neurofibromatosis to localize the lesion with malignant transformation

  17. Benign and malignant neurogenic tumors of nerve sheath origin on FDG PET

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    Yun, M. J.; Go, D. H.; Yoo, Y. H.; Shin, K. H.; Lee, J. D [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

    2004-07-01

    The differentiation between benign and malignant nerve sheath tumors is difficult based on conventional radiological imaging. This study was undertaken to investigate the value of FDG PET in distinguishing benign from malignant neurogenic tumors of nerve sheath origin. We performed a retrospective review of the medical record to select patients with nerve sheath tumors who had underdone FDG PET imaging. Fifteen patients (7F: 8M) with benign or malignant nerve sheath tumors were included in this study. Of the 15 patients, 9 were diagnosed with the known neurofibromatosis type I. A total of 19 nerve sheath tumors were included from the 15 patients. All patients had undergone FDG PET to evaluate for malignant potential of the known lesions. Images of FDG PET were semi-quantitatively analyzed and a region of interest (ROI) was placed over the area of the maximum FDG uptake and an average standardized uptake value was taken for final analysis. There were 5 malignant peripheral nerve sheath tumors, 5 schwannomas, and 9 neurofibromas. The mean SUV was 2 (ranged from 1.6 to 3.3) for schwannomas, 1.3 (0.7 to 2.5) for neurofibromas, and 8.4 (4.6 to 12.2) for malignant peripheral nerve sheath tumors. Of 14 benign tumors, all except one schwannoma showed a SUV less than 3. When a cutoff SUV of 4 was used to differentiate the nerve sheath tumors, all tumors were correctly classified as benign or malignant, respectively. Among the 9 patients diagnosed with neurofibromatosis type I. 4 had malignant peripheral nerve sheath tumors and FDG PET accurately detected all the 4 lesions with malignant transformation. According to our results, FDG PET seems to have a great potential for accurately characterizing benign versus malignant nerve sheath tumors. It appears to be extremely useful for patients with neurofibromatosis to localize the lesion with malignant transformation.

  18. FDG PET or PET/CT in evaluation of renal angiomyolipoma

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    Lin, Chun Yi [Dept. of Nuclear Medicine, Show Chwan Memorial Hospital, Changhua (China); Chen, Hui Yi [Dept. of Radiology, China Medical University Hospital, Taichung (China); Ding, Hueisch Jy [Dept. of Nuclear Medicine, E-DA Hospital I-Shou University, Kaohsiung (China); Yen, Kuo Yang; Kao, Chia Hung [Dept. of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung (China)

    2013-04-15

    Angiomyolipoma is the most common benign kidney tumor. However, literature describing FDG PET findings on renal angiomyolipoma (AML) is limited. This study reports the FDG PET and PET/CT findings of 21 cases of renal AML. The study reviews FDG PET and PET/CT images of 21 patients diagnosed with renal AML. The diagnosis is based on the classical appearance of an AML on CT scan with active surveillance for 6 months. The study is focused on the observation of clinical and radiographic features. Six men and 15 women were included in our study. The mean age of the patients was 57.14 ± 9.67 years old. The mean diameter of 21 renal AML on CT scans was 1.76 ± 1.00 cm (Min: 0.6 cm; Max: 4.4 cm). CT scans illustrated renal masses typical of AMLs, and the corresponding FDG PET scans showed minimal FDG activities in the area of the tumors. None of the 21 AMLs showed a maximum standardized uptake value (SUV{sub max}) greater than 1.98. No statistically significant correlation was present between SUV{sub max} and tumor size. Renal AMLs demonstrate very low to low uptake on FDG PET and PET/CT imaging in this study. When a fat-containing tumor in the kidney is found on a CT scan, it is critical to differentiate an AML from a malignant tumor including an RCC, liposarcoma, and Wilms tumor. This study suggests that FDG PET or PET/CT imaging is useful for differentiating a renal AML from a fat-containing malignant tumor.

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

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

  2. Detectability of T Measurable diseases in advanced gastric cancer in FDG PET CT

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Sun Young; Cheon, Gi Jeong; Kim, Young Chul; Jeong, Eugene; Kim, Seung Eun; Choe, Jae Gol [Korea Univ. Medical Center, Seoul (Korea, Republic of)

    2012-12-15

    Usefulness of FDG PET CT in monitoring response in locally advanced gastric cancer has been reported. The purpose of this study was to evaluate the related factors to detect measurable diseases in advanced gastric cancer on FDG PET CT. We retrospectively reviewed 38 patients diagnosed as having advanced gastric cancer. We defined the measurable diseases when there was visualized tumor of which maximum standardized uptake value(SUVmax) was higher than 1.35*SUVmax of liver + 2*SD of liver SUV. We evaluated what kinds of factors from the clinicopathologic features were related to identifying measurable diseases. Of 38 patients with advanced gastric cancer, 18 (50%) had measurable tumors on FDG PET CT. Measurable tumors were significantly more frequent in well or moderately differentiated adenocarcinoma (70.5% vs 35.3%, p<0.05), in the tumors located at antrum or angle (66.7% vs 29.4%, p<0.05) and in the elderly group (age of 55 years old or more, 72.0% vs 8.3%, p<0.001) than the others, respectively. By multivariate analysis, age at diagnosis was the only independent predictor for the measurable disease on FDG PET CT. We found that age at diagnosis, as well as histologic types and location of tumors, were the affecting factors to detect measurable disease on FDG PET CT in patients with advanced gastric cancer. Our study suggests that elderly patients of age of 55 years old or more can frequently have T measurable disease on FDG PET CT in advanced gastric cancer and FDG PET CT will be helpful to monitor measurable disease.

  3. FDG PET or PET/CT in evaluation of renal angiomyolipoma

    International Nuclear Information System (INIS)

    Angiomyolipoma is the most common benign kidney tumor. However, literature describing FDG PET findings on renal angiomyolipoma (AML) is limited. This study reports the FDG PET and PET/CT findings of 21 cases of renal AML. The study reviews FDG PET and PET/CT images of 21 patients diagnosed with renal AML. The diagnosis is based on the classical appearance of an AML on CT scan with active surveillance for 6 months. The study is focused on the observation of clinical and radiographic features. Six men and 15 women were included in our study. The mean age of the patients was 57.14 ± 9.67 years old. The mean diameter of 21 renal AML on CT scans was 1.76 ± 1.00 cm (Min: 0.6 cm; Max: 4.4 cm). CT scans illustrated renal masses typical of AMLs, and the corresponding FDG PET scans showed minimal FDG activities in the area of the tumors. None of the 21 AMLs showed a maximum standardized uptake value (SUVmax) greater than 1.98. No statistically significant correlation was present between SUVmax and tumor size. Renal AMLs demonstrate very low to low uptake on FDG PET and PET/CT imaging in this study. When a fat-containing tumor in the kidney is found on a CT scan, it is critical to differentiate an AML from a malignant tumor including an RCC, liposarcoma, and Wilms tumor. This study suggests that FDG PET or PET/CT imaging is useful for differentiating a renal AML from a fat-containing malignant tumor.

  4. Initial results in the assessment of multiple myeloma using18F-FDG PET

    International Nuclear Information System (INIS)

    This prospective study was undertaken to investigate the appearance of multiple myeloma on fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET). Furthermore, the accuracy of FDG-PET in detecting myeloma lesions and its influence on patient management were evaluated. Forty-three patients with known multiple myeloma (n=28) or solitary plasmacytoma (n=15) underwent FDG-PET. The results of routinely performed radiographs and of scans obtained using all available imaging modalities (MRI, CT), as well as the clinical course, were used for verification of detected lesions. Focally increased tracer uptake was observed in 38 of 41 known osteolytic bone lesions (sensitivity 92.7%) in 23 patients. In addition, 71 further bone lesions which were negative on radiographs were detected in 14 patients. Twenty-six (36.6%) of these lesions could be confirmed in ten patients. As a result of FDG-PET imaging, clinical management was influenced in five (14.0%) patients. The positive predictive value for active disease was 100% in patients with focal or mixed focal/diffuse skeletal FDG uptake and 75% in patients with diffuse bone marrow uptake. Depending on the interpretation of the PET scans in patients with diffuse bone marrow uptake, the sensitivity ranged from 83.8% to 91.9% and the specificity from 83.3% to 100%. FDG-PET thus proved highly accurate in detecting multiple myeloma, and revealed a greater extent of disease than routine radiographs in 14 of 23 (60.9%) patients who had osteolytic bone lesions. FDG-PET might contribute to the initial staging of solitary plasmacytoma. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-07-15

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

  6. Comparison of FDG Uptake with Pathological Parameters in the Well-differentiated Thyroid Cancer

    International Nuclear Information System (INIS)

    Differentiated thyroid cancer (DTC) has variable degree of F-18 FDG avidity. The purpose of this study was to evaluate the relationship between F-18 FDG uptake and pathological or immunohistochemical features of DTC. DTC patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included in the study. Maximum standardized uptake values (SUVmax) of primary tumor were calculated. If the primary tumor showed no perceptibly increased F-18 FDG uptake, region of interest was drawn based on finding of CT portion of the PET/CT images. Pathological and immunohistochemical markers such as presence of lymph node (LN) metastasis and underlying thyroiditis, tumor size, Ki-67 labeling index, expressions of EGFR, COX-2, and Galectin-3 were evaluated. Total of 106 patients was included (102 papillary carcinomas, 4 follicular carcinomas). The mean SUVmax of the large tumors (above 1 cm) was significantly higher than the mean SUVmax of small (equal to or less than 1 cm) ones (7.8±8.5 vs. 3.6±3.1, p=0.004). No significant difference in F-18 FDG uptake was found according to the presence or absence of LN metastasis and underlying thyroiditis, or the degree of Ki-67 labeling index, expression of EGFR, COX-2 and Galectin-3. In conclusion, the degree of F-18 FDG uptake in DTC was associated with the size of primary tumor. But there seem to be no relationship between F-18 FDG uptake of DTC and expression of Ki-67, EGFR, COX-2 and Galectin-3

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-01-15

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

  9. Biopsy versus FDG PET/CT in the initial evaluation of bone marrow involvement in pediatric lymphoma patients

    International Nuclear Information System (INIS)

    The objective is to assess the role of 18F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/CT versus bone marrow biopsy (BMB) in the initial evaluation of bone marrow (BM) involvement in pediatric lymphoma patients. Fifty-four pediatric patients with pathologically proven lymphoma [31 Hodgkin's disease (HD), 23 non-Hodgkin's lymphoma (NHL)] were included in this study. All patients had soft tissue biopsy and BMB and had FDG PET/CT scans within 2 weeks of biopsy. Among the 31 HD patients, FDG PET/CT revealed positive BM involvement in 4 patients, while BMB revealed BM involvement in 2 patients who were also positive on FDG PET/CT imaging. Among the 23 NHL patients, FDG PET/CT revealed positive BM involvement in 8 patients, while biopsy revealed BM involvement in 5 patients on initial studies (4 of them were also positive on FDG PET/CT, and 1 was BMB positive but was negative on FDG PET/CT), plus 1 false-negative BMB study initially but positive on repeat biopsy after FDG PET/CT. The overall sensitivity of detecting BM involvement by lymphoma was 92 and 54% (p < 0.05) for FDG PET/CT and BMB, respectively. It is noted that there were more positive BMB findings in patients with abnormal FDG activities seen in the biopsy sites on PET/CT. Our study demonstrates that FDG PET/CT has high sensitivity and accuracy and a substantial complementary value to BMB in the initial diagnosis of pediatric lymphoma, and should be employed as a first-line study. (orig.)

  10. Biopsy versus FDG PET/CT in the initial evaluation of bone marrow involvement in pediatric lymphoma patients

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Gang; Chamroonrat, Wichana; Torigian, Drew A.; Alavi, Abass [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Chen, Wengen [University of Maryland Medical Center, Department of Diagnostic Radiology and Nuclear Medicine, Baltimore, MD (United States); Zhuang, Hongming [Children' s Hospital of Philadelphia, Philadelphia, PA (United States)

    2011-08-15

    The objective is to assess the role of {sup 18}F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/CT versus bone marrow biopsy (BMB) in the initial evaluation of bone marrow (BM) involvement in pediatric lymphoma patients. Fifty-four pediatric patients with pathologically proven lymphoma [31 Hodgkin's disease (HD), 23 non-Hodgkin's lymphoma (NHL)] were included in this study. All patients had soft tissue biopsy and BMB and had FDG PET/CT scans within 2 weeks of biopsy. Among the 31 HD patients, FDG PET/CT revealed positive BM involvement in 4 patients, while BMB revealed BM involvement in 2 patients who were also positive on FDG PET/CT imaging. Among the 23 NHL patients, FDG PET/CT revealed positive BM involvement in 8 patients, while biopsy revealed BM involvement in 5 patients on initial studies (4 of them were also positive on FDG PET/CT, and 1 was BMB positive but was negative on FDG PET/CT), plus 1 false-negative BMB study initially but positive on repeat biopsy after FDG PET/CT. The overall sensitivity of detecting BM involvement by lymphoma was 92 and 54% (p < 0.05) for FDG PET/CT and BMB, respectively. It is noted that there were more positive BMB findings in patients with abnormal FDG activities seen in the biopsy sites on PET/CT. Our study demonstrates that FDG PET/CT has high sensitivity and accuracy and a substantial complementary value to BMB in the initial diagnosis of pediatric lymphoma, and should be employed as a first-line study. (orig.)

  11. Clinical efficacy of FDG-PET scan in the patients with primary or recurrent gynecologic malignancies: clinical experiences with FDG-PET scan in cervical carcinoma of uterus

    International Nuclear Information System (INIS)

    This study was done to evaluate the clinical feasibility of FDG-PET scan in patients with cervical carcinoma. PET-scans were performed in 74 patients with cervical carcinoma from March, 1998 to September, 1998. Fourteen cases were done at pretreatment period and sixty cases were done at post-treatment follow up period. In this study, the scans were obtained after bladder emptying by foley catheter insertion and diuretics to reduce the tracer activity in the bladder and improve the images of central lesions. We could find some incidental recurrent or metastatic lesions by FDG-PET scan (at pretreatment; 5 cases, at post-treatment; clinically no evidence of disease; 8 cases). FDG-PET scan had high sensitivity (100%) for central lesions and metastatic lymph nodes of cervical cancer but could not precisely define the anatomic location of the cancer and the sensitivity was not superior than MRI. Earlier detection of metastatic lymph nodes was superior than CT/MRI (sensitivity; 100 %) for metastatic lymph nodes. Also we found 3 double primary cancers incidentally (2 lung cancers and 1 thyroid cancer). In conclusion, FDG-FET scan might be useful for the earlier of hidden lesions that cannot be detected by routine conventional methods and differential diagnosis with radiation fibrosis and benign lymph adenophy

  12. Clinical efficacy of FDG-PET scan in the patients with primary or recurrent gynecologic malignancies: clinical experiences with FDG-PET scan in cervical carcinoma of uterus

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Hoon

    1998-12-01

    This study was done to evaluate the clinical feasibility of FDG-PET scan in patients with cervical carcinoma. PET-scans were performed in 74 patients with cervical carcinoma from March, 1998 to September, 1998. Fourteen cases were done at pretreatment period and sixty cases were done at post-treatment follow up period. In this study, the scans were obtained after bladder emptying by foley catheter insertion and diuretics to reduce the tracer activity in the bladder and improve the images of central lesions. We could find some incidental recurrent or metastatic lesions by FDG-PET scan (at pretreatment; 5 cases, at post-treatment; clinically no evidence of disease; 8 cases). FDG-PET scan had high sensitivity (100%) for central lesions and metastatic lymph nodes of cervical cancer but could not precisely define the anatomic location of the cancer and the sensitivity was not superior than MRI. Earlier detection of metastatic lymph nodes was superior than CT/MRI (sensitivity; 100 %) for metastatic lymph nodes. Also we found 3 double primary cancers incidentally (2 lung cancers and 1 thyroid cancer). In conclusion, FDG-FET scan might be useful for the earlier of hidden lesions that cannot be detected by routine conventional methods and differential diagnosis with radiation fibrosis and benign lymph adenophy.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  14. FDG-PET imaging in HIV-infected subjects: relation with therapy and immunovirological variables

    Energy Technology Data Exchange (ETDEWEB)

    Lucignani, Giovanni; Orunesu, Eva [Neurological Institute Milan, Laboratory of Cellular Neurophysiology, IRCCS Foundation, Milan (Italy); Cesari, Miriam [Univ. of Milan (Italy). Dept. of Clinical Science; Marzo, Katia; Chiti, Arturo [IRCCS Humanitas, Milan (Italy). Dept. of Nuclear Medicine; Pacei, Michela [Milan Univ. (Italy). Lab. of Immunology; Bechi, Giulia [IRCCS Foundation, Milan (Italy). Lab. of Cellular Neurophysiology; Gori, Andrea [Univ. of Milan Biococca, Monza (Italy). Inst. of Infectious Disseases; Gaito, Sabrina [Milan Univ. (Italy). Dept. of Computer Science; Clerici, Mario [Milan Univ. (Italy). Dept. of Biomedical Sciences and Technologies

    2009-04-15

    To characterise tissue sites of immune activation and HIV replication we performed FDG-PET in ART-treated and ART-naive HIV-infected individuals. Specific aims were to establish whether HIV-infected patients can be differentiated on the basis of the detection of specific locations of viral replication, even in the presence of an apparently optimal immunovirological response to ART, and whether these FDG-PET findings can be related to immunovirological variables and AIDS history status. Patients were divided into five groups as follows: subgroup A1 (full responders, n=8): current ART treatment, CD4+ T lymphocytes >500/mL, viral load <50 copies/mL; subgroup A2 (full responders, n=5): same criteria as A-1, but with a previous history of AIDS; subgroup A3 (immunological non responders, n=5): current ART treatment, viral load <50 copies/mL, low CD4+ T lymphocytes (<200/mL); group B (virological non responders, n = 2): current ART treatment, CD4+ T lymphocytes around 500/mL, viral load >50,000 copies/mL; group C (ART-naive, n=5): no current or previous ART treatment, increased viral load. PET images revealed different patterns of FDG uptake. All ART-treated patients with either suppressed (<50 copies/mL; Group A) or high viremia (group B) showed a normal pattern of FDG uptake. On the contrary, the ART-naive subjects with high viraemia (group C) displayed multiple foci of increased glucose metabolism in the lymph nodes. In the ART-naive subjects, FDG uptake, apparently related to viraemia level, was observed in the upper torso mainly in the axillary nodes bilaterally in patients with viraemia below 100,000 copies/mL; in those with viraemia higher than 100,000 copies/mL, FDG uptake was also observed in the inguinal lymph nodes. The emergence, in our study, of a correlation between the percentage of CD8+/CD38+/RO+ T cells (well established markers of progression to AIDS independently of CD4+ T lymphocytes) and positive FDG-PET in ART-naive patients is a novel finding that

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  17. Non-FDG PET in the practice of oncology

    Directory of Open Access Journals (Sweden)

    P Caroli

    2010-01-01

    Full Text Available Fluoro-2-deoxy-d-glucose-positron emission tomography (FDG-PET is utilized in more than 90% of cancers in staging, re-staging, assessing therapy response and during the follow-up. However, not all tumors show significant increase of metabolic activity on FDG-PET imaging. This is particularly true for prostate cancer, neuroendocrine tumors and hepatic tumors. In this review we have considered those already used for clinical applications such as 11C- and 18F-Choline, 11C-Methionine and 18F-FET, 18F-DOPA, 68Ga-DOTA-somatostatine analogues, 11C-Acetate and 18F-FLT. Choline presents a high affinity for malignant prostate tissue, even if low grade. Choline can be labeled with either 11C or 18F, the former being the preference due to lower urinary excretion and patients exposure. The latter is more useful for possible distribution to centers lacking in on-site cyclotron. Methionine is needed for protein synthesis and tumor cells require an external supply of methionine. These tracers have primarily been used for imaging of CNS neoplasms. The most appropriate indication is when conventional imaging procedures do not distinguish between edema, fibrosis or necrosis and disease relapse. In addition, the uptake of 11C-Methionine is proportional to the tumor grade and, therefore, the maximum small unilamellar vesicles (SUV inside the brain mass before therapy is somehow considered a prognostic value. Neuroendocrine tumors (carcinoids, pheocromocytoma, neuroblastoma, medullary thyroid cancer, microcytoma, carotid glomus tumors, and melanoma demonstrate an increased activity of L-DOPA decarboxylase, and hence they show a high uptake of 18FDOPA. For the study of NETs, 68Ga-DOTA-TOC/DOTA-NOC has been introduced as PET tracer. This compound for PET imaging has a high affinity for sst2 and sst5 and has been used in the detection of NETs in preliminary studies; 68Ga-DOTA-NOC PET is useful before metabolic radiotherapy in order to evaluate the biodistribution of the

  18. HPLC-MS analysis of fluordeoxyglucose (FDG) and other saccharides

    International Nuclear Information System (INIS)

    In this work the possibilities of the complex analysis of FDG, and other hexoses and pentoses with liquid chromatography (LC), mass spectrometric detector (MSD), refractometric detector (RID), UV-VIS diode-array detector (DAD) and radiometric detector (RAD) were investigated. The measurements were executed on an Agilent 1100 LC/MS equipment with the above mentioned detectors in the project SLR/2/002 and with radiometric detector Canberra Packard 500TR. The obtained results are important mainly from the practical point of view for the determination of the sensitivity and robustness of LC/MS analysis, for the electrospray ionization (ESI) and the fragmentation of primary ions in CH3CN : 0,025 % NH4COOH = 4:1 solution. Some problems were identified during the analysis in relation with the detection of saccharides. It has been proved that DAD and RID detectors are not applicable in this chromatographic conditions due to their lower sensitivity, neither RID detector because of their unsuitable construction to be joint in-line before MSD. For the detailed study chromatographic system with column Asahipak NH2P-50 (Shodex) and with mobile phase acetonitrile-ammonium formate was selected, in which there is a good solubility for the saccharides and the signals of the mass spectrometric detector and can be well-differentiated from a relatively low background. Saccharides show in this mobile phase relatively simple and characteristic mass spectrum. Reaching of constant and reproducible retention times it is necessary to wash the column with the mobile phase at least 140 min before the measurements. Also the samples had to be prepared in the eluent, or it was necessary to dilute them to the composition of the eluent. From all the saccharides only for the 2-deoxyglucose we were not able to get a chromatographic peak with good resolution. The dependence of the retention times of saccharides was also investigated at different chromatographic conditions (column temperature, eluent

  19. Metformin and cancer: Technical and clinical implications for FDG-PET imaging

    Institute of Scientific and Technical Information of China (English)

    Selene; Capitanio; Cecilia; Marini; Gianmario; Sambuceti; Silvia; Morbelli

    2015-01-01

    Metformin is the most widely used hypoglycemic agent. Besides its conventional indications, increasing evidence demonstrate a potential efficacy of this biguanide as an anticancer drug. Possible mechanisms of actions seem to be independent from its hypoglycemic effect and seemto involve the interference with key pathways in cellular proliferation and glycolysis. To date, many clinical trials implying the use of metformin in cancer treatment are on-going. The increasing use of 18F-2-fluoro-2-deoxyd-glucose positron emission tomography(FDG-PET) in cancer evaluation raises a number of questions about the possible interference of the biguanide on FDG distribution. In particular, the interferences exerted by metformin on AMP-activated protein kinase pathway(the cellular energy sensor), on insulin levels and on Hexokinase could potentially have repercussion on glucose handling and thus on FDG distribution. A better comprehension of the impact of metformin on FDG uptake is needed in order to optimize the use of PET in this setting. This evaluation would be useful to ameliorate scans interpretation in diabetic patients under chronic metformin treatment and to critically interpret images in the context of clinical trials. Furthermore, collecting prospective data in this setting would help to verify whether FDG-PET could be a valid tool to appreciate the anticancer effect of this new therapeutic approach.

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

    International Nuclear Information System (INIS)

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

  1. Neurolymphomatosis on F 18 FDG PET/CT and MRI Findings: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Chae Moon; Lee, Sang Woo; Lee, Hong Je; Song, Bong Il; Kim, Hae Won; Kang, Sungmin; Jeong, Shin Young; Ahn, Byeong Cheol; Lee, Jaetae; Chae, Yee Soo [Kyungpook National Univ. Hospital, Daegu (Korea, Republic of)

    2011-03-15

    Neurolymphomatosis is a rare manifestation of malignant lymphoma. A 74 year old man, in complete remission from diffuse large B cell lymphoma, presented with a loss of pain and temperature sensation in the left hemiface and left upper extremity, and motor weakness in the left upper and both lower extremities. Cerebrospinal fluid analysis and brain magnetic resonance imaging (MRI) findings were negative. Combined fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) revealed multiple linear hypermetabolic lesions along the mandibular branch of the left trigeminal nerve, left brachial plexus, right adrenal gland, right femoral nerve, and both sciatic nerves, which corresponded to the patient's complex neurologic symptoms. C spine and pelvic MRI revealed diffuse thickening with enhancement in the left sciatic nerve, but negative findings for other sites identified by FDG PET/CT. These findings for other sites identified by FDG PET/CT. These findings suggest that FDG PET/CT can detect peripheral nerve infiltration by malignant lymphoma earlier than MRI. Thus, if a patient with a history of lymphoma presents with neurologic symptoms, FDG PET/CT should be performed to evaluate neurolymphomatosis.

  2. Business administration of PET facilities. A cost analysis of three facilities utilizing delivery FDG

    International Nuclear Information System (INIS)

    PET (positron emission tomography) has been proved to be a powerful imaging tool in clinical oncology. The number of PET facilities in Japan has remarkably increased over the last decade. Furthermore, the approval of delivery fluorodeoxyglucose (FDG) in 2005 resulted in a tremendous expansion of the PET institutions without a cyclotron facility. The aim of this study was to conduct a cost analysis of PET institutions that utilized delivery FDG. Three PET facilities using delivery FDG were investigated about the costs for PET service. Fixed costs included depreciation costs for construction and medical equipments such as positron camera. Variable costs consisted of costs for medical materials including delivery FDG. The break-even point was analyzed in each of three institutions. In the three hospitals (A, B and C), the annual number of PET scan was 1,591, 1,637 and 914, while cost per scan was accounted as 110,262 yen, 111,091 yen, and 134,192 yen, respectively. The break-even point was calculated to be 2,583, 2,679 and 2,081, respectively. PET facilities utilizing delivery FDG seemed to have difficulty in business administration. Such a situation suggests the possibility that the current supply of PET facilities might exceed actual demand for the service. The efficiency of resource allocation should be taken into consideration in the future health service researches on PET. (author)

  3. Parameter estimation for whole-body kinetic model of FDG metabolism

    Institute of Scientific and Technical Information of China (English)

    CUI Yunfeng; BAI Jing; CHEN Yingmao; TIAN Jiahe

    2006-01-01

    Based on the radioactive tracer [18F]2-fluoro-2-deoxy-D-glucose (FDG), positron emission tomography (PET), and compartment model, the tracer kinetic study has become an important method to investigate the glucose metabolic kinetics in human body.In this work, the kinetic parameters of three-compartment and four-parameter model for the FDG metabolism in the tissues of myocardium, lung, liver, stomach, spleen, pancreas, and marrow were estimated through some dynamic FDG-PET experiments. Together with published brain and skeletal muscle parameters, a relatively complete whole-body model was presented. In the liver model, the dual blood supply from the hepatic artery and the portal vein to the liver was considered for parameter estimation, and the more accurate results were obtained using the dual-input rather than the single arterial-input. The established whole-body model provides the functional information of FDG metabolism in human body. It can be used to further investigate the glucose metabolism, and also be used for the simulation and visualization of FDG metabolic process in human body.

  4. Demonstrations of AIDS-associated malignancies and infections at FDG PET-CT

    International Nuclear Information System (INIS)

    HIV infection results in profound alterations of immunologic function that render the patient severely immunocompromised, and susceptible to malignancies and opportunistic infections. Three AIDS-defining malignancies include Kaposi's sarcoma (KS), non-Hodgkin's lymphoma (NHL) and invasive cervical cancer. In AIDS patients, KS is often aggressive and multifocal, with visceral involvement and widespread cutaneous and nodal spread; NHL is always high grade and often widely disseminated at the time of diagnosis with frequent involvement of extranodal sites; cervical cancer is invasive and has greater likelihood of progression and metastasis. Although there are very sparse systemic data available in the literature, limited studies has shown that fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) is a valuable imaging technique in the diagnosis, staging, restaging and monitoring therapeutic response in these malignancies. In addition, a unique application of FDG PET/CT is the differentiation of cerebral lesions between lymphoma and toxoplasmosis in AIDS patients, which cannot be reliably achieved with either CT or MRI. HIV-associated opportunistic infections may involve different pathogens and multiple tissues, organs or systems. Some preliminary observations have revealed a promising role of FDG PET-CT in the diagnosis and identification of these infections such as tuberculosis, fever of unknown origin, pneumocystis pneumonia and candidiasis. However, it should be stressed that FDG PET-CT alone has no role in identifying the pathology of abnormalities. FDG PET-CT, at best, can localize the sites of abnormalities and impact on patient's management in clinical decision making. (author)

  5. Role of FDG-PET in initial workup of uterine cervical cancer

    International Nuclear Information System (INIS)

    FDG-PET is widely utilized in gynecologic malignancies. In uterine cervical cancer, although CT, MRI and PET are not included for the most widely used FIGO staging, they may provide useful information additional to clinical stage. We thus investigated the role of FDG-PET in the initial workup of uterine cervical cancer. A total of 85 newly diagnosed uterine cervical cancer patients were included (mean age 50±12yr). Patients previously treated for the cancer were excluded, but conization was an exception. Attenuation corrected whole body PET was interpreted by two nuclear medicine physicians. Suspicious malignant lesions on PET were confirmed by surgical biopsy or other imaging studies. Main tumor masses were detected by FDG-PET in 79 patients (93%). PET detected 15 iliac and 8 paraaortic lymph nodes with increased uptake that was suggested to be metastatic based on other modalities. Among patients who had surgical confirmation of lymph node status, 36 of 40 (90%) patients without lymph node metastasis had concordant PET findings, while PET correctly detected 5 of 16(31%) lymph node metastases. In 8/85 patients (9%), FDG-PET detected distant metastastic lesions which had not been detected by other modalities. Of these patients, treatment modality was changed in 1 and the radiation field was modified in 3 patients. FDG-PET is useful for detecting unidentified metastastic lesions in the initial workup of uterine cervical cancer, and may thus aid in decisions for optional therapeutic strategies

  6. Hilar activity on the F-18 FDG whole-body PET studies

    International Nuclear Information System (INIS)

    We evaluated the clinical characteristics of hilar activity that would be false positive findings for cancer screening on whole-body FDG PET. The cases with increased hilar activity were selected from 1,126 cases who received whole-body FDG PET between September 1996 and August 1997, and their age, sex, complication of inflammatory process in lungs, numbers of visualized mediastinal lymph nodes, frequency of smoking, blood sugar level and concentration of HbA1c were studied. FDG accumulation in the hilar regions was found in 63 cases (5.6%). The cases with increased hilar activity were older, a higher incidence of complication of pulmonary inflammation, a larger number of visualized mediastinal lymph nodes and were more frequent smokers than the control cases with normal FDG distribution. Their male-to-female ratio, blood sugar level and concentration of HbA1c were not significantly different from those of the control cases. These results suggested that an inflammatory process around the hilar region might induce this confusing FDG accumulation. (author)

  7. Coincidence FDG-PET in the evaluation of Langerhans' cell histiocytosis: preliminary findings

    Energy Technology Data Exchange (ETDEWEB)

    Binkovitz, Larry A.; Adler, Brent H. [Department of Radiology, Columbus Children' s Hospital, OH (United States); Olshefski, Randal S. [Department of Hematology and Oncology, Columbus Children' s Hospital, OH (United States)

    2003-09-01

    Bone involvement in Langerhans' cell histiocytosis (LCH) is common. Both bone scintigraphy and plain films are used to identify osseous lesions, but lack specificity for disease activity and response to therapy. FDG-PET is a sensitive technique for identifying bone lesions when histiocytes are present. To describe the potential of coincidence FDG-PET (cFDG-PET) for identification of active bone lesions in LCH and to determine whether it can provide more specific information regarding lesional response to therapy than bone scintigraphy or radiography. The clinical data and imaging findings of three patients with osseous lesions of LCH were retrospectively reviewed. cFDG-PET identified all active LCH osseous lesions in these patients, differentiated active from healed lesions, and demonstrated normalization of uptake in a treated lesion earlier than bone scintigraphy and radiography. cFDG-PET appears to have greater specificity than bone scintigraphy and radiography for the identification of active osseous lesions in LCH. It also may predict response to treatment earlier than conventional techniques. Its use in the evaluation of LCH warrants further study. (orig.)

  8. Coincidence FDG-PET in the evaluation of Langerhans' cell histiocytosis: preliminary findings

    International Nuclear Information System (INIS)

    Bone involvement in Langerhans' cell histiocytosis (LCH) is common. Both bone scintigraphy and plain films are used to identify osseous lesions, but lack specificity for disease activity and response to therapy. FDG-PET is a sensitive technique for identifying bone lesions when histiocytes are present. To describe the potential of coincidence FDG-PET (cFDG-PET) for identification of active bone lesions in LCH and to determine whether it can provide more specific information regarding lesional response to therapy than bone scintigraphy or radiography. The clinical data and imaging findings of three patients with osseous lesions of LCH were retrospectively reviewed. cFDG-PET identified all active LCH osseous lesions in these patients, differentiated active from healed lesions, and demonstrated normalization of uptake in a treated lesion earlier than bone scintigraphy and radiography. cFDG-PET appears to have greater specificity than bone scintigraphy and radiography for the identification of active osseous lesions in LCH. It also may predict response to treatment earlier than conventional techniques. Its use in the evaluation of LCH warrants further study. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  10. Quantitative Assessment of Heterogeneity in Tumor Metabolism Using FDG-PET

    International Nuclear Information System (INIS)

    Purpose: [18F]-fluorodeoxyglucose-positron emission tomography (FDG-PET) images are usually quantitatively analyzed in “whole-tumor” volumes of interest. Also parameters determined with dynamic PET acquisitions, such as the Patlak glucose metabolic rate (MRglc) and pharmacokinetic rate constants of two-tissue compartment modeling, are most often derived per lesion. We propose segmentation of tumors to determine tumor heterogeneity, potentially useful for dose-painting in radiotherapy and elucidating mechanisms of FDG uptake. Methods and Materials: In 41 patients with 104 lesions, dynamic FDG-PET was performed. On MRglc images, tumors were segmented in quartiles of background subtracted maximum MRglc (0%–25%, 25%–50%, 50%–75%, and 75%–100%). Pharmacokinetic analysis was performed using an irreversible two-tissue compartment model in the three segments with highest MRglc to determine the rate constants of FDG metabolism. Results: From the highest to the lowest quartile, significant decreases of uptake (K1), washout (k2), and phosphorylation (k3) rate constants were seen with significant increases in tissue blood volume fraction (Vb). Conclusions: Tumor regions with highest MRglc are characterized by high cellular uptake and phosphorylation rate constants with relatively low blood volume fractions. In regions with less metabolic activity, the blood volume fraction increases and cellular uptake, washout, and phosphorylation rate constants decrease. These results support the hypothesis that regional tumor glucose phosphorylation rate is not dependent on the transport of nutrients (i.e., FDG) to the tumor.

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

    International Nuclear Information System (INIS)

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

  12. FDG PET/CT dataset for navigation on femoral bone: a feasibility study.

    Science.gov (United States)

    Militz, Matthias; Uhde, Jörg; Christian, Georg; Linke, Rainer; Morgenstern, Mario; Hungerer, Sven

    2015-12-01

    FDG PET/CT has become a valuable tool in the diagnosis of the activity of chronic osteomyelitis. The surgical strategy in the treatment of chronic osteomyelitis is the identification of the bone focus and radical debridement of sequesters. The aim of the current study was the registration and use of the FDG PET/CT imaging datasets on a navigation system to provide diagnostic imaging based feedback during surgical procedures. For the present study, FDG PET/CT scans were acquired from artificial bones and cadaver bones with a local focus of activity. The DICOM data sets were merged using a navigation system. The referenced regions of interest were matched with fluoroscopic pictures to register the PET/CT DICOM datasets to the bone and direct visual control. Navigated targeting led to accurate results when verified with fluoroscopic images by targeting previously inserted reference points in artificial and cadaver bone. FDG PET/CT datasets are suitable for navigation and compatible with conventional planning and navigation software. The combination of diagnostic FDG PET/CT imaging with surgical navigation techniques could be a valuable tool for the accurate treatment of chronic osteomyelitis. PMID:26035105

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

    International Nuclear Information System (INIS)

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

  14. Precision of repeated quantitative FDG-PET scans in patients with untreated lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Minn, H.R.I.; Zasadny, K.R.; Quint, L.E. [Univ. of Michigan, Ann Arbor, MI (United States)] [and others

    1994-05-01

    The optimal mode for quantitation of F-18 fluorodeoxyglucose (FDG) uptake is uncertain when using PET in repeated studies of oncologic patients. We compared the reproducibility of the steady-state, graphical, and kinetic model derived FDG uptake measurements in six patients with primary lung cancer referred for thoracotomy. Prior to surgery, each patient underwent two 60 minute dynamic FDG-PET scans in the fasting state within three days. Images were analysed by placing 4x4 pixel ROIs over areas of maximum tumor tracer concentration and the left atrium (blood) to define kinetic uptake curves for tumor and blood FDG activity. {open_quotes}SUV lean{close_quotes} was determined based on tumor tracer concentration between 50-60 minutes from the injection corrected for injected activity and lean body mass. Graphically (KPatlak) and model (K1*k3/k2+k3) derived parameters for FDG uptake were calculated, as well as microrate constants (K1, k2 and k3). K4 was set=0 after initial studies showed it to be <0.01.

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

    DEFF Research Database (Denmark)

    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...

  16. Optimal feature selection for automated classification of FDG-PET in patients with suspected dementia

    Science.gov (United States)

    Serag, Ahmed; Wenzel, Fabian; Thiele, Frank; Buchert, Ralph; Young, Stewart

    2009-02-01

    FDG-PET is increasingly used for the evaluation of dementia patients, as major neurodegenerative disorders, such as Alzheimer's disease (AD), Lewy body dementia (LBD), and Frontotemporal dementia (FTD), have been shown to induce specific patterns of regional hypo-metabolism. However, the interpretation of FDG-PET images of patients with suspected dementia is not straightforward, since patients are imaged at different stages of progression of neurodegenerative disease, and the indications of reduced metabolism due to neurodegenerative disease appear slowly over time. Furthermore, different diseases can cause rather similar patterns of hypo-metabolism. Therefore, classification of FDG-PET images of patients with suspected dementia may lead to misdiagnosis. This work aims to find an optimal subset of features for automated classification, in order to improve classification accuracy of FDG-PET images in patients with suspected dementia. A novel feature selection method is proposed, and performance is compared to existing methods. The proposed approach adopts a combination of balanced class distributions and feature selection methods. This is demonstrated to provide high classification accuracy for classification of FDG-PET brain images of normal controls and dementia patients, comparable with alternative approaches, and provides a compact set of features selected.

  17. C-11 Choline and FDG PET/CT Imaging of Primary Cholangiocarcinoma – a Comparative Analysis

    Directory of Open Access Journals (Sweden)

    Chanisa Chotipanich

    2015-01-01

    Full Text Available Objective(s: This study aimed to compare the diagnostic values of 11C-choline and 18F-fluorodeoxyglucose (18F-FDG positron emission tomography/computed tomography (PET/CT in patients with cholangiocarcinoma (CCA. Methods: This prospective study was conducted on 10 patients (6 males and 4 females, aged 42-69 years, suspected of having CCA based on CT or magnetic resonance imaging (MRI results. 11C-choline and 18F-FDG PET/CT studies were performed in all patients over 1 week. PET/CT results were visually analyzed by 2 independent nuclear medicine physicians and quantitatively by calculating the tumor-to-background ratio (T/B. Results: No 11C-choline PET/CT uptake was observed in primary extrahepatic or intrahepatic CCA cases. Intense 18F-FDG avidity was detected in the tumors of 8 patients (%80. Two patients, who were 18F-FDG negative, had primary extrahepatic CCA. Ki-67 measurements were positive in all patients (range; 14.2%-39.9%. The average T/B values of 11C-choline and 18F-FDG were 0.4±0.2 and 2.0±1.0 in all cases of primary CCA, respectively; these values were significantly lower for 11C-choline (P

  18. Evaluation of efficacy and clinical impact of FDG-PET 27 patients with surgery of newly diagnosed colorectal cancer

    International Nuclear Information System (INIS)

    The aim of this study was to assess the potential clinical benefit of positron emission tomography (PET) with Fluorine-18-fluorodeoxyglucose (FDG) in patients with colorectal cancer. A total of 27 patients with surgery of newly diagnosed colorectal cancer who were examined preoperatively by FDG-PET between July 2002 and December 2004 were retrospectively analyzed in this study. FDG-PET detected 89% of primary tumors. FDG-PET depicted lymph node metastases in 4 of 9 patients (sensitivity, 44%) and true-negative in 17 of 18 patients (specificity, 94%). FDG-PET depicted liver metastases in 3 of 3 patients (sensitivity, 100%) and true-negative in 22 of 24 patients (specificity, 91%). A comparison of the FDG uptake and the clinicopathologic findings showed that there was no significant association between FDG uptake and the macro finding type, the depth of invasion and histological type. Five of 8 cases with a preoperative diagnosis as lymph-node negative were diagnosed histologically as lymph-node positive, in which the tumor was less than 10 mm in maximum horizontal size, so its size can be a significant factor. FDG-PET can serve as a valuable tool for detecting primary lesions with preoperative colorectal cancer. (author)

  19. 18F-FDG PET Increases Visibility of Bone Lesions in Relapsed Multiple Myeloma : Is This Hypoxia-Driven?

    NARCIS (Netherlands)

    de Waal, Esther G. M.; Slart, Riemer H. J. A.; Leene, Marnix J.; Kluin, Philip M.; Vellenga, Edo

    2015-01-01

    INTRODUCTION: Whole-body x-ray (WBX) is used for detecting skeleton abnormalities in patients with multiple myeloma (MM). An alternative might be F-FDG PET, which makes use of metabolic changes of malignant cells. The aims of this study were to evaluate whether F-FDG PET detects more lesions compare

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

    International Nuclear Information System (INIS)

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

  1. Ability of FDG-PET to detect all cancers in patients with familial adenomatous polyposis, and impact on clinical management

    International Nuclear Information System (INIS)

    Familial adenomatous polyposis (FAP) is characterised by colonic and duodenal adenomatous polyps that carry a risk of malignant transformation. Malignant degeneration of duodenal adenomas is difficult to detect. We speculated that 2-(18F)-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) might be able to detect early duodenal cancer in FAP. Accordingly, we investigated the role of FDG-PET in the management of FAP patients. FDG-PET was performed in 24 FAP patients. Eight had advanced duodenal adenomas (Spigelman IV), including two patients with duodenal cancer. Scans were defined as positive on the basis of focal FDG accumulation. Pathological FDG accumulation was absent in 19 of 24 patients. All six patients with Spigelman IV duodenal adenomas (without cancer) were negative; two of these underwent a duodenectomy and pathological examination did not reveal duodenal cancer. In five patients, FDG-PET revealed significant uptake, in the duodenum (2), lower abdomen (1), lung (1) and multiple sites in the abdomen (1). These hot spots correlated with duodenal cancer (2), abdominal metastasis (1) and sclerosing haemangioma of the lung (1). We failed to make a histopathological diagnosis in the single patient with multiple intra-abdominal sites of FDG uptake. None of the patients from the FDG-PET-negative group developed cancer during follow-up (mean 2.8 years). (orig.)

  2. Diagnostic performance of FDG PET/CT to detect subclinical HNSCC recurrence 6 months after the end of treatment

    Energy Technology Data Exchange (ETDEWEB)

    Robin, Philippe; Abgral, Ronan; Le Roux, Pierre-Yves; Keromnes, Nathalie; Palard, Xavier; Salaun, Pierre-Yves [University Hospital of Brest, Nuclear Medicine Department, Brest Cedex (France); Valette, Gerald; Potard, Gael; Marianowski, Remi [University Hospital of Brest, Department of Head and Neck Surgery, Brest (France); Rousset, Jean [Military Hospital of Brest, Department of Radiology, Brest (France)

    2015-01-15

    Posttreatment follow-up for the recurrence of head and neck squamous cell carcinoma (HNSCC) is a diagnostic challenge. Tissue distortion from radiation and surgery can obscure early detection of recurrence by conventional follow-up approaches such as physical examination or conventional imaging. Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT is widely validated for the diagnosis of suspected recurrence. Moreover, we have shown in a previous prospective study the high effectiveness of FDG PET/CT in the assessment of subclinical recurrence 12 months after treatment. The aim of this prospective study was to evaluate the effectiveness of an earlier FDG PET/CT, at 6 months after the end of treatment. All patients treated for histologically proven HNSCC from April 2009 to May 2012 at the University Hospital of Brest who did not show any findings suggestive of recurrence at 6 months of their usual follow-up underwent an FDG PET/CT examination. FDG PET/CT findings were correlated with histopathology or imaging follow-up. The study included 116 patients. FDG PET/CT examinations were performed within a mean period ± SD of 5.6 ± 1.8 months after treatment. FDG PET/CT examinations exhibited abnormal FDG uptake in 34 patients and found no suspected recurrence in 82 cases. Of these 82 FDG PET/CT considered as negative, only 1 had a recurrence. Among the 34 positive FDG PET/CT, 22 relapsed whereas 12 did not show evidence of recurrence. The sensitivity and specificity of FDG PET/CT in this study for the diagnosis of occult HNSCC recurrence were 96 (22/23) and 87 % (81/93), respectively. The positive predictive value was 65 % (22/34). The negative predictive value was 99 % (81/82). The overall accuracy was 89 % (103/116). Of the 116 patients, FDG PET/CT highlighted 22 (19 %) subclinical recurrences. Our study showed the high effectiveness of FDG PET/CT in the assessment of subclinical HNSCC recurrence 6 months after completion of treatment. These results

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

    Directory of Open Access Journals (Sweden)

    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

  4. 18F-FDG PET imaging of postoperative and post radiotherapeutic intracranial glioma compared with CT, MRI in 16 cases

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. Annihilation photon acollinearity in PET: volunteer and phantom FDG studies

    Energy Technology Data Exchange (ETDEWEB)

    Shibuya, Kengo [Department of Biophysics, Molecular Imaging Center, National Institute of Radiological Sciences, Anagawa 4-9-1, Inage, Chiba 263-8555 (Japan); Yoshida, Eiji [Department of Biophysics, Molecular Imaging Center, National Institute of Radiological Sciences, Anagawa 4-9-1, Inage, Chiba 263-8555 (Japan); Nishikido, Fumihiko [Department of Biophysics, Molecular Imaging Center, National Institute of Radiological Sciences, Anagawa 4-9-1, Inage, Chiba 263-8555 (Japan); Suzuki, Toshikazu [Department of Dose Assessment, Research Center for Radiation Emergency Medicine, National Institute of Radiological Sciences, Anagawa 4-9-1, Inage, Chiba 263-8555 (Japan); Tsuda, Tomoaki [Department of Biophysics, Molecular Imaging Center, National Institute of Radiological Sciences, Anagawa 4-9-1, Inage, Chiba 263-8555 (Japan); Inadama, Naoko [Department of Biophysics, Molecular Imaging Center, National Institute of Radiological Sciences, Anagawa 4-9-1, Inage, Chiba 263-8555 (Japan); Yamaya, Taiga [Department of Biophysics, Molecular Imaging Center, National Institute of Radiological Sciences, Anagawa 4-9-1, Inage, Chiba 263-8555 (Japan); Murayama, Hideo [Department of Biophysics, Molecular Imaging Center, National Institute of Radiological Sciences, Anagawa 4-9-1, Inage, Chiba 263-8555 (Japan)

    2007-09-07

    Annihilation photon acollinearity is a fundamental but little investigated problem in positron emission tomography (PET). In this paper, the cause of the angular deviation from 180.00{sup 0} is described as well as how to evaluate it under conditions of a spatially distributed radiation source and a limited acquisition time for the human body. A relationship between the shape of the photopeak spectrum and the angular distribution is formulated using conservation laws of momentum and energy over the pair annihilation. Then the formula is used to evaluate the acollinearity for a pool phantom and the human body with FDG injected. The angular distribution for the pool phantom agrees well with that for pure water which had been directly measured by Colombino et al in 1965 (Nuovo Cimento 38 707-23), and also with that for the human body determined in this study. Pure water can be considered as a good approximation of the human body regarding the angular deviation. The blurring coefficient to be multiplied by the ring diameter in calculations of the PET spatial resolution is experimentally determined for the first time as 0.00243 {+-} 0.00014; this is 10% larger than the value widely used by investigators.

  7. SPECT and FDG-PET in diagnostics of neurolues

    International Nuclear Information System (INIS)

    Syphilis is a recurrent treponematosis of acute and chronic evolution. In general it is either sexually or congenitally transmitted. Primary syphilis appears as a single and painless lesion. Secondary syphilis may manifest years later, the secondary bacteremic stage is accompanied by generalized mucocutaneous lesions. Tertiary disease can be disseminated to bones and virtually any organ, involving principally the ascending aorta and the central nervous system. Nuclear medicine provides diagnostic methods in case of skeletal manifestations by bone scan - identifying periostitis and osteomyelitis. Hepatic gummas can be imaged by 99m-Tc-colloid liver scintigraphy. In neurosyphilis brain perfusion SPECT enables imaging of cerebral involvement by small vessel endartheritis resulting from syphilitic vascular disease. 18-FDG PET is also useful to evaluate neurosyphilis, a reduction of brain glucose consumption is observed. The technique adequately enables imaging of therapeutic response and might be superior to morphologic imaging. We present our experiences with these nuclear medicine methods in patients with neurolues. The incidence of neurolues is estimated at 2 per 100.000 inhabitants worldwide, migration processes might bring a re-emergence of this disease to Austria and other developed countries of the EU. Scintigraphic methods should be kept in mind for diagnostic evaluation of neurosyphilis. (author)

  8. [SPECT and FDG-PET in diagnostics of neurolues].

    Science.gov (United States)

    Pichler, Robert; Doppler, Stefan; Szalay, Elisabeth; Hertl, Christine; Knell, Ulrich; Winkler, Johanna

    2008-01-01

    Syphilis is a recurrent treponematosis of acute and chronic evolution. In general it is either sexually or congenitally transmitted. Primary syphilis appears as a single and painless lesion. Secondary syphilis may manifest years later, the secondary bacteremic stage is accompanied by generalized mucocutaneous lesions. Tertiary disease can be disseminated to bones and virtually any organ, involving principally the ascending aorta and the central nervous system. Nuclear medicine provides diagnostic methods in case of skeletal manifestations by bone scan - identifying periostitis and osteomyelitis. Hepatic gummas can be imaged by 99m-Tc-colloid liver scintigraphy. In neurosyphilis brain perfusion SPECT enables imaging of cerebral involvement by small vessel endarteritis resulting from syphilitic vascular disease. 18-FDG PET is also useful to evaluate neurosyphilis, a reduction of brain glucose consumption is observed. The technique adequately enables imaging of therapeutic response and might be superior to morphologic imaging. We present our experiences with these nuclear medicine methods in patients with neurolues. The incidence of neurolues is estimated at 2 per 100.000 inhabitants worldwide, migration processes might bring a re-emergence of this disease to Austria and other developed countries of the EU. Scintigraphic methods should be kept in mind for diagnostic evaluation of neurosyphilis. PMID:19066767

  9. Annihilation photon acollinearity in PET: volunteer and phantom FDG studies

    International Nuclear Information System (INIS)

    Annihilation photon acollinearity is a fundamental but little investigated problem in positron emission tomography (PET). In this paper, the cause of the angular deviation from 180.000 is described as well as how to evaluate it under conditions of a spatially distributed radiation source and a limited acquisition time for the human body. A relationship between the shape of the photopeak spectrum and the angular distribution is formulated using conservation laws of momentum and energy over the pair annihilation. Then the formula is used to evaluate the acollinearity for a pool phantom and the human body with FDG injected. The angular distribution for the pool phantom agrees well with that for pure water which had been directly measured by Colombino et al in 1965 (Nuovo Cimento 38 707-23), and also with that for the human body determined in this study. Pure water can be considered as a good approximation of the human body regarding the angular deviation. The blurring coefficient to be multiplied by the ring diameter in calculations of the PET spatial resolution is experimentally determined for the first time as 0.00243 ± 0.00014; this is 10% larger than the value widely used by investigators

  10. Evaluation of high-risk melanoma: comparison of [18F]FDG PET and high-dose 67Ga SPET

    International Nuclear Information System (INIS)

    Recently the potential of whole-body positron emission tomography scanning using 18F-fluorodeoxyglucose (FDG PET) has led to renewed interest in the use of functional imaging for the detection of occult metastatic melanoma. This study compared dedicated FDG PET with high-dose gallium-67 imaging incorporating whole-body scanning and comprehensive single-photon emission tomography (SPET) in 122 cases (121 patients) in which the two scans were performed 67Ga SPET in 14 cases (including three incidental primary tumours) and was true negative in three further patients with abnormal 67Ga SPET. There were six patients with true positive 67Ga SPET in whom FDG PET was false negative (one small cutaneous deposit), one residual axillary node rated equivocal on FDG PET due to postoperative changes, one adrenal metastasis inseparable from renal activity on FDG PET and three cases in which sites missed on FDG PET were seen on 67Ga SPET. Thus, FDG PET provided incremental diagnostic information compared with 67Ga SPET in 17/23 patients, while 67Ga SPET provided incremental information compared with PET in 6/23 cases (P=0.035). Based on Australian Medicare reimbursement levels, the net cost per patient with clinical management benefit of replacing 67Ga SPET with FDG PET was estimated to be less than EUR 1,750. These results suggest that FDG PET provides incremental and clinically important information in around 10% of patients at a low incremental cost which, combined with greater patient convenience and lower radiation dosimetry, make FDG PET the functional imaging technique of choice for evaluation of suspected metastatic melanoma. (orig.)

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

    International Nuclear Information System (INIS)

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

  12. Use of FDG PET/CT for investigation of febrile neutropenia: evaluation in high-risk cancer patients

    International Nuclear Information System (INIS)

    Febrile neutropenia (FNP) is a frequent complication of cancer care and evaluation often fails to identify a cause. [18 F]FDG PET/CT has the potential to identify inflammatory and infectious foci, but its potential role as an investigation for persistent FNP has not previously been explored. The aim of this study was to prospectively evaluate the clinical utility of FDG PET/CT in patients with cancer and severe neutropenia and five or more days of persistent fever despite antibiotic therapy. Adult patients with a diagnosis of an underlying malignancy and persistent FNP (temperature ≥38 C and neutrophil count <500 cells/μl for 5 days) underwent FDG PET/CT as an adjunct to conventional evaluation and management. The study group comprised 20 patients with FNP who fulfilled the eligibility criteria and underwent FDG PET/CT in addition to conventional evaluation. The median neutrophil count on the day of the FDG PET/CT scan was 30 cells/μl (range 0-730 cells/μl). Conventional evaluation identified 14 distinct sites of infection, 13 (93 %) of which were also identified by FDG PET/CT, including all deep tissue infections. FDG PET/CT identified 9 additional likely infection sites, 8 of which were subsequently confirmed as ''true positives'' by further investigations. FDG PET/CT was deemed to be of 'high' clinical impact in 15 of the 20 patients (75 %). This study supports the utility of FDG PET/CT scanning in severely neutropenic patients with five or more days of fever. Further evaluation of the contribution of FDG PET/CT in the management of FNP across a range of underlying malignancies is required. (orig.)

  13. Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression

    Energy Technology Data Exchange (ETDEWEB)

    Blokhuis, Gijsbert J.; Diender, Marije G.; Oyen, Wim J.G. [Radboud University Medical Center, Department of Nuclear Medicine, Nijmegen (Netherlands); Bleeker-Rovers, Chantal P. [Radboud University Medical Center, Division of Infectious Diseases, Department of Internal Medicine, Nijmegen (Netherlands); Draaisma, Jos M.T. [Radboud University Medical Center, Department of Paediatrics, Nijmegen (Netherlands); Geus-Oei, Lioe-Fee de [Radboud University Medical Center, Department of Nuclear Medicine, Nijmegen (Netherlands); University of Twente, MIRA Institute for Biomedical Technology and Technical Medicine, Biomedical Photonic Imaging Group, Enschede (Netherlands)

    2014-10-15

    Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression. All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis. FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively. FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value. (orig.)

  14. Clinical evaluation of multidrug resistance associated protein expression by FDG PET and MIBI SPECT in lung cancer

    International Nuclear Information System (INIS)

    Multidrug resistance is one of the major obstacles in the successful anticancer therapy. The aim of this study is to evaluate whether FDG PET and MIBI SPECT can be markers for p-glycoprotein (Pgp), multidrug resistance-associated protein (MRP), lung resistance protein (LRP) expression in lung cancer tissues. Eighty-eight patients with 92 lung cancer lesions were enrolled in this study. Before surgery, FDG PET imaging was performed 40 min after injection of FDG 185 MBq, and standardized uptake values (SUVs) were obtained. MIBI SPECT imaging was performed 15 min and 3 hour after injection of MIBI 370 MBq. Early ratio (ER), delayed ratio (DR), and washout rate (WR) were obtained. Pgp, MRP, and LRP expression in lung cancer tissues were determined by immunohistochemical staining. No significant correlations were observed between MIBI uptake and expression of Pgp, MRP and LRP. FDG uptake significantly correlated with expression of Pgp and LRP. The lung cancer with high degree of Pgp and LRP expression had significantly low FDG uptake. However, there is no correlation between FDG uptake and MRP expression. Pgp and LRP expression of adenocarcinomas were significantly higher than that of squamous cell carcinomas. FDG uptake of adenocarcinomas were significantly lower than that of squamous cell carcinomas. In lung adenocarcinomas, Pgp and LRP expression of bronchioloalveolar carcinomas were significantly higher than that of poorly differentiated adenocarcinomas. In contrast, FDG uptake of bronchioloalveolar carcinomas were significantly low when compared with that of poorly differentiated adenocarcinomas. In addition, it was also suggested that biological behavior of LRP expression was similar to that of Pgp expression. FDG uptake may be a marker for Pgp and LRP expression but not for MRP expression in patients with lung cancer. Both Pgp, LRP expression and FDG uptake correlate with cellular differentiation and histological type. (author)

  15. Impact of Non-Insulin Dependent Type-2 Diabetes on Carotid Wall 18F-FDG-PET Uptake

    Science.gov (United States)

    Bucerius, Jan; Mani, Venkatesh; Moncrieff, Colin; Rudd, James H. F.; Machac, Josef; Fuster, Valentin; Farkouh, Michael E.; Fayad, Zahi A.

    2012-01-01

    Objective & Background Inflammation is a pivotal process in the progression of atherosclerosis, which can be non-invasively imaged by 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). In this study, the impact of non-insulin dependent type-2 diabetes on carotid wall FDG uptake in patients with documented or suspected cardiovascular disease was evaluated. Methods Carotid artery wall FDG uptake was quantified in 134 patients (age 60.2±9.7 years; diabetic subjects: n=43). The pre-scan glucose (gluc) level corrected mean of the maximum standardized uptake value (SUV) values (meanSUVgluc), mean of the maximum target-to-background ratio (meanTBRgluc), and Single Hottest Segment (SHSgluc) of FDG uptake in the artery wall were calculated. Associations between FDG uptake, the presence of risk factors for atherosclerosis, and diabetes were then assessed by multiple regression analysis with backward elimination. Results We demonstrated a significant association between diabetes and FDG uptake in the arterial wall (diabetes: meanSUVgluc; β=0.324, meanTBRgluc; β=0.317, and SHSgluc; β=0.298; for all: p<0.0001, respectively). In addition, in diabetic patients, both body mass index (BMI) ≥30 kg/m2 (BMI ≥30 kg/m2: meanSUVgluc; β=0.4, meanTBRgluc; β=0.357, and SHSgluc; β=0.388; for all: p<0.015) and smoking (smoking: meanTBRgluc; β=0.312, SHSgluc; β=0.324; for all: p<0.04) were significantly associated with FDG uptake. Conclusions Type-2 diabetes was significantly associated with carotid wall FDG uptake in patients with known or suspected cardiovascular disease. In diabetic patients, obesity and smoking add to the risk of increased FDG uptake values. Furthermore, the degree of carotid wall FDG uptake increases with increments of fasting glucose levels in diabetic patients. PMID:22651864

  16. Use of FDG PET/CT for investigation of febrile neutropenia: evaluation in high-risk cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Guy, Stephen D.; Tramontana, Adrian R. [Western Health, Department of Infectious Diseases, Private Bag, Footscray, Victoria (Australia); University of Melbourne, Parkville, Victoria (Australia); Worth, Leon J.; Thursky, Karin A.; Slavin, Monica A. [University of Melbourne, Parkville, Victoria (Australia); Peter MacCallum Cancer Centre, Department of Infectious Diseases, Melbourne, Victoria (Australia); Lau, Eddie; Hicks, Rodney J. [University of Melbourne, Parkville, Victoria (Australia); Peter MacCallum Cancer Centre, Centre for Cancer Imaging, Melbourne, Victoria (Australia); Seymour, John F. [University of Melbourne, Parkville, Victoria (Australia); Peter MacCallum Cancer Centre, Department of Haematology, Melbourne, Victoria (Australia)

    2012-08-15

    Febrile neutropenia (FNP) is a frequent complication of cancer care and evaluation often fails to identify a cause. [{sup 18} F]FDG PET/CT has the potential to identify inflammatory and infectious foci, but its potential role as an investigation for persistent FNP has not previously been explored. The aim of this study was to prospectively evaluate the clinical utility of FDG PET/CT in patients with cancer and severe neutropenia and five or more days of persistent fever despite antibiotic therapy. Adult patients with a diagnosis of an underlying malignancy and persistent FNP (temperature {>=}38 C and neutrophil count <500 cells/{mu}l for 5 days) underwent FDG PET/CT as an adjunct to conventional evaluation and management. The study group comprised 20 patients with FNP who fulfilled the eligibility criteria and underwent FDG PET/CT in addition to conventional evaluation. The median neutrophil count on the day of the FDG PET/CT scan was 30 cells/{mu}l (range 0-730 cells/{mu}l). Conventional evaluation identified 14 distinct sites of infection, 13 (93 %) of which were also identified by FDG PET/CT, including all deep tissue infections. FDG PET/CT identified 9 additional likely infection sites, 8 of which were subsequently confirmed as ''true positives'' by further investigations. FDG PET/CT was deemed to be of 'high' clinical impact in 15 of the 20 patients (75 %). This study supports the utility of FDG PET/CT scanning in severely neutropenic patients with five or more days of fever. Further evaluation of the contribution of FDG PET/CT in the management of FNP across a range of underlying malignancies is required. (orig.)

  17. Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression

    International Nuclear Information System (INIS)

    Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression. All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis. FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively. FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value. (orig.)

  18. Established, emerging and future applications of FDG-PET/CT in the uterine cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, K., E-mail: kitajima@med.kobe-u.ac.j [PET Diagnosis, Institute of Biomedical Research and Innovation, Kobe (Japan); Murakami, K. [Division of Nuclear Medicine, Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo (Japan); Kaji, Y. [Radiology, Dokkyo University School of Medicine, Mibu (Japan); Sakamoto, S. [PET center, Dokkyo Medical University Hospital, Mibu (Japan); Sugimura, K. [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan)

    2011-04-15

    Integrated positron emission tomography/computed tomography (PET/CT) with 2-[{sup 18}F]fluoro-2-deoxy-D-glucose (FDG) is a useful technique to acquire both glucose metabolic and anatomic imaging data using a single device in a single diagnostic session and has opened a new field in clinical oncologic imaging. FDG-PET/CT has been used successfully for the staging, optimization of treatment, re-staging, therapy monitoring, and prognostic prediction of uterine cervical cancer and endometrial cancer as well as various malignant tumours. The present review discusses the current role of FDG-PET/CT in the management of uterine cancer, discussing its usefulness and limitations in the imaging of these patients.

  19. Carcinoma en Cuirasse from Recurrent Breast Cancer seen on FDG-PET/CT

    Directory of Open Access Journals (Sweden)

    Aung Zaw Win

    2015-01-01

    Full Text Available Our patient was a 36-year-old female diagnosed with Grade II ER+/PR−/Her-2 − ductal carcinoma in situ (DCIS in the left breast. She underwent left lumpectomy and received treatment with tamoxifen and radiotherapy. Three years later, she presented with multiple diffused skin nodules on the chest and upper left arm. 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT exam showed widespread metastasis in the chest, upper left arm, left axillary lymph nodes, and left suprascapular muscle. FDG-PET/CT imaging of breast carcinoma en cuirasse is very rare. FDG-PET/CT is useful in detecting recurrent breast cancer.

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

    International Nuclear Information System (INIS)

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

  1. FDG PET/CT in oncology: 'raising the bar'

    Energy Technology Data Exchange (ETDEWEB)

    Patel, C.N. [Departments of Radiology and Nuclear Medicine, Churchill Hospital, Oxford Radcliffe NHS Trust, Oxford (United Kingdom); Goldstone, A.R.; Chowdhury, F.U. [Departments of Radiology and Nuclear Medicine, St James' s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Scarsbrook, A.F., E-mail: andrew.scarsbrook@leedsth.nhs.u [Departments of Radiology and Nuclear Medicine, St James' s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom)

    2010-07-15

    Integrated positron-emission tomography/computed tomography (PET/CT) with 2-[{sup 18}F]-fluoro-2-deoxy-D-glucose (FDG) has revolutionized oncological imaging in recent years and now has a firmly established role in a variety of tumour types. There have been simultaneous step-wise advances in scanner technology, which are yet to be exploited to their full potential in clinical practice. This article will review these technological developments and explore how refinements in imaging protocols can further improve the accuracy and efficacy of PET/CT in oncology. The promises, and limitations, of emerging oncological applications of FDG PET/CT in radiotherapy planning and therapy response assessment will be explored. Potential future developments, including the use of FDG PET probes in oncological surgery, advanced data analysis techniques, and the prospect of integrated PET/magnetic resonance imaging (PET/MRI) will be highlighted.

  2. False Positive FDG PET/CT of Recurrent Testicular Tumour Due to Orchitis

    Directory of Open Access Journals (Sweden)

    Robert Mansberg

    2014-02-01

    Full Text Available A 47-year-old male with a history of right sided orchidectomy for stage 1 seminoma 6 months previously, was referred for a FDG PETCT scan for restaging of testicular cancer having experiencing left testicular discomfort. Abnormally increased glyoclytic metabolism of the left testis and the inferior scrotal sac was demonstrated on the initial FDG PET-CT study. Subsequent ultrasound showed subtle heterogeneous echotexture with mild hypervascularity and no focal lesion was identified. The patient was subsequently treated with antibiotics for a presumed diagnosis of orchitis. A progress FDG PET-CT study 2 months later confirmed the complete resolution of the increased glycolytic metabolism in the left testis and the inferior scrotal sac.

  3. CT and 18FDG PET/CT findings of esophageal squamous cell papillomatosis: a case report

    International Nuclear Information System (INIS)

    Esophageal squamous cell papillomatosis is a rare disorder that is usually found incidentally on an upper gastrointestinal endoscopy examination or autopsy. A 70-year-old woman presented with a two-month history of dysphagia and abdominal discomfort. A chest CT scan showed diffuse marked thickening of the esophageal wall along the entire length and multiple small enhancing polypoid projections in the distal esophagus. Diffuse circumferential FDG uptake in the entire esophagus was seen on [18F] FDG PET/CT. Squamous papillomatosis was diagnosed by an endoscopic biopsy. We report a case of extensive esophageal papillomatosis with imaging features on CT and [18F] FDG PET/CT, with a review of the clinical literature

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-12-01

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

  10. Detection of Diffuse Infiltrative Primary Hepatic Lymphoma on FDG PET-CT: Hallmarks of Hepatic Superscan

    Science.gov (United States)

    Mahajan, Sonia; Kalra, Shefali; Chawla, Madhavi; Dougall, Pankaj

    2016-01-01

    Primary hepatic lymphoma (PHL) is an extremely rare entity with scarce information in evidence-based literature. Few case reports have described the role of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) in the diagnosing and staging of PHL. We report the case of a 78-year-old man with PHL who initially presented with weight loss and nonspecific fatigue. FDG PET-CT proved to be a beneficial tool in arriving at the diagnosis of this patient with nonspecific clinical presentation and also in the staging of PHL. Physiological uptake of FDG in the liver can be a potential cause of misinterpretation in such cases. Hence, knowing the imaging hallmarks can increase the accuracy in PET image interpretation. PMID:27134567

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  14. Observation on FDG myocardial uptake in patients of lymphoma undergoing treatment with Adriamycin: can (18F)FDG-PET be an early marker of chemotherapeutic cardiotoxicity

    International Nuclear Information System (INIS)

    Full text: Adriamycin is a commonly used chemotherapeutic agent in patients with cancer, having cardiotoxicity as its main side effect. This effect is through generation of free radicals and mitochondrial damage. Adriamycin produces hypoxia and decreases synthesis of ATP molecules by aerobic oxidation. To meet this energy synthesis-demand deficit, glycolysis is favored. Hence such 'injured' myocardial cells switch over to glucose as their main source of energy. Neuregulins are a family of growth factors which exert cytoprotection in Adriamycin treated myocytes. Increased glycolysis is one of the downregulatory signal in this pathway. (18F)FDG is concentrated in the myocardial cells via Glut receptors and acts as a marker of glucose metabolism. Based on the above facts, we decided to study the effects of adriamycin on glucose metabolism in myocardium in vivo, with the help of 18F-FDG PET. Aim: To observe (18F)FDG myocardial uptake in patients of lymphoma undergoing treatment with Adriamycin. Materials and Methods: A retrospective analysis was done from the data of (18F)FDG PET scan of lymphoma patients who have completed anthracycline chemotherapy and underwent the said scan for their routine evaluation. The cardiac processing was done separately and a polar map (Bulls eye) generated from the SA slices of the myocardial tracer activity of these patients. Mean SUV value was calculated for the above-mentioned map. This mean SUV calculated in both pre- and post-chemotherapy scans was compared and analysed. Results: 18 patients (16M and 2F with mean age: 32.66 ± 14.81 years) of lymphoma who underwent pre- and post-doxorubicin therapy formed part of the study. The mean dose of doxorubicin received was 227.7 ± 116.59 mg/M2 of BSA. Three different groups were identified among these cases, 1) Group A showing increase in cardiac FDG uptake in post doxorubicin PET scan. Mean dose of doxorubicin received was 256.25 mg/m2 of BSA. 2) Group B showing fall in myocardial FDG

  15. Advantage of delayed whole-body FDG-PET imaging for tumour detection

    International Nuclear Information System (INIS)

    Delayed imaging that coincides with the highest uptake of fluorine-18 fluorodeoxyglucose (FDG) by tumour may be advantageous in oncological positron emission tomography (PET), where delineation of metastasis from normal tissue background is important. In order to identify the better imaging protocol for tumour detection, whole-body FDG-PET images acquired at 1 h and 2 h after injection were evaluated in 22 subjects, with a post-injection transmission scan at 90 min for attenuation correction. After visual interpretation, tumour uptake [tumour standardised uptake ratio (SUR)], normal tissue uptake (normal SUR) and tumour to background contrast (tumour SUR/normal tissue SUR) were evaluated in the images acquired at 1 h and at 2 h. Most malignant lesions, including primary lung cancer, metastatic mediastinal lymph nodes and lymphoma lesions, showed higher FDG uptake at 2 h than at 1 h. By contrast, benign lesions, with the exception of sarcoidosis, showed lower uptake of FDG at 2 h than at 1 h. Among normal tissues, the kidney, liver, mediastinum, lung, upper abdomen and left abdomen showed significant falls in FDG uptake from 1 h to 2 h. The lower abdomen, right abdomen and muscles (shoulder and thigh) showed no significant changes. Consequently, malignant lesions of the lung, mediastinum and upper abdomen showed significant increases in tumour to background contrast from 1 to 2 h. Three lesions (two lung cancers and a malignant lymphoma) that were equivocal on 1-h images became evident on 2-h images, changing the results of interpretation. All other malignant lesions were detected on 1-h images, but were clearer, with higher contrast, on 2-h images. Lesion-based sensitivity was improved from 92% (49/53) to 98% (52/53), and patient-based sensitivity from 78% (14/18) to 94% (17/18). It is concluded that delayed whole-body FDG-PET imaging is a better and more reliable imaging protocol for tumour detection. (orig.)

  16. Addition of 18F-FDG-PET scans to radiotherapy planning of thoracic lymphoma

    International Nuclear Information System (INIS)

    Background and purpose: FDG-PET possesses greater sensitivity and accuracy than computed tomography (CT) in detecting diseased lymph nodes. Though the FDG-PET scans are acquired for similar diagnostic reasons as CT, they are not used in the radiotherapy (RT) planning process. Successful tumourcidal dose is usually delivered but large volumes of normal and non-malignant tissues are irradiated due to the nature of lymphoma and also to the subjectivity of the field determining process. This study tries to lessen the subjectivity of the field determining process by the addition of currently acquired PET to the conventional thoracic lymphoma RT. The differences between retrospectively delineated volumes from CT and FDG-PET were compared and the effect of this additional information was evaluated. Materials and methods: Seventeen FDG-PET scans were registered to corresponding CT scans using rigid-body registration with negligible intra-observer variability. Comparisons were made between the volumes, lateral extensions and the most inferior point of the delineated gross tumour volumes (GTVs). Results: For 1/17 patient data, no diseased volumes were delineated and in 6/17, no volumes were delineated on PET and yet in CT, masses up to 367.2 cm3 were outlined. From the 10 positive-CT and PET data, the GTVPET were smaller than GTVCT in six cases. Greater than 3.0 cm lateral disease extension differences were observed in 4/10 cases. Inferior tumour extents were confirmed in 6/10 cases whereas in 2/10 patients GTVCT was greater than 12.0 cm inferior compared to GTVPET. Conclusions: FDG-PET data can be introduced to current thoracic lymphoma RT planning protocol with minimal intervention and changes. The subjectivity in the RT planning of thoracic lymphoma would be decreased with the addition of currently acquired FDG-PET data

  17. The potential clinical value of FDG-PET for recurrent renal cell carcinoma

    International Nuclear Information System (INIS)

    Purpose: The clinical value of positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) for follow-up or suspected recurrence of renal cell carcinoma (RCC) has not been fully evaluated. The purpose of this study was to assess the diagnostic performance of FDG-PET for postoperative assessment in patients with RCC. Methods: We reviewed 28 scans in 23 patients who had undergone FDG-PET scans after surgery for RCC. Diagnostic accuracy of visually interpreted PET was evaluated based on final diagnoses obtained histologically or by clinical follow-up at least 6 months. Also, additional information over CT, influence on treatment decisions, and the accuracy of FDG uptake as a predictor of survival were assessed. Results: Recurrence of renal carcinoma was histologically (n = 15) or clinically (n = 6) confirmed in 21 of 28 cases. Overall, the sensitivity, specificity, and diagnostic accuracy using FDG-PET were 81%, 71%, and 79%, respectively. In papillary RCC, the sensitivity was 100%; however, that was 75% in clear cell RCC in patient-basis. PET correctly detected local recurrence and metastases in all cases in the peritoneum, bone, muscle and adrenal gland. Additional information was obtained from scans in 6 cases (21%), which influenced therapeutic management in 3 cases (11%). Cumulative survival rates over 5 years in the PET-positive vs. the PET-negative group were 46% vs. 83%, respectively (p = 0.17). Conclusions: FDG-PET would be useful for postoperative surveillance in patients with RCC, although its impact on treatment decisions may be limited. Further investigations are necessary to conclude whether PET has a prognostic value.

  18. The potential clinical value of FDG-PET for recurrent renal cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Nakatani, Koya, E-mail: koyakn@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-Ku, Kyoto 606-8507 Japan (Japan); Nakamoto, Yuji, E-mail: 9709.ynakamo1@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-Ku, Kyoto 606-8507 Japan (Japan); Saga, Tsuneo, E-mail: saga@nirs.go.jp [Department of Diagnostic Imaging Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-Ku, Chiba 263-8555 (Japan); Higashi, Tatsuya, E-mail: higashi@shigamed.jp [Research Institute, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama City, Shiga 524-8524 Japan (Japan); Togashi, Kaori, E-mail: ktogashi@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-Ku, Kyoto 606-8507 Japan (Japan)

    2011-07-15

    Purpose: The clinical value of positron emission tomography (PET) using {sup 18}F-fluorodeoxyglucose (FDG) for follow-up or suspected recurrence of renal cell carcinoma (RCC) has not been fully evaluated. The purpose of this study was to assess the diagnostic performance of FDG-PET for postoperative assessment in patients with RCC. Methods: We reviewed 28 scans in 23 patients who had undergone FDG-PET scans after surgery for RCC. Diagnostic accuracy of visually interpreted PET was evaluated based on final diagnoses obtained histologically or by clinical follow-up at least 6 months. Also, additional information over CT, influence on treatment decisions, and the accuracy of FDG uptake as a predictor of survival were assessed. Results: Recurrence of renal carcinoma was histologically (n = 15) or clinically (n = 6) confirmed in 21 of 28 cases. Overall, the sensitivity, specificity, and diagnostic accuracy using FDG-PET were 81%, 71%, and 79%, respectively. In papillary RCC, the sensitivity was 100%; however, that was 75% in clear cell RCC in patient-basis. PET correctly detected local recurrence and metastases in all cases in the peritoneum, bone, muscle and adrenal gland. Additional information was obtained from scans in 6 cases (21%), which influenced therapeutic management in 3 cases (11%). Cumulative survival rates over 5 years in the PET-positive vs. the PET-negative group were 46% vs. 83%, respectively (p = 0.17). Conclusions: FDG-PET would be useful for postoperative surveillance in patients with RCC, although its impact on treatment decisions may be limited. Further investigations are necessary to conclude whether PET has a prognostic value.

  19. 18F-FDG PET: early postoperative period of oro-maxillo-facial flaps

    International Nuclear Information System (INIS)

    Aim: We addressed the feasibility of FDG-PET to differentiate between viability and non-viability in the immediate postoperative assessment of flaps (autologous microvascular anastomosed pedicled flaps) in oro-maxillofacial surgery. Methods: 3-7 days after surgery, FDG-PET was done in 38 patients who had received flaps for reconstruction of the mandible after partial resection. The studies were done on a dedicated full ring PET-scanner (ECAT EXACT HR+, Siemens/CTI). Acquisition started between 60 and 80 min post injection. The findings of the tissue component of the flaps were grouped using a three point scale: (I) no defect, (II) small defects, (III) one large defect. The results of PET were compared with the clinical course for at least 3 months. Results: ''No defect'' on the FDG-PET study identified viability of the flap and predicted normal clinical follow-up (22/38 patients). ''Small defects'' visualized areas of decreased perfusion and decreased glucose metabolism indicating risk of non-viability (13/38 patients); adapting the postsurgical management led to delayed but uncomplicated healing of the flaps in these patients. ''One large defect'' demonstrated early necrosis of the flap (3/38 patients). After removal and replacement of this necrotic portion of the flap the second FDG-PET scan of these 3 patients demonstrated the uncomplicated post-operative healing. Conclusion: FDG-PET facilitated the assessment of viability and non viability flaps in the immediate postsurgical period, and demonstrated the usefulness of FDG-PET for postoperative care and prognosis. (orig.)

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

    International Nuclear Information System (INIS)

    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)

  1. Incidental ovarian {sup 18}F-FDG accumulation on PET: correlation with the menstrual cycle

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seok-Ki; Kang, Keon Wook; Roh, Ju Won; Sim, Jung Suk; Lee, Eun Sook; Park, Sang-Yoon [Research Institute and Hospital, National Cancer Center, Gyeonggi (Korea)

    2005-07-01

    The aim of this study was to determine the nature of incidental ovarian {sup 18}F-fluoro-2-deoxyglucose (FDG) accumulation on positron emission tomography (PET) and the correlation with the menstrual cycle and menopause. We identified 19 incidental FDG accumulations in the ovary (FAOs). FDG PET images were compared with other anatomical imaging methods [magnetic resonance imaging (MRI), computed tomography (CT) or ultrasonography (US)]. Pathological findings, FDG PET scan during the next menstrual cycle and follow-up images (PET, CT and MRI) were reviewed. To establish the relation of FAOs to the menstrual cycle, we reviewed whole-body FDG PET acquired from 207 consecutive women and the pre-examination questionnaires, including data regarding the menstrual cycle. All spherical or discoid FAOs were attributed to normally developing ovarian follicles and corpora lutea on the basis of concurrent MRI, US or the follow-up PET scan. Three of the FAOs were proved pathologically to be either normal ovaries or a haemorrhagic corpus luteum. Fifteen FAOs spontaneously disappeared on the short-term follow-up PET scans. Of 207 women, 61 had active menstrual cycles. FAOs were found in 12 out of 61 premenopausal women (20%), appearing between the 10th and 25th days of the menstrual cycle. No FAOs were found in the women who did not have a menstrual cycle. Physiological ovarian FDG accumulation could be found around the time of ovulation and during the early luteal phase of the menstrual cycle in premenopausal woman. Since FAO is dependent on the menstrual cycle, it can be avoided by scheduling PET just after menstruation. (orig.)

  2. The role of FDG-PET/CT in the detection of recurrent colorectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Votrubova, Jana; Belohlavek, Otakar; Jaruskova, Monika [Na Homolce Hospital, PET Centre, Prague (Czech Republic); Oliverius, Martin [Institute of Clinical and Experimental Medicine, Prague (Czech Republic); Lohynska, Radka [University Hospital Motol, Department of Radiotherapy and Oncology, Prague (Czech Republic); Trskova, Kristina [Na Homolce Hospital, Department of Oncology, Prague (Czech Republic); Sedlackova, Eva [General Teaching Hospital and 1st Faculty of Medicine, Department of Oncology, Prague (Czech Republic); Lipska, Ludmila [Thomayer' s Teaching Hospital and 1st Faculty of Medicine, Department of Surgery, Prague (Czech Republic); Stahalova, Vladimira [Na Bulovce Teaching Hospital, Institute of Radiation Oncology, Prague (Czech Republic)

    2006-07-15

    The conventional diagnostic techniques used to assess recurrence of colorectal cancer (CRCR) often yield unspecific findings. Integrated FDG-PET/CT seems to offer promise for the differential diagnosis of benign and malignant lesions. The aim of this study was to compare the value of FDG-PET and PET/CT in the detection of CRCR subsequent to colonic resection or rectal amputation. The population for this retrospective study comprised 84 patients with suspected CRCR. The sensitivity, specificity and accuracy of PET and PET/CT were calculated for (a) intra-abdominal extrahepatic recurrences, (b) extra-abdominal and/or hepatic recurrences and (c) all recurrences, and tumour marker levels were analysed. The sensitivity, specificity and overall accuracy of PET in detecting intra-abdominal extrahepatic CRCR were 82%, 88% and 86%, respectively, compared with 88%, 94% and 92%, respectively, for PET/CT. The corresponding figures for detection of extra-abdominal and/or hepatic CRCR were 74%, 88% and 85% for PET and 95%, 100% and 99% for PET/CT. Considering the entire population, the sensitivity, specificity and overall accuracy of PET were 80%, 69% and 75%, respectively, compared with 89%, 92% and 90%, respectively, for PET/CT. FDG-PET/CT examination correctly detected 40 out of a total of 45 patients with CRCR. Two of five patients with falsely negative FDG-PET/CT findings had local microscopic recurrences and one had miliary liver metastases. Of 39 patients without CRCR, three showed false positive FDG-PET/CT results. Two of these cases were due to increased accumulation in inflammatory foci in the bowel wall, while one was due to haemorrhaging into the adrenal gland. FDG-PET/CT appears to be a very promising method for distinguishing a viable tumour from fibrous changes, thereby avoiding unnecessary laparotomy. (orig.)

  3. An analysis of the physiological FDG uptake in the stomach with the water gastric distention method

    International Nuclear Information System (INIS)

    Physiological FDG uptake in the stomach is a common phenomenon, especially noted at the cardia. Water intake just before scanning will result in gastric distention and thinning of the gastric wall, which in turn may lead to a reduction in the physiological uptake in the gastric wall. In the current study, we investigated whether gastric distention by water intake just before PET imaging reduces physiological FDG uptake in the stomach. The patient population comprised 60 patients who underwent whole-body FDG-PET imaging for cancer screening following gastroscopy performed within the preceding week. All patients took 400 ml of water for hydration and were administered 185 MBq of FDG intravenously. The patients were randomly divided into two groups: a group with additional water intake (AW group; n = 30) and a group without additional water intake (NW group; n = 30). In the AW group, an additional 400 ml of water was given just before PET imaging. For quantitative analysis, the stomach was classified into three areas [upper (U), middle (M) and lower (L)], and the degree of FDG uptake in each area was evaluated using standardised uptake values (SUVs). In the NW group, the mean SUVs in the U, M and L areas were 2.41 ± 0.75, 2.28 ± 0.73 and 1.61 ± 0.89, respectively, while in the AW group they were 1.82 ± 0.66, 1.73 ± 0.56 and 1.48 ± 0.49, respectively, and 2.21 ± 0.38 in the oesophago-gastric junction. The mean SUVs in the U and M areas in the AW group were significantly lower than those in the NW group (p < 0.05). Additional water intake just before PET imaging is an effective method for suppressing physiological FDG uptake in the stomach. (orig.)

  4. An analysis of the physiological FDG uptake in the stomach with the water gastric distention method

    Energy Technology Data Exchange (ETDEWEB)

    Kamimura, Kiyohisa [Fujimoto Hayasuzu Hospital, Department of Radiology, Miyazaki (Japan); Kagoshima University Graduate School of Medical and Dental Sciences, Department of Radiology, Kagoshima (Japan); Fujita, Seigo; Yano, Tatsuhiko; Ogita, Mikio; Umemura, Yoshiro; Fujimoto, Toshiro [Fujimoto Hayasuzu Hospital, Department of Radiology, Miyazaki (Japan); Nishii, Ryuichi; Wakamatsu, Hideyuki; Nagamachi, Shigeki [Miyazaki Medical College, Department of Radiology, Miyazaki (Japan); Nakajo, Masayuki [Kagoshima University Graduate School of Medical and Dental Sciences, Department of Radiology, Kagoshima (Japan)

    2007-11-15

    Physiological FDG uptake in the stomach is a common phenomenon, especially noted at the cardia. Water intake just before scanning will result in gastric distention and thinning of the gastric wall, which in turn may lead to a reduction in the physiological uptake in the gastric wall. In the current study, we investigated whether gastric distention by water intake just before PET imaging reduces physiological FDG uptake in the stomach. The patient population comprised 60 patients who underwent whole-body FDG-PET imaging for cancer screening following gastroscopy performed within the preceding week. All patients took 400 ml of water for hydration and were administered 185 MBq of FDG intravenously. The patients were randomly divided into two groups: a group with additional water intake (AW group; n = 30) and a group without additional water intake (NW group; n = 30). In the AW group, an additional 400 ml of water was given just before PET imaging. For quantitative analysis, the stomach was classified into three areas [upper (U), middle (M) and lower (L)], and the degree of FDG uptake in each area was evaluated using standardised uptake values (SUVs). In the NW group, the mean SUVs in the U, M and L areas were 2.41 {+-} 0.75, 2.28 {+-} 0.73 and 1.61 {+-} 0.89, respectively, while in the AW group they were 1.82 {+-} 0.66, 1.73 {+-} 0.56 and 1.48 {+-} 0.49, respectively, and 2.21 {+-} 0.38 in the oesophago-gastric junction. The mean SUVs in the U and M areas in the AW group were significantly lower than those in the NW group (p < 0.05). Additional water intake just before PET imaging is an effective method for suppressing physiological FDG uptake in the stomach. (orig.)

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

    International Nuclear Information System (INIS)

    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)

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  8. FDG uptake in PET imaging correlates with DNA ploidy in non small cell lung carcinoma

    International Nuclear Information System (INIS)

    Objective: DNA ploidy analysis of resected tumor tissue to grade the malignancy is of prognostic value for patients with non-small cell lung cancer (NSCLC). 18F-fluorodeoxyglucose (FDG) imaging has been proven useful for tumor staging. In this study, the authors evaluated whether 18F-FDG uptake within the primary lesion correlates with DNA ploidy of tumors in patients with NSCLC. Methods: Forty-nine patients with histologically proven NSCLC underwent whole-body FDG PET 45-90 min after i.v. injection of 6 MBq/kg body weight of 18F-FDG prior to surgery, and the primary tumor FDG uptake on PET images was quantified with the standardized uptake value (SUV) and metabolic tumor diameter (MTD). The DNA content and DNA-malignancy grading (DNA-MG) of Schiff-stained nuclei obtained from fresh tumor fragments taken from these patients during the surgery were evaluated by means of image cytometry. The correlation between SUV and MTD and between SUV and 2c deviation index (2cDI) or between SUV and DNA-MG were analyzed using linear fit. Results: The primary tumors as well as metastatic lymph nodes of the total 49 patients were well present on PET images, so that the result data of SUV and MTD were demonstrated satisfactorily. Of the DNA histograms of these 49 patients, 46(93.88%) were aneuploid and only 3(6.12%) were tetraploid. A linear correlation of the SUV versus the MTD (r = 0.632, P 18F-FDG PET as a non-invasive metabolic imaging technique, may also provide correlated information between SUV and DNA contents, 2cDI or DNA-MG, which may be valuable in malignancy differentiation and prognostic predication

  9. Malignancy rate of biopsied suspicious bone lesions identified on FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Hugo J.A.; Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Klerk, John M.H. de [Meander Medical Center, Department of Nuclear Medicine, Amersfoort (Netherlands); Heggelman, Ben G.F. [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Dubois, Stefan V. [Meander Medical Center, Department of Pathology, Amersfoort (Netherlands)

    2016-07-15

    To determine the malignancy rate of bone lesions identified on FDG PET/CT in patients who have undergone CT-guided biopsy because of the suspicion of malignancy. This single-centre retrospective study spanned eight consecutive years and included all patients who underwent both FDG PET/CT and CT-guided bone biopsy because of the suspicion of malignancy. The positive predictive value (PPV) for malignancy was calculated, and different patient and imaging characteristics were compared between malignant and benign bone lesions. Of 102 included patients with bone lesions that all showed FDG uptake exceeding mediastinal uptake, bone biopsy showed a malignant lesion in 91 patients, yielding a PPV for malignancy of 89.2 % (95 % CI 81.7 - 93.9 %). In the 94 patients with bone lesions that showed FDG uptake exceeding liver uptake, bone biopsy showed a malignant lesion in 83 patients, yielding a PPV for malignancy of 88.3 % (95 % CI 80.1 - 93.5 %). Higher age, bone marrow replacement of the lesion seen on CT, expansion of the lesion seen on CT, and presence of multifocal lesions on FDG PET/CT were significantly more frequent in patients with malignant lesions than in those with benign bone lesions (P = 0.044, P = 0.009, P = 0.015, and P = 0.019, respectively). Furthermore, there was a trend towards a higher incidence of cortical destruction (P = 0.056) and surrounding soft tissue mass (P = 0.063) in patients with malignant bone lesions. The PPV for malignancy of suspicious bone lesions identified on FDG PET/CT is not sufficiently high to justify changes in patient management without histopathological confirmation. Nevertheless, ancillary patient and imaging characteristics may increase the likelihood of a malignant bone lesion. (orig.)

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

    International Nuclear Information System (INIS)

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

  11. Pre-radiotherapy FDG PET predicts radiation pneumonitis in lung cancer

    International Nuclear Information System (INIS)

    A retrospective analysis is performed to determine if pre-treatment [18 F]-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG PET/CT) image derived parameters can predict radiation pneumonitis (RP) clinical symptoms in lung cancer patients. We retrospectively studied 100 non-small cell lung cancer (NSCLC) patients who underwent FDG PET/CT imaging before initiation of radiotherapy (RT). Pneumonitis symptoms were evaluated using the Common Terminology Criteria for Adverse Events version 4.0 (CTCAEv4) from the consensus of 5 clinicians. Using the cumulative distribution of pre-treatment standard uptake values (SUV) within the lungs, the 80th to 95th percentile SUV values (SUV80 to SUV95) were determined. The effect of pre-RT FDG uptake, dose, patient and treatment characteristics on pulmonary toxicity was studied using multiple logistic regression. The study subjects were treated with 3D conformal RT (n = 23), intensity modulated RT (n = 64), and proton therapy (n = 13). Multiple logistic regression analysis demonstrated that elevated pre-RT lung FDG uptake on staging FDG PET was related to development of RP symptoms after RT. A patient of average age and V30 with SUV95 = 1.5 was an estimated 6.9 times more likely to develop grade ≥ 2 radiation pneumonitis when compared to a patient with SUV95 = 0.5 of the same age and identical V30. Receiver operating characteristic curve analysis showed the area under the curve was 0.78 (95% CI = 0.69 – 0.87). The CT imaging and dosimetry parameters were found to be poor predictors of RP symptoms. The pretreatment pulmonary FDG uptake, as quantified by the SUV95, predicted symptoms of RP in this study. Elevation in this pre-treatment biomarker identifies a patient group at high risk for post-treatment symptomatic RP

  12. FDG uptake at the bronchial stump after curative lobectomy for non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Keyzer, Caroline; Corbusier, Florence; Kyratzi, Eirini; Gevenois, Pierre Alain [Universite libre de Bruxelles, Department of Radiology, Hopital Erasme, Brussels (Belgium); Sokolow, Youri [Universite libre de Bruxelles, Department of Thoracic Surgery, Hopital Erasme, Brussels (Belgium); Goldman, Serge [Universite libre de Bruxelles, Department of Nuclear Medicine, Hopital Erasme, Brussels (Belgium)

    2016-05-15

    Focal areas of FDG uptake may occur at the bronchial stump following curative lobectomy for non-small-cell lung carcinoma (NSCLC), even in the absence of suspicious CT changes. The purpose of our study was to investigate the significance of such PET/CT findings. FDG-PET/CT scans performed in 54 patients after lobectomy for NSCLC were reviewed. The presence of focal areas of FDG uptake at the bronchial stump, associated CT abnormalities, SUVmax, and normalized SUV (SUVnorm = SUVmax/mean liver SUV) were recorded. Final diagnosis was based on biopsy or imaging follow-up. Focal areas of FDG uptake at the bronchial stump were detected in 30 patients (56 %). Mean SUVmax was 4.0 ± 1.9 (range; 2.2-12.1) and mean SUVnorm was 1.8 ± 0.8 (range; 0.9-4.5). Biopsy showed recurrence in two patients. In these patients, SUVnorm was respectively 4.4 and 4.5 (with SUVmax of 8.8 and 12.1), whereas SUVnorm was lower than 4.0 in those without recurrence, with mean SUVnorm of 1.6 ± 0.5 (range; 0.9-3.4) and mean SUVmax of 3.6 ± 0.9 (range; 2.2-5.8). The CT component of the PET/CT revealed ill-defined peribronchial soft tissue opacity only in both patients with recurrence. FDG uptake at the bronchial stump is a frequent finding after pulmonary lobectomy. Moderate levels of FDG uptake (i.e., SUVnorm < 4.0) without corresponding abnormal CT findings might be a dual criterion for diagnosing benign post-surgical changes. (orig.)

  13. FDG imaging of the infected knee prosthesis: Analysis of periprosthetic uptake patterns

    International Nuclear Information System (INIS)

    Objectives: There are several reports regarding 18F-FDG PET (FDG) and the infected joint replacement. Although most studies indicate high sensitivity, specificity is more variable. There are data to suggest that the accuracy of FDG imaging can be improved by analysing patterns of periprosthetic activity. We, therefore, undertook this retrospective review to identify and analyse the periprosthetic FDG uptake patterns around knee replacements. Methods: 23 pts, 9 male, 14 female, 35-85 years old, with 33 knee prostheses, including 10 asymptomatic devices, 1 week to 19 years old, were included. 31 were primary implants; 30 cemented and 1 cementless. 2 were revisions; both cemented. Patients underwent imaging one hour after FDG injection. Attenuation corrected data, reconstructed in transverse, coronal and sagittal planes, were jointly reviewed by two experienced nuclear physicians without knowledge of other test results or of final diagnoses. The presence of periprosthetic uptake and the location of such uptake was noted. Uptake was classified as being synovial and/or joint space, or at the bone/ prosthesis interface. Results: There were 13 infected and 10 aseptically loosened prostheses among the 23 symptomatic devices, all of which were histopathologically confirmed. The 10 asymptomatic prostheses were considered normal. Imaging results are presented. Increased periprosthetic activity was present around 31/33 knee prostheses: all 23 symptomatic prostheses and 8/10 asymptomatic ones. Increased activity within the synovium/joint space was observed in the majority of patients with no relationship to the presence or absence of any postoperative complication. Bone/prosthesis interface activity was present in patients with infected, as well as aseptically loosened devices. This pattern was not seen in the asymptomatic prostheses. Conclusions: Increased periprosthetic FDG uptake is present in the majority of patients with knee prostheses, symptomatic or not. These uptake

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

    International Nuclear Information System (INIS)

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

  15. Diagnostic evaluation of solitary pulmonary nodules (SPNs) using PET-FDG imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, N.; Chandramouli, B.; Reeb, S. [Creighton Univ., Omaha, NE (United States)] [and others

    1994-05-01

    We have reported high sensitivity of PET-FDG imaging in detecting malignancy in SPNs. We now report clinical utility of PET-FDG imaging in pre-intervention workup of 66 pts (age 24-89 yrs) with radiographically indeterminate SPNs (0.5-3 cm) in size. All pts had PET imaging performed 1 hr after injection of 10 mCi of F-18 FDG. Images were analyzed qualitatively and semi-quantitatively to compute DUR indices using ROI analysis. Final diagnosis was established by histology in 65/66 pts (thoracotomy 47, needle biopsy 13, bronchoscopy 5, stable nodule 1). PET-FDG imaging demonstrates sensitivity, specificity and predictive accuracy of 94%, 87% and 92% respectively. All 3 false negative cases were SPNs <1.5 cm in size and histologically adenoca. True positive malignant SPNs were adenoca 18, small cell 5, squamous cell 12, nonsmall cell 7, and others 6. Among 15 benign lesions (granuloma 6, histoplasmosis 4, nonspecific inflammation 2, hamartoma 1, stable nodule 1, organizing pneumonia 1), 2 false positive cases were seen in histoplasmosis. In 10 patients hilar/mediastinal lymph node lesions were accurately classified as benign (5) or malignant (5). Mean DUR in malignant lesions (5.41{plus_minus}2.63) was significantly greater (p value <0.001) than benign lesions (1.12{plus_minus}0.78). In conclusion, PET-FDG imaging is highly accurate in differentiating benign from malignant lung modules and lymph node lesions. PET-FDG imaging may thus optimize surgical management of pts with radiographically SPNs.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-10-01

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

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

    International Nuclear Information System (INIS)

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

  18. Peripheral tuberculous lymphadenitis masquerading as metastatic gastric carcinoma on F 18 FDG dual time point PET/CT

    International Nuclear Information System (INIS)

    A 59 year old woman was hospitalized with weight loss, anorexia, and low grade fever for 2 weeks. she had under gone a total gastrectomy followed by adjuvant chemotherapy 10 years prior due to advanced gastric cancer to evaluate recurrence, fluorine 19 fluorodeoxyglucose (FDG) dual time point positron emission tomography/computed tomography (DTPP) was conducted with a gemini GXL 6 PET/CT system (Philips, Hamburg, Germany). FDG DTPP was performed twice, with an early scan 60 min after FDG injection and a delayed scan 150min after FDG injection. The early scan showed that multiple hypermetabolic lesions were located along left supraclavicular, mediastinal (1R, 2R, 3, 4R and 7) and left paraaortic (retroperitoneal) nodal stations. The delayed scan showed that all the above mentioned lesions revealed a more increased maximal standard uptake value (SUVmax) than was detected in the early scan. both scans did not show intrapulmonary lesion. For example, the left supraclavicular lymph node, 2R and retroperitoneal lymph node were observed with early and delayed SUV maxes of 4.5/7.6/3.6 and 6.7/7.7/3.6 and 6.7/10.7/4.4, respectively. Tom confirm diagnosis and establish a treatment plan, a mediastinoscopic biopsy of one of the mediastinal lymph nodes (4R) was subsequently performed and tuberculosis was ultimately diagnosed. Then, the patient started an antituberculosis treatment instead of antichemotherapy. A follow up FDG PET/CT performed 12 months later showed disappeared FDG uptake and significant decreased change of multiple peripheral tuberculous lymphadenitis. Whole body FDG PET/CT has widespread use in diagnosing and staging variable malignancies, and plays an important role in detection of gastric cancer recurrence. However, FDG is not cancer specific and some inflammatory diseases have shown higher FDG uptake on PET imaging. Infection, inflammation, and granulomatosis are also known to cause false positive FDG PET scans because activated inflammatory cells show

  19. Peripheral tuberculous lymphadenitis masquerading as metastatic gastric carcinoma on F 18 FDG dual time point PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Su Kon; Shin, Jeong Eun; Lee, Jai Hyuen [Dankook Univ. College of Medicine, Cheonan (Korea, Republic of)

    2012-12-15

    A 59 year old woman was hospitalized with weight loss, anorexia, and low grade fever for 2 weeks. she had under gone a total gastrectomy followed by adjuvant chemotherapy 10 years prior due to advanced gastric cancer to evaluate recurrence, fluorine 19 fluorodeoxyglucose (FDG) dual time point positron emission tomography/computed tomography (DTPP) was conducted with a gemini GXL 6 PET/CT system (Philips, Hamburg, Germany). FDG DTPP was performed twice, with an early scan 60 min after FDG injection and a delayed scan 150min after FDG injection. The early scan showed that multiple hypermetabolic lesions were located along left supraclavicular, mediastinal (1R, 2R, 3, 4R and 7) and left paraaortic (retroperitoneal) nodal stations. The delayed scan showed that all the above mentioned lesions revealed a more increased maximal standard uptake value (SUVmax) than was detected in the early scan. both scans did not show intrapulmonary lesion. For example, the left supraclavicular lymph node, 2R and retroperitoneal lymph node were observed with early and delayed SUV maxes of 4.5/7.6/3.6 and 6.7/7.7/3.6 and 6.7/10.7/4.4, respectively. Tom confirm diagnosis and establish a treatment plan, a mediastinoscopic biopsy of one of the mediastinal lymph nodes (4R) was subsequently performed and tuberculosis was ultimately diagnosed. Then, the patient started an antituberculosis treatment instead of antichemotherapy. A follow up FDG PET/CT performed 12 months later showed disappeared FDG uptake and significant decreased change of multiple peripheral tuberculous lymphadenitis. Whole body FDG PET/CT has widespread use in diagnosing and staging variable malignancies, and plays an important role in detection of gastric cancer recurrence. However, FDG is not cancer specific and some inflammatory diseases have shown higher FDG uptake on PET imaging. Infection, inflammation, and granulomatosis are also known to cause false positive FDG PET scans because activated inflammatory cells show

  20. Experience and role of FDG-PET lymphoma imaging in Egypt

    International Nuclear Information System (INIS)

    Background: Position Emission Tomography (PET) imaging using (F-18) fluorodeoxy glucose (FDG), has been introduced for the first time in Egypt in October 2004, and since that time, this technique has created a new trend in the diagnosis and management of the lymphomas, providing unique metabolic information. FDG uptake in lymphoma is a function of increased anaerobic metabolism as well as longer residence time of FDG in malignant cells relative to most normal tissues. Over several decades computed tomography (CT) has been the principal imaging modality for the staging and restaging of Lymphoma, although it can have shortcomings originating from its sizedbased criteria, particularly, in the post-therapy status. Aim: To evaluate the impact of FDG-PET on management of patients with lymphoma and compare its findings with the conventional investigational methods, mainly the contrast enhanced CT and to evaluate causes of discrepant findings between the two modalities. Patients and Methods: A group of 460 consecutive patients with diagnosis of lymphoma, including 118 newly diagnosed cases, 182 cases for therapy monitoring and 160 cases with suspicious relapsed disease. The study included 288 men and 172 women with a median age of 29 years (range, 6-73 years). 311 patients of them have NHL and 149 have HL. All patients underwent FDG PET and contrast enhanced CT within a maximum of 4 weeks time window. A final diagnosis was established at 1850 sites for comparison between PET and CT. Concordant PET and CT findings were regarded as positive or negative for disease. Discordant findings were defined as positive for disease, if it was confirmed by the histological examination, by the clinical progressive course or by the follow up CTs. Results: Accuracy of FDG-PET and contrast enhanced CT was 95.8% and 85% and the Positive Predictive Value was 96.4% and 85%, whereas the Negative Predictive Value was 91.1% and 55% respectively. Agreement of both methods was excellent (k = 0

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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    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

  3. Increased 18F-FDG Uptake Associated With Gastric Banding Surgical Mesh on PET/CT.

    Science.gov (United States)

    Chism, Charles B; Somcio, Ray; Chasen, Beth A; Ravizzini, Gregory C

    2016-05-01

    Surgical mesh was used in the 1980s and early 1990s for vertical banded gastroplasty as treatment for morbid obesity. This procedure was replaced by the more popular laparoscopic gastric banding in the mid-1990s. Surgical mesh, commonly used in hernioplasty, has been associated with increased F-FDG uptake related to an inflammatory foreign body reaction and is a known cause of false-positive PET scans. We present a case of increased F-FDG uptake related to surgical mesh in a patient who had undergone vertical banded gastroplasty. PMID:26825203

  4. Variable uterine uptake of FDG in adenomyosis during concurrent chemoradiation therapy for cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Jeong Il; Huh, Seung Jae; Kim, Young Il; Kim, Tae Joong; Park, Byung Kwan [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-09-15

    To avoid improper tumor volume contouring in radiation therapy (RT) and other invasive procedures, we report a case of uterine adenomyosis showing increased 18F-fl uorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/computed tomography (CT) mimicking malignant tumor in a 44-year-old woman during concurrent chemoradiation therapy (CCRT) for uterine cervical cancer. The adenomyosis was not associated with her menstrual cycle or with normal endometrium uptake, and it resolved one month after completion of RT. This case indicates that uterine adenomyosis in a premenopausal woman may show false positive uptake of 18FDG-PET/CT associated with CCRT.

  5. Variable uterine uptake of FDG in adenomyosis during concurrent chemoradiation therapy for cervical cancer

    International Nuclear Information System (INIS)

    To avoid improper tumor volume contouring in radiation therapy (RT) and other invasive procedures, we report a case of uterine adenomyosis showing increased 18F-fl uorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/computed tomography (CT) mimicking malignant tumor in a 44-year-old woman during concurrent chemoradiation therapy (CCRT) for uterine cervical cancer. The adenomyosis was not associated with her menstrual cycle or with normal endometrium uptake, and it resolved one month after completion of RT. This case indicates that uterine adenomyosis in a premenopausal woman may show false positive uptake of 18FDG-PET/CT associated with CCRT.

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

    OpenAIRE

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

    2009-01-01

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

  7. FDG-PET/CT for detection of the unknown primary head and neck tumor

    DEFF Research Database (Denmark)

    Johansen, J; Petersen, H; Godballe, Christian; Loft, Annika; Grau, Cai

    2011-01-01

    The benefit of FDG-PET in addition to standard work-up for carcinoma of unknown primary (CUP) and metastatic neck lesions has been widely described. However, most studies have been of retrospective nature with large heterogeneities in terms of workup standards and patient selection leaving several...... questions to be answered regarding the real value of PET in CUP. We here present an overview of the literature with focus on the current evidence of FDG-PET in detecting a primary in CUP and discuss the rationale of PET/CT in the diagnostic armamentarium of CUP....

  8. 18F-FDG-PET-CT imaging findings of recurrent intracranial haemangiopericytoma with distant metastases

    OpenAIRE

    Chan, W S W; Zhang, J; Khong, P. L.

    2010-01-01

    A 42-year-old woman presented with local recurrence and distant lung and liver metastases 7 years after resection of a primary intracranial haemangiopericytoma. Whole-body 18F-fluoro-2-deoxy-d-glucose (FDG)-positron emission tomography (PET)-CT scan showed no increased uptake in local recurrence or distant metastases except for a focus of increased FDG uptake within a hepatic metastasis. The hypermetabolic area correlated with an intratumoral hypoenhancing area on the CT scan. PET-CT scan may...

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2014-01-01

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

  11. Thymic Small Cell Neuroendocrine Carcinoma Displayed on 18F-FDG PET/CT Imaging.

    Science.gov (United States)

    Jiang, Lei; Li, Yanli; Luan, Lijuan; Zhang, Yongxing; Shi, Hongcheng

    2016-05-01

    A 52-year-old man presented with chest distress and low back pain for 1 month. CT examination displayed a thymic tumor with the metastases to bilateral lungs as well as mediastinal and bilateral hilar lymph nodes. To evaluate the involved extent of the disease, F-FDG PET/CT scan was carried out, which showed that in addition to the thymic mass, multiple foci of abnormally increased FDG activity in the bilateral lungs, neck and chest lymph nodes, and bones were observed. Finally, the biopsy of the mass confirmed the diagnosis of thymic small cell neuroendocrine carcinoma. PMID:26673232

  12. FDG-PET Lacks Sufficient Sensitivity to Detect Myxoid Liposarcoma Spinal Metastases Detected by MRI

    OpenAIRE

    Schwab, Joseph H.; Healey, John H.

    2007-01-01

    Purpose. To document a case of myxoid liposarcoma in which PET scan was less sensitive than MRI in detecting spinal metastasis. Materials and Methods. The case of a 65-year-old female with a history of myxoid liposarcoma (MLS) of the thigh resected 5 years previously and now presenting with low back pain is presented. Her medical oncologist ordered an FDG-PET scan to evaluate distant recurrence. Subsequently, an MRI of her spine was obtained by her surgeon. Results. The FDG-PET scan was obta...

  13. 18F-FDG PET/CT Osteometabolic Activity in Metastatic Parathyroid Carcinoma.

    Science.gov (United States)

    do Vale, Rômulo Hermeto Bueno; Queiroz, Marcelo Araújo; Coutinho, Artur Martins Novaes; Buchpiguel, Carlos Alberto; de Menezes, Marcos Roberto

    2016-09-01

    Parathyroid cancer is an uncommon type of malignancy, which is frequently associated with poor prognosis. Clinical manifestations are caused by elevated serum calcium and parathyroid hormone (PTH). Diagnostic imaging studies as neck ultrasonography, technetium Tc Tc-sestamibi whole body scintigraphy, CT, and MR are already established tools for this malignancy. Nevertheless, the role of F-FDG PET/CT remains unknown in this scenario, with few published studies in literature. Hence, in this article, we aimed to report an illustrative case of increased skeletal FDG uptake associated with high calcium and PTH levels. PMID:27276208

  14. 18F-FDG PET/CT Imaging of Burkitt Lymphoma Presenting With Unusual Muscle Involvement.

    Science.gov (United States)

    Dirlik Serim, Burcu; Gurleyen Eren, Tuba; Oz Puyan, Fulya; Durmus Altun, Gülay

    2016-08-01

    Extranodal involvement is more common with Burkitt lymphoma (BL) than other subtypes of non-Hodgkin lymphoma in childhood. According to our knowledge, there are rare cases in the literature about muscle involvement of BL, and its F-FDG PET/CT findings were not well defined. We report a 6-year-old girl with a histopathologic diagnosis of BL and referred for staging with PET/CT. FDG-avid abdominal lymph nodes and diffuse involvements of right quadriceps muscle were demonstrated. PMID:27124681

  15. ‘Double cortex’ sign on FDG-PET/CT in diffuse band heterotopia

    International Nuclear Information System (INIS)

    F-18 Fluorodeoxyglucose (FDG) Positron emission tomography/Computed Tomography (PET/CT) has come to play an increasingly important role for the pre-surgical evaluation of drug resistant epilepsy and complements Magnetic Resonance Imaging (MRI) in the evaluation of grey matter heterotopias. This case illustrates the characteristic pattern of metabolic abnormality in diffuse band heterotopia (DBH) which is otherwise called double cortex syndrome. The presence of metabolic activity in the heterotopic inner cortical band and in the overlying true cortex gives rise to the ‘double cortex’ sign on FDG-PET, concurrent CT provides a good anato-metabolic coregistration

  16. Cerebral FDG-PET scanning abnormalities in optimally treated HIV patients

    DEFF Research Database (Denmark)

    Andersen, Ase B; Law, Ian; Krabbe, Karen S;

    2010-01-01

    no history of virological failure, a CD4 count above 200 x 106 cells/l and no other co-morbidities. The distribution of the regional cerebral metabolic rate of glucose metabolism was measured using fluorine-18-flourodeoxyglucose positron emission tomography (FDG-PET) scanning. The PET scans were...... frontal reduction in the relative metabolic rate of glucose. Compared to healthy subjects, the patients with abnormal FDG-PET scanning results had a shorter history of known HIV infection, fewer years on antiretroviral therapy and higher levels of circulating TNF alpha and IL-6 (p = 0.08). CONCLUSION: A...

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

    International Nuclear Information System (INIS)

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

  18. FDG PET/CT Findings in Multiple Splenic Amebomas (Amebic Granulomas).

    Science.gov (United States)

    Dong, Aisheng; Wang, Yang; Zuo, Changjing; Zhu, Huaimin

    2016-05-01

    Splenic ameboma (amebic granuloma) is rare. A 38-year-old man with a severe pneumonia due to inhalation of swimming pool water 18 months ago complained of night sweat, tiredness, and anorexia for 1 month. Abdominal ultrasound showed multiple nodules in the spleen. These nodules showed slight enhancement on enhanced CT and intense FDG uptake on PET/CT. Splenectomy was performed. Multiple splenic amebomas were confirmed by pathology. Free-living amoebae were also detected in samples of pleural effusion and blood. Splenic ameboma, although rare, should be included in the differential diagnosis with isolated focally increased FDG activity in the spleen. PMID:26505858

  19. 18F FDG PET CT for detection of recurrent spinal ependymoma

    International Nuclear Information System (INIS)

    Ependymomas are uncommon central nervous system tumors, with the spinal cord being the most common site in adults. Magnetic resonance imaging (MRI) is currently the standard imaging modality for initial diagnosis and to assess the adequacy of surgical resection and/or the response to radiation therapy. However, as in case of brain tumors, post treatment MRI might not be able to differentiate between radiation necrosis and recurrent tumors. Here we present 18F fluorodeoxyglucose (FDG) positron emission tomography computed tomography (PET-CT) images of a 40 year old female with recurrent spinal epecdymoma. FDG PET-CT showed recurrent tumor, while MRI was equivocal in this patient

  20. Impact of FDG PET on the management of TBC treatment. A pilot study

    International Nuclear Information System (INIS)

    The aim of this study is to assess the potential impact of double-phase FDG PET versus routine staging in HIV-negative patients suffering from tuberculosis. Patients, methods: 16 consecutive patients suffering from tuberculosis underwent contrast-enhanced CT and double-phase FDG PET imaging (45 min, 120 min). Early (E) and delayed (D) SUVmax values were determined for all identified lesions and % change in SUV calculated (ΔSUV). Results: Seven patients presented with lung lesions on PET as well as CT (mean SUVmaxE 8.2), mean SUVmaxD 11.1, (p = 0.002), ΔSUV 35%. In two patients, lesions were judged as non-active on CT. In nine patients, 18 sites of LN involvement were identified on both early and delayed FDG PET images (mean SUVmaxE 6.3, mean SUVmaxD 7.9, (p = 0.0001), ΔSUV: 25%). 9 out of 18 sites of LN involvement, occurring in five patients, were missed on CT. In four of these five patients, sites of LN involvement were the only sites of extra-pulmonary involvement identified. In 6 out of 16 patients, pleural involvement was identified, respectively in 5 on FDG PET and in 6 on CT imaging (mean SUVmaxE 1.3, mean SUVmaxD 1.7, (p = 0.06), ΔSUV 21%). In 4 patients, osseous involvement was identified by both FDG PET and CT (mean SUVmaxE 7.2, mean SUVmaxD 10.7, (p = 0,06), ΔSUV 45%). Finally, in 3 patients, joint involvement was identified on both FDG PET as well as on CT imaging (mean SUVmaxE 4.7, mean SUVmaxD 5.2, ΔSUV 23%). FDG PET did not identify CT-additional sites of involvement that would have resulted in a prolonged treatment. Conclusion: In HIV-negative patients suffering from tuberculosis, FDG PET images suggested a more extensive involvement by Mycobacterium tuberculosis when compared to contrast enhanced CT. (orig.)

  1. {sup 18}F FDG PET CT for detection of recurrent spinal ependymoma

    Energy Technology Data Exchange (ETDEWEB)

    Singhal, Abhinav; Sharma, Punit; Karunanithi, Sellam; Khangembam, Bangkim Chandra; Singla, Suhas; Bal, Chandrasekhar; Kumar, Rakesh [All India Institute of Medical Sciences, New Delhi (India)

    2012-03-15

    Ependymomas are uncommon central nervous system tumors, with the spinal cord being the most common site in adults. Magnetic resonance imaging (MRI) is currently the standard imaging modality for initial diagnosis and to assess the adequacy of surgical resection and/or the response to radiation therapy. However, as in case of brain tumors, post treatment MRI might not be able to differentiate between radiation necrosis and recurrent tumors. Here we present {sup 18}F fluorodeoxyglucose (FDG) positron emission tomography computed tomography (PET-CT) images of a 40 year old female with recurrent spinal epecdymoma. FDG PET-CT showed recurrent tumor, while MRI was equivocal in this patient.

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

    OpenAIRE

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

    2009-01-01

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

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

    International Nuclear Information System (INIS)

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

  4. Extramedullary Involvement of Mast Cell Leukemia Detected by 18F-FDG PET/CT.

    Science.gov (United States)

    Fu, Zhanli; Zhang, Jin; Liu, Meng; Li, Ziao; Li, Qian

    2016-07-01

    Mast cell leukemia (MCL) is a very rare subtype of systemic mastocytosis, characterized by the leukemic expansion of immature mast cells. We present a case of MCL with extramedullary involvement of cervical lymph node and lung demonstrated by the initial F-FDG PET/CT scan. After a transient complete remission by induction chemotherapy and allogeneic hematopoietic stem cell transplantation, the follow-up PET/CT showed extensive extramedullary relapse involving multiple lymph nodes and small bowel. F-FDG PET/CT may be a useful tool to comprehensively stage and follow-up MCL. PMID:26975014

  5. Present and future roles of FDG-PET/CT imaging in the management of lung cancer.

    Science.gov (United States)

    Kitajima, Kazuhiro; Doi, Hiroshi; Kanda, Tomonori; Yamane, Tomohiko; Tsujikawa, Tetsuya; Kaida, Hayato; Tamaki, Yukihisa; Kuribayashi, Kozo

    2016-06-01

    Integrated positron emission tomography/computed tomography (PET/CT) using 2-[(18)F]fluoro-2-deoxy-D-glucose ((18)F-FDG) has emerged as a powerful tool for combined metabolic and anatomic evaluation in clinical oncologic imaging. This review discusses the utility of (18)F-FDG PET/CT as a tool for managing patients with lung cancer. We discuss different patient management stages, including diagnosis, initial staging, therapy planning, early treatment response assessment, re-staging, and prognosis. PMID:27121156

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

    International Nuclear Information System (INIS)

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

  7. 18F-FDG PET in the management of endometrial cancer

    International Nuclear Information System (INIS)

    Few studies have investigated the clinical impact of whole-body positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) in endometrial cancer. We aimed to assess the value of integrating FDG-PET into the management of endometrial cancer in comparison with conventional imaging alone. All patients with histologically confirmed primary advanced (stage III/IV) or suspicious/documented recurrent endometrial cancer, with poor prognostic features (serum CA-125 >35 U/ml or unfavourable cell types), or surveillance after salvage therapy were eligible. Before FDG-PET scanning, each patient had received magnetic resonance imaging and/or computed tomography (MRI-CT). The receiver operating characteristic curve method with calculation of the area under the curve (AUC) was used to compare the diagnostic efficacy. Clinical impacts were determined on a scan basis. Forty-nine eligible patients were accrued and 60 studies were performed (27 primary staging, 33 post-therapy surveillance or restaging on relapse). The clinical impact was positive in 29 (48.3%) of the 60 scans. Mean standardised uptake values (SUVs) of true-positive lesions were 13.2 (range 5.7-37.4) for central pelvic lesions and 11.1 (range 1.5-37.4) for metastases. The sensitivity of FDG-PET alone (P<0.0001) or FDG-PET plus MRI-CT (P<0.0001) was significantly higher than that of MRI-CT alone in overall lesion detection. FDG-PET plus MRI-CT was significantly superior to MRI-CT alone in overall lesion detection (AUC 0.949 vs 0.872; P=0.004), detection of pelvic nodal/soft tissue metastases (P=0.048) and detection of extrapelvic metastases (P=0.010), while FDG-PET alone was only marginally superior by AUC (P=0.063). Whole-body FDG-PET coupled with MRI-CT facilitated optimal management of endometrial cancer in well-selected cases. (orig.)

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

    Science.gov (United States)

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

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  10. 18F-FDG PET-CT in diagnosis of tumor thrombus

    International Nuclear Information System (INIS)

    Full text: Venous thromboembolism is a relatively common phenomenon in cancer patients while tumor thrombosis is a rare complication of solid cancers. The correct diagnosis of tumor thrombosis and its differentiation from benign thrombus can change patient management and prevent unnecessary anticoagulation treatment. Materials and Methods: We conducted a retrospective review of FDG PET-CT scans of patients who underwent the study between July 2007 and July 2010. Any focal and/or linear area of increased FDG uptake (more than mediastinal blood pool) conforming to a blood vessel was taken as positive. SUVmax of the thrombus, SUVmax of tumor (if any) and SUVmax of mediastinal blood pool were calculated. PET-CT results were confirmed with clinical follow up, structural imaging and histopathology when available. Results: Total 24 patients (15 male and 9 female) with mean age of 43.8 years (range: 3-72; median-47.5) were evaluated. All patients underwent PET/CT for staging or restaging of a known malignancy and had a FDG avid thrombus. Based on structural imaging and clinical follow up, 9 patients had benign thromboembolism and 13 patients had tumor thrombosis. On FDG PET-CT, uptake in the thrombus was linear in 18 patients and focal in 6 patients. The most common site of thrombosis was IVC (n=14) followed by PV (n=7). One patient had catheter associated thrombosis. Four patients had only the thrombus as the FDG avid foci while remaining 18 patients had other FDG avid focus of disease. The mean SUVmax in the benign thrombosis group was 3.2 (range: 2.3-4.6; median-3.3). The mean SUVmax in the tumor thrombosis group was 6.0 (range: 2.3-13.8; median-3.3).There was significant difference in SUVmax between the two groups P = 0.013. On ROC analysis a cut off SUVmax of 3.63 was obtained to differentiate tumor thrombus from benign thromboembolism. In 6 patients FDG PET-CT detected occult vascular thrombosis, which was later confirmed with other imaging modality. Conclusion: FDG

  11. Normal patterns of 18F-FDG appendiceal uptake in children

    Energy Technology Data Exchange (ETDEWEB)

    Reavey, Hamilton E. [Emory University, Department of Radiology and Imaging Sciences, Division of Nuclear Medicine Molecular Imaging, Atlanta, GA (United States); Alazraki, Adina L.; Simoneaux, Stephen F. [Emory University, Department of Radiology and Imaging Sciences, Division of Pediatric Imaging, Children' s Healthcare of Atlanta at Egleston, Atlanta, GA (United States)

    2014-04-15

    Prior to interpreting PET/CT, it is crucial to understand the normal biodistribution of fluorodeoxyglucose (FDG). It is also important to realize that the normal biodistribution can vary between adults and children. Although many studies have defined normal patterns of pediatric FDG uptake in structures like the thymus, brown fat and bone marrow, patterns of normal pediatric bowel activity, specifically uptake within the appendix, have not been well described. Active lymphoid tissue has increased FDG uptake when compared with inactive tissue. Since children have more active lymphoid tissue than adults, and because the appendix contains aggregated lymphoid tissue, we postulated that appendiceal uptake may be increased in pediatric patients. To define the normal level of appendiceal FDG activity in children by evaluating a series of consecutive FDG PET/CT scans performed for other indications. After obtaining IRB approval, we retrospectively reviewed 128 consecutive whole-body pediatric FDG PET/CT examinations obtained for a variety of clinical indications. CT scans on which the appendix could not be visualized were excluded from analysis. CT scans on which the appendix could be visualized were evaluated for underlying appendiceal pathology. Studies with appendiceal or periappendiceal pathology by CT criteria were excluded. A region of interest (ROI) was placed over a portion of each appendix and appendiceal maximum standardized uptake value (SUVmax) was calculated. If an adjacent loop of bowel activity interfered with accurate measurements of the appendix SUVmax, the scan was excluded from the analysis. A chart review was performed on patients with elevated appendiceal SUVmax values to ensure that the patients did not have clinical symptomatology suggestive of acute appendicitis. When the appendix or a portion of the appendix could be visualized and accurately measured, the SUVmax was determined. SUVmax of the appendix was compared to the SUVmax of normal liver and

  12. Normal patterns of 18F-FDG appendiceal uptake in children

    International Nuclear Information System (INIS)

    Prior to interpreting PET/CT, it is crucial to understand the normal biodistribution of fluorodeoxyglucose (FDG). It is also important to realize that the normal biodistribution can vary between adults and children. Although many studies have defined normal patterns of pediatric FDG uptake in structures like the thymus, brown fat and bone marrow, patterns of normal pediatric bowel activity, specifically uptake within the appendix, have not been well described. Active lymphoid tissue has increased FDG uptake when compared with inactive tissue. Since children have more active lymphoid tissue than adults, and because the appendix contains aggregated lymphoid tissue, we postulated that appendiceal uptake may be increased in pediatric patients. To define the normal level of appendiceal FDG activity in children by evaluating a series of consecutive FDG PET/CT scans performed for other indications. After obtaining IRB approval, we retrospectively reviewed 128 consecutive whole-body pediatric FDG PET/CT examinations obtained for a variety of clinical indications. CT scans on which the appendix could not be visualized were excluded from analysis. CT scans on which the appendix could be visualized were evaluated for underlying appendiceal pathology. Studies with appendiceal or periappendiceal pathology by CT criteria were excluded. A region of interest (ROI) was placed over a portion of each appendix and appendiceal maximum standardized uptake value (SUVmax) was calculated. If an adjacent loop of bowel activity interfered with accurate measurements of the appendix SUVmax, the scan was excluded from the analysis. A chart review was performed on patients with elevated appendiceal SUVmax values to ensure that the patients did not have clinical symptomatology suggestive of acute appendicitis. When the appendix or a portion of the appendix could be visualized and accurately measured, the SUVmax was determined. SUVmax of the appendix was compared to the SUVmax of normal liver and

  13. Extraosseous Osteosarcoma of the Liver Demonstrated on 18F-FDG PET/CT Imaging.

    Science.gov (United States)

    Jiang, Lei; Luan, Lijuan; Yun, Hong; Hou, Yingyong; Shi, Hongcheng

    2016-08-01

    A 66-year-old woman presented with abdominal pain for 1 month. Ultrasonography displayed multiple hepatic masses that were thought as metastases. FDG PET/CT was performed to assess the nature of these masses and to search primary malignancy. The images showed elevated FDG activity in the partially calcified hypodense lesions in the liver without abnormality elsewhere. The lesions were subsequently confirmed as primary extraosseous osteosarcoma in the liver. The patient received liver transplantation. Six months later, her CA-125 was significantly increased. The follow-up PET/CT scan demonstrated the widespread metastases. PMID:27055145

  14. Brain metastases after stereotactic radiosurgery using the Leksell gamma knife: can FDG PET help to differentiate radionecrosis from tumour progression?

    International Nuclear Information System (INIS)

    Stereotactic radiosurgery (SRS) using the Leksell gamma knife promotes acute and chronic local changes in glucose metabolism. We have been able to find very few papers on Medline on the subject of assessment of metastases by 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) after SRS. The aim of this work was to specify the additional value of FDG PET, in comparison with magnetic resonance imaging (MRI), in differentiating SRS-induced radionecrosis from viable brain metastasis in a clinical setting. Fifty-seven metastases in 25 patients were treated by SRS. An average of 33 weeks later, all the patients underwent FDG PET. At the same time (SD=2 weeks) all the patients underwent MRI. The sensitivity, specificity and accuracy of both FDG PET and MRI examinations were calculated with reference to clinical and radiological follow-up or biopsies. The additional value derived from use of FDG PET after MRI was assessed and progression-free survival rates were compared. The difference in progression-free survival rates between the negative and positive subgroups was significant (P=0.0005) for MRI and even more so (P<0.00001) for FDG PET. Sensitivity, specificity and accuracy were 75% (6/8), 93.9% (46/49) and 91.2% (52/57) for FDG PET, and 100% (8/8), 65.3% (32/49) and 70.2% (40/57) for MRI. In the subgroup of patients with positive or non-diagnostic MRI, the probability of presence of a viable tumour was only 32% (8/25). This probability increased to 100% (5/5) when subsequent FDG PET was positive and decreased to 11.1% (2/18) when FDG PET was negative. The frequency of a viable neoplasm was significantly different (P=0.001) in the FDG PET negative and positive subgroups. MRI and FDG PET both have an important predictive value for persistent viable metastases after treatment by SRS. Neither sensitive but non-specific MRI nor specific but insensitive FDG PET is reliable on its own. While FDG PET significantly improved the diagnostic accuracy in the

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-09-15

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

  16. Clinical efficacy of FDG-PET scan as preoperative diagnostic tool in cervical cancer stage Ib and IIa: comparison between the results of FDG-PET scan and operative findings

    International Nuclear Information System (INIS)

    This study was done to evaluate the clinical feasibility of FDG-PET scan for routine preoperative diagnostic methods in cervical carcinoma. PET-scans were performed from March, 1999 to November, 1999. There were 6 stage Ib and 7 IIa patients and all patients were performed radical hysterectomy and bilateral pelvic lymph node dissections and were evaluated by FDG-PET scan before operation. The mean age of the patients were 50.3 years old. Six cases had lymph node metastases by pelvis MRI, and three cases by FDG-PET scan. We could not find any lymph node metastases at surgery in 3 patients (50.0%) among 6 patients who were diagnosed by nodal metastases by pelvis MRI. And we found 1 patients with nodal metastases who had negative findings by pelvis MRI. By FDG-PET scan, we could find metastases in all positive patients. But we also found 2 additional metastatic cases in the patients with negative findings. In this study, the comparison was very difficult due to the individual differences in the comparison would be made by site-specific not person. The sensitivity of MRI and FDG-PET scan were 50.0% and 30.0%. The specificity were 94.1 % and 95.6%. The positive predictive value were 55.6 % and 50.0 %. In conclusion, we could find any superiority of FDG-PET scan in the diagnosis of lymph node metastases the pelvis MRI. So there are limitations to use the FDG-PET scan in the routine preoperative diagnostic tools in cervical cancer. But if we have more experiences to use the FDG-PET scan such as precise cut-off value of SUV and combination of other imaging technique, the FDG-PET scan are still promising diagnostic tools in cervical cancer

  17. Serial assessment of FDG-PET FDG uptake and functional volume during radiotherapy (RT) in patients with non-small cell lung cancer (NSCLC)

    International Nuclear Information System (INIS)

    Objectives: The objectives were (i) to confirm that diagnostic FDG-PET images could be obtained during thoracic radiotherapy, (ii) to verify that significant changes in FDG uptake or volume could be measured early enough to adapt the radiotherapy plan and (iii) to determine an optimal time window during the radiotherapy course to acquire a single FDG-PET examination that would be representative of tumour response. Methods: Ten non-small cell lung carcinoma (NSCLC) patients with significant PET/CT-FDG tumour radioactivity uptake (versus the background level), candidates for curative radiotherapy (RT, n = 4; 60–70 Gy, 2 Gray per fraction, 5 fractions per week) or RT plus chemotherapy (CT-RT, n = 6), were prospectively evaluated. Using a Siemens Biograph, 5 or 6 PET/CT scans (PETn, n = 0–5) were performed for each patient. Each acquisition included a 15-min thoracic PET with respiratory gating (RG) 60 ± 5 min post-injection of the FDG (3.5 MBq/kg), followed by a standard, 5-min non-gated (STD) thoracic PET. PET0 was performed before the first RT fraction. During RT, PET1–5 were performed every 7 fractions, i.e., at 14 Gy total dose increment. FDG uptake was measured as the variation of SUVmax,PETn versus SUVmax,PET0. Each lesions’ volume was measured by (i) visual delineation by an experienced nuclear physician, (ii) 40% SUVmax fixed threshold and (iii) a semi-automatic adaptive threshold method. Results: A total of 53 FDG-PET scans were acquired. Seventeen lesions (6 tumours and 11 nodes) were visible on PET0 in the 10 patients. The lesions were located either in or near the mediastinum or in the apex, without significant respiratory displacements at visual inspection of the gated images. Healthy lung did not cause motion artefacts in the PET images. As measured on 89 lesions, both the absolute and relative SUVmax values decreased as the RT dose increased. A 50% SUVmax decrease was obtained around a total dose of 45 Gy. Out of the 89 lesions, 75 remained

  18. An Unusual Case of Metastatic Malignant Melanoma Presenting as Pseudom