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  1. Strategies to reduce radiation dose in cardiac PET/CT

    Science.gov (United States)

    Wu, Tung Hsin; Wu, Nien-Yun; Wang, Shyh-Jen; Wu, Jay; S. P. Mok, Greta; Yang, Ching-Ching; Huang, Tzung-Chi

    2011-08-01

    Our aim was to investigate CT dose reduction strategies on a hybrid PET/CT scanner for cardiac applications.MaterialsImage quality and dose estimation of different CT scanning protocols for CT coronary angiography (CTCA), and CT-based attenuation correction for PET imaging were investigated. Fifteen patients underwent CTCA, perfusion PET imaging at rest and under stress, and FDG PET for myocardial viability. These patients were divided into three groups based on the CTCA technique performed: retrospectively gated helical (RGH), ECG tube current modulation (ETCM), and prospective gated axial (PGA) acquisitions. All emission images were corrected for photon attenuation using CT images obtained by default setting and an ultra-low dose CT (ULDCT) scan.ResultsRadiation dose in RGH technique was 22.2±4.0 mSv. It was reduced to 10.95±0.82 and 4.13±0.31 mSv using ETCM and PGA techniques, respectively. Radiation dose in CT transmission scan was reduced by 96.5% (from 4.53±0.5 to 0.16±0.01 mSv) when applying ULDCT as compared to the default CT. No significant difference in terms of image quality was found among various protocols.ConclusionThe proposed CT scanning strategies, i.e. ETCM or PGA for CTCA and ULDCT for PET attenuation correction, could reduce radiation dose up to 47% without degrading imaging quality in an integrated cardiac PET/CT coronary artery examination.

  2. Cine CT for Attenuation Correction in Cardiac PET/CT

    OpenAIRE

    Alessio, Adam M.; Kohlmyer, Steve; Branch, Kelley; Chen, Grace; Caldwell, James; Kinahan, Paul

    2007-01-01

    In dual-modality PET/CT systems, the CT scan provides the attenuation map for PET attenuation correction. The current clinical practice of obtaining a single helical CT scan provides only a snapshot of the respiratory cycle, whereas PET occurs over multiple respiratory cycles. Misalignment of the attenuation map and emission image because of respiratory motion causes errors in the attenuation correction factors and artifacts in the attenuation-corrected PET image. To rectify this problem, we ...

  3. A dual tracer (68)Ga-DOTANOC PET/CT and (18)F-FDG PET/CT pilot study for detection of cardiac sarcoidosis

    DEFF Research Database (Denmark)

    Gormsen, Lars C; Haraldsen, Ate; Kramer, Stine;

    2016-01-01

    BACKGROUND: Cardiac sarcoidosis (CS) is a potentially fatal condition lacking a single test with acceptable diagnostic accuracy. (18)F-FDG PET/CT has emerged as a promising imaging modality, but is challenged by physiological myocardial glucose uptake. An alternative tracer, (68)Ga-DOTANOC, binds...

  4. PET/MRI and PET/CT in advanced gynaecological tumours: initial experience and comparison

    Energy Technology Data Exchange (ETDEWEB)

    Queiroz, Marcelo A.; Schulthess, Gustav von; Veit-Haibach, Patrick [University Hospital Zurich, Department Medical Radiology, Nuclear Medicine, Zurich (Switzerland); University Hospital Zurich, Department Medical Radiology, Diagnostic and Interventional Radiology, Zurich (Switzerland); University of Zurich, Zurich (Switzerland); Kubik-Huch, Rahel A.; Freiwald-Chilla, Bianka [Kantonsspital Baden AG, Department of Radiology, Baden (Switzerland); Hauser, Nik [Kantonsspital Baden AG, Department of Gynaecology, Baden (Switzerland); Froehlich, Johannes M. [Guerbet AG, Zurich (Switzerland)

    2015-08-15

    To compare the diagnostic accuracy of PET/MRI and PET/CT for staging and re-staging advanced gynaecological cancer patients as well as identify the potential benefits of each method in such a population. Twenty-six patients with suspicious or proven advanced gynaecological cancer (12 ovarian, seven cervical, one vulvar and four endometrial tumours, one uterine metastasis, and one primary peritoneal cancer) underwent whole-body imaging with a sequential trimodality PET/CT/MR system. Images were analysed regarding primary tumour detection and delineation, loco-regional lymph node staging, and abdominal/extra-abdominal distant metastasis detection (last only by PET/CT). Eighteen (69.2 %) patients underwent PET/MRI for primary staging and eight patients (30.8 %) for re-staging their gynaecological malignancies. For primary tumour delineation, PET/MRI accuracy was statistically superior to PET/CT (p < 0.001). Among the different types of cancer, PET/MRI presented better tumour delineation mainly for cervical (6/7) and endometrial (2/3) cancers. PET/MRI for local evaluation as well as PET/CT for extra-abdominal metastases had therapeutic consequences in three and one patients, respectively. PET/CT detected 12 extra-abdominal distant metastases in 26 patients. PET/MRI is superior to PET/CT for primary tumour delineation. No differences were found in detection of regional lymph node involvement and abdominal metastases detection. (orig.)

  5. 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.

  6. 18F-NaF PET/CT Images of Cardiac Metastasis From Osteosarcoma.

    Science.gov (United States)

    Chou, Yi-Hsien; Ko, Kuan-Yin; Cheng, Mei-Fang; Chen, Wei-Wu; Yen, Ruoh-Fang

    2016-09-01

    Osteosarcomas are aggressive with a high incidence of recurrence and metastasis. Cardiac osteosarcoma metastasis is rare. We described a 17-year-old boy who had right distal femoral osteosarcoma with lung metastases. During follow-up, right ventricular (RV) metastasis was noted and confirmed by histopathological examination of the surgical specimen. F-NaF PET/CT was then arranged 1 month after debulking surgery for residual tumor survey. The images showed intense F-NaF uptake at RV region, suggestive of residual cardiac metastases. PMID:27405028

  7. Multimodal Registration of gated cardiac PET, CT and MR sequences

    International Nuclear Information System (INIS)

    The research described in this manuscript deals with the multimodal registration of cardiac images from Magnetic Resonance Imaging (MRI), Position Emission Tomography (PET) and Computerized Tomography (CT). All these modalities are gated to the Electrocardiogram (ECG) and provide information to evaluate cardiac function, and to diagnose and to follow-up cardiovascular pathologies. PET imaging allows the evaluation of ventricular function and MRI is a gold standard for the study of the left ventricular function. The goal of our registration process is to merge functional (from PET) and anatomical images (from CT and MRI). Our process is adapted to the modalities used and is divided in two steps: (i) a global rigid 3-dimensional model-based ICP (Iterative Closest Point) registration between CT and MR data and (ii) an iconic 2-dimensional registration based on Free Form Deformations and Mutual Information. This last step presents an original contribution by using a composite image of CT (which presents epicardic contours) and PET (where endocardic contours are partially visible) data to make mutual information more accurate in representing the similarity with the MR data. To speed up the whole process, we also present a transformation initialization scheme using displacement field obtained form MR data only. The obtained results have been evaluated by experts. (author)

  8. Impact of {sup 18}F-FDG-PET/CT on staging and irradiation of patients with locally advanced rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Paskeviciute, Brigita; Boelling, Tobias; Brinkmann, Markus; Rudykina, Ganna; Ernst, Iris; Willich, Normann; Koenemann, Stefan [Department of Radiotherapy, University Hospital Muenster (Germany); Stegger, Lars; Schober, Otmar; Weckesser, Matthias [Department of Nuclear Medicine, University Hospital Muenster (Germany)

    2009-04-15

    To investigate the impact of fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) on planning of neoadjuvant radiotherapy for locally advanced rectal cancer (LARC) patients. From January 2003 to December 2007, a total of 36 patients with LARC underwent a retroprospective PET/CT study for radiotherapy-planning purposes. Gross tumor volume (GTV), clinical target volume (CTV) and planning target volume (PTV) were defined in a retrospective analysis by a blinded reader. The hypothetical boost volume was defined primarily on CT alone, and afterwards on the fused PET/CT dataset. The CT- and PET/CT-based GTVs were quantitatively compared and percentage of overlap (OV%) was calculated and analyzed. The impact of PET/CT on radiation treatment planning and overall patient management was evaluated. PET/CT-GTVs were smaller than CT-GTVs (p < 0.05). PET/CT imaging resulted in a change of overall management for three patients (8 %). In 16 of 35 patients (46 %), PET/CT resulted in a need for modification of the usual target volumes (CT-PTV) because of detection of a geographic miss. FDG-PET/CT had significant impact on radiotherapy planning and overall treatment of patients with LARC. (orig.)

  9. Chronic thyroiditis in patients with advanced breast carcinoma: metabolic and morphologic changes on PET-CT

    Energy Technology Data Exchange (ETDEWEB)

    Tateishi, Ukihide [University of Texas, MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Yokohama City University Graduate School of Medicine, Department of Radiology, Yokohama (Japan); University of Texas MD Anderson Cancer Center, Division of Diagnostic Imaging, Houston, TX (United States); Gamez, Cristina; Yeung, Henry W.D.; Macapinlac, Homer A. [University of Texas, MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Dawood, Shaheenah; Cristofanilli, Massimo [University of Texas, MD Anderson Cancer Center, Division of Breast Medical Oncology, Houston, TX (United States); Inoue, Tomio [Yokohama City University Graduate School of Medicine, Department of Radiology, Yokohama (Japan)

    2009-06-15

    To investigate clinical implications of FDG uptake in the thyroid glands in patients with advanced breast carcinoma by comparing metabolic and morphologic patterns on positron emission tomography (PET)/computed tomography (CT). The institutional review board waived the requirement for informed consent. A retrospective analysis was performed in 146 women (mean age 54 years) with advanced breast carcinoma who received systemic treatment. All patients underwent PET-CT before and after treatment. All PET-CT studies were reviewed in consensus by two reviewers. Morphologic changes including volume and mean parenchymal density of the thyroid glands were evaluated. Maximum standardized uptake value (SUVmax) and total lesion glycolysis (TLG) were determined to evaluate metabolic changes. These parameters were compared between patients with chronic thyroiditis who received thyroid hormone replacement therapy and those who did not. Of the 146 patients, 29 (20%) showed bilaterally diffuse uptake in the thyroid glands on the baseline PET-CT scan. The SUVmax showed a linear relationship with volume (r = 0.428, p = 0.021) and the mean parenchymal density (r = -0.385, p = 0.039) of the thyroid glands. In 21 of the 29 patients (72%) with hypothyroidism who received thyroid hormone replacement therapy, the volume, mean parenchymal density, SUVmax, and TLG of the thyroid glands showed no significant changes. In contrast, 8 of the 29 patients (28%) who did not receive thyroid hormone replacement therapy showed marked decreases in SUVmax and TLG. Diffuse thyroid uptake on PET-CT represents active inflammation caused by chronic thyroiditis in patients with advanced breast carcinoma. Diffuse thyroid uptake may also address the concern about subclinical hypothyroidism which develops into overt disease during follow-up. (orig.)

  10. The value of FDG-PET/CT in the diagnostic work-up of extra cardiac infectious manifestations in infectious endocarditis

    DEFF Research Database (Denmark)

    Ozcan, C; Asmar, A; Gill, S;

    2013-01-01

    -fifty-nine infectious lesions were identified. (18)F-FDG-PET identified 64 of these, and suggested another 50. Overall sensitivity and positive predictive value was 40 and 56 %, respectively, in detecting both cardiac and extracardiac infective foci. When excluding lungs and organs with high physiological FDG-uptake....../secretion, the corresponding values increased to 87 and 52 %, respectively. (18)F-FDG-PET/CT may be an important diagnostic tool in detecting extra cardiac infections in patients with IE, particularly in organs with low physiological glucose uptake........ To discover the latter an (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET)/CT examination has been proposed. However, the diagnostic value of a PET/CT in this setting remains unresolved. Thus, we wished to assess the usefulness of a PET/CT study in patients with IE as a supplemental...

  11. Clinical impact of 18F-FDG-PET/CT in the extra cardiac work-up of patients with infective endocarditis

    DEFF Research Database (Denmark)

    Asmar, Ali; Ozcan, Cengiz; Diederichsen, Axel C P;

    2014-01-01

    OBJECTIVE: The purpose of this study was to assess the clinical importance of (18)F-FDG-PET/CT used in the extra cardiac work-up of patients with infective endocarditis (IE). BACKGROUND: IE is a serious condition with a significant mortality. Besides the degree of valvular involvement, the progno......OBJECTIVE: The purpose of this study was to assess the clinical importance of (18)F-FDG-PET/CT used in the extra cardiac work-up of patients with infective endocarditis (IE). BACKGROUND: IE is a serious condition with a significant mortality. Besides the degree of valvular involvement...

  12. The role of 18F-FDG PET/CT in evaluation of early response to neoadjuvant chemotherapy in patients with locally advanced breast cancer

    International Nuclear Information System (INIS)

    We evaluated the role of 18F-FDG PET/CT for the assessment of response after two cycles of neo-adjuvant chemotherapy (NACT) for breast cancer. Twenty-three women with locally advanced breast cancer were included in this study. Early response to NACT was evaluated after two cycles using clinical examination, CT, and 18F-FDG PET/CT. Final histopathology following surgery after six cycles of NACT served as reference. Baseline PET/CT demonstrated a total of 26 lesions in 23 patients. The size of the primary tumor ranged from 1.90 cm to 11.60 cm, and the maximum value of the standardized uptake value of FDG (SUVmax) ranged from 3.6 to 38.6 (mean, 11.7). Post-chemotherapy PET/CT examinations were done after two cycles of NACT. The size of the primary tumor on follow-up PET/CT examinations ranged from 0.0 cm to 7.6 cm, and SUVmax ranged from 0.0 to 12.0 (mean, 3.96). On clinical, CT, and PET/CT examinations, 50% reduction in the parameters was taken as the cutoff value to differentiate between responders and non-responders. Post-NACT PET/CT demonstrated that 16 patients were responders and 7 non-responders. Among 16 responders on PET/CT scan, 14 were true positive and 2 were false positive when compared with histopathology. Among seven non-responder patients, six were true negative, and one was false negative. The sensitivity, specificity, and accuracy of PET/CT in detecting responders were 93%, 75%, and 87%, respectively. In conclusion, 18F-FDG PET/CT can differentiate responders from non-responders with high accuracy after two cycles of NACT in patients with LABC. (orig.)

  13. The role of {sup 18}F-FDG PET/CT in evaluation of early response to neoadjuvant chemotherapy in patients with locally advanced breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Amandeep; Seenu, Vathalaru; Mehta, Sada Nand [All India Institute of Medical Sciences, Department of Surgical disciplines, New Delhi (India); Kumar, Rakesh; Chawla, Madhavi; Malhotra, Arun [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Gupta, Sidharatha Datta [All India Institute of Medical Sciences, Department of Pathology, New Delhi (India)

    2009-06-15

    We evaluated the role of 18F-FDG PET/CT for the assessment of response after two cycles of neo-adjuvant chemotherapy (NACT) for breast cancer. Twenty-three women with locally advanced breast cancer were included in this study. Early response to NACT was evaluated after two cycles using clinical examination, CT, and 18F-FDG PET/CT. Final histopathology following surgery after six cycles of NACT served as reference. Baseline PET/CT demonstrated a total of 26 lesions in 23 patients. The size of the primary tumor ranged from 1.90 cm to 11.60 cm, and the maximum value of the standardized uptake value of FDG (SUVmax) ranged from 3.6 to 38.6 (mean, 11.7). Post-chemotherapy PET/CT examinations were done after two cycles of NACT. The size of the primary tumor on follow-up PET/CT examinations ranged from 0.0 cm to 7.6 cm, and SUVmax ranged from 0.0 to 12.0 (mean, 3.96). On clinical, CT, and PET/CT examinations, 50% reduction in the parameters was taken as the cutoff value to differentiate between responders and non-responders. Post-NACT PET/CT demonstrated that 16 patients were responders and 7 non-responders. Among 16 responders on PET/CT scan, 14 were true positive and 2 were false positive when compared with histopathology. Among seven non-responder patients, six were true negative, and one was false negative. The sensitivity, specificity, and accuracy of PET/CT in detecting responders were 93%, 75%, and 87%, respectively. In conclusion, 18F-FDG PET/CT can differentiate responders from non-responders with high accuracy after two cycles of NACT in patients with LABC. (orig.)

  14. Evaluation of respiratory and cardiac motion correction schemes in dual gated PET/CT cardiac imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lamare, F., E-mail: frederic.lamare@chu-bordeaux.fr; Fernandez, P. [Univ. Bordeaux, INCIA, UMR 5287, F-33400 Talence (France); CNRS, INCIA, UMR 5287, F-33400 Talence (France); Service de Médecine Nucléaire, Hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux (France); Le Maitre, A.; Visvikis, D. [INSERM, UMR1101, LaTIM, Université de Bretagne Occidentale, 29609 Brest (France); Dawood, M.; Schäfers, K. P. [European Institute for Molecular Imaging, University of Münster, Mendelstr. 11, 48149 Münster (Germany); Rimoldi, O. E. [Vita-Salute University and Scientific Institute San Raffaele, Milan, Italy and CNR Istituto di Bioimmagini e Fisiologia Molecolare, Milan (Italy)

    2014-07-15

    Purpose: Cardiac imaging suffers from both respiratory and cardiac motion. One of the proposed solutions involves double gated acquisitions. Although such an approach may lead to both respiratory and cardiac motion compensation there are issues associated with (a) the combination of data from cardiac and respiratory motion bins, and (b) poor statistical quality images as a result of using only part of the acquired data. The main objective of this work was to evaluate different schemes of combining binned data in order to identify the best strategy to reconstruct motion free cardiac images from dual gated positron emission tomography (PET) acquisitions. Methods: A digital phantom study as well as seven human studies were used in this evaluation. PET data were acquired in list mode (LM). A real-time position management system and an electrocardiogram device were used to provide the respiratory and cardiac motion triggers registered within the LM file. Acquired data were subsequently binned considering four and six cardiac gates, or the diastole only in combination with eight respiratory amplitude gates. PET images were corrected for attenuation, but no randoms nor scatter corrections were included. Reconstructed images from each of the bins considered above were subsequently used in combination with an affine or an elastic registration algorithm to derive transformation parameters allowing the combination of all acquired data in a particular position in the cardiac and respiratory cycles. Images were assessed in terms of signal-to-noise ratio (SNR), contrast, image profile, coefficient-of-variation (COV), and relative difference of the recovered activity concentration. Results: Regardless of the considered motion compensation strategy, the nonrigid motion model performed better than the affine model, leading to higher SNR and contrast combined with a lower COV. Nevertheless, when compensating for respiration only, no statistically significant differences were

  15. Cardiac PET/CT for the diagnosis and prognostic evaluation of coronary artery disease

    International Nuclear Information System (INIS)

    Coronary artery disease is considered by de World Health Organization (WHO) to be pandemic. Eighty percent of the deaths occurs secondary to coronary artery disease, stroke and diabetes, thus they can be prevented. All of them are related to the same risk factors. Ischemic heart disease is the mayor cause of death in Argentina in the elderly population. Primary prevention strategies are essential in the health system. Hence, image complementary methods are very important to accomplish risk stratification, secondary prevention and pre-surgical evaluation. Nuclear cardiology has occupied this place through myocardial perfusion studies with radiopharmaceuticals, using SPECT (Single photon emission computed tomography) that have improved the level of sensitivity and specificity with ECG gated. Furthermore, positron emission tomography (PET) can evaluate relative myocardial perfusion, quantify absolute myocardial blood flow and coronary flow reserve. With its capacity to quantify rest-peak stress left ventricular systolic function we can underscore for example “balance ischemia”. By using hybrid PET/CT, also we can get information of coronary artery calcium scoring and coronary angiography. Currently, with the available softwares, we can acquire images in List mode. It means, from a single acquisition, it allows multiple image reconstructions, along with the associated electrocardiographic phase. PET/CT uses radiopharmaceuticals with short physical half life, and in conjunction with the possibility of acquiring in 3D mode, the perfusion studies can be done in a short time and offers lower radiation exposure to the patient. The new softwares for routine correction of misalignments between transmission and emission images have helped to reduce the frequency of artifacts and improve diagnostic accuracy. Hybrid PET/CT technology allows functional evaluation of myocardial perfusion combined with anatomic characterization of the epicardial coronary arteries, thereby

  16. The value of {sup 18}F-FDG PET/CT for assessing the response to neoadjuvant therapy in locally advanced rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Murcia Durendez, M.J.; Frutos Esteban, L.; Navarro Fernandez, J.L.; Mohamed Salem, L.; Claver Valderas, M.A. [University Hospital Virgen de la Arrixaca, Department of Nuclear Medicine, El Palmar, Murcia (Spain); Lujan, J.; Frutos, M.D. [University Hospital Virgen de la Arrixaca, Department of General Surgery, El Palmar, Murcia (Spain); Valero, G. [University Hospital Morales Meseguer, Department of General Surgery, Murcia (Spain); Ruiz Merino, G. [University Hospital Virgen de la Arrixaca, Department of Statistics, El Palmar, Murcia (Spain)

    2013-01-15

    Neoadjuvant radiochemotherapy (RCT) is an accepted treatment for locally advanced rectal cancer (LARC) that improves surgical outcomes. If a pathological complete response is achieved, conservative surgery can be considered. The objective of our study was to assess the reliability of {sup 18}F-FDG PET/CT for evaluating the response to neoadjuvant RCT in LARC. We prospectively studied 41 patients diagnosed with LARC and candidates for neoadjuvant RCT. PET/CT was performed before RCT and again 7 weeks later. A visual and semiquantitative analysis was carried out. The pathological response was classified according to the Mandard tumour regression grade (TRG). We analysed: (a) the relationship between TRG and the result of the posttreatment PET/CT scan, and (b) the correlation between the percentage of pathological response and the percentage decrease in SUVmax according to the response index (RI). The mean SUVmax of the rectal lesions at diagnosis was 13.6 and after RCT 3.96. The mean RI was 65.32 %. Sensitivity was 88.88 %, specificity 92.86 %, positive predictive value 96 %, negative predictive value 81 %. Of the 41 patients, 8 had TRG I (all negative PET/CT); 6 had TRG II (5 negative, 1 positive PET/CT); 16 had TRG III (13 positive, 3 negative PET/CT); 9 had TRG IV (all positive PET/CT); 2 had TRG V (all positive PET/CT). Of the 14 patients classified as responders (TRG I, II), 13 (92.86 %) had negative PET/CT. Of the 27 patients classified as nonresponders (TRG III-V), 24 (88.88 %) had positive PET/CT. Differences were statistically significant (p < 0.0001). The RI in responders was 79.9 % and in nonresponders was 60.3 %. Differences were statistically significant (p < 0.037). PET/CT is a reliable technique for assessing response to neoadjuvant RCT in LARC, with a view to considering more conservative surgical treatment. The combination of the visual and semiquantitative analysis increases the diagnostic validity of PET/CT. (orig.)

  17. PET/CT Staging Followed by Intensity-Modulated Radiotherapy (IMRT) Improves Treatment Outcome of Locally Advanced Pharyngeal Carcinoma: a matched-pair comparison

    OpenAIRE

    Lütolf Urs M; Davis J Bernard; Glanzmann Christoph; Huguenin Pia; Seifert Burkhardt; Studer Gabriela; Rothschild Sacha; Hany Thomas F; Ciernik I Frank

    2007-01-01

    Abstract Background Impact of non-pharmacological innovations on cancer cure rates is difficult to assess. It remains unclear, whether outcome improves with 2- [18-F]-fluoro-2-deoxyglucose-positron emission tomography and integrated computer tomography (PET/CT) and intensity-modulated radiotherapy (IMRT) for curative treatment of advanced pharyngeal carcinoma. Patients and methods Forty five patients with stage IVA oro- or hypopharyngeal carcinoma were staged with an integrated PET/CT and tre...

  18. Planned FDG PET-CT Scan in Follow-Up Detects Disease Progression in Patients With Locally Advanced NSCLC Receiving Curative Chemoradiotherapy Earlier Than Standard CT

    DEFF Research Database (Denmark)

    Pan, Yi; Brink, Carsten; Schytte, Tine;

    2015-01-01

    The role of positron emission tomography-computed tomography (PET-CT) in surveillance of patients with nonsmall cell lung cancer (NSCLC) treated with curatively intended chemoradiotherapy remains controversial. However, conventional chest X-ray and computed tomography (CT) are of limited value...... in discriminating postradiotherapy changes from tumor relapse. The aim of this study was to evaluate the clinical value of PET-CT scan in the follow-up for patients with locally advanced (LA) NSCLC receiving concomitant chemoradiotherapy (CCRT).Between 2009 and 2013, eligible patients with stages IIB-IIIB NSCLC...... were enrolled in the clinical trial NARLAL and treated in Odense University Hospital (OUH). All patients had a PET-CT scan scheduled 9 months (PET-CT9) after the start of the radiation treatment in addition to standard follow-up (group A). Patients who presented with same clinical stage of NSCLC...

  19. Diagnostic accuracy of 18F-FDG PET/CT for detecting synchronous advanced colorectal neoplasia in patients with gastric cancer.

    Science.gov (United States)

    Choi, Byung Wook; Kim, Hae Won; Won, Kyoung Sook; Song, Bong-Il; Cho, Kwang Bum; Bae, Sung Uk

    2016-09-01

    Preoperative screening for synchronous colorectal neoplasia (CRN) has been recommended in patients with gastric cancer because patients with gastric cancer are at increased risk for synchronous CRN. The aim of this study was to investigate the diagnostic accuracy of F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) for detecting synchronous advanced CRN in patients with gastric cancer.A total of 256 patients who underwent colonoscopy and F-FDG PET/CT for preoperative staging were enrolled in this study. The diagnosis of focal colonic F-FDG uptake on F-FDG PET/CT image was made based on histopathologic results from the colonoscopic biopsy. The F-FDG PET/CT result was considered as true positive for advanced CRN when focal F-FDG uptake matched colorectal carcinoma or adenoma with high-grade dysplasia in the same location on colonoscopy.Synchronous advanced CRN was detected in 21 of the 256 patients (4.7%). Sensitivity, specificity, and accuracy of F-FDG PET/CT were 76.2%, 96.2%, and 94.5%. The size of CRN with a true positive result was significantly larger than that with a false negative result.F-FDG PET/CT demonstrated high diagnostic accuracy for detecting synchronous advanced CRN in patients with gastric cancer. Colonoscopy is recommended as the next diagnostic step for further evaluation of a positive F-FDG PET/CT result in patients with gastric cancer. PMID:27603371

  20. Low-dose interpolated average CT for attenuation correction in cardiac PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Tung-Hsin [Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taiwan (China); Zhang, Geoffrey [Department of Radiation Oncology, Moffitt Cancer Center, Florida (United States); Wang, Shyh-Jen [Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taiwan (China); Department of Nuclear Medicine, Taipei Veterans General Hospital, Taiwan (China); Chen, Chih-Hao [Department of Nuclear Medicine, Taipei Veterans General Hospital, Taiwan (China); Yang, Bang-Hung [Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taiwan (China); Department of Nuclear Medicine, Taipei Veterans General Hospital, Taiwan (China); Wu, Nien-Yun [Department of Nuclear Medicine, Taipei Veterans General Hospital, Taiwan (China); Huang, Tzung-Chi, E-mail: tzungchi.huang@mail.cmu.edu.t [Department of Biomedical Imaging and Radiological Science, China Medical University, Taiwan (China)

    2010-07-21

    Because of the advantages in the use of high photon flux and thus the short scan times of CT imaging, the traditional {sup 68}Ge scans for positron emission tomography (PET) image attenuation correction have been replaced by CT scans in the modern PET/CT technology. The combination of fast CT scan and slow PET scan often causes image misalignment between the PET and CT images due to respiration motion. Use of the average CT derived from cine CT images is reported to reduce such misalignment. However, the radiation dose to patients is higher with cine CT scans. This study introduces a method that uses breath-hold CT images and their interpolations to generate the average CT for PET image attenuation correction. Breath-hold CT sets are taken at end-inspiration and end-expiration. Deformable image registration is applied to generate a voxel-to-voxel motion matrix between the two CT sets. The motion is equally divided into 5 steps from inspiration to expiration and 5 steps from expiration to inspiration, generating a total of 8 phases of interpolated CT sets. An average CT image is generated from all the 10 phase CT images, including original inhale/exhale CT and 8 interpolated CT sets. Quantitative comparison shows that the reduction of image misalignment artifacts using the average CT from the interpolation technique for PET attenuation correction is at a similar level as that using cine average CT, while the dose to the patient from the CT scans is reduced significantly. The interpolated average CT method hence provides a low dose alternative to cine CT scans for PET attenuation correction.

  1. Low-dose interpolated average CT for attenuation correction in cardiac PET/CT

    International Nuclear Information System (INIS)

    Because of the advantages in the use of high photon flux and thus the short scan times of CT imaging, the traditional 68Ge scans for positron emission tomography (PET) image attenuation correction have been replaced by CT scans in the modern PET/CT technology. The combination of fast CT scan and slow PET scan often causes image misalignment between the PET and CT images due to respiration motion. Use of the average CT derived from cine CT images is reported to reduce such misalignment. However, the radiation dose to patients is higher with cine CT scans. This study introduces a method that uses breath-hold CT images and their interpolations to generate the average CT for PET image attenuation correction. Breath-hold CT sets are taken at end-inspiration and end-expiration. Deformable image registration is applied to generate a voxel-to-voxel motion matrix between the two CT sets. The motion is equally divided into 5 steps from inspiration to expiration and 5 steps from expiration to inspiration, generating a total of 8 phases of interpolated CT sets. An average CT image is generated from all the 10 phase CT images, including original inhale/exhale CT and 8 interpolated CT sets. Quantitative comparison shows that the reduction of image misalignment artifacts using the average CT from the interpolation technique for PET attenuation correction is at a similar level as that using cine average CT, while the dose to the patient from the CT scans is reduced significantly. The interpolated average CT method hence provides a low dose alternative to cine CT scans for PET attenuation correction.

  2. Low-dose interpolated average CT for attenuation correction in cardiac PET/CT

    Science.gov (United States)

    Wu, Tung-Hsin; Zhang, Geoffrey; Wang, Shyh-Jen; Chen, Chih-Hao; Yang, Bang-Hung; Wu, Nien-Yun; Huang, Tzung-Chi

    2010-07-01

    Because of the advantages in the use of high photon flux and thus the short scan times of CT imaging, the traditional 68Ge scans for positron emission tomography (PET) image attenuation correction have been replaced by CT scans in the modern PET/CT technology. The combination of fast CT scan and slow PET scan often causes image misalignment between the PET and CT images due to respiration motion. Use of the average CT derived from cine CT images is reported to reduce such misalignment. However, the radiation dose to patients is higher with cine CT scans. This study introduces a method that uses breath-hold CT images and their interpolations to generate the average CT for PET image attenuation correction. Breath-hold CT sets are taken at end-inspiration and end-expiration. Deformable image registration is applied to generate a voxel-to-voxel motion matrix between the two CT sets. The motion is equally divided into 5 steps from inspiration to expiration and 5 steps from expiration to inspiration, generating a total of 8 phases of interpolated CT sets. An average CT image is generated from all the 10 phase CT images, including original inhale/exhale CT and 8 interpolated CT sets. Quantitative comparison shows that the reduction of image misalignment artifacts using the average CT from the interpolation technique for PET attenuation correction is at a similar level as that using cine average CT, while the dose to the patient from the CT scans is reduced significantly. The interpolated average CT method hence provides a low dose alternative to cine CT scans for PET attenuation correction.

  3. Role of {sup 18}F-FDG PET/CT in the diagnosis of infective endocarditis in patients with an implanted cardiac device: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Graziosi, Maddalena; Lorenzini, Massimiliano; Diemberger, Igor; Pasquale, Ferdinando; Ziacchi, Matteo; Biffi, Mauro; Martignani, Cristian; Boriani, Giuseppe; Rapezzi, Claudio [Alma Mater-University of Bologna, and S. Orsola-Malpighi Hospital, Cardiology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Bologna (Italy); Nanni, Cristina; Bonfiglioli, Rachele; Fanti, Stefano [Alma Mater-University of Bologna, and S. Orsola-Malpighi Hospital, Nuclear Medicine Unit, Department of Experimental, Diagnostic and Specialty Medicine, Bologna (Italy); Bartoletti, Michele; Tumietto, Fabio; Viale, Pier Luigi [Alma Mater-University of Bologna, and S. Orsola-Malpighi Hospital, Infectious Diseases Unit, Department of Medical and Surgical Sciences, Bologna (Italy)

    2014-08-15

    Infective endocarditis (IE) is widely underdiagnosed or diagnosed after a major delay. The diagnosis is currently based on the modified DUKE criteria, where the only validated imaging technique is echocardiography, and remains challenging especially in patients with an implantable cardiac device. The aim of this study was to assess the incremental diagnostic role of {sup 18}F-FDG PET/CT in patients with an implanted cardiac device and suspected IE. We prospectively analysed 27 consecutive patients with an implantable device evaluated for suspected device-related IE between January 2011 and June 2013. The diagnostic probability of IE was defined at presentation according to the modified DUKE criteria. PET/CT was performed as soon as possible following the clinical suspicion of IE. Patients then underwent medical or surgical treatment based on the overall clinical evaluation. During follow-up, we considered: lead cultures in patients who underwent extraction, direct inspection and lead cultures in those who underwent surgery, and a clinical/instrumental reevaluation after at least 6 months in patients who received antimicrobial treatment or had an alternative diagnosis and were not treated for IE. After the follow-up period, the diagnosis was systematically reviewed by the multidisciplinary team using the modified DUKE criteria and considering the new findings. Among the ten patients with a positive PET/CT scan, seven received a final diagnosis of ''definite IE'', one of ''possible IE'' and two of ''IE rejected''. Among the 17 patients with a negative PET/CT scan, four were false-negative and received a final diagnosis of definite IE. These patients underwent PET/CT after having started antibiotic therapy (≥48 h) or had a technically suboptimal examination. In patients with a cardiac device, PET/CT increases the diagnostic accuracy of the modified Duke criteria for IE, particularly in the subset of

  4. Hybrid cardiac imaging: SPECT/CT and PET/CT. A joint position statement by the European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC)

    DEFF Research Database (Denmark)

    Flotats, Albert; Gutberlet, Matthias; Knuuti, Juhani;

    2011-01-01

    . The European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC) in this paper want to present a position statement of the institutions on the current roles of SPECT/CT and PET/CT hybrid cardiac imaging in patients...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-08-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-05-15

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

  7. FDG-PET/CT in advanced ovarian cancer staging: Value and pitfalls in detecting lesions in different abdominal and pelvic quadrants compared with laparoscopy

    International Nuclear Information System (INIS)

    Introduction and aim: Ovarian carcinoma (OC) is a common cancer in the Western Countries, and an important cause of death in patients suffering with gynaecologic malignancies. The majority of patients present with advanced disease at the time of diagnosis. Treatment with debulking surgery followed by chemotherapy is the standard approach while chemotherapy is contemplated when surgery is not possible. A correct pre-operative staging is important to ensure a most appropriate management. Laparoscopy (LPS) is the standard diagnostic tool for the assessment of intraperitoneal infiltration but is invasive and requires general anaesthesia. FDG-PET/CT is increasingly used for staging different types of cancer, and the aim of this study is to assess the value of FDG-PET/CT in staging advanced OC and its sensitivity to detect lesions in different quadrants of the abdominal-pelvic area compared to laparoscopy. Materials and methods: From September 2004 till April 2008, 40 patients with high suspicion of OC were referred to our hospital for diagnostic LPS to explore the possibility of optimal debulking surgery. Those who were not suitable for surgery were referred for chemotherapy. Before chemotherapy, the patients underwent an FDG-PET/CT scan. The findings in 9 quadrants of abdominal-pelvic area (total 360 quadrants) for PET/CT and LPS were recorded and compared. Results: In 14/360 areas (3.8%), surgical evaluation was not possible because of presence of adhesions, thus the number of areas explored by laparoscopy was 346. Tumour was found in 308 quadrants (38 quadrants free of disease). PET/CT was positive in all 40 patients with true negative results in 26/346 quadrants (7.5%), and true positives results in 243/346 quadrants (70.2%). False positive and negative PET/CT results were found in 12/346 and 65/346 quadrants, respectively. False positive PET/CT findings were evenly present in all quadrants. False negative PET/CT findings were present in 31/109 (28.4%) upper

  8. FDG-PET/CT in advanced ovarian cancer staging: Value and pitfalls in detecting lesions in different abdominal and pelvic quadrants compared with laparoscopy

    Energy Technology Data Exchange (ETDEWEB)

    De Iaco, Pierandrea [Department of Gynaecology, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna (Italy); Musto, Alessandra [Department of Nuclear Medicine, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna (Italy); Orazi, Luca [Department of Gynaecology, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna (Italy); Zamagni, Claudio; Rosati, Marta [Department of Medical Oncology, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna (Italy); Allegri, Vincenzo [Department of Nuclear Medicine, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna (Italy); Cacciari, Nicoletta [Department of Medical Oncology, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna (Italy); Al-Nahhas, Adil [Department of Nuclear Medicine, Hammersmith Hospital, London (United Kingdom); Rubello, Domenico, E-mail: domenico.rubello@libero.it [Department of Nuclear Medicine, PET/CT Centre, Radiology, Medical Physics, ' Santa Maria della Misericordia' Hospital, Viale Tre Martiri 140, 45100 Rovigo (Italy); Venturoli, Stefano [Department of Gynaecology, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna (Italy); Fanti, Stefano [Department of Nuclear Medicine, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna (Italy)

    2011-11-15

    Introduction and aim: Ovarian carcinoma (OC) is a common cancer in the Western Countries, and an important cause of death in patients suffering with gynaecologic malignancies. The majority of patients present with advanced disease at the time of diagnosis. Treatment with debulking surgery followed by chemotherapy is the standard approach while chemotherapy is contemplated when surgery is not possible. A correct pre-operative staging is important to ensure a most appropriate management. Laparoscopy (LPS) is the standard diagnostic tool for the assessment of intraperitoneal infiltration but is invasive and requires general anaesthesia. FDG-PET/CT is increasingly used for staging different types of cancer, and the aim of this study is to assess the value of FDG-PET/CT in staging advanced OC and its sensitivity to detect lesions in different quadrants of the abdominal-pelvic area compared to laparoscopy. Materials and methods: From September 2004 till April 2008, 40 patients with high suspicion of OC were referred to our hospital for diagnostic LPS to explore the possibility of optimal debulking surgery. Those who were not suitable for surgery were referred for chemotherapy. Before chemotherapy, the patients underwent an FDG-PET/CT scan. The findings in 9 quadrants of abdominal-pelvic area (total 360 quadrants) for PET/CT and LPS were recorded and compared. Results: In 14/360 areas (3.8%), surgical evaluation was not possible because of presence of adhesions, thus the number of areas explored by laparoscopy was 346. Tumour was found in 308 quadrants (38 quadrants free of disease). PET/CT was positive in all 40 patients with true negative results in 26/346 quadrants (7.5%), and true positives results in 243/346 quadrants (70.2%). False positive and negative PET/CT results were found in 12/346 and 65/346 quadrants, respectively. False positive PET/CT findings were evenly present in all quadrants. False negative PET/CT findings were present in 31/109 (28.4%) upper

  9. A knowledge-based method for reducing attenuation artefacts caused by cardiac appliances in myocardial PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Hamill, James J [Siemens Medical Solutions, Molecular Imaging, 810 Innovation Dr., Knoxville, TN (United States); Brunken, Richard C [Department of Molecular and Functional Imaging, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH (United States); Bybel, Bohdan [Department of Molecular and Functional Imaging, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH (United States); DiFilippo, Frank P [Department of Molecular and Functional Imaging, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH (United States); Faul, David D [Siemens Medical Solutions, Molecular Imaging, 810 Innovation Dr., Knoxville, TN (United States)

    2006-06-07

    Attenuation artefacts due to implanted cardiac defibrillator leads have previously been shown to adversely impact cardiac PET/CT imaging. In this study, the severity of the problem is characterized, and an image-based method is described which reduces the resulting artefact in PET. Automatic implantable cardioverter defibrillator (AICD) leads cause a moving-metal artefact in the CT sections from which the PET attenuation correction factors (ACFs) are derived. Fluoroscopic cine images were measured to demonstrate that the defibrillator's highly attenuating distal shocking coil moves rhythmically across distances on the order of 1 cm. Rhythmic motion of this magnitude was created in a phantom with a moving defibrillator lead. A CT study of the phantom showed that the artefact contained regions of incorrect, very high CT values and adjacent regions of incorrect, very low CT values. The study also showed that motion made the artefact more severe. A knowledge-based metal artefact reduction method (MAR) is described that reduces the magnitude of the error in the CT images, without use of the corrupted sinograms. The method modifies the corrupted image through a sequence of artefact detection procedures, morphological operations, adjustments of CT values and three-dimensional filtering. The method treats bone the same as metal. The artefact reduction method is shown to run in a few seconds, and is validated by applying it to a series of phantom studies in which reconstructed PET tracer distribution values are wrong by as much as 60% in regions near the CT artefact when MAR is not applied, but the errors are reduced to about 10% of expected values when MAR is applied. MAR changes PET image values by a few per cent in regions not close to the artefact. The changes can be larger in the vicinity of bone. In patient studies, the PET reconstruction without MAR sometimes results in anomalously high values in the infero-septal wall. Clinical performance of MAR is assessed by

  10. Prognostic Value of Quantitative Metabolic Metrics on Baseline Pre-Sunitinib FDG PET/CT in Advanced Renal Cell Carcinoma.

    Directory of Open Access Journals (Sweden)

    Ryogo Minamimoto

    Full Text Available The objective of this study was to prospectively evaluate various quantitative metrics on FDG PET/CT for monitoring sunitinib therapy and predicting prognosis in patients with metastatic renal cell cancer (mRCC.Seventeen patients (mean age: 59.0 ± 11.6 prospectively underwent a baseline FDG PET/CT and interim PET/CT after 2 cycles (12 weeks of sunitinib therapy. We measured the highest maximum standardized uptake value (SUVmax of all identified lesions (highest SUVmax, sum of SUVmax with maximum six lesions (sum of SUVmax, total lesion glycolysis (TLG and metabolic tumor volume (MTV from baseline PET/CT and interim PET/CT, and the % decrease in highest SUVmax of lesion (%Δ highest SUVmax, the % decrease in sum of SUVmax, the % decrease in TLG (%ΔTLG and the % decrease in MTV (%ΔMTV between baseline and interim PET/CT, and the imaging results were validated by clinical follow-up at 12 months after completion of therapy for progression free survival (PFS.At 12 month follow-up, 6/17 (35.3% patients achieved PFS, while 11/17 (64.7% patients were deemed to have progression of disease or recurrence within the previous 12 months. At baseline, PET/CT demonstrated metabolically active cancer in all cases. Using baseline PET/CT alone, all of the quantitative imaging metrics were predictive of PFS. Using interim PET/CT, the %Δ highest SUVmax, %Δ sum of SUVmax, and %ΔTLG were also predictive of PFS. Otherwise, interim PET/CT showed no significant difference between the two survival groups regardless of the quantitative metric utilized including MTV and TLG.Quantitative metabolic measurements on baseline PET/CT appears to be predictive of PFS at 12 months post-therapy in patients scheduled to undergo sunitinib therapy for mRCC. Change between baseline and interim PET/CT also appeared to have prognostic value but otherwise interim PET/CT after 12 weeks of sunitinib did not appear to be predictive of PFS.

  11. The predictive value of {sup 18}F-FDG PET/CT for assessing pathological response and survival in locally advanced rectal cancer after neoadjuvant radiochemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Leccisotti, Lucia; Stefanelli, Antonella; Giordano, Alessandro [Universita Cattolica del Sacro Cuore, Institute of Nuclear Medicine, Rome (Italy); Gambacorta, Maria Antonietta; Valentini, Vincenzo [Universita Cattolica del Sacro Cuore, Institute of Radiation Oncology, Rome (Italy); De Waure, Chiara [Universita Cattolica del Sacro Cuore, Institute of Public Health, Roma (Italy); Barbaro, Brunella [Universita Cattolica del Sacro Cuore, Institute of Radiology, Rome (Italy); Vecchio, Fabio Maria [Universita Cattolica del Sacro Cuore, Institute of Pathology, Rome (Italy); Coco, Claudio; Persiani, Roberto; Crucitti, Antonio; Tortorelli, Antonino Pio [Universita Cattolica del Sacro Cuore, Department of Surgical Sciences, Rome (Italy)

    2015-04-01

    To evaluate whether metabolic changes in the primary tumour during and after preoperative radiochemotherapy (RCT) can predict the histopathological response in patients with locally advanced rectal cancer as well as disease-free survival (DFS) and overall survival (OS). Consecutive patients with cT2-4 N0-2 rectal adenocarcinoma were included. {sup 18}F-FDG PET/CT was performed at baseline, at the end of the second week of RCT (early PET/CT) and before surgery (late PET/CT). The PET/CT results were compared with histopathological data (ypT0 N0 vs. ypT1-4 N0-2 as well as TRG1 vs.TRG2-5) and survival. The study included 126 patients. Among 124 patients in whom TNM classification was available, 28 (22.6 %) were ypT0 N0, and among all 126 patients, 31 (24.6 %) were TRG1. The areas under the curve of the early response index (RI) for identifying non-complete pathological response (non-cPR) were 0.74 (95 % CI 0.61 - 0.87) for ypT1-4 N0-2 patients and 0.75 (95 % CI 0.62 - 0.88) for TRG2-5 patients. The optimal cut-off for differentiating patients with non-cPR and cPR was found to be a reduction of 61.2 % (83.1 % sensitivity and 65 % specificity in ypT1-4 N0-2 patients; 85.4 % sensitivity and 65.2 % specificity in TRG2-5 patients). The optimal cut-off for late RI could not be found. The qualitative analysis of images obtained after RCT demonstrated 81.5 % sensitivity and 61.3 % specificity in predicting TRG2-5. After a median follow-up of 68 months, the low number of patients with local/distant recurrence or who had died did not allow the value of PET/CT for predicting DFS and OS to be calculated. The early assessment of response to RCT by {sup 18}F-FDG PET/CT can predict non-cPR allowing practical modification of preoperative treatment. Conversely, late RI is not sufficiently accurate for guiding the decision as to whether local excision or even observation is appropriate in an individual patient. Qualitative analysis of late PET/CT images is also not sensitive enough

  12. High FDG uptake areas on pre-radiotherapy PET/CT identify preferential sites of local relapse after chemoradiotherapy for locally advanced oesophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Calais, Jeremie; Lemarignier, Charles; Vera, Pierre [Henri Becquerel Cancer Center and Rouen University Hospital, Nuclear Medicine Department, Rouen (France); University of Rouen, QuantIF-LITIS (Equipe d' Accueil 4108-FR CNRS 3638), Faculty of Medicine, Rouen (France); Dubray, Bernard [University of Rouen, QuantIF-LITIS (Equipe d' Accueil 4108-FR CNRS 3638), Faculty of Medicine, Rouen (France); Centre Henri Becquerel and Rouen University Hospital, Department of Radiotherapy and Medical Physics, Rouen (France); Nkhali, Lamyaa; Thureau, Sebastien; Modzelewski, Romain; Gardin, Isabelle [Henri Becquerel Cancer Center and Rouen University Hospital, Nuclear Medicine Department, Rouen (France); University of Rouen, QuantIF-LITIS (Equipe d' Accueil 4108-FR CNRS 3638), Faculty of Medicine, Rouen (France); Centre Henri Becquerel and Rouen University Hospital, Department of Radiotherapy and Medical Physics, Rouen (France); Di Fiore, Frederic [Rouen University Hospital, Department of Gastroenterology, Rouen (France); Rouen University Hospital, Department of Oncology, Henri Becquerel Cancer Center, IRON, Rouen (France); Michel, Pierre [Rouen University Hospital, Department of Gastroenterology, Rouen (France)

    2015-05-01

    The high failure rates in the radiotherapy (RT) target volume suggest that patients with locally advanced oesophageal cancer (LAOC) would benefit from increased total RT doses. High 2-deoxy-2-[{sup 18}F]fluoro-D-glucose (FDG) uptake (hotspot) on pre-RT FDG positron emission tomography (PET)/CT has been reported to identify intra-tumour sites at increased risk of relapse after RT in non-small cell lung cancer and in rectal cancer. Our aim was to confirm these observations in patients with LAOC and to determine the optimal maximum standardized uptake value (SUV{sub max}) threshold to delineate smaller RT target volumes that would facilitate RT dose escalation without impaired tolerance. The study included 98 consecutive patients with LAOC treated by chemoradiotherapy (CRT). All patients underwent FDG PET/CT at initial staging and during systematic follow-up in a single institution. FDG PET/CT acquisitions were coregistered on the initial CT scan. Various subvolumes within the initial tumour (30, 40, 50, 60, 70, 80 and 90 % SUV{sub max} thresholds) and in the subsequent local recurrence (LR, 40 and 90 % SUV{sub max} thresholds) were pasted on the initial CT scan and compared[Dice, Jaccard, overlap fraction (OF), common volume/baseline volume, common volume/recurrent volume]. Thirty-five patients had LR. The initial metabolic tumour volume was significantly higher in LR tumours than in the locally controlled tumours (mean 25.4 vs 14.2 cc; p = 0.002). The subvolumes delineated on initial PET/CT with a 30-60 % SUV{sub max} threshold were in good agreement with the recurrent volume at 40 % SUV{sub max} (OF = 0.60-0.80). The subvolumes delineated on initial PET/CT with a 30-60 % SUV{sub max} threshold were in good to excellent agreement with the core volume (90 % SUV{sub max}) of the relapse (common volume/recurrent volume and OF indices 0.61-0.89). High FDG uptake on pretreatment PET/CT identifies tumour subvolumes that are at greater risk of recurrence after CRT in

  13. Is metal artefact reduction mandatory in cardiac PET/CT imaging in the presence of pacemaker and implantable cardioverter defibrillator leads?

    Energy Technology Data Exchange (ETDEWEB)

    Ghafarian, Pardis [Shahid Beheshti University, Department of Radiation Medicine, Tehran (Iran, Islamic Republic of); Geneva University Hospital, Division of Nuclear Medicine, Geneva 4 (Switzerland); Tehran University of Medical Sciences, Research Center for Science and Technology in Medicine, Tehran (Iran, Islamic Republic of); Aghamiri, S.M.R. [Shahid Beheshti University, Department of Radiation Medicine, Tehran (Iran, Islamic Republic of); Ay, Mohammad R. [Tehran University of Medical Sciences, Research Center for Science and Technology in Medicine, Tehran (Iran, Islamic Republic of); Tehran University of Medical Sciences, Department of Medical Physics and Biomedical Engineering, Tehran (Iran, Islamic Republic of); Tehran University of Medical Sciences, Research Institute for Nuclear Medicine, Tehran (Iran, Islamic Republic of); Rahmim, Arman [Johns Hopkins University, Department of Radiology, Baltimore, MD (United States); Schindler, Thomas H. [Geneva University, Cardiovascular Center, Nuclear Cardiology, Geneva (Switzerland); Ratib, Osman [Geneva University Hospital, Division of Nuclear Medicine, Geneva 4 (Switzerland); Zaidi, Habib [Geneva University Hospital, Division of Nuclear Medicine, Geneva 4 (Switzerland); Geneva University, Geneva Neuroscience Center, Geneva (Switzerland)

    2011-02-15

    Cardiac PET/CT imaging is often performed in patients with pacemakers and implantable cardioverter defibrillator (ICD) leads. However, metallic implants usually produce artefacts on CT images which might propagate to CT-based attenuation-corrected (CTAC) PET images. The impact of metal artefact reduction (MAR) for CTAC of cardiac PET/CT images in the presence of pacemaker, ICD and ECG leads was investigated using both qualitative and quantitative analysis in phantom and clinical studies. The study included 14 patients with various leads undergoing perfusion and viability examinations using dedicated cardiac PET/CT protocols. The PET data were corrected for attenuation using both artefactual CT images and CT images corrected using the MAR algorithm. The severity and magnitude of metallic artefacts arising from these leads were assessed on both linear attenuation coefficient maps ({mu}-maps) and attenuation-corrected PET images. CT and PET emission data were obtained using an anthropomorphic thorax phantom and a dedicated heart phantom made in-house incorporating pacemaker and ICD leads attached at the right ventricle of the heart. Volume of interest-based analysis and regression plots were performed for regions related to the lead locations. Bull's eye view analysis was also performed on PET images corrected for attenuation with and without the MAR algorithm. In clinical studies, the visual assessment of PET images by experienced physicians and quantitative analysis did not reveal erroneous interpretation of the tracer distribution or significant differences when PET images were corrected for attenuation with and without MAR. In phantom studies, the mean differences between tracer uptake obtained without and with MAR were 10.16{+-}2.1% and 6.86{+-}2.1% in the segments of the heart in the vicinity of metallic ICD or pacemaker leads, and were 4.43{+-}0.5% and 2.98{+-}0.5% in segments far from the leads. Although the MAR algorithm was able to effectively improve

  14. Is metal artefact reduction mandatory in cardiac PET/CT imaging in the presence of pacemaker and implantable cardioverter defibrillator leads?

    International Nuclear Information System (INIS)

    Cardiac PET/CT imaging is often performed in patients with pacemakers and implantable cardioverter defibrillator (ICD) leads. However, metallic implants usually produce artefacts on CT images which might propagate to CT-based attenuation-corrected (CTAC) PET images. The impact of metal artefact reduction (MAR) for CTAC of cardiac PET/CT images in the presence of pacemaker, ICD and ECG leads was investigated using both qualitative and quantitative analysis in phantom and clinical studies. The study included 14 patients with various leads undergoing perfusion and viability examinations using dedicated cardiac PET/CT protocols. The PET data were corrected for attenuation using both artefactual CT images and CT images corrected using the MAR algorithm. The severity and magnitude of metallic artefacts arising from these leads were assessed on both linear attenuation coefficient maps (μ-maps) and attenuation-corrected PET images. CT and PET emission data were obtained using an anthropomorphic thorax phantom and a dedicated heart phantom made in-house incorporating pacemaker and ICD leads attached at the right ventricle of the heart. Volume of interest-based analysis and regression plots were performed for regions related to the lead locations. Bull's eye view analysis was also performed on PET images corrected for attenuation with and without the MAR algorithm. In clinical studies, the visual assessment of PET images by experienced physicians and quantitative analysis did not reveal erroneous interpretation of the tracer distribution or significant differences when PET images were corrected for attenuation with and without MAR. In phantom studies, the mean differences between tracer uptake obtained without and with MAR were 10.16±2.1% and 6.86±2.1% in the segments of the heart in the vicinity of metallic ICD or pacemaker leads, and were 4.43±0.5% and 2.98±0.5% in segments far from the leads. Although the MAR algorithm was able to effectively improve the quality of

  15. Prognostic Value of Metabolic Tumor Volume Measured by {sup 18F} FDG PET/CT in Locally Advanced Head and Neck Squamous Cell Carcinomas Treated by Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Kyu Ho; Yoo, Ie Ryung; Han, Eun Ji; Kim, Yeon Sil; Kim, Gi Wom; Na, Sea Jung; Sun, Dong Il; Jung, So Lyung; Jung, Chan Kwon; Kim, Min Sik; Lee, So Yeon; Kim, Sung Hoon [The Cathholic Univ. of Korea, Seoul (Korea, Republic of)

    2011-03-15

    We assessed the prognostic value of metabolic tumor volume (MTV) measured using {sup 18F} fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) inpatients with locally advanced head and neck squamous cell carcinoma (HNSCC). We retrospectively reviewed 56 patients (51 men, five women; mean age 56.0{+-}8.8 years) who had locally advanced HNSCC and underwent FDG PET/CT for initial evaluation. All patients had surgical resection and radiotherapy with or without concurrent chemotherapy. The peak standardized uptake (SUV{sup peak)} and MTV of the target lesion, including primary HNSCC and metastatic cervical lymph nodes, were measured SUV{sup peak,} MTV, and clinico pathologic variables such as age, Eastern Cooperative Oncology Group (ECOG) performance status, pN stage, pT stage, TNM stage, histologic grade and treatment modality to disease free survival (DFS) and overall survival (OS). On the initial FDG PET/CT scans, the median SUV{sup peakw}as 7.8 (range, 1.8-19.0) and MTV was 17.0cm{sup 3(}range, 0.1-131.0cm{sup 3)}. The estimated 2 year DFS and OS rates were 67.2% and 81.8%. The cutoff points of SUV{sup peak6}.2 and MTV 20.7cm{sup 3w}ere the best discriminative values for predicting clinical outcome. MTV and ECOG performance status were significantly related to DFS and OS on univariate and multivariate analyses (P=0.05). The MTV obtained from initial FDG PET/CT scan is a significant prognostic factor for disease recurrence and mortality in locally advanced HNSCC treated with surgery and radiotherapy with or without chemotherapy.

  16. TU-C-12A-09: Modeling Pathologic Response of Locally Advanced Esophageal Cancer to Chemo-Radiotherapy Using Quantitative PET/CT Features, Clinical Parameters and Demographics

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, H; Chen, W; Kligerman, S; D’Souza, W; Suntharalingam, M; Lu, W [University of Maryland School of Medicine, Baltimore, MD (United States); Tan, S [Huazhong University of Science and Technology, Wuhan (China); Kim, G [Duke University, High Point, NC (United States)

    2014-06-15

    Purpose: To develop predictive models using quantitative PET/CT features for the evaluation of tumor response to neoadjuvant chemo-radiotherapy (CRT) in patients with locally advanced esophageal cancer. Methods: This study included 20 patients who underwent tri-modality therapy (CRT + surgery) and had {sup 18}F-FDG PET/CT scans before initiation of CRT and 4-6 weeks after completion of CRT but prior to surgery. Four groups of tumor features were examined: (1) conventional PET/CT response measures (SUVmax, tumor diameter, etc.); (2) clinical parameters (TNM stage, histology, etc.) and demographics; (3) spatial-temporal PET features, which characterize tumor SUV intensity distribution, spatial patterns, geometry, and associated changes resulting from CRT; and (4) all features combined. An optimal feature set was identified with recursive feature selection and cross-validations. Support vector machine (SVM) and logistic regression (LR) models were constructed for prediction of pathologic tumor response to CRT, using cross-validations to avoid model over-fitting. Prediction accuracy was assessed via area under the receiver operating characteristic curve (AUC), and precision was evaluated via confidence intervals (CIs) of AUC. Results: When applied to the 4 groups of tumor features, the LR model achieved AUCs (95% CI) of 0.57 (0.10), 0.73 (0.07), 0.90 (0.06), and 0.90 (0.06). The SVM model achieved AUCs (95% CI) of 0.56 (0.07), 0.60 (0.06), 0.94 (0.02), and 1.00 (no misclassifications). Using spatial-temporal PET features combined with conventional PET/CT measures and clinical parameters, the SVM model achieved very high accuracy (AUC 1.00) and precision (no misclassifications), significantly better than using conventional PET/CT measures or clinical parameters and demographics alone. For groups with a large number of tumor features (groups 3 and 4), the SVM model achieved significantly higher accuracy than the LR model. Conclusion: The SVM model using all features

  17. Prognostic value of pretreatment {sup 18}F-FDG PET/CT and human papillomavirus type 16 testing in locally advanced oropharyngeal squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Nai-Ming; Yen, Tzu-Chen [Chang Gung University College of Medicine, Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Taipei (China); Chang, Joseph Tung-Chieh; Tsan, Din-Li; Lin, Chien-Yu [Chang Gung University College of Medicine, Department of Radiation Oncology, Chang Gung Memorial Hospital, Taipei (China); Huang, Chung-Guei [Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Laboratory Medicine, Taipei (China); Ng, Shu-Hang [Chang Gung University College of Medicine, Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Taipei (China); Wang, Hung-Ming; Hsu, Cheng-Lung [Chang Gung University College of Medicine, Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei (China); Liao, Chun-Ta [Chang Gung University College of Medicine, Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taipei (China)

    2012-11-15

    Human papillomavirus type 16 (HPV-16) positivity is associated with favourable survival in oropharyngeal squamous cell carcinoma (OPSCC). We report here a study of the prognostic significance of {sup 18}F-FDG PET/CT functional parameters and HPV-16 infection in OPSCC patients. We retrospectively analysed 60 patients with stage III or IV OPSCC who had had a pretherapy {sup 18}F-FDG PET/CT scan and had completed concurrent chemoradiotherapy (n = 58) or curative radiotherapy (n = 2). All patients were followed up for {>=}24 months or until death. We determined total lesion glycolysis (TLG) and the maximal standardized uptake values (SUV{sub max}) of the primary tumour and neck lymph nodes from the pretherapy {sup 18}F-FDG PET/CT scan. Optimal cut-offs of the {sup 18}F-FDG PET/CT parameters were obtained by receiver operating characteristic (ROC) curve analyses. Pretherapy tumour biopsies were studied by polymerase chain reaction to determine HPV infection status. The pretherapy tumour biopsies were positive for HPV-16 in 12 patients (20.0 %). Cox regression analyses revealed HPV-16 positivity and tumour TLG >135.3 g to be independently associated with overall survival (p = 0.027 and 0.011, respectively). However, only tumour TLG >135.3 g was independently associated with progression-free survival, disease-free survival and locoregional control (p = 0.011, 0.001 and 0.034, respectively). A scoring system was formulated to define distinct overall survival groups using tumour TLG and HPV-16 status. Patients positive for HPV-16 and with tumour TLG {<=}135.3 g experienced better survival than those with tumour TLG >135.3 g and no HPV infection (p = 0.001). Tumour TLG was an independent predictor of survival in patients with locally advanced OPSCC. A scoring system was developed and may serve as a risk stratification strategy for guiding therapy. (orig.)

  18. Prognostic value of pretreatment 18F-FDG PET/CT and human papillomavirus type 16 testing in locally advanced oropharyngeal squamous cell carcinoma

    International Nuclear Information System (INIS)

    Human papillomavirus type 16 (HPV-16) positivity is associated with favourable survival in oropharyngeal squamous cell carcinoma (OPSCC). We report here a study of the prognostic significance of 18F-FDG PET/CT functional parameters and HPV-16 infection in OPSCC patients. We retrospectively analysed 60 patients with stage III or IV OPSCC who had had a pretherapy 18F-FDG PET/CT scan and had completed concurrent chemoradiotherapy (n = 58) or curative radiotherapy (n = 2). All patients were followed up for ≥24 months or until death. We determined total lesion glycolysis (TLG) and the maximal standardized uptake values (SUVmax) of the primary tumour and neck lymph nodes from the pretherapy 18F-FDG PET/CT scan. Optimal cut-offs of the 18F-FDG PET/CT parameters were obtained by receiver operating characteristic (ROC) curve analyses. Pretherapy tumour biopsies were studied by polymerase chain reaction to determine HPV infection status. The pretherapy tumour biopsies were positive for HPV-16 in 12 patients (20.0 %). Cox regression analyses revealed HPV-16 positivity and tumour TLG >135.3 g to be independently associated with overall survival (p = 0.027 and 0.011, respectively). However, only tumour TLG >135.3 g was independently associated with progression-free survival, disease-free survival and locoregional control (p = 0.011, 0.001 and 0.034, respectively). A scoring system was formulated to define distinct overall survival groups using tumour TLG and HPV-16 status. Patients positive for HPV-16 and with tumour TLG ≤135.3 g experienced better survival than those with tumour TLG >135.3 g and no HPV infection (p = 0.001). Tumour TLG was an independent predictor of survival in patients with locally advanced OPSCC. A scoring system was developed and may serve as a risk stratification strategy for guiding therapy. (orig.)

  19. Early assessment by FDG-PET/CT of patients with advanced renal cell carcinoma treated with tyrosine kinase inhibitors is predictive of disease course

    International Nuclear Information System (INIS)

    We reported previously that 18F-2-fluoro-2-deoxyglucose positron emission tomography/ computed tomography (FDG PET/CT) had potential for evaluating early response to treatment by tyrosine kinase inhibitors (TKIs) in advanced renal cell carcinoma (RCC). This time we investigated the relation of the early assessment by FDG PET/CT to long-term prognosis with an expanded number of patients and period of observation. Patients for whom TKI treatment for advanced RCC was planned were enrolled. FDG PET/CT was performed before TKI treatment and after one month of TKI treatment. The relations of the FDGPET/CT assessment to progression free survival (PFS) and overall survival (OS) were investigated. Thirty-five patients were enrolled (sunitinib 19 cases, sorafenib 16 cases). The patients with RCC showing high SUVmax in pretreatment FDG PET/CT demonstrated short PFS (P =0.024, hazard ratio 1.137, 95% CI 1.017-1.271) and short OS (P =0.004, hazard ratio 1.210 95% CI 1.062-1.379). Thirty patients (sunitinib 16 cases, sorafenib 14 cases) were evaluated again after 1 month. The PFS of the patients whose SUVmax decreased<20% was shorter than that of the patients whose SUVmax decreased<20% (P = 0.027, hazard ratio 3.043, 95% CI 1.134-8.167). The PFS of patients whose tumor diameter sum increased was shorter than that of the patient with tumors whose diameter sum did not (P =0.006, hazard ratio 4.555, 95% CI 1.543-13.448). The patients were classified into three response groups: good responder (diameter sum did not increase, and SUVmax decreased ≥ 20%), intermediate responder (diameter sum did not increase, and SUVmax decreased<20%), and poor responder (diameter sum increased, or one or more new lesions appeared). The median PFS of good, intermediate, and poor responders were 458 ± 146 days, 131 ± 9 days, and 88 ± 26 days (good vs. intermediate P = 0.0366, intermediate vs. poor P = 0.0097, log-rank test). Additionally the mean OSs were 999 ± 70 days, 469 ± 34 days, and 374

  20. Early and delayed prediction of axillary lymph node neoadjuvant response by {sup 18}F-FDG PET/CT in patients with locally advanced breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Garcia Vicente, Ana Maria; Soriano Castrejon, Angel; Jimenez Londono, German Andres [University General Hospital, Nuclear Medicine Department, Ciudad Real (Spain); Leon Martin, Alberto [University General Hospital, Investigation Unit, Ciudad Real (Spain); Relea Calatayud, Fernanda [University General Hospital, Pathology Department, Ciudad Real (Spain); Munoz Sanchez, Maria del Mar [Virgen de la Luz Hospital, Oncology Department, Cuenca (Spain); Cruz Mora, Miguel Angel [Virgen de la Salud Hospital, Oncology Department, Toledo (Spain); Espinosa Aunion, Ruth [La Mancha Centro Hospital, Oncology Department, Ciudad Real (Spain)

    2014-07-15

    To determine the utility of {sup 18}F-FDG (FDG) PET/CT performed in an early and delayed phase during neoadjuvant chemotherapy in the prediction of lymph node histopathological response in patients with locally advanced breast cancer. FDG PET/CT studies performed in 76 patients (mean age 53 years) at baseline (PET-1), after the second course of chemotherapy (PET-2) and after the last course of chemotherapy (PET-3) were prospectively analysed. Inclusion criteria were lymph node involvement detected by PET/CT and non-sentinel node biopsy before or after the baseline PET/CT scan. Following the recommendations of the 12th International Breast Conference (St. Gallen), the patients were divided into five subgroups in relation to biological prognostic factors by immunohistochemistry. For diagnosis visual and semiquantitative analyses was performed. Absence of detectable lymph node uptake on the PET-2 or PET-3 scan with respect to the PET-1 scan was considered metabolic complete response (mCR). Lymph nodes were histopathologically classified according the lymph node regression grade and in response groups as pathological complete response (pCR) or not pCR (type A/D or B/C of the Smith grading system, respectively). ROC analysis was performed to determine a cut-off value of Δ% SUV1-2 and SUV1-3 for prediction of nodal status after chemotherapy. An association between mCR and pCR was found (Cohen's kappa analysis), and associations between phenotypes and metabolic behaviour and the final histopathological status were also found. Lymph node pCR was seen in 34 patients. The sensitivity, specificity, and positive and negative predictive values of PET-2 and PET-3 in establishing the final status of the axilla after chemotherapy were 52 %, 45 %, 50 % and 47 %, and 33 %, 84 %, 67 % and 56 %, respectively. No significant relationship was observed between mCR on PET-2 and PET-3 and pCR (p = 0.31 and 0.99, respectively). Lymph node metabolism on PET-1 was not able to predict

  1. Utility of [18F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) in the Initial Staging and Response Assessment of Locally Advanced Breast Cancer Patients Receiving Neoadjuvant Chemotherapy.

    Science.gov (United States)

    Hulikal, Narendra; Gajjala, Sivanath Reddy; Kalawat, Teck Chand; Kottu, Radhika; Amancharla Yadagiri, Lakshmi

    2015-12-01

    In India up to 50 % of breast cancer patients still present as locally advanced breast cancer (LABC). The conventional methods of metastatic work up include physical examination, bone scan, chest & abdominal imaging, and biochemical tests. It is likely that the conventional staging underestimates the extent of initial spread and there is a need for more sophisticated staging procedure. The PET/CT can detect extra-axillary and occult distant metastases and also aid in predicting response to chemotherapy at an early point in time. To evaluate the utility of FDG PET/CT in initial staging and response assessment of patients with LABC receiving NACT. A prospective study of all biopsy confirmed female patients diagnosed with LABC receiving NACT from April 2013 to May 2014. The conventional work up included serum chemistry, CECT chest and abdomen and bone scan. A baseline whole body PET/CT was done in all patients. A repeat staging evaluation and a whole body PET/CT was done after 2/3rd cycle of NACT in non-responders and after 3/4 cycles in clinical responders. The histopathology report of the operative specimen was used to document the pathological response. The FDG PET/CT reported distant metastases in 11 of 38 patients, where as conventional imaging revealed metastases in only 6. Almost all the distant lesions detected by conventional imaging were detected with PET/CT, which showed additional sites of metastasis in 3 patients. In 2 patients, PET/CT detected osteolytic bone metastasis which were not detected by bone scan. In 5 patients PET CT detected N3 disease which were missed on conventional imaging. A total of 14 patients had second PET/CT done to assess the response to NACT and 11 patients underwent surgery. Two patients had complete pathological response. Of these 1 patient had complete metabolic and morphologic response and other had complete metabolic and partial morphologic response on second PET/CT scan. The 18 FDG PET/CT can detect more number of

  2. PET/CT and histopathologic response to preoperative chemoradiation therapy in locally advanced rectal cancer

    DEFF Research Database (Denmark)

    Kristiansen, C.; Loft, A.; Berthelsen, Anne Kiil;

    2008-01-01

    PURPOSE: The objective of this study was to investigate the possibility of using positron emission tomography/computer tomography to predict the histopathologic response in locally advanced rectal cancer treated with preoperative chemoradiation. METHODS: The study included 30 patients with locally...... advanced rectal adenocarcinoma treated with a combination of radiotherapy and concurrent Uftoral (uracil, tegafur) and leucovorine. All patients were evaluated by positron emission tomography/computer tomography scan seven weeks after end of chemoradiation, and the results were compared to histopathologic...... is not able to predict the histopathologic response in locally advanced rectal cancer. There is an obvious need for other complementary methods especially with respect to the low sensitivity of positron emission tomography/computer tomography Udgivelsesdato: 2008/1...

  3. Prognostic Value of Baseline 18F-FDG PET/CT Functional Parameters in Patients with Advanced Lung Adenocarcinoma Stratified by EGFR Mutation Status.

    Directory of Open Access Journals (Sweden)

    Dalong Wang

    Full Text Available The study objective was to retrospectively analyze the metabolic variables derived from 18 F-fluorodeoxyglucose (18F-FDG positron emission tomography/computed tomography (PET/CT as predictors of progression-free survival (PFS and overall survival (OS in advanced lung adenocarcinoma stratified by epidermal growth factor receptor (EGFR mutation status. A total of 176 patients (91, EGFR mutation; 85, wild-type EGFR who underwent 18F-FDG PET/CT before treatment were enrolled. The main 18F-FDG PET/CT-derived variables: primary tumor maximum standardized uptake value (SUVmaxT, primary tumor total lesion glycolysis (TLGT, the maximum SUVmax of all selected lesions in whole body determined using the Response Evaluation Criteria In Solid Tumors (RECIST 1.1 criteria (SUVmaxWBR, and whole-body total TLG determined using the RECIST 1.1 criteria (TLGWBR were measured. Survival analysis regarding TLGWBR, and other factors in advanced lung adenocarcinoma patients stratified using EGFR mutation status, were evaluated. The results indicated that high TLGWBR (≥259.85, EGFR wild-type, and high serum LDH were independent predictors of worse PFS and OS in all patients with advanced lung adenocarcinoma. Among patients with wild-type EGFR, only TLGWBR retained significance as an independent predictor of both PFS and OS. Among patients with the EGFR mutation, high serum LDH level was an independent predictor of worse PFS and OS, and high TLGWBR (≥259.85 was an independent predictor of worse PFS but not worse OS. In conclusion, TLGWBR is a promising parameter for prognostic stratification of patients with advanced lung adenocarcinoma and EGFR status; however, it cannot be used to further stratify the risk of worse OS for patients with the EGFR mutation. Further prospective studies are needed to validate our findings.

  4. Diagnostic accuracy of 18F-FDG PET/CT for detection of advanced colorectal adenoma

    International Nuclear Information System (INIS)

    Aim: To determine the accuracy of 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) positron-emission tomography (PET) in the detection of advanced colorectal adenomas. Materials and methods: In this retrospective study, patient consent was waived by the institutional review board. Combined FDG whole-body PET and computed tomography (CT) images (2000–2009) were re-read and compared with reports of complete colonoscopy performed up to 1 year after the PET examination. One or more areas of focal colonic uptake greater than the background indicated a positive PET result, irrespective of standardized uptake value (SUV). Lesion and patient-level measures of PET accuracy with their 95% confidence intervals (CI) were calculated. Results: One hundred and eighty patients undergoing colonoscopy with or without biopsy underwent PET within 1 year prior to colonoscopy. There were 92 women and 88 men (mean age 63.3 years). Indications for PET were extent of disease and treatment response in all cases. Patients had non-colorectal cancer (n = 160) or colon cancer (n = 20). One hundred and fourteen FDG-avid lesions were present. In 33, there was no colonoscopic correlate. Two hundred and fifty-eight biopsies revealed tubular adenomas (n = 91, one with intra-mucosal cancer), tubulovillous adenomas (n = 28), adenocarcinoma (n = 37), inflammation (n = 22), hyperplastic polyps (n = 54), serrated adenoma (n = 5), metastatic disease (n = 5), normal/benign mucosa or submucosal benign tumors (n = 13) or miscellaneous (n = 3). Per-lesion performance of PET showed a sensitivity of 38% (95% CI: 31–46; 64/167) for all adenomas and carcinomas and 58% (95% CI: 49–67; 57/98) for lesions ≥10 mm. At the patient level, for all adenomas and carcinomas the sensitivity was 54% (95% CI: 44–63; 61/113), specificity 100% (pre-defined), positive predictive value (PPV) 100% (pre-defined), and negative predictive value (NPV) 56% (95% CI: 47–65; 67/119). For patients with advanced

  5. How does PET/CT help in selecting therapy for patients with Hodgkin lymphoma?

    DEFF Research Database (Denmark)

    Hutchings, Martin

    2012-01-01

    investigating the use of PET/CT for early response-adapted therapy, with therapeutic stratification based on interim PET/CT results. Posttreatment PET/CT is a cornerstone of the revised response criteria and enables the selection of advanced-stage patients without the need for consolidation radiotherapy. Once...

  6. Clinical role of18F-FDG PET/CT-based simultaneous modulated accelerated radiotherapy treatment plan-ning for locally advanced nasopharyngeal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Jianshe Wang; Tianyou Tang Co-first author; Jing Xu; Andrew Z Wang; Liang Li; Junnian Zheng; Longzhen Zhang

    2015-01-01

    Objective The aim of this study was to compare the long-term local control, overal survival, and late toxicities of positron emission tomography/computed tomography (PET/CT)-guided dose escalation radio-therapy versus conventional radiotherapy in the concurrent chemoradiotherapy treatment of local y ad-vanced nasopharyngeal carcinoma (NPC). Methods A total of 48 patients with stage III–IVa NPC were recruited and randomly administered PET/CT-guided dose escalation chemoradiotherapy (group A) or conventional chemoradiotherapy (group B). The dose-escalation radiotherapy was performed using the simultaneous modulated accelerated radiotherapy technique at prescribed doses of 77 gray (Gy) in 32 fractions (f) to the gross target volume (GTV): planning target volume (PTV) 1 received 64 Gy/32 f, while PTV2 received 54.4 Gy/32 f. Patients in group B received uniform-dose intensity-modulated radiotherapy, PTV1 received 70 Gy/35 f and PTV2 received 58 Gy/29 f. Concurrent chemotherapy consisted of cisplatin [20 mg/m2 intravenous (IV) on days 1–4] and docetaxel (75 mg/m2 IV on days 1 and 8) administered during treatment weeks 1 and 4. Al patients received 2–4 cycles of adjuvant chemotherapy of the same dose and drug regimen. Results The use of fluorine-18-fluorodeoxyglucose (18F-FDG) PET/CT significantly reduced the treat-ment volume delineation of the GTV in 83.3% (20/24) of patients. The 5-year local recurrence-free survival rates of the two groups were 100% and 79.2%, respectively (P = 0.019). The 5-year disease free survival (DFS) rates were 95.8% and 75.0%, respectively (P = 0.018). The 5-year local progression-free survival and DFS rates were significantly dif erent. The 5-year overal survival (OS) rates were 95.8% and 79.2%, re-spectively. Dif erences in OS improvement were insignificant (P = 0.079). Late toxicities were similar in the two groups. The most common late toxicities of the two arms were grade 1–2 skin dystrophy, xerostomia, subcutaneous fibrosis, and

  7. Prediction of neoadjuvant radiation chemotherapy response and survival using pretreatment [{sup 18}F]FDG PET/CT scans in locally advanced rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bang, Ji-In; Ha, Seunggyun; Kim, Sang Eun [Seoul National University Bundang Hospital, Department of Nuclear Medicine, Seoul National University College of Medicine, Seongnam (Korea, Republic of); Kang, Sung-Bum; Oh, Heung-Kwon [Seoul National University Bundang Hospital, Department of Surgery, Seoul National University College of Medicine, Seongnam (Korea, Republic of); Lee, Keun-Wook [Seoul National University Bundang Hospital, Department of Internal Medicine, Seongnam (Korea, Republic of); Lee, Hye-Seung [Seoul National University Bundang Hospital, Department of Pathology, Seoul National University College of Medicine, Seongnam (Korea, Republic of); Kim, Jae-Sung [Seoul National University Bundang Hospital, Department of Radiation Oncology, Seongnam (Korea, Republic of); Lee, Ho-Young [Seoul National University Bundang Hospital, Department of Nuclear Medicine, Seoul National University College of Medicine, Seongnam (Korea, Republic of); Seoul National University, Cancer Research Institute, Seoul (Korea, Republic of)

    2016-03-15

    The aim of this study was to investigate metabolic and textural parameters from pretreatment [{sup 18}F]FDG PET/CT scans for the prediction of neoadjuvant radiation chemotherapy response and 3-year disease-free survival (DFS) in patients with locally advanced rectal cancer (LARC). We performed a retrospective review of 74 patients diagnosed with LARC who were initially examined with [{sup 18}F]FDG PET/CT, and who underwent neoadjuvant radiation chemotherapy followed by complete resection. The standardized uptake value (mean, peak, and maximum), metabolic volume (MV), and total lesion glycolysis of rectal cancer lesions were calculated using the isocontour method with various thresholds. Using three-dimensional textural analysis, about 50 textural features were calculated for PET images. Response to neoadjuvant radiation chemotherapy, as assessed by histological tumour regression grading (TRG) after surgery and 3-year DFS, was evaluated using univariate/multivariate binary logistic regression and univariate/multivariate Cox regression analyses. MVs calculated using the thresholds mean standardized uptake value of the liver + two standard deviations (SDs), and mean standard uptake of the liver + three SDs were significantly associated with TRG. Textural parameters from histogram-based and co-occurrence analysis were significantly associated with TRG. However, multivariate analysis revealed that none of these parameters had any significance. On the other hand, MV calculated using various thresholds was significantly associated with 3-year DFS, and MV calculated using a higher threshold tended to be more strongly associated with 3-year DFS. In addition, textural parameters including kurtosis of the absolute gradient (GrKurtosis) were significantly associated with 3-year DFS. Multivariate analysis revealed that GrKurtosis could be a prognostic factor for 3-year DFS. Metabolic and textural parameters from initial [{sup 18}F]FDG PET/CT scans could be indexes to assess

  8. Prediction of neoadjuvant radiation chemotherapy response and survival using pretreatment [18F]FDG PET/CT scans in locally advanced rectal cancer

    International Nuclear Information System (INIS)

    The aim of this study was to investigate metabolic and textural parameters from pretreatment [18F]FDG PET/CT scans for the prediction of neoadjuvant radiation chemotherapy response and 3-year disease-free survival (DFS) in patients with locally advanced rectal cancer (LARC). We performed a retrospective review of 74 patients diagnosed with LARC who were initially examined with [18F]FDG PET/CT, and who underwent neoadjuvant radiation chemotherapy followed by complete resection. The standardized uptake value (mean, peak, and maximum), metabolic volume (MV), and total lesion glycolysis of rectal cancer lesions were calculated using the isocontour method with various thresholds. Using three-dimensional textural analysis, about 50 textural features were calculated for PET images. Response to neoadjuvant radiation chemotherapy, as assessed by histological tumour regression grading (TRG) after surgery and 3-year DFS, was evaluated using univariate/multivariate binary logistic regression and univariate/multivariate Cox regression analyses. MVs calculated using the thresholds mean standardized uptake value of the liver + two standard deviations (SDs), and mean standard uptake of the liver + three SDs were significantly associated with TRG. Textural parameters from histogram-based and co-occurrence analysis were significantly associated with TRG. However, multivariate analysis revealed that none of these parameters had any significance. On the other hand, MV calculated using various thresholds was significantly associated with 3-year DFS, and MV calculated using a higher threshold tended to be more strongly associated with 3-year DFS. In addition, textural parameters including kurtosis of the absolute gradient (GrKurtosis) were significantly associated with 3-year DFS. Multivariate analysis revealed that GrKurtosis could be a prognostic factor for 3-year DFS. Metabolic and textural parameters from initial [18F]FDG PET/CT scans could be indexes to assess tumour heterogeneity

  9. Brain (18)F-FDG, (18)F-Florbetaben PET/CT, (123)I-FP-CIT SPECT and Cardiac (123)I-MIBG Imaging for Diagnosis of a "Cerebral Type" of Lewy Body Disease.

    Science.gov (United States)

    Van Der Gucht, Axel; Cleret de Langavant, Laurent; Bélissant, Ophélie; Rabu, Corentin; Cottereau, Anne-Ségolène; Evangelista, Eva; Chalaye, Julia; Bonnot-Lours, Sophie; Fénelon, Gilles; Itti, Emmanuel

    2016-09-01

    A 67-year-old man was referred for fluctuating neuropsychiatric symptoms, featuring depression, delirious episodes, recurrent visual hallucinations and catatonic syndrome associated with cognitive decline. No parkinsonism was found clinically even under neuroleptic treatment. (18)F-FDG PET/CT showed hypometabolism in the posterior associative cortex including the occipital cortex, suggesting Lewy body dementia, but (123)I-FP-CIT SPECT was normal and cardiac (123)I-MIBG imaging showed no signs of sympathetic denervation. Alzheimer's disease was excluded by a normal (18)F-florbetaben PET/CT. This report suggests a rare case of α-synucleinopathy without brainstem involvement, referred to as "cerebral type" of Lewy body disease. PMID:27540431

  10. Challenges in using 18 F-fluorodeoxyglucose-PET-CT to define a biological radiotherapy boost volume in locally advanced pancreatic cancer

    International Nuclear Information System (INIS)

    The best method of identifying regions within pancreatic tumours that might benefit from an increased radiotherapy dose is not known. We investigated the utility of pre-treatment FDG-PET in predicting the spatial distribution of residual metabolic activity following chemoradiotherapy (CRT) in locally advanced pancreatic cancer (LAPC). 17 patients had FDG-PET/CT scans at baseline and six weeks post-CRT. Tumour segmentation was performed at 40% and 50% of SUVmax at baseline and 60%, 70%, 80% and 90% post-CRT. FDG-PET scans were non-rigidly registered to the radiotherapy planning CT using the CT component of the FDG-PET/CT. Percentage overlap of the post-CRT volumes with the pre-CRT volumes with one another and the gross tumour volume (GTV) was calculated. SUVmax decreased during CRT (median pre- 8.0 and post- 3.6, p < 0.0001). For spatial correlation analysis, 9 pairs of scans were included (Four were excluded following complete metabolic response, one patient had a non-FDG avid tumour, one had no post-CRT imaging, one had diffuse FDG uptake that could not be separated from normal tissues and one had an elevated blood glucose). The Pre40% and 50% of SUVmax volumes covered a mean of 50.8% and 30.3% of the GTV respectively. The mean% overlap of the 90%, 80%, 70%, 60% of SUVmax post-CRT with the Pre40% and Pre50% volumes were 83.3%, 84.0%, 83.7%, 77.9% and 77.8%, 69.9%, 74.5%, 64.8% respectively. Regions of residual metabolic activity following CRT can be predicted from the baseline FDG-PET and could aid definition of a biological target volume for non-uniform dose prescriptions

  11. A novel method for incorporating respiratory-matched attenuation correction in the motion correction of cardiac PET-CT studies

    Science.gov (United States)

    McQuaid, Sarah J.; Lambrou, Tryphon; Hutton, Brian F.

    2011-05-01

    Mismatches between PET and CT datasets due to respiratory effects can lead to artefactual perfusion defects. To overcome this, we have proposed a method of aligning a single CT with each frame of a gated PET study in a semi-automatic manner, incorporating a statistical shape model of the diaphragm and a rigid registration of the heart. This ensures that the structures that could influence the appearance of the reconstructed cardiac activity are correctly matched between emission and transmission datasets. When tested on two patient studies, it was found in both cases that attenuation correction using the proposed technique resulted in PET images that were closer to the gold standard of attenuation correction with a gated CT, compared with scenarios where only heart matching was considered (and not the diaphragm) or where no transformation was performed (i.e. where a single CT frame was used to attenuation-correct all PET frames). These preliminary results suggest that diaphragm matching between PET and CT improves the quantitative accuracy of reconstructed PET images and that the proposed method of using a statistical shape model to describe the diaphragm shape and motion, in combination with a rigid registration to determine respiratory-induced heart motion, is a feasible method of achieving this.

  12. Trabectedin in Advanced High-Grade Uterine Leiomyosarcoma: A Case Report Illustrating the Value of18FDG-PET-CT in Assessing Treatment Response

    Directory of Open Access Journals (Sweden)

    M.J. Payne

    2014-02-01

    Full Text Available We report the case of a 60-year-old woman with metastatic high-grade uterine leiomyosarcoma who achieved a delayed response to second-line therapy with the marine-derived drug trabectedin (Yondelis®, PharmaMar. We used 2-deoxy-2-[18F] fluorodeoxyglucose (FDG-positron emission tomography (PET-CT imaging as a tool for response monitoring in parallel with conventional re-staging according to Response Evaluation Criteria in Solid Tumours (RECIST using computed tomography (CT. We illustrate the role of serial 18FDG-PET-CT imaging in the functional assessment of tumour response. Three cycles after commencement of trabectedin treatment, a reduction of the maximum standardized uptake value (SUVmax of the solid component of the pelvic mass was observed, indicating a cystic or necrotic response in the tumour to trabectedin. After 7 cycles of treatment, on 18FDG-PET-CT there was clear evidence of ongoing disease improvement: the solid pelvic components were at worst stable, with an unchanged SUVmax, and possibly marginally reduced in size, while the pulmonary metastases had further reduced in size and become FDG negative; the bony metastases were stable. After a total of 13 cycles of treatment, administered over 13 months, the patient showed signs of progression on an 18FDG-PET-CT scan. The safety profile of trabectedin remained manageable, showing no evidence of cumulative toxicity and being associated with a preserved quality of life. This report illustrates potential limitations of RECIST in response assessments and the critical role of serial 18FDG-PET-CT imaging in assessing response to trabectedin treatment. Therefore, we propose that 18FDG-PET-CT may improve the assessment of response to trabectedin in selected patients.

  13. Should PET/CT be implemented in the routine imaging work-up of locally advanced head and neck squamous cell carcinoma? A prospective analysis

    International Nuclear Information System (INIS)

    The objective of this study was to determine the incremental staging information provided by positron emission tomography/computed tomography (PET/CT) and its impact on management plans in patients with untreated stage III-IV head and neck squamous cell carcinoma (HNSCC). We prospectively studied, between September 2011 and February 2013, 84 consecutive patients [median age 63.5 years (39-84); 73 men] with histologically confirmed HNSCC. First, based on a conventional work-up (physical examination, CT imaging of the head, neck and chest), the multidisciplinary Head and Neck Tumour Board documented the TNM stage and a management plan for each patient, outlining the modalities to be used, including surgery, radiation therapy (RT), chemotherapy or a combination. After release of the PET/CT results, new TNM staging and management plans were agreed on by the multidisciplinary Tumour Board. Any changes in stage or intended management due to the PET/CT findings were then analysed. The impact on patient management was classified as: low (treatment modality, delivery and intent unchanged), moderate (change within the same treatment modality: type of surgery, radiation technique/dose) or high (change in treatment intent and/or treatment modality → curative to palliative, or surgery to chemoradiation or detection of unknown primary tumour or a synchronous second primary tumour). TNM stage was validated by histopathological analysis, additional imaging or follow-up. Accuracy of the conventional and PET/CT-based staging was compared using McNemar's test. Conventional and PET/CT stages were discordant in 32/84 (38 %) cases: the T stage in 2/32 (6.2 %), the N stage in 21/32 (65.7 %) and the M stage 9/32 (28.1 %). Patient management was altered in 22/84 (26 %) patients, with a moderate impact in 8 (9.5 %) patients and high impact in 14 (16.6 %) patients. PET/CT TNM classification was significantly more accurate (92.5 vs 73.7 %) than conventional staging with a p value < 0

  14. Should PET/CT be implemented in the routine imaging work-up of locally advanced head and neck squamous cell carcinoma? A prospective analysis

    Energy Technology Data Exchange (ETDEWEB)

    Cacicedo, Jon; Bilbao, Pedro [Cruces University Hospital, Radiation Oncology Department, Barakaldo, Bizkaia (Basque Country) (Spain); BioCruces Health Research Institute, Bizkaia, Basque Country (Spain); Fernandez, Iratxe [Cruces University Hospital, Nuclear Medicine Department, Barakaldo (Spain); Hoyo, Olga del; Hortelano, Eduardo [Cruces University Hospital, Radiation Oncology Department, Barakaldo, Bizkaia (Basque Country) (Spain); Dolado, Ainara [Cruces University Hospital, Radiodiagnostic and Medical Imaging Department, Barakaldo (Spain); Gomez-Suarez, Javier [Cruces University Hospital, Otolaryngology Department, Barakaldo (Spain); Sancho, Aintzane [Cruces University Hospital, Medical Oncology Department, Barakaldo (Spain); Pijoan, Jose I. [BioCruces Health Research Institute, Bizkaia, Basque Country (Spain); Cruces University Hospital, Clinical Epidemiology Unit, Barakaldo (Spain); CIBER de Epidemiologia y Salud Publica (CIBERESP), Madrid (Spain); Alvarez, Julio [Cruces University Hospital, Oral and Maxillofacial Surgery Department, Barakaldo (Spain); Espinosa, Jose M. [Cruces University Hospital, Medical Physics Department, Barakaldo (Spain); Gaafar, Ayman [Cruces University Hospital, Department of Pathology, Barakaldo (Spain)

    2015-08-15

    The objective of this study was to determine the incremental staging information provided by positron emission tomography/computed tomography (PET/CT) and its impact on management plans in patients with untreated stage III-IV head and neck squamous cell carcinoma (HNSCC). We prospectively studied, between September 2011 and February 2013, 84 consecutive patients [median age 63.5 years (39-84); 73 men] with histologically confirmed HNSCC. First, based on a conventional work-up (physical examination, CT imaging of the head, neck and chest), the multidisciplinary Head and Neck Tumour Board documented the TNM stage and a management plan for each patient, outlining the modalities to be used, including surgery, radiation therapy (RT), chemotherapy or a combination. After release of the PET/CT results, new TNM staging and management plans were agreed on by the multidisciplinary Tumour Board. Any changes in stage or intended management due to the PET/CT findings were then analysed. The impact on patient management was classified as: low (treatment modality, delivery and intent unchanged), moderate (change within the same treatment modality: type of surgery, radiation technique/dose) or high (change in treatment intent and/or treatment modality → curative to palliative, or surgery to chemoradiation or detection of unknown primary tumour or a synchronous second primary tumour). TNM stage was validated by histopathological analysis, additional imaging or follow-up. Accuracy of the conventional and PET/CT-based staging was compared using McNemar's test. Conventional and PET/CT stages were discordant in 32/84 (38 %) cases: the T stage in 2/32 (6.2 %), the N stage in 21/32 (65.7 %) and the M stage 9/32 (28.1 %). Patient management was altered in 22/84 (26 %) patients, with a moderate impact in 8 (9.5 %) patients and high impact in 14 (16.6 %) patients. PET/CT TNM classification was significantly more accurate (92.5 vs 73.7 %) than conventional staging with a p value < 0

  15. Prognostic role of metabolic parameters of {sup 18}F-FDG PET-CT scan performed during radiation therapy in locally advanced head and neck squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Min, Myo; Forstner, Dion [Liverpool Hospital, Cancer Therapy Centre, Liverpool, NSW (Australia); University of New South Wales, Sydney, NSW (Australia); Ingham Institute of Applied Medical Research, Liverpool, NSW (Australia); Lin, Peter; Shon, Ivan Ho; Lin, Michael [University of New South Wales, Sydney, NSW (Australia); Liverpool Hospital, Department of Nuclear Medicine and Positron Emission Tomography, Liverpool, NSW (Australia); University of Western Sydney, Sydney, NSW (Australia); Lee, Mark T. [Liverpool Hospital, Cancer Therapy Centre, Liverpool, NSW (Australia); University of New South Wales, Sydney, NSW (Australia); Bray, Victoria; Fowler, Allan [Liverpool Hospital, Cancer Therapy Centre, Liverpool, NSW (Australia); Chicco, Andrew [Liverpool Hospital, Department of Nuclear Medicine and Positron Emission Tomography, Liverpool, NSW (Australia); Tieu, Minh Thi [Calvary Mater Newcastle, Department of Radiation Oncology, Newcastle, NSW (Australia); University of Newcastle, Newcastle, NSW (Australia)

    2015-12-15

    To evaluate the prognostic value of {sup 18}F-FDG PET-CT performed in the third week (iPET) of definitive radiation therapy (RT) in patients with newly diagnosed locally advanced mucosal primary head and neck squamous-cell-carcinoma (MPHNSCC). Seventy-two patients with MPHNSCC treated with radical RT underwent staging PET-CT and iPET. The maximum standardised uptake value (SUV{sub max}), metabolic tumour volume (MTV) and total lesional glycolysis (TLG) of primary tumour (PT) and index node (IN) [defined as lymph node(s) with highest TLG] were analysed, and results were correlated with loco-regional recurrence-free survival (LRFS), disease-free survival (DFS), metastatic failure-free survival(MFFS) and overall survival (OS), using Kaplan-Meier analysis. Optimal cutoffs (OC) were derived from receiver operating characteristic curves: SUV{sub max-PT} = 4.25 g/mL, MTV{sub PT} = 3.3 cm{sup 3}, TLG{sub PT} = 9.4 g, for PT, and SUV{sub max-IN} = 4.05 g/mL, MTV{sub IN} = 1.85 cm{sup 3} and TLG{sub IN} = 7.95 g for IN. Low metabolic values in iPET for PT below OC were associated with statistically significant better LRFS and DFS. TLG was the best predictor of outcome with 2-year LRFS of 92.7 % vs. 71.1 % [p = 0.005, compared with SUV{sub max} (p = 0.03) and MTV (p = 0.022)], DFS of 85.9 % vs. 60.8 % [p = 0.005, compared with SUV{sub max} (p = 0.025) and MTV (p = 0.018)], MFFS of 85.9 % vs. 83.7 % [p = 0.488, compared with SUV{sub max} (p = 0.52) and MTV (p = 0.436)], and OS of 81.1 % vs. 75.0 % [p = 0.279, compared with SUV{sub max} (p = 0.345) and MTV (p = 0.512)]. There were no significant associations between the percentage reduction of primary tumour metabolic parameters and outcomes. In patients with nodal disease, metabolic parameters below OC (for both PT and IN) were significantly associated with all oncological outcomes, while TLG was again the best predictor: LRFS of 84.0 % vs. 55.3 % (p = 0.017), DFS of 79.4 % vs. 38.6 % (p = 0.001), MFFS 86.4 % vs. 68.2 % (p = 0

  16. [{sup 18}F]FPRGD{sub 2} PET/CT imaging of integrin α{sub v}β{sub 3} levels in patients with locally advanced rectal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Withofs, Nadia; Hustinx, Roland [Division of Nuclear Medicine and Oncological Imaging, Department of Medical Physics, Liege (Belgium); Martinive, Philippe; Vanderick, Jean; Coucke, Philippe [CHU Liege, Division of Radiation Oncology, Department of Medical Physics, Liege (Belgium); Bletard, Noella; Scagnol, Irene; Delvenne, Philippe [CHU Liege, Department of Pathology, Liege (Belgium); Mievis, Frederic; Giacomelli, Fabrice [University of Liege, CYCLOTRON Research Centre, Liege (Belgium); Cataldo, Didier [University of Liege, Laboratory of Tumour and Developmental Biology, GIGA-Research, Liege (Belgium); Gambhir, Sanjiv S. [Stanford University, Molecular Imaging Program at Stanford (MIPS), Radiology Department, Stanford, CA (United States)

    2016-04-15

    Our primary objective was to determine if [{sup 18}F]FPRGD{sub 2} PET/CT performed at baseline and/or after chemoradiotherapy (CRT) could predict tumour regression grade (TRG) in locally advanced rectal cancer (LARC). Secondary objectives were to compare baseline [{sup 18}F]FPRGD{sub 2} and [{sup 18}F]FDG uptake, to evaluate the correlation between posttreatment [{sup 18}F]FPRGD{sub 2} uptake and tumour microvessel density (MVD) and to determine if [{sup 18}F]FPRGD{sub 2} and FDG PET/CT could predict disease-free survival. Baseline [{sup 18}F]FPRGD{sub 2} and FDG PET/CT were performed in 32 consecutive patients (23 men, 9 women; mean age 63 ± 8 years) with LARC before starting any therapy. A posttreatment [{sup 18}F]FPRGD{sub 2} PET/CT scan was performed in 24 patients after the end of CRT (median interval 7 weeks, range 3 - 15 weeks) and before surgery (median interval 4 days, range 1 - 15 days). All LARC showed uptake of both [{sup 18}F]FPRGD{sub 2} (SUV{sub max} 5.4 ± 1.5, range 2.7 - 9) and FDG (SUV{sub max} 16.5 ± 8, range 7.1 - 36.5). There was a moderate positive correlation between [{sup 18}F]FPRGD{sub 2} and FDG SUV{sub max} (Pearson's r = 0.49, p = 0.0026). There was a moderate negative correlation between baseline [{sup 18}F]FPRGD{sub 2} SUV{sub max} and the TRG (Spearman's r = -0.37, p = 0.037), and a [{sup 18}F]FPRGD{sub 2} SUV{sub max} of >5.6 identified all patients with a complete response (TRG 0; AUC 0.84, 95 % CI 0.68 - 1, p = 0.029). In the 24 patients who underwent a posttreatment [{sup 18}F]FPRGD{sub 2} PET/CT scan the response index, calculated as [(SUV{sub max}1 - SUV{sub max}2)/SUV{sub max}1] x 100 %, was not associated with TRG. Post-treatment [{sup 18}F]FPRGD{sub 2} uptake was not correlated with tumour MVD. Neither [{sup 18}F]FPRGD{sub 2} nor FDG uptake predicted disease-free survival. Baseline [{sup 18}F]FPRGD{sub 2} uptake was correlated with the pathological response in patients with LARC treated with CRT. However, the

  17. Innovations in PET/CT

    DEFF Research Database (Denmark)

    Levin Klausen, T; Høgild Keller, S; Vinter Olesen, O;

    2012-01-01

    impressive anatomical details. PET/CT designs are facing many challenges such as the conversion of CT numbers to attenuation coefficients, giving rise to artefacts due to the presence of high Zeff material. Patient motion during scans degrades image quality and subsequent analysis, and is a challenge......There has been a longstanding interest in positron emission tomography (PET) in combination with computed tomography (CT). Mostly because of the lack of structural information in PET which makes it difficult to assess the precise location of tissue with metabolic uptake, whereas CT can provide...... especially as spatial resolution improves. Software based image fusion remains a complex issue outside the brain. State of the art image quality in a modern PET/CT system includes incorporation of point spread function (PSF) and time-of-flight (TOF) information into the reconstruction leading to the high...

  18. 18F-FDG PET/CT Reveals Disease Remission in a Patient With Ipilimumab-Refractory Advanced Melanoma Treated With Pembrolizumab.

    Science.gov (United States)

    Sachpekidis, Christos; Hassel, Jessica C; Dimitrakopoulou-Strauss, Antonia

    2016-02-01

    Pembrolizumab is an anti-programmed cell death receptor 1 (anti-PD-1) antibody, recently approved for the treatment of ipilimumab-refractory metastatic melanoma. We report on a 49-year-old patient with unresectable metastatic melanoma initially treated with 4 cycles of ipilimumab. Because of demonstration of progressive disease on PET/CT, the patient was enrolled into a clinical trial of pembrolizumab. After completion of 4 cycles of pembrolizumab, the follow-up PET/CT scans performed early after and 7 months after the end of treatment exhibited complete disease remission, reflecting the potential role of the modality in treatment response evaluation of melanoma patients receiving anti-PD-1 therapy.

  19. Impact of maximum Standardized Uptake Value (SUVmax evaluated by 18-Fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT on survival for patients with advanced renal cell carcinoma: a preliminary report

    Directory of Open Access Journals (Sweden)

    Miura Takeshi

    2010-12-01

    Full Text Available Abstract Background In this era of molecular targeting therapy when various systematic treatments can be selected, prognostic biomarkers are required for the purpose of risk-directed therapy selection. Numerous reports of various malignancies have revealed that 18-Fluoro-2-deoxy-D-glucose (18F-FDG accumulation, as evaluated by positron emission tomography, can be used to predict the prognosis of patients. The purpose of this study was to evaluate the impact of the maximum standardized uptake value (SUVmax from 18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT on survival for patients with advanced renal cell carcinoma (RCC. Methods A total of 26 patients with advanced or metastatic RCC were enrolled in this study. The FDG uptake of all RCC lesions diagnosed by conventional CT was evaluated by 18F-FDG PET/CT. The impact of SUVmax on patient survival was analyzed prospectively. Results FDG uptake was detected in 230 of 243 lesions (94.7% excluding lung or liver metastases with diameters of less than 1 cm. The SUVmax of 26 patients ranged between 1.4 and 16.6 (mean 8.8 ± 4.0. The patients with RCC tumors showing high SUVmax demonstrated poor prognosis (P = 0.005 hazard ratio 1.326, 95% CI 1.089-1.614. The survival between patients with SUVmax equal to the mean of SUVmax, 8.8 or more and patients with SUVmax less than 8.8 were statistically different (P = 0.0012. This is the first report to evaluate the impact of SUVmax on advanced RCC patient survival. However, the number of patients and the follow-up period were still not extensive enough to settle this important question conclusively. Conclusions The survival of patients with advanced RCC can be predicted by evaluating their SUVmax using 18F-FDG-PET/CT. 18F-FDG-PET/CT has potency as an "imaging biomarker" to provide helpful information for the clinical decision-making.

  20. Impact of maximum Standardized Uptake Value (SUVmax) evaluated by 18-Fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT) on survival for patients with advanced renal cell carcinoma: a preliminary report

    International Nuclear Information System (INIS)

    In this era of molecular targeting therapy when various systematic treatments can be selected, prognostic biomarkers are required for the purpose of risk-directed therapy selection. Numerous reports of various malignancies have revealed that 18-Fluoro-2-deoxy-D-glucose (18F-FDG) accumulation, as evaluated by positron emission tomography, can be used to predict the prognosis of patients. The purpose of this study was to evaluate the impact of the maximum standardized uptake value (SUVmax) from 18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) on survival for patients with advanced renal cell carcinoma (RCC). A total of 26 patients with advanced or metastatic RCC were enrolled in this study. The FDG uptake of all RCC lesions diagnosed by conventional CT was evaluated by 18F-FDG PET/CT. The impact of SUVmax on patient survival was analyzed prospectively. FDG uptake was detected in 230 of 243 lesions (94.7%) excluding lung or liver metastases with diameters of less than 1 cm. The SUVmax of 26 patients ranged between 1.4 and 16.6 (mean 8.8 ± 4.0). The patients with RCC tumors showing high SUVmax demonstrated poor prognosis (P = 0.005 hazard ratio 1.326, 95% CI 1.089-1.614). The survival between patients with SUVmax equal to the mean of SUVmax, 8.8 or more and patients with SUVmax less than 8.8 were statistically different (P = 0.0012). This is the first report to evaluate the impact of SUVmax on advanced RCC patient survival. However, the number of patients and the follow-up period were still not extensive enough to settle this important question conclusively. The survival of patients with advanced RCC can be predicted by evaluating their SUVmax using 18F-FDG-PET/CT. 18F-FDG-PET/CT has potency as an 'imaging biomarker' to provide helpful information for the clinical decision-making

  1. The early predictive value of a decrease of metabolic tumor volume in repeated {sup 18}F-FDG PET/CT for recurrence of locally advanced non-small cell lung cancer with concurrent radiochemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Wei, E-mail: weihuang@mcw.com [Department of Radiation Oncology (Chest Section), Shandong' s Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan 250117 (China); Liu, Bo; Fan, Min [Department of Internal Medicine Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan (China); Zhou, Tao [Department of Radiation Oncology (Chest Section), Shandong' s Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan 250117 (China); Fu, Zheng [PET/CT center, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan (China); Zhang, Zicheng; Li, Hongsheng [Department of Radiation Oncology (Chest Section), Shandong' s Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan 250117 (China); Li, Baosheng, E-mail: alvinbird@163.com [Department of Radiation Oncology (Chest Section), Shandong' s Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan 250117 (China)

    2015-03-15

    Highlights: •The patients underwent the second FDG PET during the early stage of concurrent chemoradiotherapy (CCRT). •To our knowledge, this could be the first study showing that the repeated FDG PET during the early stage of CCRT has added value by being a prognostic factor for recurrence of the locally advanced NSCLC patients. •This is a result of continuous research. •The decrease of MTV was the only significant risk factor for recurrence. -- Abstract: Purpose: The aim of this study is to investigate the value of [{sup 18}F] fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F FDG PET/CT) to predict recurrence of patients with locally advanced non-small cell lung cancer (NSCLC) during the early stage of concurrent chemoradiotherapy (CCRT). Methods: A total of 53 stage III NSCLC patients without diabetics or undergoing surgery were enrolled in the prospective study. Those patients were evaluated by FDG PET before and following 40 Gy radiotherapy (RT) with a concurrent cisplatin-based heterogeneous chemotherapy regimen. Semiquantitative assessment was used to determine maximum and mean SUVs (SUVmax/SUVmean) and metabolic tumor volume (MTV) of the primary tumor. The prognostic significance of PET/CT parameters and other clinical variables was assessed using Cox regression analyses. The cutoffs of PET/CT parameters which have been determined by the previous study were used to separate the groups with Kaplan–Meier curves. Results: Recurrence rates at 1- and 2-years were 18.9% (10/53) and 50.9% (27/53) for all patients, respectively. Cox regression analysis showed that the only prognostic factor for recurrence was a decrease of MTV. Using the cutoff of 29.7%, a decrease of MTV can separate the patients into 2 groups with Kaplan–Meier curve successfully. Conclusion: The prospective study has reinforced the early predictive value of MTV in repeated {sup 18}F-FDG PET/CT for recurrence in a subgroup of locally advanced NSCLC who

  2. Inventarisatie van ontwikkelingen van PET-CT

    NARCIS (Netherlands)

    Bijwaard H; LSO; mev

    2011-01-01

    De Nederlandse ziekenhuispraktijk heeft de relatief nieuwe PET-CT-technologie omarmd: het aantal PET-CT-scanners en hun toepassingen nemen snel toe. De toepassingen in de medische praktijk lopen voor op de richtlijnen uit 2007. Voor deze richtlijnen wordt daarom een frequentere update aanbevolen. Vo

  3. PET/CT Imaging in Mouse Models of Myocardial Ischemia

    Directory of Open Access Journals (Sweden)

    Sara Gargiulo

    2012-01-01

    Full Text Available Different species have been used to reproduce myocardial infarction models but in the last years mice became the animals of choice for the analysis of several diseases, due to their short life cycle and the possibility of genetic manipulation. Many techniques are currently used for cardiovascular imaging in mice, including X-ray computed tomography (CT, high-resolution ultrasound, magnetic resonance imaging, and nuclear medicine procedures. Cardiac positron emission tomography (PET allows to examine noninvasively, on a molecular level and with high sensitivity, regional changes in myocardial perfusion, metabolism, apoptosis, inflammation, and gene expression or to measure changes in anatomical and functional parameters in heart diseases. Currently hybrid PET/CT scanners for small laboratory animals are available, where CT adds high-resolution anatomical information. This paper reviews mouse models of myocardial infarction and discusses the applications of dedicated PET/CT systems technology, including animal preparation, anesthesia, radiotracers, and images postprocessing.

  4. Diagnostic and prognostic impact of {sup 18}F-FDG PET/CT in follicular lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Le Dortz, Ludovic; Garin, Etienne [Eugene Marquis Anticancer Centre, Nuclear Medicine Department, Rennes (France); Inserm U991, Rennes (France); Guibert, Sophie de; Houot, Roch [CHU Pontchaillou, Haematological Department, Rennes (France); Bayat, Sahar; Cuggia, Marc [CHU Pontchaillou, Medical Information Department, Rennes (France); Devillers, Anne; Le Jeune, Florence; Bahri, Haifa; Barge, Marie-Luce [Eugene Marquis Anticancer Centre, Nuclear Medicine Department, Rennes (France); Rolland, Yan [Eugene Marquis Anticancer Centre, Medical Imaging Department, Rennes (France); Lamy, Thierry [CHU Pontchaillou, Haematological Department, Rennes (France); Inserm U917, Rennes (France)

    2010-12-15

    The aim of this study was to assess the usefulness of positron emission tomography/computed tomography in staging, prognosis evaluation and restaging of patients with follicular lymphoma. A retrospective study was performed on 45 patients with untreated biopsy-proven follicular lymphoma who underwent {sup 18}F-fluorodeoxyglucose PET/CT (FDG PET/CT) and CT before and after chemoimmunotherapy induction treatment (rituximab combined with cyclophosphamide, doxorubicin, vincristine and prednisone). PET/CT detected more nodal (+51%) and extranodal (+89%) lesions than CT. PET/CT modified Ann Arbor staging in eight patients (18%). Five patients (11%) initially considered as being early stage (I/II) were eventually treated as advanced stage (III/IV). In this study, an initial PET/CT prognostic score was significantly more accurate than the Follicular Lymphoma International Prognostic Index score in identifying patients with poor prognosis (i.e. patients with incomplete therapeutic response or early relapse). The accuracy of PET/CT for therapeutic response assessment was higher than that of CT (0.97 vs 0.64), especially due to its ability to identify inactive residual masses. In addition, post-treatment PET/CT was able to predict patients' outcomes. The median progression-free survival was 48 months in the PET/CT-negative group as compared with 17.2 months for the group with residual uptake (p < 10{sup -4}). FDG PET/CT is useful for staging and assessing the prognosis and therapeutic response of patients with follicular lymphoma. (orig.)

  5. The Place of FDG PET/CT in Renal Cell Carcinoma: Value and Limitations

    Science.gov (United States)

    Liu, Yiyan

    2016-01-01

    Unlike for most other malignancies, application of FDG PET/CT is limited for renal cell carcinoma (RCC), mainly due to physiological excretion of 18F-fluoro-2-deoxy-2-d-glucose (FDG) from the kidneys, which decreases contrast between renal lesions and normal tissue, and may obscure or mask the lesions of the kidneys. Published clinical observations were discordant regarding the role of FDG PET/CT in diagnosing and staging RCC, and FDG PET/CT is not recommended for this purpose based on current national and international guidelines. However, quantitative FDG PET/CT imaging may facilitate the prediction of the degree of tumor differentiation and allows for prognosis of the disease. FDG PET/CT has potency as an imaging biomarker to provide useful information about patient’s survival. FDG PET/CT can be effectively used for postoperative surveillance and restaging with high sensitivity, specificity, and accuracy, as early diagnosis of recurrent/metastatic disease can drastically affect therapeutic decision and alter outcome of patients. FDG uptake is helpful for differentiating benign or bland emboli from tumor thrombosis in RCC patients. FDG PET/CT also has higher sensitivity and accuracy when compared with bone scan to detect RCC metastasis to the bone. FDG PET/CT can play a strong clinical role in the management of recurrent and metastatic RCC. In monitoring the efficacy of new target therapy such as tyrosine kinase inhibitors (TKIs) treatment for advanced RCC, FDG PET/CT has been increasingly used to assess the therapeutic efficacy, and change in FDG uptake is a strong indicator of biological response to TKI.

  6. The Place of FDG PET/CT in Renal Cell Carcinoma: Value and Limitations.

    Science.gov (United States)

    Liu, Yiyan

    2016-01-01

    Unlike for most other malignancies, application of FDG PET/CT is limited for renal cell carcinoma (RCC), mainly due to physiological excretion of 18F-fluoro-2-deoxy-2-d-glucose (FDG) from the kidneys, which decreases contrast between renal lesions and normal tissue, and may obscure or mask the lesions of the kidneys. Published clinical observations were discordant regarding the role of FDG PET/CT in diagnosing and staging RCC, and FDG PET/CT is not recommended for this purpose based on current national and international guidelines. However, quantitative FDG PET/CT imaging may facilitate the prediction of the degree of tumor differentiation and allows for prognosis of the disease. FDG PET/CT has potency as an imaging biomarker to provide useful information about patient's survival. FDG PET/CT can be effectively used for postoperative surveillance and restaging with high sensitivity, specificity, and accuracy, as early diagnosis of recurrent/metastatic disease can drastically affect therapeutic decision and alter outcome of patients. FDG uptake is helpful for differentiating benign or bland emboli from tumor thrombosis in RCC patients. FDG PET/CT also has higher sensitivity and accuracy when compared with bone scan to detect RCC metastasis to the bone. FDG PET/CT can play a strong clinical role in the management of recurrent and metastatic RCC. In monitoring the efficacy of new target therapy such as tyrosine kinase inhibitors (TKIs) treatment for advanced RCC, FDG PET/CT has been increasingly used to assess the therapeutic efficacy, and change in FDG uptake is a strong indicator of biological response to TKI. PMID:27656421

  7. Cardiovascular magnetic resonance and PET-CT of left atrial paraganglioma

    OpenAIRE

    Ruehm Stefan; Lai Chi; Tomasian Anderanik; Krishnam Mayil S

    2010-01-01

    Abstract Cardiac paragangliomas are among the rarest primary cardiac tumors. We present a case of left atrial paraganglioma in a patient who presented with symptoms and signs of catecholamine excess in which cardiovascular magnetic resonance in multiple orientations and PET-CT played an important role in the diagnosis and tissue characterization.

  8. Early prediction of survival following induction chemotherapy with DCF (docetaxel, cisplatin, 5-fluorouracil) using FDG PET/CT imaging in patients with locally advanced head and neck squamous cell carcinoma

    International Nuclear Information System (INIS)

    Locally advanced head and neck squamous cell carcinoma (HNSCC) has a high rate of recurrence. Induction chemotherapy with DCF (docetaxel, cisplatin, 5-fluorouracil) before chemoradiotherapy could lead to the best disease control of inoperable stage III/IV HNSCC but with an increased risk of acute toxicity. Early assessment of therapeutic efficacy is a key issue in considering the benefit of escalation in a poor prognosis population. Patients with stage III/IV HNSCC, in whom DCF induction chemotherapy followed by concurrent chemoradiotherapy had been validated by a multidisciplinary team, were prospectively included in the study. FDG PET/CT scans were performed in all patients before and after two of the three cycles of DCF. EORTC99 criteria were used to evaluate PET responses as follows: group 1 (metabolic responders) showing a complete response (CR) or partial response (PR), and subgroup 0 (metabolic nonresponders) showing stable disease (SD) or progressive disease (PD). The primary endpoint for monitoring patients was event-free survival (EFS). EFS probabilities between the two groups were estimated by the Kaplan-Meier method and statistically compared using the log-rank test. Fifteen consecutive patients (14 men, 1 woman; age 57.5 ± 6.2 years, mean ± SD) were analysed. Therapeutic assessment by PET/CT demonstrated CR in four patients, PR in six, SD in four and PD in one. Among the ten patients with a metabolic response (group 1), none had relapsed at the time of this report, while four of five patients with no metabolic response (group 0) showed recurrence within an average of 9.0 ± 1.6 months. Median EFS was, respectively, 18.9 months (3.8-25.3 months) and 10.2 months (7.5-12.7 months) in group 1 and group 0. The corresponding 1-year EFS rates were 100 % and 20 %, respectively. The difference in EFS between the two groups was statistically significant (p = 0.0014). Early therapeutic response demonstrated on FDG PET/CT after two cycles of induction

  9. FDG PET/CT in cancer

    DEFF Research Database (Denmark)

    Petersen, Henrik; Holdgaard, Paw Christian; Madsen, Poul Henning;

    2016-01-01

    use of PET/CT in the RSD with these recommendations. This article summarizes the results. METHODS: A Work Group appointed a professional Subgroup which made Clinician Groups conduct literature reviews on six selected cancers responsible for 5,768 (62.6 %) of 9,213 PET/CT scans in the RSD in 2012......-recommendable" indications, respectively. RESULTS: Of 11,729 citations, 1,729 were considered for review, and 204 were included. The evidence suggested usefulness of PET/CT in lung, lymphoma, melanoma, head and neck, and colorectal cancers, whereas evidence was sparse in gynaecological cancers. The agreement between actual...... use of PET/CT and literature-based recommendations was high in the first five mentioned cancers in that 96.2 % of scans were made for grade A or B indications versus only 22.2 % in gynaecological cancers. CONCLUSION: Evidence-based usefulness was reported in five of six selected cancers; evidence...

  10. PET-CT imaging in pediatric oncology

    OpenAIRE

    McCarville, M. Beth

    2009-01-01

    Abstract Positron emission tomography (PET)-computed tomography (CT) is emerging as a valuable tool for assessing a wide variety of pediatric malignancies, including lymphomas, soft-tissue tumors, and bone sarcomas. PET-CT may provide information that is not apparent on conventional imaging performed to stage these diseases and monitor their response to treatment. The use of PET-CT in children requires an awareness of the technical and logistical issues unique to this patient population. In a...

  11. Qualitative and Quantitative Assessment of Metal Artifacts Arising from Implantable Cardiac Pacing Devices in Oncological PET/CT Studies : A Phantom Study

    NARCIS (Netherlands)

    Ay, Mohammad R.; Mehranian, Abolfazl; Abdoli, Mehrsima; Ghafarian, Pardis; Zaidi, Habib

    2011-01-01

    Purpose: We evaluate the magnitude of metallic artifacts caused by various implantable cardiac pacing devices (without leads) on both attenuation maps (mu-maps) and positron emission tomography (PET) images using experimental phantom studies. We also assess the efficacy of a metal artifact reduction

  12. PET and PET/CT in tumour of undetermined origin

    International Nuclear Information System (INIS)

    In this presentation the following conclusions were obtained regarding the use of PET and PET/CT in patient with cancer of unknown primary: 1. Detection of the primary one in 1/3 at 1/2 of patient. 2. It detects metastases in other places in 50%. 3. It changes the initial therapy planned in 1/3 at 1/2 of patient. 4. Useful in initial phases of protocol study to limit the other procedures. After standard evaluation. Before advanced protocol. 5. PET/CT study increases the % of primary detection, although in a non significant way vs. PET. 6. They are required more studies to value their utility to a more objective manner. (Author)

  13. Diagnostic performance of FDG PET/CT for surveillance in asymptomatic gastric cancer patients after curative surgical resection

    International Nuclear Information System (INIS)

    The present study evaluated the diagnostic performance of 2-[18F] fluoro-2-deoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT) for surveillance in asymptomatic gastric cancer patients after curative surgical resection. We retrospectively recruited 190 gastric cancer patients (115 early gastric cancer patients and 75 advanced gastric cancer patients) who underwent 1-year (91 patients) or 2-year (99 patients) postoperative FDG PET/CT surveillance, along with a routine follow-up program, after curative surgical resection. All enrolled patients were asymptomatic and showed no recurrence on follow-up examinations performed before PET/CT surveillance. All PET/CT images were visually assessed and all abnormal findings on follow-up examinations including FDG PET/CT were confirmed with histopathological diagnosis or clinical follow-up. During follow-up, 19 patients (10.0 %) developed recurrence. FDG PET/CT showed abnormal findings in 37 patients (19.5 %). Among them, 16 patients (8.4 %) were diagnosed as cancer recurrence. Of 153 patients without abnormal findings on PET/CT, three patients were false-negative and diagnosed as recurrence on other follow-up examinations. The sensitivity, specificity, positive predictive value, and negative predictive value of FDG PET/CT were 84.2 %, 87.7 %, 43.2 %, and 98.0 %, respectively. Among 115 early gastric cancer patients, PET/CT detected recurrence in four patients (3.5 %) and one patient with local recurrence. Among 75 advanced gastric cancer patients, PET/CT detected recurrence in 12 patients (16.0 %), excluding two patients experiencing peritoneal recurrence. In addition, FDG PET/CT detected secondary primary cancer in six (3.2 %) out of all the patients. Post-operative FDG PET/CT surveillance showed good diagnostic ability for detecting recurrence in gastric cancer patients. FDG PET/CT could be a useful follow-up modality for gastric cancer patients, especially those with advanced gastric cancer

  14. Diagnostic performance of FDG PET/CT for surveillance in asymptomatic gastric cancer patients after curative surgical resection

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won [Catholic Kwandong University College of Medicine, Department of Nuclear Medicine, International St. Mary' s Hospital, Incheon (Korea, Republic of); Lee, Sang Mi [Soonchunhyang University Hospital, Department of Nuclear Medicine, 23-20 Byeongmyeong-dong, Dongnam-gu, Chungcheongnam-do, Cheonan (Korea, Republic of); Son, Myoung Won; Lee, Moon-Soo [Soonchunhyang University Hospital, Department of Surgery, Cheonan (Korea, Republic of)

    2016-05-15

    The present study evaluated the diagnostic performance of 2-[{sup 18}F] fluoro-2-deoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT) for surveillance in asymptomatic gastric cancer patients after curative surgical resection. We retrospectively recruited 190 gastric cancer patients (115 early gastric cancer patients and 75 advanced gastric cancer patients) who underwent 1-year (91 patients) or 2-year (99 patients) postoperative FDG PET/CT surveillance, along with a routine follow-up program, after curative surgical resection. All enrolled patients were asymptomatic and showed no recurrence on follow-up examinations performed before PET/CT surveillance. All PET/CT images were visually assessed and all abnormal findings on follow-up examinations including FDG PET/CT were confirmed with histopathological diagnosis or clinical follow-up. During follow-up, 19 patients (10.0 %) developed recurrence. FDG PET/CT showed abnormal findings in 37 patients (19.5 %). Among them, 16 patients (8.4 %) were diagnosed as cancer recurrence. Of 153 patients without abnormal findings on PET/CT, three patients were false-negative and diagnosed as recurrence on other follow-up examinations. The sensitivity, specificity, positive predictive value, and negative predictive value of FDG PET/CT were 84.2 %, 87.7 %, 43.2 %, and 98.0 %, respectively. Among 115 early gastric cancer patients, PET/CT detected recurrence in four patients (3.5 %) and one patient with local recurrence. Among 75 advanced gastric cancer patients, PET/CT detected recurrence in 12 patients (16.0 %), excluding two patients experiencing peritoneal recurrence. In addition, FDG PET/CT detected secondary primary cancer in six (3.2 %) out of all the patients. Post-operative FDG PET/CT surveillance showed good diagnostic ability for detecting recurrence in gastric cancer patients. FDG PET/CT could be a useful follow-up modality for gastric cancer patients, especially those with advanced gastric cancer

  15. Fifteen different {sup 18}F-FDG PET/CT qualitative and quantitative parameters investigated as pathological response predictors of locally advanced rectal cancer treated by neoadjuvant chemoradiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Maffione, Anna Margherita [Santa Maria della Misericordia Hospital, Nuclear Medicine Department, PET Unit, Rovigo (Italy); Santa Maria della Misericordia Hospital, SOC Medicina Nucleare, Rovigo (Italy); Ferretti, Alice [Santa Maria della Misericordia Hospital, Nuclear Medicine Department, PET Unit, Rovigo (Italy); Santa Maria della Misericordia Hospital, Medical Physics Department, Rovigo (Italy); Grassetto, Gaia; Chondrogiannis, Sotirios; Marzola, Maria Cristina; Rampin, Lucia; Bondesan, Claudia; Rubello, Domenico [Santa Maria della Misericordia Hospital, Nuclear Medicine Department, PET Unit, Rovigo (Italy); Bellan, Elena; Gava, Marcello [Santa Maria della Misericordia Hospital, Medical Physics Department, Rovigo (Italy); Capirci, Carlo [Santa Maria della Misericordia Hospital, Radiotherapy Department, Rovigo (Italy); Colletti, Patrick M. [University of Southern California, Department of Radiology, Los Angeles, CA (United States)

    2013-06-15

    The aim of this study was to correlate qualitative visual response and various PET quantification factors with the tumour regression grade (TRG) classification of pathological response to neoadjuvant chemoradiotherapy (CRT) proposed by Mandard. Included in this retrospective study were 69 consecutive patients with locally advanced rectal cancer (LARC). FDG PET/CT scans were performed at staging and after CRT (mean 6.7 weeks). Tumour SUVmax and its related arithmetic and percentage decrease (response index, RI) were calculated. Qualitative analysis was performed by visual response assessment (VRA), PERCIST 1.0 and response cut-off classification based on a new definition of residual disease. Metabolic tumour volume (MTV) was calculated using a 40 % SUVmax threshold, and the total lesion glycolysis (TLG) both before and after CRT and their arithmetic and percentage change were also calculated. We split the patients into responders (TRG 1 or 2) and nonresponders (TRG 3-5). SUVmax MTV and TLG after CRT, RI, {Delta}MTV% and {Delta}TLG% parameters were significantly correlated with pathological treatment response (p < 0.01) with a ROC curve cut-off values of 5.1, 2.1 cm{sup 3}, 23.4 cm{sup 3}, 61.8 %, 81.4 % and 94.2 %, respectively. SUVmax after CRT had the highest ROC AUC (0.846), with a sensitivity of 86 % and a specificity of 80 %. VRA and response cut-off classification were also significantly predictive of TRG response (VRA with the best accuracy: sensitivity 86 % and specificity 55 %). In contrast, assessment using PERCIST was not significantly correlated with TRG. FDG PET/CT can accurately stratify patients with LARC preoperatively, independently of the method chosen to interpret the images. Among many PET parameters, some of which are not immediately obtainable, the most commonly used in clinical practice (SUVmax after CRT and VRA) showed the best accuracy in predicting TRG. (orig.)

  16. Reverse Mismatch Pattern in Cardiac 18F-FDG Viability PET/CT Is Not Associated With Poor Outcome of Revascularization

    DEFF Research Database (Denmark)

    Hansen, Allan Kjeldsen; Gejl, Michael; Bouchelouche, Kirsten;

    2016-01-01

    myocardium; however, only in 12 of 91 patients was the RM considered significant (percentage RM in the left ventricle, 42.5 ± 12.9 [reverse patients] vs 14.1 ± 8.6 [scar and hibernation patients]; P ... is common among HF patients (~15%) and is inversely correlated to insulin sensitivity. It is not, however, associated with increased cardiac morbidity and mortality and does not predict a worse outcome after revascularization....

  17. PET and PET/CT in tumour of undetermined origin; PET y PET/CT en tumor de origen indeterminado

    Energy Technology Data Exchange (ETDEWEB)

    Garcia O, J.R. [Nuclear Medicine and Molecular Imaging, PET/CT, Centro Medico ABC, Mexico D.F. (Mexico)

    2007-07-01

    In this presentation the following conclusions were obtained regarding the use of PET and PET/CT in patient with cancer of unknown primary: 1. Detection of the primary one in 1/3 at 1/2 of patient. 2. It detects metastases in other places in 50%. 3. It changes the initial therapy planned in 1/3 at 1/2 of patient. 4. Useful in initial phases of protocol study to limit the other procedures. After standard evaluation. Before advanced protocol. 5. PET/CT study increases the % of primary detection, although in a non significant way vs. PET. 6. They are required more studies to value their utility to a more objective manner. (Author)

  18. Role of 18F - DOPA PET/CT in evaluation of patients with neuroendocrine tumors (NETs)

    International Nuclear Information System (INIS)

    Full text: NETs are heterogeneous group of tumors which take up amino acids, transform them into biogenic amines and store the amines in vesicles, this forms the basis of uptake of 18F-DOPA in these tumors. These tumors can be small and situated almost throughout the body and may also present as advanced disease with multiple metastatic sites. Like in management of any other tumor it is imperative to stage the status of disease in NETs for the effective management of these patients and 18F-DOPA PET/CT is one such imaging modality used in the evaluation of neuroendocrine tumors (NETs). Here is our initial experience using 18F-DOPA PET/CT imaging in these patients. Twenty-seven patients with NETs (carcinoids, medullary thyroid carcinomas, phaeochromocytomas Insulinoma) were prospectively enrolled and scheduled for 18F-DOPA PET/CT. Wherever possible, tissue diagnosis was attempted. Results obtained were compared with other conventional diagnostic procedures (mainly 18F-FDG PET/CT, and 68Ga-DOTANOC PET/CT, and with ultrasound, CT, etc) and with follow-up. 18F-DOPA PET/CT identified 17/24 positive cases in either the primary/metastatic/recurrent tumor. In case of Insulinoma 18F-DOPA was found to be most superior than other imaging modalities in localizing the disease and staging of disease

  19. Disseminated Skeletal Muscle and Cardiac Metastasis from Squamous Cell Carcinoma of the Lung Detected with FDG and FLT PET/CT.

    Science.gov (United States)

    Jain, Tarun Kumar; Rayamajhi, Sampanna Jung; Basher, Rajender Kumar; Gupta, Dheeraj; Maturu, Venkata Nagarjuna; Mittal, Bhagwant Rai

    2016-09-01

    Lung cancer is one of the leading cancers all over the world. Positron emission tomography (PET) using 18F fluorodeoxyglucose (18F FDG) is useful for staging of the disease and decide the appropriate management. 3'-deoxy-3'-18 F-fluorothymidine (18F FLT) is a tracer being extensively evaluated currently and is said to represent tumor proliferation. Common sites of metastases from lung cancer include adrenal glands, bone, and brain. Muscle metastasis and cardiac metastasis are uncommon findings. We report a case of squamous cell carcinoma of the lung with metastases to multiple skeletal muscles and myocardium detected with both FDG and FLT PET/computed tomography (CT). PMID:27651747

  20. Multimodal Registration of gated cardiac PET, CT and MR sequences; Recalage de sequences cardiaques spation-temporelles IRM et TEP/SCAN

    Energy Technology Data Exchange (ETDEWEB)

    Baty, X

    2007-07-15

    The research described in this manuscript deals with the multimodal registration of cardiac images from Magnetic Resonance Imaging (MRI), Position Emission Tomography (PET) and Computerized Tomography (CT). All these modalities are gated to the Electrocardiogram (ECG) and provide information to evaluate cardiac function, and to diagnose and to follow-up cardiovascular pathologies. PET imaging allows the evaluation of ventricular function and MRI is a gold standard for the study of the left ventricular function. The goal of our registration process is to merge functional (from PET) and anatomical images (from CT and MRI). Our process is adapted to the modalities used and is divided in two steps: (i) a global rigid 3-dimensional model-based ICP (Iterative Closest Point) registration between CT and MR data and (ii) an iconic 2-dimensional registration based on Free Form Deformations and Mutual Information. This last step presents an original contribution by using a composite image of CT (which presents epicardic contours) and PET (where endocardic contours are partially visible) data to make mutual information more accurate in representing the similarity with the MR data. To speed up the whole process, we also present a transformation initialization scheme using displacement field obtained form MR data only. The obtained results have been evaluated by experts. (author)

  1. Semi-quantitative analysis of post-transarterial radioembolization {sup 90}Y Microsphere position emission tomography combined with computed tomography (PET/CT) images in advance liver malignancy: Comparison with {sup 99m}Tc macroaggregated albumin (MAA) single photon emission computed tomography (SPECT)

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, Seung Hong; Kim, Sung Eun; Cho, Jae Hyuk; Park, Ju Kyung; Kim, Yun Hwan; Choe, Jae Gol [Korea University Anam Hospital, Seoul (Korea, Republic of); Eo, Jae Seon; Park, So Yeon; Lee, Eun Sub [Dept. of Nuclear Medicine, Korea University Guro Hospital, Seoul (Korea, Republic of)

    2016-03-15

    The purpose of this study is to evaluate the correlation between pretreatment planning technetium-99m ({sup 99}mTc) macroaggregated albumin (MAA) SPECT images and posttreatment transarterial radioembolization (TARE) yttirum-90 ({sup 90}Y) PET/CT images by comparing the ratios of tumor-to-normal liver counts. Fifty-two patients with advanced hepatic malignancy who underwent {sup 90}Y microsphere radioembolization from January 2010 to December 2012 were retrospectively reviewed. Patients had undergone {sup 99}mTc MAA intraarterial injection SPECT for a pretreatment evaluation of microsphere distribution and therapy planning. After the administration of {sup 90}Y microspheres, the patients underwent posttreatment {sup 90}Y PET/CT within 24 h. For semiquantitative analysis, the tumor-to-normal uptake ratios in {sup 90}Y PET/CT (TNR-yp) and {sup 99}mTc MAA SPECT (TNR-ms) as well as the tumor volumes measured in angiographic CT were obtained and analyzed. The relationship of TNR-yp and TNR-ms was evaluated by Spearman's rank correlation and Wilcoxon's matched pairs test. In a total of 79 lesions of 52 patients, the distribution of microspheres was well demonstrated in both the SPECT and PET/CT images. A good correlation was observed of between TNR-ms and TNR-yp (rho value = 0.648, p < 0.001). The TNR-yp (median 2.78, interquartile range 2.43) tend to show significantly higher values than TNR-ms (median 2.49, interquartile range of 1.55) (p = 0.012). The TNR-yp showed weak correlation with tumor volume (rho = 0.230, p = 0.041). The 99mTc MAA SPECT showed a good correlation with {sup 90}Y PET/CT in TNR values, suggesting that {sup 99}mTc MAA can be used as an adequate pretreatment evaluation method. However, the {sup 99}mTc MAA SPECT image consistently shows lower TNR values compared to 90Y PET/CT, which means the possibility of underestimation of tumorous uptake in the partition dosimetry model using {sup 99}mTc MAA SPECT. Considering that

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-10-15

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

  3. Multimodality Molecular Imaging of Cardiac Cell Transplantation: Part II. In Vivo Imaging of Bone Marrow Stromal Cells in Swine with PET/CT and MR Imaging.

    Science.gov (United States)

    Parashurama, Natesh; Ahn, Byeong-Cheol; Ziv, Keren; Ito, Ken; Paulmurugan, Ramasamy; Willmann, Jürgen K; Chung, Jaehoon; Ikeno, Fumiaki; Swanson, Julia C; Merk, Denis R; Lyons, Jennifer K; Yerushalmi, David; Teramoto, Tomohiko; Kosuge, Hisanori; Dao, Catherine N; Ray, Pritha; Patel, Manishkumar; Chang, Ya-Fang; Mahmoudi, Morteza; Cohen, Jeff Eric; Goldstone, Andrew Brooks; Habte, Frezghi; Bhaumik, Srabani; Yaghoubi, Shahriar; Robbins, Robert C; Dash, Rajesh; Yang, Phillip C; Brinton, Todd J; Yock, Paul G; McConnell, Michael V; Gambhir, Sanjiv S

    2016-09-01

    Purpose To quantitatively determine the limit of detection of marrow stromal cells (MSC) after cardiac cell therapy (CCT) in swine by using clinical positron emission tomography (PET) reporter gene imaging and magnetic resonance (MR) imaging with cell prelabeling. Materials and Methods Animal studies were approved by the institutional administrative panel on laboratory animal care. Seven swine received 23 intracardiac cell injections that contained control MSC and cell mixtures of MSC expressing a multimodality triple fusion (TF) reporter gene (MSC-TF) and bearing superparamagnetic iron oxide nanoparticles (NP) (MSC-TF-NP) or NP alone. Clinical MR imaging and PET reporter gene molecular imaging were performed after intravenous injection of the radiotracer fluorine 18-radiolabeled 9-[4-fluoro-3-(hydroxyl methyl) butyl] guanine ((18)F-FHBG). Linear regression analysis of both MR imaging and PET data and nonlinear regression analysis of PET data were performed, accounting for multiple injections per animal. Results MR imaging showed a positive correlation between MSC-TF-NP cell number and dephasing (dark) signal (R(2) = 0.72, P = .0001) and a lower detection limit of at least approximately 1.5 × 10(7) cells. PET reporter gene imaging demonstrated a significant positive correlation between MSC-TF and target-to-background ratio with the linear model (R(2) = 0.88, P = .0001, root mean square error = 0.523) and the nonlinear model (R(2) = 0.99, P = .0001, root mean square error = 0.273) and a lower detection limit of 2.5 × 10(8) cells. Conclusion The authors quantitatively determined the limit of detection of MSC after CCT in swine by using clinical PET reporter gene imaging and clinical MR imaging with cell prelabeling. (©) RSNA, 2016 Online supplemental material is available for this article. PMID:27332865

  4. Quantitative Techniques in PET-CT Imaging

    NARCIS (Netherlands)

    Basu, Sandip; Zaidi, Habib; Holm, Soren; Alavi, Abass

    2011-01-01

    The appearance of hybrid PET/CT scanners has made quantitative whole body scanning of radioactive tracers feasible. This paper deals with the novel concepts for assessing global organ function and disease activity based on combined functional (PET) and structural (CT or MR) imaging techniques, their

  5. Choline-PET/CT for imaging prostate cancer; Cholin-PET/CT zur Bildgebung des Prostatakarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Krause, Bernd Joachim [Klinik- und Poliklinik fuer Nuklearmedizin, Klinikum rechts der Isar, Technische Univ. Muenchen (Germany); Treiber, U.; Schwarzenboeck, S.; Souvatzoglou, M. [Klinik fuer Urologie, Klinikum rechts der Isar, Technische Univ. Muenchen (Germany)

    2010-09-15

    PET and PET/CT using [{sup 11}C]- and [{sup 18}F]-labelled choline derivatives are increasingly being used for imaging of prostate cancer. The value of PET and PET/CT with [{sup 11}C]- and [{sup 18}F]-labelled choline derivates in biochemical recurrence of prostate cancer has been examined in many studies and demonstrates an increasing importance. Primary prostate cancer can be detected with moderate sensitivity using PET and PET/CT using [{sup 11}C]- and [{sup 18}F]-labelled choline derivatives - the differentiation between benign prostatic hyperplasia, prostatitis or high-grade intraepithelial neoplasia (HGPIN) is not always possible. At the present time [{sup 11}C]choline PET/CT is not recommended in the primary setting but may be utilized in clinically suspected prostate cancer with repeatedly negative prostate biopsies, in preparation of a focused re-biopsy. Promising results have been obtained for the use of PET and PET/CT with [{sup 11}C]- and [{sup 18}F]-labelled choline derivates in patients with biochemical recurrence. The detection rate of choline PET and PET/CT for local, regional, and distant recurrence in patients with a biochemical recurrence shows a linear correlation with PSA values at the time of imaging and reaches about 75% in patients with PSA > 3 ng/mL. At PSA values below 1 ng/mL, the recurrence can be diagnosed with choline PET/CT in approximately 1/3 of the patients. PET and PET/CT with [{sup 11}C]- and [{sup 18}F]choline derivates can be helpful for choosing a therapeutic strategy in the sense of an individualized treatment: since an early diagnosis of recurrence is crucial to the choice of optimal treatment. The localization of the site of recurrence - local recurrence, lymph node metastasis or systemic dissemination - has important influence on the therapy regimen. (orig.)

  6. Is PET/CT efficient tool to evaluate the response after stereotactic radiation therapy for pancreas cancer?

    International Nuclear Information System (INIS)

    In pancreas cancer, to evaluate the efficacy of PET/CT as tool to check the response after stereotactic radiation therapy and to define functional imaging role of PET/CT as alterative tool of computed tomography. From November 2003 to December 2004, among locally advanced pancreas cancer patients treated by stereotactic radiation therapy using CyberKnife(CK), 14 were evaluated by PET/CT before and after treatment. Four patients took PET/CT one month after CK, 4 patients 2 months after CK, and 6 patients 3 months after CK as the first evaluation of treatment. All of patients were also evaluated by CT or CA19-9 tumor antigen with the range of 1-2 months after CK. In addition of PET/CT to CT, lymph node metastasis were revealed as positive in 4 patients who had negative finding on CT. Furthermore, patients who showed partial or complete response on PET/CT findings that checked within 3 months after CK have significantly longer median survival time than patients who showed no response or disease progression(13 months and 9 months, respectively). Responses based on CA19-9 tumor antigen or CT, however, showed no significant difference in terms of median survival time. PET/CT can provide more information for lymph node metastasis compared to CT alone. It is very helpful for delineation of tumor extent for CK planning. And initial response on PET/CT scan could be a significant prognostic factor rather than response on CA19-9 level or CT. In the future, more study is necessary to evaluate if PET/CT could substitute CT and finally CT could be omitted during follow-up period after CK

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

    Directory of Open Access Journals (Sweden)

    Percy eLee

    2012-07-01

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

  8. Feasibility study of small animal imaging using clinical PET/CT scanner

    Science.gov (United States)

    Hsu, Wen-Lin; Chen, Chia-Lin; Wang, Ze-Jing; Wu, Tung-Hsin; Liu, Dai-Wei; Lee, Jason J. S.

    2007-02-01

    The feasibility of small animal imaging using a clinical positron emission tomography/computed tomography (PET/CT) scanner with [F-18]-fluoro-2-deoxy- D-glucose (FDG) was evaluated. Two protocols in PET/CT system, single-mouse high-resolution mode (SHR) and multi-mouse high throughput mode (MHT) protocol were employed to investigate the ability of the scanner and also explored the performance differences between microPET and clinical PET/CT. In this study, we have found that even the clinical PET/CT scanner could not compete with the microPET scanner, especially in spatial resolution; the high-resolution CT image could advance the anatomical information to sub-millimeter level. Besides, CT-based attenuation correction can improve the image uniformity characteristics and quantification accuracy, and the large bore of a human whole-body scanner broadens the possibility of high throughput studies. Considering all the benefits, clinical PET/CT imaging might be a potential alternative for small animal study.

  9. PET/CT in lymphoma patients; PET-CT bei Lymphompatienten

    Energy Technology Data Exchange (ETDEWEB)

    Steinert, H.C. [Universitaetsspital Zuerich, Klinik und Poliklinik fuer Nuklearmedizin (Switzerland)

    2004-11-01

    First results of PET/CT in Hodgkin's disease (HD) and aggressive non-Hodgkin's lymphoma (NHL) are reported. From March 2001 to August 2004 822 PET/CT were performed at our clinic in lymphoma patients for primary staging, restaging after therapy, and diagnosis of recurrence. For coregistration non contrast-enhanced low-dose CT were used. Due to the exact anatomic localization of {sup 18}F-FDG accumulating lesions equivocal or false positive PET findings are avoided. In comparison to contrast enhanced CT, PET/CT has a higher sensitivity and specificity in patients with HD and aggressive NHL. Integration of PET/CT in treatment planning of radiation therapy optimizes the field volume. Even in the initial phase of clinical evaluation, PET/CT has proven useful in staging and restaging of lymphoma. The exact anatomic localization of the PET findings is essential for a precise report, for treatment planning of radiation therapy, and for planning surgical biopsy. (orig.) [German] Erste Ergebnisse der PET-CT bei Morbus Hodgkin (HD) und den aggressiven Non-Hodgkin-Lymphomen (NHL) werden beschrieben. Von Maerz 2001 bis August 2004 wurden 822 PET-CT bei Lymphompatienten zum primaeren Staging, zum Restaging nach Therapie und zur Rezidivdiagnostik an unserer Klinik durchgefuehrt. Fuer die Koregistration wurde ein Low-dose-CT ohne i.v.-Kontrastmittel verwendet. Durch die exakte anatomische Zuordnung der {sup 18}F-FDG aufnehmenden Laesionen wurden unklare oder falsch-positive PET-Befunde vermieden. Die PET-CT erzielte im Vergleich zur KM-verstaerkten CT eine hoehere Sensitivitaet und Spezifitaet bei Patienten mit HD und aggressiven NHL. Die Integration der PET-CT in die Planung der Strahlentherapie fuehrte zu einer Optimierung der Feldgrenzen. Die PET-CT hat sich bereits in der Phase der initialen klinischen Evaluation als wertvoll beim Staging und Restaging von Lymphomen erwiesen. Die exakte anatomische Zuordnung der PET-Informationen ist fuer eine sichere Befundung

  10. Washout of {sup 82}Rb as a marker of impaired tissue integrity, obtained by list-mode cardiac PET/CT: relationship with perfusion/metabolism patterns of myocardial viability

    Energy Technology Data Exchange (ETDEWEB)

    Chien, David T.; Bravo, Paco; Higuchi, Takahiro; Merrill, Jennifer [Johns Hopkins University School of Medicine, Division of Nuclear Medicine, Russell H Morgan Department of Radiology, Baltimore, MD (United States); Bengel, Frank M. [Johns Hopkins University School of Medicine, Division of Nuclear Medicine, Russell H Morgan Department of Radiology, Baltimore, MD (United States); Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany)

    2011-08-15

    Myocardial washout of the potassium analogue {sup 82}Rb may indicate tissue impairment. Few studies have evaluated its usefulness for viability assessment, and controversial results were reported. We revisited this topic using list-mode positron emission tomography (PET)/CT. A total of 22 patients with chronic ischemic cardiomyopathy (ICM) and 11 control subjects with normal CT coronary angiogram were studied. Rest {sup 82}Rb PET/CT studies were acquired in list mode and resampled to static, gated, and dynamic images. Using a 17-segment model, {sup 82}Rb washout was determined by monoexponential fitting of myocardial time-activity curves. In ICM patients, {sup 18}F-fluorodeoxyglucose (FDG) studies were obtained in the same session and segments were classified as normally perfused, mismatch, or matched defect. {sup 82}Rb washout was minimal and homogeneous in control subjects. Normally perfused segments of ICM did not differ (p = 0.33). ICM patients had a left ventricular ejection fraction (LVEF) of 25 {+-} 12%, 25/353 mismatched, and 46/353 matched defect segments. {sup 82}Rb washout was higher in hypoperfused vs normal segments (p < 0.05), but not different between mismatch and matched defect (p = 0.18). Intraindividual analysis in nine patients showing both FDG mismatch and matched defect confirmed absence of differences. Overall, segmental {sup 82}Rb washout correlated inversely with {sup 82}Rb uptake (r = -0.70; p < 0.05) and less well with FDG uptake (r = -0.31; p < 0.05). Using state-of-the-art PET/CT technology for myocardial viability assessment, {sup 82}Rb washout does not distinguish between perfusion/metabolism patterns of hibernating myocardium and scar. Tissue integrity may be at least partially impaired in hibernation. (orig.)

  11. Response evaluation after chemoradiotherapy for advanced nodal disease in head and neck cancer using diffusion-weighted MRI and 18F-FDG-PET-CT

    NARCIS (Netherlands)

    C.S. Schouten; P. de Graaf; F.M. Alberts; O.S. Hoekstra; E.F.I. Comans; E. Bloemena; B.I. Witte; E. Sanchez; C.R. Leemans; J.A. Castelijns; R. de Bree

    2015-01-01

    Objectives Evaluation of accuracy and interobserver variation of diffusion-weighted magnetic resonance imaging (DW-MRI) and 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDGPET-CT) to detect residual lymph node metastases after chemoradiotherapy (CRT) in advanced stage

  12. Response evaluation after chemoradiotherapy for advanced nodal disease in head and neck cancer using diffusion-weighted MRI and 18F-FDG-PET-CT

    NARCIS (Netherlands)

    Schouten, C.S.; Graaf, P. de; Alberts, F.M.; Hoekstra, O.S.; Comans, E.F.; Bloemena, E.; Witte, B.I.; Sanchez, E.; Leemans, C.R.; Castelijns, J.A.; Bree, R. de

    2015-01-01

    OBJECTIVES: Evaluation of accuracy and interobserver variation of diffusion-weighted magnetic resonance imaging (DW-MRI) and 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDGPET-CT) to detect residual lymph node metastases after chemoradiotherapy (CRT) in advanced stag

  13. Importance of PET/CT for imaging of colorectal cancer; Stellenwert der PET/CT zur Bildgebung des kolorektalen Karzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Meinel, F.G.; Schramm, N.; Graser, A.; Reiser, M.F.; Rist, C. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Haug, A.R. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Klinik und Poliklinik fuer Nuklearmedizin, Muenchen (Germany)

    2012-06-15

    Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) has emerged as a very useful imaging modality in the management of colorectal carcinoma. Data from the literature regarding the role of PET/CT in the initial diagnosis, staging, radiotherapy planning, response monitoring and surveillance of colorectal carcinoma is presented. Future directions and economic aspects are discussed. Computed tomography (CT), magnetic resonance imaging (MRI) and FDG-PET for colorectal cancer and endorectal ultrasound for rectal cancer. Combined FDG-PET/CT. While other imaging modalities allow superior visualization of the extent and invasion depth of the primary tumor, PET/CT is most sensitive for the detection of distant metastases of colorectal cancer. We recommend a targeted use of PET/CT in cases of unclear M staging, prior to metastasectomy and in suspected cases of residual or recurrent colorectal carcinoma with equivocal conventional imaging. The role of PET/CT in radiotherapy planning and response monitoring needs to be determined. Currently there is no evidence to support the routine use of PET/CT for colorectal screening, staging or surveillance. To optimally exploit the synergy between morphologic and functional information, FDG-PET should generally be performed as an integrated FDG-PET/CT with a contrast-enhanced CT component in colorectal carcinoma. (orig.) [German] Die Fluordesoxyglukose-Positronenemissionstomographie/Computertomographie (FDG-PET/CT) hat in den letzten Jahren zunehmende Bedeutung zur Bildgebung des kolorektalen Karzinoms erlangt. In diesem Beitrag stellen wir den Stand der Literatur zur Rolle der PET/CT bei Screening, Staging, Bestrahlungsplanung, Beurteilung eines Therapieansprechens und Nachsorge des kolorektalen Karzinoms dar. Zudem wird auf gesundheitsoekonomische Aspekte und zukuenftige Entwicklungen eingegangen. CT, MRT, FDG-PET, beim Rektumkarzinom zusaetzlich endorektaler Ultraschall. Kombinierte FDG-PET/CT. Waehrend

  14. PET and PET/CT in malignant melanoma; PET y PET/CT en melanoma maligno

    Energy Technology Data Exchange (ETDEWEB)

    Garcia O, J.R. [Nuclear Medicine and Molecular Imaging PET/CT, Centro Medico ABC, Mexico D.F. (Mexico)

    2007-07-01

    The advantages that it has the PET/CT are: 1. It diminishes mainly positive false lesions. It identifies physiologic accumulate places. 2. It diminishes in smaller grade false negative. Small injuries. Injuries with low grade concentration. Injure on intense activity areas. 3. Precise anatomical localization of accumulate places. 4. Reduction of the acquisition time. (Author)

  15. Role of {sup 18}FDG PET/CT in patients treated with {sup 177}Lu-DOTATATE for advanced differentiated neuroendocrine tumours

    Energy Technology Data Exchange (ETDEWEB)

    Severi, Stefano; Sansovini, Maddalena; Ianniello, Annarita; Matteucci, Federica [Cancer Institute of Romagna (IRST), Unit of Radiometabolic Medicine, Meldola, FC (Italy); Nanni, Oriana; Scarpi, Emanuela [Cancer Institute of Romagna (IRST), Unit of Biostatistics and Clinical Trials, Meldola, FC (Italy); Bodei, Lisa; Gilardi, Laura; Paganelli, Giovanni [European Institute of Oncology, Division of Nuclear Medicine, Milan (Italy); Nicoletti, Stefania [Cancer Institute of Romagna (IRST), Unit of Medical Oncology, Meldola, FC (Italy)

    2013-06-15

    The prognostic value of FDG PET for neuroendocrine tumours (NETs) has been reported. In this study we evaluated the role of FDG PET in predicting response and progression-free survival (PFS) after {sup 177}Lu-DOTATATE peptide receptor radionuclide therapy (Lu-PRRT) in patients with advanced well-differentiated grade 1/2 NETs. We retrospectively evaluated 52 patients with progressive advanced NETs overexpressing somatostatin receptors and treated with Lu-PRRT with a cumulative activity up to 27.7 GBq divided into five courses. According to WHO 2010/ENETS classification, patients were stratified into two groups: those with grade 1 tumour (Ki-67 index {<=}2 %, 19 patients), and those with grade 2 tumour (Ki-67 index >3 % to <20 %, 33 patients). On the basis of the FDG PET scan, 33 patients were classified as PET-positive (PET+) and 19 as PET-negative (PET-). FDG PET was positive in 57 % of patients with grade 1 NET and in 66 % of patients with grade 2 NET, and the rates of disease control (DC, i.e. complete response + partial response + stable disease) in grade 1 and grade 2 patients were 95 % and 79 %, respectively (P = 0.232). In PET- and PET+ patients, the DC rates were 100 % and 76 % (P = 0.020) with a PFS of 32 and 20 months, respectively (P = 0.033). Of the PET+ patients with grade 1 NET, 91 % showed disease control, whereas about one in three PET+ patients with grade 2 NET (32 %) progressed after Lu-PRRT (DC rate 68 %). These results suggest that FDG PET evaluation is useful for predicting response to Lu-PRRT in patients with grade 1/2 advanced NETs. Notably, none of PET- patients had progressed at the first follow-up examination after Lu-PRRT. Grade 2 NET and PET+ (arbitrary SUV cutoff >2.5) were frequently associated with more aggressive disease. PET+ patients with grade 2 NET, 32 % of whom did not respond to Lu-PRRT monotherapy, might benefit from more intensive therapy protocols, such as the combination of chemotherapy and PRRT. (orig.)

  16. The relationship between the 18 F-FDG PET-CT imaging standard uptake value and the prognosis of advanced breast cancer%晚期乳腺癌18F-FDG PET-CT显像标准摄取值与预后的相关性

    Institute of Scientific and Technical Information of China (English)

    徐蓉; 马楠

    2012-01-01

    Objective To study the relationship between the 18F-FDG PET-CT imaging standard uptake value and the prognosis of advanced breast cancer. Methods 68 patients with advanced breast cancer patients were involved in the current study. The PET-CT SUV value was recorded before the systemic chemotherapy. All patients were divided into two groups depending on the demarcation point of SUV values of 8. The relationship between the SUV value and the five year survival rate was analysed. Results 68 patients were observed in this study. The negative correlation was found between the SUV value and life cycle. Conclusion 18F-FDG PET-CT imaging standard uptake value (SUV value) is probably related to the prognosis of breast cancer, which is worthy of the further study.%目的 探讨晚期乳腺癌18 F-FDG PET-CT显像标准摄取值与预后的相关性.方法 选择68例晚期乳腺癌患者,记录诊断时PET-CT的SUV值,均给予全身静脉化疗,以SUV值8为分界点,将本组患者分为两组,随访5年,观察SUV值与5年生存率的关系.结果 本组观察的68例患者,SUV值越小,生存期相对越长,反之,生存期则相对较短.结论 18F-FDG PET-CT显像标准摄取值(SUV值)对乳腺癌的预后有一定价值,值得临床进一步研究.

  17. Effectiveness of FDG-PET/CT for evaluating early response to induction chemotherapy in head and neck squamous cell carcinoma

    Science.gov (United States)

    dos Anjos, Renata Fockink; dos Anjos, Dalton Alexandre; Vieira, Danielle Leal; Leite, André Ferreira; Figueiredo, Paulo Tadeu de Souza; de Melo, Nilce Santos

    2016-01-01

    Abstract Background: 18F-Fluoro-Deoxy-Glucose Positron Emission Tomography with Computed Tomography (18F-FDG PET/CT) may be a powerful tool to predict treatment outcome. We aimed to review the effectiveness of 18F-FDG PET/CT in the assessment of early response to induction chemotherapy (IC) in patients with advanced Head and Neck Squamous Cell Cancer (HNSCC) without previous treatment. Methods: PubMed, Cochrane Library, Science Direct and Web of Science were searched to May 2016. Reference lists of the included articles and additional studies identified by one nuclear medicine expert were screened for potential relevant studies that investigated the effectiveness of 18F-FDG PET/CT performed before and after IC. Three authors independently screened all retrieved articles, selected studies that met inclusion criteria and extracted data. The methodology of the selected studies was evaluated by using the risk of bias checklist of the Agency for Healthcare Research and Quality (AHRQ). Results: Seven out of 170 eligible studies met our inclusion criteria. A total of 207 advanced HNSCC patients were evaluated with 18F-FDG PET/CT at baseline and after IC in the selected articles. Six from seven studies concluded that 18F-FDG PET/CT allowed early evaluation response to IC and predicted survival outcomes. Conclusion: The present systematic review confirms the potential value of 18F-FDG PET/CT as a diagnostic tool for early IV response assessment in HNSCC patients. However, the lack of standard definitions for response criteria and heterogeneous IC protocols indicate the need to further studies in order to better define the role of 18F-FDG PET/CT in these patients. PMID:27512861

  18. Clinical application of FDG-PET/CT in metastatic infections

    NARCIS (Netherlands)

    Kouijzer, I.J.E.; Vos, F.J.; Bleeker-Rovers, Chantal P.; Oyen, W.J.G.

    2016-01-01

    FDG-PET/CT has proven its clinical value and cost-effectiveness in diagnosing metastatic infections in patients with Gram-positive bacteremia. In identification of metastatic foci, FDG-PET/CT is useful as a screening method when localizing symptoms are absent because it provides whole-body coverage.

  19. PET-CT og kolorektal cancer - retrospektivt studie

    DEFF Research Database (Denmark)

    Larsen, Anders Christian; Julie, Pedersen; Prakash, Vineet;

    Nuklearmedicinsk Afdeling, Aalborg Sygehus : Siden september 2006 har man på Nuklearmedicinsk Afdeling, Aalborg Sygehus foretaget PET-CT i en session på integreret PET-CT scanner. Der anvendes 18F-FDG (18F-flouro- 2-deoxy-D-glukose) som tracer, og responset måles som standardized uptake value (SUV), hvilket er...

  20. PET/CT Imaging and Radioimmunotherapy of Prostate Cancer

    DEFF Research Database (Denmark)

    Bouchelouche, Kirsten; Tagawa, Scott T; Goldsmith, Stanley J;

    2011-01-01

    of more effective treatment modalities that could improve outcome. Prostate cancer represents an attractive target for radioimmunotherapy (RIT) for several reasons, including pattern of metastatic spread (lymph nodes and bone marrow, sites with good access to circulating antibodies) and small volume...... antitumor activity and is well tolerated. Clinical trials are underway to further improve upon treatment efficacy and patient selection. This review focuses on the recent advances of clinical PET/CT imaging and RIT of prostate cancer.......Prostate cancer is a common cancer in men and continues to be a major health problem. Imaging plays an important role in the clinical management of patients with prostate cancer. An important goal for prostate cancer imaging is more accurate disease characterization through the synthesis...

  1. Myocardial metastases on 6-[18F] fluoro-L-DOPA PET/CT: a retrospective analysis of 116 serotonin producing neuroendocrine tumour patients.

    Directory of Open Access Journals (Sweden)

    Walter Noordzij

    Full Text Available PURPOSE: This study evaluates the prevalence of cardiac metastases in patients with serotonin producing neuroendocrine tumours (NET, examined with 18F-FDOPA PET/CT, and the relationship of these metastases to the presence of carcinoid heart disease (CHD based on echocardiography. BACKGROUND: CHD occurs in patients with serotonin producing NET. The diagnostic method of choice remains echocardiography. The precise prevalence of cardiac metastases is unknown given the limitations of standard technologies. Nuclear medicine modalities have the potential to visualize metastases of NET. METHODS: All patients who underwent 18F-FDOPA PET/CT because of serotonin producing NET between November 2009 and May 2012 were retrospectively analyzed. The presence of cardiac metastasis was defined as myocardial tracer accumulation higher than the surrounding physiological myocardial uptake. Laboratory tests and transthoracic echocardiography (TTE results were digitally collected. RESULTS: 116 patients (62 male underwent 18F-FDOPA PET/CT, mean age was 61±13 years. TTE was performed in 79 patients. Cardiac metastases were present in 15 patients, of which 10 patients also underwent TTE. One patient had both cardiac metastasis (only on 18F-FDOPA PET/CT and echocardiographic signs of CHD. There were no differences in echocardiographic parameters for CHD between patients with and without cardiac metastases. TTE in none of the 79 patients showed cardiac metastases. CONCLUSION: The prevalence of cardiac metastases detected with 18F-FDOPA PET/CT in this study is 13%. 18F-FDOPA PET/CT can visualize cardiac metastases in serotonin producing NET patients. There appears to be no relationship between the presence of cardiac metastases and TTE parameters of CHD.

  2. 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.)

  3. PET/CT in Lung Cancer

    International Nuclear Information System (INIS)

    With an incidence of about 170,000 malignant pulmonary nodules in the United States per year there is a need to non- invasively investigate these patients. Metabolic imaging using F-18 FDG is more accurate for all purposes and at all stages than anatomical imaging. The following are the guidelines for these indications: For the differentiation of malignant from benign pulmonary nodules: Although chest X-ray and CT are the imaging modalities used for the initial discovery of these nodules the accuracy of multi-slice CT with and without contrast enhancement in differentiating benign from malignant is only 70-75%. Signs of malignancy in CT include micro-calcification, irregular margins and enhancement of more than 20-25%. Hounsfield Units (HU) with serial imaging following IV contrast injection. F-18 FDG PET/CT imaging at about 60 minutes following IV of the radiopharmaceutical has an accuracy of about 92-95% when the SUV of 2.5 or more is considered suggestive of malignancy. However, other benign nodules can be equally metabolically active such as sarcoidosis, tuberculosis and fungal infections. In order to increase the specificity of F-18 FDG early (60 minutes) and delayed (120 minutes) imaging was suggested to differentiate benign (delayed SUV lower than early SUV) from malignant lesions (delayed SUV higher than early SUV). Using this approach was helpful in some but not in all patients. Accordingly it could not be used as an alternate to pathological verification. There are other causes of false negative F-18 FDG uptake such as carcinoid and alveolar cell carcinoma. For these reasons it is the recommendation that all FDG positive lesions that are suggestive of malignancy must be biopsied irrespective of the changes in the SUV between early and delayed imaging. Although the current resolution of the new PET/CT systems is less than 5 mm the sensitivity of detecting lesions less than 8 mm is only around 60%. Pulmonary nodules that are not considered malignant by

  4. PET/CT imaging in lung cancer: indications and findings

    Directory of Open Access Journals (Sweden)

    Bruno Hochhegger

    2015-06-01

    Full Text Available The use of PET/CT imaging in the work-up and management of patients with lung cancer has greatly increased in recent decades. The ability to combine functional and anatomical information has equipped PET/CT to look into various aspects of lung cancer, allowing more precise disease staging and providing useful data during the characterization of indeterminate pulmonary nodules. In addition, the accuracy of PET/CT has been shown to be greater than is that of conventional modalities in some scenarios, making PET/CT a valuable noninvasive method for the investigation of lung cancer. However, the interpretation of PET/CT findings presents numerous pitfalls and potential confounders. Therefore, it is imperative for pulmonologists and radiologists to familiarize themselves with the most relevant indications for and limitations of PET/CT, seeking to protect their patients from unnecessary radiation exposure and inappropriate treatment. This review article aimed to summarize the basic principles, indications, cancer staging considerations, and future applications related to the use of PET/CT in lung cancer.

  5. PET and PET/CT for imaging of prostate cancer

    International Nuclear Information System (INIS)

    This review article provides an overview of the current literature data regarding the value of PET and PET/CT for imaging of prostate cancer. Most widely used PET tracers for prostate cancer imaging are 11C-acetate and 11C- or 18F-labeled choline. Available literature data on the performance of PET and PET/CT in the detection of the primary malignancy as well as local or distant metastases are presented and discussed. In addition, our own preliminary results regarding the diagnostic efficacy of 11C-choline PET and PET/CT in 43 patients with suspected prostate cancer are provided. The prevalence of prostate cancer in this patient sample was 55.8%. PET and PET/CT showed a sensitivity of 88% with a specificity of 63% in the detection of the primary prostate cancer. The sensitivity in the detection of metastatic spread was 77% and no false-positives were found. The possible value and limitations of combined PET/CT systems when compared to stand alone PET scanners are discussed. PET and PET/CT is at present the single imaging modality providing functional information not only regarding the primary malignancy but also its metastases. This unique feature distinguishes PET from MRI complemented with magnetic resonance spectroscopy - a competing procedure. Our own results as well as the still limited literature data suggest, that PET and PET/CT may prove to be useful methods for imaging of prostate cancer. (orig.)

  6. PET-CT in the typification of unique pulmonary injuries

    International Nuclear Information System (INIS)

    The objective of this document is to evaluate the usefulness of the PET-CT for the characterization of the unique pulmonary injuries. Retrospective analysis was made to patients with unique pulmonary injuries who carried out a PET-CT in the Italian Hospital between May of 2003 - March of 2005. Those patients with pulmonary outlying nodule, or unique pulmonary mass that had pathological anatomy of injury or follow-up through a computed tomography of thorax made with an interval of time not minor at 2 years of the PET-CT were included

  7. Comparison of FDG-PET/CT and bone scintigraphy for detection of bone metastases in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, Steffen; Heusner, Till; Forsting, Michael; Antoch, Gerald (Dept. of Diagnostic and Interventional Radiology and Neuroradiology, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany)), email: steffen.hahn@uk-essen.de; Kuemmel, Sherko; Koeninger, Angelika (Dept. of Gynecology and Obstetrics, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany)); Nagarajah, James; Mueller, Stefan; Boy, Christian; Bockisch, Andreas; Stahl, Alexander (Dept. of Nuclear Medicine, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany))

    2011-11-15

    Background Bone scintigraphy is the standard procedure for the detection of bone metastases in breast cancer patients. FDG-PET/CT has been reported to be a sensitive tool for tumor staging in different malignant diseases. However, its accuracy for the detection of bone metastases has not been compared to bone scintigraphy. Purpose To compare whole-body FDG-PET/CT and bone scintigraphy for the detection of bone metastases on a lesion basis in breast cancer patients. Material and Methods Twenty-nine consecutive women (mean age 58 years, range 35-78 years) with histologically proven breast cancer were assessed with bone scintigraphy and whole-body FDG-PET/CT. Twenty-one patients (72%) were suffering from primary breast cancer and eight patients (28%) were in aftercare with a history of advanced breast cancer. Both imaging procedures were assessed for bone metastases by a radiologist and a nuclear medicine physician. Concordant readings between bone scintigraphy and FDG-PET/CT were taken as true. Discordant readings were verified with additional MRI imaging in all patients and follow-up studies in most patients. Results A total of 132 lesions were detected on bone scintigraphy, FDG-PET/CT or both. According to the reference standard, 70/132 lesions (53%) were bone metastases, 59/132 lesions (45%) were benign, and three lesions (2%) remained unclear. The sensitivity of bone scintigraphy was 76% (53/70) compared to 96% (67/70) for FDG-PET/CT. The specificity of bone scintigraphy and FDG-PET/CT was 95% (56/59) and 92% (54/59), respectively. According to the reference standard bone metastases were present in eight out of the 29 patients (28%), whereas 20 patients (69%) were free of bone metastases. One (3%) patient had inconclusive readings on both modalities as well as on MRI and follow-up studies. Bone scintigraphy and FDG-PET/CT correctly identified seven out of eight patients with bone metastases and 20 out of 20 patients free of metastases. Conclusion On a lesion

  8. Prospect of PET-CT in a developing and transition economy like Bangladesh

    International Nuclear Information System (INIS)

    Full text: Background: Nuclear Medicine as a specialty has grown quite extensively in Bangladesh, yet its use in some areas is challenged due to the advent of other modern imaging modalities. Compared to advances in radiological techniques such as MRI and CT, which have successfully proliferated in Dhaka, the current Bangladesh scenario in Nuclear Medicine remains almost conventional. This is happening when all are keenly aware of the new dimension and direction of Nuclear Medicine especially after the introduction of PET and fusion imaging technology. The tremendous potential of PET technology has been realized in the developed world where 18F-FDG PET has been the fastest growing diagnostic modality in oncology in the past decade. Further advances in molecular imaging have now given an altogether new definition to nuclear medicine. The question is whether this new capacity can be competently added to nuclear medicine in transition economies. Aim: The aim of this presentation is to examine the feasibility of establishing PET-CT-Cyclotron centers in Bangladesh and to justify its use for clinical patient management and for research. Materials and Method: Public and private Radiology and Nuclear Medicine centers in Dhaka were surveyed to analyze the current situation with regards to the presence of the latest state-of-the-art technology and the utilization of these services. Oncologists, cardiologists, neurologists and other key people were interviewed to assess the demand for advanced Nuclear Medicine Techniques and to determine the clinical feasibility of establishing PET-CT technology in Dhaka, Bangladesh. Results: Diagnostic radiology facilities are available in all public and private hospitals with most centers having at least one 16 slice CT and a 1.5 Tesla MRI equipment. The only Utrafast 64-slice CT angio system is present in a large private hospital in Dhaka. Since its introduction in March, 2006 there has been remarkable response from the medical community

  9. 18 F-FDG PET/CT 确定局部晚期非小细胞肺癌加量放疗靶区的可行性%A feasibility study for boost target delineation using 18 F-FDG PET/CT in local advanced non-small cell lung cancer

    Institute of Scientific and Technical Information of China (English)

    高昂; 王世江; 付正; 孙新东; 于金明; 孟雪

    2015-01-01

    Objective To evaluate whether during-radiotherapy or post-radiotherapy 18 F-FDG uptake locations within tumour can be identified by a pre-radiotherapy scan for non-small cell lung cancer,and to explore the optimal biological sub-volume of the primary tumor for dose escalation.Methods 18 F-FDG PET/CT scans were performed at pre-radio-therapy,during-radiotherapy (40 Gy)or post-radiotherapy.The region of interests were auto-delineated using the 40%-70% maximal standardized uptake value (SUVmax )thresholds using pre-radiotherapy scan.Overlap fractions between pre-radiotherapy scan and during-radiotherapy or post-radiotherapy scan were calculated.Then,a Spearman correlation was used to analyze the correlations between the volumes of the region of interests and sensitivities of radiotherapy. Results The 50% SUVmax-delineated region of interests had large overlap fractions with the 40% SUVmax-delineated and manual-delineated regions of high uptake at during-radiotherapy,with the values being (74.3 ±15.9)% and (84.4 ±15.3)%,respectively.The overlap fractions of 50% SUVmax-delineated region of interests and the 80% SUVmax-delineated regions of high uptake at post-radiotherapy were more than 72%.The volume of 50% SUVmax-delineated region of interests was smaller than the gross tumor volume (GTV),with the value of being (29.4 ±12.3)%.However, the 50% SUVmax-delineated region of interests had no correlations with the sensitivities of radiotherapy.Conclusion A 18 F-FDG PET/CT scan at pre-radiotherapy can identify the high 18 F-FDG uptake regions at during-radiotherapy and post-radiotherapy.The 50% SUVmax-delineated volume may be a suitable region for dose boosting.%目的:评价局部晚期非小细胞肺癌患者,放疗前18 F-FDG 高代谢区能否识别放疗中及放疗后高代谢区,并探讨局部加量的最佳生物学亚靶区。方法在放疗前、放疗中(40 Gy)和/或放疗后,分别行18 F-FDG PET/CT扫描。利用放疗前原发灶内40

  10. Zosteriform Secondary Cutaneous Diffuse Large B-Cell Lymphoma on FDG PET/CT.

    Science.gov (United States)

    Liao, Chiung-Wei; Yen, Kuo-Yang; Hsieh, Te-Chun; Kao, Chia-Hung

    2016-09-01

    We present a case of a woman who had erythematous papules on the abdomen accompanied with numbness and local heat sensation. She had received chemotherapy for advanced follicular lymphoma. F-FDG PET/CT demonstrated band-like hypermetabolic lesions seemingly involving dermatomes of lower abdominal wall, which was confirmed as secondary cutaneous diffuse large B-cell lymphoma via skin biopsy. PMID:27405036

  11. Feasibility of breathing-adapted PET/CT imaging for radiation therapy of Hodgkin lymphoma

    DEFF Research Database (Denmark)

    Aznar, M C; Andersen, Flemming; Berthelsen, A K;

    2011-01-01

    Aim: Respiration can induce artifacts in positron emission tomography (PET)/computed tomography (CT) images leading to uncertainties in tumour volume, location and uptake quantification. Respiratory gating for PET images is now established but is not directly translatable to a radiotherapy setup....... in PET/CT images. These results suggest that advanced therapies (such as SUV-based dose painting) will likely require breathing-adapted PET images and that the relevant SUV thresholds are yet to be investigated....

  12. Feasibility of breathing-adapted PET/CT imaging for radiation therapy of Hodgkin lymphoma

    DEFF Research Database (Denmark)

    Aznar, M C; Andersen, Flemming; Berthelsen, A K;

    2011-01-01

    Aim: Respiration can induce artifacts in positron emission tomography (PET)/computed tomography (CT) images leading to uncertainties in tumour volume, location and uptake quantification. Respiratory gating for PET images is now established but is not directly translatable to a radiotherapy setup....... uptake in PET/CT images. These results suggest that advanced therapies (such as SUV-based dose painting) will likely require breathing-adapted PET images and that the relevant SUV thresholds are yet to be investigated....

  13. PET/CT Based Dose Planning in Radiotherapy

    DEFF Research Database (Denmark)

    Berthelsen, Anne Kiil; Jakobsen, Annika Loft; Sapru, Wendy;

    2011-01-01

    radiotherapy planning with PET/CT prior to the treatment. The PET/CT, including the radiotherapy planning process as well as the radiotherapy process, is outlined in detail. The demanding collaboration between mould technicians, nuclear medicine physicians and technologists, radiologists and radiology......This mini-review describes how to perform PET/CT based radiotherapy dose planning and the advantages and possibilities obtained with the technique for radiation therapy. Our own experience since 2002 is briefly summarized from more than 2,500 patients with various malignant diseases undergoing...... technologists, radiation oncologists, physicists, and dosimetrists is emphasized. We strongly believe that PET/CT based radiotherapy planning will improve the therapeutic output in terms of target definition and non-target avoidance and will play an important role in future therapeutic interventions in many...

  14. Preoperative PET/CT in early-stage breast cancer

    DEFF Research Database (Denmark)

    Bernsdorf, M; Berthelsen, A K; Wielenga, V T;

    2012-01-01

    The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer.......The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer....

  15. Detection of Extramedullary Multiple Myeloma in Liver by FDG-PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Daeweung; Kim, Woo Hyoung; Kim, Myoung Hyoun; Choi, Keum Ha; Kim, Chang Guhn [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of)

    2014-06-15

    We present the case of a 42-year-old man with a painful mass lesion in the right shoulder that was detected by contrast-enhanced computed tomography (CT) and {sup 18}F-fluoro-2-deoxyglucose ({sup 18}F-FDG) positron emission tomography (PET)/CT. Excisional biopsy revealed infiltration of plasma cells with anaplastic features, consistent with solitary plasmacytoma (PC). Serum analysis showed elevation of serum free lambda light chain levels (27.78 mg/l), with an abnormally high kappa:lambda ratio (2.33) and high total proteins (10.4 g/dl). Serum protein electrophoresis revealed an M spike in the gamma-globulin region (56.1 %=5.8 g/dl). Subsequently, {sup 18}F-FDG PET/CT revealed another hypermetabolic mass in the right lobe of the liver. CT-guided biopsy of the liver lesion revealed plasma cell myeloma, consistent with multiple myeloma. Multiple myeloma presenting as nodular liver masses is very rare in clinical practice. In a retrospective review of more than 2,000 patients, Talamo et al. reported only nine cases where there was nodular involvement of the liver by multiple myeloma. The organ most commonly involved was the liver, followed by pancreas, stomach, peritoneum with malignant ascites, colon, rectum, duodenum and ileum. Therefore, the literature published thus far has been limited to a few reports and case series. Among these reports, some had demonstrated the PET or PET/CT findings of nodular liver involvement of multiple myeloma. About 10 % of the solitary myelomas appeared as extramedullary PC or solitary PC of bone. In spite of the advances in therapy, the treatment of multiple myeloma is still palliative. However, solitary PC could be cured by resection or radiation therapy. Thus, differentiation between PC and multiple myeloma is essential in making a decision for the appropriate therapeutic regimen. {sup 18}F-FDG PET/CT has the unique ability to detect and characterize malignant lesions in one single examination. Schirrmeister et al. reported that

  16. Detection of Extramedullary Multiple Myeloma in Liver by FDG-PET/CT

    International Nuclear Information System (INIS)

    We present the case of a 42-year-old man with a painful mass lesion in the right shoulder that was detected by contrast-enhanced computed tomography (CT) and 18F-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography (PET)/CT. Excisional biopsy revealed infiltration of plasma cells with anaplastic features, consistent with solitary plasmacytoma (PC). Serum analysis showed elevation of serum free lambda light chain levels (27.78 mg/l), with an abnormally high kappa:lambda ratio (2.33) and high total proteins (10.4 g/dl). Serum protein electrophoresis revealed an M spike in the gamma-globulin region (56.1 %=5.8 g/dl). Subsequently, 18F-FDG PET/CT revealed another hypermetabolic mass in the right lobe of the liver. CT-guided biopsy of the liver lesion revealed plasma cell myeloma, consistent with multiple myeloma. Multiple myeloma presenting as nodular liver masses is very rare in clinical practice. In a retrospective review of more than 2,000 patients, Talamo et al. reported only nine cases where there was nodular involvement of the liver by multiple myeloma. The organ most commonly involved was the liver, followed by pancreas, stomach, peritoneum with malignant ascites, colon, rectum, duodenum and ileum. Therefore, the literature published thus far has been limited to a few reports and case series. Among these reports, some had demonstrated the PET or PET/CT findings of nodular liver involvement of multiple myeloma. About 10 % of the solitary myelomas appeared as extramedullary PC or solitary PC of bone. In spite of the advances in therapy, the treatment of multiple myeloma is still palliative. However, solitary PC could be cured by resection or radiation therapy. Thus, differentiation between PC and multiple myeloma is essential in making a decision for the appropriate therapeutic regimen. 18F-FDG PET/CT has the unique ability to detect and characterize malignant lesions in one single examination. Schirrmeister et al. reported that 18F-FDG PET revealed

  17. PET/CT and PET - application in pediatric oncology; PET/CT und PET - Einsatz in der paediatrischen Onkologie

    Energy Technology Data Exchange (ETDEWEB)

    Franzius, C.; Lang, K.; Schober, O. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Muenster (Germany); Wormanns, D. [Inst. fuer klinische Radiologie, Univ. Muenster (Germany); Vormoor, J. [Klinik und Poliklinik fuer Kinder- und Jugendmedizin - Paediatrische Haematologie und Onkologie, Univ. Muenster (Germany)

    2004-12-01

    PET-CT is a new imaging technology with a high capability to improve oncologic imaging. Introduction into clinical practise started approximately 3 years ago. Consequently, the available literature data are preliminary. There are no studies concerning PET-CT in pediatric patients. Nevertheless, it can already be supposed that the synthesis of structural and metabolic information improves the accuracy of staging and has the realistic potential to change patient management in a relevant percentage rate in pediatric patients. In this article, the advantages and special features of the application of PET-CT in young oncologic patients are pointed out. Potential clinical applications of PET-CT in this patient group include Hodgkin and non-Hodgkin lymphomas, Ewing tumors, osteosarcomas, rhabdomyosarcomas and neuroblastomas. (orig.)

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

    Science.gov (United States)

    Fischer, B M; Aznar, M C; Hansen, A E; Vogelius, I R; Löfgren, J; Andersen, F L; Loft, A; Kjaer, A; Højgaard, L; Specht, L

    2015-01-01

    Objective: To investigate reproducibility of fluorine-18 fludeoxyglucose (18F-FDG) uptake on 18F-FDG positron emission tomography (PET)/CT and 18F-FDG PET/MR scans in patients with head and neck squamous cell carcinoma (HNSCC). Methods: 30 patients with HNSCC were included in this prospective study. The patients were scanned twice before radiotherapy treatment with both PET/CT and PET/MR. Patients were scanned on the same scanners, 3 days apart and according to the same protocol. Metabolic tumour activity was measured by the maximum and peak standardized uptake value (SUVmax and SUVpeak, respectively), and total lesion glycolysis from the metabolic tumour volume defined from ≥50% SUVmax. Bland–Altman analysis with limits of agreement, coefficient of variation (CV) from the two modalities were performed in order to test the reproducibility. Furthermore, CVs from SUVmax and SUVpeak were compared. The area under the curve from cumulative SUV–volume histograms were measured and tested for reproducibility of the distribution of 18F-FDG uptake. Results: 24 patients had two pre-treatment PET/CT scans and 21 patients had two pre-treatment PET/MR scans available for further analyses. Mean difference for SUVmax, peak and mean was approximately 4% for PET/CT and 3% for PET/MR, with 95% limits of agreement less than ±20%. CV was small (5–7%) for both modalities. There was no significant difference in CVs between PET/CT and PET/MR (p = 0.31). SUVmax was not more reproducible than SUVpeak (p = 0.09). Conclusion: 18F-FDG uptake in PET/CT and PET/MR is highly reproducible and we found no difference in reproducibility between PET/CT and PET/MR. Advances in knowledge: This is the first report to test reproducibility of PET/CT and PET/MR. PMID:25634069

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-01-22

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

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

    International Nuclear Information System (INIS)

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

  2. Role of PET/CT in malignant pediatric lymphoma

    International Nuclear Information System (INIS)

    Malignant pediatric lymphoma accounts for 10-15% of all pediatric cancers, (representing 2-3% of all malignancies), with a peak incidence between 5-9 years. Chemotherapy is usually the first and most common mode of treatment. The choice of treatment and prediction of prognosis depend on the histological type of tumor, initial staging, evaluating treatment response, and detection of early recurrence. Conventional imaging modalities have many limitations. PET/CT is more accurate, however so far the literature lacks the results of a large group of patients. To report the role of PET/CT in the above-mentioned objectives at the newly established Children's Cancer Hospital in Cairo, Egypt, which is one of the busiest dedicated pediatric oncology centers of such purposes in the world. All findings were proven by histopathology, clinically, and by clinical follow-up. A total of 152 patients (35 girls and 117 boys) with histologically proven malignant lymphoma (117 HD, 35 NHL) were included in this study. They were divided into four groups. Group I: 41 patients for initial staging. Group II: 51 patients for evaluating early treatment response after two to three cycles of chemotherapy. Group III: 42 patients for evaluating treatment response 4-8 weeks after the end of their treatment. Group IV: 18 patients evaluated for long-term follow-up. Results of PET/CT were compared with the other conventional imaging modalities (CIM). The sensitivity, specificity, accuracy, and positive and negative predictive values of PET/CT and CIM were as follows: In Group I: PET/CT modified staging and treatment in 11 out of 41 cases (26.8%), upstaged 5(12.2%) patients and down-staged six (14.6%) patients. Group II: 100%, 97.7%, 98%, 85.7%, 100%, respectively, for PET/CT and 83%, 66.6%, 68.6%, 25%, 96.7% for CIM respectively Group III: At the end of chemotherapy 100%, 90.9%, 92.8%, 75%, 100%, respectively, for PET/CT and 55.5%, 57.5%, 57.1%, 26.3%, 82.6% for CIM, respectively. Group IV: For long

  3. Role of PET/CT in malignant pediatric lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Riad, Raef; Omar, Walid; Hafez, Magdy [Cairo University, Department of Nuclear Medicine, Children' s Cancer Hospital (CCH), Cairo (Egypt); Kotb, Magdy [National Cancer Institute, Department of Nuclear Medicine, Cairo (Egypt); Sidhom, Iman; Zamzam, Manal [Cairo University, Department of Pediatric Oncology, Children' s Cancer Hospital (CCH), Cairo (Egypt); Zaky, Iman [Cairo University, Department of Radio-diagnosis, Children' s Cancer Hospital (CCH), Cairo (Egypt); Abdel-Dayem, Hussein [New York Medical College, Department of Radiology, Nuclear Medicine Section, St. Vincent' s Catholic Medical Centers of New York, Valhalla, NY (United States); St. Vincent' s Catholic Medical Centers of New York, Department of Radiology, New York Medical College, Nuclear Medicine Service, New York, NY (United States)

    2010-02-15

    Malignant pediatric lymphoma accounts for 10-15% of all pediatric cancers, (representing 2-3% of all malignancies), with a peak incidence between 5-9 years. Chemotherapy is usually the first and most common mode of treatment. The choice of treatment and prediction of prognosis depend on the histological type of tumor, initial staging, evaluating treatment response, and detection of early recurrence. Conventional imaging modalities have many limitations. PET/CT is more accurate, however so far the literature lacks the results of a large group of patients. To report the role of PET/CT in the above-mentioned objectives at the newly established Children's Cancer Hospital in Cairo, Egypt, which is one of the busiest dedicated pediatric oncology centers of such purposes in the world. All findings were proven by histopathology, clinically, and by clinical follow-up. A total of 152 patients (35 girls and 117 boys) with histologically proven malignant lymphoma (117 HD, 35 NHL) were included in this study. They were divided into four groups. Group I: 41 patients for initial staging. Group II: 51 patients for evaluating early treatment response after two to three cycles of chemotherapy. Group III: 42 patients for evaluating treatment response 4-8 weeks after the end of their treatment. Group IV: 18 patients evaluated for long-term follow-up. Results of PET/CT were compared with the other conventional imaging modalities (CIM). The sensitivity, specificity, accuracy, and positive and negative predictive values of PET/CT and CIM were as follows: In Group I: PET/CT modified staging and treatment in 11 out of 41 cases (26.8%), upstaged 5(12.2%) patients and down-staged six (14.6%) patients. Group II: 100%, 97.7%, 98%, 85.7%, 100%, respectively, for PET/CT and 83%, 66.6%, 68.6%, 25%, 96.7% for CIM respectively Group III: At the end of chemotherapy 100%, 90.9%, 92.8%, 75%, 100%, respectively, for PET/CT and 55.5%, 57.5%, 57.1%, 26.3%, 82.6% for CIM, respectively. Group IV: For

  4. Virtual hybrid bronchoscopy using PET/CT data sets

    Science.gov (United States)

    Englmeier, Karl-Hans; Seemann, Marcus D.

    2007-03-01

    The aim of this study was to demonstrate the possibilities, advantages and limitations of virtual bronchoscopy using data sets from positron emission tomography (PET) and computed tomography (CT). Eight consecutive patients with lung cancer underwent PET/CT. PET was performed with F-18-labelled 2-[fluorine-18]-fluoro-2-deoxy-D: -glucose ((18)F-FDG). The tracheobronchial system was segmented with a volume-growing algorithm, using the CT data sets, and visualized with a shaded-surface rendering method. The primary tumours and the lymph node metastases were segmented for virtual CT-bronchoscopy using the CT data set and for virtual PET/CT-bronchoscopy using the PET/CT data set. Virtual CT-bronchoscopy using the low-dose or diagnostic CT facilitates the detection of anatomical/morphological structure changes of the tracheobronchial system. Virtual PET/CT-bronchoscopy was superior to virtual CT-bronchoscopy in the detection of lymph node metastases (P=0.001), because it uses the CT information and the molecular/metabolic information from PET. Virtual PET/CT-bronchoscopy with a transparent colour-coded shaded-surface rendering model is expected to improve the diagnostic accuracy of identification and characterization of malignancies, assessment of tumour staging, differentiation of viable tumour tissue from atelectases and scars, verification of infections, evaluation of therapeutic response and detection of an early stage of recurrence that is not detectable or is misjudged in comparison with virtual CT-bronchoscopy.

  5. Low radiation dose imaging of myocardial perfusion and coronary angiography with a hybrid PET/CT scanner

    OpenAIRE

    Kajander, S; Ukkonen, H; Sipilä, H.; Teräs, M.; Knuuti, J

    2009-01-01

    Objectives: To test the image quality and feasibility of a sequential low radiation dose protocol for hybrid cardiac PET/CT angiography (CTA). Background: Multidetector computed tomography (MDCT) is a non-invasive method for coronary angiography. The negative predictive value of MDCT is high but perfusion imaging has a role in detecting functional significance of coronary lesions. This has encouraged combining these techniques. However, radiation dose is of concern. We report our first experi...

  6. Influence of {sup 18}F-FDG PET/CT on therapy management in patients with stage III/IV malignant melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Schuele, Susann-Cathrin; Nikolaou, Konstantin; Pfannenberg, Christina [Eberhard-Karls-University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Eigentler, Thomas Kurt; Garbe, Claus [Eberhard-Karls-University Tuebingen, Skin Cancer Programme, Department of Dermatology, Tuebingen (Germany); Fougere, Christian la [Eberhard-Karls-University Tuebingen, Department of Nuclear Medicine, Tuebingen (Germany)

    2016-03-15

    To evaluate the influence of {sup 18}F-FDG PET/CT in comparison to CT alone on treatment decisions in patients with advanced melanoma and to analyse the 5-year survival data in comparison to literature data. Therapy management in 64 consecutive patients (primary staging n = 52; surveillance n = 12) with stage III/IV melanoma who underwent {sup 18}F-FDG PET/CT between 2004 and 2005 in our department was retrospectively analysed. Treatment decisions were made by two dermatooncologists for each patient twice, first based on the CT results and then based on the PET/CT results. Therapy changes based on the PET/CT results were classified as ''major'' (e.g. change from metastasectomy to systemic therapy) or ''minor'' (e.g. change from first to second line chemotherapy). The 5-year survival data of different patient cohorts were calculated. In the 52 patients in the primary staging group, the results of {sup 18}F-FDG PET/CT led to therapy change in 59 % and a major therapy change in 52 %. {sup 18}F-FDG PET/CT led to the avoidance of futile operations in 13 patients with suspicious lesions on CT that were deemed nontumorous on PET/CT. In the 12 patients in the surveillance group, the results of {sup 18}F-FDG PET/CT led to therapy change in 33 % and a major change in 17 %. The 5-year survival rates were 30 % in the entire cohort, 34 % in the primary staging group, and 17 % in the surveillance group. A significant overall survival benefit was observed in patients in whom {sup 18}F-FDG PET/CT excluded metastases or in whom metastases could be completely removed compared with patients who were not eligible for surgery (41 % vs. 10 %). Primary staging of patients with stage III/IV melanoma should be performed with {sup 18}F-FDG PET/CT, leading to higher diagnostic accuracy and enabling individualized therapeutic management, especially optimal patient selection for metastasectomy. This strategy may extend long-term survival even in patients

  7. Influence of 18F-FDG PET/CT on therapy management in patients with stage III/IV malignant melanoma

    International Nuclear Information System (INIS)

    To evaluate the influence of 18F-FDG PET/CT in comparison to CT alone on treatment decisions in patients with advanced melanoma and to analyse the 5-year survival data in comparison to literature data. Therapy management in 64 consecutive patients (primary staging n = 52; surveillance n = 12) with stage III/IV melanoma who underwent 18F-FDG PET/CT between 2004 and 2005 in our department was retrospectively analysed. Treatment decisions were made by two dermatooncologists for each patient twice, first based on the CT results and then based on the PET/CT results. Therapy changes based on the PET/CT results were classified as ''major'' (e.g. change from metastasectomy to systemic therapy) or ''minor'' (e.g. change from first to second line chemotherapy). The 5-year survival data of different patient cohorts were calculated. In the 52 patients in the primary staging group, the results of 18F-FDG PET/CT led to therapy change in 59 % and a major therapy change in 52 %. 18F-FDG PET/CT led to the avoidance of futile operations in 13 patients with suspicious lesions on CT that were deemed nontumorous on PET/CT. In the 12 patients in the surveillance group, the results of 18F-FDG PET/CT led to therapy change in 33 % and a major change in 17 %. The 5-year survival rates were 30 % in the entire cohort, 34 % in the primary staging group, and 17 % in the surveillance group. A significant overall survival benefit was observed in patients in whom 18F-FDG PET/CT excluded metastases or in whom metastases could be completely removed compared with patients who were not eligible for surgery (41 % vs. 10 %). Primary staging of patients with stage III/IV melanoma should be performed with 18F-FDG PET/CT, leading to higher diagnostic accuracy and enabling individualized therapeutic management, especially optimal patient selection for metastasectomy. This strategy may extend long-term survival even in patients with advanced disease. (orig.)

  8. FDG-PET/CT and FLT-PET/CT for differentiating between lipid-poor benign and malignant adrenal tumours

    Energy Technology Data Exchange (ETDEWEB)

    Nakajo, Masatoyo; Jinguji, Megumi; Fukukura, Yoshihiko; Nakabeppu, Yoshiaki; Nakamura, Fumihiko; Yoshiura, Takashi [Kagoshima University, Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima (Japan); Kajiya, Yoriko; Tani, Atushi; Nakajo, Masayuki [Nanpuh Hospital, Department of Radiology, Kagoshima (Japan); Arimura, Hiroshi; Nishio, Yoshihiko [Kagoshima University, Department of Diabetes and Endocrine Medicine, Graduate School of Medical and Dental Sciences, Kagoshima (Japan)

    2015-12-15

    To compare F-18-fluorodeoxyglucose (FDG) and F-18-fluorothymidine (FLT) PET/CT examinations for differentiating between benign and malignant adrenal tumours. Thirty lipid-poor benign and 11 malignant tumours of 40 patients were included. FDG- and FLT-based indices including visual score, maximum standardized uptake value (SUVmax) and FDG adrenal lesion/liver SUVmax (A/L SUVmax) or FLT adrenal lesion/back muscle SUVmax (A/B SUVmax) ratio were compared between benign and malignant tumours using the Mann-Whitney's U or Wilcoxon signed-rank test, and their diagnostic performances were evaluated by means of the area under the curve (AUC) values derived from the receiver operating characteristic analysis. All indices were significantly higher in malignant than benign tumours on both images (p < 0.05 each). On FDG-PET/CT, the sensitivity, specificity, and accuracy were 91 %, 63 % and 71 % for visual score, 91 %, 67 % and 73 % for SUVmax, and 100 %, 70 % and 78 % for A/L SUVmax ratio, respectively. On FLT-PET/CT, they were 100 %, 97 % and 98 % for visual score, SUVmax and A/B SUVmax ratio, respectively. All FLT indices were significantly higher than those of FDG in AUC (p < 0.05 each). FLT-PET/CT may be superior to FDG-PET/CT in differentiating lipid-poor benign from malignant adrenal tumours because of higher specificity and accuracy. (orig.)

  9. Ultrasonography Fused with PET-CT Hybrid Imaging

    DEFF Research Database (Denmark)

    Udesen, Jesper; Ewertsen, Caroline; Gran, Fredrik;

    2011-01-01

    We present a method with fusion of images of three modalities 18F-FDG PET, CT, and 3-D ultrasound (US) applied to imaging of the anal canal and the rectum. To obtain comparable geometries in the three imaging modalities, a plexiglas rod, with the same dimensions as the US transducer, is placed...... in the anal canal prior to the PET-CT examination. The method is based on manual co-registration of PET-CT images and 3-D US images. The three-modality imaging of the rectum-anal canal may become useful as a supplement to conventional imaging in the external radiation therapy in the treatment of anal cancer......-modality imaging may also be used in certain other diagnostic or therapeutic fields....

  10. Radiation Protection Challenges and Trends in PET/CT

    International Nuclear Information System (INIS)

    Positron emission tomography (PET)/computed tomography (CT) is now an essential imaging modality in various clinical circumstances, especially in the management of oncology patients. Customization of therapy through PET/CT imaging is actually becoming an indispensable process in the strategy of oncological management, that is, initial diagnosis and staging, treatment selection, planning of external beam radiation therapy, and follow-up and detection of recurrence after therapy. Standardization of PET/CT images for therapy response assessment and application of high precision radiation therapy planning will require strict quality control of the imaging. Considering the increasing number of PET/CT procedures and such higher imaging quality, measures of radiation protection for both patients and staff members should evolve to sustain the application of this modality in medical practices

  11. PET/CT in paediatric malignancies - An update

    Directory of Open Access Journals (Sweden)

    Subramanyam Padma

    2016-01-01

    Full Text Available 18F-fluorodeoxyglucose positron emission tomography (FDG-PET is a well-established imaging modality in adult oncological practice. Its role in childhood malignancies needs to be discussed as paediatric malignancies differ from adults in tumor subtypes and they have different tumor biology and FDG uptake patterns. This is also compounded by smaller body mass, dosimetric restrictions, and physiological factors that can affect the FDG uptake. It calls for careful planning of the PET study, preparing the child, the parents, and expertise of nuclear physicians in reporting pediatric positron emission tomography/computed tomography (PET/CT studies. In a broad perspective, FDG-PET/CT has been used in staging, assessment of therapy response, identifying metastases and as a follow-up tool in a wide variety of pediatric malignancies. This review outlines the role of PET/CT in childhood malignancies other than hematological malignancies such as lymphoma and leukemia.

  12. Evaluation of dosimetric techniques in positrons emission tomography and computerized tomography (PET/CT)

    International Nuclear Information System (INIS)

    Among diagnostic techniques PET/CT is one of those with the highest dose delivery to the patient as a cause of external exposure to X-rays, and the use of a radiopharmaceutical that results in a high energy gamma emission. The dosimetry of these two components becomes important in order to optimize and justify the technique. Various dosimetric techniques are found in literature without a consensus of the best to use. With the advances in technological and consequent equipment configuration changes, upgrades and variation in methodologies, particularly in computed tomography, a standardization of these techniques is required. Previous studies show that CT is responsible for 70 % of the dose delivered to the patient in PET/CT examinations. Thus, many researchers have been focused on CT dose optimization protocols studies. This work analyzes the doses involved in a PET/CT oncology protocol by using an Alderson female anthropomorphic phantom in a public hospital of Rio de Janeiro city. The dose estimate for PET examination resulting from the use of 18F - FDG radiopharmaceutical was conducted through dose factors published in ICRP 106; the dose for CT was estimated and compared by calculation of the absorbed doses to patients according to four methods: thermoluminescent dosimetry (TL0100) distributed in critical organs of the Alderson phantom; measurements of CTOI according to AAPM number 96; correction factor for effective diameter SSOE (AAPM Number 204); and simulation by ImPACT program For CT, the results in terms of effective dose presented (TLO, CTOI and ImPACT) ± 5 % maximum variations between methodologies. Considering medium absorbed dose (TLO, SSOE and ImPACT) the results differed in ± 7 % from each other. These findings demonstrate that parameters provided by the manufacturer on the console can be used to have a primary approach of both, absorbed and effective doses to the patient since that a quality assurance program of these parameters are adopted in

  13. PET/CT in infectious and inflammatory pathology

    International Nuclear Information System (INIS)

    Objective: To demonstrate the utility of PET/CT in infectious and inflammatory diseases. Materials and Methods: We evaluated retrospectively five patients with infectious and inflammatory pathology, by PET/CT scan (hybrid SIEMENS-BIOGRAPH 16, Siemens, Erlangen, Germany) in the period between january 2009 and may 2011. Results: Case 1: a 68-year-old woman presented with a 6-months duration fever, fatigue, and weight loss. The rheumatologic examination showed a decrease in both radial pulses with no other associated symptoms. She underwent a temporal artery biopsy, which confirmed temporal arteritis. A PET/CT scan showed significant uptake in the thoracic aorta and major branches. Case 2: An 85-year-old patient with fever of unknown origin (FUO) was studied suspecting osteomyelitis of the hip, but on the contrary, PET/CT demonstrated an avid enhancement indicative of gluteal cellulitis and pneumonia, ruling out bone infection. Case 3: a 35-year-old woman with evening fever. PET/CT scan showed enlarged multiple FDG-avid mediastinal, axillary and retroperitoneal lymph nodes, as well as diffuse involvement of the spleen with multiple calcifications. Diagnosis of cytomegalovirus infection was confirmed by positive immunoglobulin G and M. Case 4: a 39-year-old patient with HIV-infection presented with hypercalcaemia. PET/CT scan showed buttocks silicone implants with associated avid inflammatory process, confirmed by biopsy. Case 5: a 45-year-old female with previous history of breast cancer under follow-up presented in recent CT scans enlarged mediastinal and supraclavicular lymph nodes, as well as diffuse multifocal splenic involvement, all of them avid on PET / CT examination. Sarcoidosis was confirmed by a supraclavicular node excision biopsy. Conclusions: PET/CT is a noninvasive diagnostic tool useful for the diagnosis and follow-up of patients with FUO. Especially in patients with vasculitis, it may change decisions without needing a diagnostic biopsy, as it is

  14. Optimization of Protocol CT, PET-CT, whole body

    International Nuclear Information System (INIS)

    The objective of this study was to optimize the acquisition protocols and processing existing of the CT PET/CT scanner for clinical use of Nuclear Diagnostic Center Foundation, a way to minimize the radiation dose while maintaining diagnostic image quality properly. Dosimetric data of PET / CT service were surveyed and obtained the baseline against which we compare and define strategies and modifications to develop online. We selected transaxial up to the pulmonary hilum and liver slices as the anatomical regions of interest that led to the standardization of the study

  15. Role of PET/CT in congenital histiocytosis

    Energy Technology Data Exchange (ETDEWEB)

    Udayasankar, Unni K. [Emory University School of Medicine, Department of Radiology, Atlanta, GA (United States); Alazraki, Adina L.; Simoneaux, Stephen F. [Emory University School of Medicine, Department of Radiology, Atlanta, GA (United States); Children' s Healthcare of Atlanta at Egleston, Department of Radiology, Atlanta, GA (United States)

    2010-12-15

    Congenital Langerhans cell histiocytosis (LCH) is a rare, but often severe, form of LCH. Although a more benign single-system congenital LCH has been described, most cases present as multisystem disease with poorer prognosis and are often treated with systemic chemotherapy. Imaging plays a central role in diagnosis, initial staging and assessment of treatment response. PET/CT is increasingly utilized for pediatric LCH. We report a unique case with PET/CT used as an imaging tool in staging and evaluating treatment response in congenital multisystem LCH. (orig.)

  16. Role of PET/CT in congenital histiocytosis

    International Nuclear Information System (INIS)

    Congenital Langerhans cell histiocytosis (LCH) is a rare, but often severe, form of LCH. Although a more benign single-system congenital LCH has been described, most cases present as multisystem disease with poorer prognosis and are often treated with systemic chemotherapy. Imaging plays a central role in diagnosis, initial staging and assessment of treatment response. PET/CT is increasingly utilized for pediatric LCH. We report a unique case with PET/CT used as an imaging tool in staging and evaluating treatment response in congenital multisystem LCH. (orig.)

  17. 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.)

  18. 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.)

  19. Automatic extraction of forward stroke volume using dynamic PET/CT

    DEFF Research Database (Denmark)

    Harms, Hans; Tolbod, Lars Poulsen; Hansson, Nils Henrik;

    Background: Dynamic PET can be used to extract forward stroke volume (FSV) by the indicator dilution principle. The technique employed can be automated and is in theory independent on the tracer used and may therefore be added to any dynamic cardiac PET protocol. The aim of this study was to vali......Background: Dynamic PET can be used to extract forward stroke volume (FSV) by the indicator dilution principle. The technique employed can be automated and is in theory independent on the tracer used and may therefore be added to any dynamic cardiac PET protocol. The aim of this study...... was to validate automated methods for extracting FSV directly from dynamic PET studies for two different tracers and to examine potential scanner hardware bias. Methods: 21 subjects underwent a dynamic 27 min 11C-acetate PET scan on a Siemens Biograph TruePoint 64 PET/CT scanner (scanner I). In addition, 8...... subjects underwent a dynamic 6 min 15O-water PET scan followed by a 27 min 11C-acetate PET scan on a GE Discovery ST PET/CT scanner (scanner II). The LV-aortic time-activity curve (TAC) was extracted automatically from dynamic PET data using cluster analysis. The first-pass peak was isolated by automatic...

  20. Survival outcomes in patients with cervical cancer after inclusion of PET/CT in staging procedures

    DEFF Research Database (Denmark)

    Hansen, Henrik Villibald; Loft, Annika; Berthelsen, Anne Kiil;

    2015-01-01

    as assessed by pretreatment CT or PET/CT. Patients were stratified into two groups: PET/CT and non-PET/CT. Patient characteristics and treatment outcomes were acquired from the treatment database. RESULTS: Significant differences of 23 % (95 % CI 17 - 29 %), 19 % (95 % CI 13 - 25 %) and 12 % (95 % CI 6 - 18...

  1. 18F-FDG PET/CT changes therapy management in high-risk DTC after first radioiodine therapy

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-09-15

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

  3. Optimization of Protocol CT, PET-CT, whole body; Optimizacion de protocolo CT, en PET-CT, de cuerpo entero

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez, Fredys Santos, E-mail: fsantos@ccss.sa.cr [Caja Costarricense de Seguro Social (ACCPR/CCSS), San Jose (Costa Rica). Area Control de Calidade Y Proteccion Radiologica; Namias, Mauro, E-mail: mnamias@gmail.com [Comision Nacional de Energia Atomica (FCDN/CNEA), Buenos Aires (Argentina). Fundacion Centro Diagnostico Nuclear

    2013-11-01

    The objective of this study was to optimize the acquisition protocols and processing existing of the CT PET/CT scanner for clinical use of Nuclear Diagnostic Center Foundation, a way to minimize the radiation dose while maintaining diagnostic image quality properly. Dosimetric data of PET / CT service were surveyed and obtained the baseline against which we compare and define strategies and modifications to develop online. We selected transaxial up to the pulmonary hilum and liver slices as the anatomical regions of interest that led to the standardization of the study.

  4. Radiation dose to radiosensitive organs in PET/CT myocardial perfusion examination using versatile optical fibre

    Science.gov (United States)

    Salasiah, M.; Nordin, A. J.; Fathinul Fikri, A. S.; Hishar, H.; Tamchek, N.; Taiman, K.; Ahmad Bazli, A. K.; Abdul-Rashid, H. A.; Mahdiraji, G. A.; Mizanur, R.; Noor, Noramaliza M.

    2013-05-01

    Cardiac positron emission tomography (PET) provides a precise method in order to diagnose obstructive coronary artery disease (CAD), compared to single photon emission tomography (SPECT). PET is suitable for obese and patients who underwent pharmacologic stress procedures. It has the ability to evaluate multivessel coronary artery disease by recording changes in left ventricular function from rest to peak stress and quantifying myocardial perfusion (in mL/min/g of tissue). However, the radiation dose to the radiosensitive organs has become crucial issues in the Positron Emission Tomography/Computed Tomography(PET/CT) scanning procedure. The objective of this study was to estimate radiation dose to radiosensitive organs of patients who underwent PET/CT myocardial perfusion examination at Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia in one month period using versatile optical fibres (Ge-B-doped Flat Fibre) and LiF (TLD-100 chips). All stress and rest paired myocardial perfusion PET/CT scans will be performed with the use of Rubidium-82 (82Rb). The optic fibres were loaded into plastic capsules and attached to patient's eyes, thyroid and breasts prior to the infusion of 82Rb, to accommodate the ten cases for the rest and stress PET scans. The results were compared with established thermoluminescence material, TLD-100 chips. The result shows that radiation dose given by TLD-100 and Germanium-Boron-doped Flat Fiber (Ge-B-doped Flat Fiber) for these five organs were comparable to each other where the p>0.05. For CT scans,thyroid received the highest dose compared to other organs. Meanwhile, for PET scans, breasts received the highest dose.

  5. Restaging of colorectal cancer and PET/CT

    Science.gov (United States)

    Çınar, Alev; Gençoğlu, Esra Arzu; Korkmaz, Meliha

    2013-01-01

    Positron Emission Tomography/Computerized Tomography (PET/CT) is an important assessment method in restaging of oncology patients. Its ability to detect the metabolic/functional changes in patients with colorectal cancer during the early stages, in which morphological changes cannot be documented, is significantly superior to other imaging modalities. PMID:25931851

  6. PET and PET/CT in malignant melanoma

    International Nuclear Information System (INIS)

    The advantages that it has the PET/CT are: 1. It diminishes mainly positive false lesions. It identifies physiologic accumulate places. 2. It diminishes in smaller grade false negative. Small injuries. Injuries with low grade concentration. Injure on intense activity areas. 3. Precise anatomical localization of accumulate places. 4. Reduction of the acquisition time. (Author)

  7. Clinical evaluation of a breathing protocol for PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Juan, Ramon de [Division of Nuclear Medicine, University Hospital Zurich, 8091, Zurich (Switzerland); Department of Nuclear Medicine, San Carlos University Hospital, Madrid (Spain); Seifert, Burkhardt [Department of Biostatistics, University of Zurich, Zurich (Switzerland); Berthold, Thomas; Schulthess, Gustav K. von; Goerres, Gerhard W. [Division of Nuclear Medicine, University Hospital Zurich, 8091, Zurich (Switzerland)

    2004-06-01

    The aim of this study was to assess the frequency and severity of respiration-induced curvilinear respiration artifacts (RICA) on co-registered positron emission tomography/computed tomography (PET/CT) images acquired on a combined PET/CT scanner before and after modifying the respiration protocol for CT scanning, with retrospective analysis of two groups of 100 patients each, before and after implementing a respiration protocol with breath-hold (BH) in the normal expiration position for the acquisition of the CT images. The CT data were used as attenuation map and for image co-registration. A ranking of co-registered PET/CT and PET images (including maximum intensity projection) was done by two observers in consensus using a scale from 0 to 3. Zero indicated that no RICA was visible and 1, 2, and 3 described artifact with increasing severity. A significant difference in RICA occurrence was found between the two groups (p<0.0001). There was a 45% decrease of artifact frequency when using the normal expiration protocol and a 68% decrease of grade-2 and grade-3 artifacts (p=0.004). The results of this study suggest that BH during the normal expiration position for CT scanning can be recommended to reduce the occurrence and the severity of RICA on PET/CT. (orig.)

  8. Clinical evaluation of a breathing protocol for PET/CT

    International Nuclear Information System (INIS)

    The aim of this study was to assess the frequency and severity of respiration-induced curvilinear respiration artifacts (RICA) on co-registered positron emission tomography/computed tomography (PET/CT) images acquired on a combined PET/CT scanner before and after modifying the respiration protocol for CT scanning, with retrospective analysis of two groups of 100 patients each, before and after implementing a respiration protocol with breath-hold (BH) in the normal expiration position for the acquisition of the CT images. The CT data were used as attenuation map and for image co-registration. A ranking of co-registered PET/CT and PET images (including maximum intensity projection) was done by two observers in consensus using a scale from 0 to 3. Zero indicated that no RICA was visible and 1, 2, and 3 described artifact with increasing severity. A significant difference in RICA occurrence was found between the two groups (p<0.0001). There was a 45% decrease of artifact frequency when using the normal expiration protocol and a 68% decrease of grade-2 and grade-3 artifacts (p=0.004). The results of this study suggest that BH during the normal expiration position for CT scanning can be recommended to reduce the occurrence and the severity of RICA on PET/CT. (orig.)

  9. Clinical Utility and Future Applications of PET/CT and PET/CMR in Cardiology.

    Science.gov (United States)

    Pan, Jonathan A; Salerno, Michael

    2016-01-01

    Over the past several years, there have been major advances in cardiovascular positron emission tomography (PET) in combination with either computed tomography (CT) or, more recently, cardiovascular magnetic resonance (CMR). These multi-modality approaches have significant potential to leverage the strengths of each modality to improve the characterization of a variety of cardiovascular diseases and to predict clinical outcomes. This review will discuss current developments and potential future uses of PET/CT and PET/CMR for cardiovascular applications, which promise to add significant incremental benefits to the data provided by each modality alone. PMID:27598207

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

    International Nuclear Information System (INIS)

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

  11. (18)F-FDG PET/CT quantification in head and neck squamous cell cancer: principles, technical issues and clinical applications.

    Science.gov (United States)

    Manca, Gianpiero; Vanzi, Eleonora; Rubello, Domenico; Giammarile, Francesco; Grassetto, Gaia; Wong, Ka Kit; Perkins, Alan C; Colletti, Patrick M; Volterrani, Duccio

    2016-07-01

    (18)F-FDG PET/CT plays a crucial role in the diagnosis and management of patients with head and neck squamous cell cancer (HNSCC). The major clinical applications of this method include diagnosing an unknown primary tumour, identifying regional lymph node involvement and distant metastases, and providing prognostic information. (18)F-FDG PET/CT is also used for precise delineation of the tumour volume for radiation therapy planning and dose painting, and for treatment response monitoring, by detecting residual or recurrent disease. Most of these applications would benefit from a quantitative approach to the disease, but the quantitative capability of (18)F-FDG PET/CT is still underused in HNSCC. Innovations in PET/CT technology promise to overcome the issues that until now have hindered the employment of dynamic procedures in clinical practice and have limited "quantification" to the evaluation of standardized uptake values (SUV), de facto a semiquantitative parameter, the limits of which are well known to the nuclear medicine community. In this paper the principles of quantitative imaging and the related technical issues are reviewed so that professionals involved in HNSCC management can reflect on the advantages of "true" quantification. A discussion is then presented on how semiquantitative information is currently used in clinical (18)F-FDG PET/CT applications in HNSCC, by discussing the improvements that could be obtained with more advanced and "personalized" quantification techniques.

  12. (18)F-FDG PET/CT quantification in head and neck squamous cell cancer: principles, technical issues and clinical applications.

    Science.gov (United States)

    Manca, Gianpiero; Vanzi, Eleonora; Rubello, Domenico; Giammarile, Francesco; Grassetto, Gaia; Wong, Ka Kit; Perkins, Alan C; Colletti, Patrick M; Volterrani, Duccio

    2016-07-01

    (18)F-FDG PET/CT plays a crucial role in the diagnosis and management of patients with head and neck squamous cell cancer (HNSCC). The major clinical applications of this method include diagnosing an unknown primary tumour, identifying regional lymph node involvement and distant metastases, and providing prognostic information. (18)F-FDG PET/CT is also used for precise delineation of the tumour volume for radiation therapy planning and dose painting, and for treatment response monitoring, by detecting residual or recurrent disease. Most of these applications would benefit from a quantitative approach to the disease, but the quantitative capability of (18)F-FDG PET/CT is still underused in HNSCC. Innovations in PET/CT technology promise to overcome the issues that until now have hindered the employment of dynamic procedures in clinical practice and have limited "quantification" to the evaluation of standardized uptake values (SUV), de facto a semiquantitative parameter, the limits of which are well known to the nuclear medicine community. In this paper the principles of quantitative imaging and the related technical issues are reviewed so that professionals involved in HNSCC management can reflect on the advantages of "true" quantification. A discussion is then presented on how semiquantitative information is currently used in clinical (18)F-FDG PET/CT applications in HNSCC, by discussing the improvements that could be obtained with more advanced and "personalized" quantification techniques. PMID:26780912

  13. 18F-FDG PET/CT quantification in head and neck squamous cell cancer: principles, technical issues and clinical applications

    International Nuclear Information System (INIS)

    18F-FDG PET/CT plays a crucial role in the diagnosis and management of patients with head and neck squamous cell cancer (HNSCC). The major clinical applications of this method include diagnosing an unknown primary tumour, identifying regional lymph node involvement and distant metastases, and providing prognostic information. 18F-FDG PET/CT is also used for precise delineation of the tumour volume for radiation therapy planning and dose painting, and for treatment response monitoring, by detecting residual or recurrent disease. Most of these applications would benefit from a quantitative approach to the disease, but the quantitative capability of 18F-FDG PET/CT is still underused in HNSCC. Innovations in PET/CT technology promise to overcome the issues that until now have hindered the employment of dynamic procedures in clinical practice and have limited ''quantification'' to the evaluation of standardized uptake values (SUV), de facto a semiquantitative parameter, the limits of which are well known to the nuclear medicine community. In this paper the principles of quantitative imaging and the related technical issues are reviewed so that professionals involved in HNSCC management can reflect on the advantages of ''true'' quantification. A discussion is then presented on how semiquantitative information is currently used in clinical 18F-FDG PET/CT applications in HNSCC, by discussing the improvements that could be obtained with more advanced and ''personalized'' quantification techniques. (orig.)

  14. Diagnosing coronary artery disease with hybrid PET/CT: it takes two to tango.

    Science.gov (United States)

    Danad, Ibrahim; Raijmakers, Pieter G; Knaapen, Paul

    2013-10-01

    The noninvasive diagnosis of coronary artery disease (CAD) is a challenging task. Although a large armamentarium of imaging modalities is available to evaluate the functional consequences of the extent and severity of CAD, cardiac perfusion positron emission tomography (PET) is considered the gold standard for this purpose. Alternatively, noninvasive anatomical imaging of coronary atherosclerosis with coronary computed tomography angiography (CCTA) has recently been successfully implemented in clinical practice. Although each of these diagnostic approaches has its own merits and caveats, functional and morphological imaging techniques provide fundamentally different insights into the disease process and should be considered to be complementary rather than overlapping. Hybrid imaging with PET/CT offers the possibility to evaluate both aspects nearly simultaneously, and studies have demonstrated that such a comprehensive assessment results in superior diagnostic accuracy, better prognostication, and helps in guiding clinical patient management. The aim of this review is to discuss the value of stand-alone CCTA and PET in CAD, and to summarize the available data on the surplus value of hybrid PET/CT including its strengths and limitations. PMID:23842709

  15. {sup 18}F-Fluorocholine PET/CT for early response assessment in patients with metastatic castration-resistant prostate cancer treated with enzalutamide

    Energy Technology Data Exchange (ETDEWEB)

    De Giorgi, Ugo; Conteduca, Vincenza; Burgio, Salvatore Luca; Menna, Cecilia; Rossi, Lorena; Amadori, Dino [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Department of Medical Oncology, Meldola (Italy); Caroli, Paola; Paganelli, Giovanni; Matteucci, Federica [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Diagnostic Nuclear Medicine Unit, Meldola (Italy); Scarpi, Emanuela [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Unit of Biostatistics and Clinical Trials, Meldola (Italy); Moretti, Andrea; Galassi, Riccardo [Morgagni-Pierantoni Hospital, Nuclear Medicine Unit, Forli (Italy)

    2015-07-15

    We investigated the role of {sup 18}F-methylcholine (FCH) PET/CT in the early evaluation of patients with metastatic castration-resistant prostate cancer (mCRPC) treated with enzalutamide. The study group comprised 36 patients with a median age of 72 years (range 48-90 years) who were treated with enzalutamide 160 mg once daily after at least one chemotherapeutic regimen with docetaxel. Patients were evaluated monthly for serological prostate-specific antigen (PSA) response. FCH PET/CT was performed at baseline and repeated after 3-6 weeks. Univariate and multivariate Cox regression models addressed potential predictors of progression-free survival (PFS) and overall survival (OS). At a median follow-up of 24.2 months (range 1.8-27.3 months), 34 patients were evaluable for early FCH PET/CT evaluation of response, and of these 17 showed progressive disease (PD) and 17 had stable disease or a partial response. A decrease in PSA level of more than 50 % was observed in 21 patients. Early FCH PET/CT PD predicted radiological PD 3 months in advance of CT in 12 of 18 patients (66 %) and was discordant with the decrease in PSA level in 13 patients. In 6 of these, biochemical PD was confirmed in 2 months. In multivariate analysis, only decrease in PSA level and FCH PET/CT were significant predictors of PFS (p = 0.0005 and p = 0.029, respectively), whereas decrease in PSA level alone was predictive of OS (p = 0.007). This is one of the first studies to evaluate the role of FCH PET/CT as an early predictor of outcome in mCRPC patients treated with enzalutamide. Our preliminary results suggest that the combination of FCH PET/CT and decrease in PSA level could be a valid tool to predict PFS in mCRPC patients. PSA remains the single most important prognostic factor, while FCH PET/CT does not add more information on OS beyond that obtained from PSA. Further studies in larger populations are needed to confirm these data and to clarify the role of FCH PET/CT in predicting response

  16. SU-E-J-254: Evaluating the Role of Mid-Treatment and Post-Treatment FDG-PET/CT in Predicting Progression-Free Survival and Distant Metastasis of Anal Cancer Patients Treated with Chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, H; Wang, J; Chuong, M; D’Souza, W; Choi, W; Lu, W [University of Maryland School of Medicine, Baltimore, MD (United States); Latifi, K; Hoffe, S; Moros, E [Moffitt Cancer Center, Tampa, FL (United States); Saeed, Nadia [Brwon University, Providence, RI (United States); Tan, S [Huazhong University of Science & Technology, Wuhan (China); Shridhar, R [Florida Hospital, Orlando, FL (United States)

    2015-06-15

    Purpose: To evaluate the role of mid-treatment and post-treatment FDG-PET/CT in predicting progression-free survival (PFS) and distant metastasis (DM) of anal cancer patients treated with chemoradiotherapy (CRT). Methods: 17 anal cancer patients treated with CRT were retrospectively studied. The median prescription dose was 56 Gy (range, 50–62.5 Gy). All patients underwent FDG-PET/CT scans before and after CRT. 16 of the 17 patients had an additional FDG-PET/CT image at 3–5 weeks into the treatment (denoted as mid-treatment FDG-PET/CT). 750 features were extracted from these three sets of scans, which included both traditional PET/CT measures (SUVmax, SUVpeak, tumor diameters, etc.) and spatialtemporal PET/CT features (comprehensively quantify a tumor’s FDG uptake intensity and distribution, spatial variation (texture), geometric property and their temporal changes relative to baseline). 26 clinical parameters (age, gender, TNM stage, histology, GTV dose, etc.) were also analyzed. Advanced analytics including methods to select an optimal set of predictors and a model selection engine, which identifies the most accurate machine learning algorithm for predictive analysis was developed. Results: Comparing baseline + mid-treatment PET/CT set to baseline + posttreatment PET/CT set, 14 predictors were selected from each feature group. Same three clinical parameters (tumor size, T stage and whether 5-FU was held during any cycle of chemotherapy) and two traditional measures (pre- CRT SUVmin and SUVmedian) were selected by both predictor groups. Different mix of spatial-temporal PET/CT features was selected. Using the 14 predictors and Naive Bayes, mid-treatment PET/CT set achieved 87.5% accuracy (2 PFS patients misclassified, all local recurrence and DM patients correctly classified). Post-treatment PET/CT set achieved 94.0% accuracy (all PFS and DM patients correctly predicted, 1 local recurrence patient misclassified) with logistic regression, neural network or

  17. Correlative Imaging in a Patient with Cystic Thymoma: CT, MR and PET/CT Comparison

    International Nuclear Information System (INIS)

    Cystic thymoma is a rare variant of thymic neoplasm characterized by almost complete cystic degeneration with mixed internal structure. We describe a case of a 60 year-old woman with a cystic thymoma studied with advanced tomographic imaging stydies. CT, MRI and PET/CT with 18F-FDG were performed; volumetric CT and MRI images provided better anatomic evaluation for pre-operative assessment, while PET/CT was helpful for lesion characterization based on 18F-FDG uptake. Although imaging studies are mandatory for pre-operative evaluation of cystic thymoma, final diagnosis still remains surgical. A 60-year-old woman with recent chest pain and no history of previous disease was admitted to our departement to investigate the result of a previous chest X-ray that showed bilateral mediastinal enlargement; for this purpose, enhanced chest CT scan was performed using a 64-rows scanner (Toshiba, Aquilion 64, Japan) before and after intravenous bolus administration of iodinated non ionic contrast agent; CT images demonstrated the presence of a large mediastinal mass (11×8 cm) located in the anterior mediastinum who extended from the anonymous vein to the cardio-phrenic space, compressing the left atrium and causing medium lobe atelectasis; bilateral pleural effusion was also present. In conclusion, correlative imaging plays a foundamental role for the diagnostic evaluation of patient with cystic thymoma. In particular, volumetric CT and MRI studies can provide better anatomic informations regarding internal structure and local tumor spread for pre-operative assessment. Conversely, metabolic imaging using 18F-FDG PET/CT is helpful for lesion characterization differentiating benign from malignant lesion on the basis of intense tracer uptake. The role of PET/MRI is still under investigation. However, final diagnosis still remains surgical even though imaging studies are mandatory for pre-operative patient management

  18. 18F-FDG PET-CT Simulation for Non-Small-Cell Lung Cancer: Effect in Patients Already Staged by PET-CT

    International Nuclear Information System (INIS)

    Purpose: Positron emission tomography (PET), in addition to computed tomography (CT), has an effect in target volume definition for radical radiotherapy (RT) for non-small-cell lung cancer (NSCLC). In previously PET-CT staged patients with NSCLC, we assessed the effect of using an additional planning PET-CT scan for gross tumor volume (GTV) definition. Methods and Materials: A total of 28 patients with Stage IA-IIIB NSCLC were enrolled. All patients had undergone staging PET-CT to ensure suitability for radical RT. Of the 28 patients, 14 received induction chemotherapy. In place of a RT planning CT scan, patients underwent scanning on a PET-CT scanner. In a virtual planning study, four oncologists independently delineated the GTV on the CT scan alone and then on the PET-CT scan. Intraobserver and interobserver variability were assessed using the concordance index (CI), and the results were compared using the Wilcoxon signed ranks test. Results: PET-CT improved the CI between observers when defining the GTV using the PET-CT images compared with using CT alone for matched cases (median CI, 0.57 for CT and 0.64 for PET-CT, p = .032). The median of the mean percentage of volume change from GTVCT to GTVFUSED was -5.21% for the induction chemotherapy group and 18.88% for the RT-alone group. Using the Mann-Whitney U test, this was significantly different (p = .001). Conclusion: PET-CT RT planning scan, in addition to a staging PET-CT scan, reduces interobserver variability in GTV definition for NSCLC. The GTV size with PET-CT compared with CT in the RT-alone group increased and was reduced in the induction chemotherapy group.

  19. PET-CT in the evaluation of metastatic breast cancer

    International Nuclear Information System (INIS)

    A 44-year-old woman underwent two PET-CT scans for the evaluation of metastatic breast cancer. A radical left mastectomy with axillary dissection (1 of 43 nodes positive) followed by chemotherapy, was performed in 1998. She represented in October 2003 with a left supraclavicular fossa mass. This was confirmed to be recurrent breast cancer on FNAB. She was considered for a radical neck dissection and the surgeon requested a PET scan. Other imaging at this time included a normal bone scan and CT brain. CT neck/chest/abdomen/pelvis showed soft tissue thickening in the left lower neck. The PET-CT scan showed multiple glucose avid lesions in the sternum, mediastinum and neck lymph nodes as well as a small lesion in the proximal left femur consistent with extensive metastatic disease. Surgery was cancelled and Femara chemotherapy commenced. Femara was stopped in March 2004 and the patient began alternative therapies. In October 2004 she presented to her surgeon with new back and chest pain. CT of the neck/chest/abdomen/pelvis showed a soft tissue mass in the upper sternum and a lymph node at the base of the neck highly suspicious for metastatic disease. There were also 2 suspicious lung nodules and a lesion in the proximal left femur reported as an osteoid osteoma. Wholebody PET-CT scans were performed on a Siemens LSO Biograph, 60mins after the injection of 350Mbq of Fl 8-Fag, with arms at the patient's side and head in the field-of-view. On both occasions the patient had to pay for the scan. On the 2004 PET-CT scan, the CT brain revealed multiple hyperdense lesions consistent with hemorrhagic metastases. In addition, there were innumerable glucose avid foci involving viscera, nodes and skeleton consistent with disseminated disease. Our case illustrates: (i) the value of PET in the management of metastatic breast cancer; (ii) the improved accuracy of PET-CT in delineating sites of disease; (iii) the issues of head movement in PET-CT and. (iv) the problem with lack of

  20. Coincidental Observation of Global Hypometabolism in the Brain on PET/CT of an AIDS Patient With High-Grade Pulmonary Non-Hodgkin Lymphoma.

    Science.gov (United States)

    Chandra, Piyush; Agrawal, Archi; Purandare, Nilendu; Shah, Sneha; Rangarajan, Venkatesh

    2016-08-01

    AIDS-related dementia complex is the most severe form of cognitive dysfunction in a patient infected with human immunodeficiency virus. The use of FDG PET/CT to diagnose AIDS-related dementia complex has been studied previously and shows various specific metabolic patterns from striatal hypermetabolism in early asymptomatic stage to global hypometabolism in advanced stages. We present a case of a 49-year-old patient with long-standing human immunodeficiency virus infection, where global brain hypometabolism was noted coincidentally on FDG PET/CT done for initial staging of primary pulmonary non-Hodgkin lymphoma. PMID:27280906

  1. Use of subsequent PET/CT in diffuse large B-cell lymphoma patients in complete remission following primary therapy

    Institute of Scientific and Technical Information of China (English)

    Xu Zhang; Wei Fan; Zhong-Jun Xia; Ying-Ying Hu; Xiao-Ping Lin; Ya-Rui Zhang; Zhi-Ming Li; Pei-Yan Liang; Yuan-Hua Li

    2015-01-01

    Interim 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (I-PET/CT) is a powerful tool for monitoring the response to therapy in diffuse large B-cell lymphoma (DLBCL). This retrospective study aimed to determine when and how to use I-PET/CT in DLBCL. A total of 197 patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) were enrolled between October 2005 and July 2011; PET/CT was performed at the time of diagnosis (PET/CT0), after 2 and 4 cycles of chemotherapy (PET/CT2 and PET/CT4, respectively), and at the end of treatment (F-PET/CT). According to the International Harmonization Project for Response Criteria in Lymphoma, 110 patients had negative PET/CT2 scans, and 87 had positive PET/CT2 scans. The PET/CT2-negative patients had significantly higher 3-year progression-free survival rate (75.8% vs. 38.2%) and 3-year overal survival rate (93.5%vs. 55.6%) than PET/CT2-positive patients. Al PET/CT2-negative patients remained negative at PET/CT4, but 3 were positive at F-PET/CT. Among the 87 PET/CT2-positive patients, 57 remained positive at F-PET/CT, and 32 progressed during chemotherapy (15 at PET/CT4 and 17 at F-PET/CT). Comparing PET/CT4 with PET/CT0, 7 patients exhibited progression, and 8 achieved partial remission. Comparing F-PET/CT with PET/CT0, 10 patients exhibited progression, and 7 achieved partial remission. In conclusion, our results indicate that I-PET/CT should be performed after 2 rather than 4 cycles of immunochemotherapy in DLBCL patients. There is a limited role for subsequent PET/CT in the detection of relapse in PET/CT2-negative patients, but repeat PET/CT is required if the PET/CT2 findings are positive.

  2. 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.

  3. 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.)

  4. Detection of unknown primary neuroendocrine tumours (CUP-NET) using 68Ga-DOTA-NOC receptor PET/CT

    International Nuclear Information System (INIS)

    This bi-centric study aimed to determine the role of receptor PET/CT using 68Ga-DOTA-NOC in the detection of undiagnosed primary sites of neuroendocrine tumours (NETs) and to understand the molecular behaviour of the primarily undiagnosed tumours. Overall 59 patients (33 men and 26 women, age: 65 ± 9 years) with documented NET and unknown primary were enrolled. PET/CT was performed after injection of approximately 100 MBq (46-260 MBq) of 68Ga-DOTA-NOC. The maximum standardised uptake values (SUVmax) were calculated and compared with SUVmax in known pancreatic NET (pNET) and ileum/jejunum/duodenum (SI-NET). The results of PET/CT were also correlated with CT alone. In 35 of 59 patients (59%), 68Ga-DOTA-NOC PET/CT localised the site of the primary: ileum/jejunum (14), pancreas (16), rectum/colon (2), lungs (2) and paraganglioma (1). CT alone (on retrospective analyses) confirmed the findings in 12 of 59 patients (20%). The mean SUVmax of identified previously unknown pNET and SI-NET were 18.6 ± 9.8 (range: 7.8-34.8) and 9.1 ± 6.0 (range: 4.2-27.8), respectively. SUVmax in patients with previously known pNET and SI-NET were 26.1 ± 14.5 (range: 8.7-42.4) and 11.3 ± 3.7 (range: 5.6-17.9). The SUVmax of the unknown pNET and SI-NET were significantly lower (p 68Ga-DOTA-NOC receptor PET/CT, 6 of 59 patients were operated and the primary was removed (4 pancreatic, 1 ileal and 1 rectal tumour) resulting in a management change in approximately 10% of the patients. In the remaining 29 patients, because of the far advanced stage of the disease (due to distant metastases), the primary tumours were not operated. Additional histopathological sampling was available from one patient with bronchial carcinoid (through bronchoscopy). Our data indicate that 68Ga-DOTA-NOC PET/CT is highly superior to 111In-OctreoScan (39% detection rate for CUP according to the literature) and can play a major role in the management of patients with CUP-NET. (orig.)

  5. PET/CT for staging and follow-up of pediatric nasopharyngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Cheuk, Daniel K.L. [St Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); The University of Hong Kong, Department of Paediatrics and Adolescent Medicine, Pokfulam (China); Sabin, Noah D.; Hossain, Moinul; Krasin, Matthew J.; Shulkin, Barry L. [St Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States); Wozniak, Amy [St Jude Children' s Research Hospital, Department of Biostatistics, Memphis, TN (United States); Naik, Mihir [St Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States); University of Texas Health Science Center, Department of Radiation Oncology, San Antonio, TX (United States); Rodriguez-Galindo, Carlos [St Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); Hematology/Oncology, Dana-Farber Cancer Institute, Boston, MA (United States)

    2012-07-15

    While FDG PET/CT for the evaluation of nasopharyngeal carcinoma (NPC) in adult patients has documented advantages and disadvantages compared with conventional imaging, to our knowledge, no studies of FDG PET/CT for the evaluation of NPC in pediatric patients have been performed. In this investigation, we studied the utility of FDG PET/CT in children with NPC. The study group comprised 18 children with biopsy-proven NPC who underwent FDG PET/CT and MRI (total 38 pairs of images). All baseline and follow-up FDG PET/CT and MRI studies were independently reviewed for restaging of disease. The concordance between FDG PET/CT and MRI in T, N, and overall staging was 29%, 64%, and 43%, respectively. Compared with MRI, FDG PET/CT yielded lower T and overall staging and showed less cervical and retropharyngeal lymphadenopathy. The concordance between follow-up FDG PET/CT and MRI was 79% overall and 100% 9 months after therapy. In patients who achieved complete remission, FDG PET/CT showed disease clearance 3-6 months earlier than MRI. There were no false-positive or false-negative FDG PET/CT scans during follow-up. FDG PET/CT may underestimate tumor extent and regional lymphadenopathy compared with MRI at the time of diagnosis, but it helps to detect metastases and clarify ambiguous findings. FDG PET/CT is sensitive and specific for follow-up and enables earlier determination of disease remission. FDG PET/CT is a valuable imaging modality for the evaluation and monitoring of NPC in pediatric patients. (orig.)

  6. PET-CT in oncology: making the most of CT

    OpenAIRE

    Miles, K. A.

    2008-01-01

    Abstract Combined positron emission tomography–computed tomography (PET-CT) has made a significant impact on cancer imaging. The use of CT to map tissue attenuation for correction of PET images and the ability to co-register the functional information provided by PET with the anatomical data afforded by CT, has resulted in demonstrable improvements in diagnostic accuracy. However, attenuation correction and anatomical localisation may not represent the full benefits of integrating CT with PET...

  7. Effective dose and cancer risk in PET/CT exams

    International Nuclear Information System (INIS)

    Due to the use of radiopharmaceutical positron-emitting in PET exam and realization of tomography by x-ray transmission in CT examination, an increase of dose with hybrid PET/CT technology is expected. However, differences of doses have been reported in many countries for the same type of procedure. It is expected that the dose is an influent parameter to standardize the protocols of PET/CT. This study aimed to estimate the effective doses and absorbed in 65 patients submitted to oncological Protocol in a nuclear medicine clinic in Rio de Janeiro, considering the risk of induction of cancer from the scan. The CT exam-related doses were estimated with a simulator of PMMA and simulated on the lmPACT resistance, which for program effective dose, were considered the weight factors of the lCRP 103. The PET exam doses were estimated by multiplying the activity administered to the patient with the ICRP dose 80 factors. The radiological risk for cancer incidence were estimated according to the ICRP 103. The results showed that the effective dose from CT exam is responsible for 70% of the effective total in a PET/CT scan. values of effective dose for the PET/CT exam reached average values of up to 25 mSv leading to a risk of 2, 57 x 10-4. Considering that in staging of oncological diseases at least four tests are performed annually, the total risk comes to 1,03x 10-3

  8. PET/CT-guided Interventions: Personnel Radiation Dose

    Energy Technology Data Exchange (ETDEWEB)

    Ryan, E. Ronan, E-mail: ronan@ronanryan.com; Thornton, Raymond; Sofocleous, Constantinos T.; Erinjeri, Joseph P. [Memorial Sloan-Kettering Cancer Center, Department of Radiology (United States); Hsu, Meier [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics (United States); Quinn, Brian; Dauer, Lawrence T. [Memorial Sloan-Kettering Cancer Center, Department of Medical Physics (United States); Solomon, Stephen B. [Memorial Sloan-Kettering Cancer Center, Department of Radiology (United States)

    2013-08-01

    PurposeTo quantify radiation exposure to the primary operator and staff during PET/CT-guided interventional procedures.MethodsIn this prospective study, 12 patients underwent PET/CT-guided interventions over a 6 month period. Radiation exposure was measured for the primary operator, the radiology technologist, and the nurse anesthetist by means of optically stimulated luminescence dosimeters. Radiation exposure was correlated with the procedure time and the use of in-room image guidance (CT fluoroscopy or ultrasound).ResultsThe median effective dose was 0.02 (range 0-0.13) mSv for the primary operator, 0.01 (range 0-0.05) mSv for the nurse anesthetist, and 0.02 (range 0-0.05) mSv for the radiology technologist. The median extremity dose equivalent for the operator was 0.05 (range 0-0.62) mSv. Radiation exposure correlated with procedure duration and with the use of in-room image guidance. The median operator effective dose for the procedure was 0.015 mSv when conventional biopsy mode CT was used, compared to 0.06 mSv for in-room image guidance, although this did not achieve statistical significance as a result of the small sample size (p = 0.06).ConclusionThe operator dose from PET/CT-guided procedures is not significantly different than typical doses from fluoroscopically guided procedures. The major determinant of radiation exposure to the operator from PET/CT-guided interventional procedures is time spent in close proximity to the patient.

  9. 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.)

  10. PET/CT instrumentation: Quality assurance and quality control

    International Nuclear Information System (INIS)

    Improvement in quality assurance in Nuclear Medicine and in particular, in quality control of related equipment is a major field of interest of the International Atomic Energy Agency (IAEA). Several technical documents pertaining to scintigraphic imaging have been published and are being used as reference manuals by many professionals in the field (e.g., TECDOC 317, TECDOC 602, STI/PUB 1141). Positron emission tomography (PET) scanners and related performance assessment and quality control were not included in the previously published documents, as PET has been mainly a research tool, with limited worldwide distribution until the 90's. The tremendous role played presently by PET and PET/CT in whole-body oncology for lesion detection, staging and follow-up as well as the increasing role for PET in cardiology and neurology, associated with increasing reimbursement of multiple PET indications have prompted the need for updated guidelines specific to PET and PET/CT in terms of acceptance testing as well as quality control and assurance. The aim of this work is to present an overview of acceptance testing and quality assurance and control for PET and PET/CT

  11. 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

  12. Imaging and PET-CT evaluation of Gi tract cancers

    International Nuclear Information System (INIS)

    Imaging plays a pivotal role in the management of G.I. tract cancers for diagnosis, characterization, locoregional staging, metastatic work-up and follow-up during and after curative or palliative treatment. The imaging protocols should be optimized and reproducible because of their impact on therapy. Thoracic, abdominal and pelvic CT is the cornerstone of the imaging work-up, optimized and reproducible because of their impact on therapy. Thoracic, abdominal and pelvic CT is the cornerstone of the imaging work-up, optimized and tailored to the specific G.I. segment involved, requiring good G.I. tract distension. Image interpretation of native axial and reformatted multiplanar images is routinely performed. In specific cases, additional targeted imaging with the US or MRI or whole body imaging with PET/CT or MRI may be valuable. PET/CT is a complement to morphological imaging. PET allows detection of lesions otherwise undetected on morphological imaging, usually due to poor contrast with surrounding tissues, and characterization of known lesions. PET/CT is best used as an integral part of a comprehensive imaging work-up. Radiologist and nuclear medicine specialists provide complementary information. each must be familiar with the clinical questions at hand and related stakes, and advantages and limitations of each modality to optimize treatment as part of a multidisciplinary management approach. (authors)

  13. Whole-body staging of malignant melanoma. Advantages, limitations and current importance of PET-CT, whole-body MRI and PET-MRI; Ganzkoerperdiagnostik beim malignen Melanom. Vorteile, Grenzen und aktueller Stellenwert von PET-CT, GK-MRT und PET-MRT

    Energy Technology Data Exchange (ETDEWEB)

    Pfannenberg, C.; Schwenzer, N. [Eberhard-Karls-Universitaet Tuebingen, Abteilung Diagnostische und Interventionelle Radiologie, Tuebingen (Germany)

    2015-01-16

    Cross-sectional imaging methods are currently the standard methods for staging of advanced melanoma. The former time-consuming and expensive multimodality approach is increasingly being replaced by novel whole-body (WB) staging methods, such as 18F-fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG-PET-CT) and whole-body magnetic resonance imaging (WBMRI) because they offer a complete head-to-toe coverage of the patient in a single examination with an accurate and sensitive detection of tumor spread. Several studies in patients with advanced melanoma revealed that PET-CT is more sensitive and specific than conventional modalities, such as CT alone resulting in a change of management in up to 30 % of cases. Due to the limited sensitivity of PET for lesions smaller than 1 cm, PET-CT is not useful for the initial work-up of patients with stage I and II melanoma but has proven to be superior for detection of distant metastases, which is essential prior to surgical metastasectomy. If PET-CT is not available WB-CT or WB-MRI can alternatively be used and WB-MRI including diffusion-weighted imaging (DWI) has become a real alternative for staging of melanoma patients. So far, however, only few reports suffering from small numbers of cases and heterogeneous design have compared the diagnostic performance of WB-MRI and PET-CT. The preliminary results indicate a high overall diagnostic accuracy of both methods; however, these methods differ in organ-based detection rates: PET-CT was more accurate in N-staging and detection of lung and soft tissue metastases whereas WB-MRI was superior in detecting liver, bone and brain metastases. The value of PET-MRI for staging of advanced melanoma is the subject of ongoing clinical studies. (orig.) [German] Schnittbildmethoden sind heute der Standard bei der Ausbreitungsdiagnostik ab Stadium III des malignen Melanoms. Das fruehere zeit- und kostenaufwendige multimodale Konzept wird heute durch Ganzkoerper

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

    Science.gov (United States)

    García-Gómez, F J; Acevedo-Báñez, I; Martínez-Castillo, R; Tirado-Hospital, J L; Cuenca-Cuenca, J I; Pachón-Garrudo, V M; Álvarez-Pérez, R M; García-Jiménez, R; Rivas-Infante, E; García-Morillo, J S; Borrego-Dorado, I

    2015-08-01

    Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes that stain positively for CD68 marker but not express CD1a and S100 proteins. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. Multisystemic involvement leads to a wide variety of clinical manifestations that results in a poor prognosis although recent advances in treatment. We present the clinical, nuclear medicine findings and therapeutic aspects of a serie of 6 patients with histopathological diagnosis of ECD, who have undergone both bone scintigraphy (BS) and 18F-fluorodeoxyglucose (18FDG)-PET/CT scans in our institution. A complementary 18F-fluorodopa (18FDOPA)-PET/CT was performed in one case. Three different presentations of the disease were observed in our casuistic: most indolent form was a cutaneous confined disease, presented in only one patient. Multifocal involvement with central nervous system (CNS) preservation was observed in two patients. Most aggressive form consisted in a systemic involvement with CNS infiltration, presented in three patients. In our experience neurological involvement, among one case with isolate pituitary infiltration, was associated with mortality in all cases. 18FDG-PET/CT and BS were particularly useful in despite systemic involvement; locate the site for biopsy and the treatment response evaluation. By our knowledge, 18FDOPA-PET/CT not seems useful in the initial staging of ECD. A baseline 18FDG-PET/CT and BS may help in monitoring the disease and could be considered when patients were incidentally diagnosed and periodically 18FDG-PET/CT must be performed in the follow up to evaluate treatment response.

  15. Fluorodeoxyglucose uptake in absence of CT abnormality on PET-CT: What is it?

    OpenAIRE

    Liu, Yiyan

    2013-01-01

    The purpose of this article is to provide a pictorial review of the findings and interpretative pitfalls about focal fluorodeoxyglucose (FDG) uptake in the absence of corresponding computer tomography (CT) lesion or abnormality on an integrated positron emission tomography (PET)-CT. The integrated CT images in the PET-CT scanner allow correct co-registration and fused imaging of anatomical and functional data. On FDG PET-CT imaging, a real pathologic process often demonstrates abnormal uptake...

  16. EDG PET/CT in Pediatric Lymphoma: comparison with conventional imaging (CI) and management impact assessment

    International Nuclear Information System (INIS)

    Full text: Background: The clinical utility of PET/CT in pediatric lymphomas is not fully established. PET/CT in children with Hodgkin's Disease (HD) and Non-Hodgkin's Lymphoma (NHL) were reviewed and diagnostic test performance estimated. Methods. A retrospective review of PET/CT scans in children with lymphoma were compared to CI within 4 wks of PET/CT. A lesion based analysis of 16 lymph node and 8 extra-nodal regions per scan were compared to reference standards: histopathological findings or follow up> 6 mths. PET/CT mid way through therapy were ana lysed separately and compared to resolution of lesions on Cl to predict successful treatment. Results. 71 lymphoma pts underwent 287 PET/CT scans between JuI 2006-Dec 2008. 19 pts were excluded. There were 52 pts (35M, 17F age range 5.1-18.9 yrs, mean 1 2.8 yrs) comprising 207 scans with valid C[ comparator: 30 HD, 22 NHL with 4966 regions: 3310 lymph node, 1656 extra-nodal. PET/CT performed significantly better than CI with sensitivity and specificity of 95.7% and 99.7% compared to 69.9% and 99.0%. No treatment failures or relapses occurred. Sensitivity of PET/CT or CI for predicting poor outcome could not be estimated. PET/CT had fewer false positive lesions during therapy. The specificity for predicting good response to treatment on a lesion by lesion basis for PET/CT was 99.2% compared to CI 96.9%. Conclusion. PET/CT is more accurate than CI in detecting malignant lesions in childhood lymphoma and is a major asset in management. PET/CT performed mid way though therapy has a lower false positive rate than CI in predicting lesion response to treatment.

  17. Rise of the machines : cyclotrons and radiopharmaceuticals in the PET-CT-MR golden age

    International Nuclear Information System (INIS)

    Full text: One particularly inspiring narrative in the evolution of medical imaging over 35 years begins with the introduction of quassi-routine production of 18F, enabled by advances in reliability of (medical) cyclotrons; invention of the 'molecule of the century' [18F]FOG and its robust synthesis; comprehending betrayal of major tumour-cell types by their glucose avidity; astounding advances in PET scanners (recently, time-of-flight); and marriage of anatomic with functional 3-D imaging as PET/CT or (recently) PET/MR. Though the explosion in PET is identified historically with diagnostic oncology plus quantitation of nuclear medicine, plus the collateral leverage of advances in CT and MR, other potentially transformative opportunities (pre-diagnosis or quantifying treatment response) are emerging in dementia and diabetes-as exemplars of PET-addressable mass afflictions-driven by advances in specificity/sensitivity of targeting molecules. PET delivers femto-M functional sensitivity (e.g.; receptor-targeting)-several magnitude-orders of narrow-context superiority over MR or CT-exemplified by the rapid rise of solid-targetry metallo-PET (64Cu, 89Zr), and concomitantly, preclinical radioimmuno micro-PET/CT/SPECT imaging. Though [11C] PET has elucidated brain, prostate and other cell +/- tumour mechanisms, realistic clinical rollout demands longer halflife [18F]-labelling. [18F] innovations beyond [18F]FDG elucidate numerous metabolisms, including choline, hypoxia, apoptosis and amino-acid, and notably will soon provide a routine-clinical [18F]-alternative to [11 C] based beta-amyloid dementia diagnosis. Frontier PET is constrained by cost/dose, shackled to 'twentieth century' technologies-cyclotron, hotcell and synthesis unit. Example is [18F] bone scintigraphy; acknowledged as clinically superior to [99mTc]MOP, its widespread implementation awaits cheaper isotope, accessible PET/CT scanners, and maybe 'true' shortage of [99mTc]. Generator-sourced 68 Ga-PET is

  18. {sup 18}F-FDG PET/CT in paediatric lymphoma: comparison with conventional imaging

    Energy Technology Data Exchange (ETDEWEB)

    London, Kevin [Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); Cross, Siobhan; Dalla-Pozza, Luciano [Children' s Hospital at Westmead, Oncology Unit, Sydney (Australia); Onikul, Ella [Children' s Hospital at Westmead, Department of Medical Imaging, Sydney (Australia); Howman-Giles, Robert [Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Imaging, Sydney Medical School, Sydney (Australia)

    2011-02-15

    In children with Hodgkin's disease and non-Hodgkin's lymphoma, the ability of {sup 18}F-fluoro-2-deoxy-D-glucose PET/CT and conventional imaging (CI) to detect malignant lesions and predict poor lesion response to therapy was assessed and compared. A retrospective review of findings reported on PET/CT and CI was performed using a lesion-based analysis of 16 lymph node and 8 extra-nodal regions. Lesions were defined by histopathological findings or follow-up > 6 months. The study included 209 PET/CT scans with a valid CI comparator. A total of 5,014 regions (3,342 lymph node, 1,672 extra-nodal) were analysed. PET/CT performed significantly better than CI in the detection of malignant lesions with sensitivity and specificity of 95.9 and 99.7% compared to 70.1 and 99.0%, respectively. For predicting poor lesion response to therapy, PET/CT had fewer false-positive lesions than CI. The specificity for predicting poor lesion response to treatment for PET/CT was 99.2% compared to 96.9% for CI. PET/CT was the correct modality in 86% of lesions with discordant findings. PET/CT is more accurate than CI in detecting malignant lesions in childhood lymphoma and in predicting poor lesion response to treatment. In lesions with discordant findings, PET/CT results are more likely to be correct. (orig.)

  19. The role of 18F–NaF PET/CT in metastatic bone disease

    Directory of Open Access Journals (Sweden)

    Mine Araz

    2015-09-01

    Conclusion: Although further prospective clinical studies in specific cancer populations are indicated to set the place of 18F–NaF PET/CT in diagnostic scheme, the results of this pilot study from our country support the superiority of 18F–NaF PET/CT in investigation of bone metastasis over 99mTc-MDP bone scan and 18F-FDG PET/CT in various malignancies. 18F–NaF PET/CT is coming forward as a single step bone seeking study, considering all the advantages, but especially potential of detecting occult metastases and reliably directing patient management.

  20. 18F-FDG PET/CT in paediatric lymphoma: comparison with conventional imaging

    International Nuclear Information System (INIS)

    In children with Hodgkin's disease and non-Hodgkin's lymphoma, the ability of 18F-fluoro-2-deoxy-D-glucose PET/CT and conventional imaging (CI) to detect malignant lesions and predict poor lesion response to therapy was assessed and compared. A retrospective review of findings reported on PET/CT and CI was performed using a lesion-based analysis of 16 lymph node and 8 extra-nodal regions. Lesions were defined by histopathological findings or follow-up > 6 months. The study included 209 PET/CT scans with a valid CI comparator. A total of 5,014 regions (3,342 lymph node, 1,672 extra-nodal) were analysed. PET/CT performed significantly better than CI in the detection of malignant lesions with sensitivity and specificity of 95.9 and 99.7% compared to 70.1 and 99.0%, respectively. For predicting poor lesion response to therapy, PET/CT had fewer false-positive lesions than CI. The specificity for predicting poor lesion response to treatment for PET/CT was 99.2% compared to 96.9% for CI. PET/CT was the correct modality in 86% of lesions with discordant findings. PET/CT is more accurate than CI in detecting malignant lesions in childhood lymphoma and in predicting poor lesion response to treatment. In lesions with discordant findings, PET/CT results are more likely to be correct. (orig.)

  1. 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...

  2. PET/CT scanners: a hardware approach to image fusion.

    Science.gov (United States)

    Townsend, David W; Beyer, Thomas; Blodgett, Todd M

    2003-07-01

    New technology that combines positron tomography with x-ray computed tomography (PET/CT) is available from all major vendors of PET imaging equipment: CTI, Siemens, GE, Philips. Although not all vendors have made the same design choices as those described in this review all have in common that their high performance design places a commercial CT scanner in tandem with a commercial PET scanner. The level of physical integration is actually less than that of the original prototype design where the CT and PET components were mounted on the same rotating support. There will undoubtedly be a demand for PET/CT technology with a greater level of integration, and at a reduced cost. This may be achieved through the design of a scanner specifically for combined anatomical and functional imaging, rather than a design combining separate CT and PET scanners, as in the current approaches. By avoiding the duplication of data acquisition and image reconstruction functions, for example, a more integrated design should also allow cost savings over current commercial PET/CT scanners. The goal is then to design and build a device specifically for imaging the function and anatomy of cancer in the most optimal and effective way, without conceptualizing it as combined PET and CT. The development of devices specifically for imaging a particular disease (eg, cancer) differs from the conventional approach of, for example, an all-purpose anatomical imaging device such as a CT scanner. This new concept targets more of a disease management approach rather than the usual division into the medical specialties of radiology (anatomical imaging) and nuclear medicine (functional imaging). PMID:12931321

  3. 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

  4. Planning of External Beam Radiotherapy for Prostate Cancer Guided by PET/CT.

    Science.gov (United States)

    von Eyben, Finn Edler; Kairemo, Kalevi; Kiljunen, Timo; Joensuu, Timo

    2015-01-01

    In this paper, we give an overview of articles on non-choline tracers for PET/CT for patients with prostate cancer and planning of radiotherapy guided by PET/CT. Nineteen articles described (11)C-Acetate PET/CT. Of 629 patients 483 (77%, 95% CI 74% - 80%) had positive (11)C-Acetate PET/CT scans. Five articles described (18)F-FACBC PET/CT. Of 174 patients, 127 (73%, 95% CI 68% - 78%) had positive scans. Both tracers detected local lesions, lesions in regional lymph nodes, and distant organs. Ten articles described (18)F-NaF PET/CT and found that 1289 of 3918 patients (33%) had positive reactive lesions in bones. PET/CT scan can guide external beam radiotherapy (EBRT) planning for patients with loco-regional prostate cancer. In six studies with 178 patients with localized prostate cancer, PET/CT pointed out dominant intraprostatic lesions (DIL). Oncologists gave EBRT to the whole prostate and a simultaneously integrated boost to the DIL. Four studies with 254 patients described planning of EBRT for patients with PETpositive lymph nodes. After the EBRT, 15 of 29 node-positive patients remained in remission for median 28 months (range 14 to 50 months). Most articles describe (11)C- and (18)F-Choline PET/CT. However, (11)C-Acetate and (18)F-FACBC may also be useful tracers for PET/CT. Planning of radiotherapy guided by MRI or PET/CT is an investigational method for localized prostate cancer. Current clinical controlled trials evaluate whether the method improves overall survival.

  5. FDG PET/CT appearance of benign pilomatricoma.

    Science.gov (United States)

    Bhatt, Manoj Kumar; Sommerville, Ryan; Ravi Kumar, Aravind S

    2012-07-01

    A 56-year-old patient was referred for FDG PET/CT with a right preauricular lymph node fine-needle biopsy, suggesting poorly differentiated carcinoma and no obvious primary lesion. There was intense FDG uptake in the right preauricular nodule. The node was excised, and formal histology demonstrated a benign pilomatricoma rather than malignancy. Pilomatricoma is uncommon in adults and an unusual cause for marked FDG uptake, likely due to foreign body inflammation. Pilomatricoma can be either benign or malignant. The marked FDG uptake demonstrated in our patient with benign pilomatricoma also suggests that FDG PET cannot reliably grade this rare condition.

  6. 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...

  7. Preoperative staging of lung cancer with combined PET-CT

    DEFF Research Database (Denmark)

    Fischer, Barbara; Lassen, Ulrik; Mortensen, Jann;

    2009-01-01

    BACKGROUND: Fast and accurate staging is essential for choosing treatment for non-small-cell lung cancer (NSCLC). The purpose of this randomized study was to evaluate the clinical effect of combined positron-emission tomography and computed tomography (PET-CT) on preoperative staging of NSCLC...... one of the following: a thoracotomy with the finding of pathologically confirmed mediastinal lymph-node involvement (stage IIIA [N2]), stage IIIB or stage IV disease, or a benign lung lesion; an exploratory thoracotomy; or a thoracotomy in a patient who had recurrent disease or death from any cause...

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

    International Nuclear Information System (INIS)

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

  9. Evaluation of dosimetric techniques in positrons emission tomography and computerized tomography (PET/CT); Avaliacao de tecnicas dosimetricas em tomografia por emissao de positrons e tomografia computadorizada (PET/CT)

    Energy Technology Data Exchange (ETDEWEB)

    Pinto, Gabriella Montezano

    2014-09-01

    Among diagnostic techniques PET/CT is one of those with the highest dose delivery to the patient as a cause of external exposure to X-rays, and the use of a radiopharmaceutical that results in a high energy gamma emission. The dosimetry of these two components becomes important in order to optimize and justify the technique. Various dosimetric techniques are found in literature without a consensus of the best to use. With the advances in technological and consequent equipment configuration changes, upgrades and variation in methodologies, particularly in computed tomography, a standardization of these techniques is required. Previous studies show that CT is responsible for 70 % of the dose delivered to the patient in PET/CT examinations. Thus, many researchers have been focused on CT dose optimization protocols studies. This work analyzes the doses involved in a PET/CT oncology protocol by using an Alderson female anthropomorphic phantom in a public hospital of Rio de Janeiro city. The dose estimate for PET examination resulting from the use of {sup 18}F - FDG radiopharmaceutical was conducted through dose factors published in ICRP 106; the dose for CT was estimated and compared by calculation of the absorbed doses to patients according to four methods: thermoluminescent dosimetry (TL0100) distributed in critical organs of the Alderson phantom; measurements of CTOI according to AAPM number 96; correction factor for effective diameter SSOE (AAPM Number 204); and simulation by ImPACT program For CT, the results in terms of effective dose presented (TLO, CTOI and ImPACT) ± 5 % maximum variations between methodologies. Considering medium absorbed dose (TLO, SSOE and ImPACT) the results differed in ± 7 % from each other. These findings demonstrate that parameters provided by the manufacturer on the console can be used to have a primary approach of both, absorbed and effective doses to the patient since that a quality assurance program of these parameters are adopted

  10. {sup 18}F-FDG PET/CT for monitoring induction chemotherapy in patients with primary inoperable penile carcinoma: first clinical results

    Energy Technology Data Exchange (ETDEWEB)

    Graafland, Niels M.; Horenblas, Simon [The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands); Valdes Olmos, Renato A. [The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Teertstra, Hendrik J. [The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Radiology, Amsterdam (Netherlands); Kerst, J.M.; Bergman, Andries M. [The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Medical Oncology, Amsterdam (Netherlands)

    2010-08-15

    The aim of this study was to explore the role of {sup 18}F-FDG PET/CT for monitoring treatment response in patients with primary inoperable (i.e. advanced) penile carcinoma treated with induction chemotherapy and to compare the metabolic tumour response with the radiological evaluation provided by CT imaging. Eight patients with advanced penile carcinoma were studied. All had undergone {sup 18}F-FDG PET/CT imaging at baseline and after two cycles of induction chemotherapy. The metabolic tumour response was evaluated according to European Organisation for Research and Treatment of Cancer (EORTC) criteria for therapy response. The radiologic tumour response was assessed using the Response Evaluation Criteria in Solid Tumors (RECIST) guidelines. Response evaluations were done separately and blinded for other patient data. For definition of the reference, all patients were rated as responders or non-responders by a multidisciplinary tumour board. PET/CT showed hypermetabolic uptake of FDG matching with malignancy in all eight patients. According to the reference, six patients were responders and two non-responders after two cycles of chemotherapy. The metabolic tumour response was considered accurate in all eight patients. In seven of the eight patients, the radiological tumour response was in agreement. In three patients correctly identified as responders, the radiological tumour response was deemed suboptimal compared with the metabolic assessment. Five of the six responders continued chemotherapy after response evaluation up to four cycles and were operated subsequently. Histopathological analysis confirmed the metabolic tumour response. {sup 18}F-FDG PET/CT imaging is feasible for monitoring response in patients with advanced penile carcinoma treated with induction chemotherapy. Our preliminary results suggest that PET/CT is potentially more reliable than CT alone. (orig.)

  11. The role of {sup 18}F-FDG PET or PET/CT in the detection of fever of unknown origin

    Energy Technology Data Exchange (ETDEWEB)

    Qiu, Lin, E-mail: 425420867@qq.com [Department of Nuclear Medicine, Affiliated Hospital of Luzhou Medical College, Luzhou, Sichuan 646000 (China); Chen, Yue, E-mail: chenyue5523@126.com [Department of Nuclear Medicine, Affiliated Hospital of Luzhou Medical College, Luzhou, Sichuan 646000 (China)

    2012-11-15

    Even with the recent advance in diagnostic tools and techniques, fever of unknown origin (FUO) remains a clinical challenge. A wide range of diseases, mainly infections, autoimmune conditions (inflammatory diseases), malignancies and miscellaneous can cause FUO. Positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) scanning makes a great contribution to the diagnosis and differential diagnosis of FUO due to the high sensitivity of pathological accumulation of {sup 18}F-FDG. The diagnostic yield of PET/CT is higher than traditional radiographic imaging and other nuclear medicine scanning. Owing to the numerous advantages of PET/CT including high sensitivity and the ability to perform whole-body scans, many rare diseases presenting with FUO can be detected and the spectrum of diseases that can exhibit FUO has been increasing. Recent studies utilizing FUO are discussed in this paper. However, there are limited data available about the role of {sup 18}F-FDG PET or PET/CT in evaluation of FUO.

  12. Clinical Features and Outcome in Newly Diagnosed Hodgkin Lymphoma Patients Presenting with PET/CT-Ascertained Focal Skeletal Lesions

    DEFF Research Database (Denmark)

    El-Galaly, Tarec Christoffer; Hutchings, Martin; Juul Mylam, Karen;

    Clinical Features and Outcome in Newly Diagnosed Hodgkin Lymphoma Patients Presenting with PET/CT-Ascertained Focal Skeletal Lesions......Clinical Features and Outcome in Newly Diagnosed Hodgkin Lymphoma Patients Presenting with PET/CT-Ascertained Focal Skeletal Lesions...

  13. PET-CT for neuroendocrine tumors and nuclear medicine therapy options; PET-CT bei neuroendokrinen Tumoren und nuklearmedizinische Therapiemoeglichkeiten

    Energy Technology Data Exchange (ETDEWEB)

    Scheidhauer, K.; Miederer, M.; Gaertner, F.C. [Klinikum Rechts der Isar der Technische Universitaet Muenchen, Nuklearmedizinische Klinik und Poliklinik, Muenchen (Germany)

    2009-03-15

    Neuroendocrine tumors (NET) are defined by biochemical characteristics and structures which can be specifically addressed by radioligands for diagnostic imaging as well as radionuclide therapy in nuclear medicine. Somatostatin receptor imaging has been shown to be an important part of the diagnostic process in the management of NET for a long time. In recent years a number of tracers enabling PET-based imaging of somatostatin receptors and amine precursor uptake have been developed. By combining the specific functional information of the PET signal with anatomical information by CT imaging using PET-CT hybrid scanners, primary tumors and metastases can be detected with high resolution and high sensitivity. Compared with conventional indium-111 octreotide scintigraphy PET-CT has a higher resolution and also a lower radiation exposure. In addition, quantification of the tracer uptake allows therapy monitoring. By labelling with therapeutic beta-emitters, such as lutetium-177 or yttrium-90, a systemic internal radiotherapy with somotostatin analogues (peptide radionuclide radiation therapy, PRRT) can be provided as a therapeutic option for patients with unresectable and metastasized neuroendocrine tumors. (orig.) [German] Neuroendokrine Tumoren (NET) besitzen biochemische Eigenschaften und Zielstrukturen, die mittels spezifischer Radioliganden sowohl eine nuklearmedizinische Bildgebung zur Diagnostik als auch eine Radionuklidtherapie ermoeglichen. Die Somatostatinrezeptorszintigraphie ist im Management neuroendokriner Tumoren schon lange ein wichtiger Bestandteil des diagnostischen Work-up. In den letzten Jahren wurde zudem eine Reihe von PET-Tracern entwickelt, mit denen sich z. B. Somatostatinrezeptoren oder die Aufnahme biogener Amine darstellen lassen. So koennen mittels PET-CT in direkter Kombination mit morphologischer Bildgebung Primaertumoren und Metastasen hochaufloesend und sensitiv detektiert werden. Vorteile der PET-CT im Vergleich zur konventionellen {sup

  14. PET/CT in initial staging and therapy response assessment of early mediastinal lymphoma

    Directory of Open Access Journals (Sweden)

    Noha Hosam EL Din Behairy

    2014-03-01

    Conclusion: PET/CT proved higher sensitivity and specificity over CECT. The major strength of PET/CT over CECT was its higher ability for detection of extra-nodal sites of lymphoma and excluding active disease in residual nodal mass lesions on follow up.

  15. Clinical PET/CT Atlas: A Casebook of Imaging in Oncology

    International Nuclear Information System (INIS)

    Integrated positron emission tomography/computed tomography (PET/CT) has evolved since its introduction into the commercial market more than a decade ago. It is now a key procedure, particularly in oncological imaging. Over the last years in routine clinical service, PET/CT has had a significant impact on diagnosis, treatment planning, staging, therapy, and monitoring of treatment response and has therefore played an important role in the care of cancer patients. The high sensitivity from the PET component and the specificity of the CT component give this hybrid imaging modality the unique characteristics that make PET/CT, even after over 10 years of clinical use, one of the fastest growing imaging modalities worldwide. This publication combines over 90 comprehensive cases covering all major indications of fluorodeoxyglucose (18F-FDG)-PET/CT as well as some cases of clinically relevant special tracers. The cases provide an overview of what the specific disease can look like in PET/CT, the typical pattern of the disease’s spread as well as likely pitfalls and teaching points. This PET/CT Atlas will allow professionals interested in PET/CT imaging to embrace the variety of oncological imaging by providing clinically relevant teaching files on the effectiveness and diagnostic quality of FDG-PET/CT imaging in routine applications

  16. Evaluation of bone metastases with 18 F- Sodium fluoride PET/CT; initial experience

    International Nuclear Information System (INIS)

    The study of NaF-18 PET/CT is the modality with bigger sensitivity and specificity for the bony metastases detection. This additional value of the NaF-18 PET/CT can have a beneficent impact in the clinical handling of the patients with prostate cancer with high risk. (Author)

  17. 18F-fluorocholine-PET-CT bij hyperparathyreoïdie

    NARCIS (Netherlands)

    Kluijfhout, Wouter P; Vriens, Menno R; Borel Rinkes, Inne H M; Valk, Gerlof D.; de Klerk, John M H; de Keizer, Bart; Valk, GD

    2015-01-01

    18F-fluorocholine PET-CT is a new imaging modality for the localization of pathological parathyroid glands in patients with primary hyperparathyroidism. The PET-CT is a combination scan that uses both the physiological information from the PET and the anatomical information from the CT. Uptake of th

  18. How to study optimal timing of PET/CT for monitoring of cancer treatment

    DEFF Research Database (Denmark)

    Vach, Werner; Høilund-Carlsen, Poul Flemming; Fischer, Barbara Malene Bjerregaard;

    2011-01-01

    Purpose: The use of PET/CT for monitoring treatment response in cancer patients after chemo- or radiotherapy is a very promising approach to optimize cancer treatment. However, the timing of the PET/CT-based evaluation of reduction in viable tumor tissue is a crucial question. We investigated how...

  19. Dual-time FDG-PET/CT in patients with potential breast cancer recurrence

    DEFF Research Database (Denmark)

    Baun, Christina; Falch Braas, Kirsten; Gerke, Oke;

    Dual-time FDG-PET/CT in patients with potential breast cancer recurrence: head-to-head comparison with CT and bonescintigraphy......Dual-time FDG-PET/CT in patients with potential breast cancer recurrence: head-to-head comparison with CT and bonescintigraphy...

  20. Utility of 18FDG-PET/CT in breast cancer diagnostics--a systematic review

    DEFF Research Database (Denmark)

    Warning, Karina; Hildebrandt, Malene Grubbe; Kristensen, Bent;

    2011-01-01

    18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT) is a non-invasive method for visualization of focally increased metabolism in the presence of discrete morphological changes. Based on a systematic review of current literature, PET/CT cannot be recommended...

  1. Early PET/CT after radiofrequency ablation in colorectal cancer liver metastases: is it useful?

    Institute of Scientific and Technical Information of China (English)

    LIU Zhao-yu; CHANG Zhi-hui; LU Zai-ming; GUO Qi-yong

    2010-01-01

    Background Morphologic imaging after radiofrequency ablation (RFA) of liver metastases is hampered by an inflammatory response in the ablation margin, making the identification of local tumor progression (LTP) difficult. The aim of this study was to evaluate the efficacy of early 18F-FDG PET/CT scanning to monitor the effectiveness of RFA in colorectal liver metastases.Methods Twelve patients with 20 metastases were treated with RFA for colorectal liver metastases. They underwent PET/CT within 2 weeks before RFA and within 24 hours after RFA (so termed "early PET/CT"). PET/CT was repeated at 1, 3, and 6 months, and then every 6 months after ablation. The standard of reference was based on available clinical and radiological follow-up data.Results Early PET/CT revealed total photopenia in 16 RFA-treated metastases, which were found to be without residual tumor on the final PET/CT scan. Three RFA-treated metastases with focal uptake were identified as local tumor progression, which necessitated further treatment. One RFA-treated metastasis with rim-shaped uptake was regarded as inflammation. The results of the early PET/CT scanning were consistent with the findings of the final follow-up. Conclusions PET/CT performed within 24 hours after RFA can effectively detect whether residual tumor exists for colorectal cancer liver metastases. The results can guide further treatment, and may improve the efficacy of RFA.

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

    Science.gov (United States)

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

    2015-06-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

  4. The value of PET, CT and in-line PET/CT in patients with gastrointestinal stromal tumours: long-term outcome of treatment with imatinib mesylate

    Energy Technology Data Exchange (ETDEWEB)

    Goerres, G.W.; Hany, T.F.; Schulthess, G.K. von [University Hospital Zurich, Division of Nuclear Medicine, Zurich (Switzerland); Stupp, R.; Luthi, F.; Leyvraz, S. [University of Lausanne Medical Centre, Multidisciplinary Oncology Centre, Lausanne (Switzerland); Barghouth, G.; Schnyder, P. [University of Lausanne Medical Centre, Department of Radiology, Lausanne (Switzerland); Pestalozzi, B. [University Hospital Zurich, Department of Oncology, Zurich (Switzerland); Dizendorf, E. [University Hospital Zurich, Division of Nuclear Medicine, Zurich (Switzerland); International Tomography Center, Novosibirsk (Russian Federation)

    2005-02-01

    Gastrointestinal stromal tumours (GIST) are mesenchymal neoplasms of the gastrointestinal tract that are unresponsive to standard sarcoma chemotherapy. Imaging of GIST patients is done with structural and functional methods such as contrast-enhanced helical computed tomography (ceCT) and positron emission tomography (PET) with {sup 18}F-fluorodeoxyglucose (FDG). The aim of this study was to compare the prognostic power of PET and ceCT and to evaluate the clinical role of PET/CT imaging. All patients with GIST undergoing PET or PET/CT examinations were prospectively included in this study, and the median overall survival, time to progression and treatment duration were documented. The prognostic significance of PET and ceCT criteria of treatment response was assessed and PET/CT was compared with PET and ceCT imaging. Data for 34 patients (19 male, 15 female, 21-76 years) undergoing PET or PET/CT for staging or restaging were analysed. In 28 patients, PET/CT and ceCT were available after introduction of treatment with the tyrosine kinase inhibitor imatinib mesylate (Gleevec; Novartis, Basel, Switzerland). Patients without FDG uptake after the start of treatment had a better prognosis than patients with residual activity. In contrast, ceCT criteria provided insufficient prognostic power. However, more lesions were found on ceCT images than on PET images, and FDG uptake was sometimes very variable. PET/CT delineated active lesions better than did the combination of PET and ceCT imaging. Both PET and PET/CT provide important prognostic information and have an impact on clinical decision-making in GIST patients. PET/CT precisely delineates lesions and thus allows for the correct planning of surgical interventions. (orig.)

  5. PET-CT in the evaluation of sarcomas of soft tissues; PET-CT en la evaluacion de sarcomas de tejidos blandos

    Energy Technology Data Exchange (ETDEWEB)

    Serna M, J.A.; Quiroz C, O.; Sanchez C, N.; Diaz V, G. [Hospital Angeles del Pedregal, Mexico D.F. (Mexico)

    2007-07-01

    {sup 18} F-FDG PET-CT is an image modality of great utility in the evaluation of primary or recurrent lesions of soft tissues. It is necessary to determine the cost-benefit of the different image modalities, although one waits that by means of a better diagnostic, statification and the determination of the grade of malignancy, the PET-CT nowadays can reduce the cost and the complications of the invasive diagnostic methods. (Author)

  6. 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.)

  7. Radiological control of a microPET/CT laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Sarmento, Daniele M.; Sanches, Matias P.; Carneiro, Janete C.G.G., E-mail: dms.danica@gmail.com.br, E-mail: msanches@ipen.br, E-mail: janetgc@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    This paper presents the radiological control of a research laboratory in order to satisfy national standards and international recommendations. The microPET/CT laboratory in IPEN uses an Albira system for research purposes in small animals. This study focuses mainly to carry out an initial radiological evaluation and the exposure situation related with the task. The assessment of workplace conditions and individual exposures constitutes as integral part of the operational monitoring programme. Initially, the radiometric survey in laboratory has been carried out using an ionization chamber Radcal 9010 (10 x 5 - 1800). In addition, nine monitoring points with potential exposure were selected, where thermoluminescent dosimeters, TLDs, of CaSO{sub 4}:Dy, were positioned. The occupationally exposed workers were monthly evaluated for external exposures using TL dosimeters, worn on the surface of the body. For internal exposure, the evaluated period was approximately one year starting on April 2014. The average effective dose of the occupationally exposed workers did not exceed 2.4 mSv in the year of 2014, which is equal to the recording level. The workplace, microPET/CT laboratory, is classified as supervised area and the monitoring results in the evaluated period, are within the dose limits established by national standard, as well as the values obtained in individual control. (author)

  8. 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;

    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 FDG...... 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....

  9. Influence of androgen deprivation therapy on choline PET/CT in recurrent prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dost, Rutger J.; Breeuwsma, Anthonius J.; Jong, Igle J. de [University of Groningen, University Medical Center Groningen, Department of Urology, Groningen (Netherlands); Glaudemans, Andor W.J.M. [University of Groningen, University Medical Center Groningen, Nuclear Medicine and Molecular Imaging, Groningen (Netherlands)

    2013-07-15

    Recurrent prostate cancer is usually treated by combining radiotherapy and androgen deprivation therapy. To stage the cancer, choline positron emission tomography (PET)/CT can be performed. It is generally thought that androgen deprivation therapy does not influence choline PET/CT. In this article we focus on the molecular backgrounds of choline and androgens, and the results of preclinical and clinical studies performed using PET/CT. Using PubMed, we looked for the relevant articles about androgen deprivation therapy and choline PET/CT. During ADT, a tendency of decreased uptake of choline in prostate cancer was observed, in particular in hormone-naive patients. We conclude that in order to prevent false-negative choline PET/CT scans androgen deprivation should be withheld prior to scanning, especially in hormone-naive patients. (orig.)

  10. Influence of androgen deprivation therapy on choline PET/CT in recurrent prostate cancer

    International Nuclear Information System (INIS)

    Recurrent prostate cancer is usually treated by combining radiotherapy and androgen deprivation therapy. To stage the cancer, choline positron emission tomography (PET)/CT can be performed. It is generally thought that androgen deprivation therapy does not influence choline PET/CT. In this article we focus on the molecular backgrounds of choline and androgens, and the results of preclinical and clinical studies performed using PET/CT. Using PubMed, we looked for the relevant articles about androgen deprivation therapy and choline PET/CT. During ADT, a tendency of decreased uptake of choline in prostate cancer was observed, in particular in hormone-naive patients. We conclude that in order to prevent false-negative choline PET/CT scans androgen deprivation should be withheld prior to scanning, especially in hormone-naive patients. (orig.)

  11. PET/CT may change diagnosis and treatment in cancer patients

    DEFF Research Database (Denmark)

    Petersen, Henrik; Nielsen, Mie Jung; Høilund-Carlsen, Mette;

    2010-01-01

    diagnosis in 16% and induced a change in staging and treatment plan in 28% to 32% of cases, respectively. CONCLUSION: FDG PET/CT was mainly used for diagnosis in lung cancer and in cases with an unknown primary tumour, and for response evaluation in lymphomas and colorectal cancer. PET/CT caused a change......INTRODUCTION: The national focus on cancer has propelled the use of PET/CT for cancer imaging in Denmark. We believe that first-year experiences from a large PET centre may be of interest to new users. MATERIAL AND METHODS: Data from all scans made in the period from February 28 2006 to March 1...... 2007 with a single PET/CT scanner and 18F-fluoro-deoxyglucose (FDG) were collected prospectively along with information on action diagnosis, study purpose, etc. Referring departments indicated if PET/CT had changed or confirmed diagnosis, staging and treatment plan. RESULTS: A total of 970 scans were...

  12. PET/CT in the diagnosis of inflammatory bowel disease in pediatric patients

    DEFF Research Database (Denmark)

    Malham, Mikkel; Hess, Søren; Nielsen, Rasmus G;

    2014-01-01

    is a versatile method with a diagnostic high sensitivity ranging from 70% to 97%. In conclusion, the pediatric literature on FGD-PET/CT's role in the diagnosis of IBD is very limited. Prospective studies of well characterized populations are needed in order to validate this novel imaging modality in pediatric......The literature on positron emission tomography and computed tomography using (18)fluoro-deoxyglusose (FDG-PET/CT) in the diagnosis of pediatric inflammatory bowel disease (IBD) is presented. Only five papers representing independent studies were identified and included in this review. Of these, two...... studies dealt with both stand-alone FDG-PET and FDG-PET/CT, while three were about stand-alone FDG-PET only. No studies could be found that focused on FDG-PET/CT only. The five studies comprised analysis of a total 181 pediatric patients (0-18 years of age). They unanimously indicated that FDG-PET/CT...

  13. Performance evaluation of the Ingenuity TF PET/CT scanner with a focus on high count-rate conditions

    Science.gov (United States)

    Kolthammer, Jeffrey A.; Su, Kuan-Hao; Grover, Anu; Narayanan, Manoj; Jordan, David W.; Muzic, Raymond F.

    2014-07-01

    This study evaluated the positron emission tomography (PET) imaging performance of the Ingenuity TF 128 PET/computed tomography (CT) scanner which has a PET component that was designed to support a wider radioactivity range than is possible with those of Gemini TF PET/CT and Ingenuity TF PET/MR. Spatial resolution, sensitivity, count rate characteristics and image quality were evaluated according to the NEMA NU 2-2007 standard and ACR phantom accreditation procedures; these were supplemented by additional measurements intended to characterize the system under conditions that would be encountered during quantitative cardiac imaging with 82Rb. Image quality was evaluated using a hot spheres phantom, and various contrast recovery and noise measurements were made from replicated images. Timing and energy resolution, dead time, and the linearity of the image activity concentration, were all measured over a wide range of count rates. Spatial resolution (4.8-5.1 mm FWHM), sensitivity (7.3 cps kBq-1), peak noise-equivalent count rate (124 kcps), and peak trues rate (365 kcps) were similar to those of the Gemini TF PET/CT. Contrast recovery was higher with a 2 mm, body-detail reconstruction than with a 4 mm, body reconstruction, although the precision was reduced. The noise equivalent count rate peak was broad (within 10% of peak from 241-609 MBq). The activity measured in phantom images was within 10% of the true activity for count rates up to those observed in 82Rb cardiac PET studies.

  14. {sup 18}F-FDG PET/CT quantification in head and neck squamous cell cancer: principles, technical issues and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Manca, Gianpiero; Volterrani, Duccio [University Hospital of Pisa, Regional Center of Nuclear Medicine, Pisa (Italy); Vanzi, Eleonora [University Hospital of Siena, Service of Medical Physics, Siena (Italy); Rubello, Domenico; Grassetto, Gaia [Santa Maria della Misericordia Rovigo Hospital, Department of Nuclear Medicine, Rovigo (Italy); Giammarile, Francesco [Faculte Charles Merieux, Medecine Nucleaire, Centre Hospitalier and Biophysique, Lyon (France); Wong, Ka Kit [University of Michigan Hospital, Nuclear Medicine/Radiology Department, Ann Arbor, MI (United States); Nuclear Medicine Service, Department of Veterans Affairs Health System, Ann Arbor, MI (United States); Perkins, Alan C. [University of Nottingham, Department of Radiological Sciences, School of Medicine, Nottingham (United Kingdom); Colletti, Patrick M. [Southern University of California, Department of Radiology, Los Angeles, CA (United States)

    2016-07-15

    {sup 18}F-FDG PET/CT plays a crucial role in the diagnosis and management of patients with head and neck squamous cell cancer (HNSCC). The major clinical applications of this method include diagnosing an unknown primary tumour, identifying regional lymph node involvement and distant metastases, and providing prognostic information. {sup 18}F-FDG PET/CT is also used for precise delineation of the tumour volume for radiation therapy planning and dose painting, and for treatment response monitoring, by detecting residual or recurrent disease. Most of these applications would benefit from a quantitative approach to the disease, but the quantitative capability of {sup 18}F-FDG PET/CT is still underused in HNSCC. Innovations in PET/CT technology promise to overcome the issues that until now have hindered the employment of dynamic procedures in clinical practice and have limited ''quantification'' to the evaluation of standardized uptake values (SUV), de facto a semiquantitative parameter, the limits of which are well known to the nuclear medicine community. In this paper the principles of quantitative imaging and the related technical issues are reviewed so that professionals involved in HNSCC management can reflect on the advantages of ''true'' quantification. A discussion is then presented on how semiquantitative information is currently used in clinical {sup 18}F-FDG PET/CT applications in HNSCC, by discussing the improvements that could be obtained with more advanced and ''personalized'' quantification techniques. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-08-15

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

  16. 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

  17. Whole-body imaging of oncologic patients using 16-channel PET-CT. Evaluation of an IV contrast enhanced MDCT protocol

    International Nuclear Information System (INIS)

    Aim: this study evaluated a MDCT protocol for contrast-enhanced 16-channel PET-CT with regard to scan range and duration of a whole-body 18F-FDG PET-CT examination, the occurrence of contrast-material induced artefacts and quantitative assessment of CT attenuation. Patients, methods: 205 patients (51.9 ± 12.4 years) with different malignant tumours underwent whole-body PET-CT; the study protocol had been approved by the institutional review board. Contrast-enhanced MDCT (16 x 1.5 mm; 120 ml lomeprol 3 ml/s, 50 ml saline chaser bolus, scan delay 70 s; oral contrast) was also used for attenuation correction. From MDCT data mean scan range and duration, occurrence of contrast media-induced artefacts, and mean CT densities of jugular (jv) and subclavian (scv), superior (vcs) and inferior (vci) caval, portal (pv), and bilateral external iliac veins, pulmonary (ap) and iliac arteries, descending thoracic and abdominal aorta, all cardiac chambers, as well as both liver lobes, spleen, adrenal glands and kidneys were determined. Results: attenuation corrected PET images were free of contrast media-related image artefacts. Homogeneous contrast enhancement was found in the mediastinal veins (right/left jv 171 ± 34/171 ± 35, scv 127 ± 50/127 ± 40, vcs 153 ± 36 HU) and arteries (e.g. ap 145 ± 26/151 ± 26). Cardiac chambers, abdominal vessels (e.g. vci 138 ± 24, pv 159 ± 25 HU), and parenchymal organs revealed sufficient and homogenous contrast-enhancement in all cases. No beam-hardening artefacts occurred in the neighbourhood of the subclavian veins. Conclusion: the chosen whole-body 18F-FDG 16 slice PET-CT protocol allowed for craniocaudal CT scanning with high vessel and parenchymal contrast revealing no IV contrast-media induced artefacts in attenuation-corrected PET data sets. (orig.)

  18. Parametric imaging of myocardial viability using {sup 15}O-labelled water and PET/CT: comparison with late gadolinium-enhanced CMR

    Energy Technology Data Exchange (ETDEWEB)

    Haan, Stefan de; Allaart, Cornelis P.; Danad, Ibrahim; Rossum, Albert C. van; Knaapen, Paul [VU University Medical Center, Department of Cardiology, Amsterdam (Netherlands); VU University Medical Center, Institute for Cardiovascular Research (ICaR-VU), Amsterdam (Netherlands); Harms, Hendrik J.; Lubberink, Mark; Lammertsma, Adriaan A. [VU University Medical Center, Department of Nuclear Medicine and PET Research, Amsterdam (Netherlands); VU University Medical Center, Institute for Cardiovascular Research (ICaR-VU), Amsterdam (Netherlands); Chen, Weena J.Y.; Diamant, Michaela [Diabetes Center, Department of Internal Medicine, Amsterdam (Netherlands); VU University Medical Center, Institute for Cardiovascular Research (ICaR-VU), Amsterdam (Netherlands); Iida, Hidehiro [National Cerebral and Cardiovascular Center Research Institute, Department of Investigative Radiology, Osaka (Japan)

    2012-08-15

    The perfusable tissue index (PTI) is a marker of myocardial viability. Recent technological advances have made it possible to generate parametric PTI images from a single [{sup 15}O]H{sub 2}O PET/CT scan. The purpose of this study was to validate these parametric PTI images. The study population comprised 46 patients with documented or suspected coronary artery disease who were studied with [{sup 15}O]H{sub 2}O PET and late gadolinium-enhanced (LGE) cardiac magnetic resonance imaging (CMR). Of the 736 myocardial segments included, 364 showed some degree of LGE. PTI and perfusable tissue fraction (PTF) diminished with increasing LGE. The areas under the curve of the PTI and PTF, used to predict (near) transmural LGE on CMR, were 0.86 and 0.87, respectively. Optimal sensitivity and specificity were 91 % and 73 % for PTI and 69 % and 87 % for PTF, respectively. PTI and PTF assessed with a single [{sup 15}O]H{sub 2}O scan can be utilized as markers of myocardial viability in patients with coronary artery disease. (orig.)

  19. Human cytomegalovirus and Epstein-Barr virus infection impact on {sup 18}F-FDG PET/CT SUVmax, CT volumetric and KRAS-based parameters of patients with locally advanced rectal cancer treated with neoadjuvant therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sole, Claudio V. [Instituto de Radiomedicina, Department of Radiation Oncology, Santiago (Chile); School of Medicine Complutense University, Madrid (Spain); Calvo, Felipe A. [Hospital General Universitario Gregorio Maranon, Department of Oncology, Madrid (Spain); School of Medicine Complutense University, Madrid (Spain); Hospital General Universitario Gregorio Maranon, Institute for Sanitary Research, Madrid (Spain); Ferrer, Carlos [Hospital Provincial de Castellon, Institute of Oncology, Castellon de la Plana (Spain); School of Medicine Cardenal Herrera-CEU University, Castellon de la Plana (Spain); Alvarez, Emilio [School of Medicine Complutense University, Madrid (Spain); Hospital General Universitario Gregorio Maranon, Department of Pathology, Madrid (Spain); Hospital General Universitario Gregorio Maranon, Institute for Sanitary Research, Madrid (Spain); Carreras, Jose L. [School of Medicine Complutense University, Madrid (Spain); Hospital General Universitario Gregorio Maranon, Department of Radiology and Medical Physics, Madrid (Spain); Ochoa, Enrique [Hospital Provincial de Castellon, Institute of Oncology, Castellon de la Plana (Spain)

    2014-10-01

    It has long been debated whether human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) are associated with rectal cancer. The gene products of HCMV and EBV contribute to cell-cycle progression, mutagenesis, angiogenesis and immune evasion. The aim of this prospective study was to analyse the association between infection of a tumour by HCMV and EBV and clinical, histological, metabolic ({sup 18}F-FDG uptake), volumetric (from CT) and molecular (KRAS status) features and long-term outcomes in a homogeneously treated group of patients with locally advanced rectal cancer. HCMV and EBV were detected in pretreatment biopsies using polymerase chain reaction (PCR). The Cox proportional hazards regression model was used to explore associations between viral infection and disease-free survival (DFS) and overall survival (OS). We analysed 37 patients with a median follow-up of 74 months (range 5-173 months). Locoregional control, OS and DFS at 5 years were 93 %, 74 % and 71 %, respectively. Patients with HCMV/EBV coinfection had a significantly higher maximum standardized uptake value than patients without viral coinfection (p = 0.02). Significant differences were also observed in staging and percentage relative reduction in tumour volume between patients with and without HCMV infection (p < 0.01) and EBV infection (p < 0.01). KRAS wildtype status was significantly more frequently observed in patients with EBV infection (p <0.01) and HCMV/EBV co-infection (p = 0.04). No significant differences were observed in OS or DFS between patients with and without EBV infection (p = 0.88 and 0.73), HCMV infection (p = 0.84 and 0.79), and EBV/CMV coinfection (p = 0.24 and 0.39). This pilot study showed that viral infections were associated with metabolic staging differences, and differences in the evolution of metabolic and volumetric parameters and KRAS mutations. Further findings of specific features will help determine the best candidates for metabolic and volumetric staging and

  20. Deep-inspiration breath-hold PET/CT versus free breathing PET/CT and respiratory gating PET for reference. Evaluation in 95 patients with lung cancer

    International Nuclear Information System (INIS)

    The objective of this study was to define the factors that correlate with differences in maximum standardized uptake value (SUVmax) in deep-inspiration breath-hold (DIBH) and free breathing (FB) positron emission tomography (PET)/CT admixed with respiratory gating (RG) PET for reference. Patients (n=95) with pulmonary lesions were evaluated at one facility over 33 months. After undergoing whole-body PET/CT, a RG PET and FB PET/CT scans were obtained, followed by a DIBH PET/CT scan. All scans were recorded using a list-mode dynamic collection method with respiratory gating. The RG PET was reconstructed using phase gating without attenuation correction; the FB PET was reconstructed from the RG PET sinogram datasets with attenuation correction. Respiratory motion distance, breathing cycle speed, and waveform of RG PET were recorded. The SUVmax of FB PET/CT and DIBH PET/CT were recorded: the percent difference in SUVmax between the FB and DIBH scans was defined as the %BH-index. The %BH-index was significantly higher for lesions in the lower lung area than in the upper lung area. Respiratory motion distance was significantly higher in the lower lung area than in the upper lung area. A significant relationship was observed between the %BH-index and respiratory motion distance. Waveforms without steady end-expiration tended to show a high %BH-index. Significant inverse relationships were observed between %BH-index and cycle speed, and between respiratory motion distance and cycle speed. Decrease in SUVmax of FB PET/CT was due to tumor size, distribution of lower lung, long respiratory movement at slow breathing cycle speeds, and respiratory waveforms without steady end-expiration. (author)

  1. Metastatic Breast Lesion to the Falx Detected with PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Harrison, Chester; Schuster, David M. [Emory Univ., Atlanta (United States)

    2012-06-15

    Intracranial dural metastasis is increasingly encountered in imaging. Autopsies conducted on patients with advanced metastatic disease demonstrate dural involvement in 9% of cases, with breast and prostate cancer the most common primaries. Awareness of this entity and imaging appearances is especially important in evaluating malignancies prone to dural metastasis. A 57-year-old woman with a strong family history of breast cancer initially presented after self-detection of a right breast lump. Subsequent mammogram and biopsies yielded a diagnosis of right infiltrating ductal carcinoma with a positive lymph node as well as left invasive lobular carcinoma. Initial staging PET-CT (not shown) at the time of diagnosis demonstrated no abnormal FDG uptake remote from the breast. Neoadjuvant chemotherapy was instituted, and a PET-CT was obtained to evaluate disease response, demonstrating an approximately 1.8 cm hypermetabolic intra-cranial mass, localized to the region of the anterior corpus callosum on axian PET (Fig. 1a), axial fused PET-CT (Fig. 1b), and sagittal fused PET-CT (Fig. 1c) with a maximum SUV of 15.9. There was associated bifrontal vasogenic edema (Fig. 1d) on the CT demonstrated on brain windows. Marked progression of disease was noted elsewhere, including hypermetabolic adenopathy and skeletal disease. A contrast-enhanced MRI of the brain was obtained demonstrating extensive T1 hypointensity, T2, and FLAIR (Fig. 2a) hyperintensity in the bilateral paramedian frontallobes representing vasogenic edema. Post-contrast imaging demonstrated three solidly enhancing masses in the areas of described vasogenic edema, one large extra-axial and two sub-centimeter parenchymal lesions. The large extra-axial and two sub-centimeter parenchymal lesions. The large extra-axial mass demonstrated homogeneous solid enhancement, in the midline anteriorly centered on the falx, just superior to the anterior corpus callosum. This measured 1.7cm transverse x 3.1cm AP x 2.4cm

  2. Molecular Imaging with Small Animal PET/CT

    DEFF Research Database (Denmark)

    Binderup, T.; El-Ali, H.H.; Skovgaard, D.;

    2011-01-01

    Small animal positron emission tomography (PET) and computer tomography (CT) is an emerging field in pre-clinical imaging. High quality, state-of-the-art instruments are required for full optimization of the translational value of the small animal studies with PET and CT. However, with this achie...... small animal PET/CT for studies of muscle and tendon in exercise models. © 2011 Bentham Science Publishers Ltd.......Small animal positron emission tomography (PET) and computer tomography (CT) is an emerging field in pre-clinical imaging. High quality, state-of-the-art instruments are required for full optimization of the translational value of the small animal studies with PET and CT. However, with this...... this field of small animal molecular imaging with special emphasis on the targets for tissue characterization in tumor biology such as hypoxia, proliferation and cancer specific over-expression of receptors. The added value of applying CT imaging for anatomical localization and tumor volume...

  3. 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.)

  4. Applications of PET CT in clinical practice: Present and future

    Science.gov (United States)

    Costa, Durval Campos

    2007-02-01

    Radionuclide imaging and specially positron emission tomography (PET) has already demonstrated its benefits in three major medical subjects, i.e. neurology, cardiology and particularly clinical oncology. More recently the combination of PET and X-ray computed tomography (CT) as PET-CT led to a significant increment of the already large number of clinical applications of this imaging modality. This "anatomy-metabolic fusion" also known as Metabolic Imaging has its future assured if we can: (1) improve resolution reducing partial volume effect, (2) achieve very fast whole body imaging, (3) obtain accurate quantification of specific functions with higher contrast resolution and, if possible, (4) reduce exposure rates due to the unavoidable use of ionizing radiation.

  5. 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.)

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

    International Nuclear Information System (INIS)

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

  7. (18F) FDG PET/CT in patients with fever of unknown origin: AIIMS experience

    International Nuclear Information System (INIS)

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

  8. Gallium-68 EDTA PET/CT for Renal Imaging.

    Science.gov (United States)

    Hofman, Michael S; Hicks, Rodney J

    2016-09-01

    Nuclear medicine renal imaging provides important functional data to assist in the diagnosis and management of patients with a variety of renal disorders. Physiologically stable metal chelates like ethylenediaminetetraacetic acid (EDTA) and diethylenetriamine penta-acetate (DTPA) are excreted by glomerular filtration and have been radiolabelled with a variety of isotopes for imaging glomerular filtration and quantitative assessment of glomerular filtration rate. Gallium-68 ((68)Ga) EDTA PET usage predates Technetium-99m ((99m)Tc) renal imaging, but virtually disappeared with the widespread adoption of gamma camera technology that was not optimal for imaging positron decay. There is now a reemergence of interest in (68)Ga owing to the greater availability of PET technology and use of (68)Ga to label other radiotracers. (68)Ga EDTA can be used a substitute for (99m)Tc DTPA for wide variety of clinical indications. A key advantage of PET for renal imaging over conventional scintigraphy is 3-dimensional dynamic imaging, which is particularly helpful in patients with complex anatomy in whom planar imaging may be nondiagnostic or difficult to interpret owing to overlying structures containing radioactive urine that cannot be differentiated. Other advantages include accurate and absolute (rather than relative) camera-based quantification, superior spatial and temporal resolution and integrated multislice CT providing anatomical correlation. Furthermore, the (68)Ga generator enables on-demand production at low cost, with no additional patient radiation exposure compared with conventional scintigraphy. Over the past decade, we have employed (68)Ga EDTA PET/CT primarily to answer difficult clinical questions in patients in whom other modalities have failed, particularly when it was envisaged that dynamic 3D imaging would be of assistance. We have also used it as a substitute for (99m)Tc DTPA if unavailable owing to supply issues, and have additionally examined the role of

  9. Recent trends in Molecular Imaging : PET/CT in Neurology

    Directory of Open Access Journals (Sweden)

    R P Tripathi

    2015-06-01

    Full Text Available PET/CT is an important molecular imaging technique for the assessment ofneurological disorders. The most widely used radiopharmaceutical for both clinical and research purposes is [18F] 2-fluoro-2-deoxy-D-glucose (FDG. It is extensively used owing to its favourable physical characteristics. It enables depiction of cerebral glucose metabolism, and has thus been used to study various pathological states. Despite this, FDG has its own limitations. This is owing to its limited specificity and high cortical uptake. This has paved the way for the development of several non-FDG PET radiopharmaceuticals. We present the insights gained at our institution, using these radiotracers in the assessment of neurological disease. Our study shows that the use of FDG and non-FDG novel PET radiopharmaceuticals facilitates the early diagnosis, delineation of extent, prognostication and monitoring of therapeutic response in several neuropathological states.PET/CT is an important molecular imaging technique for the assessment ofneurological disorders. The most widely used radiopharmaceutical for both clinicaland research purposes is [18F] 2-fluoro-2-deoxy-D-glucose (FDG. It is extensivelyused owing to its favourable physical characteristics. It enables depiction of cerebralglucose metabolism, and has thus been used to study various pathological states.Despite this, FDG has its own limitations. This is owing to its limited specificity andhigh cortical uptake. This has paved the way for the development of several non-FDGPET radiopharmaceuticals. We present the insights gained at our institution, usingthese radiotracers in the assessment of neurological disease. Our study shows that theuse of FDG and non-FDG novel PET radiopharmaceuticals facilitates the earlydiagnosis, delineation of extent, prognostication and monitoring of therapeuticresponse in several neuropathological states.

  10. Prognostic Significance of 2-Deoxy-2-[18F]-Fluoro-D-Glucose PET/CT in Patients With Locally Advanced Esophageal Cancer Undergoing Neoadjuvant Chemoradiotherapy Before Surgery: A Nonparametric Approach.

    Science.gov (United States)

    Giorgetti, Assuero; Pallabazzer, Giovanni; Ripoli, Andrea; Solito, Biagio; Genovesi, Dario; Lencioni, Monica; Fabrini, Maria Grazia; D'Imporzano, Simone; Pieraccini, Laura; Marzullo, Paolo; Santi, Stefano

    2016-03-01

    To investigate the prognostic value of tumor metabolism measurements on serial 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography and computed tomography scans in patients with locally advanced esophageal cancer undergoing neoadjuvant chemoradiotherapy. Forty-five patients (63 ± 7 years, 6 female) treated with concomitant chemoradiotherapy before surgery were followed up for 24 ± 18 months (range 4-71). Positron emission tomography and computed tomography scans were obtained within 1 week before the start (PET1) and 1 month after the completion of the treatment (PET2). Total body tumor metabolic activity was measured as the sum of the parameters: SUVmax, SUV corrected for lean body mass, and total lesion glycolysis (TLG40/50/70%). Then, delta values for the parameters between PET1 and PET2 were calculated and expressed as percentage of PET1 results. At the time of the analysis, 27 patients were dead and 18 were alive. There was no difference between the 2 groups in terms of age, sex, site of the disease, histology, and the presence/absence of linfonodal metastases (P = NS). Survival random forest analysis (20,000 trees) resulted in an estimate of error rate of 36%. The nonparametric approach identified ΔTLG40 as the most predictive factor of survival (relative importance 100%). Moreover, T (17%), N (5%), and M (5%) stage of the disease, cancer histology (11%), TLG70 (5%) at the end of chemioradioterapy, and ΔTLG(50-70) (17%-5%) were positively associated with patient outcome. The nonparametric analysis confirmed the prognostic importance of some clinical parameters, such as TNM stage and cancer histology. Moreover, ΔTLG resulted to be the most important factor in predicting outcome and should be considered in risk stratification of patients treated with neoadjuvant chemoradiotherapy. PMID:27043676

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

    Energy Technology Data Exchange (ETDEWEB)

    Apostolova, I.; Steffen, I.G. [Charite University Medical Center, Department of Nuclear Medicine, Berlin (Germany); Otto-von-Guericke University, Department of Radiology and Nuclear Medicine, Magdeburg (Germany); Hofheinz, F. [Helmholtz-Center Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden (Germany); Buchert, R.; Michel, R.; Rosner, C.; Prasad, V.; Brenner, W. [Charite University Medical Center, Department of Nuclear Medicine, Berlin (Germany); Koehler, C. [Charite University Medical Center, Department of Gynaecology, Berlin (Germany); Derlin, T. [University Medical Center Hamburg-Eppendorf, Department of Radiology, Hamburg (Germany); Marnitz, S. [Charite University Medical Center, Department of Radiooncology, Berlin (Germany)

    2014-06-15

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

  12. Use of PET/CT for staging and radiation therapy planning in patients with non-small cell lung cancer.

    Science.gov (United States)

    Mac Manus, M P

    2010-10-01

    Positron emission tomography (PET) and more recently PET/computed tomography (CT) scanning represent major advances in the imaging of lung cancer and have an especially high impact on the management of patients who are candidates for potentially curative or "radical" radiotherapy (RT). This article reviews the current status of PET and PET/CT for staging patients before RT and considers the use of PET and PET/CT images for target volume definition. The relevant literature on the use of PET for staging lung cancer is reviewed and placed in the context of patients who are candidates for RT. Research that specifically considers the use of PET for RT planning is considered critically and some promising areas for future research are discussed. The available literature is almost exclusively devoted to non small cell lung cancer (NSCLC) with few relevant studies of small cell lung cancer (SCLC). The primary PET radiopharmaceutical shown to have value for staging and RT planning is 18F-fluorodeoxyglucose (FDG). In prospective studies where PET imaging was used to stage radical RT candidates, 25-30% of patients were excluded from radical therapy because of PET detected advanced disease. In all studies where "PET-assisted" and conventional target or treatment volumes were compared, there were major differences between PET and conventional volumes. Because PET-assisted staging is proven to be significantly more accurate than conventional staging and because all studies show major differences between PET-assisted and conventional treatment volumes in NSCLC, routine use of PET/CT for RT planning is recommended.

  13. 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.

  14. Influence of Arm Movement on Lesion Detection in PET/CT Imaging: Case Report

    Directory of Open Access Journals (Sweden)

    Yasemin Parlak

    2015-06-01

    Full Text Available Arm movement after the CT scan is a common artifact in PET/CT scanning. Motion artifacts may lead to difficulties in interpreting PET/CT images accurately. We report a 66 year old male patient with gastric cancer who underwent PET/CT for primary staging. He had a previous history of papillary thyroid cancer. In PET scan, there were striking cold artifacts at the level of arms. This is a classical sign of an accidental arm motion. A second scan was performed with the arms down due to the history of papillary thyroid cancer. The results were discussed.

  15. Influence of Arm Movement on Lesion Detection in PET/CT Imaging: Case Report

    OpenAIRE

    Yasemin Parlak; Gozde Mutevelizade; Gul Gumuser

    2015-01-01

    Arm movement after the CT scan is a common artifact in PET/CT scanning. Motion artifacts may lead to difficulties in interpreting PET/CT images accurately. We report a 66 year old male patient with gastric cancer who underwent PET/CT for primary staging. He had a previous history of papillary thyroid cancer. In PET scan, there were striking cold artifacts at the level of arms. This is a classical sign of an accidental arm motion. A second scan was performed with the arms down due to ...

  16. Schwannoma Showing Avid Uptake on 68Ga-PSMA-HBED-CC PET/CT.

    Science.gov (United States)

    Kanthan, Gowri L; Izard, Michael A; Emmett, Louise; Hsiao, Edward; Schembri, Geoffrey Paul

    2016-09-01

    Ga prostate-specific membrane antigen (PSMA) PET/CT is a relatively new and highly sensitive imaging modality used in staging metastatic prostate cancer. We report a case of a 65-year-old man with newly diagnosed prostate carcinoma who had a PSMA PET/CT scan for staging of his disease. A PSMA-avid right pelvic mass was identified anterior to the sacrum. Surgical removal and histopathological examination of this lesion revealed the diagnosis of schwannoma. It is important to be aware that schwannoma may also show avid uptake on PSMA PET/CT scan and may potentially lead to an incorrect diagnosis of metastatic prostate carcinoma. PMID:27405039

  17. Established, emerging and future roles of PET/CT in the management of colorectal cancer

    International Nuclear Information System (INIS)

    Positron-emission tomography-computed tomography (PET/CT) is rapidly being integrated into the imaging pathways of several different tumour types, most frequently using the glucose analogue 2- [18F]-fluoro-2-deoxy-D-glucose (FDG). Integrated FDG-PET/CT combines functional and anatomical imaging to improve sensitivity and specificity of tumour detection. The aim of this article is to review the established, emerging, and future roles of FDG-PET/CT in the management of patients with colorectal cancer (CRC)

  18. Pulmonary langerhans cell histiocytosis: PET/CT for initial workup and treatment response evaluation.

    Science.gov (United States)

    Hansen, Neil J; Hankins, Jordan H

    2015-02-01

    A 40-year-old man underwent pan-endoscopy owing to abdominal pain. Biopsies of the gastrointestinal tract demonstrated diffuse Langerhans cell histiocytosis. PET/CT was done, with CT demonstrating classic pulmonary manifestations of Langerhans cell histiocytosis that had association with intense FDG uptake on PET. Bowel appeared normal. Treatment was initiated with smoking cessation and 6 cycles of cytarabine. Follow-up PET/CT after initial treatment demonstrated improvement of parenchymal abnormalities seen on CT, with resolution of hypermetabolic activity. Maintenance chemotherapy was initiated. PET/CT is increasingly being used for initial staging and treatment response assessment in this rare disorder. PMID:24999688

  19. The role of PET/CT in detection of gastric cancer recurrence

    Directory of Open Access Journals (Sweden)

    Kang Won

    2009-03-01

    Full Text Available Abstract Background In the course of surveillance of gastric cancer recurrence after curative resection, contrast CT scan is used in general. However, new findings from CT scan are not always confirmatory for the recurrence. In this case, we usually use short-term follow up strategy or therapeutic intervention with clinical decision. Recently, the use of fusion Positron Emission Tomography/Computed Tomography (PET/CT is increasing. The purpose of this study is to evaluate the efficacy and usefulness of PET/CT for detecting recurrence of gastric cancer after curative resection. Methods Fifty two patients who received curative resection of gastric cancer and had undergone PET/CT and contrast CT for surveillance of recurrence until Dec 2006 in Seoul National University Hospital were analyzed retrospectively. Recurrence of gastric cancer was validated by histologic confirmation (n = 17 or serial contrast CT follow up with at least 5 month interval (n = 35. McNemar's test and Fisher's exact test were used to evaluate sensitivity and specificity of PET/CT and contrast CT. Results Of 52 patients, 38 patients were confirmed as recurrence. The sensitivity was 68.4% (26/38 for PET/CT and 89.4% (34/38 for contrast CT (p = 0.057. The specificity was 71.4% (10/14 and 64.2% (9/14, respectively (p = 1.0. In terms of the recurred sites, the sensitivity and specificity of PET/CT were similar to those of contrast CT in all sites except peritoneum. Contrast CT was more sensitive than PET/CT (p = 0.039 for detecting peritoneal seeding. Additional PET/CT on contrast CT showed no further increase of positive predictive value regardless of sites. Among 13 patients whose image findings between two methods were discordant and tissue confirmation was difficult, the treatment decision was made in 7 patients based on PET/CT, showing the final diagnostic accuracy of 42.8% (3/7. Conclusion PET/CT was as sensitive and specific as contrast CT in detection of recurred gastric

  20. 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

  1. Performance Evaluation of a Small-Animal PET/CT System

    OpenAIRE

    Dahle, Tordis Johnsen

    2014-01-01

    This master project is the first vendor-independent performance evaluation of the new nanoScan PET/CT system at the University of Bergen. A comprehensive performance evaluation of a novel scanner is very important, particularly when quantitative assessments of images are required. The nanoScan PET/CT system is a fully integrated small-animal PET/CT system. An abbreviated performance evaluation of the CT subsystem was done, which included a Hounsfield quality check, a comparison of reconstr...

  2. 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.

  3. Normal SUV Values Measured from NaF18- PET/CT Bone Scan Studies

    OpenAIRE

    Aung Zaw Win; Carina Mari Aparici

    2014-01-01

    Objectives Cancer and metabolic bone diseases can alter the SUV. SUV values have never been measured from healthy skeletons in NaF18-PET/CT bone scans. The primary aim of this study was to measure the SUV values from normal skeletons in NaF18-PET/CT bone scans. Methods A retrospective study was carried out involving NaF18- PET/CT bone scans that were done at our institution between January 2010 to May 2012. Our excluding criteria was patients with abnormal real function and patients with past...

  4. Efficacy of FDG PET/CT Imaging for Venous Thromboembolic Disorders

    DEFF Research Database (Denmark)

    Hess, Søren; Madsen, Poul Henning; Iversen, Else Dalsgaard;

    2015-01-01

    VTE. PATIENTS AND METHODS: Fifteen patients with suspected deep venous thrombosis (DVT) and/or pulmonary embolism (PE) were included prospectively and underwent a whole-body FDG PET/CT. Patients were divided into 4 groups as follows: DVT+ (DVT proven by high clinical suspicion and positive compression......PURPOSE: In recent years, several case reports have described venous thromboembolism (VTE) on FDG PET/CT. In this short communication, we present results from a proof-of-concept pilot study aimed at providing some preliminary data on the efficacy of FDG PET/CT in prospective patients with suspected...

  5. SPECT-CT and PET-CT progress in the research of computer analysis method

    OpenAIRE

    Jingang Guo; Shuming Xu; Xiaoli Zhang; Hongyu Zhang

    2015-01-01

    The development of multimodal imaging equipment is milestone in the development of imaging, after the PET-CT, American GE company launched a Discovery 670 NM/CT, CT and SPECT, the organic integration of the formation of SPECT-CT new molecular medical imaging equipment, with SPECT, CT and PET-CT is getting more and more widely attention and application, many of SPECT-CT and PET-CT image analysis computer method arises at the historic moment, getting increasing attention of the clinical and ima...

  6. PET-CT for nuclear medicine diagnostics of multiple myeloma; PET-CT in der nuklearmedizinischen Diagnostik des multiplen Myeloms

    Energy Technology Data Exchange (ETDEWEB)

    Dimitrakopoulou-Strauss, A. [Deutsches Krebsforschungszentrum (DKFZ), Klinische Kooperationseinheit Nuklearmedizin, Heidelberg (Germany)

    2014-06-15

    Functional or morphofunctional imaging modalities are used in myeloma patients for the diagnosis and therapy management within research protocols. Despite new staging criteria, which take into account the viability of a myeloma lesion, positron emission tomography (PET) is not used routinely. The impact of PET is therefore open. The role of PET and PET computed tomography (PET-CT) for the diagnosis and therapy management is discussed. The use of PET with 18F-fluorodeoxyglucose (FDG) allows the measurement of viable myeloma lesions and correlates with the stage of disease. A negative FDG examination correlates with a better prognosis. Furthermore, the number of focal lesions as well as the whole functional volume of myeloma lesions in FDG have a prognostic impact. Several studies have demonstrated the impact of FDG for the assessment of therapy monitoring and show that FDG is an earlier indicator for therapy response as compared to magnetic resonance imaging (MRI). The CT component of the new hybrid systems allows the assessment of osteolytic lesions in CT and their viability in FDG. The combination of PET with an MRT scanner allows the simultaneous measurement of bone marrow infiltration, focal lesions and their viability. The use of modern hybrid scanners, such as PET-CT and PET-MRT facilitates the simultaneous measurement of viable myeloma lesions, osteolytic lesions and bone marrow infiltration in the whole body; therefore, it is expected that these imaging modalities will play a greater role both in diagnosis and therapy management. (orig.) [German] Funktionelle oder morphologisch-funktionelle bildgebende Verfahren werden in der Diagnostik und im Therapiemanagement des multiplen Myeloms (MM) primaer fuer wissenschaftliche Zwecke eingesetzt. Ein routinemaessiger klinischer Einsatz ist trotz neuer Stadieneinteilung nicht erfolgt. Die Wertigkeit der Positronenemissionstomographie (PET) ist noch offen. Die Rolle von PET und PET-CT fuer die Diagnostik und das

  7. Determination of the dose in eyes lens by TLD, in PET/CT by technicians in PET/CT service

    International Nuclear Information System (INIS)

    This work was supported, on the one hand, in a part of the project ORAMED which consisted of a design of a TLD dosimeter for measurements of Hp (3) in areas close to the lens, for interventional radiology physicians. On the other hand, Berhens work proposes using calibrated TLDs Hp (0.07) and Hp (10) to estimate Hp (3) crystal. This resulted in dosimeters calibrated using Hp (10) slab, and mount them on glasses, to estimate the dose to the lens of the technical staff of the Service PET / CT. The value obtained 29mSv/year of Lens Dose Equivalent exceeds the recommended limit. We also demonstrate that, under the current working conditions, the values of Hp (3) reported from whole body dosimeter does not represent faithfully the lens dose

  8. Regional PET/CT after water gastric inflation for evaluating loco-regional disease of gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Soo Jin, E-mail: suji76@hanmail.net [Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine (Korea, Republic of); Lee, Won Woo, E-mail: wwlee@snubh.org [Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine (Korea, Republic of); Institute of Radiation Medicine, Medical Research Center, Seoul National University (Korea, Republic of); Yoon, Hai-Jeon, E-mail: punsu07@naver.com [Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine (Korea, Republic of); Lee, Ho-Young, E-mail: debobkr@gmail.com [Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine (Korea, Republic of); Lee, Kyoung Ho, E-mail: kholeemail@gmail.com [Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine (Korea, Republic of); Institute of Radiation Medicine, Medical Research Center, Seoul National University (Korea, Republic of); Kim, Young Hoon, E-mail: yhkrad@gmail.com [Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine (Korea, Republic of); Institute of Radiation Medicine, Medical Research Center, Seoul National University (Korea, Republic of); Park, Do Joong, E-mail: djpark@snubh.org [Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine (Korea, Republic of); Kim, Hyung-Ho, E-mail: hhkim@snubh.org [Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine (Korea, Republic of); So, Young, E-mail: youngso@kuh.ac.kr [Department of Nuclear Medicine, Konkuk University School of Medicine (Korea, Republic of); and others

    2013-06-15

    Objective: We aimed to improve diagnostic accuracy of {sup 18}F-fluoro-2-deoxyglucose (FDG) PET/CT for gastric cancer with water gastric inflation. Materials and methods: 44 gastric cancer patients (M:F = 30:14, age ± std = 62.1 ± 14.5y) were enrolled before surgery. Fifty minutes after injection of FDG (0.14 mCi/kg body weight), whole body PET/CT was performed first and then regional PET/CT over gastric area was obtained 80 min post FDG injection after water gastric inflation. Diagnostic accuracies for loco-regional lesions were compared between whole body and regional PET/CT. Results: 48 primary tumors (23 EGC and 25 AGC) and 348 LN stations (61 metastatic and 287 benign) in 44 patients were investigated. Primary tumor sensitivity of whole body PET/CT (50% = 24/48) was significantly improved by regional PET/CT (75% = 36/48, p < 0.005). Sensitivity of whole body PET/CT (24.6% = 15/61) for LN metastasis was also significantly improved by regional PET/CT (36.1% = 22/61, p < 0.01), whereas specificity of whole body PET/CT (99.3% = 285/287) was not compromised by regional PET/CT (98.3% = 282/287, p > 0.05). Higher primary tumor FDG uptake in regional PET/CT indicated shorter progress-free survival (p = 0.0003). Conclusion: Diagnostic accuracy of whole body PET/CT for loco-regional disease of gastric cancer could be significantly improved by regional PET/CT after water gastric inflation and prognosis could be effectively predicted by primary tumor FDG uptake in regional PET/CT.

  9. Impact of {sup 18}F-FDG PET/CT on the management of adrenocortical carcinoma: analysis of 106 patients

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Satoshi; Macapinlac, Homer A.; Chuang, Hubert H. [The University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Balachandran, Aparna [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Habra, Mouhammed Amir [The University of Texas MD Anderson Cancer Center, Department of Endocrine Neoplasia and Hormonal Disorders, Houston, TX (United States); Phan, Alexandria T. [The University of Texas MD Anderson Cancer Center, Department of Gastrointestinal Medical Oncology, Houston, TX (United States); Bassett, Roland L. [The University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States)

    2014-11-15

    Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy. Limited data are available about on value of {sup 18}F-FDG PET/CT in ACC. We evaluated the impact of PET/CT on the management of ACC. We performed a retrospective review in patients with ACC who had undergone PET/CT. The impact of PET/CT on the management plan was evaluated by comparing the findings on PET/CT to the findings on contrast-enhanced CT. The sensitivity, specificity, and accuracy of each form of imaging were calculated. The correlations between PET/CT parameters, including maximum standardized uptake value (SUV{sub max}), total lesion glycolysis, and decline in SUV{sub max} after chemotherapy, and clinical outcome were evaluated. Included in the analysis were 106 patients with 180 PET/CT scans. Of the 106 patients, 7 underwent PET/CT only for initial staging, 84 underwent PET/CT only for restaging, and 15 underwent PET/CT for both initial staging and restaging. PET/CT changed the management plan in 1 of 22 patients (5 %) at initial staging and 9 of 99 patients (9 %) at restaging. In 5 of the patients in whom PET/CT changed the management plan, PET/CT showed response to chemotherapy but contrast-enhanced CT showed stable disease. Sensitivity, specificity, and accuracy were 100 %, 100 %, and 100 % for PET/CT at initial staging; 92.6 %, 100 %, and 96.4 % for CT at initial staging; 98.4 %, 100 %, and 99.5 % for PET/CT at restaging; and 96.8 %, 98.6 %, and 98.0 % for CT at restaging, respectively. No PET/CT parameters were associated with survival at either initial diagnosis or recurrence. PET/CT findings could substantially change the management plan in a small proportion of patients with ACC. Although lesion detection was similar between PET/CT and CT, PET/CT may be preferred for chemotherapeutic response assessment because it may predict response before anatomic changes are detected on CT. (orig.)

  10. PET/CT-guided treatment planning for paediatric cancer patients: a simulation study of proton and conventional photon therapy

    Science.gov (United States)

    Brodin, N P; Björk-Eriksson, T; Birk Christensen, C; Kiil-Berthelsen, A; Aznar, M C; Hollensen, C; Markova, E; Munck af Rosenschöld, P

    2015-01-01

    Objective: To investigate the impact of including fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) scanning in the planning of paediatric radiotherapy (RT). Methods: Target volumes were first delineated without and subsequently re-delineated with access to 18F-FDG PET scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP) and estimated risk of secondary cancer (SC). Results: Considerable deviations between CT- and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target volumes, target dose coverage, irradiated volumes, estimated NTCP or SC risk, neither for IMPT nor 3DCRT. Conclusion: Our results imply that the inclusion of PET/CT scans in the RT planning process could have considerable impact for individual patients. There were no general trends of increasing or decreasing irradiated volumes, suggesting that the long-term morbidity of RT in childhood would on average remain largely unaffected. Advances in knowledge: 18F-FDG PET-based RT planning does not systematically change NTCP or SC risk for paediatric cancer patients compared with CT only. 3 out of 11 patients had a distinct change of target volumes when PET-guided planning was introduced. Dice and mismatch metrics are not sufficient to assess the consequences of target volume differences in the context of RT. PMID:25494657

  11. Prospective evaluation of {sup 68}Ga-DOTANOC PET-CT in differentiated thyroid cancer patients with raised thyroglobulin and negative {sup 131}I-whole body scan: comparison with {sup 18}F-FDG PET-CT

    Energy Technology Data Exchange (ETDEWEB)

    Kundu, Parveen; Lata, Sneh; Sharma, Punit; Singh, Harmandeep; Malhotra, Arun; Bal, Chandrasekhar [All India Institute of Medical Sciences, Department of Nuclear Medicine, Ansari Nagar, New Delhi (India)

    2014-07-15

    The purpose of the study was to evaluate the role of {sup 68}Ga-DOTANOC PET-CT in differentiated thyroid cancer (DTC) patients with negative {sup 131}I-whole body scan (WBS) along with serially increasing serum thyroglobulin (Tg), and compare the same with {sup 18}F-FDG PET-CT. Sixty two DTC patients with serially rising Tg levels and negative {sup 131}I-WBS were prospectively enrolled. All patients underwent {sup 68}Ga-DOTANOC PET-CT and {sup 18}F-FDG PET-CT within an interval of two weeks. PET-CT analysis was done on a per-patient basis, location wise and lesion wise. All PET-CT lesions were divided into four categories-local, nodal, pulmonary and skeletal. Histopathology and/or serial serum Tg level, clinical and imaging follow up (minimum-1 year) were used as a reference standard. Ga-DOTANOC PET-CT demonstrated disease in 40/62 (65 %) patients and {sup 18}F-FDG PET-CT in 45/62 (72 %) patients, with no significant difference on McNemar analysis (p = 0.226). Per-patient sensitivity and specificity of {sup 68}Ga-DOTANOC PET-CT was 78.4 %, 100 %, and for {sup 18}F-FDG PET-CT was 86.3 %, 90.9 %, respectively. Out of 186 lesions detected by both PET-CTs, 121/186 (65 %) lesions were seen on {sup 68}Ga-DOTANOC PET-CT and 168/186 (90.3 %) lesions on {sup 18}F-FDG PET-CT (p < 0.0001). There were 103/186 (55 %) lesions concordant on both. Excellent agreement was noted between {sup 68}Ga-DOTANOC PET-CT and {sup 18}F-FDG PET-CT for detection of local disease (k = 0.92), while moderate agreement was noted for nodal and pulmonary disease (k = 0.67). {sup 68}Ga-DOTANOC PET-CT changed management in 21/62 (34 %) patients and {sup 18}F-FDG PET-CT in 17/62 (27 %) patients. Ga-DOTANOC PET-CT is inferior to {sup 18}F-FDG PET-CT on lesion based but not on patient based analysis for detection of recurrent/residual disease in DTC patients with negative WBS scan and elevated serum Tg levels. It can also help in selection of potential candidates for peptide receptor radionuclide therapy

  12. Value of PET/CT in the approach to head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Curioni, Otavio Alberto; Amar, Ali; Viana, Debora [Hospital Heliopolis, Sao Paulo, SP (Brazil). Service of Head and Neck Surgery and Otorhynolaryngology; Souza, Ricardo Pires de [Hospital Heliopolis, Sao Paulo, SP (Brazil). Service of Radiology; Rapoport, Abrao [Hospital Heliopolis, Sao Paulo, SP (Brazil); Dedivitis, Rogerio Aparecido [Universidade de Sao Paulo (HC-FMUSP), SP (Brazil). Hospital das Clinicas. Group of Larynx and Hypopharynx; Cernea, Claudio Roberto; Brandao, Lenine Garcia [Universidade de Sao Paulo (FMUSP), SP (Brazil). Fac. de Medicina. Dept. of Head and Neck Surgery

    2012-11-15

    Objective: To evaluate the role of PET/CT in the approach to patients with head and neck cancer. Materials and Methods: Retrospective study of medical records and PET/CT images of 63 patients with head and neck cancer. Results: Alterations were observed in 76% of the cases. Out of these cases, 7 (11%) were considered as false-positive, with SUV < 5.0. PET/CT demonstrated negative results in 15 cases (24%). Among the 14 cases where the method was utilized for staging, 3 (22%) had their stages changed. Conclusion: PET/CT has shown to be of potential value in the routine evaluation of patients with head and neck cancer, but further studies of a higher number of cases are required to define a protocol for utilization of the method. (author)

  13. 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.

  14. 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)

  15. 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.

  16. Abdominal aortitis on PET CT: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    J. Foley

    2015-01-01

    Conclusion: This case highlights the utility of PET-CT in the diagnosis of abdominal aortitis and the need to consider aortitis as a differential in patients with abdominal pain with a history of vasculitis.

  17. 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

  18. The engagement of FDG PET/CT image quality and harmonized quantification: from competitive to complementary

    Energy Technology Data Exchange (ETDEWEB)

    Boellaard, Ronald [VU University Medical Centre, Department of Radiology and Nuclear Medicine, Amsterdam (Netherlands)

    2016-01-15

    The use of {sup 18}F-FDG PET/CT as a quantitative imaging biomarker requires standardization and harmonization of imaging procedures and PET/CT system performance to obtain repeatable and reproducible quantitative data. However, a PET/CT system optimized to meet international quantitative standards is not necessarily optimized for use as a diagnostic tool (i.e. for lesion detectability). Several solutions have been proposed and validated, but until recently none of them had been implemented commercially. Vendor-provided solutions allowing the use of PET/CT both as a diagnostic tool and as a quantitative imaging biomarker are therefore greatly needed and would be highly appreciated. In this invited perspective one such solution is highlighted. (orig.)

  19. 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.

  20. Training of staff for the delivery of PET/CT services in the UK.

    Science.gov (United States)

    Perkins, Alan C; Gordon, Isky; Read, James; Ellis, Beverly; Allen, R; Clarke, S E M; Garner, C; Hilson, A J; Frank, J W; McCool, D; Nicol, A; Prescott, M C; Ryan, P J; Shields, R A; Tindale, W B

    2006-12-01

    Evidence for the cost effectiveness of PET/CT imaging is now driving the widespread introduction of PET/CT services throughout the UK. The provision of PET/CT facilities will require a workforce of medical, scientific, technical and engineering staff who are adequately trained and fit for purpose. Suitably trained staff in this speciality are scarce. The development and accreditation of training courses and other educational resources for training programmes in all disciplines will therefore be required at a national and regional level. The implementation of PET/CT training can be achieved more cost-effectively by developing multi-professional learning resources whenever possible. It is intended that the recommendations would be implemented by close co-operation of both public and private healthcare providers together with educational establishments.

  1. 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.

  2. 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

  3. 18 F-FDG PET-CT during chemo-radiotherapy in patients with non-small cell lung cancer: the early metabolic response correlates with the delivered radiation dose

    Directory of Open Access Journals (Sweden)

    Massaccesi Mariangela

    2012-07-01

    Full Text Available Abstract Background To evaluate the metabolic changes on 18 F-fluoro-2-deoxyglucose positron emission tomography integrated with computed tomography (18 F-FDG PET-CT performed before, during and after concurrent chemo-radiotherapy in patients with locally advanced non-small cell lung cancer (NSCLC; to correlate the metabolic response with the delivered radiation dose and with the clinical outcome. Methods Twenty-five NSCLC patients candidates for concurrent chemo-radiotherapy underwent 18 F-FDG PET-CT before treatment (pre-RT PET-CT, during the third week (during-RT PET-CT of chemo-radiotherapy, and 4 weeks from the end of chemo-radiotherapy (post-RT PET-CT. The parameters evaluated were: the maximum standardized uptake value (SUVmax of the primary tumor, the SUVmax of the lymph nodes, and the Metabolic Tumor Volume (MTV. Results SUVmax of the tumor and MTV significantly (p=0.0001, p=0.002, respectively decreased earlier during the third week of chemo-radiotherapy, with a further reduction 4 weeks from the end of treatment (p Conclusions In patients with locally advanced NSCLC, 18 F-FDG PET-CT performed during and after treatment allows early metabolic modifications to be detected, and for this SUVmax is the more sensitive parameter. Further studies are needed to investigate the correlation between the metabolic modifications during therapy and the clinical outcome in order to optimize the therapeutic strategy. Since the metabolic activity during chemo-radiotherapy correlates with the cumulative dose of fractionated radiotherapy delivered at the moment of the scan, special attention should be paid to methodological aspects, such as the radiation dose reached at the time of PET.

  4. 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

  5. Quantitative FDG PET/CT in the community: experience from interpretation of outside oncologic PET/CT exams in referred cancer patients

    International Nuclear Information System (INIS)

    Tertiary care institutions often deal with patients who have had a baseline positron emission tomography (PET)/computed tomography (CT) scan performed elsewhere. Little data exist regarding the quality of these PET/CT scans and whether they are fully suitable for qualitative or quantitative interpretation. We evaluated outside PET/CT scans from cancer patients referred to our institution and compared them with PET/CT scans acquired locally. This Health Insurance Portability and Accountability Act-compliant retrospective study was approved by our institutional review board. Informed consent requirements were waived. One hundred seventy recent whole-body outside PET/CT exams from many sites were digitally imported into our radiology imaging system and reviewed for key quality metrics including time from injection until imaging, availability of patient height and weight information, serum glucose level and [18F]fluoro-2-deoxy-D-glucose (FDG) dose. The standardised uptake value (SUV) and SUV based on lean body mass (SUL) in the liver were measured whenever possible. These were compared with 170 internal studies performed at our centre during the same period. Missing data were common in outside scans with height in 62%, weight 35%, uptake time 25%, FDG dose 28% and glucose levels in 64% of cases. In quantitatively evaluable cases, mean liver SUL, SUV, FDG dose and uptake time were much more variable in outside than in internal studies. Approximately one-third of the outside PET/CT studies submitted digitally for analysis lacked key information required to secure any quantitative imaging data. Only about a third of these studies had all necessary information available for accurate SUL determination and had acceptable quality that was comparable with locally acquired scans. This suggests that many of PET studies performed in the community cannot be relied upon to provide quantitative image data that can be applied in a different centre. Greater standardisation of

  6. (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....

  7. Optimal scan time for evaluation of parathyroid adenoma with [18F]-fluorocholine PET/CT

    Directory of Open Access Journals (Sweden)

    Rep Sebastijan

    2015-12-01

    Full Text Available Background. Parathyroid adenomas, the most common cause of primary hyperparathyroidism, are benign tumours which autonomously produce and secrete parathyroid hormone. [18F]-fluorocholine (FCH, PET marker of cellular proliferation, was recently demonstrated to accumulate in lesions representing enlarged parathyroid tissue; however, the optimal time to perform FCH PET/CT after FCH administration is not known. The aim of this study was to determine the optimal scan time of FCH PET/CT in patients with primary hyperparathyroidism.

  8. The diagnostic value of PET/CT scanning in patients with cervical cancer

    DEFF Research Database (Denmark)

    Loft, Annika; Berthelsen, Anne Kiil; Roed, Henrik;

    2007-01-01

    OBJECTIVE: To investigate the clinical value of PET/CT as a supplement to FIGO staging in patients with cervical cancer stage >or=1B. METHODS: This prospective study included 120 consecutive patients. After staging, a whole-body PET/CT scan was performed and these examinations were divided into two....../CT scanning for newly diagnosed cervical cancer FIGO stage >or=1B has a high sensitivity and specificity, and can be a valuable supplement to the FIGO staging procedure....

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

    International Nuclear Information System (INIS)

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

  10. Usefulness of a PET/CT scanner and a proposal for examination fee

    International Nuclear Information System (INIS)

    A combined PET/CT scanner has been developed, its clinical application has begun and there is much evidence that it is very helpful, particularly in oncology. In our country, a PET/CT scan, like a dedicated PET scan, is obtained after other conventional imaging modalities, such as CT, are performed. Therefore, patients who receive a PET/CT scan are obliged to have CT scans performed twice, i.e. a conventional CT scan with or without contrast material and a second CT scan as a part of the PET/CT study. Since a radiation exposure by CT can be excessive, the electric current has to be reduced in order to avoid unnecessary radiation exposure by PET/CT scanning, and this results in poor image quality of the CT. A PET study with 18F-fluorodeoxyglucose (FDG) is especially useful for staging and re-staging disease in patients with cancer. If patients could undergo a PET/CT scan using the highest quality CT and avoid receiving a conventional CT scan fur diagnostic purposes, we would be able to save time for evaluating each patient, save time in ordering and interpreting procedures, and avoid redundant radiation exposure to the patients. All of this should lead to greater cost-effectiveness in patient care. If a revised fee of PET/CT with contrast would be 87300 yen, then it could reduce about 7 million yen of medical cost fur one thousand tests, as compared wit/i the case in which a CT scan is performed in 80% before a PET scan and another CT scan is recommended after PET in 50%. We have reviewed the clinical usefulness of PET/CT with FDG in oncology, and propose a novel system in applying this device based on evidence of its cost-effectiveness. (author)

  11. The rise and fall of PET and PET/CT. A German perspective

    International Nuclear Information System (INIS)

    PET is being considered a diagnostic commodity in clinical practice worldwide and thus receives increasing attention by health insurances and governmental organizations. In Germany, however, neither PET nor PET/CT are subject to reimbursement. This renders clinical PET and PET/CT imaging a challenge both in general hospital environment and in private practice. This article describes briefly these challenges, which are not solely related to turf battles and associated costs. (orig.)

  12. 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

  13. PET/CT for the staging and follow-up of patients with malignancies

    International Nuclear Information System (INIS)

    Positron emission tomography (PET) and computed tomography (CT) complement each other's strengths in integrated PET/CT. PET is a highly sensitive modality to depict the whole-body distribution of positron-emitting biomarkers indicating tumour metabolic activity. However, conventional PET imaging is lacking detailed anatomical information to precisely localise pathologic findings. CT imaging can readily provide the required morphological data. Thus, integrated PET/CT represents an efficient tool for whole-body staging and functional assessment within one examination. Due to developments in system technology PET/CT devices are continually gaining spatial resolution and imaging speed. Whole-body imaging from the head to the upper thighs is accomplished in less than 20 min. Spatial resolution approaches 2-4 mm. Most PET/CT studies in oncology are performed with 18F-labelled fluoro-deoxy-D-glucose (FDG). FDG is a glucose analogue that is taken up and trapped within viable cells. An increased glycolytic activity is a characteristic in many types of cancers resulting in avid accumulation of FDG. These tumours excel as 'hot spots' in FDG-PET/CT imaging. FDG-PET/CT proved to be of high diagnostic value in staging and restaging of different malignant diseases, such as colorectal cancer, lung cancer, breast cancer, head and neck cancer, malignant lymphomas, and many more. The standard whole-body coverage simplifies staging and speeds up decision processes to determine appropriate therapeutic strategies. Further development and implementation of new PET-tracers in clinical routine will continually increase the number of PET/CT indications. This promotes PET/CT as the imaging modality of choice for working-up of the most common tumour entities as well as some of the rare malignancies.

  14. The preliminary clinical application of PET/CT on the diagnosis and staging of lung cancer

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical value of PET/CT on the diagnosis and staging of lung cancer. Methods: 46 lung cancer patients including 35 pre-treatment and 11 post-treatment cases. PET/CT fusion images, PET images and CT images of the same patient were analyzed frame by frame. Results: 1) The sensitivity of PET/CT in 35 pre-treated cases reached 100%. Except one case of alveolar carcinoma showed a diffuse uptake in both lungs, the other patients displayed as hypermetabolic nodular or mass lesions with the size around 0.8-9.4 cm and the standardized uptake value (SUV) 4.6 ± 1.94. The position of hypermetabolic lesion of PET finding were all concordant to CT. PET/CT was superior to PET and CT in final diagnosis, delineating the border, detecting tumor invasion and in differentiating lung cancer from atelectasis, obstructive pneumonitis and pleural effusion. Among 11 post-treated cases, no malignancy was seen in 9 cases and in two cases with metastases in both lungs, the lesions were detected definitely by PET/CT. 2)For the staging, PET/CT was also superior to PET and CT alone with the sensitivity of 95.2%(PET/CT), 90.4%(PET), 73.8%(CT) respectively. PET and CT were complemental each other in the detection of the lesions. Obviously, PET was superior to CT in detection of small lymph node metastases, pleura, bone and adrenal metastases. CT was better than PET in detection of small lung metastases. Conclusions: PET/CT is superior to PET and CT alone in the diagnosis and staging of lung cancer. PET and CT can complement each other. (authors)

  15. PET/CT fusion in radiotherapy planning for lung cancer - case reports

    Directory of Open Access Journals (Sweden)

    Erak Marko Đ.

    2016-01-01

    Full Text Available Introduction. Application of imaging methods, namely computed tomography (CT, magnetic resonance imaging (MRI and in recent years positron emission tomography-computed tomography (PET/CT, and the progress of computer technology have allowed the construction of effective computerized systems for treatment planning (TPS and introducing the concept of virtual simulation in 3D conformal radiotherapy planning. Case report. We hereby presented two patients with the diagnosis of non-small cell lung cancer who did PET/CT examination. Both patients had surgery earlier and local recidives are diagnosed with PET/CT. PET/CT of the first patient described the focus of intense fluorodeoxyglucose (FDG accumulation 2.99 × 2.9 × 2.1cm in diameter in the projection of soft-tissue volume in the left corner, at operating clips height, corresponding to metabolically active recurrence of the tumor. Mediastinum and right lung parenchyma were without focal accumulation of FDG. Control PET/CT after 3 months was without detectable focus of intense pathological FDG accumulation - good therapeutic response, (metabolic disease remission. On the other hand, in the second case PET/CT showed a focus of intense FDG accumulation screening in the scar tissue of the apical part of the right lung, 20 × 16 mm, corresponding to metabolically active tumor recurrence. In the lung parenchyma on the left and in the mediastinum no visible focus of intense FDG accumulation was descrbed. Radiography included using 3D conformal radiotherapy with fusion PET/CT scan and CT simulations. Conclusion. PET/CT provides important information for planning conformal radiotherapy, especially in dose escalation, sparing of organ at risk and better locoregional control of the disease.

  16. {sup 68}Ga-PSMA PET/CT for restaging recurrent prostate cancer: which factors are associated with PET/CT detection rate?

    Energy Technology Data Exchange (ETDEWEB)

    Ceci, Francesco [Medizinische Universitaet Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); University of Bologna, Service of Nuclear Medicine, Policlinico S. Orsola-Malpighi, Bologna (Italy); Uprimny, Christian; Nilica, Bernhard; Geraldo, Llanos; Kendler, Dorota; Kroiss, Alexander; Decristoforo, Clemens; Virgolini, Irene J. [Medizinische Universitaet Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); Bektic, Jasmin; Horninger, Wolfgang [Medizinische Universitaet Innsbruck, Department of Urology, Innsbruck (Austria); Lukas, Peter [Medizinische Universitaet Innsbruck, Department of Radiotherapy, Innsbruck (Austria); Castellucci, Paolo; Fanti, Stefano [University of Bologna, Service of Nuclear Medicine, Policlinico S. Orsola-Malpighi, Bologna (Italy)

    2015-07-15

    To assess the association between PSA levels, PSA kinetics and other factors and a pathological {sup 68}Ga-PSMA PET/CT scan in patients with recurrent prostate cancer (rPCa) with biochemical relapse (BR) after radical therapy. Seventy consecutive rPCA patients referred for {sup 68}Ga-PSMA PET/CT, matching all the following criteria, were retrospectively evaluated: (a) previous radical prostatectomy or primary radiotherapy with curative intent; (b) BR or persisting high PSA levels after primary treatment; and (c) complete clinical and imaging information. The mean ± SD PSA level was 3.5 ± 5.3 ng/mL (median 1.7, range 0.2 - 32.2 ng/mL), the mean ± SD PSA doubling time (PSAdt) was 6.5 ± 5.5 months (median 5.5, range 1.3 - 31.6 months), and the mean ± SD PSA velocity was 7.9 ± 20.5 (median 2.1, range 0.2 - 147.5 ng/mL/year). Statistical analysis was performed to assess which factors were associated with the detection of rPCa on {sup 68}Ga-PSMA PET/CT. {sup 68}Ga-PSMA PET/CT was positive in 52 of 70 patients (74.2 %). In 30 patients (42.8 %) lesions limited to the pelvis were detected. Distant lesions were observed in 8 of patients (11.4 %). Local plus systemic lesions were detected in 14 patients (20 %). PSA level (p = 0.017) and PSAdt (p = 0.0001) were significantly different between PET-positive patients (higher PSA level, shorter PSAdt) and PET-negative patients (lower PSA, longer PSAdt). ROC analysis showed that PSAdt 6.5 months and PSA 0.83 ng/mL were optimal cut-off values. In multivariate analysis PSAdt was associated with {sup 68}Ga-PSMA PET/CT positivity. {sup 68}Ga-PSMA PET/CT was positive in 17 of 20 patients (85 %) with PSA <2 ng/mL and PSAdt <6.5 months, and in 3 of 16 patients (18.7 %) with PSA <2 ng/mL and PSAdt ≥6.5 months. The great potential of {sup 68}Ga-PSMA PET/CT in patients with rPCa and BR was confirmed. PSA and PSAdt were valuable predictors of pathological {sup 68}Ga-PSMA PET/CT findings. (orig.)

  17. Prognostic impact of {sup 18}F-FDG PET/CT staging and of pathological response to neoadjuvant chemotherapy in triple-negative breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Groheux, D.; Merlet, P. [Saint-Louis Hospital, Department of Nuclear Medicine, Paris Cedex 10 (France); University of Paris VII, B2T Doctoral School, Institut Universitaire d' Hematologie, Paris (France); Giacchetti, S.; Hamy, A.S.; Espie, M. [Saint-Louis Hospital, Breast Diseases Unit, Department of Medical Oncology, Paris (France); Delord, M. [Institut Universitaire d' Hematologie, Department of Biostatistics and Bioinformatics, Paris (France); Roquancourt, A. de [Saint-Louis Hospital, Department of Pathology, Paris (France); Hindie, E. [University of Bordeaux, Department of Nuclear Medicine, Haut-Leveque Hospital, CHU Bordeaux, Bordeaux (France)

    2014-11-29

    Mortality is high in patients with locally advanced triple-negative breast cancer (TNBC), especially in those with residual tumour after neoadjuvant chemotherapy (NAC). The aim of this study was to determine if pretreatment {sup 18}F-FDG PET/CT staging and pathological findings after NAC could together allow stratification of patients into prognostic groups. Initial staging with {sup 18}F-FDG PET/CT was performed prospectively in 85 consecutive patients with stage II/III TNBC. Correlations between PET findings and disease-specific survival (DSS) were examined. In patients without distant metastases on PET staging, the impact of pathological response to NAC on DSS was examined. Patterns of recurrence were also analysed. {sup 18}F-DG PET/CT revealed distant metastases in 11 of 85 patients (12.9 %). Among 74 M0 patients, 23 (31.1 %) showed a pathological complete response (pCR) at surgery, while 51 had residual invasive disease (no pCR). DSS differed considerably among the three groups of patients (log-rank P <.001): among patients with occult metastases on baseline PET/CT, 2-year DSS was 18.2 %, and among patients without initial metastases on PET/CT, 5-year DSS was 61.3 % in patients without pCR after NAC and 95.2 % in those with pCR. Of the 51 patients who did not achieve pCR, 21 relapsed (17 developed distant metastases). The sites of distant recurrence were: lung/pleura (nine patients), brain (eight patients), liver (six patients), distant lymph nodes (six patients) and bone (five patients). In patients with clinical stage II/III TNBC, {sup 18}F-FDG PET/CT findings at initial staging and pathological response at the end of NAC allow three groups of patients with quite different prognoses to be defined. Extraskeletal recurrences predominated. Specific follow-up strategies in patients with TNBC who do not achieve pCR deserve investigation. (orig.)

  18. Role of {sup 68}Ga-DOTATOC PET-CT in the diagnosis and staging of pancreatic neuroendocrine tumours

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Rakesh; Sharma, Punit; Karunanithi, Sellam; Naswa, Niraj; Lata, Sneh; Malhotra, Arun [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Garg, Pramod [All India Institute of Medical Sciences, Department of Gastroenterology and Human Nutrition, New Delhi (India); Sharma, Raju; Thulkar, Sanjay [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India)

    2011-11-15

    The objective of the present study was to evaluate the role of {sup 68}Ga-DOTA(0)-Phe(1)-Tyr(3)-octreotide ({sup 68}Ga-DOTATOC) positron emission tomography computed tomography (PET-CT) for detection and staging of pancreatic neuroendocrine tumours (NETs). Twenty patients with clinically suspected and/or histopathologically proven pancreatic NET underwent {sup 68}Ga-DOTATOC PET-CT imaging for staging and /or localisation of primary lesion. They also underwent contrast enhanced CT (CECT) and 8 patients underwent {sup 18}F-FDG PET-CT. SUVmax of primary and metastatic lesions were measured. Results were verified with histopathology for primary tumour and with clinical follow up/MRI and /or biopsy for metastatic disease. Results of {sup 68}Ga-DOTATOC PET-CT were compared to CECT and {sup 18}F-FDG PET-CT. {sup 68}Ga-DOTATOC PET-CT correctly localised primary in all 20, CECT in 15 and {sup 18}F-FDG PET-CT in 2 patients. {sup 68}Ga-DOTATOC PET-CT demonstrated metastases in 13 patients, CECT in 7 and {sup 18}F-FDG PET-CT in 2. {sup 68}Ga-DOTATOC PET-CT emerged as the best investigation with 100% sensitivity and PPV for detecting primary tumour and metastatic disease. The detection rate of CECT was lower than {sup 68}Ga-DOTATOC PET-CT, both for primary tumour (20vs.15) or metastatic disease (13vs.7). {sup 18}F-FDG PET-CT performed poorly for primary and metastasis. Ga-DOTATOC PET-CT is a very useful imaging investigation for diagnosing and staging pancreatic NET. (orig.)

  19. FDG-PET/CT imaging for staging and radiotherapy treatment planning of head and neck carcinoma

    International Nuclear Information System (INIS)

    Positron emission tomography (PET) has a potential improvement for staging and radiation treatment planning of various tumor sites. We analyzed the use of 18F-fluorodeoxyglucose (FDG)-PET/computed tomography (CT) images for staging and target volume delineation of patients with head and neck carcinoma candidates for radiotherapy. Twenty-two patients candidates for primary radiotherapy, who did not receive any curative surgery, underwent both CT and PET/CT simulation. Gross Tumor Volume (GTV) was contoured on CT (CT-GTV), PET (PET-GTV), and PET/CT images (PET/CT-GTV). The resulting volumes were analyzed and compared. Based on PET/CT, changes in TNM categories and clinical stage occurred in 5/22 cases (22%). The difference between CT-GTV and PET-GTV was not statistically significant (p = 0.2) whereas the difference between the composite volume (PET/CT-GTV) and CT-GTV was statistically significant (p < 0.0001). PET/CT fusion images could have a potential impact on both tumor staging and treatment planning

  20. Monitoring and analysis PET/CT workplace radioactivity level in Shanghai

    International Nuclear Information System (INIS)

    Objective: To understand the PET/CT basic information in Shanghai, through monitoring radioactivity level of PET/CT workplace, to get the radiological protection information about PET/CT place. Methods: Through the γ radiation air absorbed dose rate and the β surface contamination to investigate PET/CT medical institutions in Shanghai. Results: By the end of 2011, there were 13 sets of PET/CT. Detecting show that γ radiation air absorbed dose rate is at relatively higher level in waiting room and the injection rooms, the date of waiting room door was up to 19552 nSv/h, the maximum value of injection room desk surface was 6136 nSv/h, the middle of injection room was up to 5408 nSv/h. Any date was certain the limits of national standard of β surface contamination, the middle of in the injection room. It is still higher on the window and wastes barrel. Conclusion: The radiation protection of PET/CT workplace is proper, surface contamination levels can be controlled within in the standard limits, but there are a blank of limits about nuclear medicine place of γ radiation absorbed dose rate air in the national standard, and external exposure protection is still the key of radiation protection. (authors)

  1. MR imaging versus PET/CT for evaluation of pancreatic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Belião, Sara, E-mail: sara.beliao@clix.pt [Department of Radiology Hospital S. Francisco Xavier, Estrada do Forte do Alto do Duque, 1495-005 Lisbon (Portugal); Ferreira, Alexandra, E-mail: alexandratavaresferreira@gmail.com [Department of Radiology, Hospital D. Estefânia, Rua Jacinta Marto, 1169-045 Lisbon (Portugal); Vierasu, Irina, E-mail: Ortansa-Irina.Vierasu@ulb.ac.be [Service de Médecine Nucléaire, Route de Lennik 808, 1070 Brussels (Belgium); Blocklet, Didier, E-mail: dblockle@ulb.ac.be [Service de Médecine Nucléaire, Route de Lennik 808, 1070 Brussels (Belgium); Goldman, Serge, E-mail: petscan@ulb.ac.be [Service de Médecine Nucléaire, Route de Lennik 808, 1070 Brussels (Belgium); Metens, Thierry, E-mail: tmetens@ulb.ac.be [Service de Radiologie – Imagerie par Resonance Magnétique, Route de Lennik 808, 1070 Brussels (Belgium); Matos, Celso, E-mail: cmatos@ulb.ac.be [Service de Radiologie – Imagerie par Resonance Magnétique, Route de Lennik 808, 1070 Brussels (Belgium)

    2012-10-15

    Purpose: To retrospectively determine the diagnostic accuracy of magnetic resonance imaging (MRI) and combined positron emission tomography/computed tomography (PET/CT) in the differential diagnosis of benign and malignant pancreatic lesions. Materials and methods: Twenty-seven patients (15 women/12 men, mean age 56.5 years) with MR imaging and PET/CT studies performed to differentiate benign and malignant pancreatic lesions were identified between October 2008 and October 2010. Both MR and PET/CT data sets were retrospectively and blindly evaluated by two independent readers (4 readers total) with different degrees of experience, using a visual five-point score system. The results were correlated with final diagnosis obtained by histopathology. Results: 17 patients had malignant diseases and 10 patients had benign diseases. Depending on the observer, the sensitivity, specificity, positive predictive value and negative predictive value of MRI varied between 88–94%, 50–80%, 75–89% and 71–89% respectively. Sensitivities, specificities, positive predictive values and negative predictive values of PET/CT were 73%, 56%, 73% and 56% respectively. The diagnostic accuracy of MR for the differential diagnosis of pancreatic lesions was 74–89%, compared with 67% for PET/CT. The weighted Cohen's kappa coefficient was 0.47 at MR and 0.53 at PET/CT. Conclusion: MRI achieved higher sensitivity and specificity in the differential diagnosis of pancreatic lesions.

  2. MR imaging versus PET/CT for evaluation of pancreatic lesions

    International Nuclear Information System (INIS)

    Purpose: To retrospectively determine the diagnostic accuracy of magnetic resonance imaging (MRI) and combined positron emission tomography/computed tomography (PET/CT) in the differential diagnosis of benign and malignant pancreatic lesions. Materials and methods: Twenty-seven patients (15 women/12 men, mean age 56.5 years) with MR imaging and PET/CT studies performed to differentiate benign and malignant pancreatic lesions were identified between October 2008 and October 2010. Both MR and PET/CT data sets were retrospectively and blindly evaluated by two independent readers (4 readers total) with different degrees of experience, using a visual five-point score system. The results were correlated with final diagnosis obtained by histopathology. Results: 17 patients had malignant diseases and 10 patients had benign diseases. Depending on the observer, the sensitivity, specificity, positive predictive value and negative predictive value of MRI varied between 88–94%, 50–80%, 75–89% and 71–89% respectively. Sensitivities, specificities, positive predictive values and negative predictive values of PET/CT were 73%, 56%, 73% and 56% respectively. The diagnostic accuracy of MR for the differential diagnosis of pancreatic lesions was 74–89%, compared with 67% for PET/CT. The weighted Cohen's kappa coefficient was 0.47 at MR and 0.53 at PET/CT. Conclusion: MRI achieved higher sensitivity and specificity in the differential diagnosis of pancreatic lesions

  3. Clinical Applications of FDG PET and PET/CT in Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    Akram Al-Ibraheem

    2009-01-01

    Full Text Available 18F-FDG PET plays an increasing role in diagnosis and management planning of head and neck cancer. Hybrid PET/CT has promoted the field of molecular imaging in head and neck cancer. This modality is particular relevant in the head and neck region, given the complex anatomy and variable physiologic FDG uptake patterns. The vast majority of 18F-FDG PET and PET/CT applications in head and neck cancer related to head and neck squamous cell carcinoma. Clinical applications of 18F-FDG PET and PET/CT in head and neck cancer include diagnosis of distant metastases, identification of synchronous 2nd primaries, detection of carcinoma of unknown primary and detection of residual or recurrent disease. Emerging applications are precise delineation of the tumor volume for radiation treatment planning, monitoring treatment, and providing prognostic information. The clinical role of 18F-FDG PET/CT in N0 disease is limited which is in line with findings of other imaging modalities. MRI is usually used for T staging with an intense discussion concerning the preferable imaging modality for regional lymph node staging as PET/CT, MRI, and multi-slice spiral CT are all improving rapidly. Is this review, we summarize recent literature on 18F-FDG PET and PET/CT imaging of head and neck cancer.

  4. PET/CT and MR imaging in myeloma

    Energy Technology Data Exchange (ETDEWEB)

    Mulligan, Michael E. [University of Maryland Medical Center, Department of Radiology, Baltimore, MD (United States); Badros, Ashraf Z. [University of Maryland, Department of Medicine, Marlene and Stewart Greenebaum Cancer Center, Baltimore, MD (United States)

    2007-01-15

    Myeloma is the most common primary bone malignancy. It accounts for 10% of all hematological malignancies and 1% of all cancers. In the United States, there are an estimated 16,000 new cases and over 11,000 deaths yearly due to myeloma. Plasma cell dyscrasias manifest themselves in a variety of forms that range from MGUS (monoclonal gammopathy of undetermined significance) and smoldering myeloma that require no therapy, to the ''malignant'' form of multiple myeloma. The role of imaging in the management of myeloma includes: an assessment of the extent of intramedullary bone disease, detection of any extramedullary foci, and severity of the disease at presentation; the identification and characterization of complications; subsequent assessment of disease status. This review will focus on the use of PET/CT and MR imaging for myeloma patients at the time of initial diagnosis and for follow-up management, based on current reports in the literature and our practice at the Marlene and Stewart Greenebaum Cancer Center, University of Maryland Medical Center in Baltimore, USA. (orig.)

  5. PET/CT and MR imaging in myeloma

    International Nuclear Information System (INIS)

    Myeloma is the most common primary bone malignancy. It accounts for 10% of all hematological malignancies and 1% of all cancers. In the United States, there are an estimated 16,000 new cases and over 11,000 deaths yearly due to myeloma. Plasma cell dyscrasias manifest themselves in a variety of forms that range from MGUS (monoclonal gammopathy of undetermined significance) and smoldering myeloma that require no therapy, to the ''malignant'' form of multiple myeloma. The role of imaging in the management of myeloma includes: an assessment of the extent of intramedullary bone disease, detection of any extramedullary foci, and severity of the disease at presentation; the identification and characterization of complications; subsequent assessment of disease status. This review will focus on the use of PET/CT and MR imaging for myeloma patients at the time of initial diagnosis and for follow-up management, based on current reports in the literature and our practice at the Marlene and Stewart Greenebaum Cancer Center, University of Maryland Medical Center in Baltimore, USA. (orig.)

  6. Comparison of imaging with FDG PET/CT with other imaging modalities in myeloma

    Energy Technology Data Exchange (ETDEWEB)

    Breyer, Richard J. [University of Maryland Medical Center, Department of Radiology, Baltimore, MD (United States); University of Maryland Medical Center, Division of Nuclear Medicine, Baltimore, MD (United States); Mulligan, Michael E.; Smith, Stacy E. [University of Maryland Medical Center, Department of Radiology, Baltimore, MD (United States); Line, Bruce R. [University of Maryland Medical Center, Division of Nuclear Medicine, Baltimore, MD (United States); Badros, Ashraf Z. [University of Maryland Medical Center, Marlene and Stewart Greenebaum Cancer Center, Baltimore, MD (United States)

    2006-09-15

    To determine the usefulness of FDG PET/CT scanning in the management and staging of myeloma and to assess its strengths and limitations. FDG PET/CT scans and all other available imaging studies were reviewed retrospectively from 16 consecutive patients by two experienced musculoskeletal radiologists and two nuclear medicine physicians working in consensus. The 16 patients had undergone a total of 19 FDG PET/CT scans. Radiographs were available in all cases, including 13 skeletal surveys; 25 CT scans (16 chest, three abdominal, four pelvic, one spine, one neck) and 22 MR imaging studies (17 spine, three pelvic, two extremity) also were reviewed. Patients' records were examined for relevant clinical information. All focal areas of abnormal FDG uptake were correlated with the other imaging studies to determine clinical significance. FDG PET/CT scans also were reviewed to see if small lesions shown on the other imaging studies could be identified in retrospect. The 12 men and four women had an average age of 58 years (range 30-69 years). All 16 patients had an established diagnosis of multiple myeloma, with average duration of disease, from time of initial diagnosis to review, of 30 months (range 6 months to 11+ years). The FDG PET/CT scans revealed a total of 104 sites (90 in bone, 14 soft tissue) that were suspicious for neoplastic activity based on a standardized uptake value (SUV) greater than 2.5. Fifty-seven of these sites (55%) were new or previously undetected. The other imaging studies (X-ray, CT, MR) and clinical information confirmed the other 47 areas but also revealed 133 other small skeletal lesions. Six of these 133 additional lesions showed mild FDG uptake on re-review of the PET/CT scans. The FDG PET/CT findings led to management changes in 9/16 patients. MR imaging revealed five cases of diffuse bone involvement (four spine, one scapula) that were not evident by FDG PET/CT. FDG PET/CT scans are useful for the management and staging of myeloma

  7. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-04-15

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

  9. The clinical value of PET/CT in therapeutic management of the malignant tumor

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical value of hybrid PET/CT in therapeutic management of the malignant tumor. Methods: 69 patients with malignant tumor without accepting any treatment, who were diagnosed by either pathology (24 patients) or clinical data (45 patients), were analyzed in this study. The age of the 20 females and 49 males ranged between 26 and 99 years (mean 63 years). PET/CT scans were performed using Discovery LS-PET/CT system (GE Discovery LS, CT attenuation correction, OSEM reconstruction), after injection of 5.55 MBq/kg FDG 40 minutes. Results: l. PET/CT showed 18 patients with single lesion and 51 patients with multiple lesions. while in CT imaging showed 47 patients with single lesion before PET/CT scanning. 29 (61.7%) patients were changed the clinical stage and therapeutic scheme after PET/CT performing. 2. Offered biological target orientation to radiotherapy or operation extension to surgery: radiotherapy doctors used PET/CT fusion imaging to direct radiotherapy orientation to 29 patients who were fit for radiotherapy. Five of them, who had treated by MM50 for one period of treatment, reexamined PET/CT after one month later, the former tumor was disappeared or shirked and the metabolism of glucose returned to normal. 10 patients were operated after the doctor confirmed the operation extension and operation path according to the PET/CT fusion images. The pathological results showed no carcinoma cell implicated or soakage in surgery cutting margins. The metastasis lymph nodes were completely removed. One patient, her operation was failed, was diagnosed primary lung cancer with hilus and lymph nodes metastases by PET/CT which indicated that the operation was not suitable for this patient. Conclusion: Hybrid PFT/CT imaging may offer an important tool in therapeutic management of the malignant tumor. One, it can provide more accurate diagnosis for clinical stage of the malignant tumor and assistant doctor's to draw the therapeutic scheme. Two, it

  10. Performance evaluation of the Ingenuity TF PET/CT scanner with a focus on high count-rate conditions

    International Nuclear Information System (INIS)

    This study evaluated the positron emission tomography (PET) imaging performance of the Ingenuity TF 128 PET/computed tomography (CT) scanner which has a PET component that was designed to support a wider radioactivity range than is possible with those of Gemini TF PET/CT and Ingenuity TF PET/MR. Spatial resolution, sensitivity, count rate characteristics and image quality were evaluated according to the NEMA NU 2–2007 standard and ACR phantom accreditation procedures; these were supplemented by additional measurements intended to characterize the system under conditions that would be encountered during quantitative cardiac imaging with 82Rb. Image quality was evaluated using a hot spheres phantom, and various contrast recovery and noise measurements were made from replicated images. Timing and energy resolution, dead time, and the linearity of the image activity concentration, were all measured over a wide range of count rates. Spatial resolution (4.8–5.1 mm FWHM), sensitivity (7.3 cps kBq–1), peak noise-equivalent count rate (124 kcps), and peak trues rate (365 kcps) were similar to those of the Gemini TF PET/CT. Contrast recovery was higher with a 2 mm, body-detail reconstruction than with a 4 mm, body reconstruction, although the precision was reduced. The noise equivalent count rate peak was broad (within 10% of peak from 241–609 MBq). The activity measured in phantom images was within 10% of the true activity for count rates up to those observed in 82Rb cardiac PET studies. (paper)

  11. Standard Operating Procedures for PET/CT: A Practical Approach for Use in Adult Oncology

    International Nuclear Information System (INIS)

    Over the past 20 years, positron emission tomography (PET) and PET/CT (computed tomography) have revolutionized the care of cancer patients in developed countries and are increasingly being adopted in emerging economies. PET has been, and still is, one of the fastest growing fields in medical imaging. There are several reasons for the rapid development of this imaging technology. As the populations of many countries continue to age, cancer constitutes a major health problem, with increasing incidence worldwide. In developed countries where heart disease is the primary cause of mortality, cancer is a close second and may eventually overtake it. Proper cancer management requires highly accurate imaging to characterize, stage, restage, assess response to therapy, prognosticate and detect recurrence. Such information is critical in a disease that often requires the correct initial treatment in order to improve the chance of successfully curing the patient. The ability to provide, in a single imaging session, detailed anatomical and metabolic/functional information, which has a powerful synergistic effect that is greater than the sum of the two individual techniques, has established PET/CT as an indispensable imaging procedure in the management of many different types of cancer. The quality and reliability of the images acquired on a PET/CT scanner depend on the quality of the imaging technique. This publication addresses this important aspect of PET/CT imaging, namely, how to perform an 18F-fluorodeoxyglucose (FDG) PET/CT scan in an adult patient with cancer. Although there are several publications and guidelines on different protocols for PET/CT imaging using FDG, the aim here is to provide a comprehensive overview that can be used both by new PET/CT centres in the process of starting up and by established imaging centres for updating older protocols. Written by experts from several continents, the book provides an up to date, evidence based and comprehensive overview

  12. A New Method of Detecting Pulmonary Nodules with PET/CT Based on an Improved Watershed Algorithm

    OpenAIRE

    Zhao, Juanjuan; Ji, Guohua; Qiang, Yan; Han, Xiaohong; Pei, Bo; Shi, Zhenghao

    2015-01-01

    Background Integrated 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is widely performed for staging solitary pulmonary nodules (SPNs). However, the diagnostic efficacy of SPNs based on PET/CT is not optimal. Here, we propose a method of detection based on PET/CT that can differentiate malignant and benign SPNs with few false-positives. Method Our proposed method combines the features of positron-emission tomography (PET) and computed tomography (CT)....

  13. Non-target activity detection by post-radioembolization yttrium-90 PET/CT: Image assessment technique and case examples

    OpenAIRE

    Yung Hsiang eKao; Andrew EH eTan; Richard HG eLo; Kiang Hiong eTay; Bien Soo eTan; Pierce KH eChow; David CE eNg; Anthony SW eGoh

    2014-01-01

    High-resolution yttrium-90 (90Y) imaging of post-radioembolization microsphere biodistribution may be achieved by conventional positron emission tomography with integrated computed tomography (PET/CT) scanners that have time-of-flight capability. However, reconstructed 90Y PET/CT images have high background noise, making non-target activity detection technically challenging. This educational article describes our image assessment technique for non-target activity detection by 90Y PET/CT which...

  14. Non-Target Activity Detection by Post-Radioembolization Yttrium-90 PET/CT: Image Assessment Technique and Case Examples

    OpenAIRE

    Kao, Yung Hsiang; Tan, Andrew E. H.; Lo, Richard H. G.; Tay, Kiang Hiong; Tan, Bien Soo; Chow, Pierce K. H.; Ng, David C. E.; Goh, Anthony S. W.

    2014-01-01

    High resolution yttrium-90 (90Y) imaging of post-radioembolization microsphere biodistribution may be achieved by conventional positron emission tomography with integrated computed tomography (PET/CT) scanners that have time-of-flight capability. However, reconstructed 90Y PET/CT images have high background noise, making non-target activity detection technically challenging. This educational article describes our image assessment technique for non-target activity detection by 90Y PET/CT, whic...

  15. 18F-FDG-PET/CT parameters as imaging biomarkers in oral cavity squamous cell carcinoma, is visual analysis of PET and contrast enhanced CT better than the numbers?

    Energy Technology Data Exchange (ETDEWEB)

    Kendi, A.Tuba, E-mail: ayse.kendi@emory.edu [Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (United States); Corey, Amanda [Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (United States); Magliocca, Kelly R. [Department of Pathology, Emory University, Atlanta, GA (United States); Nickleach, Dana C. [Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute of Emory University, Atlanta, GA (United States); Galt, James [Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (United States); Switchenko, Jeffrey M. [Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute of Emory University, Atlanta, GA (United States); El-Deiry, Mark W.; Wadsworth, J. Trad [Otolaryngology Head and Neck Surgery, Emory University, Atlanta, GA (United States); Hudgins, Patricia A. [Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (United States); Saba, Nabil F. [Hematology Oncology, Winship Cancer Institute of Emory University, Atlanta, GA (United States); Schuster, David M. [Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (United States)

    2015-06-15

    multivariable analysis, patients with high (≥ median) tumor SUV max (OR 6.3), SUV mean (OR 6.3), MTV (OR 19.0), TLG (OR 19.0), SAM (OR 11.7) and N SAM (OR 19.0) had high pathological T-stage (T3/T4) (p < 0.05). Ring/heterogeneous pattern on CECT qualitative assessment was associated with worse DMFS and OS. Conclusion: High PET/CT parameters were associated with pathologically advanced T stage (T3/T4). Qualitative assessment of CECT has prognostic value. PET/CT parameters did not predict clinical outcome.

  16. 18F-FDG-PET/CT parameters as imaging biomarkers in oral cavity squamous cell carcinoma, is visual analysis of PET and contrast enhanced CT better than the numbers?

    International Nuclear Information System (INIS)

    multivariable analysis, patients with high (≥ median) tumor SUV max (OR 6.3), SUV mean (OR 6.3), MTV (OR 19.0), TLG (OR 19.0), SAM (OR 11.7) and N SAM (OR 19.0) had high pathological T-stage (T3/T4) (p < 0.05). Ring/heterogeneous pattern on CECT qualitative assessment was associated with worse DMFS and OS. Conclusion: High PET/CT parameters were associated with pathologically advanced T stage (T3/T4). Qualitative assessment of CECT has prognostic value. PET/CT parameters did not predict clinical outcome

  17. {sup 18}F-FDG PET/CT-Negative Recurrent High-Grade Anaplastic Astrocytoma Detected by {sup 18}F-FDOPA PET-CT

    Energy Technology Data Exchange (ETDEWEB)

    Karunanithi, Sellam; Singh, Harmandeep; Sharma, Punit; Gupta, Deepak Kumar; Bal, Chandrasekhar [All India Institute of Medical Sciences, New Delhi (India)

    2013-12-15

    A 37-year-old woman with grade 3 anaplastic astrocytoma (AA) of the left frontal lobe, underwent surgical excision, chemotherapy and external beam radiation therapy in 2004. After being in remission for 5 years, recurrence was suspected clinically when she presented with seizures. The result of contrast-enhanced magnetic resonance imaging (MRI) was equivocal for recurrence and radiation necrosis (not available ). The patient was then referred for {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography-computed tomography (PET-CT), as the initial primary tumour was high grade in nature. {sup 18}F-FDG PET-CT was negative for recurrence and demonstrated only post-operative changes in the left frontal region (Fig. 1a, b, arrow). Due to strong clinical suspicion, 3,4-dihydroxy-6-{sup 18}F-fluoro-L-phenylalanine ({sup 18}F-FDOPA) PET-CT was done, 5 days after {sup 18}F-FDG PET-CT. The study revealed an {sup 18}F-FDOPA-avid mass lesion in the left frontal region (Fig. 1c, d, arrow), thereby confirming the presence of recurrent disease. The patient underwent surgical resection of the mass, and it was confirmed by histopathology as grade 3 AA. However, after a short asymptomatic period of 4 months the patient became symptomatic again. Follow-up MRI after 6 months of surgery revealed presence of ipsilateral and contralateral multifocal contrast enhancing recurrent mass lesions (Fig. 1e, f, arrow), suggesting the progression of disease. The patient was started on temozolamide but she died after 8 months' follow-up. Though MRI is routinely used in assessment of brain tumours, its ability to differentiate between treatment-induced changes and residual or recurrent tumour is limited. {sup 18}F-FDG PET was the first tracer used for assessment of brain tumours; however, it has a low tumour-to-background ratio in brain, limiting its utility. {sup 18}F-FDG uptake correlates with tumour grade, with high-grade gliomas (grades III and IV) showing higher uptake

  18. Functional testicular evaluation using PET/CT with 18F-fluorodeoxyglucose

    International Nuclear Information System (INIS)

    PET/CT using 18F-FDG is a well-established diagnostic examination in oncology, cardiology and neurology. The clinical significance of nontumoral testicular uptake of FDG is unknown. Functional testicular imaging may have important clinical applications in the diagnosis and prognosis of male infertility. The aim of this study was to determine the andrological value of a FDG PET/CT in analysing testicular function, by correlating the PET/CT data with the sperm parameters. Retrospective analysis of FDG PET/CT in 20 consecutive cancer patients without testicular pathology in whom two semen samples had been obtained for analysis before any chemotherapy. FDG PET/CT parameters were the mean standardized uptake value (SUVmean), used for measuring the intensity of uptake, and the functional testicular volume (FV). For statistical analysis, a Spearman's rank correlation test and a Mann-Whitney test were used. Of 20 patients (mean age 22 years), 18 had provided two sperm samples for cryopreservation. Sperm concentration was above 20 x 106/ml in 55% of the patients. The intensity of uptake and the FV were correlated with the total sperm count, the sperm concentration and motility (p < 0.05). The difference in SUVmean between the two testes showed an inverse correlation with sperm concentration (p = 0.036). Normospermic and oligospermic men had significant differences in: (1) mean SUVmean, (2) mean FV, and (3) the difference in intensity of uptake between the testes (p < 0.05). This is the first report on the andrological value of FDG PET/CT in analysing nontumoral testicular function. This pilot study showed a significant correlation between intensity of uptake of FDG and testicular FV with the main sperm parameters. PET/CT with FDG could become a useful new tool in assisted reproductive technologies and other andrological or urological applications. (orig.)

  19. Functional testicular evaluation using PET/CT with {sup 18}F-fluorodeoxyglucose

    Energy Technology Data Exchange (ETDEWEB)

    Dierickx, Lawrence Oliver; Zerdoud, Slimane; Filleron, Thomas; Brillouet, Severine [Institut Claudius Regaud, Service of Nuclear Medicine, Toulouse (France); Huyghe, Eric; Delauney, Boris; Bujan, Louis; Plante, Pierre [CHU Toulouse, Toulouse (France); Nogueira, Daniela; Montagut, Jacques [I.F.R.E.A.R.E.S., Toulouse (France); Courbon, Frederic [Institut Claudius Regaud, Service of Nuclear Medicine, Toulouse (France); CHU Toulouse, Toulouse (France)

    2012-01-15

    PET/CT using {sup 18}F-FDG is a well-established diagnostic examination in oncology, cardiology and neurology. The clinical significance of nontumoral testicular uptake of FDG is unknown. Functional testicular imaging may have important clinical applications in the diagnosis and prognosis of male infertility. The aim of this study was to determine the andrological value of a FDG PET/CT in analysing testicular function, by correlating the PET/CT data with the sperm parameters. Retrospective analysis of FDG PET/CT in 20 consecutive cancer patients without testicular pathology in whom two semen samples had been obtained for analysis before any chemotherapy. FDG PET/CT parameters were the mean standardized uptake value (SUVmean), used for measuring the intensity of uptake, and the functional testicular volume (FV). For statistical analysis, a Spearman's rank correlation test and a Mann-Whitney test were used. Of 20 patients (mean age 22 years), 18 had provided two sperm samples for cryopreservation. Sperm concentration was above 20 x 10{sup 6}/ml in 55% of the patients. The intensity of uptake and the FV were correlated with the total sperm count, the sperm concentration and motility (p < 0.05). The difference in SUVmean between the two testes showed an inverse correlation with sperm concentration (p = 0.036). Normospermic and oligospermic men had significant differences in: (1) mean SUVmean, (2) mean FV, and (3) the difference in intensity of uptake between the testes (p < 0.05). This is the first report on the andrological value of FDG PET/CT in analysing nontumoral testicular function. This pilot study showed a significant correlation between intensity of uptake of FDG and testicular FV with the main sperm parameters. PET/CT with FDG could become a useful new tool in assisted reproductive technologies and other andrological or urological applications. (orig.)

  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. The additional value of PET/CT over PET in FDG imaging of oesophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bar-Shalom, Rachel; Frenkel, Alex [Rambam Medical Center, Department of Nuclear Medicine, Haifa (Israel); Guralnik, Ludmila; Leiderman, Max [Rambam Medical Center, Department of Diagnostic Imaging, Haifa (Israel); Tsalic, Medy [Rambam Medical Center, Department of Oncology, Haifa (Israel); Gaitini, Diana [Rambam Medical Center, Department of Diagnostic Imaging, Haifa (Israel); School of Medicine, Israel Institute of Technology, Haifa (Israel); Ben-Nun, Alon [Rambam Medical Center, Department of Thoracic Surgery, Haifa (Israel); Keidar, Zohar; Israel, Ora [Rambam Medical Center, Department of Nuclear Medicine, Haifa (Israel); School of Medicine, Israel Institute of Technology, Haifa (Israel)

    2005-08-01

    The aim of this study was to assess the value of combined PET/CT compared with PET reviewed side-by-side with CT, in patients with oesophageal cancer, before and after surgery. Forty-one FDG PET/CT studies were performed in 32 patients with oesophageal cancer, before surgery (n=18) or during follow-up after resection of the primary tumour (n=23). One hundred and fifteen sites suspicious for malignancy were evaluated. PET/CT was prospectively compared with PET reviewed side-by-side with CT, for detection, accurate localisation and characterisation of malignant sites. PET/CT performance in different anatomical regions was compared before and after surgery. The impact of fused data on patient management was retrospectively assessed. PET/CT had an incremental value over PET for interpretation of 25 of 115 sites (22%), changing the initial characterisation of ten sites to either malignant (n=1) or benign (n=9), and defining the precise anatomical location of 15 sites. PET/CT provided better specificity and accuracy than PET for detecting sites of oesophageal cancer (81% and 90% vs 59% and 83% respectively, p<0.01). Fusion was of special value for interpretation of cervical and abdomino-pelvic sites, for disease assessment in loco-regional lymph nodes before surgery and in regions of postoperative anatomical distortion. PET/CT had an impact on the further management of four patients (10%), by detecting nodal metastases that warranted disease upstaging (n=2) and by excluding disease in sites of benign uptake after surgery (n=2). (orig.)

  2. Survival outcomes in patients with cervical cancer after inclusion of PET/CT in staging procedures

    International Nuclear Information System (INIS)

    In cancer of the uterine cervix, lymph node metastases are associated with a poor prognosis. Even so, the International Federation of Gynecology and Obstetrics (FIGO) does not take into account diagnostic results of methods such as PET/CT, since these are not readily available everywhere. As undetected lymph node metastases can lead to undertreatment, any difference in the underlying prevalence of false-negative scans between CT and PET/CT may be reflected in treatment outcomes. This study investigated survival outcomes in node-negative patients before and after the introduction of PET/CT. This was a single-institution retrospective analysis of 301 patients with a histopathological diagnosis of cervical cancer. The patients were receiving chemoradiotherapy with curative intent according to the standard protocol of the department for patients without lymph node metastases as assessed by pretreatment CT or PET/CT. Patients were stratified into two groups: PET/CT and non-PET/CT. Patient characteristics and treatment outcomes were acquired from the treatment database. Significant differences of 23 % (95 % CI 17 - 29 %), 19 % (95 % CI 13 - 25 %) and 12 % (95 % CI 6 - 18 %) in 5-year overall, disease-free and disease-specific survival, respectively, were observed between the two patient groups. The difference remained significant in univariate and multivariate analyses of overall survival (hazard ratio 0.61, 95 % CI 0.42 - 0.89; p = 0.010), including age, FIGO stage, performance status, BMI, and histopathology. Inclusion of PET/CT in the preradiotherapy diagnostic protocol may lead to nodal stage migration not reflected in the FIGO stage. It was found to be a significant covariate, and could lead to selection bias that needs to be taken into account when designing and reporting on clinical trials. (orig.)

  3. Clinical impact of FDG PET-CT in patients with potentially operable metastatic colorectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Briggs, R.H. [Department of Radiology, Calderdale and Huddersfield NHS Foundation Trust, Huddersfield (United Kingdom); Chowdhury, F.U. [Departments of Radiology and Nuclear Medicine, St James' s University Hospital, Leeds (United Kingdom); Lodge, J.P.A. [HPB and Transplant Unit, St James' s University Hospital, Leeds (United Kingdom); Scarsbrook, A.F., E-mail: andrew.scarsbrook@leedsth.nhs.uk [Departments of Radiology and Nuclear Medicine, St James' s University Hospital, Leeds (United Kingdom)

    2011-12-15

    Aim: To assess the clinical impact of 2-[{sup 18}F]-fluoro-2-deoxy-D-glucose (FDG) positron-emission tomography-computed tomography (PET-CT) in patients with potentially resectable metastatic colorectal cancer. Materials and methods: One hundred and two patients with potentially resectable metastatic colorectal cancer underwent FDG PET-CT in addition to conventional imaging over an 18-month period. The findings were compared to conventional imaging, with histological or clinico-radiological validation. The impact on subsequent management was evaluated using information from clinico-radiological databases. Results: Of 102 patients (mean age 67 years, range 27-85 years), 94 had liver, five had isolated lung, and three had limited peritoneal metastases. In 31 patients (30%) PET-CT had a major impact on subsequent management, by correctly clarifying indeterminate lesions on conventional imaging as inoperable metastatic disease in 16 patients, detecting previously unsuspected metastatic disease in nine patients, identifying occult second primary tumours in three patients, and correctly down-staging three patients. PET-CT had a minor impact in 12 patients (12%), no impact in 49 cases (48%), and a potentially negative impact in 10 cases (10%). Following PET-CT, 36 (35%) patients were no longer considered for surgery. Of those remaining operative 45 of 66 (68%) underwent potentially curative metastatic surgery. In this cohort PET-CT saved 16 futile laparotomies. Conclusion: FDG PET-CT has a valuable role in selected patients with metastatic colorectal cancer by improving staging accuracy and characterizing indeterminate lesions and helps triage patients to the appropriate treatment.

  4. Survival outcomes in patients with cervical cancer after inclusion of PET/CT in staging procedures

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, Henrik Villibald [University of Copenhagen, Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); Section for Radiotherapy, Rigshospitalet, Department of Oncology, Copenhagen (Denmark); Loft, Annika [University of Copenhagen, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); Berthelsen, Anne Kiil [University of Copenhagen, Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); University of Copenhagen, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); Christensen, Ib Jarle [University of Copenhagen, The Finsen Laboratory, Rigshospitalet, Copenhagen (Denmark); University of Copenhagen, Biotech Research and Innovation Centre (BRIC), Copenhagen (Denmark); Hoegdall, Claus [University of Copenhagen, Department of Gynecology, Rigshospitalet, Copenhagen (Denmark); Engelholm, Svend Aage [University of Copenhagen, Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark)

    2015-11-15

    In cancer of the uterine cervix, lymph node metastases are associated with a poor prognosis. Even so, the International Federation of Gynecology and Obstetrics (FIGO) does not take into account diagnostic results of methods such as PET/CT, since these are not readily available everywhere. As undetected lymph node metastases can lead to undertreatment, any difference in the underlying prevalence of false-negative scans between CT and PET/CT may be reflected in treatment outcomes. This study investigated survival outcomes in node-negative patients before and after the introduction of PET/CT. This was a single-institution retrospective analysis of 301 patients with a histopathological diagnosis of cervical cancer. The patients were receiving chemoradiotherapy with curative intent according to the standard protocol of the department for patients without lymph node metastases as assessed by pretreatment CT or PET/CT. Patients were stratified into two groups: PET/CT and non-PET/CT. Patient characteristics and treatment outcomes were acquired from the treatment database. Significant differences of 23 % (95 % CI 17 - 29 %), 19 % (95 % CI 13 - 25 %) and 12 % (95 % CI 6 - 18 %) in 5-year overall, disease-free and disease-specific survival, respectively, were observed between the two patient groups. The difference remained significant in univariate and multivariate analyses of overall survival (hazard ratio 0.61, 95 % CI 0.42 - 0.89; p = 0.010), including age, FIGO stage, performance status, BMI, and histopathology. Inclusion of PET/CT in the preradiotherapy diagnostic protocol may lead to nodal stage migration not reflected in the FIGO stage. It was found to be a significant covariate, and could lead to selection bias that needs to be taken into account when designing and reporting on clinical trials. (orig.)

  5. Respiratory motion reduction in PET/CT using abdominal compression for lung cancer patients.

    Directory of Open Access Journals (Sweden)

    Tzung-Chi Huang

    Full Text Available PURPOSE: Respiratory motion causes substantial artifacts in reconstructed PET images when using helical CT as the attenuation map in PET/CT imaging. In this study, we aimed to reduce the respiratory artifacts in PET/CT images of patients with lung tumors using an abdominal compression device. METHODS: Twelve patients with lung cancer located in the middle or lower lobe of the lung were recruited. The patients were injected with 370 MBq of 18F-FDG. During PET, the patients assumed two bed positions for 1.5 min/bed. After conducting free-breathing imaging, we obtained images of the patients with abdominal compression by applying the same setup used in the free-breathing scan. The differences in the standardized uptake value (SUVmax, SUVmean, tumor volume, and the centroid of the tumors between PET and various CT schemes were measured. RESULTS: The SUVmax and SUVmean derived from PET/CT imaging using an abdominal compression device increased for all the lesions, compared with those obtained using the conventional approach. The percentage increases were 18.1% ±14% and 17% ±16.8% for SUVmax and SUVmean, respectively. PET/CT imaging combined with abdominal compression generally reduced the tumor mismatch between CT and the corresponding attenuation corrected PET images, with an average decrease of 1.9±1.7 mm over all the cases. CONCLUSIONS: PET/CT imaging combined with abdominal compression reduces respiratory artifacts and PET/CT misregistration, and enhances quantitative SUV in tumor. Abdominal compression is easy to set up and is an effective method used in PET/CT imaging for clinical oncology, especially in the thoracic region.

  6. Usefulness of combined metabolic volumetric indices of {sup 18}FFDG PET/CT for the early prediction of neoadjuvant chemotherapy outcomes in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Im, Hyung Jun; Kim, Yu Kyeong; Kim, Yong Il; Lee, Jong Jin; Lee, Won Woo; Kim, Sang Eun [Seoul National Univ., Seoul (Korea, Republic of)

    2012-03-15

    The purpose of this study was to investigate the usefulness of metabolic volumetric indices of {sup 18}F fluorodeoxy D glucose ({sup 18}FFDG) positron emission tomography/computed tomography (PET/CT) for the evaluation of neoadjuvant chemotherapy outcomes in breast cancer. Twenty four patients with locally advanced breast cancer were enrolled in the study. They underwent baseline {sup 18}F FDG PET/CT scan and received four or six cycles of neoadjuvant chemotherapy, interim {sup 18}F FDG PET/CT was done after second cycle of chemotherapy. Maximum standardized uptake value (SUVmax), metabolic tumor volume(MTV), and total lesion glycolysis (TLG) of the primary lesions were calculated. Reduction rates of these parameters were obtained between baseline and interim {sup 18}F FDG PET/CT. Chemotherapy outcomes were assessed using tumor size reduction rate and histological grading system (Miller and Payne system). Reduction rates of SUVmax, MTV, and TLG correlated with chemotherapy outcomes. MTV and TLG reduction rates showed significant correlation with tumor size reduction rate (R=0.68, P=0.0004; R=0.62, P=0.002, respectively). However, SUVmax reduction rate showed no significant correlation. MTV and TLG reduction rates were significantly higher in responders than nonresponders, as determined by Miller and Payne system (P<0.0007, P<0.0002). However, SUVmax reduction rate showed no significant difference. On ROC analysis, the area under the MTV and TLG curves was 0.886, and that of SUVmax was 0.743. Sensitivity, specificity, positive predictive value, and negative predictive value to predict histopathologic response were the same for MTV and TLG, and the values were 100%, 85,7%, 83.3%, and 100%, respectively (at the reduction rate of 93.2%, for MTV, and 95.8% for TLG). Changes of metabolic volumetric indices successfully reflected the neoadjuvant chemotherapy outcomes. MTV and TLG could be robust indices in discriminating pathologic responder as SUVmax, after neoadjuvant

  7. Combined evaluation of myocardial perfusion and coronary morphology in the identification of subclinical CAD. Radiation exposure of {sup 13}N-ammonia PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Vincenti, G.; Quercioli, A.; Nkoulou, R.; Mach, F.; Schindler, T.H. [Dept. of Internal Medicine, Cardiovascular Center, Nuclear Cardiology, Univ. Hospital of Geneva (Switzerland); Zaidi, H.; Dewarrat, S.; Rager, O.; Seimbille, Y.; Ratib, O. [Dept. of Radiology, Univ. Hospital of Geneva (Switzerland); Ambrosio, G. [Div. of Cardiology, Univ. Hospital of Perugia (Italy)

    2010-07-01

    Purpose: To evaluate the mean effective radiation dose of {sup 13}N-ammonia PET/CT and ECG-pulsing CT angiography (CTA) in the evaluation of myocardial perfusion, myocardial blood flow (MBF) and coronary morphology for the identification of subclinical CAD. Patients, material, methods: Following rest-stress {sup 13}N-ammonia PET/CT perfusion imaging and MBF quantification, ECG-pulsing CTA at a pulse window of 70% of the R-R cycle was performed in ten healthy controls and in sixteen individuals with cardiovascular risk factors. Individual radiation dose exposure for ECG-pulsing CTA was estimated from the dose-length product. Results: PET demonstrated normal perfusion in all study individuals, while hyperemic MBFs during dipyridamole stimulation and the myocardial flow reserve (MFR) in cardiovascular risk individuals were significantly lower than in healthy controls (1.34{+-}0.26 vs. 2.28{+-}0.47 ml/g/min and 1.48{+-}0.39 vs. 3.24{+-}0.81, both p<<0.0001). Further, ECG-pulsing CTA identified mild calcified and non-calcified coronary plaque burden in 7 (43%) individuals of the cardiovascular risk group. Rest-stress {sup 13}N-ammonia PET/CT perfusion study yielded a mean effective radiation dose of 3.07{+-}0.06 mSv (2.07{+-}0.06 mSv from the rest-stress {sup 13}N-ammonia injections and 1.0 mSv from the 2 CT transmission scans), while ECG-pulsing CTA was associated with 5.57{+-}2.00 mSv. The mean effective radiation dose of the combined {sup 13}N-ammonia PET/CT and ECG-pulsing CTA exams in the evaluation of myocardial perfusion and coronary morphology was 8.0{+-}1.5 mSv. Conclusion: {sup 13}N-ammonia PET/CT and ECG-pulsing CTA affords cardiac hybrid imaging studies in the evaluation of subclinical CAD with a relatively low mean effective radiation exposure of 8.0{+-}1.5mSv. (orig.)

  8. Diagnostic value of F18-FDG PET/CT in patients with the revised definition of fever of unknown origin

    DEFF Research Database (Denmark)

    Prakash, Vineet; Ketharanathan, Nagulabaskaran; Lorenz, Eleanor;

    2009-01-01

    Objectives: Fever of unknown origin (FUO) is an increasingly accepted indication for PET/CT where it has a relatively high diagnostic yield. This study assesses its diagnostic value for the revised definition of FUO. Methods: The revised definition of FUO is fever of greater than 38.3C for more......), neoplasm (6 pts) and drug fever (1 pt). Before ordering a PET/CT, conventional CT or MRI was performed in 43 pts. We considered that a PET/CT was essential to establish the final diagnosis in 15/43 pts (35%) with inconclusive CT or MRI. Conclusions: 18F-FDG PET/CT contributed to establishing a final...

  9. Preoperative FDG-PET/CT Is an Important Tool in the Management of Patients with Thick (T4) Melanoma.

    Science.gov (United States)

    Arrangoiz, Rodrigo; Papavasiliou, Pavlos; Stransky, Carrie A; Yu, Jian Q; Tianyu, Li; Sigurdson, Elin R; Berger, Adam C; Farma, Jeffrey M

    2012-01-01

    The yield of preoperative PET/CT (PET/CT) for regional and distant metastases for thin/intermediate thickness melanoma is low. Objective of this study is to determine if PET/CT performed for T4 melanomas helps guide management and alter treatment plans. Methods. Retrospective cohort of 216 patients with T4 melanomas treated at two tertiary institutions. Fifty-six patients met our inclusion criteria (T4 lesion, PET/CT and no clinical evidence of metastatic disease). Results. Fifty-six patients (M: 32, F: 24) with median tumor thickness of 6 mm were identified. PET/CT recognized twelve with regional and four patients with metastatic disease. Melanoma-related treatment plan was altered in 11% of the cases based on PET/CT findings. PET/CT was negative 60% of the time, in 35% of the cases; it identified incidental findings that required further evaluation. Conclusion. Patients with T4 lesions, PET/CT changed the treatment plan 18% of the time. Regional findings changed the surgical treatment plan in 11% and the adjuvant plan in 7% of our cases due to the finding of metastatic disease. Additionally 20 patients had incidental findings that required further workup. In this subset of patients, we feel there is a benefit to PET/CT, and further studies should be performed to validate our findings.

  10. Preoperative FDG-PET/CT Is an Important Tool in the Management of Patients with Thick (T4 Melanoma

    Directory of Open Access Journals (Sweden)

    Rodrigo Arrangoiz

    2012-01-01

    Full Text Available The yield of preoperative PET/CT (PET/CT for regional and distant metastases for thin/intermediate thickness melanoma is low. Objective of this study is to determine if PET/CT performed for T4 melanomas helps guide management and alter treatment plans. Methods. Retrospective cohort of 216 patients with T4 melanomas treated at two tertiary institutions. Fifty-six patients met our inclusion criteria (T4 lesion, PET/CT and no clinical evidence of metastatic disease. Results. Fifty-six patients (M: 32, F: 24 with median tumor thickness of 6 mm were identified. PET/CT recognized twelve with regional and four patients with metastatic disease. Melanoma-related treatment plan was altered in 11% of the cases based on PET/CT findings. PET/CT was negative 60% of the time, in 35% of the cases; it identified incidental findings that required further evaluation. Conclusion. Patients with T4 lesions, PET/CT changed the treatment plan 18% of the time. Regional findings changed the surgical treatment plan in 11% and the adjuvant plan in 7% of our cases due to the finding of metastatic disease. Additionally 20 patients had incidental findings that required further workup. In this subset of patients, we feel there is a benefit to PET/CT, and further studies should be performed to validate our findings.

  11. Clinical value of {sup 11}C-methionine PET/CT in patients with plasma cell malignancy: comparison with {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Nakamoto, Yuji; Kurihara, Kensuke; Nakatani, Koya; Togashi, Kaori [Kyoto University Graduate School of Medicine, Department of Diagnostic Imaging and Nuclear Medicine, Kyoto (Japan); Nishizawa, Masatoshi; Yamashita, Kouhei; Kondo, Tadakazu; Takaori-Kondo, Akifumi [Kyoto University Graduate School of Medicine, Department of Hematology and Oncology, Kyoto (Japan)

    2013-05-15

    PET/CT using FDG has been widely used for the imaging of various malignant tumours, including plasma cell malignancy (PCM), but {sup 11}C-methionine (MET), as a radiolabelled amino acid tracer, may also be useful because PCM is able to activate protein synthesis. The purpose of this study was to evaluate the clinical value of PET/CT imaging using MET in PCM, including multiple myeloma, compared with that of FDG PET/CT. The study group comprised 20 patients with histologically proven PCM who underwent FDG PET/CT and MET PET/CT scans before (n = 6) or after (n = 14) treatment. Semiquantitative analysis was performed on a lesion basis. We also visually evaluated the scans qualitatively using a five-point scale (0, negative; 1, probably negative; 2, equivocal; 3, probably positive; 4, positive) on a lesion and a patient basis. The results were compared between the two scans. Active PCM was confirmed in 15 patients, including two patients with extramedullary lesions. Uptake of MET tended to be higher (maximum standardized uptake value 10.3 {+-} 5.6, mean {+-} SD) than that of FDG (3.4 {+-} 2.7, p < 0.001), and more lesions of grade 3 or 4 were depicted by MET (MET 156 lesions vs. FDG 58 lesions). On a patient basis, two patients were accurately diagnosed only by MET. In the remaining 18 patients, consistent results were obtained, but potential upgrade of staging or restaging was necessary in 6 of 11 positive patients because more abnormal lesions were demonstrated by MET. The patient-based sensitivity, specificity and accuracy of MET for restaging were 89 %, 100 % and 93 %, respectively, while those of FDG were 78 %, 100 % and 86 %, respectively. MET revealed an equal or greater number of lesions in PCM than FDG. MET may be especially useful when negative or inconclusive findings are obtained by FDG despite highly suspicious indications of recurrence. (orig.)

  12. Clinical value of 11C-methionine PET/CT in patients with plasma cell malignancy: comparison with 18F-FDG PET/CT

    International Nuclear Information System (INIS)

    PET/CT using FDG has been widely used for the imaging of various malignant tumours, including plasma cell malignancy (PCM), but 11C-methionine (MET), as a radiolabelled amino acid tracer, may also be useful because PCM is able to activate protein synthesis. The purpose of this study was to evaluate the clinical value of PET/CT imaging using MET in PCM, including multiple myeloma, compared with that of FDG PET/CT. The study group comprised 20 patients with histologically proven PCM who underwent FDG PET/CT and MET PET/CT scans before (n = 6) or after (n = 14) treatment. Semiquantitative analysis was performed on a lesion basis. We also visually evaluated the scans qualitatively using a five-point scale (0, negative; 1, probably negative; 2, equivocal; 3, probably positive; 4, positive) on a lesion and a patient basis. The results were compared between the two scans. Active PCM was confirmed in 15 patients, including two patients with extramedullary lesions. Uptake of MET tended to be higher (maximum standardized uptake value 10.3 ± 5.6, mean ± SD) than that of FDG (3.4 ± 2.7, p < 0.001), and more lesions of grade 3 or 4 were depicted by MET (MET 156 lesions vs. FDG 58 lesions). On a patient basis, two patients were accurately diagnosed only by MET. In the remaining 18 patients, consistent results were obtained, but potential upgrade of staging or restaging was necessary in 6 of 11 positive patients because more abnormal lesions were demonstrated by MET. The patient-based sensitivity, specificity and accuracy of MET for restaging were 89 %, 100 % and 93 %, respectively, while those of FDG were 78 %, 100 % and 86 %, respectively. MET revealed an equal or greater number of lesions in PCM than FDG. MET may be especially useful when negative or inconclusive findings are obtained by FDG despite highly suspicious indications of recurrence. (orig.)

  13. PET AND PET-CT: PHYSICAL PRINCIPLE AND MEDICAL APLICATIONS

    Directory of Open Access Journals (Sweden)

    V.Rusu

    2007-04-01

    Full Text Available Positron emission tomography (PET is a noninvasive imaging method that can “see” the metabolisms inside the living cells. It involves the acquisition of functional images based on the detection of radiation coming from the positron emission of a radiotracer administered to the patient. This radiotracer can be a metabolic analog, like is the case of glucose analog 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (18FDG, the most commonly used PET radiotracer. PET images of the human body are used to evaluate a variety of diseases, most often to detect cancer and to examine the effects of cancer therapy by characterizing cell viability and biochemical changes in the cell. It is potentially useful in cancer imaging because the increased metabolism of tumor cells leads to increased uptake of glucose, and, therefore, uptake of 18FDG, also. PET-CT is the fusion of functional and anatomic information acquired almost simultaneously, that lets us see both the structural anatomy and the functional data on the same image. They complete each other: if PET scan is powerful in evaluating the functional characteristics of the tissues, CT is a powerful structural resolution imaging method. The highly sensitive PET scan detects the metabolic signal of actively growing cancer cells in the body and the CT scan provides a detailed picture of the internal anatomy that reveals sites, size and shape of cancer tissue. Alone, each imaging test has particular benefits and limitations but when the results of PET and CT scans are "fused" together, the combined image provides complete information on cancer location and metabolism.

  14. Diagnostic accuracy of {sup 68}Ga-DOTANOC PET/CT imaging in pheochromocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Punit; Dhull, Varun Singh; Arora, Saurabh; Kumar, Rajeev; Malhotra, Arun; Kumar, Rakesh; Bal, Chandrasekhar [All India Institute of Medical Sciences, Department of Nuclear Medicine, Ansari Nagar, New Delhi (India); Gupta, Poonam; Ammini, Ariachery C. [All India Institute of Medical Sciences, Department of Endocrinology and Metabolism, New Delhi (India); Durgapal, Prashant [All India Institute of Medical Sciences, Department of Pathology, New Delhi (India); Chumber, Sunil [All India Institute of Medical Sciences, Department of Surgical Disciplines, New Delhi (India)

    2014-03-15

    The purpose of the present study was to evaluate the diagnostic accuracy of {sup 68}Ga-DOTANOC positron emission tomography (PET)/CT in patients with suspicion of pheochromocytoma. Data of 62 patients [age 34.3 ± 16.1 years, 14 with multiple endocrine neoplasia type 2 (MEN2)] with clinical/biochemical suspicion of pheochromocytoma and suspicious adrenal lesion on contrast CT (n = 70), who had undergone {sup 68}Ga-DOTANOC PET/CT, were retrospectively analyzed. PET/CT images were analyzed visually as well as semiquantitatively, with measurement of maximum standardized uptake value (SUV{sub max}), SUV{sub mean}, SUV{sub max}/SUV{sub liver}, and SUV{sub mean}/SUV{sub liver}. Results of PET/CT were compared with {sup 131}I-metaiodobenzylguanidine (MIBG) imaging, which was available in 40 patients (45 lesions). Histopathology and/or imaging/clinical/biochemical follow-up (minimum 6 months) was used as reference standard. The sensitivity, specificity, and accuracy of {sup 68}Ga-DOTANOC PET/CT was 90.4, 85, and 88.7 %, respectively, on patient-based analysis and 92, 85, and 90 %, respectively, on lesion-based analysis. {sup 68}Ga-DOTANOC PET/CT showed 100 % accuracy in patients with MEN2 syndrome and malignant pheochromocytoma. On direct comparison, lesion-based accuracy of {sup 68}Ga-DOTANOC PET/CT for pheochromocytoma was significantly higher than {sup 131}I-MIBG imaging (91.1 vs 66.6 %, p = 0.035). SUV{sub max} was higher for pheochromocytomas than other adrenal lesions (p = 0.005), MEN2-associated vs sporadic pheochromocytoma (p = 0.012), but no difference was seen between benign vs malignant pheochromocytoma (p = 0.269). {sup 68}Ga-DOTANOC PET/CT shows high diagnostic accuracy in patients with suspicion of pheochromocytoma and is superior to {sup 131}I-MIBG imaging for this purpose. Best results of {sup 68}Ga-DOTANOC PET/CT are seen in patients with MEN2-associated and malignant pheochromocytoma. (orig.)

  15. PET-CT offers accurate assessment of tumour length in oesophageal malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Rollins, K.E., E-mail: james.catton@nuh.nhs.uk [Department of Oesophago-Gastric Surgery, Nottingham University Hospitals, Hucknall Road, Nottingham (United Kingdom); Lucas, E. [University of Nottingham, Derby Road, Nottingham (United Kingdom); Tewari, N. [Department of Oesophago-Gastric Surgery, Nottingham University Hospitals, Hucknall Road, Nottingham (United Kingdom); James, E. [Department of Oncology, Nottingham University Hospitals, Hucknall Road, Nottingham (United Kingdom); Hughes, S. [Department of Radiology, Nottingham University Hospitals, Hucknall Road, Nottingham (United Kingdom); Catton, J.A. [Department of Oesophago-Gastric Surgery, Nottingham University Hospitals, Hucknall Road, Nottingham (United Kingdom)

    2015-02-15

    Highlights: • We examine the accuracy of staging modalities in estimating tumour length of oesophageal malignancy. • PET CT correlates most strongly with histopathological length of resected specimen. • Better measure than EUS with OGD correlating poorly. • Potential impact in radiotherapy and surgical resection planning. - Abstract: Introduction: Radiotherapy is increasingly used for both curative and palliative treatment of oesophageal malignancy. Accurate treatment depends on determining tumour location and length. This study assessed the value of PET-CT versus other staging modalities in determining tumour length. Materials and methods: Oesophageal cancer patients who underwent staging with PET/CT and endoscopic ultrasound (EUS) in addition to their diagnostic upper GI endoscopy and subsequent surgical resection were assessed. PET/CT length was obtained retrospectively by using Hermes Hybrid Viewer™ with a 1–5 Standardised Uptake Value grey scale. An SUV of 5 was used as the cut off for determining length. Direct measurement by EUS and OGD were determined. Results: 53 patients underwent PET-CT, EUS, OGD and surgical resection for oesophageal cancer. Overall the correlation between PET-CT and histopathological length was strongest (Pearson r = 0.5977, 95% CI 0.390–0.747) versus EUS (Pearson R = 0.5365, 95% CI 0.311–0.705) and OGD (Pearson r = 0.1574, 95% CI −0.118 to 0.410). After excluding tumours with a significant chemotherapy response, PET-CT length correlated significantly with histopathological length (R = 0.5651, p = 0.0005). In comparison, the correlation between histological length and EUS (R = 0.4637, p = 0.0057) measurement was less significant and this did not correlate with OGD (R = −0.1084, p = 0.5417). Conclusion: Tumour length estimated by PET-CT correlated most strongly with histopathological length of oesophageal malignancy and is the most accurate determinant of tumour length of all the staging modalities. This suggests a

  16. 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.

  17. Integrated FDG PET-CT imaging improves staging in malignant pleural mesothelioma

    Energy Technology Data Exchange (ETDEWEB)

    Krueger, S. [Medical Clinic II, Univ. Hospital, Ulm (Germany); Medical Clinic I, Univ. Hospital RWTH, Aachen (Germany); Pauls, S. [Dept. of Diagnostic and Interventional Radiology, Univ. Hospital, Ulm (Germany); Mottaghy, F.M.; Buck, A.K.; Reske, S.N. [Dept. of Nuclear Medicine, Univ. Hospital, Ulm (Germany); Schelzig, H. [Dept. of Thoracic and Vascular Surgery, Univ. Hospital, Ulm (Germany); Hombach, V. [Medical Clinic II, Univ. Hospital, Ulm (Germany)

    2007-07-01

    Aim of this study was to investigate, how often TNM staging is changed in patients with malignant pleural mesothelioma (MPM) by the application of integrated PET-CT compared to computed tomography alone and how often these changes are clinically relevant. Patients, methods: We studied 17 patients (68 {+-} 6 years, 8 women) with MPM. Integrated PET-CT scan and histological confirmation were performed in all patients. Results: Final histological diagnosis confirmed 9 epithelial type, 2 sarcomatoid type and 6 biphasic type MPM. Mean standardized uptake value (SUV) was 5.9 {+-} 1.9 in epithelial MPM and 15.1 {+-} 10.2 in sarcomatoid MPM. CT and PET-CT revealed discordances in 8/17 (47%) patients in TNM classification with 4/8 (50%) being clinically relevant. PET-CT led to downstaging in 5 (29%) and upstaging in 3 (18%) patients. Mean survival time tended to be higher in the subgroup of patients with lower mean SUV. Conclusions: PET-CT seems to be a valuable tool in staging of MPM and leads to discordant findings in almost every second patient compared to CT alone. In many cases these differences are clinically relevant and have therapeutic consequences. (orig.)

  18. 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)

  19. PET and PET/CT imaging for the earliest detection and treatment of colorectal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Carter, Kevin [Michigan State Univ., Pontiac, MI (United States). POH Medical Center; Kotlyarov, Eduard [Michigan State Univ., Pontiac, MI (United States). POH Medical Center; Georgetown Univ. (United States)

    2005-10-15

    Approximately 150,000 new cases of colorectal cancer are diagnosed each year with the life time risk of developing colon caner in developed nations being 4.6% in men and 3.2% in women. Screening patients is essential early detection of colon carcinoma to aid in complete resection. Unfortunately current screening methods carry with them poor patient compliance. PET and PET/CT may be a significant part of this screening solution. The authors reviewed and analyzed the English language articles and case reports identified on Medline during the last 10 years. PET and PET/CT results for colorectal carcinoma were tabulated and presented for the fifth Scientific Meeting of the Brazilian Society of Nuclear Biosciences. Though most studies have been retrospective analysis in using PET for staging for other malignant processes the cases that have identified additional uptake in the colon are important. The accuracy when utilizing PET and PET/CT in this screening method has a sensitivity between 65 and 90% with a specificity of 84 to 90% and a positive predictive value 71 to 78%. Early stages of malignancies and pre-cancerous polyps avidly accumulates F-18 Deoxyfluoro glucose allowing us to conclude that whole body PET and PET/CT is an essential component in the work up, staging or treatment monitoring in colon carcinoma. We have to continue to accumulate data for possible introduction for whole body PET and PET/CT scanning for colon carcinoma and precancerous polyps.(author)

  20. 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.

  1. Correlation between PET/CT results and histological and immunohistochemical findings in breast carcinomas

    Directory of Open Access Journals (Sweden)

    Almir Galvão Vieira Bitencourt

    2014-04-01

    Full Text Available Objective To correlate the results of 18F-fluoro-2-deoxy-D-glucose (18F-FDG positron emission tomography/computed tomography (PET/CT performed with a specific protocol for assessment of breasts with histological/immunohistochemical findings in breast carcinoma patients. Materials and Methods Cross-sectional study with prospective data collection, where patients with biopsy-confirmed breast carcinomas were studied. The patients underwent PET/CT examination in prone position, with a specific protocol for assessment of breasts. PET/CT findings were compared with histological and immunohistochemical data. Results The authors identified 59 malignant breast lesions in 50 patients. The maximum diameter of the lesions ranged from 6 to 80 mm (mean: 32.2 mm. Invasive ductal carcinoma was the most common histological type (n = 47; 79.7%. At PET/CT, 53 (89.8% of the lesions demonstrated anomalous concentrations of 18F-FDG, with maximum SUV ranging from 0.8 to 23.1 (mean: 5.5. A statistically significant association was observed between higher values of maximum SUV and histological type, histological grade, molecular subtype, tumor diameter, mitotic index and Ki-67 expression. Conclusion PET/CT performed with specific protocol for assessment of breasts has demonstrated good sensitivity and was associated with relevant histological/immunohistochemical factors related to aggressiveness and prognosis of breast carcinomas.

  2. Usefulness of {sup 18}F fluoride PET/CT in breast cancer patients with osteosclerotic bone metastases

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seok Ho; Kim, Ku Sang; Kang, Seok Yun; Song, Hee Sung; Jo, Kyung Sook; Lee, Su Jin; Yoon, Joon Kee; An, Young Sil [Ajou Univ., Suwon (Korea, Republic of); Choi, Bong Hoi [Gyeongsang National Univ. Hospital, Jinju (Korea, Republic of)

    2012-03-15

    Bone metastasis is an important factor for the treatment and prognosis of breast cancer patients. Whole body bone scintigraphy (WBBS) can evaluate skeletal metastases, and {sup 18}F FDG PET/CT seems to exhibit high specificity and accuracy in detecting bone metastases. However, there is a limitation of {sup 18}F FDG PET in assessing sclerotic bone metastases because some lesions may be undetectable. Recent studies showed that {sup 18}F fluoride PET/CT is more sensitive than WBBS in detecting bone metastases. This study aims to evaluate the usefulness of {sup 18}F fluoride PET/CT by comparing it with WBBS and {sup 18}F FDG PET/CT in breast cancer patients with osteosclerotic skeletal metastases. Nine breast cancer patients with suspected bone metastases (9 females; mean age {+-} SD, 55.6{+-}10.0 years) underwent {sup 99m}Tc MDP WBBS, {sup 18}F FDG PET/CT and {sup 18}F fluoride PET/CT. Lesion based analysis of five regions of the skeletons(skull, vertebral column, thoracic cage, pelvic bones and long bones of extremities) and patient based analysis were performed. {sup 18}F fluoride PET/CT, {sup 18}F FDG PET/CT and WBBS detected 49, 20 and 25 true metastases, respectively. Sensitivity, specificity, positive predictive value and negative predictive value of {sup 18}F fluoride PET/CT were 94.2%, 46.3%, 57.7% and 91.2%, respectively. Most true metastatic lesions of {sup 18}F fluoride PET/CT had osteosclerotic change (45/49, 91.8%), and only four lesions showed osteolytic change. Most lesions on {sup 18}F FDG PET/CT also demonstrated osteosclerotic change (17/20, 85.0%) with three osteolytic lesions. All true metastatic lesions detected on WBBS and {sup 18}F FDG PET/CT were identified on {sup 18}F fluoride PET/CT. {sup 18}F FDG PET/CT in detecting osteosclerotic metastatic lesions. {sup 18}F fluoride PET/CT might be useful in evaluating osteosclerotic metastases in breast cancer patients.

  3. Prediction of positron emission tomography/computed tomography (PET/CT) positivity in patients with high-risk primary melanoma

    Science.gov (United States)

    Danielsen, Maria; Kjaer, Andreas; Wu, Max; Martineau, Lea; Nosrati, Mehdi; Leong, Stanley PL; Sagebiel, Richard W; III, James R Miller; Kashani-Sabet, Mohammed

    2016-01-01

    Positron emission tomography/computed tomography (PET/CT) is an important tool to identify occult melanoma metastasis. To date, it is controversial which patients with primary cutaneous melanoma should have staging PET/CT. In this retrospective analysis of more than 800 consecutive patients with cutaneous melanoma, we sought to identify factors predictive of PET/CT positivity in the setting of newly-diagnosed high-risk primary melanoma to determine those patients most appropriate to undergo a PET/CT scan as part of their diagnostic work up. 167 patients with newly-diagnosed high-risk primary cutaneous melanoma underwent a PET/CT scan performed as part of their initial staging. Clinical and histologic factors were evaluated as possible predictors of melanoma metastasis identified on PET/CT scanning using both univariate and multivariate logistic regression. In all, 32 patients (19.2%) had a positive PET/CT finding of metastatic melanoma. In more than half of these patients (56.3%), PET/CT scanning identified disease that was not detectable on clinical examination. Mitotic rate, tumor thickness, lymphadenopathy, and bleeding were significantly predictive of PET/CT positivity. A combinatorial index constructed from these factors revealed a significant association between number of high-risk factors observed and prevalence of PET/CT positivity, which increased from 5.8% (with the presence of 0-2 factors) to 100.0%, when all four factors were present. These results indicate that combining clinical and histologic prognostic factors enables the identification of patients with a higher likelihood of a positive PET/CT scan.

  4. 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.)

  5. 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.)

  6. Respiratory gated PET/CT of the liver: A novel method and its impact on the detection of colorectal liver metastases

    Energy Technology Data Exchange (ETDEWEB)

    Schulz, Anselm, E-mail: anselm.schulz@gmail.com [Department of Radiology and Nuclear Medicine, Oslo University Hospital, Postboks Pb 4956 Nydalen, 0424 Oslo (Norway); Institute of Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo (Norway); Godt, Johannes Clemens, E-mail: UXGODJ@ous-hf.no [Department of Radiology and Nuclear Medicine, Oslo University Hospital, Postboks Pb 4956 Nydalen, 0424 Oslo (Norway); Institute of Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo (Norway); Dormagen, Johann Baptist, E-mail: UXJORM@ous-hf.no [Department of Radiology and Nuclear Medicine, Oslo University Hospital, Postboks Pb 4956 Nydalen, 0424 Oslo (Norway); Holtedahl, Jon Erik, E-mail: JONHOL@ous-hf.no [The Intervention Centre, Oslo University Hospital, Postboks 4950 Nydalen, 0424 Oslo (Norway); Bogsrud, Trond Velde, E-mail: tvbog@aol.com [Department of Radiology and Nuclear Medicine, Oslo University Hospital, Postboks Pb 4956 Nydalen, 0424 Oslo (Norway); Department of Nuclear Medicine and PET-Center, Aarhus University Hospital, Norrebrogade 44, DK-8000 Aarhus C (Denmark); Labori, Knut Jørgen, E-mail: uxknab@ous-hf.no [Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Postboks 4950 Nydalen, 0424 Oslo (Norway); Kløw, Nils-Einar, E-mail: NILKLO@ous-hf.no [Department of Radiology and Nuclear Medicine, Oslo University Hospital, Postboks Pb 4956 Nydalen, 0424 Oslo (Norway); Institute of Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo (Norway); Bach-Gansmo, Tore, E-mail: bat@ous-hf.no [Department of Radiology and Nuclear Medicine, Oslo University Hospital, Postboks Pb 4956 Nydalen, 0424 Oslo (Norway)

    2015-08-15

    Highlights: • Combined PET/CT and respiratory gated PET/CT improved sensitivity significantly. • Respiratory gated PET/CT had greatest impact on detection of small CRLM <10 mm. • Our results were comparable to earlier reported more complex and expensive methods. • The method used is inexpensive and requires only limited additional imaging time. - Abstract: Purpose: To evaluate the diagnostic performance of a new method for respiratory gated positron emission tomography (rgPET/CT) for colorectal liver metastases (CRLM), secondly, to assess its additional value to standard PET/CT (PET/CT). Materials and methods: Forty-three patients scheduled for resection of suspected CRLM were prospectively included from September 2011 to January 2013. None of the patients had previously undergone treatment for their CRLM. All patients underwent PET/CT and rgPET/CT in the same session. For rgPET/CT an in-house developed electronic circuit was used which displayed a color-coded countdown for the patient. The patients held their breath according to the countdown and only the data from the inspiration breath-hold period was used for image reconstruction. Two independent and blinded readers evaluated both PET/CT and rgPET/CT separately. The reference standard was histopathological confirmation for 73 out of 131 CRLM and follow-up otherwise. Results: Reference standard identified 131 CRLM in 39/43 patients. Nine patients accounted for 25 mucinous CRLM. The overall per-lesion sensitivity for detection of CRLM was for PET/CT 60.0%, for rgPET/CT 63.1%, and for standard + rgPET/CT 67.7%, respectively. Standard + rgPET/CT was overall significantly more sensitive for CRLM compared to PET/CT (p = 0.002) and rgPET/CT (p = 0.031). The overall positive predictive value (PPV) for detection of CRLM was for PET/CT 97.5%, for rgPET/CT 95.3%, and for standard + rgPET/CT 93.6%, respectively. Conclusion: Combination of PET/CT and rgPET/CT improved the sensitivity significantly for CRLM. However

  7. Evaluation of bone metastases with {sup 18} F- Sodium fluoride PET/CT; initial experience; Evaluacion de metastasis oseas con {sup 18} F-Fluoruro de sodio PET/CT; experiencia inicial

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-01

    The study of NaF-18 PET/CT is the modality with bigger sensitivity and specificity for the bony metastases detection. This additional value of the NaF-18 PET/CT can have a beneficent impact in the clinical handling of the patients with prostate cancer with high risk. (Author)

  8. [18F]fluoroethylcholine-PET/CT imaging for radiation treatment planning of recurrent and primary prostate cancer with dose escalation to PET/CT-positive lymph nodes

    International Nuclear Information System (INIS)

    At present there is no consensus on irradiation treatment volumes for intermediate to high-risk primary cancers or recurrent disease. Conventional imaging modalities, such as CT, MRI and transrectal ultrasound, are considered suboptimal for treatment decisions. Choline-PET/CT might be considered as the imaging modality in radiooncology to select and delineate clinical target volumes extending the prostate gland or prostate fossa. In conjunction with intensity modulated radiotherapy (IMRT) and imaged guided radiotherapy (IGRT), it might offer the opportunity of dose escalation to selected sites while avoiding unnecessary irradiation of healthy tissues. Twenty-six patients with primary (n = 7) or recurrent (n = 19) prostate cancer received Choline-PET/CT planned 3D conformal or intensity modulated radiotherapy. The median age of the patients was 65 yrs (range 45 to 78 yrs). PET/CT-scans with F18-fluoroethylcholine (FEC) were performed on a combined PET/CT-scanner equipped for radiation therapy planning. The majority of patients had intermediate to high risk prostate cancer. All patients received 3D conformal or intensity modulated and imaged guided radiotherapy with megavoltage cone beam CT. The median dose to primary tumours was 75.6 Gy and to FEC-positive recurrent lymph nodal sites 66,6 Gy. The median follow-up time was 28.8 months. The mean SUVmax in primary cancer was 5,97 in the prostate gland and 3,2 in pelvic lymph nodes. Patients with recurrent cancer had a mean SUVmax of 4,38. Two patients had negative PET/CT scans. At 28 months the overall survival rate is 94%. Biochemical relapse free survival is 83% for primary cancer and 49% for recurrent tumours. Distant disease free survival is 100% and 75% for primary and recurrent cancer, respectively. Acute normal tissue toxicity was mild in 85% and moderate (grade 2) in 15%. No or mild late side effects were observed in the majority of patients (84%). One patient had a severe bladder shrinkage (grade 4) after a

  9. The significance of 18F-FDG PET/CT in secondary hemophagocytic lymphohistiocytosis

    Directory of Open Access Journals (Sweden)

    Zhang Li-Juan

    2012-07-01

    Full Text Available Abstract This study was aimed to investigate the significance of 18F-FDG PET/CT in secondary hemophagocytic lymphohistiocytosis (sHLH patients. A total of 18 patients received 18F-FDG PET/CT scan at initial diagnosis. All patients (18/18 had at least 3 organs involved, with increased FDG metabolism in different degrees. Fifteen cases (15/18 had definite underlying diseases, including infections (IAHLH, rheumatosis (RAHLH, or malignancy (MAHLH. The SUVmax of patients in MAHLH group was significantly higher than patients in IAHLH group or RAHLH group (P = 0.015, P = 0.045. Furthermore, the SUVmax of patients in IAHLH group was significantly higher than patients of RAHLH group (P = 0.043. Therefore, we concluded that 18F-FDG PET/CT may especially play important role in differential diagnosis of sHLH.

  10. 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.

  11. 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)

  12. Clinical experience with a commercially available negative oral contrast medium in PET/CT

    International Nuclear Information System (INIS)

    Purpose: to evaluate a commercially available negative oral contrast material for PET/CT. Material and methods: in a prospective series of 49 patients, Mukofalk registered, which is a vegetarian-based substance, was used as a negative oral contrast medium in whole body PET/CT studies. Mukofalk was administered during a time period of 1.5 hours before the examination. Quality of small bowl distension and eventual pathological tracer uptake in the intestine were evaluated. Results: distension of the small bowel was excellent or good in 41 (85%) and poor in 8 (15%) patients. Mild tracer uptake in the small bowel was observed in 5 patients (10.2%) and moderate uptake in another 2 patients (4%). In none of these patients did the F-18 FDG uptake interfere with image interpretation. Conclusion: Mukofalk registered can be used as a negative oral contrast medium in PET/CT studies. (orig.)

  13. 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.

  14. Role of F-18 FDG PET/CT imaging in the diagnosis of paraneoplastic neurological syndromes

    Institute of Scientific and Technical Information of China (English)

    Lei Kang; Xiaojie Xu; Hongwei Sun; Rongfu Wang

    2014-01-01

    Paraneoplastic neurological syndromes (PNS) is a series of rare neurologic disorders which happen with an underlying malignancy. It has various clinical symptoms proceding to the diagnosis of tumors. Although the abnormality of anti-neuronal antibodies is suggestive of PNS and tumors, there exist many false positive and false negative cases. The diagnosis of PNS is usualy a chalenge in clinic. Positron emission tomography/computed tomography (PET/CT) imaging is an anatomical and functional fusion imaging method, which provides the whole-body information by single scan. Fluorodeoxy-glucose (FDG) PET/CT imaging can not only detect potential malignant lesions in the whole body, but also assess functional abnormality in the brain. In this review, the mechanism, clinical manifestation, diagnostic procedure and the recent progress of the utility of FDG PET/CT in PNS are introduced respectively.

  15. The Dilemma of Target Delineation with PET/CT in Radiotherapy Planning for Malignant Tumors

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Currently there are many unanswered questions concerning contouring a target with PET/CT in radiotherapy planning. Who should contour the PET volume-the radiation oncologist or the nuclear medicine physician? Which factors will contribute to the dual-observer variability between them? What should be taken as the optimal SUV threshold to demarcate a malignant tumor from the normal tissue? When the PET volume does not coincide with the local area CT findings, which portion should be contoured as the target? If a reginal lymph nodedraining area or a remote region is shown to be PET positive but CT negative, or PET negative but CT positive, how is the target identified and selected? Further studies concerning the relationship between PET/CT and the cancerous tissue are needed. The long-term clinical results showing an increased therapeutic ratio will finally verify the applicability of guidelines to contour the target with PET/CT in radiotherapy planning.

  16. 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.

  17. Absorbed radiation doses in women undergone to PET-CT exams for cancer diagnosis

    International Nuclear Information System (INIS)

    The absorbed dose in several organs and the effective dose in patients submitted to PET-CT exams with the radiopharmaceutical 18F-FDG were assessed. The ICRP-106 biokinetic model and thermoluminescent detectors in a anthropomorphic phantom were used. The use of the PET-CT image acquisition protocol, with the CT protocol for anatomical mapping, showed that 60% of effective dose was from the radiotracer administration, being the effective dose values for a female patient of (5.80 ± 1.57) mSv. In conclusion, patient doses can be reduced by using appropriate imaging acquisition in 18F-FDG PET-CT examinations and promoting the compliance with the radiation protection principles. (author)

  18. {sup 18}F-FDOPA PET/CT imaging of insulinoma revisited

    Energy Technology Data Exchange (ETDEWEB)

    Imperiale, Alessio; Namer, Izzie-Jacques [University Hospitals of Strasbourg, Department of Biophysics and Nuclear Medicine, Strasbourg (France); University of Strasbourg/CNRS and FMTS, Faculty of Medicine, ICube - UMR 7357, Strasbourg (France); Sebag, Frederic [Aix-Marseille University, Department of Endocrine Surgery, La Timone University Hospital, Marseille (France); Vix, Michel [University of Strasbourg, Department of General, Digestive, and Endocrine Surgery, IRCAD-IHU, Strasbourg (France); Castinetti, Frederic [Aix-Marseille University, Department of Endocrinology, Diabetes and Metabolic Disorders, La Timone University Hospital, Marseille (France); Kessler, Laurence; Moreau, Francois [University of Strasbourg, Department of Diabetology, University Hospital of Strasbourg, Strasbourg (France); Bachellier, Philippe [University Hospitals of Strasbourg, Department of Visceral Surgery and Transplantation, Strasbourg (France); Guillet, Benjamin; Mundler, Olivier [Aix-Marseille University, Department of Nuclear Medicine, La Timone University Hospital, CERIMED, Marseille (France); Taieb, David [Aix-Marseille University, Department of Nuclear Medicine, La Timone University Hospital, CERIMED, Marseille (France); Aix-Marseille University, Biophysics and Nuclear Medecine, La Timone University Hospital, European Center for Research in Medical Imaging, Marseille (France)

    2014-11-01

    {sup 18}F-FDOPA PET imaging is increasingly used in the work-up of patients with neuroendocrine tumours. It has been shown to be of limited value in localizing pancreatic insulin-secreting tumours in adults with hyperinsulinaemic hypoglycaemia (HH) mainly due to {sup 18}F-FDOPA uptake by the whole pancreatic gland. The objective of this study was to review our experience with {sup 18}F-FDOPA PET/CT imaging with carbidopa (CD) premedication in patients with HH in comparison with PET/CT studies performed without CD premedication in an independent population. A retrospective study including 16 HH patients who were investigated between January 2011 and December 2013 using {sup 18}F-FDOPA PET/CT (17 examinations) in two academic endocrine tumour centres was conducted. All PET/CT examinations were performed under CD premedication (200 mg orally, 1 - 2 h prior to tracer injection). The PET/CT acquisition protocol included an early acquisition (5 min after {sup 18}F-FDOPA injection) centred over the upper abdomen and a delayed whole-body acquisition starting 20 - 30 min later. An independent series of eight consecutive patients with HH and investigated before 2011 were considered for comparison. All patients had a reference whole-body PET/CT scan performed about 1 h after {sup 18}F-FDOPA injection. In all cases, PET/CT was performed without CD premedication. In the study group, {sup 18}F-FDOPA PET/CT with CD premedication was positive in 8 out of 11 patients with histologically proven insulinoma (73 %). All {sup 18}F-FDOPA PET/CT-avid insulinomas were detected on early images and 5 of 11 (45 %) on delayed ones. The tumour/normal pancreas uptake ratio was not significantly different between early and delayed acquisitions. Considering all patients with HH, including those without imaging evidence of disease, the detection rate of the primary lesions using CD-assisted {sup 18}F-FDOPA PET/CT was 53 %, showing 9 insulinomas in 17 studies performed. In the control group (without

  19. The importance of PET/CT in the evaluation of patients with Ewing tumors

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Julio Brandao; Rigo, Leticia; Lewin, Fabio; Emerick, Andre, E-mail: juliobrandaoguimaraes@hotmail.com [Hospital Sao Jose-Beneficincia Portuguesa de Sao Paulo, SP (Brazil)

    2015-05-15

    The effective evaluation for the treatment of patients with Ewing tumors depends on the accuracy in the determination of the primary tumor extent and the presence of metastatic disease. Currently, no universally accepted staging system is available to assess Ewing tumors. The present study aimed at discussing the use of PET/CT as a tool for staging, restaging and assessment of therapeutic response in patients with Ewing tumors. In spite of some limitations of PET/CT as compared with anatomical imaging methods, its relevance in the assessment of these patients is related to the capacity of the method to provide further physiological information, which often generates important clinical implications. Currently, the assessment of patients with Ewing tumor should comprise a study with PET/CT combined with other anatomical imaging modalities, such as radiography, computed tomography and magnetic resonance imaging. (author)

  20. PET/CT in therapy evaluation of patients with lung cancer

    DEFF Research Database (Denmark)

    Langer, Natasha Hemicke; Christensen, Tine Nøhr; Langer, Seppo W;

    2014-01-01

    FDG-PET/CT is a well documented and widespread used imaging modality for the diagnosis and staging of patient with lung cancer. FDG-PET/CT is increasingly used for the assessment of treatment effects during and after chemotherapy. However, PET is not an accepted surrogate end-point for assessment...... of response rate in clinical trials. The aim of this review is to present current evidence on the use of PET in response evaluation of patients with lung cancer and to introduce the pearls and pitfalls of the PET-technology relating to response assessment. Based on this and relating to validation criteria......, including stable technology, standardization, reproducibility and broad availability, the review discusses why, despite numerous studies on response assessment indicating a possible role for FDG-PET/CT, PET still has no place in guidelines relating to response evaluation in lung cancer....

  1. Clinical experience with a commercially available negative oral contrast medium in PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Hausegger, K.; Reinprecht, P. [Roentgendiagnostisches Zentralinstitut, LKH Klagenfurt (Austria); Kau, T. [Roentgendiagnostisches Zentral Inst., Klagenfurt (Austria); Igerc, I.; Lind, P. [Abt. fuer Nuklearmedizin und Spezielle Endokrinologie, LKH Klagenfurt (Austria)

    2005-06-01

    Purpose: to evaluate a commercially available negative oral contrast material for PET/CT. Material and methods: in a prospective series of 49 patients, Mukofalk {sup registered}, which is a vegetarian-based substance, was used as a negative oral contrast medium in whole body PET/CT studies. Mukofalk was administered during a time period of 1.5 hours before the examination. Quality of small bowl distension and eventual pathological tracer uptake in the intestine were evaluated. Results: distension of the small bowel was excellent or good in 41 (85%) and poor in 8 (15%) patients. Mild tracer uptake in the small bowel was observed in 5 patients (10.2%) and moderate uptake in another 2 patients (4%). In none of these patients did the F-18 FDG uptake interfere with image interpretation. Conclusion: Mukofalk {sup registered} can be used as a negative oral contrast medium in PET/CT studies. (orig.)

  2. 18F-FDOPA PET/CT imaging of insulinoma revisited

    International Nuclear Information System (INIS)

    18F-FDOPA PET imaging is increasingly used in the work-up of patients with neuroendocrine tumours. It has been shown to be of limited value in localizing pancreatic insulin-secreting tumours in adults with hyperinsulinaemic hypoglycaemia (HH) mainly due to 18F-FDOPA uptake by the whole pancreatic gland. The objective of this study was to review our experience with 18F-FDOPA PET/CT imaging with carbidopa (CD) premedication in patients with HH in comparison with PET/CT studies performed without CD premedication in an independent population. A retrospective study including 16 HH patients who were investigated between January 2011 and December 2013 using 18F-FDOPA PET/CT (17 examinations) in two academic endocrine tumour centres was conducted. All PET/CT examinations were performed under CD premedication (200 mg orally, 1 - 2 h prior to tracer injection). The PET/CT acquisition protocol included an early acquisition (5 min after 18F-FDOPA injection) centred over the upper abdomen and a delayed whole-body acquisition starting 20 - 30 min later. An independent series of eight consecutive patients with HH and investigated before 2011 were considered for comparison. All patients had a reference whole-body PET/CT scan performed about 1 h after 18F-FDOPA injection. In all cases, PET/CT was performed without CD premedication. In the study group, 18F-FDOPA PET/CT with CD premedication was positive in 8 out of 11 patients with histologically proven insulinoma (73 %). All 18F-FDOPA PET/CT-avid insulinomas were detected on early images and 5 of 11 (45 %) on delayed ones. The tumour/normal pancreas uptake ratio was not significantly different between early and delayed acquisitions. Considering all patients with HH, including those without imaging evidence of disease, the detection rate of the primary lesions using CD-assisted 18F-FDOPA PET/CT was 53 %, showing 9 insulinomas in 17 studies performed. In the control group (without CD premedication, eight patients), the final

  3. 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.

  4. 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

  5. Clinical application of FDG-PET/CT for occult primary cancer

    International Nuclear Information System (INIS)

    The aim of this study was to assess the role of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in the identification of occult primary cancers. The study population consisted of 39 consecutive patients with histologically proven metastatic disease or diagnosed by conventional procedures (CT or MRI). PET/CT imaging was performed in all patients 1 hour after administration of 3.75 MBq/kg of fluorodeoxyglucose with a whole-body field of view. PET/CT detected the occult primary cancer in 31 cases (79.4%), showing higher sensitivity than other reports. PET/CT was able to depict more primary tumors, though not significantly, than either of the other imaging modalities. (author)

  6. 18F-FDG-PET/CT in fever of unknown origin

    DEFF Research Database (Denmark)

    Buch-Olsen, Karen M; Andersen, Rikke V; Hess, Søren;

    2014-01-01

    OBJECTIVE: Fever of unknown origin continues to be a diagnostic challenge for clinicians. The aim of this study was to confirm whether (18)F-fluorodeoxyglucose ((18)F-FDG)-PET/computed tomography (CT) is a helpful tool in patients suffering from this condition. PATIENTS AND METHODS: Fifty......-seven patients with fever of unknown origin were examined with (18)F-FDG-PET/CT as part of their diagnostic workup at the clinicians' discretion. The medical records were read retrospectively to establish the final diagnosis and evaluate the degree to which PET/CT contributed to the diagnosis. RESULTS......-FDG-PET/CT is a useful tool in the investigation of fever of unknown origin; it can reduce patient inconvenience and possibly costs to society if used earlier in the diagnostic process....

  7. PET/CT Imaging in Oncology: Exceptions That Prove the Rule

    Directory of Open Access Journals (Sweden)

    M. Casali

    2013-01-01

    Full Text Available 18F-FDG PET/CT is a diagnostic three-dimensional non-invasive device, routinely employed in neurology, cardiology, and oncology, and which contributes to patient care giving functional informations about glucose metabolism. In particular, staging, restaging, follow-up and response to treatment of tumors are the most common applications in oncologic field. Many neoplasms show increased glucose metabolism and consequent 18F-FDG uptake. Nevertheless, some relative differentiated cancers, such as clear cell carcinoma of the kidney and bronchioloalveolar adenocarcinoma, show tipically faintly/no uptake resulting in a consequent negative PET/CT scan. This case report represents an extreme case in which three relative well-differentiated cancer forms, all characterized by low glucose metabolism, affect the same patient at the same time while 18F-FDG PET/CT scan is negative.

  8. Diagnostic Value of FDG-PET/CT in Laryngeal Nerve Palsy

    DEFF Research Database (Denmark)

    Nielsen, Anne Lerberg; Thomassen, Anders; Hess, Søren;

    2013-01-01

    Aim Paresis of the recurrent laryngeal nerves may be a symptom of malignancy due to the anatomical course of the nerves in the neck and mediastinum. Therefore, FDG-PET/CT may be useful as an ancillary examination for diagnosing malignancy. The Aim was to investigate the frequency of malignant...... findings and the diagnostic yield of FDG-PET/CT in patients presenting with recurrent laryngeal nerve palsy. Materials and Methods We retrospectively included all patients referred for FDGPET/ CT scans with recurrent laryngeal nerve palsy from the Department of ENT Head and Neck Surgery at our hospital...... from January 2011 until March 2013. Scan results were compared to clinical workup including biopsy and pathology results. A scan was considered true positive if PET/CT was suggestive of malignancy along the pathway of the recurrent laryngeal nerves, and this finding was confirmed by biopsy and false...

  9. Generating Evidence for Clinical Benefit of PET/CT in Diagnosing Cancer Patients

    DEFF Research Database (Denmark)

    Vach, Werner; Høilund-Carlsen, Poul Flemming; Gerke, Oke;

    2011-01-01

    For diagnostic methods such as PET/CT, not only diagnostic accuracy but also clinical benefit must be demonstrated. However, there is a lack of consensus about how to approach this task. Here we consider 6 clinical scenarios to review some basic approaches to demonstrating the clinical benefit....... We also develop some guidelines for the evaluation of clinical benefit. First, it should be clarified whether there is a direct benefit of the use of PET/CT or an indirect benefit because of improved diagnostic accuracy. If there is an indirect benefit, then decision modeling should be used initially...... to assess the benefit expected from the use of PET/CT. Only if decision modeling does not allow definitive conclusions should randomized controlled trials be planned....

  10. Comparison of the prognostic values of {sup 68}Ga-DOTANOC PET/CT and {sup 18}F-FDG PET/CT in patients with well-differentiated neuroendocrine tumor

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Punit; Naswa, Niraj; Kc, Sudhir Suman; Yadav, Yashwant; Kumar, Rakesh; Bal, Chandrasekhar [All India Institute of Medical Sciences, Department of Nuclear Medicine, Ansari Nagar, New Delhi (India); Alvarado, Luis Andres; Dwivedi, Alok Kumar [Texas Tech University Health Sciences Center, Division of Biostatistics and Epidemiology, El Paso, TX (United States); Ammini, Ariachery C. [All India Institute of Medical Sciences, Department of Endocrinology and Metabolism, New Delhi (India)

    2014-12-15

    To determine the prognostic value of {sup 68}Ga-DOTANOC PET/CT in patients with well-differentiated neuroendocrine tumor (NET), and to compare the prognostic value with that of {sup 18}F-FDG PET/CT and other conventional clinicopathological prognostic factors. Data from 37 consecutive patients (age 46.6 ± 13.5 years, 51 % men) with well-differentiated NET who underwent {sup 68}Ga-DOTANOC PET/CT and {sup 18}F-FDG PET/CT were analyzed. All patients underwent a baseline visit with laboratory and radiological examinations. Clinical and imaging follow-up was performed in all patients. Progression-free survival (PFS) was measured from the date of the first PET/CT scan to the first documentation of progression of disease. {sup 68}Ga-DOTANOC PET/CT was positive in 37 of the 37 patients and {sup 18}F-FDG PET/CT was positive in 21. During follow-up 10 patients (27 %) showed progression of disease and 27 (73 %) showed no progression (24 stable disease, 3 partial response). The median follow-up was 25 months (range 2 - 52 months). Among the variables evaluated none was significantly different between the progressive disease and nonprogressive disease groups, with only SUVmax on {sup 68}Ga-DOTANOC PET/CT being borderline significant (P = 0.073). In the univariate analysis for PFS outcome, SUVmax on {sup 68}Ga-DOTANOC PET/CT (HR 0.122, 95 % CI 0.019 - 0.779; P = 0.026) and histopathological tumor grade (HR 4.238, 95 % CI 1.058 - 16.976; P = 0.041) were found to be associated with PFS. Other factors including age, sex, primary site, Ki-67 index, TNM stage, {sup 18}F-FDG PET/CT status (positive/negative), SUVmax on {sup 18}F-FDG PET/CT and type of treatment were not significant. In multivariable analysis, only SUVmax on {sup 68}Ga-DOTANOC PET/CT was found to be an independent positive predictor of PFS (HR 0.122, 95 % CI 0.019 - 0.779; P = 0.026). SUVmax measured on {sup 68}Ga-DOTANOC PET/CT is an independent, positive prognostic factor in patients with well-differentiated NET and

  11. Distilling complexity to advance cardiac tissue engineering

    Science.gov (United States)

    Ogle, Brenda M.; Bursac, Nenad; Domian, Ibrahim; Huang, Ngan F; Menasché, Philippe; Murry, Charles; Pruitt, Beth; Radisic, Milica; Wu, Joseph C; Wu, Sean M; Zhang, Jianyi; Zimmermann, Wolfram-Hubertus; Vunjak-Novakovic, Gordana

    2016-01-01

    The promise of cardiac tissue engineering is in the ability to recapitulate in vitro the functional aspects of healthy heart and disease pathology as well as to design replacement muscle for clinical therapy. Parts of this promise have been realized; others have not. In a meeting of scientists in this field, five central challenges or “big questions” were articulated that, if addressed, could substantially advance the current state-of-the-art in modeling heart disease and realizing heart repair. PMID:27280684

  12. 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.

  13. PET-CT enteroclysis: a new technique for evaluation of inflammatory diseases of the intestine

    Energy Technology Data Exchange (ETDEWEB)

    Jyoti Das, Chandan; Sharma, Raju [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India); Makharia, Govind; Goswami, Pooja [All India Institute of Medical Sciences, Department of Gastroenterology and Human Nutrition, New Delhi (India); Kumar, Rakesh; Chawla, Madhavi; Malhotra, Arun [All India Institute of Medical Sciences, Ansari Nagar, Department of Nuclear Medicine, New Delhi (India)

    2007-12-15

    While CT/MR enteroclysis provides excellent anatomical details, it fails to provide information on metabolic activity of the inflammatory lesions of the intestine. We conceptualized a fusion of metabolic imaging techniques such as PET and an anatomical imaging modality such as CT enteroclysis to derive information both on morphological details and functional activity of lesions at the same time. In a prospective study, we included 17 adult patients with newly diagnosed inflammatory diseases of the intestine. Low dose whole body PET-CT scan was obtained first, which began at approximately 60 min after injection of 10 mCi of {sup 18}fluoro-deoxyglucose (FDG). Subsequently, PET-CT enteroclysis of the abdomen was performed after infusion of 2 l of 0.5% methylcellulose through a naso-jejunal catheter. Fourteen patients had abnormal and three had normal PET-CT enteroclysis studies. Twenty-three segments of small intestine and 27 segments of large intestine showed increased FDG uptake. The detection rate of PET-CT enteroclysis was significantly higher (total =50 segments, 23 segments of small intestine and 27 segments of large intestine) as compared with barium studies (16 segments of small intestine) and colonoscopy (17 segments of large intestine) combined together (total =33 segments). In addition PET-CT enteroclysis showed extra-luminal FDG uptake (lymph nodes in two, sacroilitis in two, and mesenteric fat proliferation in five). As a single investigation, PET-CT enteroclysis detects a significantly higher number of lesions both in the small and large intestine in comparison to that detected by conventional barium and colonoscopy combined together. This technique is non-invasive, feasible and very promising. (orig.)

  14. {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.

  15. FDG PET/CT findings of rebound thymic hyperplasia in oncologic patients with chemotherapy

    International Nuclear Information System (INIS)

    Benign thymic hyperplasia in adult unlike children is a rare condition, however, it could occur, mainly associated with concurrent malignancies or chemotherapy. Rebound thymic hyperplasia in cancer patients could be a cause of great concern for cancer involvement to the thymus. In this study, we characterized the rebound thymic hyperplasia in oncologic patients who received chemotherapy on FDG PET/CT. We reviewed the 1030 PET/CT scans obtained from cancer patients for follow up purpose in Seoul National University Hospital between 2004 and 2006. 21 PET/CT scans of them (2%) revealed thymic enlargement. The scans were obtained from 11 patients (age range: 16-55 yrs) who received chemotherapy for various malignancies (4 breast cancers, 3 lymphomas, and one of each osteosarcoma, rhabdomyosarcoma, hepatocellular carcinoma, renal cell carcinoma). Six cases had more than one follow-up PET/CT, and rebound thymic hyperplasia without malignancy was finally confirmed by clinical observation for follow-up period ranged from 17 to 45 months. The uptake pattern, maximum standardized uptake values (mSUVs), uptake ratio to the liver, and CT findings of thymic hyperplasia on PET/CT were analyzed. In all cases except one, enlarged thymus showed diffuse and relatively homogenous increased FDG uptake. In only one case, nodular increased FDG uptake with mSUV of 2.7 was found. Mean mSUV in the thymus was measured as 1.580.53, and the uptake ratio to the liver was 0.750.26. Decreased thymic metabolism was depicted on follow up PET images, while, resolved thymic enlarged was demonstrated on follow up CT in three of six. Rebound thymic hyperplasia in cancer patients should be distinguished from thymic malignancy. The finding of diffuse and moderate hypermetabolism lesser than liver in the enlarged thymus on follow-up PET/CT in cancer patients may suggest rebound thymic hyperplasia rather than malignancy, especially in condition of the presence of preceding chemotherapy

  16. A comparative study of PET and PET/CT in solitary pulmonary nodules

    International Nuclear Information System (INIS)

    Objective To investigate the diagnostic accuracy of PET/CT in solitary pulmonary nodule(SPN) and compare it with PET. Methods: 60 cases of SPN (30 benigns, 30 malignants) confirmed by pathology (n=47) and follow-up (n=13) underwent PET/CT. The diagnoses of malignant SPN in PET images were made by two nuclear medicine doctors with a criterion of standardized uptake value (SUV)≥2.5. Two experienced radiologists and the two nuclear medicine doctors worked together and analyzed PET/CT images by the evidence of SUV and morphological signs in CT such as lobulation, short spiculation, acantha, vacuole or cavity, calcification, pleural indentation, bronchus truncation, texture collection and satellites. The frequency of all signs were compared statistically between benign and malignant SPN with χ2 test. Results: According to the criterion of SUV≥2.5 as malignant the sensitivity, specificity and accuracy of PET were 86.7%, 90.0% and 88.3% whereas in PET/CT were 90.0%, 93.3% and 91.7%, respectively. The main frequency of 5 malignant CT signs of SPN were in order of short spiculation (63.3%), bronchus truncation (50.0%), acantha (46.7%), typical lobulation (36.7%) and pleural indentation (26.7%). All of them were significantly different between benign and malignant (P<0.05). In 7 misdiagnose PET images, 4 cases being changed therapeutic regime after PET/CT, among them 2 with correct diagnose, 2 equivocal needed further follow-up. Conclusion: The diagnostic accuracy of SPN is further improved by PET/CT as PET alone. (authors)

  17. {sup 18}F-Fluorocholine PET/CT as a complementary tool in the follow-up of low-grade glioma: diagnostic accuracy and clinical utility

    Energy Technology Data Exchange (ETDEWEB)

    Gomez-Rio, Manuel; Rodriguez-Fernandez, Antonio; Llamas-Elvira, Jose M. [Instituto de Investigacion Biosanitaria de Granada, Granada (Spain); University Hospital ' ' Virgen de las Nieves' ' , Department of Nuclear Medicine, Granada (Spain); Testart Dardel, Nathalie [University Hospital ' ' Virgen de las Nieves' ' , Department of Nuclear Medicine, Granada (Spain); Santiago Chinchilla, Alicia [University Hospital ' ' Virgen de las Nieves' ' , Department of Radiology, Granada (Spain); Olivares Granados, Gonzalo [University Hospital ' ' Virgen de las Nieves' ' , Department of Neurosurgery, Granada (Spain); Luque Caro, Raquel [University Hospital ' ' Virgen de las Nieves' ' , Department of Medical Oncology, Granada (Spain); Zurita Herrera, Mercedes [University Hospital ' ' Virgen de las Nieves' ' , Department of Radiotherapy Oncology, Granada (Spain); Chamorro Santos, Clara E. [University Hospital ' ' Virgen de las Nieves' ' , Department of Pathology, Granada (Spain); Lardelli-Claret, Pablo [Instituto de Investigacion Biosanitaria de Granada, Granada (Spain); Centros de Investigacion Biomedica en Red de Epidemiologia y Salud Publica (CIBERESP), Granada (Spain); University of Granada, Department of Preventive Medicine and Public Health, School of Medicine, Granada (Spain)

    2015-05-01

    The follow-up of treated low-grade glioma (LGG) requires the evaluation of subtle clinical changes and MRI results. When the result is inconclusive, additional procedures are required to assist decision-making, such as the use of advanced MRI (aMRI) sequences and nuclear medicine scans (SPECT and PET). The aim of this study was to determine whether incorporating {sup 18}F-fluorocholine PET/CT in the follow-up protocol for treated LGG improves diagnostic accuracy and clinical utility. This was a prospective case-series study in patients with treated LGG during standard follow-up with indeterminate clinical and/or radiological findings of tumour activity. All patients underwent clinical evaluation, aMRI, {sup 201}Tl-SPECT and {sup 18}F-fluorocholine PET/CT. Images were interpreted by visual evaluation complemented with semiquantitative analysis. Between January 2012 and December 2013, 18 patients were included in this study. The final diagnosis was established by histology (five surgical specimens, one biopsy specimen) or by consensus of the Neuro-Oncology Group (11 patients) after a follow-up of >6 months (mean 14.9 ± 2.72 months). The global diagnostic accuracies were 90.9 % for aMRI (38.8 % inconclusive), 69.2 % for {sup 201}Tl-SPECT (11.1 % inconclusive), and 100 % for {sup 18}F-fluorocholine PET/CT. {sup 201}Tl-SPECT led correctly to a change in the initial approach in 38.9 % of patients but might have led to error in 27.8 %. The use of {sup 18}F-fluorocholine PET/CT alone rather than {sup 201}Tl-SPECT led correctly to a change in the approach suggested by routine follow-up in 72.2 % of patients and endorsed the approach in the remaining 27.8 %. Our results support the need to complement structural MRI with aMRI and nuclear medicine procedures in selected patients. {sup 18}F-Fluorocholine PET/CT can be useful in the individualized management of patients with treated LGG with uncertain clinical and/or radiological evidence of tumour activity. (orig.)

  18. 18F-Fluorocholine PET/CT as a complementary tool in the follow-up of low-grade glioma: diagnostic accuracy and clinical utility

    International Nuclear Information System (INIS)

    The follow-up of treated low-grade glioma (LGG) requires the evaluation of subtle clinical changes and MRI results. When the result is inconclusive, additional procedures are required to assist decision-making, such as the use of advanced MRI (aMRI) sequences and nuclear medicine scans (SPECT and PET). The aim of this study was to determine whether incorporating 18F-fluorocholine PET/CT in the follow-up protocol for treated LGG improves diagnostic accuracy and clinical utility. This was a prospective case-series study in patients with treated LGG during standard follow-up with indeterminate clinical and/or radiological findings of tumour activity. All patients underwent clinical evaluation, aMRI, 201Tl-SPECT and 18F-fluorocholine PET/CT. Images were interpreted by visual evaluation complemented with semiquantitative analysis. Between January 2012 and December 2013, 18 patients were included in this study. The final diagnosis was established by histology (five surgical specimens, one biopsy specimen) or by consensus of the Neuro-Oncology Group (11 patients) after a follow-up of >6 months (mean 14.9 ± 2.72 months). The global diagnostic accuracies were 90.9 % for aMRI (38.8 % inconclusive), 69.2 % for 201Tl-SPECT (11.1 % inconclusive), and 100 % for 18F-fluorocholine PET/CT. 201Tl-SPECT led correctly to a change in the initial approach in 38.9 % of patients but might have led to error in 27.8 %. The use of 18F-fluorocholine PET/CT alone rather than 201Tl-SPECT led correctly to a change in the approach suggested by routine follow-up in 72.2 % of patients and endorsed the approach in the remaining 27.8 %. Our results support the need to complement structural MRI with aMRI and nuclear medicine procedures in selected patients. 18F-Fluorocholine PET/CT can be useful in the individualized management of patients with treated LGG with uncertain clinical and/or radiological evidence of tumour activity. (orig.)

  19. Prognostic significance of standardized uptake value and metabolic tumour volume on {sup 18}F-FDG PET/CT in oropharyngeal squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Won; Roh, Jong-Lyel; Choi, Seung-Ho; Nam, Soon Yuhl [University of Ulsan College of Medicine, Department of Otolaryngology, Asan Medical Centre, Seoul (Korea, Republic of); Oh, Jungsu S.; Kim, Jae Seung [University of Ulsan College of Medicine, Department of Nuclear Medicine, Asan Medical Centre, Seoul (Korea, Republic of); Kim, Sang Yoon [University of Ulsan College of Medicine, Department of Otolaryngology, Asan Medical Centre, Seoul (Korea, Republic of); Biomedical Research Institute, Korea Institute of Science and Technology, Seoul (Korea, Republic of)

    2015-08-15

    Standardized uptake value (SUV) and metabolic tumour volume (MTV) measured by {sup 18}F-FDG PET/CT are emerging prognostic biomarkers in human solid cancers. However, their prognostic significance in oropharyngeal squamous cell carcinoma (OPSCC) has been investigated in only a few studies and with small cohorts. In the present study we evaluated the ability of SUV, MTV, and total lesion glycolysis (TLG) measured on pretreatment {sup 18}F-FDG PET/CT to predict recurrence and survival outcomes in OPSCC. The study included 221 patients with OPSCC who underwent pretreatment {sup 18}F-FDG PET/CT imaging and received definitive treatment at our tertiary referral centre. The PET imaging parameters SUV{sub max}, SUV{sub peak}, MTV and TLG were measured in primary tumours with focal {sup 18}F-FDG uptake. Clinical and imaging variables significantly associated with overall survival (OS) and disease-free survival (DFS) were identified by univariate and multivariate analyses using the Cox proportional hazards model. Overall 5-year OS and DFS rates were 72.0 % and 79.5 %, respectively, during a median follow-up of 61 months (range 18 - 122 months). The cut-off values of tumour SUV{sub max}, SUV{sub peak}, MTV and TLG for prediction of DFS were 7.55, 6.80, 11.06 mL and 78.56 g, respectively. Univariate analyses showed that age >60 years, advanced tumour stage, and high tumour SUV{sub max}, SUV{sub peak}, MTV and TLG were significantly associated with decreased OS and DFS (P < 0.05 each). Age, tumour SUV{sub max} and MTV remained independent variables for OS and DFS (P < 0.05 each) in the multivariate analyses. SUV{sub max} and MTV measured on pretreatment {sup 18}F-FDG PET/CT may be useful in predicting the clinical outcomes in OPSCC patients. This study investigated the clinical prognostic value of imaging parameters from pretreatment {sup 18}F-FDG PET/CT in 221 patients who underwent definitive treatment for oropharyngeal squamous cell carcinoma. High maximum standardized

  20. PET/CT in cancer: moderate sample sizes may suffice to justify replacement of a regional gold standard

    DEFF Research Database (Denmark)

    Gerke, Oke; Poulsen, Mads Hvid; Bouchelouche, Kirsten;

    2009-01-01

    of metastasized prostate cancer. RESULTS: An added value in accuracy of PET/CT in adjacent areas can outweigh a downsized target level of accuracy in the gold standard region, justifying smaller sample sizes. CONCLUSIONS: If PET/CT provides an accuracy benefit in adjacent regions, then sample sizes can be reduced...

  1. Design and implementation of a web-based PET-CT reporting assessment and e-portfolio tool

    International Nuclear Information System (INIS)

    Highlights: • We describe a simple internet-based reporting tool to enhance PET-CT training. • Automatically created competency based metrics are valuable in monitoring progress. • This tool provides robust evidence of competency in PET-CT reporting

  2. Bone marrow metastases from alveolar rhabdomyosarcoma with impressive FDG PET/CT finding but less-revealing bone scintigraphy.

    Science.gov (United States)

    Yang, Jigang; Zhen, Lishi; Zhuang, Hongming

    2013-12-01

    An 18F-FDG PET/CT scan was performed in a 26-year-old man with a known alveolar rhabdomyosarcoma for staging. The PET/CT scan showed abnormally increased FDG activity involving almost all bones in the imaged regions. In contrast, 99mTc-MDP whole-body bone scan demonstrated only very limited bone metastases.

  3. Integration of FDG-PET/CT into external beam radiation therapy planning Technical aspects and recommendations on methodological approaches

    NARCIS (Netherlands)

    Thorwarth, D.; Beyer, T.; Boellaard, R.; De Ruysscher, D.; Grgic, A.; Lee, J. A.; Pietrzyk, U.; Sattler, B.; Schaefer, A.; van Elmpt, W.; Vogel, W.; Oyen, W. J. G.; Nestle, U.

    2012-01-01

    This work addresses the clinical adoption of FDG-PET/CT for image-guided radiation therapy planning (RIP). As such, important technical and methodological aspects of PET/CT-based RIP are reviewed and practical recommendations are given for routine patient management and clinical studies. First, rece

  4. Assess results of PET/CT in cancer diagnosis, follow up treatment and simulation for radiation therapy

    International Nuclear Information System (INIS)

    PET/CT (Positron Emission Computed Tomography) has been studied and established as routine at the Nuclear Medicine and Oncology Center, Bach Mai hospital. From 8/2009 to 5/2015, 6223 patients have been undergone PET/CT scan. Among them, diagnostic and simulation PET/CT scan for cancer patients accounted to 5833 (93.8%). Researches about value of PET/CT for most common cancers have been done. Results: PET/CT can help the primary tumor diagnosis, metastases detection, staging, simulation for radiation therapy, response to treatment assessment, and relapses after treatment identification. Percentage accordance between PET / CT and histopathology was 96% (esophagus cancer), 94.7% (lung cancer). Average maxSUV value of primary tumor of the esophagus cancer, colorectal cancer, nasopharynx cancer, lung cancer, and NHL respectively 9.50, 9.78, 11.08, 9.17, 10.21. MaxSUV value increased with histological grade and tumor size. After undergone PET / CT, stage of disease changed in 28% esophagus cancer; 22.7% colorectal cancer; stage of disease increased in 23.5% of NHL, 32.0% of lung cancer, and 25.0% of nasopharynx cancer. PET / CT simulation for radiation therapy target volume reduced in 28% of nasopharynx cancer, which helped the radioactive dose concentrate exactly in the target lesions, minimize effect to healthy tissues, improved the effectiveness of treatment and reduced complications. (author)

  5. Integration of FDG-PET/CT into external beam radiation therapy planning. Technical aspects and recommendations on methodological approaches.

    NARCIS (Netherlands)

    Thorwarth, D.; Beyer, T.; Boellaard, R.; Ruysscher, D. de; Grgic, A.; Lee, J.A.; Pietrzyk, U.; Sattler, B.; Schaefer, A.; Elmpt, W. van; Vogel, W.; Oyen, W.J.G.; Nestle, U.

    2012-01-01

    This work addresses the clinical adoption of FDG-PET/CT for image-guided radiation therapy planning (RTP). As such, important technical and methodological aspects of PET/CT-based RTP are reviewed and practical recommendations are given for routine patient management and clinical studies. First, rece

  6. FDG PET/CT in cancer: comparison of actual use with literature-based recommendations

    International Nuclear Information System (INIS)

    The Region of Southern Denmark (RSD), covering 1.2 of Denmark's 5.6 million inhabitants, established a task force to (1) retrieve literature evidence for the clinical use of positron emission tomography (PET)/CT and provide consequent recommendations and further to (2) compare the actual use of PET/CT in the RSD with these recommendations. This article summarizes the results. A Work Group appointed a professional Subgroup which made Clinician Groups conduct literature reviews on six selected cancers responsible for 5,768 (62.6 %) of 9,213 PET/CT scans in the RSD in 2012. Rapid Evidence Assessment was applied, using the methodology of systematic reviews with predefined limitations to search PubMed, Embase and the Cochrane Library for articles published in English/Danish/Swedish/Norwegian since 2002. PICO questions were defined, data recorded and quality appraised and rated with regard to strength and evidence level. Consequent recommendations for applications of PET/CT were established. The actual use of PET/CT was compared with these, where grades A and B indicated ''established'' and ''useful'' and grades C and D ''potentially useful'' and ''non-recommendable'' indications, respectively. Of 11,729 citations, 1,729 were considered for review, and 204 were included. The evidence suggested usefulness of PET/CT in lung, lymphoma, melanoma, head and neck, and colorectal cancers, whereas evidence was sparse in gynaecological cancers. The agreement between actual use of PET/CT and literature-based recommendations was high in the first five mentioned cancers in that 96.2 % of scans were made for grade A or B indications versus only 22.2 % in gynaecological cancers. Evidence-based usefulness was reported in five of six selected cancers; evidence was sparse in the sixth, gynaecological cancers. Actual use of PET/CT agreed well with recommendations. (orig.)

  7. 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

  8. 11C-Acetate PET/CT Monitoring Therapy of Multiple Myeloma.

    Science.gov (United States)

    Zhu, Wenjia; Dang, Yonghong; Ma, Yanru; Li, Fang; Huo, Li

    2016-07-01

    A 67-year-old man with newly diagnosed multiple myeloma underwent both FDG and C-acetate PET/CT sequentially on different days. There was increased FDG activity only in L1 vertebral body, but there was diffuse abnormal C-acetate activity throughout the skeletal system. After the successful therapy, the patient who was on remission clinically underwent follow-up PET/CT scans. Interestingly, L1 remained to have elevated FDG, although with less intensity. In contrast, there was no abnormal C-acetate activity anywhere in the body. The patient remained in remission clinically. PMID:27055129

  9. 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

  10. Ambient radiation levels in a microPET/CT research laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Sarmento, D.M.; Rodrigues, D.L.; Sanches, M.P.; Carneiro, J.C.G.G., E-mail: janetegc@ipen.br [Instituto de Pesquisas Energeticas e Nucleres (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    This study focuses on initial radiological evaluation and the exposure situation related to the worker task in a micro-positron emission tomography/computed tomography laboratory (microPET/CT). Selected and calibrated thermoluminescent dosimeters, TLD, of CaSO{sub 4}:Dy were used to measure room radiation levels. The detectors were placed in several selected points inside the microPET/CT laboratory and adjacent rooms. In addition, the occupationally exposed workers were monthly evaluated for external and internal exposures. In none of the selected points the dose values exceeded the radiation dose limit established for supervised area, as well as the values obtained in individual monitoring. (author)

  11. Automated interpretation of PET/CT images in patients with lung cancer

    DEFF Research Database (Denmark)

    Gutte, Henrik; Jakobsson, David; Olofsson, Fredrik;

    2007-01-01

    cancer. METHODS: A total of 87 patients who underwent PET/CT examinations due to suspected lung cancer comprised the training group. The test group consisted of PET/CT images from 49 patients suspected with lung cancer. The consensus interpretations by two experienced physicians were used as the 'gold...... for localization of lesions in the PET images in the feature extraction process. Eight features from each examination were used as inputs to artificial neural networks trained to classify the images. Thereafter, the performance of the network was evaluated in the test set. RESULTS: The performance of the automated...

  12. 18F-Fluorodeoxyglucose PET/CT in Langerhans cell histiocytosis: spectrum of manifestations.

    Science.gov (United States)

    Agarwal, Krishan Kant; Seth, Rachna; Behra, Abhishek; Jana, Manisha; Kumar, Rakesh

    2016-04-01

    The objective of this article is to provide an illustrative tutorial highlighting the utility of 18F-FDG PET/CT imaging to detect the spectrum of manifestations in patients with Langerhans cell histiocytosis. FDG PET/CT is a powerful tool for making an early diagnosis; it allows higher diagnostic confidence with regard to lesions, measuring the extent of disease (staging) and assessing disease activity, and is consequently useful for evaluating the response to therapy in patients with Langerhans cell histiocytosis. PMID:26759026

  13. 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...

  14. A prospective study of PET/CT in initial staging of small-cell lung cancer

    DEFF Research Database (Denmark)

    Fischer, B M; Mortensen, J; Langer, S W;

    2007-01-01

    BACKGROUND: Small-cell lung cancer (SCLC) accounts for 15%-20% of all lung cancer cases. Accurate and fast staging is mandatory when choosing treatment, but current staging procedures are time consuming and lack sensitivity. PATIENTS AND METHODS: A prospective study was designed to examine the role...... of combined positron emission tomography/computed tomography (PET/CT) compared with standard staging (CT, bone scintigraphy and immunocytochemical assessment of bone marrow biopsy) of patients with SCLC. Thirty-four consecutive patients were included. Twenty-nine patients received initial PET/CT. RESULTS: PET...

  15. Kæmpecellearteritis diagnosticeret ved hjælp af PET-CT

    DEFF Research Database (Denmark)

    Larsen, Cæcilie Crawley; Schifter, Søren; Bonnema, Steen Joop

    2014-01-01

    Giant cell arteritis (GCA) is easily diagnosed in case of typical symptoms such as headache and jaw claudication. We present an 82-year-old man who was admitted due to symptoms of pneumonia, weight loss and fever. He did not respond to antibiotic treatment. An 18F-fluordeoxyglucose PET-CT scan...... showed increased uptake of the thoracic branches of aorta, raising the suspicion of GCA. The result from a subsequent temporal artery biopsy supported the diagnosis. Based on the clinical symptoms, the results from the PET-CT scan and the biopsy, and the response to high dose of prednisolone, the patient...

  16. Metastases to the breast from extramammary malignancies – PET/CT findings

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-07-15

    Detection of incidental malignant lesions in the breast has a significant clinical impact not only on healthy individuals but also on patients with known malignant disease. This review describes a spectrum of metastatic breast lesions incidentally detected by FDG PET-CT at staging that may be misinterpreted as second primary malignancy. The common non-mammary malignancies that metastasize to the breast include melanoma, hematopoietic malignancies and epithelial cancers. We present the FDG PET-CT features of incidental non-mammary metastases to the breast that may help distinguish primary breast cancer from metastatic disease and aid in the management of patients with a known malignancy.

  17. 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

  18. Necessity and clinical application of diagnostic CT in PET-CT scanner

    International Nuclear Information System (INIS)

    PET scanning has a definite clinical impact on diagnosis, initial staging, restaging, monitoring therapeutic effects of malignancies, and on assessment of myocardial viability. Whereas, PET scans has false positive diagnosis and false negative diagnosis of malignant lesions. It leads to reduce specifity in PET imaging. application of diagnostic CT, especially applying contrast enhanced CT scans, three dimensional technique, CTA(CT angiography), CT perfusion and CT virtual endoscopy can realize dominance complementation with PET and CT, PET-CT imaging diagnosis combines with PET and CT diagnostic technique, it improves sensitivity, specifity, and accuracy in clinical application of PET-CT scanner. (authors)

  19. Fluorine-18-fluorodeoxyglucose PET/CT for the evaluation of suspected recurrent uterine leiomyosarcomas

    International Nuclear Information System (INIS)

    Background Uterine leiomyosarcomas are rare and aggressive malignancies of the uterine corpus with high recurrence rates and poor prognoses. The current recommendation for detection of recurrent uterine leiomyosarcoma involves periodic physical examination and conventional imaging such as CT or MRI. The role of fluorine-18-fluorodeoxyglucose positron emission tomography with integrated computed tomography (FDG-PET/CT) in the detection of recurrent uterine leiomyosarcomas is not yet established. Purpose To evaluate the use of FDG-PET/CT as a single integrated modality for the evaluation of suspected recurrent uterine leiomyosarcomas. Material and Methods A retrospective study was performed on patients who underwent FDG-PET/CT scans for suspected recurrent uterine leiomyosarcoma. Only patients with follow-up data were included in the study. FDG-PET/CT was evaluated as a single integrated imaging modality. A positive lesion on FDG-PET/CT was defined as a focal abnormality detected on either the PET or CT components, or both. Results Sixteen consecutive patients over 5 years underwent FDG-PET/CT for suspected recurrent uterine leiomyosarcoma. Five patients were excluded due to incomplete follow-up data. The remaining 11 patients were aged 36-58 years (mean age 48). FDG-PET/CT had a sensitivity of 100% (95% CI 63-100) and specificity of 100% (95% CI 20-100) for the detection of recurrent uterine leiomyosarcomas. Sites of metastases include lungs, peritoneum, liver, pancreas and breast, of which lungs and peritoneum were the most common. Two (18%) patients had discordant findings: FDG-PET negative metastatic nodules in the breast and lung detected on the CT component. The maximum standardized uptake value (SUVmax) of metastatic lesions ranged from 2.0 to 16.0 (mean 7.6). Conclusion FDG-PET/CT as a single integrated modality may be a useful for the evaluation of suspected recurrent uterine leiomyosarcomas. FDG-PET negative discordant nodules detected on the CT component

  20. Fluorine-18-fluorodeoxyglucose PET/CT for the evaluation of suspected recurrent uterine leiomyosarcomas

    Energy Technology Data Exchange (ETDEWEB)

    Kao, Yung Hsiang; Saad, U.; Tan, Andrew E.H.; Magsombol, Butch M.; Padhy, Ajit Kumar (Dept. of Nuclear Medicine and PET, Singapore General Hospital (Singapore)), email: kao.yung.hsiang@singhealth.com.sg

    2011-05-15

    Background Uterine leiomyosarcomas are rare and aggressive malignancies of the uterine corpus with high recurrence rates and poor prognoses. The current recommendation for detection of recurrent uterine leiomyosarcoma involves periodic physical examination and conventional imaging such as CT or MRI. The role of fluorine-18-fluorodeoxyglucose positron emission tomography with integrated computed tomography (FDG-PET/CT) in the detection of recurrent uterine leiomyosarcomas is not yet established. Purpose To evaluate the use of FDG-PET/CT as a single integrated modality for the evaluation of suspected recurrent uterine leiomyosarcomas. Material and Methods A retrospective study was performed on patients who underwent FDG-PET/CT scans for suspected recurrent uterine leiomyosarcoma. Only patients with follow-up data were included in the study. FDG-PET/CT was evaluated as a single integrated imaging modality. A positive lesion on FDG-PET/CT was defined as a focal abnormality detected on either the PET or CT components, or both. Results Sixteen consecutive patients over 5 years underwent FDG-PET/CT for suspected recurrent uterine leiomyosarcoma. Five patients were excluded due to incomplete follow-up data. The remaining 11 patients were aged 36-58 years (mean age 48). FDG-PET/CT had a sensitivity of 100% (95% CI 63-100) and specificity of 100% (95% CI 20-100) for the detection of recurrent uterine leiomyosarcomas. Sites of metastases include lungs, peritoneum, liver, pancreas and breast, of which lungs and peritoneum were the most common. Two (18%) patients had discordant findings: FDG-PET negative metastatic nodules in the breast and lung detected on the CT component. The maximum standardized uptake value (SUVmax) of metastatic lesions ranged from 2.0 to 16.0 (mean 7.6). Conclusion FDG-PET/CT as a single integrated modality may be a useful for the evaluation of suspected recurrent uterine leiomyosarcomas. FDG-PET negative discordant nodules detected on the CT component

  1. 18F-FDG PET/CT in patients with adult-onset Still's disease.

    Science.gov (United States)

    Dong, Meng-Jie; Wang, Cai-Qin; Zhao, Kui; Wang, Guo-Lin; Sun, Mei-Ling; Liu, Zhen-Feng; Xu, Liqin

    2015-12-01

    (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) has become useful for the detection and diagnosis of inflammatory conditions, including rheumatic diseases, immunoglobulin (Ig) G4-related disease and giant cell arteritis. However, few articles based on small sample sizes (n = 7) diagnosed as adult-onset Still's disease (AOSD) have been published. The study aim was to observe the reliable characteristics and usefulness of (18)F-FDG PET/CT for the evaluation of consecutive patients with AOSD. Eligible patients were selected from among those who had undergone (18)F-FDG PET/CT between May 2007 and June 2014. Twenty-six consecutive AOSD patients were recruited retrospectively according to criteria set by Yamaguchi et al. All patients underwent evaluation by (18)F-FDG PET/CT. The characteristics and usefulness of (18)F-FDG PET/CT for evaluation of consecutive patients with AOSD were evaluated. All 26 patients had (18)F-FDG-avid lesion(s) related to their particular disease. Diffuse and homogeneous accumulation of (18)F-FDG was seen in the bone marrow (26/26; 100 %; maximum standardized uptake (SUVmax), 2.10-6.73) and spleen (25/26; 96.15 %). The SUVmax of affected lymph nodes was 1.3-9.53 (mean ± SD, 4.12 ± 2.24). The SUVmax and size factors (maximum diameter and areas) of affected lymph nodes were significantly different (P = 0.033 and P = 0.012, respectively). (18)F-FDG PET/CT showed the general distribution of (18)F-FDG accumulation. This factor helped to exclude malignant disease and aided the diagnosis of AOSD (42.3 %) in 11 cases when combined with clinical features and aided decisions regarding appropriate biopsy sites, such as the lymph nodes (n = 9) and bone marrow (n = 13). (18)F-FDG PET/CT is a unique imaging method for the assessment of metabolic activity throughout the body in subjects with AOSD. Characteristics or patterns of AOSD observed on (18)F-FDG PET/CT can be used for the

  2. Metastases to the breast from extramammary malignancies – PET/CT findings

    International Nuclear Information System (INIS)

    Detection of incidental malignant lesions in the breast has a significant clinical impact not only on healthy individuals but also on patients with known malignant disease. This review describes a spectrum of metastatic breast lesions incidentally detected by FDG PET-CT at staging that may be misinterpreted as second primary malignancy. The common non-mammary malignancies that metastasize to the breast include melanoma, hematopoietic malignancies and epithelial cancers. We present the FDG PET-CT features of incidental non-mammary metastases to the breast that may help distinguish primary breast cancer from metastatic disease and aid in the management of patients with a known malignancy

  3. Ambient radiation levels in a microPET/CT research laboratory

    International Nuclear Information System (INIS)

    This study focuses on initial radiological evaluation and the exposure situation related to the worker task in a micro-positron emission tomography/computed tomography laboratory (microPET/CT). Selected and calibrated thermoluminescent dosimeters, TLD, of CaSO4:Dy were used to measure room radiation levels. The detectors were placed in several selected points inside the microPET/CT laboratory and adjacent rooms. In addition, the occupationally exposed workers were monthly evaluated for external and internal exposures. In none of the selected points the dose values exceeded the radiation dose limit established for supervised area, as well as the values obtained in individual monitoring. (author)

  4. FDG PET/CT in cancer: comparison of actual use with literature-based recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, Henrik; Johansen, Allan; Hoeilund-Carlsen, Poul Flemming [Odense University Hospital, Department of Nuclear Medicine, Odense C (Denmark); Holdgaard, Paw Christian [Vejle Hospital, Department of Nuclear Medicine, Vejle (Denmark); Madsen, Poul Henning [Vejle Hospital, Department of Medicine, Vejle (Denmark); Knudsen, Lene Meldgaard [Odense University Hospital, Department of Haematological, Odense (Denmark); Gad, Dorte; Gravergaard, Anders Eggert [Odense University Hospital, Department of Plastic Surgery, Odense (Denmark); Rohde, Max; Godballe, Christian [Odense University Hospital, Department of ORL Head and Neck Surgery, Odense (Denmark); Engelmann, Bodil Elisabeth [Naestved Sygehus, Department of Clinical Physiology and Nuclear Medicine, Naestved (Denmark); Bech, Karsten [Aabenraa Sygehus, Organ Centre, Aabenraa (Denmark); Teilmann-Joergensen, Dorte [Aabenraa Sygehus, Department of Gynaecoligcal and Obstetrics, Aabenraa (Denmark); Mogensen, Ole [Odense University Hospital, Department of Gynaecoligcal and Obstetrics, Odense (Denmark); Karstoft, Jens [Odense University Hospital, Department of Radiology, Odense (Denmark); Johansen, Joergen [Odense University Hospital, Department of Oncology, Odense (Denmark); Christensen, Janne Buck [Odense University Hospital, Department of Quality and Research/HTA, Odense (Denmark); Collaboration: on behalf of the PET/CT Task Force of the Region of Southern Denmark

    2016-04-15

    The Region of Southern Denmark (RSD), covering 1.2 of Denmark's 5.6 million inhabitants, established a task force to (1) retrieve literature evidence for the clinical use of positron emission tomography (PET)/CT and provide consequent recommendations and further to (2) compare the actual use of PET/CT in the RSD with these recommendations. This article summarizes the results. A Work Group appointed a professional Subgroup which made Clinician Groups conduct literature reviews on six selected cancers responsible for 5,768 (62.6 %) of 9,213 PET/CT scans in the RSD in 2012. Rapid Evidence Assessment was applied, using the methodology of systematic reviews with predefined limitations to search PubMed, Embase and the Cochrane Library for articles published in English/Danish/Swedish/Norwegian since 2002. PICO questions were defined, data recorded and quality appraised and rated with regard to strength and evidence level. Consequent recommendations for applications of PET/CT were established. The actual use of PET/CT was compared with these, where grades A and B indicated ''established'' and ''useful'' and grades C and D ''potentially useful'' and ''non-recommendable'' indications, respectively. Of 11,729 citations, 1,729 were considered for review, and 204 were included. The evidence suggested usefulness of PET/CT in lung, lymphoma, melanoma, head and neck, and colorectal cancers, whereas evidence was sparse in gynaecological cancers. The agreement between actual use of PET/CT and literature-based recommendations was high in the first five mentioned cancers in that 96.2 % of scans were made for grade A or B indications versus only 22.2 % in gynaecological cancers. Evidence-based usefulness was reported in five of six selected cancers; evidence was sparse in the sixth, gynaecological cancers. Actual use of PET/CT agreed well with recommendations. (orig.)

  5. {sup 18}F-NaF PET/CT: EANM procedure guidelines for bone imaging

    Energy Technology Data Exchange (ETDEWEB)

    Beheshti, M.; Langsteger, W. [St Vincent' s Hospital, PET - CT Center LINZ, Department of Nuclear Medicine and Endocrinology, Linz (Austria); Mottaghy, F.M. [University Hospital Aachen, RWTH Aachen University, Department of Nuclear Medicine, Aachen (Germany); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); Payche, F. [Louis Mourier Hospital, Department of Nuclear Medicine, Colombes (France); Behrendt, F.F.F. [University Hospital Aachen, RWTH Aachen University, Department of Nuclear Medicine, Aachen (Germany); Wyngaert, T.V. den [Antwerp University Hospital, Department of Nuclear Medicine, Edegem (Belgium); Fogelman, I. [King' s College, Department of Nuclear Medicine, London (United Kingdom); Strobel, K. [Lucerne Cantonal Hospital, Department of Radiology and Nuclear Medicine, Lucerne (Switzerland); Celli, M.; Fanti, S. [Policlinico S. Orsola-Malpighi, Department of Nuclear Medicine, PET Unit, Bologna (Italy); Giammarile, F. [Centre Hospitalier Universitaire de Lyon, Department of Nuclear Medicine, Lyon (France); Krause, B. [University Hospital Rostock, Department of Nuclear Medicine, Rostock (Germany)

    2015-10-15

    The aim of this guideline is to provide minimum standards for the performance and interpretation of {sup 18}F-NaF PET/CT scans. Standard acquisition and interpretation of nuclear imaging modalities will help to provide consistent data acquisition and numeric values between different platforms and institutes and to promote the use of PET/CT modality as an established diagnostic modality in routine clinical practice. This will also improve the value of scientific work and its contribution to evidence-based medicine. (orig.)

  6. Noise correlation in PET, CT, SPECT and PET/CT data evaluated using autocorrelation function: a phantom study on data, reconstructed using FBP and OSEM

    International Nuclear Information System (INIS)

    Positron Emission Tomography (PET), Computed Tomography (CT), PET/CT and Single Photon Emission Tomography (SPECT) are non-invasive imaging tools used for creating two dimensional (2D) cross section images of three dimensional (3D) objects. PET and SPECT have the potential of providing functional or biochemical information by measuring distribution and kinetics of radiolabelled molecules, whereas CT visualizes X-ray density in tissues in the body. PET/CT provides fused images representing both functional and anatomical information with better precision in localization than PET alone. Images generated by these types of techniques are generally noisy, thereby impairing the imaging potential and affecting the precision in quantitative values derived from the images. It is crucial to explore and understand the properties of noise in these imaging techniques. Here we used autocorrelation function (ACF) specifically to describe noise correlation and its non-isotropic behaviour in experimentally generated images of PET, CT, PET/CT and SPECT. Experiments were performed using phantoms with different shapes. In PET and PET/CT studies, data were acquired in 2D acquisition mode and reconstructed by both analytical filter back projection (FBP) and iterative, ordered subsets expectation maximisation (OSEM) methods. In the PET/CT studies, different magnitudes of X-ray dose in the transmission were employed by using different mA settings for the X-ray tube. In the CT studies, data were acquired using different slice thickness with and without applied dose reduction function and the images were reconstructed by FBP. SPECT studies were performed in 2D, reconstructed using FBP and OSEM, using post 3D filtering. ACF images were generated from the primary images, and profiles across the ACF images were used to describe the noise correlation in different directions. The variance of noise across the images was visualised as images and with profiles across these images. The most important

  7. How to choose PET-CT or CT in the diagnosis and staging of lung cancer. Practical experience in China

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, T.; Tao, X.; Liu, H.; Liu, S. [Dept. of Radiology, ChangZheng Hospital, Second Military Medical Univ., SH (China); Zheng, X. [Dept. of Nutrition, ChangHai Hospital, Second Military Medical Univ., SH (China)

    2010-07-01

    How to use CT and PET-CT rationally to raise diagnosis, staging and prognostic assessment of lung cancer to a higher level at the best cost-effect ratio is a subject that Chinese clinicians and radiologists should face conscientiously. We review the rational application of CT and PET-CT in four aspects of lung cancer, including screening and detection, morphologic evaluation, haemodynamic or metabolic feature evaluation, and follow-up, staging and prognostic evaluation. As PET-CT is only available in class III-A hospitals today, CT is the most popular equipment in China. PET-CT is more valuable only in cases where CT presentation of lung cancer is atypical or difficult to determine, or in cases where the diagnosis of lung cancer has been initially confirmed, for which clinical staging and decision concerning on therapeutic regimens are needed. We also recommend the current strategies of CT and PET-CT managing of SPN in China. (orig.)

  8. The impact of PET/CT on the management of hepatic and extra hepatic metastases from gastrointestinal cancers

    International Nuclear Information System (INIS)

    Highlights: • CT is more sensitive than PET/CT in detecting hepatic metastases. • PET/CT is more specific in detecting hepatic metastases. • CT and PET/CT have equal sensitivity in detecting extra hepatic metastases. • PET/CT is more specific in detecting extra hepatic metastases. • PET/CT has an impact of about 40% on changing the management strategies. - Abstract: Purpose: To investigate the efficacy of positron emission tomography/computed tomography (PET/CT) in detection and management of hepatic and extrahepatic metastases from gastrointestinal cancers. Materials and methods: Between February 2008 and July 2010, patients histopathologically diagnosed with gastrointestinal cancer and showing suspected metastasis on CT screening were subsequently evaluated with PET/CT. All patients were subgrouped according to histopathological origin and localization of the primary tumor. Localization of gastrointestinal cancers was further specified as lower gastrointestinal system (GIS), upper GIS, or hepato-pancreato-biliary (HPB). Both accuracy and impact of CT and PET/CT on patient management were retrospectively evaluated. Results: One hundred and thirteen patients diagnosed histopathologically with gastrointestinal cancers were retrospectively evaluated. Seventy-nine patients had adenocarcinoma and 34 patients other gastrointestinal tumors. Forty-one patients were in the upper GIS group, 30 patients in the HPB group, and 42 patients in the lower GIS group. Evaluation the diagnostic performance of PET/CT for suspected metastasis according to histopathological origin of the tumor, revealed that the sensitivity of PET/CT – although statistically not different – was higher in adenocarcinomas than in non-adenocarcinomas (90% (95% CI, 0.78–0.96) vs. 71.4% (95% CI, 0.45–0.88), P = 0.86). The specificity was not significantly different (85.7% (95% CI, 0.70–0.93) vs. 85% (95% CI, 0.63–0.94), P = 1.00). In the overall patient group; CT was significantly more

  9. The impact of PET/CT on the management of hepatic and extra hepatic metastases from gastrointestinal cancers

    Energy Technology Data Exchange (ETDEWEB)

    Polat, Erdal, E-mail: erdal066@yahoo.com [Kartal Kosuyolu High Specialty Training and Research Hospital, Department of Gastrointestinal Surgery, Istanbul (Turkey); Bostanci, Erdal Birol [Sakarya University, Faculty of Medicine, Department of General Surgery, Sakarya (Turkey); Aksoy, Erol [Turkiye Yuksek Ihtisas Teaching and Research Hospital, Department of Gastroenterological Surgery, Ankara (Turkey); Karaman, Kerem [Sakarya University, Faculty of Medicine, Department of General Surgery, Sakarya (Turkey); Poyraz, Nilufer Yildirim [Ataturk Teaching and Research Hospital, Department of Nuclear Medicine, Ankara (Turkey); Duman, Ugur [Sevket Yilmaz Training and Research Hospital, Department of General Surgery, Bursa (Turkey); Gencturk, Zeynep Biyikli [Ankara University, Faculty of Medicine, Department of Biostatistics, Ankara (Turkey); Yol, Sinan [Medeniyet University, Faculty of Medicine, Department of General surgery, Istanbul (Turkey)

    2015-06-15

    Highlights: • CT is more sensitive than PET/CT in detecting hepatic metastases. • PET/CT is more specific in detecting hepatic metastases. • CT and PET/CT have equal sensitivity in detecting extra hepatic metastases. • PET/CT is more specific in detecting extra hepatic metastases. • PET/CT has an impact of about 40% on changing the management strategies. - Abstract: Purpose: To investigate the efficacy of positron emission tomography/computed tomography (PET/CT) in detection and management of hepatic and extrahepatic metastases from gastrointestinal cancers. Materials and methods: Between February 2008 and July 2010, patients histopathologically diagnosed with gastrointestinal cancer and showing suspected metastasis on CT screening were subsequently evaluated with PET/CT. All patients were subgrouped according to histopathological origin and localization of the primary tumor. Localization of gastrointestinal cancers was further specified as lower gastrointestinal system (GIS), upper GIS, or hepato-pancreato-biliary (HPB). Both accuracy and impact of CT and PET/CT on patient management were retrospectively evaluated. Results: One hundred and thirteen patients diagnosed histopathologically with gastrointestinal cancers were retrospectively evaluated. Seventy-nine patients had adenocarcinoma and 34 patients other gastrointestinal tumors. Forty-one patients were in the upper GIS group, 30 patients in the HPB group, and 42 patients in the lower GIS group. Evaluation the diagnostic performance of PET/CT for suspected metastasis according to histopathological origin of the tumor, revealed that the sensitivity of PET/CT – although statistically not different – was higher in adenocarcinomas than in non-adenocarcinomas (90% (95% CI, 0.78–0.96) vs. 71.4% (95% CI, 0.45–0.88), P = 0.86). The specificity was not significantly different (85.7% (95% CI, 0.70–0.93) vs. 85% (95% CI, 0.63–0.94), P = 1.00). In the overall patient group; CT was significantly more

  10. Effective dose and cancer risk in PET/CT exams; Dose efetiva e risco de cancer em exames de PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Pinto, Gabriella M.; Sa, Lidia Vasconcellos de, E-mail: montezano@ird.gov.br, E-mail: Iidia@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2013-07-01

    Due to the use of radiopharmaceutical positron-emitting in PET exam and realization of tomography by x-ray transmission in CT examination, an increase of dose with hybrid PET/CT technology is expected. However, differences of doses have been reported in many countries for the same type of procedure. It is expected that the dose is an influent parameter to standardize the protocols of PET/CT. This study aimed to estimate the effective doses and absorbed in 65 patients submitted to oncological Protocol in a nuclear medicine clinic in Rio de Janeiro, considering the risk of induction of cancer from the scan. The CT exam-related doses were estimated with a simulator of PMMA and simulated on the lmPACT resistance, which for program effective dose, were considered the weight factors of the lCRP 103. The PET exam doses were estimated by multiplying the activity administered to the patient with the ICRP dose 80 factors. The radiological risk for cancer incidence were estimated according to the ICRP 103. The results showed that the effective dose from CT exam is responsible for 70% of the effective total in a PET/CT scan. values of effective dose for the PET/CT exam reached average values of up to 25 mSv leading to a risk of 2, 57 x 10{sup -4}. Considering that in staging of oncological diseases at least four tests are performed annually, the total risk comes to 1,03x 10{sup -3}.

  11. Diagnostic value of PET/CT for the staging and restaging of pediatric tumors

    Energy Technology Data Exchange (ETDEWEB)

    Kleis, Margit [University of California (UCSF), Department of Radiology, San Francisco, CA (United States)]|[Technical University of Munich, Department of Radiology, Munich (Germany); Daldrup-Link, Heike; Lu, Ying; Schreck, Carole; Chu, Philip W.; Hawkins, Randall A.; Franc, Benjamin L. [University of California (UCSF), Department of Radiology, San Francisco, CA (United States); Matthay, Katherine [University of California, Department of Pediatrics, Division of Pediatric Hemato-Oncology, San Francisco, CA (United States); Goldsby, Robert [University of California, Department of Pediatric Oncology, San Francisco, CA (United States); Schuster, Tibor [Technical University of Munich, Department of Biostatistics and Epidemiology, Munich (Germany)

    2009-01-15

    The objective of this retrospective study was to compare the diagnostic value of 2-[{sup 18}F]fluoro-2-deoxy-d-glucose positron emission tomography ({sup 18}F-FDG PET)/CT versus {sup 18}F-FDG PET and CT alone for staging and restaging of pediatric solid tumors. Forty-three children and adolescents (19 females and 24 males; mean age, 15.2 years; age range, 6-20 years) with osteosarcoma (n = 1), squamous cell carcinoma (n = 1), synovial sarcoma (n = 2), germ cell tumor (n = 2), neuroblastoma (n = 2), desmoid tumor (n = 2), melanoma (n = 3), rhabdomyosarcoma (n = 5), Hodgkin's lymphoma (n = 7), non-Hodgkin-lymphoma (n = 9), and Ewing's sarcoma (n = 9) who had undergone {sup 18}F-FDG PET/CT imaging for primary staging or follow-up of metastases were included in this study. The presence, location, and size of primary tumors was determined separately for PET/CT, PET, and CT by two experienced reviewers. The diagnosis of the primary tumor was confirmed by histopathology. The presence or absence of metastases was confirmed by histopathology (n = 62) or clinical and imaging follow-up (n = 238). The sensitivities for the detection of solid primary tumors using integrated {sup 18}F-FDG PET/CT (95%), {sup 18}F-FDG PET alone (73%), and CT alone (93%) were not significantly different (p > 0.05). Seventeen patients showed a total of 153 distant metastases. Integrated PET/CT had a significantly higher sensitivity for the detection of these metastases (91%) than PET alone (37%; p < 0.05), but not CT alone (83%; p > 0.05). When lesions with a diameter of less than 0.5 cm were excluded, PET/CT (89%) showed a significantly higher specificity compared to PET (45%; p < 0.05) and CT (55%; p < 0.05). In a sub-analysis of pulmonary metastases, the values for sensitivity and specificity were 90%, 14%, 82% and 63%, 78%, 65%, respectively, for integrated PET/CT, stand-alone PET, and stand-alone CT. For the detection of regional lymph node metastases, {sup 18}F-FDG PET/CT, {sup 18}F

  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. State of the art imaging of multiple myeloma: Comparative review of FDG PET/CT imaging in various clinical settings

    Energy Technology Data Exchange (ETDEWEB)

    Mesguich, Charles, E-mail: charles.mesguich@chu-bordeaux.fr [Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (United States); Fardanesh, Reza; Tanenbaum, Lawrence [Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (United States); Chari, Ajai; Jagannath, Sundar [Department of Medicine Division of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, NY (United States); Kostakoglu, Lale, E-mail: lale.kostakoglu@mssm.edu [Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (United States)

    2014-12-15

    Highlights: • Metabolic changes on FDG PET/CT offer an earlier response evaluation than MRI. • PET/CT is less sensitive than MRI for diffuse bone marrow involvement. • PET/CT is a highly sensitive modality to determine extra-medullary disease. • Red marrow expansion: false positive findings on both FDG PET/CT and MRI. • Compression fractures are best characterized with MRI. - Abstract: 18-Flurodeoxyglucose Positron Emission Tomography with computed tomography (FDG PET/CT) and Magnetic Resonance Imaging (MRI) have higher sensitivity and specificity than whole-body X-ray (WBXR) survey in evaluating disease extent in patients with multiple myeloma (MM). Both modalities are now recommended by the Durie–Salmon Plus classification although the emphasis is more on MRI than PET/CT. The presence of extra-medullary disease (EMD) as evaluated by PET/CT imaging, initial SUV{sub max} and number of focal lesions (FL) are deemed to be strong prognostic parameters at staging. MRI remains the most sensitive technique for the detection of diffuse bone marrow involvement in both the pre and post-therapy setting. Compression fractures are best characterized with MRI signal changes, for determining vertebroplasty candidates. While PET/CT allows for earlier and more specific evaluation of therapeutic efficacy compared to MRI, when signal abnormalities persist years after treatment. PET/CT interpretation, however, can be challenging in the vertebral column and pelvis as well as in cases with post-therapy changes. Hence, a reading approach combining the high sensitivity of MRI and superior specificity of FDG PET/CT would be preferred to increase the diagnostic accuracy. In summary, the established management methods in MM, mainly relying on biological tumor parameters should be complemented with functional imaging data, both at staging and restaging for optimal management of MM.

  14. Value of surveillance {sup 18}F FDG PET/CT in colorectal cancer:comparison with conventional imaging studies

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Eun Kyoung; Yoo, Ie Ryung; Park, Hye Lim; Choi, Hyun Su; Han, Eun Ji; Kim, Sung Hoon; Chung, Soo Kyo; O, Joo Hyun [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2012-09-15

    To assess the value of PET/CT for detecting local or distant recurrence in patients who undergo surgery for colorectal cancer (CRC)and to compare the accuracy of PET/CT to that of conventional imaging studies (CIS). Tumor surveillance PET/CT scans done between March 2005 and December 2009 of disease free patients after surgery with or without adjuvant chemotherapy for CRC were retrospectively studied. CIS (serial enhanced CT from lung base to pelvis and plain chest radiograph)were performed within 1 month of PET/CT. We excluded patients with distant metastasis on initial staging, a known recurrent tumor, and a lack of follow up imaging. The final diagnosis was based on at least 6 months of follow up with colonoscopy, biopsy, and serial imaging studies in combination with carcinoembryonic antigen levels. A total of 262 PET/CT scans of 245 patients were included. Local and distant recurrences were detected in 27 cases (10.3%). On case based analysis, the overall sensitivity, specificity, and accuracy were 100, 97.0, and 97.3% for PET/CT and 85.1, 97.0, and 95.8% for CIS, respectively. On lesion based analysis, PET/CT detected more lesions compared to CIS in local recurrence and lung metastasis. PET/CT and CIS detected the same number of lesions in abdominal lymph nodes, hepatic metastasis, and peritoneal carcinomatosis. PET/CT detected two more metachronous tumors than did CIS in the lung and thyroid gland. PET/CT detected more recurrences in patients who underwent surgery for CRC than did CIS and had the additional advantage of evaluating the entire body during a single scan.

  15. Value of surveillance 18F FDG PET/CT in colorectal cancer:comparison with conventional imaging studies

    International Nuclear Information System (INIS)

    To assess the value of PET/CT for detecting local or distant recurrence in patients who undergo surgery for colorectal cancer (CRC)and to compare the accuracy of PET/CT to that of conventional imaging studies (CIS). Tumor surveillance PET/CT scans done between March 2005 and December 2009 of disease free patients after surgery with or without adjuvant chemotherapy for CRC were retrospectively studied. CIS (serial enhanced CT from lung base to pelvis and plain chest radiograph)were performed within 1 month of PET/CT. We excluded patients with distant metastasis on initial staging, a known recurrent tumor, and a lack of follow up imaging. The final diagnosis was based on at least 6 months of follow up with colonoscopy, biopsy, and serial imaging studies in combination with carcinoembryonic antigen levels. A total of 262 PET/CT scans of 245 patients were included. Local and distant recurrences were detected in 27 cases (10.3%). On case based analysis, the overall sensitivity, specificity, and accuracy were 100, 97.0, and 97.3% for PET/CT and 85.1, 97.0, and 95.8% for CIS, respectively. On lesion based analysis, PET/CT detected more lesions compared to CIS in local recurrence and lung metastasis. PET/CT and CIS detected the same number of lesions in abdominal lymph nodes, hepatic metastasis, and peritoneal carcinomatosis. PET/CT detected two more metachronous tumors than did CIS in the lung and thyroid gland. PET/CT detected more recurrences in patients who underwent surgery for CRC than did CIS and had the additional advantage of evaluating the entire body during a single scan

  16. State of the art imaging of multiple myeloma: Comparative review of FDG PET/CT imaging in various clinical settings

    International Nuclear Information System (INIS)

    Highlights: • Metabolic changes on FDG PET/CT offer an earlier response evaluation than MRI. • PET/CT is less sensitive than MRI for diffuse bone marrow involvement. • PET/CT is a highly sensitive modality to determine extra-medullary disease. • Red marrow expansion: false positive findings on both FDG PET/CT and MRI. • Compression fractures are best characterized with MRI. - Abstract: 18-Flurodeoxyglucose Positron Emission Tomography with computed tomography (FDG PET/CT) and Magnetic Resonance Imaging (MRI) have higher sensitivity and specificity than whole-body X-ray (WBXR) survey in evaluating disease extent in patients with multiple myeloma (MM). Both modalities are now recommended by the Durie–Salmon Plus classification although the emphasis is more on MRI than PET/CT. The presence of extra-medullary disease (EMD) as evaluated by PET/CT imaging, initial SUVmax and number of focal lesions (FL) are deemed to be strong prognostic parameters at staging. MRI remains the most sensitive technique for the detection of diffuse bone marrow involvement in both the pre and post-therapy setting. Compression fractures are best characterized with MRI signal changes, for determining vertebroplasty candidates. While PET/CT allows for earlier and more specific evaluation of therapeutic efficacy compared to MRI, when signal abnormalities persist years after treatment. PET/CT interpretation, however, can be challenging in the vertebral column and pelvis as well as in cases with post-therapy changes. Hence, a reading approach combining the high sensitivity of MRI and superior specificity of FDG PET/CT would be preferred to increase the diagnostic accuracy. In summary, the established management methods in MM, mainly relying on biological tumor parameters should be complemented with functional imaging data, both at staging and restaging for optimal management of MM

  17. 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.)

  18. PET-CT定位局部晚期非小细胞肺癌IMRT同步化疗的疗效和预后分析*%Concurrent chemotherapy and intensity-modulated radiation therapy positioned by PET/CT for patients with locally advanced non-small cell lung cancer

    Institute of Scientific and Technical Information of China (English)

    张真; 张小涛; 韩淑红; 吴雪松

    2013-01-01

      目的:比较局部晚期非小细胞肺癌患者普通模拟机定位常规放疗及PET-CT定位调强放疗(IMRT)同步化疗的疗效、不良反应和预后。方法:对本院放疗中心收治的放疗患者进行回顾性分析。PET-CT定位下的调强放疗同步化疗(IMRT)组患者48例,常规放疗同步化疗(CRT)组患者40例,放疗总剂量达到60 Gy,6周完成。同步化疗方案以铂类为基础联合多西他赛、长春瑞滨或培美曲塞等,同步化疗2个周期,2~4个周期巩固化疗(21 d为1个周期)。结果:IMRT组和CRT组有效率分别为77.1%和52.5%,两组差异有统计学意义(P=0.015)。IMRT组1、2和3年生存率分别为77.1%(37/48)、54.2%(26/48)和22.9%(11/48)。CRT组1、2和3年生存率分别为65.0%(26/40)、47.5%(19/40)和17.5%(7/40)(P=0.292)。两组差异无统计学意义。CRT组的骨髓抑制、体质量变化略高于IMRT组,但无显著性差异(P>0.05),消化道反应、放射性肺炎和放射性食道炎高于IMRT组(P<0.05)。CRT组死于局部复发以及放射性肺炎的比例高(P<0.05);IMRT组的局部复发率低(P<0.01)。结论:PET-CT定位IMRT可提高局部晚期非小细胞肺癌患者局部控制率,对提高近期疗效和降低放疗不良反应方面有明显优势,而其对生存率的影响,将需待更长时间的随访结果加以明确。%Objective:This work aimed to compare the three-year results, prognostic analysis, and adverse reactions of intensi-ty-modulated radiation therapy (IMRT) positioned by PET-CT and conventional radiotherapy in locally advanced non-small cell lung cancer (NSCLC) patients who underwent concurrent chemotherapy. Methods:A clinical trial was carried out in Qingdao Cancer Hospi-tal. The patients who joined our study were divided into IMRT and conventional radiotherapy (CRT) groups. A total of 48 patients were in the IMRT group and another 40 were in the

  19. PET-CT application and influence on IMRT target delineation in locally advanced non-small cell lung cancer%PET-CT在局部晚期非小细胞肺癌调强放疗靶区勾画中的应用及其影响

    Institute of Scientific and Technical Information of China (English)

    俞岑明; 葛琴; 蔡晶; 吴建亭; 杨百霞; 成国建; 赵季忠

    2015-01-01

    Objective To investigate the value of PET⁃CT image fusion to delineate the target of intensity modulated radiation therapy( IMRT) in locally advanced non⁃small cell lung cancer( NSCLC) , and the impact on target volume and dose of normal lung tis⁃sue. Methods Thirty NSCLC patients of clinical stageⅢA andⅢB were randomly selected. Target and organ at risk were delineated on the same fixed position according to enhanced CT images and fusion images of PET/CT and CT, respectively. Then the volume of gross tumor volume( GTV) and planning target volume( PTV) under these two status were compared. Moreover, the percent of the total lung volume exceeding 5 Gy( V5 ) , percent of the total lung volume exceeding 20 Gy( V20 ) , mean dose of lung irradiated( MLD) in two different conformal IMRT plans were observed when the dosage of PTV was up to 60 Gy/30 f. Results The GTV volume on fusion im⁃ages of PET⁃CT/CT was (248�39±94�80)cm3, less than (311�22±99�16)cm3 on the enhanced CT images in 30 cases. The difference was statistically significant(P<0�05). PTV, extended from GTV, in fusion images of PET⁃CT/CT was (356�68±92�73) cm3, while in the enhanced CT images were (433�58±107�89 cm3) with significant difference(P<0�01). The V5, V20 and MLD of whole lung in the two plans were compared. In fusion images of PET⁃CT/CT program, V5, V20 and MLD was (51�26±10�50)%, (25�71±5�17)% and (1595�27±148�24) cGy, remarkly less than (56�41±9�55)%, (29�09±4�10)% and (1693�59±100�60) cGy in the enhanced CT program with significant difference( P<0�05) . Conclusion Application of PET⁃CT/CT fusion image to delin⁃eate the targets of IMRT can improve the accuracy of target delineation volume and reduce the dose of normal lung tissues.%目的:探讨局部晚期非小细胞肺癌( NSCLC)调强适形放疗( IMRT)中应用PET⁃CT融合图像勾画靶区对靶体积及正常肺组织受照剂量

  20. 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

  1. Correlation of breast cancer subtypes, based on estrogen receptor, progesterone receptor, and HER2, with functional imaging parameters from {sup 68}Ga-RGD PET/CT and {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hai-Jeon [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, The Institute of Radiation Medicine, Seoul (Korea, Republic of); Ewha Womans University School of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Kang, Keon Wook; Jeong, Jae Min; Chung, June-Key [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Biomedical Sciences, Seoul (Korea, Republic of); Seoul National University College of Medicine, The Institute of Radiation Medicine, Seoul (Korea, Republic of); Seoul National University, Cancer Research Institute, Seoul (Korea, Republic of); Chun, In Kook [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Kangwon National University Hospital, Department of Nuclear Medicine, Chuncheon, Kangwon-Do (Korea, Republic of); Cho, Nariya [Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Im, Seock-Ah [Seoul National University College of Medicine, Department of Internal Medicine, Seoul (Korea, Republic of); Jeong, Sunjoo [Dankook University, Department of Molecular Biology, Yongin (Korea, Republic of); Lee, Song [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, The Institute of Radiation Medicine, Seoul (Korea, Republic of); Jung, Kyeong Cheon [Seoul National University College of Medicine, Department of Pathology, Seoul (Korea, Republic of); Lee, Yun-Sang [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul (Korea, Republic of); Lee, Dong Soo [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, The Institute of Radiation Medicine, Seoul (Korea, Republic of); Seoul National University, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul (Korea, Republic of); Moon, Woo Kyung [Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Biomedical Sciences, Seoul (Korea, Republic of); Seoul National University College of Medicine, The Institute of Radiation Medicine, Seoul (Korea, Republic of)

    2014-08-15

    Imaging biomarkers from functional imaging modalities were assessed as potential surrogate markers of disease status. Specifically, in this prospective study, we investigated the relationships between functional imaging parameters and histological prognostic factors and breast cancer subtypes. In total, 43 patients with large or locally advanced invasive ductal carcinoma (IDC) were analyzed (47.6 ± 7.5 years old). {sup 68}Ga-Labeled arginine-glycine-aspartic acid (RGD) and {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) were performed. The maximum and average standardized uptake values (SUV{sub max} and SUV{sub avg}) from RGD PET/CT and SUV{sub max} and SUV{sub avg} from FDG PET/CT were the imaging parameters used. For histological prognostic factors, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression was identified using immunohistochemistry (IHC) or fluorescent in situ hybridization (FISH). Four breast cancer subtypes, based on ER/PR and HER2 expression (ER/PR+,Her2-, ER/PR+,Her2+, ER/PR-,Her2+, and ER/PR-,Her2-), were considered. Quantitative FDG PET parameters were significantly higher in the ER-negative group (15.88 ± 8.73 vs 10.48 ± 6.01, p = 0.02 for SUV{sub max}; 9.40 ± 5.19 vs 5.92 ± 4.09, p = 0.02 for SUV{sub avg}) and the PR-negative group (8.37 ± 4.94 vs 4.79 ± 3.93, p = 0.03 for SUV{sub avg}). Quantitative RGD PET parameters were significantly higher in the HER2-positive group (2.42 ± 0.59 vs 2.90 ± 0.75, p = 0.04 for SUV{sub max}; 1.60 ± 0.38 vs 1.95 ± 0.53, p = 0.04 for SUV{sub avg}) and showed a significant positive correlation with the HER2/CEP17 ratio (r = 0.38, p = 0.03 for SUV{sub max} and r = 0.46, p < 0.01 for SUV{sub avg}). FDG PET parameters showed significantly higher values in the ER/PR-,Her2- subgroup versus the ER/PR+,Her2- or ER/PR+,Her2+ subgroups, while RGD PET parameters showed significantly lower values in the ER

  2. FDG PET/CT in clinical oncology. Case based approach with teaching points

    International Nuclear Information System (INIS)

    Organized according to the role of FDG PET/CT in the evaluation and management of oncology patients. 100 informative cases reflecting the issues that clinicians address in their daily practice. Ideal for all newcomers to the field, whether medical students, radiology, nuclear medicine, or oncology fellows, or practicing physicians. FDG PET/CT has rapidly emerged as an invaluable combined imaging modality that can identify tumors on the basis of not only anatomical alterations but also metabolic activity, thus allowing the detection of lesions that would otherwise be too small to distinguish. This book, comprising a collection of images from oncology cases, is organized according to the role of FDG PET/CT in the evaluation and management of oncology patients, and only secondarily by organ or tumor entity. In this way, it reflects the issues that clinicians actually address in their daily practice, namely: identification of an unknown or unsuspected primary; determination of the extent of disease; evaluation of response to therapy; and surveillance after response, i.e., detection of recurrent disease. In total, 100 cases involving different primary tumors are presented to illustrate findings in these different circumstances. FDG PET/CT in Clinical Oncology will be of great value to all newcomers to this field, whether medical students, radiology, nuclear medicine, or oncology fellows, or practicing physicians.

  3. A Pilot Study of 18F-FLT PET/CT in Pediatric Lymphoma.

    Science.gov (United States)

    Costantini, Danny L; Vali, Reza; McQuattie, Susan; Chan, Jeffrey; Punnett, Angela; Weitzman, Shiela; Shammas, Amer; Charron, Martin

    2016-01-01

    We performed an observational pilot study of 18F-FLT PET/CT in pediatric lymphoma. Eight patients with equivocal 18F-FDG PET/CT underwent imaging with 18F-FLT PET/CT. No immediate adverse reactions to 18F-FLT were observed. Compared to 18F-FDG, 18F-FLT uptake was significantly higher in bone marrow and liver (18F-FLT SUV 8.6 ± 0.6 and 5.0 ± 0.3, versus 18F-FDG SUV 1.9 ± 0.1 and 3.4 ± 0.7, resp., p < 0.05). In total, 15 lesions were evaluated with average 18F-FDG and 18F-FLT SUVs of 2.6 ± 0.1 and 2.0 ± 0.4, respectively. Nonspecific uptake in reactive lymph nodes and thymus was observed. Future studies to assess the clinical utility of 18F-FLT PET/CT in pediatric lymphoma are planned. PMID:27313888

  4. 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

  5. Detection of penile metastasis from bladder cancer using F 18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Yun; Lee, Jong Jin [Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2012-12-15

    A 74 year old man who had experienced priapism for 2 months after radical cystectomy for bladder cancer visited our hospital, and underwent metastatic work up {sup 18}F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography(PET/CT)showed diffuse hypermetabolic activity along the penis shaft, which was confirmed as a penile metastasis.

  6. Clinical impact of FDG-PET/CT on colorectal cancer staging and treatment strategy

    DEFF Research Database (Denmark)

    Petersen, Rasmus K; Hess, Søren; Alavi, Abass;

    2014-01-01

    FDG-PET/CT is rarely used for initial staging of patients with colorectal cancer (CRC). Surgical resection of primary tumor and isolated metastases may result in long-term survival or presumed cure, whereas disseminated disease contraindicates operation. We analyzed a retrospective material to el...

  7. PET/CT without capacity limitations: a Danish experience from a European perspective

    DEFF Research Database (Denmark)

    Høilund-Carlsen, Poul Flemming; Gerke, Oke; Vilstrup, Mie Holm;

    2011-01-01

    OBJECTIVES: We report the 3-year clinical experience of a large new Danish PET/CT centre without capacity limitations in relation to national and European developments. METHODS: The use of PET/CT in cancer was registered from early 2006 to early 2009 to judge the impact on patient management...... and to compare it with national and European trends. RESULTS: 6056 PET/CT examinations were performed in 4327 patients. Activity increased by 86 examinations per month compared with the same month the year before. Referrals came primarily from oncology (23.0%), haematology (21.6%), surgery (12.6%), internal...... medicine (12.7%) and gynaecology (5.5%). Referral indications were diagnosis (31.3%), staging (22.3%), recurrence detection (21.2%), response evaluation (17.0%) and other (8.2%). Response from nearly 60% of users showed that PET/CT caused a change in diagnosis and/or staging and/or treatment plan in 36...

  8. 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.

  9. FDG PET/CT : EANM procedure guidelines for tumour imaging: version 2.0

    NARCIS (Netherlands)

    Boellaard, Ronald; Delgado-Bolton, Roberto; Oyen, Wim J. G.; Giammarile, Francesco; Tatsch, Klaus; Eschner, Wolfgang; Verzijlbergen, Fred J.; Barrington, Sally F.; Pike, Lucy C.; Weber, Wolfgang A.; Stroobants, Sigrid; Delbeke, Dominique; Donohoe, Kevin J.; Holbrook, Scott; Graham, Michael M.; Testanera, Giorgio; Hoekstra, Otto S.; Zijlstra, Josee; Visser, Eric; Hoekstra, Corneline J.; Pruim, Jan; Willemsen, Antoon; Arends, Bertjan; Kotzerke, Joerg; Bockisch, Andreas; Beyer, Thomas; Chiti, Arturo; Krause, Bernd J.

    2015-01-01

    The purpose of these guidelines is to assist physicians in recommending, performing, interpreting and reporting the results of FDG PET/CT for oncological imaging of adult patients. PET is a quantitative imaging technique and therefore requires a common quality control (QC)/quality assurance (QA) pro

  10. FDG PET/CT in clinical oncology. Case based approach with teaching points

    Energy Technology Data Exchange (ETDEWEB)

    Mihailovic, Jasna [Novi Sad Univ. (Serbia). Dept. of Nuclear Medicine; Goldsmith, Stanley J. [Weill Cornell Medical College, New York, NY (United States). Div. of Nuclear Medicine and Molecular Imging; Killeen, Ronan P. [St. Vincents Univ. Hospital, Dublin (Ireland)

    2012-07-01

    Organized according to the role of FDG PET/CT in the evaluation and management of oncology patients. 100 informative cases reflecting the issues that clinicians address in their daily practice. Ideal for all newcomers to the field, whether medical students, radiology, nuclear medicine, or oncology fellows, or practicing physicians. FDG PET/CT has rapidly emerged as an invaluable combined imaging modality that can identify tumors on the basis of not only anatomical alterations but also metabolic activity, thus allowing the detection of lesions that would otherwise be too small to distinguish. This book, comprising a collection of images from oncology cases, is organized according to the role of FDG PET/CT in the evaluation and management of oncology patients, and only secondarily by organ or tumor entity. In this way, it reflects the issues that clinicians actually address in their daily practice, namely: identification of an unknown or unsuspected primary; determination of the extent of disease; evaluation of response to therapy; and surveillance after response, i.e., detection of recurrent disease. In total, 100 cases involving different primary tumors are presented to illustrate findings in these different circumstances. FDG PET/CT in Clinical Oncology will be of great value to all newcomers to this field, whether medical students, radiology, nuclear medicine, or oncology fellows, or practicing physicians.

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

    Directory of Open Access Journals (Sweden)

    Nappi Antonio

    2015-12-01

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

  12. 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

  13. Case report: Pulmonary syphilis mimicking pulmonary hematogenous metastases on chest CT and integrated PET/CT

    Directory of Open Access Journals (Sweden)

    Hyung Jun Kim

    2011-01-01

    Full Text Available We report a case of syphilis with pulmonary involvement. Chest CT scan and 18 F-fluorodeoxyglucose (FDG PET/CT showed multiple pulmonary nodules mimicking pulmonary hematogenous metastases. This was confirmed on follow-up images that showed therapeutic response to penicillin.

  14. 18F-FDG PET/CT in fever and inflammation of unknown origin

    NARCIS (Netherlands)

    J.J.M. Balink

    2015-01-01

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

  15. Active herpes zoster infection with cutaneous manifestation and adenopathy on FDG PET/CT

    Directory of Open Access Journals (Sweden)

    Antoine Wadih, MD

    2015-10-01

    Full Text Available We report a patient with history of Hodgkin lymphoma. Six months after treatment, 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography and/or computed tomography ([18F] FDG PET/CT scan showed abnormal uptake in right axillary lymph nodes concerning for recurrence. In addition, PET/CT showed a new hypermetabolic skin lesion overlying the right scapula. Clinical evaluation was consistent with shingles, and the patient was treated with valacyclovir. Subsequent PET/CT scan was normal with no evidence of lymphoma. Although there have been reported cases of abnormal FDG in nodes or in skin due to herpes zoster, our case is unique in the literature in that the PET/CT demonstrates abnormalities involving both the skin and associated lymph nodes. The possibility of false positive uptake, not because of recurrent malignancy, must always be considered when abnormal FDG uptake is noted in the follow-up of oncology patients. Careful review of the scan and correlation with clinical findings can avoid false positive interpretation and facilitate patient management.

  16. Case report: Pulmonary syphilis mimicking pulmonary hematogenous metastases on chest CT and integrated PET/CT

    International Nuclear Information System (INIS)

    We report a case of syphilis with pulmonary involvement. Chest CT scan and 18F-fluorodeoxyglucose (FDG) PET/CT showed multiple pulmonary nodules mimicking pulmonary hematogenous metastases. This was confirmed on follow-up images that showed therapeutic response to penicillin

  17. Uterine cervical melanoma presenting with rapid progression detected by PET/CT

    International Nuclear Information System (INIS)

    Malignant melanoma of the uterine cervix is a rare extracutaneous melanoma which develops aggressively and is associated with a bleak prognosis. To our knowledge, no prior published reports have discussed the role of 18F-FDG positron emission tomography/computed tomography (PET/CT) in managing this disease. Our case study involved a 66-year-old woman with a malignant melanoma of the uterine cervix. The patient received PET/CT that identified metastases and lesions which had not been detected from her MRI. Serial PET/CT elucidated that the disease was initially limited to the pelvis, but then metastasized to the abdominal para-aortic lymph nodes, followed by extensive metastases to the brain, lungs, breast, supraclavicular, neck, and other abdominal lymph nodes, as observed at 6-month follow-up. PET/CT was used to complement conventional anatomic imaging modalities, and provided a novel modality for whole body screening. Visualization of the metabolic activity of indeterminate lesions may help in staging, re-staging, treatment planning, and prognostic prediction for patients with this rare disease

  18. A Pilot Study of 18F-FLT PET/CT in Pediatric Lymphoma

    Directory of Open Access Journals (Sweden)

    Danny L. Costantini

    2016-01-01

    Full Text Available We performed an observational pilot study of 18F-FLT PET/CT in pediatric lymphoma. Eight patients with equivocal 18F-FDG PET/CT underwent imaging with 18F-FLT PET/CT. No immediate adverse reactions to 18F-FLT were observed. Compared to 18F-FDG, 18F-FLT uptake was significantly higher in bone marrow and liver (18F-FLT SUV 8.6±0.6 and 5.0±0.3, versus 18F-FDG SUV 1.9±0.1 and 3.4±0.7, resp., p<0.05. In total, 15 lesions were evaluated with average 18F-FDG and 18F-FLT SUVs of 2.6±0.1 and 2.0±0.4, respectively. Nonspecific uptake in reactive lymph nodes and thymus was observed. Future studies to assess the clinical utility of 18F-FLT PET/CT in pediatric lymphoma are planned.

  19. [FDG-PET/CT: a valuable technique in Staphylococcus aureus bacteraemia

    NARCIS (Netherlands)

    Bleeker-Rovers, C.P.; Vos, F.J.; Oyen, W.J.G.

    2015-01-01

    Staphylococcus aureus bacteraemia is often complicated by metastatic infectious foci. Some of these metastatic foci do not cause any localizing symptoms, which complicates early detection and adequate treatment. Where localizing symptoms are absent FDG-PET/CT is highly useful as a screening method f

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

    International Nuclear Information System (INIS)

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

  1. Safety and protection problems in the management of a plant with cyclotron, radiopharmacy laboratory and PET/CT equipment

    Energy Technology Data Exchange (ETDEWEB)

    Russo, A.; Speranza, A.; Panico, M. [University Federico-2, National Research Council - Institute of Biostructures and Bioimaging and Dept. of Bio-morphological and Functional Sciences, Napoli (Italy); Delia, R. [University La Sapienza - sez. Rieti, Faculty of Medicine, Rome (Italy); Casale, M. [University Federico-2, Dept. of Physics - Health Physics School, Napoli (Italy); Salvatore, M. [University Federico-2 and National Research Council - Institute of Biostructures and Bioimaging, Dept. of Bio-morphological and Functional Sciences, Napoli (Italy)

    2006-07-01

    The importance of Positron Emission Tomography (PET) is spreading and increasing in many clinical diagnostic fields, as well as the oncology, the cardiology, the neurology and so on. A strong input to the diffusion of this imaging technique from the research field to clinical one has been given either by the development of knowledge about PET or the modern technologies, which allow to set up at very suitable prices and in very little volumes, like in an hospital site, complete systems, which consist of: Cyclotron; Radiopharmacy Laboratory; one or more either PET or PET/CT. Such set-up arrangement allows to carry out highly innovative diagnostic examinations with a remarkable achievement of diagnostic quality and large number of daily examinations. In this paper the authors show the achieved know-how with respect to radioprotection for the set-up and running management of two systems such as PET/CT tomography unit, cyclotron and radiopharmacy laboratory, installed one in the Imaging Diagnostic Department of the Hospital of Naples University and used only for medical and research purposes, and the other one in A.C.O.M. (Advanced Center of Oncology in Macerata), used for commercial and research purposes. The following safety problems have been considered: the facility lay-out; the optimisation of the paths either for the operator, or the patients and the radiotracers; the guide lines for the protection and the safety of the patients, operators and general population, in relation to the utilization and the management of either the more common radiotracers (18 F and 11 C) or those in research progress, for example 64 Cu and 124 I; the protocol set up for the image quality control in relation to the patient protection and safety. The above problems have also been considered, taking into account the Italian regulation and the International Recommendations. (authors)

  2. PET/CT before autologous stem cell transplantation predicts outcome in refractory/relapsed follicular lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Alcantara, Marion; Tilly, Herve [Universite de Rouen, Service d' Hematologie, Centre Henri Becquerel, Rouen (France); Dupuis, Jehan; Haioun, Corinne [CHU Henri Mondor et Universite Paris-Est, Assistance Publique - Hopitaux de Paris, Unite Hemopathies Lymphoides, Marechal de Lattre de Tassigny (France); Mareschal, Sylvain; Dubois, Sydney [Centre Henri Becquerel, IRIB, Unite Inserm U918, Rouen (France); Julian, Anne [CHU Purpan, Service de Medecine Nucleaire, Toulouse (France); Cottereau, Anne Segolene; Becker, Stephanie [Centre Henri Becquerel, Service de Medecine Nucleaire, Rouen (France); Oberic, Lucie; Huynh, Anne; Laurent, Guy; Ysebaert, Loic [IUCT-Oncopole, Departement d' Hematologie, Toulouse (France); Meignan, Michel [CHU Henri-Mondor, Service de Medecine Nucleaire, Paris (France)

    2014-09-20

    Salvage of young patients with follicular lymphoma (FL) after R-CHOP includes salvage immunochemotherapy followed by autologous stem cell transplantation (ASCT). Previous studies dealing with relapsed Hodgkin lymphoma have shown the prognostic value of PET/CT prior to ASCT. We retrospectively analysed 59 patients with refractory/relapsed FL after first-line R-CHOP who were chemosensitive (as evaluated by CT) to the salvage treatment and who proceeded to ASCT. The role of PET/CT in this setting to define chemosensitivity is not definitely established. So we focused on the prognostic value of PET/CT performed after salvage treatment, before ASCT. The estimated 3-year progression-free survival (PFS) and overall survival were 63.1 % (50.9-78.3 %) and 90.5 % (82.8 - 98.8 %), respectively, and did not differ significantly according to their Follicular Lymphoma International Prognostic Index at relapse, conditioning regimen, or type of salvage. PFS was significantly lower in PET/CT-positive patients, according to the International Harmonization Project revised response criteria, with a 3-year PFS of 45.5 % (26.6 - 77.8 %) versus 72.6 % (58.5 - 90.0 %; p = 0.039). To better refine prognosis, we applied two types of thresholds: a Deauville five-point scale positive threshold of ≥3 (3-year PFS of 74.9 %, range 61.0 - 92.1 % %, versus 42.8 %, range 24.7 - 74.4 %; p = 0.02), and a ≥70 % ∇SUV{sub max} threshold between presalvage and pre-ASCT PET/CT (3-year PFS of 72.4 %, range 57.5 - 91.3 % versus 13.3 %, 2.2 - 81.7 %; p < 10{sup -3}). The PET/CT findings before ASCT were independently correlated with PFS in our series. PET/CT negativity before ASCT is a desirable and achievable goal in the management of chemosensitive FL relapsing after first-line R-CHOP. (orig.)

  3. Choline PET and PET/CT in Primary Diagnosis and Staging of Prostate Cancer

    Directory of Open Access Journals (Sweden)

    S. Schwarzenböck, M. Souvatzoglou, B. J. Krause

    2012-01-01

    Full Text Available PET and PET/CT using [11C]- and [18F]-labelled choline derivates is increasingly being used for imaging of primary and recurrent prostate cancer. While PET and PET/CT with [11C]- and [18F]-labelled choline derivates in patients suffering from biochemical recurrence of prostate cancer has been examined in many studies that demonstrate an increasing importance, its role in the primary staging of prostate cancer is still a matter of debate.Morphological and functional imaging techniques such as CT, MRI and TRUS have demonstrated only limited accuracy for the diagnosis of primary prostate cancer. Molecular imaging with PET and PET/CT could potentially increase accuracy to localize primary prostate cancer. A considerable number of studies have examined the value of PET/CT with [11C]- and [18F]- labelled choline derivates for the diagnosis of primary prostate cancer with mixed results. Primary prostate cancer can only be detected with moderate sensitivity using [11C]- and [18F]choline PET and PET/CT. The detection rate depends on the tumour configuration. Detection is also limited by a considerable number of microcarcinomas that cannot be detected due to partial volume effects. Therefore small and in part rind-like tumours can often not be visualized. Furthermore, the differentiation between benign changes like prostatitis, high-grade intraepithelial neoplasia (HGPIN or prostatic hyperplasia is not always possible. Therefore, at the present time, the routine use of PET/CT with [11C]- and [18F]-labelled choline derivates cannot be recommended as a first-line screening procedure for primary prostate cancer in men at risk. A potential application of choline PET and PET/CT may be to increase the detection rate of clinically suspected prostate cancer with multiple negative prostate biopsies, for example in preparation of a focused re-biopsy and may play a role in patient stratification with respect to primary surgery and radiation therapy in the future.

  4. 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.)

  5. {sup 18}F-Fluoride PET/CT for detection of sacroiliitis in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Strobel, Klaus [University Hospital, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Cantonal Hospital Lucerne, Nuclear Medicine, Lucerne (Switzerland); Fischer, Dorothee R.; Stumpe, Katrin D.M.; Schulthess, Gustav K. von [University Hospital, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Tamborrini, Giorgio; Kyburz, Diego; Michel, Beat A.; Ciurea, Adrian [University Hospital Zurich, Department of Rheumatology, Zurich (Switzerland); Hesselmann, Rolf G.X.; Johayem, A. [University Hospital Zurich, Radiopharmacy, Zurich (Switzerland)

    2010-09-15

    The aim of this study was to evaluate the performance of {sup 18}F-fluoride-PET/CT (PET/CT) for the diagnosis of sacroiliac joint (SIJ) arthritis in patients with active ankylosing spondylitis (AS). Included in the study were 15 patients with AS according to the modified New York criteria (AS group) and with active disease and 13 patients with mechanical low back pain (MLBP; control group) who were investigated with whole-body {sup 18}F-fluoride PET/CT. The ratio of the uptake in the SIJ and that in the sacrum (SIJ/S) was calculated for every joint. The mean SIJ/S ratio of 30 quantified joints in the AS group was 1.66 (range 1.10-3.07) with PET/CT, and the mean SIJ/S ratio of 26 quantified joints in the MLBP group was 1.12 (range 0.71-1.52). The area under the receiver operating characteristic curve for SIJ arthritis was 0.84. With plain radiography as a the gold standard and taking an SIJ/S ratio of >1.3 as the threshold, the sensitivity, specificity and accuracy on a per patient basis were 80%, 77% and 79%, respectively. On a per SIJ basis, the greatest sensitivity (94%) was found in grade 3 sacroiliitis (n = 16). Our results suggest that quantitative {sup 18}F-fluoride PET/CT may play a role in the diagnosis of sacroiliitis in active AS and is an alternative to conventional bone scintigraphy in times of molybdenum shortage. (orig.)

  6. F18-FDG PET-CT analyses of small peripheral adenocarcinoma of the lung

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Yoshiyuki; Takashima, Shodayu [Osaka Univ. Graduate School of Medicine, Div. of Allied Health Sciences, Dept. of Diagnostic Radiological Imaging, Osaka (Japan)], e-mail: yoshi_seat_128@yahoo.co.jp; Watanabe, Shinichiro [Osaka University Graduate School of Medicine, Department of Nuclear Medicine and Tracer Kinetics, Osaka (Japan)

    2013-03-15

    Background: Radiological discrimination of histologic subtypes of small peripheral adenocarcinoma of the lung is clinically important. Although there are many articles in which CT findings were used for this purpose, there are only a few reports on the capability of FDG PET-CT findings for histologic classification of this tumor. Purpose: To investigate the correlation between visual assessment or maximum standard uptake values (SUVmax) on F18-FDG PET-CT and histology grading of small peripheral adenocarcinoma of the lung. Material and Methods: Proportions of positive PET-CT diagnoses and SUVmax were retrospectively reviewed on 96 solitary pulmonary nodules of {<=}2 cm in 90 consecutive patients. Tumors were classified into four groups according to Noguchi's classification (group 1 [n = 10], atypical adenomatous hyperplasia and type A tumors; group 2 [n = 12], type B tumors; group 3 [n = 42], type C tumors; group 4 [n = 32], types D, E, and F tumors). Proportions of positive PET-CT diagnoses and mean SUVmax of lesions among four groups were compared using trend tests to examine if there is a significant linear correlation with the progression of the histology grading of tumors. Then, an optimal threshold of SUVmax was proposed to best discriminate tumors of poor (groups 3 and 4) from good (groups 1 and 2) prognosis. Results: There was a significant linear trend for both visual assessment (P < 0.01) and SUVmax (P < 0.01). A SUVmax of 0.42 showed the highest accuracy of 84% with 95% sensitivity and 50% specificity for predicting tumors of poor prognosis. A SUVmax of 2.05 showed 100% specificity with 49% sensitivity, and 60% accuracy. Positive visual diagnoses showed accuracy of 83% with 90% sensitivity and 59% specificity. Conclusion: Visual assessment and SUVmax on PET-CT correlated well with the histology grading of small peripheral adenocarcinoma of the lung.

  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. MRI and PET/CT of patients with bone metastases from breast carcinoma.

    Science.gov (United States)

    Grankvist, J; Fisker, R; Iyer, V; Fründ, E T; Simonsen, C; Christensen, T; Stenbygaard, L; Ewertz, M; Larsson, E-M

    2012-01-01

    3.0Tesla magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) was compared with combined 18F-fluorodeoxyglucose positron emission tomography and computed tomography (PET/CT) in patients with suspected bone metastases from breast cancer. A prospective clinical study was performed in 13 female breast cancer patients (mean age 61years; range 45-85 years). The spine was imaged in the sagittal plane with T1-weighted (T1), short tau inversion recovery (STIR), and T2-weighted fat-saturated (T2) sequences. The pelvis was imaged similarly in the coronal plane. Axial DWI was performed from the skull base to the mid-thigh. MRI and PET/CT were performed in all patients at a maximum interval of 10 working days and at least 14 days after chemotherapy. MRI was reviewed by two radiologists, and their consensus on potential metastases in 27 predefined locations was recorded. The predefined locations were the vertebral bodies (24), the left (1) and right (1) pelvic bones, and the sacral bone (1). The PET/CT was reviewed by a radiologists and a nuclear medicine physician. MRI detected 59 of the 60 active metastases found with our gold standard modality PET/CT. T1 had the highest sensitivity (98%) but rather low specificity (77%), but with the addition of STIR and DWI, the specificity increased to 95%. The additional metastases detected with MRI most likely represented postherapeutic residual scars without active tumour. In conclusion, 3.0Tesla MRI with T1, STIR, and DWI is useful for the clinical evaluation of bone metastases from breast cancer and compares well to PET/CT. PMID:21227614

  9. Present and future of PET and PET/CT in gynaecologic malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Musto, Alessandra [Department of Nuclear Medicine, PET Center, Policlinico Sant' Orsola Malpighi, Bologna University, Bologna (Italy); Rampin, Lucia [Department of Nuclear Medicine, PET Center, Radiology, Medical Physics, Santa Maria della Misericordia Hospital, viale tre martiri 140, 45100 Rovigo (Italy); Nanni, Cristina [Department of Nuclear Medicine, PET Center, Policlinico Sant' Orsola Malpighi, Bologna University, Bologna (Italy); Marzola, Maria Cristina [Department of Nuclear Medicine, PET Center, Radiology, Medical Physics, Santa Maria della Misericordia Hospital, viale tre martiri 140, 45100 Rovigo (Italy); Fanti, Stefano [Department of Nuclear Medicine, PET Center, Policlinico Sant' Orsola Malpighi, Bologna University, Bologna (Italy); Rubello, Domenico, E-mail: domenico.rubello@libero.it [Department of Nuclear Medicine, PET Center, Radiology, Medical Physics, Santa Maria della Misericordia Hospital, viale tre martiri 140, 45100 Rovigo (Italy)

    2011-04-15

    Objectives: To review the published data in literature on patients affected by gynaecological malignancies to establish the role of {sup 18}F-FDG positron emission tomography (PET) and PET/CT in comparison to conventional imaging (CI). Materials and methods: All papers specifically addressed to the role of {sup 18}F-FDG PET and PET/CT in gynaecological malignancies published on PubMed/Medline, in abstracts from the principal international congresses, in the guidelines from national Societies that had appeared in literature until November 2009 were considered for the purpose of the present study. Results and conclusions: The use of {sup 18}F-FDG PET, and even more of {sup 18}F-FDG PET/CT, is increasing in the follow up of patients with gynaecologic malignancies and suspected recurrent disease: there is evidence in the literature that {sup 18}F-FDG PET/CT has a higher sensitivity than CI in depicting occult metastatic spread. An interesting issue is represented by patients with ovarian cancer with an increase of the specific biomarker, CA-125, and negative/inconclusive findings at CI. The use of {sup 18}F-FDG PET in differential diagnosis and staging is more controversial, but there is some evidence that a baseline PET examination performed before commencing therapy, for staging purpose, is also useful to evaluate the response to chemoradiation treatment. In several papers it has been suggested a relevant role of {sup 18}F-FDG PET/CT in evaluating the entity of response to treatment and therefore to plan the subsequent therapeutic strategy.

  10. 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.)

  11. Application of PET and PET/CT imaging for cancer screening

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the potential application of 18F-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) and PET/CT for cancer screening in asymptomatic individuals. Methods: The subjects consisted of 3631 physical check up examinees (1947 men, 1684 women; mean age ±SD, 52.1±8.2 y) with non-specific medical histories. Whole-body FDG PET (or PET/CT), ultrasound and tumor markers were performed on all patients. Focal hypermetabolic areas with intensities equal to or exceeding the level of FDG uptake in the brain and bladder were considered abnormal and interpreted as neoplasia. Follow-up periods were longer than one year. Results: Among the 3631 FDG PET (including 1687 PET/CT), ultrasound and tumor markers examinations, malignant tumors were discovered in 47 examinees (1.29%). PET findings were true-positive in 38 of the 47 cancers (80.9%). In addition, 32 of the 47 cancers were performed with the PET-CT scan. PET detected cancer lesions in 28 of the 32 examinees. However, the CT detected cancer lesions in only 15 of 32 examinees. Conclusion: The sensitivity of FDG PET in the detection of a wide variety of cancers is high. Most cancer can be detected with FDG PET in a resectable stage. CT of the PET/CT for localization and characteristics of the lesion shows an increased specificity of the PET scan. Using ultrasound and tumor markers may complement the PET scan in cancer screening for hepatic and urologic neoplasms. (authors)

  12. 3D intrathoracic region definition and its application to PET-CT analysis

    Science.gov (United States)

    Cheirsilp, Ronnarit; Bascom, Rebecca; Allen, Thomas W.; Higgins, William E.

    2014-03-01

    Recently developed integrated PET-CT scanners give co-registered multimodal data sets that offer complementary three-dimensional (3D) digital images of the chest. PET (positron emission tomography) imaging gives highly specific functional information of suspect cancer sites, while CT (X-ray computed tomography) gives associated anatomical detail. Because the 3D CT and PET scans generally span the body from the eyes to the knees, accurate definition of the intrathoracic region is vital for focusing attention to the central-chest region. In this way, diagnostically important regions of interest (ROIs), such as central-chest lymph nodes and cancer nodules, can be more efficiently isolated. We propose a method for automatic segmentation of the intrathoracic region from a given co-registered 3D PET-CT study. Using the 3D CT scan as input, the method begins by finding an initial intrathoracic region boundary for a given 2D CT section. Next, active contour analysis, driven by a cost function depending on local image gradient, gradient-direction, and contour shape features, iteratively estimates the contours spanning the intrathoracic region on neighboring 2D CT sections. This process continues until the complete region is defined. We next present an interactive system that employs the segmentation method for focused 3D PET-CT chest image analysis. A validation study over a series of PET-CT studies reveals that the segmentation method gives a Dice index accuracy of less than 98%. In addition, further results demonstrate the utility of the method for focused 3D PET-CT chest image analysis, ROI definition, and visualization.

  13. PET-CT: accuracy of PET and CT spatial registration of lung lesions

    International Nuclear Information System (INIS)

    PET-CT scanners offer the unique ability to acquire PET and CT data with rapid full body registration. The purpose of this study was to evaluate the accuracy of spatial registration between PET and CT data in patients with fluorine-18 fluoro-2-deoxy-D-glucose (FDG)-avid lung lesions. PET, CT and fused PET-CT images from 244 consecutive clinical patients undergoing whole-body FDG PET-CT imaging (GE Discovery LS, CT attenuation correction, OSEM reconstruction) were evaluated. Inclusion criteria for this analysis were lung lesions clearly defined on both PET and CT, lesion diameter less than 5 cm and clear borders. Patients were allowed to breathe freely during both PET and CT image acquisitions. The spatial coordinates of the visually estimated centers of the lesion were determined independently for PET and CT images and compared. Thirty-six patients (26 females, 10 males) with a total of 48 lesions were included (19 lung cancer patients with 26 lesions, 17 patients with 22 lung metastases). The average lung lesion diameter was 15.6±9 mm. The mean distance between the center of lesions independently determined for both PET and CT was 7.55±4.73 mm. Misregistration tended to be more pronounced in the lower lungs (10.2±6.55 mm) than in the upper lungs (6.67±4.28 mm) (P=0.063). Misregistration also tended to be slightly more pronounced in the left lung (8.33±5.05 mm) than in the right lung (6.25±3.92 mm) (P=0.059). In conclusion, with a dedicated PET-CT scanner and this clinically practical imaging algorithm, registration is usually accurate, but spatial misregistration of primary lung lesions does occur. (orig.)

  14. PET/CT of the abdomen: optimizing the patient breathing pattern

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the respiration position, which is optimal for co-registration of abdominal CT images, and the corresponding positron emission tomography (PET) scan in a new combined PET/CT system. Ten patients (5 men, 5 women; age 57.7±15.3 years, age range 34-80 years) underwent imaging for tumor staging on a combined PET/CT scanner (Discovery LS, GE Medical Systems, Milwaukee, Wis.). The PET emission images were acquired during normal shallow breathing and during CT scanning the patients performed four different breathing tasks: free breathing (FB); maximum inspiration (MaxInsp); maximum expiration (MaxExp); and normal expiration (NormExp). NormExp was defined as the respiratory level that was reached when the patient first inhaled and then exhaled without forcing expiration, and then held the breath in this position. Movements of the spleen, liver, left and right kidney, and the bladder were measured by using the promontory of the sacrum as a reference point and measuring the distance from this point to the abdominal organs in the PET and CT images by two independent observers. Statistical comparison of the measured distances between the CT scans and the PET scan were made using a Wilcoxon signed-rank test with Bonferroni correction. Repeated-measures analysis of variance served for the assessment of intraobserver and interobserver agreement. There was no significant difference between NormExp and FB indicating that both respiration protocols are suitable for PET/CT image co-registration of abdominal studies. In contrast, the MaxExp and MaxInsp protocol are not suitable. The NormExp and FB respiration protocol are both suitable for the co-registration of abdominal PET/CT studies. In most patients the mismatch of abdominal organs will be lower than the resolution of the final co-registered PET/CT image. (orig.)

  15. PET/CT of the abdomen: optimizing the patient breathing pattern

    Energy Technology Data Exchange (ETDEWEB)

    Goerres, Gerhard W.; Burger, Cyrill; Schwitter, Michael R.; Heidelberg, Thai-Nia H.; Schulthess, Gustav K. von [Division of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Seifert, Burkhardt [Department of Biostatistics, University of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2003-04-01

    The aim of this study was to evaluate the respiration position, which is optimal for co-registration of abdominal CT images, and the corresponding positron emission tomography (PET) scan in a new combined PET/CT system. Ten patients (5 men, 5 women; age 57.7{+-}15.3 years, age range 34-80 years) underwent imaging for tumor staging on a combined PET/CT scanner (Discovery LS, GE Medical Systems, Milwaukee, Wis.). The PET emission images were acquired during normal shallow breathing and during CT scanning the patients performed four different breathing tasks: free breathing (FB); maximum inspiration (MaxInsp); maximum expiration (MaxExp); and normal expiration (NormExp). NormExp was defined as the respiratory level that was reached when the patient first inhaled and then exhaled without forcing expiration, and then held the breath in this position. Movements of the spleen, liver, left and right kidney, and the bladder were measured by using the promontory of the sacrum as a reference point and measuring the distance from this point to the abdominal organs in the PET and CT images by two independent observers. Statistical comparison of the measured distances between the CT scans and the PET scan were made using a Wilcoxon signed-rank test with Bonferroni correction. Repeated-measures analysis of variance served for the assessment of intraobserver and interobserver agreement. There was no significant difference between NormExp and FB indicating that both respiration protocols are suitable for PET/CT image co-registration of abdominal studies. In contrast, the MaxExp and MaxInsp protocol are not suitable. The NormExp and FB respiration protocol are both suitable for the co-registration of abdominal PET/CT studies. In most patients the mismatch of abdominal organs will be lower than the resolution of the final co-registered PET/CT image. (orig.)

  16. Detection of myocardial metabolic abnormalities by 18F-FDG PET/CT and corresponding pathological changes in beagles with local heart irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Yan, Rul [Nursing College of Shanxi Medical University, Taiyuan (China); Song, Jianbo; Wu, Zhi Fang; Liu, Jian Zhang; Hao, Xin Zhong; Li, Sijin [Dept. of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan (China); Guo, Min [Dept. of Cardiology, First Hospital of Shanxi Medical University, Taiyuan (China); Li, Jianguo [Dept. of Radiological and Environmental Medicine, China Institute for Radiation Protection, Taiyuan (China)

    2015-08-15

    To determine the efficacy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the detection of radiation-induced myocardial damage in beagles by comparing two pre-scan preparation protocols as well as to determine the correlation between abnormal myocardial FDG uptake and pathological findings. The anterior myocardium of 12 beagles received radiotherapy locally with a single X-ray dose of 20 Gy. 18F-FDG cardiac PET/CT was performed at baseline and 3 months after radiation. Twelve beagles underwent two protocols before PET/CT: 12 hours of fasting (12H-F), 12H-F followed by a high-fat diet (F-HFD). Regions of interest were drawn on the irradiation and the non-irradiation fields to obtain their maximal standardized uptake values (SUVmax). Then the ratio of the SUV of the irradiation to the non-irradiation fields (INR) was computed. Histopathological changes were identified by light and electron microscopy. Using the 12H-F protocol, the average INRs were 1.18 ± 0.10 and 1.41 ± 0.18 before and after irradiation, respectively (p = 0.021). Using the F-HFD protocol, the average INRs were 0.99 ± 0.15 and 2.54 ± 0.43, respectively (p < 0.001). High FDG uptake in irradiation field was detected in 33.3% (4/12) of 12H-F protocol and 83.3% (10/12) of F-HFD protocol in visual analysis, respectively (p = 0.031). The pathology of the irradiated myocardium showed obvious perivascular fibrosis and changes in mitochondrial vacuoles. High FDG uptake in an irradiated field may be related with radiation-induced myocardial damage resulting from microvascular damage and mitochondrial injury. An F-HFD preparation protocol used before obtaining PET/CT can improve the sensitivity of the detection of cardiotoxicity associated with radiotherapy.

  17. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

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

    International Nuclear Information System (INIS)

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

  20. Diagnostic value of full-dose FDG PET/CT for axillary lymph node staging in breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Heusner, Till A.; Hahn, Steffen; Forsting, Michael; Antoch, Gerald [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Kuemmel, Sherko; Koeninger, Angela; Kimmig, Klaus R. [University Hospital Essen, Department of Gynecology and Obstetrics, Essen (Germany); Otterbach, Friedrich [University Hospital Essen, Department of Pathology and Neuropathology, Essen (Germany); Hamami, Monia E.; Bockisch, Andreas; Stahl, Alexander [University Hospital Essen, Department of Nuclear Medicine, Essen (Germany)

    2009-10-15

    The aims of this study were (1) to evaluate FDG PET/CT and CT for the detection of axillary lymph node metastases in breast cancer (BC) patients and (2) to evaluate FDG PET/CT as a pre-test for the triage to sentinel lymph node biopsy (SLNB) versus axillary lymph node dissection (ALND). The sensitivity, specificity, positive and negative predictive value (PPV, NPV), and accuracy of FDG PET/CT and CT for axillary lymph node metastases were determined in 61 patients (gold standard: histopathology). According to the equation NPV = specificity .(1-prevalence)/[specificity.(1-prevalence)+(1-sensitivity).prevalence] FDG PET/CT was evaluated as a triage tool for SLNB versus ALND. The sensitivity, specificity, PPV, NPV and accuracy of FDG PET/CT was 58,92,82,77 and 79% and of CT 46,89,72,71 and 72%, respectively. Patients with an up to {proportional_to}60% risk for axillary lymph node metastases appear to be candidates for SLNB provided that the axilla is unremarkable on FDG PET/CT. FDG PET/CT cannot replace invasive approaches for axillary staging but may extend the indication for SLNB. (orig.)

  1. Detection and compensation of organ/lesion motion using 4D-PET/CT respiratory gated acquisition techniques

    International Nuclear Information System (INIS)

    Purpose: To describe the degradation effects produced by respiratory organ and lesion motion on PET/CT images and to define the role of respiratory gated (RG) 4D-PET/CT techniques to compensate for such effects. Methods: Based on the literature and on our own experience, technical recommendations and clinical indications for the use of RG 4D PET/CT have been outlined. Results: RG 4D-PET/CT techniques require a state of the art PET/CT scanner, a respiratory monitoring system and dedicated acquisition and processing protocols. Patient training is particularly important to obtain a regular breathing pattern. An adequate number of phases has to be selected to balance motion compensation and statistical noise. RG 4D PET/CT motion free images may be clinically useful for tumour tissue characterization, monitoring patient treatment and target definition in radiation therapy planning. Conclusions: RG 4D PET/CT is a valuable tool to improve image quality and quantitative accuracy and to assess and measure organ and lesion motion for radiotherapy planning.

  2. Performance of FDG PET/CT at initial diagnosis in a rare lymphoma: nodular lymphocyte-predominant Hodgkin lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Grellier, Jean Francois; Weinmann, Pierre [AP-HP- Hopital Europeen Georges Pompidou, Service de medecine nucleaire, Paris (France); Vercellino, Laetitia; Merlet, Pascal; Toubert, Marie-Elisabeth; Berenger, Nathalie [AP-HP- Hopital Saint-Louis, Service de medecine nucleaire, Paris (France); Leblanc, Thierry [Hopital Saint-Louis, Service d' immuno-hematologie, Paris (France); Thieblemont, Catherine [Universite Paris Diderot, Sorbonne Paris Cite - INSERM UMR-S1165, AP-HP- Hopital Saint-Louis, Service d' hemato-Oncologie, Paris (France); Briere, Josette [AP-HP- Hopital Saint-Louis, Service de pathologie, Paris (France); Brice, Pauline [AP-HP- Hopital Saint-Louis, Service d' hemato-Oncologie, Paris (France)

    2014-11-15

    Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare Hodgkin lymphoma distinguished from classical Hodgkin lymphoma (cHL) by the nature of the neoplastic cells which express B-cell markers. We wanted to determine the diagnostic performance of FDG PET/CT in initial assessment and its therapeutic impact on staging. We retrospectively studied a population of 35 patients with NLPHL (8 previously treated for NLHPL, 27 untreated). All patients underwent an initial staging by pretherapeutic FDG PET/CT. The impact on initial stage or relapse stage was assessed by an independent physician. In a per-patient analysis, the sensitivity of the pretherapeutic FDG PET/CT was 100 %. In a per-site analysis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pretherapeutic FDG PET/CT were 100 %, 99 %, 97 %, 100 % and 99 %, respectively. Pretherapeutic FDG PET/CT led to a change in the initial stage/relapse stage in 12 of the 35 patients (34 %). In contrast to previous results established without FDG PET/CT, 20 % of patient had osteomedullary lesions. Pretherapeutic FDG PET/CT has excellent performance for initial staging or relapse staging of NLPHL. (orig.)

  3. 18F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors

    International Nuclear Information System (INIS)

    F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children. To compare hybrid FDG positron emission tomography/computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors. Retrospective analysis of PET/CT and CI reports with histopathology or follow-up > 6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology. A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUVmax and greater SUVmax reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement. PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy. (orig.)

  4. 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)

  5. Advantages of Combined PET-CT in Mediastinal Staging in Patients with Non-small Cell Lung Carcinoma

    Science.gov (United States)

    Beslic, Nermina; Sadija, Amera; Milardovic, Renata; Ceric, Timur; Ceric, Sejla; Beganovic, Adnan; Kristic, Spomenka; Cavaljuga, Semra

    2016-01-01

    Introduction: Precise mediastinal lymph node staging in patients with non-small cell lung carcinoma (NSCLC) provides important prognostic information and it is obligatory in treatment strategy planning. 18Fluoro-deoxy-glucose (18F-FDG) positron emission tomography - computerized tomography (PET-CT) based on detection of metabolic activity showed superiority in preoperative staging of lung carcinoma. Materials and Methods: Total number of 26 patients diagnosed with NSCLC were included in this retrospective, cross-sectional study. Status of mediastinal lymph nodes was assessed in all patients comparing contrast enhanced CT and 18F-FDG PET-CT findings. Discussion: We found in our study that 50% of patients had different N stage on contrast enhanced CT comparing to 18F-FDG PET-CT findings. Among the total number of patients which had different nodal status on PET-CT comparing to CT alone, we found in our study that 54% of patients had change in further therapy protocol after PET-CT change of nodal stage. Conclusion: Combined PET-CT which offers advantages of both modalities is excellent method for nodal (N) staging, so it is recommended in initial staging in patients with NSCLC. PET-CT used preopratively for mediastinal nodal staging has significant impact on further therapy planning and also has an consequential impact on health system savings. PMID:27147799

  6. {sup 18}F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors

    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); Stege, Claudia; Kaspers, Gertjan [VU Medical Centre, Divisions of Paediatric Oncology/Haematology, Amsterdam (Netherlands); Cross, Siobhan; Dalla-Pozza, Luciano [The Children' s Hospital at Westmead, Department of Oncology, Sydney (Australia); Onikul, Ella [The Children' s Hospital at Westmead, Department of Medical Imaging, Sydney (Australia); Graf, Nicole [The Children' s Hospital at Westmead, Department of Pathology, Sydney (Australia); Howman-Giles, Robert [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Imaging, Sydney Medical School, Sydney, NSW (Australia)

    2012-04-15

    F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children. To compare hybrid FDG positron emission tomography/computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors. Retrospective analysis of PET/CT and CI reports with histopathology or follow-up > 6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology. A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUV{sub max} and greater SUV{sub max} reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement. PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy. (orig.)

  7. Whole-body FDG PET/CT is more accurate than conventional imaging for staging primary breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Riegger, C.; Heusner, T.A. [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); University of Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Herrmann, J.; Hahn, S.; Lauenstein, T. [University of Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Nagarajah, J.; Bockisch, A. [University of Duisburg-Essen, Medical Faculty, Department of Nuclear Medicine, Essen (Germany); Hecktor, J.; Kuemmel, S. [University of Duisburg-Essen, Medical Faculty, Department of Gynecology and Obstetrics, Essen (Germany); Otterbach, F. [University of Duisburg-Essen, Institute of Pathology and Neuropathology, Essen (Germany); Antoch, G. [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany)

    2012-05-15

    This retrospective study aimed (1) to compare the diagnostic accuracy of whole-body FDG PET/CT for initial breast cancer staging with the accuracy of a conventional, multimodal imaging algorithm, and (2) to assess potential alteration in patient management based on the FDG PET/CT findings. Patients with primary breast cancer (106 women, mean age 57 {+-} 13 years) underwent whole-body FDG PET/CT and conventional imaging (X-ray mammography, MR mammography, chest plain radiography, bone scintigraphy and breast, axillary and liver ultrasonography). The diagnostic accuracies of FDG PET/CT and a conventional algorithm were compared. Diagnostic accuracy was assessed in terms of primary tumour detection rate, correct assessment of primary lesion focality, T stage and the detection rates for lymph node and distant metastases. Histopathology, imaging or clinical follow-up served as the standards of reference. FDG PET/CT was significantly more accurate for detecting axillary lymph node and distant metastases (p = 0.0125 and p < 0.005, respectively). No significant differences were detected for other parameters. Synchronous tumours or locoregional extraaxillary lymph node or distant metastases were detected in 14 patients (13%) solely by FDG PET/CT. Management of 15 patients (14%) was altered based on the FDG PET/CT findings, including 3 patients with axillary lymph node metastases, 5 patients with