WorldWideScience

Sample records for cardiac pet-ct advanced

  1. PET/CT: underlying physics, instrumentation, and advances.

    Science.gov (United States)

    Torres Espallardo, I

    2017-01-12

    Since it was first introduced, the main goal of PET/CT has been to provide both PET and CT images with high clinical quality and to present them to radiologists and specialists in nuclear medicine as a fused, perfectly aligned image. The use of fused PET and CT images quickly became routine in clinical practice, showing the great potential of these hybrid scanners. Thanks to this success, manufacturers have gone beyond considering CT as a mere attenuation corrector for PET, concentrating instead on design high performance PET and CT scanners with more interesting features. Since the first commercial PET/CT scanner became available in 2001, both the PET component and the CT component have improved immensely. In the case of PET, faster scintillation crystals with high stopping power such as LYSO crystals have enabled more sensitive devices to be built, making it possible to reduce the number of undesired coincidence events and to use time of flight (TOF) techniques. All these advances have improved lesion detection, especially in situations with very noisy backgrounds. Iterative reconstruction methods, together with the corrections carried out during the reconstruction and the use of the point-spread function, have improved image quality. In parallel, CT instrumentation has also improved significantly, and 64- and 128-row detectors have been incorporated into the most modern PET/CT scanners. This makes it possible to obtain high quality diagnostic anatomic images in a few seconds that both enable the correction of PET attenuation and provide information for diagnosis. Furthermore, nowadays nearly all PET/CT scanners have a system that modulates the dose of radiation that the patient is exposed to in the CT study in function of the region scanned. This article reviews the underlying physics of PET and CT imaging separately, describes the changes in the instrumentation and standard protocols in a combined PET/CT system, and finally points out the most important

  2. 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.

  3. Does the use of diagnostic PET/CT cause stage migration in patients with primary advanced ovarian cancer?

    DEFF Research Database (Denmark)

    Risum, S; Høgdall, C; Loft, Annika

    2010-01-01

    To investigate if the use of diagnostic FDG-PET/CT leads to stage migration in patients with advanced ovarian cancer and to evaluate the prognostic significance of FDG-PET/CT.......To investigate if the use of diagnostic FDG-PET/CT leads to stage migration in patients with advanced ovarian cancer and to evaluate the prognostic significance of FDG-PET/CT....

  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. 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.)

  6. 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

  7. 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...

  8. 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...... lesions of clinical importance in one of seven IE patients and may be a substantial imaging technique for tracing peripheral infectious embolism due to IE. Thus, (18)F-FDG-PET/CT may help to guide adequate therapy and thereby improve the prognosis of patients with IE.......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 prognosis relies crucially on the presence of systemic infectious embolism. METHODS: Seventy-two patients (71% males and mean age 63 ± 17 years) with IE were evaluated with (18)F-FDG-PET/CT in addition to standard work-up including patient history, physical examination, conventional imaging modalities...

  9. 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

  10. {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.)

  11. 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.

  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. PET/CT Artifacts

    OpenAIRE

    Blodgett, Todd M.; Mehta, Ajeet S.; Mehta, Amar S.; Laymon, Charles M; Carney, Jonathan; Townsend, David W.

    2011-01-01

    There are several artifacts encountered in PET/CT imaging, including attenuation correction (AC) artifacts associated with using CT for attenuation correction. Several artifacts can mimic a 2-deoxy-2-[18F] fluoro-D-glucose (FDG) avid malignant lesions and therefore recognition of these artifacts is clinically relevant. Our goal was to identify and characterize these artifacts and also discuss some protocol variables that may affect image quality in PET/CT.

  14. 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.

  15. 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

  16. 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.)

  17. Evaluation of early response to concomitant chemoradiotherapy by interim {sup 18}F-FDG PET/CT imaging in patients with locally advanced oesophageal carcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Cuenca, Xavier; Hennequin, Christophe; Rivera, Sofia; Baruch-Hennequin, Valerie [Saint Louis Hospital, AP-HP, Department of Radiation Oncology, Paris (France); Denis Diderot University (Paris 7), Paris (France); Hindie, Elif [Saint Louis Hospital, AP-HP, Nuclear Medicine Department, Paris (France); Denis Diderot University (Paris 7), Paris (France); University of Bordeaux, Department of Nuclear Medicine, Haut-Leveque Hospital, CHU Bordeaux (France); Vercellino, Laetitia [Saint Louis Hospital, AP-HP, Nuclear Medicine Department, Paris (France); Denis Diderot University (Paris 7), Paris (France); Gornet, Jean-Marc [Saint Louis Hospital, AP-HP, Gastroenterology Department, Paris (France); Denis Diderot University (Paris 7), Paris (France); Cattan, Pierre; Chirica, Mircea [Saint Louis Hospital, AP-HP, Surgery Department, Paris (France); Denis Diderot University (Paris 7), Paris (France); Quero, Laurent [Saint Louis Hospital, AP-HP, Department of Radiation Oncology, Paris (France); Denis Diderot University (Paris 7), Paris (France)

    2013-04-15

    The best way to assess the response to chemoradiotherapy of locally advanced oesophageal carcinomas is not known. We used {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT to evaluate the metabolic response during chemoradiotherapy and tried to correlate this response to survival. Patients with biopsy-proven oesophageal carcinoma underwent FDG PET/CT with evaluation of the standardized uptake value (SUV) before any treatment (SUV1) and during chemoradiotherapy after two cycles of 5-fluorouracil (FU)/cisplatin and 20 Gy (SUV2). Metabolic response was defined as 1-(SUV2/SUV1). Surgery was discussed after 40 Gy and three cycles of chemotherapy. Results of interim PET were not considered for the therapeutic decision. Among 72 patients who underwent a first FDG PET/CT before any treatment, 59 (82 %) could receive the second FDG PET/CT examination. Median survival was 22.2 months with 1-year and 2-year survivals of 70 and 46 %, respectively. Nineteen patients (32 %) underwent surgery. Mean SUV1 and SUV2 were 12.3 {+-} 6.2 and 6 {+-} 4.1, respectively (p < 0.001). Using a cut-off for metabolic response of 50 %, sensitivity and specificity for survival were 0.7 and 0.58. The 2-year overall survival of good responders was 62 % as compared to 27 % for poor metabolic responders. A multivariate analysis was performed, including T and N stages, surgery, histology and metabolic response: only metabolic response was significantly (p = 0.009) associated with 2-year survival. Early evaluation of metabolic response had a great prognostic value and could help identify good responders to chemoradiotherapy. (orig.)

  18. 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

    . However, hybrid cardiac imaging has also generated controversy with regard to which patients should undergo such integrated examination for clinical effectiveness and minimization of costs and radiation dose, and if software-based fusion of images obtained separately would be a useful alternative....... 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...

  19. PET/CT-guided percutaneous biopsy of FDG-avid metastatic bone lesions in patients with advanced lung cancer: a safe and effective technique

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Wei; Hao, Bing; Chen, Hao-jun; Zhao, Long; Luo, Zuo-ming; Wu, Hua; Sun, Long [The First Affiliated Hospital of Xiamen University, Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital, Xiamen (China)

    2017-01-15

    {sup 18}F-FDG PET/CT should be performed before a diagnostic biopsy site is chosen in patients with a high clinical suspicion of aggressive, advanced tumour. The aim of this study was to evaluate the safety and efficacy of {sup 18}F-FDG PET/CT in guiding biopsy of bone metastases in patients with advanced lung cancer. PET/CT-guided percutaneous core biopsies were performed in 51 consecutive patients with suspected lung cancer and {sup 18}F-FDG-avid bone lesions after whole-body {sup 18}F-FDG PET/CT scans. Generally, one tissue sample was obtained from each patient. The final diagnoses were established on the basis of the histology results. The histopathological and molecular testing results were systematically evaluated. A total of 53 samples were obtained for histological examination or molecular testing as a second biopsy was required in two patients in whom the pathological diagnosis was unclear following the first biopsy. The pathological diagnosis and lung cancer classification were confirmed in 48 patients. The epidermal growth factor receptor mutation status was determined in 23 biopsies, and the mutation rate was 30.4 % (7/23). The anaplastic lymphoma kinase mutation status was determined in 19 biopsies, and the mutation rate was 31.6 % (6/19). Two of the 51 biopsies were positive for non-Hodgkin's lymphoma and one was positive for metastatic renal cell carcinoma. The first-time diagnostic success rate of biopsy was 96.1 % (49/51) and the overall diagnostic success rate and sensitivity were 100 %. All 51 patients were eventually confirmed as having stage IV disease. No serious complications were encountered and the average biopsy time was 30 min. PET/CT-guided percutaneous biopsy of {sup 18}F-FDG-avid bone metastases is an effective and safe method that yields a high diagnostic success rate in the evaluation of hypermetabolic bone lesions in patients with suspected advanced lung cancer. (orig.)

  20. PET/CT and Histopathologic Response to Preoperative Chemoradiation Therapy in Locally Advanced Rectal Cancer

    DEFF Research Database (Denmark)

    Kristiansen, Charlotte; Loft, Annika; Berthelsen, Anne K

    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(R) (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...... of chemoradiation 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....

  1. 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

  2. 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

  3. 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 locall...

  4. 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.

  5. {sup 18}F-alfatide PET/CT may predict short-term outcome of concurrent chemoradiotherapy in patients with advanced non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Luan, Xiaohui [Shandong Cancer Hospital affiliated to Shandong University, Department of Radiation Oncology, Jinan, Shandong (China); University of Jinan-Shandong Academy of Medical Sciences, School of Medicine and Life Sciences, Jinan (China); Huang, Yong; Sun, Xiaorong; Ma, Li; Teng, Xuepeng; Lu, Hong [Shandong Cancer Hospital affiliated to Shandong University, Department of Radiology, Jinan, Shandong (China); Gao, Song [Jining Infectious Diseases Hospital, Department of Oncology, Jining, Shandong (China); Wang, Suzhen; Yu, Jinming; Yuan, Shuanghu [Shandong Cancer Hospital affiliated to Shandong University, Department of Radiation Oncology, Jinan, Shandong (China)

    2016-12-15

    The study aims to investigate the role of {sup 18}F-alfatide positron emission tomography/computed tomography (PET/CT) in predicting the short-term outcome of concurrent chemoradiotherapy (CCRT) in patients with advanced non-small cell lung cancer (NSCLC). Eighteen patients with advanced NSCLC had undergone {sup 18}F-alfatide PET/CT scans before CCRT and PET/CT parameters including maximum and mean standard uptake values (SUV{sub max}/SUV{sub mean}), peak standard uptake values (SUV{sub peak}) and tumor volume (TV{sub PET} and TV{sub CT}) were obtained. The SUV{sub max} of tumor and normal tissues (lung, blood pool and muscle) were measured, and their ratios were denoted as T/NT (T/NT{sub lung}, T/NT{sub blood} and T/NT{sub muscle}). Statistical methods included the Two-example t test, Wilcoxon rank-sum test, Receiver-operating characteristic (ROC) curve analysis and logistic regression analyses. We found that SUV{sub max}, SUV{sub peak}, T/NT{sub lung}, T/NT{sub blood} and T/NT{sub muscle} were higher in non-responders than in responders (P = 0.0024, P = 0.016, P < 0.001, P = 0.003, P = 0.004). According to ROC curve analysis, the thresholds of SUV{sub max}, SUV{sub peak}, T/NT{sub lung}, T/NT{sub blood} and T/NT{sub muscle} were 5.65, 4.46, 7.11, 5.41, and 11.75, respectively. The five parameters had high sensitivity, specificity and accuracy in distinguishing non-responders and responders. Multivariate logistic regression analyses showed that T/NT{sub lung} was an independent predictor of the short-term outcome of CCRT in patients with advanced NSCLC (P = 0.032). {sup 18}F-alfatide PET/CT may be useful in predicting the short-term outcome of CCRT in patients with advanced NSCLC. (orig.)

  6. 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

  7. 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

    Infectious endocarditis (IE) is a serious condition with a high morbidity and mortality. The optimal management of IE depends not only on correct antibiotic therapy and surgery when needed, but involves identification of the portal of entry and detection of extracardiac infectious manifestations....... 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...... method to standard work-up in evaluating primary and distant infective foci. A retrospective cohort study of 72 IE patients admitted from 2008 to 2010, which had an (18)F-FDG-PET/CT performed. Findings were assessed in relation to the routine work-up, which served as the "gold standard". One hundred...

  8. 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.

  9. 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...... remission is achieved after first-line therapy, PET/CT seems to have little or no role in the routine surveillance of HL patients. PET/CT looks promising for the selection of therapy in relapsed and refractory disease, but its role in this setting is still unclear.......Positron emission tomography/computed tomography (PET/CT) has emerged as the most accurate tool for staging, treatment monitoring, and response evaluation in Hodgkin lymphoma (HL). Accurate staging and restaging are very important for the optimal management of HL, but we are only beginning...

  10. Assessment of the diagnostic accuracy of {sup 18}F-FDG PET/CT in prosthetic infective endocarditis and cardiac implantable electronic device infection: comparison of different interpretation criteria

    Energy Technology Data Exchange (ETDEWEB)

    Jimenez-Ballve, Ana; Jesus Perez-Castejon, Maria; Carreras-Delgado, Jose L. [Clinico San Carlos University Hospital, San Carlos Health Research Institute (IdISSC), Complutense University of Madrid, Department of Nuclear Medicine, Madrid (Spain); Delgado-Bolton, Roberto C. [Clinico San Carlos University Hospital, San Carlos Health Research Institute (IdISSC), Complutense University of Madrid, Department of Nuclear Medicine, Madrid (Spain); San Pedro Hospital and Centre for Biomedical Research of La Rioja (CIBIR), University of La Rioja, Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, La Rioja (Spain); Sanchez-Enrique, Cristina; Vilacosta, Isidre; Vivas, David; Olmos, Carmen [Clinico San Carlos University Hospital, Department of Cardiology, Madrid (Spain); Ferrer, Manuel E.F. [Clinico San Carlos University Hospital, Research Unit, Madrid (Spain)

    2016-12-15

    The diagnosis of prosthetic valve (PV) infective endocarditis (IE) and infection of cardiac implantable electronic devices (CIEDs) remains challenging. The aim of this study was to assess the usefulness of {sup 18}F-FDG PET/CT in these patients and analyse the interpretation criteria. We included 41 patients suspected of having IE by the Duke criteria who underwent {sup 18}F-FDG PET/CT. The criteria applied for classifying the findings as positive/negative for IE were: (a) visual analysis of only PET images with attenuation-correction (AC PET images); (b) visual analysis of both AC PET images and PET images without AC (NAC PET images); (c) qualitative analysis of NAC PET images; and (d) semiquantitative analysis of AC PET images. {sup 18}F-FDG PET/CT was considered positive for IE independently of the intensity and distribution of FDG uptake. The gold standard was the Duke pathological criteria (if tissue was available) or the decision of an endocarditis expert team after a minimum 4 months follow-up. We studied 62 areas with suspicion of IE, 28 areas (45 %) showing definite IE and 34 (55 %) showing possible IE. Visual analysis of only AC PET images showed poor diagnostic accuracy (sensitivity 20 %, specificity 57 %). Visual analysis of both AC PET and NAC PET images showed excellent sensitivity (100 %) and intermediate specificity (73 %), focal uptake being more frequently associated with IE. The accuracy of qualitative analysis of NAC PET images depended on the threshold: the maximum sensitivity, specificity and accuracy achieved were 88 %, 80 %, 84 %, respectively. In the semiquantitative analysis of AC PET images, SUVmax was higher in areas of confirmed IE than in those without IE (∇SUVmax 2.2, p < 0.001). When FDG uptake was twice that in the liver, IE was always confirmed, and SUVmax 5.5 was the optimal threshold for IE diagnosis using ROC curve analysis (area under the curve 0.71). The value of {sup 18}F-FDG PET/CT in the diagnosis of suspected IE of PVs

  11. 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.

  12. P11: 18FDG-PET/CT for early prediction of response to first line platinum chemotherapy in advanced thymic epithelial tumors

    Science.gov (United States)

    Palmieri, Giovannella; Ottaviano, Margaret; Del Vecchio, Silvana; Segreto, Sabrina; Tucci, Irene; Damiano, Vincenzo

    2015-01-01

    Background To investigate the value of the metabolic tumor response assessed with 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), compared with clinicobiological markers, to predict the response disease to first line platinum based chemotherapy in advanced thymic epithelial tumors (TETs). Methods Twenty patients with diagnosis of TET and stage of disease III and IV sec, Masaoka-Koga, were retrospectively included in this monocentric study. Different pre-treatment clinical, biological and pathological parameters, including histotype sec, WHO 2004 and stage of disease sec, Masaoka-Koga were assessed. Tumor glucose metabolism at baseline and its change after the first line platinum based chemotherapy (from 4 to 6 cycles) were assessed using FDG-PET, moreover the response disease was assessed using total body CT scan for the evaluation of RECIST criteria 1.1. Results Twelve patients had an objective response to the first line platinum based chemotherapy according RECIST criteria 1.1 and all of them started with a SUVmax at baseline major than 5, indeed the other eight patients, non-responders to chemotherapy, had a SUVmax at baseline minor than 5. Conclusions It is important to define the chemosensitivity of advanced TETs early. Combining bio-pathological parameters with the metabolism at baseline assessed with FDG-PET can help the physician to early predict the probability of obtaining a disease response to first line platinum based chemotherapy. The SUVmax cut off of 5 at 18FDG-PET/CT performed at baseline treatment might be a new parameter for choosing the most powerful first line of chemotherapy. Given these results, further prospective studies are needed to establish a new first line therapy in advanced TETs with a low SUVmax at baseline, non-responders to conventional chemotherapy.

  13. 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

  14. 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

  15. [{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

  16. 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.

  17. 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.

  18. PET/CT and radiotherapy in prostate cancer.

    Science.gov (United States)

    De Jong, I J; De Haan, T D; Wiegman, E M; Van Den Bergh, A C M; Pruim, J; Breeuwsma, A J

    2010-10-01

    Radiotherapy is one of the corner stone treatments for patients with prostate cancer. Especially for locally advanced tumors radiotherapy +/- adjuvant androgen deprivation treatment is standard of care. This brings up the need for accurate assessment of extra prostatic tumor growth and/or the presence of nodal metastases for selection of the optimal radiation dose and treatment volume. Morphological imaging like transrectal ultra sound, computed tomography (CT) and magnetic resonance imaging (MRI) are routinely used but are limited in their accuracy in detecting extra prostatic extension and nodal metastases. In this article we present a structured review of the literature on positron emission tomography (PET)/CT and radiotherapy in prostate cancer patients with emphasis on: 1) the pretreatment assessment of extra prostatic tumor extension, nodal and distant metastases; 2) the intraprostatic tumor characterization and radiotherapy treatment planning; and 3) treatment evaluation and the use of PET/CT in guidance of salvage treatment. PET/CT is not an appropriate imaging technique for accurate T-staging of prostate cancer prior to radiotherapy. Although macroscopic disease beyond the prostatic capsule and into the periprostatic fat or in seminal vesicle is often accurately detected, the microscopic extension of prostate cancer remains undetected. Choline PET/CT holds a great potential as a single step diagnostic procedure of lymph nodes and skeleton, which could facilitate radiotherapy treatment planning. At present the use of PET/CT for treatment planning in radiotherapy is still experimental. Choline PET based tumor delineation is not yet standardized and different segmentation-algorithms are under study. However, dose escalation using dose-painting is feasible with only limited increases of the doses to the bladder and rectum wall. PET/CT using either acetate or choline is able to detect recurrent prostate cancer after radiotherapy but stratification of patients

  19. 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

  20. Prognostic value of interim and restaging PET/CT in Hodgkin lymphoma. Results of the CHEAP (Chemotherapy Effectiveness Assessment by PET/CT) study - long term observation.

    Science.gov (United States)

    Miltenyi, Z; Barna, S; Garai, I; Simon, Z; Jona, A; Magyari, F; Gergely, M; Nagy, Z; Keresztes, K; Pettendi, P; Illes, A

    2015-01-01

    Very few studies have determined the prognostic value of interim and restaging PET/CT in patients with Hodgkin lymphoma using current standard of care therapy outside clinical trials. We analyzed the effect of the results of interim and restaging PET/CT on the survival (overall- and relapse-free) in patients who received standard first-line treatment based on the stage of disease and risk factors. We investigated the differences between the relapse and non-relapse groups based on the clinical pathological characteristics of patients who had positive interim PET/CT results.Between January 1, 2007 and December 31, 2011, the staging, interim and restaging PET/CT scans of patients with Hodgkin lymphoma were analyzed. The Deauville criteria were used for the evaluation of interim PET/CT scans. One hundred and thirteen Hodgkin lymphoma patients underwent staging, interim and restaging PET/CT scans. None of the therapy was modified based on the interim PET/CT results. The median follow-up time was 43.5 months. A total of 62 early stage patients and 51 advanced stage patients were identified. The five-year overall survival rates were 93.4% in the interim PET negative group and 58% in the interim PET positive group (pinterim PET positive group, patients over 40 years of age had a significantly higher probability of relapse (p=0.057).The routine clinical use of interim PET/CT is highly recommended based on our investigation. However, patients with positive interim PET/CT results required frequent additional evaluations.

  1. Sequential FDG-PET/CT reliably predicts response of locally advanced rectal cancer to neo-adjuvant chemo-radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Capirci, Carlo [Hospital, Division of Radiotherapy, Rovigo (Italy); Rampin, Lucia; Banti, Elena [Hospital, Nuclear Medicine and PET Service, Rovigo (Italy); Erba, Paola A.; Mariani, Giuliano [Regional Center of Nuclear Medicine, Univ. Pisa (Italy); Galeotti, Fabrizio [Hospital, Division of Surgery, Rovigo (Italy); Crepaldi, Giorgio [Hospital, Division of Oncology, Rovigo (Italy); Gava, Marcello [Hospital, Medical Physics Service, Rovigo (Italy); Fanti, Stefano [Politecnico Bologna (Italy). Dept. of Nuclear Medicine; Muzzio, Pier C. [Dept. of Radiology, Ist. Oncologico, Padova (Italy); Rubello, Domenico [Rovigo Hospital, Istituto Oncologico Veneto (IOV)-IRCCS, Nuclear Medicine Service, PET Unit, Rovigo (Italy)

    2007-10-15

    Prediction of rectal cancer response to preoperative, neo-adjuvant chemo-radiation therapy (CRT) provides the opportunity to identify patients in whom a major response is expected and who may therefore benefit from alternative surgical approaches. Traditional morphological imaging techniques are effective in defining tumour extension in the initial diagnostic and staging work-up, but perform poorly in distinguishing residual neoplastic tissue from scarring post CRT, when restaging the patient before surgery. Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) is a promising tool for monitoring the effect of anti-tumour therapy. The aim of this study was to prospectively assess the value of sequential FDG-PET scans in predicting the response of locally advanced rectal cancer to neo-adjuvant CRT. Forty-four consecutive patients with locally advanced (cT3-4) primary rectal cancer and four patients with pelvic recurrence of rectal cancer were enrolled in this prospective study. Treatment consisted of external beam intensified radiotherapy, chemotherapy and, 8-10 weeks later, surgery with curative intent. All patients underwent FDG-PET/CT both before CRT and 5-6 weeks after completing CRT. One patient died before surgery because of acute myocardial infarction, and was therefore excluded from further analysis. Semi-quantitative measurements of FDG uptake (SUV{sub max}), absolute difference ({delta}SUV{sub max}) and percent SUV{sub max} difference (Response Index, RI) between pre- and post-CRT PET scans were considered. Results were correlated with pathological response, assessed both by histopathological staging of the surgical specimens (pTNM) and by the tumour regression grade (TRG) according to Mandard's criteria (patients with TRG1-2 being defined as responders and patients with TRG3-5 as non-responders). Following neo-adjuvant CRT, of the 45 patients submitted to surgery, 23 (51.1%) were classified as responders according to Mandard

  2. Radiology for PET/CT reporting

    Energy Technology Data Exchange (ETDEWEB)

    Nanni, Cristina; Fanti, Stefano; Zanoni, Lucia [Univ. Hospital Sant Orsola-Malpighi, Bologna (Italy). Dept. of Nuclear Medicine

    2014-07-01

    Offers rapid access to slice by slice CT descriptions of anatomical structures from PET/CT studies. Presents images and descriptions of CT findings that may be detected while reviewing PET/CT scans. Includes principal MRI findings in diseases susceptible to PET/CT evaluation. Reading PET/CT scans is sometimes challenging. Not infrequently, abnormal findings on CT images are functionally silent and therefore difficult for nuclear medicine practitioners to interpret. Furthermore, in general only a low-dose CT scan is produced as part of the combined PET/CT study, and the resulting CT images may prove suboptimal for image interpretation. This atlas is designed to enable nuclear medicine practitioners who routinely read PET/CT scans to recognize the most common CT abnormalities. Slice-by-slice descriptions are provided of anatomical structures as visualized on CT scans obtained in PET/CT studies. The CT findings that may be detected while reviewing PET/CT scans of various body regions and conditions are then illustrated and fully described. The concluding section of the book is devoted to the principal MRI findings in diseases which cannot be evaluated using PETs/CTs.

  3. Advances of research on PET-CT hypoxia imaging in lung cancer%PET-CT乏氧显像及其在肺癌中的研究进展

    Institute of Scientific and Technical Information of China (English)

    任树华; 华逢春; 赵军

    2008-01-01

    PET-CT, as a single imaging modality for whole body providing both anatomic and biological information, offer the possibility of in vivo mapping of regional tumor hypoxia with adequate anatomical resolution as well as monitoring therapy through follow-up mapping of hypoxia. Some new advances of research and clinical study on PET-CT hypoxia imaging in lung cancer were summarized briefly, including tracers, the detections of hypoxia, therapy planning, predictioas and outcome.%PET-CT乏氧显像可以在功能和形态上对活体肿瘤乏氧区进行高分辨率的勾画,从而可以对肿瘤的乏氧状况进行定量分析、及时监测.综述了PET-CT乏氧显像对肺癌的生物学评价、治疗方案选择、治疗效果监测及预后预测等方面的应用及存在的问题.

  4. Detection of microvascular and tri-truncal coronaries injuries by quantitative cardiac PET/CT with Rb-82;Detection des lesions coronaires microvasculaires et tritronculaires par TEP-CT cardiaque quantitative au Rb-82

    Energy Technology Data Exchange (ETDEWEB)

    Dunet, V.; Allenbach, G.; Soubeyran, V.; Kosinski, M.; Bischof-Delaloye, A.; Prior, J. [CHU de Vaudois, Departement de medecine nucleaire, Lausanne (Switzerland); Camus, F. [CHU de Vaudois, institut de radiophysique appliquee, Lausanne (Switzerland)

    2010-05-15

    The results show that up to 1 in 5 investigated by PET / CT with Rb-82 with myocardium blood rate quantification shows affected myocardium flux reserve linked to microvascular or tri-truncal affect undiagnosed by semi-quantitative analysis

  5. PET and PET/CT in clinical cardiology

    Energy Technology Data Exchange (ETDEWEB)

    Won, Kyoung Sook [Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2005-02-15

    Cardiac PET emerged as a powerful tool that allowed in vivo quantification of physiologic processes including myocardial perfusion and metabolism, as well as neuronal and receptor function for more than 25 years. Now PET imaging has been playing an important role in the clinical evaluation of patients with known or suspected ischemic heart disease. This important clinical role is expected to grow with the availability of PET/CT scanner that allow a true integration of structure and function. The objective of this review is to provide and update on the current and future role of PET in clinical cardiology with a special eye on the great opportunities now offered by PET/CT.

  6. 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.

  7. 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.)

  8. Brain {sup 18}F-FDG, {sup 18}F-florbtaben PET/CT, {sup 123}I-FP-CIT SPECT and cardiac {sup 123}I-MBG imaging for diagnosis of a 'cerebral type' of Lewy Body disease

    Energy Technology Data Exchange (ETDEWEB)

    Gucht, Axel Van Der; Bélissant, Ophélie; Rabu, Corenti; Cottereau, Anne-Ségolène; Evangelista, Eva; Chalaye, Julia; Bonnot-Lours, Sophie; Fénelon, Gilles; Itti, Emmanuel [Dept. of Nuclear Medicine, AP-HP, Henri-Mondor Teaching Hospital, Crteil (France); De Langavant, Laurent Cleret [Cognitive Neurology Unit, H. Mondor Hospital, Creteil (France)

    2016-09-15

    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. {sup 18}F-FDG PET/CT showed hypometabolism in the posterior associative cortex including the occipital cortex, suggesting Lewy body dementia, but {sup 123}I-FP-CIT SPECT was normal and cardiac {sup 123}I-MIBG imaging showed no signs of sympathetic denervation. Alzheimer's disease was excluded by a normal {sup 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.

  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. 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.)

  11. 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

  12. 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)

  13. 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....

  14. Posttreatment PET/CT Rather Than Interim PET/CT Using Deauville Criteria Predicts Outcome in Pediatric Hodgkin Lymphoma: A Prospective Study Comparing PET/CT with Conventional Imaging.

    Science.gov (United States)

    Bakhshi, Sameer; Bhethanabhotla, Sainath; Kumar, Rakesh; Agarwal, Krishankant; Sharma, Punit; Thulkar, Sanjay; Malhotra, Arun; Dhawan, Deepa; Vishnubhatla, Sreenivas

    2017-04-01

    Data about the significance of (18)F-FDG PET at interim assessment and end of treatment in pediatric Hodgkin lymphoma (HL) are limited. Methods: Patients (≤18 y) with HL were prospectively evaluated with contrast-enhanced CT (CECT) and PET combined with low-dose CT (PET/CT) at baseline, after 2 cycles of chemotherapy, and after completion of treatment. Revised International Working Group (RIW) criteria and Deauville 5 point-scale for response assessment by PET/CT were used. All patients received doxorubicin (Adriamycin), bleomycin, vinblastine, dacarbazine chemotherapy along with involved-field radiotherapy (25 Gy) for early stage (IA, IB, and IIA) and advanced stage (IIB-IV) with bulky disease. Results: Of the 57 enrolled patients, median follow-up was 81.6 mo (range, 11-97.5 mo). Treatment decisions were based on CECT. At baseline, PET/CT versus CECT identified 67 more disease sites; 23 patients (40.3%) were upstaged and of them in 9 patients (39%) upstaging would have affected treatment decision; notably none of these patients relapsed. The specificity of interim PET/CT based on RIW criteria (61.5%) and Deauville criteria (91.4%) for predicting relapse was higher than CECT (40.3%) (P = 0.03 and P interim PET/CT (RIW) response was 93.3 ± 4.1 versus 89.6 ± 3.8 (positive vs. negative scan, respectively; P = 0.44). The specificity of posttreatment PET/CT (Deauville) was 95.7% versus 76.4% by CECT (P = 0.006). Posttreatment PET/CT (Deauville) showed significantly inferior overall survival in patients with positive scan versus negative scan results (66.4 ± 22.5 vs. 94.5 ± 2.0, P = 0.029). Conclusion: Interim PET/CT has better specificity, and use of Deauville criteria further improves it. Escalation of therapy based on interim PET in pediatric HL needs further conclusive evidence to justify its use. Posttreatment PET/CT (Deauville) predicts overall survival and has better specificity in comparison to conventional imaging.

  15. Extensive Invasive Extramammary Paget Disease Evaluated by F-18 FDG PET/CT

    Science.gov (United States)

    Li, Zu-Gui; Qin, Xiao-Jing

    2015-01-01

    Abstract Extramammary Paget disease (EMPD) is a rare cutaneous, intraepithelial adenocarcinoma. Because of its rarity, little is known about the value of fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in evaluating this disease. Our case report aims to increase current knowledge of FDG PET/CT in EMPD as a noninvasive imaging tool for assessing the extension of the disease and detecting distant metastases. We reported a 64-year-old Chinese man who presented with a slowly progressive, ill-margined erythematous lesion with a crusted, eroded, and scaly surface involving multiple sites of penis, scrotum, left pelvic wall, hip, groin, and thigh for >4 years, which became extensive in the past 1 year. He was referred for an FDG PET/CT examination to further evaluate the lesions. A following skin biopsy was performed to obtain a definitive histological diagnosis. FDG PET/CT imaging revealed mild FDG uptake at the extensive cutaneous lesion with subcutaneous invasion, involvement of lymph nodes, and multiple intense FDG-avid of skeletal metastases. According to the appearance of FDG PET/CT, a provisional diagnosis of advanced cutaneous malignancy was made. Histopathology findings indicated characteristic of EMPD. The patient was treated with radiation therapy and died from complications 2 months after the last dose of radiotherapy. Our case highlighted that a whole-body FDG PET/CT should be incorporated into the diagnostic algorithm of EMPD to give a comprehensive assessment of this disease. PMID:25621679

  16. Extensive invasive extramammary Paget disease evaluated by F-18 FDG PET/CT: a case report.

    Science.gov (United States)

    Li, Zu-Gui; Qin, Xiao-Jing

    2015-01-01

    Extramammary Paget disease (EMPD) is a rare cutaneous, intraepithelial adenocarcinoma. Because of its rarity, little is known about the value of fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in evaluating this disease. Our case report aims to increase current knowledge of FDG PET/CT in EMPD as a noninvasive imaging tool for assessing the extension of the disease and detecting distant metastases.We reported a 64-year-old Chinese man who presented with a slowly progressive, ill-margined erythematous lesion with a crusted, eroded, and scaly surface involving multiple sites of penis, scrotum, left pelvic wall, hip, groin, and thigh for >4 years, which became extensive in the past 1 year. He was referred for an FDG PET/CT examination to further evaluate the lesions. A following skin biopsy was performed to obtain a definitive histological diagnosis.FDG PET/CT imaging revealed mild FDG uptake at the extensive cutaneous lesion with subcutaneous invasion, involvement of lymph nodes, and multiple intense FDG-avid of skeletal metastases. According to the appearance of FDG PET/CT, a provisional diagnosis of advanced cutaneous malignancy was made. Histopathology findings indicated characteristic of EMPD. The patient was treated with radiation therapy and died from complications 2 months after the last dose of radiotherapy.Our case highlighted that a whole-body FDG PET/CT should be incorporated into the diagnostic algorithm of EMPD to give a comprehensive assessment of this disease.

  17. 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

  18. {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.

  19. 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.

  20. ⁶⁸Ga-DOTA-TOC-PET/CT detects heart metastases from ileal neuroendocrine tumors.

    Science.gov (United States)

    Calissendorff, Jan; Sundin, Anders; Falhammar, Henrik

    2014-09-01

    Metastases from ileal neuroendocrine tumors (NETs) to the myocardium are rare and generally seen in patients with widespread metastatic NET disease. The objectives of this investigation were to describe the frequency of intracardiac metastases in ileal NET patients examined by (68)Ga-DOTA-TOC-PET/CT and to describe the cases in detail. All (68)Ga-DOTA-TOC-PET/CT examinations performed at the Karolinska University Hospital since 2010 until April 2012 were reviewed. In all, 128 out of 337 examinations were in patients with ileal NETs. Four patients had seven myocardiac metastases, yielding a frequency of 4.3 % in patients with ileal NETs. One patient had cardiac surgery while three were treated with somatostatin analogs. The cardiac metastases did not affect the patients' activity of daily life. (68)Ga-DOTA-TOC-PET/CT is an established imaging modality in identifying cardiac metastases in ileal NETs. Prospective studies are needed to confirm the true clinical value of (68)Ga-DOTA-TOC-PET/CT in detecting cardiac metastases in both ileal and non-ileal NETs.

  1. 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

  2. Bladder diverticulitis on PET/CT

    OpenAIRE

    Wosnitzer, Brian

    2015-01-01

    Diverticula are commonly seen in hollow viscous organs. One common complication of diverticula is infection, known as diverticulitis. Although diverticulitis has been extensively described with respect to the colon, not many cases describe diverticulitis of the urinary bladder. We report a case of diverticulitis of the bladder to emphasize the imaging findings on PET/CT and to discuss management and possible complications.

  3. 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.)

  4. 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.

  5. Predictive factors of [{sup 11}C]choline PET/CT in patients with biochemical failure after radical prostatectomy

    Energy Technology Data Exchange (ETDEWEB)

    Giovacchini, Giampiero; Coradeschi, Elisa [University of Milano-Bicocca, Center for Molecular Bioimaging, Milano (Italy); Picchio, Maria; Bettinardi, Valentino; Gianolli, Luigi [Scientific Institute San Raffaele, Department of Nuclear Medicine, Milano (Italy); Scattoni, Vincenzo; Rigatti, Patrizio [Scientific Institute San Raffaele, Department of Urology, Milano (Italy); Cozzarini, Cesare; Di Muzio, Nadia [Scientific Institute San Raffaele, Department of Radiation Oncology, Milano (Italy); Fazio, Ferruccio [University of Milano-Bicocca, Center for Molecular Bioimaging, Milano (Italy); Scientific Institute San Raffaele, Department of Nuclear Medicine, Milano (Italy); Scientific Institute San Raffaele, Department of Radiation Oncology, Milano (Italy); Messa, Cristina [University of Milano-Bicocca, Center for Molecular Bioimaging, Milano (Italy); National Research Council, Institute for Bioimaging and Molecular Physiology, Milano (Italy); Hospital San Gerardo, Department of Nuclear Medicine, Monza (Italy)

    2010-02-15

    Detection of recurrence in prostate cancer patients with biochemical failure after radical prostatectomy by [{sup 11}C]choline PET/CT depends on the prostate-specific antigen (PSA) level. The role of other clinical and pathological variables has not been explored. A total of 2,124 prostate cancer patients referred to our Institution for [{sup 11}C]choline PET/CT from December 2004 to January 2007 for restaging of disease were retrospectively considered for this study. Inclusion criteria were: previous treatment by radical prostatectomy, and biochemical failure, defined as at least two consecutive PSA measurements of >0.2 ng/ml. These criteria were met for 358 patients. Binary logistic analysis was used to investigate the predictive factors of [{sup 11}C]choline PET/CT. PET/CT findings were validated using criteria based on histological analysis, and follow-up clinical and imaging data. Receiver operating characteristic (ROC) analysis was used to assess the performance of [{sup 11}C]choline PET/CT in relation to PSA levels. The mean PSA level was 3.77 {+-} 6.94 ng/ml (range 0.23-45 ng/ml; median 1.27 ng/ml). PET/CT was positive for recurrence in 161 of 358 patients (45%). On an anatomical region basis, [{sup 11}C]choline pathological uptake was observed in lymph nodes (107/161 patients, 66%), prostatectomy bed (55/161 patients, 34%), and in the skeleton (46/161 patients, 29%). PET/CT findings were validated using histological criteria (46/358, 13%), and follow-up clinical and imaging criteria (312/358, 87%). Sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were, respectively, 85%, 93%, 91%, 87%, and 89%. In multivariate analysis, high PSA levels, advanced pathological stage, previous biochemical failure and older age were significantly (P < 0.05) associated with an increased risk of positive PET/CT findings. The percentage of positive scans was 19% in those with a PSA level between 0.2 and 1 ng/ml, 46% in those

  6. 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

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

    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

  8. 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.)

  9. 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)

  10. The correlation between cell-free DNA and tumour burden was estimated by PET/CT in patients with advanced NSCLC

    DEFF Research Database (Denmark)

    Nygaard, A D; Holdgaard, Paw; Spindler, K-L G;

    2014-01-01

    -FDG) PET/computed tomography (CT) scan was performed and evaluated in terms of metabolic tumour volume (MTV) and total lesion glycolysis (TLG). Tumour contours were delineated semi-automatically by a threshold standardised uptake value (SUV) of 2.5. The primary end point was correlation among cfDNA, MTV...... and TLG. The secondary end point was overall survival (OS) according to cfDNA, MTV and TLG.Results:Fifty-three patients were included. There were no correlations between cfDNA and MTV (r=0.1) or TLG (r=0.1). cfDNA >75th percentile was correlated with shorter OS (P=0.02), confirmed in a multivariate...... burden defined by positron emission tomography (PET) parameters.Methods:Patients with advanced non-small cell lung cancer (NSCLC) were enrolled into a prospective biomarker trial. Before treatment, plasma was extracted and the level of cfDNA was determined by qPCR. An (18)F-fluorodeoxyglucose ((18)F...

  11. 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.

  12. 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.

  13. 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

  14. Prospective evaluation of [{sup 11}C]Choline PET/CT in therapy response assessment of standardized docetaxel first-line chemotherapy in patients with advanced castration refractory prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Schwarzenboeck, Sarah M.; Krause, Bernd J. [Technical University of Munich, Department of Nuclear Medicine, Klinikum rechts der Isar, Munich (Germany); Rostock University Medical Centre, Department of Nuclear Medicine, Rostock (Germany); Eiber, Matthias; Schwaiger, Markus [Technical University of Munich, Department of Nuclear Medicine, Klinikum rechts der Isar, Munich (Germany); Kundt, Guenther [Rostock University Medical Centre, Department of Biostatistics and Informatics, Rostock (Germany); Retz, Margitta; Treiber, Uwe; Nawroth, Roman; Gschwend, Juergen E.; Thalgott, Mark [Technical University of Munich, Department of Urology, Klinikum rechts der Isar, Munich (Germany); Sakretz, Monique; Kurth, Jens [Rostock University Medical Centre, Department of Nuclear Medicine, Rostock (Germany); Rummeny, Ernst J. [Technical University of Munich, Institute of Radiology, Klinikum rechts der Isar, Munich (Germany)

    2016-11-15

    The aim of this study was to prospectively evaluate the value of [{sup 11}C] Choline PET/CT in monitoring early and late response to a standardized first-line docetaxel chemotherapy in castration refractory prostate cancer (mCRPC) patients. Thirty-two patients were referred for [{sup 11}C] Choline PET/CT before the start of docetaxel chemotherapy, after one and ten chemotherapy cycles (or - in case of discontinuation - after the last administered cycle) for therapy response assessment. [{sup 11}C] Choline uptake (SUV{sub max}, SUV{sub mean}), CT derived Houndsfield units (HU{sub max}, HU{sub mean}), and volume of bone, lung, and nodal metastases and local recurrence were measured semi-automatically at these timepoints. Change in SUV{sub max}, SUV{sub mean}, HU{sub max}, HU{sub mean,} and volume was assessed between PET 2 and 1 (early response assessment, ERA) and PET 3 and 1 (late response assessment, LRA) on a patient and lesion basis. Results of PET/CT were compared to clinically used RECIST 1.1 and clinical criteria based therapy response assessment including PSA for defining progressive disease (PD) and non-progressive disease (nPD), respectively. Relationships between changes of SUV{sub max} and SUV{sub mean} (early and late) and changes of PSA{sub early} and PSA{sub late} were evaluated. Prognostic value of initial SUV{sub max} and SUV{sub mean} was assessed. Statistical analyses were performed using SPSS. In the patient-based ERA and LRA there were no statistically significant differences in change of choline uptake, HU, and volume between PD and nPD applying RECIST or clinical response criteria. In the lesion-based ERA, decrease in choline uptake of bone metastases was even higher in PD (applying RECIST criteria), whereas in LRA the decrease was higher in nPD (applying clinical criteria). There were only significant correlations between change in choline uptake and PSA in ERA in PD, in LRA no significant correlations were discovered. Initial SUV{sub max

  15. [PET/CT in breast cancer: an update].

    Science.gov (United States)

    Groheux, D; Moretti, J-L; Giacchetti, S; Hindié, E; Teyton, P; Cuvier, C; Bousquet, G; Misset, J-L; Boin, C; Espié, M

    2009-11-01

    The authors discuss the various roles of 18F-FDG PET/CT in the management of breast cancer. Roles of new tracers such as F-18 fluoro-L-thymidine (a marker of cell proliferation), 18-fluoro-17-B-estradiol (marker of estrogen receptor) and sodium fluoride (marker of bone matrix) are also mentioned. There is little justification for the use of FDG-PET/CT in patient with clinically T1 (occult distant metastases, notably, early osteomedullary infiltration. Thus, for these tumors, initial PET/CT can enable better intramodality treatment planning or a change in treatment. PET/CT as a whole-body examination is also very efficient in case of suspicion of recurrence. On the other hand, many studies show that this functional imaging could be used to assess early response to neoadjuvant chemotherapy or to chemotherapy of metastatic disease. 18FDG-PET/CT could thus become an unavoidable modality to answer various clinical situations.

  16. 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.)

  17. 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.

  18. Umbilical Plugoma Mimics Melanoma Metastasis on FDG PET/CT.

    Science.gov (United States)

    Alabed, Yazan Z; Sakellis, Christopher

    2015-10-01

    An 84-year-old man with history of left forehead melanoma was found on a restaging F-FDG PET/CT scan with hypermetabolic lung nodules and a mildly FDG-avid soft tissue nodule posterior to the umbilicus. Biopsy of a right lower lobe nodule revealed metastatic melanoma. Follow-up posttreatment PET/CT scan showed complete resolution of lung nodules and unchanged FDG uptake at the level of the umbilicus. Review of the patient's medical history revealed a remote history of umbilical hernia repair. We present a case of postsurgical plugoma mimicking the appearance of melanoma metastasis on FDG PET/CT.

  19. 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

  20. 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

  1. PET/CT Based Dose Planning in Radiotherapy

    DEFF Research Database (Denmark)

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

    2011-01-01

    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...... 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...... 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...

  2. 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....

  3. 18-FDG PET/CT assessment of basal cell carcinoma with vismodegib.

    Science.gov (United States)

    Thacker, Curtis A; Weiss, Glen J; Tibes, Raoul; Blaydorn, Lisa; Downhour, Molly; White, Erica; Baldwin, Jason; Hoff, Daniel D; Korn, Ronald L

    2012-10-01

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

  4. 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

  5. Environmental Radiation Monitoring in PET-CT facilities; Vigilancia radiologica ambiental en instalaciones de PET-CT

    Energy Technology Data Exchange (ETDEWEB)

    Casa, M. A. de la; Gilarranz, R.; Adaimi, P.; Martinez, L. C.; Ruiz, M. A.; Rot, M. J.; Clemente, F.; Milanes, A.; Delgado, J. M.; Manzanas, M. J.

    2012-11-01

    We have made radiological surveillance measures in three PET-CT facilities during thirteen months. The results of our measures confirm the validity of the shielding calculation and safety studies performed in each one of the facilities. (Author) 3 refs.

  6. [Advances in cardiac pacing].

    Science.gov (United States)

    de Carranza, María-José Sancho-Tello; Fidalgo-Andrés, María Luisa; Ferrer, José Martínez; Mateas, Francisco Ruiz

    2012-01-01

    This article contains a review of the current status of remote monitoring and follow-up involving cardiac pacing devices and of the latest developments in cardiac resynchronization therapy. In addition, the most important articles published in the last year are discussed.

  7. Diagnostic Accuracy of PET/CT-Guided Percutaneous Biopsies for Malignant Peripheral Nerve Sheath Tumors in Neurofibromatosis Type 1 Patients.

    Directory of Open Access Journals (Sweden)

    Mehdi Brahmi

    Full Text Available Malignant peripheral nerve sheath tumors (MPNST are one of the most frequent causes of death in patients with neurofibromatosis type 1 (NF1. Early detection is crucial because complete surgical resection is the only curative treatment. It has been previously reported that an 18F-fluorodeoxyglucose (FDG positron emission tomography/computed tomography (PET/CT image with a T/L (Tumor/Liver SUV max ratio > 1.5 provides a high negative predictive value; however, it is not specific enough to make a NF1-related MPNST diagnosis. A formal proof of malignant transformation from a histological analysis is necessary before surgical excision because the procedure can cause mutilation. The objective of the present work was to investigate the effectiveness of and complications associated with PET/CT-guided percutaneous biopsies for an NF1-related MPNST diagnosis.PET/CT-guided percutaneous biopsy procedures performed on 26 NF1 patients with a clinical suspicion of MPNST and a suspect lesion from a PET/CT scan (T/L SUV max ratio > 1.5 were retrospectively evaluated. The localization of the suspected malignant site was determined using PET/CT. A stereotactic (ultrasonic and CT control core biopsy technique was used with a local anesthesia.The first PET/CT-guided percutaneous biopsies enabled a pathological diagnosis for all of the patients (no "inconclusive " results were obtained, and no secondary procedures were needed. Among the 26 patients, the histopathological results from the biopsy were malignant in 17 cases and benign (BPNST with atypical cells in nine cases. No complications from the diagnostic procedure were observed. A surgical resection was performed in 18 patients (seven benign and 11 malignant biopsies, removing the fine needle biopsy scar. In addition, six locally advanced/metastatic MPNST were treated with chemo/radiotherapy, and two BPNST had no progression after a follow-up of 14 and 39 months, respectively. The PET/CT-guided percutaneous

  8. Observer variation in FDG PET-CT for staging of non-small-cell lung carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Hofman, Michael S. [St Thomas' Hospital, PET Imaging Centre, London (United Kingdom)]|[Southern Health, Nuclear Medicine, Melbourne (Australia); Smeeton, Nigel C. [King' s College London, Division of Health and Social Care Research, London (United Kingdom); Rankin, Sheila C.; Nunan, Tom; O' Doherty, Michael J. [St Thomas' Hospital, PET Imaging Centre, London (United Kingdom)

    2009-02-15

    Error and variation in reporting remains one of the weakest features of clinical imaging despite enormous technological advances in nuclear medicine and radiology. The aim of this study was to evaluate agreement amongst experienced readers in staging non-small-cell lung cancer (NSCLC) with PET-CT. A series of {sup 18}F-FDG PET-CT scans from 100 consecutive patients were reviewed independently by three experienced readers, with two readers reviewing each scan series a second time. Individual mediastinal lymph node stations were assessed as benign/inflammatory, equivocal or malignant, and AJCC N and M stage were also assigned. Kappa ({kappa}) was used to compare ratings from two categories and weighted kappa ({kappa}{sub w}) for three or more categories, and kappa values were interpreted according to the Landis-Koch benchmarks. Both intra- and interobserver agreement for N and M staging were high. For M staging there was almost perfect intra- and interobserver agreement ({kappa} = 0.90-0.93). For N staging, agreement was either almost perfect or substantial (intraobserver {kappa}{sub w} = 0.79, 0.91; interobserver {kappa}{sub w} = 0.75-0.81). Importantly, there was almost perfect agreement for N0/1 vs N2/3 disease ({kappa} = 0.80-0.97). Agreement for inferior and superior mediastinal nodes (stations 1, 2, 3, 7, 8, 9) was either almost perfect or substantial ({kappa}{sub w} = 0.71-0.88), but lower for hilar nodes (10; {kappa}{sub w} = 0.56-0.71). Interreporter variability was greatest for aortopulmonary nodes (5, 6; {kappa}{sub w} = 0.48-0.55). Amongst experienced reporters in a single centre, there was a very high level of agreement for both mediastinal nodal stage and detection of distant metastases with PET-CT. This supports the use of PET-CT as a robust imaging modality for staging NSCLC. (orig.)

  9. 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.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    The technology behind positron emission tomography (PET) and the most widely used tracer, 2-deoxy-2-[18F]fluoro-D-glucose (FDG), were both conceived in the 1970s, but the latest decade has witnessed a rapid emergence of FDG-PET as an effective imaging technique. This is not least due to the emerg......The technology behind positron emission tomography (PET) and the most widely used tracer, 2-deoxy-2-[18F]fluoro-D-glucose (FDG), were both conceived in the 1970s, but the latest decade has witnessed a rapid emergence of FDG-PET as an effective imaging technique. This is not least due...... to the emergence of hybrid scanners combining PET with computed tomography (PET/CT). Molecular imaging has enormous potential for advancing biological research and patient care, and FDG-PET/CT is currently the most widely used technology in this domain. In this review, we discuss contemporary applications of FDG......-PET and FDG-PET/CT as well as novel developments in quantification and potential future indications including the emerging new modality PET/magnetic resonance imaging....

  11. 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

  12. PET/CT finding in Castleman's disease

    Energy Technology Data Exchange (ETDEWEB)

    Han, E. J.; Choi, W. H.; Kim, J. H.; Jeong, Y. A.; Kim, S. H.; Shon, H. S.; Jeong, S. K. [The Catholic University of Korea, Seoul (Korea, Republic of)

    2007-07-01

    Castleman's disease, also known as angiofollicular lymph node hyperplasia, is a rare and poorly understood disease. This disease is a benign lymphoproliferative disorder and but can progress to lymphoma. Thus accurate diagnosis and treatment is very important. In this report, we present a case of multicentric Castleman's disease. We retrospectively reviewed a case (40 year-old male) that was histologically confirmed to Castleman's disease and was performed PET/CT. And from the PET/CT images before and after chemotherapy, peak standard uptake values and sites of abnormal FDG accumulations were recorded. The histological result was a plasma cell variant of Castleman's disease in both inguinal lymph nodes. PET/CT image showed FDG accumulations in both inguinal areas. And other FDG accumulations were noted in bilateral axillary and iliac regions. He received systemic chemotherapy of 6 cycles. In one month after last chemotherapy, PET/CT image was again performed. Previously noted FDG accumulations in bilateral axillary, iliac, and inguinal regions are seen with diminished intensity. Our result shows decreased intensity of abnormal FDG accumulations after systemic chemotherapy in Castleman's disease. In conclusion, PET/CT can useful for assessment of therapeutic effect in Castleman's disease.

  13. 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

  14. 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.)

  15. 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.

  16. 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......, where the precise delineation of a tumor is crucial to avoid damage from radiation therapy to the healthy tissue surrounding it. The technique is still in a phase of development, and the demands for integration different company software systems are significant before commercial application. Three...

  17. 18F-FDG PET/CT in Bladder Cancer.

    Science.gov (United States)

    Tagliabue, Luca; Russo, Giovanna; Lucignani, Giovanni

    2016-12-01

    Urinary clearance of F-FDG and variability in bladder wall FDG uptake may hamper the interpretation and limit the use of FDG-PET/CT for imaging bladder tumors. Nevertheless, careful combined evaluation of both CT and FDG-PET images of the urinary tract can provide useful findings. We present 2 cases of bladder cancer detected by FDG-PET/CT. These cases suggest that FDG uptake can be indicative of malignancy in bladder cancer when viewed in conjunction with CT scans and that whole-body FDG-PET/CT scans should always be reviewed with particular attention to the urinary tract because abnormalities suggestive of bladder cancer can be found unexpectedly.

  18. 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.)

  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. Clinical FDG PET CT in the Investigation of Suspected Inflammatory and Infective Conditions

    DEFF Research Database (Denmark)

    Lorenz, Eleanor; Wig, Surabhi; Prakash, Vineet

    PURPOSE          F18 FDG PET CT is an established molecular imaging technique most commonly used in the diagnosis and staging of oncological conditions. A rapidly growing clinical application of PET CT is in the investigation of inflammatory and infectious diseases. A review of PET CT scans perfo...

  1. 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.

  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. 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.

  4. Improved detection of localized prostate cancer using co-registered MRI and {sup 11}C-acetate PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Jambor, Ivan, E-mail: ivjamb@utu.fi [Department of Diagnostic Radiology, University of Turku, Turku (Finland); 2nd Department of Radiology, Comenius University and St. Elisabeth Oncology Institute, Bratislava (Slovakia); Turku PET Centre, University of Turku, Turku (Finland); Borra, Ronald, E-mail: ronald.borra@tyks.fi [Department of Diagnostic Radiology, University of Turku, Turku (Finland); Turku PET Centre, University of Turku, Turku (Finland); Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku (Finland); Kemppainen, Jukka, E-mail: Jukka.Kemppainen@tyks.fi [Turku PET Centre, University of Turku, Turku (Finland); Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku (Finland); Lepomaeki, Virva, E-mail: Virva.Lepomaki@tyks.fi [Turku PET Centre, University of Turku, Turku (Finland); Parkkola, Riitta, E-mail: Riitta.Parkkola@tyks.fi [Department of Diagnostic Radiology, University of Turku, Turku (Finland); Turku PET Centre, University of Turku, Turku (Finland); Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku (Finland); Dean, Kirsti, E-mail: Kirsti.Dean@tyks.fi [Department of Diagnostic Radiology, University of Turku, Turku (Finland); Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku (Finland); Alanen, Kalle, E-mail: Kalle.Alanen@tyks.fi [Department of Pathology, Turku University Hospital, Turku (Finland); Arponen, Eveliina, E-mail: Eveliina.Arponen@utu.fi [Turku PET Centre, University of Turku, Turku (Finland); Nurmi, Martti, E-mail: Martti.Nurmi@tyks.fi [Department of Surgery, Division of Urology, Turku University Hospital, Turku (Finland); Aronen, Hannu J., E-mail: Hannu.Aronen@tyks.fi [Department of Diagnostic Radiology, University of Turku, Turku (Finland); Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku (Finland); and others

    2012-11-15

    Objectives: We aimed to study the ability of contrast enhanced MRI at 1.5 T and {sup 11}C-acetate PET/CT, both individually and using fused data, to detect localized prostate cancer. Methods: Thirty-six men with untreated prostate cancer and negative for metastatic disease on pelvic CT and bone scan were prospectively enrolled. A pelvic {sup 11}C-acetate PET/CT scan was performed in all patients, and a contrast enhanced MRI scan in 33 patients (6 examinations using both endorectal coil and surface coils, and 27 examinations using surface coils only). After the imaging studies 10 patients underwent prostatectomy and 26 were treated by image guided external beam radiation treatment. Image fusion of co-registered PET and MRI data was performed based on anatomical landmarks visible on CT and MRI using an advanced in-house developed software package. PET/CT, MRI and fused PET/MRI data were evaluated visually and compared with biopsy findings on a lobar level, while a sextant approach was used for patients undergoing prostatectomy. Results: When using biopsy samples as method of reference, the sensitivity, specificity and accuracy for visual detection of prostate cancer on a lobar level by contrast enhanced MRI was 85%, 37%, 73% and that of {sup 11}C-acetate PET/CT 88%, 41%, 74%, respectively. Fusion of PET with MRI data increased sensitivity, specificity and accuracy to 90%, 72% and 85%, respectively. Conclusions: Fusion of sequentially obtained PET/CT and MRI data for the localization of prostate cancer is feasible and superior to the performance of each individual modality alone.

  5. Clinical advances on Cardiac Insuffiency

    Directory of Open Access Journals (Sweden)

    Angel Julio Romero Cabrera

    2007-06-01

    Full Text Available Cardiac insuffiency is a complex clinical syndrome which constitutes a common final path to get in by the majority of the cardiac diseases. Studies based on the communitarian surveys shows that from 30 to 40 % of the patients decease within the first year of the diagnosis. The rest of the patients (from 60 to 70 % die within the 5 years after being diagnosed. For this reason it has been called as the ¨cancer of cardiology¨. The objective of this article is to update the advances reached in the clinical and therapeutic aspects of this important syndrome.

  6. Preoperative staging of lung cancer with PET/CT

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Fischer, Barbara Malene B; Mortensen, Jann

    2011-01-01

    thoracotomy. All monetary estimates were inflated to 2010 . RESULTS: The incremental cost of the PET/CT-based regimen was estimated at 3,927 [95% confidence interval (CI) -3,331; 10,586] and the NNT at 4.92 (95% CI 3.00; 13.62). These resulted in an average incremental cost-effectiveness ratio...

  7. 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

  8. Body-wide anatomy recognition in PET/CT images

    Science.gov (United States)

    Wang, Huiqian; Udupa, Jayaram K.; Odhner, Dewey; Tong, Yubing; Zhao, Liming; Torigian, Drew A.

    2015-03-01

    With the rapid growth of positron emission tomography/computed tomography (PET/CT)-based medical applications, body-wide anatomy recognition on whole-body PET/CT images becomes crucial for quantifying body-wide disease burden. This, however, is a challenging problem and seldom studied due to unclear anatomy reference frame and low spatial resolution of PET images as well as low contrast and spatial resolution of the associated low-dose CT images. We previously developed an automatic anatomy recognition (AAR) system [15] whose applicability was demonstrated on diagnostic computed tomography (CT) and magnetic resonance (MR) images in different body regions on 35 objects. The aim of the present work is to investigate strategies for adapting the previous AAR system to low-dose CT and PET images toward automated body-wide disease quantification. Our adaptation of the previous AAR methodology to PET/CT images in this paper focuses on 16 objects in three body regions - thorax, abdomen, and pelvis - and consists of the following steps: collecting whole-body PET/CT images from existing patient image databases, delineating all objects in these images, modifying the previous hierarchical models built from diagnostic CT images to account for differences in appearance in low-dose CT and PET images, automatically locating objects in these images following object hierarchy, and evaluating performance. Our preliminary evaluations indicate that the performance of the AAR approach on low-dose CT images achieves object localization accuracy within about 2 voxels, which is comparable to the accuracies achieved on diagnostic contrast-enhanced CT images. Object recognition on low-dose CT images from PET/CT examinations without requiring diagnostic contrast-enhanced CT seems feasible.

  9. (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.

  10. {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

  11. 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

  12. Role of 18F-FDG PET/CT in the management of a case of autoimmune pancreatitis with extrapancreatic manifestations.

    Science.gov (United States)

    Santhosh, Sampath; Bhattacharya, Anish; Harisankar, Chidambaram Natarajan Balasubramanian; Kochhar, Rakesh; Mittal, Bhagwant Rai

    2013-11-01

    Autoimmune pancreatitis and pancreatic cancer share many clinical features like advanced age, painless jaundice, weight loss, and elevated serum levels of CA 19-9. The authors report a 58-year-old male patient provisionally diagnosed with periampullary carcinoma on the basis of ultrasonography and serological markers and planned for Whipple resection. (18)F-FDG PET/CT findings were suggestive of autoimmune pancreatitis, subsequently confirmed on cytological diagnosis. The follow-up PET/CT scan after 1 week of steroid therapy showed regression of FDG uptake in most of the lesions with appearance of salivary gland uptake.

  13. 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.

  14. 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.)

  15. 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.

  16. PET/CT and vascular disease: Current concepts

    Energy Technology Data Exchange (ETDEWEB)

    Cavalcanti Filho, Jose Leite Gondim; Souza Leao Lima, Ronaldo de [CDPI and Multi-Imagem Clinics, Rio de Janeiro (Brazil); Department of Radiology, Rio de Janeiro Federal University (UFRJ), Rio de Janeiro (Brazil); Souza Machado Neto, Luiz de [CDPI and Multi-Imagem Clinics, Rio de Janeiro (Brazil); Kayat Bittencourt, Leonardo, E-mail: lkayat@terra.com.br [CDPI and Multi-Imagem Clinics, Rio de Janeiro (Brazil); Department of Radiology, Rio de Janeiro Federal University (UFRJ), Rio de Janeiro (Brazil); Cortes Domingues, Romeu [CDPI and Multi-Imagem Clinics, Rio de Janeiro (Brazil); Fonseca, Lea Mirian Barbosa da [CDPI and Multi-Imagem Clinics, Rio de Janeiro (Brazil); Department of Radiology, Rio de Janeiro Federal University (UFRJ), Rio de Janeiro (Brazil)

    2011-10-15

    Since its introduction in 2001, positron emission tomography associated to computed tomography (PET/CT) has been established as a standard tool in cancer evaluation. Being a multimodality imaging method, it combines in a single session the sensitivity granted by PET for detection of molecular targets within the picomolar range, with an underlying submilimetric resolution inherent to CT, that can precisely localize the PET findings. In this last decade, there have been new insights regarding the pathophysiology of atherosclerosis, particularly about plaque rupture and vascular remodeling. This has increased the interest for research on PET/CT in vascular diseases as a potential new diagnostic tool, since some PET molecular targets could identify diseases before the manifestation of gross anatomic features. In this review, we will describe the current applications of PET/CT in vascular diseases, emphasizing its usefulness in the settings of vasculitis, aneurysms, vascular graft infection, aortic dissection, and atherosclerosis/plaque vulnerability. Although not being properly peripheral vascular conditions, ischemic cardiovascular disease and cerebrovascular disease will be briefly addressed as well, due to their widespread prevalence and importance.

  17. 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

  18. Polysplenia Syndrome With Splenic and Skeletal Muscle Metastases From Thyroid Carcinoma Evaluated by FDG PET/CT: Case Report and Literature Review

    Science.gov (United States)

    Li, Zu-Gui; Lin, Zhi-Chun; Mu, Hai-Yu

    2016-01-01

    Abstract Polysplenia syndrome (PSS) is a rare congenital abnormality. Metastases to spleen and skeletal muscle from differentiated thyroid cancer (DTC) are also extremely rare. Our case report aims to present an interesting case of PSS associated with splenic metastasis (SM) and skeletal muscle metastasis (SMM) from advanced papillary thyroid carcinoma which was evaluated on fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). An 84-year-old Chinese man was admitted with the history of multiple enlarged masses in bilateral neck, right axillary, and inguinal areas for >2 months. The results of ultrasonography examination were highly suggestive of malignancy. The histological results of the following biopsy were consistent with papillary thyroid carcinoma with involvement of multiple regional lymph nodes. He was referred for an FDG PET/CT imaging to evaluate the situation. FDG PET/CT showed that an intense FDG-avid thyroid mass with widespread regional lymph node involvement and distant metastases in the body. Unexpected sites of metastases were detected in the spleens and skeletal muscles. Most interestingly, FDG PET/CT imaging also described the typical imaging findings of PSS including the 2 right-sided spleens, azygos and hemiazygos continuation of inferior vena cava (IVC), right-sided stomach, middle line liver, a short pancreas, preduodenal portal vein (PPV), and malrotation of gut. Whole body FDG PET/CT imaging can accurately evaluate the situation of DTC by detecting regional lymph node involvement, common and rare sites of distant metastases which are closely related to staging, management, and prognosis of this disease. Whole-body FDG PET/CT is also valuable in demonstrating the typical imaging features of PSS. PMID:26825891

  19. 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.

  20. 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.......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....... We investigate the feasibility of introducing a deep inspiration breath hold (DIBH) strategy in PET/CT imaging of Hodgkin lymphoma patients and its impact on image quantification parameters.  Methods: Three patients with suspicion of large mediastinal tumour burden were selected for this study...

  1. 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.......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....... We investigate the feasibility of introducing a deep inspiration breath hold (DIBH) strategy in PET/CT imaging of Hodgkin lymphoma patients and its impact on image quantification parameters. Methods: Three patients with suspicion of large mediastinal tumour burden were selected for this study...

  2. Modern CT and PET/CT imaging of the liver; Moderne CT- und PET/CT-Bildgebung der Leber

    Energy Technology Data Exchange (ETDEWEB)

    Klasen, J.; Heusner, T.A.; Riegger, C.; Reichelt, D.; Kuhlemann, J.; Antoch, G.; Blondin, D. [Medizinische Fakultaet, Heinrich-Heine-Universitaet Duesseldorf, Institut fuer Diagnostische und Interventionelle Radiologie, Duesseldorf (Germany)

    2011-08-15

    Computed tomography (CT) is now widely available and represents an important and rapid method for the diagnostics of acute liver disease, characterization of focal liver lesions, planning of interventional therapy measures and postintervention control. In recent years CT has not become less important despite the increasing value of magnetic resonance imaging (MRI). By the use of different contrast medium phases good characterization of space-occupying lesions can be achieved. For the diagnostics of hepatocellular carcinoma (HCC) a triphasic examination protocol should always be implemented. The introduction of dual energy CT increased the sensitivity of imaging of hypervascularized and hypovascularized liver lesions and by the use of virtual native imaging it has become possible to avoid additional native imaging which reduces the x-ray exposition of patients. Positron emission tomography (PET) has an advantage for imaging in oncology because nearly the complete body of the patient can be screened and this is the main indication for PET/CT (whole-body staging). For purely hepatic problems 18F-fluorodeoxyglucose (FDG)-PET/CT using diagnostic CT data has a higher precision than CT alone but is inferior to MRI. (orig.) [German] Die Computertomographie (CT) ist heute breit verfuegbar und stellt eine wichtige und schnelle Methode zur Diagnostik akuter Lebererkrankungen, der Artdiagnostik fokaler Leberlaesionen und der Planung interventioneller Therapiemassnahmen sowie der postinterventionellen Kontrolle dar. In den letzten Jahren hat die CT trotz des zunehmenden Stellenwerts der Magnetresonanztomographie (MRT) nicht an Bedeutung verloren. Durch den Einsatz unterschiedlicher Kontrastmittelphasen kann meist eine gute Charakterisierung von Raumforderungen erfolgen. Bei der Diagnostik des hepatozellulaeren Karzinoms (HCC) sollte beispielsweise immer ein triphasisches Untersuchungsprotokoll angewendet werden. Mit Einfuehrung der Dual-energy-CT hat die Sensitivitaet in der

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

    Directory of Open Access Journals (Sweden)

    Jingang Guo

    2015-04-01

    Full Text Available 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 imaging science. The paper carried on the detailed description of the SPECT-CT and PET-CT computer analysis method.

  4. Dual-modality PET/CT instrumentation-today and tomorrow

    DEFF Research Database (Denmark)

    Lonsdale, Markus Nowak; Beyer, Thomas

    2010-01-01

    for accurate lesion localization. After a decade of PET/CT these combined systems have matured technically. Today, whole-body oncology staging is available with PET/CT in 15 min, or less. This review details recent developments in combined PET/CT instrumentation and points to implications for major......Positron emission tomography (PET) has proven to be a clinically valuable imaging modality, particularly for oncology staging and therapy follow-up. The introduction of combined PET/CT imaging has helped address challenging imaging situations when anatomical information on PET-only was inadequate...

  5. 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.

  6. Association between Metabolic Tumor Volume from 18F-FDG PET/CT and Prognosis in Patients with Advanced NSCLC%原发灶18F-FDG PET/CT肿瘤代谢体积与晚期非小细胞肺癌患者预后的相关性研究

    Institute of Scientific and Technical Information of China (English)

    赵芬; 杨国仁; 张秀丽; 孙晓蓉; 霍宗伟; 郑劲松; 付政; 马莉; 赵书强; 滕学鹏

    2011-01-01

    Purpose To evaluate the correlation between the metabolic tumor volume (MTV) of 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of primary lesions and the prognosis in patients with advanced non small cell lung cancer (NSCLC) . Materials and methods One hundred and ten patients with advanced NSCLC underwent 18F-FDG PET/CT scan were recruited in this study consecutively from January 2005 to December 2007. All the patients developed NSCLC with pathological stage on Ⅲ or Ⅳ and received treatment by radiation and chemotherapy. A 2-year follow-up was conducted after treatment for all the patients. The survival rate analysis was determined by Kaplan-Meier survival curve and log-rank test.The prognostic significance of MTV, SUVmax, and other clinical-pathological variables were calculated by Cox proportional hazards regression analysis. A time-dependent receiver operating characteristic curve (ROC) was utilized to compare the power of MTV and SUV max in predicting patient's prognosis. Results The overall two-year-survival of the patients was 20.9% after treatment. On time-dependent ROC analysis, MTV showed greater AUC value as compared to SUVmax in predicting prognosis (0.649 vs.0.523). While the cut-off point of MTV was set as 33.8cm3, a significantly higher 2-year survival rate was observed in patients with smaller MTV as compared to patients with larger MTV (5.9% vs. 27.6%, P<0.05). In the univariate and multivariate analyses,clinical stage, MTV and pathological types of primary tumors were significant predictors for 2-year survival rate. Conclusions The MTV measurement of primary lesions is significantly associated with prognosis in patients with advanced NSCLC. Advanced NSCLC patients with larger MTV may have lower survival rate.%目的 探讨晚期非小细胞肺癌(NSCLC)原发灶18F-FDG PET/CT肿瘤代谢活性体积(MTV)与预后的关系.资料与方法 回顾性分析治疗前行PET/CT检查的110例均经病

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

    Energy Technology Data Exchange (ETDEWEB)

    Soussan, Michael, E-mail: michael.soussan@avc.aphp.fr [Université Paris 13, Faculté de médecine SMBH, Department of Nuclear Medicine, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Brillet, Pierre-Yves [Université Paris 13, Faculté de médecine SMBH, Department of Radiology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Mekinian, Arsène [Université Paris 13, Faculté de médecine SMBH, Department of Internal Medicine, Hôpital Jean Verdier, Bondy (France); Khafagy, Abrahim [Université Paris 13, Faculté de médecine SMBH, Department of Radiology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Nicolas, Patrick [Université Paris 13, Faculté de médecine SMBH, Department of Pharmacology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Vessieres, Annie [Université Paris 13, Faculté de médecine SMBH, Department of Bacteriology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Brauner, Michel [Université Paris 13, Faculté de médecine SMBH, Department of Radiology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France)

    2012-10-15

    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.

  8. 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...

  9. 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.

  10. 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...

  11. 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.

  12. Role of respiratory-gated PET/CT for pancreatic tumors: A preliminary result

    Energy Technology Data Exchange (ETDEWEB)

    Kasuya, Takeo, E-mail: kasumakidon@yahoo.co.jp [Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004 (Japan); Tateishi, Ukihide, E-mail: utateish@yokohama-cu.ac.jp [Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004 (Japan); Suzuki, Kazufumi, E-mail: kazufumi@dokkyomed.ac.jp [Department of Radiology, Dokkyo Medical University Graduate School of Medicine 880, Kitakobayashi, Mibu-cho, Shimotsugagun, Tochigi, 321-0293 (Japan); Daisaki, Hiromitsu, E-mail: hdaisaki@gmail.com [Division of Cancer Screening, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045 (Japan); Nishiyama, Yuji, E-mail: t116052g@yokohama-cu.ac.jp [Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004 (Japan); Hata, Masaharu, E-mail: hatahata@yokohama-cu.ac.jp [Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004 (Japan); Inoue, Tomio, E-mail: sec229@yokohama-cu.ac.jp [Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004 (Japan)

    2013-01-15

    Purpose: The aim of this study is to ascertain role of respiratory-gated PET/CT for accurate diagnosis of pancreatic tumors. Materials and methods: Prior to clinical study, the phantom study was performed to evaluate the impact of respiratory motion on lesion quantification. Twenty-two patients (mean age 65 years) with pancreatic tumors were enrolled. Pathological diagnoses by surgical specimens consisted of pancreatic cancer (n = 15) and benign intraductal papillary mucinous neoplasm (IPMN, n = 7). Whole-body scan of non-respiratory-gated PET/CT was performed at first, and subsequent respiratory-gated PET/CT for one bed position was performed. All PET/CT studies were performed prior to surgery. The SUV max obtained by non-respiratory-gated PET/CT and respiratory-gated PET/CT, and percent difference in SUVmax (%SUVmax) were compared. Results: The profile curve of 5 respiratory bin image was most similar to that of static image. The third bin of 5 respiratory bin image showed highest FWHM (24.0 mm) and FWTM (32.7 mm). The mean SUVmax of pancreatic cancer was similar to that of benign IPMN on non-respiratory-gated PET/CT (p = 0.05), whereas significant difference was found between two groups on respiratory-gated PET/CT (p = 0.016). The mean %SUV of pancreatic cancer was greater than that of benign IPMN (p < 0.0001). Identification of the primary tumor in pancreatic head (n = 13, 59%) was improved by using respiratory-gated PET/CT because of minimal affection of physiological accumulation in duodenum. Conclusion: Respiratory-gated PET/CT is a feasible technique for evaluation of pancreatic tumors and allows more accurate identification of pancreatic tumors compared with non-respiratory-gated PET/CT.

  13. {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.)

  14. 18F-DOPA PET/CT but not 68Ga-DOTA-TOC PET/CT revealed the underlying cause of ectopic Cushing syndrome.

    Science.gov (United States)

    Schalin-Jäntti, Camilla; Ahonen, Aapo; Seppänen, Marko

    2012-09-01

    F-DOPA PET/CT but not Ga-DOTA-TOC PET/CT revealed the cause of ectopic Cushing syndrome in a 61-year-old man. The patient presented with rapid weight gain, swollen legs, and sleep disturbances. Plasma potassium level was 2.7 mM (reference range, 3.3-4.9 mM), 24-hour urinary cortisol level was 13,124 nmol (reference range, 30-144 nmol), and plasma adrenocorticotropin level was 61 ng/L (reference range, TOC PET/CT, which is recommended as the first-line PET imaging, was performed, but it was not diagnostic. Imaging with F-DOPA PET/CT revealed the underlying cause.

  15. 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.

  16. 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...

  17. 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...

  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. 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.

  20. FDG-PET/CT can rule out malignancy in patients with vocal cord palsy

    DEFF Research Database (Denmark)

    Thomassen, Anders; Nielsen, Anne Lerberg; Lauridsen, Jeppe Kiilerich;

    2014-01-01

    The aim was to investigate the performance of (18)F-fluorodeoxyglucose PET/CT to rule out malignancy in patients with confirmed vocal cord palsy (VCP). Between January 2011 and June 2013, we retrospectively included consecutive patients referred to PET/CT with paresis or paralysis of one or both...

  1. FDG PET/CT features of ovarian metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, K., E-mail: kitajima@med.kobe-u.ac.j [Department of PET Diagnosis, Institute of Biomedical Research and Innovation, Kobe (Japan); Suzuki, K. [Department of PET Diagnosis, Institute of Biomedical Research and Innovation, Kobe (Japan); Senda, M. [Department of Molecular Imaging, Institute of Biomedical Research and Innovation, Kobe (Japan); Kita, M. [Department of Obsterics and Gynecology, Kobe City Medical Center General Hospital, Kobe (Japan); Onishi, Y.; Maeda, T.; Yoshikawa, T.; Ohno, Y.; Sugimura, K. [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan)

    2011-03-15

    Aim: To assess the characteristics of [{sup 18}F]-fluoro-2-deoxy-D-glucose (FDG) uptake in cases of ovarian metastasis using positron-emission tomography/computed tomography (PET/CT). Materials and methods: Twelve patients with 16 ovarian metastases arising from colon cancer (n = 6), breast cancer (n = 4), gastric cancer (n = 3), and pancreatic cancer (n = 3) who underwent FDG-PET/CT examination were included in this study. The effect of lesion size and morphological pattern (predominantly solid or cystic) on FDG uptake was evaluated using the quantitative standardized uptake value (SUV). Results: The mean maximum SUV for the 16 lesions was 4.6 {+-} 2.4 (range 1.8 {approx} 9.9). The Pearson correlation coefficient test showed no significant correlation between maximum SUV and lesion size (r = 0.21, p = 0.42). The maximum SUV of solid (n = 5) and cystic (n = 11) lesions was 5.5 {+-} 2.7 and 4.3 {+-} 2.2, respectively, and the difference was not significant (p = 0.43). Breast cancer showed the highest maximum SUV (6.4 {+-} 3.6), followed by colon cancer (5.3 {+-} 1.4), gastric cancer (3.3 {+-} 0.5), and pancreatic cancer (2.2 {+-} 0.6). Conclusion: Ovarian metastases show a variable maximum SUV with mild to intense FDG uptake.

  2. Hepatosplenic Candidiasis Detected by (18)F-FDG-PET/CT.

    Science.gov (United States)

    Albano, Domenico; Bosio, Giovanni; Bertoli, Mattia; Petrilli, Giulia; Bertagna, Francesco

    2016-01-01

    Hepatosplenic candidiasis is a fungal infection, which mostly affects patients with hematologic malignancies such as leukemia. The pathogenesis of this infection is not clear yet, and the liver is the most commonly affected organ. Diagnosis of hepatosplenic candidiasis can be only established via biopsy, since computed tomography (CT) scan, ultrasonography, and magnetic resonance imaging (MRI) yield non-specific results. The role of fluorine-18 fluorodeoxyglucose positron emission tomography /computed tomography ((18)F-FDG PET/CT) in diagnosis of hepatosplenic candidiasis remains undetermined, considering a few evidences in the literature. In this case report, we present the case of a 47-year-old patient, affected by acute myeloid leukemia, which was treated with three cycles of chemotherapy, resulting in the development of neutropenia and fever following the last cycle. The (18)F-FDG PET/CT scan showed some foci of intense FDG uptake in the liver and spleen. The subsequent diagnostic investigations (i.e., abdominal CT scan and biopsy) were suggestive of hepatosplenic candidiasis. The patient was started on antifungal treatment with fluconazole. After one month, the clinical conditions were resolved, and the subsequent abdominal CT scan was negative.

  3. Hepatosplenic Candidiasis Detected by 18F-FDG-PET/CT

    Science.gov (United States)

    Albano, Domenico; Bosio, Giovanni; Bertoli, Mattia; Petrilli, Giulia; Bertagna, Francesco

    2016-01-01

    Hepatosplenic candidiasis is a fungal infection, which mostly affects patients with hematologic malignancies such as leukemia. The pathogenesis of this infection is not clear yet, and the liver is the most commonly affected organ. Diagnosis of hepatosplenic candidiasis can be only established via biopsy, since computed tomography (CT) scan, ultrasonography, and magnetic resonance imaging (MRI) yield non-specific results. The role of fluorine-18 fluorodeoxyglucose positron emission tomography /computed tomography (18F-FDG PET/CT) in diagnosis of hepatosplenic candidiasis remains undetermined, considering a few evidences in the literature. In this case report, we present the case of a 47-year-old patient, affected by acute myeloid leukemia, which was treated with three cycles of chemotherapy, resulting in the development of neutropenia and fever following the last cycle. The 18F-FDG PET/CT scan showed some foci of intense FDG uptake in the liver and spleen. The subsequent diagnostic investigations (i.e., abdominal CT scan and biopsy) were suggestive of hepatosplenic candidiasis. The patient was started on antifungal treatment with fluconazole. After one month, the clinical conditions were resolved, and the subsequent abdominal CT scan was negative. PMID:27408899

  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. [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

  7. Management of Mucoepidermoid Carcinoma of the Palate Utilizing 18 F-FDG PET/CT

    Directory of Open Access Journals (Sweden)

    Sankaran Sudhakar

    2014-01-01

    Full Text Available Salivary gland carcinomas are a clinically diverse group of neoplasms with histological patterns overlapping other tumors, thus complicating their diagnosis. Mucoepidermoid carcinoma (MEC, first described by Masson and Berger in 1924, is a well-recognized salivary gland neoplasm, accounting for 5-10% of all salivary gland tumors. MEC frequently involves the major salivary glands and is rarely seen involving the jaws. The biological behavior of MEC is usually more aggressive with higher nodal and metastatic status at the time of presentation, which notably reduces the survival rate. Hence, early and accurate diagnosis utilizing advanced imaging modalities can reduce its morbidity. The present case is a rare presentation of MEC involving the palate, where (18 F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT was utilized for diagnosis and treatment.

  8. 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...

  9. Clinical utility of F-18 FDG PET-CT in the initial evaluation of lung cancer

    DEFF Research Database (Denmark)

    Madsen, Poul Henning; Holdgaard, Paw Christian; Christensen, Janne Buck;

    2016-01-01

    PURPOSE: Positron emission tomography-computed tomography (PET-CT) is a resource-demanding imaging modality with increasing popularity in the workup of patients with suspected or proven lung cancer. METHODS: To review the clinical usefulness of this imaging modality in the diagnosis, staging...... the predefined criteria and were read in full to identify relevant original articles on F-18 FDG PET-CT (1) in the evaluation of solitary pulmonary nodules (n = 14), (2) in curative-intent treatment trials (n = 9), and (3) in planning of invasive procedures (n = 18). RESULTS: We found the following important...... results from the literature review: 1) PET-CT can rule out malignancy in most solitary pulmonary nodules due to high sensitivity (recommendation level A). 2) PET-CT reduces the number of futile treatment trials (recommendation level A). 3) The sensitivity of PET-CT in general is insufficient to rule out...

  10. 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....

  11. Qualification of NCI-Designated Cancer Centers for Quantitative PET/CT Imaging in Clinical Trials.

    Science.gov (United States)

    Scheuermann, Joshua S; Reddin, Janet S; Opanowski, Adam; Kinahan, Paul E; Siegel, Barry A; Shankar, Lalitha K; Karp, Joel S

    2017-03-02

    The National Cancer Institute (NCI) developed the Centers for Quantitative Imaging Excellence (CQIE) initiative in 2010 to pre-qualify imaging facilities at all of the NCI-designated Comprehensive and Clinical Cancer Centers for oncology trials using advanced imaging techniques, including positron emission tomography (PET). This paper reviews the CQIE PET/CT (Computed Tomography) scanner qualification process and results in detail. Methods: Over a period of approximately 5 years, sites were requested to submit a variety of phantom, including uniform and ACR (American College of Radiology) phantoms, PET/CT images, as well as examples of clinical images. Submissions were divided into 3 distinct time points: initial submission (T0), followed by two requalification submissions (T1 and T2). Images were analyzed using standardized procedures and scanners received a pass or fail designation. Sites had the opportunity to submit new data for failed scanners. Quantitative results were compared: across scanners within a given time point and across time points for a given scanner. Results: 65 unique PET/CT scanners across 42 sites were submitted for CQIE T0 qualification, with 64 passing qualification. 44 (68%) of the scanners from T0 had data submitted for T2. From T0 to T2 the percentage of scanners passing the CQIE qualification on the first attempt rose from 38% in T1 to 67% in T2. The most common reasons for failure were: standardized uptake value (SUV) out of specifications, incomplete data submission and uniformity issues. Uniform phantom and ACR phantom results between scanner manufacturers are similar. Conclusion: The results of the CQIE process show that periodic requalification may decrease the frequency of deficient data submissions. The CQIE project also highlighted the concern within imaging facilities about the burden of maintaining different qualifications and accreditations. Finally, we note that for quantitative imaging-based trials the relationships between

  12. {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.)

  13. Dual time point 18FDG-PET/CT versus single time point 18FDG-PET/CT for the differential diagnosis of pulmonary nodules - A meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Li; Wang, Yinzhong [The First Clinical Medical School of Lanzhou Univ., Lanzhou, Gansu (China); Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou Univ., Lanzhou, Gansu (China); Lei, Junqiang; Tian, Jinhui; Zhai, Yanan [The First Clinical Medical School of Lanzhou Univ., Lanzhou, Gansu (China); Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou Univ., Lanzhou, Gansu (China); The First Hospital of Lanzhou Univ., Lanzhou, Gansu (China)

    2013-09-15

    Background: Lung cancer is one of the most common cancer types in the world. An accurate diagnosis of lung cancer is crucial for early treatment and management. Purpose: To perform a comprehensive meta-analysis to evaluate the diagnostic performance of dual time point 18F-fluorodexyglucose position emission tomography/computed tomography (FDG-PET/CT) and single time point 18FDG-PET/CT in the diagnosis of pulmonary nodules. Material and Methods: PubMed (1966-2011.11), EMBASE (1974-2011.11), Web of Science (1972-2011.11), Cochrane Library (-2011.11), and four Chinese databases; CBM (1978-2011.11), CNKI (1994-2011.11), VIP (1989-2011.11), and Wanfang Database (1994-2011.11) were searched. Summary sensitivity, summary specificity, summary diagnostic odds ratios (DOR), and summary positive likelihood ratios (LR+) and negative likelihood ratios (LR-) were obtained using Meta-Disc software. Summary receiver-operating characteristic (SROC) curves were used to evaluate the diagnostic performance of dual time point 18FDG-PET/CT and single time point 18FDG-PET/CT. Results: The inclusion criteria were fulfilled by eight articles, with a total of 415 patients and 430 pulmonary nodules. Compared with the gold standard (pathology or clinical follow-up), the summary sensitivity of dual time point 18FDG-PET/CT was 79% (95%CI, 74.0 - 84.0%), and its summary specificity was 73% (95%CI, 65.0-79.0%); the summary LR+ was 2.61 (95%CI, 1.96-3.47), and the summary LR- was 0.29 (95%CI, 0.21 - 0.41); the summary DOR was 10.25 (95%CI, 5.79 - 18.14), and the area under the SROC curve (AUC) was 0.8244. The summary sensitivity for single time point 18FDG-PET/CT was 77% (95%CI, 71.9 - 82.3%), and its summary specificity was 59% (95%CI, 50.6 - 66.2%); the summary LR+ was 1.97 (95%CI, 1.32 - 2.93), and the summary LR- was 0.37 (95%CI, 0.29 - 0.49); the summary DOR was 6.39 (95%CI, 3.39 - 12.05), and the AUC was 0.8220. Conclusion: The results indicate that dual time point 18FDG-PET/CT and single

  14. 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

  15. FDG PET/CT predictive role in follicular lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Lopci, Egesta [University Hospital S. Orsola-Malpighi Alma Mater Studiorum, Nuclear Medicine Department, Bologna (Italy); IRCCS, Humanitas (Rozzano), Nuclear Medicine Department, Milan (Italy); Zanoni, Lucia; Fonti, Cristina; Santi, Ivan; Fanti, Stefano [University Hospital S. Orsola-Malpighi Alma Mater Studiorum, Nuclear Medicine Department, Bologna (Italy); Chiti, Arturo [IRCCS, Humanitas (Rozzano), Nuclear Medicine Department, Milan (Italy); Zinzani, Pier Luigi [University Hospital S. Orsola, Department of Hematology ' ' L. Seragnoli' ' , Bologna (Italy)

    2012-05-15

    We present findings concerning {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET) at end-treatment evaluation in follicular lymphoma (FL) in order to establish possible predictive factors for progression-free survival (PFS) and patient outcome. We retrospectively analysed data from 91 consecutive FL patients (M:F = 51:40, mean age 61) referred to our PET Unit at therapy completion: 38 with an indolent form (grade 1-2) and 53 with an aggressive FL (grade 3a and b) according to the World Health Organization (WHO) classification. A total of 148 FDG PET/CT scans were analysed and findings reported as positive or negative for disease. The overall response to treatment was assessed according to the revised International Workshop Criteria (IWC). The final outcome was defined as remission or disease by taking clinical, instrumental and histological data as standards of reference, with a mean follow-up period of 3 years (range 1-8). A statistical analysis was performed with respect to PFS and patient outcome for FDG PET result, tumour grading, Follicular Lymphoma International Prognostic Index (FLIPI), disease stage and number of relapses, on uni- and multivariate analyses, with p < 0.05 considered as significant. Overall patients presented a mean PFS of 35 months (range 3-86), with a relapse rate of 42%. At final outcome, remission was achieved in 67 of 91 patients (74%). Of the different predictive factors, only FDG PET result significantly correlated with patient outcome (p = 0.0002). PET/CT performance at the end of treatment was as follows: 100% sensitivity, 99% specificity, 89% positive predictive value and 100% negative predictive value. The Kaplan-Meier analysis demonstrated a statistically significant correlation with PFS for FDG PET (p < 0.0001), FLIPI score (0-1 versus {>=}2) (p = 0.0451) and number of relapses (none versus {>=}1) (p = 0.0058). These findings were confirmed at the univariate analysis, whereas at the multivariate analysis only

  16. 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

  17. 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

  18. PET/CT Imaging and Radioimmunotherapy of Prostate Cancer

    DEFF Research Database (Denmark)

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

    2011-01-01

    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...... disease (ideal for antigen access and antibody delivery). Furthermore, prostate cancer is also radiation sensitive. Prostate-specific membrane antigen is expressed by virtually all prostate cancers, and represents an attractive target for RIT. Antiprostate-specific membrane antigen RIT demonstrates...... of anatomic, functional, and molecular imaging information. Positron emission tomography (PET)/computed tomography (CT) in oncology is emerging as an important imaging tool. The most common radiotracer for PET/CT in oncology, (18)F-fluorodeoxyglucose (FDG), is not very useful in the imaging of prostate cancer...

  19. 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.)

  20. PET/CT in the management of haematological malignancies

    DEFF Research Database (Denmark)

    Hutchings, Martin; Specht, Lena

    2008-01-01

    Positron emission tomography (PET)/computerised tomography (CT) has proved useful in a number of haematological malignancies, particularly in Hodgkin lymphoma (HL) and aggressive non-Hodgkin lymphomas (NHL). It is recommended in the staging of HL and aggressive NHL, it has been shown to be progno......Positron emission tomography (PET)/computerised tomography (CT) has proved useful in a number of haematological malignancies, particularly in Hodgkin lymphoma (HL) and aggressive non-Hodgkin lymphomas (NHL). It is recommended in the staging of HL and aggressive NHL, it has been shown...... to be prognostically important early during treatment, and it has been incorporated in the response criteria. However, treatment modification based on early scans is still experimental, and routine use in follow up cannot be recommended. The use of PET/CT in other lymphoma types and other haematological malignancies...

  1. PET-CT og kolorektal cancer - retrospektivt studie

    DEFF Research Database (Denmark)

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

    udredningen af primært metastaserende cancer. Patienterne henvises til PET-CT, når der klinisk rejses mistanke om recidiv i form af symptomer eller biokemiske markørstigninger. Alternativt, hvis CT- og MRscanning ikke kan afklare problemstillingen. På nuværende tidspunkt er der ingen klare retningslinjer for...... radioaktiviteten af 18F-FDG i et givent punkt på et bestemt tidspunkt sat i forhold til baggrunds FDG optagelsen i kroppens organer. PET integreres med CT-scanningen på standard software. Den samlede beskrivelse er i nærværende materiale sammenholdt med kliniske data. Patientmateriale: I perioden 1/9 2006 til 1...

  2. Clinical significance of VEGFR-2 and {sup 18}F-FDG PET/CT SUVmax pretreatment score in predicting the long-term outcome of patients with locally advanced rectal cancer treated with neoadjuvant therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sole, Claudio V. [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); Hospital General Universitario Gregorio Maranon, 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); Alvarez, Emilio; Peligros, Isabel [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); Garcia-Alfonso, Pilar [Hospital General Universitario Gregorio Maranon, Service of Medical Oncology, Madrid (Spain); Hospital General Universitario Gregorio Maranon, Institute for Sanitary Research, Madrid (Spain); Ferrer, Carlos; Ochoa, Enrique [Hospital Provincial de Castellon, Institute of Oncology, Castellon de la Plana (Spain); Herranz, Rafael [Hospital General Universitario Gregorio Maranon, Service of Radiation Oncology, 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)

    2013-10-15

    Vascular endothelial growth factor receptor-2 (VEGFR-2), epidermal growth factor receptor-1 (EGFR), and cyclooxygenase-2 (COX-2) stimulate key processes involved in tumor progression and are important targets for cancer drugs. {sup 18}F-FDG maximum standardized uptake value (SUVmax) is a marker of tumor metabolic activity. The purpose of this study was to measure SUVmax combined with VEGFR-2, EGFR and COX-2 proteins in pretreatment tumor biopsies from patients with locally advanced rectal cancer receiving intensive neoadjuvant treatment and to correlate the findings with clinical outcome. VEGFR-2, EGFR and COX-2 were measured using the immunoreactive score (IRS). SUVmax (median 8.4) was quantified in tumors with molecular overexpression (IRS {>=}3 + SUVmax {>=} 8.4 indicating active tumors; SUVmax <8.4 indicating inactive tumors). The Cox proportional hazards model was used to explore associations between tumor markers, disease-free survival (DFS) and overall survival (OS). The study group comprised 38 patients with a median follow-up of 69.3 months (range 4.5 - 92 months). Multivariate analysis showed that active tumors (overexpressing VEGFR-2, high SUVmax) were associated with worse DFS (HR 4.73, 95 % CI 1.18 - 22.17; p = 0.04) and OS (HR 4.28, 95 % CI 1.04 - 20.12; p = 0.05). Active tumors overexpressing VEGFR-2 are associated with a worse overall outcome in patients with rectal cancer treated with induction chemotherapy followed by pelvic chemoradiation and surgery. The optimal diagnostic cut-off level for this novel biomarker association should be investigated. Evaluation in a clinical trial is required to determine whether selected patients could benefit from a VEGFR-targeting drug. (orig.)

  3. 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

  4. 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

  5. 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

  6. Fourier-wavelet restoration in PET/CT brain studies

    Energy Technology Data Exchange (ETDEWEB)

    Knesaurek, Karin, E-mail: karin.knesaurek@mssm.edu [Division of Nuclear Medicine, The Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029 (United States)

    2012-10-11

    Our goal is to improve brain PET imaging through the application of a novel, hybrid Fourier-wavelet (WFT) restoration technique. The major limitation of PET studies is a relatively poor resolution in comparison with MRI and CT imaging and there is a need for improved PET imaging. A GE DLS PET/CT 16 slice system was used to acquire the studies. In order to create restoration filters the point source study was performed. The 6-fillable spheres and 3D Hoffman brain phantom studies were acquired and used to test and optimize the restoration approach. The patient data used in the study were acquired in a 3D PET mode, using the standard clinical protocol. Here, we have implemented Fourier-wavelet regularized restoration. In the Fourier domain, the inverse of modulation transfer function was multiplied by a Butterworth low-pass filter, order n=6 and cut-off frequency f=0.35 cycles/pixel. In addition, wavelet (Daubechies, order 2) noise suppression was applied by 'hard threshold'. Hot spheres and 3D Hoffman brain studies showed that the restoration process not only improves resolution and contrast but also improves quantification in 3D PET/CT imaging. The average contrast increase was 19% and the quantification improved in the range 8-20% depending on sphere size. In the restored images, there was no significant increase in noise when compared with the original images. The clinical studies followed brain phantom findings, i.e., the restored images had better contrast and resolution properties, when compared with the original images. The results of the study demonstrate that the quality and quantification of 3D brain {sup 18}F FDG PET images can be significantly improved by Fourier-wavelet (WFT) restoration filtering.

  7. 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.)

  8. {sup 18}F-FLT PET/CT as an imaging tool for early prediction of pathological response in patients with locally advanced breast cancer treated with neoadjuvant chemotherapy: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Crippa, Flavio; Padovano, Barbara; Alessi, Alessandra; Bombardieri, Emilio; Pascali, Claudio; Bogni, Anna [Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy). Nuclear Medicine Unit; Agresti, Roberto; Maugeri, Ilaria; Rampa, Mario; Martelli, Gabriele [Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy). Breast Surgery Unit; Sandri, Marco [Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy). Molecular Targeting Unit; Mariani, Gabriella; Bianchi, Giulia; De Braud, Filippo [Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy). Medical Oncology Unit; Carcangiu, Maria Luisa [Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy). Pathology Unit; Trecate, Giovanna [Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy). Radiology-RMI Unit

    2015-05-01

    We evaluated whether {sup 18}F-3'-deoxy-3'-fluorothymidine positron emission tomography (FLT PET) can predict the final postoperative histopathological response in primary breast cancer after the first cycle of neoadjuvant chemotherapy (NCT). In this prospective cohort study of 15 patients with locally advanced operable breast cancer, FLT PET evaluations were performed before NCT, after the first cycle of NCT, and at the end of NCT. All patients subsequently underwent surgery. Variables from FLT PET examinations were correlated with postoperative histopathological results. At baseline, median of maximum standardized uptake values (SUV{sub max}) in the groups showing a complete pathological response (pCR) + residual cancer burden (RCB) I, RCB II or RCB III did not differ significantly for the primary tumour (5.0 vs. 2.9 vs. 8.9, p = 0.293) or for axillary nodes (7.9 vs. 1.6 vs. 7.0, p = 0.363), whereas the Spearman correlation between SUV{sub max} and Ki67 proliferation rate index was significant (r = 0.69, p < 0.001). Analysis of the relative percentage change of SUV{sub max}in the primary tumour (∇SUVT{sub max}(t{sub 1})) and axillary nodes (∇SUVN{sub max}(t{sub 1})) after the first NCT cycle showed that the power of ∇SUVT{sub max}(t{sub 1}) to predict pCR + RCB I responses (AUC = 0.91, p < 0.001) was statistically significant, whereas ∇SUVN{sub max}(t{sub 1}) had a moderate ability (AUC = 0.77, p = 0.119) to separate subjects with ΔSUVT{sub max}(t{sub 1}) > -52.9 % into two groups: RCB III patients and a heterogeneous group that included RCB I and RCB II patients. A predictive score μ based on ΔSUVT{sub max}(t{sub 1}) and ΔSUVN{sub max}(t{sub 1}) parameters is proposed. The preliminary findings of the present study suggest the potential utility of FLT PET scans for early monitoring of response to NCT and to formulate a therapeutic strategy consistent with the estimated efficacy of NCT. However, these results in a small patient population

  9. 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.

  10. Extramedullary Involvement of Mast Cell Leukemia Detected by 18F-FDG PET/CT.

    Science.gov (United States)

    Fu, Zhanli; Zhang, Jin; Liu, Meng; Li, Ziao; Li, Qian

    2016-07-01

    Mast cell leukemia (MCL) is a very rare subtype of systemic mastocytosis, characterized by the leukemic expansion of immature mast cells. We present a case of MCL with extramedullary involvement of cervical lymph node and lung demonstrated by the initial F-FDG PET/CT scan. After a transient complete remission by induction chemotherapy and allogeneic hematopoietic stem cell transplantation, the follow-up PET/CT showed extensive extramedullary relapse involving multiple lymph nodes and small bowel. F-FDG PET/CT may be a useful tool to comprehensively stage and follow-up MCL.

  11. 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.

  12. Diagnosis of Bilateral Tonsil Cancers via Staging PET/CT: Case Report and Review

    Directory of Open Access Journals (Sweden)

    Edward M. Mannina

    2011-01-01

    Full Text Available Diagnostic workup of metastatic head and neck squamous cell carcinoma of unknown primary site has traditionally included CT and/or MRI imaging and endoscopic biopsies. Routine bilateral tonsillectomy is highly controversial and the role of PET/CT is evolving, both for identification of potential primary sites and the detection of distant metastases. We report a case of cervical nodal metastasis of squamous cell carcinoma from an unknown primary site, in which dual-modality PET/CT led to the unexpected diagnosis of synchronous bilateral tonsillar cancers. In addition, PET/CT correctly distinguished pulmonary sarcoidosis from metastatic disease in this patient.

  13. 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.

  14. 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.)

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

    DEFF Research Database (Denmark)

    Iagaru, Andrei; Mittra, Erik; Mosci, Camila;

    2012-01-01

    -FDG PET/CT. The 3 PET/CT scans were performed sequentially within 4 wk of one another for each patient. Results: 18F2/18FFDG PET/CT allowed for accurate interpretation of radiotracer uptake outside the skeleton, with findings similar to those of 18F-FDG PET/CT. In 19 participants, skeletal disease...... was more extensive on 18F2 PET/CT and 18F2/18F-FDG PET/CT than on 18F-FDG PET/CT. In another 29 participants, 18F2 PET/CT and 18F2/18F-FDG PET/CT showed osseous metastases where 18FFDG PET/CT was negative. The extent of skeletal lesions was similar in 18 participants on all 3 scans. Conclusion: This trial...

  16. FDG PET/CT for rectal carcinoma radiotherapy treatment planning: comparison of functional volume delineation algorithms and clinical challenges.

    Science.gov (United States)

    Withofs, Nadia; Bernard, Claire; Van der Rest, Catherine; Martinive, Philippe; Hatt, Mathieu; Jodogne, Sebastien; Visvikis, Dimitris; Lee, John A; Coucke, Philippe A; Hustinx, Roland

    2014-09-08

    PET/CT imaging could improve delineation of rectal carcinoma gross tumor volume (GTV) and reduce interobserver variability. The objective of this work was to compare various functional volume delineation algorithms. We enrolled 31 consecutive patients with locally advanced rectal carcinoma. The FDG PET/CT and the high dose CT (CTRT) were performed in the radiation treatment position. For each patient, the anatomical GTVRT was delineated based on the CTRT and compared to six different functional/metabolic GTVPET derived from two automatic segmentation approaches (FLAB and a gradient-based method); a relative threshold (45% of the SUVmax) and an absolute threshold (SUV > 2.5), using two different commercially available software (Philips EBW4 and Segami OASIS). The spatial sizes and shapes of all volumes were compared using the conformity index (CI). All the delineated metabolic tumor volumes (MTVs) were significantly different. The MTVs were as follows (mean ± SD): GTVRT (40.6 ± 31.28ml); FLAB (21.36± 16.34 ml); the gradient-based method (18.97± 16.83ml); OASIS 45% (15.89 ± 12.68 ml); Philips 45% (14.52 ± 10.91 ml); OASIS 2.5 (41.6 2 ± 33.26 ml); Philips 2.5 (40 ± 31.27 ml). CI between these various volumes ranged from 0.40 to 0.90. The mean CI between the different MTVs and the GTVCT was algorithms and the software products. The manipulation of PET/CT images and MTVs, such as the DICOM transfer to the Radiation Oncology Department, induced additional volume variations.

  17. 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

  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. Effect of Attenuation Correction on Regional Quantification Between PET/MR and PET/CT

    DEFF Research Database (Denmark)

    Teuho, Jarmo; Johansson, Jarkko; Linden, Jani;

    2016-01-01

    UNLABELLED: A spatial bias in brain PET/MR exists compared with PET/CT, because of MR-based attenuation correction. We performed an evaluation among 4 institutions, 3 PET/MR systems, and 4 PET/CT systems using an anthropomorphic brain phantom, hypothesizing that the spatial bias would be minimized...... with CT-based attenuation correction (CTAC). METHODS: The evaluation protocol was similar to the quantification of changes in neurologic PET studies. Regional analysis was conducted on 8 anatomic volumes of interest (VOIs) in gray matter on count-normalized, resolution-matched, coregistered data. On PET....../MR systems, CTAC was applied as the reference method for attenuation correction. RESULTS: With CTAC, visual and quantitative differences between PET/MR and PET/CT systems were minimized. Intersystem variation between institutions was +3.42% to -3.29% in all VOIs for PET/CT and +2.15% to -4.50% in all VOIs...

  1. 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.

  2. 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

    PURPOSE: 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......, performance status, BMI, and histopathology. CONCLUSION: 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....... 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...

  3. 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.

  4. (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

    BACKGROUND: The aim of this article is to illustrate the possible applications of (18)F-fluorodeoxyglucose positron emission tomography/computer tomography ((18)F-FDG PET/CT) in chronic extremity lymphedema and its complications. METHODS AND RESULTS: (18)F-FDG PET/CT findings in a rare case...... of Stewart-Treves Syndrome (STS), angiosarcoma secondary to chronic extremity lymphedema, are presented. Lymphedema of the extremities is a debilitating disease characterized by chronic swelling due to interstitial edema caused by insufficient lymphatic drainage capacity. Progression with skin thickening...... pretreatment staging is paramount. (18)F-FDG PET/CT is highly sensitive in detecting increased glucose metabolism as seen in many types of cancer and inflammation. The role of (18)F-FDG PET/CT in the management of lymphedema and its complications has to our knowledge yet to be described. This case documents...

  5. 18F-FDG-PET/CT in fever of unknown origin

    DEFF Research Database (Denmark)

    Middelbo Buch-Olsen, Karen; 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...... towards an organ not regarded by the clinicians as being related to the final diagnosis. It was perceived not helpful if the cause of fever was not visible on (18)F-FDG-PET/CT. We found (18)F-FDG-PET/CT helpful in 75% of patients, not helpful in 4%, and false positive in 21% of patients. CONCLUSION: (18)F...

  6. 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)

  7. Management of epithelial ovarian cancer from diagnosis to restaging: an overview of the role of imaging techniques with particular regard to the contribution of 18F-FDG PET/CT.

    Science.gov (United States)

    Musto, Alessandra; Grassetto, Gaia; Marzola, Maria Cristina; Rampin, Lucia; Chondrogiannis, Sotirios; Maffione, Anna Margherita; Colletti, Patrick M; Perkins, Alan C; Fagioli, Giorgio; Rubello, Domenico

    2014-06-01

    Epithelial ovarian carcinoma is a major form of cancer affecting women in the western world. The silent nature of this disease results in late presentation at an advanced stage in many patients. It is therefore important to assess the role of imaging techniques in the management of these patients. This article presents a review of the literature on the role of (18)F-FDG-PET/CT in the different stages of management of epithelial ovarian cancer. Moreover, a comparison with other imaging techniques has been made and the relationship between (18)F-PET/CT and the assay of serum CA-125 levels has been discussed.

  8. 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

  9. 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.

  10. 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

    and patients divided as follows: (A) Patients with a change in therapy following FDG-PET/CT and (B) Patients without a change following FDG-PET/CT. Sixty-two patients had colon and five had rectal cancer. Of these, 20 (30%; CI 20.2-41.7) belonged to group A, whereas 47 (70%; CI 58.3-79.8) fell in group B...

  11. Extensive Invasive Extramammary Paget Disease Evaluated by F-18 FDG PET/CT

    OpenAIRE

    Li, Zu-Gui; Qin, Xiao-Jing

    2015-01-01

    Abstract Extramammary Paget disease (EMPD) is a rare cutaneous, intraepithelial adenocarcinoma. Because of its rarity, little is known about the value of fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in evaluating this disease. Our case report aims to increase current knowledge of FDG PET/CT in EMPD as a noninvasive imaging tool for assessing the extension of the disease and detecting distant metastases. We reported a 64-year-old Chinese man who presented ...

  12. 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.

  13. (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....

  14. Clinical utility of F-18 FDG PET-CT in the initial evaluation of lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Madsen, Poul Henning [Vejle Hospital, Department of Medicine, Division of Respiratory Medicine, Vejle (Denmark); Holdgaard, Paw Christian [Vejle Hospital, Department of Nuclear Medicine, Vejle (Denmark); Christensen, Janne Buck [Odense University Hospital/University of Southern Denmark, Department of Quality and Research/HTA, Odense University Hospital and Medical Research Library, Odense (Denmark); Hoeilund-Carlsen, Poul Flemming [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark)

    2016-10-15

    Positron emission tomography-computed tomography (PET-CT) is a resource-demanding imaging modality with increasing popularity in the workup of patients with suspected or proven lung cancer. To review the clinical usefulness of this imaging modality in the diagnosis, staging, and pre-operative evaluation, we conducted a systematic literature search, review, and quality assessment using the rapid evidence assessment toolkit and the Oxford Centre for Evidence-Based Medicine methodology. The literature search resulted in 4,208 records including 918 reviews, of which 139 met the predefined criteria and were read in full to identify relevant original articles on F-18 FDG PET-CT (1) in the evaluation of solitary pulmonary nodules (n = 14), (2) in curative-intent treatment trials (n = 9), and (3) in planning of invasive procedures (n = 18). We found the following important results from the literature review: (1) PET-CT can rule out malignancy in most solitary pulmonary nodules due to high sensitivity (recommendation level A). (2) PET-CT reduces the number of futile treatment trials (recommendation level A). (3) The sensitivity of PET-CT in general is insufficient to rule out mediastinal lymph node metastasis (recommendation level A). (1) With few exceptions, solitary pulmonary nodules can safely be considered benign if the PET-CT scan is negative. Exceptions consist of small (<1 cm) and non-solid, solitary pulmonary nodules. These abnormalities should be followed up by CT in a structured programme. (2) No curative-intent treatment should be commenced until a PET-CT scan has excluded occult distant metastases. (3) In general, lymph node metastasis in the mediastinum cannot be ruled out on the basis of a negative PET-CT, and confirmative invasive staging should be performed in most patients before mediastinal metastasis is confirmed or ruled out. (orig.)

  15. Oncological patient anxiety in imaging studies: the PET/CT example

    OpenAIRE

    Abreu, Carla; Grilo, Ana Monteiro; Lucena, Filipa; Carolino, Elisabete

    2016-01-01

    The purpose of this study was to investigate the subjective perception of anxiety pre- and post-procedure, and explore the relationship between demographic, clinical variables and cancer patients' anxiety during a positron emission tomography/computed tomography (PET/CT) scan. Two hundred and thirty-two oncological out patients, with clinical indication for performing an (18)F-2-fluoro-2-deoxy-D-glucose ((18)F-FDG) PET/CT scan and attending a nuclear medicine (NM) department, participated in ...

  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. Effective doses associated with PET-CT scans two common in pediatric patients; Dosis efectivas asociadas a dos exploraciones PET-CT habituales en pacientes pediatricos

    Energy Technology Data Exchange (ETDEWEB)

    Camacho Lopez, C.; Garcia Martinez, M. t.; Marti Vidal, J. f.; Falgas Lacuela, M.; Vercher Conejero, J. L.

    2011-07-01

    The main objective of this paper is to outline the effective dose (E) that can be given in two studies conducted PET-CT common for children, in the absence of standard protocols both at standardizing the way image acquisition in this field, as standard levels to guide us when it comes to associate a certain effective dose to pediatric PET-CT scan. These doses will be compared to an adult patient receiving the same type of examination, and consider the percentage of the total dose due to TC.

  18. 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.)

  19. 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

  20. 68Ga-DOTA-NOC PET/CT detects somatostatin receptors expression in von hippel-lindau cerebellar disease.

    Science.gov (United States)

    Ambrosini, Valentina; Campana, Davide; Allegri, Vincenzo; Opocher, Giuseppe; Fanti, Stefano

    2011-01-01

    A case of Von-Hippel Lindau (VHL) disease has been studied using 68Ga-DOTA-NOC PET/CT. PET/CT demonstrated the presence of somatostatin receptors within 2 focal areas in the cerebellum corresponding to the lesions detected by MRI. Considering the heterogeneous lesions localizations in VHL disease, PET/CT may be a useful imaging modality for diagnosing lesions of central nervous system and neuroendocrine lesions and for direct demonstration of somatostatin receptors for targeted treatment.

  1. {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

  2. 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.

  3. 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.)

  4. 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.)

  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. Incidental thyroid lesions detected by FDG-PET/CT: prevalence and risk of thyroid cancer

    Directory of Open Access Journals (Sweden)

    Kim Sung

    2009-08-01

    Full Text Available Abstract Background Incidentally found thyroid lesions are frequently detected in patients undergoing FDG-PET/CT. The aim of this study was to investigate the prevalence of incidentally found thyroid lesions in patients undergoing FDG-PET/CT and determine the risk for thyroid cancer. Methods FDG-PET/CT was performed on 3,379 patients for evaluation of suspected or known cancer or cancer screening without any history of thyroid cancer between November 2003 and December 2005. Medical records related to the FDG-PET/CT findings including maximum SUV(SUVmax and pattern of FDG uptake, US findings, FNA, histopathology received by operation were reviewed retrospectively. Results Two hundred eighty five patients (8.4% were identified to have FDG uptake on FDG-PET/CT. 99 patients with focal or diffuse FDG uptake underwent further evaluation. The cancer risk of incidentally found thyroid lesions on FDG-PET/CT was 23.2% (22/99 and the cancer risks associated with focal and diffuse FDG uptake were 30.9% and 6.4%. There was a significant difference in the SUVmax between the benign and malignant nodules (3.35 ± 1.69 vs. 6.64 ± 4.12; P max and the size of the cancer. Conclusion The results of this study suggest that incidentally found thyroid lesions by FDG-PET/CT, especially a focal FDG uptake and a high SUV, have a high risk of thyroid malignancy. Further diagnostic work-up is needed in these cases.

  7. 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.

  8. A rare case of mucinous cystadenoma of the lung mimicking malignancy at 18F-FDG PET/CT.

    Science.gov (United States)

    Cafarotti, Stefano; Treglia, Giorgio; Bongiovanni, Massimo; Ceriani, Luca; Paone, Gaetano; Giovanella, Luca; Dutly, André

    2014-06-01

    We describe a rare case of pulmonary mucinous cystadenoma (PMCA) detected F-FDG PET/CT and mimicking a malignancy. A 60-year-old female patient underwent F-FDG PET/CT for metabolic characterization of a left pulmonary nodule which showed increased F-FDG uptake (SUVmax = 3.7). Based on this PET/CT finding, the patient underwent a cuneiform resection of the left pulmonary nodule. Histology demonstrated the presence of a PMCA. In our case, F-FDG PET/CT has been useful in detecting this rare pulmonary tumor.

  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. FDG-PET/CT Findings in a Patient with Polymyalgia Rheumatica and Accompanying Remitting Seronegative Symmetrical Synovitis with Pitting Edema

    DEFF Research Database (Denmark)

    Emamifar, Amir; Hess, Søren; Jørgensen, Erik Øster

    2016-01-01

    , but here we report a case with F-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) findings of polymyalgia rheumatica (PMR) in a patient with RS3PE and suspected of paraneoplastic syndrome. Objectives: To briefly report the potential of FDG-PET/CT in rheumatic settings......-PET/CT findings showed no evidence of malignant disease. There was diffusely increased FDG in soft tissue around the shoulders and hips and FDG-positive axillary lymph nodes consistent with PMR. Conclusions: RS3PE and PMR may belong to the same clinical entity. FDG-PET/CT has a potential role in the management...

  12. 基于体表定位的PET/CT/MRI"二机三维"图像融合的数字化对照%Evaluation of 3D Image Fusion between PET, CT and MRI Based on Somatotopic Localization

    Institute of Scientific and Technical Information of China (English)

    彭鳒侨; 卢永辉; 李颖; 李新春; 朱巧洪; 刘襄平; 成功

    2011-01-01

    Purpose:Attempt a localization registration approach of 2- Dimension (2D) images based on somatotopic localization to achieve accurate fusion of 3- Dimension (3D) images from modalities of PET,CT and MR one by one. Methods: The original data of PET, CT and MR were converted into digital format after input. Cubic localization solution of“9 - point & 3 - plane” was designed for registration. Image fusion was completed at a real - time workstation Mimics based on auto - fusing style of information exchanged by signal overlaid technique. Results: The fused cubic images of cross modality from CT + MR,PET + MR and PET + CT were mutually practiced on cranium, chest and knee samples from lung cancer patients. Distinct complementary images of simultaneously distinguishing pathological changes nature and location between soft and hard tissue were created. Conclusion:This advanced digital algorithm for cross modality fusion is of clinical significance to improve early diagnosis and differential diagnosis, although the cross modality processing is not completely through concurrently as single modality PET + CT, this experiment will provide experience drawn on invention of CT + MRI or PET + MR single modality equipment for medical imaging enterprise in development.%目的:尝试一种基于体表定位的二维图像配准方法,逐一实现PET、MRI和CT异机图像之间的精确三维融合.方法:输入PET/CT/MRI原始数据后采用数字化格式转换,设计"9点3面"立体定位法进行配准,在实时工作站Mimics按照信息交互自动融合模式,通过讯号叠加技术完成图像融合.结果:以肺癌患者的头、胸、膝为实例交叉试验CT+MRI、PET+MRI和PET+CT立体图像的异机融合,生成了分辨软、硬组织病变性质和位置的清晰互补影像.结论:这种先进的数字化融合算法对提高早期诊断和鉴别诊断具有临床意义,虽然异机融合工序目前尚未像PET+CT的同机融合那样完全成熟,但这一

  13. 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

  14. 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.)

  15. 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.

  16. Multimodal target correction by local bone registration: a PET/CT evaluation.

    Science.gov (United States)

    Oliveira-Santos, Thiago; Weitzel, Thilo; Klaeser, Bernd; Krause, Thomas; Nolte, Lutz-Peter; Weber, Stefan; Reyes, Mauricio

    2010-01-01

    PET/CT guidance for percutaneous interventions allows biopsy of suspicious metabolically active bone lesions even when no morphological correlation is delineable in the CT images. Clinical use of PET/CT guidance with conventional step-by-step technique is time consuming and complicated especially in cases in which the target lesion is not shown in the CT image. Our recently developed multimodal instrument guidance system (IGS) for PET/CT improved this situation. Nevertheless, bone biopsies even with IGS have a trade-off between precision and intervention duration which is proportional to patient and personnel exposure to radiation. As image acquisition and reconstruction of PET may take up to 10 minutes, preferably only one time consuming combined PET/CT acquisition should be needed during an intervention. In case of required additional control images in order to check for possible patient movements/deformations, or to verify the final needle position in the target, only fast CT acquisitions should be performed. However, for precise instrument guidance accounting for patient movement and/or deformation without having a control PET image, it is essential to be able to transfer the position of the target as identified in the original PET/CT to a changed situation as shown in the control CT.

  17. 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.

  18. 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

    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......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.......0% of cases. During the study period, there was a steep increase in the national use of FDG and in the European use of PET/CT. CONCLUSIONS: We recorded a constantly increasing use of PET/CT that caused a change in diagnosis and/or staging and/or treatment plan in 36.0% of cases. In line with national...

  19. Role of FDG-PET and PET/CT in the diagnosis and management of vasculitis

    Energy Technology Data Exchange (ETDEWEB)

    Zerizer, Imene; Tan, Kathryn; Khan, Sameer; Barwick, Tara [Department of Nuclear Medicine, Imperial College Healthcare, Hammersmith Hospital, Du Cane Road, London (United Kingdom); Marzola, Maria Cristina [Department of Nuclear Medicine, PET/CT Centre, Radiology and Medical Physics, ' Santa Maria della Misericordia' Hospital, Rovigo (Italy); Rubello, Domenico [Department of Nuclear Medicine, PET/CT Centre, Radiology and Medical Physics, ' Santa Maria della Misericordia' Hospital, Rovigo (Italy)], E-mail: domenico.rubello@libero.it; Al-Nahhas, Adil [Department of Nuclear Medicine, Imperial College Healthcare, Hammersmith Hospital, Du Cane Road, London (United Kingdom)

    2010-03-15

    Purpose: to investigate the role of FDG-PET and PET/CT in the evaluation of vasculitis. Materials and methods: a systematic revision of the papers published in PubMed/Medline until December 2009 was done. Results: FDG-PET and PET/CT have been proven to be valuable in the diagnosis of large-vessel vasculitis, especially giant cells arteritis with sensitivity values ranging 77% to 92%, and specificity values ranging 89% to 100%. In particular, FDG-PET/CT has demonstrated the potential to non-invasively diagnose the onset of the vasculitis earlier than traditional anatomical imaging techniques, thus enabling prompt treatment. False positive results mainly occur in the differential diagnosis between vasculitis and atherosclerotic vessels in elderly patients. Another area where FDG-PET/CT is gaining wider acceptance is in monitoring response to therapy; it can reliably detect the earliest changes of disease improvement post-therapy, and persistent activity is an indicator of non-responders to therapy. A few data have been reported about medium/small vessel vasculitis. Discussion: FDG-PET and PET/CT have proven utility: (a) in the initial diagnosis of patients suspected of having vasculitis particularly in those who present with non-specific symptoms; (b) in the identification of areas of increased FDG uptake in which a biopsy should be done for obtaining a diagnosis; (c) in evaluating the extent of the disease; (d) in assessing response to treatment.

  20. 18F-FDG PET/CT and primary hepatic MALT: a case series.

    Science.gov (United States)

    Albano, Domenico; Giubbini, Raffaele; Bertagna, Francesco

    2016-10-01

    Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is an extremely rare disease and its glucidic metabolic behavior is not clear. We retrospectively analyzed five patients with histological diagnosis of primary hepatic MALT lymphoma who underwent twelve 18F-FDG PET/CT. All staging 18F-FDG PET/CT were positive showing 18F-FDG uptake (average SUVmax was 5.62 ± 1.6) at the corresponding liver lesion. 18F-FDG PET/CT also was useful in evaluating the complete metabolic response after chemotherapy in three patients and radiotherapy in two. Besides, in one patient 18F-FDG PET/CT detected disease relapse during follow-up. Despite the low number of patients, our case series shows the 18F-FDG avidity of hepatic MALT and the possible role of 18F-FDG PET/CT in the management of these patients, both for staging, treatment response evaluation and restaging. Further studies are needed to confirm our results.

  1. 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)

  2. 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.

  3. Distilling complexity to advance cardiac tissue engineering

    OpenAIRE

    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 repa...

  4. 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.

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    Wahl Andreas

    2011-05-01

    Full Text Available Abstract Background 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. Methods 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. Results 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

  8. 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)

  9. Clinical value of FDG-PET/CT in suspected paraneoplastic syndromes

    DEFF Research Database (Denmark)

    Kristensen, Stine Bjørn; Hess, Søren; Petersen, Henrik

    2015-01-01

    examined the value of FDG-PET/CT for ruling in or out malignancy in a heterogeneous group of patients with suspected PNS. METHODS: We retrospectively extracted data from all patients referred 2009-2013 with suspected PNS. Data included age, sex, follow-up period, scan report, further diagnostic procedures...... true positives, 22 false positives, 103 true negatives, and three false negatives. Corresponding diagnostic values were: sensitivity 75 %, specificity 82 %, accuracy 82 %, and positive and negative predictive values of 29 % and 97 %, respectively. CONCLUSION: FDG-PET/CT has in patients with suspected...... PNS an impressively high negative predictive value and may be of value in ruling out PNS, the more so, the more the number of false positives can be minimized or used in differential diagnosis. We believe that FDG-PET/CT may become an important adjunct to the work-up and triage of patients...

  10. 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.)

  11. 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.

  12. 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....

  13. Brain tissue segmentation in PET-CT images using probabilistic atlas and variational Bayes inference.

    Science.gov (United States)

    Xia, Yong; Wang, Jiabin; Eberl, Stefan; Fulham, Michael; Feng, David Dagan

    2011-01-01

    PET-CT provides aligned anatomical (CT) and functional (PET) images in a single scan, and has the potential to improve brain PET image segmentation, which can in turn improve quantitative clinical analyses. We propose a statistical segmentation algorithm that incorporates the prior anatomical knowledge represented by probabilistic brain atlas into the variational Bayes inference to delineate gray matter (GM), white matter (WM) and cerebrospinal fluid (CSF) in brain PET-CT images. Our approach adds an additional novel aspect by allowing voxels to have variable and adaptive prior probabilities of belonging to each class. We compared our algorithm to the segmentation approaches implemented in the expectation maximization segmentation (EMS) and statistical parametric mapping (SPM8) packages in 26 clinical cases. The results show that our algorithm improves the accuracy of brain PET-CT image segmentation.

  14. 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.

  15. 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

    groups: (1) patients suitable for radical hysterectomy including lymph node dissection and (2) patients referred to combined chemo/radiation therapy. The results were compared to histopathological findings and/ or follow-up. RESULTS: Twenty-seven patients underwent radical surgery; four of these had PET......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 scans revealing pathological foci in the pelvis. Three (11%) were true positive; one was false positive. Twenty-two patients had true negative PET/CT scans concerning pelvic lymph nodes. One patient had a false negative node. For these patients, we found the positive predictive value (PPV) to be 75...

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

    Directory of Open Access Journals (Sweden)

    Júlio Brandão Guimarães

    2015-06-01

    Full Text Available Abstract 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.

  17. 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.

  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. 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.

  20. Combined SPECT/CT and PET/CT for breast imaging

    Energy Technology Data Exchange (ETDEWEB)

    Russo, Paolo [Università di Napoli Federico II, Dipartimento di Fisica, Via Cintia, Naples I-80126 (Italy); INFN Sezione di Napoli, Via Cintia, Naples I-80126 (Italy); Larobina, Michele [Istituto di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, Via Tommaso De Amicis, 95, Naples I-80145 (Italy); Di Lillo, Francesca [Università di Napoli Federico II, Dipartimento di Fisica, Via Cintia, Naples I-80126 (Italy); INFN Sezione di Napoli, Via Cintia, Naples I-80126 (Italy); Del Vecchio, Silvana [Università di Napoli Federico II, Dipartimento di Scienze Biomediche Avanzate, Via Pansini, 5, Naples I-80131 (Italy); Mettivier, Giovanni, E-mail: mettivier@na.infn.it [Università di Napoli Federico II, Dipartimento di Fisica, Via Cintia, Naples I-80126 (Italy); INFN Sezione di Napoli, Via Cintia, Naples I-80126 (Italy)

    2016-02-11

    In the field of nuclear medicine imaging, breast imaging for cancer diagnosis is still mainly based on 2D imaging techniques. Three-dimensional tomographic imaging with whole-body PET or SPECT scanners, when used for imaging the breast, has performance limits in terms of spatial resolution and sensitivity, which can be overcome only with a dedicated instrumentation. However, only few hybrid imaging systems for PET/CT or SPECT/CT dedicated to the breast have been developed in the last decade, providing complementary functional and anatomical information on normal breast tissue and lesions. These systems are still under development and clinical trials on just few patients have been reported; no commercial dedicated breast PET/CT or SPECT/CT is available. This paper reviews combined dedicated breast PET/CT and SPECT/CT scanners described in the recent literature, with focus on their technological aspects.

  1. 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.

  2. 18F-FDG PET/CT in the evaluation of POEMS syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Alberti, M.A., E-mail: aalberti@bellvitgehospital.cat [Department of Neurology, Hospital Universitario de Bellvitge, C/Feixa Llarga s/n, 08907 L' Hospitalet de Llobregat, Barcelona (Spain); Martinez-Yelamos, S., E-mail: smartinezyelamos@bellvitgehospital.cat [Department of Neurology, Hospital Universitario de Bellvitge, C/Feixa Llarga s/n, 08907 L' Hospitalet de Llobregat, Barcelona (Spain); Fernandez, A., E-mail: alexfernandez@bellvitgehospital.cat [PET unit, IDI, Hospital Universitario de Bellvitge, C/Feixa Llarga s/n, 08907 L' Hospitalet de Llobregat, Barcelona (Spain); Vidaller, A., E-mail: avidaller@bellvitgehospital.cat [Department of Internal Medicine, Hospital Universitario de Bellvitge, C/Feixa Llarga s/n, 08907 L' Hospitalet de Llobregat, Barcelona (Spain); Narvaez, J.A., E-mail: jnarvaez@bellvitgehospital.cat [Department of Radiology, Hospital Universitario de Bellvitge, C/Feixa Llarga s/n, 08907 L' Hospitalet de Llobregat, Barcelona (Spain); Cano, L.M., E-mail: lcano@bellvitgehospital.cat [Department of Neurology, Hospital Universitario de Bellvitge, C/Feixa Llarga s/n, 08907 L' Hospitalet de Llobregat, Barcelona (Spain); Gamez, C., E-mail: cgamez@bellvitgehospital.cat [PET unit, IDI, Hospital Universitario de Bellvitge, C/Feixa Llarga s/n, 08907 L' Hospitalet de Llobregat, Barcelona (Spain); Martinez-Matos, J.A., E-mail: jmmatos@bellvitgehospital.cat [Department of Neurology, Hospital Universitario de Bellvitge, C/Feixa Llarga s/n, 08907 L' Hospitalet de Llobregat, Barcelona (Spain)

    2010-11-15

    In POEMS syndrome the identification and biopsy of an osteosclerotic lesion or a lymph node typical of Castleman's disease (CD) is essential to establish the diagnosis and plan appropriate treatment. We report four patients in whom the localisation and identification of diagnostic bone lesions or lymphadenopathies were guided by fluorodeoxyglucose positron emission tomography integrated with computerised tomography (FDG PET/CT). FDG PET/CT identified bone lesions not detected with other techniques in one patient, and revealed hypermetabolic characteristics in bone lesions or adenopathies in the others, thus guiding the diagnostic biopsy in those with hypermetabolism. In conclusion, FDG PET/CT may be useful in detecting and selecting bone lesions and lymph nodes for biopsy in patients with suspected POEMS syndrome.

  3. 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)

  4. 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.)

  5. Application of18F-FDG PET/CT in Rare Metastatic Locations of Esophageal Carcinoma

    Institute of Scientific and Technical Information of China (English)

    MA Lan; GUAN Dan; DING Qi-yong; SHU Yong-qian; LIU Lian-ke

    2015-01-01

    Background: Esophageal carcinoma is a kind of malignant tumor commonly seen in clinic. In recent years, positron emission tomography (PET)/CT can accurately locate the general tumor nidi and PET/CT detection is recommended to determine the clinical stages of esophageal carcinoma. The common metastatic locations of esophageal carcinoma include lymph nodes (including cervical, supraclavicular and celiac lymph nodes), lung, liver and bone. This study aimed to summarize the distribution and incidence of rare metastatic locations and the characteristics of 18F-FDG PET/CT image in patients with esophageal carcinoma. Methods:A total of 185 patients with esophageal carcinoma undergoing18F-FDG PET/CT detection in our hospital from August, 2009 to August, 2013 were collected to retrospectively analyze their clinical data. Metastatic nidi in rare locations were conifrmed according to the results of clinical evaluation, imageological methods and follow-up. Results:A total of 19 patients with esophageal carcinoma suffered from metastases in rare locations according to the18F-FDG PET/CT detection, with incidence of 10.27%. The rare locations included pleura (28.6%), peritoneum (23.8%), adrenal gland (1.6%), axillary lymph nodes (14.3%), nasal septum (4.8%), cerebellum (4.8%) and napes (4.8%). Conclusion:18F-FDG PET/CT detection can excellently detect the metastatic nidi in rare or uncommon locations and increase the accuracy of clinical staging and re-staging in patients with esophageal carcinoma, which has great guiding signiifcance for clinical therapy.

  6. {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.)

  7. 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

  8. Rare Sites of Metastases in Prostate Cancer Detected on Ga-68 PSMA PET/CT Scan—A Case Series

    Science.gov (United States)

    Dureja, Sugandha; Thakral, Parul; Pant, Vineet; Sen, Ishita

    2017-01-01

    Ga-68 labeled prostate-specific membrane antigen (PSMA) whole body PET/CT scan is a novel upcoming modality for the evaluation of prostate cancer. We present three cases of prostate cancer showing rare sites of metastases like brain, penis, and liver detected on Ga-68 PSMA PET/CT scan thus emphasizing its role in lesion detection and staging. PMID:28242977

  9. (18)F-FDG PET/CT Findings in Acute Epstein-Barr Virus Infection Mimicking Malignant Lymphoma

    DEFF Research Database (Denmark)

    Ørbæk, Mathilde; Graff, Jesper; Markova, Elena;

    2016-01-01

    We present a case demonstrating the diagnostic work-up and follow-up of a patient with acute Epstein-Barr virus (EBV) infection in which the clinical picture and imaging on (18)F-FDG PET/CT mimicked malignant lymphoma. Follow-up (18)F-FDG PET/CT scan in the patient performed 7 weeks after...

  10. Economical aspect of PET/CT-guided diagnosis of suspected infective endocarditis in a patient with implantable cardioverter-defibrillator.

    Science.gov (United States)

    Farkowski, Michal M; Milkowski, Maciej; Dziuk, Mirosław; Pytkowski, Mariusz; Marciniak, Marta; Kraska, Alicja; Szwed, Hanna; Sterlinski, Maciej

    2014-01-01

    We present a case report of potential reduction of hospitalization costs due to utilization of PET/CT in a diagnostic work-up of a patient with an implantable cardioverter-defibrillator and suspicion of infective endocarditis. The PET/CT scan would have shorten hospital stay, prevented clinical complications and reduced the cost of hospitalization by 45%.

  11. Value of 18F-FDG PET/CT in diagnosing chronic Q fever in patients with central vascular disease

    NARCIS (Netherlands)

    Hagenaars, J. C J P; Wever, P. C.; Vlake, A. W.; Renders, N. H M; van Petersen, A. S.; Hilbink, M.; De Jager-Leclercq, M. G L; Moll, F. L.; Koning, O. H J; Hoekstra, C. J.

    2016-01-01

    Background: The aim of this study is to describe the value of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in diagnosing chronic Q fever in patients with central vascular disease and the added value of18F-FDG PET/CT in the diagnostic combination s

  12. 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

  13. 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

  14. Feasibility of simultaneous PET/MR of the carotid artery: first clinical experience and comparison to PET/CT

    DEFF Research Database (Denmark)

    Ripa, Rasmus Sejersten; Knudsen, Andreas; Hag, Anne Mette Fisker;

    2013-01-01

    The study aimed at comparing PET/MR to PET/CT for imaging the carotid arteries in patients with known increased risk of atherosclerosis. Six HIV-positive men underwent sequential PET/MR and PET/CT of the carotid arteries after injection of 400 MBq of 18F-FDG. PET/MR was performed a median of 131 ...

  15. 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.

  16. PET/CT cardiology: an area whose boundaries are still out of sight

    Energy Technology Data Exchange (ETDEWEB)

    Lucignani, Giovanni [University of Milan and Unit of Molecular Imaging, Institute of Radiological Sciences, Division of Radiation Therapy, European Institute of Oncology, Milan (Italy)

    2006-05-15

    Positron emission tomography (PET) and X-ray computed tomography (CT) performed with PET/CT cameras allow us to obtain concurrently information on the presence and degree of alterations of myocardial perfusion and metabolism and on coronary arteries calcification. Furthermore, by gated myocardial perfusion studies, PET may provide crucial information on regional coronary blood flow reserve and endothelial dysfunction. A number of recent papers provide some insight on the potential of PET/CT in cardiology and in the assessment of various cardiovascular diseases including various types of vasculitis and metabolic diseases.

  17. 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)

  18. 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.)

  19. 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.

  20. 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

  1. Chondromyxoid fibroma of the rib mimics a chondrosarcoma on 18F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Makis, William (Dept. of Nuclear Medicine, Brandon Regional Health Centre, Brandon (Canada)), email: makisw79@yahoo.com; Ciarallo, Anthony; Lisbona, Robert (Dept. of Nuclear Medicine, Royal Victoria Hospital, McGill Univ. Health Centre, Montreal (Canada))

    2011-06-15

    Chondromyxoid fibroma (CMF) is a rare benign bone tumor of chondroid origin that occurs mostly in the metaphyses of long bones. CMF can occasionally mimic a chondrosarcoma on CT, and the literature on the 18F-FDG PET/CT imaging characteristics of CMF tumors is limited. In the presented case, a large histologically proven CMF chest wall mass was initially misinterpreted as a chondrosarcoma. This case highlights a potential pitfall in the PET/CT evaluation of these rare benign bone tumors

  2. 18F-FDG PET/CT diagnosis of vagus nerve neurolymphomatosis.

    Science.gov (United States)

    Tsang, Hailey Hoi Ching; Lee, Elaine Yuen Phin; Anthony, Marina-Portia; Khong, Pek-Lan

    2012-09-01

    A 62-year-old woman was in remission from previously treated stage IV diffuse large B-cell lymphoma with cranial involvement. She presented with new-onset hoarseness of voice and choking; MRI of the brain showed disease recurrence in the left cavernous sinus. She was subsequently referred for F-FDG PET/CT with contrast for further evaluation of lymphomatous recurrence. F-FDG PET/CT not only revealed hypermetabolic activity in the left cavernous sinus correlating to the MRI findings but also showed an interesting manifestation explaining the patient's hoarseness of voice, being neurolymphomatosis along the left vagus nerve.

  3. PET/CT imaging in response evaluation of patients with small cell lung cancer

    DEFF Research Database (Denmark)

    Fischer, Barbara M; Mortensen, Jann; Langer, Seppo W;

    2006-01-01

    UNLABELLED: There is an increasing amount of evidence on the usability of PET in response evaluation of non-small cell lung cancer. However, data on SCLC is scarce and mainly retrospective. This prospective study assesses the use of PET (positron emission tomography) and PET/CT in response...... evaluation of patients with small cell lung cancer (SCLC). METHODS: Assignment of early and final response was compared between PET, PET/CT, and CT in 20 patients with SCLC. Final response as assigned by CT (RECIST) served as reference. RESULTS: At response evaluation after one cycle of chemotherapy major...

  4. {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.)

  5. Mesenteric Panniculitis Demonstrated on 18F-FDG PET/CT.

    Science.gov (United States)

    Albano, Domenico; Bosio, Giovanni; Bertagna, Francesco

    2016-03-01

    Mesenteric panniculitis is an underdiagnosed inflammatory condition of unknown etiology that involves the mesenteric adipose tissue. Clinical symptoms are not specific (fever, abdominal pain, or nausea), so diagnosis is not simple. We report a case of 48-year-old man with abdominal pain and fever not responsive to antipyretics and antibiotics for 2 months, who underwent an F-FDG PET/CT after a nondiagnostic CT scan. PET/CT has proven to be a useful method for the diagnosis of mesenteric panniculitis in this patient, showing a uniformly high uptake of FDG in the mesenteric adipose tissue of the mesocolon, mesoappendix, mesosigmoid, and mesorectum.

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

    DEFF Research Database (Denmark)

    Dejanovic, Danijela; Alslev, Louise; Abrahamsson, Elisabeth;

    2016-01-01

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

  7. IgG4-Related Tubulointerstitial Nephritis Pattern in 18F-FDG PET/CT.

    Science.gov (United States)

    Bélissant, Ophélie; Guernou, Mohamed; Rouvier, Philippe; Compain, Caroline; Bonardel, Gérald

    2015-10-01

    A 17-year-old adolescent girl was admitted with chronic arthralgia, Raynaud phenomenon, pericarditis, and evidences of chronic diffuse inflammation. F-FDG PET/CT scan was performed to search systemic vasculitis and showed diffuse moderate uptake in the kidneys. We suggested the existence of a nephritis, but the ultrasonography result was normal, and no treatment was introduced. Another F-FDG PET/CT scan was performed 7 months later to explore abdominal pain. It showed again diffuse intense uptake in both kidneys. A proteinuria was highlighted, and renal biopsy allowed to diagnose IgG4-related disease.

  8. Pitfalls and artifacts in the interpretation of oncologic PET/CT of the chest

    Science.gov (United States)

    Meirelles, Gustavo de Souza Portes; Capobianco, Julia; de Oliveira, Marco Antônio Condé

    2017-01-01

    PET/CT is widely used for the evaluation of patients with thoracic malignancies. Although the levels of 18F-fluorodeoxyglucose (FDG) uptake are usually high in neoplastic diseases, they can also be physiological, due to artifacts. In addition, FDG uptake can occur in benign conditions such as infectious, inflammatory, and iatrogenic lesions. Furthermore, some malignant tumors, such as adenocarcinoma in situ (formerly known as bronchoalveolar carcinoma) and carcinoid tumors, may not show FDG uptake. Here, we illustrate the main pitfalls and artifacts in the interpretation of the results of oncologic PET/CT of the chest, outlining strategies for avoiding misinterpretation. PMID:28298733

  9. Cowden syndrome detected by FDG PET/CT in an endometrial cancer patient

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yun Hee; Lee, Hye Kyung [Eulji University Hospital, Daejeon (Korea, Republic of); Park, Geon [Dept. of Radiology, The Catholic University of Korea, Daejeon Saint Mary' s Hospital, Daejeon (Korea, Republic of)

    2016-09-15

    Cowden syndrome (CS) is a rare autosomal dominant disorder characterized by multiple hamartomas in various tissues and cancers (breast, thyroid, and endometrium). We report CS of the esophagus and gastrointestinal tract that was incidentally detected by positron emission tomography/computed tomography (PET/CT) at postoperative surveillance in an endometrial cancer patient. PET/CT showed mildly increased FDG uptake along the entire esophagus and stomach. Upper GI endoscopy and histologic examination revealed glycogenic acanthosis of the esophagus and several hundred gastric polyps. In our case, increased FDG uptake of the esophageal wall contributed to the diagnosis of CS.

  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. 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.)

  12. Inter-comparison of {sup 18}F-FDG PET/CT standardized uptake values in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hoon Hee [Department of Nuclear Medicine, Severance Hospital, Yonsei University Health System, Seoul 120-752 (Korea, Republic of); Park, Dae Sung [Department of Chonnam National University Hospital Heart Research Center, Gwangju 501-757 (Korea, Republic of); Kweon, Dae Cheol [Department of Radiology, Shinheung College, Kyungki 480-701 (Korea, Republic of); Lee, Sang Bock [Department of Radiology, Nambu University, 864-1, Wolgye-dong, Gwangsan-gu, Gwangju 506-706 (Korea, Republic of); Oh, Ki Baek; Lee, Jong Doo [Department of Nuclear Medicine, Severance Hospital, Yonsei University Health System, Seoul 120-752 (Korea, Republic of); Jin, Gye Hwan, E-mail: ghjin@nambu.ac.k [Department of Radiology, Nambu University, 864-1, Wolgye-dong, Gwangsan-gu, Gwangju 506-706 (Korea, Republic of)

    2011-01-15

    The number of PET/CT tests for diagnosing and treating tumors are increasing every year, and thus it is considered necessary to compare PET/CT images among medical institutions or among different PET/CT systems within the same medical institution. We present to get the variation of standardized uptake values (SUV) among PET/CT systems, to derive an SUV calibration table that enables quantitative comparison of PET/CT systems, and to test the usefulness of the calibration table through comparing patient's SUV with the SUV calibration table. The correlation coefficients that inter-compared the calibration constants of normal patients and the calibration constants of the mean standardized uptake value with the calibration constants of the standardized uptake value of phantom are 0.88938 (P<0.0001).

  13. Rheumatic fever: a forgotten but still existing cause of fever of unknown origin detected on FDG PET/CT.

    Science.gov (United States)

    Sathekge, Mike; Stoltz, Anton; Gheysens, Olivier

    2015-03-01

    We present a case of heterogeneous and strongly increased myocardial and valvular 18F-FDG uptake on 18F-FDG PET/CT in an HIV-positive patient with productive cough, fever, weight loss, and progressive dyspnea for 6 months. Contrast-enhanced CT did not reveal the cause of fever, but hyperechogenic valvular lesions on echocardiography in combination with PET/CT findings are suggestive of endocarditis/myocarditis. Postmortem histology 3 weeks after PET/CT showed Aschoff bodies with Anitschkow cells, pathognomonic for rheumatic carditis. This case illustrates that rheumatic heart disease can be detected on 18F-FDG PET/CT and demonstrates the value of 18F-FDG PET/CT in patients with fever of unknown origin.

  14. 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

  15. 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.)

  16. 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.

  17. 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.

  18. Diffuse Large B-Cell Lymphoma: Prospective Multicenter Comparison of Early Interim FLT PET/CT versus FDG PET/CT with IHP, EORTC, Deauville, and PERCIST Criteria for Early Therapeutic Monitoring.

    Science.gov (United States)

    Minamimoto, Ryogo; Fayad, Luis; Advani, Ranjana; Vose, Julie; Macapinlac, Homer; Meza, Jane; Hankins, Jordan; Mottaghy, Felix; Juweid, Malik; Quon, Andrew

    2016-07-01

    Purpose To compare the performance characteristics of interim fluorine 18 ((18)F) fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) (after two cycles of chemotherapy) by using the most prominent standardized interpretive criteria (including International Harmonization Project [IHP] criteria, European Organization for Research and Treatment of Cancer [EORTC] criteria, and PET Response Criteria in Solid Tumors (PERCIST) versus those of interim (18)F fluorothymidine (FLT) PET/CT and simple visual interpretation. Materials and Methods This HIPAA-compliant prospective study was approved by the institutional review boards, and written informed consent was obtained. Patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) underwent both FLT and FDG PET/CT 18-24 days after two cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone or rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin. For FDG PET/CT interpretation, IHP criteria, EORTC criteria, PERCIST, Deauville criteria, standardized uptake value, total lesion glycolysis, and metabolic tumor volume were used. FLT PET/CT images were interpreted with visual assessment by two reviewers in consensus. The interim (after cycle 2) FDG and FLT PET/CT studies were then compared with the end-of-treatment FDG PET/CT studies to determine which interim examination and/or criteria best predicted the result after six cycles of chemotherapy. Results From November 2011 to May 2014, there were 60 potential patients for inclusion, of whom 46 patients (24 men [mean age, 60.9 years ± 13.7; range, 28-78 years] and 22 women [mean age, 57.2 years ± 13.4; range, 25-76 years]) fulfilled the criteria. Thirty-four patients had complete response, and 12 had residual disease at the end of treatment. FLT PET/CT had a significantly higher positive predictive value (PPV) (91%) in predicting residual disease than did any FDG PET/CT interpretation method

  19. FDG-PET and PET/CT in the diagnostic work-up of breast cancer; FDG-PET und PET/CT in der Diagnostik des Mammakarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Haug, A.; Tiling, R. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum Innenstadt, Ludwig-Maximilians-Univ. Muenchen (Germany)

    2006-09-15

    . Nevertheless, it has to be proven in further prospective studies, if PET will be able to replace conventional imaging modalities like X-ray, ultrasound, CT or MRI. Certainly, combined PET/CT can improve sensitivity and specificity. (orig.)

  20. Strategy study of quantification harmonization of SUV in PET/CT images; Estudo da estrategia de harmonizacao da quantificacao do SUV em imagens de PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Andreia Caroline Fischer da Silveira

    2014-07-01

    In clinical practice, PET/CT images are often analyzed qualitatively by visual comparison of tumor lesions and normal tissues uptake; and semi-quantitatively by means of a parameter called SUV (Standardized Uptake Value). To ensure that longitudinal studies acquired on different scanners are interchangeable, and information of quantification is comparable, it is necessary to establish a strategy to harmonize the quantification of SUV. The aim of this study is to evaluate the strategy to harmonize the quantification of PET/CT images, performed with different scanner models and manufacturers. For this purpose, a survey of the technical characteristics of equipment and acquisition protocols of clinical images of different services of PET/CT in the state of Rio Grande do Sul was conducted. For each scanner, the accuracy of SUV quantification, and the Recovery Coefficient (RC) curves were determined, using the reconstruction parameters clinically relevant and available. From these data, harmonized performance specifications among the evaluated scanners were identified, as well as the algorithm that produces, for each one, the most accurate quantification. Finally, the most appropriate reconstruction parameters to harmonize the SUV quantification in each scanner, either regionally or internationally were identified. It was found that the RC values of the analyzed scanners proved to be overestimated by up to 38%, particularly for objects larger than 17mm. These results demonstrate the need for further optimization, through the reconstruction parameters modification, and even the change of the reconstruction algorithm used in each scanner. It was observed that there is a decoupling between the best image for PET/CT qualitative analysis and the best image for quantification studies. Thus, the choice of reconstruction method should be tied to the purpose of the PET/CT study in question, since the same reconstruction algorithm is not adequate, in one scanner, for qualitative

  1. Indikationer for anvendelse af PET eller PET/CT hos patienter med brystkræft

    DEFF Research Database (Denmark)

    Bernsdorf, Mogens; Graff, Jesper

    2011-01-01

    PET and PET/CT, using 18F-fluoro-2-deoxy-D-glucose, are not suited for primary diagnostics of small tumours or lymph node metastases to the axilla. In return, the method has a high sensitivity and specificity regarding the detection of loco-regional recurrence and metastases to mediastinal lymph...

  2. 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.

  3. 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.

  4. Plasmacytoma of the ovary: additional role of 18F-FDG PET/CT.

    Science.gov (United States)

    Santhosh, Sampath; Mittal, Bhagwant Rai; Raveendran, Ainharan; Jain, Vanita; Nijhawan, Raje; Kumar, Ritesh; Bhattacharya, Anish; Sharma, Suresh C

    2013-05-01

    We report a case of ovarian plasmacytomas where 18F-FDG PET/CT helped in staging by demonstrating increased FDG uptake limited to the ovary, and hence, surgical treatment was carried out as the disease was localized to the ovary.

  5. 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

  6. 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.

  7. 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

    as a primary diagnostic procedure in breast cancer; but it has the potential to be useful for the detection of distant metastases and for monitoring response to chemotherapy in breast cancer patients. PET/CT should still be regarded as a supplement to conventional diagnostic procedures such as CT and MRI....

  8. 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.

  9. 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.

  10. PET/CT with intravenous contrast can be used for PET attenuation correction in cancer patients

    DEFF Research Database (Denmark)

    Berthelsen, A K; Holm, S; Loft, A

    2005-01-01

    correction, but this may result in a bias in the attenuation factors. The clinical significance of this bias has not been established. Our aim was to perform a prospective clinical study where each patient had CT performed with and without IV contrast agent to establish whether PET/CT with IV contrast can...

  11. Thyroid lymphoma on a background of Hashimoto's thyroiditis: PET/CT appearances.

    Science.gov (United States)

    Mane, Mayuresh; O'Neill, Ailbhe C; Tirumani, Sree Harsha; Shi, Min; Shinagare, Atul B; Fisher, David C

    2014-01-01

    Primary thyroid lymphoma is a rare thyroid tumor accounting for only 5% of all thyroid malignancies. It is more common in patients with a background history of chronic thyroiditis. PET/CT is helpful in the initial staging and for follow up to assess treatment response.

  12. 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

    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...

  13. [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

  14. Dual time-point FDG PET/CT and FDG uptake and related enzymes in lymphadenopathies

    DEFF Research Database (Denmark)

    Christlieb, Sofie Bæk; Strandholdt, Casper Nørgaard; Olsen, Birgitte Brinkmann;

    2016-01-01

    PURPOSE: The purpose of this study was to determine the ability of dual time-point (DTP) PET/CT with (18)F-FDG to discriminate between malignant and benign lymphadenopathies. The relationship between DTP FDG uptake and glucose metabolism/hypoxia markers in lymphadenopathies was also assessed. MET...

  15. 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

    of PET/CT in cancer patients: replacement of an invasive procedure, improved accuracy of initial diagnosis, improved accuracy of staging for curative versus palliative treatment, improved accuracy of staging for radiation versus chemotherapy, response evaluation, and acceleration of clinical decisions...

  16. 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

  17. [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.

  18. False positive 18F-FDG PET/CT due to inflamed concha bullosa.

    NARCIS (Netherlands)

    Arens, A.I.J.; Verbist, B.M.; Hendrickx, B.W.; Geus-Oei, L.F. de; Oyen, W.J.G.

    2012-01-01

    A 62-year-old woman with a history of breast cancer was referred for an (18)F-FDG PET/CT scan. She had an active upper respiratory infection at the time of examination. An FDG avid (SUV(max) = 7.7) middle turbinate was identified, correlating with an inflamed concha bullosa. A short review of concha

  19. Optimization of the protocols for the use of contrast agents in PET/CT studies.

    Science.gov (United States)

    Pelegrí Martínez, L; Kohan, A A; Vercher Conejero, J L

    The introduction of PET/CT scanners in clinical practice in 1998 has improved care for oncologic patients throughout the clinical pathway, from the initial diagnosis of disease through the evaluation of the response to treatment to screening for possible recurrence. The CT component of a PET/CT study is used to correct the attenuation of PET studies; CT also provides anatomic information about the distribution of the radiotracer. CT is especially useful in situations where PET alone can lead to false positives and false negatives, and CT thereby improves the diagnostic performance of PET. The use of intravenous or oral contrast agents and optimal CT protocols have improved the detection and characterization of lesions. However, there are circumstances in which the systematic use of contrast agents is not justified. The standard acquisition in PET/CT scanners is the whole body protocol, but this can lead to artifacts due to the position of patients and respiratory movements between the CT and PET acquisitions. This article discusses these aspects from a constructive perspective with the aim of maximizing the diagnostic potential of PET/CT and providing better care for patients.

  20. A new cubic phantom for PET/CT dosimetry: Experimental and Monte Carlo characterization

    Energy Technology Data Exchange (ETDEWEB)

    Belinato, Walmir [Departamento de Ensino, Instituto Federal de Educacao, Ciencia e Tecnologia da Bahia, Campus Vitoria da Conquista, Zabele, Av. Amazonas 3150, 45030-220 Vitoria da Conquista, BA (Brazil); Silva, Rogerio M.V.; Souza, Divanizia N. [Departamento de Fisica, Universidade Federal de Sergipe-UFS, Sao Cristovao, Sergipe (Brazil); Santos, William S.; Caldas, Linda V.E. [Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP, Av. Prof. Lineu Prestes, 2242, Cidade Universitaria, 05508-000 Sao Paulo SP (Brazil); Perini, Ana P.; Neves, Lucio P. [Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP, Av. Prof. Lineu Prestes, 2242, Cidade Universitaria, 05508-000 Sao Paulo SP (Brazil); Instituto de Fisica, Universidade Federal de Uberlandia, Caixa Postal 593, 38400-902, Uberlandia, MG (Brazil)

    2015-07-01

    In recent years, positron emission tomography (PET) associated with multidetector computed tomography (MDCT) has become a diagnostic technique widely disseminated to evaluate various malignant tumors and other diseases. However, during PET/CT examinations, the doses of ionizing radiation experienced by the internal organs of patients may be substantial. To study the doses involved in PET/CT procedures, a new cubic phantom of overlapping acrylic plates was developed and characterized. This phantom has a deposit for the placement of the fluorine-18 fluoro-2-deoxy-D-glucose ({sup 18}F-FDG) solution. There are also small holes near the faces for the insertion of optically stimulated luminescence dosimeters (OSLD). The holes for OSLD are positioned at different distances from the {sup 18}F-FDG deposit. The experimental results were obtained in two PET/CT devices operating with different parameters. Differences in the absorbed doses were observed in OSLD measurements due to the non-orthogonal positioning of the detectors inside the phantom. This phantom was also evaluated using Monte Carlo simulations, with the MCNPX code. The phantom and the geometrical characteristics of the equipment were carefully modeled in the MCNPX code, in order to develop a new methodology form comparison of experimental and simulated results, as well as to allow the characterization of PET/CT equipments in Monte Carlo simulations. All results showed good agreement, proving that this new phantom may be applied for these experiments. (authors)

  1. 64CuCl2 PET/CT imaging of mouse muscular injury induced by electroporation

    Science.gov (United States)

    Xie, Fang; Cai, Huawei; Peng, Fangyu

    2017-01-01

    Skeletal muscle injury is common in body injuries suffered in sports and car accidents. Development of new tracers is significant for assessing muscular injury with positron emission tomography/computed tomography (PET/CT) and monitoring repair of muscle injury in response to treatment. Copper is required for wound healing and increased copper ions were detected in the soft tissue of wound in rodents and human. Based on the recent finding of increased 64Cu uptake in the traumatic brain injury, this study aimed to explore use of 64CuCl2 as a radiotracer for molecular imaging of muscular injury using PET/CT. Focally increased 64Cu uptake by the injured muscular tissue (5.4 ± 1.2% ID/g) was detected in the C57BL/6 mice with electroporation-induced skeletal muscle injury by PET/CT after intravenous injection of 64CuCl2 as a tracer, compared to low 64Cu uptake associated with muscular inflammation induced by intramuscular injection of lipopolysaccharides (0.82 ± 0.26% ID/g, P < 0.01) or physiological 64Cu uptake of the non-injured muscular tissues (0.78 ± 0.20% ID/g, P < 0.01). The findings support further investigation of 64CuCl2 as a new radiotracer for molecular imaging of skeletal muscle injury using PET/CT. PMID:28123866

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

    Energy Technology Data Exchange (ETDEWEB)

    Robin, Philippe; Abgral, Ronan; Le Roux, Pierre-Yves; Keromnes, Nathalie; Palard, Xavier; Salaun, Pierre-Yves [University Hospital of Brest, Nuclear Medicine Department, Brest Cedex (France); Valette, Gerald; Potard, Gael; Marianowski, Remi [University Hospital of Brest, Department of Head and Neck Surgery, Brest (France); Rousset, Jean [Military Hospital of Brest, Department of Radiology, Brest (France)

    2015-01-15

    Posttreatment follow-up for the recurrence of head and neck squamous cell carcinoma (HNSCC) is a diagnostic challenge. Tissue distortion from radiation and surgery can obscure early detection of recurrence by conventional follow-up approaches such as physical examination or conventional imaging. Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT is widely validated for the diagnosis of suspected recurrence. Moreover, we have shown in a previous prospective study the high effectiveness of FDG PET/CT in the assessment of subclinical recurrence 12 months after treatment. The aim of this prospective study was to evaluate the effectiveness of an earlier FDG PET/CT, at 6 months after the end of treatment. All patients treated for histologically proven HNSCC from April 2009 to May 2012 at the University Hospital of Brest who did not show any findings suggestive of recurrence at 6 months of their usual follow-up underwent an FDG PET/CT examination. FDG PET/CT findings were correlated with histopathology or imaging follow-up. The study included 116 patients. FDG PET/CT examinations were performed within a mean period ± SD of 5.6 ± 1.8 months after treatment. FDG PET/CT examinations exhibited abnormal FDG uptake in 34 patients and found no suspected recurrence in 82 cases. Of these 82 FDG PET/CT considered as negative, only 1 had a recurrence. Among the 34 positive FDG PET/CT, 22 relapsed whereas 12 did not show evidence of recurrence. The sensitivity and specificity of FDG PET/CT in this study for the diagnosis of occult HNSCC recurrence were 96 (22/23) and 87 % (81/93), respectively. The positive predictive value was 65 % (22/34). The negative predictive value was 99 % (81/82). The overall accuracy was 89 % (103/116). Of the 116 patients, FDG PET/CT highlighted 22 (19 %) subclinical recurrences. Our study showed the high effectiveness of FDG PET/CT in the assessment of subclinical HNSCC recurrence 6 months after completion of treatment. These results

  3. 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

  4. 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)

  5. Very low-dose adult whole-body tumor imaging with F-18 FDG PET/CT

    Science.gov (United States)

    Krol, Andrzej; Naveed, Muhammad; McGrath, Mary; Lisi, Michele; Lavalley, Cathy; Feiglin, David

    2015-03-01

    The aim of this study was to evaluate if effective radiation dose due to PET component in adult whole-body tumor imaging with time-of-flight F-18 FDG PET/CT could be significantly reduced. We retrospectively analyzed data for 10 patients with the body mass index ranging from 25 to 50. We simulated F-18 FDG dose reduction to 25% of the ACR recommended dose via reconstruction of simulated shorter acquisition time per bed position scans from the acquired list data. F-18 FDG whole-body scans were reconstructed using time-of-flight OSEM algorithm and advanced system modeling. Two groups of images were obtained: group A with a standard dose of F-18 FDG and standard reconstruction parameters and group B with simulated 25% dose and modified reconstruction parameters, respectively. Three nuclear medicine physicians blinded to the simulated activity independently reviewed the images and compared diagnostic quality of images. Based on the input from the physicians, we selected optimal modified reconstruction parameters for group B. In so obtained images, all the lesions observed in the group A were visible in the group B. The tumor SUV values were different in the group A, as compared to group B, respectively. However, no significant differences were reported in the final interpretation of the images from A and B groups. In conclusion, for a small number of patients, we have demonstrated that F-18 FDG dose reduction to 25% of the ACR recommended dose, accompanied by appropriate modification of the reconstruction parameters provided adequate diagnostic quality of PET images acquired on time-of-flight PET/CT.

  6. 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.)

  7. 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.)

  8. Screening for occult malignancy with FDG-PET/CT in patients with unprovoked venous thromboembolism.

    Science.gov (United States)

    Alfonso, Ana; Redondo, Margarita; Rubio, Tomás; Del Olmo, Beatriz; Rodríguez-Wilhelmi, Pablo; García-Velloso, María J; Richter, José A; Páramo, José A; Lecumberri, Ramón

    2013-11-01

    Extensive screening strategies to detect occult cancer in patients with unprovoked venous thromboembolism (VTE) are complex and no benefit in terms of survival has been reported. FDG-PET/CT (2-[F-18] fluoro-2-deoxy-D-glucose positron emission tomography combined with computed tomography), a noninvasive technique for the diagnosis and staging of malignancies, could be useful in this setting. Consecutive patients ≥ 50 years with a first unprovoked VTE episode were prospectively included. Screening with FDG-PET/CT was performed 3-4 weeks after the index event. If positive, appropriate diagnostic work-up was programmed. Clinical follow-up continued for 2 years. Blood samples were collected to assess coagulation biomarkers. FDG-PET/CT was negative in 68/99 patients (68.7%), while suspicious FDG uptake was detected in 31/99 patients (31.3%). Additional diagnostic work-up confirmed a malignancy in 7/31 patients (22.6%), with six of them at early stage. During follow-up, two patients with negative FDG-PET/CT were diagnosed with cancer. Sensitivity (S), positive (PPV) and negative predictive values (NPV) of FDG-PET/CT as single tool for the detection of occult malignancy were 77.8% (95% CI: 0.51-1), 22.6% (95% CI: 0.08-0.37) and 97.1% (95% CI: 0.93-1), respectively. Median tissue factor (TF) activity in patients with occult cancer was 5.38 pM vs. 2.40 pM in those without cancer (p = 0.03). Limitation of FDG-PET/CT screening to patients with TF activity > 2.8 pM would improve the PPV to 37.5% and reduce the costs of a single cancer diagnosis from 20,711€ to 11,670€. FDG-PET/CT is feasible for the screening of occult cancer in patients with unprovoked VTE, showing high S and NPV. The addition of TF activity determination may be useful for patient selection.

  9. 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.

  10. Recent advances in paediatric cardiac anaesthesia

    Directory of Open Access Journals (Sweden)

    Mahesh Vakamudi

    2012-01-01

    Full Text Available Paediatric cardiac anaesthesia involves anaesthetizing very small children with complex congenital heart disease for major surgical procedures. The unique nature of this patient population requires considerable expertise and in-depth knowledge of the altered physiology. There have been several developments in the last decade in this subspecialty that has contributed to better care and improved outcome in this vulnerable group of patients. The purpose of this review is to present some of the recent advances in the anesthetic management of these children from preoperative evaluation to postoperative care. This article reviews the role of magnetic resonance imaging and contrast-enhanced magnetic resonance angiography in preoperative evaluation, the use of ultrasound to secure vascular access, the use of cuffed endotracheal tubes, the optimal haematocrit and the role of blood products, including the use of recombinant factor VIIa. It also deals with the advances in technology that have led to improved monitoring, the newer developments in cardiopulmonary bypass, the use of centrifugal pumps and extracorporeal membrane oxygenation and the role of DHCA. The role of new drugs, especially the α-2 agonists in paediatric cardiac anesthetic practice, fast tracking and effective postoperative pain management have also been reviewed.

  11. Thoracic cavity definition for 3D PET/CT analysis and visualization.

    Science.gov (United States)

    Cheirsilp, Ronnarit; Bascom, Rebecca; Allen, Thomas W; Higgins, William E

    2015-07-01

    X-ray computed tomography (CT) and positron emission tomography (PET) serve as the standard imaging modalities for lung-cancer management. CT gives anatomical details on diagnostic regions of interest (ROIs), while PET gives highly specific functional information. During the lung-cancer management process, a patient receives a co-registered whole-body PET/CT scan pair and a dedicated high-resolution chest CT scan. With these data, multimodal PET/CT ROI information can be gleaned to facilitate disease management. Effective image segmentation of the thoracic cavity, however, is needed to focus attention on the central chest. We present an automatic method for thoracic cavity segmentation from 3D CT scans. We then demonstrate how the method facilitates 3D ROI localization and visualization in patient multimodal imaging studies. Our segmentation method draws upon digital topological and morphological operations, active-contour analysis, and key organ landmarks. Using a large patient database, the method showed high agreement to ground-truth regions, with a mean coverage=99.2% and leakage=0.52%. Furthermore, it enabled extremely fast computation. For PET/CT lesion analysis, the segmentation method reduced ROI search space by 97.7% for a whole-body scan, or nearly 3 times greater than that achieved by a lung mask. Despite this reduction, we achieved 100% true-positive ROI detection, while also reducing the false-positive (FP) detection rate by >5 times over that achieved with a lung mask. Finally, the method greatly improved PET/CT visualization by eliminating false PET-avid obscurations arising from the heart, bones, and liver. In particular, PET MIP views and fused PET/CT renderings depicted unprecedented clarity of the lesions and neighboring anatomical structures truly relevant to lung-cancer assessment.

  12. 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.)

  13. 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.

  14. 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.

  15. Lung and Nodal Involvement in Nontuberculous Mycobacterial Disease: PET/CT Role

    Directory of Open Access Journals (Sweden)

    Ginevra Del Giudice

    2015-01-01

    Full Text Available Introduction. Systematic use of 18F-FDG PET/CT has the potential to simultaneously assess both pulmonary and lymph node involvement in nontuberculous mycobacterial (NTM lung infection. Objective. The aim of the study was to evaluate the role of 18F-FDG PET/CT in the assessment of both mediastinal lymph nodes and lung involvement in NTM patients compared with active tuberculosis (TB patients. Methods. 26 patients with pulmonary NTM disease were selected; six consecutive patients had undergone 18F-FDG PET/CT and data was compared with 6 active TB patients. Results. NTM exhibited different radiological lung patterns with an average SUV max value at PET/CT scan of 3,59 ± 2,32 (range 1,14 to 9,01 on pulmonary lesions and a mean value of SUV max 1,21 ± 0,29 (range 0,90 to 1,70 on mediastinal lymph nodes. Pulmonary lesions in TB showed an average SUV max value of 10,07 ± 6,45 (range 1,20 to 22,75 whilst involved mediastinal lymph nodes exhibited a mean SUV max value of 7,23 ± 3,03 (range 1,78 to 15,72. Conclusions. The differences in PET uptake in a broad range of lung lesions and lymph nodes between NTM and M. tuberculosis patients suggest a potential role for PET/CT scan in the diagnosis and management of pulmonary mycobacterial disease.

  16. 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.

  17. {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.)

  18. 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

  19. 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.)

  20. Accuracy of combined PET/CT in image-guided interventions of liver lesions: An ex-vivo study

    Institute of Scientific and Technical Information of China (English)

    Patrick Veit; Christiane Kuehle; Thomas Beyer; Hilmar Kuehl; Andreas Bockisch; Gerald Antoch

    2006-01-01

    AIM: Positioning of interventional devices in liver lesions is a challenging task if only CT is available. We investigated the potential benefit of combined PET/CT images for localization of interventional devices in interventional liver studies.METHODS: Thirty lesions each of hyperdense, isodense and hypodense attenuation compared to normal liver parenchyma were injected into 15 ex-vivo pig livers. All lesions were composed of the same amounts of gelatine containing 0.5 MBq of 18F-FDG. Following lesion insertion, an interventional needle was placed in each lesion under CT-guidance solely. After that, a PET/CT study was performed. The localization of the needle within the lesion was assessed for CT alone and PET/CT and the root mean square (RMS) was calculated. Results were compared with macroscopic measurements after lesion dissection serving as the standard of reference. RESULTS: In hypo- and isodense lesions PET/CT proved more accurate in defining the position of the interventional device when compared with CT alone. The mean RMS for CT and PET/CT differed significantly in isodense and hypodense lesions. No significant difference was found for hyperdense lesions.CONCLUSION: Combined FDG-PET/CT imaging provides more accurate information than CT alone concerning the needle position in FDG-PET positive liver lesions.Therefore combined PET/CT might be potentially beneficial not only for localization of an interventional device,but may also be beneficial for guidance in interventional liver procedures.

  1. Combined FDG-PET/CT for the detection of unknown primary tumors: systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Kwee, Robert M. [University Medical Center Maastricht, Department of Radiology, Maastricht (Netherlands)

    2009-03-15

    The aim of this study was to systematically review and meta-analyze published data on the diagnostic performance of combined 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the detection of primary tumors in patients with cancer of unknown primary (CUP). A systematic search for relevant studies was performed of the PubMed/MEDLINE and Embase databases. Methodological quality of the included studies was assessed. Reported detection rates, sensitivities and specificities were meta-analyzed. Subgroup analyses were performed if results of individual studies were heterogeneous. The 11 included studies, comprising a total sample size of 433 patients with CUP, had moderate methodological quality. Overall primary tumor detection rate, pooled sensitivity and specificity of FDG-PET/CT were 37%, 84% (95% CI 78-88%) and 84% (95% CI 78-89%), respectively. Sensitivity was heterogeneous across studies (P = 0.0001), whereas specificity was homogeneous across studies (P = 0.2114). Completeness of diagnostic workup before FDG-PET/CT, location of metastases of unknown primary, administration of CT contrast agents, type of FDG-PET/CT images evaluated and way of FDG-PET/CT review did not significantly influence diagnostic performance. In conclusion, FDG-PET/CT can be a useful method for unknown primary tumor detection. Future studies are required to prove the assumed advantage of FDG-PET/CT over FDG-PET alone and to further explore causes of heterogeneity. (orig.)

  2. 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.

  3. {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.)

  4. 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.

  5. 18F-FDG PET-CT after Neoadjuvant Chemoradiotherapy in Esophageal Cancer Patients to Optimize Surgical Decision Making.

    Directory of Open Access Journals (Sweden)

    Maarten C J Anderegg

    Full Text Available Prognosis of esophageal cancer patients can be significantly improved by neoadjuvant chemoradiotherapy (nCRT. Given the aggressive nature of esophageal tumors, it is conceivable that in a significant portion of patients treated with nCRT, dissemination already becomes manifest during the period of nCRT. The aim of this retrospective study was to determine the value and diagnostic accuracy of PET-CT after neoadjuvant chemoradiotherapy to identify patients with metastases preoperatively in order to prevent non-curative surgery.From January 2011 until February 2013 esophageal cancer patients deemed eligible for a curative approach with nCRT and surgical resection underwent a PET-CT after completion of nCRT. If abnormalities on PET-CT were suspected metastases, histological proof was acquired. A clinical decision model was designed to assess the cost-effectiveness of this diagnostic strategy.156 patients underwent a PET-CT after nCRT. In 31 patients (19.9% PET-CT showed abnormalities suspicious for dissemination, resulting in 17 cases of proven metastases (10.9%. Of the patients without proven metastases 133 patients were operated. In 6 of these 133 cases distant metastases were detected intraoperatively, corresponding to 4.5% false-negative results. The standard introduction of a post-neoadjuvant therapy PET-CT led to a reduction of overall health care costs per patient compared to a scenario without restaging with PET-CT ($34,088 vs. $36,490.In 10.9% of esophageal cancer patients distant metastases were detected by standard PET-CT after neoadjuvant chemoradiotherapy. To avoid non-curative resections we advocate post-neoadjuvant therapy PET-CT as a cost-effective step in the standard work-up of candidates for surgery.

  6. 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 extraaxillary lymph node metastases, 4 patients with distant metastases and 3 patients with synchronous malignancies. Full-dose, intravenous contrast-enhanced FDG PET/CT was more accurate than conventional imaging for initial breast cancer staging due to the higher detection rate of metastases and synchronous tumours, although the study had several limitations including a retrospective design, a possible selection bias and a relevant false-positive rate for the detection of axillary lymph node metastases. FDG PET/CT resulted in a change of treatment in a substantial proportion of

  7. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0

    DEFF Research Database (Denmark)

    Boellaard, Ronald; O'Doherty, Mike J; Weber, Wolfgang A;

    2010-01-01

    The aim of this guideline is to provide a minimum standard for the acquisition and interpretation of PET and PET/CT scans with [18F]-fluorodeoxyglucose (FDG). This guideline will therefore address general information about[18F]-fluorodeoxyglucose (FDG) positron emission tomography......-computed tomography (PET/CT) and is provided to help the physician and physicist to assist to carrying out,interpret, and document quantitative FDG PET/CT examinations,but will concentrate on the optimisation of diagnostic quality and quantitative information....

  8. Staging accuracy of pancreatic cancer: Comparison between non-contrast-enhanced and contrast-enhanced PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Yoneyama, Tomohiro [Department of Radiology, Yokohama City University, Graduate School of Medicine, Yokohama (Japan); Tateishi, Ukihide, E-mail: utateish@yokohama-cu.ac.jp [Department of Radiology, Yokohama City University, Graduate School of Medicine, Yokohama (Japan); Endo, Itaru [Department of Surgery, Yokohama City University, Graduate School of Medicine, Yokohama (Japan); Inoue, Tomio [Department of Radiology, Yokohama City University, Graduate School of Medicine, Yokohama (Japan)

    2014-10-15

    Purpose: Our aim was to clarify the diagnostic impact of contrast-enhanced (CE) {sup 18}F-fluorodeoxyglucose (FDG)–positron emission tomography (PET)/computed tomography (CT) for staging of pancreatic cancer compared to non-CE PET/CT. Method and materials: Between April 2006 and November 2009, a total of 95 patients (age range, 36–83 years [mean age, 67]) with primary pancreatic cancer underwent {sup 18}F-FDG PET/CT examinations. Diagnostic accuracy was compared between non-CE PET/CT and CE PET/CT. Images were analyzed visually and quantitatively by two blinded reviewers. Reference standard was histological examination in 48 patients (51%) and/or confirmation of an obvious progression in number and/or size of the lesions on follow-up CT examinations in 47 patients (49%). Results: For T-staging, invasion of duodenum (n = 20, 21%), mesentery (n = 12, 13%), and retroperitoneum (n = 13, 14%) was correctly diagnosed by both modalities. The ROC analyses revealed that the Az values of celiac artery (CA), common hepatic artery (CHA), splenic artery (SV), and superior mesenteric vein (SMV) invasion were significantly higher in the CE PET/CT group for both readers. Nodal metastasis was correctly diagnosed by CE PET/CT in 38 patients (88%) and by non-CE PET/CT in 45 patients (87%). Diagnostic accuracies of nodal metastasis in two modalities were similar. Using CE PET/CT, distant metastasis, scalene node metastasis, and peritoneal dissemination were correctly assigned in 39 patients (91%), while interpretation based on non-CE PET/CT revealed distant metastasis, scalene node metastasis, and peritoneal dissemination in 42 patients (81%). Diagnostic accuracy of distant metastasis, scalene node metastasis, and peritoneal dissemination with CE PET/CT was significantly higher than that of non-CE PET/CT (p < 0.05). Conclusion: CE PET/CT allows a more precise assessment of distant metastasis, scalene node metastasis, and peritoneal dissemination in patients with pancreatic cancer.

  9. FDG PET/CT response in diffuse large B-cell lymphoma: Reader variability and association with clinical outcome.

    Science.gov (United States)

    Han, Eun Ji; O, Joo Hyun; Yoon, Hyukjin; Jung, Seung Eun; Park, Gyeongsin; Choi, Byung Ock; Cho, Seok-Goo

    2016-09-01

    F-18-fluoro-2-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is essential for monitoring response to treatment in patients with diffuse large B-cell lymphoma (DLBCL) and qualitative interpretation is commonly applied in clinical practice. We aimed to evaluate the interobserver agreements of qualitative PET/CT response in patients with DLBCL and the predictive value of PET/CT results for clinical outcome.PET/CT images were obtained for patients with DLBCL 3 times: at baseline, after 3 cycles of first-line chemotherapy (interim), and after completion of chemotherapy. Two nuclear medicine physicians (with 3 and 8 years of experience with PET/CT) retrospectively assessed response to chemotherapy blinded to the clinical outcome using International Harmonization Project (IHP) criteria and Deauville 5-point score. The associations between PET/CT results and progression-free survival (PFS) and overall survival (OS) were assessed using Cox regression analysis.A total of 112 PET/CT images were included from 59 patients with DLBCL (36 male, 23 female; mean age 53 ± 14 years). Using the IHP criteria, interobserver agreement was substantial (Cohen κ = 0.76) with absolute agreement consistency of 89%. Using the Deauville score, interobserver agreement was moderate (Cohen weighted κ = 0.54) and absolute consistency was 62%. The most common cause of disagreements was discordant interpretation of residual tumor uptake. With median follow-up period of 60 months, estimated 5-year PFS and OS were 81% and 92%, respectively. Neither interim nor posttreatment PET/CT results by both readers were significantly associated with PFS. Interim PET/CT result by the more experienced reader using Deauville score was a significant factor for OS (P = 0.019).Moderate-to-substantial interobserver agreement was observed for response assessments according to qualitative PET/CT criteria, and interim PET/CT result could predict OS in patients with DLBCL. Further

  10. Role of F-18 FDG PET/CT in the management of infected abdominal aortic aneurysm due to salmonella

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seung Jin; Lee, Jin Soo; Cheong, Moon Hyun; Byun, Sung Su; Hyun, In Young [Inha University College of Medicine, Incheon (Korea, Republic of)

    2007-12-15

    We present a case of infected abdominal aortic aneurysm due to salmonella enteritidis. F-18 FDG PET/CT was performed to diagnosis and during follow-up after antibiotic treatment. Computed tomography (CT) is considered to be the best diagnostic imaging modality in infected aortic lesions. In this case, a combination of CT and FDG PET/CT provided accurate information for the diagnosis of infected abdominal aortic aneurysm. Moreover, FDG PET/CT made an important contribution of monitoring disease activity during antibiotic treatment.

  11. The clinical utility of FDG PET/CT among solid organ transplant recipients suspected of malignancy or infection

    DEFF Research Database (Denmark)

    Wareham, Neval E; Lundgren, J D; Da Cunha-Bang, C

    2017-01-01

    PURPOSE: Solid organ transplant (SOT) recipients are at high risk of developing infections and malignancies. (18)F-FDG PET/CT may enable timely detection of these diseases and help to ensure early intervention. We aimed to describe the clinical utility of FDG PET/CT in consecutive, diagnostic...... unresolved SOT recipients transplanted from January 2004 to May 2015. METHODS: Recipients with a post-transplant FDG PET/CT performed as part of diagnostic work-up were included. Detailed chart reviews were done to extract relevant clinical information and determine the final diagnosis related to the FDG PET...

  12. The role of 18F-FDG PET/CT in pediatric lymph-node acute lymphoblastic leukemia involvement.

    Science.gov (United States)

    Cistaro, Angelina; Saglio, Francesco; Asaftei, Sebastian; Fania, Piercarlo; Berger, Massimo; Fagioli, Franca

    2011-01-01

    In pediatric oncology, positron emission tomography/computed tomography (PET/CT) is emerging as an essential diagnostic tool in characterizing suspicious neoplastic lesions and staging malignant diseases. Most studies regarding the possible role of FDG-PET/CT in the management of acute lymphoblastic leukemia (ALL) patients are limited to adults. Here we report a pediatric patient with recurrent ALL, in which FDG-PET/CT was used both to define more precisely the cause of lymphadenopathy and to assess the effect of the second-line therapy.

  13. Lymphadenopathy by scrub typhus mimicking metastasis on FDG PET/CT in a patient with a history of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won [Dept. of Nuclear Medicine, Catholic Kwandong University International St. Mary' s Hospital, Incheon (Korea, Republic of); Lee, Sang Mi; Lee, Kyu Taek; Kim, Sung Young; Han, Sun Wook; Kim, Shin Young [Sooncheonhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2015-06-15

    We report the case of a 60-year-old woman with left-sided breast cancer who showed lymphadenopathy mimicking metastatic lesions. She underwent surveillance 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) after treatment. PET/CT demonstrated multiple lymphadenopathies with increased FDG uptake, most notably in the right axilla. She had an eschar on the right axillary area, and her serologic test was positive for anti-Orientia tsutsugamushi IgM antibody. Ten months after the treatment, follow-up FDG PET/CT and ultrasonography showed improvement in generalized lymphadenopathy.

  14. Incidental colonic focal FDG uptake on PET/CT: can the maximum standardized uptake value (SUV{sub max}) guide us in the timing of colonoscopy?

    Energy Technology Data Exchange (ETDEWEB)

    Hoeij, F.B. van; Stadhouders, P.H.G.M.; Weusten, B.L.A.M. [St Antonius Ziekenhuis, Department of Gastroenterology, Nieuwegein (Netherlands); Keijsers, R.G.M. [St Antonius Ziekenhuis, Department of Nuclear Medicine, Nieuwegein (Netherlands); Loffeld, B.C.A.J. [Zuwe Hofpoort Ziekenhuis, Department of Internal Medicine, Woerden (Netherlands); Dun, G. [Ziekenhuis Rivierenland, Department of Internal Medicine, Tiel (Netherlands)

    2015-01-15

    In patients undergoing {sup 18}F-FDG PET/CT, incidental colonic focal lesions can be indicative of inflammatory, premalignant or malignant lesions. The maximum standardized uptake value (SUV{sub max}) of these lesions, representing the FDG uptake intensity, might be helpful in differentiating malignant from benign lesions, and thereby be helpful in determining the urgency of colonoscopy. The aim of our study was to assess the incidence and underlying pathology of incidental PET-positive colonic lesions in a large cohort of patients, and to determine the usefulness of the SUV{sub max} in differentiating benign from malignant pathology. The electronic records of all patients who underwent FDG PET/CT from January 2010 to March 2013 in our hospital were retrospectively reviewed. The main indications for PET/CT were: characterization of an indeterminate mass on radiological imaging, suspicion or staging of malignancy, and suspicion of inflammation. In patients with incidental focal FDG uptake in the large bowel, data regarding subsequent colonoscopy were retrieved, if performed within 120 days. The final diagnosis was defined using colonoscopy findings, combined with additional histopathological assessment of the lesion, if applicable. Of 7,318 patients analysed, 359 (5 %) had 404 foci of unexpected colonic FDG uptake. In 242 of these 404 lesions (60 %), colonoscopy follow-up data were available. Final diagnoses were: adenocarcinoma in 25 (10 %), adenoma in 90 (37 %), and benign in 127 (53 %). The median [IQR] SUV{sub max} was significantly higher in adenocarcinoma (16.6 [12 - 20.8]) than in benign lesions (8.2 [5.9 - 10.1]; p < 0.0001), non-advanced adenoma (8.3 [6.1 - 10.5]; p < 0.0001) and advanced adenoma (9.7 [7.2 - 12.6]; p < 0.001). The receiver operating characteristic curve of SUV{sub max} for malignant versus nonmalignant lesions had an area under the curve of 0.868 (SD ± 0.038), the optimal cut-off value being 11.4 (sensitivity 80 %, specificity 82

  15. Impact of design of installations and in the personal staff formation of the hybrid equipment: PET-CT; Impacto en el diseno de instalaciones y en la formacion del personal de los equipos hibridos: PET-CT

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez, R.; Soler, K.; Alonso, I., E-mail: ramon@orasen.co.cu, E-mail: karen@orasen.co.cu, E-mail: azul@orasen.con.cu [Centro Nacional de Seguridad Nuclear, La Habana (Cuba)

    2013-11-01

    In this article the general principles to be considered in the design of a Nuclear Medicine department with PET-CT, and address the existing problems regarding training needs and staff training, to take on this new technology.

  16. 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

    PURPOSE: For certain cancer indications, the current patient evaluation strategy is a perfect but locally restricted gold standard procedure. If positron emission tomography/computed tomography (PET/CT) can be shown to be reliable within the gold standard region and if it can be argued that PET....../CT also performs well in adjacent areas, then sample sizes in accuracy studies can be reduced. PROCEDURES: Traditional standard power calculations for demonstrating sensitivities of both 80% and 90% are shown. The argument is then described in general terms and demonstrated by an ongoing study...... 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...

  17. F-18 fluorodeoxyglucose PET/CT and post hoc PET/MRI in a case of primary meningeal melanomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hong Je [Dept. of Nuclear Medicine, Dongnam Institute of Radiological and Medical Sciences (DIRAMS), Busan (Korea, Republic of); Ahn, Byeong Cheol; Hwang, Seong Wook; Kim, Hae Won; Lee, Sang Woo; Hwang, Jeong Hyun; Lee, Jae Tae [Kyungpook National University School of Medicine, Kyungpook National University Hospital, Daegu (Korea, Republic of); Cho, Suk Kyong [Dept. of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2013-04-15

    Primary meningeal melanomatosis is a rare, aggressive variant of primary malignant melanoma of the central nervous system, which arises from melanocytes within the leptomeninges and carries a poor prognosis. We report a case of primary meningeal melanomatosis in a 17-year-old man, which was diagnosed with 1{sup 8F}-fluorodeoxyglucose (F-18 FDG) PET/CT, and post hoc F-18 FDG PET/MRI fusion images. Whole-body F-18 FDG PET/CT was helpful in ruling out the extracranial origin of melanoma lesions, and in assessing the therapeutic response. Post hoc PET/MRI fusion images facilitated the correlation between PET and MRI images and demonstrated the hypermetabolic lesions more accurately than the unenhanced PET/CT images. Whole body F-18 FDG PET/CT and post hoc PET/MRI images might help clinicians determine the best therapeutic strategy for patients with primary meningeal melanomatosis.

  18. Detection of synchronous parathyroid adenoma and breast cancer with {sup 18}F-fluorocholine PET-CT

    Energy Technology Data Exchange (ETDEWEB)

    Vorselaars, Wessel MCM; Kluijfthout, Wiuter P.; Vriens, Menno R; Van der Pol, Carmen C.; Rinkes, Inne HM Borel; Valk, Gerlof D.; De Keizer, Bart [University Medical Center Utrecht, Utrecht (Netherlands)

    2016-06-15

    A 71-year-old woman was referred to our tertiary care center for evaluation of asymptomatic recurrence of primary hyperparathyroidism. As per our protocol, the patient underwent neck/mediastinum {sup 18}F-fluorocholine (FCH) positron emission tomography-computed tomography (PET-CT) for localization. In our institution, FCH PET-CT is performed in patients with hyperparathyroidism and negative conventional imaging. FCH PET-CT is a promising new imaging modality for detection of hyperfunctioning parathyroid glands. As can be seen in the case presented, high FCH uptake was seen in a small breast cancer. Due to its favorable half-life and wide availability by its use as a localization technique for patients with prostate cancer and complicated hyperparathyroidism, FCH PET-CT may be a new promising modality in the imaging of breast cancer.

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

    Directory of Open Access Journals (Sweden)

    Sait Sağer

    2012-04-01

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

  20. Relationship between pSUV of {sup 18}F-FDG PET/CT and pathological diagnosis in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young [Dept. of Diagnostic Radiology, Dankook University Hospital, Cheonan (Korea, Republic of)

    2013-12-15

    The purpose of this study was to evaluate the Pathological Diagnosis associated with pSUV uptake of {sup 18}F-FDG PET/CT. We had enrolled 39 women that underwent {sup 18}F-FDG PET/CT before operative. We evaluated whether there was correlation between the pSUV of {sup 18}F-FDG PET/CT and prognostic factors. As a results, pSUV level increase according to tumor size but pSUV had no significant association with tumor size. pSUV of high histologic grade was higher than low histologic grade, and pSUV showed positive correlations with histologic grade. The ER and PR showed significant negative correlations with the pSUV of {sup 18}F-FDG PET/CT. Therefore, our results demonstrated that an correlation exists between pSUV and prognostic factors such as histologic grade, ER and PR.

  1. The value of {sup 18}F-FDG PET/CT in the management of malignant peripheral nerve sheath tumors

    Energy Technology Data Exchange (ETDEWEB)

    Khiewvan, Benjapa [University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Mahidol University, Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Siriraj Hospital, Bangkok (Thailand); Macapinlac, Homer A.; Chuang, Hubert H. [University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Lev, Dina; Al Sannaa, Ghadah [University of Texas MD Anderson Cancer Center, Department of Cancer Biology, Houston, TX (United States); McCutcheon, Ian E. [University of Texas MD Anderson Cancer Center, Department of Neurosurgery, Houston, TX (United States); Slopis, John M. [University of Texas MD Anderson Cancer Center, Department of Neuro-Oncology, Houston, TX (United States); Wei, Wei [University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States)

    2014-09-15

    Our objective was to determine how positron emission tomography (PET)/CT had been used in the clinical treatment of malignant peripheral nerve sheath tumor (MPNST) patients at The University of Texas MD Anderson Cancer Center. We reviewed a database of MPNST patients referred to MD Anderson Cancer Center during 1995-2011. We enrolled 47 patients who underwent PET/CT imaging. Disease stage was based on conventional imaging and PET/CT findings using National Comprehensive Cancer Network (NCCN) guidelines. Treatment strategies based on PET/CT and conventional imaging were determined by chart review. The maximum and mean standardized uptake values (SUV{sub max}, SUV{sub mean}), metabolic tumor volume (MTV), total lesion glycolysis (TLG), change in SUV{sub max}, change in MTV, and change in TLG were calculated from the PET/CT studies before and after treatment. Response prediction was based on imaging studies performed before and after therapy and categorized as positive or negative for residual tumor. Clinical outcome was determined from chart review. PET/CT was performed for staging in 16 patients, for restaging in 29 patients, and for surveillance in 2 patients. Of the patients, 88 % were correctly staged with PET/CT, whereas 75 % were correctly staged with conventional imaging. The sensitivity to detect local recurrence and distant metastasis at restaging was 100 and 100 % for PET/CT compared to 86 and 83 % for conventional imaging, respectively. PET/CT findings resulted in treatment changes in 31 % (5/16) and 14 % (4/29) of patients at staging and restaging, respectively. Recurrence, MTV, and TLG were prognostic factors for survival, whereas SUV{sub max} and SUV{sub mean} were not predictive. For 21 patients who had imaging studies performed both before and after treatment, PET/CT was better at predicting outcome (overall survival, progression-free survival) than conventional imaging. A decreasing SUV{sub max} ≥ 30 % and decrease in TLG and MTV were significant

  2. Clinical impact of {sup 18}F-choline PET/CT in patients with recurrent prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Soyka, Jan D.; Muster, Marco A.; Schmid, Daniel T.; Veit-Haibach, Patrick; Strobel, Klaus; Schaefer, Niklaus G.; Hany, Thomas F. [University Hospital Zurich, Department of Nuclear Medicine, Zurich (Switzerland); Seifert, Burkhardt [University of Zurich, Division of Biostatistics, Institute of Social and Preventive Medicine, Zurich (Switzerland); Schick, Ulrike; Miralbell, Raymond [University Hospital Geneva, Department of Radiation-Oncology, Geneva (Switzerland); Jorcano, Sandra [Instituto Oncologico Teknon, Department of Radiation-Oncology, Barcelona (Spain); Zaugg, Kathrin [University Hospital Zurich, Department of Radiation-Oncology, Zurich (Switzerland); Seifert, Hans-Helge [University Hospital Zurich, Department of Urology, Zurich (Switzerland); Husarik, Daniela B. [University Hospital Zurich, Department of Radiology, Zurich (Switzerland)

    2012-06-15

    To investigate the clinical value of {sup 18}F-fluorocholine PET/CT (CH-PET/CT) in treatment decisions in patients with recurrent prostate cancer (rPCA). The study was a retrospective evaluation of 156 patients with rPCA and CH-PET/CT for restaging. Questionnaires for each examination were sent to the referring physicians 14-64 months after examination. Questions included information regarding initial extent of disease, curative first-line treatment, and the treatment plan before and after CH-PET/CT. Additionally, PSA values at diagnosis, after initial treatment, before CH-PET/CT and at the end of follow-up were also obtained from the questionnaires. Mean follow-up was 42 months. The mean Gleason score was 6.9 at initial diagnosis. Initial treatment was: radical prostatectomy in 110 patients, radiotherapy in 39, and combined prostatectomy and radiotherapy in 7. Median PSA values before CH-PET/CT and at the end of follow-up were 3.40 ng/ml and 0.91 ng/ml. PSA levels remained stable, decreased or were below measurable levels in 108 patients. PSA levels increased in 48 patients. In 75 of the 156 patients (48%) the treatment plan was changed due to the CH-PET/CT findings. In 33 patients the therapeutic plan was changed from palliative treatment to treatment with curative intent. In 15 patients treatment was changed from curative to palliative. In 8 patients treatment was changed from curative to another strategy and in 2 patients from one palliative strategy to another. In 17 patients the treatment plan was adapted. CH-PET/CT has an important impact on the therapeutic strategy in patients with rPCA and can help to determine an appropriate treatment. (orig.)

  3. Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression

    Energy Technology Data Exchange (ETDEWEB)

    Blokhuis, Gijsbert J.; Diender, Marije G.; Oyen, Wim J.G. [Radboud University Medical Center, Department of Nuclear Medicine, Nijmegen (Netherlands); Bleeker-Rovers, Chantal P. [Radboud University Medical Center, Division of Infectious Diseases, Department of Internal Medicine, Nijmegen (Netherlands); Draaisma, Jos M.T. [Radboud University Medical Center, Department of Paediatrics, Nijmegen (Netherlands); Geus-Oei, Lioe-Fee de [Radboud University Medical Center, Department of Nuclear Medicine, Nijmegen (Netherlands); University of Twente, MIRA Institute for Biomedical Technology and Technical Medicine, Biomedical Photonic Imaging Group, Enschede (Netherlands)

    2014-10-15

    Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression. All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis. FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively. FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value. (orig.)

  4. Comparison of MRI and PET-CT in detecting the loco-regional recurrence of soft tissue sarcomas during surveillance

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sun-Young [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, 88, Olympic-ro 43-gil, Songpa-gu, Seoul (Korea, Republic of); Hallym University Sacred Heart Hospital, Department of Radiology, Anyang-si, Gyeonggi-do (Korea, Republic of); Chung, Hye Won [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, 88, Olympic-ro 43-gil, Songpa-gu, Seoul (Korea, Republic of); Chae, Sun Young [University of Ulsan College of Medicine, Asan Medical Center, Department of Nuclear Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul (Korea, Republic of); Lee, Jong-Seok [University of Ulsan College of Medicine, Asan Medical Center, Department of Orthopedic Surgery, 88, Olympic-ro 43-gil, Songpa-gu, Seoul (Korea, Republic of)

    2016-10-15

    To investigate the diagnostic performance of MRI and PET-CT for the detection of loco-regional recurrences after soft tissue sarcoma (STS) excision. From Dec 2003 to Aug 2014, 394 patients with STSs, who were included in the electronic patient registry for initial or repeated surgery at our hospital, were retrospectively reviewed. We identified 152 patients who underwent regular postoperative follow-ups with both MRI and PET-CT, obtained within a 3 month period of each other. We analyzed differences in the performance of MRI and PET-CT for the diagnosis of loco-regional recurrences using McNemar's test. The receiver-operating characteristic curves and calculations of the area under the curve were used. Twenty patients were found to have a loco-regional recurrence after tumor excision. For MRI and PET-CT, the sensitivities were 90.0 and 95.0 %, and the specificities 97.7 and 95.5 %, respectively, with positive predictive values of 85.7 and 76.0 % and negative predictive values of 98.5 and 99.2 %, respectively. No significant difference was detected between the sensitivities of MRI and PET-CT (p = 0.125). The area under the receiver-operating characteristic curve for PET-CT (0.952) was not significantly greater than that for MRI (0.939; p = 0.6). MRI of the area of interest is recommended for evaluation of tumor recurrence after surgical excision of STS. PET-CT was shown to be effective for detection of STS recurrence, and comparable to MRI. However, if PET-CT or MRI findings are inconclusive, the other modality may be helpful in differentiating tumor recurrence from post-therapeutic tissue change. (orig.)

  5. Head and neck squamous cell carcinoma (HNSCC) - detection of synchronous primaries with {sup 18}F-FDG-PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Strobel, Klaus; Schrank, Madeleine; Soyka, Jan D.; Veit-Haibach, Patrick; Hany, Thomas F. [University Hospital Zurich, Division of Nuclear Medicine, Department of Medical Radiology, Zurich (Switzerland); Haerle, Stephan K.; Stoeckli, Sandro J. [University Hospital Zurich, Department of Otorhinolaryngology, Head and Neck Surgery, Zurich (Switzerland)

    2009-06-15

    The aim of the study was to evaluate {sup 18}F-FDG-PET/CT for the detection of synchronous primaries at initial staging of patients with head and neck squamous cell carcinoma (HNSCC). FDG-PET/CT images acquired between March 2001 and October 2007 in 589 consecutive patients (147 women, 442 men; mean age 61.5 years, age range 32-97 years) with proven HNSCC were reviewed for the presence of synchronous primaries. Cytology, histology and/or clinical and imaging follow-up served as reference standard. FDG-PET/CT showed 69 suspected synchronous primaries in 62 patients of which 56 were finally confirmed in 44 patients. Of the 56 second cancers, 46 (82%) were found in the aerodigestive tract in the following locations: lung (26, 46%), head and neck (15, 17%), oesophagus (5, 9%). Ten second cancers (18%) were located outside the aerodigestive tract (colon, five; stomach, lymphoma, breast, thymus and kidney, one each). Six patients had three synchronous primaries and three patients had four synchronous cancers. Nine synchronous cancers were not detected by PET/CT (four head and neck, two lung, two oesophageal, one gastric). False-positive PET/CT findings were mainly related to benign FDG uptake in the intestine due to benign or precancerous polyps or physiological FDG uptake in other head and neck regions. Overall the prevalence of synchronous second primaries according to the reference standard was 9.5%, of which 84% were detected with FDG-PET/CT. In 80% of the patients, therapy was changed because of the detection of a synchronous primary. FDG-PET/CT detects a considerable number of synchronous primaries (8.0% prevalence) at initial staging of patients with HNSCC. Synchronous cancers were predominantly located in the aerodigestive tract, primarily in the lung, head and neck and oesophagus. Detection of second primaries has an important impact on therapy. PET/CT should be performed before panendoscopy. (orig.)

  6. {sup 18}F-FDG PET/CT in sarcoidosis management: review and report of 20 cases

    Energy Technology Data Exchange (ETDEWEB)

    Braun, Jean Jacques [Hopital de Hautepierre, Hopitaux Universitaires de Strasbourg, Service ORL, Strasbourg (France); Hopital Civil, Hopitaux Universitaires de Strasbourg, Service de Pneumologie Lyautey, Strasbourg (France); Kessler, Romain [Hopital de Hautepierre, Hopitaux Universitaires de Strasbourg, Service de Pneumologie, Strasbourg (France); Constantinesco, Andre; Imperiale, Alessio [Hopital de Hautepierre, Hopitaux Universitaires de Strasbourg, Service de Biophysique et de Medecine Nucleaire, Strasbourg Cedex (France)

    2008-08-15

    To evaluate the interest of {sup 18}F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) for diagnosis and therapeutic follow-up of patients with sarcoidosis. Twenty consecutive patients with biopsy-proven sarcoidosis were retrospectively included, in particular, 13 and seven cases of thoracic and extra-thoracic sarcoidosis, respectively. All patients underwent {sup 18}F-FDG PET/CT, and 12 of them also {sup 67}Ga scintigraphy. Five patients were re-examined by {sup 18}F-FDG PET/CT to assess response to corticosteroid (CS) treatment. Sensitivity of {sup 18}F-FDG PET/CT in detecting active sarcoidosis localizations was determined considering only biopsy-proven sites. For thoracic, sinonasal, and pharyngo-laryngeal localizations, {sup 18}F-FDG PET/CT sensitivity was 100%, 100%, and 80%, respectively. Overall sensitivity for all 36 biopsy-proven localizations improved from 78% to 87% after excluding skin involvement. Considering only the 12 patients who underwent both scintigraphic examinations, overall sensitivity of {sup 67}Ga scintigraphy and {sup 18}F-FDG PET/CT was 58% and 79%, respectively and improved to 67% and 86% after excluding all sites of skin involvement. To evaluate the efficacy of CS treatment, five enrolled patients underwent second {sup 18}F-FDG PET/CT. Complete regression of all foci of pathological tracer uptake was showed in two cases, permitting CS withdrawal after 2 and 6 months. Improvement but incomplete regression of mediastino-pulmonary disease occurred in two patients treated with CS for 19 and 21 months. Disease progression was assessed in one patient treated with decreasing doses of CS during 16 months. {sup 18}F-FDG PET/CT allows to obtain a complete morpho-functional cartography of inflammatory active localizations and to follow treatment efficacy in patients with sarcoidosis, particularly in atypical, complex, and multisystemic forms. (orig.)

  7. Predictive role of post-treatment [{sup 18}F]FDG PET/CT in patients with uterine cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hoon Chung, Hyun, E-mail: chhkmj@gmail.com [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Kim, Jae Weon, E-mail: chhkmj1@snu.ac.kr [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Kang, Keon Wook, E-mail: kangkw@snu.ac.kr [Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Park, Noh-Hyun, E-mail: pnhkhr@snu.ac.kr [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Song, Yong-Sang, E-mail: yssong@snu.ac.kr [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Chung, June-Key, E-mail: jkchung@snu.ac.kr [Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Kang, Soon-Beom, E-mail: ksboo308@plaza.snu.ac.kr [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of)

    2012-08-15

    Objective: To evaluate the efficacy of post-treatment positron emission tomography (PET)/computed tomography (CT) for identification of tumor recurrence, and to determine whether [{sup 18}F]fluorodeoxyglucose (FDG) uptake measured as the maximum standardized uptake value (SUV{sub max}) has predictive role regarding survival in patients with uterine cervical cancer. Methods: Medical records from 276 women with uterine cervical cancer who had post-treatment [{sup 18}F]FDG PET/CT performed were retrospectively reviewed. Results of PET/CT scans were compared with histological or clinical examination. Results: Ninety-five (34.4%) of the 276 patients had documented recurrence by either surgical biopsy or clinical and imaging follow-up. Median duration from treatment to PET/CT scan was 24 months (range, 6-307). The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of post-treatment PET/CT were 94.7%, 87.8%, 80.4%, 97%, and 90.2%, respectively. The PET/CT scan modified both the diagnostic or treatment plan in 67 patients (24.3%). Patients were divided into two groups according to cut-off SUV{sub max} established on the basis of ROC analysis (<5.25 vs. {>=}5.25), and there was a significant difference in OS between groups (p = 0.001). In addition, the 5-year progression-free survival (PFS) and OS rates of patients with a negative PET/CT scan for recurrence were significantly better than those with a positive PET/CT (98.62% vs. 17.83%, p < 0.0001 for PFS, 99.31% vs. 85.38%, p = 0.0015 for OS). Conclusion: Post-treatment PET/CT scan is a sensitive and accurate surveillance modality, and provides prognostic information in uterine cervical cancer. Furthermore, it may allow individualization of patient care.

  8. {sup 18}F-DOPA PET/CT in the diagnosis and localization of persistent medullary thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Archier, Aurelien; Mundler, Olivier [Aix-Marseille University, Department of Nuclear Medicine, La Timone University Hospital, Marseille (France); Aix-Marseille University, European Center for Research in Medical Imaging, Marseille (France); Heimburger, Celine [University Hospitals of Strasbourg, Department of Biophysics and Nuclear Medicine, Strasbourg (France); Guerin, Carole; Palazzo, Fausto F.; Henry, Jean-Francois; Sebag, Frederic [Aix-Marseille University, Department of Endocrine Surgery, Conception Hospital, Marseille (France); Morange, Isabelle [Aix-Marseille University, Department of Endocrinology, Conception Hospital, Marseille (France); Schneegans, Olivier [Paul Strauss Cancer Center, Department of Nuclear Medicine, Strasbourg (France); Abdullah, Ahmad Esmaeel [Aix-Marseille University, Department of Nuclear Medicine, La Timone University Hospital, Marseille (France); Imperiale, Alessio [University Hospitals of Strasbourg, Department of Biophysics and Nuclear Medicine, Strasbourg (France); ICube, UMR 7357 University of Strasbourg/CNRS and FMTS, Faculty of Medicine, Strasbourg (France); Taieb, David [Aix-Marseille University, Department of Nuclear Medicine, La Timone University Hospital, Marseille (France); Aix-Marseille University, European Center for Research in Medical Imaging, Marseille (France); Institut Paoli-Calmettes, Inserm UMR1068 Marseille Cancerology Research Center, Marseille (France)

    2016-06-15

    To evaluate the performance of {sup 18}F-l-dihydroxyphenylalanine ({sup 18}F-DOPA) PET/CT in the detection of locoregional and distant medullary thyroid carcinoma (MTC) metastases and to compare imaging findings with histological data. We retrospectively evaluated 86 MTC patients with persistently high serum calcitonin levels after initial surgery who had undergone {sup 18}F-DOPA PET/CT between January 2007 and December 2014 in two referral centres. They were followed up for at least 6 months after the PET/CT assessment. The results were compared with histological data or with the findings obtained during follow-up using a complementary imaging modality. {sup 18}F-DOPA PET/CT was positive in 65 of the 86 patients, corresponding to a patient-based sensitivity of 75.6 %. Distant metastatic disease (M1) was seen in 29 patients including 11 with previously unknown metastases revealed only by PET/CT. Among the 36 patients without distant metastatic spread, 25 had nodal involvement limited to the neck, and 10 of these 25 patients underwent reoperation. The lymph node compartment-based sensitivity of {sup 18}F-DOPA PET/CT was 100 % in the two institutions but lesion-based sensitivity was only 24 %. Preoperative and postoperative median calcitonin levels were 405 pg/mL (range 128 - 1,960 pg/mL) and 259 pg/mL (range 33 - 1,516 pg/mL), respectively. None of the patients achieved normalization of serum calcitonin after reoperation. {sup 18}F-DOPA PET/CT enables early diagnosis of a significant number of patients with distant metastasis. It has a limited sensitivity in the detection of residual disease but provides high performance for regional analysis. A surgical compartment-oriented approach could be the approach of choice whatever the number of nodes revealed by {sup 18}F-DOPA PET/CT. (orig.)

  9. Impact of FDG-PET/CT for the Detection of Unknown Primary Tumours in Patients with Cervical Lymph Node Metastases

    Directory of Open Access Journals (Sweden)

    İnanç Karapolat

    2012-08-01

    Full Text Available Objective: Because the detection of the primary tumour is of importance to optimize the patient’s management and allows a targeted therapy, the performance of hybrid positron emission tomography–computed tomography (PET/CT using fluorodeoxyglucose (FDG in the detection of primary tumors and unrecognized metastases with cervical lymph node metastases were evaluated in a retrospective study. Material and Methods: Twenty patients with cervical lymph node metastases of unknown primary tumors underwent staging with FDG-PET/CT. All underwent head and neck examinations, computed tomography (CT, and/or magnetic resonance imaging (MRI, panendoscopies, and biopsies of head and neck mucosal sites. The diagnostic accuracy of FDG-PET/CT in detecting primary tumors was compared with that of histopathology and clinical follow-up. The ability of FDG-PET/CT to detect distant metastases was also tested. Results: PET/CT was positive with an increased FDG uptake suggesting the potential primary site in 45% of patients (9/20. PET/CT findings were true positive in 7, true negative in 10, false positive in 2, and false negative in 1 patients, resulting in a sensitivity of 87%, a specificity of 83%, an accuracy of 85%, a positive predictive value of 77% and a negative predictive value of 90%. Also, PET/CT showed distant metastases in seven patients. Conclusion: FDG-PET/CT can be successfully used for the identification of the primary site and distant metastases in patients with cervical lymph node metastases from an unknown primary cancer. (MIRT 2012;21:63-68

  10. Preoperative staging of non-small cell lung cancer: prospective comparison of PET/MR and PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Min [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Goo, Jin Mo; Park, Chang Min [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, Cancer Research Institute, Seoul (Korea, Republic of); Yoon, Soon Ho [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Paeng, Jin Chul; Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Kim, Young Tae [Seoul National University College of Medicine, Cancer Research Institute, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Thoracic and Cardiovascular Surgery, Seoul (Korea, Republic of); Park, Young Sik [Seoul National University Hospital, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Internal Medicine, Seoul (Korea, Republic of)

    2016-11-15

    To prospectively compare the accuracies of PET/MR and PET/CT in the preoperative staging of non-small cell lung cancer (NSCLC). Institutional review board approval and patients' informed consents were obtained. 45 patients with proven or radiologically suspected lung cancer which appeared to be resectable on CT were enrolled. PET/MR was performed for the preoperative staging of NSCLC followed by PET/CT without contrast enhancement on the same day. Dedicated MR images including diffusion weighted images were obtained. Readers assessed PET/MR and PET/CT with contrast-enhanced CT. Accuracies of PET/MR and PET/CT for NSCLC staging were compared. Primary tumour stages (n = 40) were correctly diagnosed in 32 patients (80.0 %) on PET/MR and in 32 patients (80.0 %) on PET/CT (P = 1.0). Node stages (n = 42) were correctly determined in 24 patients (57.1 %) on PET/MR and in 22 patients (52.4 %) on PET/CT (P = 0.683). Metastatic lesions in the brain, bone, liver, and pleura were detected in 6 patients (13.3 %). PET/MR missed one patient with pleural metastasis while PET/CT missed one patient with solitary brain metastasis and two patients with pleural metastases (P = 0.480). This study demonstrated that PET/MR in combination with contrast-enhanced CT was comparable to PET/CT in the preoperative staging of NSCLC while reducing radiation exposure. (orig.)

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    Background The aim of this study was to develop and validate an automated method for extracting forward stroke volume (FSV) using indicator dilution theory directly from dynamic positron emission tomography (PET) studies for two different tracers and scanners. Methods 35 subjects underwent...... a dynamic 11 C-acetate PET scan on a Siemens Biograph TruePoint-64 PET/CT (scanner I). In addition, 10 subjects underwent both dynamic 15 O-water PET and 11 C-acetate PET scans on a GE Discovery-ST PET/CT (scanner II). The left ventricular (LV)-aortic time-activity curve (TAC) was extracted automatically...... from PET data using cluster analysis. The first-pass peak was isolated by automatic extrapolation of the downslope of the TAC. FSV was calculated as the injected dose divided by the product of heart rate and the area under the curve of the first-pass peak. Gold standard FSV was measured using phase...

  12. 68Ga DOTATATE PET/CT of Synchronous Meningioma and Prolactinoma.

    Science.gov (United States)

    Basu, Sandip; Ranade, Rohit; Hazarika, Suman

    2016-03-01

    Ga DOTATATE PET/CT in noninvasive characterization of synchronous pituitary neoplasm and meningioma in a 38-year-old man is illustrated. The patient presented with an MRI-detected lobulated enhancing sellar-suprasellar mass with erosion of bony sella measuring 4.5 × 3.5 × 3.4 cm (with differential diagnosis with germ cell tumor) and a right parafalcine mass (2.7 × 2.6 cm) suggesting meningioma. Ga DOTATATE PET/CT demonstrated intense uptake in both lesions, suggesting the sellar mass to be pituitary macroadenoma. The finding of high serum prolactin and normal LH, FSH, cortisol, and testosterone levels suggested diagnosis of prolactinoma, and the patient was started on cabergoline.

  13. Soft tissue metastases from differentiated thyroid cancer diagnosed by {sup 18}F FDG PET-CT

    Energy Technology Data Exchange (ETDEWEB)

    Califano, Ines; Quildrian, Sergio; Otero, Jose; Coduti, Martin; Califano, Leonardo; Rojas Bilbao, Erica, E-mail: ines.m.califano@gmail.com [Instituto de Oncologia Angel H. Roffo, Universidad de Buenos Aires (Argentina)

    2013-06-15

    Distant metastases of differentiated thyroid cancer are unusual; lung and bones are the most frequently affected sites. Soft tissue metastases (STM) are extremely rare. We describe two cases of patients with differentiated thyroid cancer metastasizing to soft tissues. Both patients had widespread metastatic disease; clinically asymptomatic soft tissue metastases were found by 18-Fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F FDG PET-CT), and confirmed by cytological and/or histopathological studies. These findings underscore the ability of {sup 18}F FDG PET-CT in accurately assessing the extent of the disease, as well as the utility of the method to evaluate regions of the body that are not routinely explored. (author)

  14. 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...... ultrasound), DVT- (DVT ruled out by low clinical suspicion and negative compression ultrasound), PE+ (PE proven by high clinical suspicion and positive lung scintigraphy), and PE- (PE ruled out by low clinical suspicion and normal lung scintigraphy). Images were interpreted visually by 2 experienced nuclear...... medicine physicians independently and without knowledge of other imaging results. RESULTS: Seven DVT+, 6 DVT-, 6 PE+, and 1 PE- were included. Five patients were suspected of both DVT and PE. FDG PET/CT correctly diagnosed the presence or lack of DVT in all patients, whereas results are more ambiguous...

  15. [Technical limits of PET/CT with 18FDG in prostate cancer].

    Science.gov (United States)

    von Mallek, D; Backhaus, B; Müller, S C; Matthies, A; Palmedo, H; Jaeger, U; Biersack, H-J; Reinhardt, M

    2006-05-01

    There is increasing evidence that (18)FDG-PET is not useful for the imaging of primary prostate cancer. The aim of this examination was to prove whether or not these poor results are due to technical deficiencies of the examination method like older image reconstruction techniques, extensive (18)FDG-tracer activity in the bladder or improper contrast staining of the rectum. We examined three patients with primary prostate cancer using a modern combined PET/CT system, continuous irrigation of the bladder and an air-inflated rectal balloon catheter. PET/CT images show an exact depiction of both the prostate and all surrounding anatomic structures but no enhanced uptake of radiotracer in the tumour. Therefore, the mentioned poor results of (18)FDG-PET seem not to be due to technical deficiencies.

  16. False Positive FDG PET/CT of Recurrent Testicular Tumour Due to Orchitis

    Directory of Open Access Journals (Sweden)

    Robert Mansberg

    2014-02-01

    Full Text Available A 47-year-old male with a history of right sided orchidectomy for stage 1 seminoma 6 months previously, was referred for a FDG PETCT scan for restaging of testicular cancer having experiencing left testicular discomfort. Abnormally increased glyoclytic metabolism of the left testis and the inferior scrotal sac was demonstrated on the initial FDG PET-CT study. Subsequent ultrasound showed subtle heterogeneous echotexture with mild hypervascularity and no focal lesion was identified. The patient was subsequently treated with antibiotics for a presumed diagnosis of orchitis. A progress FDG PET-CT study 2 months later confirmed the complete resolution of the increased glycolytic metabolism in the left testis and the inferior scrotal sac.

  17. Delayed 18F-fluorodeoxyglucose PET/CT imaging improves quantitation of atherosclerotic plaque inflammation

    DEFF Research Database (Denmark)

    Blomberg, Björn Alexander; Thomassen, Anders; Takx, Richard A P

    2014-01-01

    BACKGROUND: This study aimed to determine if delayed (18)F-fluorodeoxyglucose ((18)FDG) PET/CT imaging improves quantitation of atherosclerotic plaque inflammation. Blood-pool activity can disturb the arterial (18)FDG signal. With time, blood-pool activity declines. Therefore, delayed imaging can...... potentially improve quantitation of vascular inflammation. METHODS AND RESULTS: 40 subjects were prospectively assessed by dual-time-point PET/CT imaging at approximately 90 and 180 minutes after (18)FDG administration. For both time-points, global uptake of (18)FDG was determined in the carotid arteries...... and thoracic aorta by calculating the blood-pool corrected maximum standardized uptake value (cSUVMAX). A target-to-background ratio (TBR) was calculated to determine the contrast resolution at 90 and 180 minutes. Furthermore, we assessed whether the acquisition time-point affected the relation between c...

  18. {sup 18}F-FDG PET/CT Finding in a Case of Xanthogranulomatous Pyelonephritis

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Bong Hoi; Hong, Sun Pyo; Yoon, Joon Kee; Pai, Ki Soo; Hong, Jeong; Yim, Hyun Ee [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2009-04-15

    Xanthogranulomatous pyelonephritis is an uncommon chronic renal infection, which is usually found on middle-aged women and is rare in infant. Sometimes it forms focal mass like lesion of kidney with pathologically characteristic lipid-laden macrophage. A 1-month female infant was admitted for fever and moaning sound. On work-up of urinary tract infection, abdomen ultrasonography and computed tomography revealed a large mass on the upper portion of right kidney and PET/CT showed homogeneously increased {sup 18}F-FDG uptake. The radical nephrectomy of right kidney was performed and histology revealed a focal xanthogranulomatous pyelonephritis. To our knowledge, this is the first report presenting the finding of {sup 18}F-FDG PET/CT in the childhood xanthogranulomatous pyelonephritis.

  19. Ambient radiation levels in positron emission tomography/computed tomography (PET/CT imaging center

    Directory of Open Access Journals (Sweden)

    Priscila do Carmo Santana

    2015-02-01

    Full Text Available Objective: To evaluate the level of ambient radiation in a PET/CT center. Materials and Methods: Previously selected and calibrated TLD-100H thermoluminescent dosimeters were utilized to measure room radiation levels. During 32 days, the detectors were placed in several strategically selected points inside the PET/CT center and in adjacent buildings. After the exposure period the dosimeters were collected and processed to determine the radiation level. Results: In none of the points selected for measurements the values exceeded the radiation dose threshold for controlled area (5 mSv/year or free area (0.5 mSv/year as recommended by the Brazilian regulations. Conclusion: In the present study the authors demonstrated that the whole shielding system is appropriate and, consequently, the workers are exposed to doses below the threshold established by Brazilian standards, provided the radiation protection standards are followed.

  20. Ambient radiation levels in positron emission tomography/computed tomography (PET/CT) imaging center

    Energy Technology Data Exchange (ETDEWEB)

    Santana, Priscila do Carmo; Oliveira, Paulo Marcio Campos de; Mamede, Marcelo; Silveira, Mariana de Castro; Aguiar, Polyanna; Real, Raphaela Vila, E-mail: pridili@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil); Silva, Teogenes Augusto da [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2015-01-15

    Objective: to evaluate the level of ambient radiation in a PET/CT center. Materials and methods: previously selected and calibrated TLD-100H thermoluminescent dosimeters were utilized to measure room radiation levels. During 32 days, the detectors were placed in several strategically selected points inside the PET/CT center and in adjacent buildings. After the exposure period the dosimeters were collected and processed to determine the radiation level. Results: in none of the points selected for measurements the values exceeded the radiation dose threshold for controlled area (5 mSv/ year) or free area (0.5 mSv/year) as recommended by the Brazilian regulations. Conclusion: in the present study the authors demonstrated that the whole shielding system is appropriate and, consequently, the workers are exposed to doses below the threshold established by Brazilian standards, provided the radiation protection standards are followed. (author)

  1. Dosimetry of patients submitted to cerebral PET/CT for the diagnosis of mild cognitive impairment

    Energy Technology Data Exchange (ETDEWEB)

    Santana, Priscila do Carmo; Oliveira, Paulo Marcio Campos de; Bernardes, Felipe Dias; Mamede, Marcelo, E-mail: pridili@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil); Mourao, Arnaldo Prata [Centro Federal de Educacao Tecnologica de Minas Gerais (CEFET), Belo Horizonte, MG (Brazil); Silva, Teogenes Augusto da [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2014-11-15

    Objective: the present study was aimed at evaluating the effective radiation dose in patients submitted to PET/CT for the diagnosis of mild cognitive impairment. Materials and methods: TLD-100 detectors inserted into an Alderson Rando® anthropomorphic phantom were utilized to measure the absorbed dose coming from the CT imaging modality. The anthropomorphic phantoms (male and female adult versions) were submitted to the same technical protocols for patients’ images acquisition. The absorbed dose resulting from the radiopharmaceutical injection was estimated by means of the model proposed by the ICRP publication 106. Results: the effective dose in patients submitted to this diagnostic technique was approximately (5.34 ± 1.99) mSv. Conclusion: optimized protocols for calculation of radioactive activity injected into patients submitted to this diagnostic technique might contribute to reduce the effective radiation dose resulting from PET/CT in the diagnosis of mild cognitive impairment. (author)

  2. 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...... to plan and analyze studies to optimize this timing. Methods: General considerations about studying the optimal timing are given and four fundamental steps are illustrated using data from a published study. Results: The optimal timing should be examined by optimizing the schedule with respect...... to predicting the overall individual time course we can observe in the case of dense measurements. The optimal timing needs not to and should not be studied by optimizing the association with the prognosis of the patient. Conclusions: The optimal timing should be examined in specific ‘schedule optimizing...

  3. Prevalence of exclusive lower extremity metastases at {sup 18}F-NaF PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Ordones, Monique Beraldo, E-mail: moniqueordones@yahoo.com.br [Universidade de Sao Paulo (In-Rad/HC-FMUSP), Sao Paulo, SP (Brazil). Hospital das Clinicas. Inst. de Radiologia; Valadares, Agnes Araujo [Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, SP (Brazil). Hospital das Clinicas; Duarte, Paulo Schiavom; Sado, Heitor Naoki; Lima, Marcos Santos; Carvalho, Giovanna [Instituto do Cancer do Estado de Sao Paulo Octavio Frias de Oliveira (ICESP), Sao Paulo, SP (Brazil). Servico de Medicina Nuclear; Sapienza, Marcelo Tatit; Buchpiguel, Carlos Alberto [Universidade de Sao Paulo (FMUSP), Sao Paulo, SP (Brazil). Fac. de Medicina

    2015-05-15

    Objective: to evaluate the prevalence of exclusive lower extremity metastases, specifically in the femur and below the knee, observed at {sup 18}F-NaF PET/CT. Materials and methods: one thousand consecutive PET/CT studies were retrospectively evaluated for the presence of exclusive uptake in lower extremities suggesting metastatic involvement. The presumptive diagnoses based on such uptakes were subsequently obtained by evaluation of other imaging studies. Results: no exclusive uptake suggestive of metastasis below the femur was observed in the present series. Exclusive uptake was observed in the proximal femur with a presumptive diagnosis of metastasis in two patients. Conclusion: the prevalence of exclusive metastasis below the femur is low and scanning from head to knees is appropriate in most cases. (author)

  4. Impact of the PET/CT in the marshalling of the lung cancer; Impacto del PET/CT en el manejo del cancer de pulmon

    Energy Technology Data Exchange (ETDEWEB)

    Izquierdo F, M.C. [Hospital Angeles del las Lomas, Huixquilucan, Estado de Mexico (Mexico); Serna M, J.A.; Quiroz C, O.; Luviano V, C.; Alcala G, B. [Hospital Angeles del Pedregal, Mexico DF. (Mexico)

    2005-07-01

    The lung cancer constitutes one of the main morbimortality causes in our environment, being indispensable to carry out a clinical staging with bigger accuracy that allows to define it extension with two objectives: 1. The surgery determination. 2. To predict the prognosis. At the present time it has been possible to combine the metabolic-functional image with the anatomical image creating the PET/CT modality (Positron Emission Tomography/ Computerized Tomography) with that which has improved substantially the accuracy and localization of the lesions with sensitivity of 81%, specificity of 94% and an accuracy diagnoses of 90%. In conclusion the PET/CT image technique has been indispensable in the oncological patient's handling especially in the patient with lung cancer changing the perspective diagnoses as well as the treatment avoiding invasive methods like the mediastinoscopy until the realization of extensive surgeries. The metabolic with the anatomical image fusion it has been able to locate with more accuracy the lesions to distance especially in mediastinum, as well as staging has been achieved accurately in a single exploration to the patient with lung cancer overcoming the rest of the non invasive diagnostic tests especially in the valuation of the metastatic at distance illness, transforming it into an exploration technique with a high effectiveness at an appropriate cost benefit. (Author)

  5. Selective CT for PET/CT: dose reduction in Langerhans cell histiocytosis

    Energy Technology Data Exchange (ETDEWEB)

    Gelfand, Michael J.; Sharp, Susan E. [Cincinnati Children' s Hospital Medical Center, Section of Nuclear Medicine, Department of Radiology, Cincinnati, OH (United States); Palumbo, Joseph S. [Cincinnati Children' s Hospital Medical Center, Cancer and Blood Diseases Institute, Department of Pediatrics, Cincinnati, OH (United States)

    2014-08-23

    In Langerhans cell histiocytosis (LCH), FDG PET demonstrates active disease in bone. Other imaging modalities show the effects of bone destruction by LCH. To evaluate a selective CT method for reducing effective dose from FDG PET/CT in LCH, using whole-body modified attenuation correction CT at extremely low exposure settings, with repeat selective limited-volume CT at typical localization settings. Fifty-one PET/CT scans were performed in 23 LCH patients, median patient age 8.5 years (range: 1-25 years). Thirty-four were performed with modified attenuation correction CT settings, with bed positions (excluding head and neck) repeated at localization CT settings in regions with abnormal or difficult to interpret PET findings. Of 34 modified attenuation correction PET/CT scans, 10 required repeat localization CT of 1 to 3 bed positions (total: 17 bed positions). Lytic bone lesions were easily recognized at modified attenuation correction settings. Calculated average effective dose for the 34 whole-body CT scans at modified attenuation correction settings was 1.65 mSv. Average effective dose per patient for repeat imaging of 17 bed positions at localization settings was 1.19 mSv. Average total effective dose from CT for all 34 scans performed at the modified attenuation correction CT settings, including the 10 repeat localization CT scans, was 2.0 mSv. High-quality PET scans were consistently obtained with reduced FDG-administered activities of 3.7 MBq/kg (0.10 mCi/kg). In active LCH, abnormal FDG uptake was seen in all lytic bone lesions ≥9 mm, including cranial vault lesions. Substantial reduction in effective dose is possible using selective CT techniques for FDG PET/CT. (orig.)

  6. Normal SUV values measured from NaF18- PET/CT bone scan studies.

    Directory of Open Access Journals (Sweden)

    Aung Zaw Win

    Full Text Available 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.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 history of cancer and metabolic bone diseases including but not limited to osteoporosis, osteopenia and Paget's disease. Eleven studies met all the criteria.The average normal SUVmax values from 11 patients were: cervical vertebrae 6.84 (range 4.38-8.64, thoracic vertebrae 7.36 (range 6.99-7.66, lumbar vertebrae 7.27 (range 7.04-7.72, femoral head 2.22 (range 1.1-4.3, humeral head 1.82 (range 1.2-2.9, mid sternum 5.51 (range 2.6-8.1, parietal bone 1.71 (range 1.3-2.4.According to our study, various skeletal sites have different normal SUV values. SUV values can be different between the normal bones and bones with tumor or metabolic bone disease. SUV can be used to quantify NaF-18 PET/CT studies. If the SUV values of the normal skeleton are known, they can be used in the characterization of bone lesions and in the assessment of treatment response to bone diseases.

  7. [68Ga]-DOTATOC-PET/CT for meningioma IMRT treatment planning

    Directory of Open Access Journals (Sweden)

    Bamberg Michael

    2009-11-01

    Full Text Available Abstract Purpose The observation that human meningioma cells strongly express somatostatin receptor (SSTR 2 was the rationale to analyze retrospectively in how far DOTATOC PET/CT is helpful to improve target volume delineation for intensity modulated radiotherapy (IMRT. Patients and Methods In 26 consecutive patients with preferentially skull base meningioma, diagnostic magnetic resonance imaging (MRI and planning-computed tomography (CT was complemented with data from [68Ga]-DOTA-D Phe1-Tyr3-Octreotide (DOTATOC-PET/CT. Image fusion of PET/CT, diagnostic computed tomography, MRI and radiotherapy planning CT as well as target volume delineation was performed with OTP-Masterplan®. Initial gross tumor volume (GTV definition was based on MRI data only and was secondarily complemented with DOTATOC-PET information. Irradiation was performed as EUD based IMRT, using the Hyperion Software package. Results The integration of the DOTATOC data led to additional information concerning tumor extension in 17 of 26 patients (65%. There were major changes of the clinical target volume (CTV which modify the PTV in 14 patients, minor changes were realized in 3 patients. Overall the GTV-MRI/CT was larger than the GTV-PET in 10 patients (38%, smaller in 13 patients (50% and almost the same in 3 patients (12%. Most of the adaptations were performed in close vicinity to bony skull base structures or after complex surgery. Median GTV based on MRI was 18.1 cc, based on PET 25.3 cc and subsequently the CTV was 37.4 cc. Radiation planning and treatment of the DOTATOC-adapted volumes was feasible. Conclusion DOTATOC-PET/CT information may strongly complement patho-anatomical data from MRI and CT in cases with complex meningioma and is thus helpful for improved target volume delineation especially for skull base manifestations and recurrent disease after surgery.

  8. Evaluation of the efficiency of FDG PET/CT in detection and characterization of skeletal metastases

    Directory of Open Access Journals (Sweden)

    Ahmed Wafaie

    2014-03-01

    Conclusion: Fused PET/CT was highly efficient in evaluation of skeletal metastases with superior performance in: detection of early bone marrow infiltration not apparent on CT, resolution of metabolic activity before definite signs of complete healing on CT, detection of missed sclerotic metastases on PET due to their relatively low metabolic activity, detection of intra and extra osseous recurrence and differentiation of benign from malignant bone lesions.

  9. Incidentally detected carcinoma ex pleomorphic adenoma of parotid gland by F-18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Eun Jung; Chun, Kyung Ah; Cho, Ihn Ho [Yeungnam Univ. Hospital, Daegu (Korea, Republic of)

    2016-03-15

    A 62-year-old man underwent FDG PET/CT to determine the initial stage of gastric carcinoma, and the scan revealed an incidental FDG-avid mass in the left parotid gland. He subsequently underwent surgery, and the final diagnosis was of carcinoma ex pleomorphic adenoma with cervical lymph node metastasis. The patient underwent left total parotidectomy with left selective neck dissection 2 months later, and the histopathologic report confirmed carcinoma ex pleomorphic adenoma with cervical lymph node metastasis.

  10. Role of 18F-FDG PET/CT in the staging of pediatric peritoneal mesothelioma.

    Science.gov (United States)

    Abikhzer, Gad; Gourevich, Konstantin; Arkovitz, Marc; Postovsky, Sergey; Keidar, Zohar

    2013-08-01

    A 7-year-old girl with a 1-month history of diffuse abdominal pain underwent an ultrasound which showed a pelvic mass with multiple peritoneal implants and ascites. An US-guided core biopsy of one of the implants as well as a transrectal biopsy of the pelvic tumor showed pathological findings consistent with epithelioid mesothelioma. We describe the findings on (18)F-FDG PET/CT in pediatric peritoneal mesothelioma.

  11. (18)F-FDG PET/CT findings in a case with HIV (-) Kaposi sarcoma.

    Science.gov (United States)

    Ozdemir, E; Poyraz, N Y; Keskin, M; Kandemir, Z; Turkolmez, S

    2014-01-01

    Although mucocutaneous sites are the most frequently encountered sites of involvement, Kaposi Sarcoma (KS) may also occasionally involve the breast and the skeletal, endocrine, urinary and nervous systems.. Various imaging modalities may be used to delineate the extent of the disease by detecting unexpected sites of involvement. Herein, we report a case of classical type KS, in whom staging with (18)F-FDG PET/CT imaging disclosed widespread disease and unexpected findings of bone and salivary gland involvement.

  12. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0

    Energy Technology Data Exchange (ETDEWEB)

    Boellaard, Ronald; Hoekstra, Otto S. [VU University Medical Centre, Department of Radiology and Nuclear Medicine, Amsterdam (Netherlands); Delgado-Bolton, Roberto [University of La Rioja, Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, San Pedro Hospital and Centre for Biomedical Research of La Rioja (CIBIR), Logrono, La Rioja (Spain); Oyen, Wim J.G.; Visser, Eric [Radboud University Nijmegen Medical Centre, Department of Radiology and Nuclear Medicine, Nijmegen (Netherlands); Giammarile, Francesco [Centre Hospitalier Universitaire de Lyon, Department of Nuclear Medicine, Lyon (France); Tatsch, Klaus [Municipal Hospital Karlsruhe Inc., Department of Nuclear Medicine, Karlsruhe (Germany); Eschner, Wolfgang [University of Cologne, Department of Nuclear Medicine, Cologne (Germany); Verzijlbergen, Fred J. [Erasmus Medical Center, Department of Nuclear Medicine, Rotterdam (Netherlands); Barrington, Sally F.; Pike, Lucy C. [King' s College London, King' s Health Partners, PET Imaging Centre, St Thomas' Hospital, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Weber, Wolfgang A. [Memorial Sloan Kettering Center, Department of Radiology, New York, NY (United States); Stroobants, Sigrid [Antwerp University Hospital, Department of Nuclear Medicine, Antwerp (Belgium); Delbeke, Dominique [Vanderbilt University Medical Center, Department of Radiology and Radiological Sciences, Nashville, TN (United States); Donohoe, Kevin J. [Beth Israel Deaconess Medical Center, Boston, MA (United States); Holbrook, Scott [Invivo Molecular Imaging LLC, Gray, TN (United States); Graham, Michael M. [University of Iowa, Department of Radiology, Iowa City, IA (United States); Testanera, Giorgio; Chiti, Arturo [Humanitas Clinical and Research Center, Department of Nuclear Medicine, Rozzano, MI (Italy); Zijlstra, Josee [VU University Medical Centre, Department of Hematology, Amsterdam (Netherlands); Hoekstra, Corneline J. [Jeroen Bosch Hospital, Department of Nuclear Medicine, Den Bosch (Netherlands); Pruim, Jan; Willemsen, Antoon [University Medical Centre Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen (Netherlands); Arends, Bertjan [Catharina Hospital, Department of Clinical Physics, Eindhoven (Netherlands); Kotzerke, Joerg [University Hospital Dresden, Clinic and Outpatient Clinic for Nuclear Medicine, Dresden (Germany); Bockisch, Andreas [University Hospital Essen, Clinic for Nuclear Medicine, Essen (Germany); Beyer, Thomas [Medical University of Vienna, Centre for Medical Physics and Biomedical Engineering, Vienna (Austria); Krause, Bernd J. [University Hospital Rostock, Department of Nuclear Medicine, Rostock (Germany)

    2014-12-02

    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) procedure to maintain the accuracy and precision of quantitation. Repeatability and reproducibility are two essential requirements for any quantitative measurement and/or imaging biomarker. Repeatability relates to the uncertainty in obtaining the same result in the same patient when he or she is examined more than once on the same system. However, imaging biomarkers should also have adequate reproducibility, i.e. the ability to yield the same result in the same patient when that patient is examined on different systems and at different imaging sites. Adequate repeatability and reproducibility are essential for the clinical management of patients and the use of FDG PET/CT within multicentre trials. A common standardised imaging procedure will help promote the appropriate use of FDG PET/CT imaging and increase the value of publications and, therefore, their contribution to evidence-based medicine. Moreover, consistency in numerical values between platforms and institutes that acquire the data will potentially enhance the role of semiquantitative and quantitative image interpretation. Precision and accuracy are additionally important as FDG PET/CT is used to evaluate tumour response as well as for diagnosis, prognosis and staging. Therefore both the previous and these new guidelines specifically aim to achieve standardised uptake value harmonisation in multicentre settings. (orig.)

  13. A Putative Case of Methotrexate-Related Lymphoma: Clinical Course and PET/CT Findings

    OpenAIRE

    Rachel C. Jankowitz; James Ganon; Todd Blodgett; Christine Garcia; Samuel Jacobs

    2009-01-01

    Patients with autoimmune conditions develop lymphoproliferative disorders (LPDs) at a higher frequency than normal both in association with and independent of Methotrexate (MTX). We describe a case of MTX-associated lymphoma in a patient with psoriasis on long-standing MTX. The case is notable for the initial tumor burden, the dramatic disappearance of the PET-CT findings on discontinuation of MTX, and the subsequent early regrowth of disease. Our case report is illustrative of an MTX-related...

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

    Directory of Open Access Journals (Sweden)

    Emel TOKMAK

    2011-08-01

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

  15. Malignancy rate of biopsied suspicious bone lesions identified on FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Hugo J.A.; Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Klerk, John M.H. de [Meander Medical Center, Department of Nuclear Medicine, Amersfoort (Netherlands); Heggelman, Ben G.F. [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Dubois, Stefan V. [Meander Medical Center, Department of Pathology, Amersfoort (Netherlands)

    2016-07-15

    To determine the malignancy rate of bone lesions identified on FDG PET/CT in patients who have undergone CT-guided biopsy because of the suspicion of malignancy. This single-centre retrospective study spanned eight consecutive years and included all patients who underwent both FDG PET/CT and CT-guided bone biopsy because of the suspicion of malignancy. The positive predictive value (PPV) for malignancy was calculated, and different patient and imaging characteristics were compared between malignant and benign bone lesions. Of 102 included patients with bone lesions that all showed FDG uptake exceeding mediastinal uptake, bone biopsy showed a malignant lesion in 91 patients, yielding a PPV for malignancy of 89.2 % (95 % CI 81.7 - 93.9 %). In the 94 patients with bone lesions that showed FDG uptake exceeding liver uptake, bone biopsy showed a malignant lesion in 83 patients, yielding a PPV for malignancy of 88.3 % (95 % CI 80.1 - 93.5 %). Higher age, bone marrow replacement of the lesion seen on CT, expansion of the lesion seen on CT, and presence of multifocal lesions on FDG PET/CT were significantly more frequent in patients with malignant lesions than in those with benign bone lesions (P = 0.044, P = 0.009, P = 0.015, and P = 0.019, respectively). Furthermore, there was a trend towards a higher incidence of cortical destruction (P = 0.056) and surrounding soft tissue mass (P = 0.063) in patients with malignant bone lesions. The PPV for malignancy of suspicious bone lesions identified on FDG PET/CT is not sufficiently high to justify changes in patient management without histopathological confirmation. Nevertheless, ancillary patient and imaging characteristics may increase the likelihood of a malignant bone lesion. (orig.)

  16. Pelvic congestion syndrome initially detected by contrast enhanced F 18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-15

    Pelvic congestion syndrome (PCS) is said to occur as a result of retrograde flow in an incompetent ovarian vein. Ovarian vein incompetence is seen in approximately 10% of women, and up to 60% with this abnormality can develop PCS. The etiology of PCS is poorly understood and is likely to be multifactorial. Absence of ovarian vein valves is an important factor in its development. The causes of ovarian varicoceles are multifactorial, involving both mechanical and hormonal factors. Dilatation of the ovarian veins can result in vascular incompetence and retrograde blood flow. On either CT or magnetic resonance (MR) imaging studies, pelvic varices in PCS appear as dilated, tortuous, enhancing tubular structures near the ovaries and uterus. In addition, the extension of varices to the broad ligament and paravaginal venous plexus can be appreciated. With CT, the tubular nature of these structures and the pattern of enhancement after intravenous contrast medium administration distinguish them from lymphadenopathy or adnexal masses. Unlike such masses, pelvic varices appear isodense with other veins after contrast enhancement. Contrast enhanced CT data as part of the combined PET/CT examination provide additional information when compared with non enhanced PET/CT. Because CT data supply the anatomic background for PET, the most important benefit relates to more precise anatomic localization of pathology by differentiation of the lesion from its surrounding structures. By supporting lesion detection and characterization, CT contrast agents can be of additional value in F 18 FDG non avid disease. As in the presented case, careful review of CT images in contrast enhanced PET/CT enables the detection of F 18 FDG non avid disease such as PCS. As contrast enhanced F 18 FDG PET/CT had been performed frequently, being familiar with the findings of PCS on the contrast enhanced CT images would have been helpful for the nuclear medicine physicians.

  17. Comparison of (18)F-FDG PET/CT and (99 m)Tc-MDP bone scintigraphy for detection of bone metastasis in osteosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Byung Hyun; Lim, Ilhan; Kim, Byung Il; Choi, Chang Woon; Lim, Sang Moo [Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Nuclear Medicine, Seoul (Korea, Republic of); Kong, Chang-Bae; Song, Won Seok; Cho, Wan Hyeong; Jeon, Dae-Geun; Lee, Soo-Yong [Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Orthopedic Surgery, Seoul (Korea, Republic of); Koh, Jae-Soo [Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Pathology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2013-12-15

    We compared the diagnostic performance of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and (99 m)Tc-methylene diphosphonate bone scintigraphy (BS) for the detection of bone metastasis in osteosarcoma. We retrospectively reviewed 206 patients with stage II-IV osteosarcoma treated with surgery and chemotherapy as well as at least one paired PET/CT and BS scan (defined as an examination). PET/CT and BS images were interpreted separately. When analyzing the diagnostic yield of a combination of PET/CT and BS (PET/CT+BS), an examination was considered positive if either PET/CT or BS scored positive. The final diagnosis was obtained from histological findings or clinical follow-up with imaging studies for at least 6 months. Diagnostic performances of PET/CT, BS, and their combinations were calculated. Out of 833 examinations in 206 patients, 55 with 101 lesions in 38 patients were confirmed as bone metastases. The sensitivity, specificity, and diagnostic accuracy were 95, 98, and 98 %, respectively, for PET/CT; 76, 97, and 96 %, respectively, for BS; and 100, 96, and 97 %, respectively, for PET/CT+BS in an examination-based analysis. Lesion-based analysis demonstrated that the sensitivity of PET/CT+BS (100 %) was significantly higher than that of PET/CT (92 %) or BS (74 %) alone. BS detected significantly less bone metastases in the growth plate region than outside the growth plate region (22 vs. 77 %). PET/CT is more sensitive and accurate than BS for diagnosing bone metastases in osteosarcoma. The combined use of PET/CT and BS improves sensitivity. (orig.)

  18. Unusual False-Positive Mesenteric Lymph Nodes Detected by PET/CT in a Metastatic Survey of Lung Cancer

    Directory of Open Access Journals (Sweden)

    Hirohiko Kamiyama

    2016-06-01

    Full Text Available Positron emission tomography/computed tomography (PET/CT is a credible diagnostic modality for detecting primary and metastatic malignancy. PET/CT sometimes shows false positives and negatives, which make clinical diagnosis difficult. A 42-year-old man who had undergone right upper lobectomy for lung cancer 1 year previously had PET/CT for a metastatic survey of the lung. The lung cancer was stage IB (pT2N0M0 bronchioloalveolar carcinoma. PET/CT showed massive 18F-fluorodeoxyglucose (FDG uptake in the mesenteric lymph nodes. Because the mesentery is an unusual site of metastasis, the patient was under watchful observation. Another PET/CT after 6 months still showed FDG uptake in the same location, with a slightly increased standard uptake value. A systemic survey was performed, but it did not reveal any malignancies or inflammatory diseases. Eventually, the patient underwent probing laparoscopic surgery. For complete resection of the lymph nodes, laparoscopic ileocecal resection was performed. Histologically, the resected lymph nodes showed reactive lymphadenitis. Glucose transporter 1 immunostainings of the lung cancer and the lymph node were positive and partially positive, respectively. Although PET/CT is a powerful diagnostic modality, clinical interpretation of unusual results is difficult.

  19. Diagnosis of bone metastases: a meta-analysis comparing {sup 18}FDG PET, CT, MRI and bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Hui-Lin; Liu, Tao [Hospital of Soochow University, Department of Orthopaedics, Suzhou (China); Wang, Xi-Ming [Hospital of Soochow University, Department of Radiology, Suzhou (China); Xu, Yong [Public Health School of Soochow University, Department of Epidemiology and Biostatistics, Suzhou (China); Deng, Sheng-Ming [Department of Nuclear Medicine, The first affiliated hospital of Soochow University, Suzhou (China)

    2011-12-15

    To perform a meta-analysis to compare {sup 18}FDG PET, CT, MRI and bone scintigraphy (BS) for the diagnosis of bone metastases. Databases including MEDLINE and EMBASE were searched for relevant original articles published from January 1995 to January 2010. Software was used to obtain pooled estimates of sensitivity, specificity and summary receiver operating characteristic curves (SROC). 67 articles consisting of 145 studies fulfilled all inclusion criteria. On per-patient basis, the pooled sensitivity estimates for PET, CT, MRI and BS were 89.7%, 72.9%, 90.6% and 86.0% respectively. PET=MRI>BS>CT. (''=''indicated no significant difference, P > 0.05; ''>'' indicated significantly higher, P < 0.05). The pooled specificity estimates for PET, CT, MRI and BS were 96.8%, 94.8%, 95.4% and 81.4% respectively. PET = CT = MRI>BS. On per-lesion basis, the pooled sensitivity estimates for PET, CT, MRI and BS were 86.9%, 77.1%, 90.4% and 75.1% respectively. PET = MRI>BS>CT. The pooled specificity estimates for PET, CT, MRI and BS were 97.0%, 83.2%, 96.0% and 93.6% respectively. PET>MRI>BS>CT. PET and MRI were found to be comparable and both significantly more accurate than CT and BS for the diagnosis of bone metastases. (orig.)

  20. Comparison of 3'-deoxy-3'-[{sup 18}F]fluorothymidine positron emission tomography (FLT PET) and FDG PET/CT for the detection and characterization of pancreatic tumours

    Energy Technology Data Exchange (ETDEWEB)

    Herrmann, K.; Beer, A.J.; Wester, H.J.; Schwaiger, M. [Technische Universitaet Muenchen, Department of Nuclear Medicine, Munich (Germany); Erkan, M.; Friess, H.; Kleeff, J. [Technische Universitaet Muenchen, Department of General Surgery, Munich (Germany); Dobritz, M. [Technische Universitaet Muenchen, Institute of Radiology, Munich (Germany); Schuster, T. [Technische Universitaet Muenchen, Institute of Medical Statistics and Epidemiology, Munich (Germany); Siveke, J.T.; Schmid, R.M. [Technische Universitaet Muenchen, Department of Internal Medicine II, Munich (Germany); Buck, A.K. [Technische Universitaet Muenchen, Department of Nuclear Medicine, Munich (Germany); University Hospital Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany)

    2012-05-15

    Despite recent advances in clinical imaging modalities, differentiation of pancreatic masses remains difficult. Here, we tested the diagnostic accuracy of molecular-based imaging including 3'-deoxy-3'-[{sup 18}F]fluorothymidine (FLT) positron emission tomography (PET) and [{sup 18}F]fluorodeoxyglucose (FDG) PET/CT in patients with suspected pancreatic masses scheduled to undergo surgery. A total of 46 patients with pancreatic tumours suspicious for malignancy and scheduled for resective surgery were recruited prospectively. In 41 patients, FLT PET and FDG PET/CT scans were performed. A diagnostic CT performed on a routine basis was available in 31 patients. FLT PET and FDG PET/CT emission images were acquired according to standard protocols. Tracer uptake in the tumour [FDG and FLT standardized uptake value (SUV)] was quantified by the region of interest (ROI) technique. For FDG PET/CT analysis, correct ROI placement was ensured via side-by-side reading of corresponding CT images. Of 41 patients, 33 had malignancy, whereas 8 patients had benign disease. Visual analysis of FDG and FLT PET resulted in sensitivity values of 91% (30/33) and 70% (23/33), respectively. Corresponding specificities were 50% (4/8) for FDG PET and 75% (6/8) for FLT PET. In the subgroup of patients with contrast-enhanced CT (n = 31), sensitivities were 96% (PET/CT), 88% (CT alone), 92% (FDG PET) and 72% (FLT PET), respectively. Mean FLT uptake in all malignant tumours was 3.0 (range SUV{sub max} 1.1-6.5; mean FDG SUV{sub max} 7.9, range 3.3-17.8; p < 0.001). For differentiation of pancreatic tumours, FDG PET and FDG PET/CT showed a higher sensitivity but lower specificity than FLT PET. Interestingly, visual analysis of FLT PET led to two false-positive findings by misinterpreting physiological bowel uptake as pathological FLT uptake in the pancreas. Due to the limited number of patients, the clinical value of adding FLT PET to the diagnostic workup of pancreatic tumours remains to

  1. Treatment response evaluation with {sup 18}F-FDG PET/CT and {sup 18}F-NaF PET/CT in multiple myeloma patients undergoing high-dose chemotherapy and autologous stem cell transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Sachpekidis, Christos [German Cancer Research Center (DKFZ), Medical PET Group-Biological Imaging, Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany); University of Bern, Department of Nuclear Medicine, Inselspital, Bern University Hospital, Bern (Switzerland); Hillengass, J.; Wagner, B. [University Hospital Heidelberg, Department of Internal Medicine V, Heidelberg (Germany); Goldschmidt, H. [University Hospital Heidelberg, Department of Internal Medicine V, Heidelberg (Germany); National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg (Germany); Haberkorn, U. [German Cancer Research Center (DKFZ), Medical PET Group-Biological Imaging, Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany); University of Heidelberg, Department of Nuclear Medicine, Heidelberg (Germany); Kopka, K. [German Cancer Research Center (DKFZ), Department of Radiopharmaceutical Chemistry, Heidelberg (Germany); Dimitrakopoulou-Strauss, A. [German Cancer Research Center (DKFZ), Medical PET Group-Biological Imaging, Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany)

    2017-01-15

    The aim of this study was to assess the combined use of the radiotracers {sup 18}F-FDG and {sup 18}F-NaF in treatment response evaluation of a group of multiple myeloma (MM) patients undergoing high-dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) by means of static (whole-body) and dynamic PET/CT (dPET/CT). Thirty-four patients with primary, previously untreated MM scheduled for treatment with HDT followed by ASCT were enrolled in the study. All patients underwent PET/CT scanning with {sup 18}F-FDG and {sup 18}F-NaF before and after therapy. Treatment response by means of PET/CT was assessed according to the European Organization for Research and Treatment of Cancer (EORTC) 1999 criteria. The evaluation of dPET/CT studies was based on qualitative evaluation, semi-quantitative (SUV) calculation, and quantitative analysis based on two-tissue compartment modelling and a non-compartmental approach leading to the extraction of fractal dimension (FD). An analysis was possible in 29 patients: three with clinical complete response (CR) and 26 with non-CR (13 patients near complete response-nCR, four patients very good partial response-VGPR, nine patients partial response-PR). After treatment, {sup 18}F-FDG PET/CT was negative in 14/29 patients and positive in 15/29 patients, showing a sensitivity of 57.5 % and a specificity of 100 %. According to the EORTC 1999 criteria, {sup 18}F-FDG PET/CT-based treatment response revealed CR in 14 patients ({sup 18}F-FDG PET/CT CR), PR in 11 patients ({sup 18}F-FDG PET/CT PR) and progressive disease in four patients ({sup 18}F-FDG PET/CT PD). In terms of {sup 18}F-NaF PET/CT, 4/29 patients (13.8 %) had a negative baseline scan, thus failed to depict MM. Regarding the patients for which a direct lesion-to-lesion comparison was feasible, {sup 18}F-NaF PET/CT depicted 56 of the 129 {sup 18}F-FDG positive lesions (43 %). Follow-up {sup 18}F-NaF PET/CT showed persistence of 81.5 % of the baseline {sup 18}F

  2. Role of FDG-PET and PET/CT in the diagnosis of prolonged febrile states

    Energy Technology Data Exchange (ETDEWEB)

    Jaruskova, M.; Belohlavek, O. [Na Homolce Hospital, PET Center, Prague 5 (Czech Republic)

    2006-08-15

    The role of FDG-PET and PET/CT in patients whose main symptom is prolonged fever has not yet been defined. We addressed this topic in a retrospective study. A total of 124 patients (referred between May 2001 and December 2004) with fever of unknown origin or prolonged fever due to a suspected infection of a joint or vascular prosthesis were included in the study. The patients underwent either FDG-PET or FDG-PET/CT scanning. Sixty-seven patients had a negative focal FDG-PET finding; in this group the method was regarded as unhelpful in determining a diagnosis, and no further investigation was pursued. We tried to obtain clinical confirmation for all patients with positive PET findings. Fifty-seven (46%) patients had positive FDG-PET findings. In six of them no further clinical information was available. Fifty-one patients with positive PET findings and 118 patients in total were subsequently evaluated. Systemic connective tissue disease was confirmed in 17 patients, lymphoma in three patients, inflammatory bowel disease in two patients, vascular prosthesis infection in seven patients, infection of a hip or knee replacement in seven patients, mycotic aneurysm in two patients, abscess in four patients and AIDS in one patient. In eight (16%) patients the finding was falsely positive. FDG-PET or PET/CT contributed to establishing a final diagnosis in 84% of the 51 patients with positive PET findings and in 36% of all 118 evaluated patients with prolonged fever. (orig.)

  3. 浅析“PET/CT检查”%PET/CT Examinations

    Institute of Scientific and Technical Information of China (English)

    李燕; 邵建霞; 田蕴青

    2014-01-01

    PET/CT examinations are general inspections, which utilize different imaging principle to obtain cross-sectional and functional fusion images of the whole body by only one examination. As an important method for diagnosing early stage tumor, PET/CT examinations have some limitations such as poor specificity of smal tumor, false-positive, false-negative, image artifacts, large radiation dosage, and expensive price. However, PET/CT would overcome these limitations and be used more widely due to the continuous development of new technology of PET and CT.%PET/CT检查是一种全身性检查手段,其利用了PET和CT两种不同成像原理的设备,一次检查即可获取全身各方位的断层功能融合图像。 PET/CT检查已成为诊断早期肿瘤非常重要的检查手段,尽管其存在对小肿瘤特异性差、假阳性和假阴性、图像有伪影、辐射剂量大、价格昂贵等局限性,但在PET、CT等新技术的不断发展下,PET/CT将克服这些局限性得到更加广泛的应用。

  4. Utility of FDG PET/CT in IgG4-related systemic disease

    Energy Technology Data Exchange (ETDEWEB)

    Nakatani, K., E-mail: koyakn@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto (Japan); Nakamoto, Y.; Togashi, K. [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto (Japan)

    2012-04-15

    IgG4-related systemic disease (IgG4-RSD) is an emerging clinical entity about which much remains to be elucidated, in terms of its aetiology, pathogenesis, diagnosis, treatment and outcome. Autoimmune pancreatitis (AIP) and Mikulicz disease (MD) are the two major, well-studied constituents of IgG4-RSD. AIP and MD have common characteristics of forming tumour-mimicking lesions that consist of lymphoplasmacytic infiltrates and fibrosclerosis with numerous immunoglobulin G4 (IgG4)-positive plasma cells, as well as various multi-organ manifestations of IgG4-RSD. 2-[{sup 18}F]-fluoro-2-deoxy-D-glucose positron-emission tomography/ computed tomography (FDG PET/CT) enables the acquisition of whole-body images and provides functional information about disease activity; as such it has a valuable role in staging extent of disease, guiding biopsy, and monitoring response to treatment. However, FDG PET/CT is likely to be only one component of the management strategy, and clinical, laboratory, imaging and histological findings are crucial in the overall diagnosis of the condition. At present FDG PET/CT does not have a well-established role in the assessment of patients with IgG4-RSD and future prospective studies are required to define the cost-effectiveness and clinical impact in this patient group more accurately.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

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

  6. False-Positive FDG PET Uptake-the Role of PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Rosenbaum, Sandra J.; Lind, Thomas; Bockisch, Andreas [University of Essen, Department of Nuclear Medicine, Essen (Germany); Antoch, Gerald [University of Essen, Department of Radiology, Essen (Germany)

    2006-05-15

    Positron emission tomography (PET) is a powerful molecular imaging technique for the human body-imaging applications currently available. As altered glucose metabolism is characteristic for many malignancies, FDG-PET is mostly used in oncology for staging and therapy control. Although PET is a sensitive tool for detecting malignancy, FDG uptake is not tumor specific. It can also be seen in healthy tissue or in benign disease as inflammation or posttraumatic repair and could be mistaken for cancer. The experienced nuclear medicine physician mostly manages to differentiate malignant from non-malignant FDG uptake, but some findings may remain ambiguous. In these cases, the difficulties in differentiating physiologic variants or benign causes of FDG uptake from tumor tissue can often be overcome by combined PET and CT (PET/CT) as anatomic information is added to the metabolic data. Thus, PET/CT improves the diagnostic accuracy compared to PET alone and helps to avoid unnecessary surgery/therapy. However, PET/CT involves other sources of artifacts that may occur when using CT for attenuation correction of PET or by patient motion caused by respiration or bowel movements. (orig.)

  7. CT, MRI, and FDG PET/CT findings of sinonasal sarcoma: Differentiation from squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Ho; Yoon, Dae Young; Baek, Sora; Park, Min Woo; Kwon, Kee Hwan; Rho, Young Soo [Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of)

    2016-07-15

    To evaluate computed tomography (CT), magnetic resonance imaging (MRI), and 18F-fluorodeoxyglucose (FDG) positron emission tomography/CT (PET/CT) findings for the differentiation of sinonasal sarcoma from squamous cell carcinoma (SCC). We retrospectively reviewed CT, MRI, and FDG PET/CT results in 20 patients with pathologically proven sinonasal sarcoma (n = 7) and SCC (n = 13). Imaging characteristics of tumors, such as the shape, size, margin, MRI signal intensity, pattern of enhancement, local tumor invasion, and maximum standardized uptake value (SUVmax) were analyzed and compared between sarcoma and SCC. The SUVmax of sarcomas (7.4 ± 2.1) was significantly lower than the SUVmax of the SCCs (14.3 ± 4.5) (p = 0.0013). However, no significant difference in the shape, size, margin, MRI signal intensity, pattern of enhancement, and local tumor invasion was observed between sarcoma and SCC. Although CT and MR imaging features are nonspecific, FDG PET/CT is useful in distinguishing between sinonasal sarcoma and SCC based on the SUVmax value.

  8. Active shingles infection as detected on 18F-FDG PET/CT

    Directory of Open Access Journals (Sweden)

    Razi eMuzaffar

    2013-04-01

    Full Text Available We present the case of a 56 year old male with a history of recurrent follicular lymphoma undergoing chemotherapy with multiple 18F-FDG PET-CT studies at an outside facility. He developed a painful erythematous, pruritic rash in the left back requiring a visit to the emergency room. He was diagnosed and treated for varicella zoster infection. He then presented to our imaging center 2 months later for a follow up 18F-FDG PET/CT study. Imaging demonstrated a cutaneous band of increased metabolic activity in the upper back following a dermatomal distribution. This was confirmed to be in the same area as the treated varicella zoster eruption. A subsequent follow up 18F-FDG PET-CT scan 4 months later to confirm tumor resolution demonstrated the abnormal band of uptake in the back had resolved. This case illustrates the significance of being aware of this entity and to distinguish it from metastasis, especially in patients with a known history of malignancy.

  9. Initial prostate cancer diagnosis and disease staging--the role of choline-PET-CT.

    Science.gov (United States)

    Mapelli, Paola; Picchio, Maria

    2015-09-01

    An early and correct diagnosis together with accurate staging of prostate cancer is necessary in order to plan the most appropriate treatment strategy. Morphological imaging modalities such as transrectal ultrasonography (TRUS), CT, and MRI can have some limitations regarding their accuracy for primary diagnosis and staging of prostate cancer; for instance, they have limited specificity in differentiating cancer from benign prostatic conditions and, by using size as the only criterion to characterize lymph node metastases, they might not be accurate enough for tumour characterization. In this scenario, PET-CT with (11)C-labelled or (18)F-labelled choline derivatives provides morphological and functional characterization and could overcome the limitations of the conventional imaging techniques. PET-CT is one of the most investigated molecular imaging modalities for prostate cancer diagnosis and staging. Currently, the main investigations on the role of PET-CT in the diagnosis and staging of prostate cancer have been performed on a retrospective basis and this type of analysis might be one of the main reasons why different results regarding its diagnostic accuracy have been reported.

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

    Institute of Scientific and Technical Information of China (English)

    Yiyan; Liu

    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 associated with a visible corresponding CT lesion or abnormality.When focal uptake is seen on PET imaging but no corresponding anatomic abnormality is visualized on the integrated CT,one should always be aware of possible mis-registration or mismatch of the PET and CT images due to the patient’s respiratory or body motion.While most of the hot spots in the absence of corresponding anatomic abnormalities are artefactual or secondary to benign etiologies,some may represent small sized or early staged neoplasm or metastases,especially in the gastrointestinal tract and skeletons.Caution should be exercised to simply diagnose a pathology based on the presence of the uptake only,or exclude the disease based on the absence of anatomic abnormality.

  11. Challenges in integrating 18FDG PET-CT into radiotherapy planning of head and neck cancer.

    Science.gov (United States)

    Dandekar, P; Partridge, M; Kazi, R; Nutting, C; Harrington, K; Newbold, K

    2010-01-01

    Radiotherapy forms one of the major treatment modalities for head and neck cancers (HNC), and precision radiotherapy techniques, such as intensity-modulated radiotherapy require accurate target delineation to ensure success of the treatment. Conventionally used imaging modalities, such as X-ray computed tomography (CT) and magnetic resonance imaging are used to delineate the tumor. Imaging, such as positron emission tomography (PET)-CT, which combines the functional and anatomic modalities, is increasingly being used in the management of HNC. Currently, 18-fluorodeoxyglucose is the most commonly used radioisotope, which is accumulated in areas of high glucose uptake, such as the tumor tissue. Because most disease recurrences are within the high-dose radiotherapy volume, defining a biological target volume for radiotherapy boost is an attractive approach to improve the results. There are many challenges in employing the PET-CT for radiotherapy planning, such as patient positioning, target edge definition, and use of new PET tracers, which represent various functional properties, such as hypoxia, protein synthesis, and proliferation. The role of PET-CT for radiotherapy planning is ever expanding and more clinical data underlining the advantages and challenges in this approach are emerging. In this article, we review the current clinical evidence for the application of functional imaging to radiotherapy planning and discuss some of the current challenges and possible solutions that have been suggested to date.

  12. FDG-PET/CT brain findings in a patient with macrophagic myofascilitis

    Energy Technology Data Exchange (ETDEWEB)

    Der Gucht, Axel Van; Itti, Emmanuel; Aoun-Sebaliti, Mehdi; Kauv, Paul; Aouizerate, Jessie; Gherardi, Romain K.; Bachoud-Levi, Anne-Catherine; Authier, Francois-Jerome [Paris/Paris-Est University, Paris (France); Verger, Antoine [CHU Nancy, Nuclear Medecine and Nancyclotep Experimental Imaging Platform, Nancy (France); Guedj, Eric [Assistance Publique des Hircumflex, Marseille (France)

    2016-03-15

    Brain Positron Emission Tomography/Computed Tomography with {sup 18}F-fluorodeoxyglucose (FDG PET/CT) was performed in a 44-year-old woman with marked cognitive impairment, diffuse myalgias, sensory, memory and visual disorders, and chronic fatigue, presenting with histopathological features of macrophagic myofasciitis (MMF) at deltoid muscle biopsy. Cerebromedullary Magnetic Resonance Imaging (MRI), electromyography, ophthalmic examination, and cerebrospinal fluid analysis were normal. Visual analysis of FDG PET/CT images showed an atypical pattern of hypometabolism, involving symmetrically the occipital cortex, temporal lobes, and limbic system (including in particular amygdalo-hippocampal complexes), and the cerebellum. Posterior cingulate cortex and parietal areas were preserved. This pattern was confirmed by a voxel-based procedure using Statistical Parametric Mapping (SPM12) that compared a patient's images to normal reference samples from six healthy subjects with adjustment to age obtained using the same PET/CT camera. These results provide a glucose metabolism substrate for cognitive complaints in patients with long-lasting aluminium hydroxide-induced MMF.

  13. Left Vocal Cord Paralysis Detected by PET/CT in a Case of Lung Cancer

    Directory of Open Access Journals (Sweden)

    Ali Ozan Oner

    2015-01-01

    Full Text Available We report a patient with lung cancer. The first PET/CT imaging revealed hypermetabolic mass in the left aortopulmonary region and hypermetabolic nodule in the anterior segment of the upper lobe of the left lung. After completing chemotherapy and radiotherapy against the primary mass in the left lung, the patient underwent a second PET/CT examination for evaluation of treatment response. This test demonstrated, compared with the first PET/CT, an increase in the size and metabolic activity of the primary mass in the left lung in addition to multiple, pathologic-sized, hypermetabolic metastatic lymph nodes as well as multiple metastatic sclerotic areas in bones. These findings were interpreted as progressive disease. In addition, an asymmetrical FDG uptake was noticed at the level of right vocal cord. During follow-up, a laryngoscopy was performed, which demonstrated left vocal cord paralysis with no apparent mass. Thus, we attributed the paralytic appearance of the left vocal cord to infiltration of the left recurrent laryngeal nerve by the primary mass located in the apical region of the left lung. In conclusion, the knowledge of this pitfall is important to avoid false-positive PET results.

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

    Directory of Open Access Journals (Sweden)

    Salil Mehta

    2013-01-01

    Full Text Available Systemic imaging of patients with suspect ocular tuberculosis include chest X-rays and computed tomography (CT scans. Reports have suggested a role for 18 fluorodeoxyglucose-positron emission tomography/CT (FDG-PET/CT scans. We report on the clinical utility of 18 FDG PET/CT in two patients. Case 1: A 38-year-old female patient presented with recurrent anterior uveitis. A 18 FDG-PET scan revealed metabolically active supraclavicular and chest lymph nodes. An aspiration cytology of the cervical lymph node revealed caseating granulomas suggestive of tuberculosis. Case 2: A 58-year-old female patient presented with recurrent anterior uveitis. A 18 FDG-PET scan revealed metabolically active lymph nodes in the neck. A biopsy of the cervical lymph node revealed epithelioid granulomas suggestive of tuberculosis. Both patients were started on standard antitubercular therapy with a subsequent marked reduction of activity. PET/CT scans may suggest the sites of safe high-yield biopsies.

  15. Determination of the dose in eyes lens by TLD, in PET/CT by technicians in PET/CT service; Determinacion de la dosis en cristalino por medio de TLD, en personal tecnico de servicio PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Marino, Emiliano A., E-mail: eam.marino@gmail.com [Universidad Nacional de Cuyo (UNC), Rio Negro (Argentina). Instituto Balseiro; Arenas, German M. [Fundacion Escuela de Medicina Nuclear (FUESMEN), Mendoza (Argentina)

    2013-11-01

    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.

  16. Myocardial defect detection using PET-CT: phantom studies.

    Directory of Open Access Journals (Sweden)

    Eugene S Mananga

    Full Text Available It is expected that both noise and activity distribution can have impact on the detectability of a myocardial defect in a cardiac PET study. In this work, we performed phantom studies to investigate the detectability of a defect in the myocardium for different noise levels and activity distributions. We evaluated the performance of three reconstruction schemes: Filtered Back-Projection (FBP, Ordinary Poisson Ordered Subset Expectation Maximization (OP-OSEM, and Point Spread Function corrected OSEM (PSF-OSEM. We used the Channelized Hotelling Observer (CHO for the task of myocardial defect detection. We found that the detectability of a myocardial defect is almost entirely dependent on the noise level and the contrast between the defect and its surroundings.

  17. Myocardial defect detection using PET-CT: phantom studies.

    Science.gov (United States)

    Mananga, Eugene S; El Fakhri, Georges; Schaefferkoetter, Joshua; Bonab, Ali A; Ouyang, Jinsong

    2014-01-01

    It is expected that both noise and activity distribution can have impact on the detectability of a myocardial defect in a cardiac PET study. In this work, we performed phantom studies to investigate the detectability of a defect in the myocardium for different noise levels and activity distributions. We evaluated the performance of three reconstruction schemes: Filtered Back-Projection (FBP), Ordinary Poisson Ordered Subset Expectation Maximization (OP-OSEM), and Point Spread Function corrected OSEM (PSF-OSEM). We used the Channelized Hotelling Observer (CHO) for the task of myocardial defect detection. We found that the detectability of a myocardial defect is almost entirely dependent on the noise level and the contrast between the defect and its surroundings.

  18. Topology polymorphism graph for lung tumor segmentation in PET-CT images

    Science.gov (United States)

    Cui, Hui; Wang, Xiuying; Zhou, Jianlong; Eberl, Stefan; Yin, Yong; Feng, Dagan; Fulham, Michael

    2015-06-01

    Accurate lung tumor segmentation is problematic when the tumor boundary or edge, which reflects the advancing edge of the tumor, is difficult to discern on chest CT or PET. We propose a ‘topo-poly’ graph model to improve identification of the tumor extent. Our model incorporates an intensity graph and a topology graph. The intensity graph provides the joint PET-CT foreground similarity to differentiate the tumor from surrounding tissues. The topology graph is defined on the basis of contour tree to reflect the inclusion and exclusion relationship of regions. By taking into account different topology relations, the edges in our model exhibit topological polymorphism. These polymorphic edges in turn affect the energy cost when crossing different topology regions under a random walk framework, and hence contribute to appropriate tumor delineation. We validated our method on 40 patients with non-small cell lung cancer where the tumors were manually delineated by a clinical expert. The studies were separated into an ‘isolated’ group (n = 20) where the lung tumor was located in the lung parenchyma and away from associated structures / tissues in the thorax and a ‘complex’ group (n = 20) where the tumor abutted / involved a variety of adjacent structures and had heterogeneous FDG uptake. The methods were validated using Dice’s similarity coefficient (DSC) to measure the spatial volume overlap and Hausdorff distance (HD) to compare shape similarity calculated as the maximum surface distance between the segmentation results and the manual delineations. Our method achieved an average DSC of 0.881  ±  0.046 and HD of 5.311  ±  3.022 mm for the isolated cases and DSC of 0.870  ±  0.038 and HD of 9.370  ±  3.169 mm for the complex cases. Student’s t-test showed that our model outperformed the other methods (p-values <0.05).

  19. The role of {sup 18}F-FDG PET/CT in the assessment of suspected recurrent gastric cancer after initial surgical resection: can the results of FDG PET/CT influence patients' treatment decision making?

    Energy Technology Data Exchange (ETDEWEB)

    Bilici, Ahmet [Dr. Lutfi Kirdar Kartal Education and Research Hospital, Department of Medical Oncology, Istanbul (Turkey); Esenler, Istanbul (Turkey); Ustaalioglu, Bala Basak Oven; Seker, Mesut; Kefeli, Umut; Gumus, Mahmut [Dr. Lutfi Kirdar Kartal Education and Research Hospital, Department of Medical Oncology, Istanbul (Turkey); Canpolat, Nesrin; Ozugur, Sule [Kosuyolu Yuksek Ihtisas Education and Research Hospital, Department of Nuclear Medicine, Istanbul (Turkey); Tekinsoy, Bulent [Medipol Hospital, Department of Radiology, Istanbul (Turkey)

    2011-01-15

    {sup 18}F-fluorodeoxyglucose (FDG) PET/CT has been widely used for staging, re-staging and for monitoring therapy-induced changes and response to therapy in patients with various types of cancer, but its utilization for gastric cancer has been limited. The purpose of this study was to evaluate the clinical role of FDG PET/CT in the detection of gastric cancer recurrence as compared with diagnostic CT and to assess the impact of FDG PET/CT results on patients' treatment planning. Thirty-four patients with suspected recurrent gastric cancer, who had previously undergone curative gastrectomy and lymph node dissection, were retrospectively analysed. The diagnostic CT and FDG PET/CT imaging were performed for all patients as clinically indicated. The results of FDG PET/CT were compared with the findings of the diagnostic CT. The changes in the clinical management of patients according to the results of FDG PET/CT were also evaluated. FDG PET/CT was performed in 19 patients (55.9%) due to the suspicion of distant metastasis at diagnostic CT. The remaining 15 patients were suspected to have local recurrence at diagnostic CT (n = 4) or gastroscopy (n = 1) and due to an increase in tumour markers or clinical manifestations (n = 10). The FDG PET/CT result was positive in 23 patients (67.6%) and negative in 11 patients (32.4%). In total, 24 (70.6%) of the 34 patients had documented recurrent disease by histopathology in 7 (29.1%) and by clinical follow-up in 17 (70.9%), while 11 patients had no evidence of recurrent disease. FDG PET/CT correctly confirmed recurrent disease in 23 of the patients with recurrence and it was classified as true-positive in these patients. However, FDG PET/CT was false-negative in one patient but recurrent disease was confirmed by histopathology. The overall sensitivity, specificity, accuracy, positive and negative predictive values of FDG PET/CT were significantly superior to those of diagnostic CT (95.8 vs 62.5%, 100 vs 10%, 97 vs 47%, 100

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

    Directory of Open Access Journals (Sweden)

    Lei FANG

    2013-11-01

    Full Text Available Objective To observe the characteristics of cancer pain of the peripheral nerves on 18F-FDG PET/CT images, and explore the diagnostic value of 18F-FDG PET/CT for cancer pain of the peripheral nerves. Methods Imaging data of 18F-FDG PET/CT of 10 patients with cancer pain of the peripheral nerves confirmed by histopathology or long-term follow-up were analyzed retrospectively. The similarities and differences in PET/CT manifestations between the diseased side peripheral nerves and contralateral normal peripheral nerves were observed, and the maximum standardized uptake values (SUVmax were compared by paired t test with SPSS 17.0 software. Results Seventeen secondary malignant peripheral nerve lesions were found in 10 cases. On PET images, the lesions were found to spread along the plexus, nerve bundle or intervertebral foramen, and manifested as bundle-, root-hair- or nodule-like high 18F-FDG metabolic tissue, with the SUVmax as high as 6.67±3.24. The lesions on CT images manifested as bundle-, root-hair- or nodule-like soft tissue density shadows spreading along the nerve bundle or nerve root canal, and there was no clear border between the lesions and the surrounding soft and fat tissues. The contralateral normal peripheral nerves showed no abnormal images on 18F-FDG PET or CT, and the SUVmax was 1.19±0.48, which was significantly different from that of nerves on disease side (t=9.389, P<0.001. Conclusion 18F-FDG PET/CT can accurately show invasion and metastasis to the peripheral nerve of tumor, and it also can display the size, shape, distribution and tumor activity of the lesions, thus it is valuable for the diagnosis of cancer pain of the peripheral nerves. DOI: 10.11855/j.issn.0577-7402.2013.11.009

  1. The Role of 18F-FDG PET/CT in the Evaluation of Gastric Cancer Recurrence

    Directory of Open Access Journals (Sweden)

    Hakan Cayvarlı

    2014-10-01

    Full Text Available Objective: F-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT has been widely used for staging, re-staging and for monitoring therapy-induced changes and response to therapy in patients with various types of cancer, but its utilization for gastric cancer has been limited. This study aimed to assess the diagnostic performance of 18F-FDG PET/CT for detecting recurrence in gastric cancer patients with radiologic or clinical suspicion of recurrence and its clinical impact on making decision. Methods: We performed a retrospective review of 130 consecutive patients who underwent PET/CT scans for post-treatment surveillance of gastric cancer between January 2008 and March 2012. The mean time between the initial diagnosis of gastric cancer and PET/CT studies was 44 weeks with a median of 18 weeks. The number and site of positive FDG uptake were analyzed and correlated with the final diagnosis by calculating the diagnostic values. We evaluated the diagnostic accuracy of PET/CT for detecting the recurrence in terms of whether or not histology had been SRC/musinous adenocarcinoma. The changes in the clinical management of patients were also evaluated according to the results of PET/CT. Results: Of all 130 patients, 91 patients were confirmed to have true recurrence. The sensitivity, specificity, positive predictive value, negative predictive value and the accuracy of PET/CT for diagnosing true recurrence on a per-person basis were 91.2%, 61.5%, 84.6%, 75.0% and 82.3% respectively. Final diagnoses were confirmed histopathologically in 59 (45.4% of 130 patients and by clinical and radiological follow-up in the remaining 71 (54.6% patients. In the subgroup with SRC/mucinous adenocarcinoma differentiation of the primary tumor, there was no statistically significant difference in terms of diagnostic accuracy of PET/CT on a per-person basis. In addition, PET/CT results changed the patients’ management in 20 (15% cases

  2. Value of PET/CT and MR Lymphography in Treatment of Prostate Cancer Patients With Lymph Node Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Fortuin, Ansje S., E-mail: A.Fortuin@rad.umcn.nl [Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Deserno, Willem M.L.L.G. [Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Meijer, Hanneke J.M. [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Jager, Gerrit J. [Department of Radiology, Jeroen Bosch Hospital' s, Hertogenbosch (Netherlands); Takahashi, Satoru; Debats, Oscar A. [Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Reske, Sven N.; Schick, Christian [Department of Nuclear Medicine, University of Ulm, Ulm (Germany); Krause, Bernd J. [Department of Nuclear Medicine, Technische Universitaet Muenchen, Muenchen (Germany); Oort, Inge van; Witjes, Alfred J. [Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Hoogeveen, Yvonne L. [Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Lin, Emile N.J.Th. van [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Barentsz, Jelle O. [Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)

    2012-11-01

    Purpose: To determine the clinical value of two novel molecular imaging techniques: {sup 11}C-choline positron emission tomography (PET)/computed tomography (CT) and ferumoxtran-10 enhanced magnetic resonance imaging (magnetic resonance lymphography [MRL]) for lymph node (LN) treatment in prostate cancer (PCa) patients. Therefore, we evaluated the ability of PET/CT and MRL to assess the number, size, and location of LN metastases in patients with primary or recurrent PCa. Methods and Materials: A total of 29 patients underwent MRL and PET/CT for LN evaluation. The MRL and PET/CT data were analyzed independently. The number, size, and location of the LN metastases were determined. The location was described as within or outside the standard clinical target volume for elective pelvic irradiation as defined by the Radiation Therapy Oncology Group. Subsequently, the results from MRL and PET/CT were compared. Results: Of the 738 LNs visible on MRL, 151 were positive in 23 of 29 patients. Of the 132 LNs visible on PET/CT, 34 were positive in 13 of 29 patients. MRL detected significantly more positive LNs (p < 0.001) in more patients than PET/CT (p = 0.002). The mean diameter of the detected suspicious LNs on MRL was significantly smaller than those detected by PET/CT, 4.9 mm and 8.4 mm, respectively (p < 0.0001). In 14 (61%) of 23 patients, suspicious LNs were found outside the clinical target volume with MRL and in 4 (31%) of 13 patients with PET/CT. Conclusion: In patients with PCa, both molecular imaging techniques, MRL and {sup 11}C-choline PET/CT, can detect LNs suspicious for metastasis, irrespective of the existing size and shape criteria for CT and conventional magnetic resonance imaging. On MRL and PET/CT, 61% and 31% of the suspicious LNs were located outside the conventional clinical target volume. Therefore, these techniques could help to individualize treatment selection and enable image-guided radiotherapy for patients with PCa LN metastases.

  3. PET/MRI and PET/CT in follow-up of head and neck cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Queiroz, Marcelo A. [University Hospital Zurich, Department of Medical Radiology, Nuclear Medicine, Zurich (Switzerland); University Hospital Zurich, Department of Nuclear Medicine, Zurich (Switzerland); Huellner, Martin [University Hospital Zurich, Department of Medical Radiology, Nuclear Medicine, Zurich (Switzerland); University Hospital Zurich, Department of Medical Radiology, Neuroradiology, Zurich (Switzerland); Kuhn, Felix; Veit-Haibach, Patrick [University Hospital Zurich, Department of Medical Radiology, Nuclear Medicine, Zurich (Switzerland); University Hospital Zurich, Department of Medical Radiology, Diagnostic and Interventional Radiology, Zurich (Switzerland); Huber, Gerhardt; Meerwein, Christian [University Hospital Zurich, Department of Otorhinolaryngology, Zurich (Switzerland); Kollias, Spyros [University Hospital Zurich, Department of Medical Radiology, Neuroradiology, Zurich (Switzerland); Schulthess, Gustav von [University Hospital Zurich, Department of Medical Radiology, Nuclear Medicine, Zurich (Switzerland)

    2014-06-15

    Positron emission tomography (PET)/MRI combines the functional ability of PET and the high soft tissue contrast of MRI. The aim of this study was to assess contrast-enhanced (ce)PET/MRI compared to cePET/CT in patients with suspected recurrence of head and neck cancer (HNC). Eighty-seven patients underwent sequential cePET/CT and cePET/MRI using a trimodality PET/CT-MRI set-up. Diagnostic accuracy for the detection of recurrent HNC was evaluated using cePET/CT and cePET/MRI. Furthermore, image quality, presence of unclear {sup 18}F-fluorodeoxy-D-glucose (FDG) findings of uncertain significance and the diagnostic advantages of use of gadolinium contrast enhancement were analysed. cePET/MRI showed no statistically significant difference in diagnostic accuracy compared to cePET/CT (91.5 vs 90.6 %). Artefacts' grade was similar in both methods, but their location was different. cePET/CT artefacts were primarily located in the suprahyoid area, while on cePET/MRI, artefacts were more equally distributed among the supra and infrahyoid neck regions. cePET/MRI and cePET/CT showed 34 unclear FDG findings; of those 11 could be solved by cePET/MRI and 5 by cePET/CT. The use of gadolinium in PET/MRI did not yield higher diagnostic accuracy, but helped to better define tumour margins in 6.9 % of patients. Our data suggest that cePET/MRI may be superior compared to cePET/CT to specify unclear FDG uptake related to possible tumour recurrence in follow-up of patients after HNC. It seems to be the modality of choice for the evaluation of the oropharynx and the oral cavity because of a higher incidence of artefacts in cePET/CT in this area mainly due to dental implants. However, overall there is no statistically significant difference. (orig.)

  4. {sup 18}F-FDG PET/CT evaluation of children and young adults with suspected spinal fusion hardware infection

    Energy Technology Data Exchange (ETDEWEB)

    Bagrosky, Brian M. [University of Colorado School of Medicine, Department of Pediatric Radiology, Children' s Hospital Colorado, 12123 E. 16th Ave., Box 125, Aurora, CO (United States); University of Colorado School of Medicine, Department of Radiology, Division of Nuclear Medicine, Aurora, CO (United States); Hayes, Kari L.; Fenton, Laura Z. [University of Colorado School of Medicine, Department of Pediatric Radiology, Children' s Hospital Colorado, 12123 E. 16th Ave., Box 125, Aurora, CO (United States); Koo, Phillip J. [University of Colorado School of Medicine, Department of Radiology, Division of Nuclear Medicine, Aurora, CO (United States)

    2013-08-15

    Evaluation of the child with spinal fusion hardware and concern for infection is challenging because of hardware artifact with standard imaging (CT and MRI) and difficult physical examination. Studies using {sup 18}F-FDG PET/CT combine the benefit of functional imaging with anatomical localization. To discuss a case series of children and young adults with spinal fusion hardware and clinical concern for hardware infection. These people underwent FDG PET/CT imaging to determine the site of infection. We performed a retrospective review of whole-body FDG PET/CT scans at a tertiary children's hospital from December 2009 to January 2012 in children and young adults with spinal hardware and suspected hardware infection. The PET/CT scan findings were correlated with pertinent clinical information including laboratory values of inflammatory markers, postoperative notes and pathology results to evaluate the diagnostic accuracy of FDG PET/CT. An exempt status for this retrospective review was approved by the Institution Review Board. Twenty-five FDG PET/CT scans were performed in 20 patients. Spinal fusion hardware infection was confirmed surgically and pathologically in six patients. The most common FDG PET/CT finding in patients with hardware infection was increased FDG uptake in the soft tissue and bone immediately adjacent to the posterior spinal fusion rods at multiple contiguous vertebral levels. Noninfectious hardware complications were diagnosed in ten patients and proved surgically in four. Alternative sources of infection were diagnosed by FDG PET/CT in seven patients (five with pneumonia, one with pyonephrosis and one with superficial wound infections). FDG PET/CT is helpful in evaluation of children and young adults with concern for spinal hardware infection. Noninfectious hardware complications and alternative sources of infection, including pneumonia and pyonephrosis, can be diagnosed. FDG PET/CT should be the first-line cross-sectional imaging study in

  5. Advances in cardiac magnetic resonance imaging of congenital heart disease

    NARCIS (Netherlands)

    Driessen, Mieke M P; Breur, Johannes M. P. J.; Budde, Ricardo P J; van Oorschot, Joep W M; van Kimmenade, Roland R J; Sieswerda, Gertjan Tj.; Meijboom, Folkert J; Leiner, Tim

    2015-01-01

    Due to advances in cardiac surgery, survival of patients with congenital heart disease has increased considerably during the past decades. Many of these patients require repeated cardiovascular magnetic resonance imaging to assess cardiac anatomy and function. In the past decade, technological advan

  6. {sup 18}F-FDG-PET/CT for systemic staging of newly diagnosed triple-negative breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ulaner, Gary A.; Castillo, Raychel; Riedl, Christopher C.; Jochelson, Maxine S. [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Weill Cornell Medical College, Department of Radiology, New York, NY (United States); Goldman, Debra A.; Goenen, Mithat [Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Wills, Jonathan [Memorial Sloan Kettering Cancer Center, Department of Information Systems, New York, NY (United States); Pinker-Domenig, Katja [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States)

    2016-10-15

    National Comprehensive Cancer Network guidelines recommend {sup 18}F-FDG-PET/CT, in addition to standard staging procedures, for systemic staging of newly diagnosed stage III breast cancer patients. However, factors in addition to stage may influence PET/CT utility. As breast cancers that are negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor (triple-negative breast cancer, or TNBC) are more aggressive and metastasize earlier than other breast cancers, we hypothesized that receptor expression may be one such factor. This study assesses {sup 18}F-FDG-PET/CT for systemic staging of newly diagnosed TNBC. In this Institutional Review Board-approved retrospective study, our Healthcare Information System was screened for patients with TNBC who underwent {sup 18}F-FDG-PET/CT in 2007-2013 prior to systemic or radiation therapy. Initial stage was determined from mammography, ultrasound, magnetic resonance imaging, and/or surgery, if performed prior to {sup 18}F-FDG-PET/CT. {sup 18}F-FDG-PET/CT was evaluated to identify unsuspected extra-axillary regional nodal and distant metastases, as well as unsuspected synchronous malignancies. Kaplan Meier survival estimates were calculated for initial stage IIB patients stratified by whether or not stage 4 disease was detected by {sup 18}F-FDG-PET/CT. A total of 232 patients with TNBC met inclusion criteria. {sup 18}F-FDG-PET/CT revealed unsuspected distant metastases in 30 (13 %): 0/23 initial stage I, 4/82 (5 %) stage IIA, 13/87 (15 %) stage IIB, 4/23 (17 %) stage IIIA, 8/14 (57 %) stage IIIB, and 1/3 (33 %) stage IIIC. Twenty-six of 30 patients upstaged to IV by {sup 18}F-FDG-PET/CT were confirmed by pathology, with the remaining four patients confirmed by follow-up imaging. In addition, seven unsuspected synchronous malignancies were identified in six patients. Initial stage 2B patients who were upstaged to 4 by {sup 18}F-FDG-PET/CT had significantly shorter survival compared to

  7. Detection of cranial meningiomas: comparison of {sup 68}Ga-DOTATOC PET/CT and contrast-enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Afshar-Oromieh, Ali; Giesel, Frederik L.; Haberkorn, Uwe; Haufe, Sabine; Kratochwil, Clemens [University Hospital of Heidelberg, Department of Nuclear Medicine, Heidelberg (Germany); Linhart, Heinz G. [DKFZ, National Center for Tumor Diseases (NCT), Heidelberg (Germany); Combs, Stephanie E. [University Hospital of Heidelberg, Department of Radiation Oncology and Therapy, Heidelberg (Germany); Podlesek, Dino [University Hospital of Dresden, Department of Neurosurgery, Dresden (Germany); Eisenhut, Michael [DKFZ, Department of Radiopharmacy, Heidelberg (Germany)

    2012-09-15

    PET imaging with somatostatin receptor ligands, such as {sup 68}Ga-DOTATOC, is a well-established method for detection and target volume definition of meningiomas prior to radiotherapy. Since DOTATOC PET delivers a higher contrast between meningiomas and surrounding tissues than MRI, we conducted a retrospective analysis to compare the diagnostic accuracy of contrast-enhanced MRI (CE-MRI) with {sup 68}Ga-DOTATOC PET/CT in patients with cranial meningiomas prior to radiotherapy. Over a period of 6 years, 134 patients (20-82 years of age, 107 women and 27 men) underwent cranial CE-MRI and {sup 68}Ga-DOTATOC PET/CT. To compare the two methods, the lesions considered typical of meningiomas visually were counted and analysed with respect to their location and SUVmax. In the 134 patients investigated by both modalities, 190 meningiomas were detected by {sup 68}Ga-DOTATOC PET/CT and 171 by CE-MRI. With knowledge of the PET/CT data, the MRI scans were reinvestigated, which led to the detection of 4 of the 19 incidental meningiomas, resulting in an overall detection rate of 92 % of the meningioma lesions that were found by PET/CT. Ga-DOTATOC PET/CT demonstrated an improved sensitivity in meningioma detection when compared to CE-MRI. Tumours adjacent to the falx cerebri, located at the skull base or obscured by imaging artefacts or calcification are particularly difficult to detect by MRI. Therefore {sup 68}Ga-DOTATOC PET/CT may provide additional information in patients with uncertain or equivocal results on MRI or could help to confirm a diagnosis of meningioma based on MRI or could help to confirm MRI-based diagnosis of meningiomas in cases of biopsy limitations. It is possible that not only radiotherapy and surgical planning, but also follow-up strategies would benefit from this imaging modality. (orig.)

  8. Role of (68)Ga-DOTATATE PET/CT in patients with multiple endocrine neoplasia type 1 (MEN1).

    Science.gov (United States)

    Lastoria, Secondo; Marciello, Francesca; Faggiano, Antongiulio; Aloj, Luigi; Caracò, Corradina; Aurilio, Michela; D'Ambrosio, Laura; Di Gennaro, Francesca; Ramundo, Valeria; Camera, Luigi; De Luca, Leonardo; Fonti, Rosa; Napolitano, Vincenzo; Colao, Annamaria

    2016-06-01

    Multiple endocrine neoplasia type 1 (MEN1) is a hereditary syndrome predisposing to many endocrine and neuroendocrine tumors (NET). Conventional imaging (CI) cannot provide satisfactory results for all the different types of MEN1-related tumors. Objective of this prospective observational study was to evaluate the role of (68)Ga-DOTATATE PET/CT in MEN1 compared to CI. Diagnostic performance of (68)Ga-DOTATATE PET/CT for the detection of NET was evaluated as well as the prognostic role of SUVmax. Eighteen patients with genetically confirmed MEN1 were evaluated by (68)Ga-DOTATATE PET/CT, endoscopic ultrasounds, multidetector-row computed tomography, magnetic resonance imaging, and hormone/markers serum measurements. Four MEN1-related tumor sites (pancreas, pituitary, parathyroids, adrenals) were considered. Sensitivity and specificity of (68)Ga-DOTATATE PET/CT for the detection of NET were calculated. There was (68)Ga-DOTATATE PET/CT uptake in 11/11 patients with pancreatic lesions, in 9/12 with pituitary adenoma, in 5/15 with parathyroid enlargements, and in 5/7 with adrenal lesions. (68)Ga-DOTATATE PET/CT showed sensitivity and specificity of 100 and 100 % in pancreas, 75 and 83 % in pituitary, 28 and 100 % in parathyroids, and 62.5 and 100 % in adrenals, respectively. Compared with CI, no significant difference in sensitivity for pancreas, pituitary, and adrenals was found, while CI had a better sensitivity for parathyroids (p = 0.002). On the ROC analysis, progression of pancreatic lesions was significantly associated to SUVmax 68)Ga-DOTATATE PET/CT is greatly helpful in the work-up of MEN1 providing a panoramic view of MEN1-related lesions. There is also a prognostic role of (68)Ga-PET in patients with MEN1-pancreatic lesions.

  9. Unit Cost Analysis of PET-CT at an Apex Public Sector Health Care Institute in India

    Science.gov (United States)

    Gajuryal, SH; Daga, A; Siddharth, V; Bal, CS; Satpathy, S

    2017-01-01

    Context: PET/CT scan service is one of the capital intensive and revenue-generating centres of a tertiary care hospital. The cost associated with the provisioning of PET services is dependent upon the unit costs of the resources consumed. Aims: The study aims to determine the cost of providing PET/CT Scan services in a hospital. Methods and Material: This descriptive and observational study was conducted in the Department of Nuclear Medicine at a tertiary apex teaching hospital in New Delhi, India in the year 2014-15. Traditional costing methodology was used for calculating the unit cost of PET/CT scan service. The cost was calculated under two heads that is capital and operating cost. Annualized cost of capital assets was calculated using methodology prescribed by WHO and operating costs was taken on an actual basis. Results: Average number of PET/CT scan performed in a day is 30. The annual cost of providing PET/CT scan services was calculated to be 65,311,719 Indian Rupees (INR) (US$ 1,020,496), while the unit cost of PET scan was calculated to be 9625.92 INR (US$ 150). 3/4th cost was spent on machinery and equipment (75.3%) followed by healthcare personnel (11.37%), electricity (5%), consumables and supplies (4%) engineering maintenance (3.24%), building, furniture and HVAC capital cost (0.76%), and manifold cost (0.05%). Of the total cost, 76% was capital cost while the remaining was operating cost. Conclusions: Total cost for establishing PET/CT scan facility with cyclotron and chemistry module and PET/CT scan without cyclotron and chemistry module was calculated to be INR 610,873,517 (US$9944899) and 226,745,158 (US$3542893), respectively. (US$ 1=INR 64) PMID:28242974

  10. Prognostic significance of novel {sup 18}F-FDG PET/CT defined tumour variables in patients with oesophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Foley, Kieran G., E-mail: kfoley@doctors.org.uk [Department of Radiology, University Hospital of Wales, Cardiff (United Kingdom); Fielding, Patrick, E-mail: Patrick.Fielding@wales.nhs.uk [Department of Wales Research and Diagnostic Positron Emission Tomography Imaging Centre (PETIC), University Hospital of Wales, Cardiff (United Kingdom); Lewis, Wyn G., E-mail: Wyn.Lewis4@wales.nhs.uk [Department of Surgery, University Hospital of Wales, Cardiff (United Kingdom); Karran, Alex, E-mail: alex_karran@hotmail.co.uk [Department of Surgery, University Hospital of Wales, Cardiff (United Kingdom); Chan, David, E-mail: dcsy23@gmail.com [Department of Surgery, University Hospital of Wales, Cardiff (United Kingdom); Blake, Paul, E-mail: pblake76@yahoo.co.uk [Department of Surgery, University Hospital of Wales, Cardiff (United Kingdom); Roberts, S. Ashley, E-mail: Ashley.Roberts@wales.nhs.uk [Department of Radiology, University Hospital of Wales, Cardiff (United Kingdom)

    2014-07-15

    Purpose: {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET) combined with computed tomography (PET/CT) is now established as a routine staging investigation of oesophageal cancer (OC). The aim of the study was to determine the prognostic significance of PET/CT defined tumour variables including maximum standardised uptake value (SUVmax), tumour length (TL), metastatic length of disease (MLoD), metabolic tumour volume (MTV), total lesion glycolysis (TLG) and total local nodal metastasis count (PET/CT LNMC). Materials and methods: 103 pre-treatment OC patients (76 adenocarcinoma, 25 squamous cell carcinoma, 1 poorly differentiated and 1 neuroendocrine tumour) were staged using PET/CT. The prognostic value of the measured tumour variables were tested using log-rank analysis of the Kaplan–Meier method and Cox's proportional hazards method. Primary outcome measure was survival from diagnosis. Results: Univariate analysis showed all variables to have strong statistical significance in relation to survival. Multivariate analysis demonstrated three variables that were significantly and independently associated with survival; MLoD (HR 1.035, 95% CI 1.008–1.064, p = 0.011), TLG (HR 1.002, 95% CI 1.000–1.003, p = 0.018) and PET/CT LNMC (HR 0.048–0.633, 95% CI 0.005–2.725, p = 0.015). Conclusion: MLoD, TLG, and PET/CT LNMC are important prognostic indicators in OC. This is the first study to demonstrate an independent statistical association between TLG, MLoD and survival by multivariable analysis, and highlights the value of staging OC patients with PET/CT using functional tumour variables.

  11. Negative {sup 18}F-2-fluorodeoxyglucose PET/CT predicts good cancer specific survival in patients with a suspicion of recurrent ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hebel, Carolin B.; Behrendt, Florian F.; Heinzel, Alexander; Krohn, Thomas [University Hospital Aachen, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany); Mottaghy, Felix M. [University Hospital Aachen, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany); Maastricht University Medical Center, Department of Nuclear Medicine, P. Debyelaan 25, 6229 HX Maastricht (Netherlands); Bauerschlag, Dirk O. [University Hospital Aachen, Department of Gynecology and Obstetrics, Pauwelsstraße 30, 52074 Aachen (Germany); Verburg, Frederik A., E-mail: fverburg@ukaachen.de [University Hospital Aachen, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany); Maastricht University Medical Center, Department of Nuclear Medicine, P. Debyelaan 25, 6229 HX Maastricht (Netherlands)

    2014-03-15

    Aim: The aim of the present study was to investigate the diagnostic and prognostic value of combined {sup 18}F-2-fluorodeoxyglucose positron emission tomography and contrast enhanced X-ray computed tomography (FDG-PET/CT) in women with a suspicion of recurrent ovarian cancer. Patients and methods: We retrospectively reviewed 48 patients with a suspicion of recurrent ovarian cancer who were referred to our department for combined FDG-PET/CT. Results: Median follow-up was 25 months. 38/48 (79%) patients showed pathological findings on PET/CT. 17/48 (35%) of patients died of ovarian cancer. One FDG-PET/CT was false positive and one was false negative, leading to a sensitivity and positive predictive value of 97% and a specificity and negative predictive value of 90%. 33/48 (69%) underwent a change in therapy following FDG-PET/CT. There was a significantly better survival in FDG-PET/CT negative than in positive patients (p = 0.04). In the FDG-PET/CT negative group no patients had died of ovarian cancer during follow-up. Remarkably, there was no difference in survival between patients who only had peritoneal metastases on FDG-PET/CT and those who also had extraperitoneal metastases (p = 0.71). Conclusion: A negative FDG-PET/CT has a high negative predictive value for the presence of disease and, more importantly, is associated with a very good disease-specific survival rate.

  12. Correlation between PET/CT results and histological and immunohistochemical findings in breast carcinomas; Correlacao entre resultado do PET/CT e achados histologicos e imuno-histoquimicos em carcinomas mamarios

    Energy Technology Data Exchange (ETDEWEB)

    Bitencourt, Almir Galvao Vieira; Lima, Eduardo Nobrega Pereira; Chojniak, Rubens; Marques, Elvira Ferreira; Souza, Juliana Alves de; Graziano, Luciana; Andrade, Wesley Pereira; Osorio, Cynthia Aparecida Bueno de Toledo, E-mail: almirgvb@yahoo.com.br [A.C.Camargo Cancer Center, Sao Paulo, SP (Brazil)

    2014-03-15

    Objective: to correlate the results of {sup 18}F-fluoro-2-deoxy-D-glucose ({sup 18}F-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 {sup 18}F-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. (author)

  13. Imaging with {sup 124}I in differentiated thyroid carcinoma: is PET/MRI superior to PET/CT?

    Energy Technology Data Exchange (ETDEWEB)

    Binse, I.; Poeppel, T.D.; Ruhlmann, M.; Gomez, B.; Bockisch, A.; Rosenbaum-Krumme, S.J. [University of Duisburg-Essen, Medical Faculty, Department of Nuclear Medicine, Essen (Germany); Umutlu, L. [University of Duisburg-Essen, Medical Faculty, Department of Radiology, Essen (Germany)

    2016-06-15

    The aim of this study was to compare integrated PET/CT and PET/MRI for their usefulness in detecting and categorizing cervical iodine-positive lesions in patients with differentiated thyroid cancer using {sup 124}I as tracer. The study group comprised 65 patients at high risk of iodine-positive metastasis who underwent PET/CT (low-dose CT scan, PET acquisition time 2 min; PET/CT{sub 2}) followed by PET/MRI of the neck 24 h after {sup 124}I administration. PET images from both modalities were analysed for the numbers of tracer-positive lesions. Two different acquisition times were used for the comparisons, one matching the PET/CT{sub 2} acquisition time (2 min, PET/MRI{sub 2}) and the other covering the whole MRI scan time (30 min, PET/MRI{sub 30}). Iodine-positive lesions were categorized as metastasis, thyroid remnant or inconclusive according to their location on the PET/CT images. Morphological information provided by MRI was considered for evaluation of lesions on PET/MRI and for volume information. PET/MRI{sub 2} detected significantly more iodine-positive metastases and thyroid remnants than PET/CT{sub 2} (72 vs. 60, p = 0.002, and 100 vs. 80, p = 0.001, respectively), but the numbers of patients with at least one tumour lesion identified were not significantly different (21/65 vs. 17/65 patients). PET/MRI{sub 30} tended to detect more PET-positive metastases than PET/MRI{sub 2} (88 vs. 72), but the difference was not significant (p = 0.07). Of 21 lesions classified as inconclusive on PET/CT, 5 were assigned to metastasis or thyroid remnant when evaluated by PET/MRI. Volume information was available in 34 % of iodine-positive metastases and 2 % of thyroid remnants on PET/MRI. PET/MRI of the neck was found to be superior to PET/CT in detecting iodine-positive lesions. This was attributed to the higher sensitivity of the PET component, Although helpful in some cases, we found no substantial advantage of PET/MRI over PET/CT in categorizing iodine

  14. Efficacy of 18F-FDG PET/CT in investigation of elevated CEA without known primary malignancy

    Directory of Open Access Journals (Sweden)

    Simon Sin-man Wong

    2016-01-01

    Full Text Available Aim: To evaluate the efficacy of 18flurodeoxyglucose positron emission tomography/computer tomography (18F-FDG PET/CT in investigating patients with elevated carcinoembryonic antigen (CEA and without known primary malignancy, and the impact of PET/CT findings on patient management. Setting and Design: PET/CT scans done in a tertiary hospital between December 2007 and February 2012 for elevated CEA in patients without known primary malignancy were retrospectively reviewed. Materials and Methods: The PET/CT findings, patients' clinical information, level of CEA, histological diagnosis, and subsequent management were retrieved by the electronic patient record for analysis. Statistical Analysis: Data were analyzed using SPSS version 19. Results: One hundred and one PET/CT scans were performed for patients with elevated CEA. Fifty-eight of these were performed for patients with known primary malignancy and were excluded; 43 PET/CT scans were performed for patients without known primary malignancy and were included. Thirty-three (77% had a positive PET/CT. Among the 32 patients with malignancy, 15 (47% suffered from lung cancer and 8 (25% suffered from colorectal cancer. The sensitivity (97%, specificity (82%, positive predictive value (94%, negative predictive value (90%, and accuracy (93% were calculated. Thirty (91% patients had resultant change in management. The mean CEA level for patients with malignancy (46.1 ng/ml was significantly higher than those without malignancy (3.82 ng/ml (P < 0.05. In predicting the presence of malignancy, a CEA cutoff at 7.55 ng/ml will achieve a sensitivity of 91% and a specificity of 73%. Conclusion: PET/CT, in our study population, appears to be sensitive, specific, and accurate in investigating patients with elevated CEA and without known primary malignancy. In addition to diagnosis of underlying primary malignancy, PET/CT also reveals occult metastases which would affect patient treatment options.Its role in

  15. Incidental Phaeochromocytoma on Staging PET-CT in a Patient with a Sigmoid Tumour and Situs Inversalis Totalis

    Directory of Open Access Journals (Sweden)

    M. R. Boland

    2014-01-01

    Full Text Available An adrenal “incidentaloma” is defined as an unexpected finding on radiological imaging performed for unrelated indications. Improvements in radiological technology have seen a dramatic increase in this phenomenon. We report the unique case of a 60-year-old female presenting with a 6-month history of abdominal pain, altered bowel habit, and rectal bleeding. Her past medical history included situs inversus totalis and a patent ductus arteriosus. Colonoscopy revealed an ulcerated tumour in her sigmoid colon. Staging PET-CT confirmed a sigmoid tumour and also identified a large heterogenous enhancing FDG-avid right adrenal mass. Biochemical testing/MIBG imaging confirmed a right adrenal phaeochromocytoma. Hypertension was controlled and excision was performed via a transperitoneal laparoscopic adrenalectomy, in the left lateral decubitus position. Uniquely, liver retraction was not required due to its position in the left hypochondrium. Histology confirmed a benign 46 mm phaeochromocytoma. Subsequent uncomplicated sigmoid colectomy/right salpingo-oophorectomy for a locally advanced colonic tumour was performed with adjuvant chemotherapy. This case highlights the importance of accurately identifying functioning adrenal tumours before elective surgery as undiagnosed phaeochromocytomas carry significant intraoperative morbidity/mortality. Right adrenalectomy was made easier in this patient by the liver’s unique position. Uncomplicated colorectal resection was made possible by combined preoperative functional/anatomical imaging.

  16. Tumour length measured on PET-CT predicts the most appropriate stage-dependent therapeutic approach in oesophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Roedl, Johannes B. [Massachusetts General Hospital, Harvard Medical School, Division of Abdominal and Interventional Radiology, Department of Radiology, Boston (United States); Massachusetts General Hospital, Harvard Medical School, Division of Nuclear Medicine, Department of Radiology, Boston (United States); Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston (United States); Sahani, Dushyant V.; Mueller, Peter R.; Blake, Michael A. [Massachusetts General Hospital, Harvard Medical School, Division of Abdominal and Interventional Radiology, Department of Radiology, Boston (United States); Colen, Rivka R. [Massachusetts General Hospital, Harvard Medical School, Division of Abdominal and Interventional Radiology, Department of Radiology, Boston (United States); Massachusetts General Hospital, Harvard Medical School, Division of Nuclear Medicine, Department of Radiology, Boston (United States); Fischman, Alan J. [Massachusetts General Hospital, Harvard Medical School, Division of Nuclear Medicine, Department of Radiology, Boston (United States)

    2008-12-15

    To compare the accuracy of determining the most appropriate treatment approach based on a visual analysis on combined PET-CT, based on a visual analysis on PET (reviewed side-by-side with CT) and based on tumour length measurements (on PET and PET-CT). Tumour length, SUV, and the length-SUV index (length x SUV) were assessed (on PET and PET-CT) in benign oesophageal lesions (reflux oesophagitis; n = 29), in potentially curable stages of oesophageal cancer (Tis; T1-T3NxM0; curable group; n = 52), and in stages of oesophageal cancer best treated with palliative therapy (T4NxMx; TxNxM1; palliative group; n = 30). All lesions were histopathologically proven. Based on a visual analysis, PET-CT (sensitivity: 77%;specificity: 96%) was more accurate than PET (sensitivity: 67%; specificity: 89%) in assessing the appropriate treatment (curative vs. palliative). The length-SUV index was the most accurate quantitative parameter to distinguish palliative from curable stages (sensitivity: 93%; specificity: 90%) and to predict survival. The highest overall accuracy was reached when combining the results of the quantitative (length-SUV index) analysis with those of the qualitative (visual) analysis (sensitivity: 93%; specificity: 96%). Moreover, neither tumour length nor SUV can be used to distinguish reflux oesophagitis from early malignant lesions (T1 stage). Tumour length measured with PET-CT or PET is associated with stage and overall survival of oesophageal cancer and helps to guide the appropriate treatment approach. (orig.)

  17. Clinical value of FDG PET or PET/CT in urinary bladder cancer: A systemic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Yu-Yu, E-mail: yuoyuolu@vghtc.gov.tw [Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan (China); Chen, Jin-Hua, E-mail: chenjh99@mail.cmu.edu.tw [Biostatistics Center and Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan (China); Liang, Ji-An, E-mail: hope.jal@msa.hinet.net [Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan (China); School of Medicine, China Medical University, Taichung, Taiwan (China); Wang, Hsin-Yi, E-mail: hywang@vghtc.gov.tw [Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan (China); Lin, Cheng-Chieh, E-mail: cclin@mail.cmuh.org.tw [School of Medicine, China Medical University, Taichung, Taiwan (China); Department of Community Medicine and Health Examination Center, China Medical University Hospital, Taichung, Taiwan (China); Lin, Wan-Yu, E-mail: wylin@vghtc.gov.tw [Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan (China); School of Medicine, China Medical University, Taichung, Taiwan (China); Kao, Chia-Hung, E-mail: d10040@mail.cmuh.org.tw [School of Medicine, China Medical University, Taichung, Taiwan (China); Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (China)

    2012-09-15

    Aim: The purpose of the current study was to conduct a systemic review and meta-analysis of the published literature to evaluate the diagnostic accuracy of FDG PET or PET/CT in urinary bladder cancer. Materials and methods: The authors conducted a systematic MEDLINE search of articles published between January 2000 and December 2010. Two reviewers independently assessed the methodological quality of each study. We conducted a meta-analysis of pooled sensitivity and specificity in detecting primary and metastatic lesions of bladder cancer. Results: Six studies met the inclusion criteria. The pooled sensitivity and specificity of PET/CT for primary lesion detection of bladder cancer were 0.90 (95% CI: 0.70–0.99) and 1.00 (95% CI: 0.74–1.00), respectively. The pooled sensitivity and specificity of FDG PET or PET/CT for staging or restaging (metastatic lesions) of bladder cancer were 0.82 (95% CI: 0.72–0.89) and 0.89 (95% CI: 0.81–0.95), respectively. Conclusion: The diagnostic accuracy of FDG PET or PET/CT is good in metastatic lesions of urinary bladder cancer. Due to the small number of patients and limited number of studies analyzed, the diagnostic capability of FDG PET or PET/CT in detection of primary bladder wall lesions could not be assessed.

  18. Value of {sup 18}F-FDG PET/CT in the detection of ovarian malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Park, Tae Gyu; Lee, Si Nae; Park, So Yeon [Dept. of Nuclear Medicine, Korea University Guro Hospital, Seoul (Korea, Republic of); and others

    2015-03-15

    Ovarian cancer is a leading cause of gynecologic malignancy. As symptoms of ovarian cancer are nonspecific, only 20 % of ovarian cancers are diagnosed while they are still limited to the ovaries. Thus, early and accurate detection of disease is important for an improved prognosis. For the accurate and effective diagnosis of ovarian malignancy on {sup 18}F-fluorodeoxyglucose ({sup 18}F--FDG) positron emission tomography/computed tomography (PET/CT), we analyzed several parameters, including visual assessment. A total of 51 peritoneal lesions in 19 patients who showed ovarian masses with diffuse peritoneal infiltration were enrolled. Twelve patients were confirmed to have ovarian malignancy and seven patients with benign disease by pathologic examination. All patients were examined by {sup 18}F--FDG PET/CT, and an additional 2-h delayed {sup 18}F--FDG PET/CT was also performed for 15 patients with 42 peritoneal lesions. We measured semiquantitative parameters including maximum and mean standardized uptake values (SUV{sub max}, SUV{sub mean}), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on a 1-h initial {sup 18}F--FDG PET/CT image (Parameter1) and on a 2-h delayed image (Parameter2). Additionally, retention indices of each parameter were calculated, and each parameter among the malignant and benign lesions was compared by Mann-Whitney U test. We also assessed the visual characteristics of each peritoneal lesion, including metabolic extent, intensity, shape, heterogeneity, and total visual score. Associations between visual grades and malignancy were analyzed using linear by linear association methods. Moreover, a receiver operating characteristic (ROC) curve was analyzed to compare the effectiveness of significant parameters. In a comparison between the malignant and benign groups in the analysis of 51 total peritoneal lesions, SUV{sub max1}, SUV{sub mean1}, and TLG1 showed significant differences. Also, in the analysis of 42 peritoneal lesions

  19. Lymph node detection in IASLC-defined zones on PET/CT images

    Science.gov (United States)

    Song, Yihua; Udupa, Jayaram K.; Odhner, Dewey; Tong, Yubing; Torigian, Drew A.

    2016-03-01

    Lymph node detection is challenging due to the low contrast between lymph nodes as well as surrounding soft tissues and the variation in nodal size and shape. In this paper, we propose several novel ideas which are combined into a system to operate on positron emission tomography/ computed tomography (PET/CT) images to detect abnormal thoracic nodes. First, our previous Automatic Anatomy Recognition (AAR) approach is modified where lymph node zones predominantly following International Association for the Study of Lung Cancer (IASLC) specifications are modeled as objects arranged in a hierarchy along with key anatomic anchor objects. This fuzzy anatomy model built from diagnostic CT images is then deployed on PET/CT images for automatically recognizing the zones. A novel globular filter (g-filter) to detect blob-like objects over a specified range of sizes is designed to detect the most likely locations and sizes of diseased nodes. Abnormal nodes within each automatically localized zone are subsequently detected via combined use of different items of information at various scales: lymph node zone model poses found at recognition indicating the geographic layout at the global level of node clusters, g-filter response which hones in on and carefully selects node-like globular objects at the node level, and CT and PET gray value but within only the most plausible nodal regions for node presence at the voxel level. The models are built from 25 diagnostic CT scans and refined for an object hierarchy based on a separate set of 20 diagnostic CT scans. Node detection is tested on an additional set of 20 PET/CT scans. Our preliminary results indicate node detection sensitivity and specificity at around 90% and 85%, respectively.

  20. PET CT Identifies Reactivation Risk in Cynomolgus Macaques with Latent M. tuberculosis

    Science.gov (United States)

    Lin, Philana Ling; Maiello, Pauline; Gideon, Hannah P.; Cadena, Anthony M.; Rodgers, Mark A.; Gregg, Robert; O’Malley, Melanie; Fillmore, Daniel; Frye, L. James; Rutledge, Tara; DiFazio, Robert M.; Janssen, Christopher; Klein, Edwin; Andersen, Peter L.; Fortune, Sarah M.; Flynn, JoAnne L.

    2016-01-01

    Mycobacterium tuberculosis infection presents across a spectrum in humans, from latent infection to active tuberculosis. Among those with latent tuberculosis, it is now recognized that there is also a spectrum of infection and this likely contributes to the variable risk of reactivation tuberculosis. Here, functional imaging with 18F-fluorodeoxygluose positron emission tomography and computed tomography (PET CT) of cynomolgus macaques with latent M. tuberculosis infection was used to characterize the features of reactivation after tumor necrosis factor (TNF) neutralization and determine which imaging characteristics before TNF neutralization distinguish reactivation risk. PET CT was performed on latently infected macaques (n = 26) before and during the course of TNF neutralization and a separate set of latently infected controls (n = 25). Reactivation occurred in 50% of the latently infected animals receiving TNF neutralizing antibody defined as development of at least one new granuloma in adjacent or distant locations including extrapulmonary sites. Increased lung inflammation measured by PET and the presence of extrapulmonary involvement before TNF neutralization predicted reactivation with 92% sensitivity and specificity. To define the biologic features associated with risk of reactivation, we used these PET CT parameters to identify latently infected animals at high risk for reactivation. High risk animals had higher cumulative lung bacterial burden and higher maximum lesional bacterial burdens, and more T cells producing IL-2, IL-10 and IL-17 in lung granulomas as compared to low risk macaques. In total, these data support that risk of reactivation is associated with lung inflammation and higher bacterial burden in macaques with latent Mtb infection. PMID:27379816

  1. PET CT Identifies Reactivation Risk in Cynomolgus Macaques with Latent M. tuberculosis.

    Directory of Open Access Journals (Sweden)

    Philana Ling Lin

    2016-07-01

    Full Text Available Mycobacterium tuberculosis infection presents across a spectrum in humans, from latent infection to active tuberculosis. Among those with latent tuberculosis, it is now recognized that there is also a spectrum of infection and this likely contributes to the variable risk of reactivation tuberculosis. Here, functional imaging with 18F-fluorodeoxygluose positron emission tomography and computed tomography (PET CT of cynomolgus macaques with latent M. tuberculosis infection was used to characterize the features of reactivation after tumor necrosis factor (TNF neutralization and determine which imaging characteristics before TNF neutralization distinguish reactivation risk. PET CT was performed on latently infected macaques (n = 26 before and during the course of TNF neutralization and a separate set of latently infected controls (n = 25. Reactivation occurred in 50% of the latently infected animals receiving TNF neutralizing antibody defined as development of at least one new granuloma in adjacent or distant locations including extrapulmonary sites. Increased lung inflammation measured by PET and the presence of extrapulmonary involvement before TNF neutralization predicted reactivation with 92% sensitivity and specificity. To define the biologic features associated with risk of reactivation, we used these PET CT parameters to identify latently infected animals at high risk for reactivation. High risk animals had higher cumulative lung bacterial burden and higher maximum lesional bacterial burdens, and more T cells producing IL-2, IL-10 and IL-17 in lung granulomas as compared to low risk macaques. In total, these data support that risk of reactivation is associated with lung inflammation and higher bacterial burden in macaques with latent Mtb infection.