Strict follow-up programme including CT and (18) F-FDG-PET after curative surgery for colorectal cancer

DEFF Research Database (Denmark)

Sørensen, N F; Jensen, A B; Wille-Jørgensen, P

2010-01-01

carcinogenic embryonic antigen (CEA), chest X-ray, abdominal ultrasound (US), computed tomography (CT) and (18) F-FDG positron emission tomography (FDG-PET). Method  A cohort of 132 patients, treated by surgery with curative intent for CRC, was included. Patients were followed prospectively with scheduled...... controls at 3, 6, 12 and 24 months after curative surgery. CEA, chest X-ray, US, CT and FDG-PET supplemented by clinical examination. The end-point was recurrence. Sensitivity and specificity was estimated 2 years after surgery. Results  Of the 132 patients included in the study, 25 experienced recurrence...

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

International Nuclear Information System (INIS)

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

2010-01-01

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

Long-term follow-up and role of FDG PET in advanced pancreatic neuroendocrine patients treated with {sup 177}Lu-D OTATATE

Energy Technology Data Exchange (ETDEWEB)

Sansovini, Maddalena; Severi, Stefano; Ianniello, Annarita; Nicolini, Silvia; Fantini, Lorenzo; Paganelli, Giovanni [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Nuclear Medicine Unit, Meldola (Italy); Mezzenga, Emilio [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Medical Physics Unit, Meldola (Italy); Ferroni, Fabio [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Radiology Unit, Meldola (Italy); Scarpi, Emanuela; Monti, Manuela [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Unit of Biostatistics and Clinical Trials, Meldola (Italy); Bongiovanni, Alberto [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Osteoncology and Rare Tumors Center, Meldola (Italy); Cingarlini, Sara [University of Verona, Department of Oncology, Verona Comprehensive Cancer Network, G.B. Rossi Hospital, Verona (Italy); Grana, Chiara Maria; Bodei, Lisa [European Institute of Oncology Milan (IEO), Division of Nuclear Medicine, Milan (Italy)

2017-03-15

Lu-DOTATATE (Lu-PRRT) is a valid therapeutic option in differentiated pancreatic neuroendocrine tumors (P-NETs). FDG PET seems to be an important prognostic factor in P-NETs. We evaluated the efficacy of Lu-PRRT and the role of FDG PET in 60 patients with advanced P-NETs. From March 2008 to June 2011, 60 consecutive patients with P-NETs were enrolled in the study. Follow-up lasted until March 2016. Eligible patients were treated with two different total cumulative activities (18.5 or 27.8 GBq in 5 cycles every 6-8 weeks), according to kidney and bone marrow parameters. Twenty-eight patients received a mean full activity (FA) of 25.9 GBq and 32 a mean reduced activity (RA) of 18.5 GBq. The disease control rate (DCR), defined as the sum of CR+PR+SD was 85.7 % in the FA group and 78.1 % in the RA group. Median progression-free survival (mPFS) was 53.4 months in the FA group and 21.7 months in the RA group (P = 0.353). Median overall survival (mOS) was not reached (nr) in FA patients and was 63.8 months in the RA group (P = 0.007). Fifty-five patients underwent an FDG PET scan before Lu-PRRT, 32 (58 %) showing an increased FDG uptake in tumor sites. mPFS was 21.1 months in FDG PET-positive patients and 68.7 months in the FDG PET-negative group (P < 0.0002), regardless of the total activity administered. Both FA and RA are active in patients undergoing Lu-PRRT. However, an FA of 27.8 GBq of Lu-PRRT prolongs PFS and OS compared to an RA of 18.5 GBq. Our results indicate that FDG PET is an independent prognostic factor in this patient setting. (orig.)

Unexpected second primary malignancies detected by f-18 FDG PET/CT during follow-up for primary malignancy: Two case report

Energy Technology Data Exchange (ETDEWEB)

Bang, Ji In; Lee, Eun Seong; Kim, Tae Sung; Kim, Seok Ki [Nuclear Medicine, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)

2015-03-15

As the survival rate of cancer patients has increased over the last few decades, the risk of cancer survivors developing second primary malignancies has gained attention. We report two rare cases of second primary hematologic malignancy detected by 18F-fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) during follow-up for primary solid malignancies. Acute lymphoblastic leukemia developed in a breast cancer patient and non-Hodgkin lymphoma in an anal cancer patient. F-18 FDG PET/CT findings led to the diagnosis of unexpected second primary hematologic malignancy in cancer survivors in these two cases.

Unexpected second primary malignancies detected by f-18 FDG PET/CT during follow-up for primary malignancy: Two case report

International Nuclear Information System (INIS)

Bang, Ji In; Lee, Eun Seong; Kim, Tae Sung; Kim, Seok Ki

2015-01-01

As the survival rate of cancer patients has increased over the last few decades, the risk of cancer survivors developing second primary malignancies has gained attention. We report two rare cases of second primary hematologic malignancy detected by 18F-fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) during follow-up for primary solid malignancies. Acute lymphoblastic leukemia developed in a breast cancer patient and non-Hodgkin lymphoma in an anal cancer patient. F-18 FDG PET/CT findings led to the diagnosis of unexpected second primary hematologic malignancy in cancer survivors in these two cases

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

International Nuclear Information System (INIS)

Lim, Il Han; Lee, Won Woo; Chung, Jin Haeng; Park, So Yeon; Kim, Sang Hee; Kim, Yu Kyeong; Kim, Sang Eun

2007-01-01

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

Possibilities of FDG-PET in diagnosis of urological tumors

International Nuclear Information System (INIS)

Kawamoto, Ken; Nakagawa, Masayuki

2004-01-01

The aim of this study was to determine the value of 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) in evaluating patients with urological tumors. FDG-PET scans were taken in 116 patients with urological diseases. The number of patients with prostatic disease, renal disease and adrenal disease was 86 (74.1%), 10 and 10, respectively. Seven patients with bladder tumors who had previously undergone either cystectomy or transurethral resection of bladder cancer (TUR-Bt) received FDG-PET scan for medical check-up. Three patients with testicular disease were also included in this series. In patients with prostatic disease, 41 patients were already diagnosed as having prostate cancer and FDG-PET was performed for medical check-up. Forty-five patients were suspected of having prostate cancer because of the FDG accumulation and/or a rise in serum prostatic specific antigen (PSA). Of these patients, 9 were diagnosed as having prostate cancer by biopsy. Serum PSA levels were elevated in all 9 patients, however FDG-PET findings were false-negative in 4 of the 9 patients. In patients with renal disease, 2 of the 4 patients suspected of having renal cell carcinoma actually had benign diseases. In one patient with a renal mass, FDG-PET was false-negative. All 6 patients with metastatic adrenal tumors showed positive findings in FDG-PET, and the patients with nonhypersecreting adrenal masses showed negative findings in FDG-PET. In three patients with seminoma, viable metastatic foci were successfully detected by FDG-PET after chemotherapy. In the present study, FDG-PET was not superior to tumor markers, such as serum PSA and conventional imaging modalities for the detection of prostate cancer and renal cell carcinoma. However, in patients with nonhypersecreting adrenal masses or a metastatic adrenal tumor, FDG-PET may provide significant functional information for tissue characterization. Moreover FDG-PET can be useful for the detection of residual viable carcinoma

FDG PET/CT imaging of desmoplastic small round cell tumor: findings at staging, during treatment and at follow-up

Energy Technology Data Exchange (ETDEWEB)

Ostermeier, Austin; Snyder, Scott E.; Shulkin, Barry L. [St. Jude Children' s Research Hospital, Department of Radiological Sciences, MS 220, Memphis, TN (United States); McCarville, M.B. [St. Jude Children' s Research Hospital, Department of Radiological Sciences, MS 220, Memphis, TN (United States); College of Medicine, University of Tennessee Health Science Center, Department of Radiology, Memphis, TN (United States); Navid, Fariba [St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); University of Tennessee Health Science Center, Department of Pediatrics, College of Medicine, Memphis, TN (United States)

2015-08-15

Desmoplastic small round cell tumor (DSRCT) is a very uncommon soft-tissue tumor of children and young adults. It has an aggressive course with generally poor survival. In general the assessment of tumor burden and response has relied upon CT or MRI. However these tumors are often metabolically active and can be evaluated using FDG PET/CT imaging. The purpose of this study was to determine the metabolic activity of desmoplastic small round cell tumors using FDG PET/CT imaging and the potential utility of FDG PET/CT in this disease. Eight patients (seven male, one female; ages 2-20 years, median 11 years) with confirmed DSRCT underwent 82 positron emission tomography/computed tomography (PET/CT) scans. PET/CT was used for initial staging (seven patients, eight scans), monitoring response to therapy (eight patients, 37 scans) and for surveillance of DSRCT recurrence (six patients, 37 scans). Each scan performed at diagnosis showed abnormally elevated uptake in the primary tumor. Five patients had abdominal pelvic involvement, and two of those also had thoracic disease. Six patients whose scans showed no abnormal sites of uptake at the end of therapy have had progression-free survivals of 2-10 years. One patient whose scan continued to show uptake during treatment died of disease 1.3 years from diagnosis. Another patient with persistent uptake remained in treatment 3 years after initial diagnosis. One surveillance scan identified recurrent disease. FDG PET/CT identified elevated metabolic activity in each patient studied. Despite our small sample size, FDG PET/CT scans appear useful for the management of patients with DSCRT. Patients whose studies become negative during or following treatment may have a prolonged remission. (orig.)

FDG-PET identification of intraperitoneal metastases

International Nuclear Information System (INIS)

Gamez, C.; Jimenez-Hoyuelam, J.M.; Rebollo, A.C.; Gonzalez, P.; Rico, J.M.; Alba, E.; Sacchetti, A.; Lopez-Rueda, B.

2002-01-01

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

Direct comparison of 68Ga-DOTA-TOC and 18F-FDG PET/CT in the follow-up of patients with neuroendocrine tumour treated with the first full peptide receptor radionuclide therapy cycle

OpenAIRE

Nilica, Bernhard; Waitz, Dietmar; Stevanovic, Vlado; Uprimny, Christian; Kendler, Dorota; Buxbaum, Sabine; Warwitz, Boris; Gerardo, Llanos; Henninger, Benjamin; Virgolini, Irene; Rodrigues, Margarida

2016-01-01

Purpose To determine the value of 68Ga-DOTA-TOC and 18F-FDG PET/CT for initial and follow-up evaluation of patients with neuroendocrine tumour (NET) treated with peptide receptor radionuclide therapy (PRRT). Methods We evaluated 66 patients who had histologically proven NET and underwent both PRRT and three combined 68Ga-DOTA-TOC and 18F-FDG PET/CT studies. 68Ga-DOTA-TOC PET/CT was performed before PRRT, 3?months after completion of PRRT and after a further 6???9 months. 18F-FDG PET/CT was do...

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-03-15

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

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

International Nuclear Information System (INIS)

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

2008-01-01

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

The value of 18F-DOPA PET-CT in patients with medullary thyroid carcinoma: comparison with 18F-FDG PET-CT

International Nuclear Information System (INIS)

Beheshti, Mohsen; Poecher, Sigrid; Vali, Reza; Nader, Michael; Langsteger, Werner; Waldenberger, Peter; Broinger, Gabriele; Kohlfuerst, Susanne; Pirich, Christian; Dralle, Henning

2009-01-01

The purpose of this prospective study was to compare the value of DOPA PET-CT with FDG PET-CT in the detection of malignant lesions in patients with medullary thyroid carcinoma (MTC). Twenty-six consecutive patients (10 men, 16 women, mean age 59 ± 14 years) with elevated calcitonin levels were evaluated in this prospective study. DOPA and FDG PET-CT modalities were performed within a maximum of 4 weeks (median 7 days) in all patients. The data were evaluated on a patient- and lesion-based analysis. The final diagnosis of positive PET lesions was based on histopathological findings and/or imaging follow-up studies (i.e., DOPA and/or FDG PET-CT) for at least 6 months (range 6-24 months). In 21 (21/26) patients at least one malignant lesion was detected by DOPA PET, while only 15 (15/26) patients showed abnormal FDG uptake. DOPA PET provided important additional information in the follow-up assessment in seven (27%) patients which changed the therapeutic management. The patient-based analysis of our data demonstrated a sensitivity of 81% for DOPA PET versus 58% for FDG PET, respectively. In four (4/26) postoperative patients DOPA and FDG PET-CT studies were negative in spite of elevated serum calcitonin and CEA levels as well as abnormal pentagastrin tests. Overall 59 pathological lesions with abnormal tracer uptake were seen on DOPA and/or FDG PET studies. In the final diagnosis 53 lesions proved to be malignant. DOPA PET correctly detected 94% (50/53) of malignant lesions, whereas only 62% (33/53) of malignant lesions were detected with FDG PET. DOPA PET-CT showed superior results to FDG PET-CT in the preoperative and follow-up assessment of MTC patients. Therefore, we recommend DOPA PET-CT as a one-stop diagnostic procedure to provide both functional and morphological data in order to select those patients who may benefit from (re-)operation with curative intent as well as guiding further surgical procedures. (orig.)

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

Energy Technology Data Exchange (ETDEWEB)

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

2010-07-15

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2005-08-15

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

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

International Nuclear Information System (INIS)

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

2005-01-01

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

Focal Colonic FDG Activity with PET/CT: Guidelines for Recommendation of Colonoscopy

OpenAIRE

Liu, Tianye; Behr, Spencer; Khan, Sana; Osterhoff, Robert; Aparici, Carina Mari

2015-01-01

Focal 18F-fluorodeoxyglucose (FDG) colonic activity can be incidentally seen in positron emission tomography/computed tomography (PET/CT) scans. Its clinical significance is still unclear. The purpose of this study was to assess the significance of focal FDG activity in PET/CT scans by correlating the imaging findings to colonoscopy results, and come up with some guidelines for recommendation of follow-up colonoscopy. A total of 133 patients who underwent both 18F-FDG PET/CT for different onc...

Dynamic respiratory gated 18FDG-PET of lung tumors - a feasibility study

International Nuclear Information System (INIS)

Skjei Knudtsen, Ingerid; Skretting, Arne; Roedal, Jan; Brustugun, Odd Terje; Helland, Aaslaug; Malinen, Eirik

2011-01-01

Background. 18 FDG-PET/CT imaging is well established for diagnosis and staging of lung tumors. However, more detailed information regarding the distribution of FDG within the tumor, also as a function of time after injection may be relevant. In this study we explore the feasibility of a combined dynamic and respiratory gated (DR) PET protocol. Material and methods. A DR FDG-PET protocol for a Siemens Biograph 16 PET/CT scanner was set up, allowing data acquisition from the time of FDG injection. Breath-hold (BH) respiratory gating was performed at four intervals over a total acquisition time of 50 minutes. Thus, the PET protocol provides both motion-free images and a spatiotemporal characterization of the glucose distribution in lung tumors. Software tools were developed in-house for tentative tumor segmentation and for extracting standard uptake values (SUVs) voxel by voxel, tumor volumes and SUV gradients in all directions. Results. Four pilot patients have been investigated with the DR PET protocol. The procedure was well tolerated by the patients. The BH images appeared sharper, and SUV max /SUV mean was higher, compared to free breathing (FB) images. Also, SUV gradients in the periphery of the tumor in the BH images were in general greater than or equal to the gradients in the FB PET images. Conclusion. The DR FDG-PET protocol is feasible and the BH images have a superior quality compared to the FB images. The protocol may also provide information of relevance for radiotherapy planning and follow-up. A patient trial is needed for assessing the clinical value of the imaging protocol

Ten years summary: FDG-PET on irradiated brain tumour

International Nuclear Information System (INIS)

Wang Shuxia; Boethius, J.

2004-01-01

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

Suture Granuloma Showing False-Positive Findings on FDG-PET

Directory of Open Access Journals (Sweden)

Kohei Takahara

2013-01-01

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

FDG-PET in the clinical management of Hodgkin lymphoma

DEFF Research Database (Denmark)

Hutchings, Martin; Eigtved, Annika I; Specht, Lena

2004-01-01

Positron emission tomography (PET) is a molecular functional imaging technique that provides qualitative and quantitative information about the localization and activity of pathophysiological processes. The most commonly used tracer for oncological purposes is 2-[18F]fluoro-2-deoxy-d-glucose (FDG......). FDG-PET has within recent years become the most important nuclear medicine imaging modality in the management of lymphoma. This review summarizes the data published so far concerning the value of FDG-PET in staging, treatment monitoring, therapy planning, and follow-up of Hodgkin lymphoma (HL). FDG...

Cancer screening with FDG-PET

International Nuclear Information System (INIS)

Ide, M.

2006-01-01

Aim: This study is based on medical health check-up and cancer screening on of a medical health club using PET, MRI, spiral CT and other conventional examinations. Methods: Between October 1994 and June 2005, 9357 asymptomatic members of the health club participated in 24772 screening session (5693 men and 3664 women, mean age 52.2±10.4 years). Results: Malignant tumors were discovered in 296 of the 9357 participants (3.16%) and 24772 screening sessions (1.19%). The detection rate of our program is much higher than that of mass screening in Japan. The thyroid, lung, colon and breast cancers were PET positive, but the prostate, renal and bladder cancers were generally PET negative. Conclusion: FDG-PET has the potential to detect a wide variety of cancers at curable stages in asymptomatic individuals. To reduce false-positive and false-negative results of PET examination, there is a need of experienced radiologist and/or oncologists who had training in the wide aspect of FDG-PET. FDG-PET has limitations in the detection of urological cancers, cancers of low cell density, small cancers and hypo metabolic or FDG non-avid cancers. Therefore, conventional examinations and/or PET/CT are also needed for cancer screening in association with FDG-PET

FDG-PET on Irradiated Brain Tumor: Ten Years' Summary

International Nuclear Information System (INIS)

Wang, S.X.; Boethius, J.; Ericson, K.

2006-01-01

Purpose: To evaluate FDG-PET in post-radiotherapy differentiation of tumor recurrence/malignant degeneration and radiation reaction, and to assess the role of PET in terms of survival. Material and Methods: 117 consecutive patients with a total of 156 FDG-PET examinations with positive but non-diagnostic MRI and/or CT were included. Final diagnosis was based on histopathology or correlated with radiologic and clinical follow-up. Brain metastases from lung carcinomas were further studied separately. Survival time was analysed using the Kaplan-Meier method. Results: There were 61 true-positive, 2 false-positive, 15 false-negative, and 51 true-negative PET examinations; 5 positive and 22 negative PET examinations were indeterminate. The positive predictive value of a PET examination was 96% in all and 100% in brain metastases from lung carcinoma. The negative predictive value based on the histopathologic results was 55.6%. Survival time was significantly longer in patients with negative PET. Conclusion: FDG-PET is a valuable tool in the detection of tumor recurrence, especially lung carcinoma metastasis. FDG uptake is a prognostic marker

Additional value of integrated PET/CT over PET alone in the initial staging and follow up of head and neck malignancy

International Nuclear Information System (INIS)

Ishikita, Tomohiro; Oriuchi, Noboru; Higuchi, Tetsuya

2010-01-01

Clinical application of fluorodeoxyglucose (FDG)-positron emission tomography (PET) in head and neck cancer includes identification of metastases, unknown primary head and neck malignancy, or second primary carcinoma, and also recurrent tumor after treatment. In this study, the additional value of PET/CT fusion images over PET images alone was evaluated in patients with initial staging and follow up of head and neck malignancy. Forty patients with suspected primary head and neck malignancy and 129 patients with suspected relapse after treatment of head and neck malignancy were included. FDG-PET/CT study was performed after the intravenous administration of FDG (5 MBq/kg). Target of evaluation was set at primary tumor, cervical lymph node, and whole body. PET images and PET with CT fusion images were compared. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Results of PET and PET/CT were compared with postoperative histopathological examination, and case by case comparison of PET and PET/CT results for each region was performed. The additional value of CT images over PET only images was assessed. Statistical differences in sensitivity and specificity were evaluated. In the comparative evaluation of 507 targets by PET alone and PET/CT, 401 targets showed agreement of the results. Of the 106 discordant targets, 103 showed a positive result on PET alone and negative result on PET/CT. These results showed a significant difference (p<0.01). Sensitivity of PET/CT was slightly higher than that of PET without statistical significance, while specificity of PET/CT was significantly higher than that of PET alone (Initial Staging: 90.5% vs. 62.2%, p<0.01; Follow up: 97.2% vs. 74.4%, p<0.01). In Fisher's direct probability test, a significant difference was noted in the sensitivity (Initial staging: 91.3% vs. 87.0%, p<0.01; Follow up: 93.9% vs. 91.4%, p<0.01). Combined PET/CT showed improved diagnostic

Incidental ovarian 18F-FDG accumulation on PET: correlation with the menstrual cycle

International Nuclear Information System (INIS)

Kim, Seok-Ki; Kang, Keon Wook; Roh, Ju Won; Sim, Jung Suk; Lee, Eun Sook; Park, Sang-Yoon

2005-01-01

The aim of this study was to determine the nature of incidental ovarian 18 F-fluoro-2-deoxyglucose (FDG) accumulation on positron emission tomography (PET) and the correlation with the menstrual cycle and menopause. We identified 19 incidental FDG accumulations in the ovary (FAOs). FDG PET images were compared with other anatomical imaging methods [magnetic resonance imaging (MRI), computed tomography (CT) or ultrasonography (US)]. Pathological findings, FDG PET scan during the next menstrual cycle and follow-up images (PET, CT and MRI) were reviewed. To establish the relation of FAOs to the menstrual cycle, we reviewed whole-body FDG PET acquired from 207 consecutive women and the pre-examination questionnaires, including data regarding the menstrual cycle. All spherical or discoid FAOs were attributed to normally developing ovarian follicles and corpora lutea on the basis of concurrent MRI, US or the follow-up PET scan. Three of the FAOs were proved pathologically to be either normal ovaries or a haemorrhagic corpus luteum. Fifteen FAOs spontaneously disappeared on the short-term follow-up PET scans. Of 207 women, 61 had active menstrual cycles. FAOs were found in 12 out of 61 premenopausal women (20%), appearing between the 10th and 25th days of the menstrual cycle. No FAOs were found in the women who did not have a menstrual cycle. Physiological ovarian FDG accumulation could be found around the time of ovulation and during the early luteal phase of the menstrual cycle in premenopausal woman. Since FAO is dependent on the menstrual cycle, it can be avoided by scheduling PET just after menstruation. (orig.)

Assessing FDG-PET diagnostic accuracy studies to develop recommendations for clinical use in dementia.

Science.gov (United States)

Boccardi, Marina; Festari, Cristina; Altomare, Daniele; Gandolfo, Federica; Orini, Stefania; Nobili, Flavio; Frisoni, Giovanni B

2018-04-30

FDG-PET is frequently used as a marker of synaptic damage to diagnose dementing neurodegenerative disorders. We aimed to adapt the items of evidence quality to FDG-PET diagnostic studies, and assess the evidence available in current literature to assist Delphi decisions for European recommendations for clinical use. Based on acknowledged methodological guidance, we defined the domains, specific to FDG-PET, required to assess the quality of evidence in 21 literature searches addressing as many Population Intervention Comparison Outcome (PICO) questions. We ranked findings for each PICO and fed experts making Delphi decisions for recommending clinical use. Among the 1435 retrieved studies, most lacked validated measures of test performance, an adequate gold standard, and head-to-head comparison of FDG-PET and clinical diagnosis, and only 58 entered detailed assessment. Only two studies assessed the accuracy of the comparator (clinical diagnosis) versus any kind of gold-/reference-standard. As to the index-test (FDG-PET-based diagnosis), an independent gold-standard was available in 24% of the examined papers; 38% used an acceptable reference-standard (clinical follow-up); and 38% compared FDG-PET-based diagnosis only to baseline clinical diagnosis. These methodological limitations did not allow for deriving recommendations from evidence. An incremental diagnostic value of FDG-PET versus clinical diagnosis or lack thereof cannot be derived from the current literature. Many of the observed limitations may easily be overcome, and we outlined them as research priorities to improve the quality of current evidence. Such improvement is necessary to outline evidence-based guidelines. The available data were anyway provided to expert clinicians who defined interim recommendations.

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

International Nuclear Information System (INIS)

Poeppel, T.D.; Krause, B.J.; Heusner, T.A.; Boy, C.; Bockisch, A.; Antoch, G.

2009-01-01

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

Clinical utility of {sup 18}F-FDG PET/CT in the follow-up of a large cohort of patients with high-risk differentiated thyroid carcinoma

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Yang, Ji H.; Maciel, Rui M.B.; Nakabashi, Claudia C.D.; Janovsky, Carolina C.P.S.; Padovani, Rosalia P.; Macellaro, Danielle; Camacho, Cléber P.; Biscolla, Rosa Paula M., E-mail: rui.maciel@unifesp.br [Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, SP (Brazil). Escola Paulista de Medicina; Osawa, Akemi; Wagner, Jairo [Hospital Israelita Albert Einstein (HIAE), São Paulo, SP (Brazil). Departamento de Imagem

2017-09-15

Objective: To evaluate the clinical utility of {sup 18}F-FDG PET/CT in patients with high-risk DTC. Subjects and methods: Single-center retrospective study with 74 patients with high-risk differentiated thyroid cancer (DTC), classified in 4 groups. Group 1: patients with positive sTg or TgAb, subdivided in Group 1A: negative RxWBS and no foci of metastases identified at conventional image (n = 9); Group 1B: RxWBS not compatible with suspicious foci at conventional image or not proportional to sTg level (n = 13); Group 2: patients with histological findings of aggressive DTC variants (n = 21) and Group 3: patients with positive RxWBS (n = 31). Results: {sup 18}F-FDG PET/CT identified undifferentiated lesions and helped restage the disease in groups 1B and 2. The scan helped guide clinical judgment in 9/13 (69%) patients of group 1B, 10/21 (48%) patients of group 2 and 2/31 (6%) patients of group 3. There was no clinical benefit associated with group 1A. {sup 18}F-FDG PET/CT was associated with progressive disease. Conclusion: {sup 18}F-FDG PET/CT is a useful tool in the follow-up of patients with high-risk DTC, mainly in the group of RxWBS not compatible with suspicious foci at conventional image or not proportional to sTg level and in those with aggressive DTC variants. Additionally, this study showed that {sup 18}F-FDG PET/CT was associated with progression and helped display undifferentiated lesions guiding clinical assessments regarding surgeries or expectant treatments. (author)

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

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

2014-04-15

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

Thoracic staging in lung cancer: prospective comparison of 18F-FDG PET/MR imaging and 18F-FDG PET/CT.

Science.gov (United States)

Heusch, Philipp; Buchbender, Christian; Köhler, Jens; Nensa, Felix; Gauler, Thomas; Gomez, Benedikt; Reis, Henning; Stamatis, Georgios; Kühl, Hilmar; Hartung, Verena; Heusner, Till A

2014-03-01

Therapeutic decisions in non-small cell lung cancer (NSCLC) patients depend on the tumor stage. PET/CT with (18)F-FDG is widely accepted as the diagnostic standard of care. The purpose of this study was to compare a dedicated pulmonary (18)F-FDG PET/MR imaging protocol with (18)F-FDG PET/CT for primary and locoregional lymph node staging in NSCLC patients using histopathology as the reference. Twenty-two patients (12 men, 10 women; mean age ± SD, 65.1 ± 9.1 y) with histopathologically confirmed NSCLC underwent (18)F-FDG PET/CT, followed by (18)F-FDG PET/MR imaging, including a dedicated pulmonary MR imaging protocol. T and N staging according to the seventh edition of the American Joint Committee on Cancer staging manual was performed by 2 readers in separate sessions for (18)F-FDG PET/CT and PET/MR imaging, respectively. Results from histopathology were used as the standard of reference. The mean and maximum standardized uptake value (SUV(mean) and SUV(max), respectively) and maximum diameter of the primary tumor was measured and compared in (18)F-FDG PET/CT and PET/MR imaging. PET/MR imaging and (18)F-FDG PET/CT agreed on T stages in 16 of 16 of patients (100%). All patients were correctly staged by (18)F-FDG PET/CT and PET/MR (100%), compared with histopathology. There was no statistically significant difference between (18)F-FDG PET/CT and (18)F-FDG PET/MR imaging for lymph node metastases detection (P = 0.48). For definition of thoracic N stages, PET/MR imaging and (18)F-FDG PET/CT were concordant in 20 of 22 patients (91%). PET/MR imaging determined the N stage correctly in 20 of 22 patients (91%). (18)F-FDG PET/CT determined the N stage correctly in 18 of 22 patients (82%). The mean differences for SUV(mean) and SUV(max) of NSCLC in (18)F-FDG PET/MR imaging and (18)F-FDG PET/CT were 0.21 and -5.06. These differences were not statistically significant (P > 0.05). The SUV(mean) and SUV(max) measurements derived from (18)F-FDG PET/CT and (18)F-FDG PET

Early identification of MCI converting to AD: a FDG PET study

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Pagani, Marco [Institute of Cognitive Sciences and Technologies, CNR, Rome (Italy); Karolinska Hospital Stockholm, Department of Nuclear Medicine, Stockholm (Sweden); Nobili, Flavio; Arnaldi, Dario; Brugnolo, Andrea; Picco, Agnese [University of Genoa and IRCCS AOU San Martino-IST, Clinical Neurology, Department of Neuroscience (DINOGMI), Genoa (Italy); Morbelli, Silvia; Bauckneht, Matteo; Piva, Roberta; Sambuceti, Gianmario [University of Genoa and IRCCS AOU San Martino-IST, Department of Nuclear Medicine, Department of Health Science (DISSAL), Genoa (Italy); Giuliani, Alessandro [Istituto Superiore di Sanita, Environment and Health Department, Rome (Italy); Oeberg, Johanna [Karolinska Hospital, Department of Hospital Physics, Stockholm (Sweden); Girtler, Nicola [University of Genoa and IRCCS AOU San Martino-IST, Clinical Neurology, Department of Neuroscience (DINOGMI), Genoa (Italy); IRCCS AOU San Martino-IST, Clinical Psychology, Genoa (Italy); Chincarini, Andrea [National Institute of Nuclear Physics (INFN), Genoa section, Genoa (Italy); Jonsson, Cathrine [Karolinska University Hospital, Medical Radiation Physics and Nuclear Medicine, Imaging and Physiology, Stockholm (Sweden); De Carli, Fabrizio [AOU San Martino-IST, Institute of Molecular Bioimaging and Physiology, CNR - Genoa Unit, Genoa (Italy)

2017-11-15

Mild cognitive impairment (MCI) is a transitional pathological stage between normal ageing (NA) and Alzheimer's disease (AD). Although subjects with MCI show a decline at different rates, some individuals remain stable or even show an improvement in their cognitive level after some years. We assessed the accuracy of FDG PET in discriminating MCI patients who converted to AD from those who did not. FDG PET was performed in 42 NA subjects, 27 MCI patients who had not converted to AD at 5 years (nc-MCI; mean follow-up time 7.5 ± 1.5 years), and 95 MCI patients who converted to AD within 5 years (MCI-AD; mean conversion time 1.8 ± 1.1 years). Relative FDG uptake values in 26 meta-volumes of interest were submitted to ANCOVA and support vector machine analyses to evaluate regional differences and discrimination accuracy. The MCI-AD group showed significantly lower FDG uptake values in the temporoparietal cortex than the other two groups. FDG uptake values in the nc-MCI group were similar to those in the NA group. Support vector machine analysis discriminated nc-MCI from MCI-AD patients with an accuracy of 89% (AUC 0.91), correctly detecting 93% of the nc-MCI patients. In MCI patients not converting to AD within a minimum follow-up time of 5 years and MCI patients converting within 5 years, baseline FDG PET and volume-based analysis identified those who converted with an accuracy of 89%. However, further analysis is needed in patients with amnestic MCI who convert to a dementia other than AD. (orig.)

Early identification of MCI converting to AD: a FDG PET study

International Nuclear Information System (INIS)

Pagani, Marco; Nobili, Flavio; Arnaldi, Dario; Brugnolo, Andrea; Picco, Agnese; Morbelli, Silvia; Bauckneht, Matteo; Piva, Roberta; Sambuceti, Gianmario; Giuliani, Alessandro; Oeberg, Johanna; Girtler, Nicola; Chincarini, Andrea; Jonsson, Cathrine; De Carli, Fabrizio

2017-01-01

Mild cognitive impairment (MCI) is a transitional pathological stage between normal ageing (NA) and Alzheimer's disease (AD). Although subjects with MCI show a decline at different rates, some individuals remain stable or even show an improvement in their cognitive level after some years. We assessed the accuracy of FDG PET in discriminating MCI patients who converted to AD from those who did not. FDG PET was performed in 42 NA subjects, 27 MCI patients who had not converted to AD at 5 years (nc-MCI; mean follow-up time 7.5 ± 1.5 years), and 95 MCI patients who converted to AD within 5 years (MCI-AD; mean conversion time 1.8 ± 1.1 years). Relative FDG uptake values in 26 meta-volumes of interest were submitted to ANCOVA and support vector machine analyses to evaluate regional differences and discrimination accuracy. The MCI-AD group showed significantly lower FDG uptake values in the temporoparietal cortex than the other two groups. FDG uptake values in the nc-MCI group were similar to those in the NA group. Support vector machine analysis discriminated nc-MCI from MCI-AD patients with an accuracy of 89% (AUC 0.91), correctly detecting 93% of the nc-MCI patients. In MCI patients not converting to AD within a minimum follow-up time of 5 years and MCI patients converting within 5 years, baseline FDG PET and volume-based analysis identified those who converted with an accuracy of 89%. However, further analysis is needed in patients with amnestic MCI who convert to a dementia other than AD. (orig.)

Does Antibiotic Treatment Affect the Diagnostic Accuracy of 18F-FDG PET/CT Studies in Patients with Suspected Infectious Processes?

Science.gov (United States)

Kagna, Olga; Kurash, Marina; Ghanem-Zoubi, Nesrin; Keidar, Zohar; Israel, Ora

2017-11-01

18 F-FDG PET/CT plays a significant role in the assessment of various infectious processes. Patients with suspected or known sites of infection are often referred for 18 F-FDG imaging while already receiving antibiotic treatment. The current study assessed whether antibiotic therapy affected the detectability rate of infectious processes by 18 F-FDG PET/CT. Methods: A 5-y retrospective study of all adult patients who underwent 18 F-FDG PET/CT in search of a focal source of infection was performed. The presence, duration, and appropriateness of antibiotic treatment before 18 F-FDG imaging were recorded. Diagnosis of an infectious process was based on microbiologic or pathologic data as well as on clinical and radiologic follow-up. Results: Two hundred seventeen patients underwent 243 PET/CT studies in search of a focal source of infection and were included in the study. Sixty-seven studies were excluded from further analysis because of a final noninfectious etiology or lack of further follow-up or details regarding the antibiotic treatment. The final study population included 176 18 F-FDG PET/CT studies in 153 patients (107 men, 46 women; age range, 18-86 y). One hundred nineteen studies (68%) were performed in patients receiving antibiotic therapy for a range of 1-73 d. A diagnosis of infection was made in 107 true-positive cases (61%), including 63 studies (59%) in patients receiving appropriate antibiotic therapy started before the performance of the 18 F-FDG PET/CT study. There were 52 true-negative (29%) and 17 false-positive (10%) 18 F-FDG PET/CT studies. No false-negative results were found. Conclusion: 18 F-FDG PET/CT correctly identified foci of increased uptake compatible with infection in most patients, including all patients receiving appropriate antimicrobial therapy, with no false-negative cases. On the basis of the current study results, the administration of antibiotics appears to have no clinically significant impact on the diagnostic accuracy of 18

Incidentally Detected Penile Metastases in a Patient of Carcinoma Urinary Bladder on Follow-up FDG PET/CT.

Science.gov (United States)

Parida, Girish Kumar; Tripathy, Sarthak; Roy, Shambo Guha; Singhal, Abhinav; Das, Chandanjyoti; Shamim, Shamim Ahmed

2017-05-01

Penis is an extremely uncommon site for metastases to occur and is often associated with very grave prognosis. Most of the secondary tumors originating in the penis have primaries from prostate, urinary bladder, and gastrointestinal tract. We hereby report a 65-year-old man, known case of carcinoma urinary bladder, who came for FDG PET/CT for metastatic workup. PET/CT study revealed FDG-avid mass lesion in the root and shaft of the penis, making it suggestive of metastases, which was confirmed later by MRI correlation.

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

International Nuclear Information System (INIS)

Alongi, Pierpaolo; Picchio, Maria; Gianolli, Luigi; Zattoni, Fabio; Spallino, Marianna; Saladini, Giorgio; Evangelista, Laura

2016-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-03-15

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

Cost effectiveness of FDG-PET: rapid evaluation in recurrent colorectal cancer

International Nuclear Information System (INIS)

Kelley, B.B.; Miles, K.A.; Keith, C.J.; Wong, D.C.; Griffiths, M.R.

2002-01-01

Full text: Intensive patient follow-up in assessments of the cost-effectiveness of a new imaging modality is associated with time-delays, ethical difficulties and increased costs. This study aims to evaluate the cost-effectiveness of FDG-PET in recurrent colorectal cancer using Australian data whilst avoiding intensive patient follow-up. The study population comprised patients with recurrent colorectal under consideration for resection of apparently isolated hepatic metastasis in whom demonstration of extra-hepatic tumour would preclude surgery. The results of FDG-PET in a consecutive series of 75 such patients referred to the Wesley PET centre were used to determine the range of possible values for disease prevalence and specificity, assuming the value for PET sensitivity as reported in the federal government's PET review. These values, along with the diagnostic accuracy of CT and Australian costs for procedures (PET = $ 1200), were entered into decision trees modelling a diagnostic strategy comprising CT only and an alternative strategy where patients without extra-hepatic tumour on CT also undergo FDG-PET. The cost per patient, accuracy and Incremental Cost-Accuracy Ratio (ICAR) were determined for each strategy. The PET strategy is cheaper for all possible values of disease prevalence and PET specificity ($306-328/patient) and is more cost-effective for values of disease prevalence above 0.18 or PET specificity above 0.86. At a typical disease prevalence of 0.3 (PET specificity 0.92), the ICAR for the PET strategy is $9700 versus $11,200 for CT. PET remains cost saving even if the best reported values for sensitivity of CT and worse values for PET are used, FDG-PET for recurrent colorectal cancer in Australia would be cost-saving and most probably cost-effective. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-10-15

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

Incidental ovarian {sup 18}F-FDG accumulation on PET: correlation with the menstrual cycle

Energy Technology Data Exchange (ETDEWEB)

Kim, Seok-Ki; Kang, Keon Wook; Roh, Ju Won; Sim, Jung Suk; Lee, Eun Sook; Park, Sang-Yoon [Research Institute and Hospital, National Cancer Center, Gyeonggi (Korea)

2005-07-01

The aim of this study was to determine the nature of incidental ovarian {sup 18}F-fluoro-2-deoxyglucose (FDG) accumulation on positron emission tomography (PET) and the correlation with the menstrual cycle and menopause. We identified 19 incidental FDG accumulations in the ovary (FAOs). FDG PET images were compared with other anatomical imaging methods [magnetic resonance imaging (MRI), computed tomography (CT) or ultrasonography (US)]. Pathological findings, FDG PET scan during the next menstrual cycle and follow-up images (PET, CT and MRI) were reviewed. To establish the relation of FAOs to the menstrual cycle, we reviewed whole-body FDG PET acquired from 207 consecutive women and the pre-examination questionnaires, including data regarding the menstrual cycle. All spherical or discoid FAOs were attributed to normally developing ovarian follicles and corpora lutea on the basis of concurrent MRI, US or the follow-up PET scan. Three of the FAOs were proved pathologically to be either normal ovaries or a haemorrhagic corpus luteum. Fifteen FAOs spontaneously disappeared on the short-term follow-up PET scans. Of 207 women, 61 had active menstrual cycles. FAOs were found in 12 out of 61 premenopausal women (20%), appearing between the 10th and 25th days of the menstrual cycle. No FAOs were found in the women who did not have a menstrual cycle. Physiological ovarian FDG accumulation could be found around the time of ovulation and during the early luteal phase of the menstrual cycle in premenopausal woman. Since FAO is dependent on the menstrual cycle, it can be avoided by scheduling PET just after menstruation. (orig.)

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

International Nuclear Information System (INIS)

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

2010-01-01

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

FDG-PET/CT in oncology. German guideline

International Nuclear Information System (INIS)

Krause, B.J.; Beyer, T.; Bockisch, A.; Delbeke, D.; Kotzerke, J.; Minkov, V.; Reiser, M.; Willich, N.

2007-01-01

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

Focal Colonic FDG Activity with PET/CT: Guidelines for Recommendation of Colonoscopy

International Nuclear Information System (INIS)

Liu, Tianye; Behr, Spencer; Khan, Sana; Osterhoff, Robert; Aparici, Carina Mari

2015-01-01

Focal 18 F-fluorodeoxyglucose (FDG) colonic activity can be incidentally seen in positron emission tomography/computed tomography (PET/CT) scans. Its clinical significance is still unclear. The purpose of this study was to assess the significance of focal FDG activity in PET/CT scans by correlating the imaging findings to colonoscopy results, and come up with some guidelines for recommendation of follow-up colonoscopy. A total of 133 patients who underwent both 18 F-FDG PET/CT for different oncological indications and colonoscopy within 3 months were retrospectively studied. Imaging, colonoscopy and pathology results were analyzed. Of the 133 FDG-PET/CT scans, 109/133 (82%) did not show focal colonic FDG activity, and 24/133 (18%) did. Of the 109/133 PET/CTs without focal colonic FDG activity, 109/109 (100%) did not have evidence of colon cancer after colonoscopy and histology. Of the 24/133 PET/CTs with focal colonic FDG activity, 10/24 (42%) had pathologic confirmation of colon cancer and 14/24 (58%) did not have evidence of colon cancer after colonoscopy and histological analysis. Sensitivity was 10/10 (100%), specificity 109/123 (89%), positive predictive value (PPV) 10/24 (42%) and negative predictive value (NPV) 109/109 (100%). Incidental focal 18 FDG activity in PET/CT imaging shows a high sensitivity, specificity and NPV for malignancy, with a not so high PPV of 42%. Although some people would argue that a 42% chance of malignancy justifies colonoscopy, this maybe is not possible in all cases. However, the high sensitivity of the test does not allow these studies to be overlooked. We provide our recommendations as per when to send patients with focal FDG colonic activity to have further characterization with colonoscopy

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

DEFF Research Database (Denmark)

Ørbæk, Mathilde; Graff, Jesper; Markova, Elena

2016-01-01

We present a case demonstrating the diagnostic work-up and follow-up of a patient with acute Epstein-Barr virus (EBV) infection in which the clinical picture and imaging on (18)F-FDG PET/CT mimicked malignant lymphoma. Follow-up (18)F-FDG PET/CT scan in the patient performed 7 weeks after...... the abnormal scan revealed complete resolution of the metabolically active disease in the neck, axillas, lung hili, and spleen. This case highlights inflammation as one of the most well established false positives when interpreting (18)F-FDG PET/CT scans....

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

Energy Technology Data Exchange (ETDEWEB)

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

2004-07-01

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

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

International Nuclear Information System (INIS)

Chae, Min Jeong; Cheon, Gi Jeong; Kim, Seong Eun; Choi, Chang Woon; Lim, Sang Moo

2004-01-01

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

A study on client needs regarding FDG-PET for cancer screening

International Nuclear Information System (INIS)

Yamane, Tomohiko; Yoshiya, Kazuhiko; Nagata, Takeshi; Ito, Shinichi; Ito, Satoshi; Mezaki, Yukio; Uchida, Hideo

2006-01-01

We researched client needs regarding FDG-PET for cancer screening. The study included 1,527 individuals who underwent FDG-PET for cancer screening at our hospital. An interview sheet was distributed after injecting FDG. Clients listed the organs that required examination and the symptoms causing them anxiety. Results indicated that 9.8% of the clients listed organs for which FDG-PET would not be useful in detecting cancer. This study suggested that there exists a gap between client needs and FDG-PET utility; hence we need improved methods of providing correct information to clients. (author)

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

Science.gov (United States)

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

2015-01-01

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

Experience in qualitative and quantitative FDG PET in follow-up of patients with suspected recurrence from head and neck cancer

DEFF Research Database (Denmark)

Lapela, M; Eigtved, A; Jyrkkiö, S

2000-01-01

We evaluated positron emission tomography (PET) with 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) in the detection of recurrent head and neck cancer, and compared visual and quantitative interpretation of PET images for their accuracy in the identification of tumour recurrence. Sixty-two FDG PET...... studies were performed in 56 patients having a total of 81 lesions, which were clinically suspected for recurrent carcinoma of the head and neck. The PET images were interpreted visually, and tracer uptake was quantitated as the standardised uptake value adjusted to body weight (SUV). Sensitivity...

Cerebral FDG-PET scanning abnormalities in optimally treated HIV patients

DEFF Research Database (Denmark)

Andersen, Ase B; Law, Ian; Krabbe, Karen S

2010-01-01

with no history of virological failure, a CD4 count above 200 x 106 cells/l and no other co-morbidities. The distribution of the regional cerebral metabolic rate of glucose metabolism was measured using fluorine-18-flourodeoxyglucose positron emission tomography (FDG-PET) scanning. The PET scans were evaluated...... in the relative metabolic rate of glucose. Compared to healthy subjects, the patients with abnormal FDG-PET scanning results had a shorter history of known HIV infection, fewer years on antiretroviral therapy and higher levels of circulating TNF alpha and IL-6 (p = 0.08). CONCLUSION: A large proportion...... of optimally treated HIV patients exhibit cerebral FDG-PET scanning abnormalities and elevated TNF alpha and IL-6 levels, which may indicate imminent neuronal damage. The neuroprotective effect of early ARV treatment should be considered in future prospective follow-up studies....

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

International Nuclear Information System (INIS)

Montravers, F.; Kerrou, K.; Gutman, F.; Grahek, D.; Talbot, J.N.

2006-01-01

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

Clinical value of FDG PET/CT in the diagnosis of suspected recurrent ovarian cancer: is there an impact of FDG PET/CT on patient management?

International Nuclear Information System (INIS)

Bilici, Ahmet; Ustaalioglu, Bala Basak Oven; Seker, Mesut; Salepci, Taflan; Gumus, Mahmut; Canpolat, Nesrin; Tekinsoy, Bulent

2010-01-01

The aim of this study was to evaluate the clinical value of FDG PET/CT in patients with suspected ovarian cancer recurrence as compared with diagnostic CT, and to assess the impact of the results of FDG PET/CT on treatment planning. Included in this retrospective study were 60 patients with suspected recurrent ovarian cancer who had previously undergone primary debulking surgery and had been treated with adjuvant chemotherapy. Diagnostic CT and FDG PET/CT imaging were performed for all patients as clinically indicated. The changes in the clinical management of patients according to the results of FDG PET/CT were also analysed. FDG PET/CT was performed in 21 patients with a previously negative or indeterminate diagnostic CT scan, but an elevated CA-125 level, and provided a sensitivity of 95% in the detection of recurrent disease. FDG PET/CT revealed recurrent disease in 19 patients. In 17 of 60 patients, the indication for FDG PET/CT was an elevated CA-125 level and an abnormal diagnostic CT scan to localize accurately the extent of disease. FDG PET/CT scans correctly identified recurrent disease in 16 of the 17 patients, a sensitivity of 94.1%. Moreover, FDG PET/CT was performed in 18 patients with clinical symptoms of ovarian cancer recurrence, an abnormal diagnostic CT scan, but a normal CA-125 level. In this setting, FDG PET/CT correctly confirmed recurrent disease in seven patients providing a sensitivity of 100% in determining recurrence. In four patients, FDG PET/CT was carried out for the assessment of treatment response. Three of four scans were classified as true-negative indicating a complete response. In the other patient, FDG PET/CT identified progression of disease. In total, 45 (75%) of the 60 patients had recurrent disease, in 14 (31.1%) documented by histopathology and in 31 (68.9%) on clinical follow-up, while 15 (25%) had no evidence of recurrent disease. The overall sensitivity, specificity, accuracy, and positive and negative predictive value

The value of serial FDG PET on therapeutic evaluation and relapse monitoring of lung cancer

International Nuclear Information System (INIS)

Zhu Zhaohui; Cheng Wuying; Cui Ruixue; Chen Xin; Hao Li; Dang Yonghong; Zhe Fu; Wang Bocheng

2004-01-01

Purpose: A retrospective study was designed to investigate the value of serial FDG PET on therapeutic evaluation and relapse monitoring of lung cancer, and the influence factors to the evaluation and follow-up were also analyzed. Methods: Nineteen patients with confirmed lung cancer were included in the study, and they accepted a total of 87 FDG PET scans, with 3 to 12 times for each patient. The follow-up intervals of FDG PET varied from 14 days to 32 months, and 51 of 68 intervals were within 6 months with a mean of 3.3 months. The PET images of serial studies were analyzed with both visual and semi-quantitative Methods, and they were compared with other imaging techniques (CT, MRI and/or bone scan) and clinical follow-ups. Results: By providing metabolic information, FDG PET detected tumors with high contrast to normal tissue, and the serial examinations helped 9 patients in detecting and evaluating lesions in areas with complicated anatomic structures, such as lung hilus, mediastinum, supraclavicular and abdomen. PET also showed more accuracy and sensitivity than bone scan, CT or MRI in evaluation of bone metastases in two cases. Serial FDG PET was also helpful to the cases in complicated conditions with necrosis, fibrosis or changes of anatomic structures after multiple therapies. In two cases, the follow-up studies confirmed the metastases in the incision wound, which had increasing uptake while it decreased in the repairing wound tissue. By analyzing metabolism of the lesions, PET also showed changes in 3 cases, while they were unconcluded by CT and/or MRI. In some circumstances, benign uptake of FDG influenced the evaluation and monitoring. Inflammation after radiotherapy showed high uptake in 7 cases, and influenced the evaluation of therapy in the serial examinations. Recent use of granulocyte clone stimulation factor (G-CSF) caused diffuse high uptake in bone marrow, and it covered the bone metastases in one case. And in other two cases, diffuse high

Usefulness of FDG-PET in the evaluation of patients with colon and rectal cancer in a PET center in Chile

Energy Technology Data Exchange (ETDEWEB)

Jofre, M J; Massardo, L T; Canessa, J; Sierralta, P; Gonzalez, P [Molecular Imaging PET Center, Nuclear Medicine Department, Military Hospital, Santiago (Chile)

2007-11-15

increased); the correlation with FDG was 77%; there were 10 cases with negative CEA and positive PET. CEA positive with FDG positive Odds Ratio corresponded to 7.58 [C.I: 2.8-20.3]. Follow-up: In 9 patients surgery was performed in sites with positive FDG, confirming all lesions (lung, liver and rectum). In 49 cases there was clinical follow-up: A) 75% of those with positive PET received additional chemotherapy (4 patients deceased). B) Good evolution with negative PET was seen in 79% (follow-up range: 3m - 3.5y); 2 patients presented elevated CEA levels without demonstrated lesions and 2 others showed metastases, at least 6 months after PET. Conclusion: FDG - PET has great value in colorectal cancer evaluation, mainly in re-staging and patients with suspected recurrence. (author)

18F-FDG PET in children with lymphomas

International Nuclear Information System (INIS)

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

2005-01-01

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

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

International Nuclear Information System (INIS)

Vrachimis, Alexis; Wenning, Christian; Weckesser, Matthias; Stegger, Lars; Burg, Matthias Christian; Allkemper, Thomas; Schaefers, Michael

2016-01-01

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

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

Directory of Open Access Journals (Sweden)

Mathilde Ørbæk

2016-05-01

Full Text Available We present a case demonstrating the diagnostic work-up and follow-up of a patient with acute Epstein-Barr virus (EBV infection in which the clinical picture and imaging on 18F-FDG PET/CT mimicked malignant lymphoma. Follow-up 18F-FDG PET/CT scan in the patient performed 7 weeks after the abnormal scan revealed complete resolution of the metabolically active disease in the neck, axillas, lung hili, and spleen. This case highlights inflammation as one of the most well established false positives when interpreting 18F-FDG PET/CT scans.

18F-FDG-PET/CT in Endometrial Carcinoma

International Nuclear Information System (INIS)

Jeon, Tae Joo

2008-01-01

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

Fat necrosis after abdominal surgery: A pitfall in interpretation of FDG-PET/CT.

Science.gov (United States)

Davidson, Tima; Lotan, Eyal; Klang, Eyal; Nissan, Johnatan; Goldstein, Jeffrey; Goshen, Elinor; Ben-Haim, Simona; Apter, Sara; Chikman, Bar

2018-06-01

We describe FDG-PET/CT findings of postoperative fat necrosis in patients following abdominal surgery, and evaluate their changes in size and FDG uptake over time. FDG-PET/CT scans from January 2007-January 2016 containing the term 'fat necrosis' were reviewed. Lesions meeting radiological criteria of fat necrosis in patients with prior abdominal surgery were included. Forty-four patients, 30 males, mean age 68.4 ± 11.0 years. Surgeries: laparotomy (n=37; 84.1 %), laparoscopy (n=3; 6.8 %), unknown (n=4; 9.1 %). CTs of all lesions included hyperdense well-defined rims surrounding a heterogeneous fatty core. Sites: peritoneum (n=34; 77 %), omental fat (n=19; 43 %), subcutaneous fat (n=8; 18 %), retroperitoneum (n=2; 5 %). Mean lesion long axis: 33.6±24.9 mm (range: 13.0-140.0). Mean SUVmax: 2.6±1.1 (range: 0.6-5.1). On serial CTs (n=34), lesions decreased in size (p=0.022). Serial FDG-PET/CT (n=24) showed no significant change in FDG-avidity (p=0.110). Mean SUVmax did not correlate with time from surgery (p=0.558) or lesion size (p=0.259). Postsurgical fat necrosis demonstrated characteristic CT features and may demonstrate increased FDG uptake. However, follow-up of subsequent imaging scans showed no increases in size or FDG-avidity. Awareness of this entity is important to avoid misinterpretation of findings as recurrent cancer. • Postsurgical fat necrosis may mimic cancer in FDG-PET/CT. • Follow-up of fat necrosis showed no increase in FDG intensity. • CT follow-up showed a decrease in lesion size. • FDG uptake did not correlate with time lapsed from surgery.

Peritoneal carcinomatosis - the role of FDG PET

International Nuclear Information System (INIS)

Turlakow, A.; Yeung, H.W.; Macapinlac, H.A.; Sanchez, A.F.; Larson, S.M.

2002-01-01

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

Comparative study of FDG-PET and sestamibi-SPECT in the diagnosis of secondary hyperparathyroidism

International Nuclear Information System (INIS)

Higuchi, T.; Ozawa, K.; Oriuchi, N.; Khan, N.; Endo, K.; Otake, H.; Matsubara, K.

2002-01-01

Aim: FDG-PET is reported to be more accurate in preoperative localization of hyper functioning parathyroid gland of primary hyperparathyroidism in comparison with sestamibi-SPECT by Neumann et al. However, its usefulness in the diagnosis of secondary hyperparathyroidism has not been reported yet. In this study, we've performed the direct comparison of the usefulness of FDG-PET and sestamibi-SPECT in the detection of abnormal parathyroid tissue in the patients of secondary hyperparathyroidism under hemodilysis. Material and Methods: One primary and 5 secondary hyperparathyroidism patients underwent FDG-PET and sestamibi-SPECT. After overnight fasting, 300 to 400 MBq of FDG was intravenously injected, followed by whole body PET image acquisition after 50 minutes. In the same day before FDG-PET, 600 MBq of sestamibi was injected and early and delayed planar image and delayed SPECT image has been obtained. Visual interpretation of the abnormal parathyroid uptake has been performed by 2 experienced nuclear physician independently. Results: In the secondary cases, FDG-PET shows no hyper functioning gland in all 5 cases, whereas sestamibi-SPECT shows 8 hyper functioning glands. In contrast, hyper functioning gland of the primary hyperparathyroidism case has been clearly visualized only by FDG-PET. Conclusion: Although FDG-PET is very useful in detecting hyper functioning gland in primary hyperparathyroidism, it is not useful in secondary hyperparathyroidism. Further pathological analysis about the different glucose metabolism of primary and secondary hyper functioning gland should be added in the future study

The role of positron-emission-tomography (F-18-FDG-PET) in the staging and follow-up of lung cancer and in the evaluation of focal pulmonary abnormalities

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Baum, R.P.; Bonnet, R.B.; Presselt, N.; Leonhardi, J.

2001-01-01

For lymph node staging (especially for the detection of mediastinal lymph node involvement, i.e. N2 or N3 metastases) of non-small cell lung cancer (NSCLC), FDG PET and spiral CT were compared head to head in prospective studies. A significantly higher diagnostic accuracy was shown for FDG-PET, which is able to detect metastases (up-staging) even in normal sized lymph nodes (in CT 80%. (orig.) [de

{sup 18}F-FDG PET/CT to assess response and guide risk-stratified follow-up after chemoradiotherapy for oropharyngeal squamous cell carcinoma

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Bird, Thomas; Lei, Mary; Guerrero Urbano, Teresa [Guy' s and St Thomas' NHS Foundation Trust, Department of Clinical Oncology, London (United Kingdom); Barrington, Sally [King' s College, PET Imaging Centre at St Thomas' Hospital, London (United Kingdom); Thavaraj, Selvam [Guy' s and St Thomas' NHS Foundation Trust, Head and Neck Pathology Department, London (United Kingdom); Jeannon, Jean-Pierre; Lyons, Andrew; Oakley, Richard; Simo, Ricard [Guy' s and St Thomas' NHS Foundation Trust, Department of Head and Neck Surgery, London (United Kingdom)

2016-07-15

To evaluate the use of {sup 18}F-FDG PET/CT as the principal investigation to assess tumour response, to determine the need for further surgery and to guide follow-up following radical chemoradiotherapy for stage III/IV oropharyngeal squamous cell carcinoma (OPSCC). A retrospective analysis was undertaken in 146 patients treated at our centre with radical chemoradiotherapy for OPSCC and who had a PET/CT scan to assess response. According to the PET/CT findings, patients were divided into four groups and recommendations: (1) complete metabolic response (enter clinical follow-up); (2) low-level uptake only (follow-up PET/CT scan in 12 weeks); (3) residual uptake suspicious for residual disease (further investigation with or without neck dissection); and (4) new diagnosis of distant metastatic disease (palliative treatment options). The initial PET/CT scan was performed at a median of 12.4 weeks (range 4.3 - 21.7 weeks) following treatment. Overall sensitivity and specificity rates were 92.0 % (74.0 - 99.0 %) and 85 % (77.5 - 90.9 %). Of the 146 patients, 90 (62 %) had a complete response and had estimated 3-year overall and disease-free survival rates of 91.9 % (85.6 - 98.2 %) and 85.6 % (78.0 - 93.2 %), respectively, 17 (12 %) had residual low-level uptake only (with two having confirmed residual disease on subsequent PET/CT, both surgically salvaged), 30 (21 %) had suspicious residual uptake (12 proceeded to neck dissection; true positive rate at surgery 33 %). HPV-positive patients with reassuring PET/CT findings had an estimated 3-year progression-free survival rate of 91.7 % (85.2 - 98.2 %), compared with 66.2 % (41.5 - 90.9 %) of HPV-negative patients. A strategy of using PET/CT results alongside clinical examination to help select patients for salvage surgery appears successful. Despite a complete response on the 12-week PET/CT scan, HPV-negative patients have a significant risk of disease relapse in the following 2 years and further studies to assess whether

Functional neuroimaging using F-18 FDG PET/CT in amnestic mild cognitive impairment: a preliminary study

International Nuclear Information System (INIS)

Tripathi, Madhavi; Tripathi, Manjari; Sharma, Rajnish; Jaimini, Abhinav; D'Souza, Maria M.; Saw, Sanjiv; Mondal, Anupam; Kushwaha, Suman

2013-01-01

People with amnestic mild cognitive impairment (aMCI) are at a higher risk of developing Alzheimers Dementia (AD) than their cognitively normal peers. Decreased glucose metabolism with 18 F fluorodeoxyglucose (FDG) positron emission tomography (PET) is a downstream marker of neuronal injury and neurodegeneration. The risk of developing AD is higher in patients with aMCI who have a pattern of AD related glucose metabolic changes on FDG-PET than those who do not have these changes. We evaluated the utility of visual and 'statistical parametric mapping (SPM)-supported reading' of the FDG-PET scans of patients clinically classified as aMCI for identification of predementia patterns and for prediction of their progression to AD (PTAD). On visual analysis, four scans were classified as high likelihood of PTAD and reveled hypometabolism in AD related territories. Seven patients had hypometabolism in at least one AD related territory and were classified as intermediate likelihood for PTAD. Two patients had hypometabolism in other than AD territories, while 22 patients did not show any significant hypometabolism on their FDG-PET scans and were classified as low likelihood for PTAD. SPM analysis of these cases confirmed the areas hypometabolism in all 13 patients compared to a normal subgroup (P < 0.05). On follow-up of 24 months, all four cases with high likelihood scans had progression of cognitive deficits and were confirmed as AD in the CDM clinic while none of the others showed cognitive decline. A pattern of AD hypometabolism on the FDG-PET study is useful for predicting PTAD. A longer follow-up of patients with hypometabolism in single AD territories is needed to predict their clinical behavior

FDG-PET and FDG-PET/CT for therapy monitoring and restaging in malignant lymphoma

International Nuclear Information System (INIS)

Mottaghy, F.M.; Krause, B.J.

2003-01-01

F-18-fluorodeoxyglucose (FDG) PET allows to assess residual masses in patients with malignant lymphoma differentiating vital tumor from scar tissue. This approach is not applicable with conventional imaging methods (CDM) such as CT or MRI. On the other hand circumscribed results often cannot be definitely allocated in PET, therefore the combined morphological-biochemical approach using the now available PET/CT systems promises to be a pathbreaking technical progress. There is no doubt that stand alone PET is superior to CDM differentiating residual scar tissue from vital tumor as has been shown in 15 recently published studies. The median sensitivity for detecting active disease with FDG PET across the studies was 91%; the corresponding specificity was 89%. As a result FDG PET had a high negative predictive value of 94%. In contrast, specificity and positive predictive value (PPV) of CDM in the 9 studies were a direct comparison was available were low (31% and 46%, one study 82%). PET positive residual masses were associated with a progression-free survival of 0 - 55%. Only a few studies have included FDG-PET in therapy response monitoring studies, however also these results are promising. At the moment FDG-PET seems to be the best possibility to characterize and qualitatively visualize vitality of tumor masses and also hold promises for efficient therapy response monitoring in patients with malignant lymphoma. Therefore it should be included in standard diagnostic protocols in lymphoma patients. The combined PET/CT has to be ranked superior to conventional PET studies as in many cases the combined structural and functional imaging brings a clearer diagnostic statement. (orig.) [de

Usefulness of FDG PET/CT in determining benign from malignant endobronchial obstruction

International Nuclear Information System (INIS)

Cho, Arthur; Kang, Won Jun; Cho, Ho Jin; Lee, Jae-hoon; Yun, Mijin; Lee, Jong Doo; Hur, Jin

2011-01-01

To evaluate the usefulness of FDG PET/CT to differentiate malignant endobronchial lesions with distal atelectasis from benign bronchial stenosis. This retrospective study reviewed 84 patients who underwent contrast-enhanced chest CT and then PET/CT and had histological (n = 81) or follow-up imaging (n = 3) confirmation. Two chest radiologists reviewed initial chest CT and determined endobronchial lesions to be malignant or benign. Two nuclear medicine physicians reviewed PET/CT for FDG uptake at the obstruction site and measured SUV. Malignancy was considered when increased FDG uptake was seen in the obstruction site, regardless of FDG within the atelectatic lung. The sensitivity, specificity and accuracy of chest CT was 95%, 48% and 84%, compared with 95%, 91% and 94% for PET/CT. Benign obstructive lesions showed statistically lower FDG uptake than malignant obstructions (benign SUV 2.5 ± 0.84; malignant SUV 11.8 ± 5.95, p < 0.001). ROC analysis showed an SUV cut-off value of 3.4 with highest sensitivity of 94% and specificity of 91%. Increased FDG PET/CT uptake at the obstruction site indicates a high probability of malignancy, while benign lesions show low FDG uptake. Careful evaluation of FDG uptake pattern at the obstruction site is helpful in the differentiation between benign and malignant endobronchial lesions. (orig.)

Usefulness of FDG PET/CT in determining benign from malignant endobronchial obstruction

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Cho, Arthur; Kang, Won Jun; Cho, Ho Jin; Lee, Jae-hoon; Yun, Mijin; Lee, Jong Doo [Yonsei University Health System, Division of Nuclear Medicine, Department of Radiology, Seoul (Korea, Republic of); Hur, Jin [Yonsei University Health System, Department of Radiology, Seoul (Korea, Republic of)

2011-05-15

To evaluate the usefulness of FDG PET/CT to differentiate malignant endobronchial lesions with distal atelectasis from benign bronchial stenosis. This retrospective study reviewed 84 patients who underwent contrast-enhanced chest CT and then PET/CT and had histological (n = 81) or follow-up imaging (n = 3) confirmation. Two chest radiologists reviewed initial chest CT and determined endobronchial lesions to be malignant or benign. Two nuclear medicine physicians reviewed PET/CT for FDG uptake at the obstruction site and measured SUV. Malignancy was considered when increased FDG uptake was seen in the obstruction site, regardless of FDG within the atelectatic lung. The sensitivity, specificity and accuracy of chest CT was 95%, 48% and 84%, compared with 95%, 91% and 94% for PET/CT. Benign obstructive lesions showed statistically lower FDG uptake than malignant obstructions (benign SUV 2.5 {+-} 0.84; malignant SUV 11.8 {+-} 5.95, p < 0.001). ROC analysis showed an SUV cut-off value of 3.4 with highest sensitivity of 94% and specificity of 91%. Increased FDG PET/CT uptake at the obstruction site indicates a high probability of malignancy, while benign lesions show low FDG uptake. Careful evaluation of FDG uptake pattern at the obstruction site is helpful in the differentiation between benign and malignant endobronchial lesions. (orig.)

FDG-PET/ceCT is useful to predict recurrence of Pseudomyxoma peritonei

International Nuclear Information System (INIS)

Dubreuil, Julien; Skanjeti, Andrea; Giammarile, Francesco; Rousset, Pascal; Bakrin, Naoual; Passot, Guillaume; Isaac, Sylvie; Glehen, Olivier

2016-01-01

Pseudomyxoma peritonei (PMP) is a rare peritoneal neoplasm originating from appendicular tumours. There is no consolidated data available in the literature about the precise role of [ 18 F] fluorodesoxy-D-glucose Positron Emission Tomography / contrast enhanced Computed Tomography (FDG-PET/ceCT). The aim of this study was to evaluate the correlation between preoperative FDG-PET/ceCT (qualitative and semi-quantitative assessment) and progression free survival (PFS) of patients treated for PMP. All patients scheduled for PMP treatment by cytoreductive unicentric surgery, intraperitoneal chemotherapy (HIPEC), and who underwent a FDG-PET/ceCT between February 2008 and January 2014, were included. No previous treatment was performed (except biopsy or appendectomy). FDG-PET/ceCT was interpreted by two nuclear physicians in consensus. Positive FDG-PET/ceCT scans were further labelled in diffuse disease and poly/mono focal disease. SUVmax was measured based on post-operative reports. The Peritoneal Cancer Index (PCI) and Completeness of CytoReduction Score (CCR) were assessed after surgery. Fifty-six patients were included in this study, with a mean age of 56-years-old and a mean follow-up of 29.3 months. SUVmax, with a cut-off at 2.02, was predictive for the PFS on multivariate analysis. No differences were observed between diffuse disease and focal disease on PFS for progression free survival, PCI, and SUVmax (p = 0.1). Post-operative CCR was not significantly correlated with SUVmax or FDG-PET/ceCT qualitative assessment. SUVmax on preoperative FDG-PET/ceCT was an independent predictive factor for PFS in PMP. Further studies are needed to explore if FDG-PET/ceCT could potentially predict post-operative CCR. (orig.)

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

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William Makis

2017-10-01

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

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

International Nuclear Information System (INIS)

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

2006-01-01

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

Whole-body PET with FDG for the diagnosis of recurrent gastric cancer

International Nuclear Information System (INIS)

Potter, T. de; Flamen, P.; Bormans, G.; Maes, A.; Mortelmans, L.; Cutsem, E. van; Penninckx, F.; Filez, L.

2002-01-01

This retrospective study was designed to assess the accuracy of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in diagnosing recurrence of gastric cancer. Thirty-three patients who had received surgical treatment for gastric cancer with curative intent and who had subsequently undergone FDG-PET for suspected recurrence were retrieved from the PET database. All patients were reviewed with full knowledge of prior conventional diagnostic work-up. Results were compared with a gold standard, consisting of histological confirmation or radiological and clinical follow-up. The gold standard established disease recurrence in 20/33 patients (prevalence 61%). Sensitivity and specificity of FDG-PET for the diagnosis of recurrence were 70% (14/20) and 69% (9/13), respectively. Positive and negative predictive values were 78% (14/18) and 60% (9/15), respectively. Of the six false-negative cases, all had intra-abdominal lesions (three had generalised abdominal metastases, one liver metastasis, one local recurrence and one ovarian metastasis). In the subgroup with previous signet cell differentiation of the primary tumour (n=13, disease prevalence 62%), sensitivity was 62% (5/8) and specificity, 60% (3/5). Survival analysis for the entire patient group using Kaplan-Meier statistics yielded a longer survival in the PET-negative group (mean±SD, 21.9±19.0 months) than in the PET-positive group (mean±SD, 9.2±8.2 months) (P=0.01). In the patient group with proven recurrence (n=20), the mean survival for the PET-negative group was 18.5 (±12.5) months, as compared with 6.9 (±6.5) months for the PET-positive group (P=0.05). Because of its poor sensitivity and low negative predictive value, FDG-PET is not suited for screening purposes in the follow-up of treated gastric cancer. However, FDG-PET appears to provide important additional information concerning the prognosis of recurrent gastric cancer. (orig.)

FDG-PET evaluation of vaginal carcinoma

International Nuclear Information System (INIS)

Lamoreaux, Wayne T.; Grigsby, Perry W.; Dehdashti, Farrokh; Zoberi, Imran; Powell, Matthew A.; Gibb, Randall K.; Rader, Janet S.; Mutch, David G.; Siegel, Barry A.

2005-01-01

Purpose: To compare the results of CT and positron emission tomography (PET) and F-18 fluorodeoxyglucose (FDG) in the detection of the primary tumor and lymph node metastases in carcinoma of the vagina. Methods and Materials: This was a prospective registry study of 23 consecutive patients with carcinoma of the vagina, in which we respectively compared the results of CT and whole-body FDG-PET. The tumor was clinical Stage II in 16 patients, Stage III in 6, and Stage IVa in 1 patient. The primary tumor ranged in size from 2 to 10 cm (mean 4.9), and 4 patients had palpable groin lymph nodes. All patients were treated with external beam radiotherapy and brachytherapy, 14 received concurrent chemotherapy, and 2 underwent primary tumor excision before the imaging evaluation. The median follow-up was 21 months in those patients alive without disease. Survival was estimated by the Kaplan-Meier method. Results: Of the 21 patients with an intact primary tumor, CT visualized it in 9 (43%). CT also demonstrated abnormally enlarged groin lymph nodes in 3 patients and both groin and pelvic lymph nodes in 1 patient (4 of 23, 17%). FDG-PET identified abnormal uptake in all 21 intact primary tumors (100%). Abnormal uptake was found in the groin lymph nodes in 4 patients, pelvic lymph nodes in 2, and both groin and pelvic lymph nodes in 2 patients (8 of 23, 35%). The 3-year progression-free and overall survival estimate was 73% and 68%, respectively. Conclusion: The results of this study have demonstrated that FDG-PET detects the primary tumor and abnormal lymph nodes more often than does CT

18F-FDG PET/CT for the diagnosis of malignant and infectious complications after solid organ transplantation

International Nuclear Information System (INIS)

Muller, Nastassja; Hubele, Fabrice; Heimburger, Celine; Namer, Izzie-Jacques; Herbrecht, Raoul; Blondet, Cyrille; Imperiale, Alessio; Kessler, Romain; Caillard, Sophie; Epailly, Eric

2017-01-01

Infection and malignancy represent two common complications after solid organ transplantation, which are often characterized by poorly specific clinical symptomatology. Herein, we have evaluated the role of 18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) in this clinical setting. Fifty-eight consecutive patients who underwent FDG PET/CT after kidney, lung or heart transplantation were included in this retrospective analysis. Twelve patients underwent FDG PET/CT to strengthen or confirm a diagnostic suspicion of malignancies. The remaining 46 patients presented with unexplained inflammatory syndrome, fever of unknown origin (FUO), CMV or EBV seroconversion during post-transplant follow-up without conclusive conventional imaging. FDG PET/CT results were compared to histology or to the finding obtained during a clinical/imaging follow-up period of at least 6 months after PET/CT study. Positive FDG PET/CT results were obtained in 18 (31 %) patients. In the remaining 40 (69 %) cases, FDG PET/CT was negative, showing exclusively a physiological radiotracer distribution. On the basis of a patient-based analysis, FDG PET/CT’s sensitivity, specificity, PPV and NPV were respectively 78 %, 90 %, 78 % and 90 %, with a global accuracy of 86 %. FDG PET/CT was true positive in 14 patients with bacterial pneumonias (n = 4), pulmonary fungal infection (n = 1), histoplasmosis (n = 1), cutaneous abscess (n = 1), inflammatory disorder (sacroiliitis) (n = 1), lymphoma (n = 3) and NSCLC (n = 3). On the other hand, FDG PET/CT failed to detect lung bronchoalveolar adenocarcinoma, septicemia, endocarditis and graft-versus-host disease (GVHD), respectively, in four patients. FDG PET/CT contributed to adjusting the patient therapeutic strategy in 40 % of cases. FDG PET/CT emerges as a valuable technique to manage complications in the post-transplantation period. FDG PET/CT should be considered in patients with severe

Dual time point FDG PET imaging in evaluating pulmonary nodules with low FDG avidity

International Nuclear Information System (INIS)

Chen Xiang; Zhao Jinhua; Song Jianhua; Xing Yan; Wang Taisong; Qiao Wenli

2010-01-01

A standardized uptake value (SUV) of 2.5 is frequently used as criteria to evaluate pulmonary lesions. However, false results may occur. Some studies have shown the usefulness of delayed PET for improving accuracy, while others recently have shown fewer promising results. This study was designed to investigate the accuracy of dual time point (DTP) FDG PET imaging in the evaluation of pulmonary lesions with an initial SUV less than 2.5. DTP FDG PET studies were conducted about 1 and 2 hours after FDG injection, and pulmonary lesions with an initial SUV less than 2.5 were identified. Nodules with pathologic results or imaging follow up were included. The differences in SUV and retention index (RI) between benign and malignant pulmonary lesions were analyzed. Receiver operating characteristics (ROC) analysis was performed to evaluate the discriminating validity of SUV and RI. 51 lesions were finally included. A RI greater than 0% was observed in 64% of the benign lesions; 56% had a RI greater than 10%. Among the malignancies, 80.8% had a RI greater than 0%, and 61.5% had a RI greater than 10%. We found no significant differences in SUV and RI between benign and malignant lesions. The area under the ROC curve did not differ from 0.5 whether using SUV or the retention index. Utilizing a SUV increase of 10%, the sensitivity was 61.5%, specificity 44% and accuracy was 52.9%. Dual time point FDG PET may not be of benefit in the evaluation of pulmonary nodules with low FDG avidity. (authors)

Direct comparison of [18F]FDG PET/CT with PET alone and with side-by-side PET and CT in patients with malignant melanoma

International Nuclear Information System (INIS)

Mottaghy, Felix M.; Wohlfart, Petra; Blumstein, Norbert M.; Neumaier, Bernd; Glatting, Gerhard; Buck, Andreas K.; Reske, Sven N.; Sunderkoetter, Cord; Schubert, Roland; Oezdemir, Cueneyt; Scharfetter-Kochanek, Karin

2007-01-01

The purpose of this retrospective, blinded study was to evaluate the additional value of [ 18 F]FDG PET/CT in comparison with PET alone and with side-by-side PET and CT in patients with malignant melanoma (MM). A total of 127 consecutive studies of patients with known MM referred for a whole-body PET/CT examination were included in this study. PET alone, side-by-side PET and CT and integrated PET/CT study were independently and separately interpreted without awareness of the clinical information. One score each was applied for certainty of lesion localisation and for certainty of lesion characterisation. Verification of the findings was subsequently performed using all available clinical, pathological (n = 30) and follow-up information. The number of lesions with an uncertain localisation was significantly (p 18 F]FDG. (orig.)

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

International Nuclear Information System (INIS)

Lee, S. T.

2009-01-01

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

Diagnostic Performance of F-18 FDG PET/CT in Patients with Cancer of Unknown Primary: Additional Benefit over CT-Based Conventional Work up

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Mehrdad Bakhshayeshkaram

2016-01-01

Full Text Available Background: In the era of well-developed site-specific treatment strategies in cancer, identification of occult primary is of paramount importance in CUP patients. Furthermore, exact determination of the extent of the disease may help in optimizing treatment planning. The aim of the present study was to investigate additional value of F-18 FDG PET/CT in patients with cancer of unknown primary (CUP as an appropriate imaging tool in early phase of initial standard work up.Materials and Methods: Sixty-two newly diagnosed CUP patients with inconclusive diagnostic CT scan of chest, abdomen and pelvis referring for F-18 FDG PET/CT were enrolled in this study. Standard of reference was defined as histopathology, other diagnostic procedures and a 3-month formal clinical follow up. The results of PET/CT were categorized as suggestion for primary site and additional metastasis and classified as true positive, false positive, false negative and true negative. The impact of additional metastasis revealed by F-18 FDG PET/CT on treatment planning and the time contribution of F-18 FDG PET/CT in diagnostic pathway was investigated.Results: Sixty-two patients with mean age of 62 (30 men, 32 women, PET/CT correctly identified primary origin in 32% with false positive rate of 14.8%. No primary lesion was detected after negative PET/CT according to standard of reference. Sensitivity, Specificity and accuracy were 100%, 78% and 85%, respectively. Additional metastatic site was found in 56% with 22% impact on treatment planning. Time contribution for PET/CT was 10% of total diagnostic pathway.Conclusion: Providing higher detection rate of primary origin with excellent diagnostic performance, shortening the diagnostic pathway and improving treatment planning, F-18 FDG PET/CT may play a major role in diagnostic work up of CUP patients and may be recommended as an alternative imaging tool in early phase of investigation.

The role of positron-emission-tomography (F-18-FDG-PET) in the staging and follow-up of lung cancer and in the evaluation of focal pulmonary abnormalities; Positronenemissionstomographie (PET) mit F-18-FDG in der Diagnostik des Bronchialkarzinoms und zur Dignitaetsabklaerung von pulmonalen Raumforderungen

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Baum, R.P. [Zentralklinik Bad Berka (Germany). Klinik fuer Nuklearmedizin/PET-Zentrum; Bonnet, R.B. [Zentralklinik Bad Berka (Germany). Klinik fuer Pneumologie; Presselt, N. [Zentralklinik Bad Berka (Germany). Klinik fuer Thorax- und Gefaesschirurgie; Leonhardi, J. [Zentralklinik Bad Berka (Germany). Inst. fuer Bildgebende Diagnostik

2001-04-01

For lymph node staging (especially for the detection of mediastinal lymph node involvement, i.e. N2 or N3 metastases) of non-small cell lung cancer (NSCLC), FDG PET and spiral CT were compared head to head in prospective studies. A significantly higher diagnostic accuracy was shown for FDG-PET, which is able to detect metastases (up-staging) even in normal sized lymph nodes (in CT<10 mm). On the other hand, PET can exclude metastases in morphologically enlarged lymph nodes (downstaging in up to 30% of all patients). A change in therapeutic management due to PET results was found in up ot 30%, and including the detection of distant metastases in over 40% of the patients. Adrenal metastases, (sensitivity 100%, specificity 80%), liver, bone and lung metastases as well as abdominal and cervical lymph node metastases can be detected with high accuracy. For brain metastases, MRI is superior and the method of choice, spiral-CT is more sensitive for detecting very small lung lesions (<5 mm). Local recurrences of lung cancer can be detected with a sensitivity of 83-100% (mean 95%) and a specificity of 62-100% (mean 81%). FDG-PET can also be used for the early evaluation of therapy response by measuring the glucose metabolism in the tumor which shows a strong inverse correlation with the success of therapy. Inflammatory changes ('radiation pneumonitis'), can be a problem after radiation therapy. Therefore, a waiting period of several months is recommended after external radiation therapy. The differential diagnosis and characterization (benign versus malignant) of indeterminate solitary pulmonary nodules and masses of unknown etiology is now an established indication in the USA and elsewhere. A prospective multicenter study (44) had demonstrated a sensitivity of 98% for FDG PET for the detection of malignant SPN, which was also true for small lesions with a size of smaller than 1.5 cm (sensitivity for visual analysis 100%). A normal PET scan excludes fast growing

FDG PET/CT in initial staging and early response to chemotherapy assessment of paediatric rhabdomyosarcomas

International Nuclear Information System (INIS)

Eugene, T.; Ansquer, C.; Oudoux, A.; Carlier, T.; Kraeber-Bodere, T.; Bodet-Milin, C.; Corradini, N.; Thomas, C.; Dupas, B.

2010-01-01

Purpose: The objective of this study was to retrospectively evaluate the impact of positron emission tomography/computed tomography (PET/CT) using fluorine-18-fluorodeoxyglucose (FDG), in comparison with conventional imaging modalities (CIM), for initial staging and early therapy assessment in paediatric rhabdomyosarcoma. Patients and methods: Prior to treatment, 18 patients (age range, 9 months to 18 years) with histologically proven rhabdomyosarcoma underwent FDG PET/CT in addition to CIM (magnetic resonance imaging of primary site, whole body CT and bone scintigraphy). After three courses of chemotherapy, 12 patients underwent FDG PET/CT in addition to CIM. RECIST criteria and visual analysis of FDG uptake were used for assessment of response. The standard of reference was determined by an interdisciplinary tumor board based on imaging material, histopathology and follow-up data (median = 5 years). Results: PET/CT sensitivity was superior to CIM's concerning lymph node involvement (100% versus 83%, respectively) and metastases detection (100% versus 50%, respectively). PET/CT results changed therapeutic management in 11% of cases. After three courses of chemotherapy, the rate of complete response was 66% with PET/CT versus 8% with CIM. Five percent of patients relapsed during follow-up (median = 5 years). Conclusion: This study confirms that PET/CT depicts important additional information in initial staging of paediatric rhabdomyosarcomas and suggests a superior prognostic value of PET/CT in early response to chemotherapy assessment. (authors)

FDG PET in the diagnosis of giant cell arteritis

International Nuclear Information System (INIS)

Turlakow, A.; Yeung, H.W.D.; Pui, J.; Macapinlac, H.; Liebovitz, E.; Rusch, V.; Goy, A.; Larson, S.M.

2003-01-01

Full text: To evaluate the role of PET in the diagnosis of vasculitis. Methods: We report a case of giant cell arteritis diagnosed by FDG-PET in a 75-year-old woman with a fever of unknown origin. The patient presented with a 3 month history of fatigue, fevers, headaches, visual disturbance and jaw claudication. Diagnosis of temporal arteritis was initially excluded because of a normal ESR. CT scan showed an anterior mediastinal mass, suspicious for malignancy. An FDG-PET scan for pre-operative evaluation was acquired 45 minutes after intravenous injection of 10 mCi F18-FDG, on a dedicated PET scanner. Image reconstruction was performed using an iterative algorithm with segmented attenuation correction. The study identified striking localisation of FDG to the entire aorta, left main coronary artery, and subclavian, carotid and common iliac arteries bilaterally (SUV max range 4-4.5 g/ml), suggestive of large vessel arteritis. Subsequent excisional biopsy of the mediastinal mass confirmed giant cell vasculitis of a large muscular artery in thymic tissue. No malignancy was detected. A repeat ESR was 129 mm/hr. The patient was commenced on oral Prednisone, with prompt improvement of symptoms, ESR and anaemia and complete normalisation of the FDG-PET scan within two weeks. This case suggests a potential role of FDG-PET in the non-invasive diagnosis, classification and follow-up of giant cell arteritis, and possibly other vasculitides, so far notoriously difficult to diagnose, relying usually on a constellation of non-specific symptoms, laboratory investigations or invasive pathologic and angiographic means. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

Use of F-18 fluoro deoxyglucose (FDG) positron emission tomography (PET) in the assessment of malignant mesothelioma

International Nuclear Information System (INIS)

Brown, F.M.M.; Pathmaraj, K.; Berlangieri, S.U.; Knight, S.; Clarke, C.P.; Scott, A.M.

2002-01-01

Full text: Australia has the highest mesothelioma incidence rate in the world and the incidence of Mesothelioma is increasing. Therapy for Mesothelioma involves surgery (including phototherapy), radiotherapy and chemotherapy. Computed tomography (CT) is frequently used to stage the extent of Mesothelioma. This study aimed to evaluate the utility of FDG PET in staging Mesothelioma and monitoring response to therapy. Nineteen F-18 FDG PET was performed at the A and RMC Centre for PET in 14 patients (13M: 1F, age range 39-77 years, mean age 58 years) with biopsy proven malignant pleural Mesothelioma. Patients were referred for staging (5 patients) or evaluation of patients post surgery or phototherapy (9 patients). 3 patients had more than 1 PET scan. FDG scans were reviewed with full access to the CT report. Standardised Uptake Values (SUV) were performed in all scans in regions of maximal FDG uptake corresponding to CT abnormality. Normal lung SUVs were also calculated. Follow-up was possible in all patients to the time of death or December 2001 (Follow-up 4 - 45 months, mean 16 months; 3 patients still alive). All FDG PET scans were positive for FDG-avid pleural tissue. No surgery was deferred due to FDG PET findings. In 3 patients mediastinal nodes were identified pre-surgery. Post surgical therapy assessment by FDG PET (9 patients) guided therapy by confirming disease progression or further characterising post-operative changes when CT findings were uncertain. FDG PET was able to more accurately distinguish between collapse/consolidation and recurrent disease than CT scan. Almost all post-surgical scans were performed in patients who received phototherapy. Different Mesothelioma histological subtypes could not be differentiated by SUV criteria. False positive FDG PET studies were seen in 3 patients, all of whom had post-surgical empyemas. In conclusion, FDG PET has a potential role in the management of malignant mesothelioma patients, particularly in the post

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

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

2015-05-01

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

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

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

2018-01-15

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

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

Science.gov (United States)

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

2018-01-01

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

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

International Nuclear Information System (INIS)

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

2018-01-01

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

{sup 18}F-FDG PET/CT for the diagnosis of malignant and infectious complications after solid organ transplantation

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Muller, Nastassja; Hubele, Fabrice; Heimburger, Celine; Namer, Izzie-Jacques; Herbrecht, Raoul; Blondet, Cyrille; Imperiale, Alessio [Hautepierre Hospital, University Hospitals of Strasbourg, Strasbourg (France); Kessler, Romain; Caillard, Sophie; Epailly, Eric [Nouvel Hopital Civil, University Hospitals of Strasbourg, Strasbourg (France)

2017-03-15

Infection and malignancy represent two common complications after solid organ transplantation, which are often characterized by poorly specific clinical symptomatology. Herein, we have evaluated the role of 18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) in this clinical setting. Fifty-eight consecutive patients who underwent FDG PET/CT after kidney, lung or heart transplantation were included in this retrospective analysis. Twelve patients underwent FDG PET/CT to strengthen or confirm a diagnostic suspicion of malignancies. The remaining 46 patients presented with unexplained inflammatory syndrome, fever of unknown origin (FUO), CMV or EBV seroconversion during post-transplant follow-up without conclusive conventional imaging. FDG PET/CT results were compared to histology or to the finding obtained during a clinical/imaging follow-up period of at least 6 months after PET/CT study. Positive FDG PET/CT results were obtained in 18 (31 %) patients. In the remaining 40 (69 %) cases, FDG PET/CT was negative, showing exclusively a physiological radiotracer distribution. On the basis of a patient-based analysis, FDG PET/CT’s sensitivity, specificity, PPV and NPV were respectively 78 %, 90 %, 78 % and 90 %, with a global accuracy of 86 %. FDG PET/CT was true positive in 14 patients with bacterial pneumonias (n = 4), pulmonary fungal infection (n = 1), histoplasmosis (n = 1), cutaneous abscess (n = 1), inflammatory disorder (sacroiliitis) (n = 1), lymphoma (n = 3) and NSCLC (n = 3). On the other hand, FDG PET/CT failed to detect lung bronchoalveolar adenocarcinoma, septicemia, endocarditis and graft-versus-host disease (GVHD), respectively, in four patients. FDG PET/CT contributed to adjusting the patient therapeutic strategy in 40 % of cases. FDG PET/CT emerges as a valuable technique to manage complications in the post-transplantation period. FDG PET/CT should be considered in patients with severe

Clinical utility of FDG PET in Parkinson's disease and atypical parkinsonism associated with dementia.

Science.gov (United States)

Walker, Zuzana; Gandolfo, Federica; Orini, Stefania; Garibotto, Valentina; Agosta, Federica; Arbizu, Javier; Bouwman, Femke; Drzezga, Alexander; Nestor, Peter; Boccardi, Marina; Altomare, Daniele; Festari, Cristina; Nobili, Flavio

2018-05-19

There are no comprehensive guidelines for the use of FDG PET in the following three clinical scenarios: (1) diagnostic work-up of patients with idiopathic Parkinson's disease (PD) at risk of future cognitive decline, (2) discriminating idiopathic PD from progressive supranuclear palsy, and (3) identifying the underlying neuropathology in corticobasal syndrome. We therefore performed three literature searches and evaluated the selected studies for quality of design, risk of bias, inconsistency, imprecision, indirectness and effect size. Critical outcomes were the sensitivity, specificity, accuracy, positive/negative predictive value, area under the receiving operating characteristic curve, and positive/negative likelihood ratio of FDG PET in detecting the target condition. Using the Delphi method, a panel of seven experts voted for or against the use of FDG PET based on published evidence and expert opinion. Of 91 studies selected from the three literature searches, only four included an adequate quantitative assessment of the performance of FDG PET. The majority of studies lacked robust methodology due to lack of critical outcomes, inadequate gold standard and no head-to-head comparison with an appropriate reference standard. The panel recommended the use of FDG PET for all three clinical scenarios based on nonquantitative evidence of clinical utility. Despite widespread use of FDG PET in clinical practice and extensive research, there is still very limited good quality evidence for the use of FDG PET. However, in the opinion of the majority of the panellists, FDG PET is a clinically useful imaging biomarker for idiopathic PD and atypical parkinsonism associated with dementia.

Spatially resolved regression analysis of pre-treatment FDG, FLT and Cu-ATSM PET from post-treatment FDG PET: an exploratory study

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Bowen, Stephen R; Chappell, Richard J; Bentzen, Søren M; Deveau, Michael A; Forrest, Lisa J; Jeraj, Robert

2012-01-01

Purpose To quantify associations between pre-radiotherapy and post-radiotherapy PET parameters via spatially resolved regression. Materials and methods Ten canine sinonasal cancer patients underwent PET/CT scans of [18F]FDG (FDGpre), [18F]FLT (FLTpre), and [61Cu]Cu-ATSM (Cu-ATSMpre). Following radiotherapy regimens of 50 Gy in 10 fractions, veterinary patients underwent FDG PET/CT scans at three months (FDGpost). Regression of standardized uptake values in baseline FDGpre, FLTpre and Cu-ATSMpre tumour voxels to those in FDGpost images was performed for linear, log-linear, generalized-linear and mixed-fit linear models. Goodness-of-fit in regression coefficients was assessed by R2. Hypothesis testing of coefficients over the patient population was performed. Results Multivariate linear model fits of FDGpre to FDGpost were significantly positive over the population (FDGpost~0.17 FDGpre, p=0.03), and classified slopes of RECIST non-responders and responders to be different (0.37 vs. 0.07, p=0.01). Generalized-linear model fits related FDGpre to FDGpost by a linear power law (FDGpost~FDGpre0.93, pregression analysis indicates that pre-treatment FDG PET uptake is most strongly associated with three-month post-treatment FDG PET uptake in this patient population, though associations are histopathology-dependent. PMID:22682748

Investigations with FDG-PET Scanning in Prostate Cancer Show Limited Value for Clinical Practice

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Salminen, Eeva [Univ. of Turku (Finland). Department of Oncology and Radiotherapy; Hogg, Annette; Binns, David; Hicks, Rodney [The Peter MacCallum Cancer Institute, East Melbourne, Vic (Australia). Dept. of Diagnostic Imaging; Frydenberg, Mark [Monash Medical Centre, Clayton, Vic (Australia)

2002-09-01

The aim of this study was to investigate FDG-PET (fluorodeoxyglucose positron emission tomography) imaging in the management of prostate cancer. Twenty-two patients were studied during different disease phases of prostate cancer, for staging or restaging to clarify specific clinical questions. FDG-PET was performed encompassing the thorax, abdomen and pelvis using the Penn PET 300H scanner. Scanning was begun 60 min after {sup 18}F fluorodeoxyglucose marker. Patients were catheterized and administered diuretics to minimize urinary activity. Information obtained with FDG-PET was concordant with findings from other investigations in 7/22 (32%) patients, discordant in 15/22 (68%) patients and equivalent in one patient (4%). PET indicated progressive disease in five patients with prostate-specific antigen (PSA) <4 ng/L. The impact on management of the patients was high in 46% of cases, low in 41% and for 14% there was no impact on management. The accuracy of FDG-PET was 72% (95% CI 50-89) as confirmed by invasive diagnostics/follow-up. FDG-PET can provide useful information and improve the clinician's decision on further management procedures in selected patients with low PSA and bone or lymph node changes. A negative PET scan in prostate cancer should be interpreted with caution.

[18F]Fluorodeoxyglucose (FDG)-Positron Emission Tomography (PET)/Computed Tomography (CT) in Suspected Recurrent Breast Cancer: A Prospective Comparative Study of Dual-Time-Point FDG-PET/CT, Contrast-Enhanced CT, and Bone Scintigraphy.

Science.gov (United States)

Hildebrandt, Malene Grubbe; Gerke, Oke; Baun, Christina; Falch, Kirsten; Hansen, Jeanette Ansholm; Farahani, Ziba Ahangarani; Petersen, Henrik; Larsen, Lisbet Brønsro; Duvnjak, Sandra; Buskevica, Inguna; Bektas, Selma; Søe, Katrine; Jylling, Anne Marie Bak; Ewertz, Marianne; Alavi, Abass; Høilund-Carlsen, Poul Flemming

2016-06-01

To prospectively investigate the diagnostic accuracy of [(18)F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) with dual-time-point imaging, contrast-enhanced CT (ceCT), and bone scintigraphy (BS) in patients with suspected breast cancer recurrence. One hundred women with suspected recurrence of breast cancer underwent 1-hour and 3-hour FDG-PET/CT, ceCT, and BS within approximately 10 days. The study was powered to estimate the precision of the individual imaging tests. Images were visually interpreted using a four-point assessment scale, and readers were blinded to other test results. The reference standard was biopsy along with treatment decisions and clinical follow-up (median, 17 months). FDG-PET/CT resulted in no false negatives and fewer false positives than the other imaging techniques. Accuracy of results were similar for 1-hour and 3-hour FDG-PET/CT. For distant recurrence, the area under the receiver operating curve was 0.99 (95% CI, 0.97 to 1) for FDG-PET/CT, 0.84 (95% CI, 0.73 to 0.94) for ceCT, and 0.86 (95% CI, 0.77 to 0.94) for the combined ceCT+BS. Of 100 patients, 22 (22%) were verified with distant recurrence, and 18 of these had bone involvement. Nineteen patients (19%) had local recurrence only. In exploratory analyses, diagnostic accuracy of FDG-PET/CT was better than ceCT alone or ceCT combined with BS in diagnosing distant, bone, and local recurrence, shown by a greater area under the receiver operating curve and higher sensitivity, specificity, and superior likelihood ratios. FDG-PET/CT was accurate in diagnosing recurrence in breast cancer patients. It allowed for distant recurrence to be correctly ruled out and resulted in only a small number of false-positive cases. Exploratory findings suggest that FDG-PET/CT has greater accuracy than conventional imaging technologies in this patient group. © 2016 by American Society of Clinical Oncology.

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

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

2017-09-15

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

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

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

2017-09-01

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

A comparative study of FDG PET/CT and enhanced multi-detector CT for detecting liver metastasis according to the size and location.

Science.gov (United States)

Park, Jung Mi; Kim, Il Young; Kim, Sang Won; Lee, Sang Mi; Kim, Hyun Gi; Kim, Shin Young; Shin, Hyung Chul

2013-04-01

The aim of this study was to compare the diagnosability between (18)F-fluorodeoxyglucose (FDG) PET/CT and enhanced multi-detector CT (MDCT) for the detection of liver metastasis (LM) according to the size and location in liver and to evaluate standard maximum standardized uptake values (SUVmax) of all liver metastatic lesions. One hundred two consecutive patients with malignancy who underwent both FDG PET/CT and MDCT for LM evaluation were retrospectively reviewed. Among them, 56 patients with LM were enrolled in this study. LM was confirmed by follow-up imaging studies after at least 6 months or by histopathology. FDG PET/CT and MDCT images were visually analyzed using three-point scale by the consensus of two radiologists and two nuclear medicine physicians. The size and location (central vs. sub-capsular) of the all liver lesions were evaluated using MDCT images. Furthermore, SUVmax of all liver lesions on FDG PET/CT images were calculated. A total of 146 liver lesions were detected by FDG PET/CT and MDCT and 142 of the lesions were diagnosed as LM. The detection rates of MDCT and FDG PET/CT for LM by visual analysis were 77 and 78%, respectively. There was no significant difference of detection rate according to the overall location and size of the lesions. However, FDG PET/CT was more sensitive than MDCT for detecting small and sub-capsular LM. The detection rate of FDG PET/CT for LM was 68% by the cutoff SUVmax of 2.7. Although the diagnosabilities of MDCT and FDG PET/CT for detecting LM were comparable, FDG PET/CT is superior to MDCT for detecting small LM located in the sub-capsular portion of liver.

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-02-15

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

Poor predictive value of positive interim FDG-PET/CT in primary mediastinal large B-cell lymphoma

Energy Technology Data Exchange (ETDEWEB)

Lazarovici, Julien; Petrovanu, Cynthia; Danu, Alina; Ferme, Christophe; Ribrag, Vincent; Ghez, David [Gustave Roussy, Villejuif (France). Dept. of Hematology; Paris Saclay Univ., Saint-Aubin (France); Terroir, Marie [Gustave Roussy, Villejuif (France). Dept. of Nuclear Medicine and Endocrine Oncology; Paris Saclay Univ., Saint-Aubin (France); Arfi-Rouche, Julia [Gustave Roussy, Villejuif (France). Dept. of Radiology; Paris Saclay Univ., Saint-Aubin (France); Michot, Jean-Marie [Gustave Roussy, Villejuif (France). Dept. of Drug Development (DITEP); Paris Saclay Univ., Saint-Aubin (France); Mussot, Sacha; Florea, Valentina [Marie Lannelongue Hospital, Le Plessis Robinson (France). Dept. of Thoracic Surgery; Ghigna, Maria-Rosa [Marie Lannelongue Hospital, Le Plessis Robinson (France). Dept. of Pathology; Dartigues, Peggy [Gustave Roussy, Villejuif (France). Dept. of Pathology; Paris Saclay Univ., Saint-Aubin (France)

2017-11-15

Though commonly used to assess response to therapy, the prognostic value of interim FDG-PET/CT in Primary Mediastinal Large B-cell Lymphoma (PMBCL) is unclear. We conducted a retrospective study on 36 consecutive patients treated at our institution for a PMBCL between 2006 and 2014. All patients with a positive interim FDG-PET/CT had undergone histological restaging consisting either in a surgical debulking of the residual lesion (15 patients) or a CT-guided core needle biopsy (two patients). All FDG-PET/CT were secondarily reviewed according to the more recent Deauville criteria. Interim FDG-PET/CT was considered positive in 17/36 patients using visual evaluation. Among these patients, 14 had a Deauville score of 4. Histological restaging was negative in all but one case, showing inflammation and/or fibrosis. After a median follow-up of 48.5 months, a total of five patients have relapsed, two patients in the positive FDG-PET/CT group, and three patients in the negative FDG-PET/CT group, respectively. These data indicate that a positive interim FDG-PET/CT does not reflect persistence of active disease in the vast majority of PMBCL cases. The relapse rate appears similar regardless of interim FDG-PET/CT results and interpretation criteria. This suggests that interim FDG-PET/CT has a poor positive predictive value, thus kt should be used with caution in PMBCL. (orig.)

Differentiation of thyroid lesion detected by FDG PET/CT using SUV ratio

Energy Technology Data Exchange (ETDEWEB)

Kim, Bom Sahn; Kang, Won Jun; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

2007-07-01

We investigated the usefulness of SUV ratio to discriminate focal thyroid lesion incidentally detected on 18F-FDG PET/CT (FDG PET) in patients with malignant disease. A total of 2167 subjects with malignant tumor underwent PET/CT for staging. Forty-five of 2167 subjects (2.1%) showed hypermetabolic thyroid lesions on FDG PET. Of 45, 21 lesions were confirmed by pathology (n = 16) or follow up exam (n=5). Seventeen patients had focal FDG uptakes, while 4 patients had diffuse thyroid uptakes. Standardized uptake value (SUV) was measured by drawing region of interest (ROI) on bilateral thyroid lobes and liver. From 21 patients, 12 thyroid lesions were confirmed as malignant lesions and 9 lesions as benign lesions. All of bilateral thyroid FDG uptakes were determined as benign disease such as thyroiditis. From seventeen focal thyroid incidentaloma, FDG PET had 100 % (12/12) of sensitivity and 60 % (3/5) of specificity, retrospectively. Malignant nodules had a significantly higher lesion to liver ratio than those of benign nodules (2.10.9 vs. 1.20.6, p=0.029). With ROC curve, the best cut-off value of lesion to liver was 1.0 with sensitivity of 100% and specificity of 60 % (area under the curve=0.783). The SUV ratio of lesion to contralateral lobe do not have statistical significance to determine malignancy (3.72.1 vs. 2.61.7, p=0.079). This study showed that focal thyroidal FDG uptake detected by FDG PET could be differentiated with best performance by SUV ratio of lesion to liver.

Additive value of amyloid-PET in routine cases of clinical dementia work-up after FDG-PET

International Nuclear Information System (INIS)

Brendel, Matthias; Schnabel, Jonas; Wagner, Leonie; Brendel, Eva; Meyer-Wilmes, Johanna; Unterrainer, Marcus; Schoenecker, Sonja; Prix, Catharina; Ackl, Nibal; Schildan, Andreas; Patt, Marianne; Barthel, Henryk; Sabri, Osama; Catak, Cihan; Pogarell, Oliver; Levin, Johannes; Danek, Adrian; Buerger, Katharina; Bartenstein, Peter; Rominger, Axel

2017-01-01

In recent years, several [ 18 F]-labeled amyloid-PET tracers have been developed and have obtained clinical approval. Despite their widespread scientific use, studies in routine clinical settings are limited. We therefore investigated the impact of [ 18 F]-florbetaben (FBB)-PET on the diagnostic management of patients with suspected dementia that was still unclarified after [ 18 F]-fluordeoxyglucose (FDG)-PET. All subjects were referred in-house with a suspected dementia syndrome due to neurodegenerative disease. After undergoing an FDG-PET exam, the cases were discussed by the interdisciplinary dementia board, where the most likely diagnosis as well as potential differential diagnoses were documented. Because of persistent diagnostic uncertainty, the patients received an additional FBB-PET exam. Results were interpreted visually and classified as amyloid-positive or amyloid-negative, and we then compared the individual clinical diagnoses before and after additional FBB-PET. A total of 107 patients (mean age 69.4 ± 9.7y) were included in the study. The FBB-PET was rated as amyloid-positive in 65/107. In 83% of the formerly unclear cases, a final diagnosis was reached through FBB-PET, and the most likely prior diagnosis was changed in 28% of cases. The highest impact was observed for distinguishing Alzheimer's dementia (AD) from fronto-temporal dementia (FTLD), where FBB-PET altered the most likely diagnosis in 41% of cases. FBB-PET has a high additive value in establishing a final diagnosis in suspected dementia cases when prior investigations such as FDG-PET are inconclusive. The differentiation between AD and FTLD was particularly facilitated by amyloid-PET, predicting a considerable impact on patient management, especially in the light of upcoming disease-modifying therapies. (orig.)

Additive value of amyloid-PET in routine cases of clinical dementia work-up after FDG-PET

Energy Technology Data Exchange (ETDEWEB)

Brendel, Matthias; Schnabel, Jonas; Wagner, Leonie; Brendel, Eva; Meyer-Wilmes, Johanna; Unterrainer, Marcus [University Hospital, LMU Munich, Department of Nuclear Medicine, Munich (Germany); Schoenecker, Sonja; Prix, Catharina; Ackl, Nibal [University Hospital, LMU Munich, Department of Neurology, Munich (Germany); Schildan, Andreas; Patt, Marianne; Barthel, Henryk; Sabri, Osama [University of Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Catak, Cihan [Klinikum der Universitaet Muenchen, Institute for Stroke and Dementia Research, Munich (Germany); Pogarell, Oliver [University Hospital, LMU Munich, Department of Psychiatry, Munich (Germany); Levin, Johannes; Danek, Adrian [University Hospital, LMU Munich, Department of Neurology, Munich (Germany); DZNE - German Center for Neurodegenerative Diseases, Munich (Germany); Buerger, Katharina [Klinikum der Universitaet Muenchen, Institute for Stroke and Dementia Research, Munich (Germany); DZNE - German Center for Neurodegenerative Diseases, Munich (Germany); Bartenstein, Peter; Rominger, Axel [University Hospital, LMU Munich, Department of Nuclear Medicine, Munich (Germany); Munich Cluster for Systems Neurology (SyNergy), Munich (Germany)

2017-12-15

In recent years, several [{sup 18}F]-labeled amyloid-PET tracers have been developed and have obtained clinical approval. Despite their widespread scientific use, studies in routine clinical settings are limited. We therefore investigated the impact of [{sup 18}F]-florbetaben (FBB)-PET on the diagnostic management of patients with suspected dementia that was still unclarified after [{sup 18}F]-fluordeoxyglucose (FDG)-PET. All subjects were referred in-house with a suspected dementia syndrome due to neurodegenerative disease. After undergoing an FDG-PET exam, the cases were discussed by the interdisciplinary dementia board, where the most likely diagnosis as well as potential differential diagnoses were documented. Because of persistent diagnostic uncertainty, the patients received an additional FBB-PET exam. Results were interpreted visually and classified as amyloid-positive or amyloid-negative, and we then compared the individual clinical diagnoses before and after additional FBB-PET. A total of 107 patients (mean age 69.4 ± 9.7y) were included in the study. The FBB-PET was rated as amyloid-positive in 65/107. In 83% of the formerly unclear cases, a final diagnosis was reached through FBB-PET, and the most likely prior diagnosis was changed in 28% of cases. The highest impact was observed for distinguishing Alzheimer's dementia (AD) from fronto-temporal dementia (FTLD), where FBB-PET altered the most likely diagnosis in 41% of cases. FBB-PET has a high additive value in establishing a final diagnosis in suspected dementia cases when prior investigations such as FDG-PET are inconclusive. The differentiation between AD and FTLD was particularly facilitated by amyloid-PET, predicting a considerable impact on patient management, especially in the light of upcoming disease-modifying therapies. (orig.)

FDG PET/CT appearance of local osteosarcoma recurrences in pediatric patients

Energy Technology Data Exchange (ETDEWEB)

Sharp, Susan E.; Gelfand, Michael J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Shulkin, Barry L.; McCarville, M.B. [St. Jude Children' s Research Hospital, Department of Diagnostic Imaging, Memphis, TN (United States)

2017-12-15

Osteosarcoma is the most common pediatric malignant bone tumor, frequently surgically managed with limb salvage rather than amputation. Local recurrences are seen in up to 9% of osteosarcoma patients, with CT and MRI imaging often limited by metal artifacts. To describe the [F-18]2-fluoro-2-deoxyglucose (FDG) PET/CT appearance of local osteosarcoma recurrences with correlation to findings on other imaging modalities. A retrospective review of pediatric osteosarcoma patients imaged with FDG PET/CT was performed in patients with pathologically proven local recurrences. FDG PET/CT findings were reviewed and correlated with available comparison imaging studies. Ten local osteosarcoma recurrences in eight pediatric osteosarcoma patients were imaged with FDG PET/CT. All eight patients had a local recurrence after limb salvage; two patients had a second local recurrence after amputation. All local recurrences were seen with FDG PET/CT, demonstrating solid (n=5) or peripheral/nodular (n=5) FDG uptake patterns. Maximum standard uptake values (SUVs) ranged from 3.0 to 15.7. In five recurrences imaged with FDG PET/CT and MRI, MRI was limited or nondiagnostic in three. In four recurrences imaged with FDG PET/CT and bone scan, the bone scan was negative in three. Local osteosarcoma recurrences are well visualized by FDG PET/CT, demonstrating either solid or peripheral/nodular FDG uptake with a wide range of maximum SUVs. FDG PET/CT demonstrates the full extent of local recurrences, while MRI can be limited by artifact from metallic hardware. PET/CT appears to be more sensitive than bone scan in detecting local osteosarcoma recurrences. (orig.)

Posttreatment assessment of response using FDG-PET/CT for patients treated with definitive radiation therapy for head and neck cancers

International Nuclear Information System (INIS)

Andrade, Regiane S.; Heron, Dwight E.; Degirmenci, Berna; Filho, Pedro A.A.; Branstetter, Barton F.; Seethala, Raja R.; Ferris, Robert L.; Avril, Norbert

2006-01-01

Purpose: The goal of this study was to evaluate coregistered [ 18 F] fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) for the detection of persistent disease after definitive radiation therapy in head and neck cancer. Methods and Materials: Posttreatment FDG-PET/CT was performed in 28 patients on average 8 weeks (range, 4 to 15.7 weeks) after completing definitive radiation therapy. FDG-PET/CT was visually analyzed for the entire patient group and at two time points (4-8 and >8 weeks) after treatment. The contrast-enhanced CT portion of PET/CT was separately analyzed blinded to the results of coregistered FDG-PET/CT and classified as negative or positive for residual locoregional disease. Pathologic findings and clinical follow-up served as the reference standard. Results: Follow-up data were available for all 28 patients (median, 17.6 months). Regarding the detection of residual disease, the overall sensitivity and specificity of FDG-PET/CT was 76.9% and 93.3%, respectively, compared with 92.3% and 46.7% for contrast-enhanced CT. The accuracy of FDG-PET/CT was 85.7%, compared with 67.9% for CT alone. All false-negative (n = 3) and false-positive (n = 1) FDG-PET/CT results occurred between 4 and 8 weeks after treatment. At 8 weeks or later after treatment, the specificity of CT was 28%, compared with 100% for FDG-PET/CT. Conclusions: The metabolic-anatomic information from coregistered FDG-PET/CT provided the most accurate assessment for treatment response when performed later than 8 weeks after the conclusion of radiation therapy. FDG-PET/CT excelled by a higher specificity and overall diagnostic performance than CT imaging alone. These results support a potential clinical role of FDG-PET/CT in the early assessment of therapy response after definitive radiation therapy

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

DEFF Research Database (Denmark)

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

2014-01-01

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

The FDG-PET diagnosis of head and neck malignant tumor

International Nuclear Information System (INIS)

Kada, Shinpei; Hayashi, Masahiko; Okazawa, Hidehiko

2003-01-01

We investigated the utility of whole body FDG-PET in patients with head and neck malignant tumor, retrospectively. Fifty four FDG-PET studies were performed in 45 patients. Regarding the primary tumor and nodal metastasis, we compared the diagnosis of only FDG-PET with diagnosis using CT, MRI, and physical examination without FDG-PET (diagnosis without FDG-PET). These FDG-PET images were evaluated with visual interpretation qualitatively. At the primary tumor, sensitivity and specificity of FDG-PET diagnoses were 90% and 93%, and those of the diagnoses without FDG-PET were 95% and 100%, respectively; for nodal metastasis, sensitivity and specificity of FDG-PET diagnoses were 90% and 84%, and those of the diagnoses without FDG-PET were 72% and 80%, respectively. In nodal metastasis, the diagnosis of FDG-PET was superior to the diagnosis without FDG-PET. However, it is important to be careful of false positive findings of FDG-PET such as inflammatory lymph nodes, and false negative findings such as very thin tumors. By combining the FDG-PET diagnosis with other examinations, we could achieve almost perfect diagnosis. Farthermore, we perform FDG-PET repeatedly to improve diagnosis accuracy. (author)

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

International Nuclear Information System (INIS)

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

2001-01-01

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

Accuracy of FDG-PET-CT in the Diagnostic Work-up of Vascular Prosthetic Graft Infection

NARCIS (Netherlands)

Bruggink, J. L. M.; Glaudemans, A. W. J. M.; Saleem, B. R.; Meerwaldt, R.; Alkefaji, H.; Prins, T. R.; Start, R. H. J. A.; Zeebregts, C. J.

Objectives: To investigate the diagnostic accuracy of fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) compared with computed tomography (CT) scanning and added value of fused FDG-PET CT in diagnosing vascular prosthetic graft infection. Design: Prospective cohort study with

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

International Nuclear Information System (INIS)

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

2008-01-01

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

Cost-effectiveness of FDG-PET in staging non-small cell lung cancer: the PLUS study

International Nuclear Information System (INIS)

Verboom, Paul; Grijseels, E.W.M; Uyl-de Groot, Carin A.; Tinteren, Harm van; Diepenhorst, Fred W.; Hoekstra, Otto S.; Smit, Egbert F.; Postmus, Pieter E.; Bergh, Jan H.A.M. van den; Velthoven, Piet C.M. van; Schreurs, Ad J.M.; Stallaert, Roland A.L.M.; Comans, Emile F.I.; Teule, Gerrit J.J.; Mourik, Johan C. van; Boers, Maarten

2003-01-01

Currently, up to 50% of the operations in early-stage non-small cell lung cancer (NSCLC) are futile owing to the presence of locally advanced tumour or distant metastases. More accurate pre-operative staging is required in order to reduce the number of futile operations. The cost-effectiveness of fluorine-18 fluorodeoxyglucose positron emission tomography ( 18 FDG-PET) added to the conventional diagnostic work-up was studied in the PLUS study. Prior to invasive staging and/or thoracotomy, 188 patients with (suspected) NSCLC were randomly assigned to conventional work-up (CWU) and whole-body PET or to CWU alone. CWU was based on prevailing guidelines. Pre-operative staging was followed by 1 year of follow-up. Outcomes are expressed in the percentage of correctly staged patients and the associated costs. The cost price of PET varied between and euro;736 and and euro;1,588 depending on the (hospital) setting and the procurement of 18 FDG commercially or from on-site production. In the CWU group, 41% of the patients underwent a futile thoracotomy, whereas in the PET group 21% of the thoracotomies were considered futile (P=0.003). The average costs per patient in the CWU group were and euro;9,573 and in the PET group, and euro;8,284. The major cost driver was the number of hospital days related to recovery from surgery. Sensitivity analysis on the cost and accuracy of PET showed that the results were robust, i.e. in favour of the PET group. The addition of PET to CWU prevented futile surgery in one out of five patients with suspected NSCLC. Despite the additional PET costs, the total costs were lower in the PET group, mainly due to a reduction in the number of futile operations. The additional use of PET in the staging of patients with NSCLC is feasible, safe and cost saving from a clinical and from an economic perspective. (orig.)

Brain metabolic changes in Hodgkin disease patients following diagnosis and during the disease course: An 18F-FDG PET/CT study.

Science.gov (United States)

Chiaravalloti, Agostino; Pagani, Marco; Cantonetti, Maria; DI Pietro, Barbara; Tavolozza, Mario; Travascio, Laura; DI Biagio, Daniele; Danieli, Roberta; Schillaci, Orazio

2015-02-01

The aim of the present study was to investigate brain glucose metabolism in patients with Hodgkin disease (HD) after diagnosis and during chemotherapy treatment. Following the administration of first-line doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) chemotherapy, 74 HD patients underwent 18 F-fluoro-2-deoxy-D-glucose ( 18 F-FDG) positron emission tomography (PET)/computed tomography brain scans, both baseline (PET0) and interim (PET2) at the Department of Biomedicine and Prevention, University of Rome Tor Vergata (Rome, Italy). Fifty-seven patients were further evaluated 15±6 days after four additional cycles (PET6). Furthermore, a control group (CG) of 40 chemotherapy-naïve subjects was enrolled. Differences in brain 18 F-FDG uptake between the CG, PET0, PET2 and PET6 scans were analyzed using statistical parametric mapping. Compared with the PET0 and CG scans, the PET2 scan demonstrated a higher metabolic activity in Brodmann area (BA) 39, and a metabolic reduction in BA 11 bilaterally and in left BA 32. All of these changes disappeared at PET6. The results of the present study indicate that ABVD chemotherapy has a limited impact on brain metabolism.

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

International Nuclear Information System (INIS)

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

2007-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Kim, Jong Hoon

1998-12-01

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

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

International Nuclear Information System (INIS)

Wareham, Neval E.; Lundgren, J.D.; Cunha-Bang, C. da; Sengeloev, H.; Gustafsson, F.; Iversen, M.; Johannesen, H.H.; Kjaer, A.; Fischer, B.M.; Rasmussen, A.; Soerensen, S.S.

2017-01-01

Solid organ transplant (SOT) recipients are at high risk of developing infections and malignancies. 18 F-FDG PET/CT may enable timely detection of these diseases and help to ensure early intervention. We aimed to describe the clinical utility of FDG PET/CT in consecutive, diagnostic unresolved SOT recipients transplanted from January 2004 to May 2015. Recipients with a post-transplant FDG PET/CT performed as part of diagnostic work-up were included. Detailed chart reviews were done to extract relevant clinical information and determine the final diagnosis related to the FDG PET/CT. Based on a priori defined criteria and the final diagnosis, results from each scan were classified as true or false, and diagnostic values determined. Among the 1,814 recipients in the cohort, 145 had an FDG PET/CT performed; 122 under the indication of diagnostically unresolved symptoms with a suspicion of malignancy or infection. The remaining (N = 23) had an FDG PET/CT to follow-up on a known disease or to stage a known malignancy. The 122 recipients underwent a total of 133 FDG PET/CT scans performed for a suspected malignancy (66 %) or an infection (34 %). Sensitivity, specificity, and positive and negative predictive values of the FDG PET/CT in diagnosing these conditions were 97, 84, 87, and 96 %, respectively. FDG PET/CT is an accurate diagnostic tool for the work-up of diagnostic unresolved SOT recipients suspected of malignancy or infection. The high sensitivity and NPV underlines the potential usefulness of PET/CT for excluding malignancy or focal infections in this often complex clinical situation. (orig.)

Combined early dynamic (18)F-FDG PET/CT and conventional whole-body (18)F-FDG PET/CT provide one-stop imaging for detecting hepatocellular carcinoma.

Science.gov (United States)

Wang, Shao-Bo; Wu, Hu-Bing; Wang, Quan-Shi; Zhou, Wen-Lan; Tian, Ying; Li, Hong-Sheng; Ji, Yun-Hai; Lv, Liang

2015-06-01

It is widely accepted that conventional (18)F-FDG PET/CT (whole-body static (18)F-FDG PET/CT, WB (18)F-FDG PET/CT) has a low detection rate for hepatocellular carcinoma (HCC). We prospectively assessed the role of early dynamic (18)F-FDG PET/CT (ED (18)F-FDG PET/CT) and WB (18)F-FDG PET/CT in detecting HCC, and we quantified the added value of ED (18)F-FDG PET/CT to WB (18)F-FDG PET/CT. Twenty-two patients with 37 HCC tumors (HCCs) who underwent both a liver ED (18)F-FDG PET/CT (performed simultaneously with a 5.5 MBq/kg (18)F-FDG bolus injection and continued for 240 s) and a WB (18)F-FDG PET/CT were enrolled in the study. The WB (18)F-FDG PET/CT and ED (18)F-FDG PET/CT scans were positive in 56.7% (21/37) and 78.4% (29/37) HCCs, respectively (PPET/CT in conjunction with WB (18)F-FDG PET/CT (one-stop (18)F-FDG PET/CT) improved the positive detection rates of WB and ED (18)F-FDG PET/CT alone from 56.7% and 78.4% to 91.9% (34/37) (P0.05, respectively). One-stop (18)F-FDG PET/CT appears to be useful to improve WB (18)F-FDG PET/CT for HCC detection. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Clinical and survival impact of FDG PET in patients with suspicion of recurrent cervical carcinoma

International Nuclear Information System (INIS)

Pallardy, Amandine; Testard, Aude; Resche, Isabelle; Bridji, Boumediene; Bodet-Milin, Caroline; Oudoux, Aurore; Ansquer, Catherine; Campion, Loic; Bourbouloux, Emmanuelle; Sagan, Christine; Kraeber-Bodere, Francoise; Rousseau, Caroline

2010-01-01

The aim of this retrospective study was to evaluate the contribution of 18 F-FDG PET to the clinical management and survival outcome of patients suspected of recurrent cervical carcinoma and in line with the hypothesis that early diagnosis of recurrent cervical cancer may improve overall survival. A total of 40 patients underwent conventional imaging (CI) and FDG PET/CT for suspected cervical cancer. Clinical management decisions were recorded with CI and additional PET/CT. Discordances and concordances between CI and PET/CT results were compared to the final diagnosis as based on histopathology analysis or follow-up considered as the gold standard. The final diagnosis was established pathologically (n=25) or by median clinical follow-up for 48 months after the PET (n=15). The PET/CT was positive in 76% (20/26) of patients compared to 19% (6/26) with CI. Globally PET/CT modified the treatment plan in 55% (22/40) of patients and in 75% (18/24) when the CI was negative prior to PET/CT. These changes led to the use of previously unplanned therapeutic procedures in 37.5% (15/40). When FDG PET was positive for recurrence (>3 foci), the median overall survival was 12 months (2-70) compared to patients with PET findings with ≤1 focus for which the median survival was not attained (p=0.007). A multivariate analysis of prognostic factors demonstrated that abnormal FDG uptake (>3 foci) was the most significant factor (p<0.03) for death from cervical cancer. FDG PET is a valuable tool in the case of suspected recurrence of cervical cancer on account of its impact on treatment planning and especially in predicting patient outcome. (orig.)

How much can a negative FDG-PET be trusted?

International Nuclear Information System (INIS)

Wang Shuxia

2004-01-01

Purpose: False-negative FDG-PET constituted 22.7% of all clinically identified negative PET in a ten year retrospective review about FDG-PET on irradiated brain tumour. Uncovering possible influencing factors of false-negative FDG-PET may have significant value. Material and methods: 10 patients with a first negative and then a second positive PET during very short time separation and 6 patients with surgically confirmed false-negative PET were traced. Histological type, irradiation parameter, steroids effect were discussed. To define temporary irradiation effect on FDG uptake, interval between radiation treatment to PET examination of these two groups were compared with 24 surgically confirmed true-positive PET, 5 surgically confirmed true-negative PET Results: 80% negative-positive PET transformation happened within 31 weeks. No statistically significant difference with regard to time from irradiation could be found between groups. Steroids medication closely before PET examination was about the same before the first negative and second positive PET scan. 5/6 surgically confirmed false-negative PET patients did not take steroids before PET examination. Conclusion: Tumour histology type, temporary irradiation effect and steroids medication did not constitute the reasons for false negative PET in our patient series. PET could not identify tumour relapse in the very early stage. Therefore, if clinically indicated, second FDG-PET might be a better selection to pick up tumour relapse instead of exploratory surgery or biopsy. In that case, the suitable time point for the second PET could be within 31 weeks after the first PET examination. Keywords: false-negative, FDG-PET, influencing factor, irradiation effect, steroids. (author)

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

International Nuclear Information System (INIS)

Weiler-Sagie, Michal; Kagna, Olga; Dann, Eldad J.; Ben-Barak, Ayelet; Israel, Ora

2014-01-01

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

Clinical usefulness of PET in the management of oral cancer. Comparison between FDG-PET and MET-PET

International Nuclear Information System (INIS)

Kitagawa, Yoshimasa; Saitoh, Masaaki; Nakamura, Mikiko

2007-01-01

Inductive chemoradiotherapy has played an important role in preserving organs and functions in patients with oral squamous cell carcinoma (SCC). To determine whether a reduced form of surgery should be performed after chemoradiotherapy, accurate evaluation of residual tumor cells is essential. We investigated the clinical value of positron emission tomography with 18 F labeled fluorodeoxyglucose (FDG-PET) in the management of oral SCCs. Forty-five patients underwent two FDG-PET studies, one prior to and one at 6 weeks after the chemoradiotherapy. Pretreatment FDG-PET was useful in predicting the response to treatment. Posttreatment FDG-PET could evaluate residual viable cells and prognosis. Organ preservation may be feasible based on PET evaluation. Hence FDG-PET is a valuable tool in the treatment of oral cancer. 11 C-Methionine (MET) is another promising tracer for PET that can be used to assess metabolic demand for amino acids in cancer cells. A MET-PET and FDG-PET study was performed during the same period to investigate diagnostic accuracy in 40 oral malignancies. Sensitivity and positive predictive value of MET-PET were 95% and 100%, respectively, and were comparable with those of FDG-PET. Further study is required to determine the diagnostic significance of MET-PET in evaluating response to chemoradiotherapy. (author)

Comparison of the diagnosis using FDG-PET and AC-PET with histopathological features in lung adenocarcinomas

International Nuclear Information System (INIS)

Koizumi, Satoko

2011-01-01

Fluorodeoxyglucose-positron emission tomography (FDG-PET) is a useful tool for lung cancer diagnosis because of its good sensitivity and specificity. However, FDG-PET is problematically causing the false negative in cases of well differentiated lung adenocarcinomas which are low grade malignancies. Acetate (AC)-PET using 11 C-acetate is thought to be a superior detection tool for low grade malignancies. In this study, comparison of each type of PET in relation with histopathological features of lung adenocarcinomas was conducted. Samples obtained from 81 lesions in 75 patients with a lung adenocarcinoma who were operated at various institutions of our collaborators between 2005 and 2009 following FDG-PET and AC-PET procedures were examined. These samples consisted of fifty-seven cases of a well differentiated adenocarcinoma and twenty-four cases of a moderately- or a poorly-differentiated adenocarcinoma. Relationships between the histopathological factors (ly, v, p) as well as the lymphatic microvessel and microvessel densities in a tumor and FDG- and AC-PET findings were evaluated. AC-PET was more sensitive than FDG-PET (0.58 vs 0.74, p=0.0001). FDG-PET showed a correlation with invasiveness of the tumor and intratumoral lymphatic microvessel density (p<0.05). Furthermore, AC-PET possessed a superior sensitivity for the detection of well differentiated adenocarcinomas, and tumors without ly, v, or p factors. In lung adenocarcinoma AC-PET showed better sensitivity than FDG-PET and true positive in all cases of stage I B or more. FDG-PET showed the correlation with the pathological invasiveness (ly, v, p) of a tumor and the intratumoral lymphatic microvessel density. (author)

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

Energy Technology Data Exchange (ETDEWEB)

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

2011-11-15

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

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

International Nuclear Information System (INIS)

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

2010-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2012-10-15

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

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

International Nuclear Information System (INIS)

Kagna, Olga; Keidar, Zohar; Srour, Saher; Militianu, Daniela; Melamed, Eyal

2012-01-01

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

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

International Nuclear Information System (INIS)

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

1998-01-01

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

Has F.D.G. PET/CT an impact on the management of patients with anal carcinoma?

International Nuclear Information System (INIS)

Vercellino, L.; Nataf, V.; Kerrou, K.; Huchet, V.; Pascal, O.; Montravers, F.; Talbot, J.N.; De Parades, V.; Bauer, P.; Touboul, E.

2010-01-01

Purpose: To evaluate the impact of F.D.G. PET/C Ton the management of patients referred for the staging and/or the follow-up of anal carcinoma, and PET/CT on patient management. Patients and methods: We included patients referred to our department for anal carcinoma whose therapeutic management was evaluable thanks to follow-up data during at least 6 months. Results: Data of 44 patients were analysed: 22 had PET/CT for initial staging and 36 during follow-up. PET/CT had impact in nine patients out of 44 (20%) and it was relevant in eight of them. Conclusion: F.D.G. PET/CT is an accurate imaging modality in anal cancer, its impact on patient management is more obvious when persistence or recurrence of disease is suspected. (authors)

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

International Nuclear Information System (INIS)

Papathanassiou, D.; Domange-Testard, A.; Bruna-Muraille, C.; Cuif-Job, A.; Liehn, J.C.; Thiriaux, A.; Motte, J.

2009-01-01

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

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

DEFF Research Database (Denmark)

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

2017-01-01

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

Application of 18F-FDG PET/CT for the diagnosis of cervical cancer

International Nuclear Information System (INIS)

Zhou Wenlan; Wu Hubing; Wang Quanshi; Ye Xianghua

2008-01-01

Objective: The purpose of this study was to evaluate the clinical value of 18 F-fluorode-oxyglucose (FDG) PET/CT for staging and re-staging cervical cancer cases. Methods: This retrospective study included 88 patients. Of the 88 patients, 19 were primary cervical cancer, 11 were benign cervical tumor and 58 were cervical cancer patients with post-treatment surveillance. All had either whole body or abdominal-pelvic FDG PET/CT imaging. The diagnosis was established according to the pathologic results of surgery or biopsy, and(or) multi-modality imaging and clinical follow-up for at least six months. Results: For initial diagnosis of cervical cancer, the sensitivity, specificity and accuracy of FDG PET/CT were 17/19 (89.5%), 10/11 (90.9%) and 27/30(90.0%) respectively. For re-staging cervical cancer, the sensitivity, specificity and accuracy of FDG PET/CT were 10/11 (90. 9%), 47/47 (100. 0%) and 57/58 (98.3%) respectively. In all, 41 had metastases. The sensitivity, specificity and accuracy of FDG PET/ CT detecting metastases were 92.7%, 88.9% and 90.9% respectively. Of the metastatic sites, 66.3% were abdominal-pelvic lymph nodes, 26.8% of the metastatic lymph nodes were detected with diameters less than 1.0 cm. Twenty-two of twenty seven (28.6%) patients were identified to have extra-pelvic lesions after PET/CT and were then changed their treatment plans. Conclusions: 18 F-FDG PET/CT is useful in staging and re-staging cervical cancer patients. PET/CT is of great value in identifying small lesions and also in detecting extra-pelvic lesions. (authors)

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

Energy Technology Data Exchange (ETDEWEB)

Wareham, Neval E.; Lundgren, J.D. [Rigshospitalet, Centre for Health and Infectious Disease Research (CHIP), Department of Infectious Diseases, Copenhagen (Denmark); Cunha-Bang, C. da; Sengeloev, H. [Rigshospitalet, Department of Haematology, Copenhagen (Denmark); Gustafsson, F.; Iversen, M. [Rigshospitalet, Department of Cardiology, Copenhagen (Denmark); Johannesen, H.H.; Kjaer, A.; Fischer, B.M. [Rigshospitalet, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen (Denmark); Rasmussen, A. [Rigshospitalet, Department of Surgical Gastroenterology, Copenhagen (Denmark); Soerensen, S.S. [Rigshospitalet, Department of Nephrology, Copenhagen (Denmark)

2017-03-15

Solid organ transplant (SOT) recipients are at high risk of developing infections and malignancies. {sup 18}F-FDG PET/CT may enable timely detection of these diseases and help to ensure early intervention. We aimed to describe the clinical utility of FDG PET/CT in consecutive, diagnostic unresolved SOT recipients transplanted from January 2004 to May 2015. Recipients with a post-transplant FDG PET/CT performed as part of diagnostic work-up were included. Detailed chart reviews were done to extract relevant clinical information and determine the final diagnosis related to the FDG PET/CT. Based on a priori defined criteria and the final diagnosis, results from each scan were classified as true or false, and diagnostic values determined. Among the 1,814 recipients in the cohort, 145 had an FDG PET/CT performed; 122 under the indication of diagnostically unresolved symptoms with a suspicion of malignancy or infection. The remaining (N = 23) had an FDG PET/CT to follow-up on a known disease or to stage a known malignancy. The 122 recipients underwent a total of 133 FDG PET/CT scans performed for a suspected malignancy (66 %) or an infection (34 %). Sensitivity, specificity, and positive and negative predictive values of the FDG PET/CT in diagnosing these conditions were 97, 84, 87, and 96 %, respectively. FDG PET/CT is an accurate diagnostic tool for the work-up of diagnostic unresolved SOT recipients suspected of malignancy or infection. The high sensitivity and NPV underlines the potential usefulness of PET/CT for excluding malignancy or focal infections in this often complex clinical situation. (orig.)

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

International Nuclear Information System (INIS)

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

2008-01-01

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

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

International Nuclear Information System (INIS)

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

2014-01-01

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

Triage of Limited Versus Extensive Disease on 18F-FDG PET/CT Scan in Small Cell lung Cancer

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Saima Riaz

2017-06-01

Full Text Available Objective(s: Small cell lung cancer (SCLC is an aggressive neuroendocrine carcinoma, which accounts for 10-15% of pulmonary cancers and exhibits early metastatic spread. This study aimed to determine the added value of 18F-FDG PET/CT imaging in tumor, node, and metastasis (TNM staging of SCLC, compared to the conventional computed tomography (CT scan and its potential role as a prognosticator.Methods: This retrospective review was conducted on 23 patients, who were histopathologically diagnosed to have SCLC and referred for undergoing 18F-FDG PET/CT scanning during October 2009-December 2015. The rate of agreement between the CT and 18F-FDG PET/CT findings for TNM staging was calculated using the Cohen’s kappa (κ. The median follow-up time was eight months, ranging 27-3 months. The overall and disease-free survival rates were calculated based on the extent of disease.Results: 19 cases were male and four female with the mean age of 58±9 years. The 18F-FDG PET/CT identified limited and extensive diseases in 2 (8.7% and 21 (91.3% patients, respectively. In addition, the results of the Cohen’s kappa demonstrated a strong (κ=0.82, fair (κ=0.24, and poor (κ=0.12 agreement between the PET/CT and CT findings for determining tumor, node, and metastasis stages, respectively. The 18F-FDG PET/CT scans upstaged disease in 47% of the cases with visceral and osseous metastasis. The disease-free survival rates for the limited and extensive diseases were 100% and 23% within the 12-month follow-up. In addition, 8 (35% patients expired during the follow-up period.Conclusion: Improved nodal and metastatic disease identification highlights the role of 18F-FDG PET/CT scanning in initial staging of SCLC with prognostic implications.

Positron emission tomography with 18-fluorodeoxyglucose in the staging and follow-up of lymphoma in the chest

International Nuclear Information System (INIS)

Bangerter, M.; Griesshammer, M.; Bergmann, L.; Kotzerke, J.; Reske, S.N.; Elsner, K.

1999-01-01

The purpose of this retrospective study was to evaluate the accuracy of positron emission tomography (PET) using 18-F-fluorodeoxyglucose (FDG) in predicting lymphomatous involvement in the hilar and mediastinal regions in the staging and follow-up of patients with malignant lymphoma. One hundred forty-seven thoracic PET studies in 89 consecutive lymphoma patients were reviewed. Static FDG-PET imaging was performed following application of 270 MBq FDG (mean). Results of FDG-PET were compared with the findings of computed tomography (CT) in all patients and clinical follow-up examination. Eighty-nine of 147 (60%) PET studies showed no FDG uptake in the hilar or mediastinal regions, while 58 (40%) studied did detect FDG uptake in these regions. In 52 of 58 abnormal studies (90%), lymphomatous involvement of the hilar and/or mediastinal regions seen by CT was present. In the remaining six abnormal PET studies (10%), FDG uptake was considered as false-positive because of missing lesions on corresponding CT scans. In four patients false-positive FDG uptake was observed before treatment, in two patients after completion of therapy. In these two patients FDG uptake after therapy was caused by thymus hyperplasia. The remaining four cases before treatment remained unresolved. Sensitivity of FDG-PET was 96%, specificity 94%, positive predictive value 90%, and negative predictive value 98%, respectively. The present study suggests that FDG-PET has potential value in predicting lymphomatous involvement in the hilar and mediastinal regions. FDG-PET may obviate invasive diagnostic procedures in patients with lymphoma. (orig.)

Multicentre assessment and monitored use of [18F]FDG-PET in oncology: the Spanish experience

International Nuclear Information System (INIS)

Rodriguez-Garrido, Manuel; Asensio-del-Barrio, Cristina

2008-01-01

The aim of this study was to evaluate the diagnostic effectiveness of [ 18 F]FDG-PET in oncological diseases and to assess its clinical utility and impact (on the clinical and therapeutic management of these patients). This health technology assessment was performed in Spain, using the monitored use (MU) procedure. A multicentre and prospective follow-up study was performed in a non-consecutive sample of oncological patients who were examined with PET and other conventional diagnostic tests. A protocol for this MU method (PET-MU protocol) was developed, including the three forms used to collect all the information. Enrolment of new patients began in June 2002 and continued until August 2004. A descriptive analysis and an evaluation of the diagnostic effectiveness of FDG-PET were performed. The study population comprised 2,824 oncological patients (the third form relating to follow-up was completed for only 967 of these patients) from 100 Spanish hospitals and 16 PET centres. Seventy-nine percent of cases met the clinical requirements of the PET-MU protocol. Global diagnostic parameters of PET performance and their 95% CI values were as follows: sensitivity 86% (82-89%), specificity 83% (79-86%), positive and negative predictive values 87% (83-90%) and 82% (77-85%) respectively, diagnostic accuracy 84% (82-87%) and diagnostic odds ratio 28.75 (19.75-41.84). PET detected unsuspected new lesions in 39% of patients and avoided other unnecessary diagnostic techniques and treatments in 69% of cases. In 88% of cases, PET was considered useful by the physicians who asked for the PET tests (it was deemed decisive in 30% and very useful in almost 37%). This PET-MU study has confirmed the high diagnostic effectiveness of FDG-PET for oncological indications and demonstrates that it has a great influence on the clinical and therapeutic management of patients. (orig.)

Recurrent bladder carcinoma: clinical and prognostic role of 18 F-FDG PET/CT

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Alongi, Pierpaolo [San Raffaele G. Giglio Institute, Department of Radiological Sciences, Nuclear Medicine Unit, Cefalu (Italy); Caobelli, Federico [Basel University Hospital, Department of Nuclear Medicine, Basel (Switzerland); Gentile, Roberta; Baldari, Sergio [University of Messina, Nuclear Medicine Unit, Department of Biomedical Sciences and Morphological and Functional Images, Messina (Italy); Stefano, Alessandro; Russo, Giorgio; Gilardi, Maria Carla [IBFM-CNR, Cefalu (Italy); Albano, Domenico [Universita degli Studi di Palermo, DIBIMEF - Sezione di Scienze Radiologiche, Palermo (Italy); Midiri, Massimo [San Raffaele G. Giglio Institute, Department of Radiological Sciences, Nuclear Medicine Unit, Cefalu (Italy); Universita degli Studi di Palermo, DIBIMEF - Sezione di Scienze Radiologiche, Palermo (Italy)

2017-02-15

A small number of studies evaluated the detection rate of lesions from bladder carcinoma (BC) of 18 F-FDG PET/CT in the restaging process. However, the prognostic role of FDG PET/CT still remains unclear. The aim of the present study was to evaluate the accuracy, the effect upon treatment decision, and the prognostic value of FDG PET/CT in patients with suspected recurrent BC. Forty-one patients affected by BC underwent FDG PET/CT for restaging purpose. The diagnostic accuracy of visually interpreted FDG PET/CT was assessed compared to histology (n = 8), other diagnostic imaging modalities (contrast-enhanced CT in 38/41 patients and MRI in 15/41) and clinical follow-up (n = 41). Semiquantitative PET values (SUVmax, SUVmean, SUL, MTV, TLG) were calculated using a graph-based method. Progression-free survival (PFS) and overall survival (OS) were assessed by using Kaplan-Meier curves. The risk of progression (hazard ratio, HR) was computed by Cox regression analysis by considering all the available variables. PET was considered positive in 21 of 41 patients. Of these, recurrent BC was confirmed in 20 (95 %). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FDG PET/CT were 87 %, 94 %, 95 %, 85 %, 90 %. AUC was 0.9 (95 %IC 0.8-1). Bayesian positive and negative likelihood ratios were 14.5 and 0.13, respectively. FDG PET/CT findings modified the therapeutic approach in 16 patients (modified therapy in 10 PET-positive patients, watch-and-wait in six PET-negative patients). PFS was significantly longer in patients with negative scan vs. those with pathological findings (85 % vs. 24 %, p < 0.05; HR = 12.4; p = 0.001). Moreover, an unremarkable study was associated with a longer OS (88 % vs. 47 % after 2 years and 87 % vs. 25 % after 3 years, respectively, p < 0.05). Standardized uptake value (SUV)max > 6 and total lesion glycolysis (TLG) > 8.5 were recognized as the most accurate thresholds to predict PFS (2-year PFS 62 % for

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

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

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

(18)F-FDG PET/CT versus bone scintigraphy in the follow-up of gastric cancer.

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Sollini, M; Calabrese, L; Zangheri, B; Erba, P A; Gramaglia, A; Gasparini, M

2016-01-01

A 53-year-old patient underwent a positron emission tomography/computed tomography with 2-fluoro-2-deoxy-d-glucose ((18)F-FDG PET/CT) in the suspicious of gastric tumor recurrence (mediastinal and abdominal lymph nodes). PET/CT identified only an area of (18)F-FDGuptake in the twelfth thoracic vertebrae. Unexpectedly, a bone scintigraphy revealed many "hot" spots changing the diagnosis (single metastasis versus plurimetastatic disease) and impacting on patient's management. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

Skeletal metastasis as detected by 18F-FDG PET with negative CT of the PET/CT: Frequency and impact on cancer staging and or management

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Fatma Ahmed

2016-10-01

Full Text Available Objectives: The aim of our study is to assess the frequency of detection of PET positive CT negative skeletal metastases (SM and determine the impact of such detection on staging and/or management in patients who had FDG PET/CT as part of the cancer work up.Methods: We retrospectively reviewed 2000 18F-FDG PET/CT scans of known cancer patients. A log was kept to record cases of suspected SM with or without bone changes from the low-dose non-contrast CT. The presence or absence of SM was evaluated based on available pathological and clinical data. The impact of detection of such lesions on cancer staging and/or management was evaluated by a board certified oncologist.Results: Of the 2000 cases, 18F-FDG PET/CT suggested SM in 146/2000 (7.3%. Of those 146 cases, 105 (72% were positive on both PET and CT. The remaining 41 (28% had PET positive CT negative bone lesions. SM was confirmed in 36/41 (88% PET positive/CT negative cases. This was based on biopsy, imaging or clinical follow-up. The detection of PET positive CT negative SM did not change staging or management in 7/36 (19.4%. However, staging and/or management was affected in 29/36 (80.6%. Conclusions: SM is not uncommon in 18F-FDG PET/CT, as it accounts for 146/2000 (7.3% of cases. PET demonstrated FDG-avid SM without a CT abnormality in at least 36/146 (25%. Patients staging and or management changed in 29/36 (80.5%. We concluded that 18F-FDG PET is sensitive in detection of SM with significant impact on staging & or management. Key words18F-FDG PET/CT, Skeletal metastasis, PET positive, CT negative

Usefulness of 18F-FDG PET in intrahepatic cholangiocarcinoma

International Nuclear Information System (INIS)

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

2003-01-01

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

Diagnostic accuracy of 18F-FDG PET/CT for detection of suspected recurrence in patients with oesophageal carcinoma

International Nuclear Information System (INIS)

Sharma, Punit; Jain, Sachin; Karunanithi, Sellam; Malhotra, Arun; Bal, Chandrasekhar; Kumar, Rakesh; Pal, Sujoy; Julka, Pramod Kumar; Thulkar, Sanjay

2014-01-01

To evaluate the role of 18 F-FDG PET/CT in the detection of recurrence in patients with oesophageal carcinoma, suspected clinically or following conventional investigations. This was a retrospective study. Data from 180 patients (age 56.3 ± 10.4 years; 126 men, 54 women) with histopathologically proven oesophageal carcinoma (squamous cell 115, adenocarcinoma 59, neuroendocrine carcinoma 4, small cell 1, poorly differentiated 1) who had undergone 227 18 F-FDG PET/CT studies for suspected recurrence were analysed. Recurrence was suspected clinically or following conventional investigations. PET/CT images were revaluated by two nuclear medicine physicians in consensus. Findings were grouped into local, nodal and distant recurrence. Results were compared to those from contrast-enhanced (CE) CT when available (109 patients). Clinical/imaging follow-up (minimum 6 months) with histopathology (when available) was taken as the reference standard. Of the 227 18 F-FDG PET/CT studies,166 were positive and 61 were negative for recurrent disease. PET/CT showed local recurrence in 134, nodal recurrence in 115 and distant recurrence in 47, with more than one site of recurrence in 34. The PET/CT findings were true-positive in 153 studies, true-negative in 54, false-positive in 13 and false-negative in 7. The sensitivity of 18 F-FDG PET/CT was 96 %, the specificity was 81 %, the positive and negative predictive values were 92 % and 89 %, respectively, and the accuracy was 91 %. PET/CT showed similar accuracy in patients with squamous cell carcinoma and in those with adenocarcinoma (P = 0.181). 18 F-FDG PET/CT was more specific than CECT (67 % vs. 21 %; P 18 F-FDG PET/CT shows high accuracy in the detection of suspected recurrence in patients with oesophageal carcinoma. It is more specific than and is superior to CECT in the detection of nodal recurrence. (orig.)

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

International Nuclear Information System (INIS)

Zhang, Li; Wang, Yinzhong; Lei, Junqiang; Tian, Jinhui; Zhai, Yanan

2013-01-01

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

Value of 18F-FDG PET/CT in Follow-up of Ovarian Cancer Patients after Therapy%卵巢癌综合治疗后18F-FDG PET/CT随访的临床价值

Institute of Scientific and Technical Information of China (English)

童林军; 陈虞梅; 施一平; 万良荣; 陈涛

2012-01-01

Purpose: To evaluate the use of 18F-PET/CT in follow-up of ovarian cancer patients after therapy. Methods: A retrospective study was performed on 152 ovarian cancer patients after therapy. The following information was collected and analyzed: clinical material, CA125 and traditional imaging result. According to the indication for PET/CT, the patients were divided into 5 groups. The role of 18F-PET/CT in evaluation of surveillance and clinical management of ovarian cancer patients after therapy compared with the result of clinical follow-up was analyzed. Results: Of 137 patients with follow-up results, 105 patients were diagnosed as recurrence and 32 as disease free after long duration follow-up. The diagnostic sensitivity, specificity, accuracy, positive predictive value, negative predictive value were 98.3%, 91.2%, 96.8%, 97.5%, 93.9%, respectively. PET/CT was especially useful for the correct clinical therapeutic decision making for the patients whose PET/CT indications were to diagnose suspected recurrence, for the assessment of disease extent and for the evaluation of therapeutic response. Conclusion: PET/CT has extremely high diagnostic value for recurrent ovarian cancer and is specifically helpful in optimizing the selection of patients for appropriate treatment.%目的:探讨18F-FDG PET/CT显像在卵巢癌综合治疗后随访的应用价值及对临床治疗决策的影响.方法:回顾性分析在本中心接受PET/CT显像的152例卵巢癌治疗后患者,收集及分析临床资料、CA125及常规影像学结果.将患者按不同的PET/CT检查指征分为5组,与临床随访结果进行对比,分析PET/CT在卵巢癌治疗随访的应用价值及对临床治疗决策的影响.结果:137例有随访结果者纳入本研究,其中105例复发、32例无复发.PET/CT诊断卵巢癌复发的总体敏感度、特异度、准确率、阳性预测值、阴性预测值分别为:98.3％、91.2％、96.8％、97.5％、93.9％.PET/CT可为临床疑有复发、病情评估及疗效评价患者制定准确的治疗决策.结论:PET

Corpus luteum mimics a pelvic lesion on FDG PET in women of childbearing age

International Nuclear Information System (INIS)

Kang, K.W.; Sim, J.S.

2002-01-01

Objectives: To find out the nature of incidental single pelvic lesion on F-18 FDG PET scan in the women of childbearing age, further investigation were done. Methods: Three women who had a single round hypermetabolic lesion in the pelvic cavity on FDG PET were further investigated through follow up PET scan or MRI scan. The purposes of PET scan were routine follow up of breast cancer after surgery and adjuvant chemotherapy for a patient and cancer screening for two women. The ages were 39, 45, and 48 years old respectively. The last menstrual periods (LMP) were 21, 22 and 24 days before PET examinations. The size and peak SUVs (standard uptake values) of lesions are presented. Results: The lesion in pelvic cavity disappeared in a patients with breast cancer on a follow up PET scan 2 months and 1 week later. The lesions in two women were proved to be corpus luteum cysts on MRI examination on the same day of PET examination. Conclusion: Single pelvic lesion in women of childbearing age should be ruled out a normal corpus luteum cyst. Also, schedule of PET imaging should be adjusted according to her menstrual period

Primary squamous cell carcinoma of the thyroid. Initial assessment and follow-up using 18F-FDG PET/CT.

Science.gov (United States)

Caballero Gullón, L; Carmona González, E; Martínez Estévez, A; Gómez Camarero, M P; Corral, J J; Borrego Dorado, I

Squamous cell carcinoma of thyroid is an uncommon, very aggressive neoplasm, having a poor prognosis and poor response to chemotherapy and radiotherapy. Surgery is the initial treatment of choice, although it often presents as a widespread disease at the time of diagnosis, usually with cervical swelling that causes most of the symptoms due to local infiltration or metastasis. Local infiltration from adjacent tumour and metastatic disease needs to be excluded from other primary epidermoid carcinomas, in order to make a correct diagnosis. This also requires the typical cytokeratin pattern seen in histological studies. The case is presented of a 53 year-old man with a medical history of hepatocarcinoma, with a cervical hypermetabolic lesion detected in an 18 F-FDG PET/CT performed to exclude widespread disease. The follow-up of this lesion with this technique and its usefulness is also described. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

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

International Nuclear Information System (INIS)

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

2012-01-01

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

Significance of chronic marked hyperglycemia on FDG-PET. Is it really problematic for clinical oncologic imaging?

International Nuclear Information System (INIS)

Hara, Tadashi; Higashi, Tatsuya; Nakamoto, Yuji

2009-01-01

The purpose of this study was to evaluate the adverse effects of chronic marked hyperglycemia on clinical diagnostic performance of positron emission tomography (PET) using 18 F-fluorodeoxyglucose (FDG). Fifty-seven scans of 54 patients, who received FDG-PET for the diagnosis of various cancer(s), and who showed high plasma glucose level of more than 200 mg/dl at the time of administration of FDG in spite of at least 4-h fasting, were retrospectively analyzed. In the clinical follow-up, this high plasma glucose was confirmed as chronic hyperglycemia derived from uncontrolled diabetes (n=32) and untreated diabetes (n=25). Based on the final diagnosis of malignancy obtained by histopathology or clinical follow-up for at least 6 months, the diagnostic performance of visual PET analysis was evaluated. Excluding nine scans of nine patients without sufficient follow-up, final diagnosis was obtained in 48 scans of 45 patients. In 36 scans of 36 patients, at least one malignant lesion was finally confirmed, and true-positive and false-negative results were obtained in 30 and six cases, respectively. Six cases showed false-negative results due to low FDG-avid pathological characteristics (hepatocellular carcinoma, etc.), chemotherapeutic effect or small tumor size. Overall, the patient-based sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 83, 83, 94, 63 and 83%, respectively. In lesion-based diagnosis, 56 of 75 lesions (74%) were depicted by PET, while 19 lesions were negative on PET, also due to low FDG-avid characteristics or small size (less than 15 mm). At the time of chronic hyperglycemia (not acute hyperglycemia), the adverse effect caused by high plasma glucose level was minimum. The FDG uptake of the tumor maintained a sufficiently high level for visual clinical diagnosis in most cases, except in the cases of low FDG-avid tumors or small lesions (15 mm in size). (author)

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

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

2014-10-15

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

Clinical study of the image fusion between CT and FDG-PET in the head and neck region

International Nuclear Information System (INIS)

Shozushima, Masanori; Moriguchi, Hitoshi; Shoji, Satoru; Sakamaki, Kimio; Ishikawa, Yoshihito; Kudo, Keigo; Satoh, Masanobu

1999-01-01

Image fusion using PET and CT from the head and neck region was performed with the use of external markers on 7 patients with squamous cell carcinoma. The purpose of this study was to examine a resultant error and the clinical usefulness of image fusion. Patients had primary lesions of the tongue, the maxillary gingiva or the maxillary sinus. All patients underwent PET with FDG and CT to detect tumor sites. Of these 7 patients, diagnostic images and the clinical observation found 6 cases of regional lymph node metastasis of the neck. To ensure the anatomical detail of the PET images, small radioactive markers were placed on the philtrum and below both earlobes. The PET image and CT image were then overlapped on a computer. The image fusion of PET and CT was successfully performed on all patients. The superposition error of this method was examined between the PET and CT images. The accuracy of fit measured as the mean distance between the PET and CT image was in the range of 2-5 mm. PET-CT superimposed images produced an increase in the localization of tumor FDG uptake and localized FDG uptake on the palatine tonsils. The marker system described here for the alignment of PET and CT images can be used on a routine basis without the invasive fixation of external markers, and also improve the management and follow up on patients with head and neck carcinoma. (author)

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

Science.gov (United States)

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

2017-01-01

The aim of this study was to assess the combined use of the radiotracers 18 F-FDG and 18 F-NaF in treatment response evaluation of a group of multiple myeloma (MM) patients undergoing high-dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) by means of static (whole-body) and dynamic PET/CT (dPET/CT). Thirty-four patients with primary, previously untreated MM scheduled for treatment with HDT followed by ASCT were enrolled in the study. All patients underwent PET/CT scanning with 18 F-FDG and 18 F-NaF before and after therapy. Treatment response by means of PET/CT was assessed according to the European Organization for Research and Treatment of Cancer (EORTC) 1999 criteria. The evaluation of dPET/CT studies was based on qualitative evaluation, semi-quantitative (SUV) calculation, and quantitative analysis based on two-tissue compartment modelling and a non-compartmental approach leading to the extraction of fractal dimension (FD). An analysis was possible in 29 patients: three with clinical complete response (CR) and 26 with non-CR (13 patients near complete response-nCR, four patients very good partial response-VGPR, nine patients partial response-PR). After treatment, 18 F-FDG PET/CT was negative in 14/29 patients and positive in 15/29 patients, showing a sensitivity of 57.5 % and a specificity of 100 %. According to the EORTC 1999 criteria, 18 F-FDG PET/CT-based treatment response revealed CR in 14 patients ( 18 F-FDG PET/CT CR), PR in 11 patients ( 18 F-FDG PET/CT PR) and progressive disease in four patients ( 18 F-FDG PET/CT PD). In terms of 18 F-NaF PET/CT, 4/29 patients (13.8 %) had a negative baseline scan, thus failed to depict MM. Regarding the patients for which a direct lesion-to-lesion comparison was feasible, 18 F-NaF PET/CT depicted 56 of the 129 18 F-FDG positive lesions (43 %). Follow-up 18 F-NaF PET/CT showed persistence of 81.5 % of the baseline 18 F-NaF positive MM lesions after treatment, despite the fact that 64

FDG-PET in Follicular Lymphoma Management

Directory of Open Access Journals (Sweden)

C. Bodet-Milin

2012-01-01

Full Text Available 18-Fluoro-deoxyglucose positron emission tomography/computerised tomography (FDG PET/CT is commonly used in the management of patients with lymphomas and is recommended for both initial staging and response assessment after treatment in patients with diffuse large B-cell lymphoma and Hodgkin lymphoma. Despite the FDG avidity of follicular lymphoma (FL, FDG PET/CT is not yet applied in standard clinical practice for patients with FL. However, FDG PET/CT is more accurate than conventional imaging for initial staging, often prompting significant management change, and allows noninvasive characterization to guide assessment of high-grade transformation. For restaging, FDG PET/CT assists in distinguishing between scar tissue and viable tumors in residual masses and a positive PET after induction treatment would seem to predict a shorter progression-free survival.

Pulmonary drug toxicity. FDG-PET findings in patients with lymphoma

International Nuclear Information System (INIS)

Kazama, Toshiki; Faria, S.C.; Macapinlac, H.A.; Uchida, Yoshitaka; Ito, Hisao

2008-01-01

The objective of this study was to evaluate the prevalence and positron emission tomography (PET) imaging features of pulmonary drug toxicity in patients with lymphoma during or just following chemotherapy. A total of 677 PET scans on 460 patients with lymphoma (351 non-Hodgkin's lymphoma, 92 Hodgkin's disease, and 17 both Hodgkin's and non-Hodgkin's lymphoma) were performed for the evaluation of chemotherapy response. In 51 patients, abnormal accumulation on both sides of the chest was reported. A review of medical records, 18 fluorodeoxyglucose ( 18 FDG)-PET scans, and chest computed tomography (CT) was performed, and cases with probable drug toxicity were identified. Inclusion criteria of probable drug toxicity were abnormal but symmetrical FDG accumulation in both lungs seen during or just following the completion of chemotherapy, the abnormal accumulation or corresponding abnormal CT findings resolved on subsequent studies, exclusion of clinical diagnosis of pneumonia, radiation pneumonitis, or lymphoma involvement. In 10 patients (six men and four women, average age 47.3), 2.2% of cases, probable drug toxicity was identified. In all 10 cases, diffuse and subpleural-dominant FDG accumulation was seen on FDG-PET scans, and scattered or diffuse ground-glass opacities were observed on chest CT. Four patients reported symptoms, and six patients did not report any symptoms. Diffuse and peripheral-dominant FDG accumulation in the lung, which may represent pulmonary drug toxicity, was not uncommon in patients with lymphoma who underwent chemotherapy. FDG-PET scan might be able to detect pulmonary drug toxicity in asymptomatic patients. (author)

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

International Nuclear Information System (INIS)

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

2009-01-01

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

FDG PET-CT findings of extra-thoracic sarcoid are associated with cardiac sarcoid: A rationale for using FGD PET-CT for cardiac sarcoid evaluation.

Science.gov (United States)

Patel, Darshan C; Gunasekaran, Senthil S; Goettl, Christopher; Sweiss, Nadera J; Lu, Yang

2017-07-05

This retrospective study investigates the relationship between cardiac and extra-thoracic sarcoid findings on FDG PET-CT using a 72-hour pretest high-fat, high-protein, and very low-carbohydrate (HFHPVLC) diet. A total of 196 consecutive FDG PET-CT scans with 72-hour HFHPVLC diet preparation were performed between December 2014 and December 2015 in known sarcoid patients. Of these scans, 5 were excluded for non-adherence to diet preparation or underlying cancer. Cardiac and extra-thoracic sarcoid lesions were categorized and measured for radiotracer uptake. A total of 188 patients had 191 eligible FDG PET/CT scans (3 follow-up scans), of which there were 20 (10%) positive, 6 indeterminate (3%), and 165 (86%) negative for CS. Among the 20 scans positive for CS, 8 (40%) had findings of both cardiac and extra-thoracic sarcoid. Our study shows that 40% of CS patients also have FDG PET-CT findings of extra-thoracic sarcoid. This makes an intriguing case for FDG PET-CT use with pretest diet prep over cardiac MRI (CMR) for cardiac sarcoid evaluation, given that CMR is likely to overlook these extra-thoracic sites of disease.

Evaluation of gross tumor size using CT, 18F-FDG PET, integrated 18F-FDG PET/CT and pathological analysis in non-small cell lung cancer

International Nuclear Information System (INIS)

Yu Huiming; Liu Yunfang; Hou Ming; Liu Jie; Li Xiaonan; Yu Jinming

2009-01-01

Purpose: The correlation of gross tumor sizes between combined 18 F-FDG PET/CT images and macroscopic surgical samples has not yet been studied in detail. In the present study, we compared CT, 18 F-FDG PET and combined 18 F-FDG PET/CT for the delineation of gross tumor volume (GTV) and validated the results through examination of the macroscopic surgical specimen. Methods: Fifty-two operable non-small cell lung cancer (NSCLC) patients had integrated 18 F-FDG PET/CT scans preoperatively and pathological examination post-operation. Four separate maximal tumor sizes at X (lateral direction), Y (ventro-dorsal direction) and Z (cranio-caudal direction) axis were measured on 18 F-FDG PET, CT, combined 18 F-FDG PET/CT and surgical specimen, respectively. Linear regression was calculated for each of the three imaging measurements versus pathological measurement. Results: No significant differences were observed among the tumor sizes measured by three images and pathological method. Compared with pathological measurement, CT size at X, Y, Z axis was larger, whereas combined 18 F-FDG PET/CT and 18 F-FDG PET size were smaller. Combined 18 F-FDG PET/CT size was more similar to the pathological size than that of 18 F-FDG PET or CT. Results of linear regressions showed that integrated 18 F-FDG PET/CT was the most accurate modality in measuring the size of cancer. Conclusions: 18 F-FDG PET/CT correlates more faithfully with pathological findings than 18 F-FDG PET or CT. Integrated 18 F-FDG PET/CT is an effective tool to define the target of GTV in radiotherapy.

Assessing the impact of FDG-PET in the management of anal cancer

International Nuclear Information System (INIS)

Nguyen, Brandon T.; Joon, Daryl Lim; Khoo, Vincent; Quong, George; Chao, Michael; Wada, Morikatsu; Joon, Michael Lim; See, Andrew; Feigen, Malcolm; Rykers, Kym; Kai, Cynleen; Zupan, Eddy; Scott, Andrew

2008-01-01

Purpose: To assess the utility of FDG-PET in anal cancer for staging and impact on radiotherapy planning (RTP), response and detection of recurrent disease. Methods and materials: Fifty histopathological anal cancer patients were reviewed between 1996 and 2006. The median age was 58 years (range 36-85) with 19 males:31females. Clinical assessment with CT was compared to PET. Impact on management, disease response, recurrence and metastases was evaluated. Results: The non-PET staging was Stage I(8), Stage II(18), Stage III(22), and Stage IV(2)s. The primary was strongly FDG avid in 98% with non-excised tumors compared to CT (58%). PET upstaged 17% with unsuspected pelvic/inguinal nodal disease. Pre-treatment PET identified 11 additional by involved nodal groups in 48 patients causing RTP amendments in 19%. Post-treatment PETs at median 17 weeks (range 9-28) showed complete responses in 20 (80%) and 5 (20%) partial responses (PR). PRs were biopsy positive in 2 and negative in 3. Fifteen had follow-up scans of which all nine PETs detected recurrences were pathologically confirmed. Conclusions: Anal cancer is FDG-PET avid. PET upstages 17% and changes the RTP in 19%. PET can aid in anal cancer staging and identification of residual disease, recurrent/metastatic disease but warrants further prospective studies

Omental deposits surveillance in gynecological malignancies at first setting follow up: 18F-FDG PET/CT compared to CT

OpenAIRE

Tamer W. Kassem

2017-01-01

Objective: The aim of this study was to compare the diagnostic performance of positron emission tomography/computed tomography (PET/CT) scan and CT scan in follow up of proven gynecological malignancies omental deposits in first setting follow up after treatment. Patients and methods: 60 female patients having proven omental deposits from gynecological malignancies underwent PET/CT examination following a preset protocol as baseline study. 34 cases of them had a second PET/CT examination f...

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

Energy Technology Data Exchange (ETDEWEB)

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

2008-12-15

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

Clinical usefulness of 18F–FDG PET/CT for initial staging and assessment of treatment efficacy in patients with lymph node tuberculosis

International Nuclear Information System (INIS)

Lefebvre, Nicolas; Argemi, Xavier; Meyer, Nicolas; Mootien, Joy; Douiri, Nawal; Sferrazza-Mandala, Stefania; Schramm, Frédéric; Weingertner, Noëlle; Christmann, Daniel; Hansmann, Yves; Imperiale, Alessio

2017-01-01

Introduction: Few studies have evaluated the promising role of 18 F–fluoro-2-deoxy-D-glucose positron emission tomography (PET) and PET/computed tomography FDG PET/CT in evaluating and monitoring treatment response in patients with lymph node tuberculosis (LNTB). The aim of this clinical investigation was to assess the clinical usefulness of FDG PET/CT for initial tuberculosis staging and to determine the prognostic value of the decrease of 18 F–FDG uptake during antibiotic treatment in LNTB patients. Methods: We retrospectively reviewed 18 cases of LNTB admitted at a single center from 2004 to 2014. Medical records of patients who underwent two FDG PET/CT (>6 months interval), at initial staging and at the end of therapy were reviewed to determine the impact of FDG PET/CT on initial management of LNTB and response to therapy. Statistical analysis was performed using linear mixed-effects model. Results: Thirteen cases of disseminated LNTB and five cases of localized LNTB were included in the study. Initial FDG PET/CT allowed guided biopsy for initial diagnosis in 5 patients and identified unknown extra-LN TB sites in 9 patients. Visual analysis follow-up of FDG PET/CT showed a complete metabolic response in 9/18 patients (all of whom were cured), a partial response in 7/18 (5 of whom were cured) and no response in 2/18 (all of whom were not cured). The semi-quantitative evaluation of 18F–FDG intensity decrease based on the maximum standardized uptake value (SUVmax), compared to targeted estimated decrease allowed to predict correctly a complete response to treatment in 14/18 cases. Conclusion: FDG PET/CT allows an accurate pre-therapeutic mapping of LNTB and helps for early TB confirmation. The SUVmax follow up is a potential tool for monitoring the treatment response.

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-12-15

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

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

International Nuclear Information System (INIS)

Djelbani-Ahmed, S.; Chandesris, M.O.; Mekinian, A.; Fain, O.; Canioni, D.; Brouzes, C.; Hanssens, K.; Pop, G.; Eder, V.; Durieu, I.; Durupt, S.; Grosbois, B.; Besnard, S.; Tournilhac, O.; Beyne-Rauzy, O.; Agape, P.; Delmer, A.; Ranta, D.; Jeandel, P.Y.; Georgin-Lavialle, S.; Frenzel, L.; Hermine, O.; Damaj, G.; Lortholary, O.; Soussan, M.

2015-01-01

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

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

International Nuclear Information System (INIS)

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

2008-01-01

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

The value of FDG-PET in patients with painful total knee arthroplasty

Energy Technology Data Exchange (ETDEWEB)

Stumpe, Katrin D.M.; Schulthess, Gustav K. von; Strobel, Klaus [University Hospital, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Romero, Jose [Orthopaedic University Hospital Balgrist, Orthopaedic Surgery, Zurich (Switzerland); Center for Joint Diseases at Hirslanden Clinic, EndoClinic Zurich, Zurich (Switzerland); Ziegler, Oliver [Orthopaedic University Hospital Balgrist, Orthopaedic Surgery, Zurich (Switzerland); Ortho Zentrum Rosenheim, Rosenheim (Germany); Kamel, Ehab M. [University Hospital, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Centre Hospitalier Universitaire Vaudois (CHUV), Division of Nuclear Medicine, Lausanne (Switzerland); Hodler, Juerg [Orthopaedic University Hospital Balgrist, Department of Radiology, Zurich (Switzerland)

2006-10-15

The purpose of this study was to evaluate{sup 18}F-fluorodeoxyglucose (FDG) uptake in patients with painful total knee arthroplasty and to relate FDG uptake to the location of soft tissue pain. Twenty-eight patients with painful total knee arthroplasty had a clinical examination, standard radiographs, CT measurement of rotation of the femoral component and FDG-PET (18 PET/CT, 10 PET). The diagnosis of infection was based on microbiological examinations of surgical specimens (n=12) or clinical follow-up for at least 6 months (n=16),{sup 99m}Tc-labelled monoclonal antibody scintigraphy and joint aspiration. Twenty-seven of 28 patients presented with diffuse synovial FDG uptake. Additional focal extrasynovial FDG uptake was observed in 19 knees. Twenty-four of the 28 patients had a diagnosis of internal femoral malrotation. The remaining four patients showed no rotation (0 ) and 3 , 4 and 7 of external rotation, respectively. Three patients presented with the additional diagnosis of an infected total knee replacement. Pain was described as diffuse (n=10) or focal (n=18). In two knees a relationship between pain location and FDG uptake was observed. Of ten patients with a severe internal femoral component rotation (>6 ), seven had focal uptake, four in the femoral periosteum and three in the tibial periosteum. The difference between knees with severe malrotation and the remaining knees was not significant (p=1.000, Fisher's Exact Test). Diffuse synovial and focal extrasynovial FDG-PET uptake is commonly found in patients with malrotation of the femoral component and is not related to pain location. The information provided by FDG-PET does not contribute to the diagnosis and management of individual patients with persistent pain after total knee replacement. (orig.)

The value of FDG-PET in patients with painful total knee arthroplasty

International Nuclear Information System (INIS)

Stumpe, Katrin D.M.; Schulthess, Gustav K. von; Strobel, Klaus; Romero, Jose; Ziegler, Oliver; Kamel, Ehab M.; Hodler, Juerg

2006-01-01

The purpose of this study was to evaluate 18 F-fluorodeoxyglucose (FDG) uptake in patients with painful total knee arthroplasty and to relate FDG uptake to the location of soft tissue pain. Twenty-eight patients with painful total knee arthroplasty had a clinical examination, standard radiographs, CT measurement of rotation of the femoral component and FDG-PET (18 PET/CT, 10 PET). The diagnosis of infection was based on microbiological examinations of surgical specimens (n=12) or clinical follow-up for at least 6 months (n=16), 99m Tc-labelled monoclonal antibody scintigraphy and joint aspiration. Twenty-seven of 28 patients presented with diffuse synovial FDG uptake. Additional focal extrasynovial FDG uptake was observed in 19 knees. Twenty-four of the 28 patients had a diagnosis of internal femoral malrotation. The remaining four patients showed no rotation (0 ) and 3 , 4 and 7 of external rotation, respectively. Three patients presented with the additional diagnosis of an infected total knee replacement. Pain was described as diffuse (n=10) or focal (n=18). In two knees a relationship between pain location and FDG uptake was observed. Of ten patients with a severe internal femoral component rotation (>6 ), seven had focal uptake, four in the femoral periosteum and three in the tibial periosteum. The difference between knees with severe malrotation and the remaining knees was not significant (p=1.000, Fisher's Exact Test). Diffuse synovial and focal extrasynovial FDG-PET uptake is commonly found in patients with malrotation of the femoral component and is not related to pain location. The information provided by FDG-PET does not contribute to the diagnosis and management of individual patients with persistent pain after total knee replacement. (orig.)

Performance of FDG PET/CT in the clinical management of breast cancer.

Science.gov (United States)

Groheux, David; Espié, Marc; Giacchetti, Sylvie; Hindié, Elif

2013-02-01

In this analysis, the role of metabolic imaging with fluorine 18 fluorodeoxyglucose (FDG) in breast cancer is reviewed. The analysis was limited to recent works by using state-of-the-art positron emission tomography (PET)/computed tomography (CT) technology. The strengths and limitations of FDG PET/CT are examined in various clinical settings, and the following questions are answered: Is FDG PET/CT useful to differentiate malignant from benign breast lesions? Can FDG PET/CT replace sentinel node biopsy for axillary staging? What is the role of FDG PET/CT in initial staging of inflammatory or locally advanced breast cancer? What is the role of FDG PET/CT in initial staging of clinical stage IIA and IIB and primary operable stage IIIA breast cancer? How does FDG PET/CT compare with conventional techniques in the restaging of cancer in patients who are suspected of having disease recurrence? What is the role of FDG PET/CT in the assessment of early response to neoadjuvant therapy and of response to therapy for metastatic disease? Some recommendations for clinical practice are given.

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

International Nuclear Information System (INIS)

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

2016-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-01-15

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

Clinical significance of pretreatment FDG PET/CT IN MOBG-avid pediatric neuroblastoma

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Kang, Seo Young; Kim, Yong Il; Cheon, Gi Jeong; Kang, Keon Wook; Chung, June Key; Lee, Dong Soo; Kang, Hyoung Jin; Shin, Hee Young [Seoul National University Hospital, Seoul (Korea, Republic of); Kim, E. Edmund [Seoul National University, Seoul (Korea, Republic of); Rahim, Muhammad Kashif [Nishtar Medical College and Hospital, Multan (Pakistan)

2017-06-15

{sup 18}F-fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging is well known to have clinical significance in the initial staging and response evaluation of the many kinds of neoplasms. However, its role in the pediatric neuroblastoma is not clearly defined. In the present study, the clinical significance of FDG-PET/computed tomography (CT) in 123I- or 131I-metaiodobenzylguanidine (MIBG)-avid pediatric neuroblastoma was investigated. Twenty patients with neuroblastoma who undertook pretreatment FDG PET/CT at our institute between 2008 and 2015 and showed MIBG avidity were retrospectively enrolled in the present study. Clinical information—including histopathology, and serum markers—and several PET parameters—including SUVmax of the primary lesion (Psuv), target-to-background ratio (TBR), metabolic tumor volume (MTV), and coefficient of variation (CV)—were analyzed. The prognostic effect of PET parameters was evaluated in terms of progression-free survival (PFS). Total 20 patients (4.5 ± 3.5 years) were divided as two groups by disease progression. Six patients (30.0 %) experienced disease progression and one patient (5.0 %) died during follow-up period. There were not statistically significant in age, stage, MYCN status, primary tumor size, serum lactate dehydrogenase (LDH), neuron-specific enolase (NSE), and ferritin level between two groups with progression or no progression. However, Psuv (p = 0.017), TBR (p = 0.09), MTV (p = 0.02), and CV (p = 0.036) showed significant differences between two groups. In univariate analysis, PFS was significantly associated with Psuv (p = 0.021) and TBR (p = 0.023). FDG-PET parameters were significantly related with progression of neuroblastoma. FDG-PET/CT may have the potential as a valuable modality for evaluating prognosis in the patients with MIBG-avid pediatric neuroblastoma.

Rapid evaluation of the cost-effectiveness o FDG-PET in recurrent colorectal cancer

International Nuclear Information System (INIS)

Miles, K.A.; Keith, C.J.; Wong, D.C.; Griffiths, M.R.

2002-01-01

Full text: To evaluate the cost-effectiveness of FDG-PET in recurrent colorectal cancer using Australian data whilst avoiding the time delays, costs and ethical difficulties associated with intensive patient follow-up. A decision tree sensitivity analysis was used. The study population comprised patients with recurrent colorectal under consideration for resection of apparently isolated hepatic metastasis in whom demonstration of extra-hepatic tumour would preclude surgery.The results of FDG-PET in a consecutive series of 75 such patients referred to the Wesley PET centre were used to determine the range of possible values for disease prevalence and specificity, assuming the value for PET sensitivity as reported in the federal government's PET review. These values, along with the diagnostic accuracy of CT and Australian costs for procedures (PET = $1200), were entered into decision trees modelling a diagnostic strategy comprising CT only and an alternative strategy where patients without extrahepatic tumour on CT also undergo FDG-PET. The cost per patient, accuracy and Incremental Cost-Accuracy Ratio (ICAR) were determined for each strategy. The PET strategy is cheaper for all possible values of disease prevalence and PET specificity ($306-328 / patient) and is more cost-effective for values of disease prevalence above 0.18 or PET specificity above 0.86. At a typical disease prevalence of 0.3 (PET specificity 0.92), the ICAR for the PET strategy is $9700 versus $11,200 for CT. PET remains cost saving even if the best reported values for sensitivity of CT and worse values for PET are used. FDG-PET for recurrent colorectal cancer in Australia would be cost saving and most probably cost-effective. Copyright (2002) Blackwell Science Pty Ltd

Combined Modality Treatment for PET-Positive Non-Hodgkin Lymphoma: Favorable Outcomes of Combined Modality Treatment for Patients With Non-Hodgkin Lymphoma and Positive Interim or Postchemotherapy FDG-PET

Energy Technology Data Exchange (ETDEWEB)

Halasz, Lia M. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Jacene, Heather A. [Department of Imaging, Dana-Farber Cancer Institute, and Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Catalano, Paul J. [Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Van den Abbeele, Annick D. [Department of Imaging, Dana-Farber Cancer Institute, and Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); LaCasce, Ann [Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Mauch, Peter M. [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Ng, Andrea K., E-mail: ang@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, Massachusetts (United States)

2012-08-01

Purpose: To evaluate outcomes of patients treated for aggressive non-Hodgkin lymphoma (NHL) with combined modality therapy based on [{sup 18}F]fluoro-2-deoxy-2-D-glucose positron emission tomography (FDG-PET) response. Methods and Materials: We studied 59 patients with aggressive NHL, who received chemotherapy and radiation therapy (RT) from 2001 to 2008. Among them, 83% of patients had stage I/II disease. Patients with B-cell lymphoma received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)-based chemotherapy, and 1 patient with anaplastic lymphoma kinase-negative anaplastic T-cell lymphoma received CHOP therapy. Interim and postchemotherapy FDG-PET or FDG-PET/computed tomography (CT) scans were performed for restaging. All patients received consolidated involved-field RT. Median RT dose was 36 Gy (range, 28.8-50 Gy). Progression-free survival (PFS) and local control (LC) rates were calculated with and without a negative interim or postchemotherapy FDG-PET scan. Results: Median follow-up was 46.5 months. Thirty-nine patients had negative FDG-PET results by the end of chemotherapy, including 12 patients who had a negative interim FDG-PET scan and no postchemotherapy PET. Twenty patients were FDG-PET-positive, including 7 patients with positive interim FDG-PET and no postchemotherapy FDG-PET scans. The 3-year actuarial PFS rates for patients with negative versus positive FDG-PET scans were 97% and 90%, respectively. The 3-year actuarial LC rates for patients with negative versus positive FDG-PET scans were 100% and 90%, respectively. Conclusions: Patients who had a positive interim or postchemotherapy FDG-PET had a PFS rate of 90% at 3 years after combined modality treatment, suggesting that a large proportion of these patients can be cured with consolidated RT.

Clinical Application of 18F-FDG PET in Epilepsy

International Nuclear Information System (INIS)

Kim, Yu Kyeong

2008-01-01

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

(18)F-FDG PET/CT, cytoreductive surgery and intraperitoneal chemohyperthermia for the therapeutic management in peritoneal carcinomatosis: A pilot study.

Science.gov (United States)

Cistaro, A; Cucinotta, M; Cassalia, L; Priola, A; Priola, S; Pappalardo, M; Coppolino, P; De Simone, M; Quartuccio, N

2016-01-01

Peritoneal carcinomatosis is a common evolution of neoplasms and the terminal stage of disease. A new therapeutic technique, based on the total surgical removal of peritoneal lesions (peritonectomy procedure - PP) combined with the intraperitoneal chemohyperthermia (IPCH), has been developed. Proper patient selection is mandatory for optimizing the results of treatment. The aim of this study was to investigate the role of [(18)F]fluoro-2-deoxy-d-glucose Positron Emission Tomography/Computed Tomography ((18)F-FDG PET/CT) in patients with peritoneal carcinosis selected to undergo PP and IPCH. Furthermore, we aimed to identify characteristic patterns of abdominal(18)F-FDG uptake and to correlate these patterns with available anatomic findings after surgery. Patients with either histologically confirmed peritoneal carcinosis or suspected upon clinical follow-up and/or imaging findings were prospectively submitted to pre-surgery (18)F-FDG PET/CT scan. Only those patients without evidence of extra-peritoneal metastases at PET/CT scan were treated with PP and IPCH. 11 patients with peritoneal carcinomatosis (5 colorectal, 4 ovarian, 1 pancreatic) and 1 unknown primitive cancer, were eligible for the study. In all cases PET/CT scan showed multiple peritoneal implants. In 6 out of 11 cases (54%) metastases were evidenced by (18)F-FDG PET/CT: 2 cases with liver metastases; 1 case with bone metastases; 3 patients with lymph-node lesions. Two distinct imaging patterns, with focal or diffuse increased (18)F-FDG uptake, were recognized. PP+IPCH of patients selected by (18)F-FDG PET/CT seems to be safe and feasible. PET/CT scan appears as a reliable tool for the detection, characterization of peritoneal implants with potential impact in the therapeutic management of these patients. Copyright © 2016 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

Clinical utility of FDG PET/CT in acute complicated pyelonephritis - results from an observational study

Energy Technology Data Exchange (ETDEWEB)

Wan, Chih-Hsing [Mackay Memorial Hospital at Taipei, Department of Nuclear Medicine, Taipei (China); Tseng, Jing-Ren; Yen, Tzu-Chen [Chang Gung Memorial Hospital at Linkou, Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Taoyuan (China); Chang Gung University, Department of Medical Imaging and Radiological Science, College of Medicine, Taoyuan (China); Lee, Ming-Hsun [Chang Gung Memorial Hospital at Linkou, Division of Infectious Diseases, Department of Internal Medicine, Taoyuan (China); Yang, Lan-Yan [Chang Gung Memorial Hospital at Linkou, Biostatistics Unit, Clinical Trial Center, Taoyuan (China)

2018-03-15

Acute complicated pyelonephritis (ACP) is an upper urinary tract infection associated with coexisting urinary tract abnormalities or medical conditions that could predispose to serious outcomes or treatment failures. Although CT and magnetic resonance imaging (MRI) are frequently used in patients with ACP, the clinical value of {sup 18}F-fluorodeoxyglucose positron emission tomography and computed tomography (FDG PET/CT) has not been systematically investigated. This single-center retrospective study was designed to evaluate the potential usefulness of FDG PET/CT in patients with ACP. Thirty-one adult patients with ACP who underwent FDG PET/CT were examined. FDG PET/CT imaging characteristics, including tracer uptake patterns, kidney volumes, and extrarenal imaging findings, were reviewed in combination with clinical data and conventional imaging results. Of the 31 patients, 19 (61%) showed focal FDG uptake. The remaining 12 study participants showed a diffuse FDG uptake pattern. After volumetric approximation, the affected kidneys were found to be significantly enlarged. Patients who showed a focal uptake pattern had a higher frequency of abscess formation requiring drainage. ACP patients showing diffuse tracer uptake patterns had a more benign clinical course. Seven patients had suspected extrarenal coinfections, and FDG PET/CT successfully confirmed the clinical suspicion in five cases. FDG PET/CT was as sensitive as CT in identifying the six patients (19%) who developed abscesses. Notably, FDG PET/CT findings caused a modification to the initial antibiotic regimen in nine patients (29%). FDG PET/CT may be clinically useful in the assessment of patients with ACP who have a progressive disease course. (orig.)

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-12-15

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

Performance of FDG-PET/CT for diagnosis of recurrent uterine cervical cancer

International Nuclear Information System (INIS)

Kitajima, Kazuhiro; Murakami, Koji; Yamasaki, Erena; Domeki, Yasushi; Kaji, Yasushi; Sugimura, Kazuro

2008-01-01

The purpose is to evaluate the accuracy of integrated FDG-PET/CT, compared with PET alone, for diagnosis of suspected recurrence of uterine cervical cancer. Fifty-two women who had undergone treatment for histopathologically proven cervical cancer received PET/CT with suspected recurrence. PET-alone and integrated PET/CT images were evaluated by two different experienced radiologists by consensus for each investigation. A final diagnosis was confirmed by histopathology, radiological imaging, and clinical follow-up for over 1 year. Patient-based analysis showed that the sensitivity, specificity, and accuracy of PET/CT were 92.0% (23/25), 92.6% (25/27), and 92.3% (48/52), respectively, while for PET, the corresponding figures were 80.0% (20/25), 77.8% (21/27), and 78.8% (41/52), respectively. PET/CT resolved the false-positive PET results due to hypermetabolic activity of benign/inflammatory lesions and physiological variants, and was able to detect lung metastasis, local recurrence, peritoneal dissemination, para-aortic lymph node metastasis, and pelvic lymph node metastasis missed by PET alone. However, tiny local recurrence and lymph node metastasis could not be detected even by PET/CT. FDG-PET/CT is a useful complementary modality for providing good anatomic and functional localization of sites of recurrence during follow-up of patients with cervical cancer. (orig.)

Coincidence detection FDG-PET (Co-PET) in the management of oncological patients: attenuation correction versus non-attenuation correction

International Nuclear Information System (INIS)

Chan, W.L.; Freund, J.; Pocock, N.; Szeto, E.; Chan, F.; Sorensen, B.; McBride, B.

2000-01-01

Full text: This study was to determine if attenuation correction (AC) in FDG Co-PET improved image quality, lesion detection, patient staging and management of various malignant neoplasms, compared to non-attenuation-corrected (NAC) images. Thirty patients (25 men, 5 women, mean age 58 years) with known or suspected malignant neoplasms, including non-small-cell lung cancer, non Hodgkin's and Hodgkin's lymphoma, carcinoma of the breast, head and neck cancer and melanoma, underwent FDG Co-PET, which was correlated with histopathology, CT and other conventional imaging modalities and clinical follow-up. Whole body tomography was performed (ADAC Vertex MCD) 60 min after 200 MBq of 18 F-FDG (>6h fasting). The number and location of FDG avid lesions detected on the AC images and NAC Co-PET images were blindly assessed by two independent observers. Semi-quantitative grading of image clarity and lesion-to-background quality was performed. This revealed markedly improved image clarity and lesion-to-background quality, in the AC versus NAC images. AC and NAC Co-PET were statistically different in relation to lesion detection (p<0.01) and tumour staging (p<0.0 1). NAC Co-PET demonstrated 51 of the 65 lesions (78%) detected by AC Co-PET. AC Co-PET staging was correct in 27 patients (90%), compared with NAC Co-PET in 22 patients (73%). AC Co-PET altered tumour staging in five of 30 patients (16%) and NAC Co-PET did not alter tumour staging in any of the patients- management was altered in only two of these five patients (7%). In conclusion, AC Co-PET resulted in better image quality with significantly improved lesion detectability and tumour staging compared to NAC Co-PET. Its additional impact on patient management in this relatively small sample was minor. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

[{sup 18}F]FDG-PET in large vessel vasculitis; [{sup 18}F]FDG-PET bei Grossgefaess-Vaskulitiden

Energy Technology Data Exchange (ETDEWEB)

Hauser, A.S.D.; Walter, M.A. [Universitaetsspital Basel (Switzerland). Inst. fuer Nuklearmedizin

2007-06-15

[{sup 18}F]FDG-PET is a non-invasive metabolic imaging modality based on the regional distribution of fluorine-18-fluorodeoxyglucose that is highly effective in assessing the activity and the extent of giant cell arteritis and Takayasu's arteritis. It has shown to identify more affected vascular regions than morphologic imaging with Magnetic Resonance Imaging in both diseases. A visual grading of vascular [{sup 18}F]FDG-uptake helps to discriminate arteritis from atherosclerosis und therefore provides high specificity. High sensitivity is reached by scanning during the active inflammatory phase. [{sup 18}F]FDG-PET has the potential to develop into a valuable tool in the diagnostic work-up of giant cell arteritis and Takayasu's arteritis, respectively, and might become a first-line investigation technique. Therefore consensus regarding the most favorable imaging procedure as well as further clinical evidence is needed. The purpose of this review is to summarize current information on the present clinical data and to assist nuclear medicine practitioners in recommending, performing and interpreting the results of [{sup 18}F]FDG-PET in patients with suspected large vessel vasculitis. (orig.)

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

Energy Technology Data Exchange (ETDEWEB)

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

2007-12-15

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

The role of PET in initial work-up and evaluation after therapy in patients with carcinoma of unknown primary

Energy Technology Data Exchange (ETDEWEB)

Ryoo, Baek Yeol; Kang, Yoon Koo

1998-12-01

The carcinoma of unknown primary occupied 5 - 10 % of all malignancies. It is heterogenous in origin and has poor prognosis. The indentification of primary site and definition of involved area are more helpful in the management. The efficacy of positron emission tomography (PET) with fluorine-18- fluorodeoxyglucose (F18-FDG) positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (F18-FDG) was evaluated in several tumors such as breast, pancreas and head and neck cancers. In carcinoma of unknown primary, it was reported that the concentration of FDG was increased in tumor tissues, and that PET with F18-FDG may be much helpful in identifying primary site and defining involved area. The authors evaluated the usefulness of PET with F18-FDG in initial work-up and in evaluation after radical therapy for the patients with carcinoma of unknown primary. The visual analysis of FDG-PET would be helpful in identifying primary site and defining involved area. In detecting recurrent of residual lesions, FDG-PET seemed to be less helpful than conventional diagnostic work-up. But more studies with larger number of cases and longer follow-up were required. The results of this study can be bases for the direction of future studies for the usefulness of PET in carcinoma of unknown primary.

The role of PET in initial work-up and evaluation after therapy in patients with carcinoma of unknown primary

International Nuclear Information System (INIS)

Ryoo, Baek Yeol; Kang, Yoon Koo

1998-12-01

The carcinoma of unknown primary occupied 5 - 10 % of all malignancies. It is heterogenous in origin and has poor prognosis. The indentification of primary site and definition of involved area are more helpful in the management. The efficacy of positron emission tomography (PET) with fluorine-18- fluorodeoxyglucose (F18-FDG) positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (F18-FDG) was evaluated in several tumors such as breast, pancreas and head and neck cancers. In carcinoma of unknown primary, it was reported that the concentration of FDG was increased in tumor tissues, and that PET with F18-FDG may be much helpful in identifying primary site and defining involved area. The authors evaluated the usefulness of PET with F18-FDG in initial work-up and in evaluation after radical therapy for the patients with carcinoma of unknown primary. The visual analysis of FDG-PET would be helpful in identifying primary site and defining involved area. In detecting recurrent of residual lesions, FDG-PET seemed to be less helpful than conventional diagnostic work-up. But more studies with larger number of cases and longer follow-up were required. The results of this study can be bases for the direction of future studies for the usefulness of PET in carcinoma of unknown primary

Higher fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) uptake in tuberculous compared to bacterial spondylodiscitis

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Bassetti, Matteo; Merelli, Maria; Della Siega, Paola; Righi, Elda [Santa Maria della Misericordia University Hospital, Infectious Diseases Division, Udine (Italy); Di Gregorio, Fernando [Santa Maria della Misericordia University Hospital, Microbiology Unit, Udine (Italy); Screm, Maria; Scarparo, Claudio [Santa Maria della Misericordia University Hospital, Radiology Unit, Udine (Italy)

2017-06-15

Tuberculous spondylodiscitis can be difficult to diagnose because of its nonspecific symptoms and the similarities with non-tubercular forms of spinal infection. Fluorine-18-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG PET-CT) is increasingly used for the diagnosis and monitoring of tubercular diseases. Retrospective, case-control study comparing tuberculous spondylodiscitis with biopsy-confirmed pyogenic spondylodiscitis in the period 2010-2012. Ten cases of tuberculous spondylodiscitis and 20 controls were included. Compared to pyogenic, tuberculous spondylodiscitis was more frequent in younger patients (P = 0.01) and was more often associated with thoraco-lumbar tract lesions (P = 0.01) and multiple vertebral involvement (P = 0.01). Significantly higher maximum standardized uptake values (SUV) at FDG-PET were displayed by tuberculous spondylodiscitis compared to controls (12.4 vs. 7.3, P = 0.003). SUV levels above 8 showed the highest value of specificity (0.80). Mean SUV reduction of 48% was detected for tuberculous spondylodiscitis at 1-month follow-up. Higher SUV levels at FDG-PET were detected in tuberculous compared with pyogenic spondylodiscitis. PET-CT use appeared useful in the disease follow-up after treatment initiation. (orig.)

Speeding up PET/MR for cancer staging of children and young adults

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Aghighi, Maryam; Pisani, Laura Jean; Sun, Ziyan; Klenk, Christopher; Madnawat, Himani; Owen, Daniel; Quon, Andrew; Moseley, Michael; Daldrup-Link, Heike E. [Stanford University, Department of Radiology, Molecular Imaging Program at Stanford, Stanford, CA (United States); Fineman, Sandra Luna [Stanford University, Department of Pediatrics, Lucile Packard Children' s Hospital, Stanford, CA (United States); Advani, Ranjana [Stanford University, Department of Medicine, Stanford Hospital, Stanford, CA (United States); Von Eyben, Rie [Stanford University, Department of Radiation and Oncology, Stanford, CA (United States)

2016-12-15

Combining {sup 18}F-FDG PET with whole-body MR for paediatric cancer staging is practically feasible if imaging protocols can be streamlined. We compared {sup 18}F-FDG PET/STIR with accelerated {sup 18}F-FDG PET/FSPGR for whole-body tumour imaging in children and young adults. Thirty-three children and young adults (17.5 ± 5.5 years, range 10-30) with malignant lymphoma or sarcoma underwent a {sup 18}F-FDG PET staging examination, followed by ferumoxytol-enhanced STIR and FSPGR whole-body MR. {sup 18}F-FDG PET scans were fused with MR data and the number and location of tumours on each integrated examination were determined. Histopathology and follow-up imaging served as standard of reference. The agreement of each MR sequence with the reference and whole-body imaging times were compared using Cohen's kappa coefficient and Student's t-test, respectively. Comparing {sup 18}F-FDG PET/FSPGR to {sup 18}F-FDG PET/STIR, sensitivities were 99.3 % for both, specificities were statistically equivalent, 99.8 versus 99.9 %, and the agreement with the reference based on Cohen's kappa coefficient was also statistically equivalent, 0.989 versus 0.992. However, the total scan-time for accelerated FSPGR of 19.8 ± 5.3 minutes was significantly shorter compared to 29.0 ± 7.6 minutes for STIR (p = 0.001). F-FDG PET/FSPGR demonstrated equivalent sensitivities and specificities for cancer staging compared to {sup 18}F-FDG PET/STIR, but could be acquired with shorter acquisition time. (orig.)

Principal component analysis of FDG PET in amnestic MCI

International Nuclear Information System (INIS)

Nobili, Flavio; Girtler, Nicola; Brugnolo, Andrea; Dessi, Barbara; Rodriguez, Guido; Salmaso, Dario; Morbelli, Silvia; Piccardo, Arnoldo; Larsson, Stig A.; Pagani, Marco

2008-01-01

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

Principal component analysis of FDG PET in amnestic MCI

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

2008-12-15

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

Use of FDG-PET in differentiating benign from malignant compression fractures

International Nuclear Information System (INIS)

Bredella, Miriam A.; Essary, Brendan; Torriani, Martin; Ouellette, Hugue A.; Palmer, William E.

2008-01-01

The objective was to evaluate the use of fluorodeoxyglucose positron emission tomography (FDG-PET) in differentiating benign from malignant compression fractures. In a retrospective analysis, we identified 33 patients with 43 compression fractures who underwent FDG-PET. On FDG-PET the uptake pattern was recorded qualitatively and semiquantitatively and fractures were categorized as benign or malignant. Standardized uptake values (SUV) were obtained. MRI, CT, and biopsy results as well as clinical follow-up for 1-3 years served as standards of reference. The Student's t test was used to determine whether there was a statistically significant difference between the SUV for benign and malignant compression fractures. There were 14 malignant and 29 benign compression fractures, including 5 acute benign fractures. On FDG-PET, 5 benign fractures were falsely classified as malignant (false-positive). Three of these patients underwent prior treatment with bone marrow-stimulating agents. There were two false-negative results. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FDG-PET in differentiating benign from malignant compression fractures were 86%, 83%, 84%, 71%, and 92% respectively. The difference between SUV values of benign and malignant fractures was statistically significant (1.9 ± 0.97 for benign and 3.9 ± 1.52 for malignant fractures, p < 0.001). SUV of benign acute and chronic fractures were not statistically significant. Fluorodeoxyglucose positron emission tomography is useful in differentiating benign from malignant compression fractures. Therapy with bone marrow-stimulating agents can mimic malignant involvement. (orig.)

Contribution of 18F-FDG PET in the diagnostic assessment of fever of unknown origin (FUO): a stratification-based meta-analysis

International Nuclear Information System (INIS)

Besson, Florent L.; Chaumet-Riffaud, Philippe; Prigent, Alain; Durand, Emmanuel; Playe, Margot; Noel, Nicolas; Lambotte, Olivier; Goujard, Cecile

2016-01-01

The aim of this study was to quantify the contribution of FDG PET to the diagnostic assessment of fever of unknown origin (FUO), taking into account the diagnostic limitations resulting from the composite nature of this entity. The PubMed/MEDLINE database was searched from 2000 to September 2015. Original articles fulfilling the following criteria were included: (1) FUO as the initial diagnosis, (2) no immunosuppressed or nosocomial condition, (3) final diagnosis not based on PET, (4) a follow-up period specified, (5) adult population, and (6) availability of adapted data for calculation of odds ratios (ORs). ORs were computed for each study and then pooled using a random effects model. Stratification-based sensitivity analyses were finally performed using the following prespecified criteria: (a) study design, (b) PET device, (c) geographic area, and (d) follow-up period. A meta-analysis of the 14 included studies showed that normal PET findings led to an increase in the absolute final diagnostic rate of 36 % abnormal PET findings to an increase of 83 %, corresponding to a pooled OR of 8.94 (95 % CI 4.18 - 19.12, Z = 5.65; p < 0.00001). The design of the studies influenced the results (OR 2.92, 95 % CI 1.00 - 8.53 for prospective studies; OR 18,57, 95 % CI 7.57 - 45.59 for retrospective studies; p = 0.01), whereas devices (dedicated or hybrid), geographic area and follow-up period did not. Abnormal PET findings are associated with a substantially increased final diagnostic rate in FUO. Consequently, FDG PET could be considered for inclusion in the first-line diagnostic work-up of FUO. Further randomized prospective studies with standardized FDG PET procedures are warranted to confirm this first-line position. (orig.)

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

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Sait Sağer

2012-04-01

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

18F-FDG PET/CT for detection of the primary tumor in adults with extracervical metastases from cancer of unknown primary

DEFF Research Database (Denmark)

Burglin, Synne Alexandra; Hess, Søren; Høilund-Carlsen, Poul Flemming

2017-01-01

-up. STUDY APPRAISAL: PRISMA and QUADAS-2 were applied. SYNTHESIS METHODS: The pooled detection rate (DR) of 18F-FDG PET/CT was assessed with a fixed-effects model. Heterogeneity among studies was assessed with the I-squared statistic. RESULTS: A total of 2953 articles were identified from which N = 82 were...... CUP patients. DATA SOURCES: PubMed/Medline, Embase, and Web of Science. STUDY ELIGIBILITY CRITERIA: Studies on CUP from extracervical metastases in which every patient had received an 18F-FDG PET/CT scan and at least one 18F-FDG PET/CT-positive finding was confirmed by biopsy or clinical follow...

Diagnostic accuracy of {sup 18}F-FDG PET/CT for detection of suspected recurrence in patients with oesophageal carcinoma

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Sharma, Punit; Jain, Sachin; Karunanithi, Sellam; Malhotra, Arun; Bal, Chandrasekhar; Kumar, Rakesh [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Pal, Sujoy [All India Institute of Medical Sciences, Department of Surgical Gastroenterology, New Delhi (India); Julka, Pramod Kumar [All India Institute of Medical Sciences, Department of Radiation Oncology, New Delhi (India); Thulkar, Sanjay [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India)

2014-06-15

To evaluate the role of {sup 18}F-FDG PET/CT in the detection of recurrence in patients with oesophageal carcinoma, suspected clinically or following conventional investigations. This was a retrospective study. Data from 180 patients (age 56.3 ± 10.4 years; 126 men, 54 women) with histopathologically proven oesophageal carcinoma (squamous cell 115, adenocarcinoma 59, neuroendocrine carcinoma 4, small cell 1, poorly differentiated 1) who had undergone 227 {sup 18}F-FDG PET/CT studies for suspected recurrence were analysed. Recurrence was suspected clinically or following conventional investigations. PET/CT images were revaluated by two nuclear medicine physicians in consensus. Findings were grouped into local, nodal and distant recurrence. Results were compared to those from contrast-enhanced (CE) CT when available (109 patients). Clinical/imaging follow-up (minimum 6 months) with histopathology (when available) was taken as the reference standard. Of the 227 {sup 18}F-FDG PET/CT studies,166 were positive and 61 were negative for recurrent disease. PET/CT showed local recurrence in 134, nodal recurrence in 115 and distant recurrence in 47, with more than one site of recurrence in 34. The PET/CT findings were true-positive in 153 studies, true-negative in 54, false-positive in 13 and false-negative in 7. The sensitivity of {sup 18}F-FDG PET/CT was 96 %, the specificity was 81 %, the positive and negative predictive values were 92 % and 89 %, respectively, and the accuracy was 91 %. PET/CT showed similar accuracy in patients with squamous cell carcinoma and in those with adenocarcinoma (P = 0.181).{sup 18}F-FDG PET/CT was more specific than CECT (67 % vs. 21 %; P < 0.0001). PET/CT was superior to CECT for the detection of nodal recurrence (P < 0.0001), but not local recurrence (P = 0.093) or distant metastases (P = 0.441). {sup 18}F-FDG PET/CT shows high accuracy in the detection of suspected recurrence in patients with oesophageal carcinoma. It is more specific than

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

International Nuclear Information System (INIS)

Kim, Byung Il

2008-01-01

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

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

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Katsuya Mitamura

2015-01-01

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

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

International Nuclear Information System (INIS)

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

2008-01-01

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

Initial experience with FDG-PET/CT in the evaluation of breast cancer

International Nuclear Information System (INIS)

Tatsumi, Mitsuaki; Cohade, Christian; Mourtzikos, Karen A.; Wahl, Richard L.; Fishman, Elliot K.

2006-01-01

We retrospectively reviewed FDG-PET/CT images in patients with breast cancer to determine whether PET/CT improved the level of diagnostic confidence as compared with PET and to compare PET/CT and CT findings at the location of suspected malignancies. The study included 75 patients with known breast cancer. The initial PET/CT study for each patient was retrospectively reviewed to determine whether improved diagnostic confidence (IDC) regarding lesion localization and characterization was observed with PET/CT as compared with PET alone. PET/CT and CT findings were compared regarding lesion characterization and staging in 69 of the 75 patients, and in the case of discordant findings, comparison with histological or informative follow-up results was also performed. Fifty of the 75 patients exhibited increased FDG uptake in a total of 95 regions. In the comparison of PET/CT and PET, PET/CT resulted in IDC in 30 (60%) of these 50 patients and in 52 (55%) of the 95 regions. In the comparison between PET/CT and CT in 69 patients, PET/CT demonstrated a significantly better accuracy than CT (P<0.05). PET/CT showed definitely positive findings in 60 regions with malignancies, among which CT exhibited positive findings in 43 (72%). PET/CT and CT accurately staged 59 (86%) and 53 (77%) of the 69 patients, respectively. (orig.)

18F-FDG PET/CT findings of autoimmune pancreatitis

International Nuclear Information System (INIS)

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

2013-01-01

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

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

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Canh Nguyen

2015-01-01

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

Prognostic value and clinical impact of 18FDG-PET in the management of children with Burkitt lymphoma after induction chemotherapy.

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clement eBailly

2014-12-01

Full Text Available Objective: Burkitt Lymphoma (BL is a rare and aggressive form of B cell lymphoma that is curable using intensive chemotherapy. Obtaining a complete response (CR at the end of induction chemotherapy is a major prognostic factor. This study retrospectively evaluates the potential impact of 18FDG-PET in the management of children with BL after induction chemotherapy, and the prognostic performance of the Deauville criteria.Methods: 19 children with BL treated according to the French LMB2001 protocol between 2005 and 2012 were included. 18FDG-PET and conventional imaging (CI were performed after induction chemotherapy to confirm CR. 18FDG-PET was interpreted according to Deauville criteria with follow up and/or histology as the gold standard.Results: 18FDG-PET was negative in 15 cases, in agreement with CI in 9/15 cases. The six discordant cases confirmed to be negative by histology, were considered as true negative for 18FDG-PET. Negative predictive value (NPV of CI and 18FDG-PET were 73 and 93% respectively. The five-year PFS was significantly higher in patients with negative 18FDG-PET than those with positive 18FDG-PET (p=0.011. Conclusion: 18FDG-PET interpreted using Deauville criteria can help confirm CR at the end of induction chemotherapy, with a prognostic impact on five-year PFS. Its high NPV could limit the use of residual mass biopsy. Given the small size of our population, these results need to be confirmed by future prospective studies on a larger population.

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

International Nuclear Information System (INIS)

Jaruskova, M.; Belohlavek, O.

2006-01-01

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

Diagnostic accuracy of 18F-FDG-PET and PET/CT in patients with Ewing sarcoma family tumours: a systematic review and a meta-analysis

International Nuclear Information System (INIS)

Treglia, Giorgio; Salsano, Marco; Stefanelli, Antonella; Mattoli, Maria Vittoria; Giordano, Alessandro; Bonomo, Lorenzo

2012-01-01

To systematically review and meta-analyse literature data on the diagnostic performance of fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) and positron emission tomography/computed tomography (PET/CT) in patients with Ewing sarcoma family tumours (ESFT). PubMed/MEDLINE, Embase and Scopus databases were searched for articles that evaluated FDG-PET and PET/CT in patients with ESFT from inception to 31 May 2011. Studies that fulfilled the three following criteria were included in the systematic review: FDG-PET or PET/CT performed in patients with ESFT; articles about the diagnostic accuracy of FDG-PET and PET/CT; sample size of at least 10 patients with ESFT were included. Studies in which there were sufficient data to reassess sensitivity and specificity of FDG-PET or PET/CT in ESFT were included in the meta-analysis, excluding duplicate publications. Finally, pooled sensitivity, pooled specificity and area under the receiver operating characteristic (ROC) curve of FDG-PET or PET/CT in ESFT were calculated. We found 13 studies comprising a total of 342 patients with ESFT. The main findings of the studies included are presented. The meta-analysis of five selected studies provided these results about FDG-PET and PET/CT in ESFT: pooled sensitivity: 96% (95% confidence interval [CI] 91-99%); pooled specificity: 92% (95% CI 87-96%); area under the ROC curve: 0.97. With regard to the staging and restaging of patients with ESFT, the sensitivity, specificity and accuracy of FDG-PET and PET/CT are high; the combination of FDG-PET or PET/CT with conventional imaging is a valuable tool for the staging and restaging of ESFT and has a relevant impact on the treatment strategy plan. (orig.)

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

International Nuclear Information System (INIS)

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

2017-01-01

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

Brown Tumors Due to Primary Hyperparathyroidism in a Patient with Parathyroid Carcinoma Mimicking Skeletal Metastases on (18)F-FDG PET/CT

DEFF Research Database (Denmark)

Andersen, Kim Francis; Albrecht-Beste, Elisabeth

2015-01-01

-so-called brown tumors. These benign, osteolytic lesions may demonstrate FDG-avidity on (18)F-FDG PET/CT, and as such are misinterpreted as skeletal metastases. Regression of the lesions may occur following successful treatment. We present a case demonstrating the diagnostic work-up and follow-up of a patient...... with PHPT due to parathyroid carcinoma and with presence of brown tumors on (18)F-FDG PET/CT, visualizing the possible role of this imaging modality in the evaluation of treatment response in these patients....

FDG-PET status following chemoradiotherapy provides high management impact and powerful prognostic stratification in oesophageal cancer

International Nuclear Information System (INIS)

Duong, Cuong P.; Thomas, Robert J.S.; Hicks, Rodney J.; Drummond, Elizabeth; Weih, LeAnn; Leong, Trevor; Michael, Michael

2006-01-01

The purpose of this study was to evaluate the impact of FDG-PET following chemoradiotherapy (CRT) on treatment planning and survival in patients with oesophageal cancer (OC). Fifty-three consecutive OC patients had a post-treatment PET scan to evaluate tumour response to CRT prior to possible surgery. Baseline pre-CRT PET was performed in 33 patients. Prospectively recorded post-CRT management plans were compared with post-PET treatment. High impact was defined as a change in treatment intent or modality. Survival was analysed using the Kaplan-Meier product limit method and Cox proportional hazards regression model. After completion of CRT, 23/53 patients (43%) achieved complete metabolic response (CMR), as compared with only four (8%) with complete response on computed tomography. High PET impact was observed in 19 patients (36%). CMR was strongly predictive of survival (p<0.008) on multivariate analysis. CMR patients in whom resection was not performed had comparable survival to those (CMR and non-CMR) who underwent resection. The use of post-treatment FDG-PET for assessment of tumour response after CRT changed the clinical management of more than one-third of OC patients. CMR status as assessed by PET powerfully stratified prognosis. Even in the absence of a baseline study, normalisation of uptake at all sites of known tumoral involvement carries a good medium-term prognosis. (orig.)

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

Science.gov (United States)

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

2018-02-01

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

Impact of FDG PET on the management of TBC treatment. A pilot study

Energy Technology Data Exchange (ETDEWEB)

Sathekge, M. [Dept. of Nuclear Medicine, Univ. of Pretoria (South Africa); Maes, A. [Dept. of Nuclear Medicine, AZ Groeninge, Kortrijk (Belgium); Dept. of Morphology and Medical Imaging, Univ. Hospital Leuven (Belgium); Kgomo, M. [Dept. of Internal Medicine, Louis Pasture Hospital, Pretoria (South Africa); Stoltz, A. [Dept. of Infectious Diseases, Univ. of Pretoria (South Africa); Pottel, H. [Subfaculty of Medicine, Catholic Univ. Leuven, Campus Kortrijk (Belgium); Wiele, C. van de [Dept. of Nuclear Medicine, Univ. Hospital Ghent (Belgium)

2010-07-01

The aim of this study is to assess the potential impact of double-phase FDG PET versus routine staging in HIV-negative patients suffering from tuberculosis. Patients, methods: 16 consecutive patients suffering from tuberculosis underwent contrast-enhanced CT and double-phase FDG PET imaging (45 min, 120 min). Early (E) and delayed (D) SUVmax values were determined for all identified lesions and % change in SUV calculated ({delta}SUV). Results: Seven patients presented with lung lesions on PET as well as CT (mean SUVmaxE 8.2), mean SUVmaxD 11.1, (p = 0.002), {delta}SUV 35%. In two patients, lesions were judged as non-active on CT. In nine patients, 18 sites of LN involvement were identified on both early and delayed FDG PET images (mean SUVmaxE 6.3, mean SUVmaxD 7.9, (p = 0.0001), {delta}SUV: 25%). 9 out of 18 sites of LN involvement, occurring in five patients, were missed on CT. In four of these five patients, sites of LN involvement were the only sites of extra-pulmonary involvement identified. In 6 out of 16 patients, pleural involvement was identified, respectively in 5 on FDG PET and in 6 on CT imaging (mean SUVmaxE 1.3, mean SUVmaxD 1.7, (p = 0.06), {delta}SUV 21%). In 4 patients, osseous involvement was identified by both FDG PET and CT (mean SUVmaxE 7.2, mean SUVmaxD 10.7, (p = 0,06), {delta}SUV 45%). Finally, in 3 patients, joint involvement was identified on both FDG PET as well as on CT imaging (mean SUVmaxE 4.7, mean SUVmaxD 5.2, {delta}SUV 23%). FDG PET did not identify CT-additional sites of involvement that would have resulted in a prolonged treatment. Conclusion: In HIV-negative patients suffering from tuberculosis, FDG PET images suggested a more extensive involvement by Mycobacterium tuberculosis when compared to contrast enhanced CT. (orig.)

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-10-15

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

Clinical Application of {sup 18}F-FDG PET in Epilepsy

Energy Technology Data Exchange (ETDEWEB)

Kim, Yu Kyeong [Seoul National University College of Medicine, Seoul National University Bundang Hospital, Sungnam (Korea, Republic of)

2008-12-15

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

Granulomatous prostatitis after intravesical bacillus Calmette-Guérin instillation therapy: A potential cause of incidental F-18 FDG uptke in the prostate gland on F-18 FDG PET/CT in patients with bladder cancer

International Nuclear Information System (INIS)

Kim, Choon Young; Lee, Sang Woo; Choi, Seock Hwan; Son, Seung Hyun; Jung, Ji Hoon; Lee, Chang Hee; Jeong, Shin Young; Ahn, Byeong Cheol; Lee, Jae Tae

2016-01-01

This study aimed to evaluate the possibility that Bacillus Calmette-Guérin (BCG)-induced granulomatous prostatitis can be a potential cause of benign F-18 FDG uptake. A total of 395 bladder cancer patients who underwent F-18 FDG PET/CT (PET/CT) were retrospectively evaluated. Patients were divided into two groups according to BCG therapy status. Elapsed time after BCG therapy, serum PSA level, results of prostate biopsy, and the SUV max and uptake pattern in the prostate gland were reviewed. For patients who underwent follow-up PET/CT, the changes in SUV max were calculated. While 35 % of patients showed prostate uptake in the BCG therapy group, only 1 % showed prostate uptake in the non-BCG therapy group (p < 0.001). Among 49 patients with FDG-avid prostate lesions, none had suspected malignancy during the follow-up period (median: 16 months). Five patients revealed granulomatous prostatitis on biopsy. The incidence of FDG-avid prostate lesions was significantly higher if the elapsed time after BCG therapy was less than 1 year compared to more than 1 year (p < 0.001). Serum PSA was normal in 88 % of patients. All patients with incidental F-18 FDG uptake in the prostate gland showed focal or multifocal prostate uptake, and median SUV max was 4.7. In 16 patients who underwent follow-up PET/CT, SUV max was decreased in 14 patients (88 %) without treatment, and no patients demonstrated further increased prostate uptake (p < 0.001). BCG-induced granulomatous prostatitis can be a potential cause of benign F-18 FDG uptake, especially in those with a history of bladder cancer treated with BCG. In BCG-induced granulomatous prostatitis, focal or multifocal prostate uptake is frequently seen within 1 year after BCG therapy, and the intensity of prostate uptake is decreased on the follow-up PET/CT without any treatment

The value of [11C]-acetate PET and [18F]-FDG PET in hepatocellular carcinoma before and after treatment with transarterial chemoembolization and bevacizumab

International Nuclear Information System (INIS)

Li, Shuren; Ubl, Philipp; Wadsak, Wolfgang; Mitterhauser, Markus; Rainer, Eva; Haug, Alexander; Hacker, Marcus; Peck-Radosavljevic, Markus; Pinter, Matthias; Wang, Hao; Nanoff, Christian; Kaczirek, Klaus

2017-01-01

This prospective study was to investigate the value of [ 11 C]-acetate PET and [ 18 F]-FDG PET in the evaluation of hepatocellular carcinoma (HCC) before and after treatment with transarterial chemoembolization (TACE) and vascular endothelial growth factor (VEGF) antibody (bevacizumab). Twenty-two patients (three women, 19 men; 62 ± 8 years) with HCC verified by histopathology were treated with TACE and bevacizumab (n = 11) or placebo (n = 11). [ 11 C]-acetate PET and [ 18 F]-FDG PET were performed before and after TACE with bevacizumab or placebo. Comparisons between groups were performed with t-tests and Chi-squared tests, where appropriate. Overall survival (OS) was defined as the time from start of bevacizumab or placebo until the date of death/last follow-up, respectively. The patient-related sensitivity of [ 11 C]-acetate PET, [ 18 F]-FDG PET, and combined [ 11 C]-acetate and [ 18 F]-FDG PET was 68%, 45%, and 73%, respectively. There was a significantly higher rate of conversion from [ 11 C]-acetate positive lesions to negative lesions in patients treated with TACE and bevacizumab as compared with that in patients with TACE and placebo (p < 0.05). In patients with negative acetate PET, the mean OS in patients treated with TACE and bevacizumab was 259 ± 118 days and was markedly shorter as compared with that (668 ± 217 days) in patients treated with TACE and placebo (p < 0.05). In patients treated with TACE and placebo, there was significant difference in mean OS in patients with positive FDG PET as compared with that in patients with negative FDG PET (p < 0.05). The HCC lesions had different tracer avidities showing the heterogeneity of HCC. Our study suggests that combining [ 18 F]-FDG with [ 11 C]-acetate PET could be useful for the management of HCC patients and might also provide relevant prognostic and molecular heterogeneity information. (orig.)

The value of [11C]-acetate PET and [18F]-FDG PET in hepatocellular carcinoma before and after treatment with transarterial chemoembolization and bevacizumab.

Science.gov (United States)

Li, Shuren; Peck-Radosavljevic, Markus; Ubl, Philipp; Wadsak, Wolfgang; Mitterhauser, Markus; Rainer, Eva; Pinter, Matthias; Wang, Hao; Nanoff, Christian; Kaczirek, Klaus; Haug, Alexander; Hacker, Marcus

2017-09-01

This prospective study was to investigate the value of [ 11 C]-acetate PET and [ 18 F]-FDG PET in the evaluation of hepatocellular carcinoma (HCC) before and after treatment with transarterial chemoembolization (TACE) and vascular endothelial growth factor (VEGF) antibody (bevacizumab). Twenty-two patients (three women, 19 men; 62 ± 8 years) with HCC verified by histopathology were treated with TACE and bevacizumab (n = 11) or placebo (n = 11). [ 11 C]-acetate PET and [ 18 F]-FDG PET were performed before and after TACE with bevacizumab or placebo. Comparisons between groups were performed with t-tests and Chi-squared tests, where appropriate. Overall survival (OS) was defined as the time from start of bevacizumab or placebo until the date of death/last follow-up, respectively. The patient-related sensitivity of [ 11 C]-acetate PET, [ 18 F]-FDG PET, and combined [ 11 C]-acetate and [ 18 F]-FDG PET was 68%, 45%, and 73%, respectively. There was a significantly higher rate of conversion from [ 11 C]-acetate positive lesions to negative lesions in patients treated with TACE and bevacizumab as compared with that in patients with TACE and placebo (p < 0.05). In patients with negative acetate PET, the mean OS in patients treated with TACE and bevacizumab was 259 ± 118 days and was markedly shorter as compared with that (668 ± 217 days) in patients treated with TACE and placebo (p < 0.05). In patients treated with TACE and placebo, there was significant difference in mean OS in patients with positive FDG PET as compared with that in patients with negative FDG PET (p < 0.05). The HCC lesions had different tracer avidities showing the heterogeneity of HCC. Our study suggests that combining [ 18 F]-FDG with [ 11 C]-acetate PET could be useful for the management of HCC patients and might also provide relevant prognostic and molecular heterogeneity information.

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

Energy Technology Data Exchange (ETDEWEB)

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

2012-09-15

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

Correlation of pre-and post-induction chemotherapy 18-FDG PET findings with histopathology in patients with locally advanced non-small cell lung cancer

International Nuclear Information System (INIS)

Chan, Andrea M.; Berlangieri, Sam; Ngai, Michael W.

2009-01-01

Full text: Objective: To correlate 18F-FDG PET metabolic response to therapy with histopathology and survival, in patients with locally advanced (stage IIl) non-small cell lung carcinoma (NSCLC) receiving induction chemotherapy. Methods: A retrospective review of all patients with stage III NSCLC planned for induction chemotherapy and surgical resection, in whom pre- and post-chemotherapy FDG-PET at Austin Health between 2004 and 2007 was performed. The staging and positive nodal stations as determined by PET was compared to histopathological findings after resection. The tumour response on serial FDG PET was also compared to overall outcome. Results: 9 patients were included. There was a 100 % correlation between pre- or post- chemotherapy nodal staging and final histopathological nodal stage. Ninety percent of all positive nodal stations (9/10) seen on histopathology were correctly localised by pre- or post-chemotherapy FDG PET. Only one patient with a metastatic lymph node at nodal station 9 R could not be localised by prior PET studies. Of the patients in whom a down-staging in tumour status was observed on the postchemotherapy FDG-PET, 83% (5/6) of patients were still alive (follow-up range of 8 to 40 months) as compared with 33% (1/3 ) (follow-up range of 9-13 months) for non-responders. Conclusion: There is good correlation between pre- and/or post- chemotherapy FDG PET and final histopathology for the nodal staging of stage III NSCLC. There is an overall trend for those patients in whom PET resulted in a down-staging of tumour to have a longer survival.

Diagnostic accuracy of {sup 18}F-FDG-PET and PET/CT in patients with Ewing sarcoma family tumours: a systematic review and a meta-analysis

Energy Technology Data Exchange (ETDEWEB)

Treglia, Giorgio [Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Department of Bioimaging and Radiological Sciences, Rome (Italy); Institute of Nuclear Medicine, Positron Emission Tomography Centre, Catholic University of the Sacred Heart, Department of Bioimaging and Radiological Sciences, Rome (Italy); Salsano, Marco; Stefanelli, Antonella; Mattoli, Maria Vittoria; Giordano, Alessandro [Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Department of Bioimaging and Radiological Sciences, Rome (Italy); Bonomo, Lorenzo [Institute of Radiology, Catholic University of the Sacred Heart, Department of Bioimaging and Radiological Sciences, Rome (Italy)

2012-03-15

To systematically review and meta-analyse literature data on the diagnostic performance of fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) and positron emission tomography/computed tomography (PET/CT) in patients with Ewing sarcoma family tumours (ESFT). PubMed/MEDLINE, Embase and Scopus databases were searched for articles that evaluated FDG-PET and PET/CT in patients with ESFT from inception to 31 May 2011. Studies that fulfilled the three following criteria were included in the systematic review: FDG-PET or PET/CT performed in patients with ESFT; articles about the diagnostic accuracy of FDG-PET and PET/CT; sample size of at least 10 patients with ESFT were included. Studies in which there were sufficient data to reassess sensitivity and specificity of FDG-PET or PET/CT in ESFT were included in the meta-analysis, excluding duplicate publications. Finally, pooled sensitivity, pooled specificity and area under the receiver operating characteristic (ROC) curve of FDG-PET or PET/CT in ESFT were calculated. We found 13 studies comprising a total of 342 patients with ESFT. The main findings of the studies included are presented. The meta-analysis of five selected studies provided these results about FDG-PET and PET/CT in ESFT: pooled sensitivity: 96% (95% confidence interval [CI] 91-99%); pooled specificity: 92% (95% CI 87-96%); area under the ROC curve: 0.97. With regard to the staging and restaging of patients with ESFT, the sensitivity, specificity and accuracy of FDG-PET and PET/CT are high; the combination of FDG-PET or PET/CT with conventional imaging is a valuable tool for the staging and restaging of ESFT and has a relevant impact on the treatment strategy plan. (orig.)

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

International Nuclear Information System (INIS)

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

2010-01-01

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

Clinical value of FDG-PET/CT in suspected paraneoplastic syndromes: a retrospective analysis of 137 patients

Energy Technology Data Exchange (ETDEWEB)

Bjoern Kristensen, Stine; Hess, Soeren; Petersen, Henrik; Hoeilund-Carlsen, Poul Flemming [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark)

2015-12-15

Paraneoplastic syndromes (PNS) are relatively infrequent manifestations appearing before or after a cancer declares itself. Autoimmune mechanisms may be involved, but their cause and pathogenesis are often unknown. Due to disparity of symptoms, PNS remain a major diagnostic challenge. We examined the value of FDG-PET/CT for ruling in or out malignancy in a heterogeneous group of patients with suspected PNS. We retrospectively extracted data from all patients referred 2009-2013 with suspected PNS. Data included age, sex, follow-up period, scan report, further diagnostic procedures, and final clinical diagnosis. Conclusions of the scan reports were compared to the final follow-up outcome as determined during an average follow-up of 31 months (range 6-51.5) in patients who were not diagnosed with cancer in immediate continuation of a positive PET/CT scan. A total of 137 patients were included. Main causes for referral were neurological (n = 67), rheumatological (n = 25), dermatological (n = 18), nephrological (n = 6), haematological (n = 2), abnormal biochemistry (n = 11), and others (n = 8). The cancer prevalence was 8.8 %. The FDG-PET/CT results were as follows: nine true positives, 22 false positives, 103 true negatives, and three false negatives. Corresponding diagnostic values were: sensitivity 75 %, specificity 82 %, accuracy 82 %, and positive and negative predictive values of 29 % and 97 %, respectively. FDG-PET/CT has in patients with suspected PNS an impressively high negative predictive value and may be of value in ruling out PNS, the more so, the more the number of false positives can be minimized or used in differential diagnosis. We believe that FDG-PET/CT may become an important adjunct to the work-up and triage of patients with suspected PNS. (orig.)

The usefulness of F-18 FDG whole body PET in the evaluation of postoperative recurrence of cancer

International Nuclear Information System (INIS)

Kang, Won Jun; So, Young; Jeong, Jae Min

1997-01-01

The purpose of this study was to evaluate the usefulness of whole body F-18 FDG PET scan for detecting postoperative recurrence of cancer. One hundred four cancer patients after operation were enrolled (14 brain tumor, 15 head and neck cancer, 23 gynecologic cancer, 16 gastrointestinal cancer, 16 thyroid cancer, and 20 other cancers). Besides conventional images (CI) including CT and MRI, F-18 FDG PET scan was obtained on ECAT EXACT 47 scanner (Siemens- CTI), beginning 60 minutes after injection of 370MBq(10mCi) of F-18 FDG. Regional scan was also obtained with emission image. Transmission images using Ge-68 were carried out for attenuation correction in both whole body and regional images. Findings of PET and CI were confirmed by pathology or clinical follow up. The sensitivity and specificity of PET for detecting recurrence were 94% and 92%, respectively. Contrarily, the sensitivity and specificity of CI were 78% and 68%. CI results were negative and PET results were positive in 11 cases. The biopsy or clinical follow-up of those cases confirmed recurrence of tumor. False negative cases of CI were frequent in patients with gynecologic cancers. Also we measured the serum concentration of tumor markers in patients with gynecologic cancer (CA125), thyroid cancer (thyroglobulin), and colorectal cancer (CEA). The sensitivity and specificity of tumor markers were 71% and 84%, respectively. We conclude that F-18 FDG PET can be used valuably in detecting recurrent foci of a wide variety of malignancy compared to conventional diagnostic methods

Experience with PET FDG - Preliminary analysis

International Nuclear Information System (INIS)

Massardo, Teresa; Jofre, Josefina; Canessa, Jose; Gonzalez, Patricio; Humeres, Pamela; Sierralta, Paulina; Galaz, Rodrigo; Miranda, Karina

2004-01-01

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

Experience with PET FDG - Preliminary analysis

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Massardo, Teresa; Jofre, Josefina; Canessa, Jose; Gonzalez, Patricio; Humeres, Pamela; Sierralta, Paulina; Galaz, Rodrigo; Miranda, Karina [Centro PET de Imagenes Moleculares, Hospital Militar de Santiago, Santiago (Chile)

2004-01-01

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

FDG-PET/CT in the evaluation of anal carcinoma

International Nuclear Information System (INIS)

Cotter, Shane E.; Grigsby, Perry W.; Siegel, Barry A.

2006-01-01

Purpose: Surgical staging and treatment of anal carcinoma has been replaced by noninvasive staging studies and combined modality therapy. In this study, we compare computed tomography (CT) and physical examination to [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) in the staging of carcinoma of the anal canal, with special emphasis on determination of spread to inguinal lymph nodes. Methods and Materials: Between July 2003 and July 2005, 41 consecutive patients with biopsy-proved anal carcinoma underwent a complete staging evaluation including physical examination, CT, and 2-FDG-PET/CT. Patients ranged in age from 30 to 89 years. Nine men were HIV-positive. Treatment was with standard Nigro regimen. Results: [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) detected 91% of nonexcised primary tumors, whereas CT visualized 59%. FDG-PET/CT detected abnormal uptake in pelvic nodes of 5 patients with normal pelvic CT scans. FDG-PET/CT detected abnormal nodes in 20% of groins that were normal by CT, and in 23% without abnormality on physical examination. Furthermore, 17% of groins negative by both CT and physical examination showed abnormal uptake on FDG-PET/CT. HIV-positive patients had an increased frequency of PET-positive lymph nodes. Conclusion: [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography detects the primary tumor more often than CT. FDG-PET/CT detects substantially more abnormal inguinal lymph nodes than are identified by standard clinical staging with CT and physical examination

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

Institute of Scientific and Technical Information of China (English)

无

2007-01-01

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

F-18-FDG PET of the thyroid in Graves` disease; F-18-FDG-PET der Schilddruese bei Morbus Basedow

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Boerner, A.R.; Voth, E.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin, Koeln Univ. (Germany); Wienhard, K.; Wagner, R. [Max-Planck-Institut fuer Neurologische Forschung, Koeln (Germany)

1998-12-31

This study evaluates F-18-FDG PET of the thyroid in Graves` disease. Methods: Thirty patients were investigated the day before radioiodine therapy, 15 patients 3-10 days after radioiodine therapy. Twenty patients with cancer of the head or neck and normal thyroid function served as controls. Results: F-18-FDG uptake was higher in Graves` disease patients than in controls. Negative correlations of F-18-FDG uptake with half-life of radioiodine and absorbed radiation dose due to radioiodine therapy were found along with a positive correlation to autoantibody levels. Conclusion: Thus F-18-FDG PET is likely to give information on the biological activity of Graves` disease as well as on early radiation effects. (orig.) [Deutsch] Ziel: Diese Studie evaluiert F-18-Fluoro-Deoxy-Glukose (F-18-FDG) PET der Schilddruese bei Patienten mit M. Basedow. Methoden: 30 Patienten wurden am Tag vor Radioiod-Therapie, 15 Patienten am 3.-10. Tag nach Radioiodtherapie untersucht. 20 Patienten mit Kopf/Halstumoren und normaler Schilddruesenfunktion dienten als Kontrollgruppe. Ergebnisse: Die F-18-FDG-Aufnahme in der Schilddruese war signifikant hoeher bei Patienten mit M-Basedow im Vergleich zu den Kontrollen. Sie stieg mit hoeheren, antithyreoidalen Antikoerpern und sank bei laengerer I-131-Halbwertzeit. Es bestand eine Korrelation einer reduzierten Glukose-Utilisation bei hoeherer absorbierter Schilddruesendosis nach Radioiod-Therapie. Schlussfolgerung: Damit erscheint die F-18-FDG-PET-Untersuchung zur biologischen Aktivitaetsbeurteilung des M. Basedow und Darstellung von fruehen Strahleneffekten geeignet. (orig.)

Additional effects of FDG-PET to thin-section CT for the differential diagnosis of lung nodules. A Japanese multicenter clinical study

International Nuclear Information System (INIS)

Kubota, Kazuo; Murakami, Koji; Inoue, Tomio; Saga, Tsuneo; Shiomi, Susumu

2011-01-01

This study was a controlled multicenter clinical study on patients with peripheral lung nodules to verify the improvement in the diagnostic ability of fluorodeoxyglucose-positron emission tomography (FDG-PET) when used in combination with thin-section CT (TS-CT). Patients with peripheral lung nodules (long maximal diameter: 10-30 mm) detected using CT were examined using TS-CT and FDG-PET for the differential diagnosis of benign or malignant lesions. The primary endpoint was the specificity of the results using a combination of TS-CT and FDG-PET, compared with the results for TS-CT alone. Images were interpreted by investigators at each institution. Blind readings were also performed by an independent image interpretation committee. The gold standard was a pathological diagnosis determined using a surgical or biopsy specimen obtained after PET; and the patients in whom a pathological diagnosis could not be obtained were diagnosed based on a follow-up TS-CT performed more than 6 months later. Adverse reactions to FDG were also evaluated. The blind reading results for 82 lesions in 81 subjects eligible for analysis among the 90 subjects included in the study showed a specificity of 91.2% (31/34) (95% confidence interval (CI): 76.3-98.1) for TS-CT + PET, compared with a specificity of 67.6% (23/34) (95% CI: 49.5-82.6) for TS-CT alone. The specificity was significantly improved by the addition of the PET findings (p<0.05). The sensitivity improved from 89.6% (43/48) for TS-CT to 91.7% (44/48) for TS-CT + PET; the addition of PET increased the level of confidence in the diagnosis, but the difference was not significant. The results reported by the institutional investigators were not significantly different. No serious adverse reactions occurred, although two of the 90 subjects exhibited mild adverse reactions. The addition of FDG-PET to TS-CT for the differential diagnosis of benign or malignant peripheral lung nodules resulted in a significant improvement in

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

International Nuclear Information System (INIS)

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

2014-01-01

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

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

International Nuclear Information System (INIS)

Lee, Jeong Won; Lee, Sang Mi; Lee, Kyu Taek; Kim, Sung Young; Han, Sun Wook; Kim, Shin Young

2015-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-06-15

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

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

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

2017-03-15

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

F-18-FDG-PET Confined Radiotherapy of Locally Advanced NSCLC With Concomitant Chemotherapy: Results of the PET-PLAN Pilot Trial

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Fleckenstein, Jochen [Department of Radiotherapy and Radiation Oncology, Saarland University Medical School, Homburg (Germany); Hellwig, Dirk [Department of Nuclear Medicine, Saarland University Medical School, Homburg (Germany); Kremp, Stephanie [Department of Radiotherapy and Radiation Oncology, Saarland University Medical School, Homburg (Germany); Grgic, Aleksandar [Department of Nuclear Medicine, Saarland University Medical School, Homburg (Germany); Groeschel, Andreas [Department of Internal Medicine V, Saarland University Medical School, Homburg (Germany); Kirsch, Carl-Martin [Department of Nuclear Medicine, Saarland University Medical School, Homburg (Germany); Nestle, Ursula [Department of Nuclear Medicine, Saarland University Medical School, Homburg (Germany); Clinic for Radiotherapy, University Hospital, Freiburg (Germany); Ruebe, Christian, E-mail: christian.ruebe@uks.eu [Department of Radiotherapy and Radiation Oncology, Saarland University Medical School, Homburg (Germany)

2011-11-15

Purpose: The integration of fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) in the process of radiotherapy (RT) planning of locally advanced non-small-cell lung cancer (NSCLC) may improve diagnostic accuracy and minimize interobserver variability compared with target volume definition solely based on computed tomography. Furthermore, irradiating only FDG-PET-positive findings and omitting elective nodal regions may allow dose escalation by treating smaller volumes. The aim of this prospective pilot trial was to evaluate the therapeutic safety of FDG-PET-based RT treatment planning with an autocontour-derived delineation of the primary tumor. Methods and Materials: Eligible patients had Stages II-III inoperable NSCLC, and simultaneous, platinum-based radiochemotherapy was indicated. FDG-PET and computed tomography acquisitions in RT treatment planning position were coregistered. The clinical target volume (CTV) included the FDG-PET-defined primary tumor, which was autodelineated with a source-to-background algorithm, plus FDG-PET-positive lymph node stations. Limited by dose restrictions for normal tissues, prescribed total doses were in the range of 66.6 to 73.8 Gy. The primary endpoint was the rate of out-of-field isolated nodal recurrences (INR). Results: As per intent to treat, 32 patients received radiochemotherapy. In 15 of these patients, dose escalation above 66.6 Gy was achieved. No Grade 4 toxicities occurred. After a median follow-up time of 27.2 months, the estimated median survival time was 19.3 months. During the observation period, one INR was observed in 23 evaluable patients. Conclusions: FDG-PET-confined target volume definition in radiochemotherapy of NSCLC, based on a contrast-oriented source-to-background algorithm, was associated with a low risk of INR. It might provide improved tumor control because of dose escalation.

Incidental focal FDG uptake in the parotid glands on PET/CT in patients with head and neck malignancy

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Seo, Young Lan; Yoon, Dae Young; Lim, Kyoung Ja; Yun, Eun Joo; Cho, Young Kwon [Hallym University College of Medicine, Department of Radiology, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of); Baek, Sora [Hallym University College of Medicine, Department of Nuclear Medicine, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of); Bae, Woo Jin; Chung, Eun Jae; Kwon, Kee Hwan [Hallym University College of Medicine, Department of Otorhinolaryngology, Ilsong Memorial Institute of Head and Neck Cancer, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of)

2015-01-15

To evaluate the prevalence and clinical significance of focal parotid lesions identified by {sup 18} F- FDG PET/CT in patients with nonparotid head and neck malignancies. From 3,638 PET/CT examinations using {sup 18} F-FDG conducted on 1,342 patients with nonparotid head and neck malignancies, we retrospectively identified patients showing incidental focal FDG uptake in the parotid glands. The diagnosis of parotid lesions was confirmed histopathologically or on imaging follow-up. Patient demographics, clinical features, maximum standardized uptake value (SUV{sub max}) on PET images, size and attenuation on corresponding contrast-enhanced CT images were assessed and correlated with the final diagnosis. The prevalence of incidental focal parotid FDG uptake on PET/CT was 2.1 % (95 % CI 1.4 - 3.0 %). Among 21 patients with focal parotid lesions confirmed histologically or on imaging follow-up, 7 (33.3 %) had malignant lesions (all metastases) and 14 (66.7 %) had benign lesions (four pleomorphic adenomas, two Warthin's tumours, one benign lymph node, one granulomatous lesion, six lesions without histopathological confirmation). There were no significant differences in age, sex, SUV{sub max} or CT findings between patients with benign and those with malignant lesions. Focal parotid FDG uptake on PET/CT in patients with head and neck malignancy warrants further investigations to ensure adequate therapy for incidental parotid lesions. (orig.)

[18F]FDG-PET in large vessel vasculitis

International Nuclear Information System (INIS)

Hauser, A.S.D.; Walter, M.A.

2007-01-01

[ 18 F]FDG-PET is a non-invasive metabolic imaging modality based on the regional distribution of fluorine-18-fluorodeoxyglucose that is highly effective in assessing the activity and the extent of giant cell arteritis and Takayasu's arteritis. It has shown to identify more affected vascular regions than morphologic imaging with Magnetic Resonance Imaging in both diseases. A visual grading of vascular [ 18 F]FDG-uptake helps to discriminate arteritis from atherosclerosis und therefore provides high specificity. High sensitivity is reached by scanning during the active inflammatory phase. [ 18 F]FDG-PET has the potential to develop into a valuable tool in the diagnostic work-up of giant cell arteritis and Takayasu's arteritis, respectively, and might become a first-line investigation technique. Therefore consensus regarding the most favorable imaging procedure as well as further clinical evidence is needed. The purpose of this review is to summarize current information on the present clinical data and to assist nuclear medicine practitioners in recommending, performing and interpreting the results of [ 18 F]FDG-PET in patients with suspected large vessel vasculitis. (orig.)

Diagnostic accuracy of 201thallium-SPECT and 18F-FDG-PET in the clinical assessment of glioma recurrence

International Nuclear Information System (INIS)

Gomez-Rio, Manuel; Rodriguez-Fernandez, Antonio; Ramos-Font, Carlos; Lopez-Ramirez, Escarlata; Llamas-Elvira, Jose M.

2008-01-01

Reliable differential diagnosis between tumour recurrence and treatment-induced lesions is required to take advantage of new therapeutic approaches to recurrent gliomas. Structural imaging methods offer a high sensitivity but a low specificity, which might be improved by neurofunctional imaging. This study aimed to test the hypothesis that incorporation of 18-fluoro-deoxy-glucose positron emission tomography (FDG-PET) increases the accuracy of this differential diagnosis obtained with 201 Tl chloride-single-photon emission computed tomography ( 201 Tl-SPECT). Seventy-six patients (mean age 47.72 ± 16.19 years) under suspicion of glioma recurrence, 42% with low-grade and 58% with high-grade lesions, were studied by 201 Tl-SPECT and FDG-PET, reporting results under blinded conditions using visual analysis. Tumour was confirmed by histological confirmation (23 patients) or clinical and structural neuroimaging follow-up (mean of 2.6 years). This population had a high disease prevalence (72%). Globally, highest sensitivity was obtained using 201 Tl-SPECT assessed with MRI (96%) and highest specificity using FDG-PET + MRI (95%). FDG-PET appeared slightly better for confirming tumour recurrence, whereas 201 Tl-SPECT was superior for ruling out possible recurrence (disease present in 38% of FDG-PET negative explorations). In the high-grade subgroup, there were no false-positive examinations (specificity: 100%), but sensitivity differed among techniques ( 201 Tl-SPECT: 94%; 201 Tl-SPECT + MRI: 97%; FDG-PET + MRI: 83%). In the low-grade subgroup, 201 Tl-SPECT+ MRI showed highest sensitivity (95%) and lowest posttest negative probability (9%); FDG-PET + MRI offered highest specificity (92%) with a posttest negative probability of 35%. FDG-PET does not clearly improve the diagnostic accuracy of 201 Tl-SPECT, which appears to be a more appropriate examination for the diagnosis of possible brain tumour recurrence, especially for ruling it out. (orig.)

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

Institute of Scientific and Technical Information of China (English)

彭辽河; 丁久荣; 胡晓燕; 邱大胜; 李杰; 周静; 朱佳

2012-01-01

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

Incremental diagnostic utility of gastric distension FDG PET/CT

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

2016-04-15

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

Incremental diagnostic utility of gastric distension FDG PET/CT

International Nuclear Information System (INIS)

Le Roux, Pierre-Yves; Duong, Cuong P.; Cabalag, Carlos S.; Parameswaran, Bimal K.; Callahan, Jason; Hicks, Rodney J.

2016-01-01

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

Unusual Horner's syndrome in recurrent breast cancer: Evaluating using {sup 18}F-FDG PET/CT

Energy Technology Data Exchange (ETDEWEB)

Park, So Hyun; Kim, Tae Sung; Kim, Seok Ki [Dept. of Nuclear Medicine, National Cancer Center, Goyang (Korea, Republic of)

2017-03-15

{sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a widely used imaging modality in the initial diagnosis of cancer, treatment response evaluation and detection of recurrence. Herein, we present the case of a 39-year-old female who presented right ptosis on the follow-up of breast cancer after surgery. Clinicians suspected Horner's syndrome, and the patient underwent FDG PET/CT for the evaluation of recurrence that could cause Horner's syndrome. FDG PET/CT demonstrated a focal hypermetabolic lesion in the right cervicothoracic junction area, corresponding to the preganglionic cervical sympathetic trunk. A subsequent needle biopsy was done, and the lesion was confirmed as metastatic ductal carcinoma. In this case, we could detect the exact location of the recurring lesion that caused Horner's syndrome using FDG PET/CT.

The role of PET in staging work-up and evaluation after therapy in patients with malignant lymphoma

International Nuclear Information System (INIS)

Kang, Yoon Koo; Ryoo, Baek Yeol

1998-12-01

The stage of disease in patients with malignant lymphoma in important in decision of treatment modality and in prediction of prognosis. The authors evaluated the usefulness of PET with F18-FDG in initial staging, in reevaluation after radical therapy and in diagnosis of recurrence or disease progression of malignant lymphoma, compared with conventional imaging studies. The efficacy of positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (F18-FDG) was evaluated in several tumors. In malignant lymphoma. It was reported that the concentration of FDG was increased in tumor tissues, and that PET with F18-FDG was more sensitive and specific in staging evaluation compared with CT scan. The visual analysis of FDG-PET would be helpful in initial staging work-up, in reevaluation of residual disease after radical therapy and in suspicious recurrence or disease progression, determining the residual disease of lymphoma after radical therapy. But more studies with larger number of cases and longer follow-up were required. The results of this study can be bases for the direction of future studies for the usefulness of PET in malignant lymphoma

Accuracy of whole-body FDG-PET and FDG-PET/CT in M staging of nasopharyngeal carcinoma: A systematic review and meta-analysis

International Nuclear Information System (INIS)

Chang, Ming-Che; Chen, Jin-Hua; Liang, Ji-An; Yang, Kuang-Tao; Cheng, Kai-Yuan; Kao, Chia-Hung

2013-01-01

Background: A meta-analysis was conducted to evaluate the accuracy of whole-body positron emission tomography (PET) or PET/CT in M staging of nasopharyngeal carcinoma (NPC). Methods: Through a search of relevant English language studies from October 1996 to September 2011, pooled estimated sensitivity, specificity, positive likelihood ratios, negative likelihood ratios, and summary receiver operating characteristic (SROC) curves of whole-body PET or PET/CT in M staging of NPC were calculated. Results: Three PET and 5 PET/CT studies were identified. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of FDG-PET or PET/CT were 0.83 (95% confidence interval [CI], 0.77–0.88), 0.97 (95% CI, 0.95–0.98), 23.38 (95% CI, 16.22–33.69), and 0.19 (95% CI, 0.13–0.25), respectively. The area under curve was 0.9764 and Q* index estimate was 0.9307 for FDG-PET or PET/CT. Conclusion: Current evidence confirms the good diagnostic performance of the whole-body FDG-PET or PET/CT in M staging of NPC

The impact of FDG-PET/CT in the management of patients with vulvar and vaginal cancer.

Science.gov (United States)

Robertson, N L; Hricak, H; Sonoda, Y; Sosa, R E; Benz, M; Lyons, G; Abu-Rustum, N R; Sala, E; Vargas, H A

2016-03-01

To evaluate the changes in prognostic impression and patient management following PET/CT in patients with vulvar and vaginal carcinoma; and to compare PET/CT findings with those of conventional imaging modalities. We summarized prospectively and retrospectively collected data for 50 consecutive patients from our institution that enrolled in the National Oncologic PET Registry and underwent FDG-PET/CT for a suspected or known primary or recurrent vulvar/vaginal cancer. 54/83 (65%) studies included had a diagnosis of vulvar cancer, and the remaining 29/83 (35%), a diagnosis of vaginal cancer. Following FDG-PET/CT, the physician's prognostic impression changed in 51% of cases. A change in patient management, defined as a change to/from a non-interventional strategy (observation or additional imaging), to/from an interventional strategy (biopsy or treatment), was documented in 36% of studies. The electronic records demonstrated that 95% of the management strategies recorded in the physician questionnaires were implemented as planned. MRI and/or CT were performed within one month of the FDG-PET/CT in 20/83 (24%) and 28/83 (34%) cases, respectively. FDG-PET/CT detected nodes suspicious for metastases on 29/83 (35%) studies performed. MRI and CT detected positive nodes on 6 and 11 studies respectively. Distant metastases were identified in 10 cases imaged with FDG-PET and 5 cases that had additional conventional CT imaging. All suspicious lesions seen on CT were positively identified on PET/CT. In 4 cases, an abnormality identified on PET/CT, was not seen on diagnostic CT. FDG-PET/CT may play an important role in the management of vulvar and vaginal carcinoma. Copyright © 2015 Elsevier Inc. All rights reserved.

FDG-PET as a predictive biomarker for therapy with everolimus in metastatic renal cell cancer

International Nuclear Information System (INIS)

Chen, James L; Appelbaum, Daniel E; Kocherginsky, Masha; Cowey, Charles L; Kimryn Rathmell, Wendy; McDermott, David F; Stadler, Walter M

2013-01-01

The mTOR (mammalian target of rapamycin) inhibitor, everolimus, affects tumor growth by targeting cellular metabolic proliferation pathways and delays renal cell carcinoma (RCC) progression. Preclinical evidence suggests that baseline elevated tumor glucose metabolism as quantified by FDG-PET ([ 18 F] fluorodeoxy-glucose positron emission tomography) may predict antitumor activity. Metastatic RCC (mRCC) patients refractory to vascular endothelial growth factor (VEGF) pathway inhibition were treated with standard dose everolimus. FDG-PET scans were obtained at baseline and 2 weeks; serial computed tomography (CT) scans were obtained at baseline and every 8 weeks. Maximum standardized uptake value (SUVmax) of the most FDG avid lesion, average SUVmax of all measured lesions and their corresponding 2-week relative changes were examined for association with 8-week change in tumor size. A total of 63 patients were enrolled; 50 were evaluable for the primary endpoint of which 48 had both PET scans. Patient characteristics included the following: 36 (72%) clear cell histology and median age 59 (range: 37–80). Median pre- and 2-week treatment average SUVmax were 6.6 (1–17.9) and 4.2 (1–13.9), respectively. Response evaluation criteria in solid tumors (RECIST)-based measurements demonstrated an average change in tumor burden of 0.2% (−32.7% to 35.9%) at 8 weeks. Relative change in average SUVmax was the best predictor of change in tumor burden (all evaluable P = 0.01; clear cell subtype P = 0.02), with modest correlation. Baseline average SUVmax was correlated with overall survival and progression-free survival (PFS) (P = 0.023; 0.020), but not with change in tumor burden. Everolimus therapy decreased SUVs on follow-up PET scans in mRCC patients, but changes were only modestly correlated with changes in tumor size. Thus, clinical use of FDG-PET-based biomarkers is challenged by high variability. In this phase II trial, FDG-PET was explored as a predictive biomarker

Primary Hepatosplenic B-cell Lymphoma: Initial Diagnosis and Assessment of Therapeutic Response with F-18 FDG PET/CT

International Nuclear Information System (INIS)

Kang, Sung Min; Lee, Hong Je; Seo, Ji Hyoung; Lee, Sang Woo; Ahn, Byeong Cheol; Lee, Jae Tae

2008-01-01

A 52-year-old woman with a history of general weakness, fatigue, weight loss, elevated serum levels of liver transaminase enzyme for three months underwent an F-18 FDG PET/CT to evaluate a cause of the hepatosplenomegaly found on abdominal ultrasonography. Initial PET/CT revealed markedly enlarged liver and spleen with intense FDG uptake. Otherwise, there were no areas of abnormal FDG uptake in whole body image. Histological evaluation by a hepatic needle biopsy demonstrated diffuse large B cell type lymphoma and final diagnosis for this patient was hepatosplenic B-cell lymphoma. She received five cycles of CHOP chemotherapy, and second PET/CT was followed after then. Follow-up PET-CT revealed normal sized liver with disappearance of abnormal FDG uptake. Hepatosplenic B-cell lymphoma is relatively rare and mostly presents as single or multiple nodules. Diffuse type hepatosplenic lymphoma is extremely rare and poorly recognized entity. The diagnosis is very difficult and complicated by the presence of misleading symptoms.4 In this rare hepatosplenic B-cell lymphoma case, F-18 FDG PET/CT provided a initial diagnostic clue of hepatosplenic lymphoma and an accurate chemotherapy response

Primary Hepatosplenic B-cell Lymphoma: Initial Diagnosis and Assessment of Therapeutic Response with F-18 FDG PET/CT

Energy Technology Data Exchange (ETDEWEB)

Kang, Sung Min; Lee, Hong Je; Seo, Ji Hyoung; Lee, Sang Woo; Ahn, Byeong Cheol; Lee, Jae Tae [Kyungpook National University Hospital, Daegu (Korea, Republic of)

2008-08-15

A 52-year-old woman with a history of general weakness, fatigue, weight loss, elevated serum levels of liver transaminase enzyme for three months underwent an F-18 FDG PET/CT to evaluate a cause of the hepatosplenomegaly found on abdominal ultrasonography. Initial PET/CT revealed markedly enlarged liver and spleen with intense FDG uptake. Otherwise, there were no areas of abnormal FDG uptake in whole body image. Histological evaluation by a hepatic needle biopsy demonstrated diffuse large B cell type lymphoma and final diagnosis for this patient was hepatosplenic B-cell lymphoma. She received five cycles of CHOP chemotherapy, and second PET/CT was followed after then. Follow-up PET-CT revealed normal sized liver with disappearance of abnormal FDG uptake. Hepatosplenic B-cell lymphoma is relatively rare and mostly presents as single or multiple nodules. Diffuse type hepatosplenic lymphoma is extremely rare and poorly recognized entity. The diagnosis is very difficult and complicated by the presence of misleading symptoms.4 In this rare hepatosplenic B-cell lymphoma case, F-18 FDG PET/CT provided a initial diagnostic clue of hepatosplenic lymphoma and an accurate chemotherapy response.

Clinical impact of FDG-PET/CT on colorectal cancer staging and treatment strategy

DEFF Research Database (Denmark)

Petersen, Rasmus K; Hess, Søren; Alavi, Abass

2014-01-01

and patients divided as follows: (A) Patients with a change in therapy following FDG-PET/CT and (B) Patients without a change following FDG-PET/CT. Sixty-two patients had colon and five had rectal cancer. Of these, 20 (30%; CI 20.2-41.7) belonged to group A, whereas 47 (70%; CI 58.3-79.8) fell in group B......FDG-PET/CT is rarely used for initial staging of patients with colorectal cancer (CRC). Surgical resection of primary tumor and isolated metastases may result in long-term survival or presumed cure, whereas disseminated disease contraindicates operation. We analyzed a retrospective material...

18F-FDG PET/CT in the characterization and surgical decision concerning adrenal masses: a prospective multicentre evaluation

International Nuclear Information System (INIS)

Ansquer, Catherine; Scigliano, Sonia; Mirallie, Eric; Taieb, David; Brunaud, Laurent; Sebag, Frederic; Leux, Christophe; Drui, Delphine; Dupas, Benoit; Renaudin, Karine; Kraeber-Bodere, Francoise

2010-01-01

This prospective multicentre study assesses the usefulness of FDG PET/CT in characterizing and making the therapeutic decision concerning adrenal tumours that are suspicious or indeterminate in nature after conventional examinations (CE). Seventy-eight patients (37 men, 41 women, 81 adrenal lesions) underwent FDG PET/CT after CE including CT scan, biological tests and optionally 131 I-metaiodobenzylguanidine (MIBG) and/or 131 I-norcholesterol scans. FDG adrenal uptake exceeding that of the liver was considered positive. PET results were not decisive. Surgery was discussed when at least one of the following criteria was found during CE: size >3 cm, spontaneous attenuation value >10 HU, heterogeneous aspect, abnormal MIBG or norcholesterol scan or hormonal hypersecretion. Following the gold standard (histology analysis or ≥9 months follow-up), 49 lesions potentially qualified for surgery (malignant = 27, benign secreting = 22) and 32 benign non-secreting lesions did not. PET was negative in 97% of non-surgical lesions and positive in 73% of potentially surgical ones which included all the malignant lesions, except 3 renal cell metastases, and 12 of 22 benign secreting lesions. The negative predictive value for malignancy was 93% (41/44) and positive predictive value for detecting surgical lesions was 97% (36/37). A high FDG uptake (maximum standardized uptake value ≥ 10) was highly predictive of malignancy. Adrenal FDG uptake is a good indicator of malignancy and/or of secreting lesions and should lead one to discuss surgery. If there is no prior history of poorly FDG-avid cancer, the absence of FDG uptake should avoid unnecessary removal of benign adrenal lesions. (orig.)

Comparative benefits and limitations of 18F-FDG PET and CT-MRI in documented or suspected recurrent cervical cancer

International Nuclear Information System (INIS)

Yen, Tzu-Chen; Ma, Shih-Ya; Lai, Chyong-Huey; Huang, Kuan-Gen; Huang, Huei-Jean; Chang, Ting-Chang; Hong, Ji-Hong; Hsueh, Swei; Lin, Wuu-Jyh; Ng, Koon-Kwan

2006-01-01

The purpose of this study was to assess the comparative benefits and limitations of 18 F-fluorodeoxyglucose (FDG) PET and CT-MRI in documented or suspected recurrence of cervical cancer after primary treatment. Three patient groups were enrolled. Group A patients had biopsy-documented recurrent or persistent cervical cancer. Group B patients had suspicion of recurrent tumour on CT-MRI without biopsy proof and were potentially curable. Group C patients were in complete remission after previous definitive treatment for histologically confirmed cervical carcinoma but had elevated serum squamous cell carcinoma antigen (tumour marker) levels despite negative CT-MRI. Clinical management decisions were recorded with CT-MRI alone and with additional FDG PET. Discordances and concordances between CT-MRI and FDG PET results were identified and related to final diagnosis as based on histopathology or follow-up. A total of 150 patients (ten regions per patient) were eligible for analysis, with 58 in group A, 52 in group B and 40 in group C. For the 149 discordant regions, 126 (84.6%) had final diagnoses. Of these final diagnoses, there was additional benefit from FDG PET over CT-MRI in 73.8% (93/126), with FDG PET correcting false negatives (FNs) on CT-MRI in 74.2% (69/93) and correcting false positives (FPs) on CT-MRI in 25.8% (24/93). Among lesions confirmed by FDG PET, 75.4% (52/69) were extra-pelvic. There was additional benefit of CT-MRI compared with FDG PET in 26.2% (33/126): in nine (27.3%) CT-MRI results were shown to be true positive (TP) whereas FDG PET yielded FN results, while in 24 (72.7%) CT-MRI corrected FP results on FDG PET. Among the nine FNs on FDG PET that were identified by CT-MRI, four were extra-pelvic. Among the FPs on FDG PET that were excluded by CT-MRI, 79.2% (19/24) were extra-pelvic. For recurrent cervical cancer, the benefits of FDG PET exceed those of CT-MRI owing to the ability of FDG PET to identify extra-pelvic metastases and its higher

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

Directory of Open Access Journals (Sweden)

Percy eLee

2012-07-01

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

Solitary pulmonary nodules: accuracy and cost-effectiveness of sodium iodide FDG-PET using Australian data

International Nuclear Information System (INIS)

Keith, C.J.; Miles, K.A.; Griffiths, M.R.; Wong, D.; Pitman, A.G.; Hicks, R.J.

2002-01-01

This study uses Australian data to confirm the accuracy of dedicated sodium iodide (NaI) fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in evaluating indeterminate solitary pulmonary nodules (SPNs) and to determine the conditions under which PET could play a cost-effective role in this evaluation. Ninety-two patients from two Australian hospitals in different states underwent FDG-PET for evaluation of an SPN. Observed values for prior probability of malignancy and diagnostic accuracy of PET were applied to previously published decision tree models using published Australian health care costs. The accuracy of FDG-PET was 93% with a sensitivity of 92% and a specificity of 95%. The prior probability of malignancy (0.54), PET sensitivity and PET specificity indicated cost savings per patient of up to EUR 455 (A$ 774) based on a PET cost of EUR 706 (A$ 1,200). PET would remain cost-effective for levels of prior probability up to 0.8-0.9 and a PET cost of EUR 736-1,161 (A$ 1,252-A$ 1,974). It is concluded that NaI PET is accurate, cost saving and cost-effective for the characterisation of indeterminate pulmonary nodules in Australia. Comparison with previous reports from the United States confirms that FDG-PET can remain cost-effective despite population differences in medical costs, disease prevalence and PET diagnostic performance. (orig.)

Value of the dual phase 18F-FDG PET/CT with oral diuretic in the diagnosis of bladder cancer before therapy

International Nuclear Information System (INIS)

Li Hongsheng; Wu Hubing; Wang Qiaoyu; Han Yanjiang; Wang Quanshi

2014-01-01

Background: PET with 18 F-FDG has been considered of limited value for the detection of bladder cancer because of the urinary excretion of the tracer. Purpose: To investigate the clinical value of dual phase 18 F-FDG PET/CT with oral diuretic in the diagnosis of bladder cancer. Methods: 107 patients with suspected bladder cancer were enrolled in the present study from May, 2003 to May, 2012. Each patient underwent the whole body 18 F-FDG PET/CT scans routinely. After that, all patients received the forced diuresis by orally administration of furosemide (40 mg) and drinking a lot of water. Two hours later, after several times of urination, the patients underwent an additional delayed pelvic PET/CT scans. The intravesical radioactivity was compared between the routine and delayed the scans and the visualization of the tumor was evaluated. The diagnostic efficacy was determined based on the pathological examinations and the clinical following-up. Results: With the forced diuresis, intravesical 18 F-FDG activity decreased significantly in 96.3% of the patients. The lesions on the wall of urinary bladder were visualized clearly in the delayed PET images, which weren't seen in the rout/ne PET images. 18 F-FDG PET/CT was positive in 75 patients who all then received the operation. 69 patients were diagnosed pathologically to have the bladder cancer and 6 patients to have benign diseases. 18 F-FDG PET/CT was negative in another 32 patients. Four patients of them were then diagnosed to be bladder cancer. Another 28 patients were clinically followed up more than 6 months and none of them was found to have bladder cancer. The sensitivity, specificity and accuracy of the dual phase PET/CT imaging for diagnosing the bladder cancer were 94.5%(69/73), 82.4%(28/34) and 90.7%(97/107), respectively. Conclusion: The forced diuresis using oral furosemide can significantly reduce the intravesical radioactivity and improve the detectability of 18 F-FDG PET/CT for the bladder cancer

Appropriateness criteria of FDG PET/CT in oncology

International Nuclear Information System (INIS)

Agrawal, Archi; Rangarajan, Venkatesh

2015-01-01

18 Fluorine-2-fluoro-2-Deoxy-d-glucose ( 18 F-FDG) positron emission tomography/computerized tomography (PET/CT) is a well-established functional imaging method widely used in oncology. In this article, we have incorporated the various indications for 18 FDG PET/CT in oncology based on available evidence and current guidelines. Growing body of evidence for use of 18 FDG PET/CT in select tumors is also discussed. This article attempts to give the reader an overview of the appropriateness of using 18 F-FDG PET/CT in various malignancies

{sup 18}F-FDG PET/contrast enhanced CT in the standard surveillance of high risk colorectal cancer patients

Energy Technology Data Exchange (ETDEWEB)

Jiménez Londoño, Germán Andrés, E-mail: gjimenez91@yahoo.com [Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); García Vicente, Ana María [Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); Sánchez Pérez, Victoria [Department of Oncology, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); Jiménez Aragón, Fátima [Department of Radiology, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); León Martin, Alberto [Investigation Unit, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); Cano Cano, Juana María [Department of Oncology, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); Domínguez Ferreras, Esther [Department of Radiology, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); Gómez López, Ober Van [Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); Espinosa Arranz, Javier [Department of Oncology, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); Soriano Castrejón, Ángel María [Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain)

2014-12-15

Highlights: • We assessed the accuracy of FDG-PET/contrast enhanced CT (FDG-PET/ceCT) in the detection of unsuspected recurrence of colorectal cancer. In regard to our knowledge, no previous experience has been reported about the combined acquisition and interpretation of a FDG-PET/ceCT in the surveillance of colorectal cancer. • We designed a prospective study and performed an individual and combined assessment of both techniques (PET and ceCT), in a patient-based analysis and a lesion-based analysis. • The value of PET and ceCT was found to be similar in the detection of unsuspected recurrence of CRC in a patient-based analysis. The most interesting of our result, is that the combined assessment of PET/ceCT improves the accuracy in the lesion-based analysis. - Abstract: Objective: To assess the accuracy of FDG-PET/contrast enhanced CT (FDG-PET/ceCT) in the detection of unsuspected recurrence of colorectal cancer (CRC) in patients with high risk of relapse. Methods: Thirty-three patients (14 females and 19 males, mean age: 62, range: 41–78), with CRC in complete remission, were prospectively included. All patients underwent FDG-PET/ceCT (58 studies). FDG-PET/ceCT was requested in the surveillance setting, and performed following a standardized protocol. A portal venous phase CT scan was performed after the injection of iodinated contrast agent. An individual and combined assessment of both techniques (PET and ceCT) was performed. Concordant and discordant findings of PET, ceCT and FDG-PET/ceCT were compared in a patient-based and a lesion-based analysis. The final diagnosis, recurrence or disease free status (DFS), were established by histopathology or clinical/radiological follow-up of at least 6 months. Results: Seven out of 33 patients had a confirmed recurrence and the rest of patients had a DFS. In a patient-based analysis the sensitivity and specificity of PET, ceCT and PET/ceCT was of 86% and 88%, 86% and 92%, 86% and 85%, respectively. Attending to

Gamma camera based FDG PET in oncology

International Nuclear Information System (INIS)

Park, C. H.

2002-01-01

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

Carbon-11 choline or FDG-PET for staging of oesophageal cancer?

International Nuclear Information System (INIS)

Jager, P.L.; Que, T.H.; Vaalburg, W.; Pruim, J.; Elsinga, P.; Plukker, J.T.

2001-01-01

We investigated the feasibility of using carbon-11 choline (CHOL) positron emission tomography (PET) for the staging of oesophageal cancer, in comparison with fluorine-18 fluorodeoxyglucose (FDG) PET, using histopathological findings as the gold standard. Eighteen patients were studied: 16 patients with cancer of the oesophagus or gastro-oesophageal junction and two with in situ carcinoma/high-grade dysplasia. PET imaging was performed 5 min (CHOL) or 90 min (FDG) after injection of 370 MBq of the tracer. PET images were analysed by two independent and blinded physicians using visual and standardised uptake value (SUV) analysis. PET results were compared with surgical and histopathological findings. FDG-PET was able to detect all (100%) of the 16 malignant primary lesions, while CHOL-PET detected 73%. In situ carcinoma (n=1) and high-grade dysplasia (n=1) were not visualised with either tracer. Diffuse uptake of the tracers was noted in areas of Barrett's oesophagitis. Twelve patients had locoregional metastases (N1) that were not detected with either FDG or CHOL. Six patients had additional distant nodal (M1a) metastases; four of six (66%) were visualised by FDG, and three of five (60%) by CHOL-PET. On a lesion basis, FDG-PET detected 10/12 non-regional metastases (sensitivity 83%), while CHOL-PET detected 5/12 (sensitivity 42%). Haematogenous distant metastases (M1b) were positive on FDG-PET in three of four patients, and on CHOL-PET in two of four. SUV values were significantly higher for FDG (FDG 6.6±3.5, CHOL 5.5±2.5, P=0.04). CHOL-PET is able to visualise oesophageal carcinoma and its metastases, but appears to be inferior to FDG-PET. Presumably this is the result of lower tumoural uptake and considerable non-specific uptake of CHOL in liver, stomach wall, pancreas and small intestine. Further studies are needed to confirm these data. (orig.)

Carbon-11 choline or FDG-PET for staging of oesophageal cancer?

Energy Technology Data Exchange (ETDEWEB)

Jager, P.L.; Que, T.H.; Vaalburg, W.; Pruim, J.; Elsinga, P. [PET Centre, Groningen Univ. Hospital (Netherlands); Plukker, J.T. [Dept. of Surgical Oncology, Groningen University Hospital (Netherlands)

2001-12-01

We investigated the feasibility of using carbon-11 choline (CHOL) positron emission tomography (PET) for the staging of oesophageal cancer, in comparison with fluorine-18 fluorodeoxyglucose (FDG) PET, using histopathological findings as the gold standard. Eighteen patients were studied: 16 patients with cancer of the oesophagus or gastro-oesophageal junction and two with in situ carcinoma/high-grade dysplasia. PET imaging was performed 5 min (CHOL) or 90 min (FDG) after injection of 370 MBq of the tracer. PET images were analysed by two independent and blinded physicians using visual and standardised uptake value (SUV) analysis. PET results were compared with surgical and histopathological findings. FDG-PET was able to detect all (100%) of the 16 malignant primary lesions, while CHOL-PET detected 73%. In situ carcinoma (n=1) and high-grade dysplasia (n=1) were not visualised with either tracer. Diffuse uptake of the tracers was noted in areas of Barrett's oesophagitis. Twelve patients had locoregional metastases (N1) that were not detected with either FDG or CHOL. Six patients had additional distant nodal (M1a) metastases; four of six (66%) were visualised by FDG, and three of five (60%) by CHOL-PET. On a lesion basis, FDG-PET detected 10/12 non-regional metastases (sensitivity 83%), while CHOL-PET detected 5/12 (sensitivity 42%). Haematogenous distant metastases (M1b) were positive on FDG-PET in three of four patients, and on CHOL-PET in two of four. SUV values were significantly higher for FDG (FDG 6.6{+-}3.5, CHOL 5.5{+-}2.5, P=0.04). CHOL-PET is able to visualise oesophageal carcinoma and its metastases, but appears to be inferior to FDG-PET. Presumably this is the result of lower tumoural uptake and considerable non-specific uptake of CHOL in liver, stomach wall, pancreas and small intestine. Further studies are needed to confirm these data. (orig.)

FDG PET in the diagnosis of meningeal carcinomatosis

International Nuclear Information System (INIS)

Guan, Y. H.; Zuo, C.T.; Zhao, J.; Hua, F.C.; Lin, X.T.

2002-01-01

Objective: Meningeal involvement is frequent in metastatic lymphoma, leukemia, and other metastatic tumor. Functional signs may be misleading and the neurological examination may be normal or non-specific. Certain diagnosis requires identification of tumor cells in the cerebrospinal fluid. CSF cytology is however sometimes negative and MRI maybe help in providing the diagnosis. The aim of our retrospective study was to assess the role of FDG PET in the diagnosis of meningeal carcinomatosis. Patients and Methods: The diagnosis of meningeal carcinomatosis was made in 5 patients between 1999 and 2001. Two of the patients were suffer from lymphoma, two were lung cancer patients, and another was a breast cancer patient. Cytology examination of the cerebrospinal fluid provided the diagnosis of meningeal carcinomatosis in these 5 patients. All the patients had signs of neurological function impairment, but the neurological examination cannot demonstrate the site of lesions. Therefore, All the patients had MRI examination, but only 1 case was diagnosis correctly (the MRI showing meningeal enhancement). 3 patients' MRI results show normal .Another MRI was suspicious of ischemic change. Results: A brain FDG PET using an ECAT HR + PET examined all the 5 patients. All the FDG PET results show the hypermetabolic foci respectively. The foci were diffused on the brain meninges. Their size is bigger than the foci detected by MRI . 3 of the patients repeated the FDG PET scan after treatment (chemotherapy and radiotherapy). The therapeutic effect can be reflecting by FDG PET (the foci dismissed as the neurological symptoms disappeared), although the simultaneity MRI shows no change before and after treatment. Conclusion: 5 patients proven meningeal carcinomatosis FDG PET has better sensitivity than brain MRI scans and other anatomic modality. The patients who suffer from metastatic lymphoma, leukemia, and other metastatic tumor with nonspecific neurological signs should be explored

F-18 FDG PET/CT findings in a patient with bilateral orbital and gastric mucosa-associated lymphoid tissue lymphomas.

Science.gov (United States)

Suga, Kazuyoshi; Yasuhiko, Kawakami; Hiyama, Atsuto; Takeda, Koumei; Matsunaga, Naofumi

2009-09-01

Orbital mucosa-associated lymphoid tissue (MALT) lymphoma is an uncommon disease, while the incidence is recently increasing. We describe the F-18 fluorodeoxyglucose positron emission tomography computerized tomography (FDG PET/CT) findings in a case of bilateral orbital MALT lymphomas with a coexisting gastric lesion. Although only the lesion in the left orbit was initially identified on MR imaging, FDG PET/CT scan unexpectedly and additionally could identify the tiny lesion of the contralateral orbit and the gastric lesion. This patient received radiotherapy to all these lesions, with a combination of rituximab monoclonal antibody therapy. The follow-up PET/CT studies at 3, 6, and 9 months and 1.5 years after treatment showed regression or disappearance of all these FDG-avid lesions. Accurate localization and staging are crucial to select an adequate treatment in MALT lymphoma at any location. This case indicates the feasibility of FDG PET/CT scan for accurate localization and staging and also for monitoring treatment in patients with orbital MALT lymphoma.

Brain fluorodeoxyglucose positron emission tomography (¹⁸FDG PET) in patients with acute thallium intoxication.

Science.gov (United States)

Liu, C H; Lin, K J; Wang, H M; Kuo, H C; Chuang, W L; Weng, Y H; Shih, T S; Huang, C C

2013-03-01

Thallium toxicity induces cellular injury through impaired Na-K-ATPase activity. The aim of this study was to investigate functional imaging and the long-term clinical-imaging correlations of thallium toxicity. We measured thallium concentrations in blood, urine, stools, and hair of a 48-year-old woman and a 52-year-old man (patients 1 and 2) in the first 3 months after exposure to thallium containing water, and studied their neuropsychological functions. Using fluorodeoxyglucose positron emission tomography ((18)FDG PET) scans, we examined the brain involvement and correlated the image findings with the clinical presentations. On the 1st, 30th, and 61st days after exposure, the thallium concentrations in patient 1 were 2056, 311, and 7.5 μg/L in the blood, and 11400, 4570, and 36.4 μg/L in the urine. The concentrations in patient 2 were 956, 235, and 15.6 μg/L in the blood, and 11900, 2670, and 101 μg/L in the urine. On the 40th, 50th and 89th days after exposure, the thallium concentration in the stools were 21.6, 3.6, and 0.35 μg/g in patient 1, and 22.2, 3.2, and 0.37 μg/g in patient 2. Executive function, perceptual motor speed, and learning memory were initially abnormal but recovered particularly within the first year. The first (18)FDG PET studies of both patients disclosed a decreased uptake of glucose metabolism in the cingulate gyrus, bilateral frontal, and parietal lobes 2-5 months after exposure. The follow-up (18)FDG PET scan of patient 2 revealed a partial recovery. This study indicates that damage to the central nervous system after acute thallium poisoning may be reversible after a long-term follow-up. Brain (18)FDG PET demonstrated the brain involvement and was correlated with cognitive impairment.

Screening for distant metastases in head and neck cancer patients by chest CT or whole body FDG-PET: A prospective multicenter trial

International Nuclear Information System (INIS)

Senft, Asaf; Bree, Remco de; Hoekstra, Otto S.; Kuik, Dirk J.; Golding, Richard P.; Oyen, Wim J.G.; Pruim, Jan; Hoogen, Frank J. van den; Roodenburg, Jan L.N.; Leemans, C. Rene

2008-01-01

Background and purpose: The aim of the study was to define the added value of whole body FDG-PET in screening for distant metastases in patients with head and neck squamous cell carcinoma and risk factors. Materials and methods: In a multi-center prospective study between 1998 and 2003, 145 consecutive HNSCC patients with risk factors for distant metastases underwent chest CT and whole body FDG-PET for screening of distant metastases. The data of 92 evaluable patients who developed distant metastases or who had a follow-up of at least 12 months were analyzed. Besides their performance in clinical practice, the operational characteristics of PET and CT using ROC analyses were investigated. Results: Pretreatment screening identified distant metastases in 19 patients (21%). FDG-PET had a higher sensitivity (53% vs. 37%) and positive predictive value (80% vs. 75%) than CT. The combination of CT and FDG-PET had the highest sensitivity (63%). The ROC analyses of the five point ordinal scales revealed that the 'area under the curve' (AUC) of FDG-PET was significantly higher as compared to CT. Conclusion: In HNSCC patients with risk factors, pretreatment screening for distant metastases by chest CT is improved by FDG-PET

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

International Nuclear Information System (INIS)

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

1999-01-01

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

Risk-related 18F-FDG PET/CT and new diagnostic strategies in patients with solitary pulmonary nodule: the ITALIAN multicenter trial.

Science.gov (United States)

Spadafora, Marco; Pace, Leonardo; Evangelista, Laura; Mansi, Luigi; Del Prete, Francesco; Saladini, Giorgio; Miletto, Paolo; Fanti, Stefano; Del Vecchio, Silvana; Guerra, Luca; Pepe, Giovanna; Peluso, Giuseppina; Nicolai, Emanuele; Storto, Giovanni; Ferdeghini, Marco; Giordano, Alessandro; Farsad, Mohsen; Schillaci, Orazio; Gridelli, Cesare; Cuocolo, Alberto

2018-05-05

Diagnosis of solitary pulmonary nodule (SPN) is an important public health issue and 18 F-FDG PET/CT has proven to be more effective than CT alone. Pre-test risk stratification and clinical presentation of SPN could affect the diagnostic strategy. A relevant issue is whether thoracic segmental (s)-PET/CT could be implemented in patients with SPN. This retrospective multicenter study compared the results of FDG whole-body (wb)-PET/CT to those of s-PET/CT. 18 F-FDG PET/CT of 502 patients, stratified for pre-test cancer risk, were retrospectively analyzed. The thoracic part of wb-PET/CT, considered s-PET/CT, was compared to wb-PET/CT. Clinical and PET/CT variables were investigated for SPN characterization as well as for identification of patients in whom s-PET/CT could be performed. Histopathology or follow-up data were used as a reference. In the study population, 36% had malignant, 35% benign, and 29% indeterminate SPN. 18 F-FDG uptake indicative of thoracic and extra-thoracic lesions was detectable in 13% and 3% of the patients. All patients with extra-thoracic metastases (n = 13) had thoracic lymph node involvement and highest 18 F-FDG uptake at level of SPN (negative predictive value 100%). Compared to wb-PET/CT, s-PET/CT could save about 2/3 of 18 F-FDG dose, radiation exposure or scan-time, without affecting the clinical impact of PET/CT. Pre-test probability of malignancy can guide the diagnostic strategy of 18 FDG-PET/CT in patients with SPN. In subjects with low-intermediate pretest probability s-PET/CT imaging might be planned in advance, while in those at high risk and with thoracic lymph node involvement a wb-PET/CT is necessary.

The value of [{sup 11}C]-acetate PET and [{sup 18}F]-FDG PET in hepatocellular carcinoma before and after treatment with transarterial chemoembolization and bevacizumab

Energy Technology Data Exchange (ETDEWEB)

Li, Shuren; Ubl, Philipp; Wadsak, Wolfgang; Mitterhauser, Markus; Rainer, Eva; Haug, Alexander; Hacker, Marcus [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Vienna (Austria); Peck-Radosavljevic, Markus; Pinter, Matthias [Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna (Austria); Wang, Hao [Chinese Academy of Medical Sciences, Peking Union Medical College, Department of Nuclear Medicine, Peking Union Medical College Hospital, Beijing (China); Nanoff, Christian [Medical University of Vienna, Institute of Pharmacology, Vienna (Austria); Kaczirek, Klaus [Medical University of Vienna, Department of Surgery, Vienna (Austria)

2017-09-15

This prospective study was to investigate the value of [{sup 11}C]-acetate PET and [{sup 18}F]-FDG PET in the evaluation of hepatocellular carcinoma (HCC) before and after treatment with transarterial chemoembolization (TACE) and vascular endothelial growth factor (VEGF) antibody (bevacizumab). Twenty-two patients (three women, 19 men; 62 ± 8 years) with HCC verified by histopathology were treated with TACE and bevacizumab (n = 11) or placebo (n = 11). [{sup 11}C]-acetate PET and [{sup 18}F]-FDG PET were performed before and after TACE with bevacizumab or placebo. Comparisons between groups were performed with t-tests and Chi-squared tests, where appropriate. Overall survival (OS) was defined as the time from start of bevacizumab or placebo until the date of death/last follow-up, respectively. The patient-related sensitivity of [{sup 11}C]-acetate PET, [{sup 18}F]-FDG PET, and combined [{sup 11}C]-acetate and [{sup 18}F]-FDG PET was 68%, 45%, and 73%, respectively. There was a significantly higher rate of conversion from [{sup 11}C]-acetate positive lesions to negative lesions in patients treated with TACE and bevacizumab as compared with that in patients with TACE and placebo (p < 0.05). In patients with negative acetate PET, the mean OS in patients treated with TACE and bevacizumab was 259 ± 118 days and was markedly shorter as compared with that (668 ± 217 days) in patients treated with TACE and placebo (p < 0.05). In patients treated with TACE and placebo, there was significant difference in mean OS in patients with positive FDG PET as compared with that in patients with negative FDG PET (p < 0.05). The HCC lesions had different tracer avidities showing the heterogeneity of HCC. Our study suggests that combining [{sup 18}F]-FDG with [{sup 11}C]-acetate PET could be useful for the management of HCC patients and might also provide relevant prognostic and molecular heterogeneity information. (orig.)

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

International Nuclear Information System (INIS)

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

2003-01-01

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