WorldWideScience

Sample records for patient throughput pet

  1. Imaging and PET - PET/CT imaging

    International Nuclear Information System (INIS)

    Von Schulthess, G.K.; Hany, Th.F.

    2008-01-01

    PET/CT has grown because the lack of anatomic landmarks in PET makes 'hardware-fusion' to anatomic cross-sectional data extremely useful. Addition of CT to PET improves specificity, but also sensitivity, and adding PET to CT adds sensitivity and specificity in tumor imaging. The synergistic advantage of adding CT is that the attenuation correction needed for PET data can also be derived from the CT data. This makes PET-CT 25-30% faster than PET alone, leading to higher patient throughput and a more comfortable examination for patients typically lasting 20 minutes or less. FDG-PET-CT appears to provide relevant information in the staging and therapy monitoring of many tumors, such as lung carcinoma, colorectal cancer, lymphoma, gynaecological cancers, melanoma and many others, with the notable exception of prostatic cancer. for this cancer, choline derivatives may possibly become useful radiopharmaceuticals. The published literature on the applications of FDG-PET-CT in oncology is still limited but several designed studies have demonstrated the benefits of PET-CT. (authors)

  2. Positron Emission Tomography (PET)

    International Nuclear Information System (INIS)

    Rollo, F.D.; Hines, H.

    2001-01-01

    ADAC Laboratories has two main imaging strengths: PET and Gamma Cameras. PET's three-dimensional imaging of metabolic function is used in oncology, with emerging opportunties in cardiology, genetic mapping and pharmaceuticals research. In oncology, PET imaging can provide comprehensive and accurate staging information which is not available from CT or MRI. In some cases, this information can lead to modification of treatment, for example from an aggressive approach to one of palliation. The SKYLight is the world's first and only gantry-free camera. It is a dual-detector variable angle camera designed for high throughput, with unsurpassed openness and patient access. (orig.)

  3. The motivations and methodology for high-throughput PET imaging of small animals in cancer research

    Energy Technology Data Exchange (ETDEWEB)

    Aide, Nicolas [Francois Baclesse Cancer Centre, Nuclear Medicine Department, Caen Cedex (France); Caen University, BioTICLA team, EA 4656, IFR 146, Caen (France); Visser, Eric P. [Radboud University Nijmegen Medical Center, Nuclear Medicine Department, Nijmegen (Netherlands); Lheureux, Stephanie [Caen University, BioTICLA team, EA 4656, IFR 146, Caen (France); Francois Baclesse Cancer Centre, Clinical Research Unit, Caen (France); Heutte, Natacha [Francois Baclesse Cancer Centre, Clinical Research Unit, Caen (France); Szanda, Istvan [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Hicks, Rodney J. [Peter MacCallum Cancer Centre, Centre for Molecular Imaging, East Melbourne (Australia)

    2012-09-15

    Over the last decade, small-animal PET imaging has become a vital platform technology in cancer research. With the development of molecularly targeted therapies and drug combinations requiring evaluation of different schedules, the number of animals to be imaged within a PET experiment has increased. This paper describes experimental design requirements to reach statistical significance, based on the expected change in tracer uptake in treated animals as compared to the control group, the number of groups that will be imaged, and the expected intra-animal variability for a given tracer. We also review how high-throughput studies can be performed in dedicated small-animal PET, high-resolution clinical PET systems and planar positron imaging systems by imaging more than one animal simultaneously. Customized beds designed to image more than one animal in large-bore small-animal PET scanners are described. Physics issues related to the presence of several rodents within the field of view (i.e. deterioration of spatial resolution and sensitivity as the radial and the axial offsets increase, respectively, as well as a larger effect of attenuation and the number of scatter events), which can be assessed by using the NEMA NU 4 image quality phantom, are detailed. (orig.)

  4. PET/MRI in cancer patients

    DEFF Research Database (Denmark)

    Kjær, Andreas; Loft, Annika; Law, Ian

    2013-01-01

    Combined PET/MRI systems are now commercially available and are expected to change the medical imaging field by providing combined anato-metabolic image information. We believe this will be of particular relevance in imaging of cancer patients. At the Department of Clinical Physiology, Nuclear...... described include brain tumors, pediatric oncology as well as lung, abdominal and pelvic cancer. In general the cases show that PET/MRI performs well in all these types of cancer when compared to PET/CT. However, future large-scale clinical studies are needed to establish when to use PET/MRI. We envision...... that PET/MRI in oncology will prove to become a valuable addition to PET/CT in diagnosing, tailoring and monitoring cancer therapy in selected patient populations....

  5. High throughput static and dynamic small animal imaging using clinical PET/CT: potential preclinical applications

    International Nuclear Information System (INIS)

    Aide, Nicolas; Desmonts, Cedric; Agostini, Denis; Bardet, Stephane; Bouvard, Gerard; Beauregard, Jean-Mathieu; Roselt, Peter; Neels, Oliver; Beyer, Thomas; Kinross, Kathryn; Hicks, Rodney J.

    2010-01-01

    The objective of the study was to evaluate state-of-the-art clinical PET/CT technology in performing static and dynamic imaging of several mice simultaneously. A mouse-sized phantom was imaged mimicking simultaneous imaging of three mice with computation of recovery coefficients (RCs) and spillover ratios (SORs). Fifteen mice harbouring abdominal or subcutaneous tumours were imaged on clinical PET/CT with point spread function (PSF) reconstruction after injection of [18F]fluorodeoxyglucose or [18F]fluorothymidine. Three of these mice were imaged alone and simultaneously at radial positions -5, 0 and 5 cm. The remaining 12 tumour-bearing mice were imaged in groups of 3 to establish the quantitative accuracy of PET data using ex vivo gamma counting as the reference. Finally, a dynamic scan was performed in three mice simultaneously after the injection of 68 Ga-ethylenediaminetetraacetic acid (EDTA). For typical lesion sizes of 7-8 mm phantom experiments indicated RCs of 0.42 and 0.76 for ordered subsets expectation maximization (OSEM) and PSF reconstruction, respectively. For PSF reconstruction, SOR air and SOR water were 5.3 and 7.5%, respectively. A strong correlation (r 2 = 0.97, p 2 = 0.98; slope = 0.89, p 2 = 0.96; slope = 0.62, p 68 Ga-EDTA dynamic acquisition. New generation clinical PET/CT can be used for simultaneous imaging of multiple small animals in experiments requiring high throughput and where a dedicated small animal PET system is not available. (orig.)

  6. PET/CT in lymphoma patients; PET-CT bei Lymphompatienten

    Energy Technology Data Exchange (ETDEWEB)

    Steinert, H.C. [Universitaetsspital Zuerich, Klinik und Poliklinik fuer Nuklearmedizin (Switzerland)

    2004-11-01

    First results of PET/CT in Hodgkin's disease (HD) and aggressive non-Hodgkin's lymphoma (NHL) are reported. From March 2001 to August 2004 822 PET/CT were performed at our clinic in lymphoma patients for primary staging, restaging after therapy, and diagnosis of recurrence. For coregistration non contrast-enhanced low-dose CT were used. Due to the exact anatomic localization of {sup 18}F-FDG accumulating lesions equivocal or false positive PET findings are avoided. In comparison to contrast enhanced CT, PET/CT has a higher sensitivity and specificity in patients with HD and aggressive NHL. Integration of PET/CT in treatment planning of radiation therapy optimizes the field volume. Even in the initial phase of clinical evaluation, PET/CT has proven useful in staging and restaging of lymphoma. The exact anatomic localization of the PET findings is essential for a precise report, for treatment planning of radiation therapy, and for planning surgical biopsy. (orig.) [German] Erste Ergebnisse der PET-CT bei Morbus Hodgkin (HD) und den aggressiven Non-Hodgkin-Lymphomen (NHL) werden beschrieben. Von Maerz 2001 bis August 2004 wurden 822 PET-CT bei Lymphompatienten zum primaeren Staging, zum Restaging nach Therapie und zur Rezidivdiagnostik an unserer Klinik durchgefuehrt. Fuer die Koregistration wurde ein Low-dose-CT ohne i.v.-Kontrastmittel verwendet. Durch die exakte anatomische Zuordnung der {sup 18}F-FDG aufnehmenden Laesionen wurden unklare oder falsch-positive PET-Befunde vermieden. Die PET-CT erzielte im Vergleich zur KM-verstaerkten CT eine hoehere Sensitivitaet und Spezifitaet bei Patienten mit HD und aggressiven NHL. Die Integration der PET-CT in die Planung der Strahlentherapie fuehrte zu einer Optimierung der Feldgrenzen. Die PET-CT hat sich bereits in der Phase der initialen klinischen Evaluation als wertvoll beim Staging und Restaging von Lymphomen erwiesen. Die exakte anatomische Zuordnung der PET-Informationen ist fuer eine sichere Befundung

  7. NiftyPET: a High-throughput Software Platform for High Quantitative Accuracy and Precision PET Imaging and Analysis.

    Science.gov (United States)

    Markiewicz, Pawel J; Ehrhardt, Matthias J; Erlandsson, Kjell; Noonan, Philip J; Barnes, Anna; Schott, Jonathan M; Atkinson, David; Arridge, Simon R; Hutton, Brian F; Ourselin, Sebastien

    2018-01-01

    We present a standalone, scalable and high-throughput software platform for PET image reconstruction and analysis. We focus on high fidelity modelling of the acquisition processes to provide high accuracy and precision quantitative imaging, especially for large axial field of view scanners. All the core routines are implemented using parallel computing available from within the Python package NiftyPET, enabling easy access, manipulation and visualisation of data at any processing stage. The pipeline of the platform starts from MR and raw PET input data and is divided into the following processing stages: (1) list-mode data processing; (2) accurate attenuation coefficient map generation; (3) detector normalisation; (4) exact forward and back projection between sinogram and image space; (5) estimation of reduced-variance random events; (6) high accuracy fully 3D estimation of scatter events; (7) voxel-based partial volume correction; (8) region- and voxel-level image analysis. We demonstrate the advantages of this platform using an amyloid brain scan where all the processing is executed from a single and uniform computational environment in Python. The high accuracy acquisition modelling is achieved through span-1 (no axial compression) ray tracing for true, random and scatter events. Furthermore, the platform offers uncertainty estimation of any image derived statistic to facilitate robust tracking of subtle physiological changes in longitudinal studies. The platform also supports the development of new reconstruction and analysis algorithms through restricting the axial field of view to any set of rings covering a region of interest and thus performing fully 3D reconstruction and corrections using real data significantly faster. All the software is available as open source with the accompanying wiki-page and test data.

  8. 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.

  9. F-FDG PET/CT (PET/CT) influences management in patients with known or suspected pancreatic cancer

    International Nuclear Information System (INIS)

    Barber, Thomas W.; Kalff, Victor; Cherk, Martin H.; Yap, Kenneth SK.; Evans, Peter; Kelly, Michael J.

    2009-01-01

    Full text: Objective: To assess the impact on clinical management of PET/CT in patients with known or suspected pancreatic cancer. Methods: Between April 2006 and September 2008,25 PET/CT scans were performed using a dedicated PET/CT (22 scans) or a coincidence hybrid PET/CT camera (3 scans) in 23 patients with known or suspected pancreatic cancer. 17 scans were performed for initial evaluation and 8 for restaging of disease. The pre-PET/CT management plan and for intent were prospectively recorded in all cases. The post-PET/CT management plan was determined from the medical record and for discussions with treating clinicians. The impact of PET/CT on management was classified as High, Medium, Low or None, defined using ANZAPNM PET data collection project criteria. Follow-up was used to reconcile any discordance between PET/CT and conventional imaging. Results: Overall, PET/CT management impact was classified as high (n equal 7), medium (n equal 4), low (n equal 10) or none (n equal 4). Impact was either high or medium in l l/25 patients (44%) (95% confidence interval; 24 - 64%). Impact was high in 4/17 patients imaged for initial evaluation, predominantly by clarifying equivocal lesions on conventional imaging. In restaged patients, PET/CT impact was high in 3/8, and it correctly modified disease extent in 5/8. In the 16 discordant studies, PET/CT assessment was correct in 10, conventional imaging in 4 and there was insufficient information in 2. Conclusion: PET/CT has high or medium management impact in 44% of patients imaged for known or suspected pancreatic cancer, more commonly during restaging. Discordant PET/CT results were usually correct.

  10. Comparison between PET/MR and PET/CT in evaluation of oncological patients%PET/MR与PET/CT的对比研究

    Institute of Scientific and Technical Information of China (English)

    徐白萱; 富丽萍; 关志伟; 尹大一; 刘家金; 杨晖; 张锦明; 陈英茂; 安宁豫

    2014-01-01

    Objective To verify the feasibility of the integrated PET/MR for oncological applications by comparing PET/MR with PET/CT in terms of lesion detection and quantitative measurement.Methods A total of 277 patients (165 males,112 females,average age (52.9± 12.6) years) voluntarily participated in this same-day PET/CT and PET/MR comparative study.The time interval between the two studies was 15-35 min.PET/CT images were acquired and reconstructed following standard protocols.PET/MR covered the body trunk with a sequence combination of transverse T1 weighted imaging (WI) 3D-volumetric interpolated breath-hold,T2WI turbo spin echo with fat saturation,diffusion-weighted imaging,and simultaneous PET acquisition.PET images were reconstructed by vender-provided attenuation correction methods.The results of PET/CT and PET/MR were regarded as positive if any modality (CT,PET or MRI) was positive.SUVmax was obtained by the manually drawn ROI.Detection rates were compared with x2 test and SUVmax from the two modalities was analyzed with Spearman correlation analysis.Results A total of 353 lesions were detected in 220 patients.Compared to PET/CT,PET/MR revealed 30 additional true-positive lesions,while missed 6.The detection rates between PET/CT and PET/MR were significantly different (P<0.05).The lesion-based and patient-based consistency was 89.8% (317/353) and 85.9% (189/220),respectively.There were significant correlations of SUVmax between PET/MR and PET/CT for lesions(rs =0.91,P<0.01) and for normal tissues(rs =0.62-0.76,all P<0.01).Conclusions With reference to PET/CT,integrated PET/MR may provide comparable semi-quantitative measurements of pathological lesions as well as normal tissues.Integrated PET/MR may be more effective to detect lesions in abdomen and pelvis.%目的 通过与PET/CT在病灶检测及定量分析方面的比较,论证PET/MR一体机应用于临床的可行性.方法 2012年5月至2013年2月共300例患者同天间隔15 ~ 35 min行PET/CT和PET

  11. FDG PET and PET-CT for the detection of bone metastases in patients with head and neck cancer. A meta-analysis

    International Nuclear Information System (INIS)

    Yi, Xuelin; Zhang, Hongting; Liu, Shixi; Fan, Min; Liu, Yilin

    2013-01-01

    We performed a meta-analysis to evaluate 18FDG PET/PET-CT for the detection of bone metastases in patients with head and neck cancer. We calculated sensitivities, specificities, likelihood ratios, and constructed summary receiver operating characteristic curves for PET and PET-CT, respectively. We also compared the performance of PET/PET-CT with that of bone scintigraphy by analysing studies that had also used bone scintigraphy on the same patients. Across 9 PET studies (1621 patients) and 10 PET-CT studies (1291 patients), sensitivity and specificity of PET were 0.81 and 0.99, and of PET-CT were 0.89 and 0.99, respectively. In 5 comparative studies (1184 patients), sensitivity and specificity of PET/PET-CT were 0.85 and 0.98, and of bone scintigraphy were 0.55 and 0.98, respectively. 18FDG PET and PET-CT have high sensitivity and accuracy for the detection of bone metastasis in patients with head and neck cancer.

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

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

    International Nuclear Information System (INIS)

    Berthelsen, A.K.; Holm, S.; Loft, A.; Klausen, T.L.; Andersen, F.; Hoejgaard, L.

    2005-01-01

    If the CT scan of a combined PET/CT study is performed as a full diagnostic quality CT scan including intravenous (IV) contrast agent, the quality of the joint PET/CT procedure is improved and a separate diagnostic CT scan can be avoided. CT with IV contrast can be used for PET attenuation correction, but this may result in a bias in the attenuation factors. The clinical significance of this bias has not been established. Our aim was to perform a prospective clinical study where each patient had CT performed with and without IV contrast agent to establish whether PET/CT with IV contrast can be used for PET attenuation without reducing the clinical value of the PET scan. A uniform phantom study was used to document that the PET acquisition itself is not significantly influenced by the presence of IV contrast medium. Then, 19 patients referred to PET/CT with IV contrast underwent CT scans without, and then with contrast agent, followed by an 18 F-fluorodeoxyglucose whole-body PET scan. The CT examinations were performed with identical parameters on a GE Discovery LS scanner. The PET data were reconstructed with attenuation correction based on the two CT data sets. A global comparison of standard uptake value (SUV) was performed, and SUVs in tumour, in non-tumour tissue and in the subclavian vein were calculated. Clinical evaluation of the number and location of lesions on all PET/CT scans was performed twice, blinded and in a different random order, by two independent nuclear medicine specialists. In all patients, the measured global SUV of PET images based on CT with IV contrast agent was higher than the global activity using non-contrast correction. The overall increase in the mean SUV (for two different conversion tables tested) was 4.5±2.3% and 1.6±0.5%, respectively. In 11/19 patients, focal uptake was identified corresponding to malignant tumours. Eight out of 11 tumours showed an increased SUV max (2.9±3.1%) on the PET images reconstructed using IV contrast

  14. 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.)

  15. Value of {sup 11}C-choline PET and PET/CT in patients with suspected prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Scher, Bernhard; Albinger, Wolfram; Tiling, Reinhold; Gildehaus, Franz-Josef; Dresel, Stefan [University of Munich, Department of Nuclear Medicine, Munich (Germany); Seitz, Michael [University of Munich, Department of Urology, Munich (Germany); Scherr, Michael; Becker, Hans-Christoph [University of Munich, Department of Radiology, Munich (Germany); Souvatzogluou, Michael; Wester, Hans-Juergen [Technical University of Munich, Department of Nuclear Medicine, Munich (Germany)

    2007-01-15

    The value and limitations of {sup 11}C-choline PET and PET/CT for the detection of prostate cancer remain controversial. The aim of this study was to investigate the diagnostic efficacy of {sup 11}C-choline PET and PET/CT in a large group of patients with suspected prostate cancer. Fifty-eight patients with clinical suspicion of prostate cancer underwent {sup 11}C-choline PET (25/58, Siemens ECAT Exact HR+) or PET/CT (33/58, Philips Gemini) scanning. On average, 500 MBq of {sup 11}C-choline was administered intravenously. Studies were interpreted by raters blinded to clinical information and other diagnostic procedures. Qualitative image analysis as well as semiquantitative SUV measurement was carried out. The reference standard was histopathological examination of resection specimens or biopsy. Prevalence of prostate cancer in this selected patient population was 63.8% (37/58). {sup 11}C-choline PET and PET/CT showed a sensitivity of 86.5% (32/37) and a specificity of 61.9% (13/21) in the detection of the primary malignancy. With regard to metastatic spread, PET showed a per-patient sensitivity of 81.8% (9/11) and produced no false positive findings. Based on our findings, differentiation between benign prostatic changes, such as benign prostatic hyperplasia or prostatitis, and prostate cancer is feasible in the majority of cases when image interpretation is primarily based on qualitative characteristics. SUV{sub max} may serve as guidance. False positive findings may occur due to an overlap of {sup 11}C-choline uptake between benign and malignant processes. By providing functional information regarding both the primary malignancy and its metastases, {sup 11}C-choline PET may prove to be a useful method for staging prostate cancer. (orig.)

  16. Value of PET/CT versus PET and CT performed as separate investigations in patients with Hodgkin's disease and non-Hodgkin's lymphoma

    International Nuclear Information System (INIS)

    Fougere, Christian la; Broeckel, Nicole; Pfluger, Thomas; Haug, Alexander; Scher, Bernhard; Hacker, Marcus; Hahn, Klaus; Tiling, Reinhold; Hundt, Walter; Reiser, Maximilan

    2006-01-01

    The aim of this study was to assess the clinical benefit of combined [ 18 F]FDG PET/CT in patients with malignant lymphoma as compared to separately performed PET and CT. Overall, 100 patients with Hodgkin's disease (HD) or non-Hodgkin's lymphoma (NHL) were included in this study. Co-registered PET/CT with [ 18 F]FDG and contrast medium was performed in 50 consecutive patients with NHL (n=38) or HD (n=12) for initial staging (IS) (n=12) or re-treatment staging (RS) (n=38). Another 50 patients with NHL (n=32) or HD (n=18) underwent separate PET and CT investigations within a time frame of 10 days for IS (n=22) or RS (n=28). Lymphoma involvement was separately evaluated for seven different regions in each patient. Each patient had clinical follow-up evaluation for >6 months. PET and CT data were analysed separately as well as side-by-side or in fused mode. In the PET/CT group, region-based evaluation for lymphoma involvement suggested a sensitivity/specificity of 85%/91% for CT, 98%/99% for PET and 98%/99% for PET/CT. In the PET and CT group, region-based evaluation showed a sensitivity/specificity of 87%/80% for CT, 98%/99% for PET and 98%/100% for PET and CT read side by side. PET was superior to CT alone and was improved further by side-by-side reading of both examinations. However, no significant difference was observed between PET/CT and separate PET and CT imaging in patients with lymphoma. (orig.)

  17. Side-by-side reading of PET and CT scans in oncology: Which patients might profit from integrated PET/CT?

    International Nuclear Information System (INIS)

    Reinartz, Patrick; Wieres, Franz-Josef; Schneider, Wolfram; Schur, Alexander; Buell, Ulrich

    2004-01-01

    Most early publications on integrated positron emission tomography/computed tomography (PET/CT) devices have reported the new scanner generation to be superior to conventional PET. However, few of these studies have analysed the situation where, in addition to PET, a current CT scan is available for side-by-side viewing. This fact is important, because combined PET/CT or a software-based fusion of the two modalities may improve diagnosis only in cases where side-by-side reading of PET and CT data does not lead to a definitive diagnosis. The aim of this study was to analyse which patients will profit from integrated PET/CT in terms of lesion characterization. A total of 328 consecutively admitted patients referred for PET in whom a current CT scan was available were included in the study. The localization of all pathological PET lesions, as well as possible infiltration of adjacent anatomical structures, was assessed. Of 467 pathological lesions, 94.0% were correctly assessed with respect to localization and infiltration by either conventional PET alone (51.6%) or combined reading of PET and the already existing CT scans (42.4%). Hence, in only 6.0% of all lesions, affecting 6.7% of all patients, could evaluation have profited from integrated PET/CT. We conclude that side-by-side viewing of PET and CT scans is essential, as in 42.4% of all cases, combined viewing was important for a correct diagnosis in our series. In up to 6.7% of patients, integrated PET/CT might have given additional information, so that in nearly 50% of patients some form of combined viewing of PET and CT data is needed for accurate lesion characterization. (orig.)

  18. PET imaging in patients with Modic changes

    International Nuclear Information System (INIS)

    Albert, H.B.; Manniche, C.; Petersen, H.; Hoeilund-Carlsen, P.F.

    2009-01-01

    The aim of this study was via PET imaging to reveal if any highly metabolic processes were occurring in Modic changes type 1 and/or in the adjacent discs. Modic changes (MC) are signal changes in the vertebral endplate and body visualised by magnetic resonance imaging (MRI). MC are strongly associated with low back pain (LBP). MC type 1 appear to be inflammation on MRI, and histological and biochemical findings make it highly likely that an inflammation is present. Though MC is painful no known treatment is available, and it is unknown which entities affect the progress or regress of MC. The changes observed on MRI are slow and take months to develop, but faster changes in the metabolism might provide a platform for monitoring patients. Patients from The Back Centre Funen, with low back pain in the area of L1 to S1, MC type 1 in L1 to L5, and a previous herniated lumbar disc. All patients had a PET scan using FDG ( 18 F-fluorodeoxyglucose) as tracer. Included in the study were 11 patients, 4 women and 7 men, mean age 48.1 year (range 20-65). All MC were situated in the vertebrae both above and below the previously herniated disc/discs. Ten patients had MC at 1 level, and 1 had MC at 2 levels. The affected levels were 1 at L2/L3, 6 at L4 /L5, and 5 at L5/S1. All had a previous disc herniation and MC larger than 4 mm in diameter. Technically satisfactory PET scans were obtained. However, PET imaging showed no increases in metabolism in any vertebra or disc of any patient. Modic type 1 changes do not reveal themselves by showing increased metabolism with ordinary FDG PET imaging. PET tracers illuminating inflammation are being developed and hopefully may become more successful. (orig.)

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  20. The clinical impact of PET scanning in patients with melanoma: A prospective study

    International Nuclear Information System (INIS)

    Kalff, V.; Hicks, R.J.; Binns, D.S.; Henderson, M.A.; Ainslie, J.; Jenner, D.A.

    1998-01-01

    Full text: Small series have shown that PET scanning using F-18 fluorodeoxyglucose (FDG), can quite accurately stage patients melanoma. At this Institute these patients are only sent for PET imaging if they have high risk melanomas ( >3 Clarke's grade primaries) or there remains any significant doubt as to their clinical staging or management after the completion of conventional screening. This prospective study examines how PET scan findings influenced the clinical management decisions in 53 patients (29 males, mean age 54±13 yrs: range 31-81 yrs) Referring doctors were asked to indicate reason for the PET scan, stage their patients on the basis of all their current investigations, and to indicate their management plans prior to PET scanning. Follow-up of subsequent patient management at 2-4 weeks post PET scan was then obtained and compared to pre PET plans. PET was used to stage 26 patients, restage 17, follow-up 5, assess recurrence in 3, and other in 2 patients. To date follow-up has shown that in 32/49 (65%) patients PET was used to triage patients to locoregional surgery (10 patients), radical radiotherapy (5 patients), or to continuing follow-up only (17 patients). Three further high risk patients with negative PET scans had sentinel mode biopsy. In only 13 patients was management already determined, with planned treatment being changed in 6. Four patients have not had their post PET scan review yet. To date proven false negative PET scans have occurred in 3 cases, 2 sentinel node biopsies showed microscopic disease, and one scan incorrectly labelled gall-bladder melanoma as hydro-nephrotic kidney. Interestingly in 3 cases, PET discovered other unsuspected tumours (rectum x 2, plasmacytoma). PET scanning has been incorporated into routine management to triage most high risk patients, but it still alters interventions in half of those patients where management has already been planned. PET clearly misses small volume disease, the importance of which is

  1. 11C-methionine PET as a prognostic marker in patients with glioma: comparison with18F-FDG PET

    International Nuclear Information System (INIS)

    Kim, Sungeun; Chung, June-Key; Jeong, Jae Min; Im, So-Hyang; Kim, Dong Gyu; Jung, Hee Won; Lee, Dong Soo; Lee, Myung Chul

    2005-01-01

    The purpose of this study was to compare the prognostic value of 11 C-methionine (MET) and 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in glioma patients. The study population comprised 47 patients with gliomas (19 glioblastoma, 28 others). Pretreatment magnetic resonance imaging, MET PET and FDG PET were performed within a time interval of 2 weeks in all patients. The uptake ratio and standard uptake values were calculated. Univariate and multivariate analyses were done to determine significant prognostic factors. Ki-67 index was measured by immunohistochemical staining, and compared with FDG and MET uptake in glioma. Among the several clinicopathological prognostic factors, tumour pathology (glioblastoma or not), age (≥60 or <60 years), Karnofsky performance status (KPS) (≥70 or <70) and MET PET (higher uptake or not compared with normal cortex) were found to be significant predictors by univariate analysis. In multivariate analysis, tumour pathology, KPS and MET PET were identified as significant independent predictors. The Ki-67 proliferation index was significantly correlated with MET uptake (r=0.64), but not with FDG uptake. Compared with FDG PET in glioma, MET PET was an independent significant prognostic factor and MET uptake was correlated with cellular proliferation. MET PET may be a useful biological prognostic marker in glioma patients. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-12-15

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

  3. Early interim 18F-FDG PET in Hodgkin's lymphoma: evaluation on 304 patients

    International Nuclear Information System (INIS)

    Zinzani, Pier Luigi; Stefoni, Vittorio; Broccoli, Alessandro; Argnani, Lisa; Baccarani, Michele; Rigacci, Luigi; Puccini, Benedetta; Castagnoli, Antonio; Vaggelli, Luca; Zanoni, Lucia; Fanti, Stefano

    2012-01-01

    The use of early (interim) PET restaging during first-line therapy of Hodgkin's lymphoma (HL) in clinical practice has considerably increased because of its ability to provide early recognition of treatment failure allowing patients to be transferred to more intensive treatment regimens. Between June 1997 and June 2009, 304 patients with newly diagnosed HL (147 early stage and 157 advanced stage) were treated with the ABVD regimen at two Italian institutions. Patients underwent PET staging and restaging at baseline, after two cycles of therapy and at the end of the treatment. Of the 304 patients, 53 showed a positive interim PET scan and of these only 13 (24.5%) achieved continuous complete remission (CCR), whereas 251 patients showed a negative PET scan and of these 231 (92%) achieved CCR. Comparison between interim PET-positive and interim PET-negative patients indicated a significant association between PET findings and 9-year progression-free survival and 9-year overall survival, with a median follow-up of 31 months. Among the early-stage patients, 19 had a positive interim PET scan and only 4 (21%) achieved CCR; among the 128 patients with a negative interim PET scan, 122 (97.6%) achieved CCR. Among the advanced-stage patients, 34 showed a persistently positive PET scan with only 9 (26.4%) achieving CCR, whereas 123 showed a negative interim PET scan with 109 (88.6%) achieving CCR. Our results demonstrate the role of an early PET scan as a significant step forward in the management of patients with early-stage or advanced-stage HL. (orig.)

  4. (18)F-FDG PET-CT simulation for non-small-cell lung cancer: effect in patients already staged by PET-CT.

    Science.gov (United States)

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

    2010-05-01

    Positron emission tomography (PET), in addition to computed tomography (CT), has an effect in target volume definition for radical radiotherapy (RT) for non-small-cell lung cancer (NSCLC). In previously PET-CT staged patients with NSCLC, we assessed the effect of using an additional planning PET-CT scan for gross tumor volume (GTV) definition. A total of 28 patients with Stage IA-IIIB NSCLC were enrolled. All patients had undergone staging PET-CT to ensure suitability for radical RT. Of the 28 patients, 14 received induction chemotherapy. In place of a RT planning CT scan, patients underwent scanning on a PET-CT scanner. In a virtual planning study, four oncologists independently delineated the GTV on the CT scan alone and then on the PET-CT scan. Intraobserver and interobserver variability were assessed using the concordance index (CI), and the results were compared using the Wilcoxon signed ranks test. PET-CT improved the CI between observers when defining the GTV using the PET-CT images compared with using CT alone for matched cases (median CI, 0.57 for CT and 0.64 for PET-CT, p = .032). The median of the mean percentage of volume change from GTV(CT) to GTV(FUSED) was -5.21% for the induction chemotherapy group and 18.88% for the RT-alone group. Using the Mann-Whitney U test, this was significantly different (p = .001). PET-CT RT planning scan, in addition to a staging PET-CT scan, reduces interobserver variability in GTV definition for NSCLC. The GTV size with PET-CT compared with CT in the RT-alone group increased and was reduced in the induction chemotherapy group.

  5. 18F-FDG PET-CT Simulation for Non-Small-Cell Lung Cancer: Effect in Patients Already Staged by PET-CT

    International Nuclear Information System (INIS)

    Hanna, Gerard G.; McAleese, Jonathan; Carson, Kathryn J.; Stewart, David P.; Cosgrove, Vivian P.; Eakin, Ruth L.; Zatari, Ashraf; Lynch, Tom; Jarritt, Peter H.; Young, V.A. Linda D.C.R.; O'Sullivan, Joe M.

    2010-01-01

    Purpose: Positron emission tomography (PET), in addition to computed tomography (CT), has an effect in target volume definition for radical radiotherapy (RT) for non-small-cell lung cancer (NSCLC). In previously PET-CT staged patients with NSCLC, we assessed the effect of using an additional planning PET-CT scan for gross tumor volume (GTV) definition. Methods and Materials: A total of 28 patients with Stage IA-IIIB NSCLC were enrolled. All patients had undergone staging PET-CT to ensure suitability for radical RT. Of the 28 patients, 14 received induction chemotherapy. In place of a RT planning CT scan, patients underwent scanning on a PET-CT scanner. In a virtual planning study, four oncologists independently delineated the GTV on the CT scan alone and then on the PET-CT scan. Intraobserver and interobserver variability were assessed using the concordance index (CI), and the results were compared using the Wilcoxon signed ranks test. Results: PET-CT improved the CI between observers when defining the GTV using the PET-CT images compared with using CT alone for matched cases (median CI, 0.57 for CT and 0.64 for PET-CT, p = .032). The median of the mean percentage of volume change from GTV CT to GTV FUSED was -5.21% for the induction chemotherapy group and 18.88% for the RT-alone group. Using the Mann-Whitney U test, this was significantly different (p = .001). Conclusion: PET-CT RT planning scan, in addition to a staging PET-CT scan, reduces interobserver variability in GTV definition for NSCLC. The GTV size with PET-CT compared with CT in the RT-alone group increased and was reduced in the induction chemotherapy group.

  6. Advantage of FMISO-PET over FDG-PET for predicting histological response to preoperative chemotherapy in patients with oral squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Jun; Kitagawa, Yoshimasa; Yamazaki, Yutaka; Hata, Hironobu; Asaka, Takuya; Miyakoshi, Masaaki [Hokkaido University, Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Sapporo, Hokkaido (Japan); Okamoto, Shozo; Shiga, Tohru; Tamaki, Nagara [Hokkaido University, Department of Nuclear Medicine, Graduate School of Medicine, Sapporo, Hokkaido (Japan); Shindoh, Masanobu [Hokkaido University Graduate School of Dental Medicine, Department of Oral Pathology and Biology, Sapporo, Hokkaido (Japan); Kuge, Yuji [Hokkaido University, Central Institute of Isotope Science, Sapporo, Hokkaido (Japan)

    2014-11-15

    Hypoxia, a prognostic factor in many types of cancer, can be detected by {sup 18}F-fluoromisonidazole (FMISO) positron emission tomography (PET). It is unclear whether hypoxia reflects the response to chemotherapy in patients with oral squamous cell carcinoma (OSCC). The correlations of FMISO-PET and FDG-PET with histological response to preoperative chemotherapy were therefore assessed in patients with OSCC. This study enrolled 22 patients with OSCC undergoing preoperative chemotherapy. The T-stages were T2 in 6 patients, T3 in 3, and T4a in 13, and the N-stages were N0 in 14 patients, N1 in 3, and N2 in 5. Each patient was evaluated by both FMISO-PET and FDG-PET before surgery, and the maximum standardized uptake value (SUV{sub max}) of FDG- and FMISO-PET and tumor-muscle ratio (TMR) of FMISO-PET were measured. The threshold for the hypoxic volume based on TMR was set at 1.25. The histological response to preoperative chemotherapy was evaluated using operative materials. FMISO-PET and FDG-PET detected uptake by primary OSCCs in 15 (68 %) and 21 (95 %) patients, respectively, and median SUV{sub max}s of FMISO- and FDG-PET in the primary site were 2.0 (range, 1.3-3.5) and 16.0 (range, 1.0-32.2), respectively. The median of FMISO TMR was 1.5 (range, 0.99-2.96). There were five cases whose FMISO TMR was less than 1.25. Histological evaluation showed good response to preoperative chemotherapy in 7 patients (32 %) and poor response in 15 (68 %). Good response was significantly more prevalent in patients with negative than positive FMISO uptake (P < 0.001) and without the hypoxic area evaluated by FMISO-PET TMR (P = 0.04), whereas FDG uptake was not significantly correlated with response to chemotherapy response. Multivariate logistic regression analysis showed that FMISO uptake was an independent significant predictor of response to preoperative chemotherapy (P = 0.03, odds ratio = 0.06, 95 % confidence interval = 0.004-0.759). An advantage of FMISO-PET over FDG-PET

  7. PET/CT in therapy evaluation of patients with lung cancer

    DEFF Research Database (Denmark)

    Langer, Natasha Hemicke; Christensen, Tine Nøhr; Langer, Seppo W

    2014-01-01

    FDG-PET/CT is a well documented and widespread used imaging modality for the diagnosis and staging of patient with lung cancer. FDG-PET/CT is increasingly used for the assessment of treatment effects during and after chemotherapy. However, PET is not an accepted surrogate end-point for assessment...... of response rate in clinical trials. The aim of this review is to present current evidence on the use of PET in response evaluation of patients with lung cancer and to introduce the pearls and pitfalls of the PET-technology relating to response assessment. Based on this and relating to validation criteria......, including stable technology, standardization, reproducibility and broad availability, the review discusses why, despite numerous studies on response assessment indicating a possible role for FDG-PET/CT, PET still has no place in guidelines relating to response evaluation in lung cancer....

  8. Value of integrated PET/CT in clinical staging of patients with lung cancer

    International Nuclear Information System (INIS)

    Zhao Jun; Guan Yihui; Zuo Chuantao; Hua Fengchun; Lin Xiangtong

    2004-01-01

    Objectives: The purpose of this study was to evaluate the value of combined fluorine-18 fluorodeoxyglucose positron emission tomography and computed tomography (FDG PET/CT) in patients with lung cancer, and to compare the results of PET/CT with those of FDG PET and CT alone. Methods: Forty-two patients were studied in this group. 3D whole body images were acquired using Siemens Biograph Sensetionl6 PET/CT scanner. Attenuation corrected PET images, CT and fusion images were interpreted. Reports were compared for each patient including identified the number of lesions, their anatomical localization and certainty of diagnosis. Results: PET/CT increased the number of lesions reported as being definitely abnormal or normal (+22%). In 12 patients (28.6%), the PET/CT report positively impacted surgical management when compared to the PET report alone. 6 patients were correctly downstaged negating further treatment or imaging, 3 patient was upstaged to inoperable and in another 3 ones improved localization by PET/CT led to an altered surgical incision with decreased morbidity. Lesion-based evaluation showed sensitivity for regional lymph node involvement of 61% for CT alone, 88% for FDG PET alone, and 96% for integrated PET/CT imaging respectively. In addition, PET/CT could identify some benign disease, including lung tuberculosis, cyst of liver and kidney, calculus etc. Conclusion: PET/CT improves anatomical localization and increases the certainty in reporting abnormal and normal lesions. PET/CT imaging is superior to CT alone and has additional benefit over FDG PET alone, and is accurate in clinical staging for lung cancer. (authors)

  9. A real-time monitoring study of the personal dose received by nuclear medicine technologists administering 18F-FDG in a high patient throughput PET centre

    International Nuclear Information System (INIS)

    Wallace, Anthony; U, Paul; Hickson, Kevin; Bradley, Jason; Welch, Jessica; Pathmaraj, Kunthi

    2008-01-01

    The rapid growth in PET studies has resulted in an increasing occupational radiation exposure to nuclear medicine staff. This project has used, a real-time, solid-state, 2 second resolution, personal dosimeter to monitor the occupational Hp(10) equivalent dose of nuclear medicine technologist (NMT) staff managing FDG patients. A detailed manual mapping of the patient management procedure, time dependence and distance relationships to the sources of exposure and their magnitudes was undertaken. Experimental results show, that a junior NMT may spend on average 52% of the close contact time (< 2 m) with the patient when administering an FDG dose compared to 36% of that time for the senior NMT. The average daily dose from isotope administration of a junior NMT and senior NMT is 15 μSv and 11.4 μSv respectively. Post-administration, escorting the patient into the scanner room and setting-up the patient on the PET scanner bed, takes approximately 27% of the junior NMT time to perform, which results in an average daily dose of 7.8 μSv. The senior NMT takes approximately 33% of their time for the same task, with an average daily dose of 10.3 μSv. Removing the patient from the scanner room and escorting them from the department takes about 21% of the junior NMT time giving 6.2 μSv of dose and 31% or 9.7 μSv for the senior NMT. At the conclusion of this study the typical daily dose received by NMT staff, working in close contact with FDG patients is approximately 29 μSv for junior NMT (4 - 5 mSv/yr) and 31.4 μSv (5 - 7 mSv/yr) for senior NMT. Currently this centre is performing approximately 3,400 FDG injections per year plus 50 research injections of various positron emitters. This occupational dose load is spread across 3 dedicated PET NMT staff and 1.5 EFT NMT staff rotating through PET centre from the nuclear medicine department and 1 EFT registrar physician. (author)

  10. Clinical utility of flumazenil-PET versus [18F]fluorodeoxyglucose-PET and MRI in refractory partial epilepsy. A prospective study in 100 patients.

    Science.gov (United States)

    Ryvlin, P; Bouvard, S; Le Bars, D; De Lamérie, G; Grégoire, M C; Kahane, P; Froment, J C; Mauguière, F

    1998-11-01

    We assessed the clinical utility of [11C]flumazenil-PET (FMZ-PET) prospectively in 100 epileptic patients undergoing a pre-surgical evaluation, and defined the specific contribution of this neuro-imaging technique with respect to those of MRI and [18F]fluorodeoxyglucose-PET (FDG-PET). All patients benefited from a long term video-EEG monitoring, whereas an intracranial EEG investigation was performed in 40 cases. Most of our patients (73%) demonstrated a FMZ-PET abnormality; this hit rate was significantly higher in temporal lobe epilepsy (94%) than in other types of epilepsy (50%) (P lobe epilepsy associated with MRI signs of hippocampal sclerosis, FMZ-PET abnormalities delineated the site of seizure onset precisely, whenever they were coextensive with FDG-PET abnormalities; (ii) in bi-temporal epilepsy, FMZ-PET helped to confirm the bilateral origin of seizures by showing a specific pattern of decreased FMZ binding in both temporal lobes in 33% of cases; (iii) in patients with a unilateral cryptogenic frontal lobe epilepsy, FMZ-PET provided further evidence of the side and site of seizure onset in 55% of cases. Thus, FMZ-PET deserves to be included in the pre-surgical evaluation of these specific categories of epileptic patients, representing approximately half of the population considered for epilepsy surgery.

  11. The impact of PET scanning on management of paediatric oncology patients

    International Nuclear Information System (INIS)

    Wegner, E.A.; Barrington, S.F.; O'Doherty, M.J.; Kingston, J.E.; Robinson, R.O.; Ferner, R.E.; Taj, M.; Smith, M.A.

    2005-01-01

    Limited information is available on the use of positron emission tomography (PET) in paediatric oncology. The aim of this study was to review the impact of PET on the management of paediatric patients scanned over a 10-year period. One hundred and sixty-five consecutive oncology patients aged 11 months to 17 years were included. Two hundred and thirty-seven scans were performed. Diagnoses included lymphoma (60 patients), central nervous system (CNS) tumour (59), sarcoma (19), plexiform neurofibroma with suspected malignant change (13) and other tumours (14). A questionnaire was sent to the referring clinician to determine whether the PET scan had altered management and whether overall the PET scan was thought to be helpful. One hundred and eighty-nine (80%) questionnaires for 126 patients were returned (63 relating to lymphoma, 62 to CNS tumours, 30 to sarcoma, 16 to plexiform neurofibroma and 18 to other tumours). PET changed disease management in 46 (24%) cases and was helpful in 141 (75%) cases. PET findings were verified by histology, clinical follow-up or other investigations in 141 cases (75%). The returned questionnaires indicated that PET had led to a management change in 20 (32%) lymphoma cases, nine (15%) CNS tumours, four (13%) sarcomas, nine (56%) plexiform neurofibromas and four (22%) cases of other tumours. PET was thought to be helpful in 47 (75%) lymphoma cases, 48 (77%) CNS tumours, 24 (80%) sarcomas, 11 (69%) neurofibromas and 11 (61%) cases of other tumours. PET findings were verified in 44 (70%) lymphoma cases, 53 (85%) CNS tumours, 21 (70%) sarcomas, 12 (75%) neurofibromas and 11 (61%) other tumour cases. PET imaging of children with cancer is accurate and practical. PET alters management and is deemed helpful (with or without management change) in a significant number of patients, and the results are comparable with the figures published for the adult oncology population. (orig.)

  12. Simultaneous PET/MR imaging in a human brain PET/MR system in 50 patients-Current state of image quality

    Energy Technology Data Exchange (ETDEWEB)

    Schwenzer, N.F., E-mail: nina.schwenzer@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Tuebingen (Germany); Stegger, L., E-mail: stegger@gmx.net [Department of Nuclear Medicine and European Institute for Molecular Imaging, University of Muenster, Muenster (Germany); Bisdas, S., E-mail: sbisdas@gmail.com [Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls University Tuebingen, Tuebingen (Germany); Schraml, C., E-mail: christina.schraml@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Tuebingen (Germany); Kolb, A., E-mail: armin.kolb@med.uni-tuebingen.de [Laboratory for Preclinical Imaging and Imaging Technology of the Werner Siemens-Foundation, Department of Preclinical Imaging and Radiopharmacy, Eberhard-Karls University Tuebingen, Tuebingen (Germany); Boss, A., E-mail: Andreas.Boss@usz.ch [Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Tuebingen (Germany); Institute of Diagnostic and Interventional Radiology, University Hospital Zuerich, Zuerich (Switzerland); Mueller, M., E-mail: mark.mueller@med.uni-tuebingen.de [Department of Nuclear Medicine, Eberhard-Karls University Tuebingen, Tuebingen (Germany); and others

    2012-11-15

    Objectives: The present work illustrates the current state of image quality and diagnostic accuracy in a new hybrid BrainPET/MR. Materials and methods: 50 patients with intracranial masses, head and upper neck tumors or neurodegenerative diseases were examined with a hybrid BrainPET/MR consisting of a conventional 3T MR system and an MR-compatible PET insert. Directly before PET/MR, all patients underwent a PET/CT examination with either [{sup 18}F]-FDG, [{sup 11}C]-methionine or [{sup 68}Ga]-DOTATOC. In addition to anatomical MR scans, functional sequences were performed including diffusion tensor imaging (DTI), arterial spin labeling (ASL) and proton-spectroscopy. Image quality score of MR imaging was evaluated using a 4-point-scale. PET data quality was assessed by evaluating FDG-uptake and tumor delineation with [{sup 11}C]-methionine and [{sup 68}Ga]-DOTATOC. FDG uptake quantification accuracy was evaluated by means of ROI analysis (right and left frontal and temporo-occipital lobes). The asymmetry indices and ratios between frontal and occipital ROIs were compared. Results: In 45/50 patients, PET/MR examination was successful. Visual analysis revealed a diagnostic image quality of anatomical MR imaging (mean quality score T2 FSE: 1.27 {+-} 0.54; FLAIR: 1.38 {+-} 0.61). ASL and proton-spectroscopy was possible in all cases. In DTI, dental artifacts lead to one non-diagnostic dataset (mean quality score DTI: 1.32 {+-} 0.69; ASL: 1.10 {+-} 0.31). PET datasets of PET/MR and PET/CT offered comparable tumor delineation with [{sup 11}C]-methionine; additional lesions were found in 2/8 [{sup 68}Ga]-DOTATOC-PET in the PET/MR. Mean asymmetry index revealed a high accordance between PET/MR and PET/CT (1.5 {+-} 2.2% vs. 0.9 {+-} 3.6%; mean ratio (frontal/parieto-occipital) 0.93 {+-} 0.08 vs. 0.96 {+-} 0.05), respectively. Conclusions: The hybrid BrainPET/MR allows for molecular, anatomical and functional imaging with uncompromised MR image quality and a high accordance

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  14. Appropriate Use of FDG-PET for the Management of Cancer Patients

    International Nuclear Information System (INIS)

    2010-01-01

    The use of PET (positron emission tomography) has become the standard quality of care for optimal management of patients with cancer. The availability of the hybrid PET/CT (positron emission tomography/computed tomography) scanner has further improved the utility of PET scanning and provides additional benefits both to patients and to the health system. This publication addresses the important issue of appropriateness of the application of PET/CT procedures in different clinical scenarios for many cancers. It is a resource for specialists in nuclear medicine and oncology, and aims to make reliable information widely available to those Member States where PET programmes are still in their planning phase or where the use of PET scanning is limited.

  15. (18F) FDG PET/CT in patients with fever of unknown origin: AIIMS experience

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  16. Factors associated with furry pet ownership among patients with asthma.

    Science.gov (United States)

    Downes, Martin J; Roy, Angkana; McGinn, Thomas G; Wisnivesky, Juan P

    2010-09-01

    Exposure to indoor allergens is an established risk factor for poor asthma control. Current guidelines recommend removing pets from the home of patients with asthma. This cross-sectional study was conducted to determine the prevalence of furry pet ownership in asthmatics compared to non-asthmatics and to identify factors associated with furry pet ownership among those with asthma. Secondary analysis assessed characteristics among asthmatics that might be associated with allowing a furry pet into the bedroom. Using data from The National Asthma Survey collected from 2003 to 2004, we carried out univariate and multiple regression analyses, in 2009, to identify independent predictors of furry pet ownership in asthma sufferers after controlling for potential confounders. Overall, asthmatics were more likely to own a furry pet than nonasthmatic individuals in the general population (49.9% versus 44.8%, p ownership among asthmatics. Additionally, 68.7% of patients with asthma who own a furry pet allowed them into their bedroom. Higher income and carrying out ownership is equally or more common among asthmatics compared to those without asthma. The majority of asthmatics with furry pets allow them into the bedroom. Recognizing and addressing these problems may help decrease asthma morbidity.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-15

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

  18. PET/CT colonography in patients with colorectal polyps: a feasibility study

    International Nuclear Information System (INIS)

    Mainenti, Pier P.; Pace, Leonardo; Salvatore, Marco; Salvatore, Barbara; D'Antonio, Dario; Bucci, Luigi; De Falco, Teresa; De Palma, Giovanni D.; D'Armiento, Francesco P.

    2007-01-01

    To examine: (1) the feasibility of PET/CT colonography (PET/CTc) in patients with colorectal polyps; (2) the impact of metabolic information on CTc interpretation and, conversely, the impact of morphological information on PET characterisation of focal colorectal uptake. Ten patients with colorectal polyps underwent PET/CTc, followed within 3 h by therapeutic conventional colonoscopy (CC). A radiologist and a nuclear medicine physician analysed the PET/CTc images. The agreement of morphological and metabolic information in the colon and rectum was evaluated. The sensitivity and specificity of PET, CT and PET/CT were calculated for colorectal polyps. Seventeen polypoid lesions were identified at CC: six≤5 mm, six between 6 and 9 mm, and five ≥10 mm (four hyperplastic polyps, 11 tubular adenomas, one adenocarcinoma and one submucosal lipoma). A total of 20 scans (supine and prone) were performed in the ten patients: the agreement of morphological and metabolic information was excellent in 17 scans, good in two and moderate in one. PET/CTc showed a sensitivity of 91% for lesions ≥6 mm and a specificity of 100%. The metabolic information did not disclose any further polyps missed on CTc. The morphological information permitted correct classification of all eight instances of focal radiotracer uptake. PET/CTc is a feasible study. Adding a colonographic protocol to PET/CT images seems to allow correct characterisation of all cases of colorectal focal radiotracer uptake. The metabolic information does not seem to increase the accuracy of CTc. (orig.)

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    DEFF Research Database (Denmark)

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

    2005-01-01

    PURPOSE: If the CT scan of a combined PET/CT study is performed as a full diagnostic quality CT scan including intravenous (IV) contrast agent, the quality of the joint PET/CT procedure is improved and a separate diagnostic CT scan can be avoided. CT with IV contrast can be used for PET attenuation...... correction, but this may result in a bias in the attenuation factors. The clinical significance of this bias has not been established. Our aim was to perform a prospective clinical study where each patient had CT performed with and without IV contrast agent to establish whether PET/CT with IV contrast can...... scans without, and then with contrast agent, followed by an 18F-fluorodeoxyglucose whole-body PET scan. The CT examinations were performed with identical parameters on a GE Discovery LS scanner. The PET data were reconstructed with attenuation correction based on the two CT data sets. A global...

  1. Simultaneous 68Ga-DOTATOC PET/MRI in patients with gastroenteropancreatic neuroendocrine tumors: initial results.

    Science.gov (United States)

    Beiderwellen, Karsten J; Poeppel, Thorsten D; Hartung-Knemeyer, Verena; Buchbender, Christian; Kuehl, Hilmar; Bockisch, Andreas; Lauenstein, Thomas C

    2013-05-01

    The aim of this pilot study was to demonstrate the potential of simultaneously acquired 68-Gallium-DOTA-D-Phe1-Tyr3-octreotide (68Ga-DOTATOC) positron emission tomography/magnetic resonance imaging (PET/MRI) in comparison with 68Ga-DOTATOC PET/computed tomography (PET/CT) in patients with known gastroenteropancreatic neuroendocrine tumors (NETs). Eight patients (4 women and 4 men; mean [SD] age, 54 [17] years; median, 55 years; range 25-74 years) with histopathologically confirmed NET and scheduled 68Ga-DOTATOC PET/CT were prospectively enrolled for an additional integrated PET/MRI scan. Positron emission tomography/computed tomography was performed using a triple-phase contrast-enhanced full-dose protocol. Positron emission tomography/magnetic resonance imaging encompassed a diagnostic, contrast-enhanced whole-body MRI protocol. Two readers separately analyzed the PET/CT and PET/MRI data sets including their subscans in random order regarding lesion localization, count, and characterization on a 4-point ordinal scale (0, not visible; 1, benign; 2, indeterminate; and 3, malignant). In addition, each lesion was rated in consensus on a binary scale (allowing for benign/malignant only). Clinical imaging, existing prior examinations, and histopathology (if available) served as the standard of reference. In PET-positive lesions, the standardized uptake value (SUV max) was measured in consensus. A descriptive, case-oriented data analysis was performed, including determination of frequencies and percentages in detection of malignant, benign, and indeterminate lesions in connection to their localization. In addition, percentages in detection by a singular modality (such as PET, CT, or MRI) were calculated. Interobserver variability was calculated (Cohen's κ). The SUVs in the lesions in PET/CT and PET/MRI were measured, and the correlation coefficient (Pearson, 2-tailed) was calculated. According to the reference standard, 5 of the 8 patients had malignant NET lesions at

  2. PET/MRI in cancer patients

    DEFF Research Database (Denmark)

    Kjær, Andreas; Loft, Annika; Law, Ian

    2013-01-01

    Combined PET/MRI systems are now commercially available and are expected to change the medical imaging field by providing combined anato-metabolic image information. We believe this will be of particular relevance in imaging of cancer patients. At the Department of Clinical Physiology, Nuclear Me...

  3. [11C]Flumazenil PET in patients with epilepsy with dual pathology.

    Science.gov (United States)

    Juhász, C; Nagy, F; Muzik, O; Watson, C; Shah, J; Chugani, H T

    1999-05-01

    Coexistence of hippocampal sclerosis and a potentially epileptogenic cortical lesion is referred to as dual pathology and can be responsible for poor surgical outcome in patients with medically intractable partial epilepsy. [11C]Flumazenil (FMZ) positron emission tomography (PET) is a sensitive method for visualizing epileptogenic foci. In this study of 12 patients with dual pathology, we addressed the sensitivity of FMZ PET to detect hippocampal abnormalities and compared magnetic resonance imaging (MRI) with visual as well as quantitative FMZ PET findings. All patients underwent volumetric MRI, prolonged video-EEG monitoring, and glucose metabolism PET before the FMZ PET. MRI-coregistered partial volume-corrected PET images were used to measure FMZ-binding asymmetries by using asymmetry indices (AIs) in the whole hippocampus and in three (anterior, middle, and posterior) hippocampal subregions. Cortical sites of decreased FMZ binding also were evaluated by using AIs for regions with MRI-verified cortical lesions as well as for non-lesional areas with visually detected asymmetry. Abnormally decreased FMZ binding could be detected by quantitative analysis in the atrophic hippocampus of all 12 patients, including three patients with discordant or inconclusive EEG findings. Decreased FMZ binding was restricted to only one subregion of the hippocampus in three patients. Areas of decreased cortical FMZ binding were obvious visually in all patients. Decreased FMZ binding was detected visually in nonlesional cortical areas in four patients. The AIs for these nonlesional regions with visual asymmetry were significantly lower than those for regions showing MRI lesions (paired t test, p = 0.0075). Visual as well as quantitative analyses of FMZ-binding asymmetry are sensitive methods to detect decreased benzodiazepine-receptor binding in the hippocampus and neocortex of patients with dual pathology. MRI-defined hippocampal atrophy is always associated with decreased FMZ

  4. A prospective study of the clinical impact of PET scanning in lung cancer patients

    International Nuclear Information System (INIS)

    Hicks, R.J.; Kalff, V.; Binns, D.S.; McManus, M.; Millward, M.; Ball, D.J.

    1998-01-01

    Full text: PET scanning using F-18 fluorodeoxyglucose (FDG), has been shown to very accurately stage patients with non-small cell lung cancer. At this Institute these patients are only sent for PET imaging where there remains any significant doubt as to their clinical staging or management after the completion of conventional screening test including CT scanning. This study examines how PET scan findings influenced the clinical management decisions in 45 consecutive patients (26 males, mean age 69±9 yrs: range 36-78 yrs). Referring doctors were asked to indicate reason for the PET scan, stage their patients on the basis of aU their current investigations, including CT scans, and to indicate their management plans prior to PET scanning. Follow-up of subsequent patient management at 2-4 weeks post PET scan was then obtained and compared to pre scan plans. Results:, PET was used to stage 27 patients, restage 8, plan radiotherapy in 4, post treatment follow-up in 3, assess solitary nodules in 2, and as a baseline for experimental therapy in 1. To date follow-up has shown that in 14 (31%) patients PET scanning found new distant abnormalities which caused planned radical surgery or radiotherapy to be changed to palliative treatment only. Following PET findings, which clarified equivocal findings on other imaging modalities 9 patients underwent curative lung surgery. This found localised disease only in the 5 who have had surgery to this time. Similarly 7 patients continued on to have radical radiotherapy. In 3 patients, original treatment protocols changed (smaller radiation portal, surgery after good response to radiotherapy, planned chemotherapy ceased). In 8(18%) patients PET scans did not alter planned therapy. 1 patient awaits follow-up. Conclusions: In carefully selected patients with lung cancer, PET scanning significantly affected management decisions in 82%. It was used not only to spare unnecessary treatment, but also to target treatment appropriate to

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  6. [18F]FDG-PET scan in patients with fasting hyperglycemia

    International Nuclear Information System (INIS)

    BELOHLAVEK, Otakar; JARUSKOVA, Monika

    2016-01-01

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

  7. 18F-FDG hybrid PET in patients with suspected spondylitis

    International Nuclear Information System (INIS)

    Gratz, S.; Behr, T.M.; Behe, M.; Doerner, J.; Fischer, U.; Grabbe, E.; Altenvoerde, G.; Meller, J.; Becker, W.

    2002-01-01

    This study investigated the value of fluorine-18 2'-deoxy-2-fluoro-D-glucose (FDG) imaging with a double-headed gamma camera operated in coincidence (hybrid PET) detection mode in patients with suspected spondylitis. Comparison was made with conventional nuclear medicine imaging modalities and magnetic resonance imaging (MRI). Sixteen patients with suspected spondylitis (nine male, seven female, mean age 59 years) prospectively underwent FDG hybrid PET (296 MBq) and MRI. For intra-individual comparison, the patients were also imaged with technetium-99m methylene diphosphonate (MDP) (555 MBq) (n=13) and/or gallium-67 citrate (185 MBq) (n=11). For FDG hybrid PET, two or three transverse scans were performed. Ratios of infected (target) to non-infected (background) (T/B) vertebral bodies were calculated. MR images were obtained of the region of interest. Patients found positive for spondylitis with MRI and/or FDG hybrid PET underwent surgical intervention and histological grading of the individual infected foci. Twelve out of 16 patients were found to be positive for spondylitis. Independent of the grade of infection and the location in the spine, all known infected vertebrae (n=23, 9 thoracic, 12 lumbar, 2 sacral) were detected by FDG hybrid PET. T/B ratios higher than 1.45±0.05 (at 1 h p.i.) were indicative of infectious disease, whereas ratios below this value were found in cases of degenerative change. FDG hybrid PET was superior to MRI in patients who had a history of surgery and suffered from a high-grade infection in combination with paravertebral abscess formation (n=2; further computed tomography was needed) and in those with low-grade spondylitis (n=2, no oedema) or discitis (n=2, mild oedema). False-positive 67 Ga citrate images (n=5: 2 spondylodiscitis, 1 aortitis, 1 pleuritis, 1 pulmonary tuberculosis) and 99m Tc-MDP SPET (n=4: 1 osteoporosis, 2 spondylodiscitis, 1 fracture) were equally well detected by FDG hybrid PET and MRI. No diagnostic problems

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-11-15

    Introduction: FDG, PET is a useful imaging technique in the management of patients with gastrointestinal tumours, mainly in oesophageal and colorectal cancer. In Chile, colorectal cancer is a prevalent disease, representing the 7th cause of death in men and 6th in women. The aim of the study was to assess FDG-PET value in the management of colorectal cancer in the first PET center in Chile. Material and Methods: Population: In a retrospective analysis, we studied 130 patients with 159 PET scans, 56% corresponded to women. Group A rectal cancer: 42 patients (55 studies), mean age 61 {+-} 11 y.o. (range 39-80) Group B colon cancer: 88 patients (104 studies), mean age 61 {+-} 11 y.o. (range 39-80). Referral: In the whole population, 53% were studied by recurrence suspicion (31% with increased CEA levels with negative anatomical imaging), 33% for re-staging, 8% for therapy control and 6% for staging. Eighty-five % was submitted to surgery (range: lm -7y) and 42% presented local or distance dissemination; 70% have received chemotherapy and 23% associated radiotherapy. Technique: Whole-body images were acquired with a dedicated high resolution PET Siemens Ecat Exact HR+ camera 60 minutes after injection of intravenous F18-FDG, produced at the Chilean Nuclear Energy Commission (mean dose: 12 mCi). Visual analysis and semi-quantitative standardized uptake value (SUV) were performed by a consensus of 5 nuclear medicine physicians. Results: 65% of the PET studies were positive, showing hypermetabolic tumoral uptake (63% studies in colon cancer and 69% in rectal cancer). In 30% from the positive cases liver lesions were found, 52% of them without other lesions. In 75% from positive studies there was extrahepatic involvement. In the group B, local recurrence was found in 37%. In 48% cases there was good correlation between anatomical images available and FDG and in 42% new unknown lesions were found with PET. CEA levels: they were available in 62% of the cases (71% of them

  9. 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

  10. PET-CT findings in patients with polymyalgia rheumatica without symptoms of cranial ischaemia

    DEFF Research Database (Denmark)

    Lund-Petersen, Alexander; Voss, Anne; Laustrup, Helle

    2017-01-01

    Introduction: Polymyalgia rheumatica (PMR) is an inflammatory disorder that affects the lderly. At present, evidence is limited regarding the usefulness of positron emission tomography-computed tomography (PET-CT) in the diagnosis of PMR. This study aimed to compare patient characteristics...... and symptoms with PET-CT findings in a Danish population of PMR patients without clinical symptoms of giant cell arteritis. Methods: The medical records of 50 Danish PET-CT-scanned patients with PMR were reviewed. Symptoms, characteristics and PET-CT findings were registered from the medical records. Results...... of the following three locations: the shoulder, the hip and the spinous processes. Vascular FDG uptake was seen in 7% of the patients. No significant correlations between any symptoms and any PET-CT findings were found. C-reactive protein was significantly lower in patients receiving glucocorticoids...

  11. [18F]FDG PET/MRI vs. PET/CT for whole-body staging in patients with recurrent malignancies of the female pelvis: initial results

    International Nuclear Information System (INIS)

    Beiderwellen, Karsten; Grueneisen, Johannes; Forsting, Michael; Lauenstein, Thomas C.; Umutlu, Lale; Ruhlmann, Verena; Buderath, Paul; Aktas, Bahriye; Heusch, Philipp; Kraff, Oliver

    2015-01-01

    To evaluate the diagnostic potential of PET/MRI with [ 18 F]FDG in recurrent ovarian and cervical cancer in comparison to PET/CT. A group of 19 patients with suspected recurrence of pelvic malignancies (ovarian cancer, 11 patients; cervical cancer, 8 patients) scheduled for an [ 18 F]FDG PET/CT were subsequently enrolled for a PET/MRI. The scan protocol comprised: (1) a T1-W axial VIBE after contrast agent adminstration, (2) an axial T2-W HASTE, (3) a coronal TIRM, (4) an axial DWI, and dedicated MR sequences of the female pelvis including (5) a T1-W VIBE before contrast agent adminstration, (6) a sagittal T2-W TSE, and (7) a sagittal T1-W dynamic VIBE. The datasets (PET/CT, PET/MRI) were rated separately by two readers regarding lesion count, lesion localization, lesion conspicuity (four-point scale), lesion characterization (benign/malignant/indeterminate) and diagnostic confidence (three-point scale). All available data (histology, prior examinations, PET/CT, PET/MRI, follow-up examinations) served as standard of reference. Median values were compared using the Wilcoxon rank sum test. Metastatic lesions were present in 16 of the 19 patients. A total of 78 lesions (malignant, 58; benign, 20) were described. Both PET/CT and PET/MRI allowed correct identification of all malignant lesions and provided equivalent conspicuity (3.86 ± 0.35 for PET/CT, 3.91 ± 0.28 for PET/MRI; p > 0.05). Diagnostic confidence was significantly higher for PET/MRI in malignant (p < 0.01) and benign lesions (p < 0.05). Both PET/CT and PET/MRI offer an equivalently high diagnostic value for recurrent pelvic malignancies. PET/MRI offers higher diagnostic confidence in the discrimination of benign and malignant lesions. Considering the reduced radiation dose and superior lesion discrimination, PET/MRI may serve as a powerful alternative to PET/CT in the future. (orig.)

  12. The impact of FDG-PET in the management of patients with salivary gland malignancy

    International Nuclear Information System (INIS)

    Otsuka, Hideaki; Graham, M.M.; Kogame, Masahiro; Nishitani, Hiromu

    2005-01-01

    The aim of this study was to evaluate the impact of fluorodeoxyglucose (FDG)-PET in the management of patients with salivary gland malignancy. We performed 45 FDG PET studies in 31 patients with salivary malignant tumors, using PET (33 studies) and PET/CT (12 studies). Patients comprised 21 males and 10 females with a mean age of 69 y (range 38-89). Nineteen patients had a single study, ten patients had 2 and two patients had 3 studies. Twelve studies were performed for initial staging and 33 studies for restaging. Four patients of the initial staging group were restaged with PET after therapy. Histology consisted of 8 adenocarcinomas, 8 squamous cell carcinomas, 4 adenoid cystic carcinomas, 4 carcinoma ex pleomorphic adenomas, 2 mucoepidermoid carcinomas, 2 poorly differentiated carcinomas, 1 salivary duct carcinoma, 1 lymphoepithelial carcinoma and 1 melanoma. PET findings were reviewed with the clinical and radiologic findings and the impact of PET on staging and patient management was determined. In the initial staging group, all 12 primary lesions (100%) showed positive FDG uptake (5 squamous cell carcinomas, 2 adenocarcinomas, 2 poorly differentiated carcinomas, 1 carcinoma ex pleomorphic adenoma, 1 salivary duct carcinoma, 1 lymphoepithelial carcinoma). Three patients (25%) had FDG positive distant disease (liver, bone, lymph nodes); surgery was canceled and therapy changed to chemoradiation. One patient (9%) with no FDG uptake in the neck nodes avoided a planned neck dissection. In the restaging group (33 studies in 23 patients), 5 patients (22%) had FDG positive distant disease, which changed the treatment from surgery to chemoradiation or other. A second primary lesion was detected in one patient (4%). One patient (4%) with clinically suspected recurrence was able to avoid other invasive procedures because of the negative PET. Overall, FDG PET resulted in a major change in management in 11 of 31 patients (35%). This study shows that FDG PET has a

  13. FDG-PET improves the staging and selection of patients with recurrent colorectal cancer

    International Nuclear Information System (INIS)

    Lonneux, Max; Reffad, Abdel-Malek; Pauwels, Stanislas; Detry, Roger; Kartheuser, Alex; Gigot, Jean-Francois

    2002-01-01

    Whole-body fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has proved effective in the diagnosis and staging of recurrent colorectal cancer. In this study, we analysed how PET affects the management of patients with recurrent colorectal cancer by permitting more accurate selection of candidates for curative resection. The data of 79 patients with known or suspected recurrent colorectal cancer were analysed. Conventional imaging modalities (CIM) and PET results were compared with regard to their accuracy in determining the extent and the resectability of tumour recurrence. Recurrence was demonstrated in 68 of the 79 patients. The data indicate that PET was superior to CIM for detection of recurrence at all sites except the liver. Based on the CIM+PET staging, surgery with curative intent was proposed in 39 patients and was indeed achieved in 31 of them (80%). PET was more accurate than CIM alone in predicting the resectability or non-resectability of the recurrence (82% vs 68%, P=0.02). It is concluded that whole-body FDG-PET is highly sensitive for both the diagnosis and the staging of patients with recurrent colorectal cancer. Its use in conjunction with conventional imaging procedures results in a more accurate selection of patients for surgical treatment with curative intent. (orig.)

  14. Guide to clinical PET in oncology: Improving clinical management of cancer patients

    International Nuclear Information System (INIS)

    2008-10-01

    Positron emission tomography (PET) has an approximately 50 year-history. It was developed as a tool of medical science to quantitatively measure metabolic rates of bio-substances in vivo and in particular the number of receptors in neuroscience. Until the late 1990s PET was, in most cases, research oriented activity. In 2001, positron emission tomography/X ray computed tomography (PET/CT) hybrid imaging system became commercially available. An era of clinical PET then emerged, in which PET images were utilized for clinical practice in the treatment and diagnosis of cancer patients. PET imaging could recognize areas of abnormal metabolic behaviour of cancers in vivo, and the addition of CT imaging underlines the site of malignancy. More accurate and precise interpretation of cancer lesions can therefore be performed by PET/CT imaging than PET or CT imaging alone. Clinical PET, in particular with fluorine-18-fluorodeoxyglucose ( 18 F-FDG), has already proven itself to have considerable value in oncology. The indications include malignant lymphoma and melanoma, head and neck cancers, oesophageal cancer, breast cancer, lung cancer and colorectal cancer, and it is still being expanded. The roles of clinical PET could be for 1) preoperative staging of cancers, 2) differentiation between residual tumour and scarring, 3) demonstration of suspected recurrences, 4) monitoring response to therapy, 5) prognosis and 6) radiotherapy treatment planning. Clinical PET can be used to illustrate exactly which treatment should be applied for a cancer patient as well as where surgeons should operate and where radiation oncologists should target radiation therapy. An almost exponential rise in the introduction of clinical PET, as well as the installation of PET/CT has been seen throughout the world. Clinical PET is currently viewed as the most powerful diagnostic tool in its field. This IAEA-TECDOC presents an overview of clinical PET for cancer patients and a relevant source of

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-08-01

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

  16. PET in patients with clear-cut multiple chemical sensitivity (MCS); PET bei Patienten mit klar definierter multipler chemischer Sensibilitaet (MCS)

    Energy Technology Data Exchange (ETDEWEB)

    Bornschein, S. [Toxikologische Abt. der II. Medizinischen Klinik und Poliklinik der Technischen Univ. Muenchen, Klinikum rechts der Isar, Muenchen (Germany); Klinik und Poliklinik fuer Psychiatrie und Psychotherapie der Technischen Univ. Muenchen, Klinikum rechts der Isar, Muenchen (Germany); Hausteiner, C.; Foerstl, H. [Klinik und Poliklinik fuer Psychiatrie und Psychotherapie der Technischen Univ. Muenchen, Klinikum rechts der Isar, Muenchen (Germany); Drzezga, A.; Schwaiger, M. [Nuklearmedizinische Klinik und Poliklinik der Technischen Univ. Muenchen, Klinikum rechts der Isar, Muenchen (Germany); Bartenstein, P. [Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Mainz (Germany); Zilker, Th. [Toxikologische Abt. der II. Medizinischen Klinik und Poliklinik der Technischen Univ. Muenchen, Klinikum rechts der Isar, Muenchen (Germany)

    2002-12-01

    Aim: Multiple chemical sensitivity (MCS) is a controversially discussed symptom complex. Patients afflicted by MCS react to very low and generally non-toxic concentrations of environmental chemicals. It has been suggested that MCS leads to neurotoxic damage or neuroimmunological alteration in the brain detectable by positron emission tomography (PET) and single photon emission computer tomography (SPECT). These methods are often applied to MCS patients for diagnosis, although they never proved appropriate. Method: We scanned 12 MCS patients with PET, hypothesizing that it would reveal abnormal findings. Results: Mild glucose hypometabolism was present in one patient. In comparison with normal controls, the patient group showed no significant functional brain changes. Conclusion: This first systematic PET study in MCS patients revealed no hint of neurotoxic or neuroimmunological brain changes of functional significance. (orig.) [German] Ziel: Multiple chemische sensibilitaet (MCS) ist ein umstrittenes Krankheitsbild, das durch Reaktionen auf geringe, fueer Normalpersonen unschaedliche Mengen an Umweltchemikalien gekennzeichnet ist. Es wurde postuliert, dass MCS zu neurotoxischer Schaedigung bzw. neuroimmunologischer Veraenderung im Gehirn fuehrt, die mittels funktioneller bildgebender Verfahren, z. B. positronenemissionstomographie (PET), single-photon-emissions-computer-tomographie (SPECT) dargestellt werden koennte. Obwohl hierfuer kein wissenschaftlicher Beleg erbracht wurde, werden diese Methoden vielfach diagnostisch bei MCS-Patienten eingesetzt. Methode: Wir untersuchten 12 MCS-Patienten mit PET, um etwaige funktionelle Hirnveraenderungen nachzuweisen. Ergebnisse: Im Einzelvergleich war bei einem Patienten ein diskreter Glukose-Hypometabolismus in einzelnen Hirnregionen vorhanden. Im Gruppenvergleich konnte keine signifikante Abweichung von der Norm gefunden werden. Schlussfolgerung: Diese erste systematische PET-Studie bei MCS-Patienten erbrachte keinen

  17. [{sup 18}F]FDG PET/MRI vs. PET/CT for whole-body staging in patients with recurrent malignancies of the female pelvis: initial results

    Energy Technology Data Exchange (ETDEWEB)

    Beiderwellen, Karsten; Grueneisen, Johannes; Forsting, Michael; Lauenstein, Thomas C.; Umutlu, Lale [University Hospital Essen, University of Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Ruhlmann, Verena [University Hospital Essen, University of Duisburg-Essen, Clinic for Nuclear Medicine, Essen (Germany); Buderath, Paul; Aktas, Bahriye [University Hospital Essen, University of Duisburg-Essen, Clinic for Obstetrics and Gynecology, Essen (Germany); Heusch, Philipp [University of Dusseldorf, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Kraff, Oliver [University of Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany)

    2015-01-15

    To evaluate the diagnostic potential of PET/MRI with [{sup 18}F]FDG in recurrent ovarian and cervical cancer in comparison to PET/CT. A group of 19 patients with suspected recurrence of pelvic malignancies (ovarian cancer, 11 patients; cervical cancer, 8 patients) scheduled for an [{sup 18}F]FDG PET/CT were subsequently enrolled for a PET/MRI. The scan protocol comprised: (1) a T1-W axial VIBE after contrast agent adminstration, (2) an axial T2-W HASTE, (3) a coronal TIRM, (4) an axial DWI, and dedicated MR sequences of the female pelvis including (5) a T1-W VIBE before contrast agent adminstration, (6) a sagittal T2-W TSE, and (7) a sagittal T1-W dynamic VIBE. The datasets (PET/CT, PET/MRI) were rated separately by two readers regarding lesion count, lesion localization, lesion conspicuity (four-point scale), lesion characterization (benign/malignant/indeterminate) and diagnostic confidence (three-point scale). All available data (histology, prior examinations, PET/CT, PET/MRI, follow-up examinations) served as standard of reference. Median values were compared using the Wilcoxon rank sum test. Metastatic lesions were present in 16 of the 19 patients. A total of 78 lesions (malignant, 58; benign, 20) were described. Both PET/CT and PET/MRI allowed correct identification of all malignant lesions and provided equivalent conspicuity (3.86 ± 0.35 for PET/CT, 3.91 ± 0.28 for PET/MRI; p > 0.05). Diagnostic confidence was significantly higher for PET/MRI in malignant (p < 0.01) and benign lesions (p < 0.05). Both PET/CT and PET/MRI offer an equivalently high diagnostic value for recurrent pelvic malignancies. PET/MRI offers higher diagnostic confidence in the discrimination of benign and malignant lesions. Considering the reduced radiation dose and superior lesion discrimination, PET/MRI may serve as a powerful alternative to PET/CT in the future. (orig.)

  18. 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.

  19. A Self-Reporting Photocatalyst for Online Fluorescence Monitoring of High Throughput RAFT Polymerization.

    Science.gov (United States)

    Yeow, Jonathan; Joshi, Sanket; Chapman, Robert; Boyer, Cyrille Andre Jean Marie

    2018-04-25

    Translating controlled/living radical polymerization (CLRP) from batch to the high throughput production of polymer libraries presents several challenges in terms of both polymer synthesis and characterization. Although recently there have been significant advances in the field of low volume, high throughput CLRP, techniques able to simultaneously monitor multiple polymerizations in an "online" manner have not yet been developed. Here, we report our discovery that 5,10,15,20-tetraphenyl-21H,23H-porphine zinc (ZnTPP) is a self-reporting photocatalyst that can mediate PET-RAFT polymerization as well as report on monomer conversion via changes in its fluorescence properties. This enables the use of a microplate reader to conduct high throughput "online" monitoring of PET-RAFT polymerizations performed directly in 384-well, low volume microtiter plates. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Gamma-camera 18F-FDG PET in diagnosis and staging of patients presenting with suspected lung cancer and comparison with dedicated PET

    DEFF Research Database (Denmark)

    Oturai, Peter S; Mortensen, Jann; Enevoldsen, Henriette

    2004-01-01

    It is not clear whether high-quality coincidence gamma-PET (gPET) cameras can provide clinical data comparable with data obtained with dedicated PET (dPET) cameras in the primary diagnostic work-up of patients with suspected lung cancer. This study focuses on 2 main issues: direct comparison...

  1. Clinical value of FDG-PET in the follow up of post-operative patients with endometrial cancer

    International Nuclear Information System (INIS)

    Saga, Tsuneo; Higashi, Tatsuya; Ishimori, Takayoshi

    2003-01-01

    The clinical usefulness of FDG-PET in the follow up of post-operative patients with endometrial cancer was retrospectively evaluated. Twenty-one post-operative patients with endometrial cancer received 30 FDG-PET examinations to evaluate recurrence or response to treatment. The findings of FDG-PET were compared with their serum levels of tumor markers, CT and/or MRI findings, and the final outcome. Results of FDG-PET were also correlated with the clinical course of each patient. In detecting recurrent lesions and evaluating treatment responses, FDG-PET, with the help in anatomic information by CT/MRI, showed better diagnostic ability (sensitivity 100.0%, specificity 88.2%, accuracy 93.3%) compared with combined conventional imaging (sensitivity 84.6%, specificity 85.7%, accuracy 85.0%) and tumor markers (sensitivity 100.0%, specificity 70.6%, accuracy 83.3%). FDG-PET had no false-negative results, suggesting the possibility of its use as the first-line examination in a patient's follow-up. FDG-PET could detect unknown lesions in 4 cases, and, as reported for other malignancies, FDG-PET affected the patient management in one-third of the cases. Furthermore, the results of FDG-PET correlated well with the clinical outcome of the patients, with patients with negative PET results tending to show disease-free courses. These results suggest that, despite the limited number of patients studied, FDG-PET was accurate in detecting recurrence and evaluating therapeutic response, and could afford important information in the management of post-operative patients with endometrial cancer. FDG-PET also appeared to have a possibility to predict the outcome of each patient. (author)

  2. Impact of (18)F-Fluoride PET on Intended Management of Patients with Cancers Other Than Prostate Cancer: Results from the National Oncologic PET Registry.

    Science.gov (United States)

    Hillner, Bruce E; Siegel, Barry A; Hanna, Lucy; Duan, Fenghai; Shields, Anthony F; Quinn, Bruce; Coleman, R Edward

    2014-07-01

    The National Oncologic PET Registry prospectively assessed the impact of PET with (18)F-sodium fluoride (NaF PET) on intended management of Medicare patients with suspected or known osseous metastasis. We report our findings for cancers other than prostate and make selected comparisons to our previously reported prostate cancer cohort. Data were collected from both referring and interpreting physicians before and after NaF PET in patients (age ≥ 65 y) stratified for initial staging (IS; n = 570), for suspected first osseous metastasis (FOM; n = 1,814; breast, 781 [43%]; lung, 380 [21%]; and all other cancers, 653 [36%]), and for suspected progression of osseous metastasis (POM; n = 435). The dominant indication was bone pain. If NaF PET were unavailable, conventional bone scintigraphy would have been ordered in 85% of patients. In IS, 28% of patients had suspected or confirmed nonosseous metastasis. If neither conventional bone scintigraphy nor NaF PET were available, referring physicians would have ordered other advanced imaging more than 70% of the time rather than initiate treatment for suspected FOM (11%-16%) or POM (18%-22%). When intended management was classified as either treatment or nontreatment, the intended management change for each cancer type was highest in POM, lower in IS, and lowest in FOM. For suspected FOM, intended management change was lower in breast (24%), lung (36%), or other cancers (31%), compared with prostate cancer (44%) (P definite metastases) frequencies were similar across cancer types. After normal/benign/equivocal PET results, 15% of breast, 30% lung, and 38% prostate cancer patients had treatment, likely reflecting differences in management of nonosseous disease. For patients with definite metastasis on NaF PET, nonprostate, compared with prostate, cancer patients had post-PET plans for more frequent biopsy, alternative imaging, chemotherapy, and radiotherapy. In the smaller IS and POM cohorts, differences among cancer types

  3. Prospective evaluation of 68Ga-DOTANOC PET-CT in differentiated thyroid cancer patients with raised thyroglobulin and negative 131I-whole body scan: comparison with 18F-FDG PET-CT

    International Nuclear Information System (INIS)

    Kundu, Parveen; Lata, Sneh; Sharma, Punit; Singh, Harmandeep; Malhotra, Arun; Bal, Chandrasekhar

    2014-01-01

    The purpose of the study was to evaluate the role of 68 Ga-DOTANOC PET-CT in differentiated thyroid cancer (DTC) patients with negative 131 I-whole body scan (WBS) along with serially increasing serum thyroglobulin (Tg), and compare the same with 18 F-FDG PET-CT. Sixty two DTC patients with serially rising Tg levels and negative 131 I-WBS were prospectively enrolled. All patients underwent 68 Ga-DOTANOC PET-CT and 18 F-FDG PET-CT within an interval of two weeks. PET-CT analysis was done on a per-patient basis, location wise and lesion wise. All PET-CT lesions were divided into four categories-local, nodal, pulmonary and skeletal. Histopathology and/or serial serum Tg level, clinical and imaging follow up (minimum-1 year) were used as a reference standard. Ga-DOTANOC PET-CT demonstrated disease in 40/62 (65 %) patients and 18 F-FDG PET-CT in 45/62 (72 %) patients, with no significant difference on McNemar analysis (p = 0.226). Per-patient sensitivity and specificity of 68 Ga-DOTANOC PET-CT was 78.4 %, 100 %, and for 18 F-FDG PET-CT was 86.3 %, 90.9 %, respectively. Out of 186 lesions detected by both PET-CTs, 121/186 (65 %) lesions were seen on 68 Ga-DOTANOC PET-CT and 168/186 (90.3 %) lesions on 18 F-FDG PET-CT (p 68 Ga-DOTANOC PET-CT and 18 F-FDG PET-CT for detection of local disease (k = 0.92), while moderate agreement was noted for nodal and pulmonary disease (k = 0.67). 68 Ga-DOTANOC PET-CT changed management in 21/62 (34 %) patients and 18 F-FDG PET-CT in 17/62 (27 %) patients. Ga-DOTANOC PET-CT is inferior to 18 F-FDG PET-CT on lesion based but not on patient based analysis for detection of recurrent/residual disease in DTC patients with negative WBS scan and elevated serum Tg levels. It can also help in selection of potential candidates for peptide receptor radionuclide therapy. (orig.)

  4. Cerebral FDG-PET scanning abnormalities in optimally treated HIV patients

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  5. Comparison of lesion detection and quantitation of tracer uptake between PET from a simultaneously acquiring whole-body PET/MR hybrid scanner and PET from PET/CT

    International Nuclear Information System (INIS)

    Wiesmueller, Marco; Schmidt, Daniela; Beck, Michael; Kuwert, Torsten; Gall, Carl C. von; Quick, Harald H.; Navalpakkam, Bharath; Lell, Michael M.; Uder, Michael; Ritt, Philipp

    2013-01-01

    PET/MR hybrid scanners have recently been introduced, but not yet validated. The aim of this study was to compare the PET components of a PET/CT hybrid system and of a simultaneous whole-body PET/MR hybrid system with regard to reproducibility of lesion detection and quantitation of tracer uptake. A total of 46 patients underwent a whole-body PET/CT scan 1 h after injection and an average of 88 min later a second scan using a hybrid PET/MR system. The radioactive tracers used were 18 F-deoxyglucose (FDG), 18 F-ethylcholine (FEC) and 68 Ga-DOTATATE (Ga-DOTATATE). The PET images from PET/CT (PET CT ) and from PET/MR (PET MR ) were analysed for tracer-positive lesions. Regional tracer uptake in these foci was quantified using volumes of interest, and maximal and average standardized uptake values (SUV max and SUV avg , respectively) were calculated. Of the 46 patients, 43 were eligible for comparison and statistical analysis. All lesions except one identified by PET CT were identified by PET MR (99.2 %). In 38 patients (88.4 %), the same number of foci were identified by PET CT and by PET MR . In four patients, more lesions were identified by PET MR than by PET CT , in one patient PET CT revealed an additional focus compared to PET MR . The mean SUV max and SUV avg of all lesions determined by PET MR were by 21 % and 11 % lower, respectively, than the values determined by PET CT (p CT and PET MR were minor, but statistically significant. Nevertheless, a more detailed study of the quantitative accuracy of PET MR and the factors governing it is needed to ultimately assess its accuracy in measuring tissue tracer concentrations. (orig.)

  6. A retrospective comparison between 68Ga-DOTA-TOC PET/CT and 18F-DOPA PET/CT in patients with extra-adrenal paraganglioma.

    Science.gov (United States)

    Kroiss, Alexander; Putzer, Daniel; Frech, Andreas; Decristoforo, Clemens; Uprimny, Christian; Gasser, Rudolf Wolfgang; Shulkin, Barry Lynn; Url, Christoph; Widmann, Gerlig; Prommegger, Rupert; Sprinzl, Georg Mathias; Fraedrich, Gustav; Virgolini, Irene Johanna

    2013-12-01

    (18)F-Fluoro-L-dihydroxyphenylalanine ((18)F-DOPA) PET offers high sensitivity and specificity in the imaging of nonmetastatic extra-adrenal paragangliomas (PGL) but lower sensitivity in metastatic or multifocal disease. These tumours are of neuroendocrine origin and can be detected by (68)Ga-DOTA-Tyr(3)-octreotide ((68)Ga-DOTA-TOC) PET. Therefore, we compared (68)Ga-DOTA-TOC and (18)F-DOPA as radiolabels for PET/CT imaging for the diagnosis and staging of extra-adrenal PGL. Combined cross-sectional imaging was the reference standard. A total of 5 men and 15 women (age range 22 to 73 years) with anatomical and/or histologically proven extra-adrenal PGL were included in this study. Of these patients, 5 had metastatic or multifocal lesions and 15 had single sites of disease. Comparative evaluation included morphological imaging with CT and functional imaging with (68)Ga-DOTA-TOC PET and (18)F-DOPA PET. The imaging results were analysed on a per-patient and a per-lesion basis. The maximum standardized uptake value (SUVmax) of each functional imaging modality in concordant tumour lesions was measured. Compared with anatomical imaging, (68)Ga-DOTA-TOC PET and (18)F-DOPA PET each had a per-patient and per-lesion detection rate of 100% in nonmetastatic extra-adrenal PGL. However, in metastatic or multifocal disease, the per-lesion detection rate of (68)Ga-DOTA-TOC was 100% and that of (18)F-DOPA PET was 56.0%. Overall, (68)Ga-DOTA-TOC PET identified 45 lesions; anatomical imaging identified 43 lesions, and (18)F-DOPA PET identified 32 lesions. The overall per-lesion detection rate of (68)Ga-DOTA-TOC PET was 100% (McNemar, P TOC PET and 11.8 ± 7.9 for (18)F-DOPA PET (Mann-Whitney U test, P TOC PET may be superior to (18)F-DOPA PET and diagnostic CT in providing valuable information for pretherapeutic staging of extra-adrenal PGL, particularly in surgically inoperable tumours and metastatic or multifocal disease.

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

    Science.gov (United States)

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

    2017-01-01

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

  8. Automated movement correction for dynamic PET/CT images: evaluation with phantom and patient data.

    Science.gov (United States)

    Ye, Hu; Wong, Koon-Pong; Wardak, Mirwais; Dahlbom, Magnus; Kepe, Vladimir; Barrio, Jorge R; Nelson, Linda D; Small, Gary W; Huang, Sung-Cheng

    2014-01-01

    Head movement during a dynamic brain PET/CT imaging results in mismatch between CT and dynamic PET images. It can cause artifacts in CT-based attenuation corrected PET images, thus affecting both the qualitative and quantitative aspects of the dynamic PET images and the derived parametric images. In this study, we developed an automated retrospective image-based movement correction (MC) procedure. The MC method first registered the CT image to each dynamic PET frames, then re-reconstructed the PET frames with CT-based attenuation correction, and finally re-aligned all the PET frames to the same position. We evaluated the MC method's performance on the Hoffman phantom and dynamic FDDNP and FDG PET/CT images of patients with neurodegenerative disease or with poor compliance. Dynamic FDDNP PET/CT images (65 min) were obtained from 12 patients and dynamic FDG PET/CT images (60 min) were obtained from 6 patients. Logan analysis with cerebellum as the reference region was used to generate regional distribution volume ratio (DVR) for FDDNP scan before and after MC. For FDG studies, the image derived input function was used to generate parametric image of FDG uptake constant (Ki) before and after MC. Phantom study showed high accuracy of registration between PET and CT and improved PET images after MC. In patient study, head movement was observed in all subjects, especially in late PET frames with an average displacement of 6.92 mm. The z-direction translation (average maximum = 5.32 mm) and x-axis rotation (average maximum = 5.19 degrees) occurred most frequently. Image artifacts were significantly diminished after MC. There were significant differences (Pdynamic brain FDDNP and FDG PET/CT scans could improve the qualitative and quantitative aspects of images of both tracers.

  9. Dual-time FDG-PET/CT in patients with potential breast cancer recurrence

    DEFF Research Database (Denmark)

    Baun, Christina; Falch Braas, Kirsten; Gerke, Oke

    Dual-time FDG-PET/CT in patients with potential breast cancer recurrence: head-to-head comparison with CT and bonescintigraphy......Dual-time FDG-PET/CT in patients with potential breast cancer recurrence: head-to-head comparison with CT and bonescintigraphy...

  10. FDG PET in monitoring response to neoadjuvant chemoradiotherapy in patients with locally advanced non-small lung carcinoma

    International Nuclear Information System (INIS)

    Berlangieri, S. U.; Lee, S. T.; Chan, A. M.; Mitchell, P. L.; Knight, S. R.; Feigen, M. M.; Scott, A. M.

    2009-01-01

    Full text:Aim: The aim of our study was to correlate 18F-FDG PET response to neoadjuvant chemoradiotherapy with histopathology in patients with locally advanced non-small cell lung carcinoma. Methods: All patients with stage III NSCLC planned for surgery following induction chemotherpay and/or radiotherapy who underwent pre- and post-treatment FDG-PET between 2004 and 2007 were retrospectively reviewed. The PET scans were performed according to standard protocol. The clinical FDG-PET TNM stage was correlated with the histopathology of the surgical specimens. Results: There were 9 patients (6 M :3 F ), median age 59.7 years (range 49 to 73 years). Post-treatment FDG-PET correctly predicted mediastinal pathological N stage in 8/9 patients, with one patient having microsopic disease in two nodes. The post-treatment FDG-PET correctly predicted pathological T stage in 7/9 patients, with 2 patients having small volume T4 disease not detected by PET. Post-treatment FDG-PET correctly downstaged 4 patients. Of the 5 patients, incorrectly staged on the post-treatment FDG-PET, one patient had microscopic pN 2 disease, 2 had pN 1 disease, and 2 had pT 4 disease. Conclusion: Post-treatment FDG-PET is predictive of pathological nodal stage within the mediastinum in patients with locally advanced NSCLC treated with neoadjuvant chemoradiotherapy. FDG-PET does not detect microscopic or small volume disease, nor is it able to define the boundaries of mediastinal tissue invasion.

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  12. FDG-PET/CT in autosomal dominant polycystic kidney disease patients with suspected cyst infection.

    Science.gov (United States)

    Pijl, Jordy Pieter; Glaudemans, Andor W J M; Slart, Riemer H J A; Kwee, Thomas Christian

    2018-04-13

    Purpose: To determine the value of 18 F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) for diagnosing renal or hepatic cyst infection in patients with autosomal dominant polycystic kidney disease (ADPKD). Methods: This retrospective single-center study included all patients with ADPKD who underwent FDG-PET/CT because of suspected cyst infection between 2010 and 2017. Results: Thirty FDG-PET/CT scans of thirty individual patients were included, of which 19 were positive for cyst infection. According to a previously established clinical and biochemical reference standard, FDG-PET/CT achieved sensitivity of 88.9%, specificity of 75.0%, positive predictive value of 84.2%, and negative predictive value of 81.8% for the diagnosis of cyst infection. In 5 cases, FDG-PET/CT suggested a different pathologic process that explained the symptoms, including pneumonia ( n = 1), generalized peritonitis ( n = 1), pancreatitis ( n = 1), colitis ( n = 1), and cholangitis ( n = 1). Total duration of hospital stay and duration between FDG-PET/CT scan and hospital discharge of patients with an FDG-PET/CT scan positive for cyst infection were significantly longer than those with a negative scan ( P = 0.005 and P = 0.009, respectively). Creatinine levels were significantly higher in patients with an FDG-PET/CT scan positive for cyst infection than in patients with a negative scan ( P = 0.015). Other comparisons of clinical parameters (age, gender, presence of fever (>38.5°C) for more than 3 days, abdominal pain, history of solid organ transplantation and nephrectomy, immune status), laboratory values (C-reactive protein level (CRP), leukocyte count, estimated glomerular filtration rate), and microbiologic results (blood and urine cultures) were not significantly different ( P = 0.13-1.00) between FDG-PET/CT-positive and -negative patients. Conclusion: FDG-PET/CT is a useful and recommendable (upfront) imaging modality for the evaluation of

  13. Evaluation of {sup 124}I PET/CT and {sup 124}I PET/MRI in the management of patients with differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dercle, Laurent; Deandreis, Desiree; Terroir, Marie; Leboulleux, Sophie; Lumbroso, Jean; Schlumberger, Martin [Institut Gustave Roussy and University Paris Saclay, Department of Nuclear Medicine and Endocrine Oncology, Villejuif Cedex (France)

    2016-06-15

    The work of Binse and colleagues points out that there are probably some research perspectives for the use of {sup 124}I PET/ CT and PET/MRI in patients with DTC. It shows that there is no substantial advantage of {sup 124}I PET/MRI over {sup 124}I PET/CT for the detection of tumour lesions in the neck when using similar PET devices. It confirms the superiority of {sup 124}I PET over CT and MRI for the detection of iodine-positive lesions. It demonstrates that the use of a more sensitive PET device and a longer acquisition time leads to the detection of more lesions. {sup 124}I PET is a promising research tool for pretherapy dosimetry, the evaluation of response to {sup 131}I treatment and the staging of recurrent or residual disease. The recognized advantages of MRI are the evaluation of aerodigestive tract lesions and suprahyoid region lesions. The coregistration of MRI and {sup 124}I PET/CT might thus be more convenient than {sup 124}I PET/ MRI (shorter time of acquisition, better cost-effectiveness and more accurate attenuation correction). The benefits of these procedures in terms of patient outcome, and for the clinician and the healthcare system remain to be determined.

  14. A retrospective comparison between 68Ga-DOTA-TOC PET/CT and 18F-DOPA PET/CT in patients with extra-adrenal paraganglioma

    International Nuclear Information System (INIS)

    Kroiss, Alexander; Putzer, Daniel; Decristoforo, Clemens; Uprimny, Christian; Virgolini, Irene Johanna; Frech, Andreas; Fraedrich, Gustav; Gasser, Rudolf Wolfgang; Shulkin, Barry Lynn; Url, Christoph; Widmann, Gerlig; Prommegger, Rupert; Sprinzl, Georg Mathias

    2013-01-01

    18 F-Fluoro-l-dihydroxyphenylalanine ( 18 F-DOPA) PET offers high sensitivity and specificity in the imaging of nonmetastatic extra-adrenal paragangliomas (PGL) but lower sensitivity in metastatic or multifocal disease. These tumours are of neuroendocrine origin and can be detected by 68 Ga-DOTA-Tyr 3 -octreotide ( 68 Ga-DOTA-TOC) PET. Therefore, we compared 68 Ga-DOTA-TOC and 18 F-DOPA as radiolabels for PET/CT imaging for the diagnosis and staging of extra-adrenal PGL. Combined cross-sectional imaging was the reference standard. A total of 5 men and 15 women (age range 22 to 73 years) with anatomical and/or histologically proven extra-adrenal PGL were included in this study. Of these patients, 5 had metastatic or multifocal lesions and 15 had single sites of disease. Comparative evaluation included morphological imaging with CT and functional imaging with 68 Ga-DOTA-TOC PET and 18 F-DOPA PET. The imaging results were analysed on a per-patient and a per-lesion basis. The maximum standardized uptake value (SUV max ) of each functional imaging modality in concordant tumour lesions was measured. Compared with anatomical imaging, 68 Ga-DOTA-TOC PET and 18 F-DOPA PET each had a per-patient and per-lesion detection rate of 100 % in nonmetastatic extra-adrenal PGL. However, in metastatic or multifocal disease, the per-lesion detection rate of 68 Ga-DOTA-TOC was 100 % and that of 18 F-DOPA PET was 56.0 %. Overall, 68 Ga-DOTA-TOC PET identified 45 lesions; anatomical imaging identified 43 lesions, and 18 F-DOPA PET identified 32 lesions. The overall per-lesion detection rate of 68 Ga-DOTA-TOC PET was 100 % (McNemar, P 18 F-DOPA PET was 71.1 % (McNemar, P max (mean ± SD) of all 32 concordant lesions was 67.9 ± 61.5 for 68 Ga-DOTA-TOC PET and 11.8 ± 7.9 for 18 F-DOPA PET (Mann-Whitney U test, P 68 Ga-DOTA-TOC PET may be superior to 18 F-DOPA PET and diagnostic CT in providing valuable information for pretherapeutic staging of extra-adrenal PGL, particularly in surgically

  15. Simultaneous (68)Ga-DOTA-TOC PET/MRI with gadoxetate disodium in patients with neuroendocrine tumor.

    Science.gov (United States)

    Hope, Thomas A; Pampaloni, Miguel Hernandez; Nakakura, Eric; VanBrocklin, Henry; Slater, James; Jivan, Salma; Aparici, Carina Mari; Yee, Judy; Bergsland, Emily

    2015-08-01

    To evaluate a simultaneous PET/MRI approach to imaging patients with neuroendocrine tumor using a combination of (68)Ga-DOTA-TOC as a PET contrast agent and gadoxetate disodium as a hepatobiliary MRI contrast agent. Ten patients with neuroendocrine tumor with known or suspected hepatic disease were imaged using a (68)Ga-DOTA-TOC PET/CT immediately followed by a 3.0T time-of-flight PET/MRI, using a combined whole body and liver specific imaging. The presence of lesions and DOTA-TOC avidity were assessed on CT, PET from PET/CT, diffusion weighted imaging, hepatobiliary phase imaging (HBP), and PET from PET/MRI. Maximum standardized uptake values (SUVmax) in hepatic lesions and nodal metastases were compared between PET/CT and PET/MRI, as were detection rates using each imaging approach. A total of 101 hepatic lesions were identified, 47 of which were DOTA-TOC avid and able to be individually measured on both PET/CT and PET/MRI. HBP imaging had a higher sensitivity for detection of hepatic lesions compared to CT or PET (99% vs. 46% and 64%, respectively; p values TOC and gadoxetate disodium was successful in whole body staging of patients with neuroendocrine tumor. HBP imaging had an increased detection rate for hepatic metastases.

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

    Science.gov (United States)

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

    2015-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-12-15

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

  18. Usefulness of 18F fluoride PET/CT in breast cancer patients with osteosclerotic bone metastases

    International Nuclear Information System (INIS)

    Yoon, Seok Ho; Kim, Ku Sang; Kang, Seok Yun; Song, Hee Sung; Jo, Kyung Sook; Lee, Su Jin; Yoon, Joon Kee; An, Young Sil; Choi, Bong Hoi

    2012-01-01

    Bone metastasis is an important factor for the treatment and prognosis of breast cancer patients. Whole body bone scintigraphy (WBBS) can evaluate skeletal metastases, and 18 F FDG PET/CT seems to exhibit high specificity and accuracy in detecting bone metastases. However, there is a limitation of 18 F FDG PET in assessing sclerotic bone metastases because some lesions may be undetectable. Recent studies showed that 18 F fluoride PET/CT is more sensitive than WBBS in detecting bone metastases. This study aims to evaluate the usefulness of 18 F fluoride PET/CT by comparing it with WBBS and 18 F FDG PET/CT in breast cancer patients with osteosclerotic skeletal metastases. Nine breast cancer patients with suspected bone metastases (9 females; mean age ± SD, 55.6±10.0 years) underwent 99m Tc MDP WBBS, 18 F FDG PET/CT and 18 F fluoride PET/CT. Lesion based analysis of five regions of the skeletons(skull, vertebral column, thoracic cage, pelvic bones and long bones of extremities) and patient based analysis were performed. 18 F fluoride PET/CT, 18 F FDG PET/CT and WBBS detected 49, 20 and 25 true metastases, respectively. Sensitivity, specificity, positive predictive value and negative predictive value of 18 F fluoride PET/CT were 94.2%, 46.3%, 57.7% and 91.2%, respectively. Most true metastatic lesions of 18 F fluoride PET/CT had osteosclerotic change (45/49, 91.8%), and only four lesions showed osteolytic change. Most lesions on 18 F FDG PET/CT also demonstrated osteosclerotic change (17/20, 85.0%) with three osteolytic lesions. All true metastatic lesions detected on WBBS and 18 F FDG PET/CT were identified on 18 F fluoride PET/CT. 18 F FDG PET/CT in detecting osteosclerotic metastatic lesions. 18 F fluoride PET/CT might be useful in evaluating osteosclerotic metastases in breast cancer patients

  19. Deep-inspiration breath-hold PET/CT versus free breathing PET/CT and respiratory gating PET for reference. Evaluation in 95 patients with lung cancer

    International Nuclear Information System (INIS)

    Kawano, Tsuyoshi; Ohtake, Eiji; Inoue, Tomio

    2011-01-01

    The objective of this study was to define the factors that correlate with differences in maximum standardized uptake value (SUV max ) in deep-inspiration breath-hold (DIBH) and free breathing (FB) positron emission tomography (PET)/CT admixed with respiratory gating (RG) PET for reference. Patients (n=95) with pulmonary lesions were evaluated at one facility over 33 months. After undergoing whole-body PET/CT, a RG PET and FB PET/CT scans were obtained, followed by a DIBH PET/CT scan. All scans were recorded using a list-mode dynamic collection method with respiratory gating. The RG PET was reconstructed using phase gating without attenuation correction; the FB PET was reconstructed from the RG PET sinogram datasets with attenuation correction. Respiratory motion distance, breathing cycle speed, and waveform of RG PET were recorded. The SUV max of FB PET/CT and DIBH PET/CT were recorded: the percent difference in SUV max between the FB and DIBH scans was defined as the %BH-index. The %BH-index was significantly higher for lesions in the lower lung area than in the upper lung area. Respiratory motion distance was significantly higher in the lower lung area than in the upper lung area. A significant relationship was observed between the %BH-index and respiratory motion distance. Waveforms without steady end-expiration tended to show a high %BH-index. Significant inverse relationships were observed between %BH-index and cycle speed, and between respiratory motion distance and cycle speed. Decrease in SUV max of FB PET/CT was due to tumor size, distribution of lower lung, long respiratory movement at slow breathing cycle speeds, and respiratory waveforms without steady end-expiration. (author)

  20. Prognostic value of 18F-FLT PET in patients with neuroendocrine neoplasms

    DEFF Research Database (Denmark)

    Johnbeck, Camilla B.; Knigge, Ulrich; Langer, Seppo W.

    2016-01-01

    Neuroendocrine neoplasms (NENs) constitute a heterogeneous group of tumors arising in various organs and with a large span of aggressiveness and survival rates. The Ki-67 proliferation index is presently used as the key marker of prognosis, and treatment guidelines are largely based on this index...... study was to investigate 18F-FLT PET as a prognostic marker for NENs in comparison with 18F-FDG PET and Ki-67 index. Methods: One hundred patients were PET-scanned with both 18F-FLT and 18F-FDG within the same week, and the prognostic value of a positive scan was examined in terms of progression...... prognostic value in NEN patients but when 18F-FDG PET and Ki-67 index are also available, a multivariate model revealed that 18F-FLT PET only adds information regarding PFS but not OS, whereas 18F-FDG PET remains predictive of both PFS and OS. However, a clinically robust algorithm including 18F...

  1. The journey: from X-rays to PET-MRI

    International Nuclear Information System (INIS)

    Sheikh, Tariq Hussain

    2010-01-01

    has a common patient palette (bed), which travels from the CT gantry to the PET gantry. These advancements have led to better image registration and higher patient throughput. With further developments in crystal design, time of flight processing, CT based partial volume correction, multi-detector CT, short breath holding times, respiratory gating and newer reconstruction algorithms. PET-CTs of today have reached an unprecedented resolution reaching 2 mm across the field of view in the PET component with sub millimeter resolutions in CT. In short we have reached a long way over the last century, from X-Rays to the inception of PET-MRI, the only hindrance is the availability and high cost which we hope will improve in the days to come

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-11-15

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

  3. Colorectal cancer staging: comparison of whole-body PET/CT and PET/MR.

    Science.gov (United States)

    Catalano, Onofrio A; Coutinho, Artur M; Sahani, Dushyant V; Vangel, Mark G; Gee, Michael S; Hahn, Peter F; Witzel, Thomas; Soricelli, Andrea; Salvatore, Marco; Catana, Ciprian; Mahmood, Umar; Rosen, Bruce R; Gervais, Debra

    2017-04-01

    Correct staging is imperative for colorectal cancer (CRC) since it influences both prognosis and management. Several imaging methods are used for this purpose, with variable performance. Positron emission tomography-magnetic resonance (PET/MR) is an innovative imaging technique recently employed for clinical application. The present study was undertaken to compare the staging accuracy of whole-body positron emission tomography-computed tomography (PET/CT) with whole-body PET/MR in patients with both newly diagnosed and treated colorectal cancer. Twenty-six patients, who underwent same day whole-body (WB) PET/CT and WB-PET/MR, were evaluated. PET/CT and PET/MR studies were interpreted by consensus by a radiologist and a nuclear medicine physician. Correlations with prior imaging and follow-up studies were used as the reference standard. Correct staging was compared between methods using McNemar's Chi square test. The two methods were in agreement and correct for 18/26 (69%) patients, and in agreement and incorrect for one patient (3.8%). PET/MR and PET/CT stages for the remaining 7/26 patients (27%) were discordant, with PET/MR staging being correct in all seven cases. PET/MR significantly outperformed PET/CT overall for accurate staging (P = 0.02). PET/MR outperformed PET/CT in CRC staging. PET/MR might allow accurate local and distant staging of CRC patients during both at the time of diagnosis and during follow-up.

  4. 18F-FDG PET/CT in follow-up evaluation in pediatric patients with Langerhans histiocytosis.

    Science.gov (United States)

    Garcia, J R; Riera, E; Bassa, P; Mourelo, S; Soler, M

    We evaluated the impact of 18 F-FDG PET/CT in identifying sites of active disease and to assess therapeutic follow up in a group of pediatric patients with Langerhans cell histiocytosis (LCH). During 2007-2013, 13 18 F-FDG PET/CT studies were performed for follow-up in 7 patients with a diagnosis of LCH (4 female, 3 male; 1-12 years-old). PET findings were analyzed and correlated with the CT and MRI. Findings were also follow-up by these techniques. PET was negative in 4 patients (all diagnosed with bone lesions and one with pituitary involvement also). CT findings showed residual morphological bone lesions in all patients, and hypophysis MRI study showed no abnormal signal. PET remained negative at 10, 14, 25 and 28 months, and no new lesions on CT and MRI were detected. PET was positive in 3 patients (one with cervical lymphadenopathy and 2 with bone lesions, one also with pituitary involvement not identified by PET). CT findings showed pathological cervical lymphadenopathy (n=1), bone lesions (n=2) and also a pituitary MRI lesion (n=1). In a patient with cervical lymphadenopathy histology demonstrated LCH involvement. In the other 2 patients, PET remained positive with an increase of 18 F-FDG bone uptake at 17 and 19 months. In our preliminar study, 18 F-FDG PET is a useful imaging procedure, along with other diagnostic tools, for identification of active lesions. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  5. Evaluation of attenuation correction in cardiac PET using PET/MR.

    Science.gov (United States)

    Lau, Jeffrey M C; Laforest, R; Sotoudeh, H; Nie, X; Sharma, S; McConathy, J; Novak, E; Priatna, A; Gropler, R J; Woodard, P K

    2017-06-01

    Simultaneous acquisition Positron emission tomography/magnetic resonance (PET/MR) is a new technology that has potential as a tool both in research and clinical diagnosis. However, cardiac PET acquisition has not yet been validated using MR imaging for attenuation correction (AC). The goal of this study is to evaluate the feasibility of PET imaging using a standard 2-point Dixon volume interpolated breathhold examination (VIBE) MR sequence for AC. Evaluation was performed in both phantom and patient data. A chest phantom containing heart, lungs, and a lesion insert was scanned by both PET/MR and PET/CT. In addition, 30 patients underwent whole-body 18 F-fluorodeoxyglucose PET/CT followed by simultaneous cardiac PET/MR. Phantom study showed 3% reduction of activity values in the myocardium due to the non-inclusion of the phased array coil in the AC. In patient scans, average standardized uptake values (SUVs) obtained by PET/CT and PET/MR showed no significant difference (n = 30, 4.6 ± 3.5 vs 4.7 ± 2.8, P = 0.47). There was excellent per patient correlation between the values acquired by PET/CT and PET/MR (R 2  = 0.97). Myocardial SUVs PET imaging using MR for AC shows excellent correlation with myocardial SUVs obtained by standard PET/CT imaging. The 2-point Dixon VIBE MR technique can be used for AC in simultaneous PET/MR data acquisition.

  6. 4. Preliminary Findings of a Prospective Study of FDG-PET in Patients with Possible Lung Cancer

    DEFF Research Database (Denmark)

    Mortensen; Enevoldsen; Friberg

    2000-01-01

    Purpose: To examine the value of PET in diagnosis and staging of suspected lung cancer.Methods: 20 (13 male; mean age: 56 yr., range: 22-83 yr.) patients with chest X-ray findings suspicious of malignancy were staged a) "clinically" (X-ray, history/physical examination, lung function), b) by chest......%) patients surgery was avoided mainly because of the PET findings. In one SCLC patient and one lymphoma patient, PET showed extensive disease, which changed the chemotherapy regime. Accuracy was 83% for clinical stage, 79% for CT and 77% for PET. Four (20%) false positive PET findings were caused...

  7. The use of staging 18F-FDG PET in management and prognosis of patients with small cell lung carcinoma

    International Nuclear Information System (INIS)

    Azad, A.; Chionh, F.; White, S.; Mitchell, P. L.; Lee, S. T.; Berlangieri, S. U.; Scott, A. M.

    2009-01-01

    Full text:Background: 18F-FDG PET has been demonstrated to impact upon the stage classification and mangement of SCLC. However, the prognostic impact of using PET to stage SCLC has not been directly addressed. The aim of this study was to evaluate the prognostic impact of staging PET in SCLC. Methods: Patients who had a staging FDG-PET performed for SCLC at Austin Hospital between 1993 and 2008 were retrospectively reviewed. FDG-PET was performed according to standard protocol. Results: There were 46 patients reviewed. PET altered staging in 12/46 (26%) patients. Four patients were upstaged from limited disease (LD) to extensive disease (ED), 3 of whom subsequently received chemotherapy alone, rather than combined chemo-radiation. Eight patients were downstaged from ED to LD, with 6/8 patients receiving combined chemo-radiation instead. 7/8 patients had solitary extrathoracic disease on conventional imaging. PET altered target radiation field in 3 patients with LD on conventional imaging and PET. Patients with LD on both conventional imaging and PET had significantly longer median overall survival (OS) than patients who were upstaged to ED on PET (557 days vs. 172 days; p < 0.001). Patients with ED on conventional imaging downstaged to LD on PET had significantly longer median OS than patients with ED on both conventional imaging and PET (328 days vs. 177 days, p < 0.037). Conclusion: Staging 18F-FDG-PET for SCLC had major impact on stage classification, management and prognosis. Routine use of staging PET should be considered in patients with LD or oligometastatic ED on conventional imaging.

  8. The determination of patient dose from 18F-FDG PET/CT examination

    International Nuclear Information System (INIS)

    Khamwan, K.; Krisanachinda, A.; Pasawang, P.

    2010-01-01

    The use of positron emission tomography/computed tomography (PET/CT) system has heightened the need for medical diagnosis. However, the patient dose is increasing in comparison to whole-body PET/CT dose. The aim of this study is to determine the patient effective dose in 35 oncology Thai patients with the age range of 28-60 y from PET scan using [fluorine-18]-fluoro-2-deoxy-D-glucose and from CT scan. Cumulated activity and residence time of various organs were calculated from time-activity curves by using S-value based on the body mass. Mean organ absorbed dose and the effective dose from CT scan were calculated using the Medical Internal Radiation Dosimetry method and Monte Carlo simulation, respectively. The average whole-body effective doses from PET and CT were 4.40 ± 0.61 and 14.45 ± 2.82 mSv, respectively, resulting in the total patient dose of 18.85 mSv. This can be used as the reference dose in Thai patients. (authors)

  9. Contribution of co-registered PET/CT for patients with suspected recurrence of colo-rectal cancer

    International Nuclear Information System (INIS)

    Garin, E.; Devillers, A.; Prigent, F.; Girault, S.; Herry, J.Y.; Bourguet, P.; Bouriel, C.; Boudjema, K.; Campion, J.P.; Meunier, B.; Boucher, E.; Raoul, J.L.

    2003-01-01

    Positron emission tomography using 18 F fluorodeoxyglucose (PET) has proved to offer advantages for patients presenting with suspected recurrence of colo-rectal cancer. However; this examination is confronted with two disadvantages: the lack of anatomical reference marks and the presence of physiological uptake that can be difficult to locate. We carried out a retrospective study on 30 patients with suspected recurrence of Colo-rectal cancer in order to evaluate the diagnostic and therapeutic impact of PET/CT fusion images compared with PET alone. PET/CT acquisitions were performed on a prototype Positrace or on a double-detection head gamma camera in coincidence Hawkeye. PET/CT fusion images had a formal diagnostic impact for 6 patients out of 30 (20%), including 5 patients out of 12 (41%) having a suspected pelvic recurrence. In five cases, it allowed us to resolve ambiguities about whether the site of recurrence was located in the bone or the soft tissues. Furthermore, in one case we were able to locate an intra-abdominal uptake focus at the level of the liver. The PET/CT fusion images had a probable diagnostic impact for three additional patients. For two patients, the PET/CT fusion images allowed us to identify an ambiguous uptake focus as being related to physiological renal uptake. For 4 patients out of 30 (13%), the PET/CT fusion images had a clear additional therapeutic impact, including 4/12 (33%) for whom a pelvic recurrence could be suspected. The present study shows that PET/CT fusion images have an important diagnostic and therapeutic impact for patients with suspected recurrence of colorectal cancer; the impact becoming major for the subgroup of patients having a suspected pelvic recurrence. (author)

  10. Integrated PET/MRI for whole-body staging of patients with primary cervical cancer: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Grueneisen, Johannes; Kinner, Sonja; Forsting, Michael; Lauenstein, Thomas; Umutlu, Lale [University Hospital Essen, University of Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Schaarschmidt, Benedikt Michael [University Hospital Dusseldorf, University of Dusseldorf, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Heubner, Martin; Aktas, Bahriye [University Hospital Essen, University of Duisburg-Essen, Department of Obstetrics and Gynecology, Essen (Germany); Ruhlmann, Verena [University Hospital Essen, University of Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany)

    2015-11-15

    To assess the diagnostic value of integrated PET/MRI for whole-body staging of cervical cancer patients, as well as to investigate a potential association between PET/MRI derived functional parameters and prognostic factors of cervical cancer. The present study was approved by the local institutional review board. Twenty-seven patients with histopathologically confirmed cervical cancer were prospectively enrolled in our study. All patients underwent a whole-body PET/MRI examination after written informed consent was obtained. Two radiologists separately evaluated the PET/MRI data sets regarding the determination of local tumor extent of primary cervical cancer lesions, as well as detection of nodal and distant metastases. Furthermore, SUV and ADC values of primary tumor lesions were analyzed and correlated with dedicated prognostic factors of cervical cancer. Results based on histopathology and cross-sectional imaging follow-up served as the reference standard. PET/MRI enabled the detection of all 27 primary tumor lesions of the uterine cervix and allowed for the correct determination of the T-stage in 23 (85 %) out of the 27 patients. Furthermore, the calculated sensitivity, specificity and diagnostic accuracy for the detection of nodal positive patients (n = 11) were 91 %, 94 % and 93 %, respectively. PET/MRI correctly identified regional metastatic disease (N1-stage) in 8/10 (80 %) patients and non-regional lymph node metastases in 5/5 (100 %) patients. In addition, quantitative analysis of PET and MRI derived functional parameters (SUV; ADC values) revealed a significant correlation with pathological grade and tumor size (p < 0.05). The present study demonstrates the high potential of integrated PET/MRI for the assessment of primary tumor and the detection of lymph node metastases in patients with cervical cancer. Providing additional prognostic information, PET/MRI may serve as a valuable diagnostic tool for cervical cancer patients in a pretreatment setting

  11. Integrated PET/MRI for whole-body staging of patients with primary cervical cancer: preliminary results

    International Nuclear Information System (INIS)

    Grueneisen, Johannes; Kinner, Sonja; Forsting, Michael; Lauenstein, Thomas; Umutlu, Lale; Schaarschmidt, Benedikt Michael; Heubner, Martin; Aktas, Bahriye; Ruhlmann, Verena

    2015-01-01

    To assess the diagnostic value of integrated PET/MRI for whole-body staging of cervical cancer patients, as well as to investigate a potential association between PET/MRI derived functional parameters and prognostic factors of cervical cancer. The present study was approved by the local institutional review board. Twenty-seven patients with histopathologically confirmed cervical cancer were prospectively enrolled in our study. All patients underwent a whole-body PET/MRI examination after written informed consent was obtained. Two radiologists separately evaluated the PET/MRI data sets regarding the determination of local tumor extent of primary cervical cancer lesions, as well as detection of nodal and distant metastases. Furthermore, SUV and ADC values of primary tumor lesions were analyzed and correlated with dedicated prognostic factors of cervical cancer. Results based on histopathology and cross-sectional imaging follow-up served as the reference standard. PET/MRI enabled the detection of all 27 primary tumor lesions of the uterine cervix and allowed for the correct determination of the T-stage in 23 (85 %) out of the 27 patients. Furthermore, the calculated sensitivity, specificity and diagnostic accuracy for the detection of nodal positive patients (n = 11) were 91 %, 94 % and 93 %, respectively. PET/MRI correctly identified regional metastatic disease (N1-stage) in 8/10 (80 %) patients and non-regional lymph node metastases in 5/5 (100 %) patients. In addition, quantitative analysis of PET and MRI derived functional parameters (SUV; ADC values) revealed a significant correlation with pathological grade and tumor size (p < 0.05). The present study demonstrates the high potential of integrated PET/MRI for the assessment of primary tumor and the detection of lymph node metastases in patients with cervical cancer. Providing additional prognostic information, PET/MRI may serve as a valuable diagnostic tool for cervical cancer patients in a pretreatment setting

  12. PET and PET/CT in tumour of undetermined origin; PET y PET/CT en tumor de origen indeterminado

    Energy Technology Data Exchange (ETDEWEB)

    Garcia O, J R [Nuclear Medicine and Molecular Imaging, PET/CT, Centro Medico ABC, Mexico D.F. (Mexico)

    2007-07-01

    In this presentation the following conclusions were obtained regarding the use of PET and PET/CT in patient with cancer of unknown primary: 1. Detection of the primary one in 1/3 at 1/2 of patient. 2. It detects metastases in other places in 50%. 3. It changes the initial therapy planned in 1/3 at 1/2 of patient. 4. Useful in initial phases of protocol study to limit the other procedures. After standard evaluation. Before advanced protocol. 5. PET/CT study increases the % of primary detection, although in a non significant way vs. PET. 6. They are required more studies to value their utility to a more objective manner. (Author)

  13. 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.

  14. 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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  16. Multiparametric evaluation by simultaneous PET-MRI examination in patients with histologically proven laryngeal cancer.

    Science.gov (United States)

    Cavaliere, Carlo; Romeo, Valeria; Aiello, Marco; Mesolella, Massimo; Iorio, Brigida; Barbuto, Luigi; Cantone, Elena; Nicolai, Emanuele; Covello, Mario

    2017-03-01

    To evaluate the relationship between metabolic 18Fluoro-Deoxyglucose-Positron Emission Tomography (18FDG/PET) and morpho-functional parameters derived by Magnetic Resonance Imaging (MRI) in patients with histologically proven laryngeal cancer. To assess the clinical impact of PET/MRI examination on patient's staging and treatment planning. 16 patients with histologically proven laryngeal cancer were enrolled and underwent whole body PET/CT followed by a dedicated PET/MRI of the head/neck region. Data were separately evaluated by two blinded groups: metabolic (SUV and MTV), diffusion (ADC) and perfusion (K trans , V e , k ep and iAUC) maps were obtained by positioning regions of interest (ROIs). Tumoral local extension assessed on PET/MRI was compared to endoscopic findings. A good inter-observer agreement was found in anatomical location and local extension of PET/MRI lesions (Cohen's kappa 0.9). PET/CT SUV measures highly correlate with ones derived by PET/MRI (e.g., p=0.96 for measures on VOI). Significant correlations among metabolic, diffusion and perfusion parameters have been detected. PET/MRI had a relevant clinical impact, confirming endoscopic findings (6 cases), helping treatment planning (9 cases), and modifying endoscopic primary staging (1 case). PET/MRI is useful for primary staging of laryngeal cancer, allowing simultaneous collection of metabolic and functional data and conditioning the therapeutic strategies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

    International Nuclear Information System (INIS)

    Jaruskova, M.; Belohlavek, O.

    2006-01-01

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  19. PET-CT in oncological patients: analysis of informal care costs in cost-benefit assessment.

    Science.gov (United States)

    Orlacchio, Antonio; Ciarrapico, Anna Micaela; Schillaci, Orazio; Chegai, Fabrizio; Tosti, Daniela; D'Alba, Fabrizio; Guazzaroni, Manlio; Simonetti, Giovanni

    2014-04-01

    The authors analysed the impact of nonmedical costs (travel, loss of productivity) in an economic analysis of PET-CT (positron-emission tomography-computed tomography) performed with standard contrast-enhanced CT protocols (CECT). From October to November 2009, a total of 100 patients referred to our institute were administered a questionnaire to evaluate the nonmedical costs of PET-CT. In addition, the medical costs (equipment maintenance and depreciation, consumables and staff) related to PET-CT performed with CECT and PET-CT with low-dose nonenhanced CT and separate CECT were also estimated. The medical costs were 919.3 euro for PET-CT with separate CECT, and 801.3 euro for PET-CT with CECT. Therefore, savings of approximately 13% are possible. Moreover, savings in nonmedical costs can be achieved by reducing the number of hospital visits required by patients undergoing diagnostic imaging. Nonmedical costs heavily affect patients' finances as well as having an indirect impact on national health expenditure. Our results show that PET-CT performed with standard dose CECT in a single session provides benefits in terms of both medical and nonmedical costs.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-01-15

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

  1. A systematic review of PET and PET/CT in oncology: A way to personalize cancer treatment in a cost-effective manner?

    Directory of Open Access Journals (Sweden)

    Langer Astrid

    2010-10-01

    -effective. However, the strongest evidence for the cost-effectiveness of PET is still in the staging of non-small cell lung cancer. Management decisions relating to the assessment of treatment response or radiotherapy treatment planning require further research to show the impact of PET on patient management and its cost-effectiveness. Because of the potential for increased patient throughput and the possible greater accuracy, the cost-effectiveness of PET/CT may be superior to that of PET. Only four studies of the cost-effectiveness of PET/CT were found in this review, and this is clearly an area for future research.

  2. {sup 11}C-Choline PET/CT in castration-resistant prostate cancer patients treated with docetaxel

    Energy Technology Data Exchange (ETDEWEB)

    Ceci, Francesco [University of Bologna, Service of Nuclear Medicine, S. Orsola-Malpighi Hospital, Bologna (Italy); Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, UO Medicina Nucleare PAD. 30, Bologna (Italy); Castellucci, Paolo; Graziani, Tiziano; Renzi, Riccardo; Fanti, Stefano [University of Bologna, Service of Nuclear Medicine, S. Orsola-Malpighi Hospital, Bologna (Italy); Schiavina, Riccardo; Borghesi, Marco; Brunocilla, Eugenio [University of Bologna, Department of Urology, S. Orsola-Malpighi Hospital, Bologna (Italy); Di Tullio, Piergiorgio; Ardizzoni, Andrea [University of Bologna, Department of Oncology, S. Orsola-Malpighi Hospital, Bologna (Italy)

    2016-01-15

    To investigate the role of {sup 11}C-choline PET/CT for evaluating the response to treatment in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with docetaxel in comparison with PSA response. Inclusion criteria were (a) proven mCRPC, (b) docetaxel as first line of chemotherapy (docetaxel 75 mg/m{sup 2} + prednisone 5 mg), and (c) {sup 11}C-choline PET/CT and PSA values assessed before and after docetaxel administration. A total of 61 patients were retrospectively enrolled (mean age 68.9 years, range 57 - 84 years). {sup 11}C-Choline PET/CT was performed at baseline before docetaxel treatment (PET1) and after the end of treatment (PET2). PSA values were measured before treatment (PSA1) and after treatment (PSA2). PET2 was reported as complete response (CR), partial response (PR) or stable disease (SD). Progressive disease (PD) was considered if a new lesion was seen. PSA trend was calculated from the change in absolute values between PSA1 and PSA2. A decrease of ≥50 % between PSA1 and PSA2 was considered a PSA response. Clinical, radiological and laboratory follow-up ranged from 6 to 53 months (mean 13.5 months). Of the 61 patients, 40 (65.5 %) showed PD on PET2, 13 (21.3 %) showed SD, 2 (3.4 %) showed PR, and 6 (9.8 %) showed CR. An increasing PSA trend was seen in 29 patients (47.5 %) and a decreasing PSA trend in 32 patients (52.5 %). A PSA response of ≥50 % was seen in 25 patients (41 %). Radiological PD was seen in 23 of the 29 patients (79.3 %) with an increasing PSA trend, in 16 of the 32 patients (50 %) with a decreasing PSA trend, and in 11 of the 25 patients (44 %) with a PSA response of ≥50 %. In the multivariate statistical analysis, the presence of more than ten bone lesions detected on PET1 was significantly associated with an increased probability of PD on PET2. No association was observed between PSA level and PD on PET2. Our results suggest that an increasing PSA trend measured after docetaxel treatment could be

  3. Utility of whole-body (head-to-toe) PET/CT in the evaluation of melanoma and sarcoma patients.

    Science.gov (United States)

    Webb, Heather R; Latifi, Hamid R; Griffeth, Landis K

    2018-01-01

    The aim of this study was to assess the added benefit of whole-body (head-to-toes) PET/CT versus routine 'eyes-to-thighs' PET/CT of melanoma and sarcoma patients. We performed a retrospective review of consecutive whole-body PET/CT scans from January 2006 through December 2010 in patients with melanoma or sarcoma. PET abnormalities in the brain, distal thighs, and legs were recorded and clinical significance was assessed on the basis of pathology, imaging studies, and clinical follow-up. Patients with known primary lesions distal to the proximal femora were excluded as these patients would routinely undergo 'head-to-toe' PET/CT. We reviewed reports from 352 PET/CT examinations in 194 patients with melanoma and 75 PET/CT examinations in 44 patients with sarcoma. Melanoma: 13 patients had brain metastases on PET. In five of these patients, lesions were unknown, but all were in the setting of other metastatic disease. Twenty-seven patients had lower extremity metastases, all in the setting of other metastatic disease. No lower extremity metastases were found in the remaining 167 patients. Sarcoma: one patient had an isolated, unexpected brain metastasis. Six patients had leg metastases, but none were isolated. No lower extremity metastases were found in the remaining 38 patients. In patients with melanoma and sarcoma, inclusion of entire lower extremities adds little additional clinical value as detection of isolated, unexpected metastasis is rare. Brain imaging may add value as the presence of brain metastases alters clinical management. Overall, in patients with melanoma or sarcoma, whole-brain PET/CT imaging may be of value, but routine inclusion of the entire lower extremities adds little additional value.

  4. Role of FDG PET/CT in Diagnostic Evaluation of Granulocytic Sarcomas: A Series of 12 Patients.

    Science.gov (United States)

    Chandra, Piyush; Dhake, Sanket; Purandare, Nilendu; Agrawal, Archi; Shah, Sneha; Rangarajan, Venkatesh

    2017-01-01

    Granulocytic sarcoma (GS) is a rare extramedullary manifestation in patients with acute myeloid leukemia (AML), which can precede the diagnosis or occur in the posttreatment setting. Unlike its established role in other hematological malignancies like Hodgkin's on non-Hodgkin's disease, the exact role of positron emission tomography/computed tomography (PET/CT) in AML with or without GS remains to be defined. We retrospectively reviewed PET/CT scans of 12 patients with histologically proven GS. Marrow examination of these patients identified nine patients with isolated GS (without existent leukemia) and three patients with coexistent leukemia. PET/CT accurately identified all clinically evident GS in all 12 patients at initial staging and at follow-up with tumors, showing moderate to high 2-deoxy-2-fluoro-D-glucose uptake. Coexistent marrow disease was seen on PET/CT in three patients, which was confirmed on histopathology. In the same patients, PET/CT also detected additional sites of extramedullary disease in 66.6% (n = 8), which was either clinically occult or not evident on routine CT. PET/CT appears to be a highly sensitive imaging modality in diagnostic evaluation of GS. The most important indication of using PET/CT in these cases is to identify additional sites of clinically occult extramedullary disease, which can potentially impact treatment decisions and outcomes.

  5. Detection ability of FDG-PET/CT comparing with other imaging modalities in multiple myeloma patients

    International Nuclear Information System (INIS)

    Chae, Min Jeong; Lee, Tae Hyun; Pai, Moon Sun; Cheon, Gi Jeong; Choi, Chang Woon; Lim, Sang Moo

    2007-01-01

    Multiple myeloma (MM) is characterized by bone marrow infiltration with malignant plasma cells. It is important to detect involving bone for diagnosis and management of MM. The aim of this study was to evaluate the diagnostic ability and limitation of 18F-FDG-PET/CT (PET/CT) comparing other imaging modalities (separated PET and CT, whole body plain X-ray (XR), bone scintigraphy (BS), and MRI) in MM. Twenty PET/CT scans were performed in 16 patients (M: F=6: 10, median age=59 y). PET/CT findings were compared with available other images (n of CT=21, XR=21, BS=8, and MRI=5). Concordance with more than 2 image modalities, laboratory data, symptom, and biopsies were used for diagnosis of detected lesions. PET/CT revealed 256 of total 287 sites (sensitivity, 89.2%; accuracy, 84.8%). The sensitivity and accuracy of separating PET, CT, and XR were 86.3%, 70.4%; 47.4%, 50.3%; and 72.8%, 72.4%, respectively. Available BS identified 67 of 202 sites (sensitivity, 33.2%; accuracy, 44.0%). MRI detected 20 of 24 sites (sensitivity, 83.3%; accuracy, 36.3%). False positive rate (FP) of PET, XR, and MRI was as high as 87.8%, 95.1%, and 100%. PET for rib lesion identified 9 of 10 patients (90.0%) but for skull lesion only 4 of 7 patients (57.2%) with underestimation. 5 patients in MRI showed diffuse marrow signal change but only 3 had marrow involvement. But PET/CT showed higher accuracy than MRI. PET/CT was the most useful tool for detecting involving bone of MM comparing with other imaging modalities. Moreover, PET/CT is expected to overcome the limitations for the small osteolytic bone lesions with diffuse FDG uptake on PET

  6. Impact of {sup 18}F-FDG PET/CT on the management of adrenocortical carcinoma: analysis of 106 patients

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Satoshi; Macapinlac, Homer A.; Chuang, Hubert H. [The University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Balachandran, Aparna [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Habra, Mouhammed Amir [The University of Texas MD Anderson Cancer Center, Department of Endocrine Neoplasia and Hormonal Disorders, Houston, TX (United States); Phan, Alexandria T. [The University of Texas MD Anderson Cancer Center, Department of Gastrointestinal Medical Oncology, Houston, TX (United States); Bassett, Roland L. [The University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States)

    2014-11-15

    Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy. Limited data are available about on value of {sup 18}F-FDG PET/CT in ACC. We evaluated the impact of PET/CT on the management of ACC. We performed a retrospective review in patients with ACC who had undergone PET/CT. The impact of PET/CT on the management plan was evaluated by comparing the findings on PET/CT to the findings on contrast-enhanced CT. The sensitivity, specificity, and accuracy of each form of imaging were calculated. The correlations between PET/CT parameters, including maximum standardized uptake value (SUV{sub max}), total lesion glycolysis, and decline in SUV{sub max} after chemotherapy, and clinical outcome were evaluated. Included in the analysis were 106 patients with 180 PET/CT scans. Of the 106 patients, 7 underwent PET/CT only for initial staging, 84 underwent PET/CT only for restaging, and 15 underwent PET/CT for both initial staging and restaging. PET/CT changed the management plan in 1 of 22 patients (5 %) at initial staging and 9 of 99 patients (9 %) at restaging. In 5 of the patients in whom PET/CT changed the management plan, PET/CT showed response to chemotherapy but contrast-enhanced CT showed stable disease. Sensitivity, specificity, and accuracy were 100 %, 100 %, and 100 % for PET/CT at initial staging; 92.6 %, 100 %, and 96.4 % for CT at initial staging; 98.4 %, 100 %, and 99.5 % for PET/CT at restaging; and 96.8 %, 98.6 %, and 98.0 % for CT at restaging, respectively. No PET/CT parameters were associated with survival at either initial diagnosis or recurrence. PET/CT findings could substantially change the management plan in a small proportion of patients with ACC. Although lesion detection was similar between PET/CT and CT, PET/CT may be preferred for chemotherapeutic response assessment because it may predict response before anatomic changes are detected on CT. (orig.)

  7. PET/MRI and PET/CT in advanced gynaecological tumours: initial experience and comparison

    Energy Technology Data Exchange (ETDEWEB)

    Queiroz, Marcelo A.; Schulthess, Gustav von; Veit-Haibach, Patrick [University Hospital Zurich, Department Medical Radiology, Nuclear Medicine, Zurich (Switzerland); University Hospital Zurich, Department Medical Radiology, Diagnostic and Interventional Radiology, Zurich (Switzerland); University of Zurich, Zurich (Switzerland); Kubik-Huch, Rahel A.; Freiwald-Chilla, Bianka [Kantonsspital Baden AG, Department of Radiology, Baden (Switzerland); Hauser, Nik [Kantonsspital Baden AG, Department of Gynaecology, Baden (Switzerland); Froehlich, Johannes M. [Guerbet AG, Zurich (Switzerland)

    2015-08-15

    To compare the diagnostic accuracy of PET/MRI and PET/CT for staging and re-staging advanced gynaecological cancer patients as well as identify the potential benefits of each method in such a population. Twenty-six patients with suspicious or proven advanced gynaecological cancer (12 ovarian, seven cervical, one vulvar and four endometrial tumours, one uterine metastasis, and one primary peritoneal cancer) underwent whole-body imaging with a sequential trimodality PET/CT/MR system. Images were analysed regarding primary tumour detection and delineation, loco-regional lymph node staging, and abdominal/extra-abdominal distant metastasis detection (last only by PET/CT). Eighteen (69.2 %) patients underwent PET/MRI for primary staging and eight patients (30.8 %) for re-staging their gynaecological malignancies. For primary tumour delineation, PET/MRI accuracy was statistically superior to PET/CT (p < 0.001). Among the different types of cancer, PET/MRI presented better tumour delineation mainly for cervical (6/7) and endometrial (2/3) cancers. PET/MRI for local evaluation as well as PET/CT for extra-abdominal metastases had therapeutic consequences in three and one patients, respectively. PET/CT detected 12 extra-abdominal distant metastases in 26 patients. PET/MRI is superior to PET/CT for primary tumour delineation. No differences were found in detection of regional lymph node involvement and abdominal metastases detection. (orig.)

  8. Clinical impact of FDG PET-CT on the management of patients with locally advanced cervical carcinoma

    International Nuclear Information System (INIS)

    Fleming, S.; Cooper, R.A.; Swift, S.E.; Thygesen, H.H.; Chowdhury, F.U.; Scarsbrook, A.F.; Patel, C.N.

    2014-01-01

    Aim: To evaluate the impact of staging FDG PET-CT on the initial management of patients with locally advanced cervical carcinoma (LACC) and any prognostic variables predicting survival. Materials and methods: Retrospective analysis of consecutive patients undergoing FDG PET-CT for staging of LACC in a single tertiary referral centre, between April 2008 and August 2011. Comparison was made between MRI and PET-CT findings and any subsequent impact on treatment intent or radiotherapy planning was evaluated. Results: Sixty-three patients underwent FDG PET-CT for initial staging of LACC. Major impact on management was found in 20 patients (32%), a minor impact in five (8%), and no impact in 38 (60%). In those patients where PET-CT had a major impact, 12 had more extensive local nodal involvement, five had occult metastatic disease, two had synchronous tumours, and one patient had equivocal lymph nodes on MRI characterized as negative. PET-positive nodal status at diagnosis was found to be a statistically significant predictor of relapse-free survival (p < 0.05). Conclusion: Staging FDG PET-CT has a major impact on the initial management of approximately one-third of patients with LACC by altering treatment intent and/or radiotherapy planning. PET-defined nodal status is a poor prognostic indicator. - Highlights: • Cervical carcinoma is one of the commonest cancers in women worldwide. • Locally advanced cervical carcinoma is usually treated with chemo-radiotherapy. • FDG PET-CT can have a major impact on management in up to one-third of patients. • It may alter treatment intent or radiotherapy-planning by detecting occult disease. • PET nodal status at diagnosis is an important predictor of relapse-free survival

  9. Effectiveness of PET Scan in Postoperative Long Term Follow up of Patients with Nonsmall Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Atilla Pekcolaklar

    2012-01-01

    Full Text Available Aim: There is very few data about the use of positron emission tomography [PET] in the long term follow up of patients operated for lung cancer. We aimed to evaluate the effectiveness of PET scan in detecting distant metastases in the long term follow up of asymptomatic patients operated for non-small cell lung cancer [NSCLC]. Material and Method: PET scan was performed to sixty five asymptomatic patients. The patients who had a positive PET scan for metastasis underwent MRI and/or biopsy to verify metastasis. Result: : Mean age of the patients was 58.09 8.64 [44-82] years, and 57 [87.7 %] of them were male. Forty eight [73.8%] of the patients had epidermoid cell, 15 [23.1%] had adeno and 2 [%3.1] had large cell carcinoma. Postoperative stage of 1 [1.5%] patient was 1A, 14 [21.5%] of them were stage 1B, 1 [1.5%] of them was stage 2A, 27 [41.5%] of them were stage 2B and 22 [33.8%] of them were stage 3A. PET scan detected metastasis in 7 [10.8%] patients. In one patient PET scan was proven to be false positive. Sites of metastases in PET scan were lung in 3 [4.5%] patients, vertebra in 3 [4.6%] patients and tibia in 1 [1.5%] patient. In detecting distant metastases accuracy rate of PET was calculated as 98%, sensitivity was 100%, and specificity was 98%. Discussion: In asymptomatic patients with NSCLC, PET imaging appears to be useful as an alternative to conventional imaging to rule out unsuspected systemic disease in the postoperative long term follow up.

  10. 18FDG-PET in 733 consecutive patients with or without side-by-side CT evaluation. Analysis of 921 lesions

    International Nuclear Information System (INIS)

    Buell, U.; Wieres, F.J.; Schneider, W.; Reinartz, P.

    2004-01-01

    Side-by-side analysis of CT and conventional 18 FDG-PET in oncological imaging is well established. Aim of this study was to find out which patients or diagnostic groups may benefit the most from the newly introduced integrated PET/CT scanners. Patients, methods: 407 consecutively admitted oncological patients with accompanying CT (groups A-D) and 326 patients without CT (groups E-G) were examined by conventional ring PET. Two nuclear medicine physicians and two radiologists assessed each patient's PET and CT scans for pathological lesions with regard to localisation and infiltration of adjacent anatomical structures. Patients without pathological PET findings were assigned to groups A (with CT) or E (without CT). If the localisation and/or extent of a pathological PET focus could only be assessed by taking into account the CT scan, the patient was assigned to group C (with CT) or G (without CT). If PET alone was sufficient for both questions the patient was assigned to groups B (with CT) or F (without CT). If neither method allowed for a precise lesion characterisation, the patient was assigned to group D. Results: 38.6% (A, E) of all patients were PET-negative. PET alone sufficed in 20.6% (B, F). Side-by-side reading of PET and CT was needed for 43.5% (C) of patients referred to PET with a current CT. Side-by-side reading of CT and PET did not suffice for 7.3% (D) of patients in that cohort. A total of 28.2% (G) of the cases without CT would have profited from it. The most frequent oncological diagnoses in group D (PET and conventional CT not sufficient) were bronchial carcinoma with abdominal lesions, while in group G (without CT but CT required) head/neck cancer with thoracic lesions was predominant. Conclusions: Side-by-side reading of PET and already existing conventional CT failed to yield conclusive data with regard to lesion characterisation in only 7.4% of patients so that PET/CT might have been helpful in these cases. 28.2% of the patients without

  11. 18F-FDOPA PET/MRI fusion in patients with primary/recurrent gliomas: Initial experience

    International Nuclear Information System (INIS)

    Ledezma, Carlos J.; Chen, Wei; Sai, Victor; Freitas, Bonnie; Cloughesy, Tim; Czernin, Johannes; Pope, Whitney

    2009-01-01

    Background and purpose: 18 F-FDOPA PET demonstrates higher sensitivity and specificity for gliomas than traditional [ 18 F] FDG PET imaging. However, PET provides limited anatomic localization. The purpose of this study was to determine whether 18 F-FDOPA PET/MRI fusion can provide precise anatomic localization of abnormal tracer uptake and how this activity corresponds to MR signal abnormality. Methods: Two groups of patients were analyzed. Group I consisted of 21 patients who underwent 18 F-FDOPA PET and MRI followed by craniotomy for tumor resection. Group II consisted of 70 patients with a pathological diagnosis of glioma that had 18 F-FDOPA PET and MRI but lacked additional pathologic follow-up. Fused 18 F-FDOPA PET and MRI images were analyzed for concordance and correlated with histopathologic data. Results: Fusion technology facilitated precise anatomical localization of 18 F-FDOPA activity. In group I, all 21 cases showed pathology-confirmed tumor. Of these, 18 F-FDOPA scans were positive in 9/10 (90%) previously unresected tumors, and 11/11 (100%) of recurrent tumors. Of the 70 patients in group II, concordance between MRI and 18 F-FDOPA was found in 49/54 (90.1%) of patients with sufficient follow-up; in the remaining 16 patients concordance could not be determined due to lack of follow-up. 18 F-FDOPA labeling was comparable in both high- and low-grade gliomas and identified both enhancing and non-enhancing tumor equally well. In some cases, 18 F-FDOPA activity preceded tumor detection on MRI. Conclusion: 18 F-FDOPA PET/MRI fusion provides precise anatomic localization of tracer uptake and labels enhancing and non-enhancing tumor well. In a small minority of cases, 18 F-FDOPA activity may identify tumor not visible on MRI.

  12. How does PET/CT help in selecting therapy for patients with Hodgkin lymphoma?

    DEFF Research Database (Denmark)

    Hutchings, Martin

    2012-01-01

    investigating the use of PET/CT for early response-adapted therapy, with therapeutic stratification based on interim PET/CT results. Posttreatment PET/CT is a cornerstone of the revised response criteria and enables the selection of advanced-stage patients without the need for consolidation radiotherapy. Once...

  13. PET/MRI for Preoperative Planning in Patients with Soft Tissue Sarcoma

    DEFF Research Database (Denmark)

    Loft Jakobsen, Annika; Jensen, Karl Erik; L�fgren, Johan

    2013-01-01

    Clinical positron emission tomography (PET)/magnetic resonance imaging (MRI) acquisition protocols may improve the evaluation of soft tissue sarcomas (STS) prior to surgical planning. We examined two patients with lower extremity STS using a Siemens Biograph mMR PET/MRI scanner and the glucose...

  14. Correlation of Dynamic PET and Gene Array Data in Patients with Gastrointestinal Stromal Tumors

    Directory of Open Access Journals (Sweden)

    Ludwig G. Strauss

    2012-01-01

    Full Text Available Introduction. The results obtained with dynamic PET (dPET were compared to gene expression data obtained in patients with gastrointestinal stromal tumors (GIST. The primary aim was to assess the association of the dPET results and gene expression data. Material and Methods. dPET was performed following the injection of F-18-fluorodeoxyglucose (FDG in 22 patients with GIST. All patients were examined prior to surgery for staging purpose. Compartment and noncompartment models were used for the quantitative evaluation of the dPET examinations. Gene array data were based on tumor specimen obtained by surgery after the PET examinations. Results. The data analysis revealed significant correlations for the dPET parameters and the expression of zinc finger genes (znf43, znf85, znf91, znf189. Furthermore, the transport of FDG (k1 was associated with VEGF-A. The cell cycle gene cyclin-dependent kinase inhibitor 1C was correlated with the maximum tracer uptake (SUVmax in the tumors. Conclusions. The data demonstrate a dependency of the tracer kinetics on genes associated with prognosis in GIST. Furthermore, angiogenesis and cell proliferation have an impact on the tracer uptake.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-12-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-10-15

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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  18. Unilateral thalamic hypometabolism on FDG brain PET in patient with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Sager, Sait; Asa, Sertac; Uslu, Lebriz; Halac, Metin

    2011-01-01

    Interictal Brain 18 F fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) imaging has been widely used for localizing the focus of a seizure. Hypometabolism in the extratemporal cortex on FDG-PET study is an important finding to localize seizure focus, which might be seen as ipsilateral, contralateral or bilateral thalamus hypometabolism in epileptic patients. In this case report, it is aimed to show ipsilateral thalamus hypometabolism on FDG PET brain study of a 24-year-old male patient with temporal lobe epilepsy. (author)

  19. 18 F-FDG PET/CT for planning external beam radiotherapy alters therapy in 11% of 581 patients.

    Science.gov (United States)

    Birk Christensen, Charlotte; Loft-Jakobsen, Annika; Munck Af Rosenschöld, Per; Højgaard, Liselotte; Roed, Henrik; Berthelsen, Anne K

    2018-03-01

    18 F-FDG PET/CT (FDG PET/CT) used in radiotherapy planning for extra-cerebral malignancy may reveal metastases to distant sites that may affect the choice of therapy. To investigate the role of FDG PET/CT on treatment strategy changes induced by the use of PET/CT as part of the radiotherapy planning. 'A major change of treatment strategy' was defined as either including more lesions in the gross tumour volume (GTV) distant from the primary tumour or a change in treatment modalities. The study includes 581 consecutive patients who underwent an FDG PET/CT scan for radiotherapy planning in our institution in the year 2008. All PET/CT scans were performed with the patient in treatment position with the use of immobilization devices according to the intended radiotherapy treatment. All scans were evaluated by a nuclear medicine physician together with a radiologist to delineate PET-positive GTV (GTV-PET). For 63 of the patients (11%), the PET/CT simulation scans resulted in a major change in treatment strategy because of the additional diagnostic information. Changes were most frequently observed in patients with lung cancer (20%) or upper gastrointestinal cancer (12%). In 65% of the patients for whom the PET/CT simulation scan revealed unexpected dissemination, radiotherapy was given - changed (n = 38) or unchanged (n = 13) according to the findings on the FDG PET/CT. Unexpected dissemination on the FDG PET/CT scanning performed for radiotherapy planning caused a change in treatment strategy in 11% of 581 patients. © 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  20. {sup 68}Ga-PSMA-HBED-CC PET imaging in breast carcinoma patients

    Energy Technology Data Exchange (ETDEWEB)

    Sathekge, Mike; Lengana, Thabo; Modiselle, Moshe; Vorster, Mariza; Zeevaart, JanRijn; Ebenhan, Thomas [University of Pretoria and Steve Biko Academic Hospital, Department of Nuclear Medicine, Pretoria (South Africa); Maes, Alex [University of Pretoria and Steve Biko Academic Hospital, Department of Nuclear Medicine, Pretoria (South Africa); AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); Wiele, Christophe van de [University of Pretoria and Steve Biko Academic Hospital, Department of Nuclear Medicine, Pretoria (South Africa); University Ghent, Department of Radiology and Nuclear Medicine, Ghent (Belgium)

    2017-04-15

    To report on imaging findings using {sup 68}Ga-PSMA-HBED-CC PET in a series of 19 breast carcinoma patients. {sup 68}Ga-PSMA-HBED-CC PET imaging results obtained were compared to routinely performed staging examinations and analyzed as to lesion location and progesterone receptor status. Out of 81 tumor lesions identified, 84% were identified on {sup 68}Ga-PSMA-HBED-CC PET. {sup 68}Ga-PSMA-HBED-CC SUVmean values of distant metastases proved significantly higher (mean, 6.86, SD, 5.68) when compared to those of primary or local recurrences (mean, 2.45, SD, 2.55, p = 0.04) or involved lymph nodes (mean, 3.18, SD, 1.79, p = 0.011). SUVmean values of progesterone receptor-positive lesions proved not significantly different from progesterone receptor-negative lesions. SUV values derived from FDG PET/CT, available in seven patients, and {sup 68}Ga-PSMA-HBED-CC PET/CT imaging proved weakly correlated (r = 0.407, p = 0.015). {sup 68}Ga-PSMA-HBED-CC PET/CT imaging in breast carcinoma confirms the reported considerable variation of PSMA expression on human solid tumors using immunohistochemistry. (orig.)

  1. Diagnosis and dosimetry in differentiated thyroid carcinoma using 124I PET: comparison of PET/MRI vs PET/CT of the neck

    International Nuclear Information System (INIS)

    Nagarajah, James; Jentzen, Walter; Hartung, Verena; Rosenbaum-Krumme, Sandra; Bockisch, Andreas; Stahl, Alexander; Mikat, Christian; Heusner, Till Alexander; Antoch, Gerald

    2011-01-01

    This study compares intrinsically coregistered 124 I positron emission tomography (PET) and CT (PET/CT) and software coregistered 124 I PET and MRI (PET/MRI) images for the diagnosis and dosimetry of thyroid remnant tissues and lymph node metastases in patients with differentiated thyroid carcinoma (DTC). After thyroidectomy, 33 high-risk DTC patients (stage III or higher) received 124 I PET/CT dosimetry prior to radioiodine therapy to estimate the absorbed dose to lesions and subsequently underwent a contrast-enhanced MRI examination of the neck. Images were evaluated by two experienced nuclear medicine physicians and two radiologists to identify the lesions and to categorize their presumable provenience, i.e. thyroid remnant tissue (TT), lymph node metastasis (LN) and inconclusive tissue. The categorization and dosimetry of lesions was initially performed with PET images alone (PET only). Subsequently lesions were reassessed including the CT and MRI data. The analyses were performed on a patient and on a lesion basis. Patient-based analyses showed that 26 of 33 (79%) patients had at least one lesion categorized as TT on PET only. Of these patients, 11 (42%) and 16 (62%) had a morphological correlate on CT and MRI, respectively, in at least one TT PET lesion. Twelve patients (36%) had at least one lesion classified as LN on PET only. Nine (75%) of these patients had a morphological correlate on both CT and MRI in at least one LN PET lesion. Ten patients (30%) showed at least one lesion on PET only classified as inconclusive. The classification was changed to a clear classification in two patients (two LN) by CT and in four (two TT, two LN) patients by MRI. Lesion-based analyses (n = 105 PET positive lesions) resulted in categorization as TT in 61 cases (58%), 16 (26%) of which had a morphological correlate on CT and 33 (54%) on MRI. A total of 29 lesions (27%) were classified as LN on PET, 18 (62%) of which had a morphological correlate on CT and 24 (83%) on MRI

  2. Impact of 18F-FDG-PET/CT on staging and irradiation of patients with locally advanced rectal cancer

    International Nuclear Information System (INIS)

    Paskeviciute, Brigita; Boelling, Tobias; Brinkmann, Markus; Rudykina, Ganna; Ernst, Iris; Willich, Normann; Koenemann, Stefan; Stegger, Lars; Schober, Otmar; Weckesser, Matthias

    2009-01-01

    To investigate the impact of fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) on planning of neoadjuvant radiotherapy for locally advanced rectal cancer (LARC) patients. From January 2003 to December 2007, a total of 36 patients with LARC underwent a retroprospective PET/CT study for radiotherapy-planning purposes. Gross tumor volume (GTV), clinical target volume (CTV) and planning target volume (PTV) were defined in a retrospective analysis by a blinded reader. The hypothetical boost volume was defined primarily on CT alone, and afterwards on the fused PET/CT dataset. The CT- and PET/CT-based GTVs were quantitatively compared and percentage of overlap (OV%) was calculated and analyzed. The impact of PET/CT on radiation treatment planning and overall patient management was evaluated. PET/CT-GTVs were smaller than CT-GTVs (p < 0.05). PET/CT imaging resulted in a change of overall management for three patients (8 %). In 16 of 35 patients (46 %), PET/CT resulted in a need for modification of the usual target volumes (CT-PTV) because of detection of a geographic miss. FDG-PET/CT had significant impact on radiotherapy planning and overall treatment of patients with LARC. (orig.)

  3. Head and neck imaging with PET and PET/CT: artefacts from dental metallic implants

    International Nuclear Information System (INIS)

    Goerres, Gerhard W.; Hany, Thomas F.; Kamel, Ehab; Schulthess von, Gustav K.; Buck, Alfred

    2002-01-01

    Germanium-68 based attenuation correction (PET Ge68 ) is performed in positron emission tomography (PET) imaging for quantitative measurements. With the recent introduction of combined in-line PET/CT scanners, CT data can be used for attenuation correction. Since dental implants can cause artefacts in CT images, CT-based attenuation correction (PET CT ) may induce artefacts in PET images. The purpose of this study was to evaluate the influence of dental metallic artwork on the quality of PET images by comparing non-corrected images and images attenuation corrected by PET Ge68 and PET CT . Imaging was performed on a novel in-line PET/CT system using a 40-mAs scan for PET CT in 41 consecutive patients with high suspicion of malignant or inflammatory disease. In 17 patients, additional PET Ge68 images were acquired in the same imaging session. Visual analysis of fluorine-18 fluorodeoxyglucose (FDG) distribution in several regions of the head and neck was scored on a 4-point scale in comparison with normal grey matter of the brain in the corresponding PET images. In addition, artefacts adjacent to dental metallic artwork were evaluated. A significant difference in image quality scoring was found only for the lips and the tip of the nose, which appeared darker on non-corrected than on corrected PET images. In 33 patients, artefacts were seen on CT, and in 28 of these patients, artefacts were also seen on PET imaging. In eight patients without implants, artefacts were seen neither on CT nor on PET images. Direct comparison of PET Ge68 and PET CT images showed a different appearance of artefacts in 3 of 17 patients. Malignant lesions were equally well visible using both transmission correction methods. Dental implants, non-removable bridgework etc. can cause artefacts in attenuation-corrected images using either a conventional 68 Ge transmission source or the CT scan obtained with a combined PET/CT camera. We recommend that the non-attenuation-corrected PET images also be

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-04-15

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

  5. Hybrid 18F-FDG PET/MRI might improve locoregional staging of breast cancer patients prior to neoadjuvant chemotherapy

    International Nuclear Information System (INIS)

    Goorts, Briete; Nijnatten, Thiemo J.A. van; Voeoe, Stefan; Wildberger, Joachim E.; Lobbes, Marc B.I.; Kooreman, Loes F.S.; Boer, Maaike de; Keymeulen, Kristien B.M.I.; Aarnoutse, Romy; Smidt, Marjolein L.; Mottaghy, Felix M.

    2017-01-01

    Our purpose in this study was to assess the added clinical value of hybrid 18 F-FDG-PET/MRI compared to conventional imaging for locoregional staging in breast cancer patients undergoing neoadjuvant chemotherapy (NAC). In this prospective study, primary invasive cT2-4 N0 or cT1-4 N+ breast cancer patients undergoing NAC were included. A PET/MRI breast protocol was performed before treatment. MR images were evaluated by a breast radiologist, blinded for PET images. PET images were evaluated by a nuclear physician. Afterwards, a combined PET/MRI report was written. PET/MRI staging was compared to conventional imaging, i.e., mammography, ultrasound and MRI. The proportion of patients with a modified treatment plan based on PET/MRI findings was analyzed. A total of 40 patients was included. PET/MRI was of added clinical value in 20.0% (8/40) of patients, changing the treatment plan in 10% and confirming the malignancy of suspicious lesions on MRI in another 10%. In seven (17.5%) patients radiotherapy fields were extended because of additional or affirmative PET/MRI findings being lymph node metastases (n = 5) and sternal bone metastases (n = 2). In one (2.5%) patient radiotherapy fields were reduced because of fewer lymph node metastases on PET/MRI compared to conventional imaging. Interestingly, all treatment changes were based on differences in number of lymph nodes suspicious for metastasis or number of distant metastasis, whereas differences in intramammary tumor extent were not observed. Prior to NAC, PET/MRI shows promising results for locoregional staging compared to conventional imaging, changing the treatment plan in 10% of patients and potentially replacing PET/CT or tissue sampling in another 10% of patients. (orig.)

  6. 64Cu-DOTA-trastuzumab PET imaging in patients with HER2-positive breast cancer.

    Science.gov (United States)

    Tamura, Kenji; Kurihara, Hiroaki; Yonemori, Kan; Tsuda, Hitoshi; Suzuki, Junko; Kono, Yuzuru; Honda, Natsuki; Kodaira, Makoto; Yamamoto, Harukaze; Yunokawa, Mayu; Shimizu, Chikako; Hasegawa, Koki; Kanayama, Yousuke; Nozaki, Satoshi; Kinoshita, Takayuki; Wada, Yasuhiro; Tazawa, Shusaku; Takahashi, Kazuhiro; Watanabe, Yasuyoshi; Fujiwara, Yasuhiro

    2013-11-01

    The purpose of this study was to determine the safety, distribution, internal dosimetry, and initial human epidermal growth factor receptor 2 (HER2)-positive tumor images of (64)Cu-DOTA-trastuzumab in humans. PET was performed on 6 patients with primary or metastatic HER2-positive breast cancer at 1, 24, and 48 h after injection of approximately 130 MBq of the probe (64)Cu-DOTA-trastuzumab. Radioactivity data were collected from the blood, urine, and normal-tissue samples of these 6 patients, and the multiorgan biodistribution and internal dosimetry of the probe were evaluated. Safety data were collected for all the patients after the administration of (64)Cu-DOTA-trastuzumab and during the 1-wk follow-up period. According to our results, the best timing for the assessment of (64)Cu-DOTA-trastuzumab uptake by the tumor was 48 h after injection. Radiation exposure during (64)Cu-DOTA-trastuzumab PET was equivalent to that during conventional (18)F-FDG PET. The radioactivity in the blood was high, but uptake of (64)Cu-DOTA-trastuzumab in normal tissues was low. In 2 patients, (64)Cu-DOTA-trastuzumab PET showed brain metastases, indicative of blood-brain barrier disruptions. In 3 patients, (64)Cu-DOTA-trastuzumab PET imaging also revealed primary breast tumors at the lesion sites initially identified by CT. The findings of this study indicated that (64)Cu-DOTA-trastuzumab PET is feasible for the identification of HER2-positive lesions in patients with primary and metastatic breast cancer. The dosimetry and pharmacologic safety results were acceptable at the dose required for adequate PET imaging.

  7. 18F-FDG PET-CT after Neoadjuvant Chemoradiotherapy in Esophageal Cancer Patients to Optimize Surgical Decision Making.

    Directory of Open Access Journals (Sweden)

    Maarten C J Anderegg

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

  8. 18F-FDG PET-CT after Neoadjuvant Chemoradiotherapy in Esophageal Cancer Patients to Optimize Surgical Decision Making

    Science.gov (United States)

    Anderegg, Maarten C. J.; de Groof, Elisabeth J.; Gisbertz, Suzanne S.; Bennink, Roel J.; Lagarde, Sjoerd M.; Klinkenbijl, Jean H. G.; Dijkgraaf, Marcel G. W.; Bergman, Jacques J. G. H. M.; Hulshof, Maarten C. C. M.; van Laarhoven, Hanneke W. M.; van Berge Henegouwen, Mark I.

    2015-01-01

    Background Prognosis of esophageal cancer patients can be significantly improved by neoadjuvant chemoradiotherapy (nCRT). Given the aggressive nature of esophageal tumors, it is conceivable that in a significant portion of patients treated with nCRT, dissemination already becomes manifest during the period of nCRT. The aim of this retrospective study was to determine the value and diagnostic accuracy of PET-CT after neoadjuvant chemoradiotherapy to identify patients with metastases preoperatively in order to prevent non-curative surgery. Methods From January 2011 until February 2013 esophageal cancer patients deemed eligible for a curative approach with nCRT and surgical resection underwent a PET-CT after completion of nCRT. If abnormalities on PET-CT were suspected metastases, histological proof was acquired. A clinical decision model was designed to assess the cost-effectiveness of this diagnostic strategy. Results 156 patients underwent a PET-CT after nCRT. In 31 patients (19.9%) PET-CT showed abnormalities suspicious for dissemination, resulting in 17 cases of proven metastases (10.9%). Of the patients without proven metastases 133 patients were operated. In 6 of these 133 cases distant metastases were detected intraoperatively, corresponding to 4.5% false-negative results. The standard introduction of a post-neoadjuvant therapy PET-CT led to a reduction of overall health care costs per patient compared to a scenario without restaging with PET-CT ($34,088 vs. $36,490). Conclusion In 10.9% of esophageal cancer patients distant metastases were detected by standard PET-CT after neoadjuvant chemoradiotherapy. To avoid non-curative resections we advocate post-neoadjuvant therapy PET-CT as a cost-effective step in the standard work-up of candidates for surgery. PMID:26529313

  9. Estimation of radiation dose to patients from 18 FDG whole body PET/CT investigations using dynamic PET scan protocol

    Directory of Open Access Journals (Sweden)

    Aruna Kaushik

    2015-01-01

    Full Text Available Background & objectives: There is a growing concern over the radiation exposure of patients from undergoing 18FDG PET/CT (18F-fluorodeoxyglucose positron emission tomography/computed tomography whole body investigations. The aim of the present study was to study the kinetics of 18FDG distributions and estimate the radiation dose received by patients undergoing 18FDG whole body PET/CT investigations. Methods: Dynamic PET scans in different regions of the body were performed in 49 patients so as to measure percentage uptake of 18FDG in brain, liver, spleen, adrenals, kidneys and stomach. The residence time in these organs was calculated and radiation dose was estimated using OLINDA software. The radiation dose from the CT component was computed using the software CT-Expo and measured using computed tomography dose index (CTDI phantom and ionization chamber. As per the clinical protocol, the patients were refrained from eating and drinking for a minimum period of 4 h prior to the study. Results: The estimated residence time in males was 0.196 h (brain, 0.09 h (liver, 0.007 h (spleen, 0.0006 h (adrenals, 0.013 h (kidneys and 0.005 h (stomach whereas it was 0.189 h (brain, 0.11 h (liver, 0.01 h (spleen, 0.0007 h (adrenals, 0.02 h (kidneys and 0.004 h (stomach in females. The effective dose was found to be 0.020 mSv/MBq in males and 0.025 mSv/MBq in females from internally administered 18FDG and 6.8 mSv in males and 7.9 mSv in females from the CT component. For an administered activity of 370 MBq of 18FDG, the effective dose from PET/CT investigations was estimated to be 14.2 mSv in males and 17.2 mSv in females. Interpretation & conclusions: The present results did not demonstrate significant difference in the kinetics of 18FDG distribution in male and female patients. The estimated PET/CT doses were found to be higher than many other conventional diagnostic radiology examinations suggesting that all efforts should be made to clinically justify and

  10. Estimation of radiation dose to patients from (18) FDG whole body PET/CT investigations using dynamic PET scan protocol.

    Science.gov (United States)

    Kaushik, Aruna; Jaimini, Abhinav; Tripathi, Madhavi; D'Souza, Maria; Sharma, Rajnish; Mondal, Anupam; Mishra, Anil K; Dwarakanath, Bilikere S

    2015-12-01

    There is a growing concern over the radiation exposure of patients from undergoing 18FDG PET/CT (18F-fluorodeoxyglucose positron emission tomography/computed tomography) whole body investigations. The aim of the present study was to study the kinetics of 18FDG distributions and estimate the radiation dose received by patients undergoing 18FDG whole body PET/CT investigations. Dynamic PET scans in different regions of the body were performed in 49 patients so as to measure percentage uptake of 18FDG in brain, liver, spleen, adrenals, kidneys and stomach. The residence time in these organs was calculated and radiation dose was estimated using OLINDA software. The radiation dose from the CT component was computed using the software CT-Expo and measured using computed tomography dose index (CTDI) phantom and ionization chamber. As per the clinical protocol, the patients were refrained from eating and drinking for a minimum period of 4 h prior to the study. The estimated residence time in males was 0.196 h (brain), 0.09 h (liver), 0.007 h (spleen), 0.0006 h (adrenals), 0.013 h (kidneys) and 0.005 h (stomach) whereas it was 0.189 h (brain), 0.11 h (liver), 0.01 h (spleen), 0.0007 h (adrenals), 0.02 h (kidneys) and 0.004 h (stomach) in females. The effective dose was found to be 0.020 mSv/MBq in males and 0.025 mSv/MBq in females from internally administered 18FDG and 6.8 mSv in males and 7.9 mSv in females from the CT component. For an administered activity of 370 MBq of 18FDG, the effective dose from PET/CT investigations was estimated to be 14.2 mSv in males and 17.2 mSv in females. The present results did not demonstrate significant difference in the kinetics of 18FDG distribution in male and female patients. The estimated PET/CT doses were found to be higher than many other conventional diagnostic radiology examinations suggesting that all efforts should be made to clinically justify and carefully weigh the risk-benefit ratios prior to every 18FDG whole body PET

  11. PSA levels as a predictor of 68Ga PSMA PET/CT positivity in patients with prostate cancer?

    Science.gov (United States)

    Soydal, Cigdem; Urun, Yuksel; Suer, Evren; Nak, Demet; Ozkan, Elgin; Kucuk, Ozlem N

    2018-05-10

    The aim of this study is to evaluate predictive factors of 68Gallium (68Ga) Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography (PET)/Computed Tomography (CT) positivity. Relationships between serum Prostate Specific Antigen (PSA), Lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) levels, Gleason Score (GS) and positivity of 68Ga PSMA PET in patients who underwent 68Ga PSMA PET/CT for restaging for PCa were evaluated retrospectively. One hundred and four (median age: 67; range: 51-88) patients were included in this study. Of these patients, PSMA PET was positive in 75 (72%) patients. Mean serum PSA levels for PET negative and positive groups were 0.76±1.00 and 180.85±324.93 ng/ml (pPSA cut-off and 92% and 90%, respectively, for the 2 ng/ml PSA cut-off values. The positivity rates for patients with PSA levels PSA recurrence. Patients with higher GS and early PSA recurrence could benefit from 68Ga PSMA PET/CT.

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  13. Areas of normal pulmonary parenchyma on HRCT exhibit increased FDG PET signal in IPF patients

    International Nuclear Information System (INIS)

    Win, Thida; Thomas, Benjamin A.; Lambrou, Tryphon; Hutton, Brian F.; Endozo, Raymondo; Shortman, Robert I.; Afaq, Asim; Ell, Peter J.; Groves, Ashley M.; Screaton, Nicholas J.; Porter, Joanna C.; Maher, Toby M.; Lukey, Pauline

    2014-01-01

    Patients with idiopathic pulmonary fibrosis (IPF) show increased PET signal at sites of morphological abnormality on high-resolution computed tomography (HRCT). The purpose of this investigation was to investigate the PET signal at sites of normal-appearing lung on HRCT in IPF. Consecutive IPF patients (22 men, 3 women) were prospectively recruited. The patients underwent 18 F-FDG PET/HRCT. The pulmonary imaging findings in the IPF patients were compared to the findings in a control population. Pulmonary uptake of 18 F-FDG (mean SUV) was quantified at sites of morphologically normal parenchyma on HRCT. SUVs were also corrected for tissue fraction (TF). The mean SUV in IPF patients was compared with that in 25 controls (patients with lymphoma in remission or suspected paraneoplastic syndrome with normal PET/CT appearances). The pulmonary SUV (mean ± SD) uncorrected for TF in the controls was 0.48 ± 0.14 and 0.78 ± 0.24 taken from normal lung regions in IPF patients (p 18 F-FDG on PET in areas of lung with a normal morphological appearance on HRCT. This may have implications for determining disease mechanisms and treatment monitoring. (orig.)

  14. Comparison of CT and PET/CT for biopsy guidance in oncological patients

    Energy Technology Data Exchange (ETDEWEB)

    Cerci, Juliano J.; Bogoni, Mateos; Cunha Pereira, Carlos; Cerci, Rodrigo J.; Krauzer, Cassiano; Vicente Vitola, Joao [Quanta - Diagnostico e Terapia, Curitiba, PR (Brazil); Tabacchi, Elena; Fanti, Stefano [University Hospital S. Orsola-Malpighi, Nuclear Medicine Department, Bologna (Italy); Delbeke, Dominique [Vanderbilt University, Nashville, TN (United States); Giacometti Sakamoto, Danielle [Byori - Laboratorio de Patologia, Curitiba (Brazil)

    2017-08-15

    To compare FDG PET/CT and CT for the guidance of percutaneous biopsies with histological confirmation of lesions. We prospectively evaluated 323 patients of whom 181 underwent FDG PET/CT-guided biopsy (total 188 biopsies) and 142 underwent CT-guided biopsy (total 146 biopsies). Biopsies were performed using the same PET/CT scanner with a fluoroscopic imaging system. Technical feasibility, clinical success and complication rates in the two groups were evaluated. Of the 188 biopsies with PET/CT guidance, 182 (96.8%) were successful with conclusive tissue samples obtained and of the 146 biopsies with CT guidance, 137 (93.8%) were successful. Therefore, 6 of 188 biopsies (3.1%) with PET/CT guidance and 9 of 146 (6.1%) with CT guidance were inconclusive (p = 0.19). Due to inconclusive histological results, 4 of the 188 lesions (2.1%) were rebiopsied with PET/CT guidance and 3 of 146 lesions (2.0%) were rebiopsied with CT guidance. Histology demonstrated that 142 of 188 lesions (75.5%) were malignant, and 40 (21.2%) were benign in the PET/CT-guided group, while 89 of 146 lesions (60.9%) were malignant and 48 (32.8%) were benign in the CT-guided group (p = 0.004 and 0.01, respectively). Patients with a histological diagnosis of benign lesion had no recurrence of disease with a minimum of 6 months follow-up. Of the 188 PET/CT-guided biopsies, 6 (3.1%) were repeat biopsies due to a previous nondiagnostic CT-guided biopsy performed in a different diagnostic centre. The interval between the two biopsies was less than a month in all cases. Histology revealed five malignant lesions and one benign lesion among these. The complication rate in the PET/CT-guided biopsy group was 12.7% (24 of 188), while in the CT-guided group, was 9.5% (14 of 146, p = 0.26). Therefore, there was no significant difference in complication rates between PET/CT and CT guidance. PET/CT-guided biopsy is already known to be a feasible and accurate method in the diagnostic work-up of suspected malignant

  15. Comparison of CT and PET/CT for biopsy guidance in oncological patients

    International Nuclear Information System (INIS)

    Cerci, Juliano J.; Bogoni, Mateos; Cunha Pereira, Carlos; Cerci, Rodrigo J.; Krauzer, Cassiano; Vicente Vitola, Joao; Tabacchi, Elena; Fanti, Stefano; Delbeke, Dominique; Giacometti Sakamoto, Danielle

    2017-01-01

    To compare FDG PET/CT and CT for the guidance of percutaneous biopsies with histological confirmation of lesions. We prospectively evaluated 323 patients of whom 181 underwent FDG PET/CT-guided biopsy (total 188 biopsies) and 142 underwent CT-guided biopsy (total 146 biopsies). Biopsies were performed using the same PET/CT scanner with a fluoroscopic imaging system. Technical feasibility, clinical success and complication rates in the two groups were evaluated. Of the 188 biopsies with PET/CT guidance, 182 (96.8%) were successful with conclusive tissue samples obtained and of the 146 biopsies with CT guidance, 137 (93.8%) were successful. Therefore, 6 of 188 biopsies (3.1%) with PET/CT guidance and 9 of 146 (6.1%) with CT guidance were inconclusive (p = 0.19). Due to inconclusive histological results, 4 of the 188 lesions (2.1%) were rebiopsied with PET/CT guidance and 3 of 146 lesions (2.0%) were rebiopsied with CT guidance. Histology demonstrated that 142 of 188 lesions (75.5%) were malignant, and 40 (21.2%) were benign in the PET/CT-guided group, while 89 of 146 lesions (60.9%) were malignant and 48 (32.8%) were benign in the CT-guided group (p = 0.004 and 0.01, respectively). Patients with a histological diagnosis of benign lesion had no recurrence of disease with a minimum of 6 months follow-up. Of the 188 PET/CT-guided biopsies, 6 (3.1%) were repeat biopsies due to a previous nondiagnostic CT-guided biopsy performed in a different diagnostic centre. The interval between the two biopsies was less than a month in all cases. Histology revealed five malignant lesions and one benign lesion among these. The complication rate in the PET/CT-guided biopsy group was 12.7% (24 of 188), while in the CT-guided group, was 9.5% (14 of 146, p = 0.26). Therefore, there was no significant difference in complication rates between PET/CT and CT guidance. PET/CT-guided biopsy is already known to be a feasible and accurate method in the diagnostic work-up of suspected malignant

  16. 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.

  17. A retrospective comparison between {sup 68}Ga-DOTA-TOC PET/CT and {sup 18}F-DOPA PET/CT in patients with extra-adrenal paraganglioma

    Energy Technology Data Exchange (ETDEWEB)

    Kroiss, Alexander; Putzer, Daniel; Decristoforo, Clemens; Uprimny, Christian; Virgolini, Irene Johanna [Innsbruck Medical University, Department of Nuclear Medicine, Innsbruck (Austria); Frech, Andreas; Fraedrich, Gustav [Innsbruck Medical University, Department of Vascular Surgery, Innsbruck (Austria); Gasser, Rudolf Wolfgang [Innsbruck Medical University, Department of Internal Medicine I, Innsbruck (Austria); Shulkin, Barry Lynn [St. Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States); Url, Christoph [Innsbruck Medical University, Department of Otorhinolaryngology, Innsbruck (Austria); Widmann, Gerlig [Innsbruck Medical University, Department of Radiology, Innsbruck (Austria); Prommegger, Rupert [Sanatorium Kettenbruecke, Department of Surgery, Innsbruck (Austria); Sprinzl, Georg Mathias [State Clinic St. Poelten, Department of Otorhinolaryngology, St. Poelten (Austria)

    2013-12-15

    {sup 18}F-Fluoro-l-dihydroxyphenylalanine ({sup 18}F-DOPA) PET offers high sensitivity and specificity in the imaging of nonmetastatic extra-adrenal paragangliomas (PGL) but lower sensitivity in metastatic or multifocal disease. These tumours are of neuroendocrine origin and can be detected by {sup 68}Ga-DOTA-Tyr{sup 3}-octreotide ({sup 68}Ga-DOTA-TOC) PET. Therefore, we compared {sup 68}Ga-DOTA-TOC and {sup 18}F-DOPA as radiolabels for PET/CT imaging for the diagnosis and staging of extra-adrenal PGL. Combined cross-sectional imaging was the reference standard. A total of 5 men and 15 women (age range 22 to 73 years) with anatomical and/or histologically proven extra-adrenal PGL were included in this study. Of these patients, 5 had metastatic or multifocal lesions and 15 had single sites of disease. Comparative evaluation included morphological imaging with CT and functional imaging with {sup 68}Ga-DOTA-TOC PET and {sup 18}F-DOPA PET. The imaging results were analysed on a per-patient and a per-lesion basis. The maximum standardized uptake value (SUV{sub max}) of each functional imaging modality in concordant tumour lesions was measured. Compared with anatomical imaging, {sup 68}Ga-DOTA-TOC PET and {sup 18}F-DOPA PET each had a per-patient and per-lesion detection rate of 100 % in nonmetastatic extra-adrenal PGL. However, in metastatic or multifocal disease, the per-lesion detection rate of {sup 68}Ga-DOTA-TOC was 100 % and that of {sup 18}F-DOPA PET was 56.0 %. Overall, {sup 68}Ga-DOTA-TOC PET identified 45 lesions; anatomical imaging identified 43 lesions, and {sup 18}F-DOPA PET identified 32 lesions. The overall per-lesion detection rate of {sup 68}Ga-DOTA-TOC PET was 100 % (McNemar, P < 0.5), and that of {sup 18}F-DOPA PET was 71.1 % (McNemar, P < 0.001). The SUV{sub max} (mean {+-} SD) of all 32 concordant lesions was 67.9 {+-} 61.5 for {sup 68}Ga-DOTA-TOC PET and 11.8 {+-} 7.9 for {sup 18}F-DOPA PET (Mann-Whitney U test, P < 0.0001). {sup 68}Ga-DOTA-TOC PET

  18. Use of FDG PET/CT for investigation of febrile neutropenia: evaluation in high-risk cancer patients

    International Nuclear Information System (INIS)

    Guy, Stephen D.; Tramontana, Adrian R.; Worth, Leon J.; Thursky, Karin A.; Slavin, Monica A.; Lau, Eddie; Hicks, Rodney J.; Seymour, John F.

    2012-01-01

    Febrile neutropenia (FNP) is a frequent complication of cancer care and evaluation often fails to identify a cause. [ 18 F]FDG PET/CT has the potential to identify inflammatory and infectious foci, but its potential role as an investigation for persistent FNP has not previously been explored. The aim of this study was to prospectively evaluate the clinical utility of FDG PET/CT in patients with cancer and severe neutropenia and five or more days of persistent fever despite antibiotic therapy. Adult patients with a diagnosis of an underlying malignancy and persistent FNP (temperature ≥38 C and neutrophil count <500 cells/μl for 5 days) underwent FDG PET/CT as an adjunct to conventional evaluation and management. The study group comprised 20 patients with FNP who fulfilled the eligibility criteria and underwent FDG PET/CT in addition to conventional evaluation. The median neutrophil count on the day of the FDG PET/CT scan was 30 cells/μl (range 0-730 cells/μl). Conventional evaluation identified 14 distinct sites of infection, 13 (93 %) of which were also identified by FDG PET/CT, including all deep tissue infections. FDG PET/CT identified 9 additional likely infection sites, 8 of which were subsequently confirmed as ''true positives'' by further investigations. FDG PET/CT was deemed to be of 'high' clinical impact in 15 of the 20 patients (75 %). This study supports the utility of FDG PET/CT scanning in severely neutropenic patients with five or more days of fever. Further evaluation of the contribution of FDG PET/CT in the management of FNP across a range of underlying malignancies is required. (orig.)

  19. Use of FDG PET/CT for investigation of febrile neutropenia: evaluation in high-risk cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Guy, Stephen D.; Tramontana, Adrian R. [Western Health, Department of Infectious Diseases, Private Bag, Footscray, Victoria (Australia); University of Melbourne, Parkville, Victoria (Australia); Worth, Leon J.; Thursky, Karin A.; Slavin, Monica A. [University of Melbourne, Parkville, Victoria (Australia); Peter MacCallum Cancer Centre, Department of Infectious Diseases, Melbourne, Victoria (Australia); Lau, Eddie; Hicks, Rodney J. [University of Melbourne, Parkville, Victoria (Australia); Peter MacCallum Cancer Centre, Centre for Cancer Imaging, Melbourne, Victoria (Australia); Seymour, John F. [University of Melbourne, Parkville, Victoria (Australia); Peter MacCallum Cancer Centre, Department of Haematology, Melbourne, Victoria (Australia)

    2012-08-15

    Febrile neutropenia (FNP) is a frequent complication of cancer care and evaluation often fails to identify a cause. [{sup 18} F]FDG PET/CT has the potential to identify inflammatory and infectious foci, but its potential role as an investigation for persistent FNP has not previously been explored. The aim of this study was to prospectively evaluate the clinical utility of FDG PET/CT in patients with cancer and severe neutropenia and five or more days of persistent fever despite antibiotic therapy. Adult patients with a diagnosis of an underlying malignancy and persistent FNP (temperature {>=}38 C and neutrophil count <500 cells/{mu}l for 5 days) underwent FDG PET/CT as an adjunct to conventional evaluation and management. The study group comprised 20 patients with FNP who fulfilled the eligibility criteria and underwent FDG PET/CT in addition to conventional evaluation. The median neutrophil count on the day of the FDG PET/CT scan was 30 cells/{mu}l (range 0-730 cells/{mu}l). Conventional evaluation identified 14 distinct sites of infection, 13 (93 %) of which were also identified by FDG PET/CT, including all deep tissue infections. FDG PET/CT identified 9 additional likely infection sites, 8 of which were subsequently confirmed as ''true positives'' by further investigations. FDG PET/CT was deemed to be of 'high' clinical impact in 15 of the 20 patients (75 %). This study supports the utility of FDG PET/CT scanning in severely neutropenic patients with five or more days of fever. Further evaluation of the contribution of FDG PET/CT in the management of FNP across a range of underlying malignancies is required. (orig.)

  20. DosedPet application for Nuclear Medicine: Calculation of the volume of medication needed for PET/CT patient

    International Nuclear Information System (INIS)

    Nascimento, Pedro Augusto do; Rodrigues, Araken dos S. Werneck

    2016-01-01

    This paper presents the application (APP) DosePet that calculates the amount of medicament for PET / CT in patients according to the predetermined radiation dose. The software has been designed using the web MIT App Inventor2 tool for Android platform. The application allows the workers to simulate the amount of radiation still existing in the facilities after the applications, increasing security and reducing exposures, and enable greater efficiency in the use of the radiopharmaceutical. (author)

  1. Added Diagnostic Value of 11C-PiB-PET in Memory Clinic Patients with Uncertain Diagnosis

    Directory of Open Access Journals (Sweden)

    K.S. Frederiksen

    2012-12-01

    Full Text Available Introduction: The added diagnostic value of 11C-PiB-PET for the assessment of the accumulation of cortical beta-amyloid in memory clinic patients with uncertain diagnosis remains undetermined. Methods: All patients who underwent PiB-PET at the Copenhagen Memory Clinic between March 2008 and November 2011 were included in this uncontrolled, retrospective study. The standard diagnostic evaluation program included physical and neurological examination, cognitive and functional assessment, a cranial CT or MRI, functional imaging and cerebrospinal fluid sampling. Based on anonymized case reports, three experienced clinicians reached a consensus diagnosis and rated their confidence in the diagnosis before and after disclosure of PiB-PET ratings. PiB-PET scans were rated as either positive or negative. Results: A total of 57 patients (17 females, 30 males; age 65.7 years, range 44.2–82.6 were included in the study. Twenty-seven had a positive PiB-PET scan. At the first diagnostic evaluation, 16 patients were given a clinical Alheimer’s disease diagnosis (14 PiB positive. Of the 57 patients, 13 (23% were diagnostically reclassified after PiB-PET ratings were disclosed. The clinicians’ overall confidence in their diagnosis increased in 28 (49% patients. Conclusion: PiB-PET adds to the specialist clinical evaluation and other supplemental diagnostic investigations in the diagnostic classification of patients with uncertain diagnosis in a specialized memory clinic.

  2. Evaluation of PET and MR datasets in integrated 18F-FDG PET/MRI: A comparison of different MR sequences for whole-body restaging of breast cancer patients

    International Nuclear Information System (INIS)

    Grueneisen, Johannes; Sawicki, Lino Morris; Wetter, Axel; Kirchner, Julian; Kinner, Sonja; Aktas, Bahriye; Forsting, Michael; Ruhlmann, Verena; Umutlu, Lale

    2017-01-01

    Objectives: To investigate the diagnostic value of different MR sequences and 18F-FDG PET data for whole-body restaging of breast cancer patients utilizing PET/MRI. Methods: A total of 36 patients with suspected tumor recurrence of breast cancer based on clinical follow-up or abnormal findings in follow-up examinations (e.g. CT, MRI) were prospectively enrolled in this study. All patients underwent a PET/CT and subsequently an additional PET/MR scan. Two readers were instructed to identify the occurrence of a tumor relapse in subsequent MR and PET/MR readings, utilizing different MR sequence constellations for each session. The diagnostic confidence for the determination of a malignant or benign lesion was qualitatively rated (3-point ordinal scale) for each lesion in the different reading sessions and the lesion conspicuity (4-point ordinal scale) for the three different MR sequences was additionally evaluated. Results: Tumor recurrence was present in 25/36 (69%) patients. All three PET/MRI readings showed a significantly higher accuracy as well as higher confidence levels for the detection of recurrent breast cancer lesions when compared to MRI alone (p < 0.05). Furthermore, all three PET/MR sequence constellations showed comparable diagnostic accuracy for the identification of a breast cancer recurrence (p > 0.05), yet the highest confidence levels were obtained, when all three MR sequences were used for image interpretation. Moreover, contrast-enhanced T1-weighted VIBE imaging showed significantly higher values for the delineation of malignant and benign lesions when compared to T2 w HASTE and diffusion-weighted imaging. Conclusion: Integrated PET/MRI provides superior restaging of breast cancer patients over MRI alone. Facing the need for appropriate and efficient whole-body PET/MR protocols, our results show the feasibility of fast and morphologically adequate PET/MR protocols. However, considering an equivalent accuracy for the detection of breast cancer

  3. Evaluation of PET and MR datasets in integrated 18F-FDG PET/MRI: A comparison of different MR sequences for whole-body restaging of breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Grueneisen, Johannes, E-mail: Johannes.grueneisen@uk-essen.de [Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen (Germany); Sawicki, Lino Morris [Department of Diagnostic and Interventional Radiology, University Hospital, Dusseldorf, University of Dusseldorf, D-40225 Dusseldorf (Germany); Wetter, Axel [Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen (Germany); Kirchner, Julian [Department of Diagnostic and Interventional Radiology, University Hospital, Dusseldorf, University of Dusseldorf, D-40225 Dusseldorf (Germany); Kinner, Sonja [Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen (Germany); Aktas, Bahriye [Department of Obstetrics and Gynecology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen (Germany); Forsting, Michael [Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen (Germany); Ruhlmann, Verena [Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen (Germany); Umutlu, Lale [Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen (Germany)

    2017-04-15

    Objectives: To investigate the diagnostic value of different MR sequences and 18F-FDG PET data for whole-body restaging of breast cancer patients utilizing PET/MRI. Methods: A total of 36 patients with suspected tumor recurrence of breast cancer based on clinical follow-up or abnormal findings in follow-up examinations (e.g. CT, MRI) were prospectively enrolled in this study. All patients underwent a PET/CT and subsequently an additional PET/MR scan. Two readers were instructed to identify the occurrence of a tumor relapse in subsequent MR and PET/MR readings, utilizing different MR sequence constellations for each session. The diagnostic confidence for the determination of a malignant or benign lesion was qualitatively rated (3-point ordinal scale) for each lesion in the different reading sessions and the lesion conspicuity (4-point ordinal scale) for the three different MR sequences was additionally evaluated. Results: Tumor recurrence was present in 25/36 (69%) patients. All three PET/MRI readings showed a significantly higher accuracy as well as higher confidence levels for the detection of recurrent breast cancer lesions when compared to MRI alone (p < 0.05). Furthermore, all three PET/MR sequence constellations showed comparable diagnostic accuracy for the identification of a breast cancer recurrence (p > 0.05), yet the highest confidence levels were obtained, when all three MR sequences were used for image interpretation. Moreover, contrast-enhanced T1-weighted VIBE imaging showed significantly higher values for the delineation of malignant and benign lesions when compared to T2 w HASTE and diffusion-weighted imaging. Conclusion: Integrated PET/MRI provides superior restaging of breast cancer patients over MRI alone. Facing the need for appropriate and efficient whole-body PET/MR protocols, our results show the feasibility of fast and morphologically adequate PET/MR protocols. However, considering an equivalent accuracy for the detection of breast cancer

  4. Dedicated brain PET system of PET/MR for brain research

    International Nuclear Information System (INIS)

    Cheng, Li; Liu, Yaqiang; Ma, Tianyu; Wang, Shi; Wei, Qingyang; Xu, Tianpeng

    2015-01-01

    This work is to replace PET ring in human brain PET/MR system with a dedicated wearable PET insert, aimed at improving both patient feasibility and system performance for brain imaging. The designed PET/MR system includes two parts: the inside parts, including a radio frequency (RF) coil and PET ring, are mounted on patient’s head, and the outside part, a MR imager, is dependent of patient. The RF coil is the innermost layer, surrounded by an outer PET-ring layer. They are supported by a MRcompatible structure. And both RF coil and PET detectors are placed inside a standard clinical 3-T MR imager. From the design of the system we can infer that some advantages can be achieved. First, high sensitivity will be achieved with the same amount crystals as the PET ring is more close to region-of-interest area, at a reduced cost. Second, by using a 2-layer depth of interaction (DOI) detector, the parallax effect can be minimized. The resolution will benefit from short positron range caused by magnetic field and smaller ring diameter will also reduce the effect of non-collinearity. Thirdly, as the PET ring is mounted on head, impact of patient motion will be reduced.

  5. Dedicated brain PET system of PET/MR for brain research

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Li; Liu, Yaqiang; Ma, Tianyu; Wang, Shi; Wei, Qingyang; Xu, Tianpeng [Institute of Medical Physics, Department of Engineering Physics, Tsinghua University, Beijing (China)

    2015-05-18

    This work is to replace PET ring in human brain PET/MR system with a dedicated wearable PET insert, aimed at improving both patient feasibility and system performance for brain imaging. The designed PET/MR system includes two parts: the inside parts, including a radio frequency (RF) coil and PET ring, are mounted on patient’s head, and the outside part, a MR imager, is dependent of patient. The RF coil is the innermost layer, surrounded by an outer PET-ring layer. They are supported by a MRcompatible structure. And both RF coil and PET detectors are placed inside a standard clinical 3-T MR imager. From the design of the system we can infer that some advantages can be achieved. First, high sensitivity will be achieved with the same amount crystals as the PET ring is more close to region-of-interest area, at a reduced cost. Second, by using a 2-layer depth of interaction (DOI) detector, the parallax effect can be minimized. The resolution will benefit from short positron range caused by magnetic field and smaller ring diameter will also reduce the effect of non-collinearity. Thirdly, as the PET ring is mounted on head, impact of patient motion will be reduced.

  6. Should mediastinoscopy actually be incorporated into the FDG PET strategy for patients with non-small cell lung carcinoma?

    International Nuclear Information System (INIS)

    Hayashi, Katsumi; Abe, Katsumi; Yano, Fuzuki; Watanabe, Sadahiro; Iwasaki, Yoshie; Kosuda, Shigeru

    2005-01-01

    Incorporating mediastinoscopy (MS) into the PET-based strategy for non-small cell lung carcinoma (NSCLC) patients might be cost-effective because MS can allow unnecessary thoracotomies to be avoided. The objective of our study was to assess the cost-effectiveness of incorporating MS into a PET strategy for NSCLC patients. To determine life expectancy (LE), quality adjusted life years (QALY), and the incremental cost-effectiveness ratio (ICER), a decision-tree sensitivity analysis was designed for histopathologically confirmed NSCLC patients with M0 disease, based on the three competing strategies of chest CT only vs. PET+CT vs. PET+CT+MS. A simulation of 1,000 NSCLC patients was created using baselines of other relevant variables in regard to sensitivity, specificity, mortality, LE, utilities and cost from published data. One-way sensitivity analyses were performed to determine the influences of mediastinal metastasis prevalence on LE, QALY and ICER. The LE and QALY per patient in the CT only strategy, PET+CT strategy and PET+CT+MS strategy were 4.79 and 4.35, 5.33 and 4.93 and 5.68 and 5.33 years, respectively, with a 20% prevalence of mediastinal metastasis. The ICERs were 906.6 yen x 10 3 (US$7,555)/QALY/patient at a 20% mediastinal metastasis prevalence, and 2,194 yen x 10 3 (US$18,282)/QALY/patient at a 50% prevalence, but exceeded 5,280 yen x 10 3 (US$44,000)/QALY/patient at 80%. Our study quantitatively showed the CT+PET+MS strategy in place of the PET+CT strategy in managing NSCLC patients to be cost-effective. MS should be incorporated into the PET+CT strategy for NSCLC patients except in those highly suspected of having mediastinal disease on chest CT or PET. (author)

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

    Science.gov (United States)

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

    2016-03-01

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

  8. Presurgical evaluation of pediatric epilepsy patients prior to hemispherotomy: the prognostic value of 18F-FDG PET.

    Science.gov (United States)

    Traub-Weidinger, Tatjana; Weidinger, Philip; Gröppel, Gundrun; Karanikas, Georgios; Wadsak, Wolfgang; Kasprian, Gregor; Dorfer, Christian; Dressler, Anastasia; Muehlebner, Angelika; Hacker, Marcus; Czech, Thomas; Feucht, Martha

    2016-12-01

    OBJECTIVE The objective of this study was to investigate whether fluorine-18 fluorodeoxyglucose PET ( 18 F-FDG PET) can help to predict seizure outcome after hemispherotomy and therefore may be useful in decision making and patient selection. METHODS Children and adolescents less than 18 years of age who underwent 18 F-FDG PET studies during presurgical evaluation prior to hemispherotomy and had follow-up data of at least 12 months after surgery were included. Seizure outcome was classified according to the recommendations of the International League Against Epilepsy. PET data were reevaluated by two specialists in nuclear medicine blinded to clinical data and to MRI. MRI studies were also reinterpreted visually by an experienced neuroradiologist blinded to clinical data and PET findings. RESULTS Thirty-five patients (17 girls) with a median age of 5 years (range 0.4-17.8 years) were evaluable. Of the 35 patients, 91.4% were seizure free after surgery, including 100% of those with unilateral 18 F-FDG-PET hypometabolism compared with only 75% of those with bilateral hypometabolism. With respect to MRI, seizure freedom after surgery was observed in 96.4% of the patients with unilateral lesions compared with only 71.4% in those with bilateral MRI lesions. The best seizure outcomes were noted in patients with unilateral findings in both PET and MRI (100% seizure freedom) whereas only 50% of those with bilateral findings in both imaging techniques were seizure free. Furthermore, 100% of the patients with unilateral PET hypometabolism and bilateral MRI findings were also seizure free, but only 87.5% of those with bilateral PET hypometabolism and unilateral MRI findings. CONCLUSIONS According to these results, candidate selection for hemispherotomy can be optimized by the use of 18 F-FDG PET as part of a multimodal presurgical evaluation program, especially in patients with inconsistent (bilateral) MRI findings.

  9. PET and PET/CT in tumour of undetermined origin

    International Nuclear Information System (INIS)

    Garcia O, J.R.

    2007-01-01

    In this presentation the following conclusions were obtained regarding the use of PET and PET/CT in patient with cancer of unknown primary: 1. Detection of the primary one in 1/3 at 1/2 of patient. 2. It detects metastases in other places in 50%. 3. It changes the initial therapy planned in 1/3 at 1/2 of patient. 4. Useful in initial phases of protocol study to limit the other procedures. After standard evaluation. Before advanced protocol. 5. PET/CT study increases the % of primary detection, although in a non significant way vs. PET. 6. They are required more studies to value their utility to a more objective manner. (Author)

  10. Outcome after PSMA PET/CT based radiotherapy in patients with biochemical persistence or recurrence after radical prostatectomy.

    Science.gov (United States)

    Schmidt-Hegemann, Nina-Sophie; Fendler, Wolfgang Peter; Ilhan, Harun; Herlemann, Annika; Buchner, Alexander; Stief, Christian; Eze, Chukwuka; Rogowski, Paul; Li, Minglun; Bartenstein, Peter; Ganswindt, Ute; Belka, Claus

    2018-03-02

    PSMA PET/CT visualises prostate cancer residual disease or recurrence at lower PSA levels compared to conventional imaging and results in a change of treatment in a remarkable high number of patients. Radiotherapy with dose escalation to the former prostate bed has been associated with improved biochemical recurrence-free survival. Thus, it can be hypothesised that PSMA PET/CT-based radiotherapy might improve the prognosis of these patients. One hundred twenty-nine patients underwent PSMA PET/CT due to biochemical persistence (52%) or recurrence (48%) after radical prostatectomy without evidence of distant metastases (February 2014-May 2017) and received PSMA PET/CT-based radiotherapy. Biochemical recurrence free survival (PSA ≤ 0.2 ng/ml) was defined as the study endpoint. Patients with biochemical persistence were significantly more often high-risk patients with significantly shorter time interval before PSMA PET/CT than patients with biochemical recurrence. Patients with biochemical recurrence had significantly more often no evidence of disease or local recurrence only in PSMA PET/CT, whereas patients with biochemical persistence had significantly more often lymph node involvement. Seventy-three patients were started on antiandrogen therapy prior to radiotherapy due to macroscopic disease in PSMA PET/CT. Cumulatively, 70 (66-70.6) Gy was delivered to local macroscopic tumor, 66 (63-66) Gy to the prostate fossa, 61.6 (53.2-66) Gy to PET-positive lymph nodes and 50.4 (45-52.3) Gy to lymphatic pathways. Median PSA after radiotherapy was 0.07 ng/ml with 74% of patients having a PSA ≤ 0.1 ng/ml. After a median follow-up of 20 months, median PSA was 0.07 ng/ml with ongoing antiandrogen therapy in 30 patients. PET-positive patients without antiandrogen therapy at last follow-up (45 patients) had a median PSA of 0.05 ng/ml with 89% of all patients, 94% of patients with biochemical recurrence and 82% of patients with biochemical persistence having a

  11. Prognostic implications of 62Cu-diacetyl-bis (N4-methylthiosemicarbazone) PET/CT in patients with glioma.

    Science.gov (United States)

    Toriihara, Akira; Ohtake, Makoto; Tateishi, Kensuke; Hino-Shishikura, Ayako; Yoneyama, Tomohiro; Kitazume, Yoshio; Inoue, Tomio; Kawahara, Nobutaka; Tateishi, Ukihide

    2018-05-01

    The potential of positron emission tomography/computed tomography using 62 Cu-diacetyl-bis (N 4 -methylthiosemicarbazone) ( 62 Cu-ATSM PET/CT), which was originally developed as a hypoxic tracer, to predict therapeutic resistance and prognosis has been reported in various cancers. Our purpose was to investigate prognostic value of 62 Cu-ATSM PET/CT in patients with glioma, compared to PET/CT using 2-deoxy-2-[ 18 F]fluoro-D-glucose ( 18 F-FDG). 56 patients with glioma of World Health Organization grade 2-4 were enrolled. All participants had undergone both 62 Cu-ATSM PET/CT and 18 F-FDG PET/CT within mean 33.5 days prior to treatment. Maximum standardized uptake value and tumor/background ratio were calculated within areas of increased radiotracer uptake. The prognostic significance for progression-free survival and overall survival were assessed by log-rank test and Cox's proportional hazards model. Disease progression and death were confirmed in 37 and 27 patients in follow-up periods, respectively. In univariate analysis, there was significant difference of both progression-free survival and overall survival in age, tumor grade, history of chemoradiotherapy, maximum standardized uptake value and tumor/background ratio calculated using 62 Cu-ATSM PET/CT. Multivariate analysis revealed that maximum standardized uptake value calculated using 62 Cu-ATSM PET/CT was an independent predictor of both progression-free survival and overall survival (p PET/CT showed significant difference of progression-free survival (p PET/CT is a more promising imaging method to predict prognosis of patients with glioma compared to 18 F-FDG PET/CT.

  12. Multiparametric evaluation by simultaneous PET-MRI examination in patients with histologically proven laryngeal cancer

    International Nuclear Information System (INIS)

    Cavaliere, Carlo; Romeo, Valeria; Aiello, Marco; Mesolella, Massimo; Iorio, Brigida; Barbuto, Luigi; Cantone, Elena; Nicolai, Emanuele; Covello, Mario

    2017-01-01

    Highlights: • PET/MRI is feasible and useful for primary staging of laryngeal cancer. • PET/MRI simultaneously provides morphological, metabolic and functional parameters of tumoral laryngeal lesions. • PET/MRI allows an appropriate tumoral staging in terms of lesion extension with significant impact on therapeutic strategies. - Abstract: Objectives: To evaluate the relationship between metabolic 18Fluoro-Deoxyglucose-Positron Emission Tomography (18FDG/PET) and morpho-functional parameters derived by Magnetic Resonance Imaging (MRI) in patients with histologically proven laryngeal cancer. To assess the clinical impact of PET/MRI examination on patient’s staging and treatment planning. Methods: 16 patients with histologically proven laryngeal cancer were enrolled and underwent whole body PET/CT followed by a dedicated PET/MRI of the head/neck region. Data were separately evaluated by two blinded groups: metabolic (SUV and MTV), diffusion (ADC) and perfusion (K trans , V e , k ep and iAUC) maps were obtained by positioning regions of interest (ROIs). Tumoral local extension assessed on PET/MRI was compared to endoscopic findings. Results: A good inter-observer agreement was found in anatomical location and local extension of PET/MRI lesions (Cohen’s kappa 0.9). PET/CT SUV measures highly correlate with ones derived by PET/MRI (e.g., p = 0.96 for measures on VOI). Significant correlations among metabolic, diffusion and perfusion parameters have been detected. PET/MRI had a relevant clinical impact, confirming endoscopic findings (6 cases), helping treatment planning (9 cases), and modifying endoscopic primary staging (1 case). Conclusions: PET/MRI is useful for primary staging of laryngeal cancer, allowing simultaneous collection of metabolic and functional data and conditioning the therapeutic strategies.

  13. Multiparametric evaluation by simultaneous PET-MRI examination in patients with histologically proven laryngeal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cavaliere, Carlo [IRCCS SDN, Via E. Gianturco, 113-80143, Naples (Italy); Romeo, Valeria, E-mail: valeria.romeo@unina.it [Department of Advanced Biomedical Sciences, Federico II University, Naples (Italy); Aiello, Marco [IRCCS SDN, Via E. Gianturco, 113-80143, Naples (Italy); Mesolella, Massimo; Iorio, Brigida [Department of Neuroscience, Reproductive and Odontostomatologic Science, ENT Section, Federico II University, Naples (Italy); Barbuto, Luigi [Department of Advanced Biomedical Sciences, Federico II University, Naples (Italy); Cantone, Elena [Department of Neuroscience, Reproductive and Odontostomatologic Science, ENT Section, Federico II University, Naples (Italy); Nicolai, Emanuele; Covello, Mario [IRCCS SDN, Via E. Gianturco, 113-80143, Naples (Italy)

    2017-03-15

    Highlights: • PET/MRI is feasible and useful for primary staging of laryngeal cancer. • PET/MRI simultaneously provides morphological, metabolic and functional parameters of tumoral laryngeal lesions. • PET/MRI allows an appropriate tumoral staging in terms of lesion extension with significant impact on therapeutic strategies. - Abstract: Objectives: To evaluate the relationship between metabolic 18Fluoro-Deoxyglucose-Positron Emission Tomography (18FDG/PET) and morpho-functional parameters derived by Magnetic Resonance Imaging (MRI) in patients with histologically proven laryngeal cancer. To assess the clinical impact of PET/MRI examination on patient’s staging and treatment planning. Methods: 16 patients with histologically proven laryngeal cancer were enrolled and underwent whole body PET/CT followed by a dedicated PET/MRI of the head/neck region. Data were separately evaluated by two blinded groups: metabolic (SUV and MTV), diffusion (ADC) and perfusion (K{sub trans}, V{sub e}, k{sub ep} and iAUC) maps were obtained by positioning regions of interest (ROIs). Tumoral local extension assessed on PET/MRI was compared to endoscopic findings. Results: A good inter-observer agreement was found in anatomical location and local extension of PET/MRI lesions (Cohen’s kappa 0.9). PET/CT SUV measures highly correlate with ones derived by PET/MRI (e.g., p = 0.96 for measures on VOI). Significant correlations among metabolic, diffusion and perfusion parameters have been detected. PET/MRI had a relevant clinical impact, confirming endoscopic findings (6 cases), helping treatment planning (9 cases), and modifying endoscopic primary staging (1 case). Conclusions: PET/MRI is useful for primary staging of laryngeal cancer, allowing simultaneous collection of metabolic and functional data and conditioning the therapeutic strategies.

  14. Hybrid {sup 18}F-FDG PET/MRI might improve locoregional staging of breast cancer patients prior to neoadjuvant chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Goorts, Briete; Nijnatten, Thiemo J.A. van [Maastricht University Medical Center, GROW - School for Oncology and Developmental Biology, Maastricht (Netherlands); Maastricht University Medical Center, Department of Surgery, P.O. Box 5800, Maastricht (Netherlands); Maastricht University Medical Center, Department of Radiology and Nuclear Medicine, Maastricht (Netherlands); Voeoe, Stefan; Wildberger, Joachim E.; Lobbes, Marc B.I. [Maastricht University Medical Center, Department of Radiology and Nuclear Medicine, Maastricht (Netherlands); Kooreman, Loes F.S. [Maastricht University Medical Center, GROW - School for Oncology and Developmental Biology, Maastricht (Netherlands); Maastricht University Medical Center, Department of Pathology, Maastricht (Netherlands); Boer, Maaike de [Maastricht University Medical Center, Department of Medical Oncology, Maastricht (Netherlands); Keymeulen, Kristien B.M.I. [Maastricht University Medical Center, Department of Surgery, P.O. Box 5800, Maastricht (Netherlands); Aarnoutse, Romy; Smidt, Marjolein L. [Maastricht University Medical Center, GROW - School for Oncology and Developmental Biology, Maastricht (Netherlands); Maastricht University Medical Center, Department of Surgery, P.O. Box 5800, Maastricht (Netherlands); Mottaghy, Felix M. [Maastricht University Medical Center, Department of Radiology and Nuclear Medicine, Maastricht (Netherlands); RWTH Aachen University Hospital, Department of Nuclear Medicine, Aachen (Germany)

    2017-10-15

    Our purpose in this study was to assess the added clinical value of hybrid {sup 18}F-FDG-PET/MRI compared to conventional imaging for locoregional staging in breast cancer patients undergoing neoadjuvant chemotherapy (NAC). In this prospective study, primary invasive cT2-4 N0 or cT1-4 N+ breast cancer patients undergoing NAC were included. A PET/MRI breast protocol was performed before treatment. MR images were evaluated by a breast radiologist, blinded for PET images. PET images were evaluated by a nuclear physician. Afterwards, a combined PET/MRI report was written. PET/MRI staging was compared to conventional imaging, i.e., mammography, ultrasound and MRI. The proportion of patients with a modified treatment plan based on PET/MRI findings was analyzed. A total of 40 patients was included. PET/MRI was of added clinical value in 20.0% (8/40) of patients, changing the treatment plan in 10% and confirming the malignancy of suspicious lesions on MRI in another 10%. In seven (17.5%) patients radiotherapy fields were extended because of additional or affirmative PET/MRI findings being lymph node metastases (n = 5) and sternal bone metastases (n = 2). In one (2.5%) patient radiotherapy fields were reduced because of fewer lymph node metastases on PET/MRI compared to conventional imaging. Interestingly, all treatment changes were based on differences in number of lymph nodes suspicious for metastasis or number of distant metastasis, whereas differences in intramammary tumor extent were not observed. Prior to NAC, PET/MRI shows promising results for locoregional staging compared to conventional imaging, changing the treatment plan in 10% of patients and potentially replacing PET/CT or tissue sampling in another 10% of patients. (orig.)

  15. F.D.G.-PET scanning in managing patients with lymphoma

    International Nuclear Information System (INIS)

    Bodet-Milin, C.; Kraeber-Bodere, F.; Salaun, P.Y.; Crespin, C.; Vuillez, J.P.; Kraeber-Bodere, F.

    2009-01-01

    The place of positron emission tomography (PET) in the evaluation of diffuse at big cells B lymphomas and hodgkin lymphomas is validated. The clinical impact of the PET registered in end of therapy development is indisputable. recommendations must be followed for images interpretation. The PET is strongly recommended during the first evaluation of the disease because it is a reference examination that makes easy the interpretation at the end of the therapy and allows to evaluate the extension of the disease with a sensitivity and a specificity superior to the computerized tomography. the prognosis value of intermediate evaluations appears certain in the diffuse at big cells B lymphomas and the hodgkin lymphomas but the impact of an early therapy change induced by PET is still to determine. The criteria of interpretation of early evaluations are to standardize. for the other types of lymphomas, the PET can have an interest to confirm the the localized stages, especially for the follicular lymphomas and direct the biopsy for a patient ill of a low range lymphoma suspect of aggressive change. (N.C.)

  16. Development and validation of the Patient Experience with Treatment and Self-management (PETS): a patient-reported measure of treatment burden.

    Science.gov (United States)

    Eton, David T; Yost, Kathleen J; Lai, Jin-Shei; Ridgeway, Jennifer L; Egginton, Jason S; Rosedahl, Jordan K; Linzer, Mark; Boehm, Deborah H; Thakur, Azra; Poplau, Sara; Odell, Laura; Montori, Victor M; May, Carl R; Anderson, Roger T

    2017-02-01

    The purpose of this study was to develop and validate a new comprehensive patient-reported measure of treatment burden-the Patient Experience with Treatment and Self-management (PETS). A conceptual framework was used to derive the PETS with items reviewed and cognitively tested with patients. A survey battery, including a pilot version of the PETS, was mailed to 838 multi-morbid patients from two healthcare institutions for validation. A total of 332 multi-morbid patients returned completed surveys. Diagnostics supported deletion and consolidation of some items and domains. Confirmatory factor analysis supported a domain model for scaling comprised of 9 factors: medical information, medications, medical appointments, monitoring health, interpersonal challenges, medical/healthcare expenses, difficulty with healthcare services, role/social activity limitations, and physical/mental exhaustion. Scales showed good internal consistency (α range 0.79-0.95). Higher PETS scores, indicative of greater treatment burden, were correlated with more distress, less satisfaction with medications, lower self-efficacy, worse physical and mental health, and lower convenience of healthcare (Ps health literacy, less adherence to medications, and more financial difficulties reported higher PETS scores (Ps < 0.01). A comprehensive patient-reported measure of treatment burden can help to better characterize the impact of treatment and self-management burden on patient well-being and guide care toward minimally disruptive medicine.

  17. Areas of normal pulmonary parenchyma on HRCT exhibit increased FDG PET signal in IPF patients

    Energy Technology Data Exchange (ETDEWEB)

    Win, Thida [Lister Hospital, Respiratory Medicine, Stevenage (United Kingdom); Thomas, Benjamin A.; Lambrou, Tryphon; Hutton, Brian F.; Endozo, Raymondo; Shortman, Robert I.; Afaq, Asim; Ell, Peter J.; Groves, Ashley M. [University College London, Institute of Nuclear Medicine, University College Hospital, London (United Kingdom); Screaton, Nicholas J. [Papworth Hospital, Radiology Department, Papworth Everard (United Kingdom); Porter, Joanna C. [University College London, Centre for Respiratory Diseases, University College Hospital, London (United Kingdom); Maher, Toby M. [Royal Brompton Hospital, Interstitial Lung Disease Unit, London (United Kingdom); Lukey, Pauline [GSK, Fibrosis DPU, Research and Development, Stevenage (United Kingdom)

    2014-02-15

    Patients with idiopathic pulmonary fibrosis (IPF) show increased PET signal at sites of morphological abnormality on high-resolution computed tomography (HRCT). The purpose of this investigation was to investigate the PET signal at sites of normal-appearing lung on HRCT in IPF. Consecutive IPF patients (22 men, 3 women) were prospectively recruited. The patients underwent {sup 18}F-FDG PET/HRCT. The pulmonary imaging findings in the IPF patients were compared to the findings in a control population. Pulmonary uptake of {sup 18}F-FDG (mean SUV) was quantified at sites of morphologically normal parenchyma on HRCT. SUVs were also corrected for tissue fraction (TF). The mean SUV in IPF patients was compared with that in 25 controls (patients with lymphoma in remission or suspected paraneoplastic syndrome with normal PET/CT appearances). The pulmonary SUV (mean ± SD) uncorrected for TF in the controls was 0.48 ± 0.14 and 0.78 ± 0.24 taken from normal lung regions in IPF patients (p < 0.001). The TF-corrected mean SUV in the controls was 2.24 ± 0.29 and 3.24 ± 0.84 in IPF patients (p < 0.001). IPF patients have increased pulmonary uptake of {sup 18}F-FDG on PET in areas of lung with a normal morphological appearance on HRCT. This may have implications for determining disease mechanisms and treatment monitoring. (orig.)

  18. Diagnostic performance of 68Ga-PSMA-11 (HBED-CC) PET/CT in patients with recurrent prostate cancer: evaluation in 1007 patients.

    Science.gov (United States)

    Afshar-Oromieh, Ali; Holland-Letz, Tim; Giesel, Frederik L; Kratochwil, Clemens; Mier, Walter; Haufe, Sabine; Debus, Nils; Eder, Matthias; Eisenhut, Michael; Schäfer, Martin; Neels, Oliver; Hohenfellner, Markus; Kopka, Klaus; Kauczor, Hans-Ulrich; Debus, Jürgen; Haberkorn, Uwe

    2017-08-01

    Since the clinical introduction of 68 Ga-PSMA-11 PET/CT, this imaging method has rapidly spread and is now regarded as a significant step forward in the diagnosis of recurrent prostate cancer (PCa). The aim of this study was to analyse the influence of several variables with possible influence on PSMA ligand uptake in a large cohort. We performed a retrospective analysis of 1007 consecutive patients who were scanned with 68 Ga-PSMA-11 PET/CT (1 h after injection) from January 2014 to January 2017 to detect recurrent disease. Patients with untreated primary PCa or patients referred for PSMA radioligand therapy were excluded. The possible effects of different variables including PSA level and PSA doubling time (PSA DT ), PSA velocity (PSA Vel ), Gleason score (GSC, including separate analysis of GSC 7a and 7b), ongoing androgen deprivation therapy (ADT), patient age and amount of injected activity were evaluated. In 79.5% of patients at least one lesion with characteristics suggestive of recurrent PCa was detected. A pathological (positive) PET/CT scan was associated with PSA level and ADT. GSC, amount of injected activity, patient age, PSA DT and PSA Vel were not associated with a positive PET/CT scan in multivariate analysis. 68 Ga-PSMA-11 PET/CT detects tumour lesions in a high percentage of patients with recurrent PCa. Tumour detection is clearly associated with PSA level and ADT. Only a tendency for an association without statistical significance was found between higher GSC and a higher probability of a pathological PET/CT scan. No associations were found between a pathological 68 Ga-PSMA-11 PET/CT scan and patient age, amount of injected activity, PSA DT or PSA Vel.

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

    International Nuclear Information System (INIS)

    Kitagawa, Yoshimasa; Saitoh, Masaaki; Nakamura, Mikiko

    2007-01-01

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

  20. Dosimetry of FDG PET/CT and other molecular imaging applications in pediatric patients

    International Nuclear Information System (INIS)

    Gelfand, Michael J.

    2009-01-01

    Effective doses for PET and SPECT imaging of molecular imaging agents depend on the radiopharmaceutical, administered activity and the weight of the patient. Effective doses for the accompanying CT scan depend on the CT protocol being used. CT protocols can be designed to produce diagnostic quality images, localization images or attenuation correction data without imaging. In each case, the co-registered molecular imaging examination (PET or SPECT) and the CT study must be acquired without patient movement. For PET/CT, attention to the respiratory phase during the CT study is also of critical importance. In addition to the molecular imaging agents 18 F-FDG and 123 I-MIBG that are frequently used in children, additional PET and SPECT imaging agents may have promise for molecular imaging in children. (orig.)

  1. "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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  3. Survival outcomes in patients with cervical cancer after inclusion of PET/CT in staging procedures

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, Henrik Villibald [University of Copenhagen, Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); Section for Radiotherapy, Rigshospitalet, Department of Oncology, Copenhagen (Denmark); Loft, Annika [University of Copenhagen, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); Berthelsen, Anne Kiil [University of Copenhagen, Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); University of Copenhagen, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); Christensen, Ib Jarle [University of Copenhagen, The Finsen Laboratory, Rigshospitalet, Copenhagen (Denmark); University of Copenhagen, Biotech Research and Innovation Centre (BRIC), Copenhagen (Denmark); Hoegdall, Claus [University of Copenhagen, Department of Gynecology, Rigshospitalet, Copenhagen (Denmark); Engelholm, Svend Aage [University of Copenhagen, Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark)

    2015-11-15

    In cancer of the uterine cervix, lymph node metastases are associated with a poor prognosis. Even so, the International Federation of Gynecology and Obstetrics (FIGO) does not take into account diagnostic results of methods such as PET/CT, since these are not readily available everywhere. As undetected lymph node metastases can lead to undertreatment, any difference in the underlying prevalence of false-negative scans between CT and PET/CT may be reflected in treatment outcomes. This study investigated survival outcomes in node-negative patients before and after the introduction of PET/CT. This was a single-institution retrospective analysis of 301 patients with a histopathological diagnosis of cervical cancer. The patients were receiving chemoradiotherapy with curative intent according to the standard protocol of the department for patients without lymph node metastases as assessed by pretreatment CT or PET/CT. Patients were stratified into two groups: PET/CT and non-PET/CT. Patient characteristics and treatment outcomes were acquired from the treatment database. Significant differences of 23 % (95 % CI 17 - 29 %), 19 % (95 % CI 13 - 25 %) and 12 % (95 % CI 6 - 18 %) in 5-year overall, disease-free and disease-specific survival, respectively, were observed between the two patient groups. The difference remained significant in univariate and multivariate analyses of overall survival (hazard ratio 0.61, 95 % CI 0.42 - 0.89; p = 0.010), including age, FIGO stage, performance status, BMI, and histopathology. Inclusion of PET/CT in the preradiotherapy diagnostic protocol may lead to nodal stage migration not reflected in the FIGO stage. It was found to be a significant covariate, and could lead to selection bias that needs to be taken into account when designing and reporting on clinical trials. (orig.)

  4. Survival outcomes in patients with cervical cancer after inclusion of PET/CT in staging procedures

    International Nuclear Information System (INIS)

    Hansen, Henrik Villibald; Loft, Annika; Berthelsen, Anne Kiil; Christensen, Ib Jarle; Hoegdall, Claus; Engelholm, Svend Aage

    2015-01-01

    In cancer of the uterine cervix, lymph node metastases are associated with a poor prognosis. Even so, the International Federation of Gynecology and Obstetrics (FIGO) does not take into account diagnostic results of methods such as PET/CT, since these are not readily available everywhere. As undetected lymph node metastases can lead to undertreatment, any difference in the underlying prevalence of false-negative scans between CT and PET/CT may be reflected in treatment outcomes. This study investigated survival outcomes in node-negative patients before and after the introduction of PET/CT. This was a single-institution retrospective analysis of 301 patients with a histopathological diagnosis of cervical cancer. The patients were receiving chemoradiotherapy with curative intent according to the standard protocol of the department for patients without lymph node metastases as assessed by pretreatment CT or PET/CT. Patients were stratified into two groups: PET/CT and non-PET/CT. Patient characteristics and treatment outcomes were acquired from the treatment database. Significant differences of 23 % (95 % CI 17 - 29 %), 19 % (95 % CI 13 - 25 %) and 12 % (95 % CI 6 - 18 %) in 5-year overall, disease-free and disease-specific survival, respectively, were observed between the two patient groups. The difference remained significant in univariate and multivariate analyses of overall survival (hazard ratio 0.61, 95 % CI 0.42 - 0.89; p = 0.010), including age, FIGO stage, performance status, BMI, and histopathology. Inclusion of PET/CT in the preradiotherapy diagnostic protocol may lead to nodal stage migration not reflected in the FIGO stage. It was found to be a significant covariate, and could lead to selection bias that needs to be taken into account when designing and reporting on clinical trials. (orig.)

  5. 11C-choline vs. 18F-FDG PET/CT in assessing bone involvement in patients with multiple myeloma

    Directory of Open Access Journals (Sweden)

    Ambrosini Valentina

    2007-06-01

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

  6. 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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  8. TU-CD-BRB-08: Radiomic Analysis of FDG-PET Identifies Novel Prognostic Imaging Biomarkers in Locally Advanced Pancreatic Cancer Patients Treated with SBRT

    Energy Technology Data Exchange (ETDEWEB)

    Cui, Y; Shirato, H [Hokkaido University, Global Institute for Collaborative Research and Educat, Sapporo, Hokkaido (Japan); Song, J; Pollom, E; Chang, D; Koong, A [Stanford University, Palo Alto, CA (United States); Li, R [Hokkaido University, Global Institute for Collaborative Research and Educat, Sapporo, Hokkaido (Japan); Stanford University, Palo Alto, CA (United States)

    2015-06-15

    Purpose: This study aims to identify novel prognostic imaging biomarkers in locally advanced pancreatic cancer (LAPC) using quantitative, high-throughput image analysis. Methods: 86 patients with LAPC receiving chemotherapy followed by SBRT were retrospectively studied. All patients had a baseline FDG-PET scan prior to SBRT. For each patient, we extracted 435 PET imaging features of five types: statistical, morphological, textural, histogram, and wavelet. These features went through redundancy checks, robustness analysis, as well as a prescreening process based on their concordance indices with respect to the relevant outcomes. We then performed principle component analysis on the remaining features (number ranged from 10 to 16), and fitted a Cox proportional hazard regression model using the first 3 principle components. Kaplan-Meier analysis was used to assess the ability to distinguish high versus low-risk patients separated by median predicted survival. To avoid overfitting, all evaluations were based on leave-one-out cross validation (LOOCV), in which each holdout patient was assigned to a risk group according to the model obtained from a separate training set. Results: For predicting overall survival (OS), the most dominant imaging features were wavelet coefficients. There was a statistically significant difference in OS between patients with predicted high and low-risk based on LOOCV (hazard ratio: 2.26, p<0.001). Similar imaging features were also strongly associated with local progression-free survival (LPFS) (hazard ratio: 1.53, p=0.026) on LOOCV. In comparison, neither SUVmax nor TLG was associated with LPFS (p=0.103, p=0.433) (Table 1). Results for progression-free survival and distant progression-free survival showed similar trends. Conclusion: Radiomic analysis identified novel imaging features that showed improved prognostic value over conventional methods. These features characterize the degree of intra-tumor heterogeneity reflected on FDG-PET

  9. Automated interpretation of PET/CT images in patients with lung cancer

    DEFF Research Database (Denmark)

    Gutte, Henrik; Jakobsson, David; Olofsson, Fredrik

    2007-01-01

    cancer. METHODS: A total of 87 patients who underwent PET/CT examinations due to suspected lung cancer comprised the training group. The test group consisted of PET/CT images from 49 patients suspected with lung cancer. The consensus interpretations by two experienced physicians were used as the 'gold...... method measured as the area under the receiver operating characteristic curve, was 0.97 in the test group, with an accuracy of 92%. The sensitivity was 86% at a specificity of 100%. CONCLUSIONS: A completely automated method using artificial neural networks can be used to detect lung cancer......PURPOSE: To develop a completely automated method based on image processing techniques and artificial neural networks for the interpretation of combined [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET) and computed tomography (CT) images for the diagnosis and staging of lung...

  10. Evaluation of PET and MR datasets in integrated 18F-FDG PET/MRI: A comparison of different MR sequences for whole-body restaging of breast cancer patients.

    Science.gov (United States)

    Grueneisen, Johannes; Sawicki, Lino Morris; Wetter, Axel; Kirchner, Julian; Kinner, Sonja; Aktas, Bahriye; Forsting, Michael; Ruhlmann, Verena; Umutlu, Lale

    2017-04-01

    To investigate the diagnostic value of different MR sequences and 18F-FDG PET data for whole-body restaging of breast cancer patients utilizing PET/MRI. A total of 36 patients with suspected tumor recurrence of breast cancer based on clinical follow-up or abnormal findings in follow-up examinations (e.g. CT, MRI) were prospectively enrolled in this study. All patients underwent a PET/CT and subsequently an additional PET/MR scan. Two readers were instructed to identify the occurrence of a tumor relapse in subsequent MR and PET/MR readings, utilizing different MR sequence constellations for each session. The diagnostic confidence for the determination of a malignant or benign lesion was qualitatively rated (3-point ordinal scale) for each lesion in the different reading sessions and the lesion conspicuity (4-point ordinal scale) for the three different MR sequences was additionally evaluated. Tumor recurrence was present in 25/36 (69%) patients. All three PET/MRI readings showed a significantly higher accuracy as well as higher confidence levels for the detection of recurrent breast cancer lesions when compared to MRI alone (psequence constellations showed comparable diagnostic accuracy for the identification of a breast cancer recurrence (p>0.05), yet the highest confidence levels were obtained, when all three MR sequences were used for image interpretation. Moreover, contrast-enhanced T1-weighted VIBE imaging showed significantly higher values for the delineation of malignant and benign lesions when compared to T2w HASTE and diffusion-weighted imaging. Integrated PET/MRI provides superior restaging of breast cancer patients over MRI alone. Facing the need for appropriate and efficient whole-body PET/MR protocols, our results show the feasibility of fast and morphologically adequate PET/MR protocols. However, considering an equivalent accuracy for the detection of breast cancer recurrences in the three PET/MR readings, the application of contrast-agent and the

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

    Directory of Open Access Journals (Sweden)

    Júlio Brandão Guimarães

    2015-06-01

    Full Text Available Abstract The effective evaluation for the treatment of patients with Ewing tumors depends on the accuracy in the determination of the primary tumor extent and the presence of metastatic disease. Currently, no universally accepted staging system is available to assess Ewing tumors. The present study aimed at discussing the use of PET/CT as a tool for staging, restaging and assessment of therapeutic response in patients with Ewing tumors. In spite of some limitations of PET/CT as compared with anatomical imaging methods, its relevance in the assessment of these patients is related to the capacity of the method to provide further physiological information, which often generates important clinical implications. Currently, the assessment of patients with Ewing tumor should comprise a study with PET/CT combined with other anatomical imaging modalities, such as radiography, computed tomography and magnetic resonance imaging.

  12. 18F-氟化钠PET和PET-CT诊断肺癌骨转移的对比研究%Comparison between 18F-NaF PET and PET-CT to detect bone metastases in patients with lung cancer

    Institute of Scientific and Technical Information of China (English)

    王俊起; 高硕; 李彦生

    2009-01-01

    目的 对比研究18F-氟化钠(18F-NaF)PET和PET-CT对肺癌骨转移诊断的准确性.方法 34例初始诊断为肺癌的患者接受18F-NaF PET-CT检查,对PET和PET-CT图像分别进行解释,发现的病变分为恶性、良性和不确定三种.骨转移的综合评价方法包括MRI(34例)、18F-氟脱氧葡糖糖PET-CT(4例)、组织学活检(2例)和临床随访(6例).结果 按患者水平分析时,34例患者中的11例(32%)发生骨转移,其中,18F-NaF PET-CT准确诊断所有患者的骨转移,无假阳性和假阴性,而18F-NaF PET诊断真阳性8例、3例不能确定,18F-NaF PET确诊的8例骨转移患者中的4例PET没有显示全部转移病变(假阴性和不确定病变);按病变水平分析时,118个病变获得最终诊断,其中转移病变47个、良性病变71个,其中,18F-NaF PET诊断真阳性27个、真阴性64个、不确定病变24个、假阴性1个、假阳性2个,而18F-NaF PET-CT诊断真阳性46个、假阴性1个、真阴性71个.按患者水平分析,将不确定病变归为恶性时,18F-NaF PET-CT的特异性高于18F-NaF PET(100% vs 78%,χ2=10.78,P0.05);按病变水平分析时,得到与患者水平分析相似结果.结论 18F-NaF PET-CT诊断肺癌骨转移的准确性优于18F-NaF PET,PET-CT中的低剂量CT可进一步提高良、恶性病变的鉴别能力.%Objective To evaluate the effect of 18F-sodium fluoride(18F-NaF)PET-CT in the detection of bone metastases in patients with lung cancer.Methods Thirty-four patients with newly diagnosed lung cancer were performed with 18F-NaF PET-CT.18F-NaF PET and 18F-NaF PET-CT were interpreted separately.Lesions were categorized as malignant,benign or inconclusive.A panel of reference methods was used,including MRI(34 patients),18F-fluorodeoxyglucose PET-CT(4 patients),histopathology(2 patients),or clinical follow-up of at least 6 months(6 patients).Results In patient-based analysis,11 of 34 patients had bone metastases.18F-NaF PET-CT correctly diagnosed all 11 patients with

  13. SU-F-I-57: Evaluate and Optimize PET Acquisition Overlap in 18F-FDG Oncology Wholebody PET/CT: Can We Scan PET Faster?

    International Nuclear Information System (INIS)

    Zhang, J; Natwa, M; Hall, NC; Knopp, MV; Knopp, MU; Zhang, B; Tung, C

    2016-01-01

    Purpose: The longer patient has to remain on the table during PET imaging, the higher the likelihood of motion artifacts due to patient discomfort. This study was to investigate and optimize PET acquisition overlap in 18F-FDG oncology wholebody PET/CT to speed up PET acquisition and improve patient comfort. Methods: Wholebody 18F-FDG PET/CT of phantoms, 8 pre-clinical patients (beagles) and 5 clinical oncology patients were performed in 90s/bed on a time-of-flight Gemini TF 64 system. Imaging of phantoms and beagles was acquired with reduced PET overlaps (40%, 33%, 27%, 20%, 13% and no overlap) in addition to the system default (53%). In human studies, 1 or 2 reduced overlaps from the listed options were used to acquire PET/CT sweeps right after the default standard of care imaging. Image quality was blindly reviewed using visual scoring criteria and quantitative SUV assessment. NEMA PET sensitivity was performed under different overlaps. Results: All PET exams demonstrated no significant impact on the visual grades for overlaps >20%. Blinded reviews assigned the best visual scores to PET using overlaps 53%–27%. Reducing overlap to 27% for oncology patients (12-bed) saved an average of ∼40% acquisition time (11min) compared to using the default overlap (18min). No significant SUV variances were found when reducing overlap to half of default for cerebellum, lung, heart, aorta, liver, fat, muscle, bone marrow, thighs and target lesions (p>0.05), except expected variability in urinary system. Conclusion: This study demonstrated by combined phantom, pre-clinical and clinical PET/CT scans that PET acquisition overlap in axial of today’s systems can be reduced and optimized. It showed that a reduction of PET acquisition overlap to 27% (half of system default) can be implemented to reduce table time by ∼40% to improve patient comfort and minimize potential motion artifacts, without prominently degrading image quality or compromising PET quantification.

  14. SU-F-I-57: Evaluate and Optimize PET Acquisition Overlap in 18F-FDG Oncology Wholebody PET/CT: Can We Scan PET Faster?

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, J; Natwa, M; Hall, NC; Knopp, MV [The Ohio State University, Columbus, OH (United States); Knopp, MU [Pepperdine University, Malibu, CA (United States); Zhang, B; Tung, C [Philips Healthcare, Highland Heights, OH (United States)

    2016-06-15

    Purpose: The longer patient has to remain on the table during PET imaging, the higher the likelihood of motion artifacts due to patient discomfort. This study was to investigate and optimize PET acquisition overlap in 18F-FDG oncology wholebody PET/CT to speed up PET acquisition and improve patient comfort. Methods: Wholebody 18F-FDG PET/CT of phantoms, 8 pre-clinical patients (beagles) and 5 clinical oncology patients were performed in 90s/bed on a time-of-flight Gemini TF 64 system. Imaging of phantoms and beagles was acquired with reduced PET overlaps (40%, 33%, 27%, 20%, 13% and no overlap) in addition to the system default (53%). In human studies, 1 or 2 reduced overlaps from the listed options were used to acquire PET/CT sweeps right after the default standard of care imaging. Image quality was blindly reviewed using visual scoring criteria and quantitative SUV assessment. NEMA PET sensitivity was performed under different overlaps. Results: All PET exams demonstrated no significant impact on the visual grades for overlaps >20%. Blinded reviews assigned the best visual scores to PET using overlaps 53%–27%. Reducing overlap to 27% for oncology patients (12-bed) saved an average of ∼40% acquisition time (11min) compared to using the default overlap (18min). No significant SUV variances were found when reducing overlap to half of default for cerebellum, lung, heart, aorta, liver, fat, muscle, bone marrow, thighs and target lesions (p>0.05), except expected variability in urinary system. Conclusion: This study demonstrated by combined phantom, pre-clinical and clinical PET/CT scans that PET acquisition overlap in axial of today’s systems can be reduced and optimized. It showed that a reduction of PET acquisition overlap to 27% (half of system default) can be implemented to reduce table time by ∼40% to improve patient comfort and minimize potential motion artifacts, without prominently degrading image quality or compromising PET quantification.

  15. Evaluation of therapy response in breast and ovarian cancer patients by positron emission tomography (PET)

    Energy Technology Data Exchange (ETDEWEB)

    Baum, R. P.; Przetak, C. [Zentralklinik Bad Berka, Clinic of Nuclear Medicine, Center for PET, Bad Berka (Germany)

    2001-09-01

    Positron emission tomography (PET) has the potential to contribute significantly to treatment planning and to the evaluation of response to therapy in patients with cancer. For disease recurrence PET imaging provides information non-invasively. The final goal is to biologically characterize an individual patients' tumor and to predict the response to treatment at the earliest possible time. Quantitative and/or semi-quantitative PET studies yield valuable information in breast cancer regarding prognosis and response to chemohormontherapy in a timely fashion. In ovarian cancer, up to now only few studies have been performed applying PET techniques for the evaluation of treatment response. These preliminary studies indicate that serial assessment of tumor metabolism by FDG-PET early during effective chemotherapy may predict subsequent response to such therapy. PET studies can be repeated without any side-effects and with low radiation exposure and results can be directly correlated with clinical laboratory data and histology. Therapy monitoring by PET could help to optimize neoadjuvant therapy protocols and to avoid ineffective preoperative therapy in non-responders, but this has to be proven in a larger number of patients and in different neoadjuvant settings such as chemotherapy, radiation therapy, hormone therapy or a combination of these.

  16. Evaluation of therapy response in breast and ovarian cancer patients by positron emission tomography (PET)

    International Nuclear Information System (INIS)

    Baum, R. P.; Przetak, C.

    2001-01-01

    Positron emission tomography (PET) has the potential to contribute significantly to treatment planning and to the evaluation of response to therapy in patients with cancer. For disease recurrence PET imaging provides information non-invasively. The final goal is to biologically characterize an individual patients' tumor and to predict the response to treatment at the earliest possible time. Quantitative and/or semi-quantitative PET studies yield valuable information in breast cancer regarding prognosis and response to chemohormontherapy in a timely fashion. In ovarian cancer, up to now only few studies have been performed applying PET techniques for the evaluation of treatment response. These preliminary studies indicate that serial assessment of tumor metabolism by FDG-PET early during effective chemotherapy may predict subsequent response to such therapy. PET studies can be repeated without any side-effects and with low radiation exposure and results can be directly correlated with clinical laboratory data and histology. Therapy monitoring by PET could help to optimize neoadjuvant therapy protocols and to avoid ineffective preoperative therapy in non-responders, but this has to be proven in a larger number of patients and in different neoadjuvant settings such as chemotherapy, radiation therapy, hormone therapy or a combination of these

  17. 18F-FDG PET/CT in detection of gynecomastia in patients with hepatocellular carcinoma.

    Science.gov (United States)

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

    2013-01-01

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

  18. (18) F-FDG PET/CT for planning external beam radiotherapy alters therapy in 11% of 581 patients

    DEFF Research Database (Denmark)

    Birk Christensen, Charlotte; Loft-Jakobsen, Annika; Munck Af Rosenschöld, Per

    2018-01-01

    BACKGROUND: (18) F-FDG PET/CT (FDG PET/CT) used in radiotherapy planning for extra-cerebral malignancy may reveal metastases to distant sites that may affect the choice of therapy. AIM: To investigate the role of FDG PET/CT on treatment strategy changes induced by the use of PET/CT as part...... planning in our institution in the year 2008. All PET/CT scans were performed with the patient in treatment position with the use of immobilization devices according to the intended radiotherapy treatment. All scans were evaluated by a nuclear medicine physician together with a radiologist to delineate PET......% of the patients for whom the PET/CT simulation scan revealed unexpected dissemination, radiotherapy was given - changed (n = 38) or unchanged (n = 13) according to the findings on the FDG PET/CT. CONCLUSION: Unexpected dissemination on the FDG PET/CT scanning performed for radiotherapy planning caused a change...

  19. Early response of patients undergoing concurrent chemoradiotherapy for cervical cancer. A comparison of PET/CT and MRI

    International Nuclear Information System (INIS)

    Lee, Jeong-Eun; Huh, Seung-Jae; Nam, Heerim; Ju, Sang-Gyu

    2013-01-01

    The objective of this study was to investigate the efficacy of positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) for early response evaluation of cervical cancer patients undergoing concurrent chemoradiotherapy (CCRT). Fifty-two patients were prospectively enrolled in the study. The pathologic findings were squamous cell carcinoma in 47 patients and adenocarcinoma in 5 patients. All patients underwent PET/CT and MRI scans before, during and within 1 month after completion of CCRT. The percent change in tumor volume during and after CCRT based on PET/CT and MRI images was compared. There were significant differences (p<0.001) between the initial tumor volume and tumor volume during and after CCRT as measured by both PET/CT and MRI. During CCRT, the percent volume reduction based on PET/CT images was significantly greater than the percent volume reduction calculated from MRI images (p=0.024). However, after the completion of CCRT, no significant differences were found in volume reduction as calculated based on PET/CT versus MRI images (p=0.289). The percent volume reduction of adenocarcinomas was significantly smaller than that of squamous cell carcinomas based on both PET/CT (p=0.041) and MRI images (p<0.001). Significant decreases in tumor volume were observed during and after CCRT in patients with cervical cancer. Tumor volume reduction on PET/CT images was greater than that on MRI images during CCRT. We suggest that early PET/CT as well as MRI scans could be taken during CCRT to evaluate tumor response and allow personalized treatment of cervical cancer. (author)

  20. The diagnostic value of PET/CT scanning in patients with cervical cancer

    DEFF Research Database (Denmark)

    Loft, Annika; Berthelsen, Anne Kiil; Roed, Henrik

    2007-01-01

    OBJECTIVE: To investigate the clinical value of PET/CT as a supplement to FIGO staging in patients with cervical cancer stage >or=1B. METHODS: This prospective study included 120 consecutive patients. After staging, a whole-body PET/CT scan was performed and these examinations were divided into two....../CT scanning for newly diagnosed cervical cancer FIGO stage >or=1B has a high sensitivity and specificity, and can be a valuable supplement to the FIGO staging procedure....

  1. Distribution of prostate nodes: a PET/CT-derived anatomic atlas of prostate cancer patients before and after surgical treatment.

    Science.gov (United States)

    Hegemann, Nina-Sophie; Wenter, Vera; Spath, Sonja; Kusumo, Nadia; Li, Minglun; Bartenstein, Peter; Fendler, Wolfgang P; Stief, Christian; Belka, Claus; Ganswindt, Ute

    2016-03-11

    In order to define adequate radiation portals in nodal positive prostate cancer a detailed knowledge of the anatomic lymph-node distribution is mandatory. We therefore systematically analyzed the localization of Choline PET/CT positive lymph nodes and compared it to the RTOG recommendation of pelvic CTV, as well as to previous work, the SPECT sentinel lymph node atlas. Thirty-two patients being mostly high risk patients with a PSA of 12.5 ng/ml (median) received PET/CT before any treatment. Eighty-seven patients received PET/CT for staging due to biochemical failure with a median PSA of 3.12 ng/ml. Each single PET-positive lymph node was manually contoured in a "virtual" patient dataset to achieve a 3-D visualization, resulting in an atlas of the cumulative PET positive lymph node distribution. Further the PET-positive lymph node location in each patient was assessed with regard to the existence of a potential geographic miss (i.e. PET-positive lymph nodes that would not have been treated adequately by the RTOG consensus on CTV definition of pelvic lymph nodes). Seventy-eight and 209 PET positive lymph nodes were detected in patients with no prior treatment and in postoperative patients, respectively. The most common sites of PET positive lymph nodes in patients with no prior treatment were external iliac (32.1 %), followed by common iliac (23.1 %) and para-aortic (19.2 %). In postoperative patients the most common sites of PET positive lymph nodes were common iliac (24.9 %), followed by external iliac (23.0 %) and para-aortic (20.1 %). In patients with no prior treatment there were 34 (43.6 %) and in postoperative patients there were 77 (36.8 %) of all detected lymph nodes that would not have been treated adequately using the RTOG CTV. We compared the distribution of lymph nodes gained by Choline PET/CT to the preexisting SPECT sentinel lymph node atlas and saw an overall good congruence. Choline PET/CT and SPECT sentinel lymph node atlas are comparable to each

  2. Intraindividual comparison of 68Ga-DOTA-TATE and 18F-DOPA PET in patients with well-differentiated metastatic neuroendocrine tumours

    International Nuclear Information System (INIS)

    Haug, Alexander; Auernhammer, Christoph J.; Goeke, Burkhard; Waengler, Bjoern; Tiling, Reinhold; Bartenstein, Peter; Poepperl, Gabriele; Schmidt, Gerwin

    2009-01-01

    To compare the diagnostic impact of 68 Ga-DOTA-TATE and 18 F-DOPA PET in the diagnosis of well-differentiated metastatic neuroendocrine tumours (NET). PET/CT using both 68 Ga-DOTA-TATE and 18 F-DOPA was performed in 25 patients with histologically proven metastatic NET (nine gut, five pancreas, six lung, one paranasal sinus, four with unknown primary). Analyses of PET examinations were patient-based (pathological uptake: yes/no), and based on tumour regions (primary tumour if present and metastases of liver, lung, bones and lymph nodes). The results were compared with the results of contrast enhanced CT, and with plasma serotonin levels, which were available in 24 of the 25 patients. Patient-based sensitivities were 96% for 68 Ga-DOTA-TATE PET and 56% for 18 F-DOPA PET. 68 Ga-DOTA-TATE PET delineated metastases in 54 of 55 positive metastatic tumour regions in contrast to 29 of 55 delineated by 18 F-DOPA PET. Overall, 68 Ga-DOTA-TATE was superior to 18 F-DOPA in 13 patients (two patients showed fewer positive tumour regions with 18 F-DOPA PET). The results were comparable in 12 patients. In 13 of 24 patients, plasma serotonin levels were elevated, and 11 of these 13 patients showed pathological uptake of 18 F-DOPA. Of the 11 patients with normal levels of serotonin, 3 also showed positive 18 F-DOPA uptake. In patients positive for 18 F-DOPA uptake the maximum tumour SUVs were correlated with the levels of serotonin (r=0.66, p=0.01). In this study 68 Ga-DOTA-TATE PET proved clearly superior to 18 F-DOPA PET for detection and staging of NET. 18 F-DOPA uptake tended to be increased in those patients with elevated plasma serotonin. We conclude that 18 F-DOPA PET should be employed in patients with NET with negative 68 Ga-DOTA-TATE PET and elevated plasma serotonin. (orig.)

  3. Evaluation of acetazolamine response in patients with cerebellar ataxia using dynamic quantitative F-18-FDG PET

    International Nuclear Information System (INIS)

    Kim, Y. K.; Lee, D. S.; Lee, J. S.; Kim, M. H.; Lee, K. M.; Yeo, J. S.; Chung, J. K.; Lee, M. C.

    2001-01-01

    Cerebellar Ataxia (CA) usually shows dramatic response to acetazolamide treatment. But few cases of acetazolamide unresponse CA were reported recently. Using dynamic FDG PET, we tried to evaluate the metabolic abnormality and its drug response in CA. Quantitative F-18-FDG PET was performed prior and after treatment of acetazolamide (250 mg qid for 10 days) in two patient suspected episodic cerebellar ataxia. Using Model-based clustering method, the regional cerebral glucose metabolic rate (rCMRglu) was calculated. Two patients showed different treatment response to acetazolamide. In one patient who showed markedly reduced frequency of the ataxic attack after treatment. FDG PET showed that mean cerebellar glucose metabolism was increased after treatment (ΔrCMRglu:9%). However, in the other who showed poor response to acetazolamide, FDG PET showed the more decrease metabolism in cerebellar metabolism after treatment (ΔrCMRglu:-17%). The change of the cerebellar glucose metabolism on FDG PET reflected the symptomatic improvement after acetazolamide in these two CA patients. We could expected that FDG PET might be a very useful tool to quantitatively predict the treatment response in CA and other neurologic disorder

  4. Role of FDG-PET in the Implementation of Involved-Node Radiation Therapy for Hodgkin Lymphoma Patients

    International Nuclear Information System (INIS)

    Girinsky, Théodore; Aupérin, Anne; Ribrag, Vincent; Elleuch, Manel; Fermé, Christophe; Bonniaud, Guillaume; Ruelle, Claude; Alberini, Jean-Louis; Celebic, Aljosa; Edeline, Véronique

    2014-01-01

    Purpose: This study examines the role of 18 F-labeled fluorodeoxyglucose positron emission tomography (FDG-PET) in the implementation of involved-node radiation therapy (INRT) in patients treated for clinical stages (CS) I/II supradiaphragmatic Hodgkin lymphoma (HL). Methods and Material: Patients with untreated CS I/II HL enrolled in the randomized EORTC/LYSA/FIL Intergroup H10 trial and participating in a real-time prospective quality assurance program were prospectively included in this study. Data were electronically obtained from 18 French cancer centers. All patients underwent APET-computed tomography (PET-CT) and a post-chemotherapy planning CT scanning. The pre-chemotherapy gross tumor volume (GTV) and the postchemotherapy clinical target volume (CTV) were first delineated on CT only by the radiation oncologist. The planning PET was then co-registered, and the delineated volumes were jointly analyzed by the radiation oncologist and the nuclear medicine physician. Lymph nodes undetected on CT but FDG-avid were recorded, and the previously determined GTV and CTV were modified according to FDG-PET results. Results: From March 2007 to February 2010, 135 patients were included in the study. PET-CT identified at least 1 additional FDG-avid lymph node in 95 of 135 patients (70.4%; 95% confidence interval [CI]: 61.9%-77.9%) and 1 additional lymph node area in 55 of 135 patients (40.7%; 95% CI: 32.4%-49.5%). The mean increases in the GTV and CTV were 8.8% and 7.1%, respectively. The systematic addition of PET to CT led to a CTV increase in 60% of the patients. Conclusions: Pre-chemotherapy FDG-PET leads to significantly better INRT delineation without necessarily increasing radiation volumes

  5. Radiotherapy treatment planning for patients with non-small cell lung cancer using positron emission tomography (PET)

    International Nuclear Information System (INIS)

    Erdi, Yusuf E.; Rosenzweig, Kenneth; Erdi, Alev K.; Macapinlac, Homer A.; Hu, Yu-Chi; Braban, Louise E.; Humm, John L.; Squire, Olivia D.; Chui, Chen-Shou; Larson, Steven M.; Yorke, Ellen D.

    2002-01-01

    Purpose: Many patients with non-small cell lung cancer (NSCLC) receive external beam radiation therapy as part of their treatment. Three-dimensional conformal radiation therapy (3DCRT) commonly uses computed tomography (CT) to accurately delineate the target lesion and normal tissues. Clinical studies, however, indicate that positron emission tomography (PET) has higher sensitivity than CT in detecting and staging of mediastinal metastases. Imaging with fluoro-2-deoxyglucose (FDG) PET in conjunction with CT, therefore, can improve the accuracy of lesion definition. In this pilot study, we investigated the potential benefits of incorporating PET data into the conventional treatment planning of NSCLC. Case-by-case, we prospectively analyzed planning target volume (PTV) and lung toxicity changes for a cohort of patients. Materials and methods: We have included 11 patients in this study. They were immobilized in the treatment position and CT simulation was performed. Following CT simulation, PET scanning was performed in the treatment position using the same body cast that was produced for CT simulation and treatment. The PTV, along with the gross target volume (GTV) and normal organs, was first delineated using the CT data set. The CT and PET transmission images were then registered in the treatment planning system using either manual or automated methods, leading to consequent registration of the CT and emission images. The PTV was then modified using the registered PET emission images. The modified PTV is seen simultaneously on both CT and PET images, allowing the physician to define the PTV utilizing the information from both data sets. Dose-volume histograms (DVHs) for lesion and normal organs were generated using both CT-based and PET+CT-based treatment plans. Results: For all patients, there was a change in PTV outline based on CT images versus CT/PET fused images. In seven out of 11 cases, we found an increase in PTV volume (average increase of 19%) to

  6. Diagnostic performance of {sup 68}Ga-PSMA-11 (HBED-CC) PET/CT in patients with recurrent prostate cancer: evaluation in 1007 patients

    Energy Technology Data Exchange (ETDEWEB)

    Afshar-Oromieh, Ali; Haberkorn, Uwe [Heidelberg University Hospital, Department of Nuclear Medicine, Heidelberg (Germany); German Cancer Research Centre, Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany); Holland-Letz, Tim [German Cancer Research Center, Department of Biostatistics, Heidelberg (Germany); Giesel, Frederik L.; Kratochwil, Clemens; Mier, Walter; Haufe, Sabine; Debus, Nils [Heidelberg University Hospital, Department of Nuclear Medicine, Heidelberg (Germany); Eder, Matthias [German Cancer Research Centre, Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany); Eisenhut, Michael; Schaefer, Martin; Neels, Oliver; Kopka, Klaus [German Cancer Research Center, Division of Radiopharmaceutical Chemistry, Heidelberg (Germany); Hohenfellner, Markus [Heidelberg University Hospital, Department of Urology, Heidelberg (Germany); Kauczor, Hans-Ulrich [Heidelberg University Hospital, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Debus, Juergen [Heidelberg University Hospital, Department of Radiation Oncology and Therapy, Heidelberg (Germany)

    2017-08-15

    Since the clinical introduction of {sup 68}Ga-PSMA-11 PET/CT, this imaging method has rapidly spread and is now regarded as a significant step forward in the diagnosis of recurrent prostate cancer (PCa). The aim of this study was to analyse the influence of several variables with possible influence on PSMA ligand uptake in a large cohort. We performed a retrospective analysis of 1007 consecutive patients who were scanned with {sup 68}Ga-PSMA-11 PET/CT (1 h after injection) from January 2014 to January 2017 to detect recurrent disease. Patients with untreated primary PCa or patients referred for PSMA radioligand therapy were excluded. The possible effects of different variables including PSA level and PSA doubling time (PSA{sub DT}), PSA velocity (PSA{sub Vel}), Gleason score (GSC, including separate analysis of GSC 7a and 7b), ongoing androgen deprivation therapy (ADT), patient age and amount of injected activity were evaluated. In 79.5% of patients at least one lesion with characteristics suggestive of recurrent PCa was detected. A pathological (positive) PET/CT scan was associated with PSA level and ADT. GSC, amount of injected activity, patient age, PSA{sub DT} and PSA{sub Vel} were not associated with a positive PET/CT scan in multivariate analysis. {sup 68}Ga-PSMA-11 PET/CT detects tumour lesions in a high percentage of patients with recurrent PCa. Tumour detection is clearly associated with PSA level and ADT. Only a tendency for an association without statistical significance was found between higher GSC and a higher probability of a pathological PET/CT scan. No associations were found between a pathological {sup 68}Ga-PSMA-11 PET/CT scan and patient age, amount of injected activity, PSA{sub DT} or PSA{sub Vel}. (orig.)

  7. Diagnostic accuracy of bone metastases detection in cancer patients. Comparison between bone scintigraphy and whole-body FDG-PET

    International Nuclear Information System (INIS)

    Fujimoto, Ryota; Higashi, Tatsuya; Nakamoto, Yuji

    2006-01-01

    18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has become widely available and an important oncological technique. To evaluate the influence of PET on detection of bone metastasis, we compared the diagnostic accuracy of PET and conventional bone scintigraphy (BS) in a variety of cancer patients. Consecutive ninety-five patients with various cancers, who received both PET and BS within one month, were retrospectively analyzed. A whole-body PET (from face to upper thigh) and a standard whole body BS were performed and these images were interpreted by two experienced nuclear medicine physicians with and without patient information using monitor diagnosis. Each image interpretation was performed according to 8 separate areas (skull, vertebra, upper limbs, sternum and clavicles, scapula, ribs, pelvis, and lower limbs) using a 5-point-scale (0: definitely negative, 1: probably negative, 2: equivocal, 3: probably positive, 4: definitely positive for bone metastasis). Twenty-one of 95 patients (22.1%) with 43 of 760 areas (5.7%) of bone metastases were finally confirmed. In untreated patients, 12 of 14 bone metastasis positive patients were detected by PET, while 9 of 14 were detected by BS. Three cases showed true positive in PET and false negative in BS due to osteolytic type bone metastases. In untreated cases, PET with and without clinical information showed better sensitivity than BS in patient-based diagnosis. For the purpose of treatment effect evaluation, PET showed better results because of its ability in the evaluation of rapid response of tumor cells to chemotherapy. Out of 10 cases of multiple-area metastases, 9 cases included vertebrae. There was only one solitary lesion located outside of field of view (FOV) of PET scan in the femur, but with clinical information that was no problem for PET diagnosis. Diagnostic accuracy of bone metastasis was comparable in PET and BS in the present study. In a usual clinical condition, limited FOV (from

  8. Standardised uptake values from PET/CT images: comparison with conventional attenuation-corrected PET

    International Nuclear Information System (INIS)

    Souvatzoglou, M.; Ziegler, S.I.; Martinez, M.J.; Dzewas, G.; Schwaiger, M.; Bengel, F.; Busch, R.

    2007-01-01

    In PET/CT, CT-derived attenuation factors may influence standardised uptake values (SUVs) in tumour lesions and organs when compared with stand-alone PET. Therefore, we compared PET/CT-derived SUVs intra-individually in various organs and tumour lesions with stand-alone PET-derived SUVs. Thirty-five patients with known or suspected cancer were prospectively included. Sixteen patients underwent FDG PET using an ECAT HR+scanner, and subsequently a second scan using a Biograph Sensation 16PET/CT scanner. Nineteen patients were scanned in the reverse order. All images were reconstructed with an iterative algorithm (OSEM). Suspected lesions were grouped as paradiaphragmatic versus distant from the diaphragm. Mean and maximum SUVs were also calculated for brain, lung, liver, spleen and vertebral bone. The attenuation coefficients (μ values) used for correction of emission data (bone, soft tissue, lung) in the two data sets were determined. A body phantom containing six hot spheres and one cold cylinder was measured using the same protocol as in patients. Forty-six lesions were identified. There was a significant correlation of maximum and mean SUVs derived from PET and PET/CT for 14 paradiaphragmatic lesions (r=0.97 respectively; p<0.001 respectively) and for 32 lesions located distant from the diaphragm (r=0.87 and r=0.89 respectively; p<0.001 respectively). No significant differences were observed in the SUVs calculated with PET and PET/CT in the lesions or in the organs. In the phantom, radioactivity concentration in spheres calculated from PET and from PET/CT correlated significantly (r=0.99; p<0.001). SUVs of cancer lesions and normal organs were comparable between PET and PET/CT, supporting the usefulness of PET/CT-derived SUVs for quantification of tumour metabolism. (orig.)

  9. Staging performance of whole-body DWI, PET/CT and PET/MRI in invasive ductal carcinoma of the breast.

    Science.gov (United States)

    Catalano, Onofrio Antonio; Daye, Dania; Signore, Alberto; Iannace, Carlo; Vangel, Mark; Luongo, Angelo; Catalano, Marco; Filomena, Mazzeo; Mansi, Luigi; Soricelli, Andrea; Salvatore, Marco; Fuin, Niccolo; Catana, Ciprian; Mahmood, Umar; Rosen, Bruce Robert

    2017-07-01

    The aim of the present study was to evaluate the performance of whole-body diffusion-weighted imaging (WB-DWI), whole-body positron emission tomography with computed tomography (WB-PET/CT), and whole-body positron emission tomography with magnetic resonance imaging (WB-PET/MRI) in staging patients with untreated invasive ductal carcinoma of the breast. Fifty-one women with newly diagnosed invasive ductal carcinoma of the breast underwent WB-DWI, WB-PET/CT and WB-PET/MRI before treatment. A radiologist and a nuclear medicine physician reviewed in consensus the images from the three modalities and searched for occurrence, number and location of metastases. Final staging, according to each technique, was compared. Pathology and imaging follow-up were used as the reference. WB-DWI, WB-PET/CT and WB-PET/MRI correctly and concordantly staged 33/51 patients: stage IIA in 7 patients, stage IIB in 8 patients, stage IIIC in 4 patients and stage IV in 14 patients. WB-DWI, WB-PET/CT and WB-PET/MRI incorrectly and concordantly staged 1/51 patient as stage IV instead of IIIA. Discordant staging was reported in 17/51 patients. WB-PET/MRI resulted in improved staging when compared to WB-PET/CT (50 correctly staged on WB-PET/MRI vs. 38 correctly staged on WB-PET/CT; McNemar's test; p<0.01). Comparing the performance of WB-PET/MRI and WB-DWI (43 correct) did not reveal a statistically significant difference (McNemar test, p=0.14). WB-PET/MRI is more accurate in the initial staging of breast cancer than WB-DWI and WB-PET/CT, however, the discrepancies between WB-PET/MRI and WB-DWI were not statistically significant. When available, WB-PET/MRI should be considered for staging patient with invasive ductal breast carcinoma.

  10. {sup 18}F-FDG PET/CT imaging factors that predict ischaemic stroke in cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jahae; Song, Ho-Chun [Chonnam National University Hospital, Department of Nuclear Medicine, Gwangju (Korea, Republic of); Choi, Kang-Ho [Chonnam National University Hospital, Cerebrovascular Center, Gwangju (Korea, Republic of); Chonnam National University Hwasun Hospital, Department of Neurology, Hwasun-gun, Jeollanam-do (Korea, Republic of); Kim, Joon-Tae; Park, Man-Seok; Cho, Ki-Hyun [Chonnam National University Hospital, Cerebrovascular Center, Gwangju (Korea, Republic of)

    2016-11-15

    {sup 18}F-FDG PET/CT can acquire both anatomical and functional images in a single session. We investigated which factors of {sup 18}F-FDG PET/CT imaging have potential as biomarkers for an increased risk of ischaemic stroke in cancer patients. From among cancer patients presenting with various neurological symptoms and hemiparesis, 134 were selected as eligible for this retrospective analysis. A new infarct lesion on brain MRI within 1 year of FDG PET/CT defined future ischaemic stroke. The target-to-background ratio (TBR) of each arterial segment was used to define arterial inflammation on PET imaging. Abdominal obesity was defined in terms of the area and proportion of visceral adipose tissue (VAT), subcutaneous adipose tissue and total adipose tissue (TAT) on a single CT slice at the umbilical level. Ischaemic stroke confirmed by MRI occurred in 30 patients. Patients with stroke had higher TBRs in the carotid arteries and abdominal aorta (P < 0.001) and a higher VAT proportion (P = 0.021) and TAT proportion (P = 0.041) than patients without stroke. Multiple logistic regression analysis showed that TBRs of the carotid arteries and abdominal aorta, VAT and TAT proportions, and the presence of a metabolically active tumour were significantly associated with future ischaemic stroke. Combining PET and CT variables improved the power for predicting future ischaemic stroke. Our findings suggest that arterial FDG uptake and hypermetabolic malignancy on PET and the VAT proportion on CT could be independent predictors of future ischaemic stroke in patients with cancer and could identify those patients who would benefit from medical treatment. (orig.)

  11. The role of PET/CT in radiation treatment planning for cancer patient treatment

    International Nuclear Information System (INIS)

    2008-10-01

    Positron emission tomography (PET) and, more recently, integrated positron emission tomography/X ray computed tomography (PET/CT) have appeared as significant diagnostic imaging systems in clinical medicine. Accurate recognition of cancers in patients by means of PET scanning with Fluorine-18-fluorodeoxyglucose ( 18 F-FDG) has illustrated a need to determine a mode of therapy to achieve better prognoses. The clinical management of cancer patients has improved dramatically with the introduction of clinical PET. For treatment of cancer patients, on the other hand, radiation therapy (RT) plays an important role as a non-invasive therapy. It is crucial that cancers are encompassed by high dose irradiation, particularly in cases of curative RT. Irradiation should precisely target the entire tumour and aim to minimise the size of microscopic extensions of the cancer, as well as minimize radiation damage to normal tissues. A new imaging technique has therefore been sought to allow precise delineation of the cancer target to be irradiated. Clinical PET, combined with utilization of 18 F-FDG, may have an important role in radiation treatment planning (RTP) in lung cancer. In addition to determining if RT is appropriate and whether therapy will be given with curative or palliative intent, 18 F-FDG-PET is useful for determining therapy ports. It can be used both to limit ports to spare normal tissue and to include additional involved regions. Several studies have shown that PET has an impact on RTP in an important proportion of patients. It is to be hoped that treatment plans that include all the 18 F-FDG-avid lesions or the 18 F-FDG-avid portions of a complex mass will result in more effective local control with less unnecessary tissue being treated. The IAEA has placed emphasis on the issue of application of clinical PET for radiation treatment planning in various cancer patients. Two consultants meetings were held in 2006 and their results are summarized into this IAEA

  12. Pets and the immunocompromised person

    Science.gov (United States)

    ... marrow transplant patients and pets; Chemotherapy patients and pets ... Centers for Disease Control and Prevention website. Healthy pets healthy people. www.cdc.gov/healthypets . Updated July 19, 2016. ...

  13. PET scanning of macrophages in patients with scleroderma fibrosing alveolitis

    Energy Technology Data Exchange (ETDEWEB)

    Branley, Howard M. [Imperial College London, Hammersmith Campus, London (United Kingdom)], E-mail: Howard.Branley@whittington.nhs.uk; Bois, Roland M. du; Wells, Athol U. [Royal Brompton Hospital, London (United Kingdom); Jones, Hazel A. [Imperial College London, Hammersmith Campus, London (United Kingdom)

    2008-11-15

    Rationale: Assessment of disease activity in fibrosing alveolitis due to systemic sclerosis (FASSc) is difficult without using invasive investigation. A repeatable noninvasive method of assessing disease at a cellular level such as with positron emission tomography (PET) could be of great value in evaluating high-resolution changes in the pathological process. Objectives: To investigate whether the level of inflammatory cell traffic and lung density in FASSc, imaged in vivo by PET, is different to controls and whether they are associated with changes in pulmonary function indices. Methods: We used PET to measure lung density and tissue uptake of {sup 11}C-[R]-PK11195, a ligand that binds to receptors found in abundance in macrophages. Fifteen patients with FASSc were compared to seven controls. Results: A trend of reduced uptake of {sup 11}C-[R]-PK11195 was observed in FASSc patients (P=.09) and correlated inversely with lung density (r=-.62; P<.05), which was significantly elevated in FASSc [0.35{+-}0.02 vs. 0.23{+-}0.02 g/cc (mean{+-}S.E.M.); P<.005]. Conclusion: These results demonstrate that inflammatory cell traffic and lung density can be imaged in vivo in FASSc using PET, and that this approach might be of potential value in understanding, in situ, components of pathogenesis that may have value for prognosis.

  14. PET scanning of macrophages in patients with scleroderma fibrosing alveolitis

    International Nuclear Information System (INIS)

    Branley, Howard M.; Bois, Roland M. du; Wells, Athol U.; Jones, Hazel A.

    2008-01-01

    Rationale: Assessment of disease activity in fibrosing alveolitis due to systemic sclerosis (FASSc) is difficult without using invasive investigation. A repeatable noninvasive method of assessing disease at a cellular level such as with positron emission tomography (PET) could be of great value in evaluating high-resolution changes in the pathological process. Objectives: To investigate whether the level of inflammatory cell traffic and lung density in FASSc, imaged in vivo by PET, is different to controls and whether they are associated with changes in pulmonary function indices. Methods: We used PET to measure lung density and tissue uptake of 11 C-[R]-PK11195, a ligand that binds to receptors found in abundance in macrophages. Fifteen patients with FASSc were compared to seven controls. Results: A trend of reduced uptake of 11 C-[R]-PK11195 was observed in FASSc patients (P=.09) and correlated inversely with lung density (r=-.62; P<.05), which was significantly elevated in FASSc [0.35±0.02 vs. 0.23±0.02 g/cc (mean±S.E.M.); P<.005]. Conclusion: These results demonstrate that inflammatory cell traffic and lung density can be imaged in vivo in FASSc using PET, and that this approach might be of potential value in understanding, in situ, components of pathogenesis that may have value for prognosis

  15. 11C-acetate PET imaging in patients with multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Kazushiro Takata

    Full Text Available BACKGROUND: Activation of glial cells is a cardinal feature in multiple sclerosis (MS pathology, and acetate has been reported to be selectively uptaken by astrocytes in the CNS. The aim of this study was to investigate the efficacy of PET with (11C-acetate for MS diagnosis. MATERIALS AND METHODS: Six patients with relapsing-remitting MS and 6 healthy volunteers (HV were enrolled. The (11C-acetate brain uptake on PET was measured in patients with MS and HV. Volume-of-interest analysis of cerebral gray and white matter based on the segmentation technique for co-registered MRI and voxel-based statistical parametric analysis were performed. Correlation between 11C-acetate uptake and the lesion number in T1- and T2- weighted MR images were also assessed. RESULTS: The standardized uptake value (SUV of 11C-acetate was increased in both white and gray matter in MS patients compared to HV. Voxel-based statistical analysis revealed a significantly increased SUV relative to that in the bilateral thalami (SUVt in a broad area of white matter, particularly in the subcortical white matter of MS patients. The numbers of T2 lesions and T1 black holes were significantly correlated with SUV of (11C-acetate in white and gray matter. CONCLUSIONS: The 11C-acetate uptake significantly increased in MS patients and correlated to the number of MRI lesions. These preliminary data suggest that (11C-acetate PET can be a useful clinical examination for MS patients.

  16. 18F-FDG PET/contrast enhanced CT in the standard follow-up of patients with lymphoma.

    Science.gov (United States)

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

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

  17. 18F-FDG PET of the hands with a dedicated high-resolution PEM system (arthro-PET): correlation with PET/CT, radiography and clinical parameters.

    Science.gov (United States)

    Mhlanga, Joyce C; Carrino, John A; Lodge, Martin; Wang, Hao; Wahl, Richard L

    2014-12-01

    The aim of this study was to prospectively determine the feasibility and compare the novel use of a positron emission mammography (PEM) scanner with standard PET/CT for evaluating hand osteoarthritis (OA) with (18)F-FDG. Institutional review board approval and written informed consent were obtained for this HIPAA-compliant prospective study in which 14 adults referred for oncological (18)F-FDG PET/CT underwent dedicated hand PET/CT followed by arthro-PET using the PEM device. Hand radiographs were obtained and scored for the presence and severity of OA. Summed qualitative and quantitative joint glycolytic scores for each modality were compared with the findings on plain radiography and clinical features. Eight patients with clinical and/or radiographic evidence of OA comprised the OA group (mean age 73 ± 7.7 years). Six patients served as the control group (53.7 ± 9.3 years). Arthro-PET quantitative and qualitative joint glycolytic scores were highly correlated with PET/CT findings in the OA patients (r = 0.86. p = 0.007; r = 0.94, p = 0.001). Qualitative arthro-PET and PET/CT joint scores were significantly higher in the OA patients than in controls (38.7 ± 6.6 vs. 32.2 ± 0.4, p = 0.02; 37.5 ± 5.4 vs. 32.2 ± 0.4, p = 0.03, respectively). Quantitative arthro-PET and PET/CT maximum SUV-lean joint scores were higher in the OA patients, although they did not reach statistical significance (20.8 ± 4.2 vs. 18 ± 1.8, p = 0.13; 22.8 ± 5.38 vs. 20.1 ± 1.54, p = 0.21). By definition, OA patients had higher radiographic joint scores than controls (30.9 ± 31.3 vs. 0, p = 0.03). Hand imaging using a small field of view PEM system (arthro-PET) with FDG is feasible, performing comparably to PET/CT in assessing metabolic joint activity. Arthro-PET and PET/CT showed higher joint FDG uptake in OA. Further exploration of arthro-PET in arthritis management is warranted.

  18. Role of FDG-PET for the diagnosis of differentiated thyroid cancer relapse examination of 39 patients

    International Nuclear Information System (INIS)

    Groheux, D.; Garin, E.; Bernard, A.M.; Devillers, A.; Lescouarc'h, J.; Prigent-Le Jeune, F.; Carsin, A.; Bourguet, P.; Herry, J.Y.; Mesbah, H.

    2005-01-01

    Thirty nine patients with differentiated thyroid carcinoma (32 papillary, 4 follicular and 3 oncocytic) were studied by 18FDG whole-body PET in most cases because of elevated thyroglobulin. All patients were examined with hormone substitution at low TSH levels. Fourteen patients had 18FD G uptake in cervical region, 9 in mediastinum and 5 in lungs. Sensitivity of FDG-PET was 68%, specificity 71%, PPV 8% and NPV 56%. Sensitivity was respectively 53% and 90% if thyroglobulin was inferior or superior to 10 ng/ml. FDG-PET changed cancer staging in 27 patients and changed treatment strategy in 11 patients (10 surgical treatments and 1 radioiodine therapy). (author)

  19. The utility of FDG-PET for assessing outcomes in oligometastatic cancer patients treated with stereotactic body radiotherapy: a cohort study

    Directory of Open Access Journals (Sweden)

    Solanki Abhishek A

    2012-12-01

    Full Text Available Abstract Background Studies suggest that patients with metastases limited in number and destination organ benefit from metastasis-directed therapy. Stereotactic body radiotherapy (SBRT is commonly used for metastasis directed therapy in this group. However, the characterization of PET response following SBRT is unknown in this population. We analyzed our cohort of patients to describe the PET response following SBRT. Methods Patients enrolled on a prospective dose escalation trial of SBRT to all known sites of metastatic disease were reviewed to select patients with pre- and post-therapy PET scans. Response to SBRT was characterized on PET imaging based on standard PET response criteria and compared to CT based RECIST criteria for each treated lesion. Results 31 patients had PET and CT data available before and after treatment for analysis in this study. In total, 58 lesions were treated (19 lung, 11 osseous, 11 nodal, 9 liver, 6 adrenal and 2 soft tissue metastases. Median follow-up was 14 months (range: 3–41. Median time to first post-therapy PET was 1.2 months (range; 0.5-4.1. On initial post-therapy PET evaluation, 96% (56/58 of treated metastases responded to therapy. 60% (35/58 had a complete response (CR on PET and 36% (21/58 had a partial response (PR. Of 22 patients with stable disease (SD on initial CT scan, 13 had CR on PET, 8 had PR, and one had SD. Of 21 metastases with PET PR, 38% became CR, 52% remained PR, and 10% had progressive disease on follow-up PET. 10/35 lesions (29% with an initial PET CR progressed on follow-up PET scan with median time to progression of 4.11 months (range: 2.75-9.56. Higher radiation dose correlated with long-term PET response. Conclusions PET response to SBRT enables characterization of metastatic response in tumors non-measurable by CT. Increasing radiation dose is associated with prolonged complete response on PET.

  20. [11C]Choline PET/CT predicts survival in hormone-naive prostate cancer patients with biochemical failure after radical prostatectomy

    International Nuclear Information System (INIS)

    Giovacchini, Giampiero; Incerti, Elena; Mapelli, Paola; Gianolli, Luigi; Picchio, Maria; Kirienko, Margarita; Briganti, Alberto; Gandaglia, Giorgio; Montorsi, Francesco

    2015-01-01

    Over the last decade, PET/CT with radiolabelled choline has been shown to be useful for restaging patients with prostate cancer (PCa) who develop biochemical failure. The limitations of most clinical studies have been poor validation of [ 11 C]choline PET/CT-positive findings and lack of survival analysis. The aim of this study was to assess whether [ 11 C]choline PET/CT can predict survival in hormone-naive PCa patients with biochemical failure. This retrospective study included 302 hormone-naive PCa patients treated with radical prostatectomy who underwent [ 11 C]choline PET/CT from 1 December 2004 to 31 July 2007 because of biochemical failure (prostate-specific antigen, PSA, >0.2 ng/mL). Median PSA was 1.02 ng/mL. PCa-specific survival was estimated using Kaplan-Meier curves. Cox regression analysis was used to evaluate the association between clinicopathological variables and PCa-specific survival. The coefficients of the covariates included in the Cox regression analysis were used to develop a novel nomogram. Median follow-up was 7.2 years (1.4 - 18.9 years). [ 11 C]Choline PET/CT was positive in 101 of 302 patients (33 %). Median PCa-specific survival after prostatectomy was 14.9 years (95 % CI 9.7 - 20.1 years) in patients with positive [ 11 C]choline PET/CT. Median survival was not achieved in patients with negative [ 11 C]choline PET/CT. The 15-year PCa-specific survival probability was 42.4 % (95 % CI 31.7 - 53.1 %) in patients with positive [ 11 C]choline PET/CT and 95.5 % (95 % CI 93.5 - 97.5 %) in patients with negative [ 11 C]choline PET/CT. In multivariate analysis, [ 11 C]choline PET/CT (hazard ratio 6.36, 95 % CI 2.14 - 18.94, P < 0.001) and Gleason score >7 (hazard ratio 3.11, 95 % CI 1.11 - 8.66, P = 0.030) predicted PCa-specific survival. An internally validated nomogram predicted 15-year PCa-specific survival probability with an accuracy of 80 %. Positive [ 11 C]choline PET/CT after biochemical failure predicts PCa-specific survival in hormone

  1. SU-G-IeP4-07: Feasibility of Low Dose 18FDG PET in Pediatric Oncology Patients

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, J; Binzel, K; Hall, NC; Natwa, M; Knopp, MI; Knopp, MV [The Ohio State University, Columbus, OH (United States)

    2016-06-15

    Purpose: To evaluate and demonstrate the feasibility of low dose FDG PET in pediatric oncology patients using virtual dose reduction as well as true patients PET/CT scans. Methods: Wholebody 18F-FDG PET/CT of 39 clinical pediatric patients (0.16±0.06MBq/kg) were scanned on a Gemini TF 64 system at 75±5 min post FDG injection using 3min/bed. Based on the 180s/bed listmode PET data, subsets of total counts in 120s, 90s, 60s, 30s and 15s per bed position were extracted for PET reconstruction to simulate lower dose PET at 2/3th, 1/2th, 1/3th, 1/6th and 1/12th dose levels. PET/CT scans of Jaszczak PET phantom with 6 hot hollow spheres varying with sizes and contrast ratios were performed (real PET versus simulated PET) to validate the methodology of virtual dose PET simulation. Region of interests (ROIs) were placed on lesions and normal anatomical tissues with quantitative and qualitative assessment performed. Significant lower FDG dose PET/CT of 5 research adolescents were scanned to validate the proposal and low dose PET feasibility. Results: Although all lesions are visible on the 1/12th dose PET, overall PET image quality appears to be influenced in a multi-factorial way. 30%–60% dose reduction from current standard of care FDG PET is recommended to maintain equivalent quality and PET quantification. An optimized BMI-based FDG administration is recommended (from 1.1±0.5 mCi for BMI < 18.5 to 4.8±1.5 mCi for BMI > 30). A linear lowest “Dose-BMI” relationship is given. SUVs from 1/12th to full dose PETs were identified as consistent (R2 = 1.08, 0.99, 1.01, 1.00 and 0.98). No significant variances of count density, SUV and SNR were found across certain dose ranges (p<0.01). Conclusion: Pediatric PET/CT can be performed using current time-of-flight systems at substantially lower PET doses (30–60%) than the standard of care PET/CT without compromising qualitative and quantitative image quality in clinical.

  2. SU-G-IeP4-07: Feasibility of Low Dose 18FDG PET in Pediatric Oncology Patients

    International Nuclear Information System (INIS)

    Zhang, J; Binzel, K; Hall, NC; Natwa, M; Knopp, MI; Knopp, MV

    2016-01-01

    Purpose: To evaluate and demonstrate the feasibility of low dose FDG PET in pediatric oncology patients using virtual dose reduction as well as true patients PET/CT scans. Methods: Wholebody 18F-FDG PET/CT of 39 clinical pediatric patients (0.16±0.06MBq/kg) were scanned on a Gemini TF 64 system at 75±5 min post FDG injection using 3min/bed. Based on the 180s/bed listmode PET data, subsets of total counts in 120s, 90s, 60s, 30s and 15s per bed position were extracted for PET reconstruction to simulate lower dose PET at 2/3th, 1/2th, 1/3th, 1/6th and 1/12th dose levels. PET/CT scans of Jaszczak PET phantom with 6 hot hollow spheres varying with sizes and contrast ratios were performed (real PET versus simulated PET) to validate the methodology of virtual dose PET simulation. Region of interests (ROIs) were placed on lesions and normal anatomical tissues with quantitative and qualitative assessment performed. Significant lower FDG dose PET/CT of 5 research adolescents were scanned to validate the proposal and low dose PET feasibility. Results: Although all lesions are visible on the 1/12th dose PET, overall PET image quality appears to be influenced in a multi-factorial way. 30%–60% dose reduction from current standard of care FDG PET is recommended to maintain equivalent quality and PET quantification. An optimized BMI-based FDG administration is recommended (from 1.1±0.5 mCi for BMI 30). A linear lowest “Dose-BMI” relationship is given. SUVs from 1/12th to full dose PETs were identified as consistent (R2 = 1.08, 0.99, 1.01, 1.00 and 0.98). No significant variances of count density, SUV and SNR were found across certain dose ranges (p<0.01). Conclusion: Pediatric PET/CT can be performed using current time-of-flight systems at substantially lower PET doses (30–60%) than the standard of care PET/CT without compromising qualitative and quantitative image quality in clinical.

  3. 18F-FDG whole body positron emission tomography (PET) in patients with unknown primary tumours (UPT)

    DEFF Research Database (Denmark)

    Lassen, U; Daugaard, G; Eigtved, A

    1999-01-01

    -fluorodeoxyglucose) are of clinical value in detection of UPT. Whole-body FDG-PET scans were performed in 20 patients following standard staging procedures according to histology. PET results were verified either histologically or by the clinical course of the disease. 11 patients had neck metastases (5 squamous cell, 5......The management of patients with unknown primary tumours (UPT) often includes a large number of radiographical studies and invasive procedures, but the occult primary tumour is detected in less than 25%. In this prospective study we explored whether non-invasive whole body PET scans using FDG (18-F...... and this was verified in 9 (45%), either histologically or by the clinical course of disease. 8 of these had primary lung cancer and 1 had carcinoma at the basis of the tongue. In most patients PET had no treatment related implications. 3 patients with non-small cell lung cancer (NSCLC) received chemotherapy prompted...

  4. 18F-FDG whole body positron emission tomography (PET) in patients with unknown primary tumours (UPT)

    DEFF Research Database (Denmark)

    Lassen, U; Daugaard, G; Eigtved, A

    1999-01-01

    adenocarcinomas and 1 poorly differentiated carcinoma). The remaining patients had metastases located in bone (3), bone marrow (1), brain (1), pericardium (1), skin (1), pleura (1) and chest wall (1). All metastatic lesions were visible with PET. In 13 patients PET suggested the site for the primary tumour...... by the PET result. The rest received either radical radiotherapy to the head and neck region (7), palliative radiotherapy to the metastatic lesion (8), chemotherapy based on signet ring cell carcinoma in bone marrow (1) or no therapy (1). These results indicates that PET is useful in UPT preceding expensive......The management of patients with unknown primary tumours (UPT) often includes a large number of radiographical studies and invasive procedures, but the occult primary tumour is detected in less than 25%. In this prospective study we explored whether non-invasive whole body PET scans using FDG (18-F...

  5. Comparison of CT and integrated PET-CT based radiation therapy planning in patients with malignant pleural mesothelioma

    International Nuclear Information System (INIS)

    Pehlivan, Berrin; Topkan, Erkan; Onal, Cem; Nursal, Gul Nihal; Yuksel, Oznur; Dolek, Yemliha; Yavuz, Melek Nur; Yavuz, Ali Aydin

    2009-01-01

    When combined with adequate tumoricidal doses, accurate target volume delineation remains to be the one of the most important predictive factors for radiotherapy (RT) success in locally advanced or medically inoperable malignant pleural mesothelioma (MPM) patients. Recently, 18-fluorodeoxyglucose positron emission tomography (PET) has demonstrated significant improvements in diagnosis and accurate staging of MPM. However, role of additional PET data has not been studied in RT planning (RTP) of patients with inoperable MPM or in those who refuse surgery. Therefore, we planned to compare CT with co-registered PET-CT as the basis for delineating target volumes in these patients group. Retrospectively, the CT and co-registered PET-CT data of 13 patients with histologically proven MPM were utilized to delineate target volumes separately. For each patient, target volumes (gross tumor volume [GTV], clinical target volume [CTV], and planning target volume [PTV]) were defined using the CT and PET-CT fusion data sets. The PTV was measured in two ways: PTV1 was CTV plus a 1-cm margin, and PTV2 was GTV plus a 1-cm margin. We analyzed differences in target volumes. In 12 of 13 patients, compared to CT-based delineation, PET-CT-based delineation resulted in a statistically significant decrease in the mean GTV, CTV, PTV1, and PTV2. In these 12 patients, mean GTV decreased by 47.1% ± 28.4%, mean CTV decreased by 38.7% ± 24.7%, mean PTV1 decreased by 31.1% ± 23.1%, and mean PTV2 decreased by 40.0% ± 24.0%. In 4 of 13 patients, hilar lymph nodes were identified by PET-CT that was not identified by CT alone, changing the nodal status of tumor staging in those patients. This study demonstrated the usefulness of PET-CT-based target volume delineation in patients with MPM. Co-registration of PET and CT information reduces the likelihood of geographic misses, and additionally, significant reductions observed in target volumes may potentially allow escalation of RT dose beyond

  6. Present and future of PET and PET/CT in gynaecologic malignancies

    International Nuclear Information System (INIS)

    Musto, Alessandra; Rampin, Lucia; Nanni, Cristina; Marzola, Maria Cristina; Fanti, Stefano; Rubello, Domenico

    2011-01-01

    Objectives: To review the published data in literature on patients affected by gynaecological malignancies to establish the role of 18 F-FDG positron emission tomography (PET) and PET/CT in comparison to conventional imaging (CI). Materials and methods: All papers specifically addressed to the role of 18 F-FDG PET and PET/CT in gynaecological malignancies published on PubMed/Medline, in abstracts from the principal international congresses, in the guidelines from national Societies that had appeared in literature until November 2009 were considered for the purpose of the present study. Results and conclusions: The use of 18 F-FDG PET, and even more of 18 F-FDG PET/CT, is increasing in the follow up of patients with gynaecologic malignancies and suspected recurrent disease: there is evidence in the literature that 18 F-FDG PET/CT has a higher sensitivity than CI in depicting occult metastatic spread. An interesting issue is represented by patients with ovarian cancer with an increase of the specific biomarker, CA-125, and negative/inconclusive findings at CI. The use of 18 F-FDG PET in differential diagnosis and staging is more controversial, but there is some evidence that a baseline PET examination performed before commencing therapy, for staging purpose, is also useful to evaluate the response to chemoradiation treatment. In several papers it has been suggested a relevant role of 18 F-FDG PET/CT in evaluating the entity of response to treatment and therefore to plan the subsequent therapeutic strategy.

  7. Diagnostic performance of FDG PET or PET/CT in prosthetic infection after arthroplasty: a meta-analysis

    International Nuclear Information System (INIS)

    Jin, H.; Yuan, L.; Li, C.; Kan, Y.; Yang, J.; Hao, R.

    2014-01-01

    The purpose of this study was to systematically review and perform a meta-analysis of published data regarding the diagnostic performance of positron emission tomography (PET) or PET/computed tomography (PET/CT) in prosthetic infection after arthroplasty. A comprehensive computer literature search of studies published through May 31, 2012 regarding PET or PET/CT in patients suspicious of prosthetic infection was performed in PubMed/MEDLINE, Embase and Scopus databases. Pooled sensitivity and specificity of PET or PET/CT in patients suspicious of prosthetic infection on a per prosthesis-based analysis were calculated. The area under the receiver-operating characteristic (ROC) curve was calculated to measure the accuracy of PET or PET/CT in patients with suspicious of prosthetic infection. Fourteen studies comprising 838 prosthesis with suspicious of prosthetic infection after arthroplasty were included in this meta-analysis. The pooled sensitivity of PET or PET/CT in detecting prosthetic infection was 86% (95% confidence interval [CI] 82-90%) on a per prosthesis-based analysis. The pooled specificity of PET or PET/CT in detecting prosthetic infection was 86% (95% CI 83-89%) on a per prosthesis-based analysis. The area under the ROC curve was 0.93 on a per prosthesis-based analysis. In patients suspicious of prosthetic infection, FDG PET or PET/CT demonstrated high sensitivity and specificity. FDG PET or PET/CT are accurate methods in this setting. Nevertheless, possible sources of false positive results and influcing factors should kept in mind.

  8. Diagnostic performance of FDG PET or PET/CT in prosthetic infection after arthroplasty: a meta-analysis.

    Science.gov (United States)

    Jin, H; Yuan, L; Li, C; Kan, Y; Hao, R; Yang, J

    2014-03-01

    The purpose of this study was to systematically review and perform a meta-analysis of published data regarding the diagnostic performance of positron emission tomography (PET) or PET/computed tomography (PET/CT) in prosthetic infection after arthroplasty. A comprehensive computer literature search of studies published through May 31, 2012 regarding PET or PET/CT in patients suspicious of prosthetic infection was performed in PubMed/MEDLINE, Embase and Scopus databases. Pooled sensitivity and specificity of PET or PET/CT in patients suspicious of prosthetic infection on a per prosthesis-based analysis were calculated. The area under the receiver-operating characteristic (ROC) curve was calculated to measure the accuracy of PET or PET/CT in patients with suspicious of prosthetic infection. Fourteen studies comprising 838 prosthesis with suspicious of prosthetic infection after arthroplasty were included in this meta-analysis. The pooled sensitivity of PET or PET/CT in detecting prosthetic infection was 86% (95% confidence interval [CI] 82-90%) on a per prosthesis-based analysis. The pooled specificity of PET or PET/CT in detecting prosthetic infection was 86% (95% CI 83-89%) on a per prosthesis-based analysis. The area under the ROC curve was 0.93 on a per prosthesis-based analysis. In patients suspicious of prosthetic infection, FDG PET or PET/CT demonstrated high sensitivity and specificity. FDG PET or PET/CT are accurate methods in this setting. Nevertheless, possible sources of false positive results and influcing factors should kept in mind.

  9. Impact of {sup 18}F-FDG-PET/CT on surgical management in patients with advanced melanoma: an outcome based analysis

    Energy Technology Data Exchange (ETDEWEB)

    Forschner, Andrea; Keim, Ulrike; Eigentler, Thomas Kurt; Garbe, Claus [Eberhard-Karls-University Tuebingen, Department of Dermatology, Tuebingen (Germany); Olthof, Susann-Cathrin; Gueckel, Brigitte; Nikolaou, Konstantin; Pfannenberg, Christina [Eberhard-Karls-University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Martus, Peter [Eberhard-Karls-University Tuebingen, Department of Clinical Epidemiology and Applied Biostatistics, Tuebingen (Germany); Vach, Werner [University Freiburg, Institute of Medical Biometry and Statistics, Freiburg (Germany); Fougere, Christian la [Eberhard-Karls-University Tuebingen, Department of Nuclear Medicine and Clinical Molecular Imaging, Tuebingen (Germany)

    2017-08-15

    To evaluate the influence of {sup 18}F-FDG-PET/CT on clinical decision making and outcome in advanced melanoma patients planned for radical metastasectomy. A cohort of 333 patients with mainly stage III/IV melanoma having a PET/CT for clinical reasons was prospectively enrolled in our oncologic PET/CT registry between 2013 and 2015. Referring physicians completed questionnaires regarding their intended management for each patient before and after PET/CT. Management changes after PET/CT were classified as major and minor changes. A subgroup of 107 patients (stage I, N = 5; stage II, N = 3; stage III, N = 42; stage IV, N = 57) was planned for complete metastasectomy initially, based on conventional imaging. Management changes and outcome were evaluated by linkage with the information obtained from patients' medical records. In 28 of 107 patients (26%), the surgical treatment plan remained unchanged after PET/CT. In 24 patients (22%), minor changes were performed, such as enlargement or reduction of the surgical field. In 55 patients (51%, 95% CI 42%-61%) major changes of the intended treatment plan occurred; of those, 20 patients (19%) were classified to be tumor-free with PET/CT, 32 patients (30%) were found to have multiple previously unrecognized metastases and had to be treated by systemic therapy, three patients (3%) had to be changed to palliative radiotherapy or isolated extremity perfusion. The 1-year and 2-year overall survival (OS) in patients with complete metastasectomy (N = 52) was 90% and 79%, respectively. Systemically treated patients (N = 32) resulted in 1-year OS of 72% and 2-year OS of 61%. Eleven of 32 patients (34%) with systemic therapy experienced a complete response. Until December 2016, all 20 patients classified as tumor-free by PET/CT were alive. The study confirms the high impact of PET/CT on clinical management in patients with advanced melanoma planned for radical metastasectomy. PET/CT resulted in frequent management changes

  10. Impact of "1"8F-FDG-PET/CT on surgical management in patients with advanced melanoma: an outcome based analysis

    International Nuclear Information System (INIS)

    Forschner, Andrea; Keim, Ulrike; Eigentler, Thomas Kurt; Garbe, Claus; Olthof, Susann-Cathrin; Gueckel, Brigitte; Nikolaou, Konstantin; Pfannenberg, Christina; Martus, Peter; Vach, Werner; Fougere, Christian la

    2017-01-01

    To evaluate the influence of "1"8F-FDG-PET/CT on clinical decision making and outcome in advanced melanoma patients planned for radical metastasectomy. A cohort of 333 patients with mainly stage III/IV melanoma having a PET/CT for clinical reasons was prospectively enrolled in our oncologic PET/CT registry between 2013 and 2015. Referring physicians completed questionnaires regarding their intended management for each patient before and after PET/CT. Management changes after PET/CT were classified as major and minor changes. A subgroup of 107 patients (stage I, N = 5; stage II, N = 3; stage III, N = 42; stage IV, N = 57) was planned for complete metastasectomy initially, based on conventional imaging. Management changes and outcome were evaluated by linkage with the information obtained from patients' medical records. In 28 of 107 patients (26%), the surgical treatment plan remained unchanged after PET/CT. In 24 patients (22%), minor changes were performed, such as enlargement or reduction of the surgical field. In 55 patients (51%, 95% CI 42%-61%) major changes of the intended treatment plan occurred; of those, 20 patients (19%) were classified to be tumor-free with PET/CT, 32 patients (30%) were found to have multiple previously unrecognized metastases and had to be treated by systemic therapy, three patients (3%) had to be changed to palliative radiotherapy or isolated extremity perfusion. The 1-year and 2-year overall survival (OS) in patients with complete metastasectomy (N = 52) was 90% and 79%, respectively. Systemically treated patients (N = 32) resulted in 1-year OS of 72% and 2-year OS of 61%. Eleven of 32 patients (34%) with systemic therapy experienced a complete response. Until December 2016, all 20 patients classified as tumor-free by PET/CT were alive. The study confirms the high impact of PET/CT on clinical management in patients with advanced melanoma planned for radical metastasectomy. PET/CT resulted in frequent management changes, preventing

  11. Validating the Patient Experience with Treatment and Self-Management (PETS), a patient-reported measure of treatment burden, in people with diabetes.

    Science.gov (United States)

    Rogers, Elizabeth A; Yost, Kathleen J; Rosedahl, Jordan K; Linzer, Mark; Boehm, Deborah H; Thakur, Azra; Poplau, Sara; Anderson, Roger T; Eton, David T

    2017-01-01

    To validate a comprehensive general measure of treatment burden, the Patient Experience with Treatment and Self-Management (PETS), in people with diabetes. We conducted a secondary analysis of a cross-sectional survey study with 120 people diagnosed with type 1 or type 2 diabetes and at least one additional chronic illness. Surveys included established patient-reported outcome measures and a 48-item version of the PETS, a new measure comprised of multi-item scales assessing the burden of chronic illness treatment and self-care as it relates to nine domains: medical information, medications, medical appointments, monitoring health, interpersonal challenges, health care expenses, difficulty with health care services, role activity limitations, and physical/mental exhaustion from self-management. Internal reliability of PETS scales was determined using Cronbach's alpha. Construct validity was determined through correlation of PETS scores with established measures (measures of chronic condition distress, medication satisfaction, self-efficacy, and global well-being), and known-groups validity through comparisons of PETS scores across clinically distinct groups. In an exploratory test of predictive validity, step-wise regressions were used to determine which PETS scales were most associated with outcomes of chronic condition distress, overall physical and mental health, and medication adherence. Respondents were 37-88 years old, 59% female, 29% non-white, and 67% college-educated. PETS scales showed good reliability (Cronbach's alphas ≥0.74). Higher PETS scale scores (greater treatment burden) were correlated with more chronic condition distress, less medication convenience, lower self-efficacy, and worse general physical and mental health. Participants less (versus more) adherent to medications and those with more (versus fewer) health care financial difficulties had higher mean PETS scores. Medication burden was the scale that was most consistently associated with

  12. Comparison of [68Ga]Ga-PSMA-11 PET/CT with [18F]NaF PET/CT in the evaluation of bone metastases in metastatic prostate cancer patients prior to radionuclide therapy.

    Science.gov (United States)

    Uprimny, Christian; Svirydenka, Anna; Fritz, Josef; Kroiss, Alexander Stephan; Nilica, Bernhard; Decristoforo, Clemens; Haubner, Roland; von Guggenberg, Elisabeth; Buxbaum, Sabine; Horninger, Wolfgang; Virgolini, Irene Johanna

    2018-05-16

    The purpose of this study was to investigate the diagnostic performance of 68 Ga-PSMA-11 PET/CT in the evaluation of bone metastases in metastatic prostate cancer (PC) patients scheduled for radionuclide therapy in comparison to [ 18 F]sodium fluoride ( 18 F-NaF) PET/CT. Sixteen metastatic PC patients with known skeletal metastases, who underwent both 68 Ga-PSMA-11 PET/CT and 18 F-NaF PET/CT for assessment of metastatic burden prior to radionuclide therapy, were analysed retrospectively. The performance of both tracers was calculated on a lesion-based comparison. Intensity of tracer accumulation of pathologic bone lesions on 18 F-NaF PET and 68 Ga-PSMA-11 PET was measured with maximum standardized uptake values (SUV max ) and compared to background activity of normal bone. In addition, SUV max values of PET-positive bone lesions were analysed with respect to morphologic characteristics on CT. Bone metastases were either confirmed by CT or follow-up PET scan. In contrast to 468 PET-positive lesions suggestive of bone metastases on 18 F-NaF PET, only 351 of the lesions were also judged positive on 68 Ga-PSMA-11 PET (75.0%). Intensity of tracer accumulation of pathologic skeletal lesions was significantly higher on 18 F-NaF PET compared to 68 Ga-PSMA-11 PET, showing a median SUV max of 27.0 and 6.0, respectively (p PET, with a median SUV max of 1.0 in comparison to 2.7 on 18 F-NaF PET; however, tumour to background ratio was significantly higher on 18 F-NaF PET (9.8 versus 5.9 on 68 Ga-PSMA-11 PET; p = 0.042). Based on morphologic lesion characterisation on CT, 18 F-NaF PET revealed median SUV max values of 23.6 for osteosclerotic, 35.0 for osteolytic, and 19.0 for lesions not visible on CT, whereas on 68 Ga-PSMA-11 PET median SUV max values of 5.0 in osteosclerotic, 29.5 in osteolytic, and 7.5 in lesions not seen on CT were measured. Intensity of tracer accumulation between 18 F-NaF PET and 68 Ga-PSMA-11 PET was significantly higher in osteosclerotic (p PET

  13. Bone marrow trephine biopsy in Hodgkin's lymphoma. Comparison with PET-CT scan in 65 patients.

    Science.gov (United States)

    Lakhwani, Sunil; Cabello-García, Dolores; Allende-Riera, Ana; Cárdenas-Negro, Carlos; Raya, José María; Hernández-Garcia, Miguel T

    2018-02-09

    To compare bone marrow biopsy (BMB) and PET/CT in detecting bone marrow involvement in Hodgkin's lymphoma MATERIAL AND METHODS: Retrospective analysis of 65 patients with both tests in the initial staging or in relapse with special attention to the PET/CT uptake pattern. In 3 patients (4.6%), the BMB showed bone marrow involvement with the PET/CT being positive in them all: 2 with diffuse+multifocal pattern and one diffuse only. In 11 additional patients (total 14/65, 21%), bone marrow involvement was diagnosed by PET/CT because bone marrow uptake was above hepatic one. The pattern was focal only in 2 cases, multifocal in 5, diffuse in 3 and diffuse+multifocal in one. In these last 4 cases the BMB showed an unspecific myelopathy. PET/CT detects all cases with BMB affected and many that escape to biopsy, however when the uptake pattern is diffuse it could be by involvement or reactive hyperplasia and in those cases the BMB should be done. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  14. Diagnostic performance and impact on patient management of 68Ga-DOTA-TOC PET/CT for detecting osteomalacia-associated tumours.

    Science.gov (United States)

    Paquet, Marie; Gauthé, Mathieu; Zhang Yin, Jules; Nataf, Valérie; Bélissant, Ophélie; Orcel, Philippe; Roux, Christian; Talbot, Jean-Noël; Montravers, Françoise

    2018-03-12

    Oncogenic osteomalacia is an endocrine disorder induced by small benign tumours (TIO) producing excessive fibroblast growth factor-23 (FGF23). The only way of curing oncogenic osteomalacia is surgical resection of the culprit TIO, which is extremely difficult to detect using conventional imaging modalities due to its small size and variable location in the body. Since TIO frequently overexpress somatostatin receptors, a clinical utility of SPECT or PET with radiolabelled somatostatin analogues has been reported. Among them, 68 Ga-DOTA-TOC has recently been granted a marketing authorization, facilitating its routine application. We report here the results of the first series evaluating the diagnostic performance of 68 Ga-DOTA-TOC PET/CT in detecting TIO and its impact on patient management. 68 Ga-DOTA-TOC PET/CT and clinical and imaging data from 15 patients with clinical and biochemical signs of oncogenic osteomalacia were retrospectively reviewed. The 68 Ga-DOTA-TOC PET/CT findings were compared with the results of post-surgical pathology and clinical and biochemical follow-up. 68 Ga-DOTA-TOC PET/CT resulted in the detection of one focus suspicious for TIO in nine of 15 patients (60%), and a tumour was surgically removed in eight. Post-operative pathology confirmed a TIO in those eight patients whose symptoms diminished promptly and biochemical anomalies resolved. 68 Ga-DOTA-TOC PET/CT sensitivity, specificity and accuracy were 73%, 67% and 71%, respectively. 68 Ga-DOTA-TOC PET/CT findings affected patient management in 67% of cases. In particular, 68 Ga-DOTA-TOC PET/CT was able to detect the TIO with a negative or a false-positive result of a previous 111 In-pentetreotide SPECT/CT in 5/8 patients (63%) or a previous FDG PET/CT in 7/11 patients (64%). No close relationship was found between the positivity of 68 Ga-DOTA-TOC PET/CT and the serum level of a biochemical marker. However, a true-positive result of 68 Ga-DOTA-TOC PET/CT was obtained in only one patient

  15. Clinical Outcomes of Patients Receiving Integrated PET/CT-Guided Radiotherapy for Head and Neck Carcinoma

    International Nuclear Information System (INIS)

    Vernon, Matthew R.; Maheshwari, Mohit; Schultz, Christopher J.; Michel, Michelle A.; Wong, Stuart J.; Campbell, Bruce H.; Massey, Becky L.; Wilson, J. Frank; Wang Dian

    2008-01-01

    Purpose: We previously reported the advantages of 18 F-fluorodeoxyglucose-positron emission tomography (PET) fused with CT for radiotherapy planning over CT alone in head and neck carcinoma (HNC). The purpose of this study was to evaluate clinical outcomes and the predictive value of PET for patients receiving PET/CT-guided definitive radiotherapy with or without chemotherapy. Methods and Materials: From December 2002 to August 2006, 42 patients received PET/CT imaging as part of staging and radiotherapy planning. Clinical outcomes including locoregional recurrence, distant metastasis, death, and treatment-related toxicities were collected retrospectively and analyzed for disease-free and overall survival and cumulative incidence of recurrence. Results: Median follow-up from initiation of treatment was 32 months. Overall survival and disease-free survival were 82.8% and 71.0%, respectively, at 2 years, and 74.1% and 66.9% at 3 years. Of the 42 patients, seven recurrences were identified (three LR, one DM, three both LR and DM). Mean time to recurrence was 9.4 months. Cumulative risk of recurrence was 18.7%. The maximum standard uptake volume (SUV) of primary tumor, adenopathy, or both on PET did not correlate with recurrence, with mean values of 12.0 for treatment failures vs. 11.7 for all patients. Toxicities identified in those patients receiving intensity modulated radiation therapy were also evaluated. Conclusions: A high level of disease control combined with favorable toxicity profiles was achieved in a cohort of HNC patients receiving PET/CT fusion guided radiotherapy plus/minus chemotherapy. Maximum SUV of primary tumor and/or adenopathy was not predictive of risk of disease recurrence

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-03-15

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

  17. PET in patients with advanced hypopharynx carcinoma and undergoing systemic chemotherapy

    International Nuclear Information System (INIS)

    Haberkorn, U.A.; Strauss, L.G.; Dimitrakopoulou, A.; Knopp, M.V.; Schadel, A.; Helus, F.; Doll, J.K.; van Kaick, G.

    1989-01-01

    The authors discuss how they have preformed 10 double examinations with positron emission tomography (PET) using F-18 deoxyglucose (FDG) before and after one chemotherapeutic cycle with cisplatin and fluorouracil (5-FU). Sixty minutes after intravenous injection of 12 mCi of FDG, three PET images of the tumor region were acquired. The volume of the tumor and/or involved lymph nodes was calculated from CT cross sections. The standardized FDG uptake was increased in all tumors prior to chemotherapeutic treatment (range, 1.28-2.97 DAR). After chemotherapy, the authors notes a decrease in tumor metabolism and tumor volume in eight patients (range, 1.4-2.32 DAR), while in two patients the FDG uptake was unchanged. A correlation coefficient of r =.78 was found for the change in FDG uptake and tumor growth rate. As results demonstrated, PET offers the possibility to study changes of tumor metabolism during chemotherapy and therefore may be used to optimize therapy regimens

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

    International Nuclear Information System (INIS)

    Der Gucht, Axel Van; Itti, Emmanuel; Aoun-Sebaliti, Mehdi; Kauv, Paul; Aouizerate, Jessie; Gherardi, Romain K.; Bachoud-Levi, Anne-Catherine; Authier, Francois-Jerome; Verger, Antoine; Guedj, Eric

    2016-01-01

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

  19. A Comparison between 18F-FDG PET/CT Imaging and Biological and Radiological Findings in Restaging of Hepatoblastoma Patients

    Directory of Open Access Journals (Sweden)

    Angelina Cistaro

    2013-01-01

    Full Text Available Background. In this study we retrospectively evaluated if 18F-FDG-PET/CT provided incremental diagnostic information over CI in a group of hepatoblastoma patients performing restaging. Procedure. Nine patients (mean age: 5.9 years; range: 3.1–12 years surgically treated for hepatoblastoma were followed up by clinical examination, serum α-FP monitoring, and US. CI (CT or MRI and PET/CT were performed in case of suspicion of relapse. Fine-needle aspiration biopsies (FNAB were carried out for final confirmation if the results of CI, PET/CT, and/or α-FP levels were suggestive of relapse. PET/CT and CI findings were analyzed for comparison purposes, using FNAB as reference standard. Results. α-FP level was suggestive of disease recurrence in 8/9 patients. Biopsy was performed in 8/9 cases. CI and PET/CT resulted to be concordant in 5/9 patients (CI identified recurrence of disease, but 18F-FDG-PET/CT provided a better definition of disease extent; in 4/9 cases, CI diagnostic information resulted in negative findings, whereas PET/CT correctly detected recurrence of disease. 18F-FDG-PET/CT showed an agreement of 100% (8/8 with FNAB results. Conclusions. 18F-FDG-PET/CT scan seems to better assess HB patients with respect to CI and may provide incremental diagnostic value in the restaging of this group of patients.

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

    Science.gov (United States)

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

    2018-05-05

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

  1. Roles of posttherapy 18F-FDG PET/CT in patients with advanced squamous cell carcinoma of the uterine cervix receiving concurrent chemoradiotherapy.

    Science.gov (United States)

    Liu, Feng-Yuan; Su, Tzu-Pei; Wang, Chun-Chieh; Chao, Angel; Chou, Hung-Hsueh; Chang, Yu-Chen; Yen, Tzu-Chen; Lai, Chyong-Huey

    2018-07-01

    To assess the clinical roles of [ 18 F]fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) performed 2-3 months after completion of concurrent chemoradiotherapy (CCRT), along with pretherapy characteristics, in patients with advanced squamous cell carcinoma of the uterine cervix enrolled in a prospective randomized clinical trial. Posttherapy PET/CT in patients with advanced FIGO stage or positive pelvic or para-aortic lymph node (PALN) defined on pretherapy PET/CT was classified as positive, equivocal, or negative. Overall survival (OS) rates between patients with different PET/CT results are compared. Pretherapy characteristics are examined for association with posttherapy PET/CT results and for prognostic significance in patients with equivocal or negative PET/CT. PET/CT scans (n = 55) were positive, equivocal and negative in 9, 13 and 33 patients, respectively. All patients with positive scans were confirmed to have residual or metastatic disease and died despite salvage therapies. There is a significant OS difference between patients with positive and equivocal scans (P PET/CT (P = .033) and predicts a poorer survival in patients with equivocal or negative posttherapy PET/CT (P PET/CT 2-3 months posttherapy implies treatment failure and novel therapy is necessary to improve outcomes for such patients. A more intense posttherapy surveillance may be warranted in patients with positive pretherapy PALN.

  2. Comparison of clinical efficacy of second look operation and FDG-PET scan in patients with ovarian cancer

    International Nuclear Information System (INIS)

    Ryu, Sang Young

    1999-12-01

    This study is to investigate whether FDG-PET scan can substitute for second look operation in patients with ovarian cancer showing complete response with chemotherapy. From Jan. 1999 to Oct. 1999, 10 patients with advanced ovarian cancer who showed clinical complete response with 6 cycles of combination chemotherapy were registered in KCCH. These patients showed no residual tumors in conventional radiologic imaging studies (CT or MRI), normal tumor marker, no evidence of disease by physical examination. PET scans and second look operation were performed in 10 patients with advanced ovarian cancer (3 patients with stage IIc, 2 patients with stage IIIb, 5 patients with IIIc), who showed complete response with cytoreductive surgery and 6 cycles of post-operative adjuvant cisplatin-based combination chemotherapy. Median age of patients was 45 years, and serous cystadenocarcinoma was most common histologic type. None showed active lesion in pelvis and abdomen with FDG-PET scan (SUV; > 3.5 kg/ml), and I patient showed active lesion in lung field. On second look operations, 5 patients (50%) showed positive result on multiple blind biopsy. The patient with active lesion on FDG-PET scan in lung field confirmed to have metastatic lesions by chest CT scan. In conclusion, FDG-PET scan is not useful for detection of small ovarian cancer lesions in pelvis and abdomen, and cannot substitute for second look operation to determine pathologic complete response

  3. Comparison of clinical efficacy of second look operation and FDG-PET scan in patients with ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Sang Young

    1999-12-01

    This study is to investigate whether FDG-PET scan can substitute for second look operation in patients with ovarian cancer showing complete response with chemotherapy. From Jan. 1999 to Oct. 1999, 10 patients with advanced ovarian cancer who showed clinical complete response with 6 cycles of combination chemotherapy were registered in KCCH. These patients showed no residual tumors in conventional radiologic imaging studies (CT or MRI), normal tumor marker, no evidence of disease by physical examination. PET scans and second look operation were performed in 10 patients with advanced ovarian cancer (3 patients with stage IIc, 2 patients with stage IIIb, 5 patients with IIIc), who showed complete response with cytoreductive surgery and 6 cycles of post-operative adjuvant cisplatin-based combination chemotherapy. Median age of patients was 45 years, and serous cystadenocarcinoma was most common histologic type. None showed active lesion in pelvis and abdomen with FDG-PET scan (SUV; > 3.5 kg/ml), and I patient showed active lesion in lung field. On second look operations, 5 patients (50%) showed positive result on multiple blind biopsy. The patient with active lesion on FDG-PET scan in lung field confirmed to have metastatic lesions by chest CT scan. In conclusion, FDG-PET scan is not useful for detection of small ovarian cancer lesions in pelvis and abdomen, and cannot substitute for second look operation to determine pathologic complete response.

  4. Imaging with 124I in differentiated thyroid carcinoma: is PET/MRI superior to PET/CT?

    International Nuclear Information System (INIS)

    Binse, I.; Poeppel, T.D.; Ruhlmann, M.; Gomez, B.; Bockisch, A.; Rosenbaum-Krumme, S.J.; Umutlu, L.

    2016-01-01

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

  5. Do carotid MR surface coils affect PET quantification in PET/MR imaging?

    International Nuclear Information System (INIS)

    Willemink, Martin J; Eldib, Mootaz; Leiner, Tim; Fayad, Zahi A; Mani, Venkatesh

    2015-01-01

    To evaluate the effect of surface coils for carotid MR imaging on PET quantification in a clinical simultaneous whole-body PET/MR scanner. A cylindrical phantom was filled with a homogeneous 2L water-FDG mixture at a starting dose of 301.2MBq. Clinical PET/MR and PET/CT systems were used to acquire PET-data without a coil (reference standard) and with two carotid MRI coils (Siemens Special Purpose 8-Channel and Machnet 4-Channel Phased Array). PET-signal attenuation was evaluated with Osirix using 51 (PET/MR) and 37 (PET/CT) circular ROIs. Mean and maximum standardized uptake values (SUVs) were quantified for each ROI. Furthermore, SUVs of PET/MR and PET/CT were compared. For validation, a patient was scanned with an injected dose of 407.7MBq on both a PET/CT and a PET/MR system without a coil and with both coils. PET/MR underestimations were -2.2% (Siemens) and -7.8% (Machnet) for SUVmean, and -1.2% (Siemens) and -3.3% (Machnet) for SUVmax, respectively. For PET/CT, underestimations were -1.3% (Siemens) and -1.4% (Machnet) for SUVmean and -0.5% (both Siemens and Machnet) for SUVmax, respectively using no coil data as reference. Except for PET/CT SUVmax values all differences were significant. SUVs differed significantly between PET/MR and PET/CT with SUVmean values of 0.51-0.55 for PET/MR and 0.68-0.69 for PET/CT, respectively. The patient examination showed that median SUVmean values measured in the carotid arteries decreased from 0.97 without a coil to 0.96 (Siemens) and 0.88 (Machnet). Carotid surface coils do affect attenuation correction in both PET/MR and PET/CT imaging. Furthermore, SUVs differed significantly between PET/MR and PET/CT.

  6. [Principles of PET].

    Science.gov (United States)

    Beuthien-Baumann, B

    2018-05-01

    Positron emission tomography (PET) is a procedure in nuclear medicine, which is applied predominantly in oncological diagnostics. In the form of modern hybrid machines, such as PET computed tomography (PET/CT) and PET magnetic resonance imaging (PET/MRI) it has found wide acceptance and availability. The PET procedure is more than just another imaging technique, but a functional method with the capability for quantification in addition to the distribution pattern of the radiopharmaceutical, the results of which are used for therapeutic decisions. A profound knowledge of the principles of PET including the correct indications, patient preparation, and possible artifacts is mandatory for the correct interpretation of PET results.

  7. PET Probe-Guided Surgery in Patients with Breast Cancer: Proposal for a Methodological Approach

    Science.gov (United States)

    ORSARIA, PAOLO; CHIARAVALLOTI, AGOSTINO; FIORENTINI, ALESSANDRO; PISTOLESE, CHIARA; VANNI, GIANLUCA; VITTORIA GRANAI, ALESSANDRA; VARVARAS, DIMITRIOS; DANIELI, ROBERTA; SCHILLACI, ORAZIO; PETRELLA, GIUSEPPE; CLAUDIO BUONOMO, ORESTE

    2017-01-01

    Background: Although it is valuable for detecting distant metastases, identifying recurrence, and evaluating responses to chemotherapy, the role of 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (18F-FDG PET/CT) in assessing locoregional nodal status for initial staging of breast cancer has not yet been well-defined in clinical practice. In the current report, we describe a new PET probe-based clinical approach, with evaluation of the technical performance of a handheld high-energy gamma probe for intraoperative localization of breast carcinomas, and evaluation of lymph node metastases during radio-guided oncological surgery. Patients and Methods: Three patients underwent a PET/CT scan immediately prior to surgery following the standard clinical protocol. Intraoperatively, tumors were localized and resected with the assistance of a hand-held gamma probe. PET-guided assessment of the presence or absence of regional nodal spread of malignancy was compared with the reference standard of histopathological examination. Results: In all three cases, perioperative 18F-FDG PET/CT imaging and intraoperative gamma probe detection verified complete resection of the hypermetabolic lesions and demonstrated no additional suspicious occult disease. Conclusion: This innovative approach demonstrates great promise for providing real-time access to metabolic and morphological tumor information that may lead to an optimal disease-tailored approach. In carefully selected indications, a PET probe can be a useful adjunct in surgical practice, but further trials with a larger number of patients need to be performed to verify these findings. PMID:28064227

  8. Present and future of PET and PET/CT in gynaecologic malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Musto, Alessandra [Department of Nuclear Medicine, PET Center, Policlinico Sant' Orsola Malpighi, Bologna University, Bologna (Italy); Rampin, Lucia [Department of Nuclear Medicine, PET Center, Radiology, Medical Physics, Santa Maria della Misericordia Hospital, viale tre martiri 140, 45100 Rovigo (Italy); Nanni, Cristina [Department of Nuclear Medicine, PET Center, Policlinico Sant' Orsola Malpighi, Bologna University, Bologna (Italy); Marzola, Maria Cristina [Department of Nuclear Medicine, PET Center, Radiology, Medical Physics, Santa Maria della Misericordia Hospital, viale tre martiri 140, 45100 Rovigo (Italy); Fanti, Stefano [Department of Nuclear Medicine, PET Center, Policlinico Sant' Orsola Malpighi, Bologna University, Bologna (Italy); Rubello, Domenico, E-mail: domenico.rubello@libero.it [Department of Nuclear Medicine, PET Center, Radiology, Medical Physics, Santa Maria della Misericordia Hospital, viale tre martiri 140, 45100 Rovigo (Italy)

    2011-04-15

    Objectives: To review the published data in literature on patients affected by gynaecological malignancies to establish the role of {sup 18}F-FDG positron emission tomography (PET) and PET/CT in comparison to conventional imaging (CI). Materials and methods: All papers specifically addressed to the role of {sup 18}F-FDG PET and PET/CT in gynaecological malignancies published on PubMed/Medline, in abstracts from the principal international congresses, in the guidelines from national Societies that had appeared in literature until November 2009 were considered for the purpose of the present study. Results and conclusions: The use of {sup 18}F-FDG PET, and even more of {sup 18}F-FDG PET/CT, is increasing in the follow up of patients with gynaecologic malignancies and suspected recurrent disease: there is evidence in the literature that {sup 18}F-FDG PET/CT has a higher sensitivity than CI in depicting occult metastatic spread. An interesting issue is represented by patients with ovarian cancer with an increase of the specific biomarker, CA-125, and negative/inconclusive findings at CI. The use of {sup 18}F-FDG PET in differential diagnosis and staging is more controversial, but there is some evidence that a baseline PET examination performed before commencing therapy, for staging purpose, is also useful to evaluate the response to chemoradiation treatment. In several papers it has been suggested a relevant role of {sup 18}F-FDG PET/CT in evaluating the entity of response to treatment and therefore to plan the subsequent therapeutic strategy.

  9. Estimation of patient dose in 18 F-FDG and 18 F-FDOPA PET/CT examinations

    Directory of Open Access Journals (Sweden)

    Aruna Kaushik

    2013-01-01

    Full Text Available Purpose: To estimate specific organ and effective doses to patients resulting from the 18 F-FDG ( 18 F-2-deoxy-D-glucose and 18 F-FDOPA (6-fluoro-( 18 F-L-3, 4-dihydroxyphenylalanine PET/CT examinations for whole body and brain. Materials and Methods: Three protocols for whole body and three for brain PET/CT were used. The CTDI values were measured using standard head and body CT phantoms and also computed using a software CT-Expo for dose evaluation from the CT component. OLINDA software based on MIRD method was used for estimating doses from the PET component of the PET/CT examination. Results: The organ doses from 18 F-FDG and 18 F-FDOPA whole body and brain PET/CT studies were estimated. The total effective dose from a typical protocol of whole body PET/CT examination was 14.4 mSv for females and 11.8 mSv for male patients from 18 F-FDG, whereas it was 11 mSv for female and 9.1 mSv for male patients from 18 F-FDOPA. The total effective doses from a typical protocol for PET/CT studies of brain was 6.5 mSv for females and 5.1 mSv for males from 18 F-FDG whereas it was 3.7 mSv for females and 2.8 mSv for males from 18 F-FDOPA. Conclusions: The effective radiation doses from whole body PET/CT examination was approximately 4-8 times higher than the background radiation dose from both 18 F-FDG and 18 F-FDOPA scans, while it was 1-3 times the background radiation dose from PET/CT scans of brain.

  10. 18F-FDG PET of the hands with a dedicated high-resolution PEM system (arthro-PET): correlation with PET/CT, radiography and clinical parameters

    International Nuclear Information System (INIS)

    Mhlanga, Joyce C.; Lodge, Martin; Carrino, John A.; Wang, Hao; Wahl, Richard L.

    2014-01-01

    The aim of this study was to prospectively determine the feasibility and compare the novel use of a positron emission mammography (PEM) scanner with standard PET/CT for evaluating hand osteoarthritis (OA) with 18 F-FDG. Institutional review board approval and written informed consent were obtained for this HIPAA-compliant prospective study in which 14 adults referred for oncological 18 F-FDG PET/CT underwent dedicated hand PET/CT followed by arthro-PET using the PEM device. Hand radiographs were obtained and scored for the presence and severity of OA. Summed qualitative and quantitative joint glycolytic scores for each modality were compared with the findings on plain radiography and clinical features. Eight patients with clinical and/or radiographic evidence of OA comprised the OA group (mean age 73 ± 7.7 years). Six patients served as the control group (53.7 ± 9.3 years). Arthro-PET quantitative and qualitative joint glycolytic scores were highly correlated with PET/CT findings in the OA patients (r = 0.86. p = 0.007; r = 0.94, p = 0.001). Qualitative arthro-PET and PET/CT joint scores were significantly higher in the OA patients than in controls (38.7 ± 6.6 vs. 32.2 ± 0.4, p = 0.02; 37.5 ± 5.4 vs. 32.2 ± 0.4, p = 0.03, respectively). Quantitative arthro-PET and PET/CT maximum SUV-lean joint scores were higher in the OA patients, although they did not reach statistical significance (20.8 ± 4.2 vs. 18 ± 1.8, p = 0.13; 22.8 ± 5.38 vs. 20.1 ± 1.54, p= 0.21). By definition, OA patients had higher radiographic joint scores than controls (30.9 ± 31.3 vs. 0, p = 0.03). Hand imaging using a small field of view PEM system (arthro-PET) with FDG is feasible, performing comparably to PET/CT in assessing metabolic joint activity. Arthro-PET and PET/CT showed higher joint FDG uptake in OA. Further exploration of arthro-PET in arthritis management is warranted. (orig.)

  11. Evaluation of Dixon Sequence on Hybrid PET/MR Compared with Contrast-Enhanced PET/CT for PET-Positive Lesions

    International Nuclear Information System (INIS)

    Jeong, Ju Hye; Cho, Ihn Ho; Kong, Eun Jung; Chun, Kyung Ah

    2014-01-01

    Hybrid positron emission tomography and magnetic resonance (PET/MR) imaging performs a two-point Dixon MR sequence for attenuation correction. However, MR data in hybrid PET/MR should provide anatomic and morphologic information as well as an attenuation map. We evaluated the Dixon sequence of hybrid PET/MR for anatomic correlation of PET-positive lesions compared with contrast-enhanced PET/computed tomography (CT) in patients with oncologic diseases. Twelve patients underwent a single injection, dual imaging protocol. PET/CT was performed with an intravenous contrast agent (85±13 min after 18 F-FDG injection of 403± 45 MBq) and then (125±19 min after injection) PET/MR was performed. Attenuation correction and anatomic allocation of PET were performed using contrast-enhanced CT for PET/CT and Dixon MR sequence for hybrid PET/MR. The Dixon MR sequence and contrast-enhanced CT were compared for anatomic correlation of PET-positive lesions (scoring scale ranging from 0 to 3 for visual ratings). Additionally, standardized uptake values (SUVs) for the detected lesions were assessed for quantitative comparison. Both hybrid PET/MR and contrast-enhanced PET/CT identified 55 lesions with increased FDG uptake in ten patients. In total, 28 lymph nodes, 11 bone lesions, 3 dermal nodules, 3 pleural thickening lesions, 2 thyroid nodules, 1 pancreas, 1 liver, 1 ovary, 1 uterus, 1 breast, 1 soft tissue and 2 lung lesions were present. The best performance was observed for anatomic correlation of PET findings by the contrast-enhanced CT scans (contrast-enhanced CT, 2.64± 0.70; in-phase, 1.29±1.01; opposed-phase, 1.29±1.15; water-weighted, 1.71±1.07; fat weighted, 0.56±1.03). A significant difference was observed between the scores obtained from the contrast-enhanced CT and all four coregistered Dixon MR images. Quantitative evaluation revealed a high correlation between the SUVs measured with hybrid PET/MR (SUVmean, 2.63±1.62; SUVmax, 4.30±2.88) and contrast-enhanced PET

  12. Evaluation of Dixon Sequence on Hybrid PET/MR Compared with Contrast-Enhanced PET/CT for PET-Positive Lesions

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-03-15

    Hybrid positron emission tomography and magnetic resonance (PET/MR) imaging performs a two-point Dixon MR sequence for attenuation correction. However, MR data in hybrid PET/MR should provide anatomic and morphologic information as well as an attenuation map. We evaluated the Dixon sequence of hybrid PET/MR for anatomic correlation of PET-positive lesions compared with contrast-enhanced PET/computed tomography (CT) in patients with oncologic diseases. Twelve patients underwent a single injection, dual imaging protocol. PET/CT was performed with an intravenous contrast agent (85±13 min after {sup 18}F-FDG injection of 403± 45 MBq) and then (125±19 min after injection) PET/MR was performed. Attenuation correction and anatomic allocation of PET were performed using contrast-enhanced CT for PET/CT and Dixon MR sequence for hybrid PET/MR. The Dixon MR sequence and contrast-enhanced CT were compared for anatomic correlation of PET-positive lesions (scoring scale ranging from 0 to 3 for visual ratings). Additionally, standardized uptake values (SUVs) for the detected lesions were assessed for quantitative comparison. Both hybrid PET/MR and contrast-enhanced PET/CT identified 55 lesions with increased FDG uptake in ten patients. In total, 28 lymph nodes, 11 bone lesions, 3 dermal nodules, 3 pleural thickening lesions, 2 thyroid nodules, 1 pancreas, 1 liver, 1 ovary, 1 uterus, 1 breast, 1 soft tissue and 2 lung lesions were present. The best performance was observed for anatomic correlation of PET findings by the contrast-enhanced CT scans (contrast-enhanced CT, 2.64± 0.70; in-phase, 1.29±1.01; opposed-phase, 1.29±1.15; water-weighted, 1.71±1.07; fat weighted, 0.56±1.03). A significant difference was observed between the scores obtained from the contrast-enhanced CT and all four coregistered Dixon MR images. Quantitative evaluation revealed a high correlation between the SUVs measured with hybrid PET/MR (SUVmean, 2.63±1.62; SUVmax, 4.30±2.88) and contrast

  13. Quantitative Evaluation of Atlas-based Attenuation Correction for Brain PET in an Integrated Time-of-Flight PET/MR Imaging System.

    Science.gov (United States)

    Yang, Jaewon; Jian, Yiqiang; Jenkins, Nathaniel; Behr, Spencer C; Hope, Thomas A; Larson, Peder E Z; Vigneron, Daniel; Seo, Youngho

    2017-07-01

    Purpose To assess the patient-dependent accuracy of atlas-based attenuation correction (ATAC) for brain positron emission tomography (PET) in an integrated time-of-flight (TOF) PET/magnetic resonance (MR) imaging system. Materials and Methods Thirty recruited patients provided informed consent in this institutional review board-approved study. All patients underwent whole-body fluorodeoxyglucose PET/computed tomography (CT) followed by TOF PET/MR imaging. With use of TOF PET data, PET images were reconstructed with four different attenuation correction (AC) methods: PET with patient CT-based AC (CTAC), PET with ATAC (air and bone from an atlas), PET with ATAC patientBone (air and tissue from the atlas with patient bone), and PET with ATAC boneless (air and tissue from the atlas without bone). For quantitative evaluation, PET mean activity concentration values were measured in 14 1-mL volumes of interest (VOIs) distributed throughout the brain and statistical significance was tested with a paired t test. Results The mean overall difference (±standard deviation) of PET with ATAC compared with PET with CTAC was -0.69 kBq/mL ± 0.60 (-4.0% ± 3.2) (P PET with ATAC boneless (-9.4% ± 3.7) was significantly worse than that of PET with ATAC (-4.0% ± 3.2) (P PET with ATAC patientBone (-1.5% ± 1.5) improved over that of PET with ATAC (-4.0% ± 3.2) (P PET/MR imaging achieves similar quantification accuracy to that from CTAC by means of atlas-based bone compensation. However, patient-specific anatomic differences from the atlas causes bone attenuation differences and misclassified sinuses, which result in patient-dependent performance variation of ATAC. © RSNA, 2017 Online supplemental material is available for this article.

  14. Influence of {sup 18}F-FDG PET/CT on therapy management in patients with stage III/IV malignant melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Schuele, Susann-Cathrin; Nikolaou, Konstantin; Pfannenberg, Christina [Eberhard-Karls-University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Eigentler, Thomas Kurt; Garbe, Claus [Eberhard-Karls-University Tuebingen, Skin Cancer Programme, Department of Dermatology, Tuebingen (Germany); Fougere, Christian la [Eberhard-Karls-University Tuebingen, Department of Nuclear Medicine, Tuebingen (Germany)

    2016-03-15

    To evaluate the influence of {sup 18}F-FDG PET/CT in comparison to CT alone on treatment decisions in patients with advanced melanoma and to analyse the 5-year survival data in comparison to literature data. Therapy management in 64 consecutive patients (primary staging n = 52; surveillance n = 12) with stage III/IV melanoma who underwent {sup 18}F-FDG PET/CT between 2004 and 2005 in our department was retrospectively analysed. Treatment decisions were made by two dermatooncologists for each patient twice, first based on the CT results and then based on the PET/CT results. Therapy changes based on the PET/CT results were classified as ''major'' (e.g. change from metastasectomy to systemic therapy) or ''minor'' (e.g. change from first to second line chemotherapy). The 5-year survival data of different patient cohorts were calculated. In the 52 patients in the primary staging group, the results of {sup 18}F-FDG PET/CT led to therapy change in 59 % and a major therapy change in 52 %. {sup 18}F-FDG PET/CT led to the avoidance of futile operations in 13 patients with suspicious lesions on CT that were deemed nontumorous on PET/CT. In the 12 patients in the surveillance group, the results of {sup 18}F-FDG PET/CT led to therapy change in 33 % and a major change in 17 %. The 5-year survival rates were 30 % in the entire cohort, 34 % in the primary staging group, and 17 % in the surveillance group. A significant overall survival benefit was observed in patients in whom {sup 18}F-FDG PET/CT excluded metastases or in whom metastases could be completely removed compared with patients who were not eligible for surgery (41 % vs. 10 %). Primary staging of patients with stage III/IV melanoma should be performed with {sup 18}F-FDG PET/CT, leading to higher diagnostic accuracy and enabling individualized therapeutic management, especially optimal patient selection for metastasectomy. This strategy may extend long-term survival even in patients

  15. Role of serum S100B and PET-CT in follow-up of patients with cutaneous melanoma

    Directory of Open Access Journals (Sweden)

    Novakovic Srdjan

    2011-08-01

    Full Text Available Abstract Background Increased level of serum S100B can serve as a marker of metastatic spread in patients with cutaneous melanoma (CM. In patients with elevated S100 B and/or clinical signs of disease progression PET-CT scan is a valuable tool for discovering metastases and planning treatment. The aims of this study were to determine whether regular measurements of serum S100B are a useful tool for discovering patients with CM metastases and to evaluate the diagnostic value of PET-CT during the follow-up. Methods From September 2007 to February 2010, 115 CM patients included in regular follow up at the Institute of Oncology Ljubljana were appointed to PET-CT. There were 82 (71.3% patients with clinical signs of disease progression and 33 (28.7% asymptomatic patients with two subsequent elevated values of S100B. Sensitivity, specificity, positive and negative predictive value (PPV, NPV of S100B and PET-CT were calculated using standard procedures. Results Disease progression was confirmed in 81.7% of patients (in 86.5% of patients with clinical signs of disease progression and in 69.7% of asymptomatic patients with elevated S100B. Sensitivity, specificity, PPV and NPV of S100B was 33.8%, 90.9%, 96.0% and 17.5% in patients with clinical signs of disease progression. In 20.0% of patients increased serum S100B was the only sign of disease progression. Sensitivity and PPV of S100 in this group of patients were 100.0% and 69.7%. With PET-CT disease progression was diagnosed in 84.2% of symptomatic patients and in 72.7% of asymptomatic patients with elevated S100B. The sensitivity, specificity, PPV and NPV of PET-CT for symptomatic patients was 98.5%, 90.9%, 98.5% and 90.9% and 100%, 90.0%, 95.8% and 100% for asymptomatic patients with elevated S100. Conclusions Measurements of serum S100B during regular follow-up of patients with CM are a useful tool for discovering disease progression in asymptomatic patients. The value of its use increases if

  16. WE-G-BRF-06: Positron Emission Tomography (PET)-Guided Dynamic Lung Tumor Tracking for Cancer Radiotherapy: First Patient Simulations

    International Nuclear Information System (INIS)

    Yang, J; Loo, B; Graves, E; Yamamoto, T; Keall, P

    2014-01-01

    Purpose: PET-guided dynamic tumor tracking is a novel concept of biologically targeted image guidance for radiotherapy. A dynamic tumor tracking algorithm based on list-mode PET data has been developed and previously tested on dynamic phantom data. In this study, we investigate if dynamic tumor tracking is clinically feasible by applying the method to lung cancer patient PET data. Methods: PET-guided tumor tracking estimates the target position of a segmented volume in PET images reconstructed continuously from accumulated coincidence events correlated with external respiratory motion, simulating real-time applications, i.e., only data up to the current time point is used to estimate the target position. A target volume is segmented with a 50% threshold, consistently, of the maximum intensity in the predetermined volume of interest. Through this algorithm, the PET-estimated trajectories are quantified from four lung cancer patients who have distinct tumor location and size. The accuracy of the PET-estimated trajectories is evaluated by comparing to external respiratory motion because the ground-truth of tumor motion is not known in patients; however, previous phantom studies demonstrated sub-2mm accuracy using clinically derived 3D tumor motion. Results: The overall similarity of motion patterns between the PET-estimated trajectories and the external respiratory traces implies that the PET-guided tracking algorithm can provide an acceptable level of targeting accuracy. However, there are variations in the tracking accuracy between tumors due to the quality of the segmentation which depends on target-to-background ratio, tumor location and size. Conclusion: For the first time, a dynamic tumor tracking algorithm has been applied to lung cancer patient PET data, demonstrating clinical feasibility of real-time tumor tracking for integrated PET-linacs. The target-to-background ratio is a significant factor determining accuracy: screening during treatment planning would

  17. Differential Diagnosis of Patients with Inconclusive Parkinsonian Features Using [{sup 18}F]FP-CIT PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Park, Eunkyung; Hwang, Yu Mi; Lee, Channyoung; Oh, Sun Young; Kim, Young Chul; Choe, Jae Gol; Park, Kun Woo [Korea Univ., Seoul (Korea, Republic of); Kim, Sujin [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2014-06-15

    It is often difficult to differentiate parkinsonism, especially when patients show uncertain parkinsonian features. We investigated the usefulness of dopamine transporter (DAT) imaging for the differential diagnosis of inconclusive parkinsonism using [{sup 18}F]FP-CIT PET. Twenty-four patients with inconclusive parkinsonian features at initial clinical evaluation and nine healthy controls were studied. Patients consisted of three subgroups: nine patients whose diagnoses were unclear concerning whether they had idiopathic Parkinson's disease or drug-induced parkinsonism ('PD/DIP'), nine patients who fulfilled neither the diagnostic criteria of PD nor of essential tremor ('PD/ET'), and six patients who were alleged to have either PD or atypical parkinsonian syndrome ('PD/APS'). Brain PET images were obtained 120 min after injection of 185 MBq [{sup 18}F]FP-CIT. Imaging results were quantified and compared with follow-up clinical diagnoses. Overall, 11 of 24 patients demonstrated abnormally decreased DAT availability on the PET scans, whereas 13 were normal. PET results could diagnose PD/DIP and PD/ET patients as having PD in six patients, DIP in seven, and ET in five; however, the diagnoses of all six PD/APS patients remained inconclusive. Among 15 patients who obtained a final follow-up diagnosis, the image-based diagnosis was congruent with the follow-up diagnosis in 11 patients. Four unsolved cases had normal DAT availability, but clinically progressed to PD during the follow-up period. [{sup 18}F]FP-CIT PET imaging is useful in the differential diagnosis of patients with inconclusive parkinsonian features, except in patients who show atypical features or who eventually progress to PD.

  18. Choline-PET/CT for imaging prostate cancer; Cholin-PET/CT zur Bildgebung des Prostatakarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Krause, Bernd Joachim [Klinik- und Poliklinik fuer Nuklearmedizin, Klinikum rechts der Isar, Technische Univ. Muenchen (Germany); Treiber, U.; Schwarzenboeck, S.; Souvatzoglou, M. [Klinik fuer Urologie, Klinikum rechts der Isar, Technische Univ. Muenchen (Germany)

    2010-09-15

    PET and PET/CT using [{sup 11}C]- and [{sup 18}F]-labelled choline derivatives are increasingly being used for imaging of prostate cancer. The value of PET and PET/CT with [{sup 11}C]- and [{sup 18}F]-labelled choline derivates in biochemical recurrence of prostate cancer has been examined in many studies and demonstrates an increasing importance. Primary prostate cancer can be detected with moderate sensitivity using PET and PET/CT using [{sup 11}C]- and [{sup 18}F]-labelled choline derivatives - the differentiation between benign prostatic hyperplasia, prostatitis or high-grade intraepithelial neoplasia (HGPIN) is not always possible. At the present time [{sup 11}C]choline PET/CT is not recommended in the primary setting but may be utilized in clinically suspected prostate cancer with repeatedly negative prostate biopsies, in preparation of a focused re-biopsy. Promising results have been obtained for the use of PET and PET/CT with [{sup 11}C]- and [{sup 18}F]-labelled choline derivates in patients with biochemical recurrence. The detection rate of choline PET and PET/CT for local, regional, and distant recurrence in patients with a biochemical recurrence shows a linear correlation with PSA values at the time of imaging and reaches about 75% in patients with PSA > 3 ng/mL. At PSA values below 1 ng/mL, the recurrence can be diagnosed with choline PET/CT in approximately 1/3 of the patients. PET and PET/CT with [{sup 11}C]- and [{sup 18}F]choline derivates can be helpful for choosing a therapeutic strategy in the sense of an individualized treatment: since an early diagnosis of recurrence is crucial to the choice of optimal treatment. The localization of the site of recurrence - local recurrence, lymph node metastasis or systemic dissemination - has important influence on the therapy regimen. (orig.)

  19. SU-E-J-124: FDG PET Metrics Analysis in the Context of An Adaptive PET Protocol for Node Positive Gynecologic Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Nawrocki, J; Chino, J; Light, K; Vergalasova, I; Craciunescu, O [Duke University Medical Center, Durham, NC (United States)

    2014-06-01

    Purpose: To compare PET extracted metrics and investigate the role of a gradient-based PET segmentation tool, PET Edge (MIM Software Inc., Cleveland, OH), in the context of an adaptive PET protocol for node positive gynecologic cancer patients. Methods: An IRB approved protocol enrolled women with gynecological, PET visible malignancies. A PET-CT was obtained for treatment planning prescribed to 45–50.4Gy with a 55– 70Gy boost to the PET positive nodes. An intra-treatment PET-CT was obtained between 30–36Gy, and all volumes re-contoured. Standard uptake values (SUVmax, SUVmean, SUVmedian) and GTV volumes were extracted from the clinician contoured GTVs on the pre- and intra-treament PET-CT for primaries and nodes and compared with a two tailed Wilcoxon signed-rank test. The differences between primary and node GTV volumes contoured in the treatment planning system and those volumes generated using PET Edge were also investigated. Bland-Altman plots were used to describe significant differences between the two contouring methods. Results: Thirteen women were enrolled in this study. The median baseline/intra-treatment primary (SUVmax, mean, median) were (30.5, 9.09, 7.83)/( 16.6, 4.35, 3.74), and nodes were (20.1, 4.64, 3.93)/( 6.78, 3.13, 3.26). The p values were all < 0.001. The clinical contours were all larger than the PET Edge generated ones, with mean difference of +20.6 ml for primary, and +23.5 ml for nodes. The Bland-Altman revealed changes between clinician/PET Edge contours to be mostly within the margins of the coefficient of variability. However, there was a proportional trend, i.e. the larger the GTV, the larger the clinical contours as compared to PET Edge contours. Conclusion: Primary and node SUV values taken from the intratreament PET-CT can be used to assess the disease response and to design an adaptive plan. The PET Edge tool can streamline the contouring process and lead to smaller, less user-dependent contours.

  20. Poster - 03: How to manage a nuclear medicine PET-CT for radiation oncology patients

    Energy Technology Data Exchange (ETDEWEB)

    Hinse, Martin; Létourneau, Étienne; Duplan, Danny; Piché, Émilie; Rivière, Rose Nerla; Bouchard, Guillaume [Centre Intégré de Cancérologie de Laval (Canada)

    2016-08-15

    Purpose: Development of an adapted multidisciplinary procedure designed to optimize the clinical workflow between radiation therapy (RT) and nuclear medicine (NM) for a PET-CT located in the NM department. Methods : The radiation oncologist (RO) prescribes the PET-CT exam and the clinical RT therapist gives all the necessary information to the patient prior to the exam. The immobilization accessories are prepared in the RT department. The RT and NM therapists work together for radiotracer injection, patient positioning and scan acquisition. The nuclear medicine physician (NMP) will study the images, draw Biological Target Volumes (BTVs) and produce a full exam report. Results : All tasks related to a planning PET-CT are done within 48 hours from the request by the RO to the reception of the images with the NMP contours and report. Conclusions : By developing a complete procedure collectively between the RT and NM departments, the patient benefits of a quick access to a RT planning PET-CT exam including the active involvement of every medical practitioners in these fields.

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  4. [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.)

  5. MRI and PET/CT of patients with bone metastases from breast carcinoma

    International Nuclear Information System (INIS)

    Grankvist, J.; Fisker, R.; Iyer, V.; Fründ, E.T.; Simonsen, C.; Christensen, T.; Stenbygaard, L.; Ewertz, M.; Larsson, E.-M.

    2012-01-01

    3.0 Tesla magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) was compared with combined 18F-fluorodeoxyglucose positron emission tomography and computed tomography (PET/CT) in patients with suspected bone metastases from breast cancer. A prospective clinical study was performed in 13 female breast cancer patients (mean age 61years; range 45–85 years). The spine was imaged in the sagittal plane with T1-weighted (T1), short tau inversion recovery (STIR), and T2-weighted fat-saturated (T2) sequences. The pelvis was imaged similarly in the coronal plane. Axial DWI was performed from the skull base to the mid-thigh. MRI and PET/CT were performed in all patients at a maximum interval of 10 working days and at least 14 days after chemotherapy. MRI was reviewed by two radiologists, and their consensus on potential metastases in 27 predefined locations was recorded. The predefined locations were the vertebral bodies (24), the left (1) and right (1) pelvic bones, and the sacral bone (1). The PET/CT was reviewed by a radiologists and a nuclear medicine physician. MRI detected 59 of the 60 active metastases found with our gold standard modality PET/CT. T1 had the highest sensitivity (98%) but rather low specificity (77%), but with the addition of STIR and DWI, the specificity increased to 95%. The additional metastases detected with MRI most likely represented postherapeutic residual scars without active tumour. In conclusion, 3.0 Tesla MRI with T1, STIR, and DWI is useful for the clinical evaluation of bone metastases from breast cancer and compares well to PET/CT.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-07-15

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

  7. Diagnosis of non-osseous spinal metastatic disease: the role of PET/CT and PET/MRI.

    Science.gov (United States)

    Batouli, Ali; Braun, John; Singh, Kamal; Gholamrezanezhad, Ali; Casagranda, Bethany U; Alavi, Abass

    2018-06-01

    The spine is the third most common site for distant metastasis in cancer patients with approximately 70% of patients with metastatic cancer having spinal involvement. Positron emission tomography (PET), combined with computed tomography (CT) or magnetic resonance imaging (MRI), has been deeply integrated in modern clinical oncology as a pivotal component of the diagnostic work-up of patients with cancer. PET is able to diagnose several neoplastic processes before any detectable morphological changes can be identified by anatomic imaging modalities alone. In this review, we discuss the role of PET/CT and PET/MRI in the diagnostic management of non-osseous metastatic disease of the spinal canal. While sometimes subtle, recognizing such disease on FDG PET/CT and PET/MRI imaging done routinely in cancer patients can guide treatment strategies to potentially prevent irreversible neurological damage.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-02-15

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

  9. Evaluation of patient absorbed dose in a PET-CT test

    International Nuclear Information System (INIS)

    Guerra P, F.; Mourao F, A. P.; Santana, P. C.

    2017-10-01

    Images of PET-CT has important diagnostic applications, especially in oncology. This equipment allows overlapping of functional images obtained from the administration of radionuclides and anatomical, generated by X-rays. The PET-CT technique may generate higher doses in patients due to the fact that two diagnostic modalities are used in a single examination. A whole body CT scan is performed and in sequence, a capture of the signal generated by the photons emitted is done. In this study, the absorbed and effective doses generated by the CT scan and incorporated by the administration of the radionuclide were evaluated in 19 organs. To evaluate the CT dose, 32 radiochromic film strips were correctly positioned into the anthropomorphic male phantom. The CT protocol performed was whole-body scanning and a high-resolution lung scan. This protocol is currently used in most services. The calculation of the effective dose from the injected activity in the patient was performed using the ICRP 106 Biokinetic model (ICRP 106, 2008). The activity to be injected may vary according to the patients body mass and with the sensitivity of the detector. The mass of the simulator used is 73.5 kg, then the simulation with and injected activity of 244.76 MBq was used. It was observed that 87.4% of the effective dose in examination PET/CT comes from the CT scans, being 63.8% of the whole body scan and 23.6% of high resolution lung scan. Using activity of 0.09 mCi x kg 18 F-FDG radiopharmaceutical contributes only 12.6% of the final effective dose. As a conclusion, it was observed that the dose in patients submitted to the 18 F-FDG PET-CT examination is high, being of great value efforts for its reduction, such as the use of appropriate image acquisition techniques and promoting the application of the principle of optimization of practice. (Author)

  10. Evaluation of patient absorbed dose in a PET-CT test

    Energy Technology Data Exchange (ETDEWEB)

    Guerra P, F.; Mourao F, A. P. [Federal University of Minas Gerais, Department of Nuclear Engineering, Av. Antonio Carlos 6627, CEP 31270-901, Pampulha, Belo Horizonte, Minas Gerais (Brazil); Santana, P. C., E-mail: fgpaiva92@gmail.com [Federal University of Minas Gerais, Medical School, Av. Prof. Alfredo Balena 190, CEP 30123970, Santa Efigenia, Belo Horizonte, Minas Gerais (Brazil)

    2017-10-15

    Images of PET-CT has important diagnostic applications, especially in oncology. This equipment allows overlapping of functional images obtained from the administration of radionuclides and anatomical, generated by X-rays. The PET-CT technique may generate higher doses in patients due to the fact that two diagnostic modalities are used in a single examination. A whole body CT scan is performed and in sequence, a capture of the signal generated by the photons emitted is done. In this study, the absorbed and effective doses generated by the CT scan and incorporated by the administration of the radionuclide were evaluated in 19 organs. To evaluate the CT dose, 32 radiochromic film strips were correctly positioned into the anthropomorphic male phantom. The CT protocol performed was whole-body scanning and a high-resolution lung scan. This protocol is currently used in most services. The calculation of the effective dose from the injected activity in the patient was performed using the ICRP 106 Biokinetic model (ICRP 106, 2008). The activity to be injected may vary according to the patients body mass and with the sensitivity of the detector. The mass of the simulator used is 73.5 kg, then the simulation with and injected activity of 244.76 MBq was used. It was observed that 87.4% of the effective dose in examination PET/CT comes from the CT scans, being 63.8% of the whole body scan and 23.6% of high resolution lung scan. Using activity of 0.09 mCi x kg {sup 18}F-FDG radiopharmaceutical contributes only 12.6% of the final effective dose. As a conclusion, it was observed that the dose in patients submitted to the {sup 18}F-FDG PET-CT examination is high, being of great value efforts for its reduction, such as the use of appropriate image acquisition techniques and promoting the application of the principle of optimization of practice. (Author)

  11. Evaluation of the PET component of simultaneous [18F]choline PET/MRI in prostate cancer: comparison with [18F]choline PET/CT

    International Nuclear Information System (INIS)

    Wetter, Axel; Lipponer, Christine; Nensa, Felix; Altenbernd, Jens-Christian; Schlosser, Thomas; Lauenstein, Thomas; Heusch, Philipp; Ruebben, Herbert; Bockisch, Andreas; Poeppel, Thorsten; Nagarajah, James

    2014-01-01

    The aim of this study was to evaluate the positron emission tomography (PET) component of [ 18 F]choline PET/MRI and compare it with the PET component of [ 18 F]choline PET/CT in patients with histologically proven prostate cancer and suspected recurrent prostate cancer. Thirty-six patients were examined with simultaneous [ 18 F]choline PET/MRI following combined [ 18 F]choline PET/CT. Fifty-eight PET-positive lesions in PET/CT and PET/MRI were evaluated by measuring the maximum and mean standardized uptake values (SUV max and SUV mean ) using volume of interest (VOI) analysis. A scoring system was applied to determine the quality of the PET images of both PET/CT and PET/MRI. Agreement between PET/CT and PET/MRI regarding SUV max and SUV mean was tested using Pearson's product-moment correlation and Bland-Altman analysis. All PET-positive lesions that were visible on PET/CT were also detectable on PET/MRI. The quality of the PET images was comparable in both groups. Median SUV max and SUV mean of all lesions were significantly lower in PET/MRI than in PET/CT (5.2 vs 6.1, p max of PET/CT and PET/MRI (R = 0.86, p mean of PET/CT and PET/MRI (R = 0.81, p max of PET/CT vs PET/MRI and -1.12 to +2.23 between SUV mean of PET/CT vs PET/MRI. PET image quality of PET/MRI was comparable to that of PET/CT. A highly significant correlation between SUV max and SUV mean was found. Both SUV max and SUV mean were significantly lower in [ 18 F]choline PET/MRI than in [ 18 F]choline PET/CT. Differences of SUV max and SUV mean might be caused by different techniques of attenuation correction. Furthermore, differences in biodistribution and biokinetics of [ 18 F]choline between the subsequent examinations and in the respective organ systems have to be taken into account. (orig.)

  12. {sup 18}F-FDG PET/MRI in patients suffering from lymphoma: how much MRI information is really needed?

    Energy Technology Data Exchange (ETDEWEB)

    Kirchner, Julian; Heusch, Philipp; Antoch, Gerald [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Deuschl, Cornelius; Grueneisen, Johannes; Forsting, Michael; Umutlu, Lale [University of Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen (Germany); Herrmann, Ken [University of Duisburg-Essen, Department of Nuclear Medicine, University Hospital Essen, Essen (Germany)

    2017-06-15

    To evaluate and compare the diagnostic potential of different reading protocols, entailing non-enhanced/contrast-enhanced and diffusion-weighted {sup 18}F-FDG PET/MR imaging for lesion detection and determination of the tumor stage in lymphoma patients. A total of 101 {sup 18}F-FDG PET/MRI datasets including a (1) transverse T2-w HASTE and {sup 18}F-FDG PET (PET/MRI{sub 1}), (2) with an additional contrast enhanced VIBE (PET/MRI{sub 2}), and (3) with additional diffusion-weighted imaging (PET/MRI{sub 3}) were evaluated. Scans were performed for initial staging, restaging during treatment, or at the end of treatment and under surveillance with suspicion for tumor relapse. In all datasets lymphoma manifestations as well as tumor stage in analogy to the revised criteria of the Ann Arbor staging system were determined. Furthermore, potential changes in therapy compared to the reference standard were evaluated. Hitherto performed PET/CT and all available follow-up and prior examinations as well as histopathology served as reference standard. PET/MRI{sub 1} correctly identified 53/55 patients with active lymphoma and 190/205 lesions. Respective values were 55/55, 202/205 for PET/MRI{sub 2} and 55/55, 205/205 for PET/MRI{sub 3}. PET/MRI{sub 1} determined correct tumor stage in 88 out of 101 examinations, and corresponding results for PET/MRI{sub 2} were 95 out of 101 and 96 out of 101 in PET/MRI{sub 3}. Relating to the reference standard changes in treatment would occur in 11% based on PET/MRI{sub 1}, in 6% based on PET/MRI{sub 2}, and in 3% based on PET/MRI{sub 3}. The additional application of contrast-enhanced and diffusion-weighted imaging to {sup 18}F-FDG PET/MRI resulted in higher diagnostic competence, particularly for initial staging and correct classification of the disease extent with potential impact on patient and therapy management. (orig.)

  13. Performance of integrated FDG-PET/contrast-enhanced CT in the staging and restaging of colorectal cancer: Comparison with PET and enhanced CT

    International Nuclear Information System (INIS)

    Dirisamer, Albert; Halpern, Benjamin S.; Floery, Daniel; Wolf, Florian; Beheshti, Mohsen; Mayerhoefer, Marius E.; Langsteger, Werner

    2010-01-01

    Objective: The purpose of this study was to assess the diagnostic value of PET/CT as a one step examination in patients with colorectal cancer. Therefore we proved whether diagnostic PET/CT adds information over PET or contrast-enhanced CT alone for staging or restaging of patients with colorectal cancer. Methods: Seventy-three patients (46 males and 27 females; age range: 50-81 years; mean age: 67 years) with known colorectal cancer underwent 18F-FDG-PET/CT for staging or restaging. Results: Of the 73 patients 26 patients underwent PET/CT for staging and 47 for restaging. 266 metastases could be detected in 60 patients. Contrast-enhanced PET/CT had a lesion-based sensitivity of 100%, contrast-enhanced CT of 91% and PET of 85%. PET/CT identified 2 lesions as false positive. PET/CT could also reach a patient-based sensitivity of 100%, which was superior to contrast-enhanced CT and PET. Conclusion: Our study clearly demonstrated the added value of contrast-enhanced PET/CT in staging and restaging patients with colorectal cancer over CT and PET alone.

  14. {sup 18}F-FDG PET of the hands with a dedicated high-resolution PEM system (arthro-PET): correlation with PET/CT, radiography and clinical parameters

    Energy Technology Data Exchange (ETDEWEB)

    Mhlanga, Joyce C.; Lodge, Martin [Johns Hopkins University School of Medicine, Division of Nuclear Medicine, The Russell H. Morgan Department of Radiology and Radiological Sciences, Baltimore, MD (United States); Carrino, John A. [Johns Hopkins University School of Medicine, Division of Musculoskeletal Radiology, The Russell H. Morgan Department of Radiology and Radiological Sciences, Baltimore, MD (United States); Wang, Hao [Johns Hopkins University School of Medicine, Department of Oncology Biostatistics Division, Baltimore, MD (United States); Wahl, Richard L. [Johns Hopkins University School of Medicine, Division of Nuclear Medicine, The Russell H. Morgan Department of Radiology and Radiological Sciences, Baltimore, MD (United States); Johns Hopkins University Hospitals, Division of Nuclear Medicine, Baltimore, MD (United States)

    2014-12-15

    The aim of this study was to prospectively determine the feasibility and compare the novel use of a positron emission mammography (PEM) scanner with standard PET/CT for evaluating hand osteoarthritis (OA) with {sup 18}F-FDG. Institutional review board approval and written informed consent were obtained for this HIPAA-compliant prospective study in which 14 adults referred for oncological {sup 18}F-FDG PET/CT underwent dedicated hand PET/CT followed by arthro-PET using the PEM device. Hand radiographs were obtained and scored for the presence and severity of OA. Summed qualitative and quantitative joint glycolytic scores for each modality were compared with the findings on plain radiography and clinical features. Eight patients with clinical and/or radiographic evidence of OA comprised the OA group (mean age 73 ± 7.7 years). Six patients served as the control group (53.7 ± 9.3 years). Arthro-PET quantitative and qualitative joint glycolytic scores were highly correlated with PET/CT findings in the OA patients (r = 0.86. p = 0.007; r = 0.94, p = 0.001). Qualitative arthro-PET and PET/CT joint scores were significantly higher in the OA patients than in controls (38.7 ± 6.6 vs. 32.2 ± 0.4, p = 0.02; 37.5 ± 5.4 vs. 32.2 ± 0.4, p = 0.03, respectively). Quantitative arthro-PET and PET/CT maximum SUV-lean joint scores were higher in the OA patients, although they did not reach statistical significance (20.8 ± 4.2 vs. 18 ± 1.8, p = 0.13; 22.8 ± 5.38 vs. 20.1 ± 1.54, p= 0.21). By definition, OA patients had higher radiographic joint scores than controls (30.9 ± 31.3 vs. 0, p = 0.03). Hand imaging using a small field of view PEM system (arthro-PET) with FDG is feasible, performing comparably to PET/CT in assessing metabolic joint activity. Arthro-PET and PET/CT showed higher joint FDG uptake in OA. Further exploration of arthro-PET in arthritis management is warranted. (orig.)

  15. Indeterminate findings on oncologic PET/CT: What difference dose PET/MRI make?

    Energy Technology Data Exchange (ETDEWEB)

    Fraum, Tyler J.; Fowler, Kathryn J.; McConathy, Jonathan; Dehdashti, Farokh [Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis (United States)

    2016-12-15

    Positron emission tomography/computed tomography (PET/CT) with 2-deoxy-2-[{sup 18}F]fluoro-D-glucose (FDG) has become the standard of care for the initial staging and subsequent treatment response assessment of many different malignancies. Despite this success, PET/CT is often supplemented by MRI to improve assessment of local tumor invasion and to facilitate detection of lesions in organs with high background FDG uptake. Consequently, PET/MRI has the potential to expand the clinical value of PET examinations by increasing reader certainty and reducing the need for subsequent imaging. This study evaluates the ability of FDG-PET/MRI to clarify findings initially deemed indeterminate on clinical FDG-PET/CT studies. A total of 190 oncology patients underwent whole-body PET/CT, immediately followed by PET/MRI utilizing the same FDG administration. Each PET/CT was interpreted by our institution's nuclear medicine service as a standard-of-care clinical examination. Review of these PET/CT reports identified 31 patients (16 %) with indeterminate findings. Two readers evaluated all 31 PET/CT studies, followed by the corresponding PET/MRI studies. A consensus was reached for each case, and changes in interpretation directly resulting from PET/MRI review were recorded. Interpretations were then correlated with follow-up imaging, pathology results, and other diagnostic studies. In 18 of 31 cases with indeterminate findings on PET/CT, PET/MRI resulted in a more definitive interpretation by facilitating the differentiation of infection/inflammation from malignancy (15/18), the accurate localization of FDG-avid lesions (2/18), and the characterization of incidental non-FDG-avid solid organ lesions (1/18). Explanations for improved reader certainty with PET/MRI included the superior soft tissue contrast of MRI and the ability to assess cellular density with diffusion-weighted imaging. The majority (12/18) of such cases had an appropriate standard of reference; in all 12 cases

  16. Indeterminate findings on oncologic PET/CT: What difference dose PET/MRI make?

    International Nuclear Information System (INIS)

    Fraum, Tyler J.; Fowler, Kathryn J.; McConathy, Jonathan; Dehdashti, Farokh

    2016-01-01

    Positron emission tomography/computed tomography (PET/CT) with 2-deoxy-2-["1"8F]fluoro-D-glucose (FDG) has become the standard of care for the initial staging and subsequent treatment response assessment of many different malignancies. Despite this success, PET/CT is often supplemented by MRI to improve assessment of local tumor invasion and to facilitate detection of lesions in organs with high background FDG uptake. Consequently, PET/MRI has the potential to expand the clinical value of PET examinations by increasing reader certainty and reducing the need for subsequent imaging. This study evaluates the ability of FDG-PET/MRI to clarify findings initially deemed indeterminate on clinical FDG-PET/CT studies. A total of 190 oncology patients underwent whole-body PET/CT, immediately followed by PET/MRI utilizing the same FDG administration. Each PET/CT was interpreted by our institution's nuclear medicine service as a standard-of-care clinical examination. Review of these PET/CT reports identified 31 patients (16 %) with indeterminate findings. Two readers evaluated all 31 PET/CT studies, followed by the corresponding PET/MRI studies. A consensus was reached for each case, and changes in interpretation directly resulting from PET/MRI review were recorded. Interpretations were then correlated with follow-up imaging, pathology results, and other diagnostic studies. In 18 of 31 cases with indeterminate findings on PET/CT, PET/MRI resulted in a more definitive interpretation by facilitating the differentiation of infection/inflammation from malignancy (15/18), the accurate localization of FDG-avid lesions (2/18), and the characterization of incidental non-FDG-avid solid organ lesions (1/18). Explanations for improved reader certainty with PET/MRI included the superior soft tissue contrast of MRI and the ability to assess cellular density with diffusion-weighted imaging. The majority (12/18) of such cases had an appropriate standard of reference; in all 12 cases, the

  17. PET/CT in the complex estimation of the patient after breast cancer therapy - case report

    International Nuclear Information System (INIS)

    Ziolkowska, E.; Lozynska-Podhrebelna, D.; Zarzycka, M.; Malkowski, B.

    2007-01-01

    The connection of positron emission tomography (PET) and computer tomography (CT) with the use of FDG is finding wider application to the diagnostics, monitoring and treatment of breast cancer. The use of PET/CT improves the effectiveness of recurrence, metastases to the bones and distant internal organs diagnostics, and in some patients outdistances the presence of lesions which in conventional diagnostic examinations are described considerably later. This work presents the case of a 50-year-old woman with diagnosed breast cancer, after surgery treatment and complementary chemotherapy and radiotherapy. There was a suspicion of local recurrence in postoperative scar (in 18 th month after finished radiotherapy) and the absence of oncocytes in cytological examination in this patient and PET/CT was performed. The recurrence in postoperative scar and signs of dissemination to the bones and the liver was shown in this examination despite the negative tumour marker profile. CT and scintigraphy were performed additionally and they confirmed only the existence of metastatic changes in S1 vertebra and VI rib on the left side. Thanks to PET/CT examination both palliative radiotherapy and chemotherapy were applied immediately. After 5 months the control PET/CT examination was performed which showed a partial response to the applied treatment. The result of the examination and further growth of CA 15-3 marker were reasons for the inclusion of the next two series of chemotherapy. Bone scintigraphy, which was performed after completion of chemotherapy, showed the progression of metastatic changes. The patient was referred for radioisotopic treatment. The introduced case confirms the suitability of PET/CT in the complex assessment of a patient with diagnosed breast cancer. The use of PET/CT is a valuable element of recurrence and dissemination in neoplasmic disease quick diagnostics and directs the ways of the optimum antineoplasmic treatment. (authors)

  18. Intraindividual comparison of F-18-FLT PET and F-18 FET PET in brain tumor patients

    International Nuclear Information System (INIS)

    Kim, Sung Eun; Cheon, G. J.; Cho, Y. S.; Kwak, H. S.; Lee, C. H.; Choi, C. W.; Lim, S. M.

    2003-01-01

    To compare findings on FLT PET with FET PET, we prospectively undertaken FLT, FET and FDG PET in same patient with suspected primary/metastatic and recurrent brain tumors. Seventeen studies in 16 patients (47 8.3 years, M: F 10: 6) with brain tumor (3 for initial diagnosis, 6 for therapeutic response, 6 for detecting recurrence, 1 for diagnosis and recurrence both) were included. Brain tumors were 14 gliomas (6 high- grade 9 low-grade by the WHO classification), 2 metastatic brain tumors and 1 CNS lymphoma. 18F-FDG, FLT and FET PET were performed within two weeks. Attenuation-corrected brain images were acquired 30 minutes after injection of 370-555 MBq FDG, FLT and FET with a dedicated PET scanner (ECAT HR scanner, Siemens-CTI). Maximum SUV (max SUV) and relative uptake defined by FLT and FET accumulation within the tumor in relation to a contralateral control region (max SUV for tumor/ mean SUV for contralateral normal gray matter) were calculated. 26 tumor foci were analyzed. Relative FLT uptake (4.17 2.4, 0.58 to 7.45) was grater than than FET uptake (2.03 1.17, 0.92 to 4.53 (p<0.0006)) and FDG uptake (1.16 0.34, 0.76 to 2.08). Among FLT, FET and FDG uptakes in 20 tumor foci, correlation were poor. the relative FLT uptake of high-grade glioma was higher than low-glioma (6.070.76 vs 3.11 2.15, p=0.002), however, relative FET uptake was not different significantly (2.68 1.51, high-grade vs 1.970.78, low-grade). The correlation between tumor grade (high vs low grade) and relative uptake (FLT and FET) was shown only with relative FLT uptake (r=0.62, p=0.002). The best cut off value of relative FLT uptake between high-grade and low-grade glioma was 4.54 (AUC: 0.89 sensitivity: 100 specificity: 86.7%). Compared with FET uptake, FLT uptake showed much higher contrast and associated with tumor grade. Further study, evaluation of proliferative index of Ki-67 and its relationship with FLT and FET uptake, are ongoing

  19. Up-front PET/CT changes treatment intent in patients with head and neck squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Rohde, Max; Godballe, Christian [Odense University Hospital, Department of ORL - Head and Neck Surgery, Odense (Denmark); University of Southern Denmark, Department of Clinical Research, Odense (Denmark); Nielsen, Anne L.; Thomassen, Anders [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark); Johansen, Joergen; Gyldenkerne, Niels [Odense University Hospital, Department of Oncology, Odense (Denmark); Soerensen, Jens A. [University of Southern Denmark, Department of Clinical Research, Odense (Denmark); Odense University Hospital, Department of Plastic Surgery, Odense (Denmark); Diaz, Anabel; Asmussen, Jon T. [Odense University Hospital, Department of Radiology, Odense (Denmark); Gerke, Oke [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark); University of Southern Denmark, Centre of Health Economics Research, Odense (Denmark); Doessing, Helle; Bjoerndal, Kristine [Odense University Hospital, Department of ORL - Head and Neck Surgery, Odense (Denmark); Hoeilund-Carlsen, Poul Flemming [University of Southern Denmark, Department of Clinical Research, Odense (Denmark); Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark)

    2018-04-15

    In patients with newly diagnosed head and neck squamous cell carcinoma (HNSCC), we wanted to examine the differences in overall treatment decisions, i.e. curative versus palliative treatment intent, reached by a multidisciplinary team conference (MDTC) based on 18F-fluoro-deoxy-glucose-positron emission tomography/computed tomography (PET/CT) or chest X-ray + MRI of the head and neck (CXR/MRI). This was a prospective blinded cohort study based on paired data. Consecutive patients with histologically verified primary HNSCC were invited to participate. All included patients underwent CXR/MRI and PET/CT before diagnostic biopsy. An ordinary MDTC using all available imaging was conducted as per standard practice. After at least 3 months (to eliminate recall bias in the team), the first project MDTC was conducted, based on either CXR/MRI or PET/CT, and the tumor board drew conclusions regarding treatment. After an additional 3 months, a second project MDTC was conducted using the complementary imaging modality. A total of 307 patients were included. Based on CXR/MRI, 303 patients (99%) were recommended for curative treatment and only four patients (1%) for palliative treatment. Based on PET/CT, the MDTC concluded that 278 (91%) patients were suitable for curative treatment and 29 (9%) patients for palliative treatment. The absolute difference of 8% was statistically significant (95% CI: 4.8%-11.5%, p < 0.001). A PET/CT-based imaging strategy significantly changed the decisions regarding treatment intent made by a MDTC for patients diagnosed with HNSCC, when compared with the standard imaging strategy of CXR/MRI. (orig.)

  20. Up-front PET/CT changes treatment intent in patients with head and neck squamous cell carcinoma

    International Nuclear Information System (INIS)

    Rohde, Max; Godballe, Christian; Nielsen, Anne L.; Thomassen, Anders; Johansen, Joergen; Gyldenkerne, Niels; Soerensen, Jens A.; Diaz, Anabel; Asmussen, Jon T.; Gerke, Oke; Doessing, Helle; Bjoerndal, Kristine; Hoeilund-Carlsen, Poul Flemming

    2018-01-01

    In patients with newly diagnosed head and neck squamous cell carcinoma (HNSCC), we wanted to examine the differences in overall treatment decisions, i.e. curative versus palliative treatment intent, reached by a multidisciplinary team conference (MDTC) based on 18F-fluoro-deoxy-glucose-positron emission tomography/computed tomography (PET/CT) or chest X-ray + MRI of the head and neck (CXR/MRI). This was a prospective blinded cohort study based on paired data. Consecutive patients with histologically verified primary HNSCC were invited to participate. All included patients underwent CXR/MRI and PET/CT before diagnostic biopsy. An ordinary MDTC using all available imaging was conducted as per standard practice. After at least 3 months (to eliminate recall bias in the team), the first project MDTC was conducted, based on either CXR/MRI or PET/CT, and the tumor board drew conclusions regarding treatment. After an additional 3 months, a second project MDTC was conducted using the complementary imaging modality. A total of 307 patients were included. Based on CXR/MRI, 303 patients (99%) were recommended for curative treatment and only four patients (1%) for palliative treatment. Based on PET/CT, the MDTC concluded that 278 (91%) patients were suitable for curative treatment and 29 (9%) patients for palliative treatment. The absolute difference of 8% was statistically significant (95% CI: 4.8%-11.5%, p < 0.001). A PET/CT-based imaging strategy significantly changed the decisions regarding treatment intent made by a MDTC for patients diagnosed with HNSCC, when compared with the standard imaging strategy of CXR/MRI. (orig.)

  1. Medical application of PET technology

    International Nuclear Information System (INIS)

    Lim, Sang Moo; Choi, C. W.; An, S. H.; Woo, K. S.; Chung, W. S.; Yang, S. D.; Jun, G. S. and others

    1999-04-01

    We performed following studies using PET technology: 1. Clinical usefulness of [ 18 F]FDG whole body PET in malignant disease 2. Clinical usefulness of quantitative evaluation of F-18-FDG 3. Pilot study of C-11 methionine PET in brain tumor 4. PET study in patients with Parkinson's disease 5. A study on the clinical myocardial PET image. PET gives various metabolic information for the living human body, and is very important, new diagnostic modality. The PET study will give us the information of cancer patients such as early detection of cancer, staging, recurrence detection and characterization of cancer. The quantitative analysis using PET could be applied to evaluate the pathophysiology of various diseases and develop new drugs and develop new radiopharmaceuticals

  2. Medical application of PET technology

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang Moo; Choi, C. W.; An, S. H.; Woo, K. S.; Chung, W. S.; Yang, S. D.; Jun, G. S. and others

    1999-04-01

    We performed following studies using PET technology: 1. Clinical usefulness of [{sup 18}F]FDG whole body PET in malignant disease 2. Clinical usefulness of quantitative evaluation of F-18-FDG 3. Pilot study of C-11 methionine PET in brain tumor 4. PET study in patients with Parkinson's disease 5. A study on the clinical myocardial PET image. PET gives various metabolic information for the living human body, and is very important, new diagnostic modality. The PET study will give us the information of cancer patients such as early detection of cancer, staging, recurrence detection and characterization of cancer. The quantitative analysis using PET could be applied to evaluate the pathophysiology of various diseases and develop new drugs and develop new radiopharmaceuticals.

  3. FDG PET and CT in locally advanced adenocarcinomas of the distal oesophagus. Clinical relevance of a discordant PET finding

    International Nuclear Information System (INIS)

    Stahl, A.; Wieder, H.; Schwaiger, M.; Weber, W.A.; Stollfuss, J.; Ott, K.; Fink, U.

    2005-01-01

    Aim: the incidence of adenocarcinomas of the distal oesophagus (ADE) has dramatically increased in Western countries. The clinical importance of a FDG PET finding discordant with CT was determined in patients with locally advanced ADE. In addition, tumour standardized uptake values (SUV) were correlated with patient survival. Patients, methods: 40 consecutive patients were analyzed retrospectively. All patients underwent an attenuation corrected FDG PET scan (neck, chest, abdomen) and contrast enhanced helical CT of the chest and abdomen. PET and CT scans were reviewed independently and concomitantly with respect to metastases in predefined lymph node sites and organs. Any discordance between PET and CT was assessed for clinical relevance. Clinical relevance was defined as a change in the overall therapeutic concept (curative vs. palliative). Follow-up imaging and histological evaluation served as the gold standard. Mean tumour SUVs were determined by 1.5 cm regions of interest placed over the tumour's maximum. Results: when read independently from the CT scan FDG PET indicated a clinically relevant change in tumour stage in 9/40 patients (23%) and a non-relevant change in 11/40 patients (28%). PET was correct in 5/9 patients (56%) with clinically relevant discordances. In 4/9 patients PET was incorrect (3 false positive due to suspicion of MI-lymph nodes or lung metastases, 1 false negative in disseminated liver metastases). With concomitant reading, PET indicated a clinically relevant change in tumour stage in 6/40 patients (15%) and a non-relevant change in 5/40 patients (13%). PET was correct in 5/6 patients (83%) with clinically relevant discordances. The patient with disseminated liver disease remained the single false negative. Overall, the benefit from PET was based on its higher diagnostic accuracy at organ sites. Tumour SUV did not correlate with patient survival. Conclusion: about half of discordances between FDG PET and CT are clinically relevant

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

    Science.gov (United States)

    Németh, Zsuzsanna; Boér, Katalin; Borbély, Katalin

    2017-10-09

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

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

  6. Diagnostic performance of [18F] FDG PET-CT compared to bone scintigraphy for the detection of bone metastases in lung cancer patients

    International Nuclear Information System (INIS)

    RODRIGUES, Margarida; STARK, Hannes; RENDL, Gundula; RETTENBACHER, Lukas; PIRICH, Christian; DATZ, Lidwina; STUDNICKA, Michael

    2016-01-01

    Accurate staging of lung cancer is essential for effective patient management and selection of appropriate therapeutic strategy. The aim of this paper was to compare the value of bone scintigraphy and FDG PET-CT for detecting bone metastases in lung cancer patients and the impact of these modalities in disease staging. One hundred sixty-four lung cancer patients who had undergone both FDG PET-CT and bone scintigraphy within 14 days were included into this study. The analysis of FDG PET-CT and bone scintigraphy was carried out patient- and lesion-based. One hundred twenty-one patients were negative and 43 patients positive for bone metastases. FDG PET-CT found bone metastases in 42/43 patients and bone scintigraphy in 38/43 patients. Sensitivity, specificity and accuracy of FDG PET-CT and bone scintigraphy for detecting bone metastases were 97.7%, 100% and 99.4%, and 87.8%, 97.5% and 94.2%, respectively. FDG PET-CT identified 430 bone metastases and bone scintigraphy 246 bone metastases. Skull was the only region where bone scintigraphy identified more lesions than FDG PET-CT. Based on both scintigraphic modalities disagreement concerning disease stage was found in 3 patients. In conclusion, FDG PET-CT yielded a higher sensitivity, specificity and accuracy than bone scintigraphy for identifying bone metastases in lung cancer patients. FDG PET-CT thus can be recommended for initial staging of lung cancer patients without applying bone scintigraphy for the detection of bone metastases.

  7. 18F-fluorodeoxyglucose PET and PET-CT in early detection of cancer recurrent

    International Nuclear Information System (INIS)

    Xing Yan; Zhao Jinhua

    2007-01-01

    Early detection of recurrent can improve prognosis and survival of patients with cancer. 18 F- fluorodeoxyglucose( 18 F-FDG) PET can detect metabolic changes before structural changes. The fused imaging provided by PET-CT can precisely localize the foci and demonstrate the complementary roles of functional and anatomic assessments in the diagnosis of cancer recurrence. In addition to the accurate diagnosis and definition of the whole extent of recurrent cancer, 18 F-FDG PET and PET-CT can impact patients management. (authors)

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

    Science.gov (United States)

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

    2014-03-01

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

  9. FDG PET imaging for grading and prediction of outcome in chondrosarcoma patients

    Energy Technology Data Exchange (ETDEWEB)

    Brenner, Winfried; Eary, Janet F. [Division of Nuclear Medicine, University of Washington Medical Center, 1959 NE Pacific Street, Box 356113, WA 98195-6113, Seattle (United States); Conrad, Ernest U. [Department of Orthopaedics, University of Washington Medical Center, Seattle, WA (United States)

    2004-02-01

    The aims of this study were to assess the potential of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) for tumor grading in chondrosarcoma patients and to evaluate the role of standardized uptake value (SUV) as a parameter for prediction of patient outcome. FDG PET imaging was performed in 31 patients with chondrosarcoma prior to therapy. SUV was calculated for each tumor and correlated to tumor grade and size, and to patient outcome in terms of local relapse or metastatic disease with a mean follow-up period of 48 months. Chondrosarcomas were detectable in all patients. Tumor SUV was 3.38{+-}1.61 for grade I (n=15), 5.44{+-}3.06 for grade II (n=13), and 7.10{+-}2.61 for grade III (n=3). Significant differences were found between patients with and without disease progression: SUV was 6.42{+-}2.70 (n=10) in patients developing recurrent or metastatic disease compared with 3.74{+-}2.22 in patients without relapse (P=0.015). Using a cut-off of 4 for SUV, sensitivity, specificity, and positive and negative predictive values for a relapse were 90%, 76%, 64%, and 94%, respectively. Combining tumor grade and SUV, these parameters improved to 90%, 95%, 90%, and 95%, respectively. Pretherapeutic tumor SUV obtained by FDG PET imaging was a useful parameter for tumor grading and prediction of outcome in chondrosarcoma patients. The combination of SUV and histopathologic tumor grade further improved prediction of outcome substantially, allowing identification of patients at high risk for local relapse or metastatic disease. (orig.)

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  11. [18F]FDG PET/MRI of patients with chronic pain alters management: early experience

    International Nuclear Information System (INIS)

    Biswal, Sandip; Behera, Deepak; Yoon, Dae Hyun; Holley, Dawn; Ith, Ma Agnes Martinez; Carroll, Ian; Smuck, Matthew; Hargreaves, Brian

    2015-01-01

    The chronic pain sufferer is currently faced with a lack of objective tools to identify the source of their pain. The overarching goal is to develop clinical [18F]FDG PET/MRI methods to more accurately localize sites of increased neuronal and muscular metabolism or inflammation as it relates to neurogenic sources of pain and to ultimately improve outcomes of chronic pain sufferers. The aims are to 1) correlate imaging findings with location of pain symptomology, 2) predict location of symptoms based on imaging findings alone and 3) to determine whether the imaging results affect current management decisions. Six patients suffering from chronic lower extremity neuropathic pain (4 complex regional pain syndrome, 1 chronic sciatica and 1 neuropathic pain) have been imaged with a PET/MRI system (time-of-flight PET; 3.0T bore) from mid thorax through the feet. All patients underwent PET/MR imaging one hour after a injection of 10mCi [18F]FDG. Two radiologists evaluated PET/MR images (one blinded and the other unblinded to patient exam/history). ROI analysis showed focal increased [18F]FDG uptake in affected nerves and muscle (approx 2-4 times more) over background tissue in various regions of the body in 5 of 6 patients at the site of greatest pain symptoms and other areas of the body (SUVmax of Target 0.9-4.2 vs. Background 0.2-1.2). The radiologist blind to the patient history/exam was able to correctly identify side/location of the symptoms in 5 out of 6 patients. Imaging results were reviewed with the referring physician, who then determined whether a modification in the management plan was needed: 1/6 no change, 2/6 mild modification (e.g., additional diagnostic test ordered) and 3/6 significant modification.

  12. [18F]FDG PET/MRI of patients with chronic pain alters management: early experience

    Energy Technology Data Exchange (ETDEWEB)

    Biswal, Sandip; Behera, Deepak; Yoon, Dae Hyun; Holley, Dawn; Ith, Ma Agnes Martinez; Carroll, Ian; Smuck, Matthew; Hargreaves, Brian [Stanford University School of Medicine, California (United States)

    2015-05-18

    The chronic pain sufferer is currently faced with a lack of objective tools to identify the source of their pain. The overarching goal is to develop clinical [18F]FDG PET/MRI methods to more accurately localize sites of increased neuronal and muscular metabolism or inflammation as it relates to neurogenic sources of pain and to ultimately improve outcomes of chronic pain sufferers. The aims are to 1) correlate imaging findings with location of pain symptomology, 2) predict location of symptoms based on imaging findings alone and 3) to determine whether the imaging results affect current management decisions. Six patients suffering from chronic lower extremity neuropathic pain (4 complex regional pain syndrome, 1 chronic sciatica and 1 neuropathic pain) have been imaged with a PET/MRI system (time-of-flight PET; 3.0T bore) from mid thorax through the feet. All patients underwent PET/MR imaging one hour after a injection of 10mCi [18F]FDG. Two radiologists evaluated PET/MR images (one blinded and the other unblinded to patient exam/history). ROI analysis showed focal increased [18F]FDG uptake in affected nerves and muscle (approx 2-4 times more) over background tissue in various regions of the body in 5 of 6 patients at the site of greatest pain symptoms and other areas of the body (SUVmax of Target 0.9-4.2 vs. Background 0.2-1.2). The radiologist blind to the patient history/exam was able to correctly identify side/location of the symptoms in 5 out of 6 patients. Imaging results were reviewed with the referring physician, who then determined whether a modification in the management plan was needed: 1/6 no change, 2/6 mild modification (e.g., additional diagnostic test ordered) and 3/6 significant modification.

  13. Chronic thyroiditis in patients with advanced breast carcinoma: metabolic and morphologic changes on PET-CT

    Energy Technology Data Exchange (ETDEWEB)

    Tateishi, Ukihide [University of Texas, MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Yokohama City University Graduate School of Medicine, Department of Radiology, Yokohama (Japan); University of Texas MD Anderson Cancer Center, Division of Diagnostic Imaging, Houston, TX (United States); Gamez, Cristina; Yeung, Henry W.D.; Macapinlac, Homer A. [University of Texas, MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Dawood, Shaheenah; Cristofanilli, Massimo [University of Texas, MD Anderson Cancer Center, Division of Breast Medical Oncology, Houston, TX (United States); Inoue, Tomio [Yokohama City University Graduate School of Medicine, Department of Radiology, Yokohama (Japan)

    2009-06-15

    To investigate clinical implications of FDG uptake in the thyroid glands in patients with advanced breast carcinoma by comparing metabolic and morphologic patterns on positron emission tomography (PET)/computed tomography (CT). The institutional review board waived the requirement for informed consent. A retrospective analysis was performed in 146 women (mean age 54 years) with advanced breast carcinoma who received systemic treatment. All patients underwent PET-CT before and after treatment. All PET-CT studies were reviewed in consensus by two reviewers. Morphologic changes including volume and mean parenchymal density of the thyroid glands were evaluated. Maximum standardized uptake value (SUVmax) and total lesion glycolysis (TLG) were determined to evaluate metabolic changes. These parameters were compared between patients with chronic thyroiditis who received thyroid hormone replacement therapy and those who did not. Of the 146 patients, 29 (20%) showed bilaterally diffuse uptake in the thyroid glands on the baseline PET-CT scan. The SUVmax showed a linear relationship with volume (r = 0.428, p = 0.021) and the mean parenchymal density (r = -0.385, p = 0.039) of the thyroid glands. In 21 of the 29 patients (72%) with hypothyroidism who received thyroid hormone replacement therapy, the volume, mean parenchymal density, SUVmax, and TLG of the thyroid glands showed no significant changes. In contrast, 8 of the 29 patients (28%) who did not receive thyroid hormone replacement therapy showed marked decreases in SUVmax and TLG. Diffuse thyroid uptake on PET-CT represents active inflammation caused by chronic thyroiditis in patients with advanced breast carcinoma. Diffuse thyroid uptake may also address the concern about subclinical hypothyroidism which develops into overt disease during follow-up. (orig.)

  14. All-in-one interictal presurgical imaging in patients with epilepsy: single-session EEG/PET/(f)MRI

    Energy Technology Data Exchange (ETDEWEB)

    Grouiller, Frederic; Delattre, Benedicte M.A.; Lazeyras, Francois; Ratib, Osman; Vargas, Maria I.; Garibotto, Valentina [Geneva University Hospital, Department of Radiology and Medical Informatics, Geneva 14 (Switzerland); Pittau, Francesca; Spinelli, Laurent; Seeck, Margitta; Vulliemoz, Serge [Geneva University Hospital, EEG and Epilepsy Unit, Department of Neurology, Geneva 14 (Switzerland); Heinzer, Susanne [Philips AG Healthcare, Zuerich (Switzerland); Iannotti, Giannina R. [Geneva University Hospital, Functional Brain Mapping Laboratory, Department of Fundamental Neurosciences, Geneva 14 (Switzerland)

    2015-04-17

    In patients with pharmacoresistant focal epilepsy, resection of the epileptic focus can lead to freedom from seizures or significant improvement in well-selected candidates. Localization of the epileptic focus with multimodal concordance is crucial for a good postoperative outcome. Beyond the detection of epileptogenic lesions on structural MRI and focal hypometabolism on FDG PET, EEG-based Electric Source Imaging (ESI) and simultaneous EEG and functional MRI (EEG-fMRI) are increasingly applied for mapping epileptic activity. We here report presurgical multimodal interictal imaging using a hybrid PET/MR scanner for single-session FDG PET, MRI, EEG-fMRI and ESI. This quadrimodal imaging procedure was performed in a single session in 12 patients using a high-density (256 electrodes) MR-compatible EEG system and a hybrid PET/MR scanner. EEG was used to exclude subclinical seizures during uptake of the PET tracer, to compute ESI on interictal epileptiform discharges and to guide fMRI analysis for mapping haemodynamic changes correlated with interictal epileptiform activity. The whole multimodal recording was performed in less than 2 hours with good patient comfort and data quality. Clinically contributory examinations with at least two modalities were obtained in nine patients and with all modalities in five patients. This single-session quadrimodal imaging procedure provided reliable and contributory interictal clinical data. This procedure avoids multiple scanning sessions and is associated with less radiation exposure than PET-CT. Moreover, it guarantees the same medication level and medical condition for all modalities. The procedure improves workflow and could reduce the duration and cost of presurgical epilepsy evaluations. (orig.)

  15. All-in-one interictal presurgical imaging in patients with epilepsy: single-session EEG/PET/(f)MRI

    International Nuclear Information System (INIS)

    Grouiller, Frederic; Delattre, Benedicte M.A.; Lazeyras, Francois; Ratib, Osman; Vargas, Maria I.; Garibotto, Valentina; Pittau, Francesca; Spinelli, Laurent; Seeck, Margitta; Vulliemoz, Serge; Heinzer, Susanne; Iannotti, Giannina R.

    2015-01-01

    In patients with pharmacoresistant focal epilepsy, resection of the epileptic focus can lead to freedom from seizures or significant improvement in well-selected candidates. Localization of the epileptic focus with multimodal concordance is crucial for a good postoperative outcome. Beyond the detection of epileptogenic lesions on structural MRI and focal hypometabolism on FDG PET, EEG-based Electric Source Imaging (ESI) and simultaneous EEG and functional MRI (EEG-fMRI) are increasingly applied for mapping epileptic activity. We here report presurgical multimodal interictal imaging using a hybrid PET/MR scanner for single-session FDG PET, MRI, EEG-fMRI and ESI. This quadrimodal imaging procedure was performed in a single session in 12 patients using a high-density (256 electrodes) MR-compatible EEG system and a hybrid PET/MR scanner. EEG was used to exclude subclinical seizures during uptake of the PET tracer, to compute ESI on interictal epileptiform discharges and to guide fMRI analysis for mapping haemodynamic changes correlated with interictal epileptiform activity. The whole multimodal recording was performed in less than 2 hours with good patient comfort and data quality. Clinically contributory examinations with at least two modalities were obtained in nine patients and with all modalities in five patients. This single-session quadrimodal imaging procedure provided reliable and contributory interictal clinical data. This procedure avoids multiple scanning sessions and is associated with less radiation exposure than PET-CT. Moreover, it guarantees the same medication level and medical condition for all modalities. The procedure improves workflow and could reduce the duration and cost of presurgical epilepsy evaluations. (orig.)

  16. 68Ga-DOTA-NOC PET/CT in comparison with CT for the detection of bone metastasis in patients with neuroendocrine tumours

    International Nuclear Information System (INIS)

    Ambrosini, Valentina; Nanni, Cristina; Castellucci, Paolo; Allegri, Vincenzo; Montini, Giancarlo; Franchi, Roberto; Zompatori, Maurizio; Campana, Davide; Tomassetti, Paola; Rubello, Domenico; Fanti, Stefano

    2010-01-01

    To retrospectively evaluate the sensitivity, specificity and accuracy of 68 Ga-DOTA-NOC PET/CT and CT alone for the evaluation of bone metastasis in patients with neuroendocrine tumour (NET). From among patients with NET who underwent 68 Ga-DOTA-NOC PET/CT between April 2006 and November 2008 in our centre, 223 were included in the study. Criteria for inclusion were pathological confirmation of NET and a follow-up period of at least 10 months. PET and CT images were retrospectively reviewed by two nuclear medicine specialists and two radiologists, respectively, without knowledge of the patient history or the findings of other imaging modalities. PET data were compared with the CT findings. Interobserver agreement was evaluated in terms of the kappa score. Clinical and imaging follow-up were used as the standard of reference to evaluate the PET findings. PET was performed for staging (49/223), unknown primary tumour detection (24/223), restaging (32/223), restaging before radioimmunotherapy (1/223), evaluation during therapy (12/223), equivocal findings on conventional imaging (4/223 at the bone level; 61/223 at sites other than bone), and follow-up (40/223). A very high interobserver agreement was observed. CT detected at least one bone lesion in only 35 of 44 patients with a positive PET scan. In particular, PET showed more lesions in 20/35 patients, a lower number of lesions in 8/35, and the same number in 7/35. The characteristics of the lesions (sclerotic, lytic, mixed) on the basis of the CT report did not influence PET reading. PET revealed the presence of at least one bone metastasis in nine patients with a negative CT scan. Considering patients with a negative PET scan (179), CT showed equivocal findings at the bone level in three (single small sclerotic abnormality in two at the spine level, and bilateral small sclerotic abnormalities in the humeri, femurs and scapula). Clinical follow-up confirmed the PET findings in all patients; thus there were no false

  17. Pelvic insufficiency fracture after radiotherapy in patients with cervical cancer in the era of PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Park, Shin Hyung; Kim, Jae Chul; Lee, Jeong Eun; Park, In Kyu [Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2011-12-15

    To determine the incidence, risk factors, and clinical characteristics of pelvic insufficiency fracture (PIF) in patients with cervical cancer. Between July 2004 and August 2009, 235 patients with non-metastatic cervical cancer were treated with definitive chemoradiation or postoperative radiotherapy. Among 235 patients, 117 (49.8%) underwent the first positron emission tomography/computed tomography (PET/CT) within 1 year after radiotherapy. The median radiation dose was 55 Gy (range, 45 to 60 Gy). Medical charts and imaging studies, including PET/CT, magnetic resonance imaging (MRI), CT, bone scintigraphy were reviewed to evaluate the patients with PIF. Among 235 patients, 16 developed PIF. The 5-year detection rate of PIF was 9.5%. The 5-year detection rate of PIF in patients who underwent the first PET/CT within a year was 15.6%. The median time to development of PIF was 12.5 months (range, 5 to 30 months). The sites of fracture included 12 sacroiliac joints, 3 pubic rami, 3 iliac bones, and 1 femoral neck. Eleven of 16 patients having PIF complained of hip pain requiring medications. One patient required hospitalization for pain control. The significant risk factors of PIF were old age, body mass index less than 23, bone mineral density less than -3.5 SD, and the first PET/CT within a year after radiotherapy. Radiation dose and concurrent chemotherapy had no impact on PIF rate. PIFs were not rare after pelvic radiotherapy in cervical cancer patients in the era of PET/CT. Timely diagnosis and management of PIF can improve quality of life in patients with cervical cancer, in addition to reducing unnecessary medical expenses.

  18. Pelvic insufficiency fracture after radiotherapy in patients with cervical cancer in the era of PET/CT

    International Nuclear Information System (INIS)

    Park, Shin Hyung; Kim, Jae Chul; Lee, Jeong Eun; Park, In Kyu

    2011-01-01

    To determine the incidence, risk factors, and clinical characteristics of pelvic insufficiency fracture (PIF) in patients with cervical cancer. Between July 2004 and August 2009, 235 patients with non-metastatic cervical cancer were treated with definitive chemoradiation or postoperative radiotherapy. Among 235 patients, 117 (49.8%) underwent the first positron emission tomography/computed tomography (PET/CT) within 1 year after radiotherapy. The median radiation dose was 55 Gy (range, 45 to 60 Gy). Medical charts and imaging studies, including PET/CT, magnetic resonance imaging (MRI), CT, bone scintigraphy were reviewed to evaluate the patients with PIF. Among 235 patients, 16 developed PIF. The 5-year detection rate of PIF was 9.5%. The 5-year detection rate of PIF in patients who underwent the first PET/CT within a year was 15.6%. The median time to development of PIF was 12.5 months (range, 5 to 30 months). The sites of fracture included 12 sacroiliac joints, 3 pubic rami, 3 iliac bones, and 1 femoral neck. Eleven of 16 patients having PIF complained of hip pain requiring medications. One patient required hospitalization for pain control. The significant risk factors of PIF were old age, body mass index less than 23, bone mineral density less than -3.5 SD, and the first PET/CT within a year after radiotherapy. Radiation dose and concurrent chemotherapy had no impact on PIF rate. PIFs were not rare after pelvic radiotherapy in cervical cancer patients in the era of PET/CT. Timely diagnosis and management of PIF can improve quality of life in patients with cervical cancer, in addition to reducing unnecessary medical expenses.

  19. Validating the Patient Experience with Treatment and Self-Management (PETS, a patient-reported measure of treatment burden, in people with diabetes

    Directory of Open Access Journals (Sweden)

    Rogers EA

    2017-11-01

    Full Text Available Elizabeth A Rogers,1,2 Kathleen J Yost,3 Jordan K Rosedahl,3 Mark Linzer,4 Deborah H Boehm,5 Azra Thakur,5 Sara Poplau,5 Roger T Anderson,6 David T Eton3 1Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA; 2Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA; 3Department of Health Services Research, Mayo Clinic, Rochester, MN, USA; 4Department of Medicine, Hennepin County Medical Center, Minneapolis, MN, USA; 5Minneapolis Medical Research Foundation, Minneapolis, MN, USA; 6University of Virginia School of Medicine, Charlottesville, VA, USA Aims: To validate a comprehensive general measure of treatment burden, the Patient Experience with Treatment and Self-Management (PETS, in people with diabetes. Methods: We conducted a secondary analysis of a cross-sectional survey study with 120 people diagnosed with type 1 or type 2 diabetes and at least one additional chronic illness. Surveys included established patient-reported outcome measures and a 48-item version of the PETS, a new measure comprised of multi-item scales assessing the burden of chronic illness treatment and self-care as it relates to nine domains: medical information, medications, medical appointments, monitoring health, interpersonal challenges, health care expenses, difficulty with health care services, role activity limitations, and physical/mental exhaustion from self-management. Internal reliability of PETS scales was determined using Cronbach’s alpha. Construct validity was determined through correlation of PETS scores with established measures (measures of chronic condition distress, medication satisfaction, self-efficacy, and global well-being, and known-groups validity through comparisons of PETS scores across clinically distinct groups. In an exploratory test of predictive validity, step-wise regressions were used to determine which PETS scales were most associated with outcomes of chronic condition

  20. Longitudinal studies of the 18F-FDG kinetics after ipilimumab treatment in metastatic melanoma patients based on dynamic FDG PET/CT.

    Science.gov (United States)

    Sachpekidis, Christos; Anwar, Hoda; Winkler, Julia K; Kopp-Schneider, Annette; Larribere, Lionel; Haberkorn, Uwe; Hassel, Jessica C; Dimitrakopoulou-Strauss, Antonia

    2018-06-05

    Immunotherapy has raised the issue of appropriate treatment response evaluation, due to the unique mechanism of action of the immunotherapeutic agents. Aim of this analysis is to evaluate the potential role of quantitative analysis of 2-deoxy-2-( 18 F)fluoro-D-glucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) data in monitoring of patients with metastatic melanoma undergoing ipilimumab therapy. 25 patients with unresectable metastatic melanoma underwent dynamic PET/CT (dPET/CT) of the thorax and upper abdomen as well as static, whole body PET/CT with 18 F-FDG before the start of ipilimumab treatment (baseline PET/CT), after two cycles of treatment (interim PET/CT) and at the end of treatment after four cycles (late PET/CT). The evaluation of dPET/CT studies was based on semi-quantitative (standardized uptake value, SUV) calculation as well as quantitative analysis, based on two-tissue compartment modeling and a fractal approach. Patients' best clinical response, assessed at a mean of 59 weeks, was used as reference. According to their best clinical response, patients were dichotomized in those demonstrating clinical benefit (CB, n = 16 patients) and those demonstrating no clinical benefit (no-CB, n = 9 patients). No statistically significant differences were observed between CB and no-CB regarding either semi-quantitative or quantitative parameters in all scans. On contrary, the application of the recently introduced PET response evaluation criteria for immunotherapy (PERCIMT) led to a correct classification rate of 84% (21/25 patients). Quantitative analysis of 18 F-FDG PET data does not provide additional information in treatment response evaluation of metastatic melanoma patients receiving ipilimumab. PERCIMT criteria correlated better with clinical response.

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

    Science.gov (United States)

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

    2012-10-01

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

  2. Intra-individual comparison of F-18-FLT PET and F-18 FET PET in brain tumor patients

    International Nuclear Information System (INIS)

    Kim, S.; Cheon, G.J.; Cho, Y.S.; Kwak, H.S.; Lee, C.H.; Choi, C.W.; Lim, S.M.

    2004-01-01

    Full text: The nucleoside analogue 18F-3'-deoxy-3'-fluorothymidine (FLT) for cellular proliferation and the amino acid analogue O- (2'18F-fluoroethyl)-L-tyrosine (FET) are recently developed PET-tracer for tumor imaging. Previous studies have demonstrated that the diagnostic ability of FET PET better than FDG PET in patient with newly diagnosed or recurrent brain tumors after radiation therapy. To compare findings on FLT PET with FET PET, we prospectively undertook FLT, FET and FDG PET in same patient with suspected primary/metastatic and recurrent brain tumors. Seventeen studies (FLT +FET + FDG: 13, FLT+FDG: 3, FLT +FET: 1) in 16 consecutive patients (47 ± 8.3 years, M: F 10: 6) with brain tumor (3 for initial diagnosis, 6 for therapeutic response, 6 for detecting recurrence, 1 for diagnosis and recurrence both) were included. Brain tumors were 14 gliomas (6 high-grade, 9 low-grade by the WHO classification), 2 metastatic brain tumors and 1 CNS lymphoma. 18F-FDG, FLT and FET PET were performed within two weeks. Attenuation-corrected brain images were acquired 30 minutes after injection of 370-555 MBq FDG, FLT and FET with a dedicated PET scanner (ECAT HR+ scanner, Siemens-CTI, Knoxville, Tenn., USA). Maximum SUV (max SUV) and relative uptake defined by FLT and FET accumulation within the tumor in relation to a contra lateral control region (max SUV for tumor/mean SUV for contra lateral normal gray matter) were calculated. A total of 26 tumor foci (26 on FLT and FDG, 22 on FET) in 17 studies were analysed. In most of tumor foci (20 of 22) FLT and FET PET images showed a similar extent of tumor activity. In 2 tumor foci discrepant findings were noticed; intense FLT uptake with negative FLT uptake in primary CNS lymphoma and negative FLT uptake with mild FET uptake in low-grade astrocytoma. Overall positive FLT, FET and FDG uptakes were 85 % (22/26), 90 % (18/ 20) and 58 % (15/26) respectively. Max SUV and relative FLT/FET uptake: The mean max SUV of FLT (0.97 ± 0

  3. First experience with early dynamic 18F-NaF-PET/CT in patients with chronic osteomyelitis

    International Nuclear Information System (INIS)

    Freesmeyer, M.; Stecker, F.F.; Schierz, J.-H.; Winkens, T.; Hofmann, G.O.

    2014-01-01

    This study investigates whether early dynamic positron emission tomography/computed tomography (ed-PET/CT) using 18 F-sodium fluoride-( 18 F-NaF) is feasible in depicting early phases of radiotracer distribution in patients with chronic osteomyelitis (COM). A total of 12 ed 18 F-NaF-PET/CT examinations were performed on 11 consecutive patients (2 female, 9 male; age 53 ± 12 years) in list mode over 5 min starting with radiopharmaceutical injection before standard late 18 F-NaF-PET/CT. Eight consecutive time intervals (frames) were reconstructed for each patient: four 15 s, then four 60 s. Several volumes of interest (VOI) were selected, representing the affected area as well as different reference areas within the bone and soft tissue. Maximum and mean ed standardized uptake values (edSUV max , edSUV mean , respectively) were calculated in each VOI during each frame to measure early fluoride influx and accumulation. Results were compared between affected and non-affected (contralateral) bones. Starting in the 31-45 s frame, the affected bone area showed significantly higher edSUV max and edSUV mean compared to the healthy contralateral region. The affected bone areas also significantly differed from non-affected contralateral regions in conventional late 18 F-NaF-PET/CT. This pilot study suggests that, in patients with COM, ed 18 F-NaF-PET offers additional information about early radiotracer distribution to standard 18 F-NaF-PET/CT, similar to a three-phase bone scan. The results should be validated in larger trials which directly compare ed 18 F-NaF-PET to a three-phase bone scan. (author)

  4. Harmonizing SUVs in multicentre trials when using different generation PET systems: prospective validation in non-small cell lung cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Lasnon, Charline; Quak, Elske [Francois Baclesse Cancer Centre, Nuclear Medicine Department, Caen (France); Desmonts, Cedric [Caen University Hospital, Nuclear Medicine Department, Caen (France); Gervais, Radj; Do, Pascal; Dubos-Arvis, Catherine [Francois Baclesse Cancer Centre, Thoracic Oncology, Caen (France); Aide, Nicolas [Francois Baclesse Cancer Centre, Nuclear Medicine Department, Caen (France); Centre Francois Baclesse, Service de Medecine Nucleaire, Caen cedex 5 (France)

    2013-07-15

    We prospectively evaluated whether a strategy using point spread function (PSF) reconstruction for both diagnostic and quantitative analysis in non-small cell lung cancer (NSCLC) patients meets the European Association of Nuclear Medicine (EANM) guidelines for harmonization of quantitative values. The NEMA NU-2 phantom was used to determine the optimal filter to apply to PSF-reconstructed images in order to obtain recovery coefficients (RCs) fulfilling the EANM guidelines for tumour positron emission tomography (PET) imaging (PSF{sub EANM}). PET data of 52 consecutive NSCLC patients were reconstructed with unfiltered PSF reconstruction (PSF{sub allpass}), PSF{sub EANM} and with a conventional ordered subset expectation maximization (OSEM) algorithm known to meet EANM guidelines. To mimic a situation in which a patient would undergo pre- and post-therapy PET scans on different generation PET systems, standardized uptake values (SUVs) for OSEM reconstruction were compared to SUVs for PSF{sub EANM} and PSF{sub allpass} reconstruction. Overall, in 195 lesions, Bland-Altman analysis demonstrated that the mean ratio between PSF{sub EANM} and OSEM data was 1.03 [95 % confidence interval (CI) 0.94-1.12] and 1.02 (95 % CI 0.90-1.14) for SUV{sub max} and SUV{sub mean}, respectively. No difference was noticed when analysing lesions based on their size and location or on patient body habitus and image noise. Ten patients (84 lesions) underwent two PET scans for response monitoring. Using the European Organization for Research and Treatment of Cancer (EORTC) criteria, there was an almost perfect agreement between OSEM{sub PET1}/OSEM{sub PET2} (current standard) and OSEM{sub PET1}/PSF{sub EANM-PET2} or PSF{sub EANM-PET1}/OSEM{sub PET2} with kappa values of 0.95 (95 % CI 0.91-1.00) and 0.99 (95 % CI 0.96-1.00), respectively. The use of PSF{sub allpass} either for pre- or post-treatment (i.e. OSEM{sub PET1}/PSF{sub allpass-PET2} or PSF{sub allpass-PET1}/OSEM{sub PET2}) showed

  5. The motivations and methodology for high-throughput PET imaging of small animals in cancer research.

    NARCIS (Netherlands)

    Aide, N.; Visser, E.P.; Lheureux, S.; Heutte, N.; Szanda, I.; Hicks, R.J.

    2012-01-01

    Over the last decade, small-animal PET imaging has become a vital platform technology in cancer research. With the development of molecularly targeted therapies and drug combinations requiring evaluation of different schedules, the number of animals to be imaged within a PET experiment has

  6. Partial volume effect-corrected FDG PET and grey matter volume loss in patients with mild Alzheimer's disease

    International Nuclear Information System (INIS)

    Samuraki, Miharu; Yanase, Daisuke; Yamada, Masahito; Matsunari, Ichiro; Chen, Wei-Ping; Yajima, Kazuyoshi; Fujikawa, Akihiko; Takeda, Nozomi; Nishimura, Shintaro; Matsuda, Hiroshi

    2007-01-01

    Although 18 F-fluorodeoxyglucose (FDG) PET is an established imaging technique to assess brain glucose utilisation, accurate measurement of tracer concentration is confounded by the presence of partial volume effect (PVE) due to the limited spatial resolution of PET, which is particularly true in atrophic brains such as those encountered in patients with Alzheimer's disease (AD). Our aim was to investigate the effects of PVE correction on FDG PET in conjunction with voxel-based morphometry (VBM) in patients with mild AD. Thirty-nine AD patients and 73 controls underwent FDG PET and MRI. The PVE-corrected grey matter PET images were obtained using an MRI-based three-compartment method. Additionally, the results of PET were compared with grey matter loss detected by VBM. Before PVE correction, reduced FDG uptake was observed in posterior cingulate gyri (PCG) and parieto-temporal lobes (PTL) in AD patients, which persisted after PVE correction. Notably, PVE correction revealed relatively preserved FDG uptake in hippocampal areas, despite the grey matter loss in medial temporal lobe (MTL) revealed by VBM. FDG uptake in PCG and PTL is reduced in AD regardless of whether or not PVE correction is applied, supporting the notion that the reduced FDG uptake in these areas is not the result of atrophy. Furthermore, FDG uptake by grey matter tissue in the MTL, including hippocampal areas, is relatively preserved, suggesting that compensatory mechanisms may play a role in patients with mild AD. (orig.)

  7. TOF-PET scanner configurations for quality assurance in proton therapy: a patient case study

    NARCIS (Netherlands)

    Dendooven, Peter; Diblen, Faruk; Buitenhuis, H.J.T.; Oxley, D.C.; Biegun, A.K.; van der Borden, A.J.; Brandenburg, Sijtze; Cambraia Lopes, P.; van der Schaaf, A.; Schaart, D.R.; Vandenberghe, S.; van 't Veld, A.A.

    2014-01-01

    In order to determine the clinical benefit of positron emission tomography (PET) for dose delivery verification in proton therapy, we performed a patient case study comparing in-situ with in-room time-of-flight (TOF) PET. For the in-situ option, we consider both a (limited-angle) clinical scanner

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    The study aimed at comparing PET/MR to PET/CT for imaging the carotid arteries in patients with known increased risk of atherosclerosis. Six HIV-positive men underwent sequential PET/MR and PET/CT of the carotid arteries after injection of 400 MBq of 18F-FDG. PET/MR was performed a median of 131......) indicating that the luminal 18F-FDG content had minimal influence on the values. The study shows for the first time that simultaneous PET/MR of the carotid arteries is feasible in patients with increased risk of atherosclerosis. Quantification of 18F-FDG uptake correlated well between PET/MR and PET...

  9. Comparison of PET/CT with Sequential PET/MRI Using an MR-Compatible Mobile PET System.

    Science.gov (United States)

    Nakamoto, Ryusuke; Nakamoto, Yuji; Ishimori, Takayoshi; Fushimi, Yasutaka; Kido, Aki; Togashi, Kaori

    2018-05-01

    The current study tested a newly developed flexible PET (fxPET) scanner prototype. This fxPET system involves dual arc-shaped detectors based on silicon photomultipliers that are designed to fit existing MRI devices, allowing us to obtain fused PET and MR images by sequential PET and MR scanning. This prospective study sought to evaluate the image quality, lesion detection rate, and quantitative values of fxPET in comparison with conventional whole-body (WB) PET and to assess the accuracy of registration. Methods: Seventeen patients with suspected or known malignant tumors were analyzed. Approximately 1 h after intravenous injection of 18 F-FDG, WB PET/CT was performed, followed by fxPET and MRI. For reconstruction of fxPET images, MRI-based attenuation correction was applied. The quality of fxPET images was visually assessed, and the number of detected lesions was compared between the 2 imaging methods. SUV max and maximum average SUV within a 1 cm 3 spheric volume (SUV peak ) of lesions were also compared. In addition, the magnitude of misregistration between fxPET and MR images was evaluated. Results: The image quality of fxPET was acceptable for diagnosis of malignant tumors. There was no significant difference in detectability of malignant lesions between fxPET and WB PET ( P > 0.05). However, the fxPET system did not exhibit superior performance to the WB PET system. There were strong positive correlations between the 2 imaging modalities in SUV max (ρ = 0.88) and SUV peak (ρ = 0.81). SUV max and SUV peak measured with fxPET were approximately 1.1-fold greater than measured with WB PET. The average misregistration between fxPET and MR images was 5.5 ± 3.4 mm. Conclusion: Our preliminary data indicate that running an fxPET scanner near an existing MRI system provides visually and quantitatively acceptable fused PET/MR images for diagnosis of malignant lesions. © 2018 by the Society of Nuclear Medicine and Molecular Imaging.

  10. FLT-PET for early response evaluation of colorectal cancer patients with liver metastases

    DEFF Research Database (Denmark)

    Mogensen, Marie Benzon; Loft, Annika; Aznar, Marianne

    2017-01-01

    BACKGROUND: Fluoro-L-thymidine (FLT) is a positron emission tomography/computed tomography (PET/CT) tracer which reflects proliferative activity in a cancer lesion. The main objective of this prospective explorative study was to evaluate whether FLT-PET can be used for the early evaluation...... standardised uptake values (SUVmax, SUVmean) were measured. After three cycles of chemotherapy, treatment response was assessed by CT scan based on RECIST 1.1. RESULTS: Thirty-nine consecutive patients were included of which 27 were evaluable. Dropout was mainly due to disease complications. Nineteen patients...... between the response according to RECIST and the early changes in FLT uptake measured as SUVmax(p = 0.24). CONCLUSIONS: No correlation was found between early changes in FLT uptake after the first cycle of treatment and the response evaluated from subsequent CT scans. It seems unlikely that FLT-PET can...

  11. Clinical evaluation of TOF versus non-TOF on PET artifacts in simultaneous PET/MR: a dual centre experience

    Energy Technology Data Exchange (ETDEWEB)

    Voert, Edwin E.G.W. ter [University Hospital Zurich, Department of Nuclear Medicine, Zurich (Switzerland); University of Zurich, Zurich (Switzerland); Veit-Haibach, Patrick [University Hospital Zurich, Department of Nuclear Medicine, Zurich (Switzerland); University of Zurich, Zurich (Switzerland); University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); Ahn, Sangtae [GE Global Research, Niskayuna, NY (United States); Wiesinger, Florian [GE Global Research, Muenchen (Germany); Khalighi, M.M.; Delso, Gaspar [GE Healthcare, Waukesha, WI (United States); Levin, Craig S. [Stanford University, Department of Radiology, Molecular Imaging Program at Stanford, Stanford, CA (United States); Iagaru, Andrei H. [Stanford University, Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Stanford, CA (United States); Zaharchuk, Greg [Stanford University, Department of Radiology, Neuroradiology, Stanford, CA (United States); Huellner, Martin [University Hospital Zurich, Department of Nuclear Medicine, Zurich (Switzerland); University of Zurich, Zurich (Switzerland); University Hospital Zurich, Department of Neuroradiology, Zurich (Switzerland)

    2017-07-15

    Our objective was to determine clinically the value of time-of-flight (TOF) information in reducing PET artifacts and improving PET image quality and accuracy in simultaneous TOF PET/MR scanning. A total 65 patients who underwent a comparative scan in a simultaneous TOF PET/MR scanner were included. TOF and non-TOF PET images were reconstructed, clinically examined, compared and scored. PET imaging artifacts were categorized as large or small implant-related artifacts, as dental implant-related artifacts, and as implant-unrelated artifacts. Differences in image quality, especially those related to (implant) artifacts, were assessed using a scale ranging from 0 (no artifact) to 4 (severe artifact). A total of 87 image artifacts were found and evaluated. Four patients had large and eight patients small implant-related artifacts, 27 patients had dental implants/fillings, and 48 patients had implant-unrelated artifacts. The average score was 1.14 ± 0.82 for non-TOF PET images and 0.53 ± 0.66 for TOF images (p < 0.01) indicating that artifacts were less noticeable when TOF information was included. Our study indicates that PET image artifacts are significantly mitigated with integration of TOF information in simultaneous PET/MR. The impact is predominantly seen in patients with significant artifacts due to metal implants. (orig.)

  12. Impact of 68Ga-PSMA PET on the Management of Patients with Prostate Cancer: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Han, Sangwon; Woo, Sungmin; Kim, Yeon Joo; Suh, Chong Hyun

    2018-04-18

    68 Gallium prostate-specific membrane antigen positron emission tomography ( 68 Ga-PSMA PET) is an emerging imaging modality for assessment of prostate cancer. Recent studies show promising results regarding its ability to detect recurrent or metastatic prostate cancer superior to that of conventional imaging modalities. However, the impact of 68 Ga-PSMA PET on management of patients with prostate cancer has not been well established. To perform a systematic review and meta-analysis to evaluate the impact of 68 Ga-PSMA PET on management of patients with prostate cancer. Pubmed and EMBASE databases were searched up to January 20, 2018. We included studies that reported proportion of management change after 68 Ga-PSMA PET in patients with prostate cancer. The quality of the studies was evaluated using the GRADE system. The proportion of management changes were pooled using random-effects model. Subgroup analyses and meta-regression analyses were performed to explore heterogeneity. Fifteen studies (1163 patients) were included. The pooled proportion of management changes was 54% (95% confidence interval 47-60%). At meta-regression analyses, PET positivity (%) was a significant factor of heterogeneity (p=0.0486). For patients with biochemical failure, the proportion of radiotherapy (from 56% to 61%), surgery (from 1% to 7%), focal therapy (from 1% to 2%), and multimodal treatment (from 2% to 6%) increased, whereas that of systemic treatment (from 26% to 12%) and no treatment (from 14% to 11%) decreased with 68 Ga-PSMA PET. 68 Ga-PSMA PET had a large impact on the management of patients with prostate cancer. Greater PET positivity was associated with higher proportion of management changes. We reviewed all previous studies assessing the impact of 68 Gallium prostate-specific membrane antigen positron emission tomography ( 68 Ga-PSMA PET) in patients with prostate cancer. We found that 68 Ga-PSMA PET altered the management in approximately half of the patients. Copyright

  13. Pet ownership may attenuate loneliness among older adult primary care patients who live alone.

    Science.gov (United States)

    Stanley, Ian H; Conwell, Yeates; Bowen, Connie; Van Orden, Kimberly A

    2014-01-01

    Older adults who report feelings of loneliness are at increased risk for a range of negative physical and mental health outcomes, including early mortality. Identifying potential sources of social connectedness, such as pet ownership, could add to the understanding of how to promote health and well-being in older adults. The aim of this study is to describe the association of pet ownership and loneliness. The current study utilizes cross-sectional survey data from a sample (N = 830) of older adult primary care patients (age ≥ 60 years). Pet owners were 36% less likely than non-pet owners to report loneliness, in a model controlling for age, living status (i.e., alone vs. not alone), happy mood, and seasonal residency (adjOR = 0.64, 95% CI = 0.41-0.98, p pet ownership and living status (b = -1.60, p pet was associated with the greatest odds of reporting feelings of loneliness. The findings suggest that pet ownership may confer benefits for well-being, including attenuating feelings of loneliness and its related sequelae, among older adults who live alone.

  14. [Indications and instructions to patients for a positron emission tomography-PET scan. The importance of the hybridic PET/CT-computerised tomography scan and which specialty should be responsible for its function].

    Science.gov (United States)

    Grammaticos, Philip; Datseris, Ioannis; Gerali, Sofia; Papantoniou, Vassilios; Valsamaki, Pipitsa; Boundas, Dimitrios

    2007-01-01

    Indications and instructions to patients for performing a positron emission tomography - PET scan are mentioned. Although PET camera was developed in 1970 its clinical indications were established in about 1998. The hybridic PET/CT- computerized tomography scanner appeared in 2001 and its clinical indications are still under discussion. These discussions refer to both the use of PET/CT as an acquisition correction and anatomic localization device for PET images (AC/A) and to its use as a diagnostic CT scan (dCT). Most of the patients submitted for a PET scan have already done a dCT scan. This was the case in 286 out of the first 300 patients referred to "Evangelismos" hospital in Athens for a PET scan. These two scans can be matched electronically. Extra cost, space, personnel and radiation absorption dose especially in children, are additional factors to be considered in using the PET/CT scanner. The specialty of Nuclear Medicine is now based on the PET camera, its best part and main equipment for molecular imaging. It is very much easier and faster for a Nuclear Medicine physician who routinely reports tomographic PET and SPET images, to be familiar with the CT images than for a Radiologist to get to "know how" about the PET camera and the whole Nuclear Medicine Department. Nuclear Medicine is about open radiation sources, molecular imaging, specific radio-pharmacology, radiobiology, radiation protection etc, while on the other hand in some countries, Nuclear Physicians have already spent, as part of their official training, six months in a Radiology Department whose function is considered to be at least 25% about the CT scanner. We come to the conclusion that the PET/CT scanner should be under the responsibility of the Nuclear Medicine Department and the Radiologist should act as an advisor.

  15. 18F-FDG PET/CT diagnosis of unexpected extracardiac septic embolisms in patients with suspected cardiac endocarditis

    International Nuclear Information System (INIS)

    Bonfiglioli, Rachele; Nanni, Cristina; Morigi, Joshua James; Ambrosini, Valentina; Fanti, Stefano; Graziosi, Maddalena; Rapezzi, Claudio; Trapani, Filippo; Bartoletti, Michele; Tumietto, Fabio; Viale, Pier Luigi; Ferretti, Alice; Rubello, Domenico

    2013-01-01

    Acute infective endocarditis is a potentially life-threatening disease. Its outcome strongly depends on systemic embolization and extracardiac infections. When present, these conditions usually lead to a more aggressive therapeutic approach. However, the diagnosis of peripheral septic embolism is very challenging. 18 F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has proven to be accurate for the detection of inflammatory diseases and occult infections. The aim of this study was to assess the added value of 18 F-FDG PET/CT in the detection of extracardiac embolisms in the evaluation of patients with suspected valvular endocarditis (VE). Seventy-one patients with suspected infective endocarditis, enrolled between June 2010 and December 2012, underwent 18 F-FDG PET/CT with the standard procedure on a dedicated PET/CT scanner. Extracardiac findings were subsequently evaluated with other imaging procedures. Of the 71 patients with suspicion of infective endocarditis, we found unexpected extracardiac findings in 17 patients (24 %) without any clinical suspicion. Extracardiac findings were subsequently evaluated with other imaging procedures. PET/CT detected unexpected extra sites of infection in 24 % of cases, leading to changes in therapeutic management in a very relevant percentage of patients. These findings may have important therapeutic implications. (orig.)

  16. Combined FDG PET/CT imaging for restaging of colorectal cancer patients: impact of image fusion on staging accuracy

    International Nuclear Information System (INIS)

    Strunk, H.; Jaeger, U.; Flacke, S.; Hortling, N.; Bucerius, J.; Joe, A.; Reinhardt, M.; Palmedo, H.

    2005-01-01

    Purpose: To evaluate the diagnostic impact of positron emission tomography (PET) with fluorine-18-labeled deoxy-D-glucose (FDG) combined with non-contrast computed tomography (CT) as PET-CT modality in restaging colorectal cancer patients. Material and methods: In this retrospective study, 29 consecutive patients with histologically proven colorectal cancer (17 female, 12 male, aged 51-76 years) underwent whole body scans in one session on a dual modality PET-CT system (Siemens Biograph) 90 min. after i.v. administration of 370 MBq 18 F-FDG. The CT imaging was performed with 40 mAs, 130 kV, slice-thickness 5 mm and without i.v. contrast administration. PET and CT images were reconstructed with a slice-thickness of 5 mm in coronal, sagittal and transverse planes. During a first step of analysis, PET and CT images were scored blinded and independently by a group of two nuclear medicine physicians and a group of two radiologists, respectively. For this purpose, a five-point-scale was used. The second step of data-analysis consisted of a consensus reading by both groups. During the consensus reading, first a virtual (meaning mental) fusion of PET and CT images and afterwards the 'real' fusion (meaning coregistered) PET-CT images were also scored with the same scale. The imaging results were compared with histopathology findings and the course of disease during further follow-up. Results: The total number of malignant lesions detected with the combined PET/CT were 86. For FDG-PET alone it was n=68, and for CT alone n=65. Comparing PET-CT and PET, concordance was found in 81 of 104 lesions. Discrepancies predominantly occurred in the lung, where PET alone often showed true positive results in lymph nodes and soft tissue masses, where CT often was false negative. Comparing mental fusion and 'real' co-registered images, concordance was found in 94 of 104 lesions. In 13 lesions or, respectively, in 7 of 29 patients, a relevant information was gathered using fused images

  17. Brain connectivity study of brain tumor patients using MR-PET data: preliminary results

    International Nuclear Information System (INIS)

    Mendes, Ana Carina; Ribeiro, Andre Santos; Oros-Peusquens, Ana Maria; Langen, Karl Josef; Shah, Jon; Ferreira, Hugo Alexandre

    2015-01-01

    Brain activity results from anatomical and functional connections that can be disrupted or altered due to trauma or lesion. This work presents a first approach on the study of whole-brain connectivity of brain tumor patients using the Multimodal Imaging Brain Connectivity (MIBCA) toolbox. Two patients with glioblastoma lesions located in the left hemisphere (one in the motor cortex and the other in the temporal lobe) underwent simultaneous MRI and dynamic PET scans using a 3T MRI scanner with a BrainPET insert. The following data was acquired: T1-w MPRAGE (1x1x1mm 3 ), DTI (dir=30, b=0,800s/mm2, 2x2x2mm 3 ), and dynamic 18F-FET PET. The MIBCA toolbox was used to automatically pre-process MRI-PET data and to derive imaging and connectivity metrics from the multimodal data. Computed metrics included: cortical thickness from T1-w data; mean diffusivity (MD), fractional anisotropy (FA), node degree, clustering coefficient and pairwise ROI fibre tracking (structural connectivity) from DTI data; and standardized uptake value (SUV) from PET data. For all the metrics, the differences between left and right hemispherical structures were obtained, followed by a 25% threshold (except for SUV thresholded at 15%). Data was visualized in a connectogram, and both structural connectivity and metrics were studied in regions surrounding lesions. Preliminary results showed increased SUV values in regions surrounding the tumor for both patients. Patients also showed changes in structural connectivity involving these regions and also other more spatially distant regions such as the putamen and the pallidum, including decreased number of fibers between the subcortical structures themselves and with frontal regions. These findings suggest that the presence of a tumor may alter both local and more distant structural connections. Presently, a larger patient sample is being studied along with the inclusion of a control group to test the consistency of the findings.

  18. Brain connectivity study of brain tumor patients using MR-PET data: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Mendes, Ana Carina [Institute of Biophysics and Biomedical Engineering, Faculty of Sciences of the University of Lisbon (Portugal); Ribeiro, Andre Santos [Institute of Biophysics and Biomedical Engineering, Faculty of Sciences of the University of Lisbon (Portugal); Centre for Neuropsychopharmacology, Division of Brain Sciences, Department of Medicine, Imperial College London, London (United Kingdom); Oros-Peusquens, Ana Maria; Langen, Karl Josef; Shah, Jon [Institute of Neuroscience and Medicine - 4, Forschungszentrum Juelich (Germany); Ferreira, Hugo Alexandre [Institute of Biophysics and Biomedical Engineering, Faculty of Sciences of the University of Lisbon (Portugal)

    2015-05-18

    Brain activity results from anatomical and functional connections that can be disrupted or altered due to trauma or lesion. This work presents a first approach on the study of whole-brain connectivity of brain tumor patients using the Multimodal Imaging Brain Connectivity (MIBCA) toolbox. Two patients with glioblastoma lesions located in the left hemisphere (one in the motor cortex and the other in the temporal lobe) underwent simultaneous MRI and dynamic PET scans using a 3T MRI scanner with a BrainPET insert. The following data was acquired: T1-w MPRAGE (1x1x1mm{sup 3}), DTI (dir=30, b=0,800s/mm2, 2x2x2mm{sup 3}), and dynamic 18F-FET PET. The MIBCA toolbox was used to automatically pre-process MRI-PET data and to derive imaging and connectivity metrics from the multimodal data. Computed metrics included: cortical thickness from T1-w data; mean diffusivity (MD), fractional anisotropy (FA), node degree, clustering coefficient and pairwise ROI fibre tracking (structural connectivity) from DTI data; and standardized uptake value (SUV) from PET data. For all the metrics, the differences between left and right hemispherical structures were obtained, followed by a 25% threshold (except for SUV thresholded at 15%). Data was visualized in a connectogram, and both structural connectivity and metrics were studied in regions surrounding lesions. Preliminary results showed increased SUV values in regions surrounding the tumor for both patients. Patients also showed changes in structural connectivity involving these regions and also other more spatially distant regions such as the putamen and the pallidum, including decreased number of fibers between the subcortical structures themselves and with frontal regions. These findings suggest that the presence of a tumor may alter both local and more distant structural connections. Presently, a larger patient sample is being studied along with the inclusion of a control group to test the consistency of the findings.

  19. FDG-PET-Detected Extracranial Metastasis in Patients with Non-Small Cell Lung Cancer Undergoing Staging for Surgery or Radical Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Macmanus, Michael P.; Hicks, Rodney; Fisher, Richard; Rischin, Danny; Michael, Michael; Wirth, Andrew; Ball, David L. [Peter MacCallum Cancer Inst., Melbourne (Australia). Dept. of Radiation Oncology

    2003-03-01

    The prognostic significance of extracranial distant metastasis detected by positron emission tomography (PET) was investigated in patients with non-small cell lung cancer (NSCLC). Forty-two patients staged with 18F-fluorodeoxyglucose-PET-detected distant metastasis before planned surgery (n=7) or radical radiotherapy (RT)/chemoradiotherapy (n=35) for NSCLC were identified from a prospective database. The influence of metastasis number and other prognostic factors was investigated using Cox's regression analysis. Treatment after PET included surgery (n=2), radical RT (n =5), palliative RT (n=25), chemotherapy (n=8) or supportive care (n=2). All but 4 patients had died by the last follow-up. Median survival was 9 months overall, 12 months for 27 patients with single PET-detected metastasis and 5 months for 15 patients with >1 metastasis (p=0.009). It was found that the Eastern Cooperative Oncology Group performance status (p=0.027) but not pre-PET stage, weight loss or metastasis site correlated with survival. PET-detected metastatic tumor burden appeared to influence survival and should be evaluated as a prognostic factor in NSCLC.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-06-15

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

  1. Optimization of Acquisition time of 68Ga-PSMA-Ligand PET/MRI in Patients with Local and Metastatic Prostate Cancer.

    Science.gov (United States)

    Lütje, Susanne; Blex, Sebastian; Gomez, Benedikt; Schaarschmidt, Benedikt M; Umutlu, Lale; Forsting, Michael; Jentzen, Walter; Bockisch, Andreas; Poeppel, Thorsten D; Wetter, Axel

    2016-01-01

    The aim of this optimization study was to minimize the acquisition time of 68Ga-HBED-CC-PSMA positron emission tomography/magnetic resonance imaging (PET/MRI) in patients with local and metastatic prostate cancer (PCa) to obtain a sufficient image quality and quantification accuracy without any appreciable loss. Twenty patients with PCa were administered intravenously with the 68Ga-HBED-CC-PSMA ligand (mean activity 99 MBq/patient, range 76-148 MBq) and subsequently underwent PET/MRI at, on average, 168 min (range 77-320 min) after injection. PET and MR imaging data were acquired simultaneously. PET acquisition was performed in list mode and PET images were reconstructed at different time intervals (1, 2, 4, 6, 8, and 10 min). Data were analyzed regarding radiotracer uptake in tumors and muscle tissue and PET image quality. Tumor uptake was quantified in terms of the maximum and mean standardized uptake value (SUVmax, SUVmean) within a spherical volume of interest (VOI). Reference VOIs were drawn in the gluteus maximus muscle on the right side. PET image quality was evaluated by experienced nuclear physicians/radiologists using a five-point ordinal scale from 5-1 (excellent-insufficient). Lesion detectability linearly increased with increasing acquisition times, reaching its maximum at PET acquisition times of 4 min. At this image acquisition time, tumor lesions in 19/20 (95%) patients were detected. PET image quality showed a positive correlation with increasing acquisition time, reaching a plateau at 4-6 min image acquisition. Both SUVmax and SUVmean correlated inversely with acquisition time and reached a plateau at acquisition times after 4 min. In the applied image acquisition settings, the optimal acquisition time of 68Ga-PSMA-ligand PET/MRI in patients with local and metastatic PCa was identified to be 4 min per bed position. At this acquisition time, PET image quality and lesion detectability reach a maximum while SUVmax and SUVmean do not change

  2. Optimization of Acquisition time of 68Ga-PSMA-Ligand PET/MRI in Patients with Local and Metastatic Prostate Cancer.

    Directory of Open Access Journals (Sweden)

    Susanne Lütje

    Full Text Available The aim of this optimization study was to minimize the acquisition time of 68Ga-HBED-CC-PSMA positron emission tomography/magnetic resonance imaging (PET/MRI in patients with local and metastatic prostate cancer (PCa to obtain a sufficient image quality and quantification accuracy without any appreciable loss.Twenty patients with PCa were administered intravenously with the 68Ga-HBED-CC-PSMA ligand (mean activity 99 MBq/patient, range 76-148 MBq and subsequently underwent PET/MRI at, on average, 168 min (range 77-320 min after injection. PET and MR imaging data were acquired simultaneously. PET acquisition was performed in list mode and PET images were reconstructed at different time intervals (1, 2, 4, 6, 8, and 10 min. Data were analyzed regarding radiotracer uptake in tumors and muscle tissue and PET image quality. Tumor uptake was quantified in terms of the maximum and mean standardized uptake value (SUVmax, SUVmean within a spherical volume of interest (VOI. Reference VOIs were drawn in the gluteus maximus muscle on the right side. PET image quality was evaluated by experienced nuclear physicians/radiologists using a five-point ordinal scale from 5-1 (excellent-insufficient.Lesion detectability linearly increased with increasing acquisition times, reaching its maximum at PET acquisition times of 4 min. At this image acquisition time, tumor lesions in 19/20 (95% patients were detected. PET image quality showed a positive correlation with increasing acquisition time, reaching a plateau at 4-6 min image acquisition. Both SUVmax and SUVmean correlated inversely with acquisition time and reached a plateau at acquisition times after 4 min.In the applied image acquisition settings, the optimal acquisition time of 68Ga-PSMA-ligand PET/MRI in patients with local and metastatic PCa was identified to be 4 min per bed position. At this acquisition time, PET image quality and lesion detectability reach a maximum while SUVmax and SUVmean do not change

  3. Application study of SPM5 in analysis of PET imaging for epilepsy patient

    International Nuclear Information System (INIS)

    Ning Yanli; Jin Jianhua; Zhang Hong; Tian Mei; Yao Qiong; Li Jing; Zhan Hongwei; Zhao Chunlei; Xu Wei; Ye Xiaojuan

    2009-01-01

    Objective: To investigate the value of statistical parametric mapping 5 (SPM5) and its parameter settings in analysis of PET imaging for epilepsy patients. Methods: Seventeen epilepsy patients and seventeen controls were scanned with PET. The datas were analyzed using PET and SPM5 with qualitative and semiquantitative analysis, statistical analysis of the percentage (numbers of agent distribution decreasing in focus to brain) for different parameters combinations, which were value adjustment to contral-p and voxels-k. Results: There was decreasing of agent distribution at temporal lobe in epilepsy patients detecting with PET; the T/NT of focus to cerebellum was 1.07±0.24, the T/NT of normal tissue in opposite side to cerebellum was 1.27±0.18, there was a significant difference (t=1.87, P 0.05); for different value of p, the percentage was (42±30)%, (29±25)%, (26±21)% respectively, with a significant difference (F=3.60, P<0.05); there was linear regression in value adjustment to contral-p and the percentage(b=-18.24, t=2.57, P<0.05). Conclusions: Semiquantitative analysis by SPM5, the setting of value adjustment to contral-p would affect the results, the smaller of value adjustment to contral-p, the better of the result. SPM5 would be more objective and accurate to locate the focuses. (authors)

  4. Prospective evaluation of 18F-FACBC PET/CT and PET/MRI versus multiparametric MRI in intermediate- to high-risk prostate cancer patients (FLUCIPRO trial).

    Science.gov (United States)

    Jambor, Ivan; Kuisma, Anna; Kähkönen, Esa; Kemppainen, Jukka; Merisaari, Harri; Eskola, Olli; Teuho, Jarmo; Perez, Ileana Montoya; Pesola, Marko; Aronen, Hannu J; Boström, Peter J; Taimen, Pekka; Minn, Heikki

    2018-03-01

    The purpose of this study was to evaluate 18 F-FACBC PET/CT, PET/MRI, and multiparametric MRI (mpMRI) in detection of primary prostate cancer (PCa). Twenty-six men with histologically confirmed PCa underwent PET/CT immediately after injection of 369 ± 10 MBq 18 F-FACBC (fluciclovine) followed by PET/MRI started 55 ± 7 min from injection. Maximum standardized uptake values (SUV max ) were measured for both hybrid PET acquisitions. A separate mpMRI was acquired within a week of the PET scans. Logan plots were used to calculate volume of distribution (V T ). The presence of PCa was estimated in 12 regions with radical prostatectomy findings as ground truth. For each imaging modality, area under the curve (AUC) for detection of PCa was determined to predict diagnostic performance. The clinical trial registration number is NCT02002455. In the visual analysis, 164/312 (53%) regions contained PCa, and 41 tumor foci were identified. PET/CT demonstrated the highest sensitivity at 87% while its specificity was low at 56%. The AUC of both PET/MRI and mpMRI significantly (p PET/CT while no differences were detected between PET/MRI and mpMRI. SUV max and V T of Gleason score (GS) >3 + 4 tumors were significantly (p PET/CT and PET/MRI demonstrated true-positive findings in only 1/7 patients with metastatic lymph nodes. Quantitative 18 F-FACBC imaging significantly correlated with GS but failed to outperform MRI in lesion detection. 18 F-FACBC may assist in targeted biopsies in the setting of hybrid imaging with MRI.

  5. DosedPet application for Nuclear Medicine: Calculation of the volume of medication needed for PET/CT patient; Aplicativo DosedPet para uso em Medicina Nuclear: calculo do volume de medicamento necessario para paciente de PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Nascimento, Pedro Augusto do; Rodrigues, Araken dos S. Werneck, E-mail: pedroan88@gmail.com [Universidade de Brasilia (UnB), DF (Brazil). Programa de Pos Graduacao em Ciencias e Tecnologias em Saude

    2016-07-01

    This paper presents the application (APP) DosePet that calculates the amount of medicament for PET / CT in patients according to the predetermined radiation dose. The software has been designed using the web MIT App Inventor2 tool for Android platform. The application allows the workers to simulate the amount of radiation still existing in the facilities after the applications, increasing security and reducing exposures, and enable greater efficiency in the use of the radiopharmaceutical. (author)

  6. Florbetapir F18 PET Amyloid Neuroimaging and Characteristics in Patients With Mild and Moderate Alzheimer Dementia.

    Science.gov (United States)

    Degenhardt, Elisabeth K; Witte, Michael M; Case, Michael G; Yu, Peng; Henley, David B; Hochstetler, Helen M; D'Souza, Deborah N; Trzepacz, Paula T

    2016-01-01

    Clinical diagnosis of Alzheimer disease (AD) is challenging, with a 70.9%-87.3% sensitivity and 44.3%-70.8% specificity, compared with autopsy diagnosis. Florbetapir F18 positron emission tomography (FBP-PET) estimates beta-amyloid plaque density antemortem. Of 2052 patients (≥55 years old) clinically diagnosed with mild or moderate AD dementia from 2 solanezumab clinical trials, 390 opted to participate in a FBP-PET study addendum. We analyzed baseline prerandomization characteristics. A total of 22.4% had negative FBP-PET scans, whereas 72.5% of mild and 86.9% of moderate AD patients had positive results. No baseline clinical variable reliably differentiated negative from positive FBP-PET scan groups. These data confirm the challenges of correctly diagnosing AD without using biomarkers. FBP-PET can aid AD dementia differential diagnosis by detecting amyloid pathology antemortem, even when the diagnosis of AD is made by expert clinicians. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  7. Time-motion analysis of factors affecting patient throughput in an MR imaging center

    International Nuclear Information System (INIS)

    O'Donohue, J.; Enzmann, D.R.

    1986-01-01

    The high cost of MR imaging makes efficient use essential. In an effort to increase patient throughput, attention has been focused on shortening the imaging time through reductions in matrix size and number of excitations, and through the use of newer ''fast imaging'' techniques. Less attention has been given to other time-consuming aspects not directly related to imaging time. The authors undertook a time-motion study using a daily log of minute-by-minute activities associated with an MR imaging examination. The times required for the following components of the examination were measured: total study time, examination set-up time, intrastudy physician ''image review'' time, and interstudy patient turnover time. The time lost to claustrophobic reactions, patients' failure to appear for scheduled examinations, unanticipated patient care (sedation, reassurance), and equipment malfunction was also analyzed. Actual imaging time accounted for a relatively small proportion (42%) of total study time. Other factors such as intrastudy image review time (15%), interstudy patient turnover time (11%), and time lost due to claustrophobic reactions, patients' failure to appear for scheduled examinations, and equipment malfunction contributed significantly to the total study time. Simple solutions to these problems can contribute greatly to increasing patient throughput

  8. The Utility and indication of FDG-PET scan in patients with cervical cancer: experience in patients with no evidence of recurrence with conventional radiologic examination and tumor markers

    International Nuclear Information System (INIS)

    Kim, Jong Hoon

    2000-12-01

    The purpose of this study was to investigate the clinical feasibility of FDG-PET(Positron Emission Tomography) scan in patients with clinically no evidence of disease after treatment of cervical cancer. One hundred and one patients with clinically NED(no evidence of disease) state after treatment of cervical cancer underwent PET scan. FDG-PET scan was obtained with a GE Advance Scanner, beginning at 50 minutes after injection of 370-555 MBq(10-15 mCi) of 18F FDG. Regional scan was also obtained with emission image. Uptake exceeding 3.0 SUV was determined as a positive finding. Recurrence was confirmed by CT, MRI, and needle biopsy if possible. Among 101 patients showing no evidence of disease, 17 patients(16.8%) showed abnormal PET scan findings. Clinically, 8 patients(7.9%) were confirmed to have recurrent lesion by CT, MRI or by needle biopsy. PET scan could detect recurrent lesions in the mediastinum or lung(10/17), pelvis(7/17), and supraclavicular lymph node(2/17). The sensitivity and specificity of PET scan in patients with cervical cancer showing no evidence of disease were 100% and 90.3%, respectively. The positive predictive value, negative predictive value and false positive rate were 47.1%, 100% and 52.9%. PET scan could detect 7.9% of early recurrence in patients with cervical cancer with NED status. FDG-PET scan may be a useful method in detecting metastases or recurrence of a cervical cancer showing no evidence of disease by routine conventional imaging studies

  9. Clinical impact of PET/CT imaging after adjuvant therapy in patients with oral cavity squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Huan-Chun [Chang Gung Memorial Hospital and Chang Gung University, Department of Nuclear Medicine and Molecular Imaging Center, Taoyuan (China); Kang, Chung-Jan; Huang, Shiang-Fu; Liao, Chun-Ta [Chang Gung Memorial Hospital and Chang Gung University, Department of Otorhinolaryngology, Head and Neck Surgery, Taoyuan (China); Wang, Hung-Ming [Chang Gung Memorial Hospital and Chang Gung University, Department of Medical Oncology, Taoyuan (China); Lin, Chien-Yu [Chang Gung Memorial Hospital and Chang Gung University, Department of Radiation Oncology, Taoyuan (China); Lee, Li-Yu [Chang Gung Memorial Hospital and Chang Gung University, Department of Pathology, Taoyuan (China); Yen, Tzu-Chen [Chang Gung Memorial Hospital and Chang Gung University, Department of Nuclear Medicine and Molecular Imaging Center, Taoyuan (China); Chang Gung Memorial Hospital at Linkou, Department of Nuclear Medicine, Taoyuan (China)

    2017-09-15

    This single-center retrospective study of prospectively collected data was aimed at comparing the clinical outcomes of positron emission tomography/computed tomography (PET/CT) for patients with oral cavity squamous cell carcinoma (OSCC) with symptomatic recurrences identified by PET/CT imaging following adjuvant therapy (Group A) versus those of cases with asymptomatic recurrences diagnosed through periodic post-adjuvant therapy PET/CT surveillance (Group B). We also sought to establish the priority of salvage therapy in the two study groups. We identified 111 patients with advanced resected OSCC who developed recurrences following adjuvant therapy (51 in Group A and 60 in Group B). Histopathology served as the gold standard for recurrent lesions. The impact of post-adjuvant therapy PET/CT surveillance was examined with Kaplan-Meier curves and Cox proportional hazards regression models. The 2-year DSS and OS rates were marginally or significantly higher in Group B than in Group A (P = 0.073 and P = 0.025, respectively). Time-dependent ROC curve analysis demonstrated that the optimal cutoff values for time to positive PET/CT findings in relation to OS were 12 months for Group A and 9 months for Group B, respectively. Independent risk factors identified in multivariate analyses were used to devise two prognostic scoring systems for 2-year DSS and OS in each study group (all P < 0.001). Scheduled periodic PET/CT surveillance is a valuable tool for early detection of recurrent lesion(s) in asymptomatic OSCC patients who bear risk factors for disease recurrence. The presence of clinical symptoms and a short time to positive PET/CT findings were adverse prognostic factors for clinical outcome in patients with advanced OSCC. The priority of salvage therapy is discussed in each patient subgroup according to the devised prognostic scoring systems. (orig.)

  10. The impact of time between staging PET/CT and definitive chemo-radiation on target volumes and survival in patients with non-small cell lung cancer

    International Nuclear Information System (INIS)

    Everitt, Sarah; Plumridge, Nikki; Herschtal, Alan; Bressel, Mathias; Ball, David; Callahan, Jason; Kron, Tomas; Schneider-Kolsky, Michal; Binns, David; Hicks, Rodney J.

    2013-01-01

    Background and purpose: To investigate the impact of treatment delays on radiation therapy (RT) target volumes and overall survival (OS) in patients with non-small cell lung cancer (NSCLC) who underwent two baseline FDG PET/CT scans. Material and methods: Patients underwent a staging (PET1) and RT planning (PET2) FDG PET/CT scan. At PET1 all patients were eligible for radical chemo-RT. OS and progression-free survival (PFS) were compared for patients remaining eligible for radical RT and those treated palliatively because PET2 showed progression. RT target volumes were contoured using PET1 and PET2. Normal tissue doses were compared for patients remaining eligible for radical RT. Results: Eighty-two patients underwent PET2 scans between October 2004 and February 2007. Of these, 21 had a prior PET1 scan, median 23 days apart (range 8–176 days). Six patients (29%) were unsuitable for radical RT after PET2; five received palliative treatment and one received no treatment. Patients treated palliatively had significantly worse OS and PFS than patients treated radically p < 0.001. Mean RT tumour volume increased from 105cc to 198cc (p < 0.005) between scans. Conclusions: Disease progression while awaiting initiation of curative RT in NSCLC is associated with larger treatment volumes and worse survival

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

    Science.gov (United States)

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

    2015-02-01

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

  12. FDG PET/CT criteria for diagnosing mediastinal lymph node metastasis in patients with non-small cell lung cancer

    International Nuclear Information System (INIS)

    Cho, Y. S.; Choi, J. Y.; Lee, K. S.; Kwon, O. J.; Sim, Y. M.; Lee, S. J.; Hyun, S. H.; Lee, J. Y.; Lee, K. H.; Kim, B. T.

    2007-01-01

    We investigated the most accurate FDG PET/CT criteria using various PET and CT parameters for diagnosing metastatic mediastinal lymph nodes in patients with untreated NSCLC. Subjects were 178 consecutive patients with NSCLC undergoing PET/CT and surgical nodal staging. Diagnostic criteria of PET/CT for involvement of each mediastinal nodal station were max. SUV (mSUV), average SUV (aSUV), max. CT Hounsfield unit (mHU), average CT Hounsfield unit (aHU), and 5-point visual grading for CT attenuation; normal, suspicious/definite high attenuation (HA), partial/definite calcification (CAL). ROC curve analysis was done to assess the performance of each PET/CT criterion for detection of metastatic mediastinal nodal station. Of the pathologically examined 649 mediastinal nodal stations, 50 stations in 39 patients were proven to be malignant. The areas under curve (AUC) of ROC analysis for each criteria were 0.8882 (mSUV), 0.8875 (aSUV), 0.5668 (mHU), 0.5468 (aHU), and 0.4369 (VA), respectively. There were no malignant lymph nodes with increased FDG uptake having mHU > 120, aHU > 90, visually definite HA, or CAL. Using the benign criteria of mHU > 120, the AUCs of PET were significantly improved to 0.9233 (mSUV) and 0.9080 (aSUV), respectively (p 90, the AUCs of PET were improved to 0.8991 (mSUV, p 0.05), respectively. Using the benign criteria of visually definite HA or CAL, the AUCs of PET were significantly improved to 0.9094 (mSUV) and 0.9091 (aSUV), respectively (p 120, and visually definite HA or CAL can be used as PET/CT diagnostic criteria suggesting benign mediastinal lymph nodes in patients with NSCLC, irrespective of FDG uptake

  13. An update on the role of PET/CT and PET/MRI in ovarian cancer

    International Nuclear Information System (INIS)

    Khiewvan, Benjapa; Torigian, Drew A.; Emamzadehfard, Sahra; Paydary, Koosha; Salavati, Ali; Houshmand, Sina; Werner, Thomas J.; Alavi, Abass

    2017-01-01

    This review article summarizes the role of PET/CT and PET/MRI in ovarian cancer. With regard to the diagnosis of ovarian cancer, the presence of FDG uptake within the ovary of a postmenopausal woman raises the concern for ovarian cancer. Multiple studies show that FDG PET/CT can detect lymph node and distant metastasis in ovarian cancer with high accuracy and may, therefore, alter the management to obtain better clinical outcomes. Although PET/CT staging is superior for N and M staging of ovarian cancer, its role is limited for T staging. Additionally, FDG PET/CT is of great benefit in evaluating treatment response and has prognostic value in patients with ovarian cancer. FDG PET/CT also has value to detect recurrent disease, particularly in patients with elevated serum CA-125 levels and negative or inconclusive conventional imaging test results. PET/MRI may beneficial for tumor staging because MRI has higher soft tissue contrast and no ionizing radiation exposure compared to CT. Some non-FDG PET radiotracers such as 18 F-fluorothymidine (FLT) or 11 C-methionine (MET) have been studied in preclinical and clinical studies as well and may play a role in the evaluation of patients with ovarian cancer. (orig.)

  14. An update on the role of PET/CT and PET/MRI in ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Khiewvan, Benjapa [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Mahidol University, Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Siriraj Hospital, Bangkok (Thailand); Torigian, Drew A.; Emamzadehfard, Sahra; Paydary, Koosha; Salavati, Ali; Houshmand, Sina; Werner, Thomas J.; Alavi, Abass [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States)

    2017-06-15

    This review article summarizes the role of PET/CT and PET/MRI in ovarian cancer. With regard to the diagnosis of ovarian cancer, the presence of FDG uptake within the ovary of a postmenopausal woman raises the concern for ovarian cancer. Multiple studies show that FDG PET/CT can detect lymph node and distant metastasis in ovarian cancer with high accuracy and may, therefore, alter the management to obtain better clinical outcomes. Although PET/CT staging is superior for N and M staging of ovarian cancer, its role is limited for T staging. Additionally, FDG PET/CT is of great benefit in evaluating treatment response and has prognostic value in patients with ovarian cancer. FDG PET/CT also has value to detect recurrent disease, particularly in patients with elevated serum CA-125 levels and negative or inconclusive conventional imaging test results. PET/MRI may beneficial for tumor staging because MRI has higher soft tissue contrast and no ionizing radiation exposure compared to CT. Some non-FDG PET radiotracers such as {sup 18}F-fluorothymidine (FLT) or {sup 11}C-methionine (MET) have been studied in preclinical and clinical studies as well and may play a role in the evaluation of patients with ovarian cancer. (orig.)

  15. Blood group genotyping: from patient to high-throughput donor screening.

    Science.gov (United States)

    Veldhuisen, B; van der Schoot, C E; de Haas, M

    2009-10-01

    Blood group antigens, present on the cell membrane of red blood cells and platelets, can be defined either serologically or predicted based on the genotypes of genes encoding for blood group antigens. At present, the molecular basis of many antigens of the 30 blood group systems and 17 human platelet antigens is known. In many laboratories, blood group genotyping assays are routinely used for diagnostics in cases where patient red cells cannot be used for serological typing due to the presence of auto-antibodies or after recent transfusions. In addition, DNA genotyping is used to support (un)-expected serological findings. Fetal genotyping is routinely performed when there is a risk of alloimmune-mediated red cell or platelet destruction. In case of patient blood group antigen typing, it is important that a genotyping result is quickly available to support the selection of donor blood, and high-throughput of the genotyping method is not a prerequisite. In addition, genotyping of blood donors will be extremely useful to obtain donor blood with rare phenotypes, for example lacking a high-frequency antigen, and to obtain a fully typed donor database to be used for a better matching between recipient and donor to prevent adverse transfusion reactions. Serological typing of large cohorts of donors is a labour-intensive and expensive exercise and hampered by the lack of sufficient amounts of approved typing reagents for all blood group systems of interest. Currently, high-throughput genotyping based on DNA micro-arrays is a very feasible method to obtain a large pool of well-typed blood donors. Several systems for high-throughput blood group genotyping are developed and will be discussed in this review.

  16. Next generation PET data acquisition architectures

    Science.gov (United States)

    Jones, W. F.; Reed, J. H.; Everman, J. L.; Young, J. W.; Seese, R. D.

    1997-06-01

    New architectures for higher performance data acquisition in PET are proposed. Improvements are demanded primarily by three areas of advancing PET state of the art. First, larger detector arrays such as the Hammersmith ECAT/sup (R/) EXACT HR/sup ++/ exceed the addressing capacity of 32 bit coincidence event words. Second, better scintillators (LSO) make depth-of interaction (DOI) and time-of-flight (TOF) operation more practical. Third, fully optimized single photon attenuation correction requires higher rates of data collection. New technologies which enable the proposed third generation Real Time Sorter (RTS III) include: (1) 80 Mbyte/sec Fibre Channel RAID disk systems, (2) PowerPC on both VMEbus and PCI Local bus, and (3) quadruple interleaved DRAM controller designs. Data acquisition flexibility is enhanced through a wider 64 bit coincidence event word. PET methodology support includes DOI (6 bits), TOF (6 bits), multiple energy windows (6 bits), 512/spl times/512 sinogram indexes (18 bits), and 256 crystal rings (16 bits). Throughput of 10 M events/sec is expected for list-mode data collection as well as both on-line and replay histogramming. Fully efficient list-mode storage for each PET application is provided by real-time bit packing of only the active event word bits. Real-time circuits provide DOI rebinning.

  17. Next generation PET data acquisition architectures

    International Nuclear Information System (INIS)

    Jones, W.F.; Reed, J.H.; Everman, J.L.

    1996-01-01

    New architectures for higher performance data acquisition in PET are proposed. Improvements are demanded primarily by three areas of advancing PET state of the art. First, larger detector arrays such as the Hammersmith ECAT reg-sign EXACT HR ++ exceed the addressing capacity of 32 bit coincidence event words. Second, better scintillators (LSO) make depth-of-interaction (DOI) and time-of-flight (TOF) operation more practical. Third, fully optimized single photon attenuation correction requires higher rates of data collection. New technologies which enable the proposed third generation Real Time Sorter (RTS III) include: (1) 80 M byte/sec Fibre Channel RAID disk systems, (2) PowerPC on both VMEbus and PCI Local bus, and (3) quadruple interleaved DRAM controller designs. Data acquisition flexibility is enhanced through a wider 64 bit coincidence event word. PET methodology support includes DOI (6 bits), TOF (6 bits), multiple energy windows (6 bits), 512 x 512 sinogram indexes (18 bits), and 256 crystal rings (16 bits). Throughput of 10 M events/sec is expected for list-mode data collection as well as both on-line and replay histogramming. Fully efficient list-mode storage for each PET application is provided by real-time bit packing of only the active event word bits. Real-time circuits provide DOI rebinning

  18. Post-therapy surveillance of patients with uterine cancers: value of integrated FDG PET/CT in the detection of recurrence

    International Nuclear Information System (INIS)

    Sironi, Sandro; Picchio, Maria; Bettinardi, Valentino; Landoni, Claudio; Galimberti, Stefania; Signorelli, Mauro; Perego, Patrizia; Mangioni, Costantino; Messa, Cristina; Fazio, Ferruccio

    2007-01-01

    The purpose of this study was to prospectively determine the diagnostic accuracy of PET/CT in the detection of recurrence in patients with treated uterine cancers. Twenty-five women, ranging in age from 37 to 79 years (mean 58.9 years), who underwent primary surgical treatment for either a cervical or an endometrial cancer met the inclusion criterion of the study, which was suspicion of recurrence based on results of routine follow-up procedures. PET/CT was performed after administration of 18 F-fluorodeoxyglucose (FDG); two readers interpreted the images in consensus. Histopathological findings or correlation with results of subsequent clinical and imaging follow-up examinations served as the reference standard. Diagnostic accuracy of PET/CT was reported in terms of the proportion of correctly classified patients and lesion sites. Tumour recurrence was found at histopathological analysis or follow-up examinations after PET/CT in 14 (56%) of the 25 patients. Patient-based sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT for detection of tumour recurrence were 92.9%, 100.0%, 100.0%, 91.7% and 96.0%, respectively. Lesion site-based sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT were 94.7%, 99.5%, 94.7%, 99.5% and 99.0%, respectively. This preliminary study shows that PET/CT may be an accurate method for the evaluation of recurrence in patients who have been treated for uterine cancers and are undergoing follow-up. (orig.)

  19. 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.)

  20. Value of PET and PET-CT for monitoring tumor therapy

    International Nuclear Information System (INIS)

    Chen Xiang; Zhao Jinhua

    2007-01-01

    18 F-fluorodeoxyglucose ( 18 F-FDG) PET or PET-CT is an accurate test for differentiating residual viable tumor tissue from therapy-induced changes in tumor. Furthermore, quantitative assessment of therapy-induced changes in tumor 18 F-FDG uptake may allow the prediction of tumor response. Treatment may be adjusted according to tumor response. So it is increasingly used to monitor tumor response in patients undergoing chemotherapy and chemoradiotherapy. Here we focused on practical aspects of 18 F-FDG PET or PET-CT for treatment monitoring and on the existing advantages and challenges. (authors)

  1. FDG-PET of patients with suspected renal failure. Standardized uptake values in normal tissues

    International Nuclear Information System (INIS)

    Minamimoto, Ryogo; Takahashi, Nobukazu; Inoue, Tomio

    2007-01-01

    This study aims to clarify the effect of renal function on 2-[ 18 F] fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) imaging and determine the clinical significance of renal function in this setting. We compared FDG distribution between normal volunteers and patients with suspected renal failure. Twenty healthy volunteers and 20 patients with suspected renal failure who underwent FDG-PET between November 2002 and May 2005 were selected for this study. We define ''patients with suspected renal failure'' as having a blood serum creatinine level in excess of 1.1 mg/dl. The serum creatinine level was examined once in 2 weeks of the FDG-PET study. Regions of interest were placed over 15 regions for semi-quantitative analysis: the white matter, cortex, both upper lung fields, both middle lung fields, both lower lung fields, mediastinum, myocardium of the left ventricle, the left atrium as a cardiac blood pool, central region of the right lobe of the liver, left kidney, and both femoris muscles. The mean standardized uptake values (SUVs) of brain cortex and white matter were higher in healthy volunteers than in renal patients. The mean SUVs of the mediastinum at the level of the aortic arch and left atrium as a cardiac blood pool were lower in healthy volunteers than in patients with suspected renal failure. These regions differed between healthy volunteers and patients with suspected renal failure (P<0.05). We found decreasing brain accumulation and increasing blood pool accumulation of FDG in patients with high plasma creatinine. Although the difference is small, this phenomenon will not have a huge effect on the assessment of FDG-PET imaging in patients with suspected renal failure. (author)

  2. 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

  3. Imaging of hypoxia with 18F-FAZA PET in patients with locally advanced non-small cell lung cancer treated with definitive chemoradiotherapy

    International Nuclear Information System (INIS)

    Trinkaus, Mateya E.; Rischin, Danny; Blum, Rob

    2013-01-01

    For many cancers, tumour hypoxia is an adverse prognostic factor, and increases chemoradiation resistance; its importance in non-small cell lung cancer (NSCLC) is unproven. This study evaluated tumoural hypoxia using fluoroazomycin arabinoside ( 18 F-FAZA) positron emission tomography (PET) scans among patients with locoregionally advanced NSCLC treated with definitive chemoradiation. Patients with stage IIIA-IIIB NSCLC underwent 18 F-FAZA PET scans and 18 F-2-deoxyglucose (FDG)-PET scans within 4 weeks of commencing and 8 weeks following conventionally-fractionated concurrent platinum-based chemoradiation (60Gy). Intra-lesional hypoxic volumes of the primary and nodal masses were compared with FDG-PET metabolic volumes. Baseline tumoural hypoxia was correlated with disease free survival (DFS). Seventeen patients underwent pre-treatment 18 F-FAZA PET and FDG-PET scans. Intra-lesional hypoxia was identified on 11 scans (65%). Baseline lesional hypoxic volumes were consistently smaller than FDG-PET volumes (P=0.012). There was no statistical difference between the mean FDG-PET volumes in patients with or without baseline hypoxia (P=0.38). Eight patients with baseline hypoxia had post treatment 18 F-FAZA scans and 6 of these (75%) had resolution of imageable hypoxia following chemoradiation. The DFS was not significantly different between the hypoxic or non-hypoxic groups (median 0.8 years and 1.3 years respectively, P=0.42). Intra-lesional hypoxia, as detected by 18 F-FAZA PET, was present in 65% of patients with locally-advanced NSCLC and resolved in the majority of patients following chemoradiation. Larger studies are required to evaluate the prognostic significance of the presence and resolution of hypoxia assessed by PET in NSCLC.

  4. Radiotherapy volume delineation using 18F-FDG-PET/CT modifies gross node volume in patients with oesophageal cancer.

    Science.gov (United States)

    Jimenez-Jimenez, E; Mateos, P; Aymar, N; Roncero, R; Ortiz, I; Gimenez, M; Pardo, J; Salinas, J; Sabater, S

    2018-05-02

    Evidence supporting the use of 18F-FDG-PET/CT in the segmentation process of oesophageal cancer for radiotherapy planning is limited. Our aim was to compare the volumes and tumour lengths defined by fused PET/CT vs. CT simulation. Twenty-nine patients were analyzed. All patients underwent a single PET/CT simulation scan. Two separate GTVs were defined: one based on CT data alone and another based on fused PET/CT data. Volume sizes for both data sets were compared and the spatial overlap was assessed by the Dice similarity coefficient (DSC). The gross tumour volume (GTVtumour) and maximum tumour diameter were greater by PET/CT, and length of primary tumour was greater by CT, but differences were not statistically significant. However, the gross node volume (GTVnode) was significantly greater by PET/CT. The DSC analysis showed excellent agreement for GTVtumour, 0.72, but was very low for GTVnode, 0.25. Our study shows that the volume definition by PET/CT and CT data differs. CT simulation, without taking into account PET/CT information, might leave cancer-involved nodes out of the radiotherapy-delineated volumes.

  5. Local recurrence of prostate cancer after radical prostatectomy is at risk to be missed in {sup 68}Ga-PSMA-11-PET of PET/CT and PET/MRI: comparison with mpMRI integrated in simultaneous PET/MRI

    Energy Technology Data Exchange (ETDEWEB)

    Freitag, Martin T. [Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Heidelberg (Germany); Radtke, Jan P. [Department of Radiology, German Cancer Research Center, Heidelberg (Germany); University Hospital Heidelberg, Department of Urology, Heidelberg (Germany); Afshar-Oromieh, Ali; Flechsig, Paul; Giesel, Frederik; Haberkorn, Uwe [University Hospital Heidelberg, Department of Nuclear Medicine, Heidelberg (Germany); Roethke, Matthias C.; Bonekamp, David; Schlemmer, Heinz-Peter [Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Hadaschik, Boris A.; Hohenfellner, Markus [University Hospital Heidelberg, Department of Urology, Heidelberg (Germany); Gleave, Martin [University of British Columbia, The Vancouver Prostate Centre, Vancouver (Canada); Kopka, Klaus; Eder, Matthias [Division of Radiopharmaceutical Chemistry, German Cancer Research Center, Heidelberg (Germany); Heusser, Thorsten; Kachelriess, Marc [Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg (Germany); Wieczorek, Kathrin [University Hospital Heidelberg, Institute of Pathology, Heidelberg (Germany); Sachpekidis, Christos; Dimitrakopoulou-Strauss, A. [Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Heidelberg (Germany)

    2017-05-15

    The positron emission tomography (PET) tracer {sup 68}Ga-PSMA-11, targeting the prostate-specific membrane antigen (PSMA), is rapidly excreted into the urinary tract. This leads to significant radioactivity in the bladder, which may limit the PET-detection of local recurrence (LR) of prostate cancer (PC) after radical prostatectomy (RP), developing in close proximity to the bladder. Here, we analyze if there is additional value of multi-parametric magnetic resonance imaging (mpMRI) compared to the {sup 68}Ga-PSMA-11-PET-component of PET/CT or PET/MRI to detect LR. One hundred and nineteen patients with biochemical recurrence after prior RP underwent both hybrid {sup 68}Ga-PSMA-11-PET/CT{sub low-dose} (1 h p.i.) and -PET/MRI (2-3 h p.i.) including a mpMRI protocol of the prostatic bed. The comparison of both methods was restricted to the abdomen with focus on LR (McNemar). Bladder-LR distance and recurrence size were measured in axial T2w-TSE. A logistic regression was performed to determine the influence of these variables on detectability in {sup 68}Ga-PSMA-11-PET. Standardized-uptake-value (SUV{sub mean}) quantification of LR was performed. There were 93/119 patients that had at least one pathologic finding. In addition, 18/119 Patients (15.1%) were diagnosed with a LR in mpMRI of PET/MRI but only nine were PET-positive in PET/CT and PET/MRI. This mismatch was statistically significant (p = 0.004). Detection of LR using the PET-component was significantly influenced by proximity to the bladder (p = 0.028). The PET-pattern of LR-uptake was classified into three types (1): separated from bladder; (2): fuses with bladder, and (3): obliterated by bladder. The size of LRs did not affect PET-detectability (p = 0.84), mean size was 1.7 ± 0.69 cm long axis, 1.2 ± 0.46 cm short-axis. SUV{sub mean} in nine men was 8.7 ± 3.7 (PET/CT) and 7.0 ± 4.2 (PET/MRI) but could not be quantified in the remaining nine cases (obliterated by bladder). The present study demonstrates

  6. Sources and resources for oncologists to help answer the question: is PET/CT appropriate for my patient?

    Science.gov (United States)

    Karantanis, Dimitrios; Allen-Auerbach, Martin; Czernin, Johannes

    2012-01-01

    Positron emission tomography (PET)/computed tomography (CT)-subsequently referred to as PET/CT is emerging as a critically important diagnostic tool in oncology. There has been a substantial increase in the utilization of this modality over the last decade. The optimal imaging protocols are, however, still not established which results in considerable confusion and uncertainty among referring physicians and providers. Oncologists, hematologists and other physicians managing oncologic patients frequently face the dilemma of whether or not to order a PET/CT scan for their patients. The large body of evidence from clinical research often overwhelms the ability of physicians to stay adequately informed on the disease specific performance of PET/CT. Moreover, regulatory agencies have changed their requirements for reimbursement of PET/CT scans in an effort to curtail health care expenditures. In this article we attempt to inform users and providers about the appropriate use of this technology.

  7. PET/CT-guided treatment planning for paediatric cancer patients: a simulation study of proton and conventional photon therapy

    DEFF Research Database (Denmark)

    Kornerup, Josefine S.; Brodin, N. P.; Bjork-Eriksson, T.

    2015-01-01

    ) and estimated risk of secondary cancer (SC). RESULTS: Considerable deviations between CT- and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target...... or decreasing irradiated volumes, suggesting that the long-term morbidity of RT in childhood would on average remain largely unaffected. ADVANCES IN KNOWLEDGE: (18)F-FDG PET-based RT planning does not systematically change NTCP or SC risk for paediatric cancer patients compared with CT only. 3 out of 11...... patients had a distinct change of target volumes when PET-guided planning was introduced. Dice and mismatch metrics are not sufficient to assess the consequences of target volume differences in the context of RT....

  8. Accelerated acquisition of tagged MRI for cardiac motion correction in simultaneous PET-MR: Phantom and patient studies

    International Nuclear Information System (INIS)

    Huang, Chuan; Petibon, Yoann; Ouyang, Jinsong; El Fakhri, Georges; Reese, Timothy G.; Ahlman, Mark A.; Bluemke, David A.

    2015-01-01

    Purpose: Degradation of image quality caused by cardiac and respiratory motions hampers the diagnostic quality of cardiac PET. It has been shown that improved diagnostic accuracy of myocardial defect can be achieved by tagged MR (tMR) based PET motion correction using simultaneous PET-MR. However, one major hurdle for the adoption of tMR-based PET motion correction in the PET-MR routine is the long acquisition time needed for the collection of fully sampled tMR data. In this work, the authors propose an accelerated tMR acquisition strategy using parallel imaging and/or compressed sensing and assess the impact on the tMR-based motion corrected PET using phantom and patient data. Methods: Fully sampled tMR data were acquired simultaneously with PET list-mode data on two simultaneous PET-MR scanners for a cardiac phantom and a patient. Parallel imaging and compressed sensing were retrospectively performed by GRAPPA and kt-FOCUSS algorithms with various acceleration factors. Motion fields were estimated using nonrigid B-spline image registration from both the accelerated and fully sampled tMR images. The motion fields were incorporated into a motion corrected ordered subset expectation maximization reconstruction algorithm with motion-dependent attenuation correction. Results: Although tMR acceleration introduced image artifacts into the tMR images for both phantom and patient data, motion corrected PET images yielded similar image quality as those obtained using the fully sampled tMR images for low to moderate acceleration factors (<4). Quantitative analysis of myocardial defect contrast over ten independent noise realizations showed similar results. It was further observed that although the image quality of the motion corrected PET images deteriorates for high acceleration factors, the images were still superior to the images reconstructed without motion correction. Conclusions: Accelerated tMR images obtained with more than 4 times acceleration can still provide

  9. Accelerated acquisition of tagged MRI for cardiac motion correction in simultaneous PET-MR: Phantom and patient studies

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Chuan, E-mail: chuan.huang@stonybrookmedicine.edu [Center for Advanced Medical Imaging Sciences, Division of Nuclear Medicine and Molecular Imaging, Department of Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States); Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115 (United States); Departments of Radiology, Psychiatry, Stony Brook Medicine, Stony Brook, New York 11794 (United States); Petibon, Yoann [Center for Advanced Medical Imaging Sciences, Division of Nuclear Medicine and Molecular Imaging, Department of Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States); Ouyang, Jinsong; El Fakhri, Georges [Center for Advanced Medical Imaging Sciences, Division of Nuclear Medicine and Molecular Imaging, Department of Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114 and Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115 (United States); Reese, Timothy G. [Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115 and Martinos Center for Biomedical Imaging, Charlestown, Massachusetts 02129 (United States); Ahlman, Mark A.; Bluemke, David A. [Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland 20892 (United States)

    2015-02-15

    Purpose: Degradation of image quality caused by cardiac and respiratory motions hampers the diagnostic quality of cardiac PET. It has been shown that improved diagnostic accuracy of myocardial defect can be achieved by tagged MR (tMR) based PET motion correction using simultaneous PET-MR. However, one major hurdle for the adoption of tMR-based PET motion correction in the PET-MR routine is the long acquisition time needed for the collection of fully sampled tMR data. In this work, the authors propose an accelerated tMR acquisition strategy using parallel imaging and/or compressed sensing and assess the impact on the tMR-based motion corrected PET using phantom and patient data. Methods: Fully sampled tMR data were acquired simultaneously with PET list-mode data on two simultaneous PET-MR scanners for a cardiac phantom and a patient. Parallel imaging and compressed sensing were retrospectively performed by GRAPPA and kt-FOCUSS algorithms with various acceleration factors. Motion fields were estimated using nonrigid B-spline image registration from both the accelerated and fully sampled tMR images. The motion fields were incorporated into a motion corrected ordered subset expectation maximization reconstruction algorithm with motion-dependent attenuation correction. Results: Although tMR acceleration introduced image artifacts into the tMR images for both phantom and patient data, motion corrected PET images yielded similar image quality as those obtained using the fully sampled tMR images for low to moderate acceleration factors (<4). Quantitative analysis of myocardial defect contrast over ten independent noise realizations showed similar results. It was further observed that although the image quality of the motion corrected PET images deteriorates for high acceleration factors, the images were still superior to the images reconstructed without motion correction. Conclusions: Accelerated tMR images obtained with more than 4 times acceleration can still provide

  10. Role of 18F FDG PET scan to localize tumor in patients of oncogenic osteomalacia

    International Nuclear Information System (INIS)

    Malhotra, Gaurav; Mukta, K.; Asopa, V.; Varsha, J.; Vijaya, S.; Shah, Nalini S.; Padmavathy, M.

    2010-01-01

    Full text: Oncogenic osteomalacia is a rare paraneoplastic syndrome of renal phosphate wasting which is usually caused by phosphaturic mesenchymal tumors. Conventional radiologic techniques usually fail to detect these small, slow growing neoplasms located at unusual sites. The objective of this study was to evaluate the role of 18 F FDG PET imaging in patients of oncogenic osteomalacia. Materials and Methods: Fifteen patients (8 males and 7 females) (mean age: 38.5 ± 12.2 years) with clinical and biochemical evidence of oncogenic osteomalacia were subjected to 'total' whole body 18 F FDG PET scan including both limbs and skull views. The images were reconstructed and the final output was displayed as per the standard institution protocol. Results: 18 F FDG PET imaging localized suspicious hypermetabolic foci of SUVmax ranging from 1.4 to 3.8 (Mean ± S.D.: 2.39 ± 0.63) suggesting presence of occult tumor in 11 of 15 patients. The suspected foci were localized in lower limbs in ten patients and in the petrous temporal region of skull in 1 patient. FDG localized tumors were histopathologically correlated in 6 patients who underwent surgical biopsy/excision after correlative radiological investigations. Four of these patients were cured after surgical excision while partial surgical excision/biopsy was performed in two patients. Conclusions: 18 F FDG PET imaging is a promising technique for detection of occult tumors in patients of oncogenic osteomalacia. It is mandatory to include limbs in the field as these tumors are common in limbs and may be easily missed. Preoperative localization increases odds for cure after surgical removal of tumor

  11. 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

  12. Patient motion effects on the quantification of regional myocardial blood flow with dynamic PET imaging.

    Science.gov (United States)

    Hunter, Chad R R N; Klein, Ran; Beanlands, Rob S; deKemp, Robert A

    2016-04-01

    Patient motion is a common problem during dynamic positron emission tomography (PET) scans for quantification of myocardial blood flow (MBF). The purpose of this study was to quantify the prevalence of body motion in a clinical setting and evaluate with realistic phantoms the effects of motion on blood flow quantification, including CT attenuation correction (CTAC) artifacts that result from PET-CT misalignment. A cohort of 236 sequential patients was analyzed for patient motion under resting and peak stress conditions by two independent observers. The presence of motion, affected time-frames, and direction of motion was recorded; discrepancy between observers was resolved by consensus review. Based on these results, patient body motion effects on MBF quantification were characterized using the digital NURBS-based cardiac-torso phantom, with characteristic time activity curves (TACs) assigned to the heart wall (myocardium) and blood regions. Simulated projection data were corrected for attenuation and reconstructed using filtered back-projection. All simulations were performed without noise added, and a single CT image was used for attenuation correction and aligned to the early- or late-frame PET images. In the patient cohort, mild motion of 0.5 ± 0.1 cm occurred in 24% and moderate motion of 1.0 ± 0.3 cm occurred in 38% of patients. Motion in the superior/inferior direction accounted for 45% of all detected motion, with 30% in the superior direction. Anterior/posterior motion was predominant (29%) in the posterior direction. Left/right motion occurred in 24% of cases, with similar proportions in the left and right directions. Computer simulation studies indicated that errors in MBF can approach 500% for scans with severe patient motion (up to 2 cm). The largest errors occurred when the heart wall was shifted left toward the adjacent lung region, resulting in a severe undercorrection for attenuation of the heart wall. Simulations also indicated that the

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

    OpenAIRE

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

    2015-01-01

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

  14. {sup 18}F-FDG PET/CT diagnosis of unexpected extracardiac septic embolisms in patients with suspected cardiac endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Bonfiglioli, Rachele; Nanni, Cristina; Morigi, Joshua James; Ambrosini, Valentina; Fanti, Stefano [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Nuclear Medicine, Bologna (Italy); Graziosi, Maddalena; Rapezzi, Claudio [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Cardiology, Bologna (Italy); Trapani, Filippo; Bartoletti, Michele; Tumietto, Fabio; Viale, Pier Luigi [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Infective Diseases, Bologna (Italy); Ferretti, Alice; Rubello, Domenico [Azienda Ospedaliera S. Maria della Misericordia, Nuclear Medicine, Radiology, Neuroradiology, Medical Physics, Rovigo (Italy)

    2013-08-15

    Acute infective endocarditis is a potentially life-threatening disease. Its outcome strongly depends on systemic embolization and extracardiac infections. When present, these conditions usually lead to a more aggressive therapeutic approach. However, the diagnosis of peripheral septic embolism is very challenging. {sup 18}F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has proven to be accurate for the detection of inflammatory diseases and occult infections. The aim of this study was to assess the added value of {sup 18}F-FDG PET/CT in the detection of extracardiac embolisms in the evaluation of patients with suspected valvular endocarditis (VE). Seventy-one patients with suspected infective endocarditis, enrolled between June 2010 and December 2012, underwent {sup 18}F-FDG PET/CT with the standard procedure on a dedicated PET/CT scanner. Extracardiac findings were subsequently evaluated with other imaging procedures. Of the 71 patients with suspicion of infective endocarditis, we found unexpected extracardiac findings in 17 patients (24 %) without any clinical suspicion. Extracardiac findings were subsequently evaluated with other imaging procedures. PET/CT detected unexpected extra sites of infection in 24 % of cases, leading to changes in therapeutic management in a very relevant percentage of patients. These findings may have important therapeutic implications. (orig.)

  15. Magnetic Resonance-based Motion Correction for Quantitative PET in Simultaneous PET-MR Imaging.

    Science.gov (United States)

    Rakvongthai, Yothin; El Fakhri, Georges

    2017-07-01

    Motion degrades image quality and quantitation of PET images, and is an obstacle to quantitative PET imaging. Simultaneous PET-MR offers a tool that can be used for correcting the motion in PET images by using anatomic information from MR imaging acquired concurrently. Motion correction can be performed by transforming a set of reconstructed PET images into the same frame or by incorporating the transformation into the system model and reconstructing the motion-corrected image. Several phantom and patient studies have validated that MR-based motion correction strategies have great promise for quantitative PET imaging in simultaneous PET-MR. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. PET with a dual-head coincidence gamma camera in head and neck cancer: A comparison with computed tomography and dedicated PET

    International Nuclear Information System (INIS)

    Zimny, M.

    2001-01-01

    Positron emission tomography with 18 F-fluoro-deoxyglucose (FDG PET) is a promising imaging tool for detecting and staging of primary or recurrent head and neck cancer. The aim of this study was to evaluate a dual-head gamma camera modified for coincidence detection (KGK-PET) in comparison to computed tomography (CT) and dedicated PET (dPET). 50 patients with known or suspected primary or recurrent head and neck cancer were enrolled. 32 patients underwent KGK-PET and dPET using a one-day protocol. The sensitivity for the detection of primary/ recurrent head and neck cancer for KGK-PET and CT was 80% and 54%, respectively, specificity was 73% and 82%, respectively. The sensitivity and specificity for the detection of lymph node metastases based on neck sides with KGK-PET was 71% (CT: 65%) and 88% (CT: 89%) respectively. In comparison to dPET, KGK-PET revealed concordant results in 32/32 patients with respect to primary tumor/recurrent disease and in 55/60 evaluated neck sides. All involved neck sides that were missed by KGK-PET were also negative with dPET. These results indicate that in patients with head and neck cancer KGK-PET reveals information, that are similar to dPET and complementary to CT. (orig.) [de

  17. 18F-FDG PET/CT in the clinical management of patients with lymphoma.

    Science.gov (United States)

    Tamayo, P; Martín, A; Díaz, L; Cabrero, M; García, R; García-Talavera, P; Caballero, D

    The aim of this work was to review the current recommendations for staging and response assessment of patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) in routine clinical practice after chemotherapy and/or stem cell transplantation. A five-point scale (5-PS) from the First International Workshop on PET in Lymphoma in Deauville, France, in 2009, was recommended as the standard tool to score imaging to assess treatment response in patients with lymphoma using 18 F-Fluorodeoxyglucose (FDG) PET/CT. Following the recommendations of the 11th and 12th International Conferences on Malignant Lymphoma held in Lugano (Switzerland), in 2011 and 2013, respectively, a consensus (the so-called Lugano Classification) was reached regarding the use of PET/CT for staging and response assessment in FDG-avid lymphomas. As a result, 18 F-FDG PET/CT was formally incorporated into standard staging for FDG-avid lymphomas. A bone marrow biopsy is no longer indicated for the routine staging of HL and most diffuse large B-cell lymphomas. PET/CT will be used to assess response in FDG-avid histologies using the 5-point scale. The recent introduction of biological agents with immune mechanisms requires flexibility in interpretations of the Lugano criteria due to tumour flare or a pseudo-progression effect produced by these agents. Provisional criteria have been proposed (Lymphoma Response to Immunomodulatory Therapy Criteria) with the introduction of the term 'Indeterminate Response' in order to identify this phenomenon until confirmed as flare/pseudoprogression or true progression. All these recommendations will improve evaluations of patients with lymphoma, and allow comparison of results from clinical practice and trials. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-12-15

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

  20. [{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

  1. Dynamic 18F-FET PET in newly diagnosed astrocytic low-grade glioma identifies high-risk patients.

    Science.gov (United States)

    Jansen, Nathalie L; Suchorska, Bogdana; Wenter, Vera; Eigenbrod, Sabina; Schmid-Tannwald, Christine; Zwergal, Andreas; Niyazi, Maximilian; Drexler, Mark; Bartenstein, Peter; Schnell, Oliver; Tonn, Jörg-Christian; Thon, Niklas; Kreth, Friedrich-Wilhelm; la Fougère, Christian

    2014-02-01

    Because the clinical course of low-grade gliomas in the individual adult patient varies considerably and is unpredictable, we investigated the prognostic value of dynamic (18)F-fluorethyltyrosine ((18)F-FET) PET in the early diagnosis of astrocytic low-grade glioma (World Health Organization grade II). Fifty-nine patients with newly diagnosed low-grade glioma and dynamic (18)F-FET PET before histopathologic assessment were retrospectively investigated. (18)F-FET PET analysis comprised a qualitative visual classification of lesions; assessment of the semiquantitative parameters maximal, mean, and total standardized uptake value as ratio to background and biologic tumor volume; and dynamic analysis of intratumoral (18)F-FET uptake over time (increasing vs. decreasing time-activity curves). The correlation between PET parameters and progression-free survival, overall survival, and time to malignant transformation was investigated. (18)F-FET uptake greater than the background level was found in 34 of 59 tumors. Dynamic (18)F-FET uptake analysis was available for 30 of these 34 patients. Increasing and decreasing time-activity curves were found in 18 and 12 patients, respectively. Neither the qualitative factor presence or absence of (18)F-FET uptake nor any of the semiquantitative uptake parameters significantly influenced clinical outcome. In contrast, decreasing time-activity curves in the kinetic analysis were highly prognostic for shorter progression-free survival and time to malignant transformation (P dynamic (18)F-FET PET constitute an unfavorable prognostic factor in astrocytic low-grade glioma and, by identifying high-risk patients, may ease treatment decisions.

  2. Presentation of the DosePet application (APP) for use in Nuclear Medicine: calculation of the amount of medicament for PET / CT patients

    International Nuclear Information System (INIS)

    Nascimento, Pedro Augusto do; Rodrigues, Araken dos S. Werneck

    2016-01-01

    This paper presents the application (APP) DosePet that calculates the amount of medicament for PET / CT in patients according to the predetermined radiation dose. The software has been designed using the web MIT App Inventor2 tool for Android platform. The application allows the workers to simulate the amount of radiation still existing in the premises after the applications, increasing security and reducing exposures, and enable greater efficiency in the use of the radiopharmaceutical. (author)

  3. 18F-FDG PET for detecting metastases and synchronous primary malignancies in patients with oral and oropharyngeal cancer

    International Nuclear Information System (INIS)

    Wallowy, P.; Kovacs, A.F.; Diener, J.; Gruenwald, F.

    2009-01-01

    Assessment of the efficiency of 18 F-FDG-PET (PET) for the detection of distant metastases and synchronous primary malignancies in patients with oral and oropharyngeal squamous cell cancer (OOSCC). Patients, methods: Retrospective evaluation of PET studies of 422 patients with histologically confirmed OOSCC. 99 patients (23.5%) demonstrated a suspect distant finding of whom 84 could be interdisciplinary evaluated and consecutively confirmed or refuted by other diagnostic modalities or biopsy. Results: In 74 of 80 evaluable cases, PET showed the primary tumour (92.5%). 26/84 suspect distant lesions (31%) showed by means of PET were confirmed to be malignancies (mean SUV 3.96; range 1.4-9.37). Main sites were the lung, the upper aerodigestive tract, and the gastrointestinal system. In the other 58 cases (69%), where the suspect lesions were confirmed as benign, mean SUV was 2.65 (range 0.7-6.5) (difference statistically significant). The SUV above which every suspect finding was proven to be of malignant condition was 6.5 (specificity 100%, sensitivity 38%, accuracy 81%). Conclusion: PET may have an important role in initial staging and the detection of distant metastases and synchronous primary malignancies. Setting a SUV threshold for determining malignancies can support interpretation. In borderline cases, however, interdisciplinary evaluation by means of other diagnostic modalities remains crucial. (orig.)

  4. Preliminary results on response assessment using 68Ga-HBED-CC-PSMA PET/CT in patients with metastatic prostate cancer undergoing docetaxel chemotherapy

    International Nuclear Information System (INIS)

    Seitz, Anna Katharina; Rauscher, Isabel; Kroenke, Markus; Schwaiger, Markus; Haller, Bernhard; Luther, Sophia; Heck, Matthias M.; Horn, Thomas; Gschwend, Juergen E.; Maurer, Tobias; Eiber, Matthias

    2018-01-01

    To investigate the value of 68 Ga-HBED-CC PSMA ( 68 Ga-PSMA) PET/CT for response assessment in metastatic castration-sensitive and castration-resistant prostate cancer (mCSPC and mCRPC) during docetaxel chemotherapy. 68 Ga-PSMA PET/CT was performed in seven mCSPC patients before and after six cycles of upfront docetaxel chemotherapy and in 16 mCRPC patients before and after three cycles of palliative docetaxel chemotherapy. Radiographic treatment response was evaluated separately on the 68 Ga-PSMA PET and CT datasets. Changes in 68 Ga-PSMA uptake (SUVmean) were assessed on a per-patient and a per-lesion basis using the PERCIST scoring system with slight modification. Treatment response was defined as absence of any PSMA uptake in all target lesions on posttreatment PET (complete response, CR) or a decrease in summed SUVmean of ≥30% (partial response, PR). The appearance of a new PET-positive lesion or an increase in summed SUVmean of ≥30% (progressive disease, PD) indicated nonresponse. A moderate change in summed SUVmean (between -30% and +30%) without a change in the number of target lesions was defined as stable disease (SD). For treatment response assessment on CT, RECIST1.1 criteria were used. Radiographic responses on 68 Ga-PSMA PET [RR(PET)] and on CT [RR(CT)] were compared and correlated with biochemical response (BR). A decrease in serum PSA level of ≥50% was defined as biochemical PR. Biochemical PR was found in six of seven patients with mCSPC (86%, 95% confidence interval 42% to 99.6%). The concordance rate was higher between BR and RR(PET) than between BR and RR(CT) (6/7 vs. 3/6 patients). 68 Ga-PSMA PET and CT were concordant in only three patients (50%, 12% to 88%). In mCRPC patients, biochemical PR was found in six of 16 patients (38%, 15% to 65%). Outcome prediction was concordant between BR and RR(PET) in nine of 16 patients (56%), and between BR and RR(CT) in only four of 12 patients (33%) with target lesions on CT. 68 Ga-PSMA PET and CT

  5. Detection and quantification of focal uptake in head and neck tumours: {sup 18}F-FDG PET/MR versus PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Varoquaux, Arthur; Rager, Olivier; Ratib, Osman; Becker, Christoph D.; Zaidi, Habib; Becker, Minerva [Geneva University Hospital, Department of Imaging, Divisions of Radiology and Nuclear Medicine, Geneva 14 (Switzerland); Poncet, Antoine [Geneva University Hospital, Center for Clinical Research, Geneva (Switzerland); Delattre, Benedicte M.A. [Geneva University Hospital, Department of Imaging, Divisions of Radiology and Nuclear Medicine, Geneva 14 (Switzerland); Philips Healthcare AG, Nuclear Medicine Division, Gland (Switzerland); Dulguerov, Pavel; Dulguerov, Nicolas [Geneva University Hospital, Clinic of Otorhinolaryngology Head and Neck Surgery, Geneva (Switzerland)

    2014-03-15

    Our objectives were to assess the quality of PET images and coregistered anatomic images obtained with PET/MR, to evaluate the detection of focal uptake and SUV, and to compare these findings with those of PET/CT in patients with head and neck tumours. The study group comprised 32 consecutive patients with malignant head and neck tumours who underwent whole-body {sup 18}F-FDG PET/MR and PET/CT. PET images were reconstructed using the attenuation correction sequence for PET/MR and CT for PET/CT. Two experienced observers evaluated the anonymized data. They evaluated image and fusion quality, lesion conspicuity, anatomic location, number and size of categorized (benign versus assumed malignant) lesions with focal uptake. Region of interest (ROI) analysis was performed to determine SUVs of lesions and organs for both modalities. Statistical analysis considered data clustering due to multiple lesions per patient. PET/MR coregistration and image fusion was feasible in all patients. The analysis included 66 malignant lesions (tumours, metastatic lymph nodes and distant metastases), 136 benign lesions and 470 organ ROIs. There was no statistically significant difference between PET/MR and PET/CT regarding rating scores for image quality, fusion quality, lesion conspicuity or anatomic location, number of detected lesions and number of patients with and without malignant lesions. A high correlation was observed for SUV{sub mean} and SUV{sub max} measured on PET/MR and PET/CT for malignant lesions, benign lesions and organs (ρ = 0.787 to 0.877, p < 0.001). SUV{sub mean} and SUV{sub max} measured on PET/MR were significantly lower than on PET/CT for malignant tumours, metastatic neck nodes, benign lesions, bone marrow, and liver (p < 0.05). The main factor affecting the difference between SUVs in malignant lesions was tumour size (p < 0.01). In patients with head and neck tumours, PET/MR showed equivalent performance to PET/CT in terms of qualitative results. Comparison of

  6. Total {sup 18}F-dopa PET tumour uptake reflects metabolic endocrine tumour activity in patients with a carcinoid tumour

    Energy Technology Data Exchange (ETDEWEB)

    Fiebrich, Helle-Brit; Walenkamp, Annemiek M.; Vries, Elisabeth G.E. de [University Medical Centre Groningen, Department of Medical Oncology, Groningen (Netherlands); Jong, Johan R. de; Koopmans, Klaas Pieter; Dierckx, Rudi A.J.O.; Brouwers, Adrienne H. [University Medical Centre Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen (Netherlands); Kema, Ido P. [University Medical Centre Groningen, Department of Laboratory Medicine, Groningen (Netherlands); Sluiter, Wim; Links, Thera P. [University Medical Centre Groningen, Department of Endocrinology, Groningen (Netherlands)

    2011-10-15

    Positron emission tomography (PET) using 6-[{sup 18}F]fluoro-L-dihydroxyphenylalanine ({sup 18}F-dopa) has an excellent sensitivity to detect carcinoid tumour lesions. {sup 18}F-dopa tumour uptake and the levels of biochemical tumour markers are mediated by tumour endocrine metabolic activity. We evaluated whether total {sup 18}F-dopa tumour uptake on PET, defined as whole-body metabolic tumour burden (WBMTB), reflects tumour load per patient, as measured with tumour markers. Seventy-seven consecutive carcinoid patients who underwent an {sup 18}F-dopa PET scan in two previously published studies were analysed. For all tumour lesions mean standardised uptake values (SUVs) at 40% of the maximal SUV and tumour volume on {sup 18}F-dopa PET were determined and multiplied to calculate a metabolic burden per lesion. WBMTB was the sum of the metabolic burden of all individual lesions per patient. The 24-h urinary serotonin, urine and plasma 5-hydroxindoleacetic acid (5-HIAA), catecholamines (nor)epinephrine, dopamine and their metabolites, measured in urine and plasma, and serum chromogranin A served as tumour markers. All but 1 were evaluable for WBMTB; 74 patients had metastatic disease. {sup 18}F-dopa PET detected 979 lesions. SUV{sub max} on {sup 18}F-dopa PET varied up to 29-fold between individual lesions within the same patients. WBMTB correlated with urinary serotonin (r = 0.51) and urinary and plasma 5-HIAA (r = 0.78 and 0.66). WBMTB also correlated with urinary norepinephrine, epinephrine, dopamine and plasma dopamine, but not with serum chromogranin A. Tumour load per patient measured with {sup 18}F-dopa PET correlates with tumour markers of the serotonin and catecholamine pathway in urine and plasma in carcinoid patients, reflecting metabolic tumour activity. (orig.)

  7. Decision tree sensitivity analysis for cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma)

    International Nuclear Information System (INIS)

    Kosuda, Shigeru; Watanabe, Masumi; Kobayashi, Hideo; Kusano, Shoichi; Ichihara, Kiyoshi

    1998-01-01

    Decision tree analysis was used to assess cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma, ≤Stage IIIB), based on the data of the current decision tree. Decision tree models were constructed with two competing strategies (CT alone and CT plus chest FDG-PET) in 1,000 patient population with 71.4% prevalence. Baselines of FDG-PET sensitivity and specificity on detection of lung cancer and lymph node metastasis, and mortality and life expectancy were available from references. Chest CT plus chest FDG-PET strategy increased a total cost by 10.5% when a chest FDG-PET study costs 0.1 million yen, since it increased the number of mediastinoscopy and curative thoracotomy despite reducing the number of bronchofiberscopy to half. However, the strategy resulted in a remarkable increase by 115 patients with curable thoracotomy and decrease by 51 patients with non-curable thoracotomy. In addition, an average life expectancy increased by 0.607 year/patient, which means increase in medical cost is approximately 218,080 yen/year/patient when a chest FDG-PET study costs 0.1 million yen. In conclusion, chest CT plus chest FDG-PET strategy might not be cost-effective in Japan, but we are convinced that the strategy is useful in cost-benefit analysis. (author)

  8. Brain 18F-FDG PET Metabolic Abnormalities in Patients with Long-Lasting Macrophagic Myofascitis.

    Science.gov (United States)

    Van Der Gucht, Axel; Aoun Sebaiti, Mehdi; Guedj, Eric; Aouizerate, Jessie; Yara, Sabrina; Gherardi, Romain K; Evangelista, Eva; Chalaye, Julia; Cottereau, Anne-Ségolène; Verger, Antoine; Bachoud-Levi, Anne-Catherine; Abulizi, Mukedaisi; Itti, Emmanuel; Authier, François-Jérôme

    2017-03-01

    The aim of this study was to characterize brain metabolic abnormalities in patients with macrophagic myofascitis (MMF) and the relationship with cognitive dysfunction through the use of PET with 18 F-FDG. Methods: 18 F-FDG PET brain imaging and a comprehensive battery of neuropsychological tests were performed in 100 consecutive MMF patients (age [mean ± SD], 45.9 ± 12 y; 74% women). Images were analyzed with statistical parametric mapping (SPM12). Through the use of analysis of covariance, all 18 F-FDG PET brain images of MMF patients were compared with those of a reference population of 44 healthy subjects similar in age (45.4 ± 16 y; P = 0.87) and sex (73% women; P = 0.88). The neuropsychological assessment identified 4 categories of patients: those with no significant cognitive impairment ( n = 42), those with frontal subcortical (FSC) dysfunction ( n = 29), those with Papez circuit dysfunction ( n = 22), and those with callosal disconnection ( n = 7). Results: In comparison with healthy subjects, the whole population of patients with MMF exhibited a spatial pattern of cerebral glucose hypometabolism ( P glucose hypometabolism that was most marked in MMF patients with FSC dysfunction. Further studies are needed to determine whether this pattern could represent a diagnostic biomarker of MMF in patients with chronic fatigue syndrome and cognitive dysfunction. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  9. A prospective multi-centre study of the value of FDG-PET as part of a structured diagnostic protocol in patients with fever of unknown origin

    International Nuclear Information System (INIS)

    Bleeker-Rovers, Chantal P.; Vos, Fidel J.; Meer, Jos W.M. van der; Mudde, Aart H.; Dofferhoff, Anton S.M.; Geus-Oei, Lioe-Fee de; Rijnders, Anton J.; Krabbe, Paul F.M.; Corstens, Frans H.M.; Oyen, Wim J.G.

    2007-01-01

    Since 18 F-fluorodeoxyglucose (FDG) accumulates in neoplastic cells and in activated inflammatory cells, positron emission tomography (PET) with FDG could be valuable in diagnosing patients with fever of unknown origin (FUO). The aim of this study was to validate the use of FDG-PET as part of a structured diagnostic protocol in the general patient population with FUO. From December 2003 to July 2005, 70 patients with FUO were recruited from one university hospital (n=38) and five community hospitals (n=32). A structured diagnostic protocol including FDG-PET was used. A dedicated, full-ring PET scanner was used for data acquisition. FDG-PET scans were interpreted by two staff members of the department of nuclear medicine without further clinical information. The final clinical diagnosis was used for comparison with the FDG-PET results. Of all scans, 33% were clinically helpful. The contribution of FDG-PET to the final diagnosis did not differ significantly between patients diagnosed in the university hospital and patients diagnosed in the community hospitals. FDG-PET contributed significantly more often to the final diagnosis in patients with continuous fever than in patients with periodic fever. FDG-PET was not helpful in any of the patients with normal erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). FDG-PET is a valuable imaging technique as part of a diagnostic protocol in the general patient population with FUO and a raised ESR or CRP. (orig.)

  10. Arterial spin labeling in patients with chic cerebral artery steno-occlusive disease - Correlation with 15O-PET

    International Nuclear Information System (INIS)

    Kamano, Hironori; Yoshiura, Takashi; Hiwatashi, Akio; Abe, Koichiro; Yamashita, Koji; Honda, Hiroshi; Togao, Osamu

    2013-01-01

    Background: Heterogeneity of arterial transit time due to cerebral artery steno-occlusive lesions hampers accurate regional cerebral blood flow measurement by arterial spin labeling (ASL). Purpose: To assess the feasibility of regional cerebral blood flow measurement by ASL with multiple-delay time sampling in patients with steno-occlusive diseases by comparing with positron emission tomography (PET), and to determine whether regional arterial transit time measured by this ASL technique is correlated with regional mean transit time, a PET index of perfusion pressure. Material and Methods: Sixteen patients with steno-occlusive diseases received both ASL and 15 O-PET. The mean regional cerebral blood flow measured by ASL and PET, regional arterial transit time by ASL, and regional mean transit time by PET were obtained by a region-of-interest analysis. Correlation between regional cerebral blood flow by ASL and that by PET, and correlation between regional arterial transit time by ASL and regional mean transit time by PET were tested using Pearson's correlation coefficient for both absolute and relative values. A multivariate regression analysis was performed to test whether regional arterial transit time by ASL was a significant contributor in modeling regional mean transit time by PET after controlling the effect of regional cerebral blood flow by ASL. Results: A significant positive correlation was found between regional cerebral blood flow by ASL and that by PET for both absolute (r = 0.520, P < 0.0001) and relative (r = 0.691, P < 0.0001) values. A significant positive correlation was found between regional arterial transit time by ASL and regional mean transit time by PET both for absolute (r = 0.369, P = 0.0002) and relative (r = 0.443, P < 0.0001) values. The regression analysis revealed that regional arterial transit time by ASL was a significant contributor in modeling regional mean transit time by PET after controlling regional cerebral blood flow by ASL

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

    Science.gov (United States)

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

    2015-01-01

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

  12. Prospective evaluation of {sup 18}F-FACBC PET/CT and PET/MRI versus multiparametric MRI in intermediate- to high-risk prostate cancer patients (FLUCIPRO trial)

    Energy Technology Data Exchange (ETDEWEB)

    Jambor, Ivan [University of Turku, Department of Diagnostic Radiology, Turku (Finland); University of Massachusetts Medical School - Baystate, Department of Radiology, Springfield, MA (United States); Turku PET Centre, Turku (Finland); Kuisma, Anna [Turku University Hospital, Department of Oncology and Radiotherapy, Turku (Finland); Kaehkoenen, Esa; Bostroem, Peter J. [Turku University Hospital, Department of Urology, Turku (Finland); Kemppainen, Jukka [Turku PET Centre, Turku (Finland); Turku University Hospital, Department of Clinical Physiology and Nuclear Medicine, Turku (Finland); Merisaari, Harri [University of Turku, Department of Diagnostic Radiology, Turku (Finland); Turku PET Centre, Turku (Finland); University of Turku, Department of Information Technology, Turku (Finland); Eskola, Olli; Teuho, Jarmo [Turku PET Centre, Turku (Finland); Montoya Perez, Ileana [University of Turku, Department of Diagnostic Radiology, Turku (Finland); University of Turku, Department of Information Technology, Turku (Finland); Turku University Hospital, Medical Imaging Centre of Southwest Finland, Turku (Finland); Pesola, Marko [University of Turku, Department of Diagnostic Radiology, Turku (Finland); Aronen, Hannu J. [University of Turku, Department of Diagnostic Radiology, Turku (Finland); Turku University Hospital, Medical Imaging Centre of Southwest Finland, Turku (Finland); Taimen, Pekka [University of Turku and Turku University Hospital, Department of Pathology, Turku (Finland); Minn, Heikki [Turku PET Centre, Turku (Finland); Turku University Hospital, Department of Oncology and Radiotherapy, Turku (Finland)

    2018-03-15

    The purpose of this study was to evaluate {sup 18}F-FACBC PET/CT, PET/MRI, and multiparametric MRI (mpMRI) in detection of primary prostate cancer (PCa). Twenty-six men with histologically confirmed PCa underwent PET/CT immediately after injection of 369 ± 10 MBq {sup 18}F-FACBC (fluciclovine) followed by PET/MRI started 55 ± 7 min from injection. Maximum standardized uptake values (SUV{sub max}) were measured for both hybrid PET acquisitions. A separate mpMRI was acquired within a week of the PET scans. Logan plots were used to calculate volume of distribution (V{sub T}). The presence of PCa was estimated in 12 regions with radical prostatectomy findings as ground truth. For each imaging modality, area under the curve (AUC) for detection of PCa was determined to predict diagnostic performance. The clinical trial registration number is NCT02002455. In the visual analysis, 164/312 (53%) regions contained PCa, and 41 tumor foci were identified. PET/CT demonstrated the highest sensitivity at 87% while its specificity was low at 56%. The AUC of both PET/MRI and mpMRI significantly (p < 0.01) outperformed that of PET/CT while no differences were detected between PET/MRI and mpMRI. SUV{sub max} and V{sub T} of Gleason score (GS) >3 + 4 tumors were significantly (p < 0.05) higher than those for GS 3 + 3 and benign hyperplasia. A total of 442 lymph nodes were evaluable for staging, and PET/CT and PET/MRI demonstrated true-positive findings in only 1/7 patients with metastatic lymph nodes. Quantitative {sup 18}F-FACBC imaging significantly correlated with GS but failed to outperform MRI in lesion detection. {sup 18}F-FACBC may assist in targeted biopsies in the setting of hybrid imaging with MRI. (orig.)

  13. Application of PET and PET/CT imaging for cancer screening

    International Nuclear Information System (INIS)

    Chen Yenkung; Hu Fenglan; Shen Yehyou; Liao, A.C.; Hung, T.Z.; Su, Chentau; Chen Liangkuang

    2004-01-01

    The aim of this study was to evaluate the potential application of 18F-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) and PET/CT for cancer screening in asymptomatic individuals. Methods: The subjects consisted of 3631 physical check up examinees (1947 men, 1684 women; mean age ±SD, 52.1±8.2 y) with non-specific medical histories. Whole-body FDG PET (or PET/CT), ultrasound and tumor markers were performed on all patients. Focal hypermetabolic areas with intensities equal to or exceeding the level of FDG uptake in the brain and bladder were considered abnormal and interpreted as neoplasia. Follow-up periods were longer than one year. Results: Among the 3631 FDG PET (including 1687 PET/CT), ultrasound and tumor markers examinations, malignant tumors were discovered in 47 examinees (1.29%). PET findings were true-positive in 38 of the 47 cancers (80.9%). In addition, 32 of the 47 cancers were performed with the PET-CT scan. PET detected cancer lesions in 28 of the 32 examinees. However, the CT detected cancer lesions in only 15 of 32 examinees. Conclusion: The sensitivity of FDG PET in the detection of a wide variety of cancers is high. Most cancer can be detected with FDG PET in a resectable stage. CT of the PET/CT for localization and characteristics of the lesion shows an increased specificity of the PET scan. Using ultrasound and tumor markers may complement the PET scan in cancer screening for hepatic and urologic neoplasms. (authors)

  14. PET diagnosis. The decisive factor for early detection of the cancer

    International Nuclear Information System (INIS)

    Yonekura, Yoshiharu; Kusakabe, Kiyoko; Fukuda, Hiroshi; Inoue, Kentaro; Tanaka, Koichi; Murayama, Hideo; Amano, Masaharu; Oikawa, Koichi; Yamashita, Takashi

    2007-01-01

    The feature contains 8 articles concerned with the subject matter in the title. The first is a document of the interview with Dr. Yoshiharu Yonekura, the National Institute of Radiological Sciences (NIRS) President, by the editor in chief of the journal, entitled ''Twenty to Thirty years are Necessary for Development of Basic Technology''- discussed are progress of molecular imaging, present and future of positron emission tomography (PET) diagnosis. Lasting are the articles of: ''Recommendation for PET diagnosis'' by K. Kusakabe, Tokyo Women's Medical Univ.- the role of PET diagnosis in a mass examination; ''The present state and future development of PET diagnosis of cancer'' by H. Fukuda and K. Inoue, Tohoku Univ. Hospital- labeled compounds and others; ''Promotion of popularization of the diagnosis as a part of CSR (corporate social responsibility) in the local medicare- A participation of the Hospital of Chugoku Electric Power Co., Ltd. in the project'' by K. Tanaka; ''Trend of development of next generation PET equipment'' by H. Murayama, NIRS- equipments like PET/CT or PET/MRI, and with high system sensitivity (detector- and photo-elements, DOI detection, high performance circuit, etc.); ''Achievement and developing trend of the equipments in the manufacturer- Shimadzu Corp.'' by M. Amano- PET/CT; ''(the same title)- Sumitomo Heavy Industries, Ltd.'' by K. Oikawa- cyclotron and therapeutic heavy ion beam generator; and ''Research and development in Hamamatsu Photonics K.K.'' by T. Yamashita- high throughput PET and animal PET. (R.T.)

  15. PET/CT. Dose-escalated image fusion?

    International Nuclear Information System (INIS)

    Brix, G.; Beyer, T.

    2005-01-01

    Clinical studies demonstrate a gain in diagnostic accuracy by employing combined PET/CT instead of separate CT and PET imaging. However, whole-body PET/CT examinations result in a comparatively high radiation burden to patients and thus require a proper justification and optimization to avoid repeated exposure or over-exposure of patients. This review article summarizes relevant data concerning radiation exposure of patients resulting from the different components of a combined PET/CT examination and presents different imaging strategies that can help to balance the diagnostic needs and the radiation protection requirements. In addition various dose reduction measures are discussed, some of which can be adopted from CT practice, while others mandate modifications to the existing hard- and software of PET/CT systems. (orig.)

  16. Potential for pet animals to harbor methicillin-resistant Staphylococcus aureus (MRSA) when residing with human MRSA patients

    Science.gov (United States)

    Morris, Daniel O.; Lautenbach, Ebbing; Zaoutis, Theoklis; Leckerman, Kateri; Edelstein, Paul H.; Rankin, Shelley C.

    2011-01-01

    Summary Colonization by methicillin-resistant Staphylococcus aureus (MRSA) may be persistent in people, and is horizontally transmissible. The scientific literature suggests that domestic pets may also participate in cross-transmission of MRSA within households. The objectives of this study were to evaluate the prevalence of and risk factors for MRSA carriage by pets residing in households with an MRSA-infected person. From 66 households in which an MRSA infected patient resided, we screened 47 dogs and 52 cats using a swab protocol. Isolates from pets and humans were genotyped using two techniques, and compared for concordance. Human participants completed a 22-question survey of demographic and epidemiologic data relevant to staphylococcal transmission. Eleven of 99 pets (11.5%) representing 9 (13.6%) of households were MRSA-positive, but in only 6 of these households were the human and animal-source strains genetically concordant. Human infection by strain USA 100 was significantly associated with pet carriage [OR = 11.4 (95% C.I. 1.7, 76.9); p=0.013]. Yet, for each day of delay in sampling the pet after the person’s MRSA diagnosis, the odds of isolating any type of MRSA from the pet decreased by 13.9% [(95% C.I. 2.6%, 23.8%); p=0.017)]. It may be concluded that pets can harbor pandemic strains of MRSA while residing in a household with an infected person. However, the source of MRSA to the pet cannot always be attributed to the human patient. Moreover, the rapid attrition of the odds of obtaining a positive culture from pets over time suggests that MRSA carriage may be fleeting. PMID:22233337

  17. PET imaging in patients with Modic changes

    DEFF Research Database (Denmark)

    Albert, Hanne; Pedersen, Henrik; Manniche, Claus

    2009-01-01

    associated with low back pain (LBP). MC type 1 appear to be inflammation on MRI, and histological and biochemical findings make it highly likely that an inflammation is present. Though MC is painful no known treatment is available, and it is unknown which entities affect the progress or regress of MC....... The changes observed on MRI are slow and take months to develop, but faster changes in the metabolism might provide a platform for monitoring patients. PATIENTS, METHODS: Patients from The Back Centre Funen, with low back pain in the area of L1 to S1, MC type 1 in L1 to L5, and a previous herniated lumbar...... disc. All patients had a PET scan using FDG (18F-fluorodeoxyglucose) as tracer. RESULTS: Included in the study were 11 patients, 4 women and 7 men, mean age 48.1 year (range 20-65). All MC were situated in the vertebrae both above and below the previously herniated disc/discs. Ten patients had MC at 1...

  18. Clinical correlates of decreased anteroposterior metabolic gradients in positron emission tomography (PET) of schizophrenic patients

    International Nuclear Information System (INIS)

    DeLisi, L.E.; Buchsbaum, M.S.; Holcomb, H.H.

    1985-01-01

    The finding in schizophrenic patients of a reversal of the normal frontal to posterior pattern of brain metabolic activity with positron emission tomography (PET) is of interest, but its relevance to psychopathology is unknown. Using PET, the authors studied 21 patients with chronic schizophrenia and 21 age- and sex-matched control subjects. Although eight of the 21 patients and only one of the control subjects showed a relatively lower anteroposterior metabolic gradient, no clinical correlates of this finding were noted. In addition, cerebral atrophy, as determined by CAT scan, was not associated with this aberrant metabolic pattern

  19. Diagnosis of recurrent prostate cancer with PET/CT imaging using the gastrin-releasing peptide receptor antagonist {sup 68}Ga-RM2: Preliminary results in patients with negative or inconclusive [{sup 18}F]Fluoroethylcholine-PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Wieser, Gesche; Bartholomae, Mark [University of Freiburg, Department of Nuclear Medicine, Medical Center -Faculty of Medicine, Freiburg (Germany); Popp, Ilinca; Grosu, Anca-Ligia [University of Freiburg, Department of Radiation Oncology, Medical Center - Faculty of Medicine, Freiburg (Germany); Christian Rischke, H. [University of Freiburg, Department of Nuclear Medicine, Medical Center -Faculty of Medicine, Freiburg (Germany); University of Freiburg, Department of Radiation Oncology, Medical Center - Faculty of Medicine, Freiburg (Germany); Drendel, Vanessa [University of Freiburg, Institute for Pathology, Faculty of Medicine, Freiburg (Germany); Weber, Wolfgang A. [Memorial Sloan Kettering Cancer Center, Molecular Imaging and Therapy Service, New York, NY (United States); Mansi, Rosalba [University Hospital Basel, Division of Radiological Chemistry, Basel (Switzerland); Wetterauer, Ulrich; Schultze-Seemann, Wolfgang; Jilg, Cordula Annette [University of Freiburg, Department of Urology, Medical Center -Faculty of Medicine, Freiburg (Germany); Meyer, Philipp T. [University of Freiburg, Department of Nuclear Medicine, Medical Center -Faculty of Medicine, Freiburg (Germany); Partner Site Freiburg, German Cancer Consortium (DKTK), Freiburg (Germany)

    2017-08-15

    [{sup 18}F]fluoroethylcholine ({sup 18}FECH) has been shown to be a valuable PET-tracer in recurrent prostate cancer (PCa), but still has limited accuracy. RM2 is a gastrin-releasing peptide receptor (GRPr) antagonist that binds to GRPr on PCa cells. Recent studies suggest that GRPr imaging with PET/CT is a promising technique for staging and restaging of PCa. We explore the value of GRPr-PET using the {sup 68}Ga-labeled GRPr antagonist RM2 in a selected population of patients with biochemically recurrent PCa and a negative/inconclusive {sup 18}FECH-PET/CT. In this retrospective study 16 men with biochemical PCa relapse and negative (n = 14) or inconclusive (n = 2) {sup 18}FECH-PET/CT underwent whole-body {sup 68}Ga-RM2-PET/CT. Mean time from {sup 18}FECH-PET/CT to {sup 68}Ga-RM2-PET/CT was 6.1 ± 6.8 months. Primary therapies in these patients were radical prostatectomy (n = 13; 81.3%) or radiotherapy (n = 3; 18.7%). 14/16 patients (87.5%) had already undergone salvage therapies because of biochemical relapse prior to {sup 68}Ga-RM2-PET/CT imaging. Mean ± SD PSA at {sup 68}Ga-RM2-PET/CT was 19.4 ± 53.5 ng/ml (range 1.06-226.4 ng/ml). {sup 68}Ga-RM2-PET/CT showed at least one region with focal pathological uptake in 10/16 patients (62.5%), being suggestive of local relapse (n = 4), lymph node metastases (LNM; n = 4), bone metastases (n = 1) and lung metastasis with hilar LNM (n = 1). Seven of ten positive {sup 68}Ga-RM2 scans were positively confirmed by surgical resection and histology of the lesions (n = 2), by response to site-directed therapies (n = 2) or by further imaging (n = 3). Patients with a positive {sup 68}Ga-RM2-scan showed a significantly higher median PSA (6.8 ng/ml, IQR 10.2 ng/ml) value than those with a negative scan (1.5 ng/ml, IQR 3.1 ng/ml; p = 0.016). Gleason scores or concomitant antihormonal therapy had no apparent impact on the detection of recurrent disease. Even in this highly selected population of patients with known biochemical

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

    Science.gov (United States)

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

    2017-11-01

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

  1. Restaging of patients with lymphoma. Comparison of low dose CT (20 mAs) with contrast enhanced diagnostic CT in combined [18F]-FDG PET/CT

    International Nuclear Information System (INIS)

    Fougere, C. la; Pfluger, T.; Schneider, V.; Hacker, M.; Broeckel, N.; Bartenstein, P.; Tiling, R.; Morhard, D.; Hundt, W.; Becker, C.

    2008-01-01

    Aim: assessment of the clinical benefit of i.v. contrast enhanced diagnostic CT (CE-CT) compared to low dose CT with 20 mAs (LD-CT) without contrast medium in combined [ 18 F]-FDG PET/CT examinations in restaging of patients with lymphoma. Patients, methods: 45 patients with non-Hodgkin lymphoma (n = 35) and Hodgkin's disease (n = 10) were included into this study. PET, LD-CT and CE-CT were analyzed separately as well as side-by-side. Lymphoma involvement was evaluated separately for seven regions. Indeterminate diagnoses were accepted whenever there was a discrepancy between PET and CT findings. Results for combined reading were calculated by rating indeterminate diagnoses according the suggestions of either CT or PET. Each patient had a clinical follow-up evaluation for > 6 months. Results: region-based evaluation suggested a sensitivity/specificity of 66/93% for LD-CT, 87%/91% for CE-CT, 95%/96% for PET, 94%/99% for PET/LD-CT and 96%/99% for PET/CE-CT. The data for PET/CT were obtained by rating indeterminate results according to the suggestions of PET, which turned out to be superior to CT. Lymphoma staging was changed in two patients using PET/CE-CT as compared to PET/LD-CT. Conclusion: overall, there was no significant difference between PET/LD-CT and PET/CE-CT. However, PET/CE-CT yielded a more precise lesion delineation than PET/LD-CT. This was due to the improved image quality of CE-CT and might lead to a more accurate investigation of lymphoma. (orig.)

  2. Amnestic MCI Patients' Perspectives toward Disclosure of Amyloid PET Results in a Research Context.

    Science.gov (United States)

    Vanderschaeghe, Gwendolien; Schaeverbeke, Jolien; Vandenberghe, Rik; Dierickx, Kris

    2017-01-01

    Researchers currently are not obligated to share individual research results (IRR) with participants. This non-disclosure policy has been challenged on the basis of participants' rights to be aware and in control of their personal medical information. Here, we determined how patients view disclosure of research PET results of brain amyloid and why they believe it is advantageous or disadvantageous to disclose. As a part of a larger diagnostic trial, we conducted semi-structured interviews with patients with amnestic Mild Cognitive Impairment (aMCI). Participants had the option to receive their brain amyloid PET scan result (i.e., their IRR). Interviews were conducted before they received their IRR. A total of 38 aMCI patients (100% of study participants) wanted to know their IRR. The two most frequently mentioned reasons for choosing IRR disclosure were to better understand their brain health status and to be better able to make informed decisions about future personal arrangements (e.g., inheritance tax, moving into a smaller house, end-of-life decisions, etc.). Emotional risk was mentioned as the primary disadvantage of knowing one's IRR. On the other hand, non-disclosure was considered to be emotionally difficult also, as patients would be uncertain about their future health condition. Many patients diagnosed clinically with aMCI want to know their brain amyloid test results, even though this knowledge may be disadvantageous to them. Knowing what is going on with their health and the ability to make informed decisions about their future were the two principal advantages mentioned for obtaining their amyloid PET results. Because of the overwhelming consensus of aMCI patients was to disclose their brain amyloid PET scan results, researchers should strongly consider releasing this information to research subjects.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-12-15

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

  4. Imaging of amyloid using [11C]-PIB PET in patients with Alzheimer's disease

    International Nuclear Information System (INIS)

    Hatashita, Shizuo; Yamasaki, Hidetomo

    2010-01-01

    We investigated whether [N-methyl- 11 C]2-(4'-metylaminophenyl)-6-hydroxybenzothiazole ([11C]-PIB) positron emission tomography (PET) detects underlying amyloid deposition at clinically different stages of Alzheimer's disease (AD). Post-mortem study of typical AD brain has recently demonstrated that the in vivo retention of PIB is related directly to the amount of insoluble amyloid B peptides, including amyloid plaques. Fifty-six patients who met criteria for AD and 74 age-matched healthy controls (HC) were included. All subjects underwent cognitive testing and 60-min dynamic [11C]-PIB PET. [11C]-PIB data were acquired from 35-60 min after injection. Regions of interest were defined on co-registered MRI and applied to dynamic images. Distribution volume ratios (DVR) of PIB retention were determined using Logan graphical analysis (cerebellar gray as reference region). All 56 patients with AD showed robust increases in PIB retention in cingulate, precuneus, frontal, parietal, and lateral temporal cortical regions (typical PIB AD-pattern). In contrast, there was no PIB retention in cortical regions in all HC subjects. Mean DVR values in 11 patients with moderate AD (clinical dementia rating (CDR): 2.1±0.4) showed significantly higher PIB retention (2.38±0.42, P<0.01) than in HC subjects. The DVR values in 23 patients with very mild AD (CDR: 0.5) and 22 patients with mild AD (CDR: 1.0) were 2.32±0.45 and 2.34±0.42, respectively, and were similar to moderate AD. Mean DVR values in whole cortical regions did not significantly correlated with mini-mental state examination (MMSE) or CDR sum of boxes (SB) score in AD patients. The [11C]-PIB PET scan is potentially useful as a non-invasive method to determine brain amyloid deposition. In vivo PIB PET imaging is distinctive and reliable biomarkers of AD, even in early stage of AD. (author)

  5. Harmonizing FDG PET quantification while maintaining optimal lesion detection: prospective multicentre validation in 517 oncology patients

    International Nuclear Information System (INIS)

    Quak, Elske; Le Roux, Pierre-Yves; Robin, Philippe; Bourhis, David; Salaun, Pierre-Yves; Hofman, Michael S.; Callahan, Jason; Binns, David; Hicks, Rodney J.; Desmonts, Cedric; Aide, Nicolas

    2015-01-01

    Point-spread function (PSF) or PSF + time-of-flight (TOF) reconstruction may improve lesion detection in oncologic PET, but can alter quantitation resulting in variable standardized uptake values (SUVs) between different PET systems. This study aims to validate a proprietary software tool (EQ.PET) to harmonize SUVs across different PET systems independent of the reconstruction algorithm used. NEMA NU2 phantom data were used to calculate the appropriate filter for each PSF or PSF+TOF reconstruction from three different PET systems, in order to obtain EANM compliant recovery coefficients. PET data from 517 oncology patients were reconstructed with a PSF or PSF+TOF reconstruction for optimal tumour detection and an ordered subset expectation maximization (OSEM3D) reconstruction known to fulfil EANM guidelines. Post-reconstruction, the proprietary filter was applied to the PSF or PSF+TOF data (PSF EQ or PSF+TOF EQ ). SUVs for PSF or PSF+TOF and PSF EQ or PSF+TOF EQ were compared to SUVs for the OSEM3D reconstruction. The impact of potential confounders on the EQ.PET methodology including lesion and patient characteristics was studied, as was the adherence to imaging guidelines. For the 1380 tumour lesions studied, Bland-Altman analysis showed a mean ratio between PSF or PSF+TOF and OSEM3D of 1.46 (95 %CI: 0.86-2.06) and 1.23 (95 %CI: 0.95-1.51) for SUV max and SUV peak , respectively. Application of the proprietary filter improved these ratios to 1.02 (95 %CI: 0.88-1.16) and 1.04 (95 %CI: 0.92-1.17) for SUV max and SUV peak , respectively. The influence of the different confounding factors studied (lesion size, location, radial offset and patient's BMI) was less than 5 %. Adherence to the European Association of Nuclear Medicine (EANM) guidelines for tumour imaging was good. These data indicate that it is not necessary to sacrifice the superior lesion detection and image quality achieved by newer reconstruction techniques in the quest for harmonizing quantitative

  6. SU-E-J-86: Lobar Lung Function Quantification by PET Galligas and CT Ventilation Imaging in Lung Cancer Patients

    International Nuclear Information System (INIS)

    Eslick, E; Kipritidis, J; Keall, P; Bailey, D; Bailey, E

    2014-01-01

    Purpose: The purpose of this study was to quantify the lobar lung function using the novel PET Galligas ([68Ga]-carbon nanoparticle) ventilation imaging and the investigational CT ventilation imaging in lung cancer patients pre-treatment. Methods: We present results on our first three lung cancer patients (2 male, mean age 78 years) as part of an ongoing ethics approved study. For each patient a PET Galligas ventilation (PET-V) image and a pair of breath hold CT images (end-exhale and end-inhale tidal volumes) were acquired using a Siemens Biograph PET CT. CT-ventilation (CT-V) images were created from the pair of CT images using deformable image registration (DIR) algorithms and the Hounsfield Unit (HU) ventilation metric. A comparison of ventilation quantification from each modality was done on the lobar level and the voxel level. A Bland-Altman plot was used to assess the difference in mean percentage contribution of each lobe to the total lung function between the two modalities. For each patient, a voxel-wise Spearmans correlation was calculated for the whole lungs between the two modalities. Results: The Bland-Altman plot demonstrated strong agreement between PET-V and CT-V for assessment of lobar function (r=0.99, p<0.001; range mean difference: −5.5 to 3.0). The correlation between PET-V and CT-V at the voxel level was moderate(r=0.60, p<0.001). Conclusion: This preliminary study on the three patients data sets demonstrated strong agreement between PET and CT ventilation imaging for the assessment of pre-treatment lung function at the lobar level. Agreement was only moderate at the level of voxel correlations. These results indicate that CT ventilation imaging has potential for assessing pre-treatment lobar lung function in lung cancer patients

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  8. PET/CT-guided treatment planning for paediatric cancer patients: a simulation study of proton and conventional photon therapy

    Science.gov (United States)

    Brodin, N P; Björk-Eriksson, T; Birk Christensen, C; Kiil-Berthelsen, A; Aznar, M C; Hollensen, C; Markova, E; Munck af Rosenschöld, P

    2015-01-01

    Objective: To investigate the impact of including fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) scanning in the planning of paediatric radiotherapy (RT). Methods: Target volumes were first delineated without and subsequently re-delineated with access to 18F-FDG PET scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP) and estimated risk of secondary cancer (SC). Results: Considerable deviations between CT- and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target volumes, target dose coverage, irradiated volumes, estimated NTCP or SC risk, neither for IMPT nor 3DCRT. Conclusion: Our results imply that the inclusion of PET/CT scans in the RT planning process could have considerable impact for individual patients. There were no general trends of increasing or decreasing irradiated volumes, suggesting that the long-term morbidity of RT in childhood would on average remain largely unaffected. Advances in knowledge: 18F-FDG PET-based RT planning does not systematically change NTCP or SC risk for paediatric cancer patients compared with CT only. 3 out of 11 patients had a distinct change of target volumes when PET-guided planning was introduced. Dice and mismatch metrics are not sufficient to assess the consequences of target volume differences in the context of RT. PMID:25494657

  9. Evaluation of the various hepatic lesions with PET

    International Nuclear Information System (INIS)

    Han, Chul Ju

    1999-12-01

    When a liver lesion is found in a PET image, differential diagnosis and analysis of the lesion is very important. We tried to analyze hepatic lesions found in PET. 27 patients with focal liver lesions (6 patients with HCC, 5 patients with cholangiocarcinoma (CC), 9 patients with liver metastasis, 2 patients with hemangioma, 3 patients with liver abscess, and 1 patient with liver candidiasis) were examined. The concordance rates between CT and PET images were 57 % (4/7) for HCC, 83 % (5/6) for CC, 89% (8/9) for metastatic liver cancer, 100 % (6/6) for benign liver lesions. Therefore, PET was partially useful in the diagnosis of HCC, but it was very useful in the diagnosis of CC of liver metastasis. The contrast between lesions and surrounding liver background was very conspicuous in PET images of CC or liver metastasis, which suggests that PET might be used for the follow up and assessment of treatment response of these disease

  10. Evaluation of the various hepatic lesions with PET

    Energy Technology Data Exchange (ETDEWEB)

    Han, Chul Ju

    1999-12-01

    When a liver lesion is found in a PET image, differential diagnosis and analysis of the lesion is very important. We tried to analyze hepatic lesions found in PET. 27 patients with focal liver lesions (6 patients with HCC, 5 patients with cholangiocarcinoma (CC), 9 patients with liver metastasis, 2 patients with hemangioma, 3 patients with liver abscess, and 1 patient with liver candidiasis) were examined. The concordance rates between CT and PET images were 57 % (4/7) for HCC, 83 % (5/6) for CC, 89% (8/9) for metastatic liver cancer, 100 % (6/6) for benign liver lesions. Therefore, PET was partially useful in the diagnosis of HCC, but it was very useful in the diagnosis of CC of liver metastasis. The contrast between lesions and surrounding liver background was very conspicuous in PET images of CC or liver metastasis, which suggests that PET might be used for the follow up and assessment of treatment response of these disease.

  11. Diagnostic value of contrast-enhanced CT combined with 18-FDG PET in patients selected for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).

    Science.gov (United States)

    Sommariva, Antonio; Evangelista, Laura; Pintacuda, Giovanna; Cervino, Anna Rita; Ramondo, Gaetano; Rossi, Carlo Riccardo

    2018-05-01

    Aim of the study is to assess the reliability and correlation with surgical peritoneal cancer index (PCI) of combined PET/CT and ceCT scans (PET/ceCT) performed in a session in patients with peritoneal carcinomatosis candidates for cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC). We retrospectively analyzed data collected from 27 patients with different types of peritoneal carcinomatosis candidates to CS + HIPEC who underwent FDG PET/ceCT in a single session. Two nuclear medicine physicians and two radiologists independently and blindly evaluated PET/CT and ceCT imaging, respectively. In the case of discordance, the consensus was reached by a discussion between the specialists. Moreover, the combined images were evaluated by all the specialists in consensus. The PCIs obtained from surgical look, PET/CT, ceCT, and PET/ceCT were compared with each other. The coefficients of correlation (r) were calculated. The study was conducted after approval of local ethics committee. Surgical PCI was available in 21 patients. The coefficient of correlation between PCI of PET/CT and surgery was 0.528, while it resulted higher between PET/ceCT and surgery (r = 0.878), very similar to ceCT and surgery (r = 0.876). The r coefficient between surgical PCI and PET/CT was higher in patients with a non-mucinous cancer (n = 12) than the counterpart (0.601 vs. 0.303) and the addition of ceCT significantly increases the correlation (r = 0.863), which is anyway similar to ceCT alone (r = 0.856). PET/ceCT as single examination is more accurate than PET/CT but not than ceCT alone for the definition of PCI in a selected group of patients candidates to CS + HIPEC.

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  13. Instantaneous exposure to nuclear medicine staff involved in PET-CT imaging in developing countries. Experience from a tertiary care centre in India

    International Nuclear Information System (INIS)

    Kumar, S.; Sharma, P.; Shamim, S.A.; Malhotra, A.; Kumar, R.; Pandey, A.K.

    2012-01-01

    The purpose of this study was to assess the radiation exposure to nuclear medicine staff at a positron emission tomography-computed tomography (PET-CT) centre with high patient throughput. This prospective study included 70 adult patients who underwent 18F-fluorodeoxyglucose (FDG) PET-CT for their clinical indications. The patients' actual injected FDG activity was calculated by subtracting the syringe activity (post-injection) from the loaded syringe activity (pre-injection). The instantaneous exposure to nuclear medicine staff involved in PET-CT imaging was measured. The instantaneous dose rate of the physicians was recorded during FDG injection and that of the technologist was recorded during the patient's positioning, respectively, at 1.0-m distance from the anterior chest using a calibrated portable gamma-ray survey meter. The average FDG activity injected in adult patients was 308.5 MBq (range 173.1-438.8 MBq). The instantaneous exposure to the nuclear medicine (NM) physician during the injection time was 31 μSv/h (14-60 μSv/h). The instantaneous exposure to the NM technologist during positioning was 18 (10-34) μSv/h. With an average of 10 patients per day, the quarterly dose to physicians was 628 μSv and to technologists 182 μSv for 300 patients. The extrapolated annual dose was 2.5 mSv for physicians and 0.7 mSv for technologists, respectively. Instantaneous exposure of nuclear medicine staff involved in PET-CT imaging at a busy tertiary care centre is within permissible limits of the International Commission on Radiological Protection (ICRP-103) (total 50 mSv in a single year) and atomic energy regulatory board (total 30 mSv in a single year). (author)

  14. Evaluation of various hepatic lesions with PET

    International Nuclear Information System (INIS)

    Han, Chul Ju

    2000-12-01

    When a liver lesion is found in a PET image, differential diagnosis and analysis of the lesion is very important. We tried to analyze hepatic lesions found in PET. 53 patients with focal liver lesions (13 patients with HCC, 8 patients with cholangiocarcinoma (CC), 20 patients with liver metastasis, 5 patients with hemangioma, 7 patients with liver abscess, including 1 patient with liver candidiasis) were examined. Definitely high FDG uptake pattern were observed in 54% (7/13) of HCC, 100% (8/8) of CC, 95% (19/20) of metastatic liver cancer and 100% (7/7) of liver abscess. Therefore, PET was partially useful in the diagnosis of HCC, but it was very useful in the diagnosis of CC or liver metastasis or liver abscess. The contrast between lesions and surrounding liver background was very conspicuous in PET images of CC or liver metastasis or liver abscess, which suggests that PET might be used for the follow up and assessment of treatment response of these diseases

  15. Evaluation of various hepatic lesions with PET

    Energy Technology Data Exchange (ETDEWEB)

    Han, Chul Ju

    2000-12-01

    When a liver lesion is found in a PET image, differential diagnosis and analysis of the lesion is very important. We tried to analyze hepatic lesions found in PET. 53 patients with focal liver lesions (13 patients with HCC, 8 patients with cholangiocarcinoma (CC), 20 patients with liver metastasis, 5 patients with hemangioma, 7 patients with liver abscess, including 1 patient with liver candidiasis) were examined. Definitely high FDG uptake pattern were observed in 54% (7/13) of HCC, 100% (8/8) of CC, 95% (19/20) of metastatic liver cancer and 100% (7/7) of liver abscess. Therefore, PET was partially useful in the diagnosis of HCC, but it was very useful in the diagnosis of CC or liver metastasis or liver abscess. The contrast between lesions and surrounding liver background was very conspicuous in PET images of CC or liver metastasis or liver abscess, which suggests that PET might be used for the follow up and assessment of treatment response of these diseases.

  16. Predictive value of {sup 18}F-FDG PET/CT in restaging patients affected by ovarian carcinoma: a multicentre study

    Energy Technology Data Exchange (ETDEWEB)

    Caobelli, Federico [Medizinische Hochschule Hannover, Klinik fuer Nuklearmedizin, Hanover (Germany); Alongi, Pierpaolo [University of Milano-Bicocca, Nuclear Medicine Unit, Milan (Italy); IRCSS San Raffaele Scientific Institute, Nuclear Medicine Department, Milan (Italy); Evangelista, Laura; Saladini, Giorgio [Veneto Institute of Oncology IOV - IRCCS, Radiotherapy and Nuclear Medicine Unit, Padua (Italy); Picchio, Maria [IRCSS San Raffaele Scientific Institute, Nuclear Medicine Department, Milan (Italy); Rensi, Marco; Geatti, Onelio [Hospital of Udine, Nuclear Medicine Department, Udine (Italy); Castello, Angelo; Laghai, Iashar [University of Florence, Nuclear Medicine Department, Florence (Italy); Popescu, Cristina E. [Niguarda Ca' Granda Hospital, Nuclear Medicine Department, Milan (Italy); Dolci, Carlotta; Crivellaro, Cinzia [University of Milan-Bicocca, Nuclear Medicine Department, San Gerardo Hospital, Tecnomed Foundation, Milan (Italy); Seghezzi, Silvia [Hospital of Treviglio, Nuclear Medicine Department, Treviglio, Bergamo (Italy); Kirienko, Margarita [University of Milano-Bicocca, Nuclear Medicine Unit, Milan (Italy); De Biasi, Vincenzo [Nuclear Medicine Department, Arcispedale Santa Maria Nuova, Reggio Emilia (Italy); Cocciolillo, Fabrizio [Catholic University of the Sacred Heart, Nuclear Medicine Department, Rome (Italy); Quartuccio, Natale [University of Messina, Nuclear Medicine Unit, Department of Biomedical Sciences and of Morphological and Functional Images, Messina (Italy); Collaboration: Young AIMN Working Group

    2016-03-15

    Ovarian cancer is the eighth most common malignancy among women and has a high mortality rate. Prognostic factors able to drive an effective therapy are essential. {sup 18}F-Fluoro-2-deoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) has been investigated in patients with epithelial ovarian cancer and showed promise in diagnosing, staging, detecting recurrent lesions and monitoring treatment response. Conversely, its prognostic role remains unclear. We aimed at assessing the prognostic value of {sup 18}F-FDG PET/CT performed in the restaging process in a multicentre study. We evaluated 168 patients affected by ovarian carcinoma, who underwent a restaging {sup 18}F-FDG PET/CT. The presence of local recurrences, lymph node involvement and distant metastasis was recorded as well as lesion dimensions, maximum and mean standardized uptake values (SUV{sub max} and SUV{sub mean}, respectively). Progression-free survival (PFS) and overall survival (OS) at 3 and 4 years were computed by using Kaplan-Meier curves. Increased odds ratio was assessed using Cox regression analysis testing all lesion parameters measured by PET/CT. PFS was significantly longer in patients with a negative than a positive restaging PET/CT study (3- and 4-year PFS 64 and 53 % vs 23 and 12 %, respectively; p < 0.001). Similarly, a negative study was associated with a significantly higher OS rate after 4 years of follow-up (67 vs 25 % in negative and positive groups, respectively; p < 0.001). Lymph node or distant involvement were also independently associated with an increased risk of disease progression [hazard ratio (HR) 1.6 and 2.2, respectively; p = 0.003]. Moreover, PET/CT showed an incremental prognostic value compared to the International Federation of Gynecology and Obstetrics (FIGO) staging system. In the analysis of patient subsets, individuals with the same FIGO stage I-II but with negative PET had a significantly better 4-year OS than patients with low

  17. How much can a negative FDG-PET be trusted?

    International Nuclear Information System (INIS)

    Wang Shuxia

    2004-01-01

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

  18. Additional value of 16{alpha}-[{sup 18}F]fluoro-17{beta}-oestradiol PET for differential diagnosis between uterine sarcoma and leiomyoma in patients with positive or equivocal findings on [{sup 18}F]fluorodeoxyglucose PET

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Yoshio; Kurokawa, Tetsuji; Kotsuji, Fumikazu [University of Fukui, Department of Gynecology, Faculty of Medical Sciences, Fukui (Japan); Kiyono, Yasushi; Tsujikawa, Tetsuya; Okazawa, Hidehiko [University of Fukui, Biomedical Imaging Research Center, Fukui (Japan)

    2011-10-15

    Pathological data suggest that the rate of oestrogen receptor (ER) expression in uterine sarcoma is significantly lower than in leiomyoma. The present study aimed to investigate whether ER expression using ER imaging agents for positron emission tomography (PET), of which the most successful has been 16{alpha}-[{sup 18}F]-fluoro-17{beta}-oestradiol (FES), is able to add useful information to the differential diagnosis of uterine sarcoma and leiomyoma in patients with positive or equivocal findings on [{sup 18}F]fluorodeoxyglucose (FDG) PET. A total of 76 patients with suspected uterine sarcoma based on ultrasound and magnetic resonance imaging findings from 2007 to 2010 were enrolled. Twenty-four of the present patients were referred for FES PET because of FDG PET findings that showed equivocal or positive FDG uptake. PET images were quantitatively evaluated with reference to histopathological findings. Receiver-operating characteristic analysis was performed to determine the optimal cutoff value to differentiate uterine sarcoma and leiomyoma. Of the 24 patients, 11 had a final diagnosis of uterine sarcoma, while 13 had leiomyoma. The sensitivity, specificity and accuracy of an FDG to FES standardized uptake value (SUV) ratio greater than 2.0 were significantly higher using Cochran's Q test (p = 0.024) when compared with FDG PET greater than 3.0 alone (90.9 vs 81.8%, 92.3 vs 84.6% and 91.3 vs 83.3%, respectively). Additional FES PET findings confirmed uterine sarcoma in 91.3% of a selected group of patients with equivocal or positive FDG uptake. (orig.)

  19. Negative predictive value of 124I-PET/CT imaging in patients affected by metastatic thyroid cancer and treated with 131I

    International Nuclear Information System (INIS)

    Pettinato, C.; Civollani, S.; Nanni, C.; Celli, M.; Allegri, V.; Zagni, P.; Fanti, S.; Monari, F.; Cima, S.; Mazzarotto, R.; Spezi, E.

    2015-01-01

    Full text of publication follows. Aim: patients affected by metastatic Differentiated Thyroid Cancer (mDTC) are treated with 131 I even in presence of negative diagnostic 131 I whole body (WB) scan. Actually, very often, these patients present positive post therapy 131 I whole body scan, showing iodine avid metastases that were not seen with the diagnostic imaging. The aim of this work was the evaluation of the feasibility to use 124 I PET/CT images to predict patients who will not benefit from the iodine therapy, because of the absence of avidity, avoiding useless treatments. Material and methods: 25 patients affected by mDTC were enrolled in the study approved by the ethical Committee of our Institution, with the aim to evaluate the usefulness of 124 I PET/CT sequential scans to predict absorbed doses to metastatic thyroid cancer patients undergoing 131 I therapy. Patients (pts) were divided into 4 groups, based on their histology: group A, 4 pts with follicular cancer; group B, 13 pts with papillary cancer; group C, 2 pts with papillary tall cells cancer; group D, 6 patients with papillary cancer with follicular variant. Patients showing negative 124 I-PET/CT were treated with a reduced dose of 131 I (3700 MBq) and post treatment WB scans were acquired 96 hours after the therapeutic administration. Results: 12 patients showed at least one metastatic lesion at 124 I PET/CT imaging, and most of the lesions were visible at the 24 hours scan (4 pts group A, 3 pts group B, 5 pts group D). The remaining 13 patients did not show any uptake of all known metastatic lesions at each PET/CT time points (10 pts group B, 2 pts group C, 1 pt group D). Negative PET/CT findings were confirmed by post therapy WB scan. Discussion and Conclusion: 124 I-PET/CT scan is a useful diagnostic tool to discriminate patients with iodine avid metastases. Actually, when they are present, the superiority of PET/CT resolution and sensitivity, compared to standard 131 I planar imaging, allow the

  20. Clinical PET application

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang Moo; Hong, Song W.; Choi, Chang W.; Yang, Seong Dae [Korea Cancer Center Hospital, Seoul (Korea)

    1997-12-01

    PET gives various methabolic images, and is very important, new diagnostic modality in clinical oncology. In Korea Cancer Center Hospital, PET is installed as a research tool of long-mid-term atomic research project. For the efficient use of PET for clinical and research projects, income from the patients should be managed to get the raw material, equipment, manpower, and also for the clinical PET research. 1. Support the clinical application of PET in oncology. 2. Budgetary management of income, costs for raw material, equipment, manpower, and the clinical PET research project. In this year, 250 cases of PET images were obtained, which resulted total income of 180,000,000 won. 50,000,000 won was deposited for the 1998 PET clinical research. Second year PET clinical research should be managed under unified project. Increased demand for {sup 18}FDG in and outside KCCH need more than 2 times production of {sup 18}FDG in a day purchase of HPLC pump and {sup 68}Ga pin source which was delayed due to economic crisis, should be done early in 1998. (author). 2 figs., 3 tabs.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  2. FDG-PET in Follicular Lymphoma Management

    Directory of Open Access Journals (Sweden)

    C. Bodet-Milin

    2012-01-01

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

  3. Generating Evidence for Clinical Benefit of PET/CT in Diagnosing Cancer Patients

    DEFF Research Database (Denmark)

    Vach, Werner; Høilund-Carlsen, Poul Flemming; Gerke, Oke

    2011-01-01

    For diagnostic methods such as PET/CT, not only diagnostic accuracy but also clinical benefit must be demonstrated. However, there is a lack of consensus about how to approach this task. Here we consider 6 clinical scenarios to review some basic approaches to demonstrating the clinical benefit...... of PET/CT in cancer patients: replacement of an invasive procedure, improved accuracy of initial diagnosis, improved accuracy of staging for curative versus palliative treatment, improved accuracy of staging for radiation versus chemotherapy, response evaluation, and acceleration of clinical decisions....... We also develop some guidelines for the evaluation of clinical benefit. First, it should be clarified whether there is a direct benefit of the use of PET/CT or an indirect benefit because of improved diagnostic accuracy. If there is an indirect benefit, then decision modeling should be used initially...

  4. Are Pets in the Bedroom a Problem?

    Science.gov (United States)

    Krahn, Lois E; Tovar, M Diane; Miller, Bernie

    2015-12-01

    The presence of pets in the bedroom can alter the sleep environment in ways that could affect sleep. Data were collected by questionnaire and interview from 150 consecutive patients seen at the Center for Sleep Medicine, Mayo Clinic in Arizona. Seventy-four people (49%) reported having pets, with 31 (41% of pet owners) having multiple pets. More than half of pet owners (56%) allowed their pets to sleep in the bedroom. Fifteen pet owners (20%) described their pets as disruptive, whereas 31 (41%) perceived their pets as unobtrusive or even beneficial to sleep. Health care professionals working with patients with sleep concerns should inquire about the presence of companion animals in the sleep environment to help them find solutions and optimize their sleep. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2018-05-22

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

  6. SPECT and PET imaging in epilepsy

    International Nuclear Information System (INIS)

    Semah, F.

    2007-01-01

    Positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging are very useful for the management of patients with medically refractory partial epilepsy. Presurgical evaluation of patients with medically refractory partial epilepsy often included PET imaging using FDG. The use of SPECT in these patients adds some more information and gives the clinicians the possibility of having ictal imaging. Furthermore, PET and SPECT imaging are performed to better understand the pathophysiology of epilepsy. (authors)

  7. TOF-PET/MR和TOF-PET/CT在体部恶性肿瘤SUVmax值的比较%Comparision of SUVmax of TOF-PET/MR and TOF-PET/CT in body malignant tumor

    Institute of Scientific and Technical Information of China (English)

    宋天彬; 卢洁; 崔碧霄; 马杰; 杨宏伟; 马蕾; 梁志刚

    2017-01-01

    目的 探讨时间飞行(TOF)技术PET/CT和PET/MR检查体部恶性病变SUVmax值的一致性.方法 回顾性分析接受TOF-PET/CT和TOF-PET/MR检查的体部恶性肿瘤患者20例,分为先PET/CT后PET/MR组和先PET/MR后PET/CT组,每组10例.采用Bland-Altma图评价两次检查病灶SUVmax值的一致性,采用多因素方差分析评价扫描顺序和机器类型对病灶的SUVmax测量值的影响.结果 TOF-PET/CT与TOF-PET/MR检查病灶的SUVmax值有较好的一致性[先PET/CT后PET/MR组:均值差为3.06,95%CI(-7.5,13.6),先PET/MR后PET/CT组:均值差3.0,95%CI(-2.4,8.3)].扫描顺序对于恶性病灶的SUVmax有影响(F=46.00,P<0.001),而机器类型对恶性病灶的SUVmax值无影响(F=0.005,P=0.95).结论 TOF-PET/MR和TOF-PET/CT在体部恶性病变SUVmax值测量方面具有相当的诊断价值,且延迟显像SUVmax的增加与采集时间有关,而与检查机器类型无关.%Objective To explore the consistency of time-of-flight (TOF) technology of PET/MRI and PET/CT for max standardized uptake value (SUVmax) of body malignant tumors.Methods A retrospective analysis of TOF-PET/CT and TOF-PET/MR imaging data about twenty patients with body malignant tumors was performed.Patients were divided into two groups (each n=10),including PET/CT first and sequentially PET/MR group and PET/MR first and sequentially PET/CT group.Bland-Altman figure was used to evaluate consistency of SUVmax of malignant lesions between TOF-PET/CT and TOF-PET/MR.Multi-way ANOVA was used to analysis effect of machine type and exam order on SUVmaxof malignant lesions in TOF-PET/CT and TOF-PET/MR.Results SUVmax of malignant lesions in TOF-PET/CT and TOF-PET/MR had good consistency in two groups (PET/CT first and sequentially PET/MR group:Mean difference was 3.06,95%CI was [-7.5,13.6];PET/MR first and sequentially PET/CT group:Mean difference was 3.0,95%CI was [-2.4,8.3]).SUVmax was not influenced by machine type (F=0.005,P=0.95),but exam order (F=46.00,P<0

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-04-15

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

  9. Prediction of disease-free survival by the PET/CT radiomic signature in non-small cell lung cancer patients undergoing surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kirienko, Margarita; Fogliata, Antonella; Sollini, Martina [Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan (Italy); Cozzi, Luca [Humanitas Clinical and Research Center, Radiotherapy and Radiosurgery, Rozzano, Milan (Italy); Antunovic, Lidija [Humanitas Clinical and Research Center, Nuclear Medicine, Rozzano, Milan (Italy); Lozza, Lisa [Orobix Srl, Bergamo (Italy); Voulaz, Emanuele [Humanitas Clinical and Research Center, Thoracic Surgery, Rozzano, Milan (Italy); Rossi, Alexia [Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan (Italy); Humanitas Clinical and Research Center, Radiology, Rozzano, Milan (Italy); Chiti, Arturo [Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan (Italy); Humanitas Clinical and Research Center, Nuclear Medicine, Rozzano, Milan (Italy)

    2018-02-15

    Radiomic features derived from the texture analysis of different imaging modalities e show promise in lesion characterisation, response prediction, and prognostication in lung cancer patients. The present study aimed to identify an images-based radiomic signature capable of predicting disease-free survival (DFS) in non-small cell lung cancer (NSCLC) patients undergoing surgery. A cohort of 295 patients was selected. Clinical parameters (age, sex, histological type, tumour grade, and stage) were recorded for all patients. The endpoint of this study was DFS. Both computed tomography (CT) and fluorodeoxyglucose positron emission tomography (PET) images generated from the PET/CT scanner were analysed. Textural features were calculated using the LifeX package. Statistical analysis was performed using the R platform. The datasets were separated into two cohorts by random selection to perform training and validation of the statistical models. Predictors were fed into a multivariate Cox proportional hazard regression model and the receiver operating characteristic (ROC) curve as well as the corresponding area under the curve (AUC) were computed for each model built. The Cox models that included radiomic features for the CT, the PET, and the PET+CT images resulted in an AUC of 0.75 (95%CI: 0.65-0.85), 0.68 (95%CI: 0.57-0.80), and 0.68 (95%CI: 0.58-0.74), respectively. The addition of clinical predictors to the Cox models resulted in an AUC of 0.61 (95%CI: 0.51-0.69), 0.64 (95%CI: 0.53-0.75), and 0.65 (95%CI: 0.50-0.72) for the CT, the PET, and the PET+CT images, respectively. A radiomic signature, for either CT, PET, or PET/CT images, has been identified and validated for the prediction of disease-free survival in patients with non-small cell lung cancer treated by surgery. (orig.)

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

    Science.gov (United States)

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

    2013-03-01

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

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

    Institute of Scientific and Technical Information of China (English)

    童林军; 陈虞梅; 施一平; 万良荣; 陈涛

    2012-01-01

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

  12. The usefulness of MRI and PET imaging for the detection of parametrial involvement and lymph node metastasis in patients with cervical cancer

    International Nuclear Information System (INIS)

    Park, Won; Park, Young-Je; Huh, Seung-Jae

    2005-01-01

    The purpose of this study is to elucidate the usefulness of magnetic resonance imaging (MRI) and positron emission tomography (PET) for the detection of parametrial involvement and lymph node metastasis in patients with cervical cancer. Thirty-six patients with cervical cancer were retrospectively enrolled. MRI and PET scans were performed for all patients within a week before radical surgery. The criterion for malignancy on MRI was >1 cm short axis diameter of the suspected lymph node. On PET, only fluorodeoxyglucose (FDG) uptake was significantly higher than the background and, if this FDG uptake showed on at least two consecutive axial slices, then the lesion was considered as a malignancy. We compared the extent of tumor on the surgical findings with the International Federation of Gynecology and Obstetrics (FIGO) staging, MRI and PET scans. The accuracy of FIGO and MRI staging was 67 and 84.4%, respectively. The accuracy for detecting pelvic lymph node metastasis was better for PET than for MRI (78 versus 67%, respectively). All FDG uptake lymph nodes were confirmed as metastatic lymph nodes by pathological evaluation; this included five lymph nodes <1 cm in diameter. MRI provides an improved evaluation of local tumor extension, but PET is more useful for the evaluation of pelvic lymph nodes than MRI; however, PET still misses microscopic disease. Further studies are necessary to evaluate the usefulness of PET/computed tomography (CT) for the accuracy of the disease extension and the cost-effectiveness of MRI, PET or PET/CT in patients with cervical cancer. (author)

  13. Competitive advantage of PET/MRI

    Energy Technology Data Exchange (ETDEWEB)

    Jadvar, Hossein, E-mail: jadvar@usc.edu; Colletti, Patrick M.

    2014-01-15

    Multimodality imaging has made great strides in the imaging evaluation of patients with a variety of diseases. Positron emission tomography/computed tomography (PET/CT) is now established as the imaging modality of choice in many clinical conditions, particularly in oncology. While the initial development of combined PET/magnetic resonance imaging (PET/MRI) was in the preclinical arena, hybrid PET/MR scanners are now available for clinical use. PET/MRI combines the unique features of MRI including excellent soft tissue contrast, diffusion-weighted imaging, dynamic contrast-enhanced imaging, fMRI and other specialized sequences as well as MR spectroscopy with the quantitative physiologic information that is provided by PET. Most evidence for the potential clinical utility of PET/MRI is based on studies performed with side-by-side comparison or software-fused MRI and PET images. Data on distinctive utility of hybrid PET/MRI are rapidly emerging. There are potential competitive advantages of PET/MRI over PET/CT. In general, PET/MRI may be preferred over PET/CT where the unique features of MRI provide more robust imaging evaluation in certain clinical settings. The exact role and potential utility of simultaneous data acquisition in specific research and clinical settings will need to be defined. It may be that simultaneous PET/MRI will be best suited for clinical situations that are disease-specific, organ-specific, related to diseases of the children or in those patients undergoing repeated imaging for whom cumulative radiation dose must be kept as low as reasonably achievable. PET/MRI also offers interesting opportunities for use of dual modality probes. Upon clear definition of clinical utility, other important and practical issues related to business operational model, clinical workflow and reimbursement will also be resolved.

  14. Competitive advantage of PET/MRI.

    Science.gov (United States)

    Jadvar, Hossein; Colletti, Patrick M

    2014-01-01

    Multimodality imaging has made great strides in the imaging evaluation of patients with a variety of diseases. Positron emission tomography/computed tomography (PET/CT) is now established as the imaging modality of choice in many clinical conditions, particularly in oncology. While the initial development of combined PET/magnetic resonance imaging (PET/MRI) was in the preclinical arena, hybrid PET/MR scanners are now available for clinical use. PET/MRI combines the unique features of MRI including excellent soft tissue contrast, diffusion-weighted imaging, dynamic contrast-enhanced imaging, fMRI and other specialized sequences as well as MR spectroscopy with the quantitative physiologic information that is provided by PET. Most evidence for the potential clinical utility of PET/MRI is based on studies performed with side-by-side comparison or software-fused MRI and PET images. Data on distinctive utility of hybrid PET/MRI are rapidly emerging. There are potential competitive advantages of PET/MRI over PET/CT. In general, PET/MRI may be preferred over PET/CT where the unique features of MRI provide more robust imaging evaluation in certain clinical settings. The exact role and potential utility of simultaneous data acquisition in specific research and clinical settings will need to be defined. It may be that simultaneous PET/MRI will be best suited for clinical situations that are disease-specific, organ-specific, related to diseases of the children or in those patients undergoing repeated imaging for whom cumulative radiation dose must be kept as low as reasonably achievable. PET/MRI also offers interesting opportunities for use of dual modality probes. Upon clear definition of clinical utility, other important and practical issues related to business operational model, clinical workflow and reimbursement will also be resolved. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Competitive advantage of PET/MRI

    International Nuclear Information System (INIS)

    Jadvar, Hossein; Colletti, Patrick M.

    2014-01-01

    Multimodality imaging has made great strides in the imaging evaluation of patients with a variety of diseases. Positron emission tomography/computed tomography (PET/CT) is now established as the imaging modality of choice in many clinical conditions, particularly in oncology. While the initial development of combined PET/magnetic resonance imaging (PET/MRI) was in the preclinical arena, hybrid PET/MR scanners are now available for clinical use. PET/MRI combines the unique features of MRI including excellent soft tissue contrast, diffusion-weighted imaging, dynamic contrast-enhanced imaging, fMRI and other specialized sequences as well as MR spectroscopy with the quantitative physiologic information that is provided by PET. Most evidence for the potential clinical utility of PET/MRI is based on studies performed with side-by-side comparison or software-fused MRI and PET images. Data on distinctive utility of hybrid PET/MRI are rapidly emerging. There are potential competitive advantages of PET/MRI over PET/CT. In general, PET/MRI may be preferred over PET/CT where the unique features of MRI provide more robust imaging evaluation in certain clinical settings. The exact role and potential utility of simultaneous data acquisition in specific research and clinical settings will need to be defined. It may be that simultaneous PET/MRI will be best suited for clinical situations that are disease-specific, organ-specific, related to diseases of the children or in those patients undergoing repeated imaging for whom cumulative radiation dose must be kept as low as reasonably achievable. PET/MRI also offers interesting opportunities for use of dual modality probes. Upon clear definition of clinical utility, other important and practical issues related to business operational model, clinical workflow and reimbursement will also be resolved

  16. 18F-FDG PET/CT for early detection of embolism and metastatic infection in patients with infective endocarditis

    International Nuclear Information System (INIS)

    Riet, Jelle van; Gheysens, Olivier; Mortelmans, Luc; Hill, Evelyn E.; Herregods, Marie-Christine; Dymarkowski, Steven; Herijgers, Paul; Peetermans, Willy E.

    2010-01-01

    In the acute setting of endocarditis it is very important to assess both the vegetation itself, as well as potential life-threatening complications, in order to decide whether antibiotic therapy will be sufficient or urgent surgery is indicated. A single whole-body scan investigating inflammatory changes could be very helpful to achieve a swift and efficient assessment. In this study we assessed whether 18 F-FDG can be used to detect and localize peripheral embolism or distant infection. Twenty-four patients with 25 episodes of endocarditis, enrolled between March 2006 and February 2008, underwent 18 F-FDG PET/CT imaging on a dedicated PET/CT scanner. PET/CT imaging revealed a focus of peripheral embolization and/or metastatic infection in 11 episodes (44%). One episode had a positive PET/CT scan result for both embolism and metastatic infection. PET/CT detected seven positive cases (28%) in which there was no clinical suspicion. Valve involvement of endocarditis was seen only in three patients (12%). PET/CT may be an important diagnostic tool for tracing peripheral embolism and metastatic infection in the acute setting of infective endocarditis, since a PET/CT scan detected a clinically occult focus in nearly one third of episodes. (orig.)

  17. Clinical impact of {sup 11}C-methionine PET on expected management of patients with brain neoplasm

    Energy Technology Data Exchange (ETDEWEB)

    Yamane, Tomohiko; Senda, Michio [Institution of Biomedical Research and Innovation, Division of Molecular imaging, Kobe (Japan); Sakamoto, Setsu [Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan)

    2010-04-15

    We retrospectively examined the clinical efficacy of {sup 11}C-methionine positron emission tomography ({sup 11}C-MET PET) in patients with brain neoplasm, especially whether the {sup 11}C-MET PET changed the clinical management and whether the change was beneficial or detrimental. This study reviewed 89 {sup 11}C-MET PET scans for 80 patients (20 scans for initial diagnosis of brain tumor and 69 scans for differentiating tumor recurrence from radiation necrosis). Final diagnosis and the effect on the intended management were obtained from the questionnaire to the referring physicians or directly from the medical records. The diagnostic sensitivity, specificity, and accuracy for the {sup 11}C-MET PET were evaluated. Regarding the management impact, the rate of scans that caused changes in intended management was also evaluated. Moreover, the occurrence of scans having detrimental diagnostic impact (DDI) and beneficial diagnostic impact (BDI) were evaluated. Sensitivity, specificity, and accuracy of {sup 11}C-MET PET was 87.8, 80.0, and 85.9%. The intended management was changed in 50.0% of the scans. DDI and BDI were observed in 4.3 and 36.2% of the total relevant scans, respectively. {sup 11}C-MET PET can provide useful information in initial diagnosis and differentiating tumor recurrence from radiation necrosis. The intended management was changed in half of the scans. Since a few cases did not receive the requisite treatment due to false-negative results of {sup 11}C-MET PET, management decision should be made carefully, especially in the case of a negative scan. (orig.)

  18. Unilateral Muscle Artifacts due to Non-compliance During Uptake Phase of 18F-FDG PET/CT in an Oncologic Patient

    Directory of Open Access Journals (Sweden)

    William Makis

    2018-02-01

    Full Text Available A 49-year-old male patient with a prior history of poor compliance with medical appointments was referred for an 18F-fluoro-2-deoxy-D-glucose (18F-FDG positron emission tomography/computed tomography (PET/CT for the staging of a rectal squamous cell carcinoma. The PET/CT showed unilateral diffuse skeletal muscle 18F-FDG uptake as well as bilateral salivary gland uptake artifacts, suggestive of non-compliance with patient preparation instructions. The PET/CT nurse noted that during the 18F-FDG uptake phase, the patient appeared intoxicated, and she found two beer cans hidden in the waste disposal beside his chair just prior to imaging. The patient only admitted to eating a cookie approximately 30 minutes after the injection of 18F-FDG PET/CT and denied consuming alcohol during the uptake phase. We present the imaging findings of non-compliance with patient instructions during the uptake phase of 18F-FDG.

  19. PET/CT imaging in head and neck tumors

    International Nuclear Information System (INIS)

    Roedel, R.; Palmedo, H.; Reichmann, K.; Reinhardt, M.J.; Biersack, H.J.; Straehler-Pohl, H.J.; Jaeger, U.

    2004-01-01

    To evaluate the usefulness of combined PET/CT examinations for detection of malignant tumors and their metastases in head and neck oncology. 51 patients received whole body scans on a dual modality PET/CT system. CT was performed without i.v. contrast. The results were compared concerning the diagnostic impact of native CT scan on FDG-PET images and the additional value of fused imaging. From 153 lesions were 97 classified as malignant on CT and 136 on FDG/PET images, as suspicious for malignancy in 33 on CT and 7 on FDG-PET and as benign in 23 on CT and 10 on FDG-PET. With combined PET/CT all primary and recurrent tumors could be found, the detection rate in patients with unknown primary tumors was 45%. Compared to PET or CT alone the sensitivity, specifity and accuracy could be significantly improved by means of combined PET/CT. Fused PET/CT imaging with [F18]-FDG and native CT-scanning enables accurate diagnosis in 93% of lesions and 90% of patients with head and neck oncology. (orig.) [de

  20. Total-Body PET: Maximizing Sensitivity to Create New Opportunities for Clinical Research and Patient Care.

    Science.gov (United States)

    Cherry, Simon R; Jones, Terry; Karp, Joel S; Qi, Jinyi; Moses, William W; Badawi, Ramsey D

    2018-01-01

    PET is widely considered the most sensitive technique available for noninvasively studying physiology, metabolism, and molecular pathways in the living human being. However, the utility of PET, being a photon-deficient modality, remains constrained by factors including low signal-to-noise ratio, long imaging times, and concerns about radiation dose. Two developments offer the potential to dramatically increase the effective sensitivity of PET. First by increasing the geometric coverage to encompass the entire body, sensitivity can be increased by a factor of about 40 for total-body imaging or a factor of about 4-5 for imaging a single organ such as the brain or heart. The world's first total-body PET/CT scanner is currently under construction to demonstrate how this step change in sensitivity affects the way PET is used both in clinical research and in patient care. Second, there is the future prospect of significant improvements in timing resolution that could lead to further effective sensitivity gains. When combined with total-body PET, this could produce overall sensitivity gains of more than 2 orders of magnitude compared with existing state-of-the-art systems. In this article, we discuss the benefits of increasing body coverage, describe our efforts to develop a first-generation total-body PET/CT scanner, discuss selected application areas for total-body PET, and project the impact of further improvements in time-of-flight PET. © 2018 by the Society of Nuclear Medicine and Molecular Imaging.

  1. The value of FDG-PET/CT in assessing single pulmonary nodules in patients at high risk of lung cancer

    International Nuclear Information System (INIS)

    Kagna, Olga; Solomonov, Anna; Fruchter, Oren; Keidar, Zohar; Bar-Shalom, Rachel; Israel, Ora; Yigla, Mordechai; Guralnik, Luda

    2009-01-01

    To evaluate whether PET/low-dose CT (ldCT) using 18 F-fluorodeoxyglucose (FDG) improves characterization of indeterminate single pulmonary nodules (SPNs) in patients at high risk of lung cancer. Retrospective analysis of 307 patients who underwent FDG-PET/CT for indeterminate SPNs identified 93 (70 men, age range 46-90 years) at high risk of lung cancer (age >40 years, minimum 10 pack-year smokers). SPNs were evaluated for the presence and intensity of FDG avidity and ldCT patterns. The performance of visual and semiquantitative FDG-PET/ldCT algorithms for characterization of SPNs was compared to that of ldCT. Incongruent FDG-PET and ldCT patterns were analyzed for significance in further patient management. Malignancy was diagnosed in 38% patients. FDG avidity defined 33 SPNs as true-positive (TP) and 2 as false-negative (FN) (malignant), and 41 as true-negative (TN) and 17 as false-positive (FP) (benign). For SUVmax of 2.2 (by ROC analysis) there were 27 TP, 8 FN, 48 TN and 10 FP SPNs. LdCT defined 34 TP, 1 FN, 28 TN and 30 FP lesions. Of the FP lesions on ldCT, 60% were FDG-negative. Visual PET/ldCT analysis had a sensitivity of 94%, a specificity of 70%, an accuracy of 80%, a positive predictive value (PPV) of 66%, and a negative predictive value (NPV) of 95% as compared to 77%, 83%, 81%, 73%, 86% for semiquantitative PET/ldCT and 97%, 48%, 66%, 53%, 96% for ldCT, respectively. Both PET/ldCT algorithms had statistically significantly higher specificity and accuracy than ldCT. Semiquantitative analysis showed significantly higher PPV and lower sensitivity and NPV than found with ldCT. A single screening procedure encompassing FDG-PET and ldCT may improve screening for lung cancer in high-risk patients. The significantly improved specificity may potentially reduce FP ldCT results and further unnecessary invasive procedures. (orig.)

  2. 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.

  3. Preliminary results on response assessment using {sup 68}Ga-HBED-CC-PSMA PET/CT in patients with metastatic prostate cancer undergoing docetaxel chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Seitz, Anna Katharina [Technical University of Munich, Department of Urology, Klinikum rechts der Isar, Munich (Germany); Julius Maximilians University Medical Centre of Wuerzburg, Department of Urology and Paediatric Urology, Wuerzburg (Germany); Rauscher, Isabel; Kroenke, Markus; Schwaiger, Markus [Technical University of Munich, Department of Nuclear Medicine, Klinikum rechts der Isar, Munich (Germany); Haller, Bernhard [Technical University of Munich, Institute of Medical Informatics, Statistics and Epidemiology, Klinikum rechts der Isar, Munich (Germany); Luther, Sophia; Heck, Matthias M.; Horn, Thomas; Gschwend, Juergen E.; Maurer, Tobias [Technical University of Munich, Department of Urology, Klinikum rechts der Isar, Munich (Germany); Eiber, Matthias [Technical University of Munich, Department of Nuclear Medicine, Klinikum rechts der Isar, Munich (Germany); David Geffen School of Medicine at UCLA, Department of Molecular and Medical Pharmacology, Los Angeles (United States)

    2018-04-15

    To investigate the value of {sup 68}Ga-HBED-CC PSMA ({sup 68}Ga-PSMA) PET/CT for response assessment in metastatic castration-sensitive and castration-resistant prostate cancer (mCSPC and mCRPC) during docetaxel chemotherapy. {sup 68}Ga-PSMA PET/CT was performed in seven mCSPC patients before and after six cycles of upfront docetaxel chemotherapy and in 16 mCRPC patients before and after three cycles of palliative docetaxel chemotherapy. Radiographic treatment response was evaluated separately on the {sup 68}Ga-PSMA PET and CT datasets. Changes in {sup 68}Ga-PSMA uptake (SUVmean) were assessed on a per-patient and a per-lesion basis using the PERCIST scoring system with slight modification. Treatment response was defined as absence of any PSMA uptake in all target lesions on posttreatment PET (complete response, CR) or a decrease in summed SUVmean of ≥30% (partial response, PR). The appearance of a new PET-positive lesion or an increase in summed SUVmean of ≥30% (progressive disease, PD) indicated nonresponse. A moderate change in summed SUVmean (between -30% and +30%) without a change in the number of target lesions was defined as stable disease (SD). For treatment response assessment on CT, RECIST1.1 criteria were used. Radiographic responses on {sup 68}Ga-PSMA PET [RR(PET)] and on CT [RR(CT)] were compared and correlated with biochemical response (BR). A decrease in serum PSA level of ≥50% was defined as biochemical PR. Biochemical PR was found in six of seven patients with mCSPC (86%, 95% confidence interval 42% to 99.6%). The concordance rate was higher between BR and RR(PET) than between BR and RR(CT) (6/7 vs. 3/6 patients). {sup 68}Ga-PSMA PET and CT were concordant in only three patients (50%, 12% to 88%). In mCRPC patients, biochemical PR was found in six of 16 patients (38%, 15% to 65%). Outcome prediction was concordant between BR and RR(PET) in nine of 16 patients (56%), and between BR and RR(CT) in only four of 12 patients (33%) with target

  4. 18F-FDG PET predicts survival after pretargeted radioimmunotherapy in patients with progressive metastatic medullary thyroid carcinoma

    International Nuclear Information System (INIS)

    Salaun, Pierre-Yves; Robin, Philippe; Campion, Loic; Ansquer, Catherine; Mathieu, Cedric; Frampas, Eric; Bournaud, Claire; Vuillez, Jean-Philippe; Taieb, David; Rousseau, Caroline; Drui, Delphine; Mirallie, Eric; Borson-Chazot, Francoise; Goldenberg, David M.; Chatal, Jean-Francois; Barbet, Jacques; Kraeber-Bodere, Francoise

    2014-01-01

    PET is a powerful tool for assessing targeted therapy. Since 18 F-FDG shows a potential prognostic value in medullary thyroid carcinoma (MTC), this study evaluated 18 F-FDG PET alone and combined with morphological and biomarker evaluations as a surrogate marker of overall survival (OS) in patients with progressive metastatic MTC treated with pretargeted anti-CEA radioimmunotherapy (pRAIT) in a phase II clinical trial. Patients underwent PET associated with morphological imaging (CT and MRI) and biomarker evaluations, before and 3 and 6 months, and then every 6 months, after pRAIT for 36 months. A combined evaluation was performed using anatomic, metabolic and biomarker methods. The prognostic value of the PET response was compared with demographic parameters at inclusion including age, sex, RET mutation, time from initial diagnosis, calcitonin and CEA concentrations and doubling times (DT), SUV max , location of disease and bone marrow involvement, and with response using RECIST, biomarker concentration variation, impact on DT, and combined methods. Enrolled in the study were 25 men and 17 women with disease progression. The median OS from pRAIT was 3.7 years (0.2 to 6.5 years) and from MTC diagnosis 10.9 years (1.7 to 31.5 years). After pRAIT, PET/CT showed 1 patient with a complete response, 4 with a partial response and 24 with disease stabilization. The combined evaluation showed 20 responses. For OS from pRAIT, univariate analysis showed the prognostic value of biomarker DT (P = 0.011) and SUV max (P = 0.038) calculated before pRAIT and impact on DT (P = 0.034), RECIST (P = 0.009), PET (P = 0.009), and combined response (P = 0.004) measured after pRAIT. PET had the highest predictive value with the lowest Akaike information criterion (AIC 74.26) as compared to RECIST (AIC 78.06), biomarker variation (AIC 81.94) and impact on DT (AIC 79.22). No benefit was obtained by combining the methods (AIC 78.75). This result was confirmed by the analysis of OS from MTC

  5. Improvement of internal tumor volumes of non-small cell lung cancer patients for radiation treatment planning using interpolated average CT in PET/CT.

    Directory of Open Access Journals (Sweden)

    Yao-Ching Wang

    Full Text Available Respiratory motion causes uncertainties in tumor edges on either computed tomography (CT or positron emission tomography (PET images and causes misalignment when registering PET and CT images. This phenomenon may cause radiation oncologists to delineate tumor volume inaccurately in radiotherapy treatment planning. The purpose of this study was to analyze radiology applications using interpolated average CT (IACT as attenuation correction (AC to diminish the occurrence of this scenario. Thirteen non-small cell lung cancer patients were recruited for the present comparison study. Each patient had full-inspiration, full-expiration CT images and free breathing PET images by an integrated PET/CT scan. IACT for AC in PET(IACT was used to reduce the PET/CT misalignment. The standardized uptake value (SUV correction with a low radiation dose was applied, and its tumor volume delineation was compared to those from HCT/PET(HCT. The misalignment between the PET(IACT and IACT was reduced when compared to the difference between PET(HCT and HCT. The range of tumor motion was from 4 to 17 mm in the patient cohort. For HCT and PET(HCT, correction was from 72% to 91%, while for IACT and PET(IACT, correction was from 73% to 93% (*p<0.0001. The maximum and minimum differences in SUVmax were 0.18% and 27.27% for PET(HCT and PET(IACT, respectively. The largest percentage differences in the tumor volumes between HCT/PET and IACT/PET were observed in tumors located in the lowest lobe of the lung. Internal tumor volume defined by functional information using IACT/PET(IACT fusion images for lung cancer would reduce the inaccuracy of tumor delineation in radiation therapy planning.

  6. Usefulness of FDG PET for nodal staging using a dual head coincidence camera in patients with lung cancer

    International Nuclear Information System (INIS)

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

    2001-01-01

    Staging of lung cancer requires an accurate evaluation of the mediastinum. Positron imaging with dual head cameras may be not as sensitive as dedicated PET. Therefore, the purpose of the study was to evaluated the usefulness of F-18 FDG coincidence (CoDe) PET using a dual-head gamma camera in the nodal staging of the lung cancer. CoDe-PET studies were performed in 51 patients with histologically proven non small cell lung cancer. CoDe-PET began 60 minutes after the injection of 111-185 MBq of F-18 FDG. CoDe-PET was performed using a dual-head gamma camera equipped with coincidence detection circuitry (Elscints Varicam, Haifa, lsrael). There was no attenuation correction made and reconstruction was done using a filtered back-projection. Surgery was performed in 49 patients CoDe-PET studies were evaluated visually. Any focal increased uptake was considered abnormal. The nodal stating of CoDe-PET studies were evaluated visually. Any focal increased uptake was considered abnormal. The nodal staging of CoDe-PET and of CT were compared with the nodal stating of surgical (49) and mediastinoscopical (2) pathology. All primary lung lesions were hypermetabolic and easily visualized. Compared with surgical nodal staging as a gold standard, false positives occurred in 13 CoDe PET and 17 CT studies and false negative occurred in 5 CoDe-PET and 4 CT studies. Assessment of lymph node involvement by CoDe-PET depicted a sensitivity of 67%, specificity of 64% and accuracy of 65%. CT revealed a sensitivity of 73%, specificity of 53% and accuracy of 59% in the assessment of lymph node involvement. The detection of primary lesions were 100% but nodal staging was suboptimal for routine clinical use. This is mainly due to limited resolution of our system

  7. Comparison between whole-body MRI and Fluorine-18-Fluorodeoxyglucose PET or PET/CT in oncology: a systematic review

    International Nuclear Information System (INIS)

    Ciliberto, Mario; Maggi, Fabio; Treglia, Giorgio; Padovano, Federico; Calandriello, Lucio; Giordano, Alessandro; Bonomo, Lorenzo

    2013-01-01

    The aim of the article is to systematically review published data about the comparison between positron emission tomography (PET) or PET/computed tomography (PET/CT) using Fluorine-18-Fluorodeoxyglucose (FDG) and whole-body magnetic resonance imaging (WB-MRI) in patients with different tumours. A comprehensive literature search of studies published in PubMed/MEDLINE, Scopus and Embase databases through April 2012 and regarding the comparison between FDG-PET or PET/CT and WB-MRI in patients with various tumours was carried out. Forty-four articles comprising 2287 patients were retrieved in full-text version, included and discussed in this systematic review. Several articles evaluated mixed tumours with both diagnostic methods. Concerning the specific tumour types, more evidence exists for lymphomas, bone tumours, head and neck tumours and lung tumours, whereas there is less evidence for other tumour types. Overall, based on the literature findings, WB-MRI seems to be a valid alternative method compared to PET/CT in oncology. Further larger prospective studies and in particular cost-effectiveness analysis comparing these two whole-body imaging techniques are needed to better assess the role of WB-MRI compared to FDG-PET or PET/CT in specific tumour types

  8. 18F-FDG PET/CT for initial staging in breast cancer patients. Is there a relevant impact on treatment planning compared to conventional staging modalities?

    International Nuclear Information System (INIS)

    Krammer, J.; Schnitzer, A.; Kaiser, C.G.; Buesing, K.A.; Schoenberg, S.O.; Wasser, K.; Sperk, E.; Brade, J.; Wasgindt, S.; Suetterlin, M.; Sutton, E.J.

    2015-01-01

    To evaluate the impact of whole-body 18 F-FDG PET/CT on initial staging of breast cancer in comparison to conventional staging modalities. This study included 102 breast cancer patients, 101 patients were eligible for evaluation. Preoperative whole-body staging with PET/CT was performed in patients with clinical stage ≥ T2 tumours or positive local lymph nodes (n = 91). Postoperative PET/CT was performed in patients without these criteria but positive sentinel lymph node biopsy (n = 10). All patients underwent PET/CT and a conventional staging algorithm, which included bone scan, chest X-ray and abdominal ultrasound. PET/CT findings were compared to conventional staging and the impact on therapeutic management was evaluated. PET/CT led to an upgrade of the N or M stage in overall 19 patients (19 %) and newly identified manifestation of breast cancer in two patients (2 %). PET/CT findings caused a change in treatment of 11 patients (11 %). This is within the range of recent studies, all applying conventional inclusion criteria based on the initial T and N status. PET/CT has a relevant impact on initial staging and treatment of breast cancer when compared to conventional modalities. Further studies should assess inclusion criteria beyond the conventional T and N status, e.g. tumour grading and receptor status. (orig.)

  9. FLT-PET for early response evaluation of colorectal cancer patients with liver metastases: a prospective study.

    Science.gov (United States)

    Mogensen, Marie Benzon; Loft, Annika; Aznar, Marianne; Axelsen, Thomas; Vainer, Ben; Osterlind, Kell; Kjaer, Andreas

    2017-12-01

    Fluoro-L-thymidine (FLT) is a positron emission tomography/computed tomography (PET/CT) tracer which reflects proliferative activity in a cancer lesion. The main objective of this prospective explorative study was to evaluate whether FLT-PET can be used for the early evaluation of treatment response in colorectal cancer patients (CRC) with liver metastases. Patients with metastatic CRC having at least one measurable (>1 cm) liver metastasis receiving first-line chemotherapy were included. A FLT-PET/CT scan was performed at baseline and after the first treatment. The maximum and mean standardised uptake values (SUV max , SUV mean ) were measured. After three cycles of chemotherapy, treatment response was assessed by CT scan based on RECIST 1.1. Thirty-nine consecutive patients were included of which 27 were evaluable. Dropout was mainly due to disease complications. Nineteen patients (70%) had a partial response, seven (26%) had stable disease and one (4%) had progressive disease. A total of 23 patients (85%) had a decrease in FLT uptake following the first treatment. The patient with progressive disease had the highest increase in FLT uptake in SUV max . There was no correlation between the response according to RECIST and the early changes in FLT uptake measured as SUV max (p = 0.24). No correlation was found between early changes in FLT uptake after the first cycle of treatment and the response evaluated from subsequent CT scans. It seems unlikely that FLT-PET can be used on its own for the early response evaluation of metastatic CRC.

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

    International Nuclear Information System (INIS)

    Kang, Yun Hee; Lee, Hye Kyung; Park, Geon

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-09-15

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

  12. Role of FDG-PET/CT in stage 1–4 malignant melanoma patients

    DEFF Research Database (Denmark)

    Eldon, Mai; Kjerkegaard, Ulrik Knap; Ørndrup, Mette Heisz

    2017-01-01

    /CT scanned in 2012 at a department of plastic surgery and to analyze the pattern of referral and outcome of PET/CT scans of these patients all back from early diagnosis of the patient in the period 2008–2012. Methods: All patients with MM stages 1–4 (AJCC stages) and melanoma of unknown primary (MUP) who...

  13. Early PET imaging with [68]Ga-PSMA-11 increases the detection rate of local recurrence in prostate cancer patients with biochemical recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Uprimny, Christian; Kroiss, Alexander Stephan; Decristoforo, Clemens; Kendler, Dorota; Guggenberg, Elisabeth von; Nilica, Bernhard; Maffey-Steffan, Johanna; Di Santo, Gianpaolo; Virgolini, Irene Johanna [Medical University Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); Fritz, Josef [Medical University Innsbruck, Department of Medical Statistics, Informatics and Health Economics, Innsbruck (Austria); Bektic, Jasmin; Horninger, Wolfgang [Medical University Innsbruck, Department of Urology, Innsbruck (Austria)

    2017-09-15

    PET/CT using {sup 68}Ga-labelled prostate-specific membrane antigen PSMA-11 (HBEDD-CC) has emerged as a promising imaging method in the diagnostic evaluation of prostate cancer (PC) patients with biochemical recurrence. However, assessment of local recurrence (LR) may be limited by intense physiologic tracer accumulation in the urinary bladder on whole-body scans, normally conducted 60 min post-tracer injection (p.i.). It could be shown on early dynamic imaging studies that {sup 68}Ga-PSMA-11 uptake in PC lesions occurs earlier than tracer accumulation in the urinary bladder. This study aims to investigate whether early static PET acquisition increases detection rate of local recurrence on {sup 68}Ga-PSMA-11 PET/CT in comparison to PET imaging 60 min p.i. 203 consecutive PC patients with biochemical failure referred to {sup 68}Ga-PSMA-11 PET/CT were analysed retrospectively (median prostate specific antigen (PSA) value: 1.44 ng/ml). In addition to whole-body PET/CT scans 60 min p.i., early static imaging of the pelvis was performed, starting at a median time of 283 s p.i. (range: 243-491 s). Assessment was based on visual analysis and calculation of maximum standardized uptake value (SUV{sub max}) of pathologic lesions present in the pelvic area found on early PET imaging and on 60 min-PET scans. 26 patients (12.8%) were judged positive for LR on PET scans 60 min p.i. (median SUV{sub max}: 10.8; range: 4.7-40.9), whereas 50 patients (24.6%) revealed a lesion suggestive of LR on early PET imaging (median SUV{sub max}: 5.9; range: 2.9-17.6), resulting in a significant rise in detection rate (p < 0.001). Equivocal findings on PET scans 60 min p.i. decreased significantly with the help of early imaging (15.8% vs. 4.5% of patients; p < 0.001). Tracer activity in the urinary bladder with a median SUV{sub max} of 8.2 was present in 63 patients on early PET scans (31.0%). However, acquisition starting time of early PET scans differed significantly in the patient groups

  14. Efficacy of PET/CT to exclude leiomyoma in patients with lesions suspicious for uterine sarcoma on MRI.

    Science.gov (United States)

    Kusunoki, Soshi; Terao, Yasuhisa; Ujihira, Takafumi; Fujino, Kazunari; Kaneda, Hiroshi; Kimura, Miki; Ota, Tsuyoshi; Takeda, Satoru

    2017-08-01

    To analyze the efficacy of positron emission tomography/computed tomography (PET/CT) for the diagnosis of uterine sarcoma. Thirty-four patients evaluated between January 2010 and March 2015 were retrospectively enrolled. All patients in whom uterine sarcoma was suspected based on contrast-enhanced magnetic resonance imaging (MRI) findings (heterogeneous, high signal intensity on T2-weighted images and/or high intensity on T1-weighted images) underwent PET/CT for further assessment. Patients were divided into 2 groups based on postoperative pathological findings: uterine sarcoma (n = 15) and leiomyoma (n = 19). The maximum standardized uptake value (SUVmax) of all lesions was measured using PET/CT; we calculated the optimal cutoff value for diagnosing sarcoma. The median SUVmax for uterine sarcoma and leiomyoma was 12 and 4.1, respectively; these values were significantly different. An SUVmax of greater than 7.5 was able to exclude leiomyoma with 80.8% sensitivity and 100% specificity (area under the curve, 95.3%). A cutoff SUVmax of 7.5 yields 100% specificity, and a cutoff SUVmax of 4.4 yields a 100% negative predictive value (NPV). The combination of PET/CT and lactate dehydrogenase (LDH) levels had a sensitivity of 86.6%, specificity of 100%, positive predictive value of 100%, and an NPV of 90.4%. No relation between histopathology or International Federation of Gynecology and Obstetrics (FIGO) stage and 18-fluoro-2-deoxy-d-glucose uptake value on PET/CT was seen. The surgical outcome trended toward a correlation with the SUVmax, although this was not statistically significant. In patients with MRI findings consistent with either uterine sarcoma or leiomyoma, PET/CT can decrease the false-positive rate by setting an optimal cutoff SUVmax of 7.5. Using this cutoff can avoid unnecessary surgery. Copyright © 2017. Published by Elsevier B.V.

  15. Early Evaluation of Response Using 18F-FDG PET Influences Management in Gastrointestinal Stromal Tumor Patients Treated with Neoadjuvant Imatinib.

    Science.gov (United States)

    Farag, Sheima; Geus-Oei, Lioe-Fee de; van der Graaf, Winette T; van Coevorden, Frits; Grunhagen, Dirk; Reyners, Anna K L; Boonstra, Pieter A; Desar, Ingrid; Gelderblom, Hans; Steeghs, Neeltje

    2018-02-01

    18 F-FDG PET has previously been proven effective as an early way to evaluate the response of gastrointestinal stromal tumors (GISTs) to imatinib treatment. However, it is unclear whether early evaluation of response affects treatment decisions in GIST patients treated with neoadjuvant intent. Methods: We retrospectively scored changes in management based on early evaluation of response by 18 F-FDG PET in patients in the Dutch GIST registry treated with neoadjuvant imatinib. Results: Seventy 18 F-FDG PET scans were obtained for 63 GIST patients to evaluate for an early response to neoadjuvant imatinib. The scans led to a change in management in 27.1% of the patients. Change in management correlated strongly with lack of metabolic response ( P PET for early evaluation of response often results in a change of management in GIST patients harboring the non- KIT exon 11 mutation and should be considered the standard of care in GIST patients treated with neoadjuvant intent. © 2018 by the Society of Nuclear Medicine and Molecular Imaging.

  16. The detection rate of [11C]Choline-PET/CT depends on the serum PSA-value in patients with biochemical recurrence of prostate cancer

    International Nuclear Information System (INIS)

    Krause, B.J.; Souvatzoglou, M.; Tuncel, M.; Herrmann, K.; Buck, A.K.; Praus, C.; Schwaiger, M.; Schuster, T.; Geinitz, H.; Treiber, U.

    2008-01-01

    An increase of the serum PSA-level is a sensitive in vitro marker for recurrent prostate cancer. However, it remains difficult to differentiate between local, regional or distant recurrent disease. The aim of this study was to assess the relationship between the detection rate of [ 11 C]Choline-PET/CT and the serum PSA-level in patients with a biochemical recurrence of prostate cancer with the view towards localisation of recurrent disease. Sixty-three patients (mean age, 68.8 ± 6.9; range, 45-83 years) with biochemical recurrence after primary therapy for prostate cancer were included in the analysis. Mean PSA-levels were 5.9 ± 9.7 ng/ml (range, 0.2-39 ng/ml; median, 2.15). Of the 63 patients, 17 were under anti-androgen therapy at the time of [ 11 C]Choline PET/CT. Patients underwent a [ 11 C]Choline-PET/CT study after injection of 656 ± 119 MBq [ 11 C]Choline on a Sensation 16 Biograph PET/CT scanner. Of the 63 patients, 35 (56%) showed a pathological [ 11 C]Choline uptake. The detection rate of [ 11 C]Choline-PET/CT showed a relationship with the serum PSA-level: The detection rate was 36% for a PSA-value 11 C]Choline-PET/CT (p = 0.374). As an important result our study shows that even for PSA-values 11 C]Choline-PET/CT is 36%. Furthermore, the detection rate of [ 11 C]Choline-PET/CT shows a positive relationship with serum PSA-levels in patients with biochemical recurrence of prostate cancer after primary therapy. Therefore, in these patients, [ 11 C]Choline PET/CT allows not only to diagnose but also to localise recurrent disease with implications on disease management (localised vs systemic therapy). (orig.)

  17. The evaluation of FDG-PET imaging for epileptogenic focus localization in patients with MRI positive and MRI negative temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Gok, Beril; Jallo, George; Hayeri, Reza; Wahl, Richard; Aygun, Nafi

    2013-01-01

    We studied the contribution of interictal FDG-PET ([18 F] fluorodeoxyglucose-positron emission tomography) in epileptic focus identification in temporal lobe epilepsy patients with positive, equivocal and negative magnetic resonance imaging (MRI). Ninety-eight patients who underwent surgical treatment for drug resistant temporal lobe epilepsy after neuropsychological evaluation, scalp video EEG monitoring, FDG-PET, MRI and/or long-term intracranial EEG and with >12 months clinical follow-up were included in this study. FDG-PET findings were compared to MRI, histopathology, scalp video EEG and long-term intracranial EEG monitoring. FDG-PET lateralized the seizure focus in 95 % of MRI positive, 69 % of MRI equivocal and 84 % of MRI negative patients. There was no statistically significant difference between the surgical outcomes among the groups with Engel class I and II outcomes achieved in 86 %, 86 %, 84 % of MRI positive, equivocal and negative temporal lobe epilepsy patients, respectively. The patients with positive unilateral FDG-PET demonstrated excellent postsurgical outcomes, with 96 % Engel class I and II. Histopathology revealed focal lesions in 75 % of MRI equivocal, 84 % of MRI positive, and 23 % of MRI negative temporal lobe epilepsy cases. FDG-PET is an accurate noninvasive method in lateralizing the epileptogenic focus in temporal lobe epilepsy, especially in patients with normal or equivocal MRIs, or non-lateralized EEG monitoring. Very subtle findings in MRI are often associated with histopathological lesions and should be described in MRI reports. The patients with negative or equivocal MRI temporal lobe epilepsy are good surgical candidates with comparable postsurgical outcomes to patients with MRI positive temporal lobe epilepsy. (orig.)

  18. The evaluation of FDG-PET imaging for epileptogenic focus localization in patients with MRI positive and MRI negative temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Gok, Beril [Drexel University, Department of Radiology, Mercy Catholic Medical Center, Philadelphia, PA (United States); Johns Hopkins University, Division of Nuclear Medicine, Department of Radiology and Radiological Sciences, Baltimore, MD (United States); Jallo, George [Johns Hopkins University, Department of Neurosurgery, Baltimore, MD (United States); Hayeri, Reza [Drexel University, Department of Radiology, Mercy Catholic Medical Center, Philadelphia, PA (United States); Wahl, Richard [Johns Hopkins University, Division of Nuclear Medicine, Department of Radiology and Radiological Sciences, Baltimore, MD (United States); Aygun, Nafi [Johns Hopkins University, Division of Neuroradiology, Department of Radiology and Radiological Sciences, Baltimore, MD (United States)

    2013-05-15

    We studied the contribution of interictal FDG-PET ([18 F] fluorodeoxyglucose-positron emission tomography) in epileptic focus identification in temporal lobe epilepsy patients with positive, equivocal and negative magnetic resonance imaging (MRI). Ninety-eight patients who underwent surgical treatment for drug resistant temporal lobe epilepsy after neuropsychological evaluation, scalp video EEG monitoring, FDG-PET, MRI and/or long-term intracranial EEG and with >12 months clinical follow-up were included in this study. FDG-PET findings were compared to MRI, histopathology, scalp video EEG and long-term intracranial EEG monitoring. FDG-PET lateralized the seizure focus in 95 % of MRI positive, 69 % of MRI equivocal and 84 % of MRI negative patients. There was no statistically significant difference between the surgical outcomes among the groups with Engel class I and II outcomes achieved in 86 %, 86 %, 84 % of MRI positive, equivocal and negative temporal lobe epilepsy patients, respectively. The patients with positive unilateral FDG-PET demonstrated excellent postsurgical outcomes, with 96 % Engel class I and II. Histopathology revealed focal lesions in 75 % of MRI equivocal, 84 % of MRI positive, and 23 % of MRI negative temporal lobe epilepsy cases. FDG-PET is an accurate noninvasive method in lateralizing the epileptogenic focus in temporal lobe epilepsy, especially in patients with normal or equivocal MRIs, or non-lateralized EEG monitoring. Very subtle findings in MRI are often associated with histopathological lesions and should be described in MRI reports. The patients with negative or equivocal MRI temporal lobe epilepsy are good surgical candidates with comparable postsurgical outcomes to patients with MRI positive temporal lobe epilepsy. (orig.)

  19. Up-front PET/CT changes treatment intent in patients with head and neck squamous cell carcinoma

    DEFF Research Database (Denmark)

    Rohde, Max; Nielsen, Anne L.; Johansen, Jørgen

    2018-01-01

    underwent CXR/MRI and PET/CT before diagnostic biopsy. An ordinary MDTC using all available imaging was conducted as per standard practice. After at least 3 months (to eliminate recall bias in the team), the first project MDTC was conducted, based on either CXR/MRI or PET/CT, and the tumor board drew...... conclusions regarding treatment. After an additional 3 months, a second project MDTC was conducted using the complementary imaging modality. Results: A total of 307 patients were included. Based on CXR/MRI, 303 patients (99%) were recommended for curative treatment and only four patients (1%) for palliative...

  20. Modification of patient management when using FDG-PET in detection of recurrences of colorectal cancer: 18 month-experience

    International Nuclear Information System (INIS)

    Montravers, F.; Grahek, D.; Kerrou, K.; Younsi, N.; Petegnief, Y.; Talbot, J.N.

    2002-01-01

    Full text: The aim of this study was to evaluate the impact of [F-18] - FDG - PET on managing patients with colorectal cancer. From January 2000 to July 2001, 164 examinations were performed by the team of hospital Tenon using a 3D dedicated PET System (C-PET, ADAC) for suspicion or recurrence of colorectal cancer (53 % of the cases), for search for other localization when one or more resectable(s) lesion(s) was (were) known (37 %) or for evaluation of the therapeutic efficacy (10 %). To evaluate the impact of PET imaging on patient management, a post PET questionnaire (corresponding to the French translation of the questionnaire presented by J. Meta et al.) was sent to the referring physician. 94 responses are currently available, corresponding to: no change (n = 42), change from no treatment to surgery (n =11), change from no treatment to medical treatment (n = 11), change from surgery to medical treatment (n - 9), change from medical treatment to no treatment (n = 5), change from medical treatment to surgery (n = 4), change from surgery to no treatment (n = 4), change in medical approach (n = 3), change in surgical approach (n = 2), change from no treatment to radiotherapy (n = 1), change from radiotherapy to medical treatment (n = 1), change from medical treatment to radiotherapy (n = 1). In summary, among 94 responses from referring physicians (corresponding to 57 % of the examinations), changes in patient management were reported for 52 of the 94 patients (55 %). This result confirms, in France, the major impact of FDG-PET on the management of recurrences of colorectal cancer, as reported by the referring physician, already demonstrated in California (62 % in the 60 patients of Meta et al). (author)

  1. Quantitative simultaneous PET-MR imaging

    Science.gov (United States)

    Ouyang, Jinsong; Petibon, Yoann; Huang, Chuan; Reese, Timothy G.; Kolnick, Aleksandra L.; El Fakhri, Georges

    2014-06-01

    Whole-body PET is currently limited by the degradation due to patient motion. Respiratory motion degrades imaging studies of the abdomen. Similarly, both respiratory and cardiac motions significantly hamper the assessment of myocardial ischemia and/or metabolism in perfusion and viability cardiac PET studies. Based on simultaneous PET-MR, we have developed robust and accurate MRI methods allowing the tracking and measurement of both respiratory and cardiac motions during abdominal or cardiac studies. Our list-mode iterative PET reconstruction framework incorporates the measured motion fields into PET emission system matrix as well as the time-dependent PET attenuation map and the position dependent point spread function. Our method significantly enhances the PET image quality as compared to conventional methods.

  2. Relationship between PSA kinetics and [{sup 18}F]fluorocholine PET/CT detection rates of recurrence in patients with prostate cancer after total prostatectomy

    Energy Technology Data Exchange (ETDEWEB)

    Graute, Vera; Jansen, Nathalie; Uebleis, Christopher; Cumming, Paul; Klanke, Katharina; Tiling, Reinhold; Bartenstein, Peter; Hacker, Marcus [University of Munich, Department of Nuclear Medicine, Munich (Germany); Seitz, Michael [University of Munich, Department of Urology, Munich (Germany); Hartenbach, Markus [Bundeswehrkrankenhaus Ulm, Department of Nuclear Medicine, Ulm (Germany); Scherr, Michael Karl; Thieme, Sven [University of Munich, Institute of Clinical Radiology, Munich (Germany)

    2012-02-15

    The aim of the present study was to identify prostate-specific antigen (PSA) threshold levels, as well as PSA velocity, progression rate and doubling time in relation to the detectability and localization of recurrent lesions with [{sup 18}F]fluorocholine (FC) PET/CT in patients after radical prostatectomy. The study group comprised 82 consecutive patients with biochemical relapse after radical prostatectomy. PSA levels measured at the time of imaging were correlated with the FC PET/CT detection rates in the entire group with PSA velocity (in 48 patients), with PSA doubling time (in 47 patients) and with PSA progression (in 29 patients). FC PET/CT detected recurrent lesions in 51 of the 82 patients (62%). The median PSA value was significantly higher in PET-positive than in PET-negative patients (4.3 ng/ml vs. 1.0 ng/ml; p < 0.01). The optimal PSA threshold from ROC analysis for the detection of recurrent prostate cancer lesions was 1.74 ng/ml (AUC 0.818, 82% sensitivity, 74% specificity). Significant differences between PET-positive and PET-negative patients were found for median PSA velocity (6.4 vs. 1.1 ng/ml per year; p < 0.01) and PSA progression (5.0 vs. 0.3 ng/ml per year, p < 0.01) with corresponding optimal thresholds of 1.27 ng/ml per year and 1.28 ng/ml per year, respectively. The PSA doubling time suggested a threshold of 3.2 months, but this just failed to reach statistical significance (p = 0.071). In a study cohort of patients with biochemical recurrence of prostate cancer after radical prostatectomy there emerged clear PSA thresholds for the presence of FC PET/CT-detectable lesions. (orig.)

  3. 68Ga-PSMA PET/CT in Patients with Rising Prostatic-Specific Antigen After Definitive Treatment of Prostate Cancer: Detection Efficacy and Diagnostic accuracy.

    Science.gov (United States)

    Hamed, Maged Abdel Galil; Basha, Mohammad Abd Alkhalik; Ahmed, Hussien; Obaya, Ahmed Ali; Afifi, Amira Hamed Mohamed; Abdelbary, Eman H

    2018-06-20

    68 Ga-prostate-specific membrane antigen-11 ( 68 Ga-PSMA-11) is a recently developed positron emission tomography (PET) tracer that can detect prostate cancer (PC) relapses and metastases with high contrast resolution. The aim of this study was to assess the detection efficacy and diagnostic accuracy of 68 Ga-PSMA PET/CT image in patients with rising prostatic-specific antigen (PSA) after treatment of PC. The present prospective study included 188 patients who exhibited rising of PSA level on a routine follow-up examination after definitive treatment of PC. All patients underwent a 68 Ga-PSMA PET/CT examination. For each patient, we determined the disease stage, the Gleason score, and the maximum standardized uptake value of the local recurrence and extraprostatic metastases. The detection efficacy and diagnostic accuracy of 68 Ga-PSMA PET/CT were established by histopathology and clinical and imaging follow-up as the reference standards. 68 Ga-PSMA PET/CT detected tumour relapse in 165 patients (35 patients had local recurrence, 106 patients had extraprostatic metastases, and 24 patients had combined lesions). The sensitivity, specificity, and accuracy values of 68 Ga-PSMA PET/CT examination in the detection of PC recurrence were 98.8%, 100%, and 98.8%, respectively. 68 Ga-PSMA PET/CT revealed an overall detection rate of 87.8% (165/188) in patients with rising PSA (median of 2.2 ng/mL, and range of 0.01-70 ng/mL). 68 Ga-PSMA PET/CT is a valuable tool for the detection of PC local recurrence or extraprostatic metastases following rising PSA levels after primary definitive therapy and should be incorporated during routine work-up. Copyright © 2018. Published by Elsevier Inc.

  4. Prevalence of esophageal cancer during the pretreatment of hypopharyngeal cancer patients: Routinely performed esophagogastroduodenoscopy and FDG-PET/CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Nakaminato, Shuichiro; Toriihara, Akira; Makino, Tomoko; Shibuya, Hitoshi [Dept. of Radiology, Tokyo Medical and Dental Univ., Tokyo (Japan)], Email: S.Nakaminato@gmail.com; Kawano, Tatsuyuki [Dept. of Surgery, Tokyo Medical and Dental Univ., Tokyo (Japan); Kishimoto, Seiji [Dept. of Head and Neck Surgery, Tokyo Medical and Dental Univ., Tokyo (Japan)

    2012-05-15

    Background. The prevalence of esophageal cancer accompanied by hypopharyngeal cancer (HPC) is high and increasing rapidly in Asia. The purpose of this prospective study was to evaluate the prevalence of esophageal cancer during the pretreatment of HPC patients who were routinely examined using esophagogastroduodenoscopy (EGD) and 18F-fluorodeoxyglucose/computed tomography (FDG-PET/CT) and to discuss the utility of these examinations. Material and methods. Between September 2005 and September 2010, 33 patients with newly diagnosed HPC (all with squamous cell carcinoma) underwent EGD (after a conventional endoscopy, iodine staining was performed) and FDG-PET/CT examinations. We evaluated the prevalence of esophageal cancer among HPC patients according to the EGD findings and determined the sensitivity of FDG-PET/CT for the detection of esophageal primary tumors for each clinical T classification. Results. In 17 of the 33 patients (51.5%), 29 biopsy-proven esophageal squamous cell carcinomas were diagnosed using EGD. In eight of the 17 (47.1%) patients, two or more esophageal cancer lesions were diagnosed. Twenty-four of the 29 (82.8%) lesions were superficial esophageal cancers, and the remaining five (17.2%) lesions were advanced esophageal cancers. In six of the 29 (20.7%) esophageal cancer lesions that were detected using FDG-PET/CT, only one of the 29 (3.4%) lesions was evaluated as being equivocal; the remaining 22 (75.9%) lesions were not detected. The distribution of the clinical T classifications detected using FDG-PET/CT was as follows: T1a, 0/21 (0%); T1b, 1/3 (33%); and T3, 5/5 (100%). Conclusions. The prevalence of esophageal cancer during the pretreatment of HPC patients was 51.5%; this prevalence was higher than that in previous reports. We believe that the increasing proportion of superficial lesions (82.8%) detected using iodine staining and EGD may have led to the relatively high prevalence. FDG-PET/CT detected only 20.7% of the esophageal cancers

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  6. MR-based attenuation correction for cardiac FDG PET on a hybrid PET/MRI scanner: comparison with standard CT attenuation correction

    Energy Technology Data Exchange (ETDEWEB)

    Vontobel, Jan; Liga, Riccardo; Possner, Mathias; Clerc, Olivier F.; Mikulicic, Fran; Veit-Haibach, Patrick; Voert, Edwin E.G.W. ter; Fuchs, Tobias A.; Stehli, Julia; Pazhenkottil, Aju P.; Benz, Dominik C.; Graeni, Christoph; Gaemperli, Oliver; Herzog, Bernhard; Buechel, Ronny R.; Kaufmann, Philipp A. [University Hospital Zurich, Department of Nuclear Medicine, Zurich (Switzerland)

    2015-09-15

    The aim of this study was to evaluate the feasibility of attenuation correction (AC) for cardiac {sup 18}F-labelled fluorodeoxyglucose (FDG) positron emission tomography (PET) using MR-based attenuation maps. We included 23 patients with no known cardiac history undergoing whole-body FDG PET/CT imaging for oncological indications on a PET/CT scanner using time-of-flight (TOF) and subsequent whole-body PET/MR imaging on an investigational hybrid PET/MRI scanner. Data sets from PET/MRI (with and without TOF) were reconstructed using MR AC and semi-quantitative segmental (20-segment model) myocardial tracer uptake (per cent of maximum) and compared to PET/CT which was reconstructed using CT AC and served as standard of reference. Excellent correlations were found for regional uptake values between PET/CT and PET/MRI with TOF (n = 460 segments in 23 patients; r = 0.913; p < 0.0001) with narrow Bland-Altman limits of agreement (-8.5 to +12.6 %). Correlation coefficients were slightly lower between PET/CT and PET/MRI without TOF (n = 460 segments in 23 patients; r = 0.851; p < 0.0001) with broader Bland-Altman limits of agreement (-12.5 to +15.0 %). PET/MRI with and without TOF showed minimal underestimation of tracer uptake (-2.08 and -1.29 %, respectively), compared to PET/CT. Relative myocardial FDG uptake obtained from MR-based attenuation corrected FDG PET is highly comparable to standard CT-based attenuation corrected FDG PET, suggesting interchangeability of both AC techniques. (orig.)

  7. 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

  8. Prospective evaluation of fluciclovine (18F) PET-CT and MRI in detection of recurrent prostate cancer in non-prostatectomy patients.

    Science.gov (United States)

    Akin-Akintayo, Oladunni; Tade, Funmilayo; Mittal, Pardeep; Moreno, Courtney; Nieh, Peter T; Rossi, Peter; Patil, Dattatraya; Halkar, Raghuveer; Fei, Baowei; Master, Viraj; Jani, Ashesh B; Kitajima, Hiroumi; Osunkoya, Adeboye O; Ormenisan-Gherasim, Claudia; Goodman, Mark M; Schuster, David M

    2018-05-01

    To investigate the disease detection rate, diagnostic performance and interobserver agreement of fluciclovine ( 18 F) PET-CT and multiparametric magnetic resonance imaging (mpMR) in recurrent prostate cancer. Twenty-four patients with biochemical failure after non-prostatectomy definitive therapy, 16/24 of whom had undergone brachytherapy, underwent fluciclovine PET-CT and mpMR with interpretation by expert readers blinded to patient history, PSA and other imaging results. Reference standard was established via a multidisciplinary truth panel utilizing histology and clinical follow-up (22.9 ± 10.5 months) and emphasizing biochemical control. The truth panel was blinded to investigative imaging results. Diagnostic performance and interobserver agreement (kappa) for the prostate and extraprostatic regions were calculated for each of 2 readers for PET-CT (P1 and P2) and 2 different readers for mpMR (M1 and M2). On a whole body basis, the detection rate for fluciclovine PET-CT was 94.7% (both readers), while it ranged from 31.6-36.8% for mpMR. Kappa for fluciclovine PET-CT was 0.90 in the prostate and 1.0 in the extraprostatic regions. For mpMR, kappa was 0.25 and 0.74, respectively. In the prostate, 22/24 patients met the reference standard with 13 malignant and 9 benign results. Sensitivity, specificity and positive predictive value (PPV) were 100.0%, 11.1% and 61.9%, respectively for both PET readers. For mpMR readers, values ranged from 15.4-38.5% for sensitivity, 55.6-77.8% for specificity and 50.0-55.6% for PPV. For extraprostatic disease determination, 18/24 patients met the reference standard. Sensitivity, specificity and PPV were 87.5%, 90.0% and 87.5%, respectively, for fluciclovine PET-CT, while for mpMR, sensitivity ranged from 50 to 75%, specificity 70-80% and PPV 57-75%. The disease detection rate for fluciclovine PET-CT in non-prostatectomy patients with biochemical failure was 94.7% versus 31.6-36.8% for mpMR. For extraprostatic disease detection

  9. FDG PET as a predictor of response to resynchronisation therapy in patients with ischaemic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Campen, C.M.C. van; Visser, Frans C.; Weerdt, Arno P. van der; Knaapen, Paul; Cock, Carel C. de; Visser, Cees A. [VU University Medical Centre, Department of Cardiology, Amsterdam (Netherlands); Comans, Emile F.I.; Lammertsma, Adriaan A. [VU University Medical Centre, Deparment of Nuclear Medicine and PET Research, Amsterdam (Netherlands)

    2007-03-15

    Although resynchronisation therapy (CRT) is a promising addition to heart failure therapy, a substantial number of patients do not respond to CRT. As FDG PET has routinely been used for prediction of improvement after revascularisation in ischaemic cardiomyopathy, it was hypothesised that there is also a relationship between the extent of viable tissue and improvement as a result of CRT. Thirty-nine patients with ischaemic cardiomyopathy (ejection fraction 27 {+-} 9%) and a wide QRS complex underwent temporary pacing to determine the optimal pacing combination, i.e. that with the highest increase in cardiac index (CI) compared with baseline (measured by Doppler echocardiography). All patients also underwent FDG PET imaging. In 19 patients, CI measurements were repeated 10-12 weeks after permanent biventricular pacemaker implantation. Echocardiography (13-segment model) showed a mean of 9.8 {+-} 1.6 dyssynergic segments, with preserved FDG uptake in 4.1 {+-} 2.4 segments. CI improvement at the optimal pacing site was 20 {+-} 9%. There was a linear relationship between the extent of viable tissue and CI improvement during pacing (p < 0.001). Using a cut-off value of more than three viable segments (ROC analysis), FDG PET had a sensitivity of 72% and a specificity of 71% for detection of the presence of haemodynamic improvement (i.e. a CI improvement >15%). The relation between CI improvement and viable tissue was similar at follow-up. A correlation was found between the extent of viable tissue and the haemodynamic response to CRT in patients with ischaemic cardiomyopathy, suggesting that FDG PET imaging may be useful to discriminate between responders and non-responders to CRT. (orig.)

  10. 18F-FDG-PET detects complete response to PD1-therapy in melanoma patients two weeks after therapy start

    Energy Technology Data Exchange (ETDEWEB)

    Seith, Ferdinand; Schmidt, Holger; Pfannenberg, Christina; Gueckel, Brigitte; Schwenzer, Nina [Eberhard Karls University, Diagnostic and Interventional Radiology, Department of Radiology, Tuebingen (Germany); Forschner, Andrea; Garbe, Claus [Eberhard Karls University, Department of Dermatology, Tuebingen (Germany); Nikolaou, Konstantin [Eberhard Karls University, Diagnostic and Interventional Radiology, Department of Radiology, Tuebingen (Germany); German Cancer Consortium (DKTK), Heidelberg (Germany); La Fougere, Christian [German Cancer Consortium (DKTK), Heidelberg (Germany); Eberhard Karls University, Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, Tuebingen (Germany)

    2018-01-15

    The aim of the study was to evaluate if 18F-FDG-PET has the potential to detect complete responders to PD1-therapy in patients with unresectable metastasized melanoma two weeks after therapy initiation. Between September 2014 and May 2016, ten patients (four females; 65 ± 12 y) received a whole-body 18F-FDG-PET/MRI examination at three time points: Before therapy start (t{sub 0}, base-line), two weeks (t{sub 1}, study examination) and three months after treatment initiation (t{sub 2}, reference standard). Therapy response was assessed with PET response criteria in solid tumors (PERCIST). Time to progression and overall survival (OS) were obtained for all patients. Three patients with partial metabolic response in PET at t{sub 1} turned out to have complete response at t{sub 2}. No tumor relapse was observed in those patients so far (observation period: 265, 511 and 728 days, respectively). At t{sub 2}, progressive metabolic disease (PMD) was seen in six patients from whom four showed PMD and two showed stable metabolic disease (SMD) at t{sub 1}. OS in patients with PMD at t{sub 2} varied between 148 and 814 days. SMD at both t{sub 1} and t{sub 2} was seen in one patient, tumor progress was observed after 308 days. Our study indicates that whole-body 18F-FDG-PET might be able to reliably identify complete responders to PD1-therapy as early as two weeks after therapy initiation in stage IV melanoma patients. This might help to shorten therapy regimes and avoid unnecessary side effects in the future. (orig.)

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-04-15

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

  13. PET in neuro-oncology

    NARCIS (Netherlands)

    Roelcke, U; Leenders, K.L.

    This article reviews possible clinical applications of positron emission tomography (PET) in brain tumor patients. PET allows quantitative assessment of brain tumor pathophysiology and biochemistry. It therefore provides different information about tumors when compared to histological or

  14. Hybrid imaging for detection of carcinoma of unknown primary: A preliminary comparison trial of whole-body PET/MRI versus PET/CT

    International Nuclear Information System (INIS)

    Ruhlmann, Verena; Ruhlmann, Marcus; Bellendorf, Alexander; Grueneisen, Johannes; Sawicki, Lino M.; Grafe, Hong; Forsting, Michael; Bockisch, Andreas; Umutlu, Lale

    2016-01-01

    Highlights: • Both 18F-FDG PET/CT and 18F-FDG PET/MRI provide a comparable diagnostic ability for detection of primary cancer and metastases in CUP-syndrome. • Both imaging methods showed comparably high lesion conspicuity and diagnostic confidence (superior assessment of cervical lesions in PET/MRI). • PET/MRI may serve as a powerful alternative, particularly for therapy monitoring or surveillance considering the long-term cumulative dose. - Abstract: Purpose: The aim of this study is to evaluate and compare the diagnostic potential of integrated whole-body [18F]FDG-PET/MRI to [18F]FDG-PET/CT for detection of a potential primary cancer and metastases in patients suspected for cancer of unknown primary (CUP). Methods: A total of 20 patients (15 male, 5 female, age 53 ± 13 years) suspect for CUP underwent a dedicated head and neck & whole-body [18F]FDG-PET/CT (Biograph mCT 128, Siemens Healthcare) and a subsequent simultaneous [18F]FDG-PET/MRI examination (Biograph mMR, Siemens Healthcare). Two readers rated the datasets (PET/CT; PET/MRI) regarding the detection of the primary cancer and metastases, lesion conspicuity (4-point ordinal scale) and diagnostic confidence (3-point ordinal scale). PET analysis comprised the assessment of maximum standardized uptake values (SUVmax) of all PET-positive lesions using volume of interest (VOI) analysis derived from the PET/CT and PET/MR datasets. All available data considering histology and imaging including prior and clinical follow-up examinations served as reference standard. Statistical analysis included comparison of mean values using Mann-Whitney U test and correlation of SUVmax using Pearson‘s correlation. Results: In 14 out of 20 patients 49 malignant lesions were present. The primary cancer could be correctly identified in 11/20 patients with both PET/CT and PET/MRI. PET/CT enabled the detection of a total 38 metastases, PET/MR respectively of 37 metastases (one lung metastasis <5mm was missed). PET/CT and

  15. Hybrid imaging for detection of carcinoma of unknown primary: A preliminary comparison trial of whole-body PET/MRI versus PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Ruhlmann, Verena; Ruhlmann, Marcus; Bellendorf, Alexander [Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen (Germany); Grueneisen, Johannes [Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen (Germany); Sawicki, Lino M. [Department of Diagnostic and Interventional Radiology, University of Dusseldorf, Moorenstraße 5, 40225 Dusseldorf (Germany); Grafe, Hong [Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen (Germany); Forsting, Michael [Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen (Germany); Bockisch, Andreas [Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen (Germany); Umutlu, Lale, E-mail: verena.ruhlmann@uk-essen.de [Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen (Germany)

    2016-11-15

    Highlights: • Both 18F-FDG PET/CT and 18F-FDG PET/MRI provide a comparable diagnostic ability for detection of primary cancer and metastases in CUP-syndrome. • Both imaging methods showed comparably high lesion conspicuity and diagnostic confidence (superior assessment of cervical lesions in PET/MRI). • PET/MRI may serve as a powerful alternative, particularly for therapy monitoring or surveillance considering the long-term cumulative dose. - Abstract: Purpose: The aim of this study is to evaluate and compare the diagnostic potential of integrated whole-body [18F]FDG-PET/MRI to [18F]FDG-PET/CT for detection of a potential primary cancer and metastases in patients suspected for cancer of unknown primary (CUP). Methods: A total of 20 patients (15 male, 5 female, age 53 ± 13 years) suspect for CUP underwent a dedicated head and neck & whole-body [18F]FDG-PET/CT (Biograph mCT 128, Siemens Healthcare) and a subsequent simultaneous [18F]FDG-PET/MRI examination (Biograph mMR, Siemens Healthcare). Two readers rated the datasets (PET/CT; PET/MRI) regarding the detection of the primary cancer and metastases, lesion conspicuity (4-point ordinal scale) and diagnostic confidence (3-point ordinal scale). PET analysis comprised the assessment of maximum standardized uptake values (SUVmax) of all PET-positive lesions using volume of interest (VOI) analysis derived from the PET/CT and PET/MR datasets. All available data considering histology and imaging including prior and clinical follow-up examinations served as reference standard. Statistical analysis included comparison of mean values using Mann-Whitney U test and correlation of SUVmax using Pearson‘s correlation. Results: In 14 out of 20 patients 49 malignant lesions were present. The primary cancer could be correctly identified in 11/20 patients with both PET/CT and PET/MRI. PET/CT enabled the detection of a total 38 metastases, PET/MR respectively of 37 metastases (one lung metastasis <5mm was missed). PET/CT and

  16. Current status and future perspective of PET

    International Nuclear Information System (INIS)

    Lee, Myung Chul

    2002-01-01

    Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) detecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had, 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3

  17. CT-based texture analysis potentially provides prognostic information complementary to interim fdg-pet for patients with hodgkin's and aggressive non-hodgkin's lymphomas

    International Nuclear Information System (INIS)

    Ganeshan, B.; Miles, K.A.; Shortman, R.; Afaq, A.; Ardeshna, K.M.; Groves, A.M.; Kayani, I.; Babikir, S.

    2017-01-01

    The purpose of this study was to investigate the ability of computed tomography texture analysis (CTTA) to provide additional prognostic information in patients with Hodgkin's lymphoma (HL) and high-grade non-Hodgkin's lymphoma (NHL). This retrospective, pilot-study approved by the IRB comprised 45 lymphoma patients undergoing routine 18F-FDG-PET-CT. Progression-free survival (PFS) was determined from clinical follow-up (mean-duration: 40 months; range: 10-62 months). Non-contrast-enhanced low-dose CT images were submitted to CTTA comprising image filtration to highlight features of different sizes followed by histogram-analysis using kurtosis. Prognostic value of CTTA was compared to PET FDG-uptake value, tumour-stage, tumour-bulk, lymphoma-type, treatment-regime, and interim FDG-PET (iPET) status using Kaplan-Meier analysis. Cox regression analysis determined the independence of significantly prognostic imaging and clinical features. A total of 27 patients had aggressive NHL and 18 had HL. Mean PFS was 48.5 months. There was no significant difference in pre-treatment CTTA between the lymphoma sub-types. Kaplan-Meier analysis found pre-treatment CTTA (medium feature scale, p=0.010) and iPET status (p<0.001) to be significant predictors of PFS. Cox analysis revealed that an interaction between pre-treatment CTTA and iPET status was the only independent predictor of PFS (HR: 25.5, 95% CI: 5.4-120, p<0.001). Specifically, pre-treatment CTTA risk stratified patients with negative iPET. CTTA can potentially provide prognostic information complementary to iPET for patients with HL and aggressive NHL. (orig.)

  18. A pilot study imaging integrin αvβ3 with RGD PET/CT in suspected lung cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Song [Shandong Cancer Hospital and Institute, Department of Radiation Oncology, Jinan, Shandong (China); University of Jinan-Shandong Academy of Medical Sciences, School of Medicine and Life Sciences, Jinan, Shandong (China); Wu, Honghu [Wuyi County People' s Hospital of Hengshui City, Hengshui, Hebei Province (China); Li, Wenwu; Zhao, Shuqiang; Teng, Xuepeng; Lu, Hong [Shandong Cancer Hospital and Institute, Department of Radiology, Jinan, Shandong (China); Hu, Xudong; Wang, Suzhen; Yu, Jinming; Yuan, Shuanghu [Shandong Cancer Hospital and Institute, Department of Radiation Oncology, Jinan, Shandong (China)

    2015-12-15

    Angiogenesis is an essential step in tumour development and metastasis. Integrin αvβ3 plays a major role in angiogenesis, tumour growth and progression. A new tracer, {sup 18}F-AL-NOTA-PRGD2, denoted as {sup 18}F-alfatide, has been developed for positron emission tomography (PET) imaging of integrin αvβ3. This is a pilot study to test the safety and diagnostic value of {sup 18}F- arginine-glycine-aspartic acid (RGD) PET/computed tomography (CT) in suspected lung cancer patients. Twenty-six patients with suspected lung cancer on enhanced CT underwent {sup 18}F-alfatide RGD PET/CT examination before surgery and puncture biopsy. Standard uptake values (SUVs) and the tumour-to-blood ratios were measured, and diagnoses were pathologically confirmed. RGD PET/CT with {sup 18}F-alfatide was performed successfully in all patients and no clinically significant adverse events were observed. The {sup 18}F-alfatide RGD PET/CT analysis correctly recognized 17 patients with lung cancer, 4 patients (hamartoma) as true negative, and 5 patients (4 chronic inflammation and 1 inflammatory pseudotumour) as false positive. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of {sup 18}F-alfatide RGD PET/CT for the diagnosis of suspected lung cancer patients was 100, 44.44, 80.77, 77.27, and 100 %, respectively. The area under a receiver operating characteristic (ROC) curve was 0.75 (P = 0.038), and ROC analysis suggested an SUVmax cut-off value of 2.65 to differentiate between malignant lesions and benign lesions. The SUV for malignant lesions was 5.37 ± 2.17, significantly higher than that for hamartomas (1.60 ± 0.11; P < 0.001). The difference between the tumour-to-blood ratio for malignant lesions (4.13 ± 0.91) and tissue of interest-to-blood ratio for hamartomas (1.56 ± 0.24) was also statistically significant (P < 0.001). Neither the SUVmax nor the tumour-to-blood ratio was significantly different between malignant

  19. PET/CT and radiotherapy

    International Nuclear Information System (INIS)

    Messa, C.; CNR, Milano; S. Gerardo Hospital, Monza; Di Muzio, N.; Picchio, M.; Bettinardi, V.; Gilardi, M.C.; CNR, Milano; San Raffaele Scientific Institute, Milano; Fazio, F.; CNR, Milano; San Raffaele Scientific Institute, Milano; San Raffaele Scientific Institute, Milano

    2006-01-01

    This article reviews the state of the art of PET/CT applications in radiotherapy, specifically its use in disease staging, patient selection, treatment planning and treatment evaluation. Diseases for which radiotherapy with radical intent is indicated will be considered, as well as those in which PET/CT may actually change the course of disease. The methodological and technological aspects of PET/CT in radiotherapy are discussed, focusing on the problem of target volume definition with CT and PET functional imaging and the problem of tumor motion with respect to imaging and dose delivery

  20. (64)Cu-DOTA-trastuzumab PET imaging and HER2 specificity of brain metastases in HER2-positive breast cancer patients.

    Science.gov (United States)

    Kurihara, Hiroaki; Hamada, Akinobu; Yoshida, Masayuki; Shimma, Schuichi; Hashimoto, Jun; Yonemori, Kan; Tani, Hitomi; Miyakita, Yasuji; Kanayama, Yousuke; Wada, Yasuhiro; Kodaira, Makoto; Yunokawa, Mayu; Yamamoto, Harukaze; Shimizu, Chikako; Takahashi, Kazuhiro; Watanabe, Yasuyoshi; Fujiwara, Yasuhiro; Tamura, Kenji

    2015-01-01

    The purpose of this study was to determine whether brain metastases from HER2-positive breast cancer could be detected noninvasively using positron emission tomography (PET) with (64)Cu-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-trastuzumab. PET was performed on five patients with brain metastases from HER2-positive breast cancer, at 24 or 48 h after the injection of approximately 130 MBq of the probe (64)Cu-DOTA-trastuzumab. Radioactivity in metastatic brain tumors was evaluated based on PET images in five patients. Autoradiography, immunohistochemistry (IHC), and liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis were performed in one surgical case to confirm HER2 specificity of (64)Cu-DOTA-trastuzumab. Metastatic brain lesions could be visualized by (64)Cu-DOTA-trastuzumab PET in all of five cases, which might indicated that trastuzumab passes through the blood-brain barrier (BBB). The HER2 specificity of (64)Cu-DOTA-trastuzumab was demonstrated in one patient by autoradiography, immunohistochemistry, and LC-MS/MS. Cu-DOTA-trastuzumab PET could be a potential noninvasive procedure for serial identification of metastatic brain lesions in patients with HER2-positive breast cancer. UMIN000004170.

  1. Clinical PET/CT imaging. Promises and misconceptions

    International Nuclear Information System (INIS)

    Czernin, J.; Auerbach, M.A.

    2005-01-01

    PET/CT is now established as the most important imaging tool in oncology. PET/CT stages and restages cancer with a higher accuracy than PET or CT alone. The sometimes irrational approach to combine state of the art PET with the highest end CT devices should give way to a more reasonable equipment design tailored towards the specific clinical indications in well-defined patient populations. The continuing success of molecular PET/CT now depends more upon advances in molecular imaging with the introduction of targeted imaging probes for individualized therapy approaches in cancer patients and less upon technological advances of imaging equipment. (orig.)

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  3. qPET - a quantitative extension of the Deauville scale to assess response in interim FDG-PET scans in lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Hasenclever, Dirk [University of Leipzig, Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig (Germany); Kurch, Lars; Georgi, Thomas; Sabri, Osama; Kluge, Regine [University Hospital Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Mauz-Koerholz, Christine; Koerholz, Dieter [University Hospital Halle, Department of Pediatrics, Halle (Germany); Elsner, Andreas [Hermes Medical Solutions AB, Stockholm (Sweden); Wallace, Hamish [Royal Hospital for Sick Children, Edinburgh, Scotland (United Kingdom); Landman-Parker, Judith [Hopital d' Enfants Armand Trousseau, Paris (France); Moryl-Bujakowska, Angelina [Jagiellonian University Medical College, Department of Pediatric Oncology and Hematology, Polish-American Institute of Pediatrics, Krakow (Poland); Cepelova, Michaela [Department of Pediatric Hematology and Oncology, Faculty Hospital Motol, Prague (Czech Republic); Karlen, Jonas [Karolinska University Hospital, Pediatric Cancer Unit, Astrid Lindgrens Childrens Hospital, Stockholm (Sweden); Alvarez Fernandez-Teijeiro, Ana [University Hospital Virgen Macarena Avda, Department of Pediatric Oncology and Hematology, Sevilla (Spain); Attarbaschi, Andishe [Medical University of Vienna, Department of Pediatric Hematology and Oncology, St. Anna Children' s Hospital, Vienna (Austria); Fossaa, Alexander [Department of Medical Oncology and Radiotherapy, Rikshospitalet - Radiumhospitalet HF, Oslo (Norway); Pears, Jane [Our Lady' s Children' s Hospital, Crumlin, Dublin (Ireland); Hraskova, Andrea [University Children' s Hospital, Clinic of Pediatric Oncology, Bratislava (Slovakia); Bergstraesser, Eva [University Children' s Hospital, Department Oncology, Zurich (Switzerland); Beishuizen, Auke [MC - Sophia Children' s Hospital, Department of Pediatric Oncology/Hematology, Rotterdam (Netherlands); Uyttebroeck, Anne [University Hospitals of Leuven, Department of Pediatric Hemato-Oncology, Leuven (Belgium); Schomerus, Eckhard [University of Odense (OUH), Department of Pediatric Oncology and Hematology, H. C. Andersen Children' s Hospital, Odense (Denmark)

    2014-07-15

    Interim FDG-PET is used for treatment tailoring in lymphoma. Deauville response criteria consist of five ordinal categories based on visual comparison of residual tumor uptake to physiological reference uptakes. However, PET-response is a continuum and visual assessments can be distorted by optical illusions. With a novel semi-automatic quantification tool we eliminate optical illusions and extend the Deauville score to a continuous scale. SUV{sub peak} of residual tumors and average uptake of the liver is measured with standardized volumes of interest. The qPET value is the quotient of these measurements. Deauville scores and qPET-values were determined in 898 pediatric Hodgkin's lymphoma patients after two OEPA chemotherapy cycles. Deauville categories translate to thresholds on the qPET scale: Categories 3, 4, 5 correspond to qPET values of 0.95, 1.3 and 2.0, respectively. The distribution of qPET values is unimodal with a peak representing metabolically normal responses and a tail of clearly abnormal outliers. In our patients, the peak is at qPET = 0.95 coinciding with the border between Deauville 2 and 3. qPET cut values of 1.3 or 2 (determined by fitting mixture models) select abnormal metabolic responses with high sensitivity, respectively, specificity. qPET methodology provides semi-automatic quantification for interim FDG-PET response in lymphoma extending ordinal Deauville scoring to a continuous scale. Deauville categories correspond to certain qPET cut values. Thresholds between normal and abnormal response can be derived from the qPET-distribution without need for follow-up data. In our patients, qPET < 1.3 excludes abnormal response with high sensitivity. (orig.)

  4. qPET - a quantitative extension of the Deauville scale to assess response in interim FDG-PET scans in lymphoma

    International Nuclear Information System (INIS)

    Hasenclever, Dirk; Kurch, Lars; Georgi, Thomas; Sabri, Osama; Kluge, Regine; Mauz-Koerholz, Christine; Koerholz, Dieter; Elsner, Andreas; Wallace, Hamish; Landman-Parker, Judith; Moryl-Bujakowska, Angelina; Cepelova, Michaela; Karlen, Jonas; Alvarez Fernandez-Teijeiro, Ana; Attarbaschi, Andishe; Fossaa, Alexander; Pears, Jane; Hraskova, Andrea; Bergstraesser, Eva; Beishuizen, Auke; Uyttebroeck, Anne; Schomerus, Eckhard

    2014-01-01

    Interim FDG-PET is used for treatment tailoring in lymphoma. Deauville response criteria consist of five ordinal categories based on visual comparison of residual tumor uptake to physiological reference uptakes. However, PET-response is a continuum and visual assessments can be distorted by optical illusions. With a novel semi-automatic quantification tool we eliminate optical illusions and extend the Deauville score to a continuous scale. SUV peak of residual tumors and average uptake of the liver is measured with standardized volumes of interest. The qPET value is the quotient of these measurements. Deauville scores and qPET-values were determined in 898 pediatric Hodgkin's lymphoma patients after two OEPA chemotherapy cycles. Deauville categories translate to thresholds on the qPET scale: Categories 3, 4, 5 correspond to qPET values of 0.95, 1.3 and 2.0, respectively. The distribution of qPET values is unimodal with a peak representing metabolically normal responses and a tail of clearly abnormal outliers. In our patients, the peak is at qPET = 0.95 coinciding with the border between Deauville 2 and 3. qPET cut values of 1.3 or 2 (determined by fitting mixture models) select abnormal metabolic responses with high sensitivity, respectively, specificity. qPET methodology provides semi-automatic quantification for interim FDG-PET response in lymphoma extending ordinal Deauville scoring to a continuous scale. Deauville categories correspond to certain qPET cut values. Thresholds between normal and abnormal response can be derived from the qPET-distribution without need for follow-up data. In our patients, qPET < 1.3 excludes abnormal response with high sensitivity. (orig.)

  5. Decision-tree sensitivity analysis for cost-effectiveness of whole-body FDG PET in the management of patients with non-small-cell lung carcinoma in Japan

    International Nuclear Information System (INIS)

    Kosuda, Shigeru; Kobayashi, Hideo; Kusano, Shoichi; Ichihara, Kiyoshi; Watanabe, Masazumi

    2002-01-01

    Whole-body 2-fluoro-2-D-[ 18 F]deoxyglucose[FDG] positron emission tomography (WB-PET) may be more cost-effective than chest PET because WB-PET does not require conventional imaging (CI) for extrathoracic staging. The cost-effectiveness of WB-PET for the management of Japanese patients with non-small-cell lung carcinoma (NSCLC) was assessed. Decision-tree sensitivity analysis was designed, based on the two competing strategies of WB-PET vs. CI. WB-PET was assumed to have a sensitivity and specificity for detecting metastases, of 90% to 100% and CI of 80% to 90%. The prevalences of M1 disease were 34% and 20%. On thousand patients suspected of having NSCLC were simulated in each strategy. We surveyed the relevant literature for the choice of variables. Expected cost saving (CS) and expected life expectancy (LE) for NSCLC patients were calculated. The WB-PET strategy yielded an expected CS of $951 US to $1,493 US per patient and an expected LE of minus 0.0246 years to minus 0.0136 years per patient for the 71.4% NSCLC and 34% M1 disease prevalence at our hospital. PET avoided unnecessary bronchoscopies and thoracotomies for incurable and benign disease. Overall, the CS for each patient was $833 US to $2,010 US at NSCLC prevalences ranging from 10% to 90%. The LE of the WB-PET strategy was similar to that of the CI strategy. The CS and LE minimally varied in the two situations of 34% and 20% M1 disease prevalence. The introduction of a WB-PET strategy in place of CI for managing NSCLC patients is potentially cost-effective in Japan. (author)

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

    International Nuclear Information System (INIS)

    Ishikita, Tomohiro; Oriuchi, Noboru; Higuchi, Tetsuya

    2010-01-01

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

  7. 18F-DOPA PET/CT Physiological Distribution and Pitfalls: Experience in 215 Patients.

    Science.gov (United States)

    Calabria, Ferdinando F; Chiaravalloti, Agostino; Jaffrain-Rea, Marielise L; Zinzi, Maddalena; Sannino, Pasqualina; Minniti, Giuseppe; Rubello, Domenico; Schillaci, Orazio

    2016-10-01

    F-DOPA PET/CT is potentially helpful in the management of patients with low-grade brain tumors, movement disorders, and somatic neuroendocrine tumors. We describe the whole-body physiological distribution of F-DOPA uptake. We examined 215 patients with F-DOPA PET/CT. Among these, 161 had brain scans and 54 had whole-body scans. Physiological distribution was negligible in the brain, with the exception of basal ganglia, whereas greatest activity was noted in the liver, pancreas, other exocrine glands, and the urinary system. Incidental tracer uptake sites were identified in 5.5% of patients. Some of these findings were due to inflammation, whereas in most cases, uptake was seen in benign tumors of the brain or in the endocrine or exocrine glands. F-DOPA uptake may be seen in inflammatory tissue or benign tumors. Correlations with history, physical examination, laboratory examination, CT, MRI, and histology are necessary for optimal diagnosis.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-03-15

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

  9. 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.

  10. Impact of Endoscopic Ultrasonography on 18F-FDG-PET/CT Upfront Towards Patient Specific Esophageal Cancer Treatment.

    Science.gov (United States)

    Hulshoff, J B; Mul, V E M; de Boer, H E M; Noordzij, W; Korteweg, T; van Dullemen, H M; Nagengast, W B; Oppedijk, V; Pierie, J P E N; Plukker, John Th M

    2017-07-01

    In patients with potentially resectable esophageal cancer (EC), the value of endoscopic ultrasonography (EUS) after fluorine-18 labeled fluorodeoxyglucose positron emission tomography with computed tomography ( 18 F-FDG-PET/CT) is questionable. Retrospectively, we assessed the impact of EUS after PET/CT on the given treatment in EC patients. During the period 2009-2015, 318 EC patients were staged as T1-4aN0-3M0 with hybrid 18 F-FDG-PET/CT or 18 F-FDG-PET with CT and EUS if applicable in a nonspecific order. We determined the impact of EUS on the given treatment in 279 patients who also were staged with EUS. EUS had clinical consequences if it changed curability, extent of radiation fields or lymph node resection (AJCC stations 2-5), and when the performed fine-needle aspiration (FNA) provided conclusive information of suspicious lymph node. EUS had an impact in 80 (28.7%) patients; it changed the radiation field in 63 (22.6%), curability in 5 (1.8%), lymphadenectomy in 48 (17.2%), and FNA was additional in 21 (7.5%). In patients treated with nCRT (n = 194), EUS influenced treatment in 53 (27.3%) patients; in 38 (19.6%) the radiation field changed, in 3 (1.5%) the curability, in 35 (18.0%) the lymphadenectomy, and in 17 (8.8%) FNA was additional. EUS influenced both the extent of radiation field and nodal resection in 31 (16.0%) nCRT patients. EUS had an impact on the given treatment in approximately 29%. In most patients, the magnitude of EUS found expression in the extent of radiotherapy target volume delineation to upper/high mediastinal lymph nodes.

  11. 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

  12. Myocardial glucose metabolism in patients with hypertrophic cardiomyopathy. Assessment by F-18-FDG PET study

    International Nuclear Information System (INIS)

    Uehara, Toshiisa; Ishida, Yoshio; Hayashida, Kohei

    1998-01-01

    In an investigation of myocardial metabolic abnormalities in hypertrophic myocardium, the myocardial glucose metabolism was evaluated with F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) in 32 patients with hypertrophic cardiomyopathy, and the results were compared with those in 9 patients with hypertensive heart disease. F-18-FDG PET study was performed in the fasting and glucose-loading states. The myocardial regional %dose uptake was calculated quantitatively. The average regional %dose uptake in the fasting state in the patients with asymmetric septal hypertrophy and dilated-phase hypertrophic cardiomyopathy was significantly higher than that in the patients with hypertensive heart disease (0.75±0.34%, 0.65±0.25%, and 0.43±0.22%/100 g myocardium, respectively). In contrast, the average %dose uptake in the glucose-loading state in the patients with asymmetric septal hypertrophy and dilated-phase hypertrophic cardiomyopathy was not significantly different from that in patients with hypertensive heart disease (1.17±0.49%, 0.80±0.44% and 0.99±0.45%, respectively). The patients with apical hypertrophy had also low %dose uptake in the fasting state (0.38±0.21%) as in the hypertensive heart disease patients, so that the characteristics of asymmetric septal hypertrophy and dilated-phase hypertrophic cardiomyopathy are considered to be high FDG uptake throughout the myocardium in the fasting state. Patients with apical hypertrophy are considered to belong to other disease categories metabolically. F-18-FDG PET study is useful in the evaluation of the pathophysiologic diagnosis of patients with hypertrophic cardiomyopathy. (author)

  13. Evaluation of suspected local recurrence in head and neck cancer: A comparison between PET and PET/CT for biopsy proven lesions

    International Nuclear Information System (INIS)

    Halpern, Benjamin S.; Yeom, Kristen; Fueger, Barbara J.; Lufkin, Robert B.; Czernin, Johannes; Allen-Auerbach, Martin

    2007-01-01

    Background: 18 F-FDG PET has a high accuracy for re-staging of head and neck cancer. The purpose of this study was to determine whether the diagnostic accuracy can be further improved with integrated PET/CT. Materials and methods: Forty-nine patients with a mean age of 59 ± 18 years were studied retrospectively. Histo-pathological verification was available either from complete tumor resection with or without lymph node dissection (n = 27) or direct endoscopic biopsy (n = 16) or ultrasound guided biopsy (n = 6). Two reviewers blinded to the pathological findings read all PET images in consensus. An experienced radiologist was added for the interpretation of the PET/CT images. Results: Tissue verification was available for 110 lesions in 49 patients. Sixty-seven lesions (61%) were biopsy positive and 43 (39%) were negative for malignant disease. PET and PET/CT showed an overall accuracy for cancer detection of 84 and 88% (p = 0.06), respectively. Sensitivity and specificity for PET were 78 and 93% versus 84 (p = NS) and 95% (p = NS) with PET/CT. A patient-by-patient analysis yielded a sensitivity, specificity and accuracy for PET of 80, 56 and 76%, compared to 88% (p = NS), 78% (p = NS) and 86% (p = 0.06) for PET/CT. Conclusion: The results of this study indicate that PET/CT does not significantly improve the detection of recurrence of head and neck cancer. However, a trend towards improved accuracy was observed (p = 0.06)

  14. Detection of underlying malignancy in patients with paraneoplastic neurological syndromes: comparison of {sup 18}F-FDG PET/CT and contrast-enhanced CT

    Energy Technology Data Exchange (ETDEWEB)

    Schramm, N.; Schmid-Tannwald, C.; Meinel, F.G.; Reiser, M.F.; Rist, C. [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); Rominger, A. [Ludwig-Maximilians-University Hospital Munich, Department of Nuclear Medicine, Munich (Germany); Schmidt, C. [Ludwig-Maximilians-University Hospital Munich, Department of Neurology, Munich (Germany); Morelli, J.N. [Texas A and M Health Sciences Center, Department of Radiology, Temple, TX (United States)

    2013-07-15

    To determine the value of combined {sup 18}F-FDG PET/CT with diagnostic contrast-enhanced CT (CECT) in detecting primary malignancies and metastases in patients with paraneoplastic neurological syndromes (PNS) and to compare this with CECT alone. PET/CT scans from 66 patients with PNS were retrospectively evaluated. Two blinded readers initially reviewed the CECT portion of each PET/CT scan. In a second session 3 months later, the readers analysed the combined PET/CT scans. Findings on each study were assessed using a four-point-scale (1 normal/benign; 2 inconclusive, further diagnostic work-up may be necessary; 3 malignant; 4 inflammatory). Sensitivity and specificity for malignant findings were calculated for PET/CT and CECT. Interreader agreement was determined by calculating Cohen's kappa. Pooled data from clinical follow-up (including histopathology and follow-up imaging, median follow-up 20.0 months) served as the reference gold standard. Both readers classified 12 findings in ten patients (15 %) as malignant on the PET/CT scans (two patients had two primary tumours). One such imaging finding (suspected thymic cancer) was false-positive (i.e. benign histology). The most common tumours were bronchial carcinoma (n = 3), lymph node metastases of gynaecological tumours (n = 3) and tonsillar carcinoma (n = 2). Three of 12 findings (25 %) were not detected by CECT alone (cervical carcinoma, lymph node metastasis and tonsillar carcinoma). In a per-patient analysis, sensitivity and specificity for malignant findings were 100 % and 90 % for PET/CT and 78 % and 88 % for CECT. In 24 % (reader 1) and 21 % (reader 2) of the patients, the PET/CT findings were inconclusive. Of these findings, 57 % (reader 1) and 56 % (reader 2) were only diagnosed with PET (e.g. focal FDG uptake of the thyroid, gastrointestinal tract and ovaries). On follow-up, none of these findings corresponded to malignancy. Overall agreement between the two readers was excellent with a Cohen

  15. Neuropsychiatric symptoms and PET imaging characteristics in patients with Parkinson-plus syndromes

    Directory of Open Access Journals (Sweden)

    Miao ZHANG

    2017-01-01

    Full Text Available Objective To explore the neuropsychiatric symptoms and 18F-fluoro-2-deoxy-D-glucose (18F-FDG PET imaging features of Parkinson-plus syndromes. Methods There were 8 patients with probable Parkinson-plus syndromes, including one case of multiple system atrophy-cerebellar predominant (MSA-C, 4 cases of progressive supranuclear palsy (PSP, one case of corticobasal ganglionic degeneration (CBD and 2 cases of dementia with Lewy bodies (DLB. Mini-Mental State Examination (MMSE and Montreal Cognitive Assessment (MoCA were used to evaluate cognitive function, Neuropsychiatric Inventory (NPI was used to evaluate neuropsychiatric behaviors, and Hamilton Depression Rating Scale-21 Items (HAMD-21 was used to evaluate the emotional state of patients. Results One MSA-C patient showed only anxiety. Four PSP patients showed different degrees of cognitive disorders, of whom 3 cases also presented obvious depression, anxiety, irritability and sleep disorders. One case of CBD showed dysfunction in executive function, visual spatial ability, verbal function, attention and orientation, as well as depression, anxiety, irritability and sleep disorders. Two cases of DLB were found unable to copy pentagon in MMSE chart or draw a circle in Clock Drawing Test (CDT, and they also presented hallucination, depression and indifference. As for the result of 18F-FDG PET, one MSA-C patient showed cerebellarglucose hypometabolism; 4 PSP patients showed hypometabolism in bilateral symmetrical frontal lobes, anterior cingulate gyrus and parietal lobe, especially in thalamus, basal ganglia region and brain stem; one case of CBD showed hypometabolism in right lateral fronto-temporo-parieto-occipital lobes, left lateral parietal lobe, bilateral cingulate gyri and precuneus; 2 cases of DLB showed hypometabolism in bilateral temporo-occipital lobes. Conclusions Patients with early Parkinson-plus syndromes are easily misdiagnosed as mental illness and delayed treatment, in addition, their

  16. Potential role of 68Ga-DOTATOC PET/CT in screening for pancreatic neuroendocrine tumour in patients with von Hippel-Lindau disease

    International Nuclear Information System (INIS)

    Prasad, Vikas; Brenner, Winfried; Tiling, Nikolaus; Ploeckinger, Ursula; Denecke, Timm

    2016-01-01

    Neuroendocrine tumours of the pancreas (pNET) are observed in 8 - 17 % of patients with von Hippel-Lindau disease (vHLD), and 11 - 20 % of these patients develop metastatic disease. MRI and CT have a very high resolution; however, their sensitivity and specificity for the detection of pNET amongst cystic lesions in the pancreas of vHLD patients are generally considered insufficient. In contrast, 68 Ga-DOTATOC PET/CT demonstrates a high sensitivity for the diagnosis and staging of neuroendocrine tumours. In this study we investigated the potential role of 68 Ga-DOTATOC PET/CT in screening of patients with vHLD. 68 Ga-DOTATOC PET/three-phase contrast-enhanced CT was performed according to guidelines in all consecutive vHLD patients between January 2012 and November 2015. All patients underwent additional MRI imaging of the abdomen, spine, and head. Chromogranin A (CgA) was determined at the time of the PET/CT examination. A lesion seen on 68 Ga-DOTATOC PET in the pancreas was defined as positive if the uptake was visually higher than in the surrounding tissues. Lesions were quantified using maximum SUV. Overall, 20 patients (8 men, 12 women; mean age 44.7 ± 11.1 years) were prospectively examined. Genetically, 12 patients had type 1 vHLD and 8 had type 2 vHLD. 68 Ga-DOTATOC PET/CT detected more pNET than morphological imaging (CT or MRI): 11 patients (55 %; 8 type 1, 3 type 2) vs. 9 patients (45 %; 6 type 1, 3 type 2). The concentration of CgA was mildly elevated in 2 of 11 patients with pNET. The mean SUVmax of the pancreatic lesions was 18.9 ± 21.9 (range 5.0 - 65.6). Four patients (36.4 %) had multiple pNETs. The mean size of the lesions on CT and/or MRI was 10.4 ± 8.3 mm (range 4 - 38 mm), and 41.1 % were larger than 10 mm. In addition, somatostatin receptor-positive cerebellar and spinal haemangioblastomas were detected in three patients (SUVmax 2.1 - 10.1). One patient presented with a solitary somatostatin receptor-positive lymph node metastasis. pNETs were

  17. CyberPET: a PET service distributed over a wide area

    International Nuclear Information System (INIS)

    Pilloy, W.J.; Hellwig, D.; Schaeffer, A.; Hoffmann, P.; Lens, V.

    2002-01-01

    Aim: Demonstration of bi-directional PET data transmission, interactive display and co-registration, for the purpose of correlative imaging, treatment planning and teaching. Material and Method: In the year 2000, the initial problem to attend was to provide an effective PET service to a hospital (in Luxemburg) which lies 150 km away from a PET center (in another country). Once this solved, the procedure was expanded (in 2001) to co-registration with CT/MRI scans performed locally, and with radiotherapy simulation CT performed in another center 25 km away (in 2002). Equipment from various vendors was used (Siemens, Adac, GE, Hermes). With preliminary agreement of the national medical aid, patients are sent from the Nuclear Medicine Dept of the Centre Hospitalier in Luxemburg (CHL) to the Dept NM of the Saarland University Medical Center for PET examination. The digital data are then sent from the Siemens PET camera to a PC connected to the LAN, and then to a FTP server (Healthnet). The data are similarly collected by a PC of the hospital network in Luxemburg, and transferred to a Hermes NM station. The Dicom PET data are converted on the fly to Interfile, displayed interactively as any other tomographic data, printed and available on the NM image server. Since 2001, the PET data are co-registered with whole-body CT data recorded at CHL according to a specific protocol (see other paper of this group). Now in 2002, we are busy implementing the co-registration of PET data and simulation CT data obtained from the Centre Baclesse (CFB, 25 km from CHL) for the treatment planning of brain tumours (input into an ADAC system). Furthermore, we plan to send the data (after deletion of their digital ID) to a (South African) university which does not yet dispose of a PET camera, to allow the training of their registrars. Results: For the end-user clinician at CHL and CFB , the PET data have the quality of 'live data', which can be examined interactively, along with other imaging

  18. Clinical utility of spatially normalized PET and SPECT to evaluate patients with memory and cognitive impairments

    International Nuclear Information System (INIS)

    Okumura, Ayumi; Nakayama, Noriyuki; Soeda, Akio; Miwa, Kazuhiro; Shinoda, Jun; Iwama, Toru

    2004-01-01

    We assessed cerebral metabolism and blood flow in patients with memory and other cognitive impairment using the easy Z score imaging system (eZIS) and statistical parametric mapping (SPM) of FDG-PET and SPECT scans. Twenty patients with dementia (12 Alzheimer's disease (AD), 3 diffuse Lewy body disease (DLB), and 2 frontotemporal dementia (FTD)) and twenty with diffuse axonal injury (DAI) and cognitive impairments were studied with FDG-PET and ECD-SPECT. All images were analyzed using eZIS with the same processing procedures, including smoothing, normalization, and z-transformation, and compared to a database of normals. Z score maps were super-imposed on 3D MRI brain images. Group analyses were performed using SPM. Age-related declines in cerebral metabolism and blood flow were observed in the anterior cingulate association area. In contrast, reductions in these cerebral functions correlated best with severity of AD in the posterior cingulate association areas. In DLB and FTD, eZIS analysis of PET and SPECT revealed reductions of cerebral functions in specific areas. DAI showed low metabolism and blood flow in mesiofrontal cortex including the anterior cingulate association area. Dysfunction of the anterior cingulate association area in DAI, which resembled age-related cognitive decline, may be responsible for cognitive impairments. Overall, PET and SPECT scans showed significant correlations according to the type of dementia. Spatially normalized maps contributed to PET and SPECT image interpretation for patients with memory and cognitive impairments because better 3D visualization allowed more objective and systematic investigations. (author)

  19. MRI fused with prone FDG PET/CT improves the primary tumour staging of patients with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Velloso, Maria J.; Ribelles, Maria J.; Rodriguez, Macarena; Sancho, Lidia; Prieto, Elena [Clinica Universidad de Navarra, Department of Nuclear Medicine, Pamplona (Spain); Fernandez-Montero, Alejandro [Clinica Universidad de Navarra, Department of Occupational Medicine, Pamplona (Spain); Santisteban, Marta [Clinica Universidad de Navarra, Department of Oncology, Pamplona (Spain); Rodriguez-Spiteri, Natalia; Martinez-Regueira, Fernando [Clinica Universidad de Navarra, Department of Surgery, Pamplona (Spain); Idoate, Miguel A. [Clinica Universidad de Navarra, Department of Pathology, Pamplona (Spain); Elizalde, Arlette; Pina, Luis J. [Clinica Universidad de Navarra, Department of Radiology, Pamplona (Spain)

    2017-08-15

    Our aim was to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) fused with prone 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in primary tumour staging of patients with breast cancer. This retrospective study evaluated 45 women with 49 pathologically proven breast carcinomas. MRI and prone PET-CT scans with time-of-flight and point-spread-function reconstruction were performed with the same dedicated breast coil. The studies were assessed by a radiologist and a nuclear medicine physician, and evaluation of fused images was made by consensus. The final diagnosis was based on pathology (90 lesions) or follow-up ≥ 24 months (17 lesions). The study assessed 72 malignant and 35 benign lesions with a median size of 1.8 cm (range 0.3-8.4 cm): 31 focal, nine multifocal and nine multicentric cases. In lesion-by-lesion analysis, sensitivity, specificity, positive and negative predictive values were 97%, 80%, 91% and 93% for MRI, 96%, 71%, 87%, and 89% for prone PET, and 97%. 94%, 97% and 94% for MRI fused with PET. Areas under the curve (AUC) were 0.953, 0.850, and 0.983, respectively (p < 0.01). MRI fused with FDG-PET is more accurate than FDG-PET in primary tumour staging of breast cancer patients and increases the specificity of MRI. (orig.)

  20. The role of PET/CT in evaluation of Facet and Disc abnormalities in patients with low back pain using 18Fluorine

    International Nuclear Information System (INIS)

    Gamie, S.; El-Maghraby, T.

    2008-01-01

    Bone scintigraphy including Single Photon Emission Computed Tomography (SPECT) is known for its role in the diagnosis of low back pain disorders. Positron Emission Tomography (PET) with 18 Fluoride) as a tracer can be used to carry out bone scans with improved image quality. With the addition of CT, simultaneous PET/CT fused images provide more accurate anatomical details. The objectives of this work are E VCT 64-Slice combined scanner. Imaging started 45-60 minutes after administration of 12-15 mCi (444-55 MBq) of 18 F-Fluoride. The PET scan was acquired from the skull base through the inguinal region in 3D mode at 2 minutes/bed. A low resolution, non-contrast CT scan was also acquired for anatomic localization and attenuation correction. The 18 F-PET/CT showed abnormal uptake in the spine in 56 patients, with an overall detection ability of 84%. Facet joints as a cause of back pain was much more frequent (25 with abnormal scans). One-third (36%) of the patients showed multiple positive uptake in both facet joints and disc areas (20/56). The patients were further divided into two groups. Group A consisted of 42 patients (63%) with back pain and no previous operative procedures, and the 18 F-PET/CT showed a high sensitivity (88%) in identifying the source of pain in 37/42 patients. Group B included 25 patients (37%) with prior lumbar fusion or laminectomy, in which the PET/CT showed positive uptake in 76% (19/25 patients). 18 F-PET/CT showed positive uptake in all patients (100%) with a history of pain after lumbar fusion, while in the laminectomy subgroup only 11 cases (65%) showed positive focal uptake. 18 FPET-CT has potential use in evaluating adult patients with back pain. It has a promising role in identifying causes of persistent back pain following vertebral surgical interventions. (authors)

  1. Prognostic significance of standardized uptake value on preoperative 18F-FDG PET/CT in patients with ampullary adenocarcinoma

    International Nuclear Information System (INIS)

    Choi, Hye Jin; Kang, Chang Moo; Lee, Woo Jung; Jo, Kwanhyeong; Lee, Jong Doo; Lee, Jae-Hoon; Ryu, Young Hoon

    2015-01-01

    The purpose of this study was to investigate the prognostic value of 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with ampullary adenocarcinoma (AAC) after curative surgical resection. Fifty-two patients with AAC who had undergone 18 F-FDG PET/CT and subsequent curative resections were retrospectively enrolled. The maximum standardized uptake value (SUV max ) and tumor to background ratio (TBR) were measured on 18 F-FDG PET/CT in all patients. The prognostic significances of PET/CT parameters and clinicopathologic factors for recurrence-free survival (RFS) and overall survival (OS) were evaluated by univariate and multivariate analyses. Of the 52 patients, 19 (36.5 %) experienced tumor recurrence during the follow-up period and 18 (35.8 %) died. The 3-year RFS and OS were 62.3 and 61.5 %, respectively. Preoperative CA19-9 level, tumor differentiation, presence of lymph node metastasis, SUV max , and TBR were significant prognostic factors for both RFS and OS (p < 0.05) on univariate analyses, and patient age showed significance only for predicting RFS (p < 0.05). On multivariate analyses, SUV max and TBR were independent prognostic factors for RFS, and tumor differentiation, SUV max , and TBR were independent prognostic factors for OS. SUV max and TBR on preoperative 18 F-FDG PET/CT are independent prognostic factors for predicting RFS and OS in patients with AAC; patients with high SUV max (>4.80) or TBR (>1.75) had poor survival outcomes. The role of and indications for adjuvant therapy after curative resection of AAC are still unclear. 18 F-FDG uptake in the primary tumor could provide additive prognostic information for the decision-making process regarding adjuvant therapy. (orig.)

  2. Interpretation criteria for FDG PET/CT in multiple myeloma (IMPeTUs): final results. IMPeTUs (Italian myeloma criteria for PET USe).

    Science.gov (United States)

    Nanni, Cristina; Versari, Annibale; Chauvie, Stephane; Bertone, Elisa; Bianchi, Andrea; Rensi, Marco; Bellò, Marilena; Gallamini, Andrea; Patriarca, Francesca; Gay, Francesca; Gamberi, Barbara; Ghedini, Pietro; Cavo, Michele; Fanti, Stefano; Zamagni, Elena

    2018-05-01

    ᅟ: FDG PET/CT ( 18 F-fluoro-deoxy-glucose positron emission tomography/computed tomography) is a useful tool to image multiple myeloma (MM). However, simple and reproducible reporting criteria are still lacking and there is the need for harmonization. Recently, a group of Italian nuclear medicine experts defined new visual descriptive criteria (Italian Myeloma criteria for Pet Use: IMPeTUs) to standardize FDG PET/CT evaluation in MM patients. The aim of this study was to assess IMPeTUs reproducibility on a large prospective cohort of MM patients. Patients affected by symptomatic MM who had performed an FDG PET/CT at baseline (PET0), after induction (PET-AI), and the end of treatment (PET-EoT) were prospectively enrolled in a multicenter trial (EMN02)(NCT01910987; MMY3033). After anonymization, PET images were uploaded in the web platform WIDEN® and hence distributed to five expert nuclear medicine reviewers for a blinded independent central review according to the IMPeTUs criteria. Consensus among reviewers was measured by the percentage of agreement and the Krippendorff's alpha. Furthermore, on a patient-based analysis, the concordance among all the reviewers in terms of positivity or negativity of the FDG PET/CT scan was tested for different thresholds of positivity (Deauville score (DS 2, 3, 4, 5) for the main parameters (bone marrow, focal score, extra-medullary disease). Eighty-six patients (211 FDG PET/CT scans) were included in this analysis. Median patient age was 58 years (range, 35-66 years), 45% were male, 15% of them were in stage ISS (International Staging System) III, and 42% had high-risk cytogenetics. The percentage agreement was superior to 75% for all the time points, reaching 100% of agreement in assessing the presence skull lesions after therapy. Comparable results were obtained when the agreement analysis was performed using the Krippendorff's alpha coefficient, either in every single time point of scanning (PET0, PET-AI or PET-EoT) or

  3. Feasibility of simultaneous PET/MR of the carotid artery

    DEFF Research Database (Denmark)

    Ripa, Rasmus S; Knudsen, Andreas; Hag, Anne Mette F

    2013-01-01

    The study aimed at comparing PET/MR to PET/CT for imaging the carotid arteries in patients with known increased risk of atherosclerosis. Six HIV-positive men underwent sequential PET/MR and PET/CT of the carotid arteries after injection of 400 MBq of (18)F-FDG. PET/MR was performed a median of 131......) indicating that the luminal (18)F-FDG content had minimal influence on the values. The study shows for the first time that simultaneous PET/MR of the carotid arteries is feasible in patients with increased risk of atherosclerosis. Quantification of (18)F-FDG uptake correlated well between PET/MR and PET...

  4. {sup 18}F-FDG PET/CT for early detection of embolism and metastatic infection in patients with infective endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Riet, Jelle van; Gheysens, Olivier; Mortelmans, Luc [University Hospital KU Leuven, Department of Nuclear Medicine, Leuven (Belgium); Hill, Evelyn E.; Herregods, Marie-Christine [University Hospital KU Leuven, Department of Cardiology, Leuven (Belgium); Dymarkowski, Steven [University Hospital KU Leuven, Department of Radiology, Leuven (Belgium); Herijgers, Paul [University Hospital KU Leuven, Department of Cardiac Surgery, Leuven (Belgium); Peetermans, Willy E. [University Hospital KU Leuven, Department of Internal Medicine, Leuven (Belgium)

    2010-06-15

    In the acute setting of endocarditis it is very important to assess both the vegetation itself, as well as potential life-threatening complications, in order to decide whether antibiotic therapy will be sufficient or urgent surgery is indicated. A single whole-body scan investigating inflammatory changes could be very helpful to achieve a swift and efficient assessment. In this study we assessed whether {sup 18}F-FDG can be used to detect and localize peripheral embolism or distant infection. Twenty-four patients with 25 episodes of endocarditis, enrolled between March 2006 and February 2008, underwent {sup 18}F-FDG PET/CT imaging on a dedicated PET/CT scanner. PET/CT imaging revealed a focus of peripheral embolization and/or metastatic infection in 11 episodes (44%). One episode had a positive PET/CT scan result for both embolism and metastatic infection. PET/CT detected seven positive cases (28%) in which there was no clinical suspicion. Valve involvement of endocarditis was seen only in three patients (12%). PET/CT may be an important diagnostic tool for tracing peripheral embolism and metastatic infection in the acute setting of infective endocarditis, since a PET/CT scan detected a clinically occult focus in nearly one third of episodes. (orig.)

  5. Pretreatment evaluation of distant-site status in patients with nasopharyngeal carcinoma: accuracy of whole-body MRI at 3-Tesla and FDG-PET-CT

    International Nuclear Information System (INIS)

    Ng, Shu-Hang; Chan, Sheng-Chieh; Yen, Tzu-Chen; Chang, Joseph Tung-Chieh; Liao, Chun-Ta; Ko, Sheung-Fat; Wai, Yau-Yau; Wang, Hung-Ming; Wang, Jiun-Jie; Chen, Min-Chi

    2009-01-01

    We sought to prospectively evaluate the accuracy of 3.0-Tesla whole-body magnetic resonance imaging (WB-MRI) and integrated fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) (FDG-PET-CT), and their combined interpretation for the assessment of distant-site status in 150 patients with untreated nasopharyngeal carcinoma (NPC). Eighteen (12%) patients were diagnosed as having distant malignancies (15 patients had distant metastases, and three distant synchronous tumours). On a patient-based analysis, WB-MRI and FDG-PET-CT showed similar sensitivity (77.8% vs 72.2%, P > 0.999), specificity (98.5% vs 97.7%, P > 0.999) and diagnostic capability (0.905 vs 0.878, P = 0.669). Combined interpretation of WB-MRI and FDG-PET-CT showed no significant benefit over either technique alone. In conclusion, 3.0-Tesla WB-MRI is a feasible, non-ionising technique that showed similar diagnostic capacity to FDG-PET-CT in assessing distant-site status in patients with untreated NPC and can be recommended as the first-line imaging technique for comprehensive evaluation of such patients. (orig.)

  6. Adenocarcinoma Prostate With Neuroendocrine Differentiation: Potential Utility of 18F-FDG PET/CT and 68Ga-DOTANOC PET/CT Over 68Ga-PSMA PET/CT.

    Science.gov (United States)

    Parida, Girish Kumar; Tripathy, Sarthak; Datta Gupta, Shreya; Singhal, Abhinav; Kumar, Rakesh; Bal, Chandrasekhar; Shamim, Shamim Ahmed

    2018-04-01

    Ga-PSMA PET/CT is the upcoming imaging modality for staging, restaging and response assessment of prostate cancer. However, due to neuroendocrine differentiation in some of patients with prostate cancer, they express somatostatin receptors instead of prostate specific membrane antigen. This can be exploited and other modalities like Ga-DOTANOC PET/CT and F-FDG PET/CT should be used in such cases for guiding management. We hereby discuss a similar case of 67-year-old man of adenocarcinoma prostate with neuroendocrine differentiation, which shows the potential pitfall of Ga-PSMA PET/CT imaging and benefit of Ga-DOTANOC PET/CT and F-FDG PET/CT in such cases.

  7. Pet-Related Infections.

    Science.gov (United States)

    Day, Michael J

    2016-11-15

    Physicians and veterinarians have many opportunities to partner in promoting the well-being of people and their pets, especially by addressing zoonotic diseases that may be transmitted between a pet and a human family member. Common cutaneous pet-acquired zoonoses are dermatophytosis (ringworm) and sarcoptic mange (scabies), which are both readily treated. Toxoplasmosis can be acquired from exposure to cat feces, but appropriate hygienic measures can minimize the risk to pregnant women. Persons who work with animals are at increased risk of acquiring bartonellosis (e.g., cat-scratch disease); control of cat fleas is essential to minimize the risk of these infections. People and their pets share a range of tick-borne diseases, and exposure risk can be minimized with use of tick repellent, prompt tick removal, and appropriate tick control measures for pets. Pets such as reptiles, amphibians, and backyard poultry pose a risk of transmitting Salmonella species and are becoming more popular. Personal hygiene after interacting with these pets is crucial to prevent Salmonella infections. Leptospirosis is more often acquired from wildlife than infected dogs, but at-risk dogs can be protected with vaccination. The clinical history in the primary care office should routinely include questions about pets and occupational or other exposure to pet animals. Control and prevention of zoonoses are best achieved by enhancing communication between physicians and veterinarians to ensure patients know the risks of and how to prevent zoonoses in themselves, their pets, and other people.

  8. Diagnostic value of kinetic analysis using dynamic FDG PET in immunocompetent patients with primary CNS lymphoma

    International Nuclear Information System (INIS)

    Nishiyama, Yoshihiro; Yamamoto, Yuka; Monden, Toshihide; Sasakawa, Yasuhiro; Satoh, Katashi; Ohkawa, Motoomi; Kawai, Nobuyuki

    2007-01-01

    The purpose of this study was to investigate the accumulation of FDG in immunocompetent patients with primary central nervous system (CNS) lymphoma using qualitative and quantitative PET images and to compare baseline with follow-up PET after therapy. Twelve immunocompetent patients with CNS lymphoma were examined. Dynamic emission data were acquired for 60 min immediately following injection of FDG. In seven patients, repeated PET studies were performed after treatment. Applying a three-compartment five-parameter model, K 1 , k 2 , k 3 , k 4 , vascular fraction (V B ) and cerebral metabolic rate of glucose (CMR Glc ) were obtained. We evaluated the FDG uptake visually using qualitative and parametric images and quantitatively using parametric images. A total of 12 lesions were identified in ten patients with newly diagnosed CNS lymphoma. On visual analysis, ten lesions showed an increase on qualitative images, eight showed an increase on K 1 images, 12 showed an increase on k 3 images and ten showed an increase on CMR Glc images. On quantitative analysis, k 2 , k 3 and CMR Glc values of the lesion were significantly different from those of the normal grey matter (p 3 and CMR Glc images. The K 1 , k 2 , k 3 and CMR Glc values after treatment were significantly different from those obtained before treatment (p 3 , using dynamic FDG PET might be helpful for diagnosis of CNS lymphoma and for monitoring therapeutic assessment. (orig.)

  9. Experience of Dual Time Point Brain F-18 FDG PET/CT Imaging in Patients with Infections Disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Weung; Kim, Chang Guhn; Park, Soon Ah; Jung, Sang Ah [Wonkwang University School of Medicine, Iksan (Korea, Republic of)

    2010-06-15

    Dual time point FDG PET imaging (DTPI) has been considered helpful for discrimination of benign and malignant disease, and staging lymph node status in patients with pulmonary malignancy. However, DTPI for benign disease has been rarely reported, and it may show a better description of metabolic status and extent of benign infection disease than early imaging only. The authors report on the use F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) imaging with additional delayed imaging on a 52-year-old man with sparganosis and a 70-year-old man with tuberculous meningitis. To the best of our knowledge, this is the first report on dual time point PET/CT imaging in patients with cerebral sparganosis and tuberculous meningitis.

  10. The use of fused PET/CT images for patient selection and radical radiotherapy target volume definition in patients with non-small cell lung cancer: Results of a prospective study with mature survival data

    International Nuclear Information System (INIS)

    Mac Manus, Michael P.; Everitt, Sarah; Bayne, Mike; Ball, David; Plumridge, Nikki; Binns, David; Herschtal, Alan; Cruickshank, Deborah; Bressel, Mathias; Hicks, Rodney J.

    2013-01-01

    Background and purpose: This prospective study investigated the impact of radiotherapy (RT)-planning FDG-PET/CT on management of non-small cell lung cancer (NSCLC). Materials and methods: Patients still eligible for radical RT after conventional staging underwent RT-planning PET/CT and, if disease was still treatable to 60 Gy, they entered our planning study, where visually-contoured tumour volumes derived with and without PET information were compared. If PET/CT detected advanced disease, palliative therapy was given. Overall survival (OS) for palliative and curative patients was compared. Results: Of 76 eligible patients, only 50 (66%) received radical chemoRT after PET/CT while 26 (34%) received palliative therapies because PET/CT detected advanced disease. Without PET, FDG-avid tumour would reside outside the planning target volume (PTV) in 36% of radical cases and in 25% 95% prescribed dose. OS for all patients was 56.8% and 24.9% at 1 and 4 years, respectively. OS for patients given chemoRT was 77.5% and 35.6% at 1 and 4 years, respectively and was 32% for stage IIIA patients at 4 years. OS for patients treated palliatively was inferior (P < 0.001); 16.3% and 4.1% at 1 and 4 years, respectively. Conclusions: Planning PET/CT frequently changed management and was associated with excellent survival. Survival data from this study were presented in part at the 2011 World Lung Cancer Conference, Amsterdam and planning data at the 2010 Annual Scientific Meeting of the American Society for Therapeutic Radiology and Oncology, Chicago

  11. PET in management of breast cancer

    International Nuclear Information System (INIS)

    Lee, Myung-Chul

    2004-01-01

    Full text: PET provides useful information about tumor metabolism enabling accurate visualization of malignant lesions. Approximately 60-80% suspicious lesions on mammography have benign histology and about 10% of breast cancers with palpable mass are not identified in mammography. The key roles of PET technology in breast cancer are in: primary diagnosis, staging, recurrent diseases monitoring and prediction of therapy response. The sensitivity and specificity of FDG-PET for the diagnosis of breast cancer has been reported to be 68-100% and 83-100%, respectively. Considering the increasing number of small breast tumors detected by mammography and false negative results, the clinical relevance of FDG-PET for the primary diagnosis is limited. In selected patients, however, for example with dense breasts, breasts implants, augmented breast or after breast surgery, which can affect the accuracy of mammography, and in cases with equivocal mammography, FDG-PET can provide clinically relevant information. PET accurately determines the extent of disease, including the loco-regional lymph node status. Furthermore, whole-body PET imaging promises a high diagnostic accuracy for detecting recurrent or metastatic breast carcinoma with a high positive predictive value. We studied the usefulness of the FDG-PET in 42 preoperative patients with suspected breast cancer in differentiation of lesions. The diagnostic value of FDG-PET in terms of sensitivity and specificity was 95% and 77% respectively in primary mass while it was 73% and 100% for axillary lymph nodes. PET is much more accurate than other conventional modalities. The sensitivity of FDG-PET for correct staging of axillary nodal status is 84-100%. It has the potential to replace conventional procedures for the staging of distant metastases. We observed the sensitivity and the specificity of FDG-PET to be 96% and 85% to detect distant metastases. FDG-PET may become the method of choice for the early assessment of

  12. Analysis of the proportion of the patients referred to PET/CT in some areas of China

    International Nuclear Information System (INIS)

    Yao Zhiming; Qu Wanying; Zheng Jianguo; Lin Jiabing; Wang Mei; Luo Zhifu; Guan Yihui; Wang Quanshi; Chen Qiusong; Zhang Yongxue; Huang Qingjuan; Yin Jilin; Li Yaming; Liu Qingwei; Guo Wanhua

    2008-01-01

    Objective: The aim of this study was to analyze the current practical status of PET/CT application in China and for provision of data in support of promoting the utility of this imaging modality. Methods: All 3018 PET/CT cases from 10 hospitals in the top 3 rankings were recruited in the data analysis from June to August, 2006. Results: (1) Reason for referral: the proportions of patients referred for onco- logic diagnosis, check-up and other reasons were 63.0%, 32.9% and 4.1%, respectively. (2) Diagnosis: PET/CT had a 93.5% true positive value in diagnosing malignant tumors, 38.6% success rate in identifying the primary malignancy in patients presented with metastases, and 23.3% discovery rate of malignancy in patients with space-occupying lesions pathologically diagnosed as benign but clinically requested to differentiate between benignity and malignancy. (3) Patient data: the proportion of patients in the top 3 income groups (monthly) was: > RMB 6000, 30.4%; RMB 4001-6000, 28.8%; and RMB 2001-4000, 18.6%. The proportion of patients in the top 3 medical insurance or security category: self-paid or uninsured, 55.6%; national basic insurance scheme, 26.5%; public paid fund, 11.4%. The top 3 groups of patients categorized according to profession were: departmental officials, 21.9%; retiree, 15.6%; company leaders, 11.8%. The top 3 groups according to level of education were: university (including college), 48.2%; high school (including technical training schools), 21.3%; primary school, 13.8%. Conclusions: PET/ CT holds an essential clinical value in oncology. It is an utmost issue on how to fully utilize the existing resources with a purpose to achieve maximal benefit and return. (authors)

  13. The value of follow-up FDG-PET/CT in the management and prognosis of patients with HPV-positive oropharyngeal squamous cell carcinoma

    International Nuclear Information System (INIS)

    Taghipour, Mehdi; Marcus, Charles; Califano, Joseph; Fakhry, Carole; Subramaniam, Rathan M.

    2015-01-01

    To establish the accuracy of follow-up fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT and the impact of FDG PET/CT result on management decisions and patient outcome prediction (overall and progression free survival) in human papilloma virus (HPV)-positive oropharyngeal squamous cell carcinoma (SCC). We included 96 HPV-positive oropharyngeal SCC (OPSCC) patients with 254 follow-up PET/CT scans in the study. The PET/CT result accuracy was established with histopathology or 6-month clinical follow-up as reference standard. The impact on change in management was established for each follow-up PET/CT scan. Overall survival was evaluated using Kaplan–Meier plots with a Log-rank test. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the follow-up FDG-PET/CT were 97.0%, 92.5%, 67.0%, 99.5% and 93.1%, respectively. Follow-up PET/CT results were helpful in excluding tumour in 22% (9/41) of scans performed with prior clinical suspicion of disease and identified potential disease in 9.9% (21/213) scans performed without prior clinical suspicion. There was a change in management after 12.6% (32/254) scans. In 84.3% (214/254) scans, the patients were either observed or the same treatment was continued. The overall survival differed significantly between patients with a negative versus positive follow-up scan (log rank P < 0.001). The median progression free survival was 28 months, if the first follow-up scan performed within 6–12 months post-treatment completion was negative. Follow-up FDG PET/CT scans have an impact on the management plan and add value to clinical assessment in patients with HPV-positive OPSCC.

  14. Bias atlases for segmentation-based PET attenuation correction using PET-CT and MR.

    Science.gov (United States)

    Ouyang, Jinsong; Chun, Se Young; Petibon, Yoann; Bonab, Ali A; Alpert, Nathaniel; Fakhri, Georges El

    2013-10-01

    This study was to obtain voxel-wise PET accuracy and precision using tissue-segmentation for attenuation correction. We applied multiple thresholds to the CTs of 23 patients to classify tissues. For six of the 23 patients, MR images were also acquired. The MR fat/in-phase ratio images were used for fat segmentation. Segmented tissue classes were used to create attenuation maps, which were used for attenuation correction in PET reconstruction. PET bias images were then computed using the PET reconstructed with the original CT as the reference. We registered the CTs for all the patients and transformed the corresponding bias images accordingly. We then obtained the mean and standard deviation bias atlas using all the registered bias images. Our CT-based study shows that four-class segmentation (air, lungs, fat, other tissues), which is available on most PET-MR scanners, yields 15.1%, 4.1%, 6.6%, and 12.9% RMSE bias in lungs, fat, non-fat soft-tissues, and bones, respectively. An accurate fat identification is achievable using fat/in-phase MR images. Furthermore, we have found that three-class segmentation (air, lungs, other tissues) yields less than 5% standard deviation of bias within the heart, liver, and kidneys. This implies that three-class segmentation can be sufficient to achieve small variation of bias for imaging these three organs. Finally, we have found that inter- and intra-patient lung density variations contribute almost equally to the overall standard deviation of bias within the lungs.

  15. Initial Experience in Colombia in Patients with PET/CT-FDG Studies of the Central Nervous System

    International Nuclear Information System (INIS)

    Ucros, Gonzalo; Bernal, Patricia; Bermudez Sonia

    2009-01-01

    To describe the experience of patients who underwent a brain PET-CT during sixteen consecutive months. Method: 41 studies were made using flourodeoxiglucose (FDG) and registered with computed tomography. Results: These studies correspond to 5% of all PET studies performed at our institution. The age of patients ranged from 11 to 74 years. The main indications were: search for an epileptic focus (34%), cognitive disorder (32%), tumor evaluation (22%) and others (12%). Conclusion: The main applications of the brain PETCT FDG in our patients were: evaluation of untreatable epileptic patients thinking of undergoing surgery, evaluation of patients with cognitive disorders like Alzheimer's and other related dementias and finally, evaluation of patients with residual or primary brain tumors. It is among these patients in which this diagnostic modality has better diagnostic utility with abnormal findings, useful for their management.

  16. PET/CT Biograph trademark Sensation 16. Performance improvement using faster electronics

    International Nuclear Information System (INIS)

    Martinez, M.J.; Schwaiger, M.; Ziegler, S.I.; Bercier, Y.

    2006-01-01

    Aim: the new PET/CT biograph sensation 16 (BS16) tomographs have faster detector electronics which allow a reduced timing coincidence window and an increased lower energy threshold (from 350 to 400 keV). This paper evaluates the performance of the BS16 PET scanner before and after the Pico-3D electronics upgrade. Methods: four NEMA NU 2-2001 protocols, (i) spatial resolution, (ii) scatter fraction, count losses and random measurement, (iii) sensitivity, and (iv) image quality, have been performed. Results: a considerable change in both PET count-rate performance and image quality is observed after electronics upgrade. The new scatter fraction obtained using Pico-3D electronics showed a 14% decrease compared to that obtained with the previous electronics. At the typical patient background activity (5.3 kBq/ml), the new scatter fraction was approximately 0.42. The noise equivalent count-rate (R NEC ) performance was also improved. The value at which the R NEC curve peaked, increased from 3.7 . 10 4 s -1 at 14 kBq/ml to 6.4 . 10 4 s -1 at 21 kBq/ml (2R-NEC rate). Likewise, the peak true count-rate value increased from 1.9 . 10 5 s -1 at 22 kBq/ml to 3.4 . 10 5 s -1 at 33 kBq/ml. An average increase of 45% in contrast was observed for hot spheres when using AW-OSEM (4ix8s) as the reconstruction algorithm. For cold spheres, the average increase was 12%. Conclusion: the performance of the PET scanners in the BS16 tomographs is improved by the optimization of the signal processing. The narrower energy and timing coincidence windows lead to a considerable increase of signal-to-noise ratio. The existing combination of fast detectors and adapted electronics in the BS16 tomographs allow imaging protocols with reduced acquisition time, providing higher patient throughput. (orig.)

  17. {sup 18}F-FDG-PET/CT for systemic staging of patients with newly diagnosed ER-positive and HER2-positive breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ulaner, Gary A.; Castillo, Raychel [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Weill Cornell Medical College, Department of Radiology, New York, NY (United States); Wills, Jonathan [Memorial Sloan Kettering Cancer Center, Department of Information Systems, New York, NY (United States); Goenen, Mithat; Goldman, Debra A. [Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States)

    2017-08-15

    This study assesses {sup 18}F-FDG-PET/CT for patients with newly diagnosed estrogen receptor-positive/human epidermal growth factor receptor-negative (ER+/HER2-) and human epidermal growth factor receptor-positive (HER2+) breast cancer. In this Institutional Review Board-approved retrospective study, our Healthcare Information System was screened for patients with ER+/HER2- and HER2+ breast cancer who underwent {sup 18}F-FDG-PET/CT prior to systemic or radiation therapy. The initial stage was determined from mammography, ultrasound, magnetic resonance imaging, and/or surgery.{sup 18}F-FDG-PET/CT was evaluated to identify unsuspected extra-axillary regional nodal and distant metastases. The proportion of patients upstaged overall and stratified by stage and receptor phenotypes was calculated along with confidence intervals (CI). A total of 238 patients with ER+/HER2- and 245 patients with HER2+ who met inclusion criteria were evaluated. For patients with ER+/HER2-breast cancer, {sup 18}F-FDG-PET/CT revealed unsuspected distant metastases in 3/71 (4%) initial stage IIA, 13/95 (14%) stage IIB, and 15/57 (26%) stage III. For patients with HER2+ breast cancer, {sup 18}F-FDG-PET/CT revealed unsuspected distant metastases in 3/72 (4%) initial stage IIA, 13/93 (14%) stage IIB, and 13/59 (22%) stage III. The overall upstaging rate for IIB was 14% (95% confidence interval (CI): 9-20%). {sup 18}F-FDG-PET/CT revealed distant metastases in 14% (95% CI: 9-20%) of patients with stage IIB ER+/HER2- and HER2+ breast cancer, which is similar to upstaging rates previously seen in patients with stage IIB triple-negative breast cancer (15%, 95% CI: 9-24%). The detection of unsuspected distant metastases in these patients alters treatment and prognosis. NCCN guidelines should consider adding patients with stage IIB breast cancer for consideration of systemic staging with {sup 18}F-FDG-PET/CT at the time of initial diagnosis. (orig.)

  18. Ten years summary: FDG-PET on irradiated brain tumour

    International Nuclear Information System (INIS)

    Wang Shuxia; Boethius, J.

    2004-01-01

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

  19. {sup 18}F-FDG PET predicts survival after pretargeted radioimmunotherapy in patients with progressive metastatic medullary thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Salaun, Pierre-Yves; Robin, Philippe [University Hospital, Nuclear Medicine Department, Brest (France); Campion, Loic [ICO-Gauducheau Cancer Institute, Statistical Department, Nantes (France); Ansquer, Catherine; Mathieu, Cedric [University Hospital, Nuclear Medicine Department, Nantes (France); Frampas, Eric [University Hospital, Radiology Department, Nantes (France); Universite de Nantes, Nantes-Angers Cancer Research Center, Inserm, U 892, CNRS, UMR 6299, Nantes (France); Bournaud, Claire [University Hospital, Nuclear Medicine Department, Lyon (France); Vuillez, Jean-Philippe [University Hospital, Nuclear Medicine Department, Grenoble (France); Taieb, David [University Hospital, Nuclear Medicine Department, Marseille (France); Rousseau, Caroline [Universite de Nantes, Nantes-Angers Cancer Research Center, Inserm, U 892, CNRS, UMR 6299, Nantes (France); ICO-Rene Gauducheau, Nuclear Medicine Department, Nantes (France); Drui, Delphine [University Hospital, Endocrinology Department, Nantes (France); Mirallie, Eric [University Hospital, Surgery Department, Nantes (France); Borson-Chazot, Francoise [University Hospital, Endocrinology Department, Lyon (France); Goldenberg, David M. [IBC Pharmaceuticals, Inc., and Immunomedics, Inc., Morris Plains, NJ (United States); Center for Molecular Medicine and Immunology, Garden State Cancer Center, Morris Plains, NJ (United States); Chatal, Jean-Francois [GIP ARRONAX, Saint-Herblain (France); Barbet, Jacques [Universite de Nantes, Nantes-Angers Cancer Research Center, Inserm, U 892, CNRS, UMR 6299, Nantes (France); GIP ARRONAX, Saint-Herblain (France); Kraeber-Bodere, Francoise [University Hospital, Nuclear Medicine Department, Nantes (France); Universite de Nantes, Nantes-Angers Cancer Research Center, Inserm, U 892, CNRS, UMR 6299, Nantes (France); ICO-Rene Gauducheau, Nuclear Medicine Department, Nantes (France); Hotel Dieu University Hospital, Nuclear Medicine Department, Nantes (France)

    2014-08-15

    PET is a powerful tool for assessing targeted therapy. Since {sup 18}F-FDG shows a potential prognostic value in medullary thyroid carcinoma (MTC), this study evaluated {sup 18}F-FDG PET alone and combined with morphological and biomarker evaluations as a surrogate marker of overall survival (OS) in patients with progressive metastatic MTC treated with pretargeted anti-CEA radioimmunotherapy (pRAIT) in a phase II clinical trial. Patients underwent PET associated with morphological imaging (CT and MRI) and biomarker evaluations, before and 3 and 6 months, and then every 6 months, after pRAIT for 36 months. A combined evaluation was performed using anatomic, metabolic and biomarker methods. The prognostic value of the PET response was compared with demographic parameters at inclusion including age, sex, RET mutation, time from initial diagnosis, calcitonin and CEA concentrations and doubling times (DT), SUV{sub max}, location of disease and bone marrow involvement, and with response using RECIST, biomarker concentration variation, impact on DT, and combined methods. Enrolled in the study were 25 men and 17 women with disease progression. The median OS from pRAIT was 3.7 years (0.2 to 6.5 years) and from MTC diagnosis 10.9 years (1.7 to 31.5 years). After pRAIT, PET/CT showed 1 patient with a complete response, 4 with a partial response and 24 with disease stabilization. The combined evaluation showed 20 responses. For OS from pRAIT, univariate analysis showed the prognostic value of biomarker DT (P = 0.011) and SUV{sub max} (P = 0.038) calculated before pRAIT and impact on DT (P = 0.034), RECIST (P = 0.009), PET (P = 0.009), and combined response (P = 0.004) measured after pRAIT. PET had the highest predictive value with the lowest Akaike information criterion (AIC 74.26) as compared to RECIST (AIC 78.06), biomarker variation (AIC 81.94) and impact on DT (AIC 79.22). No benefit was obtained by combining the methods (AIC 78.75). This result was confirmed by the

  20. FDG-PET/CT at the end of immuno-chemotherapy in follicular lymphoma: the prognostic role of the ratio between target lesion and liver SUVmax (rPET).

    Science.gov (United States)

    Annunziata, Salvatore; Cuccaro, Annarosa; Tisi, Maria Chiara; Hohaus, Stefan; Rufini, Vittoria

    2018-06-01

    To retrospectively investigate the prognostic role of the ratio between target lesion and liver SUV max (rPET) in patients with follicular lymphoma (FL) submitted to FDG-PET/CT at the end of immuno-chemotherapy (PI-PET), and to compare rPET with International Harmonization Project criteria (IHP), Deauville Score (5p-DS) and FL International Prognostic Index at diagnosis (FLIPI). Eighty-nine patients with FL undergoing PI-PET were evaluated. The receiver operating characteristic (ROC) approach was applied to identify the optimal cut-point of rPET with respect to 5-years progression free survival (PFS). The prognostic significance of rPET was compared with IHP, DS and FLIPI. Positive predictive value (PPV) and negative predictive value (NPV) were calculated using the presence of adverse events as gold standard. The ROC analysis for rPET as predictor of progression showed an optimal rPET cut-point of 0.98. Patients with positive values of IHP, DS and rPET had a PFS of 50, 30 and 31%. PPV were of 56, 80 and 80%, NPV of 83, 86 and 88%, respectively. DS and rPET differed only in two patients. FLIPI was not predictive of progression and relapse. rPET is a prognostic factor in patients with FL submitted to PI-PET. Although it has a similar prognostic power as DS, it can have methodological advantages over visual analysis. PI-PET with different evaluation systems has a stronger prognostic power than FLIPI at diagnosis, so it could be useful to identify patients with FL at risk for early relapse after immuno-chemotherapy.

  1. Usefulness of PET in non-lesional temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Bertuluchi, M.; Arganaraz, R.; Buznick, J.; Pomata, H.

    2011-01-01

    Objective. To evaluate the usefulness of PET in patients with refractory non-lesional temporal lobe epilepsy. Material and methods. We present three patients with features of temporal lobe epilepsy refractory to medication, where high definition MRI was normal. Results. These patients had PET hypometabolism in the temporal areas related to clinical and neurophysiological findings. Two of these patients were implanted with subdural grids to confirm the diagnosis and the third was operated directly based on the findings of PET. Encourage the presentation of the importance in recent years is acquiring the PET. Conclusion. In those patients in clinical neurophysiology and epilepsy with suspected temporal lobe, but in the MRI images show no structural lesions, PET can play an important role defining the diagnosis. (authors)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-03-15

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

  3. Comparison of Coregistration Accuracy of Pelvic Structures Between Sequential and Simultaneous Imaging During Hybrid PET/MRI in Patients with Bladder Cancer.

    Science.gov (United States)

    Rosenkrantz, Andrew B; Balar, Arjun V; Huang, William C; Jackson, Kimberly; Friedman, Kent P

    2015-08-01

    The aim of this study was to compare coregistration of the bladder wall, bladder masses, and pelvic lymph nodes between sequential and simultaneous PET and MRI acquisitions obtained during hybrid (18)F-FDG PET/MRI performed using a diuresis protocol in bladder cancer patients. Six bladder cancer patients underwent (18)F-FDG hybrid PET/MRI, including IV Lasix administration and oral hydration, before imaging to achieve bladder clearance. Axial T2-weighted imaging (T2WI) was obtained approximately 40 minutes before PET ("sequential") and concurrently with PET ("simultaneous"). Three-dimensional spatial coordinates of the bladder wall, bladder masses, and pelvic lymph nodes were recorded for PET and T2WI. Distances between these locations on PET and T2WI sequences were computed and used to compare in-plane (x-y plane) and through-plane (z-axis) misregistration relative to PET between T2WI acquisitions. The bladder increased in volume between T2WI acquisitions (sequential, 176 [139] mL; simultaneous, 255 [146] mL). Four patients exhibited a bladder mass, all with increased activity (SUV, 9.5-38.4). Seven pelvic lymph nodes in 4 patients showed increased activity (SUV, 2.2-9.9). The bladder wall exhibited substantially less misregistration relative to PET for simultaneous, compared with sequential, acquisitions in in-plane (2.8 [3.1] mm vs 7.4 [9.1] mm) and through-plane (1.7 [2.2] mm vs 5.7 [9.6] mm) dimensions. Bladder masses exhibited slightly decreased misregistration for simultaneous, compared with sequential, acquisitions in in-plane (2.2 [1.4] mm vs 2.6 [1.9] mm) and through-plane (0.0 [0.0] mm vs 0.3 [0.8] mm) dimensions. FDG-avid lymph nodes exhibited slightly decreased in-plane misregistration (1.1 [0.8] mm vs 2.5 [0.6] mm), although identical through-plane misregistration (4.0 [1.9] mm vs 4.0 [2.8] mm). Using hybrid PET/MRI, simultaneous imaging substantially improved bladder wall coregistration and slightly improved coregistration of bladder masses and

  4. PET studies in epilepsy

    Science.gov (United States)

    Sarikaya, Ismet

    2015-01-01

    Various PET studies, such as measurements of glucose, serotonin and oxygen metabolism, cerebral blood flow and receptor bindings are availabe for epilepsy. 18Fluoro-2-deoxyglucose (18F-FDG) PET imaging of brain glucose metabolism is a well established and widely available technique. Studies have demonstrated that the sensitivity of interictal FDG-PET is higher than interictal SPECT and similar to ictal SPECT for the lateralization and localization of epileptogenic foci in presurgical patients refractory to medical treatments who have noncontributory EEG and MRI. In addition to localizing epileptogenic focus, FDG-PET provide additional important information on the functional status of the rest of the brain. The main limitation of interictal FDG-PET is that it cannot precisely define the surgical margin as the area of hypometabolism usually extends beyond the epileptogenic zone. Various neurotransmitters (GABA, glutamate, opiates, serotonin, dopamine, acethylcholine, and adenosine) and receptor subtypes are involved in epilepsy. PET receptor imaging studies performed in limited centers help to understand the role of neurotransmitters in epileptogenesis, identify epileptic foci and investigate new treatment approaches. PET receptor imaging studies have demonstrated reduced 11C-flumazenil (GABAA-cBDZ) and 18F-MPPF (5-HT1A serotonin) and increased 11C-cerfentanil (mu opiate) and 11C-MeNTI (delta opiate) bindings in the area of seizure. 11C-flumazenil has been reported to be more sensitive than FDG-PET for identifying epileptic foci. The area of abnormality on GABAAcBDZ and opiate receptor images is usually smaller and more circumscribed than the area of hypometabolism on FDG images. Studies have demonstrated that 11C-alpha-methyl-L-tryptophan PET (to study synthesis of serotonin) can detect the epileptic focus within malformations of cortical development and helps in differentiating epileptogenic from non-epileptogenic tubers in patients with tuberous sclerosis complex

  5. Towards truly integrated hardware fusion with PET/CT

    International Nuclear Information System (INIS)

    Beyer, T.

    2005-01-01

    Combined PET/CT imaging is a non-invasive means of acquiring and reviewing both, the anatomy and the molecular pathways of a patient during a quasi-simultaneous examination. Since the introduction of the prototype PET/CT in 1998 this imaging technology has evolved rapidly. State-of-the-art PET/CT tomographs combine the latest technology in spiral, multi-slice CT and PET using novel scintillator materials and image reconstruction techniques. Together with novel patient positioning systems PET/CT tomographs allow to acquire complementary PET and CT data in a single exam with the best intrinsic co-registration. In addition to the hardware integration efforts have been made to integrate the acquisition and viewing software in PET/CT, thus making the diagnostic review and reporting more efficient. Based on the first clinical experiences and the technical evolution of combined imaging technology PET/CT has become a standard in diagnostic oncology. With high-performance imaging technology at hand today, standardized, high-quality PET/CT imaging protocols are needed to provide best oncology patient care. These protocols mandate the joint efforts of a multi-disciplinary team of physicians, physicists and radiochemists. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Hoon

    1998-12-01

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

  7. Preoperative F-18-FDG PET for the detection of metastatic cervical lymph nodes in recurrent papillary thyroid carcinoma patients with negative I-131 whole body scans

    International Nuclear Information System (INIS)

    Byun, Byung Hyun; Urn, Sang Moo; Cheon, Gi Jeong; Choi, Chang Woon; Lee, Byeong Cheol; Lee, Guk Haeng; Lee, Yong Sik; Shim, Youn Sang

    2007-01-01

    We evaluated the diagnostic performance of FDG-PET for the detection of metastatic cervical lymph nodes in recurrent papillary thyroid carcinoma patients with negative I-131 scan. All patients had total thyroidectomy and following I-131 ablation therapy. In the follow-up period, FDG-PET showed suspected cervical lymph nodes metastases and neck dissection was performed within 3 months after FDG-PET. It had shown for all patients the negative I-131 scan within 3 months before FDG-PET or negative I-131 scan during the period of cervical lymph nodes metastases suspected on the basis of FDG-PET, CT, or ultrasonography until the latest FDG-PET. Preoperative FDG-PET results were compared with the pathologic findings of lymph nodes specimens of 19 papillary thyroid carcinoma patients. Serum Tg, TSH, and Tg antibody levels at the time of latest I-131 scan were reviewed. The size of lymph node was measured by preoperative CT or ultrasonography. In 45 cervical lymph node groups dissected, 31 lymph node groups revealed metastasis. The sensitivity and specificity of FDG-PET for metastasis were 74.2% (23 of 31) and 50.0% (7 of 14), respectively. Except for patients with elevated Tg antibody levels, all patients showed the elevated serum Tg levels than normal limits at the TSH of =30uIU/ml. 8 lesions without suspected metastatic findings on FDG-PET revealed metastasis (false negative), and none of them exceeded 8mm in size (4 to 8mm, median= 6mm). On the other hand, 23 true positive lesions on FDG-PET were variable in size (6 to 17mm, median=9mm). FDG-PET is suitable for the detection of metastatic cervical lymph nodes in patients with recurrent papillary thyroid carcinoma. However, false positive or false negative should be considered according to the size of lymph node

  8. PET/CT staging of T1-stage non-small cell lung cancer

    International Nuclear Information System (INIS)

    Salman, K. A.; Steinmann, C. H.; Von Schulthess, G. K.; Steinert, H. C.; Sukumar, V. P.

    2009-01-01

    Full text:Purpose: To evaluate the value of PET/CT in detecting occult metastases in patients with T 1 -stage non-small cell lung cancer (NSCLC). Method: Patients with proven NSCLC and T 1 -stage ( c m) were retrospectively analyzed. In all patients a whole-body 18 F-FDG PET/CT scan for initial staging was performed. The PET/CT findings were compared with all available clinical information, intra-operative findings and the histopathological results. Results: 95 patients (39 men, 56 women; age range, 19-85 years) were analyzed in our study. PET/CT in 68-95 patients correctly excluded mediastinal and distant metastases. In 17/95 patients (18%) mediastinal lymph-node metastases were proven (N 2 n=15; N 3 n=2). PET/CT correctly detected in 10/17 patients (58.8%) mediastinal nodal disease. The smallest mediastinal lymph-node metastasis detected by PET/CT had a size of 0.7 c m. In 7 patients PET/CT missed N 2 -stage. In three of these patients the SUVmax of the primary was c m. Only in one missed N 2 -stage metastasis was sized > 1.0 c m. The tumor histology (adenocarcinoma, squamous cell carcinoma) and location of the primary (central, periphery) did not influence the missed N 2 -stage by PET/CT. PET/CT diagnosed correctly N 3 -stage in 2 patients. 10/95 patients (10.5%) had distant metastases. PET/CT detected unknown M 1 -stage in 4/10 patients. In one patient a metastasis of the parietal pleura was missed by PET/CT. Conclusion: In our study, 28% patients with T 1 -stage NSCLC showed mediastinal or distant metastases. PET/CT was efficient in the detection of occult metastases. However, the sensitivity of PET/CT in mediastinal staging was only 64%.

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  11. Pathophysiology and diagnosis of hibernating myocardium in patients with post-ischemic heart failure. The contribution of PET

    International Nuclear Information System (INIS)

    Camici, P.G.; Rimoldi, O.E.

    2003-01-01

    Identification and treatment of hibernating myocardium (HM) lead to improvement in left ventricular (LV) function and prognosis in patients with post-ischemic heart failure. Different techniques are used to diagnose HM: echocardiography, MRI, SPECT and PET and, in patients with moderate LV impairment, their predictive values are similar. There are few data on patients with severe LV dysfunction and heart failure in whom the greatest benefits are apparent after revascularization. Quantification of FDG uptake with PET during hyperinsulinemic euglycemic clamp is accurate in these patients with the greatest mortality risk in whom other techniques may give high false negative rates. The debate on whether resting myocardial blood flow to HM is reduced or not has stimulated new research on heart failure in patients with coronary artery disease. PET with H 2 15 O or 13 NH 3 has been used for the absolute quantification of regional blood flow in human HM. When HM is properly identified, resting blood flow is not different from that in healthy volunteers although a reduction of ∼20% can be demonstrated in a minority of cases. PET studies have shown that the main feature of HM is a severe impairment of coronary vasodilator reserve that improves after revascularization in parallel with LV function. Thus, the pathophysiology of HM is more complex than initially postulated. The recent evidence that repetitive ischemia in patients can be cumulative and lead to more severe and prolonged stunning, lends further support to the hypothesis that, at least initially, stunning and HM are two facets of the same coin. (author)

  12. Functional impairment of the frontal lobe in methamphetamine dependent patients detected on FDG-PET and WCST

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yang Tae; Kwon, Do Hoon [Bugok National Hostipal, Changnyeong (Korea, Republic of); Lee, Sang Woo; Seo, Ji Hyoung; Kang, Seong Min; Lee, Jae Tae; Lee, Kyu Bo [Kyungpook National University Hospital, Daeug (Korea, Republic of)

    2007-07-01

    There are mounting evidences from neuropsychological and neuroimaging studies to support the view that patients with substance dependence have abnormalities in prefrontal cortex. However, functional deficits in prefrontal cortex has not been adequately studied in methamphetamine dependence. Therefore, the purpose of this study is to examine whether methamphetamine dependent patients have metabolic abnormalities and executive dysfunction. Twenty-one abstinent methamphetamine dependent patients who were hospitalized in Bugok National Hospital underwent resting FDG-PET, after which they completed computerized versions of the Wisconsin Card Sorting Test (WCST). Brain PET images were obtained 30 minutes after intravenous injection of 370 MBq of 18F-FDG. Significant differences of glucose metabolism were estimated for every voxel using t-statistics on SPM2 implemented in Matlab between methamphetamine dependent patients and age-matched normal controls. FDG-PET revealed significant hypometabolism in the left inferior frontal white matter (Talairach coordinates (x, y, z): -34, 7, 31) in methamphetamine dependent patients compared to the normal controls (uncorrect p<0.001, t>3.39). The nearest gray matter region was the left inferior frontal cortex (Brodmann area 9). Methamphetamine dependent patients completed significantly fewer categories (3.662.19) and made more perseveration errors (22.0411.94) and total errors (44.5719.70) on the WCST compared to the normal controls (p<0.01). These data suggest that patients with methamphetamine dependence have functional impairments in prefrontal cortex.

  13. Functional impairment of the frontal lobe in methamphetamine dependent patients detected on FDG-PET and WCST

    International Nuclear Information System (INIS)

    Kim, Yang Tae; Kwon, Do Hoon; Lee, Sang Woo; Seo, Ji Hyoung; Kang, Seong Min; Lee, Jae Tae; Lee, Kyu Bo

    2007-01-01

    There are mounting evidences from neuropsychological and neuroimaging studies to support the view that patients with substance dependence have abnormalities in prefrontal cortex. However, functional deficits in prefrontal cortex has not been adequately studied in methamphetamine dependence. Therefore, the purpose of this study is to examine whether methamphetamine dependent patients have metabolic abnormalities and executive dysfunction. Twenty-one abstinent methamphetamine dependent patients who were hospitalized in Bugok National Hospital underwent resting FDG-PET, after which they completed computerized versions of the Wisconsin Card Sorting Test (WCST). Brain PET images were obtained 30 minutes after intravenous injection of 370 MBq of 18F-FDG. Significant differences of glucose metabolism were estimated for every voxel using t-statistics on SPM2 implemented in Matlab between methamphetamine dependent patients and age-matched normal controls. FDG-PET revealed significant hypometabolism in the left inferior frontal white matter (Talairach coordinates (x, y, z): -34, 7, 31) in methamphetamine dependent patients compared to the normal controls (uncorrect p 3.39). The nearest gray matter region was the left inferior frontal cortex (Brodmann area 9). Methamphetamine dependent patients completed significantly fewer categories (3.662.19) and made more perseveration errors (22.0411.94) and total errors (44.5719.70) on the WCST compared to the normal controls (p<0.01). These data suggest that patients with methamphetamine dependence have functional impairments in prefrontal cortex

  14. Role of FDG-PET in the Diagnosis of Recurrence and Assessment of Therapeutic Response in Cervical Cancer and Ovarian Cancer Patients: Comparison of Diagnostic Report between PET, Abdominal CT and Tumor Marker

    International Nuclear Information System (INIS)

    Han, You Mie; Choe, Jae Gol; Kang, Bung Chul

    2008-01-01

    We aimed to assess the role of positron emission tomography using fluorodeoxyglucose (FDG-PET) in the diagnosis of recurrence or the assessment of therapeutic response in cervical and ovarian cancer patients through making a comparison between FDG-PET, abdominal computed tomography (CT) and serum tumor marker. We included 103 cases (67 patients) performed FDG-PET and abdominal CT. There were 42 cervical cancers and 61 ovarian cancers. We retrospectively reviewed the interpretations of PET and CT images as well as the level of tumor marker. We calculated their sensitivity, specificity, positive predictive value and negative predictive value for these three modalities. And then we analyzed the differences between these three modalities. Tumor recurrences were diagnosed in 37 cases (11 cervical cancers and 26 ovarian cancers). For PET, CT and tumor marker, in cervical cancer group, sensitivity was 100% (11/11), 54.5% (6/11) and 81.1% (9/11), respectively. And specificity was 93.6% (29/31), 93.6% (29/31) and 100% (31/31). In ovarian cancer group, sensitivity was 96.2% (25/26), 84.6% (22/26) and 80.8% (21/26), and specificity was 94.3% (33/35), 94.3% (33/35), 94.3% (33/35). PET was highly sensitive to detect the intraperitoneal and extraperitoneal metastasis with the help of the CT images to localize the lesions. However, CT had limitations in differentiation of the recurrent tumor from benign fibrotic tissue, identification of viable tumors at the interface of tissues, and detecting extraperitoneal lesions. FDG-PET can be an essential modality to detect the recurrent or residual tumors in gynecologic cancer patients because of its great field of the application and high sensitivity

  15. Use of PET and PET/CT for Radiation Therapy Planning: IAEA expert report 2006-2007

    International Nuclear Information System (INIS)

    MacManus, Michael; Nestle, Ursula; Rosenzweig, Kenneth E.; Carrio, Ignasi; Messa, Cristina; Belohlavek, Otakar; Danna, Massimo; Inoue, Tomio; Deniaud-Alexandre, Elizabeth; Schipani, Stefano; Watanabe, Naoyuki; Dondi, Maurizio; Jeremic, Branislav

    2009-01-01

    Positron Emission Tomography (PET) is a significant advance in cancer imaging with great potential for optimizing radiation therapy (RT) treatment planning and thereby improving outcomes for patients. The use of PET and PET/CT in RT planning was reviewed by an international panel. The International Atomic Energy Agency (IAEA) organized two synchronized and overlapping consultants' meetings with experts from different regions of the world in Vienna in July 2006. Nine experts and three IAEA staff evaluated the available data on the use of PET in RT planning, and considered practical methods for integrating it into routine practice. For RT planning, 18 F fluorodeoxyglucose (FDG) was the most valuable pharmaceutical. Numerous studies supported the routine use of FDG-PET for RT target volume determination in non-small cell lung cancer (NSCLC). There was also evidence for utility of PET in head and neck cancers, lymphoma and in esophageal cancers, with promising preliminary data in many other cancers. The best available approach employs integrated PET/CT images, acquired on a dual scanner in the radiotherapy treatment position after administration of tracer according to a standardized protocol, with careful optimization of images within the RT planning system and carefully considered rules for contouring tumor volumes. PET scans that are not recent or were acquired without proper patient positioning should be repeated for RT planning. PET will play an increasing valuable role in RT planning for a wide range of cancers. When requesting PET scans, physicians should be aware of their potential role in RT planning.

  16. Comparative analysis of PET/CT and PET/MR image characteristics of head and neck squamous cell carcinoma%对比分析头颈部鳞状细胞癌PET/CT与PET/MR特征

    Institute of Scientific and Technical Information of China (English)

    白乐; 程勇; 唐勇进; 凌雪英

    2017-01-01

    Objective To investigate PET/CT and PET/MR characteristics of head and neck squamous cell carcinoma (HNSCC).Methods Totally 40 patients with HNSCC underwent whole body 18F-FDG PET/CT and MR scans of head and neck before anti-tumor treatment.PET positive lesions of HNSCC,including primary lesions and lymph nodes were evaluated by 2 radiologists independently.Then the imaging quality,fusion quality,lesion conspicuity and lesion characteristics were assessed based on PET/CT,PET/MR T1WI and PET/MR T2WI.Results Ninety PET positive lesions in all 40patients were evaluated,including 40 primary lesions and 50 lymph nodes.Similar imaging quality and fusion quality of PET/CT,PET/MR T1WI and PET/MR T2WI were obtained without statistical difference (both P>0.05).For the lesion conspicuity,PET/MR T1WI and PET/MR T2WI demonstrated significantly better than PET/CT in positive primary lesions and lymph nodes (all P<0.05).For the characteristics of positive primary lesions,PET/MR T2WI provided more information than PET/CT in 29 lesions,equal to PET/CT in 4 lesions,and less than PET/CT in 7 lesions.Conclusion The application of PET/MR in HNSCC is feasible,being superior to PET/CT in indication of lesions in head and neck area.%目的 探讨头颈部鳞状细胞癌(HNSCC)的PET/CT及PET/MR特征.方法 纳入未经抗肿瘤治疗的头颈部鳞状细胞癌患者40例,所有患者均接受PET/CT及头颈部MR检查.由2名观察者独立观察PET阳性病灶,包括阳性原发灶及阳性淋巴结;并对PET/CT、PET/MR T1WI及PET/MR T2WI的图像质量、融合准确度、病灶清晰度、病灶特征等进行评分.分析2名观察者间的一致性.结果 40例患者共90个PET阳性病灶,包括阳性原发灶40个、阳性淋巴结50个.PET/CT、PET/MR T1WI及PET/MR T2WI在图像质量及融合准确度方面差异均无统计学意义(P均>0.05);在显示阳性原发灶及阳性淋巴结的清晰度方面,PET/MR T1WI及PET/MR T2WI均优于PET/CT(P均<0.05).40个阳性原发灶中,PET

  17. 18F-FDG PET/CT评价非霍奇金淋巴瘤骨髓浸润%18F-FDG PET for evaluation on bone marrow involvement in patients with non-Hodgkin lymphoma

    Institute of Scientific and Technical Information of China (English)

    张建华; 王荣福; 范岩; 付占立; 张旭初; 廖栩鹤; 王彦福

    2012-01-01

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

  18. The impact of PET-CT in suspected recurrent ovarian cancer: A prospective multi-centre study as part of the Australian PET Data Collection Project.

    Science.gov (United States)

    Fulham, M J; Carter, J; Baldey, A; Hicks, R J; Ramshaw, J E; Gibson, M

    2009-03-01

    To assess the impact of FDG PET-CT on the management of patients with suspected recurrent ovarian cancer and to determine the incremental information provided by PET-CT. This was a prospective, multi-centre, cohort study. Ninety women (mean age 59.9 years; age range 35-85 years) with a previous history of treated epithelial ovarian carcinoma and suspected recurrence based on elevated CA-125, anatomical imaging or clinical symptoms were studied with FDG PET-CT across two States. Referring doctors were asked to specify a management plan pre-PET, if management was altered after PET-CT and, the impact (rated - none, low, medium, high) of PET-CT on patient management. The pre-PET management plan could include radiotherapy, chemotherapy, surgery, and 'other' including observation. Patients were followed at 6 and 12 months and clinical status, evidence of recurrence and progression were recorded. Patients were referred by 34 individual specialists. At least 168 additional sites of disease in 61 patients (68%), not identified by conventional imaging were identified by PET-CT. In 77% the additional lesions were located below the diaphragm and most were nodal or peritoneal. PET-CT affected management in 60% (49% high, 11% medium impact). Patients where more disease was detected with PET-CT were more likely to progress in the following 12 months. For women with previously treated ovarian carcinoma with recurrent disease, PET-CT can: a) alter management in close to 60% of patients, b) detect more sites of disease than abdominal and pelvic CT, c) is superior in the detection of nodal, peritoneal and subcapsular liver disease and d) offers the opportunity for technology replacement in this setting.

  19. Compensation for photon attenuation in PET

    International Nuclear Information System (INIS)

    Chintu Chen; Ordonez, C.E.; Xiaolin Yu.

    1992-01-01

    CT/MR and PET images usually are not in registration spatially because of differences in the imaging setup. CT, MR and PET imaging parameters that are used regularly for brain studies in their institution are compared, in addition, because the patient orientations in CT/MR and PET scanners are not the same, slice centers are positioned differently relative to the patients anatomy. For application of the new idea of using structural information from CT or MR images in PET image reconstruction for attenuation correction, image registration is required as a first step so that one can obtain a corresponding anatomic map for any selected PET image plane. The authors chose to use the surface-matching technique developed in their laboratories for image registration because this method is retrospective and accurate. After the PET and CT/MR scans are registered, they reslice the CT/MR images along the planes of the PET images. The differences in slice thickness and slice separation, as well as in image resolution between various image modalities are to be considered

  20. Prediction of PET/CT to alleviate radiation pneumonitis in patients with non-small cell lung cancer for 3-dimentional conformal radiotherapy

    International Nuclear Information System (INIS)

    Gong Heyi; Yu Jinming; Li Jianbin; Li Baosheng; Fu Zheng; Liu Tonghai

    2005-01-01

    Objective: To investigate the impact of PET/CT on clinical staging of non-small cell lung cancer (NSCLC), delineation of target volume, and prediction to alleviate radiation pneumonitis (RP) from 3-dimentional conformal radiotherapy (3D-CRT) planning. Methods: From October 2002 to June 2004, 34 patients diagnosed cytologically or pathologically with NSCLC, who were candidates for radical radiotherapy or surgery, received PET/CT scanning. Both images were transmitted into treatment planning system (TPS) workstations respectively and were fused and reconstructed. All patients were staged according to the 1997 World Health Organization (WHO) staging system. The impact of PET/CT on the clinical staging of all the patients was determined. The gross tumor volume (GTV) was delineated on the CT imaging and PET/CTfused imaging respectively. Based on the two images, 3D- CRT planning was made respectively at the TPS workstation with Topslane software, the planning target volumes (PTV) being defined with a 15 mm margin around GTV of primary lumps (PTV 1 ) and 7 mm for involved lymph nodes (PTV 2 ). Evaluating indexes including V PTV (volume of PTV, V PTV = V PTV1 + V PTV2 ), V 20 (percentage of the total lung volume receiving more than 20 Gy), MLD (mean lung dose) , TCP (tumor control probability) , NTCP (normal tissue complication probability) , and Ds (dose to spinal cord) were selected to be paralleled to compare the quality of the two plans and the impact of PET/CT on RP was further analyzed. Results: In 13 of 34 (38.2%) cases, PET/CT information changed the clinical staging, 8 of which were upstaged and 5 downstaged. For 10 of 34 (29.4%) cases, PET/CT results modified their management decisions. Among 16 patients performed by surgery, 14 had consistent PET/CT staging with pathologic staging. The sensitivity of PET/CT was 93.3% and accuracy 87.5%. Difference of indexes including V PTV , V 20 and MLD between the two radiation planning was statistically significant, but Ds