The impact of 18F-FDG PET/CT in patients with liver metastases

International Nuclear Information System (INIS)

Chua, Siew C.; Groves, Ashley M.; Kayani, Irfan; Menezes, Leon; Gacinovic, Svetislav; Du, Yong; Bomanji, Jamshed B.; Ell, Peter J.

2007-01-01

The aim of this study was to assess the performance of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) versus dedicated contrast-enhanced CT (CECT) in the detection of metastatic liver disease. All patients that presented to our Institution with suspected metastatic liver disease who underwent 18 F-FDG PET/CT and CECT within 6 weeks of each other, were retrospectively analyzed, covering a 5-year period. One hundred and thirty-one patients (67 men, 64 women; mean age 62) were identified. Seventy-five had colorectal carcinoma and 56 had other malignancies. The performance of CECT and that of 18 F-FDG-PET/CT in detecting liver metastases were compared. The ability of each to detect local recurrence, extrahepatic metastases and to alter patient management was recorded. The final diagnosis was based on histology, clinical and radiological follow-up (mean 23 months). In detecting hepatic metastases, 18 F-FDG-PET/CT yielded 96% sensitivity and 75% specificity, whilst CECT showed 88% sensitivity and 25% specificity. 18 F-FDG-PET/CT and CECT were concordant in 102 out of 131 patients (78%). In the colorectal group 18 F-FDG-PET/CT showed 94% sensitivity and 75% specificity, whilst CECT had 91% sensitivity and 25% specificity. In the noncolorectal group 18 F-FDG-PET/CT showed 98% sensitivity and 75% specificity whilst CECT had 85% sensitivity and 25% specificity. Overall, 18 F-FDG-PET/CT altered patient management over CECT in 25% of patients. CECT did not alter patient management over 18 F-FDG-PET/CT alone in any patients. 18 F-FDG-PET/CT performed better in detecting metastatic liver disease than CECT in both colorectal and noncolorectal malignancies, and frequently altered patient management. The future role of CECT in these patients may need to be re-evaluated to avoid potentially unnecessary duplication of investigation where 18 F-PET/CT is readily available. (orig.)

Physiologic uptake of 18F-FDG in transposed ovaries may mimic metastasis on 18F-FDG PET/CT imaging.

Science.gov (United States)

Davidson, Tima; Komisar, Orna; Korach, Jacob; Felder, Shira; Apter, Sara; Ben-Haim, Simona; Perri, Tamar

2018-02-01

Ovarian transposition is aimed at preserving ovarian function before irradiation in pelvic malignancies. The extrapelvic location of the ovaries and their physiologic fluorine-18-fluorodeoxyglucose (F-FDG)-uptake is a potential source of misdiagnosis as metastasis on F-FDG PET/CT. We describe the F-FDG PET/CT characteristics of transposed ovaries and their changes over time. We reviewed F-FDG PET/CT studies of all consecutive women with pelvic malignancies who underwent ovarian transposition between 2007 and 2013. Studies were grouped according to the time period over which they were carried out. Findings were categorized by location, size, appearance (solid/mixed/cystic), presence of surgical clips, ovarian F-FDG uptake (maximum standardized uptake value), and attenuation values on CT (Hounsfield units). Group time-period differences were assessed. Seventy-nine F-FDG PET/CT studies were reviewed, 30 before and 49 after transposition. Time-period groups after transposition were up to 4 months (18 studies), 4.1-12 months (n=14), and more than 12 months (n=17). After transposition, ovaries were located mainly in the paracolic gutter (n=32) and subhepatic regions (n=18). Surgical clips were present in 67%. Both ovaries appeared more solid 1 year after surgery than preoperatively (13.7% before vs. 61.3% after surgery; P<0.001). Transient F-FDG-avidity was observed in 11 ovaries. Hounsfield unit values were higher within 4 months after surgery than preoperatively, reverting thereafter to preoperative values. After ovarian transposition, nonanatomic location, loss of cysts formation in favor of solid appearance over time, and intermittent F-FDG uptake of functioning transposed ovaries might mimic metastatic lesions. Careful interpretation of F-FDG PET/CT findings is mandatory in women with pelvic malignancies who have undergone ovarian transposition.

F-18-FDG-hybrid-camera-PET in patients with postoperative fever

International Nuclear Information System (INIS)

Meller, J.; Lehmann, K.; Siefker, U.; Meyer, I.; Altenvoerde, G.; Becker, W.; Sahlmann, C.O.; Schreiber, K.

2002-01-01

Aim: Evaluation of F-18-FDG-hybrid-camera-PET imaging in patients with undetermined postoperative fever (POF). Methods: Prospective study of 18 patients (9 women, 9 men; age 23-85 years) suffering from POF with 2-fluoro-2'-deoxyglucose (F-18-FDG) using a dual headed coincidence camera (DHCC). Surgery had been performed 5-94 days prior to our investigation. 13 of the 18 patients received antibiotic therapy during the time of evaluation. Ten (55%) had an infectious and eight (45%) a norr infectious cause of fever. Results: Increased F-18-FDG-uptake outside the surgical wound occurred in 13 regions (infection n = 11, malignancy n = 2). The sensitivity of F-18-FDG-hybrid-camera-PET in imaging infection in areas outside the surgical wound was 86% and the specificity 100%, respectively. Antibiotic therapy did not negatively influence the results of F-18-FDG-scanning. Increased F-18-FDG-uptake within the surgical wound was seen in 8 of 18 patients. The sensitivity of F-18-FDG-hybrid-camera-PET in imaging infection within the surgical wound was 100% and the specificty 56%, respectively. The interval between surgery and F-18-FDG-scanning was significantly shorter in patients with false positive results compared with patients showing true negative results (median 34 vs. 54 days; p = 0,038). Conclusion: In POF-Patients, F-18-FDG transaxial tomography performed with a F-18-FDG-hybrid-camera-PET is sensitive in the diagnosis of inflammation and malignant disease within and outside the surgical wound. Because of the accumulation of the tracer both in granulation tissue and infection, the specificity in detecting the focus of fever within the surgical wound is poor. (orig.) [de

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

International Nuclear Information System (INIS)

Karantanis, Dimitrios; Durski, Jolanta M.; Lowe, Val J.; Nathan, Mark A.; Mullan, Brian P.; Georgiou, Evangelos; Johnston, Patrick B.; Wiseman, Gregory A.

2010-01-01

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

F-18-FDG PET of the thyroid in Graves' disease

International Nuclear Information System (INIS)

Boerner, A.R.; Voth, E.; Schicha, H.; Wienhard, K.; Wagner, R.

1998-01-01

This study evaluates F-18-FDG PET of the thyroid in Graves' disease. Methods: Thirty patients were investigated the day before radioiodine therapy, 15 patients 3-10 days after radioiodine therapy. Twenty patients with cancer of the head or neck and normal thyroid function served as controls. Results: F-18-FDG uptake was higher in Graves' disease patients than in controls. Negative correlations of F-18-FDG uptake with half-life of radioiodine and absorbed radiation dose due to radioiodine therapy were found along with a positive correlation to autoantibody levels. Conclusion: Thus F-18-FDG PET is likely to give information on the biological activity of Graves' disease as well as on early radiation effects. (orig.) [de

Clinical Application of F-18 FDG PET (PET/CT) in Malignancy of Unknown Origin

International Nuclear Information System (INIS)

Kim, Byung Il

2008-01-01

Diagnosis of primary origin site in the management of malignancy of unknown origin (MUO) is the most important issue. According to the histopathologic subtype of primary lesion, specialized treatment can be given and survival gain is expected. F-18 FDG PET (PET/CT) has been estimated as useful in detection of primary lesion with high sensitivity and moderate specificity. F-18 FDG PET (PET/CT) study before conventional studies is also recommended because it has high diagnostic performance compared to conventional studies. Although there has few data, F-18 FDG PET (PET/CT) is expected to be useful in diagnosis of recurrence, restaging, evaluation of treatment effect, considering that PET (PET/CT) has been reported as useful in other malignancies

Guidelines for 18F-FDG PET and PET-CT imaging in paediatric oncology

DEFF Research Database (Denmark)

Stauss, J.; Franzius, C.; Pfluger, T.

2008-01-01

tomography ((18)F-FDG PET) in paediatric oncology. The Oncology Committee of the European Association of Nuclear Medicine (EANM) has published excellent procedure guidelines on tumour imaging with (18)F-FDG PET (Bombardieri et al., Eur J Nucl Med Mol Imaging 30:BP115-24, 2003). These guidelines, published...

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......-FDG-PET/CT is a useful tool in the investigation of fever of unknown origin; it can reduce patient inconvenience and possibly costs to society if used earlier in the diagnostic process....

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

Science.gov (United States)

Sachpekidis, Christos; Hillengass, J; Goldschmidt, H; Wagner, B; Haberkorn, U; Kopka, K; Dimitrakopoulou-Strauss, A

2017-01-01

The aim of this study was to assess the combined use of the radiotracers 18 F-FDG and 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 18 F-FDG and 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, 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, 18 F-FDG PET/CT-based treatment response revealed CR in 14 patients ( 18 F-FDG PET/CT CR), PR in 11 patients ( 18 F-FDG PET/CT PR) and progressive disease in four patients ( 18 F-FDG PET/CT PD). In terms of 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, 18 F-NaF PET/CT depicted 56 of the 129 18 F-FDG positive lesions (43 %). Follow-up 18 F-NaF PET/CT showed persistence of 81.5 % of the baseline 18 F-NaF positive MM lesions after treatment, despite the fact that 64

Clinical studies of 18F-FDG and 18F-FP-β-CIT PET imaging in hemi-Parkinson's disease

International Nuclear Information System (INIS)

Zhao Jun; Lin Xiangtong; Guan Yihui; Zuo Chuantao; Zhang Zhengwei; Wang Jian; Sun Bomin; Chen Zhengping

2003-01-01

Objective: To study the characteristics of 18 F-fluorodeoxyglucose (FDG) and 18 F-N-3-fluoro-propyl-2β-carbomethoxy-3β-(4-iodophenyl) nortropane ( 18 F-FP-β-CIT) PET imaging in patients with hemi-Parkinson's disease (hemi-PD) and to assess their value in early diagnosis. Methods: 34 cases of hemi-PD (Hoehn and Yahr stage I-II) and 16 normal control subjects were selected for this study. 16 patients were performed with 18 F-FDG PET imaging, 18 patients with 18 F-FP-β-CIF, while 6 patients of them both 18 F-FDG and 18 F-FP-β-CIT. 30 min after injection of 185-259 MBq 18 F-FDG, 3D brain scans were acquired. Region of interest (ROI) analysis and statistical parametric mapping (SPM) were applied. 18 F-FP-β-CIT PET imaging was carried out 2-3 h post injection, and (ROI-cerebellum)/cerebellum ratio was calculated. Results: In right hemi-PD, reductions in 18 F-FDG metabolism were observed in the left basal ganglia compared with control group, but with no significant difference (P>0.05). The results of SPM analysis showed that a significant reduction in FDG uptake in the left superior frontal gyrus, middle frontal gyrus, inferior frontal gyrus and left middle temporal gyrus, whereas a significant increase in the bilateral precentral gyrus , superior parietal lobule, left middle occipital gyrus and left thalamus as compared with the control group. There was a significant reduction in 18 F-FP-β-CIT uptake in putamen, its reduction was found not only in the contralateral putamen, but also in the ipsilateral ones, and more pronounced in the contralateral posterior putamen. Conclusions: 18 F-FDG PET imaging is non-specific for the early diagnosis of PD. 18 F-FP-β-CIT PET imaging could find the changes of striatum dopamine transporter at early stage, therefore it was helpful for early diagnosis and differential diagnosis of PD. Combined with 18 F-FDG PET imaging, the changes of local cerebral glucose metabolism in PD could also be evaluated

Complementary roles of tumour specific PET tracer {sup 18}F-FAMT to {sup 18}F-FDG PET/CT for the assessment of bone metastasis

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Morita, Motoho [Gunma University Hospital, Department of General Medicine, Maebashi, Gunma (Japan); Gunma University Graduate School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Maebashi, Gunma (Japan); Higuchi, Tetsuya; Tokue, Azusa; Arisaka, Yukiko; Tsushima, Yoshito [Gunma University Graduate School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Maebashi, Gunma (Japan); Achmad, Arifudin [Gunma University Graduate School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Maebashi, Gunma (Japan); Gadjah Mada University, Department of Radiology, Faculty of Medicine, Yogyakarta (Indonesia)

2013-10-15

The usefulness of {sup 18}F-FDG PET/CT for bone metastasis evaluation has already been established. The amino acid PET tracer [{sup 18}F]-3-fluoro-alpha-methyl tyrosine ({sup 18}F-FAMT) has been reported to be highly specific for malignancy. We evaluated the additional value of {sup 18}F-FAMT PET/CT to complement {sup 18}F-FDG PET/CT in the evaluation of bone metastasis. This retrospective study included 21 patients with bone metastases of various cancers who had undergone both {sup 18}F-FDG and {sup 18}F-FAMT PET/CT within 1 month of each other. {sup 18}F-FDG-avid bone lesions suspicious for malignancy were carefully selected based on the cut-off value for malignancy, and the SUVmax of the {sup 18}F-FAMT in the corresponding lesions were evaluated. A total of 72 {sup 18}F-FDG-positive bone lesions suspected to be metastases in the 21 patients were used as the reference standard. {sup 18}F-FAMT uptake was found in 87.5 % of the lesions. In the lesions of lung cancer origin, the uptake of the two tracers showed a good correlation (40 lesions, r = 0.68, P < 0.01). Bone metastatic lesions of oesophageal cancer showed the highest average of {sup 18}F-FAMT uptake. Bone metastatic lesions of squamous cell carcinoma showed higher {sup 18}F-FAMT uptake than those of adenocarcinoma. No significant difference in {sup 18}F-FAMT uptake was seen between osteoblastic and osteolytic bone metastatic lesions. The usefulness of {sup 18}F-FAMT PET/CT for bone metastasis detection regardless of the lesion phenotype was demonstrated. The fact that {sup 18}F-FAMT uptake was confirmed by {sup 18}F-FDG uptake suggests that {sup 18}F-FAMT PET/CT has the potential to complement {sup 18}F-FDG PET/CT for the detection of bone metastases. (orig.)

The Role of 18F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion

Science.gov (United States)

Sun, Yajuan; Yu, Hongjuan; Ma, Jingquan

2016-01-01

Objective The aim of our study was to evaluate the role of 18F-FDG PET/CT integrated imaging in differentiating malignant from benign pleural effusion. Methods A total of 176 patients with pleural effusion who underwent 18F-FDG PET/CT examination to differentiate malignancy from benignancy were retrospectively researched. The images of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging were visually analyzed. The suspected malignant effusion was characterized by the presence of nodular or irregular pleural thickening on CT imaging. Whereas on PET imaging, pleural 18F-FDG uptake higher than mediastinal activity was interpreted as malignant effusion. Images of 18F-FDG PET/CT integrated imaging were interpreted by combining the morphologic feature of pleura on CT imaging with the degree and form of pleural 18F-FDG uptake on PET imaging. Results One hundred and eight patients had malignant effusion, including 86 with pleural metastasis and 22 with pleural mesothelioma, whereas 68 patients had benign effusion. The sensitivities of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging in detecting malignant effusion were 75.0%, 91.7% and 93.5%, respectively, which were 69.8%, 91.9% and 93.0% in distinguishing metastatic effusion. The sensitivity of 18F-FDG PET/CT integrated imaging in detecting malignant effusion was higher than that of CT imaging (p = 0.000). For metastatic effusion, 18F-FDG PET imaging had higher sensitivity (p = 0.000) and better diagnostic consistency with 18F-FDG PET/CT integrated imaging compared with CT imaging (Kappa = 0.917 and Kappa = 0.295, respectively). The specificities of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging were 94.1%, 63.2% and 92.6% in detecting benign effusion. The specificities of CT imaging and 18F-FDG PET/CT integrated imaging were higher than that of 18F-FDG PET imaging (p = 0.000 and p = 0.000, respectively), and CT imaging had better diagnostic consistency with

The Role of 18F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion.

Science.gov (United States)

Sun, Yajuan; Yu, Hongjuan; Ma, Jingquan; Lu, Peiou

2016-01-01

The aim of our study was to evaluate the role of 18F-FDG PET/CT integrated imaging in differentiating malignant from benign pleural effusion. A total of 176 patients with pleural effusion who underwent 18F-FDG PET/CT examination to differentiate malignancy from benignancy were retrospectively researched. The images of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging were visually analyzed. The suspected malignant effusion was characterized by the presence of nodular or irregular pleural thickening on CT imaging. Whereas on PET imaging, pleural 18F-FDG uptake higher than mediastinal activity was interpreted as malignant effusion. Images of 18F-FDG PET/CT integrated imaging were interpreted by combining the morphologic feature of pleura on CT imaging with the degree and form of pleural 18F-FDG uptake on PET imaging. One hundred and eight patients had malignant effusion, including 86 with pleural metastasis and 22 with pleural mesothelioma, whereas 68 patients had benign effusion. The sensitivities of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging in detecting malignant effusion were 75.0%, 91.7% and 93.5%, respectively, which were 69.8%, 91.9% and 93.0% in distinguishing metastatic effusion. The sensitivity of 18F-FDG PET/CT integrated imaging in detecting malignant effusion was higher than that of CT imaging (p = 0.000). For metastatic effusion, 18F-FDG PET imaging had higher sensitivity (p = 0.000) and better diagnostic consistency with 18F-FDG PET/CT integrated imaging compared with CT imaging (Kappa = 0.917 and Kappa = 0.295, respectively). The specificities of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging were 94.1%, 63.2% and 92.6% in detecting benign effusion. The specificities of CT imaging and 18F-FDG PET/CT integrated imaging were higher than that of 18F-FDG PET imaging (p = 0.000 and p = 0.000, respectively), and CT imaging had better diagnostic consistency with 18F-FDG PET/CT integrated

Thoracic staging with {sup 18}F-FDG PET/MR in non-small cell lung cancer - does it change therapeutic decisions in comparison to {sup 18}F-FDG PET/CT?

Energy Technology Data Exchange (ETDEWEB)

Schaarschmidt, Benedikt M. [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Duesseldorf (Germany); University Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Grueneisen, Johannes; Umutlu, Lale [University Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Metzenmacher, Martin [University Duisburg-Essen, Medical Faculty, Department of Medical Oncology, Essen (Germany); Gomez, Benedikt; Ruhlmann, Verena [University Duisburg-Essen, Medical Faculty, Department of Nuclear Medicine, Essen (Germany); Gauler, Thomas [University Duisburg-Essen, Medical Faculty, Radiation and Tumour Clinic, Essen (Germany); Roesel, Christian [University Duisburg-Essen, Ruhrlandklinik, Thoracic Surgery and Endoscopy, Essen (Germany); Heusch, Philipp; Antoch, Gerald; Buchbender, Christian [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Duesseldorf (Germany)

2017-02-15

To investigate whether differences in thoracic tumour staging between {sup 18}F-FDG PET/CT and PET/MR imaging lead to different therapeutic decisions in Non-Small Cell Lung Cancer (NSCLC). Seventy-seven NSCLC patients that underwent whole-body {sup 18}F-FDG PET/CT from the base of skull to the upper thighs and thoracic PET/MR were enrolled in this retrospective study. Thoracic PET/CT and PET/MR images were staged according to the 7th edition of the AJCC staging manual. Staging results of both modalities were discussed separately in a simulated interdisciplinary tumour board and therapeutic decisions based on both imaging modalities were recorded. Descriptive statistics were used to compare the results and reasons for changes in the therapeutic decision were investigated. Staging results differed in 35 % of patients (27 patients) between thoracic PET/CT and PET/MR. Differences were detected when assessing the T-stage in 18 % (n = 14), the N-stage in 23 % (n = 18), and the M-stage in 1 % (n = 1). However, patient therapy management was changed in only six patients (8 %). Despite the variability of thoracic {sup 18}F-FDG PET/CT and PET/MR in TNM-staging, both modalities lead to comparable therapeutic decisions in patients suffering from NSCLC. Hence, {sup 18}F-FDG PET/MR can be considered an possible alternative to {sup 18}F-FDG PET/CT for clinical NSCLC staging. (orig.)

Characteristic of 18F-FDG Excretion According to Use Diuretics in 18F-FDG of PET/CT

International Nuclear Information System (INIS)

Jang, Dong Gun; Yang, Seoung Oh; Lee, Sang Ho; Bae, Jong Lim; Kim, Jeong Koo

2012-01-01

18 F-fluorodeoxyglucose ( 18 F-FDG) causes a significant amount of radioactivity retention in kidneys and urinary tract and degrades image quality and diagnostic performance. Diuretics are used to perform tests and prevent the urinary tract retention of 18 F-FDG. The purpose of the study is to investigate how the diuretics affect images and excretion rates of 18 F-FDG. The study consists of a group using diuretics for patients with no primary tumors or transfer lesions in kidneys according to PET/CT images, a group using physiological saline and the control group injecting only 18 F-FDG and SUVs are measured by configuring interested areas for each group. Also, SUVs are compared and evaluated depending on the lasix injection after basic inspection and injecting 18 F-FDG for quantitative analysis. The study shows that images with decreased background radioactivity and increased urine excretion due to using diuretics. However, an opposite result that there is no change in the amount of radioactivity in urine appears. The study concludes that the diuretics may decrease background radioactivity in the images but may not affect the 18 F-FDG excretion.

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-NaF

Diagnostic role of 18F-FDG PET in gastric MALT lymphoma

International Nuclear Information System (INIS)

Ambrosini, V.; Castellucci, P.; Nanni, C.; Farsad, M.; Fanti, S.; Rubello, D.; Zinzani, P.; Alavi, A.; Tehranipour, N.; Al-Nahhas, A.

2006-01-01

The aim of the study was to evaluate the usefulness of 18 F-FDG-PET in patients with gastric lymphoma, in particular those affected by mucosa-associated lymphoid tissue (MALT) type and aggressive gastric non-Hodgkin's lymphoma (NHL). The study group consists of 15 patients with a previous diagnosis of gastric NHL referred to our PET centres in Bologna Hospital and Rovigo Hospital, Italy, in the period 2003-2004. In 9/15 patients the subsequent histological evaluation was consistent with a gastric MALT lymphoma, while aggressive gastric NHL was diagnosed in the other 6/15. PET scan was carried out in patients with known active disease in order to stage or re-stage disease prior to treatment or in patients in complete clinical remission to monitor disease during follow up. Patients were considered in complete clinical remission if free from disease for at least 8 months after chemotherapy or surgery. 18 F-FDG PET was performed following standard procedures. 18 F-FDG-PET was true positive in all cases of gastric MALT and non-MALT aggressive NHL with known active disease, while no pathological 18 F-FDG uptake was evident in the subjects who were in complete clinical remission. The degree of 18 F-FDG uptake (mean SUVmax values) in MALT lymphoma was much less intense in comparison to aggressive gastric NHL, suggesting a prognostic role of SUV calculation in gastric lymphomas. Our data demonstrate the significant accuracy of 18 F-FDG-PET in detecting active disease in gastric lymphoma of both MALT and non-MALT NHL type. A higher SUV value appears to be related to a more aggressive disease. (author)

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

International Nuclear Information System (INIS)

Rodriguez, M.; Ahlstroem, H.; Sundin, A.; Rehn, S.; Hagberg, H.; Glimelius, B.; Sundstroem, C.

1997-01-01

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

{sup 18}F-FDG PET/CT in POEMS syndrome

Energy Technology Data Exchange (ETDEWEB)

An, Young Sil; Yoon, Joon Kee; Hong, Seon Pyo; Joh, Chul Woo; Yoon, Seok Nam [Ajou University School of Medicine, Suwon (Korea, Republic of)

2007-02-15

POEMS syndrome is a rare disorder, also known as Crow-Fukase, PEP or Takatsuki syndrome. The acronym, POEMS, represents polyneuropathy, organomegaly, endocrinopathy, M protein and skin change. However, there are associated features not included in the acronym such as sclerotic bone lesions, Castleman disease, papilledema, thromobocytosis, peripheral edema, ascites, effusion, polycythemia, fatigue and clubbing. In most cases, osseous lesions in POEMS syndrome present as an isolated sclerotic deposit and that reveal as osteosclerotic myeloma. Several cases of {sup 18}F-FDG PET in multiple myeloma involvements were reported, but there was no previous literature that reported FDG PET findings in POEMS syndrome. We describe here a 66-year-old patient with POEMS syndrome who underwent {sup 18}F-FDG PET/CT image.

18F-FDG PET/CT in breast cancer: Evidence-based recommendations in initial staging.

Science.gov (United States)

Caresia Aroztegui, Ana Paula; García Vicente, Ana María; Alvarez Ruiz, Soledad; Delgado Bolton, Roberto Carlos; Orcajo Rincon, Javier; Garcia Garzon, Jose Ramon; de Arcocha Torres, Maria; Garcia-Velloso, Maria Jose

2017-10-01

Current guidelines do not systematically recommend 18F-FDG PET/CT for breast cancer staging; and the recommendations and level of evidence supporting its use in different groups of patients vary among guidelines. This review summarizes the evidence about the role of 18F-FDG PET/CT in breast cancer staging and the therapeutic and prognostic impact accumulated in the last decade. Other related aspects, such as the association of metabolic information with biology and prognosis are considered and evidence-based recommendations for the use of 18F-FDG PET/CT in breast cancer staging are offered. We systematically searched MEDLINE for articles reporting studies with at least 30 patients related to clinical questions following the Problem/Population, Intervention, Comparison, and Outcome framework. We critically reviewed the selected articles and elaborated evidence tables structuring the summarized information into methodology, results, and limitations. The level of evidence and the grades of recommendation for the use of 18F-FDG PET/CT in different contexts are summarized. Level III evidence supports the use of 18F-FDG PET/CT for initial staging in patients with recently diagnosed breast cancer; the diagnostic and therapeutic impact of the 18F-FDG PET/CT findings is sufficient for a weak recommendation in this population. In patients with locally advanced breast cancer, level II evidence supports the use of 18F-FDG PET/CT for initial staging; the diagnostic and therapeutic impact of the 18F-FDG PET/CT findings is sufficient for a strong recommendation in this population. In patients with recently diagnosed breast cancer, the metabolic information from baseline 18F-FDG PET/CT is associated with tumor biology and has prognostic implications, supported by level II evidence. In conclusion, 18F-FDG PET/CT is not recommended for staging all patients with early breast cancer, although evidence of improved regional and systemic staging supports its use in locally advanced

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-07-01

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

The clinical role of "1"8F-FDG PET/CT in diagnosis of the peritoneal carcinomatosis

International Nuclear Information System (INIS)

Wang Xiaoyan; Zhang Xiangsong; Chen Zhifeng; Li Ziping; Li Fang; Rao Guohui; Shi Xinchong; Hu Ping

2010-01-01

Objective: To evaluate the clinical role of "1"8F-fluorodeoxyglucose (FDG) PET/CT in diagnosis of the peritoneal carcinomatosis. Methods: The "1"8F-FDG PET/CT scan was performed in 22 patients. All had documented malignancy and had ascites. Histopathology. or clinical follow-up was 'gold standard' for diagnostic accuracy in PET/CT scan. Results: Of these 22 patients, 18 had positive "1"8F- FDG PET/CT findings. Sixteen were peritoneal carcinomatosis and 2 were peritoneal tuberculosis. Four patients had negative "1"8F-FDG PET/CT findings. Three were peritonitis and 1 was peritoneal carcinomatosis. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of "1"8F-FDG PET/CT in diagnosing peritoneal carcinomatosis were 94.1% (16/17), 3/5, 88.9% (16/18), 3/4, and 86.4% (19/22). Conclusions: "1"8F-FDG PET/CT had high sensitivity in detecting peritoneal carcinomatosis. The most common false positive for "1"8F-FDG PET/CT in ascites was peritoneal tuberculosis. (authors)

PET/CT studies of multiple myeloma using {sup 18}F-FDG and {sup 18}F-NaF: comparison of distribution patterns and tracers' pharmacokinetics

Energy Technology Data Exchange (ETDEWEB)

Sachpekidis, Christos [Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Heidelberg (Germany); German Cancer Research Center, Medical PET Group - Biological Imaging Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany); Goldschmidt, Hartmut; Hose, Dirk [University of Heidelberg, Medical Clinic V, Heidelberg (Germany); National Center for Tumor Diseases Heidelberg, Heidelberg (Germany); Pan, Leyun; Cheng, Caixia; Dimitrakopoulou-Strauss, Antonia [Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Heidelberg (Germany); Kopka, Klaus [German Cancer Research Center, Division of Radiopharmaceutical Chemistry, Heidelberg (Germany); Haberkorn, Uwe [Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Heidelberg (Germany); University of Heidelberg, Division of Nuclear Medicine, Heidelberg (Germany)

2014-07-15

The aim of this prospective study is to evaluate the combined use of fluorine-18 fluorodeoxyglucose ({sup 18}F-FDG) and fluorine-18 sodium fluoride ({sup 18}F-NaF) PET/CT in the skeletal assessment of patients with multiple myeloma (MM) and to compare the efficacy of these two PET tracers regarding detection of myeloma-indicative osseous lesions. The study includes 60 patients with multiple myeloma (MM) diagnosed according to standard criteria. All patients underwent dynamic (dPET/CT) scanning of the pelvis as well as whole body PET/CT studies with both tracers. The interval between the two exams was one day. Sites of focal increased {sup 18}F-FDG uptake were considered as highly suspicious of myelomatous involvement. The lesions detected on the {sup 18}F-NaF PET/CT scans were then correlated with those detected on {sup 18}F-FDG PET/CT, which served as a reference. Moreover, the {sup 18}F-FDG PET/CT results were also correlated with the low-dose CT findings. The evaluation of dPET/CT studies was based on qualitative evaluation, SUV calculation, and quantitative analysis based on a 2-tissue compartment model and a non-compartmental approach. Whole body {sup 18}F-FDG PET/CT revealed approximately 343 focal lesions while {sup 18}F-NaF PET/CT revealed 135 MM-indicative lesions (39 % correlation). CT demonstrated 150 lesions that correlated with those in {sup 18}F-FDG PET/CT (44 % correlation). Six patients demonstrated a diffuse pattern of disease with {sup 18}F-FDG, while 15 of them had a mixed (diffuse and focal) pattern of skeletal {sup 18}F-FDG uptake. A high number of degenerative, traumatic and arthritic disease lesions were detected with {sup 18}F-NaF PET/CT. In three patients with multiple focal {sup 18}F-FDG-uptake, {sup 18}F-NaF PET/CT failed to demonstrate any bone lesion. The dPET/CT scanning of the pelvic area with {sup 18}F-FDG and {sup 18}F-NaF revealed 77 and 24 MM-indicative lesions, respectively. Kinetic analysis of {sup 18}F-FDG revealed the

Role of 18F-FDG PET/CT in primary brain lymphoma.

Science.gov (United States)

de-Bonilla-Damiá, Á; Fernández-López, R; Capote-Huelva, F J; de la Cruz-Vicente, F; Egea-Guerrero, J J; Borrego-Dorado, I

To study the usefulness of 18 F-FDG PET/CT in the initial evaluation and in the response assessment in primary brain lymphoma. A retrospective analysis was carried out on 18 patients diagnosed with primary brain lymphoma, a histological subtype of diffuse large B-cell lymphoma, on whom an initial 18 F-FDG PET/CT and MRI was performed, with 7 of the cases being analysed after the completion of treatment in order to assess response and clinical follow up. Initial 18 F-FDG PET/CT showed 26 hypermetabolic foci, whereas 46 lesions were detected by MRI. The average SUV maximum of the lesions was 17.56 with T/N 3.55. The concordance of both tests for identifying the same number of lesions was moderate, obtaining a kappa index of 0.395 (P<.001). In the evaluation of treatment, MRI identified 16 lesions compared to 7 pathological accumulations observed by 18 F-FDG PET/CT. The concordance of both tests to assess type of response to treatment was moderate (kappa index 0.41) (P=.04). In both the initial evaluation and the assessment of the response to treatment, PET/CT led to a change strategy in 22% of patients who had lesions outside the cerebral parenchyma. MRI appears to be the method of choice for detecting brain disease in patients with primary brain lymphoma, whereas 18 F-FDG PET/CT seems to play a relevant role in the assessment of extra-cerebral disease. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

The value of 18F-FDG PET/CT in diagnosing infectious endocarditis

International Nuclear Information System (INIS)

Kouijzer, Ilse J.E.; Vos, Fidel J.; Janssen, Marcel J.R.; Dijk, Arie P.J. van; Oyen, Wim J.G.; Bleeker-Rovers, Chantal P.

2013-01-01

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 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 18 F-FDG PET/CT and echocardiography. 18 F-FDG uptake in or around the heart valves was evaluated independently by two nuclear medicine physicians. Sensitivity for diagnosing infectious endocarditis with 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 18 F-FDG uptake in or around the heart valves was 18 %, and in patients without infectious endocarditis but with high 18 F-FDG uptake in or around the heart valves the mortality rate was 50 % (p = 0.181). 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.)

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

International Nuclear Information System (INIS)

Lee, Won Hyoung; Chung, Yong An

2008-01-01

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

[Study of patients with prolonged fever with (18)F-FDG PET/CT].

Science.gov (United States)

Moragas, M; Cozar, M Puig; Buxeda, M; Soler, M; Riera, E; García, J R

2015-01-01

To review the findings on (18)F-FDG PET-CT in patients with fever of unknown origin lasting more than 7 days. This retrospective descriptive observational study included 93 (18)F-FDG PET-CT studies to detect a fever-causing focus done at three nuclear medicine centers from October 2006 through February 2014. A nuclear medicine specialist and a radiologist reviewed the images for foci of pathological uptake; another specialist's opinion resolved discrepancies. The findings on (18)F-FDG PET-CT studies were checked against clinical and/or histological findings. Abnormal (18)F-FDG uptake on PET-CT that could explain the cause of the fever was found in 52 (56%) of the 93 studies, and the cause of the fever was confirmed in 50 of these 52 studies. In the 50 cases in which the cause of the fever was confirmed, infection was the most common cause (54%), followed by noninfectious inflammatory disease (28%) and tumors (18%). (18)F-FDG PET-CT is useful in diagnosing the cause of prolonged febrile illness, so it might be practical to use it earlier in the diagnostic process. Copyright © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

Small Animal [18F]FDG PET Imaging for Tumor Model Study

International Nuclear Information System (INIS)

Woo, Sang Keun; Kim, Kyeong Min; Cheon, Gi Jeong

2008-01-01

PET allows non-invasive, quantitative and repetitive imaging of biological function in living animals. Small animal PET imaging with [ 18 F]FDG has been successfully applied to investigation of metabolism, receptor, ligand interactions, gene expression, adoptive cell therapy and somatic gene therapy. Experimental condition of animal handling impacts on the biodistribution of [ 18 F]FDG in small animal study. The small animal PET and CT images were registered using the hardware fiducial markers and small animal contour point. Tumor imaging in small animal with small animal [ 18 F]FDG PET should be considered fasting, warming, and isoflurane anesthesia level. Registered imaging with small animal PET and CT image could be useful for the detection of tumor. Small animal experimental condition of animal handling and registration method will be of most importance for small lesion detection of metastases tumor model

Production of PET radiopharmaceutical 18F-FDG using synthesizer automatic module

International Nuclear Information System (INIS)

Purwoko; Chairuman; Adang Hardi Gunawan; Yayan Tahyan; Eny Lestari; Sri Aguswarini Lestiyowati; Karyadi; Sri Bagiawati

2010-01-01

Radiopharmaceutical 2-( 18 F)Fluoro-2-Deoxy-D-Glucose or 18 F(FDG) is an important PET (Positron Emission Tomography) radiopharmaceutical for tumour imaging. In the PET technique glucose metabolism in tumour tissues can be determined quantitatively and used for diagnosis staging and monitoring of treatment tumour or cancer disease in medical oncology. The production of 2-( 18 F)Fluoro-2-Deoxy-D-Glucose 18 F-FDG using compact automated system module TRACERlab MX has been carried out. The modular setup of the apparatus permits reliable for routine synthesis of radiopharmaceuticals 18 F-FDG based on kriptofix mediated nucleophilic fluorination to mannose triflate precursor. Radiochemical yield of 18 F-FDG was 53.895 % (decay time uncorrected) in 40 minutes. The product showed that the colorless and clear solution at pH:6, sterile and pirogen free, kriptofix impurities was low and radiochemical purity was 99.595%. (author)

18F-FDG-PET/CT in Endometrial Carcinoma

International Nuclear Information System (INIS)

Jeon, Tae Joo

2008-01-01

Endometrial carcinoma is one of the most common gynecologic malignancies and which is predominant in postmenopausal women. Clinically many patients are hospitalized in early stage due to clinical sign and symptom such as vaginal bleeding and in this case, patient's prognosis is known to be good. However, considerable number of patients with advanced and relapsed disease reveal poor prognosis. Therefore, exact staging work up is essential for proper treatment as is primary lesion detection. 18 F-FDG-PET has been widely used for the evaluation of gynecologic malignancies such as cervical carcinoma and ovarian cancer. In contrast, FDG PET application to endometrial carcinoma is limited until now and there is no sufficient data to validate the usefulness of FDG PET for this disease yet. However, several studies showed promising results that FDG PET is sensitive and specific in detection of recurrent or metastatic lesions. Therefore further active investigation in this field can facilitate the use of FDG PET for endometrial carcinoma

18F-FDG-PET in the follow-up of thyroid cancer

International Nuclear Information System (INIS)

Lind, P.; Kresnik, E.; Kumnig, G.; Gallowitsch, H.-J.; Igerc, I.; Matschnig, S.; Gomez, I.

2003-01-01

Differentiated thyroid cancer is a rare tumor with an incidence of 4-9/100000/year. For preoperative assessment of thyroid nodules, ultrasonography (US) and US-guided fine needle aspiration biopsy are the methods of choice to detect thyroid cancer. The value of preoperative fluorine-18 fluorodeoxyglucose positron emission tomography ( 18 F-FDG-PET) in differentiating malignant from benign nodules, especially in cases of follicular proliferation, has not yet been evaluated. After thyroidectomy and radioiodine remnant ablation, several methods are used to follow patients with differentiated thyroid cancer, including serum thyroglobulin, ultrasonography of the neck, iodine-131 ( 131 I) whole body scintigraphy (WBS) and scintigraphy with nonspecific tracers such as technetium-99 m ( 99m Tc) Tetrofosmin or Sestamibi. Whereas the specificity of 131 I-WBS is high, sensitivity is low, especially if one takes into account that only two-thirds of recurrences or metastases store iodine. With the introduction of 18 F-FDG in oncology, it is also used for the detection of local recurrences and metastases of differentiated thyroid cancer. Elevated thyroglobulin but negative 131 I-WBS belongs to the 1a indications for 18 F-FDG-PET in oncology according to the German Consensus Conference 2000. The sensitivity for detecting 131 I-negative metastases with 18 F-FDG-PET can be increased by elevated thyroid-stimulating hormone (TSH) after withdrawal of thyroid hormone therapy or after intra-muscular injection of recombinant TSH. Most of the 131 I-negative metastases demonstrate 18 F-FDG uptake, which represents rapid tumor growth and poor differentiation, whereas most of the 131 I-positive metastases are 18 F-FDG negative. The combination of 131 I-WBS and 18 F-FDG-PET leads to an increase in the detection rate to more than 90-95 % in cases of elevated thyroglobulin, because well- and less-differentiated cancer cells may be present in one patient. In rare cases, a recurrent tumor or

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

International Nuclear Information System (INIS)

Sharma, Punit; Singhal, Abhinav; Bal, Chandrasekhar; Malhotra, Arun; Kumar, Rakesh; Kumar, Arvind

2013-01-01

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

18F-FDG PET is superior to 67Ga SPECT in the staging of non-Hodgkin's lymphoma

International Nuclear Information System (INIS)

Yamamoto, Fumiyasu; Tsukamoto, Eriko; Nakada, Kunihiro; Takei, Toshiki; Zhao, Songji; Asaka, Masahiro; Tamaki, Nagara

2004-01-01

Our study aims to compare diagnostic accuracy between 18 F-FDG PET and 67 Ga SPECT in the staging of non-Hodgkin's lymphoma. Twenty-eight patients with non-Hodgkin's lymphoma, underwent 18 F-FDG PET, 67 Ga SPECT and CT for the pretreatment staging of malignant lymphoma between August 1999 and March 2002. 18 F-FDG PET imaging was obtained 60 minutes after the intravenous administration of 185 MBq of 18 F-FDG. 67 Ga SPECT imaging was obtained 2 days after the intravenous administration of 148 MBq of 67 Ga. 18 F-FDG PET and 67 Ga SPECT were performed within one month. Both imagings were performed on the area from the neck to the pelvis. The 18 F-FDG PET and 67 Ga SPECT findings were compared with the CT findings and the clinical course. Sixty-six nodal lesions were clinically confirmed. Of these, 32 were identified by both 18 F-FDG PET and 67 Ga SPECT. The remaining 34 lesions were identified only by 18 F-FDG PET. The mean (±SD) sizes of the nodes were 34.7±32.4 mm for 18 F-FDG-positive and 67 Ga-positive lesions and 15.7±8.3 mm for 18 F-FDG-positive and 67 Ga-negative lesions (p 18 F-FDG PET and 67 Ga SPECT, whereas 6 lesions were identified by only 18 F-FDG PET. Five lesions were not identified by either technique. No 18 F-FDG-negative but 67 Ga-positive nodal or extranodal lesions were observed. The difference in findings between the two studies is related to the difference in the size but not in the histology or site of the lesions. 18 F-FDG PET detected significantly more lesions particularly small lesions than 67 Ga SPECT. Thus, 18 F-FDG PET is considered to be superior to 67 Ga SPECT in the staging of non-Hodgkin's lymphoma. (author)

Value of 18F-FDG PET in Clinical Staging of Non-Small Cell Lung Cancer

Institute of Scientific and Technical Information of China (English)

Suwen Liu; Jinming Yu; Ligang Xing

2005-01-01

OBJECTIVE To evaluate the feasibility of 18F-deoxyglucose positron emission tomography (18F-FDG PET) in the staging of non-small cell lung cancer(NSCLC).METHODS 105 patients with NSCLC had been examined by 18F-FDG PET before radiotherapy. The results of the 18F-FDG PET examination were compared with those of CT:RESULTS The staging was changed in 38 patients because of 18F-FDG PET findings, with PET resulting in upstaging in 31 patients and downstaging in seven patients. Because of distant metastasis detected by PET, 21 patients received palliative treatment. Six of the seven downstaged patients underwent radical surgery, among which the PET findings were concordant with the pathological findings in five patients. Distant metastasis detected by PET elevated the pre-PET stage: at stage 110.0% (2/20), stage Ⅱ 14.3% (3/21 ) and stage Ⅲ 25.0% (16/64), respectively.CONCLUSION 18F-FDG PET, by changing clinical staging in 36.2% (38/105)of NSCLC patients, has an impact on treatment strategy in NSCLC patients.

Targeting personalized medicine in a non-Hodgkin lymphoma patient with {sup 18F}-FDG and {sup 18F}-choline PET/CT

Energy Technology Data Exchange (ETDEWEB)

Ribeiro, Thalles H.; Filho, Raul S.; Castro, Ana Carolina G.; Paulino Junior, Eduardo; Mamede, Marcelo, E-mail: mamede.mm@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil)

2017-02-15

Early diagnosis and staging of non-Hodgkin lymphoma (NHL) is essential for therapeutic strategy decision. Positron emission tomography/computed tomography (PET/CT) with fluorodeoxyglucose (FDG), a glucose analogue, labeled with fluor-18 ({sup 18F}-FDG) has been used to evaluate staging, therapy response and prognosis in NHL patients. However, in some cases, {sup 18F}-FDG has shown false- -positive uptake due to inflammatory reaction after chemo and/or radiation therapy. In this case report, we present a NHL patient evaluated with {sup 18F}-FDG and {sup 18F}-choline PET/CT scan imaging pre- and post-therapy. {sup 18F}-FDG and {sup 18F}-choline PET/CT were performed for the purpose of tumor staging and have shown intense uptake in infiltrative tissue as well as in the lymph node, but with some mismatching in the tumor. Post-treatment {sup 18F}-FDG and {sup 18F}-choline PET/ CT scans revealed no signs of radiotracer uptake, suggesting complete remission of the tumor. {sup 18F}-choline may be a complimentary tool for staging and assessment of therapeutic response in non-Hodgkin lymphoma, while non-{sup 18F}-FDG tracer can be used for targeted therapy and patient management. (author)

Combined 18F-NaF and 18F-FDG PET/CT in the Evaluation of Sarcoma Patients.

Science.gov (United States)

Jackson, Tatianie; Mosci, Camila; von Eyben, Rie; Mittra, Erik; Ganjoo, Kristen; Biswal, Sandip; Gambhir, Sanjiv Sam; Iagaru, Andrei

2015-09-01

The combined administration of F-NaF and F-FDG in a single PET/CT scan has the potential to improve patient convenience and cancer detection. Here we report the use of this approach for patients with sarcomas. This is a retrospective review of 21 patients (12 men, 9 women; age, 19-66 years) with biopsy-proven sarcomas who had separate F-NaF PET/CT, F-FDG PET/CT, and combined F-NaF/F-FDG PET/CT scans for evaluation of malignancy. Two board-certified nuclear medicine physicians and 1 board-certified musculoskeletal radiologist were randomly assigned to review the scans. Results were analyzed for sensitivity and specificity, using linear regression and receiver operating characteristics. A total of 13 patients had metastatic disease on F-NaF PET/CT, F-FDG PET/CT, and combined F-NaF/F-FDG PET/CT. Skeletal disease was more extensive on the F-NaF PET/CT scan than on the F-FDG PET/CT in 3 patients, whereas in 1 patient, F-FDG PET/CT showed skeletal disease and the F-NaF PET/CT was negative. Extraskeletal lesions were detected on both F-FDG and combined F-NaF/F-FDG PET/CT in 20 patients, with 1 discordant finding in the lung. The combined F-NaF/F-FDG PET/CT scan allows for accurate evaluation of sarcoma patients. Further evaluation of this proposed imaging modality is warranted to identify the most suitable clinical scenarios, including initial treatment strategy and evaluation of response to therapy.

Multimodal correlation of dynamic [18F]-AV-1451 perfusion PET and neuronal hypometabolism in [18F]-FDG PET.

Science.gov (United States)

Hammes, Jochen; Leuwer, Isabel; Bischof, Gérard N; Drzezga, Alexander; van Eimeren, Thilo

2017-12-01

Cerebral glucose metabolism measured with [18F]-FDG PET is a well established marker of neuronal dysfunction in neurodegeneration. The tau-protein tracer [18F]-AV-1451 PET is currently under evaluation and shows promising results. Here, we assess the feasibility of early perfusion imaging with AV-1451 as a substite for FDG PET in assessing neuronal injury. Twenty patients with suspected neurodegeneration underwent FDG and early phase AV-1451 PET imaging. Ten one-minute timeframes were acquired after application of 200 MBq AV-1451. FDG images were acquired on a different date according to clinical protocol. Early AV-1451 timeframes were coregistered to individual FDG-scans and spatially normalized. Voxel-wise intermodal correlations were calculated on within-subject level for every possible time window. The window with highest pooled correlation was considered optimal. Z-transformed deviation maps (ZMs) were created from both FDG and early AV-1451 images, comparing against FDG images of healthy controls. Regional patterns and extent of perfusion deficits were highly comparable to metabolic deficits. Best results were observed in a time window from 60 to 360 s (r = 0.86). Correlation strength ranged from r = 0.96 (subcortical gray matter) to 0.83 (frontal lobe) in regional analysis. ZMs of early AV-1451 and FDG images were highly similar. Perfusion imaging with AV-1451 is a valid biomarker for assessment of neuronal dysfunction in neurodegenerative diseases. Radiation exposure and complexity of the diagnostic workup could be reduced significantly by routine acquisition of early AV-1451 images, sparing additional FDG PET.

Multimodal correlation of dynamic [18F]-AV-1451 perfusion PET and neuronal hypometabolism in [18F]-FDG PET

International Nuclear Information System (INIS)

Hammes, Jochen; Leuwer, Isabel; Bischof, Gerard N.; Drzezga, Alexander; Eimeren, Thilo van

2017-01-01

Cerebral glucose metabolism measured with [18F]-FDG PET is a well established marker of neuronal dysfunction in neurodegeneration. The tau-protein tracer [18F]-AV-1451 PET is currently under evaluation and shows promising results. Here, we assess the feasibility of early perfusion imaging with AV-1451 as a substite for FDG PET in assessing neuronal injury. Twenty patients with suspected neurodegeneration underwent FDG and early phase AV-1451 PET imaging. Ten one-minute timeframes were acquired after application of 200 MBq AV-1451. FDG images were acquired on a different date according to clinical protocol. Early AV-1451 timeframes were coregistered to individual FDG-scans and spatially normalized. Voxel-wise intermodal correlations were calculated on within-subject level for every possible time window. The window with highest pooled correlation was considered optimal. Z-transformed deviation maps (ZMs) were created from both FDG and early AV-1451 images, comparing against FDG images of healthy controls. Regional patterns and extent of perfusion deficits were highly comparable to metabolic deficits. Best results were observed in a time window from 60 to 360 s (r = 0.86). Correlation strength ranged from r = 0.96 (subcortical gray matter) to 0.83 (frontal lobe) in regional analysis. ZMs of early AV-1451 and FDG images were highly similar. Perfusion imaging with AV-1451 is a valid biomarker for assessment of neuronal dysfunction in neurodegenerative diseases. Radiation exposure and complexity of the diagnostic workup could be reduced significantly by routine acquisition of early AV-1451 images, sparing additional FDG PET. (orig.)

Initial clinical results of simultaneous {sup 18}F-FDG PET/MRI in comparison to {sup 18}F-FDG PET/CT in patients with head and neck cancer

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Kubiessa, K.; Gawlitza, M.; Kuehn, A.; Fuchs, J.; Kahn, T.; Stumpp, P. [University Hospital of Leipzig, Department of Diagnostic and Interventional Radiology, Leipzig (Germany); Purz, S.; Steinhoff, K.G.; Sabri, O.; Kluge, R. [University Hospital of Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Boehm, A. [University Hospital of Leipzig, ENT Department, Leipzig (Germany)

2014-04-15

The aim of this study was to evaluate the diagnostic capability of simultaneous {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/MRI compared to {sup 18}F-FDG PET/CT as well as their single components in head and neck cancer patients. In a prospective study 17 patients underwent {sup 18}F-FDG PET/CT for staging or follow-up and an additional {sup 18}F-FDG PET/MRI scan with whole-body imaging and dedicated examination of the neck. MRI, CT and PET images as well as PET/MRI and PET/CT examinations were evaluated independently and in a blinded fashion by two reader groups. Results were compared with the reference standard (final diagnosis determined in consensus using all available data including histology and follow-up). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. A total of 23 malignant tumours were found with the reference standard. PET/CT showed a sensitivity of 82.7 %, a specificity of 87.3 %, a PPV of 73.2 % and a NPV of 92.4 %. Corresponding values for PET/MRI were 80.5, 88.2, 75.6 and 92.5 %. No statistically significant difference in diagnostic capability could be found between PET/CT and PET/MRI. Evaluation of the PET part from PET/CT revealed highest sensitivity of 95.7 %, and MRI showed best specificity of 96.4 %. There was a high inter-rater agreement in all modalities (Cohen's kappa 0.61-0.82). PET/MRI of patients with head and neck cancer yielded good diagnostic capability, similar to PET/CT. Further studies on larger cohorts to prove these first results seem justified. (orig.)

Characteristic of {sup 18}F-FDG Excretion According to Use Diuretics in {sup 18}F-FDG of PET/CT

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Jang, Dong Gun; Yang, Seoung Oh; Lee, Sang Ho [Dept. of Nuclear Medicine, Dongnam Institute of Radiological and Medical Sciences Cancer Center, Busan (Korea, Republic of); Bae, Jong Lim [Dept. of Physics, Daegu University, Daegu (Korea, Republic of); Kim, Jeong Koo [Dept. of Radiological Science, Hanseo University, Seosan (Korea, Republic of)

2012-06-15

{sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) causes a significant amount of radioactivity retention in kidneys and urinary tract and degrades image quality and diagnostic performance. Diuretics are used to perform tests and prevent the urinary tract retention of {sup 18}F-FDG. The purpose of the study is to investigate how the diuretics affect images and excretion rates of {sup 18}F-FDG. The study consists of a group using diuretics for patients with no primary tumors or transfer lesions in kidneys according to PET/CT images, a group using physiological saline and the control group injecting only {sup 18}F-FDG and SUVs are measured by configuring interested areas for each group. Also, SUVs are compared and evaluated depending on the lasix injection after basic inspection and injecting {sup 18}F-FDG for quantitative analysis. The study shows that images with decreased background radioactivity and increased urine excretion due to using diuretics. However, an opposite result that there is no change in the amount of radioactivity in urine appears. The study concludes that the diuretics may decrease background radioactivity in the images but may not affect the {sup 18}F-FDG excretion.

神经淋巴瘤病的18F-FDG PET/CT影像特征分析%Analysis of 18F-FDG PET/CT imaging features of neurolymphomatosis

Institute of Scientific and Technical Information of China (English)

方雷; 安建平; 赵辉; 毛军峰; 徐晓红; 李运; 代伟; 廖兰萍

2014-01-01

Objective To evaluate the imaging characteristics and value of 18F-FDG PET/CT in neurolymphomatosis.Methods Eight cases (3 males,5 females,age range: 35-82 years) with neurolymphomatosis confirmed by histopathology were included in this study.The imaging characteristics of the peripheral nerves surrounding the neurolymphoma lesions and contralateral normal tissue on 18F-FDG PET/CT were analyzed,and SUVmax was measured.Paired t test was used for data analysis by SPSS 12.0.Results Eleven lesions with increased 18F-FDG uptake in 8 cases distributed along the plexus,nerve bundle or intervertebral foramen,and shaped like bars,nodules or masses.The lesion SUVmax(6.54±3.23) was significantly higher than that of the contralateral normal peripheral nerves (1.15±0.48; t =9.357,P＜0.001).The neurolymphoma lesions on CT showed no significant density change with reference to the surrounding tissue.Conclusions The most common 18F-FDG PET/CT features of neurolymphomatosis is high 18F-FDG uptake along the neurovascular plexus,bundles or intervertebral foramina with shapes like bars,nodules or masses.18F-FDG PET/CT is a useful tool for the localization and T staging of neurolymphomatosis.%目的 分析神经淋巴瘤病18 F-FDG PET/CT影像特征,并探讨其在评估神经淋巴瘤病中的应用价值.方法 回顾性分析经病理检查证实的8例神经淋巴瘤病患者(男3例,女5例,年龄35～ 82岁)18F-FDG PET/CT影像学资料,比较神经淋巴瘤病受累周围神经与健侧周围神经PET/CT表现的异同,并利用SPSS 12.0软件对两者SUVmax行配对t检验.结果 8例神经淋巴瘤病患者PET/CT共发现病灶11个,PET示病灶均沿神经丛、神经束或椎间孔走行,表现为束条形、根块状或结节状FDG代谢异常增高,SUVmax为6.54±3.23;病灶CT表现为沿神经束或神经根管走行的束条形、根块状或结节状软组织密度影,与周围软组织及邻近脂肪间隙分界不清.健侧对应部位周围神经在18F-FDG PET

Comparison of 18F-FDG PET/CT and PET/MRI in patients with multiple myeloma

OpenAIRE

Sachpekidis, Christos; Hillengass, Jens; Goldschmidt, Hartmut; Mosebach, Jennifer; Pan, Leyun; Schlemmer, Heinz-Peter; Haberkorn, Uwe; Dimitrakopoulou-Strauss, Antonia

2015-01-01

PET/MRI represents a promising hybrid imaging modality with several potential clinical applications. Although PET/MRI seems highly attractive in the diagnostic approach of multiple myeloma (MM), its role has not yet been evaluated. The aims of this prospective study are to evaluate the feasibility of 18F-FDG PET/MRI in detection of MM lesions, and to investigate the reproducibility of bone marrow lesions detection and quantitative data of 18F-FDG uptake between the functional (PET) component ...

The clinical impact of {sup 18}F-FDG PET/CT in extracranial pediatric germ cell tumors

Energy Technology Data Exchange (ETDEWEB)

Hart, Adam; Vali, Reza; Marie, Eman; Shammas, Amer [The Hospital for Sick Children and University of Toronto, Department of Medical Imaging, Nuclear Medicine, Toronto, ON (Canada); Shaikh, Furqan [The Hospital for Sick Children and University of Toronto, Division of Haematology and oncology, Toronto, ON (Canada)

2017-10-15

Extracranial germ cell tumors are an uncommon pediatric malignancy with limited information on the clinical impact of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the literature. The purpose of this study was to evaluate and compare the clinical impact on management of {sup 18}F-FDG PET/CT with diagnostic computed tomography (CT) in pediatric extracranial germ cell tumor. The list of {sup 18}F-FDG PET/CT performed for extracranial germ cell tumor between May 2007 and November 2015 was obtained from the nuclear medicine database. {sup 18}F-FDG PET/CT and concurrent diagnostic CT were obtained and independently reviewed. Additionally, the patients' charts were reviewed for duration of follow-up and biopsy when available. The impact of {sup 18}F-FDG PET/CT compared with diagnostic CT on staging and patient management was demonstrated by chart review, imaging findings and follow-up studies. During the study period, 9 children (5 males and 4 females; age range: 1.6-17 years, mode age: 14 years) had 11 {sup 18}F-FDG PET/CT studies for the evaluation of germ cell tumor. Diagnostic CTs were available for comparison in 8 patients (10 {sup 18}F-FDG PET/CT studies). The average interval between diagnostic CT and PET/CT was 7.2 days (range: 0-37 days). In total, five lesions concerning for active malignancy were identified on diagnostic CT while seven were identified on PET/CT. Overall, {sup 18}F-FDG PET/CT resulted in a change in management in 3 of the 9 patients (33%). {sup 18}F-FDG PET/CT had a significant impact on the management of pediatric germ cell tumors in this retrospective study. Continued multicenter studies are required secondary to the rarity of this tumor to demonstrate the benefit of {sup 18}F-FDG PET/CT in particular clinical scenarios. (orig.)

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

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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.)

Application of 18F-FDG PET/CT combined with HRCT in diagnosing pneumonia type of bronchioloalveolar carcinoma%18F-FDG PET/CT结合HRCT在肺炎型细支气管肺泡癌诊断中的应用

Institute of Scientific and Technical Information of China (English)

彭辽河; 丁久荣; 胡晓燕; 邱大胜; 李杰; 周静; 朱佳

2012-01-01

Objective: To evaluate the application value of 18F-FDG PET/CT combined with HRCT in diagnosing pneumonia type of bronchioloalveolar carcinoma (PTBAC). Materials and Methods: The 18F-FDG PET/CT images of 26 cases with pathologically confirmed PTBAC were studied. Fifteen of the 26 cases were followed up after 0~3 days by HRCT study. The diagnostic accuracy rate of 18F-FDG PET/CT combined with HRCT were analyzed. Results: According to 18F-FDG PET/CT imaging, definite diagnosis of malignant was made in 9 cases, no exclusion of malignancies in 13 cases, and definite diagnosis of pulmonary inflammation in 4 cases. The diagnostic accuracy rate of 18F-FDG PET/CT imaging was 34.6%. The misdiagnosis rate of 18F-FDG PET/CT was higher. Associating 18F-FDG PET/CT with HRCT, 13 of 15 cases were diagnosed as malignant tumors. Pulmonary inflammation was diagnosed firstly in 1 case by PET/CT, and then definite diagnosis of malignancy was confirmed by HRCT. In addition, the other one case of malignant tumor was analyzed as pulmonary inflammation by PET/CT and HRCT. However, 18F—FDG PET/CT displayed metastasis during the delay scanning, which was approved by pathology. Based on 18F-FDG PET/CT and HRCT results, 15 cases were diagnosed correctly. Conclusion: PTBAC displays a variety of characteristics in 18F-FDG PET/CT and HRCT. Combining I8F-FDG PET/CT with HRCT is reasonable and practicable for PTBAC diagnosis, which may be due to the synergistic effect on diagnosing PTBAC and can greatly improve the diagnostic accuracy.%目的:探讨18F-FDG PET/CT结合高分辨率CT(HRCT)在肺炎型细支气管肺泡癌(PTBAC)诊断中的应用价值,以提高诊断准确率.资料与方法:搜集经病理证实26例PTBAC患者的18F-FDG PET/CT及HRCT影像资料,患者均先行18F_FDG PET/CT显像,其中15例根据诊断需要0～3 d内行HRCT检查,分析两者结合对PTBAC的诊断价值.结果:全组26例患者18F-FDG PET/CT显像检查,确切诊断肺癌9例,恶性不除外13�

F-18 FDG PET/CT imaging of primary hepatic neuroendocrine tumor

Directory of Open Access Journals (Sweden)

Katsuya Mitamura

2015-01-01

Full Text Available Primary hepatic neuroendocrine tumors (PHNETs are extremely rare neoplasms. Herein, we report a case of a 70-year-old man with a hepatic mass. The non-contrast computed tomography (CT image showed a low-density mass, and dynamic CT images indicated the enhancement of the mass in the arterial phase and early washout in the late phase. F18- fluorodeoxyglucose (18F-FDG positron emission tomography (PET and fused PET/CT images showed increased uptake in the hepatic mass. Whole-body 18F-FDG PET images showed no abnormal activity except for the liver lesion. Presence of an extrahepatic tumor was also ruled out by performing upper gastrointestinal endoscopy, total colonoscopy, and chest and abdominal CT. A posterior segmentectomy was performed, and histologic examination confirmed a neuroendocrine tumor (grade 1. The patient was followed up for about 2 years after the resection, and no extrahepatic lesions were radiologically found. Therefore, the patient was diagnosed with PHNET. To the best of our knowledge, no previous case of PHNET have been detected by 18F-FDG PET imaging.

18F-FDG PET/contrast enhanced CT in the standard follow-up of patients with lymphoma.

Science.gov (United States)

García Vicente, A M; Talavera Rubio, M P; Dominguez Ferreras, E; Calle Primo, C; Amo-Salas, M; Tello Galán, M J; Jiménez Londoño, G A; Jiménez Aragón, F; Hernández Ruiz, B; Soriano Castrejón, Á

To assess the diagnostic accuracy of 18 F-FDG PET/contrast enhanced computed tomography (ceCT) in the detection of asymptomatic recurrences in patients with lymphoma. Patients with lymphoma and clinical complete remission underwent 18 F-FDG PET/ceCT for standard follow-up. 18 F-FDG PET and ceCT were evaluated blindly by two independent observers, and classified as positive or negative for recurrence. Additionally a combined evaluation of both techniques was performed. The final diagnosis was established by histopathological analysis or a clinical follow-up longer than 6 months. Statistical diagnostic parameters and concordance levels between both diagnostic techniques were calculated. A total of 114 explorations on 90 patients were analyzed. Only 4 patients were diagnosed as asymptomatic recurrence during the follow-up. 18 F-FDG PET/ceCT, 18 F-FDG PET and ceCT showed an association with the final diagnosis (p=0.002 and χ 2 =11.96; p<0.001 and χ 2 =15.60; p=0.001 and χ 2 =11.96, respectively). The concordance between 18 F-FDG PET and ceCT was moderate/high and significant (kappa=0.672; p<0.001). A sensitivity and specificity of 50% and 88% was obtained for the 18 F-FDG PET/ceCT civ, 50% and 93% for the 18 F-FDG PET, and 50% and 91% for the ceCT. The combined use of 18 F-FDG PET/ceCT did not offer any advantage compared to any isolated diagnostic technique in the detection of asymptomatic lymphoma recurrence. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Anesthesia condition for 18F-FDG imaging of lung metastasis tumors using small animal PET

International Nuclear Information System (INIS)

Woo, Sang-Keun; Lee, Tae Sup; Kim, Kyeong Min; Kim, June-Youp; Jung, Jae Ho; Kang, Joo Hyun; Cheon, Gi Jeong; Choi, Chang Woon; Lim, Sang Moo

2008-01-01

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

Assessment of glucose metabolism and cellular proliferation in multiple myeloma: a first report on combined 18F-FDG and 18F-FLT PET/CT imaging.

Science.gov (United States)

Sachpekidis, C; Goldschmidt, H; Kopka, K; Kopp-Schneider, A; Dimitrakopoulou-Strauss, A

2018-04-10

Despite the significant upgrading in recent years of the role of 18 F-FDG PET/CT in multiple myeloma (MM) diagnostics, there is a still unmet need for myeloma-specific radiotracers. 3'-Deoxy-3'-[ 18 F]fluorothymidine ( 18 F-FLT) is the most studied cellular proliferation PET agent, considered a potentially new myeloma functional imaging tracer. The aim of this pilot study was to evaluate 18 F-FLT PET/CT in imaging of MM patients, in the context of its combined use with 18 F-FDG PET/CT. Eight patients, four suffering from symptomatic MM and four suffering from smoldering MM (SMM), were enrolled in the study. All patients underwent 18 F-FDG PET/CT and 18 F-FLT PET/CT imaging by means of static (whole body) and dynamic PET/CT of the lower abdomen and pelvis (dPET/CT) in two consecutive days. The evaluation of PET/CT studies was based on qualitative evaluation, semi-quantitative (SUV) calculation, and quantitative analysis based on two-tissue compartment modeling. 18 F-FDG PET/CT demonstrated focal, 18 F-FDG avid, MM-indicative bone marrow lesions in five patients. In contrary, 18 F-FLT PET/CT showed focal, 18 F-FLT avid, myeloma-indicative lesions in only two patients. In total, 48 18 F-FDG avid, focal, MM-indicative lesions were detected with 18 F-FDG PET/CT, while 17 18 F-FLT avid, focal, MM-indicative lesions were detected with 18 F-FLT PET/CT. The number of myeloma-indicative lesions was significantly higher for 18 F-FDG PET/CT than for 18 F-FLT PET/CT. A common finding was a mismatch of focally increased 18 F-FDG uptake and reduced 18 F-FLT uptake (lower than the surrounding bone marrow). Moreover, 18 F-FLT PET/CT was characterized by high background activity in the bone marrow compartment, further complicating the evaluation of bone marrow lesions. Semi-quantitative evaluation revealed that both SUV mean and SUV max were significantly higher for 18 F-FLT than for 18 F-FDG in both MM lesions and reference tissue. SUV values were higher in MM lesions than in

Prediction of standard-dose brain PET image by using MRI and low-dose brain [{sup 18}F]FDG PET images

Energy Technology Data Exchange (ETDEWEB)

Kang, Jiayin [School of Electronics Engineering, Huaihai Institute of Technology, Lianyungang, Jiangsu 222005, China and IDEA Laboratory, Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599 (United States); Gao, Yaozong [IDEA Laboratory, Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599 and Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599 (United States); Shi, Feng [IDEA Laboratory, Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599 (United States); Lalush, David S. [Joint UNC-NCSU Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina 27695 (United States); Lin, Weili [MRI Laboratory, Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599 (United States); Shen, Dinggang, E-mail: dgshen@med.unc.edu [IDEA Laboratory, Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599 and Department of Brain and Cognitive Engineering, Korea University, Seoul 136-713 (Korea, Republic of)

2015-09-15

Purpose: Positron emission tomography (PET) is a nuclear medical imaging technology that produces 3D images reflecting tissue metabolic activity in human body. PET has been widely used in various clinical applications, such as in diagnosis of brain disorders. High-quality PET images play an essential role in diagnosing brain diseases/disorders. In practice, in order to obtain high-quality PET images, a standard-dose radionuclide (tracer) needs to be used and injected into a living body. As a result, it will inevitably increase the patient’s exposure to radiation. One solution to solve this problem is predicting standard-dose PET images using low-dose PET images. As yet, no previous studies with this approach have been reported. Accordingly, in this paper, the authors propose a regression forest based framework for predicting a standard-dose brain [{sup 18}F]FDG PET image by using a low-dose brain [{sup 18}F]FDG PET image and its corresponding magnetic resonance imaging (MRI) image. Methods: The authors employ a regression forest for predicting the standard-dose brain [{sup 18}F]FDG PET image by low-dose brain [{sup 18}F]FDG PET and MRI images. Specifically, the proposed method consists of two main steps. First, based on the segmented brain tissues (i.e., cerebrospinal fluid, gray matter, and white matter) in the MRI image, the authors extract features for each patch in the brain image from both low-dose PET and MRI images to build tissue-specific models that can be used to initially predict standard-dose brain [{sup 18}F]FDG PET images. Second, an iterative refinement strategy, via estimating the predicted image difference, is used to further improve the prediction accuracy. Results: The authors evaluated their algorithm on a brain dataset, consisting of 11 subjects with MRI, low-dose PET, and standard-dose PET images, using leave-one-out cross-validations. The proposed algorithm gives promising results with well-estimated standard-dose brain [{sup 18}F]FDG PET

Prediction of standard-dose brain PET image by using MRI and low-dose brain ["1"8F]FDG PET images

International Nuclear Information System (INIS)

Kang, Jiayin; Gao, Yaozong; Shi, Feng; Lalush, David S.; Lin, Weili; Shen, Dinggang

2015-01-01

Purpose: Positron emission tomography (PET) is a nuclear medical imaging technology that produces 3D images reflecting tissue metabolic activity in human body. PET has been widely used in various clinical applications, such as in diagnosis of brain disorders. High-quality PET images play an essential role in diagnosing brain diseases/disorders. In practice, in order to obtain high-quality PET images, a standard-dose radionuclide (tracer) needs to be used and injected into a living body. As a result, it will inevitably increase the patient’s exposure to radiation. One solution to solve this problem is predicting standard-dose PET images using low-dose PET images. As yet, no previous studies with this approach have been reported. Accordingly, in this paper, the authors propose a regression forest based framework for predicting a standard-dose brain ["1"8F]FDG PET image by using a low-dose brain ["1"8F]FDG PET image and its corresponding magnetic resonance imaging (MRI) image. Methods: The authors employ a regression forest for predicting the standard-dose brain ["1"8F]FDG PET image by low-dose brain ["1"8F]FDG PET and MRI images. Specifically, the proposed method consists of two main steps. First, based on the segmented brain tissues (i.e., cerebrospinal fluid, gray matter, and white matter) in the MRI image, the authors extract features for each patch in the brain image from both low-dose PET and MRI images to build tissue-specific models that can be used to initially predict standard-dose brain ["1"8F]FDG PET images. Second, an iterative refinement strategy, via estimating the predicted image difference, is used to further improve the prediction accuracy. Results: The authors evaluated their algorithm on a brain dataset, consisting of 11 subjects with MRI, low-dose PET, and standard-dose PET images, using leave-one-out cross-validations. The proposed algorithm gives promising results with well-estimated standard-dose brain ["1"8F]FDG PET image and substantially

Imaging findings and literature review of 18F-FDG PET/CT in primary systemic AL amyloidosis

International Nuclear Information System (INIS)

Lee, Joo Hee; Lee, Ga Yeon; Kim, Seok Jin; Kim, Ki Hyun; Jeon, Eun Seok; Lee, Kyung Han; Kim, Byung Tae; Choi, Joon Young

2015-01-01

Although several case reports and case series have described 18 F-FDG PET/CT in amyloidosis, the value of 18 F-FDG PET/CT for diagnosing amyloidosis has not been clarified. We investigated the imaging findings of 18 F-FDG PET/CT in patients with primary systemic AL amyloidosis. Subjects were 15 patients (M:F = 12:3; age, 61.5 ± 7.4 years) with histologically confirmed primary systemic AL amyloidosis who underwent pretreatment 18 F-FDG PET/CT to rule out the possibility of malignancy or for initial workup of alleged cancer. For involved organs, visual and semiquantitative analyses were performed on 18 F-FDG PET/CT images. In total, 22 organs (10 hearts, 5 kidneys, 2 stomachs, 2 colons, 1 ileum, 1 pancreas, and 1 liver) were histologically confirmed to have primary systemic AL amyloidosis. F-FDG uptake was significantly increased in 15 of the 22 organs (68.2 %; 10 hearts, 2 kidneys, 1 colon, 1 ileum, and 1 liver; SUV max  = 7.0 ± 3.2, range 2.1–14.1). However, in 11 of 15 PET-positive organs (78.6 %; 10 hearts and the ileum), it was difficult to differentiate pathological uptake from physiological uptake. Definitely abnormal 18 F-FDG uptake was found in only 4 of the 22 organs (18.2 %; 2 kidneys, 1 colon, and the liver). 18 F-FDG uptake was negative for pancreas and gastric lesions. Although 18 F-FDG PET/CT showed high uptake in two-thirds of the organs involving primary systemic AL amyloidosis, its sensitivity appeared to be low to make differentiation of pathological uptake from physiological uptake. However, due to the small number of cases, further study for the role of 18 F-FDG PET/CT in amyloidosis will be warranted

Clinical Significance of Focal Breast Lesions Incidentally Identified by 18F-FDG PET/CT

International Nuclear Information System (INIS)

Cho, Young Seok; Choi, Joon Young; Lee, Su Jin; Hyun, Seung Hyup; Lee, Ji Young; Choi, Yong; Choe, Yearn Seong; Lee, Kyung Han; Kim, Byung Tae

2008-01-01

We evaluated the incidence and malignant risk of focal breast lesions incidentally detected by 18 F-FDG PET/CT. Various PET/CT findings of the breast lesions were also analyzed to improve the differentiation between benign from malignant focal breast lesions. The subjects were 3,768 consecutive 18 F-FDG PET/CT exams performed in adult females without a history of breast cancer. A focal breast lesion was defined as a focal 18 F-FDG uptake or a focal nodular lesion on CT image irrespective of 18 F-FDG uptake in the breasts. The maximum SUV and CT pattern of focal breast lesions were evaluated, and were compared with final diagnosis. The incidence of focal breast lesions on PET/CT in adult female subjects was 1.4% (58 lesions in 53 subjects). In finally confirmed 53 lesions of 48 subjects, 11 lesions of 8 subjects (20.8%) were proven to be malignant. When the PET/CT patterns suggesting benignancy (maximum attenuation value > 75 HU or 20) were added as diagnostic criteria of PET/CT to differentiate benign from malignant breast lesions along with maximum SUV, the area under ROC curve of PET/CT was significantly increased compared with maximum SUV alone (0.680±0.093 vs. 0.786±0.076, p 18 F-FDG PET/CT is not low, deserving further diagnostic confirmation. Image interpretation considering both 18 F-FDG uptake and PET/CT pattern may be helpful to improve the differentiation from malignant and benign focal breast lesion

Role of 18F-FDG PET/CT in Posttreatment Evaluation of Anal Carcinoma.

Science.gov (United States)

Houard, Clémence; Pinaquy, Jean-Baptiste; Mesguich, Charles; Henriques de Figueiredo, Bénédicte; Cazeau, Anne-Laure; Allard, Jean-Baptiste; Laharie, Hortense; Bordenave, Laurence; Fernandez, Philippe; Vendrely, Véronique

2017-09-01

The aim of this study was to evaluate the relevance of PET/CT and 18 F-FDG as a strategy for response evaluation after chemoradiotherapy for anal cancer. For this, the performance of posttreatment 18 F-FDG PET/CT, the impact on patient care, and the predictive value of metabolic response were assessed. Methods: This was a retrospective and multicenter analysis of 87 patients treated by chemoradiotherapy for anal squamous cell carcinoma between October 2007 and October 2013. All patients underwent systematic posttreatment 18 F-FDG PET/CT and were followed with at least a clinical examination every 4 mo for 2 y and every 6 mo thereafter. Disease progression was confirmed by biopsy for all patients in the case of local recurrence before surgery. Kaplan-Meier and Cox regression models were used to test for associations between metabolic or clinical endpoints and progression-free survival (PFS) or cause-specific survival (CSS). Results: The median follow-up was 25 mo. 18 F-FDG PET/CT was performed 1-8 mo (median, 4 mo) after completion of chemoradiotherapy. Overall, 25 patients relapsed and 13 died. The posttherapy 18 F-FDG PET/CT did not show any abnormal 18 F-FDG uptake (complete metabolic response [CMR]) in 55 patients whereas 32 displayed incomplete response (non-CMR): 15 patients with partial response and 17 with disease progression. The sensitivity of 18 F-FDG PET/CT to detect residual tumor tissue was 92% (95% confidence interval [CI], 75%-97%), specificity was 85% (95% CI, 75%-92%), positive predictive value was 72% (95% CI, 61%-90%), and negative predictive value was 96.4% (95% CI, 90%-98.7%). The 2-y PFS was 96% (95% CI, 90-100) for patients with CMR and 28% (95% CI, 14-47) for non-CMR patients ( P PET/CT changed patient management in 14 cases (16%), with relevant modifications in 12 (14%). A Cox proportional hazards model of survival outcome indicated that a CMR was the only significant predictor of PFS and CSS ( P PET/CT shows good accuracy in posttreatment

18F-FDG-labeled red blood cell PET for blood-pool imaging: preclinical evaluation in rats.

Science.gov (United States)

Matsusaka, Yohji; Nakahara, Tadaki; Takahashi, Kazuhiro; Iwabuchi, Yu; Nishime, Chiyoko; Kajimura, Mayumi; Jinzaki, Masahiro

2017-12-01

Red blood cells (RBCs) labeled with single-photon emitters have been clinically used for blood-pool imaging. Although some PET tracers have been introduced for blood-pool imaging, they have not yet been widely used. The present study investigated the feasibility of labeling RBCs with 18 F-2-deoxy-2-fluoro-D-glucose ( 18 F-FDG) for blood-pool imaging with PET. RBCs isolated from venous blood of rats were washed with glucose-free phosphate-buffered saline and labeled with 18 F-FDG. To optimize labeling efficiency, the effects of glucose deprivation time and incubation (labeling) time with 18 F-FDG were investigated. Post-labeling stability was assessed by calculating the release fraction of radioactivity and identifying the chemical forms of 18 F in the released and intracellular components of 18 F-FDG-labeled RBCs incubated in plasma. Just after intravenous injection of the optimized autologous 18 F-FDG-labeled RBCs, dynamic PET scans were performed to evaluate in vivo imaging in normal rats and intraabdominal bleeding models (temporary and persistent bleeding). The optimal durations of glucose deprivation and incubation (labeling) with 18 F-FDG were 60 and 30 min, respectively. As low as 10% of 18 F was released as the form of 18 F-FDG from 18 F-FDG-labeled RBCs after a 60-min incubation. Dynamic PET images of normal rats showed strong persistence in the cardiovascular system for at least 120 min. In the intraabdominal bleeding models, 18 F-FDG-labeled RBC PET visualized the extravascular blood clearly and revealed the dynamic changes of the extravascular radioactivity in the temporary and persistent bleeding. RBCs can be effectively labeled with 18 F-FDG and used for blood-pool imaging with PET in rats.

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

International Nuclear Information System (INIS)

Kim, Jin Suk; Lim, Seok Tae; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Sohn, Myung Hee

2009-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2009-08-15

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

Simultaneous Hyperpolarized 13C-Pyruvate MRI and 18F-FDG PET (HyperPET) in 10 Dogs with Cancer

DEFF Research Database (Denmark)

Gutte, Henrik; Hansen, Adam E; Larsen, Majbrit M E

2015-01-01

with biopsy-verified spontaneous malignant tumors were included for imaging. All dogs underwent a protocol of simultaneous (18)F-FDG PET, anatomic MR, and hyperpolarized dynamic nuclear polarization with (13)C-pyruvate imaging. The data were acquired using a combined clinical PET/MR imaging scanner. We found...... that combined (18)F-FDG PET and (13)C-pyruvate MRS imaging was possible in a single session of approximately 2 h. A continuous workflow was obtained with the injection of (18)F-FDG when the dogs was placed in the PET/MR scanner. (13)C-MRS dynamic acquisition demonstrated in an axial slab increased (13)C......With the introduction of combined PET/MR spectroscopic (MRS) imaging, it is now possible to directly and indirectly image the Warburg effect with hyperpolarized (13)C-pyruvate and (18)F-FDG PET imaging, respectively, via a technique we have named hyperPET. The main purpose of this present study...

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

DEFF Research Database (Denmark)

Prakash, Vineet; Vestergård, Karsten; Frost, Majbritt

PURPOSE            Dementia is a challenging clinical diagnosis. Compared with conventional clinical evaluations, F-18 Fluorodeoxyglucose (FDG) PET has been reported to improve not only the diagnostic accuracy of dementia but also help better define the underlying  type. This is because FDG PET d...... or Frontotemporal dementia.                       CLINICAL RELEVANCE/APPLICATION            F18-FDG Brain PET with visual and automated analyses can be valuable  in a diagnostic algorithim for the work up of dementia when the cause is uncertain.......PURPOSE            Dementia is a challenging clinical diagnosis. Compared with conventional clinical evaluations, F-18 Fluorodeoxyglucose (FDG) PET has been reported to improve not only the diagnostic accuracy of dementia but also help better define the underlying  type. This is because FDG PET...... patients had FDG-PET scans with visual and automated analyses. At a multidisciplinary meeting attended by a neuroradiologist and PET specialist, a pre-PET diagnosis, type of dementia and management plan was composed by a neurologist on the basis of clinical assessment, MRI, neuropsychometry...

Defining optimal tracer activities in pediatric oncologic whole-body {sup 18}F-FDG-PET/MRI

Energy Technology Data Exchange (ETDEWEB)

Gatidis, Sergios; Schmidt, Holger; Nikolaou, Konstantin; Schwenzer, Nina F.; Schaefer, Juergen F. [University of Tuebingen, Department of Radiology, Diagnostic and Interventional Radiology, Tuebingen (Germany); La Fougere, Christian [University of Tuebingen, Department of Radiology, Nuclear Medicine, Tuebingen (Germany)

2016-12-15

To explore the feasibility of reducing administered tracer activities and to assess optimal activities for combined {sup 18}F-FDG-PET/MRI in pediatric oncology. 30 {sup 18}F-FDG-PET/MRI examinations were performed on 24 patients with known or suspected solid tumors (10 girls, 14 boys, age 12 ± 5.6 [1-18] years; PET scan duration: 4 min per bed position). Low-activity PET images were retrospectively simulated from the originally acquired data sets using randomized undersampling of list mode data. PET data of different simulated administered activities (0.25-2.5 MBq/kg body weight) were reconstructed with or without point spread function (PSF) modeling. Mean and maximum standardized uptake values (SUV{sub mean} and SUV{sub max}) as well as SUV variation (SUV{sub var}) were measured in physiologic organs and focal FDG-avid lesions. Detectability of organ structures and of focal {sup 18}F-FDG-avid lesions as well as the occurrence of false-positive PET lesions were assessed at different simulated tracer activities. Subjective image quality steadily declined with decreasing tracer activities. Compared to the originally acquired data sets, mean relative deviations of SUV{sub mean} and SUV{sub max} were below 5 % at {sup 18}F-FDG activities of 1.5 MBq/kg or higher. Over 95 % of anatomic structures and all pathologic focal lesions were detectable at 1.5 MBq/kg {sup 18}F-FDG. Detectability of anatomic structures and focal lesions was significantly improved using PSF. No false-positive focal lesions were observed at tracer activities of 1 MBq/kg {sup 18}F-FDG or higher. Administration of {sup 18}F-FDG activities of 1.5 MBq/kg is, thus, feasible without obvious diagnostic shortcomings, which is equivalent to a dose reduction of more than 50 % compared to current recommendations. Significant reduction in administered {sup 18}F-FDG tracer activities is feasible in pediatric oncologic PET/MRI. Appropriate activities of {sup 18}F-FDG or other tracers for specific clinical

F-18 FDG PET scan findings in patients with pulmonary involvement in the hypereosinophilic syndrome

Energy Technology Data Exchange (ETDEWEB)

Lee, Jae Hoon; Kim, Tae Hoon; Yun, Mi Jin [College of Medicine, Yonsei University, Seoul (Korea, Republic of)] (and others)

2005-08-15

Hypereosinophilic syndrome (HES) is an infiltrative disease of eosinophils affecting multiple organs including the lung. F-18 2-fluoro-2-deoxyglucose (F-18 FDG) may accumulate at sites of inflammation or infection, making interpretation of whole body PET scan difficult in patients with cancer. This study was to evaluate the PET findings of HES with lung involvement and to find out differential PET features between lung malignancy and HES with lung involvement. F-18 FDG PET and low dose chest CT scan was performed for screening of lung cancer. Eight patients who showed ground-glass attenuation (GGA) and consolidation on chest CT scan with peripheral blood eosinophilia were included in this study. The patients with history of parasite infection, allergy and collagen vascular disease were excluded. CT features and FDG PET findings were meticulously evaluated for the distribution of GGA and consolidation and nodules on CT scan and mean and maximal SUV of abnormalities depicted on F-18 FDG PET scan. In eight patients, follow-up chest CT scan and FDG PET scan were done one or two weeks after initial study. F-18 FDG PET scan identified metabolically active lesions in seven out of eight patients. Maximal SUV was ranged from 2.8 to 10.6 and mean SUV was ranged from 2.2 to 7.2. Remaining one patient had maximal SUV of 1.3. On follow-up FDG PET scan taken on from one to four weeks later showed decreased degree of initially noted FDG uptakes or migration of previously noted abnormal FDG uptakes. Lung involvement in the HES might be identified as abnormal uptake foci on FDG PET scan mimicking lung cancer. Follow-up FDG PET and CT scan for the identification of migration or resolution of abnormalities and decrement of SUV would be of help for the differentiation between lung cancer and HES with lung involvement.

F-18 FDG PET scan findings in patients with pulmonary involvement in the hypereosinophilic syndrome

International Nuclear Information System (INIS)

Lee, Jae Hoon; Kim, Tae Hoon; Yun, Mi Jin

2005-01-01

Hypereosinophilic syndrome (HES) is an infiltrative disease of eosinophils affecting multiple organs including the lung. F-18 2-fluoro-2-deoxyglucose (F-18 FDG) may accumulate at sites of inflammation or infection, making interpretation of whole body PET scan difficult in patients with cancer. This study was to evaluate the PET findings of HES with lung involvement and to find out differential PET features between lung malignancy and HES with lung involvement. F-18 FDG PET and low dose chest CT scan was performed for screening of lung cancer. Eight patients who showed ground-glass attenuation (GGA) and consolidation on chest CT scan with peripheral blood eosinophilia were included in this study. The patients with history of parasite infection, allergy and collagen vascular disease were excluded. CT features and FDG PET findings were meticulously evaluated for the distribution of GGA and consolidation and nodules on CT scan and mean and maximal SUV of abnormalities depicted on F-18 FDG PET scan. In eight patients, follow-up chest CT scan and FDG PET scan were done one or two weeks after initial study. F-18 FDG PET scan identified metabolically active lesions in seven out of eight patients. Maximal SUV was ranged from 2.8 to 10.6 and mean SUV was ranged from 2.2 to 7.2. Remaining one patient had maximal SUV of 1.3. On follow-up FDG PET scan taken on from one to four weeks later showed decreased degree of initially noted FDG uptakes or migration of previously noted abnormal FDG uptakes. Lung involvement in the HES might be identified as abnormal uptake foci on FDG PET scan mimicking lung cancer. Follow-up FDG PET and CT scan for the identification of migration or resolution of abnormalities and decrement of SUV would be of help for the differentiation between lung cancer and HES with lung involvement

{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

Evaluation of F-18-labeled amino acid derivatives and [18F]FDG as PET probes in a brain tumor-bearing animal model

International Nuclear Information System (INIS)

Wang, H.-E.; Wu, S.-Y.; Chang, C.-W.; Liu, R.-S.; Hwang, L.-C.; Lee, T.-W.; Chen, J.-C.; Hwang, J.-J.

2005-01-01

2-Deoxy-2-[ 18 F]fluoro-D-glucose ([ 18 F]FDG) has been extensively used as positron emission tomography (PET) tracer in clinical tumor imaging. This study compared the pharmacokinetics of two 18 F-labeled amino acid derivatives, O-2-[ 18 F]fluoroethyl-L-tyrosine (L-[ 18 F]FET) and 4-borono-2-[ 18 F]fluoro-L-phenylalanine-fructose (L-[ 18 F]FBPA-Fr), to that of [ 18 F]FDG in an animal brain tumor model. Methods: A self-modified automated PET tracer synthesizer was used to produce no-carrier-added (nca) L-[ 18 F]FET. The cellular uptake, biodistribution, autoradiography and microPET imaging of L-[ 18 F]FET, L-[ 18 F]FBPA-Fr and [ 18 F]FDG were performed with F98 glioma cell culture and F98 glioma-bearing Fischer344 rats. Results: The radiochemical purity of L-[ 18 F]FET was >98% and the radiochemical yield was 50% in average of 16 runs. The uptake of L-[ 18 F]FET and L-[ 18 F]FBPA-Fr in the F98 glioma cells increased rapidly for the first 5 min and reached a steady-state level after 10 min of incubation, whereas the cellular uptake of [ 18 F]FDG kept increasing during the study period. The biodistribution of L-[ 18 F]FET, L-[ 18 F]FBPA-Fr and [ 18 F]FDG in the brain tumors was 1.26±0.22, 0.86±0.08 and 2.77±0.44 %ID/g at 60 min postinjection, respectively, while the tumor-to-normal brain ratios of L-[ 18 F]FET (3.15) and L-[ 18 F]FBPA-Fr (3.44) were higher than that of [ 18 F]FDG (1.44). Both microPET images and autoradiograms of L-[ 18 F]FET and L-[ 18 F]FBPA-Fr exhibited remarkable uptake with high contrast in the brain tumor, whereas [ 18 F]FDG showed high uptake in the normal brain and gave blurred brain tumor images. Conclusion: Both L-[ 18 F]FET and L-[ 18 F]FBPA-Fr are superior to [ 18 F]FDG for the brain tumor imaging as shown in this study with microPET

Assessing the role of {sup 18}F-FDG PET and {sup 18}F-FDG PET/CT in the diagnosis of soft tissue musculoskeletal malignancies: a systematic review and meta-analysis

Energy Technology Data Exchange (ETDEWEB)

Etchebehere, Elba C. [The University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Sirio Libanes Hospital, Department of Nuclear Medicine, Sao Paulo (Brazil); Hobbs, Brian P.; Milton, Denai R. [The University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States); Malawi, Osama [The University of Texas MD Anderson Cancer Center, Department of Imaging Physics, Houston, TX (United States); Patel, Shreyaskumar; Benjamin, Robert S. [The University of Texas MD Anderson Cancer Center, Department of Sarcoma Medical Oncology, Houston, TX (United States); Macapinlac, Homer A. [The University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States)

2016-05-15

Twelve years ago a meta-analysis evaluated the diagnostic performance of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in assessing musculoskeletal soft tissue lesions (MsSTL). Currently, PET/CT has substituted PET imaging; however, there has not been any published meta-analysis on the use of PET/CT or a comparison of PET/CT with PET in the diagnosis of MsSTL. Therefore, we conducted a meta-analysis to identify the current diagnostic performance of {sup 18}F-FDG PET/CT and determine if there is added value when compared to PET. A systematic review of English articles was conducted, and MEDLINE PubMed, the Cochrane Library, and Embase were searched from 1996 to March 2015. Studies exploring the diagnostic accuracy of {sup 18}F-FDG PET/CT (or dedicated PET) compared to histopathology in patients with MsSTL undergoing investigation for malignancy were included. Our meta-analysis included 14 articles composed of 755 patients with 757 soft tissue lesions. There were 451 (60 %) malignant tumors and 306 benign lesions. The {sup 18}F-FDG PET/CT (and dedicated PET) mean sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for diagnosing MsSTL were 0.96 (0.90, 1.00), 0.77 (0.67, 0.86), 0.88 (0.85, 0.91), 0.86 (0.78, 0.94), and 0.91 (0.83, 0.99), respectively. The posterior mean (95 % highest posterior density interval) for the AUC was 0.92 (0.88, 0.96). PET/CT had higher specificity, accuracy, and positive predictive value when compared to a dedicated PET (0.85, 0.89, and 0.91 vs 0.71, 0.85, and 0.82, respectively). {sup 18}F-FDG PET/CT and dedicated PET are both highly accurate in the diagnosis of MsSTL. PET/CT is more accurate and specific and has a higher positive predictive value than PET. (orig.)

18F-FDG PET/CT评价非霍奇金淋巴瘤骨髓浸润%18F-FDG PET for evaluation on bone marrow involvement in patients with non-Hodgkin lymphoma

Institute of Scientific and Technical Information of China (English)

张建华; 王荣福; 范岩; 付占立; 张旭初; 廖栩鹤; 王彦福

2012-01-01

目的 探讨18 F-FDG PET/CT评价非霍奇金淋巴瘤(NHL)骨髓浸润的临床应用价值,并与骨髓活检(BMB)及流式细胞分析(FCM)进行比较.方法 回顾性分析89例经病理证实且未经治疗的NHL患者18 F-FDG PET/CT资料,其中侵袭性NHL76例,惰性NHL13例.所有患者均在18 F-FDG PET/CT检查2周内接受BMB及FCM,对18F-FDG PET/CT显示骨髓局灶性18 F-FDG摄取增高而BMB及FCM阴性患者,根据PET/CT所示骨髓异常部位再次行BMB确定骨髓是否受累.结果 89例NHL患者中,根据BMB、FCM及PET/CT引导下再次BMB结果,共检出骨髓浸润26例,检出率为29.21％(26/89),PET/CT检出率为21.35％(19/89).PET/CT诊断骨髓浸润的灵敏度为73.08％(19/26),特异度为96.83％(61/63),准确率为89.89％(80/89),阳性预测值为90.48％(19/21),阴性预测值为89.71％(61/68).BMB及FCM检出率均为19.10％(17/89),PET/CT较BMB、FCM骨髓浸润检出率稍高,但差异无统计学意义(P＞0.05).将PET/CT、FCM及BMB三种方法联合诊断骨髓浸润,其检出率高于其中任意一种方法(P＜0.05).PET/CT对侵袭性NHL骨髓浸润的检出率22.37％(17/76)高于对惰性NHL骨髓浸润的检出率15.38％(2/13,P＜0.05).结论 18F-FDG PET/CT在诊断NHL骨髓浸润中有较高的应用价值.对局灶性骨髓浸润患者,PET/CT有助于引导BMB部位,提高骨髓浸润的检出率.PET/CT未检出骨髓浸润的惰性NHL患者,应进一步行BMB及FCM检查.推荐PET/CT、FCM及BMB三种方法联合应用判断NHL骨髓浸润,从而更准确地进行分期、治疗及判断预后.%Objective To evaluate the clinical value of "F-FDG PET/CT for detection of bone marrow involvement in non-Hodgkin lymphoma (NHL), and to compare it with bone marrow biopsy (BMB) and flow cytometry (FCM). Methods Eighty-nine patients with pathologically proven NHL including 76 aggressive NHL and 13 indolent NHL underwent 18F-FDG PET/CT imaging. All patients underwent BMB and FCM within 2 weeks of 18F-FDG PET/CT scan

Diagnostic and prognostic value of 18F-FDG PET/CT in recurrent germinal tumor carcinoma

Energy Technology Data Exchange (ETDEWEB)

Alongi, Pierpaolo [IRCSS San Raffaele Scientific Institute, Nuclear Medicine Department, Milan (Italy); San Raffaele G. Giglio Institute, Department of Radiological Sciences, Nuclear Medicine Unit, Cefalu (Italy); Evangelista, Laura [Veneto Institute of Oncology IOV - IRCCS, Nuclear Medicine and Molecular Imaging Unit, Padua (Italy); Caobelli, Federico [Basel University Hospital, Department of Nuclear Medicine, Basel (Switzerland); Spallino, Marianna [University of Milano-Bicocca, Milan (Italy); Gianolli, Luigi; Picchio, Maria [IRCSS San Raffaele Scientific Institute, Nuclear Medicine Department, Milan (Italy); Midiri, Massimo [San Raffaele G. Giglio Institute, Department of Radiological Sciences, Nuclear Medicine Unit, Cefalu (Italy); University of Palermo, Department of Radiology, DIBIMED, Palermo (Italy)

2018-01-15

The aim of this bicentric retrospective study was to assess the diagnostic performance, the prognostic value, the incremental prognostic value and the impact on therapeutic management of {sup 18}F-FDG PET/CT in patients with suspected recurrent germinal cell testicular carcinoma (GCT). From the databases of two centers including 31,500 {sup 18}F-FDG PET/CT oncological studies, 114 patients affected by GCT were evaluated in a retrospective study. All 114 patients underwent {sup 18}F-FDG PET/CT for suspected recurrent disease. Diagnostic performance of visually interpreted {sup 18}F-FDG PET/CT and potential impact on the treatment decision were assessed using histology (17 patients), other diagnostic imaging modalities (i.e., contrast enhanced CT in 89 patients and MRI in 15) and clinical follow-up (114 patients) as reference. Progression-free survival (PFS) and overall survival (OS) rates were computed by means of Kaplan-Meier survival analysis. The progression rate (Hazard Ratio-HR) was determined using univariate Cox regression analysis by considering various clinical variables. Recurrent GCT was confirmed in 47 of 52 patients with pathological {sup 18}F-FDG PET/CT findings, by means of histology in 18 patients and by other diagnostic imaging modalities/follow-up in 29. Sensitivity, specificity, accuracy, positive and negative likelihood ratio (LR+ and LR-, respectively), pre-test Odds-ratio and post-test Odds-ratio of {sup 18}FDG PET/CT were 86.8%, 90.2%, 88.4%, 8.85, 0.14, 0.85, 8.85, respectively.{sup 18}F-FDG PET/CT impacted significantly on therapeutic management in 26/114 (23%) cases (from palliative to curative in 12 patients, from ''wait and watch'' to new chemotherapy in six patients and the ''wait-and-watch'' approach in eight patients with unremarkable findings). At 2 and 5-year follow-up, PFS was significantly longer in patients with a negative than a pathological {sup 18}F-FDG PET/CT scan (98% and 95% vs 48% and

Diagnostic and prognostic value of 18F-FDG PET/CT in recurrent germinal tumor carcinoma.

Science.gov (United States)

Alongi, Pierpaolo; Evangelista, Laura; Caobelli, Federico; Spallino, Marianna; Gianolli, Luigi; Midiri, Massimo; Picchio, Maria

2018-01-01

The aim of this bicentric retrospective study was to assess the diagnostic performance, the prognostic value, the incremental prognostic value and the impact on therapeutic management of 18 F-FDG PET/CT in patients with suspected recurrent germinal cell testicular carcinoma (GCT). From the databases of two centers including 31,500 18 F-FDG PET/CT oncological studies, 114 patients affected by GCT were evaluated in a retrospective study. All 114 patients underwent 18 F-FDG PET/CT for suspected recurrent disease. Diagnostic performance of visually interpreted 18 F-FDG PET/CT and potential impact on the treatment decision were assessed using histology (17 patients), other diagnostic imaging modalities (i.e., contrast enhanced CT in 89 patients and MRI in 15) and clinical follow-up (114 patients) as reference. Progression-free survival (PFS) and overall survival (OS) rates were computed by means of Kaplan-Meier survival analysis. The progression rate (Hazard Ratio-HR) was determined using univariate Cox regression analysis by considering various clinical variables. Recurrent GCT was confirmed in 47 of 52 patients with pathological 18 F-FDG PET/CT findings, by means of histology in 18 patients and by other diagnostic imaging modalities/follow-up in 29. Sensitivity, specificity, accuracy, positive and negative likelihood ratio (LR+ and LR-, respectively), pre-test Odds-ratio and post-test Odds-ratio of 18 FDG PET/CT were 86.8%, 90.2%, 88.4%, 8.85, 0.14, 0.85, 8.85, respectively. 18 F-FDG PET/CT impacted significantly on therapeutic management in 26/114 (23%) cases (from palliative to curative in 12 patients, from "wait and watch" to new chemotherapy in six patients and the "wait-and-watch" approach in eight patients with unremarkable findings). At 2 and 5-year follow-up, PFS was significantly longer in patients with a negative than a pathological 18 F-FDG PET/CT scan (98% and 95% vs 48% and 38%, respectively; p = 0.02). An unremarkable scan was associated also with a

Diagnostic and prognostic value of 18F-FDG PET/CT in recurrent germinal tumor carcinoma

International Nuclear Information System (INIS)

Alongi, Pierpaolo; Evangelista, Laura; Caobelli, Federico; Spallino, Marianna; Gianolli, Luigi; Picchio, Maria; Midiri, Massimo

2018-01-01

The aim of this bicentric retrospective study was to assess the diagnostic performance, the prognostic value, the incremental prognostic value and the impact on therapeutic management of 18 F-FDG PET/CT in patients with suspected recurrent germinal cell testicular carcinoma (GCT). From the databases of two centers including 31,500 18 F-FDG PET/CT oncological studies, 114 patients affected by GCT were evaluated in a retrospective study. All 114 patients underwent 18 F-FDG PET/CT for suspected recurrent disease. Diagnostic performance of visually interpreted 18 F-FDG PET/CT and potential impact on the treatment decision were assessed using histology (17 patients), other diagnostic imaging modalities (i.e., contrast enhanced CT in 89 patients and MRI in 15) and clinical follow-up (114 patients) as reference. Progression-free survival (PFS) and overall survival (OS) rates were computed by means of Kaplan-Meier survival analysis. The progression rate (Hazard Ratio-HR) was determined using univariate Cox regression analysis by considering various clinical variables. Recurrent GCT was confirmed in 47 of 52 patients with pathological 18 F-FDG PET/CT findings, by means of histology in 18 patients and by other diagnostic imaging modalities/follow-up in 29. Sensitivity, specificity, accuracy, positive and negative likelihood ratio (LR+ and LR-, respectively), pre-test Odds-ratio and post-test Odds-ratio of 18 FDG PET/CT were 86.8%, 90.2%, 88.4%, 8.85, 0.14, 0.85, 8.85, respectively. 18 F-FDG PET/CT impacted significantly on therapeutic management in 26/114 (23%) cases (from palliative to curative in 12 patients, from ''wait and watch'' to new chemotherapy in six patients and the ''wait-and-watch'' approach in eight patients with unremarkable findings). At 2 and 5-year follow-up, PFS was significantly longer in patients with a negative than a pathological 18 F-FDG PET/CT scan (98% and 95% vs 48% and 38%, respectively; p = 0.02). An

18F-FDG PET in children with lymphomas

International Nuclear Information System (INIS)

Depas, Gisele; Barsy, Caroline De; Foidart, Jacqueline; Rigo, Pierre; Hustinx, Roland; Jerusalem, Guy; Hoyoux, Claire; Dresse, Marie-Francoise; Fassotte, Marie-France; Paquet, Nancy

2005-01-01

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

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

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

2010-07-15

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

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

International Nuclear Information System (INIS)

Liu Ningbo; Ma Li; Zhou Wei; Pang Qingsong; Hu Man; Shi Fang; Fu Zheng; Li Minghuan; Yang Guoren; Yu Jinming

2010-01-01

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

Thyroid Incidentalomas on 18F-FDG PET/CT: Clinical Significance and Controversies

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William Makis

2017-10-01

Full Text Available Objective: The purpose of the current study is to examine the incidence and clinical significance of unexpected focal uptake of 18F-fluorodeoxyglucose (18F-FDG on positron emission tomography/computed tomography (PET/CT in the thyroid gland of oncology patients, the maximum standardized uptake value (SUVmax of benign and malignant thyroid incidentalomas in these patients, and review the literature. Methods: Seven thousand two hundred fifty-two 18F-FDG PET/CT studies performed over four years, were retrospectively reviewed. Studies with incidental focal 18F-FDG uptake in the thyroid gland were further analyzed. Results: Incidental focal thyroid 18F-FDG uptake was identified in 157 of 7252 patients (2.2%. Sufficient follow-up data (≥12 months were available in 128 patients, of whom 57 (45% had a biopsy performed and 71 had clinical follow-up. Malignancy was diagnosed in 14 of 128 patients (10.9%. There was a statistically significant difference between the median SUVmax of benign thyroid incidentalomas (SUVmax 4.8 vs malignant (SUVmax 6.3, but the wide range of overlap between the two groups yielded no clinically useful SUVmax threshold value to determine malignancy. Conclusion: 18F-FDG positive focal thyroid incidentalomas occurred in 2.2% of oncologic PET/CT scans, and were malignant in 10.9% of 128 patients. This is the lowest reported malignancy rate in a North American study to date, and significantly lower than the average malignancy rate (35% reported in the literature. Invasive biopsy of all 18F-FDG positive thyroid incidentalomas, as recommended by some studies, is unwarranted and further research to determine optimal management is needed. There was no clinically useful SUVmax cut-off value to determine malignancy and PET/CT may not be a useful imaging modality to follow these patients conservatively.

18F-FDG PET/CT in detection of gynecomastia in patients with hepatocellular carcinoma.

Science.gov (United States)

Wang, Hsin-Yi; Jeng, Long-Bin; Lin, Ming-Chia; Chao, Chih-Hao; Lin, Wan-Yu; Kao, Chia-Hung

2013-01-01

We retrospectively investigate the prevalence of gynecomastia as false-positive 2-[18F]fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) imaging in patients with hepatocellular carcinoma (HCC). Among the 127 male HCC patients who underwent 18F-FDG PET/CT scan, the 18FDG uptakes at the bilateral breasts in 9 patients with gynecomastia were recorded as standard uptake value (SUVmax) and the visual interpretation in both early and delayed images. The mean early SUVmax was 1.58/1.57 (right/left breast) in nine gynecomastia patients. The three patients with early visual score of 3 had higher early SUVmaxs. Gynecomastia is a possible cause of false-positive uptake on 18F-FDG PET/CT images. Copyright © 2013 Elsevier Inc. All rights reserved.

Preoperative evaluation of cytologically indeterminate thyroid nodules with {sup 18}F-FDG PET; Avaliacao pre-operatoria com PET-{sup 18}F-FDG de nodulos de tireoide com citologia indeterminada

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Sebastianes, Fernando M.; Zanoni, Patricia H.; Tomimori, Eduardo K.; Camargo, Rosalinda Y. A. de; Pereira, Maria Adelaide A. [Universidade de Sao Paulo (HCFMUSP), SP (Brazil). Faculdade de Medicina. Hospital das Clinicas. Div. de Endocrinologia]. E-mail: fernandosebastianes@gmail.com; Cerci, Juliano J.; Soares Junior, Jose; Meneghetti, Jose Claudio [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Div. de Medicina Nuclear

2008-10-15

The aim of this article is to discuss the role of {sup 18}F-FDG Positron Emission Tomography (PET) in the preoperative evaluation of patients with cytologically indeterminate thyroid nodules. All studies with patients with thyroid cancer were selected to the calculation of sensitivity. Only studies aiming to evaluate patients with thyroid nodules whose cytological result was indeterminate were selected to establish the specificity. The finding of focal {sup 18}F-FDG uptake at PET was associated with the presence of thyroid malignancy in most of the studies. The sensitivity of the exam to the detection of thyroid malignancy was extremely high, but the specificity varied from 0 to 66%. In our experience, the specificity was 39%. In conclusion, the studies suggest that {sup 18}F-FDG PET can reduce the number of unnecessary thyroidectomies performed in patients with cytologically indeterminate thyroid nodules. However, the relatively high percentage of false positive results, the high costs, the low availability of this exam in developing countries and the low clinical experience still restrict the use of {sup 18}F-FDG PET when recommended with this aim. (author)

F-18 FDG PET/CT Findings of Subcutaneous Panniculitis - Like T- Cell Lymphoma : A Case Report

International Nuclear Information System (INIS)

Kong, Eun Jung; Cho, Ihn Ho; Chun, Kyung Ah; Bae, Yeung Kyung; Choi, Joon Hyuk; Hyun, Myung Soo

2009-01-01

F-18 FDG PET is a metabolic imaging modality that is efficacious in staging and assessment of treatment response for variety of lymphomas. We report usefulness of F-18 FDG PET/CT in evaluating severity of the disease and response to therapy in a patient with subcutaneous panniculitis- like T-cell lymphoma (SPTCL). Here we describe a case of SPTCL in 24-year-old man who had wide spread firm and tender nodular lesions with increased F-18 FDG uptake. After chemotherapy follow up F-18 FDG PET/CT image shows disseminated malignancy and then the patient died with hemophagocytic syndrome. This report suggests that F-18 FDG PET/CT may be useful in determining disease activity at the time of initial diagnosis, after treatment, and evaluating a suspected outcome of SPTCL

[{sup 18}F] FDG PET in gastric non-Hodgkin`s lymphoma

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Rodriguez, M. [Dept. of Diagnostic Radiology, Uppsala Univ., Akademiska Sjukhuset (Sweden); Ahlstroem, H. [Dept. of Diagnostic Radiology, Uppsala Univ., Akademiska Sjukhuset (Sweden)]|[PET Centre, Uppsala Univ., Akademiska Sjukhuset (Denmark); Sundin, A. [PET Centre, Uppsala Univ., Akademiska Sjukhuset (Denmark); Rehn, S.; Hagberg, H.; Glimelius, B. [Dept. of Oncology, Uppsala Univ., Akademiska Sjukhuset (Sweden); Sundstroem, C. [Dept. of Pathology, Uppsala Univ., Akademiska Sjukhuset (Sweden)

1997-12-31

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

Evaluation of head and neck cancer with 18F-FDG PET: a comparison with conventional methods

International Nuclear Information System (INIS)

Kresnik, E.; Mikosch, P.; Gallowitsch, H.J.; Heinisch, M.; Unterweger, O.; Kumnig, G.; Gomez, I.; Lind, P.; Kogler, D.; Wieser, S.; Gruenbacher, G.; Raunik, W.

2001-01-01

The aim of this study was to evaluate the usefulness of 18 F-FDG PET in the diagnosis and staging of primary and recurrent malignant head and neck tumours in comparison with conventional imaging methods [including ultrasonography, radiography, computed tomography (CT) and magnetic resonance imaging (MRI)], physical examination, panendoscopy and biopsies in clinical routine. A total of 54 patients (13 female, 41 male, age 61.3±12 years) were investigated retrospectively. Three groups were formed. In group I, 18 F-FDG PET was performed in 15 patients to detect unknown primary cancers. In group II, 24 studies were obtained for preoperative staging of proven head and neck cancer. In group III, 18 F-FDG PET was used in 15 patients to monitor tumour recurrence after radiotherapy and/or chemotherapy. In all patients, imaging was obtained at 70 min after the intravenous administration of 180 MBq 18 F-FDG. In 11 of the 15 patients in group I, the primary cancer could be found with 18 F-FDG, yielding a detection rate of 73.3%. In 4 of the 15 patients, CT findings were also suggestive of the primary cancer but were nonetheless equivocal. In these patients, 18 F-FDG showed increased 18 F-FDG uptake by the primary tumour, which was confirmed by histology. One patient had recurrence of breast carcinoma that could not be detected with 18 F-FDG PET, but was detected by CT. In three cases, the primary cancer could not be found with any imaging method. Among the 24 patients in group II investigated for staging purposes, 18 F-FDG PET detected a total of 13 local and three distant lymph node metastases, whereas the conventional imaging methods detected only nine local and one distant lymph node metastases. The results of 18 F-FDG PET led to an upstaging in 5/24 (20.8%) patients. The conventional imaging methods were false positive in 5/24 (20.8%). There was one false positive result using 18 F-FDG PET. Among the 15 patients of group III with suspected recurrence after radiotherapy

18F-FDG PET/CT in solitary plasmacytoma: metabolic behavior and progression to multiple myeloma

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Albano, Domenico; Bosio, Giovanni [Spedali Civili di Brescia, Nuclear Medicine, Brescia (Italy); Treglia, Giorgio [Oncology Institute of Southern Switzerland, Department of Nuclear Medicine and PET/CT Center, Bellinzona (Switzerland); Giubbini, Raffaele; Bertagna, Francesco [University of Brescia and Spedali Civili Brescia, Nuclear Medicine, Brescia (Italy)

2018-01-15

Solitary plasmacytoma (SP) is a rare plasma-cell neoplasm, which can develop both in skeletal and/or soft tissue and frequently progresses to multiple myeloma (MM). Our aim was to study the metabolic behavior of SP and the role of 18F-FDG-PET/CT in predicting progression to MM. Sixty-two patients with SP who underwent 18F-FDG-PET/CT before any treatment were included. PET images were qualitatively and semiquantitatively analyzed by measuring the maximum standardized uptake value body weight (SUVbw), lean body mass (SUVlbm), body surface area (SUVbsa), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and compared with age, sex, site of primary disease, and tumor size. Fifty-one patients had positive 18F-FDG-PET/CT (average SUVbw was 8.3 ± 4.7; SUVlbm 5.8 ± 2.6; SUVbsa 2 ± 1; MTV 45.4 ± 37; TLG 227 ± 114); the remaining 11 were not 18F-FDG-avid. Tumor size was significantly higher in patients avid lesions compared to FDG not avid; no other features are associated with FDG-avidity. Progression to MM occurred in 29 patients with an average of 18.3 months; MM was more likely to develop in patients with bone plasmacytoma and in patients with 18F-FDG avid lesion. Time to transformation in MM (TTMM) was significantly shorter in patients with osseous SP, in 18F-FDG avid lesion, for SUVlbm > 5.2 and SUVbsa > 1.7. 18F-FDG pathological uptake in SP occurred in most cases, being independently associated with tumor size. PET/CT seemed to be correlated to a higher risk of transformation in MM, in particular for 18F-FDG avid plasmacytoma and SBP. Among semiquantitative features, SUVlbm > 5.2 and SUVbsa > 1.7 were significantly correlated with TTMM. (orig.)

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

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

2008-01-15

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

18F-FDG PET/CT in tuberculosis: an early non-invasive marker of therapeutic response

International Nuclear Information System (INIS)

Martinez, V.; Grenier, G.; Fior, R.; Boue, F.; Castilla-Lievre, M.A.; Guillet-Caruba, C.; Desarnaud, S.

2012-01-01

To evaluate the potential of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) for early therapeutic intervention in patients with probable or confirmed tuberculosis (TB). Twenty-one consecutive human immunodeficiency virus negative patients were prospectively included. All patients underwent 18 F-FDG PET/CT before and after 1 month of anti-tuberculosis treatment. The maximum standardised uptake value (SUV max ) of the most 18 F-FDG avid lesions was recorded. The median age of patients was 36 years (range 18-84); 33.3% were male, 80.9% were born in endemic countries, and 23.8% had a past history of TB. TB was confirmed on culture in 8, on histology in 9 and on the basis of clinical symptoms in 4 patients. 18 F-FDG PET/CT detected active pulmonary TB (n = 1), extrapulmonary (n = 10) or both (n = 10). The second 18 F-FDG PET/CT showed reduced radiotracer uptake intensity in 19 of 21 patients, with a median percentage decrease of SUV max of 31% (range 2-84). Two patients showed no improvement. TB was ruled out in one patient during follow-up; the final diagnosis was a non-Hodgkin's lymphoma. The other patient was smear-positive for 3 months. 18 F-FDG PET/CT allows an easy evaluation of early therapeutic response in patients with TB, particularly extra-pulmonary TB. (authors)

Imaging findings and literature review of {sup 18}F-FDG PET/CT in primary systemic AL amyloidosis

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Lee, Joo Hee; Lee, Ga Yeon; Kim, Seok Jin; Kim, Ki Hyun; Jeon, Eun Seok; Lee, Kyung Han; Kim, Byung Tae; Choi, Joon Young [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2015-09-15

Although several case reports and case series have described {sup 18}F-FDG PET/CT in amyloidosis, the value of {sup 18}F-FDG PET/CT for diagnosing amyloidosis has not been clarified. We investigated the imaging findings of {sup 18}F-FDG PET/CT in patients with primary systemic AL amyloidosis. Subjects were 15 patients (M:F = 12:3; age, 61.5 ± 7.4 years) with histologically confirmed primary systemic AL amyloidosis who underwent pretreatment {sup 18}F-FDG PET/CT to rule out the possibility of malignancy or for initial workup of alleged cancer. For involved organs, visual and semiquantitative analyses were performed on {sup 18}F-FDG PET/CT images. In total, 22 organs (10 hearts, 5 kidneys, 2 stomachs, 2 colons, 1 ileum, 1 pancreas, and 1 liver) were histologically confirmed to have primary systemic AL amyloidosis. F-FDG uptake was significantly increased in 15 of the 22 organs (68.2 %; 10 hearts, 2 kidneys, 1 colon, 1 ileum, and 1 liver; SUV{sub max} = 7.0 ± 3.2, range 2.1–14.1). However, in 11 of 15 PET-positive organs (78.6 %; 10 hearts and the ileum), it was difficult to differentiate pathological uptake from physiological uptake. Definitely abnormal {sup 18}F-FDG uptake was found in only 4 of the 22 organs (18.2 %; 2 kidneys, 1 colon, and the liver). {sup 18}F-FDG uptake was negative for pancreas and gastric lesions. Although {sup 18}F-FDG PET/CT showed high uptake in two-thirds of the organs involving primary systemic AL amyloidosis, its sensitivity appeared to be low to make differentiation of pathological uptake from physiological uptake. However, due to the small number of cases, further study for the role of {sup 18}F-FDG PET/CT in amyloidosis will be warranted.

18F FDG PET/CT in differential diagnosis of Parkinsonian disorders

International Nuclear Information System (INIS)

Deepa; Moon, S.; Mahajan, S.; Thapa, P.; Gupta, P.; Sahana; Tripathi, M.; Sharma, R.; Mondal, A.; Batla, A.; Nehru, R.; Kushwaha, S.; Mishra, A.K.

2010-01-01

Full text: Differential diagnosis of Parkinsonian disorders can be challenging in the early phase of disease course. Positron Emission Tomography (PET) imaging with 18 F Fluorodeoxyglucose (FDG) has been used to identify characteristic patterns of glucose metabolism in patients with idiopathic Parkinson's Disease (PD) as well as variant forms of Parkinsonism such as Multisystem Atrophy (MSA), Progressive Supranuclear Palsy (PSP) and cortico basal ganglionic degeneration (CBGD). In this study we assessed the utility of 18 F FDG PET/CT in the differential diagnosis Parkinsonian syndromes. 66 Parkinsonian patients with a mean age of 59.6 ± 11.50 years, male: female ratio of 3.12:1, age range of 35-84 years with a disease duration of 2.6 ± .68 years were referred for FDG PET to determine whether their scan patterns could distinguish idiopathic Parkinsons from the Parkinson plus syndromes. Approximately 60 minutes following intravenous injection of 370 MBq of 18 F-FDG, PET/CT scan of the brain was acquired in a whole-body Full Ring PET/CT scanner (Discovery STE16 camera). A low dose CT was obtained on the same area without IV contrast for attenuation correction and coregistration. Images were reconstructed using a 3D VUE algorithm and slices were reformatted into transaxial, coronal and sagittal views. Subsequently the images were processed and visually analyzed on Xeleris workstation. Images were classified by visual analysis into the various subgroups, those with normal to increased basal ganglia uptake were classified into Idiopathic Parkinson's (40/45) and when basal ganglia uptake was decreased they were Parkinsons Plus (19/21). The study demonstrates that 18 F FDG PET performed at the time of initial referral for parkinsonism could accurately classify patients into Parkinson's disease and Parkinson plus subtypes

Defining optimal tracer activities in pediatric oncologic whole-body "1"8F-FDG-PET/MRI

International Nuclear Information System (INIS)

Gatidis, Sergios; Schmidt, Holger; Nikolaou, Konstantin; Schwenzer, Nina F.; Schaefer, Juergen F.; La Fougere, Christian

2016-01-01

To explore the feasibility of reducing administered tracer activities and to assess optimal activities for combined "1"8F-FDG-PET/MRI in pediatric oncology. 30 "1"8F-FDG-PET/MRI examinations were performed on 24 patients with known or suspected solid tumors (10 girls, 14 boys, age 12 ± 5.6 [1-18] years; PET scan duration: 4 min per bed position). Low-activity PET images were retrospectively simulated from the originally acquired data sets using randomized undersampling of list mode data. PET data of different simulated administered activities (0.25-2.5 MBq/kg body weight) were reconstructed with or without point spread function (PSF) modeling. Mean and maximum standardized uptake values (SUV_m_e_a_n and SUV_m_a_x) as well as SUV variation (SUV_v_a_r) were measured in physiologic organs and focal FDG-avid lesions. Detectability of organ structures and of focal "1"8F-FDG-avid lesions as well as the occurrence of false-positive PET lesions were assessed at different simulated tracer activities. Subjective image quality steadily declined with decreasing tracer activities. Compared to the originally acquired data sets, mean relative deviations of SUV_m_e_a_n and SUV_m_a_x were below 5 % at "1"8F-FDG activities of 1.5 MBq/kg or higher. Over 95 % of anatomic structures and all pathologic focal lesions were detectable at 1.5 MBq/kg "1"8F-FDG. Detectability of anatomic structures and focal lesions was significantly improved using PSF. No false-positive focal lesions were observed at tracer activities of 1 MBq/kg "1"8F-FDG or higher. Administration of "1"8F-FDG activities of 1.5 MBq/kg is, thus, feasible without obvious diagnostic shortcomings, which is equivalent to a dose reduction of more than 50 % compared to current recommendations. Significant reduction in administered "1"8F-FDG tracer activities is feasible in pediatric oncologic PET/MRI. Appropriate activities of "1"8F-FDG or other tracers for specific clinical questions have to be further established in selected

Pilot Study for the Prediction of Response to Radiotherapy Using [18F]Fluorothymidine PET in Nasopharyngeal Cancer: Comparison with [18F]FDG PET

International Nuclear Information System (INIS)

Baek, So Ra; Chae, Sun Young; Kim, Hye Ok; Lee, Sang Wook; Oh, Seung Jun; Im, Ki Chun; Moon, Dae Hyuk; Kim, Jae Seung; Ryu, Jin Sook

2009-01-01

This study was performed to know whether [ 18 F]Fluorothymidine (FLT) positron emission tomography (PET) can be used to monitor early response to radiotherapy in comparison with [ 18 F]Fluorodeoxyglucose (FDG) PET, and to establish the optimal imaging time for prediction of therapy response. Two patients with nasopharyngeal cancer underwent serial FLT PET and FDG PET before and during radiotherapy. Three on-treatment FLT and FDG PET scans were performed on 1 week, 2 weeks and 3 weeks (at each time of 10 Gy, 20 Gy and 30 Gy delivered). The peak standardized uptake values (SUV peak ) of primary tumors were measured on FLT and FDG PET. Then, percent changes of SUV peak after therapy were calculated. In two patients, baseline values of SUV peak on FDT PET were higher than those on FLT PET (FLT vs FDG; 3.7 vs 5.0, and 5.7 vs 15.0). In patient 1, FLT SUV peak showed 78%, 78% and 84% of decrease on 1 week, 2 and 3 weeks after treatment, whereas FDG SUV peak showed 18%, 52% and 66% of decrease, respectively. In patient 2, FLT SUV peak showed 75%, 75% and 68% of decrease, whereas FDG SUV peak showed 51%, 49% and 58% of decrease, respectively. Both patients reached to complete remission after radiotherapy. After radiotherapy, the decrease of FLT tumor uptake preceded the decrease of FDG tumor uptake in patients with nasopharyngeal cancer, and 1 week after therapy may be appropriate time for the assessment of early response. FLT PET might be more useful than FDG PET for monitoring early response to radiotherapy

Prospective study of serial 18F-FDG PET and 18F-fluoride (18F-NaF) PET to predict time to skeletal related events, time-to-progression, and survival in patients with bone-dominant metastatic breast cancer.

Science.gov (United States)

Peterson, Lanell M; O'Sullivan, Janet; Wu, Qian Vicky; Novakova-Jiresova, Alena; Jenkins, Isaac; Lee, Jean H; Shields, Andrew; Montgomery, Susan; Linden, Hannah M; Gralow, Julie R; Gadi, Vijayakrishna K; Muzi, Mark; Kinahan, Paul E; Mankoff, David A; Specht, Jennifer M

2018-05-10

Assessing therapy response of breast cancer bone metastases is challenging. In retrospective studies, serial 18 F-FDG PET was predictive of time to skeletal related events (tSRE) and time-to-progression (TTP). 18 F-NaF PET improves bone metastasis detection compared to bone scans. We prospectively tested 18 F-FDG PET and 18 F-NaF PET to predict tSRE, TTP, and overall survival (OS) in patients with bone-dominant metastatic breast cancer (BD MBC). Methods: Patients with BD MBC were imaged with 18 F-FDG PET and 18 F-NaF PET prior to starting new therapy (scan1) and again at a range of times centered around approximately 4 months later (scan2). SUV max and SULpeak were recorded for a single index lesion and up to 5 most dominant lesions for each scan. tSRE, TTP, and OS were assessed exclusive of the PET images. Univariate Cox regression was performed to test the association between clinical endpoints and 18 F-FDG PET and 18 F-NaF PET measures. mPERCIST (Modified PET Response Criteria in Solid Tumors) criteria were also applied. Survival curves for mPERCIST compared response categories of Complete Response+Partial Response+Stable Disease versus Progressive Disease (CR+PR+SD vs PD) for tSRE, TTP, and OS. Results: Twenty-eight patients were evaluated. Higher FDG SULpeak at scan2 predicted shorter time to tSRE ( P = PET mPERCIST, tSRE and TTP were longer in responders (CR, PR, or stable) compared to non-responders (PD) ( P = 0.007, 0.028 respectively), with a trend toward improved survival ( P = 0.1). An increase in the uptake between scans of up to 5 lesions by 18 F-NaF PET was associated with longer OS ( P = 0.027). Conclusion: Changes in 18 F-FDG PET parameters during therapy are predictive of tSRE and TTP, but not OS. mPERCIST evaluation in bone lesions may be useful in assessing response to therapy and is worthy of evaluation in multicenter, prospective trials. Serial 18 F-NaF PET was associated with OS, but was not useful for predicting TTP or tSRE in BD MBC

Multimodal correlation of dynamic [{sup 18}F]-AV-1451 perfusion PET and neuronal hypometabolism in [{sup 18}F]-FDG PET

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Hammes, Jochen; Leuwer, Isabel [University Hospital Cologne, Multimodal Neuroimaging Group, Department of Nuclear Medicine, Cologne (Germany); Bischof, Gerard N. [University Hospital Cologne, Multimodal Neuroimaging Group, Department of Nuclear Medicine, Cologne (Germany); INM-3, Research Center Juelich, Juelich (Germany); Drzezga, Alexander [University Hospital Cologne, Multimodal Neuroimaging Group, Department of Nuclear Medicine, Cologne (Germany); German Center for Neurodegeneration (DZNE), Berlin (Germany); Eimeren, Thilo van [University Hospital Cologne, Multimodal Neuroimaging Group, Department of Nuclear Medicine, Cologne (Germany); INM-3, Research Center Juelich, Juelich (Germany); German Center for Neurodegeneration (DZNE), Berlin (Germany)

2017-12-15

Cerebral glucose metabolism measured with [18F]-FDG PET is a well established marker of neuronal dysfunction in neurodegeneration. The tau-protein tracer [18F]-AV-1451 PET is currently under evaluation and shows promising results. Here, we assess the feasibility of early perfusion imaging with AV-1451 as a substite for FDG PET in assessing neuronal injury. Twenty patients with suspected neurodegeneration underwent FDG and early phase AV-1451 PET imaging. Ten one-minute timeframes were acquired after application of 200 MBq AV-1451. FDG images were acquired on a different date according to clinical protocol. Early AV-1451 timeframes were coregistered to individual FDG-scans and spatially normalized. Voxel-wise intermodal correlations were calculated on within-subject level for every possible time window. The window with highest pooled correlation was considered optimal. Z-transformed deviation maps (ZMs) were created from both FDG and early AV-1451 images, comparing against FDG images of healthy controls. Regional patterns and extent of perfusion deficits were highly comparable to metabolic deficits. Best results were observed in a time window from 60 to 360 s (r = 0.86). Correlation strength ranged from r = 0.96 (subcortical gray matter) to 0.83 (frontal lobe) in regional analysis. ZMs of early AV-1451 and FDG images were highly similar. Perfusion imaging with AV-1451 is a valid biomarker for assessment of neuronal dysfunction in neurodegenerative diseases. Radiation exposure and complexity of the diagnostic workup could be reduced significantly by routine acquisition of early AV-1451 images, sparing additional FDG PET. (orig.)

Longitudinal imaging of Alzheimer pathology using [11C]PIB, [18F]FDDNP and [18F]FDG PET

International Nuclear Information System (INIS)

Ossenkoppele, Rik; Tolboom, Nelleke; Adriaanse, Sofie F.; Foster-Dingley, Jessica C.; Boellaard, Ronald; Yaqub, Maqsood; Windhorst, Albert D.; Lammertsma, Adriaan A.; Berckel, Bart N.M. van; Barkhof, Frederik; Scheltens, Philip; Flier, Wiesje M. van der

2012-01-01

[ 11 C]PIB and [ 18 F]FDDNP are PET tracers for in vivo detection of the neuropathology underlying Alzheimer's disease (AD). [ 18 F]FDG is a glucose analogue and its uptake reflects metabolic activity. The purpose of this study was to examine longitudinal changes in these tracers in patients with AD or mild cognitive impairment (MCI) and in healthy controls. Longitudinal, paired, dynamic [ 11 C]PIB and [ 18 F]FDDNP (90 min each) and static [ 18 F]FDG (15 min) PET scans were obtained in 11 controls, 12 MCI patients and 8 AD patients. The mean interval between baseline and follow-up was 2.5 years (range 2.0-4.0 years). Parametric [ 11 C]PIB and [ 18 F]FDDNP images of binding potential (BP ND ) and [ 18 F]FDG standardized uptake value ratio (SUVr) images were generated. A significant increase in global cortical [ 11 C]PIB BP ND was found in MCI patients, but no changes were observed in AD patients or controls. Subsequent regional analysis revealed that this increase in [ 11 C]PIB BP ND in MCI patients was most prominent in the lateral temporal lobe (p 18 F]FDDNP, no changes in global BP ND were found. [ 18 F]FDG uptake was reduced at follow-up in the AD group only, especially in frontal, parietal and lateral temporal lobes (all p 11 C]PIB binding (ρ = -0.42, p 18 F]FDG uptake (ρ = 0.54, p 18 F]FDDNP binding (ρ = -0.18, p = 0.35) were not. [ 11 C]PIB and [ 18 F]FDG track molecular changes in different stages of AD. We found increased amyloid load in MCI patients and progressive metabolic impairment in AD patients. [ 18 F]FDDNP seems to be less useful for examining disease progression. (orig.)

Esophageal Leiomyoma with intense FDG uptake on {sup 18}F-FDG PET/CT

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Lee, Seok Mo; Bae, Sang Kyun [Inje university Medical School, Busan (Korea, Republic of)

2008-10-15

A 56 years old woman referred to our hospital with dysphagia and epigastric soreness. Gastroendoscopy revealed huge submucosal tumor with ulceration extending from distal esophagus to lesser curvature of stomach. Subsequent computed tomography (CT) demonstrated soft tissue mass encircling distal esophagus, and 18F-FDG PET/CT demonstrated intense {sup 18}F-FDG accumulation in it. Finally this case was diagnosed as esophageal leiomyoma based on pathologic evaluation of the surgical specimen.

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

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

2008-12-15

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

Utility of F-18 FDG PET/CT on the evaluation of primary bone lymphoma.

Science.gov (United States)

Wang, Li-Juan; Wu, Hu-Bing; Wang, Meng; Han, Yan-Jiang; Li, Hong-Sheng; Zhou, Wen-Lan; Wang, Quan-Shi

2015-11-01

Primary bone lymphoma (PBL) is a rare type of malignant lymphoma. Few data have been reported regarding the utility of F-18 FDG PET/CT in this disease. The aim of this study was to assess the role of F-18 FDG PET/CT in the diagnosis and therapeutic effect evaluation of PBL. A total of 19 consecutive patients with PBL were enrolled. Whole-body PET/CT scan was performed for all patients. The diagnosis of PBL was established by histopathology and immunohistochemistry. F-18 FDG PET/CT was positive in 94.7% (18/19) of patients. Uptake of FDG in lesions was intense with SUVmax of 15.14 ± 11.82. Multiple involved lesions were found in 47.4% (9/19) patients, while 52.6% presented with a single involved lesion. Based on the lesions, PET detected 98.9% (87/88) lesions. Among them, 71.6% (63/88) lesions were found to be located in axial skeleton and 28.4% (25/88) in the extremity skeleton. FDG PET/CT also found the lesions infiltrate to the surrounding soft tissue in 84.2% (16/19) patients. On the syn-modality CT, the bone destruction was noted in 43.2% (38/88) of the lesions, of which 50.0% lesions presented as slight change in bone density and 50.0% as severe change. The diagnostic sensitivity of PET was much higher than that of CT (98.9% vs. 43.2%, P=0.000). PET/CT was performed for evaluation of treatment response in 13 patients. In 12 patients with complete response(CR), PET/CT found the 25 lesions were F-18 FDG fully resoluted after treatment, however, bone destruction was still presented in 72.0% (18/25) lesions. The present study suggests that F-18 FDG PET/CT was a sensitive imaging modality for diagnosis and treatment response evaluation of PBL. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The feasibility of 11C-methionine-PET in diagnosis of solitary lung nodules/masses when compared with 18F-FDG-PET

International Nuclear Information System (INIS)

Hsieh Hungjen; Lin Shenghsiang; Lin Kohan; Lee Chienying; Chang Chengpei; Wang Shyhjen

2008-01-01

The objective of this study was to differentiate between benign and malignant lesions of the lung, 18 F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG-PET) has limitations such as a lower specificity in cases of non-specific inflammation. The positive predictive value is unsatisfactory in countries where inflammatory lung disorders are prevalent. We present the preliminary results of the usefulness of combining 11 C-methionine-PET and 18 F-FDG-PET in this context. Fifteen patients with indeterminate solitary pulmonary nodules/masses (10 men, 5 women; average age 64.7±14.0 years, ranging from 25 to 87 years) were studied using 11 C-methionine- and 18 F-FDG-PET. Interpretations were primarily made on visual analysis with five-point scale and a consensus of two nuclear medicine physicians, using standardized uptake value as an accessory reference. Foci of abnormal radiotracer uptake were subsequently correlated with clinical follow-up, imaging modalities such as chest radiography, chest computed tomography (CT), serial PET studies, and pathology results from bronchoscopic biopsy and/or surgical specimen. Diagnoses were established in 14 patients. The 11 C-methionine-PET and 18 F-FDG-PET studies were both true positive in two cases of adenocarcinoma and true negative in two cases of clinical benign nodules. In one case of lymphoid hyperplasia both 11 C-methionine-PET and 18 F-FDG-PET showed false-positive findings. Discordant results were obtained in nine cases. In spite of the false-positive results of 18 F-FDG-PET, 11 C-methionine-PET was true negative in four cases with chronic inflammatory nodules and three cases of pulmonary tuberculosis. Furthermore, 11 C-methionine-PET was true positive in one case of lung metastasis of thyroid cancer, and in another with recurrence of gastric cancer, respectively, for which 18 F-FDG-PET imaging was false negative. Our experience indicates that 11 C-methionine-PET seems more specific and sensitive when compared with

Early diagnosis and follow-up of aortitis with [{sup 18}F]FDG PET and MRI

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Meller, J.; Siefker, U.; Sahlmann, C.O.; Lehmann, K.; Conrad, M. [Department of Nuclear Medicine, Georg August University, Robert Koch-Strasse 40, 37075, Goettingen (Germany); Strutz, F.; Scheel, A. [Department of Nephrology and Rheumatology, Georg August University, Goettingen (Germany); Vosshenrich, R. [Department of Radiology, Georg August University, Goettingen (Germany)

2003-05-01

The aim of this prospective study was to compare fluorine-18 fluorodeoxyglucose ([{sup 18}F]FDG) positron emission tomography (PET) with magnetic resonance imaging (MRI) in patients with early aortitis, at the time of initial diagnosis and during immunosuppressive therapy. The study population consisted of 15 patients (nine females and six males; median age 62 years, range 26-76 years) who presented with fever of unknown origin or an elevated erythrocyte sedimentation rate or elevated C-reactive protein and who showed pathological aortic [{sup 18}F]FDG uptake. Fourteen of these patients had features of early giant cell arteritis (GCA), while one had features of early Takayasu arteritis. During follow-up, seven PET scans were performed in six patients with GCA 4-30 months (median 19 months) after starting immunosuppressive medication. The results of [{sup 18}F]FDG imaging were compared with the results of MRI at initial evaluation and during follow-up and with the clinical findings. At baseline, abnormal [{sup 18}F]FDG uptake was present in 59/104 (56%) of the vascular regions studied in 15 patients. Seven follow-up PET studies were performed in six patients. Of 30 regions with initial pathological uptake in these patients, 24 (80%) showed normalisation of uptake during follow-up. Normalisation of [{sup 18}F]FDG uptake correlated with clinical improvement and with normalisation of the laboratory findings. All except one of the patients with positive aortic [{sup 18}F]FDG uptake were investigated with MRI and MRA. Thirteen of these 14 patients showed inflammation in at least one vascular region. Of 76 vascular regions studied, 41 (53%) showed vasculitis on MRI. Of 76 vascular regions studied with both PET and MRI, 47 were concordantly positive or negative on both modalities, 11 were positive on MRI only and 18 were positive on PET only. MRI was performed during follow-up in six patients: of 17 regions with inflammatory changes, 15 regions remained unchanged and two

The Usefulness of 18F-FDG PET as a Cancer Screening Test

International Nuclear Information System (INIS)

Ko, Doo Heun; Choi, Joon Young; Song, Yun Mi; Lee, Su Jin; Kim, Young Hwan; Lee, Kyung Han; Kim, Byung Tae; Lee, Moon Kyu

2008-01-01

The aim of this study was to evaluate the usefulness of whole body positron emission tomography (PET) using 18 F-fluorodeoxyglucose ( 18 F-FDG) for cancer screening in asymptomatic subjects. The subjects were 1,762 men and 259 women who voluntarily underwent 18 F-FDG PET for cancer screening as a part of a routine health examination. Final diagnosis was decided by other diagnostic studies, pathological results or clinical follow-up for 1 year. Of 2,021 subjects, 40 (2.0%) were finally proved to have cancer. Abnormal focal 18 F-FDG uptake suggesting malignancy was found in 102 subjects (5.0%). Among them, 21 subjects (1.0%) were proved to have cancer. Other tests in the routine health examination could not find 9 of 21 cancers (42.9%) detected by PET. The sensitivity, specificity, positive predictive value, and negative predictive value of PET for cancer screening were 52.5%, 95.9%, 20.6%, and 99.0%, respectively. Pathologies of cancers missed on PET were adenocarcinoma (n=9; 3 colon cancers, 3 prostate cancers, 2 stomach cancers, and 1 rectal cancer), differentiated thyroid carcinoma (n=6), bronchioalveolar cell carcinoma (n=2), urinary bladder cancer (n=1), and melanoma (n=1). More than half of cancers which were not detected by PET were smaller than 1 cm in diameter. 18 F-FDG PET might be useful for cancer screening in asymptomatic subjects due to its high specificity and negative predictive value and play a supplementary role to the conventional health check-up, but it could not replace due to limited sensitivity for urological cancers, small-sized tumors and some hypometaboic cancers

The role of 18F-FDG PET in characterising disease activity in Takayasu arteritis

International Nuclear Information System (INIS)

Webb, Myles; Chambers, Anthony; AL-Nahhas, Adil; Maudlin, Lucy; Rahman, Lucy; Frank, John; Mason, Justin C.

2004-01-01

Takayasu arteritis (TA) is a rare, sporadic and chronic inflammatory arteritis, which predominantly affects the aorta and its branches. Diagnosis can be difficult and there are limitations to the current diagnostic work-up. By detecting areas of active glucose metabolism present in active vasculitis, imaging with fluorine-18 fluorodeoxyglucose positron emission tomography ( 18 F-FDG PET) could potentially have a role in the management of TA. Our aim was to assess this role by reviewing 28 18 F-FDG PET scans performed on 18 patients suspected of having TA. All patients had full clinical and laboratory assessment, cross-sectional imaging and angiography, and 16/18 satisfied the American College of Rheumatologists' criteria for TA. 18 F-FDG PET achieved a sensitivity of 92%, a specificity of 100%, and negative and positive predictive values of 85% and 100% respectively in the initial assessment of active vasculitis in TA. We conclude that 18 F-FDG PET can be used to diagnose early disease, to detect active disease (even within chronic changes) and to monitor the effectiveness of treatment. (orig.)

11C-choline vs. 18F-FDG PET/CT in assessing bone involvement in patients with multiple myeloma

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Ambrosini Valentina

2007-06-01

Full Text Available Abstract Background Multiple Myeloma (MM is a B cell neoplasm causing lytic or osteopenic bone abnormalities. Whole body skeletal survey (WBSS, Magnetic resonance (MR and 18F-FDG PET/CT are imaging techniques routinely used for the evaluation of bone involvement in MM patients. Aim As MM bone lesions may present low 18F-FDG uptake; the aim of this study was to assess the possible added value and limitations of 11C-Choline to that of 18F-FDG PET/CT in patients affected with MM. Methods Ten patients affected with MM underwent a standard 11C-Choline PET/CT and an 18F-FDG PET/CT within one week. The results of the two scans were compared in terms of number, sites and SUVmax of lesions. Results Four patients (40% had a negative concordant 11C-Choline and 18F-FDG PET/CT scans. Two patients (20% had a positive 11C-Choline and 18F-FDG PET/CT scans that identified the same number and sites of bone lesions. The remaining four patients (40% had a positive 11C-Choline and 18F-FDG PET/CT scan, but the two exams identified different number of lesions. Choline showed a mean SUVmax of 5 while FDG showed a mean SUVmax of 3.8 (P = 0.042. Overall, 11C-Choline PET/CT scans detected 37 bone lesions and 18F-FDG PET/CT scans detected 22 bone lesions but the difference was not significant (P = 0.8. Conclusion According to these preliminary data, 11C-Choline PET/CT appears to be more sensitive than 18F-FDG PET/CT for the detection of bony myelomatous lesions. If these data are confirmed in larger series of patients, 11C-Choline may be considered a more appropriate functional imaging in association with MRI for MM bone staging.

Diagnostic value of [18F] FDG-PET and PET/CT in urinary bladder cancer: a meta-analysis.

Science.gov (United States)

Zhang, Huojun; Xing, Wei; Kang, Qinqin; Chen, Chao; Wang, Linhui; Lu, Jianping

2015-05-01

An early diagnosis of urinary bladder cancer is crucial for early treatment and management. The objective of this systematic review was to assess the overall diagnostic accuracy of 18 F FDG-PET and PET/CT in urinary bladder cancer with meta-analysis. The PubMed and CNKI databases were searched for the eligible studies published up to June 01, 2014. The sensitivity, specificity, and other measures of accuracy of 18 F FDG-PET and PET/CT in the diagnosis of urinary bladder cancer were pooled along with 95 % confidence intervals (CI). Summary receiver operating characteristic (ROC) curves were used to summarize overall test performance. Ten studies met our inclusion criteria. The summary estimates for 18 F FDG-PET and PET/CT in the diagnosis of urinary bladder cancer in meta-analysis were as follows: a pooled sensitivity, 0.82 (95 % confidence interval [CI], 0.75 to 0.88); a pooled specificity, 0.92 (95 % CI, 0.87 to 0.95); positive likelihood ratio, 6.80 (95 % CI, 4.31 to 10.74); negative likelihood ratio, 0.27 (95 % CI, 0.19 to 0.36); and diagnostic odds ratio, 25.18 (95 % CI, 17.58 to 70.4). The results indicate that 18 F FDG-PET and PET/CT are relatively high sensitive and specific for the diagnosis of urinary bladder cancer.

Diagnosing neuroleukemiosis: Is there a role for 18F-FDG-PET/CT?

Science.gov (United States)

Sabaté-Llobera, A; Cortés-Romera, M; Gamundí-Grimalt, E; Sánchez-Fernández, J J; Rodríguez-Bel, L; Gámez-Cenzano, C

An imaging case is presented on a patient referred to our department for an 18 F-FDG-PET/CT, as a paraneoplastic syndrome was suspected due to his clinical situation. He had a history of acute myeloid leukemia (AML) treated two years earlier, with sustained complete remission to date. 18 F-FDG-PET/CT findings revealed hypermetabolism in almost all nerve roots, suggesting meningeal spread, consistent with the subsequent MRI findings. Cerebrospinal fluid (CSF) findings confirmed a leptomeningeal reactivation of AML. Although not many studies have evaluated the role of 18 F-FDG-PET/CT in leukemia, it is a noninvasive tool for detecting extramedullary sites of disease and a good imaging alternative for those patients on whom an MRI cannot be performed. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

The role of {sup 18}F-FDG PET/CT in the detection of osteosarcoma recurrence

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Angelini, Andrea; Trovarelli, Giulia; Ruggieri, Pietro [University of Padova, Department of Orthopedics and Orthopedic Oncology, Padova (Italy); Ceci, Francesco; Castellucci, Paolo; Graziani, Tiziano; Polverari, Giulia; Fanti, Stefano [University of Bologna, Service of Nuclear Medicine, S.Orsola-Malpighi Hospital, Bologna (Italy); Palmerini, Emanuela; Ferrari, Stefano [Istituto Ortopedico Rizzoli, Department of Chemotherapy, Bologna (Italy)

2017-09-15

The aim of this study was to investigate the diagnostic accuracy of {sup 18}F-FDG-PET/CT in osteosarcoma patients suspicious for disease recurrence after adequate surgical therapy. Inclusion criteria were: a) adequate surgical treatment for proven osteosarcoma and documented complete remission after therapy; b) {sup 18}F-FDG-PET/CT performed during follow-up for clinical/diagnostic suspicion of relapse; c) new surgical treatment with excision of the suspected lesions; d) histological validation of {sup 18}F-FDG-PET/CT findings. Thirty-seven patients matching all inclusion criteria were retrospectively enrolled (20 men and 17 female). Primary surgical treatment consists of resection (31 cases) or amputation (six cases). {sup 18}F-FDG-PET/CT performance was assessed with a per-patient and per-site evaluation of sensitivity, specificity, accuracy, positive predicting value (PPV), and negative predicting value (NPV). The sites of relapse were classified as local, lung, lymphnodes (LNs), and distant (other skeletal segments and/or distant soft tissue). The disease-free survival (DFS) and the overall survival (OS) after 18F-FDG PET/CT were evaluated. {sup 18}F-FDG-PET/CT was positive in 89.2% (33/37) of patients. Local uptake only was observed in 35.1% patients (13/37); lung uptake only in 18.9% (7/37); distant uptake only in 2.7% (1/37) case; multiple sites of uptake in 32.4% (12/37). Histology resulted positive in 92% (34/37) of patients. A total of 51 pathologic lesions were evaluated (22 local relapse, 11 lung metastasis, 10 metastatic LNs, eight distant metastatic lesions). On a per-patient analysis {sup 18}F-FDG-PET/CT showed a sensitivity, specificity, accuracy, PPV, and NPV of 91%, 75%, 89%, 97%, 50%. On a per-site analysis the performance for local relapse was 96%, 100%, 97%, 100%, 93%, while for lung relapse detection was 80%, 100%, 92%, 100%, 88%. The mean follow-up after {sup 18}F-FDG-PET/CT was 21.5 months. At the last follow-up, 19% (7/37) of patients were

18F-FDG-PET and 18F-FDG-PET/CT in the detection of recurrent or metastatic medullary thyroid carcinoma: a systematic review and meta-analysis

International Nuclear Information System (INIS)

Cheng, Xu; Bao, Lihua; Xu, Zhaoqiang; Li, Dianfu; Li, Yongjun; Wang, Jie

2012-01-01

The aim of this study was to investigate diagnostic performance of 18F-fluorodeoxyglucose position emission tomography (FDG-PET) and PET/computed tomography (PET/CT) for detection of recurrent or metastatic medullary thyroid carcinoma (MTC) in patients after surgery with a meta-analysis. MEDLINE and EMBASE databases were searched for relevant articles. Two investigators independently extracted the data about study characteristics and examination results. Pooled estimates of sensitivity of FDG-PET or FDG-PET/CT were obtained. Fifteen studies met all inclusion criteria. The sensitivity of FDG-PET ranged from 0.47 (95% confidence intervals (CI): 0.21–0.73) to 0.96 (95%CI: 0.86–0.99), the sensitivity of FDG-PET/CT ranger from 0.47 (95% CI: 0.31–0.64) to 0.80 (95% CI: 0.65–0.90). The pooled sensitivities of FDG-PET and PET/CT were 0.68 (95% CI: 0.64–0.72) and 0.69 (95% CI: 0.64–0.74), respectively. There was no statistic significant between FDG-PET and PET/CT. Our results indicate that FDG-PET or FDG-PET/CT has reasonable sensitivity in detecting recurrent or metastatic MTC after primary surgery. However, no single diagnostic technique is able to reliably demonstrate the full extent of disease in patients with recurrent or metastatic MTC, the combination of cross-sectional radiography with FDG-PET or PET/CT is recommended.

Unsuspected muscle metastases detected with "1"8F-FDG PET/CT

International Nuclear Information System (INIS)

San Román, J.; Hovsepian, M.

2017-01-01

Objective: To assess the prevalence of unsuspected muscle metastases (MM) in patients with known malignant disease, examined with "1"8F-fluorodeoxyglucose positron emission tomography integrated with computed tomography ("1"8F-FDG PET/CT). Materials and methods: A total of 2,953 "1"8F-FDG PET/CT examinations were retrospectively analysed, looking for cases with MM. Primary neoplasm, number and location of MM and SUV max were recorded on each patient. Oncology patients with known histology and multiple secondary lesions were included. The "1"8F-FDG PET/CT was the reference method for detection of metastases. Results: MM were observed in 33 patients (prevalence: 1.12%) aged between 18 and 88 years. The primary tumours included: kidney in 7 cases, breast in 5, melanoma in 4, lung in 3, ovary in 3, thyroid in 3, sarcomas in 3, colorectal in 2, bladder in 2, and endometrial in 1. A total of 96 MM were observed in 33 patients, and located in: thigh muscles 24, gluteal 15, chest wall 13, iliopsoas 10, paravertebral muscles 10, abdominal wall 7, leg 7, arm 4, and other locations 6 (pelvis, neck, etc.). MM affected only one muscle in 22/33 patients and several muscles in 11/33. Hypermetabolic focus was the most frequent uptake pattern, with SUV max between 1.5 and 34. Discussion: Our series has a significant number of cases, and is consistent with other authors on the incidence and location of MM. Conclusion: MM are uncommon and may be overlooked. MM may be detected with "1"8F-FDG PET/CT as single or multiple hypermetabolic foci. (authors) [es

{sup 18}F-FDG PET/CT in Primary AL Hepatic Amyloidosis Associated with Multiple Myeloma

Energy Technology Data Exchange (ETDEWEB)

Son, Youn Mi; Bak, Cheol Hee [Seoul Medical Center, Seoul (Korea, Republic of); Choi, Joon Young; Cheon, Mi Ju; Kim, Young Eun; Lee, Kyung Han; Kim, Byung Tae [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2011-10-15

We report here on a rare case of primary AL hepatic amyloidosis associated with multiple myeloma in a 64-year-old woman. The patient was referred for evaluating her progressive jaundice and right upper quadrant pain. {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET)/computed tomography (CT) showed diffusely and markedly increased {sup 18}F-FDG uptake in the liver. Although there have been several case studies showing positive {sup 18}F-FDG uptake in pulmonary amyloidosis, to the best of our knowledge, the {sup 18}F-FDG PET/CT findings of hepatic amyloidosis or primary hepatic amyloidosis associated with multiple myeloma have not been reported previously.

Characterizing IgG4-related disease with 18F-FDG PET/CT: a prospective cohort study

International Nuclear Information System (INIS)

Zhang, Jingjing; Ma, Yanru; Niu, Na; Wang, Xinwei; Li, Fang; Zhu, Zhaohui; Chen, Hua; Lin, Wei; Zhang, Fengchun; Zhang, Wen; Xiao, Yu; Liang, Zhiyong

2014-01-01

IgG4-related disease (IgG4-RD) is an increasingly recognized clinicopathological disorder with immune-mediated inflammatory lesions mimicking malignancies. A cohort study was prospectively designed to investigate the value of 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in characterizing IgG4-RD. Thirty-five patients diagnosed with IgG4-RD according to the consensus criteria were enrolled with informed consent. All patients underwent baseline 18 F-FDG PET/CT evaluation. Among them, 29 patients underwent a second 18 F-FDG PET/CT scan after 2 to 4 weeks of steroid-based therapy. All 35 patients were found with 18 F-FDG-avid hypermetabolic lesion(s); 97.1 % (34/35) of these patients showed multi-organ involvement. Among the 35 patients, 71.4 % (25/35) patients were found with more organ involvement on 18 F-FDG PET/CT than conventional evaluations including physical examination, ultrasonography, and computed tomography (CT). 18 F-FDG PET/CT demonstrated specific image characteristics and pattern of IgG4-RD, including diffusely elevated 18 F-FDG uptake in the pancreas and salivary glands, patchy lesions in the retroperitoneal region and vascular wall, and multi-organ involvement that cannot be interpreted as metastasis. Comprehensive understanding of all involvement aided the biopsy-site selection in seven patients and the recanalization of ureteral obstruction in five patients. After 2 to 4 weeks of steroid-based therapy at 40 mg to 50 mg prednisone per day, 72.4 % (21/29) of the patients showed complete remission, whereas the others exhibited > 81.8 % decrease in 18 F-FDG uptake. F-FDG PET/CT is a useful tool for assessing organ involvement, monitoring therapeutic response, and guiding interventional treatment of IgG4-RD. The image pattern is suggested to be updated into the consensus diagnostic criteria for IgG4-RD. (orig.)

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

International Nuclear Information System (INIS)

Morbelli, Silvia; Garibotto, Valentina; Giessen, Elsmarieke van de; Arbizu, Javier; Chetelat, Gael; Drezgza, Alexander; Hesse, Swen; Lammertsma, Adriaan A.; Law, Ian; Pappata', Sabina; Payoux, Pierre; Pagani, Marco

2015-01-01

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

Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in combination with ultrasonography for axillary staging in primary breast cancer

International Nuclear Information System (INIS)

Ueda, Shigeto; Ishida, Jiro; Abe, Yoshiyuki; Mochizuki, Hidetaka; Tsuda, Hitoshi; Asakawa, Hideki; Omata, Jiro; Fukatsu, Kazuhiko; Kondo, Nobuo; Kondo, Tadaharu; Hama, Yukihiro; Tamura, Katsumi

2008-01-01

Accurate evaluation of axillary lymph node (ALN) involvement is mandatory before treatment of primary breast cancer. The aim of this study is to compare preoperative diagnostic accuracy between positron emission tomography/computed tomography with 18 F-fluorodeoxyglucose ( 18 F-FDG PET/CT) and axillary ultrasonography (AUS) for detecting ALN metastasis in patients having operable breast cancer, and to assess the clinical management of axillary 18 F-FDG PET/CT for therapeutic indication of sentinel node biopsy (SNB) and preoperative systemic chemotherapy (PSC). One hundred eighty-three patients with primary operable breast cancer were recruited. All patients underwent 18 F-FDG PET/CT and AUS followed by SNB and/or ALN dissection (ALND). Using 18 F-FDG PET/CT, we studied both a visual assessment of 18 F-FDG uptake and standardized uptake value (SUV) for axillary staging. In a visual assessment of 18 F-FDG PET/CT, the diagnostic accuracy of ALN metastasis was 83% with 58% in sensitivity and 95% in specificity, and when cut-off point of SUV was set at 1.8, sensitivity, specificity, and accuracy were 36, 100, and 79%, respectively. On the other hand, the diagnostic accuracy of AUS was 85% with 54% in sensitivity and 99% in specificity. By the combination of 18 F-FDG PET/CT and AUS to the axilla, the sensitivity, specificity, and accuracy were 64, 94, and 85%, respectively. If either 18 F-FDG PET uptake or AUS was positive in allixa, the probability of axillary metastasis was high; 50% (6 of 12) in 18 F-FDG PET uptake only, 80% (4 of 5) in AUS positive only, and 100% (28 of 28) in dual positive. By the combination of AUS and 18 F-FDG PET/CT, candidates of SNB were more appropriately selected. The axillary 18 F-FDG uptake was correlated with the maximum size and nuclear grade of metastatic foci (p = 0.006 and p = 0.03). The diagnostic accuracy of 18 F-FDG PET/CT was shown to be nearly equal to ultrasound, and considering their limited sensitivities, the high radiation

(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...... the abnormal scan revealed complete resolution of the metabolically active disease in the neck, axillas, lung hili, and spleen. This case highlights inflammation as one of the most well established false positives when interpreting (18)F-FDG PET/CT scans....

Usefulness of {sup 18}F-FDG PET, combined FDG-PET/CT and EUS in diagnosing primary pancreatic carcinoma: A meta-analysis

Energy Technology Data Exchange (ETDEWEB)

Tang Shuang [Department of Nuclear Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Huang Gang, E-mail: huang2802@163.com [Department of Nuclear Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Liu Jianjun [Department of Nuclear Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Liu Tao [Department of Orthopedics, Soochow University, Suzhou (China); Treven, Lyndal [Faculty of Public Health, University of Sydney, Sydney (Australia); Song Saoli; Zhang Chenpeng; Pan Lingling [Department of Nuclear Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Zhang Ting [Department of Anesthesiology, Renji Hospital, Shanghai (China)

2011-04-15

The aim was to evaluate the diagnostic value of {sup 18}F-fluorodeoxyglucose-positron emission tomography ({sup 18}F-FDG PET), combined {sup 18}F-fluorodeoxyglucose-positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) and endoscopic ultrasonography (EUS) in diagnosing patients with pancreatic carcinoma. MEDLINE, EMBASE, Cochrane library and some other databases, from January 1966 to April 2009, were searched for initial studies. All the studies published in English or Chinese relating to the diagnostic value of {sup 18}F-FDG PET, PET/CT and EUS for patients with pancreatic cancer were collected. Methodological quality was assessed. The statistic software called 'Meta-Disc 1.4' was used for data analysis. Results: 51 studies were included in this meta-analysis. The pooled sensitivity estimate for combined PET/CT (90.1%) was significantly higher than PET (88.4%) and EUS (81.2%). The pooled specificity estimate for EUS (93.2%) was significantly higher than PET (83.1%) and PET/CT (80.1%). The pooled DOR estimate for EUS (49.774) was significantly higher than PET (32.778) and PET/CT (27.105). SROC curves for PET/CT and EUS showed a little better diagnostic accuracy than PET alone. For PET alone, when interpreted the results with knowledge of other imaging tests, its sensitivity (89.4%) and specificity (80.1%) were closer to PET/CT. For EUS, its diagnostic value decreased in differentiating pancreatic cancer for patients with chronic pancreatitis. In conclusion, PET/CT was a high sensitive and EUS was a high specific modality in diagnosing patients with pancreatic cancer. PET/CT and EUS could play different roles during different conditions in diagnosing pancreatic carcinoma.

F-18-FDG-PET in autonomous goiter

International Nuclear Information System (INIS)

Boerner, A.R.; Voth, E.; Schicha, H.

1999-01-01

Aim: Gain-of-function mutations of the thyrotropin receptor (TSHR) gene have been invoked as one of the major causes of toxic thyroid adenomas. This study evaluates F-18-FDG-PET in these patients. Methods: Twenty patients with focal autonomous nodules and ten with disseminated autonomy were investigated the day before radioiodine therapy. Twenty patients with cancer of the head or neck and normal thyroid function served as controls. Results: F-18-FDG-Uptake was higher in patients than in controls. Focal autonomous nodules were associated with focally enhanced glucose metabolism. Disseminated autonomous goiters showed various patterns of focal or global hypermetabolism. Conclusion: Autonomous thyroid tissue caused by constitutive mutations of the TSH receptor is characterised by simultaneous increases in glucose and iodine metabolism which are correlated. (orig.) [de

The role of 18F-FDG PET and PET/CT in the evaluation of primary cutaneous lymphoma.

Science.gov (United States)

Qiu, Lin; Tu, Guojian; Li, Jing; Chen, Yue

2017-02-01

Primary cutaneous lymphoma (PCL) is the second most common type of extranodal non-Hodgkin lymphoma, including both cutaneous T-cell and B-cell lymphomas. PCL comprises numerous subtypes and thus has myriad clinical presentations in the skin and subcutaneous tissues. Accurate classification and staging are important for making treatment recommendations for PCL and will further impact patient prognosis significantly. We review the role of fluorine-18-fluorodeoxyglucose (F-FDG) PET (F-FDG PET) and F-FDG PET with computed tomography (CT) in the diagnosis, staging, tumor biological evaluation, treatment response assessment, and early recurrence surveillance of PCL. Although F-FDG PET and PET/CT do not seem to adequately distinguish the plaque, patch, or erythroderma cutaneous lesions of PCL, the imaging modalities are superior to CT, MRI, and other nuclear medicine methods in detecting both the cutaneous and the extracutaneous lesions of PCL. The available literature addressing the clinical role of F-FDG PET and PET/CT in patients with PCL is promising for the use of the modalities in staging, tumor biological evaluation, biopsy guidance, early treatment response assessment, and recurrence surveillance. However, more data are needed to better specify the role of F-FDG PET and PET/CT in the management of PCL.

Advantages of 18F FDG-PET/CT over Conventional Staging for Sarcoma Patients.

Science.gov (United States)

Németh, Zsuzsanna; Boér, Katalin; Borbély, Katalin

2017-10-09

The effective management of patients with sarcomas requires accurate diagnosis and staging. Imaging, such as ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI) are the most freqently used methods for the detection of the lesion location, size, morphology and structural changes to adjacent tissues; however, these modalities provide little information about tumour biology. MRI is a robust and useful modality in tumour staging of sarcomas, however metabolic-fluorodeoxyglucose positron emission tomography/ computer tomography ( 18 F-FDG PET/CT) provides greater accuracy to overall staging in combination with MRI [1]. The advantages of 18 F-FDG PET/CT method compared with CT and MRI is that it provides a whole body imaging, maps the viability of the tumour or the metabolic activity of the tissue. Additionally, PET detects the most agressive part of the tumour, demonstrates the biological behaviour of the tumour and therefore has a predictive value. Little data ara available on the role of 18 F-FDG PET/CT in the management of sarcomas. The present manuscript aims to provide a review of the major indications of 18 F-FDG PET/CT for diagnosis, staging, restaging and monitoring response to therapy and to compare its usefulness with the conventional imaging modalities in the management of patients with sarcomas.

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

International Nuclear Information System (INIS)

Nasu, Seiji; Hata, Takashi; Nakajima, Tooru; Suzuki, Yutaka

2002-01-01

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

[F-18]FDG imaging of head and neck tumors: comparison of hybrid PET, dedicated PET and CT

International Nuclear Information System (INIS)

Dresel, S.; Brinkbaeumer, K.; Schmid, R.; Poepperl, G.; Hahn, K.; Szeimies, U.

2001-01-01

Aim: Aim of the study was to evaluate [F-18]FDG imaging of head and neck tumors using a Hybrid-PET device of the 2nd or 3rd generation. Examinations were compared to dedicated PET and Spiral-CT. Methods: 54 patients suffering from head and neck tumors were examined using dedicated PET and Hybrid-PET after injection of 185-350 MBq [F-18]FDG. Examinations were carried out on the dedicated PET first followed by a scan on the Hybrid-PET. Dedicated PET was acquired in 3D mode, Hybrid-PET was performed in list mode using an axial filter. Reconstruction of data was performed iteratively on both, dedicated PET and Hybrid-PET. All patients received a CT scan in multislice technique. All finding have been verified by the goldstandard histology or in case of negative histology by follow up. Results: Using dedicated PET the primary or recurrent lesion was correctly diagnosed in 47/48 patients, using Hybrid-PET in 46/48 patients and using CT in 25/48 patients. Metastatic disease in cervical lymph nodes was diagnosed in 17/18 patients with dedicated PET, in 16/18 patients with Hybrid-PET and in 15/18 with CT. False positive results with regard to lymph node metastasis were seen with one patient for dedicated PET and Hybrid-PET, respectively, and with 18 patients for CT. In a total of 11 patients unknown metastastic lesions were seen with dedicated PET and with Hybrid-PET elsewhere in the body. Additional malignant disease other than the head and neck tumor was found in 4 patients. Conclusion: Using Hybrid-PET for [F-18]FDG imaging reveals a loss of sensitivity and specificity of about 1-5% as compared to dedicated PET in head and neck tumors. [F-18]FDG PET with both, dedicated PET and Hybrid-PET is superior to CT in the diagnosis of primary or recurrent lesions as well as in the assessment of lymph node involvement. (orig.) [de

Localization of dystonic muscles using {sup 18}F-FDG PET/CT in idiopathic cervical dystonia

Energy Technology Data Exchange (ETDEWEB)

Choi, J. Y.; Seung, D. H.; Kim, D. H.; Kim, E. S.; Sohn, Y. I.; Choi, Y.; Choi, E. S.; Lee, K. H.; Kim, B. T. [Samsung Medical Center, Seoul (Korea, Republic of)

2007-07-01

Chemodenervation with botulinum toxin (BT) is regarded as a first-line treatment for idiopathic cervical dystonia (ICD), sometimes referred to as spasmodic torticollis. Moreover, because effective treatment involves the injection of BT into most dystonic muscles, the accurate localization of dystonic muscles is clinically important. In this preliminary study, we investigated whether {sup 18}F-FDG PET/CT is useful for localizing dystonic cervical muscles in ICD by comparing disease severity after and before BT injection into muscles determined to be hypermetabolic by PET/CT. Six consecutive patients (all males; age 37 16 y) underwent {sup 18}F-FDG PET/CT once (n = 4) or twice (n = 2) in a supine (n = 5) or sitting position (n = 3) during the {sup 18}F-FDG uptake period. Dystonic muscles suitable for BT injection therapy were defined as those showing diffusely increased {sup 18}F-FDG uptake. To evaluate response to BT injection, the Tsui scale and the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) were applied. On PET/CT, hypermetabolic cervical muscles were identified in all 6 patients (3 in a supine position and 3 in a sitting position during {sup 18}F-FDG uptake periods). In 2 patients who underwent PET/CT in a supine and in a sitting position during 18F-FDG uptake, abnormal hypermetabolic muscles were observed only by PET/CT in a sitting position with patients heads and necks in the assumed abnormal involuntary posture. Symptoms were significantly improved, according to the Tsui (10.0 2.9 to 1.8 1.3, 82% reduction) and TWSTRS scales (severity: 21.3 2.1 to 5.8 5.3, 73% reduction; disability: 19.8 1.9 to 3.8 3.8, 81 % reduction) in all 4 patients who underwent BT injection therapy guided by PET/CT and who were clinically follow-up. {sup 18}F-FDG PET/CT is potentially useful for identifying dystonic cervical muscles in patients with ICD.

The diagnostic value of 18F-FDG-PET/CT and MRI in suspected vertebral osteomyelitis - a prospective study.

Science.gov (United States)

Kouijzer, Ilse J E; Scheper, Henk; de Rooy, Jacky W J; Bloem, Johan L; Janssen, Marcel J R; van den Hoven, Leon; Hosman, Allard J F; Visser, Leo G; Oyen, Wim J G; Bleeker-Rovers, Chantal P; de Geus-Oei, Lioe-Fee

2018-05-01

The aim of this study was to determine the diagnostic value of 18 F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) and magnetic resonance imaging (MRI) in diagnosing vertebral osteomyelitis. From November 2015 until December 2016, 32 patients with suspected vertebral osteomyelitis were prospectively included. All patients underwent both 18 F-FDG-PET/CT and MRI within 48 h. All images were independently reevaluated by two radiologists and two nuclear medicine physicians who were blinded to each others' image interpretation. 18 F-FDG-PET/CT and MRI were compared to the clinical diagnosis according to international guidelines. For 18 F-FDG-PET/CT, sensitivity, specificity, PPV, and NPV in diagnosing vertebral osteomyelitis were 100%, 83.3%, 90.9%, and 100%, respectively. For MRI, sensitivity, specificity, PPV, and NPV were 100%, 91.7%, 95.2%, and 100%, respectively. MRI detected more epidural/spinal abscesses. An important advantage of 18 F-FDG-PET/CT is the detection of metastatic infection (16 patients, 50.0%). 18 F-FDG-PET/CT and MRI are both necessary techniques in diagnosing vertebral osteomyelitis. An important advantage of 18 F-FDG-PET/CT is the visualization of metastatic infection, especially in patients with bacteremia. MRI is more sensitive in detection of small epidural abscesses.

Toxoplasmic Lymphadenitis Mimicking a Metastatic Thyroid Carcinoma at 18F-FDG-PET/CT

International Nuclear Information System (INIS)

Treglia, Giorgio; Bongiovanni, Massimo; Ceriani, Luca; Paone, Gaetano; Giovanella, Luca

2013-01-01

A 28-year-old woman underwent total thyroidectomy for a papillary thyroid carcinoma in the right thyroid lobe (pTx, pN1b). Subsequently a 131 I-ablation (4.4 GBq) was performed. Four years later the patient presented increased thyroglobulin (Tg) serum levels (8.4 μg/l) during thyroxine treatment. Furthermore, enlarged hypoechoic and round-shaped bilateral cervical lymph nodes were detected at cervical ultrasonography (US). Based on laboratory and US findings suspicious for lymph nodal recurrence of thyroid carcinoma, the patient underwent an 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) to check for distant metastases (Fig. 1). The patient underwent a US-guided fine-needle aspiration cytology on an 18 F-FDG-avid cervical lymph-node. The smears were hypercellulated and consisted of numerous small- to medium-sized lymphocytes, macrophages, dendritic cells and tingible body macrophages. The cytological diagnosis was consistent with that of reactive lymphadenitis. Serological test revealed elevated IgM and IgG anti-Toxoplasma antibodies with a very low IgG-avidity, indicating an acute toxoplasmosis. Serum Tg was then measured by using heterophilic antibody blocking tubes, as previously reported, and serum value dropped to 18 F-FDG-PET/CT in oncological patients. Few reports have described toxoplasmic infection mimicking malignancy at 18 F-FDG-PET/CT; these findings were found mainly in immunodepressive patients or with history of lymphoma. Conversely, we described here a case of toxoplasmosis inducing false-positive Tg measurement, neck US and 18 F-FDG-PET/CT findings in a patient with papillary thyroid carcinoma

18F-FDG PET-CT显像在头颈部肿瘤的临床诊断中的效果研究%Study on the effect of 18F-FDG PET-CT in diagnosis of head and neck cancer

Institute of Scientific and Technical Information of China (English)

王家富; 李勇; 韩巍; 王丽范; 马铎

2012-01-01

OBJECTIVE To evaluate of the efficacy of 18F-FDG PET-CT in diagnosis of head and neck cancer. METHODS Patients diagnozed by 18F-FDG PET-CT imaging were collected for analysis. RESULTS The total detection rate of PET/CT was significantly higher than that of PET and CT. The positioning accuracy of PET/CT was significantly higher than that of PET. CONCLUSION T-FDG PET-CT can effectively identify the head and neck cancer treatment scar and tumor recurrence, lymph node and distant organ metastasis, and improve the sensitivity and accuracy of diagnosis.%目的 评价18F-FDG PET-CT对头颈部肿瘤患者的临床诊断价值.方法 患者均行18F-FDG PET-CT显像,对图像进行分析.结果 PET/CT的总检出率高于PET和CT,PET/CT的定位准确率高于PET.结论 18F-FDG PET-CT能够有效地鉴别头颈部肿瘤治疗后瘢痕与肿瘤复发、淋巴结及远处脏器转移,可提高对其诊断的敏感性和准确性.

Multi-site abdominal tuberculosis mimics malignancy on ~(18)F-FDG PET/CT:Report of three cases

Institute of Scientific and Technical Information of China (English)

无

2010-01-01

18 F-fluorodeoxyglucose positron emission/computed tomography( 18 F-FDG PET/CT)imaging,an established procedure for evaluation of malignancy,shows an increased 18 F-FDG uptake in inflammatory conditions.We present three patients with abdominal pain and weight loss.Conventional imaging studies indicated that abdominal neoplasm and 18 F-FDG PET/CT for assessment of malignancy showed multiple lesions with intense 18 FFDG uptake in abdomen of the three cases.However,the three patients were finally diagnosed wit...

18F-DG PET/CT in detection of recurrence and metastasis of colorectal cancer

Institute of Scientific and Technical Information of China (English)

无

2007-01-01

AIM: To evaluate the value of 18F-DG PET/CT in detecting recurrence and/or metastasis of colorectal cancer (CRC).METHODS: Combined visual analysis with semiquantitative analysis, the 18F-DG PET/CT wholebody imaging results and the corresponding clinical data of 68 postoperative CRC patients including 48 male and 20 female with average age of 58.1 were analyzed retrospectively.RESULTS: Recurrence and/or metastasis were confirmed in 56 patients in the clinical follow-up after the PET/CT imaging. The sensitivity of PET/CT diagnosis of CRC recurrence and/or metastasis was 94.6%, and the specificity was 83.3%. The positive predictive value (PPV)was 96.4% and the negative predictive value (NPV) was 76.9%. PET/CT imaging detected one or more occult malignant lesions in 8 cases where abdominal/pelvic CT and/or ultrasonography showed negative findings, and also detected more lesions than CT or ultrasonography did in 30.4% (17/56) cases. Recurrence and/or metastasis was detected in 91.7% (22/24) cases with elevated serum CEA levels by 18F-DG PET/CT imaging.CONCLUSION: 18F-DG PET/CT could detect the recurrence and/or metastasis of CRC with high sensitivity and specificity.

Combined use of (18)F-FDG and (18)F-FMISO in unresectable non-small cell lung cancer patients planned for radiotherapy: a dynamic PET/CT study.

Science.gov (United States)

Sachpekidis, Christos; Thieke, Christian; Askoxylakis, Vasileios; Nicolay, Nils H; Huber, Peter E; Thomas, Michael; Dimitrakopoulou, Georgia; Debus, Juergen; Haberkorn, Uwe; Dimitrakopoulou-Strauss, Antonia

2015-01-01

Aim of this study was to evaluate and compare, by means of dynamic and static PET/CT, the distribution patterns and pharmacokinetics of fluorine-18 fluorodeoxyglucose ((18)F-FDG) and of fluorine-18-fluoromisonidazole ((18)F-FMISO) in non-small cell lung cancer (NSCLC) patients scheduled for intensity modulated radiation therapy (IMRT). Thirteen patients suffering from inoperable stage III NSCLC underwent PET/CTs with (18)F-FDG and (18)F-FMISO for tumor metabolism and hypoxia assessment accordingly. Evaluation of PET/CT studies was based on visual analysis, semi-quantitative (SUV) calculations and absolute quantitative estimations, after application of a two-tissue compartment model and a non-compartmental approach. (18)F-FDG PET/CT revealed all thirteen primary lung tumors as sites of increased (18)F-FDG uptake. Six patients demonstrated also in total 43 (18)F-FDG avid metastases; these patients were excluded from radiotherapy. (18)F-MISO PET/CT demonstrated 12/13 primary lung tumors with faint tracer uptake. Only one tumor was clearly (18)F-FMISO avid, (SUVaverage = 3.4, SUVmax = 5.0). Mean values for (18)F-FDG, as derived from dPET/CT data, were SUVaverage = 8.9, SUVmax = 15.1, K1 = 0.23, k2 = 0.53, k3 = 0.17, k4 = 0.02, influx = 0.05 and fractal dimension (FD) = 1.25 for the primary tumors. The respective values for (18)F-FMISO were SUVaverage = 1.4, SUVmax = 2.2, K1 = 0.26, k2 = 0.56, k3 = 0.06, k4 = 0.06, influx = 0.02 and FD = 1.14. No statistically significant correlation was observed between the two tracers. (18)F-FDG PET/CT changed therapy management in six patients, by excluding them from planned IMRT. (18)F-FMISO PET/CT revealed absence of significant tracer uptake in the majority of the (18)F-FDG avid NSCLCs. Lack of correlation between the two tracers' kinetics indicates that they reflect different molecular mechanisms and implies the discordance between increased glycolysis and hypoxia in the malignancy.

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

International Nuclear Information System (INIS)

Nazar, A.H.; Naswa, N.; Ramya, S.; Patnecha, M.; Bangkim, Chandra K.H.; Kumar, R.; Bandopadhyay, G.P.; Bal, C.S.; Malhotra, A.

2010-01-01

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

Usefulness of 18F-FDG PET in intrahepatic cholangiocarcinoma

International Nuclear Information System (INIS)

Kim, Young-Jin; Yun, Mijin; Lee, Jong Doo; Lee, Woo Jung; Kim, Kyung Sik

2003-01-01

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

Detection of recurrent colorectal carcinoma with 18F-FDG positron emission tomography (PET)

International Nuclear Information System (INIS)

Scott, A.M.; Berlangieri, S.U.; Zalcberg, J.; Fox, R.; Cebon, J.; McLeish, A.; Thomas, D.; Chan, G.; Tochon-Danguy, H.; Egan, G.F.; McKay, W.J.

1998-01-01

Full text: The appropriate surgical management of recurrent colorectal carcinoma is dependent on the accurate detection of possible primary site recurrence and distant spread of disease. The aim of this study was therefore to evaluate the clinical accuracy of 18 F-FDG PET in detecting recurrent colorectal carcinoma. Over a 12-month period we have performed 21 studies in 17 patients (12 M: 5 F, age range 52-73 y) with known or suspected recurrent colorectal carcinoma. All patients underwent PET imaging of the abdomen and pelvis, or whole body imaging, with a whole body PET scanner (Siemens 951/R) following injection of 400 MBq of 18 F-FDG. All PET studies were interpreted with full knowledge of CT findings, and results were compared to subsequent surgical findings, biopsy or follow-up by conventional imaging methods (e.g. CT scan). Of the 21 studies performed, 18 (86%) had abnormal sites of 18 F-FDG uptake; all sites were subsequently confirmed as recurrent colorectal carcinoma. PET identified a total of 30 sites of disease in the pelvis (n = 4), abdomen (n =10), liver (n = 6), thorax (n = 9) and abdominal surgical scar (n 1), and was false negative in one lung lesion. CT scan correctly identified 14 sites as recurrent tumour; 9/12 patients (pts) with equivocal changes on CT scan had recurrent disease identified by PET. In 10 pts with elevated serum CEA but negative or equivocal CT scans, PET correctly identified 8 pts with proven recurrent disease. Previously unsuspected disease was found at six sites by PET. Lesions as small as 1.2 cm proven at surgery were identified with PET. In conclusion, this study shows 18 F-FDG PET to be a promising method for accurate detection of recurrent colorectal carcinoma

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

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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.

{sup 18}F{sub F}DG PET in evaluating malignancies compared with CT, MRI and pathology in 58 cases

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Li, L. [Air Force General Hospital, Beijing (Switzerland)

2000-07-01

This article discussed the practical application of {sup 18}F-FDG PET imaging techniques to depict, state, or define recurrences for five important malignancies: lung cancer, colorectal and head-and-neck cancer, intracranial malignant glioma and primary or secondary hepatic malignant diseases. And comparisons of {sup 18}F-FDG PET with CT, MRI imaging were addressed specifically. We reviewed our initial experience with 48 malignant and ten non-malignant cases. Among malignant group, 36 cases were confirmed by operation or biopsy, Other ten non-malignant diseases, including brain infarction, post-radiotherapy necrosis or scar and lung abscesses were followed with CT or MRI at least 6 months. All patients received intravenous administration of {sup 18}F-FDG 10-15 mCi, followed by a 40 minutes uptake phase, and subsequent imaged using a Siemens ECAT 931 whole-body scanner with resolution of 4 mm FWHM in the center of the field of view. Filtered back projection reconstruction was used to display attenuated or non-attenuated corrected images. The result of {sup 18}F-FDG PET was retrospectively evaluated to assess the degree of uptake of {sup 18}F-FDG PET in the tumor tissues and compared with CT, MRI and pathology. CT and MRI exam were taken before or after PET study in two weeks. {sup 18}F-FDG PET scans showed a significantly increased FDG metabolism in 47 malignant lesions, The tumor / normal tissue FDG uptake rate were 4.16 {+-}2.11. In 47 cases with neoplasm, {sup 18}F-FDG PET findings were constant with or further confirmed the CT or MRI diagnosis in 35/47 (74.5%) and 12/47 (253%) cases. Another one small intracranial metastasis (<0,6cm), shown on contrast MRI was not displayed by glucose metabolism Otherwise, the tumor/normal tissue FDG uptake rate were 0.86 {+-} 1,46 in ten non-malignant cases. Most of post-radiotherapy cerebral necrosis, which can't be distinguished on both contrast CT and MRI, showed FDG uptake defect. One cerebral infarction, previously

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

International Nuclear Information System (INIS)

Mandegaran, Ramin; Wagner, Thomas; Debard, Alexa; Alvarez, Muriel; Marchou, Bruno; Massip, Patrice

2014-01-01

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

Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT in combination with ultrasonography for axillary staging in primary breast cancer

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Tamura Katsumi

2008-06-01

Full Text Available Abstract Background Accurate evaluation of axillary lymph node (ALN involvement is mandatory before treatment of primary breast cancer. The aim of this study is to compare preoperative diagnostic accuracy between positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (18F-FDG PET/CT and axillary ultrasonography (AUS for detecting ALN metastasis in patients having operable breast cancer, and to assess the clinical management of axillary 18F-FDG PET/CT for therapeutic indication of sentinel node biopsy (SNB and preoperative systemic chemotherapy (PSC. Methods One hundred eighty-three patients with primary operable breast cancer were recruited. All patients underwent 18F-FDG PET/CT and AUS followed by SNB and/or ALN dissection (ALND. Using 18F-FDG PET/CT, we studied both a visual assessment of 18F-FDG uptake and standardized uptake value (SUV for axillary staging. Results In a visual assessment of 18F-FDG PET/CT, the diagnostic accuracy of ALN metastasis was 83% with 58% in sensitivity and 95% in specificity, and when cut-off point of SUV was set at 1.8, sensitivity, specificity, and accuracy were 36, 100, and 79%, respectively. On the other hand, the diagnostic accuracy of AUS was 85% with 54% in sensitivity and 99% in specificity. By the combination of 18F-FDG PET/CT and AUS to the axilla, the sensitivity, specificity, and accuracy were 64, 94, and 85%, respectively. If either 18F-FDG PET uptake or AUS was positive in allixa, the probability of axillary metastasis was high; 50% (6 of 12 in 18F-FDG PET uptake only, 80% (4 of 5 in AUS positive only, and 100% (28 of 28 in dual positive. By the combination of AUS and 18F-FDG PET/CT, candidates of SNB were more appropriately selected. The axillary 18F-FDG uptake was correlated with the maximum size and nuclear grade of metastatic foci (p = 0.006 and p = 0.03. Conclusion The diagnostic accuracy of 18F-FDG PET/CT was shown to be nearly equal to ultrasound, and considering their

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

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Mathilde Ørbæk

2016-05-01

Full Text Available 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 18F-FDG PET/CT mimicked malignant lymphoma. Follow-up 18F-FDG PET/CT scan in the patient performed 7 weeks after the abnormal scan revealed complete resolution of the metabolically active disease in the neck, axillas, lung hili, and spleen. This case highlights inflammation as one of the most well established false positives when interpreting 18F-FDG PET/CT scans.

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

International Nuclear Information System (INIS)

Su Liang; Zuo Chuantao; Guan Yihui; Zhao Jun; Shi Shenxun

2005-01-01

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

Combined approach of perioperative 18F-FDG PET/CT imaging and intraoperative 18F-FDG handheld gamma probe detection for tumor localization and verification of complete tumor resection in breast cancer

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Knopp Michael V

2007-12-01

Full Text Available Abstract Background 18F-fluorodeoxyglucose (18F-FDG positron emission tomography/computed tomography (PET/CT has become an established method for detecting hypermetabolic sites of known and occult disease and is widely used in oncology surgical planning. Intraoperatively, it is often difficult to localize tumors and verify complete resection of tumors that have been previously detected on diagnostic PET/CT at the time of the original evaluation of the cancer patient. Therefore, we propose an innovative approach for intraoperative tumor localization and verification of complete tumor resection utilizing 18F-FDG for perioperative PET/CT imaging and intraoperative gamma probe detection. Methods Two breast cancer patients were evaluated. 18F-FDG was administered and PET/CT was acquired immediately prior to surgery. Intraoperatively, tumors were localized and resected with the assistance of a handheld gamma probe. Resected tumors were scanned with specimen PET/CT prior to pathologic processing. Shortly after the surgical procedure, patients were re-imaged with PET/CT utilizing the same preoperatively administered 18F-FDG dose. Results One patient had primary carcinoma of breast and a metastatic axillary lymph node. The second patient had a solitary metastatic liver lesion. In both cases, preoperative PET/CT verified these findings and demonstrated no additional suspicious hypermetabolic lesions. Furthermore, intraoperative gamma probe detection, specimen PET/CT, and postoperative PET/CT verified complete resection of the hypermetabolic lesions. Conclusion Immediate preoperative and postoperative PET/CT imaging, utilizing the same 18F-FDG injection dose, is feasible and image quality is acceptable. Such perioperative PET/CT imaging, along with intraoperative gamma probe detection and specimen PET/CT, can be used to verify complete tumor resection. This innovative approach demonstrates promise for assisting the oncologic surgeon in localizing and

18F-FDG-PET/CT in staging, restaging, and treatment response assessment of male breast cancer

International Nuclear Information System (INIS)

Groheux, David; Hindié, Elif; Marty, Michel; Espié, Marc; Rubello, Domenico; Vercellino, Laetitia; Bousquet, Guilhem; Ohnona, Jessica; Toubert, Marie-Elisabeth; Merlet, Pascal; Misset, Jean-Louis

2014-01-01

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 ( 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. 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 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 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 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. 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

Preclinical dynamic 18F-FDG PET - tumor characterization and radiotherapy response assessment by kinetic compartment analysis

International Nuclear Information System (INIS)

Roee, Kathrine; Aleksandersen, Thomas B.; Nilsen, Line B.; Hong Qu; Ree, Anne H.; Malinen, Eirik; Kristian, Alexandr; Seierstad, Therese; Olsen, Dag R.

2010-01-01

Background. Non-invasive visualization of tumor biological and molecular processes of importance to diagnosis and treatment response is likely to be critical in individualized cancer therapy. Since conventional static 18 F-FDG PET with calculation of the semi-quantitative parameter standardized uptake value (SUV) may be subject to many sources of variability, we here present an approach of quantifying the 18 F-FDG uptake by analytic two-tissue compartment modeling, extracting kinetic tumor parameters from dynamic 18 F-FDG PET. Further, we evaluate the potential of such parameters in radiotherapy response assessment. Material and methods. Male, athymic mice with prostate carcinoma xenografts were subjected to dynamic PET either untreated (n=8) or 24 h post-irradiation (7.5 Gy single dose, n=8). After 10 h of fasting, intravenous bolus injections of 10-15 MBq 18 F-FDG were administered and a 1 h dynamic PET scan was performed. 4D emission data were reconstructed using OSEM-MAP, before remote post-processing. Individual arterial input functions were extracted from the image series. Subsequently, tumor 18 F-FDG uptake was fitted voxel-by-voxel to a compartment model, producing kinetic parameter maps. Results. The kinetic model separated the 18 F-FDG uptake into free and bound tracer and quantified three parameters; forward tracer diffusion (k1), backward tracer diffusion (k2), and rate of 18 F-FDG phosphorylation, i.e. the glucose metabolism (k3). The fitted kinetic model gave a goodness of fit (r2) to the observed data ranging from 0.91 to 0.99, and produced parametrical images of all tumors included in the study. Untreated tumors showed homogeneous intra-group median values of all three parameters (k1, k2 and k3), whereas the parameters significantly increased in the tumors irradiated 24 h prior to 18 F-FDG PET. Conclusions. This study demonstrates the feasibility of a two-tissue compartment kinetic analysis of dynamic 18 F-FDG PET images. If validated, extracted

The impact of 18F-FDG PET on the management of patients with suspected large vessel vasculitis

International Nuclear Information System (INIS)

Fuchs, Martin; Rasch, Helmut; Berg, Scott; Ng, Quinn K.T.; Mueller-Brand, Jan; Walter, Martin A.; Briel, Matthias; Daikeler, Thomas; Tyndall, Alan; Walker, Ulrich A.; Raatz, Heike; Jayne, David; Koetter, Ina; Blockmans, Daniel; Cid, Maria C.; Prieto-Gonzalez, Sergio; Lamprecht, Peter; Salvarani, Carlo; Karageorgaki, Zaharenia; Watts, Richard; Luqmani, Raashid

2012-01-01

We aimed to assess the impact of 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the management of patients with suspected large vessel vasculitis. An international expert panel determined diagnoses and clinical management in patients with suspected large vessel vasculitis, with and without the results of 18 F-FDG PET, respectively. The accuracy of the clinical diagnosis and the resulting clinical management with and without the 18 F-FDG PET results were compared using logistic regression models. The analysis included 30 patients referred to a tertiary care centre with large vessel vasculitis and 31 controls. 18 F-FDG PET had an overall sensitivity of 73.3% [95% confidence interval (CI) 54.1-87.7%], a specificity of 83.9% (95% CI 66.3-94.5%), a positive predictive value of 81.5% (95% CI 61.9-93.7%) and a negative predictive value of 76.5% (95% CI 58.8-89.3%). The diagnostic accuracy of 18 F-FDG PET was higher in patients not receiving immunosuppressive drugs (93.3 vs 64.5%, p = 0.006). Taken in context with other available diagnostic modalities, the addition of 18 F-FDG PET increased the clinical diagnostic accuracy from 54.1 to 70.5% (p = 0.04). The addition of 18 F-FDG PET increased the number of indicated biopsies from 22 of 61 patients (36.1%) to 25 of 61 patients (41.0%) and changed the treatment recommendation in 8 of 30 patients (26.7%) not receiving immunosuppressive medication and in 7 of 31 patients (22.6%) receiving immunosuppressive medication. 18 F-FDG PET is a sensitive and specific imaging tool for large vessel vasculitis, especially when performed in patients not receiving immunosuppressive drugs. It increases the overall diagnostic accuracy and has an impact on the clinical management in a significant proportion of patients. (orig.)

18F-FDG PET/CT in Neurolymphomatosis: Report of 3 Cases

International Nuclear Information System (INIS)

Canh, Nguyen Xuan; Tan, Ngo Van; Tung, Tran Thanh; Son, Nguyen Truong; Maurea, Simone

2014-01-01

Neurolymphomatosis is a rare manifestation of non-Hodgkin lymphoma characterized by infiltration of peripheral nerves, nerve roots, plexus and cranial nerves by malignant lymphocytes. This report presents positron emission tomography/computed tomography (PET/CT)imaging with 2-deoxy-2- 18 F-fluoro-D-glucose ( 18 F-FDG) in 3 cases of non-Hodgkin lymphoma with nerve infiltration, including one newly diagnosed lymphoma, one recurrent lymphoma in previous nerve lesions and one newly recurrent lymphoma. PET/CT could reveal the affected neural structures including cranial nerves, spinal nerve roots, brachial plexus, cervicothoracic ganglion, intercostal nerves, branches of the vagus nerve, lumbosacral plexus and sciatic nerves. There was relative concordance between PET/CT and MRI in detection of affected cranial nerves. PET/CT seemed to be better than MRI in detection of affected peripheral nerves. 18 F-FDG PET/CT was a whole-body imaging technique with the ability to reveal the affected cranial nerves, peripheral nerves, nerve roots and plexus in non-Hodgkin lymphoma. A thorough understanding of disease and use of advanced imaging modalities will increasingly detect neurolymphomatosis

The role of {sup 18}F-FDG PET in characterising disease activity in Takayasu arteritis

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Webb, Myles; Chambers, Anthony; AL-Nahhas, Adil; Maudlin, Lucy; Rahman, Lucy; Frank, John [Department of Nuclear Medicine, Hammersmith Hospital, Du Cane Road, W12 0HS, London (United Kingdom); Mason, Justin C. [Department of Rheumatology, Hammersmith Hospital, London (United Kingdom)

2004-05-01

Takayasu arteritis (TA) is a rare, sporadic and chronic inflammatory arteritis, which predominantly affects the aorta and its branches. Diagnosis can be difficult and there are limitations to the current diagnostic work-up. By detecting areas of active glucose metabolism present in active vasculitis, imaging with fluorine-18 fluorodeoxyglucose positron emission tomography ({sup 18}F-FDG PET) could potentially have a role in the management of TA. Our aim was to assess this role by reviewing 28 {sup 18}F-FDG PET scans performed on 18 patients suspected of having TA. All patients had full clinical and laboratory assessment, cross-sectional imaging and angiography, and 16/18 satisfied the American College of Rheumatologists' criteria for TA. {sup 18}F-FDG PET achieved a sensitivity of 92%, a specificity of 100%, and negative and positive predictive values of 85% and 100% respectively in the initial assessment of active vasculitis in TA. We conclude that {sup 18}F-FDG PET can be used to diagnose early disease, to detect active disease (even within chronic changes) and to monitor the effectiveness of treatment. (orig.)

18F-FDG PET/CT in gastric MALT lymphoma: a bicentric experience

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Albano, Domenico; Bertoli, Mattia; Ferro, Paola; Fallanca, Federico; Gianolli, Luigi; Picchio, Maria; Giubbini, Raffaele; Bertagna, Francesco

2017-01-01

The role of 18F-FDG-PET/CT in evaluating gastric MALT lymphoma is still controversial. In the literature the detection rate of 18F-FDG-PET/CT in patients with gastric MALT lymphoma is variable, and the reason for this heterogeneity is not still clear. Our aim was to investigate the particular metabolic behavior of these lymphoma. Sixty-nine patients (26 female, 43 male) with histologically confirmed gastric MALT lymphoma who underwent a 18F-FDG-PET/CT for initial staging from two centers were included. The PET images were analyzed visually and semi-quantitatively by measuring the maximum standardized uptake value (SUVmax), lesion-to-liver SUVmax ratio, and lesion-to-blood pool SUVmax ratio and compared with Ann Arbor stage, epidemiological (age, sex), histological (presence of gastritis, ulcer, H. pylori infection, plasmacytic differentiation, Ki-67 index), and morphological (tumor size, superficial lesions or mass-forming) characteristics. Thirty-six patients (52 %) had positive PET/CT (average SUVmax was 9±6.7; lesion-to-liver SUVmax ratio 3.7±2.6, lesion-to-blood pool SUVmax ratio 4.8±3.3) at the corresponding gastric lesion; the remaining 33 were not 18F-FDG-avid. In the univariate analysis, 18F-FDG avidity was significantly associated with morphological features (mass forming p<0.001 and high maximum diameter p<0.001), Ann Arbor stage (p=0.010), and Ki67 index (p<0.001) and not correlated with age, sex, presence of gastritis, ulcer, Helicobacter pylori infection, and plasmacytic differentiation. In the multivariate analysis, the correlations with gross morphological appearance, Ann Arbor stage, and Ki-67 score were confirmed. SUVmax, lesion-to-liver SUVmax ratio, and lesion-to-blood pool SUVmax ratio correlated significantly only with Ki67 index (p=0.047; p=0.012; p=0.042). 18F-FDG avidity was noted in 52 % of gastric MALT lymphoma and this avidity is correlated with gross morphological characteristics, tumor stage, and Ki-67 index. SUVmax, lesion

18F-FDG PET/CT in gastric MALT lymphoma: a bicentric experience

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Albano, Domenico; Bertoli, Mattia [Nuclear Medicine, Spedali Civili Brescia, Brescia (Italy); University Milano-Bicocca, Milan (Italy); Ferro, Paola [University Milano-Bicocca, Milan (Italy); Fallanca, Federico; Gianolli, Luigi; Picchio, Maria [IRCCS San Raffaele Scientific Institute, Department of Nuclear Medicine, Milan (Italy); Giubbini, Raffaele; Bertagna, Francesco [University of Brescia and Spedali Civili Brescia, Nuclear Medicine, Brescia (Italy)

2017-04-15

The role of 18F-FDG-PET/CT in evaluating gastric MALT lymphoma is still controversial. In the literature the detection rate of 18F-FDG-PET/CT in patients with gastric MALT lymphoma is variable, and the reason for this heterogeneity is not still clear. Our aim was to investigate the particular metabolic behavior of these lymphoma. Sixty-nine patients (26 female, 43 male) with histologically confirmed gastric MALT lymphoma who underwent a 18F-FDG-PET/CT for initial staging from two centers were included. The PET images were analyzed visually and semi-quantitatively by measuring the maximum standardized uptake value (SUVmax), lesion-to-liver SUVmax ratio, and lesion-to-blood pool SUVmax ratio and compared with Ann Arbor stage, epidemiological (age, sex), histological (presence of gastritis, ulcer, H. pylori infection, plasmacytic differentiation, Ki-67 index), and morphological (tumor size, superficial lesions or mass-forming) characteristics. Thirty-six patients (52 %) had positive PET/CT (average SUVmax was 9±6.7; lesion-to-liver SUVmax ratio 3.7±2.6, lesion-to-blood pool SUVmax ratio 4.8±3.3) at the corresponding gastric lesion; the remaining 33 were not 18F-FDG-avid. In the univariate analysis, 18F-FDG avidity was significantly associated with morphological features (mass forming p<0.001 and high maximum diameter p<0.001), Ann Arbor stage (p=0.010), and Ki67 index (p<0.001) and not correlated with age, sex, presence of gastritis, ulcer, Helicobacter pylori infection, and plasmacytic differentiation. In the multivariate analysis, the correlations with gross morphological appearance, Ann Arbor stage, and Ki-67 score were confirmed. SUVmax, lesion-to-liver SUVmax ratio, and lesion-to-blood pool SUVmax ratio correlated significantly only with Ki67 index (p=0.047; p=0.012; p=0.042). 18F-FDG avidity was noted in 52 % of gastric MALT lymphoma and this avidity is correlated with gross morphological characteristics, tumor stage, and Ki-67 index. SUVmax, lesion

A Pilot Study for the Feasibility of F-18 FLT-PET in Locally Advanced Breast Cancer: Comparison with F-18 FDG-PET

International Nuclear Information System (INIS)

Lee, Jai Hyuen; Kim, Euy Nyong; Hong, Il Ki

2008-01-01

The aim of this study was to investigate the feasibility of 3'-[F-18]fluoro-3'-deoxythymidine positron emission tomography(FLT-PET) for the detection of locally advanced breast cancer and to compare the degree of FLT and 2'-deoxy-2'-[F-18]fluoro-d-glucose(FDG) uptake in primary tumor, lymph nodes and other normal organs. The study subjects consisted of 22 female patients (mean age; 42±6 years) with biopsy-confirmed infiltrating ductal carcinoma between Aug 2005 and Nov 2006. We performed conventional imaging workup, FDG-PET and FLT PET/CT. Average tumor size measured by MRI was 7.2±3.4 cm. With visual analysis, Tumor and Lymph node uptakes of FLT and FDG were determined by calculation of standardized uptake value (SUV) and tumor to background (TB) ratio. We compared FLT tumor uptake with FDG tumor uptake. We also investigated the correlation between FLT tumor uptake and FDG tumor uptake and the concordant rate with lymph node uptakes of FLT and FDG. FLT and FDG uptakes of bone marrow and liver were measured to compare the biodistribution of each other. All tumor lesions were visually detected in both FLT-PET and FDG-PET. There was no significant correlation between maximal tumor size by MRI and SUVmax of FLT-PET or FDG-PET (p>0.05). SUVmax and SUV75 (average SUV within volume of interest using 75% isocontour) of FLT-PET were significantly lower than those of FDG-PET in primary tumor (SUVmax; 6.3±5.2 vs 8.3±4.9, p=0.02 / SUV75; 5.3±4.3 vs 6.9 4.2, p=0.02). There is significant moderate correlation between uptake of FLT and FDG in primary tumor (SUVmax; rho=0.450, p=0.04 / SUV75; rho=0.472, p=0.03). But, TB ratio of FLT-PET was higher than that of FDG-PET(11.7±7.7 vs 6.3±3.8, p=0.001). The concordant rate between FLT and FDG uptake of lymph node was reasonably good (33/34). The FLT SUVs of liver and bone marrow were 4.2±1.2 and 8.3±4.9. The FDG SUVs of liver and bone marrow were 1.8±0.4 and 1.6±0.4. The uptakes of FLT were lower than those of FDG, but all

The Usefulness of {sup 18}F-FDG PET as a Cancer Screening Test

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Ko, Doo Heun; Choi, Joon Young; Song, Yun Mi; Lee, Su Jin; Kim, Young Hwan; Lee, Kyung Han; Kim, Byung Tae; Lee, Moon Kyu [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2008-12-15

The aim of this study was to evaluate the usefulness of whole body positron emission tomography (PET) using {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) for cancer screening in asymptomatic subjects. The subjects were 1,762 men and 259 women who voluntarily underwent {sup 18}F-FDG PET for cancer screening as a part of a routine health examination. Final diagnosis was decided by other diagnostic studies, pathological results or clinical follow-up for 1 year. Of 2,021 subjects, 40 (2.0%) were finally proved to have cancer. Abnormal focal {sup 18}F-FDG uptake suggesting malignancy was found in 102 subjects (5.0%). Among them, 21 subjects (1.0%) were proved to have cancer. Other tests in the routine health examination could not find 9 of 21 cancers (42.9%) detected by PET. The sensitivity, specificity, positive predictive value, and negative predictive value of PET for cancer screening were 52.5%, 95.9%, 20.6%, and 99.0%, respectively. Pathologies of cancers missed on PET were adenocarcinoma (n=9; 3 colon cancers, 3 prostate cancers, 2 stomach cancers, and 1 rectal cancer), differentiated thyroid carcinoma (n=6), bronchioalveolar cell carcinoma (n=2), urinary bladder cancer (n=1), and melanoma (n=1). More than half of cancers which were not detected by PET were smaller than 1 cm in diameter. {sup 18}F-FDG PET might be useful for cancer screening in asymptomatic subjects due to its high specificity and negative predictive value and play a supplementary role to the conventional health check-up, but it could not replace due to limited sensitivity for urological cancers, small-sized tumors and some hypometaboic cancers.

Monitoring Vasculitis with 18F-FDG PET

International Nuclear Information System (INIS)

Jan BUCERIUS, Jan

2016-01-01

Whereas in the past the term “vasculitis” was most frequently used in context with systemic vasculitides, such as the large vessel vasculitides (LVV) Takayasa arteritis and giant cell arteritis, characterized by inflammation of blood vessel walls, it nowadays comprises also inflammatory changes of the vessel wall as a substantial part of the atherosclerotic disease process. Implementing non-invasive imaging techniques, such as computed tomography angiography (CTA), magnetic resonance angiography (MRA) as well as positron emission tomography (PET) in the diagnostic algorithm of atherosclerosis and LVV, depicts a promising step towards an earlier detection with a, consecutively, improved therapeutic approach and potentially prognostic benefit in patients suffering from vasculitis. Mainly molecular imaging with 18F-fluorodeoxyglucose (FDG) PET seems to be promising in offering an early and sensitive identification of inflammatory changes in both, atherosclerosis and LVV. This review will therefore provide an overview on the diagnostic performance and clinical relevance of FDG-PET in monitoring vasculitis in atherosclerosis and LVV, with a focus on LVV.

A Cochrane review on brain [{sup 18}F]FDG PET in dementia: limitations and future perspectives

Energy Technology Data Exchange (ETDEWEB)

Morbelli, Silvia [University of Genoa, Nuclear Medicine Unit, IRCCS San Martino - IST, Department of Health Sciences, Genoa (Italy); Garibotto, Valentina [Geneva University and Geneva University Hospitals, Department of Medical Imaging, Geneva (Switzerland); Giessen, Elsmarieke van de [University of Amsterdam, Department of Nuclear Medicine, Academic Medical Center, Amsterdam (Netherlands); Arbizu, Javier [University of Navarra, Nuclear Medicine Department, Clinica Universidad de Navarra, Pamplona (Spain); Chetelat, Gael [Inserm, U1077, Caen (France); Universite de Caen Basse-Normandie, UMR-S1077, Caen (France); Ecole Pratique des Hautes Etudes, UMR-S1077, Caen (France); CHU de Caen, U1077, Caen (France); Drezgza, Alexander [Universitaet zu Koeln, Klinik und Poliklinik fuer Nuklearmedizin, Koeln (Germany); Hesse, Swen [University of Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Lammertsma, Adriaan A. [VU University Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam (Netherlands); Law, Ian [Copenhagen University Hospital, Rigshospitalet, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen (Denmark); Pappata' , Sabina [Institute of Biostructure and Bioimaging, CNR, Naples (Italy); Payoux, Pierre [INSERM UMR 825 Toulouse Univ., Imagerie Cerebrale et Handicaps Neurologiques (France); Pagani, Marco [Institute of Cognitive Sciences and Technologies, CNR, Rome (Italy); Karolinska Hospital, Department of Nuclear Medicine, Stockholm (Sweden); Collaboration: European Association of Nuclear Medicine

2015-09-15

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

{sup 18}F-FDG uptake on PET in primary mediastinal non-thymic neoplasm: A clinicopathological study

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Kaira, Kyoichi, E-mail: kkaira1970@yahoo.co.jp [Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Abe, Masato [Division of Pathology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Nakagawa, Kazuo; Ohde, Yasuhisa; Okumura, Takehiro [Division of Thoracic Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Takahashi, Toshiaki; Murakami, Haruyasu; Shukuya, Takehito; Kenmotsu, Hirotsugu; Naito, Tateaki [Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Hayashi, Isamu [Division of Pathology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Oriuchi, Noboru [Department of Diagnostic Radiology and Nuclear medicine, Gunma University Graduate School of Medicine, Showa-machi, Maebashi 371-8511, Gunma (Japan); Endo, Masahiro [Division of Diagnostic Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Kondo, Haruhiko [Division of Thoracic Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Nakajima, Takashi [Division of Pathology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan); Yamamoto, Nobuyuki [Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777 (Japan)

2012-09-15

Background: The usefulness of 2-[{sup 18}F]-fluoro-2-deoxy-D-glucose ({sup 18}F-FDG) positron emission tomography (PET) has been investigated in thymic epithelial tumors. However, little is known about PET imaging of {sup 18}F-FDG in primary non-thymic mediastinal neoplasms. The aim of this study is to explore the clinicopathological significance of {sup 18}F-FDG PET in primary mediastinal (non-thymic) neoplasms. Methods: Twenty-one patients with mediastinal neoplasms who underwent {sup 18}F-FDG PET before treatment were included in this study. Tumor sections were stained by immunohistochemistry for glucose transporter 1 (Glut1); glucose transporter 3 (Glut3); hypoxia-inducible factor-1 alpha (HIF-1α); hexokinase I; vascular endothelial growth factor (VEGF); microvessels (CD34); epidermal growth factor receptor (EGFR); Akt/mTOR signaling pathway (p-Akt and p-mTOR); cell cycle control (p53). Results: Seventeen of 21 patients were imaged on PET system using {sup 18}F-FDG, but 4 patients with a histology of cyst showed nothing abnormal in PET scans. The histology of the resected tumors was as follows: 6 schwannoma, 3 teratoma, 4 cyst, 3 sarcoma, 1 undifferentiated carcinoma, 1 seminoma, 1 mediastinal goiter, 1 ganglioneuroma, and 1 Hodgkin lymphoma. {sup 18}F-FDG uptake was significantly correlated with Glut1, HIF-1α, EGFR, p-Akt and p-S6K. These biomarkers were highly expressed in schwannoma, teratoma and high grade malignancies, whereas all patients with cyst and ganglioneuroma had no positive expression of these biomarkers. High uptake of {sup 18}F-FDG was significant associated with Glut1, VEGF, EGFR, p-Akt, p-S6K and tumor maximal size. Conclusion: The amount of {sup 18}F-FDG uptake in primary mediastinal non-thymic neoplasms is determined by the presence of glucose metabolism (Glut1), hypoxia (HIF-1α) and upstream components of HIF-1α (EGFR, p-Akt and p-S6K)

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

International Nuclear Information System (INIS)

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

Significance of 18F-FDG PET/CT imaging in the evaluation of the efficacy of lymphoma

Institute of Scientific and Technical Information of China (English)

CHEN Chengcheng; WANG Zhengguang; CHENG Nan

2014-01-01

To evaluate the 18F-labeled deoxyglucose (18F-FDG) PET/CT imaging in the evaluation of the efficacy of ly-mphoma significance.Methods:42 cases of our hospital patients with malignant lymphoma for 2-5 times 18F-FDG PET/CT imaging results in the treatment process, and the treatment process simple CT results were compared and analyzed, the final results were confirmed by pathology and clinical. Results:The lesions were found in153,including 141 malignant, benign 12, sensitivity, specificity, and accuracy evaluating of lymphoma treatment effect of 18F-FDG PET/CT were, 99.30%, 91.67%, 98.70%, were significantly better than CT examination (P18F-FDG PET/CT in the evaluation of ly-mphoma treatment was superior to CT scan purely, it is an effective means of monitoring the efficacy of lymphoma, it can provide the basis for effective treatment programs in clinical work.

[18F]FDG-PET scan in patients with fasting hyperglycemia

International Nuclear Information System (INIS)

BELOHLAVEK, Otakar; JARUSKOVA, Monika

2016-01-01

It is generally accepted that a non-fasting state reduces [18F]FDG-PET quality, but the significance of higher levels of fasting blood glucose has aroused some doubts over time. The aim of this work was to provide further evidence to clarify this issue and its impact on the handling of hyper glycemic patients in daily routine. Muscle and liver standardized uptake values (SUV) and their ratio, tumor SUV and the frequency of positive PET findings were retrospectively analyzed in 116 hyper glycemic (HG) patients (>11 mmol/L), in 116 patients with slightly elevated glycemia (SEG) (5.6-7.0 mmol/L) and in 116 normoglycemic (NG) patients (4.7 mmol/L). No significant difference was found in the muscle to liver ratio, in muscle SUV and in the frequency of positive PET findings among HG, SEG and NG patients. HG patients exhibited ~10% higher liver SUV in comparison to SEG and NG patients; a positive correlation (r=0.2849) was found between liver SUV and blood glucose levels. Significantly higher tumor SUV was present in SEG patients. We did not confirm that hyperglycemia in a fasting state negatively influences the diagnostic quality of [18F]FDG-PET. The positive correlation between liver SUV and blood glucose levels is clinically negligible and might be explained by increased fasting hepatic gluconeogenesis in diabetics. Our data encourage the performance of [18F]FDG-PET investigations under fasting conditions, regardless of the mild to medium elevation of fasting blood glucose level.

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

International Nuclear Information System (INIS)

Mikosch, P.; Gallowitsch, H.-J.; Kresnik, E.; Lind, P.; Wuertz, F.G.

2003-01-01

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

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

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Nasu, Seiji; Hata, Takashi; Nakajima, Tooru [Yokohama Stroke and Brain Center (Japan); Suzuki, Yutaka [Tokai Univ., Isehara, Kanagawa (Japan). Hospital

2002-05-01

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

The utility of 18F-FDG PET/CT for diagnosis and adjustment of therapy in patients with active chronic sarcoidosis.

Science.gov (United States)

Sobic-Saranovic, Dragana; Grozdic, Isidora; Videnovic-Ivanov, Jelica; Vucinic-Mihailovic, Violeta; Artiko, Vera; Saranovic, Djordjije; Djuric-Stefanovic, Aleksandra; Masulovic, Dragan; Odalovic, Strahinja; Ilic-Dudvarski, Aleksandra; Popevic, Spasoje; Pavlovic, Smiljana; Obradovic, Vladimir

2012-10-01

The purpose of this study was to assess the utility of (18)F-FDG PET/CT for detection of inflammation in granulomatous sites and management of patients with chronic sarcoidosis. The 3 specific aims were to assess differences between (18)F-FDG PET/CT and multidetector CT (MDCT) findings, to compare (18)F-FDG PET/CT results with serum levels of angiotensin-converting enzyme (ACE), and to determine whether (18)F-FDG PET/CT findings are associated with the decision to change therapy. We studied 90 sarcoidosis patients (mean age ± SD, 47 ± 12 y; 32 men and 58 women) with persistent symptoms who were referred for (18)F-FDG PET/CT evaluation to assess the extent of inflammation. They also underwent MDCT and measurement of serum ACE level. After the follow-up (12 ± 5 mo after (18)F-FDG PET/CT), the clinical status and changes in therapy were analyzed. (18)F-FDG PET/CT detected inflammation in 74 patients (82%) (maximum standardized uptake value, 8.1 ± 3.9). MDCT was positive for sarcoidosis in 6 additional patients (80, 89%). The difference between the 2 methods was not significant (P = 0.238, McNemar test), and their agreement was fair (κ = 0.198). Although ACE levels were significantly higher in patients with positive than negative (18)F-FDG PET/CT results (P = 0.002, Mann-Whitney test), 38 patients (51%) with positive (18)F-FDG PET/CT results had normal ACE levels. The therapy was initiated or changed in 73 out of 90 patients (81%). Both univariate and multivariate logistic regression analyses indicated that positive (18)F-FDG PET/CT results were significantly (P changes in therapy, with no contribution from age, sex, ACE level, CT results, or previous therapy. Our results indicate that (18)F-FDG PET/CT is a useful adjunct to other diagnostic methods for detecting active inflammatory sites in chronic sarcoidosis patients with persistent symptoms, especially those with normal ACE levels. (18)F-FDG PET/CT proved advantageous for determining the spread of active

Adrenergic pathway activation enhances brown adipose tissue metabolism: A [18 F]FDG PET/CT study in mice

International Nuclear Information System (INIS)

Mirbolooki, M. Reza; Upadhyay, Sanjeev Kumar; Constantinescu, Cristian C.; Pan, Min-Liang; Mukherjee, Jogeshwar

2014-01-01

Objective: Pharmacologic approaches to study brown adipocyte activation in vivo with a potential of being translational to humans are desired. The aim of this study was to examine pre- and postsynaptic targeting of adrenergic system for enhancing brown adipose tissue (BAT) metabolism quantifiable by [ 18 F]fluoro-2-deoxyglucose ([ 18 F]FDG) positron emission tomography (PET)/computed tomography (CT) in mice. Methods: A β 3 -adrenoreceptor selective agonist (CL 316243), an adenylyl cyclase enzyme activator (forskolin) and a potent blocker of presynaptic norepinephrine transporter (atomoxetine), were injected through the tail vein of Swiss Webster mice 30 minutes before intravenous (iv) administration of [ 18 F]FDG. The mice were placed on the PET/CT bed for 30 min PET acquisition followed by 10 min CT acquisition for attenuation correction and anatomical delineation of PET images. Results: Activated interscapular (IBAT), cervical, periaortic and intercostal BAT were observed in 3-dimentional analysis of [ 18 F]FDG PET images. CL 316243 increased the total [ 18 F]FDG standard uptake value (SUV) of IBAT 5-fold greater compared to that in placebo-treated mice. It also increased the [ 18 F]FDG SUV of white adipose tissue (2.4-fold), and muscle (2.7-fold), as compared to the control. There was no significant difference in heart, brain, spleen and liver uptakes between groups. Forskolin increased [ 18 F]FDG SUV of IBAT 1.9-fold greater than that in placebo-treated mice. It also increased the [ 18 F]FDG SUV of white adipose tissue (2.2-fold) and heart (5.4-fold) compared to control. There was no significant difference in muscle, brain, spleen, and liver uptakes between groups. Atomoxetine increased [ 18 F]FDG SUV of IBAT 1.7-fold greater than that in placebo-treated mice. There were no significant differences in all other organs compared to placebo-treated mice except liver (1.6 fold increase). A positive correlation between SUV levels of IBAT and CT Hounsfield unit (HU

Value of dual-phase 18F-FDG PET/CT in preoperative staging of bladder cancer%18F-FDG PET/CT双时相显像在膀胱癌术前分期中的临床价值

Institute of Scientific and Technical Information of China (English)

李洪生; 吴湖炳; 王巧愚; 韩彦江; 王全师

2014-01-01

目的：探讨18F-FDG PET/CT双时相显像在膀胱癌术前分期中的应用价值。方法2003年5月~2012年5月进行18F-FDG PET/CT检查的膀胱癌初诊患者73例，男54例，女19例，年龄58.7（41~80）岁。所有患者18F-FDG PET/CT常规全身显像后，口服40 mg呋塞米并多饮水，多次排尿，服呋塞米后约2 h憋尿充盈膀胱，再进行18F-FDG PET/CT盆腔延迟显像。所有患者于18F-FDG PET/CT检查后1周内进行手术治疗，将PET/CT与手术病理学检查结果进行对比分析，评价18F-FDG PET/CT双时相显像在膀胱癌术前分期中的应用价值。结果18F-FDG PET/CT双时相显像对膀胱癌原发灶的T分期与病理分期符合率为63.0%（46/73），其中pT4期膀胱癌的分期符合率为100%（7/7）；另外检出75.0%（6/8）的淋巴结转移灶，100%（4/4）的远隔器官转移灶和100%（4/4）原发性第二种恶性肿瘤病灶。结论本研究结果表明18F-FDG PET/CT双时相显像在T分期方面，尽管对pTa、pT1、pT2、pT3期膀胱癌的T分期价值不大，但对pT4期膀胱癌的T分期可能有重要的应用价值；在膀胱癌的N分期、M分期及发现第二种原发癌方面也可能有重要的应用价值。%Objective To investigate the clinical value of dual-phase 18F-FDG PET/CT with oral diuretics in preoperative staging of bladder cancer. Methods The imaging data were analyzed of 73 patients with bladder cancer undergoing preoperative dual-phase 18F-FDG PET/CT with oral diuretic between May, 2003 and May, 2012. All the patients underwent whole-body PET/CT scan 60 min after intravenous injection of 270-350 MBq of 18F-FDG. Additional delayed pelvic PET/CT images were acquired after forced diuresis using oral furosemide (40 mg). All the patients underwent subsequent radical cystectomy, and 18F-FDG PET/CT findings were compared with the histopathologic results to evaluate the value of dual-phase 18F-FDG PET/CT in preoperative staging. Results The

Diagnostic value of 18F-FDG-PET/CT for the follow-up and restaging of soft tissue sarcomas in adults.

Science.gov (United States)

Kassem, T W; Abdelaziz, O; Emad-Eldin, S

2017-10-01

The purpose of this study was to evaluate the clinical utility of 2-[ 18 F] fluoro-2-deoxy-D-glucose ( 18 FDG) positron emission tomography (PET)/computed tomography (CT) ( 18 F-FDG-PET/CT) in the follow-up of adult patients with soft tissue sarcomas. We prospectively evaluated 37 consecutive patients with known soft tissue sarcoma with 18 F-FDG-PET/CT examination for suspected recurrence of disease. They were 21 men and 16 women with a mean age of 49.6±10.6 (SD) years (range, 34-75years). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 18 F-FDG-PET/CT examination were calculated on a per patient basis. 18 F-FDG-PET/CT showed an overall diagnostic accuracy of 91.8%, sensitivity of 90% and a specificity of 100%. The positive predictive value and negative predictive value were 100 and 70%, respectively. The 18 F-FDG-PET/CT interpretations were correct in 34/37 patients (91.8%). Incorrect interpretations occurred in three patients (8.1%). Reasons for false negative findings were low 18 F-FDG uptake of local recurrence in one patient and low 18 F-FDG uptake of subcentimetric inguinal lymph node metastases. 18 F-FDG-PET/CT has a high diagnostic value in the follow-up of patients with soft tissue sarcoma. Copyright © 2017 Editions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

PET imaging of cerebral metabolic change in tinnitus using 18F-FDG

International Nuclear Information System (INIS)

Tian Jiahe; Wang Hongtian; Yin Dayi; Yao Shulin; Shao Mingzhe; Yang Weiyan; Jiang Sichang

2000-01-01

Tinnitus is an auditory disorder hardly assessable by clinical technology. PET imaging of the brain in 13 cases with and 10 without tinnitus was undertaken at 40 min after injection of 280-440 MBq 18 F-FDG. To ensure the quality of the PET study, all cases followed a normalized procedure with visual and auditory blockage. CT/MRI imaging and routine acoustic tests were carried out in all subjects. PET revealed that an increased uptake of 18 F-FDG at left med-temporal lobe (primary auditory center, PAC) present exclusively in tinnitus, regardless the side of hearing hallucination. Significant asymmetry was noted between left and right PAC, but not at other cortex area. While control cases showed no asymmetric uptake between two hemispheres. The abnormal PAC uptake did not respond to external pure sound stimulus, nor did it relate to the severity of hearing loss assessed by acoustic tests. No anatomical or morphological alteration could be proven on CT/MRI. In conclusion, PET/ 18 F-FDG objectively revealed an increased metabolic change at left PAC in tinnitus, which is of diagnostic value; and there is evidence suggesting tinnitus is most likely induced by a functional change in the brain

(18)F-FDG PET/CT Findings in a Patient with Chikungunya Virus Infection

DEFF Research Database (Denmark)

Rose, Michala Vaaben; Kjaer, Anna Sophie L; Markova, Elena

2017-01-01

We present a case demonstrating the diagnostic work-up and follow-up of a patient with Chikungunya infection. An (18)F-FDG PET/CT performed four weeks after debut of symptoms revealed pathological (18)F-FDG uptake in enlarged lymph nodes on both side of the diaphragm, and inflammation of both...

[18F]FDG PET accurately differentiates infected and non-infected non-unions after fracture fixation

International Nuclear Information System (INIS)

Wenter, Vera; Albert, Nathalie L.; Brendel, Matthias; Fendler, Wolfgang P.; Bartenstein, Peter; Cyran, Clemens C.; Friederichs, Jan; Mueller, Jan-Philipp; Militz, Matthias; Hungerer, Sven; Hacker, Marcus

2017-01-01

Complete fracture healing is crucial for good patient outcomes. A major complication in the treatment of fractures is non-union. The pathogenesis of non-unions is not always clear, although implant-associated infections play a significant role, especially after surgical treatment of open fractures. We aimed to evaluate the value of [ 18 F]FDG PET in suspected infections of non-union fractures. We retrospectively evaluated 35 consecutive patients seen between 2000 and 2015 with suspected infection of non-union fractures, treated at a level I trauma center. The patients underwent either [ 18 F]FDG PET/CT (N = 24), [ 18 F]FDG PET (N = 11) plus additional CT (N = 8), or conventional X-ray (N = 3). Imaging findings were correlated with final diagnosis based on intraoperative culture or follow-up. In 13 of 35 patients (37 %), infection was proven by either positive intraoperative tissue culture (N = 12) or positive follow-up (N = 1). [ 18 F]FDG PET revealed 11 true-positive, 19 true-negative, three false-positive, and two false-negative results, indicating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 85 %, 86 %, 79 %, 90 %, and 86 %, respectively. The SUV max was 6.4 ± 2.7 in the clinically infected group and 3.0 ± 1.7 in the clinically non-infected group (p <0.01). The SUV ratio was 5.3 ± 3.3 in the clinically infected group and 2.6 ± 1.5 in the clinically non-infected group (p <0.01). [ 18 F]FDG PET differentiates infected from non-infected non-unions with high accuracy in patients with suspected infections of non-union fractures, for whom other clinical findings were inconclusive for a local infection. [ 18 F]FDG PET should be considered for therapeutic management of non-unions. (orig.)

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

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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.

18F-FDG PET/CT显像对乳腺癌术后复发及转移的诊断价值%18F-FDG PET/CT in detection of recurrence and metastasis of breast cancer

Institute of Scientific and Technical Information of China (English)

林丽莉; 吴湖炳; 王全师

2011-01-01

目的 探讨18F-脱氧葡萄糖正电子发射体层摄影术(FDG PET)/CT显像对乳腺癌术后复发、转移的诊断价值.方法 对乳腺癌术后患者104例进行全身18F-FDG PET/CT显像检查.复发或转移灶依据手术或活组织病理学检查、多种影像学检查及临床随访确诊,随访时间大于6个月.结果 104例患者中,肿瘤复发、转移52例.以患者为单位计算,18F-FDG PET/CT诊断乳腺癌术后复发和(或)转移的灵敏度为100%,特异性为98.1%,准确性为99.0%,阳性预测值为98.1%,阴性预测值为100%.以病灶为单位计算,18F-FDG PET/CT诊断乳腺癌术后复发和(或)转移的灵敏度为98.3%,特异性为75.0%,准确性为96.8%,阳性预测值为98.3%,阴性预测值为75.0%.18F-FDG PET/CT显像使8例(15.4%)患者改变了临床再分期,其中7例提高了临床再分期、1例降低了临床再分期.结论 18F-FDG PET/CT对乳腺癌术后复发和(或)转移的诊断具有重要临床价值.%Objective To evaluate the value of positron emission tomography/computed tomography(PET/CT)with 18 F-fluoro deoxy-glucose(18 F-FDG)in detecting recurrence and metastasis of breast cancer. Methods 18 F-FDG PET/CT was studied in 104 patients with breast cancer after surgery. The diagnosis of recurrent tumor and ( or) metastasts was based on pathoiogic examination, multi-modality imagings and clinical follow-up for more than 6 months. The diagnostic competent of PET/CT was assessed by comparing with the clinical findings. Results In total 104 patients, recurrent and(or)metastasis tumors were proved in 52 patients. By the patient-based unit, the sensitivity, specificity,accuracy,positive predictive value and negatice predictive value of PET/CT in detecting recurrent tumor and/or metastasis were 100％ , 98. 1％ , 99. 0％ , 98. 1％ and 100 ％ , respectively. By the lesions-based unit, the sensitivity, specificity, accuracy, positive predictive value and negatice predictive value of PET/CT were 98. 2％ , 75

18F-FDG PET in Parkinsonism: Differential Diagnosis and Evaluation of Cognitive Impairment.

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Meyer, Philipp T; Frings, Lars; Rücker, Gerta; Hellwig, Sabine

2017-12-01

Accurate differential diagnosis of parkinsonism is of paramount therapeutic and prognostic importance. In addition, with the development of invasive therapies and novel disease-specific therapies, strategies for patient enrichment in trial populations are of growing importance. Imaging disease-specific patterns of regional glucose metabolism with PET and 18 F-FDG allows for a highly accurate distinction between Parkinson disease (PD) and atypical parkinsonian syndromes, including multiple-system atrophy, progressive supranuclear palsy, and corticobasal degeneration. On the basis of a preliminary metaanalysis of currently available studies with inclusion of multiple disease groups, we estimated that the diagnostic sensitivity and specificity for visual PET readings supported by voxel-based statistical analyses for diagnosis of atypical parkinsonian syndromes are 91.4% and 90.6%, respectively. The diagnostic specificity of 18 F-FDG PET for diagnosing multiple-system atrophy, progressive supranuclear palsy, and corticobasal degeneration was consistently shown to be high (>90%), whereas sensitivity was more variable (>75%). It is increasingly acknowledged that cognitive impairment represents a major challenge in PD, with mild cognitive impairment being a prodromal stage of PD with dementia (PDD). In line with clinical and neuropsychologic studies, recent PET studies demonstrated that posterior cortical dysfunction in nondemented PD patients precedes cognitive decline and the development of PDD by several years. Taken together, the current literature underscores the utility of 18 F-FDG PET for diagnostic evaluation of parkinsonism and the promising role of 18 F-FDG PET for assessment and risk stratification of cognitive impairment in PD. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

Tumor aggressiveness and patient outcome in cancer of the pancreas assessed by dynamic 18F-FDG PET/CT.

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Epelbaum, Ron; Frenkel, Alex; Haddad, Riad; Sikorski, Natalia; Strauss, Ludwig G; Israel, Ora; Dimitrakopoulou-Strauss, Antonia

2013-01-01

This study aimed to assess the role of a quantitative dynamic PET model in pancreatic cancer as a potential index of tumor aggressiveness and predictor of survival. Seventy-one patients with (18)F-FDG-avid adenocarcinoma of the pancreas before treatment were recruited, including 27 with localized tumors (11 underwent pancreatectomy, and 16 had localized nonresectable tumors) and 44 with metastatic disease. Dynamic (18)F-FDG PET images were acquired over a 60-min period, followed by a whole-body PET/CT study. Quantitative data measurements were based on a 2-compartment model, and the following variables were calculated: VB (fractional blood volume in target area), K(1) and k(2) (kinetic membrane transport parameters), k(3) and k(4) (intracellular (18)F-FDG phosphorylation and dephosphorylation parameters, respectively), and (18)F-FDG INF (global (18)F-FDG influx). The single significant variable for overall survival (OS) in patients with localized disease was (18)F-FDG INF. Patients with a high (18)F-FDG INF (>0.033 min(-1)) had a median OS of 6 and 5 mo for nonresectable and resected tumors, respectively, versus 15 and 19 mo for a low (18)F-FDG INF in nonresectable and resected tumors, respectively (P measured by dynamic PET in newly diagnosed pancreatic cancer correlated with the aggressiveness of disease. The (18)F-FDG INF was the single most significant variable for OS in patients with localized disease, whether resectable or not.

18F-FDG PET/CT在宫颈癌诊断中的应用%Application of 18F-FDG PET/CT for the diagnosis of cervical cancer

Institute of Scientific and Technical Information of China (English)

周文兰; 吴湖炳; 王全师; 叶香华

2008-01-01

Objective The purpose of this study was to evaluate the clinical value of 18F-fluorodeoxyglucose (FDG) PET/CT for staging and re-staging cervical cancer cases. Methods This retrospective study included 88 patients. Of the 88 patients, 19 were primary cervical cancer, 11 were benign cervical tumor and 58 were cervical cancer patients with post-treatment surveillance. All had either whole body or abdominal-pelvic FDG PET/CT imaging. The diagnosis was established according to the pathologic results of surgery or biopsy, and (or) multi-modality imaging and clinical follow-up for at least six months. Results For initial diagnosis of cervical cancer, the sensitivity, specificity and accuracy of FDG PET/CT were 17/19(89.5%),10/11(90.9%) and 27/30(90.0% ) respectively. For re-staging cervical cancer, the sensitivity, specificity and accuracy of FDG PET/CT were 10/11(90.9%),47/47(100.0% ) and 57/58(98.3%) respectively. In all, 41 had metastases. The sensitivity, specificity and accuracy of FDG PET/CT detecting metastases were 92.7%,88.9% and 90.9% respectively. Of the metastatic sites, 66.3% were abdominal-pelvic lymph nodes, 26.8% of the metastatic lymph nodes were detected with diameters leas than 1.0cm. Twenty-two of twenty seven (28.6%) patients were identified to have extra-pelvic lesions after PET/CT and were then changed their treatment plans. Conclusions 18F-FDG PET/CT is useful in staging and re-staging cervical cancer patients. PET/CT is of great value in identifying small lesions and also in detecting extra-pelvic lesions.%目的 探讨18F-脱氧葡萄糖(FDG) PET/CT在宫颈癌诊断及其复发、转移灶探测中的应用价值.方法 88例患者行腹部或全身18F-FDG PET/CT显像,其中初诊者30例(宫颈良性病变11例,宫颈癌19例),宫颈癌治疗后58例.病灶根据病理检查、多种影像诊断技术及临床随访确诊,随访时间均为6个月～3年.结果 30例初诊者中,PET

F-18 FDG PET/CT in 26 patients with SAPHO syndrome: a new vision of clinical and bone scintigraphy correlation.

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Sun, Xiaochuan; Li, Chen; Cao, Yihan; Shi, Ximin; Li, Li; Zhang, Weihong; Wu, Xia; Wu, Nan; Jing, Hongli; Zhang, Wen

2018-05-22

Whole-body bone scintigraphy (WBBS) and MRI are widely used in assessment of patients with synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome. However, the value of F-18 fluorodeoxyglucose-positron emission tomography/computed tomography ( 18 F-FDG PET/CT) in SAPHO syndrome was unclear. The aim of this study was to characterize the manifestation of SAPHO syndrome on 18 F-FDG PET/CT and explore its relationship with clinical symptoms and WBBS. Twenty-six patients who suffered from SAPHO syndrome and had undergone whole-body 18 F-FDG PET/CT were recruited in Peking Union Medical College Hospital from 2004 to 2016. Clinical manifestations and laboratory findings were recorded for all patients. Imaging data on 18F-FDG PET/CT and WBBS were collected and analyzed retrospectively. All the 26 patients (20 females and 6 males) exhibited skeletal abnormalities on 18 F-FDG PET/CT. Multiple skeletal lesions affecting the anterior chest wall or spine with low to moderate 18 F-FDG uptake and coexistence of osteolysis and osteosclerosis presented as the typical features of SAPHO syndrome. Sixteen (61.5%) patients had abnormal 18 F-FDG uptake outside the osteoarticular system. PET scan had moderate to substantial agreement with CT and WBBS in revealing lesions in the anterior chest wall and axial skeleton. Nonetheless, the correlation between increased 18 F-FDG uptake and clinical symptoms was weak. SAPHO syndrome exhibits characteristic features on 18 F-FDG PET/CT. It showed comparable capacity in revealing skeletal lesions with bone scintigraphy.

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

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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

Whole-body MRI versus 18F-FDG PET/CT for pretherapeutic assessment and staging of lymphoma: a meta-analysis

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Wang D

2018-06-01

Full Text Available Danyang Wang,1 Yanlei Huo,1 Suyun Chen,1 Hui Wang,1 Yingli Ding,2 Xiaochun Zhu,3 Chao Ma1,4 1Department of Nuclear Medicine, Affiliated XinHua Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China; 2Department of Nuclear Medicine, Affiliated Third People’s Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China; 3Department of Nuclear Medicine, Affiliated Ninth People’s Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China; 4Department of Nuclear Medicine, Tenth People’s Hospital of Tongji University, Shanghai, China Purpose: 18F-fluorodeoxyglucose (18F-FDG positron emission tomography/computed tomography (PET/CT is the reference standard in staging of 18F-FDG-avid lymphomas; however, there is no recommended functional imaging modality for indolent lymphomas. Therefore, we aimed to compare the performance of whole-body magnetic resonance imaging (WB-MRI with that of 18F-FDG PET/CT for lesion detection and initial staging in patients with aggressive or indolent lymphoma. Materials and methods: We searched the MEDLINE, EMBASE, and CENTRAL databases for studies that compared WB-MRI with 18F-FDG PET/CT for lymphoma staging or lesion detection. The methodological quality of the studies was assessed using version 2 of the “Quality Assessment of Diagnostic Accuracy Studies” tool. The pooled staging accuracy (µ of WB-MRI and 18F-FDG PET/CT for initial staging and for assessing possible heterogeneity (χ2 across studies were calculated using commercially available software. Results: Eight studies comprising 338 patients were included. In terms of staging, the meta-analytic staging accuracies of WB-MRI and 18F-FDG PET/CT for Hodgkin lymphoma and aggressive non-Hodgkin lymphoma (NHL were 98% (95% CI, 94%–100% and 98% (95% CI, 94%–100%, respectively. The pooled staging accuracy of 18F-FDG PET/CT dropped to 87% (95% CI, 72%–97% for staging in patients with indolent lymphoma

18F-FDG PET radiomics approaches: comparing and clustering features in cervical cancer.

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Tsujikawa, Tetsuya; Rahman, Tasmiah; Yamamoto, Makoto; Yamada, Shizuka; Tsuyoshi, Hideaki; Kiyono, Yasushi; Kimura, Hirohiko; Yoshida, Yoshio; Okazawa, Hidehiko

2017-11-01

The aims of our study were to find the textural features on 18 F-FDG PET/CT which reflect the different histological architectures between cervical cancer subtypes and to make a visual assessment of the association between 18 F-FDG PET textural features in cervical cancer. Eighty-three cervical cancer patients [62 squamous cell carcinomas (SCCs) and 21 non-SCCs (NSCCs)] who had undergone pretreatment 18 F-FDG PET/CT were enrolled. A texture analysis was performed on PET/CT images, from which 18 PET radiomics features were extracted including first-order features such as standardized uptake value (SUV), metabolic tumor volume (MTV) and total lesion glycolysis (TLG), second- and high-order textural features using SUV histogram, normalized gray-level co-occurrence matrix (NGLCM), and neighborhood gray-tone difference matrix, respectively. These features were compared between SCC and NSCC using a Bonferroni adjusted P value threshold of 0.0028 (0.05/18). To assess the association between PET features, a heat map analysis with hierarchical clustering, one of the radiomics approaches, was performed. Among 18 PET features, correlation, a second-order textural feature derived from NGLCM, was a stable parameter and it was the only feature which showed a robust trend toward significant difference between SCC and NSCC. Cervical SCC showed a higher correlation (0.70 ± 0.07) than NSCC (0.64 ± 0.07, P = 0.0030). The other PET features did not show any significant differences between SCC and NSCC. A higher correlation in SCC might reflect higher structural integrity and stronger spatial/linear relationship of cancer cells compared with NSCC. A heat map with a PET feature dendrogram clearly showed 5 distinct clusters, where correlation belonged to a cluster including MTV and TLG. However, the association between correlation and MTV/TLG was not strong. Correlation was a relatively independent PET feature in cervical cancer. 18 F-FDG PET textural features might reflect the

PET/CT in patients with hepatocellular carcinoma using [{sup 18}F]fluorocholine: preliminary comparison with [{sup 18}F]FDG PET/CT

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Talbot, Jean-Noel; Gutman, Fabrice; Kerrou, Khaldoun; Grahek, Dany; Montravers, Francoise [Hopital Tenon, AP-HP, et Universite Pierre et Marie Curie, Department of Nuclear Medicine, Paris (France); Fartoux, Laetitia; Poupon, Raoul; Rosmorduc, Olivier [Hopital Saint-Antoine, AP-HP, et Universite Pierre et Marie Curie, Department of Hepatology, Paris (France); Grange, Jean-Didier [Hopital Tenon, AP-HP, et Universite Pierre et Marie Curie, Department of Hepatology, Paris (France); Ganne, Nathalie [Hopital Jean Verdier, AP-HP, Department of Hepatology, Bondy (France)

2006-11-15

The diagnostic accuracy of [{sup 18}F]fluorodeoxyglucose (FDG) PET is insufficient to characterise hepatocellular carcinoma (HCC) in liver masses and to diagnose all cases of recurrent HCC. HCC has been reported to take up [{sup 11}C]acetate, but routine use of this tracer is difficult. Choline is another tracer of lipid metabolism, present in large amounts in HCC. In a proof-of-concept study, we evaluated [{sup 18}F]fluorocholine (FCH) uptake by HCC and compared FCH PET/CT with FDG PET/CT. Twelve patients with newly diagnosed (n=8) or recurrent HCC (n=4) were prospectively enrolled. HCC was assessed by histology in eight cases and by American Association for the Study of Liver Diseases (AASLD) criteria in four cases. All patients underwent whole-body PET/CT 10 min after injection of 4 MBq/kg FCH. Within 1 week, 9 of the 12 patients also underwent whole-body FDG PET/CT 1 h after injection of 5 MBq/kg FDG. The per-patient analysis showed a detection rate of 12/12 using FCH PET/CT for both newly diagnosed and recurrent HCC. The median signal to noise ratio was 1.5{+-}0.38. There was a trend towards a higher FCH SUV{sub max} in well-differentiated HCC (15.6{+-}7.9 vs 11.9{+-}0.9, NS). Of the nine patients who underwent FCH and FDG PET/CT, all nine were positive with FCH whereas only five were positive with FDG. FCH provides a high detection rate for HCC, making it potentially useful in the initial evaluation of HCC or in the detection of recurrent disease. The favourable result of this proof-of-concept study opens the way to a phase III prospective study. (orig.)

Comparison of I-131 MIBG scintigrapy and F-18 FDG PET in neuroblastoma

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Pai, M.; Lee, S.; Yoo, E [Seoul National University College of Medicine, Seoul (Korea, Republic of)

2004-07-01

The purpose of this preliminary study was to compare the utility of metaiodobenzylguanidine(MIBG) scintigraphy and F-18 FDG PET for the detection of primary and metastatic lesions of neuroblatoma. F-18 FDG PET and I-131 MIBG scan or SPECT were performed with in 1 month of each other in 4 patients (age: 4-5, all female) with known neuroblastoma after primary treatment. In 3 of 4 patients with confirmed neuroblastoma, FDG PET and MIBG scans were concordant for the presence or absence of diseased sites. In two cases, residual abdominal masses less than 1cm in which the X -ray computed tomography showed no change in tumor volume had a simultaneous negative uptake in both MIBG scan and FDG PET. In a patient with histologic evidence of bone marrow involvement, there was no skeletal uptake of both MIBG and FDG but Tc-99m HDP bone scan revealed disseminated bone marrow involvement, while a large mediastinal primary mass of this patient showed intense MIBG and FDG uptake. In one patient whose large abdominal mass of neuroblastoma failed to accumulate FDG, MIBG uptake in the tumor was intense. We concluded that FDG PET could reveal metabolic state of primary or residual neuroblastoma as much as MIBG in majority of our cases but it did not show any advantages over MIBG or even bone scan. FDG PET had an obvious defect in detection of residual viable disease in one patient. FDG PET may not replace MIBG or bone scan for evaluation of primary or metastatic disease of neuroblastoma in the diagnostic and staging procedure from INSS recommendation.

Comparison of I-131 MIBG scintigrapy and F-18 FDG PET in neuroblastoma

International Nuclear Information System (INIS)

Pai, M.; Lee, S.; Yoo, E

2004-01-01

The purpose of this preliminary study was to compare the utility of metaiodobenzylguanidine(MIBG) scintigraphy and F-18 FDG PET for the detection of primary and metastatic lesions of neuroblatoma. F-18 FDG PET and I-131 MIBG scan or SPECT were performed with in 1 month of each other in 4 patients (age: 4-5, all female) with known neuroblastoma after primary treatment. In 3 of 4 patients with confirmed neuroblastoma, FDG PET and MIBG scans were concordant for the presence or absence of diseased sites. In two cases, residual abdominal masses less than 1cm in which the X -ray computed tomography showed no change in tumor volume had a simultaneous negative uptake in both MIBG scan and FDG PET. In a patient with histologic evidence of bone marrow involvement, there was no skeletal uptake of both MIBG and FDG but Tc-99m HDP bone scan revealed disseminated bone marrow involvement, while a large mediastinal primary mass of this patient showed intense MIBG and FDG uptake. In one patient whose large abdominal mass of neuroblastoma failed to accumulate FDG, MIBG uptake in the tumor was intense. We concluded that FDG PET could reveal metabolic state of primary or residual neuroblastoma as much as MIBG in majority of our cases but it did not show any advantages over MIBG or even bone scan. FDG PET had an obvious defect in detection of residual viable disease in one patient. FDG PET may not replace MIBG or bone scan for evaluation of primary or metastatic disease of neuroblastoma in the diagnostic and staging procedure from INSS recommendation

18F-FDG PET/CT findings of autoimmune pancreatitis

International Nuclear Information System (INIS)

Chen Wen; Yang Zhenghan; Qu Wanying; Yao Zhiming; Liu Fugeng

2013-01-01

Objective: To investigate the image characteristics and clinical application of 18 F-FDG PET/CT in autoimmune pancreatitis (AIP). Methods: The PET/CT images from six male patients (age ranging from 51 to 78(average 69) years) with AIP from 2005 to 2012 were studied retrospectively. Of the six patients,two had follow-up PET/CT images after steroid therapy. The morphologic abnormality was visually analyzed and SUV was calculated. Scores were obtained according to the SUV of pancreas compared with that of the liver (3=SUV higher than liver, 2=SUV similar to liver, 1=SUV lower than liver). The difference between the regular and delayed SUV was compared by paired t test using SPSS 17.0. Results: All of the 6 patients showed diffuse FDG uptake in the entire pancreas with SUV max of 3.2-6.0(5.2± 1.1). Five patients had score 3 and one had score 2. Five patients had delayed scan, of which 4 had increased uptake (SUV max 5.3-7.2), but the SUV max was not significantly different compared to that before delay scan (4.8-6.0, t=-2.424, P>0.05). Five patients showed extrapancreatic uptake, especially in the salivary glands. After the steroid therapy, the enlarged pancreas reduced and the intense uptake of the pancreas disappeared. The extrapancreatic uptake showed coinstantaneous remission. Conclusions: Increasing FDG uptake at entire pancreas was observed in patients with AIP. 18 F-FDG PET/CT may be useful for detecting AIP and the associated extrapancreatic uptake,and monitoring the change after therapy, yet it needs further evaluation. (authors)

Multicenter comparison of 18F-FDG and 68Ga-DOTA-peptide PET/CT for pulmonary carcinoid.

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Lococo, Filippo; Perotti, Germano; Cardillo, Giuseppe; De Waure, Chiara; Filice, Angelina; Graziano, Paolo; Rossi, Giulio; Sgarbi, Giorgio; Stefanelli, Antonella; Giordano, Alessandro; Granone, Pierluigi; Rindi, Guido; Versari, Annibale; Rufini, Vittoria

2015-03-01

The aims of this study were to retrospectively evaluate and compare the detection rate (DR) of 68Ga-DOTA-peptide and 18F-FDG PET/CT in the preoperative workup of patients with pulmonary carcinoid (PC) and to assess the utility of various functional indices obtained with the 2 tracers in predicting the histological characterization of PC, that is, typical versus atypical. Thirty-three consecutive patients with confirmed PC referred for 18F-FDG and 68Ga-DOTA-peptide PET/CT in 2 centers between January 2009 and April 2013 were included. The semiquantitative evaluation included the SUV max, the SUV of the tumor relative to the maximal liver uptake for 18F-FDG (SUV T/L) or the maximal spleen uptake for 68Ga-DOTA-peptides (SUV T/S), the ratio between SUV max of 68Ga-DOTA-peptides PET/CT, and the SUV max of 18F-FDG PET/CT (SUV max ratio). Histology was used as reference standard. Definitive diagnosis consisted of 23 typical carcinoids (TCs) and 10 atypical carcinoids. 18F-FDG PET/CT was positive in 18 cases and negative in 15 (55% DR). 68Ga-DOTA-peptide PET/CT was positive in 26 cases and negative in 7 (79% DR). In the subgroup analysis, 68Ga-DOTA-peptide PET/CT was superior in detecting TC (91% DR; P DOTA-peptide PET/CT findings. In the subgroup analysis, the SUV max ratio seems to be the most accurate index in predicting TC. Both methods should be performed when PC is suspected or when the histological subtype is undefined.

F-18 FDG PET/CT in Bilateral Diffuse Pulmonary Lymphangitic Carcinomatosis

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Senthil, Raja; Parghane, Rahul; Kashyap, Raghava; Bhattacharya, Anish; Mittal, Bhagwant Rai [Postgraduate Institute of Medical Education and Resaarch, Chandigarh (India)

2012-06-15

A 51-year-old female patient, who had undergone left-sided modified radical mastectomy for left breast carcinoma 4 years ago, presented with dyspnea of 4 months duration F-18 FDG PET/CT of this patient showed diffusely in-creased FDG uptake in the bilateral lung fields along the thickened bronchovascular bundles. SUVmax of lymphangitic lung was 5.2. The standardized uptake ratio (SUR) of mediastinal blood pool to lymphangitic lung was 0.44. High resolution computed tomography (HRCT) of the same patient showed thickening of interlobular septa and bronchovaseular bundles, with preservation of normal parenchymal architecture. Multiple intrapulmonary nodules and bilateral hilar lymphadenopathy with pulmonary lymphangitic carcinomatosis (PLC). The lungs are the second most common sites for metastases after lymph nodes. These metastases are usually nodular on radiologic images. PLC with interstitial involvement constitutes only 7% of pulmonary metastastases. The most common primary sites, in order of frequency, are adenocarcinoma of the lung, breast, stomach, colon, and prostrate. HRCT has been the modality of choice in the radiologic diagnosis of PLC. Only a few studies have de-scribed the F-18 FDG PET/CT findings in pulmonary lymphangitic carcinomatosis. These studies have shown diffusely increased FDG uptake corresponding to the typical changes in the CT as the most common finding. One study has reported that F-18 FDG PET/CT is 100% specific and 86% sensitive in diagnosing PLC by subjective analysis. The mean SUV in the region of pulmonary lymphangitic lung was 1.26{+-}0.45 and that of blood pool to normal lung was 3.78{+-}1.37.

18F-FDG-PET/CT Angiography for the Diagnosis of Infective Endocarditis.

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Roque, A; Pizzi, M N; Cuéllar-Calàbria, H; Aguadé-Bruix, S

2017-02-01

This article reviews the current imaging role of 18 F-fluordeoxyglucose positron emission computed tomography ( 18 F-FDG-PET/CT) combined with cardiac CT angiography (CTA) in infective endocarditis and discusses the strengths and limitations of this technique. The diagnosis of infective endocarditis affecting prosthetic valves and intracardiac devices is challenging because echocardiography and, therefore, the modified Duke criteria have well-recognized limitations in this clinical scenario. The high sensitivity of 18 F-FDG-PET/CT for the detection of infection associated with the accurate definition of structural damage by gated cardiac CTA in a combined technique (PET/CTA) has provided a significant increase in diagnostic sensitivity for the detection of IE. PET/CTA has proven to be a useful diagnostic tool in patients with suspected infective endocarditis. The additional information provided by this technique improves diagnostic performance in prosthetic valve endocarditis when it is used in combination with the Duke criteria. The findings obtained in PET/CTA studies have been included as a major criterion in the recently updated diagnostic algorithm in infective endocarditis guidelines.

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.

The value of 18F-FDG PET in three-dimensional conformal radiotherapy of cancer

International Nuclear Information System (INIS)

Lv Huiqing; Zhang Zhongmin; Lv Zhonghong

2006-01-01

Three-dimensional conformal radiotherapy (3D-CRT) is based on an extensive use of modern medical imaging techniques. Delineation of the gross tumor volume and organs at risk constitutes one of the most important phases of conformal radiotherapy procedures. 18 F-fluorodeoxyglucose ( 18 F-FDG) PET possesses greater sensitivity and accuracy in detecting diseased lymph nodes, is an important staging examination for patients considered for radiation treatment with curative intent. 18 F-FDG PET has an important role in delineation of gross tumor volume for patients treated with three-dimensional conformal radiotherapy. (authors)

18F-fluoromisonidazole (FMISO) and 18F-fluorodeoxyglucose (FDG) PET in patients undergoing radiotherapy or chemotherapy following surgery for high-grade glioma

International Nuclear Information System (INIS)

Lee, S. T.

2009-01-01

Full text:Background: Tumour hypoxia is associated with disease progression and resistance to therapy. High grade cerebral gliomas have a poor outcome despite advancements in chemotherapy and radiotherapy. 18F-fluoromisonidazole (18F-FMISO) concentrates in hypoxic cells and is associated with tumour grade in gliomas. The aim of this study was to compare the patterns of uptake of 18F-FDG PET and 18F-FMISO PET post-surgery with MRI and areas of recurrence post-radiotherapy. Methods: Patients with high grade cerebral glioma were recruited into this prospective study. All patients had post-surgical, pre-radiotherapy 18F-FDG, 18F-FMISO and MRI scans, which were all repeated 4-6 weeks post-completion to radiotherapy. The patients were followed-up clinically three monthly and re-imaged if indicated. Results: Ten patients were enrolled in this study, mean age 62 years (range 55-69 years), who all had pre-radiotherapy scans performed. Seven patients had scans done pre- and post-radiotherapy, with 3 patients with only pre-therapy scans. Nine patients had significant FMISO uptake and 8 patients demonstrated abnormal FDG uptake. The areas of FMISO uptake on pre-radiotherapy scans correlated with the most abnormal areas of contrast-enhancement on pre-treatment MRI and areas of locally recurrent disease on post-treatment MRI in eight patients. Nine patients had locally recurrent disease on follow-up MRI. FMISO was more predictive of tumour recurrence compared to FDG. Conclusion: Post-surgical 18F-FMISO PET in patients with cerebral glioma is more predictive of areas of recurrent disease compared to 18F-FDG PET.

[68Ga]DOTATATE PET/MRI and [18F]FDG PET/CT are complementary and superior to diffusion-weighted MR imaging for radioactive-iodine-refractory differentiated thyroid cancer

International Nuclear Information System (INIS)

Vrachimis, Alexis; Stegger, Lars; Wenning, Christian; Noto, Benjamin; Konnert, Julia Renate; Riemann, Burkhard; Weckesser, Matthias; Burg, Matthias Christian; Allkemper, Thomas; Heindel, Walter; Schaefers, Michael

2016-01-01

The purpose of this study was to determine whether [ 68 Ga]DOTATATE PET/MRI with diffusion-weighted imaging (DWI) can replace or complement [ 18 F]FDG PET/CT in patients with radioactive-iodine (RAI)-refractory differentiated thyroid cancer (DTC). The study population comprised 12 patients with elevated thyroglobulin and a negative RAI scan after thyroidectomy and RAI remnant ablation who underwent both [ 18 F]FDG PET/CT and [ 68 Ga]DOTATATE PET/MRI within 8 weeks of each other. The presence of recurrent cancer was evaluated on a per-patient, per-organ and per-lesion basis. Histology, and prior and follow-up examinations served as the standard of reference. Recurrent or metastatic tumour was confirmed in 11 of the 12 patients. [ 68 Ga]DOTATATE PET(/MRI) correctly identified the tumour burden in all 11 patients, whereas in one patient local relapse was missed by [ 18 F]FDG PET/CT. In the lesion-based analysis, overall lesion detection rates were 79/85 (93 %), 69/85 (81 %) and 27/82 (33 %) for [ 18 F]FDG PET/CT, [ 68 Ga]DOTATATE PET/MRI and DWI, respectively. [ 18 F]FDG PET(/CT) was superior to [ 68 Ga]DOTATATE PET(/MRI) in the overall evaluation and in the detection of pulmonary metastases. In the detection of extrapulmonary metastases, [ 68 Ga]DOTATATE PET(/MRI) showed a higher sensitivity than [ 18 F]FDG PET(/CT), at the cost of lower specificity. DWI achieved only poor sensitivity and was significantly inferior to [ 18 F]FDG PET in the lesion-based evaluation in the detection of both extrapulmonary and pulmonary metastases. [ 18 F]FDG PET/CT was more sensitive than [ 68 Ga]DOTATATE PET/MRI in the evaluation of RAI-refractory DTC, mostly because of its excellent ability to detect lung metastases. In the evaluation of extrapulmonary lesions, [ 68 Ga]DOTATATE PET(/MRI) was more sensitive and [ 18 F]FDG PET(/CT) more specific. Furthermore, DWI did not provide additional information and cannot replace [ 18 F]FDG PET for postoperative monitoring of patients with

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

International Nuclear Information System (INIS)

Kim, Jae Sung; Hong, Suk Keun; Lee, Young Tak; Kim, Youn Jung; Moon, Keon Sik; Won, Tae Kyoung; Hwang, Hweung Kon; Lee, Dong Soo; Kim, Yu Kyeong

2000-01-01

We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.=20

WE-H-207A-05: Spatial Co-Localization of F-18 NaF Vs. F-18 FDG Defined Disease Volumes

Energy Technology Data Exchange (ETDEWEB)

Ferjancic, P; Harmon, S; Jeraj, R [University of Wisconsin, Madison, WI (United States); Chen, S [1st Hospital of China Medical University, Shenyang, Liaoning (China); Simoncic, U [Jozef Stefan Institute, Ljubljana (Slovenia)

2016-06-15

Purpose: Both [F-18]NaF and [F-18]FDG show promise for quantitative PET/CT assessment in metastatic prostate cancer to bone. Broad agreement between the tracers has been shown but voxel-wise correspondence has not been explored in depth. This study evaluates the spatial co-localization of [F-18]NaF PET and [F-18]FDG PET in bone lesions. Methods: Seventy-three lesion contours were identified in six patients receiving dynamic NaF PET/CT and FDG PET/CT scans two hours apart using identical fields-of-view. Tracer uptake (SUV) reflecting 60 minutes post-injection was modeled from kinetic parameters. Lesions were segmented by a physician separately on NaF PET and FDG PET. PET images were rigidly aligned using skeletal references on CT images. Lesion size, degree of overlap, voxel-wise tracer uptake values (SUV), and CT density distributions were compared using Dice coefficient, Positive Predictive Value (PPV), and Spearman rank correlation tests. Results: Across all patients, 42 lesions were identified on NaF PET (median 1.4 cm{sup 3}, range <1–204 cm{sup 3}) compared to 31 using FDG PET (median 1.8 cm{sup 3}, range <1–244 cm{sup 3}). Spatial cooccurrence was found in 25 lesion pairs. Lesions on NaF PET had PPV of 0.91 and on FDG a PPV of 0.65. Overall, NaF-defined lesions were 47% (±24%) larger by volume with moderate overlap to FDG, resulting in mean Dice coefficient of 34% (±22%). In areas of overlap, voxel-wise correlation of NaF and FDG SUV was moderate (ρ=0.56). Expanding to regions of non-spatial overlap, voxels contained in FDG-only contours were almost exclusively low HU (median 118), compared to dense regions of NaF-only voxels (median 250). In sclerotic sub-volumes (HU > 300) NaF-defined contours encompassed 83% of total FDG volume. Conclusion: Moderate voxel-wise correlation of FDG and NaF PET/CT uptake was observed. Spatial discrepancies in FDG and NaF PET/CT imaging of boney metastases could be influenced by poor sensitivity of FDG PET/CT in

18F-FDG PET/CT显像诊断妇科肿瘤复发、转移的价值%Value of18F-FDG PET/CT in diagnosing suspected recurrence and metastasis in gynecological malignancies

Institute of Scientific and Technical Information of China (English)

张敬勉; 赵新明; 王建方; 王颖晨; 张召奇; 李德志; 戴春暖; 孙莉; 江志华

2009-01-01

Objective Recurrence and metastasis are significant prognostic factors in patients with gynecological malignancies. The purpose of the study was to evaluate the value of 18F-fluorodeoxyglucose (FDG) PET/CT in diagnosing suspected recurrence and metastasis in gynecological malignancies, and to investigate the influence of PET/CT on clinical restaging and treatment decision. Methods Forty-seven patients with gynecological malignancies clinically suspected of recurrence or metastasis underwent 18 F-FDG PET/CT imaging. The images of 18F-FDG PET/CT, PET and CT were compared respectively. X2-test with SPSS 12.0 was used for data analysis. Results One hundred and forty-nine malignant lesions and 9 benign lesions were found in 47 patients. The sensitivity, specificity, accuracy, positive predictive value and nega-tive predictive value of 18 F-FDG PET/CT in detecting recurrence and metastasis of gynecological malignan-cies were 95.97% ( 143/149), 6/9, 94.30% ( 149/158), 97.95% (143/146) and 50.00% ( 6/12), respectively. The difference was significant between ,18 F-FDG PET/CT image and CT alone in sensitivity, ac-curacy and negative predictive value (X2 = 18.198,18.890, 6.825, all P 0.05), but 18F-FDG PET/CT had a clear advantage in determining the location of the lesions [33.54% (53/158)]. PET/CT changed the TN M staging in 44.68% ( 21/47 ) and 31.91% (15/47) patients, respectively, comparing with CT or PET alone. Furthermore, 19.15% ( 9/47 ) had change in their clinical staging and treatment decision based on the results of PET/CT. Conclu-sion 18F-FDG PET/CT is valuable in the detection, restaging and management decision in recurrent and metastatic gynecological malignancies.%目的 探讨18F-脱氧葡萄糖(FDG)PET/CT显像诊断妇科肿瘤复发、转移的价值,并评价其对临床再分期及治疗决策的影响.方法 对47例临床可疑复发、转移的妇科肿瘤患者行18F-FDGPET/CT显像,对PET、CT及PET/CT图像进行对比分析.采用SPSS 12.0�

F-18 FDG PET findings for Vogt-Koyanagi-Harada disease

Energy Technology Data Exchange (ETDEWEB)

Park, Hye Lim; Yoo, Ie Ryung; Park Sonya Young Ju [Dept. of of Radiology, Seoul St. Mary' s Hospital, College of MedicineThe Catholic University of Korea, Seoul (Korea, Republic of)

2017-06-15

Vogt-Koyanagi-Harada disease is a rare multisystemic granulomatous autoimmune disorder affecting pigmented tissues such as the choroid, meninges, inner ear, and the skin. Neurologic symptoms are usually mild. Clinical manifestations include generalized muscle weakness, headache, meningismus, vertigo, decreased visual acuity, hearing loss and mental changes ranging from mild confusion to psychosis, hemiparesis, dysarthria, and aphasia. Seizures are very rare. We describe a case of 18F-fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) and software-fused PET-magnetic resonance imaging (MRI) in Vogt-Koyanagi-Harada disease with seizure.

F-18 FDG PET findings for Vogt-Koyanagi-Harada disease

International Nuclear Information System (INIS)

Park, Hye Lim; Yoo, Ie Ryung; Park Sonya Young Ju

2017-01-01

Vogt-Koyanagi-Harada disease is a rare multisystemic granulomatous autoimmune disorder affecting pigmented tissues such as the choroid, meninges, inner ear, and the skin. Neurologic symptoms are usually mild. Clinical manifestations include generalized muscle weakness, headache, meningismus, vertigo, decreased visual acuity, hearing loss and mental changes ranging from mild confusion to psychosis, hemiparesis, dysarthria, and aphasia. Seizures are very rare. We describe a case of 18F-fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) and software-fused PET-magnetic resonance imaging (MRI) in Vogt-Koyanagi-Harada disease with seizure

Bilateral Tubo Ovarian Abscess Mimics Ovarian Cancer on MRI and {sup 18F} FDG PET/CT

Energy Technology Data Exchange (ETDEWEB)

Rakheja, Rajan; Hickeson, Marc [Royal Victoria Hospital, McGill Univ. Health Centre, Montreal (Canada); Makis, William [Brandon Regional Health Centre, Brandon (Canada)

2011-09-15

A 20 year old woman, who presented with a several week history of abdominal pain, was referred for magnetic resonance imaging (MRI) and {sup 18F} fluorodeoxy glucose (FDG) positron emission tomography (PET)/computed tomography (CT) after an ultrasound showed complex cystic masses arising from both ovaries. The MRI and {sup 18F} FDG PET/CT imaging characteristics of the ovarian masses were strongly suspicious for malignancy, and the masses were surgically removed. Histopathological evaluation revealed a bilateral tuboovarian abscess, with no evidence of malignancy. This case highlights a potentially serious pitfall in the evaluation of suspicious pelvic masses by {sup 18F} FDG PET/CT, Whereby a complex bilateral tuboovarian abscess may mimic the PET/CT imaging characteristics of an ovarian or pelvic malignancy.

Diagnostic utility of PET/CT with {sup 18}F-DOPA and {sup 18}F-FDG in persistent or recurrent medullary thyroid carcinoma: the importance of calcitonin and carcinoembryonic antigen cutoff

Energy Technology Data Exchange (ETDEWEB)

Romero-Lluch, Ana Reyes; Guerrero-Vazquez, Raquel; Martinez-Ortega, Antonio Jesus; Navarro-Gonzalez, Elena [Hospital Universitario Virgen del Rocio, Unidad de Gestion Clinica de Endocrinologia y Nutricion, Seville (Spain); Cuenca-Cuenca, Juan Ignacio; Tirado-Hospital, Juan Luis; Borrego-Dorado, Isabel [Hospital Universitario Virgen del Rocio, Unidad de Medicina Nuclear, Seville (Spain)

2017-11-15

This study sought to evaluate and compare the utility of 18-F-fluorodihydroxyphenylalanine ({sup 18}F-DOPA) and 18-F-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography/computed tomography (PET/CT) for identification of lesions in patients with recurrent medullary thyroid carcinoma (MTC). In addition, we analyzed the correlation between the calcitonin (Ct), carcinoembryonic antigen (CEA) levels, each doubling time (DT), and PET positivity. We evaluated the reliability of the 150 pg/mL Ct cutoff set by the American Thyroid Association guidelines for further imaging (including {sup 18}F-DOPA PET/CT). We prospectively recruited 18 patients with recurrent MTC, identified by elevation of Ct or CEA. Each patient underwent a {sup 18}F-FDG PET/CT and a {sup 18}F-DOPA PET/CT. Abnormal uptakes were detected with {sup 18}F-DOPA (n=12) and {sup 18}F-FDG (n=9), (sensitivity of 66.7% vs. 50%; p<0.01). Twenty-eight lesions were detected with {sup 18}F-DOPA vs. 16 lesions with {sup 18}F-FDG (1.56±1.5 vs. 0.89±1.18 lesions per patient; p=0.01). None of our patients showed additional lesions with {sup 18}F-FDG in comparison to {sup 18}F-DOPA. Patient-based detection rate increased significantly with Ct levels ≥150 pg/mL vs. Ct<150 pg/mL for both {sup 18}F-DOPA (sensitivity 90.9% vs. 28.6%; p=0.013) and {sup 18}F-FDG PET/CT (sensitivity 72.7% vs. 14.3%; p=0.025). Using a CEA cutoff of ≥5 ng/mL, detection rates of {sup 18}F-DOPA and {sup 18}F-FDG PET/CT were 81.1% and 72.7%, respectively. No correlation between Ct-DT or CEA-DT and PET positivity was found. Histological confirmation was obtained in eight patients. {sup 18}F-DOPA PET/CT appears to be superior to {sup 18}F-FDG PET/CT in detecting and locating lesions in patients with recurrent MTC. This technique tends to be especially useful in patients with negative results in other imaging modalities and Ct≥150 pg/mL or CEA≥5 ng/mL. (orig.)

Evaluation of Schmorl's nodes using F-18 FDG PET/CT

International Nuclear Information System (INIS)

Lin, C.-Y.; Chen, H.-Y.; Ding, H.-J.; Chen, Y.-K.; Kao, C.-H.

2012-01-01

Aim: To evaluate the image findings of Schmorl's nodes on combined 2-[ 18 F]-fluoro-2-deoxy-D-glucose positron-emission tomography/computed tomography (FDG PET/CT). Materials and methods: Twelve patients who were diagnosed with Schmorl's nodes and had undergone magnetic resonance imaging (MRI) and FDG PET/CT were retrospectively recruited for this study. The period between the MRI and the FDG PET/CT examinations was within 1 week. The demographic data and clinical history were reviewed. The relationship between MRI findings and the values of maximum standardized uptake value (SUVmax) on FDG PET/CT was analysed. Results: The mean values of early and delayed SUVmax of Schmorl's nodes without MRI enhancement were 1.14 ± 0.28 and 1.09 ± 0.32. The mean values of early and delayed SUVmax of Schmorl's nodes with MRI enhancement were 1.73 ± 0.49 and 1.75 ± 0.54. There were significant differences in the early and delayed SUVmax between Schmorl's nodes with and without perifocal enhancement on MRI with Wilcoxon's rank-sum test (p = 0.012; p = 0.006). There was a trend of positive correlation, although not statistically significant, between delayed SUVmax on FDG PET/CT and age in Schmorl's nodes with Spearman’s rank correlation (B = 0.86, p = 0.056). Conclusions: Schmorl's nodes demonstrated low to moderate uptake on FDG PET/CT images. Schmorl's nodes with perifocal enhancement on MRI result in higher FDG uptake. The possibility of false positives caused by Schmorl's nodes should be considered when interpreting FDG PET/CT images of bone metastases, especially in the aging population.

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

International Nuclear Information System (INIS)

Kim, Hae Won; Won, Kyung Sook; Choi, Byung Wook; Zeon, Seok Kil

2010-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2010-04-15

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

The impact of {sup 18}F-FDG PET on the management of patients with suspected large vessel vasculitis

Energy Technology Data Exchange (ETDEWEB)

Fuchs, Martin; Rasch, Helmut; Berg, Scott; Ng, Quinn K.T.; Mueller-Brand, Jan; Walter, Martin A. [University Hospital, Institute of Nuclear Medicine, Basel (Switzerland); Briel, Matthias [University Hospital Basel, Institute for Clinical Epidemiology and Biostatistics, Basel (Switzerland); McMaster University, Department of Clinical Epidemiology and Biostatistics, Hamilton, ON (Canada); Daikeler, Thomas; Tyndall, Alan [University Hospital Basel, Department of Rheumatology, Basel (Switzerland); Walker, Ulrich A. [Felix Platter Spital, Department of Rheumatology of Basle University, Basel (Switzerland); Raatz, Heike [University Hospital Basel, Institute for Clinical Epidemiology and Biostatistics, Basel (Switzerland); Jayne, David [Addenbrooke' s Hospital, Vasculitis and Lupus Unit, Cambridge (United Kingdom); Koetter, Ina [University Hospital Tuebingen, Department of Internal Medicine II, Tuebingen (Germany); Blockmans, Daniel [University Hospital Gasthuisberg, Department of General Internal Medicine, Leuven (Belgium); Cid, Maria C.; Prieto-Gonzalez, Sergio [Hospital Clinic, University of Barcelona, IDIBAPS, Department of Systemic Autoimmune Diseases, 08036-Barcelona (Spain); Lamprecht, Peter [University Hospital of Schleswig-Holstein, Department of Rheumatology, Luebeck (Germany); Salvarani, Carlo [Arcispedale S. Maria Nuova, Department of Rheumatology, Reggio Emilia (Italy); Karageorgaki, Zaharenia [Agios Dimitrios General Hospital, 1st Department of Internal Medicine, Thessaloniki (Greece); Watts, Richard [University of East Anglia, Norwich Medical School, Norwich (United Kingdom); Ipswich Hospital NHS Trust, Ipswich (United Kingdom); Luqmani, Raashid [Nuffield Orthopaedic Centre, Department of Rheumatology, Oxford (United Kingdom)

2012-02-15

We aimed to assess the impact of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the management of patients with suspected large vessel vasculitis. An international expert panel determined diagnoses and clinical management in patients with suspected large vessel vasculitis, with and without the results of {sup 18}F-FDG PET, respectively. The accuracy of the clinical diagnosis and the resulting clinical management with and without the {sup 18}F-FDG PET results were compared using logistic regression models. The analysis included 30 patients referred to a tertiary care centre with large vessel vasculitis and 31 controls. {sup 18}F-FDG PET had an overall sensitivity of 73.3% [95% confidence interval (CI) 54.1-87.7%], a specificity of 83.9% (95% CI 66.3-94.5%), a positive predictive value of 81.5% (95% CI 61.9-93.7%) and a negative predictive value of 76.5% (95% CI 58.8-89.3%). The diagnostic accuracy of {sup 18}F-FDG PET was higher in patients not receiving immunosuppressive drugs (93.3 vs 64.5%, p = 0.006). Taken in context with other available diagnostic modalities, the addition of {sup 18}F-FDG PET increased the clinical diagnostic accuracy from 54.1 to 70.5% (p = 0.04). The addition of {sup 18}F-FDG PET increased the number of indicated biopsies from 22 of 61 patients (36.1%) to 25 of 61 patients (41.0%) and changed the treatment recommendation in 8 of 30 patients (26.7%) not receiving immunosuppressive medication and in 7 of 31 patients (22.6%) receiving immunosuppressive medication. {sup 18}F-FDG PET is a sensitive and specific imaging tool for large vessel vasculitis, especially when performed in patients not receiving immunosuppressive drugs. It increases the overall diagnostic accuracy and has an impact on the clinical management in a significant proportion of patients. (orig.)

Clinical study of 18F-FDG PET/CT whole-body imaging in disseminated carcinoma of unknown primary site

International Nuclear Information System (INIS)

Wang Guohui; Liang Peiyan; Cai Yanjun; Zhang Weiguang; Xie Chuanmiao; Wu Peihong

2008-01-01

Objective: Carcinoma of unknown primary (CUP) is not uncommon in usual clinical settings. They are, by definition, those cases with clinically suspected primary malignancy but not revealed by conventional investigation. The aim of this study was to investigate the efficacy of whole-body 18 F-fluoro- deoxyglucose (FDG) PET/CT in detecting a primary neoplasm for these patients. Methods: A totle of 150 patients with retrievable records from 169 CUP patients were selected within a group of consecutive 2589 patients from Jan. 2006 to Jun. 2007. All cases underwent whole-body FDG PET/CT scan. The final diagnoses were confirmed by pathologic results, other imaging modalities or clinical follow-up. Results: Among 150 patients, primary tumor sites were successfully detected by whole-body 18 F-FDG PET/CT scan in 70 cases (46.7%), of which 52 were pathologically confirmed and 18 by clinical follow-up. And 38 cases (54.3%) were lung cancer, 8 (11.4%) were nasopharyngeal carcinoma, 13 (18.6%) in digestive sys- tem, and 11 (15.7%) in other systems. Three clinically suspected CUP cases with negative 18 F-FDG PET/ CT were subsequently confirmed of benign processes by clinical follow-up. Six patients were wrongly diagnosed by 18 F-FDG PET/CT, and 15 patients did not have a confirmed diagnosis by the end of research. The primary cause of malignancy after 18 F-FDG PET/CT remained obscure in 56 patients, only 3 of whom be- came known during the course of clinical follow-up (nasopharyngeal bladder and esophageal carcinoma). Conclusion: 18 F-FDG PET/CT whole-body imaging plays an important role in patients with metastatic CUP. (authors)

(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....

Interactive 3-dimensional registration of stand-along 18F-FDG whole-body PET with CT in the thorax

International Nuclear Information System (INIS)

Zhang Xiangsong; Tang Anwu; He Zuoxiang

2004-01-01

Objective: To establish a method of 3-dimensional volume fusion of stand-alone 18 F-fluorodeoxyglucose (FDG) PET with CT in the thorax. Methods: 18 F-FDG PET and CT studies were performed on 8 patients with lung cancer. CT raw data were reconstructed into three dimensional volume data. The mutual positioning of the volume data of PET and CT was repeatedly adjusted according to the inner marker of apparent anatomical structures and lesions until the accurate registrations were obtained. The registered PET study was then displayed on a hot metal scale overlaid on top of the gray scale CT study. Results: All of the 25 lesions on 18 F-FDG PET imaging in 8 patients were correctly located on CT images using the software of three dimension volumetric fusion of stand-alone 18 F-FDG PET with CT in the thorax. The software can be run in a PC computer, and the whole computational performance time of the software algorithm is less than 10 min for one patient. Conclusion: This technique can correctly locate the FDG uptake lesions in the thorax. (authors)

Value of 18F-FDG PET/CT in the detection of ovarian malignancy

International Nuclear Information System (INIS)

Park, Tae Gyu; Lee, Si Nae; Park, So Yeon

2015-01-01

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 18 F-fluorodeoxyglucose ( 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 18 F--FDG PET/CT, and an additional 2-h delayed 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 max , SUV mean ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on a 1-h initial 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 max1 , SUV mean1 , and TLG1 showed significant differences. Also, in the analysis of 42 peritoneal lesions that underwent an additional 2-h 18 F--FDG

18F-FDG PET in the management of endometrial cancer

International Nuclear Information System (INIS)

Chao, Angel; Chang, Ting-Chang; Huang, Huei-Jean; Chou, Hung-Hsueh; Wu, Tzu-I; Ng, Koon-Kwan; Hsueh, Swei; Tsai, Chien-Sheng; Yen, Tzu-Chen; Lai, Chyong-Huey

2006-01-01

Few studies have investigated the clinical impact of whole-body positron emission tomography (PET) with 18 F-fluorodeoxyglucose (FDG) in endometrial cancer. We aimed to assess the value of integrating FDG-PET into the management of endometrial cancer in comparison with conventional imaging alone. All patients with histologically confirmed primary advanced (stage III/IV) or suspicious/documented recurrent endometrial cancer, with poor prognostic features (serum CA-125 >35 U/ml or unfavourable cell types), or surveillance after salvage therapy were eligible. Before FDG-PET scanning, each patient had received magnetic resonance imaging and/or computed tomography (MRI-CT). The receiver operating characteristic curve method with calculation of the area under the curve (AUC) was used to compare the diagnostic efficacy. Clinical impacts were determined on a scan basis. Forty-nine eligible patients were accrued and 60 studies were performed (27 primary staging, 33 post-therapy surveillance or restaging on relapse). The clinical impact was positive in 29 (48.3%) of the 60 scans. Mean standardised uptake values (SUVs) of true-positive lesions were 13.2 (range 5.7-37.4) for central pelvic lesions and 11.1 (range 1.5-37.4) for metastases. The sensitivity of FDG-PET alone (P<0.0001) or FDG-PET plus MRI-CT (P<0.0001) was significantly higher than that of MRI-CT alone in overall lesion detection. FDG-PET plus MRI-CT was significantly superior to MRI-CT alone in overall lesion detection (AUC 0.949 vs 0.872; P=0.004), detection of pelvic nodal/soft tissue metastases (P=0.048) and detection of extrapelvic metastases (P=0.010), while FDG-PET alone was only marginally superior by AUC (P=0.063). Whole-body FDG-PET coupled with MRI-CT facilitated optimal management of endometrial cancer in well-selected cases. (orig.)

Value of 18F-FDG PET-CT in nasopharyngeal carcinoma target delineation and radiotherapy boost

International Nuclear Information System (INIS)

Wang Ying; Feng Yanlin

2011-01-01

18 F-FDG PET-CT has widely used in nasopharyngeal carcinoma diagnosis and staging in recent years, it's effecten target volume delineation has received great attention. The article lays stress on the clinical research progress of 18 F-FDG PET-CT in the radiotherapy of nasopharyngeal carcinoma improve the accuracy of target delineation, reduce the difference of target delineation, guide the dose painting and boost. (authors)

Clinical value of 18F-FDG and 18F-FLT PET /CT for the detection of primary and regional lymph node metastasis of gastric cancer

Institute of Scientific and Technical Information of China (English)

杨洋

2014-01-01

Objective To evaluate the value of18F-FDG and18F-FLT PET/CT for the detection of primary and regional lymph node metastasis of gastric cancer.Methods Thirty-seven patients with gastric cancer underwent preoperative18F-FLT and18F-FDG PET/CT within one week from March 2011 to April 2013.Postoperative histopathology confirmation was obtained in all patients.The PET/CT images were assessed visually and semi-quantitatively.Two-sample t andχ2tests were analyzed using SPSS overall diagnostic

When are false-positive and false-negative 18F'FDG PET scans really false?

International Nuclear Information System (INIS)

Binns, D.S.; Hicks, R.J.; Fawcett, M.E.

1999-01-01

Full text: A 61-year-old male presented with locally advanced squamous cell carcinoma of the base of tongue. In the absence of wider metastatic disease on conventional staging, he was enrolled in a phase I, dose escalation chemoradiotherapy trial. In this study, therapeutic response to radiotherapy combined with cisplatin and a chemotherapeutic agent which specifically targets hypoxic cells (tirapazamine) was evaluated with serial 18 F-FDG PET scans. Baseline 18 F-FDG PET confirmed locally advanced disease, although a previously undetected lower cervical lymph node was identified and included in the radiotherapy portal. Whole-body PET revealed a small metabolically active area adjacent to the right hemidiaphragm. Respiratory gated, high-resolution helical CT failed to find structural evidence of disease and, as a result, the patient was enrolled in the 7 week therapy regime on the assumption that the PET finding was a false-positive result. Repeat 18 F-FDG PET scans at the middle, end and 12 weeks post-treatment showed excellent therapeutic response in the head and neck which was discordant with clinical and CT findings, and resolution of the metabolically active chest lesion. Despite the negative PET scan, persistent clinical and CT evidence of a residual tumour mass suggested a false-negative result and resulted in a neck lymph node dissection. This showed no evidence of malignant cells. Five months following treatment, the patient presented with pleural effusion at the base on the right lung. Subsequent CT scanning showed a small pleural lesion at the site of initial 18 F-FDG uptake. Biopsy confirmed metastatic disease. The apparent transient resolution of 18 F-FDG uptake in the pleural lesion with treatment presumably reflected a combination of reduced metabolic activity and size due to the partial, but not complete, cytotoxic effects of cisplatin. In conclusion, this case emphasizes the importance of pathological review and clinical follow-up in reconciling

[{sup 18}F]FDG PET accurately differentiates infected and non-infected non-unions after fracture fixation

Energy Technology Data Exchange (ETDEWEB)

Wenter, Vera; Albert, Nathalie L.; Brendel, Matthias; Fendler, Wolfgang P.; Bartenstein, Peter [University of Munich, Department of Nuclear Medicine, Munich (Germany); Cyran, Clemens C. [University of Munich, Institute for Clinical Radiology, Munich (Germany); Friederichs, Jan; Mueller, Jan-Philipp; Militz, Matthias; Hungerer, Sven [BG Trauma Center Murnau, Department of Reconstructive Arthroplasty, Murnau (Germany); PMU Salzburg, Paracelsus Medical University, Salzburg (Austria); Hacker, Marcus [University of Vienna, Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria)

2017-03-15

Complete fracture healing is crucial for good patient outcomes. A major complication in the treatment of fractures is non-union. The pathogenesis of non-unions is not always clear, although implant-associated infections play a significant role, especially after surgical treatment of open fractures. We aimed to evaluate the value of [{sup 18}F]FDG PET in suspected infections of non-union fractures. We retrospectively evaluated 35 consecutive patients seen between 2000 and 2015 with suspected infection of non-union fractures, treated at a level I trauma center. The patients underwent either [{sup 18}F]FDG PET/CT (N = 24), [{sup 18}F]FDG PET (N = 11) plus additional CT (N = 8), or conventional X-ray (N = 3). Imaging findings were correlated with final diagnosis based on intraoperative culture or follow-up. In 13 of 35 patients (37 %), infection was proven by either positive intraoperative tissue culture (N = 12) or positive follow-up (N = 1). [{sup 18}F]FDG PET revealed 11 true-positive, 19 true-negative, three false-positive, and two false-negative results, indicating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 85 %, 86 %, 79 %, 90 %, and 86 %, respectively. The SUV{sub max} was 6.4 ± 2.7 in the clinically infected group and 3.0 ± 1.7 in the clinically non-infected group (p <0.01). The SUV{sub ratio} was 5.3 ± 3.3 in the clinically infected group and 2.6 ± 1.5 in the clinically non-infected group (p <0.01). [{sup 18}F]FDG PET differentiates infected from non-infected non-unions with high accuracy in patients with suspected infections of non-union fractures, for whom other clinical findings were inconclusive for a local infection. [{sup 18}F]FDG PET should be considered for therapeutic management of non-unions. (orig.)

Automatic extraction analysis of the anatomical functional area for normal brain 18F-FDG PET imaging

International Nuclear Information System (INIS)

Guo Wanhua; Jiang Xufeng; Zhang Liying; Lu Zhongwei; Li Peiyong; Zhu Chengmo; Zhang Jiange; Pan Jiapu

2003-01-01

Using self-designed automatic extraction software of brain functional area, the grey scale distribution of 18 F-FDG imaging and the relationship between the 18 F-FDG accumulation of brain anatomic function area and the 18 F-FDG injected dose, the level of glucose, the age, etc., were studied. According to the Talairach coordinate system, after rotation, drift and plastic deformation, the 18 F-FDG PET imaging was registered into the Talairach coordinate atlas, and then the average gray value scale ratios between individual brain anatomic functional area and whole brain area was calculated. Further more the statistics of the relationship between the 18 F-FDG accumulation of every brain anatomic function area and the 18 F-FDG injected dose, the level of glucose and the age were tested by using multiple stepwise regression model. After images' registration, smoothing and extraction, main cerebral cortex of the 18 F-FDG PET brain imaging can be successfully localized and extracted, such as frontal lobe, parietal lobe, occipital lobe, temporal lobe, cerebellum, brain ventricle, thalamus and hippocampus. The average ratios to the inner reference of every brain anatomic functional area were 1.01 ± 0.15. By multiple stepwise regression with the exception of thalamus and hippocampus, the grey scale of all the brain functional area was negatively correlated to the ages, but with no correlation to blood sugar and dose in all areas. To the 18 F-FDG PET imaging, the brain functional area extraction program could automatically delineate most of the cerebral cortical area, and also successfully reflect the brain blood and metabolic study, but extraction of the more detailed area needs further investigation

Applying Amide Proton Transfer MR Imaging to Hybrid Brain PET/MR: Concordance with Gadolinium Enhancement and Added Value to [18F]FDG PET.

Science.gov (United States)

Sun, Hongzan; Xin, Jun; Zhou, Jinyuan; Lu, Zaiming; Guo, Qiyong

2018-06-01

The purpose of this study is to evaluate the diagnostic concordance and metric correlations of amide proton transfer (APT) imaging with gadolinium-enhanced magnetic resonance imaging (MRI) and 2-deoxy-2-[ 18 F-]fluoro-D-glucose ([ 18 F]FDG) positron emission tomography (PET), using hybrid brain PET/MRI. Twenty-one subjects underwent brain gadolinium-enhanced [ 18 F]FDG PET/MRI prospectively. Imaging accuracy was compared between unenhanced MRI, MRI with enhancement, APT-weighted (APTW) images, and PET based on six diagnostic criteria. Among tumors, the McNemar test was further used for concordance assessment between gadolinium-enhanced imaging, APT imaging, and [ 18 F]FDG PET. As well, the relation of metrics between APT imaging and PET was analyzed by the Pearson correlation analysis. APT imaging and gadolinium-enhanced MRI showed superior and similar diagnostic accuracy. APTW signal intensity and gadolinium enhancement were concordant in 19 tumors (100 %), while high [ 18 F]FDG avidity was shown in only 12 (63.2 %). For the metrics from APT imaging and PET, there was significant correlation for 13 hypermetabolic tumors (P PET in the evaluation of tumor metabolic activity during brain PET/MR studies.

Recognition of fibrous dysplasia of bone mimicking skeletal metastasis on 18F-FDG PET/CT imaging

International Nuclear Information System (INIS)

Su, Ming Gang; Tian, Rong; Fan, Qiu Ping; Tian, Ye; Li, Fang Lan; Li, Lin; Kuang, An Ren; Miller, John Howard

2011-01-01

Fibrous dysplasia of bone (FDB) reveals intense 18F-FDG uptake mimicking metastases on 18F-FDG PET/CT. We reviewed sites of FDB revealed by 18F-FDG PET/CT imaging to allow identification of this abnormality. Eleven patients (7 male, 4 female, aged 16-78 years) were evaluated after 55 MBq (0.15 mCi)/kg 18F-FDG utilizing a 16-slice multiple detector CT (MDCT) whole-body PET scanner, with LOR algorithm 3D reconstruction. One- and 2-h imaging was performed in 9 patients. Standard uptake value (SUV) for each lesion, on early and delayed imaging, was calculated. Lesions were confirmed in 6 patients by biopsy. The PET images correlated with MDCT to establish the imaging characteristics. Solitary lesions were found in 4 patients, two lesions in 1 patient, and in 6 patients there were multiple bone lesions. The SUV early ranged from 1.23 to 9.64 with an average of 3.76 ± 2.40. The SUV delayed ranged from 1.76 to 11.42 with an average of 4.51 ± 3.07. The SUV delayed decreased or increased slightly (-31% to 5%) in 6 of our patients, and increased significantly (11% to 39%) in 3. There was a negative correlation between SUVs and age, as well as the number of affected bones. In our study, FDB had wide skeletal distribution with variability of 18F-FDG uptake and CT appearance. SUV in the delayed stage was seen to either decrease or increase on dual-time 18F-FDG PET scanning. It is very important to recognize the characteristics of this skeletal dysplasia to allow differentiation from skeletal metastasis. (orig.)

(18)F-alfatide II and (18)F-FDG dual-tracer dynamic PET for parametric, early prediction of tumor response to therapy.

Science.gov (United States)

Guo, Jinxia; Guo, Ning; Lang, Lixin; Kiesewetter, Dale O; Xie, Qingguo; Li, Quanzheng; Eden, Henry S; Niu, Gang; Chen, Xiaoyuan

2014-01-01

A single dynamic PET acquisition using multiple tracers administered closely in time could provide valuable complementary information about a tumor's status under quasiconstant conditions. This study aimed to investigate the utility of dual-tracer dynamic PET imaging with (18)F-alfatide II ((18)F-AlF-NOTA-E[PEG4-c(RGDfk)]2) and (18)F-FDG for parametric monitoring of tumor responses to therapy. We administered doxorubicin to one group of athymic nude mice with U87MG tumors and paclitaxel protein-bound particles to another group of mice with MDA-MB-435 tumors. To monitor therapeutic responses, we performed dual-tracer dynamic imaging, in sessions that lasted 90 min, starting with injection via the tail vein catheters with (18)F-alfatide II, followed 40 min later by (18)F-FDG. To achieve signal separation of the 2 tracers, we fit a 3-compartment reversible model to the time-activity curve of (18)F-alfatide II for the 40 min before (18)F-FDG injection and then extrapolated to 90 min. The (18)F-FDG tumor time-activity curve was isolated from the 90-min dual-tracer tumor time-activity curve by subtracting the fitted (18)F-alfatide II tumor time-activity curve. With separated tumor time-activity curves, the (18)F-alfatide II binding potential (Bp = k3/k4) and volume of distribution (VD) and (18)F-FDG influx rate ((K1 × k3)/(k2 + k3)) based on the Patlak method were calculated to validate the signal recovery in a comparison with 60-min single-tracer imaging and to monitor therapeutic response. The transport and binding rate parameters K1-k3 of (18)F-alfatide II, calculated from the first 40 min of the dual-tracer dynamic scan, as well as Bp and VD correlated well with the parameters from the 60-min single-tracer scan (R(2) > 0.95). Compared with the results of single-tracer PET imaging, (18)F-FDG tumor uptake and influx were recovered well from dual-tracer imaging. On doxorubicin treatment, whereas no significant changes in static tracer uptake values of (18)F-alfatide II

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

Directory of Open Access Journals (Sweden)

Türkan Ertay

2015-02-01

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

Multifocal Colonic Lesions Detected by 18F-FDG PET/CT: Correlation with Histopathology and Gross Specimen

International Nuclear Information System (INIS)

Choi, Byung Wook; Kim, Sung Hoon; Kim, Hae Won; Won, Kyoung Sook; Zeon, Seok Kil

2010-01-01

A fluorodeoxyglucose (FDG) positron emission tomography (PET)-computer tomography (CT) scan for staging. No definite abnormal FDG uptake of the stomach was shown. Incidentally, variable FDG uptake at the bilateral serrates muscles, abdominal muscles and muscles of both thighs (Fig. 1) was observed. He had no significant past medical history except recently diagnosed stomach cancer. On personal interview, he described having had sexual activity the night before the F-18 FDG PET/CT scan, although he was aware of needing to avoid physical activity before a PET scan. The F-18 FDG PET/CT scan was done at 2:00 p.m. Therefore, the hypermetabolism of individual skeletal muscles following sexual activity lasted over 12 h. This case illustrates the hypermetabolism of skeletal muscles following sexual activity as a normal variation.

Usefulness of low dose oral contrast media in 18F-FDG PET/CT

International Nuclear Information System (INIS)

An, Young Sil; Yoon, Joon Kee; Hong, Seon Pyo; Joh, Chul Woo; Yoon, Seok Nam

2006-01-01

The standard protocol using large volume of oral contrast media may cause gastrointestinal discomfort and contrast-related artifacts in PET/CT. The aim of this study was to evaluate the usefulness of low dose oral contrast in 18 F-FDG PET/CT. We retrospectively reviewed the whole-body PET/CT images in a total of 435 patients. About 200 ml of oral contrast agent (barium sulfate) was administered immediately before injection of 18 F-FDG. The FDG uptake of intestines was analyzed by visual and semi-quantitative method on transaxial, coronal and saggital planes. Seventy (16%, 113 sites) of 435 images showed high FDG uptake (peak SUV > 4); 50 (74%, 84 sites) with diffuse and 20 (26%, 29 sites) with focal uptake. The most commonly delivered site of oral contrast media was small bowel (n = 27, 39%). On PET/CT images, FDG uptake coexisted with oral contrast media in 26 patients (54%, 38 sites) with diffuse pattern and 9 (45%, 9 sites) with focal pattern, and by sites, those were 38 (45%) and 9 (31%), respectively. In small bowel regions, the proportion of coexistence reached as high as 61% (29/47 sites). A visual analysis of available non-attenuation corrected PET images of 27 matched regions revealed no contrast-related artifact. We concluded that the application of low dose contrast media could be helpful in the evaluation of abdominal uptake in the FDG PET/CT image

Canine study on myocardial ischemic memory with 18F-FDG PET/CT imaging