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Sample records for spect und fdg-pet

  1. Functional neuroimaging in epilepsy: FDG-PET and SPECT

    International Nuclear Information System (INIS)

    Lee, Sang Kun; Lee, Dong Soo

    2003-01-01

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

  2. Functional neuroimaging in epilepsy: FDG-PET and SPECT

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-02-01

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

  3. Clinical use of digital retrospective image fusion of CT, MRI, FDG-PET and SPECT - fields of indications and results; Klinischer Einsatz der digitalen retrospektiven Bildfusion von CT, MRT, FDG-PET und SPECT - Anwendungsgebiete und Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Lemke, A.J.; Niehues, S.M.; Amthauer, H.; Felix, R. [Campus Virchow-Klinikum, Klinik fuer Strahlenheilkunde, Charite, Universitaetsmedizin Berlin (Germany); Rohlfing, T. [Dept. of Neurosurgery, Stanford Univ. (United States); Hosten, N. [Inst. fuer Diagnostische Radiologie, Ernst-Moritz-Arndt-Univ. Greifswald (Germany)

    2004-12-01

    Purpose: To evaluate the feasibility and the clinical benefits of retrospective digital image fusion (PET, SPECT, CT and MRI). Materials and methods: In a prospective study, a total of 273 image fusions were performed and evaluated. The underlying image acquisitions (CT, MRI, SPECT and PET) were performed in a way appropriate for the respective clinical question and anatomical region. Image fusion was executed with a software program developed during this study. The results of the image fusion procedure were evaluated in terms of technical feasibility, clinical objective, and therapeutic impact. Results: The most frequent combinations of modalities were CT/PET (n = 156) and MRI/PET (n = 59), followed by MRI/SPECT (n = 28), CT/SPECT (n = 22) and CT/MRI (n = 8). The clinical questions included following regions (more than one region per case possible): neurocranium (n = 42), neck (n = 13), lung and mediastinum (n = 24), abdomen (n = 181), and pelvis (n = 65). In 92.6% of all cases (n = 253), image fusion was technically successful. Image fusion was able to improve sensitivity and specificity of the single modality, or to add important diagnostic information. Image fusion was problematic in cases of different body positions between the two imaging modalities or different positions of mobile organs. In 37.9% of the cases, image fusion added clinically relevant information compared to the single modality. Conclusion: For clinical questions concerning liver, pancreas, rectum, neck, or neurocranium, image fusion is a reliable method suitable for routine clinical application. Organ motion still limits its feasibility and routine use in other areas (e.g., thorax). (orig.)

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  5. SPECT and FDG-PET in diagnostics of neurolues

    International Nuclear Information System (INIS)

    Pichler, R.; Doppler, S.; Szalay, E.; Hertl, C.; Knell, K.; Winkler, J.

    2008-01-01

    Syphilis is a recurrent treponematosis of acute and chronic evolution. In general it is either sexually or congenitally transmitted. Primary syphilis appears as a single and painless lesion. Secondary syphilis may manifest years later, the secondary bacteremic stage is accompanied by generalized mucocutaneous lesions. Tertiary disease can be disseminated to bones and virtually any organ, involving principally the ascending aorta and the central nervous system. Nuclear medicine provides diagnostic methods in case of skeletal manifestations by bone scan - identifying periostitis and osteomyelitis. Hepatic gummas can be imaged by 99m-Tc-colloid liver scintigraphy. In neurosyphilis brain perfusion SPECT enables imaging of cerebral involvement by small vessel endartheritis resulting from syphilitic vascular disease. 18-FDG PET is also useful to evaluate neurosyphilis, a reduction of brain glucose consumption is observed. The technique adequately enables imaging of therapeutic response and might be superior to morphologic imaging. We present our experiences with these nuclear medicine methods in patients with neurolues. The incidence of neurolues is estimated at 2 per 100.000 inhabitants worldwide, migration processes might bring a re-emergence of this disease to Austria and other developed countries of the EU. Scintigraphic methods should be kept in mind for diagnostic evaluation of neurosyphilis. (author) [de

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  7. 18F-FDG PET is superior to 67Ga SPECT in the staging of non-Hodgkin's lymphoma

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  8. IBZM SPECT and FDG PET in the differential diagnosis of Parkinsonian syndromes. Comparison with respect to inter-rater agreement

    DEFF Research Database (Denmark)

    Derlin, T; Afzal, W; Wilke, F

    2010-01-01

    Aim: Both IBZM SPECT and FDG PET may be used for differentiation between Parkinson's disease (PD) and atypical neurodegenerative parkinsonian syndromes (APS). However, there are only very limited data of both modalities in the same subjects. The present study compared both modalities with respect...

  9. Predictive values of F-18-FDG PET and ictal SPECT to find epileptogenic zones in cryptogenic neocortical epilepsies

    International Nuclear Information System (INIS)

    Lee, D. S.; Lee, S. K.; Jeong, Z. K.; Kim, H. Z.; Lee, M. C.; Ko, C. S.

    1997-01-01

    Though cumulated reported sensitivity were 33% (F-18-FDG PET) and 81%(ictal SPECT) in neocortical epilepsy, positive predictive values rather than sensitivity should be referred if we wish to know the reliability of positive findings to predict epileptogenic zones. In cryptogenic neocortical epilepsy which did not have structural lesions on MR, we tried to find performance of F-18-FDG PET and ictal SPECT to find epileptogenic zones. In 77 patients who had no lesion on MR and who were suspected to have neocortical epilepsy on video monitored EEG, ictal SPECT were done in 44 patients and F-18-FDG PET were done in 70 patients. Invasive study and operation was done in 24 patients. The most hyper perfused area or prominently hypometabolic area was suspected to be epileptogenic on ictal SPECT or F-18-FDG PET, respectively. We could find zones of ictal hyperperfusion in 34/44(78%) patients. Positive predictive values of ictal hyperperfusion were 58%, 60%, and 12.5% in frontal lobes (n=12), lateral temporal lobes (20), and parietal lobes (8). We could find hypometabolic areas in 50/70(76%) patients. Positive predictive values of hypometabolism were 78%, 71%, 33%, and 25% in frontal lobes (9), lateral temporal lobes (28), parietal lobes (3) and occipital lobes (4). Among 24 patients who were operated, 17 patients were followed up more than 7 months (15 ± 5). Thirteen patients improved (10 : Engel class I or II, 2: 90% reduction, 1: 75% reduction but multifocal). Five among 11 PET studies were correct, 3 among 10 SPECT studies, and 6 among 11 PET/SPECT studies (55%) were correct for localization. In conclusion, three fourths of patients gave positive results to localized epileptogenic zones in cryptogenic neocortical epilepsy, and predictive values of ictal hyperperfusion or interictal hypometabolism were highest in frontal or lateral temporal lobes if these lobes were found to be culprit though rapid ictal propagation of cortical hyperperfusion confounded the exact

  10. Brain perfusion SPECT and FDG PET findings in a patient with ballism associated with hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Sang Kyun; Kim, Sang Jin [Pusan Paik Hospital, Pusan (Korea, Republic of)

    2007-07-01

    Ballism is a very rare presentation in association with hyperthyroidism. We describe a 22-year-old lady with episodes of recurrent ballism and hyperthyroidism. A 22-year-old lady was admitted to Neurology department because of sudden development of vigorous involuntary movement and dysarthria. She was diagnosed as hyperthyroidism at the age 12 and treated irregularly. She arrived at the emergency room because of sudden onset of involuntary movement. Computed tomography (CT) scan and Magnetic Resonance Imaging (MRI) of brain was normal. Serum levels of thyroid hormone were increased (Free T4 3.15 ng/dl; normal range 0.93-1.71 ng/dl), whereas thyroid-stimulating hormone (TSH) was undetectable. The thyroid gland was diffusely enlarged and exophthalmos was found. She had been given antithyroid medication from local clinic but medicated irregularly. Technetium thyroid scan reveals diffusely enlarged thyroid with increased radioactivity. Radioiodine uptake in 24 hours was 71 %. Brain perfusion SPECT using Tc-99m ECD reveals asymmetrical perfusion pattern in basal ganglia. Brain PET using F-18 FDG reveals increased metabolism at both caudate nucleus and putamen. She was treated with radioiodine and involuntary movement was improved. There is only few report on ballism associated with hyperthyroidism and no report on functional brain imaging. Brain perfusion SPECT and FDG PET may give useful information about functional status of brain in patients with ballism associated with hyperthyroidism in case of normal anatomical finding on CT/MRI.

  11. Brain perfusion SPECT and FDG PET findings in a patient with ballism associated with hyperthyroidism

    International Nuclear Information System (INIS)

    Bae, Sang Kyun; Kim, Sang Jin

    2007-01-01

    Ballism is a very rare presentation in association with hyperthyroidism. We describe a 22-year-old lady with episodes of recurrent ballism and hyperthyroidism. A 22-year-old lady was admitted to Neurology department because of sudden development of vigorous involuntary movement and dysarthria. She was diagnosed as hyperthyroidism at the age 12 and treated irregularly. She arrived at the emergency room because of sudden onset of involuntary movement. Computed tomography (CT) scan and Magnetic Resonance Imaging (MRI) of brain was normal. Serum levels of thyroid hormone were increased (Free T4 3.15 ng/dl; normal range 0.93-1.71 ng/dl), whereas thyroid-stimulating hormone (TSH) was undetectable. The thyroid gland was diffusely enlarged and exophthalmos was found. She had been given antithyroid medication from local clinic but medicated irregularly. Technetium thyroid scan reveals diffusely enlarged thyroid with increased radioactivity. Radioiodine uptake in 24 hours was 71 %. Brain perfusion SPECT using Tc-99m ECD reveals asymmetrical perfusion pattern in basal ganglia. Brain PET using F-18 FDG reveals increased metabolism at both caudate nucleus and putamen. She was treated with radioiodine and involuntary movement was improved. There is only few report on ballism associated with hyperthyroidism and no report on functional brain imaging. Brain perfusion SPECT and FDG PET may give useful information about functional status of brain in patients with ballism associated with hyperthyroidism in case of normal anatomical finding on CT/MRI

  12. Comparison of FDG-PET and IMP-SPECT in patients with dementia with Lewy bodies

    International Nuclear Information System (INIS)

    Ishii, Kazunari; Hosaka, Kayo; Mori, Tetsuya; Mori, Etsuro

    2004-01-01

    To investigate regional differences in cerebral glucose metabolism and blood flow of dementia with Lewy bodies (DLB), we studied 7 subjects with DLB and 20 normal controls using F-18 fluorodeoxyglucose (FDG) and positron emission tomography (PET) and then examined the same 7 subjects and 20 other normal controls with I-123 iodoamphetamine (IMP) and single photon emission computed tomography (SPECT). The anatomically standardized images were produced with NEUROSTAT and the regional relative metabolic and perfusional values were calculated. The mean reduction ratios of FDG uptake in the DLB group relative to the mean normal controls in the parietal lobe and occipital lobe were 0.72 and 0.83, respectively, while the corresponding mean reduction ratios of IMP uptake were 0.81 and 0.88, respectively. In the DLB group, parietal FDG uptake was significantly lower than parietal IMP uptake (p<0.05), occipital FDG uptake was significantly lower than occipital IMP uptake (p<0.05), and parietal IMP uptake was significantly lower than occipital IMP uptake (p<0.01), but there was no difference between parietal and occipital FDG uptake. Our findings suggest that parietal metabolism and perfusion are severely affected in DLB patients, though the occipital metabolic and perfusional reduction is thought to be a feature of DLB. FDG-PET is thought to be superior to IMP-SPECT in detecting functional changes in the DLB brain. (author)

  13. A comparison of high dose Ga-67 SPECT and FDG PET imaging in malignant melanoma

    International Nuclear Information System (INIS)

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

    1998-01-01

    Full text: Ga-67 imaging for tumour localisation lost favour in the 1970's. With improvement in technology and use of higher doses, it has now found an important role in lymphoma. A similar phenomenon may be possible in the staging of melanoma. This study therefore compares high dose (370 MBq) Ga-67 imaging using a day 5 and 7 whole-body and comprehensive SPECT protocol, with (100 MBq) F-18 fluorodeoxyglucose (FDG) imaging using positron emission tomography (PET): a technique recently shown to be highly accurate in this condition. 85 patients; 46 males, mean age 52+17 yrs: range 22-83 yrs, underwent both studies within 9±16 days (max-91 days). Scans were judged as positive (+ve), negative (-ve) or equivocal (EQ) for local, regional and distant disease. Clinical follow-up resolved discordant scan findings. PET and Ga-67 results were concordant in 61 (70%) patients (19 with +ve, 37 -ve and 5 EQ scans). None of the 9 ps with one EQ and one eye scan had disease on follow-up. Follow-up was available in 4/5 patients with discordantly +ve (3 patients) or more extensive Ga-67 abnormality: 3 patients had disease confirmed, 1 patient false +ve (asymmetric lung hilum). Follow-up was available in 9/10 patients with discordantly +ve (3 patients) or more extensive PET abnormality: 4 patients had confirmed disease, l pt false +ve (bladder diverticulum). A further 4 patients had second primaries (2 rectal carcinomas, 1 plasmacytoma, 1 basal cell carcinoma). High dose Ga-67 scanning incorporating SPECT appears to be a reasonable alternative to FDG PET for screening patients with melanoma. In this series PET's main advantages were in the detection of other occult tumours, greater patient convenience and lower radiation dosimetry

  14. Role of {sup 18F} FDG PET/CT, {sup 123I} MIBG SPECT, and CT in Restaging patients Affected by Malignant Pheochromocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Cantalamessa, Antonio; Caobelli, Antonio; Vavassori, Francesca [Habilita Istituto Clinico, Bergamo (Italy); Caobelli, Federico [Univ. of Brescia, Brescia (Italy); Paghera, Barbara [Spedali Civili, Brescia (Italy)

    2011-06-15

    Pheochromocytoma (PH) is a rare catecholamine secreting tumor that arises from chromaffin tissue within the adrenal medulla and extra adrenal sites; commonly it is sporadic, and malignant PH accounts for about 10% of all cases. Several imaging modalities have been used for the diagnosis and staging og this tumor: functional imaging using radio labelled metaiodobenzylguanidine and, more recently, {sup 18F} fluorodeoxyglucose positron emission tomography ({sup 18F} FDG PET/CT), which offers substantial sensitivity and specificity to correctly detect metastatic PH and helps to identify patients suitable for treatment with radiopharmaceuticals. The aim of our study was to compare CT, {sup 18F} FDG PET/CT, and {sup 123I} metaiodobenzylguanidine single photon emission tomography ({sup 123I} MIBG SPECT) as feasible methods to restage patients diagnosed histologically with PH. We retrospectively evaluated 38 patients (27 females and 11 males; mean age: 44{+-}15 years) with malignant PH documented histologically after surgical intervention. These patients underwent CT, {sup 18F} FDG PET/CT, and {sup 123I} MIBG SPECT. {sup 18F} FDG PET/CT showed positive results for neoplastic tissue in 33/38 patients (86.8%) and negative in 5/38 (13.2%), in concordance with CT alone. {sup 123I} MIBG SPECT was positive in 30/38 patients (78.9%) and negative in 8/38 (21.1%). No differences in lesion numbers were found between {sup 18F} FDG PET/CT and {sup 123I} MIBG SPECT. {sup 18F} FDG PET/CT could more accurately restage patients with PH than CT and {sup 123I} MIBG SPECT, also in the absence of a staging study.

  15. The characteristics of syndrome X based on 201Tl-SPECT, 18 FDG-PET and histopathologic findings

    International Nuclear Information System (INIS)

    Satake, Osamichi

    1999-01-01

    Syndrome X is a microvascular disease. However, the relationship between microvascular ischemia and histopathological findings remains unknown. The present study was performed to evaluate the myocardial perfusion and metabolism of patients with Syndrome X using 201 Tl-SPECT and 18 FDG-PET, and to clarify the morphological characteristics with a ventricular myocardial biopsy. We examined 24 patients with Syndrome X and 5 patients with myocarditis as a control group. In the study using 201 Tl-SPECT and 18 FDG-PET, we evaluated the presence or absence of myocardial ischemia. We calculated the Standardized Uptake Value (SUV) (%dose/ml) of 18 FDG, and analyzed quantitatively the degree of ischemia. For histopathologic study on coronary microcirculation, we performed a right ventricular myocardial biopsy. The biopsies were examined light and electron microscopically. The semithin sections, stained with toluidine blue, were projected onto a screen. Microvessels were counted and the ratio of microvascular luminal narrowing and the number of microvessels per unit area were determined. The study using 201 Tl-SPECT and 18 FDG-PET showed that hypoperfusion of 201 Tl was found in 17 of 24 (71%) patients during 201 Tl-loaded myocardial scanning together with redistribution of 201 Tl at the same regions; 18 FDG-uptake were found in all 24 patients during 18 FDG-PET performed under resting and fasting conditions; the SUV of 18 FDG in the Syndrome X group (0.025±0.039 %dose/ml) was significantly different from that of the control group (0.003±0.002 %dose/ml) (p<0.01). Histopathological observations under the both light and electron microscope showed that an increment in number of the endothelial cells with swelling, a marked luminal narrowing due to the hypertrophy of the arteriolar media and the capillary walls, and a compression of the capillaries were shown in all the patients; the ratio of luminal narrowing of microvessels in the Syndrome X group was significantly higher than

  16. Concordance between (99m)Tc-ECD SPECT and 18F-FDG PET interpretations in patients with cognitive disorders diagnosed according to NIA-AA criteria.

    Science.gov (United States)

    Ito, Kimiteru; Shimano, Yasumasa; Imabayashi, Etsuko; Nakata, Yasuhiro; Omachi, Yoshie; Sato, Noriko; Arima, Kunimasa; Matsuda, Hiroshi

    2014-10-01

    The purpose of this study was to clarify the concordance of diagnostic abilities and interobserver agreement between 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and brain perfusion single photon-emission computed tomography (SPECT) in patients with Alzheimer's disease (AD) who were diagnosed according to the research criteria of the National Institute of Aging-Alzheimer's Association Workshop. Fifty-five patients with "AD and mild cognitive impairment (MCI)" (n = 40) and "non-AD" (n = 15) were evaluated with 18F-FDG PET and (99m)Tc-ethyl cysteinate dimer (ECD) SPECT during an 8-week period. Three radiologists independently graded the regional uptake in the frontal, temporal, parietal, and occipital lobes as well as the precuneus/posterior cingulate cortex in both images. Kappa values were used to determine the interobserver reliability regarding regional uptake. The regions with better interobserver reliability between 18F-FDG PET and (99m)Tc-ECD SPECT were the frontal, parietal, and temporal lobes. The (99m)Tc-ECD SPECT agreement in the occipital lobes was not significant. The frontal, temporal, and parietal lobes showed good correlations between 18F-FDG PET and (99m)Tc-ECD SPECT in the degree of uptake, but the occipital lobe and precuneus/posterior cingulate cortex did not show good correlations. The diagnostic accuracy rates of "AD and MCI" ranged from 60% to 70% in both of the techniques. The degree of uptake on 18F-FDG PET and (99m)Tc-ECD SPECT showed significant correlations in the frontal, temporal, and parietal lobes. The diagnostic abilities of 18F-FDG PET and (99m)Tc-ECD SPECT for "AD and MCI," when diagnosed according to the National Institute of Aging-Alzheimer's Association Workshop criteria, were nearly identical. Copyright © 2014 John Wiley & Sons, Ltd.

  17. Direct comparison study between FDG-PET and IMP-SPECT for diagnosing Alzheimer's disease using 3D-SSP analysis in the same patients

    International Nuclear Information System (INIS)

    Nihashi, Takashi; Hayasaka, Kazumasa; Yatsuya, Hiroshi

    2007-01-01

    The purpose of this study was to evaluate and compare the diagnostic ability of 2-[ 18 F]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) and N-isopropyl-p- 123 I iodoamphetamine single photon emission computed tomography (IMP-SPECT) using three-dimensional stereotactic surface projections (3D-SSP) in patients with moderate Alzheimer's disease (AD). FDG-PET and IMP-SPECT were performed within 3 months in 14 patients with probable moderate AD. Z-score maps of FDG-PET and IMP-SPECT images of a patient were obtained by comparison with data obtained from control subjects. Four expert physicians evaluated and graded the glucose hypometabolism and regional cerebral blood flow (rCBF), focusing in particular on the posterior cingulate gyri/precunei and parietotemporal regions, and determined the reliability for AD. Receiver operating characteristic (ROC) curves were applied to the results for clarification. To evaluate the correlation between two modalities, the regions of interest (ROIs) were set in the posterior cingulate gyri/precunei and parietotemporal region on 3D-SSP images, and mean Z-values were calculated. No significant difference was observed in the area under the ROC curve (AUC) between FDG-PET and IMP-SPECT images (FDG-PET 0.95, IMP-SPECT 0.94). However, a significant difference (P<0.05) was observed in the AUC for the posterior cingulate gyri/precuneus (FDG-PET 0.94, IMP-SPECT 0.81). The sensitivity and specificity of each modality were 86%, and 97% for FDG-PET and 70% and 100% for IMP-SPECT. We could find no significant difference between FDG-PET and IMP-SPECT in terms of diagnosing moderate AD using 3D-SSP. There was a high correlation between the two modalities in the parietotemporal region (Spearman's r=0.82, P<0.001). The correlation in the posterior cingulate gyri/precunei region was lower than that in the parietotemporal region (Spearman's r=0.63, P<0.016). (author)

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  19. Comparison of 18F-FDG PET and 201 thallium chloride SPECT in the evaluation of cerebral glioma prior to surgery

    International Nuclear Information System (INIS)

    Poon, A.M.T.; Cher, L.; Berlangieri, S.U.; Fabinyi, G.; Tochon-Danguy, H.; Chan, J.G.; Scott, A.M.

    2000-01-01

    Full text: The purpose of the study was to compare the accuracy of 18 F-FDG PET and 201 Tl SPECT in detecting and grading primary cerebral glioma through comparison to surgical pathology. A total of 33 patients with primary cerebral glioma had 35 18 F-FDG PET/ 201 Tl SPECT scans prior to surgery. Pre-operative 18 F -FDG PET and 201 Tl SPECT studies were reviewed and compared with histologic tumour grade. Radiological comparisons were also performed when pre-operative studies were available. 17/18 patients with glioblastoma multiforme demonstrated hypermetabolic lesions on 18 F-FDG PET scan and increased thallium uptake on SPECT scan. Increased 18 F -FDG and thallium uptake were also demonstrated in patients with anaplastic astrocytoma, gemistocytic astrocytoma, and one biopsy which was difficult to grade because of small biopsy sample and co-existing radiation necrosis. In general, low grade gliomas had reduced 18 F -FDG uptake and normal thallium uptake (6/7, where two patients had tumour with hypermetabolic and hypometabolic regions). MRI correctly identified 4/7 patients with low to intermediate grade glioma. Pilocytic astrocytoma, protoplastic astrocytoma and oligoastrocytoma all demonstrated hypometabolic PET activity and normal thallium uptake. In conclusion, 18 F-FDG PET and 201 Tl SPECT are very sensitive in pre-operative prediction of high grade glioma. In low grade tumour, 201 Tl SPECT appeared to be less useful in the absence of breakdown of the blood brain barrier. MR imaging accurately identified the presence of tumour but was less accurate in determining the grade of tumour. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  20. Comparison of 131I whole-body imaging, 131I SPECT/CT, and 18F-FDG PET/CT in the detection of metastatic thyroid cancer

    International Nuclear Information System (INIS)

    Oh, Jong-Ryool; Chong, Ari; Kim, Jahae; Kang, Sae-Ryung; Song, Ho-Chun; Bom, Hee-Seung; Byun, Byung-Hyun; Hong, Sun-Pyo; Yoo, Su-Woong; Kim, Dong-Yeon; Min, Jung-Joon

    2011-01-01

    The aim of this study was to compare 131 I whole-body scintigraphy (WBS), WBS with 131 I single photon emission computed tomography/computed tomography (SPECT/CT), and 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT in the detection of distant metastases of differentiated thyroid cancer (DTC). A total of 140 patients with 258 foci of suspected distant metastases were evaluated. 131 I WBS, 131 I SPECT/CT, and 18 F-FDG PET/CT images were interpreted separately. The final diagnosis was obtained from histopathologic study, serum thyroglobulin level, other imaging modalities, and/or clinical follow-up. Of the 140 patients with 258 foci, 46 patients with 166 foci were diagnosed as positive for distant metastasis. The sensitivity, specificity, and diagnostic accuracy of each imaging modality were 65, 55, and 59%, respectively, for 131 I WBS; 65, 95, and 85% for 131 I SPECT/CT, respectively; and 61, 98, and 86%, respectively, for 18 F-FDG PET/CT in patient-based analyses. Lesion-based analyses demonstrated that both SPECT/CT and PET/CT were superior to WBS (p 18 F-FDG PET/CT presented the highest diagnostic performance in patients who underwent multiple challenges of radioiodine therapy. (orig.)

  1. SPM analysis of brain perfusion SPECT and F-18 FDG PET in the Korean autosomal dominant nocturnal frontal lobe epilepsy family

    International Nuclear Information System (INIS)

    Won, Kyoung Sook; Zeon, Seok Kil

    2004-01-01

    This study attempted to investigate the specific pattern of brain perfusion and glucose metabolism in the Korean autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) family. Using Tc-99m ECD brain perfusion SPECT. we assessed brain perfusion in 6 patients at interictal period and 5 patients at ictal period. Interictal F-18 FDG PET was performed on 6 affected family members. The scans were statistically analyzed by using statistical parametric mapping (SPM99). The data of the affected family members were compared to those of the control subjects. Interictal F-18 FDG PET SPM group analysis showed decreased glucose metabolism over the left middle and superior frontal gyri and the left central regions including the anterior parietal lobe. There was a less pronounced decrease in glucose uptake in the right anterior superior frontal gyrus. Interictal brain perfusion SPECT SPM group analysis showed similar pattern of decreased perfusion compared to those of interictal F-18 FDG PET. Ictal brain perfusion SPECT SPM group analysis revealed increased perfusion over the left pre-and postcentral gyri and less pronounced increased perfusion in the right postcentral gyrus. lnterictal F -18 PET and brain perfusion SPECT SPM group analysis suggest that major abnormalities of ADNFLE family are in the left frontal lobe. These findings may be helpful to elucidate the pathophysiological mechanism of this rare disease entity

  2. SPM analysis of brain perfusion SPECT and F-18 FDG PET in the Korean autosomal dominant nocturnal frontal lobe epilepsy family

    Energy Technology Data Exchange (ETDEWEB)

    Won, Kyoung Sook; Zeon, Seok Kil [Keimyung University Dongsan Medical Center, Daegu (Korea, Republic of)

    2004-07-01

    This study attempted to investigate the specific pattern of brain perfusion and glucose metabolism in the Korean autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) family. Using Tc-99m ECD brain perfusion SPECT. we assessed brain perfusion in 6 patients at interictal period and 5 patients at ictal period. Interictal F-18 FDG PET was performed on 6 affected family members. The scans were statistically analyzed by using statistical parametric mapping (SPM99). The data of the affected family members were compared to those of the control subjects. Interictal F-18 FDG PET SPM group analysis showed decreased glucose metabolism over the left middle and superior frontal gyri and the left central regions including the anterior parietal lobe. There was a less pronounced decrease in glucose uptake in the right anterior superior frontal gyrus. Interictal brain perfusion SPECT SPM group analysis showed similar pattern of decreased perfusion compared to those of interictal F-18 FDG PET. Ictal brain perfusion SPECT SPM group analysis revealed increased perfusion over the left pre-and postcentral gyri and less pronounced increased perfusion in the right postcentral gyrus. lnterictal F -18 PET and brain perfusion SPECT SPM group analysis suggest that major abnormalities of ADNFLE family are in the left frontal lobe. These findings may be helpful to elucidate the pathophysiological mechanism of this rare disease entity.

  3. Differentiation of dementia with lewy bodies from Alzheimer's disease using FDG PET and I-123-fluoropropyl-β-CIT SPECT

    International Nuclear Information System (INIS)

    Park, Eun Kyung; Cho, Sang Soo; Lee, Jae Sung; Kim, Jung Eun; Kim, Sang Yun; Lee, Won Woo; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul; Kim, Sang Eun

    2004-01-01

    Dementia with Lewy bodies (DLB) shares clinical and pathological features with Alzheimer's disease (AD) and Parkinson's disease. The differentiation of DLB from these disorders poses difficulties. We compared regional cerebral metabolic impairment and dopaminergic neuronal integrity between patients with DLB and AD using FDG PET and I-123-fluoropropyl-β-CIT (FP-CIT) SPECT, respectively, as measures for differential diagnosis. Fourteen clinically diagnosed DLB patients, 15 probable AD patients, and 12 age- and gender-matched healthy controls were studied with FDG PET and FP-CIT SPECT. A voxel-wise comparison of PET images was performed using SPM99. A dopamine transporter (DAT) parameter V3 was calculated in striatal regions as (striatal VOIcerebellar VOI)/cerebellar VOI activity on SPECT images obtained 3 h after injection of 185 MBq FP-CIT. SPM analysis of PET images of DLB revealed hypometabolism bilaterally in the occipital cortices, lateral occipitotemporal gyri, cunei, caudate, and Thalami compared with controls, most pronounced in the occipital cortex compared with AD. In DLB, V3 in the caudate (1.07±0.55) and putamen (1.01±0.34) was significantly (P < 0.001) lower than in AD (2.73±0.75 and 3.17±0.88, respectively) and controls (3.00±0.45 and 3.11±0.31, respectively). There was no significant difference in striatal V3 between AD and controls. The ratio of putamen-to-caudate V3 was not significantly different between DLB (1.04±0.32) and controls (1.05±0.12), indicating that DATs in the caudate and putamen are evenly affected in DLB. In DLB, there was a significant correlation between striatal V3 and MMSE score (rho=0.97, P<0.01). These data demonstrate different biochemical features between DLB and AD, in terms of regional brain metabolism and dopaminergic neuronal integrity. Measures of the glucose metabolism in the occipital cortex and the striatal DAT density may be informative diagnostic aids to distinguish DLB from AD

  4. 99MTC-HL91 spect image versus 18F-FDG PET for detection of head and neck carcinoma

    International Nuclear Information System (INIS)

    Chu, L.S.; Liu, R.S.; Chou, K.L.; Yang, B.H.; Liao, S.Q.; Yeh, S.H.

    2004-01-01

    Objective: Tumor hypoxia is a major complication of oncologic cell switch for chemotherapy(C/T) and / or radiotherapy(R/T). Such lesions detected by selective modem conventional examination remains difficult. 99mTc-HL91 is a potential agent for imaging hypoxic tissue in vivo. This study aimed to assess efficacy of 99mTc- HL91 in imaging of head and neck cancer and compared the result with 18F-fluorodeoxyglucose(FDG)PET. Methods: Sixteen pts with head and neck cancers (7 hypopharyngeal cancers, 4 laryngeal cancers, 5 tongue base cancers) were enrolled in this study. Primary tumors and suspicious local,regional metastases were diagnosed by clinical examination, CT/MRI , and biopsy. After intravenous injection of 740 MBq of 99mTc-HL91, whole body planar scan and regional SPECT at 2hr postinjection were performed. Tumor lesion -to- normal background(T/N) ratios with 3x3 pixels of background ROI were also measured. The reference range of T/N ratio greater 3.0 defined +, close to 2.4 defined +/- and less than 1.5 defined as -. The FDG images with dedicated PET system was performed at 4hr after completion of 99mTc-HL91 study. The visualized tumors uptake with ratio of standardized uptake value (SUV) greater than 2.5 defined as +.. less than 2.5 defined -. Results: In 7 hypopharyngeal cancers, there are 2FDG+/HL91+, 3FDG+/HL91-, 2FDG+/HL91+/-, In 4 laryngeal cancers, there are 3FDG+/HL91-, 1FDG+/HL91 +/-. In 5 tongue base cancers, there are 5FDG+/HL91-.(Table 1). The T/N ratios of all head and neck cancers in primary tumor and regional lymph nodes were ranged from l.3/1.5 and 1.1/1.2 respectively. The frequency of FDG + in hypopharyngeal cancers is 1.0,in laryngeal cancers is 1.0 and in tongue base cancers is 1.0. The frequency of HL91+/+/- in hypopharyngeal cancers is 0..58,in laryngeal cancers is 0.25.and in tongue base cancers is 0. The overall detection rate of head and neck cancer by FDG+ in this study is 100% and overall detection rate of local-regional hypoxia, by

  5. Comparison of the 68Ga-DOTATATA PET/CT, FDG PET/CT, and MIBG SPECT/CT in the Evaluation of Suspected Primary Pheochromocytomas and Paragangliomas.

    Science.gov (United States)

    Jing, Hongli; Li, Fang; Wang, Ling; Wang, Zhenghua; Li, Wei; Huo, Li; Zhang, Jingjing

    2017-07-01

    Anatomical imaging modalities including CT and MRI are the mainstay of evaluation of primary pheochromocytoma or paraganglioma. However, nuclear medicine imaging is frequently necessary to determine the nature of the lesions. The purpose of this investigation is to assess which commonly used nuclear medicine modality might have a better diagnostic value in this clinical setting. Eight patients who had been suspected of having either primary pheochromocytoma or primary paraganglioma and 1 patient with known pheochromocytoma were included in the analysis. Among the 8 patients without known diagnosis, 7 had been suggested by anatomical imaging modalities, whereas one of them presented with initial negative anatomical imaging interpretation. All of 9 patients underwent Ga-DOTATATA PET/CT, FDG PET/CT, and MIBG SPECT/CT for further evaluation. The imaging findings were compared with postsurgical pathology and follow-up. Both Ga-DOTATATA PET/CT and MIBG SPECT/CT accurately identified 9 primary tumors, whereas FDG PET/CT showed increased activity in 8 of 9 primary tumors. Both Ga-DOTATATA and FDG PET/CT are able to detect associated extra-adrenal lesions not shown on MIBG study in patients with multiple endocrine neoplasia syndrome. Ga-DOTATATA PET/CT could be the nuclear medicine imaging choice to evaluate suspected primary pheochromocytoma or paraganglioma, especially in the situation of multiple endocrine neoplasia syndrome.

  6. Comparison of benzodiazepine receptor SPECT and 18F-FDG PET using a coincidence detection camera in patients with temporal lobe epilepsy: preliminary results

    International Nuclear Information System (INIS)

    Wissmeyer, M.; Geiger, L.; Luescher, D.; Krause, T.; Loevblad, K.; Donati, F.; Wielepp, J.P.

    2002-01-01

    Full text: The aim of this preliminary study was to compare the results of benzodiazepine receptor (BDR) SPECT using 123 I-Iomazenil with those of 18 F-FDG (FDG) PET obtained on a double-headed gamma camera with a coincidence detection system in patients with temporal lobe epilepsy (TLE). We evaluated 6 patients (4 female, 2 male; age range 26-54 years, average 43.5 years) with therapy-refractory TLE due to mesiotemporal sclerosis or other focal brain anomalies. To delineate the epileptogenic zone, clinical evaluation, ictal and interictal surface EEG using the international 10-20 system, brain MRI, interictal CBF SPECT using 99m Tc-ECD, BDR SPECT and FDG coincidence PET were performed. The CBF SPECT, BDR SPECT and coincidence PET scans were viewed independently by 2 observers considering the regional cerebral blood flow, BDR density and FDG uptake asymmetry in the temporal lobe visually as none (0), low (1), moderate (2) and high (3). Ictal and interictal EEG recordings located the epileptogenic focus in all patients in the temporal region. Both the BDR SPECT and the FDG coincidence PET located the epileptogenic focus correctly in circumscribed areas of the temporal lobe in all patients, whereas brain MRI revealed focal anomalies only in 5 of 6 cases . The lateralization to the right (n=4) and left hemisphere (n=2) by interictal CBF SPECT, BDR SPECT and FDG coincidence PET corresponded to the EEG findings in all patients. The visual consideration of the asymmetry revealed a slightly but not statistically significant higher value for the FDG coincidence PET (observer 1: mean 2.333, SD 0.516; observer 2: mean 2.000, SD 0.632) than for the BDR SPECT (observer 1: mean 1.667, SD 1.033; observer 2: mean 1.833, SD 0.753). Visual consideration of the interictal CBF SPECT revealed mean values of 2.000 for both observers. The inter-observer variability was higher in the BDR SPECT than in the FDG coincidence PET and the interictal CBF SPECT, but the difference was not

  7. Support vector machine-based classification of neuroimages in Alzheimer’s disease: direct comparison of FDG-PET, rCBF-SPECT and MRI data acquired from the same individuals

    Directory of Open Access Journals (Sweden)

    Luiz K. Ferreira

    2017-10-01

    Full Text Available Objective: To conduct the first support vector machine (SVM-based study comparing the diagnostic accuracy of T1-weighted magnetic resonance imaging (T1-MRI, F-fluorodeoxyglucose-positron emission tomography (FDG-PET and regional cerebral blood flow single-photon emission computed tomography (rCBF-SPECT in Alzheimer’s disease (AD. Method: Brain T1-MRI, FDG-PET and rCBF-SPECT scans were acquired from a sample of mild AD patients (n=20 and healthy elderly controls (n=18. SVM-based diagnostic accuracy indices were calculated using whole-brain information and leave-one-out cross-validation. Results: The accuracy obtained using PET and SPECT data were similar. PET accuracy was 68∼71% and area under curve (AUC 0.77∼0.81; SPECT accuracy was 68∼74% and AUC 0.75∼0.79, and both had better performance than analysis with T1-MRI data (accuracy of 58%, AUC 0.67. The addition of PET or SPECT to MRI produced higher accuracy indices (68∼74%; AUC: 0.74∼0.82 than T1-MRI alone, but these were not clearly superior to the isolated neurofunctional modalities. Conclusion: In line with previous evidence, FDG-PET and rCBF-SPECT more accurately identified patients with AD than T1-MRI, and the addition of either PET or SPECT to T1-MRI data yielded increased accuracy. The comparable SPECT and PET performances, directly demonstrated for the first time in the present study, support the view that rCBF-SPECT still has a role to play in AD diagnosis.

  8. Usefulness of {sup 131}I-SPECT/CT and {sup 18}F-FDG PET/CT in evaluating successful {sup 131}I and retinoic acid combined therapy in a patient with metastatics struma ovarii

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Hyo Jung; Lee, In Ki; Kang, Keon Wook; Lee, Dong Soo; Chung, June Key [Dept. of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Ryu, Young Hoon [Dept. of Nuclear Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Min, Hye Sook [Dept. of Pathology, Seoul National University Hospital, Seoul (Korea, Republic of); Lee, Dae Hee [Dept. of Oncology, GSAM Hosptial, Gunpo (Korea, Republic of)

    2015-03-15

    Metastatic struma ovarii is an extremely rare disease, and the treatment of choice has not been established. Here, we introduce the case of a 36-year-old female pregnant patient with metastatic struma ovarii. Initial treatment was an exploratory laparotomy to remove multiple peritoneal masses. After delivery, a total thyroidectomy was done for the further {sup 131}I-therapy. {sup 131}I-SPECT/CT and {sup 18}F-FDG PET/CT showed multiple hepatic metastases and extensive peritoneal seeding nodules. Multiple {sup 131}I and retinoic acid combination therapies were performed, resulting in marked improvement. {sup 131}I-SPECT/CT and {sup 18}F-FDG PET/CT were quite useful for evaluating the biologic characteristics of the metastase.

  9. Comparison of {sup 131}I whole-body imaging, {sup 131}I SPECT/CT, and {sup 18}F-FDG PET/CT in the detection of metastatic thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jong-Ryool; Chong, Ari; Kim, Jahae; Kang, Sae-Ryung; Song, Ho-Chun; Bom, Hee-Seung [Chonnam National University Hospital, Department of Nuclear Medicine, Clinical Medicine Research Center, Gwangju (Korea, Republic of); Byun, Byung-Hyun; Hong, Sun-Pyo; Yoo, Su-Woong [Chonnam National University Hwasun Hospital, Department of Nuclear Medicine, Clinical Medicine Research Center, Hwasun, Jeonnam (Korea, Republic of); Kim, Dong-Yeon [Dongguk University, Department of Chemistry, Seoul (Korea, Republic of); Chonnam National University Hospital, Department of Nuclear Medicine, Clinical Medicine Research Center, Gwangju (Korea, Republic of); Min, Jung-Joon [Chonnam National University Hwasun Hospital, Department of Nuclear Medicine, Clinical Medicine Research Center, Hwasun, Jeonnam (Korea, Republic of); Center for Biomedical Human Resources at Chonnam National University, Brain Korea 21 Project, Gwangju (Korea, Republic of)

    2011-08-15

    The aim of this study was to compare {sup 131}I whole-body scintigraphy (WBS), WBS with {sup 131}I single photon emission computed tomography/computed tomography (SPECT/CT), and {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT in the detection of distant metastases of differentiated thyroid cancer (DTC). A total of 140 patients with 258 foci of suspected distant metastases were evaluated. {sup 131}I WBS, {sup 131}I SPECT/CT, and {sup 18}F-FDG PET/CT images were interpreted separately. The final diagnosis was obtained from histopathologic study, serum thyroglobulin level, other imaging modalities, and/or clinical follow-up. Of the 140 patients with 258 foci, 46 patients with 166 foci were diagnosed as positive for distant metastasis. The sensitivity, specificity, and diagnostic accuracy of each imaging modality were 65, 55, and 59%, respectively, for {sup 131}I WBS; 65, 95, and 85% for {sup 131}I SPECT/CT, respectively; and 61, 98, and 86%, respectively, for {sup 18}F-FDG PET/CT in patient-based analyses. Lesion-based analyses demonstrated that both SPECT/CT and PET/CT were superior to WBS (p<0.001) in all patient groups. SPECT/CT was superior to WBS and PET/CT (p<0.001) in patients who received a single challenge of radioiodine therapy, whereas PET/CT was superior to WBS (p=0.005) and SPECT/CT (p=0.013) in patients who received multiple challenges. Both SPECT/CT and PET/CT demonstrated high diagnostic performance in detecting metastatic thyroid cancer. SPECT/CT was highly accurate in patients who underwent a single challenge of radioiodine therapy. In contrast, {sup 18}F-FDG PET/CT presented the highest diagnostic performance in patients who underwent multiple challenges of radioiodine therapy. (orig.)

  10. Fibroelastic pseudotumor elastofibroma dorsi detected by 18F-FDG PET/CT scan and by postherapy radioiodine SPECT/CT.

    Science.gov (United States)

    Oporto, M; Cepa, F; Orta, N; Rubí, S; Navalón, H; Peña, C

    Radioiodine uptake in the thyroid tissue, metastasis of differentiated thyroid cancer (DTC), and in other tissues, depends on the expression of sodium-iodide symporter (NIS). Vascular permeability, effusions, inflammation, and other mechanisms may also play a role in the accumulation of radioactive iodine. A 63-year-old woman underwent radioiodine therapy, as well as a post-therapy whole-body scan, as she was suspected of having lung metastasis from thyroid carcinoma. The scan not only showed uptake at the lung metastasis but also a faint diffuse bilateral uptake in the posterior thorax. On SPECT/CT this uptake was located in a known Elastofibroma Dorsi (ED) previously diagnosed by contrast CT and viewed in a FDG PET/CT. The radioiodine uptake in ED, especially if typical, is not a diagnostic problem in SPECT/CT study, but can be misleading in a study limited to a few planar images, particularly if the uptake occurs asymmetrically, or ED is located in a unsuspected area. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  11. Clinical Application of 18F-FDG PET in Epilepsy

    International Nuclear Information System (INIS)

    Kim, Yu Kyeong

    2008-01-01

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

  12. FDG-PET in the diagnosis of neuropsychiatric Lupus erythematosus and comparison with computed tomography and magnetic resonance imaging. Einsatz der FDG-PET bei der Diagnostik des zentralnervoesen Lupus erythematodes und Vergleich mit CT und MRI

    Energy Technology Data Exchange (ETDEWEB)

    Stoppe, G [Medizinische Hochschule Hannover (Germany, F.R.). Neurologische Klinik mit Klinischer Neurophysiologie; Wildhagen, K [Medizinische Hochschule Hannover (Germany, F.R.). Abt. Immunologie und Transfusionsmedizin; Meyer, G J [Medizinische Hochschule Hannover (Germany, F.R.). Abt. Nuklearmedizin und Spezielle Biophysik; Schober, O [Muenster Univ. (Germany, F.R.). Klinik und Poliklinik fuer Nuklearmedizin

    1989-10-01

    Central nervous system involvement has been found in 30-75% of all cases of systemic lupus erythematosus (SLE). Up to now, clinical diagnosis is difficult and there are no markers for disease activity. We have compared cranial computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) using fluorodesoxyglucose (FDG) in two cases. FDG-PET is shown to be the most sensitive method demonstrating even reversible deficits and a better correlation with other neurological findings. MRI seems to be more sensitive than CT. A survey of the literature concerning imaging methods in neuropsychiatric SLE is given. The special problem of neuronal desactivation by antineuronal activity is discussed. (orig.).

  13. SPECT and PET imaging in epilepsia; SPECT und PET in der Diagnostik von Epilepsien

    Energy Technology Data Exchange (ETDEWEB)

    Landvogt, C. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2007-09-15

    In preoperative localisation of epileptogenic foci, nuclear medicine diagnostics plays a crucial role. FDG-PET is used as first line diagnostics. In case of inconsistent MRI, EEG and FDG-PET findings, {sup 11}C-Flumazenil-PET or ictal and interictal perfusion-SPECT should be performed. Other than FDG, Flumazenil can help to identify the extend of the region, which should be resected. To enhance sensitivity and specificity, further data analysis using voxelbased statistical analyses or SISCOM (substraction ictal SPECT coregistered MRI) should be performed.

  14. The role of quantitative Tc-99m-MIBI gated SPECT/F-18-FDG PET imaging in the monitoring of intracoronary bone marrow cell transplantation

    International Nuclear Information System (INIS)

    Kaminek, M.; Myslivecek, M.

    2006-01-01

    A lot of unresolved questions still exist concerning the exact mechanism of the beneficial effects of bone marrow cell (BMC) transplantation for myocardial regeneration. The aim of this communication is to report the cases of patients with and without post-transplantation left ventricular function improvement. To this study we included consecutive patients with irreversible damage after a first acute ST-elevation myocardial infarction treated by coronary angioplasty with stent implantation. The irreversible damage was identified by dobutamine echocardiography and confirmed by rest gated Tc-99m-MIBI gated SPECT and in the majority of patients by F-18-FDG PET imaging as well. Using 4D-MSPECT software, we quantified MIBI/FDG uptake and gated SPECT left ventricular ejection fraction, end-diastolic/end-systolic volumes (LVEF, EDV/ESV) before BMC therapy and 3 months later. The results obtained in the initial group of patients in this study (27 patients in the BMC treated group, 16 patients in the control group) have been published previously [Eur J Nucl Med 2005; 32 (Suppl 1 ): S46]. Among the BMC group, we identified 13 responders to therapy with average LVEF improvement from 43.3%± 11% to 51.4%± 10.4% and EDV/ESV improvement from 145 ml/84 ml to 133 ml/67 ml. The remaining 14 patients were non-responders to therapy with no significant change in LVEF (39.1%±8.1% versus 39.8% ± 7.4%), the EDV/ESV increased from 166 ml/105 ml to 188 ml/116 ml. Responders to the cell therapy had prevailing MIBI uptake in the range of 31-50% of maximum in the infarction territory. On the other hand, non-responders to BMC therapy had prevailing MIBI uptake in the range of 0-30% of maximum. Two cases are presented in this report. Further studies with a larger cohort of patients would be helpful to evaluate our findings. We observed strong interindividual differences in the effectiveness of the cell therapy. Prevailing residual MIBI uptake in the range of 31-50% of maximum was in the

  15. Clinical use of digital retrospective image fusion of CT, MRI, FDG-PET and SPECT - fields of indications and results

    International Nuclear Information System (INIS)

    Lemke, A.J.; Niehues, S.M.; Amthauer, H.; Felix, R.; Rohlfing, T.; Hosten, N.

    2004-01-01

    Purpose: To evaluate the feasibility and the clinical benefits of retrospective digital image fusion (PET, SPECT, CT and MRI). Materials and methods: In a prospective study, a total of 273 image fusions were performed and evaluated. The underlying image acquisitions (CT, MRI, SPECT and PET) were performed in a way appropriate for the respective clinical question and anatomical region. Image fusion was executed with a software program developed during this study. The results of the image fusion procedure were evaluated in terms of technical feasibility, clinical objective, and therapeutic impact. Results: The most frequent combinations of modalities were CT/PET (n = 156) and MRI/PET (n = 59), followed by MRI/SPECT (n = 28), CT/SPECT (n = 22) and CT/MRI (n = 8). The clinical questions included following regions (more than one region per case possible): neurocranium (n = 42), neck (n = 13), lung and mediastinum (n = 24), abdomen (n = 181), and pelvis (n = 65). In 92.6% of all cases (n = 253), image fusion was technically successful. Image fusion was able to improve sensitivity and specificity of the single modality, or to add important diagnostic information. Image fusion was problematic in cases of different body positions between the two imaging modalities or different positions of mobile organs. In 37.9% of the cases, image fusion added clinically relevant information compared to the single modality. Conclusion: For clinical questions concerning liver, pancreas, rectum, neck, or neurocranium, image fusion is a reliable method suitable for routine clinical application. Organ motion still limits its feasibility and routine use in other areas (e.g., thorax). (orig.)

  16. FDG-PET-based radiotherapy planning in lung cancer. Optimum breathing protocol and patient positioning - an intraindividual comparison; FDG-PET-basierte Bestrahlungsplanung von nicht kleinzelligen Bronchialkarzinomen. Optimales Atemprotokoll und Patientenpositionierung - ein intraindividueller Vergleich

    Energy Technology Data Exchange (ETDEWEB)

    Grgic, A.; Schaefer-Schuler, A.; Kirsch, C.M.; Hellwig, D. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Nuklearmedizin; Nestle, U. [Universitaetsklinikum Freiburg (Germany). Klinik fuer Strahlenheilkunde; Kremp, S. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Strahlentherapie und Radioonkologie

    2008-12-15

    FDG-PET and PET / CT is increasingly used for radiotherapy (RT) planning in non-small-cell lung carcinoma (NSCLC). The planning process is often based on separately-acquired FDG-PET / CT and planning CT. We compared intraindividual differences between PET acquired in diagnostic and radiotherapy treatment position coregistered with planning CTs acquired using different breathing protocols. Sixteen patients with NSCLC underwent two PET acquisitions (diagnostic position-D-PET, radiotherapy position-RT-PET) and three planning-CT acquisitions (expiration-EXP, inspiration-INS, mid-breathhold-MID) on the same day. All scans were rigidly coregistered resulting in six fused datasets: D-INS, D-EXP, D-MID, RT-INS, RT-EXP and RT-MID. Fusion accuracy was assessed by three readers at eight anatomical landmarks: lung apices, aortic arch, heart, spine, sternum, carina, diaphragm and tumor using an alignment score ranging from 1 (no alignment) to 5 (exact alignment). RT-PET showed better alignment with any CT than D-PET (p < 0.001). With regard to breathing, RT-MID showed the best mean alignment score (3.7 {+-} 1.0) followed by RT-EXP (3.5 {+-} 0.9) and RT-INS (3.0 {+-} 0.8), all differences being significant (p < 0.001). Comparing the alignment scores with regard to anatomical landmarks, the largest deviations were found at diaphragm, heart and apices. Overall, there was a fair agreement (? = 0.48; p < 0.001) among the three readers. Significantly better fusion of PET and planning-CT can be reached with PET acquired in RT-position. The best intraindividual fusion results are obtained with the planning-CT performed during mid-breathhold. Our data justify the acquisition of a separate planning-PET in RT-treatment position if only a diagnostic PET-scan is available. (orig.)

  17. Clinical utility of 18-FDG-PET with a modified SPECT-camera using molecular coincidence detection in oncology

    International Nuclear Information System (INIS)

    Gabriel, M. F.

    1998-09-01

    Malignant diseases are belonging to one of the most frequent reasons for mortality and morbidity of people in industrialized countries. In order to avoid inadequate therapy such as unnecessary operations etc. accurate diagnostic techniques are needed to assess malignancy of proven lesions, for staging of cancer or to assess success of therapy. Many studies have reported the value of PET in such cases. Because of limited financial resources we started PET with a Dual-head-SPECT-camera modified with a MCD-module in February 1997 in order to obtain quick access to clinical 18-FDG studies. The aim of this work was to compare the results of our system with reports of the so called 'state of the art'-PET and with other diagnostic techniques used in clinical oncology. So far 124 studies were performed with the MCD-mode using a standardized investigation protocol between February 1997 and May 1998. The applied dose of 18-FDG for oncological studies was about 185 MBq. The tracer was supplied from the radio-pharmaceutical unit of the Department of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universitaet Muenchen. The obtained results were carefully compared with CT, MRI and conventional radiology. In addition, the final diagnosis (based on histology, surgical reports, autopsy and follow up) was also considered. Oncological studies were done either to assess malignancy in certain lesions (n = 25), for staging cancer (n = 77), or to assess success of therapy (n = 22). Sensitivity and specificity for all oncological cases were 99 % and 89 % respectively. One false negative scan was a pretreated CNS-lymphoma, where false positive studies were due to inflammation. (author)

  18. FDG PET imaging dementia

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Byeong Cheol [Kyungpook National University Medical School and Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2007-04-15

    Dementia is a major burden for many countries including South Korea, where life expectancy is continuously growing and the proportion of aged people is rapidly growing. Neurodegenerative disorders, such as, Alzheimer disease, dementia with Lewy bodies, frontotemporal dementia. Parkinson disease, progressive supranuclear palsy, corticobasal degeneration, Huntington disease, can cause dementia, and cerebrovascular disease also can cause dementia. Depression or hypothyroidism also can cause cognitive deficits, but they are reversible by management of underlying cause unlike the forementioned dementias. Therefore these are called pseudodementia. We are entering an era of dementia care that will be based upon the identification of potentially modifiable risk factors and early disease markers, and the application of new drugs postpone progression of dementias or target specific proteins that cause dementia. Efficient pharmacologic treatment of dementia needs not only to distinguish underlying causes of dementia but also to be installed as soon as possible. Therefore, differential diagnosis and early diagnosis of dementia are utmost importance. F-18 FDG PET is useful for clarifying dementing diseases and is also useful for early detection of the disease. Purpose of this article is to review the current value of FDG PET for dementing diseases including differential diagnosis of dementia and prediction of evolving dementia.

  19. FDG PET imaging dementia

    International Nuclear Information System (INIS)

    Ahn, Byeong Cheol

    2007-01-01

    Dementia is a major burden for many countries including South Korea, where life expectancy is continuously growing and the proportion of aged people is rapidly growing. Neurodegenerative disorders, such as, Alzheimer disease, dementia with Lewy bodies, frontotemporal dementia. Parkinson disease, progressive supranuclear palsy, corticobasal degeneration, Huntington disease, can cause dementia, and cerebrovascular disease also can cause dementia. Depression or hypothyroidism also can cause cognitive deficits, but they are reversible by management of underlying cause unlike the forementioned dementias. Therefore these are called pseudodementia. We are entering an era of dementia care that will be based upon the identification of potentially modifiable risk factors and early disease markers, and the application of new drugs postpone progression of dementias or target specific proteins that cause dementia. Efficient pharmacologic treatment of dementia needs not only to distinguish underlying causes of dementia but also to be installed as soon as possible. Therefore, differential diagnosis and early diagnosis of dementia are utmost importance. F-18 FDG PET is useful for clarifying dementing diseases and is also useful for early detection of the disease. Purpose of this article is to review the current value of FDG PET for dementing diseases including differential diagnosis of dementia and prediction of evolving dementia

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-12-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-12-31

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

  2. 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

  3. Assessment of the role of FDG PET in the diagnosis and management of children with refractory epilepsy

    International Nuclear Information System (INIS)

    Ollenberger, Glenn P.; Byrne, Amanda J.; Berlangieri, Salvatore U.; Pathmaraj, Kunthi; Rowe, Christopher C.; Reutens, David C.; Berkovic, Samuel F.; Scheffer, Ingrid E.; Scott, Andrew M.

    2005-01-01

    We performed a retrospective analysis of the results of FDG PET scans in children with refractory epilepsy referred to our centre over an 8-year period, with a view to ascertaining the impact of FDG PET on subsequent patient management. A questionnaire was used to assess the impact of FDG PET scan on diagnosis, management and clinical decision-making processes for epilepsy surgery from the managing clinician's perspective. FDG PET scan results were also compared with MRI, EEG and SPECT results and coded according to whether the FDG PET scan provided independent information and localisation of epileptogenic regions. A total of 118 eligible patients under the age of 14 years were identified, with questionnaires being completed on 113 evaluable patients (96%). The pre-PET management plan consisted of consideration for surgery in 92 patients (81%) and medical therapy for the remaining 21 patients (19%). Managing physicians rated FDG PET as providing information additional to that obtained with other investigations regarding epileptogenic sites in 88 patients (77%). FDG PET had either a minor or a major impact on clinical management in 58 patients (51%), principally with regard to surgical candidacy. FDG PET has a definite role in the assessment of paediatric patients with refractory epilepsy who are being considered for surgery. In the future, analysis of FDG PET data in specific subpopulations of children with refractory epilepsy may lead to novel insights regarding aetiology. (orig.)

  4. Assessment of the role of FDG PET in the diagnosis and management of children with refractory epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Ollenberger, Glenn P.; Byrne, Amanda J.; Berlangieri, Salvatore U.; Pathmaraj, Kunthi [University of Melbourne, Department of Nuclear Medicine and Centre for PET, Melbourne (Australia); Rowe, Christopher C. [University of Melbourne, Department of Nuclear Medicine and Centre for PET, Melbourne (Australia); University of Melbourne, Department of Medicine, Melbourne (Australia); Reutens, David C.; Berkovic, Samuel F.; Scheffer, Ingrid E. [University of Melbourne, Department of Neurology, Melbourne (Australia); University of Melbourne, Department of Medicine, Melbourne (Australia); Scott, Andrew M. [University of Melbourne, Department of Nuclear Medicine and Centre for PET, Melbourne (Australia); University of Melbourne, Department of Medicine, Melbourne (Australia); Austin Hospital, Ludwig Institute for Cancer Research, Heidelberg, Victoria (Australia)

    2005-11-01

    We performed a retrospective analysis of the results of FDG PET scans in children with refractory epilepsy referred to our centre over an 8-year period, with a view to ascertaining the impact of FDG PET on subsequent patient management. A questionnaire was used to assess the impact of FDG PET scan on diagnosis, management and clinical decision-making processes for epilepsy surgery from the managing clinician's perspective. FDG PET scan results were also compared with MRI, EEG and SPECT results and coded according to whether the FDG PET scan provided independent information and localisation of epileptogenic regions. A total of 118 eligible patients under the age of 14 years were identified, with questionnaires being completed on 113 evaluable patients (96%). The pre-PET management plan consisted of consideration for surgery in 92 patients (81%) and medical therapy for the remaining 21 patients (19%). Managing physicians rated FDG PET as providing information additional to that obtained with other investigations regarding epileptogenic sites in 88 patients (77%). FDG PET had either a minor or a major impact on clinical management in 58 patients (51%), principally with regard to surgical candidacy. FDG PET has a definite role in the assessment of paediatric patients with refractory epilepsy who are being considered for surgery. In the future, analysis of FDG PET data in specific subpopulations of children with refractory epilepsy may lead to novel insights regarding aetiology. (orig.)

  5. [18F]FDG-PET in large vessel vasculitis

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-06-15

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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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

  9. Chorea in systemic lupus erythematosus: evidence for bilateral putaminal hypermetabolism on F-18 FDG PET

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Wook Jang; Chung, Son Mi; Koh, Su Jin; Lee, Chang Keun; Yoo, Bin; Moon, Hee Bom [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of); Kim, Jae Seung; Im, Joo Hyuk [Asan Medical Center, Seoul (Korea, Republic of)

    2003-10-01

    We describe a 54-year-old woman with systemic lupus erythematosus (SLE) who suddenly presented with chorea and had positive antiphospholipid antibodies. F-18 FDG PET showed abnormally increased glucose metabolism in bilateral putamen and primary motor cotex. Tc-99m ECD SPECT also showed abnormally increased regional cerebral blood flow in bilateral putamen. She was treated with corticosteroid and aspirin after which the symptoms improved. Four months later, follow up F-18 FDG PET showed improvement with resolution of hypermetabolism in bilateral putamen. This case suggests that striatal hypermetabolism is associated with chorea in SLE.

  10. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-04-01

    bronchial carcinomas (except for slowly growing neuroendocrine tumors like carcinoids which show rarely an increased FDG metabolism). The specificity of FDG-PET is in the range of >80%. (orig.) [German] Prospektive Studien zeigten im Direktvergleich von PET und Spiral-CT eine deutlich hoehere diagnostische Genauigkeit der PET im Lymphknotenstaging des Bronchialkarzinoms (insbesondere mediastinal, d.h. N2- oder N3-Befall). Mittels FDG-PET koennen auch normal grosse Lymphknoten (im CT<10 mm) als tumorbefallen charakterisiert werden (Upstaging). Andererseits kann die PET aufgrund der hoeheren Spezifitaet eine Metastasierung in computertomographisch vergroesserten Lymphknoten oftmals ausschliessen (Downstaging in bis zu 30% der untersuchten Patienten). Eine Aenderung des therapeutischen Prozedere durch die PET-Untersuchung ergab sich bei bis zu 30% aller Patienten und unter Einschluss der Fernmetastasen bei ueber 40% der untersuchten Patienten. Nebennierenmetastasen (Sensitivitaet 100%, Spezifitaet 80%), als auch Leber-, Knochen- und parenchymatoese Lungenmetastasen und abdominelle und zervikale Lymphknotenmetastasen werden mit hoher Sensitivitaet und Spezifitaet detektiert. Bei zerebralen Metastasen ist die MRT im Nachweis eindeutig ueberlegen, bei sehr kleinen Lungenlaesionen (<5 mm) ist die Spiral-CT sensitiver. Der Nachweis des lokalen Rezidivs eines zuvor operierten Lungenkarzinoms ist mit einer Sensitivitaet von 83-100% (Mittel 95%) und einer Spezifitaet von 62-100% (Mittel 81%) moeglich. Auch zur Therapiekontrolle ist die FDG-PET geeignet, da die Abnahme des Glukosemetabolismus mit dem Therapieerfolg korreliert. Problematisch sind inflammatorische Veraenderungen in den ersten Wochen nach Strahlentherapie ('Strahlenpneumonitis'), die ebenfalls zu einem gesteigerten Glukosemetabolismus fuehren koennen, weshalb ein groesserer Zeitabstand (mehrere Wochen bis Monate) nach Strahlentherapie sinnvoll ist. Die FDG-PET hat sich in der Differenzialdiagnostik von

  12. Cancer screening with FDG-PET

    International Nuclear Information System (INIS)

    Ide, M.

    2006-01-01

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

  13. 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

  14. Peritoneal carcinomatosis - the role of FDG PET

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  15. 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.

  16. 18F-FDG-PET/CT in Endometrial Carcinoma

    International Nuclear Information System (INIS)

    Jeon, Tae Joo

    2008-01-01

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

  17. 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

  18. FDG-PET evaluation of vaginal carcinoma

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  19. 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

  20. The FDG-PET diagnosis of head and neck malignant tumor

    International Nuclear Information System (INIS)

    Kada, Shinpei; Hayashi, Masahiko; Okazawa, Hidehiko

    2003-01-01

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

  1. A Japanese nationwide survey on the FDG-PET scans for dementia. Analysis on the predicted costs and benefits of FDG-PET for early diagnosis of Alzheimer

    International Nuclear Information System (INIS)

    Senda, Michio; Ouchi, Yasuomi; Ishii, Kazunari

    2003-01-01

    A nation-wide survey was carried out on the FDG-PET scans for the diagnosis of dementia by the FDG-PET Working Group organized by both the Japan Radioisotope Association and the Japanese Society of Nuclear Medicine. A total of 406 case reports were presented by 15 PET centers for one year. The purpose of the PET scans included early diagnosis of Alzheimer-type Dementia (154 cases, group A) and differential diagnosis of degenerative dementia (144 cases, group B), which was achieved by the PET scan in most cases. The PET scan turned out to allow omitting cerebral blood flow (CBF)-SPECT scans. Since donepezil treatment of the Alzheimer patients prevents the progress of the disease and reduces the care cost, an economic evaluation was performed on the two-year projected cost and benefit of FDG-PET. The reduction of the total cost by incorporating PET into the protocol was predicted to be 61500 yen (group A) and 13700 yen (group B) per person. The increase of the quality adjusted life year (QALY) was predicted to be 0.0442 (group A) and 0.0137 (group B). Therefore, incorporation of PET into the clinical pass was shown to be an economically dominant. As the number of potential subjects for early diagnosis of dementia is estimated to be 9000 across the country every year, PET is expected to increase their quality of life equivalent to 398 intact persons per year while reducing the cost of health care by 554 million yen. (author)

  2. Appropriateness criteria of FDG PET/CT in oncology

    International Nuclear Information System (INIS)

    Agrawal, Archi; Rangarajan, Venkatesh

    2015-01-01

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

  3. Non-FDG PET imaging of brain tumors

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  4. FDG PET/CT in children and adolescents with lymphoma

    International Nuclear Information System (INIS)

    Kluge, Regine; Kurch, Lars; Montravers, Francoise; Mauz-Koerholz, Christine

    2013-01-01

    The aim of this review is to give an overview of FDG PET/CT applications in children and adolescents with lymphoma. Today, FDG PET is used for tailoring treatment intensity in children with Hodgkin lymphoma within the framework of international treatment optimisation protocols. In contrast, the role of this method in children with Non-Hodgkin lymphoma is not well defined. This paper overviews clinical appearance and metabolic behaviour of the most frequent lymphoma subtypes in childhood. The main focus of the review is to summarise knowledge about the role of FDG PET/CT for initial staging and early response assessment. (orig.)

  5. FDG-PET in monitoring therapy of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Biersack, H J; Bender, H; Palmedo, H [Department of Nuclear Medicine, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn (Germany)

    2004-06-01

    Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been used successfully for the staging and re-staging of breast cancer. Another significant indication is the evaluation of therapy response. Only limited data are available on the use of FDG-PET in breast cancer after radiation therapy. The same holds true for chemotherapy. Only the therapy response in locally advanced breast cancer after chemotherapy has been investigated thoroughly. Histopathological response could be predicted with an accuracy of 88-91% after the first and second courses of therapy. A quantitative evaluation is, of course, a prerequisite when FDG-PET is used for therapy monitoring. Only a small number of studies have focussed on hormone therapy. In this context, a flare phenomenon with increasing standardised uptake values after initiation of tamoxifen therapy has been observed. More prospective multicentre trials will be needed to make FDG-PET a powerful tool in monitoring chemotherapy in breast cancer. (orig.)

  6. FDG-PET in monitoring therapy of breast cancer

    International Nuclear Information System (INIS)

    Biersack, H.J.; Bender, H.; Palmedo, H.

    2004-01-01

    Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been used successfully for the staging and re-staging of breast cancer. Another significant indication is the evaluation of therapy response. Only limited data are available on the use of FDG-PET in breast cancer after radiation therapy. The same holds true for chemotherapy. Only the therapy response in locally advanced breast cancer after chemotherapy has been investigated thoroughly. Histopathological response could be predicted with an accuracy of 88-91% after the first and second courses of therapy. A quantitative evaluation is, of course, a prerequisite when FDG-PET is used for therapy monitoring. Only a small number of studies have focussed on hormone therapy. In this context, a flare phenomenon with increasing standardised uptake values after initiation of tamoxifen therapy has been observed. More prospective multicentre trials will be needed to make FDG-PET a powerful tool in monitoring chemotherapy in breast cancer. (orig.)

  7. FDG-PET/CT in oncology. German guideline

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  8. Clinical value of FDG hybrid-PET in staging and restaging of malignant lymphoma. Compared with conventional diagnostic methods; Klinische Wertigkeit der Befunde von FDG-PET mittels Koinzidenz-Gammakamera beim Staging und Restaging maligner Lymphome. Ein Vergleich zu konventioneller Diagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Pichler, R.; Maschek, W.; Hatzl-Griesenhofer, M.; Huber, H. [Allgemeines Krankenhaus Linz (Austria). Inst. fuer Nuklearmedizin; Wimmer, G.; Wahl, G.; Fridrik, M. [Allgemeines Krankenhaus Linz (Austria). I. Medizinische Abt.

    2000-09-01

    Aim of the present retrospective study was to validate the clinical value of F-18-FDG PET imaging in lymphoma patients with a dual head camera modified for coincidence detection. Staging before and after oncological treatment was compared with a conservative diagnostic approach. Methods: 48 patients (28 non-Hodgkin lymphoma, 20 Hodgkin's disease) received FDG-Hybrid-PET scans. Pretherapeutic staging was realized in 28 patients, 9 of them had control studies after they had completed therapy. Totally 29 persons were examined for posttherapeutic restaging. Computed tomography imaging and lymph node sonography was performed in all cases. Results were validated by clinical follow-up, in three cases a recidive was proven by biopsy. Results: CT and ultrasound detected 77 lesions in 28 patients compared with 100 visualized by PET, but this difference in pretherapeutic staging did not reach significance at p>0.05 by Fisher's t-test. Hybrid-PET obtained a sensitivity of 93%, a specifity of 79%, a positive of 82% and a negative predictive value of 92% for detection of residual disease. The values for CT+US were 87%, 64%, 72% and 88% respectively. Conclusion: FDG Hybrid-PET is as or even more accurate than standard morphologic diagnostic methods for prestaging in malignant lymphoma. Additionally, there is a substancial benefit for therapy monitoring of residual disease using coincidence detection PET with a 3/4-inch crystal gamma camera. (orig.) [German] Ziel der vorliegenden retrospektiven Studie war die Validierung der klinischen Wertigkeit von F-18-FDG-PET mittels Doppelkopf-Koinzidenz-Gammakamera bei Lymphompatienten. Die Ergebnisse von prae- und post-therapeutischem Staging wurden mit dem konservativ bildgebender Verfahren verglichen. Methoden: 48 Patienten (28 NHL, 20 Morbus Hodgkin) erhielten FDG-DK-PET-Untersuchungen. Ein praetherapeutisches Staging wurde bei 28 Patienten durchgefuehrt, 9 von diesen hatten weitere Kontrollstudien nach abgeschlossenem

  9. How FDG-PET helps making decision for surgery in various difficult subgroups of temporal lobe epilepsy?

    Energy Technology Data Exchange (ETDEWEB)

    Tepmongkol, S [Division of Nuclear Medicine, Department of Radiology and Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok (Thailand); Locharernkul, C [Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University and Chulalongkorn Comprehensive Epilepsy Program under the patronage of Professor Doctor HRH Princess Chulabhorn, Bangkok (Thailand); Chaiwatanarat, T; Kingpetch, K; Sirisalipoch, S [Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok (Thailand); Limotai, C; Loplumlert, J [Chulalongkorn Comprehensive Epilepsy Program under the patronage of Professor Doctor HRH Princess Chulabhorn, Bangkok (Thailand)

    2007-07-01

    Concordant pre-surgical data are the important predictors of good surgical outcome in patients with localization-related epilepsy. Medically intractable temporal lobe epilepsy with hippocampal sclerosis (HS) and concordant pre-surgical data is straightforward and may not need functional imaging. However, in other instances for example, HS with discordant data (HSD), bilateral HS with discordant data (BHSD), temporal lobe epilepsy with dual pathology (DP), non-lesional temporal lobe epilepsy (NL) are the difficult subgroups. In these groups, functional imaging eg. brain perfusion SPECT or brain PET may play a major role for surgical decision making. To our knowledge, there was no previous data in using FDG-PET in different subgroups as mentioned. Only some previous studies in single subgroup without analyzing impact of PET findings on decision-making have been reported. We thus aim to evaluate the usefulness of FDG-PET in these 4 subgroups.

  10. 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

  11. FDG-PET/CT in the evaluation of anal carcinoma

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  12. Importance of SPECT/CT for knee and hip joint prostheses; Stellenwert der SPECT/CT bei Knie- und Hueftgelenkprothesen

    Energy Technology Data Exchange (ETDEWEB)

    Strobel, K.; Steurer-Dober, I.; Huellner, M.W.; Veit-Haibach, P.; Allgayer, B. [Luzerner Kantonsspital (Switzerland). Institut fuer Nuklearmedizin und Roentgendiagnostik

    2012-07-15

    Complications, such as loosening or infections are common problems after hip or knee arthroplasty. If conventional X-rays are equivocal bone scintigraphy is the classical second-line imaging modality. Single photon emission computed tomography/computed tomography (SPECT/CT) offers metabolic and morphologic information in one imaging step and is becoming increasingly more available in larger hospitals. The SPECT/CT procedure is a promising method and is increasingly being used in daily routine to evaluate joint arthroplasty. The additional benefit compared with classical conventional bone scintigraphy has to be evaluated in further prospective studies. In our hospital SPECT/CT regularly gives important additional information regarding prosthetic joint complications. SPECT/CT is increasingly being used as the second step imaging standard modality if conventional X-rays are equivocal. (orig.) [German] Komplikationen wie Lockerung und Infekt stellen ein haeufiges Problem nach Hueft- und Kniegelenkprothesen dar. Wenn die konventionelle Roentgenaufnahme nicht zum Ziel fuehrt, ist die klassische konventionelle Skelettszintigraphie die am haeufigsten verwendete ''Second-line''-Bildgebung. Die ''single photon emission computed tomography''/CT (SPECT/CT) bietet metabolische und morphologische Informationen bzgl. Prothesenkomplikationen in einem Untersuchungsgang und ist zunehmend in groesseren Kliniken verfuegbar. Die SPECT/CT ist eine viel versprechende Methode und wird im klinischen Alltag bei der Evaluation von Gelenkprothesen zunehmend eingesetzt. Es sind noch mehr prospektive Studien noetig, um die Leistungsfaehigkeit und den Zusatznutzen gegenueber der klassischen Szintigraphie zu evaluieren. In unserer Klinik wird die Knochenszintigraphie bei der Abklaerung von Prothesenkomplikationen zumeist mit einer SPECT/CT kombiniert und liefert regelmaessig wichtige Zusatzinformationen. Die SPECT/CT entwickelt sich zunehmend zum Standard

  13. 123I-Mibg scintigraphy and 18F-Fdg-Pet imaging for diagnosing neuroblastoma

    Science.gov (United States)

    Bleeker, Gitta; Tytgat, Godelieve Am; Adam, Judit A; Caron, Huib N; Kremer, Leontien Cm; Hooft, Lotty; van Dalen, Elvira C

    2015-01-01

    Background Neuroblastoma is an embryonic tumour of childhood that originates in the neural crest. It is the second most common extracranial malignant solid tumour of childhood. Neuroblastoma cells have the unique capacity to accumulate Iodine-123-metaiodobenzylguanidine (123I-MIBG), which can be used for imaging the tumour. Moreover, 123I-MIBG scintigraphy is not only important for the diagnosis of neuroblastoma, but also for staging and localization of skeletal lesions. If these are present, MIBG follow-up scans are used to assess the patient's response to therapy. However, the sensitivity and specificity of 123I-MIBG scintigraphy to detect neuroblastoma varies according to the literature. Prognosis, treatment and response to therapy of patients with neuroblastoma are currently based on extension scoring of 123I-MIBG scans. Due to its clinical use and importance, it is necessary to determine the exact diagnostic accuracy of 123I-MIBG scintigraphy. In case the tumour is not MIBG avid, fluorine-18-fluorodeoxy-glucose (18F-FDG) positron emission tomography (PET) is often used and the diagnostic accuracy of this test should also be assessed. Objectives Primary objectives: 1.1 To determine the diagnostic accuracy of 123I-MIBG (single photon emission computed tomography (SPECT), with or without computed tomography (CT)) scintigraphy for detecting a neuroblastoma and its metastases at first diagnosis or at recurrence in children from 0 to 18 years old. 1.2 To determine the diagnostic accuracy of negative 123I-MIBG scintigraphy in combination with 18F-FDG-PET(-CT) imaging for detecting a neuroblastoma and its metastases at first diagnosis or at recurrence in children from 0 to 18 years old, i.e. an add-on test. Secondary objectives: 2.1 To determine the diagnostic accuracy of 18F-FDG-PET(-CT) imaging for detecting a neuroblastoma and its metastases at first diagnosis or at recurrence in children from 0 to 18 years old. 2.2 To compare the diagnostic accuracy of 123I

  14. Metastasis of the gastrointestinal tract. FDG-PET imaging

    International Nuclear Information System (INIS)

    Hayasaka, Kazumasa; Nihashi, Takashi; Matsuura, Toshihiro

    2007-01-01

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

  15. Usefulness of 18F-FDG PET in intrahepatic cholangiocarcinoma

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  16. FDG-PET in the clinical management of Hodgkin lymphoma

    DEFF Research Database (Denmark)

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

    2004-01-01

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

  17. Seasonal influence on stimulated BAT activity in prospective trials: a retrospective analysis of BAT visualized on 18F-FDG PET-CTs and 123I-mIBG SPECT-CTs.

    Science.gov (United States)

    Bahler, Lonneke; Deelen, Jan W; Hoekstra, Joost B; Holleman, Frits; Verberne, Hein J

    2016-06-15

    Retrospective studies have shown that outdoor temperature influences the prevalence of detectable brown adipose tissue (BAT). Prospective studies use acute cold exposure to activate BAT. In prospective studies, BAT might be preconditioned in winter months leading to an increased BAT response to various stimuli. Therefore the aim of this study was to assess whether outdoor temperatures and other weather characteristics modulate the response of BAT to acute cold. To assess metabolic BAT activity and sympathetic outflow to BAT, 64 (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography-computed tomography (PET-CT) and 56 additional (123)I-meta-iodobenzylguanidine ((123)I-mIBG) single-photon emission computed tomography-CT (SPECT-CT) scans, respectively, of subjects participating in previously executed trials were retrospectively included. BAT activity was measured in subjects after an overnight fast, following 2 h of cold exposure (∼17°C). The average daytime outdoor temperatures and other weather characteristics were obtained from the Dutch Royal Weather Institute. Forty-nine subjects were BAT positive. One week prior to the scan, outdoor temperature was significantly lower in the BAT-positive group compared with the BAT-negative group. Higher outdoor temperatures on preceding days resulted in lower stimulated metabolic BAT activity and volume (all P BAT. In conclusion, outdoor temperatures influence metabolic BAT activity and volume, but not sympathetic outflow to BAT, in subjects exposed to acute cold. To improve the consistency of the findings of future BAT studies in humans and to exclude bias introduced by outdoor temperatures, these studies should be planned in periods of similar outdoor temperatures. Copyright © 2016 the American Physiological Society.

  18. Clinical Application of 18F-FDG PET in Non-Small Cell Lung Cancer

    International Nuclear Information System (INIS)

    Choi, Joon Young

    2008-01-01

    This review focuses on the clinical use of 18 F-FDG PET to evaluate solitary pulmonary nodule (SPN) and non-small cell lung cancer (NSCLC). When SPN or mass without calcification is found on chest X-ray or CT, 18 F-FDG PET is an effective modality to differentiate benign from malignant lesions. For initial staging of NSCLC, 18 F-FDG PET is useful, and proved to be cost-effective in several countries. 18 F-FDG PET is useful for detecting recurrence, restaging and evaluating residual tumor after curative therapy in NSCLC. For therapy response assessment, 18 F-FDG PET may be effective after chemotherapy or radiation therapy. 18 F-FDG PET is useful to predict pathological response after neoadjuvant therapy in NSCLC. For radiation therapy planning, 18 F-FDG PET may be helpful, but requires further investigations. PET/CT is better for evaluating NSCLC than conventional PET

  19. FDG PET/CT imaging in canine cancer patients

    DEFF Research Database (Denmark)

    Hansen, Anders Elias; McEvoy, Fintan; Engelholm, Svend Aage

    2011-01-01

    2-Deoxy-2-[¹⁸F]fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) is becoming increasingly available as an imaging modality in veterinary medicine. The purpose of this study was to report semiquantitative standard uptake values (SUV) of malignant and nonmalignant tissues...

  20. Sequential {sup 123}I-iododexetimide scans in temporal lobe epilepsy: comparison with neuroimaging scans (MR imaging and {sup 18}F-FDG PET imaging)

    Energy Technology Data Exchange (ETDEWEB)

    Mohamed, Armin [Royal Prince Alfred Hospital, Department of PET and Nuclear Medicine, Camperdown, NSW (Australia); Royal Prince Alfred Hospital, Comprehensive Epilepsy Service, Camperdown, NSW (Australia); University of Sydney, Faculty of Medicine, Sydney, NSW (Australia); Eberl, Stefan; Henderson, David; Beveridge, Scott; Constable, Chris [Royal Prince Alfred Hospital, Department of PET and Nuclear Medicine, Camperdown, NSW (Australia); Fulham, Michael J. [Royal Prince Alfred Hospital, Department of PET and Nuclear Medicine, Camperdown, NSW (Australia); Kassiou, Michael [Royal Prince Alfred Hospital, Department of PET and Nuclear Medicine, Camperdown, NSW (Australia); University of Sydney, Department of Pharmacology, Sydney, NSW (Australia); Zaman, Aysha [University of Sydney, Faculty of Medicine, Sydney, NSW (Australia); Lo, Sing Kai [University of Sydney, Institute of International Health, Sydney, NSW (Australia)

    2005-02-01

    Muscarinic acetylcholine receptors (mAChRs) play an important role in the generation of seizures. Single-photon emission computed tomography (SPECT) with {sup 123}I-iododexetimide (IDEX) depicts tracer uptake by mAChRs. Our aims were to: (a) determine the optimum time for interictal IDEX SPECT imaging; (b) determine the accuracy of IDEX scans in the localisation of seizure foci when compared with video EEG and MR imaging in patients with temporal lobe epilepsy (TLE); (c) characterise the distribution of IDEX binding in the temporal lobes and (d) compare IDEX SPECT and {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in identifying seizure foci. We performed sequential scans using IDEX SPECT imaging at 0, 3, 6 and 24 h in 12 consecutive patients with refractory TLE undergoing assessment for epilepsy surgery. Visual and region of interest analyses of the mesial, lateral and polar regions of the temporal lobes were used to compare IDEX SPECT, FDG PET and MR imaging in seizure onset localisation. The 6-h IDEX scan (92%; {kappa}=0.83, p=0.003) was superior to the 0-h (36%; {kappa}=0.01, p>0.05), 3-h (55%; {kappa}=0.13, p>0.05) and 24-h IDEX scans in identifying the temporal lobe of seizure origin. The 6-h IDEX scan correctly predicted the temporal lobe of seizure origin in two patients who required intracranial EEG recordings to define the seizure onset. Reduced ligand binding was most marked at the temporal pole and mesial temporal structures. IDEX SPECT was superior to interictal FDG PET (75%; {kappa}=0.66, p=0.023) in seizure onset localisation. MR imaging was non-localising in two patients in whom it was normal and in another patient in whom there was bilateral symmetrical hippocampal atrophy. The 6-h IDEX SPECT scan is a viable alternative to FDG PET imaging in seizure onset localisation in TLE. (orig.)

  1. Sequential 123I-iododexetimide scans in temporal lobe epilepsy: comparison with neuroimaging scans (MR imaging and 18F-FDG PET imaging)

    International Nuclear Information System (INIS)

    Mohamed, Armin; Eberl, Stefan; Henderson, David; Beveridge, Scott; Constable, Chris; Fulham, Michael J.; Kassiou, Michael; Zaman, Aysha; Lo, Sing Kai

    2005-01-01

    Muscarinic acetylcholine receptors (mAChRs) play an important role in the generation of seizures. Single-photon emission computed tomography (SPECT) with 123 I-iododexetimide (IDEX) depicts tracer uptake by mAChRs. Our aims were to: (a) determine the optimum time for interictal IDEX SPECT imaging; (b) determine the accuracy of IDEX scans in the localisation of seizure foci when compared with video EEG and MR imaging in patients with temporal lobe epilepsy (TLE); (c) characterise the distribution of IDEX binding in the temporal lobes and (d) compare IDEX SPECT and 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in identifying seizure foci. We performed sequential scans using IDEX SPECT imaging at 0, 3, 6 and 24 h in 12 consecutive patients with refractory TLE undergoing assessment for epilepsy surgery. Visual and region of interest analyses of the mesial, lateral and polar regions of the temporal lobes were used to compare IDEX SPECT, FDG PET and MR imaging in seizure onset localisation. The 6-h IDEX scan (92%; κ=0.83, p=0.003) was superior to the 0-h (36%; κ=0.01, p>0.05), 3-h (55%; κ=0.13, p>0.05) and 24-h IDEX scans in identifying the temporal lobe of seizure origin. The 6-h IDEX scan correctly predicted the temporal lobe of seizure origin in two patients who required intracranial EEG recordings to define the seizure onset. Reduced ligand binding was most marked at the temporal pole and mesial temporal structures. IDEX SPECT was superior to interictal FDG PET (75%; κ=0.66, p=0.023) in seizure onset localisation. MR imaging was non-localising in two patients in whom it was normal and in another patient in whom there was bilateral symmetrical hippocampal atrophy. The 6-h IDEX SPECT scan is a viable alternative to FDG PET imaging in seizure onset localisation in TLE. (orig.)

  2. Decreased occipital lobe metabolism by FDG-PET/CT

    Science.gov (United States)

    Solnes, Lilja; Nalluri, Abhinav; Cohen, Jesse; Jones, Krystyna M.; Zan, Elcin; Javadi, Mehrbod S.; Venkatesan, Arun

    2017-01-01

    Objective: To compare brain metabolism patterns on fluorodeoxyglucose (FDG)-PET/CT in anti–NMDA receptor and other definite autoimmune encephalitis (AE) and to assess how these patterns differ between anti–NMDA receptor neurologic disability groups. Methods: Retrospective review of clinical data and initial dedicated brain FDG-PET/CT studies for neurology inpatients with definite AE, per published consensus criteria, treated at a single academic medical center over a 10-year period. Z-score maps of FDG-PET/CT were made using 3-dimensional stereotactic surface projections in comparison to age group–matched controls. Brain region mean Z scores with magnitudes ≥2.00 were interpreted as significant. Comparisons were made between anti–NMDA receptor and other definite AE patients as well as among patients with anti–NMDA receptor based on modified Rankin Scale (mRS) scores at the time of FDG-PET/CT. Results: The medial occipital lobes were markedly hypometabolic in 6 of 8 patients with anti–NMDA receptor encephalitis and as a group (Z = −4.02, interquartile range [IQR] 2.14) relative to those with definite AE (Z = −2.32, 1.46; p = 0.004). Among patients with anti–NMDA receptor encephalitis, the lateral and medial occipital lobes were markedly hypometabolic for patients with mRS 4–5 (lateral occipital lobe Z = −3.69, IQR 1; medial occipital lobe Z = −4.08, 1) compared with those with mRS 0–3 (lateral occipital lobe Z = −0.83, 2; p occipital lobe Z = −1.07, 2; p = 0.001). Conclusions: Marked medial occipital lobe hypometabolism by dedicated brain FDG-PET/CT may serve as an early biomarker for discriminating anti–NMDA receptor encephalitis from other AE. Resolution of lateral and medial occipital hypometabolism may correlate with improved neurologic status in anti–NMDA receptor encephalitis. PMID:29159205

  3. F-18 FDG PET finding in autonomous thyroid nodules

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  4. 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)

  5. [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.)

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

    Science.gov (United States)

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

    2015-06-01

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

  7. Clinical Application of {sup 18}F-FDG PET in Multiple Myeloma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Su Jin; Choi, Joon Young [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2009-12-15

    This review focuses on the clinical use of {sup 18}F-FDG PET to evaluate multiple myeloma. {sup 18}F-FDG PET is useful for diagnosis, staging of multiple myeloma and differential diagnosis of myeloma related disease such as monoclonal gammopathy of undetermined significance or plasmacytoma. For therapy response, {sup 18}F-FDG PET may be effective after chemotherapy for multiple myeloma and radiotherapy for plasmacytoma.

  8. Clinical Application of 18F-FDG PET in Multiple Myeloma

    International Nuclear Information System (INIS)

    Lee, Su Jin; Choi, Joon Young

    2009-01-01

    This review focuses on the clinical use of 18 F-FDG PET to evaluate multiple myeloma. 18 F-FDG PET is useful for diagnosis, staging of multiple myeloma and differential diagnosis of myeloma related disease such as monoclonal gammopathy of undetermined significance or plasmacytoma. For therapy response, 18 F-FDG PET may be effective after chemotherapy for multiple myeloma and radiotherapy for plasmacytoma

  9. Clinical Application of {sup 18}F-FDG PET in Testicular Cancer

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-12-15

    {sup 18}F-FDG PET has a higher diagnostic accuracy than CT in initial staging of testicular cancer. In seminoma, it can discriminate residual tumor from necrosis/fibrosis or mature teratoma. {sup 18}F-FDG PET is also useful for the response evaluation of chemotherapy. However, there's no clinical evidence for the use of {sup 18}F-FDG PET in the diagnosis and differential diagnosis of testicular cancer.

  10. System immune response to vaccination on FDG-PET/CT

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-12-15

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

  11. FDG PET/CT imaging as a biomarker in lymphoma

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-04-01

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

  12. System immune response to vaccination on FDG-PET/CT

    International Nuclear Information System (INIS)

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

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  14. Guidance for reading FDG PET scans in dementia patients

    International Nuclear Information System (INIS)

    Herholz, K.

    2014-01-01

    18F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) is a powerful method for detection of disease-related impairment of cerebral glucose metabolism in neuro degenerative diseases. It is of particular interest for early and differential diagnosis of dementia. Reading FDG PET scans requires training to recognise deviations from normal functional brain anatomy and its variations. This paper provides guidance for displaying FDG PET brain scans in a reproducible manner that allows reliable recognition of characteristic disease-related metabolic changes. It also describes typical findings in Alzheimer’s disease, Frontotemporal Dementia and Dementia with Lewy Bodies and possible confounding factors, such as vascular changes and brain atrophy. It provides a brief overview on findings in other neuro degenerative diseases and addresses the potential and limitations of software packages for comparison of individual scans with reference data.

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  16. FDG PET in the diagnosis of giant cell arteritis

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  17. Oncological applications of 18F-FDG PET imaging

    International Nuclear Information System (INIS)

    Li Lin

    2000-01-01

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

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  19. Simultaneous measurement of FDG-PET and NAT

    International Nuclear Information System (INIS)

    Musha, Toshimitsu; Matsuzaki, Haruyasu; Ishii, Kenji

    2011-01-01

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

  20. Risk-benefit analysis of 18FDG PET cancer screening

    International Nuclear Information System (INIS)

    Murano, Takeshi; Daisaki, Hiromitsu; Terauchi, Takashi; Iinuma, Takeshi; Tateno, Yukio; Tateishi, Ukihide; Kato, Kazuaki; Inoue, Tomio

    2008-01-01

    The benefits of 18 F-fluorodeoxyglucose ( 18 FDG) positron emission tomography (PET) cancer screening are expected to include a large population of examinees and are intended for a healthy group. Therefore, we attempted to determine the benefit/risk ratio, estimated risk of radiation exposure, and benefit of cancer detection. We used software that embodied the method of the International Commission on Radiological Protection (ICRP) to calculate the average duration of life of radiation exposure. We calculated the lifesaving person years of benefit to be obtained by 18 FDG PET cancer screening detection. We also calculated the benefit/risk ratio using life-shortening and lifesaving person years. According to age, the benefit/risk ratio was more than 1 at 35-39 years old for males and 30-34 years old for females. 18 FDG PET cancer screening also is effective for examinees older than this. A risk-benefit analysis of 18 FDG-PET/computed tomography (CT) cancer screening will be necessary in the future. (author)

  1. Lymphomatoid Granulomatosis: CT and FDG-PET Findings

    International Nuclear Information System (INIS)

    Chung, Jonathan H.; Wu, Carol C.; Gilman, Matthew D.; Palmer, Edwin L.; Hasserjian, Robert P.; Sphepar, Jo-Anne O.

    2011-01-01

    Lymphomatoid granulomatosis (LG) is a rare, aggressive extranodal Epstein-Barr virus (EBV)-positive B-cell lymphoproliferative disease. The purpose of our study was to analyze the CT and fluorodeoxyglucose positron emission tomography (FDG-PET) findings of pulmonary LG. Between 2000 and 2009, four patients with pathologically proven pulmonary LG and chest CT were identified. Two of these patients also had FDG-PET. Imaging features of LG on CT and PET were reviewed. Pulmonary nodules or masses with peribronchovascular, subpleural, and lower lung zonal preponderance were present in all patients. Central low attenuation (4 of 4 patients), ground-glass halo (3 of 4 patients), and peripheral enhancement (4 of 4 patients) were observed in these nodules and masses. An air-bronchogram and cavitation were seen in three of four patients. FDG-PET scans demonstrated avid FDG uptake in the pulmonary nodules and masses. Pulmonary LG presents with nodules and masses with a lymphatic distribution, as would be expected for a lymphoproliferative disease. However, central low attenuation, ground-glass halo and peripheral enhancement of the nodules/masses are likely related to the angioinvasive nature of this disease. Peripheral enhancement and ground-glass halo, in particular, are valuable characteristic not previously reported that can help radiologists suggest the diagnosis of pulmonary LG.

  2. Lymphomatoid Granulomatosis: CT and FDG-PET Findings

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Jonathan H. [National Jewish Health, Denver (United States); Wu, Carol C.; Gilman, Matthew D.; Palmer, Edwin L.; Hasserjian, Robert P.; Sphepar, Jo-Anne O. [Massachusetts General Hospital, Boston (United States)

    2011-11-15

    Lymphomatoid granulomatosis (LG) is a rare, aggressive extranodal Epstein-Barr virus (EBV)-positive B-cell lymphoproliferative disease. The purpose of our study was to analyze the CT and fluorodeoxyglucose positron emission tomography (FDG-PET) findings of pulmonary LG. Between 2000 and 2009, four patients with pathologically proven pulmonary LG and chest CT were identified. Two of these patients also had FDG-PET. Imaging features of LG on CT and PET were reviewed. Pulmonary nodules or masses with peribronchovascular, subpleural, and lower lung zonal preponderance were present in all patients. Central low attenuation (4 of 4 patients), ground-glass halo (3 of 4 patients), and peripheral enhancement (4 of 4 patients) were observed in these nodules and masses. An air-bronchogram and cavitation were seen in three of four patients. FDG-PET scans demonstrated avid FDG uptake in the pulmonary nodules and masses. Pulmonary LG presents with nodules and masses with a lymphatic distribution, as would be expected for a lymphoproliferative disease. However, central low attenuation, ground-glass halo and peripheral enhancement of the nodules/masses are likely related to the angioinvasive nature of this disease. Peripheral enhancement and ground-glass halo, in particular, are valuable characteristic not previously reported that can help radiologists suggest the diagnosis of pulmonary LG.

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  4. FDG-PET/CT in Skeletal Muscle: Pitfalls and Pathologies.

    Science.gov (United States)

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

    2017-07-01

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

  5. Comparative study of 99Tcm-ciprofloxacin scintigraphy, 18F-FDG PET and diffusion weighted imaging for detecting secondary infection associated with severe acute pancreatitis

    International Nuclear Information System (INIS)

    Wang Jianhua; Sun Gaofeng; Zhang Jian; Shao Chengwei; Pan Guixia; Peng Ye; Mao Juanli; Zheng Jianming; Zuo Changjing

    2013-01-01

    Objective: To compare the diagnostic values of 99 Tc m -ciprofloxacin SPECT, 18 F-FDG PET and MR diffusion weighted imaging (DWI) for detecting secondary infection associated with severe acute pancreatitis (SAP) in swine. Methods: Swine models were constructed and grouped, including control group (normal swine, n=6), non-infected SAP group (inoculated with inactivation Escherichia coli, n=6)and infected SAP group (inoculated with Escherichia coli, n=16). At 7 d after inoculation,a series of 99 Tc m ciprofloxacin SPECT, 18 F-FDG PET and MR DWI scans were performed. The imaging findings were visually evaluated and semi-quantitative analyzed. Lesion-background radioactive counts ratio (L/B), SUV max and the apparent diffusion coefficient (ADC) were calculated. The image results were compared with histopathological and bacteriological results, and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated. Bonferroni test, the least significant difference t test and χ 2 test were used for statistical data analysis. Results: (1) The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 99 Tc m -ciprofloxacin SPECT via visual analysis were 93.8% (15/16), 5/6, 90.9% (20/22), 93.8%(15/16) and 5/6, whereas 81.2% (13/16), 2/6, 68.2% (15/22), 76.5%(13/17) and 2/5 for 18 F-FDG PET, and 15.4% (2/13), 5/6, 36.8%(7/19), 2/3 and 31.3% (5/16) for MRI DWI respectively. Both 99 Tc m -ciprofloxacin SPECT and 18 F-FDG PET had higher sensitivities (both P>0.05), but the specificity of 18 F-FDG PET was lower. (2) 99 Tc m -ciprofloxacin imaging showed the changes of L/B for the infected SAP swine were significantly different from those of the non-infected and normal swine (F=95.66, P<0.001). 18 F-FDG PET early-phase images showed SUV max was not significantly different between infected SAP (2.61±1.07) and non-infected SAP (1.87±0.76) groups (P>0.05), but the SUV max of infected SAP group was

  6. 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

  7. Clinical Application of 18F-FDG PET in Pancreas Cancer

    International Nuclear Information System (INIS)

    Kang, Won Jun

    2008-01-01

    The prevalence of pancreas cancer is increasing. Due to difficulty in detecting early stage disease, the prognosis of pancreas cancer is known to be poor. Clinical use of FDG PET in pancreas has been reported. FDG PET showed good performance in diagnosing pancreas cancer, and is expected to be useful in staging and detecting recurrence

  8. 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...

  9. Is FDG-PET a useful tool in clinical practice for diagnosing corticobasal ganglionic degeneration?

    NARCIS (Netherlands)

    Coulier, IMF; de Vries, JJ; Leenders, KL

    2003-01-01

    Seven consecutive patients were suspected to suffer from corticobasal ganglionic degeneration (CBGD) and were studied with F-[18]-fluorodeoxyglucose (FDG) PET imaging of the brain. At the time of their FDG-PET scan, 4 of 7 patients fulfilled the clinical criteria of CBGD as proposed by Lang and

  10. Efficacy of FDG PET/CT Imaging for Venous Thromboembolic Disorders

    DEFF Research Database (Denmark)

    Hess, Søren; Madsen, Poul Henning; Iversen, Else Dalsgaard

    2015-01-01

    PURPOSE: In recent years, several case reports have described venous thromboembolism (VTE) on FDG PET/CT. In this short communication, we present results from a proof-of-concept pilot study aimed at providing some preliminary data on the efficacy of FDG PET/CT in prospective patients with suspected...

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  12. 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

  13. SPECT and PET imaging in epilepsia

    International Nuclear Information System (INIS)

    Landvogt, C.

    2007-01-01

    In preoperative localisation of epileptogenic foci, nuclear medicine diagnostics plays a crucial role. FDG-PET is used as first line diagnostics. In case of inconsistent MRI, EEG and FDG-PET findings, 11 C-Flumazenil-PET or ictal and interictal perfusion-SPECT should be performed. Other than FDG, Flumazenil can help to identify the extend of the region, which should be resected. To enhance sensitivity and specificity, further data analysis using voxelbased statistical analyses or SISCOM (substraction ictal SPECT coregistered MRI) should be performed

  14. Principal component analysis of FDG PET in amnestic MCI

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  15. Improved clinical staging of esophageal cancer with FDG-PET

    International Nuclear Information System (INIS)

    Kim, Young Hwan; Choi, Joon Young; Lee, Kyung Soo; Choi, Yong Soo; Lee, Eun Jeong; Chung, Hyun Woo; Lee, Su Jin; Lee, Kyung Han; Shim, Young Mog; Kim, Byung Tae

    2004-01-01

    Since preoperative staging in esophageal cancer is important in both therapy and prognosis, there had been many efforts to improve its accuracy. Recent studies indicate that whole body FDG-PET has high sensitivity in detection of metastasis in esophageal cancer. Therefore, we added FDG-PET to other conventional methods in staging esophageal cancer to evaluate the usefulness of this method. Subjects were 142 esophageal cancer patients (average 62.3±8.3 yrs) who received CT and PET just before operation. First, we compared N stage and M stage of the CT or PET with those of the post-operative results. Then we compared the stage according to the EUS (T stage) and CT (N and M stage) or EUS (T stage) and CT and PET (N and M stage) to that according to the post-operative results. Among 142 patients, surgical staging of 69 were N0 and 73 were N1. In M staging, 128 were M0 and 14 were M1. Sensitivity, specificity, and accuracy of N staging were 35.6%, 89.9%, 62.0% with CT and 58.9%, 71.0%, 64.7% with PET, respectively. In M staging, 14.3%, 96.9%, 88.7% with CT and 50.0%, 94.5%, 90.1% with PET, respectively. The concordances of [EUS+CT] and [EUS+CT+PET] with post-operative results were 41.2% and 54.6%, respectively and there was significant improvement of staging with additional PET scan (p<0.005). The concordance of [EUS+CT+PET] with post-operative result was significantly increased compared to that of [EUS+CT]. Thus, the addition of FDG-PET with other conventional methods may enable more accurate preoperative staging

  16. Principal component analysis of FDG PET in amnestic MCI

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-12-15

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

  17. Patterns of pulmonary tuberculosis on FDG-PET/CT

    International Nuclear Information System (INIS)

    Soussan, Michael; Brillet, Pierre-Yves; Mekinian, Arsène; Khafagy, Abrahim; Nicolas, Patrick; Vessieres, Annie; Brauner, Michel

    2012-01-01

    Objective: This study aims to describe patterns of pulmonary tuberculosis (TB) on FDG-PET/CT. Methods: All patients with a diagnosis of TB and who underwent FDG-PET/CT between January 2009 and June 2010 were included. Clinical, biological and imaging data were reviewed. TB was proven either on bacteriological or histopathological studies (n = 13) or on a clinical and imaging basis (n = 3). Results: Sixteen patients (11 men; median age 56, range 22–84 years) were included. Two distinct patterns were identified. In the lung pattern (9/16), patients had predominantly pulmonary symptoms (6/9 patients, 67%) with a parenchymal involvement: uptakes on lung consolidation ± cavitation surrounded by micronodules. Mediastino-hilar lymph nodes were slightly enlarged (15 mm, 10–27) with moderate uptake (3.9, 2.5–13.4). In the lymphatic pattern (7/16), patients had predominantly systemic symptoms (5/7 cases, 71%) and all had extra-thoracic involvement. Mediastino-hilar lymph nodes were more enlarged (30 mm, 18–35, p = 0.03) and with higher uptake (6.8, 5.7–16.8, p = 0.034) than in the lung pattern. Conclusion: We identified two distinct patterns of pulmonary TB on FDG-PET/CT. The lung pattern related to a restricted and slight hypermetabolic infection and the lymphatic pattern related to a systemic and intense infection. Combined interpretation of PET and CT findings improves the specificity of images, especially for the lung pattern

  18. Patterns of pulmonary tuberculosis on FDG-PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Soussan, Michael, E-mail: michael.soussan@avc.aphp.fr [Université Paris 13, Faculté de médecine SMBH, Department of Nuclear Medicine, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Brillet, Pierre-Yves [Université Paris 13, Faculté de médecine SMBH, Department of Radiology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Mekinian, Arsène [Université Paris 13, Faculté de médecine SMBH, Department of Internal Medicine, Hôpital Jean Verdier, Bondy (France); Khafagy, Abrahim [Université Paris 13, Faculté de médecine SMBH, Department of Radiology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Nicolas, Patrick [Université Paris 13, Faculté de médecine SMBH, Department of Pharmacology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Vessieres, Annie [Université Paris 13, Faculté de médecine SMBH, Department of Bacteriology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Brauner, Michel [Université Paris 13, Faculté de médecine SMBH, Department of Radiology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France)

    2012-10-15

    Objective: This study aims to describe patterns of pulmonary tuberculosis (TB) on FDG-PET/CT. Methods: All patients with a diagnosis of TB and who underwent FDG-PET/CT between January 2009 and June 2010 were included. Clinical, biological and imaging data were reviewed. TB was proven either on bacteriological or histopathological studies (n = 13) or on a clinical and imaging basis (n = 3). Results: Sixteen patients (11 men; median age 56, range 22–84 years) were included. Two distinct patterns were identified. In the lung pattern (9/16), patients had predominantly pulmonary symptoms (6/9 patients, 67%) with a parenchymal involvement: uptakes on lung consolidation ± cavitation surrounded by micronodules. Mediastino-hilar lymph nodes were slightly enlarged (15 mm, 10–27) with moderate uptake (3.9, 2.5–13.4). In the lymphatic pattern (7/16), patients had predominantly systemic symptoms (5/7 cases, 71%) and all had extra-thoracic involvement. Mediastino-hilar lymph nodes were more enlarged (30 mm, 18–35, p = 0.03) and with higher uptake (6.8, 5.7–16.8, p = 0.034) than in the lung pattern. Conclusion: We identified two distinct patterns of pulmonary TB on FDG-PET/CT. The lung pattern related to a restricted and slight hypermetabolic infection and the lymphatic pattern related to a systemic and intense infection. Combined interpretation of PET and CT findings improves the specificity of images, especially for the lung pattern.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-04-01

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

  20. Incremental diagnostic utility of gastric distension FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-04-15

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

  1. Incremental diagnostic utility of gastric distension FDG PET/CT

    International Nuclear Information System (INIS)

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

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  3. Optimization of radiotherapy planning for Non-Small Cell Lung Cancer (NSCLC) by {sup 18}FDG-PET; Optimierung der Bestrahlungsplanung beim nicht-kleinzelligen bronchialkarzinom (NSCLC) mit Hilfe von {sup 18}FDG-PET

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, S.; Nestle, U.; Kirsch, C.M. [Abt. fuer Nuklearmedizin, Universitaetskliniken des Saarlandes, Homburg/Saar (Germany); Walter, K. [Abt. fuer Strahlentherapie, Marienkrankenhaus Amberg (Germany); Licht, N.; Schnabel, K. [Abt. fuer Strahlentherapie, Universitaetskliniken des Saarlandes, Homburg/Saar (Germany); Ukena, D. [Innere Medizin V, Universitaetskliniken des Saarlandes, Homburg/Saar (Germany)

    2002-10-01

    einem NSCLC, die zwecks Staging mit PET untersucht worden waren. Sie wurden ueber (anhand der CT- und Bronchoskopiebefunde geplante) anterior/posteriore Gegenfelder bestrahlt, die den Primaertumor und das Mediastinum einschlossen. Die Ergebnisse der PET-Untersuchung wurden bei der Bestrahlungsplanung zunaechst nicht beruecksichtigt. Retrospektiv wurden anhand der FDG-Anreicherungen die Bestrahlungsfelder unter Beruecksichtigung der Groesse und Lokalisation des Primaertumors neu definiert, weiterhin wurde die Ausdehnung des mediastinalen Anteils der Feldkonturen auf PET-Aktivitaeten ausserhalb des Bestrahlungsfelds ueberprueft. Ergebnisse: Bei 15 von 39 Patienten unterschieden sich die CT-von den CT/PET-geplanten Bestrahlungsfeldern. In den meisten Faellen (n = 12) war das CT/PET-Feld kleiner als das CT-Feld. Die mediane Groesse der Bestrahlungsfelder betrug 179 cm{sup 2} und nach Neudefinition durch PET 166 cm{sup 2}. Bei 20 Patienten mit Tumor-verursachten Belueftungsstoerungen (Atelektosen, Dystelektosen) wurde die Aenderung des Bestrahlungsfelds signifikant haeufiger (p = 0,03) als bei den uebrigen Patienten vorgeschlagen. Schlussfolgerung: Unsere Ergebnisse zeigen den Synergismus von topographiscer (CT) und metabolischer (FDG-PET) Information, die in der Bestrahlungsplanung des Bronchialkarzinoms insbesondere bei Patienten mit Belueftungsstoerungen von Nutzen sein koennte. (orig.)

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  5. An individualized radiation dose escalation trial in non-small cell lung cancer based on FDG-PET imaging

    Energy Technology Data Exchange (ETDEWEB)

    Wanet, Marie; Goossens, Samuel; Lee, John Aldo; Janssens, Guillaume; Bol, Anne; Geets, Xavier [Universite Catholique de Louvain, Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Institut de Recherche Experimentale et Clinique, Brussels (Belgium); Delor, Antoine [Cliniques Universitaires Saint-Luc, Department of Radiation Oncology, Brussels (Belgium); Hanin, Francois-Xavier [Cliniques Universitaires Saint-Luc, Department of Nuclear Medicine, Brussels (Belgium); Ghaye, Benoit [Cliniques Universitaires Saint-Luc, Department of Radiology, Brussels (Belgium); Maanen, Aline van [Cliniques Universitaires Saint-Luc, Statistical Support Unit, Cancer Centre, Brussels (Belgium); Remouchamps, Vincent; Clermont, Christian [Clinique et Maternite Sainte Elisabeth, Department of Radiation Oncology, CHU UCL Namur (Belgium)

    2017-10-15

    late toxicity. (orig.) [German] Ziel der Studie war es, die Anwendbarkeit einer individualisierten Fluordesoxyglukose-Positronenemissionstomographie(FDG-PET)-gefuehrten partiellen Dosissteigerung beim nichtkleinzelligen Lungenkarzinom (NSCLC) zu pruefen und deren Einfluss auf die lokale Tumorkontrolle und Toxizitaet zu beurteilen. Dreizehn Patienten mit NSCLC in Stadium II-III wurden in die Studie einbezogen und erhielten im Rahmen einer Radiochemotherapie eine Dosis von 62,5 Gy in 25 Fraktionen auf das CT-basierte Planungszielvolumen (PTV; primaerer Tumor und betroffene Lymphknoten). Dabei wurde die Fraktionsdosis innerhalb des individuellen PET-basierten PTV (PTV{sub PET}) unter Anwendung einer intensitaetsmodulierten Radiotherapie (IMRT) mit simultan-integriertem Boost (SIB) bis zum Erreichen der vordefinierten Organ-at-risk(OAR)-Grenze erhoeht. In der Nachbeobachtungszeit wurde die Tumorantwort mit wiederholter FDG-PET/Computertomographie ueberprueft. Die fruehe und spaete Toxizitaet wurden erfasst und anhand der Common-Terminology-Criteria-for-Adverse-Events(CTCAE)-Kriterien (Version 4.0) klassifiziert. Das lokale progressionsfreie Ueberleben wurde anhand der Kaplan-Meier-Methode bestimmt. Die Durchschnittsdosis auf das PTV{sub PET} erreichte 89,17 Gy fuer periphere und 75 Gy fuer zentrale Tumoren. Nach einer medianen Nachbeobachtungszeit von 29 Monaten waren 7 Patienten weiterhin am Leben, 6 waren verstorben (4 davon an Fernrezidiven, 2 an einer Toxizitaet fuenften Grades). Bei 2 Patienten trat eine lokale Progression in Verbindung mit weiteren Rezidiven auf. Die lokalen progressionsfreien 1- und 2-Jahres-Ueberlebensraten lagen bei 76,9 % bzw. 52,8 %. Es wurden 3 Faelle akuter Oesophagitiden dritten Grades beobachtet. Zwei Patienten mit zentralen Tumoren entwickelten eine spaete Toxizitaet und verstarben infolge einer schwerwiegenden Haemoptyse. Gemaess diesen Ergebnissen ist fuer Patienten mit NSCLC eine im Rahmen der IMRT angewendete, auf der FDG-PET basierende

  6. Monitoring Vasculitis with 18F-FDG PET

    International Nuclear Information System (INIS)

    Jan BUCERIUS, Jan

    2016-01-01

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

  7. 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)

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

    International Nuclear Information System (INIS)

    Albano, Domenico; Bosio, Giovanni; Bertoli, Mattia; Petrilli, Giulia; Bertagna, Francesco

    2016-01-01

    Hepatosplenic candidiasis is a fungal infection, which mostly affects patients with hematologic malignancies such as leukemia. The pathogenesis of this infection is not clear yet, and the liver is the most commonly affected organ. Diagnosis of hepatosplenic candidiasis can be only established via biopsy, since computed tomography (CT) scan, ultrasonography, and magnetic resonance imaging (MRI) yield non-specific results. The role of fluorine-18 fluorodeoxyglucose positron emission tomography /computed tomography ( 18 F-FDG PET/CT) in diagnosis of hepatosplenic candidiasis remains undetermined, considering a few evidences in the literature. In this case report, we present the case of a 47-year-old patient, affected by acute myeloid leukemia, which was treated with three cycles of chemotherapy, resulting in the development of neutropenia and fever following the last cycle. The 18 F-FDG PET/CT scan showed some foci of intense FDG uptake in the liver and spleen. The subsequent diagnostic investigations (i.e., abdominal CT scan and biopsy) were suggestive of hepatosplenic candidiasis. The patient was started on antifungal treatment with fluconazole. After one month, the clinical conditions were resolved, and the subsequent abdominal CT scan was negative

  9. FDG-PET findings in the Wernicke-Korsakoff syndrome.

    Science.gov (United States)

    Reed, Laurence J; Lasserson, Dan; Marsden, Paul; Stanhope, Nicola; Stevens, Tom; Bello, Fernando; Kingsley, Derek; Colchester, Alan; Kopelman, Michael D

    2003-01-01

    This study reports FDG-PET findings in Wernicke-Korsakoff patients. Twelve patients suffering amnesia arising from the Korsakoff syndrome were compared with 10 control subjects without alcohol-related disability. Subjects received [18F]-fluorodeoxyglucose (FDG-PET) imaging as well as neuropsychological assessment and high-resolution MR imaging with volumetric analysis. Volumetric MRI analysis had revealed thalamic and mamillary body atrophy in the patient group as well as frontal lobe atrophy with relative sparing of medial temporal lobe structures. Differences in regional metabolism were identified using complementary region of interest (ROI) and statistical parametric mapping (SPM) approaches employing either absolute methods or a reference region approach to increase statistical power. In general, we found relative hypermetabolism in white matter and hypometabolism in subcortical grey matter in Korsakoff patients. When FDG uptake ratios were examined with occipital lobe metabolism as covariate reference region, Korsakoff patients showed widespread bilateral white matter hypermetabolism on both SPM and ROI analysis. When white matter metabolism was the reference covariate; Korsakoff patients showed relative hypometabolism in the diencephalic grey matter, consistent with their known underlying neuropathology, and medial temporal and retrosplenial hypometabolism, interpreted as secondary metabolic effects within the diencephalic-limbic memory circuits. There was also evidence of a variable degree of more general frontotemporal neocortical hypometabolism on some, but not all, analyses.

  10. Clinical Application of 18F-FDG PET in Ovarian Cancer

    International Nuclear Information System (INIS)

    Oh, So Won; Kim, Seok Ki

    2008-01-01

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

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

    Science.gov (United States)

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

    2013-02-01

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

  12. 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.)

  13. Concordance between brain 18F-FDG PET and cerebrospinal fluid biomarkers in diagnosing Alzheimer's disease.

    Science.gov (United States)

    Rubí, S; Noguera, A; Tarongí, S; Oporto, M; García, A; Vico, H; Espino, A; Picado, M J; Mas, A; Peña, C; Amer, G

    Cortical posterior hypometabolism on PET imaging with 18 F-FDG (FDG-PET), and altered levels of Aß 1-42 peptide, total Tau (tTau) and phosphorylated Tau (pTau) proteins in cerebrospinal fluid (CSF) are established diagnostic biomarkers in Alzheimer's disease (AD). An evaluation has been made of the concordance and relationship between the results of FDG-PET and CSF biomarkers in symptomatic patients with suspected AD. A retrospective review was carried out on 120 patients with cognitive impairment referred to our Cognitive Neurology Unit, and who were evaluated by brain FDG-PET and a lumbar puncture for CSF biomarkers. In order to calculate their Kappa coefficient of concordance, the result of the FDG-PET and the set of the three CSF biomarkers in each patient was classified as normal, inconclusive, or AD-compatible. The relationship between the results of both methods was further assessed using logistic regression analysis, including the Aß 1-42 , tTau and pTau levels as quantitative predictors, and the FDG-PET result as the dependent variable. The weighted Kappa coefficient between FDG-PET and CSF biomarkers was 0.46 (95% CI: 0.35-0.57). Logistic regression analysis showed that the Aß 1-42 and tTau values together were capable of discriminating an FDG-PET result metabolically suggestive of AD from one non-suggestive of AD, with a 91% sensitivity and 93% specificity at the cut-off line Aß 1-42 =44+1.3×tTau. The level of concordance between FDG-PET and CSF biomarkers was moderate, indicating their complementary value in diagnosing AD. The Aß 1-42 and tTau levels in CSF help to predict the patient FDG-PET cortical metabolic status. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  14. 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)

  15. Suture Granuloma Showing False-Positive Findings on FDG-PET

    Directory of Open Access Journals (Sweden)

    Kohei Takahara

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    International Nuclear Information System (INIS)

    Xie Boqia; Yang Minfu; Dou Kefei; Han Chunlei; Tian Yi; Zhang Ping; Yang Zihe; Yin Jiye; Wang Hao

    2012-01-01

    Objective: To explore whether the existence and duration of ischemia measured by dynamic 18 F-FDG PET/CT imaging correlated with the extent of myocardial ischemia in a canine model of myocardial ischemia-reperfusion. Methods: Canine coronary artery occlusion was carried out for 20 min (n=4) and for 40 min (n=4) followed by 24 h of open-artery reperfusion. All dogs underwent dynamic 18 F-FDG PET/CT and 99 Tc m -MIBI SPECT imaging at baseline and 1 h and 24 h after reperfusion.Quantitative analysis of myocardial 18 F-FDG uptake was performed using Carimas Core software,and the extraction ratio of 18 F-FDG (K) was calculated by the ratio of 18 F-FDG uptake rate in the ischemic area (k ischemia ) and normoperfused region (k normoperfused ). Echocardiographic data were also acquired between each PET/CT imaging study to detect the wall motion in the ischemic and normoperfused myocardium. Paired t test and non-parametric statistical tests, measured by SPSS 19.0, were used to analyze the data. Results: Coronary occlusion produced sustained, abnormal wall motion in the ischemic region for more than 1 h. Similar K values were demonstrated between the 20 min and 40 min groups at baseline (1.02 ±0.06 and 1.03 ±0.05, Z=-0.29, P>0.05). At 1 h after reperfusion, the reperfusion regions showed normal perfusion but with increased 18 F-FDG uptake, which was higher in the 40 min ischemic group than in the 20 min ischemic group (2.31 ±0.13 and 1.87 ±0.09, Z=-2.31, P<0.05). At 24 h after reperfusion, however, only the 40 min ischemic group showed slightly higher 18 F-FDG uptake than baseline (1.15 ± 0.02 and 1.03 ±0.05, t=4.32, P<0.05), whereas no significant difference was found in the 20 min ischemic group (1.05 ± 0.04 and 1.02 ± 0.06, t=0.87, P>0.05). Histological examination of the ischemic myocardium from both groups revealed neatly arranged cells without interstitial edema, hemorrhage nor inflammatory response. Conclusions: Myocardial 'ischemic memory' was

  18. Early clinical experience and impact of 18F-FDG PET

    DEFF Research Database (Denmark)

    Gutte, Henrik; Højgaard, Liselotte; Kjaer, Andreas

    2005-01-01

    PURPOSE: To determine the influence and impact of [F]- fluorodeoxyglucose positron emission tomography (FDG PET) in Denmark. METHODS: A standardized questionnaire was sent to the referring physicians of 743 consecutive cases between January 2000 and December 2001. The questionnaire was designed...... to determine whether and how the results of the FDG PET imaging changed patient management. RESULTS: The response rate was 71% (524 responded). The distribution of all responding physicians included 26 different specialities. The majority were from haematology (23%), oncology (20%), plastic surgery (17...... confirmed the diagnosis, helped staging, changed treatment plan or confirmed treatment of choice. Physicians indicated a general satisfaction with FDG PET imaging in 86% of the cases. CONCLUSION: This survey-based study indicates that FDG PET imaging has a major impact on patient management, contributing...

  19. (18)F-FDG PET/CT in a rare case of Stewart-Treves syndrome

    DEFF Research Database (Denmark)

    Jensen, Mads Radmer; Friberg, Lars; Karlsmark, Tonny

    2011-01-01

    The aim of this article is to illustrate the possible applications of (18)F-fluorodeoxyglucose positron emission tomography/computer tomography ((18)F-FDG PET/CT) in chronic extremity lymphedema and its complications....

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  1. Clinical Application of 18F-FDG PET in Alzheimer's Disease

    International Nuclear Information System (INIS)

    Ryu, Young Hoon

    2008-01-01

    PET of the cerebral metabolic rate of glucose is increasingly used to support the clinical diagnosis in the examination of patients with suspected major neurodegenerative disorders, such as Alzheimer's disease. 18 F-FDG PET has been reported to have high diagnostic performance, especially, very high sensitivity in the diagnosis and clinical assessment of therapeutic efficacy. According to clinical research data hitherto, 18 F-FDG PET is expected to be an effective diagnostic tool in early and differential diagnosis of Alzheimer's disease. Since 2004, Medicare covers 18 F-FDG PET scans for the differential diagnosis of fronto-temporal dementia (FTD) and Alzheimer's disease (AD) under specific requirements; or, its use in a CMS approved practical clinical trial focused on the utility of 18 F-FDG PET in the diagnosis or treatment of dementing neurodegenerative diseases

  2. F-18-FDG-PET in autonomous goiter

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  3. 18FDG PET and ultrasound echolucency in carotid artery plaques

    DEFF Research Database (Denmark)

    Graebe, Martin; Pedersen, Sune F; Højgaard, Liselotte

    2010-01-01

    OBJECTIVES: The objective was to evaluate inflammation in echolucent carotid artery plaques. BACKGROUND: Ultrasound echolucency of carotid artery plaques has been proven to differentiate patients at high risk of stroke. On the other hand, positron emission tomography (PET) of plaques with the use...... for ultrasound and PET imaging. Plaque standardized gray scale medians (GSM) were measured in longitudinal ultrasound images to quantitate echolucency, and GSM values were compared with FDG PET uptake quantified by maximum standardized uptake values (SUV). Symptomatic plaques were compared with contralateral...... plaques ranged from high to low inflammatory activity, as depicted with PET. Quantitative FDG SUV differentiated asymptomatic from symptomatic plaques, whereas GSM values did not. There was a positive correlation between CD68 expression and FDG uptake (r = 0.50, p = 0.04). CONCLUSIONS: Our results...

  4. Peritoneal Lymphomatosis Imaged by F-18 FDG PET/CT

    International Nuclear Information System (INIS)

    Park, Eun Kyung; Lee, Se Ryeon; Kim, Young Chul; Oh, Sun Young; Choe, Jae Gol

    2010-01-01

    Peritoneal lymphomatosis is uncommon, but when encountered is associated with aggressive histological subtypes of high-grade lymphoma, such as small-cell, large-cell, mixed large and small cell, non-cleaved, lymphoblastic Burkitt-like, and diffuse large B-cell lymphomas. The CT findings of peritoneal lymphomatosis are linear or nodular peritoneal thickening, retroperitoneal lymphadenopathy, omental and mesenteric involvement with streak-like infiltrations or a bulky mass, bowel wall thickening, hepatosplenomegaly, and ascites. The authors reports report the first FDG PET/CT images of diffuse large B-cell lymphoma of small bowel origin associated with peritoneal lymphomatosis in a 69-year-old man. The lesions demonstrated intense FDG uptake in PET/CT images.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-12-15

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

  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. 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.

  8. 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.

  9. 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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2018-05-19

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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2018-03-15

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

  14. Detection of Thyroid Metastasis pf Renal Transitional Cell Carcinoma Using FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Il; Kim, Yu Kyeong; Kim, Sang Eun [Seoul National Univ. Bundang Hospital, Seoul (Korea, Republic of); Lee, Jong Jin [Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of); Paik, Jin Ho [Seoul National Univ. Bundang Hospital, Seoul (Korea, Republic of)

    2011-06-15

    A 69 year old man who was diagnosed with renal transitional cell carcinoma (TCC) underwent F 18 fluorodeoxyglucose (FDG) positron emission tomography with computed tomography (PET/CT) for detecting recurrence after chemotherapy. FDG PET/CT revealed multiple new hypermetabolic lesions in many places, including the right thyroid gland. Biopsy of the thyroid lesion was performed,and a diagnosis of metastatic TCC was made. We could detect thyroid metastasis of renal TCC by FDG PET/CT.

  15. Incidental Detection of Urinary Leakage on FDG PET/CT Imaging for Staging of Gastric Cancer.

    Science.gov (United States)

    Kim, Dae-Weung; Kim, Myoung Hyoun; Kim, Chang Guhn

    2016-03-01

    A 71-year-old woman presented to the emergency department with right flank pain and dysuria. An abdominal CT scan detected a gastric malignancy and hydronephrosis with urinary leakage of the right kidney. Percutaneous nephrostomy was performed on the right kidney. F-FDG PET/CT for staging the gastric malignancy revealed additional urinary leakage of the contralateral kidney. The interest in this case is the incidental detection of unexpected urinary leakage during an oncologic assessment with FDG PET/CT.

  16. FDG-PET/CT imaging of elastofibroma dorsi

    International Nuclear Information System (INIS)

    Onishi, Yumiko; Maeda, Tetsuo; Yoshikawa, Takeshi; Ohno, Yoshiharu; Sugimura, Kazuro; Kitajima, Kazuhiro; Suzuki, Kayo; Senda, Michio; Sakamoto, Setsu

    2011-01-01

    The purpose of this study was to assess retrospectively the characteristics of FDG uptake in elastofibroma dorsi using integrated PET/CT. From 10,261 oncology FDG-PET/CT scans performed over a 2-year period, findings suggestive of elastofiboma dorsi were observed in 46 FDG-PET/CT scans of 34 patients. As 20 patients had bilateral lesions and 14 had unilateral lesions, a total of 75 elastofibroma dorsi lesions on images were identified in this study. For visual analysis of intensity of FDG uptake, a four-point grading system was used: grade 0 for no uptake, grade 1 for less uptake than the liver, grade 2 for uptake comparable to the liver, and grade 3 for intense uptake greater than the liver. For quantitative analysis, the standardized uptake value (SUV) was calculated. The relationships between SUV and age, blood glucose level, lesion size, and related symptoms were also assessed. Among the 75 lesions, 4 had an uptake grade of 0, 41 had grade 1, 25 had grade 2, and 5 had grade 3. The mean SUV (±SD) of the 75 lesions was 2.0 ± 0.63 (range 0-5.1). The Pearson correlation coefficient test indicated a weak positive correlation between SUV and lesion size and no correlation between SUV and either age or blood glucose level. The SUVs of patients with symptoms due to the disease and patients without symptoms were almost the same. Mild and moderate uptake of FDG is frequently observed in elastofibroma dorsi, which should not be misinterpreted as abnormal accumulation observed in malignant lesions. (orig.)

  17. 18FDG PET scanning of benign and malignant musculoskeletal lesions

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  18. FDG-PET/CT imaging of elastofibroma dorsi

    Energy Technology Data Exchange (ETDEWEB)

    Onishi, Yumiko; Maeda, Tetsuo; Yoshikawa, Takeshi; Ohno, Yoshiharu; Sugimura, Kazuro [Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Kitajima, Kazuhiro; Suzuki, Kayo [Institute of Biomedical Research and Innovation, Department of PET Diagnosis, Kobe (Japan); Senda, Michio [Institute of Biomedical Research and Innovation, Department of Molecular Imaging, Kobe (Japan); Sakamoto, Setsu [Dokkyo Medical University Hospital, Department of PET Center, Mibu (Japan)

    2011-07-15

    The purpose of this study was to assess retrospectively the characteristics of FDG uptake in elastofibroma dorsi using integrated PET/CT. From 10,261 oncology FDG-PET/CT scans performed over a 2-year period, findings suggestive of elastofiboma dorsi were observed in 46 FDG-PET/CT scans of 34 patients. As 20 patients had bilateral lesions and 14 had unilateral lesions, a total of 75 elastofibroma dorsi lesions on images were identified in this study. For visual analysis of intensity of FDG uptake, a four-point grading system was used: grade 0 for no uptake, grade 1 for less uptake than the liver, grade 2 for uptake comparable to the liver, and grade 3 for intense uptake greater than the liver. For quantitative analysis, the standardized uptake value (SUV) was calculated. The relationships between SUV and age, blood glucose level, lesion size, and related symptoms were also assessed. Among the 75 lesions, 4 had an uptake grade of 0, 41 had grade 1, 25 had grade 2, and 5 had grade 3. The mean SUV ({+-}SD) of the 75 lesions was 2.0 {+-} 0.63 (range 0-5.1). The Pearson correlation coefficient test indicated a weak positive correlation between SUV and lesion size and no correlation between SUV and either age or blood glucose level. The SUVs of patients with symptoms due to the disease and patients without symptoms were almost the same. Mild and moderate uptake of FDG is frequently observed in elastofibroma dorsi, which should not be misinterpreted as abnormal accumulation observed in malignant lesions. (orig.)

  19. 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.)

  20. 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.

  1. Clinical utility of FDG-PET in amyotrophic lateral sclerosis and Huntington's disease.

    Science.gov (United States)

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

    2018-05-01

    To evaluate the incremental value of FDG-PET over clinical tests in: (i) diagnosis of amyotrophic lateral sclerosis (ALS); (ii) picking early signs of neurodegeneration in patients with a genetic risk of Huntington's disease (HD); and detecting metabolic changes related to cognitive impairment in (iii) ALS and (iv) HD patients. Four comprehensive literature searches were conducted using the PICO model to extract evidence from relevant studies. An expert panel then voted using the Delphi method on these four diagnostic scenarios. The availability of evidence was good for FDG-PET utility to support the diagnosis of ALS, poor for identifying presymptomatic subjects carrying HD mutation who will convert to HD, and lacking for identifying cognitive-related metabolic changes in both ALS and HD. After the Delphi consensual procedure, the panel did not support the clinical use of FDG-PET for any of the four scenarios. Relative to other neurodegenerative diseases, the clinical use of FDG-PET in ALS and HD is still in its infancy. Once validated by disease-control studies, FDG-PET might represent a potentially useful biomarker for ALS diagnosis. FDG-PET is presently not justified as a routine investigation to predict conversion to HD, nor to detect evidence of brain dysfunction justifying cognitive decline in ALS and HD.

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  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. {sup 18}F-FDG PET independently predicts survival in patients with cholangiocellular carcinoma treated with {sup 90}Y microspheres

    Energy Technology Data Exchange (ETDEWEB)

    Haug, Alexander R. [Ludwig-Maximilians-University, Department of Nuclear Medicine, Munich (Germany); Klinikum Grosshadern, Department of Nuclear Medicine, Munich (Germany); Heinemann, Volker [Ludwig-Maximilians-University, Department of Internal Medicine III, Munich (Germany); Bruns, Christiane J. [Ludwig-Maximilians-University, Department of Surgery, Munich (Germany); Hoffmann, Ralf; Jakobs, Tobias [Ludwig-Maximilians-University, Institute of Clinical Radiology, Munich (Germany); Bartenstein, Peter; Hacker, Marcus [Ludwig-Maximilians-University, Department of Nuclear Medicine, Munich (Germany)

    2011-06-15

    {sup 90}Y radioembolization has emerged as a valuable therapy for intrahepatic cholangiocellular carcinomas (ICC). We aimed to evaluate the prognostic power of FDG PET/CT and that of pretherapeutic scintigraphy with {sup 99m}Tc-labelled macroagglutinated albumin (MAA), an index of tumour vascularization. The study group comprised 26 consecutive patients suffering from nonresectable ICC. Before treatment with radioembolization, all patients underwent MRI of the liver, as well as MAA scintigraphy, which was followed immediately by SPECT(/CT) to quantify the liver-lung shunt fraction. Using image fusion, regions of interest were drawn around the tumours and the entire liver, and the tumour-to-liver quotient was calculated. In addition, FDG PET/CT was performed at baseline and 3 months after radioembolization, and the percentage changes in peak ({delta}SUV{sub max}) and mean ({delta}SUV{sub mean}) FDG uptake and in metabolic tumour volume ({delta}Vol{sub 2SD}) relative to baseline were calculated. Treatment response at 3 months was also assessed using contrast-enhanced MRI and CT on the basis of standard criteria. Of 23 patients in whom follow-up MRI was available, 5 (22%) showed a partial response, 15 (65%) stable disease and 3 (13%) progressive disease. The change in all FDG values significantly predicted survival by Kaplan-Meier analysis after radioembolization; {delta}Vol{sub 2SD} responders had a median survival of 97 weeks versus 30 weeks in nonresponders (P = 0.02), whereas {delta}SUV{sub max} and {delta}SUV{sub mean} responders had a median survival of 114 weeks (responder) versus 19 weeks (nonresponder) and 69 weeks in patients with stable disease (P < 0.05). Pretherapeutic MAA scintigraphy or MRI did not predict survival, nor did the presence of extrahepatic metastases, or prior therapies. Only {delta}Vol{sub 2SD} was significantly associated with survival by univariate analysis (hazard ratio 0.25; P = 0.04) and multivariate analysis (hazard ratio 0.20, P = 0

  5. Evaluation of myocardial viability with 99Tcm-tetrofosmin after nitrate administration: comparison with FDG PET imaging

    International Nuclear Information System (INIS)

    He Wei; Cuocolo, A.

    2007-01-01

    Objective: The purpose of this study was to assess the relationship between tetrofosmin uptake after nitrate administration and the metabolic activity assessed by 18 F-FDG PET in patients with ischemic left ventricular (LV) dysfunction. Methods: A baseline 99 Tc m -tetrofosmin SPECT at rest and a repeated study after sublingual administration of 10 mg isosorbide dinitrate within two days were undertaken in 36 patients with chronic myocardial infarction and LV dysfunction. All patients underwent metabolic PET imaging with 18 F-FDG in the following week. 99 Tc m -tetrofosmin uptake and metabolic activity in 13 segments of myocardium were measured in every patient. A 55% peak activity on tetrofosmin and 50% peak activity on FDG were used as the differential threshold in evaluating myocardial viability, and the uptakes compared with regional LV function assessed by echocardiography. Results: Fifty-three (40%) of the 131 akinetic or dyskinetic segments had reduced tracer uptake. Of those segments, 14 (26%) segments showed increased tetrofosmin uptake after nitrate intervention (>10% vs baseline), 39 (74%) segments remained no change. The sensitivity and specificity of baseline tetrofosmin SPECT for detecting preserved metabolic activity were 69% and 86%, respectively. After nitrate administration, the sensitivity increased to 81% (P 99 Tc m -tetrofosmin SPECT after nitrate administration may improve the identification of ischemic but still viable myocardium in patients with chronic ischemic LV dysfunction. (authors)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-11-15

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

  7. Modification of staging and treatment of head and neck cancer by FDG-PET/CT prior to radiotherapy

    International Nuclear Information System (INIS)

    Abramyuk, A.; University Hospital Dresden; Appold, S.; Zoephel, K.; Baumann, M.; University Hospital Dresden; Abolmaali, N.; University Hospital Dresden

    2013-01-01

    Background and purpose: Reliable tumor staging is a fundamental pre-requisite for efficient tumor therapy and further prognosis. The aim of this study was to compare head and neck cancer (HNC) staging before and after FDG-PET/CT, evaluating the stage modifications for radiotherapy (RT) planning. Patients and methods: A total of 102 patients with untreated primary HNC, who underwent conventional staging and staging including FDG-PET/CT before RT, were enrolled in this retrospective study. Blinded pre-FDG-PET/CT and post-FDG-PET/CT staging data were compared. The impact on patient management was tested by comparing the intention before and after FDG-PET/CT. Results: Significant modifications of T, N, and M stage as well as clinical stage were detected after inclusion of FDG-PET/CT data (p = 0.002, 0.0006, 0.001, 0.03, respectively). Overall, the implementation of FDG-PET/CT led to modification of RT intention decision in 14 patients. Conclusions: FDG-PET/CT demonstrates essential influence on tumor staging in HNC patients scheduled for irradiation. Implementation of FDG-PET/CT in imaging protocol improves selection of candidates for curative and palliative RT and allows further optimization of treatment management and therapy intention. (orig.)

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  9. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-03-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  14. Concomitant intraarterial chemoradiotherapy for head and neck cancer evaluated by FDG-PET

    Energy Technology Data Exchange (ETDEWEB)

    Kitagawa, Yoshimasa; Yonekura, Yoshiharu; Sano, Kazuo; Maruta, Yoshihiro; Ogasawara, Toshiyuki; Ogawa, Toru; Yoshida, Masanori [Fukui Medical Univ., Matsuoka (Japan)

    2000-03-01

    To evaluate the effectiveness of combined intraarterial chemotherapy (THP-ADM, 5-FU, and carboplatin) and radiotherapy on head and neck squamous cell carcinomas using positron emission tomography with {sup 18}F labeled fluorodeoxyglucose (FDG-PET). Twenty-three patients with squamous cell carcinoma of the head and neck were included in the study. All patients completed the treatment regimen, and underwent 2 FDG-PET prior to and 4 weeks after chemoradiotherapy. The pre- and posttreatment PET images were compared with clinical and histopathological evaluations of the treatment effect. For the quantitative evaluation of regional radioactivity, standardized uptake values (SUVs) were used. The overall clinical response rate to the chemoradiotherapy was 100% (CR rate: 78.3%). Prior to treatment, FDG-PET detected neoplasms in all 23 patients. The neoplastic lesions showed high SUVs (mean: 9.15 mg/ml) prior to treatment, which significantly decreased after therapy (3.60 mg/ml, p<0.01, paired student t-test). Lesions with higher pretreatment SUVs (greater than 7 mg/ml) showed residual viable tumor cells after treatment in 4 out of 15 patients, whereas those with lower SUVs (less than 7 mg/ml 8 patients) were successfully treated. Four out of 9 tumors with posttreatment SUVs greater than 4 mg/ml had viable tumor cells, whereas all (14/14) tumors with post-SUVs less than 4 mg/ml showed no viable cells. With concomitant chemoradiotherapy monitored by FDG-PET, 8 patients avoided operation altogether, and the remaining 15 patients underwent a reduced form of surgery. Twenty patients survived (20/23, 87%) without recurrence. Concomitant chemoradiotherapy is effective for head and neck carcinoma. Pretreatment FDG-PET is useful for predicting the response to treatment. Posttreatment FDG-PET can evaluate residual viable cells. Thus FDG-PET is a valuable tool in the treatment of head and neck tumors. (author)

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2018-04-30

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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  19. 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)

  20. Comparison of F-18 FDG PET and I-131 whole body scan in diagnosis of suspicious metastatic thyroid carcinoma

    International Nuclear Information System (INIS)

    Seok, Ju Won; Chung, June Key

    2005-01-01

    There are several reports about the usefulness of F-18 FDG PET in thyroid cancer. The aim of this study was to evaluate the effectiveness of F-18 FDG PET and I-131 whole body scan in suspicious metastatic thyroid cancer. There were 46 patients (11 men, 35 women; age range, 18-74yr; mean age, 47.3yr) with suspicious metastatic thyroid cancer after total thyroidectomy who performed FDG PET and I-131 scan. The interval of FDG PET and I-131 scan was within 6 months. An overall clinical evaluation was performed including cytology, thyroglobulin level, sonography, MRI and CT. Metastatic regions were divided into four areas: neck, mediastinum, lung and bone. Among 46 patients, the number of patients, metastatic lesions were detected, totaled 36 (78.3%). Twenty-nine patients (63.0%) were detected by FDG PET and 18 patients (39.1%) were detected by I-131 scan. Twenty-one patients were detected in neck by two methods. Nineteen patients (90.5%) were detected by FDG PET and 7 patients (33.3%) were detected by I-131 scan. Eighteen patients were detected in mediastinum by two methods. Ten patients (55.5%) were detected by FDG PET and 10 patients (55.5%) were detected by I-131 scan. Ten patients were detected in lung by two methods. Nine patients (90.0%) were detected by FDG PET and 3 patients (30.0%) were detected by I-131 scan. Three patients were detected in bone by two methods. Three patients (100%) were detected by FDG PET and 0 patients (0%) were detected by I-131 scan. These data indicate that for detecting metastatic lesions, F-18 FDG PET and I-131 whole body scan may provide complementary information. Thus, the combination of FDG PET and I-131 scan is the method of choice for detecting suspicious metastatic thyroid cancer after total thyroidectomy

  1. 18F-FDG PET as a single imaging modality in pediatric neuroblastoma. Comparison with abdomen CT and bone scintigraphy

    International Nuclear Information System (INIS)

    Choi, Yun Jung; Hwang, Hee Sung; Kim, Hyun Jeong; Jeong, Yong Hyu; Cho, Arthur; Lee, Jae Hoon; Yun, Mijin; Lee, Jong Doo; Kang, Won Jun

    2014-01-01

    The purpose of this study was to evaluate the diagnostic performance of 18 F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) as a single imaging agent in neuroblastoma in comparison with other imaging modalities. A total of 30 patients with pathologically proven neuroblastoma who underwent FDG PET for staging were enrolled. Diagnostic performance of FDG PET and abdomen CT was compared in detecting soft tissue lesions. FDG PET and bone scintigraphy (BS) were compared in bone metastases. Maximal standardized uptake value (SUVmax) of primary or recurrent lesions was calculated for quantitative analysis. Tumor FDG uptake was detected in 29 of 30 patients with primary neuroblastoma. On initial FDG PET, SUVmax of primary lesions were lower in early stage (I-II) than in late stage (III-IV) (3.03 vs. 5.45, respectively, p=0.019). FDG PET was superior to CT scan in detecting distant lymph nodes (23 vs. 18 from 23 lymph nodes). FDG PET showed higher accuracy to identify bone metastases than BS both on patient-based analyses (100 vs. 94.4% in sensitivity, 100 vs. 77.8% in specificity), and on lesion-based analyses (FDG PET: 203 lesions, BS: 86 lesions). Sensitivity and specificity of FDG PET to detect recurrence were 87.5% and 93.8, respectively. FDG PET was superior to CT in detecting distant LN metastasis and to BS in detecting skeletal metastasis in neuroblastoma. BS might be eliminated in the evaluation of neuroblastoma when FDG PET is performed. (author)

  2. Can FDG-PET/CT replace blind bone marrow biopsy of the posterior iliac crest in Ewing sarcoma?

    International Nuclear Information System (INIS)

    Kasalak, Oemer; Glaudemans, Andor W.J.M.; Overbosch, Jelle; Kwee, Thomas C.; Jutte, Paul C.

    2018-01-01

    To determine and compare the value of 18 F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) to blind bone marrow biopsy (BMB) of the posterior iliac crest in detecting metastatic bone marrow involvement in newly diagnosed Ewing sarcoma. This retrospective study included 20 patients with newly diagnosed Ewing sarcoma who underwent pretreatment FDG-PET/CT and a total of 38 blind BMBs (two unilateral and 18 bilateral) of the posterior iliac crest. FDG-PET/CT scans were evaluated for bone marrow involvement, both in the posterior iliac crest and other sites, and compared to blind BMB results. FDG-PET/CT was positive for bone marrow involvement in 7/38 posterior iliac crests, whereas BMB was positive in 5/38 posterior iliac crests. FDG-PET/CT and BMB results in the posterior iliac crest agreed in 36/38 cases (94.7%, 95% confidence interval [CI]: 82.7-98.5%). On a patient level, FDG-PET/CT was positive for bone marrow involvement in 4/20 patients, whereas BMB of the posterior iliac crest was positive in 3/20 patients. On a patient level, FDG-PET/CT and BMB results agreed in 19/20 patients (95.0%, 95% CI: 76.4-99.1%). The only discrepancies between FDG-PET/CT and BMB were observed in two BMBs of one patient. Both BMBs in this patient were negative, whereas FDG-PET/CT indicated bilateral posterior iliac crest involvement and also extensive bone marrow involvement elsewhere. FDG-PET/CT appears to be a valuable method for metastatic bone marrow assessment in newly diagnosed Ewing sarcoma. The routine use of blind BMB of the posterior iliac crest should be reconsidered when FDG-PET/CT is available. (orig.)

  3. Can FDG-PET/CT replace blind bone marrow biopsy of the posterior iliac crest in Ewing sarcoma?

    Energy Technology Data Exchange (ETDEWEB)

    Kasalak, Oemer; Glaudemans, Andor W.J.M.; Overbosch, Jelle; Kwee, Thomas C. [University of Groningen, Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen (Netherlands); Jutte, Paul C. [University of Groningen, Department of Orthopedics, University Medical Center Groningen (Netherlands)

    2018-03-15

    To determine and compare the value of {sup 18}F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) to blind bone marrow biopsy (BMB) of the posterior iliac crest in detecting metastatic bone marrow involvement in newly diagnosed Ewing sarcoma. This retrospective study included 20 patients with newly diagnosed Ewing sarcoma who underwent pretreatment FDG-PET/CT and a total of 38 blind BMBs (two unilateral and 18 bilateral) of the posterior iliac crest. FDG-PET/CT scans were evaluated for bone marrow involvement, both in the posterior iliac crest and other sites, and compared to blind BMB results. FDG-PET/CT was positive for bone marrow involvement in 7/38 posterior iliac crests, whereas BMB was positive in 5/38 posterior iliac crests. FDG-PET/CT and BMB results in the posterior iliac crest agreed in 36/38 cases (94.7%, 95% confidence interval [CI]: 82.7-98.5%). On a patient level, FDG-PET/CT was positive for bone marrow involvement in 4/20 patients, whereas BMB of the posterior iliac crest was positive in 3/20 patients. On a patient level, FDG-PET/CT and BMB results agreed in 19/20 patients (95.0%, 95% CI: 76.4-99.1%). The only discrepancies between FDG-PET/CT and BMB were observed in two BMBs of one patient. Both BMBs in this patient were negative, whereas FDG-PET/CT indicated bilateral posterior iliac crest involvement and also extensive bone marrow involvement elsewhere. FDG-PET/CT appears to be a valuable method for metastatic bone marrow assessment in newly diagnosed Ewing sarcoma. The routine use of blind BMB of the posterior iliac crest should be reconsidered when FDG-PET/CT is available. (orig.)

  4. [{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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-02-15

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

  6. 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

  7. FDG-PET imaging for the staging and follow-up of small cell lung cancer

    International Nuclear Information System (INIS)

    Schumacher, T.; Brink, I.; Mix, M.; Reinhardt, M.; Moser, E.; Nitzsche, E.; Herget, G.; Digel, W.; Henke, M.

    2001-01-01

    The staging procedures for small cell lung cancer do not differ appreciably from those for other forms of lung cancer. For practical purposes, the TNM stages are usually collapsed into a simple binary classification: limited disease and extensive disease. This study was performed to answer the question of whether fluorine-18 labelled 2-deoxy-2-D-glucose positron emission tomography (FDG-PET) imaging permits appropriate work-up (including both primary and follow-up staging) of patients presenting with small cell lung cancer, as compared with currently recommended staging procedures. Thirty-six FDG-PET examinations were performed in 30 patients with histologically proven small cell lung cancer. Twenty-four patients were examined for primary staging while four were imaged for therapy follow-up only. Two patients underwent both primary staging and up to four examinations for therapy follow-up. Static PET imaging was performed according to a standard protocol. Image reconstruction was based on an ordered subset expectation maximization algorithm including post-injection segmented attenuation correction. Results of FDG-PET were compared with those of the sum of other staging procedures. Identical results from FDG-PET and the sum of the other staging procedures were obtained in 23 of 36 examinations (6 x limited disease, 12 x extensive disease, 5 x no evidence of disease). In contrast to the results of conventional staging, FDG-PET indicated extensive disease resulting in an up-staging in seven patients. In one patient in whom there was no evidence for tumour on conventional investigations following treatment, FDG-PET was suggestive of residual viability of the primary tumour. Furthermore, discordant results were observed in five patients with respect to lung, bone, liver and adrenal gland findings, although in these cases the results did not affect staging as limited or extensive disease. Moreover, FDG-PET appeared to be more sensitive for the detection of metastatic

  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. Clinical Applications of FDG PET and PET/CT in Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    Akram Al-Ibraheem

    2009-01-01

    Full Text Available 18F-FDG PET plays an increasing role in diagnosis and management planning of head and neck cancer. Hybrid PET/CT has promoted the field of molecular imaging in head and neck cancer. This modality is particular relevant in the head and neck region, given the complex anatomy and variable physiologic FDG uptake patterns. The vast majority of 18F-FDG PET and PET/CT applications in head and neck cancer related to head and neck squamous cell carcinoma. Clinical applications of 18F-FDG PET and PET/CT in head and neck cancer include diagnosis of distant metastases, identification of synchronous 2nd primaries, detection of carcinoma of unknown primary and detection of residual or recurrent disease. Emerging applications are precise delineation of the tumor volume for radiation treatment planning, monitoring treatment, and providing prognostic information. The clinical role of 18F-FDG PET/CT in N0 disease is limited which is in line with findings of other imaging modalities. MRI is usually used for T staging with an intense discussion concerning the preferable imaging modality for regional lymph node staging as PET/CT, MRI, and multi-slice spiral CT are all improving rapidly. Is this review, we summarize recent literature on 18F-FDG PET and PET/CT imaging of head and neck cancer.

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  12. Clinical utility of FDG-PET for the differential diagnosis among the main forms of dementia.

    Science.gov (United States)

    Nestor, Peter J; Altomare, Daniele; Festari, Cristina; Drzezga, Alexander; Rivolta, Jasmine; Walker, Zuzana; Bouwman, Femke; Orini, Stefania; Law, Ian; Agosta, Federica; Arbizu, Javier; Boccardi, Marina; Nobili, Flavio; Frisoni, Giovanni Battista

    2018-05-07

    To assess the clinical utility of FDG-PET as a diagnostic aid for differentiating Alzheimer's disease (AD; both typical and atypical forms), dementia with Lewy bodies (DLB), frontotemporal lobar degeneration (FTLD), vascular dementia (VaD) and non-degenerative pseudodementia. A comprehensive literature search was conducted using the PICO model to extract evidence from relevant studies. An expert panel then voted on six different diagnostic scenarios using the Delphi method. The level of empirical study evidence for the use of FDG-PET was considered good for the discrimination of DLB and AD; fair for discriminating FTLD from AD; poor for atypical AD; and lacking for discriminating DLB from FTLD, AD from VaD, and for pseudodementia. Delphi voting led to consensus in all scenarios within two iterations. Panellists supported the use of FDG-PET for all PICOs-including those where study evidence was poor or lacking-based on its negative predictive value and on the assistance it provides when typical patterns of hypometabolism for a given diagnosis are observed. Although there is an overall lack of evidence on which to base strong recommendations, it was generally concluded that FDG-PET has a diagnostic role in all scenarios. Prospective studies targeting diagnostically uncertain patients for assessing the added value of FDG-PET would be highly desirable.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-09-01

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

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

    DEFF Research Database (Denmark)

    Prakash, Vineet; Vestergård, Karsten; Frost, Majbritt

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

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

    Science.gov (United States)

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

    2016-06-01

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

  16. Clinical and diagnostic value of preoperative MR mammography and FDG-PET in suspicious breast lesions

    International Nuclear Information System (INIS)

    Walter, C.; Scheidhauer, K.; Theissen, P.; Scharl, A.; Goering, U.J.; Kugel, H.; Krahe, T.; Pietrzyk, U.

    2003-01-01

    Dynamic enhanced magnetic resonance (MR) mammography and fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) of the breast were directly compared preoperatively in suspicious breast lesions. Forty-two breast lesions in 40 patients were examined with a three-dimensional dynamic MR imaging series and FDG-PET. The MR and PET examinations were evaluated separately and the results were compared with the histological findings. The sensitivity and specificity of each method were calculated. The diagnostic value of both modalities as single diagnostic tool and in combination was investigated. Nineteen malignant and 23 benign breast lesions were proven histologically. Magnetic resonance mammography and FDG-PET showed a sensitivity of 89 and 63%, respectively. The specificity was 74 and 91%, respectively. The combination of both imaging methods decreased the not-required biopsies from 55 to 17%. Only one false-negative finding - a patient pre-treated with chemotherapy - was observed in both methods. The combination of MR mammography and FDG-PET can help to decrease biopsies of benign breast lesions. Because of their high cost, these modalities should only be used in problematic cases to either rule out or to demonstrate malignancy. The best diagnostic strategy is achieved using MR mammography first. If the diagnosis is still questionable, FDG-PET can be performed. (orig.)

  17. Effect of glucose level on brain FDG-PET images

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-06-15

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

  18. FDG PET/CT features of ovarian metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, K., E-mail: kitajima@med.kobe-u.ac.j [Department of PET Diagnosis, Institute of Biomedical Research and Innovation, Kobe (Japan); Suzuki, K. [Department of PET Diagnosis, Institute of Biomedical Research and Innovation, Kobe (Japan); Senda, M. [Department of Molecular Imaging, Institute of Biomedical Research and Innovation, Kobe (Japan); Kita, M. [Department of Obsterics and Gynecology, Kobe City Medical Center General Hospital, Kobe (Japan); Onishi, Y.; Maeda, T.; Yoshikawa, T.; Ohno, Y.; Sugimura, K. [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan)

    2011-03-15

    Aim: To assess the characteristics of [{sup 18}F]-fluoro-2-deoxy-D-glucose (FDG) uptake in cases of ovarian metastasis using positron-emission tomography/computed tomography (PET/CT). Materials and methods: Twelve patients with 16 ovarian metastases arising from colon cancer (n = 6), breast cancer (n = 4), gastric cancer (n = 3), and pancreatic cancer (n = 3) who underwent FDG-PET/CT examination were included in this study. The effect of lesion size and morphological pattern (predominantly solid or cystic) on FDG uptake was evaluated using the quantitative standardized uptake value (SUV). Results: The mean maximum SUV for the 16 lesions was 4.6 {+-} 2.4 (range 1.8 {approx} 9.9). The Pearson correlation coefficient test showed no significant correlation between maximum SUV and lesion size (r = 0.21, p = 0.42). The maximum SUV of solid (n = 5) and cystic (n = 11) lesions was 5.5 {+-} 2.7 and 4.3 {+-} 2.2, respectively, and the difference was not significant (p = 0.43). Breast cancer showed the highest maximum SUV (6.4 {+-} 3.6), followed by colon cancer (5.3 {+-} 1.4), gastric cancer (3.3 {+-} 0.5), and pancreatic cancer (2.2 {+-} 0.6). Conclusion: Ovarian metastases show a variable maximum SUV with mild to intense FDG uptake.

  19. FDG PET/CT features of ovarian metastasis

    International Nuclear Information System (INIS)

    Kitajima, K.; Suzuki, K.; Senda, M.; Kita, M.; Onishi, Y.; Maeda, T.; Yoshikawa, T.; Ohno, Y.; Sugimura, K.

    2011-01-01

    Aim: To assess the characteristics of [ 18 F]-fluoro-2-deoxy-D-glucose (FDG) uptake in cases of ovarian metastasis using positron-emission tomography/computed tomography (PET/CT). Materials and methods: Twelve patients with 16 ovarian metastases arising from colon cancer (n = 6), breast cancer (n = 4), gastric cancer (n = 3), and pancreatic cancer (n = 3) who underwent FDG-PET/CT examination were included in this study. The effect of lesion size and morphological pattern (predominantly solid or cystic) on FDG uptake was evaluated using the quantitative standardized uptake value (SUV). Results: The mean maximum SUV for the 16 lesions was 4.6 ± 2.4 (range 1.8 ∼ 9.9). The Pearson correlation coefficient test showed no significant correlation between maximum SUV and lesion size (r = 0.21, p = 0.42). The maximum SUV of solid (n = 5) and cystic (n = 11) lesions was 5.5 ± 2.7 and 4.3 ± 2.2, respectively, and the difference was not significant (p = 0.43). Breast cancer showed the highest maximum SUV (6.4 ± 3.6), followed by colon cancer (5.3 ± 1.4), gastric cancer (3.3 ± 0.5), and pancreatic cancer (2.2 ± 0.6). Conclusion: Ovarian metastases show a variable maximum SUV with mild to intense FDG uptake.

  20. Effect of glucose level on brain FDG-PET images

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  1. Diagnostic performance of 18F-FDG PET/CT and whole-body diffusion-weighted imaging with background body suppression (DWIBS) in detection of lymph node and bone metastases from pediatric neuroblastoma.

    Science.gov (United States)

    Ishiguchi, Hiroaki; Ito, Shinji; Kato, Katsuhiko; Sakurai, Yusuke; Kawai, Hisashi; Fujita, Naotoshi; Abe, Shinji; Narita, Atsushi; Nishio, Nobuhiro; Muramatsu, Hideki; Takahashi, Yoshiyuki; Naganawa, Shinji

    2018-04-17

    Recent many studies have shown that whole body "diffusion-weighted imaging with background body signal suppression" (DWIBS) seems a beneficial tool having higher tumor detection sensitivity without ionizing radiation exposure for pediatric tumors. In this study, we evaluated the diagnostic performance of whole body DWIBS and 18 F-FDG PET/CT for detecting lymph node and bone metastases in pediatric patients with neuroblastoma. Subjects in this retrospective study comprised 13 consecutive pediatric patients with neuroblastoma (7 males, 6 females; mean age, 2.9 ± 2.0 years old) who underwent both 18 F-FDG PET/CT and whole-body DWIBS. All patients were diagnosed as neuroblastoma on the basis of pathological findings. Eight regions of lymph nodes and 17 segments of skeletons in all patients were evaluated. The images of 123 I-MIBG scintigraphy/SPECT-CT, bone scintigraphy/SPECT, and CT were used to confirm the presence of lymph node and bone metastases. Two radiologists trained in nuclear medicine evaluated independently the uptake of lesions in 18 F-FDG PET/CT and the signal-intensity of lesions in whole-body DWIBS visually. Interobserver difference was overcome through discussion to reach a consensus. The sensitivities, specificities, and overall accuracies of 18 F-FDG PET/CT and whole-body DWIBS were compared using McNemer's test. Positive predictive values (PPVs) and negative predictive values (NPVs) of both modalities were compared using Fisher's exact test. The total numbers of lymph node regions and bone segments which were confirmed to have metastasis in the total 13 patients were 19 and 75, respectively. The sensitivity, specificity, overall accuracy, PPV, and NPV of 18 F-FDG PET/CT for detecting lymph node metastasis from pediatric neuroblastoma were 100, 98.7, 98.9, 95.0, and 100%, respectively, and those for detecting bone metastasis were 90.7, 73.1, 80.3, 70.1, and 91.9%, respectively. In contrast, the sensitivity, specificity, overall accuracy, PPV

  2. Combined FDG-PET/CT for the detection of unknown primary tumors: systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Kwee, Thomas C.; Kwee, Robert M.

    2009-01-01

    The aim of this study was to systematically review and meta-analyze published data on the diagnostic performance of combined 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the detection of primary tumors in patients with cancer of unknown primary (CUP). A systematic search for relevant studies was performed of the PubMed/MEDLINE and Embase databases. Methodological quality of the included studies was assessed. Reported detection rates, sensitivities and specificities were meta-analyzed. Subgroup analyses were performed if results of individual studies were heterogeneous. The 11 included studies, comprising a total sample size of 433 patients with CUP, had moderate methodological quality. Overall primary tumor detection rate, pooled sensitivity and specificity of FDG-PET/CT were 37%, 84% (95% CI 78-88%) and 84% (95% CI 78-89%), respectively. Sensitivity was heterogeneous across studies (P = 0.0001), whereas specificity was homogeneous across studies (P = 0.2114). Completeness of diagnostic workup before FDG-PET/CT, location of metastases of unknown primary, administration of CT contrast agents, type of FDG-PET/CT images evaluated and way of FDG-PET/CT review did not significantly influence diagnostic performance. In conclusion, FDG-PET/CT can be a useful method for unknown primary tumor detection. Future studies are required to prove the assumed advantage of FDG-PET/CT over FDG-PET alone and to further explore causes of heterogeneity. (orig.)

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

    NARCIS (Netherlands)

    Schinagl, D.A.X.; Hoffmann, A.L.; Vogel, W.V.; Dalen, J.A. van; Verstappen, S.M.M.; Oyen, W.J.G.; Kaanders, J.H.A.M.

    2009-01-01

    BACKGROUND AND PURPOSE: The role of FDG-PET in radiotherapy target volume definition of the neck was evaluated by comparing eight methods of FDG-PET segmentation to the current CT-based practice of lymph node assessment in head-and-neck cancer patients. MATERIALS AND METHODS: Seventy-eight

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

    NARCIS (Netherlands)

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

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

  5. 18F-FDG-PET and 18F-FDG-PET/CT in the detection of recurrent or metastatic medullary thyroid carcinoma: a systematic review and meta-analysis

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  6. Radionuclide cisternography: SPECT and 3D-rendering. Radionuklidzisternographie: SPECT- und 3D-Technik

    Energy Technology Data Exchange (ETDEWEB)

    Henkes, H; Huber, G; Piepgras, U [Universitaet des Saarlandes, Homburg/Saar (Germany, F.R.). Abt. fuer Neuroradiologie; Hierholzer, J [Freie Univ. Berlin (Germany, F.R.). Strahlenklinik und Poliklinik; Cordes, M [British Columbia Univ., Vancouver, BC (Canada). Belzberg Lab. of Neuroscience

    1991-10-01

    Radionuclide cisternography is indicated in the clinical work-up for hydrocephalus, when searching for CSF leaks, and when testing whether or not intracranial cystic lesions are communicating with the adjacent subarachnoid space. This paper demonstrates the feasibility and diagnostic value of SPECT and subsequent 3D surface rendering in addition to conventional rectilinear CSF imaging in eight patients. Planar images allowed the evaluation of CSF circulation and the detection of CSF fistula. They were advantageous in examinations 48 h after application of {sup 111}In-DTPA. SPECT scans, generated 4-24 h after tracer application, were superior in the delineation of basal cisterns, especially in early scans; this was helpful in patients with pooling due to CSF fistula and in cystic lesions near the skull base. A major drawback was the limited image quality of delayed scans, when the SPECT data were degraded by a low count rate. 3D surface rendering was easily feasible from SPECT data and yielded high quality images. The presentation of the spatial distribution of nuclide-contaminated CSF proved especially helpful in the area of the basal cisterns. (orig.).

  7. The role of F-18 FDG-PET for 3-D radiation treatment planning of non-small cell lung cancer - first results of a prospective study; Einsatz der F-18-FDG-PET in der 3-D-Bestrahlungsplanung des nichtkleinzelligen Bronchialkarzinoms: erste Ergebnisse einer prospektiven Studie

    Energy Technology Data Exchange (ETDEWEB)

    Schmuecking, M.; Baum, R.P.; Przetak, C.; Niesen, A. [Zentralklinik Bad Berka (Germany). Klinik fuer Nuklearmedizin/PET-Zentrum; Lopatta, E.C.; Wendt, T.G. [Jena Univ. (Germany). Klinik fuer Radiologie, Abt. Strahlentherapie; Plichta, K.; Leonhardi, J. [Zentralklinik Bad Berka (Germany). Inst. fuer Bildgebende Diagnostik

    2001-04-01

    To determine the role of F-18 FDG-PET in 3-D-radiation therapy planning, findings in 27 patients, studied by both, PET and CT, were analyzed prospectively. All patients were first examined by helical CT and F-18 FDG-PET. The PET data were iteratively reconstructed into 3-D images and image fusion with CT data was applied. First, based on CT data, the planning target volumes (PTV) and the volumes of organs at risk were generated. In a second step, the transversal slices of CT and PET were matched. Then, based on PET data, new target volumes were generated. Treatment plans for radiation therapy were calculated on CT-based and PET-based planning target volumes. If PET results were used additionally for the 3-D-planning procedure of radiation therapy, the planning target volume could be reduced in a range of 3-21% as compared with conventional imaging methods, e.g., PET allowed differentiation between tumor and atelectasis resulting in smaller PTV. The dose volume histograms of the PET-based treatment plans showed a reduction of dose to the organs at risk, e.g., V{sub lung} (20 Gy) could be reduced by 5% to 17%. In 2 patients, the boost volume based on PET findings was larger than the one based on CT, since PET detected lymph node metastases being of normal size in CT (<1 cm). PET can provide important complementary metabolic information to morphological imaging modalities for an exact localization of nodal involvement and the extent of the primary tumor. Due to smaller PTV, radiation therapy could be delivered with less toxicity in most patients. Using metabolic tumor localization by PET additionally to anatomic delineation by CT scan, a better tumor control may be achieved. Further studies are required to proof this concept. (orig.) [German] Es sollte in einer prospektiven Studie der Einfluss der metabolischen Zusatzinformation durch PET auf die Generierung der Zielvolumina (PTV) und der Dosis-Volumen-Histogramme (DVH) untersucht werden. Alle Patienten erhielten eine

  8. (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...

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

    Science.gov (United States)

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

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

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

    International Nuclear Information System (INIS)

    Kim, Byung Il

    2008-01-01

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

  11. 18F-FDG-PET/CT in fever of unknown origin

    DEFF Research Database (Denmark)

    Middelbo Buch-Olsen, Karen; Andersen, Rikke V; Hess, Søren

    2014-01-01

    OBJECTIVE: Fever of unknown origin continues to be a diagnostic challenge for clinicians. The aim of this study was to confirm whether (18)F-fluorodeoxyglucose ((18)F-FDG)-PET/computed tomography (CT) is a helpful tool in patients suffering from this condition. PATIENTS AND METHODS: Fifty......-seven patients with fever of unknown origin were examined with (18)F-FDG-PET/CT as part of their diagnostic workup at the clinicians' discretion. The medical records were read retrospectively to establish the final diagnosis and evaluate the degree to which PET/CT contributed to the diagnosis. RESULTS......-FDG-PET/CT is a useful tool in the investigation of fever of unknown origin; it can reduce patient inconvenience and possibly costs to society if used earlier in the diagnostic process....

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

    International Nuclear Information System (INIS)

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

    2013-01-01

    Thymic tumors represent a broad spectrum of neoplastic disorders and pose considerable diagnostic difficulties. A non-invasive imaging study to determine the nature of thymic lesions can have significant impact on management of such tumors. 18F-flurorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) has shown promising results in characterization of thymic tumors. The objective of this article is to provide an illustrative tutorial highlighting the clinical utility of 18F-FDG PET-CT imaging in patients with thymic tumors. We have pictorially depicted the 18F-FDG PET-CT salient imaging characteristics of various thymic tumors, both epithelial and non-epithelial. Also discussed is the dynamic physiology of thymus gland which is to be kept in mind when evaluating thymic pathology on 18F-FDG PET-CT, as it can lead to interpretative pitfalls

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-02-15

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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-08-15

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

  16. 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....

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

    Energy Technology Data Exchange (ETDEWEB)

    Beak, Sora [Hallym Univ. College of Medicine, Seoul (Korea, Republic of); Oh, Minyoung; Lee, Sand-Oh; Yu, Eunsil; Ryu Jin-Sook [Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    A 53-year-old man with fever of unknown origin underwent F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) as a workup for a fever of unknown origin. On presentation, he complained of fever, chills, and myalgia. The F-18 FDG PET/CT scan showed diffusely increased uptake of the liver with mild hepatomegaly. A liver biopsy then revealed fibrin-ring granulomas typically seen in Q fever. The patient was later serologically diagnosed as having acute Q fever as the titers for C. IgM and IgG were 64:1 and -16:1, respectively. He recovered completely following administration of doxycycline. This indicates that F-18 FDG PET/CT may be helpful for identifying hepatic involvement in Q fever as a cause of fever of unknown origin.

  18. 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.)

  19. 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.)

  20. Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression

    Energy Technology Data Exchange (ETDEWEB)

    Blokhuis, Gijsbert J.; Diender, Marije G.; Oyen, Wim J.G. [Radboud University Medical Center, Department of Nuclear Medicine, Nijmegen (Netherlands); Bleeker-Rovers, Chantal P. [Radboud University Medical Center, Division of Infectious Diseases, Department of Internal Medicine, Nijmegen (Netherlands); Draaisma, Jos M.T. [Radboud University Medical Center, Department of Paediatrics, Nijmegen (Netherlands); Geus-Oei, Lioe-Fee de [Radboud University Medical Center, Department of Nuclear Medicine, Nijmegen (Netherlands); University of Twente, MIRA Institute for Biomedical Technology and Technical Medicine, Biomedical Photonic Imaging Group, Enschede (Netherlands)

    2014-10-15

    Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression. All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis. FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively. FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value. (orig.)

  1. Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression

    International Nuclear Information System (INIS)

    Blokhuis, Gijsbert J.; Diender, Marije G.; Oyen, Wim J.G.; Bleeker-Rovers, Chantal P.; Draaisma, Jos M.T.; Geus-Oei, Lioe-Fee de

    2014-01-01

    Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression. All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis. FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively. FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value. (orig.)

  2. INFLUENCE OF THE FDG-PET/CT ON THE DIAGNOSE AND STAGING OF COLORECTAL CANCER.

    Directory of Open Access Journals (Sweden)

    Nikola Y. Kolev

    2012-06-01

    Full Text Available INTRODUCTION: In patients with colorectal cancer (CRC, preoperative evaluation and staging should focus on techniques that might alter the preoperative or intraoperative surgical plan. Conventional imaging methods (CT, MRI have low accuracy for identifying the depth of tumour infiltration and have limited ability to detect regional lymph node involvement. The aim of this study was to evaluate the utility of FDG-PET in the initial staging of patients with CC in comparison with conventional staging methods and to determine its impact on therapeutic management.METHODS: In First Clinic of Surgery at University Hospital “St. Marina” one hundred and four patients with a diagnosis of CRC (53 males and 51 females; mean age 66.76± 12.36 years, selected prospectively. All patients were studied for staging using a standard procedure (CT and FDG-PET. The reference method was histology. The effect of FDG-PET on the diagnose and the operative treatment was studied.RESULTS: In 14 patients, surgery was contraindicated by FDG-PET owing to the extent of disease (only 6/14 suspected by CT. FDG-PET revealed four synchronous tumours. For N staging, both procedures showed a relatively high specificity but a low diagnostic accuracy (PET 56%, CT 60% and sensitivity (PET 21%, CT 25%. For M assessment, diagnostic accuracy was 92% for FDGPET and 87% for CT. FDG-PET results led to modification of the therapy approach in 17.85% of the patients with rectal cancer and in 14.8% of the patients with colon cancer.CONCLUSION: Compared with conventional techniques, FDGPET appears to be useful in pre-surgical staging of CC, revealing unsuspected disease and impacting on the treatment approach.

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

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

    International Nuclear Information System (INIS)

    Zhou Wenlan; Wu Hubing; Wang Quanshi; Ye Xianghua

    2008-01-01

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

  6. The GABA-A benzodiazepine receptor complex: Role of pet and spect in neurology and psychiatry; Der GABA-A-benzodiazepinrezeptorkomplex: Rolle von PET und SPECT in Neurologie und Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

    Juengling, F.D. [Abt. fuer Nuklearmedizin, Radiologie III, Universitaetsklinik Ulm (Germany); Schaefer, M.; Heinz, A. [Klinik fuer Psychiatrie und Psychotherapie, Charite, Humboldt-Univ. zu Berlin (Germany)

    2002-09-01

    Nuclear medicine imaging techniques such as positron emission tomography (PET) and single photon emission tomography (SPECT) for selective depiction of GABA-A-benzodiazepine receptor (GBZR) binding are complementary investigations in the diagnostic process of neurological and psychiatric disorders. This review summarizes the current knowledge about options and limitations of PET and SPECT for in vivo diagnostics in neurology and psychiatry. The growing importance of GBZR-imaging for the understanding of pathophysiology and pharmacological treatment in different psychiatric syndromes is discussed. (orig.) [German] Mit der Entwicklung selektiver Liganden fuer den GABA-A-Benzodiazepinrezeptorkomplex (GBZR) hat die nuklearmedizinische Bildgebung mittels positronen-emissionstomographie (PET) und single-photon-emissionscomputertomographie (SPECT) einen festen Stellenwert fuer Klinik und Forschung in der Neurologie und Psychiatrie erlangt. Die vorliegende Ueberblicksarbeit fasst den aktuellen Wissensstand von Anwendungsmoeglichkeiten und -grenzen der nuklearmedizinischen Bildgebung der GBZR in vivo zusammen und beleuchtet ihren klinischen Nutzen. Die wachsende Bedeutung fuer das Verstaendnis der Pathophysiologie und pharmakotherapeutischer Konzepte unterschiedlicher psychiatrischer Erkrankungen wird herausgestellt. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-08-15

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

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

    International Nuclear Information System (INIS)

    Lee, Jai Hyuen; Ryu, Jin Sook

    2008-01-01

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

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

    International Nuclear Information System (INIS)

    Lee, Won Hyoung; Chung, Yong An

    2008-01-01

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

  10. FDG-PET identification of infected pulmonary artery conduit following tetralogy of fallot (TOF) repair

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yu Yang; Williams, Hadyn; Pucar, Darko [Dept. of Radiology, Medical College of Georgia, Augusta (United States)

    2017-03-15

    Tetralogy of Fallot (TOF) is one of the most common forms of cyanotic congenital heart disease usually managed by serial surgical repairs. The repaired prosthetic valve or conduit is susceptible to life-threatening infection. FDG-PET is an effective alternative to evaluate the source of infection when other examinations are inconclusive. We report an unusual case of an infected pulmonary artery conduit after TOF repair although the echocardiogram was negative for vegetation, which was later confirmed by surgery and pathology. The case highlights the role of FDG-PET as a problem-solving tool for potential endocarditis and cardiac device infection cases after complex cardiac surgery.

  11. Clinical value of FDG-PET in cutaneous malignant melanoma: First experience in Estonia

    International Nuclear Information System (INIS)

    Nazarenko, S.; Niin, M.; Paats, A.; Tonnov, A.

    2004-01-01

    Full text: In November 2002 first 18F-FDG-PET was performed in Estonia using a mobile truck-mounted scanning technology (Accel, Siemens) provided by the International Healthcare Group (IHG, Amersfoort, Netherlands). The FDG was provided by MAP Medical Technologies, Schering, (Helsinki, Finland). In 2003 this scheme was repeated for further scanning sessions. Evaluation of cutaneous malignant melanoma (CMM) using nuclear technique is of particular interest in Estonia as its incidence is on the rise. F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in CMM has a well-documented high diagnostic accuracy, especially in staging of the disease. The aim of the current study was to assess the impact of 18F-FDG-PET on detailed staging and clinical management in CMM. 30 patients of CMM, 16 males and 14 females, all non-diabetic, in the age range of 26 to 69 years were studied. Of these 30 patients, 12 were of high risk primary CMM, 7 had regional lymph node metastases and 11 had distant metastases. Patients were asked to consume a low-carbohydrate diet 3 days prior to the FDG-PET scan. 194 to 410 MBq (average 335 MBq) 18F-FDG was administered to the patients who were asked to come fasting for a minimum of 6 hours. Whole body scan was performed 40 to 65 minutes after the administration of FDG on the mobile PET. In 13 of the 30 patients (43%) 18F-FDG-PET changed the staging. In remaining 17 patients (57%) 18F-FDG-PET increased confidence level for the chosen treatment. Lymphadenectomy was planned in 2 patients showing lymph node involvement on FDG-PET. In other 2 patients, one with small pulmonary and other with a liver lesions found on PET but negative on radiological examination 'wait-and-watch' strategy was chosen. An unexpected hypermetabolic lesion seen in 1 case turned out to be a benign focus of connective tissue. One patient shown to have multiple distant metastases was started on chemotherapy. Finally in 8 of the 30 (27%) patients an immediate positive

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

    International Nuclear Information System (INIS)

    Lv Huiqing; Zhang Zhongmin; Lv Zhonghong

    2006-01-01

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

  13. FDG-PET identification of infected pulmonary artery conduit following tetralogy of fallot (TOF) repair

    International Nuclear Information System (INIS)

    Zhang, Yu Yang; Williams, Hadyn; Pucar, Darko

    2017-01-01

    Tetralogy of Fallot (TOF) is one of the most common forms of cyanotic congenital heart disease usually managed by serial surgical repairs. The repaired prosthetic valve or conduit is susceptible to life-threatening infection. FDG-PET is an effective alternative to evaluate the source of infection when other examinations are inconclusive. We report an unusual case of an infected pulmonary artery conduit after TOF repair although the echocardiogram was negative for vegetation, which was later confirmed by surgery and pathology. The case highlights the role of FDG-PET as a problem-solving tool for potential endocarditis and cardiac device infection cases after complex cardiac surgery

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-07-01

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

  15. FDG PET/CT findings in a case of myositis ossificans circumscripta of the forearm.

    Science.gov (United States)

    Clarençon, Frédéric; Larousserie, Frédérique; Babinet, Antoine; Zylbersztein, Christophe; Talbot, Jean-Noël; Kerrou, Khaldoun

    2011-01-01

    Myositis ossificans circumscripta (MOC) is a rare benign neoplasm located in soft tissues that, most of the time, appears after a local trauma. The positive diagnosis of MOC may be challenging on CT or MRI findings. We report on an atypical case of a spontaneous nontraumatic MOC in a 54-year-old man, located in the longus supinatus muscle diagnosed with MRI and F-18 FDG PET/CT findings. Rarely described F-18 FDG PET/CT features in MOC are presented. Pattern of avid FDG focus on PET/CT, that may wrongly suggest osteosarcoma, is presented.

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

    Science.gov (United States)

    Sun, Yajuan; Yu, Hongjuan; Ma, Jingquan

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  18. 18F-FDG PET in children with lymphomas

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  19. Clinical efficacy of FDG-PET scan as preoperative diagnostic tool in cervical cancer stage Ib and IIa: comparison between the results of FDG-PET scan and operative findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Hoon

    1999-12-01

    This study was done to evaluate the clinical feasibility of FDG-PET scan for routine preoperative diagnostic methods in cervical carcinoma. PET-scans were performed from March, 1999 to November, 1999. There were 6 stage Ib and 7 IIa patients and all patients were performed radical hysterectomy and bilateral pelvic lymph node dissections and were evaluated by FDG-PET scan before operation. The mean age of the patients were 50.3 years old. Six cases had lymph node metastases by pelvis MRI, and three cases by FDG-PET scan. We could not find any lymph node metastases at surgery in 3 patients (50.0%) among 6 patients who were diagnosed by nodal metastases by pelvis MRI. And we found 1 patients with nodal metastases who had negative findings by pelvis MRI. By FDG-PET scan, we could find metastases in all positive patients. But we also found 2 additional metastatic cases in the patients with negative findings. In this study, the comparison was very difficult due to the individual differences in the comparison would be made by site-specific not person. The sensitivity of MRI and FDG-PET scan were 50.0% and 30.0%. The specificity were 94.1 % and 95.6%. The positive predictive value were 55.6 % and 50.0 %. In conclusion, we could find any superiority of FDG-PET scan in the diagnosis of lymph node metastases the pelvis MRI. So there are limitations to use the FDG-PET scan in the routine preoperative diagnostic tools in cervical cancer. But if we have more experiences to use the FDG-PET scan such as precise cut-off value of SUV and combination of other imaging technique, the FDG-PET scan are still promising diagnostic tools in cervical cancer.

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  1. 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.

  2. 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)

  3. Performance of FDG PET/CT at initial diagnosis in a rare lymphoma: nodular lymphocyte-predominant Hodgkin lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Grellier, Jean Francois; Weinmann, Pierre [AP-HP- Hopital Europeen Georges Pompidou, Service de medecine nucleaire, Paris (France); Vercellino, Laetitia; Merlet, Pascal; Toubert, Marie-Elisabeth; Berenger, Nathalie [AP-HP- Hopital Saint-Louis, Service de medecine nucleaire, Paris (France); Leblanc, Thierry [Hopital Saint-Louis, Service d' immuno-hematologie, Paris (France); Thieblemont, Catherine [Universite Paris Diderot, Sorbonne Paris Cite - INSERM UMR-S1165, AP-HP- Hopital Saint-Louis, Service d' hemato-Oncologie, Paris (France); Briere, Josette [AP-HP- Hopital Saint-Louis, Service de pathologie, Paris (France); Brice, Pauline [AP-HP- Hopital Saint-Louis, Service d' hemato-Oncologie, Paris (France)

    2014-11-15

    Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare Hodgkin lymphoma distinguished from classical Hodgkin lymphoma (cHL) by the nature of the neoplastic cells which express B-cell markers. We wanted to determine the diagnostic performance of FDG PET/CT in initial assessment and its therapeutic impact on staging. We retrospectively studied a population of 35 patients with NLPHL (8 previously treated for NLHPL, 27 untreated). All patients underwent an initial staging by pretherapeutic FDG PET/CT. The impact on initial stage or relapse stage was assessed by an independent physician. In a per-patient analysis, the sensitivity of the pretherapeutic FDG PET/CT was 100 %. In a per-site analysis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pretherapeutic FDG PET/CT were 100 %, 99 %, 97 %, 100 % and 99 %, respectively. Pretherapeutic FDG PET/CT led to a change in the initial stage/relapse stage in 12 of the 35 patients (34 %). In contrast to previous results established without FDG PET/CT, 20 % of patient had osteomedullary lesions. Pretherapeutic FDG PET/CT has excellent performance for initial staging or relapse staging of NLPHL. (orig.)

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  5. Detection of prostate cancer by an FDG-PET cancer screening program: results from a Japanese nationwide survey

    International Nuclear Information System (INIS)

    Minamimoto, Ryogo; Senda, Michio; Jinnouchi, Seishi; Terauchi, Takashi; Inoue, Tomio

    2014-01-01

    The aim of this study was to analyze detection rates and effectiveness of 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) cancer screening program for prostate cancer in Japan, which is defined as a cancer-screening program for subjects without known cancer. It contains FDG-PET aimed at detection of cancer at an early stage with or without additional screening tests such as prostate-specific antigen (PSA) and magnetic resonance imaging (MRI). A total of 92,255 asymptomatic men underwent the FDG-PET cancer screening program. Of these, 504 cases with findings of possible prostate cancer in any screening method were analyzed. Of the 504 cases, 165 were verified as having prostate cancer. Of these, only 61 cases were detected by FDG-PET, which result in 37.0% relative sensitivity and 32.8% positive predictive value (PPV). The sensitivity of PET/computed tomography (CT) scanner was higher than that of dedicated PET (44.0% vs. 20.4%). However, the sensitivity of FDG-PET was lower than that of PSA and pelvic MRI. FDG-PET did not contribute to improving the sensitivity and PPV when performed as combined screening. PSA should be included in FDG-PET cancer screening programs to screen for prostate cancer

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  7. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-03-15

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

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  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. FDG-PET, PET/CT and conventional nuclear medicine procedures in the evaluation of lung cancer. A systematic review

    International Nuclear Information System (INIS)

    Hellwig, Dirk; Kirsch, C.M.; Baum, R.P.

    2009-01-01

    Aim: Currently, the German and Austrian S3 guidelines on the evaluation and treatment of lung cancer are about to be published whereas the American Colleague of Chest Physicians (ACCP) guidelines were already presented in 2007. An important part of the diagnostic workup of lung cancer will be the evaluation of indeterminate lung lesions and the mediastinal and extrathoracic staging using FDG-PET or PET/CT. The results from the literature on FDG-PET and PET/CT as well as on conventional nuclear medicine staging procedures and the clinical implications are presented. Methods: The literature data was amassed in analogy to the metaanalyses drawn for the current ACCP guidelines. In addition, relevant more recent publications were also considered. To answer the important question for the extent of pathological confirmation needed, the residual risk of mediastinal metastases was calculated for certain constellations of FDG-PET and CT findings. Suggested recommendations were characterized with the level of evidence. Results: FDG-PET (PET/CT) allows the differentiation of indeterminate lung lesions with high accuracy. FDG-PET (PET/CT) is the most accurate non-invasive procedure to assess the mediastinal nodal stage, for non-small cell as well as for small cell lung cancer. It is justified to omit invasive evaluation of enlarged but FDG-PET negative lymph nodes under certain circumstances. Unexpected extrathoracic metastases detected by FDG-PET imply important changes in therapeutic management. Conclusion: The upcoming S3 guideline on lung cancer will recommend FDG-PET in several indications due to its clinical efficacy well proven by data from literature (high level of evidence). The selected use of conventional nuclear medicine procedures remains beyond doubt. FDG-PET (PET/CT) belongs to the standard of care in lung cancer

  12. FDG-PET, PET/CT and conventional nuclear medicine procedures in the evaluation of lung cancer. A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Hellwig, Dirk; Kirsch, C.M. [Saarland Univ. Medical Center, Homburg (Germany). Dept. of Nuclear Medicine; Baum, R.P. [Zentralklinik Bad Berka (Germany). Dept. of Nuclear Medicine / PET Center

    2009-07-01

    Aim: Currently, the German and Austrian S3 guidelines on the evaluation and treatment of lung cancer are about to be published whereas the American Colleague of Chest Physicians (ACCP) guidelines were already presented in 2007. An important part of the diagnostic workup of lung cancer will be the evaluation of indeterminate lung lesions and the mediastinal and extrathoracic staging using FDG-PET or PET/CT. The results from the literature on FDG-PET and PET/CT as well as on conventional nuclear medicine staging procedures and the clinical implications are presented. Methods: The literature data was amassed in analogy to the metaanalyses drawn for the current ACCP guidelines. In addition, relevant more recent publications were also considered. To answer the important question for the extent of pathological confirmation needed, the residual risk of mediastinal metastases was calculated for certain constellations of FDG-PET and CT findings. Suggested recommendations were characterized with the level of evidence. Results: FDG-PET (PET/CT) allows the differentiation of indeterminate lung lesions with high accuracy. FDG-PET (PET/CT) is the most accurate non-invasive procedure to assess the mediastinal nodal stage, for non-small cell as well as for small cell lung cancer. It is justified to omit invasive evaluation of enlarged but FDG-PET negative lymph nodes under certain circumstances. Unexpected extrathoracic metastases detected by FDG-PET imply important changes in therapeutic management. Conclusion: The upcoming S3 guideline on lung cancer will recommend FDG-PET in several indications due to its clinical efficacy well proven by data from literature (high level of evidence). The selected use of conventional nuclear medicine procedures remains beyond doubt. FDG-PET (PET/CT) belongs to the standard of care in lung cancer.

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-05-01

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

  15. Neurolymphomatosis of the sciatic nerve and F.D.G. PET: case report and review

    International Nuclear Information System (INIS)

    Bruna-Muraille, C.; Papathanassiou, D.; Cuif-Job, A.; Liehn, J.C.; Job, L.; Kolb, B.; Himberlin, C.; Delmer, A.

    2009-01-01

    We are reporting the case of a woman who has been suffering from sciatica for several months. A neurolymphomatosis of the sciatic nerve was found. In this report, we present the characteristics of this lesion in conventional imaging and in F.D.G. PET. (authors)

  16. 18F-DG PET/CT in detection of recurrence and metastasis of colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

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

  17. Comparison of 18-FDG PET and CT for pretherapeutic staging of malignant lymphoma

    International Nuclear Information System (INIS)

    Thill, R.; Cremerius, U.; Wagenknecht, G.; Hellwig, D.; Buell, U.; Neuerburg, J.; Guenther, R.; Fabry, U.; Osieka, R.

    1997-01-01

    Aim: Comparison of diagnostic efficiency of FDG-PET and CT regarding localisation, histology, size and FDG-uptake of a lesion. Methods: CT- and FDG-PET studies of 27 patients with histologically confirmed malignant lymphoma as primary disease or relapse were evaluated retrospectively. In CT lesions with a diameter (D CT )>15 mm were regarded as positive. Focal accumulations of FDG, not explained by physiological metabolism, found by visual interpretation in iterative reconstructed, PET-scans, were quantified for diameter (D PET ) and corrected standardized uptake value (SUV), corrected for partial-volume-effect. Lesions were classified depending on histology and lesion quality (lymph nodes, bulks, extranodal lesions). Results: CT detected 78 lesions in 26 patients, all confirmed by FDG-PET. PET localized 18 additional lesions (+23%); in high grade NHL +25%. Both methods were equally efficient in cevical lymph nodes and lung lesions, in all other regions of lymphatic nodules and in case of liver and spleen lesions PET localized more lesions. SUV was significantly higher in high-grade NHL (19.0) than in low-grade NHL and Hodgkin's disease (10.6 resp. 11.1). D CT and D PET correlated significantly (r=0.75). Conclusion: Diagnostic efficiency of FDG-PET is equivalent or superior to CT in staging of malignant lymphoma before therapy. Qualitative interpretation seems sufficient for staging, quantitative analysis may add information about malignancy grade in NHL. (orig.) [de

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

    Directory of Open Access Journals (Sweden)

    Percy eLee

    2012-07-01

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

  19. FDG PET/CT : EANM procedure guidelines for tumour imaging: version 2.0

    NARCIS (Netherlands)

    Boellaard, Ronald; Delgado-Bolton, Roberto; Oyen, Wim J. G.; Giammarile, Francesco; Tatsch, Klaus; Eschner, Wolfgang; Verzijlbergen, Fred J.; Barrington, Sally F.; Pike, Lucy C.; Weber, Wolfgang A.; Stroobants, Sigrid; Delbeke, Dominique; Donohoe, Kevin J.; Holbrook, Scott; Graham, Michael M.; Testanera, Giorgio; Hoekstra, Otto S.; Zijlstra, Josee; Visser, Eric; Hoekstra, Corneline J.; Pruim, Jan; Willemsen, Antoon; Arends, Bertjan; Kotzerke, Joerg; Bockisch, Andreas; Beyer, Thomas; Chiti, Arturo; Krause, Bernd J.

    The purpose of these guidelines is to assist physicians in recommending, performing, interpreting and reporting the results of FDG PET/CT for oncological imaging of adult patients. PET is a quantitative imaging technique and therefore requires a common quality control (QC)/quality assurance (QA)

  20. [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.

  1. 18F-FDG PET/CT in fever and inflammation of unknown origin

    NARCIS (Netherlands)

    Balink, J.J.M.

    2015-01-01

    This thesis describes the role and the interpretation of imaging results with hybrid 18F-FDG PET/CT in patients with non-localizing or non-specific signs and symptoms like fever, weight loss, malaise and prolonged increased inflammatory parameters, without a diagnosis after routine diagnostic

  2. High impact of FDG-PET/CT in diagnostic strategies for ovarian cancer

    International Nuclear Information System (INIS)

    Zytoon, Ashraf Anas; Murakami, Koji; Eid, Hazem; El-Gammal, Mahmoud

    2013-01-01

    Background: Ovarian cancer has the highest mortality of all gynecologic malignancies. FDG-PET/CT was proven to be accurate for identification of primary ovarian tumors, regional lymph nodes, and distant metastases. Purpose: To evaluate ovarian masses at FDG-PET/CT in correlation with histopathologic findings. Material and Methods: Ninety-eight patients underwent whole body FDG-PET/CT examination. Eighty-six patients with primary ovarian cancer and 12 patients with metastatic disease to the ovaries were included. Results: PET/CT imaging was true-positive in 87/94 patients with malignant tumors. In 4/4 patients with benign tumors, PET/CT results were true-negative, with sensitivity of 92.6%, specificity 100%, total test accuracy 92.9%. Fifty-seven patients were diagnosed as stage IV ovarian cancer with distant metastasis. Conclusion: The anatomical/functional examination by FDG-PET/CT was proven to be valuable in increasing the diagnostic accuracy that can help improve patient management

  3. 18F-FDG PET-CT pattern in idiopathic normal pressure hydrocephalus.

    Science.gov (United States)

    Townley, Ryan A; Botha, Hugo; Graff-Radford, Jonathan; Boeve, Bradley F; Petersen, Ronald C; Senjem, Matthew L; Knopman, David S; Lowe, Val; Jack, Clifford R; Jones, David T

    2018-01-01

    Idiopathic normal pressure hydrocephalus (iNPH) is an important and treatable cause of neurologic impairment. Diagnosis is complicated due to symptoms overlapping with other age related disorders. The pathophysiology underlying iNPH is not well understood. We explored FDG-PET abnormalities in iNPH patients in order to determine if FDG-PET may serve as a biomarker to differentiate iNPH from common neurodegenerative disorders. We retrospectively compared 18 F-FDG PET-CT imaging patterns from seven iNPH patients (mean age 74 ± 6 years) to age and sex matched controls, as well as patients diagnosed with clinical Alzheimer's disease dementia (AD), Dementia with Lewy Bodies (DLB) and Parkinson's Disease Dementia (PDD), and behavioral variant frontotemporal dementia (bvFTD). Partial volume corrected and uncorrected images were reviewed separately. Patients with iNPH, when compared to controls, AD, DLB/PDD, and bvFTD, had significant regional hypometabolism in the dorsal striatum, involving the caudate and putamen bilaterally. These results remained highly significant after partial volume correction. In this study, we report a FDG-PET pattern of hypometabolism in iNPH involving the caudate and putamen with preserved cortical metabolism. This pattern may differentiate iNPH from degenerative diseases and has the potential to serve as a biomarker for iNPH in future studies. These findings also further our understanding of the pathophysiology underlying the iNPH clinical presentation.

  4. (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

  5. Peritoneal Super Scan on 18F - FDG PET-CT in a Patient of Burkitt's Lymphoma

    Science.gov (United States)

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

    2017-01-01

    Peritoneal lymphomatosis is seen less frequently, but when seen, it is mostly associated with aggressive variants of malignancies. FDG uptake has been reported in peritoneal lymphomatosis both in DLBCL and Burkitt's lymphoma. We report a case of Burkitt's lymphoma with involvement of entire peritoneum, which looks like a “peritoneal super scan” on FDG PET-CT. PMID:28533652

  6. Demonstrations of AIDS-associated malignancies and infections at FDG PET-CT

    International Nuclear Information System (INIS)

    Liu, Y.

    2011-01-01

    HIV infection results in profound alterations of immunologic function that render the patient severely immunocompromised, and susceptible to malignancies and opportunistic infections. Three AIDS-defining malignancies include Kaposi's sarcoma (KS), non-Hodgkin's lymphoma (NHL) and invasive cervical cancer. In AIDS patients, KS is often aggressive and multifocal, with visceral involvement and widespread cutaneous and nodal spread; NHL is always high grade and often widely disseminated at the time of diagnosis with frequent involvement of extranodal sites; cervical cancer is invasive and has greater likelihood of progression and metastasis. Although there are very sparse systemic data available in the literature, limited studies has shown that fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) is a valuable imaging technique in the diagnosis, staging, restaging and monitoring therapeutic response in these malignancies. In addition, a unique application of FDG PET/CT is the differentiation of cerebral lesions between lymphoma and toxoplasmosis in AIDS patients, which cannot be reliably achieved with either CT or MRI. HIV-associated opportunistic infections may involve different pathogens and multiple tissues, organs or systems. Some preliminary observations have revealed a promising role of FDG PET-CT in the diagnosis and identification of these infections such as tuberculosis, fever of unknown origin, pneumocystis pneumonia and candidiasis. However, it should be stressed that FDG PET-CT alone has no role in identifying the pathology of abnormalities. FDG PET-CT, at best, can localize the sites of abnormalities and impact on patient's management in clinical decision making. (author)

  7. Prognostic value of interim FDG-PET in Hodgkin lymphoma : systematic review and meta-analysis

    NARCIS (Netherlands)

    Adams, Hugo J A; Nievelstein, Rutger A J; Kwee, Thomas C.

    2015-01-01

    This study aimed to systematically review and meta-analyse the value of interim (18) F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) in predicting treatment failure in Hodgkin lymphoma. MEDLINE was systematically searched for original studies that used standardized international

  8. Peritoneal Super Scan on 18F - FDG PET-CT in a Patient of Burkitt's Lymphoma.

    Science.gov (United States)

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

    2017-01-01

    Peritoneal lymphomatosis is seen less frequently, but when seen, it is mostly associated with aggressive variants of malignancies. FDG uptake has been reported in peritoneal lymphomatosis both in DLBCL and Burkitt's lymphoma. We report a case of Burkitt's lymphoma with involvement of entire peritoneum, which looks like a "peritoneal super scan" on FDG PET-CT.

  9. 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.

  10. The effectiveness of FDG PET/CT for evaluation of intracardiac mass and pericardiac lesions

    International Nuclear Information System (INIS)

    Hwang, H. S; Yun, M. J.; Lee, J. D

    2004-01-01

    Fluorodeoxyglucose positron emission tomography has been known to be useful in diagnosis and staging of malignancy. FDG PET has high sensitivity and easily detects malignant lesions that are missed and overlooked in anatomic imaging modality. We assessed the impact of FDG PET/CT compared to echocardiogram and enhanced CT scan. Five patients of intra- and pericardiac lesions were included in this study. All patients underwent PET/CT(GE Discovery ST), enhanced CT scan and echocardiogram. Two patients were non-small cell lung cancer, one of RV metastatic mass, the other of pericardial metastasis in RV region. One of melanoma with systemic metastases, had RA malignant masses. One of suspicious lung cancer and intracardiac mass, has proved to benign LA thrombosis. One of lymphoma showed suspicious cardiac mass, but revealed no abnormality in echocardiogram. FDG PET/CT is sensitive and useful method to detect intra- and pericardiac mass in patients with suspected malignancy. All patients except lymphoma were correctly diagnosed using FDG PET/ICT

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  12. FDG-PET for diagnosing prosthetic joint infection: systematic review and metaanalysis

    International Nuclear Information System (INIS)

    Kwee, Thomas C.; Kwee, Robert M.; Alavi, Abass

    2008-01-01

    The aim of this study was to systematically review and metaanalyze published data on the diagnostic performance of 18 F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) in detecting prosthetic hip or knee joint infection. A systematic search for relevant studies was performed of the PubMed/MEDLINE and Embase databases. Two reviewers independently assessed the methodological quality of each study. A metaanalysis of the reported sensitivity and specificity of each study was performed. Subgroup analyses were performed if results of individual studies were heterogeneous. The inclusion criteria were met by 11 studies; there was a total sample size of 635 prostheses. Overall, the studies had good methodological quality. Pooled sensitivity and specificity of FDG-PET for the detection of prosthetic hip or knee joint infection were 82.1% (95%CI = 68.0-90.8%) and 86.6% (95%CI = 79.7-91.4%), respectively. Heterogeneity among the results of individual studies was present (I 2 = 68.8%). Diagnostic performance was influenced by type of joint prostheses (hip prostheses vs. knee prostheses) and type of reconstruction method used (filtered back vs. iterative) (p = 0.0164 and p = 0.0235, respectively). In this metaanalysis, overall diagnostic performance of FDG-PET was moderate to high. Caution is warranted, however, because results of individual studies were heterogeneous and could not be fully explored. Future studies should further explore potential causes of heterogeneity and validate the use of FDG-PET for diagnosing prosthetic joint infection. (orig.)

  13. Pretransplant FDG-PET in aggressive non-Hodgkin lymphoma : systematic review and meta-analysis

    NARCIS (Netherlands)

    Adams, Hugo J A; Kwee, Thomas Christian

    This study aimed to systematically review and meta-analyze the value of pretransplant FDG-PET in predicting outcome after autologous stem cell transplantation (ASCT) in aggressive non-Hodgkin lymphoma. Medline was systematically searched, included studies were methodologically assessed and

  14. FDG PET/CT in clinical oncology. Case based approach with teaching points

    Energy Technology Data Exchange (ETDEWEB)

    Mihailovic, Jasna [Novi Sad Univ. (Serbia). Dept. of Nuclear Medicine; Goldsmith, Stanley J. [Weill Cornell Medical College, New York, NY (United States). Div. of Nuclear Medicine and Molecular Imging; Killeen, Ronan P. [St. Vincents Univ. Hospital, Dublin (Ireland)

    2012-07-01

    Organized according to the role of FDG PET/CT in the evaluation and management of oncology patients. 100 informative cases reflecting the issues that clinicians address in their daily practice. Ideal for all newcomers to the field, whether medical students, radiology, nuclear medicine, or oncology fellows, or practicing physicians. FDG PET/CT has rapidly emerged as an invaluable combined imaging modality that can identify tumors on the basis of not only anatomical alterations but also metabolic activity, thus allowing the detection of lesions that would otherwise be too small to distinguish. This book, comprising a collection of images from oncology cases, is organized according to the role of FDG PET/CT in the evaluation and management of oncology patients, and only secondarily by organ or tumor entity. In this way, it reflects the issues that clinicians actually address in their daily practice, namely: identification of an unknown or unsuspected primary; determination of the extent of disease; evaluation of response to therapy; and surveillance after response, i.e., detection of recurrent disease. In total, 100 cases involving different primary tumors are presented to illustrate findings in these different circumstances. FDG PET/CT in Clinical Oncology will be of great value to all newcomers to this field, whether medical students, radiology, nuclear medicine, or oncology fellows, or practicing physicians.

  15. The pivotal role of FDG-PET/CT in modern medicine

    DEFF Research Database (Denmark)

    Hess, Søren; Blomberg, Björn Alexander; Zhu, Hongyun June

    2014-01-01

    to the emergence of hybrid scanners combining PET with computed tomography (PET/CT). Molecular imaging has enormous potential for advancing biological research and patient care, and FDG-PET/CT is currently the most widely used technology in this domain. In this review, we discuss contemporary applications of FDG...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  18. 18F-FDG PET in the management of endometrial cancer

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    DEFF Research Database (Denmark)

    Ørbæk, Mathilde; Graff, Jesper; Markova, Elena

    2016-01-01

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

  20. Lymphoma and tuberculosis: temporal evolution of dual pathology on sequential 18F-FDG PET/CT.

    Science.gov (United States)

    Mukherjee, Anirban; Sharma, Punit; Karunanithi, Sellam; Dhull, Varun Singh; Kumar, Rakesh

    2014-08-01

    Tuberculosis can often be seen in patients undergoing chemotherapy for lymphoma, especially in endemic countries. As both tuberculosis and lymphoma can lead to hypermetabolic lesions of F-FDG PET/CT, a diagnostic dilemma often ensues. We present the sequential F-FDG PET/CT images of a 22-year-old female patient with Hodgkin lymphoma who developed tuberculosis and later relapse of lymphoma. These images present the temporal evaluation of the dual pathology on F-FDG PET/CT.

  1. 18F-FDG PET/CT Findings in Acute Epstein-Barr Virus Infection Mimicking Malignant Lymphoma

    Directory of Open Access Journals (Sweden)

    Mathilde Ørbæk

    2016-05-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-12-15

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

  3. SPECT and PET in cerebrovascular diseases. SPECT und PET bei cerebrovaskulaeren Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, W.H. (Herzzentrum Nordrhein-Westfalen, Bad Oeynhausen (Germany). Inst. fuer Nuklearmedizin)

    1993-02-01

    Investigations using recently emerged perfusion tracers for SPECT, Tc-99m-HMPAO in particular, and studies of local glucose metabolism and oxygen utilisation with PET have deepened our knowledge of the pathophysiology in development and in the sequel of stroke. Studies of local cerebral blood flow and cerebrovascular reserve capacity are indicated in case of neurological symptoms suspected to be caused by transient ischemic attacks or in case of significant narrowing of the cerebral arteries. PET investigations of local metabolism (at the present state) are indicated in patients with incompleted stroke or with infarction and extended ischemic border zone. The differential diagnosis between multi-infarct-dementia and primarily neurodegenerative dementias is facilitated, in some individuals, by the characteristic topography of reduced flow. (orig./MG).

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

    Science.gov (United States)

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

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

  5. Clinical utility of FDG-PET for the clinical diagnosis in MCI.

    Science.gov (United States)

    Arbizu, Javier; Festari, Cristina; Altomare, Daniele; Walker, Zuzana; Bouwman, Femke; Rivolta, Jasmine; Orini, Stefania; Barthel, Henryk; Agosta, Federica; Drzezga, Alexander; Nestor, Peter; Boccardi, Marina; Frisoni, Giovanni Battista; Nobili, Flavio

    2018-04-27

    We aim to report the quality of accuracy studies investigating the utility of [ 18 F]fluorodeoxyglucose (FDG)-PET in supporting the diagnosis of prodromal Alzheimer's Disease (AD), frontotemporal lobar degeneration (FTLD) and prodromal dementia with Lewy bodies (DLB) in mild cognitive impairment (MCI) subjects, and the corresponding recommendations made by a panel of experts. Seven panellist, four from the European Association of Nuclear Medicine, and three from the European Academy of Neurology, produced recommendations taking into consideration the incremental value of FDG-PET, as added on clinical-neuropsychological examination, to ascertain the aetiology of MCI (AD, FTLD or DLB). A literature search using harmonized population, intervention, comparison, and outcome (PICO) strings was performed, and an evidence assessment consistent with the European Federation of Neurological Societies guidance was provided. The consensual recommendation was achieved based on Delphi rounds. Fifty-four papers reported the comparison of interest. The selected papers allowed the identification of FDG patterns that characterized MCI due to AD, FTLD and DLB. While clinical outcome studies supporting the diagnosis of MCI due to AD showed varying accuracies (ranging from 58 to 100%) and varying areas under the receiver-operator characteristic curves (0.66 to 0.97), no respective data were identified for MCI due to FTLD or for MCI due to DLB. However, the high negative predictive value of FDG-PET and the existence of different disease-specific patterns of hypometabolism support the consensus recommendations for the clinical use of this imaging technique in MCI subjects. FDG-PET has clinical utility on a fair level of evidence in detecting MCI due to AD. Although promising also in detecting MCI due to FTLD and MCI due to DLB, more research is needed to ultimately judge the clinical utility of FDG-PET in these entities.

  6. 18F-FDG PET-CT pattern in idiopathic normal pressure hydrocephalus

    Directory of Open Access Journals (Sweden)

    Ryan A. Townley

    Full Text Available Background: Idiopathic normal pressure hydrocephalus (iNPH is an important and treatable cause of neurologic impairment. Diagnosis is complicated due to symptoms overlapping with other age related disorders. The pathophysiology underlying iNPH is not well understood. We explored FDG-PET abnormalities in iNPH patients in order to determine if FDG-PET may serve as a biomarker to differentiate iNPH from common neurodegenerative disorders. Methods: We retrospectively compared 18F-FDG PET-CT imaging patterns from seven iNPH patients (mean age 74 ± 6 years to age and sex matched controls, as well as patients diagnosed with clinical Alzheimer's disease dementia (AD, Dementia with Lewy Bodies (DLB and Parkinson's Disease Dementia (PDD, and behavioral variant frontotemporal dementia (bvFTD. Partial volume corrected and uncorrected images were reviewed separately. Results: Patients with iNPH, when compared to controls, AD, DLB/PDD, and bvFTD, had significant regional hypometabolism in the dorsal striatum, involving the caudate and putamen bilaterally. These results remained highly significant after partial volume correction. Conclusions: In this study, we report a FDG-PET pattern of hypometabolism in iNPH involving the caudate and putamen with preserved cortical metabolism. This pattern may differentiate iNPH from degenerative diseases and has the potential to serve as a biomarker for iNPH in future studies. These findings also further our understanding of the pathophysiology underlying the iNPH clinical presentation. Keywords: FDG-PET, Normal pressure hydrocephalus, Hypometabolism, Caudate, Biomarker

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-06-15

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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-01

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

  11. Decreased occipital lobe metabolism by FDG-PET/CT: An anti-NMDA receptor encephalitis biomarker.

    Science.gov (United States)

    Probasco, John C; Solnes, Lilja; Nalluri, Abhinav; Cohen, Jesse; Jones, Krystyna M; Zan, Elcin; Javadi, Mehrbod S; Venkatesan, Arun

    2018-01-01

    To compare brain metabolism patterns on fluorodeoxyglucose (FDG)-PET/CT in anti-NMDA receptor and other definite autoimmune encephalitis (AE) and to assess how these patterns differ between anti-NMDA receptor neurologic disability groups. Retrospective review of clinical data and initial dedicated brain FDG-PET/CT studies for neurology inpatients with definite AE, per published consensus criteria, treated at a single academic medical center over a 10-year period. Z-score maps of FDG-PET/CT were made using 3-dimensional stereotactic surface projections in comparison to age group-matched controls. Brain region mean Z scores with magnitudes ≥2.00 were interpreted as significant. Comparisons were made between anti-NMDA receptor and other definite AE patients as well as among patients with anti-NMDA receptor based on modified Rankin Scale (mRS) scores at the time of FDG-PET/CT. The medial occipital lobes were markedly hypometabolic in 6 of 8 patients with anti-NMDA receptor encephalitis and as a group (Z = -4.02, interquartile range [IQR] 2.14) relative to those with definite AE (Z = -2.32, 1.46; p = 0.004). Among patients with anti-NMDA receptor encephalitis, the lateral and medial occipital lobes were markedly hypometabolic for patients with mRS 4-5 (lateral occipital lobe Z = -3.69, IQR 1; medial occipital lobe Z = -4.08, 1) compared with those with mRS 0-3 (lateral occipital lobe Z = -0.83, 2; p occipital lobe Z = -1.07, 2; p = 0.001). Marked medial occipital lobe hypometabolism by dedicated brain FDG-PET/CT may serve as an early biomarker for discriminating anti-NMDA receptor encephalitis from other AE. Resolution of lateral and medial occipital hypometabolism may correlate with improved neurologic status in anti-NMDA receptor encephalitis.

  12. SPECT/CT for staging and treatment monitoring in oncology. Applications in differentiated thyroid cancer and liver tumors; SPECT/CT zum initialen Staging und Therapiemonitoring in der Onkologie. Indikationen beim differenzierten Schilddruesenkarzinom und bei Lebertumoren

    Energy Technology Data Exchange (ETDEWEB)

    Weber, K.; Berger, F.; Reiser, M.F. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Innenstadt, Institut fuer Klinische Radiologie, Muenchen (Germany); Mustafa, M.; Bartenstein, P.; Haug, A. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Klinik und Poliklinik fuer Nuklearmedizin, Muenchen (Germany)

    2012-07-15

    and SPECT/CT provides more accurate imaging of the arterial supply of the liver and of potential outflows of micro-spheres into other organs. SPECT/CT allows evaluation and quantification of the uptake of liver tumors. Improved postablative staging in patients with differentiated thyroid cancer by SPECT/CT in comparison to radioiodine whole body scans can be achieved. Improved planning and monitoring of SIRT therapies utilizing SPECT/CT leads to optimized therapeutic doses within liver lesions. Integration of SPECT/CT into the clinical standard for postablative staging in patients with DTC is recommended as well as utilization of SPECT/CT during the planning process, for dose calculation and treatment monitoring of SIRT therapies. (orig.) [German] In den letzten Jahren hat die Hybridbildgebung mit Verbindung von funktioneller und morphologischer Information zur Diagnostik zahlreicher Erkrankungen zunehmend an Bedeutung gewonnen. Bei Patienten mit differenziertem Schilddruesenkarzinom (DTC) wird nach erfolgter Radiojodtherapie (RJT) ein planares Ganzkoerperszintigramm zum Staging durchgefuehrt. Die diagnostische Genauigkeit dieser szintigraphischen Methode ist jedoch aufgrund limitierter raeumlicher Aufloesung begrenzt. Die Radioembolisation von mit {sup 90}Yttrium beladenen Mikrosphaeren (selektive interne Radiotherapie, SIRT) ermoeglicht eine wenig invasive Therapie primaerer und sekundaerer Lebertumoren. Zur Vermeidung von Nebenwirkungen der Mikrosphaeren durch einen Abstrom in Darm, Magen und Lunge muss vor Therapiebeginn eine Darstellung des durch die leberversorgenden Arterien versorgten Gebiets mittels {sup 99m}Tc-MAA ({sup 99m}Technetium-makroaggregiertes Albumin) und einer Szintigraphie erfolgen. Auch hier limitiert die begrenzte morphologische Information der Szintigraphie das Therapiemonitoring. {sup 131}Jod-Ganzkoerperszintigramm zum Nachweis einer erfolgreichen Ablation und Staging ca. 3-4 Tage postablativ bei Patienten mit DTC. Ueberwachung des

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  14. Relationship between pSUV of {sup 18}F-FDG PET/CT and pathological diagnosis in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young [Dept. of Diagnostic Radiology, Dankook University Hospital, Cheonan (Korea, Republic of)

    2013-12-15

    The purpose of this study was to evaluate the Pathological Diagnosis associated with pSUV uptake of {sup 18}F-FDG PET/CT. We had enrolled 39 women that underwent {sup 18}F-FDG PET/CT before operative. We evaluated whether there was correlation between the pSUV of {sup 18}F-FDG PET/CT and prognostic factors. As a results, pSUV level increase according to tumor size but pSUV had no significant association with tumor size. pSUV of high histologic grade was higher than low histologic grade, and pSUV showed positive correlations with histologic grade. The ER and PR showed significant negative correlations with the pSUV of {sup 18}F-FDG PET/CT. Therefore, our results demonstrated that an correlation exists between pSUV and prognostic factors such as histologic grade, ER and PR.

  15. Impact of Endoscopic Ultrasonography on (18)F-FDG-PET/CT Upfront Towards Patient Specific Esophageal Cancer Treatment

    NARCIS (Netherlands)

    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.

    INTRODUCTION: 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

  16. Clinical impact of FDG-PET/CT in the planning of radiotherapy for early-stage Hodgkin lymphoma

    DEFF Research Database (Denmark)

    Hutchings, Martin; Loft, Annika; Hansen, Mads

    2007-01-01

    BACKGROUND: Early-stage Hodgkin lymphoma (HL) has excellent survival rates but carries a high risk of late treatment-related adverse effects. Modern, individualised therapeutic strategies require an accurate determination of the extent of the disease. This study investigated the potential impact...... of 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computerised tomogrpahy (FDG-PET/CT) in the planning of involved field radiotherapy (IFRT). PATIENTS AND METHODS: Thirty patients received staging FDG-PET/CT before therapy, and IFRT after a short course of ABVD (adriamycin, bleomycin......, vinblastine, dacarbazine) chemotherapy. IFRT planning was performed using only the CT data from the FDG-PET/CT scan. Later, the IFRT planning was performed anew using the FDG-PET/CT data as basis for contouring. RESULTS: In 20 out of 30 patients, the radiotherapy (RT) course was unaffected by the addition...

  17. Incidentally detected small intestine intussusception caused by primary small intenstine carcinoma on {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Jong; Oh, So Won; Kim, Yu Kyeong [Dept. of Nuclear MedicineSeoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul (Korea, Republic of)

    2017-09-15

    Small intestine intussusception in adults is a rare condition mainly caused by primary or metastatic small intestine malignancy. Here, we present a 72-year-old male patient who was diagnosed with small intestine cancer that was presented as small intestine intussusception on hybrid {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). The patient was initially referred for an abnormality on a chest radiography and severe anemia. FDG PET/CT showed the lung lesion in the right upper lobe of lung as a high FDG uptake mass. Accidentally, FDG PET demonstrated another intense hypermetabolic intraluminal lesion in the small intestine accompanied with intussusception shown as a circumferential hypermetabolic wall. By pathologic examination, the patient was diagnosed as primary small intestine cancer with lung metastasis. This case highlights usefulness of hybrid FDG PET/CT to identify unexpected malignancy.

  18. Investigations on the effects of ``Ecstasy`` on cerebral glucose metabolism: an 18-FDG PET study; Untersuchungen zum Einfluss von ``Ecstasy`` auf den zerebralen Glukosemetabolismus: eine 18-FDG-PET-Studie

    Energy Technology Data Exchange (ETDEWEB)

    Schreckenberger, M.; Sabri, O.; Arning, C.; Tuttass, T.; Schulz, G.; Kaiser, H.J.; Wagenknecht, G.; Buell, U. [Klinik fuer Nuklearmedizin, Universitaetsklinik, RWTH Aachen (Germany); Gouzoulis-Mayfrank, E.; Sass, H. [Klinik fuer Psychiatrie, Universitaetsklinikum, RWTH Aachen (Germany)

    1998-12-31

    Doppelblindstudie wurden 16 gesunde Probanden ohne Drogenanamnese mittels 18-FDG-PET 110-120 min nach oraler Verabreichung von 2 mg/kg KG MDE (n=8) oder Placebo (n=8) untersucht. Zwei Minuten vor Injektion des Radiopharmazeutikums startend erfolgte ueber insgesamt 32 min eine konstante kognitive Stimulation ueber ein Wortrepetitionsparadigma, um konstante und vergleichbare mentale Bedingungen waehrend der zerebralen 18-FDG-Aufnahme zu gewaehrleisten. Die Darstellung der Individualanatomie erfolgte anhand T1-gewichteter 3D-flash MRT mit anschliessender manueller Regionalisierung in 108 Regions-of-Interest und PET/MRT Overlay. Absolute Quantifizierung der rMRGlu sowie Normierung auf den Globalmetabolismus mit anschliessendem Vergleich MDE versus Placebo mittels U-Test nach Mann und Whitney. Ergebnisse: Gegenueber der Placebo-Gruppe fand sich unter MDE keine signifikante Aenderung der globalen MRGlu (MDE: 41,8{+-}11,1 {mu}mol/min/100 g, Placebo: 50,1{+-}18,1 {mu}mol/min/100 g, p=0,298). Die normierten metabolischen Daten zeigten eine signifikante Minderung der rMRGlu im beidseitigen Frontalkortex: Links frontal posterior (-7,1%, p<0,05) und rechts praefrontal superior (-4,6%, p<0,05). Signifikante Steigerungen der rMRGlu fanden sich dagegen im beidseitigen Zerebellum (rechts: +10,1%, p<0,01; links: +7,6%, p<0,05) sowie im rechten Putamen (+6,2%, p<0,05). Schlussfolgerung: In der vorliegenden Studie konnten unter dem Akuteinfluss des `Ecstasy`-Analogons MDE neurometabolische Veraenderungen im Sinne einer fronto-striato-cerebellaeren Dysbalance nachgewiesen werden, die parallelen zu sowohl anderen psychotropen Substanzen als auch verschiedenen endogenen Psychosen aufweisen. (orig.)

  19. 18F-FDG PET/CT for the diagnosis of malignant and infectious complications after solid organ transplantation

    International Nuclear Information System (INIS)

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

    2017-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-03-15

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

  1. 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.

  2. FDG-PET AS A ROUTINE SURVEILLANCE TOOL IN HEAD AND NECK CARCINOMA SIX MONTHS AFTER TREATMENT

    Institute of Scientific and Technical Information of China (English)

    XU Ya-nan; Sophie Périé; WANG Jia-dong

    2009-01-01

    Objective To evaluate prospectively the impact of fluorodeoxyglucose-fluorine-18 positron emission tomography (FDG-PET) in the detection of recurrence, second primary cancers, and distant metastases in head and neck squamous cell carcinoma (HNSCC) 6 months after treatment. Methods A total of 41 patients without any clinical element for recurrence, second primary cancer, or distant metastases received a whole-body FDG-PET as a routine surveillance tool 6 months after initial combined curative therapy for HNSCC. Results There were 35 negative PET results and 6 positive. One patient with abnormal FDG-PET did not have recurrent HNSCC (false positive). Five had true positive results: proven recurrence in 2 patients, second primary cancer in 2, and distant metastasis in 1. The sensitivity and specificity of FDG-PET for the diagnosis of HNSCC recurrence, second tumor, and distant metastases were 100% (5/5) and 97.2% (35/36), respectively. The positive predictive value was 83.3% (5/6). The negative predictive value was 100% (35/35). The overall accuracy was 97.6% (40/41). FDG-PET had a therapeutic impact in 5 of 41 patients (12.2%). There was no impact of FDG-PET on management in other 36 patients. Conclusion FDG-PET is useful as primary method for detecting nodal recurrence and distant metastases in HNSCC as well as second cancer in subclinical patients as it had a high effectiveness. But systematic FDG-PET performed at 6 months in patients without any clinical suspicion of local recurrence was scarcely useful.

  3. 2-¹⁸fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) for postchemotherapy seminoma residual lesions

    DEFF Research Database (Denmark)

    Bachner, M; Loriot, Y; Gross-Goupil, M

    2012-01-01

    2-¹⁸fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) has been recommended in international guidelines in the evaluation of postchemotherapy seminoma residuals. Our trial was designed to validate these recommendations in a larger group of patients.......2-¹⁸fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) has been recommended in international guidelines in the evaluation of postchemotherapy seminoma residuals. Our trial was designed to validate these recommendations in a larger group of patients....

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

    International Nuclear Information System (INIS)

    Wang Ying; Feng Yanlin

    2011-01-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-12-15

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2017-02-01

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

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

    Science.gov (United States)

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

    2018-05-01

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

  10. 18F-FDG SPECT/CT in the diagnosis of differentiated thyroid carcinoma with elevated thyroglobulin and negative iodine-131 scans

    International Nuclear Information System (INIS)

    Ma, C.; Wu, Z.; Wang, H.; Wang, X.; Shao, M.; Zhao, L.; Jiawei, X.

    2015-01-01

    Aim of the present study was to investigate the usefulness of 18 F-FDG SPECT/CT in differentiated thyroid cancer (DTC) with elevated serum thyroglobulin (Tg) but negative iodine-131 scan. This retrospective review of patients with DTC recurrence who had 18 F-FDG SPECT/CT and 18 F-FDG PET/CT for elevated serum Tg but negative iodine-131 scan (March 2007-October 2012). After total thyroidectomy followed by radioiodine ablation, 86 consecutive patients with elevated Tg levels underwent 18 F-FDG SPECT/CT or 18 F-FDG PET/CT. Of these, 45 patients had 18 F-FDG SPECT/CT, the other 41 patients had 18 F-FDG PET/CT 3-4 weeks after thyroid hormone withdrawal. The results of 18 F-FDG PET/CT and SPECT/CT were correlated with patient follow-up information, which included the results from subsequent imaging modalities such as neck ultrasound, MRI and CT, Tg levels, and histologic examination of surgical specimens. The diagnostic accuracy of the two imaging modalities was evaluated. In 18 F-FDG SPECT/CT scans, 24 (24/45) patients had positive findings, 22 true positive in 24 patients, false positive in 2 patients, true-negative and false-negative in 6, 15 patients, respectively. The overall sensitivity, specificity, and accuracy of 18F-FDG SPECT/CT were 59.5%, 75% and 62.2%, respectively. Twenty six patients had positive findings on 18 F-FDG PET/CT scans, 23 true positive in 26 (26/41) patients, false positive in 3 patients, true-negative and false-negative in 9, 6 patients, respectively. The overall sensitivity, specificity, and accuracy of 18F-FDG PET/CT were 79.3%, 81.8% and 78.1%, respectively. Clinical management changed for 13 (29%) of 45 patients by 18 F-FDG SPECT/CT, 14 (34%) of 41 patients by 18F-FDG PET/CT including surgery, radiation therapy, or multi kinase inhibitor. Based on the retrospective analysis of 86 patients, 18F-FDG SPECT/CT has lower sensitivity in the diagnosis of DTC recurrence with elevated Tg and negative iodine-131scan to 18F-FDG PET/CT. The clinical

  11. 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.

  12. Soft tissue metastases from differentiated thyroid cancer diagnosed by {sup 18}F FDG PET-CT

    Energy Technology Data Exchange (ETDEWEB)

    Califano, Ines; Quildrian, Sergio; Otero, Jose; Coduti, Martin; Califano, Leonardo; Rojas Bilbao, Erica, E-mail: ines.m.califano@gmail.com [Instituto de Oncologia Angel H. Roffo, Universidad de Buenos Aires (Argentina)

    2013-06-15

    Distant metastases of differentiated thyroid cancer are unusual; lung and bones are the most frequently affected sites. Soft tissue metastases (STM) are extremely rare. We describe two cases of patients with differentiated thyroid cancer metastasizing to soft tissues. Both patients had widespread metastatic disease; clinically asymptomatic soft tissue metastases were found by 18-Fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F FDG PET-CT), and confirmed by cytological and/or histopathological studies. These findings underscore the ability of {sup 18}F FDG PET-CT in accurately assessing the extent of the disease, as well as the utility of the method to evaluate regions of the body that are not routinely explored. (author)

  13. Using 18F FDG PET/CT to Detect an occult Mesenchymal Tumor Causing Oncogenic Osteomalacia

    International Nuclear Information System (INIS)

    Seo, Hyo Jung; Choi, Yun Jung; Kim, Hyun Jeong; Jeong, Yong Hyu; Cho, Arthur; Lee, Jae Hoon; Yun, Mijin; Lee, Jong Doo; Kang, Won Jun

    2011-01-01

    Oncogenic osteomalacia is a rare paraneoplastic syndrome characterized by renal phosphate excretion, hypophosphatemia, and osteomalacia. This syndrome is often caused by tumors of mesenchymal origin. Patients with oncogenic osteomalacia have abnormal bone mineralization, resulting in a high frequency of fractures. Tumor resection is the treatment of choice, as it will often correct the metabolic imbalance. Although oncogenic osteomalacia is a potentially curable disease, diagnosis is difficult and often delayed because of the small size and sporadic location of the tumor. Bone scintigraphy and radiography best characterize osteoma lacia; magnetic resonance imaging findings are nonspecific. Here, we report a case of oncogenic osteomalacia secondary to a phosphaturic mesenchymal tumor that was successfully detected by 18F fluorodeoxyglucose positron emission tomography/computed tomography ( 18F FDG PET/CT). This case illustrates the advantages of 18F FDG PET/CT in detecting the occult mesenchymal tumor that causes oncogenic osteomalacia.

  14. FDG PET/CT in oncology: 'raising the bar'

    Energy Technology Data Exchange (ETDEWEB)

    Patel, C.N. [Departments of Radiology and Nuclear Medicine, Churchill Hospital, Oxford Radcliffe NHS Trust, Oxford (United Kingdom); Goldstone, A.R.; Chowdhury, F.U. [Departments of Radiology and Nuclear Medicine, St James' s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Scarsbrook, A.F., E-mail: andrew.scarsbrook@leedsth.nhs.u [Departments of Radiology and Nuclear Medicine, St James' s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom)

    2010-07-15

    Integrated positron-emission tomography/computed tomography (PET/CT) with 2-[{sup 18}F]-fluoro-2-deoxy-D-glucose (FDG) has revolutionized oncological imaging in recent years and now has a firmly established role in a variety of tumour types. There have been simultaneous step-wise advances in scanner technology, which are yet to be exploited to their full potential in clinical practice. This article will review these technological developments and explore how refinements in imaging protocols can further improve the accuracy and efficacy of PET/CT in oncology. The promises, and limitations, of emerging oncological applications of FDG PET/CT in radiotherapy planning and therapy response assessment will be explored. Potential future developments, including the use of FDG PET probes in oncological surgery, advanced data analysis techniques, and the prospect of integrated PET/magnetic resonance imaging (PET/MRI) will be highlighted.

  15. Giant cell tumor of the rib: Two cases of F-18 FDG PET/CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hye Lim; Yoo, Le Ryung; Lee, Yeong Joo; Jung, Chan Kwon [Seoul St. Mary' s Hospital, College of MedicineThe Catholic University of Korea, Seoul (Korea, Republic of); Park, Sonya Young Ju [Molecular Imaging Program, Dept. of Radiology, Stanford Hospital and Clinics, Stanford (Korea, Republic of)

    2017-06-15

    We report two cases of giant cell tumor arising from the rib and their F-18 FDG PET/CT findings. The two patients complained of chest wall pain, and large lobulated soft tissue masses with intense FDG uptake were seen on F-18 FDG PET/CT. A malignant tumor such as osteosarcoma or chondrosarcoma was suspected due to the large size of the mass, bony destruction, and intense FDG uptake. En bloc resection was performed and final pathologic results revealed giant cell tumor of the rib. Giant cell tumor of the rib is very rare, and larger lesions with high FDG uptake can be misdiagnosed as an intrathoracic malignancy arising from the rib, pleura, or chest wall.

  16. Use of statistical parametric mapping of 18F-FDG-PET in frontal lobe epilepsy

    International Nuclear Information System (INIS)

    Plotkin, M.; Amthauer, H.; Luedemann, L.; Hartkop, E.; Ruf, J.; Gutberlet, M.; Bertram, H.; Felix, R.; Venz, St.; Merschhemke, M.; Meencke, H.-J.

    2003-01-01

    Aim: Evaluation of the use of statistical parametrical mapping (SPM) of FDG-PET for seizure lateralization in frontal lobe epilepsy. Patients: 38 patients with suspected frontal lobe epilepsy supported by clinical findings and video-EEG monitoring. Method: Statistical parametrical maps were generated by subtraction of individual scans from a control group, formed by 16 patients with negative neurological/psychiatric history and no abnormalities in the MR scan. The scans were also analyzed visually as well as semiquantitatively by manually drawn ROIs. Results: SPM showed a better accordance to the results of surface EEG monitoring compared with visual scan analysis and ROI quantification. In comparison with intracranial EEG recordings, the best performance was achieved by combining the ROI based quantification with SPM analysis. Conclusion: These findings suggest that SPM analysis of FDG-PET data could be a useful as complementary tool in the evaluation of seizure focus lateralization in patients with supposed frontal lobe epilepsy. (orig.)

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

    DEFF Research Database (Denmark)

    Madsen, Karine; Hesby, Sara; Poulsen, Ingrid

    2017-01-01

    BACKGROUND: Loss of consciousness has been shown to reduce cerebral metabolic rates of glucose (CMRglc) measured by brain [(18)F]FDG-PET. Measurements of regional metabolic patterns by normalization to global cerebral metabolism or cerebellum may underestimate widespread reductions. NEW METHOD......: The aim of this study was to compare quantification methods of whole brain glucose metabolism, including whole brain [18F]FDG uptake normalized to uptake in cerebellum, normalized to injected activity, normalized to plasma tracer concentration, and two methods for estimating CMRglc. Six patients suffering...... from severe traumatic brain injury (TBI) and ten healthy controls (HC) underwent a 10min static [(18)F]FDG-PET scan and venous blood sampling. RESULTS: Except from normalizing to cerebellum, all quantification methods found significant lower level of whole brain glucose metabolism of 25-33% in TBI...

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  19. Effect of blood glucose level on 18F-FDG PET/CT imaging

    International Nuclear Information System (INIS)

    Tan Haibo; Lin Xiangtong; Guan Yihui; Zhao Jun; Zuo Chuantao; Hua Fengchun; Tang Wenying

    2008-01-01

    Objective: The aim of this study was to investigate the effect of blood glucose level on the image quality of 18 F-fluorodeoxyglucose (FDG) PET/CT imaging. Methods: Eighty patients referred to the authors' department for routine whole-body 18 F-FDG PET/CT check up were recruited into this study. The patients were classified into 9 groups according to their blood glucose level: normal group avg and SUV max ) of liver on different slices. SPSS 12.0 was used to analyse the data. Results: (1) There were significant differences among the 9 groups in image quality scores and image noises (all P avg and SUV max : 0.60 and 0.33, P<0.05). Conclusions: The higher the blood glucose level, the worse the image quality. When the blood glucose level is more than or equal to 12.0 mmol/L, the image quality will significantly degrade. (authors)

  20. 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.

  1. Feasibility of F-18-FDG PET/CT scan in abdominopelvic regions

    International Nuclear Information System (INIS)

    Suga, Kazuyoshi

    2008-01-01

    F-18-2-Fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/CT scan, which simultaneously provides metabolic function and morphology on the same tomographic section, is being the key imaging modality for diagnosis and treatment strategy of makignancies in various organs. FDG PET/CT scanning of the whole body beneficially allows the assessment of primary tumor and regional lymph nodes, and distant metastases and co-existed benign/other malignant lesions, as ''one stop shopping'' fashion. This technique contributes to the selection of the optimal treatment in individual patients, and also can predict histopathologic response to treatment and postoperative/post chemo-radiation therapeutic prognosis. In this paper, we describe the fundamental knowledge required for accurate interpretation of FDG PET/CT scan, and review the utility of this technique for diagnosis and treatment strategy of makignancies in abdominal and pelvic regions. (author)

  2. A Case of Meigs' Syndrome: The {sup 18F} FDG PET/CT Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Seong; Kim, Tae Sung; Yoo, Chong Woo; Seo, Sang Soo; Kim, Seok ki [Research Institute and Hospital, National Cancer Center, Gyeonggi do (Korea, Republic of)

    2011-09-15

    The findings of an ovarian mass with marked ascites and pleural effusion are highly suggestive of malignancy, especially in a postmenopausal female with an elevated level of CA 125. However, benign conditions such as Meigs' syndrome should be considered in the differential diagnosis if the primary mass shows benign features. {sup 18F} FDG is known to be useful to differentiate between malignant and benign diseases, and this utility is also promising in the case of ovarian tumor. We present here a case of Meigs' syndrome that was evaluated by {sup 18F} FDG PET/CT, and this helped the preoperative diagnosis be made. {sup 18F} FDG PET/CT is a promising modality to diagnose the pathological character of an ovarian tumor preoperatively, which can lead to a proper therapeutic plan.

  3. 18F-FDG PET/CT in breast cancer: Evidence-based recommendations in initial staging.

    Science.gov (United States)

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

    2017-10-01

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

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

    International Nuclear Information System (INIS)

    San Román, J.; Hovsepian, M.

    2017-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-10-15

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

  6. 18F FDG PET/CT in differential diagnosis of Parkinsonian disorders

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  7. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0

    Energy Technology Data Exchange (ETDEWEB)

    Boellaard, Ronald; Hoekstra, Otto S. [VU University Medical Centre, Department of Radiology and Nuclear Medicine, Amsterdam (Netherlands); Delgado-Bolton, Roberto [University of La Rioja, Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, San Pedro Hospital and Centre for Biomedical Research of La Rioja (CIBIR), Logrono, La Rioja (Spain); Oyen, Wim J.G.; Visser, Eric [Radboud University Nijmegen Medical Centre, Department of Radiology and Nuclear Medicine, Nijmegen (Netherlands); Giammarile, Francesco [Centre Hospitalier Universitaire de Lyon, Department of Nuclear Medicine, Lyon (France); Tatsch, Klaus [Municipal Hospital Karlsruhe Inc., Department of Nuclear Medicine, Karlsruhe (Germany); Eschner, Wolfgang [University of Cologne, Department of Nuclear Medicine, Cologne (Germany); Verzijlbergen, Fred J. [Erasmus Medical Center, Department of Nuclear Medicine, Rotterdam (Netherlands); Barrington, Sally F.; Pike, Lucy C. [King' s College London, King' s Health Partners, PET Imaging Centre, St Thomas' Hospital, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Weber, Wolfgang A. [Memorial Sloan Kettering Center, Department of Radiology, New York, NY (United States); Stroobants, Sigrid [Antwerp University Hospital, Department of Nuclear Medicine, Antwerp (Belgium); Delbeke, Dominique [Vanderbilt University Medical Center, Department of Radiology and Radiological Sciences, Nashville, TN (United States); Donohoe, Kevin J. [Beth Israel Deaconess Medical Center, Boston, MA (United States); Holbrook, Scott [Invivo Molecular Imaging LLC, Gray, TN (United States); Graham, Michael M. [University of Iowa, Department of Radiology, Iowa City, IA (United States); Testanera, Giorgio; Chiti, Arturo [Humanitas Clinical and Research Center, Department of Nuclear Medicine, Rozzano, MI (Italy); Zijlstra, Josee [VU University Medical Centre, Department of Hematology, Amsterdam (Netherlands); Hoekstra, Corneline J. [Jeroen Bosch Hospital, Department of Nuclear Medicine, Den Bosch (Netherlands); Pruim, Jan; Willemsen, Antoon [University Medical Centre Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen (Netherlands); Arends, Bertjan [Catharina Hospital, Department of Clinical Physics, Eindhoven (Netherlands); Kotzerke, Joerg [University Hospital Dresden, Clinic and Outpatient Clinic for Nuclear Medicine, Dresden (Germany); Bockisch, Andreas [University Hospital Essen, Clinic for Nuclear Medicine, Essen (Germany); Beyer, Thomas [Medical University of Vienna, Centre for Medical Physics and Biomedical Engineering, Vienna (Austria); Krause, Bernd J. [University Hospital Rostock, Department of Nuclear Medicine, Rostock (Germany)

    2014-12-02

    The purpose of these guidelines is to assist physicians in recommending, performing, interpreting and reporting the results of FDG PET/CT for oncological imaging of adult patients. PET is a quantitative imaging technique and therefore requires a common quality control (QC)/quality assurance (QA) procedure to maintain the accuracy and precision of quantitation. Repeatability and reproducibility are two essential requirements for any quantitative measurement and/or imaging biomarker. Repeatability relates to the uncertainty in obtaining the same result in the same patient when he or she is examined more than once on the same system. However, imaging biomarkers should also have adequate reproducibility, i.e. the ability to yield the same result in the same patient when that patient is examined on different systems and at different imaging sites. Adequate repeatability and reproducibility are essential for the clinical management of patients and the use of FDG PET/CT within multicentre trials. A common standardised imaging procedure will help promote the appropriate use of FDG PET/CT imaging and increase the value of publications and, therefore, their contribution to evidence-based medicine. Moreover, consistency in numerical values between platforms and institutes that acquire the data will potentially enhance the role of semiquantitative and quantitative image interpretation. Precision and accuracy are additionally important as FDG PET/CT is used to evaluate tumour response as well as for diagnosis, prognosis and staging. Therefore both the previous and these new guidelines specifically aim to achieve standardised uptake value harmonisation in multicentre settings. (orig.)

  8. 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.)

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  10. 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.)

  11. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0

    International Nuclear Information System (INIS)

    Boellaard, Ronald; Hoekstra, Otto S.; Delgado-Bolton, Roberto; Oyen, Wim J.G.; Visser, Eric; Giammarile, Francesco; Tatsch, Klaus; Eschner, Wolfgang; Verzijlbergen, Fred J.; Barrington, Sally F.; Pike, Lucy C.; Weber, Wolfgang A.; Stroobants, Sigrid; Delbeke, Dominique; Donohoe, Kevin J.; Holbrook, Scott; Graham, Michael M.; Testanera, Giorgio; Chiti, Arturo; Zijlstra, Josee; Hoekstra, Corneline J.; Pruim, Jan; Willemsen, Antoon; Arends, Bertjan; Kotzerke, Joerg; Bockisch, Andreas; Beyer, Thomas; Krause, Bernd J.

    2015-01-01

    The purpose of these guidelines is to assist physicians in recommending, performing, interpreting and reporting the results of FDG PET/CT for oncological imaging of adult patients. PET is a quantitative imaging technique and therefore requires a common quality control (QC)/quality assurance (QA) procedure to maintain the accuracy and precision of quantitation. Repeatability and reproducibility are two essential requirements for any quantitative measurement and/or imaging biomarker. Repeatability relates to the uncertainty in obtaining the same result in the same patient when he or she is examined more than once on the same system. However, imaging biomarkers should also have adequate reproducibility, i.e. the ability to yield the same result in the same patient when that patient is examined on different systems and at different imaging sites. Adequate repeatability and reproducibility are essential for the clinical management of patients and the use of FDG PET/CT within multicentre trials. A common standardised imaging procedure will help promote the appropriate use of FDG PET/CT imaging and increase the value of publications and, therefore, their contribution to evidence-based medicine. Moreover, consistency in numerical values between platforms and institutes that acquire the data will potentially enhance the role of semiquantitative and quantitative image interpretation. Precision and accuracy are additionally important as FDG PET/CT is used to evaluate tumour response as well as for diagnosis, prognosis and staging. Therefore both the previous and these new guidelines specifically aim to achieve standardised uptake value harmonisation in multicentre settings. (orig.)

  12. F18-FDG PET/CT Scanning in Angiosarcoma: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Emel TOKMAK

    2011-08-01

    Full Text Available Angiosarcomas are uncommon tumors and constitute less than 5% of all soft tissue sarcomas. They are aggressive tumors with poor prognosis, therefore, it is quite important to determine disease extension and detect local recurrence and/or distant metastases for appropriate therapy management. In this paper, we aimed to demonstrate the potential role of 1F18-FDG PET/CT imaging by reporting two cases with angiosarcoma (MIRT 2011;20:63-66

  13. Molecular pathology in vulnerable carotid plaques: correlation with [18]-fluorodeoxyglucose positron emission tomography (FDG-PET)

    DEFF Research Database (Denmark)

    Graebe, M; Pedersen, Sune Folke; Borgwardt, L

    2008-01-01

    OBJECTIVES: Atherosclerosis is recognised as an inflammatory disease, and new diagnostic tools are warranted to evaluate plaque inflammatory activity and risk of cardiovascular events. We investigated [18]-fluorodeoxyglucose (FDG) uptake in vulnerable carotid plaques visualised by positron emission...... tomography (PET). Uptake was correlated to quantitative gene expression of known markers of inflammation and plaque vulnerability. METHODS: Ten patients with recent transient ischaemic attack and carotid artery stenosis (>50%) underwent combined FDG-PET and computed tomography angiography (CTA) the day...

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

    International Nuclear Information System (INIS)

    Kawasaki, Hidenori; Higa, Noboru; Yohena, Tomofumi

    2011-01-01

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

  15. Predictive value of brain 18F-FDG PET/CT in macrophagic myofasciitis?

    OpenAIRE

    Van Der Gucht, Axel; Abulizi, Mukedaisi; Blanc-Durand, Paul; Aoun-Sebaiti, Mehdi; Emsen, Berivan; Gherardi, Romain K.; Verger, Antoine; Authier, François-Jérôme; Itti, Emmanuel

    2017-01-01

    Abstract Rationale: Although several functional studies have demonstrated that positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (18F-FDG PET/CT) appears to be efficient to identify a cerebral substrate in patients with known macrophagic myofasciitis (MMF), the predictive value of this imaging technique for MMF remains unclear. Patient concerns: We presented data and images of a 46-year-old woman. Diagnoses: The patient was referred to our center for suspected MMF d...

  16. FDG-PET/CT Brain Findings in a Patient With Macrophagic Myofasciitis

    OpenAIRE

    Van Der Gucht, Axel; Aoun-Sebaiti, Mehdi; Kauv, Paul; Guedj, Eric; Aouizerate, Jessie; Verger, Antoine; Gherardi, Romain K.; Bachoud-Levi, Anne-Catherine; Authier, Fran?ois-J?r?me; Itti, Emmanuel

    2015-01-01

    Brain Positron Emission Tomography/Computed Tomography with 18F-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 anal...

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    Science.gov (United States)

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

    2018-06-01

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

  19. Visual and statistical analysis of {sup 18}F-FDG PET in primary progressive aphasia

    Energy Technology Data Exchange (ETDEWEB)

    Matias-Guiu, Jordi A.; Moreno-Ramos, Teresa; Garcia-Ramos, Rocio; Fernandez-Matarrubia, Marta; Oreja-Guevara, Celia; Matias-Guiu, Jorge [Hospital Clinico San Carlos, Department of Neurology, Madrid (Spain); Cabrera-Martin, Maria Nieves; Perez-Castejon, Maria Jesus; Rodriguez-Rey, Cristina; Ortega-Candil, Aida; Carreras, Jose Luis [San Carlos Health Research Institute (IdISSC) Complutense University of Madrid, Department of Nuclear Medicine, Hospital Clinico San Carlos, Madrid (Spain)

    2015-05-01

    Diagnosing progressive primary aphasia (PPA) and its variants is of great clinical importance, and fluorodeoxyglucose (FDG) positron emission tomography (PET) may be a useful diagnostic technique. The purpose of this study was to evaluate interobserver variability in the interpretation of FDG PET images in PPA as well as the diagnostic sensitivity and specificity of the technique. We also aimed to compare visual and statistical analyses of these images. There were 10 raters who analysed 44 FDG PET scans from 33 PPA patients and 11 controls. Five raters analysed the images visually, while the other five used maps created using Statistical Parametric Mapping software. Two spatial normalization procedures were performed: global mean normalization and cerebellar normalization. Clinical diagnosis was considered the gold standard. Inter-rater concordance was moderate for visual analysis (Fleiss' kappa 0.568) and substantial for statistical analysis (kappa 0.756-0.881). Agreement was good for all three variants of PPA except for the nonfluent/agrammatic variant studied with visual analysis. The sensitivity and specificity of each rater's diagnosis of PPA was high, averaging 87.8 and 89.9 % for visual analysis and 96.9 and 90.9 % for statistical analysis using global mean normalization, respectively. In cerebellar normalization, sensitivity was 88.9 % and specificity 100 %. FDG PET demonstrated high diagnostic accuracy for the diagnosis of PPA and its variants. Inter-rater concordance was higher for statistical analysis, especially for the nonfluent/agrammatic variant. These data support the use of FDG PET to evaluate patients with PPA and show that statistical analysis methods are particularly useful for identifying the nonfluent/agrammatic variant of PPA. (orig.)

  20. 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)

  1. 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

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

    Science.gov (United States)

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

    2016-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-10-15

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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  5. Malignancy rate of biopsied suspicious bone lesions identified on FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Hugo J.A.; Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Klerk, John M.H. de [Meander Medical Center, Department of Nuclear Medicine, Amersfoort (Netherlands); Heggelman, Ben G.F. [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Dubois, Stefan V. [Meander Medical Center, Department of Pathology, Amersfoort (Netherlands)

    2016-07-15

    To determine the malignancy rate of bone lesions identified on FDG PET/CT in patients who have undergone CT-guided biopsy because of the suspicion of malignancy. This single-centre retrospective study spanned eight consecutive years and included all patients who underwent both FDG PET/CT and CT-guided bone biopsy because of the suspicion of malignancy. The positive predictive value (PPV) for malignancy was calculated, and different patient and imaging characteristics were compared between malignant and benign bone lesions. Of 102 included patients with bone lesions that all showed FDG uptake exceeding mediastinal uptake, bone biopsy showed a malignant lesion in 91 patients, yielding a PPV for malignancy of 89.2 % (95 % CI 81.7 - 93.9 %). In the 94 patients with bone lesions that showed FDG uptake exceeding liver uptake, bone biopsy showed a malignant lesion in 83 patients, yielding a PPV for malignancy of 88.3 % (95 % CI 80.1 - 93.5 %). Higher age, bone marrow replacement of the lesion seen on CT, expansion of the lesion seen on CT, and presence of multifocal lesions on FDG PET/CT were significantly more frequent in patients with malignant lesions than in those with benign bone lesions (P = 0.044, P = 0.009, P = 0.015, and P = 0.019, respectively). Furthermore, there was a trend towards a higher incidence of cortical destruction (P = 0.056) and surrounding soft tissue mass (P = 0.063) in patients with malignant bone lesions. The PPV for malignancy of suspicious bone lesions identified on FDG PET/CT is not sufficiently high to justify changes in patient management without histopathological confirmation. Nevertheless, ancillary patient and imaging characteristics may increase the likelihood of a malignant bone lesion. (orig.)

  6. Impact of FDG-PET on lung cancer delineation for radiotherapy

    International Nuclear Information System (INIS)

    Morarji, Kavita; Fowler, Allan; Vinod, Shalini K.; Shon, Ivan Ho; Laurence, Jerome M.

    2012-01-01

    The purpose of this study is to assess the impact of fused diagnostic F-18 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) and planning FDG-PET/CT scans on voluming of lung cancer for radiotherapy. Five radiation oncologists (ROs), five radiation oncology trainees and a radiologist contoured five cases of non-small cell lung cancer. The CT alone, the diagnostic FDG-PET/CT and planning FDG-PET/CT each registered to the CT, were used to contour three volumes. The concordance index (CI) was used to compare each volume with a reference RO. Although there was considerable inter-observer variability in CT contouring, there was no significant difference between mean volumes of the gross tumour volume for the RO and radiation oncology trainees using any technique. There was no increase in CI with the addition of PET/CT, either diagnostic or planning, for the RO. However, the volumes of the radiation oncology trainees showed a significant increase in CI from 65.8% with CT alone to 68.0% and 72.3% with diagnostic PET/CT and planning PET/CT, respectively (P = 0.028). Mean variation at the tumour/mediastinum interface was significantly reduced with addition of registered PET/CT. The concordance of RO with the reference RO did not significantly increase with use of integrated FDG PET/CT images. However, the contouring of radiation oncology trainees' became more concordant with the reference.

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  10. Visual and statistical analysis of 18F-FDG PET in primary progressive aphasia

    International Nuclear Information System (INIS)

    Matias-Guiu, Jordi A.; Moreno-Ramos, Teresa; Garcia-Ramos, Rocio; Fernandez-Matarrubia, Marta; Oreja-Guevara, Celia; Matias-Guiu, Jorge; Cabrera-Martin, Maria Nieves; Perez-Castejon, Maria Jesus; Rodriguez-Rey, Cristina; Ortega-Candil, Aida; Carreras, Jose Luis

    2015-01-01

    Diagnosing progressive primary aphasia (PPA) and its variants is of great clinical importance, and fluorodeoxyglucose (FDG) positron emission tomography (PET) may be a useful diagnostic technique. The purpose of this study was to evaluate interobserver variability in the interpretation of FDG PET images in PPA as well as the diagnostic sensitivity and specificity of the technique. We also aimed to compare visual and statistical analyses of these images. There were 10 raters who analysed 44 FDG PET scans from 33 PPA patients and 11 controls. Five raters analysed the images visually, while the other five used maps created using Statistical Parametric Mapping software. Two spatial normalization procedures were performed: global mean normalization and cerebellar normalization. Clinical diagnosis was considered the gold standard. Inter-rater concordance was moderate for visual analysis (Fleiss' kappa 0.568) and substantial for statistical analysis (kappa 0.756-0.881). Agreement was good for all three variants of PPA except for the nonfluent/agrammatic variant studied with visual analysis. The sensitivity and specificity of each rater's diagnosis of PPA was high, averaging 87.8 and 89.9 % for visual analysis and 96.9 and 90.9 % for statistical analysis using global mean normalization, respectively. In cerebellar normalization, sensitivity was 88.9 % and specificity 100 %. FDG PET demonstrated high diagnostic accuracy for the diagnosis of PPA and its variants. Inter-rater concordance was higher for statistical analysis, especially for the nonfluent/agrammatic variant. These data support the use of FDG PET to evaluate patients with PPA and show that statistical analysis methods are particularly useful for identifying the nonfluent/agrammatic variant of PPA. (orig.)

  11. FDG-PET for diagnosing prosthetic joint infection: systematic review and metaanalysis

    Energy Technology Data Exchange (ETDEWEB)

    Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Kwee, Robert M. [University Medical Center Maastricht, Department of Radiology, Maastricht (Netherlands); Alavi, Abass [Hospital of the University of Pennsylvania, Division of Nuclear Medicine, Philadelphia, PA (United States)

    2008-11-15

    The aim of this study was to systematically review and metaanalyze published data on the diagnostic performance of {sup 18}F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) in detecting prosthetic hip or knee joint infection. A systematic search for relevant studies was performed of the PubMed/MEDLINE and Embase databases. Two reviewers independently assessed the methodological quality of each study. A metaanalysis of the reported sensitivity and specificity of each study was performed. Subgroup analyses were performed if results of individual studies were heterogeneous. The inclusion criteria were met by 11 studies; there was a total sample size of 635 prostheses. Overall, the studies had good methodological quality. Pooled sensitivity and specificity of FDG-PET for the detection of prosthetic hip or knee joint infection were 82.1% (95%CI = 68.0-90.8%) and 86.6% (95%CI = 79.7-91.4%), respectively. Heterogeneity among the results of individual studies was present (I {sup 2} = 68.8%). Diagnostic performance was influenced by type of joint prostheses (hip prostheses vs. knee prostheses) and type of reconstruction method used (filtered back vs. iterative) (p = 0.0164 and p = 0.0235, respectively). In this metaanalysis, overall diagnostic performance of FDG-PET was moderate to high. Caution is warranted, however, because results of individual studies were heterogeneous and could not be fully explored. Future studies should further explore potential causes of heterogeneity and validate the use of FDG-PET for diagnosing prosthetic joint infection. (orig.)

  12. Costs of F-18-FDG PET: experience with a satellite concept

    International Nuclear Information System (INIS)

    Lottes, G.; Kuwert, T.; Schober, O.; Gorschlueter, P.; Adam, D.

    1998-01-01

    Aim: One of the main arguments against the acceptance and introduction of FDG PET as a regular benefit in the statutory Medical Insurance system in Germany are its (alleged) high costs. The aim of the present study has been to determine empirically over a period of twelve months the costs of FDG PET, making use of a satellite concept. Methods: Documentation on performance and consumption data have been assembled for purposes of cost analysis. After analysis these data provided the basis for an assessment of the costs. In view of the high proportion of fixed overheads and strong fluctuations in consumption values, it was not possible to allocate reliably in an individual FDG PET investigation the various types of costs to individual causes. A monthly cost assessment procedure was therefore adopted. For this purpose data were recorded in the Department for Nuclear Medicine, while the statistical assessment of the consumption data and analysis of the costs were undertaken in the Institute of Industrial and Hospital Management. Results: Over the twelve month observation period (November 1995 to October 1996, 177 working days) 433 patients were included in the study: 244 with brain diseases, 37 cardiac patients, 130 whole body studies and 22 combined studies (brain and whole body scans). The non volume based costs, maintenance charges and depreciation accounted for the highest proportion of the total costs (48%). The FDG-related costs accounted for 41% of the total costs, while the personnel costs amounted to 11% and the film costs to only 0.45%. The total costs incurred amounted to DM 1,205,050. Conclusion: These data represent a first empirical cost analysis for FDG PET based on a satellite concept and form a starting point for a cost/benefit analysis of this procedure. (orig.) [de

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-12-31

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

  14. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

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

  16. Cylindrical SUV distribution model for detecting skin lesions in body trunk FDG-PET/CT images

    International Nuclear Information System (INIS)

    Nemoto, Mitsutaka; Nomura, Yukihiro; Masutani, Yoshitaka; Yoshikawa, Takeharu; Hayashi, Naoto; Yoshioka, Naoki; Ohtomo, Kuni; Hanaoka, Shouhei

    2010-01-01

    We have been developing a computerized detection method for skin lesions in body trunk fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT images. Spots on the skin with a high standard uptake value (SUV) are due not only to glucose metabolism in skin lesions but also to the physiological metabolism of organs near the skin. The distribution pattern of regional SUV on the skin is important information for the differential diagnosis of such high-SUV spots. In this study, we have developed a new skin lesion detection method based on a cylindrical SUV distribution model of the skin. The shape of the SUV distribution model is an approximation of the body trunk, and the SUV distribution model includes standard values for regional skin SUV. Classifier ensembles based on CT image features, SUV features, and subtraction features between the SUVs in FDG-PET images and the values in the SUV distribution model are used to extract and classify candidate regions for skin lesions. In a study of skin lesion detection using FDG-PET/CT images in 36 clinical cases, the true-positive rate was 61.7%, with 11.7 false-positive regions per case. The training results of the classifier ensemble for extracting and classifying candidate regions showed the effective features for detecting skin lesions in the study. (author)

  17. FDG-PET imaging for the assessment of physiologic volume response during radiotherapy in cervix cancer

    International Nuclear Information System (INIS)

    Lin, Lilie L.; Yang Zhiyun; Mutic, Sasa; Miller, Tom R.; Grigsby, Perry W.

    2006-01-01

    Purpose: To evaluate the physiologic tumor volume response during treatment in cervical cancer using 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). Patients and Methods: This was a prospective study of 32 patients. Physiologic tumor volume in cubic centimeters was determined from the FDG-PET images using the 40% threshold method. Results: The mean pretreatment tumor volume was 102 cm 3 . The mean volume by clinical Stages I, II, and III were 54, 79, and 176 cm 3 , respectively. After 19.8 Gy external irradiation to the pelvis, the reduction in tumor volume was 29% (72 cm 3 ). An additional 13 Gy from high-dose-rate (HDR) brachytherapy reduced the mean volume to 15.4 cm 3 , and this was subsequently reduced to 8.6 cm 3 with 13 Gy additional HDR brachytherapy (26 Gy, HDR). Four patients had physiologic FDG uptake in the cervix at 3 months after the completion of therapy. The mean time to the 50% reduction in physiologic tumor volume was 19.9 days and after combined external irradiation and HDR to 24.9 Gy. Conclusion: These results indicate that physiologic tumor volume determination by FDG-PET is feasible and that a 50% physiologic tumor volume reduction occurs within 20 days of starting therapy

  18. Utility of FDG PET/CT in IgG4-related systemic disease

    Energy Technology Data Exchange (ETDEWEB)

    Nakatani, K., E-mail: koyakn@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto (Japan); Nakamoto, Y.; Togashi, K. [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto (Japan)

    2012-04-15

    IgG4-related systemic disease (IgG4-RSD) is an emerging clinical entity about which much remains to be elucidated, in terms of its aetiology, pathogenesis, diagnosis, treatment and outcome. Autoimmune pancreatitis (AIP) and Mikulicz disease (MD) are the two major, well-studied constituents of IgG4-RSD. AIP and MD have common characteristics of forming tumour-mimicking lesions that consist of lymphoplasmacytic infiltrates and fibrosclerosis with numerous immunoglobulin G4 (IgG4)-positive plasma cells, as well as various multi-organ manifestations of IgG4-RSD. 2-[{sup 18}F]-fluoro-2-deoxy-D-glucose positron-emission tomography/ computed tomography (FDG PET/CT) enables the acquisition of whole-body images and provides functional information about disease activity; as such it has a valuable role in staging extent of disease, guiding biopsy, and monitoring response to treatment. However, FDG PET/CT is likely to be only one component of the management strategy, and clinical, laboratory, imaging and histological findings are crucial in the overall diagnosis of the condition. At present FDG PET/CT does not have a well-established role in the assessment of patients with IgG4-RSD and future prospective studies are required to define the cost-effectiveness and clinical impact in this patient group more accurately.

  19. Strategy of diagnosis and treatment for pediatric solid tumor patients using FDG-PET

    International Nuclear Information System (INIS)

    Hosono, Ako; Watanabe, Atsuko; Tsuji, Naoko; Kawamoto, Hiroshi; Makimoto, Atsushi; Tateishi, Ukihide; Terauthi, Takashi

    2006-01-01

    Usefulness of FDG-PET (18F-deoxyglucose PET) was investigated in diagnosis and therapeutic planning of childhood and adolescence malignant solid tumors. Evidence was based on 46 patients (25 males) of ages 5-30 y, involving those with rhabdomyosarcoma (17 cases), Ewing's sarcoma (13), osteosarcoma (5), neuroblastoma (4), Wilms' tumor (2), germinoma (2), and each 1 case of ganglioblastoma, retinoblastoma and hepatoblastoma. In total, they underwent 104 FDG-PET examinations for diagnosis before and during treatment in authors' hospital in the period from January 2005 to February 2006. Evaluations were done with the standard uptake value (SUV, 1 x 1 cm ROI of abnormally high distribution area of radioactivity in the lesion/FDG dose/kg body wt.), by recurrence, by early detection of exacerbation and by follow up of residual tumors, of which typical image findings were herein presented. From the aspects of the present purposes, it was concluded that FDG-PET had advantages of high resolution, short imaging time, quantitative diagnosis (SUV) as well as the tumor detection, and had defects of difficulty of detection of tumors of <1 cm size, of distribution to normal or benign tissues and of difficulty of central nervous system (CNS) imaging. (T.I.)

  20. Evaluation of malignant solid tumor in childhood with FDG-PET

    International Nuclear Information System (INIS)

    Ishida, Amane; Goto, Hiroaki; Kuroki, Fumiko

    2006-01-01

    Usefulness of FDG-PET (18F-deoxyglucose PET) was examined in evaluation of diagnosis and therapeutic efficacy of childhood malignant solid tumors. Subjects were 32 patients (16 males) of the median age of 7 y (1 - 27 y), involving those with neuroblastoma (9 cases), hepatoblastoma (4), chronic granulomatous disorder (4) and others (each ≤2). They underwent 75 FDG-PET examinations for diagnosis before and during treatment in authors' hospital in the period from May 2001 to December 2003. Standard uptake value (SUV), 1 x 1 cm region of interest (ROI) of abnormally high distribution area of radioactivity in the lesion/FDG dose/kg body wt., was used for evaluation: SUV>1.5 was defined positive. In neuroblastoma, FDG was found to be highly distributed and kinetics of SUV, to be useful for evaluation of therapeutic efficacy and early metastasis detection. In some cases of hepatoblastoma, the therapeutic effectiveness and recurrence were not satisfactorily evaluative. The distribution of FDG was not satisfactory in Wilms' tumor relative to other tumors. The PET was thought to be useful, despite their small case number examined, for those evaluations of Ewing's tumor, dysgerminoma and Langerhans cell histiocytosis. Thus FDG-PET was found useful for detection, evaluation of therapeutic efficacy and early metastasis detection of pediatric malignant solid tumors. (T.I.)

  1. Utility of FDG PET/CT in IgG4-related systemic disease

    International Nuclear Information System (INIS)

    Nakatani, K.; Nakamoto, Y.; Togashi, K.

    2012-01-01

    IgG4-related systemic disease (IgG4-RSD) is an emerging clinical entity about which much remains to be elucidated, in terms of its aetiology, pathogenesis, diagnosis, treatment and outcome. Autoimmune pancreatitis (AIP) and Mikulicz disease (MD) are the two major, well-studied constituents of IgG4-RSD. AIP and MD have common characteristics of forming tumour-mimicking lesions that consist of lymphoplasmacytic infiltrates and fibrosclerosis with numerous immunoglobulin G4 (IgG4)-positive plasma cells, as well as various multi-organ manifestations of IgG4-RSD. 2-[ 18 F]-fluoro-2-deoxy-D-glucose positron-emission tomography/ computed tomography (FDG PET/CT) enables the acquisition of whole-body images and provides functional information about disease activity; as such it has a valuable role in staging extent of disease, guiding biopsy, and monitoring response to treatment. However, FDG PET/CT is likely to be only one component of the management strategy, and clinical, laboratory, imaging and histological findings are crucial in the overall diagnosis of the condition. At present FDG PET/CT does not have a well-established role in the assessment of patients with IgG4-RSD and future prospective studies are required to define the cost-effectiveness and clinical impact in this patient group more accurately.

  2. Deep-learning-based classification of FDG-PET data for Alzheimer's disease categories

    Science.gov (United States)

    Singh, Shibani; Srivastava, Anant; Mi, Liang; Caselli, Richard J.; Chen, Kewei; Goradia, Dhruman; Reiman, Eric M.; Wang, Yalin

    2017-11-01

    Fluorodeoxyglucose (FDG) positron emission tomography (PET) measures the decline in the regional cerebral metabolic rate for glucose, offering a reliable metabolic biomarker even on presymptomatic Alzheimer's disease (AD) patients. PET scans provide functional information that is unique and unavailable using other types of imaging. However, the computational efficacy of FDG-PET data alone, for the classification of various Alzheimers Diagnostic categories, has not been well studied. This motivates us to correctly discriminate various AD Diagnostic categories using FDG-PET data. Deep learning has improved state-of-the-art classification accuracies in the areas of speech, signal, image, video, text mining and recognition. We propose novel methods that involve probabilistic principal component analysis on max-pooled data and mean-pooled data for dimensionality reduction, and multilayer feed forward neural network which performs binary classification. Our experimental dataset consists of baseline data of subjects including 186 cognitively unimpaired (CU) subjects, 336 mild cognitive impairment (MCI) subjects with 158 Late MCI and 178 Early MCI, and 146 AD patients from Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset. We measured F1-measure, precision, recall, negative and positive predictive values with a 10-fold cross validation scheme. Our results indicate that our designed classifiers achieve competitive results while max pooling achieves better classification performance compared to mean-pooled features. Our deep model based research may advance FDG-PET analysis by demonstrating their potential as an effective imaging biomarker of AD.

  3. 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.)

  4. Integrated FDG-PET/CT for detection, therapy monitoring and follow-up of granulocytic sarcoma. Initial results

    Energy Technology Data Exchange (ETDEWEB)

    Aschoff, Philip; Werner, M.K.; Lichy, M.; Pfannenberg, C. [Dept. of Diagnostic and Interventional Radiology, Univ. Hospital, Eberhard-Karls-Univ. Tuebingen (Germany); Haentschel, M.; Vogel, W. [Dept. of Internal Medicine, Univ. Hospital, Eberhard-Karls-Univ. Tuebingen (Germany); Oeksuez, M. [Dept. of Nuclear Medicine, Univ. Hospital, Eberhard-Karls-Univ. Tuebingen (Germany)

    2009-07-01

    Granulocytic sarcomas (GS) are rare extramedullary manifestations of myeloid or lymphoblastic leukaemia. Laboratory examinations are of limited use for diagnosis of extramedullary disease. Radiological imaging based on morphology is challenging. To date, the possible role of FDG-PET/CT as a method for combined metabolic and morphologic imaging is unclear. We present a series of 10 patients to evaluate the potential role of FDG-PET/CT in the management of GS. Patients, materials, methods: a retrospective evaluation of 18 FDG-PET/CT exams in 10 patients with histologically proven GS was performed. All scans included a contrast enhanced CT. The FDG uptake of GS was analyzed and the sensitivity of lesion detection was compared to PET and CT alone. The changes in FDG uptake after therapy were compared to morphological changes detected by CT and follow-up/clinical outcome. Results: 52 untreated or recurrent GS lesions were detected by FDG-PET/CT and all showed an increased FDG uptake with a mean SUVmax and SUVavg of 5.1 and 3.4, respectively. GS was multifocal in 8/10 patients. Combined PET/CT avoided 5 false positive findings compared to PET alone and 13 false negative findings and 1 false positive compared to CT alone. Changes in FDG uptake after therapy correlated with clinical outcome and were more reliable than CT assessment alone. PET/CT identified recurrent GS in 3 patients. Conclusion: viable GS are FDG-avid. Using this metabolic information and morphologic CT criteria, combined FDG-PET/CT was more accurate in lesion detection than FDG-PET or CT alone. Changes in FDG uptake after therapy might be a useful additional parameter for therapy monitoring. Therefore, FDG-PET/CU appears to be a promising diagnostic and monitoring tool in the management of patients with GS. (orig.)

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  6. Diagnosis of pancreatic cancer using fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET). Usefulness and limitations in clinical reality''

    International Nuclear Information System (INIS)

    Higashi, Tatsuya; Saga, Tsuneo; Ishimori, Takayoshi; Fujimoto, Koji; Doi, Ryuichiro; Imamura, Masayuki; Konishi, Junji

    2003-01-01

    The present review will provide an overview of the literature concerning the FDG PET diagnosis of pancreatic cancer and a summary from our experience of 231 cases of pancreatic lesions. FDG PET can effectively differentiate pancreatic cancer from benign lesion with high accuracy. Newly-developed PET scanners can detect small pancreatic cancers, up to 7 mm in diameter, by their high resolution, which could make a great contribution to the early detection of resectable and potentially curable pancreatic cancers. FDG PET is useful and cost-beneficial in the pre-operative staging of pancreatic cancer because an unexpected distant metastasis can be detected by whole-body PET in about 40% of the cases, which results in avoidance of unnecessary surgical procedures. FDG PET is also useful in evaluation of the treatment effect, monitoring after the operation and detection of recurrent pancreatic cancers. However, there are some drawbacks in PET diagnosis. A relatively wide overlap has been reported between semiquantitative uptake values obtained in cancers and those in inflammatory lesions. As for false-positive cases, active and chronic pancreatitis and autoimmune pancreatitis sometimes show high FDG accumulation and mimic pancreatic cancer with a shape of focal uptake. There were 8 false negative cases in the detection of pancreatic cancer by FDG PET, up to 33 mm in diameter, mainly because of their poor cellularity in cancer tissues. In addition, there are 19% of cancer cases with a decline in FDG uptake from 1 hr to 2 hr scan. FDG PET was recently applied to and was shown to be feasible in the differential diagnosis of cystic pancreatic lesions, such as intraductal papillary mucinous tumor of the pancreas. Further investigations are required to clarify the clinical value of FDG PET in predicting prognosis of the pancreatic patients. (author) 124 refs

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

    International Nuclear Information System (INIS)

    Koizumi, Satoko

    2011-01-01

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

  8. FDG-PET/CT detection of very early breast cancer in women with breast microcalcification lesions found in mammography screening

    International Nuclear Information System (INIS)

    Peng, Nang-Jing; Chou, Chen-Pin; Pan, Huay-Ben; Chang, Tsung-Hsien; Hu, Chin; Chiu, Yu-Li; Fu, Ting-Ying; Chang, Hong-Tai

    2015-01-01

    To assess the efficacy of positron emission tomography/computed tomography with the glucose analogue 2-[ 18 F]fluoro-2-deoxy-D-glucose (FDG-PET/CT) in Taiwanese women with early breast cancer detected by mammography screening. Dual-time-point imaging of whole-body supine and breast prone scans using FDG-PET/CT were performed sequentially in the pre-operative stage. A total of 11,849 patients underwent screening mammography, of whom 1,209 (10.2%) displayed positive results. After further investigation, 54 patients underwent FDG-PET/CT. Post-operative pathology examinations revealed malignancies in 26 lesions, including invasive breast cancer in 11 cases and non-invasive breast cancer in 15 cases, as well as benign disease in 30 lesions. The FDG-PET/CT findings from the whole-body scans were positive for 9 of 11 invasive breast cancers (81.8%) and 3 of 15 non-invasive cancers (20%), and they were negative for all benign lesions. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FDG-PET/CT with whole-body supine imaging were 46.2%, 100%, 100% and 68.2%, respectively. Breast prone imaging revealed another patient with ductal carcinoma in situ, increasing the sensitivity to 50%. Importantly, positive PET findings were significantly correlated with tumour histology (P = 0.006), tumour size (P = 0.039) and Ki-67 expression (P = 0.011). FDG-PET/CT with whole-body scanning demonstrated high sensitivity to invasive breast cancer, limited sensitivity to non-invasive breast cancer, and high specificity for breast cancer. FDG-PET/CT might be useful for differentiating tumour invasiveness. However, the good PPV but poor NPV do not allow the physician to discard the biopsy.

  9. Meta-analysis of the performance of 18F-FDG PET in cutaneous melanoma

    International Nuclear Information System (INIS)

    Jimenez-Requena, Felisa; Perez-Vazquez, Jose M.; Delgado-Bolton, Roberto C.; Carreras-Delgado, Jose L.; Fernandez-Perez, Cristina; Gambhir, Sanjiv S.; Schwimmer, Judy

    2010-01-01

    The aim of this study was to perform a systematic review of the literature to evaluate the accuracy of FDG-PET in staging and restaging of cutaneous melanoma. Systematic methods were used to identify, select, and evaluate the methodologic quality of the studies as well as to summarize the overall findings of sensitivity and specificity. The search strategy consisted of identifying studies published between 2000 and 2006. Inclusion criteria were studies that evaluated the diagnostic performance of FDG-PET in staging/restaging of cutaneous melanoma. The results were compared and pooled with a meta-analysis published previously that included studies published until 1999. The meta-analysis included 95% confidence intervals (CI) of sensitivity, specificity, likelihood-ratio (LR), and diagnostic-odds-ratio (DOR). The quantitative meta-analysis included 24 studies that were analysed in two groups: eight studies were included only in the regional staging analysis (group I), 13 studies were included only in the detection of distant metastases analysis (group II), and three studies were included in both analyses. Compliance with the methodologic-quality criteria was acceptable. We analysed the results of data presented in patients, lesions, basins, lymph-nodes, areas, and scans. Regarding the performance of FDG-PET in the detection of metastases, the pooled studies presented homogeneity for the negative-LR (0.15; 95% CI, 0.10-0.22) when analyzing lesions. When analyzing scans, there was global homogeneity for specificity (0.86; 95% CI, 0.77-0.92), positive-LR (5.86; 95% CI, 3.64-9.43), and DOR (37.89; 95% CI, 15.80-90.86). The pooled studies presented heterogeneity for the other items analysed. Regarding the detection of regional metastases, when analyzing lymph-nodes there was global homogeneity for specificity (0.99; 95% CI, 0.97-0.99; P = 0.101). The meta-regression evidenced that the variable that most influenced the DOR of the different studies and that can explain the

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

    Science.gov (United States)

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

    2015-11-01

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

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  13. Detection of Extramedullary Multiple Myeloma in Liver by FDG-PET/CT

    International Nuclear Information System (INIS)

    Kim, Daeweung; Kim, Woo Hyoung; Kim, Myoung Hyoun; Choi, Keum Ha; Kim, Chang Guhn

    2014-01-01

    We present the case of a 42-year-old man with a painful mass lesion in the right shoulder that was detected by contrast-enhanced computed tomography (CT) and 18 F-fluoro-2-deoxyglucose ( 18 F-FDG) positron emission tomography (PET)/CT. Excisional biopsy revealed infiltration of plasma cells with anaplastic features, consistent with solitary plasmacytoma (PC). Serum analysis showed elevation of serum free lambda light chain levels (27.78 mg/l), with an abnormally high kappa:lambda ratio (2.33) and high total proteins (10.4 g/dl). Serum protein electrophoresis revealed an M spike in the gamma-globulin region (56.1 %=5.8 g/dl). Subsequently, 18 F-FDG PET/CT revealed another hypermetabolic mass in the right lobe of the liver. CT-guided biopsy of the liver lesion revealed plasma cell myeloma, consistent with multiple myeloma. Multiple myeloma presenting as nodular liver masses is very rare in clinical practice. In a retrospective review of more than 2,000 patients, Talamo et al. reported only nine cases where there was nodular involvement of the liver by multiple myeloma. The organ most commonly involved was the liver, followed by pancreas, stomach, peritoneum with malignant ascites, colon, rectum, duodenum and ileum. Therefore, the literature published thus far has been limited to a few reports and case series. Among these reports, some had demonstrated the PET or PET/CT findings of nodular liver involvement of multiple myeloma. About 10 % of the solitary myelomas appeared as extramedullary PC or solitary PC of bone. In spite of the advances in therapy, the treatment of multiple myeloma is still palliative. However, solitary PC could be cured by resection or radiation therapy. Thus, differentiation between PC and multiple myeloma is essential in making a decision for the appropriate therapeutic regimen. 18 F-FDG PET/CT has the unique ability to detect and characterize malignant lesions in one single examination. Schirrmeister et al. reported that 18 F-FDG PET revealed

  14. Detection of Extramedullary Multiple Myeloma in Liver by FDG-PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Daeweung; Kim, Woo Hyoung; Kim, Myoung Hyoun; Choi, Keum Ha; Kim, Chang Guhn [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of)

    2014-06-15

    We present the case of a 42-year-old man with a painful mass lesion in the right shoulder that was detected by contrast-enhanced computed tomography (CT) and {sup 18}F-fluoro-2-deoxyglucose ({sup 18}F-FDG) positron emission tomography (PET)/CT. Excisional biopsy revealed infiltration of plasma cells with anaplastic features, consistent with solitary plasmacytoma (PC). Serum analysis showed elevation of serum free lambda light chain levels (27.78 mg/l), with an abnormally high kappa:lambda ratio (2.33) and high total proteins (10.4 g/dl). Serum protein electrophoresis revealed an M spike in the gamma-globulin region (56.1 %=5.8 g/dl). Subsequently, {sup 18}F-FDG PET/CT revealed another hypermetabolic mass in the right lobe of the liver. CT-guided biopsy of the liver lesion revealed plasma cell myeloma, consistent with multiple myeloma. Multiple myeloma presenting as nodular liver masses is very rare in clinical practice. In a retrospective review of more than 2,000 patients, Talamo et al. reported only nine cases where there was nodular involvement of the liver by multiple myeloma. The organ most commonly involved was the liver, followed by pancreas, stomach, peritoneum with malignant ascites, colon, rectum, duodenum and ileum. Therefore, the literature published thus far has been limited to a few reports and case series. Among these reports, some had demonstrated the PET or PET/CT findings of nodular liver involvement of multiple myeloma. About 10 % of the solitary myelomas appeared as extramedullary PC or solitary PC of bone. In spite of the advances in therapy, the treatment of multiple myeloma is still palliative. However, solitary PC could be cured by resection or radiation therapy. Thus, differentiation between PC and multiple myeloma is essential in making a decision for the appropriate therapeutic regimen. {sup 18}F-FDG PET/CT has the unique ability to detect and characterize malignant lesions in one single examination. Schirrmeister et al. reported that

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-12-01

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

  16. A new assessment model for tumor heterogeneity analysis with [18]F-FDG PET images.

    Science.gov (United States)

    Wang, Ping; Xu, Wengui; Sun, Jian; Yang, Chengwen; Wang, Gang; Sa, Yu; Hu, Xin-Hua; Feng, Yuanming

    2016-01-01

    It has been shown that the intratumor heterogeneity can be characterized with quantitative analysis of the [18]F-FDG PET image data. The existing models employ multiple parameters for feature extraction which makes it difficult to implement in clinical settings for the quantitative characterization. This article reports an easy-to-use and differential SUV based model for quantitative assessment of the intratumor heterogeneity from 3D [18]F-FDG PET image data. An H index is defined to assess tumor heterogeneity by summing voxel-wise distribution of differential SUV from the [18]F-FDG PET image data. The summation is weighted by the distance of SUV difference among neighboring voxels from the center of the tumor and can thus yield increased values for tumors with peripheral sub-regions of high SUV that often serves as an indicator of augmented malignancy. Furthermore, the sign of H index is used to differentiate the rate of change for volume averaged SUV from its center to periphery. The new model with the H index has been compared with a widely-used model of gray level co-occurrence matrix (GLCM) for image texture characterization with phantoms of different configurations and the [18]F-FDG PET image data of 6 lung cancer patients to evaluate its effectiveness and feasibility for clinical uses. The comparison of the H index and GLCM parameters with the phantoms demonstrate that the H index can characterize the SUV heterogeneity in all of 6 2D phantoms while only 1 GLCM parameter can do for 1 and fail to differentiate for other 2D phantoms. For the 8 3D phantoms, the H index can clearly differentiate all of them while the 4 GLCM parameters provide complicated patterns in the characterization. Feasibility study with the PET image data from 6 lung cancer patients show that the H index provides an effective single-parameter metric to characterize tumor heterogeneity in terms of the local SUV variation, and it has higher correlation with tumor volume change after

  17. 18F-FDG-PET in the follow-up of thyroid cancer

    International Nuclear Information System (INIS)

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

    2003-01-01

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

    Ovarian cancer is a leading cause of gynecologic malignancy. As symptoms of ovarian cancer are nonspecific, only 20 % of ovarian cancers are diagnosed while they are still limited to the ovaries. Thus, early and accurate detection of disease is important for an improved prognosis. For the accurate and effective diagnosis of ovarian malignancy on 18 F-fluorodeoxyglucose ( 18 F--FDG) positron emission tomography/computed tomography (PET/CT), we analyzed several parameters, including visual assessment. A total of 51 peritoneal lesions in 19 patients who showed ovarian masses with diffuse peritoneal infiltration were enrolled. Twelve patients were confirmed to have ovarian malignancy and seven patients with benign disease by pathologic examination. All patients were examined by 18 F--FDG PET/CT, and an additional 2-h delayed 18 F--FDG PET/CT was also performed for 15 patients with 42 peritoneal lesions. We measured semiquantitative parameters including maximum and mean standardized uptake values (SUV max , SUV mean ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on a 1-h initial 18 F--FDG PET/CT image (Parameter1) and on a 2-h delayed image (Parameter2). Additionally, retention indices of each parameter were calculated, and each parameter among the malignant and benign lesions was compared by Mann-Whitney U test. We also assessed the visual characteristics of each peritoneal lesion, including metabolic extent, intensity, shape, heterogeneity, and total visual score. Associations between visual grades and malignancy were analyzed using linear by linear association methods. Moreover, a receiver operating characteristic (ROC) curve was analyzed to compare the effectiveness of significant parameters. In a comparison between the malignant and benign groups in the analysis of 51 total peritoneal lesions, SUV max1 , SUV mean1 , and TLG1 showed significant differences. Also, in the analysis of 42 peritoneal lesions that underwent an additional 2-h 18 F--FDG

  19. 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

  20. Experimental study of the molecular mechanisms of myocardial ischemic memory with 18F-FDG PET/CT imaging

    International Nuclear Information System (INIS)

    Xie Boqia; Yang Minfu; Ye Jue; Yang Zihe; Dou Kefei; Tian Yi; Han Chunlei

    2012-01-01

    This study was aimed to explore whether the changes of mRNA and the existence and duration of ischemic 18 F-FDG uptake correlate with the extent of myocardial ischemia in ischemia-reperfusion canine model. The 20-minute (n= 4) and 40-minute (n=4) coronary artery occlusion followed by 24 h of open-artery reperfusion in canine model were per- formed. All dogs underwent fasting (>12 h) dynamic 18 F-FDG PET/CT and 99 Tc m -MIBI SPECT imaging at baseline, 1 h and 24 h after reperfusion. When all imaging were completed, myocardial samples from the ischemic and nonischemic region were obtained, and the mRNA expression of glucose transporter-l (GLUT-1), glucose transporter-4 (GLUT-4), and heart-fatty acid binding protein (H-FABP) were estimated by Real Time PCR. There was no difference in the ratio of hypoperfused region/nomoperfused region of 18 F-FDG up- take between the 20-minute group and 40-minute group at baseline. When examined at 1 h, increased 18 F-FDG uptake was observed in the 40-minute group. When estimated at 24 h, only the 40-minute group showed slightly higher 18 F-FDG uptake than baseline, whereas no such difference was demonstrated in the 20-minute group. Similar mRNA expression of GLUT-1, GLUT-4 and H-FABP were demonstrated in the nonischemic regions between the 2 groups, whereas increased expressions of GLUT-1 and GLUT-4, and decreased H-FABP mRNA were demonstrated in the ischemic regions. The changes of mRNA expression were more obvious in the 40 minute group than in the 20-minute group. The results showed that the existence and persistent period of ischemic 18 F-FDG uptake (ischemic memory) was correlated with the extent of myocardial ischemia. (authors)

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

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

    International Nuclear Information System (INIS)

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

    2018-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2018-01-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-10-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-09-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-11-15

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

  7. {sup 18}F-FDG PET/CT evaluation of children and young adults with suspected spinal fusion hardware infection

    Energy Technology Data Exchange (ETDEWEB)

    Bagrosky, Brian M. [University of Colorado School of Medicine, Department of Pediatric Radiology, Children' s Hospital Colorado, 12123 E. 16th Ave., Box 125, Aurora, CO (United States); University of Colorado School of Medicine, Department of Radiology, Division of Nuclear Medicine, Aurora, CO (United States); Hayes, Kari L.; Fenton, Laura Z. [University of Colorado School of Medicine, Department of Pediatric Radiology, Children' s Hospital Colorado, 12123 E. 16th Ave., Box 125, Aurora, CO (United States); Koo, Phillip J. [University of Colorado School of Medicine, Department of Radiology, Division of Nuclear Medicine, Aurora, CO (United States)

    2013-08-15

    Evaluation of the child with spinal fusion hardware and concern for infection is challenging because of hardware artifact with standard imaging (CT and MRI) and difficult physical examination. Studies using {sup 18}F-FDG PET/CT combine the benefit of functional imaging with anatomical localization. To discuss a case series of children and young adults with spinal fusion hardware and clinical concern for hardware infection. These people underwent FDG PET/CT imaging to determine the site of infection. We performed a retrospective review of whole-body FDG PET/CT scans at a tertiary children's hospital from December 2009 to January 2012 in children and young adults with spinal hardware and suspected hardware infection. The PET/CT scan findings were correlated with pertinent clinical information including laboratory values of inflammatory markers, postoperative notes and pathology results to evaluate the diagnostic accuracy of FDG PET/CT. An exempt status for this retrospective review was approved by the Institution Review Board. Twenty-five FDG PET/CT scans were performed in 20 patients. Spinal fusion hardware infection was confirmed surgically and pathologically in six patients. The most common FDG PET/CT finding in patients with hardware infection was increased FDG uptake in the soft tissue and bone immediately adjacent to the posterior spinal fusion rods at multiple contiguous vertebral levels. Noninfectious hardware complications were diagnosed in ten patients and proved surgically in four. Alternative sources of infection were diagnosed by FDG PET/CT in seven patients (five with pneumonia, one with pyonephrosis and one with superficial wound infections). FDG PET/CT is helpful in evaluation of children and young adults with concern for spinal hardware infection. Noninfectious hardware complications and alternative sources of infection, including pneumonia and pyonephrosis, can be diagnosed. FDG PET/CT should be the first-line cross-sectional imaging study in

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-10-15

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

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

    Institute of Scientific and Technical Information of China (English)

    Suwen Liu; Jinming Yu; Ligang Xing

    2005-01-01

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

  10. Detection of distant metastasis and prognostic prediction of recurrent salivary gland carcinomas using 18 F-FDG PET/CT.

    Science.gov (United States)

    Lee, S H; Roh, J-L; Kim, J S; Lee, J H; Choi, S-H; Nam, S Y; Kim, S Y

    2018-04-24

    To compare the diagnostic accuracy of 18 F-FDG PET/CT and conventional contrast-enhanced CT for the re-staging of recurrent salivary gland carcinoma (SGC). This study included 58 consecutive patients who underwent recurrent SGCs after definitive treatment. The recurrences were evaluated by 18 F-FDG PET/CT and contrast-enhanced CT of the neck and chest. McNemar's test was used to compare the diagnostic accuracy of 18 F-FDG PET/CT with standard neck and chest CT imaging, and a Cox proportional hazards model was used to assess the prognostic value of PET/CT. Of 58 patients with recurrent SGCs, 17 (29%) had a local recurrence, 17 (29%) had a regional recurrence, and 38 (66%) had a distant metastasis, with these classifications showing overlap. The sensitivity and accuracy of 18 F-FDG PET/CT for the detection of distant metastases were significantly higher than those of CT (P 0.1). The 18 F-FDG PET/CT-positive findings at distant sites were predictors of poor progression-free and overall survival outcome (all P PET/CT is a more effective method than CT for detecting distant site recurrences of SGC. This may lead to prognostic prediction for recurrent SGCs. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Diagnostic utility of FDG-PET in the differential diagnosis between different forms of primary progressive aphasia.

    Science.gov (United States)

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

    2018-05-09

    A joint effort of the European Association of Nuclear Medicine (EANM) and the European Academy of Neurology (EAN) aims at clinical guidance for the use of FDG-PET in neurodegenerative diseases. This paper addresses the diagnostic utility of FDG-PET over clinical/neuropsychological assessment in the differentiation of the three forms of primary progressive aphasia (PPA). Seven panelists were appointed by the EANM and EAN and a literature search was performed by using harmonized PICO (Population, Intervention, Comparison, Outcome) question keywords. The studies were screened for eligibility, and data extracted to assess their methodological quality. Critical outcomes were accuracy indices in differentiating different PPA clinical forms. Subsequently Delphi rounds were held with the extracted data and quality assessment to reach a consensus based on both literature and expert opinion. Critical outcomes for this PICO were available in four of the examined papers. The level of formal evidence supporting clinical utility of FDG-PET in differentiating among PPA variants was considered as poor. However, the consensual recommendation was defined on Delphi round I, with six out of seven panelists supporting clinical use. Quantitative evidence demonstrating utility or lack thereof is still missing. Panelists decided consistently to provide interim support for clinical use based on the fact that a typical atrophy or metabolic pattern is needed for PPA according to the diagnostic criteria, and the synaptic failure detected by FDG-PET is an earlier phenomenon than atrophy. Also, a normal FDG-PET points to a non-neurodegenerative cause.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-09-15

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

  13. 18F-FDG PET/CT in tuberculosis: an early non-invasive marker of therapeutic response

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ryuichi Nishii

    2018-01-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  16. Characterization of tumor heterogeneity using dynamic contrast enhanced CT and FDG-PET in non-small cell lung cancer

    International Nuclear Information System (INIS)

    Elmpt, Wouter van; Das, Marco; Hüllner, Martin; Sharifi, Hoda; Zegers, Catharina M.L.; Reymen, Bart; Lambin, Philippe; Wildberger, Joachim E.; Troost, Esther G.C.; Veit-Haibach, Patrick; De Ruysscher, Dirk

    2013-01-01

    Purpose: Dynamic contrast-enhanced CT (DCE-CT) quantifies vasculature properties of tumors, whereas static FDG-PET/CT defines metabolic activity. Both imaging modalities are capable of showing intra-tumor heterogeneity. We investigated differences in vasculature properties within primary non-small cell lung cancer (NSCLC) tumors measured by DCE-CT and metabolic activity from FDG-PET/CT. Methods: Thirty three NSCLC patients were analyzed prior to treatment. FDG-PET/CT and DCE-CT were co-registered. The tumor was delineated and metabolic activity was segmented on the FDG-PET/CT in two regions: low (<50% maximum SUV) and high (⩾50% maximum SUV) metabolic uptake. Blood flow, blood volume and permeability were calculated using a maximum slope, deconvolution algorithm and a Patlak model. Correlations were assessed between perfusion parameters for the regions of interest. Results: DCE-CT provided additional information on vasculature and tumor heterogeneity that was not correlated to metabolic tumor activity. There was no significant difference between low and high metabolic active regions for any of the DCE-CT parameters. Furthermore, only moderate correlations between maximum SUV and DCE-CT parameters were observed. Conclusions: No direct correlation was observed between FDG-uptake and parameters extracted from DCE-CT. DCE-CT may provide complementary information to the characterization of primary NSCLC tumors over FDG-PET/CT imaging

  17. Comparison of 99mTc-HYNIC-TOC and HYNIC-TATE octreotide scintigraphy with FDG PET and 99mTc-MIBI in local recurrent or distant metastatic thyroid cancers.

    Science.gov (United States)

    Sager, Sait; Kabasakal, Levent; Halac, Metin; Maecke, Helmut; Uslu, Lebriz; Önsel, Çetin; Kanmaz, Bedii

    2013-05-01

    There have been various studies for early diagnosis of local recurrent or distant metastatic thyroid cancers. The aim of this study is to evaluate the clinical utility of 99mTc-HYNIC-TOC and 99mTc-HYNIC-TATE, octreotide derivatives, to detect recurrences or distant metastases in 131I-negative thyroglobulin positive thyroid cancer patients and to compare the lesions with FDG PET and 99mTc-MIBI studies in the same patient group. Twenty differentiated thyroid cancer patients, 7 male and 13 female, mean age 54.6 ± 15.3 (range 13-78 years), were included in this study. Eighteen patients had papillary thyroid cancer and 2 had follicular thyroid cancer. Fifteen patients received HYNIC-TOC and 5 patients received HYNIC-TATE as a radiopharmaceutical. All patients underwent whole-body scan 1 and 4 hours after injection of octreotide derivatives and SPECT imagings were performed from the suspicious sites. The lesions that were seen in 99mTc-HYNIC-TOC and 99mTc-HYNIC-TATE studies were compared with 99mTc-MIBI and FDG-PET studies. Among 99mTc-HYNIC-TOC and 99mTc-HYNIC-TATE scintigraphies, 15 patient studies were evaluated as true positive (75%) and 5 were false negative (25%). The total number of lesions in octreotide scintigraphy was 48 in 20 patients. Of 20 patients, 19 had FDG-PET study, 15 of them were evaluated as true positive (78.9%), and 4 them were evaluated as false negative (21.1%). Total number of lesions in FDG PET was 74. 99mTc-MIBI study was positive in 11 patients (55%) and negative in 9 patients (45%). Total number of lesions in 99mTc-MIBI was 25. Technetium-labeled somatostatin receptor scintigraphy analogues HYNIC-TOC and HYNIC-TATE are useful imaging alternatives in somatostatin receptor expressing thyroid cancer patients. Radiolabeling is easy and they are readily available for routine use.

  18. 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.)

  19. Metabolic connectivity analysis in Alzheimer’s disease (AD) by interregional correlation combining [11C] PIB and [18F] FDG PET

    NARCIS (Netherlands)

    2015-01-01

    Objectives: to determine whether [18F] FDG PET brain pattern correlates with [11C] PIB uptake in AD specific brain region using a SPM (Statistical Parametric Mapping) based network analysis. Methods: Combined [11C] PIB and [18F] FDG PET patterns data of 15 patients: 3 controls (CP), 8 probable

  20. Role of FDG-PET scans in staging, response assessment, and follow-up care for non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cuaron, John [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Dunphy, Mark [Department of Nuclear Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Rimner, Andreas, E-mail: rimnera@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2013-01-03

    The integral role of positron-emission tomography (PET) using the glucose analog tracer fluorine-18 fluorodeoxyglucose (FDG) in the staging of non-small cell lung cancer (NSCLC) is well established. Evidence is emerging for the role of PET in response assessment to neoadjuvant therapy, combined-modality therapy, and early detection of recurrence. Here, we review the current literature on these aspects of PET in the management of NSCLC. FDG-PET, particularly integrated {sup 18}F-FDG-PET/CT, scans have become a standard test in the staging of local tumor extent, mediastinal lymph node involvement, and distant metastatic disease in NSCLC. {sup 18}F-FDG-PET sensitivity is generally superior to computed tomography (CT) scans alone. Local tumor extent and T stage can be more accurately determined with FDG-PET in certain cases, especially in areas of post-obstructive atelectasis or low CT density variation. FDG-PET sensitivity is decreased in tumors <1 cm, at least in part due to respiratory motion. False-negative results can occur in areas of low tumor burden, e.g., small lymph nodes or ground-glass opacities. {sup 18}F-FDG-PET-CT nodal staging is more accurate than CT alone, as hilar and mediastinal involvement is often detected first on {sup 18}F-FDG-PET scan when CT criteria for malignant involvement are not met. {sup 18}F-FDG-PET scans have widely replaced bone scintography for assessing distant metastases, except for the brain, which still warrants dedicated brain imaging. {sup 18}F-FDG uptake has also been shown to vary between histologies, with adenocarcinomas generally being less FDG avid than squamous cell carcinomas. {sup 18}F-FDG-PET scans are useful to detect recurrences, but are currently not recommended for routine follow-up. Typically, patients are followed with chest CT scans every 3–6 months, using {sup 18}F-FDG-PET to evaluate equivocal CT findings. As high {sup 18}F-FDG uptake can occur in infectious, inflammatory, and other non-neoplastic conditions

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

    Directory of Open Access Journals (Sweden)

    Sait Sağer

    2012-04-01

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

  2. Status gelasticus after temporal lobectomy: ictal FDG-PET findings and the question of dual pathology involving hypothalamic hamartomas.

    Science.gov (United States)

    Palmini, Andre; Van Paesschen, Wim; Dupont, Patrick; Van Laere, Koen; Van Driel, Guido

    2005-08-01

    To present the first ictal fluorodeoxyglucose-positron emission tomography (FDG-PET) evidence of the hypothalamic origin of gelastic seizures in a patient with a hypothalamic hamartoma (HH) and to raise the issue of true dual pathology related to this entity. Ictal FDG-PET was acquired during an episode of status gelasticus with preserved consciousness, in a patient previously operated on for complex partial seizures (CPSs) due to a temporal lobe epileptogenic cyst. Ictal hypermetabolism was localized to the region of the HH during the status gelasticus. CPSs had been completely eliminated after temporal lobe surgery. Ictal FDG-PET independently confirmed that gelastic seizures in patients with HH do originate in the diencephalic lesion. An HH may coexist with another epileptogenic lesion, in a context of dual pathology.

  3. Ictal 18F-FDG PET/MRI in a Patient With Cortical Heterotopia and Focal Epilepsy.

    Science.gov (United States)

    Calabria, Ferdinando F; Cascini, Giuseppe Lucio; Gambardella, Antonio; Labate, Angelo; Cherubini, Andrea; Gullà, Domenico; Tafuri, Benedetta; Sabatini, Umberto; Vescio, Virginia; Quattrone, Aldo

    2017-10-01

    A 19-year-old man with epilepsy underwent ictal F-FDG PET/MRI, showing a 5 mm heterotopic nodule in the periventricular white matter, adjacent to the frontal horn of the left lateral ventricle (SUVmax, 5.5; glucidic cerebral metabolic rate, 0.317 μmol/mL). A repeated F-FDG PET/MRI, during seizure freedom, showed, at visual analysis, subtle decrease of the nodule metabolism. SUVmax and glucidic cerebral metabolic rate were clearly reduced to 3.7 and 0.226, respectively. Ictal F-FDG PET/MRI could be useful in epilepsy because of the added value of SUVmax and cerebral metabolic rate of glucose analysis to understand the relationship between heterotopy and epilepsy.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-03-15

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

  5. F-18 FDG PET/CT findings of a case of sacral nerve root neurolymphomatosis that occurred during chemotherapy.

    Science.gov (United States)

    Suga, Kazuyoshi; Yasuhiko, Kawakami; Matsunaga, Naofumi; Yujiri, Toshiaki; Nakazora, Tatsuki; Ariyoshi, Kouichi

    2011-01-01

    Neurolymphomatosis (NL) is a rare, unique subtype of lymphomatous infiltration of peripheral nerves. Clinical/radiologic diagnosis of NL is challenging. We report F-18 FDG PET/CT findings of a case of breast diffuse large B-cell lymphoma, in which NL developed regardless of regression of systemic lesions during induction chemotherapy. FDG PET/CT showed characteristic findings of well-demarcated, linear abnormal FDG uptake along a sacral vertebral foramen, leading to diagnosis of NL, with the finding of thickened nerve roots on magnetic resonance imaging. Altered chemotherapeutic regimen resulted in disappearance of these abnormal FDG uptake, with recovery of neurologic symptoms. Peripheral nerve NL may occur during chemotherapy, and FDG PET/CT can be a useful imaging modality in diagnosis and monitoring of therapeutic response of this disease.

  6. 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

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

    Science.gov (United States)

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

    2013-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-03-15

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

  9. 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.

  10. 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.)

  11. Impact of 18F-FDG PET scan on the prevalence of benign thoracic lesions at surgical resection

    Directory of Open Access Journals (Sweden)

    Kamlesh Mohan

    2011-10-01

    Full Text Available OBJECTIVE: The main utility of 18-fluorodeoxyglucose positron emission tomography (FDG-PET lies in the staging of lung cancer. However, it can also be used to differentiate indeterminate pulmonary lesions, but its impact on the resection of benign lesions at surgery is unknown. The aim of this study was to compare the prevalence of benign lesions at thoracotomy carried out for suspected lung cancer, before and after the introduction of PET scanning in a large thoracic surgical centre. MATERIALS AND METHODS: We reviewed our prospectively recorded surgical database for all consecutive patients undergoing thoracotomy for suspected or proven lung cancer and compared the prevalence of benign lesions in 2 consecutive 2-year groups, before (group I and after (group II the introduction of FDG-PET scan respectively. RESULTS: Surgical resection was performed on 1233 patients during the study period. The prevalence of benign lesions at surgery in groups I and II was similar (44/626 and 41/607, both 7%, and also in group II between those who underwent FDG-PET scan and the remainder (21/301 and 20/306 respectively, both 7%. In group II, of the 21 patients with benign lesions, who underwent FDG-PET, 19 had a false positive scan (mean standardised uptake value 5.3 [range 2.6-12.7]. Of these, 13 and 4 patients respectively had non-diagnostic bronchoscopy and percutaneous transthoracic lung biopsy pre thoracotomy. There was no difference in the proportion of different benign lesions resected between group I and those with FDG-PET in group II. CONCLUSION: The introduction of FDG-PET scanning has not altered the proportion of patients undergoing thoracotomy for ultimately benign lesions, mainly due to the avidity for the isotope of some non-malignant lesions. Such false positive results need to be considered when patients with unconfirmed lung cancer are contemplated for surgical resection.

  12. Impact of {sup 18}F-FDG PET scan on the prevalence of benign thoracic lesions at surgical resection

    Energy Technology Data Exchange (ETDEWEB)

    Mohan, Kamlesh; Ledson, Martin J.; Walshaw, Martin J., E-mail: mwalshaw@doctors.org.u [Liverpool Heart and Chest Hospital (United Kingdom). Dept. of Respiratory Medicine; McShane, James [Liverpool Heart and Chest Hospital (United Kingdom). Dept. of Audit and Research; Page, Richard [Liverpool Heart and Chest Hospital (United Kingdom). Dept. of Thoracic Surgery; Irion, Klaus [Liverpool Heart and Chest Hospital (United Kingdom). Dept. of Radiology

    2011-09-15

    Objective: the main utility of 18-fluorodeoxyglucose positron emission tomography (FDG-PET) lies in the staging of lung cancer. However, it can also be used to differentiate indeterminate pulmonary lesions, but its impact on the resection of benign lesions at surgery is unknown. The aim of this study was to compare the prevalence of benign lesions at thoracotomy carried out for suspected lung cancer, before and after the introduction of PET scanning in a large thoracic surgical centre. Materials and methods: we reviewed our prospectively recorded surgical database for all consecutive patients undergoing thoracotomy for suspected or proven lung cancer and compared the prevalence of benign lesions in 2 consecutive 2-year groups, before (group I) and after (group II) the introduction of FDG-PET scan respectively. Results: Surgical resection was performed on 1233 patients during the study period. The prevalence of benign lesions at surgery in groups I and II was similar (44/626 and 41/607, both 7%), and also in group II between those who underwent FDG-PET scan and the remainder (21/301 and 20/306 respectively, both 7%). In group II, of the 21 patients with benign lesions, who underwent FDG-PET, 19 had a false positive scan (mean standardised uptake value 5.3 [range 2.6-12.7]). Of these, 13 and 4 patients respectively had non-diagnostic bronchoscopy and percutaneous transthoracic lung biopsy pre thoracotomy. There was no difference in the proportion of different benign lesions resected between group I and those with FDG-PET in group II. Conclusion: the introduction of FDG-PET scanning has not altered the proportion of patients undergoing thoracotomy for ultimately benign lesions, mainly due to the avidity for the isotope of some non-malignant lesions. Such false positive results need to be considered when patients with unconfirmed lung cancer are contemplated for surgical resection. (author)

  13. Impact of 18F-FDG PET scan on the prevalence of benign thoracic lesions at surgical resection

    International Nuclear Information System (INIS)

    Mohan, Kamlesh; Ledson, Martin J.; Walshaw, Martin J.; McShane, James; Page, Richard; Irion, Klaus

    2011-01-01

    Objective: the main utility of 18-fluorodeoxyglucose positron emission tomography (FDG-PET) lies in the staging of lung cancer. However, it can also be used to differentiate indeterminate pulmonary lesions, but its impact on the resection of benign lesions at surgery is unknown. The aim of this study was to compare the prevalence of benign lesions at thoracotomy carried out for suspected lung cancer, before and after the introduction of PET scanning in a large thoracic surgical centre. Materials and methods: we reviewed our prospectively recorded surgical database for all consecutive patients undergoing thoracotomy for suspected or proven lung cancer and compared the prevalence of benign lesions in 2 consecutive 2-year groups, before (group I) and after (group II) the introduction of FDG-PET scan respectively. Results: Surgical resection was performed on 1233 patients during the study period. The prevalence of benign lesions at surgery in groups I and II was similar (44/626 and 41/607, both 7%), and also in group II between those who underwent FDG-PET scan and the remainder (21/301 and 20/306 respectively, both 7%). In group II, of the 21 patients with benign lesions, who underwent FDG-PET, 19 had a false positive scan (mean standardised uptake value 5.3 [range 2.6-12.7]). Of these, 13 and 4 patients respectively had non-diagnostic bronchoscopy and percutaneous transthoracic lung biopsy pre thoracotomy. There was no difference in the proportion of different benign lesions resected between group I and those with FDG-PET in group II. Conclusion: the introduction of FDG-PET scanning has not altered the proportion of patients undergoing thoracotomy for ultimately benign lesions, mainly due to the avidity for the isotope of some non-malignant lesions. Such false positive results need to be considered when patients with unconfirmed lung cancer are contemplated for surgical resection. (author)

  14. 18F-FDG-PET/CT in staging, restaging, and treatment response assessment of male breast cancer

    International Nuclear Information System (INIS)

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

    2014-01-01

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