WorldWideScience

Sample records for emission tomography-computed tomography

  1. Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in Disseminated Cryptococcosis.

    Science.gov (United States)

    Tripathy, Sarthak; Parida, Girish Kumar; Roy, Shambo Guha; Singhal, Abhinav; Mallick, Saumya Ranjan; Tripathi, Madhavi; Shamim, Shamim Ahmed

    2017-01-01

    Disseminated cryptococcosis without pulmonary involvement is a very rare phenomenon. Patterns of organ involvement in cryptococcosis resemble various other infective conditions as well as malignant conditions on fluorodeoxyglucose positron emission tomography-computed tomography. We present a case of a 43-year-old male patient who had disseminated cryptococcosis. The rarity of the case being noninvolvement of lungs and meninges and resembling more like lymphoma due to the diffuse involvement of the lymph nodes on both sides of the diaphragm.

  2. Attenuation Correction Strategies for Positron Emission Tomography/Computed Tomography and 4-Dimensional Positron Emission Tomography/Computed Tomography

    OpenAIRE

    Pan, Tinsu; Zaidi, Habib

    2013-01-01

    This article discusses attenuation correction strategies in positron emission tomography/computed tomography (PET/CT) and 4 dimensional PET/CT imaging. Average CT scan derived from averaging the high temporal resolution CT images is effective in improving the registration of the CT and the PET images and quantification of the PET data. It underscores list mode data acquisition in 4 dimensional PET and introduces 4 dimensional CT popular in thoracic treatment planning to 4 dimensional PET/CT. ...

  3. Positron emission tomography/computed tomography imaging and rheumatoid arthritis.

    Science.gov (United States)

    Wang, Shi-Cun; Xie, Qiang; Lv, Wei-Fu

    2014-03-01

    Rheumatoid arthritis (RA) is a phenotypically heterogeneous, chronic, destructive inflammatory disease of the synovial joints. A number of imaging tools are currently available for evaluation of inflammatory conditions. By targeting the upgraded glucose uptake of infiltrating granulocytes and tissue macrophages, positron emission tomography/computed tomography with fluorine-18 fluorodeoxyglucose ((18) F-FDG PET/CT) is available to delineate inflammation with high sensitivity. Recently, several studies have indicated that FDG uptake in affected joints reflects the disease activity of RA. In addition, usage of FDG PET for the sensitive detection and monitoring of the response to treatment has been reported. Combined FDG PET/CT enables the detailed assessment of disease in large joints throughout the whole body. These unique capabilities of FDG PET/CT imaging are also able to detect RA-complicated diseases. Therefore, PET/CT has become an excellent ancillary tool to assess disease activity and prognosis in RA. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  4. Therapy response evaluation with positron emission tomography-computed tomography.

    Science.gov (United States)

    Segall, George M

    2010-12-01

    Positron emission tomography-computed tomography with F-18-fluorodeoxyglucose is widely used for evaluation of therapy response in patients with solid tumors but has not been as readily adopted in clinical trials because of the variability of acquisition and processing protocols and the absence of universal response criteria. Criteria proposed for clinical trials are difficult to apply in clinical practice, and gestalt impression is probably accurate in individual patients, especially with respect to the presence of progressive disease and complete response. Semiquantitative methods of determining tissue glucose metabolism, such as standard uptake value, can be a useful descriptor for levels of tissue glucose metabolism and changes in response to therapy if technical quality control measures are carefully maintained. The terms partial response, complete response, and progressive disease are best used in clinical trials in which the terms have specific meanings and precise definitions. In clinical practice, it may be better to use descriptive terminology agreed upon by imaging physicians and clinicians in their own practice. Copyright © 2010. Published by Elsevier Inc.

  5. RELIABILITY OF POSITRON EMISSION TOMOGRAPHY-COMPUTED TOMOGRAPHY IN EVALUATION OF TESTICULAR CARCINOMA PATIENTS.

    Science.gov (United States)

    Nikoletić, Katarina; Mihailović, Jasna; Matovina, Emil; Žeravica, Radmila; Srbovan, Dolores

    2015-01-01

    The study was aimed at assessing the reliability of 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan in evaluation of testicular carcinoma patients. The study sample consisted of 26 scans performed in 23 patients with testicular carcinoma. According to the pathohistological finding, 14 patients had seminomas, 7 had nonseminomas and 2 patients had a mixed histological type. In 17 patients, the initial treatment was orchiectomy+chemotherapy, 2 patients had orchiectomy+chemotherapy+retroperitoneal lymph node dissection, 3 patients had orchiectomy only and one patient was treated with chemotherapy only. Abnormal computed tomography was the main cause for the oncologist to refer the patient to positron emission tomography-computed tomography scan (in 19 scans), magnetic resonance imaging abnormalities in 1 scan, high level oftumor markers in 3 and 3 scans were perforned for follow-up. Positron emission tomography-computed tomography imaging results were compared with histological results, other imaging modalities or the clinical follow-up of the patients. Positron emission tomography-computed tomography scans were positive in 6 and negative in 20 patients. In two patients, positron emission tomography-computed tomography was false positive. There were 20 negative positron emission omography-computed tomography scans perforned in 18 patients, one patient was lost for data analysis. Clinically stable disease was confirmed in 18 follow-up scans performed in 16 patients. The values of sensitivty, specificity, accuracy, and positive- and negative predictive value were 60%, 95%, 75%, 88% and 90.5%, respectively. A hgh negative predictive value obtained in our study (90.5%) suggests that there is a small possibility for a patient to have future relapse after normal positron emission tomography-computed tomography study. However, since the sensitivity and positive predictive value of the study ire rather low, there are limitations of positive

  6. Positron emission tomography/computed tomography scanning for ...

    African Journals Online (AJOL)

    Background: Although the site of nosocomial sepsis in the critically ill ventilated patient is usually identifiable, it may remain occult, despite numerous investigations. The rapid results and precise anatomical location of the septic source using positron emission tomography (PET) scanning, in combination with computed ...

  7. Fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography in evaluation of residual intramuscular myxoma

    International Nuclear Information System (INIS)

    Zade, Anand; Ahire, Archana; Shetty, Shishir; Rai, Sujith; Bokka, Rajashekharrao; Velumani, Arokiaswamy; Kabnurkar, Rasika

    2015-01-01

    Intramuscular myxoma (IM) is a rare benign neoplasm. In a patient diagnosed with IM of left thigh, we report the utility of a postoperative fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography scan in assessing the efficacy of surgical excision

  8. Positron emission tomography-computed tomography has a clinical impact for patients with cervical cancer

    DEFF Research Database (Denmark)

    Sandvik, Rikke Mulvad; Jensen, Pernille Tine; Hendel, Helle W

    2011-01-01

    Many studies have found that positron emission tomography-computed tomography (PET-CT) has a high sensitivity and specificity in the identification of metastasis in cervical cancer. Herlev Hospital, Denmark, has been performing PET-CTs in stage I-IV cervical cancer since 1 May 2006. The present...

  9. 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography in Tuberculosis: Spectrum of Manifestations.

    Science.gov (United States)

    Agarwal, Krishan Kant; Behera, Abhishek; Kumar, Rakesh; Bal, Chandrasekhar

    2017-01-01

    The objective of this article is to provide an illustrative tutorial highlighting the utility of 18 F-fluorodeoxyglucose-positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) imaging to detect spectrum of manifestations in patients with tuberculosis (TB). FDG-PET/CT is a powerful tool for early diagnosis, measuring the extent of disease (staging), and consequently for evaluation of response to therapy in patients with TB.

  10. Fluorodeoxyglucose positron emission tomography-computed tomography findings in a case of xanthogranulomatous pyelonephritis

    Science.gov (United States)

    Joshi, Prathamesh; Lele, Vikram; Shah, Hardik

    2013-01-01

    Xanthogranulomatous pyelonephritis (XGNP) is an uncommon condition characterized by chronic suppurative renal inflammation that leads to progressive parenchymal destruction. This condition can clinically present as recurrent urinary tract infections, flank pain, hematuria, and occasionally sepsis, and weight loss. This condition is usually associated with obstructing renal calculus. We present 18-fluorodeoxyglucose positron emission tomography-computed tomography (18-FDG PET/CT) findings in an elderly male suffering from pyrexia and weight loss and suspected urinary tract infection. PET/CT findings in this case lead to diagnosis of XGNP. This diagnosis should be kept in mind while evaluating similar symptoms and PET/CT scan findings. PMID:24019680

  11. Diagnostic utility of fluorodeoxyglucose positron emission tomography/computed tomography in pyrexia of unknown origin

    International Nuclear Information System (INIS)

    Singh, Nidhi; Kumar, Rakesh; Malhotra, Arun; Bhalla, Ashu Seith; Kumar, Uma; Sood, Rita

    2005-01-01

    The present study was undertaken to evaluate the diagnostic utility of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) in patients presenting as pyrexia of unknown origin (PUO). Forty-seven patients (31 males and 16 females; mean age of 42.7 ± 19.96 years) presenting as PUO to the Department of Medicine at the All India Institute of Medical Sciences, New Delhi over a period of 2 years underwent F-18 FDG PET/CT. PET ⁄ CT was considered supportive when its results correlated with the final definitive diagnosis. Final diagnosis was made on the basis of combined evaluation of history, clinical findings, investigations, and response to treatment. Thirty-five PET/CT studies (74.5%) were positive. However, only 18 (38.3%) were supportive of the final diagnosis. In three patients (6.4%), PET/CT was considered diagnostic as none of the other investigations including contrast-enhanced computed tomography of chest and abdomen, and directed tissue sampling could lead to the final diagnosis. All these three patients were diagnosed as aortoarteritis. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography is an important emerging modality in the workup of PUO. It supported the final diagnosis in 38% of our patients and was diagnostic in 6.4% of patients. Thus, PET/CT should only be considered as second-line investigation for the diagnostic evaluation of PUO; especially in suspected noninfectious inflammatory disorders

  12. The role of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in resectable pancreatic cancer.

    Science.gov (United States)

    Crippa, Stefano; Salgarello, Matteo; Laiti, Silvia; Partelli, Stefano; Castelli, Paola; Spinelli, Antonello E; Tamburrino, Domenico; Zamboni, Giuseppe; Falconi, Massimo

    2014-08-01

    The role of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in pancreatic ductal adenocarcinoma is debated. We retrospectively assessed the value of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in addition to conventional imaging as a staging modality in pancreatic cancer. (18)Fluoro-deoxyglucose positron emission tomography/computed tomography was performed in 72 patients with resectable pancreatic carcinoma after multi-detector computed tomography positron emission tomography was considered positive for a maximum standardized uptake value >3. Overall, 21% of patients had a maximum standardized uptake value ≤ 3, and 60% of those had undergone neoadjuvant treatment (P=0.0001). Furthermore, 11% of patients were spared unwarranted surgery since positron emission tomography/computed tomography detected metastatic disease. All liver metastases were subsequently identified with contrast-enhanced ultrasound. Sensitivity and specificity of positron emission tomography/computed tomography for distant metastases were 78% and 100%. The median CA19.9 concentration was 48.8 U/mL for the entire cohort and 292 U/mL for metastatic patients (P=0.112). The widespread application of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in patients with resectable pancreatic carcinoma seems not justified. It should be considered in selected patients at higher risk of metastatic disease (i.e. CA19.9>200 U/mL) after undergoing other imaging tests. Neoadjuvant treatment is significantly associated with low metabolic activity, limiting the value of positron emission tomography in this setting. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  13. Fluorodeoxyglucose-positron emission tomography/computed tomography imaging features of colloid adenocarcinoma of the lung: a case report.

    Science.gov (United States)

    Wang, ZhenGuang; Yu, MingMing; Chen, YueHua; Kong, Yan

    2017-07-27

    Colloid adenocarcinoma of the lung is a rare subtype of variants of invasive adenocarcinomas. We report the appearance of this unusual entity on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography. A 60-year-old man of Chinese Han nationality coughed with a little white sputum for 1 month. Chest computed tomography showed multiple bilateral subpleural nodules and plaques accompanied by air bronchograms, which were most concentrated in the lower lobe of his right lung. Positron emission tomography indicated increased radioactivity uptake with a maximum standardized uptake value of 3.5. Positron emission tomography/computed tomography showed a soft tissue density lesion in his left adrenal gland with a maximum standardized uptake value of 4.1. The positron emission tomography/computed tomography appearance suggested a primary colloid adenocarcinoma in the lower lobe of his right lung accompanied by intrapulmonary and left adrenal gland metastases. The diagnostic rate of colloid adenocarcinoma can be increased by combining the anatomic and metabolic information of lesions. The advantage of positron emission tomography/computed tomography in the diagnosis of colloid adenocarcinoma, as with other cancers, is the ability to locate extrapulmonary disease, facilitating clinical staging.

  14. Fasciola Hepatica Mimicking Malignancy on 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

    Science.gov (United States)

    Sürücü, Erdem; Demir, Yusuf; Dülger, Ahmet C.; Batur, Abdüssamed; Ölmez, Şehmus; Kitapçı, Mehmet T.

    2016-01-01

    A 48-year-old female with complaints of gastrointestinal symptoms such as abdominal pain, fatigue, vomiting, nausea, and weight loss was diagnosed with neuroendocrine tumor after removal of a 2 mm lesion from the stomach with endoscopic biopsy. Her magnetic resonance imaging that was performed due to on-going symptoms showed multiple linear hypointense lesions in the liver. Positron emission tomography/computed tomography (PET/CT) scan was performed for differential diagnosis, which showed high fluorodeoxyglucose (FDG) uptake in these lesions. Clinical and laboratory findings revealed the final diagnosis as Fasciola hepatica. The imaging features of this case is presented to aid in differentiating this infectious disease from malignancy and avoid misdiagnosis on FDG-PET/CT. PMID:27751978

  15. Prognostic Evaluation of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Endometrial Cancer

    DEFF Research Database (Denmark)

    Vilstrup, Mie Holm; Jochumsen, Kirsten M; Hess, Søren

    2017-01-01

    .19-8.49) and 1.93 (0.80-4.68), respectively. Whole-body cTLG of greater than or equal to 176.1 g yielded a hazard ratio of 5.70 (1.94-16.78) for OS in a multivariate analysis. CONCLUSIONS: Preoperative SUVmax and cTLG showed potential as independent prognostic markers of OS in patients with primarily high...... and a preoperative F-fluorodeoxyglucose positron emission tomography/computed tomography before curatively intended treatment were included. The scans were evaluated using standard uptake values [maximum standard uptake value (SUVmax) and partial volume corrected (c) mean standardized uptake value (SUVmean...... proportional regression models were used for prognostic evaluation. RESULTS: Eighty-three patients (median age, 69.9 y; range, 26.8-91.1) with primarily high-risk endometrial cancer or suspected high The International Federation of Gynecology and Obstetrics stage were included. Mean follow-up time was 3...

  16. Fasciola Hepatica Mimicking Malignancy on 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

    Directory of Open Access Journals (Sweden)

    Erdem Sürücü

    2016-10-01

    Full Text Available A 48-year-old female with complaints of gastrointestinal symptoms such as abdominal pain, fatigue, vomiting, nausea, and weight loss was diagnosed with neuroendocrine tumor after removal of a 2 mm lesion from the stomach with endoscopic biopsy. Her magnetic resonance imaging that was performed due to on-going symptoms showed multiple linear hypointense lesions in the liver. Positron emission tomography/computed tomography (PET/CT scan was performed for differential diagnosis, which showed high fluorodeoxyglucose (FDG uptake in these lesions. Clinical and laboratory findings revealed the final diagnosis as Fasciola hepatica. The imaging features of this case is presented to aid in differentiating this infectious disease from malignancy and avoid misdiagnosis on FDG-PET/CT.

  17. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in the detection of primary pulmonary angiosarcomas

    International Nuclear Information System (INIS)

    Krishnamurthy, Arvind; Nayak, Deepika; Ramshankar, Vijayalakshmi; Majhi, Urmila

    2015-01-01

    Angiosarcoma is a malignant vascular tumor that originates from the mesenchymal cells which have undergone angioblastic differentiation. Pulmonary angiosarcomas are invariably (>90%) metastatic tumors form primaries of the skin, bone, liver, breast, or heart. Primary pulmonary angiosarcomas are exceedingly rare, with just about 20 cases being reported in the literature. We report an additional case with a brief review of the literature of a primary pulmonary angiosarcoma in a 26-year-old lady who presented with intractable hemoptysis. In addition, we highlight the potential of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography as an important diagnostic tool in the evaluation of this tumor and thus contribute to the existing sparse literature on this fascinating yet devastating disease

  18. An analysis of true- and false-positive results of vocal fold uptake in positron emission tomography-computed tomography imaging.

    Science.gov (United States)

    Seymour, N; Burkill, G; Harries, M

    2018-03-01

    Positron emission tomography-computed tomography with fluorine-18 fluorodeoxy-D-glucose has a major role in the investigation of head and neck cancers. Fluorine-18 fluorodeoxy-D-glucose is not a tumour-specific tracer and can also accumulate in benign pathology. Therefore, positron emission tomography-computed tomography scan interpretation difficulties are common in the head and neck, which can produce false-positive results. This study aimed to investigate patients detected as having abnormal vocal fold uptake on fluorine-18 fluorodeoxy-D-glucose positron emission tomography-computed tomography. Positron emission tomography-computed tomography scans were identified over a 15-month period where reports contained evidence of unilateral vocal fold uptake or vocal fold pathology. Patients' notes and laryngoscopy results were analysed. Forty-six patients were identified as having abnormal vocal fold uptake on positron emission tomography-computed tomography. Twenty-three patients underwent positron emission tomography-computed tomography and flexible laryngoscopy: 61 per cent of patients had true-positive positron emission tomography-computed tomography scans and 39 per cent had false-positive scan results. Most patients referred to ENT for abnormal findings on positron emission tomography-computed tomography scans had true-positive findings. Asymmetrical fluorine-18 fluorodeoxy-D-glucose uptake should raise suspicion of vocal fold pathology, accepting a false-positive rate of approximately 40 per cent.

  19. Report of two cases of fluorodeoxyglucose positron emission tomography/computed tomography appearance of hibernoma: A rare benign tumor

    International Nuclear Information System (INIS)

    Agrawal, Archi; Kembhavi, Seema; Purandare, Nilendu; Shah, Sneha; Rangarajan, Venkatesh

    2014-01-01

    False-positive findings are commonly seen in positron emission tomography computed tomography imaging. One of the most common false positive finding is uptake of fluorodeoxyglucose in brown adipose tissue. Herein, we report two cases with incidentally detected hibernomas-a brown fat containing tumor with metabolic activity

  20. Unusual sites of metastatic recurrence of osteosarcoma detected on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Kabnurkar, Rasika; Agrawal, Archi; Rekhi, Bharat; Purandare, Nilendu; Shah, Sneha; Rangarajan, Venkatesh

    2015-01-01

    Osteosarcoma (OS) is the most common nonhematolymphoid primary bone malignancy characterized by osteoid or new bone formation. Lungs and bones are the most common sites of metastases. We report a case where unusual sites of the soft tissue recurrence from OS were detected on restaging fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography scan done post 6 years of disease free interval

  1. The value of positron emission tomography/computed tomography for evaluating metastatic disease in patients with pancreatic cancer.

    Science.gov (United States)

    Kim, Mi-Jin; Lee, Kwang Hyuck; Lee, Kyu Taek; Lee, Jong Kyun; Ku, Bon-Ho; Oh, Cho-Rong; Heo, Jin Seok; Choi, Seong-Ho; Choi, Dong Wook

    2012-08-01

    Routine application of positron emission tomography/computed tomography (PET/CT) for pancreatic cancer staging remains a controversial approach. The purpose of this study was to reassess the clinical impact of PET/CT for the detection of distant metastasis of pancreatic cancer. From January 2006 to June 2009, 125 patients with histologically proven pancreatic cancer that had undergone PET/CT at our hospital were retrospectively reviewed. To evaluate the clinical efficacy of PET/CT on the management plan, the post-PET/CT management plans were compared with the pre-PET/CT management plans. After the conventional staging workup, we determined that 76 patients (60.8%) had resectable lesions, whereas 48 patients had unresectable lesions. One patient underwent explorative laparotomy due to equivocal resectability. Positron emission tomography/computed tomography diagnosed distant metastasis in only 2 (2.6%) of the 76 patients with resectable lesions, and these patients did not undergo unnecessary surgical treatment. Complete resection was not performed in 8 of the 74 operative patients because they had distant metastasis detected during the operative procedure. Positron emission tomography/computed tomography diagnosed distant metastasis in 32 of the 44 patients with metastatic lesions that were histologically shown to have sensitivity of 72.7%. Positron emission tomography/computed tomography has a limited role in the evaluation of metastatic disease from pancreatic cancer.

  2. Incidental head and neck findings on 18F-fluoro-deoxy-glucose positron emission tomography computed tomography.

    Science.gov (United States)

    Williams, S P; Kinshuck, A J; Williams, C; Dwivedi, R; Wieshmann, H; Jones, T M

    2015-09-01

    The overlapping risk factors for lung and head and neck cancer present a definite risk of synchronous malignant pathology. This is the first study to specifically review incidental positron emission tomography computed tomography findings in the head and neck region in lung carcinoma patients. A retrospective review was performed of all lung cancer patients who underwent positron emission tomography computed tomography imaging over a five-year period (January 2008 - December 2012), identified from the Liverpool thoracic multidisciplinary team database. Six hundred and nine patients underwent positron emission tomography computed tomography imaging over this period. In 76 (12.5 per cent) scans, incidental regions of avid 18F-fluoro-deoxy-glucose uptake were reported in the head and neck region. In the 28 patients who were fully investigated, there were 4 incidental findings of malignancy. In lung cancer patients undergoing investigative positron emission tomography computed tomography scanning, a significant number will also present with areas of clinically significant 18F-fluoro-deoxy-glucose uptake in the head and neck region. Of these, at least 5 per cent may have an undiagnosed malignancy.

  3. Extensive tumor thrombus of hepatocellular carcinoma in the entire portal venous system detected on fluorodeoxyglucose positron emission tomography computed tomography

    International Nuclear Information System (INIS)

    Agrawal, Archi; Purandare, Nilendu; Shah, Sneha; Puranik, Ameya; Rangarajan, Venkatesh

    2013-01-01

    Detection of thrombus is usually an incidental finding on fluorodeoxyglucose positron emission tomography/computed tomography studies. Nevertheless this is an important finding in terms of disease prognostication and in planning the treatment strategy. We herein report a case of a 50-years-old male, a diagnosed case of hepatocellular carcinoma with extensive hypermetabolic thrombus involving the entire portal venous system. (author)

  4. Diagnosis of sinusoidal obstruction syndrome by positron emission tomography/computed tomography: report of two cases treated by defibrotide.

    Science.gov (United States)

    Gauthé, Mathieu; Bozec, Laurence; Bedossa, Pierre

    2014-11-01

    Sinusoidal obstruction syndrome (SOS) is a potentially fatal liver injury that mainly occurs after myeloablative chemotherapy. We report two cases of SOS investigated by 18F-fluorodeoxyglucose positron emission tomography/computed tomography and treated with defibrotide. © 2014 by the American Association for the Study of Liver Diseases.

  5. Is there any role of positron emission tomography computed tomography for predicting resectability of gallbladder cancer?

    Science.gov (United States)

    Kim, Jaihwan; Ryu, Ji Kon; Kim, Chulhan; Paeng, Jin Chul; Kim, Yong-Tae

    2014-05-01

    The role of integrated (18)F-2-fluoro-2-deoxy-D-glucose positron emission tomography computed tomography (PET-CT) is uncertain in gallbladder cancer. The aim of this study was to show the role of PET-CT in gallbladder cancer patients. Fifty-three patients with gallbladder cancer underwent preoperative computed tomography (CT) and PET-CT scans. Their medical records were retrospectively reviewed. Twenty-six patients underwent resection. Based on the final outcomes, PET-CT was in good agreement (0.61 to 0.80) with resectability whereas CT was in acceptable agreement (0.41 to 0.60) with resectability. When the diagnostic accuracy of the predictions for resectability was calculated with the ROC curve, the accuracy of PET-CT was higher than that of CT in patients who underwent surgical resection (P=0.03), however, there was no difference with all patients (P=0.12). CT and PET-CT had a discrepancy in assessing curative resection in nine patients. These consisted of two false negative and four false positive CT results (11.3%) and three false negative PET-CT results (5.1%). PET-CT was in good agreement with the final outcomes compared to CT. As a complementary role of PEC-CT to CT, PET-CT tended to show better prediction about resectability than CT, especially due to unexpected distant metastasis.

  6. F-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Appearance of Extramedullary Hematopoesis in a Case of Primary Myelofibrosis

    Science.gov (United States)

    Mukherjee, Anirban; Bal, Chandrasekhar; Tripathi, Madhavi; Das, Chandan Jyoti; Shamim, Shamim Ahmed

    2017-01-01

    A 44-year-old female with known primary myelofibrosis presented with shortness of breath. High Resolution Computed Tomography thorax revealed large heterogeneously enhancing extraparenchymal soft tissue density mass involving bilateral lung fields. F-18-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography revealed mildly FDG avid soft tissue density mass with specks of calcification involving bilateral lung fields, liver, and spleen. Subsequent histopathologic evaluation from the right lung mass was suggestive of extramedullary hematopoesis. PMID:28533647

  7. Detecting Metastatic Bladder Cancer Using (18)F-Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography.

    Science.gov (United States)

    Öztürk, Hakan

    2015-10-01

    The purpose of this study was to retrospectively investigate the contribution of (18)F-fluorodeoxyglucose-positron emission tomography/computed tomography ((18)F-FDG-PET/CT) to detection of metastatic bladder cancer. The present study included 79 patients (69 men and 10 women) undergoing (18)F-FDG-PET/CT upon suspicion of metastatic bladder cancer between July 2007 and April 2013. The mean age was 66.1 years with a standard deviation of 10.7 years (range, 21 to 85 years). Patients were required to fast for 6 hours prior to scanning, and whole-body PET scanning from the skull base to the upper thighs was performed approximately 1 hour after intravenous injection of 555 MBq of (18)F-FDG. Whole body CT scanning was performed in the cranio-caudal direction. FDG-PET images were reconstructed using CT data for attenuation correction. Suspicious recurrent or metastatic lesions were confirmed by histopathology or clinical follow-up. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of (18)F-FDG-PET/CT were 89%, 78%, 90%, 75%, and 86%, respectively. (18)F-FDG-PET/CT can detect metastases with high sensitivity and positive predictive values in patients with metastatic bladder carcinoma.

  8. Brain Positron Emission Tomography-Computed Tomography Gender Differences in Tinnitus Patients.

    Science.gov (United States)

    Shlamkovich, Nathan; Gavriel, Haim; Eviatar, Ephraim; Lorberboym, Mordechay; Aviram, Eliad

    2016-10-01

    Increased metabolism in the left auditory cortex has been reported in tinnitus patients. However, gender difference has not been addressed. To assess the differences in Positron emission tomography-computed tomography (PET-CT) results between the genders in tinnitus patients. Retrospective cohort. Included were patients referred to our clinic between January 2011 and August 2013 who complained of tinnitus and underwent fluorodeoxyglucose (FDG)-PET to assess brain metabolism. Univariate and multivariate nominal logistic regressions were used to evaluate the association between upper temporal gyrus (UTG; right and left) and gender. Included were 140 patients (87 males) with an average age of 52.5 yr (median = 53.1). Bilateral tinnitus was found in 85 patients (60.7%), left sided in 30 (21.4%), and right sided in 21(15%). Increased uptake in the UTG was found in 60% of the patients on either side. Males had a statistically significant increased uptake in the UTG in those with unilateral tinnitus and in the entire population. We present the largest study reported so far on tinnitus patients who have undergone FDG-PET-CT. We found a statistically significant difference between the genders in FDG uptake by the UTG. Further investigations should be undertaken to reveal the etiologies for these differences and to assess different therapeutic protocols according to gender. American Academy of Audiology

  9. 18F-FDG positron emission tomography/computed tomography in infective endocarditis.

    Science.gov (United States)

    Salomäki, Soile Pauliina; Saraste, Antti; Kemppainen, Jukka; Bax, Jeroen J; Knuuti, Juhani; Nuutila, Pirjo; Seppänen, Marko; Roivainen, Anne; Airaksinen, Juhani; Pirilä, Laura; Oksi, Jarmo; Hohenthal, Ulla

    2017-02-01

    The diagnosis of infective endocarditis (IE), especially the diagnosis of prosthetic valve endocarditis (PVE) is challenging since echocardiographic findings are often scarce in the early phase of the disease. We studied the use of 2-[ 18 F]fluoro-2-deoxy-D-glucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) in IE. Sixteen patients with suspected PVE and 7 patients with NVE underwent visual evaluation of 18 F-FDG-PET/CT. 18 F-FDG uptake was measured also semiquantitatively as maximum standardized uptake value (SUV max ) and target-to-background ratio (TBR). The modified Duke criteria were used as a reference. There was strong, focal 18 F-FDG uptake in the area of the affected valve in all 6 cases of definite PVE, in 3 of 5 possible PVE cases, and in 2 of 5 rejected cases. In all patients with definite PVE, SUV max of the affected valve was higher than 4 and TBR higher than 1.8. In contrast to PVE, only 1 of 7 patients with NVE had uptake of 18 F-FDG by PET/CT in the valve area. Embolic infectious foci were detected in 58% of the patients with definite IE. 18 F-FDG-PET/CT appears to be a sensitive method for the detection of paravalvular infection associated with PVE. Instead, the sensitivity of PET/CT is limited in NVE.

  10. Mycosis fungoides: Positron emission tomography/computed tomography in staging and monitoring the effect of therapy

    International Nuclear Information System (INIS)

    D’Souza, Maria Mathew; D’Souza, Paschal; Sharma, Rajnish; Jaimini, Abhinav; Mondal, Anupam

    2015-01-01

    A 58-year-old woman, diagnosed as a case of mycosis fungoides (MF), underwent [18F]-fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) examination. The study revealed intense FDG uptake in a large ulceroproliferative right thigh lesion, indurated plaques in the chest wall and left thigh, along with multiple sites of cutaneous involvement, axillary and inguinal lymphadenopathy. The patient underwent chemotherapy with CHOP regimen, radiotherapy for the right thigh lesion, along with topical corticosteroids and emollients for the disseminated cutaneous involvement. Repeat [18F]-FDG PET/CT study performed a year later, showed near complete disease regression specifically of the ulceroproliferative lesion and indurated cutaneous plaques, no change in lymphadenopathy, and a subtle diffuse progression of the remaining cutaneous lesions. A multidisciplinary approach to the diagnosis, staging and treatment of MF has long been suggested for optimizing outcomes from management of patients with this disease. This case highlights the potential role of incorporating PET/CT as a single modality imaging technique in the staging and assessment of response to therapy

  11. Retroperitoneal Endometriosis: A Possible Cause of False Positive Finding at 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

    International Nuclear Information System (INIS)

    Maffione, Anna Margherita; Panzavolta, Riccardo; Lisato, Laura Camilla; Ballotta, Maria; D'Isanto, Mariangela Zanforlini; Rubello, Domenico

    2015-01-01

    Endometriosis is a frequent and clinically relevant problem in young women. Laparoscopy is still the gold standard for the diagnosis of endometriosis, but frequently both morphologic and functional imaging techniques are involved in the diagnostic course before achieving a conclusive diagnosis. We present a case of a patient affected by infiltrating retroperitoneal endometriosis falsely interpreted as a malignant mass by contrast-enhanced magnetic resonance imaging and 18 F-fluorodeoxyglucose positron emission tomography/computed tomography

  12. Utility of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in a child with chronic granulomatous disease

    International Nuclear Information System (INIS)

    Garg, Gunjan; DaSilva, Raphaella; Bhalakia, Avni; Milstein, David M.

    2016-01-01

    We report the fluorodeoxyglucose positron emission tomography/computed tomography (FDG - PET/CT) findings in an 11-month-old boy with suspected milk protein allergy, presented to the hospital with 2-month history of fever of unknown origin and failure to thrive. It showed FDG avid lymphadenopathy above and below the diaphragm and splenic focus, which could represent diffuse inflammatory process or lymphoma. Subsequent jejunal biopsy showed non-necrotizing granulomas

  13. Promising role of single photon emission computed tomography/computed tomography in Meckel's scan

    International Nuclear Information System (INIS)

    Jain, Anurag; Chauhan, MS; Pandit, AG; Kumar, Rajeev; Sharma, Amit

    2012-01-01

    Meckel's scan is a common procedure performed in nuclear medicine. Single-photon emission computed tomography/computed tomography (SPECT/CT) in a suspected case of heterotopic location of gastric mucosa can increase the accuracy of its anatomic localization. We present two suspected cases of Meckel's diverticulum in, which SPECT/CT co-registration has helped in better localization of the pathology

  14. Trails on 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Leading to Diagnosis of Testicular Adrenal Rest Tumor.

    Science.gov (United States)

    Kashyap, Raghava

    2018-01-01

    Testicular adrenal rest tumors (TARTs) are secondary to hypertrophy of adrenal rest cells in the rete testis in settings of hypersecretion of androgens. We present a case of congenital adrenal hyperplasia with TART with clues to the diagnosis on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT). To the best of our knowledge, this is the first reported case on the role of 18 F-FDG PET/CT in TART.

  15. Positron emission tomography/computed tomography surveillance in patients with Hodgkin lymphoma in first remission has a low positive predictive value and high costs.

    Science.gov (United States)

    El-Galaly, Tarec Christoffer; Mylam, Karen Juul; Brown, Peter; Specht, Lena; Christiansen, Ilse; Munksgaard, Lars; Johnsen, Hans Erik; Loft, Annika; Bukh, Anne; Iyer, Victor; Nielsen, Anne Lerberg; Hutchings, Martin

    2012-06-01

    The value of performing post-therapy routine surveillance imaging in patients with Hodgkin lymphoma is controversial. This study evaluates the utility of positron emission tomography/computed tomography using 2-[18F]fluoro-2-deoxyglucose for this purpose and in situations with suspected lymphoma relapse. We conducted a multicenter retrospective study. Patients with newly diagnosed Hodgkin lymphoma achieving at least a partial remission on first-line therapy were eligible if they received positron emission tomography/computed tomography surveillance during follow-up. Two types of imaging surveillance were analyzed: "routine" when patients showed no signs of relapse at referral to positron emission tomography/computed tomography, and "clinically indicated" when recurrence was suspected. A total of 211 routine and 88 clinically indicated positron emission tomography/computed tomography studies were performed in 161 patients. In ten of 22 patients with recurrence of Hodgkin lymphoma, routine imaging surveillance was the primary tool for the diagnosis of the relapse. Extranodal disease, interim positron emission tomography-positive lesions and positron emission tomography activity at response evaluation were all associated with a positron emission tomography/computed tomography-diagnosed preclinical relapse. The true positive rates of routine and clinically indicated imaging were 5% and 13%, respectively (P = 0.02). The overall positive predictive value and negative predictive value of positron emission tomography/computed tomography were 28% and 100%, respectively. The estimated cost per routine imaging diagnosed relapse was US$ 50,778. Negative positron emission tomography/computed tomography reliably rules out a relapse. The high false positive rate is, however, an important limitation and a confirmatory biopsy is mandatory for the diagnosis of a relapse. With no proven survival benefit for patients with a pre-clinically diagnosed relapse, the high costs and low

  16. Role of positron emission tomography-computed tomography in endometrial cancer

    Science.gov (United States)

    Erdemoğlu, Evrim; Çerçi, Sevim Süreyya; Erdemoğlu, Ebru; Yalçın, Yakup; Tatar, Burak

    2017-01-01

    Objective: The efficacy of preoperative 18F-fluoro-D-glucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) in endometrium cancer is controversial. We examined the efficacy of PET-CT and the association between maximum standardized uptake value (SUVmax) and prognostic factors in endometrial cancer. Materials and Methods: Thirty patients with endometrial cancer underwent preoperative 18F-FDG/PET-CT. The patients were treated with abdominal hysterectomy with bilateral salpingo-oophorectomy, and bilateral systemic pelvic lymphadenectomy was planned for all patients; paraaortic lymphadenectomy was performed in patients with intermediate and high risk. Tumor histology, grade, depth of myometrial invasion, maximum tumor diameter, lymphovascular invasion, nodal status, and ovarian/adnexal metastases were recorded. Results: The mean primary tumor diameter was reported smaller in PET-CT and the effect size of PET-CT was -0.60. The kappa value was 0.06 for myometrial invasion. Pelvic lymph node metastasis was reported in 22.2% of patients in PET-CT. However, 3.7% of patients had pelvic lymph node metastasis. The kappa value for pelvic lymph node metastasis was 0.23, and sensitivity, specificity, and positive and negative predictive values were 100%, 80.7%, 16.6%, and 100%, respectively. Paraaortic lymph node metastasis in PET-CT was suspected in 10%. However, paraaortic lymph node metastasis was found in 6.7% in histopathologic analyses. The kappa value was 0.15. The sensitivity, specificity, and positive and negative predictive values of PET-CT for detecting paraaortic lymph node metastases were 100%, 93.7%, 66.6%, and 100%, respectively. Myometrial invasion and tumor diameter were the only important prognostic factors affecting SUVmax. Conclusion: According to our results, PET-CT has a limited role and diagnostic efficacy in endometrial cancer. The indications of FDG/PET-CT in endometrium cancer should be studied further and revised. PMID:29379661

  17. Enhancement of positron emission tomography-computed tomography image quality using the principle of stochastic resonance

    International Nuclear Information System (INIS)

    Pandey, Anil Kumar; Sharma, Sanjay Kumar; Sharma, Punit; Singh, Harmandeep; Patel, Chetan; Sarkar, Kaushik; Kumar, Rakesh; Bal, Chandra Sekhar

    2014-01-01

    Acquisition of higher counts improves visual perception of positron emission tomography-computed tomography (PET-CT) image. Larger radiopharmaceutical doses (implies more radiation dose) are administered to acquire this count in a short time period. However, diagnostic information does not increase after a certain threshold of counts. This study was conducted to develop a post processing method based on principle of “stochastic resonance” to improve visual perception of the PET-CT image having a required threshold counts. PET-CT images (JPEG file format) with low, medium, and high counts in the image were included in this study. The image was corrupted with the addition of Poisson noise. The amplitude of the Poisson noise was adjusted by dividing each pixel by a constant 1, 2, 4, 8, 16, and 32. The best amplitude of the noise that gave best images quality was selected based on high value of entropy of the output image, high value of structural similarity index and feature similarity index. Visual perception of the image was evaluated by two nuclear medicine physicians. The variation in structural and feature similarity of the image was not appreciable visually, but statistically images deteriorated as the noise amplitude increases although maintaining structural (above 70%) and feature (above 80%) similarity of input images in all cases. We obtained the best image quality at noise amplitude “4” in which 88% structural and 95% feature similarity of the input images was retained. This method of stochastic resonance can be used to improve the visual perception of the PET-CT image. This can indirectly lead to reduction of radiation dose

  18. Does positron emission tomography/computed tomography aid the diagnosis of prosthetic valve infective endocarditis?

    Science.gov (United States)

    Balmforth, Damian; Chacko, Jacob; Uppal, Rakesh

    2016-10-01

    A best evidence topic was constructed according to a structured protocol. The question addressed was whether (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) aids the diagnosis of prosthetic valve endocarditis (PVE)? A total of 107 publications were found using the reported search, of which 6 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. The reported outcome of all studies was a final diagnosis of confirmed endocarditis on follow-up. All the six studies were non-randomized, single-centre, observational studies and thus represented level 3 evidence. The diagnostic capability of PET/CT for PVE was compared with that of the modified Duke Criteria and echocardiography, and reported in terms of sensitivity, specificity and positive and negative predictive values. All studies demonstrated an increased sensitivity for the diagnosis of PVE when PET/CT was combined with the modified Duke Criteria on admission. A higher SUVmax on PET was found to be significantly associated with a confirmed diagnosis of endocarditis and an additional diagnostic benefit of PET/CT angiography over conventional PET/non-enhanced CT is reported due to improved anatomical resolution. However, PET/CT was found to be unreliable in the early postoperative period due to its inability to distinguish between infection and residual postoperative inflammatory changes. PET/CT was also found to be poor at diagnosing cases of native valve endocarditis. We conclude that PET/CT aids in the diagnosis of PVE when combined with the modified Duke Criteria on admission by increasing the diagnostic sensitivity. The diagnostic ability of PET/CT can be potentiated by the use of PET/CTA; however, its use may be unreliable in the early postoperative period or in native valve endocarditis. © The Author 2016. Published by

  19. Clinical value of whole body fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in the detection of metastatic bladder cancer.

    Science.gov (United States)

    Yang, Zhongyi; Pan, Lingling; Cheng, Jingyi; Hu, Silong; Xu, Junyan; Ye, Dingwei; Zhang, Yingjian

    2012-07-01

    To investigate the value of whole-body fluorine-18 2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography for the detection of metastatic bladder cancer. From December 2006 to August 2010, 60 bladder cancer patients (median age 60.5 years old, range 32-96) underwent whole body positron emission tomography/computed tomography positron emission tomography/computed tomography. The diagnostic accuracy was assessed by performing both organ-based and patient-based analyses. Identified lesions were further studied by biopsy or clinically followed for at least 6 months. One hundred and thirty-four suspicious lesions were identified. Among them, 4 primary cancers (2 pancreatic cancers, 1 colonic and 1 nasopharyngeal cancer) were incidentally detected, and the patients could be treated on time. For the remaining 130 lesions, positron emission tomography/computed tomography detected 118 true positive lesions (sensitivity = 95.9%). On the patient-based analysis, the overall sensitivity and specificity resulted to be 87.1% and 89.7%, respectively. There was no difference of sensitivity and specificity in patients with or without adjuvant treatment in terms of detection of metastatic sites by positron emission tomography/computed tomography. Compared with conventional imaging modality, positron emission tomography/computed tomography correctly changed the management in 15 patients (25.0%). Positron emission tomography/computed tomography has excellent sensitivity and specificity in the detection of metastatic bladder cancer and it provides additional diagnostic information compared to standard imaging techniques. © 2012 The Japanese Urological Association.

  20. Clinical value of whole body fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in the detection of metastatic bladder cancer

    International Nuclear Information System (INIS)

    Yang Zhongyi; Pan Lingling; Cheng Jingyi; Hu Silong; Xu Junyan; Zhang Yingjian; Ye Dingwei

    2012-01-01

    The objective of this study was to investigate the value of whole-body fluorine-18 2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography for the detection of metastatic bladder cancer. From December 2006 to August 2010, 60 bladder cancer patients (median age 60.5 years old, range 32-96) underwent whole body positron emission tomography/computed tomography positron emission tomography/computed tomography. The diagnostic accuracy was assessed by performing both organ-based and patient-based analyses. Identified lesions were further studied by biopsy or clinically followed for at least 6 months. One hundred and thirty-four suspicious lesions were identified. Among them, 4 primary cancers (2 pancreatic cancers, 1 colonic and 1 nasopharyngeal cancer) were incidentally detected, and the patients could be treated on time. For the remaining 130 lesions, positron emission tomography/computed tomography detected 118 true positive lesions (sensitivity=95.9%). On the patient-based analysis, the overall sensitivity and specificity resulted to be 87.1% and 89.7%, respectively. There was no difference of sensitivity and specificity in patients with or without adjuvant treatment in terms of detection of metastatic sites by positron emission tomography/computed tomography. Compared with conventional imaging modality, positron emission tomography/computed tomography correctly changed the management in 15 patients (25.0%). Positron emission tomography/computed tomography has excellent sensitivity and specificity in the detection of metastatic bladder cancer and it provides additional diagnostic information compared to standard imaging techniques. (author)

  1. Recurrent proliferating trichilemmal tumor with malignant change on the f-18 fluorodeoxyglucose position emission tomography/computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Eun Ha; Kim, Eun Ha; Kim, Young Jun; Yoo, Seol Bong; Nam, Kyung Hwa [Presbyterian Medical Center, Seonam University College of Medicine, Jeonju (Korea, Republic of)

    2016-06-15

    F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography scan has been used for the diagnosis, assessment of treatment response, and follow-up of various neoplasms. Proliferating trichilemmal cyst or tumor (PTT) is a rare neoplasm, originated from the outer root sheath of a hair follicle. Because this tumor has unpredictable biological and clinical behavior, the long-term clinical follow-up is necessary to detect metastasis or recurrence. We reported a case of recurrent malignant PTT on scalp that showed increased FDG uptake.

  2. Spectrum of fluorodeoxyglucose-positron emission tomography/computed tomography and magnetic resonance imaging findings of ovarian tumors.

    Science.gov (United States)

    Kitajima, Kazuhiro; Ueno, Yoshiko; Maeda, Tetsuo; Murakami, Koji; Kaji, Yasushi; Kita, Masato; Suzuki, Kayo; Sugimura, Kazuro

    2011-11-01

    The purpose of this article is to review fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) and magnetic resonance imaging (MRI) findings in a variety of benign, malignant, and borderline malignant ovarian tumors. It is advantageous to become familiar with the wide variety of FDG-PET/CT findings of this entity. Benign ovarian tumors generally have faint uptake, whereas endometriomas, fibromas, and teratomas show mild to moderate uptake. Malignant ovarian tumors generally have intense uptake, whereas tumors with a small solid component often show minimal uptake.

  3. Positron emission tomography/computed tomography and biomarkers for early treatment response evaluation in metastatic colon cancer

    DEFF Research Database (Denmark)

    Engelmann, Bodil E.; Loft, Annika; Kjær, Andreas

    2014-01-01

    BACKGROUND: Treatment options for metastatic colon cancer (mCC) are widening. We prospectively evaluated serial 2-deoxy-2-[18F]fluoro-d-glucose positron-emission tomography/computed tomography (PET/CT) and measurements of tissue inhibitor of metalloproteinases-1 (TIMP-1), carcinoembryonic antigen...... evaluated by PET/CT before treatment, after one and four treatment series. Morphological and metabolic response was independently assessed according to Response Evaluation Criteria in Solid Tumors and European Organization for Research and Treatment of Cancer PET criteria. Plasma TIMP-1, plasma u...

  4. Contrast-enhanced 18F-fluorodeoxyglucose positron emission tomography/computed tomography in immunoglobulin G4-related retroperitoneal fibrosis

    International Nuclear Information System (INIS)

    Sharma, Punit; Chatterjee, Piyali

    2015-01-01

    Immunoglobulin G4 (IgG4)-related disease encompasses a wide variety of immune disorders previously thought be distinct. IgG4-related retroperitoneal fibrosis is one such entity. Metabolic imaging with 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) can be useful in the management of IgG4-related retroperitoneal fibrosis. We here discuss the case of 63-year-old male with IgG4-related retroperitoneal fibrosis and the role, 18 F-FDG PET/CT played in his management

  5. ¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography for the evaluation of bone metastasis in patients with gastric cancer.

    Science.gov (United States)

    Ma, Dae Won; Kim, Jie-Hyun; Jeon, Tae Joo; Lee, Yong Chan; Yun, Mijin; Youn, Young Hoon; Park, Hyojin; Lee, Sang In

    2013-09-01

    The roles of positron emission tomography and bone scanning in identifying bone metastasis in gastric cancer are unclear. We compared the usefulness of positron emission tomography-computed tomography and scanning in detecting bone metastasis in gastric cancer. Data from 1485 patients diagnosed with gastric cancer who had undergone positron emission tomography-computed tomography and scanning were reviewed. Of 170 enrolled patients who were suspected of bone metastasis in either positron emission tomography or scanning, 81.2% were confirmed to have bone metastasis. The sensitivity, specificity, and accuracy were 93.5%, 25.0%, and 80.6%, respectively, for positron emission tomography and 93.5%, 37.5%, and 82.9%, respectively, for scanning. 87.7% of patients with bone metastasis showed positive findings on two modalities. 15.0% of solitary bone metastases were positive on positron emission tomography only. Positron emission tomography was superior to scanning for the detection of synchronous bone metastasis, but the two modalities were similar for the detection of metachronous bone metastasis. The concordance rate of response assessment after treatment between two modalities was moderate. Positron emission tomography-computed tomography may be more effective for the diagnosis of bone metastasis in the initial staging workup. Conversely, bone scanning and positron emission tomography-computed tomography may be similarly effective for the detection of metachronous bone metastasis. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  6. 18 F-fluorodeoxyglucose positron emission tomography-computed tomography for preoperative lymph node staging in patients undergoing radical cystectomy for bladder cancer: a prospective study.

    Science.gov (United States)

    Hitier-Berthault, Maryam; Ansquer, Catherine; Branchereau, Julien; Renaudin, Karine; Bodere, Françoise; Bouchot, Olivier; Rigaud, Jérôme

    2013-08-01

    The objective of our study was to analyze the diagnostic performance of (18) F-fluorodeoxyglucose positron emission tomography-computed tomography for lymph node staging in patients with bladder cancer before radical cystectomy and to compare it with that of computed tomography. A total of 52 patients operated on between 2005 and 2010 were prospectively included in this prospective, mono-institutional, open, non-randomized pilot study. Patients who had received neoadjuvant chemotherapy or radiotherapy were excluded. (18) F-fluorodeoxyglucose positron emission tomography-computed tomography in addition to computed tomography was carried out for lymph node staging of bladder cancer before radical cystectomy. Lymph node dissection during radical cystectomy was carried out. Findings from (18) F-fluorodeoxyglucose positron emission tomography-computed tomography and computed tomography were compared with the results of definitive histological examination of the lymph node dissection. The diagnostic performance of the two imaging modalities was assessed and compared. The mean number of lymph nodes removed during lymph node dissection was 16.5 ± 10.9. Lymph node metastasis was confirmed on histological examination in 22 cases (42.3%). This had been suspected in five cases (9.6%) on computed tomography and in 12 cases (23.1%) on (18) F-fluorodeoxyglucose positron emission tomography-computed tomography. Sensitivity, specificity, positive predictive value, negative predictive value, relative risk and accuracy were 9.1%, 90%, 40%, 57.4%, 0.91 and 55.7%, respectively, for computed tomography, and 36.4%, 86.7%, 66.7%, 65%, 2.72, 65.4%, respectively, for (18) F-fluorodeoxyglucose positron emission tomography-computed tomography. (18) F-fluorodeoxyglucose positron emission tomography-computed tomography is more reliable than computed tomography for preoperative lymph node staging in patients with invasive bladder carcinoma undergoing radical cystectomy. © 2012 The Japanese

  7. Fluorodeoxyglucose positron emission tomography/computed tomography findings in a patient with cerebellar mutism after operation in posterior fossa

    Directory of Open Access Journals (Sweden)

    Gonca Kara Gedik

    2017-03-01

    Full Text Available Cerebellar mutism is a transient period of speechlessness that evolves after posterior fossa surgery in children. Although direct cerebellar and brain stem injury and supratentorial dysfunction have been implicated in the mediation of mutism, the pathophysiological mechanisms involved in the evolution of this kind of mutism remain unclear. Magnetic resonance imaging revealed dentatothalamocortical tract injuries and single photon emission computed tomography showed cerebellar and cerebral hypoperfusion in patients with cerebellar mutism. However, findings with 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT in this group of patients have not been documented previously. In this clinical case, we report a patient who experienced cerebellar mutism after undergoing a posterior fossa surgery. Right cerebellar and left frontal lobe hypometabolism was shown using FDG PET/CT. The FDG metabolism of both the cerebellum and the frontal lobe returned to normal levels after the resolution of the mutism symptoms.

  8. Technetium-99m methylene diphosphonate uptake in the brachialis muscle hematoma in a patient with prostate cancer and coagulation disorder mimicking bone metastasis evaluated by single-photon emission tomography-computed tomography/computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kamaleshwaran, Koramadai Karuppusamy; Mohanan, Vyshakh; Shinto, Ajit Sugunan, E-mail: dr.kamaleshwar@gmail.com [Department of Nuclear Medicine and PET/CT, Kovai Medical Centre and Hospital Limited, Coimbatore (India); Madhavan, Devdas [Department of Urology, Comprehensive Cancer Care Centre, Kovai Medical Centre and Hospital Limited, Coimbatore (India)

    2013-10-15

    We report a case of 79-year-old male with prostate cancer and coagulation disorder presented with left shoulder pain. He underwent bone scintigraphy to rule out metastasis, which showed intense foci of tracer activity in the left axilla. Hybrid single-photon emission tomography-computed tomography (SPECT/CT) of the shoulder region localized tracer uptake to the left brachialis muscle hematoma. (author)

  9. Technetium-99m methylene diphosphonate uptake in the brachialis muscle hematoma in a patient with prostate cancer and coagulation disorder mimicking bone metastasis evaluated by single-photon emission tomography-computed tomography/computed tomography

    International Nuclear Information System (INIS)

    Kamaleshwaran, Koramadai Karuppusamy; Mohanan, Vyshakh; Shinto, Ajit Sugunan; Madhavan, Devdas

    2013-01-01

    We report a case of 79-year-old male with prostate cancer and coagulation disorder presented with left shoulder pain. He underwent bone scintigraphy to rule out metastasis, which showed intense foci of tracer activity in the left axilla. Hybrid single-photon emission tomography-computed tomography (SPECT/CT) of the shoulder region localized tracer uptake to the left brachialis muscle hematoma. (author)

  10. A case of skeletal tuberculosis and psoas abscess: disease activity evaluated using (18) F-fluorodeoxyglucose positron emission tomography-computed tomography.

    Science.gov (United States)

    Kimizuka, Yoshifumi; Ishii, Makoto; Murakami, Koji; Ishioka, Kota; Yagi, Kazuma; Ishii, Ken; Watanabe, Kota; Soejima, Kenzo; Betsuyaku, Tomoko; Hasegawa, Naoki

    2013-11-14

    Psoas abscess complicating tuberculous spondylitis is a rare morbidity in extrapulmonary tuberculosis. There are no established guidelines for evaluating the clinical response of psoas abscess. Although several studies have shown that positron emission tomography-computed tomography with 18 F-fluorodeoxyglucose can play a potential role in diagnosing multifocal tuberculosis and monitoring the clinical response of pulmonary tuberculosis, to our knowledge, this is the first report demonstrating that positron emission tomography-computed tomography is useful for evaluating local inflammation and disease activity of a tuberculous psoas abscess. We report a case of multifocal bone and lymph node tuberculosis with concomitant lumbar psoas abscess in a 77-year-old man, along with a literature review. An initial positron emission tomography-computed tomography scan showed intense 18 F-fluorodeoxyglucose accumulation in the sternum, ribs, vertebrae, and lymph nodes. The patient was successfully treated with antitubercular agents and computed tomography-guided drainage therapy. A follow-up positron emission tomography-computed tomography after abscess drainage and 9 months of antitubercular drug treatment revealed that the majority of lesions improved; however, protracted inflammation surrounding the psoas abscess was still observed. These results indicate that disease activity of psoas abscess can remain, even after successful drainage and antitubercular medication regime of appropriate duration. We have successfully followed up the extent of skeletal tuberculosis complicated with psoas abscess by positron emission tomography-computed tomography. In this patient, positron emission tomography-computed tomography is useful for evaluating the disease activity of tuberculous psoas abscess and for assessing the appropriate duration of antitubercular drug therapy in psoas abscess.

  11. A case of skeletal tuberculosis and psoas abscess: disease activity evaluated using 18 F-fluorodeoxyglucose positron emission tomography-computed tomography

    International Nuclear Information System (INIS)

    Kimizuka, Yoshifumi; Hasegawa, Naoki; Ishii, Makoto; Murakami, Koji; Ishioka, Kota; Yagi, Kazuma; Ishii, Ken; Watanabe, Kota; Soejima, Kenzo; Betsuyaku, Tomoko

    2013-01-01

    Psoas abscess complicating tuberculous spondylitis is a rare morbidity in extrapulmonary tuberculosis. There are no established guidelines for evaluating the clinical response of psoas abscess. Although several studies have shown that positron emission tomography-computed tomography with 18 F-fluorodeoxyglucose can play a potential role in diagnosing multifocal tuberculosis and monitoring the clinical response of pulmonary tuberculosis, to our knowledge, this is the first report demonstrating that positron emission tomography-computed tomography is useful for evaluating local inflammation and disease activity of a tuberculous psoas abscess. We report a case of multifocal bone and lymph node tuberculosis with concomitant lumbar psoas abscess in a 77-year-old man, along with a literature review. An initial positron emission tomography-computed tomography scan showed intense 18 F-fluorodeoxyglucose accumulation in the sternum, ribs, vertebrae, and lymph nodes. The patient was successfully treated with antitubercular agents and computed tomography-guided drainage therapy. A follow-up positron emission tomography-computed tomography after abscess drainage and 9 months of antitubercular drug treatment revealed that the majority of lesions improved; however, protracted inflammation surrounding the psoas abscess was still observed. These results indicate that disease activity of psoas abscess can remain, even after successful drainage and antitubercular medication regime of appropriate duration. We have successfully followed up the extent of skeletal tuberculosis complicated with psoas abscess by positron emission tomography-computed tomography. In this patient, positron emission tomography-computed tomography is useful for evaluating the disease activity of tuberculous psoas abscess and for assessing the appropriate duration of antitubercular drug therapy in psoas abscess

  12. Hybrid Single Photon Emission Computed Tomography/Computed Tomography Sulphur Colloid Scintigraphy in Focal Nodular Hyperplasia

    International Nuclear Information System (INIS)

    Bhoil, Amit; Gayana, Shankramurthy; Sood, Ashwani; Bhattacharya, Anish; Mittal, Bhagwant Rai

    2013-01-01

    It is important to differentiate focal nodular hyperplasia (FNH), a benign condition of liver most commonly affecting women, from other neoplasm such as hepatic adenoma and metastasis. The functional reticuloendothelial features of FNH can be demonstrated by scintigraphy. We present a case of breast cancer in whom fluorodeoxyglucose positron emission tomography/computerized tomography (CT) showed a homogenous hyperdense lesion in liver, which on Tc99m sulfur colloid single-photon emission computed tomography/CT was found to have increased focal tracer uptake suggestive of FNH

  13. Imaging spectrum and pitfalls of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with tuberculosis.

    Science.gov (United States)

    Ito, Kimiteru; Morooka, Miyako; Minamimoto, Ryogo; Miyata, Yoko; Okasaki, Momoko; Kubota, Kazuo

    2013-08-01

    Mycobacterium tuberculosis (TB) is one of the most prominant diseases frequently causing false positive lesions in oncologic surveys using (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), since TB granulomas are composed of activated macrophages and lymphocytes with high affinity for glucose. These pitfalls of (18)F-FDG PET/CT are important for radiologists. Being familiar with (18)F-FDG images of TB could assist in preventing unfavorable clinical results based on misdiagnoses. In addition, (18)F-FDG PET/CT has the advantage of being able to screen the whole body, and can clearly detect harboring TB lesions as high uptake foci. This article details the spectrum and pitfalls of (18)F-FDG PET/CT imaging in TB.

  14. Contrast-enhanced fluorodeoxyglucose positron emission tomography/computed tomography in solid pseudopapillary neoplasm of the pancreas

    International Nuclear Information System (INIS)

    Santhosh, Sampath; Lakshmanan, Ramesh Kumar; Sonik, Bhavay; Padmavathy, Rajagopalan; Gunaseelan, Rajamani Emmanuel

    2016-01-01

    Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare pancreatic tumor with low malignant potential. It occurs characteristically more often in young women. Radiological and pathological studies have revealed that the tumor is quite different from other pancreatic tumors. Limited information is available in the literature reporting their accumulation of fluorine- 18 fluorodeoxyglucose ( 18 F-FDG) in positron emission tomography/computed tomography (PET/CT). Here, we report a case of pancreatic SPN imaged with contrast-enhanced FDG PET/CT. A percutaneous fine needle aspiration from the metabolically active lesion revealed SPN, and it was confirmed with histopathological results. Recurrence or metastasis was not found after 7 months of follow-up

  15. Benign thyroid and neck lesions mimicking malignancy with false positive findings on positron emission tomography-computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Ye Ri; Kim, Shin Young; Lee, Sang Mi [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Lee, Deuk Young [Dept. of Surgery, Younsei Angelot Women' s Clinic, Cheonan (Korea, Republic of)

    2017-02-15

    The increasing use of positron emission tomography-computed tomography (PET/CT) has led to the frequent detection of incidental thyroid and neck lesions with increased 18F-deoxyglucose (FDG) uptake. Although lesions with increased FDG uptake are commonly assumed to be malignant, benign lesions may also exhibit increased uptake. The purpose of this pictorial essay is to demonstrate that benign thyroid and neck lesions can produce false-positive findings on PET/CT, and to identify various difficulties in interpretation. It is crucial to be aware that differentiating between benign and malignant lesions is difficult in a considerable proportion of cases, when relying only on PET/CT findings. Correlation of PET/CT findings with additional imaging modalities is essential to avoid misdiagnosis.

  16. Positron emission tomography-computed tomography standardized uptake values in clinical practice and assessing response to therapy.

    Science.gov (United States)

    Kinahan, Paul E; Fletcher, James W

    2010-12-01

    The use of standardized uptake values (SUVs) is now common place in clinical 2-deoxy-2-[(18)F] fluoro-D-glucose (FDG) position emission tomography-computed tomography oncology imaging and has a specific role in assessing patient response to cancer therapy. Ideally, the use of SUVs removes variability introduced by differences in patient size and the amount of injected FDG. However, in practice there are several sources of bias and variance that are introduced in the measurement of FDG uptake in tumors and also in the conversion of the image count data to SUVs. In this article the overall imaging process is reviewed and estimates of the magnitude of errors, where known, are given. Recommendations are provided for best practices in improving SUV accuracy. Copyright © 2010 Elsevier Inc. All rights reserved.

  17. Lynch Syndrome Associated Colon Adenocarcinoma Resembling Lymphoma on Fluoro-Deoxyglucose-Positron Emission Tomography/Computed Tomography

    International Nuclear Information System (INIS)

    Aparici, Carina Mari; Win, Aung Zaw

    2015-01-01

    The patient was a 46-year-old Asian male diagnosed with lynch syndrome associated colon adenocarcinoma in the right ascending colon. A presurgical staging 18-fluoro-deoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) found increased metabolic activity in the cervical, axillary, mediastinal, supraclavicular, para-aortic and mesenteric lymph nodes. This pattern of metastasis was very unusual for lynch syndrome associated colon adenocarcinoma and the involvement of those lymph nodes resembles the pattern of spread of lymphoma. He underwent right hemicolectomy and he was subsequently treated with 12 cycles of folinic acid (leucovorin), fluorouracil (5-FU), irinotecan. A restaging FDG-PET/CT at the end of the chemotherapy showed interval decrease in size and metabolic activity in the affected lymph nodes. FDG-PET/CT is a useful imaging modality in following-up the treatment response in colon adenocarcinoma

  18. Role of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Diagnostic Evaluation of Carcinoma Urinary Bladder: Comparison with Computed Tomography

    International Nuclear Information System (INIS)

    Chakraborty, Dhritiman; Mittal, Bhagwant Rai; Kashyap, Raghava; Mete, Utham Kumar; Narang, Vikram; Das, Ashim; Bhattacharya, Anish; Khandelwal, Niranjan; Mandal, Arup K.

    2014-01-01

    Bladder carcinoma is the most frequent tumor of the urinary tract and accounts 7% of all malignancies in men and 2% of all malignancies in women. This retrospective study was carried out to assess the diagnostic utility of F18-fludeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the imaging evaluation of bladder carcinoma. Seventy-seven consecutive patients diagnosed to have carcinoma urinary bladder referred for F18-FDG PET/CT were included in this study. Thirty-four patients were for initial staging after transurethral biopsy and remaining 43 patients were for restaging. All patients also underwent CT scan of the abdomen and pelvis. PET/CT findings were correlated with diagnostic CT scan and histopathological findings. In 30 of the 34 patients for initial staging, both PET/CT and CT confirmed the primary lesion in the bladder. Histopathology report was available in 23 patients. Lymph nodes FDG uptake reported to be metastatic in 10/23 patients while CT detected lymph node metastasis in 12 patients. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy have been calculated to be 87.5%, 80%, 70%, 92%, 82% for PET/CT and 66%, 57%, 50%, 72%, 60% for CT respectively. PET/CT detected metastatic disease in 8 patients whereas CT detected in 4 patients. Of the 43 patients for restaging, local recurrence was detected in 24 patients on both PET/CT and CT. Histopathology report was available in 17 patients. Sensitivity, specificity, PPV, NPV and accuracy were 85%, 60%, 60%, 85%, 70% for PET/CT and 80%, 50%, 40%, 85%, 58% for CT respectively. Nineteen patients were detected to have metastatic disease by PET/CT, whereas CT detected metastases in 11 patients. F-18 FDG PET/CT is a very useful modality in pre-operative staging and monitoring after surgery, chemotherapy or radiotherapy of patients with carcinoma urinary bladder

  19. (18)F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography in Malignancies of the Thyroid and in Head and Neck Squamous Cell Carcinoma

    DEFF Research Database (Denmark)

    Lauridsen, Jeppe Kiilerich; Rohde, Max; Thomassen, Anders

    2015-01-01

    18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is a valuable diagnostic tool in a spectrum of malignant and benign conditions, because of a high sensitivity to detect even very small lesions with increased metabolism. This review focuses on the use of FDG...

  20. The added value of 18F-fluorodeoxyglucose positron emission tomography computed tomography in patients with neck lymph node metastases from an unknown primary malignancy.

    Science.gov (United States)

    Prowse, S J B; Shaw, R; Ganeshan, D; Prowse, P M; Hanlon, R; Lewis-Jones, H; Wieshmann, H

    2013-08-01

    The search for a primary malignancy in patients with a metastatic cervical lymph node is challenging yet ultimately of utmost clinical importance. This study evaluated the efficacy of positron emission tomography computed tomography in detecting the occult primary, within the context of a tertiary referral centre head and neck cancer multidisciplinary team tumour board meeting. Thirty-two patients (23 men and 9 women; mean and median age, 61 years) with a metastatic cervical lymph node of unknown primary origin, after clinical examination and magnetic resonance imaging, underwent positron emission tomography computed tomography. The primary tumour detection rate was 50 per cent (16/32). Positron emission tomography computed tomography had a sensitivity of 94 per cent (16/17) and a specificity of 67 per cent (10/15). Combining these results with those of 10 earlier studies of similar patients gave an overall detection rate of 37 per cent. Positron emission tomography computed tomography has become an important imaging modality. To date, it has the highest primary tumour detection rate, for head and neck cancer patients presenting with cervical lymph node metastases from an unknown primary.

  1. Routine Bone Marrow Biopsy Has Little or No Therapeutic Consequence for Positron Emission Tomography/Computed Tomography-Staged Treatment-Naive Patients With Hodgkin Lymphoma

    DEFF Research Database (Denmark)

    El-Galaly, Tarec Christoffer; d'Amore, Francesco; Mylam, Karen Juul

    2012-01-01

    PURPOSETo investigate whether bone marrow biopsy (BMB) adds useful information to [(18)F]fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) staging in patients with Hodgkin lymphoma (HL). PATIENTS AND METHODSNewly diagnosed patients with HL undergoing a pretherapeu...

  2. Coexistence of atrial myxoma and lung cancer on fluorodeoxyglucose positron emission tomography/computed tomography: The impact of distinct fluorodeoxyglucose uptake pattern on differential diagnosis

    International Nuclear Information System (INIS)

    Koc, Kevser; Aras, Mustafa; Inanir, Sabahat

    2014-01-01

    The information regarding fluorodeoxyglucose (FDG) uptake in benign and malignant cardiac tumors is limited in the literature and most of the currrently available data were derived from single case reports. Herein we reported coexistence of atrial myxoma and lung cancer on FDG positron emission tomography/computed tomography with the aim of emphasizing the importance of distinct FDG uptake pattern on differential diagnosis

  3. Efficacy of 3D-positron emission tomography/computed tomography for upper abdomen.

    Science.gov (United States)

    Murakami, Koji; Nakahara, Tadaki

    2014-04-01

    Recent advancement in computed tomography (CT) enables us to obtain high spatial resolution image and made it possible to construct extensive high-definition three-dimensional (3D) images. But a lack of contrast resolution in CT alone is still remained problem. Meanwhile, as fluorodeoxyglucose-positron emission tomography (PET) can visualize tumors in high contrast, we can create 3D images fusing the accumulation in tumors on PET/CT images. Such images can play the role of a "map of body" which makes it easy to understand the anatomical information before surgery. We also try to evaluate segmental liver function by using PET/CT fusion images. By using (11) C-methionine PET/contrast-enhanced CT, superior image quality compared to single photon emission computed tomography/CT can be obtained. CT, especially with contrast enhancement for obtaining anatomical imaging information plus PET for obtaining functional imaging information is a highly compatible combination, and adding these two types information will further increase clinical usefulness. © 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  4. Positron emission tomography/computed tomography and radioimmunotherapy of prostate cancer

    DEFF Research Database (Denmark)

    Bouchelouche, Kirsten; Capala, Jacek; Oehr, Peter

    2009-01-01

    of a number of diagnostic and therapeutic strategies. J591, a monoclonal antibody, which targets the extracellular domain of prostate-specific membrane antigen, shows promising results. HER2 receptors may also have a potential as target for PET/CT imaging and RIT of advanced prostate cancer. SUMMARY: PET......PURPOSE OF REVIEW: Traditional morphologically based imaging modalities are now being complemented by positron emission tomography (PET)/computed tomography (CT) in prostate cancer. Metastatic prostate cancer is an attractive target for radioimmunotherapy (RIT) as no effective therapies...... are available. This review highlights the most important achievements within the last year in PET/CT and RIT of prostate cancer. RECENT FINDINGS: Conflicting results exist on the use of choline for detection of malignant disease in the prostate gland. The role of PET/CT in N-staging remains to be elucidated...

  5. DIAGNOSTIC ROLE OF FLUORINE-18 (18F) FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY COMPUTED TOMOGRAPHY IN DETECTING RECURRENT DISEASE IN PATIENTS WITH COLORECTAL CANCER AND ELEVATED CARCINOEMBRYONIC ANTIGEN.

    Science.gov (United States)

    Matovina, Emil; Mihailović, Jasna; Nikoletić, Katarina; Srbovan, Dolores

    2015-01-01

    Early detection of recurrence is an important factor for long term survival of patients with colorectal cancer. Measurement of serum levels of carcinoembryonic antigen has been commonly used in the postoperative surveillance of colorectal cancer. The purpose of this study was to evaluate the ability of positron emission tomography-computed tomography to detect pathological substrate of elevated serum carcinoembryonic antigen in patients with colorectal cancer. The patients with colorectal cancer who underwent curative surgical resection and/ or chemotherapy, who were found in our database, were analyzed retrospectively. Forty-eight 18F-fluorodeoxyglucose positron emission tomography-computed tomography studies including 45 patients (14 women, 31 men; mean age: 62.93 years) with elevated serum, carcinoembryonic antigen levels, which had been performed between January 2011 and January 2014, were evaluated. Serum levels of carcinoembryonic antigen were measured within 3 months after positron emission tomography-computed tomography examination. Final diagnosis of recurrence was made by histopathological findings, radiology studies or clinical follow-up. Recurrences were diagnosed in 37 patients, the prevalence being 77.1%. Liver metastases were found in 18 patients, abdominal, pelvic and/or mediastinal lymph nodes were positive in 19 patients, 11 patients had loco regional recurrences and 4 patients had pulmonary metastasis, and bone metastases were found in one patient. One patient was diagnosed with metastasis in scar tissue. The overall sensitivity and specificity of positron emission tomography-computed tomography was 90.24% and 71.42%, respectively. The positive and negative predictive values were 94.87% and 55.56%, respectively. 18F-fluorodeoxyglucose positron emission tomography-computed tomography is a powerful tool that could be used in determining colorectal cancer recurrence in patients with elevated carcinoembryonic antigen levels and could have an

  6. X-ray-based attenuation correction for positron emission tomography/computed tomography scanners.

    Science.gov (United States)

    Kinahan, Paul E; Hasegawa, Bruce H; Beyer, Thomas

    2003-07-01

    A synergy of positron emission tomography (PET)/computed tomography (CT) scanners is the use of the CT data for x-ray-based attenuation correction of the PET emission data. Current methods of measuring transmission use positron sources, gamma-ray sources, or x-ray sources. Each of the types of transmission scans involves different trade-offs of noise versus bias, with positron transmission scans having the highest noise but lowest bias, whereas x-ray scans have negligible noise but the potential for increased quantitative errors. The use of x-ray-based attenuation correction, however, has other advantages, including a lack of bias introduced from post-injection transmission scanning, which is an important practical consideration for clinical scanners, as well as reduced scan times. The sensitivity of x-ray-based attenuation correction to artifacts and quantitative errors depends on the method of translating the CT image from the effective x-ray energy of approximately 70 keV to attenuation coefficients at the PET energy of 511 keV. These translation methods are usually based on segmentation and/or scaling techniques. Errors in the PET emission image arise from positional mismatches caused by patient motion or respiration differences between the PET and CT scans; incorrect calculation of attenuation coefficients for CT contrast agents or metallic implants; or keeping the patient's arms in the field of view, which leads to truncation and/or beam-hardening (or x-ray scatter) artifacts. Proper interpretation of PET emission images corrected for attenuation by using the CT image relies on an understanding of the potential artifacts. In cases where an artifact or bias is suspected, careful inspection of all three available images (CT and PET emission with and without attenuation correction) is recommended. Copyright 2003 Elsevier Inc. All rights reserved.

  7. Budget impact from the incorporation of positron emission tomography ? computed tomography for staging lung cancers

    OpenAIRE

    Biz, Aline Navega; Caetano, Ros?ngela

    2015-01-01

    OBJECTIVE To estimate the budget impact from the incorporation of positron emission tomography (PET) in mediastinal and distant staging of non-small cell lung cancer.METHODS The estimates were calculated by the epidemiological method for years 2014 to 2018. Nation-wide data were used about the incidence; data on distribution of the disease´s prevalence and on the technologies’ accuracy were from the literature; data regarding involved costs were taken from a micro-costing study and from Brazi...

  8. Spectrum of single photon emission computed tomography/computed tomography findings in patients with parathyroid adenomas.

    Science.gov (United States)

    Chakraborty, Dhritiman; Mittal, Bhagwant Rai; Harisankar, Chidambaram Natrajan Balasubramanian; Bhattacharya, Anish; Bhadada, Sanjay

    2011-01-01

    Primary hyperparathyroidism results from excessive parathyroid hormone secretion. Approximately 85% of all cases of primary hyperparathyroidism are caused by a single parathyroid adenoma; 10-15% of the cases are caused by parathyroid hyperplasia. Parathyroid carcinoma accounts for approximately 3-4% of cases of primary disease. Technetium-99m-sestamibi (MIBI), the current scintigraphic procedure of choice for preoperative parathyroid localization, can be performed in various ways. The "single-isotope, double-phase technique" is based on the fact that MIBI washes out more rapidly from the thyroid than from abnormal parathyroid tissue. However, not all parathyroid lesions retain MIBI and not all thyroid tissue washes out quickly, and subtraction imaging is helpful. Single photon emission computed tomography (SPECT) provides information for localizing parathyroid lesions, differentiating thyroid from parathyroid lesions, and detecting and localizing ectopic parathyroid lesions. Addition of CT with SPECT improves the sensitivity. This pictorial assay demonstrates various SPECT/CT patterns observed in parathyroid scintigraphy.

  9. Use of Positron Emission Tomography/Computed Tomography in Radiation Treatment Planning for Lung Cancer

    Directory of Open Access Journals (Sweden)

    Kezban Berberoğlu

    2016-06-01

    Full Text Available Radiotherapy (RT plays an important role in the treatment of lung cancer. Accurate diagnosis and staging are crucial in the delivery of RT with curative intent. Target miss can be prevented by accurate determination of tumor contours during RT planning. Currently, tumor contours are determined manually by computed tomography (CT during RT planning. This method leads to differences in delineation of tumor volume between users. Given the change in RT tools and methods due to rapidly developing technology, it is now more significant to accurately delineate the tumor tissue. F18 fluorodeoxyglucose positron emission tomography/CT (F18 FDG PET/CT has been established as an accurate method in correctly staging and detecting tumor dissemination in lung cancer. Since it provides both anatomic and biologic information, F18 FDG PET decreases interuser variability in tumor delineation. For instance, tumor volumes may be decreased as atelectasis and malignant tissue can be more accurately differentiated, as well as better evaluation of benign and malignant lymph nodes given the difference in FDG uptake. Using F18 FDG PET/CT, the radiation dose can be escalated without serious adverse effects in lung cancer. In this study, we evaluated the contribution of F18 FDG PET/CT for RT planning in lung cancer.

  10. Technical aspects of positron emission tomography/computed tomography in radiotherapy treatment planning.

    Science.gov (United States)

    Scripes, Paola G; Yaparpalvi, Ravindra

    2012-09-01

    The usage of functional data in radiation therapy (RT) treatment planning (RTP) process is currently the focus of significant technical, scientific, and clinical development. Positron emission tomography (PET) using ((18)F) fluorodeoxyglucose is being increasingly used in RT planning in recent years. Fluorodeoxyglucose is the most commonly used radiotracer for diagnosis, staging, recurrent disease detection, and monitoring of tumor response to therapy (Lung Cancer 2012;76:344-349; Lung Cancer 2009;64:301-307; J Nucl Med 2008;49:532-540; J Nucl Med 2007;48:58S-67S). All the efforts to improve both PET and computed tomography (CT) image quality and, consequently, lesion detectability have a common objective to increase the accuracy in functional imaging and thus of coregistration into RT planning systems. In radiotherapy, improvement in target localization permits reduction of tumor margins, consequently reducing volume of normal tissue irradiated. Furthermore, smaller treated target volumes create the possibility of dose escalation, leading to increased chances of tumor cure and control. This article focuses on the technical aspects of PET/CT image acquisition, fusion, usage, and impact on the physics of RTP. The authors review the basic elements of RTP, modern radiation delivery, and the technical parameters of coregistration of PET/CT into RT computerized planning systems. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Single-photon emission computed tomography/computed tomography in lung cancer and malignant lymphoma.

    Science.gov (United States)

    Schillaci, Orazio

    2006-10-01

    In nuclear oncology, despite the fast-growing diffusion of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET), single-photon emission computed tomography (SPECT) studies can still play an useful clinical role in several applications. The main limitation of SPECT imaging with tumor-seeking agents is the lack of the structural delineation of the pathologic processes they detect; this drawback sometimes renders SPECT interpretation difficult and can diminish its diagnostic accuracy. Fusion with morphological studies can overcome this limitation by giving an anatomical map to scintigraphic data. In the past, software-based fusion of independently performed SPECT and CT images proved to be time-consuming and impractical for routine use. The recent development of dual-modality integrated imaging systems that provide functional (SPECT) and anatomical (CT) images in the same scanning session, with the acquired images coregistered by means of the hardware, has opened a new era in this field. The first reports indicate that SPECT/CT is very useful in cancer imaging because it is able to provide further information of clinical value in several cases. In SPECT, studies of lung cancer and malignant lymphomas using different radiopharmaceutical, hybrid images are of value in providing the correct localization of tumor sites, with a precise detection of the involved organs, and the definition of their functional status, and in allowing the exclusion of disease in sites of physiologic tracer uptake. Therefore, in lung cancer and lymphomas, hybrid SPECT/CT can play a role in the diagnosis of the primary tumor, in the staging of the disease, in the follow-up, in the monitoring of therapy, in the detection of recurrence, and in dosimetric estimations for target radionuclide therapy.

  12. Positron emission tomography/computed tomography--imaging protocols, artifacts, and pitfalls.

    Science.gov (United States)

    Bockisch, Andreas; Beyer, Thomas; Antoch, Gerald; Freudenberg, Lutz S; Kühl, Hilmar; Debatin, Jörg F; Müller, Stefan P

    2004-01-01

    There has been a longstanding interest in fused images of anatomical information, such as that provided by computed tomography (CT) or magnetic resonance imaging (MRI) systems, with biological information obtainable by positron emission tomography (PET). The near-simultaneous data acquisition in a fixed combination of a PET and a CT scanner in a combined PET/CT imaging system minimizes spatial and temporal mismatches between the modalities by eliminating the need to move the patient in between exams. In addition, using the fast CT scan for PET attenuation correction, the duration of the examination is significantly reduced compared to standalone PET imaging with standard rod-transmission sources. The main source of artifacts arises from the use of the CT-data for scatter and attenuation correction of the PET images. Today, CT reconstruction algorithms cannot account for the presence of metal implants, such as dental fillings or prostheses, properly, thus resulting in streak artifacts, which are propagated into the PET image by the attenuation correction. The transformation of attenuation coefficients at X-ray energies to those at 511 keV works well for soft tissues, bone, and air, but again is insufficient for dense CT contrast agents, such as iodine or barium. Finally, mismatches, for example, due to uncoordinated respiration result in incorrect attenuation-corrected PET images. These artifacts, however, can be minimized or avoided prospectively by careful acquisition protocol considerations. In doubt, the uncorrected images almost always allow discrimination between true and artificial finding. PET/CT has to be integrated into the diagnostic workflow for harvesting the full potential of the new modality. In particular, the diagnostic power of both, the CT and the PET within the combination must not be underestimated. By combining multiple diagnostic studies within a single examination, significant logistic advantages can be expected if the combined PET

  13. Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Staging of Patients with Non-Small Cell Lung Cancer without Mediastinal Involvement at Positron Emission Tomography-Computed Tomography

    DEFF Research Database (Denmark)

    Naur, Therese Maria Henriette; Konge, Lars; Clementsen, Paul Frost

    2017-01-01

    BACKGROUND: Staging of lung cancer is essential to the treatment, which is curative only in cases of localized disease. Previous studies have suggested that endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is unnecessary when positron emission tomography-computed tomog...

  14. Increased fluoro-deoxy-D-glucose uptake on positron emission tomography-computed tomography postbronchoalveolar lavage: a potential cause of radiologic misinterpretation.

    LENUS (Irish Health Repository)

    Leong, Sum

    2011-08-01

    Cytologic analysis of bronchoalveolar lavage (BAL) fluid is used for lung cancer diagnosis. We describe a patient with a history of rectal carcinoma who presented with a new lung mass. BAL was performed, with positron emission tomography-computed tomography the following day. There was mildly increased fluoro-deoxy-D-glucose uptake in areas of the lung parenchyma with new ground-glass opacification. This created ambiguity in staging, clarified 2 weeks later by a computed tomography showing complete resolution of the ground-glass opacity. Clinicians should be aware that BAL may cause increased pulmonary fluoro-deoxy-D-glucose uptake, making accurate radiologic interpretation problematic. We suggest that to optimize positron emission tomography-computed tomography, studies should not be performed within 24 hours of BAL.

  15. Positron Emission Tomography Computed Tomography: A Guide for the General Radiologist.

    Science.gov (United States)

    Beadsmoore, Clare; Newman, David; MacIver, Duncan; Pawaroo, Davina

    2015-11-01

    Cancer remains a leading cause of death in Canada and worldwide. Whilst advances in anatomical imaging to detect and monitor malignant disease have continued over the last few decades, limitations remain. Functional imaging, such as positron emission tomography (PET), has improved the sensitivity and specificity in detecting malignant disease. In combination with computed tomography (CT), PET is now commonly used in the oncology setting and is an integral part of many cancer patients' pathways. Although initially the CT component of the study was purely for attenuation of the PET imaging and to provide anatomical coregistration, many centers now combine the PET study with a diagnostic quality contrast enhanced CT to provide one stop staging, thus refining the patient's pathway. The commonest tracer used in everyday practice is FDG (F18-fluorodeoxyglucose). There are many more tracers in routine clinical practice and those with emerging roles, such as 11C-choline, useful in the imaging of prostate cancer; 11C-methionine, useful in imaging brain tumours; C11-acetate, used in imaging hepatocellular carcinomas; 18F-FLT, which can be used as a marker of cellular proliferation in various malignancies; and F18-DOPA and various 68Ga-somatostatin analogues, used in patients with neuroendocrine tumours. In this article we concentrate on FDG PETCT as this is the most commonly available and widely utilised tracer now used to routinely stage a number of cancers. PETCT alters the stage in approximately one-third of patients compared to anatomical imaging alone. Increasingly, PETCT is being used to assess early metabolic response to treatment. Metabolic response can be seen much earlier than a change in the size/volume of the disease which is measured by standard CT imaging. This can aid treatment decisions in both in terms of modifying therapy and in addition to providing important prognostic information. Furthermore, it is helpful in patients with distorted anatomy from surgery

  16. Budget impact from the incorporation of positron emission tomography - computed tomography for staging lung cancers.

    Science.gov (United States)

    Biz, Aline Navega; Caetano, Rosângela

    2015-01-01

    To estimate the budget impact from the incorporation of positron emission tomography (PET) in mediastinal and distant staging of non-small cell lung cancer. The estimates were calculated by the epidemiological method for years 2014 to 2018. Nation-wide data were used about the incidence; data on distribution of the disease's prevalence and on the technologies' accuracy were from the literature; data regarding involved costs were taken from a micro-costing study and from Brazilian Unified Health System (SUS) database. Two strategies for using PET were analyzed: the offer to all newly-diagnosed patients, and the restricted offer to the ones who had negative results in previous computed tomography (CT) exams. Univariate and extreme scenarios sensitivity analyses were conducted to evaluate the influence from sources of uncertainties in the parameters used. The incorporation of PET-CT in SUS would imply the need for additional resources of 158.1 BRL (98.2 USD) million for the restricted offer and 202.7 BRL (125.9 USD) million for the inclusive offer in five years, with a difference of 44.6 BRL (27.7 USD) million between the two offer strategies within that period. In absolute terms, the total budget impact from its incorporation in SUS, in five years, would be 555 BRL (345 USD) and 600 BRL (372.8 USD) million, respectively. The costs from the PET-CT procedure were the most influential parameter in the results. In the most optimistic scenario, the additional budget impact would be reduced to 86.9 BRL (54 USD) and 103.8 BRL (64.5 USD) million, considering PET-CT for negative CT and PET-CT for all, respectively. The incorporation of PET in the clinical staging of non-small cell lung cancer seems to be financially feasible considering the high budget of the Brazilian Ministry of Health. The potential reduction in the number of unnecessary surgeries may cause the available resources to be more efficiently allocated.

  17. Therapeutic impact of [18F]fluoride positron-emission tomography/computed tomography on patients with unclear foot pain

    International Nuclear Information System (INIS)

    Fischer, Dorothee Rita; Hesselmann, Rolf; Johayem, Anass; Hany, Thomas F.; Schulthess, Gustav K. von; Strobel, Klaus; Maquieira, Gerardo J.; Espinosa, Norman; Zanetti, Marco

    2010-01-01

    To evaluate the therapeutic impact of [ 18 F]fluoride positron-emission tomography/computed tomography ([ 18 F]fluoride PET/CT) imaging on patients with unclear foot pain. Twenty-eight patients were prospectively included in this study. Therapeutic management was defined by two experienced dedicated foot surgeons before and after [ 18 F]fluoride PET/CT imaging. Twenty-six patients underwent cross-sectional imaging [CT, magnetic resonance (MR)] prior to PET/CT. A retrospective analysis of the magnetic resonance imaging (MRI) diagnoses was performed when a therapy change occurred after PET/CT imaging. In 13/28 (46%) patients therapeutic management was changed due to PET/CT results. Management changes occurred in patients with the following diagnoses: os trigonum syndrome; sinus tarsi syndrome; os tibiale externum syndrome; osteoarthritis of several joints; non-consolidated fragments; calcaneo-navicular coalition; plantar fasciitis; insertional tendinopathy; suggestion of periostitis; neoarticulations between metatarsal bones. Os trigonum, os tibiale externum, subtalar osteoarthritis and plantar fasciitis were only seen to be active on PET/CT images but not on MR images. [ 18 F]fluoride PET/CT has a substantial therapeutic impact on management in patients with unclear foot pain. (orig.)

  18. Prostate cancer nodal oligometastasis accurately assessed using prostate-specific membrane antigen positron emission tomography-computed tomography and confirmed histologically following robotic-assisted lymph node dissection.

    Science.gov (United States)

    O'Kane, Dermot B; Lawrentschuk, Nathan; Bolton, Damien M

    2016-01-01

    We herein present a case of a 76-year-old gentleman, where prostate-specific membrane antigen positron emission tomography-computed tomography (PSMA PET-CT) was used to accurately detect prostate cancer (PCa), pelvic lymph node (LN) metastasis in the setting of biochemical recurrence following definitive treatment for PCa. The positive PSMA PET-CT result was confirmed with histological examination of the involved pelvic LNs following pelvic LN dissection.

  19. Post meningitis subdural hygroma: Anatomical and functional evaluation with 99mTc-ehylene cysteine dimer single photon emission tomography/computed tomography

    OpenAIRE

    Sharma, Punit; Mishra, Ajiv; Arora, Geetanjali; Tripathi, Madhavi; Bal, Chandrasekhar; Kumar, Rakesh

    2013-01-01

    Subdural hygroma is the collection of cerebrospinal fluid in the subdural space. Most often these resolve spontaneously. However, in cases with neurological complications surgical drainage may be needed. We here, present the case of an 8-year-old boy with post meningitis subdural hygroma. 99mTc-ehylene cysteine dimer (99mTc-ECD) hybrid single photon emission tomography/computed tomography (SPECT/CT) carried out in this patient, demonstrated the subdural hygroma as well as the associated cereb...

  20. Unusual presentation of metastatic carcinoma cervix with clinically silent primary identified by 18F-flouro deoxy glucose positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Senthil, Raja; Mohapatra, Ranjan Kumar; Srinivas, Shripriya; Sampath, Mouleeswaran Koramadai; Sundaraiya, Sumati

    2016-01-01

    Carcinoma cervix is the most common gynecological malignancy among Indian women. The common symptoms at presentation include abnormal vaginal bleeding, unusual discharge from the vagina, or pain during coitus and postmenopausal bleeding. Rarely, few patients may present with distant metastases without local symptoms. We present two patients with an unusual presentation of metastatic disease without any gynecological symptoms, where 18 F-flouro deoxy glucose positron emission tomography/computed tomography helped in identifying the primary malignancy in the uterine cervix

  1. Review of cardiovascular imaging in the journal of nuclear cardiology in 2015. Part 1 of 2: Plaque imaging, positron emission tomography, computed tomography, and magnetic resonance.

    Science.gov (United States)

    AlJaroudi, Wael A; Hage, Fadi G

    2016-02-01

    In 2015, many original articles pertaining to cardiovascular imaging with impressive quality were published in the Journal of Nuclear Cardiology. In a set of 2 articles, we provide an overview of these contributions to facilitate for the interested reader a quick review of the advancements that occurred in the field over this year. In this first article, we focus on arterial plaque imaging, cardiac positron emission tomography, computed tomography, and magnetic resonance imaging.

  2. Rare case of isolated splenic metastases from gastric cancer detected with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Kamaleshwaran, Koramadai Karuppusamy; Shibu, Deepu; Sugunan Shinto, Ajit; Sivanesan, Balasubramanian

    2013-01-01

    We report a rare case of isolated splenic metastasis from gastric cancer detected with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT). A 55-year-old man with gastric cancer 1 year post surgery, evaluated with PET/CT showed focal, intense uptake in the spleen, with no other abnormal findings. On splenectomy, the lesion was confirmed as metastasis from gastric cancer pathologically. (author)

  3. Sacrococcygeal chordoma: increased 99mTc methylene diphosphonate uptake on single photon emission computed tomography/computed tomography bone scintigraphy

    International Nuclear Information System (INIS)

    Kamaleshwaran, Koramadai Karuppuswamy; Bhattacharya, Anish; Harisankar, Chidambaram Natarajan Balasubramaniam; Mittal, Bhagwant Rai; Goni, Vijay

    2012-01-01

    Chordoma is a malignant tumor arising from the remnants of the notochord, and is the most frequent primitive tumor of the sacrum. While most sacral tumors show increased concentration of bone-seeking radiopharmaceuticals, chordomas usually exhibit decreased uptake. The authors present an image of a sacrococcygeal chordoma with osteolysis and increased uptake of 99m Tc methylene diphosphonate on planar and single photon emission computed tomography/computed tomography bone scintigraphy. (author)

  4. Fluorodeoxyglucose positron emission tomography?computed tomography in evaluation of pelvic and para-aortic nodal involvement in early stage and operable cervical cancer: Comparison with surgicopathological findings

    OpenAIRE

    Bansal, Vandana; Damania, Kaizad; Sharma, Anshu Rajnish

    2011-01-01

    Introduction: Nodal metastases in cervical cancer have prognostic implications. Imaging is used as an adjunct to clinical staging for evaluation of nodal metastases. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has an advantage of superior resolution of its CT component and detecting nodal disease based on increased glycolytic activity rather than node size. But there are limited studies describing its limitations in early stage cervical cancers. Objectiv...

  5. Prostate cancer nodal oligometastasis accurately assessed using prostate-specific membrane antigen positron emission tomography-computed tomography and confirmed histologically following robotic-assisted lymph node dissection

    Directory of Open Access Journals (Sweden)

    Dermot B O′Kane

    2016-01-01

    Full Text Available We herein present a case of a 76-year-old gentleman, where prostate-specific membrane antigen positron emission tomography-computed tomography (PSMA PET-CT was used to accurately detect prostate cancer (PCa, pelvic lymph node (LN metastasis in the setting of biochemical recurrence following definitive treatment for PCa. The positive PSMA PET-CT result was confirmed with histological examination of the involved pelvic LNs following pelvic LN dissection.

  6. {sup 18}F-fluorodeoxyglucose positron emission tomography-computed tomography in the management of adult multisystem Langerhans cell histiocytosis

    Energy Technology Data Exchange (ETDEWEB)

    Obert, Julie [Universite Paris Diderot, Paris (France); Assistance Publique-Hopitaux de Paris, Centre National de Reference de l' Histiocytose Langerhansienne, Service de Pneumologie, Hopital Saint-Louis, Paris (France); Vercellino, Laetitia [Assistance Publique-Hopitaux de Paris, Service de Medecine Nucleaire, Hopital Saint-Louis, Paris (France); Van der Gucht, Axel [Universite Paris Diderot, Paris (France); Assistance Publique-Hopitaux de Paris, Service de Medecine Nucleaire, Hopital Saint-Louis, Paris (France); De Margerie-Mellon, Constance [Universite Paris Diderot, Paris (France); Assistance Publique-Hopitaux de Paris, Service de Radiologie, Hopital Saint-Louis, Paris (France); Bugnet, Emmanuelle; Lorillon, Gwenael [Assistance Publique-Hopitaux de Paris, Centre National de Reference de l' Histiocytose Langerhansienne, Service de Pneumologie, Hopital Saint-Louis, Paris (France); Chevret, Sylvie [Universite Paris Diderot, Paris (France); Assistance Publique-Hopitaux de Paris, Service de Biostatistique et Information Medicale, Hopital Saint-Louis, Paris (France); Biostatistics and Clinical Epidemiology Research Team, U1153 CRESS, Paris (France); Tazi, Abdellatif [Universite Paris Diderot, Paris (France); Assistance Publique-Hopitaux de Paris, Centre National de Reference de l' Histiocytose Langerhansienne, Service de Pneumologie, Hopital Saint-Louis, Paris (France); Biostatistics and Clinical Epidemiology Research Team, U1153 CRESS, Paris (France)

    2017-04-15

    The standard evaluation of multisystem Langerhans cell histiocytosis (LCH) includes a clinical evaluation, laboratory tests and a skeleton/skull X-ray survey, with chest high-resolution computed tomography (HRCT) in the case of pulmonary involvement. Preliminary reports suggest that {sup 18}F-fluorodeoxyglucose positron emission tomography-computed tomography ({sup 18}F-FDG PET-CT) may be useful for evaluating patients with LCH. Fourteen consecutive adult patients with multisystem LCH were included in this retrospective study, and were evaluated using standard procedures and {sup 18}F-FDG PET-CT. The two sets of findings were compared both at baseline and during follow-up. Serial HRCT and pulmonary function tests were used to evaluate outcome in patients with lung involvement. At the baseline evaluation, PET-CT identified every LCH localization found with the standard evaluation (except a mild cecum infiltration). PET-CT showed additional lesions in seven patients, mostly involving bones, and differentiated inactive from active lesions. Thyroid {sup 18}F-FDG uptake was identified in three cases. No pituitary stalk {sup 18}F-FDG uptake was observed in patients with pituitary LCH. Only 3/12 (25 %) patients with pulmonary LCH displayed moderate pulmonary {sup 18}F-FDG uptake. During follow-up, variations (≥50 % of maximum standardized uptake) in bone {sup 18}F-FDG uptake intensity were correlated with disease state and response to treatment. The absence of lung {sup 18}F-FDG uptake did not preclude lung function improvement after treatment. Except for cases with pulmonary and pituitary involvement, {sup 18}F-FDG PET-CT could replace the standard evaluation for staging of adult patients with multisystem LCH. Serial PET-CT scans are useful for evaluating treatment responses, particularly in cases with bone LCH involvement. (orig.)

  7. Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Patients With Carcinoma of the Nasopharynx: Diagnostic Accuracy and Impact on Clinical Management

    International Nuclear Information System (INIS)

    Gordin, Arie; Golz, Avishay; Daitzchman, Marcello; Keidar, Zohar; Bar-Shalom, Rachel; Kuten, Abraham; Israel, Ora

    2007-01-01

    Purpose: To assess the value of 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with nasopharyngeal carcinoma as compared with PET and conventional imaging (CI) alone, and to assess the impact of PET/CT on further clinical management. Methods and Materials: Thirty-three patients with nasopharyngeal carcinoma had 45 PET/CT examinations. The study was a retrospective analysis. Changes in patient care resulting from the PET/CT studies were recorded. Results: Positron emission tomography/computed tomography had sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 92%, 90%, 90%, 90%, and 91%, respectively, as compared with 92%, 65%, 76%, 86%, and 80% for PET and 92%, 15%, 60%, 60%, and 60% for CI. Imaging with PET/CT altered further management of 19 patients (57%). Imaging with PET/CT eliminated the need for previously planned diagnostic procedures in 11 patients, induced a change in the planned therapeutic approach in 5 patients, and guided biopsy to a specific metabolically active area inside an edematous region in 3 patients, thus decreasing the chances for tissue sampling errors and avoiding damage to nonmalignant tissue. Conclusions: In cancer of the nasopharynx, the diagnostic performance of PET/CT is better than that of stand-alone PET or CI. Positron emission tomography/computed tomography had a major impact on further clinical management in 57% of patients

  8. Clinical applications of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in carcinoma of unknown primary

    Institute of Scientific and Technical Information of China (English)

    HU Man; YU Jin-ming; ZHAO Wei; ZHANG Pin-liang; JU Gui-fang; FU Zheng; ZHANG Guo-li; KONG Li; YANG Yan-qin; MA Yi-dong

    2011-01-01

    Background Carcinoma of unknown primary (CUP) encompasses a heterogeneous group of tumors with varying clinical features. The management of patients of CUP remains a clinical challenge. The purpose of this study was to evaluate the clinical applications of integrated 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) information in patients with CUP,including detecting the occult primary tumor and effecting on disease therapy.Methods One hundred and forty-nine patients with histologically-proven metastases of CUP were included. For all patients,the conventional diagnostic work-up was unsuccessful in localizing the primary site. Whole-body PET/CT images were obtained approximately 60 minutes after intravenous injection of 350-425 MBq of 18F-FDG.Results In 24.8% of patients,FDG PET/CT detected primary tumors that were not apparent after conventional workup.In this group of patients,the overall sensitivity,specificity,and accuracy rates of FDG PET/CT in detecting unknown primary tumors were 86.0%,87.7%,and 87.2%,respectively. FDG PET/CT imaging also led to the detection of previously unrecognized metastases in 29.5% of patients. Forty-seven (31.5%,47 of 149) patients underwent a change in therapeutic management.Conclusions FDG PET/CT is a valuable tool in patients with CUP,because it assisted in detecting unknown primary tumors and previously unrecognized distant metastases,and optimized the mangement of these patients.

  9. Application of positron emission tomography-computed tomography in the diagnosis of pulmonary ground-glass nodules.

    Science.gov (United States)

    Hu, Lili; Pan, Yuanwei; Zhou, Zhigang; Gao, Jianbo

    2017-11-01

    The aim of the present study was to investigate the value of positron emission tomography-computed tomography (PET-CT) using 18 F-fluorodeoxyglucose in the clinical diagnosis of pulmonary ground-glass nodule. In total, 54 patients with pulmonary GGN that were identified by PET-CT examination were selected and confirmed by pathology and clinical diagnosis in hospital between April 2014 and April 2015. The association between PET-CT findings and pathology, and the value of PET-CT were then evaluated. In the 54 patients, solitary pulmonary GGN with a nodule diameter of between 0.6 and 2.0 cm were detected. Amongst them, the PET-CT examination of 42 patients revealed hyper metabolic nodules, and were all mixed GGN type nodules with a diameter >1 cm. The PET-CT examination of the remaining 12 patients demonstrated no evidence of metabolic abnormalities and the nodules in these patients were pure or mixed GGN with a diameter <1 cm (except 2 cases with a diameter ≥1 cm). Furthermore, the diagnoses for all patients were pathologically confirmed by CT-guided needle biopsy or thoracoscopic surgical resection. Amongst them, there were 41 cases of lung adenocarcinoma, 4 cases of fungal infection, 7 cases of inflammation and 2 cases of adenomatoid hyperplasia. Additionally, PET-CT has a lower detection rate for smaller GGN exhibits no clear advantage for pure GGN, but has a higher detection rate for larger GGN. In conclusion, to a certain extent, PET-CT makes up for the shortcomings of traditional imaging and has some clinical value for the diagnosis of GGN.

  10. Standardized uptake value on positron emission tomography/computed tomography predicts prognosis in patients with locally advanced pancreatic cancer.

    Science.gov (United States)

    Wang, Si-Liang; Cao, Shuo; Sun, Yu-Nan; Wu, Rong; Chi, Feng; Tang, Mei-Yue; Jin, Xue-Ying; Chen, Xiao-Dong

    2015-10-01

    The aim of the present study was to investigate the use and value of maximum standardized uptake value (SUV max) on positron emission tomography/computed tomography (PET/CT) images as a prognostic marker for patients with locally advanced pancreatic cancer (LAPC). The medical records of all consecutive patients who underwent PET/CT examination in our institution were retrospectively reviewed. Inclusion criteria were histologically or cytologically proven LAPC. Patients with distant metastasis were excluded. For statistical analysis, the SUV max of primary pancreatic cancer was measured. Survival rates were calculated using the Kaplan-Meier method, and multivariable analysis was performed to determine the association of SUV max with overall survival (OS) and progression-free survival (PFS) using a Cox proportional hazards model. Between July 2006 and June 2013, 69 patients were enrolled in the present study. OS and PFS were 14.9 months [95% confidence interval (CI) 13.1-16.7] and 8.3 months (95% CI 7.1-9.5), respectively. A high SUV max (>5.5) was observed in 35 patients, who had significantly worse OS and PFS than the remaining patients with a low SUV max (P = 0.025 and P = 0.003). Univariate analysis showed that SUV max and tumor size were prognostic factors for OS, with a hazard ratio of 1.90 and 1.81, respectively. A high SUV max was an independent prognostic factor, with a hazard ratio of 1.89 (95% CI 1.015-3.519, P = 0.045). The present study suggests that increased SUV max is a predictor of poor prognosis in patients with LAPC.

  11. Differences in fluorodeoxyglucose positron emission tomography/computed tomography findings between elderly onset rheumatoid arthritis and polymyalgia rheumatica.

    Science.gov (United States)

    Takahashi, Hiroyuki; Yamashita, Hiroyuki; Kubota, Kazuo; Miyata, Yoko; Okasaki, Momoko; Morooka, Miyako; Takahashi, Yuko; Kaneko, Hiroshi; Kano, Toshikazu; Mimori, Akio

    2015-07-01

    To compare the fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) findings in patients with elderly-onset rheumatoid arthritis (EORA) with those in patients with polymyalgia rheumatica (PMR), two conditions with similar clinical presentations. We retrospectively analyzed the FDG-PET/CT findings in 10 patients with EORA and 27 patients with PMR admitted to our department between 2006 and 2012. No significant difference was observed in the median patient ages at the time of FDG-PET/CT scans in the EORA and PMR groups (73.5 vs. 78.0 years, respectively). Significant differences in both FDG uptake scores and standardized uptake values were observed between the two groups in the ischial tuberosities, spinous processes, and wrists. No significant differences were detected in the shoulders and hips. However, specific uptake patterns were observed in each group: circular and linear uptake patterns were observed around the humeral head in the EORA group, whereas focal and non-linear uptake patterns were observed in the PMR group. Moreover, focal uptake in front of the hip joint, indicating iliopectineal bursitis, tended to be limited to the PMR group. High sensitivity (92.6%) and specificity (90%) were observed for PMR diagnoses when at least three of the following five items were satisfied: characteristic findings of shoulder and iliopectineal bursitis, FDG uptake in ischial tuberosities and spinal spinous processes, and lack of FDG uptake in the wrists. The differences in the degree of uptake at each lesion and in uptake patterns at the shoulders and hips are potentially useful for obtaining a definitive diagnosis.

  12. (18)F-FDG positron-emission tomography/computed tomography findings of radiographic lesions suggesting old healed tuberculosis.

    Science.gov (United States)

    Jeong, Yun-Jeong; Paeng, Jin Chul; Nam, Hyun-Yeol; Lee, Ji Sun; Lee, Sang-Min; Yoo, Chul-Gyu; Kim, Young Whan; Han, Sung Koo; Yim, Jae-Joon

    2014-03-01

    The presence of radiographic lesions suggesting old healed tuberculosis (TB) is one of the strongest risk factors for the subsequent development of active TB. We elucidated the metabolic activity of radiographic lesions suggesting old healed TB using (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT). This cross-sectional study included 63 participants with radiographic lesions suggesting old healed TB and with available (18)F-FDG PET/CT scans. The maximum standardized uptake value (SUVmax) measured in the lesions, the clinical characteristics, results of the tuberculin skin test (TST) and interferon-γ release assay (IGRA) were analyzed. The SUVmax in old healed TB was 1.5 or higher among nine (14.3%) participants. Age (adjusted odds ratio [aOR], 1.23; 95% CI, 1.03-1.46), history of previous TB (aOR, 60.43; 95% CI, 1.71-2131.65), and extent of the lesions (aOR, 1.34; 95% CI, 1.02-1.75) were associated with higher SUVmax. The positive rates for the TST and IGRA were not different between groups with and without increased FDG uptake. Increased FDG uptake on (18)F-FDG PET/CT was observed in a subset of patients with radiographic lesions suggesting old healed TB. Given that the factors associated with increased FDG uptake are known risk factors for TB development, the possibility exists that participants with old healed TB lesions with higher SUV on (18)F-FDG PET/CT scans might be at higher risk for active TB.

  13. Detection of thoracic aortic prosthetic graft infection with 18F-fluorodeoxyglucose positron emission tomography/computed tomography.

    Science.gov (United States)

    Tokuda, Yoshiyuki; Oshima, Hideki; Araki, Yoshimori; Narita, Yuji; Mutsuga, Masato; Kato, Katsuhiko; Usui, Akihiko

    2013-06-01

    To investigate the diagnostic value of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in detecting thoracic aortic prosthetic graft infection. Nine patients with clinically suspected thoracic aortic graft infection underwent FDG-PET/CT scanning. In these patients, the diagnoses could not be confirmed using conventional modalities. The patients' clinical courses were retrospectively reviewed. On the basis of surgical, microbiological and clinical follow-up findings, the aortic grafts were considered infected in 4 patients and not infected in 5. All 4 patients with graft infection (root: 2 cases, arch: 1 case and descending: 1 case) eventually underwent in situ re-replacement. Two of the 4 patients also had abdominal grafts; however, only the thoracic grafts were replaced because uptake was low around the abdominal grafts. The maximal standardized uptake value (SUVmax) in the perigraft area was higher in the infected group than in the non-infected group (11.4 ± 4.5 vs 6.9 ± 6.4), although the difference was not statistically significant. According to the receiver operating characteristic analysis, SUVmax >8 appeared to be the cut-off value in distinguishing the two groups (sensitivity: 1.0 and specificity: 0.8). FDG-PET/CT is useful for confirming the presence of graft infection by detecting high uptake around grafts and excluding other causes of inflammation. An SUVmax value greater than 8 around a graft suggests the presence of graft infection. In addition, FDG-PET/CT can be used to clarify the precise extent of infection. This is especially useful if multiple separated prosthetic grafts have been implanted.

  14. Utility of Quantitative Parameters from Single-Photon Emission Computed Tomography/Computed Tomography in Patients with Destructive Thyroiditis

    Science.gov (United States)

    Kim, Ji-Young; Kim, Ji Hyun; Moon, Jae Hoon; Kim, Kyoung Min; Oh, Tae Jung; Lee, Dong-Hwa; So, Young

    2018-01-01

    Objective Quantitative parameters from Tc-99m pertechnetate single-photon emission computed tomography/computed tomography (SPECT/CT) are emerging as novel diagnostic markers for functional thyroid diseases. We intended to assess the utility of SPECT/CT parameters in patients with destructive thyroiditis. Materials and Methods Thirty-five destructive thyroiditis patients (7 males and 28 females; mean age, 47.3 ± 13.0 years) and 20 euthyroid patients (6 males and 14 females; mean age, 45.0 ± 14.8 years) who underwent Tc-99m pertechnetate quantitative SPECT/CT were retrospectively enrolled. Quantitative parameters from the SPECT/CT (%uptake, standardized uptake value [SUV], thyroid volume, and functional thyroid mass [SUVmean × thyroid volume]) and thyroid hormone levels were investigated to assess correlations and predict the prognosis for destructive thyroiditis. The occurrence of hypothyroidism was the outcome for prognosis. Results All the SPECT/CT quantitative parameters were significantly lower in the 35 destructive thyroiditis patients compared to the 20 euthyroid patients using the same SPECT/CT scanner and protocol (p thyroid-stimulating hormone (TSH) significantly correlated with %uptake (p = 0.004), SUVmean (p thyroid mass (p thyroiditis patients, 16 progressed to hypothyroidism. On univariate and multivariate analyses, only T3 levels were associated with the later occurrence of hypothyroidism (p = 0.002, exp(β) = 1.022, 95% confidence interval: 1.008 – 1.035). Conclusion Novel quantitative SPECT/CT parameters could discriminate patients with destructive thyroiditis from euthyroid patients, suggesting the robustness of the quantitative SPECT/CT approach. However, disease progression of destructive thyroiditis could not be predicted using the parameters, as these only correlated with TSH, but not with T3, the sole predictor of the later occurrence of hypothyroidism. PMID:29713225

  15. The role of 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography in the management of patients with carcinoma of unknown primary.

    Science.gov (United States)

    Deonarine, P; Han, S; Poon, F W; de Wet, C

    2013-08-01

    Carcinoma of unknown primary is one of the ten most frequent cancers worldwide. Its median survival time is less than 10 months. Detecting primary tumour locations and/or occult metastatic lesions may inform definitive treatment and improve patients' prognosis. We aimed to determine: (1) the sensitivity, specificity and accuracy of (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography; (2) its detection rate of primary tumour locations and occult metastases and (3) factors associated with improved survival times. We retrospectively reviewed all cases in the West of Scotland for the period 1 December 2007 to 31 May 2011 that met all our selection criteria: (1) diagnosis of carcinoma of unknown primary; (2) a thorough but negative 'work-up' and (3) (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography report. Statistical methods included frequencies, Kaplan-Meier graphs and log-rank tests to compare survival times. (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography detected primary tumour sites in 19/51 (37.3%) and occult metastases in 28/51 (54.9%) of eligible patients. Its sensitivity, specificity and accuracy were 79.2%, 70.4% and 74.5%, respectively; 20/51 (39.2%) patients died during the study period with a median survival of 8.4 months (range 21.4, SD ± 6.2). The number of metastatic locations was strongly associated with survival (p = 0.002), but detection of a primary tumour site (p = 0.174) or histopathology (p = 0.301) was not. (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography detected occult metastatic sites in the majority and a primary cancer location in a substantial minority of patients. Our results were comparable with international literature and may indicate that (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography have an early role to improve the accuracy of cancer staging and to optimise carcinoma of unknown

  16. Positron emission tomography-computed tomography protocol considerations for head and neck cancer imaging.

    Science.gov (United States)

    Escott, Edward J

    2008-08-01

    Positron emission tomographic-computed tomographic (PET-CT) imaging of patients with primary head and neck cancers has become an established approach for staging and restaging, as well as radiation therapy planning. The inherent co-registration of PET and CT images made possible by the integrated PET-CT scanner is particularly valuable in head and neck cancer imaging due to the complex and closely situated anatomy in this part of the body, the varied sources of physiologic and benign 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) tracer uptake that occurs in the neck, and the varied and complex posttreatment appearance of the neck. Careful optimization of both the CT and the PET portion of the examination is essential to insure the most accurate and clinically valuable interpretation of these examinations.

  17. Comparison of single photon emission computed tomography-computed tomography, computed tomography, single photon emission computed tomography and planar scintigraphy for characterization of isolated skull lesions seen on bone scintigraphy in cancer patients

    International Nuclear Information System (INIS)

    Sharma, Punit; Jain, Tarun Kumar; Reddy, Rama Mohan; Faizi, Nauroze Ashgar; Bal, Chandrasekhar; Malhotra, Arun; Kumar, Rakesh

    2014-01-01

    The purpose of this study is to evaluate the added value of single photon emission computed tomography-computed tomography (SPECT-CT) over planar scintigraphy, SPECT and CT alone for characterization of isolated skull lesions in bone scintigraphy (BS) in cancer patients. A total of 32 cancer patients (age: 39.5 ± 21.9; male: female - 1:1) with 36 isolated skull lesions on planar BS, underwent SPECT-CT of skull. Planar BS, SPECT, CT and SPECT-CT images were evaluated in separate sessions to minimize recall bias. A scoring scale of 1-5 was used, where 1 is definitely metastatic, 2 is probably metastatic, 3 is indeterminate, 4 is probably benign and 5 is definitely benign. With receiver operating characteristic analysis area under the curves (AUC) was calculated for each modality. For calculation of sensitivity, specificity and predictive values a Score ≤3 was taken as metastatic. Clinical/imaging follow-up and/or histopathology were taken as reference standard. Of 36 skull lesions 11 lesions each were on frontal, parietal and occipital bone while three lesions were in the temporal bone. Of these 36 lesions, 16 were indeterminate (Score-3) on planar and SPECT, five on CT and none on SPECT-CT. The AUC was largest for SPECT-CT followed by CT, SPECT and planar scintigraphy, respectively. Planar scintigraphy was inferior to SPECT-CT (P = 0.006) and CT (P = 0.012) but not SPECT (P = 0.975). SPECT was also inferior to SPECT-CT (P = 0.007) and CT (P = 0.015). Although no significant difference was found between SPECT-CT and CT (P = 0.469), the former was more specific (100% vs. 94%). SPECT-CT is better than planar scintigraphy and SPECT alone for correctly characterizing isolated skull lesions on BS in cancer patients. It is more specific than CT, but provides no significant advantage over CT alone for this purpose

  18. Utility of single photon emission computed tomography/computed tomography imaging in evaluation of chronic low back pain

    International Nuclear Information System (INIS)

    Harisankar, Chidambaram Natrajan Balasubramanian; Mittal, Bhagwant Rai; Bhattacharya, Anish; Singh, Paramjeet; Sen, Ramesh

    2012-01-01

    Abnormal morphologic findings in imaging were thought to explain the etiology of low back pain (LBP). However, it is now known that variety of morphologic abnormalities is noted even in asymptomatic individuals. Single photon emission computed tomography/computed tomography (SPECT/CT) could be used to differentiate incidental findings from clinically significant findings. This study was performed to define the SPECT/CT patterns in patients with LBP and to correlate these with clinical and magnetic resonance imaging (MRI) findings. Thirty adult patients with LBP of duration 3 months or more were prospectively evaluated in this study. Patients with known or suspected malignancy, trauma or infectious processes were excluded. A detailed history of sensory and motor symptoms and neurologic examination was performed. All the patients were subjected to MRI and bone scintigraphy with hybrid SPECT/CT of the lumbo-sacral spine within 1 month of each other. The patients were classified into those with and without neurologic symptoms, activity limitation. The findings of clinical examination and imaging were compared. MRI and SPECT/CT findings were also compared. Thirty patients (18 men and 12 women; mean age 38 years; range 17-64 years) were eligible for the study. Clinically, 14 of 30 (46%) had neurologic signs and or symptoms. Six of the 30 patients (20%) had positive straight leg raising test (SLRT). Twenty-two of the 30 patients (73%) had SPECT abnormality. Most frequent SPECT/CT abnormality was tracer uptake in the anterior part of vertebral body with osteophytes/sclerotic changes. Significant positive agreement was noted between this finding and MRI evidence of degenerative disc disease. Only 13% of patients had more than one abnormality in SPECT. All 30 patients had MRI abnormalities. The most frequent abnormality was degenerative disc disease and facet joint arthropathy. MRI showed single intervertebral disc abnormality in 36% of the patients and more than one

  19. Is a positron emission tomography-computed tomography scan useful in the staging of thymic epithelial neoplasms?

    Science.gov (United States)

    Viti, Andrea; Terzi, Alberto; Bianchi, Andrea; Bertolaccini, Luca

    2014-07-01

    A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed concerned the employment of 18-fluorine fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT) in the preoperative evaluation of thymic epithelial neoplasms (TENs). We reviewed its role as a predictor of Masaoka stage and histology (according to the WHO). In clinical practice, stage is considered the most important determinant in the therapeutic approach. A total of 265 papers were found as a result of the reported search, of which 14 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. All the studies are retrospective analyses. Patient numbers varied from 13 to 58. Our research showed that PET-CT could clearly add information about the histology of the tumour. Thymic carcinoma constantly showed a higher standard uptake value (SUVmax) than thymomas. Furthermore, in one retrospective study of 36 patients, when using a derived PET indicator, the T/M ratio (ratio between SUVmax of the tumour and SUVmax of mediastinum, as conventionally measured at the level of the aortic arc), PET-CT could also differentiate between low- and high-risk thymomas (low risk vs high risk P = 0.01). In another study, a cut-off value of T/M ratio of 2.75 was identified between low- and high-risk TENs. The role of PET-CT in prediction of stage is harder to recognize. In one study, there was a statistically significant correlation between SUVmax, T/M ratio and Masaoka stage (P = 0.781 and 0.718, respectively). When analysing the data from the three larger series on this topic (58, 51 and 47 patients, the latter group selected in a multicentre study), only one study identified a correlation between SUVmax and Masaoka stage (Spearman correlation coefficient 0.30, P = 0.0436), while the other two failed

  20. Pretreatment Staging Positron Emission Tomography/Computed Tomography in Patients With Inflammatory Breast Cancer Influences Radiation Treatment Field Designs

    International Nuclear Information System (INIS)

    Walker, Gary V.; Niikura, Naoki; Yang Wei; Rohren, Eric; Valero, Vicente; Woodward, Wendy A.; Alvarez, Ricardo H.; Lucci, Anthony; Ueno, Naoto T.; Buchholz, Thomas A.

    2012-01-01

    Purpose: Positron emission tomography/computed tomography (PET/CT) is increasingly being utilized for staging of inflammatory breast cancer (IBC). The purpose of this study was to define how pretreatment PET/CT studies affected postmastectomy radiation treatment (PMRT) planning decisions for IBC. Methods and Materials: We performed a retrospective analysis of 62 patients diagnosed with IBC between 2004 and 2009, who were treated with PMRT in our institution and who had a staging PET/CT within 3 months of diagnosis. Patients received a baseline physical examination, staging mammography, ultrasonographic examination of breast and draining lymphatics, and chest radiography; most patients also had a bone scan (55 patients), liver imaging (52 patients), breast MRI (46 patients), and chest CT (25 patients). We compared how PET/CT findings affected PMRT, assuming that standard PMRT would target the chest wall, level III axilla, supraclavicular fossa, and internal mammary chain (IMC). Any modification of target volumes, field borders, or dose prescriptions was considered a change. Results: PET/CT detected new areas of disease in 27 of the 62 patients (44%). The areas of additional disease included the breast (1 patient), ipsilateral axilla (1 patient), ipsilateral supraclavicular (4 patients), ipsilateral infraclavicular (1 patient), ipsilateral IMC (5 patients), ipsilateral subpectoral (3 patients), mediastinal (8 patients), other distant/contralateral lymph nodes (15 patients), or bone (6 patients). One patient was found to have a non-breast second primary tumor. The findings of the PET/CT led to changes in PMRT in 11 of 62 patients (17.7%). These changes included additional fields in 5 patients, adjustment of fields in 2 patients, and higher doses to the supraclavicular fossa (2 patients) and IMC (5 patients). Conclusions: For patients with newly diagnosed IBC, pretreatment PET/CT provides important information concerning involvement of locoregional lymph nodes

  1. Ultrasound, elastography, and fluorodeoxyglucose positron emission tomography/computed tomography imaging in Riedel's thyroiditis: report of two cases.

    Science.gov (United States)

    Slman, Rouba; Monpeyssen, Hervé; Desarnaud, Serge; Haroche, Julien; Fediaevsky, Laurence Du Pasquier; Fabrice, Menegaux; Seret-Begue, Dominique; Amoura, Zahir; Aurengo, André; Leenhardt, Laurence

    2011-07-01

    Riedel's thyroiditis (RT) is a rare disease characterized by a chronic inflammatory lesion of the thyroid gland with invasion by a dense fibrosis. Publications of the imaging features of RT are scarce. To our knowledge, ultrasound elastography (USE) findings have not been previously reported. Therefore, we describe two patients with RT who were imaged with ultrasonography (US), USE, and fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT). Two women were referred for a large, hard goiter with compressive symptoms (dyspnea and dysphagia); in one patient, the goiter was associated with retroperitoneal fibrosis. In both cases, RT was confirmed by surgical biopsy with pathological examination. Thyroid US imaging was performed with a US scan and a 10-13 MHz linear transducer. The hardness of the tissues was analyzed using transient USE (ShearWave, Aixplorer-SuperSonic Imagine). PET/CT scanning was performed with a Philips Gemini GXL camera (GE Medical Systems). In the first patient, US examination revealed a compressive multinodular goiter with large solid hypoechoic and poorly vascularized areas adjacent to the nodules. The predominant right nodule was hypoechoic with irregular margins. The second patient had a hypoechoic goiter with large bilateral hypoechoic areas. In both cases, an unusual feature was observed: the presence of tissue surrounding the primitive carotid artery, associated with thrombi of the internal jugular vein. Further, USE showed heterogeneity in the stiffness values of the thyroid parenchyma varying between 21 kPa and 281 kPa. FDG-PET/CT imaging showed uptake foci in the thyroid gland. In both cases, US showed a decrease in the thyroid gland volume and the disappearance of encasement of the neck vasculature in response to corticosteroid treatment. In contrast, the FDG-PET/CT features remained unchanged. US features, such as vascular encasement and improvement under corticosteroid treatment, seem to be specific to this

  2. Role of single photon emission computed tomography/computed tomography in diagnostic iodine-131 scintigraphy before initial radioiodine ablation in differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Agrawal, Kanhaiyalal; Bhattacharya, Anish; Mittal, Bhagwant Rai

    2005-01-01

    The study was performed to evaluate the incremental value of single photon emission computed tomography/computed tomography (SPECT/CT) over planar radioiodine imaging before radioiodine ablation in the staging, management and stratification of risk of recurrence (ROR) in differentiated thyroid cancer (DTC) patients. Totally, 83 patients (21 male, 62 female) aged 17–75 (mean 39.9) years with DTC were included consecutively in this prospective study. They underwent postthyroidectomy planar and SPECT/CT scans after oral administration of 37–114 MBq iodine-131 (I-131). The scans were interpreted as positive, negative or suspicious for tracer uptake in the thyroid bed, cervical lymph nodes and sites outside the neck. In each case, the findings on planar images were recorded first, without knowledge of SPECT/CT findings. Operative and pathological findings were used for postsurgical tumor–node–metastasis staging. The tumor staging was reassessed after each of these two scans. Single photon emission computed tomography/computed tomography localized radioiodine uptake in the thyroid bed in 9/83 (10.8%) patients, neck nodes in 24/83 (28.9%) patients and distant metastases in 8/83 (9.6%) patients in addition to the planar study. Staging was changed in 8/83 (9.6%), ROR in 11/83 (13.2%) and management in 26/83 (31.3%) patients by the pretherapy SPECT/CT in comparison to planar imaging. SPECT/CT had incremental value in 32/83 patients (38.5%) over the planar scan. Single photon emission computed tomography/computed tomography is feasible during a diagnostic I-131 scan with a low amount of radiotracer. It improved the interpretation of pretherapy I-131 scintigraphy and changed the staging and subsequent patient management

  3. Post meningitis subdural hygroma: Anatomical and functional evaluation with (99m)Tc-ehylene cysteine dimer single photon emission tomography/computed tomography.

    Science.gov (United States)

    Sharma, Punit; Mishra, Ajiv; Arora, Geetanjali; Tripathi, Madhavi; Bal, Chandrasekhar; Kumar, Rakesh

    2013-01-01

    Subdural hygroma is the collection of cerebrospinal fluid in the subdural space. Most often these resolve spontaneously. However, in cases with neurological complications surgical drainage may be needed. We here, present the case of an 8-year-old boy with post meningitis subdural hygroma. (99m)Tc-ehylene cysteine dimer ((99m)Tc-ECD) hybrid single photon emission tomography/computed tomography (SPECT/CT) carried out in this patient, demonstrated the subdural hygroma as well as the associated cerebral hypoperfusion. If (99m)Tc-ECD SPECT/CT is integrated into management of these patients, it can help in decision making with respect to conservative versus surgical management.

  4. [(18) F]fluoromethylcholine (FCH) positron emission tomography/computed tomography (PET/CT) for lymph node staging of prostate cancer

    DEFF Research Database (Denmark)

    Poulsen, Mads H; Bouchelouche, Kirsten; Høilund-Carlsen, Poul F

    2012-01-01

    recurrence. Therefore, one may question whether surgical lymph node dissection (LND) is sufficiently reliable for staging of these patients. Several imaging methods for primary LN staging of patients with prostate cancer have been tested. Acceptable detection rates have not been achieved by CT or MRI...... this procedure. However, we did detect several bone metastases with [(18) F]FCH PET/CT that the normal bone scans had missed, and this might be worth pursuing. OBJECTIVES: •  To assess the value of [(18) F]fluoromethylcholine (FCH) positron emission tomography/computed tomography (PET/CT) for lymph node (LN...

  5. Primary neuroendocrine carcinoma of breast with liver and bone metastasis detected with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Kamaleshwaran, Koramadai Karuppusamy; Mohanan, Vyshak; Shibu, Deepu; Radhakrishnan, Edathuruthy Kalarikal; Shinto, Ajit Sugunan

    2014-01-01

    Cases of primary neuroendocrine carcinoma (NEC) of the breast have been reported, though rare. We report the case of a 45-year-old woman presented with jaundice and evaluated to have liver metastasis from neuroendocrine origin. She underwent whole body positron emission tomography/computed tomography, which showed left breast lesion and bone metastasis. Fine-needle aspiration (FNA) of breast revealed a NEC. A diagnosis of a primary NEC of the breast was rendered with hepatic and bone metastasis. She was treated with peptide receptor radionuclide therapy and is on follow-up

  6. A Unique Case of Diffuse Metastatic Neuroendocrine Cancer with Subcutaneous Nodules on 18F-Fluorodeoxyglucose Positron Emission Tomography/Computer Assisted Tomography

    International Nuclear Information System (INIS)

    Johnston, Mickaila J.; Sachedina, Archana; McDonald, James E.

    2015-01-01

    Neuroendocrine tumors (NETs) account for 8–10% of cases of carcinomas of unknown primary. Most of these cases are poorly differentiated with metastatic disease at the time of diagnosis. However, cutaneous metastatic presentation is rare. We present an interesting case of a 74-year-old woman presenting with cutaneous metastatic involvement from high grade poorly differentiated NET of unknown origin. She was referred to us with a diagnosis of lymphoma. 18 F-fluorodeoxyglucose positron emission tomography/computer assisted tomography imaging at our institution offered a differential diagnosis, including neuroendocrine cancer. Repeat skin lesion biopsy demonstrated “non-Merkel cell” carcinoma, favoring metastatic high-grade neuroendocrine carcinoma

  7. Malaria masquerading as relapse of Hodgkin's lymphoma on contrast enhanced 18F-fluorodeoxyglucose positron emission tomography/computed tomography: A diagnostic dilemma

    International Nuclear Information System (INIS)

    Jeph, Sunil; Thakur, Kamia; Shamim, Shamim Ahmed; Aggarwal, Ajay

    2014-01-01

    18 Flurodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) is nowadays routinely used in management of lymphoma patients. We here present a case of Hodgkin's lymphoma which showed 18 F-FDG avid splenomegaly on PET/CT done for clinically suspected relapse. Further evaluation by peripheral smear examination revealed malaria. The patient was then started on anti-malarial medications and follow-up PET/CT revealed resolution of hypermetabolic splenomegaly. This report highlights that in endemic regions malaria can cause 18 F-FDG avid splenomegaly and might mimic relapse of lymphoma

  8. A rare case of extensive skeletal muscle metastases in adenocarcinoma cervix identified by 18F-fluorodeoxyglucose positron emission tomography/computed tomography scan

    International Nuclear Information System (INIS)

    Vishnoi, Madan Gopal; Jain, Anurag; John, Arun Ravi; Paliwal, Dharmesh

    2016-01-01

    Adenocarcinoma cervix is an uncommon histological subtype of carcinoma cervix; further incidence of skeletal muscle metastases is even rarer. We report the identification of extensive fluorodeoxyglucose (FDG) avid metastatic skeletal muscle deposits in a known case of adenocarcinoma cervix. The largest lesion representative of muscle deposit in the right deltoid was histopathologically confirmed to be metastatic poorly differentiated carcinoma. This report also serves to highlight the importance of 18 F-FDG positron emission tomography/computed tomography (CT) as compared to conventional imaging modalities such as CT and ultrasonography and comments better over the description of invasiveness as well as the extent of disease in carcinoma cervix

  9. Acute Calculous Cholecystitis Missed on Computed Tomography and Ultrasound but Diagnosed with Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

    Directory of Open Access Journals (Sweden)

    Carina Mari Aparici

    2016-01-01

    Full Text Available We present a case of a 69-year-old patient who underwent ascending aortic aneurysm repair with aortic valve replacement. On postsurgical day 12, he developed leukocytosis and low-grade fevers. The chest computed tomography (CT showed a periaortic hematoma which represents a postsurgical change from aortic aneurysm repair, and a small pericardial effusion. The abdominal ultrasound showed cholelithiasis without any sign of cholecystitis. Finally, a fluorodeoxyglucose (FDG-positron emission tomography (PET/CT examination was ordered to find the cause of fever of unknown origin, and it showed increased FDG uptake in the gallbladder wall, with no uptake in the lumen. FDG-PET/CT can diagnose acute cholecystitis in patients with nonspecific clinical symptoms and laboratory results.

  10. Diagnostic performance of fluorodeoxyglucose positron emission tomography/magnetic resonance imaging fusion images of gynecological malignant tumors. Comparison with positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Nakajo, Kazuya; Tatsumi, Mitsuaki; Inoue, Atsuo

    2010-01-01

    We compared the diagnostic accuracy of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) and PET/magnetic resonance imaging (MRI) fusion images for gynecological malignancies. A total of 31 patients with gynecological malignancies were enrolled. FDG-PET images were fused to CT, T1- and T2-weighted images (T1WI, T2WI). PET-MRI fusion was performed semiautomatically. We performed three types of evaluation to demonstrate the usefulness of PET/MRI fusion images in comparison with that of inline PET/CT as follows: depiction of the uterus and the ovarian lesions on CT or MRI mapping images (first evaluation); additional information for lesion localization with PET and mapping images (second evaluation); and the image quality of fusion on interpretation (third evaluation). For the first evaluation, the score for T2WI (4.68±0.65) was significantly higher than that for CT (3.54±1.02) or T1WI (3.71±0.97) (P<0.01). For the second evaluation, the scores for the localization of FDG accumulation showing that T2WI (2.74±0.57) provided significantly more additional information for the identification of anatomical sites of FDG accumulation than did CT (2.06±0.68) or T1WI (2.23±0.61) (P<0.01). For the third evaluation, the three-point rating scale for the patient group as a whole demonstrated that PET/T2WI (2.72±0.54) localized the lesion significantly more convincingly than PET/CT (2.23±0.50) or PET/T1WI (2.29±0.53) (P<0.01). PET/T2WI fusion images are superior for the detection and localization of gynecological malignancies. (author)

  11. Detection of non-aggressive stage IA lung cancer using chest computed tomography and positron emission tomography/computed tomography.

    Science.gov (United States)

    Shiono, Satoshi; Yanagawa, Naoki; Abiko, Masami; Sato, Toru

    2014-10-01

    In contrast to lung cancer with ground-glass opacity, the radiological investigation of solid lung cancer has not been well examined. The aim of this study was to explore chest computed tomography (CT) and positron emission tomography (PET)/CT findings with regard to outcomes after lung cancer surgery in order to radiologically classify clinical stage IA lung cancers by tumour aggressiveness. Three hundred and fifteen clinical stage IA patients were analysed. Four groups were defined by tumour solidity on CT and by the standardized uptake value (SUV) index on PET-CT (tumour maximum SUV/mean right liver lobe SUV). We analysed the association between radiological findings and both pathological invasiveness and postoperative outcome. Group A (n = 84) had an SUV index <1.0 and non-solid tumours, Group B (n = 24) had an SUV index <1.0 and solid tumours, Group C (n = 54) had an SUV index ≥1.0 and non-solid tumours, while Group D (n = 153) had an SUV index ≥1.0 and solid tumours. Invasive lung cancer was found in 2/84 (2.4%) patients in Group A, 1/24 (4.2%) in Group B, 13/54 (24.1%) in Group C and 58/153 (37.9%) in Group D (P < 0.01). The 5-year recurrence-free rate was 100% in Groups A and B, 90.3% in C and 65.7% in D (P < 0.01). The cancer-specific survival rate was 100% in A and B, 94.6% in C and 81.7% in D (P < 0.01). The present results suggest that preoperative PET/CT and thin-section CT findings provide important information for a selection of surgical procedures for clinical stage IA lung cancers. In clinical stage IA lung cancers displaying solid or non-solid density in thin-section findings, an SUV index <1.0 may be a better criterion for detecting non-aggressive lung cancer even in solid lung cancers. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  12. Prediction of Central Nervous System Relapse of Diffuse Large B-Cell Lymphoma Using Pretherapeutic [18F]2-Fluoro-2-Deoxyglucose (FDG) Positron Emission Tomography/Computed Tomography.

    Science.gov (United States)

    Song, Yoo Sung; Lee, Won Woo; Lee, Jong Seok; Kim, Sang Eun

    2015-11-01

    Central nervous system (CNS) relapse of diffuse large B-cell lymphoma (DLBCL) is a rare complication, but has a poor prognosis with unknown pathophysiology. Recent trials of CNS prophylaxis have shown to be ineffective, despite patient's selection using several known clinical risk factors. In this study, the authors evaluated the value of pretreatment [F]2-Fluoro-2-deoxyglucose positron emission tomography in predicting CNS relapse in DLBCL patients.The authors analyzed 180 pathologically confirmed DLBCL patients, retrospectively. Patients underwent [F]2-Fluoro-2-deoxyglucose positron emission tomography/computed tomography before first line rituximab to cyclophosphamide, doxorubicin, vincristine, and prednisone therapy. Clinical characteristics were evaluated and total lesion glycolysis (TLG) with a threshold margin of 50% was calculated.Among age, sex, Ann Arbor stage, International Prognostic Index, revised International Prognostic Index, high serum lactate dehydrogenase level, presence of B symptoms, bulky disease (≥10 cm), extranodal lesion involvement, bone marrow involvement, high metabolic tumor volume ( >450 mL), and high TLG50 (>2000), the high TLG50 was the only significant prognostic factor for predicting CNS relapse in a multivariate analysis (P = 0.04). Kaplan-Meir survival analysis between high TLG50 (>2000) and low TLG50 (≤2000) groups revealed significantly different mean progression free survival (PFS) of 1317.2 ± 134.3 days and 1968.6 ± 18.3 days, respectively (P positron emission tomography/computed tomography is the most significant predictor of CNS relapse in un-treated DLBCL patients.

  13. Positron Emission Tomography/Computed Tomography-Guided Intensity-Modulated Radiotherapy for Limited-Stage Small-Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shirvani, Shervin M.; Komaki, Ritsuko [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Heymach, John V.; Fossella, Frank V. [Department of Thoracic/Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Chang, Joe Y., E-mail: jychang@mdanderson.org [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)

    2012-01-01

    Purpose: Omitting elective nodal irradiation from planning target volumes does not compromise outcomes in patients with non-small-cell lung cancer, but whether the same is true for those with limited-stage small-cell lung cancer (LS-SCLC) is unknown. Therefore, in the present study, we sought to determine the clinical outcomes and the frequency of elective nodal failure in patients with LS-SCLC staged using positron emission tomography/computed tomography and treated with involved-field intensity-modulated radiotherapy. Methods and Materials: Between 2005 and 2008, 60 patients with LS-SCLC at our institution underwent disease staging using positron emission tomography/computed tomography before treatment using an intensity-modulated radiotherapy plan in which elective nodal irradiation was intentionally omitted from the planning target volume (mode and median dose, 45 Gy in 30 fractions; range, 40.5 Gy in 27 fractions to 63.8 Gy in 35 fractions). In most cases, concurrent platinum-based chemotherapy was administered. We retrospectively reviewed the clinical outcomes to determine the overall survival, relapse-free survival, and failure patterns. Elective nodal failure was defined as recurrence in initially uninvolved hilar, mediastinal, or supraclavicular nodes. Survival was assessed using the Kaplan-Meier method. Results: The median age of the study patients at diagnosis was 63 years (range, 39-86). The median follow-up duration was 21 months (range, 4-58) in all patients and 26 months (range, 4-58) in the survivors. The 2-year actuarial overall survival and relapse-free survival rate were 58% and 43%, respectively. Of the 30 patients with recurrence, 23 had metastatic disease and 7 had locoregional failure. We observed only one isolated elective nodal failure. Conclusions: To our knowledge, this is the first study to examine the outcomes in patients with LS-SCLC staged with positron emission tomography/computed tomography and treated with definitive intensity

  14. Positron Emission Tomography/Computed Tomography-Guided Intensity-Modulated Radiotherapy for Limited-Stage Small-Cell Lung Cancer

    International Nuclear Information System (INIS)

    Shirvani, Shervin M.; Komaki, Ritsuko; Heymach, John V.; Fossella, Frank V.; Chang, Joe Y.

    2012-01-01

    Purpose: Omitting elective nodal irradiation from planning target volumes does not compromise outcomes in patients with non–small-cell lung cancer, but whether the same is true for those with limited-stage small-cell lung cancer (LS-SCLC) is unknown. Therefore, in the present study, we sought to determine the clinical outcomes and the frequency of elective nodal failure in patients with LS-SCLC staged using positron emission tomography/computed tomography and treated with involved-field intensity-modulated radiotherapy. Methods and Materials: Between 2005 and 2008, 60 patients with LS-SCLC at our institution underwent disease staging using positron emission tomography/computed tomography before treatment using an intensity-modulated radiotherapy plan in which elective nodal irradiation was intentionally omitted from the planning target volume (mode and median dose, 45 Gy in 30 fractions; range, 40.5 Gy in 27 fractions to 63.8 Gy in 35 fractions). In most cases, concurrent platinum-based chemotherapy was administered. We retrospectively reviewed the clinical outcomes to determine the overall survival, relapse-free survival, and failure patterns. Elective nodal failure was defined as recurrence in initially uninvolved hilar, mediastinal, or supraclavicular nodes. Survival was assessed using the Kaplan-Meier method. Results: The median age of the study patients at diagnosis was 63 years (range, 39–86). The median follow-up duration was 21 months (range, 4–58) in all patients and 26 months (range, 4–58) in the survivors. The 2-year actuarial overall survival and relapse-free survival rate were 58% and 43%, respectively. Of the 30 patients with recurrence, 23 had metastatic disease and 7 had locoregional failure. We observed only one isolated elective nodal failure. Conclusions: To our knowledge, this is the first study to examine the outcomes in patients with LS-SCLC staged with positron emission tomography/computed tomography and treated with definitive

  15. Head and neck: normal variations and benign findings in FDG positron emission tomography/computed tomography imaging.

    Science.gov (United States)

    Højgaard, Liselotte; Berthelsen, Anne Kiil; Loft, Annika

    2014-04-01

    Positron emission tomography (PET)/computed tomography with FDG of the head and neck region is mainly used for the diagnosis of head and neck cancer, for staging, treatment evaluation, relapse, and planning of surgery and radio therapy. This article is a practical guide of imaging techniques, including a detailed protocol for FDG PET in head and neck imaging, physiologic findings, and pitfalls in selected case stories. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Patterns of brown fat uptake of 18F-fluorodeoxyglucose in positron emission tomography/computed tomography scan

    International Nuclear Information System (INIS)

    Chakraborty, Dhritiman; Bhattacharya, Anish; Mittal, Bhagwant Rai

    2015-01-01

    Fluorodeoxyglucose (FDG) positron emission tomography (PET) has become the common imaging modality in oncological practice. FDG uptake is seen in brown adipose tissue in a significant number of patients. Recognizing the uptake patterns is important for optimal FDG PET interpretation. The introduction of PET/computed tomography (PET/CT) revolutionized PET imaging, bringing much-needed anatomical information. Careful review and correlation of FDG PET images with anatomical imaging should be performed to characterize accurately any lesion having high FDG uptake

  17. In Vivo Treatment Sensitivity Testing With Positron Emission Tomography/Computed Tomography After One Cycle of Chemotherapy for Hodgkin Lymphoma

    DEFF Research Database (Denmark)

    Hutchings, Martin; Kostakoglu, Lale; Zaucha, Jan Maciej

    2014-01-01

    PURPOSE: Negative [(18)F]fluorodeoxyglucose (FDG) -positron emission tomography (PET)/computed tomography (CT) after two cycles of chemotherapy indicates a favorable prognosis in Hodgkin lymphoma (HL). We hypothesized that the negative predictive value would be even higher in patients responding....... In the absence of precise pretherapeutic predictive markers, PET1 is the best method for response-adapted strategies designed to select patients for less intensive treatment....

  18. Comparison of {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography, hydro-stomach computed tomography, and their combination for detecting primary gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Hye Young; Chung, Woo Suk; Song, E Rang; Kim, Jin Suk [Konyang University Myunggok Medical Research Institute, Konyang University Hospital, Konyang University College of Medicine, Daejeon (Korea, Republic of)

    2015-01-15

    To retrospectively compare the diagnostic accuracy for detecting primary gastric cancer on positron emission tomography/computed tomography (PET/CT) and hydro-stomach CT (S-CT) and determine whether the combination of the two techniques improves diagnostic performance. A total of 253 patients with pathologically proven primary gastric cancer underwent PET/CT and S-CT for the preoperative evaluation. Two radiologists independently reviewed the three sets (PET/CT set, S-CT set, and the combined set) of PET/CT and S-CT in a random order. They graded the likelihood for the presence of primary gastric cancer based on a 4-point scale. The diagnostic accuracy of the PET/CT set, the S-CT set, and the combined set were determined by the area under the alternative-free receiver operating characteristic curve, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Diagnostic accuracy, sensitivity, and NPV for detecting all gastric cancers and early gastric cancers (EGCs) were significantly higher with the combined set than those with the PET/CT and S-CT sets. Specificity and PPV were significantly higher with the PET/CT set than those with the combined and S-CT set for detecting all gastric cancers and EGCs. The combination of PET/CT and S-CT is more accurate than S-CT alone, particularly for detecting EGCs.

  19. Comparison of 18F-fluorodeoxyglucose positron emission tomography/computed tomography, hydro-stomach computed tomography, and their combination for detecting primary gastric cancer

    International Nuclear Information System (INIS)

    Jang, Hye Young; Chung, Woo Suk; Song, E Rang; Kim, Jin Suk

    2015-01-01

    To retrospectively compare the diagnostic accuracy for detecting primary gastric cancer on positron emission tomography/computed tomography (PET/CT) and hydro-stomach CT (S-CT) and determine whether the combination of the two techniques improves diagnostic performance. A total of 253 patients with pathologically proven primary gastric cancer underwent PET/CT and S-CT for the preoperative evaluation. Two radiologists independently reviewed the three sets (PET/CT set, S-CT set, and the combined set) of PET/CT and S-CT in a random order. They graded the likelihood for the presence of primary gastric cancer based on a 4-point scale. The diagnostic accuracy of the PET/CT set, the S-CT set, and the combined set were determined by the area under the alternative-free receiver operating characteristic curve, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Diagnostic accuracy, sensitivity, and NPV for detecting all gastric cancers and early gastric cancers (EGCs) were significantly higher with the combined set than those with the PET/CT and S-CT sets. Specificity and PPV were significantly higher with the PET/CT set than those with the combined and S-CT set for detecting all gastric cancers and EGCs. The combination of PET/CT and S-CT is more accurate than S-CT alone, particularly for detecting EGCs.

  20. Preoperative lymph-node staging of invasive urothelial bladder cancer with 18F-fluorodeoxyglucose positron emission tomography/computed axial tomography and magnetic resonance imaging

    DEFF Research Database (Denmark)

    Jensen, Thor Knak; Holt, Per; Gerke, Oke

    2011-01-01

    OBJECTIVE: The treatment and prognosis of bladder cancer are based on the depth of primary tumour invasion and the presence of metastases. A highly accurate preoperative tumour, node, metastasis (TNM) staging is critical to proper patient management and treatment. This study retrospectively...... investigated the value of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed axial tomography (¹⁸F-FDG PET/CT) and magnetic resonance imaging (MRI) for preoperative N staging of bladder cancer. Material and methods. From June 2006 to January 2008, 48 consecutive patients diagnosed with bladder......) for MRI and ¹⁸F-FDG PET/CT, respectively. The differences in specificity and negative predictive values were not statistically significant. Conclusions. No significant statistical difference between ¹⁸F-FDG PET/CT and MRI for preoperative N staging of urothelial bladder cancer was found in the study...

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

    Science.gov (United States)

    Turpin, Sophie; Carret, Anne-Sophie; Dubois, Josée; Buteau, Chantal; Patey, Natalie

    2015-11-01

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

  2. Fluorodeoxyglucose positron emission tomography-computed tomography scan in von Hippel-Lindau syndrome: a case report and review of literature

    International Nuclear Information System (INIS)

    Solav, Shrikant; Bhandari, Ritu

    2012-01-01

    Von Hippel-Lindau (VHL) syndrome is a hereditary autosomal dominant disorder caused by defective tumor suppression gene at 3p25-p26. The gene for VHL disease is found on chromosome 3, and is inherited in a dominant fashion. The VHL gene is a tumor suppressor gene. This means that its role in a normal cell is to stop the uncontrolled growth and proliferation. It is characterized by abnormal growth of blood vessels. It strikes the eyes, central nervous system, kidneys, endocrine glands, etc. It predisposes the patient to retinal angiomas, central nervous system hemangioblastoma, renal cell carcinoma (RCC), pheochromocytomas, islet cell tumor of the pancreas, endolymphatic sac tumors, renal, pancreatic, epididymal cysts. We present a case of familial VHL syndrome whose Fluorine 18-fluorodeoxyglucose positron emission tomography-computed tomography scan was truly positive for adrenal pheochromocytoma but was falsely negative for RCC. Review of literature related to this entity is made. (author)

  3. Asymmetrically increased rib cage uptake on bone scintigraphy: Incidental detection of pleural mesothelioma on single photon emission computed tomography/computed tomography

    International Nuclear Information System (INIS)

    Dhull, Varun Singh; Sharma, Punit; Durgapal, Prashant; Karunanithi, Sellam; Tripathi, Madhavi; Kumar, Rakesh

    2014-01-01

    Follow-up bone scintigraphy (BS) in a patient of carcinoma left breast, who was treated with surgery followed by radiotherapy 12 years back, revealed asymmetrically increased radiotracer uptake in left-sided ribs. Since, this pattern was atypical for metastatic rib involvement, single photon emission computed tomography/computed tomography (SPECT/CT) of thorax was done in the same setting which revealed circumferential nodular left-sided pleural thickening. Biopsy confirmed it to be pleural mesothelioma. Left-sided ribs showed no abnormality on CT, thus suggesting the rib uptake as reactive in nature. This pattern of asymmetric rib uptake on BS should be kept in mind and warrants further investigation for determining underlying pathology

  4. Gallium-68 DOTA-TATE Positron Emission Tomography/Computed Tomography: Scintigraphic Changes of Adrenal Glands Following Management of Ectopic Cushing's Syndrome by Steroidogenesis Inhibitors

    International Nuclear Information System (INIS)

    Huang, Yu-Ting; Aziz, Shaikh Irfan; Kumar, Aravind S. Ravi

    2014-01-01

    In the era of emerging functional imaging techniques, an understanding of the effects of hormonal therapies on the scintigraphic appearance of endocrine organs is desirable to minimize the erroneous scan interpretation. The mechanisms by which changes in the scintigraphic appearance of endocrine organs occur however sometimes remain ambiguous. This case demonstrates the gallium-68 (Ga-68) DOTA-TATE positron emission tomography/computed tomography (CT) appearance of adrenal glands following management with steroidogenesis inhibitors. The potential mechanisms underlying this change are discussed. A 17-year-old boy with adrenocorticotropic hormone (ACTH) dependent Cushing's syndrome secondary to ectopic ACTH secretion underwent pre- and post-metyrapone and dexamethasone treatment Ga-68 DOTA-TATE scans 4 months apart. Pretreatment, both adrenals demonstrated normal symmetrical prominent Ga-68 DOTA-TATE uptake and normal CT appearance. The posttherapy scan revealed marked symmetrical suppression of Ga-68 DOTA-TATE uptake, but with bilateral adrenal hypertrophy on CT

  5. Post meningitis subdural hygroma: anatomical and functional evaluation with 99mTc-ethylene cysteine dimer single photon emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Sharma, Punit; Mishra, Ajiv; Arora, Geetanjali; Tripathi, Madhavi; Bal, Chandrasekhar; Kumar, Rakesh

    2013-01-01

    Subdural hygroma is the collection of cerebrospinal fluid in the subdural space. Most often these resolve spontaneously. However, in cases with neurological complications surgical drainage may be needed. We here, present the case of an 8-year-old boy with post meningitis subdural hygroma. 99m Tc-ethylene cysteine dimer ( 99m Tc-ECD) hybrid single photon emission tomography/computed tomography (SPECT/CT) carried out in this patient, demonstrated the subdural hygroma as well as the associated cerebral hypoperfusion. If 99m Tc-ECD SPECT/CT is integrated into management of these patients, it can help in decision making with respect to conservative versus surgical management. (author)

  6. A case of dual ectopy thyroid along the thyroglossal tract demonstrated on 99mTc-Pertechnatate hybrid single photon emission computed tomography/computed tomography

    International Nuclear Information System (INIS)

    Agarwal, Krishan Kant; Karunanithi, Sellam; Jain, Sachin; Tripathi, Madhavi

    2014-01-01

    Ectopic thyroid tissue (ETT) refers to the presence of thyroid tissue in locations other than the normal anterior neck region between the second and fourth tracheal cartilages. Multiple ectopia of the thyroid is extremely rare. Here we report a case of 10-year-old girl with anterior midline neck swelling and hypothyroidism with dual ectopia of thyroid gland without orthotopic thyroid gland. Planar 99 m-technetium pertechnatate scan identified ETT corresponding to the palpable neck swelling. Single photon emission computed tomography/computed tomography (SPECT/CT) demonstrated ETT in two locations, one corresponding to the palpable mass and another in the in the sublingual location. This case thus demonstrates the important role of hybrid SPECT/CT in the identification of dual ectopia along the thyroglossal tract

  7. "6"8Gallium-arginine-glycine-aspartic acid and "1"8F-fluorodeoxyglucose position emission tomography/computed tomography in chondroblastic osteosarcoma of the skull

    International Nuclear Information System (INIS)

    Orunmuyi, Akintunde; Modiselle, Moshe; Lengana, Thabo; Ebenhan, Thomas; Vorster, Mariza; Sathekge, Mike

    2017-01-01

    We report the case of a 32 year-old male with Chondroblastic Osteosarcoma of the skull, which was imaged with both "1"8[F]fluorodeoxyglucose ("1"8F-FDG) positron emission tomography/computed tomography (PET/CT) and "6"8Gallium-arginine-glycine-aspartic acid ("6"8Ga-RGD) PET/CT. The "1"8F-FDG PET/CT did not demonstrate the tumour, whereas the "6"8Ga-RGD PET/CT clearly depicted a left-sided frontal tumour. "6"8Ga-RGD PET/CT may be a clinically useful imaging modality for early detection of recurrent osteosarcoma, considering the limitations of "1"8F-FDG PET in a setting of low glycolytic activity

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-11-15

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

  9. Infective endocarditis detected by 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in a patient with occult infection

    Directory of Open Access Journals (Sweden)

    Chia-Lu Yeh

    2011-11-01

    Full Text Available Integrated 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG PET/CT has been clinically used to detect infectious lesions. We present a case with pyrexia and bacteremia of unknown origin. Whole body FDG PET/CT was arranged to look for an occult source of infection and it revealed a focal lesion with increased FDG uptake in the mitral valve area. Under suspicion of infective endocarditis, transthoracic echocardiography was repeated and then the presence of linear vegetation over the calcified mitral annulus was confirmed. Ultimately, definite infective endocarditis was diagnosed according to the Duke criteria. The patient recovered after the antibiotic therapy. In our case, FDG PET/CT can help to localize the exact site of occult infection, thereby guiding additional testing and facilitating timely definitive diagnosis and therapy.

  10. {sup 68}Gallium-arginine-glycine-aspartic acid and {sup 18}F-fluorodeoxyglucose position emission tomography/computed tomography in chondroblastic osteosarcoma of the skull

    Energy Technology Data Exchange (ETDEWEB)

    Orunmuyi, Akintunde; Modiselle, Moshe; Lengana, Thabo; Ebenhan, Thomas; Vorster, Mariza; Sathekge, Mike [Dept. of Nuclear MedicineUniversity of Pretoria and Steve Biko Academic Hospital, Pretoria (South Africa)

    2017-09-15

    We report the case of a 32 year-old male with Chondroblastic Osteosarcoma of the skull, which was imaged with both {sup 18}[F]fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography/computed tomography (PET/CT) and {sup 68}Gallium-arginine-glycine-aspartic acid ({sup 68}Ga-RGD) PET/CT. The {sup 18}F-FDG PET/CT did not demonstrate the tumour, whereas the {sup 68}Ga-RGD PET/CT clearly depicted a left-sided frontal tumour. {sup 68}Ga-RGD PET/CT may be a clinically useful imaging modality for early detection of recurrent osteosarcoma, considering the limitations of {sup 18}F-FDG PET in a setting of low glycolytic activity.

  11. Fluorodeoxyglucose positron emission tomography-computed tomography in evaluation of pelvic and para-aortic nodal involvement in early stage and operable cervical cancer: comparison with surgicopathological findings

    International Nuclear Information System (INIS)

    Bansal, Vandana; Damania, Kaizad; Sharma, Anshu Rajnish

    2011-01-01

    Nodal metastases in cervical cancer have prognostic implications. Imaging is used as an adjunct to clinical staging for evaluation of nodal metastases. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has an advantage of superior resolution of its CT component and detecting nodal disease based on increased glycolytic activity rather than node size. But there are limited studies describing its limitations in early stage cervical cancers. We have done meta-analysis with an objective to evaluate the efficacy of FDG PET/CT and its current clinical role in early stage and operable cervical cancer. Studies in which FDG PET/CT was performed before surgery in patients with early stage cervical cancers were included for analysis. PET findings were confirmed with histopathological diagnosis rather than clinical follow-up. The current data suggest that FDG PET/CT is suboptimal in nodal staging in early stage cervical cancer

  12. Lung Hot Spot Without Corresponding Computed Tomography Abnormality on Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: Artifactual or Real, Iatrogenic or Pathologic?

    Science.gov (United States)

    Liu, Yiyan

    Focal lung uptake without corresponding lesions or abnormalities on computed tomography (CT) scan poses a dilemma in the interpretation of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). A limited number of case reports have previously suggested an artifactual or iatrogenic nature of the uptake. In the present study, 8 relevant cases were included within a retrospective search of the database. Medical records were reviewed for follow-up radiological and pathologic information. In 7 of 8 cases with focal increased FDG uptake but no corresponding lesions or abnormalities on CT scan, the lung hot spots were artifactual or iatrogenic upon follow-up diagnostic chest CT or repeated PET/CT or both the scans. Microemboli were most likely a potential cause of the pulmonary uptake, with or without partial paravenous injection. One case in the series had a real pulmonary lesion demonstrated on follow-up PET/CT scans and on surgical pathology, although the initial integrated CT and follow-up diagnostic chest CT scans revealed negative findings to demonstrate pulmonary abnormalities corresponding to the hot spot on the PET scan. In conclusion, the finding of a lung hot spot in the absence of anatomical abnormality on FDG PET/CT was most likely artifactual or iatrogenic, but it might also represent a real pulmonary lesion. Nonvisualization of anatomical abnormality could be because of its small size and position directly overlying a segmental vessel. Further image follow-up is necessary and important to clarify the nature of the uptake. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Primary pulmonary lymphoma-role of fluoro-deoxy-glucose positron emission tomography-computed tomography in the initial staging and evaluating response to treatment - case reports and review of literature

    International Nuclear Information System (INIS)

    Agarwal, Krishan Kant; Dhanapathi, Halanaik; Nazar, Aftab Hasan; Kumar, Rakesh

    2016-01-01

    Primary pulmonary lymphoma (PPL) is an uncommon entity of non-Hodgkin lymphoma, which accounts for <1% of all cases of lymphoma. We present two rare cases of PPL of diffuse large B-cell lymphoma, which underwent 18 fluorine fluoro-deoxy-glucose positron emission tomography-computed tomography for initial staging and response evaluation after chemotherapy

  14. An economic evaluation of positron emission tomography (PET) and positron emission tomography/computed tomography (PET/CT) for the diagnosis of breast cancer recurrence.

    Science.gov (United States)

    Auguste, P; Barton, P; Hyde, C; Roberts, T E

    2011-04-01

    To review the published economic studies that have evaluated positron emission tomography/computed tomography (PET/CT) in the treatment of recurrent breast cancer, and to develop and carry out a model-based economic evaluation to investigate the relative cost-effectiveness of PET/CT to detect breast cancer recurrence compared with conventional work-up. A systematic review of economic and diagnostic evidence for PET/CT in diagnosis of breast cancer recurrence. The original databases searched include MEDLINE (Ovid) (1950 to week 5 May 2009), EMBASE (Ovid) (1980 to 2009 week 22) and the NHS Economic Evaluation Database. An updated search was conducted for each database from May 2009 to week 4 April 2010. A decision tree was developed in TREEAGE software (TreeAge Software Inc., Williamstown, MA, USA). The relevant data on accuracy, sensitivity and specificity of each diagnostic test were linked in the model, to costs and the primary outcome measure, cost per quality-adjusted life-year (QALY). The model estimated the mean cost associated with each diagnostic procedure and assumed that patients entering the model were aged 50-75 years. The results of the cost-effectiveness analysis are presented in terms of the incremental cost-effectiveness ratios (ICERs). The ICER for the strategy of PET compared with conventional work-up was estimated at £29,300 per QALY; the ICER for PET/CT compared with PET was £ 31,000 per QALY; and the ICER for PET/CT combined with conventional work-up versus PET/CT was £ 42,100. Clearly, for each additional diagnostic test that is added to PET, the more expensive the package becomes, but also the more effective it becomes in terms of QALYs gained. The probabilistic sensitivity analysis shows that at a willingness-to-pay threshold of £ 20,000 per QALY, conventional work-up is the preferred option. Only data from indirect comparisons are available from the accuracy review, and there is some uncertainty about whether the data defining the

  15. 18F-FLT Positron Emission Tomography/Computed Tomography Imaging in Pancreatic Cancer: Determination of Tumor Proliferative Activity and Comparison with Glycolytic Activity as Measured by 18F-FDG Positron Emission Tomography/Computed Tomography Imaging

    Directory of Open Access Journals (Sweden)

    Senait Aknaw Debebe

    2016-02-01

    Full Text Available Objective: This phase-I imaging study examined the imaging characteristic of 3’-deoxy-3’-(18F-fluorothymidine (18F-FLT positron emission tomography (PET in patients with pancreatic cancer and comparisons were made with (18F-fluorodeoxyglucose (18F-FDG. The ultimate aim was to develop a molecular imaging tool that could better define the biologic characteristics of pancreas cancer, and to identify the patients who could potentially benefit from surgical resection who were deemed inoperable by conventional means of staging. Methods: Six patients with newly diagnosed pancreatic cancer underwent a combined FLT and FDG computed tomography (CT PET/CT imaging protocol. The FLT PET/CT scan was performed within 1 week of FDG PET/CT imaging. Tumor uptake of a tracer was determined and compared using various techniques; statistical thresholding (z score=2.5, and fixed standardized uptake value (SUV thresholds of 1.4 and 2.5, and applying a threshold of 40% of maximum SUV (SUVmax and mean SUV (SUVmean. The correlation of functional tumor volumes (FTV between 18F-FDG and 18F-FLT was assessed using linear regression analysis. Results: It was found that there is a correlation in FTV due to metabolic and proliferation activity when using a threshold of SUV 2.5 for FDG and 1.4 for FLT (r=0.698, p=ns, but a better correlation was obtained when using SUV of 2.5 for both tracers (r=0.698, p=ns. The z score thresholding (z=2.5 method showed lower correlation between the FTVs (r=0.698, p=ns of FDG and FLT PET. Conclusion: Different tumor segmentation techniques yielded varying degrees of correlation in FTV between FLT and FDGPET images. FLT imaging may have a different meaning in determining tumor biology and prognosis.

  16. The role of positron emission tomography/computed tomography imaging with radiolabeled choline analogues in prostate cancer.

    Science.gov (United States)

    Navarro-Pelayo Láinez, M M; Rodríguez-Fernández, A; Gómez-Río, M; Vázquez-Alonso, F; Cózar-Olmo, J M; Llamas-Elvira, J M

    2014-11-01

    prostate cancer is the most frequent solid malignant tumor in Western Countries. Positron emission tomography/x-ray computed tomography imaging with radiolabeled choline analogues is a useful tool for restaging prostate cancer in patients with rising prostate-specific antigen after radical treatment (in whom conventional imaging techniques have important limitations) as well as in the initial assessment of a selected group of prostate cancer patients. For this reason a literature review is necessary in order to evaluate the usefulness of this imaging test for the diagnosis and treatment of prostate cancer. a MEDLINE (PubMed way) literature search was performed using the search parameters: «Prostate cancer» and «Choline-PET/CT». Other search terms were «Biochemical failure» and/or «Staging» and/or «PSA kinetics». English and Spanish papers were selected; original articles, reviews, systematic reviews and clinical guidelines were included. according to available data, radiolabeled choline analogues plays an important role in the management of prostate cancer, especially in biochemical relapse because technique accuracy is properly correlated with prostate-specific antigen values and kinetics. Although is an emerging diagnostic technique useful in treatment planning of prostate cancer, final recommendations have not been submitted. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  17. The diagnostic value of single-photon emission computed tomography/computed tomography for severe sacroiliac joint dysfunction.

    Science.gov (United States)

    Tofuku, Katsuhiro; Koga, Hiroaki; Komiya, Setsuro

    2015-04-01

    We aimed to evaluate the value of single-photon emission computed tomography (SPECT)/computed tomography (CT) for the diagnosis of sacroiliac joint (SIJ) dysfunction. SPECT/CT was performed in 32 patients with severe SIJ dysfunction, who did not respond to 1-year conservative treatment and had a score of >4 points on a 10-cm visual analog scale. We investigated the relationship between the presence of severe SIJ dysfunction and tracer accumulation, as confirmed by SPECT/CT. In cases of bilateral SIJ dysfunction, we also compared the intensity of tracer accumulation on each side. Moreover, we examined the relationship between the intensity of tracer accumulation and the different treatments the patients subsequently received. All 32 patients with severe SIJ dysfunction had tracer accumulation with a standardized uptake value (SUV) of >2.2 (mean SUV 4.7). In the 19 patients with lateralized symptom intensity, mean SUVs of the dominant side were significantly higher than those of the nondominant side. In 10 patients with no lateralization, the difference in the SUVs between sides was dysfunction as well as a useful technique for predicting the prognosis of this condition.

  18. Prospective evaluation of fluorodeoxyglucose positron emission tomography/computed tomography scan (FDG-PET/CT) for axillary staging in breast cancer

    International Nuclear Information System (INIS)

    Yamaguchi, Masahide; Noguchi, Akinori; Tani, Naoki

    2008-01-01

    Seventy-two patients from 2005 October to 2007 February with operative breast cancer underwent fluorodeoxyglucose positron emission tomography/computed tomography scan (FDG-PET/CT) of chest and body, ultrasound scan (US) and enhanced computed tomography scan (CT) followed by sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND). The results of PET/CT were compared with histopathological diagnosis of SLNB and ALND. Sensitivity, specificity and accuracy of PET/CT for detection of axillary lymph node metastases were 61%, 96% and 88%, respectively. Seven false-negative and two false-positive of PET/CT results were found. In patients with false-negative of PET/CT results there are two skin-invasive breast cancer patients and axillary lymph node metastases were detected in three patients with US, in one with CT and in four with SLNB. In clinical method for diagnosis of axillary lymph node metastases SLNB should be recommended because sensitivity of PET/CT for early breast cancer patients were low and positive diagnosis of axillary lymph node metastases with PET needs more than 1 cm size of lesion. PET/CT is useful for not-early breast cancer patients. To decide the operation of axillary lymph node disection needs total diagnosis of US, CT, SLNB and clinical findings. (author)

  19. Outcomes of Modestly Hypofractionated Radiation for Lung Tumors: Pre- and Mid-Treatment Positron Emission Tomography-Computed Tomography Metrics as Prognostic Factors.

    Science.gov (United States)

    Harris, Jeremy P; Chang-Halpenny, Christine N; Maxim, Peter G; Quon, Andrew; Graves, Edward E; Diehn, Maximilian; Loo, Billy W

    2015-11-01

    Many patients with lung tumors have tumors too large for stereotactic ablative radiotherapy and comorbidities precluding concurrent chemotherapy. We report the outcomes of 29 patients treated with hypofractionated radiotherapy (RT) to 60 to 66 Gy in 3-Gy fractions. We also report an exploratory analysis of the prognostic value of the pre- and mid-RT positron emission tomography-computed tomography. Modestly hypofractionated radiation therapy (HypoRT; 60-66 Gy in 3-Gy fractions) allows patients with locally advanced thoracic tumors and poor performance status to complete treatment within a shorter period without concurrent chemotherapy. We evaluated the outcomes and imaging prognostic factors of HypoRT. We retrospectively reviewed the data from all patients with primary and metastatic intrathoracic tumors treated with HypoRT from 2006 to 2012. We analyzed the survival and toxicity outcomes, including overall survival (OS), progression-free survival (PFS), local recurrence (LR), and distant metastasis. We also evaluated the following tumor metrics in an exploratory analysis: gross tumor volume (GTV), maximum standardized uptake value (SUVMax), and metabolic tumor volume using a threshold of ≥ 50% of the SUVMax (MTV50%) or the maximum gradient of fluorine-18 fluorodeoxyglucose uptake (MTVEdge). We assessed the association of these metrics and their changes from before to mid-RT using positron emission tomography-computed tomography (PET-CT) with OS and PFS. We identified 29 patients, all with pre-RT and 20 with mid-RT PET-CT scans. The median follow-up period was 15 months. The 2-year overall and non-small-cell lung cancer-only rate for OS, PFS, and LR, was 59% and 59%, 52% and 41%, and 27% and 32%, respectively. No grade ≥ 3 toxicities developed. The median decrease in GTV, SUVMax, and MTVEdge was 11%, 24%, and 18%, respectively. Inferior OS was associated with a larger pre-RT MTVEdge (P = .005) and pre-RT MTV50% (P = .007). Inferior PFS was associated with a

  20. Diagnostic accuracy of (18) F-methylcholine positron emission tomography/computed tomography for intra- and extrahepatic hepatocellular carcinoma.

    Science.gov (United States)

    Bieze, Matthanja; Klümpen, Heinz-Josef; Verheij, Joanne; Beuers, Ulrich; Phoa, Saffire S K S; van Gulik, Thomas M; Bennink, Roelof J

    2014-03-01

    Diagnosis of hepatocellular carcinoma (HCC) primarily involves imaging. The aim of this study was to assess the accuracy of (18) F-fluorocholine ((18) F-FCH) positron emission tomography (PET) for detection of HCC and evaluation of extent of disease. Patients with HCC >1 cm were included between 2009 and July 2011, and follow-up closed in February 2013. Diagnosis was based on American Association for the Study of Liver Diseases criteria, and all patients underwent (18) F-FCH PET/computed tomography (CT) at baseline before treatment, 6 underwent a second PET/CT posttreatment, and 1 a third during follow-up. Whole-body PET and low-dose CT imaging were performed 15 minutes after (18) F-FCH injection. Evaluation of imaging was done with standardized uptake value (SUV) ratios: SUV maximum of the lesion divided by the SUV mean of surrounding tissue. Statistical analyses included descriptive analyses, receiver operating characteristic curve, McNemar's test, and Kaplan-Meier's test at 5% level of significance. Twenty-nine patients revealed 53 intrahepatic lesions. In 48 of 53 lesions, (18) F-FCH PET was positive (SUVratio , 1.95 ± 0.66; sensitivity, 88%; specificity, 100%). PET/CT showed uptake in 18 extrahepatic lesions and no uptake in 3 lesions affirmed non-HCC lesions; all lesions were confirmed with additional investigation (accuracy, 100%). In 17 of 29 patients, additional lesions were found on PET/CT imaging, with implications for treatment in 15 patients. Posttreatment PET/CT showed identical results, compared with standard treatment evaluation. This study shows additional value of (18) F-FCH PET/CT for patients with HCC. (18) F-FCH PET/CT has implications for staging, management, and treatment evaluation because of accurate assessment of extrahepatic disease. © 2014 by the American Association for the Study of Liver Diseases.

  1. Cervical Lymph Node Metastases of Unknown Origin: Primary Tumor Detection with Whole-Body Positron Emission Tomography/Computed Tomography

    International Nuclear Information System (INIS)

    Nassenstein, K.; Veit-Haibach, P.; Stergar, H.; Gutzeit, A.; Freudenberg, L.; Kuehl, H.; Fischer, M.; Barkhausen, J.; Bockisch, A.; Antoch, G.

    2007-01-01

    Background: Identification of primary tumor in patients with cervical lymph node metastasis of unknown primary (MUO) has a great impact on therapy approach and potentially on patient prognosis. Purpose: To assess the diagnostic accuracy of combined positron emission tomography (PET)/computer tomography (CT) for primary tumor detection in cervical metastases of unknown origin compared to PET, CT, and PET+CT side-by-side evaluation. Material and Methods: 39 consecutive patients (eight women, 31 men; mean age 59.9±11.2 years) with MUO were enrolled in this study. PET/CT images were obtained 1 hour after injection of 350 MBq of fluorodeoxyglucose. Oral and intravenous contrast agents were administered in all patients to ensure diagnostic CT data. Fused PET/CT data were evaluated for primary tumor detection. Diagnostic accuracy was calculated and compared with CT alone, PET alone, and side-by-side PET+CT evaluation. Statistical analysis of differences in diagnostic performance between the different imaging procedures was based on the McNemar test. Results: Fused PET/CT depicted the primary tumor in 11 of 39 (28%) patients. In 28 (72%) patients, the primary tumor remained occult. CT revealed the primary in five (13%), PET alone in 10 (26%), and side-by-side evaluation of PET+CT in 10 (26%) of 39 patients. Statistical analysis showed no significant differences between the imaging modalities. Conclusion: PET, side-by-side PET+CT, and PET/CT revealed similar detection rates for primary tumors in cervical MUO patients. Therefore, cervical metastases of an unknown primary may be assessed with either of these imaging modalities. Detection rates with CT were substantially lower. Thus, inclusion of functional data for assessment of cervical MUO patients must be recommended

  2. 2-deoxy-2-(18F)fluoro-D-glucose positron emission tomography/computed tomography imaging in paediatric oncology

    Institute of Scientific and Technical Information of China (English)

    John; Freebody; Eva; A; Wegner; Monica; A; Rossleigh

    2014-01-01

    Positron emission tomography(PET) is a minimally in-vasive technique which has been well validated for the diagnosis, staging, monitoring of response to therapy, and disease surveillance of adult oncology patients. Tra-ditionally the value of PET and PET/computed tomogra-phy(CT) hybrid imaging has been less clearly defined for paediatric oncology. However recent evidence has emerged regarding the diagnostic utility of these mo-dalities, and they are becoming increasingly important tools in the evaluation and monitoring of children with known or suspected malignant disease. Important indi-cations for 2-deoxy-2-(18F)fluoro-D-glucose(FDG) PET in paediatric oncology include lymphoma, brain tumours, sarcoma, neuroblastoma, Langerhans cell histiocytosis, urogenital tumours and neurofibromatosis type Ⅰ. This article aims to review current evidence for the use of FDG PET and PET/CT in these indications. Attention will also be given to technical and logistical issues, the description of common imaging pitfalls, and dosimetric concerns as they relate to paediatric oncology.

  3. Additional benefit of 18F-fluorodeoxyglucose integrated positron emission tomography/computed tomography in the staging of oesophageal cancer

    International Nuclear Information System (INIS)

    Gillies, R.S.; Middleton, M.R.; Maynard, N.D.; Bradley, K.M.; Gleeson, F.V.

    2011-01-01

    18 F-fluorodeoxyglucose positron emission tomography (FDG PET) has been shown to improve the accuracy of staging in oesophageal cancer. We assessed the benefit of PET/CT over conventional staging and determined if tumour histology had any significant impact on PET/CT findings. A retrospective cohort study, reviewing the results from 200 consecutive patients considered suitable for radical treatment, undergoing routine PET/CT staging comparing the results from CT and endoscopic ultrasound, as well as multi-disciplinary team records. Adenocarcinoma and squamous cell carcinoma were compared for maximum Standardised Uptake Value (SUV max ), involvement of local lymph nodes and distant metastases. PET/CT provided additional information in 37 patients (18.5%) and directly altered management in 34 (17%): 22 (11%) were upstaged; 15 (7.5%) were downstaged, 12 of whom (6%) received radical treatment. There were 11 false negatives (5.5%) and 1 false positive (0.5%). SUV max was significantly lower for adenocarcinoma than squamous cell carcinoma (median 9.1 versus 13.5, p = 0.003). Staging with PET/CT offers additional benefit over conventional imaging and should form part of routine staging for oesophageal cancer. Adenocarcinoma and squamous cell carcinoma display significantly different FDG-avidity. (orig.)

  4. (18)F-fluoride positron emission tomography/computed tomography and bone scintigraphy for diagnosis of bone metastases in newly diagnosed, high-risk prostate cancer patients: study protocol for a multicentre, diagnostic test accuracy study.

    Science.gov (United States)

    Fonager, Randi F; Zacho, Helle D; Langkilde, Niels C; Petersen, Lars J

    2016-01-11

    For decades, planar bone scintigraphy has been the standard practice for detection of bone metastases in prostate cancer and has been endorsed by recent oncology/urology guidelines. It is a sensitive method with modest specificity. (18)F-fluoride positron emission tomography/computed tomography has shown improved sensitivity and specificity over bone scintigraphy, but because of methodological issues such as retrospective design and verification bias, the existing level of evidence with (18)F-fluoride positron emission tomography/computed tomography is limited. The primary objective is to compare the diagnostic properties of (18)F-fluoride positron emission tomography/computed tomography versus bone scintigraphy on an individual patient basis. One hundred forty consecutive, high-risk prostate cancer patients will be recruited from several hospitals in Denmark. Sample size was calculated using Hayen's method for diagnostic comparative studies. This study will be conducted in accordance with recommendations of standards for reporting diagnostic accuracy studies. Eligibility criteria comprise the following: 1) biopsy-proven prostate cancer, 2) PSA ≥ 50 ng/ml (equals a prevalence of bone metastasis of ≈ 50% in the study population on bone scintigraphy), 3) patients must be eligible for androgen deprivation therapy, 4) no current or prior cancer (within the past 5 years), 5) ability to comply with imaging procedures, and 6) patients must not receive any investigational drugs. Planar bone scintigraphy and (18)F-fluoride positron emission tomography/computed tomography will be performed within a window of 14 days at baseline. All scans will be repeated after 26 weeks of androgen deprivation therapy, and response of individual lesions will be used for diagnostic classification of the lesions on baseline imaging among responding patients. A response is defined as PSA normalisation or ≥ 80% reduction compared with baseline levels, testosterone below castration levels

  5. Impacts of biological and procedural factors on semiquantification uptake value of liver in fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging.

    Science.gov (United States)

    Mahmud, Mohd Hafizi; Nordin, Abdul Jalil; Ahmad Saad, Fathinul Fikri; Azman, Ahmad Zaid Fattah

    2015-10-01

    Increased metabolic activity of fluorodeoxyglucose (FDG) in tissue is not only resulting of pathological uptake, but due to physiological uptake as well. This study aimed to determine the impacts of biological and procedural factors on FDG uptake of liver in whole body positron emission tomography/computed tomography (PET/CT) imaging. Whole body fluorine-18 ((18)F) FDG PET/CT scans of 51 oncology patients have been reviewed. Maximum standardized uptake value (SUVmax) of lesion-free liver was quantified in each patient. Pearson correlation was performed to determine the association between the factors of age, body mass index (BMI), blood glucose level, FDG dose and incubation period and liver SUVmax. Multivariate regression analysis was established to determine the significant factors that best predicted the liver SUVmax. Then the subjects were dichotomised into four BMI groups. Analysis of variance (ANOVA) was established for mean difference of SUVmax of liver between those BMI groups. BMI and incubation period were significantly associated with liver SUVmax. These factors were accounted for 29.6% of the liver SUVmax variance. Statistically significant differences were observed in the mean SUVmax of liver among those BMI groups (Pvalue for physiological liver SUVmax as a reference standard for different BMI of patients in PET/CT interpretation and use a standard protocol for incubation period of patient to reduce variation in physiological FDG uptake of liver in PET/CT study.

  6. Impact of incidental findings on integrated 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in patients with gastric cancer.

    Science.gov (United States)

    Tae, Chung Hyun; Lee, Jun Haeng; Choi, Joon Young; Min, Byung-Hoon; Rhee, Poong-Lyul; Kim, Jae J

    2015-03-01

    Since positron emission tomography/computed tomography (PET/CT) has been introduced, many incidental findings have been identified. The aim of this study was to assess the clinical significance of incidental findings on PET/CT in patients with gastric cancer. A total of 421 patients with gastric cancer underwent PET/CT for initial staging. Incidental findings on PET/CT were classified into five categories according to clinical significance--normal variant, benign, probably benign, probably malignant, and definitely malignant. We obtained information regarding follow-up examinations, additional visits, final diagnosis of incidental findings and short-term medical costs for further evaluation. Eight hundred eighty-two incidental findings were detected in 386 (91.7%) patients. Of 274 incidental findings classified as probably benign, probably malignant or definitely malignant, 130 required one or more additional investigations. Finally, 12 (9.2%) were proved to be associated with second primary malignancy or metastasis of gastric cancer. One hundred twenty-nine additional outpatient visits and 10 additional hospitalizations were needed for evaluating the incidental findings. The treatment strategy for gastric cancer was changed in one patient. The estimated cost of additional investigations was $US283 (95% CI: $US248-$US311) per patient. Incidental findings on PET/CT were common. Although the incidental findings were suspicious of malignancy, most were benign with high costs for additional investigations. © 2015 Wiley Publishing Asia Pty Ltd.

  7. F-18 Sodium Fluoride Positron Emission Tomography/Computed Tomography for Detection of Thyroid Cancer Bone Metastasis Compared with Bone Scintigraphy.

    Science.gov (United States)

    Lee, Hyunjong; Lee, Won Woo; Park, So Yeon; Kim, Sang Eun

    2016-01-01

    The aim of the study was to compare the diagnostic performances of F-18 sodium fluoride positron emission tomography/computed tomography (bone PET/CT) and bone scintigraphy (BS) for the detection of thyroid cancer bone metastasis. We retrospectively enrolled 6 thyroid cancer patients (age = 44.7 ± 9.8 years, M:F = 1:5, papillary:follicular = 2:4) with suspected bone metastatic lesions in the whole body iodine scintigraphy or BS, who subsequently underwent bone PET/CT. Pathologic diagnosis was conducted for 4 lesions of 4 patients. Of the 17 suspected bone lesions, 10 were metastatic and 7 benign. Compared to BS, bone PET/CT exhibited superior sensitivity (10/10 = 100% vs. 2/10 = 20%, p = 0.008), and accuracy (14/17 = 82.4% vs. 7/17 = 41.2%, p 0.05). Bone PET/CT may be more sensitive and accurate than BS for the detection of thyroid cancer bone metastasis.

  8. Effect of furosemide administration before F-18 fluorodeoxyglucose positron emission tomography/computed tomography on urine radioactivity and detection of uterine cervical cancer.

    Science.gov (United States)

    d'Amico, Andrea; Gorczewska, Izabela; Gorczewski, Kamil; Turska-d'Amico, Maria; Di Pietro, Marco

    2014-01-01

    In evaluating uterine cervical cancer with ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), there may be overlap between the FDG activity at tumor sites and nonspecific radioactivity in the urine. We evaluated the efficacy of furosemide premedication with routine hydration to obtain better contrast and less overlap between cervical cancer and the urinary bladder. We retrospectively evaluated 166 patients who had primary or relapsed cervical cancer and underwent FDG PET/CT scanning with (133 patients) or without (33 patients) furosemide premedication (10 mg intravenous, slowly injected 30 min before the scan). We calculated bladder and tumor maximum and median standardized uptake value (SUVmax and SUVmed), and overlap between tumor and urinary activity was detected visually. Overlap between urinary and tumor radioactivity was observed in 8 of 133 scans (6%) in patients who receive furosemide and in 3 of 33 scans (9%) in patients who did not receive furosemide. The SUVmax and SUVmed for the bladder were significantly lower in patients who were pretreated with furosemide (SUVmax, 6.3; SUVmed, 4.6) than patients who were not pretreated with furosemide (SUVmax, 8.8 [P ≤ 0.008]; SUVmed, 6.5 [P ≤ 0.002]). The tumor SUVmax and SUVmed were similar between the patient groups. Furosemide premedication before FDG PET/CT scanning may enable improved evaluation of activity and extension of cervical cancer.

  9. 18F-fluorodeoxyglucose positron emission tomography/computed tomography for primary thyroid langerhans histiocytosis: A case report and literature review

    International Nuclear Information System (INIS)

    Long, Qi; Shaoyan, Wang; Hui, Wang

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disease, with an incidence rate of 4.0–5.4/1 million individuals. LCH encompasses a spectrum of disorders with diverse clinical presentations ranging from a single organ to multiple organ involvement. LCH rarely involves the thyroid gland. We presented a case with LCH of thyroid gland. The patient had painless progressive neck enlargement and then diabetes insipidus. Ultrasonic scan and magnetic resonance imaging scan revealed nodular goiter and pituitary stalk enlargement, respectively. Histopathological analysis revealed features of histiocytoid cells. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was performed in order to rule out the presence of whole body infiltration. 18F-FDG PET/CT also demonstrated increased uptake in the thickening pituitary stalk and maxillofacial skin lesion, in addition to the bilateral thyroid nodules, CT showed the left lung nodule and the skull destruction without 18F-FDG uptake. This report emphasizes the role of 18F-FDG PET/CT in multiple organs involvement of patients with LCH

  10. F-8 sodium fluoride position emission tomography/computed tomography for detection of thyroid cancer bone metastasis compared with bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Jong; Lee, Won Woo; Park, So Yeon; Kim, Sang Eun [Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2016-04-15

    The aim of the study was to compare the diagnostic performances of F-18 sodium fluoride positron emission tomography/computed tomography (bone PET/CT) and bone scintigraphy (BS) for the detection of thyroid cancer bone metastasis. We retrospectively enrolled 6 thyroid cancer patients (age = 44.7 ± 9.8 years, M:F = 1:5, papillary:follicular = 2:4) with suspected bone metastatic lesions in the whole body iodine scintigraphy or BS, who subsequently underwent bone PET/CT. Pathologic diagnosis was conducted for 4 lesions of 4 patients. Of the 17 suspected bone lesions, 10 were metastatic and 7 benign. Compared to BS, bone PET/CT exhibited superior sensitivity (10/10 = 100% vs. 2/10 = 20%, p = 0.008), and accuracy (14/17 = 82.4% vs. 7/17 = 41.2%, p < 0.025). The specificity (4/7 = 57.1%) of bone PET/CT was not significantly different from that of BS (5/7 = 71.4%, p > 0.05). Bone PET/CT may be more sensitive and accurate than BS for the detection of thyroid cancer bone metastasis.

  11. [Prognostic value of (18)F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) in extensive-stage small cell lung cancer].

    Science.gov (United States)

    Ding, C Y; Guo, Z; Li, Y Y; Li, T R

    2017-11-23

    Objective: To investigated the prognostic value of (18)F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) in extensive-stage small cell lung cancer (ES -SCLC). Methods: Fifty-five patients with ES-SCLC who underwent pretreatment (18)F-FDG PET-CT were retrospectively recruited in this study. The correlations of maximum standardized uptake value (SUVmax) of primary lesion, metabolic tumor volume (MTV) of primary lesion (MTVp), total lesion glycolysis (TLG) of primary lesion (TLGp), the highest SUVmax of all lesions, the sum of metabolic volume (MTV sum), the sum of total lesions glycolysis (TLGsum) and clinical factors were analyzed. Results: The SUVmax, MTVp, TLGp, the highest SUVmax, MTVsum and TLGsum of 55 patients were 11.34±7.02, 29.61 cm(3,) 207.72, 13.61±7.10, 123.57 cm(3) and 988.48, respectively. The SUVmax of primary lesion, MTVp and TLGp were correlated with tumor type and the maximal tumor length, respectively(all P CT has certain prognostic value of patients with ES-SCLC. MTVsum and TLGsum are the independent predictors of PFS, and TLGsum is also an independent predictor of OS.

  12. Positron emission tomography/computed tomography (PET/CT) and CT for N staging of non-small cell lung cancer.

    Science.gov (United States)

    Vegar Zubović, Sandra; Kristić, Spomenka; Hadžihasanović, Besima

    2017-08-01

    Aim The aim of this study is to investigate the possibilities of non-invasive diagnostic imaging methods, positron emission tomography/computed tomography (PET/CT) and CT, in clinical N staging of non-small cell lung cancer (NSCLC). Methods Retrospective clinical study included 50 patients with diagnosed NSCLC who have undergone PET/CT for the purpose of disease staging. The International association for the study of lung cancer (IASLC) nodal mapping system was used for analysis of nodal disease. Data regarding CT N-staging and PET/CT Nstaging were recorded. Two methods were compared using χ2 test and Spearman rank correlation coefficient. Results Statistical analysis showed that although there were some differences in determining the N stage between CT and PET/CT, these methods were in significant correlation. CT and PET/CT findings established the same N stage in 74% of the patients. In five patients based on PET/CT findings the staging was changed from operable to inoperable, while in four patients staging was changed from inoperable to operable. Conclusion PET/CT and CT are noninvasive methods that can be reliably used for N staging of NSCLC. Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

  13. Endogenous endophthalmitis caused by Cryptococcus neoformans Var. Gattii mimicking choroidal tumor: From positron-emission tomography/computed tomography to histopathology

    Directory of Open Access Journals (Sweden)

    Chun-Ju Lin

    2017-01-01

    Full Text Available A 60-year-old immunocompetent female with pneumonia history about 10 years ago suffered from blurred vision overall survival for 3 weeks. Common cold with headache and unintentional body weight loss was also noted recently. Choroidal detachment simulating choroidal tumor was observed in the temporal quadrant. The 18F-fluoro-2-deoxyglucose (FDG positron-emission tomography/computed tomography (CT scan showed focal, mild to moderate FDG uptake in the left lateral orbit, and an enhanced lesion was seen on the recent CT scan. The suspicious choroidal tumor became larger in a week. Phacoemulsification, vitrectomy, and retinal biopsies were performed. Histochemical study of the retinal specimens established the diagnosis of endogenous cryptococcal endophthalmitis. Vitreous culture yielded Cryptococcus neoformans var. gattii. Systemic and topical voriconazole eliminated the infection. In the literature, endogenous endophthalmitis caused by C. neoformans var. gattii has not been reported in detail. The key to successful management lies in early diagnosis. If clinical improvement could not be achieved after conventional management and imaging studies have failed to yield a definite diagnosis, retinal biopsy can be considered.

  14. Incidental detection of prostate-specific antigen-negative metastatic prostate cancer initially presented with solitary pulmonary nodule on fluorodeoxyglucose positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Erdogan, Ezgi Basak; Buyukpinarbasili, Nur; Ziyade, Sedat; Akman, Tolga; Turk, Haci Mehmet; Aydin, Mehmet

    2005-01-01

    A 71-year-old male patient with solitary pulmonary nodule underwent fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) showing slightly increased FDG uptake in this nodule. In addition, PET/CT detected hypermetabolic sclerotic bone lesions in the right second rib and 7 th thoracic vertebrae, which were interpreted as possible metastases, and mildly increased FDG uptake in the prostate gland highly suspicious of malignancy. The patient's prostate-specific antigen (PSA) level was within normal range (3.8 ng/dL). The histopathological examination of the lung nodule and right second rib lesion proved metastases from prostate cancer, then the prostate biopsy-confirmed prostate adenocarcinoma. The unique feature of this case is to emphasize the importance of performing PET/CT for solitary pulmonary nodule in detecting PSA-negative metastatic prostate cancer. This case indicated that it should be kept in mind that, even if the PSA is negative, a lung metastasis of prostate cancer may be an underlying cause in patients evaluated for solitary pulmonary nodule by FDG PET/CT

  15. Metastasis in urothelial carcinoma mimicking prostate cancer metastasis in Ga-68 prostate-specific membrane antigen positron emission tomography-computed tomography in a case of synchronous malignancy

    International Nuclear Information System (INIS)

    Gupta, Manoj; Choudhury, Partha Sarathi; Gupta, Gurudutt; Gandhi, Jatin

    2016-01-01

    Prostate cancer is the second most common cancer in man. It commonly presents with urinary symptoms, bone pain, or diagnosed with elevated prostate-specific antigen.(PSA) levels. Correct staging and early diagnosis of recurrence by a precise imaging tool are the keys for optimum management. Molecular imaging of prostate cancer with Ga-68 prostate-specific membrane antigen.(PSMA), positron emission tomography-computed tomography.(PET-CT) has recently received significant attention and frequently used with a signature to prostate cancer-specific remark. However, this case will highlight the more cautious use of it. A-72-year-old male treated earlier for synchronous double malignancy.(invasive papillary urothelial carcinoma right ureter and carcinoma prostate) presented with rising PSA.(0.51.ng/ml) and referred for Ga-68 PSMA PET-CT, which showed a positive enlarged left supraclavicular lymph node. Lymph node biopsy microscopic and immunohistochemistry examination revealed metastatic carcinoma favoring urothelial origin. Specificity of PSMA scan to prostate cancer has been seen to be compromised in a certain situation mostly due to neoangiogenesis, and false positives emerged in renal cell cancer, differentiated thyroid cancer, glioblastoma, breast cancer brain metastasis, and paravertebral schwannomas. Understanding the causes of false positive will further enhance the confidence of interpretating PSMA scans

  16. IgG4-associated multifocal systemic fibrosis detected by cancer screening with 18F-FDG positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Soga, Shigeyoshi; Kita, Tamotsu; Hiratsuka, Miyuki; Sakaguchi, Chiharu; Shinmoto, Hiroshi; Kosuda, Shigeru; Sakata, Ikuko; Miura, Soichiro

    2010-01-01

    Serial fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) studies were performed with an interval of one year in a 62-year-old man with IgG4-associated multifocal systemic fibrosis (IMSF). He first underwent 18 F-FDG PET/CT cancer screening, which revealed multiple 18 F-FDG-avid uptakes in the pancreas, prostate, and lymph nodes in the upper mediastinum, pulmonary hila, porta hepatis, and the left iliac and inguinal regions. He was not symptomatic at this initial examination. The follow-up 18 F-FDG PET/CT study showed disappearance of 18 F-FDG-avid uptake foci in the pancreas despite no treatment having been administered, but demonstrated new lesions in the abdominal para-aortic region and more intense FDG uptake in the porta hepatis lesion. Serial 18 F-FDG PET/CT studies might be useful in monitoring patients with IMSF, as well as evaluating the state of systemic involvement. Findings of 18 F-FDG PET/CT may provide information useful for determining the optimal initiation of IMSF treatment. (author)

  17. Skull base osteomyelitis in otitis externa: The utility of triphasic and single photon emission computed tomography/computed tomography bone scintigraphy

    International Nuclear Information System (INIS)

    Chakraborty, Dhritiman; Bhattacharya, Anish; Gupta, Ashok Kumar; Panda, Naresh Kumar; Das, Ashim; Mittal, Bhagwant Rai

    2013-01-01

    Skull base osteomyelitis (SBO) refers to infection that has spread beyond the external auditory canal to the base of the skull in advanced stages of otitis externa. Clinically, it may be difficult to differentiate SBO from severe otitis externa without bony involvement. This study was performed to determine the role of three phase bone scintigraphy (TPBS) and single photon emission tomography/computed tomography (SPECT/CT) in detecting SBO. We retrospectively analyzed records of 20 patients (14 M, 6 F) with otitis externa and suspected SBO. TPBS and SPECT/CT of the skull were performed. Findings were correlated with clinical, laboratory and diagnostic CT scan findings. All patients were diabetic with elevated erythrocyte sedimentation rate. A total of 18 patients had bilateral and two unilateral symptoms. Cranial nerves were involved in eight patients and microbiological culture of ear discharge fluid positive in seven. Early images showed increased temporal vascularity in nine patients and increased soft-tissue uptake in 10, while delayed images showed increased bone uptake in 19/20 patients. Localized abnormal tracer uptake was shown by SPECT/CT in the mastoid temporal (15), petrous (11), sphenoid (3) and zygomatic (1) and showed destructive changes in five. Thus, TPBS was found positive for SBO in 10/20 patients and changed the management in four. Our study suggests that TPBS with SPECT/CT is a useful non-invasive investigation for detection of SBO in otitis externa

  18. Predictive value of pretreatment positron emission tomography/computed tomography in patients with newly diagnosed extranodal natural killer/T-cell lymphoma.

    Science.gov (United States)

    Bai, Bing; Huang, Hui-Qiang; Cai, Qi-Chun; Fan, Wei; Wang, Xiao-Xiao; Zhang, Xu; Lin, Ze-Xiao; Gao, Yan; Xia, Yun-Fei; Guo, Ying; Cai, Qing-Qing; Jiang, Wen-Qi; Lin, Tong-Yu

    2013-03-01

    The role of (18)Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) in extranodal natural killer/T-cell lymphoma (ENKL) is not well established. This study aimed to investigate the prognostic role of the pretreatment maximum standardized uptake value (SUV(max)) on PET/CT in patients with newly diagnosed ENKL. Among 364 consecutive patients with newly diagnosed ENKL, 81 patients were included and reviewed. The impact of SUV(max) on survival and the relationship between SUV(max) and other clinicopathological parameters were analyzed. The median SUV(max) was 14.6 (range 2.0-45.4). The optimal cutoff value of SUV(max) to predict overall survival (OS) was 15. Patients with high SUV(max) (SUVmax >15) were associated with bulky disease (P KPI, P = 0.046), resistance to primary treatment (P = 0.014), poor OS (P 60 years (P = 0.001), stage III-IV (P = 0.023), SUV(max) >15 (P = 0.020), and bulky disease (>5 cm) (P = 0.002). By using the SUV(max), patients in most subgroups stratified by the KPI or the International Prognostic Index (IPI) were further discriminated in OS with significant statistical difference. Our results suggest the pretreatment SUV(max) is predictive of prognosis in patients with newly diagnosed ENKL. The SUV(max) may provide additional prognostic information for IPI and KPI.

  19. The clinical usefulness of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) in follow-up of curatively resected pancreatic cancer patients.

    Science.gov (United States)

    Jung, Woohyun; Jang, Jin-Young; Kang, Mee Joo; Chang, Ye Rim; Shin, Yong Chan; Chang, Jihoon; Kim, Sun-Whe

    2016-01-01

    Computed tomography and serum tumor markers have limited value in detecting recurrence after curative surgery of pancreatic cancer. This study evaluated the clinical utility of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) in diagnosing recurrence. One hundred ten patients underwent curative resection of pancreatic cancer were enrolled. The diagnostic value of abdominal computed tomography (CT), PET-CT and serum carbohydrate antigen (CA) 19-9 concentration were compared. The prognostic value of SUVmax on PET-CT was evaluated. PET-CT showed relatively higher sensitivity (84.5% vs. 75.0%) and accuracy (84.5% vs. 74.5%) than CT, whereas PET-CT plus CT showed greater sensitivity (97.6%) and accuracy (90.0%) than either alone. In detecting distant recurrences, PET-CT showed higher sensitivity (83.1% vs. 67.7%) than CT. Nineteen patients showed recurrences only on PET-CT, with eleven having invisible or suspected benign lesions on CT, and eight had recurrences in areas not covered by CT. SUVmax over 3.3 was predictive of poor survival after recurrence. PET-CT in combination with CT improves the detection of recurrence. PET-CT was especially advantageous in detecting recurrences in areas not covered by CT. If active post-operative surveillance after curative resection of pancreatic cancer is deemed beneficial, then it should include PET-CT combined with CT. Copyright © 2015 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

  20. Impact of Single-Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) and Positron Emission Tomography/Computed Tomography (PET/CT) in the Diagnosis of Traumatic Brain Injury (TBI): Case Report.

    Science.gov (United States)

    Molina-Vicenty, Irma L; Santiago-Sánchez, Michelaldemar; Vélez-Miró, Iván; Motta-Valencia, Keryl

    2016-09-01

    Traumatic brain injury (TBI) is defined as damage to the brain resulting from an external force. TBI, a global leading cause of death and disability, is associated with serious social, economic, and health problems. In cases of mild-to-moderate brain damage, conventional anatomical imaging modalities may or may not detect the cascade of metabolic changes that have occurred or are occurring at the intracellular level. Functional nuclear medicine imaging and neurophysiological parameters can be used to characterize brain damage, as the former provides direct visualization of brain function, even in the absence of overt behavioral manifestations or anatomical findings. We report the case of a 30-year-old Hispanic male veteran who, after 2 traumatic brain injury events, developed cognitive and neuropsychological problems with no clear etiology in the presence of negative computed tomography (CT) findings.

  1. ¹⁸F-fluorodeoxyglucose-positron emission tomography/computed tomography in malignancies of the thyroid and in head and neck squamous cell carcinoma: a review of the literature.

    Science.gov (United States)

    Lauridsen, Jeppe Kiilerich; Rohde, Max; Thomassen, Anders

    2015-01-01

    18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is a valuable diagnostic tool in a spectrum of malignant and benign conditions, because of a high sensitivity to detect even very small lesions with increased metabolism. This review focuses on the use of FDG-PET/CT in malignancies of the thyroid gland and in head and neck squamous cell carcinoma. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Diagnostic dilemma of degenerative joint disease, chronic avascular necrosis or metastasis in planar Tc-99m-methylene diphosphonate planar skeletal scintigraphy excluded by single positron emission computed tomography/computed tomography

    International Nuclear Information System (INIS)

    Jain, Tarun Kumar; Phulsunga, Rohit Kumar; Basher, Rajender Kumar; Kumar, Narendra; Bhattacharya, Anish; Mittal, Bhagwant Rai

    2005-01-01

    We present a 71-year-old male patient subjected to skeletal scintigraphy for metastasis work up of prostate cancer. Whole body planar images revealed a solitary focal tracer uptake in left femoral head mimicking as solitary metastatic focus. Single positron emission computed tomography/computed tomography images localized this increased tracer uptake to the subchondral cysts with minimal sclerosis in left femur head with no decrease in size of femur head and was reported as (degenerative joint disease)

  3. [(18)F]Fluorodeoxyglucose - positron emission tomography/computed tomography improves staging in patients with high-risk muscle-invasive bladder cancer scheduled for radical cystectomy.

    Science.gov (United States)

    Kollberg, Petter; Almquist, Helen; Bläckberg, Mats; Cronberg, Carin; Garpered, Sabine; Gudjonsson, Sigurdur; Kleist, Jakob; Lyttkens, Kerstin; Patschan, Oliver; Liedberg, Fredrik

    2015-01-01

    The aim of this study was to evaluate the clinical use of [(18)F]fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in addition to conventional preoperative radiological investigations in a defined group of patients with high-risk muscle-invasive bladder cancer. In total, 103 patients with high-risk muscle-invasive bladder cancer defined as stage T3/T4 disease or as stage T2 with hydronephrosis or high-risk histological features, who were provisionally scheduled to undergo cystectomy, were prospectively recruited to the study. The patients were referred to FDG-PET/CT in addition to standard preoperative investigation with computed tomography (CT). The final treatment decision was reached at a multidisciplinary conference based on all available information including the FDG-PET/CT findings. Compared to CT alone, FDG-PET/CT provided more supplemental findings suggesting malignant manifestations in 48 (47%) of the 103 patients. The additional FDG-PET/CT findings led to an altered provisional treatment plan in 28 out of 103 patients (27%), detection of disseminated bladder cancer and subsequent cancellation of the initially intended cystectomy in 16 patients, and identification of disseminated disease and treatment with induction chemotherapy before radical cystectomy in 12 patients. Preoperative FDG-PET/CT changed the treatment plan for a considerable proportion (27%) of the present patients. Accordingly, such examination can potentially improve the preoperative staging of cystectomy patients with high-risk features, and may also reduce the number of futile operations in patients with advanced disease who are beyond cure.

  4. Diagnostic performance of fluorodeoxyglucose-positron emission tomography/computed tomography of breast cancer in detecting axillary lymph node metastasis. Comparison with ultrasonography and contrast-enhanced CT

    International Nuclear Information System (INIS)

    Monzawa, Shuichi; Adachi, Shuji; Suzuki, Kayo; Hirokaga, Koichi; Takao, Shintaro; Sakuma, Toshiko; Hanioka, Keisuke

    2009-01-01

    The purpose of this retrospective study was to evaluate the diagnostic performance of positron emission tomography/computed tomography (PET/CT) with fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose (FDG) in comparison with that of ultrasonography and contrast-enhanced computed tomography (CT) in detecting axillary lymph node metastasis in patients with breast cancer. Fifty patients with invasive breast cancer were recruited. They had received no neoadjuvant chemotherapy and underwent PET/CT, ultrasonography and contrast-enhanced CT before mastectomy. The clinical stage was I in 34 patients, II in 15 patients, and III in one patient. The images of these modalities were interpreted in usual practice before surgery and the diagnostic reports were reviewed for analysis. Sensitivity, specificity, positive predictive value, and negative predictive value of each modality were obtained taking histopathological results of axillary lymph node dissection or sentinel lymph node biopsy as the reference standard. Axillary lymph node metastasis was confirmed in 15 of 50 patients by histopathological studies. PET/CT identified lymph node metastasis in three of these 15 patients. The overall sensitivity and specificity, positive predictive value, and negative predictive value of PET/CT in the diagnosis of axillary lymph node metastasis were 20, 97, 75, and 74%, and those of ultrasonography were 33, 94, 71, and 77% and those of contrast-enhanced CT were 27, 97, 80, and 76%, respectively. PET/CT showed poor sensitivity and high specificity in the detection of axillary lymph node metastasis of breast cancer. Diagnostic performance of PET/CT was not superior to that of ultrasonography and contrast-enhanced CT. (author)

  5. Somatostatin receptor positron emission tomography/computed tomography (PET/CT) in the evaluation of opsoclonus-myoclonus ataxia syndrome

    International Nuclear Information System (INIS)

    Joshi, Prathamesh; Lele, Vikram

    2013-01-01

    Opsoclonus-myoclonus ataxia (OMA) syndrome is the most common paraneoplastic neurological syndrome of childhood, associated with occult neuroblastoma in 20%-50% of all cases. OMA is the initial presentation of neuroblastoma in 1%-3% of children. Conventional radiological imaging approaches include chest radiography and abdominal computed tomography (CT). Nuclear medicine techniques, in form of 123 I/ 131 I-metaiodobenzylguanidine (MIBG) scintigraphy have been incorporated in various diagnostic algorithms for evaluation of OMA. We describe use of somatostatin receptor PET/CT with 68 Gallium- DOTA-DPhe 1 , Tyr 3 -octreotate (DOTATATE) in diagnosis of neuroblastoma in two cases of OMA

  6. Somatostatin receptor positron emission tomography/computed tomography (PET/CT) in the evaluation of opsoclonus-myoclonus ataxia syndrome.

    Science.gov (United States)

    Joshi, Prathamesh; Lele, Vikram

    2013-04-01

    Opsoclonus-myoclonus ataxia (OMA) syndrome is the most common paraneoplastic neurological syndrome of childhood, associated with occult neuroblastoma in 20%-50% of all cases. OMA is the initial presentation of neuroblastoma in 1%-3% of children. Conventional radiological imaging approaches include chest radiography and abdominal computed tomography (CT). Nuclear medicine techniques, in form of (123)I/(131)I-metaiodobenzylguanidine (MIBG) scintigraphy have been incorporated in various diagnostic algorithms for evaluation of OMA. We describe use of somatostatin receptor PET/CT with (68)Gallium- DOTA-DPhe(1), Tyr(3)-octreotate (DOTATATE) in diagnosis of neuroblastoma in two cases of OMA.

  7. The value of F-18 fluorodeoxyglucose positron emission tomography/computed tomography in asymptomatic examinees with unexplained elevated blood carcinoembryonic antigen levels

    Energy Technology Data Exchange (ETDEWEB)

    Li, Wenfeng [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Department of Radiation Oncology, Wenzhou (China); Yin, Weiwei [The First Affiliated Hospital of Wenzhou Medical University, Division of PET/CT, Department of Radiology, Wenzhou (China); Ou, Rongying [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Department of Gynaecology and Obstetrics, Wenzhou (China); Chen, Ting; Xiong, Lingling; Xu, Yunsheng [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Department of Dermatovenereology, Wenzhou (China); Cheng, Dezhi; Xie, Deyao [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Department of Cardiothoracic Surgery, Wenzhou (China); Zheng, Xiangwu; Zhao, Liang [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Division of PET/CT, Department of Radiology, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Institutes of Intelligent and Molecular Imaging, Wenzhou (China)

    2016-04-15

    Cancer is still a clinical challenge, with many efforts invested in order to achieve timely detection. Unexplained elevated blood carcinoembryonic antigen levels are occasionally observed in an asymptomatic population and considered as a risk factor of cancers. The purpose of this study was to determine the validity of 18 F-fluorodeoxyglucose-positron emission tomography/computed tomography (F-18 FDG-PET/CT) for detecting cancer in an asymptomatic population with an unexplained elevation in blood carcinoembryonic antigen (CEA) levels. This retrospective study included a total of 1920 asymptomatic examinees conducted from August 2011 through September 2013. The participants underwent CEA assay and conventional medical imaging (CEA-conventional), or CEA assay and F-18 FDG-PET/CT (CEA-PET/CT). The validity of conventional medical imaging and CEA-PET/CT scanning for detecting cancer and early-stage cancer in an asymptomatic population with an unexplained elevation in blood CEA levels were evaluated. Sensitivity, specificity, cancer detection rate, missed cancer detection rate, early-stage cancer detection rate, and early-stage cancer ratio using the CEA-PET/CT scanning were 96.6 %, 100 %, 10.4 %, 0.4 %, 3.7 %, and 34.5 %, respectively. In contrast, the corresponding values obtained using the conventional medical imaging were 50.6 % (P < 0.0001), 100 % (P > 0.9999), 50.6 % (P < 0.0001), 99.9 % (P = 0.055), 2.6 % (P < 0.0001), 2.5 % (P = 0.04), 0.7 % (P = 0.0004), and 14.5 % (P = 0.002), respectively. The F-18 FDG-PET/CT scanning significantly improved the validity of the cancer detection program in the asymptomatic population with an unexplained elevation in CEA levels. (orig.)

  8. 18-F flourodeoxy glucose positron emission tomography-computed tomography imaging: A viable alternative to three phase bone scan in evaluating diabetic foot complications?

    International Nuclear Information System (INIS)

    Shagos, G. S.; Shanmugasundaram, Palaniswamy; Varma, Ajith Kumar; Padma, Subramanyam; Sarma, Manjit

    2015-01-01

    This paper is based on the initial findings from a prospective ongoing study to evaluate the efficacy of flourodeoxy glucose positron emission tomography-computed tomography (FDG-PET CT) in diabetic foot evaluation. The aim was to compare the diagnostic accuracies of three phase bone scan (TPBS) and FDG PET-CT (FDG-PET) in diabetic foot evaluation. Seventy-nine patients with complicated diabetic foot (osteomyelitis/cellulitis, Charcot's neuropathy) were prospectively investigated. TPBS (15 mci methylene di phosphonate [MDP] intravenous [IV]), followed by FDG-PET (5 mci IV) within 5 days were performed in all patients. Based on referral indication, patients grouped into Group I, n = 36, (?osteomyelitis/cellulitis) and Group II, n = 43 (?Charcot's neuropathy). Interpretation was based on intensity, extent, pattern of MDP and FDG uptake (standardized uptake value) along with CT correlation. Findings were compared with final diagnostic outcome based on bone/soft tissue culture in Group I and clinical, radiological or scintigraphic followup in Group II. Results: Group I: For diagnosing osteomyelitis, TP: TN: FP: FN were 14:5:2:2 by FDG PET and 13:02:05:03 by TPBS respectively. Sensitivity, specificity, positive predictive value and negative predictive value (NPV) of FDG-PET were 87.5%, 71%, 87.5% and 71% and 81.25%, 28.5%, 72% and 40% for TPBS, respectively. Group II: charcot's: cellulitis: Normal were 22:14:7 by FDG PET and 32:5:6 by TPBS, respectively. Flourodeoxy glucose PET-CT has a higher specificity and NPV than TPBS in diagnosing pedal osteomyelitis. TPBS, being highly sensitive is more useful than FDG-PET in detecting Charcot's neuropathy

  9. Predicted extracapsular invasion of hilar lymph node metastasis by fusion positron emission tomography/computed tomography in patients with lung cancer.

    Science.gov (United States)

    Makino, Takashi; Hata, Yoshinobu; Otsuka, Hajime; Koezuka, Satoshi; Isobe, Kazutoshi; Tochigi, Nobumi; Shiraga, Nobuyuki; Shibuya, Kazutoshi; Homma, Sakae; Iyoda, Akira

    2015-09-01

    Intraoperative detection of hilar lymph node metastasis, particularly with extracapsular invasion, may affect the surgical procedure in patients with lung cancer, as the preoperative estimation of hilar lymph node metastasis is unsatisfactory. The aim of this study was to investigate whether fusion positron emission tomography/computed tomography (PET/CT) is able to predict extracapsular invasion of hilar lymph node metastasis. Between April, 2007 and April, 2013, 509 patients with primary lung cancer underwent surgical resection at our institution, among whom 28 patients exhibiting hilar lymph node metastasis (at stations 10 and 11) were enrolled in this study. A maximum lymph node standardized uptake value of >2.5 in PET scans was interpreted as positive. A total of 17 patients had positive preoperative PET/CT findings in their hilar lymph nodes, while the remaining 11 had negative findings. With regard to extracapsular nodal invasion, the PET/CT findings (P=0.0005) and the histological findings (squamous cell carcinoma, P=0.05) were found to be significant predictors in the univariate analysis. In the multivariate analysis, the PET/CT findings were the only independent predictor (P=0.0004). The requirement for extensive pulmonary resection (sleeve lobectomy, bilobectomy or pneumonectomy) was significantly more frequent in the patient group with positive compared with the group with negative PET/CT findings (76 vs. 9%, respectively, P=0.01). Therefore, the PET/CT findings in the hilar lymph nodes were useful for the prediction of extracapsular invasion and, consequently, for the estimation of possible extensive pulmonary resection.

  10. Novel application of quantitative single-photon emission computed-tomography/computed tomography to predict early response to methimazole in Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Joo; Bang, Ji In; Kim, Ji Young; Moon, Jae Hoon [Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam (Korea, Republic of); So, Young [Dept. of Nuclear Medicine, Konkuk University Medical Center, Seoul (Korea, Republic of); Lee, Won Woo [Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul (Korea, Republic of)

    2017-06-15

    Since Graves' disease (GD) is resistant to antithyroid drugs (ATDs), an accurate quantitative thyroid function measurement is required for the prediction of early responses to ATD. Quantitative parameters derived from the novel technology, single-photon emission computed tomography/computed tomography (SPECT/CT), were investigated for the prediction of achievement of euthyroidism after methimazole (MMI) treatment in GD. A total of 36 GD patients (10 males, 26 females; mean age, 45.3 ± 13.8 years) were enrolled for this study, from April 2015 to January 2016. They underwent quantitative thyroid SPECT/CT 20 minutes post-injection of {sup 99m}Tc-pertechnetate (5 mCi). Association between the time to biochemical euthyroidism after MMI treatment and uptake, standardized uptake value (SUV), functional thyroid mass (SUVmean × thyroid volume) from the SPECT/CT, and clinical/biochemical variables, were investigated. GD patients had a significantly greater %uptake (6.9 ± 6.4%) than historical control euthyroid patients (n = 20, 0.8 ± 0.5%, p < 0.001) from the same quantitative SPECT/CT protocol. Euthyroidism was achieved in 14 patients at 156 ± 62 days post-MMI treatment, but 22 patients had still not achieved euthyroidism by the last follow-up time-point (208 ± 80 days). In the univariate Cox regression analysis, the initial MMI dose (p = 0.014), %uptake (p = 0.015), and functional thyroid mass (p = 0.016) were significant predictors of euthyroidism in response to MMI treatment. However, only uptake remained significant in a multivariate Cox regression analysis (p = 0.034). A uptake cutoff of 5.0% dichotomized the faster responding versus the slower responding GD patients (p = 0.006). A novel parameter of thyroid uptake from quantitative SPECT/CT is a predictive indicator of an early response to MMI in GD patients.

  11. The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma.

    Science.gov (United States)

    Bennie, George; Vorster, Mariza; Buscombe, John; Sathekge, Mike

    2015-01-01

    Single-photon emission computed tomography-computed tomography (SPECT-CT) allows for physiological and anatomical co-registration in sentinel lymph node (SLN) mapping and offers additional benefits over conventional planar imaging. However, the clinical relevance when considering added costs and radiation burden of these reported benefits remains somewhat uncertain. This study aimed to evaluate the possible added value of SPECT-CT and intra-operative gamma-probe use over planar imaging alone in the South African setting. 80 patients with breast cancer or malignant melanoma underwent both planar and SPECT-CT imaging for SLN mapping. We assessed and compared the number of nodes detected on each study, false positive and negative findings, changes in surgical approach and or patient management. In all cases where a sentinel node was identified, SPECT-CT was more accurate anatomically. There was a significant change in surgical approach in 30 cases - breast cancer (n = 13; P 0.001) and malignant melanoma (n = 17; P 0.0002). In 4 cases a node not identified on planar imaging was seen on SPECT-CT. In 16 cases additional echelon nodes were identified. False positives were excluded by SPECT-CT in 12 cases. The addition of SPECT-CT and use of intra-operative gamma-probe to planar imaging offers important benefits in patients who present with breast cancer and melanoma. These benefits include increased nodal detection, elimination of false positives and negatives and improved anatomical localization that ultimately aids and expedites surgical management. This has been demonstrated in the context of industrialized country previously and has now also been confirmed in the setting of a emerging-market nation.

  12. Contrast-enhanced [18F] fluorodeoxyglucose-positron emission tomography-computed tomography as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin

    International Nuclear Information System (INIS)

    Jain, Avani; Srivastava, Madhur Kumar; Pawaskar, Alok Suresh; Shelley, Simon; Elangovan, Indirani; Jain, Hasmukh; Pandey, Somnath; Kalal, Shilpa; Amalachandran, Jaykanth

    2005-01-01

    To evaluate the advantages of contrast enhanced F-18-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-contrast enhanced CT [CECT]) when used as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin (MUO). A total of 243 patients with fine needle aspiration cytology/biopsy proven MUO were included in this prospective study. Patients who were thoroughly evaluated for primary or primary tumor was detected by any other investigation were excluded from the analysis. Totally, 163 patients with pathological diagnosis of malignancy but no apparent sites of the primary tumor were finally selected for analysis. The site of probable primary malignancy suggested by PET-CECT was confirmed by biopsy/follow-up. PET-CECT suggested probable site of primary in 128/163 (78.52%) patients. In 30/35 remaining patients, primary tumor was not detected even after extensive work-up. In 5 patients, where PET-CECT was negative, primary was found on further extensive investigations or follow-up. The sensitivity, specificity, positive predictive value and negative predictive value of the study were 95.76%, 66.67%, 88.28% and 85.71% respectively. F-18 FDG PET-CECT aptly serves the purpose of initial imaging modality owing to high sensitivity, negative and positive predictive value. PET-CECT not only surveys the whole body for the primary malignancy but also stages the disease accurately. Use of contrast improves the diagnostic utility of modality as well as help in staging of the primary tumor. Although benefits of using PET-CECT as initial diagnostic modality are obvious from this study, there is a need for a larger study comparing conventional methods for diagnosing primary in patients with MUO versus PET-CECT

  13. {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) Imaging in the Staging and Prognosis of Inflammatory Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Alberini, J.L.; Wartski, M.; Gontier, E.; Madar, O.; Pecking, A.P. [Nuclear Medicine Department, Cancer Research Center Rene Huguenin, Saint-Cloud (France); Lerebours, F. [Oncology Department, Cancer Research Center Rene Huguenin, Saint-Cloud (France); Fourme, E. [Biostatistics Department, Cancer Research Center Rene Huguenin, Saint-Cloud (France); Le Stanc, E. [Nuclear Medicine Department, Foch Hospital, Suresnes (France); Cherel, P. [Radiology Department, Cancer Research Center Rene Huguenin, Saint-Cloud (France); Alberini, J.L. [School of Medicine, Versailles Saint-Quentin University (France)

    2009-07-01

    Background: To prospectively assess fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) staging and prognosis value in patients with suspected inflammatory breast cancer (IBC). Methods: Sixty-two women (mean age 50.7 {+-} 11.4 years) presenting with unilateral inflammatory breast tumors (59 invasive carcinomas; 3 mastitis) underwent a PET/CT scan before biopsy. Results: PET/CT scan was positive for the primary malignant tumor in 100% and false positive in 2 of 3 benign mastitis. In 59 IBC patients, FDG nodal foci were detected in axillary (90%; n = 53) and extra-axillary areas (56%; n = 33) ipsilateral to the cancer. Compared with clinical examination, the axillary lymph node status by PET/CT was upstaged and down staged in 35 and 5 patients, respectively. In 7 of 9 N0 patients, the axillary lymph node positivity on PET/CT was correct, as revealed by pathological post surgery assessment (not available in the 2 remaining patients). The nodal foci were compared with preoperative fine needle aspiration and/or pathological post chemotherapy findings available in 44 patients and corresponded to 38 true positive, 4 false-negative, and 2 false-positive cases. In 18 of 59 IBC patients (31%), distant lesions were found. On the basis of a univariate analysis of the first enrolled patients (n = 42), among 28 patients who showed intense tumoral uptake (standard uptake value(max){>=}5), the 11 patients with distant lesions had a worse prognosis than the 17 patients without distant lesions (P =.04). Conclusions: FDG-PET/CT imaging provides additional invaluable information regarding nodal status or distant metastases in IBC patients and should be considered in the initial staging. It seems also that some prognostic information can be derived from FDG uptake characteristics. (authors)

  14. The Anatomical Biological Value on Pretreatment (18)F-fluorodeoxyglucose Positron Emission Tomography Computed Tomography Predicts Response and Survival in Locally Advanced Head and Neck Cancer.

    Science.gov (United States)

    Ashamalla, Hani; Mattes, Malcolm; Guirguis, Adel; Zaidi, Arifa; Mokhtar, Bahaa; Tejwani, Ajay

    2014-05-01

    (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has become increasingly relevant in the staging of head and neck cancers, but its prognostic value is controversial. The objective of this study was to evaluate different PET/CT parameters for their ability to predict response to therapy and survival in patients treated for head and neck cancer. A total of 28 consecutive patients with a variety of newly diagnosed head and neck cancers underwent PET/CT scanning at our institution before initiating definitive radiation therapy. All underwent a posttreatment PET/CT to gauge tumor response. Pretreatment PET/CT parameters calculated include the standardized uptake value (SUV) and the anatomical biological value (ABV), which is the product of SUV and greatest tumor diameter. Maximum and mean values were studied for both SUV and ABV, and correlated with response rate and survival. The mean pretreatment tumor ABVmax decreased from 35.5 to 7.9 (P = 0.0001). Of the parameters tested, only pretreatment ABVmax was significantly different among those patients with a complete response (CR) and incomplete response (22.8 vs. 65, respectively, P = 0.021). This difference was maximized at a cut-off ABVmax of 30 and those patients with ABVmax < 30 were significantly more likely to have a CR compared to those with ABVmax of ≥ 30 (93.8% vs. 50%, respectively, P = 0.023). The 5-year overall survival was 80% compared to 36%, respectively, (P = 0.028). Multivariate analysis confirmed that ABVmax was an independent prognostic factor. Our data supports the use of PET/CT, and specifically ABVmax, as a prognostic factor in head and neck cancer. Patients who have an ABVmax ≥ 30 were more likely to have a poor outcome with chemoradiation alone, and a more aggressive trimodality approach may be indicated in these patients.

  15. The Role of Positron Emission Tomography/Computed Tomography Imaging in Head and Neck Cancer after Radical Chemoradiotherapy: a Single Institution Experience.

    Science.gov (United States)

    Nelissen, C; Sherriff, J; Jones, T; Guest, P; Colley, S; Sanghera, P; Hartley, A

    2017-11-01

    Positron emission tomography/computed tomography (PET/CT) is used to restage head and neck cancer 3 months after chemoradiotherapy. The purpose of this study was to determine the negative predictive value (NPV) of a scan reported as having no abnormal uptake and the positive predictive values (PPV) for different maximum standardised uptake value (SUVmax) thresholds. Patients with squamous cell carcinoma of the oro-/hypopharynx/larynx (n = 206) were included. SUVmax and subsequent locoregional recurrence were documented. The median SUVmax was 11.2 (range 4-33)/4.6 (range 2-30), respectively, in patients with/without definite primary site recurrence (P = 0.004). The median SUVmax was 4.4 (range 2.6-15.6)/3.1 (range 2.1-4.6), respectively, in patients with/without definite nodal recurrence (P = 0.003). The NPV for a scan reported as having no abnormal uptake was 92%. The PPV for the SUVmax thresholds 4, 6 and 8, respectively, were 53, 65 and 92% (primary site) and 93, 100 and 100% (nodes). The NPV of PET/CT after chemoradiation is consistent with the literature and underlines the importance of PET/CT in restaging the primary site if salvage neck dissection is considered. The overall PPV of PET/CT remains low but is high for nodal SUVmax > 4. These data could be used to design risk-stratified follow-up schedules. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  16. Role and interpretation of fluorodeoxyglucose-positron emission tomography/computed tomography in HIV-infected patients with fever of unknown origin: a prospective study.

    Science.gov (United States)

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

    2013-09-01

    The aim of the study was to evaluate prospectively the usefulness of fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in investigation of fever of unknown origin (FUO) in HIV-positive patients and to determine whether HIV viraemia impacts on FDG-PET/CT performance. The FDG-PET/CT results of 20 HIV-infected patients with FUO were analysed and compared with the FDG-PET/CT results of 10 HIV-infected viraemic patients without FUO. The performance of FDG-PET/CT for identifying the aetiology of FUO was assessed. Final diagnosis for FUO was based on histopathology, microbiological assays, or clinical and imaging follow-up. FDG-PET/CT contributed to the diagnosis or exclusion of a focal aetiology of the febrile state in 80% of patients with FUO. The presence of increased FDG uptake in the central lymph node has 100% specificity for focal aetiology of fever, even in viraemic patients. The absence of hypermetabolic central lymph nodes in FUO patients has 100% negative predictive value for focal disease. Lymph node biopsy in central hypermetabolic areas allowed, in 100% of cases, identification of underlying disease in patients with FUO. Biopsy of peripheral lymph nodes should be performed in lymph nodes with maximum standardized uptake value (SUVmax) ≥ 6-8 (sensitivity 62.5%; specificity 75%) and avoided in lymph nodes with SUVmax = 0-4 (specificity 0%). High HIV viraemia does not prevent correct interpretation of FDG-PET/CT. As in HIV-negative patients, we confirm the usefulness of FDG-PET/CT in investigation of FUO in HIV-positive patients even if they are viraemic. © 2013 British HIV Association.

  17. Maximum standardized uptake value of fluorodeoxyglucose positron emission tomography/computed tomography is a prognostic factor in ovarian clear cell adenocarcinoma.

    Science.gov (United States)

    Konishi, Haruhisa; Takehara, Kazuhiro; Kojima, Atsumi; Okame, Shinichi; Yamamoto, Yasuko; Shiroyama, Yuko; Yokoyama, Takashi; Nogawa, Takayoshi; Sugawara, Yoshifumi

    2014-09-01

    Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is useful for diagnosing malignant tumors. Intracellular FDG uptake is measured as the standardized uptake value (SUV), which differs depending on tumor characteristics. This study investigated differences in maximum SUV (SUVmax) according to histologic type in ovarian epithelial cancer and the relationship of SUVmax with prognosis. This study included 80 patients with ovarian epithelial cancer based on histopathologic findings at surgery and who had undergone PET/CT before treatment. Maximum SUV on PET/CT of primary lesions and histopathology were compared based on histologic type, and the prognosis associated with different SUVmax was evaluated. Clinical tumor stage was I in 35 patients, II in 8, III in 25, and IV in 12. Histologic type was serous adenocarcinoma (AC) in 33 patients, clear cell AC in 27, endometrioid AC in 15, and mucinous AC in 5. Median SUVmax was lower in mucinous AC (2.76) and clear cell AC (4.9) than in serous AC (11.4) or endometrioid AC (11.4). Overall, median SUVmax was lower in clinical stage I (5.37) than in clinical stage ≥II (10.3). However, in both clear cell AC and endometrioid AC, when histologic evaluation was possible, no difference was seen between stage I and stage ≥II. Moreover, in clear cell AC, the 5-year survival rate was significantly higher in the low-SUVmax group (100%) than in the high-SUVmax group (43.0%, P = 0.009). Maximum SUV on preoperative FDG-PET/CT in ovarian epithelial cancer differs according to histologic type. In clear cell AC, SUVmax may represent a prognostic factor.

  18. Anticancer activity using positron emission tomography-computed tomography and pharmacokinetics of β-eudesmol in human cholangiocarcinoma xenografted nude mouse model.

    Science.gov (United States)

    Plengsuriyakarn, Tullayakorn; Karbwang, Juntra; Na-Bangchang, Kesara

    2015-03-01

    Cholangiocarcinoma (CCA) is an important public health problem in several parts of South East Asia, particularly in Thailand. The limited availability of effective diagnostic tools for early stage CCA, including chemotherapeutic options, constitutes a major problem for treatment and control of CCA. The aim of the present study was to assess the anti-CCA activity and pharmacokinetics of β-eudesmol in CCA-xenografted nude mouse model and healthy mice. Positron emission tomography-computed tomography (PET-CT) with (18)F-fluorodeoxyglucose was used for detecting and monitoring tumour development, and PET-CT with technetium-99m was used to investigate its pharmacokinetics property. Results support the role of PET-CT as a potential tool for detecting and monitoring the progress of lung metastasis. Tumour size and lung metastasis were significantly inhibited by 91.6% (of baseline) and 95% (of total lung mass), respectively, following treatment with high-dose β-eudesmol (100 mg/kg body weight for 30 days). Survival time was prolonged by 64.4% compared with untreated controls. Systemic clearance of the compound was rapid, particularly during the first 60 min. The compound was distributed to the vital organs at maximum levels 2 h after oral administration and 15 min after intravenous injection. Results from the present study suggest the potential of β-eudesmol as a promising candidate for further development as an anti-CCA drug with respect to its pharmacodynamics and pharmacokinetic properties. PET-CT, with radiotracers (18)F-fluorodeoxyglucose and technetium-99m, was shown to be a reliable tool in the investigation of anti-CCA and pharmacokinetic properties of β-eudesmol in CCA-xenografted and healthy mice. © 2014 Wiley Publishing Asia Pty Ltd.

  19. Pure ground glass nodular adenocarcinomas: Are preoperative positron emission tomography/computed tomography and brain magnetic resonance imaging useful or necessary?

    Science.gov (United States)

    Cho, Hyoun; Lee, Ho Yun; Kim, Jhingook; Kim, Hong Kwan; Choi, Joon Young; Um, Sang-Won; Lee, Kyung Soo

    2015-09-01

    The utility of (18)F-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scanning and brain magnetic resonance imaging (MRI) as a staging workup for lung adenocarcinoma manifesting as pure ground glass opacity (GGO) is unknown. The purpose of this study was to determine the utility of these 2 tests for preoperative staging of pure GGO nodular lung adenocarcinoma. The study included 164 patients (male:female, 73:91; mean age, 62 years) with pure GGO nodular lung adenocarcinoma who underwent PET/CT (in 136 patients) and/or brain MRI (in 109 patients) before surgery. Pathologic N staging and dedicated standard imaging or follow-up imaging findings for M staging were used as reference standards. The median follow-up time was 47.9 months. On PET/CT scan, abnormal FDG uptake of lymph nodes was found in 2 of 136 patients (1.5%); both were negative on final pathology. Abnormal FDG uptake of the liver was detected in 1 patient, which was also confirmed to be negative by dedicated abdominal CT. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/CT in detecting metastases were not applicable, 98% (95% confidence interval [CI], 94%-100%), 0% (95% CI, 0%-71%), 100% (95% CI, 97%-100%), and 98% (95% CI, 94%-100%), respectively. No brain metastasis was found in preoperative brain MRI of 109 patients. Of 109 patients, 1 (0.9%) developed brain metastasis 30 months after surgical resection. PET/CT and brain MRI is not necessary in the staging of pure GGO nodular lung adenocarcinoma. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  20. The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma

    International Nuclear Information System (INIS)

    Bennie, George; Vorster, Mariza; Buscombe, John; Sathekge, Mike

    2015-01-01

    Single-photon emission computed tomography-computed tomography (SPECT-CT) allows for physiological and anatomical co-registration in sentinel lymph node (SLN) mapping and offers additional benefits over conventional planar imaging. However, the clinical relevance when considering added costs and radiation burden of these reported benefits remains somewhat uncertain. This study aimed to evaluate the possible added value of SPECT-CT and intra-operative gamma-probe use over planar imaging alone in the South African setting. 80 patients with breast cancer or malignant melanoma underwent both planar and SPECT-CT imaging for SLN mapping. We assessed and compared the number of nodes detected on each study, false positive and negative findings, changes in surgical approach and or patient management. In all cases where a sentinel node was identified, SPECT-CT was more accurate anatomically. There was a significant change in surgical approach in 30 cases - breast cancer (n = 13; P 0.001) and malignant melanoma (n = 17; P 0.0002). In 4 cases a node not identified on planar imaging was seen on SPECT-CT. In 16 cases additional echelon nodes were identified. False positives were excluded by SPECT-CT in 12 cases. The addition of SPECT-CT and use of intra-operative gamma-probe to planar imaging offers important benefits in patients who present with breast cancer and melanoma. These benefits include increased nodal detection, elimination of false positives and negatives and improved anatomical localization that ultimately aids and expedites surgical management. This has been demonstrated in the context of industrialized country previously and has now also been confirmed in the setting of a emerging-market nation

  1. The Impact of Positron Emission Tomography/Computed Tomography in Edge Delineation of Gross Tumor Volume for Head and Neck Cancers

    International Nuclear Information System (INIS)

    Ashamalla, Hani; Guirgius, Adel; Bieniek, Ewa; Rafla, Sameer; Evola, Alex; Goswami, Ganesh; Oldroyd, Randall; Mokhtar, Bahaa; Parikh, Kapila

    2007-01-01

    Purpose: To study anatomic biologic contouring (ABC), using a previously described distinct halo, to unify volume contouring methods in treatment planning for head and neck cancers. Methods and Materials: Twenty-five patients with head and neck cancer at various sites were planned for radiation therapy using positron emission tomography/computed tomography (PET/CT). The ABC halo was used in all PET/CT scans to contour the gross tumor volume (GTV) edge. The CT-based GTV (GTV-CT) and PET/CT-based GTV (GTV-ABC) were contoured by two independent radiation oncologists. Results: The ABC halo was observed in all patients studied. The halo had a standard unit value of 2.19 ± 0.28. The mean halo thickness was 2.02 ± 0.21 mm. Significant volume modification (≥25%) was seen in 17 of 25 patients (68%) after implementation of GTV-ABC. Concordance among observers was increased with the use of the halo as a guide for GTV determination: 6 patients (24%) had a ≤10% volume discrepancy with CT alone, compared with 22 (88%) with PET/CT (p 3 in CT-based planning to 7.2 cm 3 in PET/CT-based planning (p < 0.001). Conclusions: Using the 'anatomic biologic halo' to contour GTV in PET/CT improves consistency among observers. The distinctive appearance of the described halo and its presence in all of the studied tumors make it attractive for GTV contouring in head and neck tumors. Additional studies are needed to confirm the correlation of the halo with presence of malignant cells

  2. Intra-tumour 18F-FDG uptake heterogeneity decreases the reliability on target volume definition with positron emission tomography/computed tomography imaging.

    Science.gov (United States)

    Dong, Xinzhe; Wu, Peipei; Sun, Xiaorong; Li, Wenwu; Wan, Honglin; Yu, Jinming; Xing, Ligang

    2015-06-01

    This study aims to explore whether the intra-tumour (18) F-fluorodeoxyglucose (FDG) uptake heterogeneity affects the reliability of target volume definition with FDG positron emission tomography/computed tomography (PET/CT) imaging for nonsmall cell lung cancer (NSCLC) and squamous cell oesophageal cancer (SCEC). Patients with NSCLC (n = 50) or SCEC (n = 50) who received (18)F-FDG PET/CT scanning before treatments were included in this retrospective study. Intra-tumour FDG uptake heterogeneity was assessed by visual scoring, the coefficient of variation (COV) of the standardised uptake value (SUV) and the image texture feature (entropy). Tumour volumes (gross tumour volume (GTV)) were delineated on the CT images (GTV(CT)), the fused PET/CT images (GTV(PET-CT)) and the PET images, using a threshold at 40% SUV(max) (GTV(PET40%)) or the SUV cut-off value of 2.5 (GTV(PET2.5)). The correlation between the FDG uptake heterogeneity parameters and the differences in tumour volumes among GTV(CT), GTV(PET-CT), GTV(PET40%) and GTV(PET2.5) was analysed. For both NSCLC and SCEC, obvious correlations were found between uptake heterogeneity, SUV or tumour volumes. Three types of heterogeneity parameters were consistent and closely related to each other. Substantial differences between the four methods of GTV definition were found. The differences between the GTV correlated significantly with PET heterogeneity defined with the visual score, the COV or the textural feature-entropy for NSCLC and SCEC. In tumours with a high FDG uptake heterogeneity, a larger GTV delineation difference was found. Advance image segmentation algorithms dealing with tracer uptake heterogeneity should be incorporated into the treatment planning system. © 2015 The Royal Australian and New Zealand College of Radiologists.

  3. Intra-tumour 18F-FDG uptake heterogeneity decreases the reliability on target volume definition with positron emission tomography/computed tomography imaging

    International Nuclear Information System (INIS)

    Dong, Xinzhe; Wu, Peipei; Yu, Jinming; Xing, Ligang; Sun, Xiaorong; Li, Wenwu; Wan, Honglin

    2015-01-01

    This study aims to explore whether the intra-tumour 18 F-fluorodeoxyglucose (FDG) uptake heterogeneity affects the reliability of target volume definition with FDG positron emission tomography/computed tomography (PET/CT) imaging for nonsmall cell lung cancer (NSCLC) and squamous cell oesophageal cancer (SCEC). Patients with NSCLC (n = 50) or SCEC (n = 50) who received 18 F-FDG PET/CT scanning before treatments were included in this retrospective study. Intra-tumour FDG uptake heterogeneity was assessed by visual scoring, the coefficient of variation (COV) of the standardised uptake value (SUV) and the image texture feature (entropy). Tumour volumes (gross tumour volume (GTV) ) were delineated on the CT images (GTV CT ), the fused PET/CT images (GTV PET-CT ) and the PET images, using a threshold at 40% SUV max (GTV PET40% ) or the SUV cut-off value of 2.5 (GTV PET2.5 ). The correlation between the FDG uptake heterogeneity parameters and the differences in tumour volumes among GTV CT , GTV PET-CT , GTV PET40% and GTV PET2.5 was analysed. For both NSCLC and SCEC, obvious correlations were found between uptake heterogeneity, SUV or tumour volumes. Three types of heterogeneity parameters were consistent and closely related to each other. Substantial differences between the four methods of GTV definition were found. The differences between the GTV correlated significantly with PET heterogeneity defined with the visual score, the COV or the textural feature-entropy for NSCLC and SCEC. In tumours with a high FDG uptake heterogeneity, a larger GTV delineation difference was found. Advance image segmentation algorithms dealing with tracer uptake heterogeneity should be incorporated into the treatment planning system.

  4. Applying standardized uptake values in gallium-67-citrate single-photon emission computed tomography/computed tomography studies and their correlation with blood test results in representative organs.

    Science.gov (United States)

    Toriihara, Akira; Daisaki, Hiromitsu; Yamaguchi, Akihiro; Yoshida, Katsuya; Isogai, Jun; Tateishi, Ukihide

    2018-05-21

    Recently, semiquantitative analysis using standardized uptake value (SUV) has been introduced in bone single-photon emission computed tomography/computed tomography (SPECT/CT). Our purposes were to apply SUV-based semiquantitative analytic method for gallium-67 (Ga)-citrate SPECT/CT and to evaluate correlation between SUV of physiological uptake and blood test results in representative organs. The accuracy of semiquantitative method was validated using an National Electrical Manufacturers Association body phantom study (radioactivity ratio of sphere : background=4 : 1). Thereafter, 59 patients (34 male and 25 female; mean age, 66.9 years) who had undergone Ga-citrate SPECT/CT were retrospectively enrolled in the study. A mean SUV of physiological uptake was calculated for the following organs: the lungs, right atrium, liver, kidneys, spleen, gluteal muscles, and bone marrow. The correlation between physiological uptakes and blood test results was evaluated using Pearson's correlation coefficient. The phantom study revealed only 1% error between theoretical and actual SUVs in the background, suggesting the sufficient accuracy of scatter and attenuation corrections. However, a partial volume effect could not be overlooked, particularly in small spheres with a diameter of less than 28 mm. The highest mean SUV was observed in the liver (range: 0.44-4.64), followed by bone marrow (range: 0.33-3.60), spleen (range: 0.52-2.12), and kidneys (range: 0.42-1.45). There was no significant correlation between hepatic uptake and liver function, renal uptake and renal function, or bone marrow uptake and blood cell count (P>0.05). The physiological uptake in Ga-citrate SPECT/CT can be represented as SUVs, which are not significantly correlated with corresponding blood test results.

  5. Correlation of uptake patterns on single-photon emission computed tomography/computed tomography (SPECT/CT)and treatment response in patients with knee pain

    International Nuclear Information System (INIS)

    Koh, Geon; Hwang, Kyung Hoon; Lee, Hae Jin; Kim, Seog Gyun; Lee, Beom Koo

    2016-01-01

    To determine whether treatment response in patients with knee pain could be predicted using uptake patterns on single-photon emission computed tomography/computed tomography (SPECT/CT) images. Ninety-five patients with knee pain who had undergone SPECT/CT were included in this retrospective study. Subjects were divided into three groups: increased focal uptake (FTU), increased irregular tracer uptake (ITU), and no tracer uptake (NTU). A numeric rating scale (NRS-11) assessed pain intensity. We analyzed the association between uptake patterns and treatment response using Pearson's chi-square test and Fisher's exact test. Uptake was quantified from SPECT/CT with region of interest (ROI) counting, and an intraclass correlation coefficient (ICC) calculated agreement. We used Student' t-test to calculate statistically significant differences of counts between groups and the Pearson correlation to measure the relationship between counts and initial NRS-1k1. Multivariate logistic regression analysis determined which variables were significantly associated with uptake. The FTU group included 32 patients; ITU, 39; and NTU, 24. With conservative management, 64 % of patients with increased tracer uptake (TU, both focal and irregular) and 36 % with NTU showed positive response. Conservative treatment response of FTU was better than NTU, but did not differ from that of ITU. Conservative treatment response of TU was significantly different from that of NTU (OR 3.1; p 0.036). Moderate positive correlation was observed between ITU and initial NRS-11. Age and initial NRS-11 significantly predicted uptake. Patients with uptake in their knee(s) on SPECT/CT showed positive treatment response under conservative treatment

  6. 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) Imaging in the Staging and Prognosis of Inflammatory Breast Cancer

    International Nuclear Information System (INIS)

    Alberini, J.L.; Wartski, M.; Gontier, E.; Madar, O.; Pecking, A.P.; Lerebours, F.; Fourme, E.; Le Stanc, E.; Cherel, P.; Alberini, J.L.

    2009-01-01

    Background: To prospectively assess fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) staging and prognosis value in patients with suspected inflammatory breast cancer (IBC). Methods: Sixty-two women (mean age 50.7 ± 11.4 years) presenting with unilateral inflammatory breast tumors (59 invasive carcinomas; 3 mastitis) underwent a PET/CT scan before biopsy. Results: PET/CT scan was positive for the primary malignant tumor in 100% and false positive in 2 of 3 benign mastitis. In 59 IBC patients, FDG nodal foci were detected in axillary (90%; n = 53) and extra-axillary areas (56%; n = 33) ipsilateral to the cancer. Compared with clinical examination, the axillary lymph node status by PET/CT was upstaged and down staged in 35 and 5 patients, respectively. In 7 of 9 N0 patients, the axillary lymph node positivity on PET/CT was correct, as revealed by pathological post surgery assessment (not available in the 2 remaining patients). The nodal foci were compared with preoperative fine needle aspiration and/or pathological post chemotherapy findings available in 44 patients and corresponded to 38 true positive, 4 false-negative, and 2 false-positive cases. In 18 of 59 IBC patients (31%), distant lesions were found. On the basis of a univariate analysis of the first enrolled patients (n = 42), among 28 patients who showed intense tumoral uptake (standard uptake value(max)≥5), the 11 patients with distant lesions had a worse prognosis than the 17 patients without distant lesions (P =.04). Conclusions: FDG-PET/CT imaging provides additional invaluable information regarding nodal status or distant metastases in IBC patients and should be considered in the initial staging. It seems also that some prognostic information can be derived from FDG uptake characteristics. (authors)

  7. Positron Emission Tomography/Computed Tomography Imaging of Residual Skull Base Chordoma Before Radiotherapy Using Fluoromisonidazole and Fluorodeoxyglucose: Potential Consequences for Dose Painting

    Energy Technology Data Exchange (ETDEWEB)

    Mammar, Hamid, E-mail: hamid.mammar@unice.fr [Radiation Oncology Department, Antoine Lacassagne Center, Nice (France); CNRS-UMR 6543, Institute of Developmental Biology and Cancer, University of Nice Sophia Antipolis, Nice (France); Kerrou, Khaldoun; Nataf, Valerie [Department of Nuclear Medicine and Radiopharmacy, Tenon Hospital, and University Pierre et Marie Curie, Paris (France); Pontvert, Dominique [Proton Therapy Center of Orsay, Curie Institute, Paris (France); Clemenceau, Stephane [Department of Neurosurgery, Pitie-Salpetriere Hospital, Paris (France); Lot, Guillaume [Department of Neurosurgery, Adolph De Rothschild Foundation, Paris (France); George, Bernard [Department of Neurosurgery, Lariboisiere Hospital, Paris (France); Polivka, Marc [Department of Pathology, Lariboisiere Hospital, Paris (France); Mokhtari, Karima [Department of Pathology, Pitie-Salpetriere Hospital, Paris (France); Ferrand, Regis; Feuvret, Loiec; Habrand, Jean-louis [Proton Therapy Center of Orsay, Curie Institute, Paris (France); Pouyssegur, Jacques; Mazure, Nathalie [CNRS-UMR 6543, Institute of Developmental Biology and Cancer, University of Nice Sophia Antipolis, Nice (France); Talbot, Jean-Noeel [Department of Nuclear Medicine and Radiopharmacy, Tenon Hospital, and University Pierre et Marie Curie, Paris (France)

    2012-11-01

    Purpose: To detect the presence of hypoxic tissue, which is known to increase the radioresistant phenotype, by its uptake of fluoromisonidazole (18F) (FMISO) using hybrid positron emission tomography/computed tomography (PET/CT) imaging, and to compare it with the glucose-avid tumor tissue imaged with fluorodeoxyglucose (18F) (FDG), in residual postsurgical skull base chordoma scheduled for radiotherapy. Patients and Methods: Seven patients with incompletely resected skull base chordomas were planned for high-dose radiotherapy (dose {>=}70 Gy). All 7 patients underwent FDG and FMISO PET/CT. Images were analyzed qualitatively by visual examination and semiquantitatively by computing the ratio of the maximal standardized uptake value (SUVmax) of the tumor and cerebellum (T/C R), with delineation of lesions on conventional imaging. Results: Of the eight lesion sites imaged with FDG PET/CT, only one was visible, whereas seven of nine lesions were visible on FMISO PET/CT. The median SUVmax in the tumor area was 2.8 g/mL (minimum 2.1; maximum 3.5) for FDG and 0.83 g/mL (minimum 0.3; maximum 1.2) for FMISO. The T/C R values ranged between 0.30 and 0.63 for FDG (median, 0.41) and between 0.75 and 2.20 for FMISO (median,1.59). FMISO T/C R >1 in six lesions suggested the presence of hypoxic tissue. There was no correlation between FMISO and FDG uptake in individual chordomas (r = 0.18, p = 0.7). Conclusion: FMISO PET/CT enables imaging of the hypoxic component in residual chordomas. In the future, it could help to better define boosted volumes for irradiation and to overcome the radioresistance of these lesions. No relationship was founded between hypoxia and glucose metabolism in these tumors after initial surgery.

  8. Correlation of uptake patterns on single-photon emission computed tomography/computed tomography (SPECT/CT)and treatment response in patients with knee pain

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Geon; Hwang, Kyung Hoon; Lee, Hae Jin; Kim, Seog Gyun; Lee, Beom Koo [Gachon University Gil Hospital, Incheon (Korea, Republic of)

    2016-06-15

    To determine whether treatment response in patients with knee pain could be predicted using uptake patterns on single-photon emission computed tomography/computed tomography (SPECT/CT) images. Ninety-five patients with knee pain who had undergone SPECT/CT were included in this retrospective study. Subjects were divided into three groups: increased focal uptake (FTU), increased irregular tracer uptake (ITU), and no tracer uptake (NTU). A numeric rating scale (NRS-11) assessed pain intensity. We analyzed the association between uptake patterns and treatment response using Pearson's chi-square test and Fisher's exact test. Uptake was quantified from SPECT/CT with region of interest (ROI) counting, and an intraclass correlation coefficient (ICC) calculated agreement. We used Student' t-test to calculate statistically significant differences of counts between groups and the Pearson correlation to measure the relationship between counts and initial NRS-1k1. Multivariate logistic regression analysis determined which variables were significantly associated with uptake. The FTU group included 32 patients; ITU, 39; and NTU, 24. With conservative management, 64 % of patients with increased tracer uptake (TU, both focal and irregular) and 36 % with NTU showed positive response. Conservative treatment response of FTU was better than NTU, but did not differ from that of ITU. Conservative treatment response of TU was significantly different from that of NTU (OR 3.1; p 0.036). Moderate positive correlation was observed between ITU and initial NRS-11. Age and initial NRS-11 significantly predicted uptake. Patients with uptake in their knee(s) on SPECT/CT showed positive treatment response under conservative treatment.

  9. Contrast-enhanced [18F] fluorodeoxyglucose-positron emission tomography-computed tomography as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin.

    Science.gov (United States)

    Jain, Avani; Srivastava, Madhur Kumar; Pawaskar, Alok Suresh; Shelley, Simon; Elangovan, Indirani; Jain, Hasmukh; Pandey, Somnath; Kalal, Shilpa; Amalachandran, Jaykanth

    2015-01-01

    To evaluate the advantages of contrast enhanced F-18-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-contrast enhanced CT [CECT]) when used as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin (MUO). A total of 243 patients with fine needle aspiration cytology/biopsy proven MUO were included in this prospective study. Patients who were thoroughly evaluated for primary or primary tumor was detected by any other investigation were excluded from the analysis. Totally, 163 patients with pathological diagnosis of malignancy but no apparent sites of the primary tumor were finally selected for analysis. The site of probable primary malignancy suggested by PET-CECT was confirmed by biopsy/follow-up. PET-CECT suggested probable site of primary in 128/163 (78.52%) patients. In 30/35 remaining patients, primary tumor was not detected even after extensive work-up. In 5 patients, where PET-CECT was negative, primary was found on further extensive investigations or follow-up. The sensitivity, specificity, positive predictive value and negative predictive value of the study were 95.76%, 66.67%, 88.28% and 85.71% respectively. F-18 FDG PET-CECT aptly serves the purpose of initial imaging modality owing to high sensitivity, negative and positive predictive value. PET-CECT not only surveys the whole body for the primary malignancy but also stages the disease accurately. Use of contrast improves the diagnostic utility of modality as well as help in staging of the primary tumor. Although benefits of using PET-CECT as initial diagnostic modality are obvious from this study, there is a need for a larger study comparing conventional methods for diagnosing primary in patients with MUO versus PET-CECT.

  10. The predictive value of single-photon emission computed tomography/computed tomography for sentinel lymph node localization in head and neck cutaneous malignancy.

    Science.gov (United States)

    Remenschneider, Aaron K; Dilger, Amanda E; Wang, Yingbing; Palmer, Edwin L; Scott, James A; Emerick, Kevin S

    2015-04-01

    Preoperative localization of sentinel lymph nodes in head and neck cutaneous malignancies can be aided by single-photon emission computed tomography/computed tomography (SPECT/CT); however, its true predictive value for identifying lymph nodes intraoperatively remains unquantified. This study aims to understand the sensitivity, specificity, and positive and negative predictive values of SPECT/CT in sentinel lymph node biopsy for cutaneous malignancies of the head and neck. Blinded retrospective imaging review with comparison to intraoperative gamma probe confirmed sentinel lymph nodes. A consecutive series of patients with a head and neck cutaneous malignancy underwent preoperative SPECT/CT followed by sentinel lymph node biopsy with a gamma probe. Two nuclear medicine physicians, blinded to clinical data, independently reviewed each SPECT/CT. Activity within radiographically defined nodal basins was recorded and compared to intraoperative gamma probe findings. Sensitivity, specificity, and negative and positive predictive values were calculated with subgroup stratification by primary tumor site. Ninety-two imaging reads were performed on 47 patients with cutaneous malignancy who underwent SPECT/CT followed by sentinel lymph node biopsy. Overall sensitivity was 73%, specificity 92%, positive predictive value 54%, and negative predictive value 96%. The predictive ability of SPECT/CT to identify the basin or an adjacent basin containing the single hottest node was 92%. SPECT/CT overestimated uptake by an average of one nodal basin. In the head and neck, SPECT/CT has higher reliability for primary lesions of the eyelid, scalp, and cheek. SPECT/CT has high sensitivity, specificity, and negative predictive value, but may overestimate relevant nodal basins in sentinel lymph node biopsy. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Radiation dose reduction through combining positron emission tomography/computed tomography (PET/CT) and diagnostic CT in children and young adults with lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Qi, Zhihua; Gates, Erica L.; Trout, Andrew T. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); O' Brien, Maureen M. [Cincinnati Children' s Hospital Medical Center, Division of Oncology, Cancer and Blood Disease Institute, Cincinnati, OH (United States)

    2018-02-15

    Both [F-18]2-fluoro-2-deoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) and diagnostic CT are at times required for lymphoma staging. This means some body segments are exposed twice to X-rays for generation of CT data (diagnostic CT + localization CT). To describe a combined PET/diagnostic CT approach that modulates CT tube current along the z-axis, providing diagnostic CT of some body segments and localization CT of the remaining body segments, thereby reducing patient radiation dose. We retrospectively compared total patient radiation dose between combined PET/diagnostic CT and separately acquired PET/CT and diagnostic CT exams. When available, we calculated effective doses for both approaches in the same patient; otherwise, we used data from patients of similar size. To confirm image quality, we compared image noise (Hounsfield unit [HU] standard deviation) as measured in the liver on both combined and separately acquired diagnostic CT images. We used t-tests for dose comparisons and two one-sided tests for image-quality equivalence testing. Mean total effective dose for the CT component of the combined and separately acquired diagnostic CT exams were 6.20±2.69 and 8.17±2.61 mSv, respectively (P<0.0001). Average dose savings with the combined approach was 24.8±17.8% (2.60±2.51 mSv [range: 0.32-4.72 mSv]) of total CT effective dose. Image noise was not statistically significantly different between approaches (12.2±1.8 HU vs. 11.7±1.5 HU for the combined and separately acquired diagnostic CT images, respectively). A combined PET/diagnostic CT approach as described offers dose savings at similar image quality for children and young adults with lymphoma who have indications for both PET and diagnostic CT examinations. (orig.)

  12. Evaluation of hypoxia in a feline model of head and neck cancer using 64Cu-ATSM positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Ballegeer, Elizabeth A; Madrill, Nicole J; Berger, Kevin L; Agnew, Dalen W; McNiel, Elizabeth A

    2013-01-01

    Human and feline head and neck squamous cell carcinoma (HNSCC) share histology, certain molecular features, as well as locally aggressive and highly recurrent clinical behavior. In human HNSCC, the presence of significant hypoxia within these tumors is considered an important factor in the development of a more aggressive phenotype and poor response to therapy. We hypothesized that feline head and neck tumors, particularly HNSCC, would exhibit hypoxia and that 64 Cu-diacetyl-bis(N4-methylthiosemicarbazone) (Cu-ATSM) positron emission tomography/computed tomography (PET/CT) would permit detection of intratumoral hypoxia. 12 cats with measureable head and neck tumors were given 64 Cu-ATSM and iodinated contrast for PET/CT scan. The presence or absence of hypoxia was also assessed using an intratumoral fluorescent life-time probe to quantitate pO 2 and pimonidazole immunohistochemical staining in biopsy specimens. In two cats, intratumoral O 2 and 64 Cu-ATSM uptake was measured before and after treatment with anti-angiogenic agents to determine the effect of these agents on hypoxia. Eleven of twelve feline tumors demonstrated significant 64 Cu-ATSM uptake, regardless of malignant or benign etiology. The presence (and absence) of hypoxia was confirmed using the fluorescent O 2 detection probe in nine tumors, and using pimonidazole staining in three tumors. Squamous cell carcinomas (HNSCC) demonstrated the highest degree of hypoxia, with T max /M ratios ranging from 4.3 to 21.8. Additional non-neoplastic tissues exhibited 64 Cu-ATSM uptake suggestive of hypoxia including reactive draining lymph nodes, non-malignant thyroid pathology, a tooth root abscess, and otitis media. In two cats with HNSCC that received anti-vascular agents, the pattern of 64 Cu-ATSM uptake was altered after treatment, demonstrating the potential of the feline model to study the modulation of tumor oxygenation. Feline HNSCC serves as a clinically relevant model for the investigation of

  13. Role of 18F fluorodeoxyglucose positron emission tomography/computed tomography in the detection of recurrence in patients with cervical cancer

    International Nuclear Information System (INIS)

    Bhoil, Amit; Mittal, Bhagwant Rai; Bhattacharya, Anish; Santhosh, Sampath; Patel, Firuza

    2013-01-01

    Treatment of cervical cancer is usually surgery in the early stages and radiotherapy or chemoradiotherapy in more advanced stages of the disease. Recurrence may occur in multiple sites following primary treatment. Although recurrent metastatic disease is not curable, surgical treatment may be of great help if locoregional recurrence is detected early. Fluorine-18 Fluorodeoxyglucose positron emission tomography - computed tomography ( 18 F FDG PET/CT) forms an important part of investigations in the diagnosis of clinically suspicious recurrent cervical cancer. To assess the role of 18 F FDG PET/CT in diagnosing recurrence in patients with clinical suspicion of recurrent cervical cancer. We retrospectively evaluated 53 histopathologically proved patients of cervical cancer. All the patients had been treated with either surgery/radiation therapy with or without chemotherapy. The standard PET/CT acquisition protocol, with delayed post void static pelvic images, wherever required, was followed in all patients. Significant uptake of FDG in the lymph nodes was considered to be a recurrence suggestive of metastasis. Para-aortic lymph nodal involvement was considered to be distant metastasis. Any significant uptake in the lung nodule on FDG PET was evaluated either by histological confirmation, by taking fine needle aspiration cytology (FNAC), or by a follow-up chest CT done after three months. Of the 53 patients with clinically equivocal recurrence, FDG PET/CT suggested recurrence in 41 patients (local recurrence in 14 patients and distant recurrence/metastasis with or without local recurrence in 27 patients). It had a sensitivity of 97.5%, a specificity of 63.6%, positive predictive value of 90.9%, and negative predictive value of 87.5%. PET/CT appears to have an important role in detecting recurrence following primary treatment of cervical cancer. The high positive and negative predictive values of PET/CT may be helpful in planning management of recurrent cervical cancer

  14. Radiation dose reduction through combining positron emission tomography/computed tomography (PET/CT) and diagnostic CT in children and young adults with lymphoma

    International Nuclear Information System (INIS)

    Qi, Zhihua; Gates, Erica L.; Trout, Andrew T.; O'Brien, Maureen M.

    2018-01-01

    Both [F-18]2-fluoro-2-deoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) and diagnostic CT are at times required for lymphoma staging. This means some body segments are exposed twice to X-rays for generation of CT data (diagnostic CT + localization CT). To describe a combined PET/diagnostic CT approach that modulates CT tube current along the z-axis, providing diagnostic CT of some body segments and localization CT of the remaining body segments, thereby reducing patient radiation dose. We retrospectively compared total patient radiation dose between combined PET/diagnostic CT and separately acquired PET/CT and diagnostic CT exams. When available, we calculated effective doses for both approaches in the same patient; otherwise, we used data from patients of similar size. To confirm image quality, we compared image noise (Hounsfield unit [HU] standard deviation) as measured in the liver on both combined and separately acquired diagnostic CT images. We used t-tests for dose comparisons and two one-sided tests for image-quality equivalence testing. Mean total effective dose for the CT component of the combined and separately acquired diagnostic CT exams were 6.20±2.69 and 8.17±2.61 mSv, respectively (P<0.0001). Average dose savings with the combined approach was 24.8±17.8% (2.60±2.51 mSv [range: 0.32-4.72 mSv]) of total CT effective dose. Image noise was not statistically significantly different between approaches (12.2±1.8 HU vs. 11.7±1.5 HU for the combined and separately acquired diagnostic CT images, respectively). A combined PET/diagnostic CT approach as described offers dose savings at similar image quality for children and young adults with lymphoma who have indications for both PET and diagnostic CT examinations. (orig.)

  15. Pilot study utilizing Fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography for glycolytic phenotyping of canine mast cell tumors.

    Science.gov (United States)

    Griffin, Lynn R; Thamm, Doug H; Selmic, Laura E; Ehrhart, E J; Randall, Elissa

    2018-03-23

    The goal of this prospective pilot study was to use naturally occurring canine mast cell tumors of various grades and stages as a model for attempting to determine how glucose uptake and markers of biologic behavior are correlated. It was hypothesized that enhanced glucose uptake, as measured by 2-[fluorine-18]fluoro-d-glucose-positron emission tomography/computed tomography (F18 FDG PET-CT), would correlate with histologic grade. Dogs were recruited for this study from a population referred for treatment of cytologically or histologically confirmed mast cell tumors. Patients were staged utilizing standard of care methods (abdominal ultrasound and three view thoracic radiographs), followed by a whole body F18 FDG PET-CT. Results of the F18 FDG PET-CT were analyzed for possible metastasis and standard uptake value maximum (SUV max ) of identified lesions. Incisional or excisional biopsies of the accessible mast cell tumors were obtained and histology performed. Results were then analyzed to look for a possible correlation between the grade of mast cell tumors and SUV max . A total of nine animals were included in the sample. Findings indicated that there was a correlation between grade of mast cell tumors and SUV max as determined by F18 FDG PET-CT (p-value = 0.073, significance ≤ 0.1). Based on the limited power of this study, it is felt that further research to examine the relationship between glucose utilization and biologic aggressiveness in canine mast cell tumors is warranted. This study was unable to show that F18 FDG PET-CT was a better staging tool than standard of care methods. © 2018 American College of Veterinary Radiology.

  16. Radiation dose reduction through combining positron emission tomography/computed tomography (PET/CT) and diagnostic CT in children and young adults with lymphoma.

    Science.gov (United States)

    Qi, Zhihua; Gates, Erica L; O'Brien, Maureen M; Trout, Andrew T

    2018-02-01

    Both [F-18]2-fluoro-2-deoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) and diagnostic CT are at times required for lymphoma staging. This means some body segments are exposed twice to X-rays for generation of CT data (diagnostic CT + localization CT). To describe a combined PET/diagnostic CT approach that modulates CT tube current along the z-axis, providing diagnostic CT of some body segments and localization CT of the remaining body segments, thereby reducing patient radiation dose. We retrospectively compared total patient radiation dose between combined PET/diagnostic CT and separately acquired PET/CT and diagnostic CT exams. When available, we calculated effective doses for both approaches in the same patient; otherwise, we used data from patients of similar size. To confirm image quality, we compared image noise (Hounsfield unit [HU] standard deviation) as measured in the liver on both combined and separately acquired diagnostic CT images. We used t-tests for dose comparisons and two one-sided tests for image-quality equivalence testing. Mean total effective dose for the CT component of the combined and separately acquired diagnostic CT exams were 6.20±2.69 and 8.17±2.61 mSv, respectively (PCT effective dose. Image noise was not statistically significantly different between approaches (12.2±1.8 HU vs. 11.7±1.5 HU for the combined and separately acquired diagnostic CT images, respectively). A combined PET/diagnostic CT approach as described offers dose savings at similar image quality for children and young adults with lymphoma who have indications for both PET and diagnostic CT examinations.

  17. The efficacy of preoperative positron emission tomography-computed tomography (PET-CT) for detection of lymph node metastasis in cervical and endometrial cancer: clinical and pathological factors influencing it.

    Science.gov (United States)

    Nogami, Yuya; Banno, Kouji; Irie, Haruko; Iida, Miho; Kisu, Iori; Masugi, Yohei; Tanaka, Kyoko; Tominaga, Eiichiro; Okuda, Shigeo; Murakami, Koji; Aoki, Daisuke

    2015-01-01

    We studied the diagnostic performance of (18)F-fluoro-2-deoxy-d-glucose-positron emission tomography/computed tomography in cervical and endometrial cancers with particular focus on lymph node metastases. Seventy patients with cervical cancer and 53 with endometrial cancer were imaged with (18)F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography before lymphadenectomy. We evaluated the diagnostic performance of (18)F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography using the final pathological diagnoses as the golden standard. We calculated the sensitivity, specificity, positive predictive value and negative predictive value of (18)F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography. In cervical cancer, the results evaluated by cases were 33.3, 92.7, 55.6 and 83.6%, respectively. When evaluated by the area of lymph nodes, the results were 30.6, 98.9, 55.0 and 97.0%, respectively. As for endometrial cancer, the results evaluated by cases were 50.0, 93.9, 40.0 and 95.8%, and by area of lymph nodes, 45.0, 99.4, 64.3 and 98.5%, respectively. The limitation of the efficacy was found out by analyzing it by the region of the lymph node, the size of metastatic node, the historical type of tumor in cervical cancer and the prevalence of lymph node metastasis. The efficacy of positron emission tomography/computed tomography regarding the detection of lymph node metastasis in cervical and endometrial cancer is not established and has limitations associated with the region of the lymph node, the size of metastasis lesion in lymph node and the pathological type of primary tumor. The indication for the imaging and the interpretation of the results requires consideration for each case by the pretest probability based on the information obtained preoperatively. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Update on nodal staging in non-small cell lung cancer with integrated positron emission tomography/computed tomography: a meta-analysis.

    Science.gov (United States)

    Pak, Kyoungjune; Park, Sohyun; Cheon, Gi Jeong; Kang, Keon Wook; Kim, In-Joo; Lee, Dong Soo; Kim, E Edmund; Chung, June-Key

    2015-06-01

    Nowadays, the number of primary studies on fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has been increasing rapidly. Thus, we updated meta-analysis to evaluate the test performance of FDG PET/CT for nodal staging in non-small cell lung cancer (NSCLC) including the most recent studies. We performed a systematic search of MEDLINE and EMBASE for English publications using keywords "positron emission tomography", "lung cancer", and "lymph node". All searches were limited to human studies. Inclusion criteria were studies of the initial nodal staging of NSCLC with PET/CT. The reasons for exclusion are as follows: (1) studies with PET, (2) previous therapy before PET/CT, (3) nodal staging not confirmed by histology, and (4) reviews, abstracts, and editorial materials. 786 articles were identified through database searching. 28 studies including 3,255 patients and 11,887 lymph nodes (LN) were eligible for this study. The pooled sensitivity was 0.62 (95% CI 0.54-0.70), widely ranging from 0.13 to 0.98. The specificity ranged between 0.72 and 0.98 with an overall estimated specificity of 0.92 (0.88-0.95) for node-based data. The pooled sensitivity, specificity, positive and negative likelihood ratio were 0.67 (0.54-0.79), 0.87 (0.82-0.91), 5.20 (3.59-7.54), and 0.37 (0.25-0.55) for patient-based data. Studies from tuberculosis (Tb) endemic countries showed lower sensitivity (0.56 vs 0.68, p = 0.03) for node-based data and lower specificity (0.83 vs 0.89, p < 0.01) for patient-based ones. PET/CT has a high specificity, but low sensitivity for detecting LN metastasis in patients with NSCLC. Tb might be one of the main reasons for lower sensitivity of PET/CT in several countries. The primary clinicians of lung cancer should be aware of the possibility of hidden metastatic LNs in bilateral FDG uptake of mediastinal and hilar LNs, especially in the Tb endemic countries.

  19. Performance of Positron Emission Tomography and Positron Emission Tomography/Computed Tomography Using Fluorine-18-Fluorodeoxyglucose for the Diagnosis, Staging, and Recurrence Assessment of Bone Sarcoma

    Science.gov (United States)

    Liu, Fanxiao; Zhang, Qingyu; Zhu, Dezhi; Li, Zhenfeng; Li, Jianmin; Wang, Boim; Zhou, Dongsheng; Dong, Jinlei

    2015-01-01

    Abstract To investigate the performance of fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and PET/computed tomography (CT) in the diagnosis, staging, restaging, and recurrence surveillance of bone sarcoma by systematically reviewing and meta-analyzing the published literature. To retrieve eligible studies, we searched the MEDLINE, Embase, and the Cochrane Central library databases using combinations of following Keywords: “positron emission tomography” or “PET,” and “bone tumor” or “bone sarcoma” or “sarcoma.” Bibliographies from relevant articles were also screened manually. Data were extracted and the pooled sensitivity, specificity, and diagnostic odds ratio (DOR), on an examination-based or lesion-based level, were calculated to appraise the diagnostic accuracy of 18F-FDG PET and PET/CT. All statistical analyses were performed using Meta-Disc 1.4. Forty-two trials were eligible. The pooled sensitivity and specificity of PET/CT to differentiate primary bone sarcomas from benign lesions were 96% (95% confidence interval [CI], 93–98) and 79% (95% CI, 63–90), respectively. For detecting recurrence, the pooled results on an examination-based level were sensitivity 92% (95% CI, 85–97), specificity 93% (95% CI, 88–96), positive likelihood ratio (PLR) 10.26 (95% CI, 5.99–17.60), and negative likelihood ratio (NLR) 0.11 (95% CI, 0.05–0.22). For detecting distant metastasis, the pooled results on a lesion-based level were sensitivity 90% (95% CI, 86–93), specificity 85% (95% CI, 81–87), PLR 5.16 (95% CI, 2.37–11.25), and NLR 0.15 (95% CI, 0.11–0.20). The accuracies of PET/CT for detecting local recurrence, lung metastasis, and bone metastasis were satisfactory. Pooled outcome estimates of 18F-FDG PET were less complete compared with those of PET/CT. 18F-FDG PET and PET/CT showed a high sensitivity for diagnosing primary bone sarcoma. Moreover, PET/CT demonstrated excellent accuracy for the staging

  20. The Comparison of Computed Tomography Perfusion, Contrast-Enhanced Computed Tomography and Positron-Emission Tomography/Computed Tomography for the Detection of Primary Esophageal Carcinoma.

    Science.gov (United States)

    Genc, Berhan; Kantarci, Mecit; Sade, Recep; Orsal, Ebru; Ogul, Hayri; Okur, Aylin; Aydin, Yener; Karaca, Leyla; Eroğlu, Atilla

    2016-01-01

    The purpose of this study was to investigate the efficiency of computed tomography perfusion (CTP), contrast-enhanced computed tomography (CECT) and 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron-emission tomography (PET/CT) in the diagnosis of esophageal cancer. This prospective study consisted of 33 patients with pathologically confirmed esophageal cancer, 2 of whom had an esophageal abscess. All the patients underwent CTP, CECT and PET/CT imaging and the imaging findings were evaluated. Sensitivity, specificity and positive and negative predictive values were calculated for each of the 3 imaging modalities relative to the histological diagnosis. Thirty-three tumors were visualized on CTP, 29 on CECT and 27 on PET/CT. Six tumors were stage 1, and 2 and 4 of these tumors were missed on CECT and PET/CT, respectively. Significant differences between CTP and CECT (p = 0.02), and between CTP and PET/CT (p = 0.04) were found for stage 1 tumors. Values for the sensitivity, specificity and positive and negative predictive values on CTP were 100, 100, 100 and 100%, respectively. Corresponding values on CECT were 93.94, 0, 93.94 and 0%, respectively, and those on PET/CT were 87.88, 0, 93.55 and 0%, respectively. Hence, the sensitivity, specificity and positive and negative predictive values of CTP were better than those of CECT and PET/CT. CTP had an advantage over CECT and PET/CT in detecting small lesions. CTP was valuable, especially in detecting stage 1 tumors. © 2016 S. Karger AG, Basel.

  1. Use of Computed Tomography and Positron Emission Tomography/Computed Tomography for Staging of Local Extent in Patients With Malignant Pleural Mesothelioma

    OpenAIRE

    Frauenfelder, Thomas; Kestenholz, Peter; Hunziker, Roger; Nguyen, Thi Dan Linh; Fries, Martina; Veit-Haibach, Patrick; Husmann, Lars; Stahel, Rolf; Weder, Walter; Opitz, Isabelle

    2015-01-01

    PURPOSE The objective of this study was to determine the diagnostic value of computed tomography (CT) and positron emission tomography (PET)/CT for staging of malignant pleural mesothelioma (MPM) in patients undergoing induction chemotherapy. METHODS Sixty-two patients (median age, 61 years; female: n = 9) with proven MPM underwent CT after induction chemotherapy. Of these, 28 underwent additional PET/CT. Extrapleural pneumonectomy was performed for pathological TNM staging. Clinical TNM s...

  2. Roles of computed tomography and [18F]fluorodeoxyglucose-positron emission tomography/computed tomography in the characterization of multiple solitary solid lung nodules

    OpenAIRE

    Travaini, LL; Trifirò, G; Vigna, PD; Veronesi, G; De Pas, TM; Spaggiari, L; Paganelli, G; Bellomi, M

    2012-01-01

    The purpose of this study is to compare the performance of multidetector computed tomography (CT) and positron emission tomography/CT (PET/CT) with [18F]fluorodeoxyglucose in the diagnosis of multiple solitary lung nodules in 14 consecutive patients with suspicious lung cancer. CT and PET/CT findings were reviewed by a radiologist and nuclear medicine physician, respectively, blinded to the pathological diagnoses of lung cancer, considering nodule size, shape, and location (CT) and maximum st...

  3. Solitary pulmonary nodule evaluation in regions endemic for infectious diseases: Do regional variations impact the effectiveness of fluorodeoxyglucose positron emission tomography/computed tomography.

    Science.gov (United States)

    Purandare, N C; Pramesh, C S; Agarwal, J P; Agrawal, A; Shah, S; Prabhash, K; Karimundackal, G; Jiwnani, S; Tandon, S; Rangarajan, V

    2017-01-01

    Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has become a preferred imaging modality for the evaluation of solitary pulmonary nodule (SPN), particularly in the developed world. Since FDG can concentrate in infective/inflammatory lesions, the diagnostic utility of FDG-PET can be questioned, particularly in regions endemic for infectious decisions. To evaluate the accuracy of FDG-PET/CT in evaluation of SPNs in a population endemic for infectious disease and to assess if regional variations have an impact on its effectiveness. All patients who underwent an FDG/PET-CT with a clinico-radiological diagnosis of SPN categorized as indeterminate were included. Based on a maximum standardized uptake values (SUVmax) cut-off of 2.5, lesions were classified as benign (2.5) and compared with gold standard histopathology. The diagnostic accuracy of PET-CT to detect malignancy was calculated. On the basis of final histopathology, lesions were grouped as (a) malignant nodules (b) infective/granulomatous nodules with a specific diagnosis and (c) nonspecific inflammatory nodules. The SUVmaxbetween these groups was compared using nonparametric statistical tests. A total of 191 patients (129 males, 62 females) with a median age of 64 years (range: 36-83) were included. Totally, 144 nodules (75.3%) were malignant and 47 were benign (24.7%). Adenocarcinoma (n = 84) was the most common malignancy. Tuberculosis (n = 16) and nonspecific infections (n = 24) were the two most common benign pathologies. There was a significant overlap in the metabolic uptake of malignant (median SUVmax-11.2, range: 3.3-34.6) and tuberculous nodules (median SUVmax-10.3, range: 2.7-22.5) with no statistically difference between their SUVmaxvalues (P = 0.43). The false-positive rate was 65.2% and the false-negative rate was 5.5%. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FDG-PET/CT for detecting malignancy were 94

  4. Detection of internal mammary lymph node metastasis with {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with stage III breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Min Jung; Lee, Jong Jin; Kim, Hye Ok; Chae, Sun-Young; Ryu, Jin-Sook; Moon, Dae Hyuk [University of Ulsan College of Medicine, Asan Medical Center, Department of Nuclear Medicine, Songpa-gu, Seoul (Korea, Republic of); Park, Seol Hoon [Ulsan University Hospital, Department of Nuclear Medicine, Ulsan (Korea, Republic of); Ahn, Sei Hyun; Lee, Jong Won; Son, Byung Ho [University of Ulsan College of Medicine, Asan Medical Center, Department of Surgery, Seoul (Korea, Republic of); Gong, Gyung-Yub [University of Ulsan College of Medicine, Asan Medical Center, Department of Pathology, Seoul (Korea, Republic of)

    2014-03-15

    The present study assessed the positive predictive value (PPV) of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the detection of internal mammary node (IMN) metastasis in patients with clinical stage III breast cancer. Patients who were diagnosed with clinical stage III breast cancer and underwent pretreatment {sup 18}F-FDG PET/CT were retrospectively analyzed. The {sup 18}F-FDG PET/CT scans were prospectively reviewed by two board-certified nuclear medicine physicians in a blinded manner. The intensities of IMNs were graded into four categories (no activity and lower, similar, and higher activities than that of the mediastinal blood pool). IMNs were measured from the combined CT (largest diameter of the short axis). Histologic data of the IMNs were obtained by ultrasonography-guided fine-needle aspiration biopsy or surgical excision. The PPV was calculated for pathologically confirmed IMNs. Visual grade, maximum standardized uptake values (SUV{sub max}), and sizes were analyzed according to the pathology results. There were 249 clinical stage III breast cancer patients (age 48.0 ± 10.1 years, range 26-79 years) who had undergone initial {sup 18}F-FDG PET/CT prior to treatment. Excluding 33 cases of stage IV breast cancer, 62 of 216 patients had visible IMNs on {sup 18}F-FDG PET/CT, and histologic confirmation was obtained in 31 patients. There were 27 metastatic and four nonmetastatic nodes (PPV 87.1 %). Metastatic nodes mostly presented with visual grade 3 (83.9 %), and SUV{sub max} and size were 3.5 ± 4.3 and 5.6 ± 2.0 mm, respectively. {sup 18}F-FDG PET/CT has a high PPV for IMN metastasis in clinical stage III breast cancer, indicating the possibility of metastasis in IMNs with FDG uptake similar to/lower than that of the blood pool or small-sized nodes. (orig.)

  5. Differentiation between malignant and benign pathologic fractures with F-18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Shin, D.S.; Shon, O.J.; Byun, S.J. [Yeungnam University, Department of Orthopedic Surgery College of Medicine, Daegu (Korea); Choi, J.H. [Yeungnam University, Department of Surgical Pathology, College of Medicine, Daegu (Korea); Chun, K.A.; Cho, I.H. [Yeungnam University, Department of Nuclear Medicine, College of Medicine, Daegu (Korea)

    2008-05-15

    To evaluate the efficacy of F-18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG PET/CT) in differentiating malignant from benign pathologic fractures. F-18 FDG PET/CT was performed on 34 patients with pathologic fractures between May 2004 and June 2007. Fractures were located in tubular bones (26), in the pelvis (six), in the spine (one) and in a rib (one). The FDG uptake pattern at the fracture site was described, whether FDG uptake occurred in the marrow or cortex and soft tissue. Maximum standardized uptake values (SUVmax, the largest value at the region of interest) were measured at the fracture site, including cortical bone, bone marrow and soft tissue. As a reference standard, biopsy was used for 12 patients and clinical follow-up for 22 patients. Sensitivity, specificity and diagnostic accuracy of PET/CT were calculated. There were 19 malignant and 15 benign fractures. In the malignant fractures, PET/CT demonstrated high (mean SUVmax 12.0, range 4.3 to 45.7) F-18 FDG uptake in bone marrow in most cases (17 of 19). In benign fractures, there was low FDG uptake (mean SUVmax 2.9, range 0.6 to 5.5) within cortical bone or adjacent soft tissue around the fracture, rarely in the marrow. There were significant differences in the pattern of intramedullary FDG uptake (P < 0.001) and in the mean SUVmax (P < 0.01) between malignant and benign fractures. The sensitivity, specificity and diagnostic accuracy of F-18 FDG PET/CT were 89.5%, 86.7% and 88.2%, respectively, with a cut-off SUVmax set at 4.7. The time interval between fracture and PET/CT did not significantly influence FDG uptake at the fracture site. F-18 FDG PET/CT reliably differentiated between malignant and benign fractures based on the SUVmax and based on medullary uptake, which was characteristic for malignant fractures. (orig.)

  6. Feasibility of Systematic Respiratory-Gated Acquisition in Unselected Patients Referred for 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

    Directory of Open Access Journals (Sweden)

    Philippe Robin

    2018-02-01

    Full Text Available ObjectiveRespiratory motion in 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT induces blurred images, leading to errors in location and quantification for lung and abdominal lesions. Various methods have been developed to correct for these artifacts, and most of current PET/CT scanners are equipped with a respiratory gating system. However, they are not routinely performed because their use is time-consuming. The aim of this study is to assess the feasibility and quantitative impact of a systematic respiratory-gated acquisition in unselected patients referred for FDG PET/CT, without increasing acquisition time.MethodsPatients referred for a FDG PET/CT examination to the nuclear medicine department of Brest University Hospital were consecutively enrolled, during a 3-month period. Cases presenting lung or liver uptakes were analyzed. Two sets of images were reconstructed from data recorded during a unique acquisition with a continuous table speed of 1 mm/s of the used Biograph mCT Flow PET/CT scanner: standard free-breathing images, and respiratory-gated images. Lesion location and quantitative parameters were recorded and compared.ResultsFrom October 1 2015 to December 31 2015, 847 patients were referred for FDG PET/CT, 741 underwent a respiratory-gated acquisition. Out of them, 213 (29% had one or more lung or liver uptake but 82 (38% had no usable respiratory-gated signal. Accordingly, 131 (62% patients with 183 lung or liver uptakes were analyzed. Considering the 183 lesions, 140 and 43 were located in the lungs and the liver, respectively. The median (IQR difference between respiratory-gated images and non-gated images was 18% (4−32 for SUVmax, increasing to 30% (14−57 in lower lobes for lung lesions, and −18% (−40 to −4 for MTV (p < 0.05. Technologists’ active personal dosimetry and mean total examinations duration were not statistically different between periods with and without

  7. [18F]-Fluoromisonidazole Positron Emission Tomography/Computed Tomography Visualization of Tumor Hypoxia in Patients With Chordoma of the Mobile and Sacrococcygeal Spine

    Energy Technology Data Exchange (ETDEWEB)

    Cheney, Matthew D., E-mail: mcheney@lroc.harvard.edu [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Chen, Yen-Lin [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Lim, Ruth [Department of Diagnostic Radiology, Massachusetts General Hospital, Boston, Massachusetts (United States); Winrich, Barbara K.; Grosu, Anca L.; Trofimov, Alexei V. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Depauw, Nicolas [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Centre of Medical Radiation Physics, University of Wollongong, Wollongong, NSW (Australia); Shih, Helen A. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Schwab, Joseph H.; Hornicek, Francis J. [Department of Orthopedic Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2014-12-01

    Purpose: To investigate [18F]-fluoromisonidazole positron emission tomography/computed tomography (FMISO-PET/CT) detection of targetable hypoxic subvolumes (HSVs) in chordoma of the mobile or sacrococcygeal spine. Methods and Materials: A prospective, pilot study of 20 patients with primary or locally recurrent chordoma of the mobile or sacrococcygeal spine treated with proton or combined proton/photon radiation therapy (RT) with or without surgery was completed. The FMISO-PET/CT was performed before RT and after 19.8-34.2 GyRBE (relative biologic effectiveness). Gross tumor volumes were delineated and HSVs defined including voxels with standardized uptake values ≥1.4 times the muscle mean. Clinical characteristics and treatments received were compared between patients with and without HSVs. Results: The FMISO-PET/CT detected HSVs in 12 of 20 patients (60%). Baseline and interval HSV spatial concordance varied (0%-94%). Eight HSVs were sufficiently large (≥5 cm{sup 3}) to potentially allow an intensity modulated proton therapy boost. Patients with HSVs had significantly larger gross tumor volumes (median 410.0 cm{sup 3} vs 63.4 cm{sup 3}; P=.02) and were significantly more likely to have stage T2 tumors (5 of 12 vs 0 of 8; P=.04). After a median follow-up of 1.8 years (range, 0.2-4.4 years), a local recurrence has yet to be observed. Three patients developed metastatic disease, 2 with HSVs. Conclusions: Detection of targetable HSVs by FMISO-PET/CT within patients undergoing RT with or without surgery for treatment of chordoma of the mobile and sacrococcygeal spine is feasible. The study's inability to attribute interval HSV changes to treatment, rapidly changing hypoxic physiology, or imaging inconsistencies is a limitation. Further study of double-baseline FMISO-PET/CT and hypoxia-directed RT dose escalation, particularly in patients at high risk for local recurrence, is warranted.

  8. 18 F-Fluoride positron emission tomography/computed tomography for noninvasive in vivo quantification of pathophysiological bone metabolism in experimental murine arthritis

    Science.gov (United States)

    2014-01-01

    Introduction Evaluation of disease severity in experimental models of rheumatoid arthritis is inevitably associated with assessment of structural bone damage. A noninvasive imaging technology allowing objective quantification of pathophysiological alterations of bone structure in rodents could substantially extend the methods used to date in preclinical arthritis research for staging of autoimmune disease severity or efficacy of therapeutical intervention. Sodium 18 F-fluoride (18 F-NaF) is a bone-seeking tracer well-suited for molecular imaging. Therefore, we systematically examined the use of 18 F-NaF positron emission tomography/computed tomography (PET/CT) in mice with glucose-6-phosphate isomerase (G6PI)–induced arthritis for quantification of pathological bone metabolism. Methods F-fluoride was injected into mice before disease onset and at various time points of progressing experimental arthritis. Radioisotope accumulation in joints in the fore- and hindpaws was analyzed by PET measurements. For validation of bone metabolism quantified by 18 F-fluoride PET, bone surface parameters of high-resolution μCT measurements were used. Results Before clinical arthritis onset, no distinct accumulation of 18 F-fluoride was detectable in the fore- and hindlimbs of mice immunized with G6PI. In the course of experimental autoimmune disease, 18 F-fluoride bone uptake was increased at sites of enhanced bone metabolism caused by pathophysiological processes of autoimmune disease. Moreover, 18 F-fluoride signaling at different stages of G6PI-induced arthritis was significantly correlated with the degree of bone destruction. CT enabled identification of exact localization of 18 F-fluoride signaling in bone and soft tissue. Conclusions The results of this study suggest that small-animal PET/CT using 18 F-fluoride as a tracer is a feasible method for quantitative assessment of pathophysiological bone metabolism in experimental arthritis. Furthermore, the

  9. Prognostic significance of metabolic tumor burden by positron emission tomography/computed tomography in patients with relapsed/refractory diffuse large B-cell lymphoma.

    Science.gov (United States)

    Tateishi, Ukihide; Tatsumi, Mitsuaki; Terauchi, Takashi; Ando, Kiyoshi; Niitsu, Nozomi; Kim, Won Seog; Suh, Cheolwon; Ogura, Michinori; Tobinai, Kensei

    2015-02-01

    The aim of the present study was to investigate the feasibility of measuring metabolic tumor burden using [F-18] fluorodeoxyglucose ((18) F-FDG) positron emission tomography/computed tomography (PET/CT) in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) treated with bendamustine-rituximab. Because the standardized uptake value is a critical parameter of tumor characterization, we carried out a phantom study of (18) F-FDG PET/CT to ensure quality control for 28 machines in the 24 institutions (Japan, 17 institutions; Korea, 7 institutions) participating in our clinical study. Fifty-five patients with relapsed or refractory DLBCL were enrolled. The (18) F-FDG PET/CT was acquired before treatment, after two cycles, and after the last treatment cycle. Treatment response was assessed after two cycles and after the last cycle using the Lugano classification. Using this classification, remission was complete in 15 patients (27%) and incomplete in 40 patients (73%) after two cycles of therapy, and remission was complete in 32 patients (58%) and incomplete in 23 patients (42%) after the last treatment cycle. The percentage change in all PET/CT parameters except for the area under the curve of the cumulative standardized uptake value-volume histogram was significantly greater in complete response patients than in non-complete response patients after two cycles and the last cycle. The Cox proportional hazard model and best subset selection method revealed that the percentage change of the sum of total lesion glycolysis after the last cycle (relative risk, 5.24; P = 0.003) was an independent predictor of progression-free survival. The percent change of sum of total lesion glycolysis, calculated from PET/CT, can be used to quantify the response to treatment and can predict progression-free survival after the last treatment cycle in patients with relapsed or refractory DLBCL treated with bendamustine-rituximab. © 2014 The Authors. Cancer Science

  10. Value of {sup 18}F-fluorodeoxyglucose uptake in positron emission tomography/computed tomography in predicting survival in multiple myeloma

    Energy Technology Data Exchange (ETDEWEB)

    Haznedar, Rauf; Aki, Sahika Z.; Oezkurt, Zuebeyde N.; Yagci, Muenci; Sucak, Gulsan T. [Gazi University Faculty of Medicine, Department of Hematology, Ankara (Turkey); Akdemir, Oezguer U. [Gazi University Faculty of Medicine, Department of Nuclear Medicine, Ankara (Turkey); Ceneli, Oezcan [Kirikkale University Sueleyman Demirel Hospital, Department of Hematology, Kirikkale (Turkey); Uenlue, Mustafa [Gazi University Faculty of Medicine, Department of Nuclear Medicine, Ankara (Turkey); Gazi University Faculty of Medicine, Ankara (Turkey)

    2011-06-15

    We assessed the role of the maximum standardized uptake value (SUV{sub max}) of bone marrow and the extramedullary lesion with the highest SUV{sub max} in positron emission tomography/computed tomography (PET/CT) of newly diagnosed multiple myeloma (MM) patients in predicting overall survival (OS). A total of 61 newly diagnosed patients (55 MM and 6 plasmacytoma) were enrolled in the study [37 men and 24 women with a median age of 57 years (range 28-80 years)]. The SUV{sub max} of bone marrow and the extramedullary lesion in PET/CT was correlated with the levels of {beta}{sub 2}-microglobulin, C-reactive protein (CRP), albumin, creatinine, per cent of bone marrow plasma cells, serum free light chain (FLC) ratio, International Staging System (ISS) score and Durie-Salmon stage. The extramedullary lesion with the highest SUV{sub max} showed significant correlation with bone marrow fluorodeoxyglucose (FDG) uptake (p = 0.027) and near significant correlation with ISS (p = 0.048). Bone marrow SUV{sub max} correlated significantly with the per cent of bone marrow plasma cell count (p = 0.024), CRP (p = 0.012) and ISS (p = 0.013). In stage III MM the mean values of SUV{sub max} in extramedullary lesions were significantly higher than stages I and II (6.23 {+-} 6.32 vs 2.85 {+-} 3.44, p = 0.023). The serum FLC ratio did not show any correlation with SUV{sub max} of lesions and bone marrow (p > 0.05). Forty-four MM patients with FDG-positive lesions in PET/CT showed inferior 5-year estimated survival (61.73%) when compared to 11 patients without FDG-positive lesions, all of whom were alive (p = 0.01). In multivariate analysis an extramedullary lesion with the highest SUV{sub max} was the only independent predictor of OS (p = 0.03). PET/CT allows identification of high-risk myeloma patients, and extramedullary lesions with the highest SUV{sub max} independently predict inferior OS. (orig.)

  11. Estimation of kidneys and urinary bladder doses based on the region of interest in 18fluorine-fluorodeoxyglucose positron emission tomography/computed tomography examination: a preliminary study.

    Science.gov (United States)

    Mustapha, Farida Aimi; Bashah, Farahnaz Ahmad Anwar; Yassin, Ihsan M; Fathinul Fikri, Ahmad Saad; Nordin, Abdul Jalil; Abdul Razak, Hairil Rashmizal

    2017-06-01

    Kidneys and urinary bladder are common physiologic uptake sites of 18fluorine-fluorodeoxyglucose ( 18 F-FDG) causing increased exposure of low energy ionizing radiation to these organs. Accurate measurement of organ dose is vital as 18 F-FDG is directly exposed to the organs. Organ dose from 18 F-FDG PET is calculated according to the injected 18 F-FDG activity with the application of dose coefficients established by International Commission on Radiological Protection (ICRP). But this dose calculation technique is not directly measured from these organs; rather it is calculated based on total injected activity of radiotracer prior to scanning. This study estimated the 18 F-FDG dose to the kidneys and urinary bladder in whole body positron emission tomography/computed tomography (PET/CT) examination by comparing dose from total injected activity of 18 F-FDG (calculated dose) and dose from organs activity based on the region of interest (ROI) (measured dose). Nine subjects were injected intravenously with the mean 18 F-FDG dose of 292.42 MBq prior to whole body PET/CT scanning. Kidneys and urinary bladder doses were estimated by using two approaches which are the total injected activity of 18 F-FDG and organs activity concentration of 18 F-FDG based on drawn ROI with the application of recommended dose coefficients for 18 F-FDG described in the ICRP 80 and ICRP 106. The mean percentage difference between calculated dose and measured dose ranged from 98.95% to 99.29% for the kidneys based on ICRP 80 and 98.96% to 99.32% based on ICRP 106. Whilst, the mean percentage difference between calculated dose and measured dose was 97.08% and 97.27% for urinary bladder based on ICRP 80 while 96.99% and 97.28% based on ICRP 106. Whereas, the range of mean percentage difference between calculated and measured organ doses derived from ICRP 106 and ICRP 80 for kidney doses were from 17.00% to 40.00% and for urinary bladder dose was 18.46% to 18.75%. There is a significant

  12. Cervical lymph node hyperplasia on [18F]-fluorodeoxyglucose positron emission tomography/computed tomography scan after treatment of children and adolescents with malignant lymphoma

    International Nuclear Information System (INIS)

    Hu, Ying-Ying; Zhang, Xu; Long, Wen; Lin, Xiao-Ping; Zhang, Ya-Rui; Li, Yuan-Hua; Xiao, Zi-Zheng; Zheng, Rong-Liang; Liang, Pei-Yan; Fan, Wei

    2015-01-01

    Highlights: • Cervical lymph node hyperplasia is a benign processes. • Lymph node hyperplasia found in treated children and adolescents with lymphoma. • We define imaging manifestations of cervical lymph node hyperplasia in PET/CT. • Awareness of lymph node hyperplasia avoid invasive procedures and over-treatment. - Abstract: Purpose: To define imaging manifestations and clinical prognosis of cervical lymph node hyperplasia using [ 18 F]-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scanning after treatment of children and adolescents with malignant lymphoma. Methods: Children and adolescent patients with malignant lymphoma who had high FDG uptake in their cervical lymph nodes via PET/CT after treatment, which was not due to tumor recurrence or residue, were retrospectively analyzed. Results: Twenty-seven patients with a median age of 12 years were included; 11 had Hodgkin's disease and 16 had non-Hodgkin's lymphoma. The time from PET/CT scan to completion of therapy was 1–36 months, 85.2% (23/27) of which took place within 12 months. Three patients had confirmed lymph node follicular hyperplasia by biopsy, while all 27 patients achieved disease-free survival during the follow-up period. The maximum standardized uptake values (SUV max ) of cervical lymph nodes were 2.2–16.2 and the maximum short axis ranged from 0.3 to 1.2 cm. Cervical lymph node hyperplasia was noted in neck levels I–V, and neck level II bilaterally had the highest incidence (100%). Bilateral cervical lymph node hyperplasia was symmetrical in terms of both the SUV max and affected locations. Thymic hyperplasia and nasopharyngeal lymphoid hyperplasia were both observed in 24 patients (88.9%). There was no relationship in terms of the SUV max between cervical lymph nodes and thymic tissue, cervical nodes or nasopharyngeal lymphoid tissue. Conclusion: Cervical lymph node hyperplasia with high FDG uptake on PET/CT scans found after treating

  13. Positron Emission Tomography/Computed Tomography Assessment After Immunochemotherapy and Irradiation Using the Lugano Classification Criteria in the IELSG-26 Study of Primary Mediastinal B-Cell Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Ceriani, Luca, E-mail: luca.ceriani@eoc.ch [Nuclear Medicine and PET-CT Center, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Martelli, Maurizio [Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome (Italy); Gospodarowicz, Maria K. [Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Ricardi, Umberto [Department of Oncology, University of Torino, Torino (Italy); Ferreri, Andrés J.M. [Unit of Lymphoid Malignancies, Department of Onco-Hematology, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milano (Italy); Chiappella, Annalisa [Hematology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Torino (Italy); Stelitano, Caterina [Hematology, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria (Italy); Balzarotti, Monica [Hematology, IRCCS Humanitas Cancer Center, Rozzano, Milan (Italy); Cabrera, Maria E. [Hematology, Hospital del Salvador, Universidad de Chile, Santiago (Chile); Cunningham, David [Department of Medicine, The Royal Marsden National Health Service Foundation Trust, London and Surrey (United Kingdom); Guarini, Attilio [Hematology Unit, Istituto Nazionale Tumori Giovanni Paolo II IRCCS, Bari (Italy); Zinzani, Pier Luigi [Institute of Hematology and Medical Oncology, Policlinico S.Orsola-Malpighi, Bologna (Italy); Giovanella, Luca [Nuclear Medicine and PET-CT Center, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Johnson, Peter W.M. [Cancer Research UK Centre, University of Southampton, Southampton (United Kingdom); Zucca, Emanuele [Oncology Department, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland)

    2017-01-01

    Purpose: To assess the predictive value of {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for disease recurrence after immunochemotherapy (R-CHT) and mediastinal irradiation (RT), using the recently published criteria of the Lugano classification to predict outcomes for patients with primary mediastinal large B-cell lymphoma. Methods and Materials: Among 125 patients prospectively enrolled in the IELSG-26 study, 88 were eligible for central review of PET/CT scans after completion of RT. Responses were evaluated using the 5-point Deauville scale at the end of induction R-CHT and after consolidation RT. According to the Lugano classification, a complete metabolic response (CMR) was defined by a Deauville score (DS) ≤3. Results: The CMR (DS1, -2, or -3) rate increased from 74% (65 patients) after R-CHT to 89% (78 patients) after consolidation RT. Among the 10 patients (11%) with persistently positive scans, the residual uptake after RT was slightly higher than the liver uptake in 6 patients (DS4; 7%) and markedly higher in 4 patients (DS5; 4%): these patients had a significantly poorer 5-year progression-free survival and overall survival. At a median follow-up of 60 months (range, 35-107 months), no patients with a CMR after RT have relapsed. Among the 10 patients who did not reach a CMR, 3 of the 4 patients (positive predictive value, 75%) with DS5 after RT had subsequent disease progression (within the RT volume in all cases) and died. All patients with DS4 had good outcomes without recurrence. Conclusions: All the patients obtaining a CMR defined as DS ≤3 remained progression-free at 5 years, confirming the excellent negative predictive value of the Lugano classification criteria in primary mediastinal large B-cell lymphoma patients. The few patients with DS4 also had an excellent outcome, suggesting that they do not necessarily require additional therapy, because the residual {sup 18}F-fluorodeoxyglucose uptake may

  14. Correlation between Standardized Uptake Value of 68Ga-DOTA-NOC Positron Emission Tomography/Computed Tomography and Pathological Classification of Neuroendocrine Tumors.

    Science.gov (United States)

    Kaewput, Chalermrat; Suppiah, Subapriya; Vinjamuri, Sobhan

    2018-01-01

    The aim of our study was to correlate tumor uptake of 68 Ga-DOTA-NOC positron emission tomography/computed tomography (PET/CT) with the pathological grade of neuroendocrine tumors (NETs). 68 Ga-DOTA-NOC PET/CT examinations in 41 patients with histopathologically proven NETs were included in the study. Maximum standardized uptake value (SUV max ) and averaged SUV SUV mean of "main tumor lesions" were calculated for quantitative analyses after background subtraction. Uptake on main tumor lesions was compared and correlated with the tumor histological grade based on Ki-67 index and pathological differentiation. Classification was performed into three grades according to Ki-67 levels; low grade: Ki-67 20. Pathological differentiation was graded into well- and poorly differentiated groups. The values were compared and evaluated for correlation and agreement between the two parameters was performed. Our study revealed negatively fair agreement between SUV max of tumor and Ki-67 index ( r = -0.241) and negatively poor agreement between SUV mean of tumor and Ki-67 index ( r = -0.094). SUV max of low-grade, intermediate-grade, and high-grade Ki-67 index is 26.18 ± 14.56, 30.71 ± 24.44, and 6.60 ± 4.59, respectively. Meanwhile, SUV mean of low-grade, intermediate-grade, and high-grade Ki-67 is 8.92 ± 7.15, 9.09 ± 5.18, and 3.00 ± 1.38, respectively. As expected, there was statistically significant decreased SUV max and SUV mean in high-grade tumors (poorly differentiated NETs) as compared with low- and intermediate-grade tumors (well-differentiated NETs). SUV of 68 Ga-DOTA-NOC PET/CT is not correlated with histological grade of NETs. However, there was statistically significant decreased tumor uptake of 68 Ga-DOTA-NOC in poorly differentiated NETs as compared with the well-differentiated group. As a result of this pilot study, we confirm that the lower tumor uptake of 68 Ga-DOTA-NOC may be associated with aggressive behavior and may, therefore, result in poor prognosis.

  15. Cervical lymph node hyperplasia on [{sup 18}F]-fluorodeoxyglucose positron emission tomography/computed tomography scan after treatment of children and adolescents with malignant lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Ying-Ying, E-mail: huyy@sysucc.org.cn; Zhang, Xu, E-mail: zhangxu2@sysucc.org.cn; Long, Wen, E-mail: longwen2@sysucc.org.cn; Lin, Xiao-Ping, E-mail: linxp@sysucc.org.cn; Zhang, Ya-Rui, E-mail: zhangyr@sysucc.org.cn; Li, Yuan-Hua, E-mail: liyh@sysucc.org.cn; Xiao, Zi-Zheng, E-mail: xiaozzh@sysucc.org.cn; Zheng, Rong-Liang, E-mail: zhengrl@sysucc.org.cn; Liang, Pei-Yan, E-mail: liangpy@sysucc.org.cn; Fan, Wei, E-mail: fanwei@sysucc.org.cn

    2015-07-15

    Highlights: • Cervical lymph node hyperplasia is a benign processes. • Lymph node hyperplasia found in treated children and adolescents with lymphoma. • We define imaging manifestations of cervical lymph node hyperplasia in PET/CT. • Awareness of lymph node hyperplasia avoid invasive procedures and over-treatment. - Abstract: Purpose: To define imaging manifestations and clinical prognosis of cervical lymph node hyperplasia using [{sup 18}F]-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scanning after treatment of children and adolescents with malignant lymphoma. Methods: Children and adolescent patients with malignant lymphoma who had high FDG uptake in their cervical lymph nodes via PET/CT after treatment, which was not due to tumor recurrence or residue, were retrospectively analyzed. Results: Twenty-seven patients with a median age of 12 years were included; 11 had Hodgkin's disease and 16 had non-Hodgkin's lymphoma. The time from PET/CT scan to completion of therapy was 1–36 months, 85.2% (23/27) of which took place within 12 months. Three patients had confirmed lymph node follicular hyperplasia by biopsy, while all 27 patients achieved disease-free survival during the follow-up period. The maximum standardized uptake values (SUV{sub max}) of cervical lymph nodes were 2.2–16.2 and the maximum short axis ranged from 0.3 to 1.2 cm. Cervical lymph node hyperplasia was noted in neck levels I–V, and neck level II bilaterally had the highest incidence (100%). Bilateral cervical lymph node hyperplasia was symmetrical in terms of both the SUV{sub max} and affected locations. Thymic hyperplasia and nasopharyngeal lymphoid hyperplasia were both observed in 24 patients (88.9%). There was no relationship in terms of the SUV{sub max} between cervical lymph nodes and thymic tissue, cervical nodes or nasopharyngeal lymphoid tissue. Conclusion: Cervical lymph node hyperplasia with high FDG uptake on PET/CT scans found

  16. Use of computed tomography and positron emission tomography/computed tomography for staging of local extent in patients with malignant pleural mesothelioma.

    Science.gov (United States)

    Frauenfelder, Thomas; Kestenholz, Peter; Hunziker, Roger; Nguyen, Thi Dan Linh; Fries, Martina; Veit-Haibach, Patrick; Husmann, Lars; Stahel, Rolf; Weder, Walter; Opitz, Isabelle

    2015-01-01

    The objective of this study was to determine the diagnostic value of computed tomography (CT) and positron emission tomography (PET)/CT for staging of malignant pleural mesothelioma (MPM) in patients undergoing induction chemotherapy. Sixty-two patients (median age, 61 years; female: n = 9) with proven MPM underwent CT after induction chemotherapy. Of these, 28 underwent additional PET/CT. Extrapleural pneumonectomy was performed for pathological TNM staging. Clinical TNM stage was assessed by 3 independent readers. Relative and absolute underestimation and overestimation were compared with pathological tumor stage. Sensitivity, specificity, and accuracy for differentiation between stages T2 and T3 were assessed. Interobserver agreement between the readers was analyzed (κ). Positron emission tomography/CT and CT underestimated T stage in up to 30% of the cases. Positron emission tomography/CT had a higher accuracy for tumor extent compared with CT (PET/CT: 0.92; CT: 0.84). The accuracy for nodal staging was higher for CT than for PET/CT (PET/CT: 0.78; CT: 0.87). Concerning International Mesothelioma Interest Group classification, PET/CT improved the accuracy of preoperative staging compared with CT (PET/CT: 0.91; CT: 0.82). Interobserver agreement was moderate for CT (0.48-0.62) and good for PET/CT (0.64-0.83) for T staging. For nodal staging, interobserver agreement was fair to moderate for CT and good for PET/CT (CT: 0.37-0.51; PET/CT: 0.73-0.76). Positron emission tomography/CT is more accurate and has a lower interobserver variability for clinical intrathoracic staging of MPM compared with CT. Nevertheless PET/CT underestimated tumor stage in a substantial number of cases, showing the need for a more accurate imaging technology or approach.

  17. Computed tomography and (18)F-fluorodeoxyglucose positron emission tomography/computed tomography findings in adrenal candidiasis and histoplasmosis: two cases.

    Science.gov (United States)

    Altinmakas, Emre; Guo, Ming; Kundu, Uma R; Habra, Mouhammed Amir; Ng, Chaan

    2015-01-01

    We report the contrast-enhanced computed tomography (CT) and (18)F-fluorodeoxyglucose positron emission tomography findings in adrenal histoplasmosis and candidiasis. Both demonstrated bilateral hypermetabolic heterogeneous adrenal masses with limited wash-out on delayed CT. Adrenal candidiasis has not been previously reported, nor have the CT wash-out findings in either infection. The adrenal imaging findings are indistinguishable from malignancy, which is more common; but in this setting, physicians should be alert to the differential diagnosis of fungal infections, since it can be equally deadly. Published by Elsevier Inc.

  18. Dystrophic calcification in muscles of legs in calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia syndrome: Accurate evaluation of the extent with 99mTc-methylene diphosphonate single photon emission computed tomography/computed tomography

    International Nuclear Information System (INIS)

    Chakraborty, Partha Sarathi; Karunanithi, Sellam; Dhull, Varun Singh; Kumar, Kunal; Tripathi, Madhavi

    2015-01-01

    We present the case of a 35-year-old man with calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly and telangiectasia variant scleroderma who presented with dysphagia, Raynaud's phenomenon and calf pain. 99m Tc-methylene diphosphonate bone scintigraphy was performed to identify the extent of the calcification. It revealed extensive dystrophic calcification in the left thigh and bilateral legs which was involving the muscles and was well-delineated on single photon emission computed tomography/computed tomography. Calcinosis in scleroderma usually involves the skin but can be found in deeper periarticular tissues. Myopathy is associated with a poor prognosis

  19. Prognostic impact of clinician-based interpretation of 18F-fluorodeoxyglucose positron emission tomography/computed tomography reports obtained in patients with newly diagnosed diffuse large B-cell lymphoma

    DEFF Research Database (Denmark)

    Mylam, Karen J; El-Galaly, Tarec C; Hutchings, Martin

    2014-01-01

    The aim of this study was to evaluate the prognostic value of clinician interpretation of positron emission tomography/computed tomography (PET/CT) reports at mid-therapy, interim PET (I-PET) and after the end of first-line therapy (E-PET) in patients with diffuse large B-cell lymphoma (DLBCL.......001) for positive, indeterminate and negative interpretation of PET/CT reports. Progression-free survival and OS did not differ significantly in patients with a negative and an indeterminate I-PET report. The use of well-defined reporting criteria, e.g. the Deauville five-point scale, is likely to reduce the number...

  20. Morphologic and Metabolic Comparison of Treatment Responsiveness with 18Fludeoxyglucose-Positron Emission Tomography/Computed Tomography According to Lung Cancer Type

    Directory of Open Access Journals (Sweden)

    Mehmet Fatih Börksüz

    2016-06-01

    Full Text Available Objective: The aim of the present study was to evaluate the response to treatment by histopathologic type in patients with lung cancer and under follow-up with 18F-fluoro-2deoxy-glucose-positron emission tomography/computed tomography (18F-FDG PET/CT imaging by using Response Evaluation Criteria in Solid Tumors (RECIST and European Organisation for Research and Treatment of Cancer (EORTC criteria that evaluate morphologic and metabolic parameters. Methods: On two separate (pre- and post-treatment 18F-FDG PET/CT images, the longest dimension of primary tumor as well as of secondary lesions were measured and sum of these two measurements was recorded as the total dimension in 40 patients. PET parameters such as standardized uptake value (SUVmax, metabolic volume and total lesion glycolysis (TLG were also recorded for these target lesions on two separate 18F-FDG PET/CT images. The percent (% change was calculated for all these parameters. Morphologic evaluation was based on RECIST 1.1 and the metabolic evaluation was based on EORTC. Results: When evaluated before and after treatment, in spite of the statistically significant change (p0.05. In histopathologic typing, when we compare the post-treatment phase change with the treatment responses of RECIST 1.1 and EORTC criteria; for RECIST 1.1 in squamous cell lung cancer group, progression was observed in sixteen patients (57%, stability in seven patients (25%, partial response in five patients (18%; and for EORTC progression was detected in four patients (14%, stability in thirteen patients (47%, partial response in eleven patients (39%, in 12 of these patients an increase in stage (43%, in 4 of them a decrease in stage (14%, and in 12 of them stability in stage (43% were determined. But in adenocancer patients (n=7, for RECIST 1.1, progression was determined in four patients (57%, stability in two patients (29%, partial response in one patient (14%; for EORTC, progression in one patient (14

  1. Simultaneous 68Ga DOTATATE Positron Emission Tomography/Magnetic Resonance Imaging in Meningioma Target Contouring: Feasibility and Impact Upon Interobserver Variability Versus Positron Emission Tomography/Computed Tomography and Computed Tomography/Magnetic Resonance Imaging.

    Science.gov (United States)

    Maclean, J; Fersht, N; Sullivan, K; Kayani, I; Bomanji, J; Dickson, J; O'Meara, C; Short, S

    2017-07-01

    The increasing use of highly conformal radiation techniques to treat meningioma confers a greater need for accurate targeting. Several groups have shown that positron emission tomography/computed tomography (PET/CT) information alters meningioma targets contoured by single observers, but whether this translates into improved accuracy has not been defined. As magnetic resonance imaging (MRI) is the cornerstone of meningioma target contouring, simultaneous PET/MRI may be superior to PET/CT. We assessed whether 68 Ga DOTATATE PET imaging (from PET/CT and PET/MRI) reduced interobserver variability (IOV) in meningioma target volume contouring. Ten patients with meningioma underwent simultaneous 68 Ga DOTATATE PET/MRI followed by PET/CT. They were selected as it was anticipated that target volume definition in their cases would be particularly challenging. Three radiation oncologists contoured target volumes according to an agreed protocol: gross tumour volume (GTV) and clinical target volume (CTV) on CT/MRI alone, CT/MRI+PET(CT) and CT/MRI+PET(MRI). GTV/CTV Kouwenhoven conformity levels (KCL), regions of contour variation and qualitative differences between PET(CT) and PET(MRI) were evaluated. There was substantial IOV in contouring. GTV mean KCL: CT/MRI 0.34, CT/MRI+PET(CT) 0.38, CT/MRI+PET(MRI) 0.39 (P = 0.06). CTV mean KCL: CT/MRI 0.31, CT/MRI+PET(CT) 0.35, CT/MRI+PET(MRI) 0.35 (P = 0.04 for all groups; P > 0.05 for individual pairs). One observer consistently contoured largest and one smallest. Observers rarely decreased volumes in relation to PET. Most IOV occurred in bone followed by dural tail, postoperative bed and venous sinuses. Tumour edges were qualitatively clearer on PET(MRI) versus PET(CT), but this did not affect contouring. IOV in contouring challenging meningioma cases was large and only slightly improved with the addition of 68 Ga DOTATATE PET. Simultaneous PET/MRI for meningioma contouring is feasible, but did not improve IOV versus PET

  2. Effects of Respiration-Averaged Computed Tomography on Positron Emission Tomography/Computed Tomography Quantification and its Potential Impact on Gross Tumor Volume Delineation

    International Nuclear Information System (INIS)

    Chi, Pai-Chun Melinda; Mawlawi, Osama; Luo Dershan; Liao Zhongxing; Macapinlac, Homer A.; Pan Tinsu

    2008-01-01

    Purpose: Patient respiratory motion can cause image artifacts in positron emission tomography (PET) from PET/computed tomography (CT) and change the quantification of PET for thoracic patients. In this study, respiration-averaged CT (ACT) was used to remove the artifacts, and the changes in standardized uptake value (SUV) and gross tumor volume (GTV) were quantified. Methods and Materials: We incorporated the ACT acquisition in a PET/CT session for 216 lung patients, generating two PET/CT data sets for each patient. The first data set (PET HCT /HCT) contained the clinical PET/CT in which PET was attenuation corrected with a helical CT (HCT). The second data set (PET ACT /ACT) contained the PET/CT in which PET was corrected with ACT. We quantified the differences between the two datasets in image alignment, maximum SUV (SUV max ), and GTV contours. Results: Of the patients, 68% demonstrated respiratory artifacts in the PET HCT , and for all patients the artifact was removed or reduced in the corresponding PET ACT . The impact of respiration artifact was the worst for lesions less than 50 cm 3 and located below the dome of the diaphragm. For lesions in this group, the mean SUV max difference, GTV volume change, shift in GTV centroid location, and concordance index were 21%, 154%, 2.4 mm, and 0.61, respectively. Conclusion: This study benchmarked the differences between the PET data with and without artifacts. It is important to pay attention to the potential existence of these artifacts during GTV contouring, as such artifacts may increase the uncertainties in the lesion volume and the centroid location

  3. Variabilities of Magnetic Resonance Imaging-, Computed Tomography-, and Positron Emission Tomography-Computed Tomography-Based Tumor and Lymph Node Delineations for Lung Cancer Radiation Therapy Planning.

    Science.gov (United States)

    Karki, Kishor; Saraiya, Siddharth; Hugo, Geoffrey D; Mukhopadhyay, Nitai; Jan, Nuzhat; Schuster, Jessica; Schutzer, Matthew; Fahrner, Lester; Groves, Robert; Olsen, Kathryn M; Ford, John C; Weiss, Elisabeth

    2017-09-01

    To investigate interobserver delineation variability for gross tumor volumes of primary lung tumors and associated pathologic lymph nodes using magnetic resonance imaging (MRI), and to compare the results with computed tomography (CT) alone- and positron emission tomography (PET)-CT-based delineations. Seven physicians delineated the tumor volumes of 10 patients for the following scenarios: (1) CT only, (2) PET-CT fusion images registered to CT ("clinical standard"), and (3) postcontrast T1-weighted MRI registered with diffusion-weighted MRI. To compute interobserver variability, the median surface was generated from all observers' contours and used as the reference surface. A physician labeled the interface types (tumor to lung, atelectasis (collapsed lung), hilum, mediastinum, or chest wall) on the median surface. Contoured volumes and bidirectional local distances between individual observers' contours and the reference contour were analyzed. Computed tomography- and MRI-based tumor volumes normalized relative to PET-CT-based volumes were 1.62 ± 0.76 (mean ± standard deviation) and 1.38 ± 0.44, respectively. Volume differences between the imaging modalities were not significant. Between observers, the mean normalized volumes per patient averaged over all patients varied significantly by a factor of 1.6 (MRI) and 2.0 (CT and PET-CT) (P=4.10 × 10 -5 to 3.82 × 10 -9 ). The tumor-atelectasis interface had a significantly higher variability than other interfaces for all modalities combined (P=.0006). The interfaces with the smallest uncertainties were tumor-lung (on CT) and tumor-mediastinum (on PET-CT and MRI). Although MRI-based contouring showed overall larger variability than PET-CT, contouring variability depended on the interface type and was not significantly different between modalities, despite the limited observer experience with MRI. Multimodality imaging and combining different imaging characteristics might be the best approach to define

  4. Role of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography in diagnosis and management of pancreatic cancer; comparison with multidetector row computed tomography, magnetic resonance imaging and endoscopic ultrasonography.

    Science.gov (United States)

    Ergul, N; Gundogan, C; Tozlu, M; Toprak, H; Kadıoglu, H; Aydin, M; Cermik, T F

    2014-01-01

    We aimed to analyze the contribution of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging to the diagnosis and management of pancreatic cancer compared with multidetector row computed tomography (MDCT), magnetic resonance imaging (MRI) and endoscopic ultrasonography (EUS). We retrospectively scanned the data of 52 patients who were referred for FDG PET/CT imaging for evaluation of pancreatic lesions greater than 10mm. The diagnostic performances of 4 imaging methods and the impact of PET/CT on the management of pancreatic cancer were defined. Pancreatic adenocarcinoma was diagnosed in 33 of 52 patients (63%), 15 patients had benign diseases of pancreas (29%), and 4 patients were normal (8%). Sensitivity and NPV of EUS and PET/CT were equal (100%) and higher than MDCT and MRI. Specificity, PPV and NPV of PET/CT were significantly higher than MDCT. However, sensitivities of two imaging methods were not significantly different. There was no significant difference between PET/CT and MRI and EUS for these values. When the cut-off value of SUVmax was 3.2, the most effective sensitivity and specificity values were obtained. PET/CT contributed to the management of pancreatic cancer in 30% of patients. FDG PET/CT is a valuable imaging method for the diagnosis and management of pancreatic cancer, especially when applied along with EUS as first line diagnostic tools. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  5. False-positive uptake on 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) positron-emission tomography/computed tomography (PET/CT) in oncological imaging

    International Nuclear Information System (INIS)

    Culverwell, A.D.; Scarsbrook, A.F.; Chowdhury, F.U.

    2011-01-01

    With the increasing utilization of integrated positron-emission tomography/computed tomography (PET/CT) using the glucose analogue 2-[ 18 F]-fluoro-2-deoxy-D-glucose (FDG) in oncological imaging, it is important for radiologists and nuclear medicine physicians to be aware that FDG uptake is not specific for malignancy, as many different physiological variants and benign pathological conditions can also exhibit increased glucose metabolism. Such false-positive FDG uptake often arises outside the area of primary interest and may mimic malignant disease, thereby confounding accurate interpretation of PET/CT studies. With the use of illustrative clinical cases, this article will provide a systematic overview of potential interpretative pitfalls and illustrate how such unexpected findings can be appropriately evaluated.

  6. Influence of 2-(18F) fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography on recurrent ovarian cancer diagnosis and on selection of patients for secondary cytoreductive surgery

    DEFF Research Database (Denmark)

    Risum, Signe; Høgdall, Claus; Markova, Elena

    2009-01-01

    physical examination, US, or increasing cancer antigen 125 (CA125) level (>50 U/mL or >15% above baseline level). Recurrent OC was diagnosed 58 times in 52 patients. The sensitivities of US, CT, and PET/CT for diagnosing recurrence were 66% (P = 0.003), 81% (P = 0.0001), and 97% (P ...The objective of this prospective study was to compare the sensitivities and the specificities of combined 2-(F) fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (PET/CT), abdominal/transvaginal ultrasound (US), and CT for diagnosing recurrent ovarian cancer (OC......) and to evaluate the influence of PET/CT on referral of patients with solitary recurrence to secondary cytoreductive surgery. From April 2005 to November 2007, 60 patients were consecutively included to PET/CT 68 times. The inclusion criteria were remission of 3 months or longer and recurrent OC suspected from...

  7. Change in the diagnosis from classical Hodgkin's lymphoma to anaplastic large cell lymphoma by 18F flourodeoxyglucose positron emission tomography/computed tomography: Importance of recognising disease pattern on imaging and immunohistochemistry

    International Nuclear Information System (INIS)

    Senthil, Raja; Mohapatra, Ranjan Kumar; Sampath, Mouleeswaran Koramadai; Sundaraiya, Sumati

    2016-01-01

    Anaplastic large cell lymphoma (ALCL) is a rare type of nonHodgkin's lymphoma (NHL), but one of the most common subtypes of T-cell lymphoma. It is an aggressive T-cell lymphoma, and some ALCL may mimic less aggressive classical HL histopathlogically. It may be misdiagnosed unless careful immunohistochemical examination is performed. As the prognosis and management of these two lymphomas vary significantly, it is important to make a correct diagnosis. We describe a case who was diagnosed as classical HL by histopathological examination of cervical lymph node, in whom 18 F-flouro deoxyglucose positron emission tomography/computed tomography appearances were unusual for HL and warranted review of histopathology that revealed anaplastic lymphoma kinase-1 negative anaplastic large T-cell lymphoma, Hodgkin-like variant, thereby changing the management

  8. Primary central nervous system lymphoma in an human immunodeficiency virus-infected patient mimicking bilateral eye sign in brain seen in fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography.

    Science.gov (United States)

    Kamaleshwaran, Koramadai Karuppusany; Thirugnanam, Rajasekar; Shibu, Deepu; Kalarikal, Radhakrishnan Edathurthy; Shinto, Ajit Sugunan

    2014-04-01

    Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG PET/CT) has proven useful in the diagnosis, staging, and detection of metastasis and posttreatment monitoring of several malignancies in human immunodeficiency virus (HIV)-infected patients. It also has the ability to make the important distinction between malignancy and infection in the evaluation of central nervous system (CNS) lesions, leading to the initiation of the appropriate treatment and precluding the need for invasive biopsy. We report an interesting case of HIV positive 35-year-old woman presented with headache, disorientation, and decreased level of consciousness. She underwent whole body PET/CT which showed multiple lesions in the cerebrum which mimics bilateral eye in brain. A diagnosis of a primary CNS lymphoma was made and patient was started on chemotherapy.

  9. Primary central nervous system lymphoma in an human immunodeficiency virus-infected patient mimicking bilateral eye sign in brain seen in fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Kamaleshwaran, Koramadai Karuppusany; Thirugnanam, Rajasekar; Shibu, Deepu; Kalarikal, Radhakrishnan Edathurthy; Shinto, Ajit Sugunan

    2014-01-01

    Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG PET/CT) has proven useful in the diagnosis, staging, and detection of metastasis and posttreatment monitoring of several malignancies in human immunodeficiency virus (HIV)-infected patients. It also has the ability to make the important distinction between malignancy and infection in the evaluation of central nervous system (CNS) lesions, leading to the initiation of the appropriate treatment and precluding the need for invasive biopsy. We report an interesting case of HIV positive 35-year-old woman presented with headache, disorientation, and decreased level of consciousness. She underwent whole body PET/CT which showed multiple lesions in the cerebrum which mimics bilateral eye in brain. A diagnosis of a primary CNS lymphoma was made and patient was started on chemotherapy

  10. Clinicopathological and prognostic relevance of uptake level using 18F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in primary breast cancer

    International Nuclear Information System (INIS)

    Ueda, Shigeto; Tsuda, Hitoshi; Asakawa, Hideki

    2008-01-01

    Using integrated 18 F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging ( 18 F-FDG PET/CT), the clinical significance of 18 F-FDG uptake was evaluated in patients with primary breast cancer. Clinicopathological correlation with the level of maximum standardized uptake values (SUV) 60 min obtained from preoperative 18 F-FDG PET/CT were examined in 152 patients with primary breast cancer. The prognostic impact of the level of SUV was explored using simulated prognosis derived from computed program Adjuvant! in 136 (89%) patients with invasive ductal carcinoma (IDC). High SUV level was significantly correlated with tumor invasive size (≤2 cm) (P 18 F-FDG would be predictive of poor prognosis in patients with primary breast cancer, and aggressive features of cancer cells in patients with early breast cancer. 18 F-FDG PET/CT could be a useful tool to pretherapeutically predict biological characteristics and baseline risk of breast cancer. (author)

  11. Late prosthetic graft infection after frozen elephant trunk presenting by haemoptysis and positive ¹⁸F-fluorodeoxyglucose-positron emission tomography/computed tomography.

    Science.gov (United States)

    Morjan, Mohammed; Ali, Khaldoun; Harringer, Wolfgang; El-Essawi, Aschraf

    2014-11-01

    In cardiothoracic surgery, prosthetic graft infection represents a diagnostic and therapeutic challenge. Although clinical assessment, imaging techniques and microbiological investigations are helpful, late graft infection can be difficult to identify using classical diagnostic tools. An aggressive surgical approach involving removal and replacement of all prosthetic materials is technically demanding but remains the best strategy to eradicate infection. Herein, we report a case of a late aortic graft infection, after frozen elephant trunk implantation with atypical presentation, diagnosed with (18)F-fluorodeoxyglucose-positron emission tomography and treated successfully through a radical surgical strategy. This case emphasizes the emerging diagnostic role of positron emission tomography and encourages the adoption of an aggressive surgical approach. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  12. Positron emission tomography/computed tomographic and magnetic resonance imaging in a murine model of progressive atherosclerosis using (64)Cu-labeled glycoprotein VI-Fc.

    Science.gov (United States)

    Bigalke, Boris; Phinikaridou, Alkystis; Andia, Marcelo E; Cooper, Margaret S; Schuster, Andreas; Schönberger, Tanja; Griessinger, Christoph M; Wurster, Thomas; Onthank, David; Ungerer, Martin; Gawaz, Meinrad; Nagel, Eike; Botnar, Rene M

    2013-11-01

    Plaque erosion leads to exposure of subendothelial collagen, which may be targeted by glycoprotein VI (GPVI). We aimed to detect plaque erosion using (64)Cu-labeled GPVI-Fc (fragment crystallized). Four-week-old male apolipoprotein E-deficient (ApoE(-/-)) mice (n=6) were fed a high-fat diet for 12 weeks. C57BL/6J wild-type (WT) mice served as controls (n=6). Another group of WT mice received a ligation injury of the left carotid artery (n=6) or sham procedure (n=4). All mice received a total activity of ≈12 MBq (64)Cu-GPVI-Fc by tail vein injection followed by delayed (24 hours) positron emission tomography using a NanoPET/computed tomographic scanner (Mediso, Hungary; Bioscan, USA) with an acquisition time of 1800 seconds. Seventy-two hours after positron emission tomography/computed tomography, all mice were scanned 2 hours after intravenous administration of 0.2 mmol/kg body weight of a gadolinium-based elastin-specific MR contrast agent. MRI was performed on a 3-T clinical scanner (Philips Healthcare, Best, The Netherlands). In ApoE(-/-) mice, the (64)Cu-GPVI-Fc uptake in the aortic arch was significantly higher compared with WT mice (ApoE(-/-): 13.2±1.5 Bq/cm(3) versus WT mice: 5.1±0.5 Bq/cm(3); P=0.028). (64)Cu-GPVI-Fc uptake was also higher in the injured left carotid artery wall compared with the intact right carotid artery of WT mice and as a trend compared with sham procedure (injured: 20.7±1.3 Bq/cm(3) versus intact: 2.3±0.5 Bq/cm(3); P=0.028 versus sham: 12.7±1.7 Bq/cm(3); P=0.068). Results were confirmed by ex vivo histology and in vivo MRI with elastin-specific MR contrast agent that measures plaque burden and vessel wall remodeling. Higher R1 relaxation rates were found in the injured carotid wall with a T1 mapping sequence (injured: 1.44±0.08 s(-1) versus intact: 0.91±0.02 s(-1); P=0.028 versus sham: 0.97±0.05 s(-1); P=0.068) and in the aortic arch of ApoE(-/-) mice compared with WT mice (ApoE(-/-): 1.49±0.05 s(-1) versus WT: 0.92±0.04 s

  13. Simultaneous whole body (18)F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging for evaluation of pediatric cancer: Preliminary experience and comparison with (18)F-fluorodeoxyglucose positron emission tomography computed tomography.

    Science.gov (United States)

    Pugmire, Brian S; Guimaraes, Alexander R; Lim, Ruth; Friedmann, Alison M; Huang, Mary; Ebb, David; Weinstein, Howard; Catalano, Onofrio A; Mahmood, Umar; Catana, Ciprian; Gee, Michael S

    2016-03-28

    To describe our preliminary experience with simultaneous whole body (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography and magnetic resonance imaging (PET-MRI) in the evaluation of pediatric oncology patients. This prospective, observational, single-center study was Health Insurance Portability and Accountability Act-compliant, and institutional review board approved. To be eligible, a patient was required to: (1) have a known or suspected cancer diagnosis; (2) be under the care of a pediatric hematologist/oncologist; and (3) be scheduled for clinically indicated (18)F-FDG positron emission tomography-computed tomography (PET-CT) examination at our institution. Patients underwent PET-CT followed by PET-MRI on the same day. PET-CT examinations were performed using standard department protocols. PET-MRI studies were acquired with an integrated 3 Tesla PET-MRI scanner using whole body T1 Dixon, T2 HASTE, EPI diffusion-weighted imaging (DWI) and STIR sequences. No additional radiotracer was given for the PET-MRI examination. Both PET-CT and PET-MRI examinations were reviewed by consensus by two study personnel. Test performance characteristics of PET-MRI, for the detection of malignant lesions, including FDG maximum standardized uptake value (SUVmax) and minimum apparent diffusion coefficient (ADCmin), were calculated on a per lesion basis using PET-CT as a reference standard. A total of 10 whole body PET-MRI exams were performed in 7 pediatric oncology patients. The mean patient age was 16.1 years (range 12-19 years) including 6 males and 1 female. A total of 20 malignant and 21 benign lesions were identified on PET-CT. PET-MRI SUVmax had excellent correlation with PET-CT SUVmax for both benign and malignant lesions (R = 0.93). PET-MRI SUVmax > 2.5 had 100% accuracy for discriminating benign from malignant lesions using PET-CT reference. Whole body DWI was also evaluated: the mean ADCmin of malignant lesions (780.2 + 326.6) was significantly lower than

  14. Simultaneous whole body 18F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging for evaluation of pediatric cancer: Preliminary experience and comparison with 18F-fluorodeoxyglucose positron emission tomography computed tomography

    Science.gov (United States)

    Pugmire, Brian S; Guimaraes, Alexander R; Lim, Ruth; Friedmann, Alison M; Huang, Mary; Ebb, David; Weinstein, Howard; Catalano, Onofrio A; Mahmood, Umar; Catana, Ciprian; Gee, Michael S

    2016-01-01

    AIM: To describe our preliminary experience with simultaneous whole body 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography and magnetic resonance imaging (PET-MRI) in the evaluation of pediatric oncology patients. METHODS: This prospective, observational, single-center study was Health Insurance Portability and Accountability Act-compliant, and institutional review board approved. To be eligible, a patient was required to: (1) have a known or suspected cancer diagnosis; (2) be under the care of a pediatric hematologist/oncologist; and (3) be scheduled for clinically indicated 18F-FDG positron emission tomography-computed tomography (PET-CT) examination at our institution. Patients underwent PET-CT followed by PET-MRI on the same day. PET-CT examinations were performed using standard department protocols. PET-MRI studies were acquired with an integrated 3 Tesla PET-MRI scanner using whole body T1 Dixon, T2 HASTE, EPI diffusion-weighted imaging (DWI) and STIR sequences. No additional radiotracer was given for the PET-MRI examination. Both PET-CT and PET-MRI examinations were reviewed by consensus by two study personnel. Test performance characteristics of PET-MRI, for the detection of malignant lesions, including FDG maximum standardized uptake value (SUVmax) and minimum apparent diffusion coefficient (ADCmin), were calculated on a per lesion basis using PET-CT as a reference standard. RESULTS: A total of 10 whole body PET-MRI exams were performed in 7 pediatric oncology patients. The mean patient age was 16.1 years (range 12-19 years) including 6 males and 1 female. A total of 20 malignant and 21 benign lesions were identified on PET-CT. PET-MRI SUVmax had excellent correlation with PET-CT SUVmax for both benign and malignant lesions (R = 0.93). PET-MRI SUVmax > 2.5 had 100% accuracy for discriminating benign from malignant lesions using PET-CT reference. Whole body DWI was also evaluated: the mean ADCmin of malignant lesions (780.2 + 326.6) was

  15. Evaluation of diffuse large B-cell lymphoma patients with 64-slice multidetector computed tomography versus 18FDG positron emission tomography/computed tomography in initial staging and restaging after treatment.

    Science.gov (United States)

    Gómez León, Nieves; Vega, Gema; Rodríguez-Vigil Junco, Beatriz; Suevos Ballesteros, Carlos

    2018-04-25

    To prospectively compare the accuracy in initial staging and end-of-treatment restaging of diffuse large B-cell lymphoma (DLBCL) between 64-slice multidetector computed tomography (64MDCT) and 18FDG positron emission tomography/computed tomography (18FGD PET/CT) with intravenous contrast injection. Randomised and blind controlled clinical multicentric trial that included biopsy-proven DLBCL patients. Seventy-two patients from five different hospitals in the region of Madrid, Spain, were enrolled in the study between January 2012 and June 2015. Thirty-six were randomly allocated to 18FDG PET/TC and the other 36 to 64MDCT for initial staging and end-of-treatment restaging. A nuclear medicine physician and a radiologist independently analysed 18FDG PET/TC images and reached an agreement post-hoc. 64MDCT images were separately evaluated by a different radiologist. Every set of images was compared to the reference standard that included clinical data, complementary tests and follow-up. The study was approved by participating centres' ethics committees and written informed consent was obtained from all the participants. A good agreement was observed between both diagnostic techniques and the reference standard in initial staging [18FDG PET/CT (k=0.5) and 64MDCT (k=0.6)], although only the 18FDG PET/TC showed a good agreement with the reference standard for the end-of-treatment restaging (k=0.7). In DLBCL, both 18FDG PET/TC and 64MDCT have shown good agreement with the reference standard in initial staging. Nevertheless, 18FDG PET/CT has shown to be superior to 64MDCT in end-of-treatment response assessment. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  16. False-positive 18F-fluorodeoxyglucose positron emission tomography/computed tomography in a patient with metallic implants following chondrosarcoma resection.

    Science.gov (United States)

    Zhou, P U; Tang, Jinliang; Zhang, Dong; Li, Guanghui

    2016-05-01

    Positron emission tomography (PET) with fluorine-18-labeled fluorodeoxyglucose ( 18 F-FDG) has been used for the staging and evaluation of recurrence in cancer patients. We herein report a false-positive result of 18 F-FDG PET/computed tomography (CT) scan in a patient following chondrosarcoma resection and metallic implanting. A 35-year-old male patient with chondrosarcoma of the left iliac bone underwent radical resection, metal brace implanting and radiotherapy. A high uptake of 18 F-FDG was observed in the metallic implants and adjacent tissue during PET/CT scanning in the 5th year of follow-up. Tissue biopsy and follow-up examination identified no tumor recurrence or infection at these sites, suggesting that the results of 18 F-FDG PET/CT must be interpreted with caution in cancer patients with metallic implants.

  17. Program standard of quality control for a system of Positron Emission Tomography-computed tomography (PET-CT) used in the Foundation Valle de Lili

    International Nuclear Information System (INIS)

    Nunez, Nathalia I.; Benavides, Sivor O.; Lopera, Wilson

    2013-01-01

    A standard protocol of quality control in the Fundacion Valle del Lili for the implementation of a multimodal scanner developed emission tomography BIOGRAPH mCT X-3R of SIEMENS ® covering routine testing, frequency, acceptance ranges necessary corrective and preventive measures to detect and correct any faults and proceed if the upper detection precision and accuracy ranges accepted deviations actions. In order to minimize errors in the planning and management of patient dose, thereby improving the quality of the diagnostic image with the dose of radiation is reasonably low as possible, consistent with the clinical use of the equipment used and the information requested diagnostic study

  18. 99m-Tc-ubiquicidin scintigraphy in diagnosis of knee prosthesis infection and comparison with F-18 fluorodeoxy-glucose positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Kamaleshwaran, Koramadai Karuppusamy; Rajkumar, N; Mohanan, Vyshak; Kalarikal, Radhakrishnan; Shinto, Ajit Sugunan

    2005-01-01

    Total knee arthroplasty has witnessed a significant increase in recent years. Despite the advantages of this surgical procedure, it has some complications, the most serious of which is prosthetic infection. The discrimination of bacterial infections from sterile inflammatory processes is of great importance in the management of periprosthetic infection (PPI). Ubiquicidin (UBI) is a synthetic antimicrobial peptide fragment reported to be highly infection-specific. Tc99m-UBI has recently been reported to be a promising radiotracer for infection imaging. We report a case of left knee PPI diagnosed using 99mTc-UBI scintigraphy and compared with F-18 fluorodeoxy-glucose positron emission tomography

  19. Detection of distant metastases in patients with locally advanced breast cancer: role of {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography and conventional imaging with computed tomography scans

    Energy Technology Data Exchange (ETDEWEB)

    Bitencourt, Almir Galvao Vieira; Andrade, Wesley Pereira; Cunha, Rodrigo Rodrigues da; Conrado, Jorge Luis Fonseca de Acioli; Lima, Eduardo Nobrega Pereira; Barbosa, Paula Nicole Vieira Pinto; Chojniak, Rubens, E-mail: rodrigo.rcunha@hotmail.com [A. C. Camargo Cancer Center, Sao Paulo, SP (Brazil); Hospital Beneficincia Portuguesa de Sao Paulo, Sao Paulo, SP (Brazil)

    2017-07-15

    Objective: To evaluate positron emission tomography/computed tomography (PET/CT) and conventional imaging tests for the detection of distant metastases in patients with locally advanced breast cancer. Materials and Methods: We included 81 patients with breast cancer who had undergone {sup 18}-fluorodeoxyglucose (FDG) PET/CT before treatment. Conventional imaging included the following: bone scintigraphy; chest X-ray (in 14.5%) or CT (in 85.5%); and abdominal ultrasound (in 10.8%), CT (in 87.8%), or magnetic resonance imaging (in 1.4%). Histopathology and clinical/imaging follow-up served as reference. Results: Distant metastases were observed in nine patients (11.1%). On patient-based analysis, conventional imaging identified distant metastases in all 9 patients. In one patient, the initial {sup 18}F-FDG PET/CT failed to demonstrate bone metastases that was evident on bone scintigraphy. In two patients, the CT scan failed to show extra-axillary lymph node metastases that were identified on {sup 18}F-FDG PET/CT. There was no significant difference between {sup 18}F-FDG PET/CT and conventional imaging in terms of their sensitivity for the detection of distant metastases in patients with locally advanced breast cancer. Conclusion: This study showed that {sup 18}F-FDG PET/CT and conventional imaging with CT scans had similar sensitivity for the diagnosis of distant metastases in patients with locally advanced breast cancer. {sup 18}F-FDG PET/CT can add information about extra-axillary lymph node involvements. (author)

  20. Imaging atherosclerosis with hybrid [18F]fluorodeoxyglucose positron emission tomography/computed tomography imaging: what Leonardo da Vinci could not see.

    Science.gov (United States)

    Cocker, Myra S; Mc Ardle, Brian; Spence, J David; Lum, Cheemun; Hammond, Robert R; Ongaro, Deidre C; McDonald, Matthew A; Dekemp, Robert A; Tardif, Jean-Claude; Beanlands, Rob S B

    2012-12-01

    Prodigious efforts and landmark discoveries have led toward significant advances in our understanding of atherosclerosis. Despite significant efforts, atherosclerosis continues globally to be a leading cause of mortality and reduced quality of life. With surges in the prevalence of obesity and diabetes, atherosclerosis is expected to have an even more pronounced impact upon the global burden of disease. It is imperative to develop strategies for the early detection of disease. Positron emission tomography (PET) imaging utilizing [(18)F]fluorodeoxyglucose (FDG) may provide a non-invasive means of characterizing inflammatory activity within atherosclerotic plaque, thus serving as a surrogate biomarker for detecting vulnerable plaque. The aim of this review is to explore the rationale for performing FDG imaging, provide an overview into the mechanism of action, and summarize findings from the early application of FDG PET imaging in the clinical setting to evaluate vascular disease. Alternative imaging biomarkers and approaches are briefly discussed.

  1. 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Accuracy in the Staging of Non-Small Cell Lung Cancer: Review and Cost-Effectiveness

    International Nuclear Information System (INIS)

    Gómez León, Nieves; Escalona, Sofía; Bandrés, Beatriz; Belda, Cristobal; Callejo, Daniel; Blasco, Juan Antonio

    2014-01-01

    Aim of the performed clinical study was to compare the accuracy and cost-effectiveness of PET/CT in the staging of non-small cell lung cancer (NSCLC). Material and Methods. Cross-sectional and prospective study including 103 patients with histologically confirmed NSCLC. All patients were examined using PET/CT with intravenous contrast medium. Those with disease stage ≤IIB underwent surgery (n = 40). Disease stage was confirmed based on histology results, which were compared with those of PET/CT and positron emission tomography (PET) and computed tomography (CT) separately. 63 patients classified with ≥IIIA disease stage by PET/CT did not undergo surgery. The cost-effectiveness of PET/CT for disease classification was examined using a decision tree analysis. Results. Compared with histology, the accuracy of PET/CT for disease staging has a positive predictive value of 80%, a negative predictive value of 95%, a sensitivity of 94%, and a specificity of 82%. For PET alone, these values are 53%, 66%, 60%, and 50%, whereas for CT alone they are 68%, 86%, 76%, and 72%, respectively. Incremental cost-effectiveness of PET/CT over CT alone was €17,412 quality-adjusted life-year (QALY). Conclusion. In our clinical study, PET/CT using intravenous contrast medium was an accurate and cost-effective method for staging of patients with NSCLC

  2. 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Accuracy in the Staging of Non-Small Cell Lung Cancer: Review and Cost-Effectiveness

    International Nuclear Information System (INIS)

    Leon, N.G.; Bandrs, B.; Escalona, S.; Callejo, D.; Blasco, J.A.; Belda, C.; Blasco, J.A.

    2014-01-01

    Aim of the performed clinical study was to compare the accuracy and cost-effectiveness of PET/CT in the staging of non-small cell lung cancer (NSCLC). Material and Methods. Cross-sectional and prospective study including 103 patients with histologically confirmed NSCLC. All patients were examined using PET/CT with intravenous contrast medium. Those with disease stage ≤IIB underwent surgery (η=40). Disease stage was confirmed based on histology results, which were compared with those of PET/CT and positron emission tomography (PET) and computed tomography (CT) separately. 63 patients classified with ≥IIIA disease stage by PET/CT did not undergo surgery. The cost-effectiveness of PET/CT for disease classification was examined using a decision tree analysis. Results. Compared with histology, the accuracy of PET/CT for disease staging has a positive predictive value of 80%, a negative predictive value of 95%, a sensitivity of 94%, and a specificity of 82%. For PET alone, these values are 53%, 66%, 60%, and 50%, whereas for CT alone they are 68%, 86%, 76%, and 72%, respectively. Incremental cost-effectiveness of PET/CT over CT alone was €17,412 quality-adjusted life-year (QALY). Conclusion. In our clinical study, PET/CT using intravenous contrast medium was an accurate and cost-effective method for staging of patients with NSCLC

  3. F-18 fluoride positron emission tomography/computed tomography in the diagnosis of avascular necrosis of the femoral head: Comparison with magnetic resonance imaging

    Science.gov (United States)

    Gayana, Shankaramurthy; Bhattacharya, Anish; Sen, Ramesh Kumar; Singh, Paramjeet; Prakash, Mahesh; Mittal, Bhagwant Rai

    2016-01-01

    Objective: Femoral head avascular necrosis (FHAVN) is one of the increasingly common causes of musculoskeletal disability and poses a major diagnostic and therapeutic challenge. Although radiography, scintigraphy, computed tomography (CT), and magnetic resonance imaging (MRI) have been widely used in the diagnosis of FHAVN, positron emission tomography (PET) has recently been evaluated to assess vascularity of the femoral head. In this study, the authors compared F-18 fluoride PET/CT with MRI in the initial diagnosis of FHAVN. Patients and Methods: We prospectively studied 51 consecutive patients with a high clinical suspicion of FHAVN. All patients underwent MRI and F-18 fluoride PET/CT, the time interval between the two scans being 4–10 (mean 8) days. Two nuclear medicine physicians blinded to the MRI report read the PET/CT scans. Clinical assessment was also done. Final diagnoses were made by surgical pathology or clinical and radiologic follow-up. Results: A final diagnosis of avascular necrosis (AVN) was made in 40 patients. MRI was 96.5% sensitive, 100% specific, and 98.03% accurate while PET/CT was 100% sensitive, specific, and accurate in diagnosing FHAVN. The agreement between the two imaging modalities for the diagnosis of AVN was 96.07%. Conclusion: F-18 fluoride PET/CT showed good agreement with MRI in the initial diagnosis of FHAVN and can be better than MRI in detecting early disease. PMID:26917886

  4. F-18 fluoride positron emission tomography/computed tomography in the diagnosis of avascular necrosis of the femoral head: Comparison with magnetic resonance imaging

    International Nuclear Information System (INIS)

    Gayana, Shankaramurthy; Bhattacharya, Anish; Sen, Ramesh Kumar; Singh, Paramjeet; Prakash, Mahesh; Mittal, Bhagwant Rai

    2016-01-01

    Femoral head avascular necrosis (FHAVN) is one of the increasingly common causes of musculoskeletal disability and poses a major diagnostic and therapeutic challenge. Although radiography, scintigraphy, computed tomography (CT), and magnetic resonance imaging (MRI) have been widely used in the diagnosis of FHAVN, positron emission tomography (PET) has recently been evaluated to assess vascularity of the femoral head. In this study, the authors compared F-18 fluoride PET/CT with MRI in the initial diagnosis of FHAVN. We prospectively studied 51 consecutive patients with a high clinical suspicion of FHAVN. All patients underwent MRI and F-18 fluoride PET/CT, the time interval between the two scans being 4–10 (mean 8) days. Two nuclear medicine physicians blinded to the MRI report read the PET/CT scans. Clinical assessment was also done. Final diagnoses were made by surgical pathology or clinical and radiologic follow-up. A final diagnosis of avascular necrosis (AVN) was made in 40 patients. MRI was 96.5% sensitive, 100% specific, and 98.03% accurate while PET/CT was 100% sensitive, specific, and accurate in diagnosing FHAVN. The agreement between the two imaging modalities for the diagnosis of AVN was 96.07%. F-18 fluoride PET/CT showed good agreement with MRI in the initial diagnosis of FHAVN and can be better than MRI in detecting early disease

  5. Prospective Study of 68Ga-DOTATATE Positron Emission Tomography/Computed Tomography for Detecting Gastro-Entero-Pancreatic Neuroendocrine Tumors and Unknown Primary Sites.

    Science.gov (United States)

    Sadowski, Samira M; Neychev, Vladimir; Millo, Corina; Shih, Joanna; Nilubol, Naris; Herscovitch, Peter; Pacak, Karel; Marx, Stephen J; Kebebew, Electron

    2016-02-20

    Gastro-entero-pancreatic neuroendocrine tumors (GEPNETs) are increasing in incidence, and accurate staging is important for selecting the appropriate treatment. (68)Ga-DOTATATE imaging is a promising approach for detecting GEPNETs and could help in selecting optimal therapeutic strategies. The aim of this study was to prospectively determine the clinical utility of (68)Ga-DOTATATE positron emission tomography (PET)/computed tomography (CT) in detecting unknown primary and metastatic GEPNETs. One hundred thirty-one patients were enrolled in a prospective study of patients undergoing (68)Ga-DOTATATE PET/CT, (111)In-pentetreotide single-photon emission computed tomography (SPECT)/CT and multiphasic CT scan, and/or magnetic resonance imaging in a blinded fashion with comprehensive biochemical testing. The primary outcome measure was the detection of lesions by each imaging study. (68)Ga-DOTATATE PET/CT imaging detected 95.1% of lesions (95% CI, 92.4% to 96.8%) with an average maximum standardized uptake value of 65.4 ± 47 (range, 6.9 to 244), anatomic imaging detected 45.3% of lesions (95% CI, 37.9% to 52.9%), and (111)In-pentetreotide SPECT/CT detected 30.9% of lesions (95% CI, 25.0% to 37.5%), with a significant difference between imaging modalities (P < .001). In four of 14 patients (28.6%), (68)Ga-DOTATATE PET/CT found a previously unknown primary tumor, and detected primary GEPNET, lymph node, and distant metastases correctly in 72 of 113 lesions (63.7%) when compared with histopathology, with 22.1% and 38.9% detected by using (111)In-pentetreotide SPECT/CT and anatomic imaging, respectively. On the basis of findings with (68)Ga-DOTATATE PET/CT, 43 of 131 patients (32.8%) had a change in management recommendation. In patients with carcinoid symptoms but negative biochemical testing, (68)Ga-DOTATATE PET/CT detected lesions in 65.2% of patients, 40% of which were detected neither by anatomic imaging nor by (111)In-pentetreotide SPECT/CT. (68)Ga-DOTATATE PET

  6. Geometrical differences in target volumes based on 18F-fluorodeoxyglucose positron emission tomography/computed tomography and four-dimensional computed tomography maximum intensity projection images of primary thoracic esophageal cancer.

    Science.gov (United States)

    Guo, Y; Li, J; Wang, W; Zhang, Y; Wang, J; Duan, Y; Shang, D; Fu, Z

    2014-01-01

    The objective of the study was to compare geometrical differences of target volumes based on four-dimensional computed tomography (4DCT) maximum intensity projection (MIP) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) images of primary thoracic esophageal cancer for radiation treatment. Twenty-one patients with thoracic esophageal cancer sequentially underwent contrast-enhanced three-dimensional computed tomography (3DCT), 4DCT, and 18F-FDG PET/CT thoracic simulation scans during normal free breathing. The internal gross target volume defined as IGTVMIP was obtained by contouring on MIP images. The gross target volumes based on PET/CT images (GTVPET ) were determined with nine different standardized uptake value (SUV) thresholds and manual contouring: SUV≥2.0, 2.5, 3.0, 3.5 (SUVn); ≥20%, 25%, 30%, 35%, 40% of the maximum (percentages of SUVmax, SUVn%). The differences in volume ratio (VR), conformity index (CI), and degree of inclusion (DI) between IGTVMIP and GTVPET were investigated. The mean centroid distance between GTVPET and IGTVMIP ranged from 4.98 mm to 6.53 mm. The VR ranged from 0.37 to 1.34, being significantly (P<0.05) closest to 1 at SUV2.5 (0.94), SUV20% (1.07), or manual contouring (1.10). The mean CI ranged from 0.34 to 0.58, being significantly closest to 1 (P<0.05) at SUV2.0 (0.55), SUV2.5 (0.56), SUV20% (0.56), SUV25% (0.53), or manual contouring (0.58). The mean DI of GTVPET in IGTVMIP ranged from 0.61 to 0.91, and the mean DI of IGTVMIP in GTVPET ranged from 0.34 to 0.86. The SUV threshold setting of SUV2.5, SUV20% or manual contouring yields the best tumor VR and CI with internal-gross target volume contoured on MIP of 4DCT dataset, but 3DPET/CT and 4DCT MIP could not replace each other for motion encompassing target volume delineation for radiation treatment. © 2014 International Society for Diseases of the Esophagus.

  7. The application of positron emission tomography/computed tomography in radiation treatment planning: effect on gross target volume definition and treatment management.

    Science.gov (United States)

    Iğdem, S; Alço, G; Ercan, T; Unalan, B; Kara, B; Geceer, G; Akman, C; Zengin, F O; Atilla, S; Okkan, S

    2010-04-01

    To analyse the effect of the use of molecular imaging on gross target volume (GTV) definition and treatment management. Fifty patients with various solid tumours who underwent positron emission tomography (PET)/computed tomography (CT) simulation for radiotherapy planning from 2006 to 2008 were enrolled in this study. First, F-18 fluorodeoxyglucose (FDG)-PET and CT scans of the treatment site in the treatment position and then a whole body scan were carried out with a dedicated PET/CT scanner and fused thereafter. FDG-avid primary tumour and lymph nodes were included into the GTV. A multidisciplinary team defined the target volume, and contouring was carried out by a radiation oncologist using visual methods. To compare the PET/CT-based volumes with CT-based volumes, contours were drawn on CT-only data with the help of site-specific radiologists who were blind to the PET/CT results after a median time of 7 months. In general, our PET/CT volumes were larger than our CT-based volumes. This difference was significant in patients with head and neck cancers. Major changes (> or =25%) in GTV delineation were observed in 44% of patients. In 16% of cases, PET/CT detected incidental second primaries and metastatic disease, changing the treatment strategy from curative to palliative. Integrating functional imaging with FDG-PET/CT into the radiotherapy planning process resulted in major changes in a significant proportion of our patients. An interdisciplinary approach between imaging and radiation oncology departments is essential in defining the target volumes. Copyright 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  8. Prognostic value of volumetric metabolic parameters measured by [18F]Fluorodeoxyglucose-positron emission tomography/computed tomography in patients with small cell lung cancer

    Science.gov (United States)

    2014-01-01

    Background We evaluated the prognostic value of volume-based metabolic positron emission tomography (PET) parameters in patients with small cell lung cancer (SCLC) compared with other factors. Methods The subjects were 202 patients with pathologically proven SCLC who underwent pretreatment 18F-fluorodeoxyglucose (FDG) PET/computed tomography (CT). Volumetric metabolic parameters of intrathoracic malignant hypermetabolic lesions, including maximum and average standardized uptake value, sum of metabolic tumor volume (MTV), and sum of total lesion glycolysis (TLG) were measured. Results 164 patients had died during follow-up (median 17.4 months) and median overall survival was 14 months. On univariate survival analysis, age, stage, treatment modality, sum of MTV (cutoff = 100 cm3), and sum of TLG (cutoff = 555) were significant predictors of survival. There was a very high correlation between the sum of MTV and the sum of TLG (r = 0.963, P < 0.001). On multivariate survival analysis, age (HR = 1.04, P < 0.001), stage (HR = 2.442, P < 0.001), and sum of MTV (HR = 1.662, P = 0.002) were independent prognostic factors. On subgroup analysis based on limited disease (LD) and extensive disease (ED), sum of MTV and sum of TLG were significant prognostic factors only in LD. Conclusion Both sum of MTV and sum of TLG of intrathoracic malignant hypermetabolic lesions are important independent prognostic factors for survival in patients with SCLC, in addition to age and clinical stage. However, it may be more useful in limited disease rather than in extensive disease. PMID:25609313

  9. Prognostic value of metabolic tumor volume as measured by fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in nasopharyngeal carcinoma.

    Science.gov (United States)

    Yoon, Young-Ho; Lee, Seok-Hwan; Hong, Sung-Lyong; Kim, Seong-Jang; Roh, Hwan-Jung; Cho, Kyu-Sup

    2014-10-01

    The prognostic value of the tumor burden characterized by the metabolic tumor volume (MTV) remains under investigation in nasopharyngeal carcinoma (NPC). The purpose of this study was to evaluate the prognostic value of the maximum standardized uptake value (SUVmax ) and MTV according to metabolic volume threshold as measured by positron emission tomography (PET)/computed tomography (CT), and other clinical factors, in patients with NPC. This study was a retrospective chart review. We evaluated the association of SUVmax , MTV2.5 , MTV3.0 , and other clinical factors with overall survival (OS) using Kaplan-Meier and Cox regression models. (MTV2.5 and MTV3.0 are the volume of hypermetabolic tissue within the regions of gross tumor volumes with a SUV value greater than the threshold values of 2.5 and 3.0, respectively.) Higher MTV2.5 of 31.45 cm(3) and MTV3.0 of 23.01 cm(3) were associated with an increased risk of death (hazard ratio [HR] = 5.028; p = 0.029), although no significant relationship was found between SUVmax and OS. Interestingly, MTV3.0 was associated with OS in both the differentiated and undifferentiated groups, although MTV2.5 was only associated with OS in the undifferentiated group. Among the clinical parameters, only radiotherapy was associated with longer OS (HR = 12.124; p < 0.001). The MTV and radiotherapy could be prognostic values associated with OS. Particularly, MTV2.5 and MTV3.0 might be valuable metabolic parameters for predicting long-term survival in patients with NPC. Furthermore, MTV3.0 may be more useful because it can be applied irrespective of pathologic subtype. © 2014 ARS-AAOA, LLC.

  10. Evaluation of renal cell carcinoma histological subtype and fuhrman grade using {sup 18}F-fluorodeoxyglucose-positron emission tomography/computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Reiko; Nozaki, Sayumi; Abe, Koichiro; Sakai, Shuji [Tokyo Women' s Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo (Japan); Kondo, Tsunenori [Tokyo Women' s Medical University, Department of Urology, Tokyo (Japan); Nagashima, Yoji [Tokyo Women' s Medical University, Department of Surgical Pathology, Tokyo (Japan)

    2017-11-15

    We evaluated {sup 18}F-fluorodeoxyglucose (FDG) uptake by renal cell carcinomas (RCCs) to determine whether different histological subtypes and Fuhrman grades can be distinguished. We retrospectively reviewed the records and maximum standardised uptake value (SUVmax) of 147 patients with 154 RCCs who underwent FDG-positron emission tomography (PET)/computed tomography (CT) prior to tumour resection. The SUVmax was significantly lower in chromophobe RCC (chRCC) tumours than in clear cell RCC (ccRCC; p = 0.003) and papillary RCC (pRCC; p = 0.034) tumours. The mean tumour SUVmax was 4.58 ± 4.1 (range, 1.29-30.4) for ccRCC, 3.98 ± 1.9 (range, 0.49-6.72) for pRCC, and 1.93 ± 0.9 (range, 0.89-3.41) for chRCC. The SUVmax was not significantly different between the ccRCC and pRCC groups. In ccRCC and pRCC tumours, high-grade tumours had a significantly greater SUVmax (p < 0.001 and p < 0.05) than low-grade tumours by analysis of variance (ANOVA) and the Mann-Whitney U test. In ccRCC, multivariate regression analysis indicated that the SUVmax was a significant indicator of Fuhrman grade. No significant differences in uptake were observed between high- and low-grade chRCC tumours. The SUVmax obtained using FDG-PET/CT may be an important indicator for predicting tumour grade in ccRCC and pRCC. (orig.)

  11. Comparison of Single-Photon Emission Computed Tomography-Computed Tomography (SPECT/CT) and Conventional Planar Lymphoscintigraphy for Sentinel Node Localization in Patients with Cutaneous Malignancies.

    Science.gov (United States)

    Doepker, Matthew P; Yamamoto, Maki; Applebaum, Matthew A; Patel, Nupur U; Jaime Montilla-Soler, M; Sarnaik, Amod A; Wayne Cruse, C; Sondak, Vernon K; Zager, Jonathan S

    2017-02-01

    Accurate preoperative lymphoscintigraphy is vital to performing sentinel lymph node biopsy (SLNB) for cutaneous malignancies. Potential advantages of single-photon emission computed tomography with integrated computed tomography (SPECT/CT) include the ability to readily identify aberrant drainage patterns as well as provide the surgeon with three-dimensional anatomic landmarks not seen on conventional planar lymphoscintigraphy (PLS). Patients with cutaneous malignancies who underwent SLNB with preoperative imaging using both SPECT/CT and PLS from 2011 to 2014 were identified. Both SPECT/CT and PLS were obtained in 351 patients (median age, 69 years; range, 5-94 years) with cutaneous malignancies (melanoma = 300, Merkel cell carcinoma = 33, squamous cell carcinoma = 8, other = 10) after intradermal injection of 99m technetium sulfur colloid (median dose 300 µCi). A mean of 4.3 hot spots were identified on SPECT/CT compared to 3.0 on PLS (p CT and PLS, while 172 (49 %) had additional hot spots identified on SPECT/CT compared to only 24 (6.8 %) additional on PLS. SPECT/CT demonstrated additional nodal basins in 103 patients (29.4 %), compared to only 11 patients (3.1 %) with additional basins on PLS. SPECT/CT is a useful adjunct that can help with sentinel node localization in challenging cases. It identified additional hot spots not seen on PLS in almost 50 % of patients. Because PLS identified hot spots not seen on SPECT/CT in 6.8 % of patients, we recommend using both modalities jointly. Long-term follow-up will be required to validate the clinical significance of the additional hot spots identified by SPECT/CT.

  12. Prognostic value of 18F-fluorodeoxyglucose positron emission tomography, computed tomography and magnetic resonance imaging in oral cavity squamous cell carcinoma with pathologically positive neck lymph node

    International Nuclear Information System (INIS)

    Jwa, Eun Jin; Lee, Sang Wook; Kim, Jae Seung

    2012-01-01

    To evaluate the prognostic value of preoperative neck lymph node (LN) assessment with 18 F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG PET), computed tomography (CT), and magnetic resonance imaging (MRI) in oral cavity squamous cell carcinoma (OSCC) patients with pathologically positive LN. In total, 47 OSCC patients with pathologically positive LN were retrospectively reviewed with preoperative 18 F-FDG PET and CT/MRI. All patients underwent surgical resection, neck dissection and postoperative adjuvant radiotherapy and/or chemotherapy between March 2002 and October 2010. Histologic correlation was performed for findings of 18 F-FDG PET and CT/MRI. Thirty-six (76.6%) of 47 cases were correctly diagnosed with neck LN metastasis by 18 F-FDG PET and 32 (68.1%) of 47 cases were correctly diagnosed by CT/MRI. Follow-up ranged from 20 to 114 months (median, 56 months). Clinically negative nodal status evaluated by 18 F-FDG PET or CT/MRI revealed a trend toward better clinical outcomes in terms of overall survival, disease-free survival, local recurrence-free survival, regional nodal recurrence-free survival, and distant metastasis-free survival rates even though the trends were not statistically significant. However, there was no impact of neck node standardized uptake value (SUV max ) on clinical outcomes. Notably, SUVmax showed significant correlation with tumor size in LN (p 2 = 0.62). PET and CT/MRI status of LN also had significant correlation with the size of intranodal tumor deposit (p 2 = 0.37 and p 2 = 0.48, respectively). 18 F-FDG PET and CT/MRI at the neck LNs might improve risk stratification in OSCC patients with pathologically positive neck LN in this study, even without significant prognostic value of SUV max .

  13. Clinical value of {sup 18}F-fluorodihydroxyphenylalanine positron emission tomography/computed tomography ({sup 18}F-DOPA PET/CT) for detecting pheochromocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Luster, Markus; Zeich, Katrin; Glatting, Gerhard; Buck, Andreas K.; Solbach, Christoph; Reske, Sven N. [University of Ulm, Department of Nuclear Medicine, Ulm (Germany); Karges, Wolfram [RWTH Aachen, Division of Endocrinology and Diabetes, Aachen (Germany); Pauls, Sandra [University of Ulm, Department of Radiology, Ulm (Germany); Verburg, Frederik A. [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Dralle, Henning [University Halle-Wittenberg, Department of General, Visceral and Vascular Surgery, Halle (Germany); Neumaier, Bernd [University of Ulm, Department of Nuclear Medicine, Ulm (Germany); Max-Planck-Institut fuer Neurologische Forschung, Section for Radiochemistry, Cologne (Germany); Mottaghy, Felix M. [University of Ulm, Department of Nuclear Medicine, Ulm (Germany); RWTH Aachen, Department of Nuclear Medicine, Aachen (Germany)

    2010-03-15

    In detecting pheochromocytoma (PHEO), positron emission tomography (PET) with the radiolabelled amine precursor {sup 18}F-fluorodihydroxyphenylalanine ({sup 18}F-DOPA) offers excellent specificity, while computed tomography (CT) provides high sensitivity and ability to localize lesions; therefore, the combination of these modalities could be advantageous in this setting. The aim of this study was to investigate whether combined {sup 18}F-DOPA PET/CT more accurately detects and localizes PHEO lesions than does each modality alone. {sup 18}F-DOPA PET, CT and {sup 18}F-DOPA PET/CT images of 25 consecutive patients undergoing diagnostic scanning of suspected sporadic or multiple endocrine neoplasia type 2 syndrome-associated PHEO were reviewed retrospectively in randomized sequence. Two blinded observers scored the images regarding the likelihood of PHEO being present and localizable. Results were correlated with subsequent clinical history and, when available, histology. Of the 19 lesions detected by all three modalities, PET identified each as positive for PHEO, but was unable to definitively localize 15 of 19 (79%). CT could definitively localize all 19 lesions, but could not definitively diagnose or exclude PHEO in 18 of 19 (95%) lesions. Furthermore, CT falsely identified as negative for PHEO one lesion which was judged to be positive for this tumor by both PET and PET/CT. Only in PET/CT scans were all 19 lesions accurately characterized and localized. On a per-patient basis, the sensitivity of {sup 18}F-DOPA PET/CT for PHEO was 100% and the specificity 88%, with a 100% positive predictive value and an 88% negative predictive value. {sup 18}F-DOPA PET/CT more accurately diagnoses and localizes adrenal and extra-adrenal masses suspicious for PHEO than do {sup 18}F-DOPA PET or CT alone. (orig.)

  14. Clinical value of 18F-fluorodihydroxyphenylalanine positron emission tomography/computed tomography (18F-DOPA PET/CT) for detecting pheochromocytoma

    International Nuclear Information System (INIS)

    Luster, Markus; Zeich, Katrin; Glatting, Gerhard; Buck, Andreas K.; Solbach, Christoph; Reske, Sven N.; Karges, Wolfram; Pauls, Sandra; Verburg, Frederik A.; Dralle, Henning; Neumaier, Bernd; Mottaghy, Felix M.

    2010-01-01

    In detecting pheochromocytoma (PHEO), positron emission tomography (PET) with the radiolabelled amine precursor 18 F-fluorodihydroxyphenylalanine ( 18 F-DOPA) offers excellent specificity, while computed tomography (CT) provides high sensitivity and ability to localize lesions; therefore, the combination of these modalities could be advantageous in this setting. The aim of this study was to investigate whether combined 18 F-DOPA PET/CT more accurately detects and localizes PHEO lesions than does each modality alone. 18 F-DOPA PET, CT and 18 F-DOPA PET/CT images of 25 consecutive patients undergoing diagnostic scanning of suspected sporadic or multiple endocrine neoplasia type 2 syndrome-associated PHEO were reviewed retrospectively in randomized sequence. Two blinded observers scored the images regarding the likelihood of PHEO being present and localizable. Results were correlated with subsequent clinical history and, when available, histology. Of the 19 lesions detected by all three modalities, PET identified each as positive for PHEO, but was unable to definitively localize 15 of 19 (79%). CT could definitively localize all 19 lesions, but could not definitively diagnose or exclude PHEO in 18 of 19 (95%) lesions. Furthermore, CT falsely identified as negative for PHEO one lesion which was judged to be positive for this tumor by both PET and PET/CT. Only in PET/CT scans were all 19 lesions accurately characterized and localized. On a per-patient basis, the sensitivity of 18 F-DOPA PET/CT for PHEO was 100% and the specificity 88%, with a 100% positive predictive value and an 88% negative predictive value. 18 F-DOPA PET/CT more accurately diagnoses and localizes adrenal and extra-adrenal masses suspicious for PHEO than do 18 F-DOPA PET or CT alone. (orig.)

  15. Additional benefit of {sup 18}F-fluorodeoxyglucose integrated positron emission tomography/computed tomography in the staging of oesophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gillies, R.S. [Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Medical Oncology, Oxford (United Kingdom); Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Oesophagogastric Surgery, Oxford (United Kingdom); Middleton, M.R. [Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Medical Oncology, Oxford (United Kingdom); Maynard, N.D. [Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Oesophagogastric Surgery, Oxford (United Kingdom); Bradley, K.M.; Gleeson, F.V. [Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Radiology, Oxford (United Kingdom)

    2011-02-15

    {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG PET) has been shown to improve the accuracy of staging in oesophageal cancer. We assessed the benefit of PET/CT over conventional staging and determined if tumour histology had any significant impact on PET/CT findings. A retrospective cohort study, reviewing the results from 200 consecutive patients considered suitable for radical treatment, undergoing routine PET/CT staging comparing the results from CT and endoscopic ultrasound, as well as multi-disciplinary team records. Adenocarcinoma and squamous cell carcinoma were compared for maximum Standardised Uptake Value (SUV{sub max}), involvement of local lymph nodes and distant metastases. PET/CT provided additional information in 37 patients (18.5%) and directly altered management in 34 (17%): 22 (11%) were upstaged; 15 (7.5%) were downstaged, 12 of whom (6%) received radical treatment. There were 11 false negatives (5.5%) and 1 false positive (0.5%). SUV{sub max} was significantly lower for adenocarcinoma than squamous cell carcinoma (median 9.1 versus 13.5, p = 0.003). Staging with PET/CT offers additional benefit over conventional imaging and should form part of routine staging for oesophageal cancer. Adenocarcinoma and squamous cell carcinoma display significantly different FDG-avidity. (orig.)

  16. The role of 11C-choline positron emission tomography- computed tomography and videomediastinoscopy in the evaluation of diseases of middle mediastinum

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background Middle mediastinal masses comprise a wide variety of tumors but may also reflect lymphadenopathy, and thus remain an interesting diagnostic challenge. We performed positron emission tomography (PET) of mediastinal masses in order to evaluate the ability of PET to predict the malignancy of these tumors. We compared histologic findings, videomediastinoscopy, computed tomography (CT), and PET-CT in patients with mediastinal disease. Methods Thirty-two patients were evaluated with CT, PET-CT and videomediastionoscopy, and all studies were performed within four weeks in each patient. 11C-choline as a PET tracer was used to visualize masses. PET data were evaluated using the standardized uptake value (SUV) and were compared with pathologic data.Results There were 13 men and 19 women aged from 21 to 74 (mean 45.2) years. Among the patients with mediastinal diseases, sarcoidosis was diagnosed in 12 patients, tuberculosis in 5 patients, lymphoma in 5 patients, and noncaseating granulomata without classical "sarcoid" finding in 3 patients. N2 or N3 nodal metastasis was revealed in 6 of 7 patients who had non-small cell lung cancer or suspected lung cancer, and one was negative (the pathological diagnosis was reactive hyperplasia). The accuracies for correctly diagnosing mediastinal masses for CT, PET-CT and videomediastinoscopy were 38% (12/32), 63% (20/32), and 91% (29/32) respectively. The diagnostic accuracy of videomediastinoscopy was superior to that of PET-CT (χ2=11.130,P<0.001). The SUVs were similar among these diseases. On the other hand, if the diagnostic classification was benign vs malignancy, the accuracies for CT, PET-CT and videomediastinoscopy were 53% (17/32), 75% (24/32), 100% (32/32) respectively. The diagnostic accuracy of videomediastinoscopy was superior to that of PET-CT (χ2=22.042, P<0.001). The SUV of malignant lesions (6.9, 3.2-9.8; n=11) appeared to be higher than that of benign lesions (4.9, 2.9-8.3; n=21), however, this difference

  17. Improving 18F-Fluoro-D-Glucose-Positron Emission Tomography/Computed Tomography Imaging in Alzheimer's Disease Studies

    International Nuclear Information System (INIS)

    Knešaurek, Karin

    2015-01-01

    The goal was to improve Alzheimer's 2-deoxy-2- 18 F-fluoro-D-glucose ( 18 F FDG)-positron emission tomography (PET)/computed tomography (CT) imaging through application of a novel, hybrid Fourier-wavelet windowed Fourier transform (WFT) restoration technique, in order to provide earlier and more accurate clinical results. General Electric Medical Systems downward-looking sonar PET/CT 16 slice system was used to acquire studies. Patient data were acquired according the Alzheimer's disease Neuroimaging Initiative (ADNI) protocol. Here, we implemented Fourier-wavelet regularized restoration, with a Butterworth low-pass filter, order n = 6 and a cut-off frequency f = 0.35 cycles/pixel and wavelet (Daubechies, order 2) noise suppression. The original (PET-O) and restored (PET-R) ADNI subject PET images were compared using the Alzheimer's discrimination analysis by dedicated software. Forty-two PET/CT scans were used in the study. They were performed on eleven ADNI subjects at intervals of approximately 6 months. The final clinical diagnosis was used as a gold standard. For three subjects, the final clinical diagnosis was mild cognitive impairment and those 13 PET/CT studies were not included in the final comparison, as the result was considered as inconclusive. Using the reminding 29 PET/CT studies (23 AD and 6 normal), the sensitivity and specificity of the PET-O and PET-R were calculated. The sensitivity was 0.65 and 0.96 for PET-O and PET-R, respectively, and the specificity was 0.67 and 0.50 for PET-O and PET-R. The accuracy was 0.66 and 0.86 for PET-O and PET-R, respectively. The results of the study demonstrated that the accuracy of three-dimensional brain F-18 FDG PET images was significantly improved by Fourier-wavelet restoration filtering

  18. Noninvasive assessment of cell proliferation in ovarian cancer using [18F] 3'deoxy-3-fluorothymidine positron emission tomography/computed tomography imaging

    International Nuclear Information System (INIS)

    Richard, Scott D.; Bencherif, Badreddine; Edwards, Robert P.; Elishaev, Esther; Krivak, Thomas C.; Mountz, James M.; DeLoia, Julie A.

    2011-01-01

    Introduction: Positron emission tomography (PET)/computed tomography (CT) imaging of suspected new and recurrent ovarian carcinoma was performed to assess the relationship between [ 18 F] 3'deoxy-3'fluorothymidine ( 18 FLT) uptake and histopathological tissue markers of cellular proliferation (Ki67) and thymidine kinase-1 (TK-1) expression. Methods: Six subjects were included in this pilot study. Subjects were injected with 5 mCi of 18 FLT prior to a planned surgery and then scanned on a GE Discovery-ST PET/CT scanner within an hour of injection. Regions of interest in tumor and control tissue were identified on the diagnostic CT scans and marked for later surgical biopsy. Surgery was performed within 2 days after the scan. At the time of surgery, the regions of interest identified on PET/CT were available to guide the surgeon to the tumor biopsy sites. Tissue from normal ovarian tissue control regions was also sampled. 18 FLT uptake in tumor and control tissue regions was calculated by measuring the maximum standardized uptake values (SUV max ). The excised tumor and normal ovarian tissue control tissues were analyzed by immunohistochemical staining for Ki67 and CD34. TK-1 messenger RNA expression was measured by real-time polymerase chain reaction. Results: 18 FLT uptake (SUV max ) was higher in malignant (mean 4.85/range 1.7-8.8) compared to benign (1.65/range 1.4-1.9) and normal ovarian control tissue (1.12/range 0.6-1.5). Mitotic index, as determined by Ki67 staining, was higher in malignant (18.89/range 11.97-27.19) compared to benign (0.59/range 0.23-0.95) and control tissue (0.45/range 0.06-1.20). TK-1 expression was also higher in malignant (35.52/range 5.21-106.62) compared to benign (8.71/range 4.74-12.67) and control tissue (9.79/range 0.85-39.46). An increasing trend between 18 FLT uptake and Ki67 mitotic index is seen in malignant tissue CD 34 staining between malignant, benign and control tissues was not qualitatively different. Conclusion: An

  19. Noninvasive assessment of cell proliferation in ovarian cancer using [{sup 18}F] 3'deoxy-3-fluorothymidine positron emission tomography/computed tomography imaging

    Energy Technology Data Exchange (ETDEWEB)

    Richard, Scott D. [Department of Obstetrics, Gynecology and Reproductive Services, Division of Gynecologic Oncology, University of Pittsburgh, Pittsburgh, PA 15213 (United States); Bencherif, Badreddine, E-mail: bencherifbb@upmc.ed [Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213 (United States); Edwards, Robert P. [Department of Obstetrics, Gynecology and Reproductive Services, Division of Gynecologic Oncology, University of Pittsburgh, Pittsburgh, PA 15213 (United States); Elishaev, Esther [Department of Obstetrics, Gynecology and Reproductive Services, Division of Gynecologic Oncology, University of Pittsburgh, Pittsburgh, PA 15213 (United States); Department of Pathology, University of Pittsburgh, Pittsburgh, PA 15213 (United States); Krivak, Thomas C.; Mountz, James M. [Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213 (United States); DeLoia, Julie A. [Department of Obstetrics, Gynecology and Reproductive Services, Division of Gynecologic Oncology, University of Pittsburgh, Pittsburgh, PA 15213 (United States)

    2011-05-15

    Introduction: Positron emission tomography (PET)/computed tomography (CT) imaging of suspected new and recurrent ovarian carcinoma was performed to assess the relationship between [{sup 18}F] 3'deoxy-3'fluorothymidine ({sup 18}FLT) uptake and histopathological tissue markers of cellular proliferation (Ki67) and thymidine kinase-1 (TK-1) expression. Methods: Six subjects were included in this pilot study. Subjects were injected with 5 mCi of {sup 18}FLT prior to a planned surgery and then scanned on a GE Discovery-ST PET/CT scanner within an hour of injection. Regions of interest in tumor and control tissue were identified on the diagnostic CT scans and marked for later surgical biopsy. Surgery was performed within 2 days after the scan. At the time of surgery, the regions of interest identified on PET/CT were available to guide the surgeon to the tumor biopsy sites. Tissue from normal ovarian tissue control regions was also sampled. {sup 18}FLT uptake in tumor and control tissue regions was calculated by measuring the maximum standardized uptake values (SUV{sub max}). The excised tumor and normal ovarian tissue control tissues were analyzed by immunohistochemical staining for Ki67 and CD34. TK-1 messenger RNA expression was measured by real-time polymerase chain reaction. Results: {sup 18}FLT uptake (SUV{sub max}) was higher in malignant (mean 4.85/range 1.7-8.8) compared to benign (1.65/range 1.4-1.9) and normal ovarian control tissue (1.12/range 0.6-1.5). Mitotic index, as determined by Ki67 staining, was higher in malignant (18.89/range 11.97-27.19) compared to benign (0.59/range 0.23-0.95) and control tissue (0.45/range 0.06-1.20). TK-1 expression was also higher in malignant (35.52/range 5.21-106.62) compared to benign (8.71/range 4.74-12.67) and control tissue (9.79/range 0.85-39.46). An increasing trend between {sup 18}FLT uptake and Ki67 mitotic index is seen in malignant tissue CD 34 staining between malignant, benign and control tissues was not

  20. Clinical practice guidelines for the utilization of positron emission tomography/computed tomography imaging in selected oncologic applications: suggestions from a provider group.

    Science.gov (United States)

    Manning, Ken; Tepfer, Beth; Goldklang, Gerald; Loyd, Richard; Garimella, Prasad; Halkar, Raghuveer

    2007-01-01

    Positron emission tomography, combined with computed tomography (PET/CT) has provided clinicians with useful information regarding the diagnosis, initial staging, restaging, and therapy monitoring of malignancies since the beginning of the current century. Our intent here is to identify the critical steps in clinical workups and follow-up, in the true outpatient clinical setting of a freestanding imaging center, for utilization of PET/CT in four different cancer types. The four most common reasons for referrals to our facility were identified by reviewing two years of referral data. They were lung cancer (including solitary pulmonary nodule), lymphomas, breast cancer, and colorectal cancer. A review of published literature from 1996 and later was accepted as evidence of appropriateness for utilizing PET/CT in various clinical scenarios. In addition, a medical advisory board consisting of 15 referring physicians representing various specialties was established to provide practical advice regarding the appropriate use of PET/CT in clinical situations. National Comprehensive Cancer Network (NCCN) guidelines were also referenced to establish a baseline for clinical workups at various stages of disease. Several inconsistencies were identified among the three primary sources of information leading to the establishment of a standardized algorithm for each cancer type. NCCN data did not always agree with published literature, which was also often different from actual clinical practices of referring physicians. The most common inconsistencies included differing opinions from the referrers vs what was published in the NCCN guidelines, especially with regard to the utilization of PET/CT for applications not yet covered by insurance companies. After a reconciliation of the medical advisory board's clinical practices and several published articles, a consensus was established by the medical advisory board for the use of PET/CT imaging for the four cancer types, enabling us to

  1. Prognostic value of 18F-fluorodeoxyglucose positron emission tomography, computed tomography and magnetic resonance imaging in oral cavity squamous cell carcinoma with pathologically positive neck lymph node

    Energy Technology Data Exchange (ETDEWEB)

    Jwa, Eun Jin; Lee, Sang Wook; Kim, Jae Seung [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); and others

    2012-12-15

    To evaluate the prognostic value of preoperative neck lymph node (LN) assessment with {sup 18}F-fluorodeoxyglucose positron emission tomography ({sup 18}F-FDG PET), computed tomography (CT), and magnetic resonance imaging (MRI) in oral cavity squamous cell carcinoma (OSCC) patients with pathologically positive LN. In total, 47 OSCC patients with pathologically positive LN were retrospectively reviewed with preoperative {sup 18}F-FDG PET and CT/MRI. All patients underwent surgical resection, neck dissection and postoperative adjuvant radiotherapy and/or chemotherapy between March 2002 and October 2010. Histologic correlation was performed for findings of {sup 18}F-FDG PET and CT/MRI. Thirty-six (76.6%) of 47 cases were correctly diagnosed with neck LN metastasis by {sup 18}F-FDG PET and 32 (68.1%) of 47 cases were correctly diagnosed by CT/MRI. Follow-up ranged from 20 to 114 months (median, 56 months). Clinically negative nodal status evaluated by {sup 18}F-FDG PET or CT/MRI revealed a trend toward better clinical outcomes in terms of overall survival, disease-free survival, local recurrence-free survival, regional nodal recurrence-free survival, and distant metastasis-free survival rates even though the trends were not statistically significant. However, there was no impact of neck node standardized uptake value (SUV{sub max}) on clinical outcomes. Notably, SUVmax showed significant correlation with tumor size in LN (p < 0.01, R{sup 2} = 0.62). PET and CT/MRI status of LN also had significant correlation with the size of intranodal tumor deposit (p < 0.05, R{sup 2} = 0.37 and p < 0.01, R{sup 2} = 0.48, respectively). {sup 18}F-FDG PET and CT/MRI at the neck LNs might improve risk stratification in OSCC patients with pathologically positive neck LN in this study, even without significant prognostic value of SUV{sub max}.

  2. Quantification of atherosclerotic plaque activity and vascular inflammation using [18-F] fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT).

    Science.gov (United States)

    Mehta, Nehal N; Torigian, Drew A; Gelfand, Joel M; Saboury, Babak; Alavi, Abass

    2012-05-02

    Conventional non-invasive imaging modalities of atherosclerosis such as coronary artery calcium (CAC) and carotid intimal medial thickness (C-IMT) provide information about the burden of disease. However, despite multiple validation studies of CAC, and C-IMT, these modalities do not accurately assess plaque characteristics, and the composition and inflammatory state of the plaque determine its stability and, therefore, the risk of clinical events. [(18)F]-2-fluoro-2-deoxy-D-glucose (FDG) imaging using positron-emission tomography (PET)/computed tomography (CT) has been extensively studied in oncologic metabolism. Studies using animal models and immunohistochemistry in humans show that FDG-PET/CT is exquisitely sensitive for detecting macrophage activity, an important source of cellular inflammation in vessel walls. More recently, we and others have shown that FDG-PET/CT enables highly precise, novel measurements of inflammatory activity of activity of atherosclerotic plaques in large and medium-sized arteries. FDG-PET/CT studies have many advantages over other imaging modalities: 1) high contrast resolution; 2) quantification of plaque volume and metabolic activity allowing for multi-modal atherosclerotic plaque quantification; 3) dynamic, real-time, in vivo imaging; 4) minimal operator dependence. Finally, vascular inflammation detected by FDG-PET/CT has been shown to predict cardiovascular (CV) events independent of traditional risk factors and is also highly associated with overall burden of atherosclerosis. Plaque activity by FDG-PET/CT is modulated by known beneficial CV interventions such as short term (12 week) statin therapy as well as longer term therapeutic lifestyle changes (16 months). The current methodology for quantification of FDG uptake in atherosclerotic plaque involves measurement of the standardized uptake value (SUV) of an artery of interest and of the venous blood pool in order to calculate a target to background ratio (TBR), which is

  3. Is Image Registration of Fluorodeoxyglucose–Positron Emission Tomography/Computed Tomography for Head-and-Neck Cancer Treatment Planning Necessary?

    International Nuclear Information System (INIS)

    Fried, David; Lawrence, Michael; Khandani, Amir H.; Rosenman, Julian; Cullip, Tim; Chera, Bhishamjit S.

    2012-01-01

    Purpose: To evaluate dosimetry and patterns of failure related to fluorodeoxyglucose–positron emission tomography (FDG-PET)–defined biological tumor volumes (BTVs) for head-and-neck squamous cell carcinoma (HNSCC) treated with definitive radiotherapy (RT). Methods and Materials: We conducted a retrospective study of 91 HNSCC patients who received pretreatment PET/CT scans that were not formally used for target delineation. The median follow-up was 34.5 months. Image registration was performed for PET, planning CT, and post-RT failure CT scans. Previously defined primary (CT PRIMARY ) and nodal (CT NODE ) gross tumor volumes (GTV) were used. The primary BTV (BTV PRIMARY ) and nodal BTV (BTV NODE ) were defined visually (PET vis ). The BTV PRIMARY was also contoured using 40% and 50% peak PET activity (PET 40, PET 50 ). The recurrent GTVs were contoured on post-RT CT scans. Dosimetry was evaluated on the planning-CT and pretreatment PET scan. PET and CT dosimetric/volumetric data was compared for those with and without local-regional failure (LRF). Results: In all, 29 of 91 (32%) patients experienced LRF: 10 local alone, 7 regional alone, and 12 local and regional. BTVs and CT volumes had less than complete overlap. BTVs were smaller than CT-defined targets. Dosimetric coverage was similar between failed and controlled groups as well as between BTVs and CT-defined volumes. Conclusions: PET and CT-defined tumor volumes received similar RT doses despite having less than complete overlap and the inaccuracies of image registration. LRF correlated with both CT and PET-defined volumes. The dosimetry for PET- and/or CT-based tumor volumes was not significantly inferior in patients with LRF. CT-based delineation alone may be sufficient for treatment planning in patients with HNSCC. Image registration of FDG-PET may not be necessary.

  4. Prostate-Specific Membrane Antigen Positron Emission Tomography-Computed Tomography for Prostate Cancer: Distribution of Disease and Implications for Radiation Therapy Planning.

    Science.gov (United States)

    Gupta, Sandeep K; Watson, Tahne; Denham, Jim; Shakespeare, Thomas P; Rutherford, Natalie; McLeod, Nicholas; Picton, Kevin; Ainsworth, Paul; Bonaventura, Tony; Martin, Jarad M

    2017-11-01

    To explore the prostate-specific membrane antigen (PSMA)-avid distribution of prostate cancer (PC) on positron emission tomography (PET), both at the time of initial diagnosis and at the time of relapse after definitive local treatment. A total of 179 PSMA PET scans in patients with nil or ≤3 lesions on conventional imaging were retrospectively categorized into 3 subgroups: group A, high-risk PC with no prior definitive therapy (n=34); group B, prior prostatectomy (n=75); and group C, prior radiation therapy (n=70). The numbers and locations of the PSMA-avid lesions were mapped. The PSMA-positive lesions were identified subjectively by a nuclear medicine physician on the basis of clinical experience and taking into account the recent literature and artefacts. A total of 893 PSMA-avid lesions were identified; at least 1 lesion was detected in 80% of all scans. A high detection rate was present even at very low serum PSA levels (eg, at PSA ≤0.20 ng/mL in group B, the detection rate was 46%). Thirty-eight percent of studies revealed extrapelvic disease (41%, 31%, and 46% in groups A, B, and C, respectively). Almost one-third of all studies showed only oligometastases (24%, 36%, and 31% in groups A, B, and C, respectively). A large proportion of these (40%) were a solitary lesion. Prostate-specific membrane antigen PET demonstrated a large number of otherwise unknown metastatic lesions. Therefore we recommend PSMA PET for more accurate assessment of disease burden in initial staging of high-risk PC, as well as for restaging in patients with prostate-specific antigen relapse after primary therapies. Furthermore, a high proportion of oligometastases on PSMA PET provides a prime opportunity to investigate the role of targeted local therapies for oligometastatic PCs. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  5. Value of (18F)-FDG positron emission tomography, computed tomography, and magnetic resonance imaging in diagnosing primary and recurrent ovarian carcinoma

    International Nuclear Information System (INIS)

    Kubik-Huch, R.A.; Doerffler, W.; Marincek, B.; Schulthess, G.K.; Steinert, H.C.; Koechli, O.R.; Haller, U.; Seifert, B.

    2000-01-01

    The aim of this study was to compare prospectively the accuracy of whole-body positron emission tomography (PET), CT and MRI in diagnosing primary and recurrent ovarian cancer. Nineteen patients (age range 23-76 years) were recruited with suspicious ovarian lesions at presentation (n = 8) or follow-up for recurrence (n = 11). All patients were scheduled for laparotomy and histological confirmation. Whole-body PET with FDG, contrast-enhanced spiral CT of the abdomen, including the pelvis, and MRI of the entire abdomen were performed. Each imaging study was evaluated separately. Imaging findings were correlated with histopathological diagnosis. The sensitivity, specificity and accuracy for lesion characterization in patients with suspicious ovarian lesions (n = 7) were, respectively: 100, 67 and 86 % for PET; 100, 67 and 86 % for CT; and 100, 100 and 100 % for MRI. For the diagnosis of recurrent disease (n = 10), PET had a sensitivity of 100 %, specificity of 50 % and accuracy of 90 %. The PET technique was the only technique which correctly identified a single transverse colon metastasis. Results for CT were 40, 50 and 43 %, and for MRI 86, 100 and 89 %, respectively. No statistically significant difference was seen. Neither FDG PET nor CT nor MRI can replace surgery in the detection of microscopic peritoneal disease. No statistically significant difference was observed for the investigated imaging modalities with regard to lesion characterization or detection of recurrent disease; thus, the methods are permissible alternatives. The PET technique, however, has the drawback of less accurate spatial assignment of small lesions compared with CT and MRI. (orig.)

  6. Role of fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography in the evaluation of axillary lymph node involvement in operable breast cancer in comparison with sentinel lymph node biopsy

    International Nuclear Information System (INIS)

    Challa, Vasu Reddy; Srivastava, Anurag; Dhar, Anita; Parshad, Rajinder; Bal, Chandrasekhar; Gona, Rama Mohan Reddy; Kumar, Rakesh; Sharma, Punit; Gupta, Siddhartha Datta

    2013-01-01

    Role of (18(F)fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography-computed tomography (PET-CT) in the evaluation of axillary lymph node involvement in T1T2N0 breast cancer and compare results with sentinel lymph node biopsy (SLNB). SLN was identified in 32 of 37 patients with an identification rate of 86.48% (32/37). With combined technique SLN identification rate was 100% (6/6) while with blue dye alone; it was 83.8% (26/31). Among 37 patients, 16 had axillary metastases of which 12 had macrometastases and four had micrometastases detected by immunohistochemistry (IHC). Of 12 patients with axillary macrometastases, skip metastases were present in two patients in whom SLN was negative and in two patients SLN was not identified, but axillary dissection showed metastases. PET-CT had shown sensitivity, specificity, negative predictive value and positive predictive value of 56%, 90%, 73%, and 81.8%, respectively. IHC of SLN detected four patients with micrometastases upstaging the disease by 11% (4/37). Because FDG PET-CT has a high specificity in the evaluation of axillary lymph node involvement in T1T2N0 breast cancer patients according to the results of this study if FDG PET-CT is positive in axillary lymph nodes, axillary lymph node dissection may be considered instead of SLNB

  7. Tumour and lymph node uptakes on dual-phased 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography correlate with prognostic parameters in breast cancer.

    Science.gov (United States)

    Chang, Chin-Chuan; Tu, Hung-Pin; Chen, Yu-Wen; Lin, Chia-Yang; Hou, Ming-Feng

    2014-12-01

    To examine correlations between the uptake of 2-deoxy-2-[18F]fluoro-D-glucose (FDG) by primary tumours and axillary lymph nodes, and clinical and biological tumour prognostic parameters, in patients with newly diagnosed breast cancer. Newly diagnosed breast cancer patients who had received a dual-phased FDG positron emission tomography/computed tomography scan for pretreatment staging were enrolled retrospectively. Maximal standardized uptake values at 1 h (SUV1), 2 h (SUV2), and retention indices (RI) of the tumours and ipsilateral axillary lymph nodes were measured. SUV and RI were compared with clinical and biological prognostic parameters. A total of 32 patients participated in the study. Tumour FDG uptake correlated with histological grade and tumour size. FDG uptake in axillary lymph nodes correlated positively with lymph node status, metastasis status and clinical stage. RI values for the tumour and lymph nodes were significantly positively correlated with human epidermal growth factor receptor-2 positivity. FDG uptake in tumours and lymph nodes showed correlations with some clinical and biological parameters, and may serve as a predictive marker of tumour biological behaviour in breast cancer. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  8. Clinical role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in post-operative follow up of gastric cancer: Initial results

    Institute of Scientific and Technical Information of China (English)

    Long Sun; Xin-Hui Su; Yong-Song Guan; Wei-Ming Pan; Zuo-Ming Luo; Ji-Hong Wei; Hua Wu

    2008-01-01

    AIM: To evaluate the clinical role of 18F-fluorodeo-xyglucose positron emission and computed tomography(18F-FDG PET/CT) in detection of gastric cancer recur rence after initial surgical resection.METHODS: In the period from January 2007 to May 2008, 23 patients who had previous surgical resection of histopathologically diagnosed gastric cancer underwent a total of 25 18F-FDG PET/CT scans as follow-up visits in our center. The standard of reference for tumor recurrence consisted of histopathologic confirmation or clinical follow-up information for at least 5 mo after PET/CT examinations.RESULTS: PET/Cr was positive in 14 patients (61%)and negative in 9 (39%). When correlated with final diagnosis, which was confirmed by histopathologic evidence of tumor recurrence in 8 of the 23 patients(35%) and by clinical follow-up in 15 (65%), PET/CT was true positive in 12 patients, false positive in 2,true negative in 8 and false negative in 2. Overall,the accuracy of PET/CT was 82.6%, the negative predictive value (NPV) was 77.7%, and the positive predictive value (PPV) was 85.7%. The 2 false positive PET/CT findings were actually chronic inflammatory tissue lesions. For the two patients with false negative PET/CT, the final diagnosis was recurrence of mucinous adenocarcinoma in the anastomosis in one patient and abdominal wall metastasis in the other. Importantly,PET/CT revealed true-positive findings in 11 (47.8%)patients who had negative or no definite findings by CT. PET/CT revealed extra-abdominal metastases in 7 patients and additional esophageal carcinoma in onepatient. Clinical treatment decisions were changed in 7 (30.4%) patients after introducing PET/CT into theirconventional post-operative follow-up program.CONCLUSION: Whole body 18F-FDG PET/CT was highly effective in discriminating true recurrence in post-operative patients with gastric cancer and had important impacts on clinical decisions in a considerable portion of patients.

  9. Computer tomography, magnetic resonance imaging, and positron emission tomography or positron emission tomography/computer tomography for detection of metastatic lymph nodes in patients with ovarian cancer: A meta-analysis

    International Nuclear Information System (INIS)

    Yuan Ying; Gu Zhaoxiang; Tao Xiaofeng; Liu Shiyuan

    2012-01-01

    Objectives: To compare the diagnostic performances of computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET or PET/CT) for detection of metastatic lymph nodes in patients with ovarian cancer. Methods: Relevant studies were identified with MEDLINE and EMBASE from January 1990 to July 2010. We estimated the weighted summary sensitivities, specificities, OR (odds ratio), and summary receiver operating characteristic (sROC) curves of each imaging technique and conducted pair-wise comparisons using the two-sample Z-test. Meta-regression, subgroup analysis, and funnel plots were also performed to explain the between-study heterogeneity. Results: Eighteen eligible studies were included, with a total of 882 patients. PET or PET/CT was a more accurate modality (sensitivity, 73.2%; specificity, 96.7%; OR [odds ratio], 90.32). No significant difference was detected between CT (sensitivity, 42.6%; specificity, 95.0%; OR, 19.87) and MR imaging (sensitivity, 54.7%; specificity, 88.3%; OR, 12.38). Meta-regression analyses and subgroup analyses revealed no statistical difference. Funnel plots with marked asymmetry suggested a publication bias. Conclusion: FDG-PET or FDG-PET/CT is more accurate than CT and MR imaging in the detection of lymph node metastasis in patients with ovarian cancer.

  10. A comparative study of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and 99mTc-MDP whole-body bone scanning for imaging osteolytic bone metastases

    International Nuclear Information System (INIS)

    Zhang, Lin; Chen, Lihua; Xie, Qiao; Zhang, Yongke; Cheng, Lin; Li, Haitao; Wang, Jian

    2015-01-01

    The objective of this study was to evaluate the feasibility and diagnostic value of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) and 99m Tc-methylenediphosphonate (MDP) whole-body bone scanning (BS) for the detection of osteolytic bone metastases. Thirty-four patients with pathologically confirmed malignancies and suspected osteolytic bone metastases underwent 18 F-FDG PET/CT and 99m Tc-MDP whole-body BS within 30 days. The sensitivity, specificity, and accuracy with respect to the diagnosis of osteolytic bone metastases and bone lesions were compared between the two imaging methods. The sensitivity, specificity, and accuracy of 18 F-FDG PET/CT for the diagnosis of osteolytic bone metastases were 94.3% (95% confidence interval [CI], 91.6–96.2%), 83.3% (95% CI, 43.6–96.9%), and 94.2% (95% CI, 91.5–96.1%), respectively. It was found that 99m Tc-MDP whole-body BS could discriminate between patients with 50.2% (95% CI, 45.4–55.1%) sensitivity, 50.0% (95% CI, 18.8–81.2%) specificity, and 50.2% (95% CI, 45.5–55.1%) accuracy. 18 F-FDG PET/CT achieved higher sensitivity, specificity, and accuracy in detecting osteolytic bone metastases than 99mTc-MDP whole-body BS (p<0.001). F-FDG PET/CT has a higher diagnostic value than 99m Tc-MDP whole-body BS in the detection of osteolytic bone metastases, especially in the vertebra

  11. Role of [18F]fluorodeoxyglucose positron emission tomography-computed tomography, sonography, and sonographically guided fine-needle aspiration biopsy in the diagnosis of axillary lymph nodes in patients with breast cancer: comparison of diagnostic performance.

    Science.gov (United States)

    Sohn, Yu-Mee; Hong, Il Ki; Han, Kyunghwa

    2014-06-01

    The aim of this study was to compare the diagnostic performance of [(18)F]fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) with that of sonography and sonographically guided fine-needle aspiration (FNA) for determining the preoperative axillary lymph node (ALN) status and to evaluate the factors related to false-negative PET-CT, sonographic, and FNA results in ALN staging of invasive ductal carcinoma. From March 2009 to July 2012, 226 patients had a diagnosis of primary breast cancer. Among these patients, 107 constituted the study population after exclusion of transferred patients and patients with breast cancer other than invasive ductal carcinoma. The diagnostic performance of the modalities was compared with pathologic reports. Univariate and multivariate analyses were used to evaluate the relationship between clinicopathologic factors (symptoms, T stage, hormone receptors, and histologic grade), false-negative results, and true-negative results on PET-CT, sonography, and FNA. Of the 107 patients, 45 (42.1%) had positive results on final pathologic analysis of ALNs. Sonographically guided FNA had a significantly higher specificity, positive predictive value, accuracy, and area under the receiver operating characteristic curve than sonography and PET-CT (P < .01). When sonography and PET-CT were combined, the sensitivity was significantly improved (P = .019) compared with sonography alone. When FNA and PET-CT were combined, the sensitivity and negative predictive value were significantly increased compared with each modality (P < .01). Sonographically guided FNA was found to be an excellent diagnostic tool for preoperative evaluation of the ALN status. To obviate the step of sentinel lymph node biopsy for determining the ALN status, combined evaluation of ALNs by these modalities may be more complementary than the use of a single modality. © 2014 by the American Institute of Ultrasound in Medicine.

  12. Diagnostic Accuracy of 64Copper Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Primary Lymph Node Staging of Intermediate- to High-risk Prostate Cancer: Our Preliminary Experience.

    Science.gov (United States)

    Cantiello, Francesco; Gangemi, Vincenzo; Cascini, Giuseppe Lucio; Calabria, Ferdinando; Moschini, Marco; Ferro, Matteo; Musi, Gennaro; Butticè, Salvatore; Salonia, Andrea; Briganti, Alberto; Damiano, Rocco

    2017-08-01

    To assess the diagnostic accuracy of 64 Copper prostate-specific membrane antigen ( 64 Cu-PSMA) positron emission tomography/computed tomography (PET/CT) in the primary lymph node (LN) staging of a selected cohort of intermediate- to high-risk prostate cancer (PCa) patients. An observational prospective study was performed in 23 patients with intermediate- to high-risk PCa, who underwent 64 Cu-PSMA PET/CT for local and lymph nodal staging before laparoscopic radical prostatectomy with an extended pelvic LN dissection. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for LN status of 64 Cu-PSMA PET/CT were calculated using the final pathological findings as reference. Furthermore, we evaluated the correlation of intraprostatic tumor extent and grading with 64 Cu-PSMA intraprostatic distribution. Pathological analysis of LN involvement in 413 LNs harvested from our study cohort identified a total of 22 LN metastases in 8 (5%) of the 23 (35%) PCa patients. Imaging-based LN staging in a per-patient analysis showed that 64 Cu-PSMA PET/CT was positive in 7 of 8 LN-positive patients (22%) with a sensitivity of 87.5%, specificity of 100%, PPV of 100%, and NPV of 93.7%, considering the maximum standardized uptake value (SUV max ) at 4 hours as our reference. Receiver operating characteristic curve was characterized by an area under the curve of 0.938. A significant positive association was observed between SUV max at 4 hours with Gleason score, index, and cumulative tumor volume. In our intermediate- to high-risk PCa patients study cohort, we showed the high diagnostic accuracy of 64 Cu-PSMA PET/CT for primary LN staging before radical prostatectomy. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Does the intensity of diffuse thyroid gland uptake on F-18 fluorodeoxyglucose positron emission tomography/computed tomography scan predict the severity of hypothyroidism? Correlation between maximal standardized uptake value and serum thyroid stimulating hormone levels

    International Nuclear Information System (INIS)

    Pruthi, Ankur; Choudhury, Partha Sarathi; Gupta, Manoj; Taywade, Sameer

    2015-01-01

    F-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) scan and hypothyroidism. The aim was to determine whether the intensity of diffuse thyroid gland uptake on F-18 FDG PET/CT scans predicts the severity of hypothyroidism. A retrospective analysis of 3868 patients who underwent F-18 FDG PET/CT scans, between October 2012 and June 2013 in our institution for various oncological indications was done. Out of them, 106 (2.7%) patients (79 females, 27 males) presented with bilateral diffuse thyroid gland uptake as an incidental finding. These patients were investigated retrospectively and various parameters such as age, sex, primary cancer site, maximal standardized uptake value (SUVmax), results of thyroid function tests (TFTs) and fine-needle aspiration cytology results were noted. The SUVmax values were correlated with serum thyroid stimulating hormone (S. TSH) levels using Pearson's correlation analysis. Pearson's correlation analysis. Clinical information and TFT (serum FT3, FT4 and TSH levels) results were available for 31 of the 106 patients (27 females, 4 males; mean age 51.5 years). Twenty-six out of 31 patients (84%) were having abnormal TFTs with abnormal TSH levels in 24/31 patients (mean S. TSH: 22.35 μIU/ml, median: 7.37 μIU/ml, range: 0.074-211 μIU/ml). Among 7 patients with normal TSH levels, 2 patients demonstrated low FT3 and FT4 levels. No significant correlation was found between maximum standardized uptake value and TSH levels (r = 0.115, P > 0.05). Incidentally detected diffuse thyroid gland uptake on F-18 FDG PET/CT scan was usually associated with hypothyroidism probably caused by autoimmune thyroiditis. Patients should be investigated promptly irrespective of the intensity of FDG uptake with TFTs to initiate replacement therapy and a USG examination to look for any suspicious nodules

  14. 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography-Based Radiotherapy Target Volume Definition in Non-Small-Cell Lung Cancer: Delineation by Radiation Oncologists vs. Joint Outlining With a PET Radiologist?

    International Nuclear Information System (INIS)

    Hanna, Gerard G.; Carson, Kathryn J.; Lynch, Tom; McAleese, Jonathan; Cosgrove, Vivian P.; Eakin, Ruth L.; Stewart, David P.; Zatari, Ashraf; O'Sullivan, Joe M.; Hounsell, Alan R.

    2010-01-01

    Purpose: 18 F-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has benefits in target volume (TV) definition in radiotherapy treatment planning (RTP) for non-small-cell lung cancer (NSCLC); however, an optimal protocol for TV delineation has not been determined. We investigate volumetric and positional variation in gross tumor volume (GTV) delineation using a planning PET/CT among three radiation oncologists and a PET radiologist. Methods and Materials: RTP PET/CT scans were performed on 28 NSCLC patients (Stage IA-IIIB) of which 14 patients received prior induction chemotherapy. Three radiation oncologists and one PET radiologist working with a fourth radiation oncologist independently delineated the GTV on CT alone (GTV CT ) and on fused PET/CT images (GTV PETCT ). The mean percentage volume change (PVC) between GTV CT and GTV PETCT for the radiation oncologists and the PVC between GTV CT and GTV PETCT for the PET radiologist were compared using the Wilcoxon signed-rank test. Concordance index (CI) was used to assess both positional and volume change between GTV CT and GTV PETCT in a single measurement. Results: For all patients, a significant difference in PVC from GTV CT to GTV PETCT exists between the radiation oncologist (median, 5.9%), and the PET radiologist (median, -0.4%, p = 0.001). However, no significant difference in median concordance index (comparing GTV CT and GTV FUSED for individual cases) was observed (PET radiologist = 0.73; radiation oncologists = 0.66; p = 0.088). Conclusions: Percentage volume changes from GTV CT to GTV PETCT were lower for the PET radiologist than for the radiation oncologists, suggesting a lower impact of PET/CT in TV delineation for the PET radiologist than for the oncologists. Guidelines are needed to standardize the use of PET/CT for TV delineation in RTP.

  15. 18F-fluorodeoxyglucose positron emission tomography/computed tomography-based radiotherapy target volume definition in non-small-cell lung cancer: delineation by radiation oncologists vs. joint outlining with a PET radiologist?

    Science.gov (United States)

    Hanna, Gerard G; Carson, Kathryn J; Lynch, Tom; McAleese, Jonathan; Cosgrove, Vivian P; Eakin, Ruth L; Stewart, David P; Zatari, Ashraf; O'Sullivan, Joe M; Hounsell, Alan R

    2010-11-15

    (18)F-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has benefits in target volume (TV) definition in radiotherapy treatment planning (RTP) for non-small-cell lung cancer (NSCLC); however, an optimal protocol for TV delineation has not been determined. We investigate volumetric and positional variation in gross tumor volume (GTV) delineation using a planning PET/CT among three radiation oncologists and a PET radiologist. RTP PET/CT scans were performed on 28 NSCLC patients (Stage IA-IIIB) of which 14 patients received prior induction chemotherapy. Three radiation oncologists and one PET radiologist working with a fourth radiation oncologist independently delineated the GTV on CT alone (GTV(CT)) and on fused PET/CT images (GTV(PETCT)). The mean percentage volume change (PVC) between GTV(CT) and GTV(PETCT) for the radiation oncologists and the PVC between GTV(CT) and GTV(PETCT) for the PET radiologist were compared using the Wilcoxon signed-rank test. Concordance index (CI) was used to assess both positional and volume change between GTV(CT) and GTV(PETCT) in a single measurement. For all patients, a significant difference in PVC from GTV(CT) to GTV(PETCT) exists between the radiation oncologist (median, 5.9%), and the PET radiologist (median, -0.4%, p = 0.001). However, no significant difference in median concordance index (comparing GTV(CT) and GTV(FUSED) for individual cases) was observed (PET radiologist = 0.73; radiation oncologists = 0.66; p = 0.088). Percentage volume changes from GTV(CT) to GTV(PETCT) were lower for the PET radiologist than for the radiation oncologists, suggesting a lower impact of PET/CT in TV delineation for the PET radiologist than for the oncologists. Guidelines are needed to standardize the use of PET/CT for TV delineation in RTP. Copyright © 2010 Elsevier Inc. All rights reserved.

  16. Metabolic and clinical assessment of efficacy of cryoablation therapy on skeletal masses by 18F-FDG positron emission tomography/computed tomography (PET/CT) and visual analogue scale (VAS): initial experience

    International Nuclear Information System (INIS)

    Masala, Salvatore; Bartolucci, Alberto D.; Mammucari, Matteo; Simonetti, Giovanni; Schillaci, Orazio; Calabria, Ferdinando

    2011-01-01

    Various therapy modalities have been proposed as standard treatments in management of bone metastases. Radiation therapy remains the standard of care for patients with localized bone pain, but up to 30% of them do not experience notable pain relief. Percutaneous cryoablation is a minimally invasive technique that induces necrosis by alternately freezing and thawing a target tissue. This technique is successfully used to treat a variety of malignant and benign diseases in different sites. 18 F-FDG positron emission tomography/computed tomography ( 18 F-FDG PET/CT) is a single technique of imaging that provides in a ''single step'' both morphological and metabolic features of neoplastic lesions of the bone. The aim of this study was to evaluate the efficacy of the cryosurgical technique on secondary musculoskeletal masses according to semi-quantitative PET analysis and clinical-test evaluation with the visual analogue scale (VAS). We enrolled 20 patients with painful bone lesions (score pain that exceeded 4 on the VAS) that were non-responsive to treatment; one lesion per patient was treated. All patients underwent a PET-CT evaluation before and 8 weeks after cryotherapy; maximum standardized uptake value (SUV max ) was measured before and after treatment for metabolic assessment of response to therapy. After treatment, 18 patients (90%) showed considerable reduction in SUV max value (>50%) suggestive of response to treatment; only 2 patients did not show meaningful reduction in metabolic activity. Our preliminary study demonstrates that quantitative analysis provided by PET correlates with response to cryoablation therapy as assessed by CT data and clinical VAS evaluation. (orig.)

  17. Metabolic and clinical assessment of efficacy of cryoablation therapy on skeletal masses by {sup 18}F-FDG positron emission tomography/computed tomography (PET/CT) and visual analogue scale (VAS): initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Masala, Salvatore; Bartolucci, Alberto D.; Mammucari, Matteo; Simonetti, Giovanni [University Hospital Tor Vergata, Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Rome (Italy); Schillaci, Orazio; Calabria, Ferdinando [University Hospital Tor Vergata, Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Rome (Italy); I.R.C.C.S. Neuromed, Department of Nuclear Medicine and Neuroradiology, Pozzilli (Italy); Policlinico Tor Vegata, Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Rome (Italy)

    2011-02-15

    Various therapy modalities have been proposed as standard treatments in management of bone metastases. Radiation therapy remains the standard of care for patients with localized bone pain, but up to 30% of them do not experience notable pain relief. Percutaneous cryoablation is a minimally invasive technique that induces necrosis by alternately freezing and thawing a target tissue. This technique is successfully used to treat a variety of malignant and benign diseases in different sites. {sup 18}F-FDG positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) is a single technique of imaging that provides in a ''single step'' both morphological and metabolic features of neoplastic lesions of the bone. The aim of this study was to evaluate the efficacy of the cryosurgical technique on secondary musculoskeletal masses according to semi-quantitative PET analysis and clinical-test evaluation with the visual analogue scale (VAS). We enrolled 20 patients with painful bone lesions (score pain that exceeded 4 on the VAS) that were non-responsive to treatment; one lesion per patient was treated. All patients underwent a PET-CT evaluation before and 8 weeks after cryotherapy; maximum standardized uptake value (SUV{sub max}) was measured before and after treatment for metabolic assessment of response to therapy. After treatment, 18 patients (90%) showed considerable reduction in SUV{sub max} value (>50%) suggestive of response to treatment; only 2 patients did not show meaningful reduction in metabolic activity. Our preliminary study demonstrates that quantitative analysis provided by PET correlates with response to cryoablation therapy as assessed by CT data and clinical VAS evaluation. (orig.)

  18. Change of Maximum Standardized Uptake Value Slope in Dynamic Triphasic [18F]-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Distinguishes Malignancy From Postradiation Inflammation in Head-and-Neck Squamous Cell Carcinoma: A Prospective Trial

    International Nuclear Information System (INIS)

    Anderson, Carryn M.; Chang, Tangel; Graham, Michael M.; Marquardt, Michael D.; Button, Anna; Smith, Brian J.; Menda, Yusuf; Sun, Wenqing; Pagedar, Nitin A.; Buatti, John M.

    2015-01-01

    Purpose: To evaluate dynamic [ 18 F]-fluorodeoxyglucose (FDG) uptake methodology as a post–radiation therapy (RT) response assessment tool, potentially enabling accurate tumor and therapy-related inflammation differentiation, improving the posttherapy value of FDG–positron emission tomography/computed tomography (FDG-PET/CT). Methods and Materials: We prospectively enrolled head-and-neck squamous cell carcinoma patients who completed RT, with scheduled 3-month post-RT FDG-PET/CT. Patients underwent our standard whole-body PET/CT scan at 90 minutes, with the addition of head-and-neck PET/CT scans at 60 and 120 minutes. Maximum standardized uptake values (SUV max ) of regions of interest were measured at 60, 90, and 120 minutes. The SUV max slope between 60 and 120 minutes and change of SUV max slope before and after 90 minutes were calculated. Data were analyzed by primary site and nodal site disease status using the Cox regression model and Wilcoxon rank sum test. Outcomes were based on pathologic and clinical follow-up. Results: A total of 84 patients were enrolled, with 79 primary and 43 nodal evaluable sites. Twenty-eight sites were interpreted as positive or equivocal (18 primary, 8 nodal, 2 distant) on 3-month 90-minute FDG-PET/CT. Median follow-up was 13.3 months. All measured SUV endpoints predicted recurrence. Change of SUV max slope after 90 minutes more accurately identified nonrecurrence in positive or equivocal sites than our current standard of SUV max ≥2.5 (P=.02). Conclusions: The positive predictive value of post-RT FDG-PET/CT may significantly improve using novel second derivative analysis of dynamic triphasic FDG-PET/CT SUV max slope, accurately distinguishing tumor from inflammation on positive and equivocal scans

  19. Benefits of adopting good radiation practices in reducing the whole body radiation dose to the nuclear medicine personnel during (18)F-fluorodeoxyglucose positron emission tomography/computed tomography imaging.

    Science.gov (United States)

    Verma, Shashwat; Kheruka, Subhash Chand; Maurya, Anil Kumar; Kumar, Narvesh; Gambhir, Sanjay; Kumari, Sarita

    2016-01-01

    Positron emission tomography has been established as an important imaging modality in the management of patients, especially in oncology. The higher gamma radiation energy of positron-emitting isotopes poses an additional radiation safety problem. Those working with this modality may likely to receive higher whole body doses than those working only in conventional nuclear medicine. The radiation exposure to the personnel occurs in dispensing the dose, administration of activity, patient positioning, and while removing the intravenous (i.v.) cannula. The estimation of radiation dose to Nuclear Medicine Physician (NMP) involved during administration of activity to the patient and technical staff assisting in these procedures in a positron emission tomography/computed tomography (PET/CT) facility was carried out. An i.v access was secured for the patient by putting the cannula and blood sugar was monitored. The activity was then dispensed and measured in the dose calibrator and administered to the patient by NMP. Personnel doses received by NMP and technical staff were measured using electronic pocket dosimeter. The radiation exposure levels at various working locations were assessed with the help of gamma survey meter. The radiation level at working distance while administering the radioactivity was found to be 106-170 μSv/h with a mean value of 126.5 ± 14.88 μSv/h which was reduced to 4.2-14.2 μSv/h with a mean value of 7.16 ± 2.29 μSv/h with introduction of L-bench for administration of radioactivity. This shows a mean exposure level reduction of 94.45 ± 1.03%. The radiation level at working distance, while removing the i.v. cannula postscanning was found to be 25-70 μSv/h with a mean value of 37.4 ± 13.16 μSv/h which was reduced to 1.0-5.0 μSv/h with a mean value of 2.77 ± 1.3 μSv/h with introduction of L-bench for removal of i.v cannula. This shows a mean exposure level reduction of 92.85 ± 1.78%. This study shows that good radiation practices are

  20. Positron Emission Tomography/Magnetic Resonance Imaging for Local Tumor Staging in Patients With Primary Breast Cancer: A Comparison With Positron Emission Tomography/Computed Tomography and Magnetic Resonance Imaging.

    Science.gov (United States)

    Grueneisen, Johannes; Nagarajah, James; Buchbender, Christian; Hoffmann, Oliver; Schaarschmidt, Benedikt Michael; Poeppel, Thorsten; Forsting, Michael; Quick, Harald H; Umutlu, Lale; Kinner, Sonja

    2015-08-01

    This study aimed to assess the diagnostic performance of integrated positron emission tomography (PET)/magnetic resonance imaging (MRI) of the breast for lesion detection and local tumor staging of patients with primary breast cancer in comparison to PET/computed tomography (CT) and MRI. The study was approved by the local institutional review board. Forty-nine patients with biopsy-proven invasive breast cancer were prospectively enrolled in our study. All patients underwent a PET/CT, and subsequently, a contrast-enhanced PET/MRI of the breast after written informed consent was obtained before each examination. Two radiologists independently evaluated the corresponding data sets (PET/CT, PET/MRI, and MRI) and were instructed to identify primary tumors lesions as well as multifocal/multicentric and bilateral disease. Furthermore, the occurrence of lymph node metastases was assessed, and the T-stage for each patient was determined. Histopathological verification of the local tumor extent and the axillary lymph node status was available for 30 of 49 and 48 of 49 patients, respectively. For the remaining patients, a consensus characterization was performed for the determination of the T-stage and nodal status, taking into account the results of clinical staging, PET/CT, and PET/MRI examinations. Statistical analysis was performed to test for differences in diagnostic performance between the different imaging procedures. P values less than 0.05 were considered to be statistically significant. Positron emission tomography/MRI and MRI correctly identified 47 (96%) of the 49 patients with primary breast cancer, whereas PET/CT enabled detection of 46 (94%) of 49 breast cancer patients and missed a synchronous carcinoma in the contralateral breast in 1 patient. In a lesion-by-lesion analysis, no significant differences could be obtained between the 3 imaging procedures for the identification of primary breast cancer lesions (P > 0.05). Positron emission tomography/MRI and

  1. 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

  2. Initial Assessment of β3-Adrenoceptor-Activated Brown Adipose Tissue in Streptozotocin-Induced Type 1 Diabetes Rodent Model Using [18F]Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

    Directory of Open Access Journals (Sweden)

    Aparna Baranwal

    2015-12-01

    Full Text Available Metabolic activity of brown adipose tissue (BAT is activated by β3-adrenoceptor agonists and norepinephrine transporter (NET blockers and is measurable using [18F]fluorodeoxyglucose ([18F]FDG positron emission tomography/computed tomography (PET/CT in rats. Using the streptozotocin (STZ-treated rat model of type 1 diabetes mellitus (T1DM, we investigated BAT activity in this rat model under fasting and nonfasting conditions using [18F]FDG PET/CT. Drugs that enhance BAT activity may have a potential for therapeutic development in lowering blood sugar in insulin-resistant diabetes. Rats were rendered diabetic by administration of STZand confirmed by glucose measures. [18F]FDG was injected in the rats (fasted or nonfasted pretreated with either saline or β3-adrenoceptor agonist CL316,243 or the NET blocker atomoxetine for PET/CT scans. [18F]FDG metabolic activity was computed as standard uptake values (SUVs in interscapular brown adipose tissue (IBAT and compared across the different drug treatment conditions. Blood glucose levels > 500 mg/dL were established for the STZ-treated diabetic rats. Under fasting conditions, average uptake of [18F]FDG in the IBAT of STZ-treated diabetic rats was approximately 70% lower compared to that of normal rats. Both CL316,243 and atomoxetine activated IBAT in normal rats had an SUV > 5, whereas activation in STZ-treated rats was significantly lower. The agonist CL316,243 activated IBAT up to threefold compared to saline in the fasted STZ-treated rat. In the nonfasted rat, the IBAT activation was up by twofold by CL316243. Atomoxetine had a greater effect on lowering blood sugar levels compared to CL316,243 in the nonfasted rats. A significant reduction in metabolic activity was observed in the STZ-treated diabetic rodent model. Increased IBAT activity in the STZ-treated diabetic rat under nonfasted conditions using the β3-adrenoceptor agonist CL316,243 suggests a potential role of BAT in modulating blood sugar

  3. Usefulness of CA125 and their kinetic parameters and positron emission tomography/computed tomography (PET/CT) with fluorodeoxyglucose ([18F] FDG) in the detection of recurrent ovarian cancer levels.

    Science.gov (United States)

    Palomar Muñoz, Azahara; Cordero García, José Manuel; Talavera Rubio, Prado; García Vicente, Ana M; González García, Beatriz; Bellón Guardia, María Emiliana; Soriano Castrejón, Ángel; Aranda Aguilar, Enrique

    2017-12-21

    To assess the usefulness of cancer antigen 125 (CA125) serum levels and kinetic values, velocity (CA125vel) and doubling time (CA125dt), as well as fluorodeoxyglucose ([ 18 F]FDG) positron emission tomography/computed tomography (PET/CT), in the detection of ovarian cancer recurrence. To assess the optimal cut-off for CA125, CA125vel and CA125dt to detect relapse with [ 18 F]FDG-PET/CT. A retrospective analysis was performed of 59 [ 18 F]FDG-PET/CT (48 patients) for suspected recurrence of ovarian cancer. Receiver operating characteristic (ROC) curves were plotted and area-under-the curve (AUC) statistics were computed for CA125, CA125vel and CA125dt. The results obtained in the group with normal and high (>35U/ml) CA125 levels were compared. Forty-four cases of recurrence were diagnosed (7 had CA125 ≤35U/ml), whereas 15 showed no disease. All of them were correctly catalogued by PET/CT. In ROC analysis, the discriminatory power of CA125 was relatively high (AUC 0.835) and the optimal cut-off point to reflect active disease was 23.9U/ml. The ROC analyses for the CA125vel and CA125dt showed an AUC of 0.849 and 0.728, respectively, with an optimal cut-off point of 1.96U/ml/month and 0.76 months, respectively. In patients with normal CA125 and recurrence of ovarian cancer, the CA125vel was significantly higher than in patients without recurrence (p=0.029). [ 18 F]FDG-PET/CT is more accurate than CA125 parameters in the detection of ovarian cancer recurrence. CA125 serum levels are essential; nevertheless, CA125 kinetic values must be considered to detect relapse. Particularly in patients with CA125 within normal values, in which a higher CA125vel is indicative of recurrence. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  4. Metabolomics of Breast Cancer Using High-Resolution Magic Angle Spinning Magnetic Resonance Spectroscopy: Correlations with 18F-FDG Positron Emission Tomography-Computed Tomography, Dynamic Contrast-Enhanced and Diffusion-Weighted Imaging MRI.

    Science.gov (United States)

    Yoon, Haesung; Yoon, Dahye; Yun, Mijin; Choi, Ji Soo; Park, Vivian Youngjean; Kim, Eun-Kyung; Jeong, Joon; Koo, Ja Seung; Yoon, Jung Hyun; Moon, Hee Jung; Kim, Suhkmann; Kim, Min Jung

    2016-01-01

    Our goal in this study was to find correlations between breast cancer metabolites and conventional quantitative imaging parameters using high-resolution magic angle spinning (HR-MAS) magnetic resonance spectroscopy (MRS) and to find breast cancer subgroups that show high correlations between metabolites and imaging parameters. Between August 2010 and December 2013, we included 53 female patients (mean age 49.6 years; age range 32-75 years) with a total of 53 breast lesions assessed by the Breast Imaging Reporting and Data System. They were enrolled under the following criteria: breast lesions larger than 1 cm in diameter which 1) were suspicious for malignancy on mammography or ultrasound (US), 2) were pathologically confirmed to be breast cancer with US-guided core-needle biopsy (CNB) 3) underwent 3 Tesla MRI with dynamic contrast-enhanced (DCE) and diffusion-weighted imaging (DWI) and positron emission tomography-computed tomography (PET-CT), and 4) had an attainable immunohistochemistry profile from CNB. We acquired spectral data by HR-MAS MRS with CNB specimens and expressed the data as relative metabolite concentrations. We compared the metabolites with the signal enhancement ratio (SER), maximum standardized FDG uptake value (SUV max), apparent diffusion coefficient (ADC), and histopathologic prognostic factors for correlation. We calculated Spearman correlations and performed a partial least squares-discriminant analysis (PLS-DA) to further classify patient groups into subgroups to find correlation differences between HR-MAS spectroscopic values and conventional imaging parameters. In a multivariate analysis, the PLS-DA models built with HR-MAS MRS metabolic profiles showed visible discrimination between high and low SER, SUV, and ADC. In luminal subtype breast cancer, compared to all cases, high SER, ADV, and SUV were more closely clustered by visual assessment. Multiple metabolites were correlated with SER and SUV in all cases. Multiple metabolites showed

  5. Metabolomics of Breast Cancer Using High-Resolution Magic Angle Spinning Magnetic Resonance Spectroscopy: Correlations with 18F-FDG Positron Emission Tomography-Computed Tomography, Dynamic Contrast-Enhanced and Diffusion-Weighted Imaging MRI.

    Directory of Open Access Journals (Sweden)

    Haesung Yoon

    Full Text Available Our goal in this study was to find correlations between breast cancer metabolites and conventional quantitative imaging parameters using high-resolution magic angle spinning (HR-MAS magnetic resonance spectroscopy (MRS and to find breast cancer subgroups that show high correlations between metabolites and imaging parameters.Between August 2010 and December 2013, we included 53 female patients (mean age 49.6 years; age range 32-75 years with a total of 53 breast lesions assessed by the Breast Imaging Reporting and Data System. They were enrolled under the following criteria: breast lesions larger than 1 cm in diameter which 1 were suspicious for malignancy on mammography or ultrasound (US, 2 were pathologically confirmed to be breast cancer with US-guided core-needle biopsy (CNB 3 underwent 3 Tesla MRI with dynamic contrast-enhanced (DCE and diffusion-weighted imaging (DWI and positron emission tomography-computed tomography (PET-CT, and 4 had an attainable immunohistochemistry profile from CNB. We acquired spectral data by HR-MAS MRS with CNB specimens and expressed the data as relative metabolite concentrations. We compared the metabolites with the signal enhancement ratio (SER, maximum standardized FDG uptake value (SUV max, apparent diffusion coefficient (ADC, and histopathologic prognostic factors for correlation. We calculated Spearman correlations and performed a partial least squares-discriminant analysis (PLS-DA to further classify patient groups into subgroups to find correlation differences between HR-MAS spectroscopic values and conventional imaging parameters.In a multivariate analysis, the PLS-DA models built with HR-MAS MRS metabolic profiles showed visible discrimination between high and low SER, SUV, and ADC. In luminal subtype breast cancer, compared to all cases, high SER, ADV, and SUV were more closely clustered by visual assessment. Multiple metabolites were correlated with SER and SUV in all cases. Multiple metabolites

  6. Comparisons of Positron Emission Tomography/Computed Tomography and Ultrasound Imaging for Detection of Internal Mammary Lymph Node Metastases in Patients With Breast Cancer and Pathologic Correlation by Ultrasound-Guided Biopsy Procedures.

    Science.gov (United States)

    An, Yeong Yi; Kim, Sung Hun; Kang, Bong Joo; Lee, Ah Won

    2015-08-01

    To compare the diagnostic performance of [(18)F]fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and ultrasound imaging (US) with pathologic results obtained by US-guided biopsy and to evaluate the role of US in detecting internal mammary lymph node (LN) metastases in patients with breast cancer. Between January 2008 and December 2012, 37 patients with breast cancer (median age, 51.4 years; range, 40-79 years) underwent US-guided biopsy for suspected internal mammary LN metastases. Medical records, radiologic images, and reports were reviewed and correlated with pathologic results. The positive internal mammary LN metastasis rate was 78.4%. All biopsies were performed safely without major complications. Only 8.1% of obtained samples were unsatisfactory. There were statistically significant differences in lesion size (P = .0002), standardized uptake value on PET/CT (P = .0015), biopsy methods (P = .002), and specimen adequacy (P = .007) between metastatic and benign groups. Of the clinical factorsreviewed, only concurrent distant metastasis was correlated with internal mammary LN metastasis (P< .0001). Sensitivities for detecting internal mammary LN metastases were 76.7%, 96.7%, and 92.9% for initial US examinations, initial US combined with second-look US for initially missed cases, and PET/CT, respectively (P= .017). In a subgroup analysis, the only significant difference found was in sensitivities between initial and combined US (P = .019). In a receiver operating characteristic curve analysis, the area under the curve for PET/CT using standardized uptake criteria (0.87) was higher than that for US using size criteria (0.83); however, this difference was not significant. Although PET/CT is the best noninvasive method for evaluating internal mammary LN metastases, US is also useful if internal mammary LN evaluation is routine during standard US surveillance of patients with breast cancer. Additionally, US-guided biopsies could be

  7. 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

    Directory of Open Access Journals (Sweden)

    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

  8. Predictive ability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography for pathological complete response and prognosis after neoadjuvant chemotherapy in triple-negative breast cancer patients

    Directory of Open Access Journals (Sweden)

    Sachiko Kiyoto

    2016-01-01

    Full Text Available Objective The mortality of patients with locally advanced triple-negative breast cancer (TNBC is high, and pathological complete response (pCR to neoadjuvant chemotherapy (NAC is associated with improved prognosis. This retrospective study was designed and powered to investigate the ability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT to predict pathological response to NAC and prognosis after NAC.Methods The data of 32 consecutive women with clinical stage II or III TNBC from January 2006 to December 2013 in our institution who underwent FDG-PET/CT at baseline and after NAC were retrospectively analyzed. The maximum standardized uptake value (SUVmax in the primary tumor at each examination and the change in SUVmax (ΔSUVmax between the two scans were measured. Correlations between PET parameters and pathological response, and correlations between PET parameters and disease-free survival (DFS were examined.Results At the completion of NAC, surgery showed pCR in 7 patients, while 25 had residual tumor, so-called non-pCR. Median follow-up was 39.0 months. Of the non-pCR patients, 9 relapsed at 3 years. Of all assessed clinical, biological, and PET parameters, N-stage, clinical stage, and ΔSUVmax were predictors of pathological response (p=0.0288, 0.0068, 0.0068; Fischer’s exact test. The cut-off value of ΔSUVmax to differentiate pCR evaluated by the receiver operating characteristic (ROC curve analysis was 81.3%. Three-year disease-free survival (DFS was lower in patients with non-pCR than in patients with pCR (p=0.328, log-rank test. The cut-off value of ΔSUVmax to differentiate 3-year DFS evaluated by the ROC analysis was 15.9%. In all cases, 3-year DFS was lower in patients with ΔSUVmax

  9. Role of 11C-choline positron emission tomography/computed tomography in evaluating patients affected by prostate cancer with suspected relapse due to prostate-specific antigen elevation

    International Nuclear Information System (INIS)

    Bertagna, F.; Bosio, G.; Abuhilal, M.

    2011-01-01

    The aim of this study was to evaluate the accuracy of 11 C-choline positron emission tomography/computed tomography (PET/CT) in restaging patients affected by prostate cancer and suspected relapse due to prostate-specific antigen (PSA) increase. We also aimed to determine a PSA cutoff that is most suited to the study in terms of best compromise between sensitivity and specificity. Secondary endpoints were a comparison between 11 C-choline PET/CT and histological results, clinical findings, and radiological imaging (CT and magnetic resonance imaging). We retrospectively evaluated 210 patients (median±standard deviation (SD) age 70±7 years) affected by prostate cancer who underwent 11 C-choline PET/CT. 11 C-choline PET/CT imaging was positive in 116 (55.2%) patients and negative in 94 (44.8%). Receiver operating characteristic (ROC) analysis showed that the highest accuracy (sensitivity 76.8%, specificity 92.5%) for the whole population was achieved when the PSA level of 1.26 ng/ml level was used as the cutoff value for interpreting the results (P=0.0001 and the area under the ROC curve area under the curve (AUC)=0.897). For patients treated with surgery or surgery plus radiotherapy the cutoff was 0.81 ng/ml (sensitivity 73.2%, specificity 86.1%). For patients treated with radiotherapy alone, the cutoff was 2.0 ng/ml (sensitivity 81.8%, specificity 92.9%). Our results indicate that 11 C-choline PET/CT is a useful diagnostic tool in patients affected by prostate cancer and a relapsed PSA level. The highest accuracy for all patients is obtained with a PSA cutoff level of 1.26 ng/ml, above which the imaging study is performed (0.81 ng/ml for patients treated with surgery or surgery plus radiotherapy and 2.0 ng/ml for patients treated with radiotherapy alone). (author)

  10. {sup 18}F-Choline Positron Emission Tomography/Computed Tomography and Multiparametric Magnetic Resonance Imaging for the Detection of Early Local Recurrence of Prostate Cancer Initially Treated by Radiation Therapy: Comparison With Systematic 3-Dimensional Transperineal Mapping Biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Kanoun, Salim, E-mail: Salim.kanoun@gmail.com [Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon (France); LE2I UMR6306, Centre national de la recherche scientifique, Arts et Métiers, Université Bourgogne Franche-Comté, Dijon (France); MRI Unit, Centre Hospitalier Régional Universitaire, Hôpital François Mitterrand, Dijon (France); Walker, Paul [LE2I UMR6306, Centre national de la recherche scientifique, Arts et Métiers, Université Bourgogne Franche-Comté, Dijon (France); MRI Unit, Centre Hospitalier Régional Universitaire, Hôpital François Mitterrand, Dijon (France); Vrigneaud, Jean-Marc; Depardon, Edouard [Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon (France); Barbier, Vincent [Department of Urology, Centre Hospitalier Régional Universitaire, Hôpital François Mitterrand, Dijon (France); Humbert, Olivier [Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon (France); Moulin, Morgan [Department of Urology, Centre Hospitalier Régional Universitaire, Hôpital François Mitterrand, Dijon (France); and others

    2017-04-01

    Purpose: To compare the diagnostic performance of {sup 18}F-fluorocholine positron emission tomography/computed tomography (FCH-PET/CT), multiparametric prostate magnetic resonance imaging (mpMRI), and a combination of both techniques for the detection of local recurrence of prostate cancer initially treated by radiation therapy. Methods and Materials: This was a retrospective, single-institution study of 32 patients with suspected prostate cancer recurrence who underwent both FCH-PET/CT and 3T mpMRI within 3 months of one another for the detection of recurrence. All included patients had to be cleared for metastatic recurrence. The reference procedure was systematic 3-dimensional (3D)-transperineal prostate biopsy for the final assessment of local recurrence. Both imaging modalities were analyzed by 2 experienced readers blinded to clinical data. The analysis was made per-patient and per-segment using a 4-segment model. Results: The median prostate-specific antigen value at the time of imaging was 2.92 ng/mL. The mean prostate-specific antigen doubling time was 14 months. Of the 32 patients, 31 had a positive 3D-transperineal mapping biopsy for a local relapse. On a patient-based analysis, the detection rate was 71% (22 of 31) for mpMRI and 74% (23 of 31) for FCH-PET/CT. On a segment-based analysis, the sensitivity and specificity were, respectively, 32% and 87% for mpMRI, 34% and 87% for FCH-PET/CT, and 43% and 83% for the combined analysis of both techniques. Accuracy was 64%, 65%, and 66%, respectively. The interobserver agreement was κ = 0.92 for FCH-PET/CT and κ = 0.74 for mpMRI. Conclusions: Both mpMRI and FCH-PET/CT show limited sensitivity but good specificity for the detection of local cancer recurrence after radiation therapy, when compared with 3D-transperineal mapping biopsy. Prostate biopsy still seems to be mandatory to diagnose local relapse and select patients who could benefit from local salvage therapy.

  11. Immune reconstitution inflammatory syndrome due to Mycobacterium avium complex successfully followed up using 18 F-fluorodeoxyglucose positron emission tomography-computed tomography in a patient with human immunodeficiency virus infection: A case report

    International Nuclear Information System (INIS)

    Namkoong, Ho; Fujiwara, Hiroshi; Ishii, Makoto; Yagi, Kazuma; Haraguchi, Mizuha; Matsusaka, Masako; Suzuki, Shoji; Asakura, Takanori; Asami, Takahiro; Saito, Fumitake; Fukunaga, Koichi; Tasaka, Sadatomo; Betsuyaku, Tomoko; Hasegawa, Naoki

    2015-01-01

    In human immunodeficiency virus (HIV)-infected patients, immune reconstitution inflammatory syndrome (IRIS) due to nontuberculous mycobacteria (NTM) infection is one of the most difficult types of IRIS to manage. 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) has been suggested as a useful tool for evaluating the inflammatory status of HIV-infected patients. We present the first case of Mycobacterium avium complex (MAC)-associated IRIS (MAC-IRIS) that was successfully followed up using 18 F-FDG PET/CT. A 44-year-old homosexual Japanese man was referred to our hospital with fever and dyspnea. He was diagnosed with Pneumocystis jiroveci pneumonia and found to be HIV positive. After the initiation of combined antiretroviral therapy (cART), the patient’s mediastinal and bilateral hilar lymphadenopathy gradually enlarged, and bilateral infiltrates appeared in the upper lung fields. 18 F-FDG PET/CT was performed five months after the initiation of cART and showed intense accumulation of fluorodeoxyglucose (FDG) corresponding to the lesions of infiltration as well as the mediastinal and bilateral hilar lymphadenopathy. A bronchial wash culture and pathology findings led to a diagnosis of MAC-IRIS. Anti-mycobacterial chemotherapy with rifampicin, ethambutol, clarithromycin, and levofloxacin was started. One year after the chemotherapy was initiated, there was a significant reduction in FDG uptake in the area of the lesions except in the mediastinal lymph node. This implied incomplete resolution of the MAC-IRIS-related inflammation. Anti-mycobacterial chemotherapy was continued because of the residual lesion. To date, the patient has not experienced a recurrence of MAC-IRIS, a period of nine months. We present a case of MAC-IRIS in an HIV-infected patient whose disease activity was successfully followed up using 18 F-FDG PET/CT. Our data suggest that 18 F-FDG PET/CT is useful for evaluating the disease activity of NTM-IRIS and

  12. Extended Field Intensity Modulated Radiation Therapy With Concomitant Boost for Lymph Node–Positive Cervical Cancer: Analysis of Regional Control and Recurrence Patterns in the Positron Emission Tomography/Computed Tomography Era

    Energy Technology Data Exchange (ETDEWEB)

    Vargo, John A.; Kim, Hayeon; Choi, Serah [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Sukumvanich, Paniti; Olawaiye, Alexander B.; Kelley, Joseph L.; Edwards, Robert P.; Comerci, John T. [Department of Gynecologic Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Beriwal, Sushil, E-mail: beriwals@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States)

    2014-12-01

    Purpose: Positron emission tomography/computed tomography (PET/CT) is commonly used for nodal staging in locally advanced cervical cancer; however the false negative rate for para-aortic disease are 20% to 25% in PET-positive pelvic nodal disease. Unless surgically staged, pelvis-only treatment may undertreat para-aortic disease. We have treated patients with PET-positive nodes with extended field intensity modulated radiation therapy (IMRT) to address the para-aortic region prophylactically with concomitant boost to involved nodes. The purpose of this study was to assess regional control rates and recurrence patterns. Methods and Materials: Sixty-one patients with cervical cancer (stage IBI-IVA) diagnosed from 2003 to 2012 with PET-avid pelvic nodes treated with extended field IMRT (45 Gy in 25 fractions with concomitant boost to involved nodes to a median of 55 Gy in 25 fractions) with concurrent cisplatin and brachytherapy were retrospectively analyzed. The nodal location was pelvis-only in 41 patients (67%) and pelvis + para-aortic in 20 patients (33%). There were a total of 179 nodes, with a median number of positive nodes of 2 (range, 1-16 nodes) per patient and a median nodal size of 1.8 cm (range, 0.7-4.5 cm). Response was assessed by PET/CT at 12 to 16 weeks. Results: Complete clinical and imaging response at the first follow-up visit was seen in 77% of patients. At a mean follow-up time of 29 months (range, 3-116 months), 8 patients experienced recurrence. The sites of persistent/recurrent disease were as follows: cervix 10 (16.3%), regional nodes 3 (4.9%), and distant 14 (23%). The rate of para-aortic failure in patients with pelvic-only nodes was 2.5%. There were no significant differences in recurrence patterns by the number/location of nodes, largest node size, or maximum node standardized uptake value. The rate of late grade 3+ adverse events was 4%. Conclusions: Extended field IMRT was well tolerated and resulted in low regional recurrence

  13. Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) Combined with Positron Emission Tomography-Computed Tomography (PET-CT) and Video-Electroencephalography (VEEG) Have Excellent Diagnostic Value in Preoperative Localization of Epileptic Foci in Children with Epilepsy.

    Science.gov (United States)

    Wang, Gui-Bin; Long, Wei; Li, Xiao-Dong; Xu, Guang-Yin; Lu, Ji-Xiang

    2017-01-01

    BACKGROUND To investigate the effect that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has on surgical decision making relative to video-electroencephalography (VEEG) and positron emission tomography-computed tomography (PET-CT), and if the differences in these variables translates to differences in surgical outcomes. MATERIAL AND METHODS A total of 166 children with epilepsy undergoing preoperative DCE-MRI, VEEG, and PET-CT examinations, surgical resection of epileptic foci, and intraoperative electrocorticography (ECoG) monitoring were enrolled. All children were followed up for 12 months and grouped by Engles prognostic classification for epilepsy. Based on intraoperative ECoG as gold standard, the diagnostic values of DCE-MRI, VEEG, PET-CT, DCE-MRI combined with VEEG, DCE-MRI combined with PET-CT, and combined application of DCE-MRI, VEEG, and PET-CT in preoperative localization for epileptic foci were evaluated. RESULTS The sensitivity of DCE-MRI, VEEG, and PET-CT was 59.64%, 76.51%, and 93.98%, respectively; the accuracy of DCE-MRI, VEEG, PET-CT, DCE-MRI combined with VEEG, and DCE-MRI combined with PET-CT was 57.58%, 67.72%, 91.03%, 91.23%, and 96.49%, respectively. Localization accuracy rate of the combination of DCE-MRI, VEEG, and PET-CT was 98.25% (56/57), which was higher than that of DCE-MRI combined with VEEG and of DCE-MRI combined with PET-CT. No statistical difference was found in the accuracy rate of localization between these three combined techniques. During the 12-month follow-up, children were grouped into Engles grade I (n=106), II (n=31), III (n=21), and IV (n=8) according to postoperative conditions. CONCLUSIONS All DCE-MRI combined with VEEG, DCE-MRI combined with PET-CT, and DCE-MRI combined with VEEG and PET-CT examinations have excellent accuracy in preoperative localization of epileptic foci and present excellent postoperative efficiency, suggesting that these combined imaging methods are suitable for serving as the

  14. Performance of Positron Emission Tomography and Positron Emission Tomography/Computed Tomography Using Fluorine-18-Fluorodeoxyglucose for the Diagnosis, Staging, and Recurrence Assessment of Bone Sarcoma: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Liu, Fengxia; Zhang, Qingyu; Zhu, Dezhi; Li, Zhenfeng; Li, Jianmin; Wang, Boim; Zhou, Dongsheng; Dong, Jinlei

    2015-09-01

    To investigate the performance of fluorine-18-fluorodeoxyglucose (F-FDG) positron emission tomography (PET) and PET/computed tomography (CT) in the diagnosis, staging, restaging, and recurrence surveillance of bone sarcoma by systematically reviewing and meta-analyzing the published literature.To retrieve eligible studies, we searched the MEDLINE, Embase, and the Cochrane Central library databases using combinations of following Keywords: "positron emission tomography" or "PET," and "bone tumor" or "bone sarcoma" or "sarcoma." Bibliographies from relevant articles were also screened manually. Data were extracted and the pooled sensitivity, specificity, and diagnostic odds ratio (DOR), on an examination-based or lesion-based level, were calculated to appraise the diagnostic accuracy of F-FDG PET and PET/CT. All statistical analyses were performed using Meta-Disc 1.4.Forty-two trials were eligible. The pooled sensitivity and specificity of PET/CT to differentiate primary bone sarcomas from benign lesions were 96% (95% confidence interval [CI], 93-98) and 79% (95% CI, 63-90), respectively. For detecting recurrence, the pooled results on an examination-based level were sensitivity 92% (95% CI, 85-97), specificity 93% (95% CI, 88-96), positive likelihood ratio (PLR) 10.26 (95% CI, 5.99-17.60), and negative likelihood ratio (NLR) 0.11 (95% CI, 0.05-0.22). For detecting distant metastasis, the pooled results on a lesion-based level were sensitivity 90% (95% CI, 86-93), specificity 85% (95% CI, 81-87), PLR 5.16 (95% CI, 2.37-11.25), and NLR 0.15 (95% CI, 0.11-0.20). The accuracies of PET/CT for detecting local recurrence, lung metastasis, and bone metastasis were satisfactory. Pooled outcome estimates of F-FDG PET were less complete compared with those of PET/CT.F-FDG PET and PET/CT showed a high sensitivity for diagnosing primary bone sarcoma. Moreover, PET/CT demonstrated excellent accuracy for the staging, restaging, and recurrence surveillance of bone sarcoma. However

  15. 18F-Fluorodeoxyglucose Positron Emission Tomography/Magnetic Resonance in Lymphoma: Comparison With 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and With the Addition of Magnetic Resonance Diffusion-Weighted Imaging.

    Science.gov (United States)

    Giraudo, Chiara; Raderer, Markus; Karanikas, Georgios; Weber, Michael; Kiesewetter, Barbara; Dolak, Werner; Simonitsch-Klupp, Ingrid; Mayerhoefer, Marius E

    2016-03-01

    The aim of this study was to compare F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/magnetic resonance (MR) (with and without diffusion-weighted imaging [DWI]) to F-FDG PET/computed tomography (CT), with regard to the assessment of nodal and extranodal involvement, in patients with Hodgkin lymphoma and non-Hodgkin lymphoma, without restriction to FDG-avid subytpes. Patients with histologically proven lymphoma were enrolled in this prospective, institutional review board-approved study. After a single F-FDG injection, patients consecutively underwent F-FDG PET[Fraction Slash]CT and F-FDG PET/MR on the same day for staging or restaging. Three sets of images were analyzed separately: F-FDG PET/CT, F-FDG PET/MR without DWI, and F-FDG PET/MR with DWI. Region-based agreement and examination-based sensitivity and specificity were calculated for F-FDG PET/CT, F-FDG PET/MR without DWI, and F-FDG PET/MR DWI. Maximum and mean standardized uptake values (SUVmax, SUVmean) on F-FDG PET/CT and F-FDG PET/MR were compared and correlated with minimum and mean apparent diffusion coefficients (ADCmin, ADCmean). Thirty-four patients with a total of 40 examinations were included. Examination-based sensitivities for F-FDG PET/CT, F-FDG PET/MR, and F-FDG PET/MR DWI were 82.1%, 85.7%, and 100%, respectively; specificities were 100% for all 3 techniques; and accuracies were 87.5%, 90%, and 100%, respectively. F-FDG PET/CT was false negative in 5 of 40 examinations (all with mucosa-associated lymphoid tissue lymphoma), and F-FDG PET/MR (without DWI) was false negative in 4 of 40 examinations. Region-based percentages of agreement were 99% (κ, 0.95) between F-FDG PET/MR DWI and F-FDG PET/CT, 99.2% (κ, 0.96) between F-FDG PET/MR and F-FDG PET/CT, and 99.4% (κ, 0.97) between F-FDG PET/MR DWI and F-FDG PET/MR. There was a strong correlation between F-FDG PET/CT and F-FDG PET/MR for SUVmax (r = 0.83) and SUVmean (r = 0.81) but no significant correlation between ADCmin and SUVmax

  16. 18F-Choline Positron Emission Tomography/Computed Tomography–Driven High-Dose Salvage Radiation Therapy in Patients With Biochemical Progression After Radical Prostatectomy: Feasibility Study in 60 Patients

    International Nuclear Information System (INIS)

    D'Angelillo, Rolando M.; Sciuto, Rosa; Ramella, Sara; Papalia, Rocco; Jereczek-Fossa, Barbara A.; Trodella, Luca E.; Fiore, Michele; Gallucci, Michele; Maini, Carlo L.; Trodella, Lucio

    2014-01-01

    Purpose: To retrospectively review data of a cohort of patients with biochemical progression after radical prostatectomy, treated according to a uniform institutional treatment policy, to evaluate toxicity and feasibility of high-dose salvage radiation therapy (80 Gy). Methods and Materials: Data on 60 patients with biochemical progression after radical prostatectomy between January 2009 and September 2011 were reviewed. The median value of prostate-specific antigen before radiation therapy was 0.9 ng/mL. All patients at time of diagnosis of biochemical recurrence underwent dynamic 18 F-choline positron emission tomography/computed tomography (PET/CT), which revealed in all cases a local recurrence. High-dose salvage radiation therapy was delivered up to total dose of 80 Gy to 18F-choline PET/CT-positive area. Toxicity was recorded according to the Common Terminology Criteria for Adverse Events, version 3.0, scale. Results: Treatment was generally well tolerated: 54 patients (90%) completed salvage radiation therapy without any interruption. Gastrointestinal grade ≥2 acute toxicity was recorded in 6 patients (10%), whereas no patient experienced a grade ≥2 genitourinary toxicity. No grade 4 acute toxicity events were recorded. Only 1 patient (1.7%) experienced a grade 2 gastrointestinal late toxicity. With a mean follow-up of 31.2 months, 46 of 60 patients (76.6%) were free of recurrence. The 3-year biochemical progression-free survival rate was 72.5%. Conclusions: At early follow-up, 18 F-choline PET/CT-driven high-dose salvage radiation therapy seems to be feasible and well tolerated, with a low rate of toxicity

  17. Improvement in the detection of locoregional recurrence in head and neck malignancies: F-18 fluorodeoxyglucose-positron emission tomography/computed tomography compared to high-resolution contrast-enhanced computed tomography and endoscopic examination.

    Science.gov (United States)

    Rangaswamy, Balasubramanya; Fardanesh, M Reza; Genden, Eric M; Park, Eunice E; Fatterpekar, Girish; Patel, Zara; Kim, Jongho; Som, Peter M; Kostakoglu, Lale

    2013-11-01

    To compare the diagnostic efficacy of positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG-PET)/computed tomography (CT) to that of contrast-enhanced high-resolution CT (HRCT) and assess the value of a combinatorial approach in detection of recurrent squamous cell cancer of the head and neck (HNC) and to assess the efficacy of FDG-PET/CT with and without HRCT in comparison to standard-of-care follow-up--physical examination (PE) and endoscopy (E)--in determination of locally recurrent HNC. Retrospective study. A total of 103 patients with HNC underwent FDG-PET/CT and neck HRCT. There were two groups of patients: Group A had an FDG-PET study acquired with low-dose CT, and group B had an FDG-PET study acquired with HRCT. The PET data obtained with or without HRCT were compared on a lesion and patient basis with the results of the PE/E. On a lesion basis, both groups combined had higher sensitivity and negative predictive value (NPV) than the HRCT. Specificity and positive predictive value (PPV) for group B were higher than for group A. On a patient basis, both groups combined had a higher sensitivity and NPV than PE/E, respectively, although specificity of PE/E was higher than that of either group. PET data obtained with either protocol directly influenced treatment. HRCT increases the specificity and PPV of PET/CT when acquired simultaneously with PET. FDG-PET/CT acquired with either LDCT or HRCT has higher accuracy than HRCT alone and increases the sensitivity and NPV of PE/E. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Cervical Gross Tumor Volume Dose Predicts Local Control Using Magnetic Resonance Imaging/Diffusion-Weighted Imaging—Guided High-Dose-Rate and Positron Emission Tomography/Computed Tomography—Guided Intensity Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Dyk, Pawel; Jiang, Naomi; Sun, Baozhou; DeWees, Todd A. [Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri (United States); Fowler, Kathryn J.; Narra, Vamsi [Department of Diagnostic Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri (United States); Garcia-Ramirez, Jose L.; Schwarz, Julie K. [Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri (United States); Grigsby, Perry W., E-mail: pgrigsby@wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri (United States); Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri (United States); Division of Gynecologic Oncology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri (United States); Alvin J. Siteman Cancer Center, Washington University School of Medicine, St Louis, Missouri (United States)

    2014-11-15

    Purpose: Magnetic resonance imaging/diffusion weighted-imaging (MRI/DWI)-guided high-dose-rate (HDR) brachytherapy and {sup 18}F-fluorodeoxyglucose (FDG) — positron emission tomography/computed tomography (PET/CT)-guided intensity modulated radiation therapy (IMRT) for the definitive treatment of cervical cancer is a novel treatment technique. The purpose of this study was to report our analysis of dose-volume parameters predicting gross tumor volume (GTV) control. Methods and Materials: We analyzed the records of 134 patients with International Federation of Gynecology and Obstetrics stages IB1-IVB cervical cancer treated with combined MRI-guided HDR and IMRT from July 2009 to July 2011. IMRT was targeted to the metabolic tumor volume and lymph nodes by use of FDG-PET/CT simulation. The GTV for each HDR fraction was delineated by use of T2-weighted or apparent diffusion coefficient maps from diffusion-weighted sequences. The D100, D90, and Dmean delivered to the GTV from HDR and IMRT were summed to EQD2. Results: One hundred twenty-five patients received all irradiation treatment as planned, and 9 did not complete treatment. All 134 patients are included in this analysis. Treatment failure in the cervix occurred in 24 patients (18.0%). Patients with cervix failures had a lower D100, D90, and Dmean than those who did not experience failure in the cervix. The respective doses to the GTV were 41, 58, and 136 Gy for failures compared with 67, 99, and 236 Gy for those who did not experience failure (P<.001). Probit analysis estimated the minimum D100, D90, and Dmean doses required for ≥90% local control to be 69, 98, and 260 Gy (P<.001). Conclusions: Total dose delivered to the GTV from combined MRI-guided HDR and PET/CT-guided IMRT is highly correlated with local tumor control. The findings can be directly applied in the clinic for dose adaptation to maximize local control.

  19. Endobronchial ultrasound-guided transbronchial needle aspiration for systematic nodal staging of lung cancer in patients with N0 disease by computed tomography and integrated positron emission tomography-computed tomography.

    Science.gov (United States)

    Ong, Philip; Grosu, Horiana; Eapen, George A; Rodriguez, Macarena; Lazarus, Donald; Ost, David; Jimenez, Carlos A; Morice, Rodolfo; Bandi, Venkata; Tamara, Luis; Cornwell, Lorraine; Green, Linda; Zhu, Angela; Casal, Roberto F

    2015-03-01

    Data regarding the sensitivity of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for staging of lung cancer in patients with radiographic N0 disease is scant and inconsistent. With increasing use of nonoperative ablative therapies, studies focusing on the performance characteristics of EBUS-TBNA in this population are important. To evaluate the sensitivity and negative predictive value (NPV) of EBUS-TBNA in patients with non-small cell lung cancer and radiographic N0 disease both by computed tomography (CT) and positron emission tomography (PET)-CT. This was a retrospective review of EBUS-TBNA performed for lung cancer staging at two major academic centers from 2009 to 2014. Patients with radiographic N0 disease (lymph nodes [LN]≤1 cm in the short axis and maximum standardized uptake value≤2.5 by PET-CT) were included. Primary outcome was sensitivity and NPV of EBUS-TBNA. Two hundred twenty patients with radiographic N0 disease underwent EBUS-TBNA, and 734 LN were sampled (median 3, range 1-6). Median LN diameter was 0.72 cm. One hundred patients (45.5%) underwent surgery, and 120 patients (54.5%) had nonsurgical therapy. N status was up-staged in 49 patients (22.3%): 18 by EBUS-TBNA (N1=11, N2=6, N3=1), 27 by surgery (N1 intralobar=16, N1 extralobar=3, N2=8 [5 LN in stations 4 and 7, and 3 LN in stations 5-6), and 4 by imaging follow-up (N1=2, N2=2). Overall false-negative rate of EBUS was 14.1% (sensitivity, 36.7%; specificity, 100%; and NPV, 84.7%). False-negative rate was 27 and 3.3% in surgical and nonsurgical populations, respectively. Excluding patients with occult disease "outside" the reach of EBUS, the overall false-negative rate of EBUS-TBNA was 5.5% (sensitivity, 60%; specificity, 100%; and NPV, 93.4%). This is the largest report of EBUS-TBNA in patients with N0 disease by "integrated" PET-CT. The majority of false-negative EBUS results were in LN stations outside its reach. In our study, both sensitivity and NPV of

  20. Three-Dimensional Image Fusion of 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography and Contrast-Enhanced Computed Tomography for Computer-Assisted Planning of Maxillectomy of Recurrent Maxillary Squamous Cell Carcinoma and Defect Reconstruction.

    Science.gov (United States)

    Yu, Yao; Zhang, Wen-Bo; Liu, Xiao-Jing; Guo, Chuan-Bin; Yu, Guang-Yan; Peng, Xin

    2017-06-01

    The purpose of this study was to describe new technology assisted by 3-dimensional (3D) image fusion of 18 F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) and contrast-enhanced CT (CECT) for computer planning of a maxillectomy of recurrent maxillary squamous cell carcinoma and defect reconstruction. Treatment of recurrent maxillary squamous cell carcinoma usually includes tumor resection and free flap reconstruction. FDG-PET/CT provided images of regions of abnormal glucose uptake and thus showed metabolic tumor volume to guide tumor resection. CECT data were used to create 3D reconstructed images of vessels to show the vascular diameters and locations, so that the most suitable vein and artery could be selected during anastomosis of the free flap. The data from preoperative maxillofacial CECT scans and FDG-PET/CT imaging were imported into the navigation system (iPlan 3.0; Brainlab, Feldkirchen, Germany). Three-dimensional image fusion between FDG-PET/CT and CECT was accomplished using Brainlab software according to the position of the 2 skulls simulated in the CECT image and PET/CT image, respectively. After verification of the image fusion accuracy, the 3D reconstruction images of the metabolic tumor, vessels, and other critical structures could be visualized within the same coordinate system. These sagittal, coronal, axial, and 3D reconstruction images were used to determine the virtual osteotomy sites and reconstruction plan, which was provided to the surgeon and used for surgical navigation. The average shift of the 3D image fusion between FDG-PET/CT and CECT was less than 1 mm. This technique, by clearly showing the metabolic tumor volume and the most suitable vessels for anastomosis, facilitated resection and reconstruction of recurrent maxillary squamous cell carcinoma. We used 3D image fusion of FDG-PET/CT and CECT to successfully accomplish resection and reconstruction of recurrent maxillary squamous cell carcinoma

  1. Comparison of primary tumour volumes delineated on four-dimensional computed tomography maximum intensity projection and 18F-fluorodeoxyglucose positron emission tomography computed tomography images of non-small cell lung cancer

    International Nuclear Information System (INIS)

    Duan, Yili; Li, Jianbin; Zhang, Yingjie; Wang, Wei; Fan, Tingyong; Shao, Qian; Xu, Min; Guo, Yanluan; Sun, Xiaorong; Shang, Dongping

    2015-01-01

    The study aims to compare the positional and volumetric differences of tumour volumes based on the maximum intensity projection (MIP) of four-dimensional CT (4DCT) and 18 F-fluorodexyglucose ( 18 F-FDG) positron emission tomography CT (PET/CT) images for the primary tumour of non-small cell lung cancer (NSCLC). Ten patients with NSCLC underwent 4DCT and 18 F-FDG PET/CT scans of the thorax on the same day. Internal gross target volumes (IGTVs) of the primary tumours were contoured on the MIP images of 4DCT to generate IGTV MIP . Gross target volumes (GTVs) based on PET (GTV PET ) were determined with nine different threshold methods using the auto-contouring function. The differences in the volume, position, matching index (MI) and degree of inclusion (DI) of the GTV PET and IGTV MIP were investigated. In volume terms, GTV PET2.0 and GTV PET20% approximated closely to IGTV MIP with mean volume ratio of 0.93 ± 0.45 and 1.06 ± 0.43, respectively. The best MI was between IGTV MIP and GTV PET20% (0.45 ± 0.23). The best DI of IGTV MIP in GTV PET was IGTV MIP in GTV PET20% (0.61 ± 0.26). In 3D PET images, the GTVPET contoured by standardised uptake value (SUV) 2.0 or 20% of maximal SUV (SUV max ) approximate closely to the IGTV MIP in target size, while the spatial mismatch is apparent between them. Therefore, neither of them could replace IGTV MIP in spatial position and form. The advent of 4D PET/CT may improve the accuracy of contouring the perimeter for moving targets.

  2. Simultaneous whole body 18F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging for evaluation of pediatric cancer: Preliminary experience and comparison with 18F-fluorodeoxyglucose positron emission tomography computed tomogra

    Institute of Scientific and Technical Information of China (English)

    Brian S Pugmire; Alexander R Guimaraes; Ruth Lim; Alison M Friedmann; Mary Huang; David Ebb; Howard Weinstein; Onofrio A Catalano; Umar Mahmood; Ciprian Catana; Michael S Gee

    2016-01-01

    AIM: To describe our preliminary experience with simultaneous whole body 18F-fluorodeoxyglucose(18F-FDG)positron emission tomography and magnetic resonance imaging(PET-MRI) in the evaluation of pediatric oncology patients.METHODS: This prospective, observational, singlecenter study was Health Insurance Portability and Accountability Act-compliant, and institutional review board approved. To be eligible, a patient was required to:(1) have a known or suspected cancer diagnosis;(2) be under the care of a pediatric hematologist/oncologist; and(3) be scheduled for clinically indicated 18F-FDG PETCT examination at our institution. Patients underwent PET-CT followed by PET-MRI on the same day. PET-CT examinations were performed using standard department protocols. PET-MRI studies were acquired with an integrated 3 Tesla PET-MRI scanner using whole body T1 Dixon, T2 HASTE, EPI diffusion-weighted imaging(DWI) and STIR sequences. No additional radiotracer was given for the PET-MRI examination. Both PET-CT and PETMRI examinations were reviewed by consensus by two study personnel. Test performance characteristics of PETMRI, for the detection of malignant lesions, including FDG maximum standardized uptake value(SUVmax) and minimum apparent diffusion coefficient(ADCmin), were calculated on a per lesion basis using PET-CT as a reference standard.RESULTS: A total of 10 whole body PET-MRI exams were performed in 7 pediatric oncology patients. The mean patient age was 16.1 years(range 12-19 years) including 6 males and 1 female. A total of 20 malignant and 21 benign lesions were identified on PET-CT. PET-MRI SUVmax had excellent correlation with PET-CT SUVmax for both benign and malignant lesions(R = 0.93). PETMRI SUVmax > 2.5 had 100% accuracy for discriminating benign from malignant lesions using PET-computed tomography(CT) reference. Whole body DWI was also evaluated: the mean ADCmin of malignant lesions(780.2 + 326.6) was significantly

  3. Pertuzumab and Erlotinib in Patients With Relapsed Non-Small Cell Lung Cancer: A Phase II Study Using 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging

    Science.gov (United States)

    Mileshkin, Linda; Townley, Peter; Gitlitz, Barbara; Eaton, Keith; Mitchell, Paul; Hicks, Rodney; Wood, Katie; Amler, Lucas; Fine, Bernard M.; Loecke, David; Pirzkall, Andrea

    2014-01-01

    Background. Combination blockade of human epidermal growth factor receptor (HER) family signaling may confer enhanced antitumor activity than single-agent blockade. We performed a single-arm study of pertuzumab, a monoclonal antibody that inhibits HER2 dimerization, and erlotinib in relapsed non-small cell lung cancer (NSCLC). Methods. Patients received pertuzumab (840-mg loading dose and 420-mg maintenance intravenously every 3 weeks) and erlotinib (150-mg or 100-mg dose orally, daily). The primary endpoint was response rate (RR) by 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) at day 56 in all patients and those with EGFR wild-type tumors. Results. Of 41 patients, 28 (68.3%) experienced treatment-related grade ≥3 adverse events, including pneumatosis intestinalis (3 patients), resulting in early cessation of enrollment. Tissue samples from 32 patients showed mutated EGFR status in 9 of 41 (22%) and wild-type EGFR in 23 of 41 (56%). The FDG-PET RR for patients with assessments at day 56 was 19.5% in all patients (n = 41) and 8.7% in patients with wild-type EGFR NSCLC (n = 23). Investigator-assessed computed tomography RR at day 56 was 12.2%. Conclusion. FDG-PET suggests that pertuzumab plus erlotinib is an active combination, but combination therapy was poorly tolerated, which limits its clinical applicability. More research is warranted to identify drug combinations that disrupt HER receptor signaling but that exhibit improved tolerability profiles. PMID:24457379

  4. A segmentectomy of the right upper lobe has an advantage over a right upper lobectomy regarding the preservation of the functional volume of the right middle lobe. Analysis by perfusion single-photon emission computed tomography/computed tomography

    International Nuclear Information System (INIS)

    Yoshimoto, Kentaro; Nomori, Hiroaki; Mori, Takeshi; Ohba, Yasuomi; Shibata, Hidekatsu; Tashiro, Kuniyuki; Shiraishi, Shinya; Kobayashi, Toshiaki

    2010-01-01

    To evaluate the advantages of a segmentectomy of the right upper lobe (RUL) over a right upper (RU) lobectomy regarding the preservation of the functional volume of the right middle lobe (RML), the postoperative forced expiratory volume in one second (FEV 1 ) of the RML was compared between an RU lobectomy and an RUL segmentectomy, by using a coregistered perfusion single-photon emission computed tomography and computed tomography (SPECT/CT). The pulmonary function tests and perfusion SPECT/CT were conducted before and after surgery (RU lobectomy: 7; RUL segmentectomy: 13). The FEV 1 of the RML before and after surgery was calculated from the data of the pulmonary function test and SPECT/CT. In the RU lobectomy group, the percentage change of FEV 1 was 71%±12%, which was significantly lower in comparison to 92%±9% in the RUL segmentectomy group (P=0.001). In the lobectomy group, the preoperative FEV 1 of the RML was 0.17±0.101 which decreased significantly to 0.06±0.061 after surgery (P=0.009). In the segmentectomy group, FEV 1 of the RML before and after the surgery were 0.23±0.101 and 0.20±0.111, of which the difference was not significant. An RUL segmentectomy has an advantage over an RU lobectomy regarding the preservation of pulmonary function, due to a greater preservation of not only the lung tissue, but also the FEV 1 of the RML. (author)

  5. Imaging Cellular Proliferation During Chemo-Radiotherapy: A Pilot Study of Serial 18F-FLT Positron Emission Tomography/Computed Tomography Imaging for Non-Small-Cell Lung Cancer

    International Nuclear Information System (INIS)

    Everitt, Sarah; Hicks, Rodney J.; Ball, David; Kron, Tomas; Schneider-Kolsky, Michal; Walter, Tania; Binns, David; Mac Manus, Michael

    2009-01-01

    Purpose: To establish whether 18 F-3'-deoxy-3'-fluoro-L-thymidine ( 18 F-FLT) can monitor changes in cellular proliferation of non-small-cell lung cancer (NSCLC) during radical chemo-radiotherapy (chemo-RT). Methods and Materials: As part of a prospective pilot study, 5 patients with locally advanced NSCLC underwent serial 18 F-FLT positron emission tomography (PET)/computed tomography (CT) scans during treatment. Baseline 18 F-FLT PET/CT scans were compared with routine staging 18 F-FDG PET/CT scans. Two on-treatment 18 F-FLT scans were performed for each patient on Days 2, 8, 15 or 29, providing a range of time points for response assessment. Results: In all 5 patients, baseline lesional uptake of 18 F-FLT on PET/CT corresponded to staging 18 F-FDG PET/CT abnormalities. 18 F-FLT uptake in tumor was observed on five of nine (55%) on-treatment scans, on Days 2, 8 and 29, but not Day 15. A 'flare' of 18 F-FLT uptake in the primary tumor of one case was observed after 2 Gy of radiation (1.22 x baseline). The remaining eight on-treatment scans demonstrated a mean reduction in 18 F-FLT tumor uptake of 0.58 x baseline. A marked reduction of 18 F-FLT uptake in irradiated bone marrow was observed for all cases. This reduction was observed even after only 2 Gy, and all patients demonstrated a complete absence of proliferating marrow after 10 Gy. Conclusions: This proof of concept study indicates that 18 F-FLT uptake can monitor the distinctive biologic responses of epithelial cancers and highly radiosensitive normal tissue changes during radical chemo-RT. Further studies of 18 F-FLT PET/CT imaging during therapy may suggest that this tracer is useful in developing response-adapted RT for NSCLC.

  6. 18F-fluorodeoxyglucose positron emission tomography/computed tomography enables the detection of recurrent same-site deep vein thrombosis by illuminating recently formed, neutrophil-rich thrombus.

    Science.gov (United States)

    Hara, Tetsuya; Truelove, Jessica; Tawakol, Ahmed; Wojtkiewicz, Gregory R; Hucker, William J; MacNabb, Megan H; Brownell, Anna-Liisa; Jokivarsi, Kimmo; Kessinger, Chase W; Jaff, Michael R; Henke, Peter K; Weissleder, Ralph; Jaffer, Farouc A

    2014-09-23

    Accurate detection of recurrent same-site deep vein thrombosis (DVT) is a challenging clinical problem. Because DVT formation and resolution are associated with a preponderance of inflammatory cells, we investigated whether noninvasive (18)F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) imaging could identify inflamed, recently formed thrombi and thereby improve the diagnosis of recurrent DVT. We established a stasis-induced DVT model in murine jugular veins and also a novel model of recurrent stasis DVT in mice. C57BL/6 mice (n=35) underwent ligation of the jugular vein to induce stasis DVT. FDG-PET/computed tomography (CT) was performed at DVT time points of day 2, 4, 7, 14, or 2+16 (same-site recurrent DVT at day 2 overlying a primary DVT at day 16). Antibody-based neutrophil depletion was performed in a subset of mice before DVT formation and FDG-PET/CT. In a clinical study, 38 patients with lower extremity DVT or controls undergoing FDG-PET were analyzed. Stasis DVT demonstrated that the highest FDG signal occurred at day 2, followed by a time-dependent decrease (Pthrombus neutrophils (Pthrombus PET signal intensity. Neutrophil depletion decreased FDG signals in day 2 DVT in comparison with controls (P=0.03). Recurrent DVT demonstrated significantly higher FDG uptake than organized day 14 DVT (P=0.03). The FDG DVT signal in patients also exhibited a time-dependent decrease (Pthrombus inflammation in murine DVT, and demonstrates a time-dependent signal decrease in both murine and clinical DVT. FDG-PET/CT may offer a molecular imaging strategy to accurately diagnose recurrent DVT. © 2014 American Heart Association, Inc.

  7. Prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with Barcelona Clinic Liver Cancer stages 0 and A hepatocellular carcinomas: a multicenter retrospective cohort study

    International Nuclear Information System (INIS)

    Hyun, Seung Hyup; Choi, Joon Young; Lee, Kyung-Han; Eo, Jae Seon; Lee, Jeong Won; Na, Sae Jung; Hong, Il Ki; Oh, Jin Kyoung; Chung, Yong An; Song, Bong-Il; Kim, Tae-Sung; Kim, Kyung Sik; Moon, Dae Hyuk; Yun, Mijin

    2016-01-01

    We evaluated the prognostic value of pretreatment 18 F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG PET/CT) in patients with Barcelona Clinic Liver Cancer (BCLC) stage 0 or A hepatocellular carcinoma (HCC) who had received curative treatment or transarterial chemoembolization (TACE). Between 2009 and 2010, 317 patients diagnosed with HCC at seven hospitals were enrolled. Among these, 195 patients underwent curative treatments including resection, liver transplantation, and radiofrequency ablation. TACE was performed in 122 patients. The tumor-to-normal liver standardized uptake value ratio (TLR) of the primary tumor was measured using pretreatment FDG PET/CT. The prognostic significance of TLR and other clinical variables was assessed using Cox regression models. Differences in the overall survival (OS) associated with TLR or other significant clinical factors were examined using the Kaplan-Meier method. Over a median follow-up period of 46 months, 77 patients died from cancer. In the curative cohort, higher TLR (≥2) was significantly associated with death (hazard ratio [HR] = 2.68; 95 % CI, 1.16-6.15; P = 0.020) in multivariable analysis. Patients with a higher TLR had significantly worse OS than patients with a lower TLR (5-year overall survival, 61 % vs. 79.4 %; P = 0.006). In the TACE cohort, the Model for End-Stage Liver Disease (MELD) score (≥8) was a significant independent prognostic factor for OS (HR = 3.34; 95 % CI, 1.49-7.48; P = 0.003), whereas TLR was not associated with OS. The Kaplan-Meier curves showed significantly poorer OS in patients with higher MELD scores (≥8) than in those with lower MELD scores (5-year survival rate, 33.1 % vs. 79.6 %; P < 0.001). Pretreatment TLR measured using FDG PET/CT was an independent prognostic factor for OS in patients with BCLC stage 0 or A HCC undergoing curative treatment. In contrast, underlying liver function appeared to be important in predicting the prognosis of patients

  8. Prospective study of tailoring whole-body dual-modality [18F]fluorodeoxyglucose positron emission tomography/computed tomography with plasma Epstein-Barr virus DNA for detecting distant metastasis in endemic nasopharyngeal carcinoma at initial staging.

    Science.gov (United States)

    Tang, Lin-Quan; Chen, Qiu-Yan; Fan, Wei; Liu, Huai; Zhang, Lu; Guo, Ling; Luo, Dong-Hua; Huang, Pei-Yu; Zhang, Xu; Lin, Xiao-Ping; Mo, Yun-Xian; Liu, Li-Zhi; Mo, Hao-Yuan; Li, Jian; Zou, Ru-Hai; Cao, Yun; Xiang, Yan-Qun; Qiu, Fang; Sun, Rui; Chen, Ming-Yuan; Hua, Yi-Jun; Lv, Xing; Wang, Lin; Zhao, Chong; Guo, Xiang; Cao, Ka-Jia; Qian, Chao-Nan; Zeng, Mu-Sheng; Mai, Hai-Qiang

    2013-08-10

    To evaluate which patients with nasopharyngeal carcinoma (NPC) obtained the greatest benefits from the detection of distant metastasis with [(18)F]fluorodeoxyglucose positron emission tomography and computed tomography (PET/CT) combined with plasma Epstein-Barr virus (EBV) DNA levels. Consecutive patients with NPC were prospectively enrolled. PET/CT, conventional work-up (CWU), and quantification of plasma EBV DNA were performed before treatment. The accuracy of these strategies for distant metastases was assessed. The costs of the diagnostic strategies were compared. Eighty-six (14.8%) of the 583 eligible patients were found to have distant metastases; 71 patients (82.6%) by PET/CT and 31 patients (36.0%) by CWU. In the multivariable analysis, advanced N stage (odds ratio, 2.689; 95% CI, 1.894 to 3.818) and pretreatment EBV DNA level (odds ratio, 3.344; 95% CI, 1.825 to 6.126) were significant risk factors for distant metastases. PET/CT was not superior to CWU for detecting distant metastases in very low-risk patients (N0-1 with EBV DNA < 4,000 copies/mL; P = .062), but was superior for the low-risk patients (N0-1 with EBV DNA ≥ 4,000 copies/mL and N2-3 with EBV DNA < 4,000 copies/mL; P = .039) and intermediate-risk patients (N2-3 disease with EBV DNA ≥ 4,000 copies/mL; P < .001). The corresponding patient management changes based on PET/CT were 2.9%, 6.3%, and 16.5%, respectively. The costs per true-positive case detected by PET/CT among these groups were ¥324,138 (≈$47,458), ¥96,907 (≈$14,188), and ¥34,182 (≈$5,005), respectively. PET/CT detects more distant metastases than conventional staging in patients with NPC. The largest benefit in terms of cost and patient management was observed in the subgroup with N2-3 disease and EBV DNA ≥ 4,000 copies/mL.

  9. Positron Emission Tomography/Computed Tomography Findings During Therapy Predict Outcome in Patients With Diffuse Large B-Cell Lymphoma Treated With Chemotherapy Alone but Not in Those Who Receive Consolidation Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Dabaja, Bouthaina S., E-mail: bdabaja@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hess, Kenneth [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Shihadeh, Ferial [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Podoloff, Donald A. [Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Medeiros, L. Jeffrey [Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mawlawi, Osama [Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Arzu, Isidora [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Oki, Yasuhiro; Hagemeister, Fredrick B.; Fayad, Luis E. [Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Reed, Valerie K.; Kedir, Aziza; Wogan, Christine F. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Rodriguez, Alma [Office of the Executive Vice President and Physician-in-Chief, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2014-06-01

    Purpose: To assess the value of mid-therapy positron emission tomography (PET) findings for predicting survival and disease progression in patients with diffuse large B-cell lymphoma, considering type of therapy (chemotherapy with or without radiation therapy). Methods and Materials: We retrospectively evaluated 294 patients with histologically confirmed diffuse large B-cell lymphoma with respect to age, sex, disease stage, International Prognostic Index score, mid-therapy PET findings (positive or negative), and disease status after therapy and at last follow-up. Overall survival (OS) and progression-free survival (PFS) were compared according to mid-therapy PET findings. Results: Of the 294 patients, 163 (55%) were male, 144 (49%) were age >61 years, 110 (37%) had stage I or II disease, 219 (74%) had International Prognostic Index score ≤2, 216 (73%) received ≥6 cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, and 88 (30%) received consolidation radiation therapy. Five-year PFS and OS rates were associated with mid-therapy PET status: PFS was 78% for those with PET-negative (PET−) disease versus 63% for PET-positive (PET+) disease (P=.024), and OS was 82% for PET− versus 62% for PET+ (P<.002). These associations held true for patients who received chemotherapy only (PFS 71% for PET− vs 52% PET+ [P=.012], OS 78% for PET− and 51% for PET+ [P=.0055]) but not for those who received consolidation radiation therapy (PFS 84% PET− vs 81% PET+ [P=.88]; OS 90% PET− vs 81% PET+ [P=.39]). Conclusion: Mid-therapy PET can predict patient outcome, but the use of consolidation radiation therapy may negate the significance of mid-therapy findings.

  10. Change of Maximum Standardized Uptake Value Slope in Dynamic Triphasic [{sup 18}F]-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Distinguishes Malignancy From Postradiation Inflammation in Head-and-Neck Squamous Cell Carcinoma: A Prospective Trial

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Carryn M., E-mail: carryn-anderson@uiowa.edu [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Chang, Tangel [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Graham, Michael M. [Department of Nuclear Medicine, University of Iowa, Iowa City, Iowa (United States); Marquardt, Michael D. [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Button, Anna; Smith, Brian J. [Department of Biostatistics, University of Iowa, Iowa City, Iowa (United States); Menda, Yusuf [Department of Nuclear Medicine, University of Iowa, Iowa City, Iowa (United States); Sun, Wenqing [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Pagedar, Nitin A. [Department of Otolaryngology—Head and Neck Surgery, University of Iowa, Iowa City, Iowa (United States); Buatti, John M. [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States)

    2015-03-01

    Purpose: To evaluate dynamic [{sup 18}F]-fluorodeoxyglucose (FDG) uptake methodology as a post–radiation therapy (RT) response assessment tool, potentially enabling accurate tumor and therapy-related inflammation differentiation, improving the posttherapy value of FDG–positron emission tomography/computed tomography (FDG-PET/CT). Methods and Materials: We prospectively enrolled head-and-neck squamous cell carcinoma patients who completed RT, with scheduled 3-month post-RT FDG-PET/CT. Patients underwent our standard whole-body PET/CT scan at 90 minutes, with the addition of head-and-neck PET/CT scans at 60 and 120 minutes. Maximum standardized uptake values (SUV{sub max}) of regions of interest were measured at 60, 90, and 120 minutes. The SUV{sub max} slope between 60 and 120 minutes and change of SUV{sub max} slope before and after 90 minutes were calculated. Data were analyzed by primary site and nodal site disease status using the Cox regression model and Wilcoxon rank sum test. Outcomes were based on pathologic and clinical follow-up. Results: A total of 84 patients were enrolled, with 79 primary and 43 nodal evaluable sites. Twenty-eight sites were interpreted as positive or equivocal (18 primary, 8 nodal, 2 distant) on 3-month 90-minute FDG-PET/CT. Median follow-up was 13.3 months. All measured SUV endpoints predicted recurrence. Change of SUV{sub max} slope after 90 minutes more accurately identified nonrecurrence in positive or equivocal sites than our current standard of SUV{sub max} ≥2.5 (P=.02). Conclusions: The positive predictive value of post-RT FDG-PET/CT may significantly improve using novel second derivative analysis of dynamic triphasic FDG-PET/CT SUV{sub max} slope, accurately distinguishing tumor from inflammation on positive and equivocal scans.

  11. Prospective Evaluation of Magnetic Resonance Imaging and [18F]Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography at Diagnosis and Before Maintenance Therapy in Symptomatic Patients With Multiple Myeloma Included in the IFM/DFCI 2009 Trial: Results of the IMAJEM Study.

    Science.gov (United States)

    Moreau, Philippe; Attal, Michel; Caillot, Denis; Macro, Margaret; Karlin, Lionel; Garderet, Laurent; Facon, Thierry; Benboubker, Lotfi; Escoffre-Barbe, Martine; Stoppa, Anne-Marie; Laribi, Kamel; Hulin, Cyrille; Perrot, Aurore; Marit, Gerald; Eveillard, Jean-Richard; Caillon, Florence; Bodet-Milin, Caroline; Pegourie, Brigitte; Dorvaux, Veronique; Chaleteix, Carine; Anderson, Kenneth; Richardson, Paul; Munshi, Nikhil C; Avet-Loiseau, Herve; Gaultier, Aurelie; Nguyen, Jean-Michel; Dupas, Benoit; Frampas, Eric; Kraeber-Bodere, Françoise

    2017-09-01

    Purpose Magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) are important imaging techniques in multiple myeloma (MM). We conducted a prospective trial in patients with MM aimed at comparing MRI and PET-CT with respect to the detection of bone lesions at diagnosis and the prognostic value of the techniques. Patients and Methods One hundred thirty-four patients received a combination of lenalidomide, bortezomib, and dexamethasone (RVD) with or without autologous stem-cell transplantation, followed by lenalidomide maintenance. PET-CT and MRI were performed at diagnosis, after three cycles of RVD, and before maintenance therapy. The primary end point was the detection of bone lesions at diagnosis by MRI versus PET-CT. Secondary end points included the prognostic impact of MRI and PET-CT regarding progression-free (PFS) and overall survival (OS). Results At diagnosis, MRI results were positive in 127 of 134 patients (95%), and PET-CT results were positive in 122 of 134 patients (91%; P = .33). Normalization of MRI after three cycles of RVD and before maintenance was not predictive of PFS or OS. PET-CT became normal after three cycles of RVD in 32% of the patients with a positive evaluation at baseline, and PFS was improved in this group (30-month PFS, 78.7% v 56.8%, respectively). PET-CT normalization before maintenance was described in 62% of the patients who were positive at baseline. This was associated with better PFS and OS. Extramedullary disease at diagnosis was an independent prognostic factor for PFS and OS, whereas PET-CT normalization before maintenance was an independent prognostic factor for PFS. Conclusion There is no difference in the detection of bone lesions at diagnosis when comparing PET-CT and MRI. PET-CT is a powerful tool to evaluate the prognosis of de novo myeloma.

  12. Integrated positron emission tomography/computed tomography for ...

    African Journals Online (AJOL)

    Methods. Patients who underwent both PET-CT and lymph node tissue sampling for the investigation of suspected NSCLC were prospectively included in this observational study. Results were analysed per patient and per lymph node stage. A post-hoc analysis was performed to test the validity of a maximum standardised ...

  13. Shielding Calculations for Positron Emission Tomography - Computed Tomography Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Baasandorj, Khashbayar [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Yang, Jeongseon [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2015-10-15

    Integrated PET-CT has been shown to be more accurate for lesion localization and characterization than PET or CT alone, and the results obtained from PET and CT separately and interpreted side by side or following software based fusion of the PET and CT datasets. At the same time, PET-CT scans can result in high patient and staff doses; therefore, careful site planning and shielding of this imaging modality have become challenging issues in the field. In Mongolia, the introduction of PET-CT facilities is currently being considered in many hospitals. Thus, additional regulatory legislation for nuclear and radiation applications is necessary, for example, in regulating licensee processes and ensuring radiation safety during the operations. This paper aims to determine appropriate PET-CT shielding designs using numerical formulas and computer code. Since presently there are no PET-CT facilities in Mongolia, contact was made with radiological staff at the Nuclear Medicine Center of the National Cancer Center of Mongolia (NCCM) to get information about facilities where the introduction of PET-CT is being considered. Well-designed facilities do not require additional shielding, which should help cut down overall costs related to PET-CT installation. According to the results of this study, building barrier thicknesses of the NCCM building is not sufficient to keep radiation dose within the limits.

  14. Positron emission tomography/computer tomography in gastrointestinal malignancies

    DEFF Research Database (Denmark)

    Tind, Sofie; Vestergaard, Sys; Farahani, Ziba A

    2017-01-01

    The use of FDG-PET/CT in GI-malignancies may not be as straightforward as in many other cancers, but the potential is clearly there in select clinical settings. The challenges include the relative non-specificity of FDG, the variable degrees of physiologic FDG-uptake, and the heterogeneous FDG-up...

  15. Positron Emission Tomography - Computed Tomography (PET/CT)

    Science.gov (United States)

    ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: ... Colorectal Cancer Treatment Head and Neck Cancer Treatment Brain Tumor Treatment Contrast Materials Alzheimer's ...

  16. Comprehensive Oncologic Imaging in Infants and Preschool Children With Substantially Reduced Radiation Exposure Using Combined Simultaneous ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/Magnetic Resonance Imaging: A Direct Comparison to ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography.

    Science.gov (United States)

    Gatidis, Sergios; Schmidt, Holger; Gücke, Brigitte; Bezrukov, Ilja; Seitz, Guido; Ebinger, Martin; Reimold, Matthias; Pfannenberg, Christina A; Nikolaou, Konstantin; Schwenzer, Nina F; Schäfer, Jürgen F

    2016-01-01

    The aim of this study was to evaluate the clinical applicability and technical feasibility of fluorodeoxyglucose (FDG) positron emission tomography (PET)/magnetic resonance imaging (MRI) compared with FDG PET/computed tomography (CT) in young children focusing on lesion detection, PET quantification, and potential savings in radiation exposure. Twenty examinations (10 PET/CT and 10 PET/MRI examinations) were performed prospectively in 9 patients with solid tumors (3 female, 6 male; mean age, 4.8 [1-6] years). Fluorodeoxyglucose PET/CT and FDG PET/MRI were performed sequentially after a single tracer injection. Lesion detection and analysis were performed independently in PET/CT and PET/MRI. Potential changes in diagnostic or therapeutic patient management were recorded. Positron emission tomography quantification in PET/MRI was evaluated by comparing standardized uptake values resulting from MRI-based and CT-based attenuation correction. Effective radiation doses of PET and CT were estimated. Twenty-one PET-positive lesions were found congruently in PET/CT and PET/MRI. Magnetic resonance imaging enabled significantly better detection of morphologic PET correlates compared with CT. Eight suspicious PET-negative lesions were identified by MRI, of which one was missed in CT. Sensitivity, specificity, and accuracy for correct lesion classification were not significantly different (90%, 47%, and 62% in PET/CT; 100%, 68%, and 79% in PET/MRI, respectively). In 4 patients, the use of PET/MRI resulted in a potential change in diagnostic management compared with PET/CT, as local and whole-body staging could be performed within 1 single examination. In 1 patient, PET/MRI initiated a change in therapeutic management. Positron emission tomography quantification using MRI-based attenuation correction was accurate compared with CT-based attenuation correction. Higher standardized uptake value deviations of about 18% were observed in the lungs due to misclassification in MRI

  17. Oblique hilar tomography, computed tomography, and mediastinoscopy for prethoracotomy staging of bronchogenic carcinoma

    International Nuclear Information System (INIS)

    Khan, A.; Gersten, K.C.; Garvey, J.; Khan, F.A.; Steinberg, H.

    1985-01-01

    Preoperative oblique hilar tomography was used to evaluate hilar lymph nodes in 150 patients with clinically resectable bronchogenic carcinoma. CT was also used in the evaluation of mediastinal lymph nodes in 50 of these patients. Subsequently, all patients underwent mediastinoscopy and/or thoracotomy. Hilar and mediastinal nodes were evaluated for the presence of metastasis, and these findings were then correlated with the radiographic findings of oblique hilar tomography and CT. CT was found to be a reliable method for prethoracotomy staging of bronchogenic carcinoma and for selecting patients for mediastinoscopy. Thus patients with negative mediastinal CT need not undergo mediastinoscopy prior to thoracotomy, while mediastinoscopy and biopsy should be done in patients with enlarged mediastinal nodes on CT. Oblique hilar tomography is an accurate method for evaluation of hilar adenopathy and for predicting mediastinal involvement by extrapolation

  18. Variation in radiotherapy target volume definition, dose to organs at risk and clinical target volumes using anatomic (computed tomography) versus combined anatomic and molecular imaging (positron emission tomography/computed tomography): intensity-modulated radiotherapy delivered using a tomotherapy Hi Art machine: final results of the VortigERN study.

    Science.gov (United States)

    Chatterjee, S; Frew, J; Mott, J; McCallum, H; Stevenson, P; Maxwell, R; Wilsdon, J; Kelly, C G

    2012-12-01

    Contrast-enhanced computed tomography (CECT) is the current standard for delineating tumours of the head and neck for radiotherapy. Although metabolic imaging with positron emission tomography (PET) has been used in recent years, the studies were non-confirmatory in establishing its routine role in radiotherapy planning in the modern era. This study explored the difference in gross tumour volume and clinical target volume definitions for the primary and nodal volumes when FDG PET/CT was used as compared with CECT in oropharyngeal cancer cases. Twenty patients with oropharyngeal cancers had a PET/CT scan in the treatment position after consent. Target volumes were defined on CECT scans by a consultant clinical oncologist who was blind to the PET scans. After obtaining inputs from a radiologist, another set of target volumes were outlined on the PET/CT data set. The gross and clinical target volumes as defined on the two data sets were then analysed. The hypothesis of more accurate target delineation, preventing geographical miss and comparative overlap volumes between CECT and PET/CT, was explored. The study also analysed the volumes of intersection and analysed whether there was any TNM stage migration when PET/CT was used as compared with CECT for planning. In 17 of 20 patients, the TNM stage was not altered when adding FDG PET information to CT. PET information prevented geographical miss in two patients and identified distant metastases in one case. PET/CT gross tumour volumes were smaller than CECT volumes (mean ± standard deviation: 25.16 cm(3) ± 35.8 versus 36.56 cm(3) ± 44.14; P standard deviation: CECT versus PET/CT 32.48 cm(3) ± 36.63 versus 32.21 cm(3) ± 37.09; P > 0.86) were not statistically different. Similarity and discordance coefficients were calculated and are reported. PET/CT as compared with CECT could provide more clinically relevant information and prevent geographical miss when used for radiotherapy planning for advanced oropharyngeal

  19. Program standard of quality control for a system of Positron Emission Tomography-computed tomography (PET-CT) used in the Foundation Valle de Lili; Programa estandar de control de calidad para un sistema de tomografia por emision de positrones-tomografia computadorizada (PET-CT) utilizado en la Fundacion Valle del Lili

    Energy Technology Data Exchange (ETDEWEB)

    Nunez, Nathalia I.; Benavides, Sivor O., E-mail: Nnunez@fcvl.org, E-mail: Obenavides@fcvl.org [Fundacion Valle del Lili (OFM-PR/FVL), Cali (Colombia). Dept. de Fisica Medica y Proteccion Radiologica; Lopera, Wilson, E-mail: wilson.lopera@correounivalle.edu.co [Universidad del Valle, Cali (Colombia). Dept. de Fisica

    2013-07-01

    A standard protocol of quality control in the Fundacion Valle del Lili for the implementation of a multimodal scanner developed emission tomography BIOGRAPH mCT X-3R of SIEMENS Registered-Sign covering routine testing, frequency, acceptance ranges necessary corrective and preventive measures to detect and correct any faults and proceed if the upper detection precision and accuracy ranges accepted deviations actions. In order to minimize errors in the planning and management of patient dose, thereby improving the quality of the diagnostic image with the dose of radiation is reasonably low as possible, consistent with the clinical use of the equipment used and the information requested diagnostic study.

  20. Emission computed tomography

    International Nuclear Information System (INIS)

    Ott, R.J.

    1986-01-01

    Emission Computed Tomography is a technique used for producing single or multiple cross-sectional images of the distribution of radionuclide labelled agents in vivo. The techniques of Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET) are described with particular regard to the function of the detectors used to produce images and the computer techniques used to build up images. (UK)

  1. Positron emission tomography

    International Nuclear Information System (INIS)

    Reivich, M.; Alavi, A.

    1985-01-01

    This book contains 24 selections. Some of the titles are: Positron Emission Tomography Instrumentation, Generator Systems for Positron Emitters, Reconstruction Algorithms, Cerebral Glucose Consumption: Methodology and Validation, Cerebral Blood Flow Tomography Using Xenon-133 Inhalation: Methods and Clinical Applications, PET Studies of Stroke, Cardiac Positron Emission Tomography, and Use of PET in Oncology

  2. Can 3'-Deoxy-3'-((18)F) Fluorothymidine Out Perform 2-Deoxy-2-((18)F) Fluoro-D-Glucose Positron Emission Tomography/Computed Tomography in the Diagnosis of Cervical Lymphadenopathy in Patients With Oral/Head and Neck Cancer?

    Science.gov (United States)

    Schaefferkoetter, Joshua D; Carlson, Eric R; Heidel, Robert E

    2015-07-01

    The present study investigated the performance of cellular metabolism imaging with 2-deoxy-2-((18)F) fluoro-D-glucose (FDG) versus cellular proliferation imaging with 3'-deoxy-3'-((18)F) fluorothymidine (FLT) in the detection of cervical lymph node metastases in oral/head and neck cancer. We conducted a prospective cohort study to assess a head-to-head performance of FLT imaging and clinical FDG imaging for characterizing cervical lymph node metastases in patients with squamous cell carcinoma (SCC) of the oral/head and neck region. The primary predictor variable of the study was the presence of FDG or FLT avidity within the cervical lymph nodes. The primary outcome variable was the histologic presence of metastatic SCC in the cervical lymph nodes. The performance was reported in terms of the sensitivity, specificity, accuracy, and positive and negative predictive values. The overall accuracy for discriminating positive from negative lymph nodes was evaluated as a function of the positron emission tomography (PET) standardized uptake value (SUV). Receiver operating characteristic (ROC) analyses were performed for both tracers. Eleven patients undergoing surgical resection of SCC of the oral/head and neck region underwent preoperative FDG and FLT PET-computed tomography (CT) scans on separate days. The interpretation of the FDG PET-CT imaging resulted in sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 43.2, 99.5, 94.4, 88.9, and 94.7%, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for FLT PET-CT imaging was 75.7, 99.2, 97.1, 90.3, and 97.7%, respectively. The areas under the curve for the ROC curves were 0.9 and 0.84 for FDG and FLT, respectively. Poor correlation was observed between the SUV for FDG and FLT within the lymph nodes and tumors. FLT showed better overall performance for detecting lymphadenopathy on qualitative assessment within the total

  3. Early Chemotherapy Intensification With Escalated BEACOPP in Patients With Advanced-Stage Hodgkin Lymphoma With a Positive Interim Positron Emission Tomography/Computed Tomography Scan After Two ABVD Cycles: Long-Term Results of the GITIL/FIL HD 0607 Trial.

    Science.gov (United States)

    Gallamini, Andrea; Tarella, Corrado; Viviani, Simonetta; Rossi, Andrea; Patti, Caterina; Mulé, Antonino; Picardi, Marco; Romano, Alessandra; Cantonetti, Maria; La Nasa, Giorgio; Trentin, Livio; Bolis, Silvia; Rapezzi, Davide; Battistini, Roberta; Gottardi, Daniela; Gavarotti, Paolo; Corradini, Paolo; Cimminiello, Michele; Schiavotto, Corrado; Parvis, Guido; Zanotti, Roberta; Gini, Guido; Ferreri, Andrés J M; Viero, Piera; Miglino, Maurizio; Billio, Atto; Avigdor, Abraham; Biggi, Alberto; Fallanca, Federico; Ficola, Umberto; Gregianin, Michele; Chiaravalloti, Agostino; Prosperini, Giuseppe; Bergesio, Fabrizio; Chauvie, Stephane; Pavoni, Chiara; Gianni, Alessandro Massimo; Rambaldi, Alessandro

    2018-02-10

    Purpose To investigate the progression-free survival (PFS) of patients with advanced Hodgkin lymphoma (HL) after a risk-adapted treatment strategy that was based on a positive positron emission tomography scan performed after two doxorubicin, vinblastine, vincristine, and dacarbazine (ABVD) cycles (PET2). Patients and Methods Patients with advanced-stage (IIB to IVB) HL were consecutively enrolled. After two ABVD cycles, PET2 was performed and centrally reviewed according to the Deauville five-point scale. Patients with a positive PET2 were randomly assigned to four cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) followed by four cycles of standard BEACOPP with or without rituximab. Patients with a negative PET2 continued ABVD, and those with a large nodal mass at diagnosis (≥ 5 cm) in complete remission with a negative PET at the end of chemotherapy were randomly assigned to radiotherapy or no further treatment. The primary end point was 3-year PFS. Results Of 782 enrolled patients, 150 (19%) had a positive and 630 (81%) a negative PET2. The 3-year PFS of all patients was 82%. The 3-year PFS of those with a positive and negative PET2 was 60% and 87%, respectively ( P < .001). The 3-year PFS of patients with a positive PET2 assigned to BEACOPP with or without rituximab was 63% versus 57% ( P = .53). In 296 patients with both interim and post-ABVD-negative PET who had a large nodal mass at diagnosis, radiotherapy was randomly added after chemotherapy without a significant PFS improvement (97% v 93%, respectively; P = .29). The 3-year overall survival of all 782 patients was 97% (99% and 89% for PET2 negative and positive, respectively). Conclusion The PET-driven switch from ABVD to escalated BEACOPP is feasible and effective in high-risk patients with advanced-stage HL.

  4. Single photon emission tomography

    International Nuclear Information System (INIS)

    Buvat, Irene

    2011-09-01

    The objective of this lecture is to present the single photon emission computed tomography (SPECT) imaging technique. Content: 1 - Introduction: anatomic, functional and molecular imaging; Principle and role of functional or molecular imaging; 2 - Radiotracers: chemical and physical constraints, main emitters, radioisotopes production, emitters type and imaging techniques; 3 - Single photon emission computed tomography: gamma cameras and their components, gamma camera specifications, planar single photon imaging characteristics, gamma camera and tomography; 4 - Quantification in single photon emission tomography: attenuation, scattering, un-stationary spatial resolution, partial volume effect, movements, others; 5 - Synthesis and conclusion

  5. Contrast-enhanced fluorodeoxyglucose positron emission tomography/contrast-enhanced computed tomography in mediastinal T-cell lymphoma with superior vena cava syndrome

    International Nuclear Information System (INIS)

    Santhosh, Sampath; Gorla, Arun Kumar Reddy; Bhattacharya, Anish; Varma, Subhash Chander; Mittal, Bhagwant Rai

    2016-01-01

    Positron emission tomography-computed tomography (PET/CT) is a routine investigation for the staging of lymphomas. Contrast-enhanced computed tomography is mandatory whenever parenchymal lesions, especially in the liver and spleen are suspected. We report a rare case of primary mediastinal T-cell lymphoma evaluated with contrast-enhanced PET/CT that showed features of superior vena cava syndrome

  6. Quantification in emission tomography

    International Nuclear Information System (INIS)

    Buvat, Irene

    2011-11-01

    The objective of this lecture is to understand the possibilities and limitations of the quantitative analysis of single photon emission computed tomography (SPECT) and positron emission tomography (PET) images. It is also to identify the conditions to be fulfilled to obtain reliable quantitative measurements from images. Content: 1 - Introduction: Quantification in emission tomography - definition and challenges; quantification biasing phenomena 2 - Main problems impacting quantification in PET and SPECT: problems, consequences, correction methods, results (Attenuation, scattering, partial volume effect, movement, un-stationary spatial resolution in SPECT, fortuitous coincidences in PET, standardisation in PET); 3 - Synthesis: accessible efficiency, know-how, Precautions, beyond the activity measurement

  7. Cardiac positron emission tomography

    International Nuclear Information System (INIS)

    Eftekhari, M.; Ejmalian, G.

    2003-01-01

    Positron emission tomography is an intrinsically tool that provide a unique and unparalleled approach for clinicians and researchers to interrogate the heart noninvasively. The ability to label substances of physiological interest with positron-emitting radioisotopes has permitted insight into normal blood flow and metabolism and the alterations that occur with disease states. Positron emission tomography of the heart has evolved as a unique, noninvasive approach for the assessment of myocardial perfusion, metabolism, and function. Because of the intrinsic quantitative nature of positron emission tomography measurements as well as the diverse compounds that can be labeled with positron- emitting radioisotopes, studies with positron emission tomography have provided rich insight into the physiology of the heart under diverse conditions

  8. Positron emission tomography

    International Nuclear Information System (INIS)

    Iio, Masahiro

    1982-01-01

    Utilization of positron emission tomography was reviewed in relation to construction and planned construction of small-size medical cyclotrons, planned construction of positron cameras and utilization of short-lived radionuclides. (Chiba, N.)

  9. Emission computed tomography

    International Nuclear Information System (INIS)

    Budinger, T.F.; Gullberg, G.T.; Huesman, R.H.

    1979-01-01

    This chapter is devoted to the methods of computer assisted tomography for determination of the three-dimensional distribution of gamma-emitting radionuclides in the human body. The major applications of emission computed tomography are in biological research and medical diagnostic procedures. The objectives of these procedures are to make quantitative measurements of in vivo biochemical and hemodynamic functions

  10. Positron emission tomography

    International Nuclear Information System (INIS)

    Dvorak, O.

    1989-01-01

    The principle is briefly described of positron emission tomography, and its benefits and constraints are listed. It is emphasized that positron emission tomography (PET) provides valuable information on metabolic changes in the organism that are otherwise only very difficult to obtain, such as brain diagnosis including relationships between mental disorders and the physiology and pathophysiology of the brain. A PET machine is to be installed in Czechoslovakia in the near future. (L.O.)

  11. Positron emission tomography

    International Nuclear Information System (INIS)

    Wienhard, K.; Heiss, W.D.

    1984-01-01

    The principles and selected clinical applications of positron emission tomography are described. In this technique a chemical compound is labeled with a positron emitting isotope and its biochemical pathway is traced by coincidence detection of the two annihilation photons. The application of the techniques of computed tomography allows to reconstruct the spatial distribution of the radioactivity within a subject. The 18 F-deoxyglucose method for quantitative measurement of local glucose metabolism is discussed in order to illustrate the possibilities of positron emission tomography to record physiological processes in vivo. (orig.) [de

  12. Positron emission tomography

    International Nuclear Information System (INIS)

    Chandrasekhar, Preethi; Himabindu, Pucha

    2000-01-01

    Positron Emission Tomography (PET) is a non-invasive nuclear imaging technique used to study different molecular pathways and anatomical structures. PET has found extensive applications in various fields of medicine viz. cardiology, oncology, psychiatry/psychology, neuro science and pulmonology. This study paper basically deals with the physics, chemistry and biology behind the PET technique. It discusses the methodology for generation of the radiotracers responsible for emission of positrons and the annihilation and detection techniques. (author)

  13. Positron emission tomography

    International Nuclear Information System (INIS)

    Pavuk, M.

    2003-12-01

    The aim of this project is to provide a simple summary of new trends in positron emission tomography and its basic physical principles. It provides thereby compendious introduction of the trends of the present development in diagnostics using PET systems. A review of available literature was performed. (author)

  14. Positron emission tomography

    NARCIS (Netherlands)

    Paans, AMJ

    Positron Emission Tomography (PET) is a method for determining biochemical and physiological processes in vivo in a quantitative way by using radiopharmaceuticals labelled with positron emitting radionuclides as C-11, N-13, O-15 and F-18 and by measuring the annihilation radiation using a

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-01-15

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

  16. Positron Emission Tomography/Computed Tomography in the Staging and Treatment of Anal Cancer

    DEFF Research Database (Denmark)

    Sveistrup, Joen; Loft, Annika; Berthelsen, Anne Kiil

    2012-01-01

    PURPOSE: This study was intended to determine the role of PET/CT in the staging of anal cancer as a supplement to three-dimensional transanal ultrasound (TAUS) and inguinal ultrasound (US). The impact of the PET/CT on the initial stage and treatment plan proposed by TAUS/US was assessed. METHODS......-88 years). Six (6%) of the patients were HIV positive. All patients were staged with TAUS/US and PET/CT. RESULTS: Twenty-eight (28) patients were diagnosed with suspicious perirectal node metastases. TAUS visualized 24 of these, whereas PET/CT detected 15. Suspicious inguinal nodes were visualized...... on either US or PET/CT in 41 patients. Seventeen (17) of these had confirmed malignant disease on biopsy, and 15 had confirmed benign disease. All 17 patients (100%) with malignant inguinal nodes were diagnosed by PET/CT, whereas US identified 16 (94%). Ten patients were diagnosed with suspicious inguinal...

  17. Positron emission tomography/computed tomography (PET/CT) in children.

    Science.gov (United States)

    Shore, Richard M

    2008-06-01

    Although PET imaging has been available for more than two decades, its use has greatly increased lately due to the advent of PET/CT, readily available sources of commercially supplied FDG, and mobile scanners. These features have enabled PET scanning to expand beyond select major university medical centers, with on-site cyclotron facilities to smaller institutions including free- standing children's hospitals. In these settings, imaging is generally limited to FDG, which suffices for most applications, with the majority of studies performed for tumor imaging. FDGI is being used for evaluation of many tumors in children, with its use in lymphoma being the most established. In lymphoma, it has proven quite useful in determining whether active tumor is present in residual masses following treatment, which may otherwise contain only residual fibrous tissue. For brain tumors, FDGI has some relation to tumor grade, although its more important role is distinguishing recurrent or residual tumor from the effects of treatment, particularly radiation necrosis. For neurological evaluation, interictal FDGI is helpful in localizing potential seizure foci for subsequent subdural EEG monitoring. Because of the relatively long uptake time of FDG, true ictal studies cannot be performed with FDG, and these remain within the domain of SPECT imaging of tracers such as Tc-99m HMPAO. Examinations utilizing radiopharmaceuticals other than FDG are significantly more limited in their availability and are limited to PET centers with on-site cyclotrons. However, these additional agents open the door to many additional studies, including more specific tumor-imaging agents of certain tumors such as neuroblastoma. Another neurotransmitter, F-18-fluoro-L-dopa, is of benefit outside of the central nervous system for evaluating infantile hyperinsulism. The use of PET/CT in children is increasing quickly, particularly FDGI imaging of tumors. It is expected that over the next few years, its role will become increasingly better defined.

  18. Positron Emission Tomography/Computed Tomography in the Staging and Treatment of Anal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sveistrup, Joen, E-mail: joensveistrup@hotmail.com [Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); Loft, Annika [PET and Cyclotron Unit, Department of Clinical Physiology and Nuclear Medicine, Centre of Diagnostic Investigations, Rigshospitalet, Copenhagen (Denmark); Berthelsen, Anne Kiil [Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); PET and Cyclotron Unit, Department of Clinical Physiology and Nuclear Medicine, Centre of Diagnostic Investigations, Rigshospitalet, Copenhagen (Denmark); Henriksen, Birthe Merete; Nielsen, Michael Bachmann [Department of Radiology, Section of Ultrasound X4123, Rigshospitalet, Copenhagen (Denmark); Engelholm, Svend Aage [Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark)

    2012-05-01

    Purpose: This study was intended to determine the role of PET/CT in the staging of anal cancer as a supplement to three-dimensional transanal ultrasound (TAUS) and inguinal ultrasound (US). The impact of the PET/CT on the initial stage and treatment plan proposed by TAUS/US was assessed. Methods and Materials: Ninety-five (95) patients referred to our clinic between July 1, 2005, and December 31, 2009, were retrospectively reviewed. All patients had biopsy-proven primary squamous cell cancer of the anal canal. There were 65 females (68%) and 30 males (32%), and the median age was 58 years (range, 35-88 years). Six (6%) of the patients were HIV positive. All patients were staged with TAUS/US and PET/CT. Results: Twenty-eight (28) patients were diagnosed with suspicious perirectal node metastases. TAUS visualized 24 of these, whereas PET/CT detected 15. Suspicious inguinal nodes were visualized on either US or PET/CT in 41 patients. Seventeen (17) of these had confirmed malignant disease on biopsy, and 15 had confirmed benign disease. All 17 patients (100%) with malignant inguinal nodes were diagnosed by PET/CT, whereas US identified 16 (94%). Ten patients were diagnosed with suspicious inguinal nodes on PET/CT that had not been seen on US. One of these was malignant, three were benign, and six were not biopsied. PET/CT diagnosed eight metastatic sites, whereas TAUS/US diagnosed three. PET/CT discovered three of the five synchronous cancers seen in this study. PET/CT upstaged the disease in 14% of the cases and changed the treatment plan proposed by TAUS/US in 17%. Conclusion: PET/CT has great potential influence on the staging and treatment of anal cancer. TAUS is important in the staging of the primary tumor and N1-stage, whereas PET/CT seems necessary for the N2/3-stage, the M-stage and synchronous cancers.

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

    Science.gov (United States)

    Santana, Priscila do Carmo; de Oliveira, Paulo Marcio Campos; Mamede, Marcelo; Silveira, Mariana de Castro; Aguiar, Polyanna; Real, Raphaela Vila; da Silva, Teógenes Augusto

    2015-01-01

    Objective To evaluate the level of ambient radiation in a PET/CT center. Materials and Methods Previously selected and calibrated TLD-100H thermoluminescent dosimeters were utilized to measure room radiation levels. During 32 days, the detectors were placed in several strategically selected points inside the PET/CT center and in adjacent buildings. After the exposure period the dosimeters were collected and processed to determine the radiation level. Results In none of the points selected for measurements the values exceeded the radiation dose threshold for controlled area (5 mSv/year) or free area (0.5 mSv/year) as recommended by the Brazilian regulations. Conclusion In the present study the authors demonstrated that the whole shielding system is appropriate and, consequently, the workers are exposed to doses below the threshold established by Brazilian standards, provided the radiation protection standards are followed. PMID:25798004

  20. F-18 fluoride positron emission tomography-computed tomography for detecting atherosclerotic plaques

    International Nuclear Information System (INIS)

    Kang, Won Jun

    2015-01-01

    A large number of major cardiovascular events occur in patients due to minimal or some lumen narrowing of the coronary artery. Recent biological studies have shown that the biological composition or vulnerability of the plaque is more critical for plaque rupture compared to the degree of stenosis. To overcome the limitations of anatomical images, molecular imaging techniques have been suggested as promising imaging tools in various fields. F-18 fluorodeoxyglucose (FDG), which is widely used in the field of oncology, is an example of molecular probes used in atherosclerotic plaque evaluation. FDG is a marker of plaque macrophage glucose utilization and inflammation, which is a prominent characteristic of vulnerable plaque. Recently, F-18 fluoride has been used to visualize vulnerable plaque in clinical studies. F-18 fluoride accumulates in regions of active microcalcification, which is normally observed during the early stages of plaque formation. More studies are warranted on the accumulation of F-18 fluoride and plaque formation/vulnerability; however, due to high specific accumulation, low background activity, and easy accessibility, F-18 fluoride is emerging as a promising non-invasive imaging probe to detect vulnerable plaque

  1. F-18 fluoride positron emission tomography-computed tomography for detecting atherosclerotic plaques

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Won Jun [Dept. of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    A large number of major cardiovascular events occur in patients due to minimal or some lumen narrowing of the coronary artery. Recent biological studies have shown that the biological composition or vulnerability of the plaque is more critical for plaque rupture compared to the degree of stenosis. To overcome the limitations of anatomical images, molecular imaging techniques have been suggested as promising imaging tools in various fields. F-18 fluorodeoxyglucose (FDG), which is widely used in the field of oncology, is an example of molecular probes used in atherosclerotic plaque evaluation. FDG is a marker of plaque macrophage glucose utilization and inflammation, which is a prominent characteristic of vulnerable plaque. Recently, F-18 fluoride has been used to visualize vulnerable plaque in clinical studies. F-18 fluoride accumulates in regions of active microcalcification, which is normally observed during the early stages of plaque formation. More studies are warranted on the accumulation of F-18 fluoride and plaque formation/vulnerability; however, due to high specific accumulation, low background activity, and easy accessibility, F-18 fluoride is emerging as a promising non-invasive imaging probe to detect vulnerable plaque.

  2. First experiences from Copenhagen with paediatric single photon emission computed tomography/computed tomography

    DEFF Research Database (Denmark)

    Andersen, Julie Bjerglund; Mortensen, Jann; Bech, Birthe Højlund

    2011-01-01

    bone scintigraphy combined with In-labelled leukocyte study (osteomyelitis), three I-meta-iodobenzylguanidine scintigraphies (neuroblastoma), three In-octreotide scintigraphies (two carcinoid tumours, one Langerhans cell histiocytosis) and one Tc-dimercaptosuccinic acid scintigraphy (suspected renal...

  3. Positron emission tomography/computed tomography data of a tuberculosis mimicking lung cancer: A Case report

    Directory of Open Access Journals (Sweden)

    Amine Benjelloun

    2014-10-01

    Full Text Available PET/CT is a modern and very valuable tool for detecting primary or secondary lung cancers. However, in countries where tuberculosis is endemic, data must be interpreted with caution because of the frequent tuberculomas. We report here a case of a cancer-like tuberculoma of the lung with paralysis of the left vocal cord, and discuss the PET/CT contribution in tuberculomas as well as the noncancer etiologies of this damage.

  4. Positron emission tomography

    International Nuclear Information System (INIS)

    Yamamoto, Y.L.; Thompson, C.J.; Diksic, M.; Meyer, E.; Feindel, W.H.

    1984-01-01

    One of the most exciting new technologies introduced in the last 10 yr is positron emission tomography (PET). PET provides quantitative, three-dimensional images for the study of specific biochemical and physiological processes in the human body. This approach is analogous to quantitative in-vivo autoradiography but has the added advantage of permitting non-invasive in vivo studies. PET scanning requires a small cyclotron to produce short-lived positron emitting isotopes such as oxygen-15, carbon-11, nitrogen-13 and fluorine-18. Proper radiochemical facilities and advanced computer equipment are also needed. Most important, PET requires a multidisciplinary scientific team of physicists, radiochemists, mathematicians, biochemists and physicians. The most recent trends are reviewed in the imaging technology, radiochemistry, methodology and clinical applications of positron emission tomography. (author)

  5. Positron emission tomography

    International Nuclear Information System (INIS)

    Marchenkov, N.S.

    2000-01-01

    The foundations of the positron emission tomography (PET), widely used for the medical diagnostics, are considered. The brief description of the cyclotron for production of radionuclides, applied in the PET, the target devices for manufacturing the position emitters, the moduli for the radiopharmaceuticals synthesis (RPS) for the PET is presented. The necessity and concept of complete automation of the RPS for the PET are discussed [ru

  6. Positron emission tomography

    International Nuclear Information System (INIS)

    Paans, A.M.J.

    1981-01-01

    Positron emitting radiopharmaceuticals have special applications in in-vivo studies of biochemical processes. The combination of a cyclotron for the production of radionuclides and a positron emission tomograph for the registration of the distribution of radioactivity in the body enables the measurement of local radioactivity concentration in tissues, and opens up new possibilities in the diagnosis and examination of abnormalities in the metabolism. The principles and procedures of positron emission tomography are described and the necessary apparatus considered, with emphasis on the positron camera. The first clinical applications using 55 Co bloemycine for tumor detection are presented. (C.F.)

  7. Modern imaging methods: positron emission tomography (PET) and positron emission tomography/computed tomography (PET/CT) combination

    International Nuclear Information System (INIS)

    Votrubova, J.; Belohlavek, O.

    2004-01-01

    An overview of the title topic is presented. Attention is paid to the technical principles of PET and CT, indications for PET and PET/CT examination, and achievements of the PET Centre of the Na Homolce hospital. (P.A.)

  8. Tomography by positrons emission

    International Nuclear Information System (INIS)

    Mosconi, Sergio L.

    1999-01-01

    The tomography by positrons emission is a technology that allows to measure the concentration of positrons emission in a tri dimensional body through external measurements. Among the isotope emissions have carbon isotopes are ( 11 C), of the oxygen ( 15 O), of the nitrogen ( 13 N) that are three the element that constitute the base of the organic chemistry. Theses have on of the PET's most important advantages, since many biological interesting organic molecules can be tracer with these isotopes for the metabolism studies 'in vivo' through PET, without using organic tracers that modify the metabolism. The mentioned isotopes, also possess the characteristic of having short lifetime, that constitute on of PET's advantages from the dosimetric point of view. Among 11 C, 15 O, and 13 N, other isotopes that can be obtained of a generator as the 68 Ga and 82 Rb

  9. Positron Emission Tomography (PET)

    International Nuclear Information System (INIS)

    Welch, M.J.

    1990-01-01

    Positron emission tomography (PET) assesses biochemical processes in the living subject, producing images of function rather than form. Using PET, physicians are able to obtain not the anatomical information provided by other medical imaging techniques, but pictures of physiological activity. In metaphoric terms, traditional imaging methods supply a map of the body's roadways, its, anatomy; PET shows the traffic along those paths, its biochemistry. This document discusses the principles of PET, the radiopharmaceuticals in PET, PET research, clinical applications of PET, the cost of PET, training of individuals for PET, the role of the United States Department of Energy in PET, and the futures of PET. 22 figs

  10. Positron Emission Tomography (PET)

    Energy Technology Data Exchange (ETDEWEB)

    Welch, M.J.

    1990-01-01

    Positron emission tomography (PET) assesses biochemical processes in the living subject, producing images of function rather than form. Using PET, physicians are able to obtain not the anatomical information provided by other medical imaging techniques, but pictures of physiological activity. In metaphoric terms, traditional imaging methods supply a map of the body's roadways, its, anatomy; PET shows the traffic along those paths, its biochemistry. This document discusses the principles of PET, the radiopharmaceuticals in PET, PET research, clinical applications of PET, the cost of PET, training of individuals for PET, the role of the United States Department of Energy in PET, and the futures of PET. 22 figs.

  11. Positron Emission Tomography (PET)

    Science.gov (United States)

    Welch, M. J.

    1990-01-01

    Positron emission tomography (PET) assesses biochemical processes in the living subject, producing images of function rather than form. Using PET, physicians are able to obtain not the anatomical information provided by other medical imaging techniques, but pictures of physiological activity. In metaphoric terms, traditional imaging methods supply a map of the body's roadways, its, anatomy; PET shows the traffic along those paths, its biochemistry. This document discusses the principles of PET, the radiopharmaceuticals in PET, PET research, clinical applications of PET, the cost of PET, training of individuals for PET, the role of the United States Department of Energy in PET, and the futures of PET.

  12. Positron emission tomography

    CERN Document Server

    Paans, A M J

    2006-01-01

    Positron Emission Tomography (PET) is a method for measuring biochemical and physiological processes in vivo in a quantitative way by using radiopharmaceuticals labelled with positron emitting radionuclides such as 11C, 13N, 15O and 18F and by measuring the annihilation radiation using a coincidence technique. This includes also the measurement of the pharmacokinetics of labelled drugs and the measurement of the effects of drugs on metabolism. Also deviations of normal metabolism can be measured and insight into biological processes responsible for diseases can be obtained. At present the combined PET/CT scanner is the most frequently used scanner for whole-body scanning in the field of oncology.

  13. Comparing staging by positron emission tomography with contrast-enhanced computed tomography and by pathology in head and neck squamous cell carcinoma.

    Science.gov (United States)

    Qualliotine, J R; Mydlarz, W K; Chan, J Y K; Zhou, X; Wang, H; Agrawal, N

    2015-12-01

    This study aimed to evaluate the ability of positron emission tomography with contrast-enhanced computed tomography to correctly stage head and neck squamous cell carcinomas, in comparison with pathological staging. Positron emission tomography computed tomography was used to determine the tumour-node-metastasis classification and overall cancer stage in 85 head and neck squamous cell carcinoma patients who underwent pre-operative imaging using this modality and primary surgery between July 2010 and January 2013. Staging by positron emission tomography computed tomography was retrospectively compared with staging using pathological specimens. Agreement between imaging stage and pathological stage was examined by univariate and multivariate analysis both overall and for each primary tumour site. This imaging modality was 87.5 per cent sensitive and 44.8 per cent specific in identifying regional cervical metastases, and had false positive and false negative rates of 18.8 per cent and 8.2 per cent, respectively. The positive predictive and negative predictive values were 75.4 per cent and 65.0 per cent, respectively. Univariate and multivariate analyses revealed a significant agreement between positron emission tomography computed tomography and pathological node classification in older patients and for the oral cavity primary tumour site. There was significant agreement between both methods in the overall classification only for tumours classified as T3 or greater. Positron emission tomography computed tomography should be used with caution for the pre-operative staging of head and neck cancers because of its high false positive and false negative rates.

  14. Positron emission tomography. Positronemisionstomografi

    Energy Technology Data Exchange (ETDEWEB)

    Bolwig, T G; Haunsoe, S; Dahlgaard Hove, J; Hesse, B; Hoejgard, L; Jensen, M; Paulson, O B; Hastrup Svendsen, J; Soelvsten Soerensen, S

    1994-10-01

    Positron emission tomography (PET) is a method for quantitative imaging of regional physiological and biochemical parameters. Positron emitting radioactive isotopes can be produced by a cyclotron, eg. the biologically important carbon ([sup 11]C), oxygen ([sup 15]O), and nitrogen ([sup 13]N) elements. With the tomographic principles of the PET scanner the quantitative distribution of the administered isotopes can be determined and images can be provided as well as dynamic information on blood flow, metabolism and receptor function. In neurology PET has been used for investigations on numerous physiological processes in the brain: circulation, metabolism and receptor studies. In Parkinson's disease PET studies have been able to localize the pathology specifically, and in early stroke PET technique can outline focal areas with living but non-functioning cells, and this could make it possible to intervene in this early state. With positron emission tomography a quantitative evaluation of myocardial blood flow, glucose and fatty acid metabolism can be made as well as combined assessments of blood flow and metabolism. Combined studies of blood flow and metabolism can determine whether myocardial segments with abnormal motility consist of necrotic or viable tissue, thereby delineating effects of revascularisation. In the future it will probably be possible to characterize the myocardial receptor status in different cardiac diseases. The PET technique is used in oncology for clinical as well as more basic research on tumor perfusion and metabolism. Further, tumor uptake of positron labelled cytotoxic drugs might predict the clinical benefit of treatment. (au) (19 refs.).

  15. Positron emission tomography

    International Nuclear Information System (INIS)

    Bolwig, T.G.; Haunsoe, S.; Dahlgaard Hove, J.; Hesse, B.; Hoejgard, L.; Jensen, M.; Paulson, O.B.; Hastrup Svendsen, J.; Soelvsten Soerensen, S.

    1994-01-01

    Positron emission tomography (PET) is a method for quantitative imaging of regional physiological and biochemical parameters. Positron emitting radioactive isotopes can be produced by a cyclotron, eg. the biologically important carbon ( 11 C), oxygen ( 15 O), and nitrogen ( 13 N) elements. With the tomographic principles of the PET scanner the quantitative distribution of the administered isotopes can be determined and images can be provided as well as dynamic information on blood flow, metabolism and receptor function. In neurology PET has been used for investigations on numerous physiological processes in the brain: circulation, metabolism and receptor studies. In Parkinson's disease PET studies have been able to localize the pathology specifically, and in early stroke PET technique can outline focal areas with living but non-functioning cells, and this could make it possible to intervene in this early state. With positron emission tomography a quantitative evaluation of myocardial blood flow, glucose and fatty acid metabolism can be made as well as combined assessments of blood flow and metabolism. Combined studies of blood flow and metabolism can determine whether myocardial segments with abnormal motility consist of necrotic or viable tissue, thereby delineating effects of revascularisation. In the future it will probably be possible to characterize the myocardial receptor status in different cardiac diseases. The PET technique is used in oncology for clinical as well as more basic research on tumor perfusion and metabolism. Further, tumor uptake of positron labelled cytotoxic drugs might predict the clinical benefit of treatment. (au) (19 refs.)

  16. Basic principles of 18F-fluoro-deoxyglucose positron emission tomography

    International Nuclear Information System (INIS)

    Standke, R.

    2002-01-01

    Positron emission tomography uses photons to receive regional information about dynamic, physiologic, and biochemical processes in the living body. A positron decay is measured indirectly by the simultaneous registration of both gamma rays created by the annihilation. The event is counted, if two directly opposite located detectors register gamma rays in coincidence. Unfortunately the detectors of a positron emission tomography system do not register only true coincident events. There are also scattered and random coincidences. Different types of positron tomographs are presented and scintillation crystals, which are in use for positron emission tomography are discussed. The 2D- and 3D-acquisition methods are described as well as preprocessing methods, such as correction for attenuation, scatter and dead time. For quantification the relative parameter standard uptake value (SUV) is explained. Finally hybrid systems, such as combined positron emission tomography/computed tomography scanners and the use of computed tomography data for attenuation correction are introduced. (author)

  17. Emission computed tomography

    International Nuclear Information System (INIS)

    Phelps, M.E.

    1977-01-01

    Although there are many common aspects to x-ray transmission and radionuclide emission (ECT) computerized tomography, there are added difficulties and a number of particular factors which form the basis of ECT. The relationship between the physical factors, system design, methodologic approach and assumptions of ECT is discussed. The instrumentation design and application strategies in ECT at this time are diverse and in a rapid stage of development. The approaches are divided into two major categories of Single Photon Counting (SPC) employing scanner and camera concepts with radionuclides of 99 /sup m/Tc, 201 Tl, 123 I etc., and Annihilation Coincidence Detection (ACD) of positron-emitting radionuclides. Six systems in the former and ten systems in the latter category, with examples of typical studies, illustrate the different approaches

  18. Positron emission computed tomography

    International Nuclear Information System (INIS)

    Grover, M.; Schelbert, H.R.

    1985-01-01

    Regional mycardial blood flow and substrate metabolism can be non-invasively evaluated and quantified with positron emission computed tomography (Positron-CT). Tracers of exogenous glucose utilization and fatty acid metabolism are available and have been extensively tested. Specific tracer kinetic models have been developed or are being tested so that glucose and fatty acid metabolism can be measured quantitatively by Positron-CT. Tracers of amino acid and oxygen metabolism are utilized in Positron-CT studies of the brain and development of such tracers for cardiac studies are in progress. Methods to quantify regional myocardial blood flow are also being developed. Previous studies have demonstrated the ability of Positron-/CT to document myocardial infarction. Experimental and clinical studies have begun to identify metabolic markers of reversibly ischemic myocardium. The potential of Positron-CT to reliably detect potentially salvageable myocardium and, hence, to identify appropriate therapeutic interventions is one of the most exciting applications of the technique

  19. Positron emission tomography camera

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    A positron emission tomography camera having a plurality of detector planes positioned side-by-side around a patient area to detect radiation. Each plane includes a plurality of photomultiplier tubes and at least two rows of scintillation crystals on each photomultiplier tube extend across to adjacent photomultiplier tubes for detecting radiation from the patient area. Each row of crystals on each photomultiplier tube is offset from the other rows of crystals, and the area of each crystal on each tube in each row is different than the area of the crystals on the tube in other rows for detecting which crystal is actuated and allowing the detector to detect more inter-plane slides. The crystals are offset by an amount equal to the length of the crystal divided by the number of rows. The rows of crystals on opposite sides of the patient may be rotated 90 degrees relative to each other

  20. Positron emission tomography camera

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    A positron emission tomography camera having a plurality of detector rings positioned side-by-side or offset by one-half of the detector cross section around a patient area to detect radiation therefrom. Each ring contains a plurality of scintillation detectors which are positioned around an inner circumference with a septum ring extending inwardly from the inner circumference along each outer edge of each ring. An additional septum ring is positioned in the middle of each ring of detectors and parallel to the other septa rings, whereby the inward extent of all the septa rings may be reduced by one-half and the number of detectors required in each ring is reduced. The additional septa reduces the costs of the positron camera and improves its performance

  1. Positron emission tomography camera

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    A positron emission tomography camera having a plurality of detector rings positioned side-by-side or offset by one-half of the detector cross section around a patient area to detect radiation therefrom. Each detector ring or offset ring includes a plurality of photomultiplier tubes and a plurality of scintillation crystals are positioned relative to the photomultiplier tubes whereby each tube is responsive to more than one crystal. Each alternate crystal in the ring is offset by one-half or less of the thickness of the crystal such that the staggered crystals are seen by more than one photomultiplier tube. This sharing of crystals and photomultiplier tubes allows identification of the staggered crystal and the use of smaller detectors shared by larger photomultiplier tubes thereby requiring less photomultiplier tubes, creating more scanning slices, providing better data sampling, and reducing the cost of the camera. The offset detector ring geometry reduces the costs of the positron camera and improves its performance

  2. The role of positron emission tomography in mediastinal staging of patients with non-small cell lung cancer.

    Science.gov (United States)

    d'Amico, Andrea; Turska-d'Amico, Maria; Jarzab, Barbara; Zielinski, Marcin

    2015-01-01

    To examine the diagnostic accuracy of positron emission tomography/computed tomography in evaluating the mediastinum of patients with non-small cell lung cancer compared to histopathology results. The prospective study was conducted at the Department of Thoracic Surgery of the Pulmonary Hospital in Zakopane, Poland, from September 2008 to August 2012 and comprised patients with radiologically-suspected lung cancer. All patients underwent histological verification by either mediastinoscopy alone or thoracotomy with mediastinal lymphanedectomy. Computed tomography and positron emission tomography/computed tomography data sets were compared with the results of the histopathology examinations. There were 80 patients in the study. In the diagnosis of mediastinal lymph nodes, computed tomography was able to detect 9(11.25%) true-positive, 17(21.25%) false-positive, 40(50%) true-negative and 14(17.5%) false-negative cases. The sensitivity, specificity and accuracy of the method were found to be 39%, 70% and 61% respectively, while the positive and negative predictive values were 35% and 74%. Positron emission tomography/computed tomography yielded 15(18.75%) true-positive, 12(15%) false-positive, 46(57.5%) true-negative and 7(8.75%) false-negative cases. Sensitivity was 68% while specificity was 79%. The accuracy was 96%, and the positive and negative predictive values were 55% and 87% respectively. Positron emission tomography/computed tomography had higher diagnostic accuracy than computed tomography in assessing mediastinal lymph nodes of patients with non-small cell lung cancer. However, a positive test requires histopathology confirmation.

  3. Neurofibroma of the breast detected on position emission tomography-CT in a patient with neurofibromatosis type 1: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ho Seok; Kim, Hye Jung; Yang, Bang; Lee So Mi; Jeong, Ji Yun [Kyungpook National University Hospital, Daegu(Korea, Republic of)

    2016-02-15

    Neurofibromas of the breast are rare. They are commonly found as solitary lesions or parts of neurofibromatosis type 1 and are usually located on the nipple-areolar area. We describe a case of neurofibroma of the breast in the retromammary space, which was detected on positron emission tomography-computed tomography after hysterectomy due to endometrial cancer.

  4. Application of the axial tomography computed for the detection of bags of dampness in dry wood of Gmelina arborea (Roxb.)

    International Nuclear Information System (INIS)

    Moya R, Roger; Munoz A, Freddy; Escalante, Ivan

    2006-01-01

    Gmelina arborea (Roxb.) is widely used for commercial reforestation in Costa Rica due to its excellent growth rate and productivity. However, during the lumber drying process, the wooden boards show non-uniform values of final moisture content (MC). The low uniformity in final MC is caused by the presence of wet pockets, originated during the growing process of the tree. The regions with wet pockets present zones with a high MC, which are hard to detect with traditional methods for MC measurements during the wood drying process. It is possible to detect and to set the limits of the presence of wet wood in Gmelina arborea boards using scanning computed tomography (CT-scanning), a technique applied in medical diagnostic. A board with wet pockets is shown in the CT-scanning images in clear color and with low values of the Hounsfield Unit (HU) or CT number. When these values were transformed to wood density, it was determined that wet pockets were in a density of around 190 kg/m 3 , a value higher than normal wood. Also, it was possible to observe growth tree rings in the CT-scanning images, an important feature for dendrochronological research. The obtained results allowed showing that it is possible to apply this technique in the process of lumber production, to detect the zones with high MC in kiln dried Gmelina arborea wood. (author) [es

  5. Positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Lindback, Stig [GEMS PET Systems AB, Uppsala (Sweden)

    1995-07-15

    Positron Emission Tomography (PET) is an advanced nuclear medicine technique used for research at major centres. Unique diagnostic information is obtained from tomographic measurements of the biochemistry and physiology of tissues and organs. In theory, diseases are related to biochemical changes and these can be observed with PET long before any anatomical changes are detectable. In PET the radioactive component is a positron-emitting isotope or 'tracer'. The positrons annihilate with electrons in the body to produce two gamma rays 180° apart; coincidence detection of these gammas provides a very efficient method of determining the spatial distribution of the radioisotope tracer. Because physiological measurements are usually required in a single imaging session, very short-lived isotopes are used to label the tracer molecules; isotope production and labelling is usually carried out in situ. The most commonly used radionuclides are carbon- 11 (half-life 20 minutes), nitrogen-13 (10 minutes), oxygen-15 (2 minutes), and fluorine-18 (110 minutes). A PET system has three major components: - a particle accelerator with targets for production of the positron-emitting isotopes; - chemistry modules for synthesis and labelling of the desired tracers; - and a PET camera for in-vivo measurements of the distribution of the tracer in the body.

  6. Positron emission tomography

    International Nuclear Information System (INIS)

    Lindback, Stig

    1995-01-01

    Positron Emission Tomography (PET) is an advanced nuclear medicine technique used for research at major centres. Unique diagnostic information is obtained from tomographic measurements of the biochemistry and physiology of tissues and organs. In theory, diseases are related to biochemical changes and these can be observed with PET long before any anatomical changes are detectable. In PET the radioactive component is a positron-emitting isotope or 'tracer'. The positrons annihilate with electrons in the body to produce two gamma rays 180° apart; coincidence detection of these gammas provides a very efficient method of determining the spatial distribution of the radioisotope tracer. Because physiological measurements are usually required in a single imaging session, very short-lived isotopes are used to label the tracer molecules; isotope production and labelling is usually carried out in situ. The most commonly used radionuclides are carbon- 11 (half-life 20 minutes), nitrogen-13 (10 minutes), oxygen-15 (2 minutes), and fluorine-18 (110 minutes). A PET system has three major components: - a particle accelerator with targets for production of the positron-emitting isotopes; - chemistry modules for synthesis and labelling of the desired tracers; - and a PET camera for in-vivo measurements of the distribution of the tracer in the body

  7. Does Computed Tomography or Positron Emission Tomography/Computed Tomography Contribute to Detection of Small Focal Cancers in the Prostate?

    NARCIS (Netherlands)

    Li, Michael M.; Rybalov, Maxim; Haider, Masoom A.; de Jong, Igle J.

    Prostate cancer is considered to be a multifocal tumor in the majority of patients. Based on histologic data after prostatectomy, there is a growing insight that a considerable number of men who receive a diagnosis in the contemporary setting of prostate-specific antigen screening have unilateral or

  8. Fluorodeoxyglucose positron emission tomography scan may be helpful in the case of ductal variant prostate cancer when prostate specific membrane antigen ligand positron emission tomography scan is negative

    International Nuclear Information System (INIS)

    McEwan, Louise M.; Wong, David; Yaxley, John

    2017-01-01

    Gallium-68 prostate specific membrane antigen ligand (Ga-68 PSMA) positron emission tomography/computed tomography (PET/CT) scanning is emerging as a useful imaging modality for the staging of suspected and known recurrent or metastatic prostate cancer and in staging of newly diagnosed higher grade prostate cancer. However, we have observed at our institution that in some cases of the more aggressive ductal variant, Ga-68 PSMA uptake has sometimes been poor compared with prominent 18-fluorodeoxyglucose (F-18 FDG) avidity seen in F-18 FDG PET/CT, which would suggest that FDG PET/CT scans are important in staging of ductal pattern prostate cancer.

  9. F18 FDG positron emission tomography revelation of primary testicular lymphoma with concurrent multiple extra nodal involvement

    International Nuclear Information System (INIS)

    Vamsy, Mohana; Dattatreya, P.S.; Parakh, Megha; Dayal, Monal; Prabhakar Rao, V.V.S.

    2013-01-01

    Primary testicular lymphoma (PTL) a relatively rare disease of non-Hodgkin's lymphomas occurring with a lesser incidence of 1-2% has a propensity to occur at later ages above 50 years. PTL spreads to extra nodal sites due to deficiency of extra cellular adhesion molecules. We present detection of multiple sites of extra nodal involvement of PTL by F-18 positron emission tomography/computed tomography study aiding early detection of the dissemination thus aiding in staging and management. (author)

  10. Positron emission tomography in the management of cervix cancer patients

    International Nuclear Information System (INIS)

    Bonardel, G.; Gontier, E.; Soret, M.; Dechaud, C.; Fayolle, M.; Foehrenbach, H.; Chargari, C.; Bauduceau, O.

    2009-01-01

    Since its introduction in clinical practice in the 1990 s, positron emission tomography (PET), usually with 18 F-fluoro-2-deoxy-D-glucose ( 18 F-F.D.G.), has become an important imaging modality in patients with cancer. For cervix carcinoma, F.D.G.-PET is significantly more accurate than computed tomography (CT) and is recommended for loco-regional lymph node and extra pelvic staging. The metabolic dimension of the technique provides additional prognostic information. Ongoing studies now concentrate on more advanced clinical applications, such as the planning of radiotherapy, the response evaluation after the induction of therapy, the early detection of recurrence. Technical innovations, such as PET cameras with better spatial resolution and hybrid positron emission tomography/computed tomography (PET-CT), available now on the whole territory, provide both anatomic and metabolic information in the same procedure. From the point of view of biological metabolism, new radiopharmaceutical probes are being developed. Those hold promise for future refinements in this field. This article reviews the current applications of F.D.G.-PET in patients with cervix cancer. (authors)

  11. Positron emission tomography in oncology

    International Nuclear Information System (INIS)

    Anon.

    1988-01-01

    This report describes the current and potential uses of positron emission tomography in clinical medicine and research related to oncology. Assessment will be possible of metabolism and physiology of tumors and their effects on adjacent tissues. Specific probes are likely to be developed for target sites on tumors, including monoclonal antibodies and specific growth factors that recognize tumors. To date, most oncological applications of positron emission tomography tracers have been qualitative; in the future, quantitative metabolic measurements should aid in the evaluation of tumor biology and response to treatment

  12. NMF on positron emission tomography

    DEFF Research Database (Denmark)

    Bödvarsson, Bjarni; Hansen, Lars Kai; Svarer, Claus

    2007-01-01

    In positron emission tomography, kinetic modelling of brain tracer uptake, metabolism or binding requires knowledge of the cerebral input function. Traditionally, this is achieved with arterial blood sampling in the arm or as shown in (Liptrot, M, et al., 2004) by non-invasive K-means clustering....... We propose another method to estimate time-activity curves (TAC) extracted directly from dynamic positron emission tomography (PET) scans by non-negative matrix factorization (NMF). Since the scaling of the basis curves is lost in the NMF the estimated TAC is scaled by a vector alpha which...

  13. Instrumentation for positron emission tomography

    International Nuclear Information System (INIS)

    Budinger, T.F.; Derenzo, S.E.; Huesman, R.H.

    1984-01-01

    Positron emission tomography with a spatial resolution of 2 mm full width at half maximum for quantitation in regions of interest 4 mm in diameter will become possible with the development of detectors that achieve ultrahigh resolution. Improved resolution will be possible using solid-state photodetectors for crystal identification or photomultiplier tubes with many small electron multipliers. Temporal resolution of 2 seconds and gating of cyclic events can be accomplished if statistical requirements are met. The major physical considerations in achieving high-resolution positron emission tomography are the degradation in resolution resulting from positron range, emission angle, parallax error, detector sampling density, the sensitivity of various detector materials and packing schemes, and the tradeoff between temporal resolution and statistical accuracy. The accuracy of data required for physiological models depends primarily on the fidelity of spatial sampling independent of statistical constraints

  14. Emission tomography system

    International Nuclear Information System (INIS)

    Phelps, M.E.; Hoffman, E.J.; Williams, C.W.; Burgiss, S.G.

    1983-01-01

    In the present invention a positron emission tomographic system is provided in which the random photon coincidence background is determined for the lines of sight along which the positron annihiliations are located. The circuitry is arranged so that this background may be subtracted almost simultaneously from the total photon coincidence measurement, or may be stored in a temporary memory for latter subtraction. In this system, an appropriate coincidence resolution time is selected and coincidences of photons detected at 180 degree opposed detectors within the time resolution are recorded as the overall coincidence count. This total count includes a source(true events) count plus a background(random coincidences) count. The background count is determined by measuring photons detected at these same sets of photon detectors and employing the same coincidence resolution period, where the signals from one set of detectors are passed through a delay longer in time than this resolution period

  15. Positron emission tomography. Basic principles

    International Nuclear Information System (INIS)

    Rodriguez, Jose Luis; Massardo, Teresa; Gonzalez, Patricio

    2001-01-01

    The basic principles of positron emission tomography (PET) technique are reviewed. lt allows to obtain functional images from gamma rays produced by annihilation of a positron, a positive beta particle. This paper analyzes positron emitters production in a cyclotron, its general mechanisms, and the various detection systems. The most important clinical applications are also mentioned, related to oncological uses of fluor-l8-deoxyglucose

  16. Combined positron emission tomography/computed tomography (PET/CT) for clinical oncology: technical aspects and acquisition protocols

    International Nuclear Information System (INIS)

    Beyer, T.

    2004-01-01

    Combined PET/CT imaging is a non-invasive means of reviewing both, the anatomy and the molecular pathways of a patient during a quasi-simultaneous examination. Since the introduction of the prototype PET/CT in 1998 a rapid development of this imaging technology is being witnessed. The incorporation of fast PET detector technology into PET/CT designs and the routine use of the CT transmission images for attenuation correction of the PET allow for anato-metabolic whole-body examinations to be completed in less than 30 min. Thus, PET/CT imaging offers a logistical advantage to both, the patient and the clinicians since the two complementary exams - whenever clinically indicated - can be performed almost at the same time and a single integrated report can be created. Nevertheless, a number of pit-falls, primarily from the use of CT-based attenuation correction, have been identified and are being addressed through optimized acquisition protocols. It is fair to say, that PET/CT has been integrated in the diagnostic imaging arena, and in many cases has led to a close collaboration between different, yet complementary diagnostic and therapeutic medical disciplines. (orig.)

  17. Primary spindle cell sarcoma of the prostate and 18 F-fluorodeoxyglucose-positron-emission tomography/computed tomography findings

    Directory of Open Access Journals (Sweden)

    Hakan Öztürk

    2015-01-01

    Conclusion: Spindle sarcomas of the prostate have quite aggressive nature and they have high potential to metastase. Average life expectancy is <1 year and the prognosis is poor. CTx and radiation therapy can′t yield curative effects due to poor differentiation.

  18. F-18 fluorodeoxyglucose position emission tomography/computed tomography imaging for diagnosing ovarian small cell carcinoma of the hypercalcaemic type

    Energy Technology Data Exchange (ETDEWEB)

    Park, Soon Ah; Kim, Hun Soo [Wonkwang University School of Medicine and Institute of Wonkwang Medical Science, Iksan (Korea, Republic of); Oldan, Jorge Daniel [Radiology, Cardiovascular Imaging at the Cleveland Clinic, Cleveland (United States)

    2016-03-15

    A 19-year-old woman presented with lower abdominal pain. Laboratory results showed elevated levels of ionized calcium 1.85 mmol/1, and total calcium, 3.75 mmol/1, but a low level of parathyroid hormone, 1.2 ng/l. This F-18 FDG PET/CT study demonstrated a hypermetabolic unilateral complex mass, composed of solid and necrotic portions, with a concomitant increase in FDG uptake on osteolytic lesions throughout the axial breakdown of bone. In young women, pelvic neoplasms are often difficult to characterize with imaging, because it is often difficult to classify a tumor as benign or malignant based on its appearance on imaging studies. Therefore, features such as ovarian masses in girl and adolescents, a high calculcium level, and the diffuse FDG-avid asterolytic lesions on F-18 FDG PET/CT are probably suggestive of a malignant OSCCHT secreting the PTH-rP.

  19. Evaluation of ambient radiation levels in positron emission tomography/computed tomography in microPET/CT laboratory

    International Nuclear Information System (INIS)

    Sarmento, Daniele Martins

    2016-01-01

    Micro PET/CT scanner is an essential tool generally used for small animal molecular imaging. Fluorine-18-labeled fluorodeoxyglucose is the most widely used radioisotope in this technique. The present study aimed to evaluate the radiation levels in a micro PET/CT research laboratory of the Radiopharmacy Center at IPEN-CNEN / SP, in order to accomplish both national standards and international recommendations. The radioprotection team has classified the laboratory as supervised area; even this laboratory does not require the adoption of specific measures for protection and safety, should be done regular re-evaluation of the conditions of occupational exposures. Workplace monitoring and individual control assessment were carried out to ensure the radiological protection of all workers directly involved in handling the scanner. Initially, there was conducted a radiometric survey, as well as measurements of the external radiation level in the workplace and its surroundings. To achieve this goal, there were placed nine thermoluminescent dosimeters of CaSO 4 :Dy in preselected locations. Monthly evaluations of the occupationally exposed individuals were carried out through the use of TL dosimeters, ported in the workers' chest. Moreover, whole body measurements were performed every six months. The study period was about two-years which started in April 2014. All tests to evaluate micro PET/CT performance were based on the standard protocol of the equipment in accordance with the standard developed by the Animal PET Standard Task Force. Present study's results demonstrated that the ambient radiation levels (ambient and effective estimated radiation dose), as well as the effective shielding equipment are both adequate. This study emphasizes that it is essential to strictly follow the principles of radioprotection in workplace, whenever researches involve radioactive unsealed sources. (author)

  20. Single photon emission computerized tomography

    International Nuclear Information System (INIS)

    Hooge, P. de.

    1983-01-01

    In this thesis two single-photon emission tomographic techniques are presented: (a) longitudinal tomography with a rotating slanting-hole collimator, and (b) transversal tomography with a rotating gamma camera. These methods overcome the disadvantages of conventional scintigraphy. Both detection systems and the image construction methods are explained and comparisons with conventional scintigraphy are drawn. One chapter is dedicated to the determination of system parameters like spatial resolution, contrast, detector uniformity, and size of the object, by phantom studies. In separate chapters the results are presented of detection of tumors and metastases in the liver and the liver hilus; skeletal diseases; various pathological aberrations of the brain; and myocardial perfusion. The possible use of these two ect's for other organs and body areas is discussed in the last chapter. (Auth.)

  1. Positron emission tomography takes lead

    International Nuclear Information System (INIS)

    Simms, R.

    1989-01-01

    Positron emission tomography (PET)'s ability to detect functional abnormalities before they manifest anatomically is examined and some of its most common applications are outlined. It is emphasised that when PET facility and Australian Nuclear Science and Technology Organization's national cyclotron are established at the Royal Prince Alfred Hospital, the availability of short-lived tracers such as oxygen 15, nitrogen 13 and fluorine 18 would improve the specificity of tests(e.g. for brain tumors or cardiac viability) further. Construction of the cyclotron will start shortly and is due to be completed and operating by the end of 1991

  2. Fundamentals of positron emission tomography

    International Nuclear Information System (INIS)

    Ostertag, H.

    1989-01-01

    Positron emission tomography is a modern radionuclide method of measuring physiological quantities or metabolic parameters in vivo. The methods is based on: (1) Radioactive labelling with positron emitters; (2) the coincidence technique for the measurement of the annihilation radiation following positron decay; (3) analysis of the data measured using biological models. The basic aspects and problems of the method are discussed. The main fields of future research are the synthesis of new labelled compounds and the development of mathematical models of the biological processes to be investigated. (orig.) [de

  3. Emission tomography for adrenal imaging

    International Nuclear Information System (INIS)

    Britton, K.E.; Shapiro, B.; Hawkins, L.A.

    1980-01-01

    Single photon emission tomography (SPET) of the adrenals was compared to convential gamma camera images. Depths of 19 adrenals were assessed by both the lateral skin-upper kidney pole method and by SPET. Eleven patients with adrenal disorders were also studied. An advantage of using SPET was that the analogue transverse section image showed improvement over the conventional posterior view because the liver activity was well separated from the adrenal. Furthermore, non-adrenal tissue background was virtually eliminated and adrenal depth determination facilitated. (U.K.)

  4. Single-photon emission computed tomography

    International Nuclear Information System (INIS)

    Budinger, T.F.

    1986-01-01

    Single photon tomography dates from the early 1960's when the idea of emission transverse section tomography was presented by Kuhl and Edwards. They used a rectilinear scanner and analogue back-projection methods to detect emissions from a series of sequential positions transverse to the cephaldcaudad axis of the body. This chapter presents an explanation of emission tomography by describing longitudinal and transverse section tomography. In principle all modes of tomography can be considered under the general topic of coded apertures wherein the code ranges from translation of a pinhole collimator to rotation of a parallel hole or focused collimator array

  5. Positron emission tomography of the heart

    International Nuclear Information System (INIS)

    Budinger, T.F.; Yano, Y.; Mathis, C.A.; Moyer, B.R.; Huesman, R.H.; Derenzo, S.E.

    1983-01-01

    Positron emission tomography (PET) offers the opportunity to noninvasively measure heart muscle blood perfusion, oxygen utilization, metabolism of fatty acids, sugars and amino acids. This paper reviews physiological principles which are basic to PET instrumentation for imaging the heart and gives examples of the application of positron emission tomography for measuring myocardial flow and metabolism. 33 references, 11 figures, 1 table

  6. Improved positron emission tomography camera

    International Nuclear Information System (INIS)

    Mullani, N.A.

    1986-01-01

    A positron emission tomography camera having a plurality of rings of detectors positioned side-by-side or offset by one-half of the detector cross section around a patient area to detect radiation therefrom, and a plurality of scintillation crystals positioned relative to the photomultiplier tubes whereby each tube is responsive to more than one crystal. Each alternate crystal in the ring may be offset by one-half or less of the thickness of the crystal such that the staggered crystals are seen by more than one photomultiplier tube. This sharing of crystals and photomultiplier tubes allows identification of the staggered crystal and the use of smaller detectors shared by larger photomultiplier tubes thereby requiring less photomultiplier tubes, creating more scanning slices, providing better data sampling, and reducing the cost of the camera. (author)

  7. Positron emission tomography and migraine

    International Nuclear Information System (INIS)

    Chabriat, H.

    1992-01-01

    Positron emission tomography (PET) is a brain imaging technique that allows in vivo studies of numerous physiological parameters. There have been few PET studies in migraine patients. Cerebral blood flow changes with no variations in brain oxygen consumption have been reported in patients with prolonged neurologic manifestations during migraine attacks. Parenteral administration of reserpine during migraine headache has been followed by a fall in the overall cerebral uptake of glucose. The small sample sizes and a number of methodologic problems complicate the interpretation of these results. Recent technical advances and the development of new PET tracers can be expected to provide further insight into the pathophysiology of migraine. Today cerebral cortex 5 HT 2 serotonin receptors can be studied in migraine patients with PET

  8. Positron emission tomography basic sciences

    CERN Document Server

    Townsend, D W; Valk, P E; Maisey, M N

    2003-01-01

    Essential for students, science and medical graduates who want to understand the basic science of Positron Emission Tomography (PET), this book describes the physics, chemistry, technology and overview of the clinical uses behind the science of PET and the imaging techniques it uses. In recent years, PET has moved from high-end research imaging tool used by the highly specialized to an essential component of clinical evaluation in the clinic, especially in cancer management. Previously being the realm of scientists, this book explains PET instrumentation, radiochemistry, PET data acquisition and image formation, integration of structural and functional images, radiation dosimetry and protection, and applications in dedicated areas such as drug development, oncology, and gene expression imaging. The technologist, the science, engineering or chemistry graduate seeking further detailed information about PET, or the medical advanced trainee wishing to gain insight into the basic science of PET will find this book...

  9. An introduction to emission computed tomography

    International Nuclear Information System (INIS)

    Williams, E.D.

    1985-01-01

    This report includes salient features of the theory and an examination of practical considerations for someone who is using or introducing tomography, selecting equipment for it or wishing to develop a clinical application. Emphasis is on gamma camera tomography. The subject is dealt with under the following headings: emission computed and gamma camera tomography and the relationship to other medical imaging techniques, the tomographic reconstruction technique theory, rotating gamma camera tomography, attenuation correction and quantitative reconstruction, other single photon tomographic techniques, positron tomography, image display, clinical application of single photon and positron tomography, and commercial systems for SPECT. Substantial bibliography. (U.K.)

  10. Positron emission tomography with Positome, 2

    International Nuclear Information System (INIS)

    Nukui, Hideaki; Yamamoto, Y.L.; Thompson, C.J.; Feindel, W.

    1979-01-01

    Positron emission tomography with Positome II using 68 Ga-EDTA was performed in cases with brain tumor and cerebral arteriovenous malformation. A significant focal uptake in static study and hemodynamic changes in dynamic study were noted in all cases except one case with intracranial lipoma. Comparing this method with sup(99m) Tc-pertechnetate cerebral image study and computerized axial tomography, the diagnostic rate for detecting brain tumor was almost equal in all of these three methods. However, detecting and localizing was easier and clearer in static positron emission tomography with 68 Ga-EDTA than in sup(99m) Tc-pertechnetate cerebral image and computerized axial tomography without infusion of contrast medium. Furthermore, static positron emission tomography with 68 Ga-EDTA was superior to computerized axial tomography without infusion of contrast medium for detecting cerebral arteriovenous malformation. Concerning dynamic positron emission tomography with 68 Ga-EDTA, semiquantitative values obtained by this method correlated well with findings of computerized axial tomography and was thought to be more precise and in detail than the findings of sup(99m) Tc-pertechnetate cerebral image study. Summation of the previous studies about dynamic positron emission tomography with 77 Kr in occlusive cerebrovascular disease is also reported. In conclusion, static positron emission tomography with 68 Ga-EDTA is a very useful diagnostic method for detecting and localizing brain tumor and cerebral arteriovenous malformation without any attendant complications. Furthermore, a good combination of static and dynamic positron emission tomography and computerized axial tomography appear to be outstandingly effective for not only detecting the lesion but also understanding the pathophysiological aspect in cases with various intracranial lesions. (author)

  11. Positron emission tomography in oncology

    International Nuclear Information System (INIS)

    Lecomte, R.; Bentourkia, M.; Benard, F.

    2002-01-01

    Positron Emission Tomography is a sophisticated molecular imaging technique, using a special scanner, that displays the functional status of tissues in the body at the cellular level (their metabolism). It is a diagnostic scan that provides the physician with information not available with traditional anatomic studies such as CT or MRI. PET can detect changes in cell function (disease) long before they are evident as physical (anatomic) changes seen on CT or MRI. In this way PET can add important information about many diseases allowing the physician to make a diagnosis often much earlier than with anatomic imaging techniques such as CT or MRI alone. In addition, in cases where an abnormality is noted on CT or MRI, PET can help differentiate benign changes from changes due to disease. PET scanning also typically images the entire body, unlike CT/MRI which is usually broken up into specific limited body section scans. All cells use glucose as an energy source but cancer cells use much more since they are growing much faster and out of control. This is the basis of imaging with F-18 FDG glucose, the radiotracer agent use in a PET oncology study. The abnormal, accelerated glucose used by cancer cells is detected by the PET scanner that processes the emissions from the F-18 FDG glucose by abnormally high levels of metabolism (tumor)

  12. Positron emission tomography in neuropsychology.

    Science.gov (United States)

    Heiss, W D; Herholz, K; Pawlik, G; Wagner, R; Wienhard, K

    1986-01-01

    By positron emission tomography (PET) of 18F-2-fluoro-2-deoxy-D-glucose (FDG) local cerebral metabolic rate for glucose (LCMRGl) can be measured in man. Normal values in cerebral cortex and basal ganglia range from 35 to 50 mumol/100 g/min, the values in gray matter structures of the posterior fossa were 25-30 mumol/100 g/min, the lowest LCMRGl was found in the white matter (15-20 mumol/100 g/min). During sensory stimulation by various modalities functional activation increases LCMRGl in the respective special areas, while sleep decreases metabolic rate in all cortical and basal gray matter structures. In many neurological disorders CMRGl is altered in a disease-specific pattern. In dementia of the Alzheimer type CMRGl is impaired even in early stages with accentuation in the parieto-temporal cortex, while in multi-infarct dementia glucose uptake is mainly reduced in the multifocal small infarcts. In Huntington's chorea the most conspicuous changes are found in the caudate nucleus and putamen. In cases of focal lesions (e.g. ischemic infarcts) metabolic disturbances extend far beyond the site of the primary lesion and inactivation of metabolism is found in intact brain structures far away from the anatomical lesion. Additional applications of PET include determination of the metabolism of various substrates, of protein synthesis, of function and distribution of receptors, of tumor growth and of the distribution of drugs as well as the measurement of oxygen consumption, blood flow and blood volume.

  13. Positron emission tomography in epilepsy

    International Nuclear Information System (INIS)

    Hosokawa, Shinichi; Kato, Motohiro; Otsuka, Makoto; Kuwabara, Yasuo; Ichiya, Yuichi; Goto, Ikuo

    1989-01-01

    Positron emission tomography (PET) was performed with the 18 F-fluoro-deoxy-glucose method on 29 patients with epilepsy (generalized epilepsy, 4; partial epilepsy, 24; undetermined type, 1). The subjects were restricted to patients with epilepsy without focal abnormality on X-CT. All the patients with generalized epilepsy showed a normal pattern on PET. Fourteen out of the 24 patients with partial epilepsy and the 1 with epilepsy of undermined type showed focal hypometabolism on PET. The hypometabolic zone was localized in areas including the temporal cortex in 11 patients, frontal in 2 and thalamus in 1. The location of hypometabolic zone and that of interictal paroxysmal activity on EEG were well correlated in most patients. The patients with poorly-controlled seizure showed a higher incidence of PET abnormality (12 out of 13) than those with well-controlled seizures (2 out of 11). The incidence of abnormality on PET and MRI and the location of both abnormality were not necessarily coincident. These results indicated that the PET examination in epilepsy provides valuable information about the location of epileptic focus, and that the findings on PET in patients with partial epilepsy may be one of the good indicators about the intractability of partial epilepsy, and that PET and MRI provide complementary information in the diagnosis of epilepsy. (author)

  14. Radiopharmaceutical chemistry for positron emission tomography

    NARCIS (Netherlands)

    Elsinga, PH

    Radiopharmaceutical chemistry includes the selection, preparation, and preclinical evaluation of radiolabeled compounds. This paper describes selection criteria for candidates for positron emission tomography (PET) investigations. Practical aspects of nucleophilic and electrophilic

  15. Development of emission computed tomography in Japan

    International Nuclear Information System (INIS)

    Tanaka, E.

    1984-01-01

    Two positron emission computed tomography (PCT) devices developed in Japan are described. One is for head and the other for wholebody. The devices show fairly quantitative images with slight modifications of the existing algorithms because they were developed based on filtered back-projection. The PCT device seems to be better than the single photon emission computed tomography (SPECT) since it provides adequade compensation for photon attenuation in patients. (M.A.C.) [pt

  16. Dynamic emission tomography of regional cerebral blood flow

    International Nuclear Information System (INIS)

    Lassen, N.A.

    1984-01-01

    The author reviews three tomographic methods for measuring the regional cerebral blood flow: single photon transmission tomography; dual photon emission tomography; and single photon emission tomography. The latter technique is discussed in detail. (Auth.)

  17. Scintillators for positron emission tomography

    International Nuclear Information System (INIS)

    Moses, W.W.; Derenzo, S.E.

    1995-09-01

    Like most applications that utilize scintillators for gamma detection, Positron Emission Tomography (PET) desires materials with high light output, short decay time, and excellent stopping power that are also inexpensive, mechanically rugged, and chemically inert. Realizing that this ''ultimate'' scintillator may not exist, this paper evaluates the relative importance of these qualities and describes their impact on the imaging performance of PET. The most important PET scintillator quality is the ability to absorb 511 keV photons in a small volume, which affects the spatial resolution of the camera. The dominant factor is a short attenuation length (≤ 1.5 cm is required), although a high photoelectric fraction is also important (> 30% is desired). The next most important quality is a short decay time, which affects both the dead time and the coincidence timing resolution. Detection rates for single 511 keV photons can be extremely high, so decay times ≤ 500 ns are essential to avoid dead time losses. In addition, positron annihilations are identified by time coincidence so ≤5 ns fwhm coincidence pair timing resolution is required to identify events with narrow coincidence windows, reducing contamination due to accidental coincidences. Current trends in PET cameras are toward septaless, ''fully-3D'' cameras, which have significantly higher count rates than conventional 2-D cameras and so place higher demands on scintillator decay time. Light output affects energy resolution, and thus the ability of the camera to identify and reject events where the initial 511 keV photon has undergone Compton scatter in the patient. The scatter to true event fraction is much higher in fully-3D cameras than in 2-D cameras, so future PET cameras would benefit from scintillators with a 511 keV energy resolution < 10--12% fwhm

  18. Lhermitte-Duclos disease presenting with positron emission tomography-magnetic resonance fusion imaging: a case report

    Directory of Open Access Journals (Sweden)

    Calabria Ferdinando

    2012-03-01

    Full Text Available Abstract Introduction Lhermitte-Duclos disease or dysplastic gangliocytoma of the cerebellum is an extremely rare tumor. It is a slowly enlarging mass within the cerebellar cortex. The majority of cases are diagnosed in the third or fourth decade of life. Case presentation We report the case of a 37-year-old Caucasian woman who underwent positron emission tomography-computed tomography with fluorine-18-fluorodeoxyglucose for evaluation of a solitary lung node. No pathological uptake was detected in the solitary lung node but the positron emission tomography-computed tomography of her brain showed intense tracer uptake, suggestive of a malignant neoplasm, in a mass in her left cerebellar lobe. Our patient had experienced two years of occipital headache and movement disorder. Subsequently, magnetic resonance imaging was performed with contrast agent administration, showing a large subtentorial mass in her left cerebellar hemisphere, with compression and dislocation of the fourth ventricle. Metabolic data provided by positron emission tomography and morphological magnetic resonance imaging views were fused in post-processing, allowing a diagnosis of dysplastic gangliocytoma with increased glucose metabolism. Total resection of the tumor was performed and histological examination confirmed the diagnosis of Lhermitte-Duclos disease. Conclusions Our case indicates that increased uptake of fluorine-18-fluorodeoxyglucose may be misinterpreted as a neoplastic process in the evaluation of patients with Lhermitte-Duclos disease, but supports the usefulness of integrated positron emission tomography-magnetic resonance imaging in the exact pathophysiologic explanation of this disease and in making the correct diagnosis. However, an accurate physical examination and exact knowledge of clinical data is of the utmost importance.

  19. Data analysis in emission tomography using emission-count posteriors

    International Nuclear Information System (INIS)

    Sitek, Arkadiusz

    2012-01-01

    A novel approach to the analysis of emission tomography data using the posterior probability of the number of emissions per voxel (emission count) conditioned on acquired tomographic data is explored. The posterior is derived from the prior and the Poisson likelihood of the emission-count data by marginalizing voxel activities. Based on emission-count posteriors, examples of Bayesian analysis including estimation and classification tasks in emission tomography are provided. The application of the method to computer simulations of 2D tomography is demonstrated. In particular, the minimum-mean-square-error point estimator of the emission count is demonstrated. The process of finding this estimator can be considered as a tomographic image reconstruction technique since the estimates of the number of emissions per voxel divided by voxel sensitivities and acquisition time are the estimates of the voxel activities. As an example of a classification task, a hypothesis stating that some region of interest (ROI) emitted at least or at most r-times the number of events in some other ROI is tested. The ROIs are specified by the user. The analysis described in this work provides new quantitative statistical measures that can be used in decision making in diagnostic imaging using emission tomography. (paper)

  20. Data analysis in emission tomography using emission-count posteriors

    Science.gov (United States)

    Sitek, Arkadiusz

    2012-11-01

    A novel approach to the analysis of emission tomography data using the posterior probability of the number of emissions per voxel (emission count) conditioned on acquired tomographic data is explored. The posterior is derived from the prior and the Poisson likelihood of the emission-count data by marginalizing voxel activities. Based on emission-count posteriors, examples of Bayesian analysis including estimation and classification tasks in emission tomography are provided. The application of the method to computer simulations of 2D tomography is demonstrated. In particular, the minimum-mean-square-error point estimator of the emission count is demonstrated. The process of finding this estimator can be considered as a tomographic image reconstruction technique since the estimates of the number of emissions per voxel divided by voxel sensitivities and acquisition time are the estimates of the voxel activities. As an example of a classification task, a hypothesis stating that some region of interest (ROI) emitted at least or at most r-times the number of events in some other ROI is tested. The ROIs are specified by the user. The analysis described in this work provides new quantitative statistical measures that can be used in decision making in diagnostic imaging using emission tomography.

  1. Measuring techniques in emission computed tomography

    International Nuclear Information System (INIS)

    Jordan, K.; Knoop, B.

    1988-01-01

    The chapter reviews the historical development of the emission computed tomography and its basic principles, proceeds to SPECT and PET, special techniques of emission tomography, and concludes with a comprehensive discussion of the mathematical fundamentals of the reconstruction and the quantitative activity determination in vivo, dealing with radon transformation and the projection slice theorem, methods of image reconstruction such as analytical and algebraic methods, limiting conditions in real systems such as limited number of measured data, noise enhancement, absorption, stray radiation, and random coincidence. (orig./HP) With 111 figs., 6 tabs [de

  2. Positron emission tomography studies of brain receptors

    International Nuclear Information System (INIS)

    Maziere, B.; Maziere, M.

    1991-01-01

    Probing the regional distribution and affinity of receptors in the brain, in vivo, in human and non human primates has become possible with the use of selective ligands labelled with positron emitting radionuclides and positron emission tomography (PET). After describing the techniques used in positron emission tomography to characterize a ligand receptor binding and discussing the choice of the label and the limitations and complexities of the in vivo approach, the results obtained in the PET studies of various neurotransmission systems: dopaminergic, opiate, benzodiazepine, serotonin and cholinergic systems are reviewed

  3. Positron emission tomography imaging of gene expression

    International Nuclear Information System (INIS)

    Tang Ganghua

    2001-01-01

    The merging of molecular biology and nuclear medicine is developed into molecular nuclear medicine. Positron emission tomography (PET) of gene expression in molecular nuclear medicine has become an attractive area. Positron emission tomography imaging gene expression includes the antisense PET imaging and the reporter gene PET imaging. It is likely that the antisense PET imaging will lag behind the reporter gene PET imaging because of the numerous issues that have not yet to be resolved with this approach. The reporter gene PET imaging has wide application into animal experimental research and human applications of this approach will likely be reported soon

  4. Positron emission tomography in brain function study

    International Nuclear Information System (INIS)

    Wu Hua

    2006-01-01

    Little has been recognized about the advanced brain function. Recent years several new techniques such as event-related potentials, megnetoencephalography, functional magnetic resonance imaging and positron emission tomography (PET) have been used in the study of brain function. The methodology, application study in normal people and clinical patients of PET in brain function are reviewed. (authors)

  5. Positron emission tomography of the heart

    International Nuclear Information System (INIS)

    Budinger, T.F.; Yano, Y.; Moyer, B.R.; Mathis, C.A.; Ganz, E.; Huesman, R.H.; Derenzo, S.E.

    1982-01-01

    Positron emission tomography (PET) of the heart can measure blood perfusion, metabolism of fatty acids, metabolism of sugars, uptake of amino acids and can quantitate infarction volume. The principles which are basic to PET instrumentation and procedures for quantitative studies of the heart muscle with examples of measurements of myocardial flow and metabolism, are reviewed

  6. Positron emission tomography of the heart

    International Nuclear Information System (INIS)

    Budinger, T.F.; Yano, Y.; Huesman, R.H.; Derenzo, S.E.; Moyer, B.R.; Mathis, C.A.; Ganz, E.; Knittel, B.

    1983-01-01

    Positron emission tomography (PET) of the heart can measure blood perfusion, metabolism of fatty acids, metabolism of sugars, uptake of amino acids and can quantitate infarction volume. The principles are reviewed which are basic to PET instrumentation and procedures for quantitative studies of human physiology with examples of measurements of myocardial flow and metabolism

  7. Is positron emission tomography useful in stroke?

    NARCIS (Netherlands)

    DeReuck, J; Leys, D; DeKeyser, J

    Positron emission tomography (PET) has been widely used in the study of stroke and related cerebrovascular diseases. It has shown the various stages leading to cerebral infarction and defined the significance of the ischaemic penumbra. PET scan can predict the clinical outcome of patients with acute

  8. Positron emission tomography in malignant haematological disease

    NARCIS (Netherlands)

    Schot, Bartholomeus Wilhelmus

    2007-01-01

    Positron emission tomography (PET) is a diagnostic technique with a promising role especially in the haemato-oncology. Although its use in the management ; of malignant lymphoma seems to be established already, much about the true potential and drawbacks of FDG-PET in this disease are still unknown.

  9. Positron emission tomography applied to fluidization engineering

    NARCIS (Netherlands)

    Dechsiri, C; Ghione, A; van de Wiel, F; Dehling, HG; Paans, AMJ; Hoffmann, AC

    The movement of particles in a laboratory fluidized bed has been studied using Positron Emission Tomography (PET). With this non-invasive technique both pulses of various shapes and single tracer particles were followed in 3-D. The equipment and materials used made it possible to label actual bed

  10. Advanced Instrumentation for Positron Emission Tomography [PET

    Science.gov (United States)

    Derenzo, S. E.; Budinger, T. F.

    1985-04-01

    This paper summarizes the physical processes and medical science goals that underlay modern instrumentation design for Positron Emission Tomography. The paper discusses design factors such as detector material, crystalphototube coupling, shielding geometry, sampling motion, electronics design, time-of-flight, and the interrelationships with quantitative accuracy, spatial resolution, temporal resolution, maximum data rates, and cost.

  11. single photon emission tomography and positron emission tomography - Part 1 (October 2012), Part 2 (October 2010)

    International Nuclear Information System (INIS)

    Buvat, Irene

    2010-10-01

    The objective of this lecture is to present the single photon emission computed tomography (SPECT) and the positron emission tomography (PET) imaging techniques. Part 1 Content: 1 - Introduction: anatomic, functional and molecular imaging; 2 - Radiotracers: chemical and physical constraints, gamma photon emitters, positon emitters, radioisotopes production, emitters type and imaging techniques; 3 - Gamma cameras; 4 - Quantification in emission tomography: attenuation, scattering, un-stationary spatial resolution; 5 - Synthesis and conclusion. Part 2 content: 1 - Positon emitters; 2 - Positons detection: Coincidence detection (electronic collimation, PET detectors with gamma cameras, dedicated PET detectors, spectrometry); PET detectors type; time-of-flight PET; 2D PET; 3D PET; 3 - Quantification in emission tomography: detected events, attenuation, scattering, fortuitous coincidences, standardisation; 4 - Common SPECT and PET problems: partial volume effect, movement, tomographic reconstruction, calibration, dead time; 5 - Synthesis and conclusion

  12. Cardiac blood pool emission tomography

    International Nuclear Information System (INIS)

    Itti, R.; Philippe, L.; Lorgeron, J.M.; Charbonnier, B.; Raynaud, P.; Brochier, M.

    1983-01-01

    After blood pool labeling using technetium-99m, a series of cardiac pictures is acquired during the rotation of a gamma-camera about the patient. Computer processing leads to reconstruction of various tomographic slices from the original planar projection. Electrocardiographic gating selects the different phases of the cardiac cycle. Individual slices through the left ventricular region are added in order to provide ''thick'' slices on which global and regional parameters of the left ventricular function can be determined. Due to the proportionality existing between count rates and labeled blood volumes, any geometrical model can be avoided. The delineation of regions of interest for count integration is made easier due to the absence of superimposition of structures; no correction for background is necessary. Tomography thus appears to be more consistent and more accurate than the classical methods using planar projections. In addition, right ventricular morphological and kinetic studies can be performed in the same conditions as for the left ventricle [fr

  13. 21 CFR 892.1200 - Emission computed tomography system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Emission computed tomography system. 892.1200... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1200 Emission computed tomography system. (a) Identification. An emission computed tomography system is a device intended to detect the...

  14. Positron emission tomography - a new approach to brain chemistry

    International Nuclear Information System (INIS)

    Jacobson, H.G.

    1988-01-01

    Positron emission tomography permits examination of the chemistry of the brain in living beings. Until recently, positron emission tomography had been considered a research tool, but it is rapidly moving into clinical practice. This report describes the uses and applications of positron emission tomography in examinations of patients with strokes, epilepsy, malignancies, dementias, and schizophrenia and in basic studies of synaptic neurotransmission

  15. Emission computed tomography: methodology and applications

    International Nuclear Information System (INIS)

    Reivich, M.; Alavi, A.; Greenberg, J.; Fowler, J.; Christman, D.; Rosenquist, A.; Rintelmann, W.; Hand, P.; MacGregor, R.; Wolf, A.

    1980-01-01

    A technique for the determination of local cerebral glucose metabolism using positron emission computed tomography is described as an example of the development of use of this methodology for the study of these parameters in man. The method for the determination of local cerebral glucose metabolism utilizes 18 F-2-fluoro-2-deoxyglucose ([ 18 F]-FDG). In this method [ 18 F]-FDG is used as a tracer for the exchange of glucose between plasma and brain and its phosphorylation by hexokinase in the tissue. The labelled product of metabolism, [ 18 F]-FDG phosphate, is essentially trapped in the tissue over the time course of the measurement. The studies demonstrate the potential usefulness of emission computed tomography for the measurement of various biochemical and physiological parameters in man. (Auth.)

  16. Positron emission tomography tracers for imaging angiogenesis

    International Nuclear Information System (INIS)

    Haubner, Roland; Beer, Ambros J.; Wang, Hui; Chen, Xiaoyuan

    2010-01-01

    Position emission tomography imaging of angiogenesis may provide non-invasive insights into the corresponding molecular processes and may be applied for individualized treatment planning of antiangiogenic therapies. At the moment, most strategies are focusing on the development of radiolabelled proteins and antibody formats targeting VEGF and its receptor or the ED-B domain of a fibronectin isoform as well as radiolabelled matrix metalloproteinase inhibitors or α v β 3 integrin antagonists. Great efforts are being made to develop suitable tracers for different target structures. All of the major strategies focusing on the development of radiolabelled compounds for use with positron emission tomography are summarized in this review. However, because the most intensive work is concentrated on the development of radiolabelled RGD peptides for imaging α v β 3 expression, which has successfully made its way from bench to bedside, these developments are especially emphasized. (orig.)

  17. A wavelet phase filter for emission tomography

    International Nuclear Information System (INIS)

    Olsen, E.T.; Lin, B.

    1995-01-01

    The presence of a high level of noise is a characteristic in some tomographic imaging techniques such as positron emission tomography (PET). Wavelet methods can smooth out noise while preserving significant features of images. Mallat et al. proposed a wavelet based denoising scheme exploiting wavelet modulus maxima, but the scheme is sensitive to noise. In this study, the authors explore the properties of wavelet phase, with a focus on reconstruction of emission tomography images. Specifically, they show that the wavelet phase of regular Poisson noise under a Haar-type wavelet transform converges in distribution to a random variable uniformly distributed on [0, 2π). They then propose three wavelet-phase-based denoising schemes which exploit this property: edge tracking, local phase variance thresholding, and scale phase variation thresholding. Some numerical results are also presented. The numerical experiments indicate that wavelet phase techniques show promise for wavelet based denoising methods

  18. Longitudinal emission tomography of thyroid and heart

    International Nuclear Information System (INIS)

    Giessen, J.W. van.

    1986-01-01

    In this thesis three devices are discussed for longitudinal emission tomography, one of which has been developed for myocardial imaging and the other two for thyroid imaging. Longitudinal emission tomography is a technique which enables three-dimensional reconstruction of the radioactivity distribution within an organ from two-dimensional distributions on a detector surface. In Ch. 1 a general survey is given of the clinical environment in which the devices will be used. Ch. 2 discusses a well-known technique for myocardial imaging: seven-pinhole tomography. In Ch. 3 this technique is applied to imaging of the thyroid. Three different reconstruction methods have been applied to the data collected with the system (from phantoms as well as from patients) and the results have been evaluated. Ch. 4 discusses simulation studies which were carried out in order to investigate the potentialities of a time-coded aperture (TCA) system designed for thyroid tomography. In Ch. 5 a prototype is tested of the time coded aperture in a clinical environment. The last chapter presents a comparison between the (thyroid) 7P collimator and the TCA device. (Auth.)

  19. Positron emission tomography in movement disorders

    International Nuclear Information System (INIS)

    Martin, W.R.W.

    1985-01-01

    Positron emission tomography provides a method for the quantitation of regional function within the living human brain. Studies of cerebral metabolism and blood flow in patients with Huntington's disease, Parkinson's disease and focal dystonia have revealed functional abnormalities within substructures of the basal ganglia. Recent developments permit assessment of both pre-synaptic and post-synaptic function ion dopaminergic pathways. These techniques are now being applied to studies of movement disorders in human subjects

  20. Positron emission tomography in movement disorders

    Energy Technology Data Exchange (ETDEWEB)

    Martin, W R.W.

    1985-02-01

    Positron emission tomography provides a method for the quantitation of regional function within the living human brain. Studies of cerebral metabolism and blood flow in patients with Huntington's disease, Parkinson's disease and focal dystonia have revealed functional abnormalities within substructures of the basal ganglia. Recent developments permit assessment of both pre-synaptic and post-synaptic function in dopaminergic pathways. These techniques are now being applied to studies of movement disorders in human subjects.

  1. Positron emission tomography imaging--technical considerations

    International Nuclear Information System (INIS)

    Muehllehner, G.; Karp, J.S.

    1986-01-01

    Positron imaging instrumentation has improved rapidly in the last few years. Scanners currently under development are beginning to approach fundamental limits set by positron range and noncolinearity effects. This report reviews the latest developments in positron emission tomography (PET) instrumentation, emphasizing the development of coding schemes that reduce the complexity and cost of high-resolution scanners. The relative benefits of using time-of-flight (TOF) information is discussed as well. 68 references

  2. Single photon emission computerized tomography (SPECT)

    International Nuclear Information System (INIS)

    Ganatra, R.D.

    1992-01-01

    Tomography in nuclear medicine did not originate after the introduction of X-ray computerized tomography (CT). Even in the days of rectilinear scanner, tomography was attempted with multiple detector heads rotating around the patient, but the counts at each plane were never very high to obtain a satisfactory image. A high resolution focusing collimator can look at different depths but taking several slices in one projection was a time consuming process. Rectilinear scanners lose lot of counts in the collimator to look at one point, at on time, in one plane. It is true that attempts to do tomography with gamma camera really got a boost after the success of CT. By that time, algorithms for doing reconstruction of images also were highly refined and for advanced. Clinical application of SPECT has become widespread now, because of the development of suitable radiopharmaceuticals and improvement in instrumentation. The SPECT provides a direct measure of regional organ function and is performed with nuclides such as 123 I and 99 Tc m that emit a mono-image photon during their decay. SPECT is far less expensive than positron emission tomography

  3. Single photon emission computerized tomography (SPECT)

    Energy Technology Data Exchange (ETDEWEB)

    Ganatra, R D

    1993-12-31

    Tomography in nuclear medicine did not originate after the introduction of X-ray computerized tomography (CT). Even in the days of rectilinear scanner, tomography was attempted with multiple detector heads rotating around the patient, but the counts at each plane were never very high to obtain a satisfactory image. A high resolution focusing collimator can look at different depths but taking several slices in one projection was a time consuming process. Rectilinear scanners lose lot of counts in the collimator to look at one point, at on time, in one plane. It is true that attempts to do tomography with gamma camera really got a boost after the success of CT. By that time, algorithms for doing reconstruction of images also were highly refined and for advanced. Clinical application of SPECT has become widespread now, because of the development of suitable radiopharmaceuticals and improvement in instrumentation. The SPECT provides a direct measure of regional organ function and is performed with nuclides such as {sup 123}I and {sup 99}Tc{sup m} that emit a mono-image photon during their decay. SPECT is far less expensive than positron emission tomography

  4. Physics and instrumentation of emission computed tomography

    International Nuclear Information System (INIS)

    Links, J.M.

    1986-01-01

    Transverse emission computed tomography can be divided into two distinct classes: single photon emission computed tomography (SPECT) and positron emission tomography (PET). SPECT is usually accomplished with specially-adapted scintillation cameras, although dedicated SPECT scanners are available. The special SPECT cameras are standard cameras which are mounted on gantries that allow 360 degree rotation around the long axis of the head or body. The camera stops at a number of angles around the body (usually 64-128), acquiring a ''projection'' image at each stop. The data from these projections are used to reconstruct transverse images with a standard ''filtered back-projection'' algorithm, identical to that used in transmission CT. Because the scintillation camera acquires two-dimensional images, a simple 360 degree rotation around the patient results in the acquisition of data for a number of contiguous transverse slices. These slices, once reconstructed, can be ''stacked'' in computer memory, and orthogonal coronal and sagittal slices produced. Additionally, reorienting algorithms allow the generation of slices that are oblique to the long axis of the body

  5. Development of novel emission tomography system

    Science.gov (United States)

    Fu, Geng

    In recent years, small animals, such as mice and rats, have been widely used as subjects of study in biomedical research while molecular biology and imaging techniques open new opportunities to investigate disease model. With the help of medical imaging techniques, researchers can investigate underlying mechanisms inside the small animal, which are useful for both early diagnosis and treatment monitoring. Based on tracer principle single photon emission computed tomography (SPECT) has increased popularity in small animal imaging due to its higher spatial resolution and variety of single-photon emitting radionuclides. Since the image quality strongly depends on the detector properties, both scintillation and semiconductor detectors are under active investigation for high resolution X-ray and gamma ray photon detection. The desired detector properties include high intrinsic spatial resolution, high energy resolution, and high detection efficiency. In this thesis study, we have made extensive efforts to develop novel emission tomography system, and evaluate the use of both semiconductor and ultra-high resolution scintillation detectors for small animal imaging. This thesis work includes the following three areas. Firstly, we have developed a novel energy-resolved photon counting (ERPC) detector. With the benefits of high energy resolution, high spatial resolution, flexible detection area, and a wide dynamic range of 27--200keV, ERPC detector is well-suited for small animal SPECT applications. For prototype ERPC detector excellent imaging (˜350microm) and spectroscopic performance (4keV Co-57 122keV) has been demonstrated in preliminary study. Secondly, to further improve spatial resolution to hundred-micron level, an ultra-high resolution Intensified EMCCD (I-EMCCD) detector has been designed and evaluated. This detector consists of the newly developed electron multiplying CCD (EMCCD) sensor, columnar CsI(Tl) scintillator, and an electrostatic de-magnifier (DM) tube

  6. Positron Emission Tomography: Its 65 years

    International Nuclear Information System (INIS)

    Del Guerra, A.; Belcari, N.; Bisogni, M.

    2016-01-01

    Positron Emission Tomography (PET) is a well-established imaging technique for in vivo molecular imaging. In this review after a brief history of PET there are presented its physical principles and the technology that has been developed for bringing PET from a bench experiment to a clinical indispensable instrument. The limitations and performance of the PET tomographs are discussed, both as for the hardware and software aspects. The status of art of clinical, preclinical and hybrid scanners (i.e., PET/CT and PET/MR) is reported. Finally the actual trend and the recent and future technological developments are fully illustrated.

  7. Methods and instrumentation for positron emission tomography

    International Nuclear Information System (INIS)

    Mandelkern, M.A.; Phelps, M.E.

    1988-01-01

    This paper reports on positron emission tomography (PET), a technique for the noninvasive measurement of local tissue concentrations of injected radioactive tracers. Tracer kinetics techniques can be applied to this information to quantify physiologic function in human tissue. In the tracer method, a pharmaceutical is labeled by a radioactive atom. When introduced into the subject that molecule follows a physiologic pathway. The space- and time-dependent distribution of the radionuclide is obtained via an imaging technique. If the radiopharmaceutical is sufficiently analogous to a natural substrate or other substance of interest, a quantitative image can be translated into a physiologic measurement

  8. Features and applications of positron emission tomography

    International Nuclear Information System (INIS)

    Fan Mingwu

    1997-01-01

    Positron emission tomography, the so-called world's smartest camera, is based on a NaI or BGO detector and imaging of positron-emitting radioisotopes which are introduced as a tracer into the regional tissue or organ of interest. With the aid of a computer visual images of a series of these distributions can be built into a picture of the functional status of the tissue or organ being imaged. This highly accurate imaging technique is already widely used for clinical diagnostics heart disease, brain disorder, tumors and so on

  9. Contribution of positron emission tomography in neurology

    International Nuclear Information System (INIS)

    Salmon, E.; Franck, G.

    1992-01-01

    Positron Emission Tomography (PET) is a scanner technique using tracers labelled with shortlived radioisotopes which allows to study and quantify human metabolic processes or drug pharmacology in vivo. The technique is first applied in physiological studies. Sleep, normal brain metabolism or cerebral activations have been studied. The pharmacological approach concerns both drug distribution in the human brain and blood flow or metabolic variations under treatment. Main neurological applications in pathology are cerebrovascular disorders, diseases leading to dementia, epilepsy, movement disorders, and brain tumors. In each field of application, PET gives unique and frequently early informations. It nicely combines both dynamic informations and measurement precision. (author)

  10. Electrocardiographic gating in positron emission computed tomography

    International Nuclear Information System (INIS)

    Hoffman, E.J.; Phelps, M.E.; Wisenberg, G.; Schelbert, H.R.; Kuhl, D.E.

    1979-01-01

    Electrocardiographic (ECG) synchronized multiple gated data acquisition was employed with positron emission computed tomography (ECT) to obtain images of myocardial blood pool and myocardium. The feasibility and requirements of multiple gated data acquisition in positron ECT were investigated for 13NH3, ( 18 F)-2-fluoro-2-D-deoxyglucose, and ( 11 C)-carboxyhemoglobin. Examples are shown in which image detail is enhanced and image interpretation is facilitated when ECG gating is employed in the data collection. Analysis of count rate data from a series of volunteers indicates that multiple, statistically adequate images can be obtained under a multiple gated data collection format without an increase in administered dose

  11. Promising Role of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Human Immunodeficiency Virus Associated Non-Hodgkin's Lymphoma

    International Nuclear Information System (INIS)

    Kung, Boom Ting; Mak, W. S.; Lau, S. M. J.; Auyong, T. K.; Tong, C. M.

    2015-01-01

    This case report explores the potential role of FDG PET/CT in HIV -associated systemic non-Hodgkin's lymphoma (HIV-NHLs). In our locality, there are a cumulative total of 5523 reported HIV infections cases since 1984. We reported a case of HIV-related Burkitt's lymphoma (BL) and a case of diffuse large B-cell lymphoma (DLBCL) that underwent PET/CT examination in our PET centre. In HIV-NHLs patients, we must be reminded that not all hypermetabolic foci represent lymphomatous lesions. There is a close correlation between the pattern of lymphoid tissue activation in FDG PET/CT and HIV progression in patients without HIV-related malignancy. The unique patterns of lymphoid tissue activation observed in HIV-infected patients have great clinical implications. Secondly, HIV-infected patients are prone to suffer from opportunistic infections due to immunosuppression, particularly in those with high levels of HIV viral loads. FDG PET/CT cannot reliably differentiate metabolic active lymphoma from other benign diseases such as inflammation in the context of low CD4 count and high viral loads. In those cases, benign markedly hypermetabolic foci can be erroneously interpreted as lymphoma, particularly in those normal-sized lymph nodes. Furthermore, FDG PET/CT may be useful for assessing the efficacy of HAART in suppressing HIV replication and detecting its complication such as lipodystrophy. FDG PET/CT may play a potential useful role in staging and management of HIV -associated systemic non-Hodgkin's lymphoma. Plasma variables such as viral loads and CD4 count must be taken into account during image interpretation. FDG PET/CT as a potential useful tool for diagnosis, treatment response assessment and disease relapse detection in HIV -associated systemic non-Hodgkin's lymphoma worth to be further explored

  12. Dose escalation of radical radiation therapy in non-small-cell lung cancer using positron emission tomography/computed tomography-defined target volumes: Are class solutions obsolete?

    International Nuclear Information System (INIS)

    Everitt, S.; Schneider-Kolsky, M.; Budd, R.; Yuen, K.; Manus, M Mac

    2008-01-01

    Full text: This study investigated the maximum theoretical radiation dose that could safely be delivered to 20 patients diagnosed with non-small-cell lung cancer. Two three-dimensional conformal radiation therapy (RT) class-solution techniques (A and B) and an individualized three-dimensional conformal RT technique (C) were compared at the standard dose of 60 Gy (part I). Dose escalation was then attempted for each technique successfully at 60 Gy, constrained by predetermined limits for lung and spinal canal (part II). Part I and part II data were reanalysed to include oesophageal dose constraints (part III). In part I, 60 Gy was successfully planned using techniques A, B and C in 19 (95%), 18 (90%) and 20 (100%) patients, respectively. The mean escalated dose attainable for part II using techniques A, B and C were 76.4, 74 and 97.8 Gy, respectively (P < 0.0005). One (5%) patient was successfully planned for 120 Gy using techniques A and B, whereas four (20%) were successfully planned using technique C. Following the inclusion of additional constraints applied to the oesophagus in part III, the amount of escalated dose remained the same for all patients who were successfully planned at 60 Gy apart from two patients when technique C was applied. In conclusion, individualized three-dimensional conformal RT facilitated greater dose conformation and higher escalation of dose in most patients. With modern planning tools, simple class solutions are obsolete for conventional dose radical RT in non-small-cell lung cancer. Highly individualized conformal planning is essential for dose escalation.

  13. Basal 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography as a prognostic biomarker in patients with locally advanced breast cancer

    International Nuclear Information System (INIS)

    Garcia Vicente, Ana Maria; Soriano Castrejon, Angel; Lopez-Fidalgo, Jesus Fernando; Amo-Salas, Mariano; Mar Munoz Sanchez, Maria del; Alvarez Cabellos, Ruth; Espinosa Aunion, Ruth

    2015-01-01

    To explore the relationship between basal 18 F-FDG PET/CT information in breast tumours and survival in locally advanced breast cancer (LABC). This prospective, multicentre study included 198 women diagnosed with LABC. All patients underwent 18 F-FDG PET/CT prior to treatment. The maximum standardized uptake value (SUVmax) in tumor (T), lymph nodes (N) and the N/T ratio was obtained in all cases. Stage according to PET/CT imaging (metabolic stage) and conventional imaging techniques (clinical stage) was established. During follow-up, patient status was established (disease free status or not). The relationship between all the variables and overall survival (OS) and disease-free survival (DFS) was analysed using the Kaplan-Meier and Cox regression methods. A ROC analysis was performed to obtain a cut-off value of SUVmax that was useful in the prediction of outcome. The mean SUVmax ± SD values in the primary tumour, lymph nodes and the SUVmax N/T index were 7.40 ± 5.57, 4.17 ± 4.74 and 0.73 ± 1.20, respectively. Higher semiquantitative metabolic values were found in more advanced metabolic and clinical stages. During follow-up, 78.4 % of patients were free of disease. Significant relationships were observed between SUVT and SUVN and patient status. With respect to OS and DFS, significant differences were detected for the metabolic stage. Kaplan-Meier analysis revealed that using the cut-off values, a primary-tumour SUVmax ≥ 6.05 or a nodal SUVmax ≥2.25 were significantly correlated with DFS and OS. PET imaging with 18 F-FDG offers prognostic information for LABC that can be obtained preoperatively and noninvasively. (orig.)

  14. Five years' experience of occupational radiation dose reduction in positron emission tomography-computed tomography imaging at Prince Sultan Military Medical City

    International Nuclear Information System (INIS)

    Alenezi, Ahmed; Soliman, Khaled

    2016-01-01

    The number of installed PET/CT scanners is increasing leading to an increased workload which could result in higher radiation dose received by nuclear medicine workers responsible for conducting the imaging studies in clinical environment. An effort should be made to further optimize the current dose reduction methods employed to achieve 'as low as reasonably achievable' (ALARA) levels. The aim of this work is to provide an overview of the recent techniques used to reduce the occupational radiation doses in PET/CT practice. The worker radiation dose in PET/ CT is higher than in conventional nuclear medicine practice. The higher radiation dose is mainly from the high energy annihilation photons. The highest radiation exposures to the involved staff occur during the dispensing, injection of the Radiopharmaceuticals and performing direct communications with the injected patients at close range. During the period of five years of PET/CT practice at Prince Sultan military medical city (PSMMC) in Saudi Arabia, we have implemented several methods for staff dose optimization. The methods included the following: (1) Training and experience of PET/CT staff, (2) use of time of flight (TOF) technology, (3) optimized design and layout of the department, (4) use of lead shields and automatic dispensing/injection systems. The results from implementing the dose optimization methods are reflected on the staff occupational dose records by a reduction of 55% over a period of 5 years. The presented data can be applied to optimize radiation protection practices during PET/CT imaging procedures. (author)

  15. Role of whole body positron emission tomography/computed tomography scan with 18F-fluorodeoxyglucose in patients with biopsy proven tumor metastases from unknown primary site

    International Nuclear Information System (INIS)

    Pelosi, E.; Pennone, M.; Deandreis, D.; Bisi, G.

    2006-01-01

    Aim: The aim of this study was to evaluate the role of whole body PET/CT scan with 1 8F -fluorodeoxyglucose (FDG) in the detection of the primary tumor in patients with metastatic cancer from unknown primary origin (CUP syndrome). Methods: Sixty-eight consecutive patients, with CUP syndrome (39 lymph nodes, 29 visceral biopsy proven tumor metastases), underwent a whole-body FDG-PET/CT study. All enrolled patients were unsuccessfully studied, within the previous month, with physical examination, laboratory tests and conventional diagnostic procedures. All the pathological findings identified at PET/CT scan and suspected for primaries, were further investigated. After PET study, the minimum follow-up period for the inclusion in the studied population was 3 months. Results: The primary tumor site was correctly identified by FDG-PET/CT in 24 patients (24/68, 35.3%): long (0-9). rino/oro-pharynx (n=6), pancreas (n=5), colon (n=2). uterus (n=2). In 5 cases, FDG-PET scan did not identify a primary pathological focus, which was subsequently detected by other diagnostic methods within 3 months. In 39 patients (39168, 57.4%), the primary tumor site was not localized. However, in 9 of them, FDG-PET/CT scan identified further unexpected metastases, modifying the stage of disease. Overall, the following oncological treatment was influenced by the PET scan, in a total of 33 patients (33/68, 48.5%). Conclusion: Our data strongly support the diagnostic contribution of whole body FDG-PET/CT scan in the evaluation of patients with CUP syndrome and suggest its use in an early phase of the diagnostic iter to optimize patient management

  16. 18F-fluoro-deoxy-glucose-positron emission tomography/computed tomography in diagnosis of head and neck squamous cell carcinoma

    DEFF Research Database (Denmark)

    Rohde, Max; Dyrvig, Anne-Kirstine; Johansen, Jørgen

    2014-01-01

    and qualitatively analysed. Along with the calculated pooled sensitivity and specificity of PET/CT and SCI, bubble- and summary receiver operating characteristics (SROC) plots were created. FINDINGS: Two meta-analyses of diagnostic accuracy were conducted. The first, on PET/CT, included 987 patients distributed...

  17. Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (FDG PET/CT) Findings in an Unusual Case of Multiple Myeloma Presenting with a Large Extra-Axial Intracranial Mass.

    Science.gov (United States)

    Ayaz, Sevin; Ayaz, Ümit Yaşar

    2016-01-01

    We aimed to present unusual cranial FDG PET/CT findings of a 56-year-old female with multiple myeloma (MM). Plain CT images revealed a lytic lesion in the right parietal bone, filled with an oval-shaped, large, extra-axial, extradural, intracranial mass which measured 75×75×40 mm and had smooth borders. The right parietal lobe was compressed by the mass. The maximum standardized uptake value (SUV max ) of the mass lesion was 8.94 on FDG PET/CT images. Multiple lytic lesions with an increased uptake were also detected in other calvarial bones, in several vertebras and in the proximal left femur. After seven months, a control FDG PET/CT following radiotherapy and chemotherapy revealed almost complete regression of the right parietal extra-axial mass lesion. The number, size and metabolism of lytic lesions in other bones also decreased. FDG PET/CT was useful for an initial evaluation of MM lesions and was effective in monitoring the response of these lesions to therapy.

  18. Basal {sup 18}F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography as a prognostic biomarker in patients with locally advanced breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Garcia Vicente, Ana Maria; Soriano Castrejon, Angel [University General Hospital, Nuclear Medicine Department, Ciudad Real (Spain); Lopez-Fidalgo, Jesus Fernando; Amo-Salas, Mariano [University of Castilla-La Mancha, Department of Mathematics, Ciudad Real (Spain); Mar Munoz Sanchez, Maria del [Virgen de la Luz Hospital, Oncology Department, Cuenca (Spain); Alvarez Cabellos, Ruth [Virgen de la Salud Hospital, Oncology Department, Toledo (Spain); Espinosa Aunion, Ruth [La Mancha Centro Hospital, Oncology Department, Ciudad Real (Spain)

    2015-11-15

    To explore the relationship between basal {sup 18}F-FDG PET/CT information in breast tumours and survival in locally advanced breast cancer (LABC). This prospective, multicentre study included 198 women diagnosed with LABC. All patients underwent {sup 18}F-FDG PET/CT prior to treatment. The maximum standardized uptake value (SUVmax) in tumor (T), lymph nodes (N) and the N/T ratio was obtained in all cases. Stage according to PET/CT imaging (metabolic stage) and conventional imaging techniques (clinical stage) was established. During follow-up, patient status was established (disease free status or not). The relationship between all the variables and overall survival (OS) and disease-free survival (DFS) was analysed using the Kaplan-Meier and Cox regression methods. A ROC analysis was performed to obtain a cut-off value of SUVmax that was useful in the prediction of outcome. The mean SUVmax ± SD values in the primary tumour, lymph nodes and the SUVmax N/T index were 7.40 ± 5.57, 4.17 ± 4.74 and 0.73 ± 1.20, respectively. Higher semiquantitative metabolic values were found in more advanced metabolic and clinical stages. During follow-up, 78.4 % of patients were free of disease. Significant relationships were observed between SUVT and SUVN and patient status. With respect to OS and DFS, significant differences were detected for the metabolic stage. Kaplan-Meier analysis revealed that using the cut-off values, a primary-tumour SUVmax ≥ 6.05 or a nodal SUVmax ≥2.25 were significantly correlated with DFS and OS. PET imaging with {sup 18}F-FDG offers prognostic information for LABC that can be obtained preoperatively and noninvasively. (orig.)

  19. Image findings of a false positive radioactive iodine-131 uptake mimicking metastasis in pulmonary aspergillosis identified on single photon emission computed tomography-computed tomography

    Directory of Open Access Journals (Sweden)

    Kamaleshwaran Koramadai Karuppusamy

    2015-01-01

    Full Text Available High doses of iodine-131 are commonly used in patients with differentiated thyroid cancer after total or subtotal thyroidectomy, in order to ablate the remaining cancer or normal thyroid tissue. Multiple different false-positive scans can occur in the absence of residual thyroid tissue or metastases. The authors present a case of abnormal uptake of radioactive iodine in the aspergilloma, potentially masquerading as pulmonary metastases.

  20. Cardiological applications of positron emission tomography

    International Nuclear Information System (INIS)

    Schelbert, H.; Czernin, J.

    1994-01-01

    Positron emission tomography (PET) expands the diagnostic possibilities of nuclear medicine techniques for the diagnosis of coronary artery disease and, especially, for the identification of myocardial viability. The presence of coronary artery disease can be detected by evaluation of myocardial blood flow at rest and during pharmacologically induced hyperemia with a sensitivity of 84 to 98% and a specificity of 78 to 100% according to recent studies. Comparative investigations in the same patients have demonstrated a significant gain in the diagnostic accuracy of PET as compared with single photon emission computed tomography (SPECT). PET has influenced even more profoundly the identification of myocardial viability. Measured against the functional outcome of regional contractile function after successful revascularization, an increase of glucose utilization relative to regional myocardial blood flow is 77 to 85% accurate in identifying reversibly injured myocardium. Conversely, PET is 78 to 92% accurate in identifying myocardium as irreversibly injured when pre-operative glucose uptake was reduced or absent. Recent studies have indicated that it is possible to predict to some extent post-revascularization improvement in left ventricular function as well as in congestive heart failure related symptoms in patients with ischemic cardiomyopathy. Furthermore, PET can identify patients with an increased risk of mortality and morbidity as a result of ischemic heart disease and, thus, stratify patients to the most appropriate and cost-effective therapeutic approach. (authors)

  1. Positron emission tomography of the lung

    International Nuclear Information System (INIS)

    Wollmer, P.

    1984-01-01

    Positron emission tomography enables the distribution of positron emitting isotopes to be imaged in a transverse plane through the body and the regional concentration of the isotope to be measured quantitatively. This thesis reports some applications of positron emission tomography to studies of pulmonary pathophysiology. Measurements in lung phantoms showed that regional lung density could be measured from a transmission tomogram obtained with an external source of positron emitting isotope. The regional, fractional blood volume was measured after labelling the blood with carbon-11-monoxide. Regional extravascular lung density (lung tissue and interstitial water per unit thoracic volume) was obtained by subtracting fractional blood volume from lung density. Measurements in normal subjects revealed large regional variations in lung density and fractional blood volume in the supine posture. Extravascular lung density showed a more uniform distribution. The technique has been used to study patients with chronic interstitial pulmonary oedema, pulmonary sarcoidosis and fibrosis, pulmonary arterial hypertension and patients with intracardiac, left-to-right shunt. Tomographic measurements of pulmonary tissue concentration of radionuclides are difficult, since corrections for the blood content and the inflation of the lung must be applied. A simultaneous measurement of lung density and fractional blood volume allows such corrections to be made and the extravascular tracer concentration to be calculated. This has been applied to measurements of the tissue penetration of carbon-11-labelled erythromycin in patients with lobar pneumonia. (author)

  2. Positron emission tomography in the management of cervix cancer patients; Tomographie par emission de positons dans la prise en charge des cancers du col de l'uterus

    Energy Technology Data Exchange (ETDEWEB)

    Bonardel, G.; Gontier, E.; Soret, M.; Dechaud, C.; Fayolle, M.; Foehrenbach, H. [Hopital d' Instruction des Armees du Val-de-Grace, Service de Medecine Nucleaire, 75 - Paris (France); Chargari, C.; Bauduceau, O. [Hopital d' Instruction des Armees du Val-de-Grace, Service de Radiotherapie, 75 - Paris (France)

    2009-10-15

    Since its introduction in clinical practice in the 1990 s, positron emission tomography (PET), usually with {sup 18}F-fluoro-2-deoxy-D-glucose ({sup 18}F-F.D.G.), has become an important imaging modality in patients with cancer. For cervix carcinoma, F.D.G.-PET is significantly more accurate than computed tomography (CT) and is recommended for loco-regional lymph node and extra pelvic staging. The metabolic dimension of the technique provides additional prognostic information. Ongoing studies now concentrate on more advanced clinical applications, such as the planning of radiotherapy, the response evaluation after the induction of therapy, the early detection of recurrence. Technical innovations, such as PET cameras with better spatial resolution and hybrid positron emission tomography/computed tomography (PET-CT), available now on the whole territory, provide both anatomic and metabolic information in the same procedure. From the point of view of biological metabolism, new radiopharmaceutical probes are being developed. Those hold promise for future refinements in this field. This article reviews the current applications of F.D.G.-PET in patients with cervix cancer. (authors)

  3. F-18-fluorodeoxyglucose-positron emission tomography in colorectal cancer

    International Nuclear Information System (INIS)

    Joerg, L.; Langsteger, W.

    2002-01-01

    Whole-body positron emission tomography (PET) with the radiolabeled glucose analog F-18-fluorodeoxyglucose (F-18-FDG) is a sensitive diagnostic tool that images tumors based on increased uptake of glucose. Several recent publications have shown that F-18-fluorodeoxyglucose-positron emission tomography is more sensitive than computed-tomography (CT) in detecting colorectal cancer. In patients with increasing CEA (carcinoembryonic antigen) and no evidence of recurrent disease on CT F-18-fluorodeoxyglucose-positron emission tomography often detects recurrent cancer. In all, patient management seems to be changed in about 25 % of patients who undergo F-18-fluorodeoxyglucose-positron emission tomography in addition to standard staging procedure. Limited reports to date on both chemotherapy and radiotherapy support the role of F-18-fluorodeoxyglucose-positron emission tomography in assessing treatment response. Also regarding preoperative staging of primary colorectal cancer the literature is very limited. (author)

  4. Usefulness of 18F-fluorodeoxyglucose positron emission tomography in follicular lymphoma management

    International Nuclear Information System (INIS)

    Le Dortz, L.; Devillers, A.; Prigent, F.; Bahri, H.; Hervouet, T.; Garin, E.; Guibert, S. de.; Lamy, T.; Rolland, Y.; Bayat, S.

    2009-01-01

    Purpose To assess the usefulness of positron emission tomography/computed tomography in staging, prognosis evaluation and re staging of patients with follicular lymphoma. Patients and methods a retrospective study was performed on 45 patients with untreated biopsy-proven follicular lymphoma who underwent F.D.G.-PET/CT and CT before and after chemo-immunotherapy induction treatment (rituximab combined with cyclophosphamide, doxorubicin, vincristine and prednisone). Results PET/CT detected more nodal (+51%) and extra nodal (+89%) lesions than CT. PET/CT changed Ann Arbor stage in eight patients (18%). Five patients (11%) initially considered with early stage (I/II) were finally managed as advanced stage (III/IV). In this study, initial PET/CT was significantly more accurate to identify patients with poor prognosis than F.L.I.P.I.. Poor prognosis was defined as incomplete therapeutic response or early relapse. Accuracy of PET/CT for therapeutic response assessment was significantly higher than that of CT (0.97 vs 0.64), especially because of its ability to identify inactive residual masses. Beside, post-treatment PET/CT was able to predict patients outcome. The median progression free survival (P.F.S.) was 48 months in the PET/CT negative group as compared to 17.2 months for the group with residual uptake (P < 10-4). Conclusion F.D.G.-PET/CT is a very useful tool for staging, assessing prognosis and therapeutic response of patients with follicular lymphoma. (authors)

  5. Single-photon emission tomography and cerebral blood flow

    International Nuclear Information System (INIS)

    Celsis, P.; Chan, M.; Marc-Vergnes, J.P.; Sveinsdottir, E.; Goldman, T.G.; Henriksen, L.; Paulson, O.B.; Stokely, E.M.; Lassen, N.A.

    1982-01-01

    This paper illustrates the capabilities of single-photon emission tomography in imaging local cerebral blood flows in man. The results purport the conclusion that a fairly good improvement has been achieved when compared to stationary detectors and that single-photon emission tomography is a well-suited tool for studying cerebral hemodynamics, especially within the framework of clinical studies [fr

  6. Positron emission tomography of the heart

    Energy Technology Data Exchange (ETDEWEB)

    Schelbert, H.R.; Phelps, M.E.; Kuhl, D.E.

    1979-01-01

    Positron emission computed tomography (PCT) represents an important new tool for the noninvasive evaluation and, more importantly, quantification of myocardial performance. Most currently available techniques permit assessment of only one aspect of cardiac function, i.e., myocardial perfusion by gamma scintillation camera imaging with Thallium-201 or left ventricular function by echocardiography or radionuclide angiocardiography. With PCT it may become possible to study all three major segments of myocardial performance, i.e., regional blood flow, mechanical function and, most importantly, myocardial metabolism. Each of these segments can either be evaluated separately or in combination. This report briefly describes the principles and technological advantages of the imaging device, reviews currently available radioactive tracers and how they can be employed for the assessment of flow, function and metabolism; and, lastly, discusses possible applications of PCT for the study of cardiac physiology or its potential role in the diagnosis of cardiac disease.

  7. Positron emission tomography in drug development

    International Nuclear Information System (INIS)

    Rubin, R. H.; Fischman, A. J.

    1997-01-01

    There are four kinds of measurements that can be carried out with positron emission tomography (PET) that can contribute significantly to the process of drug development: pharmacodynamic measurement of tissue metabolism influenced by a given drug; precise measurements of tissue blood flow; tissue pharmacokinetics of a given drug following administration of a particular dose; and the temporal course of ligand-receptor interaction. One or more of these measurements can greatly improve the decision making involved in determining the appropriate dose of a drug, the clinical situations in which a drug might be useful, and the linkage of pharmacokinetics with pharmacodynamics, which is at the heart of effective drug development. The greater the potential of a particular compound as a therapeutic agent, the greater the potential for PET to contribute to the drug development process

  8. Neutron stimulated emission computed tomography: Background corrections

    International Nuclear Information System (INIS)

    Floyd, Carey E.; Sharma, Amy C.; Bender, Janelle E.; Kapadia, Anuj J.; Xia, Jessie Q.; Harrawood, Brian P.; Tourassi, Georgia D.; Lo, Joseph Y.; Kiser, Matthew R.; Crowell, Alexander S.; Pedroni, Ronald S.; Macri, Robert A.; Tajima, Shigeyuki; Howell, Calvin R.

    2007-01-01

    Neutron stimulated emission computed tomography (NSECT) is an imaging technique that provides an in-vivo tomographic spectroscopic image of the distribution of elements in a body. To achieve this, a neutron beam illuminates the body. Nuclei in the body along the path of the beam are stimulated by inelastic scattering of the neutrons in the beam and emit characteristic gamma photons whose unique energy identifies the element. The emitted gammas are collected in a spectrometer and form a projection intensity for each spectral line at the projection orientation of the neutron beam. Rotating and translating either the body or the beam will allow a tomographic projection set to be acquired. Images are reconstructed to represent the spatial distribution of elements in the body. Critical to this process is the appropriate removal of background gamma events from the spectrum. Here we demonstrate the equivalence of two background correction techniques and discuss the appropriate application of each

  9. Positron emission tomography of the heart

    International Nuclear Information System (INIS)

    Schelbert, H.R.; Phelps, M.E.; Kuhl, D.E.

    1979-01-01

    Positron emission computed tomography (PCT) represents an important new tool for the noninvasive evaluation and, more importantly, quantification of myocardial performance. Most currently available techniques permit assessment of only one aspect of cardiac function, i.e., myocardial perfusion by gamma scintillation camera imaging with Thallium-201 or left ventricular function by echocardiography or radionuclide angiocardiography. With PCT it may become possible to study all three major segments of myocardial performance, i.e., regional blood flow, mechanical function and, most importantly, myocardial metabolism. Each of these segments can either be evaluated separately or in combination. This report briefly describes the principles and technological advantages of the imaging device, reviews currently available radioactive tracers and how they can be employed for the assessment of flow, function and metabolism; and, lastly, discusses possible applications of PCT for the study of cardiac physiology or its potential role in the diagnosis of cardiac disease

  10. Applications of positron emission tomography to psychiatry

    International Nuclear Information System (INIS)

    Volkow, N.D.; Brodie, J.D.; Gomez-mont, F.

    1985-01-01

    The brain's inaccessibility has hampered investigation of the metabolic changes underlying the behavioral and psychological symptoms of psychiatric patients. Using positron emission transaxial tomography (PET) to study the functioning human brain opens the possibility of directly investigating the patterns of activity associated with mental illness. A major focus of present-day research in psychiatry has been to identify etiological agents that fit a medical model of psychiatric illness. Experiments seeking pathophysiological indices that would permit objective classification of psychiatric illnesses have failed to reveal consistent abnormalities. The lack of consistency is explained in part by research designs that deal with the brain as if it were a homogeneous organ. PET offers a unique technique for monitoring the regional biochemical activity that is associated with the different ''brain states'' and ''brain traits'' of normal subjects and psychiatric patients

  11. Motion correction in thoracic positron emission tomography

    CERN Document Server

    Gigengack, Fabian; Dawood, Mohammad; Schäfers, Klaus P

    2015-01-01

    Respiratory and cardiac motion leads to image degradation in Positron Emission Tomography (PET), which impairs quantification. In this book, the authors present approaches to motion estimation and motion correction in thoracic PET. The approaches for motion estimation are based on dual gating and mass-preserving image registration (VAMPIRE) and mass-preserving optical flow (MPOF). With mass-preservation, image intensity modulations caused by highly non-rigid cardiac motion are accounted for. Within the image registration framework different data terms, different variants of regularization and parametric and non-parametric motion models are examined. Within the optical flow framework, different data terms and further non-quadratic penalization are also discussed. The approaches for motion correction particularly focus on pipelines in dual gated PET. A quantitative evaluation of the proposed approaches is performed on software phantom data with accompanied ground-truth motion information. Further, clinical appl...

  12. Positron emission tomography and basal ganglia functions

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Motohiro; Otsuka, Makoto; Taniwaki, Koukyo; Hosokawa, Shinichi; Kuwabara, Yasuo; Ichiya, Yuichi [Kyushu Univ., Fukuoka (Japan). Faculty of Medicine

    1990-05-01

    With the advent of positron emission tomography (PET), studies on the human brain function and pathophysiology of brain damage have been extremely progressed. It is well-known that the basal ganglia plays an important role as one of the central nervous system involved in exercise regulation. More recently, the potential involvement of the basal ganglia in psychological processes, such as cognitive function, has been pointed out, receiving much attention. In spite of such a lot of studies, however, basal ganglia function remains unclear. This paper describes the relationships between PET findings and basal ganglia function. PET findings are discussed in relation to brain energy metabolism and striatal dopamine function. Pathophysiology of the basal ganglia are described in terms of the following diseases: Parkinson's disease, Parkinson's syndrome, progressive supranuclear palsy, Huntington's disease, and dystonia. Physiological backgrounds of the basal ganglia for PET images are also referred to. (N.K.) 75 refs.

  13. Positron emission tomography and basal ganglia functions

    International Nuclear Information System (INIS)

    Kato, Motohiro; Otsuka, Makoto; Taniwaki, Koukyo; Hosokawa, Shinichi; Kuwabara, Yasuo; Ichiya, Yuichi

    1990-01-01

    With the advent of positron emission tomography (PET), studies on the human brain function and pathophysiology of brain damage have been extremely progressed. It is well-known that the basal ganglia plays an important role as one of the central nervous system involved in exercise regulation. More recently, the potential involvement of the basal ganglia in psychological processes, such as cognitive function, has been pointed out, receiving much attention. In spite of such a lot of studies, however, basal ganglia function remains unclear. This paper describes the relationships between PET findings and basal ganglia function. PET findings are discussed in relation to brain energy metabolism and striatal dopamine function. Pathophysiology of the basal ganglia are described in terms of the following diseases: Parkinson's disease, Parkinson's syndrome, progressive supranuclear palsy, Huntington's disease, and dystonia. Physiological backgrounds of the basal ganglia for PET images are also referred to. (N.K.) 75 refs

  14. Partial Volume Effects correction in emission tomography

    International Nuclear Information System (INIS)

    Le Pogam, Adrien

    2010-01-01

    Partial Volume Effects (PVE) designates the blur commonly found in nuclear medicine images and this PhD work is dedicated to their correction with the objectives of qualitative and quantitative improvement of such images. PVE arise from the limited spatial resolution of functional imaging with either Positron Emission Tomography (PET) or Single Photon Emission Computed Tomography (SPECT). They can be defined as a signal loss in tissues of size similar to the Full Width at Half Maximum (FWHM) of the PSF of the imaging device. In addition, PVE induce activity cross contamination between adjacent structures with different tracer uptakes. This can lead to under or over estimation of the real activity of such analyzed regions. Various methodologies currently exist to compensate or even correct for PVE and they may be classified depending on their place in the processing chain: either before, during or after the image reconstruction process, as well as their dependency on co-registered anatomical images with higher spatial resolution, for instance Computed Tomography (CT) or Magnetic Resonance Imaging (MRI). The voxel-based and post-reconstruction approach was chosen for this work to avoid regions of interest definition and dependency on proprietary reconstruction developed by each manufacturer, in order to improve the PVE correction. Two different contributions were carried out in this work: the first one is based on a multi-resolution methodology in the wavelet domain using the higher resolution details of a co-registered anatomical image associated to the functional dataset to correct. The second one is the improvement of iterative deconvolution based methodologies by using tools such as directional wavelets and curvelets extensions. These various developed approaches were applied and validated using synthetic, simulated and clinical images, for instance with neurology and oncology applications in mind. Finally, as currently available PET/CT scanners incorporate more

  15. Simultaneous emission and transmission scanning in positron