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

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

2004-05-01

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

The distribution of FDG at PET examinations constitutes a relative mechanism: significant effects at activity quantification in patients with a high muscular uptake

International Nuclear Information System (INIS)

Lindholm, Henry; Johansson, Ove; Jacobsson, Hans; Jonsson, Cathrine

2012-01-01

At 18 F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) examinations a high tracer uptake of the skeletal muscles is sometimes encountered which can lead to reduced uptake in pathological lesions. This was evaluated in retrospect in patients being recalled for a repeat examination after reducing the muscular uptake. Ten patients with increased muscular tracer uptake were examined with FDG PET/CT on two occasions with a mean of 6 days. All patients showed at least one pathological lesion with increased tracer uptake. The muscular uptake was reduced at the second examination by informing the patient to refrain from physical activity together with pretreatment with diazepam. The maximum standardized uptake value (SUV max ) of the pathological lesion and SUV mean of certain skeletal muscles, liver, spleen, lungs, blood and certain bone marrow portions were calculated. In all patients, the muscular uptake was reduced to a normal level at visual evaluation as well as at comparison of SUVs with 25 consecutive clinical patients exhibiting a normal FDG distribution (p max increased from 2.4 to 3.7 (54 %) between the examinations (p max to the activity of any of the reference tissues/organs there was no significant difference between the studies. The distribution of FDG constitutes a relative mechanism. This must be especially considered at longitudinal examinations in the same patient at therapy evaluations. In examinations with a somehow distorted general distribution of the activity, it may be more relevant to relate the lesion activity to a reference tissue/organ than relying on SUV assessments. (orig.)

Maximum standard uptake value on pre-chemotherapeutic FDG-PET is a significant parameter for disease progression of newly diagnosed lymphoma

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Eo, Jae Seon; Lee, Won Woo; Chung, June Key; Lee, Myung Chul; Kim, Sang Eun

2005-01-01

F-18 FDG-PET is useful for detection and staging of lymphoma. We investigated the prognostic significance of maximum standard uptake (maxSUV) value of FDG-PET for newly diagnosed lymphoma patients before chemotherapy. Twenty-seven patients (male: female = 17: 10: age: 49±19 years) with newly diagnosed lymphoma were enrolled. Nine-teen patients suffered from B cell lymphoma, 6 Hodgkins disease and 2 T cell lymphoma. One patient was stage I, 9 stage II, 3 stage III, 1 stage IV and 13 others. All patients underwent FDG-PET before initiation of chemotherapy. MaxSUV values using lean body weight were obtained for main and largest lesion to represent maxSUV of the patients. The disease progression was defined as total change of the chemotherapeutic regimen or addition of new chemotherapeutic agent during follow up period. The observed period was 389±224 days. The value of maxSUV ranged from 3 to 18 (mean±SD = 10.6±4.4). The disease progressions occurred in 6 patients. Using Cox proportional-hazard regression analysis, maxSUV was identified as a significant parameter for the disease progression free survival (p=0.044). Kaplan-Meier survival curve analysis revealed that the group with higher maxSUV (=10.6, n=5) suffered from shorter disease progression free survival (median 299 days) than the group with lower maxSUV (<10.6, n = 22) (median 378 days, p=0.0146). We found that maxSUV on pre-chemotherapeutic F-18 FDG-PET for newly diagnosed lymphoma patients is a significant parameter for disease progression. Lymphoma patients can be stratified before initiation of chemotherapy in terms of disease progression by the value of maxSUV 10.6

Long-term follow-up of metabolic activity in human alveolar echinococcosis using FDG-PET

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Reuter, S.; Gruener, B.; Kern, P.; Buck, A.K.; Blumstein, N.; Reske, S.N.

2008-01-01

Aim: [ 18 F]fluoro-deoxyglucose positron-emission-tomography (FDG-PET) detects metabolic activity in alveolar echinococcosis (AE). The slow changes in metabolic and morphological characteristics require long-term follow-up of patients. This is the first study to evaluate metabolic activity over may years, hereby assessing the utility of FDG-PET for the evaluation of disease progression and response to treatment. Patients, methods: 15 patients received a follow-up FDG-PET combined with computed tomography (integrated PET/CT) with a median of 6.5 years after the first PET in 1999. Number and location of enhanced metabolic activity in the area of AE lesions was determined. Quantification of intensity of metabolic activity was assessed by calculation of mean standardized uptake values. Results: AE lesions in 11/15 patients had been metabolically inactive initially, but only two showed permanent inactivity over the course of 81 months. Interestingly, in two patients metabolic activity was newly detected after 80 and 82 months. Benzimidazole treatment was intermittently discontinued in seven cases. Persisting activity at FDG-PET demanded continued benzimidazole treatment in four patients. Neither treatment duration, lesional size, calcifications nor regressive changes correlated with metabolic activity. Conclusion: treatment responses are heterogeneous and vary from progressive disease despite treatment to long-term inactive disease with discontinued treatment. Lack of metabolic activity indicates suppressed parasite activity and is not equivalent to parasite death. However, metabolic activity may remain suppressed for years, allowing for temporary treatment discontinuation. Relapses are reliably detected with PET and restarting benzimidazole treatment prevents parasite expansion. (orig.)

Do TSH, FT3, and FT4 Impact BAT Visualization of Clinical FDG-PET/CT Images?

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Nishii, Ryuichi; Nagamachi, Shigeki; Mizutani, Youichi; Terada, Tamasa; Kiyohara, Syogo; Wakamatsu, Hideyuki; Fujita, Seigo; Higashi, Tatsuya; Yoshinaga, Keiichiro; Saga, Tsuneo; Hirai, Toshinori

2018-01-01

We retrospectively analyzed activated BAT visualization on FDG-PET/CT in patients with various conditions and TH levels to clarify the relationships between visualization of BAT on FDG-PET/CT and the effect of TH. Patients who underwent clinical FDG-PET/CT were reviewed and we categorized patients into 5 groups: (i) thyroid hormone withdrawal (THW) group; (ii) recombinant human thyrotropin (rhTSH) group; (iii) hypothyroidism group; (iv) hyperthyroidism group; and (v) BAT group. A total of sixty-two FDG-PET/CT imaging studies in fifty-nine patients were performed. To compare each group, gender; age; body weight; serum TSH, FT3, and FT4 levels; and outside temperature were evaluated. No significant visualization of BAT was noted in any of the images in the THW, rhTSH, hypothyroidism, and hyperthyroidism groups. All patients in the BAT group were in a euthyroid state. When the BAT-negative and BAT-positive patient groups were compared, it was noted that the minimum and maximum temperature on the day of the PET study and maximum temperature of the one day before the PET study were significantly lower in BAT-positive group than in all those of other groups. Elevated TSH condition before RIT, hyperthyroidism, or hypothyroidism did not significantly impact BAT visualization of clinical FDG-PET/CT images.

Quality control of residual solvents in [18F]FDG preparations by gas chromatography

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Lee, Hak Jeong; Jeong, Jae Min; Lee, Yun Sang; Kim, Hyung Woo; Chang, Young Soo; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul

2007-01-01

Analysis of volatile organic solvents in 2-deoxy-2[ 18 F] fluoro-D-glucose ([ 18 F]FDG) preparations was performed by gas chromatography (GC), in accordance with USP. Analyses were carried out on a Hewlett-Packard 6890 gas chromatography equipped with an FID. We determined the amounts of ethanol and acetonitrile on every batch of our routine [ 18 F]FDG preparations, ranging between 5000 ppm and 100 ppm. In our routine preparation of [ 18 F]FDG, the amount of acetonitrile and ethanol in the final product were well below the maximum allowable limit described in the USP. Our [ 18 F]FDG preparations were in accordance with the suggested USP maximum allowable levels of the quality control analysis of volatile organic compounds

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

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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

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

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

2014-03-01

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

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

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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

Do TSH, FT3, and FT4 Impact BAT Visualization of Clinical FDG-PET/CT Images?

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Ryuichi Nishii

2018-01-01

Full Text Available Objective. We retrospectively analyzed activated BAT visualization on FDG-PET/CT in patients with various conditions and TH levels to clarify the relationships between visualization of BAT on FDG-PET/CT and the effect of TH. Methods. Patients who underwent clinical FDG-PET/CT were reviewed and we categorized patients into 5 groups: (i thyroid hormone withdrawal (THW group; (ii recombinant human thyrotropin (rhTSH group; (iii hypothyroidism group; (iv hyperthyroidism group; and (v BAT group. A total of sixty-two FDG-PET/CT imaging studies in fifty-nine patients were performed. To compare each group, gender; age; body weight; serum TSH, FT3, and FT4 levels; and outside temperature were evaluated. Results. No significant visualization of BAT was noted in any of the images in the THW, rhTSH, hypothyroidism, and hyperthyroidism groups. All patients in the BAT group were in a euthyroid state. When the BAT-negative and BAT-positive patient groups were compared, it was noted that the minimum and maximum temperature on the day of the PET study and maximum temperature of the one day before the PET study were significantly lower in BAT-positive group than in all those of other groups. Conclusions. Elevated TSH condition before RIT, hyperthyroidism, or hypothyroidism did not significantly impact BAT visualization of clinical FDG-PET/CT images.

Characterization of brown adipose tissue 18F-FDG uptake in PET/CT imaging and its influencing factors in the Chinese population

International Nuclear Information System (INIS)

Shao, Xiaonan; Shao, Xiaoliang; Wang, Xiaosong; Wang, Yuetao

2016-01-01

18 F-FDG PET/CT has been widely applied for tumor imaging. However, it is reported that many normal tissues, e.g., brown adipose tissue, can also uptake 18 F-FDG. The purpose of this study was to determine the imaging characteristics of 18 F-FDG uptake in brown adipose tissue (BAT) in PET/CT. A total of 2,944 patients who underwent PET/CT from September 2011 to March 2013 were analyzed retrospectively. Imaging features of 18 F-FDG uptake in BAT were analyzed. Univariate analysis and logistic regression analysis were performed to evaluate the effect of age, gender, cancer status, body mass index (BMI), average daily maximum temperature of imaging month and fasting plasma glucose (Glu) on the positive rate of 18 F-FDG uptake in BAT. The results showed that 1.9% (57/2944) patients had 18 F-FDG uptake in BAT. 18 F-FDG, manifested as flaky, nodular and beaded shape, was symmetrically distributed in the adipose tissues of cervical and supraclavicular, mediastinal, paravertebral, and perirenal areas. Uptake of 18 F-FDG within cervical/supraclavicular area was most common (89.5%, 51/57) with an SUV max ranging from 2.8 to 31.4. Univariate analysis showed that gender and cancer status were not significantly correlated with the BAT 18 F-FDG uptake rate. In contrast, age, BMI, Glu and average daily maximum temperature in the imaging month were significantly correlated with the BAT 18 F-FDG uptake rate (P < 0.05). Further logistic regression analysis showed that only age, BMI and average daily maximum temperature were significant (OR < 1, P < 0.05). Based on the value of OR, the most significant factor that affects BAT 18 F-FDG uptake rate was age, followed by the average daily maximum temperature and BMI. We concluded that Chinese adult has low positive rate of 18 F-FDG uptake in BAT. Cervical/Supraclavicular is the most common area with BAT 18 F-FDG uptake. Age, average daily maximum temperature and BMI are independent factors affecting 18 F-FDG uptake.

Significance of FDG-PET in Identification of Diseases of the Appendix – Based on Experience of Two Cases Falsely Positive for FDG Accumulation

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Shimpei Ogawa

2009-04-01

Full Text Available A discussion of the significance of F-fluorodeoxyglucose positron emission tomography (FDG-PET in the identification of diseases of the appendix is presented based on two cases falsely positive for FDG accumulation. Both cases were palpable for a tumor in the lower right abdominal region and a prominently enlarged appendix was depicted by CT. Although the patients underwent ileocecal resection based on a strong suspicion of appendiceal cancer rather than appendicitis since abnormal accumulation exhibiting maximum standard uptake values (SUVs of 7.27 and 17.11, respectively, was observed at the same site in FDG-PET examination and since there no malignant findings observed histologically, the patients were diagnosed with appendicitis. Although FDG specifically accumulates not only in malignant tumors, but also in diseases such as acute or chronic inflammation, abscesses and lymphadenitis, and identification based on SUVs has been reported to be used as a method of identification, the two cases reported here were both false-positive cases exhibiting high maximum SUVs. At the present time, although the significance of FDG-PET in the identification of diseases of the appendix is somewhat low and there are limitations on its application, various research is currently being conducted with the aim of improving diagnostic accuracy, and it is hoped that additional studies will be conducted in the future.

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

International Nuclear Information System (INIS)

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

2008-01-01

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

Regional cerebral glucose metabolism associated with ataxic gait. An FDG-PET activation study in patients with olivo-pontocerebellar atrophy

International Nuclear Information System (INIS)

Mishina, Masahiro; Ohyama, Masashi; Kitamura, Shin; Terashi, Akirou; Senda, Michio; Ishii, Kenji.

1995-01-01

In 7 patients with olivo-pontocerebellar atrophy (OPCA), regional cerebral glucose metabolism was evaluated using 18 F-FDG PET under two different conditions; 30 minutes' treadmill walking, and supine resting. The two sets of PET images were three-dimensionally registered to the MRI. Then, the PET images were normalized by the global value. Regions of interest (ROIs) were drawn on the cerebellar vermis, cerebellar hemispheres, pons, and thalamus, and FDG uptake was obtained to calculate the activation ratio (=[FDG uptake under walking]/ [FDG uptake under resting]) for each region. Normalized resting FDG uptake had no significant difference between controls and OPCA patients in any region. Activation ratio of OPCA patients was significantly decreased in the cerebellar vermis compared with the controls. In the controls, FDG uptake had little difference between resting and walking in the cerebellar hemisphere, pons and thalamus. On the other hand, the FDG uptake of OPCA patients was moderately increased by walking in these regions. The reduction of activation ratio in the cerebellar vermis reflects the dysfunction caused by degeneration. The result suggests that the PET activation study can demonstrate cerebellar dysfunction in the early phase of OPCA, in which other neuro-imaging methods cannot detect the tissue atrophy, hypometabolism or hypoperfusion in the resting state. In the cerebellar hemisphere, pons and thalamus, the activation ratio was nearly equal to one in control subjects, while it was larger in OPCA patients. The instability during the ataxic gait increases the inputs from the vestibular, somatosensory and visual systems to these regions and outputs from these regions to the other neural systems. In conclusion, PET activation study is a useful and noninvasive technique for investigating the brain function associated with human gait. (H.O.)

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

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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.

FDG-PET imaging for chronic expanding hematoma in pelvis with massive bone destruction

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Hamada, Kenichiro [Osaka University Graduate School of Medicine, Department of Nuclear Medicine and Tracer Kinetics, Suita, Osaka (Japan); Osaka University Graduate School of Medicine, Department of Orthopaedic Surgery, Suita, Osaka (Japan); Myoui, Akira; Ueda, Takafumi; Tamai, Noriyuki; Yoshikawa, Hideki [Osaka University Graduate School of Medicine, Department of Orthopaedic Surgery, Suita, Osaka (Japan); Higuchi, Ichiro; Hatazawa, Jun [Osaka University Graduate School of Medicine, Department of Nuclear Medicine and Tracer Kinetics, Suita, Osaka (Japan); Inoue, Atsuo [Osaka University Graduate School of Medicine, Department of Radiology, Suita, Osaka (Japan)

2005-12-01

Chronic expanding hematoma is a rare presentation of a hematoma characterized by a persistent increase in size for more than a month after the initial hemorrhage. We present a 65-year-old man with a chronic expanding hematoma in his ilium who was receiving anticoagulant treatment. The patient had a delayed manifestation of a femoral neuropathy with massive bone destruction. 2-Deoxy-[{sup 18}F]fluoro-d-glucose (FDG) positron emission tomography (PET) imaging revealed an increased uptake in the rim of the mass in images acquired 1 h after FDG injection. FDG-PET scans were performed using a dedicated PET scanner (HeadtomeV/SET2400 W, Shimadzu, Kyoto, Japan), and the PET data for the most metabolically active region of interest (ROI) were analyzed. The maximum standardized uptake value (SUVmax) was set to a cut-off point of 3.0 to distinguish between benign and malignant lesions. The SUVmax of the patient's lesion was 3.10, suggesting a malignant lesion. The characteristics of FDG-PET images of chronic expanding hematomas, including the uptake of FDG in the peripheral rim of the mass as a result of inflammation, should be recognized as a potential interpretive pitfall in mimicking a sarcoma. (orig.)

Patterns of FDG uptake in stomach on F-18 FDG positron emission tomography: correlation with endoscopic findings

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Chae, Min Jeong; Cheon, Gi Jeong; Lee, Sang Woo; Byun, Byung Hyun; Kim, Sung Eun; Kim, Yu Chul; Choi, Chang Woon; Lim, Sang Moo [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

2005-10-15

We often find variable degrees of FDG uptake and patterns in stomach, which can make difficult to distinguish physiologic uptake from pathologic uptake on FDG PET. The purpose of this study was to find out the significant findings of stomach on FDG PET. Thirty-eight patients who underwent both FDG PET and endoscopy within one week from Jun. 2003, to Aug. 2004 were included in this study. We reviewed 38 patients (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. Two nuclear physicians evaluated five parameters on FDG PET findings of stomach with a consensus: 1) visual grades 2) maximum SUV (max.SUV) 3) focal 4) diffuse and 5) asymmetric patterns. We correlated the lesions of FDG PET findings of stomach with those of endoscopy. We considered more than equivocal findings on FDG PET as positive. The six of 38 patients were proven as malignant lesions by endoscopic biopsy and others were inflammatory lesions (ulcer in 3, chronic atrophic gastritis in 12, uncommon forms of gastritis in 5), non-inflammatory lesions (n=3), and normal stomach (n=9). By the visual analysis, malignant lesions had higher FDG uptake than the others. The max.SUV of malignant lesions 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 atrophic gastritis, 3.2 {+-} 1.49 in uncommon forms of gastritis ( {rho} =0.044). In the appearance of stomach on FDG PET, malignant lesions were shown focal (5 of 6) and benign inflammatory lesions were shown diffuse (9 of 20) and asymmetric (14 of 20). Benign lesions and normal stomach were shown variable degrees of uptake and patterns. Some cases of benign inflammatory lesions such as ulcer and gastritis were shown focal and mimicked cancerous lesions (4 of 15). Gastric malignant lesions had higher FDG uptake and focal pattern

Patterns of FDG uptake in stomach on F-18 FDG positron emission tomography: correlation with endoscopic findings

International Nuclear Information System (INIS)

Chae, Min Jeong; Cheon, Gi Jeong; Lee, Sang Woo; Byun, Byung Hyun; Kim, Sung Eun; Kim, Yu Chul; Choi, Chang Woon; Lim, Sang Moo

2005-01-01

We often find variable degrees of FDG uptake and patterns in stomach, which can make difficult to distinguish physiologic uptake from pathologic uptake on FDG PET. The purpose of this study was to find out the significant findings of stomach on FDG PET. Thirty-eight patients who underwent both FDG PET and endoscopy within one week from Jun. 2003, to Aug. 2004 were included in this study. We reviewed 38 patients (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. Two nuclear physicians evaluated five parameters on FDG PET findings of stomach with a consensus: 1) visual grades 2) maximum SUV (max.SUV) 3) focal 4) diffuse and 5) asymmetric patterns. We correlated the lesions of FDG PET findings of stomach with those of endoscopy. We considered more than equivocal findings on FDG PET as positive. The six of 38 patients were proven as malignant lesions by endoscopic biopsy and others were inflammatory lesions (ulcer in 3, chronic atrophic gastritis in 12, uncommon forms of gastritis in 5), non-inflammatory lesions (n=3), and normal stomach (n=9). By the visual analysis, malignant lesions had higher FDG uptake than the others. The max.SUV of malignant lesions 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 atrophic gastritis, 3.2 ± 1.49 in uncommon forms of gastritis ( ρ =0.044). In the appearance of stomach on FDG PET, malignant lesions were shown focal (5 of 6) and benign inflammatory lesions were shown diffuse (9 of 20) and asymmetric (14 of 20). Benign lesions and normal stomach were shown variable degrees of uptake and patterns. Some cases of benign inflammatory lesions such as ulcer and gastritis were shown focal and mimicked cancerous lesions (4 of 15). Gastric malignant lesions had higher FDG uptake and focal pattern. However, benign

A novel description of FDG excretion in the renal system: application to metformin-treated models

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Garbarino, S.; Caviglia, G.; Sambuceti, G.; Benvenuto, F.; Piana, M.

2014-05-01

This paper introduces a novel compartmental model describing the excretion of 18F-fluoro-deoxyglucose (FDG) in the renal system and a numerical method based on the maximum likelihood for its reduction. This approach accounts for variations in FDG concentration due to water re-absorption in renal tubules and the increase of the bladder’s volume during the FDG excretion process. From the computational viewpoint, the reconstruction of the tracer kinetic parameters is obtained by solving the maximum likelihood problem iteratively, using a non-stationary, steepest descent approach that explicitly accounts for the Poisson nature of nuclear medicine data. The reliability of the method is validated against two sets of synthetic data realized according to realistic conditions. Finally we applied this model to describe FDG excretion in the case of animal models treated with metformin. In particular we show that our approach allows the quantitative estimation of the reduction of FDG de-phosphorylation induced by metformin.

A novel description of FDG excretion in the renal system: application to metformin-treated models

International Nuclear Information System (INIS)

Garbarino, S; Caviglia, G; Piana, M; Sambuceti, G; Benvenuto, F

2014-01-01

This paper introduces a novel compartmental model describing the excretion of 18F-fluoro-deoxyglucose (FDG) in the renal system and a numerical method based on the maximum likelihood for its reduction. This approach accounts for variations in FDG concentration due to water re-absorption in renal tubules and the increase of the bladder’s volume during the FDG excretion process. From the computational viewpoint, the reconstruction of the tracer kinetic parameters is obtained by solving the maximum likelihood problem iteratively, using a non-stationary, steepest descent approach that explicitly accounts for the Poisson nature of nuclear medicine data. The reliability of the method is validated against two sets of synthetic data realized according to realistic conditions. Finally we applied this model to describe FDG excretion in the case of animal models treated with metformin. In particular we show that our approach allows the quantitative estimation of the reduction of FDG de-phosphorylation induced by metformin. (paper)

Simple pulmonary eosinophilia evaluated by means of FDG PET: the findings of 14 cases

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Kim, Tae Jung; Lee, Kyung Won [Seoul National University Bundang Hospital, Bundang (Korea, Republic of); Kim, Hyae Young; Lee, Joo Hyuk; Kim, Eun A; Kim, Seok Ki; Kang, Keon Wook [National Cancer Center, Seoul (Korea, Republic of)

2005-12-15

We wanted to describe the findings of simple pulmonary eosinophilia with using 18 fluorodeoxyglucose (FDG) positron emission tomography (PET). We analysed the findings of 14 patients who underwent thoracic computed tomography (CT) and PET, and then they were subsequently proven to have simple pulmonary eosinophilia. PET studies were performed in four patients with malignancy to evaluate for cancer metastasis, and PET scans were also done in 10 healthy subjects who underwent volunteer cancer screening. The PET scans were evaluated by using the maximum standardized uptake values (SUVs). The subjects' CT findings also were reviewed and correlated with the PET findings. A total of 42 nodules were detected on the CT scans. There were single nodules in three patients and multiple nodules in 11 patients (mean number of nodules: 3, range: 1-10, mean diameter: 9.5 mm {+-} 4.7). Twelve of 42 (28.6%) nodules showed FDG uptake and their mean maximum SUV was 2.5 {+-} 1.6 (range: 0.6-5.3). Five of six solid nodules showed FDG uptake (2.2 {+-} 1.1, range: 0.9-3.6), six of 11 semisolid nodules showed FDG uptake (3.1 {+-} 1.8, range: 0.6-5.3) and one of 25 pure ground-glass opacity nodule showed a maximum SUV of 0.8. The maximum SUVs of seven nodules in five patients were greater than 2.5. The maximum SUVs were significantly different according to the nodule types ({rho} < 0.001). Simple pulmonary eosinophilia commonly causes an increase in FDG uptake. Therefore, correlation of the PET findings with the CT findings or the peripheral eosinophil counts can help physicians arrive at the correct diagnosis of simple pulmonary eosinophilia.

Physiological FDG uptake in the palatine tonsils

International Nuclear Information System (INIS)

Kawabe, Joji; Okamura, Terue; Shakudo, Miyuki

2001-01-01

In clinical F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) studies of the head and neck region, remarkable symmetric tonsillar FDG uptake is sometimes observed. We determined the incidence and degree of tonsillar FDG uptake and investigated the significance of tonsillar FDG uptake. Between June 1998 and August 1998, we obtained informed consent from 17 patients who were scheduled to undergo a FDG-PET study for their own disease (11 men and 6 women; aged 22 to 77 yr) and who did not have head and neck disease to perform FDG-PET scanning of the head and neck region in addition to their target organs. The incidence and degree of tonsillar FDG uptake were determined. Remarkable tonsillar FDG uptake was found in 9 patients. The SUVs of these FDG uptakes ranged from 2.48 to 6.75, with a mean of 4.29±1.20 (SD). Tonsillar FDG uptakes in the remaining 8 patients were not remarkable, and their SUVs ranged from 1.93 to 3.31, with a mean of 2.46±0.45. Head and neck disease does not appear to have been responsible for the increase in tonsillar FDG uptake. Differences among tonsillar FDG uptake in these 17 patients without head and neck disease appear to reflect differences in activity of ''physiological'' inflammation of the palatine tonsils. (author)

Effect of MRI Acoustic Noise on Cerebral FDG Uptake in Simultaneous MR-PET Imaging

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Abolmaali, Nasreddin; Arabasz, Grae; Guimaraes, Alexander R.; Catana, Ciprian

2013-01-01

Integrated scanners capable of simultaneous PET and MRI data acquisition are now available for human use. Although the scanners’ manufacturers have made substantial efforts to understand and minimize the mutual electromagnetic interference between the two modalities, the potential physiological inference has not been evaluated. In this work, we have studied the influence of the acoustic noise produced by the MR gradients on brain FDG uptake in the Siemens MR-BrainPET prototype. While particular attention was paid to the primary auditory cortex (PAC), a brain-wide analysis was also performed. Methods The effects of the MR on the PET count rate and image quantification were first investigated in phantoms. Next, ten healthy volunteers underwent two simultaneous FDG-PET/MR scans in the supine position with the FDG injection occurring inside the MR-BrainPET, alternating between a “quiet” (control) environment in which no MR sequences were run during the FDG uptake phase (the first 40 minutes after radiotracer administration) and a “noisy” (test) case in which MR sequences were run for the entire time. Cortical and subcortical regions of interest (ROIs) were derived from the high-resolution morphological MR data using FreeSurfer. The changes in FDG uptake in the FreeSurfer-derived ROIs between the two conditions were analyzed from parametric and static PET images, and on a voxel-by-voxel basis using SPM8 and FreeSurfer. Results Only minimal to no electromagnetic interference was observed for most of the MR sequences tested, with a maximum drop in count rate of 1.5% and a maximum change in the measured activity of 1.1% in the corresponding images. The ROI-based analysis showed statistically significant increases in the right PAC in both the parametric (9.13±4.73%) and static (4.18±2.87%) images. SPM8 analysis showed no statistically significant clusters in any images when a p<0.05 (corrected) was used; however, a p<0.001 (uncorrected) resolved bilateral

Dual Tracer PET Imaging with FDG and FLT Differentiates Tuberculous Lymphadenopathy from Metastases in a Case of Carcinoma Cervix

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Joshi, Prathamesh; Lele, Vikram; Aland, Parag; Gemawat, Shilpa [Jaslok Hospital and Research Centre, Woril (India)

2013-09-15

A forty-year-old woman with a known case of carcinoma cervix underwent 18-fluorodeoxyglucose positron emission tomography.computed tomography (18-FDG PET/CT) for evaluation of abdominal lymphadenopathy. Her treatment history included radical hysterectomy and radiotherapy 6 months ago. She complained of weight loss of 7 kg over last 5 months. The maximum intensity projection (MIP) image (Fig. 1a, arrows) revealed multiple areas of intense FDG uptake, which on CT and fused PET/CT images were localized to multiple lymph nodes in bilateral cervical region, right axilla, mediastinum and abdomen. The SUVmax of right axillary lymph nodes (most FDG avid of all lymph node groups) was 15.3. There was no evidence of metabolically active disease or CT demonstrable abnormality in rest of the body. Presence of metabolically active disease in extensive supradiaphramatic lymphadenopathy was unusual for a case of carcinoma cervix. This finding, along with history of significant weight loss and absence of extranodal disease, was suspicious for unrelated pathology like lymphoproliferative disorder or granulomatous disease. Mixed malignant and benign lymphadenopathy was also considered a possibility. To solve the conundrum, 18-fluoro-L-thymidine (FLT) PET/CT was performed on the next day. This scan was performed to assess the proliferation rate in various above-mentioned lymph nodes, and to plan the optimum site of biopsy. The FLT PET scan (Fig. 1b) showed physiological distribution of the tracer in bone marrow, liver, gall bladder and urinary bladder. There was minimal FLT uptake in the enlarged, FDG avid lymph nodes (Fig. 1c and d). SUVmax of FLT uptake in right axillary lymph nodes was 1.4 (SUVmax of FDG uptake = 15.8). The SUVmax of FLT uptake in cervical, mediastinal and abdominal lymph nodes were 1.3, 1.4 and 1.0 respectively. (SUVmax of FDG uptake 12.1, 12.7 and 11.9, respectively). Considering avidity for FDG and non-avidity of proliferation marker tracer (FLT), possibility of

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

International Nuclear Information System (INIS)

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

2012-01-01

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

Assessment of disease activity of idiopathic pulmonary fibrosis (IPF) using FDG PET and high-resolution computed tomography (HRCT)

International Nuclear Information System (INIS)

Kim, Bom Sahn; Kang, Won Jun; Oh, So Won; Lee, Jeong Won; Kang, Ji Yeon; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul

2007-01-01

Idiopathic pulmonary fibrosis (lPF) is induced by an uncontrolled accumulation and an activation of fibroblasts. The activity of IPF can be assessed according to the degrees of fibrosis and ground glass opacity (GGO) on HRCT. However, it has been thought that FDG PET reflects activity of inflammatory disease. The aim of this study was to compare the HRCT score and FDG uptake in patients with IPF. Six patients with IPF (M: F=4: 2, age 66.513.8 y) who underwent both FDG PET-CT and HRCT were enrolled (interval=33.042.6 d). The activity of IPF was scored at the level of the 1 cm above the diaphragm on HRCT, which was thought to be standard level of lower lobe. The degree of fibrosis was scored from 0 to 5 (0: no fibrosis, 1: interlobular septal wall thickening, 2: 75%). GGO was quantified from 0 to 5 (0: no GGO, 1: = 5 % of the lobe, 2: 5- 75%). Total score of HRCT was defined as the summed score of fibrosis and GGO. Standardized uptake value (SUV) was measured on same plane of FDG PET-CT by manual drawing of region of interest (ROI). SUV ratio of lung to liver was used as a metabolic marker of IPF activity. SUV ratio had a positive correlation with fibrosis score of HRCT (r=0.727, p=0.027), but did not have a significant correlation with GGO score (r=0.228, p=0.556). SUV ratio had a better correlation with total score of HRCT (r=0.895 and p<0.001). We demonstrated that SUV ratio might reflect disease activity of IPF. SUV ratio had a positive correlation with fibrosis score or total score on HRCT. FDG PET could be used to assess disease activity of IPF

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

Double-phase 18F-FDG PET-CT for determination of pulmonary tuberculoma activity

International Nuclear Information System (INIS)

Kim, In-Ju; Kim, Seong-Jang; Kim, Yong-Ki; Lee, Jung Sub; Jeong, Yeon Joo; Jun, Sungmin; Nam, Hyun Yul; Kim, Ju Sung

2008-01-01

The aim of this study is to evaluate the potential role of double phase acquisition of 18 F fluorodeoxyglucose (FDG) positron emission tomography (PET) for the differentiation of active pulmonary tuberculoma. A total of 25 consecutive patients with pulmonary tuberculoma were enrolled. PET/CT imaging was performed 60 (range 53-71) and 120 min (range 109-131) after injection of 18 F-FDG. The intensity of 18 F-FDG uptake by pulmonary lesions was assessed visually, and the intensity was scored with a four-point scale (grade 1: absent, grade 2: faint, grade 3: moderate, grade 4: intense). Active tuberculoma shows statistically significant higher values in maximal standardized uptake values SUV maxE (active = 2.3 ± 0.75, inactive 0.79 ± 0.15), SUV maxD (active = 2.48 ± 0.79, inactive = 0.75 ± 0.13), and %ΔSUV max (active = 8.07 ± 7.77%, inactive = -3.83 ± 6.59) than those of inactive tuberculoma. When greater than or equal to visual grade 2 was used as the cutoff value, the sensitivity and specificity were 100 and 81.8%. When SUV maxE 1.05 was used as the cutoff point, the sensitivity and specificity were 100 and 100%. When SUV maxD 0.97 was used as the cutoff value, the sensitivity and specificity were 92.8 and 100%. When %ΔSUV max 6.59 was used as the cutoff value, the sensitivity and specificity were 71.4 and 100%. The %ΔSUV max was the potent predictor by logistic regression analysis. The ΔSUV max is a potential predictor for activity of pulmonary tuberculoma. However, the diagnostic performances were similar between visual and quantitative analyses. The visual assessment may be sufficient for determination of pulmonary tuberculoma activity. Further studies are needed to confirm these results and improve statistical accuracy. (orig.)

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.

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

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Senait Aknaw Debebe

2016-02-01

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

In vivo quantification of {sup 18}F-Fdg uptake in human placenta during early pregnancy

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Zanotti-Fregonara, P.; Jan, S.; Trebossen, R.; Maroy, R. [CEA, DSV, I2BM, SHFJ, F-91401 Orsay (France); Champion, C. [Univ Paul Verlaine Metz, Lab Phys Mol et Collis, Inst Phys, Metz (France); Hindie, E. [Hop St Antoine, AP-HP, F-75571 Paris (France); Hindie, E. [Univ Paris 07, IMDCT, IUH, Ecole Doctorale B2T, F-75221 Paris (France)

2008-07-01

{sup 18}F-FDG is the most widely used PET radiopharmaceutical. Nevertheless, no data for {sup 18}F-FDG uptake in the human placenta have been reported. We recently reported on embryo dosimetry in a woman who underwent an {sup 18}F-FDG PET/CT scan during early pregnancy. In the present work we attempt an in vivo quantification of the {sup 18}F-FDG uptake by the placenta. The 27-y-old woman received 320 MBq of {sup 18}F-FDG for a follow-up study for Hodgkin's lymphoma and was later discovered to be pregnant (embryo age 8 wk). Imaging started 1 h after injection. The maximum placental tissue uptake (SUVmax) was 2.5. This value was conservatively attributed to the entire placental volume, i.e., 45 mL, a value representative of the average dimensions of a normal placenta at 8 wk. On the basis of these measurements, placenta {sup 18}F-FDG uptake in our patient was 0.19% of the injected activity. A Monte Carlo simulation was used to derive the photon dose to the embryo from the placenta (0.022 * 10{sup -2} mGy per MBq of injected {sup 18}F-FDG) and from the surrounding amniotic fluid (0.017 * 10{sup -2} mGy MBq{sup -1}). This increases our previously calculated dose (3.3 * 10{sup -2} mGy MBq{sup -1}) by only a small fraction (1.18%), which does not justify modifying the previous estimate given the overall uncertainties. (authors)

Enhanced {sup 18}F-FDG uptake in activated neutrophils is unaffected by respiratory burst inhibition with RGD

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Paik, J. Y.; Lee, K. H.; Go, B. H.; Jeong, K. H.; Kim, H. K.; Choi, J. S.; Choi, Y.; Kim, P. T [Samsung Medical Center, Seoul (Korea, Republic of)

2004-07-01

Respiratory burst generation is an important response of activated neutrophils and is associated with enhanced glucose metabolism. Since such activation in dependent on adhesion through integrins, we investigated how integrin occupation with RGD influences respiratory burst response and {sup 18}F-FDG uptake in neutrophils. Human neutrophils separated from healthy volunteers were incubated in RPMI media. For RGD peptide inhibitory experiments, neutrophils were preincubated with 200 {mu} g/ml of cRGD peptides ad 37.deg. for 2 hr prior. Respiratory burst generation and uptake of {sup 18}F-FDG was then measured with or without PMA stimulation. Cellular total hexokinase levels were assayed with a colorimetric method. Treatment with RGD in the basal state resulted in a significant but relatively small increase in neutrophil superoxide release to 1.5{+-}0.25 fold o control levels (p<0.005). Whereas PMA stimulation caused a marked increase in superoxide generation, pretreatment with RGD caused a significant attenuation of this response to 35.6{+-}0.2% (p<0.005). PMA stimulation resulted in a significant increase in {sup 18}F-FDG uptake. However, unlike the attenution of superoxide generation, neutrophils pretreated with RGD before PMA stimulation showed an identical magnitude of enhanced {sup 18}F-FDG uptake (201.8{+-}20.5 of controls, p=0.0001). In addition, hexokinase levels were increased to comparable levels of approximately 1.5 fold for PMA stimulated neutrophils irrespective of RGD pretreatment. In conclusion, soluble RGD blocks stimulation of respiratory burst activation in neutrophils but does not inhibit stimulation of cellular glucose metabolism. This dissociation may contribute to maximally enhanced neutrophil FDG uptake in inflammatory lesions regardless of the occupancy of their integrin receptors.

Early dynamic 18F-FDG PET to detect hyperperfusion in hepatocellular carcinoma liver lesions.

Science.gov (United States)

Schierz, Jan-Henning; Opfermann, Thomas; Steenbeck, Jörg; Lopatta, Eric; Settmacher, Utz; Stallmach, Andreas; Marlowe, Robert J; Freesmeyer, Martin

2013-06-01

In addition to angiographic data on vascularity and vascular access, demonstration of hepatocellular carcinoma (HCC) liver nodule hypervascularization is a prerequisite for certain intrahepatic antitumor therapies. Early dynamic (ED) (18)F-FDG PET/CT could serve this purpose when the current standard method, contrast-enhanced (CE) CT, or other CE morphologic imaging modalities are unsuitable. A recent study showed ED (18)F-FDG PET/CT efficacy in this setting but applied a larger-than-standard (18)F-FDG activity and an elaborate protocol likely to hinder routine use. We developed a simplified protocol using standard activities and easily generated visual and descriptive or quantitative endpoints. This pilot study assessed the ability of these endpoints to detect HCC hyperperfusion and, thereby, evaluated the suitability in of the protocol everyday practice. Twenty-seven patients with 34 HCCs (diameter ≥ 1.5 cm) with hypervascularization on 3-phase CE CT underwent liver ED (18)F-FDG PET for 240 s, starting with (18)F-FDG (250-MBq bolus injection). Four frames at 15-s intervals, followed by 3 frames at 60-s intervals were reconstructed. Endpoints included focal tracer accumulation in the first 4 frames (60 s), subsequent focal washout, and visual and quantitative differences between tumor and liver regions of interest in maximum and mean ED standardized uptake value (ED SUVmax and ED SUVmean, respectively) 240-s time-activity curves. All 34 lesions were identified by early focal (18)F-FDG accumulation and faster time-to-peak ED SUVmax or ED SUVmean than in nontumor tissue. Tumor peak ED SUVmax and ED SUVmean exceeded liver levels in 85% and 53%, respectively, of lesions. Nadir tumor signal showed no consistent pattern relative to nontumor signal. HCC had a significantly shorter time to peak and significantly faster rate to peak for both ED SUVmax and ED SUVmean curves and a significantly higher peak ED SUVmax but not peak ED SUVmean than the liver. This pilot study

Optimizing the interval between G-CSF therapy and F-18 FDG PET imaging in children and young adults receiving chemotherapy for sarcoma

International Nuclear Information System (INIS)

Trout, Andrew T.; Sharp, Susan E.; Gelfand, Michael J.; Turpin, Brian K.; Zhang, Bin

2015-01-01

Granulocyte colony-stimulating factors (G-CSF) speed recovery from chemotherapy-induced myelosuppression but the marrow stimulation they cause can interfere with interpretation of F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) exams. To assess the frequency of interfering G-CSF-induced bone marrow activity on FDG PET imaging in children and young adults with Ewing sarcoma and rhabdomyosarcoma and to define an interval between G-CSF administration and FDG PET imaging that limits marrow interference. Blinded, retrospective review of FDG PET exams performed in patients treated with long-acting G-CSF as part of their chemotherapeutic regimen. Exams were subjectively scored by two reviewers (R1 and R2) who assessed the level of marrow uptake of FDG and measured standardized uptake values in the marrow, liver, spleen and blood pool. FDG PET findings were correlated with time since G-CSF administration and with blood cell counts. Thirty-eight FDG PET exams performed in 17 patients were reviewed with 47.4% (18/38) of exams having marrow uptake of FDG sufficient to interfere with image interpretation. Primary predictors of marrow uptake of FDG were patient age (P = 0.0037) and time since G-CSF exposure (P = 0.0028 for subjective marrow uptake of FDG, P = 0.008 [R1] and P = 0.004 [R2] for measured maximum standardized uptake value (SUVmax)). The median interval between G-CSF administration and PET imaging in cases with marrow activity considered normal or not likely to interfere was 19.5 days (range: 7-55 days). In pediatric and young adult patients with Ewing sarcoma and rhabdomyosarcoma, an interval of 20 days between administration of the long-acting form of G-CSF and FDG PET imaging should limit interference by stimulated marrow. (orig.)

Optimizing the interval between G-CSF therapy and F-18 FDG PET imaging in children and young adults receiving chemotherapy for sarcoma

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Trout, Andrew T.; Sharp, Susan E.; Gelfand, Michael J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Turpin, Brian K. [Cincinnati Children' s Hospital Medical Center, Cancer and Blood Diseases Institute, Division of Oncology, Cincinnati, OH (United States); Zhang, Bin [Cincinnati Children' s Hospital Medical Center, Division of Biostatistics and Epidemiology, Cincinnati, OH (United States)

2015-07-15

Granulocyte colony-stimulating factors (G-CSF) speed recovery from chemotherapy-induced myelosuppression but the marrow stimulation they cause can interfere with interpretation of F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) exams. To assess the frequency of interfering G-CSF-induced bone marrow activity on FDG PET imaging in children and young adults with Ewing sarcoma and rhabdomyosarcoma and to define an interval between G-CSF administration and FDG PET imaging that limits marrow interference. Blinded, retrospective review of FDG PET exams performed in patients treated with long-acting G-CSF as part of their chemotherapeutic regimen. Exams were subjectively scored by two reviewers (R1 and R2) who assessed the level of marrow uptake of FDG and measured standardized uptake values in the marrow, liver, spleen and blood pool. FDG PET findings were correlated with time since G-CSF administration and with blood cell counts. Thirty-eight FDG PET exams performed in 17 patients were reviewed with 47.4% (18/38) of exams having marrow uptake of FDG sufficient to interfere with image interpretation. Primary predictors of marrow uptake of FDG were patient age (P = 0.0037) and time since G-CSF exposure (P = 0.0028 for subjective marrow uptake of FDG, P = 0.008 [R1] and P = 0.004 [R2] for measured maximum standardized uptake value (SUVmax)). The median interval between G-CSF administration and PET imaging in cases with marrow activity considered normal or not likely to interfere was 19.5 days (range: 7-55 days). In pediatric and young adult patients with Ewing sarcoma and rhabdomyosarcoma, an interval of 20 days between administration of the long-acting form of G-CSF and FDG PET imaging should limit interference by stimulated marrow. (orig.)

Clearance of the high intestinal 18F-FDG uptake associated with metformin after stopping the drug

International Nuclear Information System (INIS)

Oezuelker, Tamer; Oezuelker, Filiz; Oezpacaci, Tevfik; Mert, Meral

2010-01-01

This study was done to determine whether interruption of metformin before 18 F-FDG PET/CT imaging could prevent the increased 18 F-FDG uptake in the intestine caused by this drug. Included in the study were 41 patients with known type 2 diabetes mellitus who were referred to our department for evaluation of various neoplastic diseases. Patients underwent two 18 F-FDG PET/CT scans, the first while they were on metformin and the second after they had stopped metformin. They stopped metformin and did not take any other oral antidiabetic medication starting 3 days before the second study and their blood glucose level was regulated with insulin when necessary to keep it within the range 5.55-8.33 mmol/l. FDG uptake was graded visually according to a four-point scale and semiquantitatively by recording the maximum standardized uptake value (SUVmax) in different bowel segments. A paired-samples t-test method was used to determine whether there was a significant difference between SUVmax measurements and visual analysis scores of the metabolic activity of the bowel in the PET/CT scans before and after stopping metformin. Diffuse and intense 18 F-FDG uptake was observed in bowel segments of patients, and the activity in the colon was significantly decreased both visually and semiquantitatively in PET/CT scans performed after patients stopped metformin (p 0.05). Metformin causes an increase in 18 F-FDG uptake in the bowel and stopping metformin before PET/CT study significantly decreased this unwanted uptake, especially in the colon, facilitating the interpretation of images obtained from the abdomen and preventing the obliteration of lesions. (orig.)

Assessment of disease activity of idiopathic pulmonary fibrosis (IPF) using FDG PET and high-resolution computed tomography (HRCT)

Energy Technology Data Exchange (ETDEWEB)

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

2007-07-01

Idiopathic pulmonary fibrosis (lPF) is induced by an uncontrolled accumulation and an activation of fibroblasts. The activity of IPF can be assessed according to the degrees of fibrosis and ground glass opacity (GGO) on HRCT. However, it has been thought that FDG PET reflects activity of inflammatory disease. The aim of this study was to compare the HRCT score and FDG uptake in patients with IPF. Six patients with IPF (M: F=4: 2, age 66.513.8 y) who underwent both FDG PET-CT and HRCT were enrolled (interval=33.042.6 d). The activity of IPF was scored at the level of the 1 cm above the diaphragm on HRCT, which was thought to be standard level of lower lobe. The degree of fibrosis was scored from 0 to 5 (0: no fibrosis, 1: interlobular septal wall thickening, 2: <25 % of the lobe, 3: 25-49 %, 4: 50-75 %, 5: >75%). GGO was quantified from 0 to 5 (0: no GGO, 1: = 5 % of the lobe, 2: 5-<25 %, 3: 25-49 %, 4: 50-75%, 5: >75%). Total score of HRCT was defined as the summed score of fibrosis and GGO. Standardized uptake value (SUV) was measured on same plane of FDG PET-CT by manual drawing of region of interest (ROI). SUV ratio of lung to liver was used as a metabolic marker of IPF activity. SUV ratio had a positive correlation with fibrosis score of HRCT (r=0.727, p=0.027), but did not have a significant correlation with GGO score (r=0.228, p=0.556). SUV ratio had a better correlation with total score of HRCT (r=0.895 and p<0.001). We demonstrated that SUV ratio might reflect disease activity of IPF. SUV ratio had a positive correlation with fibrosis score or total score on HRCT. FDG PET could be used to assess disease activity of IPF.

A PET study of 18FDG uptake in soft tissue masses

International Nuclear Information System (INIS)

Lodge, M.A.; Marsden, P.K.; Cronin, B.F.; O'Doherty, M.J.; Lucas, J.D.; Smith, M.A.

1999-01-01

A study was performed with the aim of investigating some of the methodological factors affecting the ability of quantitative 2-[ 18 F]-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography to assess tumour malignancy. Twenty-nine patients with soft tissue masses were studied using a 6-hour scanning protocol and various indices of glucose metabolism were compared with histological grade. Significant differences were observed in the time-activity response of benign and high-grade tumours. High-grade sarcomas were found to reach a peak activity concentration approximately 4 h after injection whereas benign lesions reached a maximum within 30 min. This translated to improved differentiation between these two tumour types using a standard uptake value (SUV) derived from images acquired at later times. An SUV measured 4 h post-injection was found to be as useful an index of tumour malignancy as the metabolic rate of FDG determined using either Patlak or non-linear regression techniques. Each of these indices had a sensitivity and specificity of 100% and 76% respectively for the discrimination of high-grade sarcomas from benign tumours. (orig.)

Comparison of quantitative methods on FDG PET/CT for treatment response evaluation of metastatic colorectal cancer

Energy Technology Data Exchange (ETDEWEB)

Bang, Ji In; Paeng, Jin Chul; Park, So Hyun [Dept. of Nuclear Medicine, Seoul National University Hospital, Seoul (Korea, Republic of); and others

2017-06-15

FDG PET is effective in treatment response evaluation of cancer. However, there is no standard method for quantitative evaluation of FDG PET, particularly regarding cytostatic drugs. We compared various FDG PET quantitative methods in terms of response determination. A total of 39 refractory metastatic colorectal cancer patients who received a multikinase inhibitor treatment were included. Baseline and posttreatment FDG PET/CT scans were performed before and two cycles after treatment. Standardized uptake value (SUV) and total lesion glycolysis (TLG) values using various margin thresholds (30–70 % of maximum SUV with increment 10 %, twice mean SUV of blood pool, SUV 3.0, and SUV 4.0) were measured, with measurement target of the hottest lesion or a maximum of five hottest lesions. Treatment response by the PERCIST criteria was also determined. Predictive values of the PET indexes were evaluated in terms of the treatment response determined by the RECIST 1.1 criteria. The agreement rate was 38 % between response determined by the PERCIST and the RECIST criteria (κ = 0.381). When patients were classified into disease control group (PR, SD) and non-control group (PD) by the RECIST criteria, percent changes of TLG with various margin thresholds (particularly, 30–50 % of maximum SUV) exhibited significant differences between the two groups, and high diagnostic power for the response by the RECIST criteria. TLG-based criteria, which used a margin threshold of 50 % of maximum SUV, exhibited a high agreement with the RECIST criteria compared with the PERCIST criteria (κ = 0.606). In metastatic colorectal cancer, FDG PET/CT could be effective for treatment response evaluation by using TLG measured by margin thresholds of 30–50 % of maximum SUV. Further studies are warranted regarding the optimal cutoff values for this method.

Altered biodistribution of FDG in patients with type-2 diabetes mellitus

International Nuclear Information System (INIS)

Ozguven, M.A.; Karacalioglu, A.O.; Ince, S.; Emer, M.O.

2014-01-01

Positron emission tomography-computed tomography (PET-CT) imaging of patients with diabetes can be problematic because elevated glucose levels may cause competitive inhibition of [F-18]-2-deoxy-2-fluoro-D-glucose (FDG) uptake in different tissues. Therefore, the aim of the study was to evaluate the biodistribution of FDG in patients with type-2 diabetes mellitus. Two hundred forty patients were retrospectively enrolled to the study. Study population was divided into three subgroups, named as the normal (group 1), the insulin (group 2) and the oral anti-diabetic (group 3). Unenhanced low-dose CT and PET emission data were acquired from the mid-thigh to the vertex of the skull. FDG uptakes in different organs were evaluated qualitatively or semi-quantitatively. In the diabetic groups, diffuse FDG uptake of the colon was increased (p > 0.001) but segmental FDG uptake was decreased (p > 0.001). Intestinal FDG uptake was detected in 20% of the study population and only 3% of these uptakes were in diffuse pattern. Segmental FDG uptake in the bowel was increased significantly in the groups of patients with diabetes (p = 0.002). Maximum standardized uptake values of the liver in the groups 1, 2, and 3 were 2.66 ± 0.6, 3.25 ± 0.9 and 3.16 ± 0.8, respectively, and the difference between the groups was not statistically significant (p = 0.083). Cardiac FDG uptake was decreased significantly in the groups of patients with diabetes (p < 0.001). According to our results, whole body bio-distribution of FDG uptake seems to be changed in patients with type-2 diabetes who were using insulin or oral anti-diabetic drugs. Although the use of oral antidiabetic drugs was known to change the biodistribution of FDG, insulin use also seems to change FDG uptake in different organs of diabetic patients. (author)

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

Science.gov (United States)

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

2012-05-02

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

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

International Nuclear Information System (INIS)

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

2012-01-01

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

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...

High and typical 18F-FDG bowel uptake in patients treated with metformin

International Nuclear Information System (INIS)

Gontier, Eric; Bonardel, Gerald; Mantzarides, Marina; Foehrenbach, Herve; Fourme, Emmanuelle; Wartski, Myriam; Pecking, Alain-Paul; Alberini, Jean-Louis; Blondet, Cyrille; Le Stanc, Elise

2008-01-01

This prospective and bi-centric study was conducted in order to determine the impact of antidiabetic treatments (AD) on 18 F-FDG bowel uptake in type 2 diabetic patients. Fifty-five patients with previously diagnosed and treated type 2 diabetes mellitus (group 1) were divided in two subgroups: AD treatment including metformin (n=32; group 1a) and AD treatment excluding metformin (n=23; group 1b). The 95 patients without diabetes mellitus made up controls (group 2). 18 F-FDG uptake in small intestine and colon was visually graded and semi-quantitatively measured using the maximum standardized uptake value. 18 F-FDG bowel uptake was significantly increased in AD patients (group 1) as compared to controls (group 2) (p 18 F-FDG uptake in colon and, to a lesser extent, in small intestine. It raises the question of stopping metformin treatment before an 18 F-FDG PET/CT scan is performed for intra-abdominal neoplasic lesion assessment. (orig.)

[{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.)

Incidental thyroid uptake on F-18 FDG PET/CT. Correlation with ultrasonography and pathology

International Nuclear Information System (INIS)

Kang, Bong-Joo; Baik, Jun-Hyun; Jung, So-Lyung; Park, Young-Ha; O, Joo-Hyun; Chung, Soo-Kyo

2009-01-01

The purpose of this study was to evaluate the usefulness of maximum standard uptake value (max SUV) calculated from F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) examination and findings from ultrasonographic (US) examination on incidentally detected thyroid FDG uptake on FDG PET/CT. We collected and reviewed FDG PET/CT images performed at our institution from March 2005 to March 2008. This study included 190 subjects with increased FDG uptake of thyroid gland who later underwent thyroid US and histological examinations. Of these subjects, the uptake pattern on FDG PET/CT was classified as either diffuse or focal. The FDG uptake pattern, max SUV, and US findings were evaluated and correlated with the histological results. In the focal FDG uptake pattern cases (n=148), the mean max SUV of malignant cases was higher than that of benign cases (5.93±5.35 vs. 3.47±2.89). Of the diffuse FDG uptake cases (n=42), nodules were detected in 25 subjects (59.5%) by US examination. Thyroid nodules were well characterized on US studies, and combined findings of suspicious US features or high max SUV of focal FDG uptake lesion increased sensitivity, positive predictive value (PPV), negative predictive value (NPV), and accuracy. Focal uptake pattern and high max SUV may be helpful in differentiating benign and malignant nodules on FDG PET/CT. However, US examination provides further information, and for lesions with increased FDG uptake of thyroid, US examination should be recommended. (author)

A strategy for obtaining both resting and psychologically activated state metabolic data from a single PET study using [F-18]-fluorodeoxyglucose(FDG)

International Nuclear Information System (INIS)

Chang, J.; Duara, R.; Barker, W.; Apicella, A.; Gilson, A.

1985-01-01

When psychological activation is studied with PET using the deoxyglucose method, a stable and specific psychological state for at least 30 minutes is required before commencing the scan. At this time, if the subject reverts to the testing state, a progressive degradation of the activated pattern occurs. However, a strategy could be used to obtain corrected activation state data and resting state data in a single study using a tracer such as FDG. The amount of tracer FDG and FDG-6P in the tissue at the time of study completion, t, will be the sum of the remaining quantity (R) of tracer accumulated in the tissue at the time T, when activation ceases, and the uptake during the subsequent period t-T when resting state glucose transport kinetics apply

Quantitative assessment of the hepatic metabolic volume product in patients with diffuse hepatic steatosis and normal controls through use of FDG-PET and MR imaging: a novel concept.

Science.gov (United States)

Bural, Gonca G; Torigian, Drew A; Burke, Anne; Houseni, Mohamed; Alkhawaldeh, Khaled; Cucchiara, Andrew; Basu, Sandip; Alavi, Abass

2010-06-01

The aim of this study was to compare hepatic standardized uptake values (SUVs) and hepatic metabolic volumetric products (HMVP) between patients of diffuse hepatic steatosis and control subjects with normal livers. Twenty-seven subjects were included in the study (13 men and 14 women; age range, 34-72 years). All had 18F-2-fluoro-2-D-deoxyglucose-positron emission tomography (FDG-PET) and magnetic resonance imaging (MRI) scans with an interscan interval of 0-5 months. Twelve of 27 subjects had diffuse hepatic steatosis on MRI. The remaining 15 were selected as age-matched controls based on normal liver parenchyma on MRI. Mean and maximum hepatic SUVs were calculated for both patient groups on FDG-PET images. Hepatic volumes were measured from MRI. HMVP in each subject was subsequently calculated by multiplication of hepatic volume by mean hepatic SUV. HMVPs as well as mean and maximum hepatic SUVs were compared between the two study groups. HMVPs, mean hepatic SUVs, and maximum hepatic SUVs were greater (statistically significant, p < 0.05) in subjects with diffuse hepatic steatosis compared to those in the control group. The increase in HMVP is the result of increased hepatic metabolic activity likely related to the diffuse hepatic steatosis. The active inflammatory process related to the diffuse hepatic steatosis is the probable explanation for the increase in hepatic metabolic activity on FDG-PET study.

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.)

Value of 18F-FDG PET in the detection of peritoneal carcinomatosis

International Nuclear Information System (INIS)

Suzuki, Akiko; Kawano, Tsuyoshi; Takahashi, Nobukazu; Lee, Jin; Nakagami, Yoshihiro; Inoue, Tomio; Miyagi, Etsuko; Hirahara, Fumiki; Togo, Shinji; Shimada, Hiroshi

2004-01-01

Peritoneal carcinomatosis can be difficult to diagnose using computed tomography (CT). The purpose of this study was to evaluate the role of 2-(fluorine 18) fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in the detection of peritoneal carcinomatosis. We reviewed the CT and FDG PET radiological reports and clinical charts of 18 patients with peritoneal carcinomatosis and 17 cancer patients without peritoneal carcinomatosis. We also assessed FDG PET scans from 20 healthy volunteers as a baseline study. The maximum standardised uptake values (SUV max ) over peritoneal lesions in cancer patients and over the area of most intense intestinal uptake in healthy volunteers and cancer patients without peritoneal carcinomatosis were measured. The sensitivity and positive predictive value (PPV) of combined FDG PET and CT were superior to those of CT alone for the detection of peritoneal lesions (sensitivity: 66.7% vs 22.2%, p max threshold of 5.1 produced a diagnostic accuracy of combined FDG PET and CT of 78%. The additional information provided by FDG PET allowed a more accurate diagnosis in 14 patients (40.0%), and led to alteration of the therapeutic strategy in five (14.3%) of the enrolled cancer patients. We found that use of an intra-abdominal FDG uptake cut-off value for SUV max of >5.1 assists in the diagnosis of peritoneal carcinomatosis. FDG PET may play an important role in the clinical management of patients with suspected peritoneal carcinomatosis. (orig.)

Optimizing {sup 18}F-FDG PET/CT imaging of vessel wall inflammation: the impact of {sup 18}F-FDG circulation time, injected dose, uptake parameters, and fasting blood glucose levels

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Bucerius, Jan [Icahn School of Medicine at Mount Sinai, Translational and Molecular Imaging Institute, One Gustave L. Levy Place, P.O. Box 1234, New York, NY (United States); Mount Sinai School of Medicine, Department of Radiology, New York, NY (United States); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); Maastricht University Medical Center, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); University Hospital, RWTH Aachen, Department of Nuclear Medicine, Aachen (Germany); Mani, Venkatesh; Fayad, Zahi A. [Icahn School of Medicine at Mount Sinai, Translational and Molecular Imaging Institute, One Gustave L. Levy Place, P.O. Box 1234, New York, NY (United States); Mount Sinai School of Medicine, Department of Radiology, New York, NY (United States); Mount Sinai School of Medicine, Department of Cardiology, Zena and Michael A. Weiner Cardiovascular Institute and Marie-Josee and Henry R. Kravis Cardiovascular Health Center, New York, NY (United States); Moncrieff, Colin [Icahn School of Medicine at Mount Sinai, Translational and Molecular Imaging Institute, One Gustave L. Levy Place, P.O. Box 1234, New York, NY (United States); Mount Sinai School of Medicine, Department of Radiology, New York, NY (United States); Machac, Josef [Mount Sinai School of Medicine, Division of Nuclear Medicine, Department of Radiology, New York, NY (United States); Fuster, Valentin [Mount Sinai School of Medicine, Department of Cardiology, Zena and Michael A. Weiner Cardiovascular Institute and Marie-Josee and Henry R. Kravis Cardiovascular Health Center, New York, NY (United States); The Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid (Spain); Farkouh, Michael E. [Mount Sinai School of Medicine, Department of Cardiology, Zena and Michael A. Weiner Cardiovascular Institute and Marie-Josee and Henry R. Kravis Cardiovascular Health Center, New York, NY (United States); Mount Sinai School of Medicine, Cardiovascular Imaging Clinical Trials Unit, New York, NY (United States); Tawakol, Ahmed [Massachusetts General Hospital, Harvard University, Cardiac MR PET CT Program, Boston, MA (United States); Rudd, James H.F. [Cambridge University, Division of Cardiovascular Medicine, Cambridge (United Kingdom)

2014-02-15

{sup 18}F-FDG PET is increasingly used for imaging of vessel wall inflammation. However, limited data are available on the impact of methodological variables, i.e. prescan fasting glucose, FDG circulation time and injected FDG dose, and of different FDG uptake parameters, in vascular FDG PET imaging. Included in the study were 195 patients who underwent vascular FDG PET/CT of the aorta and the carotids. Arterial standardized uptake values ({sub mean}SUV{sub max}), target-to-background ratios ({sub mean}TBR{sub max}) and FDG blood-pool activity in the superior vena cava (SVC) and the jugular veins (JV) were quantified. Vascular FDG uptake values classified according to the tertiles of prescan fasting glucose levels, the FDG circulation time, and the injected FDG dose were compared using ANOVA. Multivariate regression analyses were performed to identify the potential impact of all variables described on the arterial and blood-pool FDG uptake. Tertile analyses revealed FDG circulation times of about 2.5 h and prescan glucose levels of less than 7.0 mmol/l, showing a favorable relationship between arterial and blood-pool FDG uptake. FDG circulation times showed negative associations with aortic{sub mean}SUV{sub max} values as well as SVC and JV FDG blood-pool activity, but positive correlations with aortic and carotid{sub mean}TBR{sub max} values. Prescan glucose levels were negatively associated with aortic and carotid{sub mean}TBR{sub max} and carotid{sub mean}SUV{sub max} values, but were positively correlated with SVC blood-pool uptake. The injected FDG dose failed to show any significant association with vascular FDG uptake. FDG circulation times and prescan blood glucose levels significantly affect FDG uptake in the aortic and carotid walls and may bias the results of image interpretation in patients undergoing vascular FDG PET/CT. The injected FDG dose was less critical. Therefore, circulation times of about 2.5 h and prescan glucose levels less than 7.0 mmol

Solitary pulmonary nodules: Comparison of dynamic first-pass contrast-enhanced perfusion area-detector CT, dynamic first-pass contrast-enhanced MR imaging, and FDG PET/CT.

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Ohno, Yoshiharu; Nishio, Mizuho; Koyama, Hisanobu; Seki, Shinichiro; Tsubakimoto, Maho; Fujisawa, Yasuko; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Sugimura, Kazuro

2015-02-01

To prospectively compare the capabilities of dynamic perfusion area-detector computed tomography (CT), dynamic magnetic resonance (MR) imaging, and positron emission tomography (PET) combined with CT (PET/CT) with use of fluorine 18 fluorodeoxyglucose (FDG) for the diagnosis of solitary pulmonary nodules. The institutional review board approved this study, and written informed consent was obtained from each subject. A total of 198 consecutive patients with 218 nodules prospectively underwent dynamic perfusion area-detector CT, dynamic MR imaging, FDG PET/CT, and microbacterial and/or pathologic examinations. Nodules were classified into three groups: malignant nodules (n = 133) and benign nodules with low (n = 53) or high (n = 32) biologic activity. Total perfusion was determined with dual-input maximum slope models at area-detector CT, maximum and slope of enhancement ratio at MR imaging, and maximum standardized uptake value (SUVmax) at PET/CT. Next, all indexes for malignant and benign nodules were compared with the Tukey honest significant difference test. Then, receiver operating characteristic analysis was performed for each index. Finally, sensitivity, specificity, and accuracy were compared with the McNemar test. All indexes showed significant differences between malignant nodules and benign nodules with low biologic activity (P Dynamic perfusion area-detector CT is more specific and accurate than dynamic MR imaging and FDG PET/CT in the diagnosis of solitary pulmonary nodules in routine clinical practice. © RSNA, 2014.

FDG decomposition products

International Nuclear Information System (INIS)

Macasek, F.; Buriova, E.

2004-01-01

In this presentation authors present the results of analysis of decomposition products of [ 18 ]fluorodexyglucose. It is concluded that the coupling of liquid chromatography - mass spectrometry with electrospray ionisation is a suitable tool for quantitative analysis of FDG radiopharmaceutical, i.e. assay of basic components (FDG, glucose), impurities (Kryptofix) and decomposition products (gluconic and glucuronic acids etc.); 2-[ 18 F]fluoro-deoxyglucose (FDG) is sufficiently stable and resistant towards autoradiolysis; the content of radiochemical impurities (2-[ 18 F]fluoro-gluconic and 2-[ 18 F]fluoro-glucuronic acids in expired FDG did not exceed 1%

Double-phase {sup 18}F-FDG PET-CT for determination of pulmonary tuberculoma activity

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Kim, In-Ju; Kim, Seong-Jang; Kim, Yong-Ki [Pusan National University Hospital, Department of Nuclear Medicine, Busan (Korea); Pusan National University Hospital, Medical Research Institute, Busan (Korea); Lee, Jung Sub [Pusan National University Hospital, Medical Research Institute, Busan (Korea); Pusan National University Hospital, Department of Orthopaedic Surgery, Busan (Korea); Jeong, Yeon Joo [Pusan National University Hospital, Medical Research Institute, Busan (Korea); Pusan National University Hospital, Department of Radiology, Busan (Korea); Jun, Sungmin; Nam, Hyun Yul [Pusan National University Hospital, Department of Nuclear Medicine, Busan (Korea); Kim, Ju Sung [College of Medical and Life Sciences, Silla University, Department of Nursing, Busan (Korea)

2008-04-15

The aim of this study is to evaluate the potential role of double phase acquisition of {sup 18}F fluorodeoxyglucose (FDG) positron emission tomography (PET) for the differentiation of active pulmonary tuberculoma. A total of 25 consecutive patients with pulmonary tuberculoma were enrolled. PET/CT imaging was performed 60 (range 53-71) and 120 min (range 109-131) after injection of {sup 18}F-FDG. The intensity of {sup 18}F-FDG uptake by pulmonary lesions was assessed visually, and the intensity was scored with a four-point scale (grade 1: absent, grade 2: faint, grade 3: moderate, grade 4: intense). Active tuberculoma shows statistically significant higher values in maximal standardized uptake values SUV{sub maxE} (active = 2.3 {+-} 0.75, inactive = 0.79 {+-} 0.15), SUV{sub maxD} (active = 2.48 {+-} 0.79, inactive = 0.75 {+-} 0.13), and %{delta}SUV{sub max} (active = 8.07 {+-} 7.77%, inactive = -3.83 {+-} 6.59) than those of inactive tuberculoma. When greater than or equal to visual grade 2 was used as the cutoff value, the sensitivity and specificity were 100 and 81.8%. When SUV{sub maxE} 1.05 was used as the cutoff point, the sensitivity and specificity were 100 and 100%. When SUV{sub maxD} 0.97 was used as the cutoff value, the sensitivity and specificity were 92.8 and 100%. When %{delta}SUV{sub max} 6.59 was used as the cutoff value, the sensitivity and specificity were 71.4 and 100%. The %{delta}SUV{sub max} was the potent predictor by logistic regression analysis. The {delta}SUV{sub max} is a potential predictor for activity of pulmonary tuberculoma. However, the diagnostic performances were similar between visual and quantitative analyses. The visual assessment may be sufficient for determination of pulmonary tuberculoma activity. Further studies are needed to confirm these results and improve statistical accuracy. (orig.)

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

Science.gov (United States)

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

2017-02-01

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

The value of FDG-PET in diagnosing peritoneal seeding of colorectal cancer

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Kim, Sung Eun; Moon, Sun Mi; Cheon, Gi Jeong; Choi, Chang Woon; Hwang, Dae Yong; Lim, Sang Moo [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

2004-07-01

Peritoneal seeding of colon cancer cells is a common cause of morbidity and eventual mortality with recurrent disease. This study evaluated the role of F -18 FDG PET in detecting peritoneal seeding in colorectal carcinoma (CRC and to identify characteristic patterns of abdominal F-18 FDG uptake. We reviewed the FDG PET and CT images and clinical charts of 49 patients with peritoneal seeding and 22 cancer patients without peritoneal seeding. We also assessed FDG PET scans from 20 healthy volunteers as a baseline study. The maximum standardised uptake values (SUVmax) over peritoneal lesions in cancer patients and over the area of most intense intestinal uptake in healthy volunteers and cancer patients without peritoneal carcinomatosis were measured. The result were correlated with either biopsy or ascitic aspirate. The characteristics of FDG uptake were evaluated: overall pattern (focal or diffuse), heterogeneity (yes or none), intensity (low, or equal, faint to moderate, intense). The sensitivity and positive predictive value (PPV) of FDG PET were superior to CT for the detection of peritoneal lesions (sensitivity: 71.4% vs 57.1%, specificity: 72.7% vs 54.5%: PPV: 85.4% vs 73.7%, NPV: 53.3 % vs 36.4% ). The FDG uptake in patients with peritoneal carcinomatosis was divided into nodular(14), diffuse (23) and mixed pattern (12). An SUVmax threshold of 5.2 produced a diagnostic accuracy of FDG PET of 78%. The additional information provided by FDG PET allowed a more accurate diagnosis in 12 patients (24 %), and led to alteration of the therapeutic strategy in 6 (12.2%) of the enrolled patients (n=49) with peritoneal seeding. FDG-PET was more sensitive than CT for the detection of peritoneal seeding in CRC, and altered patient management. Thus, the application of PET may be beneficial to the management of peritoneal seeding in patient with CRC.

The value of FDG-PET in diagnosing peritoneal seeding of colorectal cancer

International Nuclear Information System (INIS)

Kim, Sung Eun; Moon, Sun Mi; Cheon, Gi Jeong; Choi, Chang Woon; Hwang, Dae Yong; Lim, Sang Moo

2004-01-01

Peritoneal seeding of colon cancer cells is a common cause of morbidity and eventual mortality with recurrent disease. This study evaluated the role of F -18 FDG PET in detecting peritoneal seeding in colorectal carcinoma (CRC and to identify characteristic patterns of abdominal F-18 FDG uptake. We reviewed the FDG PET and CT images and clinical charts of 49 patients with peritoneal seeding and 22 cancer patients without peritoneal seeding. We also assessed FDG PET scans from 20 healthy volunteers as a baseline study. The maximum standardised uptake values (SUVmax) over peritoneal lesions in cancer patients and over the area of most intense intestinal uptake in healthy volunteers and cancer patients without peritoneal carcinomatosis were measured. The result were correlated with either biopsy or ascitic aspirate. The characteristics of FDG uptake were evaluated: overall pattern (focal or diffuse), heterogeneity (yes or none), intensity (low, or equal, faint to moderate, intense). The sensitivity and positive predictive value (PPV) of FDG PET were superior to CT for the detection of peritoneal lesions (sensitivity: 71.4% vs 57.1%, specificity: 72.7% vs 54.5%: PPV: 85.4% vs 73.7%, NPV: 53.3 % vs 36.4% ). The FDG uptake in patients with peritoneal carcinomatosis was divided into nodular(14), diffuse (23) and mixed pattern (12). An SUVmax threshold of 5.2 produced a diagnostic accuracy of FDG PET of 78%. The additional information provided by FDG PET allowed a more accurate diagnosis in 12 patients (24 %), and led to alteration of the therapeutic strategy in 6 (12.2%) of the enrolled patients (n=49) with peritoneal seeding. FDG-PET was more sensitive than CT for the detection of peritoneal seeding in CRC, and altered patient management. Thus, the application of PET may be beneficial to the management of peritoneal seeding in patient with CRC

FDG-PET/CT finding of benign metastasizing leiomyoma of the lung

International Nuclear Information System (INIS)

Nakajo, Masatoyo; Nakayama, Hirofumi; Sato, Masayuki; Fukukura, Yoshihiko; Nakajo, Masayuki; Kajiya, Yoriko; Yanagi, Masakazu; Tabata, Kazuhiro; Higashi, Michiyo

2012-01-01

We report a case of multiple benign metastasizing leiomyoma (BML) lung nodules showing faint or non-avid uptake of F-18 fluorodeoxyglucose (FDG) (respective 1-hour early and 2-hour delayed maximum standardized uptake values; 1.3 or less and 1.2 or less) in a 50-year-old woman with a history of hysterectomy for uterine leiomyoma at the age of 38 years. When multiple lung nodules show faint or non-avid FDG uptake in a patient with a history of hysterectomy for uterine leiomyoma, BML should be included in the differential diagnosis

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

Kidney Modelling for FDG Excretion with PET

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Huiting Qiao

2007-01-01

Full Text Available The purpose of this study was to detect the physiological process of FDG's filtration from blood to urine and to establish a mathematical model to describe the process. Dynamic positron emission tomography scan for FDG was performed on seven normal volunteers. The filtration process in kidney can be seen in the sequential images of each study. Variational distribution of FDG in kidney can be detected in dynamic data. According to the structure and function, kidney is divided into parenchyma and pelvis. A unidirectional three-compartment model is proposed to describe the renal function in FDG excretion. The time-activity curves that were picked up from the parenchyma, pelvis, and abdominal aorta were used to estimate the parameter of the model. The output of the model has fitted well with the original curve from dynamic data.

Clinical Significance of 18F-FDG-PET in Invasive Lobular Carcinoma.

Science.gov (United States)

Fujii, Takaaki; Yajima, Reina; Kurozumi, Sasagu; Higuchi, Toru; Obayashi, Sayaka; Tokiniwa, Hideaki; Nagaoka, Rin; Takata, Daisuke; Horiguchi, Jun; Kuwano, Hiroyuki

2016-10-01

The diagnostic utility of 18 F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) for breast cancer is controversial. The histological type or tumor size of breast cancer has been reported to be associated with a greater likelihood of positive FDG uptake. Compared to invasive ductal carcinomas (IDCs), invasive lobular carcinomas (ILCs) have a lower level of FDG uptake and are detected at a significantly lower sensitivity. The role of preoperative FDG-PET for ILCs may, thus, be limited. Few data evaluating the significance of FDG-PET in ILCs are available. Here, we evaluated the clinical significance of FDG-PET for ILC patients. We retrospectively investigated the cases of 196 consecutive patients with primary breast cancer who were diagnosed as having ILC (n=15) or IDC (n=181) and underwent FDG-PET preoperatively. Fifteen (7.7%) of patients were histopathologically diagnosed as ILC. A univariate analysis revealed that tumor size, extent of tumor, estrogen receptor (ER) expression and progesterone receptor (PgR) expression were significantly different between the ILC and IDC groups. The maximum standardized uptake value (SUV max ) values of the primary tumors were not significantly different between the two groups but, regardless of the larger size of tumor or ductal spread, the SUV max was relatively lower in the ILC group compared to the IDC group. The tumors in two ILC cases showed no FDG uptake. Among the ILC cases, there were linear associations between SUV max and tumor size and between SUV max and the nuclear grade by Pearson correlation (r=0.447, p=0.048 and r=0.519, p=0.024, respectively). Our findings imply that the preoperative FDG uptake in ILC may be reflective of the tumor size and the nuclear grade of the tumor. FDG uptake may be useful and predictive of aggressive features or prognosis in ILC patients. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

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

Science.gov (United States)

Nakajima, Reiko; Abe, Koichiro; Kondo, Tsunenori; Tanabe, Kazunari; Sakai, Shuji

2016-06-01

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

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

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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

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

FDG avidity and PET/CT patterns in primary gastric lymphoma

International Nuclear Information System (INIS)

Radan, Lea; Fischer, Doron; Bar-Shalom, Rachel; Israel, Ora; Dann, Eldad J.; Epelbaum, Ron; Haim, Nissim; Gaitini, Diana

2008-01-01

The use of 18F-fluoro-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in primary gastric lymphoma (PGL) is challenging due to physiologic FDG activity in the stomach and variability in the degree of uptake in various histologic subtypes. This study assesses FDG avidity and PET/CT patterns in newly diagnosed PGL. Sixty-two PET/CT studies of newly diagnosed PGL were reviewed (24 low-grade mucosa-associated lymphoid tissue [MALT], 38 aggressive non-Hodgkin's lymphoma [AGNHL]). FDG avidity, patterns (focal/diffuse), and intensity (visually vs. the liver and SUVmax) were assessed and compared to 27 controls. Gastric CT abnormalities and extragastric sites were recorded. Gastric FDG uptake was found in 55/62 (89%) PGL (71% MALT vs. 100% AGNHL, p < 0.001) and 63% controls. A diffuse pattern was found in 60% PGL (76% MALT vs. 53% AGNHL, p = NS) and 47% controls. FDG uptake higher than liver was found in 82% PGL (58% MALT vs. 97% AGNHL, p < 0.05) and 63% controls. SUVmax in FDG-avid PGLs was 15.3 ± 11.7 (5.4 ± 2.9 MALT vs. 19.7 ± 11.5 AGNHL, p < 0.001) and 4.6 ± 1.4 in controls. CT abnormalities were found in 79% PGL (thickening, n = 49; ulcerations, n = 22). Extra-gastric FDG-avid sites were seen in none of MALT, but 61% of AGNHL (nodal, n = 18; nodal and extranodal, n 5). FDG avidity was present in 89% of PGLs, including all patients with AGNHL but only 71% of MALT. FDG uptake can be differentiated, in particular in AGNHL-PGL, from physiologic tracer activity by intensity but not by pattern. Extragastric foci on PET and structural CT abnormalities are additional parameters that can improve PET/CT assessment of PGL. Defining FDG avidity and PET/CT patterns in AGNHL and a subgroup of MALT-PGL before treatment may be important for further monitoring therapy response. (orig.)

FDG avidity and PET/CT patterns in primary gastric lymphoma

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Radan, Lea [Rambam Health Care Campus, Department of Nuclear Medicine, Haifa (Israel); Fischer, Doron [Rambam Health Care Campus, Department of Diagnostic Imaging, Haifa (Israel); Bar-Shalom, Rachel; Israel, Ora [Technion - Israel Institute of Technology, Department of Nuclear Medicine, Rambam Health Care Campus and R. and B. Rappaport School of Medicine, Haifa (Israel); Dann, Eldad J. [Technion - Israel Institute of Technology, Department of Hematology, Rambam Health Care Campus, and R. and B. Rappaport School of Medicine, Haifa (Israel); Epelbaum, Ron; Haim, Nissim [Technion - Israel Institute of Technology, Department of Oncology, Rambam Health Care Campus, and R. and B. Rappaport School of Medicine, Haifa (Israel); Gaitini, Diana [Rambam Health Care Campus, and R. and B. Rappaport School of Medicine, Technion - Israel Institute of Technology, Department of Diagnostic Imaging, Haifa (Israel)

2008-08-15

The use of 18F-fluoro-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in primary gastric lymphoma (PGL) is challenging due to physiologic FDG activity in the stomach and variability in the degree of uptake in various histologic subtypes. This study assesses FDG avidity and PET/CT patterns in newly diagnosed PGL. Sixty-two PET/CT studies of newly diagnosed PGL were reviewed (24 low-grade mucosa-associated lymphoid tissue [MALT], 38 aggressive non-Hodgkin's lymphoma [AGNHL]). FDG avidity, patterns (focal/diffuse), and intensity (visually vs. the liver and SUVmax) were assessed and compared to 27 controls. Gastric CT abnormalities and extragastric sites were recorded. Gastric FDG uptake was found in 55/62 (89%) PGL (71% MALT vs. 100% AGNHL, p < 0.001) and 63% controls. A diffuse pattern was found in 60% PGL (76% MALT vs. 53% AGNHL, p = NS) and 47% controls. FDG uptake higher than liver was found in 82% PGL (58% MALT vs. 97% AGNHL, p < 0.05) and 63% controls. SUVmax in FDG-avid PGLs was 15.3 {+-} 11.7 (5.4 {+-} 2.9 MALT vs. 19.7 {+-} 11.5 AGNHL, p < 0.001) and 4.6 {+-} 1.4 in controls. CT abnormalities were found in 79% PGL (thickening, n = 49; ulcerations, n = 22). Extra-gastric FDG-avid sites were seen in none of MALT, but 61% of AGNHL (nodal, n = 18; nodal and extranodal, n = 5). FDG avidity was present in 89% of PGLs, including all patients with AGNHL but only 71% of MALT. FDG uptake can be differentiated, in particular in AGNHL-PGL, from physiologic tracer activity by intensity but not by pattern. Extragastric foci on PET and structural CT abnormalities are additional parameters that can improve PET/CT assessment of PGL. Defining FDG avidity and PET/CT patterns in AGNHL and a subgroup of MALT-PGL before treatment may be important for further monitoring therapy response. (orig.)

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.)

[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.)

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

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

2010-07-15

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

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

the report was not definitive requiring additional confirmatory studies. In 3 other patients a second tumor was found (proven as rectal and breast cancer and a uterine tumor). 25 more new lesions were seen on PET in 41 patients having pulmonary lesions. In 11 patients, there was no evidence of tumor activity. Remaining patients showed abnormal activity only in the known malignant lesions. There was an overall agreement between FDG and CT for 60% pulmonary and 74% extra pulmonary lesions. In 6/30 cases, PET scan showed distant metastatic involvement, not seen on CT. A patients with abscessed pneumonia presented severely abnormal uptake of FDG. Several small peripheral lung metastases of size < 8mm from a gastric cancer did not show FDG uptake. No uptake was seen in a huge tuberculoma. The mesothelioma showed extensive pleural activity. In our initial experience, we confirm that metabolic imaging with F18-FDG is helpful in the evaluation of oncological patients and is able to improve its management. This is in corroboration with the worldwide reports on PET imaging showing its impact on the clinical management of oncological patients. (author)

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

patients the report was not definitive requiring additional confirmatory studies. In 3 other patients a second tumor was found (proven as rectal and breast cancer and a uterine tumor). 25 more new lesions were seen on PET in 41 patients having pulmonary lesions. In 11 patients, there was no evidence of tumor activity. Remaining patients showed abnormal activity only in the known malignant lesions. There was an overall agreement between FDG and CT for 60% pulmonary and 74% extra pulmonary lesions. In 6/30 cases, PET scan showed distant metastatic involvement, not seen on CT. A patients with abscessed pneumonia presented severely abnormal uptake of FDG. Several small peripheral lung metastases of size < 8mm from a gastric cancer did not show FDG uptake. No uptake was seen in a huge tuberculoma. The mesothelioma showed extensive pleural activity. In our initial experience, we confirm that metabolic imaging with F18-FDG is helpful in the evaluation of oncological patients and is able to improve its management. This is in corroboration with the worldwide reports on PET imaging showing its impact on the clinical management of oncological patients. (author)

Inflammatory cytokines and hypoxia contribute to 18F-FDG uptake by cells involved in pannus formation in rheumatoid arthritis.

Science.gov (United States)

Matsui, Tamiko; Nakata, Norihito; Nagai, Shigenori; Nakatani, Akira; Takahashi, Miwako; Momose, Toshimitsu; Ohtomo, Kuni; Koyasu, Shigeo

2009-06-01

Assessment of the activity of rheumatoid arthritis (RA) is important for the prediction of future articular destruction. (18)F-FDG PET is known to represent the metabolic activity of inflammatory disease, which correlates with the pannus volume measured by MRI or ultrasonography. To evaluate the correlation between (18)F-FDG accumulation and RA pathology, we assessed (18)F-FDG accumulation in vivo using collagen-induced arthritis (CIA) animal models and (3)H-FDG uptake in vitro using various cells involved in arthritis. (18)F-FDG PET images of rats with CIA were acquired on days 10, 14, and 17 after arthritis induction. The specimens were subsequently subjected to macroautoradiography, and the (18)F-FDG accumulation was compared with the histologic findings. (3)H-FDG uptake in vitro in inflammatory cells (neutrophils, macrophages, T cells, and fibroblasts) was measured to evaluate the contributions of these cells to (18)F-FDG accumulation. In addition, the influence on (3)H-FDG uptake of inflammatory factors, such as cytokines (tumor necrosis factor alpha [TNFalpha], interleukin 1 [IL-1], and IL-6), and hypoxia was examined. (18)F-FDG PET depicted swollen joints, and (18)F-FDG accumulation increased with the progression of arthritis. Histologically, a higher level of (18)F-FDG accumulation correlated with the pannus rather than the infiltration of inflammatory cells around the joints. In the in vitro (3)H-FDG uptake assay, fibroblasts showed the highest (3)H-FDG uptake, followed by neutrophils. Although only a small amount of (3)H-FDG was incorporated by resting macrophages, a dramatic increase in (3)H-FDG uptake in both fibroblasts and macrophages was observed when these cells were exposed to inflammatory cytokines, such as TNFalpha and IL-1, and hypoxia. Although neutrophils showed relatively high (3)H-FDG uptake without activation, no increase in (3)H-FDG uptake was observed in response to inflammatory cytokines. (3)H-FDG uptake by T cells was much lower than

Correlation of primary tumor FDG uptake with histopathologic features of advanced gastric cancer

International Nuclear Information System (INIS)

Kim, Hae Won; Won, Kyoung Sook; Song, Bong Il; Kang, Yu Na

2015-01-01

Histopathologic features could affect the FDG uptake of primary gastric cancer and detection rate on FDG PET/CT. The aim of this study was to evaluate the FDG uptake of primary gastric cancer by correlating it with the histopathologic features of the tumors. Fifty patients with locally advanced gastric adenocarcinoma who were referred for preoperative FDG-PET/CT scans were enrolled in this study. The detection rate of PET/CT and maximum standardized uptake values (SUV max ) of the primary tumor were compared using the WHO, Lauren, Ming and Borrmann classifications and tumor size and location. In 45 of the 50 patients (90 %), the primary gastric tumors were detected by FDG PET/CT. On comparison using the WHO classification, the detection rate and SUV max of the tubular type were significantly higher than those of the poorly cohesive type. On comparison using the Lauren and Ming classifications, the SUV maxs of the intestinal type and expanding type were significantly higher than those of the diffuse and infiltrative type, respectively. On comparison using the Borrmann classification and tumor size and location, there was no significant difference in the detection rate and SUV max of primary gastric tumors. This study demonstrates that the poorly cohesive type according to the WHO classification, diffuse type according to the Lauren classification and infiltrative type according to the Ming classification have low FDG uptake in patients with locally advanced gastric carcinoma. Understanding the relationship between primary tumor FDG uptake and histopathologic features would be helpful in detecting the primary tumor by FDG PET/CT in patients with gastric cancer

FDG-PET in the initial staging of squamous cell oesophageal carcinoma

International Nuclear Information System (INIS)

Buchmann, I.; Schreckenberger, M.; Bartenstein, P.; Hansen, T.; Brochhausen, C.; Kneist, W.; Junginger, T.; Oberholzer, K.

2006-01-01

Squamous cell oesophageal carcinoma is the most common carcinoma of the oesophagus worldwide. The tumour stage as most important prognostic factor determines the clinical management. Aim of this study was to evaluate the value of FDG-PET 1. in imaging the primary tumour and 2. in N- and M-staging of squamous cell oesophogeal carcinoma. Patients, methods: in 20 patients with histological proven squamous cell carcinoma of the upper and middle oesophagus, FDG-PET was performed in standard technique prior to therapy. FDG uptake in the primary was determined by calculation of the SUVmax. NM-staging due to PET findings was performed as designated by the AJCC/UICC group classification and was compared with pathological and clinically based staging. Sensitivities, specificities and accuracies were calculated. Results: in 19 of 20 patients, primary squamous cell oesopohageal carcinoma was detected by FDG-PET findings with a maximum SUV of 12.5 (mean) ± 5.1 (median 11.5; range 4.8-23.8). One carcinoma in situ was missed. The sensitivity of FDG-PET in imaging the primary tumour was 96%. The sensitivities, specificities and accuracies were 20%, 100%, 58% for N-staging, and 60%, 86% and 93% for M-staging. PET findings caused changes of therapy in 5% (1 patient). Conclusions: FDG-PET was excellent in imaging the primary of squamous cell oesophageal carcinoma in stage T1-T4 and was efficient in M-staging. The low sensitivity in N-staging is of inferior clinical importance. The efficacy of FDG-PET seems to be not significantly be influenced by the histological subtype of oesophageal carcinoma. (orig.)

Brown Adipose Tissue Can Be Activated or Inhibited within an Hour before 18F-FDG Injection: A Preliminary Study with MicroPET

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Chenxi Wu

2011-01-01

Full Text Available Brown adipose tissue (BAT is emerging as a potential target for treating human obesity. It has been indicated that BAT is rich in innervations of sympathetic nerve control. Using 18F-FDG microPET imaging, this study aims at evaluating how factors related to sympathetic activation/inhibition changed BAT metabolism of mice. BAT 18F-FDG uptake were semiquantitatively evaluated in different groups of mice under temperature (cold or warm stimulus or pharmacological interventions (norepinephrine, epinephrine, isoprenaline, or propranolol and were compared with the corresponding controls. It was found that BAT activation can be stimulated by cold exposure (P=1.96×10−4, norepinephrine (P=.002, or both (P=2.19×10−6 within an hour before 18F-FDG injection and can also be alleviated by warming up (P=.001 or propranolol lavage (P=.027. This preliminary study indicated that BAT function could be evaluated by 18F-FDG PET imaging through short-term interventions, which paved the way for further investigation of the relationship between human obesity and BAT dysfunction.

Hybrid FDG-PET/MR compared to FDG-PET/CT in adult lymphoma patients.

Science.gov (United States)

Atkinson, Wendy; Catana, Ciprian; Abramson, Jeremy S; Arabasz, Grae; McDermott, Shanaugh; Catalano, Onofrio; Muse, Victorine; Blake, Michael A; Barnes, Jeffrey; Shelly, Martin; Hochberg, Ephraim; Rosen, Bruce R; Guimaraes, Alexander R

2016-07-01

The goal of this study is to evaluate the diagnostic performance of simultaneous FDG-PET/MR including diffusion compared to FDG-PET/CT in patients with lymphoma. Eighteen patients with a confirmed diagnosis of non-Hodgkin's (NHL) or Hodgkin's lymphoma (HL) underwent an IRB-approved, single-injection/dual-imaging protocol consisting of a clinical FDG-PET/CT and subsequent FDG-PET/MR scan. PET images from both modalities were reconstructed iteratively. Attenuation correction was performed using low-dose CT data for PET/CT and Dixon-MR sequences for PET/MR. Diffusion-weighted imaging was performed. SUVmax was measured and compared between modalities and the apparent diffusion coefficient (ADC) using ROI analysis by an experienced radiologist using OsiriX. Strength of correlation between variables was measured using the Pearson correlation coefficient (r p). Of the 18 patients included in this study, 5 had HL and 13 had NHL. The median age was 51 ± 14.8 years. Sixty-five FDG-avid lesions were identified. All FDG-avid lesions were visible with comparable contrast, and therefore initial and follow-up staging was identical between both examinations. SUVmax from FDG-PET/MR [(mean ± sem) (21.3 ± 2.07)] vs. FDG-PET/CT (mean 23.2 ± 2.8) demonstrated a strongly positive correlation [r s = 0.95 (0.94, 0.99); p < 0.0001]. There was no correlation found between ADCmin and SUVmax from FDG-PET/MR [r = 0.17(-0.07, 0.66); p = 0.09]. FDG-PET/MR offers an equivalent whole-body staging examination as compared with PET/CT with an improved radiation safety profile in lymphoma patients. Correlation of ADC to SUVmax was weak, understating their lack of equivalence, but not undermining their potential synergy and differing importance.

Hepatic steatosis is associated with increased hepatic FDG uptake

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Keramida, Georgia, E-mail: G.Keramida@bsms.ac.uk [Clinical Imaging Sciences Centre, Brighton Sussex Medical School, Brighton (United Kingdom); Department of Nuclear Medicine, Brighton Sussex University Hospitals NHS Trust, Brighton (United Kingdom); Potts, Jon [Department of Medicine, Brighton Sussex University Hospitals NHS Trust, Brighton (United Kingdom); Bush, Janice [Clinical Imaging Sciences Centre, Brighton Sussex Medical School, Brighton (United Kingdom); Dizdarevic, Sabina; Peters, A. Michael [Clinical Imaging Sciences Centre, Brighton Sussex Medical School, Brighton (United Kingdom); Department of Nuclear Medicine, Brighton Sussex University Hospitals NHS Trust, Brighton (United Kingdom)

2014-05-15

Objective: The use of liver as a reference tissue for semi-quantification of tumour FDG uptake may not be valid in hepatic steatosis (HS). Previous studies on the relation between liver FDG uptake and HS have been contradictory probably because they ignored blood glucose (BG). Because hepatocyte and blood FDG concentrations equalize, liver FDG uptake parallels BG, which must therefore be considered when studying hepatic FDG uptake. We therefore re-examined the relation between HS and liver uptake taking BG into account. Methods: This was a retrospective study of 304 patients undergoing routine PET/CT with imaging 60 min post-FDG. Average standard uptake value (SUV{sub ave}), maximum SUV (SUV{sub max}) and CT density (index of HS) were measured in a liver ROI. Blood pool SUV was based on the left ventricular cavity (SUV{sub LV}). Correlations were assessed using least squares fitting of continuous data. Patients were also divided into BG subgroups (<4, 4–5, 5–6, 6–8, 8–10 and 10+ mmol/l). Results: SUV{sub ave}, SUV{sub max} and SUV{sub LV} displayed similar relations with BG. SUV{sub max}/SUV{sub LV}, but not SUV{sub ave}/SUV{sub LV}, correlated significantly with BG. SUV{sub max}, but not SUV{sub ave}, correlated inversely with CT density before and after adjusting for BG. SUV{sub max}/SUV{sub ave} correlated more strongly with CT density than SUV{sub max}. CT density correlated inversely with SUV{sub max}/SUV{sub LV} but positively with SUV{sub ave}/SUV{sub LV}. Conclusions: Hepatic SUV is more influenced by BG than by HS. Its relation with BG renders it unsuitable as a reference tissue. Nevertheless, hepatic fat does correlate positively with liver SUV, although this is seen only with SUV{sub max} because SUV{sub ave} is ‘diluted’ by hepatic fat.

18F-FDG PET/CT Equivalent of the Hepatic Hot Spot Sign With CT Correlation.

Science.gov (United States)

Jundt, Michael C; Broski, Stephen M; Binkovitz, Larry A

2018-05-01

A 43-year-old woman presented with an FDG-avid mediastinal Ewing sarcoma invading and nearly occluding the superior vena cava. Geographic increased FDG uptake in hepatic segment IVA was the only other site of nonphysiologic FDG activity. This focal activity was without an underlying mass, had atypical morphology for a hepatic metastasis, and correlated well with prior CT findings of abnormal segment IVA enhancement resulting from the recruitment of portocaval collaterals. In the correct setting, the F-FDG hepatic hot spot should be considered in the differential of a focal FDG-avid hepatic lesion in segment IVA.

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

"1"8F-FDG PET reveals unique features of large vessel inflammation in patients with Takayasu's arteritis

International Nuclear Information System (INIS)

Incerti, Elena; Fallanca, Federico; Alongi, Pierpaolo; Gianolli, Luigi; Picchio, Maria; Tombetti, Enrico; Sartorelli, Silvia; Sabbadini, Maria Grazia; Manfredi, Angelo A.; Baldissera, Elena M.; Tombolini, Elisabetta; Papa, Maurizio; De Cobelli, Francesco; Mason, Justin C.

2017-01-01

The object of this study was to assess whether "1"8F-fluorodeoxyglucose PET/CT (FDG PET/CT) provides novel information in patients with Takayasu's arteritis (TA) in addition to that provided by current activity assessment, to analyse the effects of possible confounders, such as arterial grafts, and to verify whether PET/CT could be informative in lesions <4 mm thick. We studied 30 patients with TA, evaluated from October 2010 to April 2014 by both PET/CT and magnetic resonance imaging (MRI). All arterial lesions were evaluated by PET both qualitatively (positive/negative) and semiquantitatively (maximum standardized uptake value, SUV_m_a_x), and the thickness of lesions in the MRI field of view was evaluated. In a per-patient analysis, the relationships between the PET data and acute-phase reactants and NIH criteria for active TA were evaluated. In a per-lesion analysis, the relationships between the PET features of each lesion and MRI morphological data were evaluated. The effects of the presence of arterial grafts were also evaluated. Increased FDG uptake was seen in 16 of 30 patients (53%) and in 46 of 177 vascular lesions (26%). Significant periprosthetic FDG uptake was seen in 6 of 7 patients (86%) with previous vascular surgery and in 10 of 11 of grafts (91%). Graft-associated uptake influenced the PET results in three patients (10%) and the SUV_m_a_x values in five patients (17%). Of 39 lesions with significant FDG uptake, 15 (38%) were <4 mm thick. Lesion thickness was correlated with lesion SUV_m_a_x in FDG-avid lesions only. FDG arterial uptake was not associated with systemic inflammation or NIH criteria. PET/CT reveals unique and fundamental features of arterial involvement in TA. PET/CT may be useful in the assessment of local inflammatory and vascular remodelling events independent of systemic inflammation during follow-up, even in lesions in which the arterial wall is <4 mm. The presence of arterial grafts is a potential confounder. Prospective

The Relationship between Brown Adipose Tissue Activity and Neoplastic Status: an ¹⁸F-FDG PET/CT Study in the Tropics

OpenAIRE

Huang Yung-Cheng; Chen Tai-Been; Hsu Chien-Chin; Li Shau-Hsuan; Wang Pei-Wen; Lee Bi-Fang; Kuo Ching-Yuan; Chiu Nan-Tsing

2011-01-01

Abstract Background Brown adipose tissue (BAT) has thermogenic potential. For its activation, cold exposure is considered a critical factor though other determinants have also been reported. The purpose of this study was to assess the relationship between neoplastic status and BAT activity by 2-deoxy-2-[18F]fluoro-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in people living in the tropics, where the influence of outdoor temperature was low. Methods 18F-FDG PE...

Evaluation of solitary pulmonary nodules by integrated PET/CT: improved accuracy by FDG uptake pattern and CT findings

International Nuclear Information System (INIS)

Joon Young Choi; Kyung Soo Lee; O Jung Kwon; Young Mog Shim; Kyung-Han Lee; Yong Choi; Yearn Seong Choe; Byung-Tae Kim

2004-01-01

Objective: FDG PET is useful to differentiate malignancy from benign lesions in the evaluation of solitary pulmonary nodules (SPNs). However, FDG PET showed false positive results in benign inflammatory lesions such as tuberculosis and organizing pneumonia. Furthermore, malignant tumors such as adenocarcinoma (AC) with bronchioloalveolar carcinoma (BAC) type had lower FDG uptake than other cell types of non-small cell lung cancer. We investigated whether FDG uptake pattern and image findings of CT for attenuation correction could improve accuracy for evaluating SPNs over SUV in integrated PET/CT imaging using FDG. Methods: Forty patients (M:F = 23:17, mean age 58.2±9.4 yrs) with non-calcified SPNs (diameter on CT 30 mm, no significant mediastinal node enlargement, no atelectasis) were included. All subjects underwent integrated PET/CT imaging using FDG. One nuclear medicine physician and 1 chest radiologist interpreted the PET and non-contrast CT images for attenuation correction, respectively. On PET images, maximum SUV of SPN was acquired, and FDG uptake pattern was categorized as diffusely increased or heterogeneously increased with upper threshold of window setting adjusted to maximum SUV of each nodule. A radiologist interpreted SPNs as benign or malignant based on CT images with lung and mediastinai window settings blinded to PET findings. Results: On pathological exam, 30 SPNs were confirmed to be malignant (11 AC with non-BAC type, 8 AC with BAC type, 8 squamous cell carcinoma, 1 adenosquamous cell carcinoma, 1 neuroendocrine carcinoma, 1 large cell carcinoma), and 10 were benign (4 tuberculosis, 3 organizing pneumonia, 2 sclerosing pneumocytoma, 1 non-specific inflammation). All 5 nodules with max SUV 7.0 except one with tuberculoma had malignancy. When only nodules with diffusely increased uptake were considered malignant in indeterminate group with max SUV of 4.0 to 7.0, PET could diagnose 5 of 9 malignant nodules with one false positive nodule. In 6 of

Assessment of muscle function using hybrid PET/MRI: comparison of 18F-FDG PET and T2-weighted MRI for quantifying muscle activation in human subjects

International Nuclear Information System (INIS)

Haddock, Bryan; Holm, Soeren; Poulsen, Jakup M.; Enevoldsen, Lotte H.; Larsson, Henrik B.W.; Kjaer, Andreas; Suetta, Charlotte

2017-01-01

The aim of this study was to determine the relationship between relative glucose uptake and MRI T 2 changes in skeletal muscles following resistance exercise using simultaneous PET/MRI scans. Ten young healthy recreationally active men (age 21 - 28 years) were injected with 18 F-FDG while activating the quadriceps of one leg with repeated knee extension exercises followed by hand-grip exercises for one arm. Immediately following the exercises, the subjects were scanned simultaneously with 18 F-FDG PET/MRI and muscle groups were evaluated for increases in 18 F-FDG uptake and MRI T 2 values. A significant linear correlation between 18 F-FDG uptake and changes in muscle T 2 (R 2 = 0.71) was found. for both small and large muscles and in voxel to voxel comparisons. Despite large intersubject differences in muscle recruitment, the linear correlation between 18 F-FDG uptake and changes in muscle T 2 did not vary among subjects. This is the first assessment of skeletal muscle activation using hybrid PET/MRI and the first study to demonstrate a high correlation between 18 F-FDG uptake and changes in muscle T 2 with physical exercise. Accordingly, it seems that changes in muscle T 2 may be used as a surrogate marker for glucose uptake and lead to an improved insight into the metabolic changes that occur with muscle activation. Such knowledge may lead to improved treatment strategies in patients with neuromuscular pathologies such as stroke, spinal cord injuries and muscular dystrophies. (orig.)

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

International Nuclear Information System (INIS)

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

2010-01-01

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

The Role of Pretreatment FDG-PET in Nasopharyngeal Carcinoma Treated With Intensity-Modulated Radiotherapy

International Nuclear Information System (INIS)

Liu, Wen-Shan; Wu, Ming-Fang; Tseng, Hsien-Chun; Liu, Jung-Tung; Weng, Jui-Hung; Li, Yueh-Chun; Lee, Jong-Kang

2012-01-01

Purpose: Pretreatment with 2- [ 18 F] fluorodeoxyglucose positron emission tomography ( 18 F-FDG-PET) was evaluated as a predictor of local failure-free survival (LFFS), disease-free survival (DFS), and overall survival (OS) in patients with nonkeratinizing nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT) alone or concurrently with chemotherapy (CCRT). Patients and Methods: Seventy-five M0 NPC patients who received FDG-PET before treatment were analyzed. The primary tumor FDG uptake was measured as the maximum standardized uptake value (SUVmax). The LFFS, DFS, and OS were calculated by the Kaplan-Meier method, and the differences were evaluated on log-rank test. The prognostic significance was assessed by univariate and multivariate analyses. Results: Eighteen patients received IMRT alone and 57 received CCRT. The mean SUVmax was significantly higher in 12 patients with locoregional or distant failure than in those without failure (p 18 F-FDG uptake (SUVmax >5) indicates poor outcome in patients with NPC.

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

International Nuclear Information System (INIS)

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

1998-01-01

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

18FDG PET scanning of benign and malignant musculoskeletal lesions

International Nuclear Information System (INIS)

Feldman, Frieda; Heertum, Ronald van; Manos, Chitra

2003-01-01

To describe the technique, applications and advantages of 18 FDG PET scanning in detection, analysis and management of musculoskeletal lesions.Design and patients Forty-five patients (19 males,26 females) aged 9 to 81 years had radiographs, routine radionuclide scans, CT and/or MRI of clinically suspected active benign or malignant musculoskeletal lesions. 18 FDG scans with a Siemens ECAT EXACT 921 dedicated PET unit (Knoxville, Tenn.) and FWH=6 mm images acquired as a 5-6 bed examination (6 min emission and 4 min transmission) used OSEM iterative reconstruction with segmented transmission attenuation correction and a Gaussian filter (cutoff 6.7 mm). Region of interest (ROI) 3 x 3 pixel image analysis based on transverse whole body images (slice thickness 3.37 mm) generated Maximum Standard Uptake Values (Max SUV) with a cutoff of 2.0 used to distinguish benign and malignant lesions. Thirty-nine studies were available for SUV ROI analysis. Overall sensitivity for differentiating malignant from benign osseous and non-osseous lesions was 91.7% (22/24), overall specificity was 100% (11/11) with an accuracy of 91.7%. All aggressive lesions had a Max SUV >2.0. Data separating benign from malignant lesions and aggressive from benign lesions were statistically significant (P 18 FDG PET contributes unique information regarding metabolism of musculoskeletal lesions. By supplying a physiologic basis for more informed treatment and management, it influences prognosis and survival. Moreover, since residual, recurrent or metastatic tumors can be simultaneously documented on a single whole body scan, PET may theoretically prove to be cost-effective. (orig.)

Basic study on relationship between estimated rate constants and noise in FDG kinetic analysis

International Nuclear Information System (INIS)

Kimura, Yuichi; Toyama, Hinako; Senda, Michio.

1996-01-01

For accurate estimation of the rate constants in 18 F-FDG dynamic study, the shape of the estimation function (Φ) is crucial. In this investigation, the relationship between the noise level in tissue time activity curve and the shape of the least squared estimation function which is the sum of squared error between a function of model parameters and a measured data is calculated in 3 parameter model of 18 F-FDG. In the first simulation, by using actual plasma time activity curve, the true tissue curve was generated from known sets of rate constants ranging 0.05≤k 1 ≤0.15, 0.1≤k 2 ≤0.2 and 0.01≤k 3 ≤0.1 in 0.01 step. This procedure was repeated under various noise levels in the tissue time activity curve from 1 to 8% of the maximum value in the tissue activity. In the second simulation, plasma and tissue time activity curves from clinical 18 F-FDG dynamic study were used to calculate the Φ. In the noise-free case, because the global minima is separated from neighboring local minimums, it was easy to find out the optimum point. However, with increasing noise level, the optimum point was buried in many neighboring local minima. Making it difficult to find out the optimum point. The optimum point was found within 20% of the convergence point by standard non-linear optimization method. The shape of Φ for the clinical data was similar to that with the noise level of 3 or 5% in the first simulation. Therefore direct search within the area extending 20% from the result of usual non-linear curve fitting procedure is recommended for accurate estimation of the constants. (author)

The effect of aging on aortic atherosclerotic plaque inflammation and molecular calcification: A FDG and NaF PET CT imaging study

DEFF Research Database (Denmark)

Blomberg, Björn; Thomassen, Anders; Hildebrandt, Malene

2013-01-01

prospectively assessed by 18-FDG (inflammation) and Sodium 18-Fluoride (Na-18F) (calcification metabolism) PET CT imaging. Global aortic uptake of 18-FDG and Na-18F was quantified by subtracting the blood pool SUVmean from the aortic SUVmax (cSUV) [maximum SUVaorta - mean SUVblood pool]. Calculating regression...

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

Directory of Open Access Journals (Sweden)

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

Usefulness of {sup 18}F FDG PET/CT in evaluating disease activity at different times in a patient with chronic periaortitis

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Treglia, Giorgio; Stefanelli, Antonella; Mattoli, Maria Vittoria; Leccisotti, Lucia; Muoio, Barbara [Catholic Univ. of the Sacred Heart, Rome (Italy); Bertagna, Francesco [Univ. of Brescia, Brescia (Italy)

2012-03-15

We report the case of a 53 year old man with a chronic periaortitis (CP) in whom Fluorine 18 Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has been useful in assessing the disease extent at diagnosis, in evaluating the treatment response, in diagnosing the relapse, and in monitoring the disease activity during follow up. This case highlights the usefulness of FDG PET/CT at different times in patients with CP. CP is a rare inflammatory disorder that affects the abdominal aorta and the retroperitoneum. Imaging procedures are essential to diagnose and monitor the disease course. Ultrasonography may be used as first line screening test, and is particularly useful to monitor patients with hydronephrosis and aortic aneurysms. However, CT or magnetic resonance imaging (MRI) of the abdomen are currently considered the investigations of choice to diagnose CP. In active CP, the periaortic mass usually enhances on CT and MRI. Both these methods can be used to monitor the disease course of CP and to evaluate response to treatment. A note of caution: signs of vasculitis seen on MRI and CT may persist for some time, despite achievement of clinical remission. A further limitation of abdominal CT and MRI is that neither technique can detect vasculitis in vessels other than the abdominal aorta, which has been described in 43% of patients with CP. FDG PET/CT has been proposed as useful tool in inflammatory diseases, such as aortitis, because metabolic changes assessed by FDG PET/CT usually precede morphological changes assessed by conventional imaging methods. Our case highlights the usefulness of FDG PET/CT at different times in patients with CP. This method may be useful in assessing disease activity and extent at diagnosis, in evaluating the treatment response, in diagnosing the relapse, and in monitoring the disease during follow up.

Dynamic Functional Imaging of Brain Glucose Utilization using fPET-FDG

Science.gov (United States)

Villien, Marjorie; Wey, Hsiao-Ying; Mandeville, Joseph B.; Catana, Ciprian; Polimeni, Jonathan R.; Sander, Christin Y.; Zürcher, Nicole R.; Chonde, Daniel B.; Fowler, Joanna S.; Rosen, Bruce R.; Hooker, Jacob M.

2014-01-01

Glucose is the principal source of energy for the brain and yet the dynamic response of glucose utilization to changes in brain activity is still not fully understood. Positron emission tomography (PET) allows quantitative measurement of glucose metabolism using 2-[18F]-fluorodeoxyglucose (FDG). However, FDG PET in its current form provides an integral (or average) of glucose consumption over tens of minutes and lacks the temporal information to capture physiological alterations associated with changes in brain activity induced by tasks or drug challenges. Traditionally, changes in glucose utilization are inferred by comparing two separate scans, which significantly limits the utility of the method. We report a novel method to track changes in FDG metabolism dynamically, with higher temporal resolution than exists to date and within a single session. Using a constant infusion of FDG, we demonstrate that our technique (termed fPET-FDG) can be used in an analysis pipeline similar to fMRI to define within-session differential metabolic responses. We use visual stimulation to demonstrate the feasibility of this method. This new method has a great potential to be used in research protocols and clinical settings since fPET-FDG imaging can be performed with most PET scanners and data acquisition and analysis is straightforward. fPET-FDG is a highly complementary technique to MRI and provides a rich new way to observe functional changes in brain metabolism. PMID:24936683

Detectability of T Measurable diseases in advanced gastric cancer in FDG PET CT

International Nuclear Information System (INIS)

Oh, Sun Young; Cheon, Gi Jeong; Kim, Young Chul; Jeong, Eugene; Kim, Seung Eun; Choe, Jae Gol

2012-01-01

Usefulness of FDG PET CT in monitoring response in locally advanced gastric cancer has been reported. The purpose of this study was to evaluate the related factors to detect measurable diseases in advanced gastric cancer on FDG PET CT. We retrospectively reviewed 38 patients diagnosed as having advanced gastric cancer. We defined the measurable diseases when there was visualized tumor of which maximum standardized uptake value(SUVmax) was higher than 1.35*SUVmax of liver + 2*SD of liver SUV. We evaluated what kinds of factors from the clinicopathologic features were related to identifying measurable diseases. Of 38 patients with advanced gastric cancer, 18 (50%) had measurable tumors on FDG PET CT. Measurable tumors were significantly more frequent in well or moderately differentiated adenocarcinoma (70.5% vs 35.3%, p<0.05), in the tumors located at antrum or angle (66.7% vs 29.4%, p<0.05) and in the elderly group (age of 55 years old or more, 72.0% vs 8.3%, p<0.001) than the others, respectively. By multivariate analysis, age at diagnosis was the only independent predictor for the measurable disease on FDG PET CT. We found that age at diagnosis, as well as histologic types and location of tumors, were the affecting factors to detect measurable disease on FDG PET CT in patients with advanced gastric cancer. Our study suggests that elderly patients of age of 55 years old or more can frequently have T measurable disease on FDG PET CT in advanced gastric cancer and FDG PET CT will be helpful to monitor measurable disease

Comparison of FDG Uptake with Pathological Parameters in the Well-differentiated Thyroid Cancer

International Nuclear Information System (INIS)

Choi, Woo Hee; Chung, Yong An; Kim, Ki Jun; Park, Chang Suk; Jung, Hyun Suk; Sohn, Hyung Sun; Chung, Soo Kyo; Yoo, Chang Young

2009-01-01

Differentiated thyroid cancer (DTC) has variable degree of F-18 FDG avidity. The purpose of this study was to evaluate the relationship between F-18 FDG uptake and pathological or immunohistochemical features of DTC. DTC patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included in the study. Maximum standardized uptake values (SUVmax) of primary tumor were calculated. If the primary tumor showed no perceptibly increased F-18 FDG uptake, region of interest was drawn based on finding of CT portion of the PET/CT images. Pathological and immunohistochemical markers such as presence of lymph node (LN) metastasis and underlying thyroiditis, tumor size, Ki-67 labeling index, expressions of EGFR, COX-2, and Galectin-3 were evaluated. Total of 106 patients was included (102 papillary carcinomas, 4 follicular carcinomas). The mean SUVmax of the large tumors (above 1 cm) was significantly higher than the mean SUVmax of small (equal to or less than 1 cm) ones (7.8±8.5 vs. 3.6±3.1, p=0.004). No significant difference in F-18 FDG uptake was found according to the presence or absence of LN metastasis and underlying thyroiditis, or the degree of Ki-67 labeling index, expression of EGFR, COX-2 and Galectin-3. In conclusion, the degree of F-18 FDG uptake in DTC was associated with the size of primary tumor. But there seem to be no relationship between F-18 FDG uptake of DTC and expression of Ki-67, EGFR, COX-2 and Galectin-3

Comparison of FDG Uptake with Pathological Parameters in the Well-differentiated Thyroid Cancer

Energy Technology Data Exchange (ETDEWEB)

Choi, Woo Hee; Chung, Yong An; Kim, Ki Jun; Park, Chang Suk; Jung, Hyun Suk; Sohn, Hyung Sun; Chung, Soo Kyo; Yoo, Chang Young [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

2009-02-15

Differentiated thyroid cancer (DTC) has variable degree of F-18 FDG avidity. The purpose of this study was to evaluate the relationship between F-18 FDG uptake and pathological or immunohistochemical features of DTC. DTC patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included in the study. Maximum standardized uptake values (SUVmax) of primary tumor were calculated. If the primary tumor showed no perceptibly increased F-18 FDG uptake, region of interest was drawn based on finding of CT portion of the PET/CT images. Pathological and immunohistochemical markers such as presence of lymph node (LN) metastasis and underlying thyroiditis, tumor size, Ki-67 labeling index, expressions of EGFR, COX-2, and Galectin-3 were evaluated. Total of 106 patients was included (102 papillary carcinomas, 4 follicular carcinomas). The mean SUVmax of the large tumors (above 1 cm) was significantly higher than the mean SUVmax of small (equal to or less than 1 cm) ones (7.8{+-}8.5 vs. 3.6{+-}3.1, p=0.004). No significant difference in F-18 FDG uptake was found according to the presence or absence of LN metastasis and underlying thyroiditis, or the degree of Ki-67 labeling index, expression of EGFR, COX-2 and Galectin-3. In conclusion, the degree of F-18 FDG uptake in DTC was associated with the size of primary tumor. But there seem to be no relationship between F-18 FDG uptake of DTC and expression of Ki-67, EGFR, COX-2 and Galectin-3.

Imaging of the myocardium using {sup 18}F-FDG-PET/MRI

Energy Technology Data Exchange (ETDEWEB)

Ferda, Jiří, E-mail: ferda@fnplzen.cz [Clinic of the Imaging Methods, University Hospital Plzen, Alej Svobody 80, 304 60 Plzeň (Czech Republic); Hromádka, Milan, E-mail: hromadkam@fnplzen.cz [Department of Cardiology, University Hospital Plzen, Alej Svobody 80, 304 60 Plzeň (Czech Republic); Baxa, Jan, E-mail: baxaj@fnplzen.cz [Clinic of the Imaging Methods, University Hospital Plzen, Alej Svobody 80, 304 60 Plzeň (Czech Republic)

2016-10-15

Highlights: • The natural combination of the metabolic and structural information is the most important strenghtof myocardial PET/MRI. • Metabolic conversion to glycolysis is needed in the assesment ov the viable myocardium. • Metabolic conversion to the fatty acid metabolism is the crucial in the assesment of the ischemic memory and myocardial inflammation. - Abstract: The introduction of the integrated hybrid PET/MRI equipment creates the possibility to perform PET and MRI simultaneously. Depending on the clinical question, the metabolic conversion to glycolytic activity or beta-oxidation is performed before the application of FDG. Since FDG aids to evaluate the energetic metabolism of the myocytes and myocardial MRI reaches the imaging capabilities of perfusion and tissue characterization in the daily routine, FDG-PET/MRI looks to be a promising method of PET/MRI exploitation in cardiac imaging. When myocardial FDG uptake should be evaluated in association with the perfusion distribution, the cross-evaluation of FDG accumulation distribution and perfusion distribution pattern is necessary. The different scenarios may be used in the assessment of myocardium, the conversion to glycolytic activity is used in the imaging of the viable myocardium, but the glycolytic activity suppression might be used in the indications of the identification of injured myocardium by ischemia or inflammation. FDG-PET/MRI might aid to answer the clinical tasks according to the structure, current function and possibilities to improve the function in ischemic heart disease or to display the extent or activity of myocardial inflammation in sarcoidosis. The tight coupling between metabolism, perfusion and contractile function offers an opportunity for the simultaneous assessment of cardiac performance using one imaging modality.

FDG Dose Extravasations in PET/CT: Frequency and Impact on SUV Measurements

International Nuclear Information System (INIS)

Osman, Medhat M.; Muzaffar, Razi; Altinyay, M. Erkan; Teymouri, Cyrus

2011-01-01

Objectives: Positron emission tomography (PET)/CT with 18F-FDG has proven to be effective in detecting and assessing various types of cancers. However, due to cancer and/or its therapy, intravenous (IV) FDG injection may be problematic resulting in dose extravasations. In the most frequently used field of view (FOV), arms-up, and base of skull to upper thigh [limited whole body (LWB)], the injection site may not be routinely imaged. The purpose of this study was to evaluate the frequency of dose extravasations in FDG PET and the potential impact on standard uptake value (SUV) measurements. Methods: True whole body FDG PET/CT scans (including all extremities) of 400 patients were retrospectively reviewed. A log recorded cases of IV dose extravasations. When possible, SUVs were measured in two frequently used reference locations: mediastinum and liver. The SUVs were obtained in the same patients who had studies with and without FDG extravasations within an average of 3 months without interval therapy. Results: Of the 400 scans, 42 (10.5%) had extravasations on the maximum intensity projections images. In scans with or without dose infiltration, FDG injection site was at or distal to the antecubital fossa in 97% of studies. Of those 42 cases, dose infiltration was within the LWB FOV in 29/42 (69%) and outside in the remaining 13/42 (31%). Of those 42 patients, 5 had repeat PET studies with no interval therapy. For those 5 patients, liver maximum SUV was 11.7% less in patients with infiltration than those without (2.22 ± 0.54 vs. 2.48 ± 0.6). Mediastinum SUVmax was 9.3% less in patients with infiltration than those without (1.72 ± 0.54 vs. 1.88 ± 0.49). Conclusion: We conclude dose extravasations were commonly encountered (10.5%) in PET/CT. However, it is underreported by at least 31% due to omitting injection site from the FOV. When present, extravasations may lead to underestimation of SUVmax. Therefore, it should not only be avoided but also reported in order to

FDG dose extravasations in PET/CT: frequency and impact on SUV measurements

Directory of Open Access Journals (Sweden)

Medhat M Osman

2011-11-01

Full Text Available Objectives: PET/CT with 18F-FDG has proven to be effective in detecting and assessing various types of cancers. However, due to cancer and/or its therapy, intravenous (IV FDG injection may be problematic resulting in dose extravasations. In the most frequently used field of view (FOV, arms-up and base of skull to upper-thigh (limited Whole Body (LWB, the injection site may not be routinely imaged. The purpose of this study was to evaluate the frequency of dose extravasations in FDG PET and the potential impact on SUV measurements.Methods: True Whole Body (TWB FDG-PET/CT scans (including all extremities of 400 patients were retrospectively reviewed. A log recorded cases of IV dose extravasations. When possible, SUVs were measured in two frequently used reference locations: mediastinum and liver. The SUVs were obtained in the same patients who had studies with and without FDG extravasations within an average of 3 months without interval therapy.Results: Of the 400 scans, 42 (10.5% had extravasations on the maximum intensity projections (MIP images. In scans with or without dose infiltration, FDG injection site was at or distal to the antecubital fossa in 97% of studies. Of those 42 cases, dose infiltration was within the LWB FOV in 29/42 (69% and outside in the remaining 13/42 (31%. Of those 42 patients, 5 had repeat PET studies with no interval therapy. For those 5 patients, liver maximum SUV was 11.7% less in patients with infiltration than those without (2.22 ± 0.54 vs. 2.48 ± 0.6. Mediastinum SUVmax was 9.3% less in patients with infiltration than those without (1.72 ± 0.54 vs. 1.88 ± 0.49.Conclusion: We conclude dose extravasations were commonly encountered (10.5% in PET/CT. However, it is underreported by at least 31% due to omitting injection site from the FOV. When present, extravasations may lead to underestimation of SUVmax. Therefore, it should not only be avoided but also reported in order to avoid false interpretations of the exam.

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

International Nuclear Information System (INIS)

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

2017-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-04-15

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

Assessment of muscle function using hybrid PET/MRI: comparison of {sup 18}F-FDG PET and T2-weighted MRI for quantifying muscle activation in human subjects

Energy Technology Data Exchange (ETDEWEB)

Haddock, Bryan; Holm, Soeren; Poulsen, Jakup M.; Enevoldsen, Lotte H.; Larsson, Henrik B.W.; Kjaer, Andreas; Suetta, Charlotte [Rigshospitalet Glostrup, Copenhagen University Hospital, Department of Clinical Physiology, Nuclear Medicine and PET, Glostrup (Denmark)

2017-04-15

The aim of this study was to determine the relationship between relative glucose uptake and MRI T{sub 2} changes in skeletal muscles following resistance exercise using simultaneous PET/MRI scans. Ten young healthy recreationally active men (age 21 - 28 years) were injected with {sup 18}F-FDG while activating the quadriceps of one leg with repeated knee extension exercises followed by hand-grip exercises for one arm. Immediately following the exercises, the subjects were scanned simultaneously with {sup 18}F-FDG PET/MRI and muscle groups were evaluated for increases in {sup 18}F-FDG uptake and MRI T{sub 2} values. A significant linear correlation between {sup 18}F-FDG uptake and changes in muscle T{sub 2} (R {sup 2} = 0.71) was found. for both small and large muscles and in voxel to voxel comparisons. Despite large intersubject differences in muscle recruitment, the linear correlation between {sup 18}F-FDG uptake and changes in muscle T{sub 2} did not vary among subjects. This is the first assessment of skeletal muscle activation using hybrid PET/MRI and the first study to demonstrate a high correlation between {sup 18}F-FDG uptake and changes in muscle T{sub 2} with physical exercise. Accordingly, it seems that changes in muscle T{sub 2} may be used as a surrogate marker for glucose uptake and lead to an improved insight into the metabolic changes that occur with muscle activation. Such knowledge may lead to improved treatment strategies in patients with neuromuscular pathologies such as stroke, spinal cord injuries and muscular dystrophies. (orig.)

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-06-15

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

Clinical Application of 18F-FDG PET in Ovarian Cancer

International Nuclear Information System (INIS)

Oh, So Won; Kim, Seok Ki

2008-01-01

Ovarian cancer is often fatal since it is difficult to diagnose early and recurrence is quite frequent despite successful implementation of cytoreductive surgery and chemotherapy, thus exact diagnosis and early detection of recurrence are crucial to patient management. For pre-treatment staging, FDG PET could be helpful in a limited patient group possessing high risks of ovarian cancer. Besides, FDG PET could be recommended to patients with a high suspicion of recurrence i.e. rise of CA-125, especially in cases of conventional diagnostic imaging modalities presenting no evidence of disease because FDG PET provides critical information for treatment planning such as recurrence site or pattern. In order to expand the use of FDG PET to general population at staging or routine surveillance of ovarian cancer, more investigation is needed. The usefulness of FDG PET in evaluating treatment response and prognosis of ovarian cancer has not yet been determined, but it has been reported that FDG PET could evaluate treatment response early and show a close relationship with overall survival. PET/CT has been actively adopted in management of ovarian cancer. Not only in detecting tumor recurrence and evaluating treatment response but also in pre-treatment staging, FDG PET/CT is expected to play a role due to available anatomical information

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

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

2018-01-15

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

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

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Choi, Byung Wook; Kim, Sung Hoon; Kim, Hae Won; Won, Kyoung Sook; Zeon, Seok Kil [Keimyung University School of Medicine, DaeKolecular Imaging, Daegu (Korea, Republic of)

2010-09-15

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

Factors influencing [F-18]2-fluoro-2-deoxy-D-glucose (F-18 FDG) uptake in melanoma cells. The role of proliferation rate, viability, glucose transporter expression and hexokinase activity

International Nuclear Information System (INIS)

Yamada, Kiyoshi; Brink, I.; Bisse, E.; Epting, T.; Engelhardt, R.

2005-01-01

Using human (SK-MEL 23, SK-MEL 24 and G361) and murine (B16) melanoma cell lines, the coregulatory potential of the uptake of the positron emission tomography (PET) tracer, [Fluorine-18]2-fluoro-2-deoxy-D-glucose (F-18 FDG) has been investigated in relationship to tumor characteristics. Comparative studies among the four melanoma cell lines demonstrated that the lowest FDG uptake in SK-MEL 24 corresponded strongly to the data for DT (population doubling time) and MTT (tetrazolium salt) cell viability as well as hexokinase (HK) activity, but was not related to the glucose transporter 1 (GLUT 1) expression level. Furthermore, the FDG uptake in each melanoma cell line measured by cell cycle kinetics was significantly positively correlated to both the proliferation index (PI=S/G 2 M phase fractions) and the cell viability, though with one exception relating to the proliferation index (PI) of the lowest FDG uptake cell line, SK-MEL 24. No positive correlation was found between the expression of GLUT 1 and FDG uptake in any individual cell line. However, the HK activities in SK-MEL 23 and 24 showed considerable positive relationships with FDG uptake. Our present study suggests that both the proliferation rate and the cell viability of melanoma cells may be key factors for FDG uptake and that HK activity, rather than GLUT 1 expression, seems to be a major factor. (author)

The Relationship between Brown Adipose Tissue Activity and Neoplastic Status: an 18F-FDG PET/CT Study in the Tropics

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Huang Yung-Cheng

2011-12-01

Full Text Available Abstract Background Brown adipose tissue (BAT has thermogenic potential. For its activation, cold exposure is considered a critical factor though other determinants have also been reported. The purpose of this study was to assess the relationship between neoplastic status and BAT activity by 2-deoxy-2-[18F]fluoro-D-glucose (18F-FDG positron emission tomography/computed tomography (PET/CT in people living in the tropics, where the influence of outdoor temperature was low. Methods 18F-FDG PET/CT scans were reviewed and the total metabolic activity (TMA of identified activated BAT quantified. The distribution and TMA of activated BAT were compared between patients with and without a cancer history. The neoplastic status of patients was scored according to their cancer history and 18F-FDG PET/CT findings. We evaluated the relationships between the TMA of BAT and neoplastic status along with other factors: age, body mass index, fasting blood sugar, gender, and outdoor temperature. Results Thirty of 1740 patients had activated BAT. Those with a cancer history had wider BAT distribution (p = 0.043 and a higher TMA (p = 0.028 than those without. A higher neoplastic status score was associated with a higher average TMA. Multivariate analyses showed that neoplastic status was the only factor significantly associated with the TMA of activated BAT (p = 0.016. Conclusions Neoplastic status is a critical determinant of BAT activity in patients living in the tropics. More active neoplastic status was associated with more vigorous TMA of BAT.

Factors Associated with Diffusely Increased Splenic F-18 FDG Uptake in Patients with Cholangiocarcinoma

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Kim, Keunyoung; Kim, Seongjang; Kim, Injoo; Kim, Dong Uk; Kim, Heeyoung; Kim, Sojung; Ahn, Sang Hyun [Pusan National Univ. Hospital, Busan (Korea, Republic of)

2014-06-15

Although diffuse splenic {sup 18}F-fluorodeoxyglucose (F-18 FDG) uptake exceeding hepatic activity, is considered abnormal, its clinical significance is rarely discussed in the literature. The aim of this study was to determine the contributing factors causing diffusely increased splenic FDG uptake in patients with cholangiocarcinoma. From January 2010 to March 2013, 140 patients (84 men, 56 women) were enrolled in this study. All patients had been diagnosed with cholangiocarcinoma and underwent F-18 FDG positron emission tomography/computed tomography (PET/CT) for the pretreatment staging work up. Clinical records were reviewed retrospectively. Various hematological parameters, C-reactive protein (CRP) level, CEA, CA19-9, pancreatic enzymes and liver function tests were conducted within 2 days after the F-18 FDG PET/CT study. Diffuse splenic uptake was observed in 23 patients (16.4%). Of those, 19 patients (82.6%) underwent endoscopic retrograde cholangiopancreastography (ERCP) 7 days before F-18 FDG PET/CT. The CRP level (p <0.001) and white blood cell count (p =0.023) were significantly higher in the group of patients with diffuse splenic FDG uptake. The hemoglobin (p <0.001) and the hematocrit (p <0.001) were significantly lower in patients with diffuse splenic FDG uptake. Pancreatic enzymes, liver function test results, and tumor markers were not significantly different between the patients who did or did not have diffusely increased splenic FDG uptake. The significant factors for diffuse splenic F-18 FDG uptake exceeding hepatic F-18 FDG uptake on multivariate analysis included: performing ERCP before F-18 FDG PET-CT (odds ratio [OR], 77.510; 95% CI, 7.624-132.105), and the presence of leukocytosis (OR, 12.436; 95% CI, 2.438-63.445) or anemia (OR, 1.211; 95% CI, 1.051-1.871). In conclusion, our study demonstrated that concurrent inflammation could be associated with diffusely increased splenic FDG uptake. We suggest that performing ERCP before F-18 FDG PET

Factors Associated with Diffusely Increased Splenic F-18 FDG Uptake in Patients with Cholangiocarcinoma

International Nuclear Information System (INIS)

Kim, Keunyoung; Kim, Seongjang; Kim, Injoo; Kim, Dong Uk; Kim, Heeyoung; Kim, Sojung; Ahn, Sang Hyun

2014-01-01

Although diffuse splenic 18 F-fluorodeoxyglucose (F-18 FDG) uptake exceeding hepatic activity, is considered abnormal, its clinical significance is rarely discussed in the literature. The aim of this study was to determine the contributing factors causing diffusely increased splenic FDG uptake in patients with cholangiocarcinoma. From January 2010 to March 2013, 140 patients (84 men, 56 women) were enrolled in this study. All patients had been diagnosed with cholangiocarcinoma and underwent F-18 FDG positron emission tomography/computed tomography (PET/CT) for the pretreatment staging work up. Clinical records were reviewed retrospectively. Various hematological parameters, C-reactive protein (CRP) level, CEA, CA19-9, pancreatic enzymes and liver function tests were conducted within 2 days after the F-18 FDG PET/CT study. Diffuse splenic uptake was observed in 23 patients (16.4%). Of those, 19 patients (82.6%) underwent endoscopic retrograde cholangiopancreastography (ERCP) 7 days before F-18 FDG PET/CT. The CRP level (p <0.001) and white blood cell count (p =0.023) were significantly higher in the group of patients with diffuse splenic FDG uptake. The hemoglobin (p <0.001) and the hematocrit (p <0.001) were significantly lower in patients with diffuse splenic FDG uptake. Pancreatic enzymes, liver function test results, and tumor markers were not significantly different between the patients who did or did not have diffusely increased splenic FDG uptake. The significant factors for diffuse splenic F-18 FDG uptake exceeding hepatic F-18 FDG uptake on multivariate analysis included: performing ERCP before F-18 FDG PET-CT (odds ratio [OR], 77.510; 95% CI, 7.624-132.105), and the presence of leukocytosis (OR, 12.436; 95% CI, 2.438-63.445) or anemia (OR, 1.211; 95% CI, 1.051-1.871). In conclusion, our study demonstrated that concurrent inflammation could be associated with diffusely increased splenic FDG uptake. We suggest that performing ERCP before F-18 FDG PET

Breast cancer with low FDG uptake: Characterization by means of dual-time point FDG-PET/CT

International Nuclear Information System (INIS)

Zytoon, Ashraf Anas; Murakami, Koji; El-Kholy, Mohamed Ramdan; El-Shorbagy, Emad; Ebied, Osama

2009-01-01

Background: Malignant breast lesions usually are differentiated by FDG-PET with a semiquantitative FDG standardized uptake value (SUV) of 2.5. However, the frequency of breast cancer with an SUV of less than or equal to 2.5 is noteworthy, and often present diagnostic challenges. This study was undertaken to evaluate the accuracy of dual-time point FDG-PET/CT with FDG standardized uptake value (SUV) calculation in the characterization of such breast tumors. Methods: Forty-nine female patients with newly diagnosed breast cancer were found to have primary breast cancer with minimally increased FDG uptake and met the criteria for inclusion in this study by having borderline levels of increased FDG uptake (SUVmax less than or equal to 2.5) in the initial FDG-PET/CT images. Consequently, they underwent further delayed phase FDG-PET/CT scan for better evaluation of the disease. Results: Of the 49 cancer lesions; the majority were found to have rising or unvarying dual-time changes in SUVmax (75.5%). The median value of SUVmax increases by 25% between the early and delayed scan. The means ± S.D. of the SUVmax1, the SUVmax2, and the ΔSUVmax% were 1.2 ± 0.6%, 1.3 ± 0.9%, and 5.1 ± 22.4%, respectively. The receiver-operating-characteristic (ROC) analysis proved that the highest accuracy for characterization of malignant breast lesions was obtained when a ΔSUVmax% cut-off value 0.0% was used as criteria for malignant FDG uptake-change over time with sensitivity 75.5%, and false-positive rate 20.4%. Conclusion: These results suggested that dual-time FDG-PET/CT imaging with standardized uptake value (SUV) estimation can improve the accuracy of the test in the evaluation of breast cancer with low FDG uptake.

Benign and malignant neurogenic tumors of nerve sheath origin on FDG PET

International Nuclear Information System (INIS)

Yun, M. J.; Go, D. H.; Yoo, Y. H.; Shin, K. H.; Lee, J. D

2004-01-01

The differentiation between benign and malignant nerve sheath tumors is difficult based on conventional radiological imaging. This study was undertaken to investigate the value of FDG PET in distinguishing benign from malignant neurogenic tumors of nerve sheath origin. We performed a retrospective review of the medical record to select patients with nerve sheath tumors who had underdone FDG PET imaging. Fifteen patients (7F: 8M) with benign or malignant nerve sheath tumors were included in this study. Of the 15 patients, 9 were diagnosed with the known neurofibromatosis type I. A total of 19 nerve sheath tumors were included from the 15 patients. All patients had undergone FDG PET to evaluate for malignant potential of the known lesions. Images of FDG PET were semi-quantitatively analyzed and a region of interest (ROI) was placed over the area of the maximum FDG uptake and an average standardized uptake value was taken for final analysis. There were 5 malignant peripheral nerve sheath tumors, 5 schwannomas, and 9 neurofibromas. The mean SUV was 2 (ranged from 1.6 to 3.3) for schwannomas, 1.3 (0.7 to 2.5) for neurofibromas, and 8.4 (4.6 to 12.2) for malignant peripheral nerve sheath tumors. Of 14 benign tumors, all except one schwannoma showed a SUV less than 3. When a cutoff SUV of 4 was used to differentiate the nerve sheath tumors, all tumors were correctly classified as benign or malignant, respectively. Among the 9 patients diagnosed with neurofibromatosis type I. 4 had malignant peripheral nerve sheath tumors and FDG PET accurately detected all the 4 lesions with malignant transformation. According to our results, FDG PET seems to have a great potential for accurately characterizing benign versus malignant nerve sheath tumors. It appears to be extremely useful for patients with neurofibromatosis to localize the lesion with malignant transformation

{sup 18}F-FDG PET reveals unique features of large vessel inflammation in patients with Takayasu's arteritis

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Incerti, Elena; Fallanca, Federico; Alongi, Pierpaolo; Gianolli, Luigi; Picchio, Maria [IRCCS San Raffaele Scientific Institute, Unit of Nuclear Medicine, Milan (Italy); Tombetti, Enrico; Sartorelli, Silvia; Sabbadini, Maria Grazia; Manfredi, Angelo A. [Vita-Salute San Raffaele University, Milan (Italy); IRCCS San Raffaele Scientific Institute, Unit of Internal Medicine and Clinical Immunology, Milan (Italy); Baldissera, Elena M. [IRCCS San Raffaele Scientific Institute, Unit of Internal Medicine and Clinical Immunology, Milan (Italy); Tombolini, Elisabetta [Vita-Salute San Raffaele University, Milan (Italy); Papa, Maurizio [IRCCS San Raffaele Scientific Institute, Department of Radiology, Milan (Italy); De Cobelli, Francesco [Vita-Salute San Raffaele University, Milan (Italy); IRCCS San Raffaele Scientific Institute, Department of Radiology, Milan (Italy); Mason, Justin C. [Imperial College London and Imperial College Healthcare NHS Trust, Vascular Science and Rheumatology, London (United Kingdom)

2017-07-15

The object of this study was to assess whether {sup 18}F-fluorodeoxyglucose PET/CT (FDG PET/CT) provides novel information in patients with Takayasu's arteritis (TA) in addition to that provided by current activity assessment, to analyse the effects of possible confounders, such as arterial grafts, and to verify whether PET/CT could be informative in lesions <4 mm thick. We studied 30 patients with TA, evaluated from October 2010 to April 2014 by both PET/CT and magnetic resonance imaging (MRI). All arterial lesions were evaluated by PET both qualitatively (positive/negative) and semiquantitatively (maximum standardized uptake value, SUV{sub max}), and the thickness of lesions in the MRI field of view was evaluated. In a per-patient analysis, the relationships between the PET data and acute-phase reactants and NIH criteria for active TA were evaluated. In a per-lesion analysis, the relationships between the PET features of each lesion and MRI morphological data were evaluated. The effects of the presence of arterial grafts were also evaluated. Increased FDG uptake was seen in 16 of 30 patients (53%) and in 46 of 177 vascular lesions (26%). Significant periprosthetic FDG uptake was seen in 6 of 7 patients (86%) with previous vascular surgery and in 10 of 11 of grafts (91%). Graft-associated uptake influenced the PET results in three patients (10%) and the SUV{sub max} values in five patients (17%). Of 39 lesions with significant FDG uptake, 15 (38%) were <4 mm thick. Lesion thickness was correlated with lesion SUV{sub max} in FDG-avid lesions only. FDG arterial uptake was not associated with systemic inflammation or NIH criteria. PET/CT reveals unique and fundamental features of arterial involvement in TA. PET/CT may be useful in the assessment of local inflammatory and vascular remodelling events independent of systemic inflammation during follow-up, even in lesions in which the arterial wall is <4 mm. The presence of arterial grafts is a potential confounder

Unsuspected Active Sarcoidosis Diagnosed by 18F-FDG PET/CT During the Search for a Primary Tumour in a Patient with Bone Lesions

International Nuclear Information System (INIS)

Caobelli, Federico; Pizzocaro, Claudio; Soffientini, Alberto; Guerra, Ugo Paolo; Gabanelli, Sara Vincenzina; Brucato, Antonio; Giubbini, Raffaele

2013-01-01

Sarcoidosis is a systemic chronic inflammatory disease of unknown aetiology, characterised by granulomatous lesions with heterogeneous clinical manifestations affecting multiple organs and tissues. Although the respiratory system is most commonly affected, the disease may also present with bone lesions. We report the case of a 31-year old woman who presented with low back pain and no history of cancer and who was found to have suspicious lesions involving the entire spine on magnetic resonance imaging (MRI). The patient underwent 18 F-fluorodeoxyglucose (FDG) PET/CT to search for a primary tumour and for staging purposes. 18 F-FDG PET/CT revealed a pattern of hypermetabolic activity in widespread skeletal lesions and in a single left cervical lymph node. The primary tumour was not found, thus suggesting a haematologic disorder. Subsequent biopsies of a cervical lymph node and of bone tissue from L4 revealed active sarcoidosis with no evidence of cancer. This underlines the importance of considering all alternatives when hypermetabolic lesions are found on 18 F-FDG PET/CT. Furthermore, 18 F-FDG PET can be very useful to indicate accessible sites for guiding fine-needle aspiration cytology (FNAC)

A Case of Esophageal Leiomyoma Showing High FDG Uptake on F-18 FDG PET

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Lee, Jai Hyuen [College of Medicine, Cheonan (Korea, Republic of); Ryu, Jin Sook [Asan Medical Center, University of Ulsan College of Medicine (Korea, Republic of)

2008-08-15

An esophageal leiomyoma is the most common benign tumor of the esophagus mainly occurred in intramural portion. Occasionally, it is difficult to discriminate esophageal malignancy from large leiomyoma. Although F-18 FDG PET has been used for differentiating malignant from benign disease, false-positive cases have been reported. Recently, uterine leiomyoma has been reported to have relatively high F-18 FDG uptake in some patients but little is known about how an esophageal leiomyoma might be showed on F-18 FDG PET. We report a case of esophageal leiomyoma that showed high FDG uptake on PET images.

A Case of Esophageal Leiomyoma Showing High FDG Uptake on F-18 FDG PET

International Nuclear Information System (INIS)

Lee, Jai Hyuen; Ryu, Jin Sook

2008-01-01

An esophageal leiomyoma is the most common benign tumor of the esophagus mainly occurred in intramural portion. Occasionally, it is difficult to discriminate esophageal malignancy from large leiomyoma. Although F-18 FDG PET has been used for differentiating malignant from benign disease, false-positive cases have been reported. Recently, uterine leiomyoma has been reported to have relatively high F-18 FDG uptake in some patients but little is known about how an esophageal leiomyoma might be showed on F-18 FDG PET. We report a case of esophageal leiomyoma that showed high FDG uptake on PET images

Preparation of 18F-FDG by basic hydrolysis on '1-pot' FDG synthesis module

International Nuclear Information System (INIS)

Li Qiming; Jin Rongbing; Fan Xijiang

2007-01-01

'1-pot' equipment is an automatic synthesis module of producing 18 F-FDG by acid hydrolysis process. Simple changes in the chemistry, plumbing, and programming of CPCU enable two back-to-back '1-pot' systems in a unit. The preparation of precursor of 18 F-FDG is the same with origin. The results of experiments showed that by basic hydrolysis procedure, the synthesis time is shorten from 45-50 min to 30-35 min, uncorrected synthesis yield can be increased from 45%-50% to 60%-65%, and the preparing procedure is stable. The quality of 18 F-FDG meets the requirements under USP fludeoxyglucose 18 F injection, radiochemical purity is more than 99% especially by HPLC. With '1-pot' FDG synthesis module Chemical Processing Control Unit (CPCU), 18 F-FDG can be prepared by basic hydrolysis process. (authors)

The value of [18F]FDG-PET in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease

International Nuclear Information System (INIS)

Walter, Martin A.; Mueller-Brand, Jan; Nitzsche, Egbert U.; Melzer, Ralph A.; Tyndall, Alan; Schindler, Christian

2005-01-01

This study was performed to investigate the value of 18 F-fluorodeoxyglucose positron emission tomography ([ 18 F]FDG-PET) in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease. Twenty-six consecutive patients (21 females, 5 males; median age - years, range 17-86 years) with giant cell arteritis or Takayasu's arteritis were examined with [ 18 F]FDG-PET. Follow-up scans were performed in four patients. Twenty-six age- and gender-matched controls (21 females, 5 males; median age 71 years, range 17-86 years) were included. The severity of large-vessel [ 18 F]FDG uptake was visually graded using a four-point scale. C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) were measured and correlated with [ 18 F]FDG-PET results by logistic regression. [ 18 F]FDG-PET revealed pathological findings in 18 of 26 patients. Three scans were categorised as grade I, 12 as grade II and 3 as grade III arteritis. Visual grade was significantly correlated with both CRP and ESR levels (p=0.002 and 0.007 respectively; grade I: CRP 4.0 mg/l, ESR 6 mm/h; grade II: CRP 37 mg/l, ESR 46 mm/h; grade III: CRP 172 mg/l, ESR 90 mm/h). Overall sensitivity was 60% (95% CI 40.6-77.3%), specificity 99.8% (95% CI 89.1-100%), positive predictive value 99.7% (95% CI 77-100%), negative predictive value 67.9% (95% CI 49.8-80.9%) and accuracy 78.6% (95% CI 65.6-88.4%). In patients presenting with a CRP 18 F]FDG-PET is highly effective in assessing the activity and the extent of large-vessel vasculitis. Visual grading was validated as representing the severity of inflammation. Its use is simple and provides high specificity, while high sensitivity is achieved by scanning in the state of active inflammation. (orig.)

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

International Nuclear Information System (INIS)

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

2006-01-01

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

[18F]FDG Accumulation in Early Coronary Atherosclerotic Lesions in Pigs.

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Miikka Tarkia

Full Text Available Inflammation is an important contributor to atherosclerosis progression. A glucose analogue 18F-fluorodeoxyglucose ([18F]FDG has been used to detect atherosclerotic inflammation. However, it is not known to what extent [18F]FDG is taken up in different stages of atherosclerosis. We aimed to study the uptake of [18F]FDG to various stages of coronary plaques in a pig model.First, diabetes was caused by streptozotocin injections (50 mg/kg for 3 days in farm pigs (n = 10. After 6 months on high-fat diet, pigs underwent dual-gated cardiac PET/CT to measure [18F]FDG uptake in coronary arteries. Coronary segments (n = 33 were harvested for ex vivo measurement of radioactivity and autoradiography (ARG.Intimal thickening was observed in 16 segments and atheroma type plaques in 10 segments. Compared with the normal vessel wall, ARG showed 1.7±0.7 times higher [18F]FDG accumulation in the intimal thickening and 4.1±2.3 times higher in the atheromas (P = 0.004 and P = 0.003, respectively. Ex vivo mean vessel-to-blood ratio was higher in segments with atheroma than those without atherosclerosis (2.6±1.2 vs. 1.3±0.7, P = 0.04. In vivo PET imaging showed the highest target-to-background ratio (TBR of 2.7. However, maximum TBR was not significantly different in segments without atherosclerosis (1.1±0.5 and either intimal thickening (1.2±0.4, P = 1.0 or atheroma (1.6±0.6, P = 0.4.We found increased uptake of [18F]FDG in coronary atherosclerotic lesions in a pig model. However, uptake in these early stage lesions was not detectable with in vivo PET imaging. Further studies are needed to clarify whether visible [18F]FDG uptake in coronary arteries represents more advanced, highly inflamed plaques.

Effects of anesthesia upon 18F-FDG uptake in rhesus monkey brains

International Nuclear Information System (INIS)

Itoh, Takashi; Wakahara, Shunichi; Nakano, Takayuki; Suzuki, Kazutoshi; Kobayashi, Kaoru; Inoue, Osamu

2005-01-01

The kinetics of 18 F-fluorodeoxyglucose ( 18 F-FDG) in the monkey brain were monitored, and comparisons were made between the conscious state and when under ketamine and pentobarbital anesthesia. Rhesus monkeys were intravenously injected with 18 F-FDG and followed by 60 min of PET scanning. In the conscious state, the 18 F-FDG concentration reached a plateau 5 min after intravenous injection. Under ketamine anesthesia, the 18 F-FDG concentration gradually increased with time in all monitored regions. At 60 min after injection, the concentration in the striatum was about 3.2 times greater than that in the conscious state, and about 4.5 times greater in the cerebral cortex. Under pentobarbital anesthesia, the 18 F-FDG concentration in the occipital cortex was slightly lower. These findings demonstrate that 18 F-FDG concentration in the monkey brain is significantly affected by anesthesia. The results also imply the existence of a short-term regulation mechanism for hexokinase activity in intact monkey brain. (author)

Factors influencing [F-18]2-fluoro-2-deoxy-D-glucose (F-18 FDG) accumulation in melanoma cells. Is FDG a substrate of multidrug resistance (MDR)?

International Nuclear Information System (INIS)

Yamada, Kiyoshi; Brink, I.; Engelhardt, R.

2005-01-01

In order to specify the influence of multidrug-resistance (MDR) on the accumulation of the PET tracer, F-18 FDG ([Fluorine-18]2-fluoro-2-deoxy-D-glucose, in melanoma cells, both the MDR function and expression of two human melanoma cell lines SK-MEL 23 and 24, were evaluated. The effects of MDR modulators on FDG accumulation and efflux were also investigated. A functional analysis using representative MDR fluorescent substrates and inhibitors clarified the following characteristics: SK-MEL 23 possesses a highly active function of multidrug resistance-associated protein (MRP), but not P-gp. SK-MEL 24 possesses weak functions of both MRP and P-gp. Western blot analysis using monoclonal antibodies for MDR expression demonstrated an exceedingly high MRP expression of SK-MEL 23 and only slight P-gp and MRP expression of SK-MEL 24, corresponding to the functional data. The efflux inhibition assay using F-18 FDG revealed a considerable retention of FDG in SK-MEL 23 in the presence of the MRP inhibitor probenecid. It was also found that the P-gp inhibitor verapamil depressed the FDG efflux of SK-MEL 24. Our present in vitro study suggests that FDG may be a substrate of MDR in some melanoma cells and further MDR may be one of the important factors affecting FDG-PET melanoma imaging. (author)

Grading of Cerebral Glioma with Multiparametric MR Imaging and {sup 18}F-FDG-PET: Concordance and Accuracy

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Yoon, Jeong Hee; Kim, Ji-hoon; Sohn, Chul-Ho; Choi, Seung Hong; Yun, Tae Jin; Song, Yong Sub [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Kang, Won Jun [Seoul National University Hospital, Department of Nuclear Medicine, Seoul (Korea, Republic of); Yonsei University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Eun, Yong [Seoul National University, College of Medicine, Seoul (Korea, Republic of); Chang, Kee-Hyun [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Soonchunhyang University Bucheon Hospital, Department of Radiology, Bucheon (Korea, Republic of)

2014-02-15

To retrospectively evaluate concordance rates and predictive values in concordant cases among multiparametric MR techniques and FDG-PET to grade cerebral gliomas. Multiparametric MR imaging and FDG-PET were performed in 60 consecutive patients with cerebral gliomas (12 low-grade and 48 high-grade gliomas). As the dichotomic variables, conventional MRI, minimum apparent diffusion coefficient in diffusion-weighted imaging, maximum relative cerebral blood volume ratio in perfusion-weighted imaging, choline/creatine ratio and (lipid and lactate)/creatine ratio in MR spectroscopy, and maximum standardised uptake value ratio in FDG-PET in low- and high-grade gliomas were compared. Their concordance rates and positive/negative predictive values (PPV/NPV) in concordant cases were obtained for the various combinations of multiparametric MR techniques and FDG-PET. There were significant differences between low- and high-grade gliomas in all techniques. Combinations of two, three, four, and five out of the five techniques showed concordance rates of 77.0 ± 4.8 %, 65.5 ± 4.0 %, 58.3 ± 2.6 % and 53.3 %, PPV in high-grade concordant cases of 97.3 ± 1.7 %, 99.1 ± 1.4 %, 100.0 ± 0 % and 100.0 % and NPV in low-grade concordant cases of 70.2 ± 7.5 %, 78.0 ± 6.0 %, 80.3 ± 3.4 % and 80.0 %, respectively. Multiparametric MR techniques and FDG-PET have a concordant tendency in a two-tiered classification for the grading of cerebral glioma. If at least two examinations concordantly indicated high-grade gliomas, the PPV was about 95 %. (orig.)

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

Science.gov (United States)

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

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

Myocardial viability assessment with gated SPECT Tc-99m tetrofosmin % wall thickening. Comparison with F-18 FDG-PET

International Nuclear Information System (INIS)

Maruyama, Atsushi; Hasegawa, Shinji; Paul, A.K.; Xiuli, M.; Yoshioka, Jun; Maruyama, Kaoru; Hori, Masatsugu; Nishimura, Tsunehiko

2002-01-01

This study was designed to assess the value of gated SPECT Tc-99m-tetrofosmin (TF) wall thickening (WT) in addition to TF exercise (Ex)/rest myocardial SPECT, in comparison with F-18 fluorodeoxyglucose (FDG)-PET. The study population consisted of 33 patients with old myocardial infarction (27 men and 6 women; mean age, 62±8 years old). All patients underwent Ex/rest TF SPECT and glucose loading FDG-PET. Polar map images of Ex/rest TF were generated and divided into 24 segments for further analysis. We classified LV segments according to the exercise-rest perfusion scintigraphy. LV segments with less than 70% of the maximum TF activity on the exercise image were defined as stress-induced defects. Among these, the segments whose TF acitvity increased by 10% from exercise to rest images or exceeded 70% of the maximum uptake were defined as reversible (viable) defects. The remaining defects on the rest image were irreversible (non-viable) defect segments, and were considered for viability study on the basis of %WT. %WT was calculated according to the standard method: {(counts ES-counts ED)/ counts ED} x 100. A viable segment on gated SPECT was defined as a segment whose %WT exceeded the lower limit of the normal value (mean-SD). PET viability was defined as FDG uptake exceeding 50% of the maximum count. Among the 792 segments evaluated in the 33 patients studied, there were 689 PET viable segments. Of the 689 segments analyzed, 198 (29%) were identified as having defects on Ex images. Among these defects, 55 (8%) were reversible or partially reversible, as evidenced by rest images, and 143 (21%) were irreversible. Of the irreversible segments on Ex/rest images, 106 (15%) demonstrated no apparent WT by gated TF SPECT, whereas 37 (6%) segments with irreversible defects did have apparent WT. Overall, the sensitivity of Ex/rest TF perfusion imaging was 79%. Sensitivity was improved from 79% to 85% by combining %WT and perfusion data, but specificity was reduced from 70

Unsuspected Active Sarcoidosis Diagnosed by {sup 18}F-FDG PET/CT During the Search for a Primary Tumour in a Patient with Bone Lesions

Energy Technology Data Exchange (ETDEWEB)

Caobelli, Federico; Pizzocaro, Claudio; Soffientini, Alberto; Guerra, Ugo Paolo [Fondazion Poliambulanza, Brescia (Italy); Gabanelli, Sara Vincenzina; Brucato, Antonio [Ospedali Riuniti, Bergamo (Italy); Giubbini, Raffaele [Univ. of Brescia, Brescia (Italy)

2013-09-15

Sarcoidosis is a systemic chronic inflammatory disease of unknown aetiology, characterised by granulomatous lesions with heterogeneous clinical manifestations affecting multiple organs and tissues. Although the respiratory system is most commonly affected, the disease may also present with bone lesions. We report the case of a 31-year old woman who presented with low back pain and no history of cancer and who was found to have suspicious lesions involving the entire spine on magnetic resonance imaging (MRI). The patient underwent {sup 18}F-fluorodeoxyglucose (FDG) PET/CT to search for a primary tumour and for staging purposes. {sup 18}F-FDG PET/CT revealed a pattern of hypermetabolic activity in widespread skeletal lesions and in a single left cervical lymph node. The primary tumour was not found, thus suggesting a haematologic disorder. Subsequent biopsies of a cervical lymph node and of bone tissue from L4 revealed active sarcoidosis with no evidence of cancer. This underlines the importance of considering all alternatives when hypermetabolic lesions are found on {sup 18}F-FDG PET/CT. Furthermore, {sup 18}F-FDG PET can be very useful to indicate accessible sites for guiding fine-needle aspiration cytology (FNAC)

Anatomical and functional volume concordance between FDG PET, and T2 and diffusion-weighted MRI for cervical cancer: a hybrid PET/MR study

International Nuclear Information System (INIS)

Sun, Hongzan; Xin, Jun; Zhang, Shaomin; Guo, Qiyong; Lu, Yueyue; Zhai, Wei; Zhao, Long; Peng, Weiai; Wang, Baijun

2014-01-01

To evaluate the concordance among 18 F-FDG PET imaging, MR T2-weighted (T2-W) imaging and apparent diffusion coefficient (ADC) maps with diffusion-weighted (DW) imaging in cervical cancer using hybrid whole-body PET/MR. This study prospectively included 35 patients with cervical cancer who underwent pretreatment 18 F-FDG PET/MR imaging. 18 F-FDG PET and MR images were fused using standard software. The percent of the maximum standardized uptake values (SUV max ) was used to contour tumours on PET images, and volumes were calculated automatically. Tumour volumes measured on T2-W and DW images were calculated with standard techniques of tumour area multiplied by the slice profile. Parametric statistics were used for data analysis. FDG PET tumour volumes calculated using SUV max (14.30 ± 4.70) and T2-W imaging volume (33.81 ± 27.32 cm 3 ) were similar (P > 0.05) at 35 % and 40 % of SUV max (32.91 ± 18.90 cm 3 and 27.56 ± 17.19 cm 3 respectively) and significantly correlated (P 3 . DW volumes were not significantly different from FDG PET volumes at either 35 % SUV max or 40 % SUV max or from T2-W imaging volumes (P > 0.05). PET subvolumes with increasing SUV max cut-off percentage showed an inverse change in mean ADC values on DW imaging (P max is recommended for 18 F-FDG PET/MR SUV-based tumour volume estimation. The linear tumour subvolume concordance between FDG PET and DW imaging demonstrates individual regional concordance of metabolic activity and cell density. (orig.)

FDG-PET/CT in the prediction of pulmonary function improvement in nonspecific interstitial pneumonia. A Pilot Study

Energy Technology Data Exchange (ETDEWEB)

Jacquelin, V. [AP-HP, Hosp. Avicenne, Department of Nuclear Medicine, Bobigny (France); Mekinian, A. [AP-HP, Hosp. Saint-Antoine, Department of Internal Medicine and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris (France); Brillet, P.Y. [AP-HP, Hosp. Avicenne, Department of Radiology, Bobigny (France); Univ. Paris 13, Sorbonne Paris Cité, Bobigny (France); Nunes, H. [AP-HP, Hosp. Avicenne, Department of Pneumology, Bobigny (France); Univ. Paris 13, Sorbonne Paris Cité, Bobigny (France); Fain, O. [AP-HP, Hosp. Saint-Antoine, Department of Internal Medicine and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris (France); Valeyre, D. [AP-HP, Hosp. Avicenne, Department of Pneumology, Bobigny (France); Univ. Paris 13, Sorbonne Paris Cité, Bobigny (France); Soussan, M., E-mail: michael.soussan@aphp.fr [AP-HP, Hosp. Avicenne, Department of Nuclear Medicine, Bobigny (France); Univ. Paris 13, Sorbonne Paris Cité, Bobigny (France)

2016-12-15

Purpose: Our study aimed to analyse the characteristics of nonspecific interstitial pneumonia (NSIP) using FDG-PET/CT (PET) and to evaluate its ability to predict the therapeutic response. Procedures: Eighteen NSIP patients were included. Maximum standardized uptake value (SUV{sub max}), FDG uptake extent (in percentage of lung volume), high resolution CT scan (HRCT) elementary lesions, and HRCT fibrosis score were recorded. The predictive value of the parameters for lung function improvement was evaluated using logistic regression and Receiver Operating Characteristic (ROC) curve analysis (n = 13/18). Results: All patients had an increased pulmonary FDG uptake (median SUV{sub max} = 3.1 [2–7.6]), with a median extent of 19% [6–67]. Consolidations, ground-glass opacities, honeycombing and reticulations showed uptake in 90%, 89%, 85% and 76%, respectively. FDG uptake extent was associated with improvement of pulmonary function under treatment (increase in forced vital capacity > 10%, p = 0.03), whereas SUV{sub max} and HRCT fibrosis score were not (p > 0.5). For FDG uptake extent, ROC analysis showed an area under the curve at 0.85 ± 0.11 and sensitivity/specificity was 88%/80% for a threshold fixed at 21%. Conclusions: Increased FDG uptake was observed in all NSIP patients, both in inflammatory and fibrotic HRCT lesions. The quantification of FDG uptake extent might be useful to predict functional improvement under treatment.

FDG-PET/CT in the prediction of pulmonary function improvement in nonspecific interstitial pneumonia. A Pilot Study

International Nuclear Information System (INIS)

Jacquelin, V.; Mekinian, A.; Brillet, P.Y.; Nunes, H.; Fain, O.; Valeyre, D.; Soussan, M.

2016-01-01

Purpose: Our study aimed to analyse the characteristics of nonspecific interstitial pneumonia (NSIP) using FDG-PET/CT (PET) and to evaluate its ability to predict the therapeutic response. Procedures: Eighteen NSIP patients were included. Maximum standardized uptake value (SUV max ), FDG uptake extent (in percentage of lung volume), high resolution CT scan (HRCT) elementary lesions, and HRCT fibrosis score were recorded. The predictive value of the parameters for lung function improvement was evaluated using logistic regression and Receiver Operating Characteristic (ROC) curve analysis (n = 13/18). Results: All patients had an increased pulmonary FDG uptake (median SUV max = 3.1 [2–7.6]), with a median extent of 19% [6–67]. Consolidations, ground-glass opacities, honeycombing and reticulations showed uptake in 90%, 89%, 85% and 76%, respectively. FDG uptake extent was associated with improvement of pulmonary function under treatment (increase in forced vital capacity > 10%, p = 0.03), whereas SUV max and HRCT fibrosis score were not (p > 0.5). For FDG uptake extent, ROC analysis showed an area under the curve at 0.85 ± 0.11 and sensitivity/specificity was 88%/80% for a threshold fixed at 21%. Conclusions: Increased FDG uptake was observed in all NSIP patients, both in inflammatory and fibrotic HRCT lesions. The quantification of FDG uptake extent might be useful to predict functional improvement under treatment.

Influence of N-butylscopolamine on SUV in FDG PET of the bowel

International Nuclear Information System (INIS)

Sanghera, B.; Emmott, J.; Chambers, J.; Wong, W.L.; Wellsted, D.

2009-01-01

Peristalsis can lead to confusing fluorodeoxyglucose (FDG) positron emission tomography (PET) bowel uptake artefacts and potential for recording inaccurate mean standardised uptake value (SUV) measurements in PET-CT scans. Accordingly, we investigate the influence of different SUV normalisations on FDG PET uptake of the bowel and assess which one(s) have least dependence on body size factors in patients with and without the introduction of the anti-peristalsis agent N-butylscopolamine (Buscopan). This study consisted of 92 prospective oncology patients, each having a whole body 18 F-FDG PET scan. Correlations were investigated between height, weight, glucose, body mass index (bmi), lean body mass (lbm) and body surface area (bsa) with maximum and mean SUV recorded for bowel normalised to weight (SUV w ), lbm (SUV lbm ), bsa (SUV bsa ) and blood glucose corrected versions (SUV wg , SUV lbmg , SUV bsag ). Standardised uptake value normalisations were significantly different between control and Buscopan groups with less variability experienced within individual SUV normalisations by the administration of Buscopan. Mean SUV normalisations accounted for 80% of correlations in the control group and 100% in the Buscopan group. Further, >86% of all correlations across both groups were dominated by mean SUV normalisations of which, about 69% were accounted for by SUV bsa and SUV bsag . We recommend avoiding mean SUV bsa and individual glucose normalisations especially, mean SUV bsag as these dominated albeit relatively weak correlations with body size factors in control and Buscopan groups. Mean and maximum SUV w , and SUV lbm were shown to be independent of any body size parameters investigated in both groups and therefore considered suitable for monitoring FDG PET uptake in the normal bowel for our patient cohort. (author)

Dose painting based on tumor uptake of Cu-ATSM and FDG: a comparative study

International Nuclear Information System (INIS)

Clausen, Malene Martini; Hansen, Anders Elias; Lundemann, Michael; Hollensen, Christian; Pommer, Tobias; Munck af Rosenschöld, Per; Kristensen, Annemarie Thuri; Kjær, Andreas; McEvoy, Fintan J; Engelholm, Svend Aage

2014-01-01

Hypoxia and increased glycolytic activity of tumors are associated with poor prognosis. The purpose of this study was to investigate differences in radiotherapy (RT) dose painting based on the uptake of 2-deoxy-2-[ 18 F]-fluorodeoxyglucose (FDG) and the proposed hypoxia tracer, copper(II)diacetyl-bis(N 4 )-methylsemithiocarbazone (Cu-ATSM) using spontaneous clinical canine tumor models. Positron emission tomography/computed tomography scans of five spontaneous canine sarcomas and carcinomas were obtained; FDG on day 1 and 64 Cu-ATSM on day 2 and 3 (approx. 3 and 24 hours pi.). Sub-volumes for dose escalation were defined by a threshold-based method for both tracers and five dose escalation levels were formed in each sub-volume. Volumetric modulated arc therapy plans were optimized based on the dose escalation regions for each scan for a total of three dose plans for each dog. The prescription dose for the GTV was 45 Gy (100%) and it was linearly escalated to a maximum of 150%. The correlations between dose painting plans were analyzed with construction of dose distribution density maps and quality volume histograms (QVH). Correlation between high-dose regions was investigated with Dice correlation coefficients. Comparison of dose plans revealed varying degree of correlation between cases. Some cases displayed a separation of high-dose regions in the comparison of FDG vs. 64 Cu-ATSM dose plans at both time points. Among the Dice correlation coefficients, the high dose regions showed the lowest degree of agreement, indicating potential benefit of using multiple tracers for dose painting. QVH analysis revealed that FDG-based dose painting plans adequately covered approximately 50% of the hypoxic regions. Radiotherapy plans optimized with the current approach for cut-off values and dose region definitions based on FDG, 64 Cu-ATSM 3 h and 24 h uptake in canine tumors had different localization of the regional dose escalation levels. This indicates that 64 Cu-ATSM at two

Supply of FDG : production and distribution

International Nuclear Information System (INIS)

Pilloy, W.J.; Fallais, A.

2004-01-01

Full text: Aim: To review the means of production of PET tracers and the logistIcs of their distribution, with special emphasis on 18 FDG - from an end-user point of view. Material and method: The experience of a satellite center (i.e. without in-house cyclotron) over one year. Results: The following topics are presented: Basic introduction to FDG and its radio-synthesis; properties of cyclotrons and linear accelerators; the economics of buying and running a cyclotron to produce FDG; satellite facilities (availability from radiopharmacies; fraction of FDG in the cost of running a PET center; recent developments in PET cameras, and their implications of FDG supply; diversification in the offer of commercial PET tracers; regulatory issues, and their influence on FDG supply; possible developments in onco-PET, neuro-PET, cardio-PET; generators and full PET Nuclear Medicine. Conclusion: The European experience is not necessarily completely applicable to a large country like South Africa; the question can be raised whether it is advisable to move the patients, the FDG or the camera around the country or its provinces. (author)

F-18-FDG positron emission tomography findings correlate pathological proliferative activity of oral squamous cell carcinoma

International Nuclear Information System (INIS)

Toyoizumi, Osamu; Oriuchi, Noboru; Miyakubo, Mitsuyuki

2010-01-01

It is still controversial whether fluorodeoxyglucose (FDG) uptake is correlated with cellular proliferation and prognosis of oral squamous cell carcinoma (OSC). In this study, we performed positron emission tomography (PET) study and immunohistochemical analysis to elucidate the relationship between FDG uptake and expression of cellular proliferative markers and pathological prognostic markers in patients with OSC. FDG PET and immunohistochemical staining have been carried out in sixteen patients with OSC. Tumor uptake of FDG was expressed with standardized uptake value (SUV). The expression of Ki-67, Topoisomerase IIα (Topo IIα), p53, and p63 in cancer cells was quantitatively assessed with positivity of the immunohistochemical staining. SUV was compared with the results of immunohistochemical analysis. FDG PET study revealed that SUV ranged from 3.6 to 22.1 with average of 10.4. Average positive rate of Ki-67, Topo IIα, p53, and p63 was 68.9%, 58.9%, 72.0%, and 65.2%, respectively. Pearson product-moment correlation coefficient analysis revealed that SUV was significantly correlated with Ki-67 (r=0.616, p=0.01), Topo IIα (r=0.677, p=0.004), p53 (r=0.613, p=0.01), and p63 (r=0.710, p=0.002), respectively. The present preliminary study indicated that FDG uptake was closely correlated with pathological cellular proliferative and prognostic markers in patients with OSC. (author)

Clinical characteristics of elastofibroma dorsi incidentally detected on FDG-PET/CT for a thoracic tumor

International Nuclear Information System (INIS)

Kawasaki, Hidenori; Higa, Noboru; Yohena, Tomofumi

2011-01-01

When elastofibroma dorsi with FDG accumulation is found by 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) in patients with a malignant tumor, its differentiation from a metastasis seems to be a difficult and critical problem. As there are few reports on FDG-PET for elastofibroma dorsi, we reviewed those cases of elastofibroma dorsi which were incidentally discovered on FDG-PET/CT. We retrospectively reviewed 306 patients who underwent FDG-PET/CT for the evaluation of a lung or mediastinal tumor, and in whom elastofibroma dorsi was detected, and analyzed their clinical characteristics. Elastofibroma dorsi was detected in 16 of the 306 cases (5.2%); 10 of whom were women and 6 were men. Age ranged from 55 to 82 years, with an average of 71.6 years. Woman were predominant among the patients with elastofibroma dorsi, compared with patients without a tumor (p=0.0177). Elderly patients were also predominant among the patients with elastofibroma dorsi, compared with patients without a tumor, but the difference was not significant (p=0.0587). The accumulation of FDG was observed in 8 of the 16 cases (15 of 31 tumors). The maximum standardized uptake values (SUVmax) ranged from 2.0 to 2.9, with an average of 2.3, among those cases in which the SUVmax was evaluated. Although elastofibroma is rare, it is important for physicians to know that some elastofibromas exhibit FDG accumulation on PET. This knowledge may help to prevent unnecessary biopsies or surgical interventions, and also prevent excessive anxiety in patients with elastofibroma dorsi. (author)

Prognostic Value of Metabolic Activity Measured by 18F-FDG PET/CT in Patients with Advanced Endometrial Cancer

International Nuclear Information System (INIS)

Kim, Hyun Jeong; Choi, Jiyoun; Jeong, Yong Hyu; Jo, Kwan Hyeong; Lee, Jaehoon; Cho, Arthur; Yun, Mijin; Lee, Jong Doo; Kim, Young Tae; Kang, Won Jun

2013-01-01

We evaluated the potential prognostic value of 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with stage IIIC/IV endometrial cancer. Patients with stage IIIC/IV endometrial cancer who had undergone FDG PET/CT workup for staging were enrolled. Maximum standardized uptake values (SUV max ) measured from regions of interest (ROIs) of the primary tumor (SUVt) and lymph nodes (SUVn) were correlated with overall survival (OS). The SUVn was defined as the highest SUV max of the metastatic lymph nodes. Survival probability was assessed using the Kaplan-Meier method. A total of 42 patients with a median age of 55.5 years (range 32-76 years) were included. Twenty-nine percent (n =12) of patients were premenopausal and 71 % (n =30) were postmenopausal. The average SUVt was 12.9 (range 1.8-36.5), and the average SUVn was 7.3 (range 2.0-22.5). Median follow-up time was 25.9 months (range 1.84 months). Using a SUVt of 9.5 as a cutoff value, two groups with different rates were determined (P=0.026). In addition, patients with a low SUVn had significantly better OS than those with a high SUVn (P=0.003). Patients in the International Federation of Obstetrics and Gynecology (FIGO) stage IV group with SUVt≥9.5 or SUVn≥7.3 showed a significantly longer OS than the other groups. FDG uptake of primary endometrial cancer and lymph nodes might be a prognostic factor in advanced endometrial cancer. More aggressive therapy could be considered in patients with stage IV endometrial cancer and high SUVt and/or high SUVn

FDG-PET/CT imaging in the management of HIV-associated multicentric Castleman's disease

International Nuclear Information System (INIS)

Barker, Rob; Kazmi, Fahrad; Stebbing, Justin; Chinn, Roger; Ngan, Sarah; Bower, Mark; Nelson, Mark; O'Doherty, Michael

2009-01-01

To evaluate the role of FDG-PET/CT scanning in the management of HIV-associated multicentric Castleman's disease (MCD) a rare lymphoproliferative disorder associated with infection by human herpesvirus 8 (HHV8). Nine patients with histologically confirmed MCD underwent fused FDG-PET/CT scans at initial MCD diagnosis (n = 3), at MCD relapse (n = 4), or during remission (n = 2). All seven patients with active MCD had markedly elevated plasma HHV8 viral loads, but the patients in remission had no HHV8 viraemia. The three patients with newly diagnosed MCD were not on antiretroviral therapy at the time of imaging, but the other six were all on fully suppressive antiretroviral regimens. In the seven patients with active MCD (newly diagnosed or relapse) 33/91 lymph node groups (36%) included radiologically enlarged nodes on the CT scan, whilst 57/91 lymph node groups (63%) showed enhanced FDG uptake on the PET scan. In scans from patients in remission, there were no enlarged lymph nodes on the CT scan but 3 lymph nodes (11%) demonstrated enhanced FDG uptake. The median SUV recorded for the seven patients with active MCD was 4.8 (range 2.6-9.3) which was significantly higher than the median value of 2.5 recorded for the patients in remission (Mann-Whitney U test, p = 0.011). Despite the small number of patients, in HIV-positive individuals with active MCD, FDG-PET scans more frequently detected abnormal uptake than CT scans detected enlarged lymph nodes. FDG-PET scanning has a useful role in the management of HIV-associated MCD in selecting appropriate sites for biopsy, and in staging and monitoring these lymphoproliferations. (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.)

Prognostic value of defining the systemic tumor volume with FDG-PET in diffuse large b cell lymphoma

International Nuclear Information System (INIS)

Byun, Byung Hyun; Lim, Sang Moo; Cheon, Gi Jeong; Choi, Chang Woon; Kang, Hye Jin; Na, Im Il; Ryoo, Baek Yeol; Yang, Sung Hyun

2007-01-01

We measured the systemic tumor volume using FDG-PET in patients with diffuse large B cell lymphoma (DLBL). We also investigated its prognostic role, and compared it with that of other prognostic factors. FDG PET was performed in 38 newly diagnosed DLBL patients (20 men, 18 women, age 55.715.1 years) at pre-treatment of chemotherapy. Clinical staging of lymphoma was evaluated by Ann Arbor system. On each FDG PET scan, we acquired volume of interest (VOl) at the cut-off value of SUV=2.5 in every measurable tumor by the automatic edge detection software. According to the VOI, we measured the metabolic volume and mean SUV, and estimated volume-activity indexes (SUV Vol) as mean SUV times metabolic volume. And then, we calculated the summed metabolic volume (VOLsum) and summed SUV Vol (SUV Volsum) in every FDG PET scan. Maximum SUV of involved lesion (SUVmax) was also acquired on each FDG PET scan. Time to treatment failure (TTF) was compared among VOLsum (median), SUV Volsum (median), SUVmax (median), clinical stage, gender, age, LDH, and performance status-assigned response designations by Kaplan-Meier survival analysis. Initial stages of DLBL patients were stage I in 4, II in 14, III in 15, and IV in 4 by Ann Arbor system. Median follow up period was 15.5months, and estimated mean TTF was 22.3 months. Univariate analysis demonstrated that TTF is statistically significantly reduced in those with high VOLsum (>215.1cm2, p=0.004), high SUV Volsum (>1577.5, p=0.003), and increased LDH (p=0.036). TTF did not correlate with SUVmax (p=0.571), clinical stage (p=0.194), gender (p=0.549), and age (p=0.128), and performance status =2 (p=0.074). Multivariate analysis using VOLsum, SUV Volsum, LDH, and performance status demonstrated no statistically significant predictor of TTF (p>0.05). Systemic tumor volume measurement using FDG-PET is suggestive to be the significant prognostic factor in patients with DLBL

Effect of glucose level on brain FDG-PET images

Energy Technology Data Exchange (ETDEWEB)

Kim, In Young; Lee, Yong Ki; Ahn, Sung Min [Dept. of Radiological Science, Gachon University, Seongnam (Korea, Republic of)

2017-06-15

In addition to tumors, normal tissues, such as the brain and myocardium can intake {sup 18}F-FDG, and the amount of {sup 18}F-FDG intake by normal tissues can be altered by the surrounding environment. Therefore, a process is necessary during which the contrasts of the tumor and normal tissues can be enhanced. Thus, this study examines the effects of glucose levels on FDG PET images of brain tissues, which features high glucose activity at all times, in small animals. Micro PET scan was performed on fourteen mice after injecting {sup 18}F-FDG. The images were compared in relation to fasting. The findings showed that the mean SUV value w as 0 .84 higher in fasted mice than in non-fasted mice. During observation, the images from non-fasted mice showed high accumulation in organs other than the brain with increased surrounding noise. In addition, compared to the non-fasted mice, the fasted mice showed higher early intake and curve increase. The findings of this study suggest that fasting is important in assessing brain functions in brain PET using {sup 18}F-FDG. Additional studies to investigate whether caffeine levels and other preprocessing items have an impact on the acquired images would contribute to reducing radiation exposure in patients.

Effect of glucose level on brain FDG-PET images

International Nuclear Information System (INIS)

Kim, In Young; Lee, Yong Ki; Ahn, Sung Min

2017-01-01

In addition to tumors, normal tissues, such as the brain and myocardium can intake 18 F-FDG, and the amount of 18 F-FDG intake by normal tissues can be altered by the surrounding environment. Therefore, a process is necessary during which the contrasts of the tumor and normal tissues can be enhanced. Thus, this study examines the effects of glucose levels on FDG PET images of brain tissues, which features high glucose activity at all times, in small animals. Micro PET scan was performed on fourteen mice after injecting 18 F-FDG. The images were compared in relation to fasting. The findings showed that the mean SUV value w as 0 .84 higher in fasted mice than in non-fasted mice. During observation, the images from non-fasted mice showed high accumulation in organs other than the brain with increased surrounding noise. In addition, compared to the non-fasted mice, the fasted mice showed higher early intake and curve increase. The findings of this study suggest that fasting is important in assessing brain functions in brain PET using 18 F-FDG. Additional studies to investigate whether caffeine levels and other preprocessing items have an impact on the acquired images would contribute to reducing radiation exposure in patients

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.

FDG uptake in cervical lymph nodes in children without head and neck cancer.

Science.gov (United States)

Vali, Reza; Bakari, Alaa A; Marie, Eman; Kousha, Mahnaz; Charron, Martin; Shammas, Amer

2017-06-01

Reactive cervical lymphadenopathy is common in children and may demonstrate increased 18 F-fluoro-deoxyglucose ( 18 F-FDG) uptake on positron emission tomography/computed tomography (PET/CT). We sought to evaluate the frequency and significance of 18 F-FDG uptake by neck lymph nodes in children with no history of head and neck cancer. The charts of 244 patients (114 female, mean age: 10.4 years) with a variety of tumors such as lymphoma and post-transplant lymphoproliferative diseases (PTLD), but no head and neck cancers, who had undergone 18 F-FDG PET/CT were reviewed retrospectively. Using the maximum standardized uptake value (SUVmax), increased 18 F-FDG uptake by neck lymph nodes was recorded and compared with the final diagnosis based on follow-up studies or biopsy results. Neck lymph node uptake was identified in 70/244 (28.6%) of the patients. In 38 patients, the lymph nodes were benign. In eight patients, the lymph nodes were malignant (seven PTLD and one lymphoma). In 24 patients, we were not able to confirm the final diagnosis. Seven out of the eight malignant lymph nodes were positive for PTLD. The mean SUVmax was significantly higher in malignant lesions (4.2) compared with benign lesions (2.1) (P = 0.00049). 18 F-FDG uptake in neck lymph nodes is common in children and is frequently due to reactive lymph nodes, especially when the SUVmax is cervical lymph nodes is higher in PTLD patients compared with other groups.

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

Distinguishing benign from malignant gallbladder wall thickening using FDG-PET

International Nuclear Information System (INIS)

Oe, Ai; Kawabe, Joji; Torii, Kenji

2006-01-01

Because thickening of the gallbladder wall is observed not only in patients with gallbladder cancer but also in those with benign diseases such as chronic cholecystitis and gallbladder adenomyosis, it is difficult to distinguish between benign and malignant gallbladder wall thickening by conventional techniques of diagnostic imaging such as computed tomography (CT), magnetic resonance imaging (MRI), and abdominal ultrasonography (US). In the present study, we attempted to distinguish between benign and malignant gallbladder wall thickening by means of fluorine-18-fluorodeoxyglucose (FDG)-Positron emission tomography (PET). FDG-PET was performed in 12 patients with gallbladder wall thickening detected by CT or US, to determine whether it was benign or malignant. Emission scans were taken, beginning 45 minutes after intravenous administration of FDG, and standardized uptake value (SUV) was calculated as an indicator of glucose metabolism. Of the 12 patients, 4 showed positive uptake of FDG in the gallbladder wall. Of these 4 patients, 3 had gallbladder cancer. The remaining one, who had chronic cholecystitis, had false-positive findings. The other 8 patients had negative uptake of FDG in the gallbladder wall. Two of these 8 underwent surgical resection, which yielded a diagnosis of chronic cholecystitis. The other 6 patients exhibited no sign of gallbladder malignancy and have been followed without active treatment. FDG-PET appears able to distinguish between benign and malignant gallbladder wall thickening. (author)

Interobserver and Intraobserver Variability among Measurements of FDG PET/CT Parameters in Pulmonary Tumors

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Gülgün Büyükdereli

2016-06-01

Full Text Available Background: 18F-fluorodeoxyglucose (FDG positron emission tomography computed tomography (PET/CT provides information about metabolic and morphologic status of malignancies. Tumor size and standardized uptake value (SUV measurements are crucial for cancer treatment monitoring.: 18F-fluorodeoxyglucose (FDG positron emission tomography computed tomography (PET/CT provides information about metabolic and morphologic status of malignancies. Tumor size and standardized uptake value (SUV measurements are crucial for cancer treatment monitoring. Aims: The purpose of our study was to assess the variability of these measurements performed by observers evaluating lung tumors. Study Design: Retrospective cross-sectional study. Methods: FDG PET/CT images of 97 patients with pulmonary tumors were independently evaluated by two experienced nuclear medicine physicians. Primary tumor size (UDCT, maximum SUV (SUVmax, mean SUV (SUVmean and maximum SUV normalized to liver mean SUV (SUVnliv max were measured by each observer at two different times with an interval of at least 2 weeks. Interobserver and intraobserver variabilities of measurements were evaluated through statistical methods. Results: Size of the lesions varied from 0.81 to 13.6 cm (mean 4.29±2.24 cm. Very good agreement was shown with correlation, Bland-Altman and regression analysis for all measured PET/CT parameters. In the interobserver and intraobserver variability analysis, the Pearson correlation coefficients were greater than 0.96 and 0.98, respectively. Conclusion: Semi-quantitative measurements of pulmonary tumors were highly reproducible when determined by experienced physicians with clinically available software for routine FDG PET/CT evaluation. Consistency may be improved if the same observer performs serial measurements for any one patient.

Colonic uptake patterns of F-18-FDG PET in asymptomatic adults: correlation with colonoscopic findings

International Nuclear Information System (INIS)

Pai, M.; Cho, Y.; Shim, K

2004-01-01

Physiologic intestinal FDG uptake is frequently observed in asymptomatic individuals for cancer screening FDG PET. Colonic FDG accumulation is a well-known confusing findings that interfere true cancer detection or cause false positive. The aim of this study was to evaluate the pattern and intensity of colonic uptake in whole body FDG PET in asymptomatic healthy adults and to correlate those with colonoscopic findings. We reviewed retrospectively 64 subjects (age: 27-87, M:F = 31:33) who underwent both FDG PET and colonoscopy for cancer screening. FDG uptake pattern was classified as focal, segmental and diffuse. Maximum SUV were measured. The PET results were compared with colonoscopic and histologic findings. In 34 patients FDG bowel uptake was interpreted as diffuse(group I), in 17 patients as segmental(group II) and in 13 patients as focal uptake(group III). Six adenomas(17.6%, average diameter = 5 mm) were found in group I, 7 adenomas (41.1%, 5.57 mm) in group II and 4 adenomas and 1 adenocarcinoma (30.7%, 16.4 mm) in group III. There was no difference in averages of SUV between patients with adenoma and with negative colonoscopic results in each group of intestinal FDG pattern (group I: 1.675±1.15 vs 1.94±0.62, group II: 4.78±3.66 vs 4.23±1.13, group III: 6.50±4.68 vs 4.1±1.01). Large adenomas( >1 cm) were detected more frequently in group III (4 out of 5) rather than in group II (1 out of 7) or group I (none) and had higher SUV (6.30±4.84) than small adenomas (3.74±3.23). In group III, 4 patients without adenomas were non-physiologic(30.7%, 2 intestinal tuberculosis, 2 mucosal ulcer). Focal FDG uptake is associated more often with large adenoma and other pathologic findings in colonoscopy. Segmental uptake cannot discriminate presence of adenoma from negative results, while diffuse pattern may imply normal or having small adenomas

Colonic uptake patterns of F-18-FDG PET in asymptomatic adults: comparison with colonoscopic findings

International Nuclear Information System (INIS)

Pai, Moon Sun; Cho, Yoo Kyung; Jung, Sung Ae; Shim, Ki Nam; Lee, Hong Soo

2005-01-01

Physiologic intestinal FDG uptake is frequently observed in asymptomatic individuals for cancer screening FDG PET. Colonic FDG accumulation is a well-known confusing findings that interfere true cancer detection or cause false positive. The aim of this study was to evaluate the pattern and intensity of colonic uptake in whole body FDG PET in asymptomatic healthy adults and to correlate them with colonoscopic findings. We reviewed retrospectively 64 subjects (age: 27-87, M:F=31:33) who underwent both FDG PET and colonoscopy for cancer screening. FDG uptake patterns were classified as focal, segmental and diffuse. Maximum SUV were measured. The PET results were compared with colonoscopic and histologic findings. In 13 patients FDG bowel uptake was interpreted as focal, in 17 patients as segmental and in 34 patients as diffuse uptake. Six adenomas (17.6%, average diameter=5.0 mm) were found in diffuse pattern, 7 adenomas (41.1%, 5.6 mm) in segmental and 4 adenomas and 1 adenocarcinoma (38.5%, 16.4 mm) in focal uptake pattern. In patients with focal uptake, four were non-adenomatous pathologic lesions (30.8%, 2 intestinal tuberculosis, 2 mucosal ulcer). There is no difference of mean SUV between patients with adenoma and with negative colonoscopic results in each group of intestinal FDG pattern (Diffuse: 1.7 ± 0.1 vs 1.9 ± 0.5, Segmental: 4.8 ± 3.6 vs 4.2 ± 1.2, Focal: 6.5 ± 4.7 vs 3.5 ± 1.3). Large adenomas (>1 cm) can be detected more in the focal uptake pattern (4 out of 5) rather than in segmental (1 out of 7) or diffuse uptake (none) and had higher SUV (6.3 ± 4.8) than small adenomas (3.5 ± 3.0)(statistically insignificant). Focal FDG uptake is associated more often with large adenoma and other pathologic findings in colonoscopy. Segmental uptake cannot discriminate presence of adenoma from negative results, while diffuse pattern may have more chance to be normal

FDG-PET in Follicular Lymphoma Management

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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.

Steam sterilization and automatic dispensing of [18F]fludeoxyglucose (FDG) for injection

International Nuclear Information System (INIS)

Karwath, Pascal; Sartor, Johannes; Gries, Wolfgang; Wodarski, Christine; Dittmar, Claus; Biersack, Hans J.; Guhlke, Stefan

2005-01-01

For the purpose of implementing steam sterilization of 2-[ 18 F]FDG (FDG) in the final container into routine production, we have validated and established a fully automated dispensing and sterilization system, thereby considerably reducing the radiation burden to the personnel. Methods: The commercially available system combines aseptic dispensing of the product solution under a miniaturized laminar flow unit with subsequent steam sterilization, realized by heating of the product in the final containers by an autoclave included in the dispensing unit, thus incorporating current pharmaceutical manufacturing standards for the production of parental radiopharmaceuticals. The efficiency of the used sterilization cycle, the stability of FDG under the conditions of sterilization and the stability of the final product towards radiolysis was investigated with respect to various pH-formulations. Results: The system was found to be fully valid for filling of vials in a laminar flow class A (US-class 100) environment and for sterilization of FDG in the final container. The pH for sterilizing FDG solutions must be slightly acidic to avoid decomposition. A pH of 5.5 appears to be optimal and gives FDG of very high radiochemical purity (∼99%). In addition, radiolysis of FDG in solutions of high activity concentration was significantly lower at pH 5.5 than at neutral pH. Conclusion: Terminal sterilization enables the production of FDG in full compliance with GMP-regulations even in Class C or D (US class 10,000 or 100,000) laboratories

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)

Localization of Epileptogenic Zones using Partical Volume Corrected FDG Uptake on FDG PET and Voxel Based Morphometry on MRI

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Kang, Won Jun; Lee, Ho Young; Lee, Jae Sung; Lee, Dong Soo; Lee, Sang Kun; Chung, June Key; Lee, Myung Chul [College of Medicine, Univ. of Seoul National, Seoul (Korea, Republic of)

2003-07-01

Partial volume corrected (PVC) FDG uptake yields information about regional metabolic level void of volume change, and voxel based morphometry (VBM) yields objective information regarding gray matter concentration. We investigated the roles of PVC PET and VBM to localize epileptogenic zones in medial temporal lobe epilepsy (mTLE) and non-lesional neocortical epilepsy. As a control group for PVC, 40 normal volunteers without history of neurologic or psychiatric diseases underwent FDG PET and MRI. Seventeen mTLE patients (M: F=7: 10, age=309 y) and nine neocortical epilepsy patients (M: F=6: 3, age=246, lateral temporal: 5, frontal: 3, occipital: 1) confirmed by surgery or epilepsy board meeting were enrolled. Standard VBM analysis was performed using individual MRI images compared with those of age-matched controls. For PVC, FDG PET was co-registered with its own MRI. PVC PET was obtained by dividing spillover-corrected PET by smoothed gray matter image pixel by pixel. SPAM was applied as a mask of volume of interest (VOI) to calculate gyral FDG uptake on PVC-FDG PET. Hippocampus, amygdala, superior, middle, inferior temporal gyrus and parahippocampal gyrus were the gyral SPAM VOIs in mTLE. Globally normalized PVC-FDG counts were compared with those of age-matched controls in mTLE and neocortical epilepsy patients. In mTlE, PVC-FDG PET correctly localized epileptogenic zones with the accuracy of 76% (13/17) in hippocampus and 82% (14/17) in any of six regions. VBM correctly localized 59% (10/17) in mTLE. In neocortical epilepsy, PVC-FDG PET localized epileptogenic zones in 44%, and VBM in 33%, Using VBM and PVC-FDG PET altogether, epileptogenic zones were localized in 66% (6/9). In mTLE, gyral PVC FDG uptake of temporal lobes was useful in localizing epileptogenic zones by demonstrating partial volume-void FDG concentration. In non-lesional cryptogenic neocortical epilepsy, combination of PVC-FDG PET and VBM is recommended to localize epileptogenic zones.

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

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

2015-12-15

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

Prognostic Value of Metabolic Activity Measured by {sup 18}F-FDG PET/CT in Patients with Advanced Endometrial Cancer

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Kim, Hyun Jeong; Choi, Jiyoun; Jeong, Yong Hyu; Jo, Kwan Hyeong; Lee, Jaehoon; Cho, Arthur; Yun, Mijin; Lee, Jong Doo; Kim, Young Tae; Kang, Won Jun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

2013-12-15

We evaluated the potential prognostic value of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with stage IIIC/IV endometrial cancer. Patients with stage IIIC/IV endometrial cancer who had undergone FDG PET/CT workup for staging were enrolled. Maximum standardized uptake values (SUV{sub max}) measured from regions of interest (ROIs) of the primary tumor (SUVt) and lymph nodes (SUVn) were correlated with overall survival (OS). The SUVn was defined as the highest SUV{sub max} of the metastatic lymph nodes. Survival probability was assessed using the Kaplan-Meier method. A total of 42 patients with a median age of 55.5 years (range 32-76 years) were included. Twenty-nine percent (n =12) of patients were premenopausal and 71 % (n =30) were postmenopausal. The average SUVt was 12.9 (range 1.8-36.5), and the average SUVn was 7.3 (range 2.0-22.5). Median follow-up time was 25.9 months (range 1.84 months). Using a SUVt of 9.5 as a cutoff value, two groups with different rates were determined (P=0.026). In addition, patients with a low SUVn had significantly better OS than those with a high SUVn (P=0.003). Patients in the International Federation of Obstetrics and Gynecology (FIGO) stage IV group with SUVt≥9.5 or SUVn≥7.3 showed a significantly longer OS than the other groups. FDG uptake of primary endometrial cancer and lymph nodes might be a prognostic factor in advanced endometrial cancer. More aggressive therapy could be considered in patients with stage IV endometrial cancer and high SUVt and/or high SUVn.

Biological distribution of [18F-FDG] using reactor produced [18F

International Nuclear Information System (INIS)

Sierralta, P.; Massardo, T; Gil, M.C; Gonzalez, P; Chandia, M.; Godoy, N.; Troncoso, F

2002-01-01

The animal model that relates biodistribution of a substance is fundamental prior to using it in human beings. For the evaluation of myocardial viability after a recent MI, the use of reactor produced [ 18 F]-FDG (a radiotracer usually obtained in Cyclotron) is proposed, production of which has never been attempted in our country. Specific Activities founded in the different tissues after injection of this radiotracer in an animal model were compared with those obtained by other authors with cyclotron [ 18 F]-FDG. No statistically significant differences in the critical organs were found. Hence, reactor produced [ 18 F]-FDG is a useful radiopharmaceutical in cardiac cellular metabolism assessment (author)

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.

The value of [{sup 18}F]FDG-PET in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease

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Walter, Martin A.; Mueller-Brand, Jan; Nitzsche, Egbert U. [University Hospital Basel, Institute of Nuclear Medicine, Basel (Switzerland); Melzer, Ralph A.; Tyndall, Alan [University Hospital Basel, Division of Rheumatology (Switzerland); Schindler, Christian [University Hospital Basel, Institute of Social and Preventive Medicine (Switzerland)

2005-06-01

This study was performed to investigate the value of{sup 18}F-fluorodeoxyglucose positron emission tomography ([{sup 18}F]FDG-PET) in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease. Twenty-six consecutive patients (21 females, 5 males; median age - years, range 17-86 years) with giant cell arteritis or Takayasu's arteritis were examined with [{sup 18}F]FDG-PET. Follow-up scans were performed in four patients. Twenty-six age- and gender-matched controls (21 females, 5 males; median age 71 years, range 17-86 years) were included. The severity of large-vessel [{sup 18}F]FDG uptake was visually graded using a four-point scale. C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) were measured and correlated with [{sup 18}F]FDG-PET results by logistic regression. [{sup 18}F]FDG-PET revealed pathological findings in 18 of 26 patients. Three scans were categorised as grade I, 12 as grade II and 3 as grade III arteritis. Visual grade was significantly correlated with both CRP and ESR levels (p=0.002 and 0.007 respectively; grade I: CRP 4.0 mg/l, ESR 6 mm/h; grade II: CRP 37 mg/l, ESR 46 mm/h; grade III: CRP 172 mg/l, ESR 90 mm/h). Overall sensitivity was 60% (95% CI 40.6-77.3%), specificity 99.8% (95% CI 89.1-100%), positive predictive value 99.7% (95% CI 77-100%), negative predictive value 67.9% (95% CI 49.8-80.9%) and accuracy 78.6% (95% CI 65.6-88.4%). In patients presenting with a CRP <12 mg/l or an ESR <12 mm/h, logistic regression revealed a sensitivity of less than 50%. In patients with high CRP/ESR levels, sensitivity was 95.5%/80.7%. [{sup 18}F]FDG-PET is highly effective in assessing the activity and the extent of large-vessel vasculitis. Visual grading was validated as representing the severity of inflammation. Its use is simple and provides high specificity, while high sensitivity is achieved by scanning in the state of active inflammation. (orig.)

FDG-PET/CT assessment of differential chemotherapy effects upon skeletal muscle metabolism in patients with melanoma

International Nuclear Information System (INIS)

Goncalves, M.D.; Alavi, A.; Torigian, D.A.

2014-01-01

To quantify the differential effects of chemotherapy on the metabolic activity of skeletal muscle in vivo using molecular imaging with [18F]-fluorodeoxy-glucose (FDG)-positron emission tomography/computed tomography (PET/CT). In this retrospective study, 21 subjects with stage IV melanoma who underwent pre- and post-chemotherapy whole-body FDG-PET/CT imaging were included. The mean standardized uptake value (SUV mean ) of 8 different skeletal muscles was measured per subject. Pre- and post-treatment measurements were then averaged across all subjects for each muscle and compared for statistically significant differences between the muscles and following different chemotherapy regimens including dacarbazine (DTIC) and temozolomide (TMZ). Analysis of FDG-PET/CT images reliably detected changes in skeletal muscle metabolic activity based on muscle location. The percent change in metabolic activity of each skeletal muscle in each subject following chemotherapy was observed to be related to the type of chemotherapy received. Subjects receiving DTIC generally had a decrease in metabolic activity of all muscle groups, whereas subjects receiving TMZ generally had an increase in muscle activity of all muscle groups. FDG-PET/CT can reveal baseline metabolic differences between different muscles of the body. Different chemotherapies are associated with differential changes in the metabolic activity of skeletal muscle, which can be detected and quantified with FDG-PET/CT. (author)

Anatomical and functional volume concordance between FDG PET, and T2 and diffusion-weighted MRI for cervical cancer: a hybrid PET/MR study

Energy Technology Data Exchange (ETDEWEB)

Sun, Hongzan; Xin, Jun; Zhang, Shaomin; Guo, Qiyong; Lu, Yueyue; Zhai, Wei; Zhao, Long [Shengjing Hospital of China Medical University, Department of Radiology, Shenyang, Liaoning (China); Peng, Weiai [NM Marketing, Great China, Philips Healthcare, Guangzhou (China); Wang, Baijun [Philips China Investment Co. Ltd. Shenyang Office, Shenyang, Liaoning (China)

2014-05-15

To evaluate the concordance among {sup 18}F-FDG PET imaging, MR T2-weighted (T2-W) imaging and apparent diffusion coefficient (ADC) maps with diffusion-weighted (DW) imaging in cervical cancer using hybrid whole-body PET/MR. This study prospectively included 35 patients with cervical cancer who underwent pretreatment {sup 18}F-FDG PET/MR imaging. {sup 18}F-FDG PET and MR images were fused using standard software. The percent of the maximum standardized uptake values (SUV{sub max}) was used to contour tumours on PET images, and volumes were calculated automatically. Tumour volumes measured on T2-W and DW images were calculated with standard techniques of tumour area multiplied by the slice profile. Parametric statistics were used for data analysis. FDG PET tumour volumes calculated using SUV{sub max} (14.30 ± 4.70) and T2-W imaging volume (33.81 ± 27.32 cm{sup 3}) were similar (P > 0.05) at 35 % and 40 % of SUV{sub max} (32.91 ± 18.90 cm{sup 3} and 27.56 ± 17.19 cm{sup 3} respectively) and significantly correlated (P < 0.001; r = 0.735 and 0.766). The mean DW volume was 30.48 ± 22.41 cm{sup 3}. DW volumes were not significantly different from FDG PET volumes at either 35 % SUV{sub max} or 40 % SUV{sub max} or from T2-W imaging volumes (P > 0.05). PET subvolumes with increasing SUV{sub max} cut-off percentage showed an inverse change in mean ADC values on DW imaging (P < 0.001, ANOVA). Hybrid PET/MR showed strong volume concordance between FDG PET, and T2-W and DW imaging in cervical cancer. Cut-off at 35 % or 40 % of SUV{sub max} is recommended for {sup 18}F-FDG PET/MR SUV-based tumour volume estimation. The linear tumour subvolume concordance between FDG PET and DW imaging demonstrates individual regional concordance of metabolic activity and cell density. (orig.)

Effects of blood glucose level on FDG uptake by liver: a FDG-PET/CT study

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Kubota, Kazuo, E-mail: kkubota@cpost.plala.or.j [Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo 162-8655 (Japan); Watanabe, Hiroshige; Murata, Yuji [Department of Radiology, Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519 (Japan); Yukihiro, Masashi; Ito, Kimiteru; Morooka, Miyako; Minamimoto, Ryogo [Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo 162-8655 (Japan); Hori, Ai [Department of Epidemiology and International Health, Research Institute, National Center for Global Health and Medicine, Tokyo 162-8655 (Japan); Shibuya, Hitoshi [Department of Radiology, Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519 (Japan)

2011-04-15

In FDG-PET for abdominal malignancy, the liver may be assumed as an internal standard for grading abnormal FDG uptake both in early images and in delayed images. However, physiological variables of FDG uptake by the liver, especially the effects of blood glucose level, have not yet been elucidated. Methods: FDG-PET studies of 70 patients examined at 50 to 70 min after injection (60{+-}10 min: early images) and of 68 patients examined at 80 to 100 min after injection (90{+-}10 min: delayed images) were analyzed for liver FDG uptake. Patients having lesions in the liver, spleen and pancreas; patients having bulk tumor in other areas; and patients early after chemotherapy or radiotherapy were excluded; also, patients with blood glucose level over 125 mg/dl were excluded. Results: Mean standardized uptake value (SUV) of the liver, blood glucose level and sex showed no significant differences between early images and delayed images. However, liver SUV in the delayed image showed a larger variation than that in the early image and showed significant correlation to blood glucose level. The partial correlation coefficient between liver SUV and blood glucose level in the delayed image with adjustment for sex and age was 0.73 (P<.0001). Multivariate regression coefficient (95% confidence interval) of blood glucose was 0.017 (0.013-0.021). Conclusion: Blood glucose level is an important factor affecting the normal liver FDG uptake in nondiabetic patients. In the case of higher glucose level, liver FDG uptake is elevated especially in the delayed image. This may be due to the fact that the liver is the key organ responsible for glucose metabolism through gluconeogenesis and glycogen storage.

FDG PET/CT patterns of treatment failure of malignant pleural mesothelioma: relationship to histologic type, treatment algorithm, and survival

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Gerbaudo, Victor H.; Mamede, Marcelo [Brigham and Women' s Hospital, Harvard Medical School, Division of Nuclear Medicine and Molecular Imaging, Boston, MA (United States); Trotman-Dickenson, Beatrice; Hatabu, Hiroto [Brigham and Women' s Hospital, Harvard Medical School, Division of Thoracic Radiology, Boston, MA (United States); Sugarbaker, David J. [Brigham and Women' s Hospital, Harvard Medical School, Division of Thoracic Surgery, Boston, MA (United States)

2011-05-15

unplanned treatment at the time of failure. Multivariate analysis showed that histologic type remained the only independent predictor of progression-free survival. Survival after relapse was independently predicted by the pattern of FDG uptake and PET nodal status, and overall survival by the maximum standard uptake value. FDG PET/CT is an accurate modality to diagnose and to estimate the extent of locoregional and distant MPM recurrence, and it carries independent prognostic value. Once the disease recurs, survival outcomes seem to be independent of histologic type and highly dependent on the intensity of lesion uptake and on the pattern of metabolically active disease in FDG PET/CT. Our observations should be considered limited to patients treated surgically with or without perioperative therapies and should not be extrapolated to those unresectable cases treated with chemotherapy alone. (orig.)

FDG PET/CT patterns of treatment failure of malignant pleural mesothelioma: relationship to histologic type, treatment algorithm, and survival

International Nuclear Information System (INIS)

Gerbaudo, Victor H.; Mamede, Marcelo; Trotman-Dickenson, Beatrice; Hatabu, Hiroto; Sugarbaker, David J.

2011-01-01

unplanned treatment at the time of failure. Multivariate analysis showed that histologic type remained the only independent predictor of progression-free survival. Survival after relapse was independently predicted by the pattern of FDG uptake and PET nodal status, and overall survival by the maximum standard uptake value. FDG PET/CT is an accurate modality to diagnose and to estimate the extent of locoregional and distant MPM recurrence, and it carries independent prognostic value. Once the disease recurs, survival outcomes seem to be independent of histologic type and highly dependent on the intensity of lesion uptake and on the pattern of metabolically active disease in FDG PET/CT. Our observations should be considered limited to patients treated surgically with or without perioperative therapies and should not be extrapolated to those unresectable cases treated with chemotherapy alone. (orig.)

Diffuse and diffuse-plus-focal uptake in the thyroid gland identified by using FDG-PET. Prevalence of thyroid cancer and Hashimoto's thyroiditis

International Nuclear Information System (INIS)

Kurata, Seiji; Ishibashi, Masatoshi; Hiromatsu, Yuji; Kaida, Hayato; Miyake, Ikuyo; Uchida, Masafumi; Hayabuchi, Naofumi

2007-01-01

The objective of this study was to investigate and evaluate the prevalence of incidental thyroid diffuse and diffuse-plus-focal fluorine-18 fluorodeoxyglucose (FDG) uptake in healthy subjects who underwent cancer screening on positron emission tomography (PET) scan, and also to evaluate the prevalence of thyroid cancer and Hashimoto's thyroiditis. We carried out a retrospective review of 1626 subjects who underwent PET scanning at our institution. Diffuse uptake was defined as FDG uptake in the whole thyroid gland, whereas diffuse-plus-focal uptake was defined as a thyroid lesion with both diffuse uptake and focal FDG uptake. The maximum standardized uptake value of the thyroid lesions was recorded and reviewed. In each selected subject with positive thyroid FDG uptake, serum thyroid-stimulating hormone, thyroid hormone, and thyroid antibodies were measured. Fine needle aspiration cytology was performed on patients with a definite nodule using ultrasonography. Twenty-nine subjects (1.78%) were identified as having either diffuse FDG uptake (n=25, 1.53%) or diffuse-plus-focal FDG uptake (n=4, 0.24%). All subjects with diffuse FDG uptake were diagnosed as having Hashimoto's thyroiditis. In 1 of the 25 subjects with diffuse FDG uptake and two of the four with diffuse-plus-focal FDG uptake, histopathologic diagnosis showed papillary thyroid carcinoma associated with Hashimoto's thyroiditis. However, PET scan did not detect papillary carcinoma associated with Hashimoto's thyroiditis in one of the three subjects. Our results suggest that although diffuse FDG uptake usually indicates Hashimoto's thyroiditis, the risk of thyroid cancer must be recognized in both diffuse FDG uptake and diffuse-plus-focal FDG uptake on PET scan. (author)

Using oral 18F-FDG for infection imaging

International Nuclear Information System (INIS)

Bolwell, Jacob J.

2009-01-01

Full text:A 22-year-old female with a complex medical history presented to our department with a complaint of pain around the site her Portocath (PaC). Multiple imaging techniques failed to identify any sign of infection around the pac. A 99 m Tc-Phytate Colloid labelled white cell (LWC) scan was arranged to identify any infective processes in or around the pac. Severe difficulty was encountered attempting to gain IV access aside from the pac and the LWC scan had to aborted. In order to identify infection of the pac a Positron Emission Tomography (PET) scan using oral administration 18F-fluorodeoxyglucose (18F-FDG) was arranged. The oral 18F-FDG PET scan showed active glucose metabolism around the site of the pac port and along the cathe tubing near the medial right clavicle. As a result of this the pac was removed and replaced and the patient is now receiving continued antibiotics and medication through her new POC. In conclusion we found oral administration of 18F-FDG to be a suitable alternative to IV administered 18F-FDG in on to obtain functional imaging in a case where there was severe difficulty in obtaining venous access.

FDG uptake in cervical lymph nodes in children without head and neck cancer

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Vali, Reza; Bakari, Alaa A.; Marie, Eman; Kousha, Mahnaz; Shammas, Amer [University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON (Canada); Charron, Martin [Brampton Nuclear Services, Toronto, ON (Canada)

2017-06-15

Reactive cervical lymphadenopathy is common in children and may demonstrate increased {sup 18}F-fluoro-deoxyglucose ({sup 18}F-FDG) uptake on positron emission tomography/computed tomography (PET/CT). We sought to evaluate the frequency and significance of {sup 18}F-FDG uptake by neck lymph nodes in children with no history of head and neck cancer. The charts of 244 patients (114 female, mean age: 10.4 years) with a variety of tumors such as lymphoma and post-transplant lymphoproliferative diseases (PTLD), but no head and neck cancers, who had undergone {sup 18}F-FDG PET/CT were reviewed retrospectively. Using the maximum standardized uptake value (SUVmax), increased {sup 18}F-FDG uptake by neck lymph nodes was recorded and compared with the final diagnosis based on follow-up studies or biopsy results. Neck lymph node uptake was identified in 70/244 (28.6%) of the patients. In 38 patients, the lymph nodes were benign. In eight patients, the lymph nodes were malignant (seven PTLD and one lymphoma). In 24 patients, we were not able to confirm the final diagnosis. Seven out of the eight malignant lymph nodes were positive for PTLD. The mean SUVmax was significantly higher in malignant lesions (4.2) compared with benign lesions (2.1) (P = 0.00049). {sup 18}F-FDG uptake in neck lymph nodes is common in children and is frequently due to reactive lymph nodes, especially when the SUVmax is <3.2. The frequency of malignant cervical lymph nodes is higher in PTLD patients compared with other groups. (orig.)

Strong association of epidermal growth factor receptor status with breast cancer FDG uptake

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Lee, Joohee; Moon, Seung Hwan; Hyun, Seung Hyup; Cho, Young Seok; Choi, Joon Young; Kim, Byung-Tae; Lee, Kyung-Han [Sungkyunkwan University School of Medicine, Department of Nuclear Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Lee, Eun Jeong [Seoul Medical Center, Department of Nuclear Medicine, Seoul (Korea, Republic of); Kim, Seokhwi [Sungkyunkwan University School of Medicine, Department of Pathology, Samsung Medical Center, Seoul (Korea, Republic of)

2017-08-15

Imaging tumor FDG uptake could complement breast cancer biomarkers of risk and treatment response. Although breast cancer FDG uptake is reputedly influenced by major biomarker states, the role of epidermal growth factor receptor (EGFR) expression remains largely unexplored. This is a retrospective study that included 499 patients with primary breast cancer at initial presentation. Tumor FDG uptake was measured on pretreatment PET/CT as maximum standardized uptake value (SUVmax), and biomarkers were assessed by immunohistochemistry of tumor tissue. Regression analysis was performed for predictors of high tumor FDG uptake (SUVmax ≥ 8.6). SUVmax was higher in ER- (36.5%; 11.2 ± 6.0 vs. 8.3 ± 5.3), PR- (42.3%; 10.9 ± 6.0 vs. 8.2 ± 5.2), and triple-negative tumors (19.8%; 12.0 ± 6.9 vs. 8.7 ± 5.2; all p < 0.0001). EGFR expression (28.5%) was more frequent in ER-, PR-, triple-negative, cytokeratin 5/6 (CK5/6) + and mutant P53 (mP53) + tumors (all p < 0.0001). EGFR+ was associated with higher SUVmax among all tumors (11.9 ± 6.0 vs. 8.3 ± 5.3), ER- tumors (p < 0.0001), PR- and + tumors (p < 0.0001 and 0.027), hormone receptor- and + tumors (p < 0.0001 and 0.004), human epidermal growth factor receptor 2 (HER2)- and + tumors (p < 0.0001 and 0.006), non-triple negative tumors (p < 0.0001), CK5/6- and + tumors (p = 0.021 and <0.0001), and mP53- and + tumors (p < 0.0001 and 0.008). Tumors had high FDG uptake in 73.2% of EGFR+ and 40.6% of EGFR- tumors. On regression analysis, significant multivariate predictors of high tumor FDG uptake were large size, EGFR+ and CK5/6+ for the entire subjects, and EGFR+ and CK5/6+ for ER- and hormone receptor negative subgroups. High FDG uptake was able to sub-stratify EGFR+ tumors that were more likely to be ER- and CK5/6+, and EGFR- tumors more likely to be mP53 +. Primary breast tumor FDG uptake is strongly influenced by EGFR status beyond that by other major biomarkers including hormone receptor and HER2 status, and EGFR

Giant cell tumor with secondary aneurysmal bone cyst shows heterogeneous metabolic pattern on {sup 18}F-FDG PET.CT: A case reort

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Park, Hee Jeong; Kwon, Seong Young; Yoon, Yeon Hong [Chonnam National University Hwasun Hospital, Huasun (Korea, Republic of); Cho, Sang Geon; Kim, Jahae; Song, Ho Chun; Kim, Sung Sun; Park, Jin Gyoon [Chonnam National University Hospital, Gwangju (Korea, Republic of)

2016-12-15

Giant cell tumor (GCT) is a generally benign bone tumor accounting for approximately 5 % of all primary bone neoplasms. Cystic components in GCTs that indicate secondary aneurysmal bone cysts (ABCs) are reported in 14 % of GCTs. Although both of them have been described separately in previous reports that may show considerable fluorodeoxyglucose (FDG) uptake despite their benign nature, the findings of GCT with secondary ABC on 18F-FDG positron emission tomography/computed tomography (PET/CT) have not been well-known. We report a case of GCT with secondary ABC in a 26-year-old woman. 18F-FDG PET/CT revealed a heterogeneous hypermetabolic lesion in the left proximal femur with the maximum standardized uptake value of 4.7. The solid components of the tumor showed higher FDG uptake than the cystic components. These observations suggest that the ABC components in GCTs show heterogeneous metabolic patterns on {sup 18}F-FDG PET/CT.

Giant cell tumor with secondary aneurysmal bone cyst shows heterogeneous metabolic pattern on "1"8F-FDG PET.CT: A case reort

International Nuclear Information System (INIS)

Park, Hee Jeong; Kwon, Seong Young; Yoon, Yeon Hong; Cho, Sang Geon; Kim, Jahae; Song, Ho Chun; Kim, Sung Sun; Park, Jin Gyoon

2016-01-01

Giant cell tumor (GCT) is a generally benign bone tumor accounting for approximately 5 % of all primary bone neoplasms. Cystic components in GCTs that indicate secondary aneurysmal bone cysts (ABCs) are reported in 14 % of GCTs. Although both of them have been described separately in previous reports that may show considerable fluorodeoxyglucose (FDG) uptake despite their benign nature, the findings of GCT with secondary ABC on 18F-FDG positron emission tomography/computed tomography (PET/CT) have not been well-known. We report a case of GCT with secondary ABC in a 26-year-old woman. 18F-FDG PET/CT revealed a heterogeneous hypermetabolic lesion in the left proximal femur with the maximum standardized uptake value of 4.7. The solid components of the tumor showed higher FDG uptake than the cystic components. These observations suggest that the ABC components in GCTs show heterogeneous metabolic patterns on "1"8F-FDG PET/CT

Value of 18F-FDG PET/CT Combined With Tumor Markers in the Evaluation of Ascites.

Science.gov (United States)

Han, Na; Sun, Xun; Qin, Chunxia; Hassan Bakari, Khamis; Wu, Zhijian; Zhang, Yongxue; Lan, Xiaoli

2018-05-01

The purpose of this study is to investigate the value of 18 F-FDG PET/CT combined with assessment of tumor markers in serum or ascites for the diagnosing and determining the prognosis of benign and malignant ascites. Patients with ascites of unknown cause who underwent evaluation with FDG PET/CT were included in this retrospective study. The maximum standardized uptake value (SUV max ) and levels of the tumor markers carbohydrate antigen-125 (CA-125) and carcinoembryonic antigen (CEA) in serum and ascites were recorded. The diagnostic values of FDG PET/CT, CEA and CA-125 levels in serum or ascites, and the combination of imaging plus tumor marker assessment were evaluated. Factors that were predictive of survival were also analyzed. A total of 177 patients were included. Malignant ascites was eventually diagnosed in 104 patients, and benign ascites was diagnosed in the remaining 73 patients. With the use of FDG PET/CT, 44 patients (42.3%) were found to have primary tumors. The sensitivity, specificity, and accuracy of FDG PET/CT were 92.3%, 83.6%, and 88.7%, respectively. CA-125 levels in serum and ascites showed much better sensitivity than did CEA levels, but they showed significantly lower specificity. If the combination of tumor markers and FDG PET/CT was analyzed, the sensitivity, specificity, and accuracy of tumor markers in serum were 96.6%, 78.1%, and 88.7%, and those of tumor markers in ascites were 97.7%, 80.0%, and 90.4%, respectively. Sex may be an important factor affecting survival time (hazard ratio, 0.471; p = 0.004), but age, CEA level, and FDG PET/CT findings could not predict survival. FDG PET/CT combined with assessment of tumor markers, especially CEA, increased the efficacy of diagnosis of ascites of unknown causes. Male sex conferred a poorer prognosis, whereas age, CEA level, and FDG uptake had no predictive significance in patients with malignant ascites.

FDG PET/CT and MR imaging of intramuscular myxoma in the gluteus maximus

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Nishio Jun

2012-06-01

Full Text Available Abstract Intramuscular myxoma is a rare benign soft tissue tumor which may be mistaken for other benign and low-grade malignant myxoid neoplasms. We present the case of a 63-year-old woman with an asymptomatic intramuscular myxoma discovered incidentally on a whole-body F-18 fluorodeoxyglucose (FDG positron emission tomography (PET/computed tomography. PET images showed a mild FDG uptake (maximum standardized uptake value, 1.78 in the left gluteus maximus. Subsequent magnetic resonance (MR imaging revealed a well-defined ovoid mass with homogenous low signal intensity on T1-weighted sequences and markedly high signal intensity on T2-weighted sequences. Contrast-enhanced MR images showed heterogeneous enhancement throughout the mass. The diagnosis of intramuscular myxoma was confirmed on histopathology after surgical excision of the tumor. The patient had no local recurrence at one year follow-up. Our case suggests that intramuscular myxoma should be considered in the differential diagnosis of an oval-shaped intramuscular soft tissue mass with a mild FDG uptake.

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

International Nuclear Information System (INIS)

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

2012-01-01

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

Prognostic value of preoperative intratumoral FDG uptake heterogeneity in patients with epithelial ovarian cancer

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Lee, Maria; Kim, Hee Seung; Chung, Hyun Hoon; Kim, Jae-Weon; Park, Noh-Hyun; Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Lee, Hyunjong; Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Cancer Research Institute, Seoul (Korea, Republic of)

2017-01-15

To investigate the prognostic value of intratumoral FDG uptake heterogeneity (IFH) derived from PET/CT in patients with epithelial ovarian cancer (EOC). We retrospectively reviewed patients with pathologically proven epithelial ovarian cancer who underwent preoperative {sup 18}F-FDG PET/CT scans. PET/CT parameters such as maximum and average standardized uptake values (SUV{sub max} and SUV{sub avg}), sum of all metabolic tumour volume (MTV), cumulative total lesion glycolysis (TLG) and IFH were assessed. Regression analyses were used to identify clinicopathological and imaging variables associated with disease-free survival (DFS). Clinicopathological data were reviewed for 61 eligible patients. The median duration of DFS was 13 months (range, 6-26 months), and 18 (29.5 %) patients experienced recurrence. High IFH values were associated with tumour recurrence (P = 0.005, hazard ratio 4.504, 95 % CI 1.572-12.902). The Kaplan-Meier survival graphs showed that DFS significantly differed in groups categorized based on IFH (P = 0.002, log-rank test). Moreover, there were significant differences in DFS (P = 0.009) and IFH (P = 0.040) between patients with and without recurrence. Preoperative IFH measured by {sup 18}F-FDG PET/CT was significantly associated with EOC recurrence. FDG-based heterogeneity could be a useful and potential predicator of EOC recurrence before treatment. (orig.)

FDG-PET/CT and diffusion-weighted imaging for resected lung cancer: correlation of maximum standardized uptake value and apparent diffusion coefficient value with prognostic factors.

Science.gov (United States)

Usuda, Katsuo; Funasaki, Aika; Sekimura, Atsushi; Motono, Nozomu; Matoba, Munetaka; Doai, Mariko; Yamada, Sohsuke; Ueda, Yoshimichi; Uramoto, Hidetaka

2018-04-09

Diffusion-weighted magnetic resonance imaging (DWI) is useful for detecting malignant tumors and the assessment of lymph nodes, as FDG-PET/CT is. But it is not clear how DWI influences the prognosis of lung cancer patients. The focus of this study is to evaluate the correlations between maximum standardized uptake value (SUVmax) of FDG-PET/CT and apparent diffusion coefficient (ADC) value of DWI with known prognostic factors in resected lung cancer. A total of 227 patients with resected lung cancers were enrolled in this study. FEG-PET/CT and DWI were performed in each patient before surgery. There were 168 patients with adenocarcinoma, 44 patients with squamous cell carcinoma, and 15 patients with other cell types. SUVmax was a factor that was correlated to T factor, N factor, or cell differentiation. ADC of lung cancer was a factor that was not correlated to T factor, or N factor. There was a significantly weak inverse relationship between SUVmax and ADC (Correlation coefficient r = - 0.227). In analysis of survival, there were significant differences between the categories of sex, age, pT factor, pN factor, cell differentiation, cell type, and SUVmax. Univariate analysis revealed that SUVmax, pN factor, age, cell differentiation, cell type, sex, and pT factor were significant factors. Multivariate analysis revealed that SUVmax and pN factor were independent significant prognostic factors. SUVmax was a significant prognostic factor that is correlated to T factor, N factor, or cell differentiation, but ADC was not. SUVmax may be more useful for predicting the prognosis of lung cancer than ADC values.

Comparison between FDG Uptake and Pathologic or Immunohistochemical Parametersin Pre-operative PET/CT Scan of Patient with Primary Colorectal Cancer

International Nuclear Information System (INIS)

Na, Sae Jung; Chung, Yong An; Maeng, Lee So; Kim, Ki Jun; Sohn, Kyung Myung; Kim, Sung Hoon; Sohn, Hyung Sun; Chung, Soo Kyo

2009-01-01

To evaluate the relationship between F-18 FDG uptake of tumor in PET/CT scan and pathological or immunohistochemial parameters of colorectal cancer. 147 colorectal cancer patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The pathologic results such as site, size, depth of invasion (T stage), growth pattern, differentiation of primary tumor, lymph node metastasis and Dukes-Astler and Coller stage and immunohistochemical markers such as expression of EGFR, MLH1, MSH2 and Ki-67 index were reviewed. 146 out of 147 PET/CT scans with colorectal cancer showed perceptible focal FDG uptake. SUVmax showed mild positive linear correlation with size of primary tumor (r=0.277, p=0.001) and Ki-67 index (r=0.226, p=0.019). No significant difference in F-18 FDG uptake was found according to site, depth of invasion (T stage), growth pattern, differentiation of primary tumor, presence of lymph node metastasis, Dukes-Astler and Coller stage and expression of EGFR. The degree of F-18 FDG uptake in colorectal cancer was associated with the size and the degree of Ki-67 index of primary tumor. It could be thought that FDG uptake of primary tumor has a correlation with macroscopic and microscopic tumor growth

Cases with focal FDG uptake in the thyroid gland detected by FDG-PET screening

International Nuclear Information System (INIS)

Takeda, Yutaka; Iguchi, Atsuko; Matsuo, Chikashi; Otawa, Kouichi; Nakamura, Mamoru

2007-01-01

We examined fifteen cases with focal fluorodeoxyglucose (FDG) uptake in the thyroid gland detected by FDG-positron emission tomography (PET) screening for cancer. Examination of the thyroid gland was carried out by using computer tomography, ultrasound sonography, laboratory test and fine needle aspiration cytology (FNAC). Surgical operation was performed to the patient who was suspected of having thyroid cancer by FNAC or clinical findings. Thyroid cancer was histologically confirmed in 4 cases. Malignancy was not ruled out by FNAC in one patient. Seven patients were suspected of having benign thyroid tumor (adenoma, adenomatous goiter). Three patients were diagnosed with thyroiditis (Hashimoto thyroiditis, subacute thyroiditis, painless thyroiditis) by laboratory tests. It was not easy to differentiate between cancer and benign diseases only by FDG-PET. However, it was useful to detect thyroid tumor especially if the tumor is hardly palpable. FDG-PET was also valuable as a diagnostic imaging technique to evaluate metastasis and the extent of cancer. (author)

Normal cerebral FDG uptake during childhood

International Nuclear Information System (INIS)

London, Kevin; Howman-Giles, Robert

2014-01-01

Current understanding of cerebral FDG uptake during childhood originates from a small number of studies in patients with neurological abnormalities. Our aim was to describe cerebral FDG uptake in a dataset of FDG PET scans in children more likely to represent a normal population. We reviewed cerebral FDG PET scans in children up to 16 years of age with suspected/proven extracranial malignancies and the following exclusions: central nervous system metastases, previous malignancies, previous chemotherapy or radiotherapy, development of cerebral metastases during therapy, neurological conditions, taking antiepileptic medication or medications likely to interfere with cerebral metabolism, and general anaesthesia within 24 h. White matter, basal ganglia, thalamus and the cerebellar cortex were analysed using regional SUV max , and the cerebral cortex, basal ganglia, thalamus and cerebellum were analysed using a regional relative uptake analysis in comparison to maximal cortical uptake. Scans from 30 patients (age range 11 months to 16 years, mean age 10 years 5 months) were included. All regions showed increasing SUV max with age. The parietal, occipital, lateral temporal and medial temporal lobes showed lower rates of increasing FDG uptake causing changing patterns of regional FDG uptake during childhood. The cortical regions showing the most intense uptake in early childhood were the parietal and occipital lobes. At approximately 7 years of age these regions had relatively less uptake than the frontal lobes and at approximately 10 years of age these regions had relatively less uptake than the thalamus. Relative FDG uptake in the brain has not reached an adult pattern by 1 year of age, but continues to change up to 16 years of age. The changing pattern is due to different regional rates of increasing cortical FDG uptake, which is less rapid in the parietal, occipital and temporal lobes than in the frontal lobes. (orig.)

Normal cerebral FDG uptake during childhood

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London, Kevin [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, NSW (Australia); Howman-Giles, Robert [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Disciplines of Imaging and Paediatrics and Child Health, Sydney Medical School, Sydney, NSW (Australia)

2014-04-15

Current understanding of cerebral FDG uptake during childhood originates from a small number of studies in patients with neurological abnormalities. Our aim was to describe cerebral FDG uptake in a dataset of FDG PET scans in children more likely to represent a normal population. We reviewed cerebral FDG PET scans in children up to 16 years of age with suspected/proven extracranial malignancies and the following exclusions: central nervous system metastases, previous malignancies, previous chemotherapy or radiotherapy, development of cerebral metastases during therapy, neurological conditions, taking antiepileptic medication or medications likely to interfere with cerebral metabolism, and general anaesthesia within 24 h. White matter, basal ganglia, thalamus and the cerebellar cortex were analysed using regional SUV{sub max}, and the cerebral cortex, basal ganglia, thalamus and cerebellum were analysed using a regional relative uptake analysis in comparison to maximal cortical uptake. Scans from 30 patients (age range 11 months to 16 years, mean age 10 years 5 months) were included. All regions showed increasing SUV{sub max} with age. The parietal, occipital, lateral temporal and medial temporal lobes showed lower rates of increasing FDG uptake causing changing patterns of regional FDG uptake during childhood. The cortical regions showing the most intense uptake in early childhood were the parietal and occipital lobes. At approximately 7 years of age these regions had relatively less uptake than the frontal lobes and at approximately 10 years of age these regions had relatively less uptake than the thalamus. Relative FDG uptake in the brain has not reached an adult pattern by 1 year of age, but continues to change up to 16 years of age. The changing pattern is due to different regional rates of increasing cortical FDG uptake, which is less rapid in the parietal, occipital and temporal lobes than in the frontal lobes. (orig.)

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

International Nuclear Information System (INIS)

Kim, Jin Ho; Yoon, Dae Young; Baek, Sora; Park, Min Woo; Kwon, Kee Hwan; Rho, Young Soo

2016-01-01

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

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

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

2016-07-15

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

Steam sterilization and automatic dispensing of [{sup 18}F]fludeoxyglucose (FDG) for injection

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Karwath, Pascal [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany) and MC-Pharma GmbH (MCP), Bonn (Germany); Sartor, Johannes [MC-Pharma GmbH (MCP), Bonn (Germany); Gries, Wolfgang [MC-Pharma GmbH (MCP), Bonn (Germany); Wodarski, Christine [MC-Pharma GmbH (MCP), Bonn (Germany); Dittmar, Claus [MC-Pharma GmbH (MCP), Bonn (Germany); Biersack, Hans J [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany); Guhlke, Stefan [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany) and MC-Pharma GmbH (MCP), Bonn (Germany)

2005-04-01

For the purpose of implementing steam sterilization of 2-[{sup 18}F]FDG (FDG) in the final container into routine production, we have validated and established a fully automated dispensing and sterilization system, thereby considerably reducing the radiation burden to the personnel. Methods: The commercially available system combines aseptic dispensing of the product solution under a miniaturized laminar flow unit with subsequent steam sterilization, realized by heating of the product in the final containers by an autoclave included in the dispensing unit, thus incorporating current pharmaceutical manufacturing standards for the production of parental radiopharmaceuticals. The efficiency of the used sterilization cycle, the stability of FDG under the conditions of sterilization and the stability of the final product towards radiolysis was investigated with respect to various pH-formulations. Results: The system was found to be fully valid for filling of vials in a laminar flow class A (US-class 100) environment and for sterilization of FDG in the final container. The pH for sterilizing FDG solutions must be slightly acidic to avoid decomposition. A pH of 5.5 appears to be optimal and gives FDG of very high radiochemical purity ({approx}99%). In addition, radiolysis of FDG in solutions of high activity concentration was significantly lower at pH 5.5 than at neutral pH. Conclusion: Terminal sterilization enables the production of FDG in full compliance with GMP-regulations even in Class C or D (US class 10,000 or 100,000) laboratories.

Development of a Primary Standard for Calibration of [18F]FDG Activity Measurement Systems

International Nuclear Information System (INIS)

Capogni, M; Felice, P De; Fazio, A; Simonelli, F; Abbas, K

2006-01-01

The 18 F national primary standard was developed by the INMRI-ENEA using the 4πβ Liquid Scintillation Spectrometry Method with 3 H-Standard Efficiency Tracing. Measurements were performed at JRCIspra under a scientific collaboration between the Institute for Health and Consumer Production, the Amersham Health and the National Institute for Occupational Safety and Prevention (ISPESL). The goal of the work was to calibrate, with minimum uncertainty, the INMRI-ENEA transfer standard portable well-type ionisation chamber as well as other JRC-Ispra and Amersham Health reference Ionising Chambers used for FDG activity measurement

FDG-PET/CT imaging in the management of HIV-associated multicentric Castleman's disease

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Barker, Rob; Kazmi, Fahrad; Stebbing, Justin; Chinn, Roger [Imperial College School of Medicine, The Chelsea and Westminster Hospital, Department of Radiology, London (United Kingdom); Ngan, Sarah; Bower, Mark [Imperial College School of Medicine, The Chelsea and Westminster Hospital, Department of Oncology, London (United Kingdom); Nelson, Mark [Imperial College School of Medicine, The Chelsea and Westminster Hospital, Department of HIV Medicine, London (United Kingdom); O' Doherty, Michael [St. Thomas' Hospital, Clinical PET Centre, Guys and St. Thomas Hospital Trust, London (United Kingdom)

2009-04-15

To evaluate the role of FDG-PET/CT scanning in the management of HIV-associated multicentric Castleman's disease (MCD) a rare lymphoproliferative disorder associated with infection by human herpesvirus 8 (HHV8). Nine patients with histologically confirmed MCD underwent fused FDG-PET/CT scans at initial MCD diagnosis (n = 3), at MCD relapse (n = 4), or during remission (n = 2). All seven patients with active MCD had markedly elevated plasma HHV8 viral loads, but the patients in remission had no HHV8 viraemia. The three patients with newly diagnosed MCD were not on antiretroviral therapy at the time of imaging, but the other six were all on fully suppressive antiretroviral regimens. In the seven patients with active MCD (newly diagnosed or relapse) 33/91 lymph node groups (36%) included radiologically enlarged nodes on the CT scan, whilst 57/91 lymph node groups (63%) showed enhanced FDG uptake on the PET scan. In scans from patients in remission, there were no enlarged lymph nodes on the CT scan but 3 lymph nodes (11%) demonstrated enhanced FDG uptake. The median SUV recorded for the seven patients with active MCD was 4.8 (range 2.6-9.3) which was significantly higher than the median value of 2.5 recorded for the patients in remission (Mann-Whitney U test, p = 0.011). Despite the small number of patients, in HIV-positive individuals with active MCD, FDG-PET scans more frequently detected abnormal uptake than CT scans detected enlarged lymph nodes. FDG-PET scanning has a useful role in the management of HIV-associated MCD in selecting appropriate sites for biopsy, and in staging and monitoring these lymphoproliferations. (orig.)

Clinical relevance of F-18 FDG PET for imaging of neuroendocrine tumors; Wertigkeit der F-18-FDG-PET bei neuroendokrinen Tumoren

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Adams, S. [Klinikum der Ruhr-Univ. Bochum - Marienhospital, Herne (Germany). Klinik fuer Radiologie und Nuklearmedizin; Baum, R.P. [Zentralklinik Bad Berka (Germany). Klinik fuer Nuklearmedizin/PET-Zentrum; Hoer, G. [Frankfurt Univ., Frankfurt am Main (Germany). Klinik fuer Nuklearmedizin

2001-04-01

Neuroendocrine tumors are characterized immunocytochemically by the expression of different peptides and biogenic amines. Hormones induce their biological action by binding to and stimulating specific membrane-associated receptors for e.g. somatostatin. The presence of somatostatin receptors (SR) has been described mainly in endocrine glands and the central nervous system. Interestingly, a large variety of human tumors, including gastroenteropancreatic (GEP) tumors and medullary thyroid carcinomas (MTC) also express a high density of SR and can be imaged with [{sup 111}In-DTPA-D-Phe{sup 1}]-pentetreotide. Cell proliferative activity is an important indicator of the growth of various malignant tumors associated with a poorer prognosis and Ki-67 expression. {sup 18}F-FDG is a marker of tumor viability, based upon the increased glycolysis that is associated with malignancy as compared with normal tissue. SR-containing neuroendocrine tumors are well-differentiated and tend to grow slowly. Furthermore, these tumors demonstrate inverse relationship between in vivo SR expression, cell proliferation (low Ki-67 expression) and FDG uptake (normal biodistribution). In comparison, less differentiated tumors, e.g. atypical carcinoids or MTC with increasing CEA levels show mitotic activity (high levels of Ki-67 immunoreactivity and increased FDG uptake) and often lack of SR. In conclusion, SR scintigraphy has been shown to localize well-differentiated neuroendocrine tumors. In contrast, PET imaging is valuable for predicting malignancy only in less differentiated tumors with incresed glucose metabolism. Therefore, an additional F-18 FDG PET should be performed if SR scintigraphy (GEP tumors) or combined imaging using [{sup 111}In-DTPA-D-Phe{sup 1}]-pentetreotide and {sup 99m}Tc(V)-DMSA (MTC) is negative. (orig.) [German] Neuroendokrine Tumoren werden durch die spezifische Produktion von Polypeptidhormonen und biogenen Aminen klassifiziert. Die Informationsuebertragung der

Dual-time-point 18F-FDG PET imaging for diagnosis of disease type and disease activity in patients with idiopathic interstitial pneumonia

International Nuclear Information System (INIS)

Umeda, Yukihiro; Demura, Yoshiki; Ishizaki, Takeshi; Ameshima, Shingo; Miyamori, Isamu; Saito, Yuji; Tsuchida, Tatsuro; Fujibayashi, Yasuhisa; Okazawa, Hidehiko

2009-01-01

Individual clinical courses of idiopathic interstitial pneumonia (IIP) are variable and difficult to predict because the pathology and disease activity are contingent, and chest computed tomography (CT) provides little information about disease activity. In this study, we applied dual-time-point [ 18 F]-fluoro-2-deoxy-D-glucose ( 18 F-FDG) positron emission tomography (PET), commonly used for diagnosis of malignant tumours, to the differential diagnosis and prediction of disease progression in IIP patients. Fifty patients with IIP, including idiopathic pulmonary fibrosis (IPF, n = 21), non-specific interstitial pneumonia (NSIP, n = 18) and cryptogenic organizing pneumonia (COP, n = 11), underwent 18 F-FDG PET examinations at two time points: scan 1 at 60 min (early imaging) and scan 2 at 180 min (delayed imaging) after 18 F-FDG injection. The standardized uptake values (SUV) at the two points and the retention index (RI-SUV) calculated from them were evaluated and compared with chest CT findings, disease progression and disease types. To evaluate short-term disease progression, all patients were examined by pulmonary function test every 3 months for 1 year after 18 F-FDG PET scanning. The early SUV for COP (2.47 ± 0.74) was significantly higher than that for IPF (0.99 ± 0.29, p = 0.0002) or NSIP (1.22 ± 0.44, p= 0.0025). When an early SUV cut-off value of 1.5 and greater was used to distinguish COP from IPF and NSIP, the sensitivity, specificity and accuracy were 90.9, 94.3 and 93.5%, respectively. The RI-SUV for IPF and NSIP lesions was significantly greater in patients with deteriorated pulmonary function after 1 year of follow-up (progressive group, 13.0 ± 8.9%) than in cases without deterioration during the 1-year observation period (stable group, -16.8 ± 5.9%, p 18 F-FDG PET are useful parameters for the differential diagnosis and prediction of disease progression in patients with IIP. (orig.)

Simultaneous measurement of FDG-PET and NAT

International Nuclear Information System (INIS)

Musha, Toshimitsu; Matsuzaki, Haruyasu; Ishii, Kenji

2011-01-01

NAT (Neuronal Activity Topography), which has been developed by the Brain Functions Lab., Inc., displays on the standard brain surface locations of hyperactive and hyperactive neuronal activities, and this result is compared with locations of enhanced and suppressed glucose metabolism which were measured with fluorodeoxyglucose-positron emission tomography (FDG-PET) for three AD patients. Locations with enhanced glucose metabolism are approximately overlap areas with enhanced neuronal activities. (author)

Is 18F-FDG PET/CT useful for distinguishing between primary thyroid lymphoma and chronic thyroiditis?

Science.gov (United States)

Nakadate, Masashi; Yoshida, Katsuya; Ishii, Akihiro; Koizumi, Masayuki; Tochigi, Naobumi; Suzuki, Yoshio; Ryu, Yoshiharu; Nakagawa, Tassei; Umehara, Isao; Shibuya, Hitoshi

2013-09-01

This study aims to investigate the usefulness of (18)F-FDG PET/CT for distinguishing between primary thyroid lymphoma (PTL) and chronic thyroiditis. We retrospectively reviewed the data of 196 patients with diffuse (18)F-FDG uptake of the thyroid gland and enrolled patients who were diagnosed as having PTL or chronic thyroiditis based on the medical records, pathological findings, and laboratory data. The enrolled patients comprised 10 PTL patients (M/F = 4:6) and 51 chronic thyroiditis patients (M/F = 8:43). Images had been acquired on a PET/CT scanner at 100 minutes after intravenous injection of (18)F-FDG. The PTL group consisted of 7 patients with diffuse large B-cell lymphoma (DLBCL) and 3 with mucosa-associated lymphoid tissue (MALT) lymphoma. The maximum standardized uptake value (SUV(max)) was significantly higher in the PTL group than that in the chronic thyroiditis group (25.3 ± 8.0 and 7.4 ± 3.2, P thyroiditis group (46.1 ± 7.0 HU and 62.1 ± 6.9 HU, P thyroiditis. Thus, (18)F-FDG PET/CT may be useful for distinguishing between PTL and chronic thyroiditis.

Relationship between pretreatment FDG-PET and diffusion-weighted MRI biomarkers in diffuse large B-cell lymphoma

Science.gov (United States)

de Jong, Antoinette; Kwee, Thomas C; de Klerk, John MH; Adam, Judit A; de Keizer, Bart; Fijnheer, Rob; Kersten, Marie José; Ludwig, Inge; Jauw, Yvonne WS; Zijlstra, Josée M; den Bos, Indra C Pieters - Van; Stoker, Jaap; Hoekstra, Otto S; Nievelstein, Rutger AJ

2014-01-01

The purpose of this study was to determine the correlation between the 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) standardized uptake value (SUV) and the diffusion-weighted magnetic resonance imaging (MRI) apparent diffusion coefficient (ADC) in newly diagnosed diffuse large B-cell lymphoma (DLBCL). Pretreatment FDG-PET and diffusion-weighted MRI of 21 patients with histologically proven DLBCL were prospectively analyzed. In each patient, maximum, mean and peak standardized uptake value (SUV) was measured in the lesion with visually highest FDG uptake and in the largest lesion. Mean ADC (ADCmean, calculated with b-values of 0 and 1000 s/mm2) was measured in the same lesions. Correlations between FDG-PET metrics (SUVmax, SUVmean, SUVpeak) and ADCmean were assessed using Pearson’s correlation coefficients. In the lesions with visually highest FDG uptake, no significant correlations were found between the SUVmax, SUVmean, SUVpeak and the ADCmean (P=0.498, P=0.609 and P=0.595, respectively). In the largest lesions, there were no significant correlations either between the SUVmax, SUVmean, SUVpeak and the ADCmean (P=0.992, P=0.843 and P=0.894, respectively). The results of this study indicate that the glycolytic rate as measured by FDG-PET and changes in water compartmentalization and water diffusion as measured by the ADC are independent biological phenomena in newly diagnosed DLBCL. Further studies are warranted to assess the complementary roles of these different imaging biomarkers in the evaluation and follow-up of DLBCL. PMID:24795837

Dependence of FDG uptake on tumor microenvironment

International Nuclear Information System (INIS)

Pugachev, Andrei; Ruan, Shutian; Carlin, Sean; Larson, Steven M.; Campa, Jose; Ling, C. Clifton; Humm, John L.

2005-01-01

Purpose: To investigate the factors affecting the 18 F-fluorodeoxyglucose ( 18 F-FDG) uptake in tumors at a microscopic level, by correlating it with tumor hypoxia, cellular proliferation, and blood perfusion. Methods and Materials: Nude mice bearing Dunning prostate tumors (R3327-AT) were injected with 18 F-FDG and pimonidazole, bromodeoxyuridine, and, 1 min before sacrifice, with Hoechst 33342. Selected tumor sections were imaged by phosphor plate autoradiography, while adjacent sections were used to obtain the images of the spatial distribution of Hoechst 33342, pimonidazole, and bromodeoxyuridine. The images were co-registered and analyzed on a pixel-by-pixel basis. Results: Statistical analysis of the data obtained from these tumors demonstrated that 18 F-FDG uptake was positively correlated with pimonidazole staining intensity in each data set studied. Correlation of FDG uptake with bromodeoxyuridine staining intensity was always negative. In addition, FDG uptake was always negatively correlated with the staining intensity of Hoechst 33342. Conclusions: For the Dunning prostate tumors studied, FDG uptake was always positively correlated with hypoxia and negatively correlated with both cellular proliferation and blood flow. Therefore, for the tumor model studied, higher FDG uptake is indicative of tumor hypoxia, but neither blood flow nor cellular proliferation

Using Positron Emission Tomography with [18F]FDG to Predict Tumor Behavior in Experimental Colorectal Cancer

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Bryan M. Burt

2001-01-01

Full Text Available This study investigates the relationship between FDG uptake as determined by positron emission tomography (PET imaging and rates of tumor growth, cellular GLUT1 transporter density, and the activities of hexokinase and glucose-6-phosphatase in a solid tumor implant model. Five different human colorectal xenografts of different growth properties were implanted in athymic rats and evaluated by dynamic 18F-FDG-PET. The phosphorylating and dephosphorylating activities of the key glycolytic enzymes, hexokinase and glucose-6-phosphatase, were measured in these tumor types by spectrophotometric assays and the expression of GLUT1 glucose transporter protein was determined by immunohistochemistry. Correlations among FDG accumulation, hexokinase activity, and tumor doubling time are reported in these colon xenografts. The results indicate that the activity of tumor hexokinase may be a marker of tumor growth rate that can be determined by 18F-FDG-PET imaging. PET scanning may not only be a useful tool for staging patients for extent of disease, but may provide important prognostic information concerning the proliferative rates of malignancies.

Clinical value of FDG dual-head tomography with coincidence imaging in suspected malignant pleural effusion or atelectasis

International Nuclear Information System (INIS)

Wang Huoqiang; Wu Jiyang; Pan Huizhong; Liu Jinjun; Shen Yi; Zhao Xianguo

2004-01-01

Objective: To determine the ability of 18F-fluorodeoxyglucose (FDG) dual-head tomography with coincidence (DHTC) imaging in detecting lung cancer in patients with suspected malignant pleural effusion or malignant atelectasis on CT scanning. On the other hand, used FDG DHTC to differentiate benign and malignant pleural effusions in patients with lung cancer. Methods: Over a 4-year period, 110 patients with abnormal findings on CT scanning for presence of pleural effusion (n=84) and/or pleural thickening or mediastinal lymph nodes enlargement, or presence of atelectasis (n-26). All patients were suspected malignant pleural effusion or atelectasis caused by lung cancer. But all of them could not found primary lesions in the lungs on CT scanning. FDG DHTC was underwent for all the patients. Imagings were visually analyzed by two experienced observers. They were considered positive if the FDG uptake was increased relative to that in the adjacent lung tissue, and the uptake appeared localized pattern. They were considered negative if the uptake was the same as or less than the adjacent lung tissue, and/or the uptake appeared diffused pattern. Results of FDG DHTC were correlated with pathologic diagnosis for lung cancer. In these patients with proven lung cancer and a suspected malignant pleural effusion, FDG DHTC revealed positive findings (malignant pleural effusion) if pleural activity was greater than background mediastinal activity; or FDG DHTC revealed negative findings (benign pleural effusion) if pleural activity was the same or less than background mediastinal activity. Results of FDG DHTC were compared to pleural cytology, histologic findings of pleural biopsy, or clinical follow-up for presence or absence of malignant pleural effusion. Results: 38 of 110 patients were proven with lung cancer. Among the 38 lung cancer patients, 30 of them had a pleural effusion and 8 of them had a atelectasis. 72 of 110 patients were proven with lung benign diseases (50 with

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

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.)

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.)

Concurrent low brain and high liver uptake on FDG PET are associated with cardiovascular risk factors

International Nuclear Information System (INIS)

Nam, Hyun Yeol; Jun, Sung Min; Pak, Kyoung June; Kim, In Joo

2017-01-01

Concurrent low brain and high liver uptake are sometimes observed on fluorine-18-labeled fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET). We investigated the potential clinical significance of this uptake pattern related to metabolic syndrome (MS). We retrospectively reviewed data from 264 consecutive males who had undergone general health check-ups, including FDG PET/CT scans. After an overnight fast, the men had their peripheral blood drawn and the levels of various laboratory parameters measured; an FDG PET/CT scan was performed on the same day. We measured the maximum standardized uptake values of the brain and liver from regions of interest manually placed over the frontal cortex at the level of the centrum semiovale and the right lobe of the liver parenchyma, respectively. Fasting blood glucose (FBG; odds ratio [OR] = 1.063, p < 0.001) and glycated hemoglobin (HbA1c; OR = 3.634, p = 0.010) were the strongest predictive factors for low brain FDG uptake, whereas waist circumference (OR = 1.200, p < 0.001) and γ-glutamyl transpeptidase (OR = 1.012, p = 0.001) were the strongest predictive factors for high liver uptake. Eleven subjects (4.2%) showed concurrent low brain and high liver FDG uptake, and all but one of these subjects (90.9%) had MS. Systolic blood pressure, waist circumference, FBG, triglyceride, alanine aminotransferase, insulin resistance (measured by homeostasis model assessment), insulin, HbA1c, and body mass index were higher in subjects with this FDG uptake pattern than in those without (all, p < 0.001). Concurrent low brain and high liver FDG uptake were closely associated with MS. Moreover, subjects with this pattern had higher values for various cardiovascular risk factors than did those without

Concurrent low brain and high liver uptake on FDG PET are associated with cardiovascular risk factors

Energy Technology Data Exchange (ETDEWEB)

Nam, Hyun Yeol [Dept. of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon (Korea, Republic of); Jun, Sung Min [Dept. of Nuclear Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan (Korea, Republic of); Pak, Kyoung June; Kim, In Joo [Dept. of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan (Korea, Republic of)

2017-04-15

Concurrent low brain and high liver uptake are sometimes observed on fluorine-18-labeled fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET). We investigated the potential clinical significance of this uptake pattern related to metabolic syndrome (MS). We retrospectively reviewed data from 264 consecutive males who had undergone general health check-ups, including FDG PET/CT scans. After an overnight fast, the men had their peripheral blood drawn and the levels of various laboratory parameters measured; an FDG PET/CT scan was performed on the same day. We measured the maximum standardized uptake values of the brain and liver from regions of interest manually placed over the frontal cortex at the level of the centrum semiovale and the right lobe of the liver parenchyma, respectively. Fasting blood glucose (FBG; odds ratio [OR] = 1.063, p < 0.001) and glycated hemoglobin (HbA1c; OR = 3.634, p = 0.010) were the strongest predictive factors for low brain FDG uptake, whereas waist circumference (OR = 1.200, p < 0.001) and γ-glutamyl transpeptidase (OR = 1.012, p = 0.001) were the strongest predictive factors for high liver uptake. Eleven subjects (4.2%) showed concurrent low brain and high liver FDG uptake, and all but one of these subjects (90.9%) had MS. Systolic blood pressure, waist circumference, FBG, triglyceride, alanine aminotransferase, insulin resistance (measured by homeostasis model assessment), insulin, HbA1c, and body mass index were higher in subjects with this FDG uptake pattern than in those without (all, p < 0.001). Concurrent low brain and high liver FDG uptake were closely associated with MS. Moreover, subjects with this pattern had higher values for various cardiovascular risk factors than did those without.

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

Adaptive region-growing with maximum curvature strategy for tumor segmentation in 18F-FDG PET

Science.gov (United States)

Tan, Shan; Li, Laquan; Choi, Wookjin; Kang, Min Kyu; D'Souza, Warren D.; Lu, Wei

2017-07-01

Accurate tumor segmentation in PET is crucial in many oncology applications. We developed an adaptive region-growing (ARG) algorithm with a maximum curvature strategy (ARG_MC) for tumor segmentation in PET. The ARG_MC repeatedly applied a confidence connected region-growing algorithm with increasing relaxing factor f. The optimal relaxing factor (ORF) was then determined at the transition point on the f-volume curve, where the volume just grew from the tumor into the surrounding normal tissues. The ARG_MC along with five widely used algorithms were tested on a phantom with 6 spheres at different signal to background ratios and on two clinic datasets including 20 patients with esophageal cancer and 11 patients with non-Hodgkin lymphoma (NHL). The ARG_MC did not require any phantom calibration or any a priori knowledge of the tumor or PET scanner. The identified ORF varied with tumor types (mean ORF  =  9.61, 3.78 and 2.55 respectively for the phantom, esophageal cancer, and NHL datasets), and varied from one tumor to another. For the phantom, the ARG_MC ranked the second in segmentation accuracy with an average Dice similarity index (DSI) of 0.86, only slightly worse than Daisne’s adaptive thresholding method (DSI  =  0.87), which required phantom calibration. For both the esophageal cancer dataset and the NHL dataset, the ARG_MC had the highest accuracy with an average DSI of 0.87 and 0.84, respectively. The ARG_MC was robust to parameter settings and region of interest selection, and it did not depend on scanners, imaging protocols, or tumor types. Furthermore, the ARG_MC made no assumption about the tumor size or tumor uptake distribution, making it suitable for segmenting tumors with heterogeneous FDG uptake. In conclusion, the ARG_MC was accurate, robust and easy to use, it provides a highly potential tool for PET tumor segmentation in clinic.

Evolving role of 18F-FDG-PET/CT for the body tumor and metastases in pediatrics

International Nuclear Information System (INIS)

Chen Zhengguang; Li Xiaozhen; Li Fang; Ouyang Qiaohong; Yu Tong

2010-01-01

18 F-FDG-positron emission tomography-computerized tomography ( 18 F-FDG-PET/CT) scan is an important imaging tool which may provide both functional and anatomical information in a single diagnostic test. It has the potential to be a valuable tool in the noninvasive evaluation and monitoring of pediatric tumors including the metastases because 18 fluorodeoxyglucose ( 18 F-FDG) is a glucose analogue that concentrates in areas of active metabolic activity. This review provides an update on functional and metabolic imaging approaches for assessment and management of the body tumor and metastases in pediatrics using a combined whole body 18 F-FDG-PET/CT scanners. We discuss the benefits include improved pediatric patients' outcome facilitated by staging and monitoring of disease and better treatment planning. It is worth to concern the preparation of children undergoing PET studies and radiation dosimetry and its implications for family and caregivers. It is important to consider the normal distribution of 18 FDG in children, common variations of the normal distribution. We show some of our cases that most tumors in children accumulate and retain FDG, allowing high-quality images of their distribution and pathophysiology either at the primary site as well as in the areas of metastatic disease.

[{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

Prognostic impact of initial maximum standardized uptake value of 18F-FDG PET/CT on treatment response in patients with metastatic lung adenocarcinoma treated with erlotinib

Directory of Open Access Journals (Sweden)

Kus T

2015-12-01

Full Text Available Tulay Kus,1 Gokmen Aktas,1 Alper Sevinc,1 Mehmet Emin Kalender,1 Mustafa Yilmaz,2 Seval Kul,3 Serdar Oztuzcu,4 Cemil Oktay,5 Celaletdin Camci1 1Department of Internal Medicine, Division of Medical Oncology, Gaziantep Oncology Hospital, 2Department of Nuclear Medicine, 3Department of Biostatistics, Faculty of Medicine, 4Department of Medical Biology, Faculty of Medicine, University of Gaziantep, Gaziantep, 5Department of Radiology, Faculty of Medicine, University of Akdeniz, Antalya, Turkey Purpose: To investigate whether the initial maximum standardized uptake value (SUVmax on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT has a prognostic significance in metastatic lung adenocarcinoma.Patients and methods: Sixty patients (24 females, mean age: 57.9±12 years with metastatic stage lung adenocarcinoma who used erlotinib and underwent 18F-FDG PET/CT at the time of diagnosis between May 2010 and May 2014 were enrolled in this retrospective study. The patients were stratified according to the median SUVmax value, which was found as 11. Progression-free survival (PFS rates for 3, 6, and 12 months were examined for SUVmax values and epidermal growth factor receptor (EGFR mutation status.Results: The number of EGFR-sensitizing mutation positive/negative/unknown was 26/17/17, respectively, and the number of patients using erlotinib at first-line, second-line, and third-line therapy was 15, 31, and 14 consecutively. The PFS rates of EGFR mutation positive, negative, and unknown patients for 3 months were 73.1%, 35.3%, and 41.2% (P=0.026, odds ratio [OR]=4.39; 95% confidence interval [CI]: 1.45–13.26, respectively. The PFS rates of EGFR positive, negative, and unknown patients for 6 months were 50%, 29.4%, and 29.4% (P=0.267, OR: 2.4; 95% CI: 0.82–6.96, respectively. The PFS rates of EGFR positive, negative, and unknown patients for 12 months were 42.3%, 29.4%, 23.5% (P=0.408, OR: 2.0; 95% CI: 0.42�

Comparison of {sup 18}F-FET and {sup 18}F-FDG PET in brain tumors

Energy Technology Data Exchange (ETDEWEB)

Pauleit, Dirk; Stoffels, Gabriele [Institute of Neuroscience and Medicine, Forschungszentrum Juelich, D-52425 Juelich (Germany); Bachofner, Ansgar [Clinic of Nuclear Medicine, Heinrich-Heine-University, D-40001 Duesseldorf (Germany); Floeth, Frank W.; Sabel, Michael [Department of Neurosurgery, Heinrich-Heine-University, D-40001 Duesseldorf (Germany); Herzog, Hans; Tellmann, Lutz [Institute of Neuroscience and Medicine, Forschungszentrum Juelich, D-52425 Juelich (Germany); Jansen, Paul [Institute of Advanced Simulation, Forschungszentrum Juelich, D-52425 Juelich (Germany); Reifenberger, Guido [Department of Neuropathology, Heinrich-Heine-University, D-40001 Duesseldorf (Germany); Hamacher, Kurt; Coenen, Heinz H. [Institute of Neuroscience and Medicine, Forschungszentrum Juelich, D-52425 Juelich (Germany); Langen, Karl-Josef [Institute of Neuroscience and Medicine, Forschungszentrum Juelich, D-52425 Juelich (Germany)], E-mail: k.j.langen@fz-juelich.de

2009-10-15

The purpose of this study was to compare the diagnostic value of positron emission tomography (PET) using [{sup 18}F]-fluorodeoxyglucose ({sup 18}F-FDG) and O-(2-[{sup 18}F]fluoroethyl)-L-tyrosine ({sup 18}F-FET) in patients with brain lesions suspicious of cerebral gliomas. Methods: Fifty-two patients with suspicion of cerebral glioma were included in this study. From 30 to 50 min after injection of 180 MBq {sup 18}F-FET, a first PET scan ({sup 18}F-FET scan) was performed. Thereafter, 240 MBq {sup 18}F-FDG was injected and a second PET scan was acquired from 30 to 60 min after the second injection ({sup 18}F-FET/{sup 18}F-FDG scan). The cerebral accumulation of {sup 18}F-FDG was calculated by decay corrected subtraction of the {sup 18}F-FET scan from the {sup 18}F-FET/{sup 18}F-FDG scan. Tracer uptake was evaluated by visual scoring and by lesion-to-background (L/B) ratios. The imaging results were compared with the histological results and prognosis. Results: Histology revealed 24 low-grade gliomas (LGG) of World Health Organization (WHO) Grade II and 19 high-grade gliomas (HGG) of WHO Grade III or IV, as well as nine others, mainly benign histologies. The gliomas showed increased {sup 18}F-FET uptake (>normal brain) in 86% and increased {sup 18}F-FDG uptake (>white matter) in 35%. {sup 18}F-FET PET provided diagnostically useful delineation of tumor extent while this was impractical with {sup 18}F-FDG due to high tracer uptake in the gray matter. A local maximum in the tumor area for biopsy guidance could be identified with {sup 18}F-FET in 76% and with {sup 18}F-FDG in 28%. The L/B ratios showed significant differences between LGG and HGG for both tracers but considerable overlap so that reliable preoperative grading was not possible. A significant correlation of tracer uptake with overall survival was found with {sup 18}F-FDG only. In some benign lesions like abscesses, increased uptake was observed for both tracers indicating a limited specificity of both

False positive FDG-PET extensive diffuse abdominal tracer activity in a patient with CLL on whole-body 18FDG-PET/CT indicative of Ritcher's transformation

International Nuclear Information System (INIS)

Mahmood, S.; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Martinez de Llano, S.R.; Imperial College, London; Sajid, S.

2009-01-01

The authors present a patient with CLL (chronic lymphocytic leukemia)with diffuse high SUV values in the abdomen. These disturbing findings can sometimes lead to unnecessary procedures. Because of the potential for detection of other malignancies, histological confirmation of the cause of abnormal PET findings is always advisable before one decides on subsequent management (9), but not always possible. SUV values are considered pathological whenever focal FDG deposits (not corresponding to normal physiologic uptake or physiologic elimination of FDG) are higher than 2.5-3.0 (the most frequent standard SUV used in the literature to differentiate benign from malignant lesions).

Estimation of radiation dose received by the radiation worker during 18F FDG injection process

International Nuclear Information System (INIS)

Jha, Ashish Kumar; Zade, Anand; Rangarajan, Venkatesh

2011-01-01

The radiation dosimetric literature concerning the medical and non-medical personnel working in nuclear medicine departments are limited, particularly radiation doses received by radiation worker in nuclear medicine department during positron emission tomography (PET) radiopharmaceutical injection process. This is of interest and concern for the personnel. To measure the radiation dose received by the staff involved in injection process of Fluorine-18 Fluorodeoxyglucose (FDG). The effective whole body doses to the radiation workers involved in injections of 1511 patients over a period of 10 weeks were evaluated using pocket dosimeter. Each patient was injected with 5 MBq/kg of 18 F FDG. The 18 F-FDG injection protocol followed in our department is as follows. The technologist dispenses the dose to be injected and records the pre-injection activity. The nursing staff members then secure an intravenous catheter. The nuclear medicine physicians/residents inject the dose on a rotation basis in accordance with ALARA principle. After the injection of the tracer, the nursing staff members flush the intravenous catheter. The person who injected the tracer then measures the post-injection residual dose in the syringe. The mean effective whole body doses per injection for the staff were the following: Nurses received 1.44 ± 0.22 μSv/injection (3.71 ± 0.48 nSv/MBq), for doctors the dose values were 2.44 ± 0.25 μSv/injection (6.29 ± 0.49 nSv/MBq) and for technologists the doses were 0.61 ± 0.10 μSv/injection (1.58 ± 0.21 nSv/MBq). It was seen that the mean effective whole body dose per injection of our positron emission tomography/computed tomography (PET/CT) staff who were involved in the 18 F-FDG injection process was maximum for doctors (54.34% differential doses), followed by nurses (32.02% differential doses) and technologist (13.64% differential doses). This study confirms that low levels of radiation dose are received by staff during 18 F-FDG injection and

Administered activities of 18F-FDG PET clinics in pediatrics patients in Brazil- preliminary study

International Nuclear Information System (INIS)

Oliveira, Cassio Miri; Sa, Lidia V. de

2013-01-01

A survey was conducted among the Brazilian clinical PET, with the purpose of investigating the activities administered to pediatric oncology patients and assess whether significant differences between the protocols adopted. In addition, this survey can cooperate to the suggestion diagnostic reference levels (DRLs) in nuclear medicine. Although the methodology for delivering doses by most clinics be based on patient's weight, the results showed variations of up to 191, 6% between the activities administered in clinics, even for similar devices. The average value of the distribution of activities reported was 4.46 ± 1,6 MBq /kg. These data demonstrate the need for harmonization and optimization of 18 F-FDG/PET procedures, as well as training for professionals involved in the clinical routine

Factors influencing physiological FDG uptake in the intestine

International Nuclear Information System (INIS)

Yasuda, Seiei; Takahashi, Wakoh; Takagi, Shigeharu; Fujii, Hirofumi; Ide, Michiru; Shohtsu, Akira

1998-01-01

The intestine is a well-known site of physiological 18 F-fluorodeoxyglucose (FDG) accumulation in positron emission tomography (PET). To identify factors influencing physiological FDG uptake in the intestine, the intensity of FDG uptake was evaluated in a total of 1,068 healthy adults. Non-attenuation-corrected whole-body PET images were obtained for all subjects and visually evaluated. Subjects were then classified into two groups according to the intensity of intestinal FDG uptake. Sex, age, presence or absence of constipation, and serum glucose, hemoglobin A 1 c, and free fatty acid levels were compared between the two groups. High intestinal FDG uptake was observed at an overall rate of 11.0%. Sex (female), age, and bowel condition (constipation) were found to affect intestinal FDG uptake. The factors we identified lead to further questions the relationship between intestinal motility and glucose uptake that warrant further study. (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 imaging in HIV-infected subjects: relation with therapy and immunovirological variables

International Nuclear Information System (INIS)

Lucignani, Giovanni; Orunesu, Eva; Cesari, Miriam; Marzo, Katia; Chiti, Arturo; Pacei, Michela; Bechi, Giulia; Gori, Andrea; Gaito, Sabrina; Clerici, Mario

2009-01-01

To characterise tissue sites of immune activation and HIV replication we performed FDG-PET in ART-treated and ART-naive HIV-infected individuals. Specific aims were to establish whether HIV-infected patients can be differentiated on the basis of the detection of specific locations of viral replication, even in the presence of an apparently optimal immunovirological response to ART, and whether these FDG-PET findings can be related to immunovirological variables and AIDS history status. Patients were divided into five groups as follows: subgroup A1 (full responders, n=8): current ART treatment, CD4+ T lymphocytes >500/mL, viral load 50,000 copies/mL; group C (ART-naive, n=5): no current or previous ART treatment, increased viral load. PET images revealed different patterns of FDG uptake. All ART-treated patients with either suppressed (<50 copies/mL; Group A) or high viremia (group B) showed a normal pattern of FDG uptake. On the contrary, the ART-naive subjects with high viraemia (group C) displayed multiple foci of increased glucose metabolism in the lymph nodes. In the ART-naive subjects, FDG uptake, apparently related to viraemia level, was observed in the upper torso mainly in the axillary nodes bilaterally in patients with viraemia below 100,000 copies/mL; in those with viraemia higher than 100,000 copies/mL, FDG uptake was also observed in the inguinal lymph nodes. The emergence, in our study, of a correlation between the percentage of CD8+/CD38+/RO+ T cells (well established markers of progression to AIDS independently of CD4+ T lymphocytes) and positive FDG-PET in ART-naive patients is a novel finding that seems to confer prognostic value on FDG uptake. FDG uptake is strongly associated with response to ART independently of a previous AIDS diagnosis. Notably, no differences were observed between ART-treated subjects classed as immunological responders and those classed as non responders. Data herewith indicate that FDG uptake and immunological variables are

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.)

Peripheral tuberculous lymphadenitis masquerading as metastatic gastric carcinoma on F 18 FDG dual time point PET/CT

Energy Technology Data Exchange (ETDEWEB)

Kim, Su Kon; Shin, Jeong Eun; Lee, Jai Hyuen [Dankook Univ. College of Medicine, Cheonan (Korea, Republic of)

2012-12-15

A 59 year old woman was hospitalized with weight loss, anorexia, and low grade fever for 2 weeks. she had under gone a total gastrectomy followed by adjuvant chemotherapy 10 years prior due to advanced gastric cancer to evaluate recurrence, fluorine 19 fluorodeoxyglucose (FDG) dual time point positron emission tomography/computed tomography (DTPP) was conducted with a gemini GXL 6 PET/CT system (Philips, Hamburg, Germany). FDG DTPP was performed twice, with an early scan 60 min after FDG injection and a delayed scan 150min after FDG injection. The early scan showed that multiple hypermetabolic lesions were located along left supraclavicular, mediastinal (1R, 2R, 3, 4R and 7) and left paraaortic (retroperitoneal) nodal stations. The delayed scan showed that all the above mentioned lesions revealed a more increased maximal standard uptake value (SUVmax) than was detected in the early scan. both scans did not show intrapulmonary lesion. For example, the left supraclavicular lymph node, 2R and retroperitoneal lymph node were observed with early and delayed SUV maxes of 4.5/7.6/3.6 and 6.7/7.7/3.6 and 6.7/10.7/4.4, respectively. Tom confirm diagnosis and establish a treatment plan, a mediastinoscopic biopsy of one of the mediastinal lymph nodes (4R) was subsequently performed and tuberculosis was ultimately diagnosed. Then, the patient started an antituberculosis treatment instead of antichemotherapy. A follow up FDG PET/CT performed 12 months later showed disappeared FDG uptake and significant decreased change of multiple peripheral tuberculous lymphadenitis. Whole body FDG PET/CT has widespread use in diagnosing and staging variable malignancies, and plays an important role in detection of gastric cancer recurrence. However, FDG is not cancer specific and some inflammatory diseases have shown higher FDG uptake on PET imaging. Infection, inflammation, and granulomatosis are also known to cause false positive FDG PET scans because activated inflammatory cells show

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

18F-FDG uptake in breast cancer correlates with immunohistochemically defined subtypes

International Nuclear Information System (INIS)

Koo, Hye Ryoung; Park, Jeong Seon; Kang, Keon Wook; Cho, Nariya; Chang, Jung Min; Bae, Min Sun; Kim, Won Hwa; Lee, Su Hyun; Seo, Mirinae; Moon, Woo Kyung; Kim, Mi Young; Kim, Jin You

2014-01-01

To determine whether a correlation exists between maximum standardized uptake value (SUV max ) on 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) and the subtypes of breast cancer. This retrospective study involved 548 patients (mean age 51.6 years, range 21-81 years) with 552 index breast cancers (mean size 2.57 cm, range 1.0-14.5 cm). The correlation between 18 F-FDG uptake in PET/CT, expressed as SUV max , and immunohistochemically defined subtypes (luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) positive and triple negative) was analyzed. The mean SUV max value of the 552 tumours was 6.07 ± 4.63 (range 0.9-32.8). The subtypes of the 552 tumours were 334 (60 %) luminal A, 66 (12 %) luminal B, 60 (11 %) HER2 positive and 92 (17 %) triple negative, for which the mean SUV max values were 4.69 ± 3.45, 6.51 ± 4.18, 7.44 ± 4.73 and 9.83 ± 6.03, respectively. In a multivariate regression analysis, triple-negative and HER2-positive tumours had 1.67-fold (P max values, respectively, than luminal A tumours after adjustment for invasive tumour size, lymph node involvement status and histologic grade. FDG uptake was independently associated with subtypes of invasive breast cancer. Triple-negative and HER2-positive breast cancers showed higher SUV max values than luminal A tumours. circle 18 F-FDG PET demonstrates increased tissue glucose metabolism, a hallmark of cancers. (orig.)

Non-invasive differentiation of pancreatic lesions: is analysis of FDG kinetics superior to semiquantitative uptake value analysis?

International Nuclear Information System (INIS)

Nitzsche, E.U.; Hoegerle, S.; Mix, M.; Brink, I.; Otte, A.; Moser, E.

2002-01-01

The diagnostic utility of fluorine-18 2-deoxy-D-glucose positron emission tomography (FDG PET) for the non-invasive differentiation of focal pancreatic lesions originating from cancer or chronic pancreatitis by combined visual image interpretation and semiquantitative uptake value analysis has been documented. However, in clinical routine some misdiagnosis is still observed. This is because there is potential overlap between the semiquantitative uptake values obtained for active inflammatory lesions and cancer. Therefore, this prospective study was undertaken to test the hypothesis that analysis of dynamic kinetics of focal pancreatic lesions based on FDG PET may more accurately determine the benign or malignant nature of such lesions. Thirty patients (56±17 years) were studied dynamically with FDG PET for a period of 60-90 min. Patients were assigned to one of four groups: control, acute pancreatitis, chronic pancreatitis or pancreatic cancer. Two observers, blinded to the clinical data, analysed the time-activity curves of FDG kinetics based on region of interest analysis. The diagnosis predicted by FDG PET was compared with the result of histological examination of the surgical specimen. Analysis of FDG kinetics revealed significant differences in the shape of the time-activity curve for controls, pancreatic cancer and inflammatory disease. Surprisingly, there was no significant difference in the time-activity curve shape for chronic pancreatitis and acute pancreatitis; this is, however, not a clinical issue. Furthermore, acquisition time (60 min vs 90 min) did not affect interpretation of the time-activity curve, so that scanning time may be regularly shortened to 60 min. Interobserver agreement was 1. Based on these findings, non-invasive differentiation between pancreatic cancer and chronic pancreatitis was correctly predicted in all cases, as confirmed by histology. In addition, the specificity was increased compared with that obtained from standardised

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

Energy Technology Data Exchange (ETDEWEB)

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

2012-06-15

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

Association of primary tumour FDG uptake with clinical, histopathological and molecular characteristics in breast cancer patients scheduled for neoadjuvant chemotherapy

Energy Technology Data Exchange (ETDEWEB)

Koolen, B.B.; Aukema, T.S. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Surgical Oncology, Amsterdam (Netherlands); Vrancken Peeters, M.J.T.F.D.; Rutgers, E.J.T. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Surgical Oncology, Amsterdam (Netherlands); Wesseling, J.; Lips, E.H. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Pathology and Experimental Therapy, Amsterdam (Netherlands); Vogel, W.V.; Valdes Olmos, R.A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Werkhoven, E. van [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Biometrics, Amsterdam (Netherlands); Gilhuijs, K.G.A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Radiology, Amsterdam (Netherlands); University Medical Centre Utrecht, Department of Radiology, Utrecht (Netherlands); Rodenhuis, S. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Medical Oncology, Amsterdam (Netherlands)

2012-12-15

The aim of this study was to evaluate the association of primary tumour {sup 18}F-fluorodeoxyglucose (FDG) uptake with clinical, histopathological and molecular characteristics of breast cancer patients scheduled for neoadjuvant chemotherapy. Second, we wished to establish for which patients pretreatment positron emission tomography (PET)/CT could safely be omitted because of low FDG uptake. PET/CT was performed in 214 primary stage II or III breast cancer patients in the prone position with hanging breasts. Tumour FDG uptake was qualitatively evaluated to determine the possibility of response monitoring with PET/CT and was quantitatively assessed using maximum standardized uptake values (SUV{sub max}). FDG uptake was compared with age, TNM stage, histology, hormone and human epidermal growth factor receptor 2 status, grade, Ki-67 and molecular subtype in univariable and multivariable analyses. In 203 tumours (95 %) FDG uptake was considered sufficient for response monitoring. No subgroup of patients with consistently low tumour FDG uptake could be identified. In a univariable analysis, SUV{sub max} was significantly higher in patients with distant metastases at staging examination, non-lobular carcinomas, tumours with negative hormone receptors, triple negative tumours, grade 3 tumours, and in tumours with a high proliferation index (Ki-67 expression). After multiple linear regression analysis, triple negative and grade 3 tumours were significantly associated with a higher SUV{sub max}. Primary tumour FDG uptake in breast cancer patients scheduled for neoadjuvant chemotherapy is significantly higher in tumours with prognostically unfavourable characteristics. Based on tumour characteristics associated with low tumour FDG uptake, this study was unable to identify a subgroup of patients unlikely to benefit from pretreatment PET/CT. (orig.)

FDG uptake in vaginal tampons is caused by urinary contamination and related to tampon position

International Nuclear Information System (INIS)

Burger, Irene A.; Crook, David W.; Treyer, Valerie; Hany, Thomas F.; Schulthess, Gustav K. von; Scheiner, David A.

2011-01-01

The aim of the study was to determine the aetiology of FDG uptake in vaginal tampons (VT), a known artefact in premenopausal women evaluated by PET/CT. This Institutional Review Board approved study consisted of retrospective and prospective parts. The retrospective analysis included 685 women examined between January 2008 and December 2009 regarding VT presence. PET/CT images were analysed to determine the localization and the standardized uptake value (SUV) of VTs. We prospectively recruited 24 women (20-48 years old) referred for staging or follow-up in an oncology setting between February and April 2010, who were provided a commercial VT to be used during the entire examination after obtaining written informed consent. After image acquisition, VTs were individually analysed for creatinine concentration and blood traces. Statistical significance was tested with the Mann-Whitney U test. In the retrospective part, 38 of 685 women were found to have a VT of which 17 (45%) were FDG positive. A statistically significant correlation was found between FDG activity and VT position below the pubococcygeal line (PCL) (13 ± 11.2 mm). In the prospective study, 7 of 24 (29%) women had increased FDG activity in their VTs (SUV 18.8 ± 11 g/ml) but were not menstruating. FDG-positive VTs were significantly lower in position (14.6 ± 11.4 mm,below the PCL) than FDG-negative VTs (p = 0.039). The creatinine concentration was significantly increased in all seven positive VTs (931 ± 615 μmol/l). FDG uptake in VTs is caused by urine contamination, which is likely related to localization below the PCL resulting in contact with urine during voiding. (orig.)

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

Energy Technology Data Exchange (ETDEWEB)

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

2008-10-15

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

Evaluation of the use of activated carbon for the filtration of gaseous effluents generated in the production of the radiopharmaceutical FDG-18F

International Nuclear Information System (INIS)

Cunha, R.S.; Goulart, A.S.; Flores, M.R.; Saibt, M.

2017-01-01

Gaseous rejects generated in the production of FDG- 18 F are produced mainly during the irradiation of the enriched water (H2O 18 ) within the niobium / target body at the cyclotron accelerator and during the process of FDG- 18 F synthesis in the synthesizer modules within the cell hot. In order to reduce the levels of gaseous effluents emitted, activated carbon filters are used in the exhaust system. These have the ability to adsorb the 18 F gaseous molecules generated in the synthesis. This work aims to quantify the efficiency of the activated carbon filters in relation to the dose rate before and after the passage of the gases through the filtration system. To quantify the values in the exhaust system, two radiation detectors were used, in the equivalent dose rate mode in μSv/h. To evaluate the values obtained, graphs of the levels before and after the filtration system were generated. These graphs were compared to each other, relating the values found. The generated graphs showed a high efficiency in the filtration of gaseous effluents. Several dose rate peaks are presented in the exhaust system during FDG- 18 F synthesis, however after the passage of the gases through the filters these peaks become values very close to the Background values

FDG uptake heterogeneity evaluated by fractal analysis improves the differential diagnosis of pulmonary nodules

Energy Technology Data Exchange (ETDEWEB)

Miwa, Kenta, E-mail: kenta5710@gmail.com [Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550 (Japan); Division of Medical Quantum Science, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Inubushi, Masayuki, E-mail: inubushi@med.kawasaki-m.ac.jp [Department of Nuclear Medicine, Kawasaki Medical School, 577 Matsushima Kurashiki, Okayama 701-0192 (Japan); Wagatsuma, Kei, E-mail: kei1192@hotmail.co.jp [Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550 (Japan); Nagao, Michinobu, E-mail: minagao@radiol.med.kyushu-u.ac.jp [Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Murata, Taisuke, E-mail: taisuke113@gmail.com [Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550 (Japan); Koyama, Masamichi, E-mail: masamichi.koyama@jfcr.or.jp [Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550 (Japan); Koizumi, Mitsuru, E-mail: mitsuru@jfcr.or.jp [Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550 (Japan); Sasaki, Masayuki, E-mail: msasaki@hs.med.kyushu-u.ac.jp [Division of Medical Quantum Science, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan)

2014-04-15

Purpose: The present study aimed to determine whether fractal analysis of morphological complexity and intratumoral heterogeneity of FDG uptake can help to differentiate malignant from benign pulmonary nodules. Materials and methods: We retrospectively analyzed data from 54 patients with suspected non-small cell lung cancer (NSCLC) who were examined by FDG PET/CT. Pathological assessments of biopsy specimens confirmed 35 and 19 nodules as NSCLC and inflammatory lesions, respectively. The morphological fractal dimension (m-FD), maximum standardized uptake value (SUV{sub max}) and density fractal dimension (d-FD) of target nodules were calculated from CT and PET images. Fractal dimension is a quantitative index of morphological complexity and tracer uptake heterogeneity; higher values indicate increased complexity and heterogeneity. Results: The m-FD, SUV{sub max} and d-FD significantly differed between malignant and benign pulmonary nodules (p < 0.05). Although the diagnostic ability was better for d-FD than m-FD and SUV{sub max}, the difference did not reach statistical significance. Tumor size correlated significantly with SUV{sub max} (r = 0.51, p < 0.05), but not with either m-FD or d-FD. Furthermore, m-FD combined with either SUV{sub max} or d-FD improved diagnostic accuracy to 92.6% and 94.4%, respectively. Conclusion: The d-FD of intratumoral heterogeneity of FDG uptake can help to differentially diagnose malignant and benign pulmonary nodules. The SUV{sub max} and d-FD obtained from FDG-PET images provide different types of information that are equally useful for differential diagnoses. Furthermore, the morphological complexity determined by CT combined with heterogeneous FDG uptake determined by PET improved diagnostic accuracy.

Ultrasound stratification of the FDG-avid thyroid nodule

International Nuclear Information System (INIS)

Beech, P.; Lavender, I.; Jong, I.; Soo, G.; Ramdave, S.; Chong, A.; Nandurkar, D.

2016-01-01

Aim: To determine whether the malignancy risk in an 2-["1"8F]-fluoro-2-deoxy-D-glucose (FDG)-avid thyroid nodule can be stratified according to the presence or absence of suspicious ultrasound features and thereby identify which nodules require further cytological assessment. Materials and methods: A retrospective review of FDG-positron-emission tomography (PET) combined with computed tomography (CT) studies with FDG-avid thyroid nodules (defined as FDG uptake greater than blood pool) that were further assessed with ultrasound and fine-needle aspiration cytology or surgery was performed. FDG-avid thyroid nodules were classified as having either suspicious ultrasound features (marked hypo-echogenicity, irregular margins, microcalcifications, marked hypervascularity, or nodules that were taller than they were wide) or no suspicious ultrasound features and these findings were correlated with the subsequent cytological results. Results: Forty-eight FDG-avid thyroid nodules were assessed. On cytological assessment five nodules were malignant (10.4%), nine were indeterminate (18.75%), and 34 were benign (70.8%). On ultrasound, 24 (50%) had no suspicious features and 24 (50%) had one or more suspicious features. Of the nodules with no suspicious features, 22 (91.6%) were benign, two (8.3%) were indeterminate, and none were malignant. Of the nodules with suspicious features, five (20.8%) were malignant, seven (29.1%) were indeterminate, and 12 (50%) were benign. The absence of suspicious ultrasound features demonstrated a strong association with benign cytology (p=0.009). Out of the suspicious sonographic features, marked hypoechoic appearance (p=0.02), irregular margins (p=0.009), and taller than wide morphology (p=0.04) were statistically most significantly associated with malignancy. Conclusion: The rate of malignancy in FDG-avid thyroid nodules is low in the absence of specific suspicious ultrasound features. The SUV values are non-discriminatory to differentiate

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)

Consideration of myocardial FDG uptake in differentiation of mediastinal lymph node of non-small cell lung cancer

International Nuclear Information System (INIS)

Eo, Jae Seon; Lee, Won Woo; Chung, Jin Haeng; So, Young; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul; Kim, Sang Eun

2004-01-01

The whole body FDG PET suffers from poor diagnostic competency in differentiation of mediastinal lymph node (LN) in non-small cell lung cancer. In addition to LN FDG uptake. We considered myocardial FDG uptake in mediastinal lymph node staging. Thirty-nine non-small cell lung cancer patients (male: female = 32: 7, age = 63±11 years) who underwent preoperative whole body FDG PET were enrolled. There were 18 squamous cell cancer, 13 adenocarcinoma, and 8 others. Maximum standard uptake values (maxSUVs) of myocardium and LNs using lean body weight were measured and compared with pathological results. Among 187 LNs which were confirmed postoperatively, 31 were malignant, and 156 benign. Of 31 malignant LNs, only 11 were visible on FDG PET (sensitivity : 35.5% = 11/31) but majority of 20 nonvisible metastatic LNs had relevant cause of false negative (11 peribroncheal, 3 mucine producing adenocarcinoma, or 6 low amount of tumor cells). Of 156 benign LNs, 137 were nonvisible (specificity : 87.8% 137/156) and 19 visible. Under subgroup analysis of 30 visible LNs on whole body FDG PET (11 malignant, and 19 benign), maxSUV of myocardium (p = 0.020) as well as maxSUV of LN (p = 0.002) were significant predictor of malignant LN in multivariate analysis. Using the ROC curve, a cut-off value of LN maxSUV > 2.4 provided sensitivity of 81.8% and specificity of 63.2% (AUC 0.775, 95% confidence interval = 0.586 to 0.906). Meanwhile, the composite criterion of LN maxSUV plus square root of myocardial maxSUV > 4.65 provided slightly improved diagnostic competencies (sensitivity 90.9%, specificity 84.2%, AUC 0.876, 95% confidence interval 0.704 to 0.966) (p = 0.08). Taking into consideration myocardial FDG uptake may improve the diagnostic competency of whole body FDG PET in differentiation of mediastinal LNs of non-small cell lung cancer

18FDG CDET in staging of lung cancer

International Nuclear Information System (INIS)

Grahek, D.; Montravers, F.; Kerrou, K.; Talbot, J.N.; Tofighi, M.; Tamgac, F.; Breau, J.L.; Moretti, J.L.

2000-01-01

A clinical study, involving two centres, was promoted by AP-HP Paris. It aimed to evaluate feasibility and detection sensitivity of Coincidence Detection Emission Tomography (CDET) using 18 FDG in the stating of pulmonary cancer, with 2 different dual head y cameras (Vertex ADAC and Prism 2000 Picker, without attenuation correction. Forty patients, including 35 men, with a mean age of 58.6 y were explored by CDET and conventional imaging. Lung cancer was assessed by biopsy during bronchoscopy prior to patient's inclusion. CDET-FDG visualized the primitive lesion in 39 patients (sensitivity: 97.5%). The lesion that was not detected was an bronchoalveolar adenocarcinoma. In 26 patients, a histologic evaluation of malignancy invasion of ipsilateral lymph nodes was obtained in 48 lymph node sites. The site-based accuracy of CDET-FDG to detect malignancy in these lymph nodes was 79% versus 65% for CT. The metastatic status in 39 patients (M0 or M1) was evaluated by clinicians and surgeons from the data of conventional imaging and CDET-FDG, before the management of the patient was decided. Then their results were compared to the metastatic status evaluated separately by CDET-FDG and conventional imaging. In this case, the accuracy of CDET-FDG was 95 % versus 90 % for conventional imaging. This clinical study in this indication demonstrated the feasibility of CDET-FDG, with a better performance than conventional imaging and similar to performance of PET-FDG. (authors)

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.

(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....

Incidence and characteristics of uterine leiomyomas with FDG uptake

International Nuclear Information System (INIS)

Nishizawa, Sadahiko; Inubushi, Masayuki; Kido, Aki; Miyagawa, Masao; Inoue, Takeshi; Shinohara, Katsura; Kajihara, Makoto

2008-01-01

Uterine leiomyomas sometimes show focal 18 F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) images that may result in a false-positive diagnosis for malignant lesions. This study was conducted to investigate the incidence and characteristics of uterine leiomyomas that showed FDG uptake. We reviewed FDG-PET and pelvic magnetic resonance (MR) images of 477 pre-menopausal (pre-MP, age 42.1±7.3 years) and 880 post-MP (age 59.9±6.8 years) healthy women who underwent these tests as parts of cancer screening. Of 1357, 323 underwent annual cancer screening four times, 97 did three times, 191 did twice, and the rest were screened once. Focal FDG uptake (maximal standardized uptake value >3.0) in the pelvis was localized and characterized on co-registered PET/MR images. Uterine leiomyomas were found in 164 pre-MP and 338 post-MP women. FDG uptake was observed in 18 leiomyomas of 17 of the 164 (10.4%) pre-MP women and in 4 leiomyomas of 4 of the 338 (1.2%) post-MP women. The incidence was significantly higher in pre-MP women than in post-MP women (chi-square, P<0.001). Of the 22, 13 showed signal intensity equal to or higher than that of the myometrium on T2-weighted MR images, which suggested abundant cellularity, whereas the majority of leiomyomas without FDG uptake showed low signal intensity. Of the 13 women, 12 examined more than twice showed substantial changes in the level of FDG uptake in leiomyomas each year with FDG uptake disappearing or newly appearing. These changes were observed frequently in relation with menopause or menstrual phases. Leiomyomas with focal FDG uptake were seen in both pre- and post-MP women with a higher incidence in pre-MP women. Abundant cellularity and hormonal dependency may explain a part of the mechanisms of FDG uptake in leiomyomas. It is important to know that the level of FDG uptake in leiomyomas can change and newly appearing FDG uptake does not necessarily mean malignant transformation. (author)

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.

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

Free fatty acid has a negative correlation with myocardial uptake of FDG

Energy Technology Data Exchange (ETDEWEB)

Eo, Jae Seon; Lee, Won Woo; Park, Eun Kyung; So, Young; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul; Kim, Sang Eun [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

2004-07-01

Free fatty acid (FFA) is a marker of insulin resistance. Myocardial uptake of FDG is influenced by insulin resistance. We investigated the correlation of FFA and myocardial uptake of FDG in whole body PET. We measured serum FFA levels in consecutive 112 patients who underwent whole body FDG PET due to malignancy work up. Twelve patients with diabetes. 13 with liver disease, 4 with suspicious ischemic heart disease. 1 with steroid therapy, and 10 with final diagnosis of benign disease were excluded. After fasting of diet or beverages for at least 6 hours, blood was aspirated at peripheral vein for measurement of FFA and glucose in serum. FDG was injected as a dose of 0.14 mCi/kg body weight. Fifty minutes later, whole body PET scan was performed from skull base to upper thigh. Maximum SUV (maxSUV) using lean body weight was obtained in heart. liver, cerebellum, muscle and malignant tissues. Finally 72 patients (M:F 45:27, age 56.9{+-}15.8 years) were enrolled. There were 27 non small cell lung cancer, 14 lymphoma, 10 esophageal cancer, 3 breast cancer, 3 colon cancer, 3 renal cell cancer, 2 melanoma, and 10 other cancers. Serum glucose level was 96.6{+-}14.3 mg/dL. Serum FFA level was 720.0{+-}315.2 uEq/L. MaxSUV of main malignant tissue ranged from 0.7 to 11.5 (mean 4.9{+-}2.6). MaxSUV of each organs were 1.0 to 14.6 (mean 4.0{+-}3.0) in heart, 2.7 to 6.4 (mean 3.9{+-}0.6) in cerebellum, 1.0 to 2.6 (mean 1.9{+-}0.3) in liver, and 0.6 to 1.1 (mean 0.8{+-}0.1) in gluteal muscle. FFA and maxSUV of heart had a negative correlation. The best fitting line was MaxSUV of Heart = -4.4583 x In(FF A) + 32.964. But FFA had no correlation with any other parameters like serum glucose level, and MaxSUV of cerebellum, muscle, liver and malignant tissues. We found a negative correlation between FFA levels and myocardial uptake of FDG. FFA modifying drugs such as nicotinic acid derivatives may have influence on myocardial uptake of FDG.

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

Energy Technology Data Exchange (ETDEWEB)

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.)

Glycolytic activity in breast cancer using 18F-FDG PET/CT as prognostic predictor: A molecular phenotype approach.

Science.gov (United States)

Garcia Vicente, A M; Soriano Castrejón, A; Amo-Salas, M; Lopez Fidalgo, J F; Muñoz Sanchez, M M; Alvarez Cabellos, R; Espinosa Aunion, R; Muñoz Madero, V

2016-01-01

To explore the relationship between basal (18)F-FDG uptake in breast tumors and survival in patients with breast cancer (BC) using a molecular phenotype approach. This prospective and multicentre study included 193 women diagnosed with BC. All patients underwent an (18)F-FDG PET/CT prior to treatment. Maximum standardized uptake value (SUVmax) in tumor (T), lymph nodes (N), and the N/T index was obtained in all the cases. Metabolic stage was established. As regards biological prognostic parameters, tumors were classified into molecular sub-types and risk categories. Overall survival (OS) and disease free survival (DFS) were obtained. An analysis was performed on the relationship between semi-quantitative metabolic parameters with molecular phenotypes and risk categories. The effect of molecular sub-type and risk categories in prognosis was analyzed using Kaplan-Meier and univariate and multivariate tests. Statistical differences were found in both SUVT and SUVN, according to the molecular sub-types and risk classifications, with higher semi-quantitative values in more biologically aggressive tumors. No statistical differences were observed with respect to the N/T index. Kaplan-Meier analysis revealed that risk categories were significantly related to DFS and OS. In the multivariate analysis, metabolic stage and risk phenotype showed a significant association with DFS. High-risk phenotype category showed a worst prognosis with respect to the other categories with higher SUVmax in primary tumor and lymph nodes. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

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)

Disease activity and 18F-FDG uptake in organising pneumonia: semi-quantitative evaluation using computed tomography and positron emission tomography

International Nuclear Information System (INIS)

Tateishi, Ukihide; Arai, Yasuaki; Hasegawa, Tadashi; Seki, Kunihiko; Terauchi, Takashi; Moriyama, Noriyuki

2006-01-01

Purpose: The present study was conducted to evaluate whether 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) in combination with computed tomography (CT) reflects disease activity in patients with organising pneumonia.Methods: Eighty-eight subjects who were normal (n=66) or who had proven organising pneumonia (n=22) underwent FDG-PET and CT imaging. The subjects included 55 men and 33 women, ranging in age from 24 to 63 years (mean 47 years). PET and CT data sets were digitally fused using a conformational PET/CT fusion algorithm. All scans were evaluated independently by two chest radiologists who were unaware of other clinical data. The visual score, maximal and mean standardised uptake value (SUV), and maximal and mean lesion-to-normal tissue ratio (LNR) were calculated. The imaging results were compared with the laboratory and pulmonary function test results. The inflammatory cells in the lesions were quantified immunohistochemically. The visual score, maximal and mean SUV, and maximal and mean LNR of the patients with organising pneumonia were significantly higher than those of the normal subjects. The patients with air-space consolidation had a significantly higher SUV than those without air-space consolidation (mean±SD 3.08±0.39 vs 2.35±0.56; p + cells was positively correlated with the maximal SUV (r=0.632, p + T lymphocytes also showed positive correlations with the maximal SUV (r=0.540, p<0.01) and the maximal LNR (r=0.547, p<0.01). Patients with organising pneumonia have an enhanced FDG accumulation which reflects the degree of disease activity. (orig.)

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

Combining functional CT and FDG PET allows the calculation of FDG extraction fraction and hepatic glucose phosphorylation

Energy Technology Data Exchange (ETDEWEB)

Griffiths, M R [Centre for Medical and Health Physics, Queensland University of Technology (Australia); Wesley Research Institute, QLD (Australia); Miles, K A [Centre for Medical and Health Physics, Queensland University of Technology (Australia); Wesley Research Institute, QLD (Australia); Southern X-ray Clinics, Brisbane [Australia; Keith, C J [Wesley Research Institute, QLD (Australia)

2002-09-01

Perfusion data from Functional CT and FDG-PET data may be combined to provide additional information about the uptake of FDG. We have developed methods to calculate FDG extraction fraction in tissues and to quantify hepatic glucose phosphorylation in the liver. Extraction fraction: Functional CT and FDG-PET studies were used to obtain measurements of perfusion and glucose uptake respectively within ten pulmonary nodules. The net influx constant (Ki) was determined from SUV measurements for each lung mass Extraction fraction (E) for each mass lesion was determined from: E=Ki/(Px[1-Hct]). A pixel by pixel calculation allowed generation of extraction fraction maps. The extraction fraction measurements ranged (median) from 0.6% to 4.81% (2.7%). The values for a benign nodule and an organising pneumonia were 0.6% and 0.71% respectively. Extraction fraction measurements for the malignant nodules ranged from 2.01% to 4.81%. A clearer separation of benign and malignant lesions is seen with E values rather than with SUV. Hepatic Glucose Phosphorylation: Functional CT and FDG-PET were utilised to obtain measurements of perfusion and glucose uptake respectively within the livers of a series of 35 patients with colorectal cancer. Hepatic perfusion and the net influx constant were incorporated into FDG kinetic analysis to determine hepatic glucose phosphorylation fraction. SUV and Ki were significantly lower in the 12 patients with advanced disease (p=0.015 and p=0.013 respectively) whereas portal and total hepatic perfusion were increased (p=0.013 and p=0.008 respectively). Combining the PET and CT data yielded phosphorylation fractions of 1.14% and 0.74% for early and advanced disease respectively (p=0.002). By combining functional CT measurements of blood flow with PET measurements of FDG uptake, it is possible to calculate the extraction fraction of FDG and Hepatic glucose phosphorylation. The use of the extraction fraction has improved the distinction between malignant and

Combining functional CT and FDG PET allows the calculation of FDG extraction fraction and hepatic glucose phosphorylation

International Nuclear Information System (INIS)

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

2002-01-01

Perfusion data from Functional CT and FDG-PET data may be combined to provide additional information about the uptake of FDG. We have developed methods to calculate FDG extraction fraction in tissues and to quantify hepatic glucose phosphorylation in the liver. Extraction fraction: Functional CT and FDG-PET studies were used to obtain measurements of perfusion and glucose uptake respectively within ten pulmonary nodules. The net influx constant (Ki) was determined from SUV measurements for each lung mass Extraction fraction (E) for each mass lesion was determined from: E=Ki/(Px[1-Hct]). A pixel by pixel calculation allowed generation of extraction fraction maps. The extraction fraction measurements ranged (median) from 0.6% to 4.81% (2.7%). The values for a benign nodule and an organising pneumonia were 0.6% and 0.71% respectively. Extraction fraction measurements for the malignant nodules ranged from 2.01% to 4.81%. A clearer separation of benign and malignant lesions is seen with E values rather than with SUV. Hepatic Glucose Phosphorylation: Functional CT and FDG-PET were utilised to obtain measurements of perfusion and glucose uptake respectively within the livers of a series of 35 patients with colorectal cancer. Hepatic perfusion and the net influx constant were incorporated into FDG kinetic analysis to determine hepatic glucose phosphorylation fraction. SUV and Ki were significantly lower in the 12 patients with advanced disease (p=0.015 and p=0.013 respectively) whereas portal and total hepatic perfusion were increased (p=0.013 and p=0.008 respectively). Combining the PET and CT data yielded phosphorylation fractions of 1.14% and 0.74% for early and advanced disease respectively (p=0.002). By combining functional CT measurements of blood flow with PET measurements of FDG uptake, it is possible to calculate the extraction fraction of FDG and Hepatic glucose phosphorylation. The use of the extraction fraction has improved the distinction between malignant and

FDG-PET/CT response evaluation during EGFR-TKI treatment in patients with NSCLC

Institute of Scientific and Technical Information of China (English)

Matthijs; H; van; Gool; Tjeerd; S; Aukema; Koen; J; Hartemink; Renato; A; Valdés; Olmos; Houke; M; Klomp; Harm; van; Tinteren

2014-01-01

Over recent years,[18F]-fluorodeoxyglucose positron emission tomography acquired together with low dose computed tomography(FDG-PET/CT)has proven its role as a staging modality in patients with non-small cell lung cancer(NSCLC).The purpose of this review was to present the evidence to use FDG-PET/CT for response evaluation in patients with NSCLC,treated with epidermal growth factor receptor(EGFR)-tyrosine kinase inhibitors(TKI).All published articles from 1November 2003 to 1 November 2013 reporting on 18FFDG-PET response evaluation during EGFR-TKI treatment in patients with NSCLC were collected.In total 7studies,including data of 210 patients were eligible for analyses.Our report shows that FDG-PET/CT responseduring EGFR-TKI therapy has potential in targeted treatment for NSCLC.FDG-PET/CT response is associated with clinical and radiologic response and with survival.Furthermore FDG-PET/CT response monitoring can be performed as early as 1-2 wk after initiation of EGFR-TKI treatment.Patients with substantial decrease of metabolic activity during EGFR-TKI treatment will probably benefit from continued treatment.If metabolic response does not occur within the first weeks of EGFR-TKI treatment,patients may be spared(further)unnecessary toxicity of ineffective treatment.Refining FDG-PET response criteria may help the clinician to decide on continuation or discontinuation of targeted treatment.

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

International Nuclear Information System (INIS)

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

2002-01-01

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

Cortical activity during olfactory stimulation in multiple chemical sensitivity: a 18F-FDG PET/CT study

International Nuclear Information System (INIS)

Chiaravalloti, Agostino; Di Pietro, Barbara; Pagani, Marco; Micarelli, Alessandro; Alessandrini, Marco; Genovesi, Giuseppe; Schillaci, Orazio

2015-01-01

To investigate the differences in brain glucose consumption during olfactory stimulation between subjects affected by multiple chemical sensitivity (MCS) and a group of healthy individuals. Two 18 F-FDG PET/CT scans were performed in 26 subjects (6 men and 20 women; mean age 46.7 ± 11 years) with a clinical diagnosis of MCS and in 11 healthy controls (6 women and 5 men; mean age 45.7 ± 11 years), the first scan after a neutral olfactory stimulation (NS) and the second after a pure olfactory stimulation (OS). Differences in 18 F-FDG uptake were analysed by statistical parametric mapping (SPM2). In controls OS led to an increase in glucose consumption in BA 18 and 19 and a reduction in glucose metabolism in BA 10, 11, 32 and 47. In MCS subjects, OS led to an increase in glucose consumption in BA 20, 23, 18 and 37 and a reduction in glucose metabolism in BA 8, 9 and 10. The results of our study suggest that cortical activity in subjects with MCS differs from that in healthy individuals during olfactory stimulation. (orig.)

Cortical activity during olfactory stimulation in multiple chemical sensitivity: a (18)F-FDG PET/CT study.

Science.gov (United States)

Chiaravalloti, Agostino; Pagani, Marco; Micarelli, Alessandro; Di Pietro, Barbara; Genovesi, Giuseppe; Alessandrini, Marco; Schillaci, Orazio

2015-04-01

To investigate the differences in brain glucose consumption during olfactory stimulation between subjects affected by multiple chemical sensitivity (MCS) and a group of healthy individuals. Two (18)F-FDG PET/CT scans were performed in 26 subjects (6 men and 20 women; mean age 46.7 ± 11 years) with a clinical diagnosis of MCS and in 11 healthy controls (6 women and 5 men; mean age 45.7 ± 11 years), the first scan after a neutral olfactory stimulation (NS) and the second after a pure olfactory stimulation (OS). Differences in (18)F-FDG uptake were analysed by statistical parametric mapping (SPM2). In controls OS led to an increase in glucose consumption in BA 18 and 19 and a reduction in glucose metabolism in BA 10, 11, 32 and 47. In MCS subjects, OS led to an increase in glucose consumption in BA 20, 23, 18 and 37 and a reduction in glucose metabolism in BA 8, 9 and 10. The results of our study suggest that cortical activity in subjects with MCS differs from that in healthy individuals during olfactory stimulation.

Physiological FDG uptake in the ovaries after hysterectomy

International Nuclear Information System (INIS)

Nishizawa, Sadahiko; Inubushi, Masayuki; Ozawa, Fukujiro; Kido, Aki; Okada, Hiroyuki

2007-01-01

It is known that focal 18 F-fluorodeoxyglucose (FDG) uptake is physiologically seen in the ovaries and uterus of premenopausal women in correlation with the menstrual cycle, which may cause false-positive diagnoses on the images of FDG positron emission tomography (PET). The objective of this study was to clarify whether women of reproductive age after hysterectomy whose ovaries were preserved, also showed physiological ovarian FDG uptake. We reviewed 26 women after hysterectomy (age 51.1±5.0 years), who underwent annual cancer screening, including FDG-PET and pelvic magnetic resonance (MR) imaging, three times. Seven women (age 45.9±5.8 years, range 34-52 years) had at least one ovary, showing changes in its appearance including the size and number of follicles on MR images each year, which suggested that the ovary was functioning. Four of the seven women showed focal FDG uptake (standardized uptake value 4.2±1.1) that corresponded to the normal ovaries on five PET examinations. Another group of 19 women (age 53.1±3.1 years, range 47-59 years) who had small ovaries without changes on MR images each year did not show FDG uptake in the ovaries. Physiological FDG uptake observed in the ovaries of women of reproductive age even after hysterectomy is reasonably common. As it is not easy to determine the hormonal cycle in these women, it is essential to correlate focal FDG uptake in the pelvis with anatomical and morphological findings on MR images to avoid false-positive diagnoses. (author)

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

Science.gov (United States)

Sun, Yajuan; Yu, Hongjuan; Ma, Jingquan

2016-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

18 F-FDG uptake in focal organising pneumonia mimicking bronchial carcinoma.

Science.gov (United States)

Baha, Ayse; Yildirim, Fatma; Kokturk, Nurdan; Akdemir, Umit Ozgur; Demircan, Sedat; Turktas, Haluk

2016-11-01

Organising pneumonia (OP) is not a well-known cause of increased 18 F-FDG uptake, and the relationship of the increased 18 F-FDG uptake to clinical parameters has not been clearly identified. This study aims to assess the role of positron emission tomography-computed tomography (PET-CT) for the diagnosis of focal organised pneumonia that may mimic malignity because of mass-like lesions on the radiological images it causes. Among 40 patients of whom histopathological exams were consistent with OP, medical records of 14 focal OP patients diagnosed with surgical biopsy were evaluated retrospectively. There were 10 male (71.4%) and 4 female (28.6%) patients. The mean age at the time of diagnosis was 57.2 ± 11.7 years, ranging from 38 to 85 years. Nine subjects (64.3%) were smokers. Eleven patients (78.5%) had symptoms, the remaining 3 patients (21.5%) were asymptomatic. Three patients (21.3%) had a history of malignancy. Focal lung lesion was initially detected by chest radiography in 10 patients (71.4%) and by computed tomography (CT) scan in all patients. CT scan showed a single lesion in 12 (85.7%) patients. The lesions were located in the right lung of the half of patients (50%) and in the left lung of the other half. The median diameter of the lesions was 3.4 cm (range, 1.8-6.0 cm). PET with 18 F-FDG was performed in all patients, and hypermetabolic activity of the focal lung lesion was demonstrated in all cases. The median values of maximum standardized uptake value was 3.5 ± 2.7 (min 2.1-max 13.1). Focal OP is a discrete form of OP that is associated with unifocal lesions on radiological images, and it can easily mimic lung cancer because of positivity on PET scans. There are no specific findings of PET scan for the diagnosis of OP. © 2015 John Wiley & Sons Ltd.

Comparison of F-18-FDG PET/CT findings between pancreatic solid pseudopapillary tumor and pancreatic ductal adenocarcinoma

International Nuclear Information System (INIS)

Kim, Yong-il; Kim, Seok-ki; Paeng, Jin Chul; Lee, Ho-Young

2014-01-01

Objective: Pancreatic solid pseudopapillary tumor (SPT) is a rare benign tumor. Little data are available on positron emission tomographic/computed tomographic (PET/CT) characteristics of this tumor. Therefore, we analyzed the metabolic characteristics of SPT using F-18-FDG PET/CT and compared the results with those of pancreatic ductal adenocarcinoma. Methods: We retrospectively reviewed the records of 11 SPT patients and 46 patients with ductal adenocarcinoma. Ten SPT patients had primary tumors and 1 patient had metastatic SPT. Maximum standardized uptake value (max SUV), mean SUV, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and tumor-to-background ratio (TBR) were evaluated. Mann–Whitney U test between pancreatic SPT and ductal adenocarcinoma was performed. In addition, age, gender and tumor size-adjusted analysis of covariance (ANCOVA) was done between pancreatic SPT and ductal adenocarcinoma. Results: Compared with pancreatic ductal adenocarcinomas, SPTs had significantly higher tumor size-adjusted MTV and TLG. MTV and TLG values were significantly correlated with T-stage of the SPTs. In 1 SPT patient, metastases in the liver and mesentery were revealed by intense uptake of FDG on F-18-FDG PET/CT, and after PET/CT had suggested the presence of pancreatic SPT. Conclusion: We recommend that SPT be considered when a solid pancreatic mass with increased FDG metabolism is encountered on PET/CT. F-18-FDG PET/CT may be useful in detecting subtle metastases of SPT

Correlation of primary tumor FDG uptake with clinicopathologic prognostic factors in invasive ductal carcinoma of the breast

International Nuclear Information System (INIS)

Jo, I; Kim, Sung Hoon; Kim, Hae Won; Kang, Sung Hee; Zeon, Seok Kil; Kim, Su Jin

2015-01-01

The purpose of this study was to investigate the correlation of primary tumor FDG uptake to clinicopathological prognostic factors in invasive ductal carcinoma of the breast. We retrospectively reviewed 136 of 215 female patients with pathologically proven invasive ductal breast cancer from January 2008 to December 2011 who underwent F-18 FDG PET/CT for initial staging and follow-up after curative treatment with analysis of estrogen receptor (ER), progesterone receptor (PR) and human epithelial growth factor receptor 2 (HER2). The maximum standardized uptake value (SUV max ) of the primary breast tumor was measured and compared with hormonal receptor and HER2 overexpression status. The high SUV max of primary breast tumors is significantly correlated with the clinicopathological factors: tumor size, histologic grade, TNM stage, negativity of ER, negativity of PR, HER2 overexpression and triple negativity. The recurrent group with non-triple negative cancer had a higher SUV max compared with the non-recurrent group, though no significant difference in FDG uptake was noted between the recurrence and non-recurrent groups in subjects with triple-negative cancer. Lymph node involvement was the independent risk factor for cancer recurrence in the multivariate analysis. In conclusion, high FDG uptake in primary breast tumors is significantly correlated with clinicopathological factors, such as tumor size, histologic grade, TNM stage, negativity of the hormonal receptor, HER2 overexpression and triple negativity. Therefore, FDG PET/CT is a helpful prognostic tool to direct the further management of patients with breast cancer

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

Unexpected visitor on FDG PET/CT--brown adipose tissue (BAT) in mesentery in a case of retroperitoneal extra-adrenal pheochromocytoma: is the BAT activation secondary to catecholamine-secreting pheochromocytoma?

Science.gov (United States)

Joshi, Prathamesh Vijay; Lele, Vikram Ramchandra

2012-05-01

Fused positron emission tomography-computed tomography (PET/CT) technology has enabled the determination that nonmalignant fluorodeoxyglucose (FDG) uptake is observed in brown adipose tissue (BAT). FDG uptake in BAT is a known potential source of false-positive interpretations for PET. The typical locations of BAT include neck, supraclavicular area, mediastinum, and paravertebral intercostal spaces. Examples of atypical locations for BAT include posterior neck, left paratracheal area, axillae, perirenal area, and retrocrural area. We report PET/CT findings in a young male patient with malignant retroperitoneal extra-adrenal pheochromocytoma, who demonstrated FDG uptake in BAT at multiple locations including mesenteric BAT. We also propose catecholamine-secreting pheochromocytoma as a possible cause of BAT activation in our case.

(18)F-FDG uptake predicts diagnostic yield of transbronchial biopsy in peripheral lung cancer.

Science.gov (United States)

Umeda, Yukihiro; Demura, Yoshiki; Anzai, Masaki; Matsuoka, Hiroki; Araya, Tomoyuki; Nishitsuji, Masaru; Nishi, Koichi; Tsuchida, Tatsuro; Sumida, Yasuyuki; Morikawa, Miwa; Ameshima, Shingo; Ishizaki, Takeshi; Kasahara, Kazuo; Ishizuka, Tamotsu

2014-07-01

Recent advances in endobronchial ultrasonography with a guide sheath (EBUS-GS) have enabled better visualization of distal airways, while virtual bronchoscopic navigation (VBN) has been shown useful as a guide to navigate the bronchoscope. However, indications for utilizing VBN and EBUS-GS are not always clear. To clarify indications for a bronchoscopic examination using VBN and EBUS-GS, we evaluated factors that predict the diagnostic yield of a transbronchial biopsy (TBB) procedure for peripheral lung cancer (PLC) lesions. We retrospectively reviewed the charts of 194 patients with 201 PLC lesions (≤3cm mean diameter), and analyzed the association of diagnostic yield of TBB with [(18)F]-fluoro-2-deoxy-d-glucose ((18)F-FDG) positron emission tomography and chest computed tomography (CT) findings. The diagnostic yield of TBB using VBN and EBUS-GS was 66.7%. High maximum standardized uptake value (SUVmax), positive bronchus sign, and ground-glass opacity component shown on CT were all significant predictors of diagnostic yield, while multivariate analysis showed only high (18)F-FDG uptake (SUVmax ≥2.8) and positive bronchus sign as significant predictors. Diagnostic yield was higher for PLC lesions with high (18)F-FDG uptake (SUVmax ≥2.8) and positive bronchus sign (84.6%) than for those with SUVmax PLC lesions. (18)F-FDG uptake and bronchus sign may indicate for the accurate application of bronchoscopy with those modalities for diagnosing PLC. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

Science.gov (United States)

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

2017-10-01

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

FDG uptake and glut-1 expression in primary tumors and loco-regional lymph nodes in non-small-cell lung cancer

International Nuclear Information System (INIS)

Lee, Won Woo; Nguyen, Xuan Canh; Chung, Jin Haeng; Park, So Yeon; Kim, Sang Eun

2007-01-01

FDG uptake level by primary tumors in NSCLC may affect the likelihood of malignant involvement in loco-regional lymph nodes (LNs). FDG uptake in tumors has been reported to be mediated by glucose transporter type 1 (Glut-I). Here, we investigated the correlations between primary tumors and loco-regional LNs in NSCLC regarding FDG uptake and Glut-1 expression. 126 NSCLC patients (M: F=103: 23, age=659.7y) who underwent curative resection and loco-regional LN dissection within 4 week period after FDG-PET study were enrolled. Maximum standardized uptake value (maxSUV) by PET and %Glut-1 expression by immunostaining were compared between primary tumors and FDG uptake positive loco-regional LNs. Significant correlations were found between 52 malignant LNs and 37 primary tumors in terms of maxSUV (r=0.6451, p<0.0001) and %Glut-1 expression (r=0.8341, p<0.0001). Linear regression of the relation between maxSUVs of malignant LNs (Y) and maxSUVs of primary tumors (X) yielded the expression Y = 0.5938 + 0.4808 X with an r2 value of 0.4162. On the other hand, no significant correlation was observed between 144 benign LNs and 75 primary tumors in terms of maxSUVs (r= -0.0125, p 0.8831). Moreover, %Glut-1 expressions of pathologically proven benign LNs and primary tumors were found to be correlated (r=0.3863, p=0.0004), but r2 value was low at 0.1492. High correlations were found between primary tumors and loco-regional metastatic LNs in NSCLC regarding FDG uptake and Glut-1 expression. Mediastinal LN staging of NSCLC by FDG-PET may be improved by considering the linear correlation between FDG uptakes of metastatic LNs and primary tumors

Standardized uptake value of FDG corrected by lean body mass measured by DEXA

International Nuclear Information System (INIS)

Guirao, M.A.; Sanchez, A.M.; Saravi, F.D.; Mosconi, S.; Frias, L.

2002-01-01

Evaluating the metabolic activity of tumor lesion sometimes becomes important to evaluate grading of malignancy, prognosis, or response to therapy. The most used measure of the metabolic activity of [18F]-Fluorodeoxiglucose (FDG) in clinical PET is the Standardized Uptake Value (SUV). It relates the activity measured by the PET scan to the injected dose of FDG divided by the body mass. This approach overestimates SUV in 'heavy' patients, as the proportion of the 'low avid of FDG' fat mass increases. For this reason, different approaches are being evaluated to obtain a more accurate SUV measure. Aims: to compare the measured lean body mass by Dual X-Ray Absorptiometry with the previous methods of correction, to assess the more independent to the body constitution. Material and Methods: FDG metabolism was studied to 15 patients of both sexes, age between 28 and 72 y.o., body weight 55 to 92 Kg. One hour after the IV injection of 0.0045mCi/Kg of FDG, a whole body emission and transmission scan was performed to each subject in a positron emission tomograph (QUEST 250, GE-UGM, USA) for over 1 hour. Body lean mass composition was measured the same or next day by DEXA (Lunar DPX-L, USA.) ROIs were drawn on brain, liver and muscle. SUVbw =[(corrected mCi/g of tissue) / (mCi injected / body weight in grams)] was calculated for each tissue, and then recalculated replacing body weight with the measured lean body mass (SUVlm), calculated lean mass (SUVlc), body mass index (SUVmi) and body surface area (SUVsa). Corrected SUVs were normalized to each SUVbw average for a comparable visualization of results. Results: obtained data was analyzed by linear regression and curve estimation for each case in all tissues with the SPSS statistical software. A positive correlation between SUVbw and subject weight was confirmed for the 3 tissues. In Muscle and liver there was no significant correlation. The liver scanning time was variable ( 90 to 123 minutes after injection). Relating liver

[18F]-2-FDG as a tool for studying hexokinase kinetics

International Nuclear Information System (INIS)

Mertens, J.; Gysemans, M.

1990-01-01

In the basic research related to the development of radiolabelled glucose analogues or to sugar metabolism, the measurement of hexokinase kinetics is very important. The article of S. J. Gatley et al about the quality control of [ 18 F]-2-FDG preparations using the hexokinase reaction in vitro was the basic idea of the method proposed in this paper dealing with the direct measurement of hexokinase kinetics by the measurement of the activity related to [ 18 F]-2-FDG-6-phosphate. Experimental results indicate that the method is appropriate for hexokinase studies

Relationship Between the Elevated Muscle FDG Uptake in the Distal Upper Extremities on PET/CT Scan and Prescan Utilization of Mobile Devices in Young Patients.

Science.gov (United States)

Bai, Xia; Wang, Xuemei; Zhuang, Hongming

2018-03-01

It is common to notice increased FDG activity in the muscles of the forearms or hands on PET/CT images. The purpose of this study was to determine relationship between the prevalence of increased FDG activity in the forearms or hands and using mobile devices prior to the FDG PET/CT study. A total of 443 young patients with ages between 5 and 19 years who underwent FDG PET/CT scan were included in this retrospective analysis. All patients had FDG PET/CT with their arms within the field of views. The images were reviewed for elevated activity in the muscles of the distal upper extremities (DUEs), which include forearms and hands. The preimaging questionnaire/interview records regarding using mobile devices prior to FDG PET/CT were also reviewed and compared with the imaging findings. Most patients (72.0% [319/443]) used mobile devices more than 60 minutes in the period of 24 hours prior to the FDG PET/CT study. Elevated uptake in the muscles in the DUEs was observed in 38.6% (123/319) of these patients. In contrast, among 124 patients who did not use the mobile devices or used the mobile device minimally prior to the study, only 6.5% (8/124) of them had elevated FDG activity in the DUEs. The difference persisted following stratification analysis for sex, age, and serum glucose level in our patient population. Increased FDG uptake in the muscles of the DUEs in young patients is commonly seen in those who used mobile devices prior to PET/CT study. Recommendation should be considered to reduce using mobile devices prior to FDG PET/CT study in young patient population.

18F-FDG PET/CT imaging of 100 normal adrenal gland cases

International Nuclear Information System (INIS)

Yu Zhiguo; Qu Wanying; Yao Zhiming; Zheng Jianguo; Song Renhe; Liu Xiuqin

2008-01-01

Objective: The purpose of this study was to obtain the 18 F-fluorodeoxyglucose (FDG) uptake characteristics in normal adrenal gland as the criteria to diagnose abnormal glucose metabolism in ad- renal gland by 18 F-FDG PET or PET/CT imaging. Methods: One hundred healthy persons underwent 18 F- FDG PET/CT imaging in this study. The images were reviewed by visual judgement and measured by stand-ardized uptake value (SUV). With reference to normal liver, the uptake of adrenal gland was scored from 0 to 3, namely, 0=no uptake, 1=less than the uptake of normal liver, 2=equal to the uptake of normal liver, 3=more than the uptake of normal liver. SUV was measured on the trans-axial images. The regions of interest (ROIs) of adrenal glands and livers were manually drawn based on the CT images. Both average SUV (SUV avg ) and maximum SUV(SUV max ) were calculated. Results: (1) By visual judgment, 94% and 91% of left and right normal adrenal glands had uptake intensity less than that of livers. (2) The SUV avg of left and right adrenal glands were 1.39 and 1.65, and the SUV max 1.98 and 2.19, respectively with the up- per limit of 95% confidence interval (Cf). (3)The ratios of left and right adrenal glands SUV avg to livers SUV avg were 0.65 and 0.75 and left and right adrenal glands SUV max to livers SUV max were 0.76 and 0.83 respectively with the upper limit of 95% CI. (4)The uptake of right adrenal gland was higher than that of the left. (5)There was no significant difference of the SUVs between men and women, except that right ad- renal gland SUV max of men was higher than that of women. (6) There was no significant difference in 18 F- FDG uptake between persons younger and elder than 60 years old. Conclusion: The physiological FDG uptake of the adrenal gland in normal healthy individuals is generally lower than that of liver. (authors)

Oncological applications of 18F-FDG PET imaging

International Nuclear Information System (INIS)

Li Lin

2000-01-01

Considering normal distribution of 18 F-FDG in human body, 18 F-FDG imaging using PET can be applied to brain tumors, colorectal cancer, lymphoma, melanoma, lung cancer and head and neck cancer. The author briefly focuses on application of 18 F-FDG PET imaging to breast cancer, pancreatic cancer, hepatocellular carcinoma, musculoskeletal neoplasms, endocrine neoplasms, genitourinary neoplasms, esophageal and gastric carcinomas

Can FDG-PET assist in radiotherapy target volume definition of metastatic lymph nodes in head-and-neck cancer?

International Nuclear Information System (INIS)

Schinagl, Dominic A.X.; Hoffmann, Aswin L.; Vogel, Wouter V.; Dalen, Jorn A. van; Verstappen, Suzan M.M.; Oyen, Wim J.G.; Kaanders, Johannes H.A.M.

2009-01-01

Background and purpose: The role of FDG-PET in radiotherapy target volume definition of the neck was evaluated by comparing eight methods of FDG-PET segmentation to the current CT-based practice of lymph node assessment in head-and-neck cancer patients. Materials and methods: Seventy-eight head-and-neck cancer patients underwent coregistered CT- and FDG-PET scans. Lymph nodes were classified as 'enlarged' if the shortest axial diameter on CT was ≥10 mm, and as 'marginally enlarged' if it was 7-10 mm. Subsequently, lymph nodes were assessed on FDG-PET applying eight segmentation methods: visual interpretation (PET VIS ), applying fixed thresholds at a standardized uptake value (SUV) of 2.5 and at 40% and 50% of the maximum signal intensity of the primary tumor (PET SUV , PET 40% , PET 50% ) and applying a variable threshold based on the signal-to-background ratio (PET SBR ). Finally, PET 40%N , PET 50%N and PET SBRN were acquired using the signal of the lymph node as the threshold reference. Results: Of 108 nodes classified as 'enlarged' on CT, 75% were also identified by PET VIS , 59% by PET 40% , 43% by PET 50% and 43% by PET SBR . Of 100 nodes classified as 'marginally enlarged', only a minority were visualized by FDG-PET. The respective numbers were 26%, 10%, 7% and 8% for PET VIS , PET 40% , PET 50% and PET SBR . PET 40%N , PET 50%N and PET SBRN , respectively, identified 66%, 82% and 96% of the PET VIS -positive nodes. Conclusions: Many lymph nodes that are enlarged and considered metastatic by standard CT-based criteria appear to be negative on FDG-PET scan. Alternately, a small proportion of marginally enlarged nodes are positive on FDG-PET scan. However, the results are largely dependent on the PET segmentation tool used, and until proper validation FDG-PET is not recommended for target volume definition of metastatic lymph nodes in routine practice.

Correction for FDG PET dose extravasations: Monte Carlo validation and quantitative evaluation of patient studies

Energy Technology Data Exchange (ETDEWEB)

Silva-Rodríguez, Jesús, E-mail: jesus.silva.rodriguez@sergas.es; Aguiar, Pablo, E-mail: pablo.aguiar.fernandez@sergas.es [Fundación Ramón Domínguez, Santiago de Compostela, Galicia (Spain); Servicio de Medicina Nuclear, Complexo Hospitalario Universidade de Santiago de Compostela (USC), 15782, Galicia (Spain); Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias (IDIS), Santiago de Compostela, 15706, Galicia (Spain); Sánchez, Manuel; Mosquera, Javier; Luna-Vega, Víctor [Servicio de Radiofísica y Protección Radiológica, Complexo Hospitalario Universidade de Santiago de Compostela (USC), 15782, Galicia (Spain); Cortés, Julia; Garrido, Miguel [Servicio de Medicina Nuclear, Complexo Hospitalario Universitario de Santiago de Compostela, 15706, Galicia, Spain and Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias (IDIS), Santiago de Compostela, 15706, Galicia (Spain); Pombar, Miguel [Servicio de Radiofísica y Protección Radiológica, Complexo Hospitalario Universitario de Santiago de Compostela, 15706, Galicia (Spain); Ruibal, Álvaro [Servicio de Medicina Nuclear, Complexo Hospitalario Universidade de Santiago de Compostela (USC), 15782, Galicia (Spain); Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias (IDIS), Santiago de Compostela, 15706, Galicia (Spain); Fundación Tejerina, 28003, Madrid (Spain)

2014-05-15

Purpose: Current procedure guidelines for whole body [18F]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) state that studies with visible dose extravasations should be rejected for quantification protocols. Our work is focused on the development and validation of methods for estimating extravasated doses in order to correct standard uptake value (SUV) values for this effect in clinical routine. Methods: One thousand three hundred sixty-seven consecutive whole body FDG-PET studies were visually inspected looking for extravasation cases. Two methods for estimating the extravasated dose were proposed and validated in different scenarios using Monte Carlo simulations. All visible extravasations were retrospectively evaluated using a manual ROI based method. In addition, the 50 patients with higher extravasated doses were also evaluated using a threshold-based method. Results: Simulation studies showed that the proposed methods for estimating extravasated doses allow us to compensate the impact of extravasations on SUV values with an error below 5%. The quantitative evaluation of patient studies revealed that paravenous injection is a relatively frequent effect (18%) with a small fraction of patients presenting considerable extravasations ranging from 1% to a maximum of 22% of the injected dose. A criterion based on the extravasated volume and maximum concentration was established in order to identify this fraction of patients that might be corrected for paravenous injection effect. Conclusions: The authors propose the use of a manual ROI based method for estimating the effectively administered FDG dose and then correct SUV quantification in those patients fulfilling the proposed criterion.

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

International Nuclear Information System (INIS)

Ueda, Shigeto; Tsuda, Hitoshi; Asakawa, Hideki

2008-01-01

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

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.

System immune response to vaccination on FDG-PET/CT

Energy Technology Data Exchange (ETDEWEB)

Mingos, Mark; Howard, Stephanie; Giaclone, Micholas; Kozono, David; Jacene, Heather [Brigham and Women' s Hospital, Boston (United States)

2016-12-15

A patient with newly diagnosed right lung cancer had transient 18F-fluorodeoxyglucose (FDG)-avid left axillary lymph nodes and intense splenic FDG uptake on positron emission tomography (PET)/computed tomography (CT). History revealed that the patient received a left-sided influenza vaccine 2-3 days before the examination. Although inflammatory FDG uptake in ipsilateral axillary nodes is reported, to our knowledge, this is the first report of visualization of the systemic immune response in the spleen related to the influenza vaccination on FDG-PET/CT. The history, splenic uptake and time course on serial FDG-PET/CT helped to avoid a false-positive interpretation for progressing lung cancer and alteration of the radiation therapy plan.

System immune response to vaccination on FDG-PET/CT

International Nuclear Information System (INIS)

Mingos, Mark; Howard, Stephanie; Giaclone, Micholas; Kozono, David; Jacene, Heather

2016-01-01

A patient with newly diagnosed right lung cancer had transient 18F-fluorodeoxyglucose (FDG)-avid left axillary lymph nodes and intense splenic FDG uptake on positron emission tomography (PET)/computed tomography (CT). History revealed that the patient received a left-sided influenza vaccine 2-3 days before the examination. Although inflammatory FDG uptake in ipsilateral axillary nodes is reported, to our knowledge, this is the first report of visualization of the systemic immune response in the spleen related to the influenza vaccination on FDG-PET/CT. The history, splenic uptake and time course on serial FDG-PET/CT helped to avoid a false-positive interpretation for progressing lung cancer and alteration of the radiation therapy plan

Stability and the improved methods of "1"8F-FDG

International Nuclear Information System (INIS)

Zhang Jinming; Li Yungang; Liu Jian; Zhang Xiaojun; Tian Jiahe

2011-01-01

To study the stability of "1"8F-FDG with routinely synthesis at high radio-dose and high radioconcentration, "1"8F-FDG was added 0.1% ethanol or repurification by solid-phase extract ion for radiolytic "1"8F-FDG to improve its radiochemical purity (RCP). The results showed that the RCP declined from 99% to 95% within 4 h at 6 TBq/L for room temperature (RT). The radiolysis could be depressed with 0.1% ethanol, the RCP could be over 95% even if the radioactivity concentration was 7.4 TBq/L at RT for 6 h. The repurification method could improve the RCP of "1"8F-FDG from 80% to 99%. Micro PET/ CT imagings of normal rats showed that the vertebra had high uptake with radiolytic "1"8F-FDG because of impurity. There were no radioactivity uptaking in bone with repuification of "1"8F- FDG. It indicated that 0.1% ethanol could be used as stabilizers for "1"8F-FDG to improve the RCP when "1"8F-FDG had high radio-do se and high radioconcentrtion. The radiolytic 18 F-FDG could be repurified by so lid-phase extraction to remove the radio-impurity. The method of added 0.1% thanot could be combined with repurification method to assure the RCP of "1"8F-FDG for over 95% at any given time andradiodose or contcentrayion. (authors)

Neurolymphomatosis detected by 18F-FDG PET/CT scan - a case report

International Nuclear Information System (INIS)

Czepczynski, R.; Guzikowska-Ruszkowska, I.; Sowinski, J.

2008-01-01

Lymphoma involvement of the peripheral nerves is a rare clinical presentation of non-Hodgkin lymphoma. We report the case of a 59-year-old woman with the defect of peripheral motor neuron admitted for PET/CT scan. The scan disclosed increased 18 F-FDG activity along the brachial and lumbar plexuses together with very intense 18 F-FDG uptake in the cervical lymph node masses. The diagnosis, based on the subsequent histopathologic lymph node examination, was diffuse large B-cell lymphoma. (authors)

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.

Development of a Primary Standard for Calibration of [{sup 18}F]FDG Activity Measurement Systems

Energy Technology Data Exchange (ETDEWEB)

Capogni, M [ENEA Istituto Nazionale di Metrologia delle Radiazioni Ionizzanti (INMRI), Centro Ricerche Casaccia, I-00060 Rome (Italy); Felice, P De [ENEA Istituto Nazionale di Metrologia delle Radiazioni Ionizzanti (INMRI), Centro Ricerche Casaccia, I-00060 Rome (Italy); Fazio, A [ENEA Istituto Nazionale di Metrologia delle Radiazioni Ionizzanti (INMRI), Centro Ricerche Casaccia, I-00060 Rome (Italy); Simonelli, F [Institute for Health and Consumer Protection, Joint Research Centre (JRC), European Commission, I-21020 Ispra (Vatican City State, Holy See,), Italy; D' Ursi, V [Amersham Health Srl (AH), I-13040 Saluggia (Saint Vincent and the Grenadines), Italy; Pecorale, A [Amersham Health Srl (AH), I-13040 Saluggia (Saint Vincent and the Grenadines), Italy; Giliberti, C [Istituto Superiore per la Prevenzione e la Sicurezza del Lavoro (ISPESL), I-00184 Rome (Italy); Abbas, K [Institute for Health and Consumer Protection, Joint Research Centre (JRC), European Commission, I-21020 Ispra (Vatican City State, Holy See,), Italy

2006-05-15

The {sup 18}F national primary standard was developed by the INMRI-ENEA using the 4{pi}{beta} Liquid Scintillation Spectrometry Method with {sup 3}H-Standard Efficiency Tracing. Measurements were performed at JRCIspra under a scientific collaboration between the Institute for Health and Consumer Production, the Amersham Health and the National Institute for Occupational Safety and Prevention (ISPESL). The goal of the work was to calibrate, with minimum uncertainty, the INMRI-ENEA transfer standard portable well-type ionisation chamber as well as other JRC-Ispra and Amersham Health reference Ionising Chambers used for FDG activity measurement.

{sup 18}F-FDG PET/CT and contrast-enhanced CT findings of pulmonary cryptococcosis

Energy Technology Data Exchange (ETDEWEB)

Wang, Si-yun, E-mail: wang_shuxia@outlook.com [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Chen, Gang, E-mail: cgggh@outlook.com [Department of Thoracic Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Luo, Dong-lan, E-mail: 695532870@qq.com [Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Shao, Dan, E-mail: shaodan501@outlook.com [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Liu, En-tao, E-mail: GDGH2015@gmail.com [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Sun, Taotao, E-mail: sunmoodsdaisy@bjmu.edu.cn [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Wang, Shu-Xia, E-mail: wsyggh@outlook.com [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China)

2017-04-15

Purpose: Pulmonary cryptococcosis is an uncommon cause of pulmonary nodules in non-AIDS patients. This study reports the {sup 18}F-fluorodeoxyglucose-positron emission tomography ({sup 18}F-FDG PET/CT) and contrast-enhanced CT (CE-CT) findings of 42 patients with pulmonary cryptococcosis. Materials and methods: A retrospective review of the {sup 18}F-FDG PET/CT and CE-CT findings of 42 patients with histologically proven pulmonary cryptococcosis was conducted. All patients underwent PET/CT and CE-CT in the same session. The CT diagnosis was based on the location, morphological features, and enhancement of lesions. The PET/CT findings were recorded, and clinical data and surgical and histopathological findings were collected. Results: The results of the PET scans revealed that 37 (88%) of 42 patients showed higher FDG uptake, and 5 (12%) patients demonstrated lower FDG uptake than the mediastinal blood pool. The maximum standardized uptake value (SUV) of pulmonary cryptococcosis ranged from 1.4 to 13.0 (average: 5.7 ± 3.3, median 4.9). A single nodular pattern was the most prevalent pattern observed and was found in 29 (69%) patients. This pattern was followed by scattered nodular (n = 4, 10%), clustered nodular (n = 3, 7%), mass-like (n = 3, 7%), and bronchopneumonic (n = 3, 7%) patterns. The most frequent pattern of immunocompetent patients was the single nodular pattern (29 of 33, 88%). Immunocompromised patients most frequently pattern exhibited mass-like (3 of 9, 33%) and bronchopneumonic (3 of 9, 33%) patterns. Conclusion: Pulmonary cryptococcosis most commonly appears as single nodules in immunocompetent patients. Mass-like and bronchopneumonic patterns were common in immunocompromised patients. In 88% of patients, lung lesions showed high FDG uptake, thus mimicking a possible malignant condition.

Functional neuroimaging in epilepsy: FDG-PET and SPECT

International Nuclear Information System (INIS)

Lee, Sang Kun; Lee, Dong Soo

2003-01-01

Finding epileptogenic zone is the most important step for the successful epilepsy surgery. F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and single photon emission computed tomography (SPECT) can be used in the localization of epileptogenic foci. In medial temporal lobe epilepsy, the diagnostic sensitivity of FDG-PET and ictal SPECT is excellent. However, detection of hippocampal sclerosis by MRI is so certain that use of FDG-PET and ictal SPECT in medial temporal lobe epilepsy is limited for some occasions. In neocortical epilepsy, the sensitivities of FDG-PET or ictal SPECT are fair. However, FDG-PET and ictal SPECT can have a crucial role in the localization of epileptogenic foci for non-lesional neocortical epilepsy. Interpretation of FDG-PET has been recently advanced by voxel-based analysis and automatic volume of interest analysis based on a population template. Both analytical methods can aid the objective diagnosis of epileptogenic foci. lctal SPECT was analyzed using subtraction methods and voxel-based analysis. Rapidity of injection of tracers, ictal EEG findings during injection of tracer, and repeated ictal SPECT were important technical issues of ictal SPECT. SPECT can also be used in the evaluation of validity of Wada test

Functional neuroimaging in epilepsy: FDG-PET and SPECT

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Lee, Sang Kun; Lee, Dong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

2003-02-01

Finding epileptogenic zone is the most important step for the successful epilepsy surgery. F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and single photon emission computed tomography (SPECT) can be used in the localization of epileptogenic foci. In medial temporal lobe epilepsy, the diagnostic sensitivity of FDG-PET and ictal SPECT is excellent. However, detection of hippocampal sclerosis by MRI is so certain that use of FDG-PET and ictal SPECT in medial temporal lobe epilepsy is limited for some occasions. In neocortical epilepsy, the sensitivities of FDG-PET or ictal SPECT are fair. However, FDG-PET and ictal SPECT can have a crucial role in the localization of epileptogenic foci for non-lesional neocortical epilepsy. Interpretation of FDG-PET has been recently advanced by voxel-based analysis and automatic volume of interest analysis based on a population template. Both analytical methods can aid the objective diagnosis of epileptogenic foci. lctal SPECT was analyzed using subtraction methods and voxel-based analysis. Rapidity of injection of tracers, ictal EEG findings during injection of tracer, and repeated ictal SPECT were important technical issues of ictal SPECT. SPECT can also be used in the evaluation of validity of Wada test.

A meta-analysis of 18FDG-PET–CT, 18FDG-PET, MRI and bone scintigraphy for diagnosis of bone metastases in patients with lung cancer

International Nuclear Information System (INIS)

Qu Xinhua; Huang Xiaolu; Yan Weili; Wu Lianming; Dai Kerong

2012-01-01

Background and purpose: Lung cancer is the most common cause of cancer related death among both men and women worldwide. The skeleton is the most common site of cancer metastasis. Early detection is crucial for prognosis. To evaluate and compare the capability for bone metastasis assessment of [ 18 F] fluoro-2-D-glucose positron emission tomography with computed tomography ( 18 FDG-PET–CT), [ 18 F] fluoro-2-D-glucose positron emission tomography ( 18 FDG-PET), magnetic resonance imaging (MRI) and bone scintigraphy (BS) in lung cancer patients, a meta-analysis is preformed. Methods: We searched MEDLINE, OVID, EMBASE and the Cochrane Library for studies evaluating diagnosis validity of 18 FDG-PET–CT, 18 FDG-PET, MRI and BS between January 1990 and August 2010. Meta-analysis methods were used to pool sensitivity, specificity, diagnostic odd ratios (DORs) and to construct a summary receiver-operating characteristic curve (SROC). Results: A total of 17 articles (9 18 FDG-PET–CT studies, 9 18 FDG-PET studies, 6 MRI studies and 16 BS studies) that included 2940 patients who fulfilled all of the inclusion criteria were considered for inclusion in the analysis. The pooled sensitivity for the detection of bone metastasis in lung cancer using 18 FDG-PET–CT, 18 FDG-PET, MRI and BS were 0.92 (95% CI, 0.88–0.95), 0.87 (95% CI, 0.81–0.92), 0.77 (95% CI, 0.65–0.87) and 0.86 (95% CI, 0.82–0.89), respectively. The pooled specificity for the detection of bone metastasis from lung cancer using 18 FDG-PET–CT, 18 FDG-PET, MRI and BS were 0.98 (95% CI, 0.97–0.98), 0.94 (95% CI, 0.92–0.96), 0.92 (95% CI, 0.88–0.95), 0.88 (95% CI, 0.86–0.89), respectively. The pooled DORs estimates for 18 FDG-PET–CT 449.17 were significantly higher than for 18 FDG-PET (118.25, P 18 FDG-PET–CT and 18 FDG-PET were better imaging methods for diagnosing bone metastasis from lung cancer than MRI and BS. 18 FDG-PET–CT has higher diagnostic value (sensitivity, specificity and DORs

Low carbohydrate diet before 18F-FDG tumor imaging contributes to reduce myocardial 18F-FDG uptake

International Nuclear Information System (INIS)

Miao Weibing; Chen Shaoming; Zheng Shan; Wu Jing; Peng Jiequan; Jiang Zhihong

2014-01-01

Objective: To evaluate whether low carbohydrate diet before 18 F-FDG tumor imaging could reduce myocardial 18 F-FDG uptake. Methods: From April 2011 to January 2012, 70 patients were enrolled in this study.They were randomly divided into control group (34 cases) and test group (36 cases). Patients in control group were on regular diet, while those in test group had low carbohydrate diet in the evening before imaging. Blood samples were taken before injection of 18 F-FDG for the measurement of serum glucose, free fatty acid,insulin and ketone body. Whole body 18 F-FDG tomography was performed with dual-head coincidence SPECT. The myocardial uptake of FDG was assessed visually and scored as 0 for no uptake, 1 for uptake lower than liver, 2 for uptake similar to liver, 3 for uptake higher than liver, and 4 for remarkable uptake.The ratio of myocardium to liver (H/L) was calculated. Two-sample t test, Wilcoxon rank sum test and linear correlation analysis were performed. Results: The myocardial uptake in test group was significantly lower than that in control group with H/L ratios of 0.94±0.57 and 1.50±1.04, respectively (t=-2.75, P<0.05). The concentrations of serum free fatty acid and ketone body in test group were significantly higher than those in control group: (0.671±0.229) mmol/L vs (0.547±0.207) mmol/L and (0.88±0.60) mmol/L vs (0.57±0.32) mmol/L, t=2.38 and 2.67, both P<0.05. The concentrations of glucose and insulin were (5.28±1.06) mmol/L and (35.16±33.70) pmol/L in test group, which showed no significant difference with those in control group ((5.19±0.78) mmol/L and (41.64±35.13) pmol/L, t=0.39 and-0.79, both P>0.05). A negative correlation was found between the myocardial uptake of 18 F-FDG and serum free fatty acid/ketone body concentration (r=-0.40, -0.33, both P<0.01), respectively. There was no correlation between the myocardial uptake of 18 F-FDG and glucose/insulin (r=-0.02, 0.13, both P>0.05), respectively. Conclusion: Low carbohydrate

FDG-PET imaging in HIV-infected subjects: relation with therapy and immunovirological variables

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Lucignani, Giovanni; Orunesu, Eva [Neurological Institute Milan, Laboratory of Cellular Neurophysiology, IRCCS Foundation, Milan (Italy); Cesari, Miriam [Univ. of Milan (Italy). Dept. of Clinical Science; Marzo, Katia; Chiti, Arturo [IRCCS Humanitas, Milan (Italy). Dept. of Nuclear Medicine; Pacei, Michela [Milan Univ. (Italy). Lab. of Immunology; Bechi, Giulia [IRCCS Foundation, Milan (Italy). Lab. of Cellular Neurophysiology; Gori, Andrea [Univ. of Milan Biococca, Monza (Italy). Inst. of Infectious Disseases; Gaito, Sabrina [Milan Univ. (Italy). Dept. of Computer Science; Clerici, Mario [Milan Univ. (Italy). Dept. of Biomedical Sciences and Technologies

2009-04-15

To characterise tissue sites of immune activation and HIV replication we performed FDG-PET in ART-treated and ART-naive HIV-infected individuals. Specific aims were to establish whether HIV-infected patients can be differentiated on the basis of the detection of specific locations of viral replication, even in the presence of an apparently optimal immunovirological response to ART, and whether these FDG-PET findings can be related to immunovirological variables and AIDS history status. Patients were divided into five groups as follows: subgroup A1 (full responders, n=8): current ART treatment, CD4+ T lymphocytes >500/mL, viral load <50 copies/mL; subgroup A2 (full responders, n=5): same criteria as A-1, but with a previous history of AIDS; subgroup A3 (immunological non responders, n=5): current ART treatment, viral load <50 copies/mL, low CD4+ T lymphocytes (<200/mL); group B (virological non responders, n = 2): current ART treatment, CD4+ T lymphocytes around 500/mL, viral load >50,000 copies/mL; group C (ART-naive, n=5): no current or previous ART treatment, increased viral load. PET images revealed different patterns of FDG uptake. All ART-treated patients with either suppressed (<50 copies/mL; Group A) or high viremia (group B) showed a normal pattern of FDG uptake. On the contrary, the ART-naive subjects with high viraemia (group C) displayed multiple foci of increased glucose metabolism in the lymph nodes. In the ART-naive subjects, FDG uptake, apparently related to viraemia level, was observed in the upper torso mainly in the axillary nodes bilaterally in patients with viraemia below 100,000 copies/mL; in those with viraemia higher than 100,000 copies/mL, FDG uptake was also observed in the inguinal lymph nodes. The emergence, in our study, of a correlation between the percentage of CD8+/CD38+/RO+ T cells (well established markers of progression to AIDS independently of CD4+ T lymphocytes) and positive FDG-PET in ART-naive patients is a novel finding that

The influence of I-131 therapy on FDG uptake in differentiated thyroid cancer

International Nuclear Information System (INIS)

Hung Guanguei; Lee Kwowhei; Liao Peiyung; Yang Liheng; Yang Kwangtao

2008-01-01

18F-fluorodeoxyglucose positron emission tomography (FDG-PET) [or PET/computed tomography (CT)] is more likely to show false-negative results when it is performed shortly after chemotherapy and/or radiotherapy because of ''metabolic stunning''. The present study aimed to evaluate the influence of I-131 therapy on FDG uptake and the detection of recurrence or metastasis of differentiated thyroid cancer (DTC). We retrospectively enrolled 16 consecutive FDG-PET/CT studies which had been performed in patients with DTC with elevated thyroglobulin (TG) but negative I-131 whole-body scan. All studies were performed under L-thyroxine suppression. The patients were divided into groups A and B for PET/CT performed within 4 months of I-131 therapy or no such therapy, respectively. Each lesion identified on PET/CT was characterized using a 5-point scale by visual analysis: 0=definitely benign, 1=probably benign, 2=equivocal, 3=probably malignant, and 4=definitely malignant. The maximum standardized uptake value (SUV max ) in each lesion was also measured for semiquantitative analysis. We compared the visual grading and SUV max of the lesion of highest FDG uptake between groups A and B. For visual analysis, group B had significantly more patients with an uptake score of 3 or 4 than group A (80% vs. 17%, P=0.01). In addition, there were significantly more equivocal results from group A than from group B (67% vs. 10%, P=0.02). If the patients with the highest uptake scores of 2, 3, and 4 were considered to be positive for local recurrence or metastasis, there would be no significant difference between the positive rates of groups A and B (83% vs. 90%, P=0.7). However, the mean SUV max of positive results was significantly lower for group A than for group B (3.1±0.9 and 6.6±3.5 respectively, P=0.02). The preliminary results suggested that FDG uptake in DTC may be negatively influenced by I-131 therapy within 4 months, resulting in lower FDG uptake and more equivocal results

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

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

2002-05-01

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

Hepatic FDG Uptake is not associated with hepatic steatosis but with visceral fat volume in cancer screening

International Nuclear Information System (INIS)

Pak, Kyoung June; Kim, Seong Jang; Kim, In Joo; Kin, Keun Young; Kim, Hee Young; Kim, So Jung

2012-01-01

We aimed to evaluate the relation between visceral fat volume and fluorodeoxyglucose (FDG)uptake of the liver measured by maximum or mean standardized uptake value. We retrospectively analyzed 96 consecutive records of positron emission tomography/computed tomography (PET/CT)performed for cancer screening between May 2011 and December 2011. Subjects were divided into 2 groups according to Hounsfield unit (HU)of the liver comparing with that of the spleen. The control group (20 women, 56 men)demonstrating HU of the liver equal or greater than that of the spleen included 76 patients, while the fatty liver group (2 Women, 18 men)showing HU of the liver less than that of the spleen included 20 patients. We compared FDG uptake of the liver and visceral fat volume between two groups. We evaluated correlation of hepatic FDG uptake measured by maximum or mean standardized uptake value (SUV)with visceral fat volume and attenuation. The fatty liver disease group showed higher aspartate aminotransferase (AST)of (24.42±7.22, p=0.012), alanine aminotransferase (ALT)of (25.16±11.68, p=0.011), body mass index (BMI)of (24.58±3.29, p=0.021), and visceral fat volume (3063.53±1561.42, p=0.011)than the control group. There were no statistically significant differences of mean standardized uptake value of the liver (liver SUV mean )(2.73±0.19, p=0.723), maximum standardized uptake value of the liver (liver SUV max )(3.39±0.53, p=0.8248)and liver SUV mean /spleen SUV mean (1.13±0.10, p=0.081)between the two groups. Strong correlations were shown between liver SUV mean and BMI (r=0.609, p mean and visceral fat volume (r=0.457, p max was also strongly correlated with BMI (r=0.622, p=0.001)and visceral fat volume (r=0.547, p mean )with liver SUV mean (r=0.003, p=0.979)or liver SUV max (r=-0.120, p=0.244). Hepatic FDG uptake quantified as SUV mean of SUV max is not correlated with hepatic steatosis but with visceral fat volume in cancer screening

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

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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.

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

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

2010-03-15

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

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

International Nuclear Information System (INIS)

Zerizer, Imene; Tan, Kathryn; Khan, Sameer; Barwick, Tara; Marzola, Maria Cristina; Rubello, Domenico; Al-Nahhas, Adil

2010-01-01

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

Labelling of leucocytes with 18 F-FDG

International Nuclear Information System (INIS)

Tomas, M.B.; Tronco, G.G.; Palestro, C.J.

2003-01-01

Full text: Objective: To investigate the effect of blood glucose levels on in-vitro 18 F-FDG labeling of autologous leucocytes. Methods: Seventeen volunteers, 11 men and 6 women, 20 - 54 years old, participated in this study. Using standard techniques, a mixed leucocyte suspension was prepared from 40 ml of blood withdrawn from each volunteer. Blood glucose levels were also measured for each blood sample. After resuspension in 3 ml heparinized saline, the leucocytes were incubated with 11.03 (± 4.48) mCi 18 F-FDG for 30 minutes at 370 C. The labeled cell suspension was then centrifuged for 5 min (150 g). Activity in the cell pellet and supernatant were measured and labelling efficiency calculated. Results: Blood glucose levels ranged from 80 to 178 mg% with a mean of 113 mg%. The overall labelling efficiency was 61.2% (±7.3%). The mean labelling efficiency for blood glucose levels 100 mg%. There is no statistically significant difference between the labeling efficiencies obtained at blood glucose levels 100 mg% (p =0.72). Blood Glucose Level (mg%) Labelling Efficiency (%) 100 61. Conclusion: In summary, no correlation between blood glucose levels and labeling efficiency was observed. Blood glucose levels up to 178 mg% do not affect 18 F-FDG in-vitro labelling of autologous leucocytes. (author)

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

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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.)

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

Comparison of MET-PET and FDG-PET for differentiation between benign lesions and lung cancer in pneumoconiosis

International Nuclear Information System (INIS)

Kanegae, Kakuko; Kuge, Yuji; Shiga, Tohru; Zhao, Songji; Okamoto, Shouzo; Tamaki, Nagara; Nakano, Ikuo; Kimura, Kiyonobu; Kaji, Hiroshi

2007-01-01

The aim of this study was to evaluate and compare the ability of C-11-methionine (MET) and F-18 fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) to diagnose lung cancer in patients with pneumoconiosis. Twenty-six subjects underwent both wholebody MET-PET and FDG-PET on the same day. The first group was a lung cancer group, which consisted of 15 patients, and included those with pneumoconiosis with increased nodules (13 cases), hemoptysis (1 case), and positive sputum cytology (1 case). The second group was a no-malignancy control group, consisting of 11 patients with pneumoconiosis. Significant correlations between nodule size and the maximum standardized uptake value (SUV max ) of the two PET tracers were observed in the control group. The larger the nodule size, the greater were the amounts of these tracers accumulated (MET: r=0.771, P max of MET was significantly lower than that of FDG in the pneumoconiotic nodules (P max of MET was significantly higher in the lung cancer than in the pneumoconiotic nodules, with 3.48±1.18 (mean ± SE) for the lung cancer and 1.48±0.08 for the pneumoconiotic nodules (P max of FDG, with 7.12±2.36 and 2.85±0.24 (P<0.05), respectively. On the basis of the criteria for the control group, FDG and MET identified lung cancer with sensitivities of 60% and 80%, specificities of 100% and 93%, accuracies of 90% and 90%, positive predictive values of 100% and 80%, and negative predictive values of 88% and 93%, respectively. Our results indicate that nodules with an intense uptake of MET and FDG relative to their size should be carefully observed because of a high risk for lung cancer. (author)

18F-FDG positron autoradiography with a particle counting silicon pixel detector.

Science.gov (United States)

Russo, P; Lauria, A; Mettivier, G; Montesi, M C; Marotta, M; Aloj, L; Lastoria, S

2008-11-07

We report on tests of a room-temperature particle counting silicon pixel detector of the Medipix2 series as the detector unit of a positron autoradiography (AR) system, for samples labelled with (18)F-FDG radiopharmaceutical used in PET studies. The silicon detector (1.98 cm(2) sensitive area, 300 microm thick) has high intrinsic resolution (55 microm pitch) and works by counting all hits in a pixel above a certain energy threshold. The present work extends the detector characterization with (18)F-FDG of a previous paper. We analysed the system's linearity, dynamic range, sensitivity, background count rate, noise, and its imaging performance on biological samples. Tests have been performed in the laboratory with (18)F-FDG drops (37-37 000 Bq initial activity) and ex vivo in a rat injected with 88.8 MBq of (18)F-FDG. Particles interacting in the detector volume produced a hit in a cluster of pixels whose mean size was 4.3 pixels/event at 11 keV threshold and 2.2 pixels/event at 37 keV threshold. Results show a sensitivity for beta(+) of 0.377 cps Bq(-1), a dynamic range of at least five orders of magnitude and a lower detection limit of 0.0015 Bq mm(-2). Real-time (18)F-FDG positron AR images have been obtained in 500-1000 s exposure time of thin (10-20 microm) slices of a rat brain and compared with 20 h film autoradiography of adjacent slices. The analysis of the image contrast and signal-to-noise ratio in a rat brain slice indicated that Poisson noise-limited imaging can be approached in short (e.g. 100 s) exposures, with approximately 100 Bq slice activity, and that the silicon pixel detector produced a higher image quality than film-based AR.

Suture Granuloma Showing False-Positive Findings on FDG-PET

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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/CT in Skeletal Muscle: Pitfalls and Pathologies.

Science.gov (United States)

Parida, Girish Kumar; Roy, Shambo Guha; Kumar, Rakesh

2017-07-01

FDG-PET/CT is an integral part of modern-day practice of medicine. By detecting increased cellular metabolism, FDG-PET/CT can help us detect infection, inflammatory disorders, or tumors, and also help us in prognostication of patients. However, one of the most important challenges is to correctly differentiate the abnormal uptake that is potentially pathologic from the physiological uptake. So while interpreting a PET/CT, one must be aware of normal biodistribution and different physiological variants of FDG uptake. Skeletal muscles constitute a large part of our body mass and one of the major users of glucose. Naturally, they are often the site of increased FDG uptake in a PET study. We as a nuclear medicine physician must be aware of all the pitfalls of increased skeletal muscle uptake to differentiate between physiological and pathologic causes. In this review, we have discussed the different causes and patterns of physiological FDG uptake in skeletal muscles. This knowledge of normal physiological variants of FDG uptake in the skeletal muscles is essential for differentiating pathologic uptake from the physiological ones. Also, we reviewed the role of FDG-PET/CT in various benign and malignant diseases involving skeletal muscle. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Comparison between FDG Uptake and Clinicopathologic and Immunohistochemical Parameters in Pre-operative PET/CT Scan of Primary Gastric Carcinoma

International Nuclear Information System (INIS)

Han, Eun Ji; Choi, Woo Hee; Chung, Yong An; Kim, Ki Jun; Maeng, Lee So; Sohn, Kyung Myung; Jung, Hyun Suk; Sohn, Hyung Sun; Chung, Soo Kyo

2009-01-01

The purpose of this study was to find out what clinicopathologic or immunohistochemical parameter that may affect FDG uptake of primary tumor in PET/CT scan of the gastric carcinoma patient. Eighty-nine patients with stomach cancer who underwent pre-operative FDG PET/CT scans were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The clinicopathologic results such as depth of invasion (T stage), tumor size, lymph node metastasis, tumor differentiation and Lauren's classification and immunohistochemical markers such as Ki-67 index, expression of p53, EGFR, Cathepsin D, c-erb-B2 and COX-2 were reviewed. Nineteen out of 89 gastric carcinomas showed imperceptible FDG uptake on PET/CT images. In cases with perceptible FDG uptake in primary tumor, SUVmax was significantly higher in T2, T3 and T4 tumors than T1 tumors (5.8±3.1 vs. 3.7±2.1, p=0.002). SUVmax of large tumors (above or equal to 3 cm) was also significantly higher than SUVmax of small ones (less than 3 cm) (5.7±3.2 vs. 3.7±2.0, p=0.002). The intestinal types of gastric carcinomas according to Lauren showed higher FDG uptake compared to the non-intestinal types (5.4±2.8 vs. 3.7±1.3, p=0.003). SUVmax between p53 positive group and negative group was significantly different (6.0±2.8 vs. 4.4±3.0, p=0.035). No significant difference was found in presence of LN metastasis, tumor differentiation, Ki-67 index, and expression of EGFR, Cathepsin D, c-erb-B2 and COX-2. T stage of gastric carcinoma influenced the detectability of gastric cancer on FDG PET/CT scan. When gastric carcinoma was perceptible on PET/CT scan, T stage, size of primary tumor, Lauren's classification and p53 expression were related to degree of FDG uptake in primary tumor

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.

Molecular imaging using Cu-ATSM and FDG in solid canine tumors

DEFF Research Database (Denmark)

Hansen, Anders Elias

. Identification of hypoxic tumor and intratumoral hypoxic regions therefore hold the potential to serve as a basis for individualized treatment protocols, including image guided radiation therapy. The current PhD project was undertaken to study tumor hypoxia in cancer bearing dogs, with the aims of 1) identifying...... glycolysis and blood perfu- sion. 3) To compare tumor uptake of 64 Cu-ATSM and [ 18 F]fluoro-D-glucose ( 18 FDG) (glycolytic activity) to pimonidazole (immunological hypoxia marker) immunohistochemistry. 4) To investigate 18 FDG PET as a diagnostic modality in canine cancer patients. The thesis contains...

Characterization of solitary pulmonary nodules with 18F-FDG PET/CT relative activity distribution analysis

Energy Technology Data Exchange (ETDEWEB)

Zhao, Liang; Lin, Jie; Tang, Kun; Zheng, SiSi; Yin, WeiWei; Zheng, XiangWu [The First Affiliated Hospital of Wenzhou Medical University, Division of PET/CT, Department of Radiology, Wenzhou (China); Tong, Li [The First People' s Hospital of Hefei, CT Department, Hefei (China); Li, WenFeng [The First Affiliated Hospital of Wenzhou Medical University, Department of Radiotherapy and Chemotherapy, Wenzhou (China); Cheng, DeZhi [The First Affiliated Hospital of Wenzhou Medical University, Department of Cardiothoracic Surgery, Wenzhou (China)

2015-07-15

To compare the capability of relative activity distribution (RAD), a new index of fluorodeoxyglucose F18 ({sup 18}F-FDG) uptake, with those of the typical markers for differentiating benign and malignant solitary pulmonary nodules (SPNs) by integrated positron emission tomography (PET)/computed tomography (CT). RAD, maximal standardised uptake value (SUV{sub max}), partial volume corrected SUV{sub max} (corrSUV{sub max}), and retention index (RI) were calculated prospectively for 115 malignant and 60 benign SPNs. Area under receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy were compared (P < 0.05). Malignant lesions (0.98 ± 0.03) had significantly lower RAD than benign lesions (1.01 ± 0.02). AUC (0.935) was significantly larger and specificity (96.67 %) was significantly higher for RAD than for SUV{sub max} (P ≤ 0.0001), corrSUV{sub max} (P < 0.0001), RI (P < 0.0001), and visual assessment (P = 0.01 and 0.002, respectively). Further, RAD had significantly higher sensitivity (92.17 %) than SUV{sub max} (P = 0.0007) and higher accuracy (93.71 %) than SUV{sub max} (P < 0.0001), corrSUV{sub max} (P < 0.0001), and RI (P = 0.002). RAD seems to be more specific and accurate than the typical markers for differentiating malignant and benign SPNs by {sup 18}F-FDG PET/CT. (orig.)

Cortical activity during olfactory stimulation in multiple chemical sensitivity: a {sup 18}F-FDG PET/CT study

Energy Technology Data Exchange (ETDEWEB)

Chiaravalloti, Agostino; Di Pietro, Barbara [University Tor Vergata, Department of Biomedicine and Prevention, Rome (Italy); Pagani, Marco [Institute of Cognitive Sciences and Technologies, CNR, Rome (Italy); Department of Nuclear Medicine Karolinska Hospital Stockholm, Stockholm (Sweden); Micarelli, Alessandro; Alessandrini, Marco [University Tor Vergata, Department of Medical Science and Translational Medicine, Rome (Italy); Genovesi, Giuseppe [University La Sapienza, Department of Experimental Medicine, Rome (Italy); University La Sapienza, Regional Center for Diagnosis, Treatment and Prevention of MCS, Rome (Italy); Schillaci, Orazio [University Tor Vergata, Department of Biomedicine and Prevention, Rome (Italy); IRCCS Neuromed, Pozzilli (Italy)

2015-04-01

To investigate the differences in brain glucose consumption during olfactory stimulation between subjects affected by multiple chemical sensitivity (MCS) and a group of healthy individuals. Two {sup 18}F-FDG PET/CT scans were performed in 26 subjects (6 men and 20 women; mean age 46.7 ± 11 years) with a clinical diagnosis of MCS and in 11 healthy controls (6 women and 5 men; mean age 45.7 ± 11 years), the first scan after a neutral olfactory stimulation (NS) and the second after a pure olfactory stimulation (OS). Differences in {sup 18}F-FDG uptake were analysed by statistical parametric mapping (SPM2). In controls OS led to an increase in glucose consumption in BA 18 and 19 and a reduction in glucose metabolism in BA 10, 11, 32 and 47. In MCS subjects, OS led to an increase in glucose consumption in BA 20, 23, 18 and 37 and a reduction in glucose metabolism in BA 8, 9 and 10. The results of our study suggest that cortical activity in subjects with MCS differs from that in healthy individuals during olfactory stimulation. (orig.)

F-18 FDG PET finding in autonomous thyroid nodules

International Nuclear Information System (INIS)

Park, Chan H.; Lee, Myoung Hoon; Yoon, Seek Nam; Hwang, Kyung Hoon

2001-01-01

F-18 FDG PET has become an important diagnostic imaging modality of various malignancies including thyroid cancer. Focal hypermetabolic lesion in the thyroid gland is usually considered malignant (Fig.1), although some benign lesions are also hypermetabolic. The aim of our poster presentation is to demonstrate F-18- FDG PET finding in autonomous thyroid nodules (ATN) and to avoid confusion in the interpretation of F-18-FDG PET performed for the evaluation of thyroid malignancy. Two patients with ATN (one with toxic and the other with nontoxic) underwent F-18-PET. ATN was proven by Tc-99m pertechnate thyroid scan (TS) and thyroid function tests (TFTs) were performed. First patient with ATN was asymptomatic and had a long history of thyroid nodule. Second patient was suffering from acute myelogenous leukemia (AML) and he was mildly thyrotoxic clinically and chemically. Gamma camera based F-18 FDG PET was performed utilizing Elscints Varicam (Haifa, Israel) one hour after IV administration of 111 MBq (3mCi) F-18 FDG. Patients were fasting more than 6 hours prior ot FDG injection. First patients was scanned the neck and second patient had scan of the whole trunk including neck for the evaluation of AML. Both nontoxic and toxic ATNs were hypermetabolic and it was impossible to differentiate benign from malignancy. Biopsy of nodule of the first patient and surgical removal of the nodule in the second patient was benign. Benign nontoxic and toxic ATNs are F-18 FDG avid. The reason for this is that ATN has increased glycolysis and iodide metabolism. Therefore, focal increased FDG uptake within the thyroid gland should be interpreted with TS and TFTs for an accurate diagnosis when F-18 FDG PET is used in the evaluation of thyroid malignancy

Biological distribution of reactor produced 18F-FDG. Local experience

International Nuclear Information System (INIS)

Sierralta, M.P.; Massardo, T.; Gil, M.C.; Chandia, M.; Godoy, N.; Troncoso, F.; Jofre, M.J.

2002-01-01

Introduction: Quality control through an animal model that relates bio distribution of a substance is fundamental prior to using it in human beings. For the evaluation of myocardial viability after recent myocardial infarction, the use of reactor produced 18F-FDG (a radiotracer usually obtained in cyclotron) is proposed, production of wish had never been attempted in our country. The aim of the study was to compare the specific activities found in the different tissues after the injection of this reactor produced radiopharmaceutical with those obtained by others authors with cyclotron 18F-FDG. Material WISTAR female white mice, men weight 25,28 +/- 1,09 g (23,8-26,9 range) in standard support conditions was used. 1,22 MBq (33 mCi) of 18F-FDG were injected in a lateral tail vein. Previously anaesthetised with Chloroform, the animals were sacrificed by jugular section at 5, 30 and 60 minutes intervals post injection. Blood and organs were removed (liver, lungs, heart, brain, urine plus bladder, kidneys, femur, muscle and quivers), placed in vials, then weighed, and finally taken to a Gamma Packard Minaxi γ Auto-gamma 5000 serie counter to obtain the counts per minute (cpm) (previously the empty vials were weighed too). At same time, STANDARDS (STD) (3 dilutions) cpm and BACKGROUND (BKG) cpm were collected. We calculate 1) mean BKG cpm, 2) mean STD cpm, who then were corrected by decay factor and dilution, and 3) each one of the tissues cpm, that then were corrected by decay factor, divided by the corresponding dilution cpm and multiplied by 100 to obtain the Injected Activity % (IA%). Finally, the IA% was divided by the tissue weight and get the Specific Activity (SA). Mean and standard deviation for each tissue at the 3 intervals were calculated. Results: The uptake distribution at 30 and 60 minutes were similar between reactor and cyclotron produced 18F-FDG, with significant bigger SA in heart and brain respect of the rest organs. There were significant

Biological distribution of reactor produced 18F-FDG. Local experience

Energy Technology Data Exchange (ETDEWEB)

Sierralta, M P [University of Chile Clinical Hospital Nuclear Medicine Centre, Santiago (Chile); Military Hospital Nuclear Medicine Department, Santiago (Chile); Massardo, T [University of Chile Clinical Hospital Nuclear Medicine Centre, Santiago (Chile); Gil, M C [CGM Nuclear, Santiago (Chile); Chandia, M; Godoy, N; Troncoso, F [CCHEN, CEN La Reina, Santiago (Chile); Jofre, M J [Military Hospital Nuclear Medicine Department, Santiago (Chile)

2002-09-01

Introduction: Quality control through an animal model that relates bio distribution of a substance is fundamental prior to using it in human beings. For the evaluation of myocardial viability after recent myocardial infarction, the use of reactor produced 18F-FDG (a radiotracer usually obtained in cyclotron) is proposed, production of wish had never been attempted in our country. The aim of the study was to compare the specific activities found in the different tissues after the injection of this reactor produced radiopharmaceutical with those obtained by others authors with cyclotron 18F-FDG. Material WISTAR female white mice, men weight 25,28 +/- 1,09 g (23,8-26,9 range) in standard support conditions was used. 1,22 MBq (33 mCi) of 18F-FDG were injected in a lateral tail vein. Previously anaesthetised with Chloroform, the animals were sacrificed by jugular section at 5, 30 and 60 minutes intervals post injection. Blood and organs were removed (liver, lungs, heart, brain, urine plus bladder, kidneys, femur, muscle and quivers), placed in vials, then weighed, and finally taken to a Gamma Packard Minaxi {gamma} Auto-gamma 5000 serie counter to obtain the counts per minute (cpm) (previously the empty vials were weighed too). At same time, STANDARDS (STD) (3 dilutions) cpm and BACKGROUND (BKG) cpm were collected. We calculate 1) mean BKG cpm, 2) mean STD cpm, who then were corrected by decay factor and dilution, and 3) each one of the tissues cpm, that then were corrected by decay factor, divided by the corresponding dilution cpm and multiplied by 100 to obtain the Injected Activity % (IA%). Finally, the IA% was divided by the tissue weight and get the Specific Activity (SA). Mean and standard deviation for each tissue at the 3 intervals were calculated. Results: The uptake distribution at 30 and 60 minutes were similar between reactor and cyclotron produced 18F-FDG, with significant bigger SA in heart and brain respect of the rest organs. There were significant

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.

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.)

Potential role of combined FDG PET/CT & contrast enhancement MRI in a rectal carcinoma model with nodal metastases characterized by a poor FDG-avidity.

Science.gov (United States)

Farace, Paolo; Conti, Giamaica; Merigo, Flavia; Tambalo, Stefano; Marzola, Pasquina; Sbarbati, Andrea; Quarta, Carmelo; D'Ambrosio, Daniela; Chondrogiannis, Sotirios; Nanni, Cristina; Rubello, Domenico

2012-04-01

To investigate the additional role of MRI contrast enhancement (CE) in the primary tumor and the FDG uptake at PET in the lymph-node metastases. A model of colorectal cancer induced by orthotopic HT-29 cells microinjection, producing pelvic lymph node metastases, was assessed using CE-MRI and FDG-PET. Histology and GLUT-1 immunohistochemistry were performed on primary tumors and iliac lymph nodes. Primary tumors were characterized by low FDG-uptake but high CE-MRI, particularly at tumor periphery. Undetectable FDG-uptake characterized the metastatic lymph-nodes. Histology revealed large stromal bundles at tumor periphery and a dense network of stromal fibers and neoplastic cells in the inner portion of the tumors. Both primary tumors and positive lymph nodes showed poor GLUT-1 staining. Our data support the complementary role of MRI-CE and FDG PET in some types of carcinomas characterized by abundant cancer-associated stroma and poor FDG avidity consequent to poor GLUT-1 transported. In these tumors FDG-PET alone may be not completely adequate to obtain an adequate tumor radiotherapy planning, and a combination with dual CE-MRI is strongly recommended. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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.)

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

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.)

{sup 18}F-FDG uptake in breast cancer correlates with immunohistochemically defined subtypes

Energy Technology Data Exchange (ETDEWEB)

Koo, Hye Ryoung [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Hanyang University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Park, Jeong Seon [Hanyang University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Kang, Keon Wook [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Cho, Nariya; Chang, Jung Min; Bae, Min Sun; Kim, Won Hwa; Lee, Su Hyun; Seo, Mirinae; Moon, Woo Kyung [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Kim, Mi Young [Konkuk University Medical Center, Department of Radiology, Seoul (Korea, Republic of); Kim, Jin You [Pusan National University Hospital, Department of Radiology, Pusan (Korea, Republic of)

2014-03-15

To determine whether a correlation exists between maximum standardized uptake value (SUV{sub max}) on {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) and the subtypes of breast cancer. This retrospective study involved 548 patients (mean age 51.6 years, range 21-81 years) with 552 index breast cancers (mean size 2.57 cm, range 1.0-14.5 cm). The correlation between {sup 18}F-FDG uptake in PET/CT, expressed as SUV{sub max}, and immunohistochemically defined subtypes (luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) positive and triple negative) was analyzed. The mean SUV{sub max} value of the 552 tumours was 6.07 ± 4.63 (range 0.9-32.8). The subtypes of the 552 tumours were 334 (60 %) luminal A, 66 (12 %) luminal B, 60 (11 %) HER2 positive and 92 (17 %) triple negative, for which the mean SUV{sub max} values were 4.69 ± 3.45, 6.51 ± 4.18, 7.44 ± 4.73 and 9.83 ± 6.03, respectively. In a multivariate regression analysis, triple-negative and HER2-positive tumours had 1.67-fold (P < 0.001) and 1.27-fold (P = 0.009) higher SUV{sub max} values, respectively, than luminal A tumours after adjustment for invasive tumour size, lymph node involvement status and histologic grade. FDG uptake was independently associated with subtypes of invasive breast cancer. Triple-negative and HER2-positive breast cancers showed higher SUV{sub max} values than luminal A tumours. circle {sup 18} F-FDG PET demonstrates increased tissue glucose metabolism, a hallmark of cancers. (orig.)

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

Imaging Radiation-Induced Gastrointestinal, Bone Marrow Injury and Recovery Kinetics Using 18F-FDG PET.

Science.gov (United States)

Tang, Tien T; Rendon, David A; Zawaski, Janice A; Afshar, Solmaz F; Kaffes, Caterina K; Sabek, Omaima M; Gaber, M Waleed

2017-01-01

Positron emission tomography using 18F-Fluro-deoxy-glucose (18F-FDG) is a useful tool to detect regions of inflammation in patients. We utilized this imaging technique to investigate the kinetics of gastrointestinal recovery after radiation exposure and the role of bone marrow in the recovery process. Male Sprague-Dawley rats were either sham irradiated, irradiated with their upper half body shielded (UHBS) at a dose of 7.5 Gy, or whole body irradiated (WBI) with 4 or 7.5 Gy. Animals were imaged using 18F-FDG PET/CT at 5, 10 and 35 days post-radiation exposure. The gastrointestinal tract and bone marrow were analyzed for 18F-FDG uptake. Tissue was collected at all-time points for histological analysis. Following 7.5 Gy irradiation, there was a significant increase in inflammation in the gastrointestinal tract as indicated by the significantly higher 18F-FDG uptake compared to sham. UHBS animals had a significantly higher activity compared to 7.5 Gy WBI at 5 days post-exposure. Animals that received 4 Gy WBI did not show any significant increase in uptake compared to sham. Analysis of the bone marrow showed a significant decrease of uptake in the 7.5 Gy animals 5 days post-irradiation, albeit not observed in the 4 Gy group. Interestingly, as the metabolic activity of the gastrointestinal tract returned to sham levels in UHBS animals it was accompanied by an increase in metabolic activity in the bone marrow. At 35 days post-exposure both gastrointestinal tract and bone marrow 18F-FDG uptake returned to sham levels. 18F-FDG imaging is a tool that can be used to study the inflammatory response of the gastrointestinal tract and changes in bone marrow metabolism caused by radiation exposure. The recovery of the gastrointestinal tract coincides with an increase in bone marrow metabolism in partially shielded animals. These findings further demonstrate the relationship between the gastrointestinal syndrome and bone marrow recovery, and that this interaction can be studied

Imaging Radiation-Induced Gastrointestinal, Bone Marrow Injury and Recovery Kinetics Using 18F-FDG PET.

Directory of Open Access Journals (Sweden)

Tien T Tang

Full Text Available Positron emission tomography using 18F-Fluro-deoxy-glucose (18F-FDG is a useful tool to detect regions of inflammation in patients. We utilized this imaging technique to investigate the kinetics of gastrointestinal recovery after radiation exposure and the role of bone marrow in the recovery process. Male Sprague-Dawley rats were either sham irradiated, irradiated with their upper half body shielded (UHBS at a dose of 7.5 Gy, or whole body irradiated (WBI with 4 or 7.5 Gy. Animals were imaged using 18F-FDG PET/CT at 5, 10 and 35 days post-radiation exposure. The gastrointestinal tract and bone marrow were analyzed for 18F-FDG uptake. Tissue was collected at all-time points for histological analysis. Following 7.5 Gy irradiation, there was a significant increase in inflammation in the gastrointestinal tract as indicated by the significantly higher 18F-FDG uptake compared to sham. UHBS animals had a significantly higher activity compared to 7.5 Gy WBI at 5 days post-exposure. Animals that received 4 Gy WBI did not show any significant increase in uptake compared to sham. Analysis of the bone marrow showed a significant decrease of uptake in the 7.5 Gy animals 5 days post-irradiation, albeit not observed in the 4 Gy group. Interestingly, as the metabolic activity of the gastrointestinal tract returned to sham levels in UHBS animals it was accompanied by an increase in metabolic activity in the bone marrow. At 35 days post-exposure both gastrointestinal tract and bone marrow 18F-FDG uptake returned to sham levels. 18F-FDG imaging is a tool that can be used to study the inflammatory response of the gastrointestinal tract and changes in bone marrow metabolism caused by radiation exposure. The recovery of the gastrointestinal tract coincides with an increase in bone marrow metabolism in partially shielded animals. These findings further demonstrate the relationship between the gastrointestinal syndrome and bone marrow recovery, and that this

PET/CT with 18F-FDG- and 18F-FBEM-labeled leukocytes for metabolic activity and leukocyte recruitment monitoring in a mouse model of pulmonary fibrosis.

Science.gov (United States)

Bondue, Benjamin; Sherer, Félicie; Van Simaeys, Gaetan; Doumont, Gilles; Egrise, Dominique; Yakoub, Yousof; Huaux, François; Parmentier, Marc; Rorive, Sandrine; Sauvage, Sébastien; Lacroix, Simon; Vosters, Olivier; De Vuyst, Paul; Goldman, Serge

2015-01-01

Idiopathic pulmonary fibrosis is characterized by a progressive and irreversible respiratory failure. Validated noninvasive methods able to assess disease activity are essential for prognostic purposes as well as for the evaluation of emerging antifibrotic treatments. C57BL/6 mice were used in a murine model of pulmonary fibrosis induced by an intratracheal instillation of bleomycin (control mice were instilled with a saline solution). At different times after instillation, PET/CT with (18)F-FDG- or (18)F-4-fluorobenzamido-N-ethylamino-maleimide ((18)F-FBEM)-labeled leukocytes was performed to assess metabolic activity and leukocyte recruitment, respectively. In bleomycin-treated mice, a higher metabolic activity was measured on (18)F-FDG PET/CT scans from day 7 to day 24 after instillation, with a peak of activity measured at day 14. Of note, lung mean standardized uptake values correlated with bleomycin doses, histologic score of fibrosis, lung hydroxyproline content, and weight loss. Moreover, during the inflammatory phase of the model (day 7), but not the fibrotic phase (day 23), bleomycin-treated mice presented with an enhanced leukocyte recruitment as assessed by (18)F-FBEM-labeled leukocyte PET/CT. Autoradiographic analysis of lung sections and CD45 immunostaining confirm the higher and early recruitment of leukocytes in bleomycin-treated mice, compared with control mice. (18)F-FDG- and (18)F-FBEM-labeled leukocyte PET/CT enable monitoring of metabolic activity and leukocyte recruitment in a mouse model of pulmonary fibrosis. Implications for preclinical evaluation of antifibrotic therapy are expected. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Incidental Focal 18F FDG Uptake in the Prostate: Clinical Significance and Differential Diagnostic Criteria

International Nuclear Information System (INIS)

Cho, Suk Kyong; Choi, Joon Young; Yoo, Jang; Cheon, Miju; Lee, Ji Young; Hyun, Seung Hyup; Lee, Eun Jeong; Lee, Kyung Han; Kim, Byung Tae

2011-01-01

The extent and intensity of 18F FDG uptake in prostate cancer patients are known to be variable, and the clinical significance of focal 18F fluorodeoxyglucose ( 18F FDG) uptake that is incidentally found on positron emission tomography (PET) has not been established. We investigated the clinical significance of incidental focal prostate uptake of 18F FDG on PET/computed tomography (CT) and analyzed differential findings on PET/CT Between malignant and benign uptake. A total of 14,854 whole body 18F FDG PET/CT scans (4,806 that were conducted during cancer screening and 10,048 that were conducted to evaluate suspected of alleged cancer outside of the prostate) were retrospectively reviewed to determine the presence, location, multiplicity reviewed to determine the presence, location, multiplicity and maximum standardized uptake value (SUVmax) of focal prostate uptake and combined calcification. The final diagnosis determined by serum prostate specific antigen (PSA) level and biopsy was compared with PET findings. Incidental focal prostate uptake was observed in 148 of 14,854 scans (1.0%). Sixty seven of these 148 subjects who had diagnostic confirmation were selected for further analysis. Prostate cancer was diagnosed in nine of 67 subjects (13.4%). The remaining 58 subjects had no malignancy in the prostate based on normal serum PSA level (n=53), or elevated serum PSA level with a negative biopsy result (n=5). While 84.6% (11/13) of malignant uptake was peripherally located in the prostate glands, 60.2% (50/83) of benign uptake was centrally located (p 18F FDG uptake un the prostate is not common, the incidence of cancer with focal uptake is not low. Therefore, these findings deserve further evaluation. The location of the focal prostate uptake may help with the selection of high risk prostate cancer patients.

Reproducibility of functional volume and activity concentration in 18F-FDG PET/CT of liver metastases in colorectal cancer.

Science.gov (United States)

Heijmen, Linda; de Geus-Oei, Lioe-Fee; de Wilt, Johannes H W; Visvikis, Dimitris; Hatt, Mathieu; Visser, Eric P; Bussink, Johan; Punt, Cornelis J A; Oyen, Wim J G; van Laarhoven, Hanneke W M

2012-12-01

Several studies showed potential for monitoring response to systemic therapy in metastatic colorectal cancer patients with (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET). Before (18)F-FDG PET can be implemented for response evaluation the repeatability should be known. This study was performed to assess the magnitude of the changes in standardized uptake value (SUV), volume and total lesion glycolysis (TLG) in colorectal liver metastases and validate the biological basis of (18)F-FDG PET in colorectal liver metastases. Twenty patients scheduled for liver metastasectomy underwent two (18)F-FDG PET scans within 1 week. Bland-Altman analysis was performed to assess repeatability of SUV(max), SUV(mean), volume and TLG. Tumours were delineated using an adaptive threshold method (PET(SBR)) and a semiautomatic fuzzy locally adaptive Bayesian (FLAB) delineation method. Coefficient of repeatability of SUV(max) and SUV(mean) were ∼39 and ∼31 %, respectively, independent of the delineation method used and image reconstruction parameters. However, repeatability was worse in recently treated patients. The FLAB delineation method improved the repeatability of the volume and TLG measurements compared to PET(SBR), from coefficients of repeatability of over 85 % to 45 % and 57 % for volume and TLG, respectively. Glucose transporter 1 (GLUT1) expression correlated to the SUV(mean). Vascularity (CD34 expression) and tumour hypoxia (carbonic anhydrase IX expression) did not correlate with (18)F-FDG PET parameters. In conclusion, repeatability of SUV(mean) and SUV(max) was mainly affected by preceding systemic therapy. The repeatability of tumour volume and TLG could be improved using more advanced and robust delineation approaches such as FLAB, which is recommended when (18)F-FDG PET is utilized for volume or TLG measurements. Improvement of repeatability of PET measurements, for instance by dynamic PET scanning protocols, is probably necessary to effectively

Reproducibility of functional volume and activity concentration in 18F-FDG PET/CT of liver metastases in colorectal cancer

International Nuclear Information System (INIS)

Heijmen, Linda; Geus-Oei, Lioe-Fee de; Visser, Eric P.; Oyen, Wim J.G.; Wilt, Johannes H.W. de; Visvikis, Dimitris; Hatt, Mathieu; Bussink, Johan; Punt, Cornelis J.A.; Laarhoven, Hanneke W.M. van

2012-01-01

Several studies showed potential for monitoring response to systemic therapy in metastatic colorectal cancer patients with 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET). Before 18 F-FDG PET can be implemented for response evaluation the repeatability should be known. This study was performed to assess the magnitude of the changes in standardized uptake value (SUV), volume and total lesion glycolysis (TLG) in colorectal liver metastases and validate the biological basis of 18 F-FDG PET in colorectal liver metastases. Twenty patients scheduled for liver metastasectomy underwent two 18 F-FDG PET scans within 1 week. Bland-Altman analysis was performed to assess repeatability of SUV max , SUV mean , volume and TLG. Tumours were delineated using an adaptive threshold method (PET SBR ) and a semiautomatic fuzzy locally adaptive Bayesian (FLAB) delineation method. Coefficient of repeatability of SUV max and SUV mean were ∝39 and ∝31 %, respectively, independent of the delineation method used and image reconstruction parameters. However, repeatability was worse in recently treated patients. The FLAB delineation method improved the repeatability of the volume and TLG measurements compared to PET SBR , from coefficients of repeatability of over 85 % to 45 % and 57 % for volume and TLG, respectively. Glucose transporter 1 (GLUT1) expression correlated to the SUV mean . Vascularity (CD34 expression) and tumour hypoxia (carbonic anhydrase IX expression) did not correlate with 18 F-FDG PET parameters. In conclusion, repeatability of SUV mean and SUV max was mainly affected by preceding systemic therapy. The repeatability of tumour volume and TLG could be improved using more advanced and robust delineation approaches such as FLAB, which is recommended when 18 F-FDG PET is utilized for volume or TLG measurements. Improvement of repeatability of PET measurements, for instance by dynamic PET scanning protocols, is probably necessary to effectively use PET for

Non-FDG PET imaging of brain tumors

Institute of Scientific and Technical Information of China (English)

HUANG Zemin; GUAN Yihui; ZUO Chuantao; ZHANG Zhengwei; XUE Fangping; LIN Xiangtong

2007-01-01

Due to relatively high uptake of glucose in the brain cortex, the use of FDG PET imaging is greatly limited in brain tumor imaging, especially for low-grade gliomas and some metastatic tumours. More and more tracers with higher specificity were developed lately for brain tumor imaging. There are 3 main types of non-FDG PET tracers:amino acid tracers, choline tracers and nucleic acid tracers. These tracers are now widely applied in many aspects of brain tumor imaging. This article summarized the general use of non-FDG PET in different aspects of brain tumor imaging.

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.)

The correlation between FDG uptake and biological molecular markers in pancreatic cancer patients

Energy Technology Data Exchange (ETDEWEB)

Kaida, Hayato, E-mail: kaida@med.kindai.ac.jp [Department of Radiology, Kindai University Faculty of Medicine, Osakasayama City, Osaka, 589-8511 (Japan); Azuma, Koichi [Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume City, Fukuoka, 830-0011 (Japan); Kawahara, Akihiko [Department of Diagnostic Pathology, Kurume University Hospital, Kurume City, Fukuoka, 830-0011 (Japan); Yasunaga, Masafumi; Kitasato, Yuhei [Department of Surgery, Kurume University School of Medicine, Kurume City, Fukuoka, 830-0011 (Japan); Hattori, Satoshi [Biostatic Center, Kurume University School of Medicine, Kurume City, Fukuoka, 830-0011 (Japan); Taira, Tomoki [Department of Diagnostic Pathology, Kurume University Hospital, Kurume City, Fukuoka, 830-0011 (Japan); Ureshino, Hiroki [Department of Surgery, Kurume University School of Medicine, Kurume City, Fukuoka, 830-0011 (Japan); Kage, Masayoshi [Department of Diagnostic Pathology, Kurume University Hospital, Kurume City, Fukuoka, 830-0011 (Japan); Ishii, Kazunari; Murakami, Takamichi [Department of Radiology, Kindai University Faculty of Medicine, Osakasayama City, Osaka, 589-8511 (Japan); Ishibashi, Masatoshi [Division of Nuclear Medicine, PET Center, and Department of Radiology, Fukuoka Tokushukai Hospital, Kasuga City, Fukuoka, 816-0864 (Japan)

2016-10-15

Purpose: We examined whether fluorine-18 fluorodeoxyglucose (FDG) uptake is related to the mammalian target of rapamycin (mTOR) signal pathway and its related proteins in pancreatic cancer patients. Methods: We retrospectively studied 53 pancreatic cancer patients who underwent FDG positron emission tomography (PET) or FDG PET/CT, and complete curative surgical resection. The SUV max, the tumor to nontumor activity of pancreas [T/N (P)] ratio and the T/N of liver [T/N (L)] ratio were calculated. The expressions of glucose transporter-1(Glut-1) and mTOR pathway proteins in pancreas cell lines were examined by immune blots. Excised tumor tissue was analyzed by immunohistochemistry using monoclonal antibodies for Glut-1, epidermal growth factor receptor (EGFR), mTOR, p70S6kinase (p70S6) and S6 ribosomal protein (S6). Results: The expressions of Glut-1, EGFR and p70S6 were significantly correlated with the SUV max, T/N (P) ratio and T/N (L) ratio. The expressions of mTOR and S6 were not correlated with all parameters. The expression of Glut-1 was positively correlated with the expressions of EGFR and p70S6, but not with mTOR or S6. S6 was positively correlated with p70S6. Conclusions: Glut-1, EGFR and p70S6 expressions are associated with the FDG uptake mechanism of pancreatic cancer. FDG uptake may predict the levels of EGFR and p70S6 expressions, and FDG uptake reflects glucose metabolism and cancer progression.

The role of F-18 FDG PET/CT in intrahepatic cholangiocarcinoma

Energy Technology Data Exchange (ETDEWEB)

Lee, Yeong Joo; Yoo, Le Ryung; Boo, Sun Ha; Kim, Hyoung Woo; Park, Hye Lim; O, Joo Hyun [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

2017-03-15

The aim of this study was to evaluate the diagnostic and prognostic role of metabolic parameters of FDG PET/CT in patients with intrahepatic cholangiocarcinoma (ICC). From December 2008 to December 2013, 76 FDG PET/CT scans performed for initial staging of ICC in a single institution (57 male and 19 female; mean age 68 ± 9 years) were retrospectively reviewed. Patients with history of other known malignancy were excluded. Detection rates of regional lymph node and distant metastasis by FDG PET/CT were analyzed in comparison with conventional imaging modalities such as CT or MRI. Metabolic parameters including maximum, peak and mean standardized uptake values (SUV{sub max}, SUV{sub peak}, SUV{sub mean}), metabolic tumor volume (MTV), total lesion glycolysis (TLG), glucose corrected SUV (SUV{sub gluc}), and glucose corrected TLG (TLG{sub gluc}) were measured for the primary tumor. Cut-off values for the metabolic parameters were calculated by ROC curve analysis, and used to dichotomize the patient groups. The overall survival time (OS) was calculated and compared using the Cox proportional hazard regression analysis. The median duration of follow-up period was 5.4 months (interquartile range: 1.45∼15.45). FDG PET/CT showed higher sensitivity than conventional imaging modalities in detection of regional node involvement (74.5 % vs. 61.8 %, p = 0.013). In six patients, distant metastasis was identified only by FDG PET/CT. The mean SUV{sub max}, SUV{sub peak}, SUV{sub mean}, MTV, and TLG for the primary tumor were 8.2 ± 3.1, 6.8 ± 2.5, 4.0 ± 0.8, 192.7 ± 360.5 cm{sup 3}, and 823.7 ± 1615.4, respectively. Patients with higher (≥7.3, HR: 4.280, p = 0.001), higher SUV{sub peak} (≥6.5, HR: 2.333, p = 0.020), higher SUV{sub mean} (≥3.9, HR: 2.799, p = 0.004), higher SUV{sub gluc} (≥8.1, HR: 2.648, p = 0.012), and higher TLG{sub gluc} (≥431.6, HR: 2.186, p = 0.030) showed significantly shorter survival time. By

Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (FDG PET/CT) Findings in an Unusual Case of Multiple Myeloma Presenting with a Large Extra-Axial Intracranial Mass.

Science.gov (United States)

Ayaz, Sevin; Ayaz, Ümit Yaşar

2016-01-01

We aimed to present unusual cranial FDG PET/CT findings of a 56-year-old female with multiple myeloma (MM). Plain CT images revealed a lytic lesion in the right parietal bone, filled with an oval-shaped, large, extra-axial, extradural, intracranial mass which measured 75×75×40 mm and had smooth borders. The right parietal lobe was compressed by the mass. The maximum standardized uptake value (SUV max ) of the mass lesion was 8.94 on FDG PET/CT images. Multiple lytic lesions with an increased uptake were also detected in other calvarial bones, in several vertebras and in the proximal left femur. After seven months, a control FDG PET/CT following radiotherapy and chemotherapy revealed almost complete regression of the right parietal extra-axial mass lesion. The number, size and metabolism of lytic lesions in other bones also decreased. FDG PET/CT was useful for an initial evaluation of MM lesions and was effective in monitoring the response of these lesions to therapy.

FDG goes BP

International Nuclear Information System (INIS)

Chan, J.G.

2000-01-01

Full text: A monograph for Fluorodeoxyglucose F-18 Injection (FDG) was first released in Supplement 1 of the United States Pharmacopoeia 1990 (USP 90) on 1 November 1989 to become effective on 1 January 1990. As this was the only monograph available until recently it served as the applicable standard to be followed. The Therapeutic Goods Act states that the British Pharmacopoeia (BP) is the precedent to be followed in Australia and implies that if a monograph exists for a finished product then this needs to be applied to achieve a certain standard of quality. If the monograph does not exist in the BP then other pharmacopoeia monographs can be sourced starting with the European Pharmacopoeia (Ph Eur) then the USP. A monograph for FDG first appeared in the Ph Eur in a 1999 Supplement (effective 1 January 1999 and now included in the Ph Eur 2000) and then in the BP 1999 (effective 1 December 1999). The Commonwealth Government Gazette (Notice 48, 1/12/99) published that the BP 99 was adopted on the 1st December 1999. Since then manufacturers have been required to comply with the monograph for FDG in the BP 99. This presentation looks at the content of the BP 99 monograph and compares it with that in the USP. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

Reproducibility of tumor uptake heterogeneity characterization through textural feature analysis in 18F-FDG PET.

Science.gov (United States)

Tixier, Florent; Hatt, Mathieu; Le Rest, Catherine Cheze; Le Pogam, Adrien; Corcos, Laurent; Visvikis, Dimitris

2012-05-01

(18)F-FDG PET measurement of standardized uptake value (SUV) is increasingly used for monitoring therapy response and predicting outcome. Alternative parameters computed through textural analysis were recently proposed to quantify the heterogeneity of tracer uptake by tumors as a significant predictor of response. The primary objective of this study was to evaluate the reproducibility of these heterogeneity measurements. Double baseline (18)F-FDG PET scans were acquired within 4 d of each other for 16 patients before any treatment was considered. A Bland-Altman analysis was performed on 8 parameters based on histogram measurements and 17 parameters based on textural heterogeneity features after discretization with values between 8 and 128. The reproducibility of maximum and mean SUV was similar to that in previously reported studies, with a mean percentage difference of 4.7% ± 19.5% and 5.5% ± 21.2%, respectively. By comparison, better reproducibility was measured for some textural features describing local heterogeneity of tracer uptake, such as entropy and homogeneity, with a mean percentage difference of -2% ± 5.4% and 1.8% ± 11.5%, respectively. Several regional heterogeneity parameters such as variability in the intensity and size of regions of homogeneous activity distribution had reproducibility similar to that of SUV measurements, with 95% confidence intervals of -22.5% to 3.1% and -1.1% to 23.5%, respectively. These parameters were largely insensitive to the discretization range. Several parameters derived from textural analysis describing heterogeneity of tracer uptake by tumors on local and regional scales had reproducibility similar to or better than that of simple SUV measurements. These reproducibility results suggest that these (18)F-FDG PET-derived parameters, which have already been shown to have predictive and prognostic value in certain cancer models, may be used to monitor therapy response and predict patient outcome.

Value of 18F-FDG PET/MRI for the outcome of CT-guided facet block therapy in cervical facet syndrome: initial results

International Nuclear Information System (INIS)

Sawixki, Lino M.; Schaarscjmidt, Benedikt M.; Heusch, Philipp; Buchbender, Christian; Antoch, Gerald; Rosenbaum-Krumme, Sandra; Bockisch, Andreas; Umutlu, Lale; Eicker, Sven O.; Floeth, Frank W.

2017-01-01

The aim of this study was to evaluate the ability of 18 F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging ( 18 F-FDG PET/MRI) to detect PET-positive cervical facet arthropathy and identify patients who benefit from facet block therapy. Ten patients with cervical facet syndrome (mean age: 65 ± 12 years) underwent 18 F-FDG PET/MRI of the neck. Focal 18 F-FDG uptake in PET-positive facet joints served as target for computed tomography (CT)-guided facet blocks. In PET-negative patients, the target joint for facet block therapy was selected by current clinical standards considering the level of maximum facet arthrosis and pain. Neck pain was measured on visual analogue scale (VAS) before and after therapy. Bone marrow signal intensity (SI) ratio on turbo inversion recovery magnitude (TIRM) images and maximum standard uptake values (SUVmax) was calculated for each facet joint. Pearson's correlation coefficient (r) was calculated between bone marrow SI ratios on TIRM and SUVmax. 18 F-FDG PET/MRI detected PET-positive facet arthropathy in six patients. Patients with PET-positive facet arthropathy had significantly less pain compared with the pretreatment pain 3 h (P = 0.002), 4 weeks (P = 0.002) and 3 months (P = 0.026) after facet block therapy. Pain did not change significantly in patients with PET-negative facet arthropathy. TIRM SI ratio was higher in PET-positive facet arthropathy than in PET-negative facet arthropathy (P < 0.001). Correlation was strong between bone marrow SI ratio on TIRM images and SUVmax (r = 0.7; P < 0.001).

Discussion on the alteration of FDG uptake by the breast according to the menstrual cycle in 18F-FDG PET/CT

Science.gov (United States)

Park, H. H.; Park, M. S.; Lee, C. H.; Cho, J. H.; Dong, K. R.; Chung, W. K.

2012-09-01

18F-FDG (fluorodeoxyglucose) PET (positron emission tomography)/CT (computed tomography) is a useful modality for identifying high-glucose-consuming cells, such as cancer cells, by the glucose metabolism of FDG. FDG is taken up by cancer and inflammatory cells, but occasionally there is also some FDG uptake by normal tissues as a result of their individual physiological characteristics. In particular, in fertile females, unusual FDG uptake in the breast changes according to the stages in the menstrual cycle, which can adversely affect a diagnosis. Therefore, this study examined the change in breast FDG uptake in the menstrual cycle on 18F-FDG PET/CT. One hundred and sixty females (34±3.5 years old), who had not undergone a gynecologic anamnesis and had a regular menstrual cycle over the previous 6 months, were examined from March 2010 to February 2011. The subjects were divided into the following four groups (each with 40 patients): flow phase, proliferative phase, ovulatory phase and secretory phase using Pregnancy Calculator Ver. 0.14 and history taking. Discovery Ste was used as the PET/CT. The standardized uptake values (SUVs) on the accumulated region on the breast were analyzed, and three nuclear medicine specialists performed a blind test. The SUVs on the breast were the flow phase (1.64±0.25), proliferative phase (0.93±0.28), ovulatory phase (1.66±0.26) and secretory phase (1.77±0.28). A high uptake value was observed in the secretory, flow and ovulatory phases. The FDG accumulation of the breast was divided into the following three grades compared with the lung and liver by gross analysis: the breast uptake was equal to the lung (Grade I), between the lung and liver (Grade II) and equal to or greater than the liver (Grade III). These results showed a high uptake value in the secretory, flow and ovulatory phases. In fertile females, the FDG uptake of the breast showed changes according to the menstrual cycle, which can be used to improve the diagnosis

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)

Emerging role of FDG-PET/CT in assessing atherosclerosis in large arteries

International Nuclear Information System (INIS)

Chen, Wengen; Bural, Gonca G.; Torigian, Drew A.; Alavi, Abass; Rader, Daniel J.

2009-01-01

Atherosclerosis is a dynamic inflammatory disorder. The biological composition and inflammatory state of an atherosclerotic plaque, rather than the degree of stenosis or its size are the major determinants of acute clinical events. A noninvasive technique to detect vulnerable atherosclerotic plaque is critically needed. FDG-PET/CT, a combined functional and structural whole-body imaging modality, holds great potential for this purpose. FDG uptake in large arteries has been frequently observed and is associated with cardiovascular risk factors. FDG accumulates in plaque macrophages and uptake is correlated with macrophage density. It is known that vascular FDG uptake and calcification do not overlap significantly and changes of FDG uptake are common, suggesting that FDG uptake may represent a dynamic inflammatory process. It has been reported that vascular FDG uptake can be attenuated by simvastatin in patients, and by the antiinflammatory drug probucol in rabbits. Vascular FDG uptake has been linked to cardiovascular events in some preliminary studies. Data from basic sciences, and animal and clinical studies support the emerging role of FDG-PET/CT in assessing atherosclerosis in large arteries in humans. (orig.)

A segmentation framework towards automatic generation of boost subvolumes for FDG-PET tumors: A digital phantom study

International Nuclear Information System (INIS)

Yang, Fei; Grigsby, Perry W.

2012-01-01

Potential benefits of administering nonuniform radiation dose to heterogeneous tumors imaged with FDG-PET have been widely demonstrated; whereas the number of discrete dose levels to be utilized and corresponding locations for prescription inside tumors vary significantly with current existing methods. In this paper, an automated and unsupervised segmentation framework constituted mainly by an image restoration mechanism based on variational decomposition and a voxel clustering scheme based on spectral clustering was presented towards partitioning FDG-PET imaged tumors into subvolumes characterized with the total intra-subvolume activity similarity and the total inter-subvolume activity dissimilarity being simultaneously maximized. Experiments to evaluate the proposed system were carried out with using FDG-PET data generated from a digital phantom that employed SimSET (Simulation System for Emission Tomography) to simulate PET acquisition of tumors. The obtained results show the feasibility of the proposed system in dividing FDG-PET imaged tumor volumes into subvolumes with intratumoral heterogeneity being properly characterized, irrespective of variation in tumor morphology as well as diversity in intratumoral heterogeneity pattern.

Correlation between 11C-choline or 18F-FDG uptake and tumor proliferation: a rabbit bearing lung cancer model study

International Nuclear Information System (INIS)

Li Yajun; Bai Renju; Gao Shuo; Li Yansheng; Liu Lei; Jia Wei; Cai Li; Xing Xiling

2009-01-01

Objective: Tumor proliferative activity has been recognized as an indicator of malignant degree in lung cancer and related to prognosis. The purpose of this study was to evaluate the feasibility of assessing proliferative activity with 11 C-choline and 18 F-fluorodeoxyglucose (FDG) PET on a rabbit bearing lung VX2 tumor model. Methods: About 0.5 ml of viable VX2 tumor cell suspension was slowly injected into the right lungs of 54 New Zealand white rabbits through a transthoracical needle insertion. 11 C-choline and 18 F-FDG PET scan were performed 10-11 d after tumor implantation. One ear vein was cannulated for administration of the tracers, 11 C-choline PET scan (with Discovery LS PET/CT scanner, GE) was performed 5 rain after intravenously injection of 37 MBq 11 C-choline. Then 18.7 MBq 18 F-FDG was infused at 60 min after 11 C-choline administration and 18 F-FDG PET scan was performed at 60 min after 18 F-FDG administration. The maximal standardized uptake value of tumor was calculated. The animals were euthanized after examination. Histochemical stain with proliferating cell nuclear antigen (PCNA) was performed and PCNA index was obtained to assess tumor proliferation. The difference of 11 C-choline and 18 F-FDG was analyzed using paired student t-test. The correlation of 11 C-choline 18 F-FDG and tumor cell density and PCNA index was analyzed using Pearson linear regression. Results: Of the 54 rabbits, 36 had a solitary pulmonary tumor. The rate of successful generation of a solitary VX2 tumor was 66.7% (36/54). Only 33 rabbits underwent both 11 C-choline and 18 F-FDG PET, and enrolled in this study. The mean cellular density was (547.36 ± 64.78) cells/field and the mean PCNA index was (42.34 ± 15.26)%. 18 F-FDG was higher than 11 C-choline (5.70 ± 3.45 vs 4.02 ± 3.07, t=-3.188, P=0.003). 11 C-choline significantly and positively correlated with PCNA index (r=0.786, P 11 C-choline and tumor cellular density (r=-0.176, P=0.327). 18 F-FDG significantly and

Utility of FDG-PET in neuropediatric pathology; Utilidad del PET-FDG en patologia neuropediatrica

Energy Technology Data Exchange (ETDEWEB)

Massardo, Teresa V; Canessa G, Jose; Sierralta C, M. Paulina; Gonzalez E, Pstricio; Jofre M, M. Josefina [Centro PET Imagenes Moleculares Hospital Militar de Santiago (Chile)

2007-07-01

Due to the recent incorporation of positron technology (PET) it appears interesting to review the present indications of fluor-deoxyglucose (FDG) in neuropediatric pathology. The main indication is in the evaluation of refractory epilepsy mainly in cases with negative magnetic resonance or discordance with electroencephalography Some uses in tumors are also discussed, such as tumor characterization and differentiation between radionecrosis and recurrence. The experience between years 2003 and 2007 at the Santiago Military Hospital, using FDG in 66 children and adolescents cases with diverse neurological indications was reviewed.

Usefulness of PET-FDG in pathology neuropediatric; Utilidad del PET-FDG en patologia neuropediatrica

Energy Technology Data Exchange (ETDEWEB)

Massardo V, Teresa; Canessa G, Jose; Sierralta C, M Paulina; Gonzalez E, Patricio; Jofre M, M Josefina [Centro PET Imagenes Moleculares Hospital Militar de Santiago, Santiago (Chile)

2007-07-01

Due to the recent incorporation of positron technology (PET) it appears interesting to review the present indications of fluor-deoxyglucose (FDG) in neuropediatric pathology. The main indication is in the evaluation of refractory epilepsy mainly in cases with negative magnetic resonance or discordance with electro encephalography Some uses in tumors are also discussed, such as tumor characterization and differentiation between radio necrosis and recurrence. The experience between years 2003 and 2007 at the Santiago Military Hospital, using FDG in 66 children and adolescents cases with diverse neurological indications was reviewed (au)

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

Energy Technology Data Exchange (ETDEWEB)

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.

18 F-FDG PET／CT早期动态显像的应用研究%Value of early dynamic 18 F-FDG PET/CT

Institute of Scientific and Technical Information of China (English)

王绍波; 王全师; 季云海

2017-01-01

The early dynamic 18 F⁃FDG PET/CT can reflect perfusion, bio⁃distribution, uptake and excretion of 18 F⁃FDG in certain organs ( or lesions) in the early phase post injection. This imaging technique could be used to evaluate the organ ( or lesion) perfusion and to serve as a supplement for conventional 18 F⁃FDG PET/CT in the evaluation of glucose metabolism. This review summarizes the basic principle, imaging methods and clinical application of early dynamic 18 F⁃FDG PET/CT.%18 F⁃FDG PET／CT早期动态显像可反映18 F⁃FDG进入体内后随血流运行的最初时间段内被脏器（或病变组织）摄取及排泄的情况，其可作为18 F⁃FDG PET／CT常规显像的有益补充，用于评估脏器（或病灶组织）的血流灌注。笔者对18 F⁃FDG PET／CT早期动态显像的基本原理、显像方法及其临床应用进行综述。

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

Energy Technology Data Exchange (ETDEWEB)

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.)

Metastasis of the gastrointestinal tract. FDG-PET imaging

International Nuclear Information System (INIS)

Hayasaka, Kazumasa; Nihashi, Takashi; Matsuura, Toshihiro

2007-01-01

We assess the usefulness of F-18-fluoro-deoxy-glucose (FDG) positron emission tomography (PET) in the evaluation of gastrointestinal metastases. Four cases (five lesions) in which metastases from three lung cancers and one malignant fibrous histiocytoma (MFH) of the femur were found in the gastrointestinal tract were reviewed (men/women 3:1, age 63-78 years, mean 72 years). The five lesions were duodenal, jejunal metastasis, and two stomach metastases from lung carcinoma, and rectal metastasis from MFH of the femur. FDG-PET was unable to detect small masses, but it was able to detect unforeseen lesions such as gastrointestinal metastases because FDG-PET is a whole-body scan in a single-operation examination. FDG-PET imaging provided valuable information for the diagnosis of gastrointestinal metastasis. (author)

Potential role of combined FDG PET/CT and contrast enhancement MRI in a rectal carcinoma model with nodal metastases characterized by a poor FDG-avidity

International Nuclear Information System (INIS)

Farace, Paolo; Conti, Giamaica; Merigo, Flavia; Tambalo, Stefano; Marzola, Pasquina; Sbarbati, Andrea; Quarta, Carmelo; D’Ambrosio, Daniela; Chondrogiannis, Sotirios; Nanni, Cristina; Rubello, Domenico

2012-01-01

Purpose: To investigate the additional role of MRI contrast enhancement (CE) in the primary tumor and the FDG uptake at PET in the lymph-node metastases. Materials and methods: A model of colorectal cancer induced by orthotopic HT-29 cells microinjection, producing pelvic lymph node metastases, was assessed using CE-MRI and FDG-PET. Histology and GLUT-1 immunohistochemistry were performed on primary tumors and iliac lymph nodes. Results: Primary tumors were characterized by low FDG-uptake but high CE-MRI, particularly at tumor periphery. Undetectable FDG-uptake characterized the metastatic lymph-nodes. Histology revealed large stromal bundles at tumor periphery and a dense network of stromal fibers and neoplastic cells in the inner portion of the tumors. Both primary tumors and positive lymph nodes showed poor GLUT-1 staining. Conclusion: Our data support the complementary role of MRI-CE and FDG PET in some types of carcinomas characterized by abundant cancer-associated stroma and poor FDG avidity consequent to poor GLUT-1 transported. In these tumors FDG-PET alone may be not completely adequate to obtain an adequate tumor radiotherapy planning, and a combination with dual CE-MRI is strongly recommended.

Dual-time-point {sup 18}F-FDG PET imaging for diagnosis of disease type and disease activity in patients with idiopathic interstitial pneumonia

Energy Technology Data Exchange (ETDEWEB)

Umeda, Yukihiro; Demura, Yoshiki; Ishizaki, Takeshi; Ameshima, Shingo [University of Fukui, Department of Respiratory Medicine, Yoshida-gun, Fukui (Japan); Miyamori, Isamu [University of Fukui, Third Department of Internal Medicine, Yoshida-gun, Fukui (Japan); Saito, Yuji [Fujita Health University, Division of Respirology and Allergology, Department of Internal Medicine, School of Medicine, Toyoake, Aichi (Japan); Tsuchida, Tatsuro [University of Fukui, Department of Radiology, Yoshida-gun, Fukui (Japan); Fujibayashi, Yasuhisa; Okazawa, Hidehiko [University of Fukui, Biomedical Imaging Research Center, Yoshida-gun, Fukui (Japan)

2009-07-15

Individual clinical courses of idiopathic interstitial pneumonia (IIP) are variable and difficult to predict because the pathology and disease activity are contingent, and chest computed tomography (CT) provides little information about disease activity. In this study, we applied dual-time-point [{sup 18}F]-fluoro-2-deoxy-D-glucose ({sup 18}F-FDG) positron emission tomography (PET), commonly used for diagnosis of malignant tumours, to the differential diagnosis and prediction of disease progression in IIP patients. Fifty patients with IIP, including idiopathic pulmonary fibrosis (IPF, n = 21), non-specific interstitial pneumonia (NSIP, n = 18) and cryptogenic organizing pneumonia (COP, n = 11), underwent {sup 18}F-FDG PET examinations at two time points: scan 1 at 60 min (early imaging) and scan 2 at 180 min (delayed imaging) after {sup 18}F-FDG injection. The standardized uptake values (SUV) at the two points and the retention index (RI-SUV) calculated from them were evaluated and compared with chest CT findings, disease progression and disease types. To evaluate short-term disease progression, all patients were examined by pulmonary function test every 3 months for 1 year after {sup 18}F-FDG PET scanning. The early SUV for COP (2.47 {+-} 0.74) was significantly higher than that for IPF (0.99 {+-} 0.29, p = 0.0002) or NSIP (1.22 {+-} 0.44, p= 0.0025). When an early SUV cut-off value of 1.5 and greater was used to distinguish COP from IPF and NSIP, the sensitivity, specificity and accuracy were 90.9, 94.3 and 93.5%, respectively. The RI-SUV for IPF and NSIP lesions was significantly greater in patients with deteriorated pulmonary function after 1 year of follow-up (progressive group, 13.0 {+-} 8.9%) than in cases without deterioration during the 1-year observation period (stable group, -16.8 {+-} 5.9%, p < 0.0001). However, the early SUV for all IIP types provided no additional information of disease progression. When an RI-SUV cut-off value of 0% and greater was

MCNPX dosimetry and radiation-induced cancer risk estimation from 18F-FDG pediatric PET at Brazilian population

International Nuclear Information System (INIS)

Mendes, Bruno M.; Fonseca, Telma C.F.; Campos, Tarcisio P.R.

2017-01-01

Positron emission tomography (PET) using 18 F-FDG has increased significantly in pediatric patients. PET with 18 F-FDG has often been applied in oncology. Cancer induction is one of the main stochastic risk from exposure to ionizing radiation of 18 F-FDG. Radiation-induced cancer risk estimation due to medical exposures is an important tool for risk/benefit assessing. The objective was to perform dosimetry and estimate the risk of cancer induction due to pediatric use of 18 F-FDG. MCNPX Computational dosimetry was performed to estimate organ absorbed doses resulting from 18 F-FDG pediatric use. Two voxelized phantoms, kindly provided by the GSF - Helmholtz Zentrum, were used: 'Child' - 7 years child and 'Baby' 8-week-old infant. ICRP-128 publication provided the radiopharmaceutical biodistribution of F-18. Tables containing organ absorbed dose and effective dose per unit of injected activity for the two phantoms were obtained. The injected activities were estimated according to data provided in the literature. Images of the absorbed dose distribution were generated from both models. The BEIR VII methodology was used to calculate the risk of cancer induction. The risk of cancer induction (per imaging procedure) for the seven-year-old child was (0.09% ♂ and 0.15% ♀) and for the eight-week old baby was (0.11% ♂ and 0.21% ♀). The 18 F-FDG absorbed dose distribution in the children and infants showed some divergences in comparison to adult data. Probably, the biokinetic data used to children and infants is the main reason for this disconnection. (author)

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.)

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

Metastatic Brachial Plexopathy in a Case of Recurrent Breast Carcinoma Demonstrated on 18F-FDG PET/CT

International Nuclear Information System (INIS)

Tripathi, Madhavi; Das, Chandan J.; Srivastava, Anurag; Bal, ChandraSekhar; Malhotra, Arun

2014-01-01

This case highlights the importance of recognition of the pattern of metastatic brachialplexopathy in breast cancer patients undergoing 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) for evaluation of recurrent disease.This pattern can be appreciated on maximum intensity projection (MIP) and coronal 18 F-FDG PET/CT images as a linear extension of tracer activity from superomedial aspect(supra/infraclavicular) to lateral aspect of the axilla closely related to the subclavian/axillary vessels). A 35-year-old woman diagnosed with infiltrating ductal carcinoma of the right breast had undergone six cycles of neoadjuvant chemotherapy, followed by wide local incision and radiotherapy. She had local recurrence, for which she was operated upon and given chemotherapy. She presented to her oncologist with pain and swelling in the right breast, nodules in the right axilla and restriction of movement of the right upper limb. The patient was referred for 18 F-FDG PET/CT to evaluate the extent of recurrent/metastatic disease. Whole-body PET/CT was acquired 1 h following the intravenous injection of 296 MBq of 18 F-FDG on a Biograph mCT scanner (Siemens). Evaluation of the MIP image revealed abnormal FDG accumulation at multiple sites in the thorax, along with a linear pattern of FDG uptake in the right lateral aspect of the upper chest (Fig. 1a, arrow). The coronal fused PET/CT image revealed a linear pattern of FDG uptake corresponding to an ill-defined mass extending from just behind the right clavicle into the right axilla (arrow). In addition, abnormal FDG accumulation was seen in a soft tissue density mass in the upper outer quadrant of the right breast, skin of the right breast laterally, both pectoral muscles (discrete foci) and in a few subpectoral nodes. Soft tissue nodular opacities in both lungs showed FDG accumulation suggestive of pulmonary metastasis (Fig. 1b, thick arrow). The patient was referred for magnetic

Correlation of intra-tumor 18F-FDG uptake heterogeneity indices with perfusion CT derived parameters in colorectal cancer.

Science.gov (United States)

Tixier, Florent; Groves, Ashley M; Goh, Vicky; Hatt, Mathieu; Ingrand, Pierre; Le Rest, Catherine Cheze; Visvikis, Dimitris

2014-01-01

Thirty patients with proven colorectal cancer prospectively underwent integrated 18F-FDG PET/DCE-CT to assess the metabolic-flow phenotype. Both CT blood flow parametric maps and PET images were analyzed. Correlations between PET heterogeneity and perfusion CT were assessed by Spearman's rank correlation analysis. Blood flow visualization provided by DCE-CT images was significantly correlated with 18F-FDG PET metabolically active tumor volume as well as with uptake heterogeneity for patients with stage III/IV tumors (|ρ|:0.66 to 0.78; p-valueheterogeneity of 18F-FDG PET accumulation reflects to some extent tracer distribution and consequently indicates that 18F-FDG PET intra-tumor heterogeneity may be associated with physiological processes such as tumor vascularization.

Clinical Value of a One-Stop-Shop Low-Dose Lung Screening Combined with (18)F-FDG PET/CT for the Detection of Metastatic Lung Nodules from Colorectal Cancer.

Science.gov (United States)

Han, Yeon-Hee; Lim, Seok Tae; Jeong, Hwan-Jeong; Sohn, Myung-Hee

2016-06-01

The aim of this study was to evaluate the clinical usefulness of additional low-dose high-resolution lung computed tomography (LD-HRCT) combined with (18)F-fluoro-2-deoxyglucose positron emission tomography with CT ((18)F-FDG PET/CT) compared with conventional lung setting image of (18)F-FDG PET/CT for the detection of metastatic lung nodules from colorectal cancer. From January 2011 to September 2011, 649 patients with colorectal cancer underwent additional LD-HRCT at maximum inspiration combined with (18)F-FDG PET/CT. Forty-five patients were finally diagnosed to have lung metastasis based on histopathologic study or clinical follow-up. Twenty-five of the 45 patients had ≤5 metastatic lung nodules and the other 20 patients had >5 metastatic nodules. One hundred and twenty nodules in the 25 patients with ≤5 nodules were evaluated by conventional lung setting image of (18)F-FDG PET/CT and by additional LD-HRCT respectively. Sensitivities, specificities, diagnostic accuracies, positive predictive values (PPVs), and negative predictive values (NPVs) of conventional lung setting image of (18)F-FDG PET/CT and additional LD-HRCT were calculated using standard formulae. The McNemar test and receiver-operating characteristic (ROC) analysis were performed. Of the 120 nodules in the 25 patients with ≤5 metastatic lung nodules, 66 nodules were diagnosed as metastatic. Eleven of the 66 nodules were confirmed histopathologically and the others were diagnosed by clinical follow-up. Conventional lung setting image of (18)F-FDG PET/CT detected 40 of the 66 nodules and additional LD-HRCT detected 55 nodules. All 15 nodules missed by conventional lung setting imaging but detected by additional LD-HRCT were LD-HRCT. By ROC analysis, the area under the ROC curve (AUC) of conventional lung setting image and additional LD-HRCT were 0.712 and 0.827 respectively. Additional LD-HRCT with maximum inspiration was superior to conventional lung setting image of (18)F-FDG PET

Persistent non-specific FDG uptake on PET imaging following hip arthroplasty

Energy Technology Data Exchange (ETDEWEB)

Zhuang, Hongming; Chacko, Thomas K.; Hickeson, Marc; Stevenson, Karen; Feng, Qi; Ponzo, Fabio; Alavi, Abass [Division of Nuclear Medicine, Department of Radiology, The Hospital of University of Pennsylvania, 110 Donner Building, 3400 Spruce Street, Philadelphia, PA 19104 (United States); Garino, Jonathan P. [Department of Orthopedic Surgery, The Hospital of University of Pennsylvania, Philadelphia, PA 19802 (United States)

2002-10-01

Hip arthroplasty is a common surgical procedure, but the diagnosis of infection associated with hip arthroplasty remains challenging. Fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) has been shown to be a promising imaging modality in settings where infection is suspected. However, inflammatory reaction to surgery can result in increased FDG uptake at various anatomic locations, which may erroneously be interpreted as sites of infection. The purpose of this study was to assess the patterns and time course of FDG accumulation following total hip replacement over an extended period of time. Firstly, in a prospective study nine patients with total hip replacement were investigated to determine the patterns of FDG uptake over time. Three FDG-PET scans were performed in each patient at about 3, 6 and 12 months post arthroplasty. Secondly, in a retrospective analysis, the medical and surgical history and FDG-PET imaging results of 710 patients who had undergone whole-body scans for the evaluation of possible malignant disorders were reviewed. The history of arthroplasty and FDG-PET findings in the hip region were reviewed for this study. Patients with symptomatic arthroplasties or related complaints during FDG-PET scanning were excluded from the analysis. During the entire study period, all nine patients enrolled in the prospective study were demonstrated to have increased FDG uptake around the femoral head or neck portion of the prosthesis that extended to the soft tissues surrounding the femur. Among the patients reviewed in the retrospective study, 18 patients with a history of 21 hip arthroplasties who were asymptomatic at the time of FDG-PET scan met the criteria for inclusion. The time interval between the hip arthroplasty and the FDG-PET study ranged from 3 months to 288 months (mean{+-}SD: 80.4{+-}86.2 months). In 81% (17 of 21) of these prostheses, increased FDG uptake could be noted around the femoral head or neck portion of the

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

Energy Technology Data Exchange (ETDEWEB)

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

Changes of FDG brain uptake in patients with abnormal thyroid function

International Nuclear Information System (INIS)

Huang, Wen-Sheng; Chang, Chih-Yung; Cheng, Cheng Yi

2009-01-01

Full text: Objective: To investigate FOG brain uptake in patients with hypo- and subclinical hyperthyroidism undergoing whole-body FOG PET/CT. Methods: Sixty-four patients who had received total thyroidectomy for thyroid carcinoma underwent whole-body FDG PETI CT. Thirty-two of them received imaging in subclinical hyperthyroid status (15 males; 17 females; mean age, 55 ± 14 years) while the other 32 age-matched patients underwent the scan 4 wk after thyroid hormone withdrawal (12 males; 20 females; mean age, 56 ± 13 years). Brain images were performed I h after 370 MBq intravenous injection using a dedicated PET/CT (Siemens Biograph BGO duo). FOG-uptake was quantified by the standardized uptake value (SUY), normalized to patient's body weight. The volume of brain was determined by PET with 40% maximum SUY threshold. The brain mean SUV (SUY mean) were calculated in each patient. Data were compared between the two groups. Results: The brain mean SUYs for the hypothyroid patients ranged between 3.11 and 6.35 (averaged SUY mean 5.13 ± 0.91) while those of the subclinical hyperthyroid patients varied from 3.53 to 8.29 (mean SUY mean 5.77 ± 1.04). There was a significant global reduction of brain FDG uptake in the hypothyroid group (II.] %, P < 0.0 I) but no significant changes in the sub-clinical hyperthyroid group compared to the controls. Conclusion: FDG brain uptake in subclinical hyperthyroid patients was significantly greater than that of patients with hypothyroidism, suggesting effects of thyroid hormone on cerebral glucose metabolism.

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.

(18)F-FDG PET imaging of murine atherosclerosis

DEFF Research Database (Denmark)

Hag, Anne Mette Fisker; Pedersen, Sune Folke; Christoffersen, Christina

2012-01-01

To study whether (18)F-FDG can be used for in vivo imaging of atherogenesis by examining the correlation between (18)F-FDG uptake and gene expression of key molecular markers of atherosclerosis in apoE(-/-) mice....

Are dual-phase 18F-FDG PET scans necessary in nasopharyngeal carcinoma to assess the primary tumour and loco-regional nodes?

International Nuclear Information System (INIS)

Yen, Tzu-Chen; Chang, Yu-Chen; Chan, Sheng-Chieh; Lin, Kun-Ju; Chang, Joseph Tung-Chieh; Hsu, Ching-Han; Lin, Wuu-Jyh; Fu, Ying-Kai; Ng, Shu-Hang

2005-01-01

This prospective study aimed to investigate the efficacy of dual-phase positron emission tomography (PET) in evaluating the loco-regional status of nasopharyngeal carcinoma (NPC). Eighty-four patients with newly diagnosed NPC and a fasting serum glucose level of 18 F]fluoro-2-deoxy-D-glucose ( 18 F-FDG) PET studies (at 40 min and 3 h after injection of 370 MBq 18 F-FDG) and head and neck magnetic resonance imaging (MRI) were performed within 1 week. Diagnostic criteria for NPC comprised the histopathological findings, the joint judgments of the research team and the post-treatment outcome. Each lesion's maximum standardised uptake value (SUV) and retention index were obtained. SUV data were evaluated using a paired test. Receiver operating characteristic curves and calculation of the area under the curve (AUC) determined the discriminative power. 18 F-FDG PET was significantly superior to MRI in identifying lower neck NPC nodal metastasis (AUC: 1 vs 0. 972, P=0.046) and overall loco-regional metastases (AUC: 0.985 vs 0.958, P=0.036). However, 18 F-FDG PET was similar to MRI in detecting primary tumour, as well as retropharyngeal, upper neck and supraclavicular nodal metastases. There was no significant difference between early phase (40 min) and delayed phase (3 h) 18 F-FDG PET in the detection of primary tumours (accuracy: 100% vs 100%) or loco-regional nodal metastasis (AUC: 0.984 vs 0.985, P=0.834). 18 F-FDG PET is superior to MRI in identifying lower neck nodal metastasis of NPC. Additional 3-h 18 F-FDG PET contributes no further information in the detection of primary tumours or loco-regional metastatic nodes in untreated NPC patients. (orig.)

The Prognostic Value of {sup 18}F-FDG PET/CT for Early Recurrence in Operable Breast Cancer: Comparison with TNM Stage

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O, Joo Hyun; Choi, Woo Hee; Han, Eun Ji; Choi, Eunkyoung; Chae, Byung Joo; Park, Yonggyu; Kim, Sung Hoon [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

2013-12-15

We evaluated whether the maximum standardized uptake values (SUV{sub max}) of primary tumor from the initial staging by {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) of patients with breast cancer could identify patients at risk for early recurrence within 2 years, particularly in comparison to the American Joint Committee on Cancer (AJCC) stage. We reviewed the staging {sup 18}F-FDG PET/CT images of patients with primary breast cancer and their medical records. The SUV{sub max} of the primary tumor was measured. The presence or absence of FDG uptake in the axillary lymph node (ALN) was also assessed. The patient's pathologic primary tumor stage (pT), pathologic regional lymph node stage (pN), stage grouping, age, estrogen receptor (ER) and progesterone receptor (PR) status, and neoadjuvant chemotherapy history were evaluated with the FDG uptake parameters for recurrence within 2 years following the end of first-line therapy. Recurrence within 2 years was present in 9.1%(n =40) out of the 441 patients assessed. The FDG uptake in ALN, pT, pN, stage grouping and neoadjuvant chemotherapy history were prognostic for early recurrence, while primary tumor SUV{sub max}, age, and ER or PR status were not significant on logistic regression. On multivariate analysis, only the stage grouping (odds ratio 2.79; 95 % CI 1.73, 4.48; p <0.0001) and neoadjuvant chemotherapy history (odds ratio 2.70; 95 % CI 1.22, 5.98; p =0.0141) could identify patients at increased risk for recurrence within 2 years. Primary tumor FDG uptake measured by SUV{sub max}, and visual assessment of FDG uptake in the ALN in the initial staging PET/CT of patients with breast cancer may not have additional prognostic value compared with the AJCC stage grouping for early recurrence.

FDG PET/CT imaging as a biomarker in lymphoma

Energy Technology Data Exchange (ETDEWEB)

Meignan, Michel; Itti, Emmanuel [Hopitaux Universitaires Henri Mondor, Paris-Est Creteil University, LYSA Imaging, Department of Nuclear Medicine, Creteil (France); Gallamini, Andrea [Nice University, Research, Innovation and Statistic Department, Antoine Lacassagne Cancer Center, Nice (France); Scientific Research Committee, S. Croce Hospital, Cuneo (Italy); Younes, Anas [Memorial Sloan Kettering Cancer Center, Lymphoma Service, New York, NY (United States)

2015-04-01

FDG PET/CT has changed the management of FDG-avid lymphoma and is now recommended as the imaging technique of choice for staging and restaging. The need for tailoring therapy to reduce toxicity in patients with a favourable outcome and for improving treatment in those with high-risk factors requires accurate diagnostic methods and a new prognostic algorithm to identify different risk categories. New drugs are used in relapsed/refractory patients. The role of FDG PET/CT as a biomarker in this context is summarized in this review. New trends in FDG metabolic imaging in lymphoma are addressed including metabolic tumour volume measurement at staging and integrative PET which combines PET data with clinical and molecular markers or other imaging techniques. The quantitative approach for response assessment which is under investigation and is used in large ongoing trials is compared with visual criteria. The place of FDG in the era of targeted therapy is discussed. (orig.)

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

Comparison of analytical methods of brain [18F]FDG-PET after severe traumatic brain injury.

Science.gov (United States)

Madsen, Karine; Hesby, Sara; Poulsen, Ingrid; Fuglsang, Stefan; Graff, Jesper; Larsen, Karen B; Kammersgaard, Lars P; Law, Ian; Siebner, Hartwig R

2017-11-01

Loss of consciousness has been shown to reduce cerebral metabolic rates of glucose (CMRglc) measured by brain [ 18 F]FDG-PET. Measurements of regional metabolic patterns by normalization to global cerebral metabolism or cerebellum may underestimate widespread reductions. The aim of this study was to compare quantification methods of whole brain glucose metabolism, including whole brain [18F]FDG uptake normalized to uptake in cerebellum, normalized to injected activity, normalized to plasma tracer concentration, and two methods for estimating CMRglc. Six patients suffering from severe traumatic brain injury (TBI) and ten healthy controls (HC) underwent a 10min static [ 18 F]FDG-PET scan and venous blood sampling. Except from normalizing to cerebellum, all quantification methods found significant lower level of whole brain glucose metabolism of 25-33% in TBI patients compared to HC. In accordance these measurements correlated to level of consciousness. Our study demonstrates that the analysis method of the [ 18 F]FDG PET data has a substantial impact on the estimated whole brain cerebral glucose metabolism in patients with severe TBI. Importantly, the SUVR method which is often used in a clinical setting was not able to distinguish patients with severe TBI from HC at the whole-brain level. We recommend supplementing a static [ 18 F]FDG scan with a single venous blood sample in future studies of patients with severe TBI or reduced level of consciousness. This can be used for simple semi-quantitative uptake values by normalizing brain activity uptake to plasma tracer concentration, or quantitative estimates of CMRglc. Copyright © 2017 Elsevier B.V. All rights reserved.

FDG PET as a prognostic predictor in the early post-therapeutic evaluation for unresectable hepatocellular carcinoma

Energy Technology Data Exchange (ETDEWEB)

Higashi, Tatsuya; Nishii, Ryuichi [Shiga Medical Center Research Institute, Moriyama City, Shiga (Japan); Hatano, Etsuro; Ikai, Iwao; Seo, Satoru; Kitamura, Koji; Takada, Yasuji; Kamimoto, Shinji [Kyoto University Graduate School of Medicine, Department of Gastroenterological Surgery, Sakyo-ku, Kyoto (Japan); Nakamoto, Yuji; Ishizu, Koichi; Suga, Tsuyoshi; Kawashima, Hidekazu; Togashi, Kaori [Kyoto University Graduate School of Medicine, Department of Diagnostic Imaging and Nuclear Medicine, Sakyo-ku, Kyoto (Japan)

2010-03-15

To elucidate the prognostic role of post-therapeutic {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET), we conducted a retrospective cohort study analysing the clinical factors that affect overall survival after non-operative therapy for unresectable hepatocellular carcinoma (HCC). Sixty-seven cases with unresectable HCC who received non-operative therapy (transcatheter arterial chemoembolization: n=24, transcatheter arterial infusion chemotherapy: n=31, radiofrequency ablation: n = 5 or systemic chemotherapy: n = 7) and had received FDG PET for the evaluation of the therapeutic effect within 1 month after the end of the therapy were evaluated. Overall survival rate was evaluated using the univariate and multivariate analyses of relevant clinical and laboratory parameters before and after therapy, including visual PET analysis and quantitative analysis using maximum standardized uptake value (SUV). Visual PET diagnosis of post-therapeutic lesions was a good predictor of overall survival of unresectable HCC patients. The low FDG group showed significantly longer survival (average: 608 days) than that (average: 328 days) of the high FDG group (p<0.0001). Multivariate analysis showed four significant prognostic factors for the survival: post-therapeutic alpha-fetoprotein ({alpha}FP) level (=400 ng/ml, p=0.004), post-therapeutic visual PET diagnosis (p=0.006), post-therapeutic clinical stage (UICC stage IV, p=0.04) and post-therapeutic Milan criteria (p=0.03), while pre-therapeutic clinical factors, SUV by post-therapeutic FDG PET (5.0 or more) or others did not show significance. The present study suggests that post-therapeutic PET performed within 1 month after non-operative therapy can be a good predictor of overall survival in unresectable HCC patients, while pre-therapeutic evaluation including PET, tumour markers and clinical staging may not be useful. (orig.)

Relationship Between Dual Time Point FDG PET and Immunohistochemical Parameters in Preoperative Colorectal Cancer: Preliminary Study

International Nuclear Information System (INIS)

Lee, Jai Hyuen; Lee, Won Ae; Park, Seok Gun; Park, Dong Kook; Namgung, Hwan

2012-01-01

The clinical availability of 2 deoxy 2 [18F] fluoro D glucose (FDG) dual time point positron emission tomography/computerized tomography (DTPP) has been investigated in diverse oncologic fields. The aim of this preliminary study was to evaluate the relationship between various immunohistopathologic markers reflecting disease progression of colorectal cancer and parameters extracted from FDG DTPP in colorectal cancer patients. Forty seven patients with histologically confirmed colorectal cancer were analyzed in this preliminary study. FDG DTPP consisted of an early scan 1 h after FDG injection and a delayed scan 1.5 h after the early scan. Based on an analysis of FDG DTPP, we estimated the maximum standardized uptake value (SUV) of tumors on the early and delayed scans (SUV earlya nd SUV delayed, respectively). The retention index (RI) was calculated as follows: (SUV delayed- SUV early) x 100/ SUV early. The clinicopathological findings (size and T and N stages) and immunohistochemical factors [glucose transporter 1 (GLUT 1), hexokinase 2 (HK 2), p53, P504S, and β catenin] were analyzed by visual analysis. The RIs calculated from the SUVs ranged from -1.8 to 73.4 (31.8±15.5). The RIs were significantly higher in patients with high T stages (T3 and T4) than with low T stages (T1 and T2; P earlya nd SUV delayeda nd clinicopathologic parameters in this study. The RIs obtained from preoperative colorectal cancers had a significant relationship to tumor size, T staging, GLUT 1, and p53, in contrast to SUV earlyo r SUV delayed. Compared with previous reports, our results showed that RI can better predict GLUT 1 expression than HK 2 and other immunohistochemical markers. This study demonstrated that the RI might have the potential to be applied as a prognostic marked in preoperative colorectal cancer

‘Double cortex’ sign on FDG-PET/CT in diffuse band heterotopia

International Nuclear Information System (INIS)

Tripathi, Madhavi; Tripathi, Manjari; Kumar, Ganesh; Malhotra, Arun; Bal, Chandra Sekhar

2013-01-01

F-18 Fluorodeoxyglucose (FDG) Positron emission tomography/Computed Tomography (PET/CT) has come to play an increasingly important role for the pre-surgical evaluation of drug resistant epilepsy and complements Magnetic Resonance Imaging (MRI) in the evaluation of grey matter heterotopias. This case illustrates the characteristic pattern of metabolic abnormality in diffuse band heterotopia (DBH) which is otherwise called double cortex syndrome. The presence of metabolic activity in the heterotopic inner cortical band and in the overlying true cortex gives rise to the ‘double cortex’ sign on FDG-PET, concurrent CT provides a good anato-metabolic coregistration

‘Double cortex’ sign on FDG-PET/CT in diffuse band heterotopia

Science.gov (United States)

Tripathi, Madhavi; Tripathi, Manjari; Kumar, Ganesh; Malhotra, Arun; Bal, Chandra Sekhar

2013-01-01

F-18 Fluorodeoxyglucose (FDG) Positron emission tomography/Computed Tomography (PET/CT) has come to play an increasingly important role for the pre-surgical evaluation of drug resistant epilepsy and complements Magnetic Resonance Imaging (MRI) in the evaluation of grey matter heterotopias. This case illustrates the characteristic pattern of metabolic abnormality in diffuse band heterotopia (DBH) which is otherwise called double cortex syndrome. The presence of metabolic activity in the heterotopic inner cortical band and in the overlying true cortex gives rise to the ‘double cortex’ sign on FDG-PET, concurrent CT provides a good anato-metabolic coregistration. PMID:24379541

Cases of diffusely increased 18F FDG uptake in bone marrow

International Nuclear Information System (INIS)

Suga, Kazuyoshi; Kawakami, Yasuhiko; Matsunaga, Naofumi

2009-01-01

A whole body imaging of 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT provides assessment of FDG uptake in bone marrow and other systemic organs. Diffuse increase of FDG uptake in bone marrow can be associated with leukocytosis, infection, anemia, administration of granulocyte-colony stimulating factor or erythropoietin. and cytokine-producing neoplasms and myeloproliferative syndromes, and etc, and this finding can be an important sign indicative of hyper-metabolism in hemopoietic tissue associated by various etiology. Diffuse increase of FDG uptake in bone marrow affect on FDG uptake in other organs or primary lesions, and must be differentiated from diffuse bone marrow involvement of malignant tumors. In this paper, we report cases of diffuse increase of FDG uptake in bone marrow experienced in our hospital, and discuss the mechanisms and diagnostic importance of this finding, by referring to the published literatures. (author)

The diagnostic ability of {sup 18}F-FDG PET/CT for mediastinal lymph node staging using {sup 18}F-FDG uptake and volumetric CT histogram analysis in non-small cell lung cancer

Energy Technology Data Exchange (ETDEWEB)

Lee, Jeong Won [Catholic Kwandong University College of Medicine, Department of Nuclear Medicine, International St. Mary' s Hospital, Incheon (Korea, Republic of); Kim, Eun Young [Yonsei University College of Medicine, Division of Pulmonology, Department of Internal Medicine, Seoul (Korea, Republic of); Kim, Dae Joon [Yonsei University College of Medicine, Department of Thoracic and Cardiovascular Surgery, Seoul (Korea, Republic of); Lee, Jae-Hoon [Yonsei University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Yonsei University College of Medicine, Department of Nuclear Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of); Kang, Won Jun; Yun, Mijin [Yonsei University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Lee, Jong Doo [Catholic Kwandong University College of Medicine, Department of Radiology, International St. Mary' s Hospital, Incheon (Korea, Republic of)

2016-12-15

To evaluate the clinical implications of lymph node (LN) density on {sup 18}F-FDG PET/CT for mediastinal LN characterization in non-small cell lung cancer (NSCLC). One hundred and fifty-two patients with 271 mediastinal LNs who underwent PET/CT and endobronchial ultrasound-guided transbronchial needle aspiration for staging were enrolled. Maximum standardized uptake value (SUVmax), short axis diameter, LN-to-primary cancer ratio of SUVmax, and median Hounsfield unit (HU) based on CT histogram were correlated to histopathology. Of 271 nodes, 162 (59.8 %) were malignant. SUVmax, short axis diameter, and LPR of malignant LNs were higher than those of benign nodes. Among malignant LNs, 71.0 % had median HU between 25 and 45, while 78.9 % of benign LNs had values <25 HU or >45 HU. Using a cutoff value of 4.0, SUVmax showed the highest diagnostic ability for detecting malignant LNs with a specificity of 94.5 %, but showing a sensitivity of 70.4 %. Using additional density criteria (median HU 25-45) in LNs with 2.0< SUVmax ≤4.0, the sensitivity increased to 88.3 % with the specificity of 82.6 %. LN density is useful for the characterization of LNs with mild {sup 18}F-FDG uptake. The risk of mediastinal LN metastasis in NSCLC patients could be further stratified using both {sup 18}F-FDG uptake and LN density. (orig.)

Single Hind Limb Burn Injury to Mice Alters NF Kappa B (NF-κB) Expression and [18F] 2-Fluoro-2-Deoxy-d-Glucose (FDG) Uptake

Science.gov (United States)

Carter, Edward A.; Hamrahi, Victoria; Paul, Kasie; Bonab, Ali A.; Jung, Walter; Tompkins, Ronald G.; Fischman, Alan J.

2014-01-01

Burn trauma to the extremities can produce marked systemic effects in mice1, 6, 7. Burn injury to the dorsal surface of mice is also associated with changes in glucose metabolism (18FDG uptake) by brown adipose tissue (BAT) and NF-κB activity in a number of tissues including skeletal muscle. This study examined the effect of a single hindlimb burn in mice on 18FDG uptake by in vivo, NF-κB activity in vivo, and blood flow determined by laser Doppler techniques. Male mice NF-κB luciferase reporter mice (28 grams- 30 grams, male) were anesthetized, both legs were shaven, and the right leg was subjected to scald injury by immersion in 90°C water for 5 seconds. Sham treated animals were used as controls. Each burned and sham mouse was resuscitated with saline (2 ml, IP). The individual animals were placed in wire bottom cages with no food and free access to water. 24 hrs later, the animals were imaged with Laser Doppler for measurements of blood flow in the hind limb. The animals were then injected unanesthetized with 50 µCi of FDG or luciferin (1.0 mg), I.V. via tail vein. Five minutes after luciferin injection, NF-kB mice were studied by bioluminescence imaging with a CCD camera. One hour after 18FDG injection the animals were euthanized with carbon dioxide overdose and 18FDG biodistribution was measured. Tissues were also analyzed for NF-κB luciferase activity. The scalding procedure used here produced a full thickness burn injury to the leg with sharp margins. 18FDG uptake by the burned leg was lower than in the contralateral limb. Similarly luciferase activity and blood flow in the burned leg were lower than in the contralateral leg. 18FDG uptake by BAT and heart was increased, while brain was decreased. In conclusion, the present study suggests that burn injury to a single leg reduced 18FDG uptake by skeletal muscle but increased 18FDG uptake by BAT. The injury to the leg reduced NF-κB expression as compared to the contralateral leg and the uninjured

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.

Hepatic FDG Uptake is not associated with hepatic steatosis but with visceral fat volume in cancer screening

Energy Technology Data Exchange (ETDEWEB)

Pak, Kyoung June; Kim, Seong Jang; Kim, In Joo; Kin, Keun Young; Kim, Hee Young; Kim, So Jung [Pusan National Univ. Hospital, Busan (Korea, Republic of)

2012-09-15

We aimed to evaluate the relation between visceral fat volume and fluorodeoxyglucose (FDG)uptake of the liver measured by maximum or mean standardized uptake value. We retrospectively analyzed 96 consecutive records of positron emission tomography/computed tomography (PET/CT)performed for cancer screening between May 2011 and December 2011. Subjects were divided into 2 groups according to Hounsfield unit (HU)of the liver comparing with that of the spleen. The control group (20 women, 56 men)demonstrating HU of the liver equal or greater than that of the spleen included 76 patients, while the fatty liver group (2 Women, 18 men)showing HU of the liver less than that of the spleen included 20 patients. We compared FDG uptake of the liver and visceral fat volume between two groups. We evaluated correlation of hepatic FDG uptake measured by maximum or mean standardized uptake value (SUV)with visceral fat volume and attenuation. The fatty liver disease group showed higher aspartate aminotransferase (AST)of (24.42{+-}7.22, p=0.012), alanine aminotransferase (ALT)of (25.16{+-}11.68, p=0.011), body mass index (BMI)of (24.58{+-}3.29, p=0.021), and visceral fat volume (3063.53{+-}1561.42, p=0.011)than the control group. There were no statistically significant differences of mean standardized uptake value of the liver (liver SUV{sup mean})(2.73{+-}0.19, p=0.723), maximum standardized uptake value of the liver (liver SUV{sup max})(3.39{+-}0.53, p=0.8248)and liver SUV{sup mean}/spleen SUV{sup mean}(1.13{+-}0.10, p=0.081)between the two groups. Strong correlations were shown between liver SUV{sup mean} and BMI (r=0.609, p<0.001)and between liver SUV{sup mean} and visceral fat volume (r=0.457, p<0.001). Liver SUV{sup max} was also strongly correlated with BMI (r=0.622, p=0.001)and visceral fat volume (r=0.547, p<0.001). There was no significant association of mean attenuation value of the liver (liver HU{sup mean})with liver SUV{sup mean} (r=0.003, p=0.979)or liver SUV{sup max} (r

The association of {sup 18}F-FDG PET/CT parameters with survival in malignant pleural mesothelioma

Energy Technology Data Exchange (ETDEWEB)

Klabatsa, Astero; Lang-Lazdunski, Loic [Guys and St Thomas' NHS Foundation Trust, Department of Thoracic Oncology, London (United Kingdom); Chicklore, Sugama; Barrington, Sally F.; Goh, Vicky [Kings College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Cook, Gary J.R. [Kings College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Kings College London, Clinical PET Centre, Division of Imaging Sciences and Biomedical Engineering, St Thomas' Hospital, London (United Kingdom)

2014-02-15

Malignant pleural mesothelioma (MPM) is a disease with poor prognosis despite multimodal therapy but there is variation in survival between patients. Prognostic information is therefore potentially valuable in managing patients, particularly in the context of clinical trials where patients could be stratified according to risk. Therefore we have evaluated the prognostic ability of parameters derived from baseline 2-[{sup 18}F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT). In order to determine the relationships between metabolic activity and prognosis we reviewed all {sup 18}F-FDG PET/CT scans used for pretreatment staging of MPM patients in our institution between January 2005 and December 2011 (n = 60) and measured standardised uptake values (SUV) including mean, maximum and peak values, metabolic tumour volume (MTV) and total lesion glycolysis (TLG). Overall survival (OS) or time to last censor was recorded, as well as histological subtypes. Median follow-up was 12.7 months (1.9-60.9) and median OS was 14.1 months (1.9-54.9). By univariable analysis histological subtype (p = 0.013), TLG (p = 0.024) and MTV (p = 0.038) were significantly associated with OS and SUV{sub max} was borderline (p = 0.051). On multivariable analysis histological subtype and TLG were associated with OS but at borderline statistical significance (p = 0.060 and 0.058, respectively). No statistically significant differences in any PET parameters were found between the epithelioid and non-epithelioid histological subtypes. {sup 18}F-FDG PET/CT parameters that take into account functional volume (MTV, TLG) show significant associations with survival in patients with MPM before adjusting for histological subtype and are worthy of further evaluation to determine their ability to stratify patients in clinical trials. (orig.)

Direct comparison of 18F-FDG and 11C-methionine PET in suspected recurrence of glioma: sensitivity, inter-observer variability and prognostic value

International Nuclear Information System (INIS)

Laere, Koen Van; Ceyssens, Sarah; Mortelmans, Luc; Calenbergh, Frank Van; Groot, Tjibbe de; Bormans, Guy; Menten, Johan; Flamen, Patrick

2005-01-01

18 F-fluorodeoxyglucose (FDG) and 11 C-methionine (MET) PET imaging studies allow the investigation of metabolism and amino acid transport in brain tumours. Their (relative) usefulness and prognostic value in suspected recurrence or progression of primary brain tumours after previous therapy is an issue of debate. The aim of this study was to compare directly both radioligands in this setting. Cerebral uptake of FDG and MET was determined sequentially on the same day in 30 patients (21 males, nine females; age 40.4±15.6 years), on average 4.0 years (range 0.1-18) after therapy for a primary brain tumour (23 grade II-IV astrocytomas, four oligodendrogliomas and three mixed oligo-astrocytomas). Images were acquired on a Siemens HR+ dedicated PET camera. Two observers scored FDG and MET scans independently. Semi-quantitative indices defined by the tumour (maximum)-to-background ratio were calculated based on manual ROI delineation and by using MET ROIs for FDG after automated co-registration. Patient follow-up was conducted until the last contact with inconspicuous clinical findings (average 41 months, range 12-62 months after PET) [(n=10)] or until death (n=20). Overall median survival was 15.0 months. MET showed pathologically increased uptake in 28/30 scans, and FDG in 17/30. The inter-observer agreement was 100% for MET and 73% for FDG. Using Kaplan-Meier survival analysis, significant differences were found for both FDG (cut-off 0.8, log-rank p=0.007) and MET (cut-off 2.2, log-rank p=0.014). The combination of FDG and MET information resulted in the highest prognostic accuracy (p=0.003), while MET alone was the best prognostic predictor in the subgroup of patients with primary astrocytoma (n=23). FDG and MET PET studies provide complementary prognostic information in patients with suspected brain tumour recurrence or progression after primary therapy. MET is considered the single agent of choice in the evaluation of these patients because of its sensitivity and

Quantifying murine bone marrow and blood radiation dose response following {sup 18}F-FDG PET with DNA damage biomarkers

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Manning, Grainne [Biological Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire OX11 ORQ (United Kingdom); Taylor, Kristina [Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, ON (Canada); Finnon, Paul [Biological Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire OX11 ORQ (United Kingdom); Lemon, Jennifer A.; Boreham, Douglas R. [Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, ON (Canada); Badie, Christophe, E-mail: christophe.badie@phe.gov.uk [Biological Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire OX11 ORQ (United Kingdom)

2014-12-15

Highlights: • Mice received either a range of {sup 18}F-FDG activities or whole body X-ray doses. • Blood samples were collected at 24 and 43 h for MN-RET and QPCR analysis. • Regression analysis showed that both types of exposure produced a linear response. • BM doses of 33 mGy ({sup 18}F-FDG) and 25 mGy X-rays were significantly higher than controls. • No significant difference between internal ({sup 18}F-FDG) and external (X-ray) was found. - Abstract: The purpose of this study was to quantify the poorly understood radiation doses to murine bone marrow and blood from whole-body fluorine 18 ({sup 18}F)-fluorodeoxyglucose (FDG) positron emission tomography (PET), by using specific biomarkers and comparing with whole body external low dose exposures. Groups of 3–5 mice were randomly assigned to 10 groups, each receiving either a different activity of {sup 18}F-FDG: 0–37 MBq or whole body irradiated with corresponding doses of 0–300 mGy X-rays. Blood samples were collected at 24 h and at 43 h for reticulocyte micronucleus assays and QPCR analysis of gene expression in peripheral blood leukocytes. Blood and bone marrow dose estimates were calculated from injected activities of {sup 18}F-FDG and were based on a recommended ICRP model. Doses to the bone marrow corresponding to 33.43 mGy and above for internal {sup 18}F-FDG exposure and to 25 mGy and above for external X-ray exposure, showed significant increases in radiation-induced MN-RET formation relative to controls (P < 0.05). Regression analysis showed that both types of exposure produced a linear response with linear regression analysis giving R{sup 2} of 0.992 and 0.999 for respectively internal and external exposure. No significant difference between the two data sets was found with a P-value of 0.493. In vivo gene expression dose–responses at 24 h for Bbc3 and Cdkn1 were similar for {sup 18}F-FDG and X-ray exposures, with significant modifications occurring for doses over 300 mGy for Bbc3

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

FDG uptake heterogeneity in FIGO IIb cervical carcinoma does not predict pelvic lymph node involvement.

Science.gov (United States)

Brooks, Frank J; Grigsby, Perry W

2013-12-23

Many types of cancer are located and assessed via positron emission tomography (PET) using the 18F-fluorodeoxyglucose (FDG) radiotracer of glucose uptake. There is rapidly increasing interest in exploiting the intra-tumor heterogeneity observed in these FDG-PET images as an indicator of disease outcome. If this image heterogeneity is of genuine prognostic value, then it either correlates to known prognostic factors, such as tumor stage, or it indicates some as yet unknown tumor quality. Therefore, the first step in demonstrating the clinical usefulness of image heterogeneity is to explore the dependence of image heterogeneity metrics upon established prognostic indicators and other clinically interesting factors. If it is shown that image heterogeneity is merely a surrogate for other important tumor properties or variations in patient populations, then the theoretical value of quantified biological heterogeneity may not yet translate into the clinic given current imaging technology. We explore the relation between pelvic lymph node status at diagnosis and the visually evident uptake heterogeneity often observed in 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) images of cervical carcinomas. We retrospectively studied the FDG-PET images of 47 node negative and 38 node positive patients, each having FIGO stage IIb tumors with squamous cell histology. Imaged tumors were segmented using 40% of the maximum tumor uptake as the tumor-defining threshold and then converted into sets of three-dimensional coordinates. We employed the sphericity, extent, Shannon entropy (S) and the accrued deviation from smoothest gradients (ζ) as image heterogeneity metrics. We analyze these metrics within tumor volume strata via: the Kolmogorov-Smirnov test, principal component analysis and contingency tables. We found no statistically significant difference between the positive and negative lymph node groups for any one metric or plausible combinations thereof. Additionally

FDG uptake heterogeneity in FIGO IIb cervical carcinoma does not predict pelvic lymph node involvement

International Nuclear Information System (INIS)

Brooks, Frank J; Grigsby, Perry W

2013-01-01

Many types of cancer are located and assessed via positron emission tomography (PET) using the 18F-fluorodeoxyglucose (FDG) radiotracer of glucose uptake. There is rapidly increasing interest in exploiting the intra-tumor heterogeneity observed in these FDG-PET images as an indicator of disease outcome. If this image heterogeneity is of genuine prognostic value, then it either correlates to known prognostic factors, such as tumor stage, or it indicates some as yet unknown tumor quality. Therefore, the first step in demonstrating the clinical usefulness of image heterogeneity is to explore the dependence of image heterogeneity metrics upon established prognostic indicators and other clinically interesting factors. If it is shown that image heterogeneity is merely a surrogate for other important tumor properties or variations in patient populations, then the theoretical value of quantified biological heterogeneity may not yet translate into the clinic given current imaging technology. We explore the relation between pelvic lymph node status at diagnosis and the visually evident uptake heterogeneity often observed in 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) images of cervical carcinomas. We retrospectively studied the FDG-PET images of 47 node negative and 38 node positive patients, each having FIGO stage IIb tumors with squamous cell histology. Imaged tumors were segmented using 40% of the maximum tumor uptake as the tumor-defining threshold and then converted into sets of three-dimensional coordinates. We employed the sphericity, extent, Shannon entropy (S) and the accrued deviation from smoothest gradients (ζ) as image heterogeneity metrics. We analyze these metrics within tumor volume strata via: the Kolmogorov-Smirnov test, principal component analysis and contingency tables. We found no statistically significant difference between the positive and negative lymph node groups for any one metric or plausible combinations thereof. Additionally

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.

Correlation of hypoxic cell fraction with glucose metabolic rate in gliomas with 18F-Fluoromisonidazole (FMISO) and 18F- Fluorodeoxyglucose (FDG) positron emission tomography (PET)

International Nuclear Information System (INIS)

Tauro, A.J.; Scott, A.M.; Hannah, A.; Pathmaraj, K.; Tochon-Danguy, H.; Sachinidis, J.I.; Chan, J.D.; Berlangieri, S.U.; Egan, G.F.; Fabinyi, G.; McKay, W.J.; Cher, L.M.; Austin and Repatriation Medical Centre, Heidelberg, VIC

1998-01-01

Full text: FDG-PET studies of brain tumours to measure tumour activity are well established, with regions of higher grade tumour utilising more glucose compared to lower grade tumour tissue and normal tissue. FDG uptake in tumour cells may reflect anaerobic glycolysis, but this has not been proven in- vivo. FMISO is a novel positron-emitting compound that has been shown to selectively identify hypoxic but viable tissue, which may contribute to chemoradiotherapy resistance in tumour cells. Studies correlating measurements of regional hypoxia and glucose activity within brain tumours prior to therapy may help gain further insight into the relationship between hypoxic tumour tissue and resistance to chemoradiotherapy. Three patients with newly diagnosed primary brain tumours have been prospectively studied with FMISO-PET, FDG-PET and MRI, prior to surgery. Each patient presented with a suspected primary brain glioma on MRI, which were all confirmed to be high grade glioma on subsequent histology at surgery FMISO-PET, FDG-PET and MRI images of all patients were co-registered to precisely identify the areas of metabolic activity within tumour and surrounding cortical tissue. All gliomas demonstrated areas of FMISO uptake, which corresponded to areas of maximal FDG uptake, indicating a correlation between hypoxic areas within tumour with areas of increased glucose metabolic activity. This supports the hypothesis that hypoxic areas within tumour tissue may be associated with increased FDG uptake, although whether hypoxia itself increases FDG uptake remains controversial. These correlative studies characterising areas of hypoxia and glucose activity should hopefully assist in future therapeutic manipulations to improve the outcome from treatment of primary brain tumours

The gender difference in the brain FDG distribution with aging

International Nuclear Information System (INIS)

Nakabeppu, Yoshiaki; Tanabe, Hiroaki; Jinguji, Megumi; Umanodan, Tomokazu; Nakajo, Masayuki; Nakajo, M.; Tateno, T.; Jinnouchi, S.

2007-01-01

The purpose of this study is to examine the change in brain fluorodeoxyglucose (FDG) distribution with aging. Subjects were 85 men and 116 women who had no mental abnormality and no evidence of cancer in the whole body FDG-positron emission tomography (PET) study for cancer checkup. The brain data were extracted from whole body data, and stratified according to the age: 30-39 (M: 10, F: 18), 40-49 (M: 11, F: 14), 50-59 (M: 10, F: 27), 60-64 (M: 11, F: 13), 65-69 (M: 11, F: 11), 70-74 (M: 11, F: 10), 75-79 (M: 13, F: 11), over 80 (M: 8, F: 12) years. Forties or more male and female stratified age groups were compared with each gender 30's age data using Statistical Parametric Mapping (SPM)2. In the man, the FDG activity of the bilateral temporal and frontal lobes decreased and the decreased domains were expanded with aging. But in the females, the decreased domains were complicated in 40-69 years old. Dynamic changes of sex hormones in the individual female menopause may affect the complicated results in the females. Further studies are needed to confirm it. (author)

Simultaneous analysis of FDG, ClDG and Kryptofix 2.2.2 in [18F]FDG preparation by high-performance liquid chromatography with UV detection

International Nuclear Information System (INIS)

Nakao, Ryuji; Ito, Takehito; Yamaguchi, Masatoshi; Suzuki, Kazutoshi

2008-01-01

A practical, sensitive and rapid analytical method was established and validated for chemical impurity tests of 2-deoxy-2-fluoro-D-glucose (FDG), 2-deoxy-2-chloro-D-glucose (ClDG) and Kryptofix 2.2.2 (K-222) in [ 18 F]FDG. This method was based on precolumn derivatization with ultraviolet (UV) detection. FDG and ClDG were rapidly derivatized with 1-phenyl-3-methyl-5-pyrazolone in the presence of borate buffer at 40 o C, and the labeled derivatives and K-222 were separated by reversed-phase high-performance liquid chromatography and monitored by UV absorbance at 210 nm. After optimization of the conditions, FDG, ClDG and K-222 could be determined within 15 min and showed good performance in terms of sensitivity, linearity and reproducibility. This method could be successfully applied to the quality control test of [ 18 F]FDG produced by a commercially available apparatus

Cancer-associated stroma affects FDG uptake in experimental carcinomas. Implications for FDG-PET delineation of radiotherapy target

Energy Technology Data Exchange (ETDEWEB)

Farace, Paolo; Merigo, Flavia; Galie, Mirco; Sbarbati, Andrea; Marzola, Pasquina [University of Verona, Department of Morphological-Biomedical Sciences, Section of Anatomy and Histology, Verona (Italy); D' Ambrosio, Daniela; Nanni, Cristina; Spinelli, Antonello; Fanti, Stefano [Policlinico ' S. Orsola-Malpighi' , Department of Nuclear Medicine, Bologna (Italy); Degrassi, Anna [Nerviano Medical Sciences, Milan (Italy); Rubello, Domenico [' S. Maria della Misericordia' Hospital, PET Centre, Department of Nuclear Medicine, Rovigo (Italy)

2009-04-15

To analyse the influence of cancer-associated stroma on FDG-uptake in two carcinoma models characterized by different stromal degrees. Eight nude mice were subcutaneously injected with DU-145 prostate cancer cells or BXPC-3 pancreatic cancer cells, and underwent FDG-PET imaging about 2 weeks after implantation. After the mice were killed, histology, and CD31 and GLUT1 immunohistochemistry were performed. To further evaluate the highly stromalized carcinoma using perfusion-sensitive imaging, four BXPC-3 tumours underwent two successive albumin-binding (MS-325) MRI scans during tumour growth. FDG uptake was significantly higher in the DU-145 than in the BXPC-3 tumours, which were hardly distinguishable from adjacent normal tissue. In the BXPC-3 tumours, histology confirmed the widespread presence of aberrant infiltrated stroma, embedded with numerous vessels marked by CD31. In both tumour types, the stromal matrix was negative for GLUT1. In DU-145 tumour cells, GLUT1 immunostaining was greater than in BXPC-3 tumour cells, but not homogeneously, since it was less evident in the tumour cells which were nearer to vessels and stroma. Finally, MS-325 MRI always clearly showed areas of enhancement in the BXPC-3 tumours. Cancer-associated stroma has been reported to be capable of aerobic metabolism with low glucose consumption. Furthermore, it has been proposed that regions with high vascular perfusion exhibit a significantly lower FDG uptake, suggesting some vascular/metabolic reciprocity. Since our results are consistent with these recent findings, they signal a risk of tumour volume underestimation in radiotherapy if FDG uptake alone is used for target delineation of carcinomas, which suggests that additional evaluation should be performed using vasculature/perfusion-sensitive imaging. (orig.)

Cancer-associated stroma affects FDG uptake in experimental carcinomas. Implications for FDG-PET delineation of radiotherapy target.

Science.gov (United States)

Farace, Paolo; D'Ambrosio, Daniela; Merigo, Flavia; Galiè, Mirco; Nanni, Cristina; Spinelli, Antonello; Fanti, Stefano; Degrassi, Anna; Sbarbati, Andrea; Rubello, Domenico; Marzola, Pasquina

2009-04-01

To analyse the influence of cancer-associated stroma on FDG-uptake in two carcinoma models characterized by different stromal degrees. Eight nude mice were subcutaneously injected with DU-145 prostate cancer cells or BXPC-3 pancreatic cancer cells, and underwent FDG-PET imaging about 2 weeks after implantation. After the mice were killed, histology, and CD31 and GLUT1 immunohistochemistry were performed. To further evaluate the highly stromalized carcinoma using perfusion-sensitive imaging, four BXPC-3 tumours underwent two successive albumin-binding (MS-325) MRI scans during tumour growth. FDG uptake was significantly higher in the DU-145 than in the BXPC-3 tumours, which were hardly distinguishable from adjacent normal tissue. In the BXPC-3 tumours, histology confirmed the widespread presence of aberrant infiltrated stroma, embedded with numerous vessels marked by CD31. In both tumour types, the stromal matrix was negative for GLUT1. In DU-145 tumour cells, GLUT1 immunostaining was greater than in BXPC-3 tumour cells, but not homogeneously, since it was less evident in the tumour cells which were nearer to vessels and stroma. Finally, MS-325 MRI always clearly showed areas of enhancement in the BXPC-3 tumours. Cancer-associated stroma has been reported to be capable of aerobic metabolism with low glucose consumption. Furthermore, it has been proposed that regions with high vascular perfusion exhibit a significantly lower FDG uptake, suggesting some vascular/metabolic reciprocity. Since our results are consistent with these recent findings, they signal a risk of tumour volume underestimation in radiotherapy if FDG uptake alone is used for target delineation of carcinomas, which suggests that additional evaluation should be performed using vasculature/perfusion-sensitive imaging.

Cancer-associated stroma affects FDG uptake in experimental carcinomas. Implications for FDG-PET delineation of radiotherapy target

International Nuclear Information System (INIS)

Farace, Paolo; Merigo, Flavia; Galie, Mirco; Sbarbati, Andrea; Marzola, Pasquina; D'Ambrosio, Daniela; Nanni, Cristina; Spinelli, Antonello; Fanti, Stefano; Degrassi, Anna; Rubello, Domenico

2009-01-01

To analyse the influence of cancer-associated stroma on FDG-uptake in two carcinoma models characterized by different stromal degrees. Eight nude mice were subcutaneously injected with DU-145 prostate cancer cells or BXPC-3 pancreatic cancer cells, and underwent FDG-PET imaging about 2 weeks after implantation. After the mice were killed, histology, and CD31 and GLUT1 immunohistochemistry were performed. To further evaluate the highly stromalized carcinoma using perfusion-sensitive imaging, four BXPC-3 tumours underwent two successive albumin-binding (MS-325) MRI scans during tumour growth. FDG uptake was significantly higher in the DU-145 than in the BXPC-3 tumours, which were hardly distinguishable from adjacent normal tissue. In the BXPC-3 tumours, histology confirmed the widespread presence of aberrant infiltrated stroma, embedded with numerous vessels marked by CD31. In both tumour types, the stromal matrix was negative for GLUT1. In DU-145 tumour cells, GLUT1 immunostaining was greater than in BXPC-3 tumour cells, but not homogeneously, since it was less evident in the tumour cells which were nearer to vessels and stroma. Finally, MS-325 MRI always clearly showed areas of enhancement in the BXPC-3 tumours. Cancer-associated stroma has been reported to be capable of aerobic metabolism with low glucose consumption. Furthermore, it has been proposed that regions with high vascular perfusion exhibit a significantly lower FDG uptake, suggesting some vascular/metabolic reciprocity. Since our results are consistent with these recent findings, they signal a risk of tumour volume underestimation in radiotherapy if FDG uptake alone is used for target delineation of carcinomas, which suggests that additional evaluation should be performed using vasculature/perfusion-sensitive imaging. (orig.)

Disease activity and {sup 18}F-FDG uptake in organising pneumonia: semi-quantitative evaluation using computed tomography and positron emission tomography

Energy Technology Data Exchange (ETDEWEB)

Tateishi, Ukihide; Arai, Yasuaki [National Cancer Center Hospital, Division of Diagnostic Radiology, Tokyo (Japan); Hasegawa, Tadashi [Sapporo Medical University School of Medicine, Department of Clinical Pathology, Sapporo (Japan); Seki, Kunihiko [National Cancer Center Hospital, Pathology Division, Tokyo (Japan); Terauchi, Takashi; Moriyama, Noriyuki [Research Center for Cancer Prevention and Screening, National Cancer Center, Division of Radiology, Tokyo (Japan)

2006-08-15

Purpose: The present study was conducted to evaluate whether{sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) in combination with computed tomography (CT) reflects disease activity in patients with organising pneumonia.Methods: Eighty-eight subjects who were normal (n=66) or who had proven organising pneumonia (n=22) underwent FDG-PET and CT imaging. The subjects included 55 men and 33 women, ranging in age from 24 to 63 years (mean 47 years). PET and CT data sets were digitally fused using a conformational PET/CT fusion algorithm. All scans were evaluated independently by two chest radiologists who were unaware of other clinical data. The visual score, maximal and mean standardised uptake value (SUV), and maximal and mean lesion-to-normal tissue ratio (LNR) were calculated. The imaging results were compared with the laboratory and pulmonary function test results. The inflammatory cells in the lesions were quantified immunohistochemically. The visual score, maximal and mean SUV, and maximal and mean LNR of the patients with organising pneumonia were significantly higher than those of the normal subjects. The patients with air-space consolidation had a significantly higher SUV than those without air-space consolidation (mean{+-}SD 3.08{+-}0.39 vs 2.35{+-}0.56; p<0.05). The number of CD45{sup +} cells was positively correlated with the maximal SUV (r=0.632, p<0.01) and the maximal LNR (r=0.453, p<0.05). The number of CD8{sup +} T lymphocytes also showed positive correlations with the maximal SUV (r=0.540, p<0.01) and the maximal LNR (r=0.547, p<0.01). Patients with organising pneumonia have an enhanced FDG accumulation which reflects the degree of disease activity. (orig.)

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

Incidental Detection of Temporary Focal FDG Retention in the Spleen

Energy Technology Data Exchange (ETDEWEB)

Park, Youn Joon; Lee, Jai Hyuen; Jee, Keum Nahn; Namgung, Hwan [Dankook Univ. College of Medicine, Seoul (Korea, Republic of)

2011-06-15

F 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is a valuable tool in discriminating malignancy from benign lesion. But because various false positive results reduce the diagnostic specificity, nuclear medicine physicians should be familiar with possible false positive cases. Although many cases of high FDG uptake mimicking malignancy have been reported, temporary intense focal FDG uptake of normal spleen has not been reported previously. We report herein a phenomenon of temporary intense focal FDG uptake of normal spleen without evidence of metastasis in a 46 year old woman with a history of anal cancer.

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

International Nuclear Information System (INIS)

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

2002-01-01

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

Ion chromatographic analysis of high specific activity 18FDG preparations and detection of the chemical impurity 2-deoxy-2-chloro-D-glucose

International Nuclear Information System (INIS)

Alexoff, D.L.; Casati, R.; Fowler, J.S.; Wolf, A.P.; Shea, C.; Schlyer, D.J.; Chyng-Yann Shiue

1992-01-01

Because of the widespread use of 2-deoxy-2-[ 18 F]fluoro-D-glucose(FDG) prepared by the ''Julich'' method or its variants it was decided necessary to determine the major chemical impurities present in the final product. An analytical system for quantifying FDG was developed using pulsed amperometry after separation by high-performance anion exchange chromotography. With this system a heretofore unidentified impurity, 2-deoxy-2-chloro-D-glucose(C1DG) was found in our preparation and in those from other laboratories using the ''Julich'' method. C1DG arises from C1 - ion displacement during the labeling procedure where C1 - ion comes from several sources, and C1 - ion displacement from the HC1 used in the hydrolysis step. FDG mass was present in the same preparations at a level of ca 1-40 μg. Other major chemical constituents were glucose (ca 1-6 mg) and mannose (ca 10-18 μg). Glycerol, arising from sterilizing filters, was also detected in most preparations. Although C1DG is a chemical impurity which has not been detected previously in nca FDG preparations, its biochemical and pharmacological properties are similar to FDG and 2-deoxy-D-glucose. Thus it is unlikely that the presence of small quantities of C1DG found in typical FDG preparations (ca 100 μg) would have adverse pharmacological or toxicological consequences that would limit continued application of this radiopharmaceutical in basic and clinical studies. (Author)

Risk stratification of gallbladder polyps (1-2 cm) for surgical intervention with 18F-FDG PET/CT.

Science.gov (United States)

Lee, Jaehoon; Yun, Mijin; Kim, Kyoung-Sik; Lee, Jong-Doo; Kim, Chun K

2012-03-01

We assessed the value of (18)F-FDG uptake in the gallbladder polyp (GP) in risk stratification for surgical intervention and the optimal cutoff level of the parameters derived from GP (18)F-FDG uptake for differentiating malignant from benign etiologies in a select, homogeneous group of patients with 1- to 2-cm GPs. Fifty patients with 1- to 2-cm GPs incidentally found on the CT portion of PET/CT were retrospectively analyzed. All patients had histologic diagnoses. GP (18)F-FDG activity was visually scored positive (≥liver) or negative (L ratio) were also measured. Univariate and multivariate logistic regression analyses were performed to determine the utility of patient and clinical variables--that is, sex, age, gallstone, polyp size, and three (18)F-FDG-related parameters in risk stratification. Twenty GPs were classified as malignant and 30 as benign. Multivariate analyses showed that the age and all parameters (visual criteria, SUVgp, and GP/L) related to (18)F-FDG uptake were significant risk factors, with the GP/L being the most significant. The sex, size of GPs, and presence of concurrent gallstones were found to be insignificant. (18)F-FDG uptake in a GP is a strong risk factor that can be used to determine the necessity of surgical intervention more effectively than other known risk factors. However, all criteria derived from (18)F-FDG uptake presented in this series may be applicable to the assessment of 1- to 2-cm GPs.

Molecular pathology in vulnerable carotid plaques: correlation with [18]-fluorodeoxyglucose positron emission tomography (FDG-PET)

DEFF Research Database (Denmark)

Graebe, M; Pedersen, Sune Folke; Borgwardt, L

2008-01-01

OBJECTIVES: Atherosclerosis is recognised as an inflammatory disease, and new diagnostic tools are warranted to evaluate plaque inflammatory activity and risk of cardiovascular events. We investigated [18]-fluorodeoxyglucose (FDG) uptake in vulnerable carotid plaques visualised by positron emission...... tomography (PET). Uptake was correlated to quantitative gene expression of known markers of inflammation and plaque vulnerability. METHODS: Ten patients with recent transient ischaemic attack and carotid artery stenosis (>50%) underwent combined FDG-PET and computed tomography angiography (CTA) the day...

An analysis of the physiological FDG uptake pattern in the stomach

International Nuclear Information System (INIS)

Koga, Hirofumi; Kuwabara, Yasuo; Hiraka, Kiyohisa; Nakagawa, Makoto; Abe, Koichiro; Kaneko, Koichiro; Hayashi, Kazutaka; Honda, Hiroshi; Sasaki, Masayuki

2003-01-01

The purpose of this study was to clarify the normal gastric FDG uptake pattern to provide basic information to make an accurate diagnosis of gastric lesions by FDG PET. We examined 22 cases, including 9 of malignant lymphoma, 8 of lung cancer, 2 of esophageal cancer, and 3 of other malignancies. No gastric lesions were observed in any of the 22 cases on upper gastrointestinal examinations using either barium meal or endoscopic techniques. The intervals between FDG PET and the gastrointestinal examination were within one week in all cases. The stomach regions were classified into the following three areas: U (upper)-area, M (middle)-area, and L (lower)-area. The degree of FDG uptake in these three gastric regions was qualitatively evaluated by visual grading into 4 degrees, and then a semiquantitative evaluation was carried out using the standardized uptake value (SUV). Based on a visual grading evaluation, the mean FDG uptake score in the U-, M-, and L-areas was 1.14±0.96, 0.82±0.96, and 0.36±0.49 (mean±S.D.), respectively. The FDG uptake scores obtained in the three areas were significantly different (Friedman test, p M>L. In conclusion, the physiological gastric FDG uptake was significantly higher at the oral end. A stronger gastric FDG uptake at the anal end may therefore be suggestive of a pathological uptake. (author)

Clinical Application of 18F-FDG PET in Multiple Myeloma

International Nuclear Information System (INIS)

Lee, Su Jin; Choi, Joon Young

2009-01-01

This review focuses on the clinical use of 18 F-FDG PET to evaluate multiple myeloma. 18 F-FDG PET is useful for diagnosis, staging of multiple myeloma and differential diagnosis of myeloma related disease such as monoclonal gammopathy of undetermined significance or plasmacytoma. For therapy response, 18 F-FDG PET may be effective after chemotherapy for multiple myeloma and radiotherapy for plasmacytoma

Clinical relevance of F-18 FDG PET for imaging of neuroendocrine tumors

International Nuclear Information System (INIS)

Adams, S.; Baum, R.P.; Hoer, G.

2001-01-01

Neuroendocrine tumors are characterized immunocytochemically by the expression of different peptides and biogenic amines. Hormones induce their biological action by binding to and stimulating specific membrane-associated receptors for e.g. somatostatin. The presence of somatostatin receptors (SR) has been described mainly in endocrine glands and the central nervous system. Interestingly, a large variety of human tumors, including gastroenteropancreatic (GEP) tumors and medullary thyroid carcinomas (MTC) also express a high density of SR and can be imaged with [ 111 In-DTPA-D-Phe 1 ]-pentetreotide. Cell proliferative activity is an important indicator of the growth of various malignant tumors associated with a poorer prognosis and Ki-67 expression. 18 F-FDG is a marker of tumor viability, based upon the increased glycolysis that is associated with malignancy as compared with normal tissue. SR-containing neuroendocrine tumors are well-differentiated and tend to grow slowly. Furthermore, these tumors demonstrate inverse relationship between in vivo SR expression, cell proliferation (low Ki-67 expression) and FDG uptake (normal biodistribution). In comparison, less differentiated tumors, e.g. atypical carcinoids or MTC with increasing CEA levels show mitotic activity (high levels of Ki-67 immunoreactivity and increased FDG uptake) and often lack of SR. In conclusion, SR scintigraphy has been shown to localize well-differentiated neuroendocrine tumors. In contrast, PET imaging is valuable for predicting malignancy only in less differentiated tumors with increased glucose metabolism. Therefore, an additional F-18 FDG PET should be performed if SR scintigraphy (GEP tumors) or combined imaging using [ 111 In-DTPA-D-Phe 1 ]-pentetreotide and 99m Tc(V)-DMSA (MTC) is negative. (orig.) [de

The differentiation of benign from malignant soft tissue lesions using FDG-PET: comparison between semi-quantitative indices

International Nuclear Information System (INIS)

Choi, Joon Young; Lee, Kyung Han; Choe, Yearn Seong; Choi, Yong; Kim, Sang Eun; Kim, Byung Tae; Seo, Jae Gon

1997-01-01

The purpose of this study is to evaluate the diagnostic accuracy of various quantitative indices for the differentiation of benign from malignant primary soft tissue tumors by FDG-EPT. A series of 32 patients with a variety of histologically or clinically confirmed benign (20) or malignant (12) soft tissue lesions were evaluated with emission whole body (5min/bed position) PET after injection of [ 18 F]FDG. Regional 20min transmission scan for the attenuation correction and calculation of SUV was performed in 16 patients (10 benign, 6 malignnant) followed by dynamic acquisition for 56 min. Postinjection transmission scan for the attenuation correction and calculation of SUV was executed in the other 16 patients (10 benign, 6 malignant ). The following indices were obtained: the peak and average SUV (pSUV, aSUV) of lesions, tumor-to-background ratio acquired at images of 51 min p.i. (TBR 51 ), tumor-to-background ratio of areas under time-activity curves (TBR area ) and the ratio between the activities of tumor ROI at 51 min p.i. and at the time which background ROI reaches maximum activity on the time-activity curves (T 51 /T max ). The pSUV, aSUV, TBR 51 , and TBR area in malignant lesions were significantly higher than those in benign lesions. We set the cut-off values of pSUV, aSUV, TBR 51 , TBR area and T 51 /max for the differentiation of benign and malignant lesions at 3.5, 2.8, 5.1, 4.3 and 1.55, respectively. The sensitivity, specificity and accuracy were 91.7%, 80.0%, 84.4% by pSUV and aSUV, 83.3%, 85.0%, 84.4% by TBR 51 , 83.3%, 100%, 93.8% by TBR area and 66.7%, 70.0%, 68.8% by T 51 /T max . The time-activity curves did not give additional information compared to SUV or TBR. The one false negative was a case with low-grade fibrosarcoma and all four false positives were cases with inflammatory change on histology. The visual analysis of FDG-PET also detected the metastatic lesions in malignant cases with comparable accuracy. In conclusion, all pSUV, a